Dr Richard Burt is a Clinical Associate Professor in Haemato-oncology whose work spans both the clinic and the lab. Specialising in acute lymphoblastic leukaemia, he focuses on understanding treatment resistance and improving patient outcomes. In this profile, he describes his career, research, and balancing the priorities of a clinician and a researcher.
Q: Who are you and what do you do?
I’m a clinician scientist and an honorary consultant haematologist, focusing on acute lymphoblastic leukaemia (ALL). I’m interested in both the clinical aspects of the disease and the translational research that links the clinic to the lab.
What I love most about my job is being able to identify problems at the bedside, whether that’s how patients respond to treatment, their risk of relapse, or the side effects they experience and then take those questions into the lab. I work with talented scientists to try to answer challenging problems we identify in the clinic and then bring those findings back into patient care.
I’m actively involved in managing patients in the clinic, including in clinical trials, and contributing to basic scientific research aimed at improving treatments and quality of life for people with ALL.
Q: Tell us about your career path. When did you join Imperial and how did you get here?
I went to medical school in Dunedin, New Zealand, and early on realised I was interested in oncology and haematology. After about a year and a half of clinical work in New Zealand, my partner and I decided to move to the UK. The original plan was to travel, and eventually head home, but once I started training here, particularly at Imperial and local hospitals, I found a path that really suited me.
I completed most of my haematology training at UCLH and undertook a PhD with Adele Fielding at the UCL Cancer Institute, focusing on the biology of ALL. That experience really hooked me on basic research and the mechanisms of treatment resistance.
From there I received a Clinician Scientist Fellowship through Cancer Research UK, working across the Francis Crick Institute and the Department of Life Sciences. I later moved to the Department of Immunology and Inflammation as a Senior Lecturer and began setting up my own research group about a year and a half ago.
Q: What research questions are you working on right now?
In the last 10 – 15 years, new immunotherapies and targeted drugs have emerged for ALL, significantly improving patient outcomes. But we still rely heavily on chemotherapy, especially to cure children and young adults, and it remains very challenging to cure older adults.
My group is focused on mechanisms of resistance to these newer drugs, particularly a drug called Inotuzumab ozogamicin. We’re studying both mouse models and human samples to understand how the cells that survive treatment differ from the ones that are killed.
We’ve found that surviving cells have distinct metabolic properties and seem to persist in a specific micro-environmental niche in the bone marrow. We’re now investigating combination therapies that target these resistant cells. If these strategies look promising in preclinical models, the goal is to take them forward into clinical trials.
Q: Did your clinical experience influence your decision to focus on cancer treatments, especially ALL?
Definitely. It was a series of experiences that shaped my interests. Early on, I noticed that patients with newly diagnosed ALL often responded well to treatment and went into remission, but many relapsed later despite initially promising results.
I vividly remember seeing patients at different stages: after chemotherapy, after transplant, and later when being palliated. It was frustrating to see such deep remissions followed by relapse, suggesting something unusual in the disease biology.
Working with Adele Fielding at the Royal Free London NHS Trust showed me that you could investigate these challenges in the clinic. During my PhD we discovered that stromal cells in the micro-environment can transfer mitochondria to leukaemia cells, helping them resist chemotherapy-induced oxidative stress, an insight that affected how we thought about chemotherapy scheduling going forward.
That experience gave me a taste of how lab discoveries can shape clinical practice. From then on, I knew I wanted to be a clinical academic. I now split my time roughly 80% research, 20% clinical, and I wouldn’t have it any other way.
Q: What is the most challenging aspect of being a clinician scientist?
The hardest part is staying up to date with both wet-lab science and clinical practice. Most people eventually lean more toward one or the other because it’s difficult to excel in both fields.
A challenge has been accepting that I won’t have the same level of clinical experience as full-time clinicians and shaping my role to reflect that. However, haematology now offers so many different career paths from diagnostic lab-focused clinicians, early-phase trialists, late-phase trialists, and clinician scientists like me who do predominantly wet-lab research, that no-one can be an expert in these areas.
Balancing responsibilities is also challenging. In the clinic, people expect to be able reach you 9-5, Monday to Friday (and sometimes in the evenings and weekends!), but at times you’re deep in lab work and don’t want to be interrupted. Managing those competing demands is an ongoing challenge that I haven’t quite mastered yet.
Q: And what do you find most rewarding about wearing both hats?
It’s a real privilege to work in a university environment. I enjoy teaching, forming collaborations with people across different disciplines, and engaging in scientific writing and project design. There’s a creative aspect to research that I missed when I was working purely as a clinician, where things tend to be more protocol-driven.
It’s also helpful that if one part of your work isn’t going well, you can find satisfaction in the other. If the lab is challenging, you can escape to the clinic, and vice versa. Teaching students and having the time to contribute to education is another rewarding aspect of the role.
Q: When you’re not working, what are your passions and hobbies?
We’re quite a multinational family: I’m from New Zealand, my wife is from Belgium, and our children were born here in the UK. Unsurprisingly, we love travelling. We enjoy holidays in Europe and escaping to New Zealand or Australia during the English winter for an extra summer.
I’m also very into sports. Growing up in New Zealand, I had a very outdoor lifestyle, and I’ve tried to bring that to my kids. We’re involved in tennis, and my daughters are very into swimming. Those are the main things that keep us busy outside of work.