Alumni Profile: William Oldham, M.D. Ph.D.
William Oldham, MD, PhD
Associate Physician and Instructor of Medicine
Brigham and Women’s Hospital and Harvard Medical School
Vanderbilt MSTP Graduate, 2008
I attended the University of North Carolina at Chapel Hill. While there, I was an undergraduate research technician in the Department of Pharmacology where I stuffed pipette tip boxes, cleaned glassware, and learned how to do yeast two-hybrid screening. I wanted to be a physician since high school, but this research experience motivated my decision to apply to dual degree programs. I chose the Vanderbilt MSTP because of the atmosphere of collegiality and the reputation of the Pharmacology Department. I completed my graduate research with Dr. Heidi Hamm studying the mechanisms of receptor-mediated G protein activation. As an M3, I enjoyed internal medicine and was particularly drawn to the physiology and care of critically ill patients. I joined the medicine residency program at MGH followed by subspecialty training in the Harvard Pulmonary and Critical Care Fellowship via the ABIM research pathway. During clinical training, I developed an interest in pulmonary vascular disease and joined Dr. Joseph Loscalzo’s laboratory for my post-doctoral research. In his lab, I began to study the metabolic adaptations of pulmonary vascular cells to hypoxia. I completed fellowship in June 2015 and continue to study pulmonary vascular cell metabolism and bioenergetics at the bench, attend six weeks per year on the inpatient pulmonary vascular disease service, and see outpatients with unexplained dyspnea every other week as a faculty member in the pulmonary division at BWH. I was recently awarded a Mentored Clinical Scientist Research Career Development Award (K08) and am developing my own research program.
Reflecting on your journey thus far as an MD/PhD, what has been the most impactful training experience in preparing you to establish your career?
My post-doctoral research fellowship in Dr. Loscalzo’s laboratory has had the most impact in this regard. My future academic career is growing directly out of the research interests and approaches that I developed during this training period. Moreover, I had the protected time and independence to really learn the field, identify key knowledge gaps, and develop relevant experimental approaches to the study of pulmonary vascular disease. I also took the opportunity to forego any clinical commitments during my final year of fellowship to focus on my research endeavors. During that year, I wrote and submitted a first-author manuscript, participated in several collaborative research projects, wrote several grants, and learned several new assays. This time really helped me to establish a strong foundation for my current work. While not entirely consistent with the physician-scientist model, it may be beneficial to take time to focus purely on investigative activities when transitioning from fellow to faculty.
Looking back on your training, what is one thing you would do differently? What is the most important piece of advice you would give to current MSTP trainees?
I regret how little attention I gave to pulmonary physiology and pathology as an M1 and M2! I thought I wanted to be a cardiologist early in medical school, then became enamored with critical care medicine, and only during residency did I really appreciate how fascinating pulmonary disease is. This history of interests probably accounts for my passion for pulmonary vascular disease.
The most important piece of advice I could give is to try to develop a general vision of your future career and then try to take the most direct path to get there. By the end of the MSTP, my vision was that I wanted to be a physician-scientist who spent most of his time at the bench doing clinically relevant basic research (I love G proteins, but I wanted to move my research closer to the clinic). I thought the most direct pathway to get there was through the ABIM research pathway, early subspecialty training, and getting back into the lab as soon as possible. As I pursued this track, I was able to fill in the details in terms of subspecialty training and research focus. In my opinion, the benefit of an extra year of research substantially outweighs the cost of one fewer year of clinical training.
The other benefit of having a general vision of your future career is that it will allow you to weigh the benefit of the numerous exciting opportunities that will come to you. I think MSTP students, probably even more than medical students generally, are good at so many things and are interested in so many things that it is hard to say “no.” (We couldn’t even choose between medical school and graduate school!) As your careers progress, opportunities to participate in new and exciting clinical programs, or educational activities, or research collaborations, or editorial roles will multiply. It will be important to think carefully about how these opportunities help or hinder progress toward your vision of your career, because you won’t be able to continue to do it all. For example, I enjoy doing right heart catheterizations, but I think my research progress would suffer substantially if I was out of the lab an additional half day per week.
Mentorship is a crucial component of both medical and scientific training. What advice would you give to MSTP trainee about selecting the best mentor?
Start by making a list of potential mentors based on your research interests. For my graduate mentor search, I started with all of the investigators in the Department of Pharmacology based on my undergraduate research experience. For my post-doctoral mentor search, I started with everyone who was doing basic research in pulmonary vascular disease. Meet with everyone on your list and make sure to ask everyone, “who else should I talk to?” This exercise is important because it allows you to get to know the local players in your field and what resources may be available through future collaborations. I was also often surprised at how frankly potential mentors discuss their colleagues. After making the rounds, I picked the people who I thought were doing the most exciting science, would allow me to be independent, had resources to support my ideas, had a track record of training successful investigators, and had a clearly defined research space that I could make my own (i.e., did not have multiple people working on nearly identical projects).
In addition to my primary research mentors, I think it is just as important to identify mentors who are 1-2 and 4-5 years further along their career paths. Find the people who are now where you want to be in the near future. These individuals will know what grants you should apply for, what meetings you should attend, how you should navigate administrative conflicts, how to get involved in professional societies, how to hire a good research assistant, how to get promoted, what seminars are worth your time, how to get time on the confocal microscope, and so on. Find these people and have lunch with them often.
What factors must an MSTP student consider in choosing a field of scientific research and clinical training for residency?
I think only one factor is important – what are you most passionate about? Some people are fortunate enough to have a very specific idea of what that is (“I have wanted to be a medical oncologist studying the mechanisms of chemotherapy tolerance in breast cancer since I was six years-old”). So many aspects of medicine and research have been interesting to me that I have chosen to focus only on the next major decision facing me. For most MSTP students, that choice will be what type of residency training to pursue. Pick the specialty you enjoyed the most! It’s hard not to get tangled in other considerations (compensation, lifestyle, research opportunities, what your mother thinks, etc.), but the physician-scientist road is hard enough without absolutely enjoying the day-to-day. Once you get into residency, you will learn so much more about subspecialty and research opportunities in your area of interest than you ever knew existed as a medical student. And it’s highly likely that your specific research and clinical interests will change as your training progresses. It’s for this reason that I would focus on developing that general vision of your career path and then fill in the details as you learn more about your clinical and research interests.
Please feel free to add any other advice, thoughts, or commentary you may have!
Boston is a great town and it would be great to see even more Vanderbilt alumni find their way to training programs up here!