Hilary Edgcombe
Consultant Anaesthetist
Nuffield Department of Clinical Neurosciences
Tell us a bit About your role
I am fascinated by training and interactions between anaesthetists of different cadres and backgrounds. I direct a unique international course in Uganda (faculty combined from Africa and the UK) which equips anaesthetists from the high-income world to work effectively in supporting safe anaesthesia in low-income settings. I’m privileged to supervise some incredibly motivated and proficient ‘global anaesthesia’ fellows in their research, and am working on a project developing concepts of networking among anaesthesia providers in low-resource settings.
I am the clinical lead for the LIFE project (Life-saving Instruction for Emergencies) which aims to develop and evaluate novel training tools using mobile technology for remote areas. Of course anaesthesia is closely linked with surgery and I’m therefore also an active and founding member of the Oxford Global Surgery Group, linking surgeons, obstetricians, anaesthetists, health systems specialists, ethicists and more in working for safer surgery worldwide.
My somewhat eclectic professional life has evolved through a combination of informal and formal routes, including standard clinical training during which I took opportunities to travel and engage in short-term projects in sub-Saharan Africa, mentorship by an inspiring clinical colleague, the opportunity to complete an MSc in Global Health and Global Surgery at King’s College London alongside my clinical commitments in Oxford, role modelling and encouragement from senior academics within and outside the MSD and the continuing motivation of speaking with anaesthesia providers who live and work in far more challenging environments than Oxford.
‘Global anaesthesia’ is a nascent field, but carries great potential to improve the safety and quality of surgical care, critical care, pain management and maternal health for millions in countries where those things cannot be assumed. Collaboration with physicians, paediatricians, surgeons, obstetricians and many more with expertise in global health research will be essential to develop our understanding and effectiveness, and Oxford is the ideal place for these collaborations to flourish. I continue to value connecting people, and learning from others in our efforts to develop useful and impactful research.
What is the most meaningful aspect of your work?
The most meaningful aspect of my work is the potential to learn from, encourage and where possible, equip my colleagues working in much more difficult settings with fewer resources, for sicker patients, who are yet so focused on giving the best clinical care they can. Working with them to build capacity for clinical care and ongoing research relevant to their context carries the most meaning for me.
Can you tell us about something you’ve done, contributed to that you’re most proud of?
The opportunity to speak to non-physician anaesthesia providers in Sierra Leone, Somaliland and Uganda about their training and practice as part of a recent research study gave me a far greater understanding of the challenges they face, and I was proud to have the opportunity to highlight their underappreciated views and voices through that project and its publication.
What changes would you most like to see in the Medical Sciences in the next 100 years?
I would like to see free transnational collaboration and cross-fertilisation between medical scientists and experts outside medicine in solving the health problems of our world, greater involvement of patients in setting research priorities, and the opportunity for medical scientists to ‘dream big’ in thinking of and developing novel solutions to the health challenges of the next century. In particular I would hope for far greater attention to and success in achieving mental health, without which no one can be truly well.