Many kids dream of becoming an astronaut when they grow up. Others are drawn to medicine. Kjell Lindgren, MD, managed to do both. For six months in 2015, he served as a NASA flight engineer and the only physician on International Space Station Expedition 44/45.
Aerospace physicians support the health, safety, and well-being of pilots, aircrews, and astronauts. With five accredited U.S. residency programs, space medicine is an attractive career option for physicians who want to practice preventative or occupational medicine with unique challenges.
Lindgren has a substantial resume—a requirement for space travelers. He earned a bachelor’s degree in biology from the U.S. Air Force Academy in 1995, a master’s degree in cardiovascular physiology from Colorado State University in 1996, and an MD from University of Colorado School of Medicine (UCSM) in 2002. He then went on to complete a two-year residency in aerospace medicine and a master’s degree in public health at the University of Texas Medical Branch at Galveston and is board certified in emergency and aerospace medicine.
“The field is pretty competitive and the person needs to have a decent clinical background to be able to draw from in order to make appropriate aerospace decisions,” said Dean M. Olson, MD, director of the aerospace medicine residency program at Wright State University Boonshoft School of Medicine in Dayton, Ohio. “It’s not impossible for someone to get through with one year of internship [at Wright], but the ideal candidate is someone who has completed their residency and is either board certified or board eligible.”
Aerospace physicians often train in multiple disciplines such as internal medicine, family practice, emergency medicine, ophthalmology, otolaryngology, and psychology. “I had a versatile background with emergency medicine and military experience in an operational setting,” Lindgren said in a UCSM alumni profile. “I was used to decision making under high pressure in a team environment.”
“There’s microgravity when you are orbiting the earth, there is radiation exposure; these are very complicated problems you have to solve.”
Dean M. Olson, MD
Space wreaks havoc on the body. Bones, muscles, organs, eyes, and ears are all affected, which can lead to bone and muscle loss, reduced cardiac function, and blindness. “You can’t go up in altitude without having some physiological effects or having some protection against them,” said Olson. “That’s a lot of what we focus on—hypoxia, for example—in addition to those physiological changes caused by acceleration or deceleration. There’s microgravity when you are orbiting the earth, there is radiation exposure; these are very complicated problems you have to solve.” Close quarters and long periods away from family and friends can affect mental health, too.
Olson started his career as an aerospace engineer. With limited jobs in his field, he decided to go to the Medical College of Wisconsin and entered a family practice residency program in Colorado. Eventually he transitioned to emergency medicine, then occupational medicine. After years of practice, he discovered aerospace medicine. “It was a good pathway because having that clinical experience really was beneficial for my work and knowledge when I went into aerospace medicine.”
Much of aerospace medicine is preventative, ensuring crew members are fit to fly. In addition, doctors consult with engineers to develop the proper equipment to promote safety once they are in the air, according to Vincent Michaud, MD, deputy chief health and medical officer at NASA.
“Having people who know about basic physiology and how it applies to the hardware is very helpful,” he said during a recent presentation at the AAMC.
Michaud served 25 years in the U.S. Air Force before joining NASA as a civilian. He noted, many aerospace physicians also take the military route.
“One of the nicest things about [being a flight surgeon] is that you are expected to fly with F16 crew members,” he said. “The air force had a lot of great opportunities for me in the aerospace medicine arena, then I moved to NASA where I could do space medicine.”
There are two military residency programs in aerospace medicine—one at Wright-Patterson Air Force Base in Ohio and the other at the Naval Aerospace Medical Institute in Pensacola, Fla.—in addition to the three civilian programs at Wright State University, the University of Texas Medical Branch at Galveston, and Mayo Clinic in Rochester, Minn.
NASA offers a four-week aerospace medicine clerkship for six fourth-year medical students in October and April at the Johnson Space Center in Houston, Tex. Throughout the month of rotations, students get to interact with NASA experts, including engineers, scientists, and the astronauts themselves.
As NASA plans to send humans to Mars by the 2030s, Michaud said it’s a good time for young medical students and doctors to consider going into aerospace medicine. “If you do the math, today’s medical students are going to be that crew of docs—crew members are about 45 years old when they fly.”
Olson added that new areas of study may open up as the general population begins traveling to space. Astronauts are relatively young, healthy individuals, but people who are not as healthy might respond differently to space travel. “These are questions that we are slowly finding a few answers for, but we don’t have the data set yet,” he said.
Varun Shahi, MD, a recent graduate from Mayo Medical School participated in NASA’s April rotation.
“Growing up, a lot of us have dreams of going to space and wanting to be an astronaut. Eventually those dreams fade away, or we get caught up in doing other things. I held on to that dream for a very long time and still one day want to apply to the astronaut program and see where it takes me.”
Brent Monseur, MD, now an intern at Thomas Jefferson University Hospitals in Philadelphia, participated in NASA’s October clerkship rotation as a fourth-year student at Virginia Commonwealth University School of Medicine in Richmond. He said that he always fantasized about being an astronaut but knew he wanted to become a doctor. On a whim, he applied to NASA’s program, which he described as a “once in a lifetime experience.”
Monseur encourages other fourth-year students to try something different like he did. “We sometimes say ‘no’ to ourselves as opposed to going for it. Showing interest can be the first step to getting what you want. I say, go for it!”