- I try to make time for informal mentorship and formal mentorship because I think it's important to pay it forward. I also just think it's A, it's fun, you know? - Right, right. - I enjoy chatting with people about how they're looking at these issues. But B, I mean, honestly, having these conversations is also helpful to sharpen my own thinking. - [Narrator] This is the ORISE Featurecast, a special edition to Further Together, the ORAU Podcast. Join Michael Holtz for conversations with ORISE experts on STEM workforce development, scientific and technical reviews, and the evaluation of radiation exposure and environmental contamination. You'll also hear from ORISE research program participants and their mentors as they talk about their experiences and how they are helping shape the future of science. Welcome to the ORISE Featurecast. - Welcome to another episode of the ORISE Featurecast. As always, I'm your host, Michael Holtz from the communications and marketing department of ORISE and ORAU. I am genuinely excited to have as my guest today, Dr. Hilary Marston, who is the new chief medical officer at the Food and Drug Administration and is a past ORISE participant. So, Dr. Marston, welcome so much to the ORISE Featurecast. I'm thrilled to have you here. - Well, thank you so much for having me, I appreciate it. - So you have a new role, pretty much a brand new role at this point still, as the chief medical officer for the Food and Drug Administration. Give me a little bit of your background, how did you get there from where you started? - Sure. Thank you so much. And I will say it right off the bat that ORISE played a pretty important role in how that happened. So I'm an internist by training. I trained in internal medicine at Brigham and Women's and also did a global health equity residency along with that training. So I worked very closely with partners and health colleagues and other individuals working in the global health space. So I left training knowing that I really wanted to work in public health policy, global health policy and public health policy in particular. And so that led me to work at the NIH when I had an opportunity to work with Dr. Tony Fauci-- - Sure. - Which if you're interested in public health policy and global health policy, there really is no better way to learn that than have the opportunity to learn alongside him. And so I started out in government there, and I worked at NIH for about 10 years, increasingly focusing on infectious disease preparedness and response. So I helped him coordinate our responses to several outbreaks, including Ebola, Zika and certainly COVID 19. That brought me to the National Security Council working on similar issues, and then to the COVID response team where I had the real privilege, honestly, of leading some of our global vaccine donation work. So that was a program led by this administration where we donated, at that point, over 500 million doses of vaccines around the world. And from there to the FDA. - That's amazing. What a trajectory and what a focus. I love your focus on global public health policy. I think that's really exciting and obviously much needed to not only manage and prepare for and execute during pandemics but you know, other illnesses and outbreaks that we don't even know about in this country, right? - Yeah. Just not part of our daily reality. Yeah. - Right. So how did you get... I want to kind of go back to the beginning and talk about how did you get interested in a career in STEM, in the sciences? What was kind of the driving force behind that? - I love this question because these things are things that develop over time, right? And they come into focus over time. So even back in undergrad, I was working at The Wistar Institute in a vaccine lab and I had a very patient mentor who took me into the lab even though I was, frankly, a disaster in the lab, right? I was terrible, but very enthusiastic and really wanted to learn. And Dr. Ertl was very generous with her time and really took me under her wing and I appreciate that. So I was working initially just on DNA vaccines for a variety of different things but also specifically focused on HIV. And this was back in the '90s, in the early '90s and the promise of DNA vaccines, at the time, we were just really beginning to scratch the surface. And mRNA vaccines weren't even a glimmer in anyone's eyes but I was already seeing the potential power for something that I cared a lot about-- - Yeah. - Global health already at that point. The potential that science had to impact that. I also was there at the time when some of the first estimates of prevalence in Sub-Saharan Africa and around the world were coming out of UNAIDS. So it was a stark reminder of how important that sort of work could be. And that was something that I carried through with me through all of my training and just built on those experiences through my training with more practical clinical on the ground activities. So I worked, for example, I was at the University of Pennsylvania for my medical school training and they had a partnership with Princess Marina Hospital in Gaborone, Botswana. So went over there and did clinical rotations there and, you know, the burden of disease at that point, the folks who were coming into the state hospital were, typically had very, very advanced HIV and a lot of co-infections. So was able to pitch in but also learn just so much from my clinical colleagues there. And you carried that through the rest of my training working in partners in health sites in primarily Rwanda and a little bit in Haiti. - Wow. So, you've worked, kinda all over the world. - Yeah. - In your career. You mentioned at the jump that ORISE played kind of a critical role in the trajectory of your career. You were an ORISE research participant at the National Institutes for Allergy and Infectious Diseases, and Dr. Tony Fauci, as you said, was your mentor. Talk about what you did during your research participation program experience and what it was like to be mentored by Tony Fauci. - Yeah. So I think he is one of these folks who really prioritizes mentorship in their day-to-day work. And I think that those are rare folks to find, particularly at his level of leadership. But mentorship is a skill and you have to hone it. And he certainly has. So he's done this over the years actually where he's brought people into his office for a couple of years and just kind of says, you know, "Shadow me, I'm gonna bring you to any number of things that I'm working on. We'll write together. You'll help prepare talks for me and learn about the way that I communicate." And so that was kind of the pitch when we discussed coming on board. And certainly I couldn't have even imagined the breadth of things that I would be able to do. So it gave the opportunity to work with him and see as he worked around the interagency, worked on critical issues related to HIV, related to influenza but also you're at the NIH, right? - Right. - And I think it's a remarkable institution where people, obviously you have the experts of the experts there, right? But also people are pretty darn generous with their time and willing to really break it down for you and help you come up to speed, certainly not to their level but more than you could ever hope to from the outside. - So talk about, I guess, some of those experiences. You've mentioned some in terms of preparing some talks for him and learning how he communicates. I know science is a very collaborative process. So I imagine at the NIH where you have scientists from across the board together, there has to be a lot of great collaboration. - There really is. And a couple of... It's somewhat uneven how much collaboration that there is. So some areas are just very practiced in this and know how to reach across the NIH, across scientific disciplines to get more input from the outside and really see the value of that. And some areas, you know, are more siloed. What I think was impressive over time and particularly in the emerging infectious disease space is that we built on the experience of collaboration. - Okay. - And from one outbreak to the next, folks saw the value in it and just sought that out more and more. So an example there, so probably the best model that I saw for collaboration initially, was in the HIV vaccines space. - Okay. - So we had a couple of outside extramural cooperative agreements with the Center for HIV/AIDS Vaccinology & Immunogen. So I'm gonna butcher it. It's the CHAVIS, though. - Okay. - And they worked very, very closely with the Vaccine Research Center which it was an intramural program and also with the Department of Defense. So these folks were just bringing the best of their research expertise to this critically important problem, which is how you effectively begin to prevent HIV infection. Now, a vaccine is an incredibly difficult challenge there but the knowledge that's been gained through those efforts has both advanced the ball in HIV prevention, right? But also in other infectious disease spaces. So for example we have structural immunologists working with vaccinologists at the Vaccine Research Center and working across with the CHAVIS as well. So they brought their knowledge of how to design vaccines for HIV straight to RSV. - Okay. - Respiratory syncytial virus, which is a huge problem for neonates, but also that work kind of fed directly into our COVID vaccine work. - Okay. - Right? So that model of collaborative science, literally is saving millions of lives around the world right now. - That's amazing. And I like the example that you just shared because, and again, not to get into the politics of anything but none of that happens in a vacuum, right? I mean, scientists didn't just wake up one day and say, "Here's a vaccine." Right? It built on years and years and years of work to get to the point where you could speed along the development of a vaccine faster because of what you already knew. - That's exactly right. That's exactly right. And so well said. The investments in basic science research and the investments in funding the clinical trials networks that took that ball and ran with it, right? I'm obviously not that much of a sports fan 'cause I'm butchering sports metaphors . - I'm right there through with you. - Apologize for that. But if you didn't have those investments in place you would have been so much slower, so much slower. And you probably would've ended up with less effective countermeasures in the end. - Gotcha. I wanna go back to talking about Dr. Fauci as a mentor and how has that shaped you as being a mentor to other scientists? - Yeah. So I will say that somebody showing... He's not the first mentor that I benefited from, right? - Sure. - So I've had great models for me... Extraordinary models for mentorship, him included, throughout my career. And I'm very fortunate in that way. I mentioned Dr. Hildegund a little earlier. He made the time for it. And he really, he's a very busy man, and when he was sitting down and focusing on a career directions conversation with you, emails were off, right? Like he was just singularly focused on you and you got to benefit from the wealth of his experience. And I speak about it in the past tense, that's-- - In accurate, right? Like I still certainly consult with him. - Sure. - I really value his opinion. I came from the COVID team most recently, right? And Jeff Zients, who was the COVID coordinator when I first started there. Natalie Quillian and the new leadership, Ashish Jha and Lisa Barclay, they set aside the time, right? And they asked hard questions. That it's one thing to be a sounding board, to offer a little bit of input here and there but to be fundamentally challenging of the way that you are thinking about future directions, I think it's a skill and it's important because we can get into ruts with our thinking about our future work. I tried to make time for informal mentorship and formal mentorship because I think it's important to pay it forward. I also just think it's, A, it's fun, you know? - Right, right. - I enjoy chatting with people about how they're looking at these issues. But B, I mean, honestly having these conversations is also helpful to sharpen my own thinking. - Gotcha. Okay. That makes perfect sense. As you were speaking, I heard you reel off number of names of women-- - Sorry. - In STEM. No, no, no. - Yes. Yes. - Women in STEM. And my next question was gonna be, you know, what's it like being a woman in STEM, maybe today compared to, you know, when you started, but it sounds like today, you know, in the world that you're working in, I mean, there are a lot of women in the STEM fields that you are working in. - Yeah. So I am frequently on panels, on conference calls where there is a rare male-- - All right. - There. You know. And I'm not gonna say that there are no challenges being a female in these spaces but I've been very, very fortunate and I think that gen... I encourage a broader lens on how we think about diversity in the voices that we have represented at the table. So I certainly think that gender diversity as broadly defined is an important perspective here but I also think a broader lens is important. - Awesome. Okay. I wanna talk a little bit about resilience. We obviously, as a country, have had to learn to adapt and adjust over the last few years. In terms of your career, are there times that you have had to do that, you know, through the course of your work as you've learned more, made mistakes, made, you know, maybe judgements that, you know, you had to adjust from that sort of thing? - Yeah. Look, we work in learning organizations at our best, right? So we should be looking-- - Right. To learn all the time. And if we make mistakes then we need to figure out how to reflect on them but also how to pick ourselves up from them. I would say that small missteps are made frequently, right? You forget to bring somebody into a conversation that you should have gotten input from. You phrase something just slightly off, just slightly off. Not totally incorrect, but just you wish you had phrased it differently. And so I think it's important to A, be forgiving but also to recognize those moments and go back, circle back with those people and note that you are gonna do better for the future. And then really act on it. I think on that, not consulting with the right folks issue. This is something that for ORISE fellows, I think is particularly important because government works in silos and when sometimes it's necessary particularly for response activities to work across those silos, to work in a matrixed way. That's really, really... It's a challenge because all of the processes are set up to work through the silo. - Sure. - And you are laying on top of that, the crosswalk and figuring out who exactly you need to touch at each of those silos, to get that right is a challenge. And also, people aren't used to necessarily working across. I think certainly COVID and other outbreaks before that has gotten a whole padre of people who know how to do this well. But we've all, all of us who are working in this space have had those issues along the way. So I think folks coming into government from the outside should recognize that that will be a challenge. Especially because you're coming in as a fellow and you are going to be a new addition onto a machine that's kind of working. - Right. - So be patient with yourself, be open to pitch in wherever you can and also be open to people saying, "Nope, we got this. Let's focus your attention someplace else." - Gotcha. That sounds like great advice for an up and coming scientist regardless of ORISE participation or other, right? - Hope so. - Is there anything I... Oh, I did wanna ask you about your new role since it is brand new. Do you have a vision for where you are headed, where the agency is headed? Or is it still sort of trial by fire hose kind of? - Coming together. Yeah. No, I do. And so I'll say this is a tremendous moment to be at the FDA. I think that the folks here are doing just some remarkable work. The focus on the public health mission. I don't know if I can say it's never been stronger but I can certainly say it's incredibly strong at this moment. And the leadership is fantastic. The focus that I have really in my role seems to be coalescing into three basic buckets. So number one is based on my background I'm continuing to work in the response space. So monkey-pox response, a little bit on COVID and long-term preparedness work. Number two, I'm directly overseeing the Office of Clinical Policy and Programs. That's a number of crosscutting clinical policy and product matters that sit in the office of the commissioner. So products for rare diseases, pediatric therapeutics, some of the patient engagement. And a combo products that can't... I have to mention combo products. And then number three is some crosscutting commissioner priorities that Dr. Califf has laid out and he's asking both me and the chief scientist to help drive forward. So the chief scientist is also new in the role, a woman by the name of Dr. Namandjé Bumpus. We're very fortunate to have her. So those are things like use the evidence generation system, combating misinformation and disinformation. Long-term priorities that the FDA has been struggling with for some time. We're looking for some concrete ways that we can drive those forward. - And I would assume, particularly, on that last point that that will hopefully help reinstall some faith in the public, in public health. I mean, you know, I come from a public health background. But you know, there are people questioning all the time as you know. So hopefully combating some of that mis and disinformation will be beneficial in the future. - That's right. That's right. Couldn't be more important. - I'm sorry, say that again. - I just said couldn't be more important. - Absolutely. So last question for you, Dr. Marston, what brings you joy? - So number one, I have to say my family, right? I know that's cheesy, but I have two budding scientists I hope, coming up. Two young daughters. - Nice. - And they are, I'm a proud mama. They're the apple of my eye and they bring me tremendous joy. Number two is a real satisfaction with doing work that matters. I wish that for everyone in their life, 'cause we do spend a lot of time in these chairs and I certainly have no end of satisfaction in that area with the problems I've been able to take on and and pitch in on. - Awesome. That sounds great. Dr. Hilary Marston, thank you so much for your time and for the opportunity to chat with you about your career, about your ORISE experience. I assume, just based on our conversation you would recommend an ORISE experience for anyone. - I would indeed. I would indeed. - But thank you very much, for your time. I greatly appreciate it. I know you are very busy and I appreciate the opportunity to speak with you. - Thank you so much. Thanks for-- - Yeah. - The invitation. - Have a great day. - [Narrator] Thank you for listening to the ORISE Featurecast. To learn more about the Oak Ridge Institute for Science and Education, visit orise.orau.gov or find us on Facebook, Twitter and Instagram at ORISE Connect. The Oak Ridge Institute for Science and Education is managed by ORAU for the US Department of Energy.