Interview with Evan Casalino

About Evan

Evan Casalino is a second-year MD/PhD student at Yale University. He completed his undergraduate studies at Harvard University, where he worked in a bioengineering lab for all four years.

In high school in New Jersey, Evan was heavily involved in debate and many expected him to pursue law or business. However, when both of his parents passed away during high school and he spent significant time in the hospital with his sick mother, he was inspired to consider medicine as a career path.

It wasn't until college that Evan discovered the world of physician scientists. His research mentor at Harvard introduced him to the MD/PhD path and encouraged him to pursue the dual degree. Evan found his calling in research, working in Kit Parker's lab throughout his undergraduate years.

After graduation, Evan took two gap years. Evan's first opportunity to lead a scientific project from start to finish was at Bristol Myers Squibb in their neuroscience research group, focusing on Parkinson's drug discovery. He then spent a year at NYU doing health policy research, gaining valuable perspective on the healthcare system.

Today, Evan's research interests center on neuroscience, specifically brain development and the cellular and molecular biology of neurons. He's currently doing lab rotations to choose his PhD focus and is leaning toward a career in neurosurgery, hoping to split his time 50/50 between clinical practice and research.

For aspiring MD/PhD students, Evan emphasizes the importance of choosing mentors carefully, prioritizing those who will provide individualized attention over simply the most famous names. He also stresses the need to gain clinical experience to ensure genuine interest in patient care, since the MD/PhD path involves extensive clinical training alongside the research component.

My favorite quote from the interview:

Having someone that I can resonate with was crucial in terms of having confidence I can go down this path. 

Watch the video or continue reading to learn more about Trae's story.

Transcript

Chelsy Do: All thank you again for sitting down with me.

Evan Casalino: Happy to. Yeah, thanks for inviting me.

Chelsy Do: Okay, whenever you're ready, we can begin the interview.

Evan Casalino: Yeah, I'm ready.

Evan's Educational Background

Chelsy Do: So, I wanted to start talking about you and your educational background. Maybe we can begin with your educational journey, starting in high school and then undergraduate.

Evan Casalino: Yeah, so I grew up in New Jersey, pretty close to New York City. [I] went to public high school there. In high school, I did a lot of debate and reading and writing and that kind of thing.  So, a lot of my family and friends thought I was going to be a lawyer or go into business or something like that. But my parents both passed away when I was in high school. My mom got sick. So, I spent a lot of time in the hospital with her around her doctors and that's what kind of first inspired me to think about medicine as a career. And I didn't even know there was such a thing as a physician scientist at that point, but I knew I wanted to be a doctor.

So, it wasn't until I got to college–I did my undergrad at Harvard–and I started doing some research there in a bio-engineering lab, and I had a great mentor there. His name was Kit Parker, and he kind of introduced me to the idea of what a physician scientist was, and that it might be a good career path for me. It wasn't until maybe my sophomore year of college that I started to think maybe this is actually what I wanted to do. And that's when I started considering applying to MD/PhD programs, so I did that. I took a couple gap years along the way and then applied to MD/PhD programs and now I'm here in my first year at Yale and really enjoying it so far.

Influential Figures and Mentors

Chelsy Do: Yeah. Wow. During high school that must have been really tough on you. It's amazing and inspiring to see where you are right now. So when (you could either talk about your high school or childhood or college or undergrad) were there any really influential figures in your life? That could be parents, family members or mentors at school?

Evan Casalino: Thanks. Yeah, absolutely. In high school, my biology teacher, her name was Miss Vogle, and she was one of the first people to really recognize that I had the ability to do science and could maybe pursue it in higher education, and she was super encouraging. So, I definitely have a lot of gratitude for what she did for me, and she was really supportive early on in my journey.

And then in college, Kit Parker, my research mentor at Harvard, was fantastic as well. I worked in his lab for all four years of college, which is not super common. I think a lot of people bump around between different labs at some point in their education, and that's good. There's nothing wrong with that, but I had a really good relationship with him and with the people in his lab. And, he was kind of the person who said, MD is great, but I really think you could do an MD/PhD and be a physician scientist.

So, his encouragement is a huge reason why I'm here too. And then definitely in my family, of course, and then my grandparents as well. When my parents passed away, [they] kind of stepped in and have never second guessed anything that I've wanted to do in terms of my education or career and have really given me everything I needed to get here. So, still a long way to go, but have had a lot of great mentors so far and already starting to discover some new ones here at Yale.

Chelsy Do: Gotcha. You mentioned taking a couple of gap years. Can you kind of go into more detail what you did then?

Evan Casalino: Yeah, I was in college when COVID hit in March of 2020 and…so I did the rest of that semester virtually and then the following school year was going to be virtual as well. So I decided I wanted to skip that, take a gap year and then come back and finish college once I could be in person back on campus.  So, I started just cold emailing every biotech and pharmaceutical company that I could find because I had a couple years of research under my belt at that point. And so, about a week before the school year was supposed to start, I got a job offer at Bristol Myers Squibb, which is a big pharmaceutical company to work in their, neuroscience research group. And I did, a year of full-time research there on, Parkinson's, drug discovery for Parkinson's disease, which was great.

That's another mentor I should mention. Shuchi Mittal there at Bristol Myers was great and that was kind of the first time I really got to run my own scientific project from start to finish, rather than just kind of assisting on other people's projects. So that was a really great year. I wasn't sure how it would go because it was kind of an impulse decision when I took that job, but it really ended up being great. And then after I graduated, I took one more gap year and did something a bit different at NYU. I worked with a faculty member there named Lauren Taylor who was also fantastic doing health policy research. So nothing lab related, but it was a great experience. [I] got to learn a lot about the healthcare system in the US and how it works and she's another person that was just super supportive.

So two great gap years, both research related but pretty different from one another, and they were great years for personal life as well because it kind of gave me a chance to decompress from school and live as an adult in the real world before I just start the next degree program. So no regrets about that and definitely really enjoyed both of those years.

Chelsy Do: Awesome. So, what was the transition like from those gap years into, applying to MDPhD and actually starting your medical degree?

Evan Casalino: Yeah, it's different. I mean even the application process alone takes a ton of time. So, it's good to have a gap year job or activity that offers you the flexibility to do that kind of thing because there's a lot of interviewing, essay writing, all that kind of thing. And then, getting to school, I think college prepared me and my peers pretty well for med school. I think, in college, if you major in one of the biological sciences, you end up taking science classes that are more complex than what you end up learning in med school. I think science is actually pretty easy to wrap your head around, but the volume of information that you're presented with in med school is just huge. So, it's a lot more difficult in that respect because it's tough to take a day off and then catch back up the next day if you're not keeping up with studying and learning the material. 

So, I think just getting used to–they use the metaphor drinking out of a fire hose–it's important in college too to start building those study habits because I think the hardest part of the transition is just realizing that things that you would spend an hour or a week learning in a college class, you spend five minutes learning in a med school class and then it's on to the next thing and you're responsible for kind of solidifying those concepts on your own. So, I think that's been the biggest adjustment so far.

Evan's MD/PhD Journey

Chelsy Do: And why did you choose to pursue both an MD and a PhD? I know this is a basic interview question that you've probably been asked before.

Evan Casalino: No, that's okay. It's a good question because I really wasn't sure for a while.

Yeah, I think for me, I knew I wanted to be a doctor. That was super important to me. So, I never would have passed up on the MD.  But once I got to college, I realized I just really loved research. And that's not to say you can't do research with an MD. There's plenty of MDs that do great quality research and in fact people who want to do things like clinical trial research or clinical studies. There's really no reason to get a PhD. 

But the MD/PhD program is really good if you want rigorous scientific training in basic science or translational science that you do either in the lab or computationally nowadays a lot of the time. So it's really for people who want to uncover the mechanisms of disease and human health and you get a level of training I think with the dual degree that you don't necessarily get just doing the MD.

So that's kind of why I decided to go this route. And yeah, the people that you meet and the faculty members and your classmates too are all just really scientifically oriented. And I think it's great for someone who sees themselves doing a lot of basic science later in their career. So that's kind of why I chose to do it.

Chelsy Do: And could you remind me, what year are you in your MD/PhD?

Evan Casalino: Just finished my first year, so still a long way to go.

Chelsy Do: Gotcha. so, that means that you haven't started your PhD portion yet. So, you don't really know what project you're working on. Do you have any ideas of what you want to work on?

Evan Casalino: Yeah. We just finished the first year of med school and then during the summer we all do lab rotations to start to pick who we want to do our PhD.

So right now, I'm working in a lab with a faculty member named Angeliki Louvi, who studies brain development and diseases that can happen during brain development, and is trying to kind of use those diseases to unravel some of the molecular mechanisms that cause the brain to develop the way it does, both normally and abnormally.

And then next month I'm rotating in a different lab that does more basic cell biology of neurons using C. elegans, so small worms as a model organism. So both of them are super interesting to me and I'm not sure where I'll end up yet, but definitely something in the neuroscience realm kind of with a cellular and molecular biology bent to it is what I'm most interested in right now.

Chelsy Do: Gotcha. Your research interest is in neuroscience. Is that something that you want to work in on the medical side like your specialty in the future you think?

Evan Casalino: Yeah, I think so.

Right now I'm leaning towards neurosurgery, which it's tough, with the MD/PhD too, because both are such long training paths. It's seven or eight years of MD/PhD and then seven more years of residency after that. But I think there's a lot of cool science going on in the neurosurgery department here at Yale and all over the country as well. And [it’s a] super cool specialty too that you need to know your neuroanatomy really well, obviously, and there's a lot of new technology and stuff that's coming into play, especially in the world of functional neurosurgery where we can actually stimulate specific regions of the brain to correct certain diseases. 

So that's where I see myself right now. Probably something like a 50/50 split between clinical time and research time if that's possible. We'll see how it all plays out. Long way to go, but that's what I'm thinking right now.

Chelsy Do: Yeah. Awesome. Could you expand more on one of your past projects that you've worked on?

Evan Casalino: Yeah. When I was at the pharmaceutical company, we were working on ways to develop drugs for Parkinson's disease. And so one of the main proteins that gets dysfunctional in Parkinson's is called alpha-synuclein, and in the disease, all this alpha-synuclein starts to aggregate and form these plaques that are thought to be toxic to neurons and cause them to die. 

One of the strategies for addressing that is to find drugs that will reduce the amount of alpha-synuclein that the neurons in your brain produce. So the idea being less of it can aggregate and less toxicity. The way a lot of these drugs are found is just taking a bunch of drugs, maybe 50,000 - 100,000 potential molecules that could be drugs, and trying them all on a little well of cells and seeing which ones work and reducing the amount of alpha-synuclein. 

But one of the challenges with that is that alpha-synuclein lasts for a really long time once it's produced by your cells. So, it takes somewhere in the range of 24 to 48 hours for alpha-synuclein to be broken down. And usually these screens of all these molecules are confined to a 24-hour period because if you leave them there too long, the drugs themselves can become toxic to the cells and they can also start to degrade at high temperatures and things like that. So, what we wanted to do was create a screening method against alpha-synuclein that could be done in a shorter period of time.

So we created basically a destabilized version of alpha-synuclein that degrades in about 30 minutes rather than 48 hours. And so you can pick up drugs that are acting on the translational pathways of alpha-synuclein. We validated that screen and did a small experiment with 3,000 potential drugs and were able to publish those results. So that was kind of the first project that I really led. Of course with a lot of help from my mentor there, Shui and that was really rewarding. [I] then went back to Harvard and did my senior thesis project after that.

Chelsy Do: That sounds so cool. Can you talk a little bit more about that you just finished your first year in your MD/PhD. what are you looking forward to in starting your PhD years soon?

Evan Casalino: I love medical school this year. It's been great. They start us really early in the hospital, seeing real patients and talking to real patients and definitely excited for that. But I think what the PhD gives you is a lot more opportunity to really dig deep into the scientific mechanisms behind things and to think critically about science. I think in med school, a lot of it is just, here's all the information we know about this particular disease. Now you have to memorize it and learn it inside and out.

But there's not quite as much of the fundamental mechanisms that govern these diseases. And so, with the PhD, you have a lot more time to not only investigate those experimentally but even just to read papers and to discuss with other scientists and to really think deeply about those concepts. So even already just having started my summer rotations, I've gotten a lot more of that and definitely looking forward to that as the PhD starts up next summer. Yeah.

Advice for Aspiring MD/PhDs

Chelsy Do: All right. So, we can move on to the concluding advice portion of this. Looking back, what do you wish you had known earlier that maybe could have made your journey smoother?

Evan Casalino: That's a good question. I would say, it's super important to get good at reading and evaluating other people's science. I think that's one of the best skills to learn as an undergrad…You can find a journal club or something like that to go to, where you can really go figure by figure and figure out what are the shortcomings of a particular experiment [and] what are the implications for future experiments. 

Flexing those muscles as much as you can before you start your PhD is going to be super helpful and will make it go much more smoothly because you're going to eventually have to design your own project and troubleshoot all kinds of experiments that don't go the way you want them to–sometimes for months or a year at a time–and it will make the process you'll be a lot more successful…if you are able to look at what other people have done and figure out what that means in relation to your project, then in the larger scope of whatever disease you're studying or area of research you're in.

So, it's easy to focus on your college classes and study for your exams and all of that is super important, don't get me wrong, but any time you can set aside to start thinking about becoming a scientist is, I think, going to be really valuable later on.

Chelsy Do: And do you have any advice, let's start with kids in high school, who are wanting to go either into a STEM path or maybe even MD/PhD?

Evan Casalino: Yeah, I think I would say keep an open mind about what it is that you're interested in. 

I think a lot of people either in high school or college pick an area that they are interested in and then they feel like they have to stick with that area in terms of the extracurriculars that they do or the research that they do. And I think that, whatever you end up doing in high school is going to be different than what you end up studying in the lab in college. And then whatever you do in college is probably going to be different than what you do your PhD in. And even once you do your most faculty members end up studying things that are very different from whatever they did their PhD dissertation about.

So I'd say what's much more important is learning how to think about science, [generating] creative scientific ideas and [designing] experiments much more so than learning all the specific ins and outs of a particular field because there's always time for that later on. So I'd say just keep an open mind and see and experience as many areas of the field as you can, and then be honest with yourself about if that's what you really want. By the time you get to your junior year of college, you either think one of the degrees is better suited for you than the other or you want to change fields entirely, it's important to be honest with yourself because it's a really long training path and you don't want to get stuck doing something that you really don't want to do later on.

But, if you do all those things and you decide that that's what you want to do, it's I think a super rewarding career path and we definitely need people to do it and I think it's great for anyone who decides to go for it.

Chelsy Do: Awesome. I know you said that you were involved in debate in high school and then what you ended up doing in college definitely didn't match that, but a big part of my blog is, I'm really interested in singing and I love to sing. I'm in chorus and I hope to continue doing that alongside, just studying biology in college and stuff and research. And so I was wondering if you had anything similar like another passion or something else that wasn't related to research that you maybe felt kind of passionate about or helped you in your own applications to your MD/PhD?

Evan Casalino: Yeah. To be honest, I kind of stopped doing a lot of the things that I was doing in high school by the time I got to college level debate. It’s super competitive and I just didn't feel like I had the time to do any of that. So most of my quote unquote extracurricular experiences in college were more pre-med or science oriented, but definitely always made time for things outside of that that I enjoyed as well. 

So I've done a lot of travel. That's something that I really enjoy. So, finding a few weeks a year to do that is, I think, really important for me. And then, sports are something that I love, too. I never played a division one sport or anything competitive, but finding time to play intramurals or pickup basketball or things like that is something I always really enjoyed. 

And yeah, I think for you, to stick with the singing, that's fantastic. And most colleges have lots of opportunities to do stuff like that in an official capacity as well if that's something you're interested in. And med schools and these kinds of programs want to see people that are well-rounded, too. So I think definitely keep that up if that's something you enjoy. 

Chelsy Do: All right. Last thing, [do] you have overarching advice for anyone watching this that might be interested in an MD/PhD?

Evan Casalino: Yeah, I think one of the most important decisions you can make, especially as an undergrad who's getting ready for one of these programs when you get to college, is who you're going to work with, who your mentor is going to be (and there can be several of them).

But people, I guess, tend to sometimes gravitate towards whoever is the most famous or well-known faculty member. And sometimes it works out, but sometimes that's not the best choice because these people are often super busy and they're on a bunch of different committees and all these things that compete for their time and you may not get as much individualized attention. 

So, I'd say even if it's a field that maybe isn't your particular interest at a given time, if you meet a mentor who you really think you get along with or if there's a graduate student who works in the lab that really takes you under their wing, stick with that because that's going to be a much more valuable experience in developing you as a scientist.

And then I think the other thing is a lot of people who apply to MD/PhD programs are very science oriented and maybe sometimes don't get as much clinical experience shadowing or volunteering in high school and in college. So, do that too, and make sure clinical medicine is really something you're interested in.  Otherwise, there are careers where you can just do research, but you're going to put in four extra years of medical school, and the last two or three of those years are going to be full-time in the hospital and then you have residency after that. So, you're going to be spending a lot of time clinically with patients and, I think it's really important to get a sense of whether that's something that you genuinely enjoy, talking to these people sometimes when they're having some of the worst days of their lives.

So it takes a particular type of personality to want to do that. And I think it's important to flesh out that before you just commit to doing the MD/PhD program because it sounds like a great idea. I guess those would be my two pieces of advice. But, there are probably plenty of others too that you and whoever's watching will discover on your own throughout the coming years. And it really is a really rewarding path and you get to really be on the ground floor of all this knowledge that's changing every day and really having an impact on people's real lives and health outcomes. 

So yeah, congratulations for getting on the path yourself and best of luck to you going forward.

Chelsy Do: Thank you so much Evan, again, for your time. I know you have a conference or something to go after this.

Evan Casalino: Yeah. No, I'm happy to do it. And good luck with your blog and with everything else.

Chelsy Do: Thank you. It was a pleasure talking to you.

Evan Casalino: Yeah, you too. Bye, Chelsy.