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Ann Thorac Surg 2004;78:1135-1136
© 2004 The Society of Thoracic Surgeons
Thoracic Surgery Foundation for Research and Education, Beverly, Massachusetts, David Geffen School of Medicine, Los Angeles, California and State University of New York Upstate Medical Center, Syracuse, New York , USA
* Address reprint requests to Dr Benfield, Thoracic Surgery Foundation for Research and Education, 900 Cummings Center Drive, Suite 221, Beverly, MA01915 (E-mail: rebecca{at}prri.com).
To serve as a mentor for young cardiothoracic surgeons is a privilege and a responsibility. The Thoracic Surgery Foundation for Research and Education (TSFRE) exists to insure continuing opportunities for young surgeons to become productive investigators and mentors for their successors. An important example of the work of the TSFRE is the Nina Starr Braunwald Award. Who was Nina and why should we remember her?
Nina Starr Braunwald, in 1961, was the first woman to be certified by the American Board of Thoracic Surgery. In Boston, in 1985, Nina told one of us (LJK) about the development of her career. She had spoken with Helen Taussig, late in her life, when Taussig had ascended to dominant world leadership in pediatric cardiology. Nevertheless, Taussig expressed anger that Harvard had not accepted her for training, and that no one had let her become a cardiac surgeon when she came to Hopkins. Women were excluded from cardiac surgery! How did Nina break the gender barrier?
At the age of 14, Nina grew paramecia in Brooklyn and became a member of the American Society of Amateur Microscopers. After medical school at New York University, she was accepted for the prestigious internship at Bellevue. House officers had not been allowed to marry, but Nina was engaged to her classmate, Eugene Braunwald (Gene). Reluctantly and grudgingly, J William Hinton—Nina's chief—consented to their marriage. Only 22 women in the entire US had been certified by the American Board of Surgery when Nina started her internship.
After 3 happy years at Bellevue, where Nina was well-accepted by her peers and her attendings, Gene accepted a position at National Institutes of Health. He asked Nina to complete her residency in Washington, DC. Under Charles Hufnagel, a pioneer in valve surgery at Georgetown University, she completed her residency with distinction and earned a Master of Science degree in surgery for her work in transplantation. Norman Shumway was among the visitors to Hufnagel's laboratory, to which he came to learn about Nina's successful models of transplanted tissue.
After her residency, Nina worked at National Institutes of Health, where Andrew Morrow was a superb mentor, and where Gene had become Director of Cardiology. She developed and tested prosthetic mitral valves made of flexible open-cell polyurethane with Teflon chordae tendineae. On March 11, 1960, in a "surgical first," she successfully replaced the diseased mitral valve of a 44-year-old woman with severe rheumatic mitral regurgitation [1]. The ten years at National Institutes of Health were wonderful and "unbelievably happy" for Nina and Gene, who had 3 daughters while they were at National Institutes of Health.
Gene was recruited to the Chair of Medicine at the new School of Medicine at the University of California School in San Diego (UCSD). Nina supported Gene's move to UCSD and persevered through an inhospitable tenure for Nina at UCSD under a Chairman who had avowed never to have a woman head up any of his divisions. It took a special committee to get her a tenured associate professorship. During Nina's 4 years in California, despite little support for her endeavors, she established an open heart surgery program and did the first coronary bypass in the San Diego area. When Gene was recruited to an endowed professorship at Harvard, Nina became the first woman on the surgical faculty at Harvard.
Nina was the first woman member of the American Association for Thoracic Surgery (AATS), and for 22 years she was the only woman member of AATS. In 1992, she was one of 3 surgeons profiled in a film entitled Pioneers: Women Firsts in Surgery.
Nearly 40 years ago, Nina was first to be certified in our specialty. Since then, nearly 150 women have been certified by the American Board of Thoracic Surgery (ABTS). Carolyn Reed and Valerie Rusch are Directors of ABTS, and Carolyn is now the chairperson. Since 1998, ABTS has been certifying an average of 10 (8–12) women annually. There are now 13 women members of AATS (W. A. Gay, personal communication). Thus, there has been progress, but it has not been easy.
Nina's story relates to TSFRE because TSFRE exists to support young cardiothoracic surgeons who share her dedication to patients and our profession. In memory of Nina, Gene established the "Nina Starr Braunwald Fund" of the TSFRE. This fund provides up to $35,000 a year for up to 2 years for women cardiac surgeons through research fellowships or career development awards. The fellowships support academic cardiac surgeons still in residencies, and the development awards are for women who, within 5 years after completion of residencies, are in academic cardiac surgery positions. In the selection process, emphasis is placed on the potential of the applicant, based on her prior accomplishments, and the quality of her educational experience. Particular emphasis is placed on evidence of supervisory interaction (mentorship) with experienced, successful senior investigators.
Mentorship is fundamental to the work of TSFRE. For example, TSFRE has partnerships with the National Institutes of Health (NIH)entitled the Mentored Clinical Scientist Development Award (K08) and the Mentored Patient Oriented Research Career Development Award (K23). These awards are intended to support the development of outstanding research scientists who are committed to careers in laboratory or clinical research. For opportunities to study cardiovascular disease, there is a TSFRE partnership with the National Heart, Lung and Blood Institute (NHLBI), and for oncologic studies there is a TSFRE partnership with the National Cancer Institute (NCI). The goal of these awards is the development of independent cardiothoracic surgical investigators who are within 10 years after completion of an approved thoracic surgery residency. Award recipients spend a minimum of 75% of full time professional effort conducting research and research career development in projects during 5 years. The TSFRE and NHLBI or NCI each award a salary up to $75,000 per year and National Institutes of Health additionally provides research development support up to $30,000 per year. The institution may supplement the contribution of TSFRE and NIH up to a level that is consistent with the salary scale of the institution. The mentors and role models are people with extensive research experience and a track record of independent research support. In keeping with the Nina Starr Braunwald legacy, mentors who are women or members of other minority groups are encouraged.
Nina Starr Braunwald was a pioneer who admirably overcame obstacles, including gender discrimination. Her legacy to TSFRE, and TSFRE's dedication to mentorship for today's young cardiothoracic surgeons, is what TSFRE is all about.
References
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