Alex Duncan, MD, PhD, knew he wanted to pursue a career as a physician scientist, but infectious diseases wasn’t always on his radar. A clinical rotation under the guidance of an infectious diseases attending physician during his third year of medical school changed all of that.
“I went down the infectious diseases rabbit hole,” Duncan says with a laugh. “Infectious diseases captured a way for me to do research and stay in medicine at the same time.”
Duncan wears many hats at UNC: He sees patients at UNC’s Infectious Diseases Clinic at NC Memorial Hospital; He conducts research in his lab with a focus on innate immune signaling or how the body recognizes and responds to pathogens; He is an Associate Professor of Medicine and Pharmacology at UNC’s School of Medicine; and Duncan recently accepted the role as Director of UNC’s Infectious Diseases Fellowship program.
As a clinician, he says he applies the same conceptual process he uses to conduct research in his lab to treating a patient in the clinic. For example, if Duncan sees a patient suffering from a fever of unknown origin, a common reason that he and other infectious diseases physicians are consulted, he gathers preliminary information by examining the patient’s medical records as well as taking detailed note of their travel and exposure history. This information guides formulation of his hypothesis on the origin of the patient’s illness. He then orders tests and based on these results, he either verifies the diagnosis or revises his hypothesis.
“You can take a scientific experimental approach to each patient,” Duncan says. “In this way, practicing infectious diseases is intellectually compatible with performing translational research.”
Research has always been his passion. Duncan is especially interested in the body’s inflammatory response to pathogens like bacteria.
“In my heart of hearts, I am a hardcore bench translational researcher,” Duncan says. “I love going into my lab and seeing new data. That new answer to a question no one has seen before. That discovery that drives patient care down the line. UNC provides a great environment for our trainees to develop careers as physician scientists.”
And it’s the career development component that Duncan really wants the ID Fellowship experience at UNC to stress. The three-year program provides fellows with a mix of clinical and research training. But Duncan says under his direction, he wants the program to also provide mentoring, networking and cultivation of other necessary skills for this career path, such as grant writing.
“I recognized early on in my career as an MD-PhD that to be successful in research took a lot more than me just knowing how to do research or being a decent clinician,” Duncan says. “I really relied on the help of a lot of people, networking and developing skills outside of things that we normally think of physicians receiving traditional training in. Career development is very important. We can help with all of these. We limit the number of fellows we take. We give them a lot of personal attention. That’s been the hallmark of our program.”