Chapter 19: The Physician-Scientist in Pathology: A Challenging Career

Title

Chapter 19: The Physician-Scientist in Pathology: A Challenging Career

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Here Dr. Bruner talks about the challenges to a physician-scientists in pathology. (Noting that they do not have the responsibility of being on call for patients.) She notes that there is a different between the passion for laboratory work and an interest in thinking about problems that come up in the laboratory. The laboratory research career, she says, takes internal drive, and the Department of Pathology attempts to support those who have it with time and laboratory space. She mentions some young faculty members who have that drive and observes that all researchers need early support and mentoring to become successful.

Identifier

BrunerJM_02_20120607_C19

Publication Date

6-7-2012

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Personal Background; The Researcher; Overview; On Research and Researchers; Understanding Cancer, the History of Science, Cancer Research; Understanding the Institution; The Life and Dedication of Clinicians and Researchers; Institutional Processes; Building/Transforming the Institution; Multi-disciplinary Approaches; MD Anderson Culture

Transcript

Tacey Ann Rosolowski, PhD:

I wanted to shift gears just a little bit, and it’s kind of returning to a question that we touched on sort of obliquely when you were mentioning the challenges that those two faculty members were having when you were trying to encourage them to switch to the clinical track. This is actually an issue—a theme—that’s come up in other interviews, which is the challenges that the faculty involved in patient care face when they’re trying to support a research career. In fact, Margaret Kripke in the interview I did with her said that one of the lingering issues that she felt she had not been able to fully address or even really begin to address when she was in her vice presidency was solving that problem of how to support the physician—the physician scientist—the physician researcher. Now, you mentioned in your essay that you did for “Legends and Legacies” that they were using digital media strategies to address that. So I was wondering. Could you talk a little bit about what those are and also what your view is of that problem for the physician scientist?

Janet M. Bruner, MD:

I don’t know what I said about digital media for research. I think the first thing that you have to have to be a scientist is you’ve got to have the internal drive that way. All the faculty who come to work here think that they should be very interested in research, and a lot of them are not as interested in having their own investigative research career as they are in just thinking about problems—in clinical problems, clinical research, interesting cases, maybe teaching—and that’s fine. It’s a part of clinical research or non-patient care but valuable activity, but I think to have a laboratory research career is really another level, and that is very, very challenging. I think you have to have the internal drive. You have to be a person who if you don’t have that you’re going to feel deprived, because it’s so difficult to do that. I think we do—at least in pathology—we do a fair job of allowing the people who have that drive and who are going to be determined to succeed. We allow those people to have that time. It’s much more difficult in the clinics, I think. Here, we have laboratory space that they can use. Getting started is a challenge, and it may not go as smoothly as they wish it would go. It may take years. We’ve hired some junior faculty in 1998 who came on just as we were subspecializing, and we had a few of those who wanted to have a research career. I think at least two or three of them were these people that wanted to think about clinical problems and mainly do clinical research, and they’ve been able to write enough publications and do enough research that they’ve had tenured careers. They’re professors and they’re respected, but we had at least a couple of the others who were these committed research people who really, really had to have their labs—had to have lab careers. One of them, I’ll never forget, was so dogged at pursuing his research, and he had some bad luck. It took him five and one-half years to get his first grant, and I was really worried that he wasn’t going to get it, but somehow he knew he was. He just kept applying and applying and applying. He made it to associate professor. He was tenured. Since then he has continued to have a really great research career. He’s kept his grants going. He was promoted to professor without a problem. In fact, I think he went up a year early to go to professor. So it took him a while to get started, and I just applaud his determination to do that.

Tacey Ann Rosolowski, PhD:

Who was this person? Or is this person?

Janet M. Bruner, MD:

It’s a guy named Jinsong Liu, who is not the greatest diagnostic pathologist, I will say. He’s okay, but he is just a very, very successful research pathologist. I was really worried about him, but he’s one that really made it. We’ve had a few younger people. There was a woman that we recruited—I think we recruited her in 2004 with the Mays Clinic group.

Tacey Ann Rosolowski, PhD:

What’s that? The Mays Clinic group?

Janet M. Bruner, MD:

I consider that the Mays Clinic group, although they weren’t assigned to Mays Clinic. It was just that I got all those positions that year because of Mays Clinic.

Tacey Ann Rosolowski, PhD:

Oh, I see. Okay.

Janet M. Bruner, MD:

It was one of the few times where the administration allowed me to hire faculty in advance of an increase in workload. Usually we’re behind the curve, and it was like, “Wow! Okay!” But she had gotten a PhD here and then went on to do a pathology residency and, again, was one of these determined researchers and just doggedly determined. She did get a grant and has continued to do her research. Now, she’s also done more clinical work than Dr. Liu has, but I think the biggest problem is giving them support and mentoring at the beginning of their careers so that they do know how to get started and become successful. And you don’t know—that’s the problem. You don’t know if it’s a person who’s going to be successful eventually or if they’re just going to keep on grinding away and never be successful. I don’t know how you tell that. We’ve got a couple of highly successful research people in the department. Dr.[Bogdan] Czerniak, who is acting chair now, has a huge lab program and still does diagnostic pathology. Who else? Dr. Ken Aldape, who’s one of our neuropathologists, also has a very well-known research program. He does a lot of collaborations outside of MD Anderson with other researchers. So it’s a difficult issue because it’s more—I want to say more evanescent, if you will. You’re now—maybe it’s like “the eye.” You’re not sure if those people will have the research ear or the research heart.

Tacey Ann Rosolowski, PhD:

Yeah.

Janet M. Bruner, MD:

It’s the research heart, really.

Tacey Ann Rosolowski, PhD:

Yeah.

Janet M. Bruner, MD:

It’s in their heart.

Tacey Ann Rosolowski, PhD:

It’s the heart and then also, I imagine, it’s a sense of—if someone is on a track—the point of doing research is to be breaking new ground, and you just don’t know if that is going to be creative.

Janet M. Bruner, MD:

Right.

Tacey Ann Rosolowski, PhD:

If it’s something that’s part of the coming thing, and you have to have some faith and savvy, I guess, to make those determinations.

Janet M. Bruner, MD:

Yeah.

Tacey Ann Rosolowski, PhD:

Yeah. But I’ve been struck as people talk about this and what a real dilemma it is given the workload. I wonder if it’s a little different in pathology since these individuals don’t have to be on call to patients all the time.

Janet M. Bruner, MD:

Right. Right. I think we are able to cordon off our time a little bit better, and I know Dr. Liu has done that. If he’s got a grant deadline coming up, he would come to me and say, “Look” and I’ll say—each pathologist knows what percent of time they’re supposed to be on the diagnostic service. So he knows how many days a month or how many—yeah, I guess it’s mostly days a month that we do it by—and he would say, “Look, I know I’ve got a grant deadline coming up, and for the month of May, I’m going to have to be working on that grant.” So he would say, “I want to do extra service in March and April,” and I’ve got to give him credit. It’s only that he would pay it forward. He would do it before, and then he would write his grant. I have others who say, “Oh, okay. It’s May 1st. I’ve got a grant deadline coming up. I’m going to need all May off service so I can do my grant,” and, “Oh, I’ll pay it back later.” And we’d catch them because we make that service schedule by the year, so we’d catch them. They also have to be willing—they can affect their schedule, but they have to watch it and be willing to do that. And you’re right. They’re not—a patient is not going to call them on Friday if they’re on their grant-writing thing. They can—they really can separate their time off.

Tacey Ann Rosolowski, PhD:

Right. I wanted to go back and just catch a quick detail. You were talking about the young woman who was part of the “Mays Clinic group,” and I’m just wondering what her name—?

Janet M. Bruner, MD:

Her name was Yun Wu. She was a graduate student here, and I don’t know when she graduated, but she actually won the prize for the outstanding dissertation the year she was a graduate student, and then she went away to do pathology residency I think at Southwestern, and I think she did a fellowship at Sloan-Kettering and then wanted to come back.

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Chapter 19: The Physician-Scientist in Pathology: A Challenging Career

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