23 November 2020

The Crucible Prize is an innovative trainee-led initiative with a £1000 prize. The theme for BSH Virtual 2020 was "What lessons learnt during the COVID-19 pandemic should change future practice in haematology?”

The five best abstracts were selected for oral presentation at BSH Virtual 2020, which was held on 9-14 November 2020. We are pleased to announce the 2020 winner was Joshua Bomsztyk. Joshua presented on the topic of ' A hospital avoidance strategy should be the forefront of our minds'. You can read his abstract here.

We interviewed Dr Bomsztyk to find out a little bit more about his journey in haematology and his Crucible Prize success.

What is your education/career background in haematology?

My interest in haematology as a career began early in medical school when I was fortunate to be part of a summer research project in the early development of CAR-T cells. Following on from that I completed an intercalated BMedSci in multiple myeloma and after university took up an academic foundation programme placement in Manchester where I was fortunate to do some research in CLL and other forms of lymphoma.

After core medical training I began a two-year fellowship developing the Rory Morrison Registry for Waldenstrom Macroglobulinaemia which truly gave me an insight into the exciting world of haematology beyond the four walls of a hospital. I am currently an ST4 in Haematology training in Northwest London.

What was your Crucible session presentation about?

My Crucible session presentation was a part reflection, part proposal, of two design strategies that could be adopted in light of the COVID-19 pandemic. The overarching theme is the need to adopt a hospital avoidance strategy when designing trials, treatment protocols and outpatient services. I proposed that the use of telemedicine could be expanded to integrate other specialities especially for patients who are vulnerable thereby limiting hospital exposure. The use of a hybrid ‘face to face’ and virtual clinic with other clinicians dialling in could be an exciting option in the future. More critically, the need to pandemic-proof our treatments so that in the future, if we were to have another pandemic, we could continue treatments without interruption.

What inspired the content of your presentation?

The inspiration for this presentation came after I was redeployed to act as an acute medical registrar during the first surge of COVID-19. I was fortunate to be integrated into an excellent Care of the Elderly team who were exceptionally supportive and great to work with. One striking aspect of the redeployment was how isolated working in haematology could sometimes be and that integration with the general medical team was beneficial for both services and patients.

It was after my return to Haematology where the idea for hospital avoidance sprouted. A consultant, half-jokingly said that ‘hospitals were dangerous places for patients’. COVID-19 has exposed serious holes in our current service, one that actively promotes patients coming to hospital repeatedly for diagnostic investigations, treatments and reviews. What is more this pattern is repeated, somewhat in isolation in every speciality – therefore patients with comorbidities, who are especially vulnerable for COVID-19, were potentially needing to attend hospital repeatedly. I felt better communication and integration between specialities could limit these multiple attendances and that treatments or trials need to be designed with hospital avoidance as a desirable aim.

What does winning this award mean to you?

Wining the Crucible award has been fantastic, especially alongside some really great and innovative presenters. Although a somewhat surreal experience given that it was all virtual, I was fortunate to be able to take part. The Crucible award is a great way to showcase your own views, reflections and ideas when it comes to Haematology. I would strongly encourage others to consider applying as it is really an exciting opportunity.

What would your advice be for someone wanting to choose haematology as their specialism?

Haematology is a fantastic speciality as there is truly something for everyone. Prior to starting as a registrar, my experience – which I suspect is like most CMT/IMT now – was based around malignant haematology and the occasional clotting query when doing a surgical job! Once I started the worlds of morphology, immunohistochemistry, haemophilia, transfusion to name but a few were properly opened up to me. This can be quite daunting at first and very steep learning curve – but that is the exciting part; you learn so much about areas you have never even heard of that might turn out to be your calling.  So my advice would be to go into the speciality with an open mind, try to soak up as much as possible and have as much exposure to all the areas as you can. 

What do you plan to do next in your haematology career?

At present my next focus is exams and try to get through the Part 1. After that, I am considering some time out for research or to develop my management and leadership skills. In the long term, I feel most drawn to Myeloma or Lymphoma as a sub-speciality – but keeping a very open mind!