Malcolm aims to improve the outcomes of patients undergoing major cancer surgery, utilising multimodality prehabilitation interventions and interrogating the interplay between physiological resilience, surgical technique and cancer biology to deliver long-term patient benefit.

He is a senior investigator within the NIHR Southampton BRC Perioperative and Critical Care theme. Malcolm leads a translational research programme, aimed at improving perioperative and long-term outcomes in patients undergoing major cancer surgery. He leads various clinical trials interrogating the variability around the perioperative period utilizing risk assessment techniques and tailored multimodal prehabilitation interventions to improve resilience and outcomes after cancer treatment and major surgery. 

His research interests include interrogating the interplay between pathophysiological mechanisms of changing fitness, body composition, tumour/immune microenvironments and mitochondrial function with cancer therapies and the prehabilitation interventions to rescue and improve metabolic health, physiological resilience, and cancer outcomes.

Malcolm trained as an undergraduate at the University of Malta (MD, 2000-2005) before moving to the Northwest and Merseyside for foundation and core surgical training. 

He completed an NIHR-funded doctoral research programme in prehabilitation, exercise physiology, perioperative surgical risk stratification, and mitochondrial energetics with Professors Kemp, Grocott and Jack (PhD, 2011-2014) leading the first UK prehabilitation study in locally advanced rectal cancer patients undergoing chemoradiotherapy. During his PhD, he was the Clinical Lead for the Perioperative Cardio-Pulmonary Exercise Testing (CPET) service at University Hospitals Aintree. 

He was then appointed as an NIHR academic clinical fellow in

Wessex (NIHR ACF, 2014-2016) and subsequently an NIHR clinical lecturer (NIHR ACL, 2016-2020). He completed specialist training in general surgery in August 2020, with a subspeciality in colorectal surgery (FRCS 2019, FEBS 2023). 

Malcolm was awarded the Royal College of Surgeons, England, Minimally Invasive and Maximally Invasive (MIMICC) fellowship in Complex and Robotic colorectal cancer surgery at St. Mark’s Hospital, London (2020-2021), and the Association of Surgeons Great Britain and Ireland Moynihan Travelling Fellow (2021-2022). 

In 2021, he was appointed Associate Professor in Colorectal Surgery and Prehabilitation Medicine at the University of Southampton, with an honorary appointment as a consultant colorectal and complex cancer surgeon at University Hospitals Southampton NHS Foundation Trust. He has published extensively with significant high-impact papers in risk stratification, prehabilitation and perioperative medicine. During his training he was awarded the British Journal of Surgery, John Farndon Prize in 2015, and again in 2017 for his research in predicting surgical outcomes using CPET. 

He was co-investigator for several NIHR and NHSE trials including WesFit – The Wessex Fit-4-Cancer Surgery (wesfit.org.uk), SafeFit (safefit.nhs.uk) and FrOGS (>£3M). He is an NIHR GlobalSurg core member with an interest in global surgery and cancer outcomes in low to middle-income countries, with impactful publications in healthcare utilization and long-term outcomes. 

Currently his week is split between NHS clinical activity, academia and education. He is the Academic Career Development Lead (ACDL) for the Southampton BRC, and the co-lead for rapid diagnostics in colorectal surgery for the Wessex Cancer Alliance. 

He has previously served as the sub-speciality lead for the surgical research portfolio at the Clinical Research Network, Wessex. He is also the incoming co-chair of the NIHR Research for Patient Benefit programme for southern England. 

He has a keen interest in career development and education. He supervises numerous PhD, MD, MMedSc and BMedSc students, mentors research nurses in Principal Investigator roles, is the MMedSc Deputy Module Lead for Research and the Southampton NIHR Clinical Academic Training Lead for SoCATs.