Encouraged to explore
Medical Oncology Fellows Levi Garraway MD, PhD, (left) and Rameen Beroukhim, MD, PhD, (right) are working with William Sellers, MD, whose lab is exploring how prostate cells turn cancerous.
Fellows, who hold either MD or MD/PhD degrees and have already completed their residencies, spend the first year of their fellowships treating patients under the supervision of mentors and attending physicians. Next comes two or more years working on individual research projects, either in the clinic or the lab.
Both fellowships are among the most sought-after and prestigious in the nation, and for similar reasons. Participants have the opportunity to work with and learn from some of the most esteemed cancer physicians and reseachers in the country, within a group of hospitals renowned for the quality of their research. The roster of alumni alone — more than 75 percent of whom are in academic medicine, many as cancer center directors, department chairs, division chiefs, or tenured professors — is an indication not just of the quality of the fellows themselves, but of the training they receive.
"During our clinical year, we have the opportunity to follow patients over time — from six to 12 months, in some cases," says Lauren Dias, MD, a fellow currently based at Mass General. "The level of autonomy we're given lets us feel that these really are our patients."
Says Robert Mayer, MD, who heads the adult hematology/oncology fellowship program, "One of the great strengths of our program is its flexibility. Fellows are encouraged to explore different fields and take advantage of the breadth of work being done here to discover their interests. Many of our graduates start out intending to pursue one area of research only to find, as a result of their experience, that another area intrigued them more.
"What's ultimately important," he adds, "is the intellectual challenge and its ability to help them become academic leaders."
One who made such a shift was Jeffrey Meyerhardt, MD, MPH, who began his fellowship in 2000 planning to study genetic changes associated with tumor development. "During my first fellowship year, I was exposed to work being done by a variety of people at Dana-Farber, such as Charles Fuchs [MD, MPH], who studies the connection between lifestyle factors and colon cancer," Meyerhardt says. To learn about this type of population research, he took an intensive two-month course in clinical epidemiology at the Harvard School of Public Health and later pursued a master's degree at the school. He now works at DFCI with Fuchs, focusing on the impact of diet and lifestyle in patients with colorectal cancer.
The career directions taken by graduates of the program are as diverse as the graduates themselves. DFCI's Phillip Febbo, MD, began his fellowship in 1997 on a path to become an academic clinician. Working with Todd Golub, MD, he became interested in studying how gene expression profiling — analyzing patterns of gene activity — can improve science's understanding of prostate cancer biology and advance clinical care. "The fellowship doesn't immediately pressure you to be pigeonholed into one career track or research area," Febbo remarks. "It provides the protected time to pursue your research interests, ask difficult questions, and gain the necessary skills and expertise required for an independent research career."
Roy Herbst, MD, PhD, a Dana-Farber fellow between 1994 and '97, and now associate professor and chief of thoracic medical oncology at the University of Texas M.D. Anderson Cancer Center in Houston, offers similar praise. "A cancer fellowship is very much about the role models you have, and the models I had at Dana-Farber were among the best anywhere," he states. "During the clinical year, you're very closely supervised, but you have the chance to be your patients' primary caregiver. At the same time, the expertise and resources available to fellows for developing their research projects is second to none. I'm very happy to now be at M.D. Anderson, but I'm glad I did my training at Dana-Farber."
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