Next Generation is a Brigham Clinical & Research News (CRN) column penned by students, residents, fellows and postdocs. If you are a Brigham trainee interested in contributing a column, email us. This month’s column is written by David Chiang, MD, PhD, a research fellow in the lab of Calum MacRae, MD, PhD, at the Brigham and a current fellow at Boston Scientific through the Partners Innovation Fellows Program.

David Chiang

Growing up in academia, the concept of industry had always been a black box to me: You submit ideas, mostly gleaned from academic research along with a ton of money, and novel therapeutics come out of the box years later. As trainees in academia, we spend years learning and developing what becomes the input and how to apply the output, yet we receive little or no training in how the black box works, and perhaps more importantly, how we should partner with it. This is partly due to the way academic trainings are structured: There is simply no time or space for adequate exposure to or exploration of the industry. As science and medicine move into the 21st century, it is becoming increasingly evident that this old model of interaction between academia and industry is broken. Instead, novel ways of partnership are now leading to efficient cycling between bench and bedside. This is the environment in which I found myself when I came to the Brigham for my residency training in Internal Medicine.

Under the leadership of Marshall Wolf, MD, and later Joel Katz, MD, the Internal Medicine Residency Program has a long-standing tradition of producing leaders in every field of medicine. However, it also has the reputation of helping trainees succeed in fields that intersect with medicine, such as biomedical research, education, health policy and industry. This fact is highlighted in part by the Science in Residency (SiR) track, led by Rebecca (Becky) Baron, MD, which is designed to expose research-oriented residents to role models in both academia and industry. I was particularly impressed with examples of established academic investigators who later decided to collaborate with or join industry full-time in order to speed the translation of science to medicine. Learning about these and other non-traditional paths that are rapidly transforming medicine inspired me to start exploring the black box myself.

With this in mind, and with the full support and encouragement of Joel, Becky and my residency program mentor Juan (Carl) Pallais, MD, I decided to do a research fellowship following residency training with Calum MacRae, MD, PhD, who, as vice chair for Scientific Innovation, exemplifies how academia can partner with industry to speed innovation. Around this time, I also began to actively look for opportunities to get my feet wet in industry. After making my intentions known to Calum, he suggested that I consider a new opportunity that was forming with the Digital Health Group at Boston Scientific through the Partners Innovation Fellows Program (Fellows Program). This relatively new program matches Partners HealthCare trainees and early career investigators (MDs and/or PhDs) with industry partners, ranging from pharmaceutical companies to device companies to venture capital firms for short-term, experiential opportunities at these companies while maintaining their position within Partners.

Thinking Like an Entrepreneur

At first, I was somewhat hesitant about the program because it seemed so different from what I was used to and what I have been trained to do (to be a physician-scientist). But, after talking to the program manager of the Fellows Program, Cary Mazzone, and chief digital officer at Boston Scientific, David Feygin, PhD, I realized that this is a rare and wonderful opportunity. In particular, it allows me to not only get an insider look at one of the largest medical device companies, but to do so from inside their very own innovation group, Digital Health, which is basically a start-up within the device giant. However, because I still wanted to maintain my basic research program, the Fellows Program was flexible to work out an 80/20 split for me where I would spend 20 percent of my efforts with Boston Scientific.

As soon as I started at Boston Scientific, David gave me several entrepreneurial books to read, including Competing Against Luck and Lean Start-up. Right away, this initiated me in the start-up culture and taught me to think like an entrepreneur with concepts I have never even heard of during my academic training. Then, on a weekly basis, I watched and worked with the “lean” teams, each of which consisted of a product manager, a designer and two computer engineers working side-by-side, who create digital products within a short timeframe through rapid iterative cycles. Each of these team members share the same vision for their product from day one and are constantly re-evaluating their goals and processes. And as one of the Innovation Fellows, I was welcomed into their workplace (called a “studio”) and learned about several projects at different phases of development. At the same time, using my academic training, I contributed clinical and research insights to help guide these processes and hopefully save valuable development time. Finally, I have also had many opportunities to interact directly with David, over many lunches, to get an insider look at the corporate culture of Boston Scientific. Specifically, I witnessed how the device giant incubates its own innovation group to stay ahead of the curve in the current health care revolution. The black box has finally been opened to me, with mentors there to walk me through its inner workings.

These non-traditional experiences that I have gained at the Brigham have no doubt enriched my career growth and will help guide my future interactions with industry as I continue to pursue innovative ways to accelerate improvements in medicine. My current intention is still to be primarily based in academia as I pursue my research interests to understand and ultimately treat various types of cardiac arrhythmias. However, I now envision that future in close collaboration and partnership with industry. Deep down my goal remains the same as when I embarked on this path more than 10 years ago: Translate scientific discoveries to patient care as quickly as possible so that we can fundamentally improve human health.

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