Friday 3 January 2025
Dr (Surg Lt Cdr) Laura Cottey, an accomplished Royal Navy ST4 in Emergency Medicine (EM) working in the Peninsula Deanery was recently honoured with the prestigious Gilbert Blaine Medal. Dr Cottey has made significant strides in trauma research, focusing on mitochondrial dysfunction in critically ill patients. She is also Research Fellow for the Academic Department of Military Emergency Medicine. Her dedication to advancing EM is evident through her extensive involvement in research networks and Royal College of Emergency Medicine (RCEM) committees, including the Trainee Emergency Research Network (TERN) and the Gender Equity Committee (GEC). Passionate about improving patient care and supporting her peers, Dr Cottey continues to inspire with her commitment to excellence and innovation in the field.
She shares her experiences of progressing through EM with the College.
Left to right: Dr Sarah Watts, Dr Laura Cottey, Commodore Alison Hofman, immediate past RCEM President Dr Katherine Henderson. The Gilbert Blane Medal is given to medical officers who have made significant advancements or improvements in matters affecting the health or living conditions of Naval personnel. Commodore Hofman presented the medal to Dr Cottey, who was joined for the celebration by her supervisor Dr Watts and Dr Henderson.
We are delighted to have Dr Cottey with us today. Congratulations on being awarded the prestigious Gilbert Blaine Medal! Can you tell us more about this honour and what it means to you?
Dr Laura Cottey: Thank you! It feels incredible to be awarded the Gilbert Blaine Medal, which is a Royal Naval Medal presented by the Royal College of Surgeons and the Royal College of Physicians. A big leather-bound book of my PhD work was submitted, and the Presidents of the Colleges had to review it to determine if it was worthy of the award. I pursued my PhD full-time over three years, stepping away from my EM training for that time.
What was the focus of your PhD research?
Dr Laura Cottey: My research focused on critically ill trauma patients in military settings, specifically examining mitochondrial dysfunction in traumatic injury and haemorrhagic shock. I explored how we can improve resuscitation outcomes on the frontline, especially when hospital-level care isn’t immediately available.
What would you say were the most enjoyable and challenging aspects of the work that went into getting the medal?
Dr Laura Cottey: With all research, it’s a huge team-based approach. There were significant challenges during the PhD, especially as it fell over the period of COVID, which restricted access to laboratories I was working in. The work I was undertaking was really innovative, which brought its own challenges. Some aspects of the work didn’t go as planned, and the PhD took a slightly different course. The most important thing was having the support of good supervisors and the EM academic community. Other EM doctors doing PhDs and those who had done similar work were crucial in overcoming these challenges.
In terms of the most enjoyable aspect, it was having the opportunity to spend time conducting the research and delving into the details. I was hugely grateful for the chance to spend three years out of training to conduct the research. Working with the teams I collaborated with was definitely the most enjoyable part.
It’s impressive to hear about such specialised research. What insights did you gain from this experience?
Dr Laura Cottey: This deep dive into cell-based research, though unusual for an EM doctor, provided incredible insights into the challenges of resuscitating severely injured patients. Collaborating with teams across the UK, I aimed to contribute valuable evidence to enhance trauma care in both military and civilian contexts.
How has the Navy shaped your course towards specialising in research?
Dr Laura Cottey: It’s given me the opportunities to pursue an academic career. It started with an academic clinical fellowship in Plymouth, which gave me a broad introduction to research. With the support of my supervisor Professor Jason Smith, the team in Plymouth and the wider EM academic community I had the opportunity to explore various research areas, which led me to pursue a PhD.
Undertaking the PhD within the Royal Navy meant focusing on our military research priorities, aiming to deliver the best possible care for our future patients. This project idea came about from thinking about the future patient, the environment we might operate in, and the types of patients we might encounter. My research was very much focused on that, aiming to deliver the best possible care.
How has being part of RCEM boosted your career and helped you progress to where you are now?
Dr Laura Cottey: I’m hugely thankful to RCEM and the research community within it. Without the opportunities provided directly by the College or through networking opportunities, study days, or College conferences, my career path over the last six to seven years would have been very different. The biggest thing for me was the start of the Trainee Emergency Research Network (TERN). One of the first research projects I undertook during my academic clinical fellowship was through this network.
I remember when the network was starting, we had a meeting with a small number of people in a room in London, and the College was thinking about setting it up. I pitched the idea for the project that then ended up becoming the inaugural project for TERN. From that initial meeting, I went on with the first TERN fellow to launch the inaugural project, which was the TIRED [Trainee-led evaluation of the need for Intershift Recovery among Emergency Department doctors in the United Kingdom] study, looking into shift recovery within the Emergency Department (ED). At the beginning, we had no idea how incredible this research network would become for EM, not just for trainees but for EM research as a whole.
The project went from strength to strength, with over 100 EDs taking part. Trainees became lead investigators within their departments for the first time. We conducted a survey on shift recovery, fatigue, and how to improve well-being and retention in EM, with over 4,000 participants responding. It was incredible, and I learned a huge amount from that project, wholly supported by the College and key members, including EM consultants and professors.
The support wasn’t just financial; it was the platform and motivation to support trainees in conducting research on this scale. Once we completed the project, we presented it at the College Conference and were supported in sharing and disseminating the findings. For me, that was the first big interaction with the College, starting back in 2018 and continuing over the next couple of years. It made me want to get more involved, initially by attending academic training days and College conferences, and eventually applying for a committee position.
What’s the legacy left by the TIRED?
Dr Laura Cottey: It was a two-year project that finished back in 2019, and we then disseminated our findings. But I think what it did was help TERN build a reputation for delivering fantastic research led and organised by trainees. We learned a lot during that project and were able to not just disseminate the findings but also share our learnings and pitfalls with future projects. Hopefully, we created a bit of a blueprint for future work that TERN has gone on to do.
That work itself has finished, but I’ve been very fortunate to get involved in other projects. The skills I learned, such as managing a project, networking, collaborating with other researchers, and leadership, have really helped me in other endeavours within EM and the College.
More recently, I was involved in the James Lind Alliance Priority Setting Partnership. Back in 2017, the first set of research priorities for EM was published. That was due for a refresh, and I was fortunate to be on the steering group for that, coordinating some of the work particularly evaluating the questions submitted and the existing evidence for those. It was great to engage with another organisation, the James Lind Alliance, and with our EM patients, hearing their perspectives on what is important to them.
That work concluded in 2023. The College’s 2017 research priorities were key to me developing the TIRED project because two of the top 10 research priorities were around staff well-being and retention within EM. Being involved in the refresh allowed me to see how our research priorities have changed and where people have worked on those original priorities to advance the evidence.
How did RCEM’s committees and other organisations shape your EM journey?
Dr Laura Cottey: I was on what was originally the Women in Emergency Medicine Special Interest Group (WEMSIG), which then changed to the Gender Equity Committee (GEC). Although I had been involved in RCEM through study days and sessions at the Annual Scientific Conference, this was my first time on a committee. It was an area that really interested me, and it was an open call. That’s what’s fantastic about the College committees—if you feel you have the skills to contribute, you can apply.
I have been involved in a large charity for girls and young women, Girlguiding, for a number of years, doing advocacy, external relations, and charity governance. When I saw the advert for WEMSIG, I was thrilled that the College recognised this issue and was acting. It aligned well with the skills I had gained outside of EM, and I was passionate about supporting everyone in the field while recognising the specific challenges women face.
Being part of this new committee from the beginning, we set our strategy and goals. What was great about the College committees is that you can get co-opted onto another committee to bring a different perspective. Because I was involved in research, I volunteered to join the Research Committee as the WEMSIG representative. This cross-committee collaboration brings a wealth of voices to discussions, enriching the decision-making process.
I’ve gained so much personal development through the incredible support of staff members, consultants, professors, and peers from all over my EM journey. The community is exceptionally friendly and always willing to help others get started, so I encourage anyone with an interest or passion to get involved, whether locally or with RCEM. There are immense opportunities out there, and the support you’ll receive is invaluable.
