Latest / The Science of Skin / Clinical Trials in Dermatology: Insider Tips from Top Researchers

Transcript

Clinical Trials in Dermatology: Insider Tips from Top Researchers · The Science of Skin

• 0:08
  SPEAKER_00: Hello and welcome to the Science of Skin Podcast.
• 0:10
  SPEAKER_00: My name is Dr.
• 0:11
  SPEAKER_00: Ted Lane.
• 0:12
  SPEAKER_00: I'm a board certified dermatologist in Austin, Texas.
• 0:15
  SPEAKER_00: And I've got such a treat for everyone.
• 0:18
  SPEAKER_00: I've got Dr.
• 0:19
  SPEAKER_00: Jason Hawkes from Oregon as my guest.
• 0:23
  SPEAKER_00: Jason, how are you?
• 0:24
  SPEAKER_01: Great.
• 0:25
  SPEAKER_01: Happy to be here, Ted.
• 0:26
  SPEAKER_00: Man, it's awesome to have you.
• 0:27
  SPEAKER_00: So Jason is the co-owner, chief scientific officer, and investigator at the Oregon Medical Research Center.
• 0:37
  SPEAKER_00: And Jason, you guys run trials and gosh, all aspects of dermatology, at least all medical aspects.
• 0:44
  SPEAKER_01: Yeah, we we don't really have any cosmetic studies, but any given time we could be 35, 40 clinical trials, you know, AD, psoriasis, chronic urticaria, vitiligo, alopi shariata, you know, PN, if we have those studies.
• 1:00
  SPEAKER_01: I think that's the fun part because I don't I don't like to be pigeonholed.
• 1:04
  SPEAKER_01: So to have, you know, all of medical derm and to go from room to room, it keeps you on your toes, it keeps you in different mechanisms of action.
• 1:12
  SPEAKER_01: It's perfect.
• 1:12
  SPEAKER_01: It's fun.
• 1:13
  SPEAKER_00: Yeah.
• 1:14
  SPEAKER_00: Let me just say right now for everybody listening, if if this episode engenders any questions in your mind, if you have ideas for future podcast episodes, please send us an email at questions at science of skinsummit.com.
• 1:27
  SPEAKER_00: That's questions at science of skinsummit.com.
• 1:29
  SPEAKER_00: Jason, I thought that we would focus then on your passion.
• 1:33
  SPEAKER_00: And I got to share that passion with you, which is clinical trials, clinical research.
• 1:38
  SPEAKER_00: I I started my research center 13 or 14 years ago now.
• 1:43
  SPEAKER_00: And um, after running hundreds of trials at this point, I still love it.
• 1:47
  SPEAKER_00: It I really think it makes me a better doctor.
• 1:50
  SPEAKER_00: I'm able to care for patients better.
• 1:51
  SPEAKER_00: It makes me a better speaker.
• 1:53
  SPEAKER_00: It just really hits on all aspects of what I do.
• 1:56
  SPEAKER_00: Uh when did you start your research career?
• 2:00
  SPEAKER_01: Yeah, I mean, if I'm honest, it I was always kind of research first and then medicine second.
• 2:06
  SPEAKER_01: So, you know, going through training, I was in, you know, chemistry, biochemistry, and you know, I thought maybe eventually I would, you know, get a PhD or run a lab.
• 2:15
  SPEAKER_01: And I think the pull towards applying that, the true translational science, I think hit early on, brought me to medical school.
• 2:24
  SPEAKER_01: I spent time at the NIH during medical school, came back, you know, did did some translational work, some basic science work, molecular profiling, and really kind of saw that intersection between using the science to answer clinical questions or to develop new therapies.
• 2:42
  SPEAKER_01: And that's what really pushed me towards my master's in clinical investigation.
• 2:46
  SPEAKER_01: So I was at Rockefeller University three years after my residency, and I was four days in the lab, day in clinic.
• 2:53
  SPEAKER_01: And that for me was just kind of that perfect balance.
• 2:57
  SPEAKER_01: So I don't think research ever wasn't ever a decision.
• 3:01
  SPEAKER_01: It was always something I did.
• 3:02
  SPEAKER_01: It was just that I eventually found a way to keep the clinical care sort of at every day with the research.
• 3:10
  SPEAKER_01: And the clinical trials does that.
• 3:12
  SPEAKER_01: It's like you're using new therapies and new mechanisms, you're taking care of patients, you have more time.
• 3:18
  SPEAKER_01: It feels like a little slower approach than maybe the cattle herding that I think the system wants to push on providers.
• 3:25
  SPEAKER_01: So it gives me a chance to stop, think, digest, work through hard problems.
• 3:30
  SPEAKER_01: And it's actually just something that's always been with me.
• 3:33
  SPEAKER_00: Yeah.
• 3:33
  SPEAKER_00: It's funny, your your uh your path is a little bit different than mine.
• 3:37
  SPEAKER_00: I was I was seeing patients, I had done a little bit of clinical research and some bench top work in medical school, but otherwise I was seeing patients just kind of in the grind.
• 3:45
  SPEAKER_00: And at some point, probably 10 years of my career, I decided, you know what, I I really need to do something to just just to make things a little bit more interesting, right?
• 3:54
  SPEAKER_00: Otherwise, I felt like I was gonna get burned out.
• 3:56
  SPEAKER_01: And that's not uncommon.
• 3:58
  SPEAKER_01: We're seeing that in our colleagues.
• 3:59
  SPEAKER_01: And and you know, it I do think it's really important that you have those periods.
• 4:03
  SPEAKER_01: So, you know, there were you know years where I just had these high volume clinics, high throughput, but you set the foundations.
• 4:11
  SPEAKER_01: I think those aren't as stimulating and intellectually challenging as you know, that there's a point where after so many skin checks, you're you're ready to kind of pull back a little bit.
• 4:21
  SPEAKER_01: So inflammatory conditions, they give you that little bit of you know, extra detective work or a challenge.
• 4:27
  SPEAKER_01: I love when those patients come in and they're like, I've been to four or five other doctors and no one knows what's going on.
• 4:32
  SPEAKER_01: Like, you know, that that gets me excited for that that extra effort.
• 4:36
  SPEAKER_01: And I think we've gotten away from the medical derm a little bit more towards some of the other areas, but the medical derm is satisfying that these patients, they're just so miserable and to give them their lives back is is very satisfying.
• 4:52
  SPEAKER_00: Completely agree that you know, for the medical patient, you can find such career and personal intellectual, emotional satisfaction by helping someone who's suffering so much.
• 5:04
  SPEAKER_00: And and you can, with the tip of the spear treatment, you can, you know, find something in that that helps and that nothing else so far has.
• 5:13
  SPEAKER_00: And that is an incredible part of clinical trial work.
• 5:17
  SPEAKER_00: Because let's face it, a lot of people, you know, there's there's different motivations for getting involved in the trial as a subject, um, one of which is financial, and you hope that's not why, but for for some people it's financial.
• 5:29
  SPEAKER_00: And then the other part is they're just frustrated with the system, they just haven't been helped.
• 5:34
  SPEAKER_00: And whether that's because they haven't had access to care because of their financial or life situation or underinsured, or because they have a condition that's just resistant to treatment.
• 5:46
  SPEAKER_00: Uh we see all those patients, and and I I try and highlight that.
• 5:50
  SPEAKER_00: And I know, I know I've heard you as well, Jason, highlight the fact that when you're looking at um data, the you know, patient characteristics and disease characteristics and in clinical trials, and you're looking at these promotional decks, it's always good a good idea to really focus on, you know, what the severity is, how long they've had it, what's the body surface area involved, and then keep in mind the type of patient that gets involved in a clinical trial as well.
• 6:14
  SPEAKER_00: It's not the run-of-the-mill moderate patient that a lot of us see, for example, a psoriasis or AD.
• 6:19
  SPEAKER_00: It's somebody very different.
• 6:21
  SPEAKER_01: Yeah, no, they're all great points.
• 6:23
  SPEAKER_01: And and I love what you said about sort of the financial, because one of the consistent things that our subjects will say is that, you know, I actually I don't care about the money.
• 6:33
  SPEAKER_01: Like they genuinely want to do, they want to opt in for the biopsies or the optional blood draws because, you know, they'll frequently say, I want to, I want to help patients.
• 6:43
  SPEAKER_01: But then you hear, you listen to their story and you hear two common things.
• 6:46
  SPEAKER_01: One, the system that they're in, whether it's a big healthcare system or a private healthcare group, you know, they're they keep pushing topicals or, you know, ultraviolet therapy or with alopecia, they want to keep doing, you know, kenalog shots or with her docariates that, you know, let's try this different recipe of antihistamines, which hasn't worked for 10 years, but let's just see, maybe we'll figure it out.
• 7:08
  SPEAKER_01: And they get frustrated with the systems or they don't have access to the medications.
• 7:13
  SPEAKER_01: And I think they genuinely love being building the relationships.
• 7:17
  SPEAKER_01: They like to spend time, they want to learn what's driving their disease.
• 7:21
  SPEAKER_01: We always talk about patients don't care about the immunology.
• 7:24
  SPEAKER_01: It's not true.
• 7:25
  SPEAKER_01: They want to understand it, they want to know why their body's doing this and you know why their children don't have it or their parents don't have it.
• 7:32
  SPEAKER_01: So that that's a really satisfying aspect.
• 7:35
  SPEAKER_01: And and to your last point about the data, when you start to do clinical research, you start to see that artificial nature of the trial system, which helps you interpret data, but it also helps you see the regulatory flaws, the you know, the FDA reporting and the adverse events, and you start to interpret it very differently as opposed to somebody who you know hasn't done the trial.
• 8:00
  SPEAKER_01: We we have that extra lens, which I think allows us to bring that educational component about, you know, what does this data really mean?
• 8:08
  SPEAKER_00: Yeah.
• 8:08
  SPEAKER_00: I think when you're hearing someone maybe present a deck or or talk about new therapies, you can I I feel like I can always tell who's a c a clinical trialist and who isn't, because you have that foundational knowledge of how these trials were run and and your experience in in many trials that help you interpret the data and and give give the audience some nuances that someone that just doesn't run trials is just can't do.
• 8:33
  SPEAKER_00: And that and that's not a knock.
• 8:34
  SPEAKER_00: It's just they just don't have the experience.
• 8:37
  SPEAKER_00: And um, so I I always like to learn from clinical trialists um on podium.
• 8:42
  SPEAKER_00: I find that they they give a more profound and deeper understanding and and again can translate the the data maybe to to the audience in a in a little bit better way.
• 8:54
  SPEAKER_00: So um I I really appreciate that.
• 8:57
  SPEAKER_00: Jason, as you kind of have moved forward in your research career, clinical trials have changed, haven't they, from 10 years ago to where they are now?
• 9:05
  SPEAKER_00: And and if you were to, you know, a new five years in dermatologist comes to you and says, you know, I'd like to get involved in clinical trials, what what would you tell them?
• 9:13
  SPEAKER_00: Because they're definitely more onerous to run than they used to be.
• 9:16
  SPEAKER_01: Yeah, I mean, we see that where the complexity of the trials have gone up.
• 9:20
  SPEAKER_01: Even just the conduct of the trial, there are um more treatment arms, there's you know, treatment withdrawal and retreatment.
• 9:29
  SPEAKER_01: You've got um de novo entry into studies from parent studies that now all these new people go into open label, and you know, now you have these programs where you can sign up for a program and then they can just add different trials, different disease states.
• 9:43
  SPEAKER_01: So, you know, I I it is getting more complex.
• 9:46
  SPEAKER_01: I think it gets getting harder to work with vendors.
• 9:49
  SPEAKER_01: And I think kind of across the board that some of these vendors have just taken on too much, and it can be a slow process.
• 9:57
  SPEAKER_01: There's definitely a lot of admin work, and it's not better or worse than full clinical care.
• 10:02
  SPEAKER_01: It's just it's just different, whether it's prior auths and other paperwork, answering messages, it's same on the trial side.
• 10:10
  SPEAKER_01: There's just other aspects of work from you know, sign-offs, viewing safety reports, you know, filling out adverse events, fighting for budgets.
• 10:19
  SPEAKER_01: So it's it's different.
• 10:22
  SPEAKER_01: And I think when people go into research, if somebody said, you know, I'm really thinking about research, um, I wouldn't do it from a business perspective.
• 10:31
  SPEAKER_01: I I wouldn't I wouldn't go into it because it's gonna be the way you're gonna, you know, make more money per se.
• 10:37
  SPEAKER_01: I think the trials do well and they have some advantages, but you want to be doing it because you want to be on that forefront.
• 10:45
  SPEAKER_01: And for me, it was very natural because I was already an early adopter.
• 10:50
  SPEAKER_01: When a new medicine came out, you know, my mentor when I was in residency was saying, use that medication as much as possible.
• 10:57
  SPEAKER_01: Find those patients, use it, get your own experience.
• 11:00
  SPEAKER_01: And that's how I practiced.
• 11:02
  SPEAKER_01: So the trials for me are also fun because you get these patients who have failed therapies or you're treating a disease where it has no approved indications or medicines, that you can offer those treatments and you start to see how it's working from the very beginning.
• 11:17
  SPEAKER_01: So that when we get out, we've already used it.
• 11:19
  SPEAKER_01: And so to me, that felt very natural.
• 11:22
  SPEAKER_01: And those should be the primary motivators to really understand a disease, help give people access where maybe the system or even the providers are seeing haven't really offered those medications and to want to be a part of that research process.
• 11:37
  SPEAKER_01: And if that makes you tick like it did for me, then it's a good fit.
• 11:41
  SPEAKER_01: If not, then you know, honestly, you're probably better off in the clinical space.
• 11:45
  SPEAKER_01: So it's not for everybody.
• 11:46
  SPEAKER_00: No, I totally agree.
• 11:47
  SPEAKER_00: I think um when I'm speaking to younger Durhams, and you know, either I'm hiring someone that I'd like to become a sub eye or a PI, or where someone has come to me just asking about that opportunity.
• 11:58
  SPEAKER_00: I you have to find someone with that intellectual curiosity and the passion because not every part of research is reimbursable, right?
• 12:06
  SPEAKER_00: There's there there aren't codes for a lot of what we do, whether it's some training or or speaking with monitors or taking the phone call from the sponsor.
• 12:14
  SPEAKER_00: You know, there's so much time involved.
• 12:17
  SPEAKER_00: Um, and and you know, when done right, research can be financially rewarding.
• 12:22
  SPEAKER_00: Don't get me wrong, I'm not saying it's a it's a loss leader or anything like that, but it it's certainly something that you have to have a passion for because otherwise you're not gonna put up with the mishigas of of of all the stuff that goes along um with running a research trial.
• 12:37
  SPEAKER_00: But then there's some of the ancillary things that are really interesting, right?
• 12:40
  SPEAKER_00: Like if you run trials and and you have these great relationships with industry, I mean, you get to do some really fun things.
• 12:48
  SPEAKER_00: Um you and I have done that together, you know, and and uh and and I think if if you don't mind just talking about what, you know, as your role as a leading clinical trialist, that's opened up all sorts of doors for you.
• 13:02
  SPEAKER_01: Oh, no doubt about it.
• 13:03
  SPEAKER_01: And and I think we have gone through the phase in medicine where pharma's been viewed as the bad guy, right?
• 13:09
  SPEAKER_01: And that's probably been perpetuated more by the academic centers where there's been this probably an artificial barrier.
• 13:19
  SPEAKER_01: We train these residents to, you know, be protected and you know, stay away from pharma.
• 13:24
  SPEAKER_01: And then, you know, one day they graduate and they have to go out in the real world where getting these expensive medications, um, you need the help.
• 13:32
  SPEAKER_01: And and I think we clinical trials helps us view uh industry as one of the many stakeholders in healthcare.
• 13:41
  SPEAKER_01: And the reality is that these groups, you know, care a lot about patients.
• 13:45
  SPEAKER_01: They care a lot about advancing therapies.
• 13:48
  SPEAKER_01: These therapies are getting better and better, so you can't benefit from a medication with very high skin clearance or good disease response without the this industry group and their RD that develop these therapies.
• 14:01
  SPEAKER_01: So I think the newer generations have moved beyond this idea.
• 14:05
  SPEAKER_01: Most people are going out into private practice, they're developing these relationships, they're partnering with industry in uh ways for educating.
• 14:13
  SPEAKER_01: I mean, pharma's single-handedly really pushed some of the greatest educational efforts out in research.
• 14:20
  SPEAKER_01: And you look at all of these conferences, who's bringing the data?
• 14:24
  SPEAKER_01: They're trialists, they're companies that have worked together, they're developing new therapies.
• 14:29
  SPEAKER_01: And so I think we have to just get past that narrative.
• 14:34
  SPEAKER_01: And to your point, I you know, those industry partnerships, just like some of the academic and research partnerships, have advanced my understanding of a lot of diseases.
• 14:45
  SPEAKER_01: They are very good at what they do, they know the data, the scientists have taught me a lot, the trialists have taught me a lot, the medical doctors within the companies, you know, they really bring you know unique inspites, especially outside of our specialty.
• 14:58
  SPEAKER_01: So I do a lot of erticaria and to learn from the allergists.
• 15:01
  SPEAKER_01: The same with you know, psoriatic disease, the rheumatologists.
• 15:05
  SPEAKER_01: Uh, we we learn from each other, but you know, who brings us together?
• 15:09
  SPEAKER_01: Often these conferences and often some of these industry uh collaborations.
• 15:14
  SPEAKER_01: So I I think that's that's something that if you want to be involved in, just a huge opportunity to really network and connect.
• 15:21
  SPEAKER_01: And just like, you know, as you mentioned, you and I have worked together and those have been really satisfying and and uh enjoyable.
• 15:29
  SPEAKER_00: Yeah, I think um lots to unpack there, and I completely agree with you.
• 15:33
  SPEAKER_00: It's it's so interesting if you're, for example, involved in protocol consultation or an advisory board to review phase one or two data.
• 15:42
  SPEAKER_00: And the people from the company that are presenting it to you are bird certified dermatologists, they could be uh gastroenterologist if you're dealing with the Nile 23, for example, they could be of all different specialties who have either practiced or continue to practice, but they've decided to join industry to again progress, um, progress medicine.
• 16:01
  SPEAKER_00: Uh, and they find that that's the best way for them to make a difference.
• 16:06
  SPEAKER_00: And I cannot agree more.
• 16:08
  SPEAKER_00: I learn something from them every single time.
• 16:11
  SPEAKER_00: Maybe learning is is about the machinations of how things work, you know, how the sausage is made, and that's really interesting.
• 16:18
  SPEAKER_00: But a lot of it is academic, where I'm I'm learning new things about these medicines or pathways or gut skin, brain skin connection.
• 16:27
  SPEAKER_00: I just I completely agree.
• 16:29
  SPEAKER_00: It opens up these opportunities that would be otherwise difficult to have.
• 16:33
  SPEAKER_00: And then, and and you know, those are the academic opportunities which are amazing, and but there's commercial opportunities as well, Jason.
• 16:40
  SPEAKER_00: Uh, you know, when you were mentioning we worked together, we we were involved in a national sales meeting together where we were presenting in front of the sales for some of the data and why we thought it was so exciting and and how the reps could possibly interpret that data and and use it for for their presentations and detailing.
• 16:56
  SPEAKER_00: But plus, plus, plus, there's so many great opportunities.
• 16:59
  SPEAKER_00: I mean, I don't know, Jason, if you if you want to kind of detail maybe a two or three of the things that you've done commercially that have been really fun for you.
• 17:07
  SPEAKER_01: I mean, some of the global events have been, you know, really amazing.
• 17:11
  SPEAKER_01: Um, going over and meeting with, you know, I was at a meeting uh over in Spain where, you know, people from 30 countries, specialists, and you know, different um disease states coming together and like talking about where inflammation tied these conditions together.
• 17:29
  SPEAKER_01: You know, the advisory boards are you know very satisfying because you get experts, people are colleagues that have different perspectives.
• 17:38
  SPEAKER_01: They they dice up the data a different way or they had a different experience, or maybe they even had some of these patients that had these unusual adverse events and created some context.
• 17:48
  SPEAKER_01: So uh the education components, one of the things I did recently that I really enjoyed was it was a virtual speaker program, but it was for patients.
• 17:58
  SPEAKER_01: They weren't teaching other doctors.
• 17:59
  SPEAKER_01: It was actually, I was with the patient ambassador speaking about her experience with a treatment in urticaria, but talking to other patients who are living with the same disease to try to help them understand what options were available, what they were experiencing.
• 18:15
  SPEAKER_01: Like those are really unique and satisfying.
• 18:18
  SPEAKER_01: And we've done those in other non-industry avenues, but the point is they're facilitating some of those meetings, conversations, collaborations.
• 18:27
  SPEAKER_01: I've been on publications with groups where you know we saw a need for something and we wrote the paper.
• 18:33
  SPEAKER_01: And, you know, that group brought us all together and helped facilitate that.
• 18:38
  SPEAKER_01: So it is truly an academic enterprise.
• 18:41
  SPEAKER_01: And, you know, academia, I've always said it's not a place, it's it's a mindset and it's a feeling that it's a spirit of people who want to contribute.
• 18:50
  SPEAKER_01: And you can do that from anywhere.
• 18:51
  SPEAKER_01: You can do it from your private practice or within a big group.
• 18:54
  SPEAKER_01: Uh you just have to carve out the time and the resources to do that, and and it can be extremely satisfying.
• 19:00
  SPEAKER_01: So I've been I've really enjoyed those things as much as I have anything in my academic training.
• 19:05
  SPEAKER_00: Yeah, and I have to say, Jason, you you recently presented uh at a speaker training, and and gosh, it was hour plus of you presenting all this data and and basic science knowledge and and pathogenesis of disease, and it was incredible.
• 19:22
  SPEAKER_00: And and so your your understanding of the immunology underlying many of these inflammatory skin diseases is you know probably the best that I've ever heard.
• 19:31
  SPEAKER_00: And it it that kind of opportunity is also great because I you enjoyed it.
• 19:36
  SPEAKER_00: We could tell that you were enjoying it, you love what you were talking about, you were educating us, and we were soaking it all in.
• 19:42
  SPEAKER_00: Um, but I don't know if that would happen if you weren't so involved with the clinical trial work and and your industry relationships as well.
• 19:48
  SPEAKER_01: I mean, it's true.
• 19:49
  SPEAKER_01: There's so many people, you know, I was just talking with my wife about that recently, that there are people who would be great in these scenarios that don't participate or are not allowed to participate based on the institution that they're a part of.
• 20:02
  SPEAKER_01: And and and I think that's that's a loss for all of us because um I enjoy it.
• 20:07
  SPEAKER_01: It's as you mentioned, like for me, talking about the immunology where it meets the clinic, that that's the sweet spot.
• 20:13
  SPEAKER_01: That was my master's at translational immunology.
• 20:16
  SPEAKER_01: And and I think that's that's what we want to bring to our colleagues.
• 20:21
  SPEAKER_01: We you cannot practice good dermatology anymore without some understanding of the immune system.
• 20:28
  SPEAKER_01: Choosing therapies, using these therapies, how they work.
• 20:32
  SPEAKER_01: Doesn't matter if you're in skin cancer.
• 20:34
  SPEAKER_01: We see the developments happening in Mo's and the new technology about digital pathology and AI incorporation.
• 20:41
  SPEAKER_01: It doesn't matter where you're gonna go or what you do, you have to have some fundamental understanding about statistics, about science, about the immunology.
• 20:51
  SPEAKER_01: You have to recognize the disease and you have to know how to manage it.
• 20:55
  SPEAKER_01: So, you know, I I it's sad for me that there are people that would be so great in this space that that maybe don't feel like they uh are welcome or they're not allowed to participate.
• 21:06
  SPEAKER_01: And and I'd like to see that education go a little bit broader and and to bring in some of our colleagues because that's where we can help people is when we can see a gap and bridge it with some of the science, and then make an informed decision to get those patients better.
• 21:23
  SPEAKER_01: It should translate to to improvement, and I think that's the goal.
• 21:27
  SPEAKER_00: Yeah.
• 21:28
  SPEAKER_00: I I think what I'm nervous about though is that you know, we have our generation of of trialists and educators such as yourself, but then I'm a little worried that the next generation isn't as robust as it needs to be.
• 21:41
  SPEAKER_00: And some of that is because there's a misunderstanding of what being a clinical trialist involves, and maybe there's a lack of desire to get involved in it.
• 21:50
  SPEAKER_00: But also I think some people are held back because of the practice situation that they're in.
• 21:55
  SPEAKER_00: Perhaps it's a private equity backed situation where they're just not supported in trials or academically.
• 22:00
  SPEAKER_00: Anemia as well.
• 22:02
  SPEAKER_00: And that makes me a little nervous for the future of our specialty.
• 22:06
  SPEAKER_00: So, you know, I again I mentioned we have the uh the questions that's at scienceeskinsummit.com as as the as the email.
• 22:15
  SPEAKER_00: If you have any questions, if you're a young dermatologist that wants to get in involved in clinical trials, and you have any questions, uh, you know, Jason and myself are both, we'd both like, I don't want to volunteer you for this, Jason.
• 22:27
  SPEAKER_00: So please tell me if you don't, but I think you'd be happy to help as well and and act as mentors for the next generation of clinical trialists, because if we don't have people coming in, it's not like the trials are gonna stop, they're gonna go to non-core.
• 22:39
  SPEAKER_00: So they'll go to the family medicine doctors that are running trials, and God bless them, they're they're doing their best, but they're not dermatologists.
• 22:45
  SPEAKER_00: Um, and so it makes me a little nervous for meeting primary endpoints if you're assessing something that you don't truly understand, you don't see on a day-to-day basis.
• 22:52
  SPEAKER_01: So Yeah, and you think that's yeah, you hit on that key point about mentorship.
• 22:56
  SPEAKER_01: There actually still one of my favorite articles to date was a JAMA article called Mentorship Malpractice.
• 23:04
  SPEAKER_01: And if you haven't read it, read it.
• 23:06
  SPEAKER_01: It's within a series.
• 23:07
  SPEAKER_01: Um, there's like mentee missteps, is another one.
• 23:11
  SPEAKER_01: But the mentorship malpractice article talks about basically we talk a lot about good mentors, but we don't spend any time phenotyping bad mentors.
• 23:20
  SPEAKER_01: And it really kind of gives the, you know, there's one called like the exploiter, where their job is just to exploit you and to take advantage of your efforts.
• 23:29
  SPEAKER_01: And it's an interesting article because it does help you start to identify that you need to surround yourself with some of the right people.
• 23:36
  SPEAKER_01: And I think particularly in this area, it's very hard to just do this on your own.
• 23:42
  SPEAKER_01: Find someone who's doing it, find someone that has it, spend some days with them, spend some time, see what that day-to-day is like.
• 23:50
  SPEAKER_01: And it's actually better.
• 23:51
  SPEAKER_01: I mean, I I spent most of my time in the early trial space with um two really good mentors who did the trials.
• 23:58
  SPEAKER_01: They've been doing it for years.
• 24:00
  SPEAKER_01: They didn't need the prestige of running another trial.
• 24:04
  SPEAKER_01: They let me take a trial, be the PI, mentored me through that process.
• 24:08
  SPEAKER_01: And I think there are a lot of people in our specialty that are willing to do that.
• 24:12
  SPEAKER_01: But if you get stuck with someone who's not interested in your career development or helping further your career, then you're gonna find yourself stuck.
• 24:20
  SPEAKER_01: And that that is our responsibility as individuals to make sure we have those right people and that you have to advocate for yourself.
• 24:27
  SPEAKER_01: So it's a great article to kind of help you identify are you with the right people or is there someone else you're looking for?
• 24:34
  SPEAKER_01: But yeah, definitely happy to help the group who's thinking about it, you know, in our practice.
• 24:38
  SPEAKER_01: We're more than willing to have people come in and see how it's done, see the day-to-day.
• 24:42
  SPEAKER_01: So, you know, definitely people can reach out.
• 24:45
  SPEAKER_00: Yeah, I I agree with that.
• 24:47
  SPEAKER_00: And I have to tell you, from you know, from my experience, I had great professors in in residency and they helped me as I started my own practice, but then I kind of lost this idea of mentorship.
• 24:58
  SPEAKER_00: And and for the first 10 years of my practice, I made all these mistakes.
• 25:02
  SPEAKER_00: And I wish I had just reached out to mentors instead of making all the mistakes myself.
• 25:07
  SPEAKER_00: And then certainly when I was trying to get into research, I didn't reach out to anybody either.
• 25:11
  SPEAKER_00: I just kind of found my way through this, you know, maze of clinical trial work, and I was very lucky that some people helped me along the way from industry.
• 25:21
  SPEAKER_00: But my goodness, don't be like me.
• 25:22
  SPEAKER_00: Like use the mentors.
• 25:24
  SPEAKER_00: I mean, there's you know, the wonderful thing about our specialty is that we're so collegial and we we want to see everybody rise to the top.
• 25:31
  SPEAKER_00: And we're such a small specialty, there's no there's no need for competitiveness uh or competition.
• 25:37
  SPEAKER_00: So um, yeah, take to do the opposite of me and listen to Jason.
• 25:43
  SPEAKER_01: Although I will say, you know, my my my path, you know, I I thought about you know going up in in life as being a ladder, right?
• 25:52
  SPEAKER_01: These rungs, but I I wasn't.
• 25:53
  SPEAKER_01: I went sideways and backwards.
• 25:55
  SPEAKER_01: And you know, one of my um trainees when I was at at or my mentor, I guess, um, when I was a trainee in Rockefeller said, you need to start to view your career more like a lattice.
• 26:06
  SPEAKER_01: And you can move sometimes sideways rather than just up and down.
• 26:10
  SPEAKER_01: And and my path wasn't efficient, but it got me every layer.
• 26:15
  SPEAKER_01: I took something that added to my to where I'm at now.
• 26:19
  SPEAKER_01: And actually I'm really happy doing what I'm doing now.
• 26:22
  SPEAKER_01: So, you know, don't don't be discouraged to make those missteps or you're doing something that might seem a little bit, you know, atypical or unconventional.
• 26:30
  SPEAKER_01: That's fine.
• 26:31
  SPEAKER_01: If if it really feels like it connects, then follow it.
• 26:34
  SPEAKER_01: And ultimately that will come back in a strong ROI for what you're really trying to build.
• 26:39
  SPEAKER_01: So don't be afraid of that either.
• 26:41
  SPEAKER_00: Yeah, lattice, not a ladder.
• 26:42
  SPEAKER_00: I love that.
• 26:43
  SPEAKER_00: I I I think there are some times as you're building your career where there's kind of this one step forward, two steps back, and you just feel like, oh, am I ever going to kind of achieve what I want to achieve?
• 26:54
  SPEAKER_00: But if you think it's the right thing, just like you said, if if that is the right goal for you, if you really believe in it, then that slog is worth it.
• 27:00
  SPEAKER_00: Uh and and that one step forward, they'll accumulate.
• 27:03
  SPEAKER_00: And then so eventually it'll be one step forward, half a step back.
• 27:05
  SPEAKER_00: And then it's just gonna be the steps forward, and you'll kind of get to where you want to be.
• 27:09
  SPEAKER_00: So so I I completely agree with that.
• 27:12
  SPEAKER_00: Look, we're being inspirational now, Jason.
• 27:14
  SPEAKER_00: Listen to us.
• 27:15
  SPEAKER_01: That's a good change for us.
• 27:17
  SPEAKER_00: Yeah, right.
• 27:19
  SPEAKER_00: Um, listen, Jason, um, we're at the end of the podcast episode.
• 27:23
  SPEAKER_00: Thank you so much.
• 27:23
  SPEAKER_00: We didn't even get to talk about science, but I promise I need you back on so we can kind of dive into your amazing knowledge of all the immunology.
• 27:30
  SPEAKER_00: I I completely agree.
• 27:31
  SPEAKER_00: I I think we should rebrand as cutaneous immunologists and and not dermatologists, because that's really what we are uh at this point.
• 27:39
  SPEAKER_00: And and who knows in 10 years what it's gonna be like.
• 27:41
  SPEAKER_00: I mean, just the targets are changing and the understanding of the inflammation is changing.
• 27:47
  SPEAKER_00: So we're we're at just a such an exciting point in our specialty, aren't we?
• 27:51
  SPEAKER_01: Agreed, yeah.
• 27:51
  SPEAKER_01: Well, I'm happy to do a part two and and nerd out a little bit.
• 27:55
  SPEAKER_00: Nice, nice.
• 27:56
  SPEAKER_00: Uh, everybody, thank you so much for listening.
• 27:58
  SPEAKER_00: My name is Dr.
• 27:59
  SPEAKER_00: Ted Lane.
• 27:59
  SPEAKER_00: I'm a board certified dermatologist in Austin.
• 28:01
  SPEAKER_00: I've got Dr.
• 28:02
  SPEAKER_00: Jason Hawkes, also a board certified dermatologist.
• 28:04
  SPEAKER_00: He runs the Oregon Medical Research Center, uh, a hugely prolific, prolific, and influential research center.
• 28:12
  SPEAKER_00: Uh, and uh thank you so much, Jason, for for doing this and and taking some time away from the conference that you're at where you're going to be speaking.
• 28:20
  SPEAKER_00: So I really appreciate it.
• 28:22
  SPEAKER_01: Yeah, thanks, Ted.
• 28:23
  SPEAKER_01: My pleasure.
• 28:23
  SPEAKER_00: Okay, great.
• 28:24
  SPEAKER_00: Thanks for listening, everybody.
• 28:25
  SPEAKER_00: Take care.