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MEDx Spurs Discovery at the Intersection of Medicine and Engineering

Thanks to an innovative initiative now entering its third year, the proximity between Duke University School of Medicine and the Pratt School of Engineering is closer than ever

From the Spring 2018 issue of Duke Med Alumni News

By Mara Catherine Shurgot
Photographs by Bruce Deboer

duke doctors and engineers huddled with chapel in backgroundAccording to Google Maps, the walking distance between Duke University School of Medicine and the Pratt School of Engineering is 0.8 miles, or about 1,800 steps. You can cover it in less than 15 minutes.

Thanks to an innovative initiative now entering its third year, in terms of collaboration, joint research, and shared goals, the proximity between the two schools is even closer than that. The result is a fast-growing growing synergy between medicine and engineering that is producing dramatic new advances on a wide range of fronts.

Aristotle's aphorism "The whole is greater than the sum of its parts" describes the impetus behind MEDx—an initiative launched in 2015 by then-School of Medicine Dean Nancy Andrews and then Pratt School of Engineering Dean Tom Katsouleas, with support by Provost Sally Kornbluth, to further increase collaboration between the schools of medicine and engineering.

They understood that the School of Medicine and the School of Engineering could innovate more nimbly, translate discoveries into clinical practice more quickly, and have a much greater positive impact on patient care if they worked together.

"Duke has a number of existing strengths, and MEDx was created to build upon those strengths by creating an ecosystem that would support engineering and medicine activity at all levels across the university," says Geoffrey S. Ginsburg, MD, PhD, professor of medicine, biomedical engineering, pathology and nursing.

Ginsburg co-leads the initiative along with Ken Gall, PhD, chair of mechanical engineering and materials science and professor of biomedical engineering, and executive director Donna Crenshaw, PhD, MHA.

MATCHMAKING OPPORTUNITY

MEDx builds on a long-established culture of collaboration at Duke that has resulted in an impressive track record of biomedical innovation, including new technologies for ultrasound, the cochlear implant, artificial vasculature, and bio-absorbable stents. The program is built on four "pillars" of activity — creating communities, energizing education, inspiring and enabling innovative science, and embracing entrepreneurship—and directs the expertise of both schools in those areas.

"When interviewing around the country, I couldn't find any other place like Duke, where collaboration is so seamless. The doctors here love new technology, and you have talented students and engineers who want to make a real difference in the world."

Junjie Yao
assistant professor of biomedical engineering

"Rather than starting at the department level, this is a school-to-school collaboration," says Gall. "We have more than 2,000 faculty in the School of Medicine and more than 110 faculty in the School of Engineering. With the breadth and size of the medical school and the various fields of engineering, there is enormous potential."

Ginsburg envisions the initiative as a zipper: the twin disciplines of engineering and medicine uniting at multiple points, starting at the undergraduate level and running all the way up through joint faculty hires and distinguished lecturers, and ultimately out into the world of clinical application and commercialization.

"What's been surprising is just how many new opportunities we're finding through MEDx, how many people there are who didn't know they should be working with each other," says Ginsburg. "We have developed insights into which connections could be very productive. We're an effective matchmaking opportunity."

That opportunity to bridge the disciplines attracts attention.

"I came here enthusiastically for the marriage of engineering and medicine," says Junjie Yao, PhD, assistant professor of biomedical engineering, who joined Duke in 2016. "When interviewing around the country, I couldn't find any other place like Duke, where collaboration is so seamless. The doctors here love new technology, and you have talented students and engineers who want to make a real difference in the world."[MS1]

CREATING COMMUNITIES

One of the first steps in bringing the two fields together is creating opportunities for busy people to meet, learn, and brainstorm.

"There are natural areas where engineers have interacted with clinicians and physicians and basic scientists for a while," says George Truskey, MD, PhD, R. Eugene and Susie E. Goodson Professor of Biomedical Engineering and senior associate dean of Pratt School of Engineering. "But MEDx has opened up opportunities beyond the traditional areas."

Geoffrey S. GinsburgFor example, in the School of Medicine, an active group of more than 140 medical students initiated and formed the Medicine Engineering Interest Group [MEIG] to facilitate such interaction. With additional support from MEDx, they have created a lunchtime seminar series for engineering faculty to share information with medical students about topics such as 3D printing, devices, implants, software, and applications. This is a chance for medical students to learn about engineering research happening at Duke in advance of choosing how they want to spend their third year. In some cases, the exposure to these ideas changes a student's trajectory.

Other MEDx-sponsored events include MEDx Café—informal coffee shop office hours where people can meet and bat around ideas. Targeted research collaboration dinners, seminars, and speaker series designed to attract attendees from both engineering and medicine also bring people with collaboration potential together.

"It's easy to imagine, but it can be hard to do," says Liping Feng, MD, assistant professor of obstetrics and gynecology. "Generally, clinical scientists care about improving medicine and basic scientists care about developing technology. MEDx has been able to bridge the two sides, and everyone hopes this leads to better patient care in the future."

ENERGIZING EDUCATION

A second focus is re-imagining education. At the undergraduate level, engineering students now travel to the medical center to shadow surgeons. Surgeons, in turn, explain their "pain points" or bottlenecks. The engineering students then return to the classroom to brainstorm possible solutions to the real-world problems.

Undergraduate senior design courses are another avenue of collaboration. "We've connected students and faculty from the School of Medicine to the biomedical engineering and mechanical engineering and materials science design courses," says Gall. "Individuals can pitch their project to the students in a reverse 'Shark Tank' scenario. If the students like the project, they can take it on. We'd like to extend this to other design courses, too. We want to give people multiple paths to connect with the right resource."

One path is the InnovateMD Fellowship,- a competitive one-year program for clinical trainees who are interested in medical device development. Co-founded in 2016 by David Ranney, MD, HS'13-Present, and Gall, the program pairs a trainee with engineering students to design a solution for an identified clinical need. The program involves project-based coursework and includes access to mentors, industry experts, and networking. Upon completion, trainees have a prototype or design they can continue developing. InnovateMD also provides educational resources, events, and seminars to faculty, residents, and fellows who wish to tackle a project or challenge in their specialty with an entrepreneurial perspective.

For other students, the right path might involve pursuing an additional degree. Joshua D'Arcy, MD'19 is the first recipient of the Barr-Spach Medicine and Engineering Scholarship. He is spending his third year of medical school pursuing a master's degree in biomedical engineering.

"Medicine is very present-oriented: physicians try to solve the problem that is directly in front of them," says D'Arcy. "Engineering is very future-oriented: what can be improved? The two are wonderfully complementary. I wanted to have a future-oriented mindset while practicing medicine."

George Cheng and Ken Gall

INSPIRING AND ENABLING INNOVATIVE SCIENCE

Innovation lies at the heart of MEDx and is being nurtured through competitively funded interschool colloquia and interdisciplinary seed grants.

MEDx also provides biomedical research seed funding. Recent award winners read like a roll-call of science fiction plot lines: tissue engineering, the brain machine interface, artificial intelligence and machine learning, robotics, microfluidics, body-on-a-chip, and miniaturized diagnostics.

"We are trying to do something that is totally different than what currently exists. It is entirely outside of the box and in some ways moving in a different direction than our field, but I think taking those risks is really important, both in the context of science and engineering," says Kafui Dzirasa, MD'09, PhD'07, HS'10-'16, associate professor of psychiatry and behavioral sciences.

Dzirasa and Nenad Bursac, PhD, professor of biomedical engineering, are co-principal investigators of an ambitious 2017 MEDx biomedical research grant involving six different labs. The project is exactly the type of collaboration MEDx embraces: innovative, audacious, and interdisciplinary – research that more traditional funders might shy away from. Ideally, with early success, these projects will grab the attention of much larger funders such as the National Institutes of Health.

"There's definitely a palpable hunger among the faculty and students to do this cross-cutting work," says Ginsburg. "Innovation is proportional to diversity in terms of bringing different ways of thinking to a problem. Diversity of thought and diversity of backgrounds leads to much more accelerated innovation. People are less afraid to step out of their own disciplines to seek others' viewpoints. MEDx has contributed to this culture of innovation at Duke."

And the inspiration stemming from these collaborations is far-reaching.

"We are a group of creative engineers working in the lab," says Yao. "We encourage each other by imagining about how our work might be useful in the future. But after we started our project, the distance between technology and human health care decreased: not just physically, but mentally. It dramatically motivated the team, including me, to say, 'Here is a big problem in the real world, and many people are suffering, and we could potentially help.' It is very exciting for all of us."

ENHANCING ENTREPRENEURSHIP

Beyond promoting collaboration and research, MEDx is also working to support entrepreneurship. Students not only design prototypes, but can meet with potential investors or others who may want to support continued research and development.

"As projects move up this ladder, MEDx wants to help find a pathway to the clinic and commercialization," says Ginsburg.

With the Duke Innovation and Entrepreneurship Initiative, the Duke Office of Licensing and Ventures, and MedBlue—a medical school incubator that provides funding—MEDx works with numerous programs to help students and faculty understand commercialization and launch companies. MEDx co-sponsors workshops on topics such as the legal landscape of entrepreneurism; how to file intellectual property, patents, and licenses; and how to secure follow-on funding. In sum: how to be serious, strategic, and smart about starting a company.

To date, three start-up companies have been formed, or are in the process of being formed, based on work directly supported by MEDx.

BLUE SKIES AHEAD

As MEDx continues to grow, the focus will be on finding new areas of collaboration and sustainability. Mary E. Klotman, MD, dean of the School of Medicine, and Vice Chancellor for health affairs at Duke University appointed Ginsburg and Kathryn Nightingale, PhD, James L. and Elizabeth M. Vincent Professor of Biomedical Engineering, to co-chair a joint medicine and engineering task force. Their charge was to investigate what opportunities and strategic gaps may still exist between the two schools, and then to explore what programs and resources may need to be amplified to address those gaps.

"I'm totally excited about the science and the translational and commercialization opportunities," says Ginsburg. "It's about creating a model that allows us do even more crazy things—a model that allows people to escape current boundaries that exist because of resource constraints."

Several paths lead toward sustainability: one approach is through public and private philanthropy and another is through industry partnerships.

"If you look at the Big 5—Facebook, Amazon, Apple, Google, and Microsoft—they're all doing something in the health care space," says Ginsburg. "MEDx is in a really good position to seek out strategic partnerships with those who are aligned with the work we're doing here. Those partnerships could also lead to our expansion into new areas and provide internship opportunities for students to work in new and different types of research environments."

There is also tremendous interest in finding the $100 million idea.

"There are a lot of blue-sky opportunities," says Ginsburg. "In physics, we talk about potential energy. There is a lot of potential energy at Duke. You need just a small catalyst, and the fire will grow from there."

GET INVOLVED

Do you have an idea for a MEDx project?  Is there a challenge you see in your own clinical setting?  Would you like to become involved with a MEDx team as a mentor? Contact Geoffrey.ginsburg@duke.edu.