Dr Clara Faria Welcome to the In Conversation Podcast series for the Association for Child and Adolescent Mental Health, or ACAMH for short. I’m Clara Faria, an ACAMH Young Person Ambassador. In today’s episode, I have the pleasure to talk to Emelia Pasternak-Albert from King’s College London. Emelia is a medical student at King’s and an aspiring Clinical Academic Child and Adolescent Psychiatrist. She completed an MPhil in the Department of Psychiatry in the University of Cambridge, looking at “Teacher Perceptions of Difficult Interactions with ADHD Pupils.” Emelia also won the 2024 ACAMH Clinical Trainee of the Year Award. Today, we will be discussing her research journey, her future aspirations and how to maximise research opportunities as a medical student. If you’re a fan of our In Conversation series, please subscribe on your preferred streaming platform, let us know how we did, with a rating or review, and share with your friends and colleagues. Welcome, Emelia, and thank you so much for being here today. Could you start with a brief introduction to our audience, explaining a bit of how you became interested in child and adolescent psychiatry? Emelia Pasternak-Albert Thank you, Clara, and it’s such an honour and a pleasure to get invited to come on the podcast and to get to talk about this. I’m also very grateful for the Clinical Trainee of the Year Award, that was such a highlight for me. So, in terms of how I became interested in child and adolescent psychiatry, it really started at school for me. There were a few things that were going on at the same time. I was involved in a peer mentoring scheme – 17 at the time, and I was mentoring pupils that just came into the school who were about 12 years old, and at the same time, I was diagnosed with ADHD. So, it was quite a late diagnosis. And so I was figuring that out for myself, and also finding that I was really getting stuck in with learning how to help other young people And, also, in terms of the academic sense, I had an independent research project as part of my school leaver assessments, and for this, I chose to do it in my psychology class. We were studying abnormal psychology, and it was in quite a niche field. It was on depersonalisation and derealisation, which are, sort of, aspects and experiences that can be part of anxiety, and for other people, it can be a more pervasive problem. But the sense of feeling unreal in your own body, can be out of body type experiences, and/or experiences that the environment is not feeling right or real, that things might be different shapes or sizes, further or closer. Just, sort of, strange experiences about the sense of self and the sense of the environment. And so all of these things were going on at the same time, and I remember at that time I didn’t even have access to journals. So, it was a really difficult thing, as a school student, trying to get access to academic research and papers and all the books, and that kind of thing, going to the library, but it was the first time that I felt myself really directing myself in what projects I wanted to do. So, I did some youth mental health first aid training. That was an amazing experience for me, I did it when I was 17, it was alongside Headteachers, Designated Safeguarding Leads. Even my old Teacher from my primary school when I was 10 years old was there. So, I was still in full-time education at school, and I was alongside these real professionals, getting a sense of the awareness of these different conditions and different challenges that there can be for young people for the first time, and how you might approach that in a more professional context, rather than an experiential context. As a young person who was also figuring out what it meant to have ADHD as a young woman, in a way that I had not really experienced before with stereotypes. At that time, I was a teenager and I saw it as, you know, stereotypically being a young boy who couldn’t sit still, would get up and walk around in the cla – that was the only presentation of ADHD that I knew. So, learning about that in a more professional context, doing all of this research on experiences and things that I’d taken from my psychology course and wanted to read up more about, and then helping other children, really all came together, and I decided that I wanted to learn more. And so, I shadowed in a neurodevelopmental outpatient clinic, and I just absolutely loved the approach that there was in child and adolescent psychiatry to seeing the young person, all of them, and being able to help, sort of, with those experiences really early on, prevent them potentially from becoming larger problems, really interested me. I think, interestingly has ended up becoming part of the work that I did with the MPhil. Dr Clara Faria It’s so fascinating that from such an early age you were already involved with mental health initiatives, such as Young Minds, and Emelia just completed an MPhil degree in Cambridge, so huge congratulations, by the way. And as you know, we just started an Early Career Branch here at ACAMH, and I wanted to ask you, how did you find out about that opportunity? And if you could tell us a little bit more, especially to our medical students in the audience, about how to identify potential Supervisors and how to make a competitive application. Emelia Pasternak-Albert Absolutely. Ended up applying to medical school, knowing that I really wanted to pursue psychiatry and having this interest in child and adolescent psychiatry. And when you apply to medical school, I learnt about this opportunity to intercalate. So, for me, completing the MPhil meant taking a year out of medical school. I wanted to get ahead and I was really interested in learning about opportunities to intercalate in psychiatry. To be honest, I Googled it. I wasn’t sure what was out there. I knew that, for example, that at King’s College London have had amazing experiences, at my home medical school, with psychiatry teaching, but I think I had a specific interest in making sure that I could maximise my time to learn more specifically about child and adolescent psychiatry. And I found the course, I also found some amazing blog posts by Jessica O’Logbon, a graduated medical student, now a Medical Doctor, from King’s College London, who at the time, was a couple of years my senior in medical school, and was able to share more about her experiences of applying. What the day-to-day schedule was actually like, because I found myself completing this MPhil, because we didn’t – you are not registered on modules with lectures and seminars and tutorials, it’s an entirely research-based year. Which is great, because you get to really integrate yourself into the team, you get to lead your own project and really take ownership of it and learn that methodology of how to complete a project, with the help, of course, of your Supervisors. And you really get stuck in with your field and get the time to really read up a lot on it, and learn a lot, about both methodology and your specific field of interest. So, for me, getting to read about what the course would be like, and to learn that it was one of the only courses that I could find where I could do a whole research-based year, specifically in child and adolescent psychiatry, and specifically, I think that point about the Supervisor is really important. I was quite lucky that at the time, I was one of the Royal College of Psychiatrists’ Psych Stars, which is a scholarship and mentorship scheme that they offer to medical students for a year, and I was specifically working with the Child and Adolescent Faculty. And because of this, I was funded to attend conferences, and I was very fortunate to get to our Head of Department, Professor Tamsin Ford, as a keynote speaker at some of those conferences, and learn a bit more about what the department, and specifically the ChARM team, the Child and Adolescent Resilience in Mental Health Team, in our department was doing. At the same time, Professor Ford is an amazing Epidemiologist, and I knew that my skillset lied more in qualitative research, but as I was reading more about what was going on in the team and in the department, I became acquainted with some of the work of the people who became my Supervisors, eventually, Dr Anne-Marie Burn and Dr Jo Anderson, who were absolutely lovely. And I reached out to them, in the context of the experiences I’d had, my interest in the specific fields that they were working in, in school-based mental health, having read some of the work, including where we aligned on methodology, in qualitative work, interviews and surveys with free text input, as well. And it seemed that we aligned, both on that specific field, and also the methodology that I wish to upskill in, and also in the context of my goals to become a Child and Adolescent Psychiatrist with an academic component in the future. So, I’d say that in terms of the Supervisors and the application, it’s really about trying to identify who has expertise in what you want to learn, how are you going to maximise that opportunity for yourself, and how that fits into the context of what has driven you, what has interested you so far, and what it is that you want to do in the future. There are lots of amazing resources I found out there online, including I think in the context of our MPhil, with it being so research-based, some of them were for PhD applications. And I found that they were also really applicable to us, in terms of learning how to justify an – a rationale for your research, and also, as you’ll come to find, with things like funding, sort of, justifying your projects and how it contributes to that field and it sits within. Those were the most difficult things, especially with medical school. We don’t do many essays, and we don’t have that same research training in the way that if you did, say, a bachelor’s in psychology, and if you did an undergraduate dissertation you might have a lot of experience in that style of writing. So, I’d say that was the hardest part in the learning curve in that process. But I think that once you identify a good relationship with a potential Supervisor, and you can have an open discussion about what you need from them in terms of what you need to learn about that process, I find that really helps. ‘Cause I could come to them saying, “I’ve done placement in this, I have more clinical experience,” but in terms of the academic side and the research, that’s really what I needed, sort of, to get up to speed with, compared to our peers. Because we were lucky, we have peers from so many different disciplines and backgrounds working in mental health in this area, on the research side. Dr Clara Faria I’m sure that is going to help a lot. Thank you so much for sharing so many good insights with our audience. And you mentioned in your answer ‘Psyche Fellow’. I know that beside Psyche Fellow, you also took part in several other initiatives in child and adolescent mental health, and I wanted to ask you, out of all of these experiences, which one you found most useful to support your development in the area, and I know you’ve done several projects, as well, so feel free if you want to talk about more than one. Emelia Pasternak-Albert I’ve had a variety of experiences, and I was having a think about what might be the most unique or interesting to hear about for an audience. And I think that my work, I’m on the National Young People’s Advisory Group for the Centre for Mental Health, on quite a large multisite study, and that’s from the lived experience side, rather than the Investigator side, and this was something that I started working on in my second year of medical school, so about three years ago. And it’s been really eye opening to have that experience from the young person side, learning more about co-production and lived experience, from the PPI side, the patient and public involvement side. It was during a time where I was doing a module on psychiatry at the same time, and I was doing some co-produced work for my assessment, which I found really pivotal for learning about how important it is, specifically in psychiatry, and when working with young people, to understand their experience. But it’s also been a really interesting experience for me, because we have expanded our conceptualisation of what a young person is, to go up to the age of 25, it’s considered most widely. But that puts people like me in quite an interesting position, in that I have a lot of lived experience of mental health services, with my ADHD, for example, and we did some policy work with Luciana Berger’s Mental Health Strategic Review as part of this advisory group, really helping them with the strategy that they took to their manifesto and have now been elected, which was a completely new and unique experience for me. It’s been really interesting sitting both in – on my clinical placements, where I’m privy to discussions in a professional context, sort of – it’s, kind of, built on that experience that I had the first time I did some of those more formal courses and seeing how professionals approach mental health and young people and their experiences. Whilst also having the experience myself and still being considered a young person myself. So, that was some of the most unique and interesting and, I think, pivotal experiences for me. Dr Clara Faria Yeah, I think it’s really interesting to see how, like, you took that experience, as a lived experience member, and, like, this major project that influenced policy. And I know in your MPhil you did lots of interviews with Teachers to assess their perceptions on their relationship with pupils with ADHD, and how you used – harnessed those skills to make the interviews even better. And I think it’s fascinating how you made the most out of so many good opportunities. And, on that note, I would like to ask you if you would have – would you have any advice for current medical students who want to get their first research experience in psychiatry, and any particular advice on how to make the most out of these opportunities, as well, ‘cause it’s something you’ve done fantastically well? Emelia Pasternak-Albert From a personal plug standpoint, I’m one of the steering group members for SPARC, which is the Student Psychiatry Audit and Research Collaborative, and it’s affiliated with the Royal College of Psychiatrists. So, whilst that’s quite a UK focus, initiatives like that, which are partly student run – so, the steering group will have a student side and then a Clinician side, as well. And it really creates an interface between current Psychiatrists, as well as our Junior Clinical Advisors, who may be Foundation Doctors, or in other stages of training. And that has been a really useful experience for me, in learning how much we can do. We’ve been able to get over 35 medical schools involved with our current project, which is so exciting, and it really involves having a champion or a good mentor, and I find that with a lot of these projects, it is something that has snowballed. My earlier experiences in medical school, sometimes I would get discouraged with feeling like – it was so reliant on having a good mentor, and unfortunately, I feel like sometimes, it will really depend. Like, for example, some of my earlier experiences at King’s is because they have amazing schemes, such as undergraduate research fellowships over the summer. And that was my first time being on a project that has now gone through to be presented at conferences, and has been submitted for publication, which was a really big learning curve for me. Equally, I know a lot of people who this has been more ad hoc, based on experiences they’ve had on placement, for example, finding a mentor or Supervisor through that. And so, it really will depend on organisations like this. I think that what ACAMH is doing in terms of your Early Career Branch is a really great first step to making that more universal across different types of clinical trainee, for example. I have managed to create a really good relationship with the Royal College of Psychiatrists, but of course, that is most useful for medical students who are considering a career in psychiatry. And more broadly, I think that organisations such as yourselves can really help to make this more universal across different disciplines. Because that has been my experience both throughout MPhil and on placement, that some of the best, sort of, sparks of research has come out of people with different perspectives. And I think when you’re earlier in your career, you don’t always have the experience to see what might be the most innovative project, but you have the ability to see from a more broad perspective because you are early in your career. And so, that’s what I found with my projects, over time. It really started in medical school with that one module, where we learnt about so many different things, and my project from that, the co-produced one, it ended up being on addiction psychiatry, and it was co-produced with a young person who had experience of inpatient addiction psychiatry services, which is quite rare in the UK. But the reason that we were able to do that is because we explored her experiences of those services in a really vulnerable way, that is quite difficult for a young person at times, especially in a setting like this, with a podcast. It can be quite overwhelming if you don’t have any experience of it. We were able to do it because we used a medium of theatrical analysis. So, the young person was a really creative person and had a lot of experience with theatre and writing, and so, we used analysing a play as, sort of, a proxy, with a main character that had some similarities in experience of addictive psychiatry. So, the play, it was “People, Places and Things,” by Duncan MacMillan, and by doing that, we were able to overcome this barrier of, for me, feeling like I had this authority in the role as the Researcher, and that kind of thing, and for her, it was this absolute overwhelm of talking to someone who seemed a really professional, with, like, the Researcher or the medical student title. And that just came about because we both had experiences of theatre growing up. And so, I’d say also using your strengths. If you have strengths in other areas, that may not have been related to research in the past, that’s another strength I think that you have early in your career. Because you can learn about the conventions of research, but you also are still very adaptable and malleable to the experiences that you’ve had before. And so, I think not seeing that as a weakness, but seeing it as a strength and something that you can bring to a team, is something that I’ve found really valuable. That I can learn a lot from very experienced academics who are way more experienced and specialists in methodologies and fields of research that I’m just beginning to learn about, but I can also bring what makes me, me into that team. And you’ll be surprised what you can add in the academic sphere based on transferable things. Dr Clara Faria That’s great advice, Emelia, and yeah, I think some initiatives you mentioned, like, SPARC, are great opportunities for medical students who – you mentioned King’s, and I know you and other King’s medical students have access to so many cool research opportunities. And I know that it might not be the case on your medical school, but there are some really amazing national initiatives, like the one Emelia just mentioned, SPARC, that can help you get started on your first research project. Oh my God, I agree with you so much on the importance of the Supervisor, because I think you said, like, it ultimately depends on the Supervisor sometimes if a project goes forward or not. And I think especially if it’s the first research experience done, that can be frustrating. Definitely, it’s important to persevere. But on the topic of challenging and frustrating experiences, I wanted to ask you, what do you think has been your greatest academic or medical school challenge so far? Are there any honourable failures you feel were important in your career development so far and that you would like to share? Emelia Pasternak-Albert I think a great point from this is to not give up, to keep trying and to know that it is really normal to have lots of rejection and failure early in your career. And I think it’s brilliant that we’re able to celebrate so many successes, but I feel like I wouldn’t be my authentic self without also mentioning some rejections and failures. Something that was told to me a lot when I was first dealing with rejections is this idea of “rejection is redirection.” I think at the time that can sometimes feel really frustrating, especially if it’s something that you’ve really wanted. But I think I have a really good example of this. I’ve always known that I’ve been interested in child and adolescent psychiatry, which is quite a sub-specialist clinical interest, but I’ve been quite intrigued about what that can mean for a more portfolio career, which is something that is becoming increasingly popular. And what that would mean for different things, such as, research, but also education, leadership, in terms of my different projects. And at the time I was becoming really interested in medical journalism and how we can communicate these things about child and adolescent mental health to a wider audience and through media to the public. So, being on a podcast is definitely something that I find really interesting at the same time, and I think you’re doing amazing work here. So, in my third year, I applied to – the British Medical Journal had what’s called the ‘Clegg Scholarship’, which is a really amazing scholarship that they run every year for medical students. And it’s a funded scholarship where you get to go into the BMJ offices, you get to record podcasts like this and write articles, as well. And they offer this to medical students as an opportunity to see how you could get involved with, I guess, partly scientific communication, and also just media and journalism, but with the medical context in, as well. And I remember I applied for it, I even got an interview. It was a very competitive process, and ultimately, I didn’t get that scholarship. And at the time I was devastated because I thought it was the coolest thing, and I really wanted to share more, but I had this specific interest in it relating to mental health and psychiatry. Later that summer, I had applied to be the Medical Student Representative at the Royal College of Psychiatrists in the Psychiatric Trainees Committee, the PTC, and that was a two-year term position, and ultimately, I did get that role. And what I didn’t fully appreciate at the time was part of that role is to be one of two Editors of the FuturePsych magazine, which is the magazine that the Royal College of Psychiatrists publishes for medical students and Foundation Doctors. And that was really exciting, because I ended up getting to have that role as Editor of a magazine, but also combine it with my love of psychiatry and mental health. And being able to publish pieces and articles that were relating to mental health, and how medical students reflected on their placements, different projects that people did, and, like, opinion pieces, as well, as well as research. And be able to communicate that in a different way to, say, a journal article, because it is absolutely not like a scientific journal. The pieces are four to 600 words, and it’s a completely different style of writing. You have to adapt the way that you edit to that, as well. But it’s been a really great experience, this magazine. So, it took a long time to get to this point, and I’m thinking about two years ago when I applied for that scholarship and I had to write a sample piece for that and, sort of, thinking about how that rejection felt. And I know that in academia, it’s often to do with funding. I narrowly missed out on a fully funded scholarship for the MPhil, which required a lot of time dedicated to writing that application and preparing for interviews and everything. And so, I think that it’s so important to talk about failure and rejection in early career, because it’s often not as publicly talked about that we all face these rejections. Dr Clara Faria Thank you so much for sharing that story, and you framed it really well. Sometimes other opportunities come and we don’t appreciate that if the one we wanted first had worked out, maybe then this later thing wouldn’t have happened later on. Like, there’s a, kind of, a cascade effect, and we never know how things could have gone. Other congrats are also in order, because Emelia won the 2024 Clinical Trainee of the Year. It’s clear that you’ve done an impressive number of very exciting things this year, and also, in the past few years, as well, and I wanted to ask you, what are you most excited to do in this next stage? Emelia Pasternak-Albert Thank you, Clara, and it’s very exciting, because I am back at medical school, and I’m currently on a child and adolescent psychiatry clinical placement. I’m at the Bethlem Adolescent Unit, at the Royal Bethlem Hospital, as part of the South London and Maudsley NHS Trust. Which is a really full circle moment for me, because I actually went on a school trip to The Bethlem when I was 17, going back to the first question. So, getting to go back there, but as a medical student, and being part of the team, has been an amazing experience. And I’ve also been very fortunate to arrange some additional placements, as well. I was with the Maudsley Centre for Child and Adolescent Eating Disorders the other day, which was super insightful, and I’m learning so much more, and it’s really helping me to learn more about where I would want to go next. So, in terms of projects, right now, the main one for me that is coming up is there is an International Child Psychiatry Mentoring Network that is really coming through, that I have been working tangentially with that project for a long time, about potentially bringing it to King’s. And so that’s really exciting, and that I’m working on at the moment. It’s really exciting, it’s connecting – in a similar way to the Early Career Branch, it’s connecting medical students specifically who are interested in this, what is considered to be a very niche subspeciality for our stage of training elsewhere, in child and adolescent psychiatry. Lectures and projects and collaborations, so it’s really exciting. What I’m most excited about is I’m in my penultimate years of medical school now, which means I’m soon coming to my final year, which is very exciting because that is when we have our electives. So, we have two months, and a “career development period” is what it’s called at King’s, as well, so in total about three months, of time at the end of medical school which we get to dedicate to whatever we want to do. And so, for me, it was definitely going to be in child and adolescent psychiatry and the question now is, where specifically will it be? Will it be in the UK, will it be further afield, or a combination? And how much of it will be academic and research-based, how much will be clinical, or something completely different, as we’ve highlighted today? I think, for me, the best part of my experiences over the past year is getting to see so many enthusiastic and bright and brilliant people who are at a similar stage of career to myself, and so, it’s been great to talk to you today about it and to learn more about ACAMH and the Early Career Branch. It’s really exciting. Dr Clara Faria Thank you so much, Emelia, for sharing your research and so many fantastic insights with our audience today, and about your elective in King’s. Well, I’m sure that wherever you go, you’re going to do a fantastic and a brilliant job. It’s really good, and also really refreshing, to see someone like you that is so engaged with child and adolescent psychiatry. If you want to know more about Emelia’s work, visit ACAMH website, it’s www.acamh.org. ACAMH is spelt A-C-A-M-H.