Puja Mehta: taking the path untrodden

As both a specialist registrar in rheumatology and a clinical research training fellow in respiratory medicine (University College London [UCL], UK), Puja Mehta's curriculum vitae reads like that of several doctors combined. In 2021 alone, she gave talks at the American College of Rheumatology annual meeting and at an intensive care medicine conference, and chaired a scientific session at the winter meeting of the British Thoracic Society. Currently undertaking a basic science PhD on post-COVID-19 interstitial lung disease, Puja's unconventional career path is providing her with an impressive breadth of expertise and unique perspective, combining training across rheumatology, respiratory medicine, haematology, and intensive care medicine.

Despite having no doctors within her immediate family, Puja was drawn to medicine from an early age. “There was ill health in my family, and I grew up in hospitals”, she reflects. What stuck with her from those times was “the sense of safety and trust” in the doctors. “They were there for my family when I was younger, and it is privilege now to be there for other people.” Although initially interested in haematology, the field of rheumatology ultimately offered the perfect home for a generalist with such broad-ranging and interconnected interests. “Rheumatology is the specialty of multisystem conditions and I've really enjoyed working within cross-specialty teams, both clinically and in academia, learning and sharing knowledge to make progress together.” She adds that she really enjoys the diagnostic challenge, as well as the strong relationships built with patients and the ability to explore challenging problems in the lab. Despite not following a traditional career path and not having a constant guide, she notes “it's nice to have met many people that I admire along the way that I can ask for advice. People with a hand on your shoulder, but not pushing you in any direction”.

Puja is also keen to advance scientific discovery and drive the field forward. With research interests including rheumatic-associated interstitial lung disease, immunotherapeutics, hyperinflammation, and the dysregulated immune response, it is no surprise that she is a strong proponent of cross-specialty working. “The best way to refine our thinking and make progress is to work together through collaborations, and I'm keen to bring people together, at the local, national, and international level.” Positioned at the intersection of multiple clinical communities, she believes that “disruption, innovation and creativity usually happen at the edge”.

During her clinical training Puja gained experience in drug development, designing a clinical trial during a pharmaceutical industry fellowship—an out-of-programme experience that was considered atypical at the time. “Taking the path untrodden is now less uncomfortable and we only really know what we are capable of by pushing past our fears. Doing something different on unfamiliar terrains has made me feel a little nervous, but if you are authentic with a strong sense of purpose and passion, and you find like-minded people to work with and share ideas, the ground is very fertile and that sense of belonging (at the edge) comes.”

With an interest in hyperinflammation originating from her background in haematology, she was among the first to make a link between COVID-19 and hyperinflammation, publishing a letter in The Lancet that has now been cited more than 7500 times. The COVID-19 pandemic has highlighted the importance of cross-specialty working as well as the role of rheumatology and the “importance of collaboration with the pharmaceutical industry”, she says, pointing to the unprecedented speed of large-scale clinical trials for vaccines. Puja adds that her pharmaceutical industry experience was not about trying out an alternative career, but about seeing how, as a clinical academic, she might work at the industry–academic interface to drive progress. “We cannot get by one without the other. Partnerships with industry allow us to make changes on a large-scale to help the most patients.”

Putting her wide-ranging expertise to good use, Puja is a member of the EULAR COVID-19 Task Force and the UK Coronavirus Therapeutics and Advisory Group, where she has been impressed with the civility of discourse—“the process of how people make decisions by being open to alternative views and disagreeing respectfully”.

Now collaborating with The Lancet Rheumatology on the Clinical Realities podcast miniseries, Puja describes the process as refreshing and energising. She hopes that the podcast series will not only illuminate unmet need but also bring about real change. “The pandemic has captured a zeitgeist of acknowledging and addressing injustice that has long been normalised and gone unchallenged.” As the current clinical chair of the early career research network and a member of the Athena Swan committee at UCL, she is committed to inclusion, diversity, and equality initiatives to improve research culture. As a former radio presenter, she is also driven by making connections with people and is eager to explore the journeys and motivations of pioneers leading progress and addressing unmet needs.

Outside of her wide-ranging clinical and academic interests, Puja makes keeping in touch and spending time with friends a top priority as well as practising barre—which she describes as a fusion of ballet, pilates, and yoga—reflecting her talents for building strong personal connections and community as well as her love of combining disciplines.