Urshila Durani, M.D., M.P.H.

Senior Associate Consultant, Hematology

What moment or experience in your life influenced your decision to be a clinician?

In college, I took a medical anthropology class that turned medicine from a "safe" career choice into a field I was excited about. We read about how diseases can manifest as very different illnesses in different cultures and learned about structural violence and its impact on health. We also learned about how the success of public health interventions can depend on a deep understanding of the cultural and socioeconomic context of the populations you are working with.

This class opened my eyes to the cultural, social and economic context of medicine — which was fascinating.

What motivated you to become a Kern Health Care Delivery Scholar?

I recognized in my fellowship that I wanted to focus my research on ways to improve cancer care delivery and change practice to be more patient-centered.

My fellowship mentors were former Kern Health Care Delivery Scholars, and I admired how their research was directly linked to improving clinical practice. I thought that as a scholar, I could utilize the training, resources and network from the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery as building blocks toward my goal of advancing the practice of cancer care.

What is your focus as a scholar within the Mayo Clinic Kern Center for the Science of Health Care Delivery?

I'm conducting a prospective study of patients who receive CAR-T cell therapy to understand the longitudinal financial toxicity of this effective yet expensive treatment.

My team is gathering both quantitative data, via surveys, and qualitative data, via interviews. Our goal is to pinpoint unique aspects of financial toxicity in this setting and identify when they occur, as well as to develop potential interventions to decrease financial toxicity for patients.

Tell us about your mentoring team.

My two primary mentors are Carrie A. Thompson, M.D. — a former Kern Health Care Delivery Scholar and lymphoma physician at Mayo Clinic who has extensive experience in longitudinal patient-reported outcomes research — and David T. Eton, Ph.D., who is an expert in the field of qualitative research.

Vital collaborating mentors include Yi Lin, M.D., Ph.D. — a lymphoma and myeloma physician and expert in CAR-T cell therapy — and Rahma Warsame, M.D., also a former Kern Health Care Delivery Scholar, as well as a myeloma and CAR-T cell therapy physician and financial toxicity researcher.

How will your research improve patient care or impact public health?

The quantitative and qualitative data my team collects will provide us with potential interventions to decrease financial toxicity among patients who receive CAR-T cell therapy, and their families — which is growing rapidly every year.

My goal is for the intervention to be both patient-derived, from qualitative data, and patient-centered. The research will help identify granular steps in the CAR-T cell therapy delivery process that can be altered to improve the financial burdens of care for patients. These steps can then be targeted with interventions in follow-up studies to determine how they have improved patient financial burden and distress.

Why did you choose Mayo Clinic to pursue your career?

Having trained here for both residency and fellowship, I've developed a deep appreciation for the culture of collaboration, collegiality and patient-forward care unique to Mayo Clinic.

I've also been lucky to work with mentors here who demonstrate these values and have carved out unique careers. Rather than leading me down the beaten path, they've encouraged me to pursue my own goals in research, education and clinical practice.

As such, Mayo Clinic stood out as a center that provides early-career clinicians with the flexibility and support to forge their own paths to improve patient care.