International multimorbidity

As a fourth-year medical student at the University of Glasgow, a career as a clinical academic particularly interests me. Networking early in my degree with staff at the School of Health & Wellbeing offered numerous opportunities to contribute to the school’s research themes. In particular, I wanted to do something that could offer meaningful value rather than a tick-box portfolio-building exercise.

Last summer, I spent eight-weeks with the Public Health group working on a Medical Research Scotland funded fellowship, exploring the relationship between park qualities and psychotic disorders. This was an exciting project which offered opportunities to work on big datasets such as the UK Biobank, develop, code and test research hypotheses, contribute to an active research theme; while also building on my knowledge around research methods, biostatistics and psychotic disorders. This year, I wanted to build on that opportunity and transfer the library of skills I had developed through a clinical focus.

Multimorbidity through a Cardiometabolic Lens

Glasgow is recognised as a research hub for multimorbidity, and it is unsurprising that multimorbidity is rising globally, with ageing populations and increasingly common lifestyle-related conditions. Whether the type of multimorbidity someone has matters when it comes to their risk of heart attacks, strokes and cancer is less well understood. Funded generously by the Scottish Heart & Arterial Disease Risk Prevention (SHARP) Summer Studentship Fund, I was able to undertake a 5-week research project exploring cardiometabolic, non-cardiometabolic and mixed phenotypes of multimorbidity.

This project under the supervision of Dr Takayuki Ando and Professor Bhautesh Jani investigated the risk of developing major adverse cardiovascular events (MACE) and cancer in participants with cardiometabolic, non-cardiometabolic and mixed multimorbidity. Working with longitudinal data from 2009-2019 of the Understanding Society: UK Household Longitudinal Study, I focussed on early multimorbidity (2 conditions) to better understand risk at a stage where lifestyle and preventive medicine could still have a viable impact on patient outcomes.

Condition combinations rather than counts

Analysing data across 10 waves of the survey, I found that mixed multimorbidity – the co-occurrence of a cardiometabolic and non-cardiometabolic condition had the highest point estimate for MACE among the groups examined and was also associated with increased odds of incident cancer. This indicates that the composition of multimorbidity may provide prognostic information beyond the number of conditions alone, even at the early two-condition stage.

These findings may be relevant to how doctors, academics and public health scientists conceptualise risk among patients with early multimorbidity and could help inform future approaches to risk assessment and preventive care.

Is 5 weeks enough?

Reflecting upon my experience, I believe 5 weeks is an achievable timeframe to undertake a summer studentship. However, careful planning and ensuring necessary systems are in place can be instrumental to the success of a short fellowship. This includes access to research data, IT systems, relevant equipment and training before rather than during the fellowship. Working to a defined plan and adapting as the project develops is also a useful competency.

While most summer research fellowships at the undergraduate level typically tend to extend between 6 to 8 weeks, this short span helped us stay focussed and work towards defined goals.

Reflections on the fellowship

An aspect of this project that I particularly enjoyed was discussing our results as a team and exploring the multiple ways we could interpret our findings. It offered me a chance to present my research in a relaxed, constructive setting – an opportunity that is very valuable, especially as an early career researcher.

Those discussions also taught me one of the most important lessons of the summer: learning to sit with uncertainty. Not every result arrives as a clear-cut answer, and I found myself thinking carefully about the difference between what our data suggested and what it could prove.

Choosing the right words to describe a finding, without overstating or underselling it, turned out to be just as much a skill as running the analysis itself. It's something I expect to carry into clinical practice, where explaining risk honestly to patients matters just as much.

Transitioning Findings to Practice

Perhaps the most rewarding part has been noticing how the project has changed the way I think on placement. When I meet a patient with two long-term conditions, I now find myself thinking less about each condition in isolation and more about how they might interact – and what that could mean for their future health. Seeing research questions grow out of everyday clinical encounters and knowing that findings like ours could one day shape how we approach prevention, has reinforced why I want to pursue a clinical academic career.

Overall, I thoroughly enjoyed this project and would highly recommend students interested in multimorbidity to consider a summer studentship with the General Practice & Primary Care research group. It's been an experience that has shaped both my research interests and the kind of doctor I hope to become. This project wouldn't have been possible without the generous support of Dr Takayuki Ando and Professor Bhautesh Jani for their expert supervision, and for giving me the space to ask questions, share ideas and learn from every step of the process.

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First published: 6 October 2026