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September 24, 2020 by Diego Avella Patino

Broadening the Spectrum of Surgeons with an Interest in Basic Science

It seems only fitting that in celebration of Hispanic Heritage Month, as the liaison to the Association of Academic Surgery from the Latino Surgical Society, I should lend my voice to the growing call for increased diversity in surgery, specifically with respect to an academic career that combines surgery and basic science research. It has been reported that Latinos account for at least 18% of the population of the United States, and the numbers are growing.

Still, less than 6% of all physicians in the United States identify themselves as Latino. This does not come close to reflecting the percentage of the population of the United States attributable to Latinos. Even fewer surgeons are Latino, and many less are surgeon-scientists with an interest in basic science.

I am a Latino surgeon-scientist with a clinical practice focusing on cardiothoracic surgery combined with research in tumor immunology and genetics. I emigrated to the United States just over 15 years ago from Colombia.

When I completed medical school, as is the case in many countries outside of the United States, the infrastructure to support a career in basic science research in Colombia was very underdeveloped. A pathway for a surgical career that combined a clinical practice with academic development focused on basic science research was essentially nonexistent.

However, I was fortunate to secure a postdoctoral fellowship in cancer immunology in the United States. The four years that I spent in the lab were life-changing in so far as I gained important skills, knowledge, and a passion for research.

Following that fellowship, I continued with training in general surgery and a fellowship in cardiothoracic surgery. I am now in my first faculty position, three years out of training. Not surprisingly, there are not many Latino surgeon scientists, and even fewer with an interest in basic science research. Though I do not assume to have it all figured it out, from my own experience navigating this pathway, a few things stand out as crucial pieces that I believe will be universally important if we are to continue to grow representation among surgeon scientists from underrepresented minorities.

Building a Passion: Medical training exposes young, future physicians to many areas of basic science. However, that knowledge, for the most part, is broad and not very specific. Therefore, to have a successful career in basic science research, physicians will generally need to go beyond the basic medical training to gain expertise in new technologies and a deeper understanding of the particular field of science to which he or she is interested in pursuing.

Early investment in research is key. Young, future physicians should be encouraged early to become involved in research by volunteering in labs while in medical school. At a minimum, this will introduce students to what research entails. Of course, there are many impediments to this, not the least of which is knowing that such opportunities exist.

It has been my experience that people who try to find their “passion” from a book or based on what someone else believes about a certain field or because some profession is considered more prestigious than another, often find themselves later in life wondering why they entered the field or feeling burned out and disappointed. On the other hand, people who experience something first hand can develop a passion that is long-lasting and indelible.

That is why it is so important for young, future physicians to get into the lab and see what doing research is really all about, and we must create these opportunities for them. Finding a passion that is lasting is not a directive you can give yourself – it is the result of trying something and learning over time that you are good at it or can be good at it, and then devoting yourself to gaining expertise. You can develop your “passion.” But it starts with access and opportunity.

Language of Science: I think that sometimes the first barrier to entry into the field of basic science is the language itself. And I’m not referring to the English language. Instead, science has a language unto itself, separate and apart from everyday English.

As a native Spanish speaker with limited English when I arrived in the United States, my first experience in the lab involved more than improving my English. It was also about learning the language of science. This can be intimidating, but I challenge young, future physicians to embrace the challenge. In fact, something I realized was that the language of science connects people, regardless of gender, race, background, or ethnicity. If one is able to master the technical language of his or her area of interest in science, he or she will be privy to a whole host of experiences and possibilities, as well as relationships. I learned to communicate and build partnerships through science, a language that I had initially been introduced to in medical school and that I was able to build upon and improve. Indeed, the technical language of science has, for me, continued to be a way to forge a sense of community.

We need to encourage young, future physicians, especially those from underrepresented minorities, to put themselves out there to gain new experiences in basic science early in their careers and to really embrace how learning the technical language of science can create bonds and ties not otherwise formed with other physicians and scientists.

Mentorship: Difficult to define, mentoring – the relationship that can be forged with a mentor, if one is so fortunate – is often a crucial step in a pathway that includes basic science research.

The attributes so often espoused as important in a mentor – being a good listener, being knowledgeable in the field, being able to value the mentee’s opinion while giving a broader perspective based on experience, providing constructive feedback and advice, etc. – are foundational and desirable from the standpoint of any mentee. However, as a mentor, the list seems daunting.

Oftentimes, no one person can act as a mentor in all aspects of a mentee’s career. And that is ok. It is important to understand (from both the standpoint of the mentor and the mentee) that the relationship does not need to encompass all aspects or all periods of a mentee’s career. Indeed, mentees should seek out more than one mentor and be continually looking to forge new relationships that can turn into mentor/mentee relationships.

While as a Latino, I sometimes wish that I could find a mentor with an ethnic background similar to my own, that can be limiting, particularly since there are so few Latino surgeons who do basic science research. I have learned over time, though, that this impediment should not be a barrier to finding help and mentorship.

Instead, finding a mentor who has some genuine connection and/or perhaps even similar values is enough. What is most important is to find someone who is invested in you, as a mentee, for the long run. While that person may not mentor you your whole career, his or her outlook and advice should be given with the perspective of your full career in mind. It is incumbent on each of us, as surgeons, to volunteer and reach out to young, future physicians to build these relationships.

In conclusion, if you see young, future physicians that have even a minimum interest in basic science, encourage them to cultivate that interest because through that cultivation, they may build a passion for research. Indeed, I believe that if a person has what it takes to be a surgeon, he or she has what it takes to be a scientist.  The same principles of hard work, creativity, resilience, and discipline apply in both.

 

September 15 to October 15 is National Hispanic Heritage Month – for more information and events, hispanicheritagemonth.gov

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Diego Avella Patino

Dr. Avella is an Assistant Professor of Surgery at the University of Missouri. He is a cardiothoracic surgeon and tumor immunology researcher. His clinical practice focuses on thoracic surgery and thoracic oncology. Dr. Avella's research concentrates on cancer immunology and the epigenetic regulation of the anti-tumor immune response, T cell exhaustion, and immunotherapy. He has accumulated a significant amount of experience in the development of animal models for cancer. Dr. Avella graduated from the Universidad el Bosque in Colombia. He did a postdoctoral fellowship at Penn State University in cancer immunology. Thereafter, he completed his surgical residency training at Penn State and a fellowship in cardiothoracic surgery at the University of Chicago. Dr. Avella is also interested in furthering diversity and inclusion in surgery. He sits on the Committee for Diversity at the University of Missouri School of Medicine and is the liaison to the Association of Academic Surgery from the Latino Surgical Society. Dr. Avella lives in Columbia with his wife, Laura, and their golden retriever, Noelle.

Latest posts by Diego Avella Patino (see all)

  • Broadening the Spectrum of Surgeons with an Interest in Basic Science - September 24, 2020

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