Physician-scientist, Reshma Jagsi, MD, DPhil, was encouraged by her parents to become a politically active, socially conscious citizen of the world. “As a young woman, my mother traveled from Africa on a scholarship to the United States, where she attended the University of Wisconsin. It was in the 1960s, and she joined a “peace caravan” that journeyed into the Deep South. I loved seeing pictures from her scrapbook; one in particular was a local paper headline that read: “African Student Arrives to Speak About World Peace.” When she returned home, she met my father, who was a physician from her hometown in Tanzania. They eventually moved to England, where I was born,” said Dr. Jagsi.
Texas Heat and a Formative Experience
Dr. Jagsi moved with her parents from England to Chicago in 1978, during Chicago’s Great Blizzard, the city’s all-time snowiest winter. “My father had to redo his residency, which took 3 years, after which we immediately moved to Texas, a place that offered a more hospitable climate for immigrants fom
Africa,” said Dr. Jagsi.
“I decided I wanted to promote human health, and the most direct way to do that was to become a physician.”— Reshma Jagsi, MD, DPhil
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She continued: “I had some wonderful teachers who encouraged my passion for science and social studies. I also had a terrific experience volunteering at the local VA Hospital where my father worked in my hometown of Waco, Texas. That was where my desire to pursue social activism with medical service really gelled. Working in a medical center opened my eyes about what my father did as a physician. I worked there every summer during high school. One summer, I actually worked on the long-term care floor with my father and saw the positive impact he had on his patients, which remained as a lasting inspiration.”
First in Her Class
After graduating high school in Waco, Texas, Dr. Jagsi entered Harvard College in Boston. “I majored in government, and I searched for a career path that involved service to the community. To that end, I volunteered at a legal aid firm that helped people avoid eviction and potentially homelessness. I also tried teaching and working with underprivileged students, which also offered me an opportunity to fulfill my goals of social activism and service. However, in my mind, I always returned to the patients at the VA hospital in Texas. My father didn’t want me to default into pursuing medicine just because that is what he loved, but when I told him why I wanted to be a doctor, he realized I was making the right choice.”
She told him: “I decided I wanted to promote human health, and the most direct way to do that was to become a physician. There’s just no other field that offers such an instant opportunity to use one’s knowledge and skills to make a positive difference in someone’s life. But I also wanted to continue working in ethics and policy, as I had become acutely aware of the socioeconomic determinants of health from my other volunteer experiences.”
Dr. Jagsi graduated first in her class from Harvard College and then pursued her medical training at Harvard Medical School. “At first, I thought about becoming a neurologist. But, during my neurology rotations, when I raised questions about what we could do next for particular patients, I was told that, although we could prevent future neurologic deficits, there was nothing available to undo the existing deficits, which left me wanting to do more. One day, a neurology resident pointed to a woman in the cafeteria who is now a leader in the field of gynecologic radiation oncology (and was then a resident) and suggested I talk to her. Well, in my surgery rotation during a brain tumor clinic, there she was, and we spoke at length about radiation oncology. Soon after, I decided I’d found my specialty.”
According to Dr. Jagsi, breast cancer research and treatment became personal. “My long-standing interest in breast cancer arose, in part, from family experiences. Four of my aunts developed breast cancer, two of whom died of the disease.”
A Key Mentor
Asked about mentors along the way, Dr. Jagsi told The ASCO Post that she was fortunate to meet Dr. Nancy Tarbell, who had been recruited to Mass General as a pediatric radiation oncologist and was Founding Director of the Office for Women’s Careers. “When I began working with Nancy, I truly enjoyed every minute in the challenging field of pediatric oncology, but I was still drawn to breast cancer. Nancy saw that in me and, as the great mentor she was, encouraged me to pursue that area of clinical specialization. During my time with Nancy, I learned about the importanceof minimizing treatment-related toxicity that later translated into my breast cancer work,” shared Dr. Jagsi.
Dr. Jagsi’s relationship with Dr. Tarbell led to another exciting career move. “Nancy explained that, in her leadership role with the Office for Women’s Careers, she was working on many initiatives to promote gender equity in academic medicine, but she’d been frustrated by the lack of data on the issue. She knew I had done my doctorate in social policy at Oxford University and suggested that I study gender inequity and ways to promote bright young women in their careers in medicine. One issue we discussed was the inordinate number of women in academic medicine who sort of drop off the scene after bearing a child, which offered an exciting avenue of research and intervention. So, Nancy set me on this fascinating path of investigation and activism that I’ve been pursuing to this very day,” stated Dr. Jagsi.
Fellowship in Bioethics
Following her residency, Dr. Jagsi did a fellowship in bioethics at the Center for Ethics at Harvard University. “The bioethics fellowship at Harvard was certainly a significant experience that helped prepare me for my current position as Director of the Center for Bioethics & Social Sciences in Medicine at the University of Michigan,” explained Dr. Jagsi. She also is Deputy Chair of Radiation Oncology and Newman Family Professor of Radiation Oncology at the University of Michigan.
Along with her work at the Center for Bioethics, Dr. Jagsi is an internationally recognized clinical trialist and health services researcher. Her clinical research focuses on improving the quality of care received by patients with breast cancer, both by advancing the ways in which breast cancer is treated with radiation and by advancing the understanding of patient decision-making, cost, and access to appropriate care.
For her tireless work on behalf of gender equity, Dr. Jagsi was the 2019 recipient of the Association of American Medical Colleges Group on Women in Medicine and Science Leadership Award. The awards are presented annually to the individual and organization that demonstrate a significant impact on the advancement of women’s roles in academic medicine and science.
Future of Breast Radiation Oncology: Tailoring Treatment
Asked to envision her field emerging over the next decade, Dr. Jagsi replied: “I see the future of breast radiation oncology as being about the individualization of therapy: some patients have aggressive disease and need intensification of treatment, whereas others have excellent prognoses and may warrant treatment de-escalation. Clinical trials have demonstrated we can safely shorten courses of radiation therapy for many women with breast cancer and reduce their burden. In some, we can even forgo certain
treatments altogether.”
However, according to Dr. Jagsi, a key challenge moving forward is moving knowledge from trials into patient populations as quickly as possible. She also notes the need for more effective treatments for some types of breast cancer, adding: “We are doing some promising work combining radiation with radiosensitizing systemic therapy for inflammatory breast cancer.”
How does a super-busy academic oncologist stave off burnout: “First, I truly love what I do and have a wonderful husband, who’s a law professor here in town, and two great kids. My mother’s close by, too, so family is a great buffer against burnout. I also enjoy playing the piano, which is one of my passions.”
