Great Minds Think Differently: National Eye Institute’s Michael Chiang, MD

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Michael Chiang, MD, director of the National Eye Institute, spent more than 20 years in academic research. Now, he leads an organization that supports that research by funding more than 1,500 research and training grants for projects that address vision impairment and blindness.

A pediatric ophthalmologist who’s board-certified in clinical informatics, Dr. Chiang remains intensely curious and generous. “I succeed when the vision research field succeeds,” he says in this OIS Podcast.

With host Sophia Pathai, MD, PhD, Dr. Chiang lays out NEI’s recently unveiled strategic plan. The plan hints at where NEI plans to invest its annual $860 million budget over the next five years and how it plans to continue moving forward with its “audacious goals.” Literally, the NEI’s Audacious Goals Initiative for Regenerative Medicine was established in 2012 to push the boundaries of retina science and restore vision through retina regeneration. It has funded $80 million in research to date, and there’s more work to be done.

There’s also room to improve diversity, equity, and inclusion in science and medicine—another area Dr. Chiang is passionate about. His mantra for collaboration: Instead of “great minds think alike,” it’s “great minds think differently.” Follow him @NEIDirector.

Listen to this OIS Podcast to discover:
• More about Dr. Chiang’s background, which starts with electrical engineering and continues with ophthalmology and biomedical engineering.
• What’s inside the NEI strategic plan, including its revised mission statement, its “audacious goals,” and its priorities for the next five years.
• What’s involved in developing such a large-scale plan, from buy-in to contributor involvement to change management.
• How the NEI promotes equal access to care as well as diversity within scientific collaboration.
• Where he sees room for opportunity in the relationship between academic institutions, industry, investment, and government.
• How emerging researchers can stay at the leading edge of innovation over the next 10 years.

Click “play” to listen.

Transcript:

Sophia Pathai, MD, PhD:
Hello, everyone. It’s Sophia Pathai, MD, PhD, ophthalmologist, venture partner and your host for today’s episode. Now, this podcast is a course about innovation. And we’ve been very fortunate to speak to some startup founders of some great early-stage companies, as well as larger stage companies who are continuously innovating on their product platforms. But it got me thinking about innovation. Innovation can happen anyplace, anytime. And actually, when we think about innovation in ophthalmology, a lot of the innovations that have had direct clinical application have had their very seeds planted in academic institutions or universities. So I’m really thrilled today that we have a chance to talk with none other than the director of the National Eye Institute. Michael Chang, MD. Welcome to the podcast.

Michael Chiang, MD:
Sophia. Thank you. It’s great to be here.

Sophia Pathai, MD, PhD:
So we want to hear all about the NAI. And you know, I think there are so many great things going on. But before we do that, let’s just dig a bit into Dr. Chang, the person and you know, I’m a huge fan of your tweets. And I did see on July the fourth, you’re in a very poignant tweet, in fact, about yearning to breathe. So maybe you could tell us a little bit about your career arc and your journey to the NEI.

Michael Chiang, MD:
Yeah, sure, Sophia. So, I was raised in Detroit, Michigan. You know, I grew up in a family where almost everybody was an engineer. And my dad worked for Ford Motor Company, you know, which is, you know, the US automotive industry is all in Michigan. And so when it came time to go to college, I never seriously considered studying anything other than electrical engineering. That ended up being my college major. And during that time, I had a couple of experiences. I’d spent a summer working at a startup company in Northern California that built cardiac ultrasound machines. And then I spent another summer working in a lab in the medical school that basically analyzed images, we wrote little computer programs analyzed images to diagnose heart disease, and the images came from cardiac ultrasound machines. And that actually, those experiences just fascinated me, you know, that you could you could build a device and then use them to take care of somebody. And that’s actually what made me go into medicine. And I thought I wanted to build machines and treat people. And during that time, as a medical students, this was now the early to mid 1990s. I actually started out thinking that I might want to be a neurosurgeon, because computational neuroscience was a very hot back then artificial neural networks. And I basically, you know, found a lab in the medical school that was in the Division of neurosurgery research. And they did basically neurophysiology and neuroanatomy, but it happened to be in the rabbit retina. I worked there for about three years. And it was a guy dick masland lab at Massachusetts General Hospital in Boston. And I learned a lot about vision and visual information processing. And, you know, that’s what made me become an ophthalmologist. Okay, I thought that’s what I wanted to study, because I thought it was an amazing system. And then I went off and trained in ophthalmology. And during that time, you know, this is now the late 90s, early 2000s, medical record keeping was all paper based. It was sort of handwritten notes and, and, you know, MRI films and Kodachrome slides. I remember that too. You know, and, yeah, and I just thought there must be a more efficient way to manage data. And so that’s what made me thinking like, you know, maybe we don’t need more people in the world that build machines, maybe we need more people who manage data. And that got me interested in biomedical informatics. You know, I learned about the field. And in the late in the early, early 2000s, it was 2001. When I finished my fellowship, training pediatric ophthalmology. There was there were very few people in the country who were doing this and actually in any field, but particularly in ophthalmology. And, and so my first job was at Columbia University, which has one of the best informatics training programs in the US and I had a couple of people who I’d met, whose work I was fascinated by and my career there started doing telehealth for retinopathy of prematurity. We built systems, trained nurses to take photographs, collected data servers that we had, and we basically trained readers and basically spent years developing and validating those systems. You know, I worked there for nine years, and then moved to Oregon Health and Science University KCI Institute, where I spent 10 years and we moved into artificial intelligence, data science, electronic health records, and it was just a ton of fun to do. And then about a year and a half ago, it was November 2020, I moved to Bethesda, Maryland to take this job at the National Eye Institute. So basically, that that’s my story. It’s been a combination of engineering to medicine to ophthalmology, slash biomedical informatics, and now I work at the NIH.

Sophia Pathai, MD, PhD:
Well, thank you so much for sharing that journey. And you’re right. It’s made up of many leaps. But what I do see is a constant theme of curiosity. And you mentioned fun, which is, I think so important in the work that we do as well.

Michael Chiang, MD:
You know, Sophia, I know when I was 22. I’m not sure I ever would have imagined that I’d have a job I love doing as much as the jobs I’ve had, I think that’s really you know, it’s kind of amazing.

Sophia Pathai, MD, PhD:
It is, it is amazing. And let’s come right forward to your post of the NEI, because as you mentioned, you took it up November 2020, if I’m not mistaken. And that’s a big organization, right. And you’ve got to lead it and you know, infuse a culture. So that’s a big change. So maybe you can share with us some of the adaptations you had, if you had to make any what would they like? And, you know, what was that jump like?

Michael Chiang, MD:
Yeah, Sophia, it’s a great question. Maybe, let me just sort of start by saying, you know, what is the National Eye Institute. So, you know, we’re part of the National Institutes of Health, the NIH. And so in the States, the NIH is the main body that manages and supports biomedical research. And I just made up of over 20, so called Institute’s National Cancer Institute, NIH ID for Allergy and Infectious Disease, that’s Dr. Fauci is Institute, and NEI is one of those Institute’s and we basically directing, we fund vision research. And so in a nutshell, what we try to do is we try to identify where the field is going. And we try to prepare for that, you know, our budgets about $860 million a year. And so we try to find the best way to be able to do that, that, you know, that’s in the interests of, you know, supporting, what’s going to help the most people out there. So, Sophia to answer your question, I spent almost 20 years and academic careers, you know, I basically, ran my own research group, I took care of patients worked with trainees and just had a lot of fun doing it. And so it’s been an enormous change, to be working for the US government, and also to be doing essentially, a different kind of job. You asked sort of, what this role was like, or what that big transition is, and I sort of think in terms of, what makes someone well suited for this position? Or what do you do in a leadership position, I sort of think throughout my career, you start out your career planning what’s right for yourself, and then you start to do things like, run a group, help run a department help run an organization like this, and I’ve sort of found that, the more I advanced, the more I think, in terms of how is what I’m going to do help other people succeed. And, in this kind of position, I feel like, I really, I still do a little bit of my own research, but it’s only a really, really small percentage of what I do. And I think of myself, as I succeed when the vision research field succeeds.

Sophia Pathai, MD, PhD:
And I think that’s a really different way of thinking. And I’ve been trying to embrace that, really, I think that’s a great way of thinking. And I really love what you said about going from thinking about what you could contribute to the field as to how you could bring others along on the journey and collectively succeed. So I think that culture is really infiltrating throughout the organization. So I really commend you on kind of influencing that change. I was really astonished because as you can tell from my accent, as well, I’m not an American. I’m a Brit. And I was trying to familiarize myself more with the NIH and I came across a great tweet, not from your handle, I have to add, but from the NIH Office of portfolio analysis, and it said over the last five years or 2016 ‘21, NIH funded research involving retinitis pigmentosa involved 219 grants 150 research organizations and 17 countries. I mean, I didn’t realize the scope is so ginormous. So when we think about the influence of change, and the overall strategy of the NEI, I must say, you’ve been really great about sharing your mission and vision of on all the social handles. So on Twitter and on LinkedIn, I did come across, you know, a couple months back your National Eye Institute strategic plan, titled vision for the future, and I mean, I say this very honestly, it blew me away because it had all the elements you might see like a corporate biopharma plan, like it was very intentional, had a great executive summary, all these different elements, and it’s very well articulated. And I know that would have taken In a lot of work, so tell me more about that plan. How did you gain community and stakeholder input? And why did you feel the need in particular to revisit that visit the mission statement after 50 years? So tell us more about that, please.

Michael Chiang, MD:
Those are great questions. And I think they’re really important questions. I spent most of my first year in this job working on that strategic plan. I mean, there were some people during this pandemic, you see people for, you know, that you haven’t seen for two years, and a couple people commented, oh, gosh, you have so much more gray hair than you used to. And some of that is because of this strategic plan. But, you know, I guess I’ll take those questions backwards, and maybe start with a mission statement, like you talked about. I’m a big believer in mission statements. I think it’s really important for an organization to understand where it’s headed and what the North Star is of the organization. And our mission statement at the National Eye Institute, had not changed since we were founded in 1968. And so, the mission statement was older than I was. And so, we took a close look at it, and we spent months looking at, and what we came up with, is that our mission is to eliminate vision loss, and improve quality of life through vision research. And, obviously, we thought really carefully about every single word and, review this with a lot of different people. And you’re right, that we published a strategic plan in November 2021. And that outlines basically what our priorities are for the next five years. Now, obviously, science is fluid. And, we can’t necessarily know what we’re going to what things are going to be like, you know, five years, but you know, we got to have that roadmap, right. And the way that we really did this, is that you start by getting community input. And what that meant is that we put out a request for information. And, the input came from groups that were basically professional organizations, different researchers, research groups, clinicians, clinician groups, patient advocacy groups, and there were just individual private citizens, that these are all public, publicly available. RFIs. And so there were hundreds of comments. And so we started by basically organizing those comments. And we organized our plan based on a cross cutting sort of methodological approach. So the way that the National Eye Institute is organized is that our portfolio is organized anatomically, parts of the eye, retina, cornea, glaucoma optic neuropathy, and our strategic plan was organized methodologically, like we define the seven cross cutting areas of emphasis, genetics, neuroscience, immunology, data science, public health and disparities. And so there’s seven of them. And the way that I sort of like to explain that is that academic ophthalmology departments are organized anatomically right retina, cornea, and basic science departments are organized methodologicall, genetics, neuroscience, immunology. And so we thought that this was the best way to foster collaborations by getting the methodology to intersect with the anatomy, if you will, or the disease. And basically, the way that we did this is that for each of those methodologies, we gathered, we compiled basically expert panels, and they came up with their sense of, where’s the field? Now, where’s the field, what are the most likely sort of areas of growth for the next five years, and we got, you know, basically hundreds of pages of input from those people. And then we and our people basically reviewed those and compiled what we thought would best go into a strategic plan. And so that’s what you see up on the webinar, and we published it basically, November 2021.

Sophia Pathai, MD, PhD:
And you’re summing up in a few minutes, what is clearly, you know, a large body of work, but I’m curious to know how often people talk about change management, and there are courses you can go on in business school, where some of the folks may be, resistant to this kind of change because you were shaking things up, essentially, right? you’d gone from anatomical parts to functional and, you know, to is finding this new kind of method, methodological process. So, how was that received and did you have to do some kind of influencing to kind of get that accepted.

Michael Chiang, MD:
You know, I think Sophia, change management is really, you know, I think it’s really important to me. What I hope to communicate is, what our vision is for where the where the research where the vision field is headed and how we’re going to get there and what the rationale for it is. You know, one of the things that we did is we published a series of editorials in some of the major vision journals that described various aspects of it. There were basically five of these editorials that we published, and we published them basically on the same day, as you know, the strategic plan that was released in November 2021. That contains some of the rationale behind it, it was basically ophthalmology. Io vs. American Journal of ophthalmology, Jama ophthalmology, and optometry and vision science, and each of those editorials, talks about a different aspect that I thought was sort of foundational to what we’re thinking of in this strategic plan. But, you know, I agree that I think that one important part of my job I see is, is communicating with everybody out there who’s doing the real work, what are we doing? Why do we think it’s important, and I think it’s important to obviously emphasize that the majority of research that we support at the NEI is what we call investigator initiated, you’ve got an idea, you write a grant, and, that’s never going to change, you know research, we always sort of rely on the individual creativity and ideas of people who are out there who are doing the work. Now, of course, I hope that people are going to read our plan, you know, as they think about their investigator initiated research, because there were some very smart people who contributed the plan and had their own sense of like, what’s important, and what’s, you know, what’s hot right now, but investigator initiated research is not going to change. But, of course, our ideas about directed research and initiatives that we want to target each year to focus the community on areas that we think are really going to be important for, yhow are we going to make those advances that eliminate vision loss, and ultimately improve quality of life for people out there.

Sophia Pathai, MD, PhD:
So I think what we should do, as part of the show notes is definitely include those five editorials and the link to the plan, so that anyone who’s listening around the world could access those. So we’ll make sure we do that for the folks listening. But you just mentioned creativity, and you know, aligning back to the main mission statement. And I looked at the plan. And, one of the initiatives that really caught my eye was the audacious goals. Because, I’d like to think that we can all be audacious in our own way. So tell me more about that initiative.

Michael Chiang, MD:
Yeah, that’s great. So, audacious goals initiative was something that was started by policy even who was my predecessor, and it was in 2013, that basically 2020 2012 2013 that the idea is, what can you all say we do, but it was really what can policymaking do back then to really focus the Committee on something and the project that they came up with, was basically regenerative medicine. Specifically, how can we regenerate neurons and neural connections specifically that involve photoreceptors and retinal ganglion cells? So it was diseases like glaucoma, AMD inherited retinal degenerations, where you get death of, you know, photoreceptors, for example, and audacious goals was about how can we regenerate those using cell based therapies, okay, things like stem cell transplantation. And so over the course of, now, seven, eight years, we’ve funded about $80 million of projects in that area. So the idea is that we’ve tried to fund collaborative teams to work on various aspects of Audacious Goals initiative. The first set of collaborative teams, for example, a dealt with imaging, how do we develop for example, adaptive optics methodologies to image at the individual photoreceptor level with the idea if we’re going to regenerate we have to visualize okay, what we what we see is it working. Another set of collaborative teams involves identifying factors that are related to regeneration, what factors allow neurons to connect or reconnect and another team that is just another set of collaborative teams that’s getting underway now is basically what are translation enabling models. What are the animal models, for example, or other models that are going to take us toward clinical trials. So it’s basically those sets. And so, by the time, you know, so far, it’s been depending on when you started the clock, seven to nine years, and it’s been a really exciting project. And obviously, what we’re trying to do now, with this new strategic plan is to come up with what are some other targeted initiatives where we can really try to direct the field a little bit.

Sophia Pathai, MD, PhD:
Well, it sounds truly audacious in scope. And you know, as you’ve mentioned, a lot of these technologies are now coming to fruition, right, like adaptive optics. And I’m thrilled, you mentioned cell therapy, because one of our future podcasts will be with an early-stage company that actually started from an academic institution. So, it’s great to see that innovation coming full circle, as it were. So Dr. Chiang, we’ve really kind of, talked intensively about the kind of mechanics of the plan from an ophthalmology perspective. But what I was also personally very thrilled to see is the commitment that you have overall, to diversity, equality, inclusion and accessibility. So I think it’s really important that you call that out. So can you elaborate a bit more about the NDIS commitment to those parameters?

Michael Chiang, MD:
Yeah, this is an extremely important topic. And I think that, we could talk about that on a couple of different levels. But I think on some visceral level, I would just say that this pandemic, I think, has exposed a lot of things in our society. And one of them is that we don’t have a world where everybody has equal access to care. And there are a lot of gaps that we see. And I think that one of the realizations, I think that all of us have had, is that the best scientific advances really aren’t quite as useful if they don’t, if they’re not available to the people, especially the people who need it the most. And so, I think that’s something that drives a lot of our commitment to the NEI. And I think there are many other components of this. One of them, of course, is that coming up with structures of care to deliver them to, the people who need it, when you’ve got a situation, the people who are in many cases best suited to do that, or to understand the research topics that relate to a particular group, or to actually deliver that care or collect that data to or to, to really deliver it. I think there’s a lot of issues in terms of trust and understanding that really come when the people who do that work come from the same background as the people who they’re treating or studying whatever the specific application is. And I think another issue that is sometimes under recognized is that everybody, like we all talk about the benefits of interdisciplinary collaboration, right, we talked about that with the strategic plan, cross cutting areas of emphasis. And the premise of that is basically, that when you get people from different backgrounds, academically, to tackle the same problem, they have different insights based on their own training. And the part that I think is really under recognized is that, when you when you get a group of people who all went to the same college, and who all grew up the same way, and who all kind of think the same way, that’s a potential barrier to creativity. And maybe what we need is more teams. And there’s been really good literature to support this, this intuition, that when you get teams of people who don’t think the same way because they came from different backgrounds, and they see the world a little bit differently, I hope that’s going to be the mechanisms that we can really promote, as you know, why do we really want DEIA and science? It’s because sometimes people quote the mantra that, great minds think alike. And, one of the things that we’ve been talking about at NIH is, maybe the mantra should be that great minds think differently.

Sophia Pathai, MD, PhD:
Well, I love that.

Michael Chiang, MD:
And so I think that has a lot to do with why do we care about the AIA and, we feel we’ve been trying to have some initiatives to really promote DIA and support those areas in science, both at the NAI level and also at the broader NIH level. So really, really important topic.

Sophia Pathai, MD, PhD:
Thank you so much for sharing your perspective. And let me kind of go back to the great minds don’t think alike, because maybe that’s a great way to go to our next topic, which is around the relationship between government or academic institutions, between investors and maybe early stage founders. Because, I’ve seen it from many different angles as a clinician, myself, as someone who’s worked in large cap, corporate biopharma, and now in a venture capital firm. And I’ve been academic. So I do see where there are a lot of upsides. But I’ve also seen where there are challenges. So I’d love to know from your position, what you’re seeing where you see the winds, and where there are room really for opportunity.

Michael Chiang, MD:
Yeah, Sophia, really, really important question, I think that there’s a lot of wind for opportunity. And I guess, you know, like, we talked about our mission, eliminating vision loss, improving quality of life. You can’t do that without industry. And without people who do what you do in venture capital. And so, people who do science, we don’t want to, we can’t have a situation where we’re researchers are like, you know, trees falling in the forest. And so there’s got to be a, I think the premise of this is really, really important. So a couple of thoughts, Sophia, one of them is that I think we need really good basic science as the foundation of innovation. And that sort of probably goes without saying, but I think that it would be ideal to have good communication, so that clinicians can learn about the basic science, and can hopefully inform, like, the direction of that basic science like, what, what is it that what are the problems that people need solutions to? And what’s the science that can solve that? And, by the same token, I think we need communication so that people from it from industry can hear about the clinical work and the scientific innovation that’s going on. And ideally, we’ve got a situation where these groups of people can work together. I think in the vision field, we’ve had some, what I would consider pretty big wins in areas like gene therapy and artificial intelligence, where science has led to forming companies that are basically I think, on track to becoming successful. Just some of these are very small companies, obviously, that deal with rare diseases, but I think they’re, as far as I can tell, on the right track. And, one of the things that I hope what we’ve been doing at NEI is that we’ve been participating pretty actively in a, an NIH wide, public private partnership, to stimulate research in gene therapy. And there’s been a really robust response from the vision community to that, because obviously, there’s been so much ongoing gene therapy work involving different eye diseases, retinal disease, corneal disease, these inherited retinal degenerations. And I really hope that we can, and that’s something that I’ve been interested in, and I hope that we can find ways to inspire more K, what I’d call public private partnerships. And yeah, I’d like to see how this one works out, and that we can really promote innovation by working together. But that’s sort of what I hope for. And I think the premise of your question is really important that I don’t see any one group being able to do this on their own.

Sophia Pathai, MD, PhD:
Exactly. And, you know, I think it’s imperative we all have this chance to work together. And that’s why we’re so delighted to have you on the podcast today. And, you talked about communications, you’re obviously a great communicator, not only audio wise, but also in social media. And so, I’ve referred to a Twitter handle before, and you’re pretty active. And it’s a great way I think, for you to communicate to many different stakeholders. And I want to draw your memory back to one tweet which I found, which made me smile, in fact, and led to me writing an article in fact about med tech and ophthalmology. So new residents were starting that training and you wrote, enjoy, I began my #ophthalmology residency 25 years ago, and never imagined it would be so amazing. 50% of what you learn will become obsolete in your career, make sure to learn how the standard of care evolves through research, and you #med Twitter. So, I mean, tell us a bit more about your visibility, and how you manage your Twitter handle. And tell us about that tweet in particular, because I think that’s a great tweet, and maybe a little controversial, in fact.

Michael Chiang, MD:
Thank you for asking that. And for highlighting that. I view one of my I mean, my personality, I don’t think is innately like, you know, look at what we’re doing here. But I view one of my main jobs as communication with the larger world in terms of what we’re doing at the National Eye Institute, and, why we think it’s important. And, on a pragmatic level, we’ve got a lot of grant opportunities. And, I used to have situations where I couldn’t apply for a grant, because I didn’t know about it before the deadline. And I just hate when that happens. And so I don’t want people to not know about opportunities, and we’re trying to use social media to just push that, you know, broaden a little bit more broadly, I see myself as a little bit of a spokesperson for the vision community, in terms of researchers and clinicians about, what we do, and just why it’s exciting, and why it’s important. And, why we have a worthy mission of trying to eliminate vision, loss and improve quality of life. And so, I’ve just been trying to use social media to communicate those messages. Now, in terms of that particular tweet, I used to teach a lot of medical students, especially in the first part of my career at Columbia, and it was a ton of fun, and every medical student, starts by asking, what research can I get involved with? Right, and, you know, you want to match an ophthalmology and I started to think that people viewed research as the mechanism to get into a good residency program. And to me, that just seemed a little unsatisfying. You know, because it was very, like, you know, what is the real reason we want to do this? And, I actually thought for years about how to articulate why do you really want to do research, I mean, I don’t want to go tell young people that you do this as a means to an end, right, it’s got to have some innate value. And I have to be I, you know, I asked people about this, I struggled about it, and I couldn’t come up, you know, of course, I came up with all sorts of explanations, but I wasn’t sure I could come up with something that would really, that 100% made sense to me. But my little epiphany, if you will, was and I didn’t think about this until after I’ve moved from Columbia, and was working in Oregon. That, you know, the use case or example that I thought of was when I was a resident, and learning medical retina, you know, what I learned was the macular photocoagulation study the MPs and I know that we’re roughly the same era in life and, we had these templates to overlay, we learned rules. And, when do you laser, and within five to 10 years after, so I learned this thing that 50% of education becomes obsolete, within the first 15 minutes of my first day of medical school, somebody got up and said that, and I never believed it, I thought, you know, I use the same physics book as my parents used. And, how could medical education become obsolete and, but when anti VEGF came along, I would say 100% of my medical retina education in that area became obsolete within five to 10 years after I finished learning the state of the art. And that really impressed upon me that if I honestly reflect in life, having been around, we’ve all been around people who are incredibly talented. But it occurred to me that there are some people who are really good at taking in new knowledge and understanding where the field goes, where the field is going. And I think that there are some people who are really not very good at that and are very, very good venture capital. There are some people who can be literally the best in the world at what they do but not be very good at being the best in the world later and I never realized that when I was 25 that what it means to be the best evolves over time, and that the spirit of that particular tweet was that I actually think a lot of education is focused on teaching, how are you going to get the highest score on your board exam by learning all the information that state of the art in 2022. But I actually think more and more a lot of education is about developing the skills to be the best in 2030, or 2040. And I think that so that that was the spirit of what I’m trying to get across. And to me, that’s the biggest reason now that students should understand research, because the way the standard of care evolves is through research, and you can’t understand how to evolve your practice, if what you’re going to do is you want to take care of patients, like sometimes people ask Well, all I want to do is take care of patients, I don’t want to do research. My sort of epiphany was that you can’t do the best job taking care of patients unless you understand what is like how you’re going to evolve your practice, and that really hit home with the anti VEGF example. So that’s a long answer to what I think is a really, really important topic.

Sophia Pathai, MD, PhD:
Now, that’s a very profound and philosophical response as well. And I love the way you’ve thought about that, and in fact, almost encompasses my final question, which is really around, how you want to inspire the future generation, because it has been a number of years since you’ve been on the boards or in the clinic at Columbia. But you’ve really nicely articulated the rationale for research moving forward. But we do have a lot of folks who are maybe embarking on their careers or students or vision scientists. So would you like to leave them with some words about how they could move forward, and, what you want to share with them?

Michael Chiang, MD:
You know, Sophia, one of the things that you’ve focused on is innovation. And I think that that’s really, I mean, one of my hopes, is to make sure the vision field stays on being at the leading edge of innovation. I mean, the AI is such an accessible organ, and it’s a great model system, for doing work that really matters to people. I think that what I would really leave with is that I think this is a great field. It’s an amazing field, for all the reasons that we’ve talked about, we get to do work that really matters to people. And you get to do great science that matters to people. And I think I would leave on that last thing that you highlighted, I know you come at it from a venture capital perspective, I’ll come at it from a science perspective. But I think that being at the leading edge of innovation, means that things move really, really quickly. And, I think it’s important to focus on skills that are going to keep you on the leading edge. So in other words, what’s important, you got to know what you have to know, to be the best in 2022. But I think it’s just as important and in some ways more important to develop those skills that are going to let you identify what’s going to be on the leading edge in 2030. Because it’s not going to be the same as what’s on the leading edge right now. And so, it’s a challenge to do that. But I think in some ways, it’s the most important thing.

Sophia Pathai, MD, PhD:
Nicely said, and you’ve inspired me, and I think you’ll continue to do so for so many of us by all the communications and your tweets, please keep tweeting. But Michael Chiang, MD, thank you so much for joining us today.

Michael Chiang, MD:
Sophia, thank you very much. Thank you for having me.