An interview with Professor Claire Hogg

International Women’s Day 2020 – interview series

In celebration of International Women's Day, we interviewed five women from Royal Brompton & Harefield NHS Foundation Trust.

In this interview, we sat down with Professor Claire Hogg, a leading clinician in the field of Primary Ciliary Dyskinesia (PCD), to ask her about her research, her time working in the City, and the advice she’d give her 13-year-old self.

What do you do?

I’m currently the clinical director for paediatric respiratory medicine here at Royal Brompton.  

My main interest, from both a clinical and research perspective, is PCD which is a rare, inherited, long-term condition that children are born with.

Back in 2006 we were lucky enough to get nationally commissioned to run a diagnostic service for PCD here at the Trust, which I lead. 

A few years later we could see there was a gap for the management of these patients because we were rapidly increasing the number of patients we were diagnosing. We were successful in getting commissioned for a second time. 

And after increasing the numbers of PCD patients we were diagnosing and successfully managing them through their childhood we realised there was a gap for adult services. In 2019 we were successful in getting commissioned for an adult service - and we now have the three services, diagnostics, paediatrics and adult, all sort of coming together, which is brilliant.

When it comes to research all of my work has been primarily built up around PCD. Before that I was dabbling in infant wheeze, a little bit in cystic fibrosis and then when I got my first consultant job here in 2004, I became interested in PCD. 

I have quite a big team and we have a laboratory down in the basement here in Chelsea wing. We’re engaged in an array of things, particularly around diagnostics, and through our research we’ve managed to bring two new tests from bench to bedside in the last decade.

We’ve also been heavily involved in the gene discovery aspects for PCD which have gone up from just 35% of patients having a known gene to around 80% now. The number of genes we’ve identified that are linked to PCD have also gone from just 3 or 4 genes to 50.

How would you describe your typical day?

It’s never typical!

Today I’m having quite a nice morning because I’m working on some research. This afternoon I have bronchoscopy list and then a management meeting between 4-6pm. 

The meeting is partly internal management related, but I’m also involved on three or four different boards with the King’s Health Partnership – the transformation programme that’s going on at the moment. 

Then tomorrow I’ve got clinic in the morning but in the afternoon, I’ve got a Trust governors meeting which actually, will be my last one, I’ve been a Trust governor for 6 years. I can’t even think what I’m doing on Wednesday - probably more clinical meetings and something management related!

And what inspired you to get into respiratory paediatric medicine?

I’m slightly odd – well my pathway is slightly odd which I realised after I did a presentation for Athena Swan last year with Professors Sejal Saglani and Jane Davies

The three of us went up and spoke about our careers, and it was quite funny because I could see exactly how their career pathways were mapped out, but mine? I was much more haphazard. 

I didn’t go to university to do medicine, it hadn’t occurred to me to do that. I went to do zoology, but I switched after year one into anatomy and physiology. And I really enjoyed that, so I did a BSc in anatomy and physiology before going into graduate medicine. 

I didn’t really look back after that – I didn’t think, ‘Was I really right to do that?’, I just really enjoyed it. 

Within the first year of coming out of medical school I knew that I wanted to do paediatrics. But getting into respiratory medicine, I think that was more about who I met along the way and the jobs I had.

It was part luck, part who I met. I worked in Australia for 4 years where I did a lot of paediatric respiratory medicine, and when I came back the first job I had was here at the Trust as a registrar. 

What excites you most about your job?

Probably the research. I wouldn’t have said that 15 years ago when I was a research fellow, because the output of that project just didn’t work out very well. 

But now I really enjoy it, and I have a great team around me. They are very motivated and that’s really motivating for me. We have a steady stream of good outputs and the research we do is very translational, which I love. 

So, I love my clinical practice, and I love the fact that I can do research and then see it actually get to the bedside. 

What do you enjoy most about working at the Trust? What could be done better?

I think we’re incredibly lucky working here - we have a culture that’s really rare. 

We have an exceptional clinical academic culture here. If you walk along this corridor you wouldn’t really know who was primarily clinical, and who was primarily academic because everybody just works together as a team. It’s that sort of segue of the two cultures that’s been so successful, that’s why people want to work here. 

I also like that fact that I can, most times of the day, figure out where people are going to be that I can get a clinical opinion from. It’s a real team approach. 

And really, I think the teams here just really pull together. You know we’ve had some pretty unusual cases come through this hospital and the teams just go the extra mile. It’s exceptional actually.  

Do you remember any difficult choices in your career path where you really had to think about what direction to take?

When I finished my training, and I was looking for a consultant job, there were none around. I had quite young children, 3 young children in fact, and my husband had a consultant job, so we couldn’t move. It was actually quite difficult, because I was thinking, what am I going to do? 

There weren’t as many fellow-type jobs around at the time, so I went and worked in the City for a year, which was quite interesting. I really enjoyed it and I learnt a lot of new things but actually within 6-9 months I was thinking, I’m not sure I want to do this for the rest of my life. 

Around that time a locum consultant job came up here, part time, 3 days a week and the first day I got back, I just thought, ‘This is where I want to be’. I felt like I’d come home. So, working in the City, although it was really educational, and I gained some quite useful skills, everyone was just in constant competition with each other. I came back here, and I realised that everyone is just working together towards a common goal, for a patient or a family. 

How important is it for women to lift each other up and what does that mean to you?

I think it’s very important, but I don’t necessarily think it has to be just women supporting women. I think it should be a team supporting each other. 

I think we’re quite a good example of that here because we have Professor Andrew Bush who has been a fantastic mentor of women, and his department is very female-centric now. He has 3 professors coming up behind him, all female and we now have a cohort of young male consultants coming up behind us. It’s just as important for us to mentor and support them in their careers and make sure they get time for research, as it is for us to support each other. 

Do you think as a woman it’s still necessary to decide between a career and children, and what advice would you give to young women in such a situation?

I don’t think it’s necessary to choose between them, but I don’t think your career should be a bar to having family. I think it’s really the responsibility of the organisation to enable that and as a team for us to support women through that period of their career. 

I think if women are made to choose then it always ends unhappily, whichever choice you make. It’s also quite dependent on what support you have at home, whether it’s your partner or wider family. 

I think the advice I’ve given 2 or 3 of our female registrars recently, quite senior and with young families, is not to panic about what they might see as a timetable and where they need to be at any given time or perceived stage of their career. Because the thing is, when you become a consultant, you’re likely to be a consultant for 30 years or more. Does it matter if you were 5 years more as a senior registrar or a clinical fellow because you were having family, or because you were part time? 

Ultimately, I think there are so many ways to get to where you want to be and there’s no reason to shoot through and jettison what might be a better work like balance if you can be patient. You can still do all the right things, still get noticed. People aren’t sitting there going ‘This time next year she should be applying for that’ if you’ve just had a second child, or go on mat leave, or decide to come back part time. 

Don’t rush – it’s a long old haul and it should be a happy and balanced one.

If you could go back in time, what one's piece of advice you would give your 13-year-old self? 

It’s funny because the advice I would give myself would probably be to put a little more effort into my school work than I did at the time!

I went to a school on the west coast of Scotland which didn’t offer anything beyond GCSE’s, so most people left school at 16. There were a few of us who wanted to go on to university, but we had to go to a state school up the coast where you did Highers, the equivalent of A-Levels in Scotland. 

It wasn’t the sort of school where you could say, ‘I’m definitely going to university’. You just quietly did it and hoped no-one gave you a hard time for being different. The school was shocked because I think I was the only person who went to university in my year.

If I look back – maybe I should have ignored that and been a bit more ambitious. It wasn’t cool to be clever in that sort of school. I think you learn just to keep your head down below the parapet. Maybe if I had the confidence to sort of stick my head up and say ‘Oh no, I want to do this’ – if I’d asked for support or help to develop better at that age. 

So, because of that I think it took me a while and I always felt like a bit of late developer by the time I got to university. I was fine academically, but it was that sort of persisting lack of confidence.  

It’s that sort of environment that I grew up in, so I think if I was thinking back to 13, I guess what I’d like to do better, is handle that better and not let it limit my ambitions at the time.