In the spotlight: Early Career Member Awardee 2020, ERS Lung Science Conference 2021, and Sleep and Breathing 2021

You are a physiotherapist by training. What made you choose a career in academia and do you ever regret not pursuing a clinical career?

I cannot remember that I actively decided to go for an academic career, because after graduation, which is 15 years ago now, I initially worked as a clinician for 18 months at the University Hospital in Leuven (Belgium). I was replacing colleagues and at some point there were no immediate job opportunities anymore. Exactly at that time, Prof. Dr. Rik Gosselink was looking for a part-time research assistant. So basically, my transition from clinician to researcher was mainly by coincidence. But I never returned.

For the second question, I do not regret missing out on the clinical career. I am still seeing patients fairly regularly in light of the clinical research and I am still working together with the local hospital. In the near future, I will also perform some clinical work in the local hospital to keep practising my clinical skills.

Can you tell us a bit more about those parts that you particularly enjoy?

Well, do you know these circus artists who have plates turning on a stick, and if they are good, they can have a lot of plates turning at the same time? I like the continuous challenge of combining leadership activities, teaching, mentoring, networking and community service. Let's say I like the fact that every day looks a little bit different. This keeps my motivation high.

Being an academic involves taking on teaching, research and academic leadership responsibilities. How do you prioritise opportunities and manage your time effectively?

This is very challenging in terms of time management. Sometimes it still goes wrong, but I think I already went through a steep learning curve. My general approach is that education is the core business, which ranges from teaching bachelor students to mentoring the PhD students that are in our team now. Other key activities, like research and leadership tasks, are built around the educational part. So, if I need to decide whether I use my time to thoroughly prepare a teaching class for the next day or to write a paper, I will always choose the first one, making sure that the classes are of the highest possible quality. All the other tasks, like community service activities, guest lectures, peer reviews, etc., come last. So, for me these extra tasks are kind of a test case: if I find myself reviewing a paper on Saturday evening, then I know that I need to push the brake a little and say “no” more often. In conclusion, education remains the most important because this is how we build future professionals, whether they will be clinicians, teachers or academics. These are the people who will lead our profession in the future.

What or who has been the biggest influence on your career and why?

There are many people that influenced my career, but from the beginning I have been very lucky to always stand on the shoulders of giants. During my PhD I was mentored by Prof. Dr. Thierry Troosters and Prof. Dr. Rik Gosselink, and in recent years I have closely collaborated with Prof. Dr. Martijn Spruit. That way, I have always learnt, and I still continue to learn from real leaders in our profession and I realise how tremendously lucky I have been with these opportunities. How many physiotherapists can say that they were mentored by a president of the ERS, right? I am very proud that I was able to convince them of my qualities. But on the other side, I realise that it was also serendipity and I was at the right place at the right time to work with these people.

What has been the biggest hurdle you had to face in your career and how did you overcome this?

I think the biggest issue for academics is the job insecurity. For about 14 years, I have been honestly told that long-term prospects were insecure, despite being an appreciated team member. At a certain point, that insecurity becomes frustrating because, when you are in academia for a long time, it also means that you deviate away from the rest of the professional pathways and it might be tough to make the transition back to other professional fields. Recently, I am thirty-nine now (at the time of interview), I was allowed to enter a tenure track which increases my chances to stay at my current institution, Hasselt University. So my patience was rewarded, but this is not reality for everyone.

Thus, if PhD students or postdocs ask me for advice on the next steps to take in their career, I confront them with the insecurity of this working environment as one of the factors to take into account.

Why did you choose to specialise in the cardiorespiratory discipline? Was it strategic to focus on two areas within the cardiorespiratory discipline, for example pulmonary rehabilitation and lung cancer, or was it opportunistic?

Well, I was clearly more interested in cardiorespiratory and metabolic diseases during my bachelor and master's education. At some point, I did an internship in the pulmonary rehabilitation programme at the University Hospital of Leuven, where I actually started working. The first day at that internship, I decided that this was what I wanted to do based on an immediate click that I had with both patients and the team. And I never left these patients…

The second question is a tricky question. I can say that both are old loves of mine, because these are the two settings that I was working in as a clinician, the outpatient pulmonary rehabilitation and the inpatient care for patients with lung cancer. I used to have a strong focus on COPD in the context of pulmonary rehabilitation. One of the reasons why I am now shifting my attention to patients with lung cancer is the hospital where we perform our research. The leadership and medical doctors there truly acknowledge the lack of attention given to the extrapulmonary consequences of lung cancer and its treatment. And next to that, it is important to create your own focus as an early career academic. Now the challenge is to merge these two passions, because I am convinced that selected lung cancer patients are excellent candidates for rehabilitation.

Congratulations on receiving the ERS Early Career Member award. Can you please explain what motivated you to apply for this award and what being successful means to you?

Well I did not apply for the award, I was nominated by the ECM representative of our Assembly, and honestly, I doubt whether I would have applied myself. I am an introvert person by nature and typically I do not actively chase recognition. I cannot deny that winning an award like this provides a feeling of success, but for me personally, being successful in the profession means making a difference. It can be at the micro level or on the larger level; for example, I can really enjoy seeing my PhD students pumped with energy after a nice presentation at a Congress or to comfort the same students when things are going rough; or to organise an event and then see people networking and having a great professional time; or to see the energy of clinicians who are stimulated by taking part in research. These little things give me a feeling of success.

You have been very involved in the ERS, for example you were secretary and now chair of Assembly group 9.2. Do you think these roles have helped you to advance your career and if so how?

To give you a little bit of background on that, within ERS there are 14 Assemblies that are further subdivided into groups, which connect clinicians and researchers with common interests together. Assembly 9 connects allied respiratory professionals and currently includes physiotherapists, nurses and respiratory function technologists. I am proud to say that the Physio group is pretty unique within ERS since we have a young group with a high percentage of people that are actively involved during and beyond the ERS Congress.

Answering your question, I truly think it helped and it still does very directly, as taking up a leadership position outside university is part of the requirements to successfully finish my tenure track. Next to that, as I said previously, I am rather introvert by nature so this position tremendously facilitated my networking skills, as you frankly cannot escape from it.

Due to the situation with COVID-19 this year the ERS Congress will be held virtually. How do you feel about this, what are the potential pros and cons of a virtual format, and do you think it will change the way the Congress is held in the future?

I am sad that we are going to miss a real-life ERS Congress, because the Congress is one of the professional highlights of the year for many people. However, I think that ERS has come up with the best possible solution. We have to face the current situation and we can use this as the perfect test case to see how far we can go with an online platform. I already had a sneak preview of how things will look and I can tell you that the ERS office is really doing an amazing job; it will be a really exciting platform with lots of opportunities and possibilities, even to interact with each other. I am very much looking forward to how it will evaluated by colleagues; if this is a major success, who knows, maybe in the future we will be able to choose between a full onsite ERS Congress and a light online version, for colleagues with lack of budget or time. Only time will tell.

Staying on the subject of COVID-19: how has it impacted your research and how do you think it will change the direction of respiratory research over the next 5–10 years?

To be short, the impact is huge, all research has been immediately stopped. I guess that in the next 5 years, there will be lots of papers published that will state how many patients were lost to follow-up due to COVID-19. But I also think this is a minor issue, because we all face the same situation and the safety of patients and researchers is way more important. As for how much this will impact future research within 5–10 years, I guess it will depend on whether and when the world gets a grip on this situation. So, I will use my joker for this question. Ask me this question again in a year.

Respiratory sleep conditions/diseases

Several symposia will provide new insights into the management of sleep-disordered breathing, including obstructive sleep apnoea (OSA), central sleep apnoea, nocturnal hypoventilation, dental aspects of sleep disordered breathing, obesity hypoventilation syndrome, sleep apnoea overlap syndromes and neuromuscular disease. In addition, an update on sleep-disordered breathing in children will be presented.

Non-respiratory sleep diseases

Other important updates in sleep disorders not related to respiratory conditions will be covered, e.g. insomnia, narcolepsy, sleep deprivation and psychiatric disorders, among other related diseases.

Diagnostic techniques

The SBC will offer various sessions about new approaches to OSA diagnostic criteria and severity grading, as well as diagnostic techniques used in the sleep medicine field, especially polysomnography and assessment of daytime sleepiness in both adults and children. In addition, the role of telemonitoring in the management of sleep-disordered breathing will be discussed in depth.

Clinical assessment/examination

There will be space for debates on hot topics in differential diagnosis, comorbidity assessment and ENT (ears, nose and throat) aspects of sleep-disordered breathing. The links and distinctions between OSA, cognitive fatigue and sleepiness will be presented. Also, basic mechanisms of sleep apnoea and translation to clinical practice will be debated. For instance, different sessions will demonstrate the association between sleep apnoea and neurodegeneration, cancer, metabolic comorbidities and cardiovascular disease, among others. Furthermore, due to the COVID-19 pandemic, the connection between OSA and COVID-19 infection will be discussed in a promising session.

Treatment

The SBC will provide a state-of-the-art overview of current insights into OSA and hypoventilation treatment considering both continuous airway pressure and bilevel positive airway pressure, as well as high-flow oxygen. In addition, a comprehensive summary of the status of non-continuous positive airway pressure therapies and upcoming personalised treatment of sleep apnoea will be presented.