Professor Anna Dominiczak: I don’t believe in impossible

When Professor Dame Anna Dominiczak greets me at the door of the Cardiovascular Research Centre at the University of Glasgow, she comes across a little shy. Ushering me through to her ground floor office, she apologises for the mess (there’s no mess) before taking a seat across from me, elbows close to her side and hands, clasped, resting on the table in front. She admits to being a little nervous about the interview – and then she starts talking about science.

“Many colleagues in the Scottish Government and the NHS would like to use our health science in the best possible way to help patients, communities, population,” she says effusively. “And I think it’s a good time to rethink our strategy and also to focus on innovation that can be applied in our own NHS, and to make things better.”

Dominiczak became Scotland’s chief health scientist in July. It is her enthusiasm for bringing innovation into the NHS which secured the appointment, which lasts until 2025.

Asked what she wants to achieve over the next three years, she says: “I would like to see a real, working, successful pipeline from research and development to innovation, that implements what I like to call triple helix partnership between the NHS, academia and industry.”

It’s a good time to rethink our strategy and also to focus on innovation that can be applied in our own NHS

“We have lots of great discoveries, lots of great ideas,” she continues, “but [we need] to take them through the pipeline, to truly adopt in our NHS and adopt everywhere in Scotland – not just in one health board or two health boards, but for the entire population.

“And that transformative innovation – selected, prioritised, adopted – we hope will reduce waiting lists and make things better for patients, but it will also increase economic growth. It will bring money back to our economy, create jobs. As you know, health is extremely expensive – and yet by bringing innovative thinking, by bringing entrepreneurship to our activities, the life sciences industry in Scotland is very, very strong.”

Indeed, she compares her new position to that of Mark Logan, the Scottish Government’s chief entrepreneur. “What he’s been doing with digital tech, with FinTech, we can do in health. It’s early days, but I strongly believe in working closely with industry, which perhaps we’ve been a little reluctant in the past [to do]. That triple helix can make us much more successful and powerful.”

Dominiczak is no stranger to innovation. She is a world-leading expert in cardiovascular science and has been at the forefront of groundbreaking research into precision medicine.

“Precision medicine, in the widest possible definition, uses all the discoveries of molecular medicine in the last 20 years – all the DNA, proteomics, metabolomics, other -omics – all this mechanistic, detailed information to improve the way we both diagnose disease and treat the disease,” she explains. “And what we’ve learned is that the old names of diseases are no longer completely true. This is particularly obvious in cancer, but also in other diseases. We know that there isn’t one breast cancer, there are several subtypes. And it’s this stratification on the basis of molecular biomarkers that really allows us to treat patients better. We have multiple biomarkers to diagnose more precisely, and then to apply the right treatment for the right patient at the right time.”

Dominiczak started studying medicine at Gdansk Medical University in Poland before moving to Glasgow in the 80s where she has stayed ever since. She’s held various roles through that time, starting out as a junior doctor at the Glasgow Royal Infirmary before moving up through the ranks and ultimately pursuing a career as a clinician scientist. “I came to Glasgow with the idea that I’ll become a professor of medicine and I never changed my mind,” she says.

That determination and single-mindedness is driven by an absolute love of what she does. I ask if she’s still as excited about health science now as the day she became a doctor. “Probably more,” she says. “I think it’s really interesting that in the role I’ve taken on, I see the really big picture. What I used to look at, when I had a research group at the University of Glasgow, was mostly cardiovascular area and mostly high blood pressure…. Precision medicine has moved forward the most in cancer, which has not been my research area. Had I stayed in the same role forever, I might have not had such a privilege to help people to develop these other areas. I like the big picture and to be able to help influence and see what people are doing.”

Dominiczak played a key role during the pandemic, as director of the Lighthouse Laboratory. At its peak, the lab collected and analysed over half a million Covid tests in a single day. It was an exceptionally busy time, with 16-hour days, no weekends, and a lot of time spent away from home.

But she says she wouldn’t have had it any other way. “It was a great privilege to be able to contribute. Knowing what I knew about laboratories, about medicine, I couldn’t just sit at home. I had to join in and I’m glad I did because you feel useful, and you’re also learning an enormous amount.”

She sings the praises of how colleagues across sectors rose to the challenge, despite the pressure it inevitably put on wellbeing and mental health. “The teamwork was incredible, from the beginning to end – different, changing, but incredible. What comes out of people in these situations is mostly hugely positive. I like to say occasionally to my colleagues that I don’t believe in impossible; that was what was happening there. Nothing was impossible.”

This is also the attitude that helped her forge ahead in her career at a time where women were few and far between in the medical community. She admits to being quite shocked when she first moved to Glasgow to find there were no women in senior positions and only one female professor in the entire medical faculty – quite different from what she had been used to in Poland.

Naturally, she has had to overcome barriers in the UK. One early interaction she had with a senior colleague in one of her first jobs stands out. “He looked at my hand and said, ‘are you married, dear?’. That was the way in those times. And I said yes, I’m married. ‘Why don’t you go home and have babies?’ he said.”

And it wasn’t just male colleagues. “There was a woman consultant in geriatrics who helped me because I had a baby during this training programme. But yet, the same woman asked me at the interview, ‘do you plan to have children during three years of training?’”

She laughs at the memory of it now, adding things have become much better for women since then. Indeed, she herself became the first female Regius Professor of Medicine at Glasgow University in 2009 and has held numerous other roles that once would have been impossible for women.

But despite improvements, the gender gap in medical science, particularly at senior levels, persists. Dominiczak is determined to do something about it. She and another female colleague established a new leadership development programme in 2019, open to both genders but predominately aimed at women. “There are great women with leadership potential and ability who don’t put themselves forward. You just need to help them a little,” she says.

Science has no borders. And I hope Brexit will not have a lasting effect

It was her own mother that put her on the path to becoming a clinician in the first place. Both her parents were doctors, but Dominiczak initially wanted to become a geographer. “I had a wonderful teacher in geography, and I decided I would study geography. And my mother, who is very skilled in persuasion, got that teacher to persuade me otherwise – thank goodness!”

And while she realised in the middle of her undergraduate degree she wanted to go into research, she always felt it was necessary to keep close ties with patients. Even as she became internationally recognised for her work, she continued to treat patients. “I’ve been a doctor, a real doctor in the hospital, on the floor, in the middle of the night, for the majority of my life, whilst doing research, too. That’s what a clinician scientist is, really. I think if you don’t, you lose that bit of being a doctor.”

I wonder if she believes politicians might also benefit from having that professional experience before taking decisions. After a pause, she says it is “very difficult to say” because there must be a clear line between the role of advisor and of decision-maker.

“Research advisors and clinical advisors are there to advise but not to make decisions. I think Patrick Vallance [the UK Government’s chief scientific advisor], with whom I worked during Covid, summarised this very beautifully: there is advice, and the best advice, and the best evidence, but somebody has to make a decision. We are not here to make decisions. Elected leaders make decisions; we advise. I think that’s correct.”

That doesn’t stop her being critical of some of the decisions taken by elected leaders through – particularly over the Brexit deal and the UK’s continued research links with the European Union. Last month, talks over the UK continuing to participate in the flagship Horizon programme stalled. Britain was expected to continue to benefit from the scientific funding initiative under the co-operation agreement, but it’s never been ratified due to the ongoing dispute over other arrangements.

“I think everybody I know in biomedical or any science in this country is concerned,” Dominiczak says. “Horizon allowed us not only money, great amounts of money, but also collaborative links with lots of fantastic scientists across Europe.

“I ran a couple of EU projects some 10-plus years ago, and I think it’s very, very difficult to replace this experience. You may replace money, but you can’t replace this open collaboration, sharing of researchers, having PhD students from all over Europe funded by the EU, all these things. And I think particularly colleagues who were privileged to have big ERC [European Research Council] grants that were very flexible, they could spend it on a variety of things, have really novel, innovative ideas, and have collaborations.

“Yes, it’s great to say we can collaborate with the rest of the world. We’ve always been able to collaborate with the rest of the world. But that joint money, joint system, that’s very mature now, it’s had the time to become really perfect in its design – it’s a huge loss.”

But she is hopeful that collaboration will continue whatever happens politically, with many universities across the UK and Europe already committed to doing so. “Science has no borders. And I hope Brexit will not have a lasting effect, but we need to somehow mould new collaborations and new ways of working together.”