1 00:00:01,110 --> 00:00:09,660 This is David Patterson, Professor David Patterson being interviewed by Derek Hockaday 8th of January 2009. 2 00:00:09,660 --> 00:00:14,310 David, what really made you come from Western Australia to Oxford? 3 00:00:14,310 --> 00:00:28,140 Well, I was fortunate to get a scholarship from Australia not being Australian, but they were kind enough to give me a scholarship to do fill. 4 00:00:28,140 --> 00:00:31,690 And I came to new college to. You must have applied for the scholarship. 5 00:00:31,690 --> 00:00:40,260 I mean, you wanted to come to England. Well, that's right. I actually visited Oxford a year or so before in the early 80s and met Dan 6 00:00:40,260 --> 00:00:44,940 Cunningham and Evie Peterson because I was in Sydney and the control of breathing. 7 00:00:44,940 --> 00:00:49,680 And at that stage, Oxford was the Mecca home for the control of breathing. 8 00:00:49,680 --> 00:00:59,160 And I came to Oxford and fell in love with the place and was tossing up about going to UCLA or coming to Oxford. 9 00:00:59,160 --> 00:01:03,420 So I applied for a scholarship and was fortunate to get it. 10 00:01:03,420 --> 00:01:08,160 And the scholarship could take me anywhere I wanted to go in the world. 11 00:01:08,160 --> 00:01:14,430 And I was minded to go to America. But the Americans never wrote back, whereas Oxford did. 12 00:01:14,430 --> 00:01:19,020 And the rest is history. So I understood. So you came to work with Dan Cunningham? 13 00:01:19,020 --> 00:01:25,290 Yeah, I came to work and Dan had, in fact, had just retired and so I didn't see much of him. 14 00:01:25,290 --> 00:01:33,870 And then I worked with Abbey Peterson at New College and he sadly died of cancer during my time. 15 00:01:33,870 --> 00:01:39,450 And then I was shunted to Bob Torrance because I was in chemo reception. 16 00:01:39,450 --> 00:01:45,900 So I kind of flipped between room three Bob Torrance repairs. 17 00:01:45,900 --> 00:01:53,730 And I was and at that stage, Peter Robbins has been appointed and had taken Dan's post. 18 00:01:53,730 --> 00:02:03,270 So I kind of worked across the human and the cat lounge. When did you switch from breathing to the heart of, let's say, 19 00:02:03,270 --> 00:02:12,960 breathing to the heart is interesting because I was working on the regulation of potassium and potassium effects, 20 00:02:12,960 --> 00:02:18,540 physiological systems, and we had seen in humans during exercise. 21 00:02:18,540 --> 00:02:24,450 And this was worked on with James Conway and Cardiology with Peter Slide. 22 00:02:24,450 --> 00:02:31,050 They put catheters in our subjects and these subjects got very hyperkalemia during exercise. 23 00:02:31,050 --> 00:02:34,620 And of course, all the physicians at the Radcliffe said, well, 24 00:02:34,620 --> 00:02:44,550 this is impossible because clearly you've got Hamel's blood and and no one has a potassium of eight millimoles. 25 00:02:44,550 --> 00:02:54,990 Right. Without not having serious cardiac events. And and then that got me into into the heart because I, I said, well, look, here's an observation. 26 00:02:54,990 --> 00:03:00,120 The hyperkalemia, why are they going to asystole? Why were they dropping dead? 27 00:03:00,120 --> 00:03:10,770 And so I work that got me into cardiac electrophysiology and I post-box with Dennis Noble and Hilary Brown learnt to patch, 28 00:03:10,770 --> 00:03:15,390 clamp and worked and that area of the heart. 29 00:03:15,390 --> 00:03:25,720 So it was a sort of a tortuous route, but that's how I got there after spending some time in America as opposed to this fundamental. 30 00:03:25,720 --> 00:03:31,380 I want to ask you how things have changed during your contract with Oxford. 31 00:03:31,380 --> 00:03:36,720 How do you see teaching have changed because he would have come as a tutor? 32 00:03:36,720 --> 00:03:41,430 Yeah, yes, I was at my first appointment was a tutorial fellow back in the early 90s, 33 00:03:41,430 --> 00:03:46,800 and it was quite a scene before the visualisations had taken place. 34 00:03:46,800 --> 00:03:55,740 It was the old faculty board of Physiological Sciences and Clinical Medicine. 35 00:03:55,740 --> 00:04:07,470 And in those days, you know, the tutors, the tutorial fellows, you know, had a big influence in the system. 36 00:04:07,470 --> 00:04:11,070 You know, in terms of what went on, you know, 37 00:04:11,070 --> 00:04:22,590 the most of the research took place in South Park's road and on the old Radcliffe Infirmary with some taking place, John Radcliffe. 38 00:04:22,590 --> 00:04:31,830 But this is long before the Old Road campus was built and the Wetherall Institute was just being conceived of and being built at that time. 39 00:04:31,830 --> 00:04:36,490 So the teaching has changed a lot. 40 00:04:36,490 --> 00:04:47,010 Um, the curriculum has evolved, and I think it's more focussed because before the Oxford students were very good, 41 00:04:47,010 --> 00:04:58,380 as David Whitchurch would say, and journalistic style writing, but for content might be seen to be wanting in some areas. 42 00:04:58,380 --> 00:05:04,290 But having said that. John Ledingham would always say it doesn't really matter what you chaps teach them, 43 00:05:04,290 --> 00:05:10,140 just get them excited and we'll fill the gaps when they come up to see us in terms of content. 44 00:05:10,140 --> 00:05:16,620 So we tend to pretty much in my early days as a tutor, we would not work in curriculum. 45 00:05:16,620 --> 00:05:27,360 We would tend to work around areas that interested us and hopefully interested our pupils and not be too textbook driven. 46 00:05:27,360 --> 00:05:31,020 And I would have thought there was even more choice. Is that right? 47 00:05:31,020 --> 00:05:33,180 Yeah. There's way more choice. Yeah. Yeah. 48 00:05:33,180 --> 00:05:42,390 Because, you know, the curriculum was small and, you know, 30 years ago and we didn't have all that post genomic information. 49 00:05:42,390 --> 00:05:50,970 And, you know, genetics plays a big part now in medicine, whereas 30 years ago it was a very small part of it. 50 00:05:50,970 --> 00:05:55,200 So, you know, something has got to shift to accommodate that. 51 00:05:55,200 --> 00:06:07,490 And these days. You know, I think these days the students have much more pro forma experience compared to students 30. 52 00:06:07,490 --> 00:06:17,270 I think it's more precooked in the system, get more precooked, whereas I think before it was a little bit Darwinian, I guess, you know, 53 00:06:17,270 --> 00:06:24,320 like Oxford is a funny place, as you know, because you've been a student here that, you know, you'll either make it or you don't make it. 54 00:06:24,320 --> 00:06:30,890 And I think that's how it used to be, I think. And now, you know, it's it's more integrated. 55 00:06:30,890 --> 00:06:37,010 It's you know, you've got to be pretty bad not to get through the system here, 56 00:06:37,010 --> 00:06:44,180 whereas I think many, many decades ago, you know, you're kind of left to your own devices a bit. 57 00:06:44,180 --> 00:06:53,390 And that suited some people very well. And other people and some of your contemporaries might have been like but struggled in that environment. 58 00:06:53,390 --> 00:07:04,130 Now, I don't know what happened when you came, but in the old days of pharmacology and pathology and back would separate themselves. 59 00:07:04,130 --> 00:07:08,750 But now pathology has come into the mainstream, is that right? 60 00:07:08,750 --> 00:07:13,280 Yeah, yeah. Pathology is the dance school has always been a bit of a powerhouse sitting there 61 00:07:13,280 --> 00:07:18,620 in South Park's road and they make up a certain amount of the medical curriculum. 62 00:07:18,620 --> 00:07:23,900 Not you're not a huge amount of physiological sciences. Physiology makes up the most. 63 00:07:23,900 --> 00:07:29,780 More than fifty five per cent of the preclinical teaching is done through physiology. 64 00:07:29,780 --> 00:07:33,080 But physiology is deep as deep. Yeah, yeah. 65 00:07:33,080 --> 00:07:40,340 So that's an amalgamation of the old university laboratory physiology with the Department of Human Anatomy 66 00:07:40,340 --> 00:07:48,680 and Genetics and Genetics obviously came along is when Kay Davies was appointed Dr Leaves Professor. 67 00:07:48,680 --> 00:07:54,180 Yeah. And administration. You mentioned about the divisions. 68 00:07:54,180 --> 00:07:59,750 How does that changed and has it affected them? Well, I think it's definitely affected how the university runs. 69 00:07:59,750 --> 00:08:09,680 And I think in earlier on it was a slightly devolved system with the general board and heads of department would have to make the case for 70 00:08:09,680 --> 00:08:20,720 various events to do with their department to visualisations has provided more co-ordination in the university and like minded subjects. 71 00:08:20,720 --> 00:08:32,420 So in medical sciences, it has facilitated the preclinical and clinical campuses and many aspects of that have been very good. 72 00:08:32,420 --> 00:08:38,360 In other aspects, you could debate about the issue being just the word itself. 73 00:08:38,360 --> 00:08:43,610 Division, you know, imposes a certain description. 74 00:08:43,610 --> 00:08:52,730 And, you know, often we don't want to see that as an impediment to do other things across other divisions, mainly many for interdisciplinarity. 75 00:08:52,730 --> 00:08:58,100 I think that's very important, especially with the physical sciences. Yeah, physics and chemistry and different. 76 00:08:58,100 --> 00:09:03,410 Yeah, because I think if you look at how Oxford has developed as a university, as a science university, 77 00:09:03,410 --> 00:09:09,890 it really only took off for modern science in the eighteen hundreds and in the old Parks Road, 78 00:09:09,890 --> 00:09:17,870 South Park's road area and the preclinical schools departments were embedded in amongst the physical sciences. 79 00:09:17,870 --> 00:09:21,890 You know, most unusual, you wouldn't build a medical school like that these days, you know, 80 00:09:21,890 --> 00:09:28,970 having physiology, pharmacology, pathology next to chemistry, physics, mathematics. 81 00:09:28,970 --> 00:09:38,330 So that is historical. But that's also given great strength, the basic science in preclinical arena. 82 00:09:38,330 --> 00:09:45,350 And then, of course, when the Radcliffe Infirmary moved to the John Radcliffe and then the Oldroyd campus, 83 00:09:45,350 --> 00:09:50,210 then there was a new suite in science that has taken place. 84 00:09:50,210 --> 00:09:56,840 Certainly the results have been way back. There was a little interaction between the clinicians and the great nations. 85 00:09:56,840 --> 00:10:03,440 Do you feel there's much more now? Yes and no. I think in the old days there was probably much more because, you know, 86 00:10:03,440 --> 00:10:10,580 the the the physicians and surgeons were placed at the Radcliffe Infirmary and say many of them, 87 00:10:10,580 --> 00:10:18,590 especially on the academic side, they all had college appointments. So just geographically they would go to the college for lunch. 88 00:10:18,590 --> 00:10:24,740 And one was in much closer geographical proximity to the old university. 89 00:10:24,740 --> 00:10:31,640 Then in the 70s, when the John Radcliffe Hospital was built, most of that activity went up the hill. 90 00:10:31,640 --> 00:10:39,290 The old Radcliffe Infirmary just kept some of the sub specialisations and then eventually that has evolved. 91 00:10:39,290 --> 00:10:45,230 So in answer to your question, it's different. 92 00:10:45,230 --> 00:10:51,270 I think people are more mobile now, just electronically with communication. 93 00:10:51,270 --> 00:10:59,050 So that has helped. And there's still a lot of movement, you know, across the different aspects of the city with. 94 00:10:59,050 --> 00:11:09,790 With science, but it probably is not as close as it used to be, in my opinion, just given the geography and, 95 00:11:09,790 --> 00:11:17,380 you know, you get medical societies, bring the two groups together, which you and I are both members of. 96 00:11:17,380 --> 00:11:24,340 So that's always been a vehicle to facilitate that interaction. 97 00:11:24,340 --> 00:11:33,490 I imagine that you and clinicians might easily put in a joint fund application because that wouldn't have happened in there very much. 98 00:11:33,490 --> 00:11:43,000 No, not at all. Also, you know, that's been facilitated by new funding models at the university, which have been very good. 99 00:11:43,000 --> 00:11:52,450 And, you know, because of some specialisation, you know, if you take cardiovascular or if you take urology or rheumatology, 100 00:11:52,450 --> 00:12:00,620 then, you know, you can bring in many aspects of science to underpin new medical discoveries here. 101 00:12:00,620 --> 00:12:04,960 That is just not attacking it from a clinical point of view. 102 00:12:04,960 --> 00:12:07,900 It's attacking it from a basic science point of view. 103 00:12:07,900 --> 00:12:15,730 And so often, if you're getting chemists by chemists, physiologists and all involved geneticists, 104 00:12:15,730 --> 00:12:24,310 engineers, you know, I think there's much more interdisciplinarity now than there ever used to be. 105 00:12:24,310 --> 00:12:27,040 Tell me how the whole business of funding is changed, 106 00:12:27,040 --> 00:12:32,950 because nowadays you're never paid for your bench or your flooring and now you have to pay that out. 107 00:12:32,950 --> 00:12:37,870 I know. Well, I think, as was a former vice chancellor once said that came to this university, 108 00:12:37,870 --> 00:12:43,750 one thing Oxford's very good at, it's losing money and everything it does, which is probably true. 109 00:12:43,750 --> 00:12:51,970 Um, yeah. We never costed anything properly. And these days, you know, there was a cost model. 110 00:12:51,970 --> 00:12:58,540 It's still a cost to properly you know, we still lose money on virtually everything we do apart from industrial research. 111 00:12:58,540 --> 00:13:08,950 And that's fine. But basic research, the research councils and the charities, you know, the jewel support system is very fragile. 112 00:13:08,950 --> 00:13:12,190 And for every pound, you get many people to see this. 113 00:13:12,190 --> 00:13:16,660 But as a head of department, I see this, you know, cost money to run money. 114 00:13:16,660 --> 00:13:20,920 And so, you know, you can have the direct cost to do your experiment, 115 00:13:20,920 --> 00:13:26,830 but you've still got to pay for the heating, the lighting and the infrastructure for that work to take place. 116 00:13:26,830 --> 00:13:31,420 And there's a cost with that. So there is real pressure. This is not unique to Oxford. 117 00:13:31,420 --> 00:13:37,870 This is true of British science. And just currently how much you get from Europe? 118 00:13:37,870 --> 00:13:46,000 Well, we get quite a lot of money from you. In fact, we take more out of Europe than we put in direct costs, fantastic indirect costs, 119 00:13:46,000 --> 00:13:51,790 not so good because we lose money on the EU grants because they're not directly costed correctly. 120 00:13:51,790 --> 00:13:59,110 So, again, as a head of department, I hate them because they cost me money to run. 121 00:13:59,110 --> 00:14:03,610 But if you get one, if you get one as a scientist, you like it obviously. 122 00:14:03,610 --> 00:14:07,780 But they're a bit like NIH grants. They've lost loses. 123 00:14:07,780 --> 00:14:11,760 Really? Yeah. Not many people realise that in the. 124 00:14:11,760 --> 00:14:20,290 Yeah. And then have things sort of changed in the in the subjects that are being taught. 125 00:14:20,290 --> 00:14:23,830 Do you see much change in that. Well the type of subject has been. 126 00:14:23,830 --> 00:14:29,620 Yeah. Sort of information. No. Well anatomy is moderately static because anatomy is what it is. 127 00:14:29,620 --> 00:14:35,080 You're learning a new language and that language probably hasn't changed for centuries or tissues of the body. 128 00:14:35,080 --> 00:14:41,440 You know, the great Clarke's book was a revelation. Yeah, but you may say it's not anatomy, but I know it is. 129 00:14:41,440 --> 00:14:49,600 It is. And I think, you know, with imaging and technology and physics, medical physics, imaging, 130 00:14:49,600 --> 00:14:59,650 spatial resolution has has changed out of all recognition and teaching, as well as doing stand to morbid anatomy. 131 00:14:59,650 --> 00:15:05,140 You know, we're now starting to move into more situations of virtual reality. 132 00:15:05,140 --> 00:15:10,480 Three dimensions. I don't holo lens ultrasound. 133 00:15:10,480 --> 00:15:24,220 Yeah. Yeah. As we reconstruct images and students put on their holo lens goggles and they can see an organ in front of them and space is rotating it. 134 00:15:24,220 --> 00:15:31,900 And of course, if you're going to be a surgeon, then the surgical planning, this type of technology is critically important. 135 00:15:31,900 --> 00:15:37,420 And, you know, I think some areas of medicine have hugely improved as a consequence of this. 136 00:15:37,420 --> 00:15:44,290 You know, especially precision surgery, like neurosurgery has really taken off because of new technology. 137 00:15:44,290 --> 00:15:50,770 And the medical students now are getting exposed to this new technology and really clinically, 138 00:15:50,770 --> 00:15:55,450 clinically, clinically, because they're all very tech savvy. 139 00:15:55,450 --> 00:16:05,390 And I think as as this moves into the clinical arena. Especially in surgery, then this is going to be hugely influential, so that part of teaching, 140 00:16:05,390 --> 00:16:11,450 we're doing a smarter the basic principles of physiology haven't changed that much, 141 00:16:11,450 --> 00:16:16,400 but our understanding of the cellular and molecular processes are now that much better. 142 00:16:16,400 --> 00:16:27,020 And, of course, that's important for targeted therapy. So the students understand much more now about how drugs work, where to target the drug. 143 00:16:27,020 --> 00:16:33,020 And it's just not seen as a black box where you give something and wait for a response. 144 00:16:33,020 --> 00:16:43,760 Our teaching at Oxford, you know, is pretty academic in terms of what we try to get across to the student about how processes work. 145 00:16:43,760 --> 00:16:50,630 So the people who write essays, you know, people still write essays once a week, once a week, I'm not sure all colleges. 146 00:16:50,630 --> 00:16:56,870 But as a college they do. We don't tend to like what I don't get the students to type them. 147 00:16:56,870 --> 00:17:02,180 I like them to handwrite them, because at the end of the day, that's what they're going to have to do in the exams. 148 00:17:02,180 --> 00:17:04,820 So why shouldn't they take that? Exactly. 149 00:17:04,820 --> 00:17:13,550 And also, they're not used to writing, you know, because they get fatigued and they're busy, used to tapping on their phones and their computers. 150 00:17:13,550 --> 00:17:20,390 And I think there is a certain rhythm of thinking that handwriting brings out. 151 00:17:20,390 --> 00:17:26,000 Ah, that is your brain is moving at the right place for transfer of information. 152 00:17:26,000 --> 00:17:33,300 So traditionally, we still give the students the essay to write, to bring back, to discuss. 153 00:17:33,300 --> 00:17:38,270 And, um, and it's just not one essay. 154 00:17:38,270 --> 00:17:43,490 We're preparing them over many, many terms to sit these exams. 155 00:17:43,490 --> 00:17:47,180 And so, you know, we like to think we're not running content. 156 00:17:47,180 --> 00:17:56,300 We're running process in terms of trying to teach them how to think, because what I'm really interested in is not their problems for IBM. 157 00:17:56,300 --> 00:18:00,350 You know, it's the final on a school year. 158 00:18:00,350 --> 00:18:08,780 When the real work starts, though, we're preparing them over several years to really become young scholars. 159 00:18:08,780 --> 00:18:14,850 And they've got to learn a new language because they don't do this language at school called medicine. 160 00:18:14,850 --> 00:18:20,210 So as a professor and head of a department used to tutor, I do every turn. 161 00:18:20,210 --> 00:18:23,990 Every time. Yeah. I don't have a full load. I must reduce. 162 00:18:23,990 --> 00:18:31,670 But yeah, I yeah, I'm one of the few heads of department that still tutors. 163 00:18:31,670 --> 00:18:39,620 I think I like it because I think it's important for the head of department professor to, you know, 164 00:18:39,620 --> 00:18:47,480 turn up and give the lectures and teach undergraduates as well as to research how many at a time do you have? 165 00:18:47,480 --> 00:18:54,590 Ah, in my first year I do them in threes for finals pairs. 166 00:18:54,590 --> 00:19:01,650 Yes. Yeah. And say they'd come and one of them would read his essay and I mean it's a waste of time. 167 00:19:01,650 --> 00:19:06,410 I never really I've never taken down my ride. 168 00:19:06,410 --> 00:19:13,490 My, my line is, you know, their essays will get inked up and we'll discuss them. 169 00:19:13,490 --> 00:19:21,260 It's not a recapitulation of the lecture. It is more detailed, it's a different focus, it's a different angle. 170 00:19:21,260 --> 00:19:25,820 And we may go off paced and talk about other things. 171 00:19:25,820 --> 00:19:30,110 We tend to in parallel, we tend to run a close to the lecture series. 172 00:19:30,110 --> 00:19:38,570 So it's not completely uncoupled. But, you know, having just written a textbook, 173 00:19:38,570 --> 00:19:47,690 I've got a real appreciation of admiration for people that have done this previously because I didn't realise the amount of work involved. 174 00:19:47,690 --> 00:19:53,600 But trying to explain complex cardiovascular. 175 00:19:53,600 --> 00:20:04,040 Yeah, complex matters to a medical student is, um, you know, it's often difficult. 176 00:20:04,040 --> 00:20:11,960 You know, we take a lot of this for granted. But, you know, since, you know, William Harvey and Starling and these people, 177 00:20:11,960 --> 00:20:20,150 well, the the field has grown enormously just given the technology in the system. 178 00:20:20,150 --> 00:20:23,930 So, yeah, I think teaching is very important. 179 00:20:23,930 --> 00:20:35,480 Um, as an academic, uh, for the next generation, is funding a problem of undergraduate and graduate students? 180 00:20:35,480 --> 00:20:41,270 Uh, it's funding a problem. Well, we can always fill the place up with people. 181 00:20:41,270 --> 00:20:45,200 That's not a problem. Whether they can afford to pay for it. It's another question then, 182 00:20:45,200 --> 00:20:58,250 I guess because we're a state funded university and you pay the same at Oxford as you pay Birmingham or Newcastle or Manchester, I think. 183 00:20:58,250 --> 00:21:04,490 We give something different from those universities were very expensive to run, given our style of teaching. 184 00:21:04,490 --> 00:21:12,230 So nine thousand two hundred and fifty pounds a year, no way reflects the true cost of that experience. 185 00:21:12,230 --> 00:21:18,050 You know, roughly, it's been calculated that it's about eighteen thousand pounds. 186 00:21:18,050 --> 00:21:22,610 So clearly there's a cross subsidy that takes place in the system. 187 00:21:22,610 --> 00:21:31,010 And the question is, how long can that be sustained for undergraduates to have this Rolls-Royce experience and many tutors? 188 00:21:31,010 --> 00:21:36,980 We don't want to dumb it down. We want to be able to continue to give a high end experience. 189 00:21:36,980 --> 00:21:47,780 But that comes at a cost and a financial cost. Postgraduates much better because students are better funded now in the system. 190 00:21:47,780 --> 00:21:51,110 Arguably, one could say, are we training? 191 00:21:51,110 --> 00:22:02,210 Too many are for the jobs that are out there because there's been a huge explosion in postgraduate education in the last 20 years. 192 00:22:02,210 --> 00:22:10,070 But the number of faculty positions has not increased proportionately. So a lot of these students graduate. 193 00:22:10,070 --> 00:22:14,810 So they have to move on to other areas of work. 194 00:22:14,810 --> 00:22:20,360 And maybe that's not everyone has to be an academic. I think that's also important. 195 00:22:20,360 --> 00:22:27,830 You know, some go into clinical medicine, the pharmaceutical industry, publishing or the city of London. 196 00:22:27,830 --> 00:22:31,610 Do you get a lot from abroad now? Relatively? Yeah, a lot. 197 00:22:31,610 --> 00:22:41,060 A lot from abroad. When I first came to Oxford and physiology, there are only eight graduate students in the department. 198 00:22:41,060 --> 00:22:49,790 And that was you know, there was the you know, the foreign scholars like myself, Commonwealth scholars, Rhodes Scholar. 199 00:22:49,790 --> 00:22:55,280 Then you had your MRC students and that was it. 200 00:22:55,280 --> 00:22:58,940 Know there was no one was privately funded to come. 201 00:22:58,940 --> 00:23:05,270 And of course, that's all changed. Now, that is there's a high percentage of privately funded students. 202 00:23:05,270 --> 00:23:08,240 By that, you mean welcome by their parents? 203 00:23:08,240 --> 00:23:16,430 Well, I think their parents, yeah, all their tight loans come with a lot of privately funded people in the system. 204 00:23:16,430 --> 00:23:25,670 What has helped us? A lot of the research charities, because they have been terrific in creating these doctoral training programmes, you know, 205 00:23:25,670 --> 00:23:35,610 especially the Welcome Trust and the British Heart Foundation, who have given Oxford a huge amount of support for doctoral training in the system. 206 00:23:35,610 --> 00:23:39,900 I'm sure you are very involved in the admissions of people, as it were. 207 00:23:39,900 --> 00:23:48,110 How important do you think that is and how critical is it to people's careers to get accepted or not accepted? 208 00:23:48,110 --> 00:23:52,160 Well, I think coming to Oxford is a badge of honour if you can get into the place. 209 00:23:52,160 --> 00:23:56,390 So, you know, it's the admissions are very important here. 210 00:23:56,390 --> 00:24:02,750 You know, it's hard to get out. You this is you know, this is arguably one of the top medical schools in the world. 211 00:24:02,750 --> 00:24:06,620 You know, if you believe the metrics, I'm not sure we do. 212 00:24:06,620 --> 00:24:13,250 But but let's take it. Um, it's very competitive, like medical admissions we've just done now. 213 00:24:13,250 --> 00:24:19,760 We had one thousand seven hundred applicants for one hundred and fifty places. 214 00:24:19,760 --> 00:24:26,000 So you can't interview all those people. You know, you can shortlist for 50 and interview for 50. 215 00:24:26,000 --> 00:24:30,260 And most of these candidates are highly competitive for places at medical school. 216 00:24:30,260 --> 00:24:36,080 But we can't take everybody. And, you know, Oxford is a boutique medical school. 217 00:24:36,080 --> 00:24:44,180 And if you look at the best medical schools in the world, which are mainly in the United States, you know, there are about the same size as us. 218 00:24:44,180 --> 00:24:49,910 So I wouldn't personally like to see us get two big name as a medical school, 219 00:24:49,910 --> 00:24:57,200 because otherwise I think it'll take away some of the training aspects and personalisation that we have with the pupils. 220 00:24:57,200 --> 00:25:04,310 Do you think it's ever possible to aim for life or social background? 221 00:25:04,310 --> 00:25:14,630 Educational background? Yeah, yeah. I'm a deprived and no and no question and we do that like we we do factor that and people always ask, 222 00:25:14,630 --> 00:25:19,040 you know, is Oxford just not occupied by the elite public schools? 223 00:25:19,040 --> 00:25:21,740 And, you know, aspects of it are in some subjects. 224 00:25:21,740 --> 00:25:26,960 But I like to think in medicine and I can only talk about this college because I've been doing it for a long time here now. 225 00:25:26,960 --> 00:25:34,940 But my life has always been that you can't blame the child to the school their parents decided to send them to. 226 00:25:34,940 --> 00:25:44,090 So, you know, I've taken Etonians and one year, along with kids from Scunthorpe and John Leggat College, which, 227 00:25:44,090 --> 00:25:50,120 you know, more deprived area of the United Kingdom, and these kids would not normally meet one another. 228 00:25:50,120 --> 00:25:55,100 And life and to be honest, it's good for both of us is to make one. 229 00:25:55,100 --> 00:26:05,470 And so my life has always been I'm. Interested in, you know, potential, I'm interested in rough diamonds, I don't like the polished product because I, 230 00:26:05,470 --> 00:26:12,750 I think if you're seeing that at 17, then there's not much more I can do to them if they're coming into polished. 231 00:26:12,750 --> 00:26:20,190 But I like to see the potential. And I realise that some pupils come from different baselines because they've had different experiences. 232 00:26:20,190 --> 00:26:25,950 And, you know, we're interested in their rate of rise as the incline that I'm interested in. 233 00:26:25,950 --> 00:26:33,600 And even if their baseline is low, you know, I think if we can see the potential of them, then we will give them the opportunity. 234 00:26:33,600 --> 00:26:39,660 And, you know, we've had some terrific pupils who have gone on to have stellar careers. 235 00:26:39,660 --> 00:26:45,390 And, you know, we're not I'm not starting from the position of choosing GPS. 236 00:26:45,390 --> 00:26:52,050 No, I'm not. You know, a lot of them may become cheap, and that's fine because it's important to have brought GP's out there. 237 00:26:52,050 --> 00:27:03,810 But, you know, I'm looking for the next generation of leaders in medicine and surgery who want to do to tertiary academic work. 238 00:27:03,810 --> 00:27:12,930 And and, you know, most of our our pupils, you know, they've all gone on to become consultants and are now becoming professors of medicine or surgery. 239 00:27:12,930 --> 00:27:16,830 And that that's that's fulfilling seeing that. 240 00:27:16,830 --> 00:27:23,280 But, you know, I think it's harder admissions are harder now than they were 30 years ago. 241 00:27:23,280 --> 00:27:30,930 And the reason I say that is because 30 years ago, if you were predicted three A's at every level, 242 00:27:30,930 --> 00:27:37,830 then you were pretty darn smart and you come in and do the Oxford entrance test and that would usually affirm it. 243 00:27:37,830 --> 00:27:45,180 These days you look at the UCAS forms and they've all got 12 ace stars at GCSE. 244 00:27:45,180 --> 00:27:51,150 They're all predicted three or four ace stars at a high level. 245 00:27:51,150 --> 00:27:55,410 Um, and they're all super brilliant on their forms. 246 00:27:55,410 --> 00:28:05,980 And for the poor old shooter, as pretty high as pretty and they're on the ball, got grade eight, whatever. 247 00:28:05,980 --> 00:28:11,820 And you know, I've represented the county or country and speak three languages and like, 248 00:28:11,820 --> 00:28:21,270 there's no way we would ever get into Oxford as anybody ever looked at the outcome of people turned out no show. 249 00:28:21,270 --> 00:28:25,740 Yeah, no, that's probably that's probably something like we make mistakes, of course. 250 00:28:25,740 --> 00:28:32,850 And good. And I always like to say to the students when they come, look, I'm sure you're well suited for medicine, 251 00:28:32,850 --> 00:28:36,330 you know, and, you know, we'll do our best to get the best slot. 252 00:28:36,330 --> 00:28:40,110 If you don't make it this time around, then, you know, 253 00:28:40,110 --> 00:28:48,960 you get into a good medical school and you may be able to come back to Oxford as a clinical student or do a house job here. 254 00:28:48,960 --> 00:28:55,150 Are you involved at all in the decision between where as to where they do their clinical now? 255 00:28:55,150 --> 00:29:03,660 I so we've changed our policy now at Oxford two years ago and of course before after the first B.M., when they applied to do the second year, 256 00:29:03,660 --> 00:29:09,690 they'd have to apply again to the clinical school and they would most of them would get it, but not all of them. 257 00:29:09,690 --> 00:29:16,350 And we would transfer students to London and then we would backfill them with students from Cambridge. 258 00:29:16,350 --> 00:29:20,640 Two years ago, the policy was changed, that seamless entry. 259 00:29:20,640 --> 00:29:26,340 So as long as you pass your prelims, then you're guaranteed a place at the John Radcliffe. 260 00:29:26,340 --> 00:29:31,620 Now now we we don't handcuff the students to John Radcliffe. 261 00:29:31,620 --> 00:29:41,160 We would say to them at the end of finals, final score school in the third year, if you wanted to go to another clinical school, then you can. 262 00:29:41,160 --> 00:29:46,380 And of course, London schools like our students, 263 00:29:46,380 --> 00:29:53,430 despite what they say about despite what they say about our lack of innocence, they still like our students. 264 00:29:53,430 --> 00:29:54,390 And, you know, 265 00:29:54,390 --> 00:30:02,970 I've always argued that was quite a good system because it gave the student an opportunity to have a break from Oxford if they wanted it. 266 00:30:02,970 --> 00:30:08,580 And also for the students that were ranked down the list, you know, 267 00:30:08,580 --> 00:30:15,840 like the students that were ranked one hundred and forty five to one hundred and fifty five on exam performance, 268 00:30:15,840 --> 00:30:21,660 you know, if they're dragging themselves at that end of the class. Now, those students all pretty bright. 269 00:30:21,660 --> 00:30:22,980 Yeah. 270 00:30:22,980 --> 00:30:34,560 But those students typically we would send to London and they would actually then appear on the top part of the class list, UCL or Imperial College. 271 00:30:34,560 --> 00:30:42,750 Right. And I've always said to the students, look, it's a bit like running the final of the 100 metres at the Olympic Games. 272 00:30:42,750 --> 00:30:47,340 Someone's got to get last right now. Someone's got to get lost. 273 00:30:47,340 --> 00:30:51,720 But that doesn't mean you're slow. You're right. That doesn't mean you're slow. 274 00:30:51,720 --> 00:30:58,290 You're still fast, but you got lost. And I think that's a little bit like medicine at Oxford. 275 00:30:58,290 --> 00:31:06,150 Student number one five five Houssein, seen at the bottom of the class, are still pretty darn good at Oxford. 276 00:31:06,150 --> 00:31:11,670 Now, you've done a lot, as it were, outside Oxford, the editing Journal of Physiology or writing books. 277 00:31:11,670 --> 00:31:16,100 And so how do you fit that in with great difficulty in education? 278 00:31:16,100 --> 00:31:22,140 So what I did when I was editor in chief of the Journal of Physiology, I used to about two hours every day. 279 00:31:22,140 --> 00:31:26,850 So I would I would tend to do that in the evening and at lunchtime. 280 00:31:26,850 --> 00:31:36,360 And with electronic media these days, because of the immediacy thing, you can push information around the world quite quickly. 281 00:31:36,360 --> 00:31:47,550 And I had a fantastic editorial staff in London. So, you know, I was just really triaging and making, you know, strategic decisions. 282 00:31:47,550 --> 00:31:49,830 Yeah, it was a fantastic job. Yeah. 283 00:31:49,830 --> 00:32:00,570 Being editor in chief of JP, because I saw a lot of science travelled the world and met a lot of very interesting people. 284 00:32:00,570 --> 00:32:05,310 So I you know, I enjoyed that part. Academic publishing. 285 00:32:05,310 --> 00:32:07,320 I enjoyed that part of the job, you know, 286 00:32:07,320 --> 00:32:17,550 just like I enjoy still teaching undergraduates because they will always ask you the silly question that no one will ask you. 287 00:32:17,550 --> 00:32:24,120 But often it's one of the most poignant questions, and especially if you're trying to explain it to them. 288 00:32:24,120 --> 00:32:33,510 And, you know, when I was doing the textbook with Neil Haring, who was one of my former pupils, who's now a consultant, John Radcliffe in cardiology, 289 00:32:33,510 --> 00:32:46,440 I would use different chapters to rehearse on the students to see how they and tutorials to see how they reacted to the concept of explaining it. 290 00:32:46,440 --> 00:32:55,050 And if they couldn't understand it and they're all much brighter than I am, then then I think, well, I haven't written that properly. 291 00:32:55,050 --> 00:33:01,710 Yeah. You know, I have an Oxford medical student doesn't understand this then, you know, how could anyone else understand it? 292 00:33:01,710 --> 00:33:05,830 So I found that quite useful. And did you do the same? 293 00:33:05,830 --> 00:33:17,310 I say you're welcome. Oh, yeah, I was I've been on my sort of standard stint on BHF committees and for my sins, 294 00:33:17,310 --> 00:33:25,050 I did the Iraqi National Committee in 2008, then the committee in 2014. 295 00:33:25,050 --> 00:33:31,050 I decided to P45 myself from that experience ever again. 296 00:33:31,050 --> 00:33:37,690 Someone has to do it. But I think I've done my tour of duty as far as that's concerned. 297 00:33:37,690 --> 00:33:43,530 And I didn't know the beginning, but well, I did move from a target to Western Australia. 298 00:33:43,530 --> 00:33:50,970 Oh. So I was when I left a targo, I was sort of travelling trying to figure out what I was wanting to do. 299 00:33:50,970 --> 00:33:59,760 And I always, you know, I got physiology quite late at medical school at a targo has been exposed to anatomy and physiology. 300 00:33:59,760 --> 00:34:07,080 And I always liked physiology kind of lefter bit and then rediscovered it again when I went to Australia. 301 00:34:07,080 --> 00:34:12,210 And Wolf, Simmons' was professor of Physiology, a University of Western Australia, 302 00:34:12,210 --> 00:34:18,060 and he was a Rhodes Scholar at Oxford and knew George Gordon, right? 303 00:34:18,060 --> 00:34:24,570 Yeah. He was that era and had done his day film in physiology. 304 00:34:24,570 --> 00:34:31,950 And so just indirectly, Oxford got planted in my mind. 305 00:34:31,950 --> 00:34:38,040 Um, and then my very good friend, John Koop, who sadly passed away last year. 306 00:34:38,040 --> 00:34:41,040 He was Bowmen Professor of physiology at Birmingham. 307 00:34:41,040 --> 00:34:48,990 And I met him in the Himalayas because I was very tense and climbing and and I met him in the early eighties. 308 00:34:48,990 --> 00:34:53,160 And I was trying to decide, do I go to L.A. or do I go to Oxford? 309 00:34:53,160 --> 00:35:02,940 And John had just been my chair of physiology at Birmingham and said to me in a bar in Katmandu in the early 80s, 310 00:35:02,940 --> 00:35:05,970 oh, well, why don't you come to Birmingham? 311 00:35:05,970 --> 00:35:13,980 Because, you know, and I think you should go to Oxford because that's where all those great respiratory physiologists are. 312 00:35:13,980 --> 00:35:15,350 So that's why I came. 313 00:35:15,350 --> 00:35:25,980 Eventually I came to see John and then then had met Dan Cunningham, Bob Torrence and every Peterson, and then I was sold to come here. 314 00:35:25,980 --> 00:35:32,220 But, you know, for me, I've drifted. So, you know, there's a lot of serendipity. 315 00:35:32,220 --> 00:35:34,980 There really are. No, there always is, to be honest. 316 00:35:34,980 --> 00:35:41,070 Like, this was not preplanned because, you know, I was the first in my family to go to university. 317 00:35:41,070 --> 00:35:48,750 Like, you know, I come from a farming heritage and, you know, everyone left school very early. 318 00:35:48,750 --> 00:35:57,000 So, you know, for me, Oxford was a long way away, which hadn't asked you that I should have. 319 00:35:57,000 --> 00:36:01,580 You've asked me here. No, no, no, no. It's been most interesting. 320 00:36:01,580 --> 00:36:04,670 Well, you've been at Oxford a long time, much longer than I have, 321 00:36:04,670 --> 00:36:11,480 and you would have seen it change tremendously during your time as an undergraduate, just the evolution of the clinical school. 322 00:36:11,480 --> 00:36:17,810 Like, you know, that that's been on my mind. That's been the biggest change in the last 20 years like that. 323 00:36:17,810 --> 00:36:24,320 You know, they've done a terrific job on, you know, the last two Regius professors. 324 00:36:24,320 --> 00:36:26,120 Oh, yeah, yeah, yeah. 325 00:36:26,120 --> 00:36:37,800 You know, it's been phenomenal what David Wetherall and John Bell have done and building, you know, modern medicine in medical sciences. 326 00:36:37,800 --> 00:36:39,260 You yeah, it's been terrific. 327 00:36:39,260 --> 00:36:48,470 And I think the challenge is to make sure that that, you know, that momentum doesn't get uncoupled from the preclinical schools. 328 00:36:48,470 --> 00:36:55,850 You know, the preclinical schools just don't become some sort of teaching rump or of the medical school that, you know. 329 00:36:55,850 --> 00:37:05,840 Yes, there is indeed that. And that it's important that, you know, the preclinical department are not translational motivated departments. 330 00:37:05,840 --> 00:37:14,060 You know, they're they're USPI is different. You know, they're USPI is to educate, you know, which are claiming the clinical school is, too. 331 00:37:14,060 --> 00:37:19,970 But, you know, they're involved in basic fundamental discovery science, which may have Transito. 332 00:37:19,970 --> 00:37:24,680 Absolutely. And it's important to have some of your portfolio there. 333 00:37:24,680 --> 00:37:33,050 Right. As well as being mission driven, because, you know, a lot of the you know, the new exciting science on the old road cambers, 334 00:37:33,050 --> 00:37:38,990 you know, it's very mission driven to, you know, solve and treat certain diseases. 335 00:37:38,990 --> 00:37:47,180 And that's terrific. You know, we need to do that. But at the same time, you need to discover new principles to base translational. 336 00:37:47,180 --> 00:37:54,080 And if you look at all the big Nobel prises that you know, that have really influenced medical science, 337 00:37:54,080 --> 00:38:01,160 you know, these have come from these basic science departments. 338 00:38:01,160 --> 00:38:06,830 If you look at their history, fluorescent proteins at Patch, clamp it. 339 00:38:06,830 --> 00:38:12,740 Yeah, right. Yeah. And you can you can trace back the technology. 340 00:38:12,740 --> 00:38:18,980 I think you'll see the same thing with opto genetics. I think you see the same thing with CRISPR, with gene editing. 341 00:38:18,980 --> 00:38:25,490 Right. These have come from basic science departments as the tools have been made like imaging for example. 342 00:38:25,490 --> 00:38:33,830 OK, so in clinical medicine we use where end users of those tools to help solve problems. 343 00:38:33,830 --> 00:38:45,320 But Oxford is unique. I think that it's got this good mix of basic science, clinical science embedded amongst physical sciences, 344 00:38:45,320 --> 00:38:48,980 like there's no medical school in the world that looks like that. 345 00:38:48,980 --> 00:38:55,160 You know that because medical schools tend to be entities to themselves and Cambridge or Cambridge. 346 00:38:55,160 --> 00:39:02,510 Yeah, but I think when they when they tend to have moved away from the tennis court roadside to Adam Brooks, 347 00:39:02,510 --> 00:39:07,490 you know, they've still kept a little bit of that in their life science programme. 348 00:39:07,490 --> 00:39:16,220 You know, Cambridge is super successful science like fantastic with no you know, the Olympians, the there's no question about that. 349 00:39:16,220 --> 00:39:21,110 But I think Oxford is going it's in a transitional period at the moment. 350 00:39:21,110 --> 00:39:26,870 And, you know, it's important that, you know, we can be even better, you know, 351 00:39:26,870 --> 00:39:33,020 if we get a lot more integration across the sites, you know, and be a little bit more imaginative. 352 00:39:33,020 --> 00:39:40,010 And the way we make appointments in terms of adjunct appointments across the different departments. 353 00:39:40,010 --> 00:39:48,650 Um, but, you know, I think on the whole, I've spent my life sitting on committees and allegedly trying to think about strategy. 354 00:39:48,650 --> 00:39:56,180 And at the end of the day, you know, probably the best strategy is not to have a strategy and and and just, 355 00:39:56,180 --> 00:40:00,410 you know, like my life and just leave people alone whether or not to have a community. 356 00:40:00,410 --> 00:40:01,520 No, not well, exactly. 357 00:40:01,520 --> 00:40:09,410 And the thing is, you know, the our job is to hire the best people and let them get on with it and provide a good environment for them. 358 00:40:09,410 --> 00:40:18,200 And not having too many committees, I think, because otherwise you can be death by committee and you never actually get anything done. 359 00:40:18,200 --> 00:40:22,340 So but also it's in great shape. Yeah. 360 00:40:22,340 --> 00:40:26,890 Do any of the American medical schools have a tutorial system or anything like that? 361 00:40:26,890 --> 00:40:32,600 It's very interesting because Hamilton I think started trying something a bit like that. 362 00:40:32,600 --> 00:40:44,000 Maybe, I'm sure in Canada. Yeah, no, they know that because medicine on the whole outside of the UK is gradually entry is so they've got a four year, 363 00:40:44,000 --> 00:40:48,440 four year medical degree based on another degree going in, 364 00:40:48,440 --> 00:40:57,850 whereas where direct entry from school, you know, we're both models, but many were direct entry from school and the very problem based. 365 00:40:57,850 --> 00:41:09,530 But I would argue that, you know, we're problem based, too, and we invent a problem based learning, you know, we call it a tutorial. 366 00:41:09,530 --> 00:41:14,560 So we do the traditional lecture based stuff, which you will have as a medical student, 367 00:41:14,560 --> 00:41:19,190 but then you come to your tutor and that's where you get your PBO. 368 00:41:19,190 --> 00:41:25,660 Mm hmm. Right now, the tutors know a little bit about something, but on the whole, we don't know much about anything. 369 00:41:25,660 --> 00:41:31,460 And, you know, as a little bit of the blind leading the blind, but that's what PBL is to an extent. 370 00:41:31,460 --> 00:41:37,090 It's about facilitation. So it's taking them down areas that they may not normally have gone. 371 00:41:37,090 --> 00:41:45,800 But I think the nice thing about Oxford and Cambridge, too, is that our foundations are very strong scientifically to base the tutorials on. 372 00:41:45,800 --> 00:41:50,950 I think it would be different if you didn't if you just had the tutorials and nothing else. 373 00:41:50,950 --> 00:41:54,760 I think that would be a completely Darwinian surance show. 374 00:41:54,760 --> 00:42:01,600 But I think the combination of the college and the lectures and the labs is still pretty good. 375 00:42:01,600 --> 00:42:08,020 As for training students and you know, we get criticised as being old fashioned. 376 00:42:08,020 --> 00:42:11,680 But having said that, you know, the proof is in the product. 377 00:42:11,680 --> 00:42:22,160 You know, our kids, you know, if you look at national examinations, membership examinations for physicians and surgeons, we're not doing too bad. 378 00:42:22,160 --> 00:42:31,540 They sure are here. And I think having that direct involvement with the college and the tutor, yeah, 379 00:42:31,540 --> 00:42:36,580 I still think is very important because it depends when you ask the question. 380 00:42:36,580 --> 00:42:44,920 You know, if you ask the question to a fifth or sixth year medical student about the importance of it, 381 00:42:44,920 --> 00:42:55,300 or you ask them 15 years later or 20 years later, you get a different answer when they look back about the experience. 382 00:42:55,300 --> 00:42:59,830 So I think it depends when you ask the question, because we do it all the time. 383 00:42:59,830 --> 00:43:12,550 You know, as we get older, when we see our pupils, you know, climbing, climbing the medical ladder, anything else you might say? 384 00:43:12,550 --> 00:43:16,720 Well, thank you very much, Superlative. You really know my. 385 00:43:16,720 --> 00:43:18,000 My pleasure.