Q&A: Past, Present, and Future with Dr. Bernard P. Chang
Bernard P. Chang, MD, PhD, is an emergency physician and Associate Dean of Faculty Health and Research Career Development at Columbia's Vagelos College of Physicians and Surgeons, where he holds the Tushar Shah and Sarah Zion Endowed Associate Professorship in Emergency Medicine. He also serves as Vice Chair of Research in Emergency Medicine and as an Associate Director of the Irving Institute and its TRANSFORM program.
Q:1 How did you first get involved in research? What sparked your interest?
I came to research through a fairly non-traditional path. In college, I studied both psychology and art history. I was fascinated by creativity - by artists and musicians, and by the line between creativity and mental health. That was really my first interest in understanding the “why,” and the connection between the mind and the body. It got me excited enough to go on to graduate school, where I earned my PhD in psychology. That was where I first learned what research really is: how to ask questions and design studies. As a research psychologist, I loved trying to understand the brain, behavior, and emotion.
In my last year of graduate school, I was working with patients living with schizophrenia and other severe mental illness. I watched the psychiatrists, neurologists, and internal medicine doctors caring for those patients at the bedside, and it struck me that as much as I loved asking “why,” it was incredibly impactful to see clinicians actually do something to help patients directly. That inspired me, after finishing my PhD, to go back to school for my medical degree - with the hope of bridging my interest in research with my interest in being at the bedside with patients.
2. Can you describe your current research - its primary focus, objectives, and the key questions it seeks to address?
A lot of my work sits at the intersection of emergency medicine and psychology. I’m an emergency physician, and with my background as a research psychologist, much of my research focuses on neuropsychiatric conditions. On one side, I study stroke “brain attacks” - and treatments for stroke in the emergency setting. On the other, I look at the psychological factors at play in acute and hospital care. Many stroke survivors, for instance, go through a profoundly stressful experience, and some develop post-traumatic stress disorder following their stroke or other medical events. I study that PTSD, along with health anxiety, and the way the hospital environment itself - crowding, long hospitalizations, disrupted sleep-wake cycles - affects psychological stress and healing.
More recently, I’ve extended this work from patients to clinicians. Doctors and nurses are exposed to many of the same stressful conditions as patients, but for years on end - it’s their job. So, I’ve become fascinated by clinician well-being, burnout, and moral injury, and especially by how those things relate to clinicians’ cardiovascular health and biological aging. Much of my NIH funding supports cohorts of nurses and doctors, where we follow not just their psychological and professional trajectories but also their long-term cardiovascular health, compared with similarly educated professionals in other fields.
The bigger objective is to build a national database - a national center of excellence for optimizing and supporting the healthcare workforce - that can inform best practices for career longevity, professional satisfaction, and productivity across the field.
3. How did you first become involved with the Irving Institute for Clinical and Translational Research?
The Irving Institute has been my academic home since I arrived at Columbia in 2012. What I thought would be a short first faculty role became nearly 15 years in a place that truly felt like home.
My first introduction came through one of my early grants - a study on managing severe versus mild stroke in the emergency department. My mentor, the neurologist Mitch Elkind, had done work with the Irving Institute and introduced me to several faculty, including Harold Pincus, who became an early mentor in emergency care and mental health emergencies. Through them I met Daichi Shimbo, whose work on hypertension and stress was part of the Center for Behavioral Cardiovascular Health. That group -Harold, Daichi, and Mitch - became my first circle of mentors. They were enormously supportive when I received my first K award, through the Irving Institute’s KL2 Mentored Career Development Award program. As a KL2 scholar I went through the Columbia Summer Research Institute (CSRI) and did my training within the Irving Institute, and the preliminary pilot data from that K award allowed me to transition directly to independence with my first R01.
4. In what ways has your engagement with the Irving Institute influenced or advanced your research and career trajectory?
The Irving Institute genuinely helped me get off the ground. It supported my earliest work, connected me to the mentors and collaborators who shaped my career, and gave me the resources to move from a K award to independent funding.
What’s been especially meaningful is the full-circle nature of it. I eventually became faculty director of CSRI, and now I’m stepping into a leadership role with TRANSFORM. I’ve gone from student and mentee, to investigator, to mentor - moving to the other side of the Irving Institute. Having benefited so much from its resources, I feel a real love and appreciation for the place, and I want to help pay that forward: to highlight the Institute’s strengths, build on them, and make it the premier CTSA hub for aspiring scholars and faculty in translational science.
With TRANSFORM, I’m fortunate to inherit a phenomenal foundation built by its leaders. Where I’d most like to build on it is by widening the umbrella. TRANSFORM has been a tremendous resource for PIs - the K and T scholars, the PhDs and MDs - and I want to extend that footprint to the allied research professionals who are essential to high-impact science: research administrators and coordinators, community health workers, and data scientists. Creating more programs and resources to support their professional development is a major emphasis for me.
5. What aspect of your research or career are you most proud of?
What I’m most proud of is helping to bridge a divide. For a long time there’s been a kind of barrier between the people who advocate for clinician well-being and the scientists who focus on hard metrics, hard outcomes, and hard data. Over the last several years I’ve tried to bring those worlds together - to establish clinician health as a rigorous science: something genuinely worthy of study, that can be carefully questioned and analyzed, and that can deliver outcomes meaningful for science, for healthcare, and for clinicians themselves. Being able to contribute to that conversation and help elevate the science of clinician well-being into a more rigorous discipline, both here at Columbia and nationally, is what I’m proudest of.
Ultimately, the aspiration is for this science to inform policymakers, deans, and institutional leaders, giving them data-guided ways to support the workforce. If the research leads to policy and practice changes that genuinely improve the healthcare workforce - and, in turn, how healthcare is delivered - that would be the biggest impact I could hope for. Much of this is anchored in concrete work at Columbia, including two NIH R01 studies on clinician health (5R01HL157341-05 and 5R01HL146911-04), one is among the largest longitudinal cohorts of clinicians in the country.
6. What advice or perspective would you offer to early-career researchers?
First, the journey is rarely linear. There will be challenges and roadblocks, but you are not alone. Research is team science, which means you’re supported by your mentors and by the resources behind you at the Irving Institute. I’ve been on the receiving end of rejection many times - for grants, programs, and promotions - so I understand how hard the environment can be. But I’ve also been fortunate to have wonderful mentors and resources who helped me get back up, and that same support is there for today’s scholars.
Second, don’t neglect your personal development and growth. As exciting as science and research are, you have to balance them with care for your family, your friends, your significant other, and yourself. A successful scientist has to also feel personally fulfilled.