Interview with Salma Chaudhury, Early Careers Research Fellow

ORUK wants to see more women involved in orthopaedic research. This International Women’s Day, we are therefore spotlighting a recent recipient of one of our Early Careers Research Fellowships, Salma Chaudhury. The Clinical Lecturer in Trauma & Orthopaedics at the University of Oxford is using MRI techniques to research the relationship between shoulder dislocations and early arthritis.

Please could you summarise the goals of your MRI fingerprinting research?

This study can help address clinical uncertainty about whether shoulder dislocations cause damage resulting in cartilage changes predictive of arthritis. This is important to understand as it typically occurs in younger patients who are more likely to get early arthritis. It usually presents when it is irreversible and hard to treat.

We aim to use new quantitative MRI techniques, “MRI fingerprinting,” to help patients and doctors know if:

1. Shoulder dislocations result in progressive glenohumeral joint collagen matrix changes that predict early chondral degradation (arthritis).
2. Surgery or physiotherapy can prevent arthritis from developing or slow its progression.

We hope to identify which specific patients sustained enough cartilage damage predictive of arthritis who may benefit from earlier treatment, and to monitor treatment effectiveness.

If our study shows dislocations don’t cause early arthritis it will suggest that fewer patients should have surgery, which means fewer surgical complications and lower costs. However, if we show that surgery does stop arthritis, maybe we should operate earlier to prevent disability and associated costs. If our MRI scanning techniques detect arthritis earlier it will help us judge if treatments such as surgery, physiotherapy or new drugs can help prevent or slow down arthritis in shoulders, hips, and knees.

What has been the impact of the ORUK Early Career Research Fellowship on your research?

The Early Career Research Fellowship has had a huge impact on my research in many ways. It has facilitated a really important study which we may have struggled to fund otherwise. It has allowed me to build up important collaborations with Cambridge University and non-medical researchers such as physicists and big data analysts. This is the first opportunity I have had to lead a study as the principal investigator. The grant has provided me with important protected research time, which is increasingly difficult to obtain in busy clinical jobs.

This fellowship will act as an important building block for collecting preliminary data that will support future studies, and improving my research standing with high impact publications and conference presentations. The results and successful completion of this study should support larger grant applications.

I am grateful for the working relationship with ORUK, and the subsequent opportunities to support them with some of their important other endeavours, such as teaching.

What or who are the main inspirations in your career?

My inspirations and the people who I admired or who influenced me have changed as my career has progressed. As I trained, I didn’t know anyone who matched my demographics and background but that never mattered to me as I came across many impressive colleagues.

My greatest initial inspiration was Professor Andrew Carr, an academic shoulder and elbow surgeon from Oxford, who led the musculoskeletal research unit. He displayed a mix of personal, surgical and academic skills that I really admired.

At different points in my career, I have been hugely fortunate to receive support, praise and encouragement from a number of inspiring orthopaedic surgeons, all of whom have been white males.

In the latter part of my career, I have had the pleasure of working with Professor Deborah Eastwood, who is the President of the British Orthopaedic Association. She leads by being herself – with a very warm, inclusive and yet firm style.

Which developments in arthritis or T&O research and treatment are you most excited about?

I think that the most exciting areas in arthritis research are related to two key areas; firstly, the early detection of preclinical arthritis, either through imaging or biomarkers. This will allow effective evaluation of the efficacy of interventions and treatments to slow progression or prevent arthritis.

The second is the development of biological treatments for arthritis. An exciting example is drugs classified as DMOADS: Disease Modifying Osteoarthritis Drugs, with some having reached phase 2 and phase 3 clinical trials. It is hoped that similar to disease modifying drugs for rheumatoid arthritis, DMOADs will help to modulate clinical disease progression.

Do you have any words of advice for other women who currently work in, or aspire to work in orthopaedics?

1. Orthopaedics is a fun and really rewarding career.
2. If you want to do it, don’t let anything or anyone stop you.
3. Orthopaedics is changing. There are more women doing orthopaedics, and women account for 25% of new female consultants appointed over the past 1 year.
4. Some of the typical stereotypes about orthopaedics are changing and becoming outdated. The British Orthopaedic Association has data that shows that the demographics of orthopaedic surgeons is changing significantly, representing a more diverse group of gender, ethnicities, socio-economic groups, training paths, sexual orientations, and disabilities.
5. You can juggle an orthopaedic career with being a mother, an academic, working less than full time, disabilities etc. It might just be a little bit more challenging.
6. Look for a support network of senior mentors, and peer support groups, of both genders.
7. There are additional challenges to being a female in orthopaedics, but hopefully important steps are being taken to lower these barriers for future generations.