Transcript Physician Scientist 醫生科學家 Dr.James B. Wyngaarden, Director of the National Institutes of Health

Physician Scientist
醫生科學家
Immunology Research Center
Shie-Liang, Edmond, Hsieh
免疫學研究中心
謝世良 主任
Dr.James B. Wyngaarden, Director of the National
Institutes of Health (April 29,1982-July 31,1989)
Sir Hans Sloane
(1660-1753)
In his long life, the noted physician, scientist and
collector Sir Hans Sloane amassed one of the greatest
collections of plants, animals, antiquities, coins and many
other objects of his time. It was to be the founding core of
the British Museum and later The Natural History Museum.
Who are physician-scientists, and why do
we need them?
They are individuals with medical training
who spend most or all of their time engaged in
basic, disease-oriented or patient-oriented
research.
 Physician Scientist

– MD program
– MD, PhD Program
Contribution of Physician Scientist
in the Past

The eradication of smallpox and the neareradication of polio.
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The cures for childhood leukemia, Hodgkin
disease, and testicular cancer.
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The development of open-heart surgery, of organ
and bone-marrow transplantation
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Approaches to decrease mortality after heart
attacks and strokes.
The Nobel Prize in Physiology or Medicine 1962
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for their discoveries concerning the molecular
structure of nucleic acids and its significance for
information transfer in living material“
Francis Harry
Compton Crick
James Dewey
Watson
Maurice Hugh
Frederick Wilkins
Genomic Aspirations

Molecular and Post-genomic Medicine
– To apply the enormous genomic
information and newly developed cuttingedge technology for disease diagnosis,
prevention and treatment
Science as a Way of Life:
Perplexities of a Physician-Scientist

New diagnosis
– Single genetic mutation:
– Multiple genetic mutations
• Cancer
• Brain diseases: Alzheimer’s disease
• Cardiovascular diseases:lipid lowering drugs
• Metabolic diseases
• Diabetes Mellitus (DM)
Amplification of Minute Amounts of DNA

Amplification of DNA from a drop of blood or
a hair
– Genetic Fingerprinting
– Sex determination
– Diagnosis of gene defects
– Single nucleotide polymorphism (SNP)
– Gene cloning and Human Cloning
High Throughput Screening of Gene
Expression
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Gene expression profile of cancer vs noncancer cells
– Identification of oncogenes
– Identification of tumor suppressor gene
 Gene expression profile in response to SARS
– Identification of virus resistant genes
– Identification of disease susceptible genes
Science as a Way of Life:
Perplexities of a Physician-Scientist

New Treatment
– Gene Therapy
– Immunotherapy
– Stem Cell Therapy
Immunotherapy
Computing Power
for Medicine

10,000 drugs
 More than 100,000 diseases and conditions
 Thousands of guidelines
 Millions of rules
The clinical symptoms can be converted into
machine language to get answers to the most
complex medical questions in real time and
without physician effort.
Automated Doctor Machine (ADM)
vs
Automated Teller Machine (ATM)
Why do we need
the Physician Scientist Program?

Physician who does not only
– Apply well-known knowledge for medicare
– But also apply advanced new technology
to develop new methods for medical
• Diagnosis
• Treatment
• Disease Prevention
• New discovery
Is our training program
competitive?
Classical Courses for Medical Doctors

1st Year:
– Biology, Chemistry (General & Organic)

2nd Year
– Histology, Anatomy, Biochemistry

3rd Year
– Microbiology and Immunology
– Physiology, Pathology

4nd Year
– Parasitology, Pharmacology, Genetics

5th Year
– Clinical Courses
Classical Courses for Medical Doctors
(New Curriculum)

1st Year:
– Biology, Chemistry (General & Organic)

2nd Year
– Biochemistry, Cell Biology

3rd to 5th Years: PBL
– Microbiology and Immunology
– Physiology, Pathology
– Parasitology
– Pharmacology
– Genetics
– Other clinical courses
Conventional Medical Training

What they offer?
– The ability to implement current medical
knowledge for medical diagnosis and
treatment of patients

What they do not offer?
– The ability for use modern biomedical
technology to renovate or create new
approaches for Medicare.
PhD (Dr. of Philosophy) Program

Lectures
– Molecular Biology
– Genomics, Proteomics, Bioinformatics
– Methodology
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Recombinant DNA Technology
Polymerase Chain Reaction (PCR)
Real-time PCR
DNA Microarray
Protein Chips
Flow Cytometry
Others
Logical Approaches
PhD (Dr. of Philosophy) Program

Seminar
– Paper reading and Presentation

Laboratory Experiences
– Perform experiments independently
– Figure out new hypothesis
– Explore un-discovered disciples
The Goals of PhD Program
The ability and experience to use the
advanced knowledge and technology
for investigation.
 The ability to design and perform
experiments independently.
 The ability to implement their idea.

Why should we care?
Knowledge is Power
NIH director James Wyngaarden
The clinical investigator as an endangered species

if medical schools drift so far away from science...
that the students more and more see the research
as irrelevant to medicine as they wish to practise it.

if MDs do not stay in the world of clinical
research, their place will be taken by welltrained
PhD scientists.
Initiatives launched

Mayo Clinic Training programme supporting 1012 ‘residents’ each year, with 2 years experiences
in a clinical research lab.

It is essential to engage students in science while they
are still in medical school and thinking about careers.
Number of NIH Principal Investigators in
Medical School Department
Number of faculties in medical school departments
Comparison of NIH charted review panel
Where have all the young girls go?
By NANCY C. ANDREWS
Director of Harvard-MIT MD-PhD Program
1. childbearing and family life.
2. have to be better than their male
counterparts to be considered equal.
3. women receive very little encouragement to
become physician-scientists.
4. lack compelling role models.
In Some Medical Schools
A career in research in not actively promoted or held
in such high guard.
Physician Scientist Program in YM
在已有的醫學課程外，增加醫學生選修
實驗課程。
 從大一升大二暑假開始，設置獎學金，
共10名，至陽明大學專任老師實驗室從
事研究工作。採取申請作業方式，經委
員審核後通過，計畫結束後，於開學一
個半月，提出成果報告。

Physician Scientist Program in YM

從大二上開始，增加醫學生選修實驗課
程，最高上限共可修選六次(1~6)，從大
二到大四為止，每學期一學分。

(4)有意攻讀博士者，可在大四結束進入
臨床前，允許報考研究所攻讀碩士、博
士，待畢業後，再繼續臨床研究。
第一屆陽明校友
陳宜民: Harvard
 鄭明媛: Yale
 黃自強: John Hopkins
 郭旭嵩: Yale
 張宏仁: Harvard
 陳俊忠
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第二屆陽明校友
鄭宏志: Karolinska, Sweden
 謝仁俊: Karolinska, Sweden
 李丞華: John Hopkins
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第三屆陽明校友
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宋晏仁: Cornell
謝世良: Oxford/Stanford
周德盈: John Hopkins
蔡果荃: John Hopkins/MGH
黃怡超: Glasgow
張武修: Harvard
李芬瑤: UCLA
瞿光裕:UCLA