From Bench to Bedside: Career Translation from Science to Medicine
By: Petri Takkala
Dr. Joseph Gabriel, MD, MSc
Resident, University of Toronto Family and Community Medicine
Seeing patients and delivering babies are all in a day’s work for Dr. Joseph Gabriel, MD, MSc. As a first year resident in a rural family medicine program affiliated with the University of Toronto Family and Community Medicine program, Joe, as he likes to be called, has the daily opportunity to provide the first line of care to a diverse population of patients in various parts of Ontario.
Building Foundations in Biomedical Science
Growing up in rural Ontario, in the small town of Cobourg, east of Toronto, Joe knows first hand how important it is for rural communities to have access to family doctors. Joe began his training in science at Queen’s University where he completed his BSc in Life Science. He developed an interest in obstructive sleep apnea while working on his senior year research project in this area. Taking his interest in biomedical science further, he joined the Institute of Medical Science (IMS) at the University of Toronto to work towards his Master’s degree in the lab of Dr. Douglas Bradley, MD, a world leader in obstructive sleep apnea. Joe’s MSc thesis project examined the role of fluid retention on upper airway obstruction and the incidence of sleep apneas. In a unique set of experiments, normal healthy participants were given intravenous saline while sleeping and wearing compression stockings, causing fluid to accumulate rostrally. They found that intravenous fluid loading in older participants could narrow the upper airway causing or exacerbating obstruction sleep apnea. This work led to a number of publications and has broadened our scientific understanding of this common sleep disorder. After defending his thesis in the summer of 2011, Joe only had a few weeks off before returning to Queen’s University to embark on his medical training.
Clinical Training and Family Medicine
During medical school, students have the opportunity to explore a number of disciplines during their clinical rotations, however it was the 7-week rural family medicine rotation in Midland Ontario that really attracted Joe’s interest to becoming a primary care physician in a rural community. Delivering babies, performing minor surgical procedures, and being exposed to a lot of different situations was all very exciting for the young physician. The University of Toronto has a rural family medicine residency program in which doctors spend one year training in a hospital in Toronto, and the second year of training in Midland Ontario. As 1 of 8 doctors in the program, Joe is enthusiastic about the comprehensive medical education that the program offers for primary care physicians, and the services that he will be able to provide to communities around Ontario. A typical day for Joe runs from 8 am, occasionally to 7 am the next morning. During this time, he provides acute care to patients, and gets exposure to a wide variety of specialties (e.g. obstetrics, pediatrics, internal medicine, emergency medicine, etc.), which is a great way to learn about medicine and appreciate the work of doctors in a diverse range of specialties. Joe is also looking forward to working on a quality improvement research project that is an integrated program requirement in year 1 of the residency program. Joe will rely foremost on the scientific tools and training he received at the IMS in assessing and evaluating ways to improve patient care. As part of a team and working with hospital administrators, one clinical research area of interest is in investigating whether prescription rates for proton pump inhibitors are in line with best practice guidelines for patient care, or whether changes can be made to optimize patient health and minimize complications. These are good drugs often prescribed for treatment of a variety of conditions including acid reflux, but have connections to a number of adverse effects. As a physician, the results of his research have a direct impact on the daily clinical experience of his patients.
Maintaining a Healthy Work-Life Balance
Finding time in such a busy life to pursue other personal interests is important for limiting stress and maintaining a positive outlook, but Joe advises that the extracurricular activities that students pursue during their studies must be sustainable. During his MSc, Joe often took opportunities to explore Toronto to discover the vibrant culture that we’re all fortunate to be surrounded by. The big city’s Indy and hip hop communities gave him the perfect opportunity to take his love of rap and hip hop and practice rapping in a small club to develop his hobby among a core group of regulars with a shared enthusiasm. As the talented rapper known as the Egyptian Prescription, Joe has since had the honour to open for his musical idol, Shad, been interviewed by the CBC, worked with producers and played shows in Toronto and Kingston, and is in the process of writing an album.
For students currently thinking about pursing a career in medicine, Joe recommends that they apply broadly and be persistent. Take the time to develop yourself and have something interesting about you that makes you unique. Medicine is a life long and rewarding career that demands that physicians are constantly learning about new developments in biomedical science and patient care. Working well with colleagues and on a team are essential skills for physicians in any discipline. Joe emphasizes that the strong friendships and collegial environment of medical school and residency training have made both experiences a fantastic time. Joe is enthusiastic as he continues to develop his career and pursue his goals of providing care to patients in communities throughout Ontario.