Ryanne Wu, MD, tells about Singapore experience

Sunday, January 20, 2019

We are especially honored to hear from Dr. Ryanne Wu, a GIM faculty member who recently returned to Duke after three years in Singapore. You will want read about the experience and the career impact for this clinician-researcher.

Submitted by Ryanne Wu, MD, Assistant Professor of Medicine, Division of General Internal Medicine

My family and I recently returned to the Triangle area after spending three years in Singapore.  My husband’s job at GlaxoSmithKline prompted the move, but I have always loved experiencing new cultures and had hoped to live overseas one day.  Leaving our extended family and a conventional career path was difficult, but the opportunities at Duke-NUS Medical School made it an easier decision.

Research at Duke-NUS

My research at Duke before Singapore had largely been with Geoffrey Ginsburg and Lori Orlando’s team at the Center for Applied Genomics and Precision Medicine (CAGPM), where we developed a family health history risk assessment platform, MeTree, to help primary care providers more effectively implement precision medicine within their practices.  At Duke-NUS, I joined the SingHealth Duke-NUS Institute of Precision Medicine (PRISM). PRISM had recently established a biorepository of multi-dimensional data from healthy Singaporeans incorporating genomic, clinical, lifestyle, and imaging data. I built a collaboration with our Duke team to incorporate MeTree into the data collection process for PRISM’s biorepository. In the next few months, we will have whole genome sequencing and detailed family health histories on over 1,000 subjects ready for analysis and publication. 

While in Singapore, I also used my training in health services research and implementation science to help one of the primary care clinics within SingHealth, the healthcare system associated with Duke-NUS, to develop an evaluation framework for testing new models of care.  SingHealth is considering expanding implementation of the model as a result of that work. The experience of navigating a completely different research and healthcare delivery model was fascinating and deeply satisfying, and I enjoyed the partnership with colleagues from not just Singapore but all over the world. Our PRISM team alone had members from at least six countries across Europe, Asia, and Australia; I continue to collaborate with many of them since my return.

Travels!
On a personal level, the experience was very gratifying for my family.  Singapore was a wonderful place to live – safe, efficient, organized, and with fantastic food!  My two boys, now ages 7 and 9, went to an international school with students from over 60 countries. They were part of a dual language program in which half of their school curriculum was taught in Mandarin Chinese. We enjoyed making many new friends from both Singapore and others relocating like us from around the globe. We also traveled to Australia, South Africa, and throughout Asia every chance we had, visiting some countries numerous times. We saw amazing sites (e.g. Great Wall of China, Mt. Fuji, Angkor Wat) and ate amazing local fare!

Back to NC

While we enjoyed our time abroad and miss many aspects of life overseas, we are also enjoying being back in the Triangle area with cooler weather and family nearby. I remained on faculty at Duke while we were away, but it is good to interact with my Duke colleagues face to face again.  Since returning, I have continued my work with CAGPM, where we continue to develop MeTree to optimize it for clinical use and improve its accessibility among underserved populations. I have also joined the Durham VA Cooperative Studies Program Epidemiology Center (CSPEC) led by Dawn Provenzale.  At CSPEC, I help manage our portfolio of research with Gulf War veterans. We have several trials ongoing and in development evaluating the genomic and epidemiologic underpinnings of Gulf War Illness and ALS.

I greatly appreciate the opportunity I had to live and work in Singapore. I am thankful to the Department of Medicine, our division chief, Ebony Boulware, my collaborators at Duke, and Dean Coffman and Dr. David Matchar from Duke-NUS for thinking creatively with me about what the career path of a clinician researcher can look like. By having another medical school in a major, global hub like Singapore, Duke and Duke faculty have a unique platform. There are numerous avenues for collaboration to create powerful research proposals and improve health and healthcare in significant ways.  From the clinical and medical education perspective, there are also tremendous opportunities to learn from each other and optimize the experience of our students at both campuses. Speaking from my own experience, the potential is as high as the ability to think outside the box!