Pediatric-trained cardiac surgeon reflects on graduate training in clinical research
by Roxanna Van Norman
Before coming to Stanford, Andrew Goldstone, MD, PhD, was a few years into his residency program in cardiothoracic surgery at the University of Pennsylvania (Penn), where he was a mentee of Joseph Woo, MD. He developed a strong interest in clinical research during medical school, where he completed a scholarship funded by the Doris Duke Charitable Foundation and continued conducting observational studies under Dr. Woo's mentorship while at Penn.
As Dr. Goldstone gained more experience in cardiac surgery, he encountered unanswered clinical questions on a regular basis. He knew advanced training would be necessary to learn how to conduct better clinical studies with a more rigorous methodology background and to become an independent investigator.
Shortly after, Dr. Goldstone was invited to join Stanford's Department of Cardiothoracic Surgery by Dr. Woo, who had been recruited and appointed as the department's new chair. He agreed to move to California and joined the department as a postdoctoral research fellow in Dr. Woo's lab.
"Although a primary focus of my role as a postdoctoral research fellow in Dr. Woo's lab was to conduct basic and translational research, Dr. Woo understood my interest in clinical research as well," said Dr. Goldstone. "I wanted to apply for the master's program in epidemiology at Stanford, and Dr. Woo was very supportive of it."
He enrolled in a master's program for epidemiology and clinical research within the Department of Epidemiology and Population Health at Stanford. Toward the end of completing his first year in the program, the administration encouraged Dr. Goldstone to pursue a doctorate instead of a master's degree. The program's curriculum included rigorous methodologic and interdisciplinary training to equip students with advanced tools to conduct high-level research.
"I thought it was a great opportunity to receive in-depth investigative skills for improving my skills as a researcher to conduct rigorous clinical studies."
"They [Department of Epidemiology and Population Health] were interested in having a clinician join the PhD program in epidemiology," said Dr. Goldstone, who has a medical degree from the Mount Sinai School of Medicine. His mentors at Stanford and Penn were supportive, despite an understanding that it would delay his return to residency. "I thought it was a great opportunity to receive in-depth investigative skills for improving my skills as a researcher to conduct rigorous clinical studies."
During his three years at Stanford, Dr. Goldstone conducted numerous observational studies that were published in top
medical journals, including The New England Journal of Medicine and Circulation. Some of his research ultimately led to changes in professional guidelines for the management of valvular heart disease.
After obtaining his PhD in Epidemiology and Clinical Research from Stanford, Dr. Goldstone returned to Penn to complete his residency for a few more years. During that time, he became drawn to congenital heart surgery.
"Congenital heart surgery encompasses a broad range of complex pathophysiology and anatomy which require individualized reconstructive surgeries. The field also offers the chance to make a long-term, positive impact on someone's life," said Dr. Goldstone. He subsequently completed his training in pediatric heart surgery at the Children's Hospital of Philadelphia in Pennsylvania.
Dr. Goldstone recently joined the faculty of Columbia University Irving Medical Center as Assistant Professor of Surgery in 2021. He is a member of the Section of Pediatric and Congenital Cardiac Surgery in the Division of Cardiac, Thoracic, and Vascular Surgery at the New York-Presbyterian Morgan Stanley Children's Hospital.
"I'd like to think that my research background was a major factor in making me stand out as a candidate for this job, in addition to my recommendations and clinical skills," said Dr. Goldstone. By applying rigorous statistical methods in his current work, his research group leverages population-based data to investigate questions that could not otherwise be answered by the conventional randomized trial.
In addition to having fellowship support through the Department of Cardiothoracic Surgery at Stanford, Dr. Goldstone said having leadership support for research endeavors was critical to his academic career.
"Having Dr. Woo prioritize research was critically important. This set the standard and culture where everyone was excited to do research, and that's what made it possible to get a degree," said Dr. Goldstone. "The faculty within the Department of Epidemiology were very helpful, and they also wanted to see their students succeed in their research."
To this day, Dr. Goldstone maintains active collaborations with his mentors in both cardiothoracic surgery and epidemiology departments at Stanford. He attributes his dedication to a career as a physician-scientist in large part to his Stanford mentors. He encourages aspiring academic surgeons to explore such opportunities if they are available.
"The most amazing thing about Stanford on the research side is the culture of interdisciplinary collaboration," said Dr. Goldstone. "With the opportunity to obtain a Stanford degree in addition to outstanding surgical training, this [experience] elevates and broadens your career to a whole different level."