Inside Cancer Careers

In this week's episode, we hear from Dr. Kenneth Gibbs on training opportunities at NIGMS, the importance of finding career success, aligning your values, and more. We then hear from Dr. Petria Thompson and Valeria Velez Galiano on being a postbaccalaureate fellow at NCI and the many opportunities at NIH that support your career journey.

Segment 1:

• Kenneth Gibbs, Ph.D.
• Maximizing Opportunities for Scientific and Academic Independent Careers (MOSAIC) (K99/R00 and UE5)
• Bridges to the Baccalaureate (T34)
• Undergraduate Research Training Initiative for Student Enhancement (U-RISE) (T34)
• Maximizing Access to Research Careers (T34)
• Postbaccalaureate Research Education Program (PREP) (R25)
• Bridges to the Doctorate (T32)
• Graduate Research Training Initiative for Student Enhancement (G-RISE) (T32)
• Initiative for Maximizing Student Development (IMSD) (T32)
• NIH Common Fund
• Diversity Program Consortium, NIH Common Fund Initiative
• NCI Cancer Prevention Fellowship Program
• The Invisible University: Postdoctoral Education in the United States
• Planning a Career in Today's Landscape
• From pipettes to policy: Reflections on a decade working to expand opportunity and equity in science

Ad: NCI Future Fellows Application System

Segment 2:

• Petria Thompson, MD, PhD
• Valeria Velez Galiano, B.S.
• Postbaccalaureate Intramural Research Training Award (Postbac IRTA/CRTA)
• NIH Postbac Career Services

Your Turn: Guests Recommendations:

• TV Show: New Star Trek: Picard & Discovery

• Play: Ceramics
• Podcast: Ordinarily Extraordinary
• Book: Misconceiving Merit: Paradoxes of Excellence and Devotion in Academic Science and Engineering

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host, Oliver Bogler. I work at the NCI in the Center for Cancer Training. On Inside Cancer Careers, we explore all the different ways that people join the fight against disease, and hear their stories. Today, we're talking to Dr. Kenny Gibbs from NIGMS, who has studied the biomedical career and developed and managed a series of key programs to support early career scientists from diverse backgrounds and shares his perspective on where we are today. After the break, we turn our attention to the NIH Postbac program and learn how participating in research at NCI for a year or two after your bachelor's can be a great experience and steppingstone. We have two guests: an alum and a current participant. Stick around to the end to hear how you can take your turn and benefit from the suggestions and recommendations made by our guests.

OLIVER: It's a pleasure to welcome Dr. Kenny Gibbs to the podcast today, welcome.

KENNY GIBBS: Thank you Oliver, great to be here.

OLIVER: Dr. Gibbs is the chief of the undergraduate and predoctoral cross-disciplinary training branch of the National Institute of General Medical sciences here at NIH.

He also serves as a program director for a portfolio of awards in the area of stem cell biology within the division of genetics, and molecular, and cellular, and developmental biology. Dr. Gibbs you've been engaged in programs to enhance diversity in the biomedical workforce for some time. And I wonder if we could start with what your assessment is of where we are with this important work in 2023.

GIBBS: Yeah, thank you for the question, Oliver. You know, I got poetic, it was the best of times, it was the worst of times, I don't know if it's necessarily the worst of times. But I think, you know, I'm dispositionally optimistic. And so, I see clear progress on a number of fronts. And so, some of this work I've done and published, but you can look at, for example, where we were as it relates to better engaging the entire population, including those from underrepresented groups, you know, three or four decades ago to now. And there's a clear increase at all levels. Now, there's still also clear gaps between sort of the available talent pool and the talent pool people who get biomedically relevant bachelor's degrees or research focused higher degrees. And so, in that respect there is progress, we also haven't fully actualized our desire to, or really the imperative to make sure we have all available minds on the playing field, right? Because that's how we identify and then go about solving complex biomedical problems. You know, I just say, through time, you know, there are varying currents and so there are different currents at various levels of government, which I won't elaborate on, where there are both efforts to advance these issues rapidly and then efforts to focus on a vocabulary and other things like that. And so my main work is focusing on continuing the work of ensuring we enable opportunities for promising trainees from all backgrounds, all meaning all. To participate in the biomedical research workforce. And then one thing I'll note is, a number of positive NIH-wide initiatives and one that I've been involved in very recently is the MOSAIC program to promote faculty diversity, which many ICs participate in. And so we've been able to, you know, through that mechanism, really encourage a broader more representative pool of PhD level scientists and postdocs. To come into the K99 pool and many of are going on to great jobs in their own right. So, I'm dispositionally an optimist, I think this line of work requires you to continue to look on the positive, while dealing with some of the challenges, but that's where I say where we are right now. We've made a lot of progress, but still much work to do. But we will make it.

OLIVER: So, you mentioned the MOSAIC and you also mentioned that it's a K99, so maybe just for our audience who may not be familiar with that mechanism. What is the K99 specifically and what is the MOSAIC version of that program that you built?

KENNY: Thank you so much. I've worked with colleagues NIGMS and across NIH on this effort. So, MOSAIC stands for maximizing opportunities for scientific and academic independent careers. And so, my job as you mentioned is chief of the undergrad and predoctoral cross disciplinary training branch. So we lay the groundwork for developing future scientists, innovators. Right, and so we do a lot of work at the undergraduate level, a postbac level, masters, and PhD level to say, let's make sure we're creating an environment where we can enhance institutions and support trainees from all backgrounds representing that recognizing there might be some differences and approach that might need to be taken based on, you know, individual experience. And so, we've done a lot of great work there, but what we realize and I'm a product of some of these programs is that, once you get to the postdoc level a lot of the infrastructure to expand opportunity and broad participation, wasn't as structured. So MOSAIC uses a mechanism that NIH has for a long time. I guess for about 15 years now called the K99/R00. And that says, hey, you're a postdoc, you need maybe two more years of training before you're ready for independence. And so we'll give you an award for those final two years, followed by a three-year award that you could start your independent research career with the R00. You know, NIH had had that award for a long time but, you know, when you looked at who even applied at the parent K99 it was fewer than 7% from, you know, historically underrepresented racial and ethnic backgrounds, like Black or African American, Hispanic, or Latin, American Indian, Alaskan native. And about just a 1/3 were women, across any racial ethnic group. When you consider that women are more than 50% of postdocs, we're saying there were gaps in even who was applying. And so when you have gaps in who applies, you have gaps who gets awarded.

OLIVER: Of course.

KENNY: And so, we said, here it's, hey let's create a new mechanism that rewards your science and that rewards efforts to enable broader participation at your institution. So, we know that many scientists, especially those from underrepresented groups are often doing additional academic service work even when they're grad students and postdocs to create a better opportunity. We also know those efforts aren't always appropriately recognized in scientific review mechanisms. And, you know, it takes time, and everybody has a certain amount of time. And so that might actually ding your productivity a little bit but, you know, in time if you can sort of say, let's support both of these efforts and recognize both of these efforts, you allow people to persist within the enterprise. So, what this is a K99 award that recognizes science, as well as contributions to enhancing broader participation. And then we also pair them, the individual awardees in cohorts with scientific society partners, to provide additional mentoring networking professional development. Because what I like to say is that everybody needs to the same things. We all need mentors, we all need networks, we all need strong peer groups. Different people are able to get that in the environment by and large and individuals from certain backgrounds, especially those that are underrepresented, often don't get those by the way the environment is structured. So, we're really just creating a parallel structure to support scientists from all backgrounds, including those underrepresented. And progressing into independence.

OLIVER: What you just said there is a recognition that I think is relatively recent right, I mean in historically perhaps NIH has supported the science and the scientific endeavors of people on early career mechanisms. But now we are recognizing that they need more than that, they need support, they need connections, they need some soft skills, all the things that you mentioned.

KENNY: Yeah, and networks, peer groups, you know, I think broadly, right, when you think about it, for everybody, right, the postdoc is sort of the first educational training stage where you kind of go in as an independent person. Right, because K-12, undergrad, grad school, you enter as a cohort postdoc, enter as a singleton, similar with a faculty career. But you don't stop needing peer groups, and support, and mentoring, and networking. And so, yeah, it's really just saying, let's just use what we know and use it to continue to support folks that we supported earlier. A number of them had been previously supported by you know, F31's, including the diversity version, diversity supplements, some of have been supported by, you know, the sort of mainline T32 training programs, R25s, which is the alphabet soup of mechanisms if you're not familiar. But what we're saying is that people that we supported earlier are finding an additional on ramp and we've been able to attract a number of people who've not previously had any level of NIH support. And so I think it's great and we see the pool of people who was applying, more than three quarters of them have been women. About that same number have been from historically underrepresented racial and ethnic groups. And so, then of course when we have more diverse pool, we have much more diverse set of awardees. And so, it's been a delight to be able to work on that with my colleagues in NIGMS, as well as many colleagues across NIH.

OLIVER: So, of course you have many other programs, you mentioned already I think in passing that you've focused a lot on the phases that come before undergraduate and so on. So, can you tell us a little bit about the programs that you lead there for NIGMS?

KENNY: Yeah, I get to work with a great team of program officers and so there's a lot of programs, but mainly they are at the undergrad, postbac, masters and then PhD level. At the undergrad level we start at the community college level. A program called Bridges to the Baccalaureate. And so that supports partnerships between community colleges and four-year institutions. Again, allowing those who are starting at the community college level to be then in a structured program, to allow them to transition to a four-year institute and then hopefully, graduate with a STEM degree. MARC and U-RISE, are sister programs, they're at different institution types based on the amount of NIH funding they have. But really those takes sophomores, juniors and seniors who have a clear interest in getting a research-focused higher degree, like an MD PhD or a PhD. And again, provided a nice, structured training program, an environment thinking about, peer group, how do they help develop their identity, self-efficacy, provide opportunities for research both at their institution and at external institutions. And again, those programs are great and they, you know, provide kind of a starting ground for the next generation of scientists. Then we move to the postbac level. And so, we have there our candidates who finished their undergrad degree. They're interested in their PhD. And they either, sometimes, you know, haven't yet had the level of research experience that they would want to be competitive and so they get a year, sometimes two, but a year structured activity, where they spend most of the time in their lab and then, again, these networking cohort activities. And then they move on, I think it's the last analysis was like 75% of them move on to get a PhD, which is great. We also have another bridge program at the master's level and so some people use the postbac route, some people use the master's route to get the additional skills they want as they prepare themselves for the PhD. So again, that's a partnership between a master's degree granting institution and an institution that offers biomedical PhD's. And then finally at the PhD level, so NIGMS is well known for our discipline area, our basic biomedical T32 program. So those provide training within the discipline, like genetics, chemistry and biology interface, molecular medicine, biostatistics, things like that. What these programs are, IMSD and G-RISE are cross-disciplinary. So, what they're really aiming to do is to provide additional, to strengthen the research training environments. And to really enable broader participation and so thinking about, you know, are there people within these disciplines for whatever reason who might be more likely to have challenges in acclimating and feeling that they fully belong in the environment. And then how do we create some additional wrap-around activities and structures, so they have what we know that everybody needs, a peer group, a set of strong mentors and things like that. So, I feel really fortunate to be able to, you know, do the work that I do and work with people that I work with. Because I think it's just, really important and, you know, we can see alumni from these programs doing all sorts of great things, a number of them have been, you know, gotten NIH research project grants, R01, R35's, whichever alphabet you want to use. Have gotten other prestigious awards from foundations and even a number of them have gone on to, you know, be Howard Hughes investigators and things like that. And so, these programs have been going for a long time, I mean some of these are older than me, at least in some versions of them, there was an early version of the MARC program. And so, I feel privileged to be able to steward this legacy and the last point I'll mention is that I actually first was an NIH funded person through the MARC program. And so, an early version of the MARC funded me a few decades ago, when I was an undergrad at the University of Maryland, Baltimore County. And so, it's just, you know, it's kind of wild to go from being supported by the program to then overseeing that program and a number of other ones. But I just feel privileged and blessed to be able to do what I'm doing.

OLIVER: It's certainly an interesting trajectory yeah. So, beyond what your work at NIGMS thanks for sharing that with us. You also work with the NIH common fund and have helped develop programs there. Before we go into the programs can you tell us a little bit about what the common fund is?

KENNY: Oh, that's a great question. The common fund is, really as I think about it, it is funds used by the NIH director to address critical, scientific, and biomedical problems. Or opportunities, if you will, that are beyond the span of one or just a few institutes. And so, all institutes and centers at NIH pay into the fund and then there's an elaborate process which I'm not fully a part of, or aware of how it happens. But then you know, a number of concepts come out to really tackle in an evidence-informed approach to really tackle some of these NIH-wide, problems that are of NIH-wide importance that no single institute might have the resources to or really should be tackling on its own, it should have NIH-wide partnership and leadership in moving it forward.

OLIVER: So, what are the programs in the common fund that you've been engaged with?

KENNY: Yeah. So, we have, at NIGMS we have for the last I guess nine years managed what's called a Diversity Program Consortium. And what this is intended to do is really take an evidence-informed approach to both developing the future scientific workforce, developing faculty, and developing institutional capacity. And so, there's a number of different components called BUILD, which focuses again on those three levels, a number of different, you know, approaches at ten different institutions, ten different sites. Thinking about, what are different approaches that we could take to developing students, faculty, institutions, and that can be the University Alaska, Fairbanks, using a one health model to try to integrate indigenous ways of knowledge into biomedical research training. Keeping Morgan State, trying to use an entrepreneurial model to better engage. The BUILD programs also focus on, you know, developing faculty capacity to be mentors who have the skills, because again, mentoring is a skill set that individuals can learn to be able to be more effective for a wide variety of students and to develop the skills to more successfully compete for NIH competitive research support, as well as the institution. How does the institution develop the facilities and other capacity to sustain these efforts? There's also the National Research Mentoring Network, which has a number of different projects on the science of mentoring, as well as a number of different projects around how to best equip trainees with the skills they need to be able to effectively navigate the workforce. And then there is the CEC, which is the Coordination and Evaluation Center. Which really takes an approach to harmonizing these various projects under a shared set of hallmarks of success. And evaluating the impact of these projects, you know, broadly across the consortium. Because again, it's a consortium, not just you did this one thing, you did this one thing. But as we take these different approaches, how do we then move forward and again using a rigorous evidence-informed approach, to say, well what works for whom and where? And then how can we, importantly, because it's the common fund, then use that to inform the training programs across the NIH institutes and centers.

OLIVER: Really trying to, yeah, and including NCI, right, really trying to affect system change.

KENNY: Exactly, yeah, through these experiments. Right, we always note that these, like every other common fund program it's not going to, quote unquote, solve the problem. Right, a ten-year program at a few different sites is not going to, you know, shift everything that that has happened for the last 40 or 400 years depending on how you're counting. That said, you know, it can and is being used to then inform how we evaluate our own programs going forward and how, I think if you even ask applicants to further articulate as they're designing the programs, they have to train the next generation, expand opportunity, etcetera.

OLIVER: So I'm curious about your path. You're clearly working now on a variety of

different venues and I'm sure you've had experiences of your own that inform what you're doing today, but I'm curious about your own path. How did you first get interested in science?

KENNY: Very interesting question. Yeah, and so, you know, when I was a kid, I was really into meteorology. Some may say I still have my head in the clouds. But I was really interested in how the world works. I will set my story in a broader story, so I'm descended from enslaved Africans here in America. And so, you know, my family lived through slavery. My grandparents grew up in the Jim Crowe South, my grandfathers have fourth and eighth grade educations. My parents were able to go to college in the '70s through a program called Upward Bound, which is designed to help promising students from low-income backgrounds transition and succeed in higher education. And so, public investment changed the trajectory of their lives and by virtue of me being their child, changed the trajectory of my life. Because then I showed up and my parents was like, you know, you'll go to college. So, I remember being four talking about going to college, didn't know what it was, but I knew I was going to go there. And they also, I grew up in a Christian home and so big on the idea of to whom much is given much is required. And so, it's like, you know, you've gotten a lot, Kenny, like use what you have for service and so those were sort of the big points that oriented my world view. I also liked science and it was, quote, unquote was good at it. But, you know, if you're good at science then your attracted towards being a medical doctor, because that's a way to help people. But I had a number of teachers, and I grew up in Durham, North Carolina, so I actually had black science teachers in middle and high school. And they saw promise and so they encouraged me to do some precollege research programs. But because I grew up in Durham my high school jobs were working in labs at Duke and UNC.

OLIVER: Nice.

KENNY: And so, one of the speakers said, you know, if you're a medical doctor you'll likely treat 10,000 patients in your lifetime. The person who discovered penicillin has treated billions on every continent for the last six decades. And I was like, whoa, I can do use science to help people, I was 15, so I said I will cure cancer. I have a more complicated view of how that works but, you know, I was like we're going to go forth. And so yeah, that set me trajectory, I was at the University of Maryland, Baltimore County. With the support from, well, the university's Meyerhoff Scholarship program, which is a national model for, again, enhancing broader participation in the biomedical research workforce, actually in STEM broadly. I also had support from MARC program that I mentioned earlier, NIH, NIGMS and Howard Hughes. And then, yeah, I was on my way. So, I did cancer immunology work as an undergrad. Did my PhD in immunology at Stanford. And again, there I was looking at stem cells in the blood during normal blood development and during leukemia, or blood cancer. So, always been with this nexus. And I would just say, you know, I written about this kind of going from pipette to policy. You know, the further my training progressed I felt farther from the reasons that I went into science, because my reasons were using science for public benefit. And by public meaning all the public. But I wasn't seeing that before me, in the miles before me and it's not a knock on anybody, it was just sort of the value systems of the institutions that I saw weren't really about that, they were about, you know, kind of building your own little fiefdom and making yourself best known for a very focused area of science. Which is, that wasn't exciting to me. And then I also saw my friends, who had also gone through these training programs and three of my friends who were very accomplished black women scientists at institutions that had publications in the fancy one-word journals. A number of them were leaving science, because they had such bad experiences in grad training. And one said, you know, I'll stay in science, but I'll never do academia, I thought well this is kind of a waste, this is a tragedy for them and a waste for all of us because we can't benefit from their perspectives. And then I saw some of my other colleagues who were white guys also leaving and I was like, well what is happening, why did everybody making the decisions that they're making? I said that just because so much of the effort has been on getting, especially if you talk about underrepresentation, get folks interested early and support them early. With the idea being that once you get the degree –

OLIVER: Everything's good.

KENNY: All the challenges that existed until then go away. And I am of a generation like these programs that kind of maturity and I was like, no, we have PhD's from, you know, Stanford, and all peer institutions and publishing in Science Cell Nature. No, like we can do it, you're not creating an environment where people with choices feel like that, they should choose that. So anyways, I came to DC as an AAAS Science Technology Policy Fellow. I said, you know, maybe I can try to fix it. I figured I'd do a one-year thing and then go back to my postdoc at Harvard, and I had it all, you know, the very well-known stem cell lab, the 30 postdocs, I like might be one of the three to get the brass ring out. But I worked at the National Science Foundation, the director for education and human resources, now called STEM Education. And really there I was able to work with a colleague, Kim Griffin, to, who's now the Dean of Education at the University of Maryland School of Education. Then she was an assistant professor. But I worked with her to really start to study, why do PhD's make the career decisions they make. And I tell people, I was like, this can sound esoteric, but we spend a lot of money trying to shape the career decisions of PhDs specifically to both generate, you know, develop the people, and then shape the choices they want to make. And I hadn't, I'd seen a lot of literature, K12, some undergrad, some grad. And some when you become a faculty but not in that, as I call it PhD to j-o-b land. Where, we worked and we got a number of different papers published. And interestingly, the very first weekend when I was an AAAS fellow, I met Neil Freeman from the NCI intramural. And so, his wife was an AAAS fellow with me. I met him at a picnic. And he described the Cancer Prevention Fellowship Program to me. And so, I just got to DC, but I said, if I ever do a postdoc that's probably the one I would do, because it's the only people who probably take me given all my varied interests. And so, you know, a year later and I in an AAAS fellowship I needed to figure out what I wanted to do. I had met my now wife, then girlfriend and I was like, okay, I think I should stay in the area. Just hit ten years, yay! So, …

OLIVER: Congratulations!

KENNY: Thank you! And so, I had applied for the cancer prevention fellowship, which allowed me to move in this direction of, I called it policy science, so thinking about, because my PhD training trained me to think about things rigorously at a kind of individual level. That allowed me to think more population systems level. And then, long story short, continued to publish on the work that I was doing. And then applied for a position at NIGMS, National Institute of General Medical Sciences, where I am now in the data and policy office. Was there for a year, published some more and then, you know, moved in the direction of program officer mainly because I thought I could have an impact on shaping how, you know, understanding it better I thought I would now move towards shaping how the money is spent and what we think about that. And I've had a great time there, been very fortunate, the director John Lorsch, the Division Director Alison Gammie and everybody has been very supportive of me. And so, the program officer had different roles and now I'm a branch chief, meaning I oversee a team of program officers and a team of programs.

OLIVER: Amazing breadth of experiences that you've had I have to say. I'm jealous, you really followed your passion. I want to pick up one thread though, so you mentioned that you observed peers and friends who were very accomplished, getting great papers, doing their graduate work at fantastic institutions, deciding to leave science because of the environment, and that seems to me is a direct line from there to what you've been working on and you told us a little bit earlier, which is to develop programs that support diverse scientists when they come into research environments. It's not enough to attract their attention and recruit them, then you have to really work hard to support them. Is that correct?

KENNY: Correct. Yeah, totally, right this is basic human nature. And sometimes, we live in America, we've had slavery, a civil war, Jim Crowe, and we continue to have challenges making sure all of us, meaning like literally all of us can fully participate in any sphere of life here and both contribute and benefit from the great aspects that come here. So, it also happens in science in America. Around the world too, but I'm just focusing here. And so, yeah, it's totally correct in thinking about, you know, how we can actually move forward, which for me, because sometimes, especially when I was publishing more, but even now, you know, and I'd say especially in 2020, after George Floyd was murdered, without exaggeration I got like 25 speaking invitations to help institutions, scientific societies, like how do we fix it? I was also home with my kids during COVID, I was like I do not have time to talk. I have written about this. But, you know, what I wrote at the time, and I still think holds is sort of listen to people. Because there are variations on a theme, but some environments might be doing well on some aspect but no other aspects, right? So, listening means like understanding what's happening and listening to the people who are there, about the challenges that they are dealing with. Acknowledging what they are saying. Which can come with discomfort, because, my observation is that many scientists want to, many, not all, but most of the people in the field want to do well. Most want to support all the trainees and most don't want to be perpetuating any forms of individual and systemic bias. But acknowledging means that, we sometimes make mistakes, right? Like my good intentions are not the same as a good outcome. And this happens in every relationship context. And then after you listen, acknowledge, you have to act. Right? Which is where we sometimes fall short, because like just, you know, like hearing people and feeling sad is not enough. You have to actually then use the resources that are available to create an environment that will then help our articulated values to become enacted values. And again, I don't say it as the person who has it all figured out or pointing my finger, because in every context I'm in I'm like, oh, here are things I'm messing up, I didn't realize that. But I try to say, hey, let me act. And so, I think that's what is, but you have environments. And again, you can tell our racial, ethnic underrepresentation, which again, I think is one of the hardest problems we've had to deal with. Because usually people say, oh we just need more, get more folks interested. And I say, okay well let's look at gender in science. And so, you see women have been more than 50% of PhD's for two decades now, and still about a third of the new investigators. So, I was like if you have a gap when you have more than half the population, maybe it's not numbers. Maybe it's how people are experiencing both science and science within the sociological context of the different systems that you have so. Yes, I'll stop there. But I, you have to actually support people, the actual people that are there, that you're looking at and like listen to what they need. Which also means, not presuming what they need, but just actually asking.

OLIVER: Right, right. Actually yeah.

KENNY: Because everyone's like, I know you need that and I'm like, no, I don't, I'm good on this, I need you to do this thing. So.

OLIVER: Supporting in the way they need to. I want to take a small pivot, we've talked about all different kinds of career stages. And you mentioned that you're focused right now in your current role is a little bit earlier. But you've also had a passion for postdoc training right, you lead NIGMS's postdoc research associate training program.

KENNY: Mm-hmm.

OLIVER: You served on the board of the National Postdoc Association. I feel that the postdoc phase of the biomedical career is in a particular moment, you know, today in the summer of 2023 as we speak. I wonder what your take is. Where is postdoc training today?

KENNY: Yes. I agree, we're having a moment. Yeah, some of us, you know, like the postdoc apocalypse. You know, and I'm not saying that to be cavalier, it's just like those are some of the headlines you read and then sometimes I'll take to investigators and say, you know, I can't now find the 20 postdocs that I use to be able to find. Which can cause the question, did you need 20 postdocs? But the market has changed, and I think science is a passion for many. It's also a vocation. And so, when I think about sort of broader labor market changes and these are things that I don't have an answer to and this is just me as an observer and not as an official of the NIH, right. But you've seen students and postdocs striking across the country saying, we need better working conditions. And that's sort of a broader movement of people organizing in labor. So that's a moment that's happening. There are additional opportunities as it relates to moving directly from PhD to career. Whereas a number of organizations would say, hey, you do a postdoc for a few years before you apply, now a number, particularly in the private sector are taking people right out of grad school. So that the alignment or misalignment between the number of postdocs and the number of the types of faculty positions that mean those postdocs wants continues to be an issue. And I mean, this has been talked about, you know, I graduated more than a decade ago, I was a postdoc a decade ago and this is conversation we were having then. And when I was doing my work at NSF I looked at publications from the '90s and the '60s. There was something called the invisible university. Right? And so, so in some ways I say, hey, you know, there's nothing new under the sun. And there's new attention, but there are new opportunities for people. And so, I think it'll be interesting to see how this all shakes out. I know the NIH central is doing a sort of study on what's happening with postdocs and so, have a panel. So, we look forward to hearing what NIH announces how institutions move forward and then how individuals are able to move forward. And I think at the same time that you're having all this structural issues, you still have issues of, we want postdocs from all backgrounds to be able to move forward, and especially those who have been, from underrepresented groups to, if interested have the pathways to move forward. Right, and so you have oftentimes these cross currents, or you have this sort of structural aspect, or also continuing to focus on longstanding issues of, for example, underrepresentation in the workforce. So, yeah, it's hard right, like we think about postdoc life of course. I had my first kid when I was a postdoc. And so that does, it does focus the mind a bit, it focuses the mind and the finances, especially in the DC area, where childcare is exceptionally expensive. And so, you know, I have sympathy for people when they're trying to navigate because you hit, you know, life course. People in their late 20s to mid to late 30s, which is the bulk of people in postdoc. Like, there's life, there's family formation, there's all these other things that are happening that pull on people so, yeah. If you're a postdoc listening, keep up the good work, we're cheering you on. And, you know, always reach out, there are ways that we can be helpful and help you navigate. And be even aware of what they actually try to help navigate. Because sometimes people don't know. Oh, I can get this kind of supplement, I can get this sort of thing so. Yeah.

OLIVER: That's great advice. And I mean I think you put your finger on it when you said that being a scientist is a passion, it's a vocation, right, it's a calling in that sense and I think,

it's, probably not often enough talked about, that that is something incredibly valuable to society, as well as important to the individuals. So, we need to think of ways of focusing our attention and then nurturing that in people.

KENNY: Yeah. I want to say that like don't say, because sometimes people say, oh it's your passion and it's like, yeah, I got to eat, I got to like pay my bills. And so sometimes people like, oh but you get to do your passion, I was like, I understand it's difficult for people to pursue a passion if they don't feel that they have, you know, kind of was in Maslow's Hierarchy of Needs. Right, if you don't feel like you can meet your basic sort of financial and then by implication, relational needs, you know, particularly if you're any sort of relational context, whether it's, you know, whether it's partner, a child, parent, a grandparent, a sibling. Like people have all sorts of things going on in their lives right? And so it's a passion but it's a vocation, meaning like it's a, there's a job and people need to be able to have appropriate remuneration for what they're contributing.

OLIVER: Yeah, thank you, thank you for pointing that out. I certainly, didn't mean that because it's a passion that you should do it for free.

KENNY: No, I know you don't, but I've heard that.

OLIVER: People, yeah, no that's –

KENNY: It's like, oh your passion and it's like, no, folks got to eat. Right?

OLIVER: Exactly. So, in closing then Dr. Gibbs, I wonder what advice you would give to someone who's listening, who might be thinking about a career in biomedicine, might be earlier on. What's your advice given all that we've talked about?

KENNY: Yeah. I'd say there are a lot of opportunities, right? And so, if you're interested, I mean think about what we're doing now. We've had a COVID vaccine in less than a year. We're CRISPering all sorts of things, right, like there are new treatments for cancers, new fundamental discoveries on any number of various, you know what I'm mean, stem cell biology grant, like oh look at this is very interesting at how you can think about developmental plasticity. So, what I say is that there are a lot of opportunities. There are challenges, but the thing is, there's challenges everywhere. Right? And so, one of my friends is always saying, you know, the grass may be greener on the other side, but you still have to mow and water. Right? And so like, every field, whether it's, you know, academia, industry, government has things that are wonderful about it, and things that are challenging. And so, my thing is, and I think it's really important to understand what the options are. And then and I wrote about this with Kim Griffin about a decade ago, really think about your values, because a lot of literature that, in the context where you can make choice about your career, to the extent that you can align the work you're doing with your own values, like what's important to you. Then you will very likely sort of find the career success and find longevity. Right, and so if you say, this is what I really want to do, whether it's being able to do discovery that I can hopefully just direct, being able to work on the cutting edge of pharmaceuticals, being able to work with students. Being able to pay my bills, like, I struggle, I don't want to struggle, I don't want my family to struggle. Right? As long as you are clear on what your values are, then you can make choices that are informed and align with those values. And when I managed the intramural postdoc program, I know one of the scholars he said to me like, I've never actually been asked to think about my values, right, I added the question on the individual development plans like, what is it important to you? Think about it. Does a career you say you want to pursue, allow you to pursue the things that important to you. If not, you should at least be aware of that tension, because it will come up and, so, I think this values piece is really important and it's often under-discussed. There's a lot of opportunity, know your values and then finally network, network, network. It's really, really important. Because what you know helps you get through, you know, helps you stay there, but who you know helps you get in the door. So, I think that's good, I'll leave it there. About ten years ago I wrote something in Science Careers, I'll send it to you, or you can look in the show notes, called Planning a career in today's landscape. And there it has some tips that I think still are resonant, but, yeah networking is one and then go for it. Actually, I'll stop there, because my mother, Laura Gibbs, would always say, never self-eliminate, make other people tell you no. And so, you know, I just kind of go for it. A lot of people do say no, but enough people say yes and so keep going for it, you know, rejection is part of life. The only people who don't experience it are the people who don't try anything. And so, yeah just go for it.

OLIVER: Thank you so much Dr. Gibbs. Thank you for sharing all these insights and this breadth of experience and knowledge. It's a really valuable information, thank you very much.

KENNY: Thank you.

OLIVER: And Dr. Gibbs actually mentioned the show notes, so we're going to put a lot of stuff that you've heard about, lots of touch points in this conversation into the show notes so you can check out the links there. Stick around, after the break we're talking to two scientists about the NIH's postbac program and how it can give you a chance to experience research and prepare you for your next steps towards a career in biomedicine.

[UPBEAT MUSIC]

OLIVER: The NCI is the US federal government's principal agency for cancer research and training and conducts a broad range of research in its Intramural Research Program. If you are interested in gaining research experience and training at NCI there is a great first step, you can take. Here with me to tell you about that is Chanelle Case Borden, Associate Director of Training Programs in our Office of Training and Education.

CHANELLE: Thanks Oliver! We are talking about a webpage called Future Fellows where you can submit your CV or resume if you are interested in a postdoctoral, doctoral, or postbaccalaureate fellowship here at the NCI. And that's at both, the master level and post-college level. We will put the link in the show notes, but you can find the webpage by searching for "future fellows NCI." At the site, you can tell us about your research interests and also indicate a division or center that you would like to work in.

OLIVER: What happens once someone has submitted their material at the site, Chanelle?

CHANELLE: Once you are in the database, any research team leader at NCI can see your application for the next six months. If they have an open position that fits your indicated interests, they will contact you directly to arrange an interview. A question we commonly get is when are positions available. And generally, most postbac and postdoc positions are available on a rolling basis. However, the fall and the winter is generally a time where we see a lot of postbac hiring and that usually begin the following summer. Internally, we are always promoting the use of Future Fellows to our investigators and staff to fill their open positions. So, if you are considering completing training at the NCI, I encourage you to submit your information.

OLIVER: Great, thanks Chanelle. So that's Future Fellows on the NCI's cancer.gov website – check it out and submit your info today. You never know where it might lead.

Welcome back. Now, we're turning our attention to NIH's Postbac program, formally known as the Postbaccalaureate Intramural or Cancer Research Training Award. It provides recent college graduates who are planning to apply to graduate or professional school, like medical, dental, pharmacy, nursing or veterinary, an opportunity to spend one or two years performing full-time research at the NIH. Postbacs work side by side with some of the leading scientists in the world in an environment devoted exclusively to biomedical research, a great way to see if science is for them. I'm delighted to welcome two guests to the pod to talk about their experiences in the Postbac program. Dr. Petria Thompson is currently a resident in radiation oncology at the University of California San Francisco. She obtained her MD and her PhD from Vanderbilt University and her BA from Emory University. She is an alum of NCI's Postbac program. Welcome.

PETRIA THOMPSON: Thank you so much for having me.

OLIVER: Also with us is Valeria Velez Galiano, who is a current Postbac in the Laboratory of Receptor Biology and Gene Expression in the NCI's Center for Cancer Research. She obtained her bachelor's degree from the University of Puerto Rico in Arecibo. Welcome.

VALERIA VELEZ GALIANO: Hi, thank you for having me.

OLIVER: Petria, let's start with you. I'm curious what first sparked your interest in science and medicine?

PETRIA: A long-winded story, but I entered undergrad thinking that I was going to go to divinity school, actually. And in that process, I was taking a psychology class, and we were having long discussions around, you know, behavior and what influences behavior. But there was also a segment where we were talking about receptors and serotonin and dopamine and how all those things work. And I realized that the majority of the class was more focused on the chemistry and the biology behind behavior, and that kind of sparked an interest into, "Hmm, I wonder what this is all about." So, after about a month or so into my undergraduate experience, I'd say probably by the second semester, I ended up reaching out to one of our chemistry professors and started working on a project, not really related to behavior but related to chemistry in general. And that kind of sparked what has been a long journey that will not end anytime soon into science. Yeah.

OLIVER: Interesting. Valeria, how about you?

VALERIA: Yeah. So, during high school, I had the opportunity to volunteer at a veterinary clinic. And, you know, it was mostly, like, cleaning and that kind of stuff, but this day, like, a rescue puppy came in. And so they were, like, doing a bunch of tests, and I was around. And they were like, "Oh, come join us," and "Come and see this." So, they, like, took a blood sample to check the puppy's health. And they were, like, "Oh, look through the microscope." And that was just so eye-opening that I was able to see, like, the red blood cells and everything. And then there was, like, this little weird, like, darker spots, and they were like, "Oh, those are parasites." And I was like, "What? This is just so cool that you can just, like, right now, just taking, like, the blood out of the puppy." And so that really sparked an interest and then it led me to, like, do my undergraduate degree in microbiology, too. So, that was, like, really cool for me.

OLIVER: So, now, Valeria, you're working at the NCI. You're doing cancer research. Why cancer?

VALERIA: Yes. So, like, starting my undergrad, cancer research wasn't really an interest for me. I was doing mostly research on bioremediation, like, more environmental kind of stuff. But then, like, the diagnosis of a loved one, like, really sparked that interest, and so I started, like, doing more research about it and reading about it, and then having that day-to-day, like, experience with my loved one, like, really motivated me. And so, I ended up shadowing an oncologist. And then I also had the opportunity to be an intern at Fred Hutch Cancer Research Center for a summer, and so that was an experience all by itself because, firstly, it was after COVID. So, it was, like, back in-person experience and also a bunch of research that I hadn't had the opportunity to really experience, mostly, again, being in person and doing stuff in the lab. And then just a different campus, and it was just eye-opening, and I really, really fell in love with it. And I was like, okay, I really want to try and do this, give it another shot. And I guess that's what also led me to do a postbac because -- Again, because of COVID, we had a bunch of labs that were just online, and it didn't give us, like, the space to actually do the research. It was like just giving you data, and you're, like, doing, like, simulations about it. And so, I wanted more actual research time, so that's why I thought, like, a Postbac program would be, like, the right fit for me. And yeah, that's really what led me to be here, today.

OLIVER: Petria, you turned to cancer and you're combining, now, patient care with research in radiation oncology. What made you take that particular direction?

PETRIA: I am thinking back to two moments in particular. The first moment was in the weeks before I came to the NCI. One of the first oncologists that I shadowed was a breast surgical oncologist at Grady Memorial in Atlanta, Georgia. It was the first time I was in an OR. I spent a couple of days with her, just seeing different breast cancer patients. And I was just really moved by their stories, really moved at the place that she played and role that she played in their lives at that moment in time. To be quite honest, when I started at the NCI, I actually didn't know what I wanted to do in terms of science, whether that be clinical, seeing patients, or getting a PhD. And at the NCI, at the time when I was there as a postbac, there was a program where you can shadow the oncologist in the cancer center. And what was really cool about that program is, I think this was around the time they were developing some kind of, like, tyrosine-kinase inhibitor. I don't remember all the details. But as a postbac, I would see the patients that were at the cancer institute with the physicians and then also go to almost like a tumor board-like environment, where they were discussing, you know, current treatments that are in clinical trials that were developed at the National Cancer Institute. And I think -- If this was a lightbulb moment in my life, I think that was one of them, where it's like, "Oh, wow. There are people here who are working in a lab, trying to develop new therapeutics, but also see patients." So, really getting the gratification of being with people during their most vulnerable times but also getting the gratification of really tinkering and thinking through problems and critically assessing, you know, what are the needs at the, you know, this bench side to, bench model. What are the needs, and being able to be at both sides of that fence. Those two moments definitely, you know, started solidifying that idea or the process of pushing me towards becoming, like, a physician scientist.

OLIVER: Yeah. So, you've both already touched on how the postbac experience influenced your paths. I want to go a little deeper in that. So, Petria, did you finish undergraduate, and you were then not entirely sure what to do next or you were focused -- I mean, how did you even hear about the Postbac program?

PETRIA: I was in my senior year of undergrad. I think it was in the fall time. And at that time, I was working as an honors thesis student in Edward Morgan's lab. And he asked me, "Well, what are your plans after graduation?" And I said, you know, I really don't know. He said, "Well, you should look into, you know, are there postbac opportunities? You're free to stay here but, you know, look into what opportunities are available." So, I kind of had honestly stumbled across this program on Google and submitted an application. It was a lot of serendipity there. But honestly, one of the best decisions that I made. At that time, they fly you, you interview with multiple different PIs. I was just, like, overwhelmed in a good way with that experience. I ultimately interviewed with Dinah Singer, and I remember during that interview, she's like, "You know, typically I want my postbacs to be here for at least two years." And at first, I was hesitant. Even though I didn't know what the next step was in terms of higher training, hesitant for, you know, saying I'm going to take two years, quote on quote, off from my life to work with her in her lab. But honestly, the best decision. She was very invested in making sure that I matured as a scientist but also making sure I had opportunities to explore different avenues while I was there. If it wasn't for that experience, I don't think I would have pursued a PhD or even the MD-PhD combination. Her lab was really diverse. Some of my closest friends are postbacs or postdocs from that lab that I still keep in touch with. Between the three postbacs that run the lab at that time, I think one is doing, like, public policy, another is an emergency medicine physician, and myself, and you know, we still keep up pretty close. And then Chanelle Case, who is still working at the NIH, also a really close mentor. And so, you know, it's both, like, the development of becoming a scientist but you also develop these relationships that end up years later -- I think we're, like, almost ten years out -- really impacting you in more ways than you, you know, you could have even imagined.

OLIVER: Yeah. That's really interesting. And I should disclose that Chanelle is part of my team in the Center for Cancer Training, a close colleague, and Dr. Singer, one of the deputy directors of NCI, is actually my boss. So. But that's fantastic. So, Valeria, you already kind of told us you were, after the pandemic or as the pandemic was easing off, if you will, were keen to get your hands back sort of in the game, so to speak, to do practical science. So, tell us what is the postbac? What is your day like as a postbac?

VALERIA: Oh, my day like as a postbac? I guess I spend most of my day in the lab. I just plan out my experiments for the week, you know, like my objectives, my goals for the week, what I want to, like, try to accomplish. So, some days, it's more data analysis. Some other days are actual heavy bench work, and I guess it alternates between that. Some days, I do have meetings with other postbacs, and that's really fun. So, I guess it depends, really. So -- But a lot of time in the lab.

OLIVER: But it's focused on research. You're not necessarily taking any courses or anything like that. It's really a break from the undergraduate life. Right?

VALERIA: Yes. But you can also take classes. Like, the NIH offers a bunch of classes. So I took a class back in January, and that was very nice. It was like introductions to the hallmarks of cancer, so it was like a good refresher and, like, a good thing to relook at and also get back into, like, a steady curriculum. It was very nice, and I think the professors were also super great and encouraging. They always gave, like, really good feedback. So, that was, like, really fun.

OLIVER: Petria, when you were a Postbac, did you take any classes?

PETRIA: I was just going to say, Valeria, thank you so much for reminding me of those classes. Yeah, as a postbac, I did take some classes which was a good, you know, bridge between being a student and not being a student. I took an immunology course as well as a biostats course. Both really helpful. I probably don't have my notes from my biostats course but the immunology course, I used a lot in my day to day and also really formed a foundational understanding of immunology for me. So, yeah. Those courses were absolutely wonderful, and also there were some other opportunities there. I don't know if Valeria's done any of these but opportunities to, like, present your work to other postbacs, so kind of like a postbac seminar. there was, like, a career development office that helped with CV and resumes and personal statements. And I also did, like, a mock interview with them, actually, before going off for my medical school interviews. So, a lot of really good resources there for sure.

OLIVER: Yeah. Thanks for mentioning that. I mean, a lot of the postbacs -- I don't have the exact number, but it's many of them -- as I said in the intro, are aspiring to go to professional schools, medical school, other kinds of schools, or graduate schools. So, there are programs to help with that, right? You just mentioned an interview preparation and things like that, CV preparation. Valeria, are there other professional development things that you've had a chance to engage with?

VALERIA: Yeah. They always have a bunch of seminars every week for the postbacs and also, like, spaces for, like -- They have this thing called mindful meditation. So, there are, like, groups to, like, help you develop, and if you're, like, feeling stressed or anything, you can go and talk to them. So, they also have those kind of spaces for the postbacs. But, yeah, a lot of professional development seminars and, as she mentioned, like, mock interviews, CVs, and everything. They do that. I haven't done it yet but will take advantage of that because that's just part of it. But yeah. I know of -- I have a bunch of friends that have done it, and they just really like it.

OLIVER: So, Valeria, what has been the major impact of being a postbac? I think you're coming towards the end of your first year, is that correct?

VALERIA: Yes, that is correct. My postbac experience was supposed to be one year. In January, I made it official for two years since I kind of, like, really like it a lot and have seen, like, my progress overall, and I think I really want to stay for another year. Also give myself a little bit more chance to actually decide what I want to do afterwards.

OLIVER: -- What are your next steps? If you have any ideas. This is not a commitment. I won't hold you to it.

VALERIA: Yes, so, I feel like it depends. Some days I'm like, "Oh, yeah. I want to do a PhD," and then other days I'm like, "Oh, I just want to do an MD." So, I feel like I got, like, both sides of it, but I think mostly I'm inching towards the MD. So, we'll see how that goes, prepping for that, and obviously, my time here is really helping a lot.

OLIVER: Petria, same question for you. You've already kind of indicated that at the NIH during your postbac, you kind of got the spark for research and for medicine. Tell us more about that.

PETRIA: You know, being a physician scientist was a long road. Although the initial spark happened during my time at the NIH, I think there are a lot of transition points both, you know, during the medical school, graduate school training here in residency and then after residency. So, I think I find myself oftentimes returning back to that initial childlike, you know, really idealized version of the career before I started out. I think as you progress through this, you realize that mentorship and sponsorship is going to be really important. That relationships are really important. Understanding what questions are important and how to answer those questions is something that kind of started at the NCI and NIH but continues even to this day. I'm in a bit of a transition period right now. I'm in my first year of residency as a radiation oncologist. I did an intern year before this, so not a lot of time at the bench during these two years, and so trying to figure out what that next bench is, who that next mentor is, what the next question is, is kind of the point in my life that I find myself right now. I think, broadly, still obviously interested in cancer and, you know, I'm training in a field where I tell my parents that I am learning head-to-toe cancer, from, you know, birth to grave. And so that really does afford an opportunity to really be exposed to a lot of clinical, interesting scenarios and questions. And hopefully, you know, will really push me forward and as I continue on this journey, yeah.

OLIVER: You mentioned, Petria, earlier, I think, as one of the learning experiences you had as a postbac was sitting in on tumor boards. What is a tumor board?

PETRIA: Ah, yeah. So, a tumor board is a multi-disciplinary event that happens -- I can give you an example. Right now, I'm on a prostate cancer rotation. So, the physicians that come to that tumor board are a pathologist, that look at gross and microscopic anatomy for our patients; radiologists that review scans for our patients; and then the physicians that would be involved with either surgery, systemic therapy, or radiation therapy. So, that would be your medical oncologist, your surgical oncologist, and your radiation oncologist. So, cases or patients are presented with their clinical and pathology and imaging data. And then you, you know, as a team, make decisions in terms of what is the next best step of care. And it can be a combination of all three of us, two of us, just depending on, you know, the stage and circumstances of their tumor. Seeing that as a Postbac student, I thought, was a really cool opportunity. Not a lot of people get to sit in on those unless, you know, they're already shadowing an oncologist and they're tagging along. But I think what's a little bit more unique with the NIH experience is that there are also scientists at those tumor boards as well, so they can speak to the data in terms of things that are up and coming, or things that are currently in the lab that they will, you know, like to try for these patients.

OLIVER: Valeria, you've indicated that you might be leaning towards medical school. Have you had a chance to sort of interact with any of the clinical activity on the NIH campus during your postbac?

VALERIA: Yes, I have. So, here at the lab, they have, they're part of a clinical trial so I get to join in on some meetings with clinical doctors and then you also have the scientists, and it's very interesting to see their discussion about the patients and how you get both sides of, like, the actual medical doctors and then the scientists, and it's very interesting to see how they work things out.

OLIVER: My last question to you, Valeria -- What advice would you give to people who are listening who might be thinking about participating in the Postbac program? What's your advice?

VALERIA: To always ask questions. Just ask questions. Have a conversation. And don't be afraid. I feel like that. I have to apply that to myself a bunch of times because I feel like I get more, not scared but just timid to ask. But, yeah. Just be upfront. Like, talk to people. Everyone is super, super nice, and you're not going to regret it.

OLIVER: Petria, same question for you. If our listeners are interested in the Postbac program, what's your advice?

PETRIA: I really like Valerie's comments on maintaining curiosity and not being afraid. I think I would add to that and say, you know, it is an opportunity or a transition point to explore and not to be afraid of exploring. You know, as I think about, like, the group of postbacs that I, you know, went to the NCI with and the various different things that they're doing even if you leave the program not being a scientist, not being a physician, not being, you know, a dentist, whatever may have you, I think, you know, understanding the process of science, being around people who are, you know, leaders in the field is like a once-in-a-lifetime opportunity. So, use that time to, you know, really explore and, you know, decide, you know, what your next steps are and utilize resources there to get to that next step.

OLIVER: Well, thank you both very much for sharing your experiences and your insights.

VALERIA: Thank you for having me.

PETRIA: Thank you so much.

OLIVER: If you're interested in the Postbac program, check out the links in our show notes. On the NIH and NCI web pages linked there, you can see all the info on how to apply, including some recorded webinars with great advice. For NCI, consider entering your information into the Future Fellows website. Again, there will be a link.

Now, it's time for a segment we call Your Turn because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk that you found interesting, inspirational, or amusing. You can send these to us at [email protected]. Record a voice memo and send it along. We may just play it in an upcoming episode. Now, I'd like to invite our guests to take their turn. Let's start with you, Dr. Gibbs.

KENNY: Thanks, Oliver. The thing I will recommend, and this is not endorsement of the service, but are all the new Star Trek… [Giggle]

OLIVER: [Laughs]

KENNY: …iterations that are on Paramount Plus. And so, we got it because when Covid was running through my house, I needed to allow my children some digital reprieve. And so, some movies that they liked were only on Paramount Plus. But then I realized they had Picard, which is a second take on the Star Trek Next Generation series, which I loved as a kid. And so, Picard, season three is excellent. So, if you have any positive feelings for the Next Generation and 90s Star Trek, I highly recommend Picard, especially season three. And I've gotten really, really into Star Trek: Discovery. It's just -- And, you know, all of these, it's just a large level of complexity. Discovery is great. It's great as it relates to representation, but also it's really mind bending as it relates to space time, multiverses, all the good things. So Star Trek: Picard, season three, and Star Trek: Discovery. I just finished season three, and I'll start season four soon. [Giggles].

OLIVER: That sounds like a lot of fun. I'm going to check those out myself.

KENNY: Yeah.

OLIVER: Thank you.

KENNY: All right. Thanks.

OLIVER: Petria.

PETRIA: I would recommend play in all its various forms, especially for adults. So, for me, my play right now is ceramics so making mugs, bowls, plates, plate bowls on a wheel. And it really gives me an opportunity to lose track of time, build a community outside of what I do, practice and patience, a little bit of resilience when things don't go right but also something that's -- I don't have to take too seriously but still enjoy. So, play, whatever that means for you, is my recommendation.

OLIVER: Well, thank you. I think it's a great recommendation. Valeria.

VALERIA: I would recommend that this podcast that's called Ordinarily Extraordinary. So, it's a podcast about women in STEM and their journey through their career paths. And I think it's very interesting just to get motivation from other people and just see how their life has been and how it's different for everyone.

OLIVER: Thank you. So that presumably you can get anywhere you listen to podcasts, right?

VALERIA: Yes.

OLIVER: All right. We'll dig out a link and put it in the show notes. Well, thank you both for those recommendations. I'd like to make a recommendation as well. It's a book called Misconceiving Merit, Paradoxes of Excellence and Devotion in Academic Science and Engineering. It's by Mary Blair-Loy and Erin Cech. Based on a study of STEM faculty that these two investigators did at a top research university, they address the paradox that these fields, the STEM fields, are meant to be a meritocracy, that women and some racial and sexual minorities remain underrepresented in them nevertheless, often feel unwelcome and devalued. My opinion, it convincingly shows that dominant cultural beliefs in STEM are responsible for this underrepresentation, and the authors provide some really good insights as to how this may be addressed. As always, we'll put a link in the notes.

That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training.

It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser.

A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this episode, we hear from NIH fellows, Dr. Vasty Osei Amponsa and Dr. Marja Brolinson on resources, leadership opportunities, and more at NIH. We then hear from Dr. Eugene Manley Jr., Director of STEM Initiatives at LUNGevity Foundation who shares his path from bench science to a successful career in non-profit organizations.

Segment 1: Fellows Who Lead

Vasty Osei Amponsa, Ph.D.

NCI Center for Cancer Research - Center for Structural Biology

Marja Brolinson, M.D.

Todd Macfarlan Lab

Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

Fellows Committee (FelCom)

Office of Intramural Training and Education (OITE)

Nina Schor, M.D., Ph.D.

Ad: NCI Tech Transfer: Transition to Industry Fellowship T2I

Segment 2: Pathways to Non-Profit Careers

Karmanos Cancer Institute Research & Training Programs

LUNGevity Foundation

LUNGevity Health Equity Speaker Series

AACR Translational Cancer Research for Basic Scientists Workshop

American Society for Cell Biology Biotech Course

R25 Youth Enjoy Science (YES) Research Program

Annual Biomedical Research Conference for Minoritized Scientists (ABCRMS)

Society for Advancement of Chicanos/Hispanics and Native Americans in Science (SACNAS) Black in Cancer

Black in STEM

Black in BioPhysics

Your Turn: Guest Recommendations

Podcast: Fertility and Sterility On Air by American Society for Reproductive Medicine

Book: 12 Rules for Life: An Antidote to Chaos by Jordan Peterson

Movie: John Wick Chapter 4

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute, I'm your host, Oliver Bogler. I work at the NCI in the Center for Cancer Training. On Inside Cancer Careers, we explore all the different ways that people join the fight against disease and hear their stories. Today, we're talking to two fellows at NIH, Dr. Amponsa and Dr. Brolinson about being at NIH and their work in NIH Fellows Committee FelCom. Then after the break, Dr. Eugene Manley from the Lungevity Foundation is joining us to talk about his work in the non-profit and professional society sectors. Listen through to the end of the show to hear our guests make some interesting recommendations and where we invite you to take your turn.

OLIVER: It's a pleasure to welcome Dr. Vasty Osei Amponsa and Dr. Marja Brolinson to the podcast. Dr. Amponsa is a post-doctoral fellow in the Center for Structural Biology at NCI. She's involved in fellow leadership at the NCI and also serves as the Basic Science Co-Chair of the NIH Fellows Committee or FelCom. Dr. Brolinson is a clinical fellow at the NIH Clinical Center and the Clinical Fellows Co-Chair of FelCom. Welcome.

VASTY OSEI AMPONSA: Thank you.

MARJA BROLINSON: Thank you. Happy to be here.

OLIVER: So, I want to talk with you a little bit about FelCom but before we get there, I wonder if you'd share with our listeners your career journey so far. Perhaps we'll start with you Dr. Amponsa.

VASTY: Yeah, sure, thanks for this opportunity to have me on the NCI podcast. So as Dr. Bogler mentioned, my name is Dr. Osei Amponsa and I'm a post-doctoral fellow at NCI. I joined NCI back in 2019 when I finished my graduate studies at Penn State at Hershey Medical Center. And I graduated in biomedical science and clinical translational science. I started my journey in science because I was passionate about finding solutions to, not really in the field of cancer, but it was mainly for infectious diseases, immuno disease, because I grew up in Ghana, I was born in Ghana, but later on grew up in Italy so all my years as a child I was like "Okay, I want to find something, be part of the community that tries to solve issues for diseases especially infectious diseases." The truth of my journey, I was pushed by serendipity and by forces so out of my control, then to be in the cancer field which turned out also to be quite interesting and quite an exciting field to work in. So yes, my background has been through doing experience in several pharmacology departments, learning about how a drug operates and then doing my graduate research on bladder cancer disease and how manipulating tumor suppressors and a transcription factor can affect the tumorigenesis of blood and cancer disease. And so, with that background in -molecular background and cell biology background and also I guess my oncology background, I'm now applying that to support the studies that my current lab here at NCI does. So, I use that knowledge to support structural studies. So that's about me. Thanks.

OLIVER: Thank you very much. Dr. Brolinson.

MARJA: Thank you so much for the opportunity to be here. We are both very excited to discuss FelCom. And a little bit of background about myself. I am currently a clinical fellow in reproductive endocrinology and infertility in the combined federal fellowship at the NIH and Walter Reed. I am born and raised in Ohio, completed my undergraduate training there, as well as my medical training at the University of Cincinnati, College of Medicine, before moving to Columbus to complete a four-year obstetrics and gynecology residency, and then ultimately to the Washington, DC and DMV area to complete a three-year reproductive endocrinology and infertility fellowship. I also similarly knew from a very young age that I always wanted to go into the field of medicine and help people. During our clinical time in medical school, we had the very cool opportunity to essentially rotate in a lot of different specialties. One to learn the medicine of that specialty but two, it really gives us the chance to work within that field, work with those physicians, work with those patients and kind of experience what medicine looks like and all of these varieties and specialties. So, it's within that, that similar to Vasty, I really learned that I was drawn to fields where I felt that we were solving problems. I really enjoyed every rotation, but in particular the rotations such as like surgery, where we would take a patient to the OR, we would like treat them there, and then produce an outcome. And after my surgical rotation, I had my obstetrics and gynecology rotation. And it was a really love for me, not only from the surgical aspect, where you were treating patients, but the opportunity to really care for patients throughout their entire lifetime. From, you know, adolescence coming in, throughout their reproductive years, and then in their post-reproductive years. So that's kind of what drew me into the field of obstetrics and gynecology. And then REI, reproductive endocrinology and infertility is a subspecialty within that field. And why I became interested in that field was, again, being on a rotation where I saw REI and learned kind of the intersection of the human side of medicine, making connections with patients, while also having the procedural side, the treatment side, in addition to the science and technology within the field of REI. That really allowed us with this treatment to help patients kind of grow healthy families in whatever way that looks like for them; or at least give them the opportunity to make those kinds of decisions for themselves. In particular we had a patient be kind of the oncofertility world with the intersection of cancer and fertility; so in treating patients who are diagnosed with cancer, they can become referred to us and we can help to preserve their fertility or at minimum have a discussion so that they can choose what they are interested for their future to look like and not have cancer take that choice away from them. So that's kind of how I became very passionate in this particular field and kind of the intersection of the humanistic side of medicine, as well as the science and technology and advances of this field.

OLIVER: Thank you; very interesting. So, I guess it's fair to say that NIH, NCI is a little bit of an unusual environment; it's not a typical academic environment, either for a post-doc or I'm guessing for a clinical fellowship; because I'm guessing a lot of the patients, particularly at the clinical center are on experimental protocols. I'm wondering if you could both comment on how you've experienced doing this section of your training at the NIH.

VASTY: For me I think one of the amazing things about being a trainee at the NIH is the myriad of opportunities and technologies that you get exposed to. That is something that I found myself to be very fortunate because you get to be exposed to new technologies and also networking and expanding your knowledge, not only your scientific knowledge, but also getting to know people and relate to people and building also those interpersonal relationships as well. Yes, their technologies are just amazing. I work in a lab with the structural biology people, and I get to know techniques and technologies, and approaches such as the CryoEM and NMR, all things that I was not really exposed to during my graduate years. That I get to learn how they also are fundamental for the knowledge of building the basic science knowledge and how you can then develop new therapies with the discoveries of the various protein structures. And so, it amazed me when I look at all what my colleagues do with building all those protein features and structures, and so I found that to be quite very interesting. And like I always tell my other peers that when it comes to the NIH, take advantage of all the -for your scientific growth, take advantage of all the opportunities and technologies that you have available. So, reach out to the cores, reach out to everybody that you know that can give you access to these things. It really is helpful.

MARJA: I'll second that. We really are so fortunate to be trainees of the NIH, because of just the endless opportunities that exist. You mentioned that there, it's a different environment to train within, at least from a clinical standpoint, since all of the patients that we see are on research protocols. Because of that, within my fellowship in particular, we rotate at the NIH. We also rotate at Walter Reed, as well as Shady Grove Fertility, so that we have exposure to a wide range of patients. And a big portion of the patients we treat at the NIH tend to be patients that are on, again, protocols that may have impacted their fertility, or their kind of future fertility options, such as the patients who are being treated with cancer, our oncofertility patients. And we end up treating a lot of those patients at the NIH and helping them with fertility preservation prior to their undergoing their chemotherapy or radiation therapy. So that is kind of a really fascinating and cool clinical area to work within. And then we also -as part of our fellowship, half of our time is spent in research. And some of that is clinical research projects but we all also all work in basic science laboratories. So as part of my fellowship, I've had the opportunity to work in the Macfarlan Lab within NICHD. And that opportunity has been just exceptional in terms of connecting the clinical side of medicine with the basic science side, and how we can really connect patients and their samples with our basic scientists to kind of expand our research and our knowledge within the field. So, I think we really have an amazing wealth of resources with at the NIH.

OLIVER: You mentioned the institute where you're doing your research. Sorry, some of listeners may not be familiar with all the acronyms.

MARJA: So the NICHD is the National Institute of Child Health and Human Development. And the Macfarlan lab specifically studies development, and we look -I particularly, look at a protein that causes altered DNA binding properties, in men with azoospermia. So, there's a lot of kind of many different institutes, like you mentioned, then a wide variety of projects and research that are going in within each institute every day.

OLIVER: Great. Well, thanks so much both of you for sharing these interesting things about your research. So, in addition to your research and your clinical training and all that stuff, you are also serving on the NIH Fellows Committee, generally known as "FelCom". So, what is FelCom?

MARJA: FelCom, I can kind of discuss a little bit. It's -there is this voice of all the fellows at NIH with both of post-doctoral fellows, as well as the clinical fellows. And specifically, it's composed of post-doc fellow representatives from all of the ICs or institutions that have intramural programs at the NIH. So, we have meetings every month, and that allows the fellows to come together in one forum, both to disseminate information amongst each other, but also kind of disseminate information both ways, from the fellows up and then from kind of the leadership down and allow an open forum and for open discussion.

VASTY: So, what is FelCom's mission? So, our mission is to share ideas among fellows to improve their training experience while they are here at NIH. And so, we are supported by OITE, the Office of Intramural Training and Education to develop programs and build strategies. So, we come there to share ideas and things that concern fellows when they are at NIH. And recently we had the opportunity to sit with Dr. Nina Schor from the Deputy Director of Intramural Research Programs to talk about some of the things that is in her goals to do for trainees and the Intramural Research Program, but also for the fellows to have a one-to-one discussion with her about the things that they would like to see changed at NIH. So, it's really an opportunity for the fellows to voice their concerns and bring it to the leadership. And again, FelCom, we are also there because we are not only here to be training in our scientific career journey, but also to be the next leaders, right, in this field. So, it gives us the opportunity to, besides networking, also gain those transferrable skills, as we normally say. So, learning to be in a leadership position, learning improving your own communication skills, both written and spoken, and also managing. It's a lot too, especially the two of us being at a leadership position for FelCom is a lot of management, because we have about 28 representatives from the different NIH institute and centers. And we have several liaisons that connect fellows to organizations within the NIH itself, but also other national organizations like NPA, the National Postdoctoral Association. So, we have different subcommittees. So, we have the career development subcommittee, we have the social subcommittee, we have the wellness group, we have a committee for the visiting fellows, because we have a lot of visiting fellows at the NIH. So, we create a community where they can find a sub, come together and see all, for whatever thing we are going through, we can share with; and it's like you said, a problem shared is half solved. So, we try to make sure that there's the sense of community where the fellows can feel that they belong. and like Marja mentioned, FelCom is open to every NIH trainee. Whether you are on the Bethesda campus, Frederick campus, Shady Grove, all NIH national campuses; it's open to everybody. Now, for the leadership positions, however, only if you are postdoctoral, or a research fellow, or clinical fellows that you can have the position. And we have positions also for graduate students. But postbacs normally don't get any position. But for them to attend the meeting they are more than welcome to attend the meetings that we have.

OLIVER: So, you're the co-chairs. How do you become a co-chair?

VASTY: [Laughs] How do you become a co-chair here? Well, we have like for any committee we have rules. We have our bylaws that need to be respected and followed. So, to become a co-chair, you have to have attended at least six FelComm meetings and be actively present, be actively involved in one of the subcommittees of the FelCom, and also invite the IC representatives to get themselves involved in one of the subcommittees and, yes, being actively present and learning about FelCom's activities.

MARJA: And the additional component that's allowed me to become involved in FelCom is that I'm also the chair of the Clinical Fellows Committee. So, within the Fellows Committee as the whole, a portion of the fellows is the NIH, our clinical fellows. And again, we have two co-chairs for the Clinical Fellows Committee. And so, as part of that role, one of us also gives our time to the Fellows Committee. And then I think kind of an unspoken part of how you do what you do is just the passion for the fellows; here the passion for the training process, teaching, and kind of making the NIH be one of the best places to train that we can.

OLIVER: So, I wonder if you could share with our listeners some of the things that FelCom has been thinking about in the last months or even years, some of the areas of particular interest and concern to current post-docs, visiting fellows, clinical fellows, grad students, post-bacs.

VASTY: Yes, sure, so FelCom, like I said, our mission is to help the fellows and the trainees. So, one of the things that we experienced, especially following the pandemic, is that the fellows felt very isolated, and it was really hard to come together and even just socialize; so especially for the new fellows that join and especially people coming from outside the country. But even within the country moving from one place to come to the DC area, it was quite challenging to make new friends and socialize with people outside their own labs. So, one of the things that we discussed within FelCom ourselves was to make sure that we are able to reach out to individuals and make sure that we get exposure to the fellows. So, our mission is making sure that our IC representatives are able to share. We just created even our flyer that we want to share with the different IC training directors and the different IC's to distribute among their fellows. So, the fellows actually learn about the existence of this committee and what it does for them. So, our goal that we set last year and we have been trying to carry on, so far, is that to get as much exposure to the fellows for them to learn about this. So recently even I was at different career symposiums the CCR FYI Colloquium for NCI. I was at the NIDDK one and some of the fellows that came to the poster for FelCom, they were like, "Oh, we had never heard about FelCom before. It's quite interesting." I really want to get to unplug from the bench work at times and just be involved in something quite different. So FelCom seems a good opportunity for them. And I was like, "I'm so sorry," like I had to apologize because it's my responsibility, right, as the co-chair to make sure that this information is reaching out to the fellows and then there is something out there that can be useful to them. So, our main mission has been to make sure that the fellows know that this community exists -this committee exists, and that within this committee there are subcommittees that address different aspects of things that they are looking for into doing their training.

OLIVER: You mentioned IC, so Institutes and Centers. And they are, of course, they are the ones onboarding new early career scientists. And they tell people about FelCom as they come in, then the people can connect with the FelCom community much more easily and connect. Dr. Brolinson, please.

MARJA: Yes, so that's exactly right. It's a little bit different than it would be for our Clinical Fellows Committee. Of course, we similarly want to make sure that everyone, all the incoming clinical fellows are aware, we're able to do that at the beginning of the academic year, since typically a whole new group of clinical fellows will come into the NIH every July. It's a little bit different for other postdoctoral fellows in terms that their timing can be a little bit more staggered as to when they join the NIH. So, one of our initiatives is to attend the kind of rolling monthly OITE orientation and share about what FelCom is during that orientation as well. So, we're kind of hitting it from the angles of the different institutes and centers and their orientations but from the OITE; that's the Office of Intramural Training and Education, which is an amazing resource for fellows at the NIH as well. So, we work very closely with them and have had the opportunity to attend their orientations more regularly in order to catch all the fellows as they're entering their time at the NIH.

OLIVER: So, in your work with OITE and also your constituency, the people in their early careers, what are some of the key concerns that perhaps your community has voiced in recent months or years that you've considered?

MARJA: I think one question that people are thinking about as they're starting their early career and thinking about where the opportunities the NIH can lead them in potentially future careers is the desire to be exposed to a very wide variety of scientific careers, whether that's within research, whether that's within like, you know, basic science lab work, whether that's within like dry bench work, or data science, or even industry. I think there are many, many, many fields that fellows from the NIH go into; and to do that desire to kind of have a greater exposure, the OITE has done an amazing job with their career panels and with their kind of career webinars. And I think part of the reason why they've had the opportunity to expand that is because everything has moved onto a digital platform. So now it is no longer that they're in person, it's a much more digital experience. And because of that, we're able to bring in many, many, many more speakers; though OITE does an amazing job with that and allows the fellows to kind of attend a much more broad range of career development sections.

VASTY: So, to add to that, I must say that every fellow that comes to us are different and have a different problem. So, like if I take the group of visiting fellows, when they come to us their concerns are completely different from the other fellows. Most of them, like Marja said, OITE has been doing a great job making sure that's the really have a career development strategy. And people most of the times they say that people mainly have a clear idea of where they want to go. So, throughout their experience here, they attend seminars and all those workshops that they're putting out there available for them; so, the visiting fellows some of them when they reach the point when they want to transfer to their next career, one of the major issues they find is more with the immigration problems. And that became actually quite challenging because that's not our role. The question then becomes, "if NIH is giving these opportunities to all these visiting fellows to be here in this great country and do this great work when they are trying to go to the next chapter of their career, they find themselves stagnant. They find themselves in a place where they can't move forward, they can't move back. And so, what are the things that can be implemented to actually help the fellows move into their next chapter?" And I know all or some of this is actually out of the control of NIH itself. So, when I say that each fellow has their own concerns and things that concern them, we as trainees, we have some of the great benefits. At a national level, we are really fortunate. And I can't complain about that if I compare it to other colleagues from other national levels. But when it comes to what kind of the benefits because, some of us, we are already at the age where we are also building families. We also have our own personal lives while we are trying to establish our career trajectory and establish our future. And so, the question is, "What kinds of benefits can we get from being trainees and so when it comes to parental leaves or when it comes to those things?" So those are the things that sometimes the fellows bring up to our attention.

MARJA: And like Vasty said, every fellow has their own question or own concerns that are vastly different. And our role in continuing, I guess, our desire to help solve problems. When fellows come to us with a problem, we try to get them the answer, or if we don't have the answer, we try to connect them to resources that would and to be part of the solution for them, and then to help disseminate that information to other fellows that may have similar questions.

OLIVER: Well, thank you. I mean, FelCom is a great resource for our fellows at NIH, and I appreciate both of you for doing the work that you do. In closing, then, I wonder if you have any advice for listeners, perhaps particularly listeners who are completing their doctoral degrees and are looking for their next perhaps a post-doc or a clinical training, perhaps even at the NIH. I wonder what your advice might be.

VASTY: For me, what I will say, like Marja mentioned it earlier, the passion. What I try to even tell people whenever they're starting something new, you are driven by the initial passion, but you have to work to maintain that passion. The moment that you see that passion dying is either you try to find new things to revive it, so that it keeps you going, it drives you. And then, have a plan. Plans change every time. But if you have a plan, you write it down and you write down the strategies; the objectives. They have to be practical. They have to be realistic for sure. So have like a two-year, five-year, and ten-year plan. And as you go through them, there are some that you might not be able to get them accomplished. There are some, because they might take longer than what you expect. But having those plans keeps you focused, and it keeps you going. And besides the plan, the passion, be confident. And there are going to be ups and downs. And especially if you are coming from grad school and even from medical school, the hardest part of your journey you have been through it. And so, the resilience you have it because grad school makes you resilient and also medical school. So just be confident and build a network. Build, expand your networking. And speak to people, talk to people, and have mentors. You never know how the next chapter of your career will open to you. So just connect with people.

OLIVER: Yes, perhaps through FelCom.

VASTY: Yes, exactly.

OLIVER: Dr. Brolinson.

MARJA: Something that I would state to fellows incoming or kind of completing their time at the NIH is I think it's important to always be open to opportunities. New opportunities that come or a space where you see that there's something that's lacking. That is an opportunity that you could create something in that space. And you never know who you're going to talk to, who you're going to meet, and where the next opportunity is going to come. And that could be from, you know, patients clinical care, it could be from the laboratory care, or like Vasty said, just people that you meet at the NIH through networking, through attending meetings, and working within this space. I think that within those kinds of opportunities it's all a little bit of hard work, luck, and timing that kind of comes together. And if you're open to it, then you can really develop some really cool projects and processes out of that. And then I think secondarily, like Vasty mentioned, this part of your training you also have your personal life, your training, your career, your goals. There is going to be times that you are pulled in many, many, many different directions where you can feel like it's imbalanced all the time. And sometimes some things are going to be weighed a lot more heavily, you're going to be spending a lot more time on certain areas than others. But overall, there's kind of an ebb and a flow and a give and a take. And it doesn't need to be balanced every single day, but over time, you know, as long as you are kind of moving forward in the direction of those goals, that will help steer you through some of those more challenging waters.

OLIVER: Well, thank you both for being with us today and sharing your insights, and the great work you do in your professional careers and for FelCom. Thank you.

VASTY: Thank you so much for having me.

MARJA: Thank you so much.

VASTY: It's been a pleasure.

[UPBEAT MUSIC]

OLIVER: After the break, we're going to hear from Dr. Eugene Manly, whose career has touched not just research but also various nonprofit and professional society engagements, so stick with us.

LAURA PRESTIA, TECH TRANSFER CENTER: Are you a postdoc or research fellow in the NCI Center for Cancer Research, or a CCR investigator with one of these trainees in your lab? Is there a project in your lab or that you're working on for which a patent or patent application has been filed or was just recommended for filing? If you answered yes to these questions, then we have an exciting opportunity for you.

Through the Transition to Industry Fellowship (or T2I) trainees are supported by CCR under a CRTA (also known as the Cancer Research Training Award) fellowship. T2I fellows are supported for 2 years as they advance a scientific invention toward a regulatory milestone, clinical trials, and commercialization. An added benefit for PIs is that if your trainee applies and is accepted to T2I, CCR will fund that CRTA and you may backfill your trainee's previous position, while they continue to advance your lab's technology.

In the program, T2I fellows spend 80% of their time in their current lab focused on invention development research and 20% taking courses and hands-on trainings in tech transfer, entrepreneurship, and small business grantsmanship through rotations in the NCI Technology Transfer Center and NCI's Small Business Innovation Research (SBIR) Development Center.

Our goal with T2I is to speed up the development and increase the commercialization potential of NCI inventions, while we nurture post-doctoral career development and industry-focused research training.

If you want to advance your career or are interested in T2I for one of your fellows or technologies, applications for T2I are due November 1st and new fellows start in January. You can find more information about T2I and other lab-to-market-based programs for NIH investigators at the NCI Technology Transfer Center website: https://techtransfer.cancer.gov

OLIVER: It's a pleasure to welcome Dr. Eugene Manly to the pod. Dr. Manly serves as the director of STEM workforce initiatives at the Lungevity Foundation and has in the past worked at the Lung Cancer Research Foundation and the American Association for Cancer Research. Welcome, Dr. Manly.

EUGENE MANLY: Thank you very much. It's an honor to be here.

OLIVER: So, my first question, Dr. Manly, is what led you to a career in science?

EUGENE: Oh man. This goes way back to even when I was a kid. I grew up in Detroit and I had chronic asthma as a kid. So, I was in a hospital 20 to 30 times a year just for my asthma until I was about 10. So, I always saw nurses and doctors and got used to needles. And so, I always wanted to learn how the body worked, how it functioned, how it was injured, and how it was repaired. So, in essence that sort of started me on a path of science.

OLIVER: Interesting. So, then you pursued science as an undergraduate?

EUGENE: Yes. Actually, I started even in high school. I found a research internship program, at that time it was Wayne State Univers… no, it was Karmanos Cancer Institute. And then, the next summer after I finished high school, I went to Wayne State University lab. They have some summer internship programs, and so I did the first project in lung cancer. No, actually it was AML looking at different drugs and how they were metabolized. And then a second summer I did a biophysics project looking at hemoglobin and modified hemoglobin or transfusions.

OLIVER: And then you did study biomedical engineering and did your PhD at Boston University. Right?

EUGENE: Yes. Completely different things, but I did my undergrad in mechanical engineering. I did the masters in biomedical engineering. So, I did a lot of knee ligament bio-mechanics, viscoelasticity, mechanical testing of the tissues. And that was sort of contrast to my undergrad which my degree was in mechanical. That's when a lot of my summers were in biomedical research in different research programs over the summer. So, I got really adept at finding programs. And then when I got to the PhD I said, "Look. I want to get back to more of the wet bench work." And so, I ended up at Boston University working a lot in lung cancer, pathology, gene therapy, combination drug therapy, and cancer and stem cells.

OLIVER: So, was there any particular draw for you to lung cancer?

EUGENE: Well, you know, I had some family members who had a history with smoking and we just saw a lot of it in the inner cities. And so, I never saw lung cancer, but it sort of stuck in my mind and that sort was my leaning towards lung cancer. And I did one of my first projects on just the amount of tar and nicotine in cigarettes. And this was in eighties. Go to corner stores and get little single cigarettes and then I ordered some kit. I don't know how I found this, but I had a kit that had this kind of bulb end apparatus and then you could light the cigarette with the bulb. And then tap through the amount of tar and nicotine on the filter and then sort of assess, you know, which cigarettes were worse or, you know, had more carcinogens. And then I got all the stuff from the American Cancer Society about tongue and throat cancer. It's like it was very interesting.

OLIVER: So, at BU you also in addition to the science you were doing you got involved in some associations. Right? Can you tell us a little bit about that? You worked with I guess the graduate student community.

EUGENE: So, I was part of the biology grad student association, and they're the back end. So, we just provided a lot of sessions, professional development for the grad students, but I was also part of the graduate student association which is slightly different from the biology. So, the grad student organization is sort of the umbrella grad student group for this whole college of arts and sciences. And so, I was the social chair for way too many years, but I organized a lot of our social events, our pub nights, and sort of just brought people together.

OLIVER: It's important. Right? Forming a community. Forming a network even at that stage in your career.

EUGENE: Yes.

OLIVER: I notice that you also joined the American Association for Cancer Research at that time. Is that correct?

EUGENE: Yes, I think I joined around 2009. That was around the time I had my first poster ready for the AACR annual meeting. So, and at that time you still had to pay for, you know, for conference membership. And when you are a poor grad student, you don't have a lot of funds so you have to, you know, put your money judiciously. But yes. So I joined around 2009, and then spent time in and out of the org. and as I jumped out of cancer and back into cancer. And I've joined and left and joined again. So, now I am back in.

OLIVER: So, after your PhD, what was your next step?

EUGENE: I did three post docs. I did one at the University of Michigan in orthopedic surgery, did some work on bone biomechanics and looking at matrix proteins and how blocking them affects bone formation and collagen formation. And then I went to Thomas Jefferson University and did some work in pathology. Really worked on arsenic and loose carcinogenesis in lung epithelial cells and I also studied some ovarian cancer stem cells, and that was when I did my first project, tried to do my first project, on not siRNA, but it was CRISPR, but the plasmid was not the plasmid, so we sort of let that to the side. And then I ended up at Oregon Health and Science University and did a lot of work with breast cancer looking at 2D and 3D models of cells, looking at invasive proteins, and then trying to use multiplex imaging. So basically, running antibody panels to identify markers of not just breast cancer, but also invasion, metastasis, stroma, immune, and just trying to see if we could identify cell specific markers that are more general broad markers across differences tissues.

OLIVER: So quite a broad spectrum of research. And then at that point after that last post doc you took a pivot. Right?

EUGENE: Yes. So, near the end I was figuring out what I wanted to do with my career because I deduced I didn't want to do a career in academia, and I knew I had done a lot of, I wanted to do a lot of mentoring and outreach. And my first pick was not quite mentoring and outreach, but it was related to some workshops I had done that last year. So, I had attended the AACR Clinical Research for Basic Scientists Workshop. I think that was 2019. And then I also had attended the American Society for Cell Biology biotech course. So different programs were really great. The biotech course really taught you a lot about business development, entrepreneurship. We all had to pitch a bio marker for the cancer we as a group were assigned. And the AACR course really great about teaching about clinical research, how to do research, how to, you know, go from basic to translational, write grants and then we also got to go and see patients with the doctors on their visits if the patients permitted. So, it was really just eye opening, but that sort of got me into the realm of really using the work I've done and all the stuff I work with to have a broader and greater impact.

OLIVER: And you joined the AACR?

EUGENE: Yes. And then I joined AACR as Assistant Director of Corporate Alliances. And so, I basically use a lot of the engineering and biology skills because I'm with so many different vendors and sectors and was able to build a portfolio of companies in different spaces to fund, you know, different AACR programs and initiatives. And because I wear many hats, I could look at what a company does or funds and then project how to run a pitch or talk to them about what they do and sort of where I think we can have synergy to get funding for some things.

OLIVER: So, the breadth of your research experience was really an asset for you.

EUGENE: Yes. Yes.

OLIVER: What were the challenges? What new things did you have to learn moving into a nonprofit? I mean the AACR as a society, a different environment from the lab. What was new to you?

EUGENE: Being very precise in how you communicate, you know, one thing I learned is how to really prospect companies. I did not have to do that where I just sort of knew what they did, but really leveraging the whole totality of a company to determine if you should reach out. And then learning a lot of rejections which you do as a postgraduate anyway. You still get papers, but you know sometimes you don't get responses. You just have to keep moving. But, you know, so really just learning that aspect of corporate fundraising and relationship building and sort of, you know, and maintaining those relationships on a more regular basis.

OLIVER: So for people listening who are wondering about a transition like this, it sounds to me like the science of course and also the science communication are readily transferable skills, but maybe working at an organization like the AACR is a little different in terms of how you show up and how you work with colleagues and things.

EUGENE: Exactly. And when I joined it was sort of right before COVID hit us. So, we were just going from the office to going to remote. So, I really wasn't in the office that long before COVID started. So, it was really hard to build relationships when you aren't on site. You can't really fix that and it is sort of the balancing act you work with. But what COVID has taught me is you can work from home now.

OLIVER: Right. Right. It's a mixed situation for sure. So, after AACR, you moved on to the Lung Cancer Research Foundation. Right?

EUGENE: Yes. So, there I was the director of scientific programs, and the bulk of my job was overseeing our grant mechanisms. We run three. And I think when I left, we were up to four or five. And so, I pretty much did the grant administration, draft the RFAs, answered questions in the inbox, make sure everything's submitted on time, and move stuff to reviewers and make sure we get the reviews back. And then I did a lot, you know, at that point I started doing more science communication, working with talking to external researchers about, you know, workforce diversity, trial diversity, and just you know sort of liaison between the internal and external stakeholders.

OLIVER: Can you tell us a little bit about the grant portfolio at the Lung Cancer Research Foundation? Are they primarily research grant or also career development?

EUGENE: a lot of it is basic research and clinical research. They have some grants with patient advocacy organizations like for EGFR, cancer, and ALK driven lung cancer. And then right before I left, I had created the minority career development award which was a career development award for underrepresented researchers doing, you know, basic and translational research in thoracic oncology.

OLIVER: So that's an interesting development. Obviously, the foundation was probably primarily focused on the research theme of lung cancer. Why and how did you implement the diversity program you mentioned?

EUGENE: We know that black patients in particular have some of the highest lung cancer rates and highest mortality, but we don't have a lot of providers in the workforce that can treat these patients, look like these patients. And I'm not saying that you have to have a provider that looks like you, but there is clear evidence that patients that have providers that look like them experience much less bias. They feel more seen and heard. And they actually might consider doing treatments that they might otherwise not do because they don't see as much bias. And so that was sort of the impetus for trying to provide some funding for underrepresented researchers with the goal of increasing diversity of the workforce.

OLIVER: Very interesting. And now you're Director of STEM Workforce at the Lungevity Foundation. So, you stayed with lung cancer, I guess, but you're more workforce focused rather than scientific program focused. Is that correct?

EUGENE: Yes. I have this more broad encompassing role now, and so really what I do the biggest thing is I run three of our health equity virtual series. I launched the minority mentorship and training program for our health equity and inclusiveness research grant awardees. So, these are postdocs, clinical fellows, or early career clinicians scientists. And this program is designed to mitigate many of the barriers and challenges that impede the career progress of underrepresented scholars in STEM. And then I oversee some academic partnerships to give exposure and training to underrepresented scholars that are med students and grad students. And I do a lot of STEM outreach and engagement. So really going to minority conferences to increase just their presence of what we do, our programs, and then just so they can see us. And so, this allows me to reach, you know a wider swath of scholars that you might not necessarily see at the major ASCO/AACR. So, things like SACNAS and ABRCMS where there's more Latino, Hispanic, and Black scholars from across the spectrum. So of course, they all aren't in lung cancer we have all this free education material on the website, and we do fund research grants and we do fund grants for underrepresented scholars.

OLIVER: Interesting. I mean my team in the Center for Cancer Training also attends those conferences, and we also try to spread the news about our grant mechanisms and opportunities. That's great. So, what's your perspective of where we are at this point in the middle of 2023 regarding the biomedical workforce and the diversity of that workforce and its general state?

EUGENE: I think we still don't have enough diversity and that's across the board. And because we don't have diversity, it impacts how care is delivered. It impacts who gets funded for research. It impacts who advances in research. Also even impacts who even enters research, because we know you can look at some of the other reports that show, you know, NIH R01 funding establishes you as an expert and allows you to sit as a reviewer, but you look at the success rates of black applicants on R01s and even a K99 getting awarded and it's much lower than other groups. And so K99 is supposed to be prestigious, but if they still aren't getting mentoring, then how are we helping change that system? So, really we have a lot of work to do to really increase workforce diversity, listen to these diverse voices because often there are diverse voices there, but if issues get raised, they still are silenced or not listened to. And so really, more empathy, more listening, more understanding lived experiences of people and really thinking about how you help those groups that are under-served because those are often the ones that still experience the greatest disparity.

OLIVER: I wonder what your take is on some of the recent developments at NIH, the attempt to build cohorts and communities of underrepresented researchers, for example, the common funds FIRST program recruiting a group of faculty; the K99 MOSAIC program which builds again a cohort. We have the iCURE program at NCI. Do you think those programs are effective? Is that a good approach? Is that something Lungevity is thinking about?

EUGENE: I think I've done stuff with the iCURE program. I've been in the iCURE many, many years ago. I was definitely in the CURE because I was definitely in the CURE umbrella because I was doing supplements in different times.

OLIVER: CURE is the extramural, iCURE is the intramural. Sorry. I probably should have just said CURE. Yeah.

EUGENE: Yeah. sounds familiar.

OLIVER: They stand for intramural. My bad. Yeah.

EUGENE: You know, I think supplements are great because they give you funding. It's just, you know, the funding is great, but you still need the mentoring and really checking that the mentoring is happening. And that's harder to do when it's extramural. I do think as far as what the mechanism does, it is great because it gives those scholars funding that is not necessarily tied to the parent award that they might not otherwise have. So, it does free up resources for the labs, but it's just really focusing on the mentoring piece and the longer-term professional development is where we still are losing a lot of scholars. And, you know, a lot of this is not just the funding, but it's external pressures, lack of income, you know trying to navigate universities with low income, especially first gen, but you don't often get to talk about those. There's no extra funding to help cover those costs.

OLIVER: Yeah. I mean that's definitely true. I mean we've seen that in recent years, the conversation shifting towards the economic challenges of being a grad student and a post doc and these stages. You also serve on the board of Project RADICAL. Can you tell us what RADICAL stands for and what that program is about?

EUGENE: Project RADICAL is sort of an acronym sort of racial disparities in cancer of the lung. And the group formed two to three years ago really to focus on the needs of black patients navigating lung cancer. Really bring their perspective and concerns to the table and really trying to educate, empower, and teach them about different things that are lung cancer care continuum. And so, we had different social media people, researchers, clinicians, providers, and even patients. Through these meetings, we put together a five-webinar series October not last year, but the year before, for minority health month just about different aspects of navigating your diagnosis, research and workforce, you know, what to look for in trial. So really just providing information and resources for people. And I think we last year had to disband because of, you know, lack of funding, but it was such a great initiative and program, but you know as grassroots we didn't have one course. We were all scattered. So, we didn't have a core space for, you know, congregating. So that kind of made it challenging.

OLIVER: In closing, Dr. Manly, I wonder what advice you might have for our listeners, for people coming. I sort of think of this in two ways. Let's start with what advice do you have for someone listening who is interested in diversity, who is interested in cancer health disparities, that may not be the subject of their research. Obviously, a lot of people do research on that, but how can people get involved if they are interested in these two areas?

EUGENE: So, you're thinking about health equity disparities sort of, you know, try to read some of the ACS reports, some of the AACR reports, on cancer health disparities just to learn what the disparities are across diseases and then determine if there's a disease you are interested in studying and then try to find researchers or universities that are conducting research and disparities in that cancer and then depending on your career stage. See if you can, you know, maybe do a grad degree there, or if you're an undergrad check to see… often schools have, you know, these undergraduate research programs. Some are undergraduate research experiences or…

OLIVER: Yep. R25. The R25 YES, things like that, yes.

EUGENE: Programs which get you into grad school. There are even some R grants, some U54s. So, you just sort of have to do a deep dive and just sort of find an area you're interested in and find a researcher that you're interested in. And it's often just an email. Often if they don't know you, you may not get a response, but if you think of the bandwidth of academics, they get so many emails a day from all over and sort of they can't answer them all. So sometimes it's not that they're ignoring it. It's just bandwidth. Or like if you go away for a conference and you're gone for a week, then your mailbox is just gone in the ether because you just can't get through.

OLIVER: You'll never catch up. True enough, but I guess networking and connecting with people at conferences if you're able to go and similar things is, yeah.

EUGENE: Going to conferences, really trying to network, going to conferences in disparities, health equity, where there are more people that also understand the challenges and may be easier to find those connections to health. Or, you know, things like ABRCMS, SACNAS, you know, Latino Medical Student Association. National Medical Association is for generally Black physicians, and that was sort of founded, you know, as Black physicians could not go to many of the major meetings in the late 1800s because of Jim Crow and all that stuff. And so just finding even under conferences that serve a cancer you want or a group, and then just start there and then just network. And networking is a key thing, you know. And as you get more presence and reach, just keep connecting with more people. And then it goes from there. It is always networking, is the key.

OLIVER: I mean there's some grassroots organizations developing as well. There's Black in Cancer recently launched, and we'll put some links in our show notes to these organizations that you've mentioned as well, ABRCMS and SACNAS and so on.

EUGENE: Black in Cancer and at the same time Black in STEM, Black in Bio. They all sort of rolled around essentially right after each other, and that was all out of George Floyd and all that stuff. And that was what led to their own rise of all the groups. Before then there was really no way for black or Latino scholars to really find each other, and then that sort of drove that. So that was actually one positive thing.

OLIVER: Indeed. Indeed. And then lastly another advice, type of advice, you might be willing to give, is more around the career structure. So, you did do that pivot from primarily doing research, going into the nonprofit sector, doing all kinds of interesting things there. What would you wish you'd known perhaps before or as you were making that transition? What kind of advice might you give to someone who's listening who's thinking, you know, "I love the bench, but I love what Dr. Manly is doing because I can have so much broader impact."

EUGENE: You know, sometimes in academia we get wed to the idea that we have to only stay at the bench. And sometimes it's pushed on us. And you don't often know the alternative paths that you can go. So, you really have to, you know, think about professional development sessions, take a stake of what your skills are and then think about what you want to do or what you can do. Now, in my case, I've been in three nonprofits, but what I've done at each one is I've learned different skills. If you told me five years ago, I'd be doing webinars and writing on health equity and doing manuscripts, I'd be like, "No. That's not happening." But, you know, sometimes you just never know what you're going to do and pick up and learn. And just take any job you do, take the skills, add them to your tool kit, and then sometimes it takes a while, but the light bulb will click into what you want to do to make your impact. And you never know when the light bulb is going to go off. And so, you could be just doing things. All of a sudden, "Oh. I want to do this." And so now I'm in a position to really make move the needle for health equity and disparities and there's no way that I could do it when I was in the lab. But that's because I've gotten different experiences and this other networking that have allowed me to then build on that and now sort of make the, you know, help implementing change.

OLIVER: Dr. Manly, thank you so much for sharing your path and your advice.

EUGENE: Thank you so much for inviting me.

[UPBEAT MUSIC]

OLIVER: Now it's time for our segment we call your turn because it's a chance for our listeners to send in recommendations that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk. Anything that you found inspirational or amusing or interesting. You can send to us at [email protected], record a voice memo and send it along. We may just play it on an upcoming episode. Now I'd like to invite our guests to take their turn. Let's start with you Dr. Brolinson.

MARJA: Thank you, Oliver. I am going to recommend a podcast called fertility and sterility on air. This is a podcast that's produced by the American Society for Reproduction, ASRM, family of podcast. And this podcast allows you to stay current on the latest research in reproductive medicine. Every month they review the latest issue of the journal of Fertility and Sterility and discuss interesting information about the articles. Sometimes they invite the authors of the article on, and it really serves as a very cool way to help disseminate scientific information today.

OLIVER: Thank you so much. Dr. Amponsa.

VASTY: All right. I guess my recommendation will be I recently finished the book by Dr. Jordan B. Peterson "The 12 Rules for Life." I really enjoyed this book because I was looking for something that a turnaround point for my life myself, and I heard about him speaking on a podcast and they was talking about the book, and it was quite interesting. And one of the rules, I don't remember which rule was that he mentioned that assume that a person they are listening to know something that you don't know. So, the power of listening. Being able to listen to other people and not jumping into wanting to answer. Opening your ears to listen because the information that you can actually get from listening rather than interrupting might be completely different. So, I really recommend if you want to have learn some things new about yourself and how you can apply it to your own life, I invite you to read the "12 Rules for Life" by Dr. Jordan Peterson.

OLIVER: Thank you. Dr. Manley, your recommendation, please.

EUGENE: Okay, so I had to think hard about this, but then I just saw John Wick IV this weekend. So, if you are averse to blood and gore, I would say do not see this movie, but the movie was very interesting because I used to be a jujitsu practitioner, and I always love watching the throws. But I will say, at some points, it was overkill. Like at the end where they're going up 200 steps. I'm like that was overkill, and then there was a scene in the middle of the movie that had the top-down view. It was like one of those 80s or 90s video games where someone has this flame shotgun and shooting it. When you see flames, people bursting in flames, it's like this became a video game, and it just made me laugh. But then the other cool thing I noticed is three pieces. There was a scene. There's a guy that's this bouncer at this club in Germany that's really notoriously hard to get into, and he'll walk down the line and say you can get in or not, this big techno club. So he was in the movie, and he said his name, "I am Klaus," which is a play on "I am Groot," and then, he was the one who decided who could get in the club. It was actually -- when you saw that, it was absolutely hilarious, so.

OLIVER: Hilarious. Well, thank you for that recommendation. It's very fun. I mean, you have to have fun along with all the work that we do.

EUGENE: Yes, indeed.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests. We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected]. Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser. A special thanks to Lakshmi Grama and Sabrina Islam-Rahman. Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers. If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query. We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this exclusive episode, we feature Dr. Otis Brawley, Bloomberg Distinguished Professor and Professor of Oncology at Sidney Kimmel Comprehensive Cancer Center. Dr. Brawley leads interdisciplinary research of cancer health disparities at the School of Public Health and the Kimmel Cancer Center. Dr. Brawley shares with us his career journey into science and his thoughts on the future of cancer research, cancer health disparities, and more.

Show Notes

1. Otis Brawley, M.D.

2. The Sidney Kimmel Comprehensive Cancer Center

3. Division of Cancer Prevention

4. How We Do Harm: A Doctor Breaks Ranks About Being Sick in America

5. National Cancer Plan

6. Cancer Intervention and Surveillance Modeling Network (CISNET)

7. Cancer Prevention Overview

Your Turn: The slogan "5 A Day—For Better Health"

Ad: NCI Future Fellows

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host, Oliver Bogler. I work at the NCI in the Center for Cancer Training. On Inside Cancer Careers, we explore all the different ways that people join the fight against disease and hear their stories. Today, we have a special, we are talking to Dr. Otis Brawley about his wide-ranging career and the many things he has brought to cancer research, cancer prevention, and health disparities research. Listen through to the end of the show to hear him make an interesting recommendation that we can all take to heart, and where will also invite you to take your turn.

OLIVER: It's an honor to welcome Dr. Otis Brawley to the podcast. Welcome.

OTIS BRAWLEY: Thank you. Thank you for having me.

OLIVER: Dr. Brawley is Bloomberg Distinguished Professor of Oncology and Associate Director of Community Outreach and Engagement at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. He leads a broad interdisciplinary research effort on cancer health disparities, working to close racial, economic, and social disparities in the prevention, detection, and treatment of cancer in the United States and worldwide. He is a member of the National Academy of Medicine, and Dr. Brawley also serves on the NCI's Board of Scientific Advisors. Dr. Brawley, we could fill several episodes with conversation about the many interesting things and important things you've done, but given that our focus here is on careers, perhaps I might start by asking you of your assessment of where the future of the cancer research workforce is in 2023.

OTIS: Sure. Thank you for having me. And you can still call me Otis.

OLIVER: Okay, thank you.

OTIS ley: Okay. You know, we're in an amazing time where the science is all coming together, and there are huge opportunities for people who want a career in cancer medicine and cancer science in terms of being able to do things. Now, that being said, I'm very concerned that money is tight, and support for people going into oncologic research, especially the basic and translational oncologic research is very scarce. I worry, and many people -- I was once at the American Cancer Society. I still work with people at the American Cancer Society to advocate for support of young investigators because the opportunities for society are so great. The number of young investigators, the number of graduate students, the number of graduate students in the sciences and the basic sciences as well as medical students going into medical oncology, some amazing people out there, people who understand things that I will never be able to understand. And so, I see huge opportunity, but I'm worried that we need to support the people who can go grab that opportunity.

OLIVER: Yeah. I mean, it strikes me that one of the big changes that we've seen in the last several decades is the growth of sectors adjacent to biomedical research, right? We have the tech sector, we have the biotech sector, the pharmacy sector. So we're competing now for talent in a way that we might not have been for 20, 30 years ago.

OTIS: That's right. That's right. Now, keep in mind, the academics are trying to advance science and create new knowledge, and they create new knowledge for new knowledge's sake. The people in biotech and the people in corporations take knowledge, some of it new, and try to apply it, and especially apply it for profit. I'm not putting that down at all; that's a very legitimate thing. But we need to be careful over the next 10, 20, 30 years, or else we're going to lose the academic component that actually trains people that go into the corporate world as well as the academic component -- That's where a lot of the really new, hard-hitting stuff is developed, the creativity that you can have in academics that's not allowed in corporate America.

OLIVER: So how do we remain competitive in academia?

OTIS: Well, I actually believe that, you know, some of the things that the NCI have done in community outreach and engagement, something I'm very interested in, is really important because, when I say "community," I'm talking about the broader community of the entire United States. I'm not talking about inner-city Baltimore, for example. Not just inner-city Baltimore, but broader. We need to make sure the people, the constituency, the United States taxpayer, understands the importance of science and the importance of what we're doing. Now, there's a lot of people out there who are very pro-cancer research. I want people to be pro-supporting and giving money to cancer research. And how you do that is through good outreach and engagement and explain to them the things that we can do today because of great research and the things that we will be able to do in the future because of great research. In the same token, by the way, I worry sometimes people are so into treatment of cancer at the expense of risk reduction or prevention of cancer. Much of what we've learned over the last 50 years since Richard Nixon signed the National Cancer Act is a lot of molecular biology and understanding of the inner workings inside the cell, how to manipulate the inner workings inside the cell. From that, you get how cancer is caused, carcinogenesis, which is heavily linked to risk reduction or cancer prevention, how you can stop cancer from happening, as well as how you can kill cancer, which is treatment.

OLIVER: So you touched on community outreach and engagement. That's one of your roles at Johns Hopkins. You're the associate director of the Sidney Kimmel Comprehensive Cancer Center, which is an NCI-designated cancer center. This community outreach and engagement role is a relatively new element in the NCI-designated cancer centers. Can you tell us a little bit more about why that role was created and what you do?

OTIS: The role was created, and it was first created about ten years ago. And it has evolved, and I'm actually trying to evolve it even further. It was initially created to increase the number of minorities on clinical trials, to increase understanding in minority and inner-city communities what's going on with cancer. It then changed a little bit more to include cancer centers need to know what's going on in their catchment area. What are the unique problems in their catchment area? For example, certain cancer centers have large numbers of Southeast Asians in their population and have a hepatitis, hepatoma problem. Here in Baltimore, at Hopkins, we have a huge HIV malignancy problem that needs to be addressed, and the cancer center should be addressing those things. In order to address things that are pertinent to the community, you need to know what's going on in the community. That was where the NCI moved at about three to five years ago. I'm trying to move it even further and say that we need to be the people who interact with Congress folks in the state legislatures and do things that NCI and NIH cannot do. We need to be the folks who explain to people throughout the community of our catchment area what science is and the scientific process and how being scientific has gotten us a lot of things. We can also do things -- you know, I'm very high on the fact that the COVID vaccine was developed so quickly because of basic science that was developed through Nixon's war on cancer that started in 1972. You know, very much all the tools that were used to understand this virus and to get an RNA vaccine were developed over the last 20, 30, 40 years it's just -- thank goodness we had all those tools together and could very quickly come up with an RNA vaccine, test that vaccine, and by George, it worked.

OLIVER: Yeah. I think that's a really good point. It's underappreciated, perhaps, how much fundamental science occurs in the context of trying to deal with the cancer problem, and then that can beneficially move into other areas. Otis, you touched on the outreach element and also diversity. You've been very frank about your own experiences. I wonder what your assessment is of current efforts to diversify the cancer research workforce. I mean, I think there's -- we all acknowledge there's a long way to go and there's much to be done. Are we making progress?

OTIS: Well, yes, we are making progress. I'm one of the people who's very grateful that a large, large number of people in cancer medicine and cancer science acknowledge that this is a problem, and we need to do better. There are a substantial number of older white men in oncology who want to do better and who have tried to mentor and brought both women and minorities under their wing to bring them into the system. But we still need to do better. One of the things that I am hellbent on is we need to have better science taught in grade schools, especially inner-city grade schools where minority kids go to school. We need to actually stress STEM in high school. We need to create opportunities for young folks who are in their early teens to go into laboratories and do things. You know, I went into a laboratory when I was 14 years old, and we need to create these opportunities. There's a whole world out there that a large number of folks, especially poor folks in inner-city schools, don't know exists. And if they knew that it existed, they actually might find this kind of fun. And it's interesting.

OLIVER: So a perfect segue. You mentioned you first went into a lab when you were 14. That's pretty amazing. Why? How did you end up going to a lab? What sparked your interest in science?

OTIS: Well, yeah, I was always interested in science. I had my little doctor's kit when I was seven or eight years old. I had a science fair kit and science fair projects. And, you know, for Christmas, I would always get the various laboratory stuff. So I was very interested and very curious and was very fortunate that my father encouraged it, you know. When our washing machine stopped working and he had to buy a new one, he didn't let the people who delivered the new washing machine take the old one away. He kept the old washing machine so I could take it apart and see what was inside, how did it work, you know. And my father encouraged curiosity, and that's how I got the bug. Then I ended up going to a Jesuit high school. It was a combination of my mother and father and the nuns in grade school sent me off to the Jesuit high school. And the Jesuits, of course, are very famous in saying, "We teach people to ask questions, and we teach people not what to think, but how to think." And how you think is by asking questions and by having inherent curiosity. And then the Jesuits sent me off to the University of Chicago, which is a collection of nerds interested in asking questions. And so that's how I was created, and that's how I was cultivated over time.

OLIVER: Interesting. What led you, then, to pursue medicine as well? I mean, did you feel like you wanted to treat patients or --

OTIS: Well, now, that's interesting. When I was in high school, I developed a true interest in policy and politics. You know, this is the time of Watergate. This is the early 1970s early to mid-1970s, and I got very interested in policy and politics. Many people, at that time, would have guessed that I would have ended up going to law school and not medical school. I was also interested in science. And when I went to the University of Chicago, I did chemistry. And for some time, I thought I'd do chemistry in law school. Sometime I thought I'd do chemistry in graduate school. I was very fortunate to befriend a full professor who happened to be an infectious disease doctor, a herpes specialist, named Elliott Kieff. And Elliott took me into his laboratory, and I actually worked for a summer in his laboratory. And Elliott said, "Why don't you forget about this law school thing or this chemistry? You should go to medical school." And so, he started introducing me to his friends, and that's how I ended up at the University of Chicago Pritzker School of Medicine.

OLIVER: And then, pretty quickly, you got interested in lymphoma and oncology, right?

OTIS: Yeah. I keep coming under the influence of people. There was an oncologist there, a guy named John Ultmann. He was one of the original 60 oncologists who founded ASCO. And John and I became very good friends, and John became influential to me for the rest of his life. Indeed, I first met John in the early 1980s, and for the next 20 years, he guided me. I never took a job without first running it by him and getting his view of things. And John very much guided me throughout medical oncology. The importance of mentorship. There were the nuns in grade school; the Jesuit priests; Father Polakowski, who told me to go to the University of Chicago; once I got to Chicago, Elliott Kieff, who told me to go to medical school; and then John Ultmann, who got me into oncology. And he convinced me, by the way, that there was a lot of policy going on in oncology. This was ten years after the National Cancer Act. It was still being developed, and he really explained to me that I could take this interest in science and this interest in policy, and I could meld it all together. Of course, it really bloomed when I spent 12 years at the American Cancer Society as the chief medical and scientific officer because, there, I did policy. I explained policy to people. We were heavily involved in the crafting of the Affordable Care Act. We did epidemiology to show that, if we could get our act together and actually provide adequate care throughout the entire spectrum from prevention through appropriate screening, appropriate diagnosis, and appropriate treatment, of the 600,000 people who die every year in the United States, our estimate is we could prevent 130,000 of those deaths. Twenty-two percent of all deaths in the United States due to cancer are preventable by applying current technologies. No new drugs, no new treatment; just give everybody adequately what we already have, and 22% of the current deaths would go away.

OLIVER: Staggering number. And, you know, given that Dr. Bertagnolli recently developed, you know, a National Cancer Plan, which emphasizes, how do we get to the goals that President Biden has set, very important. So you've brought in two themes that I want to explore a little bit more, that of cancer prevention and then also that of health disparity. So maybe we'll start with the prevention. You also spent some of your time at NCI, I believe.

OTIS: That's right.

OLIVER: At some point, you got fascinated by cancer prevention as a discipline, right?

OTIS: Oh, I had 13 beautiful years at the National Cancer Institute from 1988 to 2001. I trained in medical oncology at the NCI because John Ultmann told me to come there and train, and then I went over to the Division of Cancer Prevention and Control and worked for another mentor, Barry Kramer. That's where I learned the importance of risk reduction, the fact that we could actually save more lives through an effective prevention and risk reduction program than through an effective treatment program. I went to the Division of Cancer Prevention and Control. And then, in the middle 1990s, I was very fortunate. Rick Klausner was director at the time, and he moved me into his office, and I created a suboffice in special populations research where we tried to help develop the field of health disparities. At the time, the Surgeon General, David Satcher, made it something that he really wanted to focus on. Indeed, it was called minority health, or special populations health, and David Satcher, in 1996, said, "Let's call it what it is: disparities in health."

OLIVER: So tell us a little bit more. Maybe not everybody listening is intimately familiar with cancer prevention as a discipline…

OTIS: Mm

OLIVER: Or the discipline of health disparities research.

OTIS: Mm. Well, the clearest cancer prevention discipline ever, of course, is smoking cessation, tobacco control. How do we stop people from smoking? We've learned that giving them very graphic messages in Europe actually keeps people from smoking. We learned that taxing it, raising the minimum age, all of these things decrease the number of people smoking. Health promotion, health education among children at the age of eight and nine years. By the way, the majority of people who smoke start smoking before their 17th birthday. Most common age that people start smoking is 16. The second most common age is 15.

OLIVER: Wow.

OTIS: So, getting into these people, getting into their minds before they start smoking, that's all very important. Now, that's easy prevention. Epidemiology over the last 25 to 30 years old us the second-leading cause of cancer in the United States is not obesity, but the combination of obesity, consumption of too many calories, and not enough exercise. Think of it as a three-legged stool. Obesity is the easiest marker to remember, but it's the consumption of too many calories and not enough exercise. Indeed, our success with tobacco control is such that, by the end of this decade, the obesity-energy imbalance combination will be the leading cause of cancer in the United States. Again, another something that we can do to help reduce the number of people getting cancer: risk reduction again. We've had tremendous success with risk reduction through vaccination: hepatitis B; human papillomavirus vaccine and so forth, preventing cervical, probably some head and neck cancers with HPV, as well as preventing some hepatomas, or liver cancers, and some lymphomas with hepatitis B vaccine. The things that we can do to lower risk, pollution. You know, when we smell things like diesel engine exhaust, that's not a good thing. We've learned these things by the way over the last 40-50 years and trying to implement it. Now, poor people tend to live in more polluted environments, heavy metals; they work in jobs that are more likely to expose them to things that cause cancer. And so, risk reduction among poor people is a really, really important thing. These are the cheap ways, by the way, to save lives through reducing the number of people getting cancer. Now, you asked me talk about health disparities; we focus a lot on this, but still not enough. There's a substantial number of Americans, actually large number of Whites than Blacks or any other race, who get less than optimal care once diagnosed. Now, they get less than optimal care once diagnosed because they live in systems where resources are scarce, and this is one of the reasons why one of my themes throughout my career has been if we do screening we have to do smart screening, because there's a lot of screening out there that's being done that's unwise. It's not going to save lives, but it does consume resources and by consuming those resources, it's actually depriving people of getting adequate treatment once diagnosed. So, it's harming the people who are getting the unnecessary or unwise screening and it's harming people who actually have disease by taking resources away such that they don't get adequate treatment for their diagnosed disease.

OLIVER: Sounds to me like you're beginning to touch on a theme in your book which you wrote about 10 years ago I think, with Paul Goldberg "How We Do Harm" where you make the case that there is overtreatment in some parts of our population and under-treatment in other parts, and maybe screening as well. Is that correct?

OTIS: That's absolutely correct. Now, many people think I'm against screening. I'm not against screening at all. I'm against stupid screening.

OLIVER: Okay.

OTIS: And I'm for wise screening and I'm for people being in screening programs. And so, frequently for example, everybody is fixated about breast cancer, or now more recently, everybody's fixated about lung cancer and they forget the rest of the patient exists. You know, we literally have women who get annual mammography, but end up dying of cervical cancer because they don't get cervical cancer screening. Or very recently I was reviewing a case--this woman who was getting lung cancer screening which is something very few people get, but she was religiously getting her lung cancer screening and the lung cancer screening was read by the radiologist as, "Her lungs are clear, but did you know she has stage III breast cancer?"

OLIVER: Wow.

OTIS: She's not getting breast cancer screening; she's only been getting lung cancer screening. We get--we need to think about the whole person and we need to do the screening tests that have been proven beneficial in perspective randomized trials in the populations that will benefit from it.

OLIVER: And do you think adjusting that kind of work would then allow us to bring more people into screens and be more equitable in our distribution of those resources?

OTIS: It absolutely would. It absolutely would. Sometimes we get hung up on certain things like screening and we forget things. For example, in breast cancer screening, lots of discussion about should we be screening women in their 40s? Now, I'm going to say I'm not against screening women in their 40s, but I am against forgetting the fact that there is a substantial number of women in their 50s and 60s where we know it saves lives and they don't get screened, or once screened, they don't get adequate treatment. Let's talk about that as well. You know, literally 40% of women in their 50s and 60s don't get routine regular high-quality mammography and that's, by the way, the average age of a breast cancer death is in the late 60s.

OLIVER: Uh-hmm.

OTIS: We literally talk about should we screen women in their 40s while we let a larger number of women in their 50s and 60s die and not say anything about how we could save their lives, again, I have to end that thought by I'm not against screening women in their 40s. I'm just against focusing only on that and forgetting about women in their 50s and 60s. The other thing I will point out is there's a beautiful CISNET NCI study from about 10 years ago that says, of the 43,000 or so women who die every year from breast cancer, about 10,000 deaths are due to lack of good treatment and about 5000 deaths are due to lack of screening. We talk about screen, screen, screen. More women die because they don't get good treatment after diagnosis and because they don't get early diagnosis. And I'm for, again, I'm not against screening.

OLIVER: Right.

OTIS: We talk about screen, screen, screen. More women die because they don't get good treatment after diagnosis, than because they don't get early diagnosis. And, again, I am not against screening. I'm just--let's think about what we can do to best save as many lives as possible.

OLIVER: Sounds to me like you're saying follow the science, right? Follow the evidence and apply the resources you have most wisely at the points where you can have most effect.

OTIS: Follow the science and let's do what we can do to save as many lives, prevent as many deaths as possible.

[UPBEAT MUSIC]

OLIVER: The NCI is the US federal government's principal agency for cancer research and training and conducts a broad range of research in its Intramural Research Program. If you are interested in gaining research experience and training at NCI there is a great first step, you can take. Here with me to tell you about that is Chanelle Case Borden, Associate Director of Training Programs in our Office of Training and Education.

CHANELLE BORDEN: Thanks Oliver! We are talking about a webpage called Future Fellows where you can submit your CV or resume if you are interested in a postdoctoral, doctoral, or postbaccalaureate (both master-level and post-college) fellowship at NCI. We will put the link in the show notes, but you can find the webpage by searching for "future fellows NCI." At the site, you can tell us about your research interests and also indicate a division or center that you would like to work in.

OLIVER: What happens once an applicant has submitted their material at the site, Chanelle?

CHANELLE: Once you are in the database, any research team leader at NCI can see your application for the next six months. If they have an open position that fits your indicated interests, they will contact you directly to arrange an interview. A question we commonly get is when are positions typically available. Generally, most postbac and postdoc positions are available on a rolling basis, but the fall/winter is generally a time where we see a lot of postbac hiring to begin the following summer. Internally, we are always promoting the use of Future Fellows to our investigators and staff to fill their open positions. So, if you are considering completing training at the NCI, I encourage you to submit your information.

OLIVER: Great, thanks Chanelle. So that's Future Fellows on the NCI's cancer.gov website – check it out and submit your info today. You never know where it might lead.

So, to someone listening maybe still making a choice about which, you know, career to go in to which may be part of the cancer research world, what do you think are the most exciting opportunities and challenges that are in the fields that you work in in prevention in health disparities research?

OTIS: That's probably the most unfair question. I--well, I'm really turned on by looking at the numbers; looking at the trends; looking at what treatments work, what treatments don't work; what screening tests work, what screening tests work better; looking at resources. That's what turns me on. There's some folks out there who are really into molecular biology. I encourage them to go into molecular biology. You know, I speak the language, but I'm not a molecular biologist. I know enough about molecular biology to truly appreciate it, and I would encourage people if you are really interested in something, pursue what you're interested in. At Hopkins I was very fortunate that Michael Bloomberg gave me an endowment to come spice things up at Hopkins and mentor young faculty, you know, I'm now of age that I'm doing for young faculty what I hope I'm doing for young faculty what John Ultmann and Elliott Kieff did for me and Barry Kramer as well. So, what I tell people is, find something that you're really interested in. Now, it's best that you find something that you're really interested in that's really hot or that's better yet going to be hot in 5 to 10 years, and if you're really good, you're going to be the one that makes it hot, okay? Those are the people who end up getting tenured early and get to full professor by the time they're 40 and start winning things like Lasker awards and so forth. You know, there's a fellow named Eddy Reid [assumed spelling] who was, he was I think the first Black Fellow in the medicine branch at the NCI. He got there a few years before I did and he was famous for saying two things that stuck with me, and this is important for young people coming into science. "Focus, focus, focus." And the other thing that he said which is I think is very appropriate for the clinicians or the clinician want-to-be's, "It's the greatest honor one human being can give another is to say, can you help me?" And if you're a physician, you need to remember that every time you meet a patient, what they're really saying is, "Can you help me?" And they're giving you the greatest honor one human can give another.

OLIVER: Thank you. That's amazing advice. You just touched on it, I wanted to ask you, you've combined medicine and science in your entire career. I wonder if you could comment on how seeing patients informs your research. I know you've wrote very movingly in your book; I think the opening scene in "How We Do Harm" is you taking care of an emergency situation with a breast cancer patient. You were Chief Medical Officer I believe, Medical Director of the Georgia Cancer Center at the Grady Memorial Hospital, Atlanta famous public hospital.

OTIS: Yes. I got called down to the emergency room by a wonderful emergency medicine doctor Tammie Quest, somebody who really cares and she was just totally disgusted when she saw me and sort of flipped the clipboard, we didn't have computers back then, Grady I think got computers just in the last few years, and the lady's chief complaint was "My breast fell off can you reattach it?" And this is a woman who had a little bit of education. She might not had been a college graduate, who had watched her breast cancer grow in her breast. She could feel it for over 10 years. She had a fairly large breast. The tumor was close to the chest wall and --there's this phenomenon that we call "auto-mastectomy" where the tumor eroded all of the blood vessels and her breast shriveled up and dropped off and she had a gaping wound on her chest where her breast used to be. And the other part of the story is, she wrapped the shriveled up breast in a moist white terrycloth, put it in a plastic bag and brought it in a paper bag, the kind that you would have your lunch in--brought it to the emergency room, but that was my introduction to people who have a problem, either don't know what to do about that problem or it's a combination of not one to realize they have a problem, as well as, if I just ignore it maybe it will go away. And I took care of that woman for about two years. She had widely metastatic disease, I took care her for about two years, but she taught me a lot. And this is a longwinded way of saying, I still see patients. I still take care of patients, because it keeps me grounded. It keeps me understanding of what is going on out there, what the patient's face, what some of the doctors who are taking care of the patients face in terms of obstacles to provide the good care.

OLIVER: Thank you for sharing that, and you know, I in reading the book, you--maybe I'll put it this way, you don't shy away from being critical of your discipline of medicine and I wonder if you could tell us a little bit about that. I can't believe that's necessarily a comfortable place or a comfortable thing to do, but…

OTIS: Well, no. You know, I was--I was amazed at this myself. You know, grew up in the inner city of Detroit. I've been beat up by gangs. I actually sort of had adjunct membership in a gang for a while for protection purposes. I'm a big guy. I can take a hit. I've had tremendous fortune and I felt an obligation to tell the truth. I was willing to take a big hit for that. Amazingly, my colleagues in medical oncology especially, but medicine broadly embraced me and said thank you. The first thank you, The American Society for Clinical Oncology gave me a special recognition award. The American Medical Association gave me the first of these medals you wear around your neck on a ribbon, you know, they gave me an award and their--they have every year they have a Distinguished Physician Award, C. Everett Koop is one and a few other--all of a sudden little Otis from Detroit [brief laughter]. So, I found out that a lot of people especially doctors, and you know, some of the things I said in the book actually, you know, was critical how some doctors make money, but the professional societies embraced me and said thank you and so I learned to respect people in medicine in a way I never dreamed.

OLIVER: Well, that's very encouraging to hear. I do think it's a phenomenal read. I even--I'm not a physician, but I learned a lot about these things, and you also describe a lot of sort of big systemic issues, right, that that are sort of built in to the system that we have in the United States. I wonder in closing whether you could make any comment; what do you think the future holds? How do we address these big, uh--big issues?

OTIS: Well, you know, we had the Affordable Care Act which I've actually written--I've actually authored papers and studies, that show that people are not dying because of the Affordable Care Act and some of the new disparities of the 21st-century are not Black versus White, they're Mississippi versus Massachusetts, because Massachusetts has more better implemented the Affordable Care Act versus Mississippi. So, as we go forth, I think we need to focus on those sorts of things looking at disparities in general. I'm somewhat optimistic. I'm somewhat--I am truly optimistic that we can get people to focus on worrying about the health of others. The Affordable Care Act was called health care reform. I think we actually need to try to transform health care. We need to think differently about how we approach health care. Part of health care in my world involves going in the second and third grade and teaching kids about the value of vegetables and avoiding fast food. Part of my idea of health care is bringing their parents in the PTA and teaching them the same thing, trying to get beyond this obesity epidemic. You know, in 1970 15% of American adults were obese; today, it's well-over 40%, for Black women it's closer to 70%. We need to get on top of this. And so, my view is we need to try to transform health care. We need to stress a lot of the risk reduction things out there. We need to try to teach and coach people how to stay healthy. And we need to also have good screening programs that are scientifically based, also remember to stress diagnostics and stress appropriate care. We need to think about how people get into the health care system and are guided through the health care system; navigation and those sorts of things that are important.

OLIVER: Well, you give me hope as a cancer survivor and as a person working in cancer for my whole life, and let me just say that I think if there is hope, it's because people like yourselves have this systemic view and this broad view and deep view of the field and what needs to change and you know work in it, advocate for it and teach us about it. So, thank you very much Dr. Brawley for coming on the podcast.

OTIS: Well, thanks for having me. I really appreciate this.

[UPBEAT MUSIC]

OLIVER: So, I'd like to now turn to a segment we call "Your Turn" because it's chance also for our listeners to send in a recommendation about something they'd like to share. If you listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk that you found inspirational or amusing or interesting. You can send those to us at [email protected], record a voice memo and we might just play it. But now I'd like to invite our guest Dr. Brawley to give his recommendation.

OTIS: Well, I'm not going to give a recommendation of a book or a TV show, my recommendation is that all of us focus on, you know, this was a slogan at that the old NCI had that maybe should be brought back. I hope Monica Bertagnolli is listening to me. It was "5 a Day--for Better Health!"

OLIVER: Okay.

OTIS: And people should try to eat 5 to 9 servings of fruits and vegetables per day for better health. You know, an apple a day is not good enough. It's 5 to 9 servings of fruits and vegetables and then we should all think about how much exercise we do.

OLIVER: Oh, well thank you very much Otis. I can sense that you're taking care of us like we are your patients, so I really appreciate that. I'd like to make a recommendation myself as well, and that is the book that Dr. Brawley wrote with Paul Goldberg, the "How We Do Harm" book. It's 10 years ago, but it speaks to a lot of the themes that we touched on here and it's an exciting and fun read and I can only recommend it. We will put show note--this in the show notes and let me just thank you again Otis for coming on the podcast and sharing your views and your experience.

OTIS: Thank you.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests. We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected]. Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser. A special thanks to Lakshmi Grama and Sabrina Islam-Rahman. Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers. If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query. We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this week's episode, we discuss how the revolution in computational science is changing what we can learn from clinical trials and biological samples to improve immunotherapy in a conversation with Dr. Peng Jiang. Then we turn to the practical matter of personal finances and taxes for graduate students and postdocs in a conversation with Dr. Emily Roberts of Personal Finances for PhDs.

Segment 1: Computation to Improve Therapy

Peng Jiang, Ph.D.

Cancer Data Science Laboratory

NIH Earl Stadtman Program

Ad: NCI Rising Scholars: Cancer Research Seminar Series

Segment 2: Finances

Emily Rodgers, Ph.D.

NIH Intramural Research Training Award (IRTA)

Strength Finders Assessment

Personal Finance for PhDs Podcast Apple or Spotify

PhDstipends.com

Postdocsalaries.com

Your Turn:

Let Go, Move On Between Ignorance and Enlightenment by Venerable Master Hsing Yun

Die With Zero: Getting All You Can from Your Money and Your Life by Bill Perkins

Tig Notaro LIVE

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host Oliver Bogler. I work at the NCI in the Center for Cancer Training. On Inside Cancer Careers, we explore all the different ways that people join the fight against disease and hear their stories. Today, we're talking to Dr. Peng Jiang, a computational scientist in NCI's Center for Cancer Research who is focusing on using big data to understand how cancer can become resistant to immunotherapy and overcoming it. After the break, we are speaking to Dr. Emily Roberts of Personal Financial for PhDs. She joins us to talk about how to make things work financially during grad school and post-doc years. Then stay tuned to hear recommendations for interesting things from our guests and learn how you can take your turn.

OLIVER: It's a pleasure to welcome Dr. Peng Jiang, a Stadtman Investigator in the NCI's Cancer Data Science Laboratory, where he leads the section on Computational Cancer Immunology to the show. Welcome.

PENG JIANG: Yes, thank you, Oliver, for the introduction.

OLIVER: It's a great time in the history of cancer research with the explosion of knowledge about many cancers leading to the development of a good number of new therapy approaches. But in many cases, resistance arises to these new therapies. And we're learning resistance itself may be mediated by many different mechanisms, so making it very hard to predict the response to a treatment and its durability. How can a computational scientist like yourself address this challenge?

PENG: Yes, Oliver, this is a really great question. As you know, like for almost any type of an effective therapy, in most cases -- I will say for more than 70% of cases for any therapy resistance will eventually come one day. It's really a bottle neck for the entire field. And a unique angle from our data science is that we utilized the large amount of clinical data from patients. Realize that patients' data tells us what is going on under that resistance. Like, you know, the cause for resistance could be really complicated, right? Like one clinical trial, one cohort patient may only tell you part of the story, because it's so complicated. However, if you aggregate a lot of data sites from different centers, from different studies, and really look at the behavior of tumors with developing resistance, you know, really big data mining, you can see lots of like new mechanisms as a price. This is a unique advantage of data scientists because we can utilize the big data-driven approach to aggregate lots of resources from different publications from different centers to get a holistic overview of that resistance process, and then develop some hypothesis and gather some key experimental validation. So in short, like I think our data sciences are an advantage in this process is the big data, the size.

OLIVER: So what kind of data are you analyzing, clinical data but also biological data of the tumors?

PENG: Yes, yes. So like right now, tumor sequencing is becoming cheaper and cheaper so there are lots of RNA sequencing, whole exome sequencing to tell you RNA level somatic mutations, and also epigenetic sequencing to tell you the epigenetic modifications. So we analyze all kinds of sequencing data, transcriptomic data from different studies paired with the patient's clinical outcomes.

OLIVER: And you're focused on immunotherapy, which of course is a particularly exciting area right now. You've got check point blockades, you've got CAR-T cells now, personalized mRNA vaccines.

PENG: Yes.

OLIVER: What are the challenges of these approaches, and how does your work specifically address them?

PENG: Yes, so first of all, immunotherapy is indeed a breakthrough, but remember for most current immunotherapies, for most solid tumor types more than two-third of the patients will not respond to the treatment. So basically for the majority of the patients still immunotherapy does not bring any help to them. And if you look at the rule of nature, any mechanism you develop in biology or in the human body, must have one or two counter-mechanisms to stop that. For any kind of mechanism, including immunological processes or any kind of other process. The same for immunology. Any anti-tumor or anti-pathogen pathogen immune response process must have two or even more of a counter-mechanisms to stop that through the evolution. It basically means that the tumors have so many options to go against any immunotherapy we deliver against them, right? Because nature through evolution, there are so many things to just come up.

OLIVER: So, these counter-mechanisms they are normally -- in a healthy individual, they balance each other out to --

PENG: Yes.

OLIVER: Prevent runaway processes.

PENG: Exactly. And this is a later product of evolution, because -- right, because in evolution there is no single mechanism that can overcome all other mechanisms. There is always something that has to counter.

OLIVER: So that really strikes me as incredibly complicated, the immune system is itself complicated. But then we also recognize that the tumor is really a complex community, almost a tissue in itself or an organ in itself, right, with all kinds of cellular components in it.

PENG: Yes.

OLIVER: How do you pull and tease that apart?

PENG: Yes, you know, like the sequencing technologies nowadays are becoming so powerful, right, through like at least through whole exome sequencing you can see lots of mutations. RNA sequencing you can roughly infer what cell populations are in a tumor, and also like spatial sequencing is becoming more and more affordable. Right now you can even know the molecular spatial structure of like tumors, so which means our with the advance of our technologies understanding the tumor structure will become easier and easier. So I will say that eventually, we should be able to get a really reasonable view of the tumor structure and the underside of how the tumor counteracts against the immune response.

OLIVER: How does the structural three-dimensional composition of the tumor, how will you learn from looking at that, how the immune activities are overcome or the resistance arises?

PENG: Yes; you know, like the most conventional histopathology staining like H&E, a very conventional and commonly used approach, right? It just looks at texture, looks at morphology. You can infer what type of cells roughly through the cell morphology. This is pretty cheap, I would say, like several dollars for a tumor sample. And then if you want to know more of the sub-types of the cells in the tumor then multiplexing immunofluorescence of six or seven proteins are becoming more and more possible right now. And this could already tell you a lot. If there are some immunosuppressive cells what could they come from? What could be their lineage? Multiplexing immunofluorescence can already tell you a lot. And then here come new technologies, like spatial transcriptomics, coded spatial proteomics of 40 protein markers or maybe RNA sequencing on a genome scale. However, these technologies are still too expensive from a clinical application, right? But at least for research, they greatly help to reveal the structure of the tumor.

OLIVER: So, help me understand how this knowledge will then allow you to support therapies or to avoid resistance or overcome resistance.

PENG: Yes.

OLIVER: I imagine these three-dimensional tumors, there are immune cells in there, there are tumor cells, there are all kinds of stromal cells. Now you have detailed transcriptomic, and mutational, and epigenetic information about all these different cells. How does that then transform into something that you can do in the clinic?

PENG: So, like when a tumor is fighting a mechanism to go against, you know, immune-attack, typically, this mechanism will not happen all across the tumor. It will only happen at a certain region more frequently the border between the tumor and the immune cell section; because you only need like the soldiers to fight in the front line, right? So which means conventionally if you sequence the whole tumor, you will really dilute the signal of the key mechanism at the front line. This is why the current special technologies is very useful, because it can help you to pinpoint on the most critical region and have detailed resolution of what is going on molecularly there.

OLIVER: am I right in thinking that you are actually trying to sort of see the resistance arising in that zone that you described - the interface?

PENG: Yes - a very specific zone, and we really focus your sequencing power on the most important zone.

OLIVER: Interesting. So, you're a computer engineer, computer scientist by training. I have two questions. How did you become interested in the work that you're doing today, and how as a computer scientist and computer engineer do you approach it? Do you approach it differently do you think than if you had trained as a biologist primarily?

PENG: Yes. So, like initially when I came to the USA for graduate school study my major was computer graphics. Because Princeton University, my PhD school, has a terrific computer graphics program. But most programs -- most students who graduated from Princeton's computer graphics program, they will join Pixar or like Snapchat, you know, like to make computer games, movies, more for entertainment. To be honest, I could be biased. I think, you know, depends on what is the utility of computer games for our young generation. And then at that time, one of my most respected people, my flute teacher died of a brain tumor.

OLIVER: Hmm.

PENG: I learned so much from him, both music and also being a good person, and you know, like I think kind of like my father kind of deal.

OLIVER: Yes.

PENG: And for such people, I deeply respect, just suddenly die of brain tumor within three months --

OLIVER: Wow.

PENG: It's really a big shock for me. Because like three months before, I had seen him. He seems to me quite normal. But suddenly, he starts to respond very slowly if I ask him a question, and then, after 90 days, he died.

OLIVER: Wow.

PENG: Like this is a really deep shock to me because some people you really respect can leave you, right? Like in a short amount of time.

OLIVER: Of course.

PENG: And but you know, at that time, I just keep an open mind. A good thing about Princeton is it does give graduate students lots of flexibility so if you suddenly become interested in some other aspect; because the school gave you -- gave everyone really a safeguard financially. So you can -- you have some free time to explore around the graduate school. And then you know, after many years, I realized that the cancer research is not about starting off, it's not only about science, it's more about human emotion. If you want to do something to allow the people you love, the people you respect to have a better life or to at least live a few months longer --

OLIVER: Yes.

PENG: To enjoy the company of family members. And gradually, I just found out that cancer research is a really mixture of enjoying scientific exploration, scientific endeavors, and also doing something to help our basic human emotions. So this is why, you know, I eventually decided to switch from computer graphics to like bioinformatics with some focus on cancer-related applications.

OLIVER: I can see that it's a deeply motivating experience. And obviously, we're excited to have people with your skill set and expertise in the world of cancer. So you bring that computer engineering expertise --

PENG: Yes, but Oliver...

OLIVER: Yes.

PENG: I also mentioned one important thing here. I enjoy a lot in this process, but also I somehow not only me, I suffered a lot in this process; because to be honest, like if you look at the industry, the computer and IT industry in the US, and you know, other parts of the world are really booming a lot.

OLIVER: Yes.

PENG: Which means if I'd stayed in computer science, joined Pixar or joined those big IT companies. The pay is so high. The pay is just so high. You know what I mean, and --

OLIVER: Yes.

PENG: To be honest, I think that it's much easier if you are getting high pay to stay computer science than going into biology and cancer research. And unfortunately, this is the truth. So like I will say that going this path compared to staying in computer science, it's not really kind of -- even if it's young people, from the financial point of view. And I'm still thinking about very hard of how to resolve this balance, this like, through some mechanism. But I think it's a major difficulty, especially at NCI, when we want to recruit computational post-docs, we are competing with Amazon close to us. They are paying something that is even comparable to my like boss, our bosses at NCI.

OLIVER: Yes.

PENG: So, then it's so hard to compete for talented young people to join our endeavor nowadays. So, I think this could call attention of our higher leadership or maybe people around us could think about some crazy solutions.

OLIVER: Yes, thank you for bringing that up. I think that is a real challenge, because we need people with that talent, but we are competing with --

PENG: Yes.

OLIVER: A very active private sector.

PENG: Exactly.

OLIVER: Yes. So as a computer scientist, how do you think your approach to the biological problem of cancer is perhaps different from that of someone like myself who trained as a biologist?

PENG: Yes. This is really a personal viewpoint, in my just a personal case, I think a key difference is the way we develop hypotheses, right? Because fundamentally, biology is a hypothesis driven science. We need to find a hypothesis first. Like as computer scientists, we have a little bit of luxury to look at lots of data from human clinics and see clinically what are our biggest correlatives of our patients' clinical outcomes, adverse events, through some more complicated like models what are potential regulators. So this means that, I think that we do have a big advantage about developing some more -- some better hypotheses through large -- through analyzing a larger amount of human genetic data. However, our disadvantage, our biggest disadvantage is because we are trained as computer scientists sometimes, we may not really know the biology deep enough, so we may focus on something, which may not be really useful at the very beginning. This is why personally, I started reading biology studies since the fourth year of my PhD studies. I spent years to catch up with biology knowledge. So I will say a computer scientist, if you want to do cancer research, should take a considerable amount of time to learn biology. Otherwise, we may put our focus on something not so useful.

OLIVER: Yes, and you continued your journey after Princeton at Dana Farber in the Harvard School of Public Health, right? So --

PENG: Yes.

OLIVER: Presumably, that -- you were steeped there in cancer biology. Why the Harvard School of Public Health? Did you do public health research?

PENG: Oh, it's just a name issue because like the Dana Farber Cancer Institute is an affiliate of Harvard University. And our department is affiliated under the School of Public Health.

OLIVER: Ah.

PENG: But all other departments are affiliated under the medical school, but it's not really related to the public health. It's just an affiliation issue.

OLIVER: I understand. So you focused there then on the kind of detailed molecular analysis of cancers that you're now combining with your computation?

PENG: Yes. Yes. Yes.

OLIVER: And you -- I believe you were using AI, of course, in your work as well, right? I mean, AI is exploding all around us even --

PENG: Yes.

OLIVER: Non-computational people myself can't avoid noticing it these days. How are you using it?

PENG: Yes; so like in biology, lots of data does not really have obvious dimensions, right? For example, for gene titres, it's easy. – you can look at the readout of different genes. But for other data types, like histopathology images, or protein or spatial transcriptomic what you get then is both the molecular marker and the spatial structure information. It's just impossible for human eyes to analyze those kinds of data. This is why you have to use AI to somehow model this data in a more dimensional space to analyze what is the differential feature. So like I will say that for unidimensional data and spatially structured data, that lots of new biology technologies are generating right now, AI is a tool you have to utilize.

OLIVER: So, you received the K99/R00 award while you were a post-doc, right?

PENG: Yes.

OLIVER: And how did that impact your next step? You came to the NCI, obviously, so.

PENG: Yes. Yes, so I gave up the K99 because if I want to join NCI, I have to give up the K99, right --

OLIVER: Yes.

PENG: Like at NIH. I think the advantage is after I got the K99, lots of schools invited me to go for a faculty interview. So, you know, and also for like a free flight, and dinner, and talking with lots of people. It's really kind of an enjoyment, even though eventually I did not really use the K99. I do think the K99 did a really good thing indirectly. The main thing is that I got a lot of invited talks and publicized my research profile. Otherwise, as a young faculty or as young people, it should take some time for me to really get lots of invitations.

OLIVER: Right. So you came to NCI. What made you decide that the NCI's Intramural Research Program was the right place for you?

PENG: It's about people. I remember I met with my current boss, Eytan Ruppin -- or I will say current mentors, like my Lab Chief, at the AACR conference in 2018. After talking with Eytan for ten minutes, I immediately decided that he is the one I want to work with. I want him to be my mentor and my boss in the future. So it's more about like the charisma and also the dynamic feeling when I talked with my current mentor, Eytan Ruppin, is the number one reason. The second reason is that I interviewed at NCI. I talked with so many people here. I really love my scientific discussions with NCI people and NIH people. The third reason, and also a very important reason, is the possibility of scientific research. If I stay in the medical school, I need to probably write grants all day long. How can I focus on research idea? But it's a little bit more time, right? So, for example, at Princeton, Andrew Wiles could spend a decade of years to focus on proving Fermat's conjecture because he had financial stability and safety. The counterpart in biology, the only place I find this is NCI. So, this institute just gave me some safety so that I can take a risk and work on some long range things. Otherwise, you know, in other private institutions who are also very great. I cannot really probably afford to focus on some long-term projects without just keep writing grants.

OLIVER: Yes, the NCI's -- or NIH's program, intramural program, is designed exactly for that, right?

PENG: Yes.

OLIVER: Longer-term --Higher-risk projects with less cycle. That's fantastic. So, what was it like to start your own research group?

PENG: Yes, like to be honest, at the very beginning, it's not so much different from being a post-doc; like maybe I actually became a super post-doc doing the research by myself because at the very beginning I was just by myself. And then COVID-19 came, right? You know, it's very hard for me to recruit people, because for me, as a young PI, mostly I still recruit people from China; you know from my Chinese background. But then when the COVID hit with the travel ban, I cannot recruit people from China, so just by myself still as a single post-doc. And gradually, I have a post-doc and one student, so I mentored them, but, you know, I still need to do quite a portion of the programming work by myself, but also mentor them to somehow do the work together, basically. It's not really like my post-doc mentor. She can somehow more depend on us to closely work with my usual trainees. They are my colleagues, my bench mate, you know, this kind of work. And until recently, like after the COVID is gone, I can kind of get more people in the lab. Then gradually my focus switched from programming and working like a close -- like a colleague more to the mentor and maybe manager, actually how to manage people; but this only happened recently.

OLIVER: Yes, and then you were recruited as part of the Stadtman program.

PENG: Yes.

OLIVER: What is that program?

PENG: Yes, this program is -- like I guess, you know, like it's like an NIH institution-wide kind of umbrella program to -- recruit promising young faculties, give a kind of a guarantee of research resources, making sure we can totally focus on scientific research without worrying about the money issue. So, like basically I think this is a really unique setting, at least, of what I could find in the US that could really give young people total scientific budget safety to focus on some long-term things, even from the very beginning.

OLIVER: So, help us understand what the next months or years for your research program look like. What are you excited about?

PENG: Yes, so currently I'm really excited about using big data approach to find new secreted proteins underlying cancer immunotherapy resistance. Because like recently like we have collected lots of human clinical data from different clinical trials that other people published, and also from our collaborators. And we mathematically examined this large body of human clinical outcome data from cancer immunotherapy trials. We really found out that a group of secreted proteins with really less-known functions are really top indicators of either bad or good immunotherapy outcome. And also traditionally, secretion proteins studies is a blind spot for a genetic screening approach; because genetic screening cannot study secretion proteins. All neighbor cells are still sending other signals. So mutagenesis on one cell will tell you nothing in the microenvironment. In fact, this is why I was so excited about this blind spot of traditional genetics approach, but really gave a computational data driven approach some unique advantage. So currently, we are doing data integration, computational modeling and also mouse models to study the -- to identify new secreted proteins driving the cancer immunotherapy response. And we have some -- quite promising initial results; found of some new secreted proteins that are -- have really unknown functions but that really have a dramatic effect in driving cancer immunotherapy results.

OLIVER: So those proteins might be points of future intervention.

PENG: Yes, because any secreted proteins could be a drug by itself, based on kind of engineering, right?

OLIVER: Interesting.

PENG: Yes.

OLIVER: What's the advice you're giving to early career scientists, maybe even computation scientists like yourself who might be interested in cancer? What advice are you giving them?

PENG: Yes, maybe my advice is more specific to computational scientists. Like the first advice, only do science if you are really enthusiastic about it. Otherwise, for computational scientists, just don't do it. Most of the time, you will probably -- for people who are not really sure about science, what you'll end up is that they do maybe one or two years science research then just go to industry. Because for the industry market is booming so much. So I think that otherwise, you know, like one or two years, then why bother just to do that at the very beginning, right, and also for the PIs it's unfair to waste the PI's one or two years of funding and then see the postdoc just leave to industry. And then if you are really enthusiastic about science and you really want to use your knowledge to change people's life, to make sure that your beloved people, or other people's beloved people who have a few more months of survival time to enjoy family time, or eventually have the disease cured. But if this is your inner drive, then do cancer research with your computational expertise. But for people who don't really have this inner drive to serve for the human beings, the emotion, like I didn't consider about it -- maybe like the industry sector is a really good option. And then, you know, like for people who decide to do the research, my second advice is just to slow down; you know, like don't be too eager to publish or gather papers or scientific publications. Scientific research is not easy. Ninety-nine percent we are getting failures or imperfect results. You really need to slow down to somehow have a kind of a smooth mood-- to somehow enjoy the process of doing scientific research with your colleagues. And then under this mode maybe it's even quicker in the long run to get a good research work published and then establish your signature work in the field.

OLIVER: Well, thank you so much for telling us about your work and your story, and sharing this advice with us. Thank you.

PENG: Yes, thank you, Oliver.

[UPBEAT MUSIC]

OLIVER: The NCI recently launched a new online seminar series. Here to tell us more is Nas Zahir, Director of the Cancer Training Branch.

NAS ZAHIR: Yes, we launched the NCI Rising Scholars Cancer Research Seminar Series in January to highlight the research and contributions made by NCI-supported postdoctoral fellows, and early career investigators at NCI laboratories and NCI-funded institutions nationwide. The talks are every month on the third Thursday, and you can see them and register for them on the NCI website. There will be a link in the show notes, or you can search for "NCI Rising Scholars".

OLIVER: That sounds great! What kind of topics are the speakers covering?

NAS: We have a broad range of topics – pretty much any kind of cancer research. We have had basic science topics, clinical research, health disparities, cancer prevention, immunology, and many more. Each talk is related to a recent publication by the presenter and there is plenty of time for Q&A.

OLIVER: What if you missed a talk?

NAS: We post a recording of the presentation a few days after the talk, along with a transcript and captions so you can always catch the talks at your convenience.

OLIVER: Thanks, Nas –check out NCI's Rising Scholars seminar series if you are interested in some great research that's increasing knowledge right now.

It's a pleasure to welcome Dr. Emily Roberts. Dr. Roberts obtained her doctorate in biomedical engineering from Duke University in 2014, but now she's focused on providing financial advice to early career scientists. Welcome.

EMILY ROBERTS: Thank you so much for having me. It's great to be with you.

OLIVER: Emily, I'm interested. How did you first get the science bug?

EMILY: I -- tough one. So I remember when I was in, let's say, middle school even into high school, I always was a good academic performer, across a lot of subject areas. So I was, you know, on an advanced math track for example, probably like many of your listeners, but I also really loved reading and writing and so forth, and I had the opportunity in high school to attend a magnet high school that was science and technology focused, and I remember that was actually a tough decision for me. I mean, I ended up going there, but my alternative if I hadn't gone there was an international baccalaureate program at my base high school, and so I was like, oh, torn between these two worlds, you know? But I decided to go kind of the science and tech track, and it was in high school that I fell in love with physics, which is what I ended up majoring in, in college, and so it was really, I think, during high school, sort of, I got, you know, a little bit pushed in that direction by the environment that I was in, and I really loved astronomy and astrophysics, and so forth. And I actually decided to go to Harvey Mudd College for my undergraduate degree, which if your listeners are not familiar with it, its tagline is the liberal arts college of engineering. So it's a liberal arts education, but the only majors that are offered are engineering and sciences. And so I thought that was a great balance for me of like, still being able to have like, these different elements in my life, still being able to pursue some humanities studies, social sciences, and so forth, as well as being able to major in physics at an excellent institution. So yeah, that's kind of -- I've always had sort of a foot or an interest in all kinds of different academic subject areas.

OLIVER: Interesting, and then you chose biomedical engineering for your PhD.

EMILY: Yeah, so this might speak to like, I've never settled in one area for very long. So yes, I did physics in my undergraduate. And I liked biology, but I hadn't had a really good biology background in high school, and so it wasn't till I got to college, that I got more biology classes and decided oh, I'm really interested in this too, and so I kind of shifted from physics to biophysics, and then into biomedical engineering. And honestly, I actually ended up picking biomedical engineering. I was very torn again. My passion would have been to study astrobiology for my graduate degree, not an area I know a ton about, but I was reading books about it. I tried to take some courses at the undergraduate level. And I was just oh, this is my passion. But I was also very practical, and I realized that it would be difficult to get funding in that area, and it'd be difficult -- you know, the career options are very limited, and so I ended up choosing biomedical engineering, which I was also very interested in, but because the career prospects on the other side of that degree were much more solid. And yeah, so I don't necessarily like, you know, regret doing my PhD or whatever, but there's always that path not taken of like the subject matter I didn't end up studying.

OLIVER: Yeah, for sure. I mean, there's so many areas of interest. It's always difficult to choose. But then I understand that you chose not to stay in science primarily, but you pivoted to a new career. Tell us about that, and how did that happen?

EMILY: Yeah, absolutely. I -- well, I should mention that in between my undergraduate and graduate degrees, I did a one-year postdoc fellowship at the NIH --

OLIVER BOGLER: Oh.

EMILY: I was in IRTA for a year.

OLIVER: Okay.

EMILY: Great experience. And then when I started graduate school, like I'm sure so many others, I was very optimistic, wide-eyed, and a couple of years into that, I was getting pretty burned out on the research track, was not enjoying myself as much as I had been in the earlier years, and I did a big kind of career reevaluation sort of in my third year, I would say, of my PhD, and was really trying to decide, should I just leave with a master's? Should I finish? What are my career options? What am I really wanting to pursue here? And I decided that I did have a few career options I was quite interested in that were -- you know, it depends on what term you use, right, alternative careers, outside of academia, these kinds of things. I knew I didn't want to stay in academia, but there were some things I was interested in, in terms of other careers that still required the PhD or the PhD would be very useful as a credential, and so I decided to finish the PhD kind of for that reason. And then, as we'll talk about in a minute, ended up pivoting completely in my subject matter again, but I still find the PhD credential and experience that I had to be very useful in my current career, even though I'm not using my specific research area.

OLIVER: Yeah, no, for sure. I mean, the PhD, you learn a lot about how to research things in depth, how to assemble information, study data, and all those kinds of things. I'd like to go -- dig a little deeper in what you just told us. So, you spent some time kind of doing a survey of what you could do in your career. How did you tackle that?

EMILY ROBERTS: So, I was really, really fortunate that the university I attended (Duke) has a really robust support area in terms of professional development and career services and so forth. I don't actually know right now, but it did at that time, and I think it was really kind of one of the forerunners in providing those kinds of services to the PhD population, not just, you know, the undergraduates and the master's students and so forth. So, I really utilized the services and the exercises and the programs that they were offering. Like, I was one of those, like frequent fliers, you know, at those, like professional development events. So, I did that a lot in about my third year of graduate school, and I, you know, did like the strengths inventory and did those tests and all these things, and was just trying to figure out what I wanted. I did identify, as I said, a few careers that I was interested in. The main one that I actually worked in for a tiny bit after my PhD, was science policy.

OLIVER BOGLER: Interesting, so I think you're referring to the Strength Finders methodology, which kind of takes a look at your abilities and interests and tries to match you to domains of work, I guess, is one way of putting it. Interesting. So, I think a lot of our listeners probably have similar resources on their -- at their institutions, and I guess engaging with them is a good thing. All right, so where did you end up, and why specifically there?

EMILY: Yes. Okay, so now we have to go back again to this period of time, right after I finished undergrad, when I was doing my postbac and then when I started graduate school. So, I -- no shade to my parents, but I was never really explicitly taught anything about money. And when I was growing up, I mean, we all absorb things about money from our environments, you know, the attitudes and so forth about it, but they were not overtly teaching me anything like about budgeting or credit cards or retirement accounts or any of those kinds of things. And so once I graduated from college and I started this post-bac, I knew I was going to be receiving a stipend. If I remember correctly, was about $24,000 a year. This was like 2007, and I was living, you know, right outside DC. And so this, I knew, because I'm actually from the DC area from the Virginia side, I knew that this is a high-cost of living area, and that $24,000 per year was going to be challenging, and so I sort of started to undertake a self-study in personal finance just to figure out, well, how am I going to survive on this level of income in this certain, you know, cost of living area? And then further than that, like, how do I thrive? Like, what are the adulting things that I am supposed to be doing with my money? And can I manage to do any of those things as a post-bac fellow, and then as a graduate student? So, what started off in around 2007, 2008, as like reading books about personal finance turned into -- if you remember this time period, we're into the Great Recession --, into like reading blogs about personal finance. There was a huge boom in the personal finance blogosphere, and so I was consuming a lot of that content. And then about midway through graduate school, I realized that nobody was like -- not nobody, but there was very little content in terms of these blogs that were being produced about the graduate student experience, like graduate student on stipend experience in terms of the finances. And so I started blogging about my own finances, and in that, was also from time to time discussing kind of grad student-specific issues, like, can I use a Roth IRA, or like what's going on with my taxes? And like these sort of weird technical things, and I realized after a few years of doing this sort of toward the end of graduate school, that I was looking at, you know, the search traffic that my blog got (I had a very small blog) but like the search traffic that it would get, these posts that I was writing about grad student-specific issues were getting all this search traffic in comparison to my other stuff, and I was like, oh, wow, like this content is needed, and there's not really anyone like teaching or talking about this, at least at a national level. And so that was one of the early clues for me that I was interested in this area, but also that it was an area of need among my peer group.

OLIVER: So how did that need manifest? What information were your early readers of your blog looking for?

EMILY: Yeah, as I said, my post, I think it was titled: "The bane of the graduate student's Roth IRA". That was definitely the top post that was getting traffic on that particular blog. So, at that time, you could not contribute non-W2 fellowship income to an IRA that was not considered taxable compensation. That law has since changed, but this was an area that was not well understood, and a lot of people were contributing to IRAs without realizing that they didn't have the proper income to be able to do so. And so my, you know, writing about that and just reading the text and like interpreting what the tax code is saying was helpful to them in understanding, you know, maybe if their brokerage firm or, you know, the IRS sent something back that said, "Oh, actually this is not proper. You can't do this," whenever, they found some information, and then I was hoping to kind of explain and interpret that to them. So that crossover, actually, of like investing and taxes, those are like my two favorite personal finance subject areas, so I actually love that it was the crossover point between those two.

OLIVER: Yeah, you clearly have a passion for this stuff. So just to be the acronym police, IRA is?

EMILY: Ah, Individual Retirement Arrangement. So, an IRA is the type of tax-advantaged retirement account that you can open independent of your workplace. So like your workplace might offer -- well, not as a graduate student, but later on it might offer a 401(k) or 403(b) or a 457. We've probably all heard these kinds of acronyms floating around. But the one that you can get that's independent that does not depend on your university or your employer or whatever is the IRA, the Individual Retirement Arrangement.

OLIVER: And the Roth is a subtype of that, correct?

EMILY: Yes, there's two flavors of IRAs, the traditional (the type that came first) and the Roth, and without necessarily going into details, the Roth is generally preferred by people with lower incomes, like graduate students and postdocs.

OLIVER: Yeah, I'm not asking you to give tax advice here on the podcast, but just trying to make sure our listeners sort of understand what you're sharing with them. So okay, so you had this experience. You were -- let me get this right -- you were still in graduate school, but you were developing this interest and passion, and you were blogging about that, is that correct?

EMILY: That's correct. I started my first blog in about 2011. That's about midway through my PhD. The other thing that happened that sort of made me realize that this information was needed actually is a good faith effort that was undertaken by Duke, which is that they had put on some seminars. One was maybe about investing. There were a couple on taxes. I actually, ultimately, as through a volunteer position, became involved in like setting up these kinds of events with like, local, you know, CPAs and like Wealth Advisors, and so forth, but what I was realizing is that despite our best efforts from the university side, bringing in these licensed, credentialed very capable professionals to do these kinds of teaching events was not a great fit, because the clients that they typically served were totally out of step with the current reality of the graduate students and postdocs that they were speaking to. And so they, you know, maybe like on the tax side, they might be accustomed to preparing the tax returns of, you know, high-income earning parents of college students, and so then they think they know something about grad student taxes, which are kind of a whole different beast, so they knew a little bit, but not quite enough to make the material tailored and fit the best for that particular audience. On the investment side, they were talking about 401(k)s and I was like, "Um, like, I have a Roth IRA over here. Like, what do I do with that?" You know, so I just realized that, you know, because of the client mismatch, those were not the best kinds of people to be teaching this material. And, frankly, someone from their own peer group (me) with that self-knowledge and that, you know, reading and so forth I was doing was quite capable of teaching this material.

OLIVER: So, a real gap, I guess, in what was being offered and what was being talked about, despite Duke's best efforts here.

EMILY: Yeah, and again, like, I want to commend Duke for even trying to do anything in that area, because so many universities don't and didn't at that time, but, you know, I could do a little better, and so actually, I again, like thank you, them, for giving me the opportunity to give my first speaking engagement on this subject, which was after I defended, I was sticking around Durham because my husband, who also defended at the same time was transitioning to a postdoc position in his same PhD advisor's lab, but my advisor had left the university and I was like, "Whoops, I don't have a job anymore." And so I was kind of kicking around, not sure what I was doing and, you know, looking for some work opportunities, and in that time, I was like, hey, why don't I just like, develop a seminar on everything I think a graduate student, you know, on a stipend needs know about personal finance? And I gave that as a, you know, a volunteer thing through the group that I had been working with for a couple of years there at Duke, and I just loved it. Like I had so much fun developing the material, delivering the engagement, answering people's questions, and I was like, how do I make that my job? Like, that was so much fun, and so that was kind of what launched the business, Personal Finance for PhDs out of, you know, the sort of side hustle hobby-type of pursuits that I had been doing earlier.

OLIVER: Yeah, so you had a really good chance to kind of market test what you were offering, but I would guess that it would have still taken some courage to take that leap into, okay, I'm now going to start my own consulting business, if that's the right way to put it. Is that true? Did you feel courageous or was it -- did it just seem obvious to you?

EMILY: Mm, so I am not really a risk taker, so this was a big risk to be doing with my career. And so there are a couple of things that contributed to me being able to take that risk at that time. By the way, I don't call what I do consulting or advice giving.

OLIVER: Oh.

EMILY: I call it financial education --

OLIVER: Okay.

EMILY: -- because I don't have a CPA. I'm not a CFP. No, it's totally fine. Like, everybody gets confused about this, so I just wanted to -- people are always like, "Oh, you're a consultant, right?" I'm like, well, the business is similar to a consultancy, but what I do is not consulting.

OLIVER: Got it.

EMILY: So anyway. But yes, there were of couple things at that time. So one was that, as I mentioned, my husband had a job, and we had joint finances and so, you know, while not lovely living, you know, two people on a postdoc salary, it was okay, and I was also -- I had a side hustle. Like, I was bringing in some degree of income, right? And so that was okay, at that time for a little while because the other part of this picture is that my husband and I, we got married about halfway through graduate school. We were both kind of aligned on this, and so we were both working on our personal finances. I mentioned earlier, I was doing a lot of learning about it, but I was also doing a lot of application, right, you know, saving up the emergency fund, starting to use investments like in Roth IRAs, so forth, these kinds of things, paying off debt. And so because we had been doing that for this seven years, right, between when we both graduated from college in 2007, and then, you know, 2014, we had quite a decent nest egg built up by that time. And so that gave us both some confidence that it was okay to take some risk in our careers that we might not have been able to do had we not had that kind of financial safety net in place. So not only did I eventually start my business, which certainly at first did not earn what I would have been earning if I had gotten a standard-type job, but my husband, also not a career risk taker, but he was able to go to a startup. That actually was a really, really great fit for his PhD work, and he would not have considered a job like that if we didn't have that financial security that we had generated, you know, on our personal balance sheets, because we obviously, were not necessarily thinking it was going to come from our, in my case, myself, my own employer. In his case, a, you know, 12-person company that he went to in I guess it would have been like about 2015.

OLIVER: Interesting. So now, we're almost 10 years later, and you've obviously not only continued in this work, but expanded it significantly is my understanding, so what is the state of your activities now?

EMILY: It's so varied. I'm really grateful that so at the beginning, I was sort of billing myself as like, a professional public speaker on this topic of personal finance for this particular audience of graduate students and postdocs. And that has remained something that I continue to do, but now and, you know, things change with the pandemic, obviously. I was traveling, you know, some before then, and then that was not an option anymore, so the business has had to shift a bit over time. So I've added a lot of different types of offerings. Right now, what I'm really excited about, so I still do the live speaking, you know, whether it's webinars, in person, but what I'm really excited about now is more of like a flipped classroom-type model of content that I've developed. So I pre-recorded a lot of the various areas that I teach, chiefly taxes, but also in some other areas, and so what I do, I'll just give an example for the tax workshops that I offer during tax season, which we're recording this in April, so it just ended. It's heavy on my mind. So I pre-record all this teaching about how to generate your tax return correctly as a graduate student or postdoc. This year, I actually expanded to offering it to nonresidents as well as US citizens and residents. So I pre-record all these videos, I give the slides, I give the text. It's like maybe two hours of content, something like that, if you were to watch it straight through, also worksheets to help people keep things straight. So they have all this pre-recorded content. I like this because they can access it at any point during tax season, right? Like some people want to file in January. Some people want to file in April. And then I pair that with periodic live Q&A sessions. So I really love this because I get to spend my time creating the teaching material, like creating the slide deck, writing the script, doing it once or, you know, doing it well. And then I just get to answer people's questions as like the thing that I show up live for, which is so much more fun and exciting to me than presenting, you know, the same material over and over again. I get to present it once, as I said, do it right, and then just answer people's questions. I love that interaction with people as like part of my job, answering questions, hearing stories from them, hearing how the material has helped them or, you know, what area they're moving into next. So I have that for the tax area of my business, but also several other areas, and so that's what I'm really excited about. It's just like, me getting more face time, like, answering people's questions instead of just people listening to me talk live.

OLIVER: Makes sense. What's the business model?

EMILY: I don't know. That's one thing about solopreneurship that is so fun is like you don't have to write a business plan at the beginning of this. You just kind of feel out how it goes, but yeah, I --

OLIVER: Are people paying a subscription to your content, or?

EMILY: Okay, so my main revenue comes from universities.

OLIVER: Ah, okay.

EMILY: So, I really love it when I can get this material in front of graduate students and postdocs without them having to pay for it, so I really want the universities ideally to pay for it on their behalf and offer it as like a free benefit. That's not always possible, and so I do have for example for the tax workshops I just mentioned, there is a way for individuals to purchase those through my website, but the vast majority of the revenue comes from the university clients.

OLIVER: And I think you mentioned that you had given this presentation or this workshop at the NIH this past year, is that correct?

EMILY: Yeah, so NIH was a new client this year. Thank you so much to the Office of Intramural Training and Education. Yeah, so this tax season, so again, we're in April 2023, so for the 2022 tax year, OITE offered all four versions of my tax return workshop, so one for post-bacs, one for grad students, one for postdocs, all US citizens or residents, and then one for nonresidents, all those groups together, and so it was awesome to have them as a first-time client this year. I was so glad to be able to work with them.

OLIVER: That is fantastic. I know it's something that our post-bacs, postdocs and grad students continues to ask for is help us with taxes, so it's great that that happened. So sort of taking a slight pivot, you speak to a lot of folks in their early careers. What are the biggest challenges that grad students, postdocs, are facing at the moment in 2023, in terms of the financial issues?

EMILY: Hm, it's got to be income versus cost of living, no question. I mean, we've seen this, you know, I don't want to say unprecedented, that's not the right word, but not precedented in a long-time degree of inflation going on in our, you know, economy generally, and that has really obviously squeezed people's budgets. And these stipends, and salaries have not -- you know, some of them have budged, but not enough of them and not enough movement, right, to really keep up with all of the levels of inflation, so again, like great job to those universities and institutes and programs and so forth that have significantly raised the stipends and salaries, but it needs to be more across the board for sure. So, I would say, income is the main challenge.

OLIVER: So, you described a moment ago about your own journey, and that, together with your husband, how you focused a lot of your energy on improving your own financial health with I'm going to characterize it as just disciplined measures of paying down debt and savings and things like that. Is that an area you also offer advice into to grad students and postdocs?

EMILY: For sure. So, it's interesting for me, like when I have to think about speaking engagements that I do, I have to serve two groups of people, right? I have to serve the people who are paying for me to be there, which is the universities, the clients, and I have to serve the people in the audience, the graduate students and the postdocs. And so I'm probably not talking enough about fixing the income side of the equation as I would like to be, in those settings. So tune in to my podcast, Personal Finance for PhDs, if you want to hear more about, you know, the income side of the equation, because in those settings, I do talk more about the financial management side of things. So for sure, you know, we talk about budgeting. I have like a really budgeting sort of tactic that I used when I was in graduate school that I found really helpful that my audiences are always asking, like, follow-up questions about. They're so interested in it when I teach it. But also, yes, the debt management, the saving, the emergency funds, and just cashflows, how to use credit cards, like all those kinds of things, for sure, but I really find that, okay, let's set aside the income problem, which is a major, major problem right now, especially. I do find that my audiences are quite interested in the topic of taxes (I already talked about that so much) and investing, again, my two favorite topics. So even though maybe a graduate student or a postdoc, you know, some of them are ready to start investing while they're in graduate school, but even if they're not ready, they're still quite interested in learning because they know when they get to that, you know, post-PhD post-postdoc career job, that they -- that investing is going to be part of their lives. They're savvy enough that they already realize they're going to be starting that as soon as possible, because they feel this pressure of having lost, you know, sometime during their PhD training. So, of course, if you can get started investing now, that's awesome, but if you can't right now, then, you know, there's some steps you can take to be ready to do so once you have the income to support it. So I love talking about that area. And the audiences are quite interested in there, yeah.

OLIVER: Yeah, I mean, investment is -- it's very time driven, so the earlier you start, the better you start, and but I'm guessing your observation is that no matter how financially disciplined someone is, right now the just the income is not sufficient in most parts of the United States, I would guess.

EMILY: It's so hard to generalize here, you know, because we hear so many anecdotes, and I would love to have more data around this. I actually have a database website called PhDstipends.com that people can go to report their -- you know, what they're earning in their graduate positions. There's also a sister website postdocsalaries.com for the postdoc, you know, population. So, you can get some idea of what people are being paid and compare those to, you know, your local cost of living kind of things, but that's not like a scientifically generated, you know, survey group, so I would love to see more studies around this, because certainly, some people are dramatically underpaid. They're in very precarious positions in graduate school or in their postdocs, whether that's because the income is too low, whether it's because, you know, they have academic-year-only income but not summer income, or maybe they have only guaranteed income for five years, but the degree is going to take seven, all kinds of different reasons that this can happen. Yet, there are others who think that they're being paid fine, well enough, that they might, you know, want to do things like investing and paying down debt while they're in graduate school, and of course, a lot of people in the middle who are kind of making it, they're not too stressed, but they're certainly not able to reach any financial goals, and so it's really a kind of a heterogeneous group. And so on my podcast, for example, kind of because I -- people volunteer to come on. So generally speaking, people volunteer to be interviewed who are doing pretty okay with their finances, because they feel good about talking about it, and so I have a lot of like, success stories on the podcast, but those are not representative of what's going on generally with the entire, you know, PhD population, and so, like I said, it's just really heterogeneous. And of course, I'm only talking about the income versus cost-of-living side of things right now. There're also different family situations, right? So, some people may have dependents to support whether those are children, whether that is, you know, an aging parent, whether they're sending, you know, remittent -- is that the right word -- remittances back to their home countries to support, you know, someone there. So, like, you know, we kind of maybe assume like an avatar of a graduate student who's like a single young person, but that's definitely not everybody, and some people have other financial responsibilities. And so, yeah, it's, it's kind of all over the map, but I would really, really love to see those people who are being paid the least brought up out of this really poverty-level, you know, income, that they have to be able to have more financial security, because, frankly, how can we be expected to perform well and succeed with our research, with finishing our degrees with, you know, publishing the papers, when we're not receiving sufficient financial support? You know, when you have that stress of money on your mind, how can you be expected to perform well? And so it's really, I think, in the best interest of the universities to support people better, because they're going to get better work out of them in the meantime, and it's also the humane thing to do. Yeah.

OLIVER: Yeah. Thank you very much for that feedback. You've mentioned the podcast a couple of times. So, you're in your 14th season. That's impressive.

EMILY: Not 14 years, just 14 seasons --

OLIVER: Sure.

EMILY: -- because we do about three per year.

OLIVER: Three seasons per year. But give us a sort of overview of what kind of topics. You've mentioned you have guests come on -- coming on and who talk about their own financial journeys. What else do you cover in the podcast?

EMILY: The vast majority of the episodes are interviews with, as I said, volunteers. So hey, if you're a podcast lover, you know, come on my podcast and talk about your finances. So that could be talking about like the overall financial journey that they've had, let's say entirely through graduate school, or it could be on more specific topics. Like I recently had a fantastic interview be published from a first-year graduate student who talked about, you know, how she selected the graduate schools that she was going to apply to partially based on the stipends that they offered, how she, you know, valuated those offers. So it's sort of talking about, like the process of getting into graduate school. Other times, I'll have kind of like professionals on, so I've interviewed a few, for instance, financial planners, people who do legally give advice on these kinds of things. So I've had some financial planners on. If they, you know, focus on academics or on PhDs as part of their like core client population, they talk about how those clients are similar or dissimilar from general financial planning clients that they might have. And then from time to time, I also do solo episodes where there's a certain area that I really want to teach on for free for everybody. They don't have to come to one of my seminars, just listen to the podcast. So, you know, I mentioned earlier, for example, there was a law change that allowed fellowship income not reported on W2s to be considered taxable compensation and contributed to an individual retirement arrangement, and so when that -- when the Secure Act passed, and that was one of the changes that happened with that law I devoted an episode, for example, to explaining what was going on with that. So from time to time, there'll be me teaching on things. I teach about taxes sometimes, so yeah, it's a little bit of a mix, but as I said, mostly volunteer driven, so I'm really always pleased when people decide to come on and open up this part of their, you know, this part of their lives that's kind of taboo to talk about still.

OLIVER: Yeah, no, I think that's fantastic, and that's a great way to learn is from hearing other people's experiences and stories, so that's fantastic. Two questions I have to finish up with, so since you provide your services primarily through universities, if we have someone listening who cannot access your expertise and your teaching through their institution, how can they advocate for their dean or, you know, to consider engaging you?

EMILY: Hm, thank you so much for asking that. Let's see. Mostly my university hosts are in like, professional development kind of areas, so that'd be the right kind of person to work with, usually at the graduate school level. I work with a lot of graduate schools or medical schools, not so much with -- I should say medical schools that offer PhDs -- not so much with like individual departments, although that does happen sometimes. So one kind of person to approach would be like a professional development-type person. It's always great when you have a group of people, not just a single person, say, hey, we really want to learn more about this and, you know, here's a particular resource, that would be me. Thank you very much. And so, you know, offering that to that person, as a group or individually from separate people would be great. Another great group to approach is the Graduate Student Governments or Graduate Student Association. Sometimes they don't have a great deal of discretionary funding, but if they do, then they could be able to host an event with me or like, you know, purchase a set of tax workshops, for example. So I have a lot of clients from the student-driven side of things as well. And then kind of same thing on the postdoc side, right? Like the postdoc offices or the postdoc associations are great people to approach about that, but yeah, I would say just, you know, request it. Send them my website. I have pages on there that explain kind of the different speaking things that I offer, the different workshops, yeah.

OLIVER: Fantastic. I'm not going to ask you to give financial advice, because that's your day job, but I do want another kind of advice, wonder if you'd be willing to give it. So coming -- pivoting back to the career question, you were in graduate school. You took a turn to a very interesting and compelling area that you're very passionate about. What's your advice to our listeners who are maybe themselves in graduate schools or early in postdoc and they're, you know, thinking about what else they could be doing? What's your advice to them?

EMILY: Yes, the advice is, try things. Don't get so overly spending too much time at the bench or at your primary research area. Of course, you want to put in sufficient time. You want to do your 40 hours, 45, whatever it is, but don't get so carried away with that, that you forget that there are other areas of your life that need to flourish as well, and one of those is preparing for your future career, which is -- could be in research, but is frankly very unlikely to be in academia, at least in the long term, and so I would just say try things. So like, for me, my example, what I was trying was blogging, and that gave me some feedback. I mean, I wasn't making money from that, but it was giving me some feedback about what other people, you know, wanted and needed. And so some of the things you can try is like, you know, getting an internship. It doesn't have to be like an official, you know, summer internship you do full time, although that is possible in many fields. It could be a part-time internship that you do, you know, a few hours a week. It could be freelancing on the side. I'm mentioning things that you're probably going to get paid to do, but it's certainly okay to do volunteer work as well to just -- yeah, just get some experience outside of the academy. See how workplaces operate. See what people are interested in outside of your immediate context of, you know, your lab or the research that you're doing. So yeah, just try some things and do it all through your PhD, all through your postdoc. Don't leave this for just the last year when you're trying to transition out.

OLIVER: Emily, thank you so much for all your advice and all that you do for our biomedical early career scientists.

EMILY: Well, thank you so much for having me. It was really a pleasure to be here and thank you so much for giving me the opportunity.

OLIVER: Now it's time for a segment we call "Your Turn", because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk, or anything that you found inspirational, or amusing, or interesting. You can send these to us at [email protected]. If you record a voice memo and send it along, we may just play it on an upcoming episode. Now, I'd like to invite our guests to take their turn. Let's start with you, Dr. Jiang.

PENG: Yes. Yes, so my favorite book is a book called "Life is About Giving Up".

OLIVER: Okay.

PENG: It's a book written by a very famous like Buddhist or monk in China called "The Master Nebula" like, you know, this a book that is a book about having the importance of learning to give up in your life. Like because for managing the important things in your life, if you want to achieve more, you need to give up a lot at the very beginning. However, the most important thing is to decide when to give up and when not to give up. This is a very hard thing in life. Like so this whole book is about how to adjust your expectation for life, how to accept failures, and give up smartly to avoid basically more resource in your life. And eventually like I think this -- after reading this book, I've become much happier instead of lots of false pretense. And I think that those -- like actually giving up will only somehow make your life much better and maybe even more in the long run. So this is why I recommend this book, it's about life is giving up.

OLIVER: Thank you very much. That sounds like a really good read. Appreciate it.

PENG: Yes.

OLIVER: And how about your recommendation Emily, Dr. Roberts?

EMILY: My recommendation is a book I read in about the past year that really shook me and it's kind of a personal finance book but it's kind of a life book and it's called "Die With Zero", the author is Bill Perkins. And one of the main concepts that he teaches is that as you exit different phases of your life, the 'you' that existed in that phase dies, so we have a high school you, that person is dead and gone, we have a college you, that person is dead and gone, the grad school you, et cetera, et cetera. So, the basic idea behind this is to encourage you to have experiences in the phase of life that you're in and not either, you know, put them off too much for the future or think that they're, you know, just basically match the experiences that you want to have to the phase of life that you're in. And so now that I'm like, you know, I have a couple of kids, like I'm in a certain phase of life right now, I'm in the little kid phase of life and the grad school me is gone. And so there are some things I wish I had done during graduate school, some opportunities I wish I'd taken and some I'm really glad that I took. And so just realize that you are, whatever phase you're in right now, it's a special phase of life, it's not going to be around forever and please do, you know, pursue the opportunities that you have that are unique to that phase while you have the chance to do so.

OLIVER: That's a great recommendation, good advice. Thank you very much. And I'd like to make a recommendation as well. It's for the stand-up comic Tig Notaro and specifically her set from about 8 years ago when she was diagnosed with breast cancer. This original set is just remarkable and its candor and in her descriptions of the experience of receiving a diagnosis, just her ability to digest this very difficult time in her life and see the humor in it and bring it to an audience. We'll post a link to the recording and actually since then she's continued to shed light on this topic and related issues. She's pursued her goals in life and she shares much of her journey in documentaries and on social media and YouTube and other places, so you can find all that online. I have to say I find her work always helps me regain perspective and strength.

That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests. We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected]. Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser. A special thanks to Lakshmi Grama and Sabrina Islam-Rahman. Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers. If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers. If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query. We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this episode, hear how the National Cancer Institute can support one's graduate studies from Dr. Caitlin Allen and Dr. Samantha Yee, both recipients of the NCI Predoctoral to Postdoctoral Fellow Transition (F99/K00) Award, and Megan Majocha, who is currently completing her Ph.D. research at NCI while enrolled in Georgetown University.

Segment 1

• Caitlin Allen
• Samantha Yee
• NCI Predoctoral to Postdoctoral Fellow Transition Award (F99/K00)
• F99/K00 Program Director: Dr. Mariam Eljanne
• NCI Pathway to Independence Award (K99/R00)

Ad: Interagency Oncology Task Force Fellowship

Segment 2

• Megan Majocha
• Georgetown NIH Partnership Program
• NIH Graduate Partnership Program
• Dr. Kent Hunter Lab: Laboratory of Cancer Biology and Genetics
• OncoBites Blog

Your Turn: Guests Recommendations

• Diva Dance
• Visit a Local Library
• Atomic Hands

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host, Oliver Bogler. I work at the NCI in the Center for Cancer Training. On inside Cancer Careers, we explore all the different ways that people join the fight against disease and hear their stories. Today we are talking to people about their time in graduate school. First up are Dr. Sam Yee and Dr. Caitlin Allen, both of whom were supported by a transition fellowship during graduate school. Then after the break, we speak to Megan Majocha, who is doing her Ph.D. research at the NCI right now. Listen through to the end of the show to hear our guests make some interesting recommendations and where we invite you to take your turn.

OLIVER: At NIH we are interested in supporting early career scientists through the stages of their training and are trying to find the best approach. One of the newer grants that was developed is the NCI pre-doctoral to post-doctoral fellow transition award, or F99/K00. Here to talk to us about this are two folks, Dr. Sam Yee, post-doctoral fellow at the University of Chicago, welcome.

SAMANTHA YEE: Hi. Thank you so much for hosting.

OLIVER: And Dr. Caitlin Allen, assistant professor at the Medical University of South Carolina. Welcome to you.

CAITLIN ALLEN: Thanks, Oliver.

OLIVER: Before we get to the F99/K00, I'd love to hear how you first got interested in science itself. Let's start with you, Sam.

SAMANTHA: So, when I first got interested in science and wanted to do basic science research, I was a senior in high school. I suddenly had fatigue after playing multiple sports events and I started having sharp pain in my pelvic area, and so after going to the Emergency Department a bunch of times, they weren't able to diagnose me except send me away with a bunch of Advil and ibuprofen and so after that, after multiple testing, ultrasounds, they eventually found a solid mass on my ovary. And so what really got me interested in the science aspect was really curious about the diagnosis and prevention of ovarian cancer as there wasn't really much they can do except send me home with a bunch of pills. So that's how I got interested into basic science research.

OLIVER: Wow, that's quite a shock, it must have been. How about you Caitlin?

CAITLIN: So, my interest in science also stems back to some of my formative years. And I have a very vivid memory of a couple of my teachers in 7th grade and then through high school just really instilling a love for asking good questions and some of the, I was thinking about this today, but some of the sort of hand gestures and ways that we were thinking about things, I remember going through the process with Miss Biswas in 7th grade and we had problem, research, hypothesis, experimental design, and conclusion. There was this whole sort of song and dance that we did and we then would have binders about my own science where we would be asking hypothesis driven questions, and so I think that those sort of early days of just curiosity really is what instilled that interest in me and then that has shaped my desire and sort of been shaped in different ways from being a biology major in undergrad to public health and more population focused work in graduate school doctoral work. But really being instilled early on in my education.

OLIVER: So what is the focus of your research at this time?

CAITLIN: So the current work that I'm doing is primarily focused in implementation science and particularly the implementation of population wide genomic screening for hereditary conditions and so we are focused on hereditary breast and ovarian cancer and Lynch syndrome. And so the idea is that if we're able to screen population, at the population level for these conditions, we could identify the nearly two million people that are at risk but don't know that they're at risk for these conditions. And so we've been doing this population level screening at MUSC over the past year plus and I've had the, I came in at a really wonderful time where the program was just getting started and we could really think about the implementation science and the evaluation at the very beginning of the program. And so that's been a big focus of my work, and then also the downstream aspects of that, including you know, once someone's been identified, how do we make sure that they get into the right care and the right services and that they are really able to do all of those additional screenings and recommendations for when they've been identified at higher risk.

OLIVER: And Sam, what's the focus of your post-doc?

SAMANTHA: The focus of my post-doc is looking at ovarian cancer, particularly the secondary site so the omentum particularly, which is a fat curtain an understanding how ovarian cancer progression and drug resistance occurs with these ovarian cancer cells as well as the tumor microenvironment, so really pulling multiple different cell types together and taking an account of the microenvironment to really understand the crosstalk that's going on.

OLIVER: Yeah, so like cancer isn't just you know, a bunch of malignant cells, it's kind of a community of cells, right? Formed in part from the malignant cells but then also some of the body's cells that are in the neighborhood.

SAMANTHA: Yes, that's right. And a very hot topic deal right now is the immunotherapuetics and so our lab is also currently looking at immune cells as well.

OLIVER: Well thanks very much for describing your, both of your areas of research. Very interesting. If you would be so kind as to cast your mind back to when you were in graduate school, I'm very curious how you came across the F99/K00 award and maybe Sam, I'll start with you, maybe you could tell us what is this award, what does it actually do for you?

So this award allows for the transition of a pre-doctoral student to becoming a post-doc with multiple different resources and opportunities that one, in my opinion would not have gotten, if I am not on this award right now. And so, this award funds up to the last two years of your pre-doctoral and funds up to four years of your post-doctoral experience.

OLIVER: So you were at the University of Texas Health, University of Texas Health in San Antonio, right, Sam, when you applied for the F99 portion of this?

SAMANTHA: Yes, so I was very fortunate that one of my mentors, not my primary research mentor, told me about this award and I'm an international trainee and so I couldn't apply for the other F awards and so once he told me, I started working on this application just through what's called F-Troop, a grant writing workshop to prepare in case I got chosen as a sole nominee of the institution.

OLIVER: Yeah, I should explain that the F99/K00 is still a new program. At the moment, the NCI only has one application cycle a year, which is different, most mechanisms allow three, and we only accept one application from an institution, so there has to be an internal process at that institution to select an applicant, so that's what you're describing, right Sam?

SAMANTHA: Yeah, so I believe some of the components is a Specific Aims page, a letter from your mentor, also a quick bio sketch as well, and that allows the institution where you're at, so for example, UT Health San Antonio then had a committee to decide which of the following applicants would be that sole nominee of the institution.

OLIVER: Caitlin, what was it like for you, you were at Emery, right?

CAITLIN: So, I had a very similar experience as Sam in my application process at Emery. I think I was in the third cohort or so, of nominees, and I was one of the first applicants that was more at the population level whereas others were basic science. And I had a really positive experience where once I went through the process of submitting the internal application, which as Sam said, it was just what Emery had put together. It included a bio sketch and other materials to let the search committee know what your interest was. Then I felt like I had a really strong support network of past applicants at Emery and also my mentors. So I had previously applied for the F31, but it was not successful in the year prior and I felt like that experience of applying to the F31 was helpful in preparing for the F99/K00, but ultimately the F99/K00 was a much better fit for me because I knew that I wanted to go into academia. And so I think that the really beautiful part of the mechanism is that it does give you that doctoral funding but then you are just spring boarded into four years of support, right? And so having that and sort of being able to start talking to post-doctoral institutions and let them know that you have the resources, you have sort of the NCI's backing to move forward into the post-doctoral research spaces is really fantastic and I think sets people up, and sets people apart in this space. So, that was my experience.

OLIVER: Right, so you bring the K00 money with you to your post-doc institution, which obviously as you say, makes you an attractive candidate. What is the process then, do you have to reapply? Do you have to get re-reviewed for the K00 part?

CAITLIN: Sure, so my experience was that you did submit another application. It was not, I'm trying to think back now, because it's been a while, but it was, it did involve, because when you apply initially for the F99/K00, it's okay for the K00 portion of your application to be a little bit amorphous and you're thinking more big picture, what do I hope my post-doc will look like, et cetera. And so when you get to the point of then actually needing to move into the K00 phase, it is necessary to work with the new institution that you plan to do your post-doc at and really think through and conceptualize what your specific aims are and what you hope to accomplish during your post-doc. And so, I think that was helpful to need to reapply in the sense that it required you to work with your new mentors and start having those conversations and sort of set yourself up for success just stepping in day one to the K00 phase.

OLIVER: Yes, Sam, what was your experience with that phase, you just made that transition relatively recently, right?

SAMANTHA: Yeah, I just started my first year as a post-doc last June and so for the K00 application, like Caitlin was mentioning, you do tailor it more specific to where you're going for your post-doc, and so the opportunity to work with your post-doc mentor very closely on what your science is as well as your professional development was very key and I really enjoyed it because it showed that they really care about your future and it helps you set up for where you want to go for your career.

OLIVER: Yeah, fantastic. And I want to just mention that this review is from the transition review to the K00 happens at the program level at NCI, you don't have to go back to a study section for a new score and review. Talking of program, Dr. Mariam Eljanne is the lead program director for the NCI's F99/K00, and I think she's worked very hard with the community of recipients to bring people together and I wonder if you could tell me a little bit about your experience of that. Has that been helpful to you? Sam.

SAMANTHA: Yeah, so Dr. Mariam Eljanne, has been very, very welcoming as well as very, very helpful in the sense of bringing all the different fellows from both F99 phase and the K00 phase together for these monthly meetings where we can present our research or invite guest speakers and so with that network and the ability of all of our contact information, we can reach out to one another if we see something and that opens up doors for collaboration. And so we really appreciate all that Dr. Mariam has done.

OLIVER: Caitlin, were you able to participate in that as well?

CAITLIN: Yes, I certainly participated and we had a planning committee to prepare for the conference that Sam mentioned, which brought together F99 and K00 awardees. At the time, we did it virtually but it was really an honor and pleasure to be part of kind of thinking through how that conference would look. I think one of the things that's really nice about the way that Mariam has structured the networking is that she's very, very accessible and responsive to questions, which I think we have a lot of those when we're in this early phase, even just figuring out how to engage with the NCI and then the different networking opportunities give us the experience of presenting, right? Presenting to your peers, getting feedback from your peers, and she's also been able to bring in external speakers. I remember an external speaker that was talking about the K to R transition award, right? Which is another mechanism that I think many F99/K00 folks think about and so just having that sort of broad scope of kind of the experience of presenting and getting that opportunity as well as kind of thinking ahead about where your career might go.

OLIVER: Yeah, it's interesting that you mentioned the K99/R00 because the award that you both received is in our minds, hopefully could lead towards such an award and we recently interviewed Dr. Simon Schwörer, a colleague of yours, Sam, at the University of Chicago, who recent transitioned to his R00 phase, opening up his lab there. So, graduate school and being a post-doc are challenging times in your career and I think at the moment in particular, there are some significant challenges. I wonder if you could both address those and tell me a little bit more about that. Let's start with you, Sam.

SAMANTHA: So when I first transitioned from a graduate student to a post-doc, I saw some similar recurring themes of having to start afresh and so it does take time to really know where things are in different labs, so the first couple to maybe first six months, I was still trying to figure out where things were, trying to really meet the core people from each core facility to understand what resources I really had, and make those connections. So that's one of the, I guess, recurring themes of transitioning. Another theme I guess is the independence, so most often than not, I experienced some imposter syndrome and with that I had to really dig deep and remind myself that I do have a PhD, and all my years really counted towards something, so really just believing in yourself and taking things to the next level that you've already created was another theme I guess, that I encountered from that transition.

OLIVER: Thank you for sharing that. Caitlin, I wonder if you have things you could share with us.

CAITLIN: Sure, I would agree with Sam in the sense of kind of this liminal space in part where you have gone from having such intense mentorship and training in your doctoral program to now being almost independent, right? Or you're almost there but you still are relying on your mentors in a lot of ways, while also trying to forge your own path. And so, I think that that's just the reality of where we are in our career and it's okay, but it's certainly something that is relatable and I would imagine other listeners are probably have similar experiences, so definitely validating what Sam mentioned. But I do think that what is nice about the K00 phase is that it gives you time, right, so it really gives you dedicated, protected time to think and so I remember early in my doctoral days, being so grateful that I had the time and space to think and to really put together conceptual models, et cetera, and so I still have that, right? Like that's nice because there are, there's not as many competing demands as what may come in the future as you move further along in your career, you know, expected to add on service and teaching, et cetera, et cetera. So I do, I do appreciate that element of the K00.

OLIVER: Yeah, thank you. So as I mentioned at the beginning of our conversation, the F99/K00 is still a relatively new mechanism and we are trying to innovate and think of ways to build mechanisms like that to really help people. But I wonder if you have any feedback for us. What is it about the F99/K00 that we could do better or that we could improve? Caitlin.

CAITLIN: So I would say that in my recollection of the transition, it did feel a little bit rushed. And I wonder if there is an opportunity to, I almost wanted a summer break, which may sound kind of silly, but I just recall trying to finish my doctoral coursework, doing a ton of paperwork to finish my dissertation and wrap all of that up, while also needing to think about moving and apply, you know, the shift and transition and it all worked out, it was all fine, but I would love sort of a little bit of breathing room in between that F99/K00. Another piece is that during the shift to the K00 as we talked about earlier, you needed to do an internal application back to the NCI for review about what you were going to do for the K00 and to do that, I ended up working with the grant administrators at my K00 institution and that was tough because I had no real, I mean my mentor of course had ties, but I had no real personal ties to the institution and so I did feel like that was a little bit awkward to be asking so much of an institution and of grant administrators, even before I was there.

OLIVER: Yeah, thank you for sharing those things. Those are characteristics of the mechanism, so there's a limited time window between when you satisfy the requirements for your doctoral degree there's a window by which you have had to then start your post-doc, and I do hear what you say about the grants support team. That's really because the K00 award is held by your new institution and so they, unfortunately they have to engage so, but we could certainly help on the program side perhaps grants administrators have never come across this particular mechanism before and that might be helpful.

CAITLIN: I think that is kind of the, you hit the nail on the head there, it's that the grant, it was such a new grant at the time, that they're like K what? You know, so as sort of it becomes more commonplace, then administrative offices will know what to do or have the ability to sort of make that smoother. But like we talked about, this is, it's new, it's developing, which is wonderful to get feedback.

OLIVER: And we thank you for breaking new ground. Sam, your feedback please.

SAMANTHA: Okay, so what I really did like about the F99/K00 webinars is that they provide a lot of information on how to apply, but I think some emphasis could go more on yes, you apply for the F99/K00 but later on, that same K00 application just goes internally and it follows a certain timeline that you have to submit it by so the reminder of always planning ahead is great in order to get those certain deadlines done. And like Caitlin was mentioning, you transition from your pre-doctoral to post-doctoral, I remember just moving within a week and then starting one thing to take account of too is how your post-doc institution hires new post-docs, because you'll either be back paid or you might not be able to start until your actual department can hire you. So those are some things to take in account of when you're transitioning and I think that we could just bring awareness when fellows are talking to potential applicants and things like that, just to spread the word.

OLIVER: Yeah, that's good practical advice, thank you. Thank you both. Last question, let's start with you, Sam, people are listening right now might be wondering about this mechanism, what would your advice be to someone perhaps recently started in grad school or in the research part of their grad school and they're interested in the F99.

SAMANTHA: I would say, start planning ahead and thinking about all the different materials and really just value the opportunity of applying because if you do get it, your opportunities are unlimited and so I feel really, really thankful for being a fellow of this prestigious award because I'm able to have all these resources and basically conduct some translational science which I wouldn't have been able to do, I think, without this award. So just plan ahead, do your best and reach for the stars because this award can really get you places in my opinion.

OLIVER: Thank you. Caitlin.

CAITLIN: I would say, I mean as Sam mentioned, some of the more administrative sides of this award are really helpful to think about early and work closely with the grant team within your institution. Just having gone through the process of applying to a Federal grant is, makes you light years ahead of a lot of folks, and so I think that that's good advice. I would also say that it's important to be resilient in your doctoral training and moving into the post-doc and I say this because you know, I had the experience of applying to the F31 and not receiving that. Which was difficult but also set me up really nicely to then move forward with an F99/K00 mechanism. So that's something where it's both being resilient but also being able to pivot and identify mechanisms that are appropriate for your interests and your career stage, and working closely with your mentors and past recipients at your institution. Also the F99/K00 network is amazing. I, have had potential applicants reach out to me and just ask about my experience and we're all, I think, very happy to talk about it, work through logistics, think about science, etcetera, and so kind of tapping into that network is fantastic as you're thinking about your application.

OLIVER: Thank you, that's really good advice as well, thank you. I would say also if you're interested in this mechanism, you might explore whether there is already a process at your university in your graduate school for selecting the nominees, so you might check in with the Dean's Office. If there isn't a mechanism and if there hasn't yet been an applicant from your university, we are very happy to receive applications and I would recommend that you reach out to program to engage and ask some questions there. So, we'll put links in the show notes for the award and the F99 mechanism and you can check it out there. So thank you to both of you, Caitlin and Sam, thank you very much for being with us today and sharing your insights and your experience.

SAMANTHA: Great, thank you so much.

CAITLIN: Thanks for having us.

[UPBEAT MUSIC]

OLIVER: Cancer scientists do all kinds of interesting things, and one of them is to work on the regulation of drugs and medical devices at the US Food and Drug Administration, or FDA. Others shepherd discoveries from the lab to the bedside which requires knowledge of regulatory processes. If you are interested in this work, we have a program at NCI and here to tell us more about it is Glorivee Pagan-Mercado from our Office of Training and Education.

GLORIVEE PAGAN-MERCADO: It is a fellowship with a bit of a strange name. It is called the Interagency Oncology Task Force Fellowship or IOTF for short, because it is between agencies of the federal government including FDA and NCI.

The program trains scientists in research and research-related regulatory review, policies, and regulations.

Fellows learn to build awareness of regulatory requirements into the early stages of the medical product development process and to develop strategies to improve planning throughout research and regulatory review.

OLIVER: That is interesting. Where do graduates of the IOTF program go to practice what they have learned?

GLORIVEE: Well, some transition to regulatory work at FDA or in industry while others take what they have learned back to their research work where it helps them plan for eventual commercialization and regulatory approval of their discoveries. You can see the comments of several IOTF alums on our webpage.

OLIVER: Are there applications dates our listeners should know about?

GLORIVEE: Applications open on May first and close on June fifth, with a potential start day of September first. There are 4 different tracks depending on the applicants background and interests. For more information please visit our webpage – you can search for IOTF and NCI and there you can also see how to reach out to us if you have questions.

OLIVER: Thanks, Glorivee – we will also put a link in our show notes, and I am sure if people want to reach out to you to find out more they can.

GLORIVEE: thank you.

OLIVER: Before the break, we spoke to two scientists supported by NCI through extramural grants during their graduate work. Now I'm delighted to welcome Megan Majocha, a graduate student who's doing her PhD research in a lab at the NCI. Welcome.

MEGAN MAJOCHA: Hi, thank you for inviting me to be here. I'm really happy to be here today.

OLIVER: Megan, you're talking to us through interpreters today. Is that correct?

MEGAN: Yes. Yes, I'll explain that briefly. I have two sign language interpreters who are working with us currently. One interpreter is going to be speaking for me. She will be my voice while I sign, and the other interpreter will be signing for Oliver.

OLIVER: Great. So, Megan, I'm always curious to learn what draws people to do science. How did that happen for you?

MEGAN: I've always been very fascinated with science ever since I was a little girl. When I was in middle school and high school, that's when I really started to take extra science credits that weren't necessary for my degree, because I was just so fascinated with the science world. I was interested in forensics, anatomy, really the whole gamut, the whole range of the scientific field. But I wasn't sure what exactly it was that I was interested in. I did always find myself curious about everything, and wanting to know the reasoning behind everything. What is the explanation for this? I would Google things. I would Google why something happened. I would always ask my parents why, why, why everything. I needed to know the reason behind it, and so, I guess there's always been a little bit of a scientist within me. When I got into college, and I had to pick my major, and figure out what I wanted to focus on, I had picked biology. As time went on, I really became fascinated with genetics, but there's a lot that can be done when you do genetic research, and I wasn't sure what exactly I wanted to do with that interest of mine. So, I decided to go ahead and apply for a Postbac opportunity here at NCI, and this was right after I had finished my undergrad in college. That's when I fell into the cancer genetic research world, and that's where I'm at currently.

OLIVER: So, what prompted you to do a Postbac?

MEGAN: So, when I graduated college, I had my mind set that I had wanted to go to medical school. I wanted to become a gynecologist. However, when I was looking into medical school, it was a very in-depth application process that I wasn't quite ready for yet. And I knew that there would be many different opportunities other than just medical school, so I wasn't sure where exactly I wanted to go. So, my Gallaudet advisor had suggested that I should apply for a Postbac opportunity here at NIH, and that's what I did.

OLIVER: So, an opportunity to experience research.

MEGAN: Yes, correct. Yes. During college, I only had one outer lab experience or internship experience. I did have many other opportunities with wet labs. I didn't have many opportunities with wet labs, but I did with qualitative research. So, I needed more wet lab bench work experience, and that's what led me to taking advantage of the position and the opportunity here to gain that experience.

OLIVER: So, I'm going guess you liked it because you signed up for a PhD?

MEGAN: Yes. Really, I fell into it quite quickly, and after several months of my Postbac, I went ahead and I applied for my PhD. Well, I wasn't quite sure what field I wanted to go into whether it was cancer biology or human genetics. So, I applied for both programs, and then I decided that I would pick the Georgetown NIH Partnership Program, which is a field of tumor biology.

OLIVER: Yeah, so you mentioned the partnership program. Obviously NIH, NCI, are not universities. They cannot give you a degree. So, your degree is coming from Georgetown, but you chose to do your research in the lab at NCI.

MEGAN: Yes. It's a very unique program that is offered here in partnership with Georgetown. I didn't know about this program until I saw a few other graduate students. In my lab, I work in Dr. Ken Hunter's lab, and there were two grad students who were involved in the GPP. That's the Graduate Partnership Program. When I was able to see them involved in that, I became really interested in the program because I really enjoy working here at NCI. The accessibility is fantastic. The research here is just top notch, and so, I decided to apply to Georgetown because they do have a few -- NIH has a few partnerships with a few different universities, but I picked Georgetown University. All of my class course credits, I took at Georgetown. My lab rotations were a mixture between Georgetown labs as well as NIH labs, and then I picked a lab here at NIH to continue my thesis research.

OLIVER: So, what's it like being a grad student on the NIH campus?

MEGAN: Really, it's just the perfect opportunity being a student here. The research is very quick-moving. There are amazing resource opportunities here, and the interpreting accessibility. Oh, well, another reason I did pick this program I should add in specifically at NIH is because of that accessibility. It's guaranteed accessibility with highly qualified interpreters that are available on campus here. So, my experience has been really amazing thus far.

OLIVER: I'm going to ask what are researching. What's the focus of your thesis work?

MEGAN: I am currently researching a more in-depth mechanism of a very poorly characterized gene an estrogen receptor negative breast cancer metastasis. And so, I'm analyzing how this gene impacts metastasis and what the mechanisms are behind the gene that are affecting the metastasis.

OLIVER: That sounds like a really important project - metastatic breast cancer, particularly, estrogen-receptor negative is a tough disease.

MEGAN: Yes, and it's a very -- there's very poor treatments available for this disease. We need to we need to improve the current availability of these treatments.

OLIVER: Now you mentioned the availability of skilled interpreters is one of the reasons you chose this program. You've also been advocating in that area. Can you tell us a little bit about that, please?

MEGAN: Yes. So, when I was in my Postbac year, I really didn't work with many interpreters prior to my Postbac because I went to Gallaudet University which had complete communication access. My professors all signed. My peers all used sign language. So, I didn't need an interpreter during my undergrad. So, when I got here, I wasn't sure what to expect. Kent Hunter's lab already had a deaf biologist working here, and he's been here for quite a long time. So, he had already established a team of scientific interpreters that he had been working with for many years and had developed over time. So, as I joined the lab, I saw how the interpreters picked up the scientific sign language, and many interpreters who work here have worked here for a very long time. So, they're knowledgeable about what our lab research does, the vocabulary that comes up, as well as our language needs and preferences. When I left my Postbac and I went to grad school, I couldn't bring the interpreters who worked here with me because they were already in the lab with the biologists working. So, it was really tough to look for scientific interpreters. I didn't know who else knew science. So, I was kind of stuck in a position, and I was asking around, and nobody seemed to have any recommendations for me. For grad school, my one request was that I had consistent interpreters. I wanted interpreters who were available to interpret for me every single day. I didn't want one interpreter for one day, another interpreter for the next day and have that constant turnover of interpreters in my classes. So, the consistency was better, because the interpreters were then able to pick up the language and learn as we went on. So, I was able to find two interpreters that worked with me consistently through my schooling, both of them did not know science prior to working with me. They had no scientific background, but they were able to pick up the language and learn with a positive attitude and the motivation to learn my language and to learn the science directly from me, as well as from internet resources. So, they had worked -- we've worked with each other for about four years now. And they are considered scientific interpreters because they know how to interpret science.

OLIVER: Yeah, one thing, I learned from reading on this area from the materials you've also shared with the community, is that I guess, there are not necessarily signs for scientific terms that are developed yet, right? So new vocabulary hasn't yet been included into the American Sign Language. Is that correct?

MEGAN: Yes, there are a lot of scientific terminologies that need to be fingerspelled, which can be very difficult to spell out everything. So, we have developed our own signs to go with the words. We call them our lab signs that makes sense to the people within our lab, but we are open to changing those signs if we learn something that's better, maybe from another deaf scientist, anywhere in the country. But in general, deaf scientists have been developing STEM-based sign language dictionaries over the last several years, and it's getting better and better every day. It's slow moving, but it's getting better.

OLIVER: So, are there essential resources that have been created?

MEGAN: Yes. I plan to share that for the ending part of the segment.

OLIVER: Okay. I don't want to get ahead of myself, but it sounds like a real challenge, right?

MEGAN: Yes, but it's very rewarding as well.

OLIVER: And Megan, I understand that you also are interested in science communication in general, right. You write for a blog called OncoBites?

MEGAN: Yes, that's correct. Let me think? I started writing for them, when I first started grad school, in my first year or two, I realized that there was a gap between the research and public knowledge, especially with the deaf community. There aren't many information resources available within sign language, they're always they're all written in English, and the deaf community likes to see both the ASL, as well as the written English, and they want to have both available to them. So, that's when I started to realize and kind of get into the field of communication of science within the deaf community, but not exclusively, the deaf community -- for a general audience. With the in-depth specific terminology, specifically related to cancer research, there's a lot of large words or words that the general public just aren't familiar with. And so, I saw an opportunity arise with OncoBites, which is a small group of scientist, patients, advocates and really anyone within the cancer field can write an article for OncoBites based off of their specialty in lay terms, so everyone can understand. So, I just started writing for them last year. I've written a few articles for them, sharing my knowledge and practicing my science communication skills, which I've really enjoyed.

OLIVER: Megan, I'm curious. This just occurred to me but there's a revolution in artificial intelligence going on, and one of the things that these new technologies are able to do is to take large amounts of data and summarize them and make them more digestible. I wonder, how is that being received in the deaf community and are there technologies being developed to make it easier for people who cannot sign to communicate with deaf people?

MEGAN: Yes, and no. So, technology is still not perfect. We still need interpreters to communicate, that's the best approach for communication, but for example with the iPhone, I believe Android, as well. The iPhone has live captioning features that will automatically set up. For example, if I run into somebody who's hearing and they are speaking, they can speak to my phone and write out a transcript for me, and I can text back to them. However, that's not the best approach, but it is slightly improving every day. So, I think so. Yes.

OLIVER: You said earlier that deaf people prefer to see sign language or signing up if I'm saying that right.

MEGAN: Yes. So, we are bilingual. We know English as well as ASL. So, it's nice to see everything in ASL as well as English. English, written English, is typically not the first language for deaf people, because we learned sign language first. So, ASL is our native language. So, it's just natural to us to have access to both is to have accessibility to everybody in the community.

OLIVER: That makes sense. I guess there's a lot more work yet to be done.

MEGAN: Yes, however, work does tend to move pretty quickly as things get developed, and there's new inventions. It's always fast moving.

OLIVER: Great. I'm curious. What's next for you. How far are you through your graduate school?

MEGAN: Yes, I'm about to start my fifth year; I can't believe it.

OLIVER: So where are you headed next, or you're not sure about that yet?

MEGAN: I'm still unsure of what I'm doing next. I have two pathways that I really love doing. The first is I wouldn't mind continuing with research. I wouldn't mind actively researching and continuing that field as well as the science communication as we've talked about, and more related to consultations, as well as project management within science communication, or grant writer, or scientific writer of some sort. I'm not really sure. I'm still investigating what opportunities there are for me.

OLIVER: Well, I think we need qualified scientists in all these different areas. So, I hope you have a chance to explore them, those options.

MEGAN: Yes, me too. I'm excited to continue to explore these options.

OLIVER: In the Center for Cancer Training, where I work, we provide some opportunities for grad students and postdocs on campus to learn a little bit about these different career paths. I hope you've had a chance to make use of those.

MEGAN: Yes, I'm planning to go to the Career Center Symposium very soon, and I'm looking forward to that.

OLIVER: Great, finally, then I just wonder what advice you might have to our audience who are thinking about a career in cancer, what would you say to someone who was just a few years behind you?

MEGAN: I would advise them to take advantage of every opportunity that's presented to them. I would also tell them to stay flexible and to have resiliency. Things are going to change. The unexpected will happen. You're going to go through really tough as well as really good times and just stay the course, and it's important to keep resilient and persevere through all of that.

OLIVER: Great. I think that's very good advice. Thank you. I could use that myself.

MEGAN: Yes.

OLIVER: Well, thank you so much for joining us on the podcast and sharing your experiences and your work with us.

MEGAN: Thank you so much for inviting me to participate in the podcast. I'm honored to be here.

OLIVER: Now it's time for a segment we call Your Turn because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn, send us a tip for a book, or a video, a podcast, or a talk that you found amusing or inspirational or interesting. You can send these to us at [email protected]. Record a voice memo and send it along. We may just play it in an upcoming episode. Now I'd like to invite our guests to take their turn. Let's start with you, Sam.

SAMANTHA: So, this is a little different than a talk or a book, but I do want to recommend, I guess, a community that's out there, if you do enjoy doing dance or doing something active. So, there's a community out there called Diva Dance, and it's more for adult dance classes. And so, basically, it's really fun. You don't need to have previous dance experience, and you can basically go for an hour of cardio and then have friends and go to brunch and other social events. So, if you do like dance, which is what I've done before, as an ex-professional, NHL cheerleader, diva dance is really fun and dancing with everyone with different skills is something I like to do on the weekend just to stay active.

OLIVER: That's fantastic. Is there a website for this group?

SAMANTHA: I believe it's www.divadance.com, and there should be different locations in different areas of the United States.

OLIVER: Great. Well, we'll put a link in the show notes. Caitlin?

CAITLIN: I'm going to have to sign up for Diva Dance, Sam. So, when I was thinking about this, my recommendation is to go sit at a library. I recently rediscovered my local library. It reopened and has been having a bunch of community events. I have a young son, and we just spent a Saturday morning, at the library, and it was so lovely. So, take some time. Go to your local library and just enjoy.

OLIVER: And Megan, as you know, at the end of our show, we always invite our guests to make recommendations about something interesting or cool that they'd like to share with the audience. We call this segment Your Turn, so I invite you to take your turn.

MEGAN: Yes, so I'm excited to recommend Atomic Hands. The sign for that is what I just demonstrated Atomic Hands. It's a small nonprofit organization that is established by two deaf women scientists, and it's an amazing resource for everyone. And their website is AtomicHands.com, and it includes various different resources including ASL STEM dictionaries, ASL STEM signs within ASL videos, ASL stem news. So different events related to science and current events, and there are some small, short clips of educational things explaining different science activities, what's going on behind them. It follows a different scientific process. So, for example, climate change and how that happens, what the impact is currently, and all of it is done within sign language. So, there's ASL, as well as English, all their videos are captioned. They're really fascinating to watch. They also include a large list of deaf STEM people. Well, people in STEM scientists, educators, mathematicians, engineers. They have a list of different people with their bios, as well as contact information, which I think is a really great resource that should be checked out.

OLIVER: That's such a great recommendation. We'll put a link in the show notes, I really appreciate you sharing that with us. Thank you.

MEGAN: Sure.

OLIVER: Well, thank you very much.

MEGAN: Thank you.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training.

It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser.

A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this episode of Inside Cancer Careers, we hear from Avery August of Cornell University who shares his insights on how to support early career faculty and build a healthy research culture. We then hear from Dr. Jiyeon Choi of NCI's Division of Cancer Epidemiology and Genetics about training and establishing her research team at NCI.

Segment 1:

Avery August, Ph.D.

Belonging at Cornell

PubMed: Productivity, prominence, and the effects of academic environment

Cornell CANN Model

Faculty Institutional Recruitment for Sustainable Transformation (FIRST)

Cancer Biology Training Consortium

NCI Rising Scholars: Cancer Research Seminar Series

Segment 2:

Jiyeon Choi, Ph.D., M.S.

Division of Cancer Epidemiology & Genetics, Laboratory of Translational Genomics

Stadtman Tenure-Track Investigators

NIH Intramural Research Program (IRP)

NIH Distinguished Scholars Program

Your Turn:

Artist: Congo Natty

Movie: Free Solo

Book Recommendation: Factfulness by Hans Rosling

TRANSCRIPT

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.

On Inside Cancer Careers we explore all the different ways that people join the fight against disease and hear their stories.

Today we are talking to Dr. Avery August of Cornell University who shares his insights on how to support early career faculty and build a healthy research culture.

Then, after the break, we speak with Dr. Jiyeon Choi of NCI's Division of Cancer Epidemiology and Genetics – she tells us about training and establishing her research team at NCI.

Stick around to the end to hear our recommendations on music, a movie and a book and to learn how you can take Your Turn!

OLIVER: So, it's a pleasure to welcome Dr. Avery August to the podcast today. Welcome.

AVERY AUGUST: Thank you. Thank you for having me, Oliver.

OLIVER: Dr. August is Professor of Microbiology and Immunology and Deputy Provost for Academic Affairs at Cornell University in Ithaca, New York where he studies kinase signaling in the regulation of T-cells in infectious disease, inflammation, and allergies. He's also a Howard Hughes Medical Institute professor. Dr. August I'm always curious about how scientists choose to become scientists, what led you to do this work?

AVERY: Well, this is, you know, I think I was probably like many children very curious about the natural world and I look back, recall sort of doing natural experiments mixing things and capturing, you know, bugs and bees and that sort of thing, without understanding that you know what I was trying to do was science in my own way. But it wasn't really until I was in college trying to get a degree in medical technology that I was introduced to research formally by one of my faculty members who I really appreciated them doing that Professors Costello Brown and Phoebe Dea and that's when I started my formal research experience in chemistry actually.

OLIVER: And now you're--is it fair to say you're an immunologist or … you study T-cells?

AVERY: I think I would say I'm an immunologist, although, you know, some reviewers disagree, but [brief laughter].

OLIVER: So, and what led you to immunology?

AVERY: You know, I too as I was taking courses, you know in college, you know I was doing a degree in medical technology which is sort of a clinical laboratory sciences, and one of the courses that I took was immunology and serology, and what really fascinated me, was the fact that that the immune system has the capacity to respond to anything that it would be exposed to over a lifetime of an animal. And so, that really fascinated me and so I you know that one course in immunology made me want to do a Ph.D. in immunology and so that's what I embarked on.

OLIVER: Fantastic. So, I saw your presentation at the CABTRAC, the Cancer Biology Training Consortium meeting last October, and you spoke about diversifying faculty. I recall that you shared some interesting research published by Way and colleagues in PNAS as part of your presentation. Would you mind telling us what they showed?

AVERY: Yeah, so this is a group that's been analyzing the dynamics of sort of faculty hiring over time. They had several papers published including in Science Advances and then more recently in PNAS. In essence what they've shown is that academic institutions tend to hire very limited--from a limited number of institutions. So, you know, I think the calculation was 24% of all faculty that are hired in academic institutions come from 10 institutions which is a huge number when you think about the number of academic institutions that we have in the U.S. It also tells us something about you know our blinders that we have on when we think about hiring and who we think is important enough for us to hire as faculty at our institutions. So, I thought that that this was quite fascinating.

OLIVER: Yeah, we see a similar pattern when we look at some of our career development awards at NCI. It's a fascinating thing. It seems to be common even in the liberal arts is my understanding.

AVERY: That's correct. Actually, it's even more extreme in the liberal arts where if you wanted to become a faculty member and you're a potential graduate student, there are a handful of institutions in your particular field that will get you a faculty position.

OLIVER: What I also thought was interesting in that paper is the observation that success, if you will, of the faculty member is much more dependent on the institution in which--into which they are recruited, rather than the institution from which they come is that correct?

AVERY: Yes, and actually that's the piece that really struck me, because I think it provides us with an opportunity to perhaps rethink how we look at sort of "pedigree" of individuals that we're trying to hire, and also how institutions support faculty that they're hiring, and you know as you said, what that paper showed was correcting for sort of the background of the candidates, what was more important for their success is the resources of the institution that they were actually hired into as compared to what institutions they actually came from.

OLIVER: So, that suggests that search committees should refrain from using sort of sometimes the classical shorthand that the people employ, right? They look at you know just a very small number of signifiers, public--first author publications in you know so-called top journals and things like that and perhaps consider more broadly who they might add to their faculty.

AVERY: That's correct. I think potential, you know, one can glean that from a number of different approaches, you know, distance traveled, perhaps in candidates--but what, I think again, underlying this idea that the support you know financial and otherwise that institutions provide to the faculty that they hire, is much better a predictor of their success. I mean, one can have the best training, but if you're not an institution that doesn't support you then you won't be successful. I think it's sort of intuitive.

OLIVER: Yeah, and I think well you certainly presented it at CABTRAC, so let me put you on the spot. You presented a mathematical model of that support if you may permit, and I was wondering if you could explain it to our listeners. I remember you put up an equation that says, R-zero equals p times c times d. What is that?

AVERY: Yes. So, I was fascinated by you know so I'm an immunologist, and sort of adjacent to infectious disease in a way we use some infectious disease modeling in our research, but I've been always fascinated actually since I was an undergraduate student, when I took epidemiology, about the dynamics of infectious disease. And for many people who work in infectious disease, they will recognize that formula as a formula that describes epidemics and we've gone, you know, we're sort of in one of those right now and so people, you know, I think the general public is much more aware.

OLIVER: Yeah.

AVERY: Of some of these things, and so R-naught or R-zero is this equation that describes whether an infectious agent will cause an epidemic if it's greater than 1; if it's less than--if it's equal to 1 it's going to be endemic and if it's less than 1 then eventually it dies out which means that the pathogen doesn't replicate enough to maintain itself in a population.

So, p is the probability of infection; c is the contacts per time; and d is the duration of infection. And so, those functions sort of integrate to determine the dynamics of these infections. And so, I was fascinated by that and because I started to think about, you know, scientifically how can we look at--how can we look at the survival so to speak in loose terms, of scientists in a community? And so, I thought about these functions and I thought well, we can convert this formula where R-naught is actually persistence in the scientific enterprise, success however you might define it, and if it's greater than 1 then we then one will persist and be successful; if it's less than 1 than you know we for a given population, they won't be successful if we think about those who were historically excluded or underrepresented, and if it's 1 then it's the status quo; we won't change the dynamics of who participates in science. And so, for those individuals, you know, I took the same sort of formula and thought about p in this case being the probability of the comfort of those individuals; c being the contacts per time that sort make them feel like they belong; and d is the duration of that comfort. And if you think about the parameters that make us feel like we belong in particular place, you know, the interactions that we have, those contacts we have with those around us, increase that and actually as I've been talking about this, I developed a model 2.0.

OLIVER: Okay.

AVERY: Because I've been thinking about and you know those interactions that we have, and so there's 4th function which I call theta and I squared it, and that is, sort of disparaging remarks. So, we can have increased, you know, probability of comfort, we can have increased contacts that kind of make us feel comfort the duration can last, but that can be counteracted by a remark that someone says or an experience that one has that sort of, you know, sort of decreases the effect of those, and so we put those altogether, again, R-naught you know 1 that can be above 1 so that individuals can feel success.

OLIVER: So, you and theta is squared suggesting that that is something that has a profound impact, right?

AVERY: Yes. And again, this comes from anecdotal experience to talking to students, the faculty, and others where they can sort of be in a very welcome environment, an institution in the department, but there's that one thing that happens that makes them question and that can have a profound effect, and so I thought okay, we'll square this. I mean, it could be you know it could be a higher order function.

OLIVER: Sure. But it kind of reframes all the positive experiences, that makes a lot of sense. Now, being a scientist, you went out and got data, so you showed us at CABTRAC a dashboard called Belonging at Cornell which I guess you're using to monitor whether you were able to get above 1 for the R-naught?

AVERY: Yeah. So, this is our diversity initiative here at Cornell. We developed this a few years ago, and what we do is we track--we track elements of belonging; do you feel like you belong at Cornell? Would you recommend Cornell as a place and do you feel a sense of fairness at the institution? I think, a sense of fairness in the literature seems to be really predictive of whether people feel like - even if they disagree with things that might be happening in the institution if they change, that that those have you know been arrived at in a fair manner and they were part of that solution then they're more likely to feel like they belong at an institution. And so, we do regular surveys to sort of monitor that across departments, across particular subgroups, and then of course, we also track you know who we hire and most importantly retention. And we coordinate or integrate retention, parameters of retention, with the sense of belonging that people have and, of course, as you can imagine, I mean, most of this is intuitive but we you know we try to get the data from this; that if one does feel like one feels a sense of belonging, then you're much more less likely to remain in that institution so retention parameters go down.

OLIVER: Yeah. I think that's often overlooked, retention discussions are often about dollars and lab square footage and things like that, but how you actually feel about the institution is obviously also very significant. I'd like to talk to you a little bit about the FIRST award. So, this is a relatively new initiative at NIH, the Faculty Institutional Recruitment for Sustainable Transformation, abbreviated as FIRST, it's a government program we have to have an acronym, and I know that my colleague Dr. Sanya Springfield at NCI was one of the architects of this program and you were the PI of an award at Cornell in the first cohort if I recall.

AVERY: That's correct. You know, we were--we were fortunate enough and to be in the first, among the first cohort for one of those awards, and we're really, really excited about -about this.

OLIVER: And I should say that I'm being acronym happy, PI here means Principal Investigator, so, not all out listeners will know that. So, tell us please Dr. August, what was your FIRST award and what is it you're--that you are accomplishing with it?

AVERY: So, our FIRST award is you know Faculty Institutional Recruitment for Sustainable Transformation to translate that acronym. You know, we proposed to hire, using an approach to hire up to 10 faculty in the biological and the social sciences related to health in three areas, in quantitative biomedical sciences, in infection biology, and in health equity. And this is a collaboration across 7 colleges and schools here at Cornell and 20 departments are participating, of course, not all departments will hire, but the idea is we're using the FIRST approaches to pilot an experiment with some interesting approaches to both hire, but more importantly, to think about this piece that we talked about earlier, which is retention and preparing the environment for individuals to be successful; increasing the probability of comfort, increasing the probability duration and contacts, and reducing the aspects of some of disparaging remarks if we look at that formula. So, we've taken the approach to use very clear check-ins with search committees in ways that you know we've done from at a small scale but doing it more broadly here with the FIRST program. What we really look for in individuals who have strong interests and potential for inclusive excellence. We do that by looking at the work that they've done in the space that they think about how they can broadly engage with who participates in science; do they understand the nature of the field to understand, you know, our students who are quite--who come from all over the world? Do they appreciate some of those perspectives of some of those students and some of the barriers that those students might have faced in entering science? And so, we look for individuals who are able to speak to that in these particular areas, so there's a sort of scientific understanding of the culture of science that we'd like to embody here. We have regular check-ins with the search committees that are doing these searches, such that we can sort of underline some of the principles that we're trying to do here, and we started this by bringing in potential candidates in what we call the "FIRST Symposium" for early career candidates and we brought in about 25 individuals. We announced this broadly. We got a number of applications. We selected a smaller number, because we could only accommodate about 25 of those individuals to come, and this was a 2-and-a-half-day event. We spent a lot of time interacting with these individuals. We did some workshops with them on the faculty search, you know, what we do here at Cornell obviously, and then they also spent about a day with the departments that were hiring and then those individuals then got fed into the searches that the departments were hiring. And so, where we are now is we've started to make some offers for some of those searches. I think we have at least 2 offers that have been--that have gone out. We have 3 or 4 more that are being developed as we speak. And so, the idea is by integrating some strong principles of check-ins, by looking for individuals who appreciate the inclusive excellence, and then bringing them to campus and introducing them to the departments, we hope to be able to sort of boost hiring in this area.

OLIVER: So, much more high-touch approach to hiring than I guess is traditionally done, and I guess emphasizing also the cohort nature of the hiring?

AVERY: That's correct. So, and it's very interesting to see how much interest potential candidates have paid to be part of a cohort that has these components in it.

OLIVER: Fantastic. I understand that the FIRST Program also has a sort of national integration of amongst the different FIRST awards is that correct? Is that part of the process?

AVERY: Yeah, that's correct. But I've only told you about half of what we're doing.

OLIVER: Oh!

AVERY: So, the other half.

OLIVER: Please!

AVERY: Which is actually really, really important for us and in terms of how we've come and arrived at this approach, is at the same time as we're doing the hiring piece, we're working with departments to prepare them who they're hiring. And so, departments that are participating in the FIRST search, we're working with the chairs, we're working with the department faculty themselves, we're climate surveys in those departments to both understand the climate that those faculty will come into, but also work with those faculty to say here's who you are hiring. Here's what they bring to your department. Here's how you can support them so that we can you know, because we do--all these resources to hiring and we devote--we want to devote equal amount of resources to retaining those faculty when they come so when they arrive, they have a higher probability for being comfortable, the integration of contacts is high. We reduce that sort of you know disparaging remarks that increase that R-naught for persistence here in the departments. So, that's the other piece that's happening at the same time as we're working to hire faculty.

OLIVER: That makes a lot of sense, of course yeah. So, thank you. Back to the question about the national integration, is there a national integration in FIRST?

AVERY: Yeah, so the FIRST institutions have … meet very regularly once a month or you know depending on the group. We have several you know sort of subgroups that meet, and you know the first cohort started with about 6 or 7 institutions that were meeting; we have now have a second cohort have joined this group. And the idea really is to exchange you know what we're doing, we're all very different institutions, some are medical schools, some are smaller undergraduate focused institutions, some are collaborations between two institutions and so it's really interesting to both see the diversity of approaches, but the diversity of institutions and some of the hurdles that we all have in trying to do this in a way that's successful. And so, we get together regularly. We have an evaluation, a core that's working together. We have a faculty development core that's been working together. And then of course, we are also coming up in May, all of the institutions will meet together, will bring the faculty that we've already hired so that they can meet each other and ongoing, these faulty will become you know a part of a national cohort in addition to the local cohort that we're hiring at the institutions.

OLIVER: That's fantastic. So, underlying this work is culture change essentially which is not easy. How are you measuring that? How successful is it, has it been at Cornell so far?

AVERY: Yeah, so culture change is you know we can do all these sort of what I call "mechanical" things, but what's really important is if the unit, the department that's hiring those faculty and the institution that's hiring those faculty, is able to adjust its culture to accommodate people who haven't been there before. And that's a long-term strategy. I mean, that culture change comes from both culture change in society, but importantly, you know, how the institution views the climate and the culture at the institution and that's the coming back to our Belonging at Cornell initiative; that's what we're monitoring. So, we survey every 2 years. We've just done--we're just digesting our survey here at Cornell that happened last fall. The FIRST institutions are also participating in a survey that's run out of Brandeis that's sort of doing a similar thing. So, we have both our internal survey that we've been doing for some time, but also surveys across the FIRST institutions that's run out of Brandeis. That will allow us to sort of start to track what you know metrices that change. And one of the interesting things that in looking at this data over time, is that if you look at an institution you can see small shifts of climate, but what's really important especially as institutions get more diverse and hire more diverse faculty, is whether those faculty that are coming in whether they feel welcome, because if you look at the institutional level where still the majority of faculty are, you know, have been there for some time, you know they feel as you know happy and their happiness doesn't change very much, but what is useful and this is where the data comes in that's important, is looking at subpopulations in some, you know, certain in department, at the department level where a lot of the activity is happening so that you can determine whether those individuals that are joining an institution are finding an environment such that they feel like they belong and feel happy. And so, parsing that data is really important.

OLIVER: Fantastic. You also shared with at CABTRAC faculty development work that you're doing. You presented the CAN model. I'm sure that's part of the strategy as well. Can you tell us a little bit about that please?

AVERY: Yeah. So, the CAN model was--is something that our faculty development core developed here, Dr. Yael Levitte, Dr. Cynthia Leifer here who leads that core, and it's sort of a model that's you know is culturally aware network and navigate model, and the sort of core of

this and it's evolved to be a fairly nuanced and complex, is you know, many of our graduate programs use individual development plan model to called and IDP, to sort of try to determine and understand the needs of our students so that we can provide them with the appropriate enhancements for their success. And that will be different for each student because every student comes and arrives at our institution with different preparation and different strengths and areas of improvement. And so, that's a similar model that we're using for the faculty, you know, we hired these all fantastic individuals, they'll be very successful and there are areas where they have where they've spent a lot of time are very good; and areas where you know there could be room for improvement. And so, the CAN model you know we the A stands for advocate, so we have sponsors, we have mentors that support those faculty. The N stands for network. So, we want a network, you know, we want to build a network for those individuals, connect them with program officers, connect them with individuals in their discipline that can support them, and that's sort of at a pair level, at the community level. And we want to cultivate and challenge those individuals by ensuring that they receive rigorous workshops in grant writing and professional development gets really strong feedback. And then help them to navigate and nurture in these environments so, again, supporting this idea of increasing the probability of comfort and that R-naught so it's above 1.

OLIVER: Fantastic. Thank you so much. I wonder if lastly you might share with us the advice that you're giving to the students and the postdocs that are in your own lab, in your own research team who are thinking about their own future, what are you saying to them?

AVERY: Yeah, so I mean, you know, one of the things that we had here at Cornell, and I was also the principle investigator on is the BEST Program which is also run out of the Office of the Director of the NIH. And BEST stood for Broadening Experiences and Scientific Training, and I'm starting there, because you know the idea behind this program, which is now--has now picked up nationally, is to ensure that all of our trainings have the best information that they need to make informed choices about their careers. And so, what that means is to think about where would you like to be in the next, you know, short-term, midterm, and long-term? And how can we provide you with the resources and the information, point you to the right person; it might not be from me, it might be something from someone else who has better information, for you to get that information that can then help you make those decisions. And so, those are the sort of conversations I have with my students; some of my students want to become faculty members and so we talk about you know what would you need to be competitive in an academic environment? Others want to go into industry, you know, what would you need to do that? What sort of experiences would you need to have? And then supporting that and this is all, of course, in addition to being you know sort of providing the mentoring, the scientific mentoring that happens in the research lab. And so, I you know I would love to put--to see my students go on and become successful in academics, but I also would like love to see them become successful in whatever it is that they would like to do. And so, so that's the approach that I take with my students.

OLIVER: That's fantastic. I mean, this podcast, although it's focused on cancer, is focused on all the cancer careers. So, we certainly appreciate that stance, because there are so many different ways that people can contribute. Dr. August, thank you so much for spending time with us and sharing all your experiences and insights with us.

AVERY: My pleasure. This was a fun conversation.

OLIVER: Thank you.

[UPBEAT MUSIC]:

OLIVER: The NCI recently launched a new online seminar series. Here to tell us more is Nas Zahir, Director of the Cancer Training Branch.

NAS ZAHIR: Yes, we launched the NCI Rising Scholars Cancer Research Seminar Series in January to highlight the research and contributions made by NCI-supported postdoctoral fellows and early career investigators at NCI laboratories and NCI-funded institutions nationwide.

The talks are every month on the third Thursday, and you can see them and register for them on the NCI website. There will be a link in the show notes, or you can search for "NCI Rising Scholars".

OLIVER: What kind of topics are the speakers covering?

NAS: We have a broad range of topics – pretty much any kind of cancer research. We have had basic science topics, clinical research, health disparities, cancer prevention, immunology and many more. Each talk is related to a recent publication by the presenter and there is plenty of time for Q&A.

OLIVER: What if you missed a talk?

NAS: We post a recording of the presentation a few days after the talk, along with a transcript and captions so you can always catch the talks at your convenience.

OLIVER: Thanks, Nas – check out NCI's Rising Scholars seminar series if you are interested in some great research that's increasing knowledge right now.

It's a pleasure to welcome Dr. Jiyeon Choi to the podcast today. Welcome.

JIYEON CHOI: Thank you.

OLIVER: Dr. Choi's a Stadtman investigator in the Laboratory of Translational Genomics in NCI's Division of Cancer Epidemiology and Genetics. She studies genetic susceptibility to melanoma and lung cancer. Let's start at the beginning, Dr. Choi. What first led you to think about a career in science, or a career in cancer research?

JIYEON: So, cancer research in specific, kind of came a little later in my career, but for science, I guess I think I liked math a little bit when I was little. Not too much in science, but I -- well, in high school, I had a crush on my biology teacher. So, that led me to biology as a major in college. And it kind of grew on me slowly because I didn't see my career as a researcher right after college. So, I started working for this company, and then which involves actually very high-tech technology back then. Like high throughput sequencing and microarrays and then related to like the boom in the Human Genome Project and then all that. So, I -- that kind of got me interested in science and technology in general. So, that eventually I went back to graduate school to study further, and then started studying genetics. So -- so then, I initially started with neuropsychiatric diseases and then moved over to cancer for my post-doctoral training. And then that was a little more practical decision in terms of choosing cancer field, because compared to neuroscience, the systems that you can study, your subject is very much more, I would say, versatile and available so you can get cancer cell lines from patients, much more easily than when you need to study the brain, where we have to go to mouse models.

OLIVER: So, you're able to get closer to the patient with cancer?

JIYEON: That's true, yes.

OLIVER: Excellent. Excellent. So, then you are doing genetics. You got interested in cancer. What made you pick genetic susceptibilities as sort of -- as a specific discipline?

JIYEON: Oh, yes. So, that's -- I guess it's -- the question that I'm most interested in, so people could -- you can get cancer from environmental factors. People know that -- that contribute to cancer, but even some people are exposed to the same amount of carcinogens, for example, but how the human body reacts to those stimulus is not the same. So, there could be a lot of reasons, but genetic factors clearly is one very particular -- specific factor that contribute to that. So, it always intrigues me that -- how we're sort of designed from the beginning to be susceptible to something versus another. So yes, that's a somewhat intriguing question to me.

OLIVER: Yes, I mean you study lung cancer. I mean, when I was growing up, there was a lot of smoking, you know, a lot of people smoked, and we all knew someone's grandpa who'd, you know, was in their 90s who'd smoked their whole life. Never had a lung problem, and then of course there were also other people who may never have smoked or may have smoked for a short period of time, who had lung cancer. So, clearly just knowing that, you'd think there must be something different in the genetics. Interesting. You also study melanoma. So, how are those two cancers different in terms of susceptibility?

JIYEON: Sure. So, they're different it's -- for example, you can actually measure the heritability from the populations. So, how much genetics explain the variability in the risk of a certain disease. So, there are different method, and no one method is perfect. But if you use those like multiple measures, melanoma seems to have higher heritability than lung cancer. But both cancers have very strong, well-known environmental factors. Smoking for lung cancer and UV exposure for melanoma. So, since I've studied mainly melanoma for my post-doctoral training, it was a really interesting connection that -- the fact that the -- they have different heritability levels, but there's strong environmental factors. So, I found some similarity between two cancers in that way.

OLIVER: So, you did your bachelor's degree in Korea. You came to the United States for your PhD, to Rutgers University, if I recall.

JIYEON: Yes.

OLIVER: And did your post-doc then at the NCI. What was it like moving from one country, one culture to another, as you did your training?

JIYEON: Yes. Obviously, there are a lot of challenges. And also, it's an adventure, right? And so, the goal is science. So, that's pretty clear. And in the laboratory setting, we speak international language of science. So, in that sense, it's familiar. But since I live in the -- as an adult, I live in a different country, so it -- to me it feels like being a teenager forever. So, you try to define yourself, how to behave, try to read the cultural cues, and you know, I feel less and less over time, but still, it doesn't go away.

OLIVER: Of course. Of course. So, you were a post-doc at the NCI, and of course you were part of the Intramural Research Program. Now, not everybody knows that there's research actually happening at the NCI. Now, you lead a group there. So, what's it like doing research in the Intramural Program?

JIYEON: Yes. So, yes, as you said, a lot of people considered NCI as the kind of money lender. You know, where you get the research funding from. But we have -- in NCI, we have a lot of fantastic intramural research programs. So, I was lucky to be able to discover great post-doctoral opportunities in NCI. So, and then when I was a fellow, post-doctoral fellow here, I was able to recognize a lot of benefits because compared to the university setting, where I was a graduate student, in NCI and in the the bigger NIH, post-doctoral fellows that actually, the majority of, the main people, we don't have too many graduate students. So, actually the institute actually cares about post-doctors -- post-docs a lot and their career development. So, I really felt I had a lot of resources to go for when I need help, and especially in developing my career. And so that's how I kind of knew that all -- there's going to be a lot of benefit even as a PI because we don't really need to write grants to get funding for our research. We do get kind of audited or reviewed from outside scientific community because we're using tax money. So, we have to justify if our research is valid. So, we get reviewed every four year, regardless of tenure-ship. So, but still, it's a very collaborative environment and also rich resources. So, yes, I highly recommend people to take some interest in this area of NIH.

OLIVER: Take a look, yes. So, you're part of the Division of Cancer Epidemiology and Genetics, which is one of the two sort of groups, if you will, inside NCI's Intramural Research Program. The other being the Center for Cancer Research. Tell us about DCEG. What is it?

JIYEON: Oh, yes. So, I was trained as a molecular geneticist. So, like mainly doing wet lab work. So, it was still -- although CCR, the other part of NCI is much bigger in terms of number. And I think it's better known to kind of lab scientists. But the DCEG is mainly doing epidemiology and epidemiological studies of cancer. So, the -- we care more about etiology and what can lead us for better prevention and prediction and early detection. So, curing cancer in the therapy setting, when you're already diagnosed and then developed a lot, people put a lot more money into that, but catching it early, it saves more lives, obviously, right?

OLIVER: Yes.

JIYEON: So, you could save lives by simple surgery in the early stage if we have tools to find and detect cancer earlier. So, but this is using population scale data, a lot of registry data and then survey data. So, a lot of it is computational and then traditionally the training trajectories were pretty different, but especially in our branch in the division. We also have wet lab space, so we are kind of trying to bridge two areas of experimental science and population study.

OLIVER: So, in 2019, I think you transitioned from being a fellow to being a principal investigator leading your own research group. What was that like?

JIYEON: Well, yes, I transitioned within the same branch. So, that was interesting because all of a sudden now I was a lowly post-doc, and then now like I have a lab. So, yes, it was very exciting because I was a little familiar with the system already. So, now I get to do like a lot of different things, yes, independently. So, that was really cool. And we have a good support system here. All the senior PI's are very supportive, and then we particularly in our branch, we have a very collaborative environments. So, that has been really fun, but also at the same time, it's late 2019. So, as soon as I started, we hit the pandemic. So, lab closed. So, yes. So, starting a lab anywhere is pretty challenging and the pandemic didn't help much. So, yes, it was a struggle, but it's getting much better right now.

OLIVER: I can only imagine. What was the most challenging part of starting the lab?

JIYEON: Yes, so it's a totally different mindset, at least to me, because we -- as a post-doc, I'd never been trained in -- how to manage a lab. How to manage people, how to hire people, you know, and how to spend money, budgeting, and things like that. So, most of what I do is not actually generating or analyzing data. It's more managing part and meetings and networking with other scientists to kind of find our space in the scientific community. So, yes, that's very different. But yes, I'm having fun so far.

OLIVER: Fantastic. Now, I believe you were -- you're a Stadtman investigator. Can you tell us about the Stadtman Program?

JIYEON: Yes. So, Stadtman Program is NIH-wide program to recruit principal investigators. So, it's not just within NIH, but anywhere in the world, people can apply. And we -- the program starts a little early in the game. So, like I think early fall, we collect the candidates and then I think there's a central committee who select X number of percent, and then each institute within NIH could pick the qualifying candidate through interview. So, it comes with a title. So, that's prestigious and also, we have kind of a cohort of people that we can reach out to once you become one. And as I said earlier, like it's -- it's intramural. So, we are given the funding as opposed to write grants every time for each project.

OLIVER: Right, so you have a network of other Stadtman investigators across NIH that you can connect with, is that right?

JIYEON: Oh, yes. You can do that. I mean, there's like no organized official things, but yes, we kind of know at least a few of them, yes.

OLIVER: You know of each other?

JIYEON: Yes.

OLIVER: And I believe you're also an NIH Distinguished Scholar, correct?

JIYEON: Yes.

OLIVER: What is that program?

JIYEON: Okay. So, that's a newer program where each year, out of Stadtman pool and also other route, they select these investigators who are dedicated to promoting diversity and reduce health disparities. So, they collect -- they select the scholars and this is really well-structured program where we're given mentoring from senior investigators regularly. We're given opportunities to network, and also the cohort membership is very strong, and then we have our chat group, and then we meet regularly. So, support each other, and yes, exchange information. So, that has been really fantastic.

OLIVER: What's the most important thing do you think of being part of such a community, such a cohort? How has that helped you get started?

JIYEON: Sure. So, I was saying a little bit about transitioning from post-doc to PI. So, as a post-doc, you have a lot of people in your group. You have a peer group, because like you're large in number. But all of sudden, all the peers disappear and, right? The one thing that -- one of the challenges as a PI in the beginning is you cannot really find a peer group easily. But these are group of people who are in the same stage mostly as you, and also, we have the same goal. Not just get your lab up and going and then making it successful, but we have good cause to -- for more diversity. So, that's really -- that's really a good group in the way of good rapport in our group.

OLIVER: So, it's slightly less lonely at the top when you have a cohort.

JIYEON: Certainly.

OLIVER: Excellent. And just finally then, now you are a PI. You have your own research team. You've got post-docs and students and folks. What advice are you giving them as they work in your group and think about their own futures?

JIYEON: Yes. So, they usually come in with some sort of sense of what to do. So, I -- if they have clear goal, then I try to help them achieve that goal. And -- but if they don't, then, especially some people are debating between, "Should I be a PI or like should I go -- like go other, quote/unquote 'alternate route?'" But in reality, the alternative route is the majority, so I tell them that, "Don't be fixated on becoming a PI. You do it only if you like it." But at the same time, for people who are not confident enough, then I try to make sure to tell them that, "Do not give up just because you like, because of lack of self-confidence." And it's not the most horrible job in the world. So, yes. I try to give advice in both ways.

OLIVER: Yes, fantastic. Thank you. I really appreciate it. Well, thank you very much Dr. Choi for coming on the podcast and sharing your personal journey, and your experiences. Thank you.

JIYEON: Thank you.

[UPBEAT MUSIC]

OLIVER: Now it's time for a segment that we call Your Turn because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast or a talk, or anything that you found inspirational or amusing or interesting. You can send those to us at [email protected]. Record a voice memo and send it along. We may just play it an upcoming episode. Now I'd like to invite our guests to take their turn. Let's start with you, Dr. August.

AVERY: Thanks, Dr. Bogler. So, you know, I enjoy listening and actually mixing electronic music. So, one of the things I would recommend is one of my favorite artists. He's called Congo Natty. He's a UK artist, and he has a really interesting history, but also some really interesting music. It's sort of a blend of reggae, electronic music, and it's sort of unique in this space. So, I like big up his props whenever I can, Congo Natty.

OLIVER: That sounds like fun. Is he on Spotify?

AVERY: He's on Spotify.

OLIVER: All right, we'll dig out a link and put it in the show notes for our listeners to check. Thank you so much.

AVERY: Thank you.

OLIVER: Dr. Choi.

JIYEON: So, my recommendation is a movie that I watch regularly, it's called Free Solo. It was out a few years ago. It's a documentary of this person, professional climber, Alex Honnold, who free soloed El Capitan of Yosemite. And I'm a climber myself, a beginner, just a few years in, not that good. But just like something about this documentary, both entertaining and also, I don't know, encouraging me sometimes. Yeah, so the best part is that you're watching somebody risking their life doing this extraordinary thing while you're eating potato chips. So that's pretty fun.

OLIVER: [Laughing] Excellent. Thank you very much, Dr. Choi. And I'd like to make a recommendation as well. It's a book I read a few years back which had a profound impact on me. It's called Factfulness, by Dr. Hans Rosling. He's co-authored it with his son and daughter-in-law, who work together with him at the Gapminder Foundation. Dr. Rosling, who died in 2017, was a medical doctor, professor of international health, and influencer. He was famous for a series of TED Talks that described the world through facts. You may have seen his famous animated bubble graphs. The premise of this eye-opening book is that most people answer questions about global trends incorrectly because of 10 instincts that distort our perspective and because of biases that we harbor. It encourages a worldview based on facts. And it's filled with beautiful data. And shows that while there is much that needs urgent attention, armed with facts, we see some progress in the world and can take heart that positive change is possible.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training.

It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser.

A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this episode of Inside Cancer Careers, we hear the amazing story of the very successful Appalachian Career Training in Oncology (ACTION) Program from Dr. Nathan Vanderford, an Associate Professor within the Department of Toxicology and Cancer Biology at the University of Kentucky College of Medicine and Director of the ACTION program along with two ACTION program alums Susanna Goggans, a second year medical student and Michael Buoncristiani, a senior and soon to be first year medical student at the University of Kentucky.

Show Notes:

Nathan Vanderford, Ph.D., MBA

Appalachian Career Training in Oncology (ACTION) Program

Youth Enjoy Science (YES) Research Education Program (R25)

Book Recommendation: ReSearch: A Career Guide for Scientists

Your Turn:

Book Recommendations:

· The Guest List by Lucy Foley

· The Cancer Crisis in Appalachia: Kentucky Students Take ACTION (1st edition)

· The Cancer Crisis in Appalachia: Kentucky Students Take ACTION (2nd edition)

Cancer in Appalachia Instagram Page

TRANSCRIPT

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.

On Inside Cancer Careers we explore all the different ways that people join the fight against disease and hear their stories.

Today we are talking to Dr. Nathan Vanderford from the University of Kentucky who runs a program for high school and undergraduate students that are tackling the cancer crisis in Appalachia and will also have two of the alums from that program on the show.

OLIVER: It's a pleasure to welcome Dr. Nathan Vanderford to the show. He's an associate professor in the Department of Toxicology and Cancer Biology at the University of Kentucky College of Medicine and the Director of the Appalachian Career Training and Oncology or ACTION Program. Welcome, Dr. Vanderford.

NATHAN VANDERFORD: Thank you very much, it's great to be here.

OLIVER: Before we jump in to learn more about the ACTION Program, I wanted to ask you about your own journey to the position that you hold today, what was it that you got you interested in science and cancer?

NATHAN: Yeah, you know, from a very early age, I mean, from, you know, five years old or maybe a little younger I had aspirations of being a medical doctor. Didn't quite make it there, but, you know, in science, nonetheless. But I think I was inspired by, you know, being sick as a kid, it turns out, long story short, grew up in a house where we burned wood to heat our house and I was allergic to the wood smoke, and it would make me very sick as a kid in the wintertime. And, so, I was inspired, I wanted to, you know, help others that were sick like me. And then, you know, over time I just got even more interested in science, basic biology, I wanted to really understand how we worked, like, you know, biomedicine, biomedical research really interested me. And, so, when I went to college all I wanted to do was just take biology and chemistry classes and learn as much as I could about how we as humans functioned.

OLIVER: Fascinating. You have an MBA, a Master's in Business Administration, that's not a common qualification among scientists, can you tell us what prompted you to get an MBA?

NATHAN: Yeah, so, when I finished training, so I did a post-doc in Vanderbilt and then I came back to the University of Kentucky and started out a quote real job, real world job, and, you know, some of the things that I was doing I could see where even though, you know, I just said I loved being an undergraduate and grad student, learning everything I could about science, but I missed out on opportunities to learn other things and, you know, business administration concepts I think many of use in a variety of different job settings. You know, as scientists, you know, if you run your own research program, you have grant funding, whatever the case might be, you know, having some business acumens, some business, understanding of business principles, even working in an organization and trying to understand how the organization functions and how projects work and all that kind of thing, I think is really useful. And, so, I was kind of inspired by that and the lack of knowledge in these areas and, you know, just being sort of a sucker for wanting to learn more and, you know, loving education, I thought I'd go back and get an MBA and it's been really useful, I think. You know, I learned a ton of things that I wouldn't have otherwise known, met a lot of great people that some of which I'm still connected with through that program, so it was a great opportunity for me.

OLIVER: You focused on mentoring and teaching, as you just mentioned, and giving career guidance to the people you are mentoring, you've even co-authored book, "Research, a Career Guide for Scientists" and you've written about graduate education, so where are we, in your opinion, in 2023 regarding the biomedical scientist training path?

NATHAN: Yeah, that's a great question, and I think, you know, it's a question that is being asked out there a lot, you know, and in the media, you know, what I tell people is getting a graduate degree or professional degree is a phenomenal opportunity. I think, you know, we are blessed to have these opportunities to get, you know, a high level of education. If we talk specifically about, you know, PhD level education, we're getting paid to get educated and to learn and to, you know, to do science, discover things that nobody else has discovered before, so it's a fantastic opportunity. That said though, as many of us know, there's issue in the PhD training world and I think, you know, while it's a phenomenal opportunity, I think we have a lot to do in terms of making the training experiences better, more positive for trainees. And I think that we have some opportunities to improve how we train trainees and to better align that training with the jobs that our trainees are actually getting to get, rather than focusing specifically on preparing the next generation of faculty members when, you know, as many of us know, a small sliver percentage of our PhD trainees are actually going to pursue and obtain that kind of career path. So, there's a lot of other training that we need to be providing our grads.

OLIVER: I'd like to pivot to talk a little bit about the ACTION Program now. Can you tell us what it is and how the idea came about?

NATHAN: Yeah, so ACTION -- the Appalachian Group Career Training Oncology Program, it's an experiential cancer education training program, it's funded by the National Cancer Institute, which I'm very, very, very appreciative of. I think we'll get into this more in a little bit, but it's a Youth Enjoy Science R25 program. We're very fortunate to be funded through that mechanism, it's a fantastic mechanism. It's through this R25 mechanism, there are three components of the training, there's research, education and outreach aspects of the program. And, so, we recruit students and prepare and motivate them for cancer biomedical careers. And I think we're going to get more into the specifics of who we're reaching and what our specific goals are and, you know, we're very excited about those goals, because our program is really situated in an area that has great need for this kind of work.

OLIVER: Yeah, you mentioned the R25, that's a program through the Center to Reduce Cancer Health Disparities at NCI and it is a program designed to help people to experience science and think about careers in science. So, I think your program is definitely excellent component of that bigger program. So, you mentioned just briefly, you alluded to the cancer situation in Kentucky and the books that you've published with your participants, we'll get to in a moment, but they talk about a cancer crisis in Kentucky, can you tell us a little bit about that?

NATHAN: That's right and I think I forgot to answer part of your other questions, so I'll circle back too.

OLIVER: Sure.

NATHAN: So, sort of how it came about, so it came about because of this cancer crisis in part. So, for those who don't know, Kentucky has a massive cancer problem. We rank first in the nation in overall cancer incidence and mortality levels. So, no other state in the US has a worse cancer problem than does Kentucky. And that's bad, I mean, we're talking, you know, over 30,000 new cases each year, over 10,000 deaths in the state, so significant cancer problem. That's bad, but what's worse is that the cancer problem is significantly worse in the eastern part of the state, the part that's in the Appalachian region. There're 54 counties, out of the 120 counties in Kentucky. These 54 counties have really significantly higher cancer rates than does the rest of Kentucky, which again is number one in the country. So that was part of the motivation for this program. I mean, I think that describes the cancer crisis, you know, and it's not to be sensational in saying that. I think from my opinion, we really do have a crisis, I mean, in terms of the high rates of the disease. The other inspiration for the program was, and this is some of the reason why the cancer rates are so bad in Kentucky, there's also, again, Kentucky doesn't rank so well in education levels across the state, but again, that's worse in east Kentucky, so education attainment levels are low, so you, you sort of marry the cancer crisis with the education crisis and so coming up with the ACTION Program sort of, you know, was a no brainer in terms of trying to think of a long-term strategy to help solve the cancer problem, while also addressing the education attainment, really focusing on, you know, providing opportunities, resources for students to help them prepare academically and succeed academically, while also providing this cancer training was, I thought, a phenomenal opportunity.

OLIVER: So, you draw your participants in the program from those 54 counties on the east side of the state, the Appalachian region, is that correct?

NATHAN: Absolutely, yes. So, in our program we engage high school and undergraduate students as participants. Through our outreach we reach elementary through, you know, community members of all ages, but participants specifically in the program are high school students to undergraduates and specifically from those 54 counties in eastern Kentucky.

OLIVER: Yeah, we're going to get to talk to two of your alums in this the next segment, but I read the books that you published with your participants, these are personal essays written by the high school students and undergraduate students. I tell you, very impressive, very moving, very thoughtful essays. How did you come up with the idea of actually bringing out these books?

NATHAN: Yeah, that's a great question. You know, these essays are -- I'm biased and you said it too, but I, you know, they're phenomenal, you know, I originally, I wanted a way that we could sort of innovatively uniquely engage the students in a learning exercise, have them explore their personal connections with cancer and get them to think about cancer in their families and their communities. And, so, that sort of was the inspiration of this idea to have them write essays. You know, originally it wasn't a project where I thought we would publish these essays, it was just, you know, really an activity to get the students to think and, you know, start talking with their families, and learn about cancer in their communities, but they were just so phenomenal and I thought, man, you know, other people need to read these. And, so, that's when, you know, I started talking, we have a university press, in our university -- the first book was published by our university press, and they also thought it was something that needed to get out there in the community. So, you know, the students learned a lot about cancer, I think many of them, particularly the high school students, it was a great exercise in writing and being critiqued and learning how to be, you know, go through edits. As a high school student -- when I was a high school student, you know, I would write something, turn it in, I might get a C on the paper, but I didn't have an opportunity to revise it, you know. And in the scientific world it's all about writing and rewriting and editing and revisions, so I think that was a big learning step too for the students. So we went through all that process and then getting it out there has been a great opportunity to engage the community here in Kentucky, but even more broadly. You know, you said you've read the books and, so, they've been distributed beyond the borders of Kentucky, which I think is phenomenal.

OLIVER: Yeah, absolutely, I recommend them. On your website, the program website at the University of Kentucky, you have information about all the different folks, can you give us just a feel for the numbers how many participants have you had over the years?

NATHAN: Yeah, so, alumni and current students we're at a 116 now and that breaks down to about -- there's 60 high school students, 56 undergraduates. And for those who aren't maybe as familiar with the YES Program as others, it's a two-year program, so students are in the program two years and we engage our students continuously across those two years, not just in the summer. So, you know, that, you know, a 116 may not sound as high as what some other programs are able to accumulate over the years, but I think this long-term engagement, you know, is significant, it has a significant impact on our students.

OLIVER: And one of the goals, I guess, is to interest students in a career and in biomedicine, perhaps even in cancer research, have you got some outcomes information, has that happened?

NATHAN: Yeah, I think, you know, the students are who make the magic happen, they're the phenomenal ones of this whole thing. And we've been very fortunate, so our undergraduates we have 40 alum who, you know, have finished the program. Out of those 40, so the undergraduates, we have 33 that have gone on to either professional or graduate programs. And out of those 33, we have 25 that have gone to medical school. And you're going to hear from one that's in medical school now in just a little bit and another that's going in the fall and that's phenomenal, I think. And what's really exciting is that these students are continuing to also be interested in research, not only medicine, but they're continuing with research too, which I think that, you know, I hope, and we'll see what the students say, but I think that we helped spark that interest, you know. Or maybe they might have done some research without this program, but I think they might not have done it as deeply or in such a sustained way without. Our high school students are also being, you know, very successful, out of 20 that have graduated high school now, 18 of those have gone on to college, which is way above what's expected in Appalachian, Kentucky, you know, we've already talked about the educational issues, it far exceeds the percentage of those that go to college. And, I mean, I think all of them, the last time I checked, are in a science related field and are continuing the, you know, the steps to pursue the next thing of graduate school or, you know, professional school and focusing on research or medicine.

OLIVER: Anything else, Dr. Vanderford, that you'd like to share about the ACTION Program?

NATHAN: Well, I, you know, I'm -- I'm just so grateful for the opportunity. We have, you know, we have a renewal grant in review right now, it's going to be actually reviewed later this month, so we'll see what happens in review, but I really look forward to, you know, either now or in the near future getting this program refunded and continuing. The other exciting thing that has just very recently happened, I think that as another layer of impact is that I've worked with our philanthropy groups here on campus in a variety of different ways, but we just had some donations to start a scholarship program for our students and current students and alumni, which is huge, because, you know, many students from this area need significant financial support to be able to attend college and so I think this is going to be a great opportunity to continue supporting our students beyond being in this program and helping them, you know, be successful doing whatever it is they want to do.

OLIVER: Well, thank you very much, Dr. Vanderford. We're going to take a quick break and when we come back, we'll talk to two of the alums of the ACTION Program.

OLIVER: PubMed lists over 270,000 cancer papers published in 2022 – that is a staggering 750 papers every day. It's great that cancer research is such an active field, but it makes finding the pubs that are critical to your work a challenge. What if you had an AI that paid attention to the papers you read and suggested others as they appear in PubMed? That is exactly what the NCI is building with an app called NanCI. With me to discuss NanCI are two members of the team that are creating NanCI: Chris Perrien of Blue Pane Studios and Duncan Anderson of Humanise.ai.

Chris, you've been building apps for NCI for over a decade. What is new about NanCI?

CHRIS PERRIEN: Oh, thank you. Fundamentally NanCI represents a shift in user experience – in the prior generation of apps people had to know where to look to find things. Now, they can find the information using AI agents. I think of NanCI as a friendly research assistant who makes suggestions and answers questions. Of course, it is early days, and NanCI is still learning from their users, but they will get better and better over time.

Duncan, you bring AI expertise to the project. Can you tell us what capabilities that brings to NanCI?

DUNCAN ANDERSON: Yes, NanCI is all about connecting scientists. Right now, the focus is on connecting them to papers relevant to their interests, which NanCI does by matching vector representations of abstracts and looking at co-citations. If you tell NanCI that you find a group of papers interesting, by bookmarking them, the app will keep an eye on PubMed for you and suggest related publications. You can also share these folders with colleagues and export them to your reference manager. You can read the paper right there in NanCI and follow any author to see when they publish preprints. Down the road we intend to help people network based on shared scientific and career interests. And much more – these are just some of the features of the app.

OLIVER: Thanks, Chris and Duncan. Right now, NanCI is available in the Apple app store, and it will be coming to android later this year. Download it and give it a try! Your feedback on NanCI is very welcome – you can send that to us here at [email protected].

Welcome back. I'd like to welcome Susanna Goggans, who is a second-year medical student at the University of Kentucky. Susanna participated in the ACTION Program from 2018 to 2020 and is from Johnson County, Kentucky. Welcome, Susanna.

SUSANNA GOGGANS: Hello, thank you for having me.

OLIVER: Also with us is Michael Buoncristiani, a senior at the University of Kentucky, majoring in biology, neuroscience and agriculture and medical biotechnology. He's starting med school there in the fall of 2023. Michael was a participant in the ACTION Program from 2019 to 2021 and he's from Wayne County, Kentucky. Welcome, Michael.

MICHAEL BUONCRISTIANI: Hello, thanks for having me.

OLIVER: I'd like to start with you, Susanna. In your essay, Malignancy in the Mountains, which is in the first book, you described the events of the summer of your freshman year, what happened?

SUSANNA: So, the summer of my freshman year -- well, first of all, in like April my mom called me and she said that I went to go get my yearly free scan from UK, she had been going once a year through UK's ovarian cancer prevention program and getting a transvaginal ultrasound, which was part of a study that they were doing, so her and my grandma would go once a year and get this ultrasound done and it was to detect any signs of ovarian cancer. And she told me, she said, "They saw something a little suspicious, they're not too worried, I'm going to the doctor." And then I was like, "Okay, well, you say not to be worried." And so then in that May I took my first finals of my freshman year at UK, I came home, my mom went to the doctor, she said, "Well, they said I need a hysterectomy, but like still nothing to be worried about," and I said, "Okay," you know, I still like, hysterectomy, like, you know, but okay. And so, then the hysterectomy came around and I had already -- I was interested in medicine, so I had already watched the YouTube videos and how, you know, what a hysterectomy is, I knew how long it was supposed to take and it was supposed to take around two-ish hours. And I was at home, my dad was in Lexington where she got the surgery with my mom and I was at home because I was in charge of watching my little sister who has cerebral palsy, so she needs 24-hour care, so I was in charge of babysitting her for like these couple of days that my mom was going to be in Lexington. And I kept on waiting and I noticed that she wasn't coming out of surgery, and I kept on texting my dad, I was like, "Did you forget to text me, is she out?" And he's like, "No, no." And then eventually I got the phone call that she -- that they found cancer, that the cyst on her ovary was ovarian cancer. And I guess I should have been a little bit more expected, because I knew there was -- or a little bit less surprised because I knew there was a chance, but it really took me aback or it took me back by surprise for some reason. And, yeah, the good news is because she was part of this screening program, they found it extremely early. Ovarian cancer is notorious, if you Google just ovarian cancer you'll see that the mortality rate is like 50%, it's really high. But usually, they don't find it until around stage 3, they found hers in stage 1 at the very, very, very beginning. So that -- we were very, very lucky for that. And then she went through her six rounds of chemo and ever since then she's been good. So, it was an interesting summer, it was kind of a rough summer and fall, but we're all so thankful for that program that found her cancer so early that she just needed the chemo and now it's been over five years and she's still good.

OLIVER: Yeah, you described the wait during the surgery when you don't get the text and you don't get the text, it's definitely -- I wonder what was going through your mind at the time?

SUSANNA: A lot of thoughts. I was having a busy day anyways, because I was taking care of my sister and I wasn't, like, too used to taking care of her without my mom, because my mom is a stay-at-home mom, so she's generally at home, like I help her with her a lot. And so, I was already a little bit overwhelmed with that and I was also trying to get, like, this shadowing program set up at home so I could be shadowing in the local hospital that summer, it was the very beginning of my summer break. And so, I just kept on wondering, I don't think cancer really crossed my mind, but maybe that's what happened, I just kept on thinking that she had just gotten out and my dad was just so over -- you know, like, someone gets out of surgery, he was just busy and had forgotten to text me. So, that's really all that was going through my mind and eventually when it hit around hour 3 or 4, I was thinking, well, maybe something's wrong. Maybe, but, you know, it really didn't cross my mind that much until he called me.

OLIVER: Yeah.

SUSANNA: Once he called me, I kind of knew, since I saw it was a phone call, but.

OLIVER: Yeah. Came out of the blue, like a shock, yeah.

SUSANNA: Yeah.

OLIVER: So, Michael, in your essay, A Continuous War, Cancer in Kentucky, it's in the second book, you described that your first contact with cancer through your grandfathers. You were pretty young at the time, if I remember, and I wonder how it felt to see this in your family and what was the impact?

MICHAEL: So, I think that was an interesting part of my, like, journey with recognizing cancer. So, when my grandfather was diagnosed, like you said, I was very young, so you don't really know, don't really know what cancer is, you don't really know what's going on, but you can just feel how people are interacting, you can tell that something's wrong, but you don't really understand it. And I think that that really, really impacted me as, like, I got to -- got to see it first hand from, like, the -- how big of an effect cancer has on not just the patient with it, but the family. And I also got to see, as I got older, how big of a role that the provider played in the cancer journey of each patient -so I really respected my grandfather as most grandkids do and he liked his cancer care providers, his oncologists and nurses and everybody, they that were at the Markey Cancer Center. And, so as I was growing up I got to -- I kind of transitioned more into, like, the understanding of how it affected everyone and then I was like, okay, so this is what's going on and then I got to see, even when I was still early on in college when he was still receiving treatment here at Markey, got to see the power of the advanced medicine that goes on at big cancer care centers, because we're from -- I'm from about 2 1/2 hours from here, from Lexington, so to get cancer treatment this is the closest place you can go to get that kind of care. So, I remember my grandfather would drive up to Lexington and there's a Hope Lodge here in Lexington, he got to stay there a few times. But I got to see how much -- how much of a toll that took on him and so it was kind of a unique transition into, like, understanding the emotions around it and how it affected everyone. And then I got to kind of see more of the science side when I was middle/high school and then transitioning into college I got to see how much of a role that can play if people are able to get that quality cancer care. So, I think that was a great part of that journey being able to see it through different stages as I got older. And thankfully to cancer care at places like Markey, in the book I think I even wrote that he lived 15 years after his initial diagnosis, so I just -- I do think that played a big role in how I decided to do what I'm doing now and kind of get involved with the ACTION Program, which was amazing for me. So, yeah, I think that was really interesting and I think that progression made a big difference.

OLIVER: In your essays you both described the high rate of cancer that Dr. Vanderford already talked about, and you identified some reasons, I wonder what your research showed? Michael, do you want to start?

MICHAEL: Yeah, so I got the amazing opportunity with Dr. Vanderford's direction to work in a research lab. It was here, they moved here recently to another university, but I got to work in a research lab for 2 to 3 years and worked mainly on a project. So, they knew I was coming from the ACTION Program and the PI that I was working for knew Dr. Vanderford, so they let me work with one of the post-docs on an Appalachian lung cancer project, which was amazing. So, my grandfather's tumor metastasized to his lung, so he lived with lung cancer for many years, so I got to work with that project and we were -- some of this stuff has been published, but we were using mass spectrometry to investigate the tumor microenvironment on -- of lung cancer patients from Appalachia versus non-Appalachia patients. So that's the cool thing about the Markey Cancer Center here is they get these patient samples and they put whether these patients were from Appalachia County, so those 54 counties that the ACTION Program has and then patients that weren't from there with different types of lung tumors and we compared these lung tumors and trying to investigate whether diet plays a role in that. So, the Appalachian region is well-known for poor dietary habits and it's not because people have a choice, it's because a lot of places don't have fresh food around, the nearest Wal-Mart could be 45 minutes, an hour away, so you've got to go to McDonald's, you have to go to Wendy's, you don't really have a choice if you're running late at night, you've worked a 12 hour shift. So, a lot of these individuals have to -- have to pretty much eat unhealthy and we wanted to investigate the impacts of these unhealthy diets on this and eventually transferred that into other studies and things. That's an ongoing process, it's a big project, but I was really glad to be able to do that. And one thing that I wanted to say was, it was really interesting, so I got to go out of state to present some of this, some of the data that we had and people that were from states that were not around Kentucky, they had no idea that this was such a big issue, and they were really surprised. And that was another really interesting thing to me, and I was glad that I talked about some of the statistics in the book, because I don't think even in the Appalachia region, I don't think a lot of people realized the rates that we have and how much difference some of those, like, food insecurity and stuff is between there and places like Lexington, places like these bigger cities. And I also know that that plays a role to areas in the bigger cities that are really far away from fresh food, so I think that investigating that Appalachian lung cancer may unlock a lot of answers to what's going on in a lot of these regions that have these insecurities and a lot of the issues that we have in the region.

OLIVER: Yeah, lots of social determinants of health play a role. Susanna, in your essay you also talk about opportunities to maybe turn the tide a little bit in Kentucky and make advances on these issues, I wonder if you could tell us your thoughts on that?

SUSANNA: Yeah, like Michael was talking about, where there's so many factors that go into these high cancer rates in eastern Kentucky, I think it's difficult to target all those factors at once, but I think just having the overarching goal to try to improve, oh no, like make -- help eastern Kentucky have a healthier lifestyle. As Michael was kind of talking with the obesity rates, I think that might be a hot high -- there might be a high correlation between that and cancer to just try to encourage healthy eating habits, which is difficult because of, you know, the distance to -- you have to drive sometimes to go to a grocery store when you live in a very rural area and just the availability of fast-food over other types of food. But I think just trying to target some of these factors might be a good way to start the process of helping to decrease these cancer rates. Along with also just preventative screenings. I'm into preventative screenings since that's what caught my mom's cancer. But it's hard to go to -- get to the doctor sometimes when you live very far away to do a screen that might not even detect anything. You can see how it would be hard to motivate yourself or find the time or resources to be able to do that. We don't even know for sure it will help, but just making all of these things more accessible I think could be a good start.

OLIVER: Thanks. So I'm curious, what was it like to be in the ACTION Program, Susanna, and has it -- I think you indicated you were already interested in medicine when your mom was diagnosed, so maybe those are longstanding interests, but I wonder if it's influenced perhaps even the direction of the medicine that you intend to practice?

SUSANNA: It definitely has influenced the direction of medicine I intend to practice. When I first started undergrad, I was interested in medicine because of growing up with my sister with cerebral palsy, as I previously mentioned. So, I was looking into PM & R, physical medicine and rehabilitation and I was just kind of looking into specialties like that, because I wanted to be a doctor like the doctors that have worked with my sister and I had never really -- I definitely never even thought of oncology, I just thought what everyone else thinks, oh, that would be so sad. And then my mom got diagnosed and I saw what impact her doctor had on my family and on her cancer journey and how amazing her doctor was. When my dad did that first phone call he said, "I wish you were here just so you could see her doctor, she's amazing, you need to be a doctor like her." And then through the ACTION Program I got the opportunity to shadow my mom's doctor specifically and other oncologists a lot throughout -- all throughout my undergrad experience and something that I saw over and over again is that these doctors had such a high impact on their patient's lives. And when you have a cancer diagnosis it is likely going to be one of the worst times of your life and it just kind of resonated with me that I could be someone to help people through that time of their life and be there for them and help make this worse time in their life hopefully not as bad and help them get through it.

OLIVER: Yeah, yeah, I think that's fantastic, and I wish you all the best in that journey. Michael, you had already indicated a little bit that the ACTION Program influenced your choice to go to medical school later this year, are you thinking of oncology as a specialty?

MICHAEL: Yeah, the ACTION Program really -- definitely influenced my decision to do that. So I already had that previous experience with cancer, but coming from a small town in the Appalachian region you don't -- you don't have anybody to ask what to do, so you kind of just -- you come here on campus with a bag and you got to figure it out from there. And I noticed that some of the individuals that have these interactions with the colleges while they're in high school and stuff, they kind of knew what was going on, they already found a research lab right after they graduated high school. So I was influenced there, but I didn't know how to go about it. I knew I was here, I Googled everything that I could, but the ACTION Program was really pivotal in helping me direct my career trajectory to what I wanted to do and what I was really interested in. So, working with Dr. Vanderford and Chris -- my first semester I was just trying to make it through college, so the ACTION Program was like a backbone of support of, like, what should I do here, what do I need to do and they helped me find shadowing opportunities while we were still able to shadow my -- freshman and sophomore year. And I got to shadow oncology, I got to shadow a great oncologist and he actually worked with my grandfather, like Susanna said her oncologist that she shadowed worked with her mother. So, I got to shadow an oncologist and see how much of a role he played with his patients and it was amazing to see the interaction. So I got to go to a few of my -- with my grandfather to a few of his oncologist appointments, and, so getting to see that -- because whenever you're going with a family member it's a little bit different, because you have, like, you -- it's hard to listen after you're -- whenever you're hearing the word cancer and it's somebody so close to you, but if you get to sit on the outside and watch a provider interact with a patient and their family, it's just really amazing to watch maybe a really good physician. So, the ACTION Program brought that opportunity. And then further, the opportunity to work in a research lab and see what goes on behind all of that. So, and see what's really driving the needle as far as cancer research and cancer therapeutics and care goes. So I got to do all of these things and immerse myself in these opportunities I would never -- I wouldn't have even known how to type an email -- I didn't know you could type an email and ask if you could work in their lab and it was thanks to Dr. Vanderford helping me navigate all that, because it's -- you kind of get in, you get slammed with all these opportunities and you just got to throw your hands up and grab as many as you can like you're in a money -- wind money tunnel and you just got to grab the $1 bills. So the ACTION Program helped me navigate that and really decide, like, hey, I'm very interested in oncology, I know that I still have a lot to learn and things can change, but I will always have that -- I know for sure that I will always have that piece of cancer care, cancer education, cancer outreach, even if I decide to do primary care in a rural area or oncology, I will still know that -- how important cancer education is and especially to the Appalachian region of Kentucky. So the ACTION Program was very pivotal in me navigating those pathways and figuring out what opportunities I should take advantage of.

OLIVER: Thank you for sharing that. I, likewise, wish you all the best in your journey. Michael, to end with, I wonder, what would you say to someone, perhaps, coming up behind you, someone younger, if they were thinking about cancer as a career, what would you say to them?

MICHAEL: I -- first things first, with everybody that that even mentions that to me, if they're from the county that I'm from or any of the other 53 counties involved in ACTION, I say, "Apply to ACTION." We've got a little program here at school and I tell everybody, like, you need to apply to the ACTION Program, it's amazing. We had Dr. Vanderford come talk. So -- and based off that I know that there are some students that can or whatever happens and what I would say is, find a mentor and I think that's important, and I think that's a great thing that the ACTION Program provides, because you can't navigate all that stuff alone. So, especially being a young student freshman year, because you guys, UK is a great research institution here in the state of Kentucky and coming from a high school, it doesn't really matter the size, you're going to be in a bigger place than you've ever been before, and the classes are going to be bigger than any class you've been in. And as a young student coming in at 18 years old, you can't navigate that alone. So I would say one of the many things is find a mentor, find mentors to help guide you on the path that you want to go and that's the amazing thing that I've seen with the ACTION Program and a lot of the other faculty here is they're really willing to help undergraduate students, which is also been very great for me, because I hope one day that I'm able to provide some type of help to somebody. I don't know if anybody would want my advice, but I can at least tell them what not to do sometimes maybe.

OLIVER: I'm sure they would, I'm sure they would.

MICHAEL: But I think mentor, mentorship and just immersing yourself in the opportunities available are probably the two biggest pieces of advice that I would give.

OLIVER: Susanna, what about you?

SUSANNA: I would tell that student to not be afraid, to get involved in research, get involved in shadowing, because when I first started undergrad that was my main issue is that I was just too scared to reach out to anyone, to scared to -- research, the thought of that just intimidated so much and I really needed ACTION, I was so grateful for it, because I needed someone to basically hold my hand while I wrote an email to the PIs and, like, tell me that it was okay, look over it and tell me that I deserved to be there and I deserved to do research too, because I felt a lot of times that I came from a high school that was really, really small, we didn't have a super strong science program just because of the size of it. And then in my classes I was surrounded by a bunch of people that went to these fancy high schools and they did AP this and that, that I just didn't have. So I needed some guidance and someone to tell me that I can do the research and do the shadowing and all of that, all the things that are important to do if you want to go to medical school and to confirm your interest in medical school and then oncology.

OLIVER: Thank you. Dr. Vanderford, the last word to you, I'm sure you have that conversation with a lot of students as well, what advice do you give them?

NATHAN: Well, I think, as I said earlier, these -- these are just such phenomenal opportunities, you know, to be here at this university, others like it, where you have an opportunity to do research, shadowing. We're fortunate that we are on a campus where, you know, the undergraduate campus is on the same -- it's at the same location as the medical school. So I tell students all the time, you know, you can go from your chemistry classroom, walk 5 minutes down Rose Street and you can be in a world class research lab or you can be in an OR observing a cancer surgery. And take advantage of those opportunities. You know, I think as the students have said, these are phenomenal opportunities that are going to be transformational for you as an undergraduate student, but also for your futures in whatever it is you want to do. So take advantage, you know, even manage your time well and do well in class, but all these other activities, you know, they're at your fingertips and they are great things to part of.

OLIVER: Well, thank you all very much, very much appreciate you sharing your journeys and your insights, thank you.

NATHAN: Thank you for having us.

MICHAEL: Yeah, appreciate you having us.

[UPBEAT MUSIC]:

OLIVER: Now it's time for segment we call Your Turn, because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip of a book or a video, a podcast or a talk that you found inspirational or amusing or interesting. You can send those to us at [email protected]. Record a voice memo and send it along, we may just play it an upcoming episode. Now I'd like to invite our guests to take their turn, let's start with you, Dr. Vanderford.

NATHAN: Yeah, I've given this a lot of thought and I think I want to recommend the books we've already talked about, you know, the books are titled, The Cancer Crisis in Appalachia, Kentucky Students Take Action. And I think if you want to, you know, if listeners want a better understanding of the cancer problem in Kentucky and particularly the problem through the lens of our students and what they think the problems are and how to deal with those problems, then these books are phenomenal -- a phenomenal lens to sort of get perspective on that.

OLIVER: Thank you. Susanna, it's your turn.

SUSANNA: So, this is now necessarily cancer related. But just a random book recommendation, it's one -- I just got back into kind of not really reading, but listening to audio books and such as I, like, drive or walk, which is a great way to relieve some stress and just take my mind off medical school, sometimes you need to do that. But the most recent one that I listened to is The Guest List, by Lucy Foley, I think that's how you pronounce her last name. And that book, let me tell you, it just -- it starts out kind of here on suspense and it just gradually builds. So, if you need a way to de-stress by getting stressed about something else, I think that's a great book to listen to or read.

OLIVER: Thank you, Susanna. Michael, please take a turn.

MICHAEL: I wanted to mention, I thought maybe Dr. Vanderford might steal it, but the ACTION Program has the cancer and Appalachian page where they post these pictures that students take from around the state of Kentucky and they just represent cancer in the area and I always thought that was really interesting, because a lot of them are high school students too and just see, like, behind the mind of -- before you kind of get immersed in, like, being stressed out about medical school or being stressed out about science classes and what you think about the cancer and what reminds you of cancer. And I think that the images and things that the students upload are really cool and better pictures than I would ever take, so I just like to scroll on there and see what could be if I had a steady hand that could take a good photo, so I think that's really interesting.

OLIVER: Thank you for sharing that. I was going to recommend the books that Dr. Vanderford already recommended, the books from this program, so I will just endorse his recommendation and remind our listeners that links to all these recommendations can be found on our show notes and on our webpage. And with that, I'll thank our guests one more time and thank you.

NATHAN: So much for having us, appreciate it.

SUSANNA: Thank you for having us.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training.

It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser.

A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this episode of Inside Cancer Careers, we hear from Dr. Adrienne Boire, a Physician Scientist at Memorial Sloan Kettering Cancer Center, discuss how being a clinician in the research world is like Alice in Wonderland. We then hear from Dr. Jim Woodgett, a President and Scientific Director of the Terry Fox Research Institute, Canada, Senior Scientist at the Lunenfeld-Tanenbaum Research Institute (LTRI), and Professor in the Department of Medical Biophysics, University of Toronto, who shares his career in cancer kinases from the point of view of a scientist, institute director, and head of a funding organization.

Segment 1: A Lab Tea Party

• The Adrienne Boire Lab

• The Joan Massagué Lab

• Alice's Adventures in Wonderland by Lewis Caroll

• ChatGPT

Ad: NanCI by NCI mobile application

Segment 2: A Career in Cancer Kinases

• Dr. Jim R. Woodgett

• Ludwig Cancer Research

• Lunenfeld-Tanenbaum Research Institute

• Terry Fox Research Institute

Your Turn: Guests Recommendations

• A Poem Titled "Wild Geese" by Mary Oliver

• BBC Two by Horizon

TRANSCRIPT

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.

On Inside Cancer Careers we explore all the different ways that people join the fight against disease and hear their stories.

Today we are talking to Dr. Adrienne Boire a physician scientist at Memorial Sloan Kettering Cancer Center about how being a clinician in a research world is like Alice in Wonderland, and Dr. Jim Woodgett of the Lunenfeld-Tanenbaum Research Institute who shares his experience on cancer research from the point of view of a scientist, institute director and head of a funding organization.

Listen to the end for recommendations from our guests and to hear how you can send us yours in a segment we call "Your Turn".

OLIVER: It's a pleasure to welcome Dr. Adrienne Boire to the show. Dr. Boire is an associate member of Memorial Sloan Kettering Cancer Center in New York City. She's a physician-scientist who treats and studies brain metastases, and I met her at a conference where she gave a really intriguing talk on lab culture, which we'll get to in a minute, but Dr. Boire, welcome.

ADRIENNE BOIRE: Thank you. It's lovely to be here.

OLIVER: And I wanted to start with your journey. I'm always fascinated to learn how people come to do the work that they do, and I wonder if you'd be willing to share that with us?

ADRIENNE: Oh, sure. Yes, I think my path to becoming a physician-scientist is certainly not a traditional one. I grew up in Minnesota, and was always a curious kid, but truthfully, I thought that when I was going to college, that I might become a diplomat. I really enjoyed foreign languages. I enjoyed the idea that, you know, through listening, and kind of considering all of the possibilities that we could ultimately find ways to compromise. And, you know, I was an idealist, so, you know, come to world peace, right? But when I was in college, I was taking a biology class, a biochemistry class, and we were hearing a -- we were hearing about the Krebs cycle for the first time, and it was a transformative event for me, as unbelievable as that sounds, because I know quite a lot of people don't love biochemistry. So we were hearing about, you know, the just the basic processes that underlie molecular life, and I thought it was just gorgeous. I mean, it still is gorgeous. It still gives me goosebumps. It still kind of inspires me actually, this idea that the, you know, the biochemistry is really the grammar of life, right? And I think that was sort of my entry into all of biology, into becoming a scientist, was this idea that I really wanted to understand kind of the grammar of life. I really wanted to understand the rules that define how cells do what they do, how, you know, how cells are put together to make organs, how it all works together was just, and still is, utterly fascinating to me. So that's how I got hooked, and from then, actually, I spoke to the professor after that lecture, and basically asked him, "Do you know how cool this is? I can't believe that this is like -- that you just passed this by." I was kind of annoyed with my friends in class, who are taking notes because I thought, "How can you even take notes? This is far too fascinating to even -- you just had to appreciate it." And he said people like you would go to graduate school, and no one in my family had done anything close to that, so I followed his advice and applied to graduate school, and I did my PhD at Tufts University at the biomedical campus in Boston where I worked on a kind of an entomology and signal transduction project where we had found a new ligand for a receptor. So I was studying the protease-activated receptors, also known as the thrombin receptor, and we had found that actually a matrix metalloprotease can cleave the receptor productively and lead to signal transduction, and this was all in a context of cancer biology. And so while I was there, my mentor actually, Athan Kuliopulos, he was a physician-scientist, and I had truthfully never met a physician-scientist before. The physicians that I knew were the general practitioners who the, you know, the family practice doc who, you know, set my broken bones and delivered my brother. I'm from a small town, and I had never even encountered this kind of medicine before and even this kind of thinking. And I was intrigued, and I thought, well, these are my people, because they think in a really different way. They think, in terms of the organism and in terms of disease, but they also think in terms of mechanism, and I found that irresistible, and it is kind of a funky personality type, I think we can all agree. Physician-scientists are different people, and so --

OLIVER: How are they different? Now that you've said it, I have to ask.

ADRIENNE: I guess I think we are a little bit like scientific diplomats when I think about it, right? We kind of straddle these two worlds where we sort of view the same question in kind of, almost sort of like a chiral way, right? We see the same problem in opposite ways, and a physician-scientist has the capacity to see it as a physician and also see it as a scientist and to kind of toggle back between those two identities, and I think that kind of intellectual flexibility is key to the job, and also key to success as a physician-scientist, so --

OLIVER: Which explains why you gave the talk that we'll get to in a moment, but just to finish your story then, are you saying then you were in graduate school and decided to then also go to medical school afterwards?

ADRIENNE: I did, I did. So when my paper -- we were in our final revisions, and then I applied to medical school, and then went over to the University of Chicago for medical school. So and in medical school at UofC, you know, there are -- some schools tend to be kind of magnets for physician-scientists and I met so many physician-scientists in a wide variety of specialties, and I really -- I found a lot of commonalities and kind of a kinship with neurologists and neuroscientists, and so elected to pursue my clinical training in neurology, and did my neurology residency at Columbia. And then, in fellowship, I sort of put everything together. So I knew I wanted to study the brain. I knew that I loved cancer biology and mechanism, and I had been following Joan Massagué for many years, going to his lectures, reading his papers. I had sort of a science crush on him. I kind of -- I just loved his work.

ADRIENNE: And so I thought, I really want to study metastasis, and I couldn't think of really no better place to do that than with Joan Massagué at Sloan Kettering, and so, I sort of figured out where I wanted to do my scientific training first, and then from that, I thought this is where I will pursue my postdoc, and then I back-formed my clinical training to correspond with that, and I was fortunate that at Sloan, I would be doing my clinical training at a place where neuro-oncology was literally born, where the subspecialty of neuro-oncology was, was first sort of defined by Jerome Posner. So, I was able to study at the -- you know, elbow to elbow with these giants, and that was transformative for me. That's where I found leptomeningeal metastasis, which is the center of my scientific universe. It's where I first started appreciating ways in which we could study this disease from the perspective of a basic scientist, but also from the perspective of a physician, and it's the community that's really fostered my growth. I have a practice there now, where I treat patients with leptomeningeal metastasis. I run clinical trials, but the vast majority of my time is spent running my laboratory where we investigate the leptomeninges from soup to nuts. We look at how cancer cells live in the space, and we also look at the space itself, what, you know, what is the biochemical composition of the leptomeninges? What is the cellular composition? How does this change over time and under different stresses? Yeah, it's the best job ever. I have a terrific time doing my job.

OLIVER: Fantastic. Just a quick definition, leptomeninges, that's the lining of the cerebrospinal fluid cavity.

ADRIENNE: Yeah.

OLIVER: I probably didn't say that right.

ADRIENNE: Yeah.

OLIVER: Yeah?

ADRIENNE: No, you said it perfectly. So the leptomeninges are the kind of soft coverings of the brain and the spinal cord. So all of the meninges, these are all of the coverings, they're the pachymeninges or the dura, and the kind of outer hard kind of more rough coatings, and then the softer coatings are the leptomeninges, and they contain the circulating cerebrospinal fluid.

OLIVER: So it's the bag you keep your brain in, basically.

ADRIENNE: It's the bag that holds the brain, where the brain water is kept. It supports, and it also is one of the major interfaces between the brain and the systemic circulation. So it's also in many ways the front door to the brain. It's the way that the brain also can communicate biochemically with the rest of the body.

OLIVER: So you've mentioned the term physician-scientist several times. Obviously, it means a little bit of physician, a little bit of scientist, but what does that look like in practice?

ADRIENNE: So in practice, I never really take my physician hat off, because my patients are extraordinarily ill, but in day-to-day life, I run my laboratory, truthfully, seven days a week, I'm thinking about laboratory things. I don't think I could stop thinking about spinal fluid if you paid me, but I have clinic a half-day a week, and that half-day kind of spills over into a few other days because of course I'm answering patient phone calls. If my patients are in the hospital, I pop over to see them, but I'm a 90/10 physician-scientist, meaning that 90% of my effort is on the research side, and then 10% of my effort is on the clinical side.

OLIVER: So the continuous contact with patients informs the areas that you're investigating in your lab, I imagine.

ADRIENNE: Absolutely, so I have this privilege of being able to care for these patients and to take part in a pretty tense and extraordinary part of their lives, and this allows me to not just, you know, do the emotional work of caring for people, but it really provides me with a lot of hypothesis generation, which can sound sort of cold, but the way I mean it is, is that, you know, when I see how a disease unfolds in a human being, this necessarily provides me with a lot of unique observations and also some questions. So, for example, patients with leptomeningeal metastasis very often have seizures. And, you know, what is a seizure? Well, a seizure is an area of an extremely organized electrical activity on the surface of the brain. And normally, this is not the case, so why is this happening? Is there a metabolic cause for this? Is -- could the cancer cells be the nidus that's causing this metabolic cause that's causing this ultimate disorganization and this clinical outcome? So these are the sorts of things that I see at the bedside, that then kind of cause me to reexamine the way that I think about the process at the bench. My lab --the people in my laboratory are lovely people, and definitely are quite interested in the patients, and so very often I have a member of my laboratory at my side when we're seeing patients in clinic, and I'm surprised how often they are the ones who make the clinical observations, because very often, I'm trained to kind of just see patterns and to think about them in a clinical context, but the people in my laboratory, they'll say things like, "Well, what's happening there? Why is her finger twitching?" And I'll say, "Oh, that's because she's having a focal motor seizure." And then that precipitates this discussion. So I really love the way that I'm able to kind of bring the people in my laboratory to the bedside. And before COVID, truthfully, we don't do this so much anymore, because of COVID restrictions, but before COVID, patients and their families would occasionally come out to our laboratory or come to lab meeting, because they wanted to see how we conduct research, and because of course, we're using their patient samples, so we bring spinal fluid from the clinic into the laboratory to study. And I think that there are a lot of ethical difficulties with this process of really thoughtfully and carefully using patient samples, and I think the best solution is to be utterly transparent. So I talk to the patients and, you know, consent them of course, for the use of their samples, and we're very clear with them about what we're doing with the samples, what we can learn from the samples that we couldn't learn from our mouse models, and then what happens with their data? So is it -- you know, how is this -- is it de-identified? How so? And then where is it published? And I think that this process really allows everyone to derive a lot of meaning from what could be a pretty bleak complication of cancer. I think it's really lovely how generous my patients are, actually.

OLIVER: That's fascinating. Thank you so much. I can also see of course that being a physician-scientist gives you access to both cultures, and that's where I want to turn now. You gave this fascinating lecture, "Scientific diplomacy, everyone wins," so you kind of did become a diplomat, after all.

ADRIENNE: I did.

OLIVER: And in this lecture that you gave, this talk at the conference, you used a famous scene from literature to orient people to the culture that's often encountered in biomedical research teams, particularly from the viewpoint of the clinician. What scene did you pick and what gave you that idea?

ADRIENNE: So I picked the tea party scene from Alice in Wonderland, and I chose it because actually, my husband used to teach literature and one of the books that he would teach is Alice in Wonderland by Lewis Carroll, and what I love about this scene and about Alice in Wonderland generally, is that I like that, you know, Alice in Wonderland, at first blush, it seems to be just kind of this kind of chaotic and almost kind of trippy experience, right, where you think nothing really makes sense, but of course, Lewis Carroll was a mathematician and really enjoyed logic, and when you take it down to its first principles, Alice in Wonderland is intensely logical. And that, I think, also spoke to me in terms of this clinician-scientist framework, that from the outside, it might seem that scientists are kind of goofy and silly, but we're actually very logical. We're very logical creatures, and so I thought that was a nice moment of an outsider coming into something that seems chaotic, but is not.

OLIVER: So our listeners may not be intimately familiar with the book, so what I thought I would do to orient them to the framing of your ideas was to give a brief summary and I asked ChatGPT to describe the scene, and I only edited what ChatGPT said a little bit, so let me read that and then I'd like to go further with your -- how you sort of disassembled the scene and to make it helpful. So here's what ChatGPT said. "The Mad Hatter's Tea Party is a famous scene from the classic novel Alice's Adventures in Wonderland by Lewis Carroll. The party takes place in a strange surreal world where everything is topsy-turvy and rules of reality don't seem to apply. Here's a description of the scene. Alice stumbles upon the Mad Hatter's Tea Party while wandering through Wonderland. The Mad Hatter, the March Hare and the Dormouse are seated at a large elaborate table, set with fine China, teapots and cakes. However, Alice is not invited to sit, so she is left standing awkwardly on the fringes of the party. The Mad Hatter and March Hare are engaged in a nonsensical conversation about time while the Dormouse dozes off at the table. Alice tries to join in the conversation but finds it impossible to follow the logic. The Mad Hatter then invites Alice to join in a tea party game, but it confuses her further. The party continues in a chaotic manner with the Mad Hatter and March Hare constantly switching seats and Alice trying to make sense of their strange behavior." So in your analogy, who is Alice?

ADRIENNE: Alice would be the clinician, and the Mad Hatter is the PI, so is the principal investigator in a basic science laboratory.

OLIVER: Okay, and the Dormouse?

ADRIENNE: So the Dormouse is, you know, is a postdoc, so he's asleep in a teapot.

OLIVER: And the March Hare, I think was the graduate student.

ADRIENNE: The March Hare is the graduate student, exactly.

OLIVER: So tell us more about the these different roles and how you feel this diplomacy that you're proposing can help collaboration?

ADRIENNE: Sure. I think, you know, part of the reason that I bring this up is because I would think that what is essential to a real conversation, a real collaboration, is understanding, right, and that we all want to work together. The scientists and the clinicians, we all really do want to work together well, but we get bogged down in these issues, because we don't really understand each other. And I thought, well, all right, so the -- as you illustrated, this tea party was sort of rolling along before Alice showed up, and it continued on after she left, right? And the party, you know, has its own rules, and so it seemed to me that we really need to understand all of the aspects of the tea party, and we're going to be able to play along a bit better. And so in terms of the members of the tea party, I thought, well, you need to understand the Mad Hatter. So the PI, you know, the PI's job is to really keep the tea party moving, no matter what, right? He's continually making the party happen. He's obtaining funding for the laboratory, so a PI is writing grants. She's getting, you know, she's constantly working with the NIH and the NSF, shout out to my friends at the NIH. She's -- you know, knowing that funds from grants don't really cover the cost of all work, PIs are often talking to donors, and we're really assigning nearly every dollar is going to a project. A PI also needs to publish results, so we need to write papers, we're reviewing other manuscripts and we're traveling quite a bit to give lectures and attend conferences, and we're teaching graduate students. We're lecturing, we're grading, we're interviewing, we're on thesis committees. And in general, the PI very often is feeling a little bit underappreciated by clinicians and by society, and so it's kind of, as in Alice in Wonderland, the PI, the Mad Hatter is sort of buzzing along and is sort of answering sort of perfunctorily to Alice's questions because, you know, he has bigger fish to fry. He's got to pour tea. The graduate student, the March Hare, you know, we always say mad as a March hare, right, because the graduate student is just delighted to be there, right? And that really encapsulates how graduate students generally are feeling. They are thrilled to be invited to this party, and they are learning everything sort of all at once. They're eager-eager. They're learning all these bench techniques. They're learning analyses and how to cope with failure. They're learning how to manage their time and projects, and they're learning how to do a lot of just how-to science, right? We say like they're learning how to write scientifically. They're learning how to give a lecture. They're learning how to critically read and how basic science is generated, but they're also enthusiastic and they are perhaps not so cynical and so are very often, you know, ready to make this Nobel Prize winning discovery. They're -- just the enthusiasm from a graduate student is often what kind of drives a lot of people in the laboratory because it's so infectious. And then of course, once the graduate student becomes the postdoc, they turn into the Dormouse, who is exhausted and is, you know, in the tea party of course, has fallen asleep in the teapot. So a postdoc is very often, you know, characterized as sort of working to the point of exhaustion, right? The postdoc needs a big paper in order to be able to get their own lab and to become the Mad Hatter, right, to become -- to get their own little tea party going. So they're sort of working on the edge of what is known. A postdoc is very often designing new methods, designing, you know, new analytic approaches. They're reading almost more than anyone else in the laboratory, and they're learning how to cope with this idea of sort of intense competition. And they're also learning little bits, like how to manage a team, how to teach practical skills, and how to write a grant, and how to write a review article, and they tend to be quite anxious. They're underpaid, and they're very often tired of explaining to friends and family that they're not that kind of doctor, which, you know, of course, brings us to the clinician. And the reason I bring up Alice is that I think it's also important for the members of the tea party, the basic scientists, to understand Alice. So Alice is our clinician or clinician-investigator, right? So she wants transitional data -- translational data, rather. She'd like new therapeutic targets. She's seeing patients, and as a result, is very tired. She's constantly battling the EMR, the electronic medical record. She's constantly answering emails and phone calls. She's in clinic. She's on service. She's taking up slack from trainees who have something called work hours, which a finished -- you know, a fully trained clinician doesn't really have work hours. And she really doesn't have very much time for work that's not billable, so she has very little time for research as otherwise stated. So the role of Alice, you know, she, if she's running clinical trials, is also dealing with a lot of writing where she's writing revisions for her trial, protocol deviations. She's calling and conferencing with co-investigators, etc. She also needs to teach students. She needs to lecture. She needs to grade. She needs to interview, and she has to teach at the bedside. Importantly, though, Alice is accustomed to leadership, as she is in the story, right? In the story, Alice, you know, is used to things sort of going her way and people listen.

OLIVER: Right. She's the focal point, yeah.

>> And she's the focal point of the story. And clinicians also tend to be used to a certain amount of societal respect and deference because this is how the hierarchical system of the clinical world runs, and so this is another fundamental tension in the relationship, right, that Alice comes to the Tea Party, and is like, "Explain this to me. Get this done." And the Mad Hatter won't give her the time of day, because, you know, he's busy pouring tea.

OLIVER: You have this fascinating slide where you talk about speaking science to basic scientists and you really sort of put up almost paired sentences, if you will, or paired ideas of how the different -- the two different specialties, if you will, speak. I wonder if you could tell us a little bit more about that?

ADRIENNE: Of course. So, the Mad Hatter -- you know, as a scientist, we're trained rigorously through many, many years, to really take a complex system and to break it down into an observation and a question, to derive a hypothesis from the question. And from the hypothesis, then we turn to method, and the method itself is encumbered by statistics, and then ultimately, interpretation, right? And this hierarchy of thought, and this rigorous approach is time-tested, and it's something that you can almost -- I don't know a scientist that can be broken up at once we've learned how to do it, right? However, very often, clinicians will come to a basic scientist and will say -- you know, they'll come right to a method. They'll say I want to do this method on this, you know, on this sample. So, the example that I used in my lecture was from Highlights magazine, which I remember from my childhood, of Goofus and Gallant. And of course, Goofus, and Gallant, you know, they have -- they ultimately want the same thing, but Goofus does it in the way that you should not do it, and Gallant, you know, always gets things done properly. So the example I used was, you know, if Goofus says, "I want two more pancakes," and then Gallant says, "May I have another pancake, please?" And of course, we know that Gallant is the right answer. So Goofus would say, "I want to run proteomics on CSF," whereas Gallant would say, "We hypothesize that the CSF proteome changes after immune therapy." And then now that that actually says something to a basic scientist. It actually is -- there is a hypothesis there, there is a question, and it actually tells the basic scientist sort of where to start, and also allows the basic scientists to engage in the conversation. So that's really speaking the language of science, you know, from a clinical standpoint to a basic scientist.

Those are the things that are said, you know, overtly, but there's quite a lot that remains sort of unsaid as well, and I think that this is almost the heart of the issue. So a scientist wants to discover patterns that are common to all life, right? Whereas clinicians tend to be very excited to discover a subclassification of a disease. Let's see. A scientist really wants to discover a rule, right? We want to discover the grammar of life, right? Whereas a clinician tends to discover or more interested in exceptions or extraordinary cases. So this difference between the rule and the exception, this is something I run into quite a bit in my life. A scientist likes to relate findings to other fundamental processes, like wound healing or development. And a clinician wants to relate their findings to treatment or therapeutics, right? Scientists are generally not very happy unless they have a mechanism, and clinicians are actually okay if with understanding something on a level of phenomena as long as the patients are improving, right? And that's also a huge difference. So the literature they read is very different. Scientists read basic science journals, and so this fills their head and kind of their subconscious, right? Whereas clinicians are reading clinical journals, and so this is also sort of how framing how they view the world. And so I think these kind of unsaid ideas are also underlying this, this kind of difficulty with conversation and this difficulty of understanding one another.

OLIVER: Yeah, fascinating. Another thing that I found really -- that really hit home for me in your talk was the fact that the Mad Hatter, the basic scientist, lives in Wonderland, while Alice, the clinician, visits Wonderland. And you describe the constraints that these two different -- these two people have in pursuing their own goals, and they can constrain how they could work together.

ADRIENNE: Absolutely, and I think this is also -- this is the other issue, right? In diplomacy, we think about this also. We think about not just who the players are, and what languages they're speaking and their kind of motivations, but also what constraints are there that are preventing them from working together. And the basic scientist, you know, has very few kind of uncommitted personnel. There's really no free person in the lab who's just sort of, you know, able to do work that should just walk in, right? The clinical scientist, of course, cannot perform the experiments herself, because she also doesn't have any time to train and she doesn't have the right training to do the experiments. The basic scientist doesn't have very much slush, you know, meaning a lot of kind of uncommitted funds to be able to do projects that just sort of come out of nowhere. And the clinical scientist very often has funding, but the funding is from pharma, and that funding from pharma very often comes with considerable constraints on the use of those funds. In terms of just space, you know, a basic scientist very often doesn't have enough free bench space. The scientist, the clinical scientist doesn't really have enough, you know, time to work in the lab. The basic scientist very often cannot, however, usually access clinical charts or clinical data, and so that -- those data are not available to the -- to the basic scientist, whereas the clinical scientist, you know, has a hard time interpreting basic science data herself. There are a few points where actually the constraints are very helpful to each other. So a basic scientist needs to be the corresponding author on a manuscript. And of course, the clinical scientist needs to be the first author, so there's that moment where it's like a-ha!

OLIVER: It all comes together.

ADRIENNE: It's like Jack Sprat, right? And, as you said earlier, I think the really the fundamental problem also is that the basic scientist lives in Wonderland. This is where he makes his home, and this is where, you know, we're ultimately judged on Wonderland constraints, right? So if a basic scientist doesn't get publications, doesn't get grants, you know, you know, we're out of a job. Whereas a clinical scientist who doesn't get publications or grants can fall back on, as they say, (I say this in quotes) seeing patients. So she's really visiting Wonderland. She may elect to live there, but this tension between someone who is living in the space and someone who's just visiting, this is real and this is something that I hear from pure basic scientists very often, this idea that, you know, I just don't have time and I'm not willing to take the risk and the space and all of this working with someone for whom this is essentially sort of like a mad holiday, right? And I know that both groups really want the same things, right? We both want to work on a disease process, right? We both want to ultimately use our work to help others, but I do think that we can work together, but providing we understand each other a bit better. I think that clinicians can attempt to be a little bit more question-driven, can frame their queries in more scientific terms, and can of course, read their potential collaborators' work, attend lab meetings. And writing grants and reviews together, really is going to forge some of these bonds and really help illustrate to the basic scientists that they truly want to live in Wonderland, that they're really willing to buy into this process. I do think that scientists, however, can be more open to new viewpoints. They can be open to visitors to Wonderland. They can read their collaborators' work, and they can visit the clinic in the hospital to see the disease in question and to see and really try and understand the constraints that the clinician is under, and of course, potentially, this could be hypothesis-generating for the scientist as well. And I think really working together with this, with eyes open and really understanding each other has the possibility of really being really, I guess -- how to say this without sounding too sunny -- I mean, of course, I think it's going to be helpful for both groups, but I think really, something new is created in this in this dialectic, right? So when a clinician and a scientist are truly working together, you really get more than the sum of its parts because you're forging a third entity, right? And that's huge. That's what -- that's why I work in a place like Sloan Kettering, right? It's like, why I work in a place where we have the clinicians and the scientists together so closely is because it's so generative to do this.

OLIVER: Thank you so much, Dr. Boire. I mean, what you've shared with us and the vision and the framing you've provided us is incredible. A lot of institutions put clinicians and scientists together, but they don't invest in the diplomacy that could really help spark those fruitful collaborations, like you described, so thank you so much for joining us for this and really appreciate it.

ADRIENNE: Oh, it's my pleasure. Thank you for inviting me.

[UPBEAT MUSIC]

OLIVER: PubMed lists over 270,000 cancer papers published in 2022 – that is a staggering 750 papers every day. It's great that cancer research is such an active field, but it makes finding the pubs that are critical to your work a challenge. What if you had an AI that paid attention to the papers you read and suggested others as they appear in PubMed? That is exactly what the NCI is building with an app called NanCI. With me to discuss NanCI are two members of the team that are creating NanCI: Chris Perrien of Blue Pane Studios and Duncan Anderson of Humanise.ai.

Chris, you've been building apps for NCI for over a decade. What is new about NanCI?

CHRIS PERRIEN: Fundamentally NanCI represents a shift in user experience – in the prior generation of apps people had to know where to look to find things. Now, they can find the information using AI agents. I think of NanCI as a friendly research assistant who makes suggestions and answers questions. Of course, it is early days, and NanCI is still learning from their users, but they will get better and better over time.

OLIVER: Duncan, you bring AI expertise to the project. Can you tell us what capabilities that brings to NanCI?

DUNCAN ANDERSON: NanCI is all about connecting scientists. Right now the focus is on connecting them to papers relevant to their interests, which NanCI does by matching vector representations of abstracts and looking at co-citations. If you tell NanCI that you find a group of papers interesting, by bookmarking them, the app will keep an eye on PubMed for you and suggest related publications. You can also share these folders with colleagues and export them to your reference manager. You can read the paper right there in NanCI, and follow any author to see when they publish preprints. Down the road we intend to help people network based on shared scientific and career interests. And much more – these are just some of the features of the app.

OLIVER: Thanks, Chris and Duncan. Right now NanCI is available in the Apple app store, and it will be coming to android later this year. Download it and give it a try! Your feedback on NanCI is very welcome – you can send that to us here at [email protected].

It's an honor to welcome Dr. Jim Woodgett to the show. He's a senior investigator at the London Phil Tenenbaum Research Institute, part of Sinai Health in Toronto. An accomplished scientist, mentor and leader. He also participates in discussions about the state of science, the nature of biomedical careers and what's going on in the world on social media. Dr. Woodgett has seen academic science from many different angles, and we'll get to that in a moment.

But I want to start with asking you, what motivated you to become a scientist?

JIM WOODGETT: Ah, jeez, I mean, that's a -- it's -- you know, when you go back and think about this, your sort of vision of what initially got you started is often -- often changes over time, right. So I think it's because of reading so many student applications to graduate school where they talk about their inspiration. And, you know, my story was not that inspiring. It was -- it a came out of realization I was just interested in discovering new things rather than repeating things.

And that came from a Saturday morning job I used to have or a whole day job where I was working in a greengrocer in a little village. And I hated doing the same thing every day. And so, no, I don't want to do this. But -- so science was appealing. And then it just was a series of just -- this is an in the early 1980s, a series of things falling into place, some good, some bad, and you get sort of pushed in different directions and, at the time, don't necessarily realize what's going on, right.

A lot of students today maybe overthink what they want to do because often our ideas of especially science and research are quite different. They're sort of molded by what we see on TV or reading books or what have you, whereas, in fact, it's not usually like that. It's in some ways much more interesting but also very different. And so I wouldn't -- I wouldn't overthink it.

And going back, you know, I was inspired by lots of people. Science seemed to be the future, as it were. It is the future. And I was, I can't point at one particular thing. I must say, though, you know, again, reading letters or applications for graduates -- the graduate school, some people have some remarkable driven ambitions. And I do sometimes wonder whether or not if, you're that driven in a particular direction, science maybe isn't the thing for you because you really got to be open-minded.

[00:02:51] And that's the most important, open-minded and being creative. Those are the two key aspects, key qualities which will define success, I think, in scientific research.

OLIVER: You got started working on kinases as a grad student, right?

JIM: I did. Yes, I did.

OLIVER: Why kinases?

JIM: Why kinases. Oh, you should know better than that. What a question. I mean, there's -- at the time, we -- this is pre-genomics and stuff like that. And I was working in the lab of Phil Cohen at the University of Dundee in Scotland. And I'd been -- had gone directly to his lab based on studies, citations of work I'd been doing for a project as an undergraduate. And it seemed like kinases were kind of interesting because they gave us an idea of at the time, what insulin was doing.

And, of course, insulin's really important with diabetes and all that sort of stuff. And so when I finished those studies on glycogen metabolism for my PhD, I was fortunate to get a postdoctoral fellowship with Tony Hunter at the Salk Institute. It's just amazing. Going from Dundee to Salk Institute was a bit of a culture clash, I can say, as well as a welcome weather improvement or upgrade. And he worked on tyrosine kinases and is still working on tyrosine kinases.

And I spent three years in his lab, but I didn't work on tyrosine kinase because I worked on other protein kinases. And that's because the majority of kinases don't phosphorylate tyrosine. A lot of interesting ones do. But a lot of interesting genes associated with cancer are protein kinases. And that's from the perspective of cancer research. And it gets really exciting because a lot of the precision tools, the inhibitors and drugs are now targeting protein kinases like the EGF receptor, for example, in certain forms of lung cancer and breast cancer with HER2/neu.

So these drugs are incredibly -- they really are the future of cancer research insofar as they target specific molecular changes, which are specific to the tumor cells, unlike most chemotherapy -- therapeutic drugs, for example, which target the property of a tumor cell, which is to grow uncontrollably. But, of course, there are important cells in our body which do that normally, and they also get affected by these chemotherapy therapeutic agents. So when you're targeting a specific molecular mutation in a cancer, the side effects and off-target effects tend to be much less of a problem.

And so, therefore, these drugs are much better tolerated by patients. So I think that's -- that's when I first got in -- at the Salk Institute was when I first got interested in cancer research. And then I moved to -- I was offered a position at the Ludwig Institute for Cancer Research where we both crossed paths.

OLIVER: Indeed.

JIM: [Inaudible] Yeah. Many, many years ago when we both had hair and colored hair. And, you know, that was -- again, that was being directed by an amazing leader in the field, Mike Waterfield, who actually identified and sequenced the EGF receptor and also with Paul Stroobant, who sequenced the platelet derived growth factor which to another -- two amazing findings which linked together the fact that oncogenes, which were actually taken up by viruses, oncogenic retroviruses pulled out bits of human DNA.

And, in these cases, were the proteins associated with growth factor control my defense is why protein kinases for all this time is because they are components of signal transduction pathways. And the signal transduction pathways are those processes by which cells understand their environment, they -- how they transmit changes in the environment or inside them -- themselves. DNA damage, for example, triggers signal transduction cascades. And it's kind of there. So they're the control circuitry of the cell, and it kind of makes sense to me that you want to be -- if you want to understand how normal cells and cancer cells are working, you need to understand how they're controlled.

This idea that, if you want to control the cell, of course, you control the controlling elements has borne fruit again and again and again.

If we look at most drugs and not just in cancer therapies but, in most drugs, they target some elements of signal transduction. For example, antipsychotic drugs, mood stabilizing drugs, they're all affecting signal transduction, G protein signaling, for example. So I think that's -- it's a bit of a -- you and I can afford to look back over many years and justify why we've worked on particular areas.

But that's my rationale, which is I think it's planned out. And there's still tons to be done. That's why I still am excited by protein kinases.

OLIVER: Talking of which, what's the best part of being a scientist?

JIM: Oh. Everybody says, oh, you know, it's -- there's moments of discovery when you really just have to do an experiment, you see a result, and you're the first person to see it. You know, I -- in 30 whatever years, I think that's happened to me a handful of times. And, my goodness, I don't think that's enough to keep you going to work and writing grant applications. It is amazing when you do put some jigsaw pieces together and see a bit more of the picture and are able to describe and to, you know, elaborate on that.

That certainly is a driver. But I think -- I think what it is for me is it sort of it -- science really doesn't care about what we think. All right. I mean, there are a whole -- the world, the universe around us doesn't care what we -- how we interpret the world. The only people who care are, of course, we, are us because we want to try to understand and, therefore, hopefully avoid -- you know, generate better medicines, and better rocket fuel or whatever that science is contributing to.

And that -- I find that actually very hum -- not humiliating. It is humiliating sometimes.

OLIVER: Humbling.

JIM: -- when your experiments go wrong. But, yeah. But, really, it's a form of humility to remind you that, in fact, you're just -- it's your ideas. And I think that's, again, comes back to another element. I started off about how creativity is really, really important as a measure of potential success for research. Creativity means being able to see things slightly differently from somebody else. And we've -- there are a lot of scientists in the world, so they're thinking about the same sort of problems.

So you need to be able to look at things a little bit askew, a little bit from a different perspective. And we need to value that. And it's difficult to teach people. They've -- they've either got it or they haven't. And that doesn't mean that -- you know, again, you can be a scientist and make tremendous contributions and never discover something totally new. What you're doing is you're filling out the rest of the jigsaw puzzle. Right? And that's very, very important as well. But I think, you know, what the discovery to me is the most important part.

OLIVER: So, Jim, you also took on a couple of roles. You were the director of the Lunenfeld-Tanenbaum Research Institute for 15 years, if I counted correctly. It's an institute of 800 people, a budget of upwards of $90 million, publishes over 700 papers a year. So what was it like to take on that role? And what skills did you have to learn maybe that you didn't already have from your research experience?

Yeah. Actually, that comes back to a previous question you had about what do you like about science and research.

And what I like, and I think this is probably true as you get older, actually, and by older I mean as soon as you start your own research lab, you realize that, you know, you're, you quickly become outdated in terms of techniques. And so you rely on students and postdoctoral fellows and technicians and highly skilled people to be doing the actual experiments. And you end up writing the grants and helping with the papers and all that sort of stuff. So we all actually start doing this pretty soon.

But it's a form of -- what you're ending up doing is living science vicariously, right? And so being a research director, you've got to -- you've got to take pride in other people's abilities to do great science. And you try to build an environment where that is -- you enable that, where you can enable that. And, therefore, you can have impact, not just in your own research laboratory but in helping others to achieve things which you could never do yourself.

And I think that's -- that was particularly rewarding when you're trying to recruit a new scientist and it may be in a particular area of neuroscience or in cancer research or whatever, it's amazing when you do interview six or seven people, and they're just amazing.

It's -- they've got some great ideas. And you really want to hire them all, but you can't. You've got to pick one or two. But that's a really important decision, right. And you make that decision not necessarily on just what they've done but clearly their potential for doing it again and building out their own programs but also how they fit in with your environment and your culture. So those things are really important. Those are all elements that I enjoyed very much about directing research.

OLIVER: Now, you've also just recently now taken on a another role. You're the President and Scientific Director of the Terry Fox Research Institute, which funds over $10 million annually in cancer research across Canada and internationally. That sounds like a very different kind of responsibility. Can you tell us more about that.

JIM: So, actually, we spend -- we invest about $30 million a year. It depends. We've had -- but we've had a couple of bad years. So the fundraising and especially for most listeners following this, the podcast in the US, the Terry Fox Research Institute is -- fundraises based on a amazing feat from a young Canadian, Terry Fox, in 1980 who had osteosarcoma.

Had his leg amputated. But he was an athlete, and he decided to run a marathon a day across Canada. And he got to Thunder Bay, which is about halfway, just well over, actually, halfway in northern Ontario. And, unfortunately, the cancer metastasized. And he subsequently died the following year. But the legacy of that sort of brought the country together to be aware of cancer research.

And when he was getting his chemotherapy after his initial diagnosis and he saw so many kids suffering and wanted to do something about it. So that's basically where the funds come from, from annual runs every year from the communities and schools. So we support cancer research just like the NCI and NIH do. And it's -- again, seeing, supporting, and enabling others is what I get out of this role.

OLIVER: So you've been running a research lab for a while. I wonder if you could share with us what advice you give to the students and postdocs that are in your lab.

JIM: Well, there's all sorts of advice. I know the first piece of advice is get lots of advice, and get it from -- ask anybody because everybody will have different experiences. Everybody's circumstances are different, and that's good. You want to get different experiences during your training. That's really important.

It's a great way to see the world. So, you know, I did my PhD in Dundee and then, as I mentioned, postdoc in San Diego. Getting to see completely different systems with totally different people really helps broaden your mind. And so, in the UK, I did my PhD. So it was a three-year program. And when I went to the Salk Institute, I was younger than quite a few of the graduate students because, of course, the US system is as the undergraduate degree's often four years, and then the PhD -- well, now it's -- it spreads out to beyond five years in many cases.

So that's changed a little bit. So -- and, in Canada, it's very much like the US. But you are investing this amount of time, right, in doing research, especially if you want to continue doing research either in the private sector where there's lots and lots of opportunities or in the public sector in universities or research institutes or in other sectors as well. So it's -- you know, the fact is only you know what your real motivations are. And so it's -- you've got to find, you know, what tweaks your interests, what tweaks your interests, what makes sense to you.

And you're not going to replicate what somebody else has done, and you're going to find your own path. But there isn't a -- one path. Being open to new opportunities. I think that's the key advice I would give to people. Recognize that it's important to be patient and persistent but also to enjoy what you're doing. If you're not enjoying it now, it's -- it's like, you know, further flagellation isn't going to help.

OLIVER: Well, thank you very much, Dr. Woodgett, for spending time with us and sharing your insights. Really appreciate it.

JIM: You're welcome.

OLIVER: Now it's time for a segment we call Your Turn, because it's a chance for our listeners to send in recommendations that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk that you found inspirational or amusing or interesting. You can send these to us at [email protected], record a voice memo and send it along. We may just play it on an upcoming episode. Now I'd like to invite our guests to take their turn. Let's start with you. Dr. Woodgett.

JIM: What I like to do actually is and it's you got to be careful, but I like to dive into YouTube to look at old science programs and not just it's not because of learning new things. It's just realizing what was really fascinating to audiences 20, 30, 40 years ago. And you can find this you know, there is there are various BBC programs called Horizon, which I used to watch when I was growing up as a kid. And I think what it does is it sort of gives you a perspective and you can do the same with, you know, interviews of Richard Feynman and other well-known scientists.

OLIVER: Thank you so much. I really appreciate it. Dr. Boire, please take your turn.

ADRIENNE: So I'd like to recommend a book of poetry. So I really love Mary Oliver. So she's an American poet, and she's known for her poems that explore the natural world and the experience of being a human being. So I'm just going to read a poem that I particularly love. It's called Wild Geese. And it says:

You do not have to be good. You do not have to walk on your knees for 100 miles through the desert repenting. You only have to let the soft animal of your body love what it loves. Tell me about despair, yours, and I will tell you mine. Meanwhile, the world goes on. Meanwhile, the sun and the clear pebbles of the rain are moving across the landscapes, over the prairies and the deep trees, the mountains and the rivers. Meanwhile, the wild geese, high in the clean blue air are heading home again. Whoever you are, no matter how lonely, the world offers itself to your imagination, calls to you like the wild geese, harsh and exciting, over and over, announcing your place in the family of things.

I just love that poem because I love the way it captures how we all belong, right? We all belong in this world. And we all belong in this family of things, in biology. And I also think it speaks to science itself, right? We all belong. We just we need to find our place in it. And once you do, once you find that thing that you love, well, that's all you really need. You just have to follow it.

OLIVER: Thank you so much, Dr. Boire. That was a great recommendation.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training.

It is produced by Angela Jones and Astrid Masfar and Edited by Janette Goeser.

A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this special episode, we feature Dr. Karen Knudsen, CEO of the American Cancer Society (ACS). Dr. Knudsen shares with us her career journey into science and the path that led her to her current leadership role at the ACS. She shares her story of finding the right mentor, asking the right questions, and being open to new opportunities.

Show Notes:

• Dr. Karen Knudsen

• American Cancer Society Cancer Action Network

• Frederick National Laboratory for Cancer Research

• Cancer Letter interviews with Dr. Knudsen

• NCI Rising Scholars: Cancer Research Seminar Series

Your Turn: Guest Recommendations

• TED Talks by Simon Sinek

• New York Times Podcast: Hard Fork

TRANSCRIPT

[UPBEAT MUSIC}

OLIVER BOGLER:

Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.

On Inside Cancer Careers we explore all the different ways that people join the fight against disease and hear their stories.

Today we are talking to Dr. Karen Knudsen, CEO of the American Cancer Society about how curiosity and strategy combine to make progress against disease.

Listen to the end to hear Dr. Knudsen's recommendation and to have chance to take Your Turn.

It's an honor to welcome Dr. Karen Knudsen to the pod. Welcome.

KAREN KNUDSEN: Thank you so much for having me, Dr. Bogler. It is just an honor and a pleasure to be here.

OLIVER: Dr. Knudsen is the Chief Executive Officer of the American Cancer Society and its advocacy affiliate the ACS Cancer Action Network. She was the first woman to hold those positions. Before ACS, she was on faculty, and held leadership positions at Sidney Kimmel Comprehensive Cancer Center at Jefferson Health, including serving as the executive vice president of oncology services, overseeing both care delivery and research. Her research was focused on precision medicine for advanced prostate cancer with a focus on relapse, a significant problem in that disease. And I should mention that Dr. Knudsen also serves on NCI's Board of Scientific Advisors. Dr. Knudsen, I'm always interested in how people find their way to science as a career. What got you started?

KAREN: Yeah, so I actually don't come from a family that's full of physicians or scientists. It's just something that I wish I could understand even in myself. I think I was just naturally curious about science, and followed that path, and it's steered me in the right direction, that curiosity, I think, my whole career.

OLIVER: Your primary interest was in biology. That's what you studied at George Washington University. You moved into molecular biology. That seems natural. People of our generation were drawn to that field. But then cancer, how did you get interested in cancer?

KAREN: Yeah, it was a really interesting journey that I wish I could say was planned, but really wasn't. So in fact, you know, as a child growing up, I had always thought I would go become a physician, because I thought that if you enjoyed science, that that's what you should do. Again, I didn't know any scientists, so I didn't know how to go about becoming a scientist, nor did it honestly even enter my mind. So I went to George Washington. They have a wonderful biology program where you can have a very rich ability to get to know your professors very quickly, you know, starting your sophomore year. So I started interning in a lab, and in that laboratory, they really recognized how much I loved science and nominated me to work at the National Cancer Institute at Frederick for the summer. And so I interned with Dr. Garfinkel at NCI Frederick, and it was at the time that the HIV epidemic was really in its peak, and really, lack of understanding about retroviruses was profound. And so the Garfinkel lab study Ty1, retrotransposition, and it was thought that this was a way for us to understand how HIV worked. And so I was very excited, in retrospect, to get involved in that because I could draw a clear line behind the science and helping someone, which I think was my driver. So after those experiences, and I was using yeast genetics as a model system, which was very exciting at the time, and still is for me --

OLIVER: Yeah?

KAREN: But it is the case that, you know, I decided to make a shift and that what I really loved was science in the way that you can generate breakthroughs that can truly help more people than you could seeing individuals come to your clinic every day. So this led to this going to UCSD and getting my PhD with a focus in molecular biology. I loved yeast genetics, so yeast genetics was what actually brought me to cancer. At the time that I was there was the time that all of the cell cycle genes were being identified, and the way that that happened in part was that mutational analyses or mutational strategies had been performed at in fission yeast, Schizosaccharomyces pombe, and those new mutant lines, which were sensitive to radiation, distributed across the world in different laboratories, and I was given one to work on, Schizosaccharomyces pombe rad1, which was highly radiation sensitive. And so through complementation strategies, I cloned rad1. It is now known to be what now we know is part of the 911 complex for DNA repair. It got me really interested in cell cycle, really interested in checkpoints, and then of course, you started to envision, well, what do you do with this information if your goal is to help someone? And so that linked to cancer, uncontrolled cell growth and cell cycle, it started to really resonate with me, and still right up until the moment that I stepped into my role as CEO of the American Cancer Society have a very active funded lab where a core component of what we did was always cell cycle, and I'm very proud of my trainees and what they were able to discern but that's how I came to cancer was love of science, being in the right place at the right time, and being able to track it to something that I wanted to do, and that's help people.

OLIVER: Fascinating. I mean, it's interesting that you say, you know, when you were younger, you were thinking of being a medical doctor, right? And then experiencing science gave you that other perspective. That's a lot of what we're trying to achieve with this podcast is to help people see all the different ways that you can participate in the cancer community. So was prostate cancer a disease that you were particularly interested in? Was it just a good model or how did that happen?

KAREN: Yeah, great question. So in my doctoral work, it was certainly all about cell cycle, and I loved it, and I loved the intricacy and the logic of cell cycle and cell cycle gone awry in cancer, but for my fellowship, I recognized within myself that I needed to make that next step, the next step toward more of a direct line for helping someone, in other words, translation. And so I thought about that, as I thought about what mentor I would go work for, and so I, you know, I had the benefit of having all these wonderful labs around me in San Diego, and the interview that really resonated with me was with Dr. Web Cavenee, who was also I know your mentor, too. We had a little time to be in each other's labs --

OLIVER: Indeed.

KAREN: -- And boy, what a great, great decision I made. You know, when I sat down in his office, I realized his mind was aligned with mine, which is the reason that we do this. The reason that we do cancer research is we're aligned towards solving for a problem that is a real life human problem, and I loved that. And so when I decided to join Web's lab, that was probably one of the most pivotal decisions I made in my scientific career, and I thought I would be joining his brain tumor group or his rhabdomyosarcoma group. Of course, I knew him from the cell cycle world as being the person who had identified tumor suppressors through studying retinoblastomas and I was very interested in the RB1 gene. And much to my surprise, after I had already agreed to come, he sat me down in his office and said, "Here's the thing, Karen. All of this work is happening right now in the world in breast cancer." And it was at the time that women had really started to demand more, more clinical trials, more research being done in breast cancer. He said we're going to make gains over there, we, the oncology community. He said but the counterfoil to that is prostate. And you know, the population is aging. Prostate cancer is going to become even more, frequently diagnosed, which was already the number one diagnosed cancer of men in the country, not, you know, like number one malignancy. And he said, we've got to do something about it, because we actually don't understand advanced disease. And I thought, well, what do I know about prostate cancer? But the more I started to look into it from the clinical point of view, from the point of view of what is the clinical problem that needs to get solved, it was a lack of understanding of how it is that hormone action drives uncontrolled cell growth in the prostate. Now this starts to resonate with me. It's like, okay, nobody understands -- everybody understands prostate cancer needs testosterone, but nobody knows how to make that link between what testostero ne does, and how cells get the go grow signal. Understanding that the androgen receptor is present in, you know, many tissues, almost every tissue in the body, what's unique about the prostate, that it gets a go grow signal from testosterone. I thought, oh, okay, I'm probably uniquely positioned to figure that out. And so then pulling together all these wonderful nuclear receptor people that were all around me at the time, you know, I had to of course understand androgen receptor and nuclear receptor signaling in order to link that to cell cycle, and so I was able through partnerships and learning with the community around me, able to put together what I think was a pretty unique research program that led to new nodes of opportunity, new understanding of hormone action, but also new nodes of opportunity for treatment in prostate cancer. And then all these years later, you know, co-writing clinical trials using CDK4/6 inhibitors in combination with hormone therapy. Bingo. I mean, it was really -- it just felt like it kind of all came home when that started to happen. It was -- I was in the right place at the right time, but going to Dr. Cavenee's lab was the most important choice I made to get to the path where I am right now.

OLIVER: And I think you highlight a very interesting and important point, which is being able to identify the right question at the right time in the right environment is so critical to finding work that can make impact.

KAREN: Yeah, and I mean, and I think that's -- I'm very proud of my trainees, and it's the thing that we talked about a lot in the lab all the time. You know, every year, we would set aside some time to say all right, here's our body of work. Here's our body of work in the context of the whole environment around us, and there were no sacred cows. And, you know, we'd say like, what are we uniquely positioned to answer that we can do faster and more thoroughly than another lab? Like, why would we want to go into this particular area? And I think that kind of rigor in thinking actually allowed us to shape and change beyond just cell cycle and to add new types of thinking in the lab about the importance of understanding hormonal control of DNA repair, and then ultimately being able to contribute to PARP inhibitors as, you know, breakthrough approvals for prostate cancer because of that work was really meaningful. And it's because we had such a good tie to the clinic. So, you know, we were constantly thinking about what are the clinical problems that we're trying to solve? What are we good at, at modeling? What is better for somebody else to do because it's just not our sweet spot? And then what resources, meaning people and infrastructure, do I need if I'm going to attack this particular scientific problem?

OLIVER: Interesting perspective. Often the kind of research that you did, that I did, is called curiosity-driven research, but I'm hearing from you that it's curiosity plus strategy.

KAREN: Yeah, I think that's right. I think that ultimately, is how I lead the lab. I think that now when I watch my previous trainees that are, you know, now professors and in pharma, I think it's how their mind works, too. And it was really not me saying, here's the strategy. What I loved about it, what I really, really loved about it was being able to sit with my team every year - we do a retreat, right - and sit and think with them about what is the right thing for us, and hearing their view, their points of view. You know, when you get to that go/no-go part on a experiment, a go/no-go part on a project, it's nice to have the divergence of thought, so that you can ultimately come as the head of the lab to make, hopefully the right decision, not that I always make the right ones.

OLIVER: Who does, right? So around 10 years or so ago, you started taking on some leadership roles in the Sidney Kimmel Cancer Center. You've already kind of told us how strategic your approach was to your science, so I can imagine that was a natural step, but what motivated you to take on those kinds of responsibilities?

KAREN: Yeah, so when I left my fellowship, my first faculty appointment was in Cincinnati at the University of Cincinnati School of Medicine, and I was again, right place, right time. You know, all these brilliant minds had been hired in Cincinnati, right out of their fellowship. Everybody was, you know, very excited about having this groundswell of knowledge of cancer, but I also recognized that I needed to stay very current, again, with what was happening in the clinic, so I was very lucky to have a urologist, Bruce Bracken, and a radiation oncologist who kind of took me under their wing and we started to work together in partnership, and we formed this what we called the prostate cancer working group, and that way, I could explain to him the kinds of things we were doing. They were telling me the problems that they had in the clinic, and we set about trying to solve those together. A missing component was medical oncology, and ultimately, that's why I started thinking about going elsewhere, because at the time, it just was not a missing component, and when you study advanced disease, it's very hard not to have a robust GU oncology program right there. I think they have one now, but at the time, it was just kind of missing, so okay. So I was amenable to recruitment, and when Jefferson came calling in Philadelphia, they said we want you to start the process -- we want you to take -- we have all the stuff. We have all the pieces. We have urology, rad onc, med onc. We have a risk clinic, and we have this massive, diverse patient base, and we've got scientists, but we don't have anybody to anchor them all together. Okay, so now you're speaking my language. So they wanted me to come and start the prostate cancer program. So I did that, and I find a lot of personal satisfaction in building teams. I've learned that about myself through the years. And so I put that together for Jefferson. We started a program that became part of our official programs at the NCI through our NCI-designated cancer center, but we also expanded it to the entirety of Philadelphia. So we started a prostate cancer working group that included every prostate cancer researcher or clinician who wanted to that we could find from Temple, from Penn, from Wistar, and we met once a month, and we put together -- we did work, and which was great, and so I loved that. And so then when you start to be that person, people started to ask you to do other things that require team assembly, so probably not known by the external world very much, but I actually served as the first Vice Provost at Jefferson. So my whole goal there was to -- I was charged by the Provost to put together the clinical and the basic research teams. And at that time then, it was also the Deputy Director of the Cancer Center. So ultimately, you know, the institution made a change, asked me to take on the cancer center right on the precipice of this massive expansion that I actually didn't know was going to be planned. Nor did I think anybody really in the know except our new CEO, so we were a three-hospital system in Center City, Philly. We had great science. The prostate cancer group was ticking and humming. It was really phenomenal, and then we had this incredible opportunity to expand because we went from three hospitals wholly owned and operated with a big prostate cancer base to ultimately, by the time I left, 16 hospitals wholly owned and operated. Now it's 18 across two states. And so I had the opportunity to think about how we take all the awesome research that we do, and put that into practice by putting clinical trials out into the community and setting up four different advanced care hubs with clinical trials so that we actually had an opportunity to get breakthroughs, to get the research that was happening in Jefferson and beyond out to people, and I loved that.

OLIVER: Phenomenal. I mean it sounds like yet another opportunity to make more of an impact and an exciting time also to be there. You obtained an MBA. I don't know if that was coincident with this or what the timing there was, but what was the reason for that?

KAREN: So in at Jefferson Health, we were ultimately a 33,000-employee $11-billion company, and I reported to the CEO. And he's a brilliant guy, Steve Klasko. He's absolutely brilliant. And, you know, I, I learned a lot from my C-suite colleagues, but what I saw (one person's opinion) is that as we went and expanded and assumed these community hospital systems that did cancer care, but had not a lot of expertise in clinical trials, and sometimes they were employed, and sometimes they were not employed, sometimes they were happy that Jefferson had come over, and sometimes they were deeply skeptical about what was going to happen, I realized that we were going through this rapid merger and acquisition and doing it, I'm going to call it in an academic medicine kind of way. And I thought to myself, that there must be a better way, and I'm not going to learn it listening to the echo chamber in academic medicine, and so I'm going to go get my MBA. So I sat with my CEO, and I said this is what I'm going to do. And what he said to me, which I think was brilliant, is he said, "Look, go get your MBA. You go do that thing." He said, "But don't -- do not focus on healthcare. In fact, get away from the healthcare people, because if you really want to break some things and make change, you've got to hear from people with external points of view." And it was great advice. So I learned about M&A from people who were bankers and in finance. And, you know, it's an executive MBA program, so you're working with people who are already in a C-suite, or just below the C-suite and want to be, but you learn a lot from each other. I learned so much that I didn't expect to learn about people strategy and managing, you know, human capital, which you don't ever learn about in science, and so that was really valuable to me, but I also realized what an advantage you have as a scientist, because you are -- you don't realize it, but you are trained with a business mindset, right, because when you're running a lab, you're running a business. You have to think about strategic priorities and finances and human and managing people, but you also have a real comfort with hypotheses and a real comfort with being wrong, and a real comfort with using data to guide your decision, which like It shocked me that some people in the business world just like they actually don't know how to statistically analyze data, and they don't lean on it like I do. So if there's one thing I brought to the American Cancer Society is that we are a data-driven organization. If you want me to run in Direction A, you better tell me why B is wrong, and A is the right way to go, and I'm going to ask you for every piece of data to understand that. And so it's like it's very freeing. I actually think that scientists are uniquely positioned to be business people, (one person's opinion).

OLIVER: That's, that's really interesting, that combination of thought processes. We're going to take a quick break. When we come back, we'll talk to Dr. Knudsen about her work at the American Cancer Society.

[insert ad here please]

All right, and we're back. Dr. Knudsen, your move to the American Cancer Society, from academia to the nonprofit world, represents another career pivot. Same question, what motivated you to take this leap?

KAREN: Yeah, if you would have ever asked me if I would do what I'm doing right now sitting here in Center City, Philadelphia, I would say absolutely not. I loved my job. I was the EVP of Oncology Services. I found great satisfaction in taking the clinical teams and delivering the best possible cancer care in every corner that we covered, and also getting the science there, right, and ensuring that our science is addressing the needs of our catchment area and leaving nobody behind, and developing cancer screening strategies to bring out to the community instead of asking them to come to Jefferson, again, using data-driven research solutions. So I loved all of that, and then I got this call to look at the CEO position at the American Cancer Society, and like you and like other cancer leaders, you get these calls kind of regularly, right? But I was very thankful to ACS because I was an ACS grant holder, right? When I needed research as a cancer center director, I had an IRG grant that gave me pilot funds to spawn what were really amazing new ideas from my faculty. So okay, I was appreciative of that. I was also the president of the AACI, the Association of American Cancer Institutes, which is largely an advocacy organization, and that's where the 106 cancer centers in the US hang together every year, link arms and push for common sense policies to help cancer patients. And the ACS had been our partner there too, so I really respected that part of it, but the thing that really got me about ACS was the fact that a lot of our cancer patients were in Center City and came to our safety net hospital in Jefferson. And so the difference in outcome between someone who can come to chemotherapy five days a week, versus someone who can only come three days a week because they don't have transportation, is huge. So this what I call basic blocking and tackling of cancer care, housing, transportation, digital literacy, information about cancer, education of the caregiver, all of that stuff, which I now call Patient Support at ACS, was how we got our patients to care. And so I was very thankful to ACS, because of all these things, but especially patient support. So I got a call from ACS, and they asked me to take on this job, and they told me something I didn't know, even though I'd known about ACS my whole career. What I didn't know is that this 100-plus-year-old organization was actually not at all 100 years-plus. It was brand new, because ACS had been a federated model. It had been multiple separate organizations with many CEOs and multiple strategies and multiple different areas of emphasis across the country, which explained a lot to me. It explained why I was touching and feeling something at ACS in Philadelphia that's very different than someone might touch in DC, or in Los Angeles or in a rural community, because they were truly separate organizations. So what they explained to me is that they had gone through a business transformation, which I considered to be a good word, and they put together these multiple into one, one ACS, and it was legal, it was financial, as one unit, but it was not yet strategic. So now you're speaking my language, right, because now I have an opportunity to take previous teams, meaning the federated models, and put them together in the name of cancer for the greater good, and so I had this series of meetings with the board, because I had no reason to leave Jefferson. I loved what I did. And if I was going to do it, I was not going to be the keep-the-trains-running CEO, I was going to say we're going to have to have a greater impact than we have right now and define that with data and metrics, and really, act where we are uniquely positioned to act and not someone else. So I had a series of meetings with the board --

OLIVER: Of course.

KAREN: -- I gave them tough talk. Here's what's wonderful. We got to do more of this. And here's some stuff that I don't know it belongs to ACS, and some of that was with research, and some of it was with advocacy, and some of it was with patient support. I had thoughts about how to structure this to make it more impactful across the country in everything that we do. And I didn't realize that that's what they were looking for, but I think they were looking for someone to come in and really be a change agent, and for a positive. It's always been an amazing organization, always, but clearly ready for logarithmic growth in other ways, and so I feel very humbled and honored and absolutely delighted to lead this organization. We have so much more to do, and we do a huge amount of what we do in partnership, including, the NCI even advocating for NCI funds. It's one of the things I can do as a CEO that you, you know, can't do from within the NCI, but we can and we know how important that is. So every day is a good day because I know we're doing good in the world, and I love that.

OLIVER: And we're deeply grateful for that advocacy. Obviously, it's critical. So I mean, you broke quite a few barriers in taking on this role. As I mentioned already, you were the first woman to be the CEO. You're also the first CEO to come from cancer science and to have been a leader of a cancer center, so the transformation, you've implemented pillars, advocacy, patients support, discovery and development. How's that transformation going?

KAREN: It's going really well and I credit my executive team. So one of the one of the things that I wanted to dismantle was the idea that ACS is a location, right? We work in 5,000 communities across the country, so I had no ambition to relocate everyone to Philadelphia or to Atlanta or to any main location. So I really hired the best and brightest to lead these pillars, but before I talk about them, because I want to mention those guys for a minute, the foundation of everything that we do, right, rests on health equity, and cancer care equity in particular. And so it was surprising to me that we had not yet put in a chief diversity officer. So my first -- one of my first moves was to put in place our chief diversity officer, Tawana Thomas Johnson, who is a rock star of my world, and when I talked about strategic choices, things that we are uniquely poised to act on that maybe, you know, setting aside things that we shouldn't act on, if it doesn't align to our commitment to health equity or to cancer care equity, that's a somebody-else thing. Everything really has to stand true to that. So she's got a big role. You know, she shapes everything we do, all pillars. And so our vision of what it is that success looks like is ending cancer as we know it for everyone. I always call this the eight words that define us, but those two words are more powerful than the rest, right?

OLIVER: Yeah.

KAREN: So and because there are things that we can uniquely do in that space that are harder to do for a government program, but we can. And so putting that person in place was just, I think, I'm very blessed to find her already within ACS, and so she knew it, she knows it and, you know, she does magical things like goes out and ensures that 1,500 health equity ambassadors are trained to go out and work in communities for prevention and screening that are, you know, movers and shakers in their communities, and it makes a difference. And then we measure ourselves by how well we do. So all of our organizational goals hang on things like impact, like lives touched through prevention screening, not just did we do a screening activity, but did we enhance screening as a result, right? So these are the kinds of things that we put into play as an executive team that are really what we can do as ACS. So then standing on that foundation of health equity are the pillar, so, you know, research is, of course, incredibly important. Our research team in Atlanta continues to just, you know, set the single book of truth for the nation on cancer incidence and mortality and trends, but then we also have the extramural program. So what are the kinds of things that ACS should be funding that is complementary, but non-redundant with the NCI or other funding agencies? So we went on the listening tour of the cancer centers. I polled my peer group, my brother and sister cancer center directors, asked them what they prioritize, and we've started to shape our research priorities accordingly. Now, in order to have somebody lead that, I needed just the right Chief Science Officer, so this is where I have to apologize to you because I stole him from the NCI, and that's Bill Dahut. Dr. Dahut is amazing, another rockstar in my world, and just absolutely revolutionizing our ability to have impact through discovery. He is terrific. I know you guys already know that. So he is wonderful, but as much as these breakthroughs happen, access to those breakthroughs, we know is only happening for a percentage of people in this country, and that's where advocacy comes into play, so this is a 501(c)(4), so that's -- you know, in business jargon, what does that mean? It means that you can and do lobby, and a lot of the battles that are fought in the name of health equity happen at the state level. A perfect example is biomarkers. You know, we've just gone state by state to ensure that all these wonderful oncology agents that require biomarkers to match a patient to therapy are covered in the state plans, because guess what team? They weren't. And so Illinois was the first one that, you know, with our push, passed this into law, and then other states followed, Arizona, Rhode Island, Louisiana. But all of those advocacy wins came because we have the data from research and experience with our patients, right, the last pillar, patient support. So that's all of the places that cancer patients fall through the cracks. That's the transportation, the lodging, the patient navigation, the patient education, prevention and screening programs. And so finding just the right person to lead that was challenging because this is a new construct, not new activities, but new in terms of thinking about who is going to be the strategic head of that who thinks about, from a data-driven way, what patients need now and what they're going to need five years from now? So I had the bliss and honor of leading that at the beginning, and so we hired Dr. Arif Kamal out of Duke, a medical oncologist who leads patient support. And I should also mention that advocacy required no new hire. I mean, Lisa Lacasse, who's the president of ACS CAN is absolutely first rate, and to watch her masterfully acquire e verything she needs to know from patient support and research in order to have advocacy push forward in ways that truly improve lives, like millions of lives with one signature, she's phenomenal.

OLIVER: I mean, I could talk to you for hours about your strategy, but we don't have the time today, but I do refer our listeners to the in-depth interviews you've given to the Cancer Letter and elsewhere where you take a much deeper dive into the into this incredibly interesting strategy. I do want to take a slight pivot and ask you about career advice. You've -- your career has obviously been phenomenally varied and interesting, and has presented you with many different challenges. Our listeners, people who are listening and thinking, "Wow, that's very interesting," what advice would you give to people listening if they're interested in the kind of work that you've done?

KAREN: Yeah, I mean, I'm very willing to, you know, talk to people if they have any questions about things that they think particularly that I did or didn't do. Always is important to understand. But the advice that I generally have given to my team, my lab, and my trainees and faculty was always be willing to take the call, you know? Understand what drives you and what you're -- where you really excel, but also really want to continue to grow, and when someone calls you and says, I want you to think about a thing, don't just discount it. Take the call, because only two things will happen, one of two things will happen. One, you'll either feel great about what you do, right? Like, "God no, I want to stay in what I'm doing right now, because I absolutely love it," and this -- like, this is it. This is my buoyancy point. This is what I want to do. Or you'll think, "You know, I never thought of that before." And maybe you'll see yourself in that role. Maybe you won't. But it's the case, it may get your mind thinking to how close to your ultimate goal is it? And so I think just taking the call and being willing to explore is a really important thing to do.

OLIVER: Well, thank you so much for sharing all these insights, and we wish you of course continued good luck at the American Cancer Society, and excited to see what you accomplish there. We're going to take a quick pivot and go to a segment that we call Your Turn because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast or a talk that you found inspirational or amusing or interesting. You can send those to us at [email protected]. Record a voice memo and send it along. We might just play it in an upcoming episode, but I would like to invite our guest Dr. Knudsen to take her turn.

KAREN: Oh, boy, this is really hard. Of have all the things I could say off the top of my mind, here's -- since we did talk about career and career advice, I also think a corollary to that is motivating people. And so one of the things that I really enjoy, and I used it with my faculty at Jefferson, I used it with my trainees, and I've used it here at ACS, is it's a little bit dated in terms of the actual content, but the examples, but the messaging is absolutely on point. It's Simon Sinek on 'why', on teaching people why it is that you do what you do, that people are attracted to the why you do what you do, not the what you do. And he has this incredible podcast of TED Talks that tells you -- gives you some insight about why the Wright Brothers, despite the fact that they had very little funding and no training, were successful in flight versus someone who was actually very well resourced from the government and had all the right technical training and the background. It talks about why it is that Apple was so successful as a company in coming up with different types of strategies. It also talks about Martin Luther King, and how it is that he stood out amongst all the very important people and orators and those who were trying to motivate others in the civil rights movement. And his philosophy on how it is that Martin Luther King was so successful in his messaging, I think is applicable to everyone, irrespective of what it is that you do, but I think especially when you're trying to describe your role in solving for cancer and ending cancer as we know it for everyone. I really think it's insightful, and so something I would highly recommend.

OLIVER: Well, thank you, and I'd like to make a recommendation as well. Like many, I've become intrigued by the advent of large language models in AI and the possibilities they open today and the promises they make for tomorrow. Of course, there's also risks as with any new technology. One of the most important guides to this world for me is The New York Times podcast, Hard Fork. It's hosted by two very knowledgeable tech journalists who keep it light and real, and they really know their stuff. You can find it wherever you listen, and we'll put links in the show notes for this podcast, and the series of TED Talks that Dr. Knudsen recommended.

That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training.

It is produced by Angela Jones and Astrid Masfar. A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.

In this episode of Inside Cancer Careers, we first hear from Dr. Simon Schwörer, Assistant Professor of Medicine at the University of Chicago in Hematology Oncology, and how he started his own lab. We then hear from Matthew Lockhart, Director of the Division of Loan Repayment at the NIH to discuss the Loan Repayment Program (LRP) along with LRP Ambassador, Dr. Dionna Williams, an Assistant Professor of Molecular and Comparative Pathobiology at Johns Hopkins and LRP recipient, Dr. Arnethea Sutton, Assistant Professor of Kinesiology and Health Sciences at Virginia Commonwealth University.

Show Notes

Segment 1: Starting Your Lab

• Dr. Simon Schwörer

• Leibniz Institute on Aging in Jena

• The Craig Thompson Lab

• Hirshberg Foundation for Pancreatic Cancer Research

• NCI K99/R00

Segment 2: Repaying Your Loans

• NIH Loan Repayment Programs

• LRP Dashboard

• LRP Ambassador Program

• LRP Institutes & Centers Contacts

• Dr. Arnethea Sutton

• Dr. Dionna Williams

• NIH LRP Twitter

Your Turn: Guests Recommendations

• Getting Things Done: The Art of Stress-Free Productivity

• Cancer History Project Podcast: Otis Brawley & Robert Winn

TRANSCRIPT

[UPBEAT MUSIC]

OLIVER BOGLER: Hello and welcome to Inside Cancer Careers, a podcast from the National Cancer Institute. I'm your host Oliver Bogler. I work at the NCI, in the Center for Cancer Training.

On Inside Cancer Careers we explore all the different ways that people join the fight against disease and hear their stories.

In this episode we are talking with Dr. Simon Schwörer who recently started his lab at the University of Chicago and to Matthew Lockhart, director of the Loan Repayment Program at the National Institutes of Health who is joined by two recent participants in that program: Dr. Dionna Williams and Dr. Arnethea Sutton.

Listen to the end to hear some interesting recommendations – and where we invite you to take "Your Turn".

OLIVER: Welcome Dr. Simon Schwörer to the podcast. He's an assistant professor of medicine at the University of Chicago in Hematology Oncology and focuses research on the interaction between cancer cells and associated fibroblasts and how they interact with the goal of finding metabolic pathways that can be targeted for therapy. Welcome to the podcast.

SIMON: Schwörer: Thanks Oliver. It is a pleasure to be here.

OLIVER: I'd like to know more about how you chose your path, both in terms of where you trained and also why you wanted to become a scientist and why you chose the area of cancer biology that you're working in.

SIMON: Yeah. So becoming a scientist was really based on my interest of just understanding how things work all the time, always asking why and never being satisfied with "Oh yeah, that's just how it is". And I always wanted to understand, you know, even on a smaller scale level, a molecular level, how do things work, you know, why do we get sick?

So that's why I really wanted to become a researcher and trying to understand causes of disease. That's kind of what motivated me to, you know, study science. Regarding my path, so I studied molecular medicine at Ulm University, with the goal of becoming a researcher and I guess the trajectory from there was more a combination of, you know, my own interests that would offer sign, but also to some extent, you know, serendipity kind of things just went came together in a good way for me to some extent. I just finished my and my bachelor thesis. I was I was working for a few months here in the lab that studies the neuroregeneration. I was being open minded at the time, interested in anything. And then I started my master's thesis, which is a thing that people normally do in Europe before they do their Ph.D. training. And it became clear to me that I needed a bit more. I wanted to have more training in research, learning more methods and just becoming more exposed. So I, I applied for several positions as a research assistant and eventually obtained one in a lab that studied stem cell aging that was still at Ulm University in Germany. But my main job was genotyping of mice.

But, you know, of course I was not satisfied with that and wanted to do more and more and spend a lot of time in the work in the lab and the post-doc that mentored me, who I worked for at the time was really supportive. And, you know, even trying to teach me more methods and gave me more insight in his work.

And I was able to participate in lab meetings. And so I got really excited about the research in the lab back then. And the research was in the lab of Dr. Karl Lenhard Rudolph at Ulm University back then. And eventually I decided to do my master's thesis there spent half a year every day in the lab. And it was really a lot of fun.

And my topic was, if you understand molecular mechanisms of stem cell dysfunction and aging, so majorly focusing on muscle stem cells, with the idea being that, you know, stem cell dysfunction is a cause for the inability of the elderly to regenerate muscle tissue. So I did this work on the stem cell, function and regeneration, and that was really exciting.

And we had some very interesting findings. And at the time, that's where first, you know, serendipity comes into play. The head of the lab was offered a position as a director of a Leibniz Institute in Germany, the Leibniz Institute on Aging, and that was in the east of Germany, in Jena. And he offered me a position as Ph.D. student.

And because I was so in love with what I was doing and really liked it, I didn't hesitate. And I accepted this position. So I moved back in 2013 to Jena and started my Ph.D. work there.

OLIVER: So, Simon, you mentioned a couple of times that you loved your work. Can you tell us a little bit more about what is it that you loved? You loved the actual doing of it, the intellectual elements? Tell us more.

SIMON: It was it was all of it. So it was both, you know, still at this young stage of my career, learning a lot of new things, learning new methods, but also, you know, having some interesting findings that you're trying to understand, come up with experiments to address these things. So it was both like the intellectual aspect and just having interesting results that we didn't understand at the time and, you know, provoking us to ask more questions and getting a deeper understanding.

So it was really just a lot of joy for me, spending long hours in the lab and it's really great. So really what's clear for me at the time that this is what I wanted to do going forward, and it was an easy decision for me doing a Ph.D. because I knew exactly what I wanted to do. That makes sense.

OLIVER: Yeah. So you did that PhD at Jena, at the Leibniz Institute.

SIMON: Exactly at the Leibniz Institute on Ageing in Jena so I started there in 2013 and my topic was building up to some extent on the master's thesis work that I did. At the end, we had some very interesting findings on a specific gene being, or gene signature being upregulated in old muscle stem cells. And I further explored this in a mouse model and we tried to see if we can prevent the accumulation of this gene product can we potentially, you know, reverse stem cell dysfunction.

That is exactly what we found. And furthermore, building up on these findings, what are the causes of upregulation of this gene signature? And again, we ended up defining what we call it at the time and epigenetic stress response. And so basically and we found that most stem cells show a very particular change in their epigenome after stress or stress being, for example, the injury to the muscle tissue.

And that response is very different in the old stem cells and that was our big finding at the time. And from there on, I of course, wanted to explore. So why is that? You know, why do we see this dysregulation of the epigenome, you know, and at the same time, there were several studies coming out specifically in the cancer metabolism world that there's a strong connection between epigenome and metabolism.

So metabolism regulates the epigenome. And you know, based on this and my reading and my interest, I was really convinced almost that some metabolic changes have to be the cause of these findings that we had. And so I realized this is the next step in my career. I needed to know more about metabolism because I need to come to the root cause of this defect that we observed.

And I was clear to me that I definitely have to go to a metabolism lab to really get deep training in metabolism and not just go to a stem cell lan that potentially has a metabolism project. So I really wanted to get this deep understanding of this. Again with the idea of potentially applying it to my stem cell dysfunction and aging system.

OLIVER: So that informed your of your search for a postdoc lab?

SIMON: Exactly. That informed my search for postdoc lab. I really wanted to go to a lab in the end that does metabolism work. And then I luckily ended up on yeah, I ended up in the lab of Craig Thompson at Memorial Sloan-Kettering Cancer Center. So he offered me a position in his lab after I interviewed there, and I moved then to New York in October 2017 and then started my work there.

OLIVER: And so that must have been a change from Jena to New York.

SIMON: It was a, it was a big change for me. Quite so. So I even more so because I come from a very small village in Germany, which is a few thousand inhabitants. So it was a big change. But, you know, over the course of my career and, you know, being in Ulm and Jena, like small, smaller cities in Germany, I really enjoyed more the city life.

I mean, it was not as big city, of course, as in New York. But that gave me, you know, the opportunity to really enjoy it even more so in New York. I mean, all the things that are offered in such a big city was really great. In addition to the science, of course, that was really great at Memorial Sloan-Kettering Cancer Center.

So that was was a big change. But yeah, for the good in the end.

OLIVER: Fantastic. And then and you completed your postdoc with Dr. Thompson and then moved on to the next part of the career, which I think is one of the most probably exciting and stressful. Was it stressful for you looking for your faculty position?

SIMON: It was stressful. So let me just mention, I think complete the circle a little bit. How I ended up with, you know, what I'm doing now. So there is one small thing to share about this, which is that I came to Craig Thompson's lab again, still had the idea of metabolism and stem cells, which he even did at a time.

And when I started it was more like "Yeah, we are not working on this anymore, Simon". So I kind of had to come up with, okay, what am I doing now in this lab? I was really never exposed in my research career on cancer despite having studied cancer metabolism.

And so I realized I'm probably not a good cancer biologist, but maybe I'll start working on the normal cells in the tumor microenvironment. So that's how I ended up working on cancer associated fibroblasts. And at the time, you know, people published work on how that these cells can even release metabolites to support the survival or growth of cancer cells in the tumor.

But it was not really known how, you know, these cells actually work themselves. And how can they support their own function. It's known that cancer cell rely on their metabolism to support their proliferation. But how fibroblasts in the tumor do that hasn't been. You know, and that's really the problem that I started to tackle as a postdoc, and that eventually that helped me to get to this point of having a successful postdoc and being able to compete for faculty positions.

OLIVER: Fascinating because, I mean, I think it represents a recognition of a tumor as more than just a bunch of cancer cells, right? I mean, we've learned about blood vessels and so on. And now we're learning through your work and that of others that that these other quote, normal cells are being recruited into the community of the tumor and their behavior is changing in a way that's important.

So it's fascinating and interesting that you came out of a non-cancer background and found that niche for yourself, just like the cancer fibroblasts associated fibroblasts have their niche. You kind of came in, right? And now you're doing great stuff. So yeah. So tell us about the hunt for the assistant professorship.

SIMON: Yeah. So the hunt started probably in summer 2021. So we're trying we are just trying to wrap up our second story of my postdoc work. And, you know, we've just got to actually reviews back of a paper that we're trying to send, that we were sending out and I was sitting with my mentor, Craig Thompson, in his office, and he was…

He was we were talking about, of course, about the experiments we were doing and all we would have to do to address all the reviewers' comments. But then he also after the conversation asked me "Oh, Simon, when you when are you starting to apply?" And I'm like, "Oh yeah", I wasn't sure if I'm if I should apply this year.

I he said, "Yeah, you should definitely apply. You know, your paper is coming out, hopefully". And so that really motivated me to, okay, this is it's actually really good timing for me. I mean, I knew I wanted to attain a faculty position, but I wasn't sure that I could already apply at this time. And so that's started it all.

And then, you know, while doing all the experiments to revise our manuscript, I also, you know, tried to think, what is there beyond this? You know, I'm trying to develop my own research program over the course of that summer, 2021. And and then probably September, I started to submit my first applications to positions that were posted online.

OLIVER: And how many positions, if I may ask, did you apply for?

SIMON: I applied for 22 positions in the end. So I guess there was a recent study and I think that described this process. And I think that's more like average what people do nowadays, about 20ish, some people more, some people have less. But I felt I felt, at least at the time, comfortable with the number of applications that I that I sent out.

That potentially if I if I don't get anything at this moment, I would still have another chance, maybe a year later.

OLIVER: Right. Right. And the position at the University of Chicago. Tell us a little bit more about why you picked that particular place.

SIMON: Yeah. So in the end, what would make me choose this is yes, one main thing was the that at the University of Chicago, they really are building up a new center for cancer metabolism that is really focused on all aspects of metabolism that are related to cancer. And they were looking for they recruited recently another person at just a year earlier who was focused on metabolic flux analysis in vivo and tumors and an even in patients and now they were interested in someone and it was interesting to microenvironment and that's really I think was a great fit for I was a good fit for them, but also they were a great fit for what I was looking for.

I really wanted to be in an environment where I'm not the only one who's doing metabolism research, but to have a community where I could discuss my ideas, but also have the resources available to do the research that I'm doing. That was a big driver for me. And yeah, of course then also during the interview process, the discussions with the other faculty and the search committee, but also, you know, and the entire department and section, they were really all positive.

And so that was I guess one of the major aspects. And, you know, being then be able to be part of this new program and even develop, help develop and shape this program. So that you can at this early stage kind of being influential on where this program of cancer metabolism goes. So that was really one of the biggest factors driving my decision to come to the

OLIVER: Sounds fantastic. It sounds like a great environment, lots of colleagues and interest in the area. So so you set up your lab towards the end of last year, right? Is that correct? And so tell us about that. What was it like to move to another city, you know, come into an empty space and start imagining your own research lab in that space?

SIMON: Yeah. So it was not that much of a shock like it's often reported, you know, when you scoured the Internet that, you know, you come there, people open the door of your office and say, Oh, is this the office that you go to? And the lab? So I mean, I had a lot of support early on and you know, and in our section and department and everybody was trying to help me, you know, set up lab, set up the office.

You know, people were looking after me - that was really good. And again, I got a lot of help initially, even now still from the other person they recruited a year before me for the same program, so a shout out to my neighbor and friend Brandon [Faubert] for his help in getting me started. And yeah. And so, you know, I kind of had another lab that was built from scratch next to me, and so I kind of took that a lot of it as inspiration.

But of course also my pictures are all my former lab and maps looked like and of course my own idea what did I like and did I not like about how these other labs were set up. What do I want to have different if I can create my own lab? So that was a super exciting time just to get I mean, to build up the lab in a way that I like.

So that was really a lot of fun and it took a lot of time to research all the equipment, consumables, reagentsyou get, but you know, once they were in, it was really a lot of fun, especially, you know, the month of December, I kind of waited on unpacking a lot of the boxes and then took the month of December, kind of almost like I dealt with the boxes of like Christmas presents and opened them.

And it was a lot of fun. And then, you know, rearranging things every day. And and then, you know, just before the holidays, we had the lab set up and I got all my major equipment. Most of my major equipment. And so, yeah, then I left for the holiday break with very great feeling that the lab was set up and starting January 2nd, we could really do something in there.

OLIVER: That sounds fantastic. Yeah. Congratulations. But I do wonder what was the hardest part of, you know, taking that step towards independence.

SIMON: So I think to answer to that in terms of the job hunt. So what was it maybe that might be interesting to your listeners? What was hard for me in the beginning to actually communicate my science in those initial interviews. There were a lot of screening interviews involved, and I think I did poorly in those. And I think the problem was that I just often wasn't concise enough, couldn't bring my message and also why my work matters.

Why is it important to, you know, to the point and I think, you know, I know in those 20 - 30 minute phone calls, I didn't do my best job. But then later, you know, I learned through the process and, you know, communication with other lab members and other people, you know, who we're also in this helped, you know, to refine, you know, those answers from my side.

And, you know, and of course, the experience that I had myself. So that was the one part. And then the other part about, you know, what is challenging in terms of being independent now? I think the most challenging thing is now really doing needing to take care of everything yourself. So and that has of course, has it's great side, like really being able to develop your own ideas and just doing what you are interested in that is now that's awesome.

At the same time, you know, I have to get all the things organized in the background so you can actually do those cool things that I'm interested in. That's, that's with all the, you know, biosafety animal protocols that starts, and a lot of other administration administrative tasks that I have to do that we're just always taking care of.

And in the background, some to some extent didn't even know I needed to do these kinds of things that I now have to do. So I wouldn't say it was a shock, but it was there was just more work through it than than I thought there would be.

OLIVER: You know, Thank you very much. I mean, there are those chores, right? I mean, it's not, unfortunately, a science like any job. You have to keep certain things running. Simon, we met on Twitter, and I remember you were posting about a grant that you got very soon after you made this transition. And I know that you were part of the NCI's K99/R00 program.

I wonder if you could tell us a little bit about that grant and then the new one that you got and what that was like?

SIMON: Yeah, absolutely. Yeah. So I was lucky, or I was happy enough to obtain the K99 from the NCI. I was awarded in April 2021. Writing the grant back then was a good experience because I was able to write it during the lockdown in 2020. So that kind of helped me to keep it together, I guess writing this grant and and then, you know, afterwards the work we did and then we later published at the end of 2021 was based on this grant and that was and was really good experience and really helped me to, I guess, build up the foundation of the research program that I'm working on now.

So that was a great experience and transition to the R00 phase. And I think I mentioned this to you on Twitter, it took a bit longer than I than I would have imagined. And so we started I started to work on the R00 transition in summer 2021, just one or two months after I obtained my faculty position and we so writing that was you know interesting and it again again helped me shape my ideas what I actually what I'm actually doing in my own lab and I got a lot of good support from the University of Chicago, even though I wasn't there yet.

You know, from the administration side, from the grants management office, there was really a lot of support there. And yeah, it took, maybe it was the end of one fiscal year to start the other fiscal year, that it took so long. But I eventually obtained the R00 in mid-January. So I'm really relieved to have this support. But now the other grant and yeah so I'm just mentioning I wrote the R00 in the summer 2021 and we submitted it in in July.

So it was kind of in grant writing mode at the time. And, and I was of course, researching what else is out there and what could be some early what could be some grants that I could apply as as a once I once I transitioned to my faculty position and at the time and still my research is now focusing a lot on pancreatic cancer.

And I found an opportunity from the Hirshberg Foundation for Pancreatic Cancer Research. And, you know, it turned out that to have that to have one cycle every year in mid-August, that was, of course, before I started, I started my new position and I was in the grant writing mode, but why not? I have so many ideas and so I, you know, just after finishing my R00, I took, you know, some more time and developed this proposal.

And again, it was very helpful in shaping the ideas and of course there are a lot of ideas out there when I interviewed for the position, but actually really planning to entire research program in this proposal was also very helpful. So I said, even if I don't obtain this award, it was a good experience because I really know now what we should do to get to the point to get from A to Z and just and yeah, I told myself, even if I don't get it,

it is a good experience and I have nothing to lose by not doing it? And because no one expects me to get a grant even before I start my position and yeah. And it looked like that's the proposal I wrote was, was good enough. And yeah, I was lucky to obtain this grant early on. So I really appreciate the support of the Hirshberg Foundation for even for such a early career investigator like myself who just started out.

So I really appreciate that.

OLIVER: Well, congratulations. That's fantastic. It sounds like you're off to a running start. One last question. Now that you are the head of the group, what are you telling or what are you planning on telling the grad students and postdocs that will be part of your team?

SIMON: So I would tell I would speak, of course, a lot about my own experience. And you know, what helped me to get to the point where I'm now, you know, of course, always saying that my that my experience might not be, you know, exactly what your experience would be or my position is not the same that your position is.

But, you know, that being said, what I always tell people who are interested in joining my lab now that you know what I'm really looking for, and I think what you should be, if you want to be in this in environment, is really be just excited about science in general, kind of having this love for science and and that's what drives so much of your motivation to kind of show up every day and go deeper.

And even if a lot of things fail I mean, experiments fail, job applications fail, that it still keeps you going. And I think at least that has been my experience that at some point this is always going to going to be rewarded, just being with, you know, coming to the core or what it really is that is driving what are there for, obtaining a faculty position or other positions, even if the first time doesn't work, you know, just don't give up.

And I have some, you know, even personal experience to share in this. So I had some failures and of course in my science. But I guess one personal failure, that was when I participated in the New York City marathon in 2018, and I ran marathons before and I was motivated to do a new personal best.

And I was on track of that until I fainted one mile before the finish line. And I couldn't finish the race just one mile before the finish line. And I was I was so down for so many days and weeks afterwards. But I stood up again and I was able to qualify for the year after. And I just did it all over again, learning from my mistakes that I did.

And then I made it. And it wasn't my personal best, but it was still I made it. And sometimes it's also just good to make it. You don't necessarily have to be the best, but just even making it and, you know, overcoming things that you failed before has been a good lesson also on a personal level. So kind of being dedicated, being excited about what you're doing. Don't let yourself, you know, be down even if people tell you so that is something which I would share.

OLIVER: Well, thank you so much, Dr. Schwörer, for that. Very inspirational and thanks for sharing your most recent steps of your career. And we wish you all the best success in the future. Exciting research and that you continue to share your passion and enjoyment for science with, with us and with the community. Thank you.

SIMON: Thank you very much.

[UPBEAT MUSIC]

OLIVER: Let's take a quick break to alert our listeners to an upcoming opportunity. In April, we will be at the annual meeting of the American Association for Cancer Research, AACR, in Orlando to share about how NCI supports cancer research training. With me today are two colleagues who can tell us more. First, Erika Ginsburg, director of the Office of Training and Education. Erika, what will you be talking about at our ACR session?

ERIKA GINSBURG: Well, NCI is known primarily for funding cancer research across the nation, but there are also numerous fellowships available to conduct basic clinical or genomic and population based research at one of the three NCI campuses in Maryland. My team and I help take care of our trainees on these campuses. At ACR, you will hear about training opportunities as well as some of the career exploration and professional development resources provided to trainees within the intramural research program.

OLIVER: That sounds great. Erika, thank you. Let's turn to Nas Zahir, the director of the cancer training branch. Nas, what will you be sharing in the session?

NAS ZAHIR: I will be at AACR with several colleagues from the branch. My group will have informative presentations on NCI funding opportunities, including fellowships and career development awards, and they will share tips for preparing strong applications. I will be providing an overview of the session and serve as a session moderator.

OLIVER: It sounds fantastically helpful to people who are thinking of submitting grants. Thank you. All three of us will be at the NCI booth in the exhibit hall from time to time. So come to our session where you can listen and ask questions and come to the booth and find out more there. We look forward to seeing you all in Orlando in April. Now back to the podcast.

[UPBEAT MUSIC]

OLIVER: At Inside Cancer Careers, we're interested in how people make challenging cancer careers work. It's important to support people who are engaged in academic biomedicine because their research contributes to advances against disease. Many people know that the NIH, the National Institutes of Health, give out a lot of competitive research grants. Perhaps less well known is a program that we're talking about today with Matthew Lockhart, Director of the Division of Loan repayment at the NIH. Matthew is speaking with us with the help of an American Sign Language interpreter. Welcome, Matthew.

MATTHEW LOCKHART: And thank you, Oliver. I appreciate it. Happy to be here.

OLIVER: So I thought the NIH gave research grants, Matthew, but what is this about loan repayment?

MATTHEW: Loan repayments is a separate committee-mandated program that encourages and gives incentives to scientists who want to pursue research through career in academia, so and we do that by paying the student loans and up to 50,000 for a two-year commitment for research.

OLIVER: So the mission of the LRP is to help people stay in academic medicine, is that correct?

MATTHEW: That's correct. Yes, and in any nonprofit setting, we, you know, we don't want to be losing researchers to the industry who offer a higher salary and better incentives, so we -- how we compete with that is by offering a loan repayment program as an option to keep them, to stay in academia.

OLIVER: When was the program started?

MATTHEW: Okay. So it's a little bit of a long history, but so we started back in the '80s, the extramural research programs like as we know it now is more than 20 years old.

OLIVER: So how many awards does the LRP typically make in a given year?

MATTHEW: I think roughly around about 1,000, 1300 awards. I should mention that we do have different subcommittees under the extramural program. We have six, currently, subcategories, clinical research, pediatric research, health disparities, clinical research for individuals from disadvantaged backgrounds, and contraception and infertility research.

And then the sixth is the newest, and the new subcommittee is REACH, research in emerging areas that are critical to human health, and that's REACH for short. So those six are all -- within those six, it's about a total of about 1,300 yearly.

OLIVER: You mentioned the size of the awards. Are they for multiple years?

MATTHEW: Yeah, so that's a good question. So all the new awards are two years, and then and they can possibly be renewed for one or two years. There's no limit to the number of renewals, renewal awards, and as long as the applicant maintains the eligibility criteria, and then they can apply for that renewals until their education debt is paid off in full.

OLIVER: What's the chance of success? What -- how many people of the people who apply obtain the awards?

MATTHEW: Historically, we say about 50%. We have a 50% success rate, but in recent years, that has gone up a bit. Maybe we're closer to 55% or 60%. And we have a good success rate. With the renewals, that success rate is higher and that's around 75% to 80%

OLIVER: So what kind of individuals does the LRP typically go to? What are the requirements for an application?

MATTHEW: So the eligibility criteria, right, we have five basic eligibility criterias that you have to meet. First is you have to be a US citizen or a permanent resident or a naturalized US citizen. You have to have your doctorate level degree, or equivalent, and so and we do have some exceptions to that rule, for example. Contraception and infertility research program, that category does not require a doctorate level degree, and there are some REACH programs, and some of the ICs don't require a doctorate level degree.

Require a commitment to research for average of 20 hours per week. We -- you have to have a debt that is equivalent or above to 20% of your annual income. Then and the research has to be done -- it has to be at a nonprofit institute.

OLIVER: I understand that there are some myths that you commonly hear about the LRP program. I wonder what the most common ones are and what the real story is.

MATTHEW: Yeah, so I'm laughing because yeah, there are many myths out there, and I can't cover them all. a lot of people think that they have to come to NIH to do the research here and to be eligible to be qualified for that, and that's not the case. Another one would be, I think that they think they have to come up with some new research and that -- you know, the project separate from what they're already doing, and that's not the case as well.

You can use existing research that's already been approved. For example, if you have a K award or a T32 or F30, or even a R01, if you already have that grant approved, you can use that to qualify for the LRP. You don't have to come up with something new, new research programs for the purposes of applying to for that program.

OLIVER: That's interesting, because usually in NIH grants, there's strict rules around overlap, but you're saying that LRP is not subject to that.

MATTHEW: That's right, because we're not funding research activity, per se. We're just paying down the scientist person or the loan debt.

OLIVER: Right, you're helping people stay in academic medicine, rather than funding their research directly.

MATTHEW: That's correct.

OLIVER: Fantastic. Well, thank you very much, Matthew. I'd like to turn now to our other guests we have with us today. Dr. Dionna Williams, an Assistant Professor of Molecular and Comparative Pathobiology at Johns Hopkins, and Dr. Arnethea Sutton, Assistant Professor of Kinesiology and Health Sciences at Virginia Commonwealth University. Welcome.

DIONNA WILLIAMS: Thank you. Happy to be here.

OLIVER: Dr. Williams, I understand that you are an ambassador for the LRP program. Could you tell us what an ambassador does in this program?

DIONNA: Yes, the ambassadors I think are really important kind of points of contact for the LRP, particularly people who are interested in applying. That's most the people that I interact with. They're stationed throughout the whole country, and you can look this up, it's on the website. And people reach out to me to get help with their applications from the very, very beginning stages of thinking up ideas, to seeing if they're eligible for certain criteria, should they go for clinical or health disparities, that kind of thing, to really the nitty-gritty of what loans are eligible, and if I consolidate, does that discount me or, you know, what should I do to prepare the award.

Or I'm coming up for renewal; what did you do to become, you know, successful in getting your renewals? So it really runs the gamut of people contacting me for inquiries. People at my home institution of Hopkins have come up to me, but there are people who I don't even know just who email me from across the country. And I've even had people on social media say, "Hey, I saw your Twitter. I saw you tweet about LRP. Do you want to talk about it with me?" And I'm always happy to do that. So really, my job is to help educate and raise awareness of the LRPs, and ultimately how people receive it successfully.

I even have put on like seminars at my home institution as well just like [inaudible] people to be able to get more information about it.

OLIVER: Thank you very much. Dr. Sutton, I wonder. You participated in the LRP program. Can you tell us a little bit about how that worked and what the impact was on your career?

ARNETHEA SUTTON: Yeah, so I was fortunate enough to get an LRP. I believe the first one I got was in 2018, and that was as a postdoc, and I am currently still funded under it, so I had a two-year award to start out, and then I've had two one-year awards, and I am patiently awaiting to hear about my most recent application for renewal, but it's definitely been like a burden lifted. It's just like, you know, Matt was talking about.

They handle your student loans, and so definitely, as a postdoc, even as a junior faculty, knowing that you don't have to worry about how am I going to pay off my loans, what, you know, what kind of side hustles do I need to do to pay off my loans, like, you can focus on your research and know that that part is taken care of. It's been a tremendous blessing.

OLIVER: So you applied right in while you were still in postdoc?

ARNETHEA: I did. I started my postdoc in 2017, and that's when I first learned about it, and I underestimated that application. So I found out about it, and I said, "Oh, yeah, I'll apply for this." And September applications opened up and I said, "Oh, I got time," and before I knew it, applications closed, and I did not have an application in, and so knowing what the application process took, I went in in 2018, and was successfully funded the following year.

OLIVER: How did you hear about the program?

ARNETHEA: There -- I heard. It's old school. I saw a flyer around our department, and then I asked my PI about it, and she knew about it and gave me more information, but that was prior to -- I don't even think I saw much on Twitter, and I was pretty active on Twitter. Now that's not the case, because you see a large LRP Twitter presence now, but back then, it was just a flyer hanging around.

OLIVER: Well, thank you. Dr. Williams, you've also participated in the program, in addition to being an ambassador. I wonder if you could tell us how it impacted your career.

DIONNA: Yeah, so I applied. I got my first award in 2015, so I began April 2nd, 2014, in September, right when it was opening. And when I interviewed for the postdoc, I asked my mentor, I said, "Okay, I'm going to need time for this thing. Are you okay with that? I hope, you know." And she said sure, she'd support me. And I submitted for November, and I got it on the first try, very, very thankfully. I've renewed since then. One year, I did not get the renewal, and I was like, "Oh, no, should I reapply?"

But I did, and I got them subsequently, and my loans were just paid off this last, like this last summer, so it's been incredibly life-changing at that time, because salaries are much lower than they are now, so I only made I think, like $41,000. I had a lot of extenuating life circumstances, and younger siblings to take care of on that postdoc salary, so it was just not affordable, and it really came to the point where I had to be like, I can't afford to stay here.

I can't. I just can't pay my bills. Like I want to do this, but I'm not able to, and so LRP was been just a huge burden lifted, because that was 500 bucks in my pocket each month, right? -- that I didn't have to pay after the very, very first payment. So it's been outstanding for my life. It's also been really helpful for my career as well and helped me stay competitive in academia. My LRP proposal was not funded.

It was kind of like my side project, and it let my mentor kind of help me get dedicated time for this thing that was unique to her, and that became the base of my K award that I got. And then that K award I came here basis of my R01 that I got, so it really stemmed from the LRP and being able to work on this thing that I was really interested in, but I didn't have training in and my mentor was not working on it. And of course she didn't have funds for that project either, but I think it helped her see like, oh, this something that's important.

It's fundable by the NIH. Yes, you can have this time to work on this, you know, project.

OLIVER: That's fantastic. It's so good to hear that the LRP and then the K award and the R award. That's how we try to support our scientists, investigators. So that's fantastic. Dr. Sutton, I wonder if you were speaking to someone who's thinking about applying for LRP, what advice would you be giving them?

ARNETHEA: The first thing I would say is read that application guide from cover to cover. I think no matter how many times I've applied, I print it out and I read it. It's just like any grant. So, you know, you might think you know it one time, and the next time something will change, and especially with some of the new like, institutes and like categories they have, so it's worth reading it. The other thing I would highly suggest is, you know, if you're on social media, if you even type in LRP, you'll find a ton of people who have it. You'll find individuals who work for NIH who are willing to engage you about what, you know, what it's like, what the process is like, you know, help dispel some of those myths, and so I highly recommend that.

And then, you know, similar to what Dr. William says, I consider myself I guess, a more unofficial ambassador, but I have -- people have reached out to me all the time on social media about the LRP process, if I'm willing to get on a Zoom and talk about it, talk about some of my materials, and I'm always welcome to do that. I'm sure others are, too.

OLIVER: Dr. Williams, I -- you're an ambassador. You're giving advice all the time. What would you add to what Dr. Sutton has already shared with us?

DIONNA: I will totally second reading the instructions because since I first applied to my last renewal, the application process and the website changed substantially, so read the rules. I would say become really well versed with the website. There are so many nuggets and gems on there that people don't realize, like success rates for different institutes. If you're thinking about my work could be, you know, between these two, well, what's the success rate? Be strategic.

Think about and kind of shop around where your grant or your proposal might best fit. And I'd say the other one would be to go for it and not feel like, well, you know, I'm only a brand-new postdoc, or, well, I can, you know, be persistent and wait till I get to become faculty to apply. No, just apply right away. There's no reason to wait. And another thing I would say was I had some people who didn't understand LRP give me well-intentioned, but not good advice, and they told me not to apply because they didn't give funds for your research, and that it wouldn't be quote-unquote counted as [inaudible] grant.

And it is true, it is a contract. It is not a grant, but it's reviewed by NIH-funded investigators because LRP very likely, right, and it's prestigious, and it can still go on your CV, and so there are merits to it. It also helps give you confidence that this is fundable by the NIH and [inaudible] funding, so I'd say don't be discouraged just because it doesn't come with research funds.

OLIVER: Thank you very much, Dr. Williams. Let me turn back to you, Matthew, please. What advice do you give to people about the application process?

MATTHEW: Yeah, so first piece of advice I would give most applicants and I do say this all the time, is you really have to talk with a program officer before you apply. The LRP has 24 different institute centers that participate in this program. Each one of them that I see has their own missions and research priorities, and sometimes the applicant will have some research that might be -- have -- might fit more than one institute center, so I encourage them to talk to the program officers at each institute to really figure out which ones are a good match before you submit your application.

So we do have a list of programs, program officers on our website with their name and their contact information, emails and stuff like that. So and I always encourage the applicant to talk with them, the program officers first.

OLIVER: Thank you very much. I want to thank all of you for joining us today to talk about LRP. As always, we have lots of links and information on our show notes, so people can click through to the LRP website and also Dr. Sutton and Dr. Williams's pages on their respective universities, and I'm sure there's ways to contact them and also on social media. So thank you very much to our guests.

ARNETHEA: Thank you for having me.

DIONNA: Yes. Thank you again. It's been great being here.

MATTHEW: And thank you, yes.

[UPBEAT MUSIC]

OLIVER: And now, now it's time for a segment we call Your Turn, because it's a chance for our listeners to send in a recommendation that they would like to share. If you're listening, then you're invited to take your turn. Send us a tip for a book, a video, a podcast, or a talk that you found inspirational or amusing or interesting.

You can send these to us at [email protected]. Record a voice memo and send it along. We may just play it in an upcoming episode. Now I'd like to invite Dr. Schwörer to take his turn.

SIMON: Thank you. And can I also share multiple things?

OLIVER: Of course. Please. Yes.

SIMON: Great. So an immediate recommendation that is tangible. I liked reading recently the book Getting Things Done - people know about it. That was recommended to me by another recent new PI and it has helped me getting my time management in place and getting things a bit better organized. Although I learned that I did already many things that were suggested.

But you know, you can always improve. So that was a good recommendation. And then I think what I can also recommend is – we talked earlier about academic review and recommendations there. You know, have some good hobbies and recommendations and things to do outside the lab. Have a pet. I have a cat. I love my cat. And I always forget about anything else when I cuddle and play with her.

So it's great having hobbies like running. That's what I do. Cooking helps me calm down after a long day at work. You know? Just have some fun outside the lab as well.

OLIVER: Thank you for that. That's. Yeah, I think I can only agree with that. Thank you. I'd like to make a recommendation as well. It's a podcast, the Cancer History podcast. It's part of the Cancer History project itself. An interesting resource documenting the fight against cancer since the 1970s. In the February 3rd episode of the podcast, Dr. Otis Brawley, a Bloomberg distinguished professor at Johns Hopkins, holds a conversation with Dr. Robert Winn, the director of the Massey Cancer Center at Virginia Commonwealth University.

They're talking about the killing of Tyree Nichols and the power dynamics in policing in health care. A compelling listen from two leaders in cancer who have generously shared their own experiences regarding race and hold a frank conversation on where we are and where we need to go.

[UPBEAT MUSIC]

OLIVER: That's all we have time for on today's episode of Inside Cancer Careers! Thank you for joining us and thank you to our guests.

We want to hear from you – your stories, your ideas and your feedback are always welcome. And you are invited to take your turn to make a recommendation we can share with our listeners. You can reach us at [email protected].

Inside Cancer Careers is a collaboration between NCI's Office of Communications and Public Liaison and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar A special thanks to Lakshmi Grama and Sabrina Islam-Rahman.

Join us every first and third Thursday of the month when new episodes can be found wherever you listen – subscribe so you won't miss an episode. I'm your host Oliver Bogler from the National Cancer Institute and I look forward to sharing your stories here on Inside Cancer Careers.

If you have questions about cancer or comments about this podcast, email us at [email protected] or call us at 800-422-6237. And please be sure to mention Inside Cancer Careers in your query.

We are a production of the U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Thanks for listening.