Waël C. Hanna, MD | Global Clinical Scholars Research Training
As a thoracic surgeon affiliated with McMaster University in Canada, Waël C. Hanna, MD, connects innovations made in his research lab to his expertise in the surgical suite in order to achieve improved outcomes for patients with lung and esophageal cancers. He credits his success in this area to the many skills he gained through Harvard Medical School’s postgraduate Global Clinical Scholars Research Training program.
It all began back in 2016, when Hanna was looking to strengthen his research skills.
“As part of my appointment in academia, I am required to do research. I didn’t have a research background so I thought it would be good to build my statistical tools and skills,” Hanna says.
This desire led him to attend Harvard Medical School’s postgraduate Global Clinical Scholars Research Training program, which is a one-year advanced training experience in health care research and methods for clinicians and clinician-scientists.
“The program offers a one-year blended learning model that allowed me to continue working and complete the coursework remotely,” Hanna says. It also has three in-person workshops where he connected with other scholars from around the world and learned from Harvard’s renown faculty.
While Hanna expected the coursework to get him up to speed on epidemiology and biostatistics, what he did not expect was the program’s strong focus on strategy that helped him and his classmates to develop a deeper understanding of every stage of the research process — from writing grant proposals and launching new projects to analyzing data and presenting the results within a meaningful framework.
Since graduating from the program, Hanna has used the many insights he gained throughout the course of the year to start his own research lab, where he focuses on exploring ways to integrate technology into the lung cancer surgery and apply artificial intelligence — such as robotic-assisted surgery — to improve processes and outcomes.
Lesson: Develop Meaningful Research Questions
“Through the Harvard program, we were taught that for a lab to be successful, we needed a good research idea,” Hanna says. “This is essential since no one will find value in your work if your question isn’t worth asking or your idea worth funding.”
He also learned how to weed through different options to narrow in on the best question to focus his efforts around.
“Of all that questions that come to mind, I learned to figure out what is the most interesting to people and where the change will be significant,” he says. “Once you have narrowed in on a good question, you also need to see what has been done before so you can see if there is there anything new you can say or add,” Hanna says.
One of his goals was to explore a more effective way to prepare lung cancer patients for surgery.
“When you run a marathon, you train for it. Yet for surgery, you used to perform the procedure and then do rehab afterward. But I wondered why we didn’t train people before surgery first so they would recover faster afterward,” Hanna stresses. “I thought we could give people a trainer and an exercise tracker, a nutritionist, and a mindfulness coach so they could prepare their bodies for the month before the surgery was performed.” His concept has proved beneficial.
“We discovered that the people on a training program did much better after surgery,” he says. People are able to be discharged the next day, which saves money and increases throughput so more people have faster access to surgery. Patients are also able to get back to their normal activities faster.
Start Small with Funding and Build
“Initially, I thought I needed big money to fund these types of research efforts [such as training patients before lung surgery], but I learned through the Harvard program that it was better to start with focusing on very small grants,” he says. “As part of the Harvard coursework, we did an exercise of filling out a grant form and this experience really helped me to get started.” In fact, he used the training in this area to successfully apply for grants in the real world.
“Once I got seed funding, it was much easier to apply for bigger grants,” he says. This has allowed his research to take off beyond his initial expectations.
Applying Research Funding Exercises to Real Life
He also points out that his classmates were grouped together in teams to compete on different challenges.
“We had this one team exercise where we had to take data sets from the Framingham Heart Study,” he recalls. The team was charged with coming up with a different question they could ask that could be answered using the existing data set from the original study. “My team wanted to design a score to assess cardiovascular risks. We did that and we won that competition,” he says. This experience sparked Hanna to go further with the idea.
Back in Canada, he took the same exercise, and this time, he applied it to the findings from a Canadian national study on lung cancer called the Canada Lymph Node Project. “Just as we did at Harvard for cardiovascular disease, I posed a question that I could answer using the existing data to develop a score to assess the risk for lung cancer to spread to the lymph nodes,” he says.
This is significant because currently, lung cancer patients require the lymph nodes in their chests to biopsied; yet the results are often inconclusive, resulting in repeat biopsies and treatment delays that can increase patient mortality and increase health care costs. To circumvent the problem, Hanna used the Harvard exercise approach to develop the Canada Lymph Node Score, a four-point scale using ultrasound imaging to predict whether cancer has spread to the lymph nodes without needing to perform a biopsy.
He recently had a paper introducing this concept accepted for publication in the Journal of Thoracic and Cardiovascular Surgery. Hanna is also leading a clinical trial to further explore the validity of the idea.
Mentoring Research Students
Today, with so many projects underway, Hanna’s lab now employees half a dozen students who are gaining valuable real-world experience under his mentorship.
“I really enjoy leading a team of scientists who work continuously to develop and evaluate advancements in the field of thoracic surgery, making some operations that were thought to be impossible, now possible,” he stresses.
He credits many of his recent successes to the knowledge he gained through the Global Clinical Scholars Research Training program.
“My participation in the program gave me the foundation to get organized in my thoughts. It taught me to effectively raise money for research, explore new ways to improve surgical outcomes, and mentor people to share the knowledge I have gained,” Hanna says. He adds that he hopes more clinicians will take a similar path to deepen their research capacity, exploring the many possibilities that exist.
Learn more about the Harvard Medical School Global Clinical Scholars Research Training program.
Written by Lisa D. Ellis