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The Right Stuff


The New Physician March 2001
The life of a NASA flight surgeon is anything but ordinary. With such diverse responsibilities, it’s not surprising that flight surgeons come from various backgrounds and have a wide range of knowledge and interests. Flight surgeon and astronaut candidate Michael Barrett holds a bachelor’s degree in zoology, while flight surgeon Phil Stepaniak has a brown belt in karate and continues to work as an emergency room physician at a Houston hospital. And before coming to NASA, Dr. James Bagian was a process engineer at the 3M Company.

Dr. Sam Pool, the assistant director of Johnson Space Center’s (JSC) Space Medicine and Life Sciences Directorate, says the agency intentionally seeks people who have followed pursuits outside of medicine. “We look at [a candidate with only a medical background] and say, ‘Hmm, that’s not a very rich background academically. How about somebody with math and physics, like myself, or somebody with some other background which will make them a little bit better rounded,’” he says.

Regardless of their other interests, though, all flight surgeons end up with a medical education specifically addressing the unique demands of the job. Their schooling often begins in the broader field of aerospace medicine, which focuses on issues related to military and commercial flight, as well as the space program. Falling under the domain of preventive medicine and sharing characteristics with occupational medicine, aerospace medicine manages to be both extremely broad and very specialized at the same time.

Training in aerospace medicine is only offered through a handful of institutions. The Air Force, the Navy and the Federal Aviation Administration offer physicians “short courses” lasting between seven weeks and six months, while Vanderbilt University, Wright State University and the University of Texas Medical Branch (UTMB) are among the schools that include aerospace medicine in their curricula.

Beyond the preliminary training and basic medical studies, there are only four aerospace medicine residency programs—two military and two civilian—that lead to official certification by the Accreditation Council for Graduate Medical Education and the American Board of Preventive Medicine.

For military personnel, the Navy Operational Medical Institute in Pensacola, Florida, and the U.S. Air Force School of Aerospace Medicine at Brooks Air Force Base in San Antonio, Texas, provide physicians training for service on air bases or aircraft carriers, with the top physicians in each class given the opportunity to apply to NASA.

For civilians, Wright State offers a three-year residency program in affiliation with nearby Wright-Patterson Air Force Base in Dayton, Ohio. In conjunction with JSC in Houston, UTMB offers a two-year residency program in aerospace medicine as well as a four-year combined aerospace/internal medicine residency. The UTMB programs have developed into a physician pipeline for JSC, while Wright State has made steady contributions to the agency as well.

Dr. Richard Jennings, the director of UTMB’s aerospace medicine residency programs, says the programs are extremely selective; UTMB takes a maximum of two residents per year. Jennings looks for candidates with two distinct traits: an established clinical skill and a firm commitment to aerospace medicine. “We may not always pick the best candidate,” Jennings says. “I’m looking for someone who has thought about [working in space medicine] for a long time and wants to do this.… NASA is paying the money. We want to provide them someone.”

NASA has some educational programs of its own. The agency offers a four-week clerkship program at JSC to provide medical students with exposure to clinical, operational and research aspects of space medicine. For undergraduates, Kennedy Space Center offers a six-week training program on space flight and life sciences.

For medical students more interested in the research aspects of space medicine, the National Space Biomedical Research Institute (NSBRI) offers educational opportunities. Through Morehouse School of Medicine, the NSBRI sponsors an introductory course for undergraduates, while a summer research program specifically provides opportunities to undergraduate women and minorities. Furthermore, the NSBRI is developing a fellowship program for graduate students and postdoctorates. “I encourage people who have a flair for adventure, want to work on revolutionary advances, perhaps work that is a little higher risk but higher impact, [to apply],” the NSBRI’s director, Dr. Jeffrey Sutton, says. “We have fantastic opportunities, particularly if the person is from a school that does not have medical science.”

Despite already having many well-qualified, competitive applicants, both the NSBRI and NASA are expanding their student outreach programs to ensure there is a new generation of space medicine researchers and flight surgeons. “I did [not plan to enter space medicine], but the hook was pretty strong when I finally became aware of the opportunity,” Pool says. “So I took it with gusto and worked very hard in this field and enjoyed it a great deal. Like any job, I’m sure it has good points and bad points, but in my case they far outweighed on the good side.”
Scott T. Shepherd is an associate editor with The New Physician.