Beth Kozel is a 2015 Lasker/NIH Clinical Research Scholar. She is a geneticist and a matrix and vascular biologist at the US National Heart, Lung, and Blood Institute (NHLBI). The majority of her work is focused on the study of two elastin insufficiency-related diseases: Williams syndrome and isolated supravalvular aortic stenosis. Kozel obtained a medical degree and doctorate in cell biology and physiology at the Washington University School of Medicine in 2004 through a combined MD/PhD program. Prior to joining the NHLBI, she was an assistant professor of pediatrics in genetics and genomic medicine at Washington University.
Q: How did you decide to pursue the physician-scientist career path?
A: I was one of those people who wanted to be a doctor from the beginning. I was interested in science all along going through school. At that time, the US Department of Energy ran an honors program where they would take one person from each state to participate in a summer internship at one of their laboratories. I went to Lawrence Berkeley laboratory and learned molecular biology, and I thought that it was fascinating. As a result of that experience, I was awarded a summer position at the University of Nebraska Medical Center the following year, and there I ended up joining a lab run by an MD/PhD. That was the first time that I realized I could actually do both science and medicine. I never looked back.
Q: How has the NIH Lasker Clinical Scholars program helped your career so far?
A: At my previous institution, I ran a research laboratory that studied elastin insufficiency in animal models and directed a multidisciplinary clinic that cared for individuals with elastin-mediated disease. Coming to the NIH [US National Institutes of Health] Clinical Center gave me the ability to more directly connect my basic research studies to human disease. By allowing me to bring in rare disease patients from all over the country, the Lasker program gave me the opportunity to take observations made in a patient and then take that back to the laboratory for further study and to translate the lessons we learn in cell and animal studies back into humans under one roof and funding scheme. That was a launching point for me.
Q. During the April Lasker Lessons in Leadership talk, Craig Thomson said that it’s getting harder to be both a great physician and a great scientist because the issues and the science today are so complex. Do you feel that way?
A: I’d like to believe that I manage to do both. My training is in clinical genetics, and the breadth that genetics covers is immense. Every organ system, every problem, could be genetic. I recognized very early that there was no way that I could be an expert on everything genetic and be able to maintain a research lab. So I chose to try to be a very good doctor to a smaller subset of patients whose clinical problems relate directly to my research.
Q. What other challenges do you experience as someone who is doing both basic and clinical research and clinic?
A: I think that there is a push toward ‘translational medicine’ and approaches to science that combine the best of bench and clinical science. My understanding, in terms of how grants are reviewed, is that there are study sections that review basic science grants and sections that review clinical grants. If I had wanted to fully fund my program in academia, I would have had to write separate grants for the clinical side and for the bench side. It would have been a different approach where you piece things together from different funding mechanisms. I wouldn’t have had that bench to bedside all rolled into one program. That’s one of the benefits of being able to come here and work with the Lasker-NIH program — to have a seamless translational program that has a really nice basic science side and a clinical program component, as well. It was a really good fit for me.
Q: In an interview for our spring newsletter, the Howard Hughes Medical Institute’s president at that time, Robert Tjian, said that we need to modernize the path for the training of the physician-scientist because it’s currently taking too long. Do you agree with that?
A: It entirely depends on the person and what they want to do. For someone like me, who knew exactly what she wanted to do, it wasn’t the MD/PhD that was too long, but the college preparation part. It would be great if there were a way to streamline that whole program, combining college with MD/PhD training. That way, you are still getting the in-depth medical exposure you need as well as strong research skills, but maybe not so many of the undergraduate elective classes. If an individual wants to get their MD/PhD so that they can understand physiology but they really don’t intend to take care of patients later on, then maybe completing a residency and fellowship isn’t necessary. However, when patient care is a significant part of a person’s job, it’s important to have enough clinical experience to handle complex patients. The institution where I trained did an excellent job at recognizing that physician-scientists have a unique set of goals and challenges. They worked with us to create programs that met our needs. Institutions that train physician-scientists well work to optimize training based on career goals of their students.
Q: Have you encountered much gender bias in your career or any challenges that you think are specific to you being a woman scientist?
A: Certainly there were bumps along the road, but I am grateful to the women who came before me: the ones who blazed the trail that allowed me to never really consider my gender when it came to deciding on a career. I simply followed my passion. Throughout my training, I felt like my mentors generally saw me more as a scientist than a female scientist. But at the same time, they were very supportive of the approaches I took to balance my career and life.When we had our first child, we couldn’t get into a daycare right away. So my husband and I moved to a system where he went into work early in the morning and was done at noon, and I worked from noon until 8 o’clock, and we made the system work for us. Nobody ever blinked an eye because the work was getting done. Having mentors who value the end work product and not necessarily the hours of the day in which it’s done — who provide flexibility — allowed me to have time at home with my family and the time I needed for work to meet the goals that were set for me. That continues to be a key. That is how I run my lab.
The other key support I received from my mentors was that they recommended me for events that allowed me to get more exposure — for example, my mentor would be asked to give a lecture at a conference and he would suggest me instead. Consequently, I was able to speak at national meetings and serve on national committees earlier than others in my peer group. My mentors understood that those opportunities were critical for career development of men and women and helped me find ways to showcase my work.