Alumni Profile: Mark Midwinter

After entering medical school, Mark Midwinter (PGDip Applied Statistics, 1985) pursued an intercalated Bachelor of Medical Science degree focused on transplant immunology.  He then strengthened his statistical knowledge with a Diploma in Applied Statistics at the then-Green College before going on to have an extensive career in the Military. He played a key role in founding the National Institute of Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC). He settled in Queensland, Australia.

Here Mark reflects on his professional journey in work and life so far:

Upon entry to medical school, I was selected to intercalate with a Bachelor of Medical Science degree within my broader medical degree studies. In this, my major area of study was transplant immunology and included a major research component, which made me wish to pursue a clinical research career. Hence, following medical graduation and internship, I enrolled in a Diploma in Applied Statistics to strengthen my knowledge in this area and to prepare for a clinical academic career. I entered a surgical training program with an academic pathway including a period of research to complete my MD (by research).

Following my time at Oxford, I spent 2 years with the British Antarctic Survey as the Medical Officer at Halley Base Research Station on the Wedell Sea. Here, in addition to clinical duties, I researched changes in circadian rhythm of melatonin secretion from the pineal gland. On my return I entered a surgical training program with an academic pathway including a period of research to complete my MD (by research).

During my surgical residency, I developed an interest in trauma and joined the Royal Navy. During this time, I served afloat and ashore with the Royal Marines, including operational deployments, as part of the Commando Forward Surgical Group. Recognising the challenges of early haemorrhage control at both at the Care Under Fire and Tactical Field Care phases of Tactical Combat Casualty Care, these experiences of clinical research and operational forward surgery determined my research interest going forward to the study of haemostasis and damage control resuscitation and surgery particularly in military contexts but also with a view to civilian translation. I worked in collaboration with Defence Scientific and Technical Laboratory scientists at Porton Down on haemostatsis and damage control resuscitation, including in porcine haemorrhage and trauma models. I have supervised 11 military and civilian anaesthetic trainees in their higher research degrees, including some who conducted part of their work both at Porton Down and in military operational environments, as well as more conventional university-based laboratories.

I was appointed Defence Professor of Surgery in 2006 (a joint appointment between Royal College of Surgeons of England and Surgeon General) responsible for academic activities across all surgical specialties and all three branches of the armed forces (Royal Navy, Army and Royal Air Force). I also held an honorary Chair at University of Birmingham (UoB) where my surgical practice was based and was the principal military repatriation hospital for military patients returning to the UK. This was an active time with Operation Telic (Iraq) and Operation Herrick (Afghanistan). I deployed on several occasions to both theatres as part of the surgical team and established the first UK operational research laboratory. This was studying clotting, inflammation, resuscitation and the microcirculation in combat injuries. During my time as Defence Professor I established links with US Army Institute of Surgical Research (USAISR), where I had the privilege of presenting Grand Rounds, and with the US Airforce (59th Medical Wing, Wilford Hall). I organized for 5 trainees to undertake research at USAISR at different times, which was productive and built strong collaborative research and clinical partnerships. These collaborations led to many peer-reviewed publications, including a UK-US examination of tranexamic acid in combat trauma (published as MATTERS I and II studies) and the role of enhanced medical retrieval for wounded combatants. More importantly, the collaborations led to real improvement in care for the wounded.

During this time, I was part of the team that established the National Institute of Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre (SRMRC) and became Deputy Director. This was a $34M collaborative investment between UK Ministry of Defence, NIHR and the University of Birmingham to translate findings between military and civilian trauma clinicians and scientists for mutual benefit. Through this Centre I was successful in obtaining a further $2.5M NIHR grant for a randomized clinical trial of pre-hospital blood product-based resuscitation for major trauma in the UK (RePHILL); this is still currently recruiting. I was graciously awarded a CBE by Her Majesty The Queen for work in improving combat casualty care.

I finished my 24 years of active military service in 2016 and moved to Australia where I practiced Surgery in Queensland. I took up an academic position as Professor of Clinical Anatomy at the University of Queensland and am now Deputy Head of School of Biomedical Sciences. My research work in shock, haemorrhage, clotting, microcirculation and endothelium continues, but also in the context of frailty. I am part of the Jamieson Trauma Institute (Queensland Health, MetroNorth).

With respect to my time at GTC (then Green College), I could add this was one of the most formative experiences, not just because of my academic development, but the enduring friendships I formed.