Episode 81
The PhD Balancing Act for Lasting Capacity in Practice
In this final episode of our mini-series on research capacity strengthening, we explore how pursuing a PhD, using the PACTS programme (Patient-centred Sickle Cell Disease Management in sub-Saharan Africa), as a real-world example—can enhance, rather than compete with, clinical practice.
Our guests reflect on what it means to balance research with clinical care, teaching, community outreach, and academic responsibilities, and share honest insights about the challenges and opportunities that come with embedding a PhD within a larger programme. From learning by doing to mentoring the next generation, this episode looks at how research can be a powerful tool for real-world impact in health systems.
In this episode:
Dr. Mmamulatelo Siame Mumba - PhD Student, SBA lead, Project coordinator, Zambia
Dr. Mmamulatelo Siame Mumba is a paediatrician and implementation researcher based in Zambia. She is undertaking a PhD with the Liverpool School of Tropical Medicine and leads the Standards-Based Audit teams across PACTS sites while coordinating research activities on the ground.
Dr. Hezekiah Isa Albarka - Lecturer at University of Abuja, Nigeria
Dr. Hezekiah Isa Albarka is a senior lecturer at the University of Abuja and a haematologist with a long-standing interest in sickle cell disease. He is currently pursuing a PhD through the PACTS project, building on years of experience in clinical care and academic teaching.
Dr. Eunice Agyeman Ahmed - PhD Student Liverpool School of Tropical Medicine, Ghana
Dr. Eunice Agyeman Ahmed is a haematologist at Komfo Anokye Teaching Hospital in Ghana and a PhD student at the Liverpool School of Tropical Medicine. Her research supports adolescents with sickle cell disease transitioning into adult care, alongside her wider advocacy and training work across Ghana and Africa.
- Patient-Centered Sickle Cell Disease Management in Sub-Saharan Africa
- Patient-centred sickle cell disease management in sub-Saharan Africa (PACTS) | LSTM
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Transcript
Dr. Kim Ozano: Hello listeners and welcome to Connecting Citizens to Science, the
Speaker:global health podcast that brings together people from across sectors and settings
Speaker:to explore current debates and real world challenges in health systems research.
Speaker:This final episode of our miniseries on research capacity strengthening,
Speaker:we're turning our attention to the PhD.
Speaker:Not just as a qualification, but as a catalyst for change.
Speaker:And today we ask what does it take to balance a PhD with the demands
Speaker:of clinical care and teaching community engagement and management?
Speaker:And how can embedding a PhD in a programme go beyond just academic outputs, becoming
Speaker:a tool for learning by doing and leading systems change that is really needed.
Speaker:We also discuss the advantages of embedding research capacity and skills
Speaker:early on in your clinical career, and the advantages that that can bring
Speaker:for maximum impact and sustainability.
Speaker:Joining us for this conversation are three inspiring clinicians who are also
Speaker:researchers currently undertaking their PhDs as part of the PACTS programme.
Speaker:We have Dr. Hezekiah Isa Albarka, who is a senior lecturer at the
Speaker:University of Abuja, and a haematologist who is currently pursuing his
Speaker:PhD through the PACTS project.
Speaker:He is building on a career rooted in both clinical care and sickle cell research.
Speaker:We also have with us Dr. Mmamulatelo Siame Mumba, who is a paediatrician
Speaker:and researcher based in Zambia with a focus on tropical paediatrics
Speaker:and implementation research.
Speaker:She coordinates research activities across PACT sites and leads the standards
Speaker:based audit teams as part of her PhD.
Speaker:Finally we have joining us Dr. Eunice Jeman Ahmad, who is a
Speaker:haematologist and a PhD student.
Speaker:Her research focuses on supporting adolescents with sickle cell disease
Speaker:to transition into adult care, and she plays a key role in both
Speaker:national training and the Pan-African Sickle Cell Research Consortium.
Speaker:So, here's the challenge, whether you're a policymaker, a practitioner,
Speaker:or a researcher, how are you creating the space and support
Speaker:for embedded learning and capacity strengthening within your programmes?
Speaker:Is your system set up to value real world problem solving, or
Speaker:are we still treating research as something separate from practice?
Speaker:Let's jump into the conversation.
Speaker:It's so great to have you here today to discuss research capacity
Speaker:strengthening, and you have a really unique position in that you're all
Speaker:clinicians and also have a PhD and lots of different responsibilities.
Speaker:So, perhaps you could tell us a bit about your understanding of
Speaker:research capacity-strengthening and what you get from your PhD that is
Speaker:different from your other practice.
Speaker:Dr. Mmamulatelo Siame Mumba: Hi, my name is Mmamulatelo Siame Mumba.
Speaker:I do prefer to be called Telo.
Speaker:I am a paediatrician based in Lusaka, Zambia.
Speaker:I am working with the Sickle Cell disease and I am now a PhD candidate with
Speaker:Liverpool School of Tropical Medicine.
Speaker:So, maybe I can start with a story.
Speaker:Dr. Kim Ozano: Yeah.
Speaker:Dr. Mmamulatelo Siame Mumba: My education or my postgraduate studies
Speaker:to become a paediatrician, I was focused on the clinical work.
Speaker:I had a lot of fulfilment in the clinical work.
Speaker:However, I was thrown into the world of research by a certain mentor of mine, and
Speaker:this research was implementation research.
Speaker:And I was like, what is this and how will it, help my practice?
Speaker:I love children.
Speaker:I wanna be working with them and so on.
Speaker:But he said something very unique.
Speaker:He said, when you step out into the world of research, your mind opens up
Speaker:to so much more that you can do, even as a clinician, should you decide to go
Speaker:back, you'll find that your practice will be enhanced in everything that you do.
Speaker:And I was looking at him, I'm like, nah, like what you on about?
Speaker:And he kept on saying, you have to do your PhD. And that was two years ago.
Speaker:And, two years after that discussion with him, I had the opportunity now to join
Speaker:the programme as a PhD student with PACTS.
Speaker:And during this time I've also had the opportunity to go back to a
Speaker:bit of clinical practice and boom, exactly what he said has happened
Speaker:with every time that I'm practicing, I'm looking at the patients I'm
Speaker:teaching students, postgraduate students, undergraduate students.
Speaker:I find myself referring back to some of the principles that I've learned.
Speaker:That I'm learning through my PhD work through that research.
Speaker:So, I think that story just sums up how that capacity, that research does
Speaker:impact the work that we do as clinicians.
Speaker:Dr. Kim Ozano: Thank you very much.
Speaker:I love that story from, first of all what is this research?
Speaker:Why do I need it to really understanding in practice.
Speaker:Has it been the same for you too, Hezekiah?
Speaker:Dr. Hezekiah Isa Albarka: My name is Hezekiah Isa, I'm an adult
Speaker:haematologist based in Nigeria.
Speaker:I'm currently doing my PhD in global health, which is
Speaker:embedded in the PACTS project.
Speaker:I consider the PhD programme a necessity.
Speaker:It's a very important programme that one needs because my
Speaker:background is basically clinical.
Speaker:Even though I did a postgraduate training and did a project at the
Speaker:end of it, the research component, it was not very extensive.
Speaker:If you are in academia, I'm also a lecturer, I train medical
Speaker:students and conduct research.
Speaker:One of the things that will impact more on your career is a PhD
Speaker:programme because it opens up your mind and makes you think critically.
Speaker:You analyse problems, it enhances your capacity to think critically and how to
Speaker:solve problems and so on and so forth.
Speaker:So, it is a very important programme that is very essential for any academic.
Speaker:Dr. Kim Ozano: Excellent.
Speaker:I love this link to solving problems.
Speaker:So, we've heard in our previous episode that, clinicians are often
Speaker:faced with problems, but maybe don't think about the solutions so much.
Speaker:Have you found it's really affected your practice as well Eunice?
Speaker:Dr. Eunice Agyeman Ahmed: Yes.
Speaker:I was also drawn so much into clinical practice and more like shying away from
Speaker:research as much as I could because it was a bit of like a daunting area to go to.
Speaker:But each and every day that I practice, I realised that there was this gap
Speaker:that needed to be filled, and the only thing that could fill it was research.
Speaker:So, I didn't have a choice.
Speaker:I just had to open up and then embrace research because it brings
Speaker:much more to my practice than just rendering a service to the patient.
Speaker:And it also helps you reach out more to the world rather than just
Speaker:reaching out to your patients.
Speaker:Dr. Kim Ozano: So, it connects you to more of the wider global health.
Speaker:Dr. Eunice Agyeman Ahmed: Exactly.
Speaker:Dr. Kim Ozano: And is that useful?
Speaker:Dr. Eunice Agyeman Ahmed: Yes.
Speaker:It's very useful.
Speaker:Dr. Kim Ozano: In what way?
Speaker:Dr. Eunice Agyeman Ahmed: So, for my professional growth you can
Speaker:network to other people who are also interested in the things that you do.
Speaker:That's one of the benefits to me as an individual, and of course there's also
Speaker:a benefit to the patient because if you are linking whatever knowledge that
Speaker:you would use to impact them, you are linking it not just with what you know,
Speaker:but with what others can also input.
Speaker:Dr. Hezekiah Isa Albarka: Most of the time we compartmentalise the clinical
Speaker:disciplines, but they are actually related to each other to enrich practice.
Speaker:So, for example, I can tell you that when some colleagues hear that as
Speaker:a haematologist, I'm doing a PhD in global health, they'll be surprised.
Speaker:They will say, 'Ah, what is a haematologist doing in global
Speaker:health, leave that to the public health physicians or specialists?'.
Speaker:It has really opened my eyes because as a clinician that is just seeing
Speaker:patients in the ward and in a clinic, you are really limited when the patients
Speaker:come to you, that is when you see them.
Speaker:But sometimes, it really involves going out there to reach out to the
Speaker:patients, and it also involves really making sure that the patients also
Speaker:participate in their own management.
Speaker:It is a patient-centred management.
Speaker:That is what makes it so beautiful, and it has a lot of impact on both
Speaker:the practitioner and the patients.
Speaker:Dr. Mmamulatelo Siame Mumba: By taking the principles up and learning in
Speaker:terms of implementation research in global health, we are able to spot
Speaker:the problems more clearly than most of our other colleagues . And we're able
Speaker:to harness some of the things we've learned to bring up the solutions.
Speaker:So, I have a few mentees, that I speak about some of the things I'm learning
Speaker:and there are clinical meetings that bring together the consultants, the
Speaker:postgraduate students, the junior resident medical officers, and in those platforms,
Speaker:there are presentations of clinical cases within the hospital, certain departments
Speaker:will bring forth presentations.
Speaker:So, in those discussions, I have learned even with the mentees, to just
Speaker:ask them, what can we do about it?
Speaker:What resources can we use to bridge those gaps to solve the problems.
Speaker:And using those approaches, a lot of them are opening up and they're actually
Speaker:saying, oh, we can actually do this.
Speaker:So, I am part of the haematology, the paediatric haematology unit,
Speaker:which looks at sickle cell disease.
Speaker:Other conditions are haemophilia and aplastic anaemias and
Speaker:some leukaemias as well.
Speaker:So, when I have a new set of registrars, I tell them, look for
Speaker:a problem that you can find on the ward and let's solve it together.
Speaker:We don't need any funds.
Speaker:You don't need money.
Speaker:You can actually think about changing the system.
Speaker:So, that's some of the impact.
Speaker:Also they're now having interest as well.
Speaker:So, I have some of them asking me, I also want to know what you can do,
Speaker:and even speaking to the heads of institutions as well, there are what
Speaker:we call quality improvement committees that look at various aspects of the
Speaker:hospital beyond the clinical area.
Speaker:It could be infection prevention, it could be the pharmacy unit and
Speaker:so on that form these committees.
Speaker:So, we've been speaking to the the head of the institution.
Speaker:To see how we can use some of the principles within implementation
Speaker:research to embed in those particular units as well.
Speaker:Those are some of the ripple effects that I feel are very important on our end.
Speaker:I think the other thing we've noticed, in our low and middle income settings,
Speaker:when we want to apply for grants, I think what we found anecdotal in the past and
Speaker:from what our mentors have really spoken about is we need the PhD certificate or
Speaker:programme to be able to speak, and to be able to have that that setting or that
Speaker:force of nature when we are out there.
Speaker:I think it's something we need to think about in the global health setting, some
Speaker:may not have that certificate as PhD, but they have that expertise and worth.
Speaker:Dr. Kim Ozano: Eunice, what has it meant for you, the capacity
Speaker:strengthening through the PhD and the path that you're looking towards?
Speaker:Dr. Eunice Agyeman Ahmed: As has been said problem solving.
Speaker:Basically implementation science is about closing the gap between what we know or
Speaker:what we already know, what is evidence based and then what has to be done.
Speaker:Having that capacity strengthening in implementation science will
Speaker:help you be able to solve problems.
Speaker:So, you identify a problem in your space of work and then you
Speaker:begin to think, what can I do?
Speaker:Because you most likely know what will work, but what is
Speaker:preventing it from working?
Speaker:So, you begin to pull resources that are available to you to be able to
Speaker:close that gap and solve problems.
Speaker:Dr. Kim Ozano: You've used the term open your eyes a few times.
Speaker:It sounds like it's affected some of the values in your ways of working
Speaker:as well, but balancing a PhD against your other work, how has that been?
Speaker:Dr. Hezekiah Isa Albarka: That is really a good question because the way we are
Speaker:trained as clinicians is like, even though at the specialist level, you are
Speaker:supposed to be involved in some level of research and to be on top of your game,
Speaker:especially if you are in the university system, of course you need to be updating
Speaker:your knowledge and do some research.
Speaker:But doing a PhD programme in the means of clinical practice is tough, because
Speaker:you have the patients to attend to, and then you have the residents to
Speaker:train and medical students to teach, and then the research work itself.
Speaker:My PhD research topic is in a different setting in terms of
Speaker:the study sites and location.
Speaker:My research participants are not the patients I'm dealing with.
Speaker:They're in another setting.
Speaker:Where I collect data is outside the hospital.
Speaker:So, to really balance that in terms of time, it is a big issue.
Speaker:You just have to create the time, prioritise... work outside work hours in
Speaker:the evenings and right into the night.
Speaker:So, it requires a lot of commitment and energy.
Speaker:That it is worthwhile and it's it really fulfilling.
Speaker:Even with these challenges, I think it should be part of the training
Speaker:and the experience that one is expecting to gain from this programme.
Speaker:We see this type of commitment in our mentors, they really work hard.
Speaker:This experience that we are currently undergoing in terms of the time
Speaker:management, in terms of energy and discipline we need, I think it
Speaker:is also part of it because beyond the PhD, we are also hopefully
Speaker:going to step into their shoes.
Speaker:Dr. Kim Ozano: So, it sounds like during your clinical training you weren't fully
Speaker:aware of the importance of research and how it could affect your practice.
Speaker:Do you think that embedding discussions about research and strengthening
Speaker:capacity for research earlier on would've been beneficial or does
Speaker:it have to come at the right time?
Speaker:Dr. Mmamulatelo Siame Mumba: With our programme or postgraduate studies,
Speaker:yes, we do have a research component, but I think there's so much focus
Speaker:on the clinical aspect and there's not so much focus on the research.
Speaker:So, there are two things.
Speaker:So, one thing is the, it's heavily clinical.
Speaker:So, more emphasis is placed on do you know the conditions that you
Speaker:are managing more than your thesis or what research are you doing?
Speaker:Alright.
Speaker:So, over time the institutions have been trying to strengthen that
Speaker:component, but it's been very difficult.
Speaker:So, the second thing, aside from knowing the clinical side is, there's just
Speaker:no manpower there, there are no people to work if you're not going to work.
Speaker:Because our postgraduate studies as clinicians is largely based
Speaker:on practice as you learn.
Speaker:So you are on the ward, you are seeing patients, and you're also reading
Speaker:around the patients you're seeing to gain the expertise that you need as
Speaker:a paediatrician or even my colleagues here as haematologist as well.
Speaker:So, that is where the focus is, but you are practically part of the institution
Speaker:as someone who's working there, meaning if you're not there and you say, oh,
Speaker:let me go and focus on reading, there's no one who's going to see the patient
Speaker:that you're supposed to be seeing to gain the experience that you need.
Speaker:So, there's that vicious cycle that sort of happens, that you have to be there to
Speaker:see the patients, to read on the patients.
Speaker:Then what time do you then have to do the other things?
Speaker:So, I think putting more emphasis would be lovely in terms of the research
Speaker:part and I think we have been working with the University of Zambia, where
Speaker:the most of the postgraduate studies are done, and where I am seated.
Speaker:So, we've been working with institutions to see how much more can we improve this?
Speaker:And one of the things is what we've learned in research...
Speaker:My focus is on participatory design or participatory approach to help
Speaker:healthcare, healthcare workers translate guidelines into practice.
Speaker:So, in my reading around participatory approaches and participatory design,
Speaker:I spoke to the department head and I said, we need to speak to the
Speaker:postgraduate students themselves.
Speaker:How do they want the support that they need for their research, and it came
Speaker:up that they start to learn about the research a bit later on in their years.
Speaker:So, they want it done early.
Speaker:So, I think that was quite interesting as well.
Speaker:Those are the two things that are really hindered that embedding of research
Speaker:early on in the postgraduate studies.
Speaker:Dr. Kim Ozano: It sounds like institutionally you're on the cusp
Speaker:of changing the culture, and that there's a real thirst to bring in
Speaker:the idea of research and research capacity strengthening earlier
Speaker:into the training programme.
Speaker:And also, maybe to carve out some space so that you can do a PhD alongside
Speaker:your clinical work, but then this is challenged by the availability of
Speaker:people to to see patients as well, which is difficult for the institutions
Speaker:and for the individuals as well.
Speaker:So, I think we could talk all day, but we've come to the point in our
Speaker:podcast where we like to ask your one piece of advice for anyone who wants to
Speaker:strengthen their capacity for research.
Speaker:So, what would be your one piece of advice?
Speaker:Eunice, we'll start with you.
Speaker:Dr. Eunice Agyeman Ahmed: Okay.
Speaker:Okay.
Speaker:What I would say is you cannot do without research, let's
Speaker:not put research in a box.
Speaker:Yeah.
Speaker:Where you feel okay, I'll go for it when I need it.
Speaker:It's something that you need in your practice.
Speaker:It has to work hand in hand with your clinical practice and without that,
Speaker:it'll be almost impossible to get the best that you might be looking for.
Speaker:Dr. Kim Ozano: Excellent piece of advice.
Speaker:It's not additional, its core to what you do.
Speaker:Yeah.
Speaker:Wonderful.
Speaker:Dr. Eunice Agyeman Ahmed: Yeah.
Speaker:Dr. Hezekiah Isa Albarka: The emphasis, just like we said earlier,
Speaker:is on training clinicians and specialists for patient's care with
Speaker:just a little research component.
Speaker:Whereas in the university systems, there are well developed systems for research
Speaker:in the PhD programmes, so if there could be some interface between these
Speaker:colleges that are involved in training clinicians at specialist level with the
Speaker:university systems, this will be good so that as one is undergoing clinical
Speaker:training as a specialist, one will also be heavily involved in research work,
Speaker:and at the end of the day, you are coming out with a PhD and also, very good and
Speaker:solid clinical knowledge and skills.
Speaker:Dr. Kim Ozano: I think you've just designed a whole system right there.
Speaker:You can go back and implement that entirely, but I think
Speaker:it's an excellent point.
Speaker:Working across institutions to maximise the capacities and bring those skills
Speaker:together, I think is a great suggestion.
Speaker:Thank you very much.
Speaker:Telo.
Speaker:Take us home with one final piece of advice
Speaker:Dr. Mmamulatelo Siame Mumba: Go big or go home!
Speaker:Nice.
Speaker:So I just tell anyone that I talk to, go for it.
Speaker:Look for the opportunities and everything else will fall into place.
Speaker:And the second thing is find a mentor.
Speaker:I think just find a mentor, someone you can run to and help you.
Speaker:By the way, you can actually have more than one mentor that can take you up
Speaker:in various aspects of your career, your personal development and growth.
Speaker:Dr. Kim Ozano: Look for a mentor and go big or go home.
Speaker:I think that's an excellent way to end our podcast.
Speaker:Thank you for joining us today.
Speaker:It has been an absolute pleasure talking to you.
Speaker:Well, listeners, that's it for this episode and our miniseries on
Speaker:research capacity strengthening.
Speaker:I've certainly learned a lot and I hope you have too, and importantly
Speaker:that these conversations have sparked ideas, reflections, and new ways of
Speaker:thinking that you can apply in your work.
Speaker:But the conversation doesn't stop here.
Speaker:In our upcoming series, we'll be shifting focus to gender justice and backlash,
Speaker:exploring how power, resistance and social norms are shaping not just
Speaker:health systems, but the wider structures that impact our lives from climate and
Speaker:economics to migration and care, because as we keep hearing across all of these
Speaker:episodes, nothing happens in isolation.
Speaker:So, here's your next challenge.
Speaker:In the face of growing gender backlash, how are these forces reshaping your work,
Speaker:your context, your policies, and more importantly, how are you responding?
Speaker:Those episodes are coming soon, so if you haven't already, make sure
Speaker:you like, subscribe, and follow Connecting Citizens to Science on
Speaker:your favourite podcast platform.
Speaker:You won't wanna miss out on what's coming next.
