Today we have an interview with Professor Mariya Moosajee, consultant ophthalmologist specialising in adult and paediatric genetic eye disease at Moorfields Eye Hospital and Great Ormond Street Hospital for Children.
Can you tell us 3 things about yourself?
I have always been very passionate about my clinical work and research, especially engaging with patients and the public so they understand the impact of sight threatening diseases on individuals and their families, and the importance of what we do as in academic ophthalmology to mitigate this.
I love travelling and seeing the world, building memories that will last a lifetime.
I love art, and am truly inspired by it, I need to work on a better work-life balance so I can get back to oil painting.
Can you tell us about your professional background?
I undertook an intercalated BSc in Biochemistry and Molecular Genetics at Imperial College London during my MBBS, and that was when I was first exposed to the Human Genome Project and ophthalmic genetics. I think I knew then, that this would be area that would interest me for the long-term future. I went back to Imperial College London, after the now equivalent of Foundation year 1 and 2 training, to undertake a PhD investigating the molecular defects of optic fissure morphogenesis (otherwise clinically known as ocular coloboma). And then secured my ophthalmology specialist training in the North Thames London Deanery. I was a full-time clinical trainee for 3 years, then applied for a National Institute of Health Research Academic Clinical Lectureship, which allowed me to spend 50% of my time in research and the 50% completing my ophthalmology training. I then completed this with a clinical fellowship at Great Ormond Street Hospital for Children in paediatric ophthalmology. Straight after I was awarded a Wellcome Trust Clinical Research Career Development Fellowship, which tied in with my Consultant Ophthalmologist appointment at Moorfields Eye Hospital and Great Ormond Street Hospital for Children. I built up my research lab and lead a large team based partly at University College London (UCL) Institute of Ophthalmology and the Francis Crick Institute in London. I was appointed Professor of Molecular Ophthalmology earlier this year through UCL.
What is your current role?
I am a clinician-scientist, I spend 60% of my time in research and 40% in clinical work. My formal role is Consultant Ophthalmologist, specialising in adult and paediatric genetic eye disease at Moorfields Eye Hospital and Great Ormond Street Hospital for Children. I am the group leader of the Ocular Genomics and Therapeutics Lab at the Francis Crick Institute, and also lead my lab at UCL Institute of Ophthalmology. I have several national roles, as President of the UK Eye Genetics Group, President (and Founder) of Women and Vision UK and I am also a committee member on several divisions of the Royal College of Ophthalmologists (Education, Academic and Genomics).
Can you tell us a bit about what it entails?
My clinical work involves seeing patients and families with rare genetic eye diseases from all over the country. I have a great team who come together to provide a gold standard service including a developmental paediatrician, low vision optometrist, genetic counsellor, and family support. This is a really rewarding part of my week because sometimes the families I have seen have never had specialist input and it makes a real difference to the care they receive and well-being, feeling more knowledgeable and that they are doing all they can for themselves or their children. This also feeds the purpose of my research. The patient’s questions form the main basis of my research questions, “What is the cause of my disease, and is there any treatment?” We undertake start-of-the-art genomic testing to identify the molecular cause of inherited eye disorders and then will often move to the basic science lab to understand the role of the gene in question, mutation and develop novel therapies for these patients. The rest of my time is spent in meetings trying to make positive changes, especially related to equality and diversity.
What does a typical day look like for you?
Woken up by my twins way too early! Get them ready for their day, and then off to work. Things have changed dramatically with the Covid-19 pandemic, as I have been working from home since the end of March, so now there is usually a zoom or Microsoft teams meeting lined up. This can be with my lab where we discuss their research and plan for the following weeks experiments, discuss results and writing up scientific papers. Or it may be a virtual clinic consulting patients followed by MDTs to discuss patient results or further management.
When I am not on a virtual meeting, then I concentrate on writing grants, research reports, and publications. I am currently writing a book called the Textbook of Genomic Ophthalmology and creating an open access genetic eye disease web resource called www.Gene.Vision for health care professionals and patients, which is fully accessible to sight impaired and blind users. As a consequence, these are two very big projects taking quite a lot of my time.
I may also have to chair meetings for Women in Vision UK or the UK Eye Genetics Group: I am very proactive and like to ensure that there is a tangible action plan at every meeting, so I hope both groups have seen improvements and change since I have been in post. I usually step away from work in the later afternoon to look after my children, and then once they go to bed, restart to get some more computer work done. If my brain goes into overdrive, sometimes I keep going but I have put a “Please do not feel obliged to read or respond to this email outside your normal working hours,” to avoid stressing anyone else out. But sometimes when you have kids, you have to make the most of anytime you can get to work especially under current circumstances.
What are some exciting opportunities and progress you are seeing or have seen in (academic) ophthalmology?
I have seen a lot of talented colleagues secure great academic research fellowships (you’ve just interviewed one: Dr Lola Solebo!) I think seeing these group of individuals push to the forefront of science, not just ophthalmology, and being competitive amongst all specialities is just fantastic and lays down the pathway for more juniors trainees who are interested in pursuing a similar career track. I believe academic ophthalmologists have a great working life, you have almost full autonomy, gets load of opportunities, chances to travel (pre-Covid!) for lectures/meetings, make strong collaborations with those in other countries. And importantly you really do become an authority on your subject area. Some of the advances in recent years based on artificial intelligence, big data, genomics, personalised medicine, advanced imaging are shaping the future of our healthcare. I am just pleased to be part of this.
What are some of the challenges you are facing or areas of improvement you are seeing in (academic) ophthalmology?
Although everything I have said above is true, the trade-off is that you work incredibly hard, and must be unfalteringly committed. For true success, you need to be very resilient, able to take rejection (constantly) for grants, fellowships, and thus insecurity of employment, until you reach the stage when the universities/hospital may relieve you of this. I would like for this to be much earlier in our careers, so we can focus more on our research output than worry about how we may be able to pay the mortgage.
Can we explore the reasons why you entered academic ophthalmology and decided to focus on genetic eye diseases?
As I mentioned, I got my first taste of proper research during my BSc. I was in a lab extracting RNA from foetal ocular tissue and looking for EFEMP1 gene expression levels, which when mutated causes a very rare disease called Doyne honeycomb retinal dystrophy. Whilst I was a surgical house officer on call, I decided to Google myself for the first time and discovered my name on a scientific publication. I was struck by the integrity of my BSc supervisor for recognising my contribution. When I got in touch to say thank you, it led to her offering me a fully funded PhD and so I grabbed the opportunity. Hence, I have always focused on genetic eye diseases, and luckily, it’s a clinical area which requires active research. We are still discovering new causative genes, for most patients there are no treatments, so lots of work is required to develop potential therapies. I find this a really stimulating and fast moving area of ophthalmology and medicine overall, as we really are at the forefront with genomic medicine and personalised medicine.
What do you enjoy most about your position?
Autonomy, discovery and leadership, which the research side provides in spades. My clinical work makes me feel like I am making a difference, the close relationships and rapport you build with families, plus providing them with hope for their future.
What is the professional achievement you are most proud of and why?
I was awarded the Wellcome Trust Beit Prize in 2017, which is awarded to individuals who had the best fellowship application. It was at that stage, that I felt acknowledged on a wider scientific level, as I had competed against all medical and veterinary specialties for this award (unknowingly). I felt hugely privileged and still do. I was also very proud to be selected as one of the top 10 Champions for Change (Philanthropists, humanitarians and lobbyists pushing for a better tomorrow – for everyone) in The Ophthalmologist Power List 2019, this was 50 individuals chosen from 2000 international nominations across 5 domains.
Can you tell us about Women in Vision UK and the work you are doing there?
I am one of the founders of Women in Vision UK (WVUK), along with Prof Maryse Bailly and Prof Julie Daniels from UCL Institute of Ophthalmology. We set this up in 2017, around the time when the #MeToo Campaign had gone viral. The gender inequality gap was very visible in all aspects of our work, and except for the efforts of the Athena Swan initiative, not much was being done or changing. So, we wanted to help make a positive change and the first step was raising awareness of this issue within our wider vision community. By forming a network of brilliant and invested women who want to see a better future for themselves and the next generation, we have certainly begun the mission. WVUK promotes all women working in ophthalmology and vision research, providing them with support, mentorship, collaborations, networking and opportunities to progress and reach their full potential.
One aspect of WVUK which is very unique but hugely important, is the inclusivity of the network, for example, with ophthalmologists, basic science researchers, statisticians, dispensing opticians, publishers and those in industry. We do not work in isolation in real life, we require the skills and expertise of a number of individuals as a team, and so we made a conscious decision that “together was better.” Having now represented our group internationally and joined the Women Ophthalmologists of the World network, this has certainly been regarded as a gold standard. For more info visit www.womeninvision.co.uk and read the recent blog Spotlight On: Women in Vision UK by Manasi Mahesh Shirke.
What would Professor Moosajee of 2020 say to Mariya – your younger self as a first-year medical student?
There were times during my training when I had never-ending post-graduate exams combined with sleepless nights with my twins and them crawling around whilst I was trying to revise, busy night shifts, early theatre starts and long glaucoma clinics finishing at 8.30 pm at night, never seeing daylight or my family, that’s when I really disliked medicine. It’s a long hard slog! But it is worth it in the end, when you reach that level of seniority, when you have autonomy, and know you are really making a difference to so many people.
Although I would equally be happy to tell my younger self to go to Art College and follow a more creative path…I still have this aspiration for my future!
What do you think Mariya - your younger self as a first-year in medical school -, would say to Professor Moosajee if she was talking to you today (seeing how your life and career turned out to be)?
I would hope that she would look at me and say, “if you can do it, so can I.” I have never had a mentor or proper role model, and I hope that my career path will show others that you can achieve whatever you want. I have seen far too many ophthalmology trainees enter specialist training and progress through like a heard of sheep, with nothing that really sets them apart. It’s good to stand out, be different, and excel in what you are doing. If you are good, people will want you!