Nurturing a New Generation of Clinician Scientists Ready to Combat Future Healthcare Challenges

Sponsored by Duke-NUS Medical School

In the wake of the COVID-19 pandemic, the world has witnessed a dramatically changing medical and healthcare landscape.

With the spotlight on global health and the importance of biomedical sciences, it has become apparent that now, more than ever, the world needs to better understand the molecular basis of new viral diseases, accelerate development of both diagnostic tools and novel therapeutic approaches to better diagnose and treat patients today, and be prepared for future healthcare challenges of tomorrow.

The key to impactful biomedical research needs strong links between basic and clinical science and industry leaders.

This is where clinician scientists or ‘Clinicians Plus’ (as Duke-NUS Medical School refers to them) come in. Doctors who are fluent in science, medicine and are able to facilitate a two-way process of translating scientific findings into clinical applications and clinical observations into basic science investigations are essential.

Clinician scientists are a small but critically important component of the medical profession and should be nurtured carefully so they can give back to the society through their expertise to advance healthcare. The path to being a clinician scientist is not an easy one as it combines clinical commitments with the demands of scientific research and the process is usually very long.

While Duke-NUS’s primary commitment as a medical school is to train outstanding clinicians or Clinicians First, they are in fact nurturing these competent, world-class clinicians to eventually become Clinicians Plus who will become leaders in the healthcare community.

Duke-NUS’s research efforts are also thriving thanks to the team of researchers, clinician scientists and PhD students who are all working hard to respond to COVID-19.

The Emerging Infectious Diseases Program at the Duke-NUS Medical School was among the first groups in the world to culture the SARS-CoV-2. It also developed and commercialized a world-first serological test to detect neutralizing antibodies rapidly.

It has also partnered with biotech companies to develop a therapeutic vaccine to treat and prevent COVID-19, respectively. Professor Ooi Eng Eong, Deputy Director of the Emerging Infectious Diseases Program at Duke-NUS Medical School in Singapore and his team are playing a significant role in these partnerships.

So, how does Duke-NUS, a research-intensive graduate medical school stand out as a training ground for clinician scientists and bringing such outstanding research into the community?

Is it the personal mentorship of high-level scientists and clinicians who supervise the students while being deeply embedded in the nation’s healthcare and biomedical ecosystem? Or the innovative curriculum that embraces the diversity of the graduate students’ prior academic training and work experiences to inculcate their unique insights and capabilities into their own clinical perspectives?

We spoke to Professor Ooi Eng Eong and two of his PhD students at Duke-NUS to find out.

State-of-the-art technologies can help address the novel capabilities needed to work as clinician scientists

Duke-NUS boasts many ‘first-in-the-worlds’ in its fight against COVID-19, and Professor Ooi believes the School’s world-class research has an important impact on its medical students, and the ways in which they are mentored and nurtured, as they train to eventually become clinician scientists. He said: “Access to technology and being able to build on foundational evidence from past research would be an excellent place for students to start their own research and develop their thesis.

“They will be able to experience the rigor of enquiry needed to glean new knowledge and sense the excitement of discoveries. Some students may even have the experience of witnessing their findings being translated into new vaccines and therapies,” he added.

A holistic perspective is critical when you serve as an interface between science and medicine 

While the latest technologies, such as advanced imaging tools, can be integrated into the curriculum, students need to see these technologies used in practice.

Because health crises, such as pandemics are generally quite difficult to predict, it’s important for medical students to understand which research methods, tools, strategies and pieces of equipment need to be used at different times and in different circumstances.

“Learning how to conduct research in an outbreak is like learning how to swim in a storm,” explained Professor Ooi.

“You have to put in your own effort but with a coach who will dive in to help you stay afloat when needed. Conducting research during an outbreak is also a great opportunity to learn to focus on the medical or health problem that needs to be solved.”

‘I hope to be able to balance clinical work and research so I see patients in the hospital and continue lab-based research’

A keen interest in microbiology led Dr Kwek Swee Sen to pursue his undergraduate education at the University of Wisconsin-Madison in the US, where he graduated with a degree in Medical Microbiology and Immunology. Afterwards, Dr Kwek enrolled in the MD-PhD program at Duke-NUS and graduated in 2019, having completed his PhD with Professor Ooi working on live attenuated vaccine development during the Zika virus outbreak in 2016.

“It was exciting to be working on a virus at the peak of its outbreak and to see how things develop. It puts your research into perspective and makes you think about how you can contribute to the rapidly evolving global climate with your research,” said Dr Kwek.

“Besides Professor Ooi, I’ve met and worked with many inspiring clinician scientists, such as my undergraduate research mentor at the University of Wisconsin-Madison, as well as Associate Professor Jenny Low, from the SingHealth Duke-NUS Academic Medical Centre, who continue to fuel my interests in infectious diseases.”

Dr Kwek is now a House Officer (Post-Graduate Year 1 Trainee) at Singapore’s Changi General Hospital. Although he isn’t able to get involved with the current coronavirus research at Duke-NUS, he reiterates the importance of having up-to-date and evidence-based information in order to advance any potential breakthroughs based on his experience studying at Duke-NUS.

Looking ahead as a clinician scientist in the making, Dr Kwek hopes to break into the field of Infectious Diseases, but keeps an open mind.

“I hope to be able to balance clinical work and research so that I can still see patients in the hospital and continue lab-based research for my future career. The biomedical research environment in Singapore is growing and I am optimistic that it will continue to evolve and be more amenable to clinician scientists who want to do both clinical work and research in the future,” said Dr Kwek.

‘While the threat of a pandemic is scary, it also has the potential to unite us'

Amanda Makha Bifani has lived in Singapore for five years and looked to Duke-NUS to pursue her PhD in Integrated Biology and Medicine, thanks to the School’s world-renowned research and cutting-edge technologies.

With a long-standing interest in tropical infectious diseases, an undergraduate course in virology, and keen interest in reading popular book titles such as Richard Preston’s Hot Zone and Laurie Garrett’s Coming of the Plague, Ms Bifani realized her ambition to pursue a career as a scientist in infectious diseases. 

“Another aspect of infectious disease that caught my attention is how ubiquitous it is. Due to the global health nature of my parents’ jobs, my childhood was spent in numerous countries around the world. My international upbringing, together with the current COVID-19 outbreak has made me realize that infectious diseases affect us all regardless of nationality,” said Ms Bifani.

“While the threat of a pandemic is scary, it also has the potential to unite us as human beings.”

As labs at Duke-NUS shift their focus to the coronavirus, Ms Bifani has been working hard to explore how the virus interacts and infects organs, as well as estimate its basic reproduction number (R0) in order to assess whether protective outbreak measures, such as lockdowns, have been effective enough.  

“It is definitely an interesting and exciting time to be a virologist and especially to be a part of the Emerging Infectious Diseases Program at Duke-NUS,” she said.

“People often tend to stick to one specific virus, but this outbreak has reminded us that basic skills, methodology, and infectious disease concepts are cross-applicable and transferable to other viruses,” Ms Bifani remarks, and Professor Ooi agrees in encouragement hearing this insightful comment.

After all, this is what Professor Ooi and other faculty at Duke-NUS imbibe in each student – think critically and broaden your approach so they can be effective in meeting the challenge of future healthcare needs in both Singapore and the rest of the world.

Lead image: Professor Ooi Eng Eong (center) and his team in their laboratory at Duke-NUS Medical School.