Hisham Abdelmotilib had always considered himself a consumer of knowledge. His thirst for discovery became even more apparent when he became a physician and he realized that knowledge could be used to change the health outcomes of his patients.
Hisham Abdelmotilib's dream of becoming a physician scientist came one step closer to reality on March 16 when he received word that he got into his first choice residency program.But what if he could do more? What if he could actually create the knowledge he was sharing?
“I realized I could have a much larger impact on many patients, not just mine, if I not only treated patients but did research on the diseases that impacted them,” said the 37-year-old fifth-year Ph.D. student in pathobiology molecular medicine from Egypt.
And so it began — a new career path that would lead Abdelmotilib thousands of miles from his home to a city he knew nothing about with only his young family and a dream of becoming a physician scientist.
Becoming a physician
Abdelmotilib knew he wanted to be a physician when he was 12 years old. He loved biology and chemistry, but it was more than just an interest in the sciences that made up his mind.
“My father had chronic liver disease because of a Hepatitis C virus and I was with him through all of his hospital admissions, observing the many difficult things that happened to him because of this disease,” he said. “That only made the decision to go to medical school more clear.”
Abdelmotilib focused on his schooling and earned high grades throughout high school so he could join medical school in Egypt. He succeeded and started medical school in 1999. By 2005, he was a certified physician and began a two-year residency in obstetrics and gynecology.
It was then he learned that if he could pass the physician licensing exam in the United States, he could join a residency program in the U.S. This would be his next step, or so he thought.
He finished his OB/GYN residency and worked in a private practice for a few years, all the while studying for the U.S. board exams. He passed with high scores, but realized going to the United States at that point was not an option because of financial reasons so he made a small detour.
He found a general surgery residency program at Hamad Medical Corporation in Qatar that was affiliated with Weill Cornell Medical College.
“The college had a few basic research labs and since I had this hidden dream of being a physician scientist and doing research while seeing patients, I saw this as a chance to get some research and lab experience,” Abdelmotilib said.
While it was not easy balancing a residency and lab work, he was able to focus on research during one of his elective rotations. He worked in Weill Cornell Medical College Vice Dean Dietrich Busselberg’s lab trying to understand calcium current in neuroblastoma cells and breast cancer cells.
“I didn’t get any interesting results or publish anything, but this experience led to an interest in neuroscience research,” Abdelmotilib said. “My professor suggested I apply for a Ph.D. program so I could learn the philosophy of science and how to work in a lab, how to think scientifically. It is totally different from the clinical side.”
So, he did, never imagining where that would lead him.
Becoming a student
Abdelmotilib did a Google search on Ph.D. programs with molecular medicine and applied to a few. He wanted to focus on programs with translational research because it would have a direct impact on patients.
Shortly after, he received an email from UAB requesting a Skype interview.
“I left my phone at home so my wife was the one who told me about the interview. It was very exciting,” Abdelmotilib said. “I wasn’t expecting anyone to actually call. I was a physician with only six months research experience so not sure why someone would be interested in me for a Ph.D. program. So, when I got the interview request, I thought that was a good sign that I had a chance.”
He did more research on the university and the city and liked what he found. UAB was known for its high-caliber research and had a great reputation worldwide, he said. It was especially strong in medical research, which was his particular interest. He also learned that Birmingham was very similar to his home in Egypt, particularly the weather, and the cost of living would allow him to support his family on a Ph.D. stipend. All in all, a perfect fit, he added. "At that particular moment, I was a second-year resident in general surgery at Hamad Medical Corporation. I had a good salary and the usual future path of finishing my residency and continuing as a specialist in Qatar,” he said. “But I decided to leave all of this and go to the U.S. to start the Ph.D. program on a lower salary. It was a very difficult decision for me and my family, but it turned out to be the best decision I made.”
So began Abdelmotilib’s life as a doctoral student at UAB. It was a very difficult life initially. It was a life that took him out of his comfort zone and away from the life he had known, a life that involved thinking clinically and communicating with patients and families.
“Now I had to communicate with the tools in the lab and with the animals. I had to use a different thinking approach,” he said. “It was very difficult and I thought of quitting many times. I kept asking myself why was I there. I was a physician. I had trained as a physician so why am I doing research now in a lab with students who were 10 years younger than me.”
But he soon realized that the questions being asked were interesting and it was rewarding to see research results six to seven months after asking those questions. So, he pushed forward, caught on to the techniques and adapted — and thrived.
Becoming a researcher
Abdelmotilib’s first UAB lab experience was with Dr. Andrew West doing animal surgery. Because of his surgical skills and general surgery training, he caught on quickly. It was exactly the kind of research he wanted to pursue — trying drugs on animal models in hopes that the drugs would move to clinical trials and impact patients.
He received an offer to join Dr. West’s lab after his second lab rotation and quickly accepted. He has spent the past four years doing research on two main projects.
The first focuses on a gene called LRRK2. A mutation in this gene is the most common mutation in genetic Parkinson’s disease and studies have shown that a hyperactive LRRK2 enzyme could be associated with Parkinson’s.
“If we could block kinase activity of LRRK2, then we may be able to slow the progression of the disease,” Abdelmotilib said.
The research also looks at the relationship between LRRK2 and another important protein called Alpha-synuclein, which is a central protein in Parkinson’s disease pathology. Abdelmotilib and his colleagues are trying to figure out the role of LRRK2 and how it impacts the toxicity caused by Alpha-synuclein.
“My role focused on exposing the rats and mice to the Alpha-synuclein protein by injecting them with a virus that carried the gene into the brains of the rats and mice,” he said. “Then we gave those animals the drug that can inhibit the kinase activity of LRRK2. The results showed that the drug was working and rescued the rats from the Alpha-synuclein toxicity. This means that anti-LRRK2 therapeutics were successful in animals and it could be translated in humans. There’s still more research that needs to be done, but this could be another treatment option for Parkinson’s patients.”
The second area of research looked at how Alpha-synuclein propagated from cell to cell and how that transmission could explain why Parkinson’s disease progresses in patients.
“Parkinson’s starts with motor symptoms and then eventually causes dementia through impacting other brain areas,” Abdelmotilib said. “We think that transmission of Alpha-synuclein from cell to cell is correlated with cell loss in the brain. We need to do further studies to understand why this happens, but it’s a good start.”
Looking back, moving forward
Abdelmotilib’s initial concerns about his past experience and age actually turned into benefits. Not only did his surgical techniques come in handy, but his life experience helped him more than he thought possible.
“I knew how to handle pressure,” Abdelmotilib said. “I had difficult courses and had to learn how to study for those courses while also working in the lab and taking care of my family. I could see younger students become very stressed, but my past experiences gave me an advantage on handling that stress.”
Hisham Abdelmotilib credits his academic success to his supportive wife and family.Abdelmotilib soon discovered the best way to balance the stress of graduate school was to find interests outside of the lab. He became active in Graduate Biomedical Student Outreach, a UAB graduate student organization that strives to enrich the graduate student experience by organizing various events that connect faculty members and graduate students, and he taught science to local elementary school students and UAB undergraduate students.
He also had an incredibly supportive wife who wouldn’t let him give up.
“She was here taking care of our two boys and I’d tell her I was going to quit. She wouldn’t let me. She’d just tell me it’s my passion and I’m not going to give up, I’m going to finish it,” he said. “I wouldn’t have been able to do this without her.”
Abdelmotilib has now authored five papers on his research. He is first author on two, second author on two and fifth author on one. He is scheduled to defend his dissertation in May and then will begin his neurology residency program with a clinician/neuroscientist track at the University of Iowa, which was his first choice.
His goal is to specialize in movement disorders so he can work with Parkinson’s patients, as well as other patients with movement disorders, but also continue his research with Parkinson’s disease.
“I have a lot of knowledge and built a foundation in this area, and I would like to use it to continue to understand more about the disease,” Abdelmotilib said. “We know very little about Parkinson’s and its mechanisms, and I believe success in the treatment of one neurodegenerative disease may help in the treatment of other neurodegenerative diseases. They have common underlying mechanisms so research from one disease may help us better understand another.”
When he finishes his residency, he will be a physician scientist. He will be an academic neurologist who can see patients but also do translational research. He will be living his dream.