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Schooling Surgeon Scientists
Florida Physician
UF College of Medicine Alumni Magazine
Summer 2008
Schooling. Solving. Suturing. All start with ‘s’ but there is another common
thread if you consider these words in the context of the University of
Florida’s General Surgery Residency Training Program. When woven together,
the result is the next generation of leading academic surgeons.
Taking research training of its surgical residents to the next level, the UF
department of surgery encourages the pursuit of an additional doctorate
degree, and as a result, this year, two general surgery residents, Matthew
J. Delano, M.D., and Darrell L. Hunt, M.D., added another degree to their
title -- Ph.D.
Lyle L. Moldawer, Ph.D., professor and vice chairman of research for the
department of surgery, said the UF program, which is offered in conjunction
with the College of Medicine’s Interdisciplinary Program in Biomedical
Sciences, is unique for a couple of reasons. Through the program surgical
residents take at least three years off from their general surgery residency
training to focus on research.
“The general surgery residency program is a clinical program that starts
with an M.D. and makes a surgeon out of him or her,” Moldawer said. “We have
a program that produces not only outstanding surgeons, but surgeons who are
trained in answering the theoretical questions about surgery and surgery
research.”
He added, “We believe that a combined knowledge of the scientific method and
surgery makes a better surgeon, and also trains a small and unique cadre who
are capable of translating research from the bench to the bedside, and
moving the field forward. These will be the future academic leaders in
surgery.”
A research component in surgical training is not unique; many programs, as
does UF, offer an opportunity to spend one or two years in a laboratory
conducting research. At UF, traditionally this opportunity is available to
any of the five residents in each training class who have the interest.
Fostering the pursuit of a doctorate of philosophy is, however, rare for
surgery departments.
“There are very few surgical residency programs that incorporate a combined
clinical training and Ph.D. degree-track research program,” Moldawer said.
“Several offer M.S. or M.P.H. degrees, but very few surgery programs offer a
terminal research degree like UF. It takes a major commitment not only from
the department of surgery, but also from the Interdisciplinary Program in
Biomedical Sciences to support the research education of these residents.”
Delano successfully defended his dissertation in March and graduated in May.
His research focuses on inflammation’s role in the development of sepsis. He
was the first to describe the involvement of myeloid derived suppressor
cells in sepsis, a newly discovered population of cells which regulate the
body’s immune system response to insults, such as surgery or infection.
“We are trying to understand what roles these cells play in sepsis, and
whether they are a potential target for therapy,” said Delano, who will
spend an additional year working in the department’s Laboratory of
Inflammation Biology and Surgical Science before returning to the operating
room. “Depleting these cells may potentiate survival to an infectious
challenge.”
Delano, who plans to pursue a career in trauma or cardiothoracic surgery,
said he specifically likes the idea of practicing medicine and actually
trying to do research that solves some of the problems one sees in clinic.
“As a surgeon it would be nice to identify a clinical problem…and then go
solve that problem from a basic science standpoint,” he added.
Hunt successfully defended his dissertation in May and officially graduates
in August. His research centers on breast cancer and what makes cells grow
out of control and metastasize.
While working in the laboratory of surgical oncology professor William G.
Cance, M.D., Hunt examined the relationship between a protein called focal
adhesion kinase, or FAK, and vascular endothelial growth factor receptor 3,
or VEGFR-3. Working closely with research assistant professor Elena Kurenova,
Ph.D., Hunt’s investigations first defined the role of VEGFR-3 in promoting
growth and survival of breast cancer cells and then, for the first time,
showed in an in vivo model that overexpression of VEGFR-3 promotes tumor
growth. He then proved, in mice, that a small molecule disrupting the
interaction between FAK and VEGFR-3 suppresses breast cancer tumor growth.
As far as his interest in science and medicine, Hunt says he feels his
purpose is to help people maximize their potential and that this cannot be
done in the setting of disease.
“If you know you have cancer, it’s going to interfere with what you are able
to do,” said Hunt, who plans to be a surgical oncologist. “So for me,
fighting against disease is my way of helping others maximize their human
potential.”
Support for the training of these surgical residents as scientists comes
from the National Institute of General Medical Sciences’ Ruth L. Kirschstein
and the National Cancer Institute’s National Research Service Award training
grants.
General surgery residency program director Kevin E. Behrns, M.D., said it is
quite an honor that the department has two National Institutes of Health
research training awards through the research laboratories directed by Cance
and Moldawer.
“These awards help make our training program unique in that two trainees per
year can enter a basic science laboratory and immerse themselves in
important basic science and clinical questions,” said Behrns, who also
serves as interim chair of the department of surgery and chief of general
surgery.
In 2005, Priscilla F. McAuliffe, M.D., Ph.D., was the first UF surgical
resident to earn her research doctorate degree during residency training.
McAuliffe, whose research centered on inflammation and vascular injury, is
completing her general surgery residency this year and will begin an
advanced fellowship this fall at M.D. Anderson Cancer Center in Houston.
This summer Alex G. Cuenca, M.D., entered the graduate program as the fourth
surgery resident to matriculate into the Ph.D. program.
Moldawer said the common model is to have an M.D./Ph.D. program where
students earn both degrees during their medical school training.
“We think our approach may be more advantageous for the student who has
already expressed an interest in surgery, and wants to be trained to ask
surgically relevant questions,” Moldawer said. “By delaying the Ph.D.
training until the student has had some surgery experience and is committed
to a career in surgery, we can focus more effectively on the research
training’s relevance to surgery.
We create a better translational scientist because training is focused on
issues more relevant to their clinical practice, he said.
One more ‘s’ word to tie into the knot – Success.
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