Medical marvels: the critical role of clinician-scientists 

This article featured in Illuminate Newsletter Autumn ‘24
Key Researchers
Research Officer
A microscopic image of myositis muscle showing scattered necrotic muscle fibres, stained pink for scientific analysis (left). Dr Jessica Day (right)

Travelling between the adjacent buildings of the WEHI labs and the Royal Melbourne Hospital takes only a few quick steps, but Dr Jessica Day manages to rack up plenty as she bounces between them.

On a given workday she might spend her morning meeting with patients at the hospital, before heading into theatre to collect muscle biopsies. After placing the resulting tissue samples into an esky, Dr Day will head across to the lab, spending the afternoon processing these to further her research. She then might have to head back to the hospital if one of her patients needs help.

Dr Day is a clinician-scientist: an exceptional cohort of medical professionals that play an essential role in translating lab discoveries into practical healthcare solutions.

Splitting their professional lives between the distinct challenges of lab-based research, and the direct care of patients in hospitals and clinics, clinician-scientists are renowned for their incredible drive and passion for helping others.

After graduating in medicine and completing advanced training in rheumatology, Dr Day decided to take time off from clinical work to focus full-time on a PhD.

“I realised then how much I loved research, and had this opportunity to immerse myself in it, and experiment with different concepts and ideas,” she says.

But she also found that she missed the immediacy and satisfaction of medicine. The experience highlighted how much she needed both the lab and the clinic in her life.

Better patient outcomes

Dr Day is a rheumatologist, specialising in diseases of the body’s locomotor system, including myositis – a group of rare autoimmune diseases that cause muscle inflammation.

Myositis has a major impact on quality of life, leading to fatigue, weakness and decreased ability to perform daily activities. Although these conditions are commonly managed with immunosuppressive medications, these treatments can cause toxicity and certain forms of myositis do not respond to any existing therapy.

The clinical work guides her research in the Wicks lab at WEHI, helping Dr Day see where the knowledge gaps are. But it also goes the other way.

The muscle biopsies she takes are conducted for diagnostic reasons, however most patients consent to extra samples being collected for research.

Back in the lab, after she’s taken off her ‘people hat’, Dr Day takes a look at the muscle samples under the microscope and processes patient blood samples into basic cells and plasma to be stored in a biobank for her ongoing research.

In the case of a particularly aggressive form of myositis, by examining tissue samples in the lab Dr Day hopes to be able to better inform her diagnosis and treatment.

“Working in both the lab and the clinic gives you this added layer of knowledge about the disease that you wouldn’t have otherwise.”

Specialist support program

Combining the two roles, and staying on top of both providing patient care and conducting a large research workload can be difficult. WEHI introduced the Attracting and Retaining Clinician-Scientists (ARCS) program in recognition of the complexities of combining research with clinical practice and making this into a sustainable career.

The program aims to make WEHI an attractive destination for clinician-scientists by providing support, including mentoring and funding to maintain clinical engagement when this is not otherwise available. It has helped 11 clinician-scientists since it started in 2020.

For Dr Day, that support was essential to maintaining her clinical engagement in the rheumatology unit at the Royal Melbourne Hospital.

“The ARCS funding has supported my involvement in a systemic autoimmune diseases clinic at the Royal Melbourne Hospital that includes myositis patients – I wouldn’t have been able to dedicate myself to the clinic without that funding.

“It has also helped raise my profile at the Royal Melbourne Hospital and internationally in the field which increases my opportunities for collaboration and has been fantastic for my career.

“It’s a unique opportunity, and it’s great to feel so well supported by WEHI.”

Dr Day’s ultimate goal is to see the outcomes for myositis patients improve substantially, like they have for other conditions.

Take rheumatoid arthritis for example, another autoimmune inflammatory condition.

In a relatively short period of time the prognosis has gone from bed rest, joint deformities and progressive disability, to the expectation that patients receive appropriate treatment as early as possible and then hopefully live close to a normal life.

“It’s inspiring to see what’s happened with rheumatoid arthritis when there’s been such a dedicated research effort towards the disease,” says Dr Day.

“Now is the time to move to other diseases that are less well studied.”

Header image: A microscopic image of myositis muscle showing scattered necrotic muscle fibres, stained pink for scientific analysis (left). Dr Jessica Day (right)

First published on 06 March 2024
This article featured in Illuminate Newsletter Autumn ‘24
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