Professor Paula O'Leary, Department of Medicine
Paula O'Leary, Professor in Medicine & Consultant Physician & Immunologist
College: Medicine & Health
Research Interests: Clinical Immunology, Medical Education
IRIS profile: http://apc.ucc.ie/paula_oleary/
What first attracted you to your academic discipline?
In the early stages of my career in Medicine, the scientific understanding and technologies required to study the immune system and its relevance in a broad range of common clinical conditions was becoming increasingly evident. I saw rapid advances in the understanding of inflammatory disorders such as arthritis, inflammatory bowel diseases and multiple sclerosis and in the immunomodulating treatments used to manage them. I also became aware of more accurate recognition of immunodeficiency disorders and the emergence of HIV infection as a worldwide healthcare challenge, as well as the growing place for organ transplantation in restoring organ function in critical, life-limiting diseases and dramatic increases in the frequency of asthma and other allergic diseases. This provided a wide-ranging and fruitful ground in which to develop as a medical doctor.
The whole area of Clinical Immunology appealed to my interest in studying disease mechanisms at a laboratory level while still directly caring for patients. I knew no Clinical Immunologists when my career focus began to develop in this direction, but I was supported by good mentorship to make the correct initial connections to allow me to explore, and ultimately find my way into formal training in the evolving specialty of Clinical and Laboratory Immunology in the UK. I remain excited by the specialty and by the array of ongoing scientific discovery and most of all fascinated by my clinical work with people with disorders of the immune system. Many of these conditions are life-long, treatable but not curable, and pose daily challenges for sufferers. Bringing an understanding of the factors involved in the causation and persistence of these disorders, providing interventions to improve patient wellbeing and studying new ways to diagnose, treat and prevent some of the diseases in this area is at the heart of my attraction to my chosen specialty.
How were you drawn to your current research interests?
My entire training in Immunology was undertaken in major teaching hospitals in Ireland and the UK. In addition, research training in the University of Birmingham medical school brought me to one of the longest established and flourishing centres for Immune research as well as one of the best medical schools in the UK. My own experiences first-hand of excellent clinical and medical science teaching at UCC, as well as an expectation and encouragement of participation in clinical teaching from the outset of my own practice left a lasting impression on me. The importance of participating in the education of doctors and ensuring that it is of high quality in terms of its organisation, content, relevance and delivery was always to the fore. One of the core elements of my appointment and progression in UCC has been to participate and oversee clinical education in the broad area of Internal Medicine. Ensuring that the UCC medical school maintains and further develops its international reputation and continues to promote the highest standards of clinical practice among its graduates through its educational programmes is a challenging and satisfying focus of my academic discipline.
What professional achievements do you consider particularly rewarding?
A number of milestones punctuate professional progression in academic Clinical Medicine. In no particular order, the most satisfying achievements are: [i] convincing the clinical Immunology community in the UK that although unknown and untried in their system, I deserved a chance in one of the prime training posts over some better known candidates, and proving that they made a reasonable choice given my performance in the clinical setting; [ii] completing specialty examinations promptly and seamlessly; [iii] the successful completion of doctoral studies. I successfully competed for funding in the early stages of my first pregnancy when I felt less than my usual self, and undertook and completed my research studies and doctoral thesis at the same time as becoming a mother to 2 children in as many years, living in a foreign country and with little hands-on support other than that of my husband who was also developing his career along a similar trajectory. While some of it feels like a dream now (I probably dozed through at least some of it given the propensity of my oldest child to turn night into day!), undertaking doctoral research made me appreciate the value of academic research training and the effort that underlies it; [iv] co-writing a text book in Clinical Immunology and seeing it published with my name on the cover, [v] the ultimate achievement for a practicing doctor is to rest assured that one’s actions, interaction with and treatment of patients has brought cure or ease, comfort and support in the challenge of illness and that every patient interaction is undertaken to the highest standard.
Have you had professional role models? What impact did they have on you?
Over the course of my career, I have observed closely many role models whom I have admired and from whom I have learned a great deal in my career. The intricacies of the clinical method, the basis of good clinical practice, was clearly evident from my undergraduate years under the direction of the late Professor Denis O’Sullivan (Medicine, UCC), and later and more directly with Dr Dermot Murnaghan, a “physician’s physician” under whose supervision I spent much of my early formative career in general medical training. The visibility of a small but highly able, contributing and approachable community of female consultants in Cork (the recently deceased Dr Paule Cotter, UCC statutory lecturer and Consultant Haematologist, and Prof Katy Keohane, Consultant Neuropathologist) and in the United Kingdom (Prof Helen Chapel, Consultant Immunologist in Oxford) showed by example that women could and did practice medicine at the highest level and perform important research effectively, while showing care and compassion to patients and to students in their own inimitable ways. Prof Fidelma Dunne, now a Professor in Medicine in NUIG, had trodden a very similar path to mine before I embarked on my own career trajectory. My observations of her modus operandi gave me a close up lesson in the practicalities of working in academic medicine and managing parenthood while remaining functional and sane at the same time. I never had a formal tutorial from any as to how to function and succeed as a woman in Medicine, but the observership method was useful and inspiring. I continue to learn from those around me; it is never too late and one is never so far on in one’s career that some new observation or insight cannot be useful or occasionally transformative. Remain vigilant for such moments.
What aspects of your work do you find most rewarding?
The distinct and privileged nature of the doctor-patient relationship is at the core of what I find most rewarding about my career. Using emerging research and knowledge in my discipline to provide new ways to diagnose and treat patients is exciting. Seeing medical students develop into able professional practitioners, medical researchers and healthcare leaders following different specialty paths is very rewarding. This reinforces my belief in the value of excellence in medical education and most of all makes me proud to have played a small part in shaping the clinical doctors for the next generation.
Academic careers present specific challenges in achieving balance, whether between research, teaching and administration, or in work/life balance. What advice might you give a student/younger colleague/your 18-year old self?
Medical training and practice, and the added element of academic participation makes for a satisfying and rewarding career. However, it is a long and challenging road in terms of the investment of time and self, demanding much of the individual and also family and loved ones. Some important life and career lessons for me are synopsised here. Successful outcomes, particularly in patient care but also in other aspects of workload, usually match the effort, expertise and effectiveness of the approach, but that is not always the case. Always try your best, do not be despondent when the outcome is less than optimal. Learn from all experiences, and particularly those with less favourable outcomes. Do not be afraid to analyse situations, even when the answers are difficult for you to accept. Seek and heed the views and insights of your senior colleagues and those you trust. Do not leave disappointment mar progress. Move on, better informed for the future once the initial disappointment passes and most of all learn from failures. It is important not only for yourself, but also for your patient in the context of clinical care, for your students and colleagues and for your institution. While engagement with all aspects of a varied career is essential in academic medicine, do not be afraid to be clear about what you like doing best and the way in which you can best contribute to the larger academic enterprise. Be true to yourself, your talents and your unique contributions, exercise them to your best ability, keep them valid to the needs and aspirations of students and the institution you serve and do not underestimate the importance of your effort. Work, for academics, is more than just a job and is among the most important aspects of your life. It defines an important part of yourself. You owe it to yourself to ensure there is room for more beyond it though, and especially for family. On a practical level, never leave a phone call from a child unanswered, little is more important than them knowing you are there and available, no matter what is going on in other parts of your life. You can and should always make space for them. Finally, your friendships and interests within and beyond your profession are important for your happiness and wellbeing. While lifestyle may limit the time you have, stay connected and make efforts to meet and participate whenever possible. Career success can be a lonely place without family, friends and other interests in your life.