Chapter 02: Medical School with a Path to Research and Team Science

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Chapter 02: Medical School with a Path to Research and Team Science

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Dr. Mills discusses the Canadian system in which he received his Bachelors of Medical Science in 1975 at the University of Alberta (Edmonton, Canada), leading to his MD in 1977. He also explains how he approached medical training with the intent of going into research: medical training gave him the breadth he needed for research by providing an understanding of how the body worked; he decided to specialize in obstetrics and gynecology because the question of why the mother's body does not reject a fetus is an analogue to the question of why a host does not reject a tumor. Dr. Mills also explains that he wanted to go into research in order to have a greater impact on patients. He notes that medical school at that time was very clinically focused and that he felt some tension with other students and faculty with that mindset. Next Dr. Mills comments on the shift in the focus of biomedical research to team science and talks about the importance of team sports in training individuals to work on research teams. He notes he is proud of his history of collaboration.

Identifier

Mills,GB_01_20160505_C02

Publication Date

5-23-2016

Publisher

The Historical Resources Center, The Research Medical Library, The University of Texas MD Anderson Cancer Center

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Educational Path; Professional Path; Inspirations to Practice Science/Medicine; The Researcher; Understanding Cancer, the History of Science, Cancer Research; The History of Health Care, Patient Care; Diversity at MD Anderson; Personal Background; Influences from People and Life Experiences; Professional Practice; The Professional at Work; Collaborations; Career and Accomplishments; Professional Values, Ethics, Purpose

Transcript

Tacey Ann Rosolowski, PhD:

Right, cross fertilization, absolutely. And just for the record, you got your BS in '75, at the University of Alberta, in Edmonton, is that correct?

Gordon B. Mills, MD, PhD :

That's actually not a BS, it's a… oh, what's the formal term?

Tacey Ann Rosolowski, PhD:

Oh, because the Canadian degrees are different?

Gordon B. Mills, MD, PhD :

No. It's actually a bachelor of medical sciences.

Tacey Ann Rosolowski, PhD:

Oh, okay.

Gordon B. Mills, MD, PhD :

B Med Science, and what that is, is that in the Canadian system and frequently here, you go into medical school after your second year of college, and then in your fourth year, as long as things are going well, they confer a bachelor of medical sciences, saying that this is equivalent of a bachelor of science.

Tacey Ann Rosolowski, PhD:

And then you got your MD in '77?

Gordon B. Mills, MD, PhD :

I did.

Tacey Ann Rosolowski, PhD:

Okay. So tell me about that choice, to go to medical school. Why did you stay at the University of Alberta? And I didn't ask you why you selected that university for undergrad too.

Gordon B. Mills, MD, PhD :

It's where I grew up and so it was something that I would say I didn't know better. But on the other side, I would say that despite the fact that I trained in a nonconventional program in the U.S., I did not go to Harvard, I did not go to Johns Hopkins, I did not go to Duke, I've done okay. I think it really does show that the benefit of where you go can be very important, but a lot of people at MD Anderson, and my guess is about half, came through a nontraditional medical program, and it says that it's the person, not the program that matters in many cases. So, it was my home university, it was a good university, and so I went there. I went into medical school, really with the idea, again, of saying that the breadth of having medicine as a background, to understand what was going on in a disease, but further, if my research program did not flower, it would be a way to make a living. And then to a degree, even the same concept when I went into obstetrics and gyne as my specialty, my interest had really become immunology, and one of the major aspects of pregnancy is understanding why the fetus is not rejected by the mother, and so this is a major immunological question. Sort of along that way, I became much more interested in tumor immunology, why the tumor is not rejected, and further, in how one could trick the immune system into rejecting the tumor, which I think now, thirty-some years later, is becoming a real opportunity, and that led to sort of my process. While I would never recommend that somebody else do what I did, it worked. So during medical school, I did approximately eighty hours of research a month, at two and three in the morning, and went into obstetrics and gyne and did a year of clinical training and then finished a PhD, and then went back and completed my obstetrics and gyne training, and so these were separate. This was not an MD PhD program, these were bona fide MD programs, PhD programs, but were all mixed up, where I used every elective that was available, to look at research opportunities and move those forward, really based very much on our tumor immunology concepts.

Tacey Ann Rosolowski, PhD:

I didn't ask you earlier, I mean obviously, you had an understanding very early, that research was where you wanted to focus your attention. Why? Why did you make that choice?

Gordon B. Mills, MD, PhD :

At one point, it was not completely clear and again, as I mentioned earlier, one of my major goals was to keep as many opportunities open as possible, but by the time I was completing my PhD, during my obstetrics and gynecology fellowship, it became clear that if I treated the patient in front of me, that could have a great impact, but if I determined how to treat hundreds of patients, for other obstetricians and gynecologists, that would have a much greater impact. Further, unlike some of my colleagues, where it was absolutely required that they have the ego input of grateful patients, that was not nearly as exciting to me as saying I can have a much greater influence by doing research than I can by treating a single individual. It actually was an interesting challenge, because my medical school class was very clinically oriented, and to a degree, I think there was a resentment or a concern, that perhaps a slot in the medical school could be better filled by the individuals who would treat the one patient across from then, than those that were going to determine the direction of the future. Now, I think that that attitude has completely changed. I think we now value the impact of research in how we are going to improve patient outcome, but at that time, in that institution, it was a major discussion.

Tacey Ann Rosolowski, PhD:

I'm not surprised, I'm not surprised at all. I mean, there is a history to translational work and it's crossing a really -- there's a traditional, fairly big gap.

Gordon B. Mills, MD, PhD :

And I think that I would say that now, there really isn't a discussion. I think that medical schools, with a few exceptions, really are trying to determine how to bridge that gap, and to train the people that will do both. I think again, out of order, I'm not sure what the future is. Is it the single individual who is going to be the triple threat of teaching, treating patients and doing research? Is it going to be teams, where you have a clinician who understands research, working with a PhD who understands clinical questions, or even much bigger teams? I would say that the biggest transition over the last five years, which again is after the development of the Department of Systems Bio, is really the understanding or the push on my side, that team science is going to be the future of making progress rapidly, to improve patient outcome, and that the day of the single professor, small lab, one postdoc, one trainee, one technician, focusing on a single molecule for life is wonderful and will give us the base science information that is necessary, but with the incredible explosion in information that we have that's available, we're going to need to figure out how to build, how to maintain, and how to reward teams, if we're really going to move all of this to our patients in an efficient manner.

Tacey Ann Rosolowski, PhD:

Is there a particular kind of individual who is drawn to this? I mean, you mentioned something you say to recruits when they come. What kind of people do you like to recruit, what's their profile, if you will?

Gordon B. Mills, MD, PhD :

I'm looking for people who understand what a team is. Indeed, one of my interview questions is tell me what team sports you played in college. It's very interesting, because the vast majority will say tennis or swimming, and those are not team sports. I want someone who has understood the concept that if you are playing on a football team or a baseball team, it is the weakest member of the team that is critical, and that you work with them, to build their strengths, to work around their strengths and weaknesses, and that it is the team that succeeds, it's not one person. That works for people who train in the United States. It's not quite the same when you're interviewing people from outside, where the culture of sports and team sports is different, but it is an important question to try and get an understanding of those people who want to be part of a team, and knowing that team will accomplish far more than a bunch of individuals.

Tacey Ann Rosolowski, PhD:

Now, am I assuming correctly, that individuals from outside the U.S. have less of a culture of team sports? [00:25:[00]

Gordon B. Mills, MD, PhD :

Absolutely, and so that question is one that doesn't help a lot. And then you try and elicit the same concepts through different types of questions.

Tacey Ann Rosolowski, PhD:

And what sort of questions do you ask to get at that?

Gordon B. Mills, MD, PhD :

My first question to everyone is the same, with a slight difference in timeline, and that includes administrative assistants, all the way through to assistant professors, and that is, is tell me what the perfect job would be for you five, seven, ten years from now, depending on where they are in their training. There's no right answer, it really just is to start a conversation. And then the second part of that is tell me what would make you excited to get up in the morning and go to work, and that gives you a very good feeling of whether they say well, I want to be the boss and I want to run things and I'm going to have my own lab and I'm going to have five people reporting to me, versus I'm going to be part of a group that is going to make a difference. That comes all the way from administrative assistants, that says I'm going to be excited to see that I can help the people around me succeed. Frankly, you hear that from a few faculty candidates. They usually are looking at a different pathway of setting up their own lab first. What you want to then elicit, is that meant to be my lab, one my one postdoc, my one student and my one project for life, or I'm going to do that but the second half of what I want to do once that is established is to be part of a team that is going to make a difference. And so you're looking for people who are interactive, collaborative by nature.

Tacey Ann Rosolowski, PhD:

Did you play team sports?

Gordon B. Mills, MD, PhD :

Yes.

Tacey Ann Rosolowski, PhD:

What did you play? Where did you get these skills in other words.

Gordon B. Mills, MD, PhD :

Football, rugby, hockey, baseball, I played team sports.

Tacey Ann Rosolowski, PhD:

Yes you did.

Gordon B. Mills, MD, PhD :

Basketball. If it was a team sport, I played it, usually at an intramural college level, although I did play rugby at a much higher level. Again, team sport concept of working with the people around you and understanding where their strengths and weaknesses are is a key point.

Tacey Ann Rosolowski, PhD:

When you said you played rugby at a higher level, what did you mean by that?

Gordon B. Mills, MD, PhD :

I played rugby at a city side, I played against international teams.

Tacey Ann Rosolowski, PhD:

Wow.

Gordon B. Mills, MD, PhD :

So, yes.

Tacey Ann Rosolowski, PhD:

Yeah. So you didn't want to brag on yourself, but that's cool, that's very cool. So obviously, a big learning experience, going through all of that.

Gordon B. Mills, MD, PhD :

I think that really has been part of what I have done for my career. Indeed, I think you would have a great difficulty in finding anyone who has more collaborations, more collaborative papers, who has done constantly, the concept of developing technologies and ideas to share with others and move things forward, and that has very much been something that has worked for me throughout my career. I think I can actually give you the number. I believe that I now have papers with over fifty thousand different individuals. Now, let me check and make sure it's not five thousand, but it's still a massive number.

Tacey Ann Rosolowski, PhD:

It's still a jaw-dropper.

Gordon B. Mills, MD, PhD :

I would guess and I'm not going to guarantee, but we can look, that it's five thousand. We can look this up online here at MD Anderson, and I'm quite certain that that network is broader than any other individual in the institution, but it's what has worked for me. I'm not going to argue that it's right or wrong, it's the way it has worked for me, yeah. I don't know that I can get it any more. It's fifty-five thousand citations on my papers and -- it no longer gives us that number -- over five thousand colleagues, on papers.

Tacey Ann Rosolowski, PhD:

Wow.

Gordon B. Mills, MD, PhD :

So it's something that I do and as I said, not everyone works in that environment but it does work for me.

Chapter 02: Medical School with a Path to Research and Team Science

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