The PiTT-CMU MSTP NewSleTTer - University of Pittsburgh :: MSTP

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Profiles in Medicine: David Levinthal An alumnus from the Class of 2006 explores the decisions that shaped his path from undergraduate studies at Cornell University to the Pitt-CMU MSTP and his current fellowship in GI. 2 Dr. David Levinthal graduated from the Pitt MSTP in 2006. Accepted into the University of Michigan’s gastroenterology fast-track program, he completed two years of Internal Medicine Residency in Ann Arbor, before returning to Pitt to pursue a post-doctoral year of research with Dr. Peter Strick in the Department of Neurobiology. Dr. Levinthal continued to do full-time research with Dr. Strick during the first year of his GI Fellowship and is now entering his second fellowship year. Below, he shares his candid thoughts on his career path and advice for future physician-scientists. Q: How did you decide on a career as an MD-PhD? A: I have known from an early age that I wanted to pursue a career in the sciences. That interest became more specifically targeted to neuroscience by the time I completed college and began medical school. I had a tremendous research experience in my undergraduate lab at Cornell University, working on vitamin A metabolism, intracellular trafficking, and nuclear receptor interaction. Although this experience prepared me well for the reality and frustrations of laboratory science, I loved it and was hooked. In retrospect, I realize that my mentor gave me a lot of responsibility and an actual, publishable project – my data ended up in a JBC publication! I had a solid two years with that group, and I felt a bit like a graduate student by the end. After that experience, there was no question in my mind that I wanted to be a scientist. Cornell has a very strong premed curriculum and I had a few good experiences shadowing physicians, as well as doing a hospital-based research project, but I wasn’t sure I wanted to pursue medicine at first. I thought I had to make a choice, and although I really liked the idea of being a physician, I would have pursued a PhD program if I’d been forced to decide between the two. Then I learned about MD/PhD programs. What a perfect fit! You can do BOTH? What a cool way to synthesize patient care, basic science, and the potential for translational research. When the time came to apply to medical school, I applied to mostly MD/PhD programs. Q: How did you pick your thesis lab and mentor? A: I think the main drives for choosing my thesis lab were: 1) to actually like my mentor as a person (and potential friend) 2) finding a mentor with a good reputation as a advisor/teacher, and 3) being presented with a clear idea about my research project from the very beginning. I interviewed with many advisors, but ultimately when I met Don DeFranco we just clicked. He had a great idea for a research project dealing with oxidative stress and cell death in neurons, and so I signed on. I think it’s really important that a thesis project have discernable research goals and publishable experimental units that are designed to answer a question no matter what the result. Dr. DeFranco had a clear sense of my thesis project pretty much from the start, and he laid it all out when we first met. I decided to join the lab because the project appeared interesting and feasible. We applied for an F-30 and it was funded in the first round of review, largely because he had already put a lot of thought into the project before we even got started. That helped me get through my PhD in a timely manner (3.5 years) even with the anticipated research snags and inevitable technical problems. Q: How did you choose your specialty? A: Like most medical students, I didn’t know which direction I was going in until sometime during third year. By the time I’d nearly finished graduate school, I had developed an interest in pain research, so I thought about how best to pursue that – anesthesiology? neurology? internal medicine? After I started third year rotations, it became clear to me that internal medicine really was the best fit. Then I had to come up with a specialty. So I did rotations in gastroenterology, endocrine, and critical care. After reflecting and speaking with faculty, I realized that my interests were directed toward a procedure-based specialty that required a broad scope of medical knowledge. For me, that specialty was gastroenterology. GI deals with multiple organs, complex physiology, manifestations of disease secondary to systemic illness, among other things – in total, a complex and varied field. Perfect for me. Then how does GI relate to neuroscience? Well one of the fascinating aspects of GI is the mind-body connection that likely plays a role in functional bowel disorders. While intuitively connected, the neurophysiologic basis of CNS control over GI function is poorly understood. As you may imagine, there are not many neuro-gastroenterologists, so my interest in neuroscience seemed like a natural fit to fill this gap in knowledge. In addition, from a funding standpoint, it’s always a good thing to study an incredibly prevalent disease, and to be uniquely trained to do so. Q: Can you tell me what a typical day for you right now is like? A: Right now, my days are spent on inpatient consults, performing procedures, and spending half a day a week in continuity clinic. I’m on-call once every eight to nine days, and during that time, I cover the VA, Magee, and Montefiore/ Presby. It can get very busy. Our fellowship program has an impressive educational component with lectures/conferences throughout the week, typically starting at 7:30 a.m. So a typical day could be: conference from 7:30-8:30 a.m., see follow-up patients in the hospital, get new consults, do some procedures, finish see page 3, Levinthal
On June 1, 2010 we matriculated a new class of 14 students (13 new students in addition to one internal second year medical student). As in past years, the new students hail from outstanding undergraduate schools where they excelled in both academics and research. With an average GPA of 3.73 and an average MCAT of ~35 they demonstrate the continued success of our MSTP to matriculate the best and the brightest. All of the first years completed their first professional development course (molecular medicine) in addition to a lab rotation from which they compiled their Retreat posters. For the rising second year students, this was the inaugural year of the summer professional development ii course (methods and analysis) taught by Dr. Geoff Murdoch and myself. In addition to learning about their classmates’ summer research, the students were given ample opportunity to formally present their data and begin to create their “elevator spiel” for use in future networking. To keep them “off their toes,” the students sampled a variety of red wines throughout the course and then were rigorously grilled in a blind tasting. Only one student correctly matched all the wines to grapes, so while Neil Kelly has a potential additional career as a sommelier, the rest will have to buckle down to science and medicine. This fall begins our MSTP workshops, a yearlong series of eight discussions over dinner. These workshops are designed to maximize interactions between students across different stages of training. Groups of eight students (one student from each class) will analyze research, training, medical and ethical cases germane to the training of all physician scientists. Each class, in turn, will have the opportunity to contribute to the case discussed, Director’s Corner A Message From Clayton Wiley, MD, PhD Associate Dean, Director of MSTP lead the discussion at their respective tables, and to summarize the outcome of the dinner discussion and potentially present it in a written form such as in future newsletters. Like all other aspects of our MSTP, the workshops are an experiment and represent our continued efforts to push the edge of the envelope in training physician scientists. from page 2, Levinthal documentation, go home by about 6:30-7 p.m. Repeat. But the past two years I was doing 100 percent research during a post-doc period of training built into my fast-track pathway in GI. The fast-track is a relatively new training path in internal medicine designed for MD/PhDs who have a very good sense of what specialty they wish to pursue. For GI, the pathway is two years residency plus four years fellowship (two and a half years of which can be spent doing research). Q: How do you balance family time and career or how do you see yourself balancing these in the future? A: My wife, Sarah, and I have found a balance that works for us. It was really hard to have quality time with her during my internship – I was a walking zombie for most of the year. But she was so wonderful and supportive – I don’t think I could have made it through it without her. The best advice is to really make the most of the time you have with your family. We tend to plan little day trips or outings for my days off. That makes them memorable and special. Our son was born last August and I was very fortunate to have a flexible schedule last year. Now it’s much harder that I’m back in the clinic full-time. Again, the days off are precious and my first priority is to spend time with the family. There is no question that pursuing a medical career puts a strain on family life. But the silver lining is that an academic medicine career, once well established, may present some opportunities for a more flexible schedule. Someday. Maybe. Q: Where do you see yourself in ten years? A: By then I will certainly be on the faculty somewhere, likely here at the University of Pittsburgh if all works out. I hope to have my second R01 grant by then and have made it to the rank of associate professor with a successful tenure. My ideal balance would be to have about 80 percent of my time devoted to research with 20 percent clinical effort. I’d also like to be involved in national GI organizations like the AGA by serving on committees, as well as beginning to be invited to give presentations at outside institutions. I’d also like to have an independent lab, with graduate students, post-docs, and possibly fellows working with me. The coolest thing would be to begin to translate some of my research into actual therapeutic trials. A tall order, but one can dream. Q: What advice do you have for current MSTP students? A: ASK QUESTIONS! Navigating this career path is very difficult. It is easy to lose time. Before making any of the major decisions, ask lots and lots of questions – of the alumni, of students further along in the program, of PhD program students, post-docs, everyone. Don’t forget about your original class of medical students that went straight through to residency. They are seasoned, veteran residents/fellows, maybe even attending physicians, by the time you are applying to residency programs. Their input is invaluable because they are your friends and they’ll give you the honest truth about specific residencies and career paths. Q: Final thoughts? A: I couldn’t have made a better decision for my career. Every year that goes by, I love practicing medicine more and more. It becomes a part of your self-image and at this point, after being involved in patient care to some degree since 1998, it’s pretty hard-wired into me. Of course, research has always been something that I have loved from the start. Interview conducted by Niyathi Hegde (G1) Alunni Relations Chair Dr. David Levinthal can be reached at dlevinth@pitt.edu 3
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The PiTT-CMU MSTP NewSleTTer - University of Pittsburgh :: MSTP

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