Specialising as a physician while doing a second doctorate in the natural sciences, medical professional Nadine Heiden initially considered this idea an experiment as there are not yet many colleagues in her field who are going down this road. “I always wanted to do both – take care of patients and do research,” the 30-year-old says. The director of her clinic, Prof Michael Schäfers, himself a practising physician and active scientist, encouraged her to pursue the opportunity.
For just under a year and a half, Nadine Heiden has been an assistant physician in training to become a specialist in nuclear medicine at the Münster University Hospital. In this role, she is working through the various stages of her training, taking care of patients with tumours, thyroid conditions, and heart disease, among other issues, making diagnoses using medical imaging and carrying out therapies. In her day-to-day work at the clinic, she discusses numerous patient cases with her colleagues and works on her accompanying education courses. So as to also be able to engage in research during this specialisation process, she is periodically released from her clinical tasks. During these dedicated periods of protected research time, she works on a scientific project on imaging inflammation with a research network at the University of Münster – although initially alternating between full-time roles, the intention is that both activities will eventually become part of her daily work routine. “During my research time, I’m not deployed in the clinic, so I can focus on my work in the lab and reliably plan my series of experiments,” she explains. To ensure that the clinic continues to operate without any additional workload for her colleagues, the research network funds a substitute position. This funding model for so-called “clinician-scientists” is well-established at medical faculties throughout Germany and aims to enable medical professionals to combine clinical and scientific careers on the grounds that close links between patient care and research are essential for medical progress. However, it is crucial that the dual qualification remains compatible with personal careers and lifestyles. After all, it takes six years to study medicine and at least another five to complete medical specialist training. To help overcome this challenge and as the work in both her positions is closely related, the Medical Council of Westphalia-Lippe has approved Nadine Heiden’s application for twelve months of her research work to count towards her medical specialist training.
Clinical relevance is my first thought with every experiment.
What Nadine Heiden especially likes about research is being able to pursue her own ideas: “You are continuously encountering new questions and challenges,” she says. Yet she appreciates that her job as a physician allows her to help people with their illnesses and work with them to find viable ways forward. “If I had had to choose one or the other, I would definitely have felt I had missed out on something,” she says. That is why when she was still studying human medicine at the University of Münster, she decided to complete a concurrent master’s degree in “Experimental Medicine”, which trains future physicians in scientific research and qualifies them to do a PhD in the natural sciences. “The questions you deal with every day are very different in each area and you need different approaches to find solutions”, says Nadine Heiden, and she finds this variety particularly enriching.
Medical imaging provides the connection between her work in the clinic and her research. Nuclear medicine uses radioactive substances to diagnose and treat diseases – even small amounts of radioactivity can be measured using sensitive tomographs and, in turn, this makes it possible to create images showing how the so-called radiopharmaceuticals are distributed in the body. This enables, for example, the visualisation of transport and metabolic processes, the assessment of various organ functions and the identification of tumour tissue. In therapy, higher doses of radiopharmaceuticals are used, which bind to, for example, tumour tissue so that their radiation can target and destroy the specific tissue. In her research time, Nadine Heiden is part of a team working on techniques for imaging specific immune cells, monocytes, within the organism using radioactive and other substances. “We want to visualise how these cells behave in the body over time and find out what contribution they make to driving inflammation on the one hand and stopping it again on the other,” explains Nadine Heiden. In this way, the team, led by nuclear medicine specialist Prof Michael Schäfers and immunologist Prof Johannes Roth, wants to gain a better understanding of inflammation and its stages. Even though Nadine Heiden is currently investigating basic inflammatory mechanisms in the body, it is still important to her to have a clear view of the potential benefit that her research findings may eventually have in the treatment of patients. “Clinical relevance is my first thought with every experiment,” she says.
The hurdles are not as high as you think they are.
To acquire funding for her research project, Nadine Heiden wrote an application in which she described the plans for her scientific project and explained how her research time and clinical training time would be combined. She then presented herself and her project ideas to a selection committee in person and, shortly thereafter, received funding approval from the Collaborative Research Centre 1450 “inSight” – one of several large biomedical research networks at the University of Münster. Physicians, biologists, chemists, mathematicians and computer scientists all work closely together within this network and Nadine Heiden comments on how “being part of this community helps you make valuable contacts and opens up new horizons”. Her application to the Medical Council for permission to count of her research activities towards her medical specialist training was also approved very quickly. Thus, she encouragingly notes that, overall, “the hurdles are not as high as you think they are.” Although, she does add that having the support of both her clinic and her research institute has been important and that she also benefits greatly from her boss’s experience.
When Nadine Heiden was first redeployed in the clinic after focussing on research for several months, it was a moment when she felt that combining clinical and scientific work in her professional day-to-day life could actually work. “I realised that you’re quickly back in the team, and the hands still know what to do,” she says, adding that if there was, temporarily, a time in her career that both fields could not be combined, it would be okay. “I like both fields and they open up many options,” she says. “For me personally, this really takes the pressure off.”
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Author: Doris Niederhoff
English language editing and consulting: Julie Davies