Molecular Medicine Pathway Nurtures Physician Scientists

To advance patient care, pediatrics needs a healthy supply of physician-scientists whose training combines basic science and clinical medicine. The molecular medicine pathway within the Department of Pediatrics residency program is designed to support and encourage physicians whose interests lean to research. The need for such support is urgent. According to the NIH Physician-Scientist Workforce Working Group report from 2014, the number of active physician scientists is declining, with only about 5,000 doctors age 50 and younger currently engaged in medical research.

Under the direction of infectious disease specialist Anna Bakardjiev, MD, molecular medicine has seen an increase in the number of residents enrolling in this pathway. Seven first-year residents are participating this year, and eight enrolled last year, when Bakardijiev became head of the program at the invitation of Division of Medical Education Chief Dan West, MD.

“Our goal is to train skillful and caring clinicians who conduct cutting edge research,” said Bakardjiev, who codirects a similar program for the School of Medicine that is focused on medical students.

Molecular medicine offers regular programs of mentorship, networking and cross-departmental seminars with Internal Medicine and Surgery. Residents have protected time to participate in the seminars, which are designed to foster a community of physician scientists who explore the links between clinical medicine and basic science. Although the programs are geared to residents, they are also open to medical students, fellows and junior faculty.

A typical meeting might feature an established UCSF physician scientist talking about his or her research and career course. Part of the time is often devoted to an emerging technology, such as CRISPR for gene editing, or the intricacies of grant writing.

Most participants in the pathway have a PhD or other extensive basic science background, said Bakardjiev, and they usually go on to complete subspecialty training. Often clinical training is accelerated to enable residents to move on to fellowship work.

Bakardjiev, whose own research focuses on host-pathogen interactions in the placenta, meets with residents two to three times a year and helps introduce them to laboratories and mentors that match their research interests.

“It’s really important to have a supportive community of other physician-scientists, especially in these days of declining NIH budgets, when it is harder to get funding for research,” said Bakardjiev. “We work to keep that flame for basic science burning in our residents.”

Here are the perspectives of three residents currently participating in the molecular medicine pathway:

Jeff Russ, MD, PhD

A first-year resident in pediatrics and neurology, Russ has been interested in brain science since high school. He completed his medical degree and a PhD in developmental neuroscience at Weill Cornell, and during his clinical training, realized he loved working with children. Russ has a clear vision for his professional path: he expects to focus his clinical practice on childhood neurological diseases that affect movement, such as Tourette syndrome and dystonias, while conducting research on the development of neural circuitry. With Bakardjiev’s assistance he is beginning to meet with different mentors and figure out how to integrate lab work with the demands of residency. “It’s a little hard to come to a new institution with only a vague sense of the research going on. As a first-year, you are so busy that a structured approach is very helpful. It was a high priority when looking at programs to have support in finding a research mentor. “

Julie Boiko, MD, MS

For first-year pediatrics resident Julie Boiko, the molecular medicine program was a significant selling point in her decision to attend UCSF. Boiko earned her MD at the University of Pittsburgh with graduate training at Stanford. Her interest is focused on pediatric hematology-oncology, and she hopes to specialize in bone marrow transplantation, with most of her time devoted to research on immune system recovery following BMT. Although the clinical demands of first year residency do not allow time for her own bench research, she appreciates the opportunity to hear in an interspecialty environment from a range of scientists inside and outside UCSF. Boiko noted that many residency programs recruit scientifically minded residents, but UCSF provides coverage for clinical responsibilities, so molecular medicine students can participate in programs. “Residency is clinical boot camp and the number one priority is to become a solid clinician, but is important to keep that fire burning for research,” said Boiko.

Jane Symington, MD, PhD

As the child of a foreign service officer, Symington grew up “all over the world,” spawning an early interest in infectious diseases. She completed her MD at Washington University St. Louis, along with a PhD in microbiology. She was drawn to pediatrics by the realization that there is still much to be learned about the developing immune system and antigen-pathogen response. Many diseases, including rheumatologic conditions and tuberculosis, look very different in children than adults. “A common cold can cause a sore throat in an adult, but send an otherwise healthy child to the ICU on a respirator. We don’t know why that sometimes happens,” she said. Symington plans to use her residency to define where she wants to focus her research. In the meantime, she finds inspiration in the twice-monthly interdepartmental molecular medicine meetings. “It’s wonderful to see the contribution of pediatrics to the group,” she said.

Story by Leslie Lingaas