It really is a small world.
When Aysegul Ozgur Gezer, D.O., Ph.D., a 2021 graduate from the Michigan State University College of Osteopathic Medicine (MSUCOM), decided to apply for a stroke fellowship, she reached out to a former stroke fellow for some ideas on where to apply. Dr. Gezer was advised to investigate the stroke program at the University of Cincinnati (UC), and the Vascular Neurology Fellowship director there was highly recommended, too. It would be a great fit, Dr. Gezer was told.
That was a few years ago.
Dr. Gezer, who recently completed her Neurology Residency at the University of Iowa, started the fellowship program July 1 at UC to study stroke and cerebrovascular disease. Among others, she will be mentored by Stacie Demel, D.O., Ph.D., a 2010 graduate of MSUCOM and associate professor of Neurology & Rehabilitation Medicine. She is an expert in intracerebral hemorrhage genomics and stroke genetic epidemiology. Through her work, Dr. Gezer hopes to identify novel targets for stroke recovery.
The pair’s mentor-mentee relationship is believed to be the first example of a D.O.-Ph.D. mentoring another D.O.-Ph.D., both of whom are graduates of the MSU College of Osteopathic Medicine’s Physician-Scientist Training Program.
Perhaps even more coincidental was Dr. Gezer’s realization that when she was a first-year dual degree student at MSU more than 10 years ago, she had attended some presentations by Dr. Demel in East Lansing.
According to Brian Schutte, Ph.D., co-director of MSUCOM’s D.O.-Ph.D. program and associate professor in Microbiology, Genetics and Immunology and in Pediatrics and Human Development, the coming together of Drs. Gezer and Demel at the University of Cincinnati is remarkable because it was spontaneous.
“This feels like a milestone for our program,” he said. “We now have 89 graduates from the D.O.-Ph.D. program at MSUCOM, and apparently that is enough that seemingly random convergences are now more likely to occur. The program has achieved a level of maturity where the new graduates should expect to find prior graduates at the institutions and programs they are targeting. Knowing those trailblazers are already out there, they can be more confident about their chosen path, and it might even make their journey a bit easier.”
Dr. Gezer’s fellowship is a two-year, T32-funded training program sponsored by the National Institutes of Health (NIH) that aims to develop physician-scientists who are specializing in stroke and neurocritical care. In fact, the unique stroke program provides 75% of Dr. Gezer’s time protected for research.
Dr. Gezer always knew she wanted to combine clinical practice with research as a career and decided on her specialization in her second year of residency.
“I like the acuity of the pathology and rewarding outcomes when we diagnose and treat rapidly. I feel the adrenaline. I love how everyone works together to move fast in synchrony, even in a chaotic environment focusing on one common goal that is to best serve the patient, as the time is brain,” she said. “I feel that my personality thrives in that environment. Bedside is great, but I also cannot not do research. I really find a lot of meaning in it. Being able to bring bench to bedside for better outcomes is why I committed to be a physician-scientist.”
Sacrifice and resiliency through MSUCOM’s D.O.-Ph.D. dual degree program
In addition to their training at MSU, Dr. Demel and Dr. Gezer have much in common as physician-scientists devoted to stroke medicine.
“This is why Aysegul and I joined the D.O.-Ph.D. program from the very beginning,” Dr. Demel said. “We've always wanted to work with patients and help patients and do that acute piece. But we also want to help patients in a bigger sense, in a broader, long-term sense. Conducting research that could impact thousands of people is something that we strive to do, too.”
Looking back on their training at MSUCOM, both doctors agree that the D.O.-Ph.D. program excels in successfully integrating the medical and research worlds. But they also acknowledge that spending seven to eight years in education and training to become physician-scientists requires a great deal of personal sacrifice.
“When all your friends are getting their medical degrees after four years, and they're moving on to residency, we're there slogging away in the lab or trying to work on our thesis and our Ph.D.,” Dr. Demel said. “The class we start with and the friends we make move on, and we ultimately graduate with a class of people who we don't know as well. Yet even though it's a sacrifice up front, I think MSU does a really good job of preparing us for the real world.”
There’s also a lot of pressure throughout one’s career as a physician and researcher, Dr. Demel added – pressure to publish, pressure to get results. “And you can't make things happen. We're testing hypotheses, and they are what they are. So, you kind of have to roll with the punches as they come.”
Dr. Gezer said she is grateful for the unique perspective and resiliency that the dual degree program gave her.
“Constant failure in experiments, the need to learn from it and to keep going is a very humbling and unique experience that served me well during residency,” she explained. “Resilience is a skill that I mastered during my Ph.D. and applied it to clinical settings during residency. There is constant feedback targeting gaps in knowledge as part of the residency training, more so than praising. Some residents may have struggled a little bit more inwards, whereas I view these as an opportunity to learn and grow. It's really hard to break my heart, I guess. If you didn't know something that you were prepped on, and you couldn't answer a question, you just go study and come back stronger the next day. This is how we grow, and everybody has room to grow.”
Translational neuroscience through clinical trials
After finishing her residency in neurology at the University of Pittsburgh Medical Center, Dr. Demel knew she wanted to get back into research, specifically stroke research. She applied and was offered a position with the University of Cincinnati, one of the leading stroke research institutions in the nation.
“Honestly, having a Ph.D. was helpful in setting me apart from other applicants,” she said. “I am really grateful for the opportunity to come here to Cincinnati and learn from the giants in stroke research.”
The Comprehensive Stroke Center at UC Health is nationally recognized as a powerhouse in the research and treatment of stroke. The UC Gardner Neuroscience Institute is the national coordinating center for clinical stroke trials within NIH StrokeNet, a major network for stroke research. Further, the Greater Cincinnati/Northern Kentucky Stroke Study has been continuously funded for almost 30 years, and is a rich, population-based stroke epidemiology database available for research projects involving stroke risk factors, incidence rates, acute and in-hospital treatment practices and much more.
Dr. Demel focuses on intracerebral hemorrhage (ICH) stroke caused by a ruptured artery that feeds the brain. While ischemic strokes, strokes caused by blocked arteries, are more common, ICH has very high morbidity and mortality rates. Dr. Demel’s specific research interest is cerebrovascular genetics. She studies biomarkers, neuroradiology markers, genetics, patients’ medical histories, and their clinical outcomes after ICH.
“We compare biomarkers in patients who recovered well after their stroke versus those who continued to decline to identify novel targets for recovery,” she explained. “That’s the idea of translational neuroscience, to utilize patient data, whether it’s certain genes, proteins, metabolites, etc. that might be important for recovery, and determine how we can leverage them to bring new treatments back to the bedside through clinical trials.”
According to Dr. Demel, future clinical researchers like Dr. Gezer have numerous research opportunities at UC through exposure to stroke epidemiology, clinical trials and stroke genetics.
“I feel like my world came full circle here,” she said. “I am able to utilize what I learned in my Ph.D., which was bench science, with what I learned through clinical training, and bring it all together. I wasn’t always entirely sure how I was going to make that happen, but it is what I'm able to do here at the University of Cincinnati. My hope for Aysegul’s future is to take one of the research pathways available to her here and truly understand what it is like to do translational neuroscience.”
by Lynn Waldsmith