Carmen M. Terzic, M.D., Ph.D.

Program launched career in stem cell regeneration

Carmen M. Terzic, M.D., Ph.D., chairs the Department of Physical Medicine & Rehabilitation at Mayo Clinic in Rochester, Minn., and plays a leading role in the development of stem cell therapy to repair damaged hearts.

Looking back, she says Mayo Clinic's Clinician-Investigator Program provided the foundation to become a physician-scientist and was "essential" to her success in obtaining research grants.

"The Clinician-Investigator Program really helped me consolidate my research knowledge," Dr. Terzic explains. "And it helped me obtain the publications and preliminary data I needed to be competitive for extramural funding, which ultimately helped me launch my career as an independent clinician-investigator."

A long way from home

Growing up in Venezuela, the future physiatrist showed interest in research as a child. "I remember my father giving me a chemistry set at Christmas," she says. "I liked to explore."

After medical school in Venezuela, Dr. Terzic practiced at a medical center, taught physiology at her hometown university and conducted research on skeletal muscle. After meeting David E. Clapham, M.D., Ph.D., then a neurobiologist at Mayo Clinic in Rochester, Dr. Terzic moved 2,800 miles north in 1992 to work with him on a Ph.D. in pharmacology.

"I wanted to get a Ph.D., and Mayo offered one of the best Ph.D. programs in the United States," she recalls.

Choosing a specialty

She eventually compiled more than a decade of training at Mayo, including a Ph.D., a postdoctoral fellowship in cardiovascular research, an internship in internal medicine, and a residency in physical medicine and rehabilitation, the specialty that helps restore movement and function to people disabled by disease or injury.

"I was attracted to physical medicine by the approach," Dr. Terzic says. "We don't see the patient as a heart or as a lung or as a bladder. We see the patient as a whole individual. We help patients deal with and overcome a disability and reintegrate to their environment — socially, economically, professionally — so they can have a productive and high-quality life."

Becoming a competitive investigator

Not long after Dr. Terzic started the residency, the department chair suggested that she consider the Clinician-Investigator Program, which integrates an additional two years of research experience related to the chosen specialty or subspecialty.

"I knew it was the right thing to do, even though it would extend my residency two more years," Dr. Terzic says. "The Clinician-Investigator Program gives you protected time and mentorship, allowing you to continue your research at the same time you get clinical training.

"If you get into a four-year residency, it's very difficult to stay involved in research because the workload is so high. When you finish, you have a significant gap of several years. You fall behind others who have been productive as researchers. When seeking funding, it really can hurt you, compared to other applicants."

Healing hearts from the inside

By 2000, Dr. Terzic had redirected her research to another muscle, the heart, and the use of stem cells to restore heart function following a heart attack.

"It was very exciting," Dr. Terzic says. "I wanted to start developing a research program that I could continue when I graduated and as an independent researcher."

Through the program, she gained experience, gleaned the keys to success from mentors and developed additional research skills. She also built a network of researchers throughout Mayo Clinic and beyond. "That was a definite advantage when participating in this program," she says.

Meanwhile, working toward completion of the Clinician-Investigator Program in 2003, she positioned herself for a successful career.

"I avoided a gap in my research, and the program allowed me to obtain more training and enough data and publications to apply for extramural funding," Dr. Terzic says. She joined Mayo Clinic's Department of Physical Medicine & Rehabilitation and soon received research grants from the National Institutes of Health (NIH) and American Heart Association.

On the leading edge of regenerative medicine

Now department chair, Dr. Terzic primarily sees patients for cardiovascular rehabilitation and neuromuscular diseases. She remains passionate about her exploration of adult stem cells to understand cardiac differentiation and regeneration of heart muscle.

"We think we will slowly help advance the science and the care of patients with cardiovascular disease," she says. "We're making a difference. Regeneration of tissue with stem cells, in the heart and in other tissue, will be an important part of medical practice, hopefully in the near future."

Dr. Terzic often collaborates with other Mayo researchers, including her husband, pharmacologist Andre Terzic, M.D., Ph.D., director of Mayo Clinic's Center for Regenerative Medicine. In addition to working with colleagues on other cardiovascular applications, she is part of a large Mayo group developing regenerative stem cell therapies for more than a dozen conditions.

"Mayo Clinic is one of the best places to work," Dr. Terzic says. "The teamwork that is essential to research is a reality here. It's amazing how you can pick up the phone and talk to a colleague about a patient or research project. Everyone is willing to help. That makes a huge difference."

Oct. 26, 2016