From Mark Levine, the doc with the pink tights
At the heart of our BRIGHT Run enterprise is the notion that research improves the lives of patients with breast cancer. You might wonder, “what is needed to conduct successful research?” The simple answer is, “a scientist with a good question.”
To me, a good question is one that will have an impact on patient treatment and care. This could involve research in the laboratory or the clinic. Examples of good questions in the lab are: research that explains why a drug works or does not work; or research that provides insights on new mechanisms for killing cancer cells. In the clinic there are lots of relevant questions that can be addressed in clinical studies (also called clinical trials). Examples are: how to improve the management of pain? How to identify patient groups where treatments can be avoided?
In addition to the question, there are other important factors that facilitate research. There must be resources, i.e. money to pay for the equipment, laboratory supplies and animals in laboratory studies and for staff to collect, manage and analyze the data in clinical trials. In addition, there should also be a supportive environment where research is a priority, e.g. the cancer centre. This helps reduce barriers.
Today, I want to emphasize that research starts with people. Each week I spend several hours helping young people with their research projects. This involves marking up their work with lots of red ink or the track function on the computer. Some of the young people I work with spend most of their time in clinic seeing patients and they have an interest in conducting perhaps one or two studies. At the other end of the spectrum are the young people who desire to spend a day or two in clinic and the remainder of their time doing research. Our system needs both kinds of people working together. Although I help both types of researchers, my goal is to produce the research leaders of tomorrow, so I spend lots of time with the latter group.
What are the components needed to potentially develop into an independent researcher with his/her own research program? First, mentorship. It is critical that there be a mentor who spends time helping identify the most important questions and helping write grants and manuscripts. Mentorship does not stop after one or two years; a mentor continues to foster the career of the mentee, often for a decade or more. At some point, the mentee will have established themselves as a successful researcher and they in turn become a mentor for the next generation of researcher.
Second, a critical mass of likeminded individuals is needed. To learn or conduct research as an independent person not surrounded by other researchers of like mind is a recipe for failure. Having a group to discuss research is key.
Third, a passion or burning desire to succeed on behalf the researcher is required. The final component is hard work. The young researcher must prioritize research in their busy lives. Unfortunately, sometimes this comes at the expense of family and patients.
When I think of my own career, I was very fortunate to have had two mentors who worked with me. They helped me identify questions, prepare grant applications and write manuscripts. They taught me how to write (something which most people do not learn in high school and university). Even though I was already an Assistant Professor, I served an apprenticeship for at least 10 years. My mentors only accepted excellence. They instilled this in me, sometimes with “tough love.”
In time, I gradually became a successful researcher and functioned independently. I soon continued the cycle by becoming a mentor to the next generation of researchers. I would be remiss in not acknowledging my wife and family, who supported me. They frequently received less attention because I was writing a grant with a deadline or revising a manuscript.
I often wonder why or how my mentors selected me for future development. I am not sure, but I think they had their antennas out for someone with potential and who had a flame in their belly to succeed. It was sort of a gut feeling. There is no doubt that a chemistry develops between a mentor and mentee.
In recent years there are fewer clinicians who are interested in research. The reasons why are complex but certainly less priority is being given to research in university and hospital settings. This troubles me. The current big challenge is that there are increasing clinical demands being placed on physician researchers, with less protected time to do research.
In my next column, I will share the story of one of my mentees who has become an internationally acclaimed researcher in breast cancer. A real star!