Academic Medicine In Conversation:

Associate Professor Chow Wan Cheng
Group Director, Academic Medicine, SingHealth
Senior Associate Dean, Academic Medicine, Duke-NUS Medical School

Associate Professor Derrick Chan
Academic Vice Chair, Research, Paediatrics Academic Clinical Programme
Head & Senior Consultant, Department of Paediatrics, Neurology, KK Women's and Children's Hospital

Panellists:

Professor Aung Tin
Kwan Im Thong Hood Cho Temple Professor in Ophthalmology
Executive Director, Singapore Eye Research Institute
Academic Vice Chair, Research, Ophthalmology & Visual Sciences Academic Clinical Programme

Professor Teh Bin Tean
Academic Vice Chair, Research, Oncology Academic Clinical Programme
Deputy Director (Research), National Cancer Centre Singapore

Associate Professor Jenny Low
Director, Research Skills Enhancement & Support, Medicine Academic Clinical Programme
Senior Consultant, Department of Infectious Diseases, Singapore General Hospital
Programme in Emerging Infectious Diseases, Duke-NUS Medical School

Professor Ooi Eng Eong
Deputy Director, Programme in Emerging Infectious Diseases, Duke-NUS Medical School

Professor Antonio Bertoletti
Programme in Emerging Infectious Diseases, Duke-NUS Medical School

The Science of Preparedness: What a Firm Research Foundation Lends to a Pandemic

While COVID-19 has been a blow to society, the pandemic has accelerated many changes and inspired life-changing discoveries, said co-facilitator Assoc Prof Chow. In this webinar, she led a discussion on how our researchers' past work on infectious diseases laid the groundwork for better understanding of and overcoming COVID-19.

• Backed by earlier experience of studying dengue and yellow fever, clinician-scientists Prof Ooi Eng Eong
  and Assoc Prof Jenny Low are in the final stages of developing a vaccine and antibody drug for COVID-19.
• Additionally, Prof Antonio Bertoletti's longstanding work in Hepatitis B led to the discovery of the
  importance of T cells for longer-term immunity against SARS-CoV-2.
• Ground breaking scientific success often shadows humble beginnings and setbacks, but the rewards are worth it, said panellists.

"Don't discount something even when it sounds really crazy," said Associate Professor Jenny Low during the second session of Academic Medicine in Conversation about her journey developing the Lunar-Cov19 vaccine together with Professor Ooi Eng Eong.

It was a daunting prospect to lead clinical trials for a vaccine that works through replicating the dreaded viral spike protein to stimulate a stronger immune response, but Assoc Prof Low decided to give it a shot, and it wasn't based on blind faith.

Since 2005, Assoc Prof Low and Prof Ooi have partnered up to study infectious diseases such as dengue and yellow fever. Their work deepened their understanding of how vaccines work and what drives humans' antibody response among other intricacies of fighting viruses.

"We know, okay, here's what we look for, here's how we know it's safe. This is how [our past work] brought us forward," said Prof Ooi.

Their fellow scientist at Duke-NUS, Professor Antonio Bertoletti had a similar experience. His longstanding work in Hepatitis B led to the discovery of the importance of T cells for longer-term immunity against SARS-CoV-2. His paper was published in scientific journal Nature in July 2020.

From clinicians to scientists

The trio's success stories certainly were a result of dedication to science. Once clinicians, Professors Ooi and Bertoletti decisively made the switch to become full-time scientists years ago.

"As a houseman doing a four-month posting, I saw the same patient several times. It became apparent that we don't understand the disease that's why we're just patching. I wanted to solve the problem rather than patch the problem," said Prof Ooi.

Prof Bertoletti sees his current job as an extension of his duty to patients. "I'm not giving directly drugs to patients but in reality I'm thinking how to treat them better. So to be completely honest, I still think I'm doing my work as an MD."

Future of research

A career in research and innovation comes with its fair share of road bumps, and COVID-19 has thrown additional challenges in the way such as less funding for non-COVID related projects and slower recruitment for study participants who prefer not to dwell in hospitals, shared veteran clinician-scientist Professor Aung Tin.

Nonetheless, the panellists in AM In Conversation are looking to the future as new research topics are poised to emerge.

"Some obvious areas would be digital science, Artificial Intelligence and big data. And with our ageing population, regenerative medicine is a good area to look at, such as how to boost immunity in older people," said Professor Teh Bin Tean.

Prof Aung added, "It's very important to also look at health services research, especially [factors affecting] the uptake of care, barriers to accessing care, compliance and adherence."

Aspirants take note

Lack of time may be a common reason full-time clinicians hesitate to step into research but the panellists are confident that with self-motivation to make their own opportunities, every healthcare professional will not be denied the opportunity to try.

Assoc Prof Low recalled how she once presented a proposal of her career vision to her former boss. "You have to be thick-skinned. I got tremendous departmental support and that's really crucial. After that it's all about identifying your niche, finding out where all the good people are and working with them," she added.

Prof Teh got his start in cancer research by taking family history of patients in the night ward as an intern in the surgery department. "There were so many cancer patients there but no one took their family history. I found so many hereditary cancer syndromes."

At the end of the day, the experts advised young clinicians to keep an open mind as a career in research can be unpredictable. Said Prof Ooi, "I don't think we can anticipate a lot of it. We do what we think is the best science today and that preparation allows us to move on to the next thing. You just go where the science takes you."

Co-facilitator Assoc Prof Derrick Chan closed the session on an encouraging note: "It's evident that research is alive and well at SingHealth. It's tough but worth the journey. We want to keep innovating and keep agile, and bring new discoveries back to the frontline where we can really help our patients."