Anthony L. McCall, MD, PhD, FACP, Vice President, Clinical Scientist, shared his advice for navigating ENDO 2017 and offered his thoughts on the future of the endocrinology field with the ENDO Daily. Dr. McCall is James M. Moss Professor of Medicine at the University of Virginia School of Medicine and Health System in Charlottesville, VA.
ENDO Daily: What drew you to the endocrinology field?
Dr. McCall: It was a confluence of several factors, including my mentors. My advisor in medical school was an endocrinologist; he was a thyroid specialist. Some of the folks whose teaching I really liked in medical school were endocrinologists, one of whom was a diabetes specialist and interested in metabolic issues even beyond strictly diabetes at that point. When I looked for places to do my residency, I went to Boston City Hospital and worked with my mentor’s mentor, Izzy Rosenberg, who was a thyroid specialist at Boston City Hospital. I just found that I really liked the way they thought. I liked the way they analyzed problems. I liked their world view of nature as a puzzle that you put your brain against and try to figure out what is going on. I think the appeal, in part, was that endocrinology seemed like a large connected complex intertwining physiology that if you understood it well enough you could figure out what was going wrong with people and help.
This was around the time that the Nobel Laureates Roger Guillemin, Andrew Schally, and Rosalyn Yalow had been doing their work and getting it recognized. I just thought that the fields that they were representing were very diverse, very interesting. They had developed tools to unlock some of the mysteries of endocrinology. Rosalyn Yalow with Solomon Berson had gotten the radioimmunoassay for insulin. When I was a medical student visiting Boston, I would go make rounds and I would then spend whole evenings typically until fairly late at night trying to make a single well counter work so I could make the TSH radioimmunoassay work in my hands. I would have racks of tubes trying to get a dose response curve that looked something like a reasonable thing. It was really my first attempt to work in a lab in a serious way. It was like learning to play the piano. You had to do things very particularly and you had to practice, practice, practice, practice. It wasn’t perfect, and we found out that our single well counter was not exactly correct. But it allowed me to see how to get into the niceties of measuring things well enough that you could begin to use your data to unravel mysteries. It was not what I expected to do, but it introduced me to a whole world of science supporting medicine.
ENDO Daily: What advice would you give clinical scientists, particularly first-time attendees, to maximize their ENDO 2017 experience?
Dr. McCall: One of the things to keep in mind about ENDO and the Endocrine Society in general is that it is the one place where you run the whole gamut of basic to clinical science to clinical care. They are side by side. One of my pieces of advice is don’t stick only within your field. Look for things outside your field to expand your knowledge and your worldview. Don’t miss the plenaries. They may not seem like your area, but, boy, what an incredible way to have the best people in the world let you know what’s going on and give you a glimpse of the future.
I think it’s critical to network and talk to people, particularly at posters. Give yourself enough time to not just see what’s there but to talk to somebody about why they are doing this, what’s going on, where are the breakthroughs.
I ask people to always look at symposia in a broad sense. I often pick speakers as much as topics because certain speakers everyone knows are wonderful.
One thing clinical science folks sometimes do, and I think it is a mistake, is to ignore basic science things because they are “not what they do.” But actually the basis for most of our clinical science in the future is the current basic science and where it’s going. For example, look at the evolution of molecular biology. It was all extremely basic science stuff, now these tools are routinely being used in clinical science as readouts for what the physiology is, as new ideas that we can to apply clinical problems.
The last thing I would say is have fun and talk to people. Don’t forget, this is a great group of people. There’s a lot going on that you can both learn from and just get an exciting view of what’s is happening in the broader context, not only your specialty.
ENDO Daily: As the Society embarks on its second century, what is on the horizon for the Society and the field at large?
Dr. McCall: I think these are incredibly exciting times. The Society has been very much on the move. Its recent presidents and its leadership are very engaged in making both the meetings, and the whole society more responsive, more inclusive, and very open and democratic. It’s actually a great organization to belong to. I belong to a bunch of organizations, and they all have different strengths. But I find myself more at home in the Endocrine Society. It’s growing fast. It’s very much a worldwide organization, broad in its reach. I think what many people don’t realize is they can get involved in the Endocrine Society and play a critical role in helping in its development. It’s a great place to learn, to network, and to talk to incredibly smart people and learn about what’s going on in life and the world. It’s a group of people that is going to play really important roles in the development of not only science, but of society.
There are a great many areas where there are breakthroughs. I am primarily someone who deals with diabetes. As an example, the movement of diabetes as a clinical specialty and as a clinical science has gone from being an art to real science. Technology is having an enormous impact. We are about to have the first commercial artificial pancreas delivered clinically in the next few months. There are a half dozen more in preparation at my own university and at other places that have done incredible work. This stuff was supposed to happen near the beginning of my career, and it seemed around the corner for about 30 years. But now in the last eight or nine years, it has actually come to fruition. It has just exploded.
In genomics and prevention of diabetes, I went to Doug Melton’s talk at ENDO 2016 and listened to him tell us about how he’s done things in mice that basically recapitulate every aspect of the basic molecular biology of creating insulin producing cells, beta cells. If you can do it in mice, you should be able to do it in people. Our artificial pancreas may actually be a bridge to a fully molecular development of replacing an endocrine pancreas that no longer works.
In cancers, in bone metabolism, we see advancements happening in leaps and bounds. It’s actually somewhat dizzying how incredibly quickly things have been developing in many areas.
One great thing about the Society is that it is going to continue to be a leader because of its broad view of a number of scientific fields. A lot of people don’t realize they are endocrinologists even though they are, and the Society is a great home for them.