Not all surgical residency programs can afford having a resident step out of the clinical realm to pursue other academic goals. I was very lucky that I was encouraged to do basic science research in the Thoracic Aortic Disease Laboratory at the University of Pittsburgh. My pursuit of basic science research was based off of curiosity and desire to expand my surgical knowledge. Furthermore, as a surgeon, you help a finite number of patients. In the basic sciences, some discoveries can help an infinite number of patients. I was never really part of basic science research efforts, so this was new territory for me.
Starting research was the most difficult part of my time in the lab. I was tasked to formulate an independent project which took some time, as opposed to being placed on existing projects. This was quite difficult, especially with the lack of experience at the time. However, it solidified my scientific method and fostered a more mechanistic approach to developing my projects. I finally understood after many struggles and ended up receiving NIH funding through a F32 and finishing 3 years in the basic science laboratory. I remember one of my surgical mentors, who ran the lab, Dr. Thomas Gleason, telling me that my experience in the lab would change my experience as a surgeon and clinician.
Basic science research has helped me understand a pathology down to its finest details. It has helped me understand and formulate treatment options for patients using a scientific method, as opposed to just following guidelines. It has also helped me understand the deficiency of current therapies and helped me foster ideas on how to address these deficiencies. Though my research was on smooth muscle cell physiology and bicuspid aortic valve aortopathy, this thought process has pervaded into the whole realm of cardiothoracic surgery for me. I have noticed I asked different types of questions. Prior to my experience, I was always interested in how to do certain things. I am now equally interested in why we do certain things. In addition to this, during my time in the lab, I have improved my analytical skills. I am more equipped to critique both basic science and clinical research manuscripts. These analytical abilities are also used as I take care of patients. Once again, it has allowed me to think outside of the box in order to treat my patients.
Keswani and colleagues published a study in 2016 that suggested that there is a decrease in interest in the basic science research from academic surgeons. There are fewer surgeons applying for NIH grants and NIH funding to surgical departments have slowly decreased over the years. As someone who is graduating and hopes to pursue basic science research efforts as a surgeon-scientist, this is troublesome to me. As a surgeon, there is only a finite number of patients you can help throughout the span of your career. As a surgeon-scientist, the discoveries on the benchtop can potentially help an infinite number of patients. A prime example of that is Dr. Thomas Starzl. Many of us can only dream of accomplishing a minute fraction of his achievements. But he has shown us that as surgeons, we can operate and making lasting discoveries at the same time.
Patrick G. Chan, MD, MPH and Danny Chu, MD, FACS
Department of Cardiothoracic Surgery
University of Pittsburgh School of Medicine