Before starting at City, and following an early career in landscape gardening, Rosa worked in primary care as a general practice manager before joining the School of Medicine and Dentistry at Queen Mary University of London (QMUL) in 1999, where she led a team of clinicians and facilitators in the Clinical Effectiveness Group (CEG). Rosa facilitated the development of a set of clinical and administrative performance indicators, a local initiative and a precursor to the GMS Contract. The CEG additionally adapted clinical guidelines for local use and provided support and training to primary care practitioners across east London. During this time, Rosa was also a sessional Primary Care Tutor in City and Hackney, organising and facilitating education for GPs as well as being a fully trained Kings Fund Organisational Auditor, travelling around the UK and carrying out organisational audits of NHS trusts which had applied for Kings Fund accreditation. Rosa was also lead of the Hackney Practice Development Project, a local scheme matching practice managers to general practices requiring organisational or management support.

"Transgender health and social issues - Queer and feminist research methods - LGBTQ sexual health - National and international health policy and the impact of migration on the health of migrants"