Speaker

Prof. Malcolm Sim
B.Sc. (Hons), M.B.Ch.B. (Commended), M.D., F.R.C.A., F.R.C.P., F.F.I.C.M., E.D.I.C.
Consultant in Anaesthesia and Intensive Care Medicine

Intensive Care Unit
Queen Elizabeth University Hospital
1345 Govan Road
Glasgow, G51 4TF

Honorary Professor

College of Medical, Veterinary & Life Sciences
Wolfson Medical School Building
University of Glasgow
University Avenue
Glasgow
G12 8QQ

NHS Research Scotland Senior Fellow

Current Positions
Consultant in Anaesthesia and Intensive Care Medicine, Queen Elizabeth University Hospital Glasgow

I was appointed as a consultant in November 2010 to the Western Infirmary Glasgow. I moved to the new Queen Elizabeth University Hospital in May 2015 following the merger of the Western Infirmary with two other Intensive Care Units.

NHS Research Scotland Senior Fellow

I lead the Critical Care Research at the Queen Elizabeth University Hospital. I am the Chief Investigator or Principal Investigator on a portfolio of local and national studies. Following a successful review, this Fellowship has been renewed until the end of March 2024.

Academic Representative to the Royal College of Anaesthetists’ Scottish Board

As well as updating the college on relevant academic issues I am developing a network of clinicians in Scotland with an interest in academic anaesthesia. This network will allow better dissemination of potential anaesthetic and perioperative trials.

Academic Representative to the Scottish Anaesthetic, Intensive Care Medicine and Emergency Medicine Specialty Training Board.

I advise the national training board Anaesthesia, Intensive Care Medicine and Emergency Medicine on academic issues relevant to training of doctors in these specialties in Scotland.

Academic Representative to the West of Scotland Executive Subcommittee of the Anaesthesia Specialty Training Committee.

As well as my national academic roles I also advise the West of Scotland Executive Subcommittee on issues relating to academia locally. I speak at their yearly induction programme for trainees to outline and promote academic training options available in the West of Scotland.

Invited roles National Institute of Clinical Excellence

I have previously been a part of a panel of experts giving advice to NICE in relation to a particular drug therapy for use in a patient with COVID-19. A large amount of trial evidence has been produced in a relatively short period of time. My role on this committee was to put this evidence into a clinical context and advise NICE as to where in the clinical course of a typical COVID-19 patient the drug should be administered. In addition I contributed the final written report.

Scottish Muscle Network

I was invited to be the anaesthetic and critical care link on the Myotonic Dystrophy Subgroup of the Scottish Muscle Network. In this capacity I have reviewed and updated their guidelines for the perioperative management of such patients including induction and maintenance of anaesthesia. I am also the named point of contact should any person require specialist advice.

Previous Positions

NRS Career Research Fellowship 2015-2018

I was awarded a 3-year NRS Career Research Fellowship in 2015. This has enabled me to substantially progress my research activity described below.

Chair Scottish Critical Care Trials Group 2014-2016

I succeeded Prof. Tim Walsh (Professor of Critical Care, University of Edinburgh) as chair of the Scottish Critical Care Trials Group in 2014. I was actively involved in promoting the uptake of commercial and non-commercial critical cares studies within the 4 NHS Research Scotland Nodes.

Studies promoted included REST (pRotective vEntilation with veno-venouS lung assisT in respiratory failure), STARRT-AKI (Standard versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury), EPOCH (Enhanced Peri-Operative Care for High-risk patients), LUNG-SAFE (Large observational study to UNderstand the Global impact of Severe Acute respiratory Failure), CRANE (novel anti-Flu A compound) and Fluid-TRIPS (The Fluid-Translation of Research into Practice Study).

I undertook a national critical care research prioritisation Delphi exercise with Prof. Peter Andrews (Edinburgh). This identified 3 areas which Scottish clinicians felt were priorities. These were the use of high flow nasal oxygen and outcomes, troponin positive events in ICU and biomarkers to limit antibiotic usage. I devised and secured funding for a 5 UK site high flow nasal oxygen dosing equivalence trial.

I organised the 2014 and 2015 national Scottish Critical Trials Group research meetings. These were combined with the Scottish Intensive Care Society Audit Group meeting to form a two-day event and attracted a range of local and national speakers from across the UK. They were well attended by consultants, trainee doctors, nurses and other allied health professionals.

To support the new CSO Critical Care Specialty Group achieve its aims of promoting awareness of and engagement in research I established a network of research “champions” for every Intensive Care Unit in Scotland. At a meeting in March 2016 (“Critical Care Research in Scotland - Planning for the Next Decade”), it was decided that since there was considerable overlap between the aims and objectives of the Trials Group and the new Specialty Group that there should be the one organisation only (the Specialty Group). The network of research champions became the basis of representation in the new Specialty Group.

Critical Care Representative on the Scottish Healthcare Associated Infection Prevention Institute.

I was the Critical Care representative on this committee and commented on their activity from the perspective of a practising Critical Care Clinician.

Teaching and Education
University of Glasgow Postgraduate On Campus and Online Masters Courses in Critical Care
With a colleague in Critical Care, I have co-developed (since 2016) a portfolio of 4 postgraduate on campus and online courses. They are all available at Postgraduate Certificate, Postgraduate Diploma and full MSc level as follows:
On Campus: Critical Care (first intake of students 2018)
On Campus: Critical Care, Leadership and Management (first intake of students 2019)
Online: Clinical Critical Care (first intake of students 2019)
Online: Critical Care and Leadership (first intake of students 2019)
The courses are very popular and attract applicants from all over the world. I have co-directed and lectured extensively on these courses.
We now have approximately 40 students in the various programmes
Future Post Graduate Online Masters Course in Anaesthesia
I am helping a colleague develop an Online Masters Programme in Anaesthesia. We hope to launch these courses in 2024. Massive Open Online Course (MOOC) “Introduction to Critical Care Medicine”
Along with a colleague in Critical Care, I co-developed a massive open online course “Introduction to Critical Care.” A venture between the University and Future Learn this 3-week online course attracted 1795 learners from across the world in its first run in 2018. The MOOC will now run several times per year and provides an introduction to those who might be interested in the postgraduate on campus and online courses.

University of Glasgow Critical Care Intercalated BMedSci

I coordinate and lecture on the cardiovascular module of the undergraduate Critical Care BMedSci course. This is run by the Glasgow University Section of Anaesthesia, Pain and Critical Care Medicine. It is currently the most sought after intercalated degree amongst medical students at the University.

Supervisor of postgraduate Higher Degree Students

I am currently the supervisor of three MD students and one PhD student:

Student one has recently submitted her thesis examining whether it is possible to relocate dislocated shoulders in the Emergency Department using a target controlled infusion of propofol rather than traditional boluses of the drug. An infusion may be associated with fewer complications e.g. apnoea, aspiration, cardiovascular instability than bolus administration.

Student two is examining metabolomics in sepsis and its use in predicting secondary infections in COVID-19 patients.

Student three is using Electrical Impedance Tomography to examine lung recruitment following extubation using high flow nasal oxygen therapy started prior to the extubation.

Student four is examining the relationship between obesity and critical illness

Higher Degree examiner

I have been an internal examiner for four Higher Degrees and convened a panel for a fifth.

Supervisor of Critical Care Teaching and Research Fellows

To help in the delivery and development of the Masters Programmes we have two Teaching Fellows. I am responsible for coordinating their activity and personal development. In addition several of our Critical Care Fellows have chosen to use the non-clinical component of the posts to undertake research. They help recruit into the portfolio of critical care trials at the Queen Elizabeth University Hospital.

Other Teaching

I lecture on statistics in the local primary FRCA course.
I am an Advanced Trauma Life Support (ATLS) and Ill Medical Patients’ Acute Care and Treatment (IMPACT) instructor.
I undertake bedside Critical Care teaching and tutorials for medical students attached to the Critical Care department at the Queen Elizabeth University Hospital.

I am and have been a supervisor for two Academic Foundation doctors and a senior anaesthetic trainee undertaking an academic rotation in our unit.

Current Research
I am the lead for Critical Care research at the Queen Elizabeth University Hospital. We recruit patients into a diverse portfolio of investigator led as well as local, national and international critical care trials. I am the Chief Investigator for several multi-centre studies I have designed and am or have been the Scottish / UK Principal or Chief Investigator on other multi-centre studies.
Investigator led Critical Care trials

Flow veRsus OxygeNaTion In acutE ReSpiratory failure (FRONTIERS)

High flow nasal oxygen has revolutionised oxygen delivery to critically ill patients. With flow rates up to 60 litres per minute, it better matches a patient’s peak inspiratory flow rate and helps avoid intubation and mechanical ventilation in those with respiratory failure. However, surprisingly, no guidelines exist as to an appropriate flow or inspired oxygen concentration when commencing high flow nasal oxygen therapy which can lead to over treatment and masking of patient deterioration. In this multi-centre study we are recruiting 180 patients with varying degrees of respiratory failure and randomising to three different high flow rates of oxygen. A weaning protocol determines the lowest inspired oxygen concentration at that flow rate to keep the patient appropriately saturated. This study will inform how to commence the therapy in patients with different degrees of respiratory failure.