In pursuit of clinical research career, surgeon follows in parents’ footsteps

Meera Kotagal, MD ’09, MPH ’14, and her parents Uma Kotagal, MSc '96, and Shashi Kant, MSc '99

November 13, 2012 — When Meera Kotagal, MD ’09, MPH ’14, a surgical resident and research fellow at the University of Washington, entered the classroom to begin the Summer Program in Clinical Effectiveness(PCE) at Harvard School of Public Health this summer, she walked in the footsteps of her parents.

Two decades ago her parents, Cincinnati physicians Uma Kotagal, M.Sc.’96, and Shashi Kant, M.Sc.’99, took the same course for the same reason: to prepare themselves for careers in clinical research.

For Meera, enrolling in HSPH’s summers-only MPH program was a natural choice. Clinical research is a good fit with her plans to pursue a career in pediatric surgery, her current work at the Surgical Outcomes Research Center at the University of Washington, and her interest in global surgery. “My mother and father had such a positive experience here. They felt it changed the way they thought about research. It gave them an opportunity to be surrounded by incredibly thoughtful classmates who were doing interesting work of their own. It was a chance to be exposed to those people, to remarkable professors, and to learn in that unique environment,” she said.

Rigorous training

As a 47-year-old clinician-teacher-researcher at the time, Meera’s father wanted the rigorous training in methodology that PCE provides. “I have found the training and learning from PCE has seeped into my daily teaching and clinical activities,” said Kant, professor of clinical medicine at the University of Cincinnati, a nephrologist (kidney specialist) at The University Hospital, Cincinnati, and a clinical researcher.

Uma Kotagal enrolled in PCE at the suggestion of Marie McCormick,Sumner and Esther Feldberg Professor of Maternal and Child Health at HSPH. At the time, Uma was a researcher, neonatologist, and director of neonatal intensive care nurseries at University and Children’s hospitals in Cincinnati, and mother of two school-aged children. “I was looking for training in research that addressed the questions I experienced in my role as a clinical director and the gaps I saw in health care delivery,” Uma said. PCE, with its condensed schedule that she could juggle with managing her family, met her needs best. “This program helped jump start my second career at a pace I did not expect,” said Uma, now senior vice president for quality, safety, and transformation at Cincinnati Children’s Hospital.

A common thread                                

The PCE course attended by all three was taught by E. Francis Cook, professor of epidemiology. Cook, known for his dedication to students, had kept in touch with Meera’s parents. “They are two of my all-time favorite students and now good friends,” Cook said.

“It’s been really neat to be a student in Professor Cook’s class because I’ve known him since he visited my parents in Cincinnati when I was in high school. My mother and father raved about him for years as one of the most inventive, thoughtful, and generous teachers they have known…And I would agree,” Meera said.

Cook co-directs the course with Arnold Epstein, John H. Foster professor of health policy and management and chair of HSPH’s Department of Health Policy and Management, and David Bates, professor in health policy and management.

Students in the Summer MPH program, who take PCE during their first summer semester at the School, study clinical epidemiology and biostatistics, and choose from electives like current issues in health policy, decision analysis in clinical research, measuring health outcomes, and working with databases. With Cook’s mentorship and guidance, similar programs have been set up at academic sites ranging from Buenos Aires to Argentina.

Helping to bridge a gap

While the National Institutes of Health (NIH) reports the number of physician-researchers nationally has declined over the past two decades, the need is great for research that quickly translates basic science discoveries into clinical treatments. The burden of student loans, additional time required for advanced training, competition for limited research funding, and lack of mentors are among reasons cited by NIH for the drop.

Meera and her parents are among nearly 2,500 physicians who have gone through the intensive seven-week, 15-credit PCE since it began in 1986. Most take it during their post-residency fellowship training to equip themselves with quantitative skills for careers in clinical research or health care administration. Jointly run by HSPH, Brigham and Women’s Hospital, Massachusetts General Hospital, Harvard Medical School, PCE is thought to be the first and largest program to train MDs in clinical research methods. A 2009 survey showed nearly one-third of PCE graduates pursue investigations in epidemiology, clinical trials, and health services.

Meera agrees with her parents’ assessment of the program. “I feel lucky to be here at HSPH learning from some of the best teachers and thinkers in the field, and using their expertise in teaching people like me to pursue a career in research,” she said. “I feel lucky to be here back in the classroom learning.”

–Marge Dwyer

Photo by Kalpana Kotagal