The Impact of Early Exposure to Research in Building Great Physician-Scientists

#LINO23 Lindau Alumnus Khalid El Bairi remembers the inspirational meeting with Nobel Laureate William G. Kaelin Jr., accompanied by a statement of PhD student Ayman Kricha, about people who inspired his scientific way.

The pursuit of knowledge to make a meaningful impact in oncology motivates healthcare professionals to embark on unique and challenging educational journeys. One such path is the clinician-scientist programme, a demanding endeavor that combines medical and scientific training.

Recently, I had the privilege of meeting a Nobel Laureate who pursued this programme passionately, emphasizing the sacrifices it requires and the remarkable achievements it can foster. I met William G. Kaelin Jr., an oncologist who won the 2019 Nobel Prize in Physiology and Medicine along with other researchers. Their discoveries on tumor hypoxia have shown great promise in treating cancer and related disorders such as anemia. Kaelin developed a research-oriented mindset early in his career, even before attending medical school. This early focus on research significantly shaped his vision for advancing cancer research during his fellowship, leading to groundbreaking discoveries in oncology.

Returning to Research

Kaelin’s undergraduate mentor recommended gaining research lab experience earlier in his career. Indeed, this approach of early exposure of future medical doctors to research methods was shown to have a deep impact on building clinician-scientists globally. Kaelin worked in a chemistry lab during the summer between his junior and senior years. Despite being told that previous students from the lab had successfully entered excellent medical schools, Kaelin found his project uninteresting, unimportant, and undoable. He received a C-grade with a note suggesting his future outside the laboratory. Already enrolled at Duke University School of Medicine, he decided to focus on a career in academic medicine or private practice. During his medical school, Dr. Kaelin returned to research, working on a project involving tumor blood flow and angiogenesis, sparking his interest in biology of tumors. This experience, although better than his first, did not immediately influence him towards a research career. Instead, his fascination with the diagnostic process in multisystem diseases attracted him towards medical oncology. After earning his medical degree from Duke in 1982, Kaelin completed his internal medicine residency at Johns Hopkins University, earning extensive knowledge of cancer medicine. In 1987, Kaelin joined Dana-Farber Cancer Institute as a medical oncology fellow with plans to become a clinical oncologist. After his year, he decided to give laboratory work another try. His first research mentor, Shelly Bernstein, closed his lab after a couple of months to enter private practice, leading Kaelin to doubt his research path. However, he then started working with David M. Livingston, who was researching tumor suppressor genes. Livingston proved to be an excellent mentor, teaching Kaelin how to become a scientist and significantly influencing his career.

After years of lab research, Kaelin’s investigations revealed that tumor growth in VHL was linked to angiogenic activity. He found that VHL regulates levels of hypoxia-inducible factor (HIF), which adjusts the body’s response to low oxygen by triggering angiogenesis and promoting tumor growth. His discovery was crucial for understanding cellular reactions to oxygen variations, paving the way for new anticancer treatments. For this groundbreaking research, Kaelin, along with Gregg Semenza and Sir Peter Ratcliffe, received the 2019 Nobel Prize in Physiology or Medicine.

My Key Takeaways

In fact, Kaelin’s story underscores the vital role of mentorship in guiding young students toward research. Mentors provide the support necessary for budding scientists to flourish. Without doubt, mentorship can be transformative by providing opportunities for growth, encouraging students to persevere and succeed in their research endeavors, not only in developed countries but also in under-resourced settings. Kaelin’s journey highlights how a dedicated mentor can profoundly impact a student’s career trajectory. In addition, combining rigorous curriculum of medical school with the intensive research training of a PhD programme has also the potential to equip medical doctors with the skills to bridge the gap between clinical medicine and scientific research, thus, promoting a deeper understanding of disease mechanisms and innovative treatments. This journey demands a lot of dedication, perseverance, and sacrifice. One of the key takeaways from my conversation with Kaelin is the unique skill set acquired through this path, less traveled. Kaelin had a challenging, but rewarding, trip in research with sleepless nights, numerous hours spent in laboratories, clinical rotations, and projects. He highlighted the sacrifices made in terms of time, energy, and personal life to excel in both aspects of the programme. Despite the immense cost, the “clinician-scientist” path may provide groundbreaking therapeutic approaches and contribute to the advancement of medical knowledge.

Driven by this vision, I was very happy when my institution provided me with the opportunity to implement research initiatives for undergraduate medical and pharmacy students, exposing them early in their careers to the importance of research in medical practice. They are now enrolled in mentorship programs, courses focusing on Evidence-Based Medicine (EBM), medical library, research methodology, and the critical role of early research exposure in strengthening health systems. 

In Morocco, the concept of physician-scientists remains rare, as most medical doctors concentrate primarily on patient care with limited involvement in academic research. My goal was to highlight to students the value of integrating research into their future careers, emphasizing that early exposure can lead to more effective, evidence-based clinical decisions. This approach holds the promise of bridging the gap between medicine and research.

Do You Always Need to Meet a Nobel Laureate to Get Inspired and Evolve?

While meeting a Nobel Laureate can definitely be a transformative experience, it is not the only way to find inspiration and evolve. I invited a young PhD student, Ayman Kricha, who is currently conducting research on innovative approaches for treating brain cancer in a joint effort between our university and Harvard Medical School, to share his insights on exploring alternative sources of motivation and professional development.

A PhD Student’s Perspective

“When we mention inspiring scientists, we often celebrate prize laureates and their groundbreaking achievements. However, on my scientific journey, I was profoundly inspired by three ordinary people. Their influence shaped my research and fueled my passion that continues to drive me today.

The first was an ordinary man I met in a hospital early in my career. Diagnosed with cancer, he was filled with hope and resilience. During our conversation, I explained my research to him. His eyes lit up, and he spoke about the importance of hope in the face of adversity. He said, “People like you give us hope that one day there will be a cure.” His words resonated deeply, inspiring me to direct my efforts into cancer research, knowing that life and survival may depend on my work and that millions are waiting for my achievements.

The second person who inspired me was Dr. Baderddine, a molecular biologist from a modest lab. I met him during an undergraduate internship. Dr. Baderddine’s passion for science was infectious. He taught me the fundamentals of scientific research, showing me how to ask the right questions, formulate hypotheses, and approach problems with curiosity and rigor. His mentorship was transformative, instilling in me the skills and mindset that became the basis of my research career.

Lastly, an online interview for a research position introduced me to a researcher whose passion was contagious. Although, I didn’t end up joining her lab, our discussion was transformative. She spoke about macrophages in translational cancer research with such excitement and clarity that it left a lasting impression on me. Her enthusiasm and the brightness in her eyes when discussing macrophages inspired me to turn my research focus into cancer immunotherapy. From that moment, I became dedicated to exploring macrophages as both a target and therapeutic agent in neuro-oncology.

These three individuals – a hopeful cancer patient, a dedicated mentor, and an enthusiastic researcher – collectively shaped my scientific journey. They inspired me to pursue rigorous, evidence-based research with the aim of developing innovative immunotherapeutic approaches to treat aggressive cancers such as glioma. Their influence reminds me that inspiration can come from the most unexpected places and people, each playing a crucial role in the pursuit of scientific excellence.”

Empowerment by Partnerships

To make the connection to my experiences – developing academic partnership between Lindau Nobel Meeting Foundation and institutions in Africa represents a visionary step towards empowering African young scientists. It is an opportunity to bridge the gap between continents, adopting a global scientific community that is inclusive and collaborative. Putting together Nobel Laureates and Young Scientists can inspire a new generation of leaders in science. My experience with this meeting had considerably impacted my career and path toward excellence in cancer research. This initiative is not just about participation; it creates unforgettable impact through fruitful discussions with Nobel Laureates and participants to foster collaboration and transcontinental dialogue on resolving the current issues humanity faces. Nevertheless, the potential benefits of this prestigious event have not been fully accomplished across all regions, particularly in Africa. Thus, bringing more African scientists to this event is a true dream. Indeed, associating our institution, which is currently the hub of research in Africa, with Lindau Nobel Meeting Foundation may create an opportunity for Moroccan and African Young Scientists to engage with Nobel Laureates and contribute to this transformative global event. Raising a call to action for equitable training and mentorship opportunities should be our mission to enhance diversity, equity, and inclusion.