Our next Student Sketch is MS4, Travis Hull. This newly matched MSTP just accepted a rock-star residency in General Surgery at Mass General Hospital in Boston, MA. Travis grew up in Summerhill, Pennsylvania (a small town about an hour and a half from Pittsburg) and stuck around the Keystone State for his undergraduate education at Juniata College, a small liberal arts institution. He always knew he wanted to be a doctor in the medical sense, but went into undergrad not really knowing what a PhD entailed or what being that kind of “doctor” meant. After deciding to do some research to check off a box on his CV, he ended up in the lab of an enthusiastic, young PI working as her lab manager and member and accompanied her to scientific meetings. His newly developed love for science led him to a summer research program at Brigham Women’s Hospital in Boston, where he studied diabetic vasculopathy in his first exposure to academic medicine. Read our interview below to find out more about Travis’s career path thus far and what’s up next for him:
Paige: What made you choose UAB’s MSTP program?
Travis: My undergraduate health professions advisor met Robin (program director, Dr. Robin Lorenz) at a meeting and told me about her. I decided to submit an application and ended up getting an interview. The day after my interview I remember calling my dad and saying, if I get in I’ll go here. I loved the interview, the program, Robin, all of it. I had another offer, but decided to defer and come down here.
Paige: Awesome. Did you feel like you were at a disadvantage at all coming from a liberal arts college?
Travis: Being at a liberal arts school like Juniata, it’s all about connections. We weren’t really known for research.
Paige: Good to see you found a good advisor early on, and heard about Dr. Lorenz! Can you give an example of a time the MSTP or Dr. Lorenz specifically has supported you?
Travis: I had a son in July 2010, during the Neurology module of my MS-2 year. I wasn’t married at the time, so soon after I went to Dr. Lorenz and asked when would be a good time to get married, and she suggested the next summer.
Paige: That’s great, what was your experience like having a child during medical school?
Travis: My son wasn’t planned, but it was the best thing that ever happened to me, because it taught me how to manage both my personal and professional time. I also had a daughter, Olivia, in the middle of my PhD. That time, it was more laid back, but I grew more as a person with the first kid.
Paige: Can you talk about any challenges you’ve come across having a family during the program?
Travis: I am extremely fulfilled with my personal/home life. At one of the SEMSS conferences, I got advice from Dr. Standaert, who has twins, on work-life balance. He reflected that he may not play legos with his kids as much as other fathers, but when he does, he puts down everything and is the best lego player on earth. You have to make the most of your time. I may have less time to spend with my family, but the time that I do have we make very good use of. We love outdoor activities, like camping and white water rafting. I also coach my son’s baseball team and make it to my daughter’s dance recitals when I can. I’m apprehensive about how that’s going to chance as I transition to residency, but everyone told me I wouldn’t have time to do all of that now, and I do.
Paige: That’s a great mindset to take. Switching gears a bit, can you tell us about your PhD lab and why you chose it?
Travis: I wanted to do transplant immunobiology, and I found James George, who was the only PI on campus studying this at the time. I fell into his lab because of the research rather than the kind of mentor that he was, which is actually an awful strategy. But I was so incredibly lucky for how it worked out because he is an absolutely incredible mentor and an incredible person outside of research. I also developed a co-mentor relationship with Anupam Agarwal, who is a well-respected leader in the field and also a phenomenal person. Even though I would not advise doing things the way I did, I got the best mentors I could ask for. Co-mentorship was incredibly important for me because it broadened the horizons of my PhD. Instead of being really focused on one topic, I was able to study immunology and nephrology more broadly, which is especially useful for a physician-scientist.
Paige: Definitely. Do you have an “elevator pitch” of your thesis?
Travis: Oh man. So, I was interested in how the innate immune system, like macrophages and dendritic cells, affect the outcome of acute kidney injury and transplantation of the kidney. I studied how trafficking of these cells between the kidney and peripheral organs influenced recovery and graft fibrosis in transplanted kidneys, and found that manipulation of heme-oxygenase 1 affects outcomes. I would advise having a really good interview pitch for interviews, because everyone will ask that.
Paige: Sounds like cool science. What are some strategies you used to help navigate the PhD years?
Travis: The most important thing is mentorship. Always be on the lookout to expand your mentorship network. Don’t be afraid to approach a speaker at a conference and ask for help if they’re doing something you’re interested in—attending conferences is important. Use them to get to know people from other institutions and expand your network nationally, because these connections can be your advocates when applying to residency. Always be on the lookout for connections and reach out to solidify them. Don’t rely on your mentor to do this for you, even though a good mentor will. I’ve made connections by just sending an email to say I’m interested in learning something that a group does, and asking to stop by their lab and watch them do it, or going a step further to ask for help in applying it to my research. Don’t be afraid to get turned down, either. If you get one response out of five emails, the one response you get could be the person who makes a call for you during residency applications. My relationship with Dr. Agarwal stemmed from asking him a cool question after a medical school lecture, and I’m still working with him. Second, try to find your own sources of funding. Third, get involved somewhere outside of UAB professionally, such as APSA. It was personally important for me to have that, but it’s also great for networking, and it shows that you’re interested in being a leader in the future. People will expect that your goal is to become an academic leader, and it’s important to say you’ve taken steps outside of the lab to show you’re interested in that. It’s great to have a Nature publication, but that’s not enough today. Programs aren’t looking for someone who buries themselves in the lab.
Paige: You’ve been very influential in the development of APSA, which is now such a great program and offers opportunities to so many students like ourselves. Can you talk about your experience with that?
Travis: I was an institutional representative my MS-1 year, and wanted to be more involved, so helped plan SEMSS my MS-2 year. I noticed that APSA wasn’t as involved with SEMSS as it should have been, so I started a local chapter here at UAB, assuming that was a thing (it wasn’t). I thought that was ridiculous, so I joined the national committee and, along with Stephanie Robert, drafted an application process and resources for other institutions to start local chapters. We recruited 30 schools and are still recruiting more, so it’s been very successful. I went on to become vice chair and now chair of Membership.
Paige: How was balancing the responsibility of this thorough involvement with normal coursework/lab-work?
Travis: I look at it as practice. If you look at successful physician-scientists (like Robin and my mentor, Jim), they are a practicing physician and a scientist and do administrative work, as well, both here at UAB and within extramural societies they’re involved in. It’s important to start practicing for this kind of career now and integrate extracurriculars into your professional and personal lives. It’s not something you should say you don’t have time for—make time for it, given you signed up to be a leader.
Paige: Great advice. What was it like going back to medical school after the PhD?
Travis: Having the PhD is useful, because attendings that have an interest in research will take an interest in you. Realize that this bond exists and take advantage of that to find additional mentors. You don’t want to be continuously talking about research, but when an attending takes the initiative to ask you about your research, have a pitch ready. Common interests can help you expand your network.
Paige: What are your clinical interests?
Travis: I always wanted to be a surgeon, and spent four years trying to talk myself out of it. I met surgeon-scientists at UAB and at meetings, though there is less substrate in terms of expanding your network in this niche. Once I did find people that did it well and enjoyed it, I stopped trying to convince myself I wanted to do medicine. About halfway through my PhD I was decided. I like the technical aspect and the ability to offer patients a definitive treatment. Initially, I wanted to do cardiothoracic surgery, so I shadowed throughout my PhD and really liked it. Going back to medical school, however, my first service on my surgery rotation was hepatobiliary, then I did an AI in liver transplant and realized that what I enjoy most is transplant—the science behind it, the way you think, the technical aspect. I met Dr. Tector, who is doing xenotransplant here at UAB, and he became a role model of mine. After this, I decided that instead of applying to an integrated cardiac surgery residency, I would apply to general surgery and keep all of my options open. My goal is to work at an academic medical center and have my own lab and be engaged in a collaborative atmosphere. I think the easiest way to do this is to find a niche in a surgical specialty so that you can be a good surgeon by doing similar surgeries day-in/day-out as opposed to the gamut of general surgery, and then integrate scientific interests into this field.
Paige: How valuable was shadowing to you in choosing a field?
Travis: I spent my entire PhD shadowing in cardiac surgery, but it wasn’t until my MS-3 year that I thought of general surgery. I wish I had done more broad shadowing during my PhD in areas outside of my interest, and had done it more often (like once a month). In the PhD phase, you’re way too junior to have the knowledge base to even know what you’re interests are, and during the MS-3 and MS-4 years, it’s almost too late. In the PhD phase, at least figure out what you don’t want to do. I thought there was no chance I would do anything besides cardiac surgery starting out, and shadowing just once in general surgery would have helped me figure out my true interests sooner. Plus, it’s a good way to add to your mentoring network. Pull clinical mentors into research and ask for advice or try to get samples or see how what you’re doing relates to your research. Gravitate towards people who have similar interests—there are several who are very eager to mentor students, and it’s not hard to find those people if you put yourself out there. Make yourself discoverable. You can’t do that when you’re hidden in a lab.
Paige: Very cool. Switching gears a bit, again, how has the interview trail been treating you?
Travis: Interviews are about chronic preparation, and acute preparation won’t help you much. People stress out about trying to learn about every school and every surgeon, which is not important. The most important thing is getting the interview, which means your credentials meet their expectations. They interview you to find out if you’re normal or a weirdo, and you interview them to find out if they’re normal or a weirdo. I view interviews as an honor and a privilege. If you work hard during your PhD and during medical school, they will be excited. They know you want to do good stuff and want to learn more about your research, so again, have a really solid elevator pitch and be able to solidly articulate your goals for the future. Do you want your own lab? What kind of research do you want to do? What type of specialty? You think you know everything about yourself going in, but you don’t—so make a game plan. Writing grants during the PhD helps with that, too. When you do start interviewing, falling back on the mentoring network you built over the last 8 years is important. I spend 70% of my interview time talking about mentors I met at UAB, and about my wife and kids. If you do have a partner/family, there is no reason to hide that. Be upfront about it. The first time I was asked, “what are you most proud of?” I said my family, and they really appreciated that answer. It’s mature and speaks to your personality and is not looked down on by anyone. Lastly, there will always be inherent anxiety on the interview trail, so having people and mentors to talk to is essential—research AND clinical mentors. Research mentors are easy to come by, but having mentors that do both is important. These are harder to come by and you have to work harder for them.
Paige: Do you plan on doing research during residency?
Travis: It depends on the mentors I find. I can’t see myself passing up the opportunity to do research, but then again, if I do 2+ years of research on top of residency and fellowship, that starts to add up. There are pluses and minuses of both sides; I love research and think it’s a good way to break up a rigorous residency, and it’s also appealing for personal reasons, but there are tremendous opportunities at the places I’ve applied. The top academic surgery residency programs will go to any length imaginable to make you a successful surgeon-scientist, and you can be successful doing research as a resident in any of these programs. The ABIM programs are relatively new, but surgery programs have been doing the same thing for 40 years. It all comes down to mentors. I’ll also consider my family and what is best for us at the time. It’s a decision you don’t have to make while interviewing.
Paige: What are you most excited about going into residency?
Travis: To have more responsibility as far as patient care goes. I learn best under stress and pressure, and you’re insulated as a medical student because any decision you make filters through so many levels of supervision. This isn’t always the case as a resident; you can have direct influence on patients. I’m excited and extremely terrified of this new level of responsibility. I’m also excited to take the things I’ve learned over the past 8 years and apply them to my own patients, and interested to see what my path will be after looking at all of these different successful physician-scientists I’ve come across. Everyone has done it differently.
Paige: Last thing—what was your favorite part of the MSTP program and what are your parting words for those who are coming up behind you?
Travis: I hated the first two years, because it’s less professionally fulfilling sitting in a classroom, but at the same time it’s an honor and a privilege listening to experts in their respective fields every day. The PhD phase is phenomenal, and provides so much personal and professional growth. Your education is in your own hands and what you get out is directly proportional to what you put in. Mentors and luck can affect your progress, but if you put in the work, you will be successful. You can live a really rewarding personal life during that time, as well. Third and fourth years of medical school are bittersweet, because you have no responsibility and ultimately, nothing you do is able to tangibly affect a patient because of all of the checks and balances set up in the system. You work hard and long hours and it can be hard to see what good comes of it. You have to step back and see how the suggestions you make are helping their care. You do, however, have the privilege of seeing people at the worst time in their life and leaving a lasting impression with them. When you keep that in mind, you see how lucky you are. I really liked all of the years of the program for different reasons and can’t choose a favorite. The whole lure of the physician-scientist pathway is the strength you gain through all of these different perspectives at each step along the way, and they all integrate into your overall perspective on helping patients through biomedical research. My parting words would be that the 8 years go fast. I remember moving stuff into my first apartment in Highland Park and living on my own for the first time and thinking that 2017 is never going to be here—and it goes fast.