By Eric Skaar, PhD, MPH
My interest in infectious disease research started when I was in high school. I was lucky to attend a public high school in suburban Chicago that offered a class in microbiology. I can even remember the moment I learned about the mechanism of action of penicillin; and from that moment forward I knew that I would work towards a career studying bacterial pathogens. Following high school I attended the University of Wisconsin at Madison and majored in Bacteriology. During that time I performed research in Dr. Timothy Donohue’s laboratory studying single carbon metabolism in Rhodobacter sphaeroides. This experience solidified my interest in microbiology and provided insight into the career options that exist in academia for someone interested in biomedical research. With this information in hand, I enrolled in the Integrated Graduate Program (IGP) in September 1997 at Northwestern University Medical School and started my thesis work in the laboratory of Dr. Hank Seifert, where my PhD thesis studies focused on antigenic variation in Neisseria gonorrhoeae, the causative agent of the disease gonorrhea.
I have always been very interested in the pathologic manifestations of infections caused by microbial pathogens. This interest became more pronounced while working in the Seifert laboratory, where the research was focused on an organism that places a tremendous burden on global public health. During my second year of graduate school I began to go through that period that I believe most graduate students go through where you realize that the clock is ticking and you don’t have much data yet, and you begin to wonder if bench science is the right career for you. Simultaneously, I was becoming more and more interested in the growing field of molecular epidemiology. The revolution in molecular biology had finally begun to affect the practice of epidemiology and I was excited about the potential that this interdisciplinary approach to public health could have on our understanding of how organisms such as N. gonorrhoeae are transmitted. However, I was concerned that training exclusively in molecular biology would not give me the expertise that I needed to truly understand the dynamic process of microbial transmission and spread. When I learned that Northwestern Medical School had a part-time Master’s in Public Health Program in place for medical students, this seemed like an excellent opportunity for me to expand my thesis training into public health, with the long-term goal of a career in molecular epidemiology. In particular, I had become very interested in pursuing a position as an Epidemic Intelligence Service (EIS) officer for the CDC and I thought that this dual degree would ideally position me for the EIS program. The only problem was that PhD students were not allowed into the MPH program at that time.
When I first inquired with the graduate school about the possibility of enrolling in the MPH program, I was told that there was no way I would be allowed to enroll in this Master’s program as a PhD student as this program was designed exclusively for the MD students. I thought this to be very silly as I was convinced that training in the MPH program would enhance my education and improve my career outlook so I launched a search to find an advocate who could help me make this plan a reality. Over a period of a few weeks I worked my way through various members of the Department of Microbiology and Immunology, the Department of Preventative Medicine, and the Integrated Graduate Program in Life Sciences until I finally had a meeting with Dr. James Duncan, who at the time was a faculty member in the Department of Microbiology and Immunology and a Dean of the Graduate School. Dean Duncan and I had a long discussion about my interests and reasoning behind wanting to enroll in the MPH program, and he expressed concerns regarding the workload involved in obtaining a PhD being incompatible with an additional part-time graduate program. However, in the end he saw the value that a PhD/MPH could bring to someone with an interest in molecular epidemiology, and he told me that I would be allowed to enroll in the program as long as Dr. Seifert approved, which he did. Dr. Seifert was a tremendous mentor to me during this time; now that I run my own laboratory, I realize how much it was asking of him to allow me to take on this additional responsibility when the vast majority of my time should have been spent at the bench. If it wasn’t for his support, I certainly would have never moved forward with my efforts to obtain an MPH.
Once I had the blessings of Drs. Seifert and Duncan, all of the red tape disappeared and I was rapidly engaged in meetings with members of the IGP and Department of Preventative Medicine to create a curriculum suitable for a PhD student with my interests. During the initial design of the dual degree curriculum, Dr. Steven Anderson was exceptionally helpful on the IGP side and Drs. Rowland (“Bing”) Chang, Maureen Moran, and Susan Gapstur were very helpful on the Public Health side. In fact, Dr. Gapstur generously agreed to be my thesis advisor for the MPH portion of my training and I am tremendously thankful to her for all of the support and assistance she gave me during my time in graduate school. There were many meetings in those early days where we discussed the number and make-up of the courses I would take. It was agreed that the core curriculum would not be changed much, but in some cases the elective courses that were in place were not relevant for my training. In those cases, the institution was very flexible and allowed me to enroll in courses through the genetic counseling program to satisfy some of my elective requirements. It was also decided that my MPH thesis should complement my PhD thesis, so my MPH thesis focused on sequencing clinical samples of N. gonorrhoeae in an effort to identify variations in gonococcal surface proteins in isolates from multiple patients.
My time as a dual PhD/MPH student was challenging. I have vivid memories of having to stop experiments at 5:30 in the Seifert lab so I could spend 30 minutes doing my biostatistics homework before my 6:00–9:00 PM biostatistics class. I also remember many, many nights in the drive-through line at the Portillo’s on Ontario because Portillo’s was the only restaurant in the area besides McDonald’s that had a drive-through and was open after 9:00 PM. In addition to all the hard work, I remember developing a deep appreciation for the practice of epidemiology, which improved the quality and rigor of my PhD thesis. As I progressed through my thesis, I was fortunate to begin to experience success at the bench. This success strengthened my confidence that perhaps I had what it took to pursue a career in academia, so I decided to forgo applications to the EIS Program and instead pursued more traditional postdoctoral training in the laboratory of Dr. Olaf Schneewind at the University of Chicago. My MPH had taught me about the significant burden that infectious diseases place on public health; Dr. Schneewind’s laboratory researches Staphylococcus aureus, which is the most common cause of infectious disease in the United States. During my time in the Schneewind laboratory, I employed many of the skills I learned in the MPH program, most notably the ability to apply rigorous quantitative analysis to complex molecular data. I remember all the wonderful people who I met in both programs and I am indebted to those individuals who provided me with the opportunity to obtain a truly interdisciplinary training experience.
After I started my program, a few additional students also decided to pursue the dual degree option on an ad hoc basis. Hank Seifert (Director of the IGP) and Steve Anderson (Associate Director of the IGP) decided to make this program formal, and, after consultation with the Public Health program, they put in a request for a new dual degree program to the Northwestern Graduate School, which was approved in 2002. The first formal class matriculated in 2003.
Currently, I am an Associate Professor in Pathology, Microbiology, and Immunology at Vanderbilt University School of Medicine and the Chief of the Division of Host-Pathogen Interactions. My laboratory is focused on understanding how bacterial pathogens acquire nutrients during infection that enable them to replicate and cause disease in human hosts. We focus on infections caused by Staphylococcus aureus (Staph infections), Acinetobacter baumannii (hospital-acquired infections), and Bacillus anthracis (anthrax). My laboratory takes a diverse approach to this research topic, employing techniques ranging from chemistry and biochemistry to imaging and epidemiology. Molecular epidemiology is not the primary focus of my lab, but we do have a number of epidemiology projects that are currently ongoing. In addition, I am certain that my simultaneous training in molecular biology and epidemiology has provided me with a large and diverse toolbox that has improved my lab’s ability to ask penetrating questions and apply diverse techniques to answer those questions.
It is my understanding that 27 students are enrolled in or have completed the dual PhD/MPH program at Northwestern. I am thrilled to know that the institution has created a formal path for these students, and that there are this many students interested in merging these two exciting fields of study. I think that the leadership at Northwestern and the faculty listed above should be credited for their flexibility and creative approach to graduate education, as I am confident that there are not many other schools in the nation who would have seen the potential and created such a program.
About the Author
The dual PhD/MPH program at Northwestern remains one of the only programs in the country that allows students to obtain a PhD in any program and a master’s in public health concurrently. This program would not exist without the pioneering efforts of the first dual degree student, Dr. Eric Skaar. Curious about his inspiration and challenges in advocating for the joint PhD/MPH, the editors at the NPHR reached out to Dr. Skaar, now an associate professor at Vanderbilt, to share his story.