We recently caught up with OW Dr Mrinalini Dey who spoke to us all about her journey into medical research. Developing an interest in rheumatology, Dr Dey works with patients who have relatively rare diseases and describes it as a real privilege to be able to contribute to their care, as well as research which will hopefully have implications for how we manage these conditions in future.

What inspired you to pursue a career in research? What do you enjoy most about your job and what do you find challenging?

As far back as I can remember, I always wanted to pursue a career in medical research.

After leaving Westholme in 2009, I gained a place at Murray Edwards College, University of Cambridge, to read medicine. The medical degree at Cambridge is six years long, with the third year dedicated to an intercalated Bachelor’s degree, during which I completed a project on the treatment of neuropathic pain. There were plenty of opportunities to get involved with research during both the pre-clinical and clinical years of my degree, and I am grateful to my Director of Studies and many fantastic supervisors at Cambridge who encouraged me to pursue a path in academic medicine.

During medical school, I developed an interest in rheumatology. Rheumatologists care for people with systemic conditions related to dysregulation of the immune system, such as rheumatoid arthritis and lupus. These are long-term conditions which require input from multiple hospital teams- the complex pathology, scope for research, opportunity to work with a diverse range of people, and develop relationships with patients over many years, convinced me to pursue this specialty as a career.

After graduating in 2016, I was keen to move back closer to home, and undertook the two-year Academic Foundation Programme in Lancaster, during which I undertook a dedicated period of research in the rheumatology department, alongside my clinical work in the hospital. I subsequently won an Academic Clinical Fellowship, funded by the National Institute of Health Research, and continued my integrated academic and clinical training in Liverpool. I became a Specialty Registrar in Rheumatology and General Internal Medicine in 2020, which is the period of training before becoming a Consultant. This also, of course, coincided with the COVID-19 pandemic- like so many others, I was forced to rapidly adapt to new ways of working, both as a junior doctor and as a researcher.

I transferred my training to London in 2022, and, in October 2023, commenced a clinical PhD at the Centre for Rheumatic Diseases at King’s College London. I have an interest in social determinants of health, and the wider implications of these in the progression and management of chronic diseases. My PhD focuses on the interaction between socioeconomic factors, comorbidities and outcomes in people with inflammatory arthritis, such as rheumatoid arthritis.

Training to be a medical specialist in the UK is quite long (minimum nine years post-graduation- and I have made it longer by doing a PhD!). However, I absolutely love rheumatology and research, and ultimately wish to have a role in which I can integrate both my clinical and academic work. I work with patients who have relatively rare diseases, which they will usually have for the rest of their lives, and it is a real privilege to be able to contribute to their care, as well as research which will hopefully have implications for how we manage these conditions in future.

How would you describe your Westholme experience? Did you have any favourite subjects/hobbies/clubs?

I look back on my time at Westholme with great fondness, and my time there has certainly shaped me into who I am today. There were ample opportunities to get involved with extra-curricular activities and I was fortunate to have several inspirational teachers, too many to name individually, who encouraged me greatly. It is very difficult to pick a favourite subject! However, although I pursued what would be considered a scientific career, and have wonderful memories of my maths and science classes, I probably most enjoyed the arts, mainly Latin and Music. I thoroughly enjoyed my GCSE Latin classes with Mrs Gardner, whose enthusiasm for her subject was just contagious, and the knowledge became surprisingly useful during anatomy classes at medical school a few years later!

As a keen pianist and violinist, I do recall having some sort of music club or rehearsal almost every lunchtime. During Sixth Form, these were a welcome interruption to my otherwise science and maths-filled timetable! Leading the Senior Orchestra during my last few years at Westholme was a real highlight, especially for events such as Prizegiving. Beyond having the opportunity to play some amazing pieces of music, it instilled a sense of leadership and teamwork which has stayed with me. However, my best orchestral memories are from the annual summer productions, in which I took part throughout my time at the Senior School, including My Fair Lady and Carmen, to name a couple. I cannot mention all of this without thanking Mr Millest for giving me these opportunities. I am also extremely indebted to my parents for taking a great deal of time to drive me to and from endless rehearsals and shows.

While I had to pare back many of my hobbies at university, I continued to be part of an orchestra, and it was a true privilege when they agreed to play an orchestral piece I had composed whilst at school.

Could you tell us a little about what a ‘day in the life’ would look like for you?

I am a Specialist Registrar in Rheumatology and General Internal Medicine, which is the grade of junior doctor prior to becoming a consultant. So, one may be a “junior doctor” for a minimum of nine years when training to be a rheumatologist.

As the rheumatology registrar, I will usually collect the bleep (our hospital communication system) first thing in the morning before heading to outpatient clinic. During this time I may see up to ten patients. Junior doctors rotate through hospitals for each year of their training, so, depending on the size and specialisation of the department/hospital in which I am working, this could either be a general clinic (in which I may see patients with various rheumatological conditions) or specialist clinic, e.g. for patients with lupus or early stages of rheumatoid arthritis.

I will usually discuss my cases with a consultant and then try and get a short break for lunch, although, this can often be difficult! I will usually receive referrals from other hospital teams or GPs via my bleep and will spend the afternoon assessing these patients, as well as finishing admin and tasks from the morning clinic. On most days, there are also meetings with other teams, such as radiology, or to discuss prescribing immunosuppressive medication for patients with more advanced diseases.

My training is combined with general internal medicine. The number of days on which I do this varies from hospital to hospital and year to year, and looks very different to my days on rheumatology. As the medical registrar oncall, I am responsible for leading the team who will be seeing medical patients in A&E and on the acute medical unit, seeing unwell patients on the ward, and the cardiac arrest team.

What are your plans for the future? Have you got any projects you are looking forward to beginning, or an area of research you would be interested in pursuing?

I am currently pursuing a PhD looking at social determinants of health and comorbidities in people with inflammatory arthritis. I am focusing on many socioeconomic factors, including health literacy, in which relatively few studies have been done. I was recently awarded a prize from King’s College London at the prestigious Policy Idol competition, for my pitch on a health literacy policy to help people with chronic diseases- the full pitch can be viewed here (including a brief shout-out to Lancashire!).

In addition to my academic work, I am heavily involved in the work of the European Alliance of the Associations of Rheumatology (EULAR). Until recently, I was the co-lead for social media for the young rheumatologists’ network (EMEUNET- the Emerging EULAR Network). Currently, I am the EMEUNET representative to EULAR Patients with Arthritis and Rheumatism in Europe (PARE)- as the sole doctor on the committee, this is a great learning experience as well as being very humbling. I am also involved in advocacy work for EULAR, which closely relates to my PhD, as well as guideline groups.

I have been very fortunate to be able to travel extensively throughout my training, including to Europe and the USA, presenting my research in various forums and conferences, and contribute to meetings on policy and practice. I look forward to strengthening these collaborations and networks. Ultimately, I aim to become an academic rheumatologist, doing both clinical work and research.

Any advice for current students here at Westholme?

Seize every opportunity and don’t be afraid to be yourself! It will pay off in the future. It can seem tempting to try to blend in, but, through trying new things, stepping out of your comfort zone and standing out from the crowd, you will grow and gain skills and experiences which will remain with you for life.

While there are too many experiences to share from my time at Westholme, I would like to highlight just one example- during my Upper Sixth Year, I noticed a small announcement that had been pinned discreetly to the noticeboard. It was advertising for applications to the Fulbright Commission Summer Institute for European Student Leaders. The Fulbright Commission facilitates academic exchanges, for all disciplines, between the USA and the rest of the world. I took a chance and applied- and a few months later, I found myself on an all-expenses paid five-week academic and cultural exchange in Philadelphia, along with twenty-three other students from Europe.  This experience subsequently opened up many doors, and recently, I was interviewed by the Fulbright Women’s Affinity Group. You can watch the full interview, which includes much more about my current work, here