Accomplished pediatric researcher advances study of pediatric bleeding disorders.
HemAware is conducting a series of interviews with recipients of the NHF-Baxter Clinical Fellowships. The fellowships are funded through the generous support of Baxter Healthcare Corporation. The objective of this grant is to increase the number of skilled clinicians committed to providing comprehensive care for individuals with bleeding and clotting disorders, and to prepare candidates for academic careers.
This interview was conducted with Jordan A. Shavit, MD, PhD, assistant professor of pediatrics, University of Michigan, Ann Arbor. He is a pediatric hematologist/oncologist at the C.S. Mott Children’s Hospital in Ann Arbor. The fellowship was funded from 2006-2008.
Why did you decide to study medicine?
For students who excel in math and science, it is often assumed that they will pursue a career in medicine, says Shavit, who grew up in Highland Park, Illinois. “I was also always a very social person and I like interacting with people, so that seemed like a natural combination.”
What initially attracted you to hematology?
A summer fellowship in a coagulation lab at Loyola University as an undergraduate was Shavit’s introduction to hematology. “I learned a lot about some of the anticoagulants that are now standard of care, but were just being tested in pre-clinical models back then.”
In graduate school at Northwestern University (NU) in Evanston, Illinois, Shavit worked in a lab whose emphasis was hemoglobin switching and hematopoiesis, the formation and development of blood cells. “I liked looking at blood under a microscope,” he says.
In the combined MD/PhD program at NU, Shavit attended medical school for two years, completed his PhD, then resumed medical school. When reviewing residency options, he knew he wanted to subspecialize.
“I liked hematology/oncology in general because there was a lot of strong evidence-based practice and it was a very team-oriented approach to taking care of patients.” Shavit chose pediatrics because he likes kids.
How did the training and mentorship you received as an NHF-Baxter Clinical Fellow affect your decision to pursue clinical care and/or research in bleeding disorders?
“The mentorship that I received truly dictated my career,” says Shavit. Working in the University of Michigan laboratory of David Ginsburg, MD, who had cloned the genes for von Willebrand disease and combined FV/FVIII deficiency, Shavit discovered how to combine his two interests: research and patient care.
“Dr. Ginsburg is a highly accomplished physician-scientist. What the Baxter Fellowship enabled me to do was go into his lab and learn from somebody who had put those two areas together.” But lab time wasn’t solely for bench work. The two often discussed clinical care and its relationship to their lab work. “What I learned from him actually informed how I take care of patients to a certain extent.”
Are you still engaged in the clinical aspects of patient care or bleeding disorders research? In what aspect of care are you most interested?
Years ago, someone gave Shavit this piece of advice: “You’re going to find a little corner of the world and that’s going to be your specialty--that’s the patients you’ll take care of and that’s the research that you’ll do.” Shavit’s corner of the world is now centered in Michigan.
He enjoys his half-day in the clinic each week, overseeing the care of pediatric patients with bleeding and clotting disorders. The rest of his time is devoted to research. “For example, 10% of severe hemophilia patients don’t bleed very much,” he says. Shavit hopes to help answer the question of whether they should be receiving prophylaxis, as other genetic factors may influence an individual’s bleeding patterns, not just the mutations in factors VIII or IX.
“We’re trying to identify the other genetic factors that interact with those primary mutations, leading to the clinical phenotypes that we see in our patients.”
Did your NHF-Baxter Clinical Fellowship assist in advancing your own position at your institution? Or did it serve as a building block to further your career in coagulation?
Shavit says that the fellowship enabled him to do both. The funding provided him with the time he needed to engage in research. “You can’t be successful in a laboratory science career without that kind of protected time.”
The fellowship also served as a building block, Shavit says, because he is still heavily involved in research pursuits that he began thanks to it. It also had a side benefit for someone as social as Shavit is—introducing him to other fellows and mentors. “I was meeting people in the field anyway, but the fellows and mentors became a tight-knit group and I got to know people with whom I might not have otherwise interacted closely.”
Where do you think bleeding disorders research and clinical care may be headed in the near future? In the next decade?
In 1992, when Shavit was entering his combined MD/PhD program, friends and family asked what he thought about gene therapy. He told them he thought it was about two decades away. Now in 2015, his prediction has come true. “And so it’s about 20 years later, we’ve had the first successful trial (in hemophilia),” he says with a smile, because he is quick to admit that “I would have given the same answer 5 years ago.”
Although gene therapy holds promise for people with bleeding disorders, Shavit does have some reservations about its safety for children. “The question of whether we will be comfortable administering gene therapy to young children with hemophilia still needs to be addressed given that infusion therapy is highly effective and generally safe.”
Shavit is interested in the plethora of long-acting factor products coming to market. The hematologist’s role will entail “sorting through those and figuring out which ones are appropriate for which patients.” Despite these advances, Shavit says breakthroughs for better treatment options are still needed for patients with mild bleeding disorders and those with inhibitors.
When you are not working, how do you relax or escape from your work?
Shavit’s down time is spent with his family, not on personal pursuits. “Unfortunately, I don’t feel that I have a lot of time for hobbies,” he says. “My hobby is my kids and my family.” His kids, ages 13 and 10, are active. Over the years, Shavit has coached their soccer and basketball teams. “They’re involved in a lot of extracurricular activities, including academic ones that have led to competition at national tournaments.” He says he enjoys nothing more than “just to hang out with them when I can in our free time.”