Five years after joining the faculty at Duke University School of Medicine and Duke Cancer Institute, Tammara Watts, MD, PhD, associate professor of head and neck surgery & communication sciences, is finally outfitting her own lab.

In 2019, as a newly recruited surgeon and scientist, she was charged with finding an established researcher who would agree to lend her space to get her research program started. This model is not uncommon at Duke for junior physician-scientists. They are just beginning their clinical practices, and without large amounts of independent federal research funding, starting their own lab at the same time is a heavy lift.

Watts found a generous mentor and colleague in Gerard “Gerry” Blobe, MD, PhD, professor of medicine, cell biology, and pharmacology and cancer biology. “I didn’t know a single person on campus, but I called a lot of people. Gerry was gracious enough to take me in,” Watts said. “He gave me a quarter of his lab. That’s where my team works. He gave me use of his common equipment, so I didn’t have to spend any money on that. His team has helped me out in a pinch when my folks have not been able to come in for experiments, and vice versa.”

Watts would not be setting up her own lab without a $3.1 million grant that she received in April 2024. Awarded by the National Institutes of Health (NIH), it’s an R01 — an independent investigator grant that funds a specific, mature research project for up to five years.

She attributes this success to many factors, including the lab home with Blobe, mentoring and collaboration from other Duke colleagues, and a Duke Cancer Institute (DCI) pilot grant that allowed her to collect preliminary data that she used to show proof of concept in the NIH grant application.

Watts’s experiences demonstrate some of the challenges of building a career as a clinician-scientist. Paying for lab space is just one of the hurdles. Putting in the time required is another; It takes years beyond earning an MD-PhD to build a lab. Increasingly, new PhD graduates go into industry, said Blobe, who is also director of education and training at DCI. “The number of postdocs on campus has declined pretty significantly,” he said. That’s a problem because academic scientists, and particularly physician-scientists, who both care for patients and conduct research, drive discovery of new and better treatments.

To nurture the next generation of scientists and build a diverse, robust cancer workforce, the National Cancer Institute and DCI have put increased emphasis on education and training. DCI has launched 19 new training initiatives in the last five years, including efforts to engage high school students and undergraduates, all the way to junior faculty. (See “Filling in the Gaps.”)

Many of the new training programs focus on groups that are typically under-represented in medicine. Duke is also increasingly focusing on reaching out to the Durham community to engage middle and high school students in science and get them interested in coming to Duke, in collaboration with DCI Associate Director of Community Outreach, Equity, and Engagement Tomi Akinyemiju, PhD, Blobe said.

Creating a clinical and academic workforce that reflects the population of the people it serves is a priority for Duke Cancer Institute, said Steven Patierno, PhD, deputy director of DCI, who has for more than 20 years directed programs to eliminate cancer health disparities and achieve health equity.

As Watts pointed out, several studies show that having a diverse physician workforce is linked to better patient outcomes, including a 2023 study from John Snyder, MD, of the US

Department of Health and Human Services, which showed that increased Black representation in the primary care physician workforce was associated with a higher life expectancy for Black patients and inversely associated with all cause Black mortality.

In addition to funding the science, the grant supports new efforts to help diversify the oncology workforce, including a surgery resident from Howard University who will spend two years at Duke conducting oncology research in an area of their choosing. This part of the grant will also support a high school student from the City of Medicine Academy in Durham to spend a summer in Watts’s lab or that of any of her co-investigators to earn school credit while learning what it’s like to conduct research.

The grant will also fund an effort to make laboratory space available to junior faculty who want to get started conducting translational research. “I’d like to have a dedicated incubator lab with all of the equipment that someone would need to run experiments, so that their precious pilot funds and startup funds can be used purely for generating data,” said Watts, who is associate director for equity, diversity, and inclusion at DCI.

None of these plans would have been possible if Watts hadn’t found a temporary home for her research with Blobe’s lab. “I credit a lot of my ability to write these grants and get the data and brainstorm ideas for Gerry taking me in,” Watts said. “I have benefited from outstanding mentorship throughout my career in academic medicine,” she said. “If we aim to improve workforce diversity, we must create welcoming environments for the development of early career faculty interested in pursuing research.”

This article was originally published in the Fall 2024 Breakthroughs. Read more about DCI's breakthrough research and patient care in this biannual magazine.