physician scientist 醫生科學家 immunology research center shie-liang, edmond, hsieh...

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 near-eradication of polio.

The cures for childhood leukemia, Hodgkin disease, and testicular cancer.

The development of open-heart surgery, of organ and bone-marrow transplantation

Approaches to decrease mortality after heart attacks and strokes.

The Nobel Prize in Physiology or Medicine 1962

for their discoveries concerning the molecular structure of nucleic acids and its significance for information transfer in living material“

Francis Harry Compton Crick

James DeweyWatson

Maurice HughFrederick Wilkins

Genomic Aspirations

Molecular and Post-genomic Medicine– To apply the enormous genomic

information and newly developed cutting-edge 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

Gene expression profile of cancer vs non-cancer 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 Powerfor 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

• 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 WyngaardenThe 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

10-12 ‘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 SchoolsA 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

第二屆陽明校友

鄭宏志 : Karolinska, Sweden 謝仁俊 : Karolinska, Sweden 李丞華 : John Hopkins

第三屆陽明校友

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