1 00:00:11,440 --> 00:00:13,640 Welcome to the Clinical Center Grand Rounds, 2 00:00:13,640 --> 00:00:17,440 a weekly series of educational lectures for physicians and 3 00:00:17,440 --> 00:00:20,080 health care professionals broadcast from the Clinical 4 00:00:20,080 --> 00:00:23,040 Center at the National Institutes of Health in 5 00:00:23,040 --> 00:00:24,840 Bethesda, MD. 6 00:00:24,840 --> 00:00:28,400 The NIH Clinical Center is the world's largest hospital totally 7 00:00:28,400 --> 00:00:32,080 dedicated to investigational research and leads the global 8 00:00:32,080 --> 00:00:35,040 effort in training today's investigators and discovering 9 00:00:35,040 --> 00:00:37,200 tomorrow's cures. 10 00:00:37,200 --> 00:00:48,120 Learn more by visiting us online at http://clinicalcenter.nih.gov 11 00:00:48,120 --> 00:00:52,560 TODAY I'M VERY PLEASED TO INTRODUCE A 12 00:00:52,560 --> 00:00:57,360 GREAT FRIEND TO THE NIH AND A 13 00:00:57,360 --> 00:01:00,000 GREAT ALUMNUS OF OUR PROGRAM 14 00:01:00,000 --> 00:01:01,480 MARK GLADWIN WHO IN AUGUST OF 15 00:01:01,480 --> 00:01:03,200 2022 WAS A POINTED THE VICE 16 00:01:03,200 --> 00:01:06,240 PRESIDENT OF THE UNIVERSITY OF 17 00:01:06,240 --> 00:01:07,200 MARYLAND SCHOOL OF MEDICINE. 18 00:01:07,200 --> 00:01:08,720 MARK'S JOURNEY TO LEADERSHIP 19 00:01:08,720 --> 00:01:10,320 STARTED AT THE UNIVERSITY OF 20 00:01:10,320 --> 00:01:13,400 MIAMI IN 1985 WHERE HE WAS IN A 21 00:01:13,400 --> 00:01:22,040 JOINT BACHELOR AND MD PROGRAM HE 22 00:01:22,040 --> 00:01:24,960 STARTED TODAY DO HIS INTERNAL 23 00:01:24,960 --> 00:01:26,480 TRAINING AT UNIVERSITY OF AND 24 00:01:26,480 --> 00:01:28,040 THREE IMPORTANT THINGS HAPPEN 25 00:01:28,040 --> 00:01:29,240 WHILE HE WAS THERE. 26 00:01:29,240 --> 00:01:32,280 FIRST, HE BECAME A GREAT 27 00:01:32,280 --> 00:01:37,040 CLINICIAN ENERGIZED BY HIS 28 00:01:37,040 --> 00:01:38,440 INQUISITIVENESS ABOUT ALL THE 29 00:01:38,440 --> 00:01:40,880 PATIENTS HE SAW AND THE SECOND 30 00:01:40,880 --> 00:01:42,920 THING IS HE RECOGNIZED THAT 31 00:01:42,920 --> 00:01:46,760 EDUCATION IS IMPORTANT AND FOR 32 00:01:46,760 --> 00:01:47,480 THE SAKE OF HIS MEDICAL 33 00:01:47,480 --> 00:01:50,440 STUDENTS, HE WROTE A BOOK CALLED 34 00:01:50,440 --> 00:01:52,480 "MICROBIOLOGY MADE RIDICULOUSLY 35 00:01:52,480 --> 00:01:54,600 SIMPLE" WHICH I SUSPECT EVERY 36 00:01:54,600 --> 00:01:56,160 YOUNGER MEMBER IN THIS AUDIENCE 37 00:01:56,160 --> 00:01:57,560 USED DURING THEIR SECOND YEAR OF 38 00:01:57,560 --> 00:01:59,120 MEDICAL SCHOOL TO GET THROUGH 39 00:01:59,120 --> 00:02:01,920 THEIR MICROBIOLOGY COURSE AND 40 00:02:01,920 --> 00:02:03,240 PREPARE AND STILL REMAINS THE 41 00:02:03,240 --> 00:02:06,840 BIBLE FOR MEDICAL STUDENTS IN 42 00:02:06,840 --> 00:02:07,240 2023. 43 00:02:07,240 --> 00:02:09,240 THE THIRD THING THAT HAPPENED IS 44 00:02:09,240 --> 00:02:17,880 OF OREGON IS AND LYNN TOLD HIM 45 00:02:17,880 --> 00:02:20,320 THAT HIS RESEARCH HE HAD COME TO 46 00:02:20,320 --> 00:02:21,480 THE NIH. 47 00:02:21,480 --> 00:02:27,200 AND FROM 1995, TO 2008, MARK HAD 48 00:02:27,200 --> 00:02:29,320 A 13-YEAR CAREER AS A CRITICAL 49 00:02:29,320 --> 00:02:30,440 CARE MEDICINE FELLOW AND HE 50 00:02:30,440 --> 00:02:32,040 SPENT A YEAR AT THE UNIVERSITY 51 00:02:32,040 --> 00:02:35,200 OF WASHINGTON DOING PULMONARY 52 00:02:35,200 --> 00:02:36,520 BEFORE COMING BACK AND HE ROSE 53 00:02:36,520 --> 00:02:39,080 FROM THE SENIOR STAFF TO THE 54 00:02:39,080 --> 00:02:40,440 NSBI WHERE I TRANSFERRED TO BE 55 00:02:40,440 --> 00:02:44,800 THE BRANCH CHIEF OF VASCULAR 56 00:02:44,800 --> 00:02:46,680 MEDICINE AND THE PULMONARY 57 00:02:46,680 --> 00:02:47,000 BRANCH. 58 00:02:47,000 --> 00:02:50,120 WHILE HE WAS AT NIH, ON THE NEXT 59 00:02:50,120 --> 00:02:52,320 SLIDE, MARK BENEFITED FROM A 60 00:02:52,320 --> 00:02:53,480 NUMBER OF MENTORS. 61 00:02:53,480 --> 00:02:56,600 HE REALLY HAD A TALENT FOR 62 00:02:56,600 --> 00:02:57,600 FINDING PEOPLE WHO COULD BE 63 00:02:57,600 --> 00:03:00,840 EFFECTIVE MENTORS, CHUCK AND JIM 64 00:03:00,840 --> 00:03:02,760 EX TAUGHT HIM A LOT ABOUT THE 65 00:03:02,760 --> 00:03:05,520 SCIENCE AND THE CLINICAL TRIALS. 66 00:03:05,520 --> 00:03:13,240 GIGRIFF ROGERS WAS A MENTOR AND 67 00:03:13,240 --> 00:03:18,720 ALAN SHECTOR IN UNDERSTANDING 68 00:03:18,720 --> 00:03:19,800 HEMO GLOBAL BIOLOGY AND IT'S 69 00:03:19,800 --> 00:03:23,520 STILL AN IMPORTANT ADVISORY 70 00:03:23,520 --> 00:03:24,000 MARK. 71 00:03:24,000 --> 00:03:26,160 MARK WAS SO SUCCESSFUL AT NIH, 72 00:03:26,160 --> 00:03:27,960 THAT IN 2008, HE WAS RECRUITED 73 00:03:27,960 --> 00:03:29,760 TO THE UNIVERSITY OF PITTSBURGH 74 00:03:29,760 --> 00:03:33,920 WHERE AGAIN HE HAD A METEORIC 75 00:03:33,920 --> 00:03:35,200 RISES WITH CRITICAL CARE 76 00:03:35,200 --> 00:03:36,560 MEDICINE AND ULTIMATELY AS THE 77 00:03:36,560 --> 00:03:38,120 CHAIRMAN OF THE DEPARTMENT OF 78 00:03:38,120 --> 00:03:39,440 MEDICINE AND THEN AS I SAID 79 00:03:39,440 --> 00:03:41,240 INITIALLY IN THE NEXT SLIDE, HE 80 00:03:41,240 --> 00:03:42,640 WAS LAST AUGUST RECRUITED TO 81 00:03:42,640 --> 00:03:44,080 UNIVERSITY OF MARYLAND WHERE HE 82 00:03:44,080 --> 00:03:46,680 IS NOW THE VICE PRESIDENT DEAN. 83 00:03:46,680 --> 00:03:48,440 I'D LIKE TO MENTION A FEW THINGS 84 00:03:48,440 --> 00:03:49,360 ABOUT HIS CAREER. 85 00:03:49,360 --> 00:03:51,640 FIRST OF ALL, MARK HAS ALWAYS, I 86 00:03:51,640 --> 00:03:54,160 THINK, GOTTEN HIS MOST ENERGY 87 00:03:54,160 --> 00:03:56,120 AND HIS MOST STIMULATION FROM 88 00:03:56,120 --> 00:03:57,920 SEEING PATIENTS. 89 00:03:57,920 --> 00:04:00,400 AND I VIVIDLY REMEMBER HIS 90 00:04:00,400 --> 00:04:02,760 INTEREST OF SICKLE CELL DISEASE 91 00:04:02,760 --> 00:04:04,800 AND HIS DESIRE TO UNDERSTAND THE 92 00:04:04,800 --> 00:04:06,080 BIOLOGY OF THE DISEASE IS SO HE 93 00:04:06,080 --> 00:04:07,880 CAN WORK ON BETTER BAYS TO 94 00:04:07,880 --> 00:04:09,400 IMPROVE THE OUTCOME OF HIS 95 00:04:09,400 --> 00:04:09,680 PATIENTS. 96 00:04:09,680 --> 00:04:14,080 IT WAS PATIENTS WITH MOTIVATED. 97 00:04:14,080 --> 00:04:18,280 MARK WAS AN EXPERT AT THE 98 00:04:18,280 --> 00:04:19,480 BIOLOGY OF NITRIC OXIDE. 99 00:04:19,480 --> 00:04:21,360 HE UNDERSTOOD ITS IMPORTANCE FOR 100 00:04:21,360 --> 00:04:23,000 BLOOD FLOW TO THE BRAIN, THE 101 00:04:23,000 --> 00:04:23,960 HEART, HE UNDERSTOOD THE 102 00:04:23,960 --> 00:04:25,640 RELEVANCE TO SICKLE CELL AND 103 00:04:25,640 --> 00:04:27,520 BECAUSE HE WAS A CLINICIAN, WHEN 104 00:04:27,520 --> 00:04:29,920 HE SAW OTHER PROBLEMS LIKE 105 00:04:29,920 --> 00:04:34,120 CARBON MONOXIDE POI POISONING, E 106 00:04:34,120 --> 00:04:35,520 RECOGNIZED THIS BIOLOGY WAS 107 00:04:35,520 --> 00:04:37,080 IMPORTANT TO OTHER CLINICAL 108 00:04:37,080 --> 00:04:38,840 PROBLEMS LIKE FINDING A SOLUTION 109 00:04:38,840 --> 00:04:41,200 WITH PEOPLE CARBON MONOXIDE 110 00:04:41,200 --> 00:04:41,680 POISONING. 111 00:04:41,680 --> 00:04:42,760 WHILE HE WAS AT NIH AND THE 112 00:04:42,760 --> 00:04:47,960 UNIVERSITY O PITTSBURGH, HE HAD 113 00:04:47,960 --> 00:04:48,640 THREE TALENTS. 114 00:04:48,640 --> 00:04:50,520 HE KNOWS HOW TO ATTRACT PEOPLE, 115 00:04:50,520 --> 00:04:52,880 BUILD TEAMS AND BUILD CENTERS. 116 00:04:52,880 --> 00:04:55,120 AND THE UNIVERSITY OF PITTSBURG 117 00:04:55,120 --> 00:04:57,880 HE BUILT A NUMBER OF VERY 118 00:04:57,880 --> 00:05:00,320 SUCCESSFUL CENTERS THAT WERE 119 00:05:00,320 --> 00:05:02,480 GREAT ABOVE BASIC SCIENCE AND 120 00:05:02,480 --> 00:05:02,920 TRANCATIONAL MEDICINE. 121 00:05:02,920 --> 00:05:05,760 HE WAS THE EXPERT AT LEADING 122 00:05:05,760 --> 00:05:08,480 CLINICAL TRIALS FOR NHLBI AND HE 123 00:05:08,480 --> 00:05:10,400 RECOGNIZED THAT, IN THE SCIENCE 124 00:05:10,400 --> 00:05:12,200 HE DID, THE SCIENCE WAS ONLY 125 00:05:12,200 --> 00:05:16,120 IMPORTANT IF HE COULD TRANSLATE 126 00:05:16,120 --> 00:05:22,080 IT INTO ADVANCES FOR PATIENTS SY 127 00:05:22,080 --> 00:05:23,520 STARTED A COMPANY THAT COULD 128 00:05:23,520 --> 00:05:25,320 TAKE ADVANTAGE OF NEURO GLOBIN 129 00:05:25,320 --> 00:05:26,280 AND SOME OF THE OTHER 130 00:05:26,280 --> 00:05:27,800 DISCOVERIES TO MAKE THEM MORE 131 00:05:27,800 --> 00:05:29,840 EFFECTIVE THERAPIES THAT 132 00:05:29,840 --> 00:05:34,640 PATIENTS HE WAS SEEING. 133 00:05:34,640 --> 00:05:36,320 THE TWO OTHER FEATURES THAT 134 00:05:36,320 --> 00:05:38,560 CHARACTERIZE MARK, MARK IS THE 135 00:05:38,560 --> 00:05:39,160 ONLY DEAN IN THE UNITED STATES 136 00:05:39,160 --> 00:05:41,960 WHO IS MAKING ROUNDS IN THE ICU. 137 00:05:41,960 --> 00:05:44,320 MARK HAS NEVER WANTED TO LEAVE 138 00:05:44,320 --> 00:05:46,120 CLINICAL MEDICINE SO HE IS 139 00:05:46,120 --> 00:05:47,280 INSISTED AS PART OF HIS CONTRACT 140 00:05:47,280 --> 00:05:49,440 AT MARYLAND, THAT HE WOULD 141 00:05:49,440 --> 00:05:52,960 ATTEND IN THE ICU FOR SIX WEEKS 142 00:05:52,960 --> 00:05:54,840 EACH YEAR AND YOU CAN SEE HIM AT 143 00:05:54,840 --> 00:05:56,400 HIS FIRST ROTATION TO CLINICAL 144 00:05:56,400 --> 00:05:57,440 MEDICINE IS STILL HIS 145 00:05:57,440 --> 00:05:57,880 FOUNDATION. 146 00:05:57,880 --> 00:06:02,360 AND LASTLY, ON THE NEXT SLIDE, 147 00:06:02,360 --> 00:06:04,000 MARK FEELS STRONGLY ABOUT 148 00:06:04,000 --> 00:06:06,720 EDUCATING THE NEXT GENERATION. 149 00:06:06,720 --> 00:06:08,160 MENTORING PHYSICIAN-SCIENTISTS 150 00:06:08,160 --> 00:06:10,600 IS COMING HE HAD AN AMAZINGLY 151 00:06:10,600 --> 00:06:14,360 SUCCESSFUL PROGRAM AT PITTSBURGH 152 00:06:14,360 --> 00:06:15,600 AND SOMETHING THAT WE'D LIKE TO 153 00:06:15,600 --> 00:06:17,680 TALK TO HIM ABOUT HOW WE CAN 154 00:06:17,680 --> 00:06:20,720 WORK WITH HIM TO ENHANCE OUR 155 00:06:20,720 --> 00:06:22,320 PROGRAMS HERE IN COLLABORATION 156 00:06:22,320 --> 00:06:24,440 WITH MARYLAND. 157 00:06:24,440 --> 00:06:27,840 SO I'M VERY PLEASED TO INTRODUCE 158 00:06:27,840 --> 00:06:30,560 MARK WHO WILL TALK ABOUT 159 00:06:30,560 --> 00:06:31,280 CREATING PHYSICIAN-SCIENTIST 160 00:06:31,280 --> 00:06:34,000 SOMETHING HE HAS BEEN REALLY 161 00:06:34,000 --> 00:06:35,320 SUCCESSFUL FOR OR WITH AT THE 162 00:06:35,320 --> 00:06:37,000 UNIVERSITY OF PITTSBURGH AND 163 00:06:37,000 --> 00:06:38,320 HOPEFULLY AT THE UNIVERSITY OF 164 00:06:38,320 --> 00:06:42,960 MARYLAND. 165 00:06:42,960 --> 00:06:45,440 THANK YOU FOR THAT VERY KIND 166 00:06:45,440 --> 00:06:46,640 AND COMPREHENSIVE INTRODUCTION. 167 00:06:46,640 --> 00:06:49,720 I REALLY APPRECIATE IT. 168 00:06:49,720 --> 00:06:53,360 I WILL POINT OUT, 22 YEARS AGO, 169 00:06:53,360 --> 00:06:57,080 I HAD THE HONOR OF BEING ASKED 170 00:06:57,080 --> 00:07:00,760 TO PRESENT AT THE CLINICAL 171 00:07:00,760 --> 00:07:02,640 CENTER GROUND UNDERSTAND AT A 172 00:07:02,640 --> 00:07:04,800 POSTDOCTORAL CENTER AND TWO 173 00:07:04,800 --> 00:07:07,160 HOURS BEFORE THE GRAND ROUNDS, 174 00:07:07,160 --> 00:07:08,920 MY WIFE WENT INTO LABOR WITH OUR 175 00:07:08,920 --> 00:07:11,280 FIRST CHILD, FLORA, AND HER 176 00:07:11,280 --> 00:07:12,640 WATER BROKE AN HOUR AND A HALF 177 00:07:12,640 --> 00:07:14,400 BEFORE THE GRAND ROUNDS. 178 00:07:14,400 --> 00:07:18,920 I WENT OVER MY SLIDES WITH ALAN 179 00:07:18,920 --> 00:07:20,960 AND HE TOLD ME 180 00:07:20,960 --> 00:07:22,360 MARK, I'VE GIVEN A TALK BEFORE, 181 00:07:22,360 --> 00:07:24,600 GET OUT OF HERE. 182 00:07:24,600 --> 00:07:26,560 I LEFT AND FLORA WAS DELIVERED 183 00:07:26,560 --> 00:07:29,320 AT 12:30, RIGHT IN THE MIDDLE OF 184 00:07:29,320 --> 00:07:29,880 THE GROUND ROUNDS. 185 00:07:29,880 --> 00:07:32,120 I'M HOPEFUL I CAN MAKE MY WAY 186 00:07:32,120 --> 00:07:33,280 THROUGH THIS AND I THANK YOU FOR 187 00:07:33,280 --> 00:07:35,400 THE HONOR OF SPEAKING TO THIS 188 00:07:35,400 --> 00:07:35,840 GROUP. 189 00:07:35,840 --> 00:07:39,720 WHAT I'D LIKE TO TALK ABOUT 190 00:07:39,720 --> 00:07:41,280 TODAY IS LESSONS LEARNED FROM A 191 00:07:41,280 --> 00:07:43,040 CAREER AT THE NIH CLINICAL 192 00:07:43,040 --> 00:07:44,560 CENTER, REALLY LOOKING AT THE 193 00:07:44,560 --> 00:07:46,480 PAST, THE PRESENT AND THE 194 00:07:46,480 --> 00:07:46,800 FUTURE. 195 00:07:46,800 --> 00:07:49,880 I LISTED MY GRANTS AS 196 00:07:49,880 --> 00:07:50,560 DISCLOSURES. 197 00:07:50,560 --> 00:07:58,160 I AM A P.I. ON A TRIAL WITH BEAE 198 00:07:58,160 --> 00:07:59,440 WITH SICKLE CELL BUT THERE 199 00:07:59,440 --> 00:08:01,720 AREN'T CONFLICTS RELATED IN THIS 200 00:08:01,720 --> 00:08:02,360 PRESENTATION. 201 00:08:02,360 --> 00:08:03,520 SO THERE ARE A NUMBER OF 202 00:08:03,520 --> 00:08:05,280 CHALLENGES FACING PHYSICIANS 203 00:08:05,280 --> 00:08:07,200 SCIENTISTS IN MODERN ACADEMIC 204 00:08:07,200 --> 00:08:08,240 MEDICAL CENTERS. 205 00:08:08,240 --> 00:08:09,960 AND NUMBER ONE, THERE'S 206 00:08:09,960 --> 00:08:12,240 INCREASING INTENSE AND 207 00:08:12,240 --> 00:08:14,360 COMPREHENSIVE MULTI-YEAR 208 00:08:14,360 --> 00:08:15,400 CLINICAL TRAINING REQUIREMENTS 209 00:08:15,400 --> 00:08:17,080 FOR FELLOWS. 210 00:08:17,080 --> 00:08:20,280 CARDIOLOGY WITH CO CATS IMAGING 211 00:08:20,280 --> 00:08:21,920 CERTIFICATES, A LOT OF OUR 212 00:08:21,920 --> 00:08:24,440 FELLOWS WANT MULTIPLE OF THESE, 213 00:08:24,440 --> 00:08:28,120 EXTRA YEARS FOR HEART FAILURE, 214 00:08:28,120 --> 00:08:30,440 CARDIOLOGY, ELECTRO PHYSIOLOGY, 215 00:08:30,440 --> 00:08:31,160 NUCLEAR MEDICINE. 216 00:08:31,160 --> 00:08:32,960 MANY ARE EXTENDING TRAINING FOUR 217 00:08:32,960 --> 00:08:34,560 TO FIVE YEARS WITHOUT PROTECTED 218 00:08:34,560 --> 00:08:36,560 TIME FOR RESEARCH. 219 00:08:36,560 --> 00:08:39,320 THERE'S AN INCREASING LACK OF 220 00:08:39,320 --> 00:08:40,240 FUNDED PROTECTED TIME FOR 221 00:08:40,240 --> 00:08:41,200 INVESTMENT AND FUNDAMENTAL 222 00:08:41,200 --> 00:08:43,120 RESEARCH STUDIES THAT ARE 223 00:08:43,120 --> 00:08:44,160 NEEDED. 224 00:08:44,160 --> 00:08:47,360 THERE ARE LIMITED AND HIGHLY 225 00:08:47,360 --> 00:08:49,120 COMPETITIVE T-32 GRANTS THAT 226 00:08:49,120 --> 00:08:50,040 SUPPORT THIS TRAINING AND I 227 00:08:50,040 --> 00:08:51,360 THINK THESE GRANTS ARE KEY TO 228 00:08:51,360 --> 00:08:53,080 SUCCESS IN THE EXTRAMURAL WORLD 229 00:08:53,080 --> 00:08:55,520 AND I'LL TALK ABOUT THAT 230 00:08:55,520 --> 00:08:56,080 STRATEGY. 231 00:08:56,080 --> 00:09:02,880 THE T # 2 T32 AND K GRANTS THAR 232 00:09:02,880 --> 00:09:04,840 YOUR SALARY HAS FIVE YEARS AS 233 00:09:04,840 --> 00:09:06,040 FACULTY, BUT THOSE SALARIES ARE 234 00:09:06,040 --> 00:09:07,360 MUCH LOWER THAN WHAT PEOPLE ARE 235 00:09:07,360 --> 00:09:09,720 PAID FOR CLINICAL REIMBURSEMENT 236 00:09:09,720 --> 00:09:11,480 IN THIS MODERN ERA. 237 00:09:11,480 --> 00:09:13,240 THERE'S LIMITED 238 00:09:13,240 --> 00:09:14,200 PHYSICIAN-SCIENTISTS ROLE MODEL 239 00:09:14,200 --> 00:09:16,040 AT MANY INSTITUTIONS AS YOU WILL 240 00:09:16,040 --> 00:09:17,640 HEAR ABOUT AND ESPECIALLY WOMEN 241 00:09:17,640 --> 00:09:19,280 AND FACULTY THAT ARE UNDER 242 00:09:19,280 --> 00:09:21,400 REPRESENTED IN MEDICINE AND 243 00:09:21,400 --> 00:09:22,360 SCIENCE. 244 00:09:22,360 --> 00:09:26,280 AND THERE'S SIP CAL CYNICAL 245 00:09:26,280 --> 00:09:27,480 COMMUNICATION ABOUT CAREER IN 246 00:09:27,480 --> 00:09:27,680 SCIENCE. 247 00:09:27,680 --> 00:09:29,240 IT'S HARD TO GET GRANTS AND 248 00:09:29,240 --> 00:09:30,200 BALANCE. 249 00:09:30,200 --> 00:09:32,120 IT'S A LONG PATHWAY TO 250 00:09:32,120 --> 00:09:33,520 INDEPENDENCE, THERE'S LESS 251 00:09:33,520 --> 00:09:34,840 COMPENSATION COMPARED WITH 252 00:09:34,840 --> 00:09:35,400 CLINICAL WORK. 253 00:09:35,400 --> 00:09:36,240 THERE'S A REAL OPPORTUNITY FOR 254 00:09:36,240 --> 00:09:38,760 US TO COMMUNICATE THE JOY, THE 255 00:09:38,760 --> 00:09:40,960 FREEDOM OF TIME WITH A RESEARCH 256 00:09:40,960 --> 00:09:42,360 CAREER, THE DIVERSITY OF THE 257 00:09:42,360 --> 00:09:44,160 EXPERIENCE GOING FROM THE CLINIC 258 00:09:44,160 --> 00:09:47,400 TO THE EDUCATIONAL SPACE TO THE 259 00:09:47,400 --> 00:09:47,960 RESEARCH. 260 00:09:47,960 --> 00:09:50,560 THERE'S ALSO A LACK OF UNIVERSAL 261 00:09:50,560 --> 00:09:51,880 CULTURE ACROSS CLINICAL 262 00:09:51,880 --> 00:09:53,160 DEPARTMENTS AROUND THE NEED TO 263 00:09:53,160 --> 00:09:53,880 TRAIN PHYSICIAN-SCIENTIST. 264 00:09:53,880 --> 00:09:56,200 THESE ARE OUR MANY CHALLENGES. 265 00:09:56,200 --> 00:09:57,480 THIS IS DATA SHOWING THAT THE 266 00:09:57,480 --> 00:09:59,480 NUMBER OF PHYSICIANS SCIENTISTS 267 00:09:59,480 --> 00:10:01,320 IS STEADILY DECREASING OVER THE 268 00:10:01,320 --> 00:10:03,080 LAST DECADE. 269 00:10:03,080 --> 00:10:06,720 WE HAVE ALMOST 937,000 ACTIVE 270 00:10:06,720 --> 00:10:08,960 PHYSICIANS AND ONLY 12,000 THAT 271 00:10:08,960 --> 00:10:10,960 REPORT RESEARCH AT THE MAJOR 272 00:10:10,960 --> 00:10:11,960 PROFESSIONALLAL ACTIVITY WITH 273 00:10:11,960 --> 00:10:16,360 THE PERCENTAGE DROPPING FROM 1.6 274 00:10:16,360 --> 00:10:18,120 TO 1.3%. 275 00:10:18,120 --> 00:10:21,640 ONLY 121 OF OUR 155 MEDICAL 276 00:10:21,640 --> 00:10:24,480 SCHOOLS HAVE MD-PH.D PROGRAMS 277 00:10:24,480 --> 00:10:28,040 AND 450 ARE FUNDED THROUGH NIH 278 00:10:28,040 --> 00:10:30,680 T32 TRAINING AWARDS. 279 00:10:30,680 --> 00:10:31,720 KNOWN REPAYMENT PROGRAMS ARE 280 00:10:31,720 --> 00:10:33,680 VITAL FOR THE DEVELOPMENT 281 00:10:33,680 --> 00:10:34,320 PHYSICIAN-SCIENTISTS AND THESE 282 00:10:34,320 --> 00:10:35,640 PROGRAMS WILL ASSIST GRADUATES 283 00:10:35,640 --> 00:10:40,120 WITH RESEARCH CAREERS AND REPAY 284 00:10:40,120 --> 00:10:41,400 50,000 UP TO THREE YEARS IN 285 00:10:41,400 --> 00:10:44,360 RETURN FOR A COMMITMENT TO NIH 286 00:10:44,360 --> 00:10:45,200 MISSION-RELATED RESEARCH AND 287 00:10:45,200 --> 00:10:47,400 THIS IS RESTRICTED RESEARCHERS 288 00:10:47,400 --> 00:10:49,000 AND SPECIFIC FIELDS OR NEED 289 00:10:49,000 --> 00:10:50,520 BASED AND IN FACT, I RECEIVED 290 00:10:50,520 --> 00:10:54,200 ONE OF THESE AWARDS FOR INTO 291 00:10:54,200 --> 00:10:54,800 EVIDENCE-BASED SCHOLARSHIP WHICH 292 00:10:54,800 --> 00:10:56,400 WAS ESSENTIAL TO MY STAYING THE 293 00:10:56,400 --> 00:10:57,960 MANY, MANY YEARS THAT I NEEDED 294 00:10:57,960 --> 00:11:00,080 TO DEVELOP A COMPETITIVE ABILITY 295 00:11:00,080 --> 00:11:03,920 TOLL PERFORM BASIC SCIENCE 296 00:11:03,920 --> 00:11:06,040 RESEARCH. 297 00:11:06,040 --> 00:11:06,640 THESE AWARDS WORK. 298 00:11:06,640 --> 00:11:08,640 IN RED WE SEE THE PERSIST APPS 299 00:11:08,640 --> 00:11:10,160 OF RESEARCH IN PEOPLE FUNDED 300 00:11:10,160 --> 00:11:11,320 WITH LONGER PAYMENT AWARDS 301 00:11:11,320 --> 00:11:12,880 COMPARED TO THOSE NOT FUNDED. 302 00:11:12,880 --> 00:11:14,520 YOU CAN SEE WE HAVE CHALLENGES 303 00:11:14,520 --> 00:11:17,760 AT BOTH GROUPS BUT EVEN 15 YEARS 304 00:11:17,760 --> 00:11:22,440 OUT, 24% OR SO REMAIN IN 305 00:11:22,440 --> 00:11:24,320 RESEARCH COMPARED TO 7% IN THOSE 306 00:11:24,320 --> 00:11:26,960 UUNFUNDED. 307 00:11:26,960 --> 00:11:29,800 THESE AWARDS APPEAR TO HAVE THE 308 00:11:29,800 --> 00:11:31,200 DECLINING IN ORANGE WE SEE 309 00:11:31,200 --> 00:11:33,040 AWARDS GOING TO PH.D WHICH ARE 310 00:11:33,040 --> 00:11:34,440 STABLE, A DROPPING IN AWARDS 311 00:11:34,440 --> 00:11:37,080 GOING TO BOTHS MD ONLIES IN BLUE 312 00:11:37,080 --> 00:11:41,240 AND EVEN A DROP IN THE PH.D 313 00:11:41,240 --> 00:11:41,720 AWARDEES. 314 00:11:41,720 --> 00:11:43,400 SO, WHAT ARE SOME OF THE LESSON 315 00:11:43,400 --> 00:11:45,920 WE CAN LEARN ABOUT SUSTAINING 316 00:11:45,920 --> 00:11:48,120 AND CAPTURING 317 00:11:48,120 --> 00:11:48,720 PHYSICIAN-SCIENTISTS AND 318 00:11:48,720 --> 00:11:49,800 RESEARCH AND I'D LIKE TO START 319 00:11:49,800 --> 00:11:51,600 WITH WHAT THE NIH CLINICAL 320 00:11:51,600 --> 00:11:55,080 CENTER TAUG TAUGHT US AND MUCH F 321 00:11:55,080 --> 00:11:58,400 THIS DATA CAME FROM GREAT 322 00:11:58,400 --> 00:12:00,440 INFORMATION THAT ROBERT SHARED 323 00:12:00,440 --> 00:12:02,400 WITH ME, WHO HAS BEEN A BIG 324 00:12:02,400 --> 00:12:06,120 PROPONENT OF THE ROLE OF THE 325 00:12:06,120 --> 00:12:08,440 YELLOW BERET PROGRAM IN 326 00:12:08,440 --> 00:12:09,400 ADVANCING PHYSICIAN-SCIENTIST. 327 00:12:09,400 --> 00:12:11,760 SO, THE YELLOW BERETS WERE 328 00:12:11,760 --> 00:12:13,520 PHYSICIANS FROM THE DOCTOR DRAFT 329 00:12:13,520 --> 00:12:16,120 DURING THE VIETNAM WAR. 330 00:12:16,120 --> 00:12:17,440 THESE WERE SUPPORTED THROUGH THE 331 00:12:17,440 --> 00:12:18,040 BARRIE PLAN. 332 00:12:18,040 --> 00:12:20,400 THIS PLAN ALLOWED GRADUATING 333 00:12:20,400 --> 00:12:22,680 MDs TO DIVERT TO FIRST SERVICE 334 00:12:22,680 --> 00:12:23,520 IN VIETNAM TO UNDERTAKE TWO 335 00:12:23,520 --> 00:12:25,280 YEARS OF CLINICAL TRAINING 336 00:12:25,280 --> 00:12:27,760 WITHOUT INTERRUPTIONS. 337 00:12:27,760 --> 00:12:29,600 42,000 PHYSICIANS PARTICIPATED 338 00:12:29,600 --> 00:12:31,880 AND THEY COULD HAVE SERVICE AS A 339 00:12:31,880 --> 00:12:33,400 COMMISSION OFFICER IN THE NAVY, 340 00:12:33,400 --> 00:12:35,200 ARMY, AIR FORCE, OR U.S. 341 00:12:35,200 --> 00:12:35,920 PUBLIC-HEALTH SERVICE. 342 00:12:35,920 --> 00:12:37,600 AND THE U.S. PUBLIC-HEALTH 343 00:12:37,600 --> 00:12:38,520 SERVICE OPPORTUNITIES INCLUDED 344 00:12:38,520 --> 00:12:39,600 THE NATIONAL INSTITUTE OF 345 00:12:39,600 --> 00:12:42,800 HEALTH, CENTERS FOR DISEASE 346 00:12:42,800 --> 00:12:44,080 CONTROL AND INDIAN HEALTH 347 00:12:44,080 --> 00:12:44,720 SERVICE. 348 00:12:44,720 --> 00:12:48,440 AT ITS PEAK IN 1970s, THERE IN 349 00:12:48,440 --> 00:12:49,520 200 ASSOCIATE PER YEAR AT THE 350 00:12:49,520 --> 00:12:52,120 NIH AND AS YOU CAN SEE HERE 351 00:12:52,120 --> 00:12:53,800 AFTER THE VIETNAM WAR, THERE WAS 352 00:12:53,800 --> 00:12:56,680 A DECLINE ALMOST TO ZERO BY THE 353 00:12:56,680 --> 00:13:00,120 TIME I ARRIVED IN 1995 AT THE 354 00:13:00,120 --> 00:13:01,160 NIH. 355 00:13:01,160 --> 00:13:02,720 NOW, THIS PROGRAM LED TO A 356 00:13:02,720 --> 00:13:04,840 LEGACY OF SUCCESS. 357 00:13:04,840 --> 00:13:06,000 YELLOW BERETS WERE THREE TIMES 358 00:13:06,000 --> 00:13:07,560 AS LIKELY TO BE A DEAN, TWO 359 00:13:07,560 --> 00:13:09,320 TIMES AS LIKELY TO BE A 360 00:13:09,320 --> 00:13:11,200 DEPARTMENT CHAIR, 1.5 TIMES AS 361 00:13:11,200 --> 00:13:13,320 LIKELY TO ACHIEVE FULL PROFESSOR 362 00:13:13,320 --> 00:13:13,680 RANK. 363 00:13:13,680 --> 00:13:15,200 THERE WERE 64 ELECTED AND 364 00:13:15,200 --> 00:13:17,120 NATIONAL ACADEMY OF SCIENCE AND 365 00:13:17,120 --> 00:13:18,880 125 ELECTED TO THE INSTITUTE OF 366 00:13:18,880 --> 00:13:20,640 MEDICINE, FOUR OF NINE NIH 367 00:13:20,640 --> 00:13:23,400 DIRECTORS, 10 OF 122 NIH 368 00:13:23,400 --> 00:13:27,160 INSTITUTE DIRECTORS AND 10 NOBEL 369 00:13:27,160 --> 00:13:28,640 LAWYER ATS, SO WHAT CONDITIONS 370 00:13:28,640 --> 00:13:31,880 IN THE '60s ENABLE THIS 371 00:13:31,880 --> 00:13:33,080 UNPRECEDENTED SUCCESS. 372 00:13:33,080 --> 00:13:34,720 THE VIETNAM WAR DROVE INTENSE 373 00:13:34,720 --> 00:13:36,040 COMPETITION FOR THE ABSOLUTE TOP 374 00:13:36,040 --> 00:13:39,160 TALENT IN THE NATION TO GO TO 375 00:13:39,160 --> 00:13:42,920 THE NERVES NIH AND COMMIT TO BD 376 00:13:42,920 --> 00:13:43,600 TRANSLATIONAL RESEARCH. 377 00:13:43,600 --> 00:13:45,320 THERE WERE OUT STANDING MENTORS 378 00:13:45,320 --> 00:13:48,520 AT NIH, BOTH PH.D AND MD. 379 00:13:48,520 --> 00:13:49,560 THERE WAS RESEARCH EXPERIENCE 380 00:13:49,560 --> 00:13:51,680 WITH FEW DISTRACTIONS. 381 00:13:51,680 --> 00:13:54,280 THEIR EVENING COURSES WITH MANY 382 00:13:54,280 --> 00:13:55,360 CUTTING-EDGE AREAS OF NEW BASIC 383 00:13:55,360 --> 00:13:55,640 SCIENCE. 384 00:13:55,640 --> 00:13:57,600 THERE WAS A FOCUS ON FUNDAMENTAL 385 00:13:57,600 --> 00:14:00,120 BASIC SCIENCE RESEARCH HOWEVER, 386 00:14:00,120 --> 00:14:02,920 THESE DISCOVERIES WERE STRONG 387 00:14:02,920 --> 00:14:03,520 LEASE INFLUENCED DRUG 388 00:14:03,520 --> 00:14:04,560 DEVELOPMENT AND MEDICAL PRACTICE 389 00:14:04,560 --> 00:14:06,360 IN HUMAN HEALTH AND MEDICAL 390 00:14:06,360 --> 00:14:07,680 STUDENTS WERE TAUGHT THE JOY OF 391 00:14:07,680 --> 00:14:10,360 FINDING NEW FACTS FOR OVER 392 00:14:10,360 --> 00:14:13,160 TURNING OLD ONES AND REALLY 393 00:14:13,160 --> 00:14:14,520 LEVERAGING THE NEW REVOLUTION 394 00:14:14,520 --> 00:14:16,920 AND THE LACK OF BIOLOGY. 395 00:14:16,920 --> 00:14:18,440 SO WHAT CAN WE LEARN FROM THE 396 00:14:18,440 --> 00:14:19,520 RESENT PAST AND THESE ARE REALLY 397 00:14:19,520 --> 00:14:22,520 MY PERSONAL REFLECTIONS AND AN 398 00:14:22,520 --> 00:14:24,680 ODYSSEY AS AN MD-ONLY 399 00:14:24,680 --> 00:14:26,040 PHYSICIAN-SCIENTIST ARRIVING AT 400 00:14:26,040 --> 00:14:27,560 THE NIH AFTER MY CLINICAL 401 00:14:27,560 --> 00:14:30,280 TRAINING, WHICH WAS FROM '95 TO 402 00:14:30,280 --> 00:14:33,200 '97 SO START NORTH 1997. 403 00:14:33,200 --> 00:14:34,520 AND JUST BRIEFLY SHARE WITH YOU 404 00:14:34,520 --> 00:14:36,280 THE OVERVIEW OF THE FOLKS IN MY 405 00:14:36,280 --> 00:14:38,920 CAREER HAS BEEN ON THE 406 00:14:38,920 --> 00:14:40,480 INTERSECTION OF NITRIC OXIDE AND 407 00:14:40,480 --> 00:14:41,120 HEMOGLOBIN SIGNALING. 408 00:14:41,120 --> 00:14:46,560 WHEN I CAME TO THE NIH IN 1997, 409 00:14:46,560 --> 00:14:47,600 A PAM A DIME WAS DEVELOPING AND 410 00:14:47,600 --> 00:14:49,200 NO WAS A MOLECULE AND IT'S 411 00:14:49,200 --> 00:14:53,640 PRODUCED BY THE NO CELLS AND 412 00:14:53,640 --> 00:14:56,480 DIFFUSES AS A MODEL OF A SMOOTH 413 00:14:56,480 --> 00:14:58,040 MUSCLE WITH CAN DRYS WITH 414 00:14:58,040 --> 00:14:58,360 DILATION. 415 00:14:58,360 --> 00:15:00,880 THERE WAS A MYSTERY AND THAT WAS 416 00:15:00,880 --> 00:15:04,320 HEMOGLOBIN WAS KNOWN TO SCAVAGE 417 00:15:04,320 --> 00:15:07,040 NITRIC OXIDE AND PEOPLE SAID HOW 418 00:15:07,040 --> 00:15:09,040 CAN COULD NOB WHEN THERE'S SO 419 00:15:09,040 --> 00:15:11,480 MUCH HEMOGLOBIN IN BLOOD AND THE 420 00:15:11,480 --> 00:15:13,600 SOLUTION WAS EMERGING THAT THERE 421 00:15:13,600 --> 00:15:14,680 WERE DIFFUSION BARRIERS AROUND 422 00:15:14,680 --> 00:15:18,760 THE RED CELL, AROUND THIS 423 00:15:18,760 --> 00:15:21,320 CELL-FREE ZONE ALONG THE BLOOD 424 00:15:21,320 --> 00:15:22,520 AND THESE DIFFUSION BARRIERS 425 00:15:22,520 --> 00:15:26,440 REDUCE THE REACTION RATE OF NO 426 00:15:26,440 --> 00:15:29,480 WITH HEMOGLOBIN BY A THOUSAND 427 00:15:29,480 --> 00:15:29,680 FOLD. 428 00:15:29,680 --> 00:15:33,240 WE SO DISCOVERED THAT DURING 429 00:15:33,240 --> 00:15:35,840 HEMOLYSIS IT TOOK 1 EVERY 1,000 430 00:15:35,840 --> 00:15:39,400 RED CELLS AND TWO TO FOUR PLASMA 431 00:15:39,400 --> 00:15:41,320 HEMOGLOBIN TO SCAVAGE NITRIC 432 00:15:41,320 --> 00:15:43,120 OXIDE, CREATE INSTABILITY AND 433 00:15:43,120 --> 00:15:48,080 LEAD OVER TIME TO VAAS. 434 00:15:48,080 --> 00:15:51,000 THE SECOND DISCOVERY WAS THAT NO 435 00:15:51,000 --> 00:15:56,240 TO BE OXIDIZED TO NORM NITRITE 436 00:15:56,240 --> 00:16:00,040 AND IT FORMED NO THAT COULD BE 437 00:16:00,040 --> 00:16:04,040 REACTIVATED WITH THE HEMOGLOBIN, 438 00:16:04,040 --> 00:16:07,520 OTHER HEMO PROTEINS AND TO 439 00:16:07,520 --> 00:16:09,800 GENERATE NITRIC OXIDE. 440 00:16:09,800 --> 00:16:15,080 SO, A KEY TO MY TRANSITION WAS 441 00:16:15,080 --> 00:16:17,080 THAT I HAD TO MOST FROM A 442 00:16:17,080 --> 00:16:18,840 COMFORT ZONE TO SOMETHING 443 00:16:18,840 --> 00:16:20,040 DIFFERENT AND I CALL THAT WHERE 444 00:16:20,040 --> 00:16:22,600 THE MAGIC HAPPENS AND THAT 445 00:16:22,600 --> 00:16:25,200 COMFORT ZONE WAS AN ORGAN HEALTH 446 00:16:25,200 --> 00:16:26,400 SCIENCE UNIVERSITY CHIEF 447 00:16:26,400 --> 00:16:29,000 CLINICIAN EDUCATOR TO LEARN AND 448 00:16:29,000 --> 00:16:30,280 TO COMMIT TO TAKING A RISK AND 449 00:16:30,280 --> 00:16:32,280 LEARNING CELL EX MOLECULAR 450 00:16:32,280 --> 00:16:33,240 BIOLOGY AT THE NIH. 451 00:16:33,240 --> 00:16:36,040 I THINK THAT THIS STEP REQUIRES 452 00:16:36,040 --> 00:16:38,680 A COMMITMENT TO GO DEEP AND 453 00:16:38,680 --> 00:16:41,160 UNDERSTAND FUNDAMENTAL SCIENCE. 454 00:16:41,160 --> 00:16:43,160 THE SECOND PIECE IS THAT YOUR 455 00:16:43,160 --> 00:16:43,800 MENTORS MATTER. 456 00:16:43,800 --> 00:16:45,520 THIS IS PROBABLY ONE OF THE MOST 457 00:16:45,520 --> 00:16:46,920 IMPORTANT THINGS AND HENRY 458 00:16:46,920 --> 00:16:48,520 ALLUDE TODAY THIS AND I 459 00:16:48,520 --> 00:16:51,240 BENEFITED FROM MANY IMPRESSIVE, 460 00:16:51,240 --> 00:16:52,800 ABSOLUTELY COMMITTED PARTNERS IN 461 00:16:52,800 --> 00:16:54,120 MENTORS AND THEY'RE ALL SHOWN 462 00:16:54,120 --> 00:16:56,960 HERE AND I'LL TOUCH ON THEM AS I 463 00:16:56,960 --> 00:16:58,720 MOVED THROUGH. 464 00:16:58,720 --> 00:17:03,920 RICHARD GALLON, ALAN, JIM, GRIFF 465 00:17:03,920 --> 00:17:05,040 ROGERS AND ALL OTHERS I'LL TALK 466 00:17:05,040 --> 00:17:06,800 ABOUT AS I GO THROUGH MANY OF 467 00:17:06,800 --> 00:17:08,880 WHICH ARE STIM AT THE NIH AND 468 00:17:08,880 --> 00:17:11,960 THRIVING IN THE RESEARCH ARENA 469 00:17:11,960 --> 00:17:14,480 SO JIM SHELLHAMMER AND HIS 470 00:17:14,480 --> 00:17:16,360 TECHNICIAN, CAROLE LOGAN, TAUGHT 471 00:17:16,360 --> 00:17:17,080 ME LESSONS. 472 00:17:17,080 --> 00:17:18,360 FIRST OF ALL THEY WERE THE 473 00:17:18,360 --> 00:17:19,920 ULTIMATE ROLE MODEL. 474 00:17:19,920 --> 00:17:21,120 THE PHYSICIAN-SCIENTIST AND LAB 475 00:17:21,120 --> 00:17:21,560 PARENTS. 476 00:17:21,560 --> 00:17:23,600 THEY CARED ABOUT MY LIFE 477 00:17:23,600 --> 00:17:23,960 HOLISTICALLY. 478 00:17:23,960 --> 00:17:25,520 THEY TAUGHT ME THAT BOTH 479 00:17:25,520 --> 00:17:27,960 GARDENING AND MOLECULAR BIOLOGY 480 00:17:27,960 --> 00:17:28,680 WERE COOL. 481 00:17:28,680 --> 00:17:31,200 THEY TAUGHT ME TO BE PATIENT, 482 00:17:31,200 --> 00:17:32,400 SUPPORTIVE AND NURTURE AND IT 483 00:17:32,400 --> 00:17:32,800 WILL WORKOUT. 484 00:17:32,800 --> 00:17:34,840 THIS IS A LESSON THAT CARRIED ME 485 00:17:34,840 --> 00:17:36,160 FORWARD AS I MENTORED PEOPLE 486 00:17:36,160 --> 00:17:37,440 THROUGH THEIR CHALLENGES WITH 487 00:17:37,440 --> 00:17:39,880 NEGATIVE DATA, NOT GETTING 488 00:17:39,880 --> 00:17:41,240 GRANTS, AND THIS WAS AN 489 00:17:41,240 --> 00:17:42,640 INCREDIBLE LESSON TO BE A 490 00:17:42,640 --> 00:17:43,360 LEADER. 491 00:17:43,360 --> 00:17:44,680 CAROLE ALWAYS TAUGHT ME PRE 492 00:17:44,680 --> 00:17:47,080 LABEL AND ORGANIZE YOUR TUBES, I 493 00:17:47,080 --> 00:17:48,600 LIKE TO MOVE FAST AND FURIOUS 494 00:17:48,600 --> 00:17:50,640 AND WOULD GET IN TROUBLE. 495 00:17:50,640 --> 00:17:52,000 JIM TAUGHT ME THAT TRUTH IS 496 00:17:52,000 --> 00:17:54,040 DEFINED BY HAVING YOUR DATA 497 00:17:54,040 --> 00:17:57,360 REPRODUCED BY OTHERS. 498 00:17:57,360 --> 00:17:59,600 AND JIM'S MONTRA WAS DO JUSTICE 499 00:17:59,600 --> 00:18:02,360 LOVE KINDNESS AND WALK HUMBLY. 500 00:18:02,360 --> 00:18:04,360 ALAN HAD TOUGHER LESSONS. 501 00:18:04,360 --> 00:18:05,800 HE ALWAYS THOUGHT BIG, HE 502 00:18:05,800 --> 00:18:07,000 APPRECIATED WHAT THE IMPORTANT 503 00:18:07,000 --> 00:18:08,840 QUESTIONS WERE IN SCIENCE AND HE 504 00:18:08,840 --> 00:18:10,240 THOUGHT MY BEST WORK WOULD ARISE 505 00:18:10,240 --> 00:18:11,800 FROM MY STUDIES IN NORMAL 506 00:18:11,800 --> 00:18:13,800 VOLUNTEERS AND REALLY THE 507 00:18:13,800 --> 00:18:16,280 DISCOVERY OF NITRITE CAME FROM 508 00:18:16,280 --> 00:18:17,680 NORMAL VOLUNTEER STUDIES, HE 509 00:18:17,680 --> 00:18:19,120 WANTED ME TO FOCUS ON THE 510 00:18:19,120 --> 00:18:20,440 CLINIC. 511 00:18:20,440 --> 00:18:22,080 HE HATED TRANSGENIC MICE AND 512 00:18:22,080 --> 00:18:23,680 WHILE I DON'T AGREE WITH HIM 513 00:18:23,680 --> 00:18:25,960 COMPLETELY, I HAVE TO SAY THAT 514 00:18:25,960 --> 00:18:27,400 PEOPLE CAN -- THERE'S AN EASIER 515 00:18:27,400 --> 00:18:29,560 PATH TO GO TO ANIMAL MODELS. 516 00:18:29,560 --> 00:18:31,480 YOU HAVE TO WORK HARDER TO 517 00:18:31,480 --> 00:18:33,520 DEVELOP RIGOROUS METHOD OLE GEEZ 518 00:18:33,520 --> 00:18:35,600 APPLIED TO HUMAN STUDIES. 519 00:18:35,600 --> 00:18:39,280 AND HE THOUGHT CRITICALLY AND HE 520 00:18:39,280 --> 00:18:39,960 QUESTIONED EVERYTHING. 521 00:18:39,960 --> 00:18:41,720 SO ANOTHER LESSON FROM MY TIME 522 00:18:41,720 --> 00:18:43,480 AT NIH IS ASK IMPORTANT 523 00:18:43,480 --> 00:18:44,880 QUESTIONS AND FIND CO MENTORS 524 00:18:44,880 --> 00:18:46,880 AND TECHNOLOGY TO ANSWER THEM. 525 00:18:46,880 --> 00:18:49,040 AND THE QUESTION THAT I BECAME 526 00:18:49,040 --> 00:18:50,000 INTERESTED, AFTER ABOUT TWO AND 527 00:18:50,000 --> 00:18:57,720 A HALF YEARS, OF DOING CELL 528 00:18:57,720 --> 00:18:57,960 CULTURE. 529 00:18:57,960 --> 00:18:59,240 I WAS INTERESTED IN THE QUESTION 530 00:18:59,240 --> 00:19:04,120 IS THERE ENDOCRINE OF NO. 531 00:19:04,120 --> 00:19:06,480 WE KNEW WHEN YOU INHALED IT AS A 532 00:19:06,480 --> 00:19:08,280 THERAPY, THAT THERE WAS NO BLOOD 533 00:19:08,280 --> 00:19:08,880 PRESSURE EFFECT. 534 00:19:08,880 --> 00:19:10,920 THAT THE NO IS LARGELY 535 00:19:10,920 --> 00:19:12,680 INACTIVATED BY REACTION WITH 536 00:19:12,680 --> 00:19:13,520 BLOOD. 537 00:19:13,520 --> 00:19:15,280 HOWEVER, THERE WAS SOME DATA 538 00:19:15,280 --> 00:19:16,320 SUGGESTED THAT THERE WAS A 539 00:19:16,320 --> 00:19:18,000 SUBTLE PERIPHERAL DELIVERY OF 540 00:19:18,000 --> 00:19:18,680 NO. 541 00:19:18,680 --> 00:19:21,360 THE BEST DATA CAME FROM WORK BY 542 00:19:21,360 --> 00:19:23,360 PAUL CUBES IN PUBLISHED IN THE 543 00:19:23,360 --> 00:19:24,640 JCI WHERE HE LOOKED AT CATS. 544 00:19:24,640 --> 00:19:27,480 HE INFUSIONED INTO THE CAT 545 00:19:27,480 --> 00:19:32,200 INTESTINE AN NO INHIBITOR L-NAME 546 00:19:32,200 --> 00:19:33,880 AND THERE'S A DROP IF BLOOD 547 00:19:33,880 --> 00:19:34,120 FLOW. 548 00:19:34,120 --> 00:19:36,840 THIS IS A DECREASE IN DIAMETER 549 00:19:36,840 --> 00:19:39,400 AND IF HE WAS LIVING INHALED NO 550 00:19:39,400 --> 00:19:40,400 AT THE SAME TIME IT WAS 551 00:19:40,400 --> 00:19:43,160 ABROGATED AND SOMETHING WAS 552 00:19:43,160 --> 00:19:44,240 CARRIED IN BLOOD TO TRANSDUCE 553 00:19:44,240 --> 00:19:44,840 THAT NO SIGNAL. 554 00:19:44,840 --> 00:19:46,160 IT COULDN'T BE NO BECAUSE THE 555 00:19:46,160 --> 00:19:47,800 HALF LIFE OF NO IS TOO SHORT FOR 556 00:19:47,800 --> 00:19:51,440 EVEN AN ARTERY-TO-VEIN TRANSIT 557 00:19:51,440 --> 00:19:51,720 TIME. 558 00:19:51,720 --> 00:19:53,040 TO ANSWER THESE QUESTIONS, I HAD 559 00:19:53,040 --> 00:19:55,560 TO LEARN TO EMBRACE FUNDAMENTAL 560 00:19:55,560 --> 00:19:58,880 BASIC SCIENCE AND COMPLIMENT 561 00:19:58,880 --> 00:20:00,080 TRANSLATIONAL TOOLS SO I ARGUE 562 00:20:00,080 --> 00:20:02,440 WE HAVE TO REALLY PUT THAT 563 00:20:02,440 --> 00:20:03,720 INVESTMENT IN LEARNING THESE 564 00:20:03,720 --> 00:20:04,080 TECHNOLOGIES. 565 00:20:04,080 --> 00:20:07,360 WHETHER IT'S CHEMISTRY, 566 00:20:07,360 --> 00:20:08,920 MOLECULAR BIOLOGY AND BEDSIDE 567 00:20:08,920 --> 00:20:10,200 TOOLS ON THE RIGHT. 568 00:20:10,200 --> 00:20:15,440 I REALLY FOCUSED ON CHEMISTRY 569 00:20:15,440 --> 00:20:18,600 MASS SPECK, IMAGING, WRITE BY 570 00:20:18,600 --> 00:20:20,400 TAKING ON ANOTHER MENTOR, 571 00:20:20,400 --> 00:20:21,560 RICHARD CANNON, BLOOD FLOW. 572 00:20:21,560 --> 00:20:24,440 I ALSO DID SOME WORK WITH MRI 573 00:20:24,440 --> 00:20:32,520 DEPEDEPENDENT FLOOD PLOW, IMAGIG 574 00:20:32,520 --> 00:20:34,960 BLOOD FLOW BUT THE MAIN WAS 575 00:20:34,960 --> 00:20:36,560 BLOOD FLOW W Dr. CANNON, HE 576 00:20:36,560 --> 00:20:39,200 TAUGHT ME HOW TO ONE THESE VERY 577 00:20:39,200 --> 00:20:42,320 FOCUSED, 18-PATIENT TRIALS. 578 00:20:42,320 --> 00:20:43,520 WE PUT CATHETERS IN THE ARTERY 579 00:20:43,520 --> 00:20:46,360 AND INFUSED A INHIBITOR AND THEN 580 00:20:46,360 --> 00:20:47,760 WE REPEAT THAT WITH INHALED NO 581 00:20:47,760 --> 00:20:49,600 TO LOOK AT THAT CUBES EXPERIMENT 582 00:20:49,600 --> 00:20:51,000 IN HUMANS AND IF YOU FOCUS IN 583 00:20:51,000 --> 00:20:52,760 THE LOWER-LEFT, WE ESSENTIALLY 584 00:20:52,760 --> 00:20:55,000 SAW THE SAME THING IN HUMANS. 585 00:20:55,000 --> 00:20:56,760 THAT WHILE BREATHING ROOM AIR, 586 00:20:56,760 --> 00:21:01,560 IF WE BLOCK NO SYNTHESIS WITH 587 00:21:01,560 --> 00:21:03,680 L-NMMA OUR BLOOD DEGREE DROPS 588 00:21:03,680 --> 00:21:04,360 25%. 589 00:21:04,360 --> 00:21:07,440 IT'S CONTROLLED BY NO PRODUCTION 590 00:21:07,440 --> 00:21:08,320 FROM NAS. 591 00:21:08,320 --> 00:21:10,800 WHEN YOU BREATHED NO IT WAS 592 00:21:10,800 --> 00:21:14,160 ABROGATED AND THIS WAS ALSO SEEN 593 00:21:14,160 --> 00:21:15,280 WITH EXERCISE. 594 00:21:15,280 --> 00:21:17,160 SO SOMETHING WAS BEING CARRIED 595 00:21:17,160 --> 00:21:17,680 IN BLOOD. 596 00:21:17,680 --> 00:21:19,680 AT THAT POINT I REALLY DOUBLED 597 00:21:19,680 --> 00:21:20,920 DOWN ON CHEMISTRY. 598 00:21:20,920 --> 00:21:23,720 I WAS ABLE TO TAKE SOME NO 599 00:21:23,720 --> 00:21:25,440 DETECTION EQUIPMENT THAT WAS 600 00:21:25,440 --> 00:21:26,640 AVAILABLE IN THE DEPARTMENT AND 601 00:21:26,640 --> 00:21:28,560 BEGAN PARTNERING WITH CHEMISTS, 602 00:21:28,560 --> 00:21:30,800 STUDYING PAPERS, TRYING TO 603 00:21:30,800 --> 00:21:33,480 MEASURE NO MODIFIED SPECIES IN 604 00:21:33,480 --> 00:21:36,040 BLOOD AND DEVELOPED ASSAY FOR 605 00:21:36,040 --> 00:21:39,080 SNOWMOBILE HEMOGLOBIN AND I 606 00:21:39,080 --> 00:21:39,680 MEASURED NIEHS TRIED AS 607 00:21:39,680 --> 00:21:40,320 BOOKKEEPING BECAUSE EVERYONE AT 608 00:21:40,320 --> 00:21:42,680 THE TIME KNEW THAT IT WAS INERT 609 00:21:42,680 --> 00:21:46,080 AND TO OUR SURPRISE, DURING 610 00:21:46,080 --> 00:21:48,600 EXERCISE, DURING L-MNA INFLATION 611 00:21:48,600 --> 00:21:52,880 THERE'S A CONSUMPTION FROM 612 00:21:52,880 --> 00:21:53,240 ARTERY-TO-VEIN. 613 00:21:53,240 --> 00:21:55,480 AS IT IT WEPT FROM THE ARTERY TO 614 00:21:55,480 --> 00:21:56,840 THE VEIN THE LEVEL DROPPED MUCH 615 00:21:56,840 --> 00:21:58,680 LIKE OXYGEN DROPS. 616 00:21:58,680 --> 00:22:00,640 OXY HEMOGLOBIN CONCENTRATION 617 00:22:00,640 --> 00:22:03,400 RESPONSE IF YOU MULTIPLY THAT 618 00:22:03,400 --> 00:22:04,680 GRADIENT TIMES BLOOD FLOW IT'S 619 00:22:04,680 --> 00:22:06,560 THE CALCULATION OF CONSUMPTION 620 00:22:06,560 --> 00:22:08,320 THERE WAS ALWAYS CONSUMPTION OF 621 00:22:08,320 --> 00:22:09,920 NITRATE AND IT WENT UP WITH 622 00:22:09,920 --> 00:22:11,280 EXERCISE SO WE BEGAN TO ASK THE 623 00:22:11,280 --> 00:22:12,440 QUESTIONS AND THIS WAS A PAPER 624 00:22:12,440 --> 00:22:16,000 THAT I PUBLISHED, THAT WAS VERY 625 00:22:16,000 --> 00:22:19,880 CONTROVERSIAL. 626 00:22:19,880 --> 00:22:20,720 COULD NITRATE REGULAR BLOOD FLOW 627 00:22:20,720 --> 00:22:22,520 AND EVENTUALLY WE DID ANOTHER 628 00:22:22,520 --> 00:22:24,520 TRANSLATIONAL STUDY AND WE GOT 629 00:22:24,520 --> 00:22:26,040 NITRATE FROM THE ANECDOTES KIT 630 00:22:26,040 --> 00:22:27,480 AND RIGHT THERE IN THE CLINICAL 631 00:22:27,480 --> 00:22:32,160 CENTER, WE INFUSED NITRATE AND 632 00:22:32,160 --> 00:22:34,280 EVEN AT NEAR PHYSIOLOGICAL 633 00:22:34,280 --> 00:22:36,560 CONCENTRATIONS, WE SAW VASE 634 00:22:36,560 --> 00:22:38,440 ODILEATION IN 10/10 VOLUNTEERS, 635 00:22:38,440 --> 00:22:42,040 WE SAW DILATION AT REST DURING 636 00:22:42,040 --> 00:22:43,240 INHIBITION AND DILATION WITH 637 00:22:43,240 --> 00:22:44,000 EXERCISE. 638 00:22:44,000 --> 00:22:46,400 AND THIS OCCURRED AT THE NEAR 639 00:22:46,400 --> 00:22:54,160 PHYSIOLOGICAL LEVELS OF NIEHS 640 00:22:54,160 --> 00:23:00,640 TRITE. 641 00:23:00,640 --> 00:23:02,520 ONE DAY I ASKED HER TO PLOT THE 642 00:23:02,520 --> 00:23:03,720 AMOUNT OF NO THAT WAS FORMING 643 00:23:03,720 --> 00:23:05,680 FROM ARTERY TO VEIN IN OUR 644 00:23:05,680 --> 00:23:08,160 PATIENTS VERSUS THE OXY 645 00:23:08,160 --> 00:23:09,800 HEMOGLOBIN CONCENTRATION AND SHE 646 00:23:09,800 --> 00:23:15,240 SAW THIS RELATIONSHIP THAT FROM 647 00:23:15,240 --> 00:23:16,160 ARTERY TO VEIN THERE WAS A 648 00:23:16,160 --> 00:23:19,360 FORMATION TO THE HEMOGLOBIN THAT 649 00:23:19,360 --> 00:23:20,800 APPEARED TO BE CORRELATED WITH 650 00:23:20,800 --> 00:23:22,320 DROPPING OXYGEN SATURATION AND 651 00:23:22,320 --> 00:23:23,640 SO THERE WAS A RELATIONSHIP 652 00:23:23,640 --> 00:23:27,240 BETWEEN LOW OXYGEN SATURATION OF 653 00:23:27,240 --> 00:23:29,640 HEMOGLOBIN AND IN THE VEIN AND 654 00:23:29,640 --> 00:23:32,680 THE CONVERSION OF NITRITE TO NO 655 00:23:32,680 --> 00:23:35,160 BOUND TO THE HEMOGLOBIN AND THAT 656 00:23:35,160 --> 00:23:39,080 BROUGHT US TO OLD PUBLISHED DATA 657 00:23:39,080 --> 00:23:40,520 FROM BROOKS AND DOYLE AS FAR AS 658 00:23:40,520 --> 00:23:42,200 1936 THAT THIS WAS THIS 659 00:23:42,200 --> 00:23:43,240 WELL-KNOWN SECOND ORDER 660 00:23:43,240 --> 00:23:43,760 REACTION. 661 00:23:43,760 --> 00:23:46,000 WELL ACTUALLY IT REALLY WAS 662 00:23:46,000 --> 00:23:48,760 FORGOTTEN IN SCIENCE, BUT 663 00:23:48,760 --> 00:23:51,480 NITRITE PLUS DESOXY HEMOGLOBIN 664 00:23:51,480 --> 00:23:52,680 THERE'S AN ELECTRIC TRANSFER SO 665 00:23:52,680 --> 00:23:54,400 YOU HAVE MET HEMOGLOBIN AND YOU 666 00:23:54,400 --> 00:23:55,000 MAKE NO. 667 00:23:55,000 --> 00:23:58,680 THAT NO COULD BE POUND TO 668 00:23:58,680 --> 00:23:59,840 ANOTHER DEOXY HEMOGLOBIN TO MAKE 669 00:23:59,840 --> 00:24:02,120 THE NO HEMOGLOBIN WE THOUGHT WE 670 00:24:02,120 --> 00:24:04,800 MIGHT DETECT AS A SO SIM TER OF 671 00:24:04,800 --> 00:24:07,320 THIS REACTION OCCURRING FROM 672 00:24:07,320 --> 00:24:07,960 ARTERY TO BRAIN. 673 00:24:07,960 --> 00:24:09,600 I WAS STRUCK BY THE PHYSICAL 674 00:24:09,600 --> 00:24:11,480 LOGIC SIGNIFICANCE OF THIS 675 00:24:11,480 --> 00:24:13,040 REACTION BECAUSE IT REQUIRES 676 00:24:13,040 --> 00:24:14,760 DEOXYGENATION OF HEMOGLOBIN SO 677 00:24:14,760 --> 00:24:17,600 IT CAN BE REGULATED AND IT WAS 678 00:24:17,600 --> 00:24:18,320 HYPOXIC SENSITIVE AND IT 679 00:24:18,320 --> 00:24:20,360 REQUIRED A PROTEIN SO IT HAD 680 00:24:20,360 --> 00:24:22,120 METABOLIC SENSING AND IT MADE NO 681 00:24:22,120 --> 00:24:25,080 WHICH IS A DILATER SO COULD THIS 682 00:24:25,080 --> 00:24:27,560 BE DRIVING HYPOXIC BASE' 683 00:24:27,560 --> 00:24:29,000 DILATION AND WITHOUT GOING INTO 684 00:24:29,000 --> 00:24:29,840 DETAIL THE CHEM TREE WAS A 685 00:24:29,840 --> 00:24:32,000 LITTLE MORE COMPLICATED IN THAT 686 00:24:32,000 --> 00:24:35,080 IT IS A SECOND ORDER REACTION 687 00:24:35,080 --> 00:24:36,960 BULL IT'S REGULATED SO THE 688 00:24:36,960 --> 00:24:38,520 REACTIVITY OF NITRITE IS HIGHEST 689 00:24:38,520 --> 00:24:42,960 WITH THE A STATE SO THE INTENSE 690 00:24:42,960 --> 00:24:45,240 DROPS AS HEMOGLOBIN GOES FROM R 691 00:24:45,240 --> 00:24:48,520 TO T BUT THE AVAILABLE HEMES 692 00:24:48,520 --> 00:24:51,360 INCREASES AS YOU DEGOX AGAIN 693 00:24:51,360 --> 00:24:52,600 EIGHT THE HEMES SO YOU GET A 694 00:24:52,600 --> 00:24:54,240 RATE OF INOWE PRODUCTION AROUND 695 00:24:54,240 --> 00:24:57,760 THE P50 AND IDEAL SITE FOR 696 00:24:57,760 --> 00:25:03,480 SENSING AND HYPOXIC BASE OWE 697 00:25:03,480 --> 00:25:05,920 DILATION. 698 00:25:05,920 --> 00:25:08,920 SO ANOTHER LESSON LEARNED WAS 699 00:25:08,920 --> 00:25:09,880 COLLABORATIVE PEER NETWORKS AND 700 00:25:09,880 --> 00:25:12,560 WHILE I HAD INCREDIBLE MENTORS I 701 00:25:12,560 --> 00:25:13,760 ACCUMULATED PARTNERS IN THE 702 00:25:13,760 --> 00:25:14,160 CHEMISTRY WORLD. 703 00:25:14,160 --> 00:25:16,960 I WAS SORT OF THE COUNTRY LUNG 704 00:25:16,960 --> 00:25:19,320 DOCTOR AND I IDEA PERSON BUT I 705 00:25:19,320 --> 00:25:21,680 HAD INCREDIBLE CHEMISTRY. 706 00:25:21,680 --> 00:25:23,960 DANNY KIM SHAPIRO IS THE CHAIR 707 00:25:23,960 --> 00:25:27,360 OF BIOPHYSICS AT WAKE FOREST 708 00:25:27,360 --> 00:25:30,160 TODAY AND RAKE IS SS PA SELL, 709 00:25:30,160 --> 00:25:32,160 NEIL HOG, CLAUDE WHY MORRIS, 710 00:25:32,160 --> 00:25:34,080 DAVID WINK, KATRINA MIRANDA AND 711 00:25:34,080 --> 00:25:35,640 THESE PEOPLE TAUGHT ME CHEMISTRY 712 00:25:35,640 --> 00:25:39,920 AND WERE GREAT PARTNERS IN THESE 713 00:25:39,920 --> 00:25:40,400 DISCOVERIES. 714 00:25:40,400 --> 00:25:42,720 THE LAST LESSON FROM MY 715 00:25:42,720 --> 00:25:43,920 INTRAMURAL EXPERIENCE IS I THINK 716 00:25:43,920 --> 00:25:45,360 IT'S IMPORTANT TO INVEST TIME 717 00:25:45,360 --> 00:25:47,240 AND RESOURCES IN RARE PATIENT 718 00:25:47,240 --> 00:25:48,640 COHORTS AND UNMET NEED. 719 00:25:48,640 --> 00:25:49,920 THAT'S ONE ONE OF THE GREATEST 720 00:25:49,920 --> 00:25:53,200 OF THE NIH IF YOU THINK OF LAMB 721 00:25:53,200 --> 00:25:54,240 COHORTS, MEL A THEM A COHORTS 722 00:25:54,240 --> 00:25:56,240 AND SOMETHING THAT PROBABLY 723 00:25:56,240 --> 00:25:57,800 REQUIRES MORE INVESTMENTS. 724 00:25:57,800 --> 00:25:59,680 AND I BECAME VERY INTERESTED AS 725 00:25:59,680 --> 00:26:03,120 A SIDE PROJECT AGAIN, IN SICKLE 726 00:26:03,120 --> 00:26:07,080 CELL DISEASE AND HENRY PUSHED ME 727 00:26:07,080 --> 00:26:08,760 TO RUN THIS SIDE PROJECT AND 728 00:26:08,760 --> 00:26:11,000 INTRODUCED ME TO GRIF ROGERS AND 729 00:26:11,000 --> 00:26:14,760 ALAN AND WE DID A SMALL STUDY OF 730 00:26:14,760 --> 00:26:15,880 SCREENING. 731 00:26:15,880 --> 00:26:17,480 195 PEOPLE IN THE WASHINGTON 732 00:26:17,480 --> 00:26:19,880 BALTIMORE REGION WITH TRANS 733 00:26:19,880 --> 00:26:21,840 THORACIC ECHO CARDIO GRAM AND WE 734 00:26:21,840 --> 00:26:23,400 COVERED THAT PULMONARY 735 00:26:23,400 --> 00:26:24,360 HYPERTENSION IS ESTIMATED BY 736 00:26:24,360 --> 00:26:26,280 ECHO WAS A MAJOR RISK FACTOR FOR 737 00:26:26,280 --> 00:26:28,280 DEATH AND OUR PATIENTS WITH 738 00:26:28,280 --> 00:26:29,400 SICKLE CELL DISEASE AND COUNT 739 00:26:29,400 --> 00:26:31,600 LESS STUDIES WERE PUBLISHED FROM 740 00:26:31,600 --> 00:26:33,520 THIS COHORT BUT THIS IS ONE OF 741 00:26:33,520 --> 00:26:34,640 OUR STUDIES JUST SHOWING THAT 742 00:26:34,640 --> 00:26:37,000 THIS IMPACT OF HAVING PULMONARY 743 00:26:37,000 --> 00:26:37,840 HYPERTENSION ON THE PROBABLE A 744 00:26:37,840 --> 00:26:39,800 LOT OF SURVIVAL OVER EIGHT 745 00:26:39,800 --> 00:26:40,080 YEARS. 746 00:26:40,080 --> 00:26:41,960 YOU KNOW, ONLY 40% OF PATIENTS 747 00:26:41,960 --> 00:26:44,120 WITH PULMONARY HYPERTENSION 748 00:26:44,120 --> 00:26:46,720 SURVIVING THAT LONG AND THE 749 00:26:46,720 --> 00:26:48,680 PROBABILITY OF SURVIVING TO AGE 750 00:26:48,680 --> 00:26:52,360 60, ONLY 40% OF OUR ADULTS 751 00:26:52,360 --> 00:26:54,960 SURVIVAL TO AGE 60 AND 80%. 752 00:26:54,960 --> 00:26:57,320 THE RISK RATIO FOR DEATH 753 00:26:57,320 --> 00:26:58,800 ASSOCIATED WITH AND ECHO 754 00:26:58,800 --> 00:27:00,080 ESTIMATE OF PULMONARY 755 00:27:00,080 --> 00:27:00,800 HYPERTENSION IS 10. 756 00:27:00,800 --> 00:27:02,200 ONE OF THE HIGHEST RISK FACTORS 757 00:27:02,200 --> 00:27:03,880 FOR DEATH IN PATIENTS WITH 758 00:27:03,880 --> 00:27:04,960 SICKLE CELL DISEASE. 759 00:27:04,960 --> 00:27:07,120 WE ALSO FOUND IN THESE CLINICAL 760 00:27:07,120 --> 00:27:11,640 STUDIES, THAT HEMA LIDIC ANEMIA 761 00:27:11,640 --> 00:27:14,600 LEAD TO A CONSTELLATION OF 762 00:27:14,600 --> 00:27:15,800 SYMPTOMS AS PATIENTS GOT OLDER. 763 00:27:15,800 --> 00:27:17,680 THIS IS ANEN DOUGH OR SUB 764 00:27:17,680 --> 00:27:21,240 PHENOTYPE OF SICKLE CELL. 765 00:27:21,240 --> 00:27:25,760 CHRONIC KIDNEY DISEASE, LEG 766 00:27:25,760 --> 00:27:27,880 ULCER, HAS THE DEATH. 767 00:27:27,880 --> 00:27:29,520 GRIFF ROGERS, WALKING IN THE 768 00:27:29,520 --> 00:27:32,600 HALLWAY ONE DAY, I WAS TELLING 769 00:27:32,600 --> 00:27:34,840 HIM ABOUT MY THEORY AND THE LINK 770 00:27:34,840 --> 00:27:36,480 TO PULMONARY HYPERTENSION AND HE 771 00:27:36,480 --> 00:27:39,080 SAID YOU KNOW, MARK, PATIENTS 772 00:27:39,080 --> 00:27:43,160 WITH SICKLE CELL AND GET LEG 773 00:27:43,160 --> 00:27:45,440 ULCERS ALSO YOU SEE IF LEG 774 00:27:45,440 --> 00:27:47,280 ULCERS IS ASSOCIATED WITH HEM 775 00:27:47,280 --> 00:27:48,080 OLE SIS AND IT IT RETURNS OUT 776 00:27:48,080 --> 00:27:52,200 THIS IS ONE OF THE MOST STRONGLY 777 00:27:52,200 --> 00:27:56,200 ASSOCIATED PHENOTYPES OF CHRONIC 778 00:27:56,200 --> 00:27:57,360 IS LEG ULCERS. 779 00:27:57,360 --> 00:28:00,160 THIS COHORT WORK IS CONTINUED TO 780 00:28:00,160 --> 00:28:00,840 DRIVE RESEARCH. 781 00:28:00,840 --> 00:28:04,760 THIS IS THE RECENT STUDY FROM 782 00:28:04,760 --> 00:28:07,080 THE NIH RESEARCH GROUP WHERE 783 00:28:07,080 --> 00:28:09,600 THEY LOOKED AT MACHINE LEARNING 784 00:28:09,600 --> 00:28:11,600 PREDICTORS OF RISK OF DEATH AND 785 00:28:11,600 --> 00:28:15,040 YOU CAN SEE THIS A VARIABLE 786 00:28:15,040 --> 00:28:16,080 IMPORTANCE FOR DEATH BUT YOU CAN 787 00:28:16,080 --> 00:28:19,880 SEE THE DOMINANCE OF THE PULL 788 00:28:19,880 --> 00:28:21,400 MINNAAR HE'S HYPERTENSION AND 789 00:28:21,400 --> 00:28:23,280 THE RIGHT SYSTEM I CAN PRESSURE 790 00:28:23,280 --> 00:28:26,520 AND ALSO MEASURES THE DNP WHICH 791 00:28:26,520 --> 00:28:29,240 PREDICTS HYPERTENSION, CHRONIC 792 00:28:29,240 --> 00:28:29,960 KIDNEY KISS SEIZE AND HEART 793 00:28:29,960 --> 00:28:32,160 DISEASE AND PARAMETERS BY ECHO 794 00:28:32,160 --> 00:28:35,120 AND MEASURES OF YOU CAN SEE THE 795 00:28:35,120 --> 00:28:36,880 SIDE COUNT HERE. 796 00:28:36,880 --> 00:28:37,800 AND THEY I AM PROVED, THIS IS 797 00:28:37,800 --> 00:28:39,440 THE ECHO PREDICTORS OF DEATH ON 798 00:28:39,440 --> 00:28:41,880 THE RIGHT AND THEY IMPROVED ON 799 00:28:41,880 --> 00:28:43,360 THAN THIS WITH THIS MACHINE 800 00:28:43,360 --> 00:28:46,280 LEANING RISK RISK SCORE. 801 00:28:46,280 --> 00:28:48,840 SO THIS NIH SICKLE CELL AND MULL 802 00:28:48,840 --> 00:28:50,920 MINNAAR' HYPERTENSION PROGRAM 803 00:28:50,920 --> 00:28:52,320 LEAD 250 DOWNSTREAM 804 00:28:52,320 --> 00:28:53,160 PUBLICATIONS, MULTIPLE LEADERS 805 00:28:53,160 --> 00:28:55,640 IN THE SICKLE CELL FIELDS 806 00:28:55,640 --> 00:28:56,960 CENTERS OF EXCELLENCE AROUND THE 807 00:28:56,960 --> 00:28:58,360 COUNTRY TRAINED AT THE NIH 808 00:28:58,360 --> 00:28:59,480 DURING THOSE YEARS AND ALMOST 809 00:28:59,480 --> 00:29:01,000 FIVE MAJOR CLINICAL TRIALS IN 810 00:29:01,000 --> 00:29:02,520 ONE OF THEM IS RUNNING NOW IT'S 811 00:29:02,520 --> 00:29:05,360 A VERY LARGE 22-CENTER STUDY 812 00:29:05,360 --> 00:29:06,720 SPONSORED BY THE NATIONAL HEART 813 00:29:06,720 --> 00:29:08,920 LUNG AND BLOOD INSTITUTE THAT'S 814 00:29:08,920 --> 00:29:11,040 LOOKING AT CHRONIC AGGRESSIVE 815 00:29:11,040 --> 00:29:13,600 EXCHANGE TRANSFUSION VERSUS 816 00:29:13,600 --> 00:29:14,200 STANDARD CARE. 817 00:29:14,200 --> 00:29:16,200 FOR PATIENTS AT THE HIGHEST RISK 818 00:29:16,200 --> 00:29:17,760 OF DEATH AND THE DEVELOPMENT OF 819 00:29:17,760 --> 00:29:23,240 EARLY CROP I CAN K CHRONIC KIDN. 820 00:29:23,240 --> 00:29:25,800 SO WHAT ARE THE LESSONS OF THE 821 00:29:25,800 --> 00:29:26,480 PRESENT? 822 00:29:26,480 --> 00:29:28,040 THAT WE LEARN FROM THE 823 00:29:28,040 --> 00:29:29,240 EXTRAMURAL WORLD AND HERE I'LL 824 00:29:29,240 --> 00:29:30,280 BE SHARING SOME INFORMATION THAT 825 00:29:30,280 --> 00:29:32,160 MAY NOT BE AS FAMILIAR TO YOU 826 00:29:32,160 --> 00:29:34,520 AND THAT IS HOW HAVE WE 827 00:29:34,520 --> 00:29:36,560 LEVERAGED STRATEGIES TO DEVELOP 828 00:29:36,560 --> 00:29:37,640 PHYSICIAN-SCIENTISTS AT THE 829 00:29:37,640 --> 00:29:38,960 UNIVERSITY OF PITTSBURGH. 830 00:29:38,960 --> 00:29:42,280 NOW, THE UNIVERSITY OF 831 00:29:42,280 --> 00:29:43,920 PITTSBURGH HAS BECOME AN ELITE 832 00:29:43,920 --> 00:29:44,560 INSTITUTION. 833 00:29:44,560 --> 00:29:45,480 THE DEPARTMENT OF MEDICINE 834 00:29:45,480 --> 00:29:47,800 THERE, THESE ARE THE DIVISIONS, 835 00:29:47,800 --> 00:29:49,280 WE'VE ALSO BUILT TWO MAJOR 836 00:29:49,280 --> 00:29:52,360 RESEARCH INSTITUTES, THE LED BY 837 00:29:52,360 --> 00:29:56,200 STEVEN CHAP AND THE AGING 838 00:29:56,200 --> 00:30:01,400 INSTITUTE LED BY -- I'M HAVING A 839 00:30:01,400 --> 00:30:02,240 PLANK I'LL COME BACK TO THAT. 840 00:30:02,240 --> 00:30:05,520 WE HAVE 750 FACULTY AND WE HAVE 841 00:30:05,520 --> 00:30:09,200 335 RESIDENTS AND FELLOWS, 842 00:30:09,200 --> 00:30:10,880 116ACG FELLOWS SO LARGE FACULTY 843 00:30:10,880 --> 00:30:12,640 AND WE'RE REALLY IN THE TOP 10 844 00:30:12,640 --> 00:30:15,280 SIZE FOR DEPARTMENTS OF MEDICINE 845 00:30:15,280 --> 00:30:16,960 AND ALSO VERY STRONG RESEARCH 846 00:30:16,960 --> 00:30:19,440 AND 64 RESEARCH CENTERS AS HENRY 847 00:30:19,440 --> 00:30:20,400 MENTIONED AND NUMBER EIGHT IN 848 00:30:20,400 --> 00:30:23,240 THE NATION BY BLUE RIDGE FOR NIH 849 00:30:23,240 --> 00:30:26,080 FUNDING AND THEN VERY, VERY BIG 850 00:30:26,080 --> 00:30:30,720 OUT PATIENT AND IN PATIENT 851 00:30:30,720 --> 00:30:33,680 WORLD. 852 00:30:33,680 --> 00:30:36,480 IN THE EXTRAMURAL WORLD WE FOCUS 853 00:30:36,480 --> 00:30:39,080 ON GRANT RESOURCES TO SUPPORT 854 00:30:39,080 --> 00:30:39,520 PHYSICIAN-SCIENTIST. 855 00:30:39,520 --> 00:30:42,120 THESE GRANTS ARE THE T TO F TO K 856 00:30:42,120 --> 00:30:42,600 TO R. 857 00:30:42,600 --> 00:30:46,960 SO THE T IS A TRIP IS TRAINING T 858 00:30:46,960 --> 00:30:48,000 PROTECTS TIME AFTER YOU ARE A 859 00:30:48,000 --> 00:30:49,560 FELLOW FOR RESEARCH, LIKE I DID 860 00:30:49,560 --> 00:30:53,960 AT THE INTRAMURAL PROGRAM OR FOR 861 00:30:53,960 --> 00:30:55,200 GRAD STUDENTS OR POSTDOC PH.D 862 00:30:55,200 --> 00:30:55,800 FELLOWS. 863 00:30:55,800 --> 00:30:57,000 IT PROTECTS TIME EARLY IN 864 00:30:57,000 --> 00:30:58,520 TRAINING AND F IS AN INDIVIDUAL 865 00:30:58,520 --> 00:31:00,440 AWARD SO T IS INSTITUTIONAL, YOU 866 00:31:00,440 --> 00:31:02,880 WRITE THESE, AS A DEPARTMENT OF 867 00:31:02,880 --> 00:31:03,920 CARDIOLOGY, FOR EXAMPLE, AND F 868 00:31:03,920 --> 00:31:06,120 WOULD BE AN INDIVIDUAL T. 869 00:31:06,120 --> 00:31:08,080 A K IS A CAREER DEVELOPMENT 870 00:31:08,080 --> 00:31:08,440 AWARD. 871 00:31:08,440 --> 00:31:09,680 YOU HAVE TO BE ASSIST APARTMENT 872 00:31:09,680 --> 00:31:11,480 PROFESSOR AND IT'S FIVE YEARS 873 00:31:11,480 --> 00:31:14,160 AND 100,000 A YEAR AND THESE ARE 874 00:31:14,160 --> 00:31:14,880 OFTEN PHYSICIAN-SCIENTISTS 875 00:31:14,880 --> 00:31:16,160 RESTRICTED ALTHOUGH SOME 876 00:31:16,160 --> 00:31:17,680 INSTITUTES ALLOW PH.D SCIENTISTS 877 00:31:17,680 --> 00:31:19,960 TO HAVE THESE AND THE R IS THAT 878 00:31:19,960 --> 00:31:22,880 INDIVIDUAL CAREER DEVELOPMENT 879 00:31:22,880 --> 00:31:23,240 AWARD. 880 00:31:23,240 --> 00:31:29,640 AND MY APOLOGY, I HAD A MINI 881 00:31:29,640 --> 00:31:30,960 TORN IF YOU ARE LISTENING I LOVE 882 00:31:30,960 --> 00:31:32,960 YOU AND FORGIVE ME. 883 00:31:32,960 --> 00:31:35,200 SO WE REALLY FOCUSED ON T32. 884 00:31:35,200 --> 00:31:38,040 BY THE TIME I LEFT, WE HAD 13 885 00:31:38,040 --> 00:31:39,480 FUNDED T32s ACROSS THE 886 00:31:39,480 --> 00:31:42,040 DEPARTMENT OF MEDICINE AND YOU 887 00:31:42,040 --> 00:31:43,800 CAN SEE ALL THE PIs HERE. 888 00:31:43,800 --> 00:31:46,640 WE WERE WORKING ON RENEWING THE 889 00:31:46,640 --> 00:31:48,200 GERIATRIC AGING ONE WHICH TORN 890 00:31:48,200 --> 00:31:50,440 IS IS THE P.I. ON AND THEN 891 00:31:50,440 --> 00:31:52,560 THERE'S OTHER TRAINING GRANTS 892 00:31:52,560 --> 00:31:54,560 THAT FOCUS ON DEVELOPING 893 00:31:54,560 --> 00:31:55,240 PHYSICIAN-SCIENTIST AND THEY 894 00:31:55,240 --> 00:31:57,040 HAVE MANY, MANY LETTERS BUT I'LL 895 00:31:57,040 --> 00:31:59,480 JUST HIGHLIGHT THE K12 AND THE 896 00:31:59,480 --> 00:32:00,400 KL2. 897 00:32:00,400 --> 00:32:01,920 THOSE ARE LIGHT Ks EARLY 898 00:32:01,920 --> 00:32:03,720 ASSIST APARTMENT PROFESSOR 899 00:32:03,720 --> 00:32:04,400 PHYSICIAN-SCIENTIST CAREER 900 00:32:04,400 --> 00:32:05,560 DEVELOPMENT AWARDS FOR FIVE 901 00:32:05,560 --> 00:32:06,760 YEARS AND THEY'RE INSTITUTIONAL 902 00:32:06,760 --> 00:32:09,680 MEANING THAT YOU CAN PEAK AT THE 903 00:32:09,680 --> 00:32:10,880 INSTITUTIONAL LEVEL FOR THOSE. 904 00:32:10,880 --> 00:32:12,520 THERE'S AN INTERESTING ONE, A 905 00:32:12,520 --> 00:32:13,120 K24. 906 00:32:13,120 --> 00:32:15,040 A K24 ACTUALLY FUNDS A MENTOR 907 00:32:15,040 --> 00:32:17,400 FOR 50% TIME TO MENTOR. 908 00:32:17,400 --> 00:32:19,760 THOSE ARE VERY NICE GRANTS. 909 00:32:19,760 --> 00:32:22,120 AND THERE'S A NEW R38 PROGRAM 910 00:32:22,120 --> 00:32:23,920 WHICH ACTUALLY FUNDS LATE 911 00:32:23,920 --> 00:32:25,680 PLOOMERS AND RESIDENCY SO A YEAR 912 00:32:25,680 --> 00:32:28,080 OFF DURING RESIDENCIES AND IF 913 00:32:28,080 --> 00:32:30,880 YOU WEREN'T AN MD-PH.D TO ENGAGE 914 00:32:30,880 --> 00:32:33,240 IN RESEARCH. 915 00:32:33,240 --> 00:32:34,640 AND THIS INVESTMENT PAID OFF. 916 00:32:34,640 --> 00:32:37,040 SO BY THE TIME I LEFT, WE 917 00:32:37,040 --> 00:32:40,080 ACTUALLY HAD 40K AWARDEES, THESE 918 00:32:40,080 --> 00:32:41,400 ARE PHYSICIAN-SCIENTISTS WITH 919 00:32:41,400 --> 00:32:42,720 EARLY CAREER DEVELOPMENT AWARDS. 920 00:32:42,720 --> 00:32:43,920 THIS IS AMONG UP WITH OF THE TOP 921 00:32:43,920 --> 00:32:45,600 IN THE NATION. 922 00:32:45,600 --> 00:32:47,440 WE HAD 55 TOTAL CAREER 923 00:32:47,440 --> 00:32:49,000 DEVELOPMENT AWARDS IF YOU COUNT 924 00:32:49,000 --> 00:32:50,680 VA CAREER DEVELOPMENT AWARDS, 925 00:32:50,680 --> 00:32:51,720 AMERICAN HEART CAREER 926 00:32:51,720 --> 00:32:54,240 DEVELOPMENT AWARDS AND OTHER 927 00:32:54,240 --> 00:32:57,160 ONES. 928 00:32:57,160 --> 00:32:59,400 AND WE HAD 266 TOTAL NIH AWARDS 929 00:32:59,400 --> 00:33:04,360 LEADING INTO 1,600 PUBLICATIONS 930 00:33:04,360 --> 00:33:05,280 AND AGAIN OUR RANKING SIX TO 931 00:33:05,280 --> 00:33:07,760 EIGHT IN BLUE RIDGE. 932 00:33:07,760 --> 00:33:13,640 NOW THESE T32 A LINE AROUND 933 00:33:13,640 --> 00:33:15,240 INTEGRATION AND COLLABORATION 934 00:33:15,240 --> 00:33:19,800 AND IN NHLBI WE HAD A LUNG T32 935 00:33:19,800 --> 00:33:21,120 AND YOU SEE THE DISEASE FOCUS. 936 00:33:21,120 --> 00:33:25,160 WE HAD A HEART T32, A BLOOD T32 937 00:33:25,160 --> 00:33:27,680 AND A SLEEP T32 AND PEOPLE COULD 938 00:33:27,680 --> 00:33:30,400 PARTICIPATE ACROSS AND BREAKDOWN 939 00:33:30,400 --> 00:33:32,720 SILOS BETWEEN DEPARTMENTS 940 00:33:32,720 --> 00:33:33,800 DIVISIONS FOR EXAMPLE. 941 00:33:33,800 --> 00:33:37,480 AND THE FOCUS WAS ON 942 00:33:37,480 --> 00:33:38,400 MILESTONE-DRIVEN MENTORING. 943 00:33:38,400 --> 00:33:40,200 AND I THINK THIS IS ONE THING 944 00:33:40,200 --> 00:33:41,800 THE NIH COULD LEARN. 945 00:33:41,800 --> 00:33:43,800 WHEN I WAS A FELLOW, YOU KNOW, I 946 00:33:43,800 --> 00:33:45,120 JOKED THAT TO BE A BASIC SCIENCE 947 00:33:45,120 --> 00:33:46,520 RESEARCH WE PUT SOMEONE IN A 948 00:33:46,520 --> 00:33:48,040 BASIC SCIENCE LAB AND WE CLOSED 949 00:33:48,040 --> 00:33:49,320 THE DOOR, LOCK IT IT AND LET 950 00:33:49,320 --> 00:33:51,000 THEM OUT IN THREE YEARS TO BE A 951 00:33:51,000 --> 00:33:52,040 CLINICAL SCIENCE INVESTIGATOR, 952 00:33:52,040 --> 00:33:53,840 YOU GET A MASTERS IN 953 00:33:53,840 --> 00:33:54,320 PUBLIC-HEALTH. 954 00:33:54,320 --> 00:33:55,640 I THINK NOW WE HAVE TO 955 00:33:55,640 --> 00:33:56,360 APPRECIATE THAT THE PRESSURES 956 00:33:56,360 --> 00:33:57,880 AND THE TIME LINES FOR OUR 957 00:33:57,880 --> 00:33:59,920 TRAINEES ARE TIGHTER, SO WE HAVE 958 00:33:59,920 --> 00:34:02,080 TO HAVE MORE STRUCTURE. 959 00:34:02,080 --> 00:34:03,960 SO, FOR EXAMPLE, IN FIRST 960 00:34:03,960 --> 00:34:10,280 YEAR-AND-A-HALF OF THE PULMONARY 961 00:34:10,280 --> 00:34:12,320 SO WE CHOSE A MENTOR SO THEY'RE 962 00:34:12,320 --> 00:34:13,600 WORKING WITH A MENTOR BEFORE 963 00:34:13,600 --> 00:34:14,800 THEY HIT THEIR PROTECTED TIME 964 00:34:14,800 --> 00:34:16,400 AFTER A YEAR AND A HALF. 965 00:34:16,400 --> 00:34:19,480 THEY DO A TWO-WEEK FUND MENTAL 966 00:34:19,480 --> 00:34:19,920 OF RESEARCH COURSE. 967 00:34:19,920 --> 00:34:21,960 THIS IS TEACHING THEM A HALF A 968 00:34:21,960 --> 00:34:23,760 DAY OF LAB-BASED FUNDAMENTALS 969 00:34:23,760 --> 00:34:26,040 AND HALF A DAY OF DIDACTIC. 970 00:34:26,040 --> 00:34:29,600 YOU KNOW, WHAT RNCA SEEK IS ASK 971 00:34:29,600 --> 00:34:33,520 EX PCR AND BIO STATS, AND THEN 972 00:34:33,520 --> 00:34:40,760 THEY SATURDAY A SIX-MONT S STARA 973 00:34:40,760 --> 00:34:41,360 LITTLE BIT. 974 00:34:41,360 --> 00:34:42,760 WE TRY TO GET THEM TO PRESENT 975 00:34:42,760 --> 00:34:43,960 THEIR FIRST RESEARCH 976 00:34:43,960 --> 00:34:45,600 PRESENTATION, EVEN THOUGH THEY 977 00:34:45,600 --> 00:34:46,800 HAVEN'T DONE A LOT OF RESEARCH 978 00:34:46,800 --> 00:34:48,680 AND GO TO A NATIONAL MEETING 979 00:34:48,680 --> 00:34:49,240 WITH AN ABSTRACT. 980 00:34:49,240 --> 00:34:50,320 THERE'S NOTHING MORE EXCITE TO 981 00:34:50,320 --> 00:34:52,680 GO GO TO A NATIONAL MEETING AND 982 00:34:52,680 --> 00:34:54,120 REALIZE THERE'S A BIG BEAUTIFUL 983 00:34:54,120 --> 00:34:55,200 WORLD OF SCIENCE OUT THERE. 984 00:34:55,200 --> 00:34:57,160 THEY START FULL-TIME RESEARCH, 985 00:34:57,160 --> 00:34:58,560 ALTHOUGH THEY HAVE A CLINIC THEY 986 00:34:58,560 --> 00:35:00,080 CAN GET ADVANCE TRAINING, IF 987 00:35:00,080 --> 00:35:07,360 THEY WANT AND WE START A GRANT 988 00:35:07,360 --> 00:35:08,120 WRITING. 989 00:35:08,120 --> 00:35:09,720 EVERYBODY IN OUR FELLOWSHIPS 990 00:35:09,720 --> 00:35:13,320 DOES A T32 TRAINING GRANTOR AN 991 00:35:13,320 --> 00:35:13,680 F32, EXCUSE ME. 992 00:35:13,680 --> 00:35:15,760 SO THEY'RE ON THE T32 BUT THEY 993 00:35:15,760 --> 00:35:16,920 SUBMIT AN F32. 994 00:35:16,920 --> 00:35:18,280 ONE IS THAT CREATES MORE SLOTS 995 00:35:18,280 --> 00:35:19,960 FOR US IN THE T32 FOR OTHER 996 00:35:19,960 --> 00:35:22,240 PEOPLE AND THEY LEARN TO WRITE A 997 00:35:22,240 --> 00:35:23,000 SIX-PAGE GRANT. 998 00:35:23,000 --> 00:35:25,000 AND WE MAKE IT ACCESSIBLE AND 999 00:35:25,000 --> 00:35:26,560 NOT SCARY AND FOR TWO MONTHS 1000 00:35:26,560 --> 00:35:28,200 THEY JUST WORK ON THEIR AIMS 1001 00:35:28,200 --> 00:35:28,600 PAGE. 1002 00:35:28,600 --> 00:35:29,840 FOR ANOTHER MONTH THEY WORK ON 1003 00:35:29,840 --> 00:35:31,320 THEIR BACKGROUND AND 1004 00:35:31,320 --> 00:35:34,600 SIGNIFICANCE FOR ANOTHER MONTH 1005 00:35:34,600 --> 00:35:36,240 IT'S THE RESEARCH PLAN AND THE 1006 00:35:36,240 --> 00:35:37,440 CAREER DEVELOPMENT SUPPLEMENTS 1007 00:35:37,440 --> 00:35:39,720 AND THEY HAVE IT AT NIGHT OVER 1008 00:35:39,720 --> 00:35:40,520 PIZZA AND WE HAVE PEOPLE THAT 1009 00:35:40,520 --> 00:35:43,520 ARE ON STUDY SECTIONS MENTORING 1010 00:35:43,520 --> 00:35:45,520 THEM SO THEY LEARN T ANTI-SEMITC 1011 00:35:45,520 --> 00:35:50,880 LEARN TO WRITE ANDREVIEW THESE . 1012 00:35:50,880 --> 00:35:52,640 YOU CAN SEE THERE'S MILESTONES 1013 00:35:52,640 --> 00:35:54,080 HIGHLIGHTED AND I TOUCHED ON 1014 00:35:54,080 --> 00:35:55,760 MANY OF THESE MILESTONES. 1015 00:35:55,760 --> 00:35:58,000 WE ALSO HAD SOME VERY UNIQUE 1016 00:35:58,000 --> 00:36:00,080 THINGS LIKE FDA ROTATIONS AND 1017 00:36:00,080 --> 00:36:02,720 NIH ROTATIONS, INDUSTRY RND FOR 1018 00:36:02,720 --> 00:36:05,200 PEOPLE THAT ARE IN AN 1019 00:36:05,200 --> 00:36:06,720 ENTREPRENEUR DRUG DEVELOPMENT 1020 00:36:06,720 --> 00:36:08,360 PATHWAY AND WE LOOKED FOR EARLY 1021 00:36:08,360 --> 00:36:09,600 PUBLICATION IN ABSTRACTS AND 1022 00:36:09,600 --> 00:36:14,520 AGAIN THIS F32 APPLICATION BEING 1023 00:36:14,520 --> 00:36:15,640 REQUIRED. 1024 00:36:15,640 --> 00:36:16,920 THE OTHER IMPORTANCE IS 1025 00:36:16,920 --> 00:36:19,040 DEVELOPING NETWORKS SO THERE'S A 1026 00:36:19,040 --> 00:36:20,560 NURTURING SUPPORTIVE ENVIRONMENT 1027 00:36:20,560 --> 00:36:22,520 OF LIKE MINDED PEERS THAT YOU 1028 00:36:22,520 --> 00:36:26,200 ARE NOT THAT MINORITY PERSON IN 1029 00:36:26,200 --> 00:36:30,160 A MAJORITY CLINICAL ENTERPRISE 1030 00:36:30,160 --> 00:36:32,600 AND WE CALLED THE K AWARDEE TO 1031 00:36:32,600 --> 00:36:35,280 OUR ADVANCEMENT TRAINING 1032 00:36:35,280 --> 00:36:35,640 PROGRAM. 1033 00:36:35,640 --> 00:36:38,840 AND AGAIN THIS WAS A NETWORK. 1034 00:36:38,840 --> 00:36:41,000 I THINK THIS HAD 54 PEOPLE WHEN 1035 00:36:41,000 --> 00:36:42,160 I LEFT. 1036 00:36:42,160 --> 00:36:44,480 WE INVESTED A PROGRAM AND 1037 00:36:44,480 --> 00:36:46,120 1,500,000 A YEAR OF HARD MONEY 1038 00:36:46,120 --> 00:36:49,320 THAT PEOPLE COULD APPLY FOR A 1039 00:36:49,320 --> 00:36:50,800 GRANT AND THE GRANT WAS FOR 1040 00:36:50,800 --> 00:36:52,760 SOMETHING THAT WOULD BE 1041 00:36:52,760 --> 00:36:54,520 INDEPENDENT OF THEIR PI GIVING 1042 00:36:54,520 --> 00:36:56,320 THEM SOME ADVANTAGE FOR THEIR 1043 00:36:56,320 --> 00:36:57,640 NOT R SUBMISSION. 1044 00:36:57,640 --> 00:37:00,600 IT MIGHT HELP THEM MAKE A NEW 1045 00:37:00,600 --> 00:37:03,200 CRISPR 9 MOUSE OR HELPING A 1046 00:37:03,200 --> 00:37:04,480 TECHNICIAN TO DO MORE WORK OR 1047 00:37:04,480 --> 00:37:06,840 HALF A COORDINATOR TO GET 1048 00:37:06,840 --> 00:37:07,800 TRANSLATIONAL THINGS GOING. 1049 00:37:07,800 --> 00:37:09,440 AND THEY HAD REGULAR MEETINGS 1050 00:37:09,440 --> 00:37:12,000 TOGETHER AND VISITING SPEAKERS, 1051 00:37:12,000 --> 00:37:13,600 MOCK STUDY SECTIONS AND AGAIN A 1052 00:37:13,600 --> 00:37:17,560 COMMUNITY OF NETWORK OF LIKE 1053 00:37:17,560 --> 00:37:23,720 MINDED PEOPLE. 1054 00:37:23,720 --> 00:37:25,760 SO, WHAT ABOUT OUR FUTURE. 1055 00:37:25,760 --> 00:37:28,360 I'M SHARE OUR EXPERIENCES FROM A 1056 00:37:28,360 --> 00:37:29,520 COMPETITIVE BURROW WELCOME 1057 00:37:29,520 --> 00:37:30,960 FOUNDATION GRANT THAT Dr. 1058 00:37:30,960 --> 00:37:32,720 RICHARD STEIN MAN AND I WERE 1059 00:37:32,720 --> 00:37:36,200 AWARDED AND THIS WAS INNOVATIONS 1060 00:37:36,200 --> 00:37:38,400 AROUND TRAINING MD-ONLY 1061 00:37:38,400 --> 00:37:39,240 PHYSICIAN-SCIENTISTS AND IN THE 1062 00:37:39,240 --> 00:37:40,680 WORLD OF EXTRAMURAL RESEARCHERS 1063 00:37:40,680 --> 00:37:43,520 THERE'S BEEN A BIG PUSH TOWARDS 1064 00:37:43,520 --> 00:37:45,680 FOCUSING ON MD-PH.D SCIENTISTS 1065 00:37:45,680 --> 00:37:48,320 BUT WE CAN'T FORGET PEOPLE LIKE 1066 00:37:48,320 --> 00:37:49,640 ME, LATE BLOOMERS, AND I FIND 1067 00:37:49,640 --> 00:37:52,920 THAT THE MD-ONLY SCIENTISTS ARE 1068 00:37:52,920 --> 00:37:54,000 MORE PASSIONATE ABOUT RESEARCH 1069 00:37:54,000 --> 00:37:55,960 AND MORE COMMITTED BECAUSE THEIR 1070 00:37:55,960 --> 00:37:57,400 INTEREST IS OCCURRING MAYBE AT A 1071 00:37:57,400 --> 00:38:02,960 DIFFERENT STAGE IN LIFE. 1072 00:38:02,960 --> 00:38:05,560 IT WAS FOCUSED AROUND PILOT 1073 00:38:05,560 --> 00:38:05,920 INNOVATIONS. 1074 00:38:05,920 --> 00:38:07,080 WHAT IS INTERESTING ABOUT THIS 1075 00:38:07,080 --> 00:38:10,400 PROGRAM, WE WERE GOING TO TRAIN 1076 00:38:10,400 --> 00:38:11,360 RESIDENTS IN PROTECTED RESEARCH 1077 00:38:11,360 --> 00:38:13,600 TIME OR FELLOWS DURING THEIR 1078 00:38:13,600 --> 00:38:15,240 PROTECTED RESEARCH TIME FROM 1079 00:38:15,240 --> 00:38:15,840 SEVEN SPECIALITIES. 1080 00:38:15,840 --> 00:38:17,240 AND THERE WAS HIGH ENGAGEMENT 1081 00:38:17,240 --> 00:38:19,400 WITH THE SCIENTISTS -- I'M 1082 00:38:19,400 --> 00:38:21,720 SORRY, PHYSICIAN-SCIENTIST 1083 00:38:21,720 --> 00:38:23,960 SURGEONS. 1084 00:38:23,960 --> 00:38:24,520 NOW, PHYSICIAN-SCIENTIST 1085 00:38:24,520 --> 00:38:26,880 SURGEONS ARE THE MOST RARE BREED 1086 00:38:26,880 --> 00:38:28,320 AND IF YOU BECOME A 1087 00:38:28,320 --> 00:38:29,280 PHYSICIAN-SCIENTIST SURGEON I 1088 00:38:29,280 --> 00:38:31,440 THINK THE WORLD IS AT YOUR FEET. 1089 00:38:31,440 --> 00:38:34,360 I TRY TO ENCOURAGE PEOPLE IF YOU 1090 00:38:34,360 --> 00:38:35,960 WANT TO BE A LEADER AND THE BEST 1091 00:38:35,960 --> 00:38:38,880 PATH AND THERE'S A REAL UNMET 1092 00:38:38,880 --> 00:38:39,480 NEED HERE. 1093 00:38:39,480 --> 00:38:42,440 AS I'LL TELL YOU, WE LOOKED TO 1094 00:38:42,440 --> 00:38:44,000 IDENTIFY BARRIERS, PERCEIVED 1095 00:38:44,000 --> 00:38:45,320 BARRIERS TO SUCCESS COMING FROM 1096 00:38:45,320 --> 00:38:47,080 OUR YOUNG PEOPLE AND THEN WE 1097 00:38:47,080 --> 00:38:48,280 DEVELOPED INNOVATIVE PROGRAMMING 1098 00:38:48,280 --> 00:38:49,600 TO ADDRESS IT AND AS YOU ARE 1099 00:38:49,600 --> 00:38:51,520 GOING TO HEAR, THAN ENDED UP 1100 00:38:51,520 --> 00:38:53,480 BEING INSECURE TEASE ABOUT 1101 00:38:53,480 --> 00:38:55,120 FINDING MENTORS, WORK-LIFE 1102 00:38:55,120 --> 00:38:57,720 BALANCE, LAB SUPPORT DURING 1103 00:38:57,720 --> 00:39:01,640 CLINICAL ROTATIONS AND 1104 00:39:01,640 --> 00:39:02,240 RESILIENCE OR GRIT. 1105 00:39:02,240 --> 00:39:05,320 AND SO WE SURVEYED 143 RESIDENTS 1106 00:39:05,320 --> 00:39:07,360 AND FELLOWS IN OUR ACADEMIC 1107 00:39:07,360 --> 00:39:09,080 TRACKS AND THIS WAS REALLY THE 1108 00:39:09,080 --> 00:39:12,000 WORK OF RICHARD STEINMAN. 1109 00:39:12,000 --> 00:39:14,440 AND WE ASKED THEM, WHAT'S 1110 00:39:14,440 --> 00:39:15,640 EXTREMELY INFLUENTIAL TO YOU. 1111 00:39:15,640 --> 00:39:16,800 THEY HAD A LONG LIST. 1112 00:39:16,800 --> 00:39:18,480 WE EXPECTED IT WOULD BE ABOUT 1113 00:39:18,480 --> 00:39:19,880 GRANTS AND PAY. 1114 00:39:19,880 --> 00:39:21,920 THEY GAVE US DIFFERENT ANSWERS. 1115 00:39:21,920 --> 00:39:25,800 GRANTS AND PAY WAS THERE. 1116 00:39:25,800 --> 00:39:27,080 BALANCING THE CLINICAL AND 1117 00:39:27,080 --> 00:39:28,200 RESEARCH RESPONSIBILITIES. 1118 00:39:28,200 --> 00:39:29,560 HOW AM I GOOD AT BOTH. 1119 00:39:29,560 --> 00:39:32,520 THAT WAS A TOP CONCERN. 1120 00:39:32,520 --> 00:39:34,640 HOW DO I HAVE THE MASTERING NEED 1121 00:39:34,640 --> 00:39:36,800 OF THE RANGE OF EXPERTISE WITH 1122 00:39:36,800 --> 00:39:38,840 STATISTICS TO BASIC SCIENCE AND 1123 00:39:38,840 --> 00:39:42,960 TO GRANT WRITING AND TO 1124 00:39:42,960 --> 00:39:43,280 PROTOCOLS. 1125 00:39:43,280 --> 00:39:45,360 HOW DO I BALANCE PERSONAL AND 1126 00:39:45,360 --> 00:39:46,200 PROFESSIONAL RESPONSIBILITIES 1127 00:39:46,200 --> 00:39:48,120 AND FIND MY NICHE, YOU KNOW, 1128 00:39:48,120 --> 00:39:50,000 RELATED TO MENTORING. 1129 00:39:50,000 --> 00:39:53,080 SO WE BUILT A VERY INNOVATIVE 1130 00:39:53,080 --> 00:39:54,280 PROGRAM I HAVE TO SAY. 1131 00:39:54,280 --> 00:39:57,280 WE BUILT IN FOR EXAMPLE, 1132 00:39:57,280 --> 00:39:58,440 EXECUTIVES COACHING AND LOOKING 1133 00:39:58,440 --> 00:40:00,640 AT RESILIENCE AND HOW DO WE 1134 00:40:00,640 --> 00:40:01,720 PREPARE PEOPLE WHEN THAT GRANT 1135 00:40:01,720 --> 00:40:04,880 IS REJECTED WHEN THOSE HAVE THAT 1136 00:40:04,880 --> 00:40:07,040 FIRST OR SECOND CHILD. 1137 00:40:07,040 --> 00:40:08,600 THOSE INTERRUPTIONS THAT CAN 1138 00:40:08,600 --> 00:40:09,760 OVERWHELM YOU AND REALLY 1139 00:40:09,760 --> 00:40:12,160 BUILDING ON THAT RESILIENCE. 1140 00:40:12,160 --> 00:40:13,800 WE LOOKED AT WORK-LIFE BALANCE. 1141 00:40:13,800 --> 00:40:16,880 WE CREATED A FUND FOR CONCIERGE 1142 00:40:16,880 --> 00:40:18,560 SERVICE AND TIME MANAGEMENT 1143 00:40:18,560 --> 00:40:20,480 SUPPORT AND NOW THE MOST POPULAR 1144 00:40:20,480 --> 00:40:22,600 THING WAS A HOUSE CLEANER. 1145 00:40:22,600 --> 00:40:23,800 THAT ALMOST EVERYBODY WANTED 1146 00:40:23,800 --> 00:40:25,600 SOMEONE TO CLEAN THEIR HOUSE. 1147 00:40:25,600 --> 00:40:27,400 ONCE A WEEK CLEANING SERVICE 1148 00:40:27,400 --> 00:40:28,600 COULD BE OFF THEIR PLATE TO 1149 00:40:28,600 --> 00:40:29,880 ALLOW THEM FOCUS ON THEIR 1150 00:40:29,880 --> 00:40:31,640 FAMILIES AND THEIR RESEARCH. 1151 00:40:31,640 --> 00:40:35,480 WE CREATED WEEKLY GRANT WRITING 1152 00:40:35,480 --> 00:40:39,200 GROUPS AND WE JUST HAD EXTENSIVE 1153 00:40:39,200 --> 00:40:41,480 MENTOR-MENTEE MARRIAGE PROGRAMS, 1154 00:40:41,480 --> 00:40:43,600 AND CONFLICT RESOLUTION IN CASE 1155 00:40:43,600 --> 00:40:44,720 DISCUSSION PROGRAMS. 1156 00:40:44,720 --> 00:40:46,840 AND WE HAD BIO STATS BOOTCAMP 1157 00:40:46,840 --> 00:40:48,560 AND RIG OR TRAINING AND THE BIO 1158 00:40:48,560 --> 00:40:49,840 STATS PROGRAM SUPPORTED THEM FOR 1159 00:40:49,840 --> 00:40:50,600 THEIR PAPERS. 1160 00:40:50,600 --> 00:41:01,160 AND WE HAD MENTORING TEAMS, WHEN 1161 00:41:03,560 --> 00:41:05,120 PEOPLE GO BACK IN THE CLINIC WE 1162 00:41:05,120 --> 00:41:08,080 HAVE A HALF TIME TECHNICIAN 1163 00:41:08,080 --> 00:41:09,160 RUNNING THEIR WORK WHILE THEY'RE 1164 00:41:09,160 --> 00:41:10,800 IN AND OUT OF THE SURGICAL 1165 00:41:10,800 --> 00:41:14,680 ROTATIONS THAT THEY HAVE TO GO 1166 00:41:14,680 --> 00:41:16,760 BACK TO. 1167 00:41:16,760 --> 00:41:17,960 HOW DID THIS DO? 1168 00:41:17,960 --> 00:41:19,280 WOMAN IT'S EARLY AND THE PROGRAM 1169 00:41:19,280 --> 00:41:19,960 IS STILL RUNNING. 1170 00:41:19,960 --> 00:41:21,520 THESE SCHOLARS WERE PRODUCTIVE. 1171 00:41:21,520 --> 00:41:24,560 THEY OBTAINED MULTIPLE GRANTS 1172 00:41:24,560 --> 00:41:29,400 LISTED HERE AND THE FIRST 1173 00:41:29,400 --> 00:41:32,320 AUTHORSHIP, THEY'VE GOT ABOUT 1174 00:41:32,320 --> 00:41:35,040 THREE PUBLICATIONS PER SCHOLAR 1175 00:41:35,040 --> 00:41:38,600 AND BASIC SCIENCE TO 1176 00:41:38,600 --> 00:41:39,680 PUBLICATIONS. 1177 00:41:39,680 --> 00:41:43,200 EXTREMELY PRODUCTIVE IN TERMS OF 1178 00:41:43,200 --> 00:41:44,680 PUBLICATIONS AND WE ALSO 1179 00:41:44,680 --> 00:41:46,200 IDENTIFIED IN OUR SURVEY A 1180 00:41:46,200 --> 00:41:48,480 GENDER GAP IN CONFIDENCE AT THE 1181 00:41:48,480 --> 00:41:49,520 START OF PHYSICIAN-SCIENTIST 1182 00:41:49,520 --> 00:41:50,240 TRAINING. 1183 00:41:50,240 --> 00:41:53,200 THERE WERE 36 MEASURES OF 1184 00:41:53,200 --> 00:41:54,520 SELF-EFFICACY ACROSS THESE 1185 00:41:54,520 --> 00:41:56,760 RANGES AND A 10 IS A HIGH 1186 00:41:56,760 --> 00:41:57,640 CONFIDENT LEVEL. 1187 00:41:57,640 --> 00:41:59,520 YOU CAN SEE WE SAW SIGNIFICANT 1188 00:41:59,520 --> 00:42:01,200 DIFFERENCES BETWEEN MALE AND 1189 00:42:01,200 --> 00:42:01,760 FEMALE. 1190 00:42:01,760 --> 00:42:04,480 THESE ARE MD-PH.D STUDENTS AND A 1191 00:42:04,480 --> 00:42:06,240 PROTECTED YEAR AND 1192 00:42:06,240 --> 00:42:08,200 PHYSICIAN-SCIENTIST TRAINING 1193 00:42:08,200 --> 00:42:10,040 THEY'RE A YEAR OF RESEARCH 1194 00:42:10,040 --> 00:42:12,080 BETWEEN THEIR SECOND AND THIRD 1195 00:42:12,080 --> 00:42:13,280 YEAR OF MED SCHOOL. 1196 00:42:13,280 --> 00:42:14,680 WE SAW THIS ALSO IN OUR 1197 00:42:14,680 --> 00:42:18,680 RESIDENTS AND FELLOWS. 1198 00:42:18,680 --> 00:42:26,920 HOMICIDE. 1199 00:42:26,920 --> 00:42:27,400 THIS IS 1200 00:42:27,400 --> 00:42:28,720 ALL HIGHLY SIGNIFICANT 1201 00:42:28,720 --> 00:42:31,760 DIFFERENCES AND SOME NUMERICAL 1202 00:42:31,760 --> 00:42:32,960 DIFFERENCES PERSISTED BUT YOU 1203 00:42:32,960 --> 00:42:37,640 CAN SEE THAT DIFFERENCE BECAME 1204 00:42:37,640 --> 00:42:39,240 LESS SIGNIFICANT. 1205 00:42:39,240 --> 00:42:42,160 SO, JUST TO CONCLUDE, DO WE HAVE 1206 00:42:42,160 --> 00:42:44,680 AN OPPORTUNITY TO LEVERAGE THE 1207 00:42:44,680 --> 00:42:46,320 NIH AND THE UNIVERSITY OF 1208 00:42:46,320 --> 00:42:48,000 MARYLAND NOW THAT WE'RE SO 1209 00:42:48,000 --> 00:42:48,560 CLOSE? 1210 00:42:48,560 --> 00:42:50,560 OUR STRENGTHS IN A VITAL 1211 00:42:50,560 --> 00:42:52,520 PARTNERSHIP, FOCUSED ON TRAINING 1212 00:42:52,520 --> 00:42:54,600 THE NEXT GENERATION OF 1213 00:42:54,600 --> 00:42:55,040 PHYSICIAN-SCIENTIST? 1214 00:42:55,040 --> 00:42:57,480 AND IF YOU DON'T MIND, I'LL DO 1215 00:42:57,480 --> 00:42:59,360 AN NIH SWAT ANALYSIS AT RISK OF 1216 00:42:59,360 --> 00:43:00,680 PICKING A FIGHT WITH SOME OF 1217 00:43:00,680 --> 00:43:01,240 YOU. 1218 00:43:01,240 --> 00:43:03,760 I'M HAPPY TO HEAR YOUR FEEDBACK. 1219 00:43:03,760 --> 00:43:07,320 I FEEL THAT WHAT THE NIH HAS IS 1220 00:43:07,320 --> 00:43:09,320 AN INTERNATIONAL REPUTATION AND 1221 00:43:09,320 --> 00:43:11,560 AN ELITE STATUS IN THE HISTORY 1222 00:43:11,560 --> 00:43:13,320 OF MEDICINE AND SCIENCE. 1223 00:43:13,320 --> 00:43:16,320 THE NIH HAS REMARKABLE MENTORS 1224 00:43:16,320 --> 00:43:17,840 AND TECHNOLOGY AND NEW 1225 00:43:17,840 --> 00:43:21,000 TECHNOLOGY CUTTING EDGE 1226 00:43:21,000 --> 00:43:24,280 TECHNOLOGY, THE CLINICAL CENTER, 1227 00:43:24,280 --> 00:43:25,320 CLINICAL OPPORTUNITIES IN CORE. 1228 00:43:25,320 --> 00:43:27,120 THE NIH HAS STRONG SCIENCE 1229 00:43:27,120 --> 00:43:29,320 FOCUSED ENVIRONMENT WITH RICH 1230 00:43:29,320 --> 00:43:30,880 BASIC SCIENCE AND THE NIH HAS 1231 00:43:30,880 --> 00:43:32,440 THE CLINICAL CENTER WHICH IS IS 1232 00:43:32,440 --> 00:43:35,240 I THINK UNMATCHED AND AN ABILITY 1233 00:43:35,240 --> 00:43:37,960 TO LEVERAGE T1 CAPACITY TO 1234 00:43:37,960 --> 00:43:38,360 BEDSIDE CAPACITY. 1235 00:43:38,360 --> 00:43:40,200 THE NIH CAN BE VERY FAST. 1236 00:43:40,200 --> 00:43:42,200 HENRY MASUR TOOK ADVANTAGE WHEN 1237 00:43:42,200 --> 00:43:45,800 THERE WAS AN OUTBREAK, OBVIOUSLY 1238 00:43:45,800 --> 00:43:49,640 THE NIAD HAS EX EMPTIED THIS. 1239 00:43:49,640 --> 00:43:52,120 THERE'S AN ABILITY TO RAPIDLY 1240 00:43:52,120 --> 00:43:53,320 PIVOT WITH NEW OUTBREAKS. 1241 00:43:53,320 --> 00:43:55,560 YOU DON'T HAVE TO WAIT ON GRANT 1242 00:43:55,560 --> 00:43:57,840 FUNDING TO PIVOT TO AN EMERGING 1243 00:43:57,840 --> 00:43:59,280 CHALLENGE AND THEN THERE ARE 1244 00:43:59,280 --> 00:44:00,480 RESOURCES FOR PROTECTED TIME. 1245 00:44:00,480 --> 00:44:03,240 YOU KNOW, I HAD THE ABILITY 1246 00:44:03,240 --> 00:44:05,600 WITHOUT WRITING A T32 OR AN F TO 1247 00:44:05,600 --> 00:44:05,960 STAY. 1248 00:44:05,960 --> 00:44:07,960 THAT LENGTH OF TIME NEEDED AS A 1249 00:44:07,960 --> 00:44:10,360 POSTDOC FELLOW TO MAKE THE 1250 00:44:10,360 --> 00:44:13,160 PROGRESS THAT I SHARED WITH YOU. 1251 00:44:13,160 --> 00:44:15,520 BUT THERE'S ALSO WEAKNESSES. 1252 00:44:15,520 --> 00:44:18,040 THE NIH HAS A LIMITED TALENT 1253 00:44:18,040 --> 00:44:19,600 PIPELINE AND I MEAN MEDICAL 1254 00:44:19,600 --> 00:44:22,320 STUDENTS, RESIDENTS AND FELLOWS. 1255 00:44:22,320 --> 00:44:24,320 THE NIH HAS LIMITED GRANT 1256 00:44:24,320 --> 00:44:25,760 WRITING AND CAREER DEVELOPMENT 1257 00:44:25,760 --> 00:44:26,320 PATHWAYS. 1258 00:44:26,320 --> 00:44:28,280 THE INTRA TO EXTRAMURAL 1259 00:44:28,280 --> 00:44:28,520 PATHWAYS. 1260 00:44:28,520 --> 00:44:30,640 YOU HAVE THE K22 WHICH IS VERY 1261 00:44:30,640 --> 00:44:31,680 SUCCESSFUL. 1262 00:44:31,680 --> 00:44:33,320 BUT THESE OPPORTUNITIES COULD BE 1263 00:44:33,320 --> 00:44:33,720 EXPANDED. 1264 00:44:33,720 --> 00:44:36,640 THERE ARE LIMITED LARGE PATIENT 1265 00:44:36,640 --> 00:44:38,200 COHORTS AND SOME OF THOSE ARE 1266 00:44:38,200 --> 00:44:41,520 DWINDLING OVER TIME, THERE'S 1267 00:44:41,520 --> 00:44:42,960 LIMITED IN DATASETS. 1268 00:44:42,960 --> 00:44:44,640 WE'RE IN THE WORLD OF DATA AND 1269 00:44:44,640 --> 00:44:47,600 THOSE DATASETS CAN BE LIMITED. 1270 00:44:47,600 --> 00:44:50,200 FIXED BUDGETS CAN OFTEN LIMIT 1271 00:44:50,200 --> 00:44:51,120 CAREER GROWTH OF EARLY AND MID 1272 00:44:51,120 --> 00:44:53,160 CAREER INVESTIGATORS AND I 1273 00:44:53,160 --> 00:44:53,920 ALWAYS JOKED WITH PEOPLE, IT WAS 1274 00:44:53,920 --> 00:44:55,440 A COMMON JOKE AT NIH THE ONLY 1275 00:44:55,440 --> 00:44:57,440 WAY YOU MOVE UP AS A YOUNG 1276 00:44:57,440 --> 00:44:58,880 PERSON IS SOMEONE NEED TODAY DIE 1277 00:44:58,880 --> 00:45:01,120 OR THERE WAS AN ETHICS SCANDAL 1278 00:45:01,120 --> 00:45:03,800 AND OFTEN I WAS GIVEN LEADERSHIP 1279 00:45:03,800 --> 00:45:08,640 WHEN CHANGES OCCURRED IN 1280 00:45:08,640 --> 00:45:09,560 LEADERSHIP AND WE'D LIKE YOUNG 1281 00:45:09,560 --> 00:45:11,880 PEOPLE TO MOVE UP THAT LADDER. 1282 00:45:11,880 --> 00:45:13,800 IN STRAT MURAL WORLD YOU COMPETE 1283 00:45:13,800 --> 00:45:16,280 IN A BIG POOL OF LEADERSHIP AND 1284 00:45:16,280 --> 00:45:17,800 RO1 AND K GRANTS THAT GIVE YOU 1285 00:45:17,800 --> 00:45:19,960 THAT FIRST FACULTY STEP. 1286 00:45:19,960 --> 00:45:22,120 ALTHOUGH YOU GET LESS RESOURCES 1287 00:45:22,120 --> 00:45:23,760 AT EACH STEP AND A LIMITED 1288 00:45:23,760 --> 00:45:25,280 ABILITY TO LEVERAGE CLINICAL 1289 00:45:25,280 --> 00:45:26,120 RESOURCE THIS IS PATIENTS. 1290 00:45:26,120 --> 00:45:28,240 WHEN I DO A CLINICAL TRIAL, I 1291 00:45:28,240 --> 00:45:33,680 CAN PAY FOR A LOT OF IT THROUGH 1292 00:45:33,680 --> 00:45:35,080 TESTING AND SUPPORT AND AT THE 1293 00:45:35,080 --> 00:45:36,960 ENOUGH ALL OF THOSE RESOURCES 1294 00:45:36,960 --> 00:45:38,400 HAVE TO BE COVERED CENTRALLY. 1295 00:45:38,400 --> 00:45:40,680 SO HOW COULD WE FORM AN ALLIANCE 1296 00:45:40,680 --> 00:45:41,680 AND COLLABORATE MORE AND I'M 1297 00:45:41,680 --> 00:45:44,000 GOING TO VISIT NIH TOMORROW AND 1298 00:45:44,000 --> 00:45:45,720 I'D LOVE TO BRAINSTORM ABOUT 1299 00:45:45,720 --> 00:45:46,240 THESE THINGS. 1300 00:45:46,240 --> 00:45:49,320 COULD THE UNIVERSITY OF MARYLAND 1301 00:45:49,320 --> 00:45:50,720 BRING MED STUDENTS TO CAREER 1302 00:45:50,720 --> 00:45:51,360 DEVELOPMENT TRACKS. 1303 00:45:51,360 --> 00:45:53,320 WE WOULD LOVE TO DO THAT. 1304 00:45:53,320 --> 00:45:54,520 WE'RE THE MAJOR PUBLIC 1305 00:45:54,520 --> 00:45:56,400 UNIVERSITY IN THE REGION, THAT'S 1306 00:45:56,400 --> 00:45:57,840 OUR RESPONSIBILITY. 1307 00:45:57,840 --> 00:45:59,520 CAN WE BRING OUR LARGE DATASETS 1308 00:45:59,520 --> 00:46:01,240 AND PATIENT COHORTS O 1309 00:46:01,240 --> 00:46:02,320 COLLABORATIVE RESEARCH PROGRAMS 1310 00:46:02,320 --> 00:46:04,080 AND I'LL POINT OUT THAT WE JUST 1311 00:46:04,080 --> 00:46:06,080 LAUNCHED A VERY EXCITING NEW 1312 00:46:06,080 --> 00:46:07,160 UNIVERSITY MARYLAND INSTITUTE 1313 00:46:07,160 --> 00:46:13,280 FOR HEALTHCARE COMPUTING. 1314 00:46:13,280 --> 00:46:15,000 WE HAVE A $56 MILLION INVESTMENT 1315 00:46:15,000 --> 00:46:16,760 AND WE'LL BE BUILDING A MAJOR 1316 00:46:16,760 --> 00:46:18,440 HEALTHCARE COMPUTING LEARNING 1317 00:46:18,440 --> 00:46:20,200 HEALTH-CARE SYSTEM RIGHT NORTH 1318 00:46:20,200 --> 00:46:26,360 OF YOU AT THE WHITE FLINT NORTH 1319 00:46:26,360 --> 00:46:27,480 BETHESDA METRO STOP. 1320 00:46:27,480 --> 00:46:28,800 THAT PROGRAM, WE'LL TAKE THE 1321 00:46:28,800 --> 00:46:29,720 DATA COMING FROM THE UNIVERSITY 1322 00:46:29,720 --> 00:46:33,120 OF MARYLAND SYSTEM OF HOSPITALS, 1323 00:46:33,120 --> 00:46:34,720 2 MILLION UNIQUE PATIENT 1324 00:46:34,720 --> 00:46:35,560 ELECTRONIC HEALTHCARE RECORDS 1325 00:46:35,560 --> 00:46:37,200 AND THAT DATA IS DEIDENTIFIED, 1326 00:46:37,200 --> 00:46:39,080 RUN THROUGH HONEST BROKER SYSTEM 1327 00:46:39,080 --> 00:46:40,880 FOR REAL WORLD DATA, REAL WORLD 1328 00:46:40,880 --> 00:46:41,120 ANALYSIS. 1329 00:46:41,120 --> 00:46:42,760 NOW THIS IS GOING TO BE AN 1330 00:46:42,760 --> 00:46:44,280 IMPORTANT INITIATIVE BECAUSE 1331 00:46:44,280 --> 00:46:46,160 MANY OF OUR A.I. BASED ANALYSIS 1332 00:46:46,160 --> 00:46:48,720 AND OUR POPULATIONS ARE BIAS 1333 00:46:48,720 --> 00:46:50,200 THAT THOSE DON'T HAVE DIVERSE 1334 00:46:50,200 --> 00:46:51,920 POPULATION AND IN MARRY LAPPED 1335 00:46:51,920 --> 00:46:56,680 MAR LAND WE'REPROUD 30% OF UNDEN 1336 00:46:56,680 --> 00:46:56,960 MEDICINE. 1337 00:46:56,960 --> 00:46:59,600 AFRICAN AMERICAN, LA TEEN X AND 1338 00:46:59,600 --> 00:47:01,520 WE HAVE AN OPPORTUNITY TO USE 1339 00:47:01,520 --> 00:47:02,800 AND LEVERAGE HEALTHCARE 1340 00:47:02,800 --> 00:47:04,720 COMPUTING TO PROVIDE BETTER 1341 00:47:04,720 --> 00:47:06,600 POPULATION HEALTH, BETTER 1342 00:47:06,600 --> 00:47:07,200 INTERVENTIONS AND BETTER 1343 00:47:07,200 --> 00:47:08,640 ANALYSIS OF RISK AND SUPPORT FOR 1344 00:47:08,640 --> 00:47:09,200 THE FUTURE. 1345 00:47:09,200 --> 00:47:10,840 SO WE'RE VERY EXCITE BESIDE THIS 1346 00:47:10,840 --> 00:47:11,920 PARTNERSHIP AND WE LOOK FORWARD 1347 00:47:11,920 --> 00:47:14,080 TO PARTNERING AND WE'D LOVE NIH 1348 00:47:14,080 --> 00:47:16,000 TO BUILD A FLOOR ABOVE US AT THE 1349 00:47:16,000 --> 00:47:17,520 SITES WE'RE MOVING INTO. 1350 00:47:17,520 --> 00:47:19,160 WE CAN HAVE SHARED FACULTY 1351 00:47:19,160 --> 00:47:21,640 MENTORS, CLINICAL AND BASIC 1352 00:47:21,640 --> 00:47:22,120 PARTNERSHIPS. 1353 00:47:22,120 --> 00:47:24,120 WE CAN PROVIDE CLINICAL EXPOSURE 1354 00:47:24,120 --> 00:47:25,400 OF OPPORTUNITIES FOR SHARED 1355 00:47:25,400 --> 00:47:28,360 RECRUITS. 1356 00:47:28,360 --> 00:47:29,160 PHYSICIAN-SCIENTIST SURGEONS AT 1357 00:47:29,160 --> 00:47:30,520 THE NIH NEED CLINICAL OPERATING 1358 00:47:30,520 --> 00:47:32,120 TIME AND CAN WE PROVIDE THAT 1359 00:47:32,120 --> 00:47:33,600 THROUGH UNIQUE PARTNERSHIPS? 1360 00:47:33,600 --> 00:47:35,920 THE NIH CAN PROVIDE ACCESS TO 1361 00:47:35,920 --> 00:47:38,480 FUNDS FOR PROTECTED TIME, 1362 00:47:38,480 --> 00:47:40,200 TECHNOLOGIES, FACULTY POSITIONS 1363 00:47:40,200 --> 00:47:42,080 FOR SUCCESSFUL TRAINEES AND SO 1364 00:47:42,080 --> 00:47:44,320 I'LL END WITH HOW DO WE CREATE 1365 00:47:44,320 --> 00:47:46,720 SUCH PROGRAMS THAT FUND THIS AND 1366 00:47:46,720 --> 00:47:48,760 BREAKDOWN OUR EXISTING 1367 00:47:48,760 --> 00:47:50,160 REGULATORY BARRIERS TO SUCH 1368 00:47:50,160 --> 00:47:50,480 PARTNERSHIPS? 1369 00:47:50,480 --> 00:47:55,640 AND THEN I'LL CONCLUDE JUST WITH 1370 00:47:55,640 --> 00:47:59,360 A POINT OF OPTIMISM AND A CALL 1371 00:47:59,360 --> 00:48:03,960 FOR ACTION, WE LIVE IN JUST THE 1372 00:48:03,960 --> 00:48:05,240 ABSOLUTE MOST EXCITING PLACE TO 1373 00:48:05,240 --> 00:48:07,160 BE AND THAT'S ACADEMIC MEDICAL 1374 00:48:07,160 --> 00:48:08,800 CENTERS AND WE ARE SORT OF 1375 00:48:08,800 --> 00:48:14,640 HAVING THE RESPONSIBILITY IN THE 1376 00:48:14,640 --> 00:48:16,520 PRIVILEGE THE WAY THE NIH 1377 00:48:16,520 --> 00:48:18,880 CONFRONTED OF AIDS EPIDEMIC AND 1378 00:48:18,880 --> 00:48:20,880 THE EPIDEMIC DEVELOPING RNA 1379 00:48:20,880 --> 00:48:24,920 VACCINES AND THE WAY WE ADD 1380 00:48:24,920 --> 00:48:26,160 MARYLAND WE AT THE TIMED 20% OF 1381 00:48:26,160 --> 00:48:27,160 ALL THE CITIZENS THAT WERE 1382 00:48:27,160 --> 00:48:28,840 TESTED IN THE STATE OF MARYLAND 1383 00:48:28,840 --> 00:48:30,280 AND WE WERE THE FRONTLINES AND 1384 00:48:30,280 --> 00:48:33,080 OUR ERs, OUR CLINICS, OUR 1385 00:48:33,080 --> 00:48:39,800 HOSPITALS, OUR ICU AND WHAT ARE 1386 00:48:39,800 --> 00:48:41,960 THE GENERATIONAL CHALLENGES FACE 1387 00:48:41,960 --> 00:48:42,680 OUR YOUNG PEOPLE AND BECAUSE 1388 00:48:42,680 --> 00:48:44,440 THIS IS WHAT WE INSPIRE THEM 1389 00:48:44,440 --> 00:48:46,240 WITH AND I THINK IN OF THESE ARE 1390 00:48:46,240 --> 00:48:49,920 LISTED HERE AND THE OBESITY AND 1391 00:48:49,920 --> 00:48:52,040 METABOLIC SYNDROME EPIDEMIC LIKE 1392 00:48:52,040 --> 00:48:53,480 SMOKING AFTER WORLD WAR II. 1393 00:48:53,480 --> 00:48:55,160 A WARM CONNECTED WORLD WITH 1394 00:48:55,160 --> 00:48:59,760 EMERGING PATHOGENS AND MIKE 1395 00:48:59,760 --> 00:49:02,080 MICROBIAL RESISTANCE AND AGING 1396 00:49:02,080 --> 00:49:03,920 EPIDEMIC AND THE OPIOID AND 1397 00:49:03,920 --> 00:49:06,360 ADDICTION EPIDEMIC IN ALL ITS 1398 00:49:06,360 --> 00:49:08,400 FORMS AND THIS DISRUPTIVE 1399 00:49:08,400 --> 00:49:10,640 EMERGENCE OF BIG DATA 1400 00:49:10,640 --> 00:49:13,040 INFORMATION TECHNOLOGY AI AND 1401 00:49:13,040 --> 00:49:15,040 PRECISION MEDICINE AND HOW DO WE 1402 00:49:15,040 --> 00:49:17,080 MENTOR OUR YOUNG PEOPLE TO 1403 00:49:17,080 --> 00:49:19,040 LEVERAGE THE NEW TECHNOLOGY TO 1404 00:49:19,040 --> 00:49:20,480 ADDRESS THESE GENERATIONAL 1405 00:49:20,480 --> 00:49:22,040 CHALLENGES AND SO WITH THAT I'LL 1406 00:49:22,040 --> 00:49:26,960 STOP AND I'LL UNSHARE AND TURN 1407 00:49:26,960 --> 00:49:28,840 THIS OVER FOR THE NEXT 11 1408 00:49:28,840 --> 00:49:30,360 MINUTES WE HAVE TIME FOR 1409 00:49:30,360 --> 00:49:34,920 DISCUSSION, FEEDBACK AND 1410 00:49:34,920 --> 00:49:35,200 QUESTIONS. 1411 00:49:35,200 --> 00:49:38,080 >>THAT'S A GREAT CHALLENGED TO 1412 00:49:38,080 --> 00:49:39,240 PRESENT TO US IN TERMS OF WHAT 1413 00:49:39,240 --> 00:49:40,920 WE MIGHT TAKE ADVANTAGE OF. 1414 00:49:40,920 --> 00:49:44,040 ONE OF THE QUESTIONS THAT AGAIN 1415 00:49:44,040 --> 00:49:45,840 SOME OF THE PEOPLE HAVE 1416 00:49:45,840 --> 00:49:47,520 IDENTIFIED THEMSELVES, BUT JACK 1417 00:49:47,520 --> 00:49:49,160 BENNETT WANTED TO KNOW, IN TERMS 1418 00:49:49,160 --> 00:49:51,000 OF MENTORS, WHAT DO YOU THINK AN 1419 00:49:51,000 --> 00:49:52,840 IDEAL MENTOR-COMMITTEE SHOULD 1420 00:49:52,840 --> 00:49:53,280 BE? 1421 00:49:53,280 --> 00:49:56,240 SOMEONE IN THE LAB, SOMEONE 1422 00:49:56,240 --> 00:49:57,160 OUTSIDE THE LAB? 1423 00:49:57,160 --> 00:49:58,680 WHAT DO YOU NEED FOR SCIENTIFIC 1424 00:49:58,680 --> 00:50:03,400 AND PROFESSIONAL DEVELOPMENT? 1425 00:50:03,400 --> 00:50:04,040 >>Dr. Mark T. Gladwin: WELL, 1426 00:50:04,040 --> 00:50:05,640 I'M EMBARRASSED TO SHARE MY 1427 00:50:05,640 --> 00:50:06,720 PERSPECTIVES WITH Dr. BENNETT 1428 00:50:06,720 --> 00:50:07,720 BECAUSE HE IS OBVIOUSLY ONE OF 1429 00:50:07,720 --> 00:50:09,960 THE GREAT MENTORS. 1430 00:50:09,960 --> 00:50:14,760 I WOULD SAY THAT ONE THING WE'VE 1431 00:50:14,760 --> 00:50:17,640 DONE AND ENCOURAGED, THAT 1432 00:50:17,640 --> 00:50:20,080 ORGANICALLY YOU PROMOTED IN YOUR 1433 00:50:20,080 --> 00:50:21,720 FACULTY, PROMOTED AT THE NIH IN 1434 00:50:21,720 --> 00:50:24,160 THE CRITICAL CARE DEPARTMENT, 1435 00:50:24,160 --> 00:50:26,440 WAS CO MENTORSHIP MODELS. 1436 00:50:26,440 --> 00:50:28,000 SO WE THINK IT'S IMPORTANT TO 1437 00:50:28,000 --> 00:50:31,200 HAVE ONE MENTOR WHO HAS REAL 1438 00:50:31,200 --> 00:50:33,880 OWNERSHIP AND RESPONSIBILITY FOR 1439 00:50:33,880 --> 00:50:34,720 THE MENTEE. 1440 00:50:34,720 --> 00:50:35,920 SOMEONE WHO WILL SHARE IN THE 1441 00:50:35,920 --> 00:50:37,960 FINANCIAL SUPPORT AT THE LAB 1442 00:50:37,960 --> 00:50:39,960 LEVEL, SHARE RESOURCES, WHETHER 1443 00:50:39,960 --> 00:50:42,840 IT'S ON THE CLINICAL SPACE, IT'S 1444 00:50:42,840 --> 00:50:44,000 COORDINATORS AND IN THE BASIC 1445 00:50:44,000 --> 00:50:47,920 LAB AND IT'S TECHNICIANS AND 1446 00:50:47,920 --> 00:50:49,000 COST OF COLONIES AND MICE. 1447 00:50:49,000 --> 00:50:52,040 YOU KNOW, THIS IS SOMEONE WITH A 1448 00:50:52,040 --> 00:50:53,680 REAL COMMITMENT AND THAT IS 1449 00:50:53,680 --> 00:50:56,160 RESPONSIBLE FOR THE 1450 00:50:56,160 --> 00:50:56,880 MILESTONE-DRIVEN PROGRESS. 1451 00:50:56,880 --> 00:50:59,360 BUT THEN IT'S NICE TO HAVE OTHER 1452 00:50:59,360 --> 00:50:59,840 MENTORS. 1453 00:50:59,840 --> 00:51:03,120 MAYBE SOMEONE THAT MENTORS ON 1454 00:51:03,120 --> 00:51:06,280 THAT CLINICAL LANDSCAPE LIKE 1455 00:51:06,280 --> 00:51:07,680 RICHARD CANNON DID FOR ME OR 1456 00:51:07,680 --> 00:51:09,080 SOMEONE ALONG THE CAREER 1457 00:51:09,080 --> 00:51:10,600 DEVELOPMENT PATHWAY WHICH YOU 1458 00:51:10,600 --> 00:51:11,480 HENRY, DID FOR ME. 1459 00:51:11,480 --> 00:51:13,080 WHAT WE TRY TO DO IS COME UP 1460 00:51:13,080 --> 00:51:15,200 WITH A MENTORSHIP COMMITTEE AND 1461 00:51:15,200 --> 00:51:16,960 WE ASK ALL TRAINEES THAT THEY 1462 00:51:16,960 --> 00:51:18,720 NEEDED A STATED MENTORSHIP 1463 00:51:18,720 --> 00:51:19,120 COMMITTEE. 1464 00:51:19,120 --> 00:51:21,840 THE F32 AND K GRANTS REQUIRE A 1465 00:51:21,840 --> 00:51:22,720 MENTORSHIP COMMITTEE SO FOR 1466 00:51:22,720 --> 00:51:24,320 EXAMPLE, I MENTOR A LOT OF 1467 00:51:24,320 --> 00:51:27,720 PEOPLE TO Ks WITH YOU PEOPLE 1468 00:51:27,720 --> 00:51:29,480 ASK ME AREN'T YOU TOO BUSY TO DO 1469 00:51:29,480 --> 00:51:31,160 THAT SO I HAVE A CO MENTOR AND 1470 00:51:31,160 --> 00:51:32,840 WE ARGUE IN OUR CAREER 1471 00:51:32,840 --> 00:51:34,960 DEVELOPMENT PLAN HOW I'M 1472 00:51:34,960 --> 00:51:36,400 ABSOLUTELY COMMIT TODAY THIS 1473 00:51:36,400 --> 00:51:38,640 MENNITY AND I HAVE A TRACK 1474 00:51:38,640 --> 00:51:40,760 RECORD OF SUCCESS BUT BECAUSE OF 1475 00:51:40,760 --> 00:51:42,280 TIME LIMITATIONS I HAVE A VERY 1476 00:51:42,280 --> 00:51:43,920 ENGAGE CO MENTOR WHO IS YOUNGER, 1477 00:51:43,920 --> 00:51:46,120 IN THE LAB ALL THE TIME. 1478 00:51:46,120 --> 00:51:48,600 SO I LIKE EVEN IF YOU LOOK AT 1479 00:51:48,600 --> 00:51:51,080 JIM SHELLHAMMER, I WAS IN A LAB 1480 00:51:51,080 --> 00:51:52,720 WITH TWO FELLOWS FROM CHINA. 1481 00:51:52,720 --> 00:51:55,960 Dr. YAO WAS MY DAY-TO-DAY 1482 00:51:55,960 --> 00:51:56,520 MENTOR. 1483 00:51:56,520 --> 00:51:58,040 SHE TAUGHT ME EVERYTHING ABOUT 1484 00:51:58,040 --> 00:51:59,360 MOLECULAR BIOLOGY. 1485 00:51:59,360 --> 00:52:01,200 SO I SAW CAROLE THE LAB MANAGER 1486 00:52:01,200 --> 00:52:03,800 AND YAO AS MY CO MENTORS. 1487 00:52:03,800 --> 00:52:05,440 >>OF COURSE WE ENCOURAGE 1488 00:52:05,440 --> 00:52:08,320 EVERYBODY TO SEND IN QUESTIONS. 1489 00:52:08,320 --> 00:52:09,840 ANOTHER ISSUE THAT'S COME UP IS, 1490 00:52:09,840 --> 00:52:12,240 YOU KNOW, FELLOWSHIPS ARE SEEN 1491 00:52:12,240 --> 00:52:14,160 AS TWO YEARS, THREE YEARS, FOUR 1492 00:52:14,160 --> 00:52:16,880 YEARS, WITH ONLY A YEAR OR TWO 1493 00:52:16,880 --> 00:52:17,600 FOR RESEARCH. 1494 00:52:17,600 --> 00:52:19,360 DO WE HAVE TO RETHINK HOW WE 1495 00:52:19,360 --> 00:52:20,680 FUND THOSE BECAUSE YOU'VE DONE A 1496 00:52:20,680 --> 00:52:21,960 GREAT JOB APPLYING FOR T GRANTS 1497 00:52:21,960 --> 00:52:24,320 AND IT'S VERY COMPLICATED 1498 00:52:24,320 --> 00:52:26,760 PROCESS AND DOES NIH NEED A MORE 1499 00:52:26,760 --> 00:52:29,400 COMPREHENSIVE PROCESS SO IF IT'' 1500 00:52:29,400 --> 00:52:31,160 YEAR TO GET RESEARCH TRAINING 1501 00:52:31,160 --> 00:52:33,160 DURING YOUR QUOTE FELLOWSHIP? 1502 00:52:33,160 --> 00:52:33,840 >>Dr. Mark T. Gladwin: YES SO, 1503 00:52:33,840 --> 00:52:38,000 THE T32 ALLOWS FOR UP TO THREE 1504 00:52:38,000 --> 00:52:42,440 YEARS OF SUPPORT. 1505 00:52:42,440 --> 00:52:44,240 AND HOWEVER, THEY'RE VERY 1506 00:52:44,240 --> 00:52:46,640 COMPETITIVE TO GET AND YOU DON'T 1507 00:52:46,640 --> 00:52:47,880 GET THAT MANY SLOTS. 1508 00:52:47,880 --> 00:52:48,920 SO OF COURSE TIMES, PROGRAMS 1509 00:52:48,920 --> 00:52:52,440 LIKE HOPKINS, THEY'RE JUGGLING 1510 00:52:52,440 --> 00:52:52,920 PEOPLE. 1511 00:52:52,920 --> 00:52:54,760 THEY'RE COVERING THEM ON A 1512 00:52:54,760 --> 00:52:56,680 CLINICAL SUPPORT FOR A 1513 00:52:56,680 --> 00:52:57,560 YEAR-AND-A-HALF AND THEN THEY 1514 00:52:57,560 --> 00:52:59,120 PUT THEM ON THE T SUPPORT AND 1515 00:52:59,120 --> 00:53:01,320 THEY DON'T HAVE ENOUGH T32 SLOTS 1516 00:53:01,320 --> 00:53:03,760 SO MUCH TIMES THEY'RE ONLY 1517 00:53:03,760 --> 00:53:05,400 GIVING PEOPLE TWO YEARS 1518 00:53:05,400 --> 00:53:05,760 PROTECTED TIME. 1519 00:53:05,760 --> 00:53:06,800 I ABSOLUTELY AGREE, IN THE 1520 00:53:06,800 --> 00:53:10,760 MODERN ERA, THE COMPLEXITY OF A 1521 00:53:10,760 --> 00:53:14,040 COMPETITIVE JCI CIRCULATION 1522 00:53:14,040 --> 00:53:16,240 PAPER, REALLY REQUIRES, EVEN FOR 1523 00:53:16,240 --> 00:53:18,240 SOME SOMEONE WITH EXTENSIVE 1524 00:53:18,240 --> 00:53:19,040 BACKGROUND RESEARCH EXPERIENCE 1525 00:53:19,040 --> 00:53:20,720 IN A BIG LAB, REQUIRES YEARS. 1526 00:53:20,720 --> 00:53:21,680 SO I THINK THERE'S TWO ANSWERS 1527 00:53:21,680 --> 00:53:22,640 TO THE QUESTION. 1528 00:53:22,640 --> 00:53:25,240 ONE IS YES AND WE NEED TO 1529 00:53:25,240 --> 00:53:26,680 PROTECT PEOPLE AND WE ALWAYS NOT 1530 00:53:26,680 --> 00:53:28,920 SAID THAT ONE OF THE STRENGTHS 1531 00:53:28,920 --> 00:53:30,480 OF OUR PULMONARY DIVISION AND 1532 00:53:30,480 --> 00:53:31,840 DEPARTMENT OF MEDICINE THAT WE 1533 00:53:31,840 --> 00:53:33,360 GUARANTEED UP TO THREE YEARS OF 1534 00:53:33,360 --> 00:53:35,000 REAL PROTECTED RESEARCH TIME AND 1535 00:53:35,000 --> 00:53:37,160 AFTER THAT, WE WOULD PUT PEOPLE 1536 00:53:37,160 --> 00:53:40,960 IN HIGH REVENUE CLINI CLIN ROTAS 1537 00:53:40,960 --> 00:53:42,280 SO THEY CAN OFFSET THEIR TIME. 1538 00:53:42,280 --> 00:53:43,360 THE OTHER THING IS WHILE THEY 1539 00:53:43,360 --> 00:53:45,800 WERE ON THE T32, WHEN THEY WERE 1540 00:53:45,800 --> 00:53:47,720 BOARD ELIGIBLE, THEY STILL COULD 1541 00:53:47,720 --> 00:53:49,400 DO TWO MONTHS OF CLINICAL WORK 1542 00:53:49,400 --> 00:53:51,440 TO SUPPLEMENT THEIR PAY SO WE 1543 00:53:51,440 --> 00:53:53,440 TRIED TO GET PAY UP TO BE MORE 1544 00:53:53,440 --> 00:53:54,120 COMPETITIVE BECAUSE A LOT OF 1545 00:53:54,120 --> 00:53:56,120 PEOPLE DON'T WANT TO DO FOUR 1546 00:53:56,120 --> 00:53:58,760 YEARS AT A 50 TO 60,000 SALARIES 1547 00:53:58,760 --> 00:54:01,560 SO YOU HAVE TO CREATE THOSE 1548 00:54:01,560 --> 00:54:03,320 ADDITIONAL REVENUES. 1549 00:54:03,320 --> 00:54:05,760 SO I THINK HAVING MORE TIME IS 1550 00:54:05,760 --> 00:54:06,000 VITAL. 1551 00:54:06,000 --> 00:54:07,920 A LOT OF BRILLIANT PEOPLE THAT 1552 00:54:07,920 --> 00:54:11,360 WANT TO BE PHYSICIAN-SCIENTIST 1553 00:54:11,360 --> 00:54:13,200 TIME OUT. 1554 00:54:13,200 --> 00:54:14,280 WE HAVE TO HAVE MORE TIME AND 1555 00:54:14,280 --> 00:54:16,240 GET THE PAY UP IN THE T32. 1556 00:54:16,240 --> 00:54:18,840 >>THAT'S A GOOD SEG WAY TO 1557 00:54:18,840 --> 00:54:20,560 STEVE HOLLAND WHO WANTS TO KNOW, 1558 00:54:20,560 --> 00:54:22,000 IS TRAINING TOO LONG? 1559 00:54:22,000 --> 00:54:24,400 BECAUSE AS YOU ARE JUST 1560 00:54:24,400 --> 00:54:25,880 ALLUDING, THE TIME YOU PUT IN, 1561 00:54:25,880 --> 00:54:27,720 THE SLOW SALARY AND UNCERTAIN 1562 00:54:27,720 --> 00:54:30,080 FUTURE IS VERY DAUNTING. 1563 00:54:30,080 --> 00:54:33,160 WHAT'S YOUR ADVICE ABOUT THAT? 1564 00:54:33,160 --> 00:54:33,800 >>Dr. Mark T. Gladwin: YEAH, 1565 00:54:33,800 --> 00:54:34,280 STEVE, GREAT QUESTION. 1566 00:54:34,280 --> 00:54:36,720 YOU KNOW, THIS IS REALLY 1567 00:54:36,720 --> 00:54:37,800 INTERESTING. 1568 00:54:37,800 --> 00:54:39,800 I COMPLETELY AGREE. 1569 00:54:39,800 --> 00:54:43,760 I WAS A SIX-YEAR MEDICINE 1570 00:54:43,760 --> 00:54:45,680 STUDENT LIKE AND THEY GOT RID OF 1571 00:54:45,680 --> 00:54:47,200 SIX YEAR MEDICINE PROGRAMS 1572 00:54:47,200 --> 00:54:48,640 BECAUSE WE WERE TOO IMMATURE AND 1573 00:54:48,640 --> 00:54:51,000 THEY WENT TO SEVEN YEARS AND WE 1574 00:54:51,000 --> 00:54:52,320 WERE STILL TOO IMMATURE AND 1575 00:54:52,320 --> 00:54:53,120 THEY'VE AGAIN TO EIGHT. 1576 00:54:53,120 --> 00:54:56,200 THE SIX-YEAR PROGRAM ALLOWED ME 1577 00:54:56,200 --> 00:54:57,840 TO MOVE QUICKLY. 1578 00:54:57,840 --> 00:55:00,280 I STILL WAS ABLE TO ACHIEVE 1579 00:55:00,280 --> 00:55:02,320 RESIDENT BUT I COMMITTED, I WAS 1580 00:55:02,320 --> 00:55:04,680 A RESEARCH FELLOW AND IT SEEMED 1581 00:55:04,680 --> 00:55:10,880 LIKE 10 YEARS AT THE NIH. 1582 00:55:10,880 --> 00:55:12,880 I WAS ABLE TO MOON LIGHT FOR 1583 00:55:12,880 --> 00:55:14,960 EXTRA MONEY WHICH I DID AT 1584 00:55:14,960 --> 00:55:16,240 PROVIDENCE HOSPITAL A WEEKEND A 1585 00:55:16,240 --> 00:55:20,640 MONTH IN WASHINGTON. 1586 00:55:20,640 --> 00:55:25,000 THE PROBLEM NOW IS EVERYBODY 1587 00:55:25,000 --> 00:55:26,200 WANTS MORE RIGOR AND TRAINING 1588 00:55:26,200 --> 00:55:29,400 AND THERE'S A STRONG FOCUS ON 1589 00:55:29,400 --> 00:55:33,440 ADDITIONADDITIONED ADVANCES TRAD 1590 00:55:33,440 --> 00:55:38,760 THE CARD ALG CARD OWE GEE IS PUD 1591 00:55:38,760 --> 00:55:40,320 TO A EXTREME. 1592 00:55:40,320 --> 00:55:43,240 THERE ARE CO CATS 1, 2, 3, 4 AND 1593 00:55:43,240 --> 00:55:45,320 MANY CARDIOLOGY FELLOWS WANT 1594 00:55:45,320 --> 00:55:47,360 MULTIPLE, THEY WANT TO DO MULTI 1595 00:55:47,360 --> 00:55:49,000 MODALITY IMAGING, THEY WANT 1596 00:55:49,000 --> 00:55:52,000 ECHO, MRI SO THEY DO MULTIPLE CO 1597 00:55:52,000 --> 00:55:54,560 CATS AND THEN THEY WANT TO DO 1598 00:55:54,560 --> 00:55:55,120 EXTRA YEARS. 1599 00:55:55,120 --> 00:55:57,960 THEY RUN OUT OF TIME TO DO 1600 00:55:57,960 --> 00:55:59,520 PROTECTED RESEARCH ON A T32. 1601 00:55:59,520 --> 00:56:00,840 EITHER WE HAVE TO PAY MORE FOR 1602 00:56:00,840 --> 00:56:03,680 THE T32 AND ADD THE LOAN 1603 00:56:03,680 --> 00:56:04,840 REPAYMENT OR EXCEL. 1604 00:56:04,840 --> 00:56:06,280 I TRY TO MENTOR PEOPLE IF YOU 1605 00:56:06,280 --> 00:56:10,240 WANT TO BE A LEADER IN 1606 00:56:10,240 --> 00:56:11,280 CARDIOLOGY, YOUR BEST WAY 1607 00:56:11,280 --> 00:56:12,720 FORWARD IS TO DO GENERAL CARDS 1608 00:56:12,720 --> 00:56:15,120 WITH IMAGING AND ECHO IMAGING, 1609 00:56:15,120 --> 00:56:17,480 ET CETERA, AND THEN GO QUICKLY 1610 00:56:17,480 --> 00:56:19,280 INTO THE PROTECTED CLINICAL TIME 1611 00:56:19,280 --> 00:56:20,080 AND GET YOUR K. 1612 00:56:20,080 --> 00:56:23,040 IF YOU ARE A K FUNDED 1613 00:56:23,040 --> 00:56:24,720 CARDIOLOGIST OR GASTRO 1614 00:56:24,720 --> 00:56:26,040 INTROOLOGIST OR SURGEON, YOU CAN 1615 00:56:26,040 --> 00:56:27,680 GET ANY JOB IN THE COUNTRY AND 1616 00:56:27,680 --> 00:56:30,680 PEOPLE WILL OFFER YOU 1.5 TO 1617 00:56:30,680 --> 00:56:32,600 2 MILLION TO START UP YOUR LAB. 1618 00:56:32,600 --> 00:56:34,240 IT'S COMPETITIVE NOW TO GET 1619 00:56:34,240 --> 00:56:39,440 CARDIOLOGY GI, SURGEONS WITH 1620 00:56:39,440 --> 00:56:41,600 Ks. 1621 00:56:41,600 --> 00:56:43,520 >>CINDY DUNBAR HAS A NUMBER OF 1622 00:56:43,520 --> 00:56:44,280 QUESTIONS. 1623 00:56:44,280 --> 00:56:50,000 ONE IS WHAT'S THE BEST TIME TO 1624 00:56:50,000 --> 00:56:51,520 ENGAGE STUDENTS OR RESIDENTS OR 1625 00:56:51,520 --> 00:56:52,600 FELLOWS IN RESEARCH SO THEY 1626 00:56:52,600 --> 00:56:54,960 START AT I A POSTBAC AND THEY 1627 00:56:54,960 --> 00:56:57,360 START THE FIRST PART OF A 1628 00:56:57,360 --> 00:56:58,400 MULTI-FACETED QUESTION? 1629 00:56:58,400 --> 00:56:59,120 >>Dr. Mark T. Gladwin: LET ME 1630 00:56:59,120 --> 00:56:59,880 ANSWER THAT ONE QUICK. 1631 00:56:59,880 --> 00:57:02,800 FIRST OF ALL, THERE IS IS DATA 1632 00:57:02,800 --> 00:57:05,040 ABOUT STICKINESS THAT THERE IS 1633 00:57:05,040 --> 00:57:06,600 DATA, I'M NOT ACTUALLY YORK HAVE 1634 00:57:06,600 --> 00:57:08,760 THE CITATIONS BUT THERE'S BEEN 1635 00:57:08,760 --> 00:57:11,640 ANALYSIS FROM HOWARD HUGHES AND 1636 00:57:11,640 --> 00:57:12,800 OTHER GROUPS THAT THE PREDICT OR 1637 00:57:12,800 --> 00:57:14,280 OF DOING RESEARCH IS ENGAGING 1638 00:57:14,280 --> 00:57:15,480 PEOPLE IN RESEARCH AT ALL 1639 00:57:15,480 --> 00:57:16,280 STAGES. 1640 00:57:16,280 --> 00:57:17,840 SO THAT PRE YEAR TO YEAR AT THE 1641 00:57:17,840 --> 00:57:22,400 NIH, SUMMER RESEARCH, BUT HAVING 1642 00:57:22,400 --> 00:57:25,320 SAID OF THAT, THERE'S THIS 1643 00:57:25,320 --> 00:57:29,160 CHALLENGE GOING BACK AND FOURTH 1644 00:57:29,160 --> 00:57:29,840 AND THE MOVEMENT EFFECTIVE TIME 1645 00:57:29,840 --> 00:57:33,400 TO DO RESEARCH IN THE FLOW IS 1646 00:57:33,400 --> 00:57:36,720 THE PROTECTED TIME DURING A 1647 00:57:36,720 --> 00:57:37,320 FELLOWSHIP. 1648 00:57:37,320 --> 00:57:40,840 BECAUSE YOU ARE PRETTY MATURE, 1649 00:57:40,840 --> 00:57:47,200 YOU HAVE COMPLETED YOUR 1650 00:57:47,200 --> 00:57:48,400 CERTIFICATION SO YOU CAN MOON 1651 00:57:48,400 --> 00:57:50,520 LIGHT, YOU CAN BE AN EARLY 1652 00:57:50,520 --> 00:57:52,880 FACULTY BUT YOU CAN REALLY GET 1653 00:57:52,880 --> 00:57:55,720 T32s FOR THOSE POSTBAC T32s 1654 00:57:55,720 --> 00:57:57,040 AND YOU ARE CLOSE TO THE END SO 1655 00:57:57,040 --> 00:57:59,320 YOU CAN GET CAUGHT UP IN THAT 1656 00:57:59,320 --> 00:58:01,640 EXCITEMENT. 1657 00:58:01,640 --> 00:58:03,920 THE MD-PH.D, NOT ALL OF THEM GO 1658 00:58:03,920 --> 00:58:05,920 INTO RESEARCH BECAUSE THEY DO 1659 00:58:05,920 --> 00:58:07,960 THE MD PH.D BUT THEN THEY HAVE 1660 00:58:07,960 --> 00:58:11,480 AHEAD OF THEM A RESIDENCY AND 1661 00:58:11,480 --> 00:58:12,360 FELLOWSHIP. 1662 00:58:12,360 --> 00:58:14,360 THE DATA DOES SHOW STICKINESS 1663 00:58:14,360 --> 00:58:19,720 AND MD-PH.D, P IS STPs, 1664 00:58:19,720 --> 00:58:21,400 MSPPs, SUMMER ROTATIONS AND 1665 00:58:21,400 --> 00:58:22,560 THE OTHER THING IS EXCITE THEM 1666 00:58:22,560 --> 00:58:24,600 HAVING THEM GO TO MEETINGS, THEY 1667 00:58:24,600 --> 00:58:26,680 HAVE TO, THE MENTOR HAVE TO GIVE 1668 00:58:26,680 --> 00:58:28,560 THEM A LITTLE EARLY SUCCESS, 1669 00:58:28,560 --> 00:58:30,280 SEEN IF IT'S HELPING THEM WITH 1670 00:58:30,280 --> 00:58:31,320 THAT FIRST ABSTRACT SO THEY GET 1671 00:58:31,320 --> 00:58:34,600 TO GO TO THAT MEETING. 1672 00:58:34,600 --> 00:58:36,000 >>THERE'S SEVERAL QUESTIONS AND 1673 00:58:36,000 --> 00:58:38,480 WE'LL MAKE THESE THE LAST. 1674 00:58:38,480 --> 00:58:42,120 YOU MENTIONED YOUR VERY CREATIVE 1675 00:58:42,120 --> 00:58:42,360 PROGRAM. 1676 00:58:42,360 --> 00:58:46,080 YOU SEE SOME MD-PH.D AND SOME 1677 00:58:46,080 --> 00:58:49,840 MDs WHO GET BURPED BURNED OUT D 1678 00:58:49,840 --> 00:58:51,240 DON'T WANT TO ENGAGE. 1679 00:58:51,240 --> 00:58:52,800 ANYTHING MORE TO SAY OTHER THAN 1680 00:58:52,800 --> 00:58:55,280 YOU CREATED A WELL-FUNDED 1681 00:58:55,280 --> 00:58:59,200 PROGRAM AND NOT EVERYBODY I CANO 1682 00:58:59,200 --> 00:59:00,240 THAT? 1683 00:59:00,240 --> 00:59:00,920 >>Dr. Mark T. Gladwin: SO 1684 00:59:00,920 --> 00:59:04,200 OBVIOUSLY THERE'S PASSION AND 1685 00:59:04,200 --> 00:59:05,800 AMBITION, RIGHT. 1686 00:59:05,800 --> 00:59:07,160 YOU HAVE TO HAVE THAT PASSION 1687 00:59:07,160 --> 00:59:10,120 AND AMBITION THAT ALL OF YOU 1688 00:59:10,120 --> 00:59:10,360 HAVE. 1689 00:59:10,360 --> 00:59:14,800 I DO THINK THIS RESILIENCE IN 1690 00:59:14,800 --> 00:59:18,360 GRIT, THE CLINICAL WORLD SO 1691 00:59:18,360 --> 00:59:18,720 SUPPORTIVE. 1692 00:59:18,720 --> 00:59:20,720 YOU GO INTO THE ICU AND PATIENTS 1693 00:59:20,720 --> 00:59:23,720 LOVE YOU AND YOU SEE IMMEDIATE 1694 00:59:23,720 --> 00:59:27,360 RESULTS AND RETURNS ON 1695 00:59:27,360 --> 00:59:30,400 INVESTMENTS. 1696 00:59:30,400 --> 00:59:32,800 YOU ARE A LEADER AND THEN YOU GO 1697 00:59:32,800 --> 00:59:35,920 TO THE LAB AND AS YOU KNOW, I 1698 00:59:35,920 --> 00:59:38,720 JUST PUT IN AN RO1 RENEWAL AND 1699 00:59:38,720 --> 00:59:39,800 DIDN'T GET IT. 1700 00:59:39,800 --> 00:59:41,960 IT'S ALWAYS EVERY PAPER YOU 1701 00:59:41,960 --> 00:59:43,440 SUBMIT GETS PEER-REVIEWED AND 1702 00:59:43,440 --> 00:59:44,720 YOU ARE CHALLENGED AND THE 1703 00:59:44,720 --> 00:59:46,480 NATURE OF SCIENCE IS TO 1704 00:59:46,480 --> 00:59:46,840 CHALLENGE. 1705 00:59:46,840 --> 00:59:49,200 I DO THINK THAT THE THING WE DID 1706 00:59:49,200 --> 00:59:52,160 WITH THE BURROWS THE COACHING IS 1707 00:59:52,160 --> 00:59:52,600 INTERESTING. 1708 00:59:52,600 --> 00:59:54,960 MORE AND MORE PEOPLE ARE TAKING 1709 00:59:54,960 --> 00:59:57,320 ON COACHING AT THE LEADERSHIP 1710 00:59:57,320 --> 00:59:58,400 LEVEL AND THERE'S GROUP 1711 00:59:58,400 --> 00:59:59,000 COACHING. 1712 00:59:59,000 --> 01:00:00,880 SO THAT WAS ONE THING WE DID TO 1713 01:00:00,880 --> 01:00:01,840 TRY TO HELP PEOPLE TO PREPARE 1714 01:00:01,840 --> 01:00:03,360 FOR THAT RESILIENCE AND HOW DO 1715 01:00:03,360 --> 01:00:05,040 YOU DEAL WITH THAT REJECTED 1716 01:00:05,040 --> 01:00:08,880 PAPER AND THAT REJECTED GRANT 1717 01:00:08,880 --> 01:00:10,960 AND A LOT OF PEOPLE STRUGGLED 1718 01:00:10,960 --> 01:00:18,080 WITH OCD, ADHD, A LOT OF OUR 1719 01:00:18,080 --> 01:00:19,520 MOST SUCCESSFUL PEOPLE HAVE 1720 01:00:19,520 --> 01:00:20,320 THOSE THINGS. 1721 01:00:20,320 --> 01:00:21,520 SO, I THINK THIS IDEA OF 1722 01:00:21,520 --> 01:00:23,200 COACHING AND RESILIENCE SHOULD 1723 01:00:23,200 --> 01:00:26,760 BE ADDED. 1724 01:00:26,760 --> 01:00:27,880 THANK YOU SO MUCH THESE ARE 1725 01:00:27,880 --> 01:00:28,960 GREAT QUESTIONS AND I WISH I 1726 01:00:28,960 --> 01:00:30,880 COULD STAY FOR ANOTHER HOUR AND 1727 01:00:30,880 --> 01:00:32,440 ANSWER THEM ALL AND I KNOW WE'RE 1728 01:00:32,440 --> 01:00:34,080 RUN A TIGHT TIMELINE BUT THANK 1729 01:00:34,080 --> 01:00:34,240 YOU. 1730 01:00:34,240 --> 01:00:35,360 >>THANK YOU SO THE AUDIENCE FOR 1731 01:00:35,360 --> 01:00:36,880 BEING SO ENGAGE AND WE LOOK 1732 01:00:36,880 --> 01:00:37,000 FORWARD TO SEEING MARK A LOT 1733 01:00:37,000 --> 01:00:38,000 MORE ON CAMPUS. 1734 01:00:38,000 --> 01:00:50,560 THANK YOU, VERY MUCH, EVERYBODY.