Hello Professor Pirmohamed, and welcome to Pharmacologist in Phrame!
What is your background and career pathway to date?
At the age of 12, I was essentially inspired to study medicine by watching television series such as Horizon. After my medical training at the University of Liverpool, while working in the A&E department I was exposed to various medical cases and became interested in how medicines work, and how we can develop novel drugs. Since I wanted to pursue a career in clinical pharmacology, I undertook a Medical Research Council-funded PhD in Pharmacology. I started working as a consultant physician at the Royal Liverpool University Hospital in 1996 and as a clinical senior lecturer at the University of Liverpool. In 2001, I became a Professor of Clinical Pharmacology and subsequently became the NHS Chair of Pharmacogenetics in 2007. I am the Director of the MRC Centre for Drug Safety Sciences, and Director of the Wolfson Centre for Personalised Medicine. I am also an inaugural NIHR Senior Investigator, Fellow of the Academy of Medical Sciences in the UK, and a Commissioner on Human Medicines. I was awarded a Knights Bachelor in the Queen's Birthday Honours in 2015.
What research are you currently working on?
My research focuses on personalised medicine, clinical pharmacology and drug safety.
How do you balance your time as both a clinician and researcher?
During my time as a lecturer and senior lecturer, I shared my time equally on clinical work and research, as well as teaching. As I grew into a more senior role, I was able to reduce my clinical work to 20% to be able to concentrate on research, teaching and my other current roles. It is important to balance one’s time according to what is required if you want to succeed. It is also a personal choice in how you want to develop your career.
How would you choose a mentor and what are on your thoughts on mentorship?
Having a mentor at each stage of my career was very important, especially if you want to pursue a career in research. My mentors were able to provide me with important advice in an unbiased way at different stages of my career. Nowadays, mentorship is more organised as several mentorship programmes are available through various organisations, including the universities and Academy of Medical Science. Sometimes, you may be lucky enough to find a mentor that you can actually rely on throughout your career – I was lucky enough to do that! I was mentored by Professor Sir Alasdair Breckenridge from the start of my career. I relied on his thoughts, support and advice even when I became a professor. He was someone I can turn to and say ‘Actually, I have been asked to do this, what do you think about this?’
What do you like and dislike about your current position?
I do something different every day, which is what I like and it keeps my brain active and interested. ‘I would hate to do the same thing every day’. I like seeing my patients, enjoy doing my own research, being involved in the society and other national activities. Unfortunately, there is not enough time to do all that at the same time, which is a disadvantage. I like most of the things that I actually do, which makes it hard to think of anything that I don’t like. I would perhaps like less bureaucracy. Although it is important to have a regulatory framework to protect patients and data and other aspects of research, it is important that any regulation and bureaucracy is proportionate.
[Note added after interview: the COVID-19 pandemic has clearly shown how we can work much faster in research and with less bureaucracy, and I hope this is carried forward as we overcome this pandemic. We have many other diseases that we need to tackle!]
What are you looking forward to in terms of research?
It is an exciting time for research and I anticipate that the power of genomic revolution will transform how we work and what we do in terms of finding novel drugs and target validation right through to patients’ treatment. It will also affect training and education of everybody involved in research and healthcare. Of course, ‘big data’ is also very important where I think pharmacology can make a big contribution. This is a topic that Professor Chris Holmes touched on at Pharmacology 2019. The questions that arise in relation to my work are as follows:
- How do we use big data in electronic health records, big data in genomes and big data with other omics technologies to improve treatments?
- How do we integrate all data to facilitate systems approaches?
- How do we go beyond focussing on a single targets (e.g. a single marker/pathway), which is common at the moment, but instead bring together different markers from different disciplines?
- How can this be implemented and does it help us move forward?
- The cell in any organism is complex and we are complex organisms. Whilst studying a single molecule provides important information in a particular pathway, we need to embrace complexity to develop novel ways of curing diseases and improve patients’ quality of life and outcomes.
What are your views on experimental models in pre-clinical studies?
There are a range of models one can utilise for experiments. For example, for particular genomic variants, I have used models ranging from C. elegans to mouse. Whatever is used, I think it is important that we embrace the 3Rs and ARRIVE guidelines. However, as we move forward, we also need to improve our in vitro models, especially the use of the complex organoid models which will allows us to explore complex multicellular effects of drugs and ultimately will lead to better understanding of the pathogenesis of diseases. Given my clinical background, I think the ultimate model to show that a drug works or cause adverse effects, hence why much of the work that I undertake is clinically based. Whilst some my work starts in vitro and subsequently progresses through into in vivo models using C-elegans and/or rodents, I always aim to undertake the final studies in humans.
Why do you think a lot of drug clinical trials fail?
There are many reasons for failure of drugs including unsuitable kinetics, and efficacy and safety issues. The attrition rate for the development of new drugs continues to be high and this is not a good business model. Novel approaches, for example, using genetic data to identify drug targets has been very encouraging in improving success rates. Verifying and understanding the drug target together with the use of novel technologies, as highlighted at Pharmacology 2019 remains very important.
What has been your most important scientific finding to date?
There are a couple of findings. We have identified the burden of drug safety issues for our healthcare system through epidemiological studies. The information from such studies has led to improving patients’ and healthcare workers’ education in drug safety, and led to curriculum changes for doctors, nurses and pharmacists. These findings have also had a wide-ranging impact on drug regulation. We have also been prominent in identifying novel genetic predisposing factors for a number of serious adverse drug reactions, some of which have been implemented.
What do you enjoy doing outside of work?
I don’t have much time outside of work as I should, but I do enjoy football. I have supported Arsenal since I was 10 years old. I also like cars, particularly fast cars, but unfortunately cannot afford them.
Why is public engagement important in our field?
Public engagement is important in everything we do in science because, in the end we are doing this for patients and the public. Improvement in knowledge will hopefully lead to new discoveries. Thus, the public needs to be able to understand what we do and why it is important; support from the public is crucial throughout the experimental process because it makes our work more relevant, and in the end will also lead to more science funding. It is important for both the scientists and members of the public to engage with each other, so that the scientists can understand what is important to people’s everyday lives. In my research, we have developed patient panels which advise us on the areas of drug safety they find important, they help us with patient recruitment and with dissemination of our work.
What advice will you give to a young person interested in studying pharmacology?
It is a very interesting area and thus I would certainly encourage them to work in this research space. It is important for them to identify which area they are interested in, so that they can gain more experience, for example laboratory experience. If they are interested in pursuing a PhD in Pharmacology, it is important to identify a good laboratory, devise a strong and testable hypothesis, find a good supervisor and publish your research as extensively as you can. It is also important to identify a mentor. Remember, most scientists are keen and happy to be contacted by the younger generation, especially to talk about career pathways. In my laboratory, we hold work experience placements for GCSE and A-level students.
What are your top tips for networking in this field?
In pharmacology and medicine, make sure you present your work as much as you can, and interact with your peers both nationally and internationally through conferences. Networks are very important in building leadership – organising a symposium through British Pharmacological Society meetings, for example, allows you to network with scientist from different disciplines which can transform your thinking. Interdisciplinary interactions can also be very rewarding (e.g. in a recent meeting I was attending, I sat next to engineer and we started talking, which has led to a new collaboration and a new avenue of research).
Looking forward to your new role as President of the British Pharmacological Society, what do you anticipate happening in the new few years?
Many things are happening in the Society and I am very excited to be representing the organisation. We need to grow the society by encouraging new members to join and become involved in the Society – the role of ambassadors therefore is very important. We also need to (1) look after our current members to make sure we fulfil what the membership wants, (2) organise high quality meetings by attracting internationally renowned speakers, (3) develop our international presence, (4) make sure there is collaborative atmosphere where both basic scientists and clinicians work seamlessly together and (5) increase visibility of both pharmacology and BPS, so that we can show why pharmacology is important at all levels.
How would you like to be remembered?
As a clinical pharmacologist who did his best!
Rapid-fire round with Munir
- Favourite book? To Kill a Mockingbird
- Favourite movie? Deer Hunter
- Favourite Scientist? Professor Francis Crick
- Sweet or savoury? Sweet
- Tea or Coffee? Tea
- Night in or night out? Night in
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