Caroline Alexander at a CATO event

Congratulations to CATO team member, and chair of the Clinical Academic Research Committee, Caroline Alexander, on being awarded a Professor of Practice (Musculoskeletal Physiotherapy).

We spoke to Caroline about her fantastic news and her journey as a clinical academic thus far.

Caroline, firstly congratulations on being awarded a Professor of Practice (Musculoskeletal Physiotherapy)! Where did this journey all begin for you?

Caroline AlexanderIt all started when I was a child - during the school holidays I remember going into work with my Mum, who was a physiotherapist. I would chat to patients and watch my mum and her colleagues work with them - can you imagine being allowed to bring in your children now! I thought it looked like fun and so I can’t remember a time I didn’t want to be a physiotherapist. Then when I became one and specialised in outpatient physiotherapy, I wanted to be more effective than I was but I wasn’t always convinced by the advice and messages that the local clinicians and the gurus of the time were giving. I thought that the MSc in Advanced Musculoskeletal Physiotherapy at UCL would give me all the answers, but instead it taught me that it was OK not to know the answers - and it opened a world of science and clinical practice that I didn’t know was there. It changed everything for me; I stayed on as a lecturer of that MSc part-time as well as getting back to clinical practice, I got introduced to different researchers and four years later after a few rejected grants, I found my way to a PhD in neurophysiology related to patients with shoulder problems.

So you wanted to be a physiotherapist from an early age, but was becoming a Professor always part of your career plan?

Definitely not! In the beginning of my career a clinical academic path didn’t exist for us; we’ve had to carve our own path up until relatively recently. My career plan was to give patients the best treatment I could. However, when you are trying to improve as a clinician it means you ask questions, and when you position yourself in the right place, you find yourself talking to fantastic people who want to support you. I now see I took a classic path of mentorship, supervision and research development, but I wouldn’t have recognised it as that at the time. My unofficial mentor introduced me to people who were willing to support me to answer my questions. I became well networked within the physiotherapy world and that enabled me to influence the type of job I got after my PhD. I found a supportive structure at Imperial College Healthcare NHS Trust, where I was valued for my clinical and research skills, and I was able to slowly progress both clinically and in my research before being awarded a National Institute for Health Research Senior Clinical Lectureship in 2012. That finished in 2017 and since then I’ve led the Clinical Academics within the Therapy department at the Trust.

As well as leading the clinical academics at the Trust, you were already a fantastic advocate for NMAHPP (Nurses, Midwives, Allied Health Professionals, Healthcare Scientists, Pharmacy Staff and Psychologists) research across the AHSC - how will this new role enhance that?

Establishing myself further in the College enables me to further link our clinicians to Imperial College London's world-leading researchers, situating us in groups that are already successful and know how to support and train clinicians to become great independent researchers. It helps me to influence the clinical academic agenda for NMAHPPs and is recognition by the college that we are valued members of the team.

Why do you think it is so important that NMAHPPs get involved with and lead on clinical research? How do you think you have been able to make a positive difference to the research projects you have been involved with?

The questions we ask are commonly specific to our professions and the needs of our patients from a NMAHPP perspective. We bring our clinical acumen to these questions. No one else will ask those questions and so it is up to us to progress our professions’ ability to impact care of patients. My questions relate to the physiotherapeutic care of musculoskeletal patients so I bring my understanding of specific conditions and the state of the evidence for physiotherapeutic practice to my research. It is my skills as a clinician that influence the questions I ask, my ability to involve patients and my ability to supervise and teach in research. It is my skills as a researcher that informs my clinical practice and pushes me to be a better clinician and facilitator of other physios’ practice.

You’ve been a part of Imperial for 18 years now, is there a particular moment or memory that stands out for you?

Getting the job with a mix of research and clinical practice in the first place. I’d never heard the term clinical academic at the time, so I didn’t know that was what I’d become. Running some of our clinics with patients who have long term musculoskeletal conditions and within that clinic setting, supporting clinicians who developed their skills; the success of my first PhD student when he came out of his viva; working with colleagues in Imperial College in the lab answering questions and working through problems to find a way, being around NMAHPPs who you’ve supported when they win that fellowship. Specific patients also stick in my mind; the resilience and focus of a hypermobile woman who had been through umpteen potentially life saving surgeries; certain patients who I didn’t help; clinicians who I supported and the rehab assistant who became a physiotherapist. There are too many memories to name one!

Throughout those 18 years you must have given and received plenty of career advice. But what’s the best advice you could give/ you’ve been given?

The best advice I've been given: Rejection is part of the game, get used to it! Enhance your resilience!

The best advice I could give: Don’t be shy of asking questions; what can you do now that will help tomorrow?

And the quote I put at the start of my thesis: The world is a narrow bridge; the important thing is not to be afraid.

Finally, now you have achieved your Professor of Practice, what’s next? What are your hopes for the future?

I would like to continue supporting clinicians into research careers and impacting the care of patients.