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
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. “