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From studying history at Middlebury college to pursuing medicine post-undergrad, rheumatologist Dr. Gregory McDermott’s unconventional career journey is one that led him to become a physician-researcher whose clinical observations inform his research questions. In this blog post, Dr. McDermott muses on his transition from history to medicine, his passion for rheumatology, and his COMET T-32 research project involving ankylosing spondyloarthritis, a spinal disease that presents various challenges in its diagnosis.
The Road to OrACORe
Dr. McDermott fondly recounts his time as an undergrad at Middlebury college, where he studied history with a focus on anti-Catholicism in American politics. Like other humanities majors, he was encouraged to consider a career in law or academics, “but I realized through summer internship experiences that these were not the right career choices for me,” he recounted. “During college, I was involved in several volunteer extracurricular activities that I loved that had more of a medical ‘flavor’ – I was a student athletic trainer and provided volunteer physical therapy to a member of the town’s community who had cerebral palsy.” These experiences convinced him to pivot from his history studies to pursue a career in medicine. His next stop was the completion of a post-baccalaureate pre-medical program after graduation. Although this path to medical school is slightly atypical, Dr. McDermott said, “I had the opportunity to study a topic I love while also discovering a career that I love, and that’s the best experience any student can ask for.”
Upon completing his post-bac program, McDermott matriculated into Cornell Medical School to begin his medical training. “In the first year of medical school, they taught anatomy and physiology at the same time, which was a simple barometer for us to determine if we might fit better in a surgical or medical specialty. I enjoyed anatomy, but loved physiology, so I set my sights on Internal Medicine.” He then moved to Boston for his Internal Medicine residency at the Massachusetts General Hospital. Letting his interests take the lead, McDermott described how the rheumatology rotation during his second year of residency felt right for him, “I chose to train in rheumatology because I loved general internal medicine and learning about all the different internal medicine subspecialties. Rheumatic diseases are often multi-systemic. Because they encompass many parts of the body and require a broad knowledge of different organ systems, I could engage in multiple areas of internal medicine.” Another factor that led McDermott to choose rheumatology was the opportunity to develop long-term relationships with patients. “There’s an inherent reward to longitudinal care. In rheumatology, you have this wonderful opportunity to build trust with your patients and guide them through a chronic illness. It can be difficult at times worrying about those patients with a hard disease course, but I have the opportunity to walk alongside them during those tough times. Seeing them when they’re doing better is also an incredible privilege.”
There’s an inherent reward to longitudinal care. In rheumatology, you have this wonderful opportunity to build trust with your patients and guide them through a chronic illness.Dr. Gregory McDermott
A Bridging of Interests
After starting rheumatology fellowship at Brigham and Women’s Hospital, McDermott decided to pursue research to better understand the troubling diseases that his patients face. He learned about the COMET T-32 fellowship while working on the inpatient rheumatology consult service with Dr. Katz, who encouraged him to seek mentorship and apply to research training programs. “Hearing about the COMET program at a time in my career when I wanted to engage in research was a rather auspicious moment. I feel so fortunate that I had the opportunity to apply for a fellowship with OrACORe.”
Upon joining OrACORe as a T-32 post-doctoral fellow, McDermott began his research on diagnostic delay in axial spondyloarthritis (axSpA), an inflammatory condition that can affect the spine, pelvis, eyes, and skin causing a range of lifestyle and emotional burdens for patients who suffer from the disease. The hallmark symptom of axSpA is chronic low back pain. However, back pain is a common complaint for many patients seeking pain relief. “AxSpA is a rare cause of a common complaint, and that often results in a delayed diagnosis. It may take many years for patients to receive the correct diagnosis,” said McDermott. Investigating the factors involved with delayed diagnosis of axSpA, including patient characteristics and social vulnerability, in addition to understanding its consequences is important to McDermott. “A timely diagnosis allows for the initiation of anti-inflammatory treatment that may prevent joint damage and other long-term disease consequences.” McDermott hopes that his research can illuminate how socioeconomic factors may contribute to delayed diagnosis and create resources to help patients efficiently navigate the medical system and find the appropriate provider for diagnosing and managing their back pain. “I hope that my work will help identify patients who are at high risk for a delayed diagnosis. I also want my research to highlight practice settings that may benefit from educational and screening initiatives so patients can receive timely and appropriate care.”
Undertaking such a detailed research project with multiple areas of analysis can be challenging, and McDermott points to the importance of having mentors along for the journey. “Drs. Katz and Losina have been so supportive of my project and clinical interests. They’ve been instrumental in providing helpful research and life advice as I navigate this exciting period in my career where I’m growing as a physician-researcher.”
A Path Forward
McDermott’s fellowship years represent a time where he balances both his clinical and research goals. “The whole process [of performing independent research] has given me insight into how to prioritize projects that are feasible and impactful while also maintaining a healthy work and life balance. Creating a balance is not without its challenges, but I’m glad that this fellowship protects my research time and I also love that I can continue to see my patients.”
As McDermott continues to practice medicine, he envisions a future where his research continues to investigate the diseases that his patients confront every day. “Seeing the challenges in clinical care gives roots to my research questions. I aspire to continue working at the interface between research and clinical care and follow the example of all of my great mentors.” For those interested in a career in research, McDermott offers valuable advice—“When you’re deciding on what research questions to ask, try to keep the impact on the patient in mind. In times when I’m struggling to decide which projects to pursue, I take a step back to ask myself big-picture questions about who it benefits and how. If there are multiple research questions you can ask, choose the one that’s the most helpful to current or future patients.”
If there are multiple research questions you can ask, choose the one that’s the most helpful to current or future patients.Dr. Gregory McDermott
To learn more about the COMET T-32 program, click here.