AAMC Reporter: May 2009

Medical, Engineering Schools Team Up to Tackle Big Research

—By Stephen Pelletier, special to the Reporter

Bioengineering is a term that is becoming more prominent these days. Many bioengineering projects are underway at academic institutions around the country, but experts say that truly effective bioengineering programs—both for research and training—must be a collaborative effort between schools of engineering and medicine.

As the relationship between those two disciplines has become clearer and closer, universities have invented a wide variety of administrative structures to foster productive collaboration between the two areas, which historically have tended to work more or less separately, comfortable in their respective academic silos. Models of collaboration include partnerships among individual faculty, interdisciplinary courses, institutes and centers, links between university departments or schools, collaboration in a merged department such as bioengineering, and even formal ties between schools in different institutions.

The fact that so many different models exist suggests that strong forces are impelling the two disciplines to intermingle. Indeed, many universities have found that powerful synergies between medicine and engineering have accelerated the pace of research. The fact that no one model has emerged as the preferred way to blend the disciplines suggests that institutions are still experimenting to find the right mix and structures.

Seeded with Engineers

At the University of Pittsburgh, for example, much of the work to combine medicine and engineering flows through the department of bioengineering, whose chair, Harvey S. Borovetz, Ph.D., also holds a professorship in the department of surgery. The department has a longstanding relationship with the University of Pittsburgh Medical Center.

Sparked by a grant from the Whitaker Foundation to create bioengineering departments in engineering schools, Pittsburgh did just that. Importantly, though, the new department "was seeded with engineers who were originally on the medical school faculty," said Margaret C. McDonald, Ph.D., Pittsburgh's associate vice chancellor for academic affairs in health sciences. Today, McDonald reports, most of the department's faculty retain close ties to the school of medicine, including joint appointments.

The results are tangible. In a finding published recently in the journal Nature, for example, scientists based in Pittsburgh's schools of medicine and engineering, with colleagues, collaborated to get a monkey to successfully feed itself with a prosthetic arm using only signals from its brain. That research could benefit people with paralysis and spinal cord injuries.

"Engineering is integral to understanding the human body at every level," McDonald said. She adds that bringing medicine and engineering together enables researchers to examine a problem from different but often complementary perspectives.

Stanford University has invented a somewhat different take on the blended department. There, the mission of the relatively new department of bioengineering—it was established in 2002—is to fully fuse engineering and the life sciences and "embrace biology as a new engineering paradigm and apply engineering principles to medical problems and biological systems."

"We've been doing bioengineering at Stanford for 50 years without a department, and there was always a big debate about whether or not a department should be formed," said Russ B. Altman, M.D., Ph.D., who chairs the department. "One of the problems was that it wasn't clear whose turf it should be on," he said—engineering and medicine both made strong cases for why a joint department should logically reside with them.

Several years ago, however, Stanford faculty found themselves engaging in conversations rooted in the reality that biology was becoming more quantitative and biomedicine was requiring more engineering. "It was no longer just mechanical or electrical engineering applied to biology," Altman said. "There was this emerging discipline where you were doing biological engineering."

Setting aside turf wars, Stanford created a department of bioengineering that essentially combines the disciplines. The schools of medicine and engineering each contribute 50 percent to the department's budget. Faculty members hold joint appointments in both schools. Candidates for tenure are approved by the department and then by a joint committee appointed by the two schools, whose recommendation goes on to the provost.

Plans for the department include a new building, shared space with chemical engineering, that will be sited in the engineering quad. The department is also starting an undergraduate major.

Northwestern University takes a tack that many institutions follow—seeding cross-disciplinary work at many different levels throughout the academic structures, with varying degrees of formality. The university's Institute for Bionanotechnology in Medicine, for example, combines expertise of faculty members from Northwestern's schools of medicine, engineering, and arts and sciences. As just one example of Northwestern's cross-disciplinary work, a recent finding used nanotechnology to help repair spinal cord injuries in mice.

Julio M. Ottino, Ph.D., dean of Northwestern's Robert R. McCormick School of Engineering and Applied Sciences, was instrumental in bringing to life an interdisciplinary course in the life sciences called

"Medical Innovation." The two-quarter course draws students from Northwestern's schools of engineering, medicine, management, and law. Working with mentors from Northwestern Memorial Hospital, the primary teaching hospital for the Feinberg School of Medicine, the students collaborate to find an idea for a medical innovation and convert the idea into a product. At the end of the course they pitch business plans to venture capitalists. Ottino reports that at the end of the course's first year, nine of the 11 ideas pitched were patentable; one product has already been licensed.

Interinstituitional Partnerships

An altogether different model seeks synergies through formal partnerships between strong programs at different institutions. A case in point is the Wallace H. Coulter Department of Biomedical Engineering, a joint program of the College of Engineering at Georgia Tech and the Emory University School of Medicine. The Coulter Department was created in 1997 with a goal of integrating engineering methods into the mainstream of health care.

In practice, that mission translates into such specific components as the Emory-Georgia Tech Nanotechnology Center for Personalized and Predictive Oncology. With large-scale funding from the National Cancer Institute, the center brings engineering and medicine together by applying the power of nanotechnology to develop new approaches to diagnose and treat cancer. As another example, a project within another center, the Nanomedicine Center for Nucleoprotein Machines, seeks to repair genetic defects using nanomedicine.

According to Gilda A. Barabino, Ph.D., the vice provost for academic diversity at Georgia Institute of Technology and a professor and associate chair for graduate studies in the Coulter Department, the department's genesis was rooted in the sense that "if you really wanted to facilitate interactions between biomedical engineering and medicine, there should be a stronger infrastructure to support that."

The Coulter Department is headquartered in the U.A. Whitaker Building on Georgia Tech's campus, but also has lab space and administrative staff in the medical school at Emory. Faculty members have appointments in the department, but have primary affiliations with either Georgia Tech or Emory, Barabino said. Tenure is handled through a faculty member's primary institution.

Ph.D.-level students in the department take classes on both campuses and conduct research on one or the other. Barabino says that students are attracted to the program because of the access it provides to the resources of both institutions.

The formal partnership "enhances, facilitates, encourages, and stimulates collaboration, bridging engineering and medicine and bringing the two disciplines together," Barabino said, and "makes those connections stronger." She believes partnerships like the Coulter Department help speed the translation of research from bench to bedside.

Another example is the Virginia Tech-Wake Forest University School of Biomedical Engineering and Sciences (SBES), a joint graduate program with three partners: the Virginia Tech College of Engineering, the Wake Forest School of Medicine, and the VA-MD Regional College of Veterinary Medicine.

The genesis for the partnership came when both Virginia Tech and Wake Forest found they were not competitive for major bioengineering grants—the former school because it was not affiliated with a medical school, the latter because it lacked an engineering school. The partnership was formalized in part to give a structured home for such support.

The collaboration has paid off in many ways, according to SBES director J. Wallace Grant, Ph.D. One net result, he says, is that research funding at both institutions increased dramatically. The partnership also made Wake Forest more competitive for NIH grants in translational science. Grant also points to the collaboration as a spark in specific research findings, including work to kill cancer cells using electrodes. Another benefit is the ready access it gives researchers to different kinds of laboratory settings, including animal subjects.

About efforts to link medicine and engineering, Stanford's Altman said, "this is a hot area, and one of the ways it manifests itself is in the big push towards translational medicine."

"We've done the science, and now we have to figure out how to reduce it to practice for the purpose of delivering to patients," he said.

Altman believes the push to translation helps engage engineers. He also observed that recent hiring in medical schools of physicians who trained in engineering prior to studying medicine "brings an engineering mentality" into the medical schools and further helps bridge the two disciplines.

"As I have learned about engineering" as chair of the department, Altman said, "I have realized that a lot of doctoring is more like engineering than like science. There is a very natural affinity between engineers and doctors."