In terms of your educational and professional development, to what extent have you been affected by international relationships?

I have always believed that travel broadens the mind at all stages of life, but especially during education. For me, that probably began early in childhood because my mother, who grew up in one of the poorest parts of Lisburn, left Ireland when she was 16. She eventually joined the The Women’s Auxiliary Air Force (WAAF) and met my father who was in the Royal Air Force (RAF). After the war, he went on to fly with the British Overseas Airways Corporation (BOAC) which went on to become British Airways. This gave us the opportunity to travel internationally as a family; we even went to live in Japan for six months when I was 12. 

When I went to university in Oxford, I continued to love travelling and worked as a travel guide in Europe during several summer vacations. I had nine months off between finishing my undergraduate degree and going to medical school and spent most of that working as a travel guide for a British tour company in Eastern Europe and Russia.  This was very challenging and gave me all kinds of diplomatic and negotiation skills –  it is always essential to get a win-win. 

Throughout my time at Mayo Clinic, I have continued to build on these international networks. My career has been built as a clinician-scientist in the neuroregenerative medicine space. I spent almost a year on sabbatical at NUI Galway in 2005 working with Tim O’Brien and the folks in REMEDI. We continue to have productive collaborations and host exchange students at the medical school – PhD and postdoctoral levels. I believe we have more than 30 collaborative research publications that have come from this relationship. During the sabbatical, we had a very nice apartment in Galway that has continued to form a base when we come there – which pre-COVID was at least three or four times a year. The scientific collaborations continue, but we also have many friends that we often meet in Sheridan’s or around town at the weekend.

We have also built collaborative networks in Europe and Austria in association with Paracelsus Medical University (PMU) and in Puerto Rico with the University of Puerto Rico School of Medicine. Both of these collaborations are in the medical education space and allow us to improve the research education of medical students, even if they are not going to become researchers. 

In my final year of medical school at Oxford, I spent my two months ‘away elective’ at the Mayo Clinic in the neurology and neurosurgery departments, and created a lot of networks. Four years later, when I was looking at fellowship training, I remembered what an incredible educational experience I had in Rochester Minnesota. I applied for a very competitive fellowship, and I think because of the contacts I had made as a student, I was accepted. That was for two years initially, but life happens, and I am still here 40 years later.

At the moment, we have 13 third year medical students from PMU completing four-month research trimesters at Mayo. I always believe that we learn as much from the students as they learn from us. During the summer break, we have 10 to 12 second year medical students from the University of Puerto Rico carrying out 10-week research projects. All our visiting students bring the richness of their culture to the Mayo Clinic. 

Can you tell us about The Mayo Clinic Centre for Regenerative Medicine and NUI Galway collaborations in clinical trials using regenerative therapies?

The Mayo Clinic Centre for Regenerative Medicine and NUI Galway have had a number of collaborations over the years and in many different areas. In my areas of spinal cord injury, peripheral nerve injury and stem-cell treatment for Motor Neuron Disease, they have mostly focused on pre-clinical studies in tissue engineering and stem-cells; I think we have continued to learn from each other practically. It was after the sabbatical at NUI Galway that I began to socialise with Mayo investigators the concept of the importance of developing a centre for regenerative medicine at Mayo Clinic. 

I have been involved in the leadership of that centre since its inception 10 years ago as the director for discovery and throughout that time, it has grown exponentially. I know that when Professor O’Brien was designing the cell manufacturing and cell therapy facilities at NUI Galway, they were closely modeled on Mayo. We continue to collaborate very actively in this neuro regenerative space, especially now with Professor Pandit in CURAM.

At the more practical clinical training level, Professor O’Brien has exchange programs with our internal medicine program for young doctors to do part of the training at Mayo, which have always been very productive for the trainees. Most of them come back to Ireland, and even if they stay at Mayo on the faculty for a number of years, they usually return to NUI Galway as did Professors Dineen, Matt Griffin, and O’Brien. 

In terms of internationalisation, why are global partnerships important?

The world is becoming ever smaller and we share our medical problems, as we have just seen in the pandemic. It is also becoming more complex and there are multiple different ways to deliver medical care and perform biomedical research. It makes no sense to reduplicate systems or expertise, particularly in highly specialised areas. One of the most important things we continue to learn is that we can learn together and collaborate – this dramatically speeds up the medical research process. We can learn from our partners in business that globalisation is critical to building and strengthening enterprise. In many ways, Ireland leads the way in this type of business globalisation. The hub of biomedical business development in the West of Ireland makes Galway a very strong potential partner in commercialising and translating research into clinical use and health benefits. 

During the early years of the Mayo Clinic in the late 19th and early 20th Centuries, the founders strongly believed in the value of international travel and cooperation. Every year, they took a party of around 20 of their senior physicians and scientists to medical centres in Europe to learn about the best medical techniques that they could bring back and apply in their clinical practices.

What are your thoughts on the idea of educating young people, who then leave to pursue opportunities abroad?  

As I mentioned, when they leave, they may stay away for a while and then return. Or if they stay abroad, especially in the academic environment, they tend to form strong collaborations with investigators or clinicians in their home country. It is always a concern that a ‘brain drain’ will occur from the poorest countries. It has been my experience, however, that almost all of these émigrés continue to serve the people in their home country – either from a medical care or medical education perspective. 

Do you think international relationships are important, not just on the basis of opportunity, but also to serve human needs and human development?

This is a great question. Rich countries could simply close their doors and keep everyone out. Poor countries could similarly restrict their medical learners from leaving the country. It does not take us long to understand that this would be a loss for both poor and rich countries. The diffusion of knowledge and talent through international collaboration is always a net gain for both sides.