ACR REF Niche Award Helps Define a Research Career

Joyce Hsu, MD, has always been interested in pediatric medicine and she found a perfect niche for herself in pediatric rheumatology. She completed a pediatric residency at the University of California, Los Angeles and worked as a general pediatrician for a year while considering rheumatology.

“I have always enjoyed working with pediatric patients,” says Dr. Hsu. “As a healthcare provider, you get to experience a continuity of care with younger patients, unlike most other groups of patients. Your patients really do grow up with you and sometimes it feels like you are part of the extended family.”

Dr. Hsu became interested in the subspecialty after exposure to rheumatology during her pediatric residency. “I liked the multi-organ system aspect of rheumatology,” says Dr. Hsu. “And, again, I was drawn to the fact that a rheumatologist really gets to experience a continuity of care, developing a lasting patient–clinician relationship.”

After her year in pediatric practice, Dr. Hsu began a pediatric rheumatology fellowship at Stanford University. “It was the best of all possible worlds for me, professionally speaking,” she says. “My passion for pediatric medicine coupled with my interest in rheumatology would allow for a deeper understanding of rheumatic disease in juvenile patients and the opportunity to make a difference in these young patients’ lives.”

Joyce Hsu, MD, received an ACR REF/LRI Lupus Investigator Fellowship Award.

Focus on Lupus

In years two and three of her fellowship, research would become a focus. She already had some basic science research experience from college and medical school. Because of her passion for working with patients, she opted to focus on clinical research during her fellowship, hoping to concentrate that research on lupus, particularly in children.

During that first year, as she was planning her future clinical research work, Dr. Hsu learned about the ACR REF/LRI Lupus Investigator Fellowship Award and immediately decided to apply. “It was the perfect funding opportunity for me. The award was geared toward the junior investigator and it was focused on lupus investigation,” she says. “Funding can be really difficult to secure as a junior investigator, especially in such a defined niche as I was hoping to pursue—pediatric lupus. With this award, though, I felt like my defined niche would not limit me, but rather give me an edge against the competition.”

Dr. Hsu was right. She stood out among the competition and received the award, with three years of funding to begin in her second year of fellowship. “I was so excited to receive the award and it was such a relief to know that I had research funding to take me through my last two years of fellowship,” she says.

Foundation for a Research Career

The award allowed Dr. Hsu to devote her attention to refining her clinical research techniques and projects, even matriculating in a masters program in clinical epidemiology. Her clinical research began with a study evaluating lupus presentation among juvenile patients of different ethnic groups and analyzing any correlations between ethnicity and the severity of the disease. During the initial phases of this study, she discovered a subset of her lupus patients that also had kidney disease. Using her REF funding, she began working with these patients to learn more about kidney disease and lupus in young patients.

“Lupus in children is rare,” she notes. “But, when the disease does manifest itself in young patients, it is so much more severe and quite often attacks the kidneys.” This complication occurs in 75% of pediatric patients with lupus.

Dr. Hsu is working to determine of more aggressive treatment is appropriate and effective for these patients. By tracking her young patients over several years using a database, she hopes to learn more about specific predictors for kidney disease in juvenile lupus patients and identify effective preventative treatments.

“Launching my clinical science career would not have gone as smoothly without my REF funding,” she shares. “I was able to work as a lead researcher very early in my career and, because the funding allowed me to finance my last two years of fellowship, I was able to fully invest myself in the research.”

The ACR REF/Lupus Research Institute Lupus Investigator Fellowship Award is part of the ACR Research and Education Foundation’s extensive awards and grants portfolio. This award encourages qualified physicians without significant prior research experience to develop a research career that will emphasize better understanding of systemic lupus erythematosus as a disease process affecting many individuals.