|Faces of Physician Scientists: Nancy Brown, MD|
Interview on November 2017
Tell me about yourself, your research, and how you started on the physician scientist path?
I was fortunate to have good mentors along the way. Beginning in college, I did research with a man named Ethan Nadel doing exercise physiology and then enrolled in the HST Program, which is a joint Harvard-MIT program focused on developing physician scientists, and worked on an insulin nasal spray with Alan Moses and Jeff Flyer. Their laboratory was my intellectual home during medical school. I came to Vanderbilt for my clinical training and stayed on doing a fellowship in clinical pharmacology, working initially with Bob Branch as my mentor, and ultimately joined the faculty here, at the time under the division directorship of Dan Roden.
So I think mentorship is a key piece of the development of physician scientists and I was fortunate enough to identify those folks along the way.
What qualities and skills are necessary to be a Physician-Scientist?
Curiosity is critical. Being smart and hard working is a given. Another important personality characteristics of successful physician scientists is the ability to accept a certain amount of uncertainty about where your questions will take you. Often the characteristics of the best clinicians are organization and orderly progression, but science doesn’t always progress that way. An ability to look at the outliers and tolerate that uncertainty is important.
Describe a time when your research did not work as expected and what positive things came out of that?
I think the most fun experiments we have are those that turn out completely the opposite of what we thought. Then trying to figure out why they did and how they did leads to the next round of questioning. I think that’s where mentors can be important. When you are getting started, when things don’t go the way you expect them to, there’s a tendency to feel disappointed when, in fact, sometimes the richest information is there.
Medical school and residency are busy times, how did you find time to stay involved in research during these times?
During medical school there are lots of ways to carve out time to do research. During residency, you really have one primary role, which is to learn as much clinical medicine as you can. Having said that, your approach to that learning can be scholarly and scientific and it is important to seek out faculty members who are investigating a problem. It is important to ask “why” when you see a patient and not just accept the evidence, which is often inadequate.
I highly recommend that people who are interested in a career as a physician scientist go to programs that have a track record for mentoring physician-scientists because the support and culture around you matters a lot.
What are your thoughts on the Fast Track programs?
We have a physician-scientist development program and we don’t require that people fast track, however the majority of folks choose to do that. There’s not one size fits all and I think for someone who is very certain about the type of clinical work and research they would like to do these programs are appropriate. I think other people want to have a broad clinical training because they don’t know where their research will take them or they know this will be the last time they will be able to immerse themselves in clinical training.
Is it more difficult for physician scientists to be good at both research and medicine?
I think you bring something different when you are doing both, you bring an insight to your clinical work. But I think you have to be aware of time limitations and you cannot practice as broadly as you could if that were the only thing you were doing. And conversely, when one is doing both clinical work and science you have to be very focused so that you are doing what you intend to do. members sometimes who don’t turn off their pager when they are not on call, etc. and making every day decisions that undermine their larger decision to become a physician scientist. If those choices are not intentional, it can lead to unhappiness. You have to be proactive in making the choice.
Is it more difficult for physician scientist to be involved in basic research? What is the role of physician scientists in basic research?
I don’t think it’s more difficult at all. It depends on the interest of the person.
What made you choose the field you did for clinical practice and research?
I have always enjoyed physiology and molecular physiology and, in essence, that’s what my research is. Both in mice and in humans, it’s understanding mechanisms but as it applies to disease. For me that was meaningful.
What is the best type of training to initiate during med school/grad school that would best prepare trainees to become physician scientists (business training, financial training, leadership training, etc)?
I don’t think one requires a degree or formal training. Programs that train physician scientists should spend some time on what we refer to as “career development,” such as how to manage a lab, how to make financial decisions. I think this can be done with seminar series and without a designated course but that kind of practical information can be very helpful.
Do you think there a more women in the physician scientist field now than before, and if not what you do think inhibits more women pursing a physician scientist track?
Statistically there are more men in MD/PhD programs until fairly recently and now there is a growing number of women. It’s actually a great career field for women because, in many ways, one has more flexibility in terms of time than you would in a busy clinical practice, for example. A challenge for women who are physician scientists is travel to meetings but there are ways to work those things out