The Pathways Consult Service aims to discover new insights into the unifying mechanisms and underlying biology of disease through the close examination of a single patient.

Background

The Pathways program was founded by Dr. Lauren Zeitels and Dr. Victor Fedorov. As aspiring physician-scientists, Dr. Zeitels and Dr. Fedorov understood that the field of medicine shares a historic bond with scientific discovery. In the past, advancing the fundamentals of biology through the careful investigation of patients seen in clinic was common practice for the physician. During their first year of residency, Lauren and Victor saw patient after patient whose cases raised important and unanswered questions about the mechanisms driving disease. At the same time, Lauren and Victor understood the incredible leaps being made in bench science, as tools like DNA and RNA sequencing became ubiquitous in academic settings. Far ahead of their time, they recognized how bringing together individual patient questions with these tools could enhance medical training, advance science and help patients and families seeking explanations. In 2016, they approached Department of Medicine leadership with an idea—to set aside dedicated time during residency for house staff to connect with scientists and delve into the fascinating biological questions that arise at the bedside. With the full support of department leadership, the Pathways Consult Service was born.

Tragically, Lauren and Victor passed away in March 2017 in an accident while pursuing their love of nature and outdoor activities. Their spirit of intellectual curiosity and patient-driven investigation remain at the core of the Pathways Service.

Pathways Consult

When medical staff at Massachusetts General Hospital encounter patients whose cases raise fundamental questions regarding unknown mechanisms of disease, they can refer them to the Pathways Consult Service.

During a Pathways consult, a team will devote two weeks to investigating the pathophysiology of one of these patients and the questions these cases raise. With guidance from scientists, teams will generate hypotheses and propose ways to harness new technologies like next-generation DNA sequencing, induced pluripotent cell culture and proteomics to shed light on poorly understood disease processes.

The Pathways Consult Service provides an unparalleled educational experience to the residents, promotes cutting-edge scientific research and has the potential to tangibly improve the health status of patients at Mass General and beyond.