Hossein Gharib, MD, MACP, MACE, professor of medicine at the Mayo Clinic College of Medicine and consultant in the division of endocrinology, diabetes, nutrition and metabolism at Mayo Clinic in Rochester, Minnesota, was awarded the 2018 H. Jack Baskin, MD, Endocrine Teaching Award by the American Association of Clinical Endocrinologists at its annual meeting.
The award recognizes professors who have had a strong and lasting impact on their medical students.
Gharib, himself a past president of AACE, is renowned internationally for his work on thyroid disorders and for his contributions to the field of endocrinology more broadly. Endocrine Today spoke with Gharib about his career, which spans more than 4 decades, the research that interests him most and the rewarding nature of traveling with colleagues.
What was the defining moment that led you to your field?
Gharib: Early in my education, I was exposed to some true endocrine giants. First, at the University of Michigan Medical School where I studied medicine in the 1960s, I met Jerome W. Conn, MD, who first identified primary aldosteronism or Conn’s syndrome, Stefan S. Fajans, MD, and William H. Beierwaltes, MD. Later, during my internal medicine residency and endocrine fellowship at Mayo Clinic, I met William M. McConahey, MD; F. Raymond Keating Jr., MD; Robert M. Salassa, MD; Raymond V. Randall, MD; W. Gene Mayberry, MD; and Robert E. Ryan, MD. These people shaped my future in endocrinology.
What area of thyroid research most interests you right now and why?
Gharib: Thyroid cytology and molecular markers most interest me now. There has been considerable progress in this area in the past few years, with new developments and improved patient care. I am positive there will be new advances to help our practice and our patients.
What has been the greatest challenge in your professional career thus far?
Gharib: I can mention at least two. While we witness progress in practice and develop guidelines to improve patient care, implementation of these recommendations has been challenging and slow. We need to inform our colleagues worldwide of these advances, so they can apply them to their practice.
Second, resources are limited, and priorities are different in many parts of the world. What we recommend for optimal care in the U.S. or EU may not be easily applicable or available in the Middle East, Africa or South America, due to financial or political concerns. Therefore, we must be practical and flexible in promoting our practice guidelines and preferences in different parts of the world.
What are some of the most exciting advances that you have been a part of?
Gharib: I’ve been fortunate to have been directly involved in several major areas of thyroid research during the past 50 years. We developed serum thyroid-stimulating hormone radioimmunoassay at Mayo Clinic in the early 1970s, applied it to practice and confirmed it as a useful and reliable test of thyroid function.
Later, we were the first to accurately measure triiodothyronine by radioimmunoassay in human serum, a finding that was confirmed by others and has lasted more than 40 years. My colleagues and I at Mayo were among the first to promote fine-needle aspiration as a reliable test in evaluation of thyroid nodules, publishing many articles in the 1980s and 1990s to prove its validity and emphasize the expertise of the cytologist as the underpinning of this practice.
Finally, I am pleased to report that our novel observation, published in 1987, that thyroxine suppressive therapy for benign nodular goiter is ineffective and fraught with side effects, was confirmed by many other groups and led to a major change of practice. T4 therapy is no longer recommended for this purpose.
What advice would you offer to a student going into the field today?
Gharib: Endocrinology remains an exciting field with many unknowns and mysteries to be explored and solved. A young investigator or researcher can clarify puzzles and improve patient care. That is the ultimate goal and should result in personal pride and gratification.
What are your hobbies/interests outside of work?
Gharib: My greatest joy has been contacts with AACE colleagues and my travels, having traveled to 35 countries in the past 20 years and having met with hundreds of colleagues in five continents. During these professional trips, now annually five in the U.S. and eight internationally, I meet many colleagues and share challenges of endocrine practice. I’ve learned that there are more similarities than differences in endocrine practice around the globe. These visits and exchanges have been mutually beneficial.
For example, I discovered that worldwide, goiters are common, obesity is on the rise, diabetes is increasing, vitamin D deficiency and bone disease are very prevalent and imaging, while available, is usually expensive. These are similar to issues we face in our own practice in the U.S. Moreover, limitations of resources, priorities of practice and costs of tests and procedures significantly influence practice patterns from one location to another. – by Melissa J. Webb
Disclosure: Gharib reports no relevant financial disclosures.