DOCS bring clout, as well as funding, to campus
The Disease-Oriented Clinical Scholars (DOCS) Program is designed to help recruit talented junior faculty members to UT Southwestern Medical Center and to retain them. The creative program is providing significant benefits to UT Southwestern and for the scholars themselves.
The DOCS program, which began in 2007, facilitates the growth of state-of-the-art research in clinical departments by providing clinical chairs with funds to attract early-career faculty members whose work holds promise for major advances in clinically relevant areas of basic research.
An important benefit has been the growing population of early-career researchers who are key players in the success of UT Southwestern’s clinical programs.
“Their work truly is ‘The future of medicine, today,’ ” said Charles Ginsburg, M.D., Senior Associate Dean of UT Southwestern Medical School and DOCS Program Director. “Accordingly, we have invested much time and reasonably large institutional resources to recruit, retain, and nurture these impressive individuals. They are important, if not essential, to the future success of the institution.”
Acquiring competitive funding
UTSW currently has eight DOCS scholars, funded at amounts of up to $750,000 each. Whether it’s the study of fatty liver disease or the impact of hunger hormones on the brain, the range and depth of their projects are significant.
The eight DOCS physicians are:
- Jeffrey Browning, M.D., Assistant Professor, Internal Medicine and Advanced Imaging Research Center
- Ezra Burstein, M.D., Associate Professor, Internal Medicine and Molecular Biology. Lab website.
- Lu Le, M.D., Ph.D., Assistant Professor, Dermatology. Lab website.
- Nikhil Munshi, M.D., Ph.D., Assistant Professor, Internal Medicine, Eugene McDermott Center for Human Growth and Development, Molecular Biology. Lab website.
- Michael Shiloh, M.D., Ph.D., Assistant Professor, Internal Medicine and Microbiology. Lab website.
- Rafael Ufret-Vincenty, M.D., Assistant Professor, Ophthalmology. Lab website.
- Richard Wang, M.D., Ph.D., Assistant Professor, Dermatology
- Jeff Zigman, M.D., Ph.D., Associate Professor, Internal Medicine and Psychiatry. Lab website.
The DOCS program attracts physician-scientists with the promise of financial support and a network of pre-eminent mentors interested in scholars who pass what Dr. Ginsburg calls the “handshake” test. These are doctors who actively see patients, while still devoting more than half their time in the laboratory.
Although the true success of the program will be measured in the longitudinal contributions of the physician scientists, the return on the institution’s financial investment has been excellent – the first five DOCS recipients garnered more than $8.6 million in competitive external research funding, more than the institution has invested in the entire program.
Jeffrey Browning, M.D. first came to UT Southwestern in 2001 on a fellowship and has never left, thanks to the support from the DOCS program. In 2006, he received funding after a year as an assistant professor in Internal Medicine. His work focuses on understanding metabolic derangements that lead to fatty liver disease, through the application of advanced imaging and metabolic techniques.
“DOCS enabled me to have the necessary funds to do laboratory studies, clinical trials, and inpatient studies of patients who have fatty liver disease,” Dr. Browning said. “All of these things cost a lot of money. For example, one stable isotope study that I do is very expensive as it requires the use of high-field magnets. Without funding such as that provided by DOCS, well, it just never would have happened.”
Dr. Zigman, another DOCS physician, is studying the impact of the hunger hormone grehlin on the brain and how anxiety can cause over-eating and obesity. He credits the DOCS program, as well as the unique collaborative atmosphere at UT Southwestern, with some of the early translational success.
The program enjoys strong faculty support, and “we are hopeful that many of the new chairs will utilize the program in their efforts to recruit physician-scientists to their respective departments,” said David Johnson, M.D., a DOCS mentor who chairs Internal Medicine and holds the Donald W. Seldin Distinguished Chair in Internal Medicine. “It is our belief that the effort to institutionalize greatness through a program like this one can be facilitated through the nurturing of natural talent, at all levels of our medical center.”
Faculty members are eligible for nomination to the DOCS program during the recruitment phase and during their first three years at UTSW, as long as it is the candidate’s first faculty appointment.
Dr. Burstein was recruited to UT Southwestern from the University of Michigan in 2008. He credits the DOCS program for the opportunity to continue research into inflammatory bowel disease (IBD) and the connection between that chronic condition and cancer.
In 1994, Dr. Burstein completed medical school at the Universidad Peruana Cayetano Heredia, and came to UTSW to pursue his training in Internal Medicine. (Notably, the links between Cayetano and UTSW have grown substantially since then and a partnership was established last year.)
IBD is a condition that exemplifies the effects of chronic inflammation on tissues and is closely linked to colorectal cancer.
“I’ve always been interested in the molecular regulation of the inflammatory response,” Dr. Burstein said. “While I always had a strong connection to UT Southwestern since my training days, the establishment of the DOCS program provided the unique opportunity to be in the right environment, with the right tools, and among the right people to pursue my research interests. It is a key reason why I am here today.”
In the long run, Dr. Burstein envisions the establishment of an IBD research center that can support collaborative efforts by various investigators on the UTSW campus who have interests in the fields of genetics, immunology, and gastroenterology.
Dr. Le planned to come to UT Southwestern for clinical and post-doctoral training, and then return to California. But the availability of the DOCS program convinced him to stay at UTSW.
DOCS support allowed Dr. Le to establish a lab to study how genetic and other microenvironmental factors regulate tumor formation in the peripheral nervous system. He describes the process as understanding how “a few bad kids move into a neighborhood and influence all the other kids.”
His work focuses on elucidating the biology of neurofibromatosis, a complicated disorder characterized by the growth of tumors along the nervous system or on the skin. Neurofibromatosis type 1 (NF1) is one of the most common genetic disorders of the nervous system, affecting one in 3,500 people.
Dr. Le said the DOCS program allows him to “take what I learn in the lab to my clinical work, or if I have a question from my clinical work, I can take it to the lab and work it out.” He is co-director of the Comprehensive Neurofibromatosis Clinic at UT Southwestern, caring for patients with NF1.
In July, the National Institutes of Health (NIH) awarded Dr. Ufret-Vincenty his first R01 research grant, which he says would not have been possible without the initial support he received through the DOCS program. Dr. Ufret-Vincenty plans to use the NIH grant over five years to study age-related macular degeneration using a transgenic mouse model developed in his laboratory.
Dr. Ufret-Vincenty became interested in eye diseases in medical school after realizing that, as a clinical specialty, ophthalmology combines both the medical and surgical care of patients, and is fertile ground for research. Vision loss from eye diseases, and in particular from age-related macular degeneration (AMD), is widespread. Approximately 1.8 million Americans have AMD.
After completing medical school in Puerto Rico, Dr. Ufret-Vincenty went to Harvard for his residency at the Massachusetts Eye and Ear Infirmary. While there, he embraced a retina subspecialty and plowed ahead as he looked to further research on the role of inflammation in AMD. After completing his training, Dr. Ufret-Vincenty was looking for an opportunity where he could combine his love for clinical ophthalmology with his passion for research.
“Without the support of the DOCS program, it would have been impossible to maintain the support needed to generate the preliminary data that ultimately led to NIH awarding me an R01 grant,” he explained. “A strong emphasis in providing and maintaining the necessary protected research time was a big factor.”
Through the DOCS program, Dr. Ufret-Vincenty reserves 60 percent to 70 percent of his time for his research interests.
While helping keep doctors at the bedside, the DOCS program seeks to nurture the scientists who potentially will make the medical breakthroughs of tomorrow.
“The physician-scientist is an endangered species,” Dr. Ginsburg said. “All too often, M.D.s who transition to bench work give up their clinical obligations, and never see patients again. The kind of candidate that the DOCS program is looking for is someone who still has a feel for the translational aspect of their studies, and can effectively interact with a patient.”