From Tokyo to Baltimore
After his studies he moved to the U.S. National Institutes of Health (NIH), which in 1960 started an institute on aging research in Baltimore. That facility has since been absorbed by Johns Hopkins University, but for decades it was America’s primary gerontological research center. Around 1962 this NIH program began a longitudinal heart study that helped start a global cardiac research boom as well as the first serious scientific research into human aging.
Chairman Chang calls his 30 months in Baltimore the starting point of his enduring research interests. He returned to Japan to conduct research for Tokyo’s city government, which saw the demographic tsunami of a rapidly aging society approaching as families grew smaller.
“In the 1960s and ’70s, both countries [i.e. USA and Japan] began paying attention to the aging problem,” Chairman Chang said. “Now our society recognizes this as a medical problem, with cancers and neurological diseases seen as diseases of aging.”
Cardiovascular research made major advances then, achieving such milestones as statins and stents. “There was good progress in cardiac medical therapies. But now cancer and neurological diseases are the two major problems facing our society,” he said. For the former, there is abundant progress and hope: “Cancer etiology is complicated, but we have new drugs, with recent Tang Prize awarded for this work.”
In contrast, he noted that “There are no good neurological drugs” to treat such major diseases as dementia, Parkinson’s and Alzheimer’s: “We don’t even have a good drug for Parkinson’s disease; levodopa delays but cannot stop its course.”
Taiwan’s Ministry of Education is soliciting proposals for research and education programs in a major push for progress, Chairman Chang said. The TMU team, led by President Lin, is putting forward proposals for neurological programs to compete in this critical area.
TMU’s ‘big three’ priorities
The university’s current research prioritizes three vital societal needs: Taiwan’s high cancer death rates, its vast human toll from traumatic brain injury, and the looming demographic challenges of becoming a “super-aged” society.
“First, we are focusing on translational cancer research, including research on ‘personalized medicine’ approaches to therapy and drug development,” he said. This research will especially try to address colon and breast cancers, which are among the top killers in Taiwan.
“Second, we are focusing on brain and neurological research. This brain research is very important for an aging society like Taiwan’s,” he said. This year, TMU started a Neurological Research Center based at Shuangho Hospital that involves more than 70 doctors － both attending physicians and researchers － in this research, plus another 30 support staff in areas like bioimaging. TMU also plans to build two high-rise buildings that will vastly expand the Shuangho campus’s educational and research operations.
“We hope that since the center started this year, it will also give our students a better-integrated research perspective,” Chairman Chang said. This effort builds on nine years of collaborations between surgeons and neurologists who attend a weekly meeting to discuss cases and findings. Together, these efforts address the traumatic brain injuries associated with scooter transportation as well as Alzheimer’s, Parkinson’s and other brain diseases.
The university’s third priority research area is aging. A recent strategy meeting at Wanfang Medical Center discussed that hospital superintendent’s research collaborations with Nagoya and Matsumoto. This followed a TMU fact-finding delegation’s visits to both cities that studied Japanese gerontological care approaches that might offer useful insights. As the Ministry of Health and Welfare is developing long-term care and other services for Taiwan’s elders, TMU is supporting these efforts with both clinical and basic studies.
In terms of predicting future directions for progress, Chairman Chang said biomedical research is progressing the fastest. For example, the time required for human genome analysis has fallen from five years to just 30 minutes using new technologies. “You can see that the progress is fast, but we need to focus on ‘What are the medical needs?’ ” he said. TMU is doing this with priority research programs in neurology, cancer and geriatrics that address the most pressing needs of today’s health care systems.
How changes affect students
The university’s educational and service missions are being transformed as well. For example, TMU started requiring a computer software “coding course” this year to help students add more to their clinical and research fields.
Other changes look far beyond the TMU campus to engage useful educational resources. “In the 1970s and 1980s, many Taiwan graduates went to the U.S. and U.K. for postgraduate studies – but now we have the problem that they want to stay in Taiwan,” the chairman said. “This is not good: Taiwan needs to globalize.”
The university’s answer to this problem has been to increase programs that encourage outbound students to make use of opportunities abroad, and to promote these opportunities with funding support and expanded publicity.
Chairman Chang said another change from his own era as a student at Taipei Medical College is a vast expansion of English-friendly programs and international student recruitment: “I’m also glad to see so many international students presenting in English and asking questions at TMU events. It’s a good educational environment now.”
Yet he spoke of other changes over the decades, particularly the much greater pressure on students to compete with professional publications. “In our era, if you wanted to purify a protein, it took three years. Now it takes one week. Molecular biological tools make these tasks very easy, but the progress of research makes competition tougher. … Now high impact factors are important in building careers.”
It’s harder to recruit young researchers because they consider this pressure, and they wonder whether they will have enough ability to succeed, Chairman Chang said. “For example, I’m involved in the selection of winners of the Tang Prize [awarded biennially in Biopharmaceutical Science and other fields]. Last year(2016) it went to a very young researcher in MIT, only 35 years old.” But his work on CRISPER/Cas9 contributions earned him this prestigious global award together with two other distinguished scientists.
“If you have a good idea and study hard, you can do a better job than we did. But even then, we had to work nights and weekends,” he laughed. His advice to young researchers takes the faster pace of scientific progress into account, but does not candy-coat the difficulties they will face: “You have more opportunities due to these better tools and reagents. This helps balance the tougher competition – but there’s no question that you must make more effort.”