Signup to the American Physician Scientist Association Conference April 15th-17th 2011; An opportunity to meet world-class physician scientists

If you are a medical student interested in research, this meeting should be one of the items in your to-do list! The APSA meeting provides exceptional opportunity for medical students undertaking research or considering a science career in medicine. You get to meet up with first-class physician scientists and important policy makers in medical science.

I went to APSA meeting on April last year and tremendously enjoyed it , and here is a 'summary' of the events and highlights from last year's meeting.

The meeting started with a keynote lecture by Professor E. Albert Reece (pictured), Dean of the University of Maryland Medical School. His research team is trying to figure out the mechanism of birth defects in fetuses born to mothers with type 2 diabetes mellitus. While summarizing unpublished data, he emphasized the advantage of being a physician scientist whereby the problem is identified in the clinic and taken to the laboratory for thorough investigation.

E. Albert Reece

The Noble Laureate in Medicine and Physiology, professor Joseph Goldstein (pictured) from UT Southwestern Medical Centre inspired the audience as he explained the ingredients of being a good physician scientist. In order to get his message across, he used quotes from noble laureates and other notable scientists. For example, one of the interesting quotes were for Sir Peter Medawar (pictured); ‘the intensity of a conviction that a hypothesis is true has no bearing over whether it is true or not.’

Professor Goldstein also emphasized the following for those about to embark on science research;

1/ Have focused research strategy

2/ Don’t become wedded to a technical gimmick

3/ Don’t confirm a finding that no longer needs reconfirmation

Following the publication of recent figures reflecting inequalities between male and female doctors in respect to a number of features including income and professorship positions, the meeting invited a panel of speakers to address the roots of this happening and how to change it. Deans of New York and Johns Hopkins were among the audience and contributed to the discussion in different ways.

Day 1 ended with a number of science talks on areas of cancer biology, mechanism of vascular disease, neurodegeneration and cell biology. Conference delegates were invited for dinner followed by drink receptions with live Jazz music at the Jay Pritzker stage in Chicago’s lively Millennium park.

Jay Prtizker

The Highlight of Day 2 was a speech given by the director of the National Institute of Health (NIH), Francis Collins (pictured) who was nominated by President Barack Obama in July 2009. Professor Collins supervised the Human Genome Project. If you don’t know him, I recommend Google; otherwise you might be able to see few clips of him playing guitar on Youtube !! He described four opportunities for the NIH to contribute to research in the US and worldwide;

1/ Using high throughput technologies to understand basic biology and uncover causes of diseases

2/ Translating basic science discoveries into better treatments

3/ Putting science to work for the benefit of health care

4/ Encouraging a greater focus on global health

During dinner, He reflected on his experience as an MD/PhD student facing a high degree of uncertainty and feeling challenged in a lab that no one spokes English very well to offer some help !! Nonetheless, it was one of Winston Churchill’s quotes hanging on the lab wall that kept his enthusiasm going despite negative results and technical difficulty – ‘’ Success is made by moving from failure to failure to failure’’!!! Keeping this in mind, together with a motivating mentor, Collins research made it to shores with a discovery of genetic locus responsible for sickle cell anaemia. Reflection does not stop at this point for Collins as he pulls out his guitar (with a symbol of the DNA helix imprinted on it) and starts singing with talent !

Later talks focused on how a study of worm biology can yield a therapeutic potential in worms, the mechanism of degenerative disease in muscle disorders and genetic strategies to modify disease pathophysiology.

We were broken into three seminars of ‘how to write a grant’, ‘residency planning’ and ‘the transition from being a medic into a scientist’. I attended the later meeting attended by MD/PhD directors of Rochester University and Stanford University. Directors spoke of perseverance as a quality to cultivate in the beginning of one’s academic career. ‘Two important points you need to remember; select a suitable lab and have perseverance’’, one of the speakers said. Choosing a lab depends on the personality of the student and their supervisors – other important points are whether you prefer working in a lab where you prefer to be left alone to do your own experiments and present whenever you have data, or else a lab where you get monitored constantly and shown what to do. Selecting the appropriate supervisor should be an informed decision of the student following a meeting with the supervisor and exploration of what other students thought of the lab.

Exchange of research ideas and critical feedback of one’s own work take place mostly in the poster session. I have been lucky to have breakfast with Dr Germino, Deputy Director of the National Institute of Diabetes and Digestive and Kidney Diseases. He came afterwards to look at my poster and provided very helpful feedback. It got more exciting when I had another prolific discussion with Prof Marcus, a distinguished scientist from Cornell University. The beauty of the meeting is that you get a chance to meet up with successful and bright physician scientists.

The last day of the conference was highlighted by talks from important physician scientists such as John Niederhuber, Director of the National Cancer Institute, and a noble laureate Ferid Murad, the director of the institute of molecular medicine at the University of Texas. In addition, I had opportunity to listen to elegant presentation of interesting science on stem cell research.

The meeting ended with a lunch with residency directors and directors of MD/PhD programmes across the US.

Even though I travelled by myself to the meeting, I felt very welcomed and accommodated by APSA members including very respectable and approachable MD/PhD colleagues. This made my stay in Chicago even more exciting !!

In short, the meeting is highly enjoyable, very educational, mind broadening and full of opportunities for collaboration and exchange of thoughts, scientific criticism and feedback, but most importantly a great way to make friends !!

So you better watch out for the next meeting ; http://meeting.physicianscientists.org/

Ayoub Dakson

Membership Committee, Manchester University/UK rep

Please email Ayoubdakson@googlemail.com for further queries.

Nature Book Reviews: The Vanishing Physician Scientists?

The USA is the birthplace of many prominent physician-scientists and even there, it appears that the numbers of practicing physician-scientists are dwindling. This book, reviewed by the journal Nature, offers possible explanations for the drop in physicians who practice science.

The academic niche for physician-scientists has been degenerating for over three decades. In 1979, the director of the US National Institutes of Health (NIH), James Wyngaarden, initially highlighted an alarming drop-off in the number of physician-scientists and their success rates in NIH funding. Since then, the combined burdens of an increasingly stringent overall NIH budget, educational loans on young physicians (often in the six figures), the procedure-driven nature of modern clinical medicine, and the financial vise of managed care and its follow-on effects on the academic environment have created an increasingly ablative force on the necessary environment to maintain a proper balance in the numbers of physician-scientists. In The Vanishing Physician-Scientist?, edited by Andrew I. Schafer, currently chairman of the Department of Medicine at Weill Cornell Medical College, the fate of the physician-scientist is revisited from multiple angles: renewal versus extinction, the evolution of diverse lineages (MD-PhD, late bloomers with MD degrees alone, PhDs in clinical departments), implications for biotechnology and drug discovery, gender imbalance, pipeline versus attrition effects, role models, financial and modern lifestyle concerns and the fragile microenvironmental niche of academic medicine in general. The result is a fascinating must-read for those of us with a deep interest in the subject that goes beyond conjecture and anecdotal personal experience to recent academic survey data, population analyses, current NIH funding trends, outcome analyses of MD-PhD trainees and, most importantly, onward toward a series of cogent, specific and implementable suggestions for regeneration. As the last page is turned, a more sanguine view of the problem emerges, along with a few surprises.

The book is comprised of 15 chapters written by over twenty leading physician-scientists who offer a number of penetrating insights into the crux of the problem of regenerating a new cadre of leaders in academic medicine. For example, as noted in the book by Tim Ley, a former president of the American Society of Clinical Investigation, the demographics of physician-scientists have been relatively stable since 1990. The bulk of these researchers hold an MD degree alone, and their success rates for NIH funding are similar to others with PhD or MD-PhD joint degrees. A surprising trend of combined MD-PhD trainees moving away from scientific careers is also evident in survey analyses. Interestingly, a case can be made to enhance our focus on designing strategies for renewing the population of physician-scientists. Also, as noted by Ley, the pool of physician-scientists is still overwhelmingly male, despite the near equal number of females in medical school today, indicating a need to address gender-specific issues.

'Translational medicine' has become the mantra for every medical school dean in the US and elsewhere, and, as presented by Barry Coller, the physician-in-chief of Rockefeller University, in his chapter, regenerating the pool of physician-scientists is clearly central to this goal. Increasingly, scientific centers of excellence are forging close networks with leading medical institutions, creating an interactive, nurturing microenvironment for physician-scientists. In this new era, in which humans themselves are models for human disease, technological barriers are rapidly breaking down, as higher-throughput human genotyping, whole exome or genome sequencing and high-content chemical screening on human stem cell model systems are becoming customary. The major discoveries in genomics research coming out of the Broad Institute at the Massachusetts Institute of Technology, in close collaboration with physicians at Massachusetts General Hospital and elsewhere, come to mind. Finding the extreme and rare clinical phenotypes of major interest, and having the capability of calling back the patient for additional information, will be increasingly important going forward. However, as Coller clearly documents, academia must recalibrate how young physicians are recognized, protected and promoted as essential components of these large interdisciplinary teams.

The crucial role of the environmental academic niche for physician-scientists, and the need for its substantial modification, is a major point of discussion in many chapters. In terms of mentoring, the needs for earlier exposure to research in the core medical curriculum, as well as in post-graduate MD training, the inclusion of off-site mentors and exposure to successful physician-scientists that have managed to balance the scientific and medical demands of their profession with personal family goals are mentioned throughout the book. The need for the institution itself to create a more nurturing infrastructure is also highlighted.

Finally, as noted by the preeminent physician-scientist David Nathan, the former president of the Dana-Farber Cancer Institute and also the physician-in-chief of Children's Hospital in Boston, there has never been a more exciting time to be a physician-scientist. “They must not and will not vanish,” he writes. “Indeed, their future can be as bright as ever if we proactively fashion it with creativity, foresight, and vision.” This future is clearly being empowered by annotated digital medical records, expanding databases on genotype-phenotype disease correlations from global collaborations, and research centers and networks funded by major philanthropic organizations and individuals. Likewise, the ability to study human disease in a dish, offered by recent advances in human stem cell biology, are extraordinary, offering the possibility of studying extremely rare and highly differentiated human cells from people with specific, rare and/or common diseases. Clearly, a resurgence in human physiology is on the horizon, and this need alone is likely to lead to a new breed of physician-scientists. The future of biology might be summed up in three words: human, human and human. Stethoscope, anyone?

You can buy this book from Amazon here.

The Magic of Placebo

We posted previously about the placebo effect. Here is Eric Mead demonstrating the placebo effect using magic! Warning: this video is not for the quesy.

How can sugar pills cure diseases?

Ben Goldacre, doctor and author of 'Bad Science', explains what the placebo effect is and describes its role in medical research and in the pharmaceutical industry.

For more about this subject, you can buy the bestselling book, 'Bad Science' by Ben Goldacre, from Amazon