Professor Thomas Justin Clark MB ChB, MD (Hons), FRCOG

Professor Thomas Justin Clark

Department of Metabolism and Systems Science
Consultant Gynaecologist
Honorary Professor of Gynaecology

Contact details

Justin Clark was appointed as a Consultant Gynaecologist at the Birmingham Women’s and Children’s Hospital NHSFT in 2004. He was made an Honorary Professor at the University of Birmingham in 2015. Justin is dedicated to conducting relevant, high quality, patient-centred research to improve clinical outcomes.

Justin’s research team evaluates health technologies, care pathways / settings, novel medical therapies and minimally invasive surgery to manage abnormal uterine bleeding, pelvic pain, endometriosis and early pregnancy loss; highly prevalent conditions causing significant morbidity and NHS resource use. He conducts large, multicentre trials and attracts substantial collaborative funding. Justin pioneered outpatient hysteroscopic interventions and his work has led directly to the expansion in ambulatory services across the NHS.

Justin is an international leader of clinical research in gynaecology and lectures across the world. He formed the Royal College of Obstetricians and Gynaecologists Clinical Studies Group in Benign Gynaecology, which he chaired from 2011-2017. In 2019, Justin established a national research network for ambulatory hysteroscopic interventions. Justin is the President of the British Society of Gynaecological Endoscopy (BSGE) (2020-2022).

Two of Justin’s students have been awarded PhDs and three MDs. He has supervised an NIHR Academic Fellowship and is currently lead supervising one PhD and one MD student. He has published over 200 peer reviewed papers, national evidence-based guidelines / reports and several books, including a major textbook in hysteroscopic surgery (2020). Justin is on the Editorial Board of the British Journal of Obstetrics & Gynaecology, having previously been a Scientific Editor from 2009-2020.

Qualifications


  • F.R.C.O.G. Fellowship of the Royal College of Obstetricians and Gynaecologists, UK (23/09/16)
  • M.D. (Hons) Doctor of Medicine (awarded with honours), University of Birmingham, Birmingham, UK (15/7/04)
  • M.R.C.O.G. Membership of the Royal College of Obstetricians and Gynaecologists, UK (13/05/99)
  • D.F.F.P. Diploma of the Faculty of Family Planning, UK (1/3/97)
  • M.B., Ch.B. Bachelor of Medicine, Bachelor of Surgery, University of Birmingham, Birmingham, UK (5/7//93)

Biography

Justin Clark was appointed as a Consultant Gynaecologist at the Birmingham Women’s Hospital in 2004 and an Honorary Professor at the University of Birmingham in 2015. He has clinical and research interests in benign gynaecological conditions, especially uterine disorders, abnormal bleeding and pelvic pain / endometriosis, and the use of ambulatory interventions including outpatient hysteroscopy and the role of endoscopic surgery.

Justin’s research includes conducting systematic reviews, observational studies and multi-centre trials evaluating interventions and health technologies for diagnosing and treating gynaecological conditions. He is currently leading two NIHR RCTs evaluating laparoscopic surgery for benign uterine pathologies and deep endometriosis.

In 2011 Justin formed the Royal College of Obstetricians and Gynaecologists Clinical Studies Group in Benign Gynaecology (Chair 2011-2017). In 2019 he established a national research network for ambulatory hysteroscopy. Justin is President of the British Society of Gynaecological Endoscopy (2020-2022) and he has chaired its Scientific Advisory Committee since 2013.

Justin is on the Editorial Board of the British Journal of Obstetrics & Gynaecology (Scientific Editor 2009-2020) and an Associate Editor on Facts, Views and Vision in ObGyn.

Justin has published over 200 peer reviewed papers including original research, reviews / commentaries, national reports and evidence-based guidelines, book chapters and several books, including a major textbook in hysteroscopic surgery (2020) and an post-graduate educational book which won a BMJ Book Award (2009).

Justin have developed novel teaching programmes including the use of expert patients to teach gynaecological examination and simulation in gynaecological ultrasound. He is Director of the Birmingham Women’s Hospital Clinical Teaching Academy (2005 - ) and was an external examiner at Keele University (2012-2016).

Two of his research students have been awarded PhDs, three MDs and he is currently supervising two students (one PhD, one MD). Justin has examined several research theses in the UK and Europe.

Teaching

General contribution to undergraduate teaching at the University of Birmingham

  • Head of Birmingham Women’s Hospital Clinical Teaching Academy
  • Senior Clinical Examiner / Invigilator MBChB (host of the Birmingham Women’s Hospital Clinical Teaching Academy examination site)
  • Interviewer for UoB Medical School Admissions (MMIs)
  • Member of ad hoc Fitness to Practice committees
  • Acting as an external Head of Academy during the UoB Medical School Quality Assurance Visits to Clinical Teaching Academies

Undergradute teaching programmes

5th year MBChB Obstetrics, Gynaecology and Neonatology clinical placement:

  • Lecture on Academic in Days
  • Tutorials

2nd year MBChB:

  • Provide (supervise and examine) ‘Personal Interest Projects

1st year MBChB:

  • Provide two ‘Research Taster’ sessions

Postgraduate supervision

Two of his research students have been awarded PhDs, three MDs and he is currently supervising two students (one PhD, one MD). One was awarded an NIHR Academic Fellowship and three became University Lecturers (two now Honorary Senior Lecturers)

Current Supervision

  • PhD - University of Birmingham, UK. Preth de Silva. Best practice in the diagnosis and treatment of endometrial pathology and miscarriage in the outpatient setting (2019 – date)
  • MD - University of Birmingham, UK. Helen Stevenson. Management of uterine disorders (2016-date) 

Past supevision - Doctor Philosophy (PhD)

Past supervision - Doctor of Medicine (MD)

Research

Research Themes

  • Evaluation of diagnostic and therapeutic health technologies, care pathways / settings, novel medical therapies and minimally invasive surgery to manage common benign gynaecological conditions; abnormal uterine bleeding, pelvic pain, endometriosis, menopause, subfertility and early pregnancy loss

Research Activity

  • Systematic reviews and meta-analyses into pain control and clinical outcomes of outpatient hysteroscopic surgery
  • Developing through systematic reviews and a delphi consensus process an endometrial polyp classification and evaluation of reproducibility and predictive value for endometrial (pre)malignancy
  • Series of systematic reviews and meta-analyses into medical and non-surgical interventions for dysmenorrhoea and a randomised controlled trial (RCT) evaluating pulsed electromagnetic field treatment
  • Diagnostic accuracy study of a new blood test biomarker for endometriosis, compared with the current gold standard surgery for diagnosis
  • RCTs into the impact of hysteroscopic treatment of intrauterine retained products of conception after miscarriage in subsequent fertility
  • Observational study evaluating the feasibility and effectiveness of portable glycine endometrial ablation device in treating women with heavy menstrual bleeding
  • RCT comparing endometrial ablation plus levonorgestrel releasing intrauterine system versus endometrial ablation alone to prevent dysmenorrhea in women with heavy menstrual bleeding
  • RCT comparing laparoscopic and abdominal hysterectomy (LAVA)
  • RCT comparing medical management versus early surgery for deep infiltrating endometriosis (DIAMOND)
  • RCT to determine the effectiveness of laparoscopic treatment of isolated superficial peritoneal endometriosis for the management of chronic pelvic pain in women (EsPRIT).
  • RCT Recurrence of Endometriosis: clinical and cost effectiveness of gonadotrophin releasing hormone analogues with add back hormone replacement therapy versus repeat laparoscopic surgery (REGAL)
  • Ulipristal acetate versus conventional management of heavy menstrual bleeding (HMB; including uterine fibroids): a randomised controlled trial and exploration of mechanism of action (UCON)
  • Preventing Recurrence of Endometriosis by Means of long acting Protestogen Therapy   (PREEMPT)
  • Phase III clinical trial evaluating neurokinin receptor antagonists for the treatment Moderate to severe Vasomotor symptoms in patients with menopause

Research Groups and Centres

Other activities

Research appointments

  • Member of the Editorial Board of the British Journal of Obstetrics & Gynaecology (2020 – present)
  • Associate Editor of Facts, Views and Vision in ObGyn (2017-2019)
  • Member, National Institute for Health Research (NIHR) Health Technology Assessment (HTA) Programme for Hospital Inpatient Care (previously Women, Children and Mental Health Research Panel (2016 - present)
  • Chair of the BSGE Scientific Advisory Group in Endometriosis (2013 – present)
  • Member Royal College of Obstetricians and Gynaecologists Clinical Studies Group for Benign Gynaecology and Early Pregnancy (2017 – present)
  • Chair, Data Monitoring Committee, Dexamethasone for Excessive Menstrual Bleeding (DexFEM trial - NCT01769820) – MRC 2016 –Developmental Clinical Studies - PI: Prof H Critchley, University of Edinburgh (2013-2019)
  • Member of the Royal College of Obstetricians and Gynaecologists Lindsay Stewart Audit & Clinical Informatics Committee (2015 – 2019)
  • Chair, Royal College of Obstetricians and Gynaecologists Clinical Studies Group for menstrual disorders, endometriosis and gynaecological endoscopy (part of the NRHRN RCOG research network, 2011 – 2017).
  • Member of the Royal College of Obstetricians and Gynaecologists Research Committee (2011 – 2017:)
  • Scientific Editor of the British Journal of Obstetrics & Gynaecology (2009 – 2020)
  • Associate Editor of Gynecological Surgery (2017-2019)

Clinical appointments

  • President of British Society for Gynaecological Endoscopy (BSGE; 2020-2022), Vice President (2018-2020) and elected Council Member, Research and Audit Portfolio (2013-2018)
  • Chair of the Scientific Advisory Committee for the BSGE Virtual Annual Scientific Meeting (2020-2021) and BSGE Birmingham ASM (2021 - 2022)
  • Member of the Executive Board of the European Society of Gynecological Endoscopy (ESGE; 2020 – present)
  • Elected Member of the Gynaecological Visiting Society (GVS; 2008 - present)
  • Member of the National Institute for Health and Care Excellence (NICE) Heavy Menstrual Bleeding Guideline / Quality Standards Advisory Committee (2016 – 2020)
  • Member of the International Federation for Gynecology & Obstetrics (FIGO), Menstrual Disorders sub-committee (2015 – present)
  • Elected Council Member of the Royal College of Obstetricians and Gynaecologists (2007-2013)
  • Elected Council Member of the Birmingham and Midland Obstetrical and Gynaecological Society (2007 – 2014)

Publications

Mahmud A, Smith PP, Clark TJ. Benchmarking services in Outpatient hysteroscopy (OPH): a quality improvement project. EJOG 2021 (E Pub ahead of print).

De Silva PM, Stevenson H, Smith PP, Clark TJ. A systematic review of the effect of type, pressure and temperature of the distension medium on pain during office hysteroscopy. JMIG 2021 (https://doi.org/10.1016/j.jmig.2021.01.003. E pub ahead of print)

Rikken JF, Verhorstert MW, Emanuel MH, Bongers MY, Kuchenbecker W,  Jansen FW, van der Steeg JW, Janssen CA, Kapiteijn CJ, Schols WA, Torrenga B, Torrance HL, Verhoeve HR, Huirne JA, Hoek A, Nieboe TEr, van Rooij IA, Clark TJ, Robinson LL, Stephenson M, Mol BW, van der Veen F, van Wely M, Goddijn M. Septum resection in women with a septate uterus: a cohort study. Hum Reprod. 2020 Jul 1;35(7):1578-1588. doi: 10.1093/humrep/dez284. PMID: 32353142.

Horne AW, Vincent K, Hewitt CA, Middleton LJ, Koscielniak M, Szubert W, Doust AM, Daniels JP; GaPP2 collaborative (GaPP2 collaborative: Suraiya Abdi, Santanu Acharya, Shamma Al-Inizi, Elizabeth Ball, Andrew Baranowski, Nadia Bhal, Kalsang Bhatia, Siladitya Bhattacharya, Judy V Birch, Tyrone Carpenter, Tony Chalhoub, Ying C Cheong, T Justin Clark, Roman Cregg, Tunde D Dada, Dib Datta, Radwan Faraj, Max G Feltham, Pratima Gupta, Dharani Hapangama, Chris Hardwick, Jon Hughes, Pinky Khatri, Geeta Kumar, Lisa J Leighton, Kingshuk Majumder, Gary J MacFarlane, Alex Mortimer, Smita Odedra, Bruce Ramsay, Amer Raza, William Rea, Somendra Roy, Afia Sajid, Lucky Saraswat, Ahmar Shah, Jambulingam Sivasamy, Rashmi Srivastava, Clive Stubbs, Ajay Swaminathan, Premila Thampi, Omar Thanoon, Tony Thomas, Irene Tracey, Martyn Underwood, Clare Willocks, Amanda C de C Williams, Simon Wood, Krina Zondervan). Gabapentin for chronic pelvic pain in women (GaPP2): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet. 2020 Sep 26;396(10255):909-917. doi: 10.1016/S0140-6736(20)31693-7. PMID: 32979978

De Silva PM, Wilson L, Carnegy A, Smith PP, Clark TJ. Cervical dilatation and preparation prior to outpatient hysteroscopy: a systematic review and meta-analysis. BJOG. 2020. doi: 10.1111/1471-0528.16604. Online ahead of print. PMID: 33219606.

De Silva PM, Mahmud A, Smith PP, Clark TJ. Analgesia for Office Hysteroscopy: A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2020;27:1034-1047. doi: 10.1016/j.jmig.2020.01.008. Epub 2020 Jan 23. PMID: 31982584

De Silva PM, Carnegy A, Smith PP, Clark TJ. Vaginoscopy for office hysteroscopy: A systematic review & meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2020;252:278-285. doi: 10.1016/j.ejogrb.2020.06.045. Epub 2020 Jun 23. PMID: 32645643

De Silva PM, Carnegy A, Smith PP, Clark TJ. Local anaesthesia for office hysteroscopy: A systematic review & meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2020;252:70-81. doi: 10.1016/j.ejogrb.2020.05.062. Epub 2020 Jun 2. PMID: 32570188.

Clark TJ and Connor ME. (Eds). Diagnostic & Operative Hysteroscopy 2020 1st Edition ISBN 9781107111608 Cambridge University Press, August 2020. ISBN 9781107111608

Cooper K, Breeman S, Scott NW, Scotland G, Clark TJ, Hawe J, et al. Laparoscopic supracervical hysterectomy versus endometrial ablation for women with heavy menstrual bleeding (HEALTH): a parallel-group, open-label, randomised controlled trial. The Lancet 2019;394:1425-1436. DOI:https://doi.org/10.1016/S0140-6736(19)31790-8