The mid-career metamorphosis from mentee to mentor is something every clinical and translational researcher will face at one point, and negotiating the transition can be daunting. For Jonathan Gaffin, MD, assistant professor of pediatrics and a pulmonologist at Boston Children’s Hospital (BCH), our mentorship-based Visiting Research Internship Program (VRIP) provided the structure and support necessary to smooth the transition.

Gaffin mentored Gabriella “Gaby” Sierra, a rising second-year medical student at Meharry Medical College. Her research project investigated health-related quality of life in children who were born prematurely with bronchopulmonary dysplasia, a chronic lung disorder. We caught up with him shortly after the VRIP closing ceremony in July.

This is your first year as a VRIP mentor. What led you to get involved in the program?

I found out about the program because I was interested in mentoring Gaby. She was working in my lab as a research assistant when she applied for medical school, and I was really proud to be able to support her application. When she reached back out to see if there was a way she could return to the lab to do academic work as part of medical school, I was excited to hear from her. It prompted me to look for ways that we could enrich that experience, for her to not just work on a project in my lab for a couple months, but to actually have a broader academic mentorship experience. From that, I found the VRIP program through my own search through Harvard Catalyst’s offerings. It just seemed like a great fit for somebody with her background. VRIP offered broader mentorship than what I would be able to offer on my own and some structure within a true academic program that will also look really good on her CV, as she uses this experience as a stepping stone in her career.

You have a perspective both as mentee and mentor. What do you see as the value of mentorship?

“I’m definitely at a point in my career where I’m expanding the amount of mentorship I do and the level of mentorship I do. VRIP was a nice stepping stone for me in that regard, because it is a more formalized mentorship that takes place during a discrete period of time.”

We’re all in mentoring relationships at some level, whether we’re receiving it or giving it. In my experience, I do both. To know that there’s someone who is looking out for you and thinking of your career aspirations and your research is just invaluable to advancing your career, especially at a large academic institution. Even outside of the research realm, mentorship is really important to clinical and educational progression. I’ve certainly benefited from it throughout my career. Being in a position where I can offer it to others, it’s important to me that I continue that tradition.

I have participated in other Harvard-based or Harvard Catalyst programs that had a mentorship component early in my career when I was pursuing a master’s degree, including the Scholars in Clinical Science Program (SCSP). I also completed the Grant Review and Support Program (GRASP), which was really helpful in transitioning from early-career-development grants into more established grant success. I’ve mentored many pulmonary fellows within my division as well as other undergraduate and graduate students, but this is the first time that I’ve been a mentor for a Harvard Catalyst program.

I’m definitely at a point in my career where I’m expanding the amount of mentorship I do and the level of mentorship I do. VRIP was a nice stepping stone for me in that regard, because it is a more formalized mentorship that takes place during a discrete period of time.

What was the focus of Gaby Sierra’s research project and how does that fit into your broader research?

Broadly speaking, I’m interested in long-term respiratory health outcomes–and really all health outcomes–in children who have any type of chronic lung disease. I’ve worked in asthma research for a long time and my current focus is now broadening to children who were born prematurely and diagnosed with bronchopulmonary dysplasia, the most common chronic lung disease of prematurity. I’m interested in how these children develop throughout their childhood and into adulthood. One of my main research projects is to look at their long-term lung function and respiratory outcomes when they’re school age.

The overall objective of the main cohort is to understand the environmental health influences for lung function and respiratory symptoms. How does the indoor environment–air quality and exposure to contaminants–affect the development of lung function and respiratory health later on? We’re doing indoor air-quality monitoring and dust-sampling for allergens and other types of home-based exposures because we’re particularly interested in what happens after the child goes home from the NICU. Does it influence what happens later on? We know that some of what happens in the NICU is going to influence their breathing issues later on, but this other piece hasn’t really been explored.

As part of that research, we collect data on other health outcomes, including some other psychosocial comorbidity factors or medical diagnoses that may come up during their childhood and health-related quality of life, which is what Gaby worked on this summer. She really dug in on those measures, which we’re generating currently. It’s an area that’s new to our lab and to our research group, but also it really hasn’t been done very much. There are very few publications on health-related quality of life in similar cohorts.

In presenting her research project at the VRIP closing ceremony, Gaby described a surprising finding. Did it surprise you as well?

“Whenever we have an opportunity to mentor someone or to provide an experience in a field that a mentee is considering, we want them to have an honest understanding of what clinical research looks like and not just a glorified assessment.”

Yes, because we assumed that our study cohort would have similar findings as children with asthma, where we see decreased health-related quality of life and increased reports of anxiety, depression, and disability. We were shocked to find that, in actuality, this group of children reported similar or even better health outcomes and health-related quality of life than a control group who are not premature and don’t have any chronic health conditions. This research used data from a well-established NIH resource designed exactly for this purpose, to compare apples to apples across cohorts and across disease conditions.

At the closing ceremony, you shared how, going into the VRIP mentorship, you questioned whether such a short internship can truly mirror clinical research in real life. Can you expand on that?

Whenever we have an opportunity to mentor someone or to provide an experience in a field that a mentee is considering, we want them to have an honest understanding of what clinical research looks like and not just a glorified assessment. For most, if not all clinical researchers, the career path is never success after success after success. In fact, it’s usually some successes mixed with a number of either disappointments or redirections along the way.

To do a mentored internship in a short period of time requires the mentor to come to the table day one with a well-defined project that is manageable and more closely in line with guaranteed success, at least success of completion. It’s different than if we had two years to work on something. So my initial concern was that we’d be handing over something that’s too neatly packaged, that there would be success in the end, but it wouldn’t be a true reflection of what a career in clinical research looks like, especially at the career stage the VRIP participants are in.

What actually happened was in fact typical of science: As we started to dig into the analysis and understand the data, we realized there were several holes, and we ended up having to take one step forward, two steps back for several weeks while we sorted it out. There were inconsistencies with some of the NIH data and Gaby had to go back to the actual sources of data to make sure we had everything correct. She did a fantastic job reaching out to the NIH team directly to get advice on some of the analytics that go into their survey tool, and how best to analyze them as individual cohorts go through. That was really impressive. It also made me feel more confident that she was truly getting an experience of how difficult it is to do clinical research and how much extra work it takes than you anticipated just to get the data.