Otolaryngology Surgeon-Scientist Program

From Operating Room to Bench to Bedside, All in a Day’s Work

BY LISA YUAN, NIDDK

On any given day, surgeon-scientists might perform surgery, see patients in clinic, or conduct biomedical research. They bring clinical perspectives to the laboratory as they seek to better understand the diseases they treat, and in turn, their lab discoveries help guide and improve patient care. However, the challenges of pursuing a dual career in research and medicine have contributed to a decline in the number of physician-scientists entering the biomedical workforce.

To help address this concern, the National Institute on Deafness and Other Communication Disorders (NIDCD) developed the Otolaryngology Surgeon-Scientist Program (OSSP), a career-development program for junior faculty.

Five surgeons are in the program: Michael Hoa, Clint Allen, Wade Chien, Nicole Schmitt, and Nyall London Jr.

Michael Hoa, an otolaryngology surgeon-scientist who joined the program in 2013, treats patients with hearing loss and neurotologic diseases at MedStar Georgetown University Hospital (Washington, D.C.), where he co-directs the hospital’s cochlear-implant program. When he is not in the clinic or operating room, he spends time in his NIDCD lab, running the Auditory Development and Restoration Program. The lab studies the development and function of adult inner-ear cell types and the mechanisms behind their degeneration, with a focus on the stria vascularis. His research is motivated by the diseases he sees in the clinic that lack effective treatments, such as disorders that cause fluctuations in hearing loss including Ménière disease and autoimmune inner-ear disease.

“As surgeon-scientists, we take the problems we see in the clinic back to the lab and find approaches to study those problems,” said Hoa. “Our clinical insight informs our science and vice versa. This interplay is essential in bringing scientific advances to the clinical realm.”

He recently performed cochlear-implant surgery on a young Clinical Center patient with Niemann-Pick type C1 disease, a rare neurodegenerative disorder caused by the body’s inability to metabolize cholesterol and other cellular waste products. The surgery was the first pediatric, bilateral cochlear implantation ever performed at the NIH Clinical Center.

The four other surgeons are otolaryngology head-and-neck surgeons at Johns Hopkins–Suburban Hospital (Bethesda, Maryland). Like Hoa, they split their time among seeing patients, performing surgery, and overseeing NIDCD intramural research programs.

Allen’s Translational Tumor Immunology Program explores how the immune system fights nonmalignant laryngeal papillomatosis and malignant tumors, particularly head-and-neck squamous-cell carcinoma, the most common form of head-and-neck cancer. The lab aims to identify treatments that both kill tumor cells and enhance the body’s natural antitumor immune response.

The Integrative Therapeutics Program, run by Schmitt, also focuses on treatments for head-and-neck squamous-cell carcinoma, mainly cisplatin, the most commonly used systemic drug for the disease. Because cisplatin has significant adverse effects, including hearing loss, Schmitt’s team is researching alternative agents and strategies to limit the drug’s toxicity while optimizing its therapeutic effects.

Chien’s Inner Ear Gene Therapy Program investigates gene therapy as a treatment option for hereditary hearing loss and dizziness. The lab was among the first to study whether genome editing could be used to restore hearing and balance in animal models.

London’s Sinonasal and Skull Base Tumor Program is focused on how and why malignant tumors develop in the nasal cavity, sinuses, and the base of the skull. The lab seeks to translate these results into better therapies, particularly in a type of malignancy called olfactory neuroblastoma, which researchers think arises from the olfactory epithelium, the area of the nose important for the sense of smell.

The OSSP has provided “a great opportunity to perform a wide range of research from basic science to clinical trials,” said Chien, who was the first otolaryngology surgeon-scientist to join the program when it was created in 2011.

In fact, research from all four of the otolaryngology surgeon-scientists’ labs has led to preclinical and clinical studies to improve the prevention, diagnosis, and treatment of human communication disorders or to better understand processes related to these disorders. The OSSP has been so successful from the academic perspective that Johns Hopkins University has reported that it seeks to develop similar collaborations with other institutes across NIH.

To find out more about the program and how to apply, go to https://www.nidcd.nih.gov/training/otolaryngology-surgeon-scientist.

NIDCD’s Otolaryngology Surgeon-Scientist Program (OSSP)

The National Institute on Deafness and Other Communication Disorders (NIDCD) developed the Otolaryngology Surgeon-Scientist Program (OSSP), a career-development program for junior faculty. The OSSP provides research opportunities, mentorship, and funding support to foster the next generation of surgeon-scientists in otolaryngology, a medical-surgical specialty focusing on diseases of the head and neck, especially those involving the ears, nose, and throat.

“What makes this program unique is that it brings surgeons from the outside to conduct intramural research at the NIH while maintaining their surgical practices. These collaborations lead to creative, impactful science,” said Michael Gottesman, NIH deputy director of intramural research. “In this way, the NIDCD OSSP has forged a new path at the NIH.”

Though the NIDCD has been training otolaryngologist-scientists since 1995, it created the OSSP in 2011 as a mechanism through which to provide the formal research training and career mentorship necessary for a successful transition to an independent, tenure-track surgeon-scientist position. Application to the OSSP is open to board-certified or board-eligible otolaryngologist-surgeons interested in pursuing research in disorders affecting hearing, balance, taste, smell, voice, speech, or language.

“The program is highly selective, and the career-development mentorship process is rigorous,” noted Carter Van Waes, OSSP program director and NIDCD clinical director. Through partnerships with institutions such as Johns Hopkins University (Baltimore), Georgetown University (Washington, D.C.), and Walter Reed National Military Medical Center (Bethesda, Maryland), the program allows participants to tailor the balance between their clinical and surgical practices and their NIDCD research programs. Participation typically requires a commitment of five to eight years.

Andrew Griffith, NIDCD’s scientific director, added, “By offering a combination of exploratory risk-taking and strong hypothesis-based investigation, we hope this program will develop a robust cadre of surgeon-scientists whose body of work improves the understanding and clinical management of human communication disorders.”

With intramural labs at the Porter Neuroscience Research Center (Building 35) and the NIH Clinical Center, NIDCD otolaryngology surgeon-scientists have the resources they need to conduct innovative translational and clinical research, along with the opportunity to easily collaborate with scientists across NIH. And with clinical privileges at the Clinical Center, the surgeon-scientists also have the chance to study patients with rare diseases and conduct first-in-human clinical trials, further expanding their knowledge and expertise.

“We have the unique opportunity to make an impact on the science behind clinically relevant diseases in otolaryngology, while at the same time, we maintain our surgical skills that give us critical insight into those diseases,” said Michael Hoa, an otolaryngology surgeon-scientist who joined the program in 2013. He splits his time between his NIH lab and MedStar Georgetown University Hospital (Washington, D.C.) where he treats patients with hearing loss and neurotologic diseases. “The OSSP’s highly supportive and flexible environment allows surgeon-scientists to balance these endeavors. I am grateful for the opportunities the program provides.”

To find out more about the program and how to apply, go to https://www.nidcd.nih.gov/training/otolaryngology-surgeon-scientist.