About seven years ago, the two top graduates at the University of Toronto with the highest GPAs [grade point averages] came to my lab. As a requirement for one of them to get into Stanford medical school, they would only accept her if she spent one year in my lab to do research. That’s Stanford, because it’s one of the top medical schools in the world. There are very creative minds there.
Did you know that 97 per cent of Stanford medical school grads have some connection to academia? So when they graduated and went on to a career, they didn’t just set up a private practice, they also remained connected to a university. 97 per cent! So that says very clearly that is a medical school that is training doctors to be innovators.
Would that be your advice to medical students who want to innovate? Spend time doing research?
The 20th century was a great century for science. It was a century where fundamental paradigms of biology were discovered. But we basically have discovered 99 per cent of the biological paradigms. I think the only discipline where there will be new fundamental paradigms that we have not yet discovered would be neurobiology, how the brain works.
But the 21st century will be about applying that fundamental knowledge – the paradigms and principles of biology – into medicine. And the only group of people who can translate that well will be the physicians. So to me, in the 21st century, the great principles of new insight into physiology will come from brilliant people who are trained in both fields: the clinician-scientists.
I constantly have in my lab five clinician-scientists, who are with me but are also qualified doctors. I have a medical oncologist, a nephrologist, I just had a cardiologist. They are actually seeing patients one day a week and spending six days in my lab, because they work seven days a week. These people, if they see something one day in the clinic and then can connect it to something in the lab, that kind of translation will be above and beyond just listening to music. It’s like learning how to play the violin and then integrating all that knowledge to compose a symphony.
I think that is the most important convergence needed – clinician-scientists – and Canada has very, very few.
Why don’t we have more?
It has to be something you want to do, because when you graduate from medical school and you’ve done your residency and you are now a specialist in a particular discipline, you can make $300,000 or $400,000 a year. You want two cars, a house with three garages. That is fundamentally in conflict with deciding to go into research.
One of the clinician-scientists in my lab makes a salary of $23,000. He has a wife and two kids at home. So I applied to have special permission to pay him more. Is that person not pressured to give it up and go into practice? Who is going to be a fully trained physician and go into research? But there are some people like that. These are the people of the future.
Is part of the motivation to innovate about wanting to do something good for the world? To help sick people?
I think that is probably to some extent flawed. If you are like, oh, I feel so bad because every day I come to work I see these patients, some are very young and they are dying of cancer, I’ve got to help them, that is not enough.
If you’re doing it just for the patients, it doesn’t work as well as if you are just driven by the curiosity of finding new scientific and medical connections. A brilliant scientist could do it all out of the curiosity, and not care about the patients, and whatever happens that is good for the patients is just a bonus.
So taking the emotion out of the process is a good thing?
As Aesop said about emotion, ‘It is with our passions as it is with fire and water, they are good servants, but bad masters.’ When we use water to shower or fire to cook, it’s a servant. But when it is a master, it’s a building burning down or you drowning.
So emotion should be used as a servant. You use your emotion because you care and therefore you try to make that scientific discovery. But if your emotion is your master, when your experiment doesn’t work, you will break down. And that doesn’t help, because you have to keep on trying.