Professor Rustam Al-Shahi Salman
President, British Association of Stroke Physicians (2018 to 2019)
Professor Rustam Al-Shahi Salman MA MB BChir PhD FRCP Edin FHEA FESO.
I am a professor of clinical neurology at the University of Edinburgh and honorary consultant neurologist in NHS Lothian (professional webpage). I lead the Research to Understand Stroke due to Haemorrhage (RUSH) programme (www.RUSH.ed.ac.uk), which is dedicated to improving the outcome for adults who have diseases that may cause, or have caused, intracranial haemorrhage. I also care for people with these conditions, audit their care, and help undergraduate and postgraduate students to develop and answer research questions within the RUSH programme. I am committed to BASP’s vision to provide leadership in the improvement of clinical services, science and research, education and training relating to the health and wellbeing of our patients, their carers and the public. I look forward to leading the delivery of the current BASP strategy and updating it for the following three years as BASP president 2020-2021.
Stroke and Me
I became interested in neurology during undergraduate medical training at Cambridge University. The importance of stroke as a common neurological disease became apparent to me while I was a house officer working with Nick Coni in Cambridge in 1994. Concerned by the shortage of treatments for stroke, I was inspired by the clinical research that was being done to address this whilst I was a senior house officer at the Whittington Hospital in London 1994-1996. During this time, recruiting patients to the first International Stroke Trial gave me first-hand experience of how large, simple randomised trials could answer uncertainties about treatments reliably and easily. Attending the Edinburgh Clinical Trials course helped me to understand how to do this, and attending Charles Warlow’s Advanced Clinical Neurology Course in Edinburgh confirmed my commitment to advancing stroke care, even though this has not been the cultural norm for neurologists in the UK.
In order to realise these ambitions, I wrote funding applications in the small hours of the morning whilst I was a trainee doctor in London for funding from the Chief Scientist Office to set up a population-based cohort study in Scotland and funding from the MRC for a clinical research training fellowship to allow me to conduct a PhD. These grants enabled me to move to Edinburgh and join the stroke research group in 1998.
Subsequently, I undertook clinical training to be a neurologist in Edinburgh and kept my research going alongside a full-time training post. I progressed to MRC patient-oriented clinician scientist and senior clinical fellowships until 2016. Since becoming a professor of clinical neurology at the University of Edinburgh in August 2013, the depth and breadth of my research has expanded beyond stroke and intracranial haemorrhage in response to several of the global challenges in non-communicable diseases, vascular multi-morbidity, cerebral small vessel diseases, and therapeutic dilemmas provoked by vascular ageing (www.RUSH.ed.ac.uk).
My lived experience of clinical research has also made me concerned about increasing the value of biomedical research by minimising waste in the choice of research question, study design, study conduct, regulation, and reporting. This led to me becoming one of the lead authors of The Lancet‘s 2014 Series on Increasing Value and Reducing Waste in Research (www.thelancet.com/series/research) and the related campaign (www.thelancet.com/campaigns/efficiency), as well as a founding member of the REWARD Alliance (http://rewardalliance.net).
My clinical work in stroke includes TIA/stroke clinics, a specialist service for people with intracerebral haemorrhage or conditions that may cause it, out-of-hours thrombolysis on call work, and emergency stroke outreach services to my hospital’s emergency department and inpatient wards. My involvement with these services has made me acutely aware of the large shortfall (33%) in the clinical capacity at consultant and trainee level that we have to deliver the astounding advances in stroke care that have been discovered by clinical research in recent years.
For all of these reasons, I sought election to serve BASP as the specialty’s professional organization in order to continue the UK’s great tradition of clinical stroke research (BASP scientific committee member 2011-2014 and chair 2014-2017) and redress the balance in the clinical services that the NHS allows us to provide for patients with stroke in the UK (BASP president elect 2018-2019 and president 2020-2021).