Clin-STAR Journey Story

Mentors and Research Training Transformed a Clinician into a Clinician-Scientist

Clinician-scientists who focus on issues of aging often start from a grounding in geriatrics. But for Charles Brown, IV, MD, MHS, it was choosing a subspecialty in which most of his patients were older adults that motivated him to pursue research related to aging.

Today Dr. Brown is an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine. A cardiac anesthesiologist by training, his research program addresses a range of issues around preventing cognitive and functional decline in older adults undergoing surgery. He has carried out award-winning studies of post-operative delirium and frailty in older adults who are cardiac surgery patients.

"I always knew that I had a clinical research bent, and I liked physiology," says Dr. Brown. But it was late in his clinical training when he turned his focus to research, during an anesthesiology residency, and a fellowship in cardiac anesthesiology. "That's when I really started taking care of older adults more, seeing delirium, understanding the increasing prevalence, seeing patients concerned about cognitive and functional change. The clinical need, and my clinical experiences shaped the research interests that I had."

Dr. Brown credits mentors for guiding him on a successful journey from clinician and resident to investigator and faculty. He started developing a research project during residency at Johns Hopkins. "I was very interested in the physiology of how monitoring blood flow to the brain might be relevant to delirium," he says.

During residency, he found a mentor in Charles Hogue, MD, then on the faculty at Hopkins, who had done work on cognitive change after surgery. Given their related interests, it made sense to stay at Hopkins for his fellowship year and continue this line of research. "Chuck's mentorship was really critical at that stage," Dr. Brown adds. "I ended up developing an idea, and then also building out collaborations with the geriatrics world, with the psychiatry world in terms of delirium assessment, and the public health school world to focus resources on the project I was interested in."

During his fellowship year Dr. Brown also applied for a KL2 grant, an NIH Mentored Clinical Research Scholar Award that allows investigators time off from teaching or clinical duties to focus on developing their research career. In addition, he had an offer to stay at Hopkins as faculty.

"That let me hit the ground running as faculty with protected time," says Dr. Brown. At the same time, he got some valuable advice from Peter Pronovost, MD, PhD. "I remember him saying, 'if you're going to do clinical research, you need to get the formal training. No one will try and take care of patients without an MD. Why would you think that you can do clinical research without formal training in research methods?' "

"I really took that to heart," says Dr. Brown. He spent his protected time earning an MHS in epidemiology. "It was seminal training for me to be able to take the ideas that I had and rigorously, to conduct clinical research."

During his fellowship year in cardiac anesthesiology, Dr. Brown also applied for and received an NIA Grants for Early Medical/Surgical Specialists' Transition to Aging Research (GEMSSTAR) award. The KL2 underwrote his epidemiology training, while the GEMSSTAR gave him funding for research. But the GEMSSTAR award also provided a valuable benefit beyond project support—an entrée into the community of scientists focused on issues of aging.

"The GEMSSTAR really accelerated my transition to clinician-researcher and solidified my commitment to research in the older adult population," says Dr. Brown. "I got to be part of the broader NIA community. That means getting to know the NIA and research priorities and how they work. Getting to know the program officers, being able to have personal relationships, which helps in a lot of different ways for feedback. And getting to know both junior investigators at my stage across the country but also senior investigators who also could be mentors—in a formal way, and also in the informal conversations that you have in GEMSSTAR meetings or other aging research meetings."

The GEMSSTAR award helped pave the way for another career development award, the Paul B. Beeson Emerging Leaders Career Development Award (K76). That, in turn, provided Dr. Brown additional ways to connect to the field of aging research, and to get career advice at this new stage.

Now a mentor himself, Dr. Brown has this advice for early-career clinicians who want to turn their focus to research on aging: mentorship and education are key. "A mentor is preferably someone at your institution who is actively engaged in the research area that interests you. Find a way to interact with that person in a particular project. Try to focus on a question that can be answered and that has broader implications—a problem that is common and important. Then, if you are going to do research, get the right training. Finding the time to get formal training creates a springboard."