March 25, 2021

The making of a modern clinician-scientist: Merging data science with medicine to produce graduates on the cutting edge of medical research

By brit

The human body is like a computer in many ways. For example, much like storage in a computer, cells contain a vast amount of information. The difference lies in how the information is stored. Where on a computer these data are saved as electrical charges on flash memory chips, human data are stored in the form of DNA, which then makes the proteins we are made of.

In the trillions of cells that make up every human being, the amount of available data is overwhelming. Hidden deep inside is the key to unlocking valuable information that could lead to the successful treatment of a patient, the development of a needed vaccine, or even a revolution in the way diseases are currently classified.

And that is where the clinician-scientist comes in. The “modern” clinician-scientist is a clinician equipped with skills in data science and its related fields, capable of processing these colossal amounts of biological data and translating it into tangible medical outcomes.

With the sheer amount of data generated through modern medical research, and the realisation of the game-changing role clinician-scientists play at the medical forefront today, the demand for the profession has skyrocketed.

It should thus come as no surprise that Duke-NUS’ Centre for Computational Biology has seen an all-time-high number of applicants to its PhD programmes in Quantitative Biology and Medicine and Integrated Biology and Medicine.

About 25 per cent of Duke-NUS’ PhD students are currently enrolled in the school’s MD-PhD double degree programme that integrates medical and research training, and for good reason – it is the only fully-integrated programme of its kind in Singapore.

With its dual focus on both laboratory research and medical practice, the MD-PhD programme offers a uniquely interdisciplinary approach that attracts prospective clinician-scientists from a multitude of different backgrounds.

There is no one archetypical MD-PhD student. Take for example Mr Gabriel Chew, 30, now a sixth-year student, who studied biomedical engineering on the A*STAR Scholarship at Johns Hopkins University before spending a year at A*STAR to work on brain-computer interfaces and decoding neural signals prior to joining the MD-PhD track.

Similarly, third-year student Mr Kevin Yu, 26, also read biomedical engineering at Johns Hopkins University, but chose instead to go into cancer and genomics research for a year prior to matriculation at Duke-NUS.

Yet another different approach was taken by eighth-year student Dr Liu Shiyang, 30, who majored at biological sciences in Nanyang Technological University before going straight into the MD-PhD programme upon graduation.

A close-knit community of knowledge

With each student bringing a unique set of skills to the table, the opportunities for collaborative research are boundless, particularly under Duke-NUS’ collaborative TeamLEAD pedagogical approach.

TeamLEAD, which stands for Learn, Engage and Develop, is a team-based learning platform that puts students in charge of facilitating not just their own learning, but that of their peers as well.

Unlike a traditional medical education where lectures make up most of the learning process, student-led seminar discussions take centre stage in TeamLEAD, along with group-based critical problem solving.

“The unique TeamLEAD medical education programme, cutting-edge and collaborative research culture, dedicated faculty members and inspiring fellow students were what drew me to Duke-NUS,” Dr Liu says.

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Dr Liu Shiyang’s research into long non-coding RNAs in the development of pancreatic cancer required mentorship from both the computational biology and cancer biology departments – a non-issue thanks to Duke-NUS’ diverse faculty. PHOTO: WEE TY

And speaking of cutting-edge research, students are given free rein to explore a myriad of different areas of research, thanks to the support of the Centre for Computational Biology’s faculty, whose expertise spans the entire gamut of medical knowledge.

For instance, Dr Liu’s research on the role of long non-coding RNAs in pancreatic cancer required him to use both computational tools and experimental methods – two very different approaches.

“Having mentors from both computational biology and cancer biology greatly helped and guided me through various difficulties I faced during my research,” he says.

For students undertaking an MD-PhD programme, strong faculty support is indispensable. Unlike undergraduate programmes, PhD programmes are characterised by their flexibility and the autonomy afforded to candidates. From inception to completion of their PhD thesis, students alone are responsible for the planning, design and execution of their own projects.

“Ultimately, you are the only one there to make your project happen,” says Mr Yu. “If it doesn’t, you don’t graduate.”

While, like many of his peers, Mr Yu was at first unsure of what area of research to focus on, the consultative process with his mentor led him to settle on studying a particular gene’s role in the development of scar tissue in the lungs using cutting-edge computational Systems Biology approaches.

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Mr Kevin Yu’s eventual focus on pulmonary scar tissue formation was a process guided closely by mentorship from Duke-NUS faculty. PHOTO: WEE TY

“I am grateful for my mentor’s understanding and support throughout the whole process,” he finishes.

But the relative newness of the clinician-scientist role makes mentorship all the more important.

“Given the niche nature of the clinician-scientist pathway and the unique scientific training of each trainee, the faculty’s guidance with regards to career development has been quite vital,” says Mr Chew.

From lab to ward

The primary role of a clinician-scientist is to put research into practice – to bridge the “translational gap” between research and clinical implementation.

Duke-NUS offers its students a vast number of opportunities to do so, thanks to an increasing number of collaborations with Singapore General Hospital and Duke University in the United States – even allowing its students to spend a portion of their PhD studies at Duke.

“The Programme distinguishes itself from others in Singapore and abroad by emphasising training in translational bioscience and health services, and preparing our graduates to take their research findings from ‘bench to bedside’ and back,” says Dr Ong Sin Tiong, director of the MD-PhD Programme.

“Such training equips our graduates with an intimate understanding of unmet medical needs with the ability to use the scientific approach to address those needs. Over time, we anticipate that our graduates will contribute significantly to the local biomedical research landscape, and translate their discoveries toward positive outcomes for patients in Singapore and beyond.”

This “bench to bedside” approach ensures that the “clinician” aspect of the clinician-scientist does not go overlooked.

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The MD-PhD Programme at Duke-NUS prides itself on keeping its clinician-scientists sharp with ample opportunities for clinical practice, as Mr Gabriel Chew, can attest. PHOTO: WEE TY

Upon completion of his second year of MD study, Mr Chew found himself concerned with keeping his clinical skills sharp as he began his PhD research into Alzheimer’s disease – but quickly found his fears allayed.

“The programme, in close partnership with the Graduate Medical Education Office as well as Clinical Departments at SingHealth, has been instrumental in providing opportunities for me to revisit my clinical skills through tutorials and clinical preceptorships during my PhD years,” he says.

So when it comes time to embark on his clinical rotations in his final year, Mr Chew knows he will be ready for the challenges that lie ahead – and as newly-minted clinician-scientists, he and his colleagues hope to revolutionise the medical field.

“The explosion of data in recent decades is a treasure trove of discoveries waiting to be uncovered,” he says. “These are discoveries which can really make an impact in the lives of patients and their families.”

“These data contain limitless opportunity to better understand diseases and ultimately improve healthcare,” agrees Mr Yu. “I hope my research could eventually lead to the improvement of the current standard of care.”