Best of Both Worlds

Entering the world of pediatric hematology as a foreign medical graduate (FMG) has been challenging, but now that I'm here, I'm soaking it all in. Through my training, I have had the opportunity to learn from mentors in two different worlds — through clinical work at Children's National Hospital and by undertaking the research aspect of my fellowship at the National Institutes of Health (NIH). This offers me the opportunity to develop my skills as a physician scientist. The contrast between the two experiences is striking yet surprisingly complementary.

On the clinical front, the care is at the forefront of modern hematology, and it was my exposure as a visiting resident on the bone marrow transplant (BMT) service that piqued my interest in curative therapy for hemoglobinopathies. This experience involved caring for patients with sickle cell disease (SCD) undergoing allogeneic hematopoietic stem cell transplant for the first time — an experience that has resonated with me ever since. Fast-forward three years and I've had the privilege of witnessing the first pediatric patient receive a clinically approved gene therapy product for SCD, an experience that underscores the rapid evolution of our field.

Now, as a fellow at this institution, I have been able to work with many mentors who help me become a better clinician with each interaction. I have been able to focus on my interests by caring for unique patients while also gaining diverse exposure to the world of hematology/oncology and BMT. Treating international patients has expanded my perspective, allowing me to manage diseases rarely seen in the United States. With the support of my clinical mentors, I became involved with the American Society of Hematology through its Trainee Council, an enriching experience that deepens my passion for trainee education in hematology and presents new challenges at every turn.

During my first year of fellowship, I had the opportunity to meet with various principal investigators from NIH to find the right fit for my research interests, which have long centered on hemoglobinopathies. I decided it was important for me to gain bench lab experience given my lack of exposure thus far. While I was obtaining significant clinical exposure, it was difficult to fully comprehend certain therapies and clinical trials without understanding them from the ground up. After my initial meeting with John Tisdale, MD, senior investigator and director of cellular and molecular therapeutics at NIH’s National Heart, Lung, and Blood Institute, I was certain that his lab was where I could achieve my goals. Having never worked in basic science research before, I knew I needed a lot of patience and support to get my research started. Thankfully, I found exactly that in a lab full of supportive researchers. With the help of Dr. Tisdale’s mentorship and his lab team, I have grown significantly and eagerly anticipate what more I can learn.

Being able to work on projects focused on curative therapies in SCD, particularly on preclinical work on innovative gene therapies, has been incredibly rewarding and affirms my interests further on a daily basis. By understanding the nuances involved in the development of gene therapy products, I am now better able to understand the process from bench to bedside. It is also via NIH that I have had the chance to learn more about clinical research through the NIH-Duke Clinical Research Training Program, which walks students through clinical research methodologies through hands-on projects.

Collectively, these experiences in parallel have been transformative to my training, with time in each world pushing me to progress in the other. A common interview question is, "Where do you see yourself in five years?" While I never anticipated being here five years ago, there’s certainly nowhere else I’d rather be. I look forward to progressing towards a fellowship in bone marrow transplantation and cellular therapies in the coming years, and I am excited for the journey ahead and the opportunities that await.

Dr. Butt indicated no relevant conflicts of interests.

Acknowledgment: This article was edited by Drs. WIliam Nicol and Lawrence Boise.