Dr. José P. Zevallos, Department of Otolaryngology, University of Pittsburgh

 

Dr. José P. Zevallos, MD, MPH, FACS

Professor & Chairman, Department of Otolaryngology,

The Eugene N. Myers, M.D., Professor and Chairman of Otolaryngology, University of Pittsburgh

 

Dr. Zevallos earned his Medical Degree from the New Jersey Medical School and completed his residency in Otolaryngology at Baylor College of Medicine. He subsequently pursued a Head and Neck Surgical Oncology/ Microvascular Surgery Fellowship at Mount Sinai/ Beth Israel Medical Center and a Masters of Public Health at the University of Texas School of Public Health. Dr. Zevallos’ clinical interests include the management of head and neck squamous cell carcinoma, salivary gland tumors, thyroid and parathyroid conditions, and benign tumors of the head and neck. He has >130 peer-reviewed publications (>3150 citations; h-index=32). Dr. Zevallos is also an entrepreneur and inventor. He is the founder and chair of the board of Droplet Biosciences, a molecular diagnostics start-up company based in Cambridge, MA and the chief scientific advisor and co-inventor of the novel soft robotics technology with Vine Medical located in Santa Barbara, CA.

 

Dr. Zevallos, why did you choose to specialize in Otolaryngology? Why head and neck in particular? Is there anything you don’t like about it?

I come from a family of physicians, mostly in Peru, where I’m from originally. I’m the 6^th physician in my family and the first surgeon. When I started medical school, I didn't know what kind of surgery I would go into but  decided fairly early on what path I wanted to pursue. In the first few weeks of medical school, and I remember being fascinated by the anatomy of the head and neck.  From that point on, I was sold on otolaryngology. I had a great opportunity as a medical student to shadow the attending surgeons in New Jersey from my first year of medical school.   Those were foundational experiences in the operating room that ultimately led me to train at otolaryngology at Baylor College of Medicine.  As a resident, I had the privilege of learning from the incredible faculty at MD Anderson Cancer Center.  My experience there led to pursue not just head and neck surgical oncology but also sparked my research career.  Mentors like Erich Sturgis, Randy Weber, and Jeff Myers provide the early guidance that led me down the path towards academic head and neck surgical oncology. 

 

That's really interesting to hear! It actually covers part of my next question, which was about surgeon-scientists. It's really impressive. So, let me follow up on this and ask you: what particular steps do you think we as a field should take to cultivate this breed of surgeon-scientists? And where do you see the next generation of surgeon-scientists in terms of balancing clinic and research?

The surgeon-scientist career can be both incredibly rewarding and challenging.  Surgeon scientists inherently wear multiple hats on a weekly or sometimes daily basis.  At academic medical centers like UPMC, surgeon scientists provide the bridge between basic and clinical sciences.  Here at the University of Pittburgh, we have a phenomenal hearing sciences research group within our Department , the Pittsburgh Hearing Research Center. We have five NIH funded hearing scientists and researchers. Part of my job is to ensure that these scientists are connect to our clinicians, both in otology and in audiology.  If not, there will be missed opportunities to make rapid translational discoveries. It's much more interesting and there is when you have different types of people bring their perspective to trying to solve a problem, whether it be hearing loss or head and neck cancer.  As a Chair, my role is to provide an environment where surgeon-scientists are allowed the time and resources to build their research careers. This is especially true for junior faculty, where having the right mentorships is essential to success.  We also have to make sure that surgeon-scientists not only have, but use, their protected time for research. As surgeons, we are programmed to always say yes. We are always willing to see more patients and do more surgeries.  However, in order to make a surgeon-scientist successful they have to be encouraged, and incentivized to spend time in the laboratory.   As leaders, we also have to ensure that the rest of the clinical faculty understand the role of their surgeon-scientist partners.  This is very important because productivity expectations are often quite different. 

 

Right. That's really important! It's impressive to hear this from a from a Chair- that you're so passionately committed on this. So, I actually want to ask you more about residency applicants and prospective residents. And I'm curious to hear what you're what are you looking for? And if there are certain qualities that would make someone stand out in your eyes.

We recently reviewed our resident applications, and it was amazing to see how skilled and talented the applicants are from across the country. It is often hard to put together a rank list and where we need to chose one exceptional person over another.  Often our decisions come down to whether we feel someone would be good fit for the Department.  During the application process,  we try to look beyond just scores and medical school pedigree but try to understand life circumstances that each of our applicants bring to the table.   

 

A question about research now: I know that there's this discussion always about quantity vs quality, and I know that within a residency application it's really hard to evaluate that. But if you had to pick, which one would you go with? Do you evaluate more quality or quantity?

As medical students, sometimes we tend to overestimate the importance of quantity (number of publications, posters and presentations).  However, during interviews you will have an opportunity to really showcase the quality of your research. One of the most important things you can do to prepare for the interviews is to know your topic better than most of the people who will be interviewing you. To really know a topic is much more than writing a case series or doing a case study right up. Having a deep understanding of your research, whether it's published or not, will help you shine during an interview.

 

That's a very interesting perspective. I never thought about it like this!

Let me be clear, the number of publications is important. But once you make it through the door for an interview, the way you express yourself regarding the work you've done, and your contributions become even more relevant.

Now I want to move to a different subject. So aside from your other academic activities, I see that you are also the president of Droplet Biosciences.

I'm the founder of the company, Droplet Biosciences, based in Cambridge, MA.

Back in 2019, my lab at WashU was working on novel biomarkers for HPV-positive oropharynx cancer. There has been a lot of work on plasma based liquid biopsy across multiple cancer types, which has been really meaningful.

One of the challenges with the technology at the time and even today is that it's not very good at picking up local regional recurrence and it's not used within the curative pathway. It's used to discover recurrences after treatment has completed, but not necessarily to make decisions in real time about adjuvant therapy. We decided to see if we could measure tumor DNA in the surgical drain fluid of patients undergoing head and neck cancer surgery to see if this could be used as a marker of high-risk disease or recurrence.  We discovered that this fluid contains  tumor-associated cfDNA and that the quantity of tumor DNA is predictive of the pathologic risk. Therefore, the assumption is that you could potentially use this technology as an adjunct to pathology to define adjuvant therapy stratification. This was the insight that led to the formation of my start-up company.

When I started the company, I was working with a University of Colorado spinoff company on a different diagnostic test. Their entrepreneur in residence was Stanley Lapidus. Stan is the inventor of Cologuard and the inventor of the ThinPrep pap smear used worldwide. He is the founder of 2 different multi-billion-dollar molecular diagnostics companies, Cytec and Exact Sciences.

Stan saw many parallels between the work that we are doing with surgical drain fluid and the early days of Cologuard. He helped me raise a large seed round in early 2020 and introduced me to Theresa Tribble, who is our CEO. We now have eight full-time employees and the company lab in Cambridge. MA.  Along with my scientific co-founder Aadel Chaudhuri MD PhD, we advise the company on the science but are not involved operationally. We are very optimistic about where it's headed but also realistic about the challenges that start-ups like this can face. I have learned a great deal about entrepreneurship as a result of this experience that I hope will encourage others in our specialty to innovate.  As surgical leaders, I think it is important that we embrace innovation and entrepreneurship as key to the future of academic medicine.

And like you said, it's a new world for most of the people in Otolaryngology.

Yes, and it was certainly a new world for me a couple of years back. If we can do it responsibly and do it within the parameters of our mission, then it can be a very, very exciting thing for our residents and fellows to learn about, and, of course, our faculty to be involved with.

 

Do you do you think you have time for one more question?

I think so, yes.

So like you said, UPMC Oto is a historic program. I can think of several giants in the field there. That is the case today and that was the case in the past as well. So my question is what in your opinion is that what in your opinion makes training there so unique? What's so unique about this place?

The leadership of Drs. Eugene Myers and Jonas Johnson made this department exceptional. As the third Chair at the University of Pittsburgh, I am humbled and honored by the opportunity to help lead this Department into a new and modern era.

The residency program at the University of Pittsburgh is really the foundation of the Department and our strength in reflected in the accomplishments of our alumni.  Many nationally and internationally-recognized leaders in otolaryngology have come from Pittsburgh. Why is that?  I think it comes down to a culture of surgical excellence that was started by Dr. Myers and continues to this day.  The culture here is welcoming and collegial, but also has a quiet intensity that’s reflected in every aspect of the work, whether in the OR, in the clinic, or in the lab.  It helps of course that we are a high-volume place with five major academic hospitals and faculty that take on the most challenging cases. It also helps that our health system includes 40 hospitals over three states.  Finally, it  helps that we are part of a highly-ranked, research-intense medical school and university that is currently ranked third in the nation in NIH funding. 

Our history and legacy are important, but we also recognize the need to continuously innovate and define new paths. 

Thank you so much Dr Zevallos!