Profiles of three young orthopaedic clinician scientists

They are a rare breed: orthopaedists who are not only passionate about patient care but also have a driving curiosity to advance the science behind the surgery. These clinician scientists, as they are known, juggle a clinical practice, a research laboratory, and a family life.

The 2008 Clinician Scientist Development Program (CSDP)—sponsored by the AAOS, the Orthopaedic Research and Education Foundation (OREF), and the Orthopaedic Research Society (ORS)—brought together 18 such individuals. Among them were Patrick W. O’Donnell, MD, PhD, a resident orthopaedic oncologist and traumatologist at the University of Minnesota; Carolyn Hettrich, MD, MPH, an orthopaedic surgery resident at the Hospital for Special Surgery; and Aaron P. Omotola, MD, a chief resident orthopaedic surgeon at the Louisiana State University Health Sciences Center will be completing a fellowship in arthroscopic surgery and sports medicine next year.

Interested in learning how to balance their research interests with patients and a family, these young clinician scientists took advantage of the opportunity to learn about available support and funding and the first-hand experiences of the program faculty.

Disparate interests
Before deciding on a career in orthopaedics, Dr. O’Donnell was actively pursuing hematology due to an interest in hematopoietic stem cells and “liquid” tumors. He always felt a calling to cancer patients, and his research focus has been tumor immunology. Through his research, he hopes to characterize potential mechanisms of sarcoma immune recognition. “I have found in orthopaedics a way to combine my research interests in stem cell biology and tumor immunology with my love for reconstructive surgery,” said Dr. O’Donnell.

Dr. Hettrich focuses her clinical practice on sports medicine, particularly injuries, diseases, and disorders of the shoulder and elbow. Her research interest lies specifically in clinical and translational basic science research of the shoulder. Dr. Hettrich took a year off from her residency to obtain her Master’s in Public Health and to research rotator cuff repairs. Looking at ways to improve the healing tendon-to-bone interface, her studies evaluate the effect of the mechanical environment, immune cells, cytokines, and rPTH on the healing process.

Inspired to become an orthopaedic surgeon to help people return to a higher quality of life, Dr. Omotola is aiming to have a research practice as well as a clinical practice in sports medicine. He has been involved in the AAOS resident liaison program and various specialty societies.

Money and mentors
“As a resident clinician scientist, I not only need monetary support for research, but emotional support as I take the road less traveled,” Dr. O’Donnell explained. During the CSDP program he found out about available research funding sources, including grant opportunities with the National Institutes of Health (NIH) and OREF.

Mentorship, which also provides significant support, was a key theme of the program. Constance R. Chu, MD, an active member of the AAOS Research Development Committee and past CSDP chair, discussed the importance of mentors. Mentorship, especially early in a career, has been associated with higher career satisfaction, higher rate of promotion, and personal growth. Dr. Chu explained that residents can have several mentors serving in various capacities throughout their careers, including scientific, academic, and lifestyle mentors. CSDP participants had time to meet with faculty mentors and candidly ask how they manage to do it all.

“The mentors at the CSDP are crucial to the program,” said Dr. O’Donnell. He was able to ask many tough questions of his mentor, John Healey, MD, a fellow oncologist and chair of the 2008 CSDP. “Dr. Healey was an amazing help. He and the other mentors were not only interested in my career goals and what it takes to achieve them, but they all showed great interest in me personally through their encouragement and advice in life outside of orthopaedics,” Dr. O’Donnell said. “That means a lot to me as a budding orthopaedic surgeon.”

Residents also looked to the faculty for advice on time management and balancing the various aspects of their busy lives. “With extensive responsibilities as a resident, my biggest challenge is finding time,” said Dr. Omotola.

Dr.Hettrich agreed. “The biggest challenge faced by a clinician scientist is how to find balance and excel both in your clinical practice and in your research. These both are full-time jobs that require successful time management and creativity to build a cohesive career.”

Achieving a balanced life
The challenge, of course, is achieving that balance. Serena S. Hu, MD, vice chair of the department of orthopaedic surgery at the University of California, San Francisco, and Regis J. O’Keefe, MD, PhD, chairman of orthopaedics and rehabilitation at the University of Rochester, each presented their personal views on the delicate work/life balance.

As chief of the spine service, Dr. Hu has an active clinical practice in all aspects of spinal surgery. She conducts research in spine biomechanics, disk repair and regeneration, and clinical outcomes and cost effectiveness analysis. She is also married and has two children. Dr. O’Keefe, who directs the Center for Musculoskeletal Research, is a dedicated oncologist, father of four, and author of nearly 200 articles, 300 abstracts, and 14 book chapters. He is active in the AAOS, the ORS, the American Orthopaedic Association, the American Society of Bone and Mineral Research, the Interurban Orthopaedic Society, and the Musculoskeletal Tumor Society.

The CSDP faculty served as both role models and sounding boards for the next generation of clinician scientists. “The presentations covered everything from research funding options available for residents to the honest trials and tribulations our mentors had to tackle in their training,” Dr. O’Donnell declared.

“The CSDP is unequaled in its aim to help develop every aspect of our career by educating us on our future clinical practices, research and funding, and finding balance in our lives,” said Dr. Hettrich. “Having a clinical practice and making substantial contributions to scientific knowledge is challenging; exposure to successful clinician scientists encouraged me that my similar aspirations can be realized.”

Words of advice
Dr. Hettrich recommends that aspiring clinician scientists obtain mentors early; she also encourages other young orthopedists to apply to participate in the CSDP and start looking at early funding and education opportunities through OREF and NIH. Dr. Omotola also emphasizes the significance of mentors and encourages aspiring clinician scientists to persevere to accomplish goals. “Instead of being discouraged by failure, use it to motivate yourself to achieve success,” he advised.

The time and energy it takes to balance a clinical practice, research, teaching, administration, family, and personal interests demand fortitude, determination, and perseverance. “There have been times in my career when I have tried to convince myself that a path other than that of a clinician scientist would be easier,” said Dr. O’Donnell. “I know, however, that those paths would not make me happy, as they wouldn’t fulfill my scientific interests. The field of orthopaedics needs clinician scientists more than ever, and programs like the CSDP will only strengthen the conviction of young orthopaedic surgeons interested in this career path.”

With the assistance of their mentors, Drs. O’Donnell, Hettrich, and Omotola are on the right track to making their dreams of doing it all a reality.

Erin Lynn Ransford is the research coordinator in the AAOS office of government relations. She can be reached at ransford@aaos.org

Funding opportunities for residents and clinician scientists
NIH Funding Mechanisms: http://grants.nih.gov/grants/

• Medical School/Residency: T32
• Fellowship: F32
• Junior Faculty: K08, K23, K99/R00, R03, R21
• Career: R01, R21, K24

Orthopaedic Research and Education Foundation: www.oref.org

• Resident Clinician Scientist Training Grant
• OREF/DePuy Orthopaedic Resident Educational Grant http://www.oref.org/site/PageServer?pagename=grants_homepage

Orthopaedic Research Society: www.ors.org

• U.S. Army Institute of Surgical Research
• Orthopaedic Extremity Trauma Research Program (OETRP)

American Academy of Orthopaedic Surgeons: www.aaos.org

• 2009 Clinician Scientist Development Program: http://www.aaos.org/member/csdp/csdp.asp

Ask Dr. Hu
Serena S. Hu, MD, provided CSDP participants with her personal perspective on necessary elements to achieve a successful, balanced life as a clinician scientist. Her list included the following element and techniques to achieve them:

Time to do research

• Avoid extensive other “academic” commitments
• Develop a research focus

Adequate laboratory support

Strong intellectual environment

• Maintain mentors
• Be part of a research group

Stable personal life

• Maintain important outside interests
• Keep abreast of current research
• Have passion; a desire to contribute