Get to Know ... Victor Orellana-Noia, MD, MSc

Dr. Orellana-Noia, Assistant Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine, has some advice on being honest with oneself in the pursuit of academic medicine as a career path.

Where did you grow up, and when did you know you wanted to be a physician scientist? I grew up outside of Atlanta, so coming to Emory has been a little bit of coming home for me. I didn’t know I wanted to be a physician until late in college. I started off as a literature major. I did my thesis in comparative literature and decided at the last minute that I needed something very different from that.

My late uncle was a physician, which my dad always talked highly about. My father is from Chile, and he wanted to become a physician. But when he was pre-med in college, he was still working on his English, and it was challenging. It was hard for me not to gravitate to medicine just based on that alone.

The first job in which I made any real money was in a commercial painting crew. We rode in the back of the van sitting on top of paint buckets, driving around to commercial construction sites all over downtown Atlanta. It certainly gave me an appreciation for sticking it out with my formal education. Ever since then, it was college, then med school, residency, fellowship, etc.

How did you choose hematologic oncology as a specialty? I didn’t have a lot of experience in oncology during med school, but in my second residency rotation, I was with Eric Winer, MD, on the leukemia service at Brown University. It was just fascinating—the pace of the disease, the complexity of it, the biology that went into treating someone, and seeing the dramatic turnarounds. It was fast-paced, and Dr. Winer was so dedicated to his patients. He knew so much of the science behind what was happening. He was a very influential figure early on.

Did you have other mentors who guided your career path? What do you think makes a good mentor? My two mentors in fellowship, the ones who really turned me into a lymphoma specialist, were Craig Portell, MD, and Mike Williams, MD. They’re both still at the University of Virginia. I decided early in the fellowship that I wanted to be like them.

Dr. Williams closed his clinic recently, but he’s one of the elder statesmen in the field and really a consummate physician through and through. He is one of those people that you can’t help but emulate—the charisma and passion that he had taking care of people and in driving the science forward.

In terms of what makes a good mentor, some of it is hard to put into words, and some of it is just recognizing someone who you resonate with. The mentors who have made the biggest difference for me were the ones who clearly took time outside of what they had to do to focus on what my experience was going to be and thinking more about what my path was going to be. They went out of their way to make those opportunities happen. I’ve been very fortunate to have some of those people along the way. Most recently, Jonathon B. Cohen, MD, MS, at Emory has been someone who has taken the initiative in saying, “How are we going to move this person’s career forward?” I am where I am because of the people who have shepherded me each time.

What advice would you give fellows and early career professionals who may be struggling to find their career focus? It’s tricky. You have to be really honest because academic medicine is certainly not for everyone. There are a lot of challenges you don’t get to see until you’re already in it. I think the biggest questions first come with what kind of medicine do you want to be dealing with on a day-to-day basis? Even when the hours of the day are running short. What kinds of encounters are going to allow you to say, “I need to do this. I’m going to do it well, even though it’s not convenient.”

In the bigger picture, in terms of career path, I think each person decides what kind of research they want to be involved in. Do you want to be involved in research at all? If the answer to that is no, then I think having an academic career is really challenging, because you have to be so self-motivated at times. The times when someone hands you that next great opportunity are so few compared to all the moments where you have to make the best of things with the resources that are available. But I think the first step with any of this is some brutal self-assessment and making sure this is what you’re passionate about.

What have you learned recently that has informed your practice? In a way, we’re always having to learn and adapt how we take care of patients—it’s a blessing to work in a field that grows and evolves so quickly. One of the biggest lessons for me in the past few months has been an appreciation for some of the nuances in the side effects our treatments can cause. As a trainee, there’s only so much of this you get to see with a given patient because you’re always bouncing around from one rotation to the next. It takes being in the same clinic week after week to really see the effect these therapies can have. It has definitely changed how I counsel patients up front, how I think about the kinds of supportive care I need to have in place, and also how I think of things like treatment duration when I’m designing a clinical trial.

Do you have any thoughts on what the future holds for hematologic oncology? It’s fascinating that we have these immune system cancers that we’re harnessing the immune system to treat. It’s one of the most incredible things we do. We’re just starting to scratch the surface of how we do that. Chimeric antigen receptor T-cell therapy is one obvious example, and another really important class is the range of emerging bispecific antibodies in lymphoma. There’s this whole spectrum of these agents, and the key will be finding what the right interventions are for the right populations at the right point in their disease course. We also need to be willing to do the trials in the populations that most resemble the patients we see in clinics—that might not fit the perfect bill on how we’ve historically set up a standard industry trial. We have work to do in making sure that future studies in our field are designed to address the unmet needs our patients are facing, and that starts with more reflective enrollment criteria.

How do you spend your time outside of work and with whom? I have two young kids, so I spend a lot of time with my wife and family. I think the pandemic has forced us to spend a lot more time with family, but that time has been such a blessing. Outside of that, I run, play music, and cook.

Do you have any hobbies? I’m not a competitive runner anymore, but I still try to get out four or five times a week. I started playing guitar in college and that has been another way to release. Trying to get out of my comfort zone with cooking has been something I have spent a lot more time on in the past few years.

What is one thing most people would find surprising to learn about you? My family is from Chile, and I learned how to ski on an active volcano (Volcán Villarica) in Chile.

Victor Orellana-Noia, MD, MSc, is an Assistant Professor in the Department of Hematology and Medical Oncology at Emory University School of Medicine.