Suzette Farber-Katz (suzetteable@gmail.com)

Lab PI: Dr. Seth Field
Undergraduate Institution: University of California, San Diego
Med-into-Grad clinical training area: Diabetes/Obesity
Main clinical mentors: Sunder Mudaliar, Sunder.Mudaliar@va.gov

Quote:  “This training will definitely impact my research.  I am motivated to find a post-doctoral position that will incorporate what I have learned from the Med-into-Grad program.  As a biomedical researcher, it is extremely important to have a clinical perspective in mind when designing novel therapies.”.

Rational for Med-into-Grad training: Prior to beginning my doctoral thesis research at UCSD I worked in the Diabetes/Obesity group at Pfizer.  There, I was involved in developing and running cell based assays to evaluate potential therapies for diabetes and obesity.  After ending my position at Pfizer I began research for my master’s degree with Fred Levine.  In this laboratory, I worked on a project aimed at creating a replacement for the beta cells of the pancreas.  Currently, I am in Seth Field’s lab working on a project that examines the Golgi protein GOLPH3 and how it is regulated.  Seth is a M.D./PhD who does his clinical work in the field of endocrinology, so he is very experienced with treating diabetes and other endocrine disorders.  Because of my previous experience working on therapies for diabetes, I was interested in the Med-into-Grad program for Diabetes/Obesity.  I was curious to see how different drugs were utilized in the clinic and also where there was potential for novel therapies.

Medical training and identification of medically-relevant research issues: 
I attended two diabetes outpatient clinics, the diabetes post-clinic conference, endocrine clinic, the endocrine post-clinic conference, the endocrine grand rounds and didactic session, and weight control clinic each week.  The outpatient clinics were where I learned the most by interacting with patients and learning which therapies were best for each patient.  In these clinics I was able to spend time with the fellows and residents, the dieticians, the diabetes educators, the diabetic podiatrist, and the pharmacists.  I learned the best approach to diabetes treatment involves more than simply a doctor to effectively treat a patient with diabetes.  All of the different kinds of diabetes caregivers at the VA hospital are crucial.  I also was able to observe clinical trials that relate to endocrinology.  This was particularly informative because I am interested in doing research on drug discovery.  I was able to see how clinical trials are conducted and organized, as well as how the subjects are monitored.

Potential Research collaborations:
I did not develop any collaborations at this time because my current research is not directly related to diabetes treatment.  I would love to work on diabetes research in my post-doctoral work and use my contacts at the VA hospital as collaborators.

Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs:  I definitely acquired a solid understanding of the diagnostics and therapeutics associated with diabetes/obesity.  For diabetes, there are at least 10 drug categories spanning almost every hormone involved in insulin secretion or resistance.  Currently, a major problem I noticed is that the better drugs are not generic yet, so a lot of patients are not receiving them as first line therapies.  A lot of therapies cause weight gain, which is an unfortunate side effect for patients already struggling with their weight.  For example, some of the newer drugs such as Byetta also cause weight loss, but less than 3% of patients receive Byetta due to cost and unfamiliarity.  For obesity treatment, there is only one drug treatment available.  Many patients do not want to use this therapy due to its side effects.  Other than that, the only option is weight loss surgery.  There is definitely potential for other weight loss drugs, and several are in late stage clinical trials.  A major difficulty in treating diabetes is that patients do not consistently monitor their blood sugar levels, mainly because it involved painful finger pricks.  Without information about blood sugar levels throughout the day, the doctors are completely unable to help their patients.  The doctors get extremely frustrated when patients waste valuable clinic time by not bringing in any blood sugar numbers.   I learned that a few companies are developing equipment to measure blood sugar accurately through the skin.  This will greatly improve diabetes care in the future by increasing the ease and comfort of blood glucose testing. 

Diagnostic & Therapeutic collaborations:  At this time I do not have plans for collaborations.  I am interested in pursuing collaborations when I start a post-doctoral position.

Long term impact:  This training will definitely impact my research.  I am motivated to find a post-doctoral position that will incorporate what I have learned from the Med-into-Grad program.  As a biomedical researcher, it is extremely important to have a clinical perspective in mind when designing novel therapies.

Student-specific experiences:  I have several relatives with diabetes and weight control issues, and now I am able to give them suggestions on how to effectively treat their diabetes or weight problems.  I have an appreciation for the treatment that the veterans get at the VA hospital as compared to my own experiences with private practice doctors.  I met some really interesting veterans, including a brigadier general who served in WWII, Korea, and Vietnam.  I was also inspired by the weight control clinic to make a lifestyle change in the way I eat (not that I was obese before).  I realize how a lifetime of bad habits can really affect your quality of life later on.

Advice for new trainees--Autumn preparatory quarter:  I would suggest attending the fall class regularly to get an idea of how doctors approach treating disease.  Also, I would suggest some light reading on diabetes using the textbooks giving to you.  Most importantly, it is helpful to have an idea of which drugs are available, their mechanisms of action, and their side effects.  I would suggest asking Dr. Steve Edelman for a copy of his book on type 2 diabetes that he wrote with Dr. Robert Henry because it is very informative for the winter clinical training.  I received this book partway through my winter quarter training.  It’s easier to understand than a large textbook.

Advice for new trainees—Winter clinical training quarter:  The attending doctors and fellows in endocrinology are all extremely nice and willing to help you in the VA endocrinology department.  You will have to explain your program over and over, but everyone was willing to let me sit in with his or her patients and everyone was nice about explaining things that were confusing to me.  Don’t be afraid to make suggestions every once in awhile.  I found it more informative sometimes to observe the residents instead of the fellows because they received more instruction as part of their training as well. 

Take home perspective on Med-into-Grad at UCSD: I would highly recommend this program to other students.  You learn SO much in one quarter.  There is no other opportunity like this unless you decide to go to medical school.  The clinical perspective on treating is very different from the scientific perspective. It was also nice to get a break during my fourth year of nonstop research.  The Med-into-Grad program will continue to shape my career in the future.  I am excited to apply what I have learned to my future research.