05/28/08

 

BY DIANE ROGERS

	Oscar Abilez

Oscar Abilez, MD, wants to look back on the days of inorganic stents and valves as a quaint era.

"Titanium, carbon-based material, Teflon, silicone—everything has been inert," he mused. "But over the last 10 years we've transitioned from nonliving to living replacement parts."

During his two years as a resident in general surgery at Stanford Hospital, Abilez assisted in thoracic and vascular surgeries, and he knows what dying heart muscle and blocked arteries look like. "That's what you do every day—you deal with tissue, and you know it has to be of this strength, this integrity, this function," he said.

Now, after putting the remaining three years of his residency on hold to earn a PhD in bioengineering, Abilez is trying to grow tissue that one day will be used to heal and renew the body's critical pump and its blood supply. "On any given day, we can take undifferentiated embryonic stem cells and start to process heart-muscle and blood vessel cells," he said. "You can look into the culture dish and nothing's beating, but when you come back the next day, it's beating on its own—it's fascinating."

Abilez is finishing his first year of Advanced Residency Training at Stanford, a program launched in fall 2007 that aims to promote bench-to-bedside learning by helping residents and clinical fellows earn PhDs. "It's about how we can bridge the work of laboratories on campus with what goes on in the hospital," said ARTS director Sam Gambhir, MD, PhD, professor of radiology, who participated in a similar program at UCLA.

Abilez is one of the first two ARTS fellows with two more set to begin this fall, but Gambhir expects the numbers to grow as word of the program circulates. Current residents or clinical fellows at Stanford are eligible, but must be separately admitted to a graduate program. More information is available online at http://med.stanford.edu/arts/.

The ARTS fellows can complete their PhDs at the end of their residencies or, more typically, two or three years into a residency program.

	Sam Gambhir

Research interests of future fellows, Gambhir said, will undoubtedly broaden: "One of the ARTS fellows has chosen to do her PhD in education, and we had someone who applied who wanted to do a PhD in philosophy."

At an annual cost of some $120,000 per fellow for five years it can take to earn a PhD, ARTS could be an expensive experiment. But Gambhir said School of Medicine Dean Philip Pizzo, MD, has agreed to have the medical school underwrite the cost as an investment in "improving our entire educational process."

Unlike students enrolled in traditional MD/PhD programs, who do their doctoral work while they're still in medical school, ARTS fellows have completed several years of clinical work before they start their research. "You definitely look at things differently," said Christine Ham, MD, who is in the inaugural ARTS cohort along with Abilez. "You've seen something at the bedside that doesn't make sense, and you can say, 'Let's look at it in the lab. Let's see, molecularly, what it means.'"

Gambhir said Abilez and Ham are just what the doctors at the School of Medicine and at the hospital ordered. "They have a commitment to medicine, and they bring to the lab environment a perspective on clinical issues and problems," he said about the two future physician-scientists. More importantly, "they really want to do research."

If Abilez's pulse quickens when he discusses his research projects, Ham beams like a proud auntie as she pulls out pictures to share from her labs. Tiny red and yellow clusters mark tumors in mice, detected with molecular imaging, that she hopes to wipe out. "I'm looking at a particular protein and how, by inhibiting it, we can treat metastasis in lung and pancreatic cancer." What's more, Ham hones her surgical skills with every mouse microsurgery.

For Abilez, landing the fellowship was like getting a second chance. "I always had an inkling that I might do a doctoral degree, but the timing had never been quite right," he recalled. Then his supervisor, Christopher Zarins, MD, professor of surgery, urged him to apply for ARTS. "I honestly thought I hadn't heard him correctly," Abilez said. He was concerned that his wife would object to additional years of schooling, but when they considered the full tuition provided by ARTS, plus a generous stipend and health benefits, the couple decided the timing couldn't be better.

Abilez and Ham are headed for careers in academic surgery, and hope to combine teaching and research with patient care. "The PhD program is allowing me to gain the necessary skills to successfully run a research lab, interrogate clinical problems at the molecular level and translate findings back to the clinics. It's the best of both worlds," Ham said. "There's creativity in the basic science lab, and you also have to be creative with patients and treatment. It's not just an algorithm."

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Diane Rogers is a freelance writer for the medical school's Office of Communication & Public Affairs.