In June 2012, the NIDCR held a ribbon-cutting ceremony to mark a new start and look for the NIDCR Dental Clinic. Among the new faces are a D.D.S./M.D. and three D.D.S./Ph.D. students participating in the NIDCR Clinical Research Fellowship. Science Spotlight spoke recently to Jim Melvin, D.D.S., Ph.D., the NIDCR Clinical Director, about the latest progress at the clinic, located on the main-floor of Building 10, and his vision for the revived fellowship program.
The renovation of the NIDCR dental clinic was just completed in June. The clinic looks fantastic.
Thanks, it’s been a long process. The renovation was on hold for a while, and we’ve now rebuilt our roster of outstanding staff clinicians. And you’re right, the clinic itself has never looked better.
You mentioned at the ribbon-cutting ceremony that the NIDCR dental clinic isn’t a typical dental clinic. It’s a consult clinic. What’s the difference between the two?
In a treatment clinic, you walk in and hear drills whirring. Treatment is being delivered to patients. In a consult clinic, the focus is primarily diagnostic. In our case, the diagnostic focus fills a very specific niche at NIH. The NIH intramural, or on-campus, research program has over 1,500 clinical protocols under way. Most physicians are not trained to provide an in-depth oral examination. In fact, it’s not something that they often think to do during the course of a busy day. That said, numerous medical conditions have dental components. In the dental clinic, our staff clinicians and clinical fellows have a range of professional backgrounds and can rigorously evaluate the oral cavities of clinical trial patients with conditions ranging from diabetes to cancer to graft-versus-host disease. They can say to a principal investigator, “Let me show you. I found something unusual here in the oral mucosa.” If the lesion is associated with the underlying condition, the examination may help to better classify the patient and his or her treatment needs.
So the dental clinic is a diagnostic resource for those participating in NIH clinical trials?
Exactly. We’re here to assist patients and clinicians with their protocols. Obviously, we lack the space and resources to evaluate everybody. There are hundreds of patients who walk through the front door of the NIH Clinical Center every day. But we do our best to help those in need.
Among those doing the evaluating are four new NIDCR Clinical Research fellows. You were in the fellowship program in the mid 1980s. How does it feel now to oversee a program that was so instrumental in launching your own research career?
It feels great. The Clinical Research Fellowship program had gone through some adjustments in recent years, and I wanted to help get it going again. That meant suspending the program for a year and reaching out to potential fellows to learn more about their training needs. I’m happy to report that the program is back up and running with four new fellows. Their backgrounds and research interests are diverse, and that makes for a very dynamic group. I’ve said before, you don’t want staff in a diagnostic clinic that looks and thinks the same. You want a diverse but complementary skill set on hand. Like on a sports team, you want clinicians who will make the clinicians around them better.
Before we move on and talk more about the NIDCR Clinical Research Fellowship, I’d be interested to hear what the students told you about their training needs. With whom did you meet?
I met with the D.D.S/Ph.D. students who were finishing up with their training programs at three universities. I wanted to find out what types of positions they might seek. How many are thinking beyond just doing a Ph.D.? What are their career goals? What do they need to do to get themselves there?
What did they tell you?
Most hadn’t thought about it in quite that way. The whole idea of doing a postdoc or a research fellowship like we have here was pretty foreign to them.
There are a couple of issues. One is they already had invested a great deal of time and money into their training. The thought of investing another three or four years in a training program made them wonder what they would really gain? Why not just head out and land a faculty position?
But that doesn’t necessarily prepare you to run a laboratory.
Bingo. A Ph.D. doesn’t really prepare you to run a lab, write a strong grant proposal, and think about science in a more general way. The point of our program is a dentist-scientist can train here at NIH and use the experience as a springboard to rise to the next level and compete in the extramural world, whether that be at a dental school, a medical complex, or industry. The fellowship gives them the time that they need to develop as a scientist.
What about as a dentist?
I’m glad that you asked the question. Dentists sometimes are concerned that if they spend two or three years completing a research fellowship, they will lose the skills that they acquired in dental school. I’ve been around long enough to know that’s not the case. I think a better way to look at it is (a) you will have your chairside skills very much intact, and (b) your benchside experience will be world class. That’s a very marketable combination.
It’s a practical investment?
Absolutely. The environment at NIH is so unique. We can prepare dentists for research careers in ways that really can’t be done anywhere else. Fellows have the opportunity to assemble research portfolios that any senior scientist would review and say, “Wow, this is really somebody that we’d like to recruit.” That’s our goal.
You were once a young, aspiring D.D.S. What made you take the leap to pursue a Ph.D.?
That’s never a simple answer. When I was an undergraduate at Kent State in the early 70s, the biology department was very strong. I took part in quite a few research projects, and that got me thinking that I probably wanted to do a combined D.D.S./PhD. In fact, when I applied to dental school, I selected Case Western University for that very reason.
That’s how you made the transition?
Actually, the story turned out to be more complicated. After I was accepted to dental school, Case Western brought in a whole new administration. That administration wasn’t open at all to dentists doing research. Three years later, I had a D.D.S. degree and a stack of student loans in my name. So I joined the Air Force as a dentist to travel the world and pay down my student loans. Along the way, I had time to reconsider the idea that had lingered in my head for several years: Did I want to take the leap to the Ph.D. side and pursue a career in research? After much reflection, I knew it would be the right choice for me.
Well, after about two years as a full-time dentist, I realized that I probably wouldn’t get any better or faster. For me, practicing dentistry just had become too routine. I wanted a greater challenge. I wanted a career that better captured my interests. So I applied to graduate school and started in the Department of Neurobiology and Anatomy at the University of Rochester. I studied the development of the innervation of the seminal vesicles and prostate.
But you later ended up back in the mouth studying the salivary glands.
That’s right. During my Ph.D. years at the University of Rochester, I was fortunate enough that Bill Bowen was recruited to the University of Rochester during my second year. Bill had been a branch chief at NIH’s then-National Institute of DentaI Research (NIDR), and he rebuilt the department of dental research. I got to know Bill quite well, and he gave me a lot of advice on directions for a D.D.S./Ph.D.
One day I walked into Bill’s office with about 10 months to go in my program. He asked me about my plans for the future. In anticipation of this question, I had a list in my pocket of the 10 best places to do a postdoc. At the top of the list was NIDR’s Bruce Baum, who studied the salivary glands. Bill didn’t say a word. He picked up the phone, dialed Bruce’s number by heart, and said, “I have a postdoc for you.” That’s how I ended up doing a postdoc at NIDR with Bruce Baum and Jim Turner. I came to Bethesda in late 1985 and stayed through the summer of 1988.
Then you returned to Rochester and spent the next 22 years as a basic researcher. Did life as a basic researcher give you the greater challenge that you had wanted?
Very much so. Every day brought a new challenge. My career goal was to understand the rate-limiting step involved in salivary gland fluid secretion. My lab and others confirmed the final key player in the process a few years ago, interestingly all at about the same time.
So the next stop was Disney World?
I wish. But it was quite an accomplishment for all of the groups involved. Some researchers spend their entire careers chasing a complex problem but never quite get to the bottom of it. I was lucky. I got my answer. The funny thing was I now found myself staring into a question that I hadn’t really anticipated. What next?
Is that what prompted you to come to Bethesda and NIDCR?
Yes, it provided the impetus to come here. I thought NIH would help me recreate my career in two ways. One, I want to translate some of my basic research discoveries, and NIH is just a great place to perform translational medicine. All of the technological and intellectual resources are here. You just need to tap into them. Two, call me idealistic, but I wanted to give back to NIDCR for everything that I gained from being a postdoctoral fellow here. I wanted to help get the NIDCR Clinical Research Fellowship back up to speed.
And, you are well on your way. How many applicants did you have last year?
We had 12 applicants. I narrowed down the list to seven, and we ended up accepting four fellows.
How many fellows can you have in the program at one time?
Maybe five or six fellows total. Their scientific backgrounds will determine the training that they seek and whether they stay two, three, or four years.
What are you looking for in a prospective fellow?
The main thing is a candidate already must have a strong research background. This fellowship isn’t intended to train a student to become a researcher. The other important point, as I mentioned earlier, is the candidate must want to take their research skills to the next level. That’s what the fellowship is all about. Getting to the next level.
How is the first class of fellows taking their research skills to the next level?
They, of course, have clinical responsibilities. Given the diversity of patients and conditions that present here each day, their clinical time presents a tremendous opportunity to hone their diagnostic skills. On the laboratory side, each fellow has a primary project. But as a group, they have taken on other projects, in some cases working in other institutes and areas of science that fall outside of NIDCR’s mission or current research focus. The reason is great science knows no institutional boundaries. The same goes for mentors. My job is to make sure that the fellows don’t get overextended. At the same time, I get it. They’re only here for three or four years. They want to get the most out of the time.
So the program is all about the science?
The program is all about giving each fellow the best possible research and career development training. In my mind, our training program should be the flagship for training dental scientists. You know, it’s hard to predict what’s going to happen 10 years down the road, but I think each fellow will look back on this time and say that it was probably the most unique and even enjoyable time in their careers.
How can prospective fellows get more information on the program?
Here’s a link to the NIDCR Clinical Research Fellowship web page. It spells out the application process:
Prospective applicants should take a look there first. If they have any additional questions, I’m happy to answer them. My email address is:
Or, feel free to give me a call. My number is: 301-402-1706.