UNC Health Talk

Building Pipelines of Physician-Scientists

During the past several summers, Morehead-Cain scholar and London native Bridget Larman’s educational experiences have taken her all over the world: to rural Thailand for public health work, a marine biotech company in Spain, and Oregon Health and Sciences University, where she researched Dengue Virus. In May, Larman will complete her undergraduate career at UNC with a degree in chemistry and minors in biology and medical Spanish.

For Larman, the culmination of her hard work lies not only in next month’s graduation but also in the decision she’ll soon make about her future: will she bridge her interests in research and clinical medicine by pursuing an MD-PhD dual-degree?

The answer, she says, is yes. After a year off from school, during which time she’ll gain critical clinical experience at UNC Hospitals, she plans to pursue an MD-PhD and become a physician-scientist. But the decision hasn’t been an easy one.

“As I was thinking about it over the past couple years, I wondered whether I could accomplish a career in research earlier by simply going for my Ph.D.,” says Larman. “I knew that I loved research, but if I went for both degrees, would I be getting the MD just for the sake of the degree? And can you have a personal life if you’re pursuing an MD-PhD?”

“Can you have a personal life if you’re pursuing an MD-Ph.D.?”

Such questions aren’t uncommon for undergraduates interested in becoming physician-scientists. Down the road from Chapel Hill, Elizabeth Zieser-Misenheimer, a sophomore at Duke, has had similar concerns about pursuing interests in both medicine and research. Zieser-Misenheimer hails from South Carolina, where her high school graduating class consisted of only nine students. She admits that she didn’t have much experience with research until joining a cancer biology lab at Duke this past school year.

“As an undergraduate, you don’t have a lot of people telling you about the MD-PhD degree,” says Zieser-Misenheimer, pointing out what so many undergraduates all over the country experience when interested in the dual-degree. “And when you do hear about it, you wonder how people are able to balance their personal lives with the challenges of the degree. I was one of those people – it was the first question I asked when I met my MD-PhD mentor at Duke.”

Melodi Javid Whitley, a sixth-year MD-PhD student at Duke, serves as Zieser-Misenheimer’s mentor through Duke School of Medicine’s chapter of Advocates for MD-PhD Women in Science (AMPWIS).

“That was Elizabeth’s first question,” confirms Whitley, president of Duke AMPWIS. “Frankly, that’s the concern of a lot of undergraduates, especially female undergraduates, when they’re thinking about the MD-PhD. You wonder how there’s time to have a personal life or do the things that other people do in their 20s. You wonder whether you’ll be able to get married. There’s a lot of misunderstanding about the MD-PhD among undergraduates. But doing those things is possible. I, and many others have been able to enjoy a balanced life.”

Partnering and Mentoring

Fortunately, undergraduates at UNC and Duke who are interested in pursuing the MD-PhD, but are lacking information about it, have access to resources. The UNC chapter of AMPWIS, a student organization founded for the purpose of promoting the success, recognition, and excellence of women in academic medicine and medical research, was launched two years ago by soon-to-be eighth-year MD-PhD students Audrey Verde, Ph.D., and Kate Hacker, Ph.D. Verde and Hacker were motivated to form the group when they became familiar with the research about gender disparities in science.

“Our mission is to reach all interested undergraduates, regardless of gender – not only at UNC and Duke, but at universities around the Triangle, including NCSU and NCCU – that may want to apply to MD-PhD programs,” says Verde, whose research utilizes several neuroimaging modalities to understand structural alterations in cigarette smokers compared to nonsmokers. “Women are well represented in most MD and Ph.D. programs, but women only make up 30 percent of the MD-PhD student population. Through AMPWIS, we would love to see the number of women applicants to MD-PhD programs increase.”

After launching UNC AMPWIS, Verde and Hacker encouraged Whitley, whom they knew from a prior UNC-Duke MD-PhD Research Symposium, to consider starting a chapter of the organization at Duke, and she did. Last year, the trio, along with Amy Wisdom, second-year medical student at Duke and vice president of Duke AMPWIS, received a Kenan-Biddle Partnership grant, funded by the William R. Kenan Charitable Trust and the Mary Duke Biddle Foundation, to enhance the intellectual life at both universities by strengthening established and encouraging new collaborations between Duke and UNC.

Today, the groups work closely together, hosting joint events that enhance networking and career-development skills among MD-PhD students and that give female and male students at both universities opportunities to connect and talk about ways to encourage young women to pursue becoming physician-scientists.

“We’re in touch with the UNC group several times a day,” says Wisdom, laughing. “They’ve been a huge help to us.”

Each semester the groups hold information sessions for undergraduates at their respective universities. Brooke Matson, chair of career development and outreach for UNC AMPWIS, has been leading the undergraduate mentoring program at UNC. The mentoring program has two components, explains Matson, whose research focuses on reproductive biology and maternal health during pregnancy. First, the information sessions, which have been well attended at both universities, give interested undergraduates a chance to hear from current MD-PhD students about their career paths. Second, AMPWIS at each institution is working to establish one-on-one mentor relationships like the one developed between Whitley and Zieser-Misenheimer and other successful mentor-mentee connections the groups have made.

“As MD-PhD students, we are all mentees in our programs, and through AMPWIS, we have the unique capacity to serve as mentors to undergraduates,” says Matson. “We’re able to serve on both sides of the mentoring equation because undergraduates can identify with us and feel comfortable sharing their concerns with us. We’ve all been in their shoes: either we’ve had good mentors ourselves as undergraduates or felt that we’ve needed a mentor at some point.”

For Larman, the information session was useful and has helped her connect with a mentor that understands her perspective on research and medicine.

“When I went to the AMPWIS information session, I’d been going back and forth about the degree,” says Larman. “The session was incredibly helpful. MD-PhD students were answering questions about their paths to the program, which were all different, and I was able to connect with a mentor who, like me, had the interest in the Ph.D. as a starting point – my mentor had begun her Ph.D. and completed a year of it before applying to the joint program.”

Creating Future Women Physician-Scientists

Everyone has a different experience of being mentored. Amy Wisdom grew up in northern California and studied multiple sclerosis in her neuroscience lab as an undergraduate at UCLA. Although she hasn’t begun the Ph.D. portion of her degree, she is considering oncology. She remembers how important having a mentor was in her decision to pursue the dual-degree.

“My principal investigator was an MD and I was interested in the way she balanced research and seeing patients,” says Wisdom, who points to her PI as the reason she decided to pursue the MD-PhD. “She told me that if she had the two degrees, her training would have been more well-rounded and certain aspects of her research career would have been much easier for her.”

Whitley had a similar experience when considering the degree. As an undergraduate at the University of Maryland, she had mentors, but she didn’t have an MD-PhD role model. Like Wisdom, she’d heard from some of her mentors that they’d wished they’d pursued the degree because they felt it would have given them better insight into clinical problems and helped them be better scientists.

“I had it in mind my mind that I wanted to do it, but I couldn’t find any good resources on my campus that could give me information about it, and I didn’t know anyone who had pursued that career path,” says Whitley, who has been working on clinically translatable cancer research during her time at Duke. “I was fortunate to learn a lot during my interview process at various schools, but a lot of my stress could have been reduced and I could have been much more successful researching programs if I’d had some sort of guidance.”

“A lot of my stress could have been reduced and I could have been much more successful researching programs if I’d had some sort of guidance.”

Verde echoes the lack of formal guidance to the MD-PhD career path. Already certain about a career in science, she’d first heard about the MD-PhD program through an undergraduate lab mate she worked with at NC State. Her lab mate was interested in going to medical school and encouraged Verde to think about patient care in addition to research. In response, Verde shadowed several neurologists, became involved in an Alzheimer’s clinical trial at UNC, and worked as a medical assistant for two years. Through these experiences she knew that she not only loved patient care, but wanted to be a part of the research community to advance the understanding of neurologic disease.

Verde points out that she wouldn’t be where she is today, nearly done with her eight-year experience at UNC, without the support of mentors along the way, including all the faculty in her program.

“All of us in AMPWIS are fortunate to have or have had mentors at UNC and Duke in the clinic and the lab,” says Verde. “Because of this, through AMPWIS, one of our goals is to provide our students with a framework to build these relationships.”

Although fewer women have leadership positions in medical research positions today, the groups believe that by educating their community on the disparities that continue to exist and serving younger women who may go on to MD-PhD degrees, they’re preparing students to become future leaders, and propagating a culture of mentorship.

Based on their experiences with AMPWIS, Zieser-Misenheimer and Larman both envision serving as mentors themselves one day, and continuing a pipeline of mentorship that all the AMPWIS leaders credit faculty members at their institutions for making strong.

“Without opportunities like AMPWIS and getting to know MD-PhD students in my lab, I wouldn’t know about the degree,” says Zieser-Misenheimer. “It’s given me new possibilities to think about and I’m leaning toward pursuing it. One day I can imagine being a resource for undergraduates like me.”

“It’s given me new possibilities to think about and I’m leaning toward pursuing it. One day I can imagine being a resource for undergraduates like me.”

Larman, meanwhile, has been encouraged by the example the UNC MD-Ph.D. students have set for her.

“You see that they’re normal people who have lives,” says Larman. “You see that a sense of community exists among them and that when your classmates are going on in their clinical lives, you’re still going to have a group of people you’ve been experiencing the program with. That’s really important. If I’m in an MD-PhD program in the future, I will definitely be available to students to talk about it and encourage them to consider it.”

Last year, UNC AMPWIS hosted the first Southeast Symposium for MD-PhD Women in Science. Women MD-PhD students from six universities in N.C., S.C., and Virginia attended the event for networking and career-development workshops. On May 16, Duke AMPWIS will host the 2015 Southeast Symposium for MD-PhD Women in Science. For more information about UNC AMPWIS mentoring, email Brooke Matson at . For more information about Duke AMPWIS mentoring, email Melodi Javid Whitley at . For young women interested in building a career in medical research, read these five tips from Audrey Verde and Kate Hacker.