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Moving to the enlightened side: how did I end up here?
  1. Stephen H Powis1,2
  1. 1 Medical Directorate, NHS England, London, UK
  2. 2 Department of Nephrology, University College London Medical School, London, UK
  1. Correspondence to Professor Stephen H Powis, Department of Nephrology, University College London Medical School, London SE1 6LH, UK; s.powis{at}

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My guess is that most medical leaders feel like imposters from time to time. How did we end up in such influential positions? How on earth did we get here? For myself, it only feels a heartbeat since I was a medical student and I certainly did not set out to be where I am now. So exactly how did I end up being national medical director of NHS England? This is my story.

The simple truth is I initially set out to be a clinical academic, but somewhere along the way I got diverted. After various senior house officer posts in London, I decided to pursue a career in renal medicine. I already had an intercalated BSc in Immunology and had always intended to study for a PhD in the same subject. Renal medicine, and in particular transplantation, was a good fit. And most importantly of all, the SHO job I had enjoyed the most was at Guy’s renal unit.

So in 1988, I began my nephrology specialty training back at Guy’s. Two years later I successfully applied for a 7-year Medical Research Council Clinician Scientist Fellowship, the first 3 years of which was to be spent in the immunogenetics laboratory at the Imperial Cancer Research Fund in central London.

Fast forward another 5 years, my training was complete and I was appointed Senior Lecturer at Guy’s. Then 2 years later I moved to the Royal Free to take up the newly created Moorhead Chair of Renal Medicine. My intent was to build a …

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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