APSA Northeast Regional Meeting Review
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By Alex Adami, University of Connecticut

The 7th Northeast Regional Meeting of APSA was held at Temple University School of Medicine. The Northeast Regional Meeting is perhaps the best opportunity to interact with your fellow trainees from across the northeast, and with nearly 200 attendees, this year’s meeting was no exception.

The first speaker was Temple’s Arthur Feldman, MD, PhD, Executive Dean of the School of Medicine and Chief Academic Officer for Temple University Health System. He began his talk with six key points to success and satisfaction as a physician-scientist:

First, find a mentor. That mentor might be two people, one clinician and one researcher, or it might be one person who excels at both. They need not be local, but they need to be lifetime; the challenges of a physician-scientist career do not end when training does. Second, don’t take shortcuts in training. Both clinical and scientific training are important, and shortchanging one will not serve you. Third, link your research with your clinical interests, so one builds upon the other. Fourth, remember that the translational research highway is bi-directional. Bedside-to-bench insights can be just as significant as bedside-to-bench. Fifth, it is all about people, from your trainees to your collaborators. Sixth, your career is not your entire life. Make time for your spouse and children.

A researcher involved in understanding heart failure, Dr. Feldman brought us through his career, highlighting stories that related to each of the key points he raised. He spoke to the power of bedside-to-bench eloquently with the story of a patient who came to his clinic suffering the effects of hypothyroid disease, including many symptoms of heart failure. He had recently developed a method of quantitative PCR (this in the days before such techniques became commonplace), and discovered that samples from his patient had a similar pattern to that of heart failure. Obtaining post-treatment samples from that patient, Dr. Feldman discovered that his gene expression pattern had normalized, providing the first hints that medical science might be able to change the phenotype of the failing heart. From bedside to bench indeed.

The next keynote address was given by Stephen Ostroff, MD, epidemiologist, former Assistant Surgeon General in the Public Health Service, and first cousin, once removed, of current APSA President Evan Noch. Quoting that unsung epidemiologist Yogi Berra ("You can observe a lot just by watching”), he described his passion for epidemiology and the circuitous path his career took. Just how circuitous? As a newly-minted internist in the National Health Service Corps, he was placed on the small island of Pohnpei, a member of the Federated States of Micronesia and located thousands of miles from the continental United States. This experience created his interest in infectious diseases, for an isolated tropical island is a haven for disease outbreaks, with everything from worms to leprosy to Dengue fever. Inspired to learn more about epidemics, he undertook the CDC’s Epidemic Intelligence Service, a two-year, on-the-job training program for MDs, PhDs, and other health professionals. Since then, he has had no shortage of work, with newly-emerging diseases including outbreaks of Cholera in Latin America, the re-emergence of polio in war-torn Syria, and the respiratory crises of SARS, Middle East Respiratory Syndrome (MERS), and avian influenza. For trainees interested in infectious diseases, his career path highlights an alternative career pathway for the budding epidemiologist (no guarantees of tropical island assignment, of course).

Following the morning keynotes, the poster session began. With nearly 30 posters presented from schools across the northeast, the small meeting environment was ideal for interaction. In fact, the interest and interaction between meeting attendees and presenters was so strong and crowds were so dense that this author, stuck hobbling about with a cane and stabilizing boot, could only circle the periphery of the session.

The small group sessions are a highlight of all APSA regional meetings. The Northeast Regional Meeting never fails to disappoint in the breadth of small group topics, and this year was no exception. From advice for undergraduates interested in MD/PhD programs to advice on alternative careers after clinical training, sessions covered the range of trainee interests.

The session on unconventional career paths for physician-scientists, led by Temple’s Chair of Otolaryngology and Associate Dean of Graduate Medical Education, John Krouse, MD, PhD, illustrates the knowledge the moderators brought to their sessions. Dr. Krouse’s career was unconventional from the start, beginning as a music major at Carnegie Mellon, obtaining a PhD in clinical psychology (after deciding he would be unlikely to survive on music alone), and moving to medical school at Harvard, where he decided he loved surgery and became an otolaryngologist. Deciding he needed to break from academia, Dr. Krouse opened his own private practice in a small Florida town, proving very successful until he realized that he missed interacting with students. Transitioning yet again, he began a nearly six-year journey back to academic medicine, landing at Wayne State University and subsequently at Temple as the Chair of the Department of Otolaryngology. He emphasized multiple times that you "can learn from any experience” and to "never look at anything as a wrong turn.” For the student considering a career path that departs from the crowd, his words should give encouragement.

Another interesting session concerned the role of physicians and physician-scientists in shaping health policy. Representatives of the Philadelphia County Medical Society, Pennsylvania Medical Society, American Medical Association, and the policy offices of the health insurance industry spoke passionately of the need for participation in organized medicine. They encouraged students to become involved even before completing their training, noting that medical society membership can be free or greatly reduced in cost for trainees. They acknowledged that many physicians today have lost faith in organized medicine, particularly following the rancorous debate over the Affordable Care Act. However, they raised a critical point for those who would remain outside of the system: when you are not at the table, you are not anywhere, and those who choose to avoid organized medicine guarantee that their voices will not be heard. The moderators noted the power of a united voice and reminded us that if physicians do not advocate for changes in medicine, those that will do so may not push for change that is beneficial for physicians or for patients.

Following the small group sessions came the final two keynote speakers. First, Carol Weiss, MD, PhD, spoke from the perspective of working for the Federal Government. A Senior Regulatory Officer at the Food and Drug Administration, Dr. Weiss not only regulates but also does research on viral vaccines. She too emphasized that the path to your dream career is "rarely straight, never easy, always evolving.” She began her career as a chemistry major and subsequent medical student with some research during medical school but little realization that it would become the focus of her career. Entering residency, she became interested in infectious diseases as HIV/AIDS became an epidemic, and dove into the research world with a postdoctoral fellowship in an HIV lab immediately following residency. Obtaining her PhD on an NIH physician-scientist grant, she took her interest in the fusion of the HIV virus to the FDA, where she became a scientist and regulator. Today, she focuses on the two ends of the vaccine spectrum: the initial basic, scientific inquiry and the final regulation of vaccines that protects society from science misapplied.

APSA’s final keynote speaker, Susan Morgello, MD brought a thespian touch to the meeting. As a student at MIT, she was passionate about the theater, but ultimately decided that it would prove unlikely to pay the bills. Entering the Duke School of Medicine, she excelled but ultimately dropped out in her second year, moving to New York City to work for a year on Gilbert and Sullivan plays. Noting that "nothing will make someone run back to medicine faster than singing Gilbert and Sullivan for a year,” she returned to Duke and completed her training. She described how her research, focusing on the neuropathology of HIV/AIDS, has proven most significant as a result of the lives it has touched. Dr. Morgello showed this in the first lines of her talk, opening a 12,000-line spreadsheet comprised of all of the patients she had enrolled in a nearly 15-year study of HIV/AIDS, each of their stories and lives reminding her just how important what she did was to them.

Dr. Morgello left the audience with several pieces of advice. She reminded us that as young people we will not be listened to as the old and "experienced” are, but that does not make us always wrong, nor does it make the "experienced” always right. In considering where to make one’s scientific career, she encouraged us to examine the environment of the institution and potential mentors available there, noting that a supportive environment and good mentorship are as critical to success as a fancy name.

With that, the 7th Northeast Regional Meeting drew to a close. The organizers announced the winners of the three best poster awards: Amrit Misra (Drexel College of Medicine), Lindsey Gerngross (Temple University School of Medicine), and Michael Quinn (Thomas Jefferson University). Congratulations to them! As this author left for his train, those gathered were enjoying appetizers and desserts in the lobby, continuing the interactions built during the day’s events. See you in 2014.