Pathways to Neuro-immunology

Discussion in 'Physician Scientists' started by NeuroFP, Jun 22, 2008.

  1. NeuroFP

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    I recently made this same post, which can be located in the pre-medical directory; however, the suggestion was put forth that I repost my queries in the PhD/MD category, as more help might be available.

    That being said, here is my original post. Thank you for taking the time to read it!

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    I recently became fascinated with the field of Immunology. With my prior interests stemming from Neural-science, I thought it would be absolutely fascinating to combine the two into a MD program with a focus on neural-immunology.

    However, my troubles come into play when I try to research the lifestyles of immunologists. Income doesn't interest me. I want to know if I'll be able to work with people/patients rather than sit in a lab all day long, working on the same experiment for years on end, which is the last thing I would want out of my career.

    That being said, are there any med graduates here with this type of specialization? Or are there any med students who know people that specialize in this field? Even immunology alone would be excellent.

    Thanks for any help!
     
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  3. mercaptovizadeh

    mercaptovizadeh ἀλώπηξ

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    Immunology (and inflammation) per se is not really something that one can specialize in in medicine, because it touches on so many fields. You could be a transplant surgeon and immunology would play a central role in your research. Same with infectious disease research (how pathogens evade the immune system), oncology (how the immune system fights cancer and how cancer evades it), rheumatology (most systemic and many tissue-specific autoimmune diseases), as well as other branches of medicine (sarcoidosis in pulm, autoimmune hepatitides and IBD in GI, atherosclerosis in cardiology, etc.).

    There is a branch of medicine called Allergy & Immunology, but you would primarily treat people for their allergies and immunodeficiencies.

    If you're interested in combining neuro and immuno, I know of a professor at my school who specializes in autoimmune neurology; I don't know if there is a fellowship for that or if that's just his focus. Either way, you would first do a neurology residency for that. You would probably work with multiple sclerosis, myasthenia gravis, some of the paraneoplastic syndromes like Lambert-Eaton and opsoclonus-myoclonus, and also CNS vasculitides (e.g. Behcet and giant cell arteritis). Alternatively, you could do neuro-oncology and try to work on immunotherapeutics for CNS neoplasms.
     
  4. NeuroFP

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    All of those fields sound absolutely fascinating. But what has stricken me at the moment is what you told about transplant surgery. My original fascination of medicine was surgery, and now that I know that the option is available to do immunology work AND surgery...that would be a dream that I might just have to pursue immediately.

    One question I have, though, is this: Does the professor at your school do solely research? Since he is in academia with the label of 'professor' I would imagine so.

    Thanks so much for your time.
     
  5. mercaptovizadeh

    mercaptovizadeh ἀλώπηξ

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    No, he only does clinical research, no basic science. Many of the autoimmune diseases (all?) have no real cures, only ameliorating therapies, and the same is the case with the neuro-immune diseases. I had a professor at college who was a neurologist but his research interest was broader questions in autoimmunity and he focused on multiple sclerosis and inflammatory bowel disease, two widely disparate disorders clinically but perhaps not that different pathophysiologically.

    Regarding transplant, just be aware that these surgeries are brutally long, complicated, and taxing. You probably wouldn't have too much time for research, or you'd have to cut a bit on the clinical duties (if the department allowed it) and focus predominantly on the research in order to run a successful lab.
     
  6. NeuroFP

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    Well, commenting on the length of surgeries...
    I wanted to do neurosurgery before, and I know that some of the neurosurgeries are extensively long. I'm thinking of the 7-8 hour ones where the surgeons switch spots to eat or take a quick nap or something.
    How do transplant surgeries compare?
     
  7. bottles999

    bottles999 Senior Member

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    These are two of my passions too and have been working to merge the two fields together in some fashion too. I'll comment on a few areas of interest and some of the things that I have found.

    One poster mentioned Transplant surgery. Our student surgery group hosted a transplant specialist for a breakfast talk that I attended. He talked at length differences of Live vs cadaveric doners for organs, HLA matching, and then need to immuno-supression pretty much for life for these patients. In addition, he did mention that this was the one field of surgery that requires actual application of medical knowledge since your not just coming in to do a specific procedure. Your following the patients for a time and monitor for rejection. Keep in mind there was an addition year of fellowship over the requires surgery residency.

    As far as bench work/translatable (potentially) research, consider looking into a field of Stem cell research or the new induced stem cells (SELF). Alot of work is being looked into differentiation into liver/lung/kidney/neurons etc. for transplants that would avoid the HLA matching issues.

    This might help shed some light where things are leading relative to transplants.


    One area not mentioned is how the CNS communicates with the immune system vs. the Immune sys communicating with the CNS. This will also dove tail into Stress research since the HPA axis release cortisol in response to stress. Cortisol is a potent suppressor of the immune system, think NSAIDS. Immune system on the other hand releases many cytokines in response inflammation which is perceived by the CNS at some key locations and translated into Stress. All this is primary around the Hypothalamic/pituitary axis area.

    Of course as mentioned, there are alot of autoimmunity/CNS Disorders being investigated. Areas of research there are things like Tregs/Centeral & peripheral Tolerance.

    Just to name a few areas how these can be merged.

    Good Luck
     
  8. NeuroFP

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    Wow, great info. Feels like I attended the conference! :D
    You certainly helped fill in some gaps for me, but I still have some more research to do on my own.


    Thanks a lot for your time everyone!!

    Good luck to you all!
     
  9. JHopRevisit

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    Just a quick point...most biomedical research is going to involve "sitting in a lab all day long, working on the same experiment for years on end," until you make it as a PI, at which point its going to involve "sitting in your office writing grants all day long, working on the same experiments for years on end." This is more true for basic science research, but even more translational or clinical research will involve years of long, tedious days working on the same stuff over and over. That's just science.

    As an MD/PhD researcher, you can have periods in your life where you're doing pure clinical stuff (ie residency) and then most of your career where you're doing mostly research but you might have a few weeks a year of pure clinical or a day or two per week of clinical/patient care stuff. The breakdown is usually cited as about 80% research (with the lifestyle you described dislking)/20% clinical.

    This might be a bit different for a transplant surgeon who also does some research on the side. For this lifestyle mainting your own laboratory would be difficult, but working as an assistant professor in a laboratory with someone else as the PI might be easier: you don't get the research prestige and you don't get to look at the big picture as much (as you're focused on a particular project rather than several), but you get to be a surgeon, don't deal with as much administrative hassle, and do get to do some science, so ultimately this might be where you end up. You didn't mention MD/PhD explicitly in your post, but if the second scenario is something you're looking into, pure MD might be more your style, and you might want to consider more carefully what your goals are (and it seems like you're doing that, so keep on truckin').
     

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