Abin Abraham
May 5, 2016
Posted in Alumni Profiles

Fessel_Joshua faculty photo_0.jpeg

Joshua P. Fessel, Ph.D., M.D.               

Assistant Professor of Medicine           

Assistant Professor of Pharmacology   

Assistant Professor of Cancer Biology 

 

M.D., Medicine, Vanderbilt University   

Ph.D., Pharmacology, Vanderbilt University

 

Dr. Joshua Fessel graduated from the Vanderbilt MSTP in 2006 as the Founder’s Medal

winner for the School of Medicine. He is currently an Assistant Professor within the

Division of Allergy, Pulmonary and Critical Care Medicine at Vanderbilt University with

appointments in Medicine, Pharmacology, and Cancer Biology. As a physician-scientist,

Dr. Fessel splits his time between 20-25% clinical and 75-80% research. To date, he

equally weights the discovery of isofurans and his work to help build the mitochondrial

science community at Vanderbilt as his most important scientific endeavors thus far. His

laboratory investigates redox biology and molecular metabolism with a focus on a

variety of different disease models, most notably pulmonary arterial hypertension.

Closing the gap between the bench and bedside, Dr. Fessel attends in the medical

intensive care unit and on the pulmonary consultation service eight weeks per year and

serves in a general pulmonary outpatient clinic.

 

A short biography of Dr. Joshua Fessel’s professional experiences.

Dr. Joshua Fessel began the MSTP at Vanderbilt in 1999. During his first year of

medical school, Dr. Fessel rotated with Dr. Jack Roberts, the Williams Stokes Professor

of Experimental Therapeutics and an internationally renowned investigator in the field of

redox biology. Following an unconventional path, Dr. Fessel decided to start graduate

school at the end of his first lab rotation. He studied free radical lipid biochemistry and

discovered isofurans, a class of oxidation products formed from free radical induced

peroxidation of arachidonic acid. After his graduate training, he finished the remaining

three years of medical school and matched into anesthesiology at Massachusetts

General Hospital. He was named one of two Beecher Scholars which provided two

years of protected time to do research after residency. Dr. Fessel’s plan was to

complete the anesthesiology residency followed by a critical care fellowship, and then to

join the faculty at MGH and Harvard Medical School on the physician-scientist track.

Unexpectedly, during his first year of anesthesiology residency, Dr. Fessel realized that

anesthesiology was not a good fit for him. He reached out to his PhD mentor, who

advised that life was too short to be unhappy and, as a result, fail to do your best work.

Reflecting on his experiences as an intern with the pulmonary and critical care services,

Dr. Fessel returned to internal medicine with an interest in specializing in pulmonary and

critical care medicine. The approach to diagnostic dilemmas encountered in the routines

of internal medicine were reminiscent of hypothesis testing in the research lab. In

addition, Dr. Fessel realized that he enjoyed getting to know patients and their families

moreso than he had expected. With the help of his mentors, Dr. Fessel returned to

Vanderbilt University and joined the Tinsley Harrison Society midway through his

second year of residency. For his postdoctoral research during fellowship, Dr. Fessel

joined the pulmonary vascular group at Vanderbilt, a world-famous multidisciplinary

team of basic, translational, and clinical investigators focusing on the study of

pulmonary hypertension.

 

Thoughts on the relationship between clinical and scientific interests.

 

“I think it is always cool when your clinical life interdigitates beautifully with your

research life. But I don’t think it is a requirement, I really don’t. It helps - to say

colloquially - to prevent some professional schizophrenia, but I like to study

fundamental processes. So in graduate school I did free radical lipid biochemistry. So

any cell with a membrane is fair game. That’s a fundamental thing that can apply to any

specialty. Every cell has to solve the energy and biosynthesis problem. Now, I touch on

neuroscience, pharmacology, and inflammatory immunology as a few examples.

Studying a fundamental process will allow you to cross many boundaries.”

 

Thoughts on figuring out what clinical specialty is right for you, especially as a

dual degree trained physician-scientist.

 

“For medicine and medicine subspecialties, there are pretty natural pathways that fall

out. In practical terms, you are going to be looking for a residency and fellowship as a

package deal. Make sure the people you are talking to know what you mean when you

say, 'This is what I intend to do with my life.'; Ask them, ‘How do you support people like

me?’ And the answer should require no thought on their part, because it should be

something they do routinely.

 

The other thing I will say in picking a medical specialty, pay attention to the intangible

factors. There is a draw to the ‘lifestyle specialties’ and you might have it in your head

that some specialties will mesh better with a life in research (and this may have been

true for me in thinking about anesthesiology). That is not enough to make it worthwhile.

Pick a specialty where you feel like you really fit personally. It doesn’t take long to notice

that there are distinct personalities that gravitate to certain specialties - see where you

gravitate too. Pay attention to the intangibles because they won’t show up on any

survey or anything like that.”

 

Thoughts on how to make the most of your PhD training.

 

“During my PhD training, I started out trying to answer a very simple question about

chemistry and free radical oxidation. It was at first a very focused question that yielded

an odd result. I was lucky enough to have a mentor that had the same reaction I did:

that looks interesting, let's figure that out. A key lesson that came out of that is to follow

your data. If you did the experiment correctly, believe your data and go where it takes

you. I think it is always wise to ask yourself ‘What can I do with this to better understand

a disease in human beings?’”

 

Thoughts on publications in high impact journals.

 

"I think there is a weak and maybe nonexistent correlation between what is published in

high impact journals and what is important science. What I will say to that is that I have

seen many examples of people who have had very successful scientific careers and

they don’t have a single Science, Nature, or Cell paper on their CV.   Dr. James West,

my postdoctoral mentor is a bit like this. He has published great work that has truly

changed the field, but more importantly, he is very consistent. He does the work, has

over 100 papers to his name, and has an incredible success rate with funding. That lack

of a Science, Nature, or Cell paper has not slowed him down. It is more important to do

consistently solid work that answers and raises interesting questions. Your work should

be reproducible, relied upon and believed by your field and colleagues. Do you have to

work hard? Yes, without a doubt. You have to consistently publish. And you need to try

and answer questions that are actually important questions to answer. Always be

thinking about going after them - things that will truly advance the field and things that

will lead to something that you can actually deploy in a human being."

 

Thoughts on personal challenges and lessons learned from training.

 

“The biggest challenges in my training were personal ones that didn’t have a whole lot

to do with the training itself. This training takes a big chunk of someone’s life, and it is

not just any window, it is this very dynamic, formative decade. There are going to be

personal challenges and crises. Those were the biggest challenges for me. In fact, it

sounds cliché, but the stuff outside of work is the really important stuff. We throw the

phrase "work-life balance" around as if that addresses the issue, but you have to learn

to value the outside stuff. You can’t ignore or compartmentalize the crises that you face.

From my training, I learned that it is OK to put value on things that don’t have anything

to do with a p value < 0.05 or the heart and lung exam. And you have to be a good,

healthy person before you can be anything else. You will not do your best work if you

are not seeing to those issues that we refer to as "wellness" or "work-life balance. “