Angille Heintzman: Transition from MSc to DPhil in Evidence-Based Healthcare

My research interests

I believe that everyone deserves quality healthcare. I have worked for nearly 20 years in patient safety in the NHS and healthcare improvement in Canada, and one thing that worries me is that some groups of people miss out on quality healthcare services. Often there are linguistic and cultural reasons for newcomers missing out on healthcare services, but sometimes there are larger systemic barriers for refugees. I’m interested in understanding how we can improve care delivery for this population. For my MSc, I completed a realist review on cancer screening for refugees focusing on the Canadian context and now I’m working on a DPhil realist evaluation on the same topic across OECD countries.

My MSc experience

The great thing about doing the MSc programme first is learning about EBHC and having practical opportunities through group work and individual assignments to think about and apply different research methods and new knowledge about EBHC. I started on the part-time MSc in 2019 and really enjoyed the in-person Oxford weeks. I felt immersed in the coursework and the university environment and loved getting to know other students and staff in the programme. Of course, my timing meant that the last half of my MSc journey was online, but I still felt connected to the university and my fellow students due to the brilliant way that courses transitioned to online delivery.

Practically, doing the MSc first was invaluable in teaching me about the realist paradigm and the mechanics of looking for contexts, mechanisms, and outcomes – ideas that are key to approaching realist methodology. But also doing coursework in medical statistics and qualitative research will equip me for the later stages of my research project, where I’m hoping to look at quantitative data about cancer screening, and to conduct interviews with patients, primary care providers, and policymakers. I want to understand the full picture of how cancer screening works for refugees and I don’t think I would have been able to do that effectively without the MSc training.

Motivations for completing the DPhil in EBHC

My motivation for doing a DPhil on the same subject was to further expand my knowledge and really get into the detail of all aspects of the topic. The Canadian context was interesting, but what happens when refugees arrive in other high-income countries? And what do refugee patients and healthcare providers really think about cancer screening? These questions couldn’t be explored in as much depth as I’d have liked during the MSc, so I’m excited that I have the opportunity to read around the topic and conduct primary research.

I like improvement work because you get to know new people and how they work in different parts of the healthcare system. I get to help people think differently – and often creatively! – about what they do and how their work could be streamlined. One day, I’d like to work with refugee organizations, small local ones or even one of the large organizations like UNHCR, and I’m hoping my doctoral research will help me build relevant experience and credibility to do that alongside my passions for improvement and healthcare equity.

I’m now finishing up my first year in the part-time EBHC DPhil programme and I’ve had a very positive experience with supervision. Because I used a realist paradigm to carry out my Master's research project, and I’m continuing with a realist evaluation for my DPhil research, having a supervisor who is an expert in realism has been invaluable. It was great to continue with the same supervisor as I started my DPhil, because I know what to expect – like how often my supervisor likes to meet, and what feedback for my written work looks like. I am looking for a second supervisor with more content expertise around screening or refugee healthcare generally.

Before I started, I didn’t look very hard for funding outside of a doctoral student loan. I am currently self-funded in conjunction with the loan, which covers about half of the tuition fees annually, but going into my second year, I have been looking at other sources, like scholarships and travel grants. My suggestion to aspiring DPhil students is to apply by the January deadline so that you’re considered automatically for University of Oxford and your chosen College’s scholarships. Then keep an eye on College newsletters and on Oxford’s funding website for what is out there. Apply for everything you qualify for!

Words of advice

My advice to someone contemplating the DPhil in EBHC? Make sure you can set aside time for it!

The part-time MSc programme worked well for me while also working for a medical association in my home province of Canada and on contract with the NHS. During my first year as a DPhil student, my day jobs got very busy and I struggled to juggle work demands, studying, and all the other things in my life. I’ve now moved over to a quality improvement manager role at Canadian Blood Services, and so far, the work is interesting, and my schedule is again flexible enough to continue my part-time studies. Finding that sweet spot between work, life, and study is important, so you don’t get overwhelmed or feel like you are falling behind. Getting to know your fellow students and keeping in touch with them helps a lot in staying realistic about what student life as a working professional looks like. Good luck to everyone applying for or accepting a DPhil place this year!