In November 2023, I marked a grim milestone.
I turned the age my mom was when she died. “Milestone” is certainly an odd way to characterize it. We tend to think of milestones as positive, like my baby’s first steps. But in many ways, her passing defined my raison d’etre.
I have constantly moved through life with the knowledge that we are neither guaranteed days nor opportunities on this earth. My mother had just started planning her life after the early years of child rearing. I took on the task of wanting to accomplish what she could not.
In that regard, I certainly built a life I was quite proud of. And yet, as I approached that birthday, I couldn’t help but feel that while I had made the most out of the days I had been given, I wasn’t sure that I could find continued satisfaction on my current path in full-time clinical practice. I always knew I wanted to take part in “big picture” medicine, but I figured that a component of my career had to be primarily in clinical medicine first.
A Critical Decision
Although clinical medicine is quite gratifying, when I thought back to some of my most fulfilling days, I thought about my time working with the United Nations to implement mobile health technologies in refugee settings. The opportunity to collaborate with others to research and validate impactful public health policies had been an exceedingly meaningful experience for me. As my birthday approached, I no longer wanted to put off pursuing my dream career.
It felt almost like fate that I learned about the work at the U.S. Food and Drug Administration’s Center for Biologics Evaluation and Research (CBER) right around my birthday. The center is the hub for regulating cell and gene therapies as well as other emerging biotechnologies in the U.S. A fellow ophthalmologist and medical officer in the Ophthalmology Moms Group (OMG) shared the job opening through the Ophthalmology Moms Group. To best position myself as a candidate, I drew upon my MPH background and clinical training, emphasizing my commitment to supporting the development of safe and effective therapies within a robust regulatory framework.
Although I had always been aware of the promise of gene therapy in our field (ophthalmology had the first FDA-approved adeno-associated virus (AAV)-gene therapy with Luxturna for Leber’s congenital amaurosis), I did not realize the depth and breadth of this field for ophthalmic conditions and the center’s role in this space.
There have been 159 ophthalmology-focused gene therapy clinical trials up until the end of 2022, with 21 trials started just in 2021, according to the journal Biomedicines ("Frequency and Pattern of Worldwide Ocular Gene Therapy Clinical Trials up to 2022"). Several of these trials are attempting to mitigate or provide a cure for inherited retinal diseases, which currently have significant unmet medical need. It is so exciting to get to be a part of this conversation as a medical officer.
Today, I find my work deeply meaningful. Especially in the rare disease space, we are uniquely aware of the pressing need for patients to have safe and effective treatment options for the many vision-threatening disorders in ophthalmology. Our leadership is committed to helping these therapies get to the finish line. Our discussions revolve around innovative topics, such as supporting adaptive clinical trials designs for rare diseases and the evaluation of new endpoints that allow for a more realistic assessment of patients’ functional vision.
This is especially important in the rare disease space where small patient populations can make running a clinical trial challenging. I am privileged to play a small role in this endeavor and look forward to supporting my ophthalmic community and our patients as much as I can.
Find Rewarding Work
In medicine, we accept delayed gratification as a necessary part of our journey. Certainly, we need the knowledge and skill set that medical training provides. Even if you like what you are doing now, it’s also exciting to feel like there can be seasons or chapters to your career — some that could include nontraditional opportunities.
Life is too unpredictable and too short to feel stuck in a path that doesn’t fulfill you. There are many ways to contribute to the ophthalmic community, so I urge you to find what is most meaningful and exciting for you and to pursue that.
(My comments are informal and come from my own best judgment. They do not represent the opinions or work of the FDA.)
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About the author: Cherie A. Fathy, MD, completed her residency at Wills Eye Hospital in Philadelphia and finished her cornea fellowship in 2022 at Wilmer Eye Institute at Johns Hopkins Hospital in Baltimore. She joined the YO Info Editorial Board in 2022. She currently serves as a medical officer in the Center for Biologics Evaluation and Research at the FDA. |