“I continue to have new ideas that excite me:” Experience as a senior academic leader and entrepreneur in STEMM

A Professor of Ophthalmology with decades of leadership experience in academia co-founded a Biotech start-up. She shares her career story, offering advice on leadership training, persevering, and finding the right career path.
By M. Elizabeth Fini with Patricia A. Maurice and Janet G. Hering
6 August 2024, DOI: 10.5281/zenodo.12744343

M. Elizabeth “Betty” Fini [1], Professor of Ophthalmology at Tufts University School of Medicine (Boston, MA, USA), is a molecular biologist with more than 3 decades of leadership experience as a scientist, professor, mentor, and administrator.  About a decade ago, she co-founded Proteris Biotech, a start-up that is developing a biologic eye drop for the treatment of dry eye [2]. Here, she shares her career story which attests, once again, to the joys of being a senior academic leader in STEMM [3].

Like most senior women leaders in STEMM, you have 'worn many hats’. What has been your most enjoyable role, to date?

When I joined Tufts University in 1995, I moved my lab across town from the Massachusetts General Hospital (a teaching hospital of Harvard Medical School), bringing a number of trainees and staff.  I formed several new and interesting research collaborations, one of which resulted in a high-profile publication and a scientific prize. Our grant funds were plentiful, so I was able to support faculty appointments financially, launching several of my lab’s trainees into successful academic careers.  

I left Tufts in 2002 to serve as Director of the Evelyn F and William L McKnight Vision Research Center at the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine. This was my most enjoyable role in leadership. I was hired to rebuild a laboratory research program that had been slowly fading away following the retirement of the founding director. I was the hands-on implementer, as our recruitments were all at junior rank. We added many new faculty members and obtained NIH and Department of Defense center grants. During this period, Bascom Palmer rose to number one in US News and World Report.

People who choose a career in science do so because they love science. But two of the unexpected perks of academic STEMM are forming collegial friendships and traveling around the world. Around this time, I traveled to Europe, Asia, Australia, and South America to deliver research presentations at conferences and as an invited guest at academic institutions.

Which of your career accomplishments have you been most proud of?

As a leader, I am proud of my efforts to grow the research enterprise. But I am most proud of my record supporting career development for younger scientists. Many of my mentees are successful academics, in some cases surpassing me. Several are now academic leaders. 

As a scientist, I am most proud of my multidisciplinary collaborations that have enabled me to stretch myself intellectually. This would include our team’s prize-winning glaucoma project, which led to other similarly interesting and challenging projects. Currently, I am wrapping up a project that has identified genomic variants associated with development of ocular hypertension (and subsequent glaucoma) following treatment with steroids in the eye. These variants are linked to specific genes and thus allow us to generate hypotheses for a potential mechanism and help to screen out patients who will respond poorly to the drug. I now have a treasure trove of new information to mine for years to come! 

What are the biggest challenges you have faced in your career? 

The hardest thing I ever did was to establish the Tufts Center for Vision Research during my first period at Tufts. This required assembly of faculty members from across multiple entities affiliated with the University. Several were men, more senior to me, who felt they should have been given the leadership position. Ultimately however, we pulled together and successfully obtained an NIH core center grant to support the Center.  

My position as research dean at Keck Medicine at the University of Southern California (USC), which I began in 2008, was also challenging. During this transformative period, the medical school acquired its hospital, renewed its $125 million Keck gift, and substantially expanded its faculty, research programs and built space. My new role, with a charge from the university to implement new initiatives, was high pressure and – unlike my position in Miami – it was not fun. But it was very interesting. My office was a revolving door, with a new person to meet and a new problem to solve every half hour. I am very glad I did it, but it was also a relief to return to the laboratory full-time. 

I am grateful that I never had to face tenure stresses. Harvard and Tufts medical school clinical departments are based in the teaching hospitals rather than in the Universities, and no tenure is possible. When I moved to the University of Miami I was appointed as a full professor with tenure. I did go through a full committee review, but by that time I was established, and it was not the nail-biting situation experienced by a junior faculty member.

What have you learned from serving as a Co-Founder and Chief Scientific Officer of Proteris Biotech?

When I stepped down from senior administration, I set out to reinvent my research program, with the goal to do something new and different. An opportunity arose when USC sought a patent on a discovery from my lab. Proteris Biotech was envisioned as a vehicle to translate this and other inventions from my lab for further development in the public sector. Maintaining a small size and flexible process, the company will develop new technologies through the proof-of-principle stage and first-in-human clinical trial. Our immediate objective is the development and commercialization of the natural tear protein, clusterin, as a biologic to treat dry eye disease. The formulated drug product, which we are calling ProtearinTM, will be self-administered by the patient as eye drops. If ProtearinTM is as effective in humans as in mice, the company will be well positioned to attract investors for out-licensing.

I was fortunate to have a highly suitable co-founder in my husband, who has a complementary background to my own in biomedical research management. He agreed to serve as CEO, at least initially. Neither of us knew the first thing about setting up a company, but USC’s technology transfer office provided advice, as well as introductions to consultants. Given our seniority in our respective fields, we also had large collegial networks that we were able to tap for a scientific & medical advisory board and a large array of consultants.

Since we both had experience obtaining and managing grants from the National Institutes of Health (NIH), it was natural to organize our company around NIH small business funding. The program officers have been very accessible and helpful, and we learned a lot from talking with them. Using the R41 Small Business Technology Transfer (STTR) mechanism, we developed a process for manufacturing our protein via recombinant DNA technology and obtained additional data on its efficacy in the treatment of dry eye disease in mice. Now we have to convince the peer review committee to recommend our R44 application so that we can get enough money to make and test the drug for human use under the highly regulated (and expensive) processes required by the FDA. All three reviewers have to rank the proposal highly, and so far, we have not been able to convince the third reviewer. But we continue to persevere.

What do you wish you had known before founding a Biotech start-up?

I don’t think anything has surprised me, but I have a greater personal appreciation of my prior knowledge. I knew this would not be easy and I was right!

Despite significant efforts to improve each aspect of the drug development process, the success rate of drug development remains at 10%–15%. For dry eye drugs, the success rate has been far lower, due to various complexities. That said, Proteris Biotech now has efficacy results from three different mouse models. By designing our human clinical trial to target one specific form of dry eye, we may be able to overcome some of the difficulties experienced by other companies.

As a basic biomedical scientist, I have been comfortable planning and overseeing the early stages of development, as we learned to manufacture our protein and worked to establish efficacy in animals. However, preclinical drug development is a new area for me that’s different from investigative science, more about regulations to ensure safety. Fortunately, I’ve found some superb consultants who are guiding us into this next stage.

We’ve become increasingly aware that we can’t rely entirely on NIH funding; the process for review and award is too slow, and in the end, it’s not enough money. We are adding some new governing board members who will assist with fund raising from investors.

Did you engage in any leadership training and if so, what did you find most helpful?

I have participated in several formal academic leadership training opportunities [4].

When I was developing the Tufts Center for Vision Research, my institution paid my way to the Professional Development Seminar for Senior Women in Medicine, held annually by the American Association of Medical Colleges [5]. This three-day seminar provides women faculty with the knowledge and skills necessary to support their continued progress along the path to leadership.

The University of Miami offered to support my application to the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program for Women [6], a year-long part-time fellowship for women faculty members in schools of medicine, dentistry, public health and pharmacy. The program is dedicated to developing the professional and personal skills required to lead and manage in today's complex health care environment, with special attention to the unique challenges facing women.  Unfortunately, I had to withdraw my application when I accepted a position at USC.

Not long after I assumed the position of research dean at USC, I attended the American Association of Medical Colleges, Executive Development Seminar for Associate Deans/Department Chairs [7]. This five-day course was designed to equip new academic leaders with the skills needed to support their institutions' mission and goals.

A short time later, my dean sent me to the week-long course “Finance and Accounting for the Non-Financial Manager” [8], at the Wharton School of Business, University of Pennsylvania.

The programs provided valuable knowledge and experience, and my institutions happily paid my way. Surprisingly, there was little or no competition for participation. I encourage those interested in academic leadership to contact your dean and/or provost about under-utilized opportunities such as these. The courses provide context and structure to personal experiences which, along with personal relationships, are key to progressing in any field.  

If you want to advance in academic leadership, I recommend that you search out and develop a relationship with an individual whom you can help, and who will, in return, provide mentorship to promote your career. The reciprocity is key.

Do you have advice for women in STEMM considering potential future career paths?  

I love being an academic scientist. I love being able to determine my research direction and having trainees at all levels working with me in the lab. But a lot has changed since I first began.  

One big change concerns funding. At medical schools, it is expected that a basic science faculty member will bring in NIH grants to support a portion of their salary. In clinical departments, the required percentage can be as high as 95%. Medical schools are dependent on the indirect costs that NIH grants bring to support the research enterprise; in the US, foundation grants do not allow these indirect costs.  

During my early career, it was typical for a faculty member to stably maintain two NIH project grants, renewing them every five years. A faculty member and her medical school could usually rely on this stable support. This has dramatically changed; success in NIH funding is now much more of a ‘crap shoot’. Perseverance pays, but it can be frustrating and discouraging.  

Another change is the regulatory burden on a faculty member conducting biomedical research. I spend a great deal more time now writing protocols for regulatory committee approval and taking courses on training updates. Tufts provides a lot of support for faculty members, but it is still a significant burden.  

I often wonder if I would enjoy academia if I were beginning my career today. There are many different career paths for women in STEMM besides academics.  Friends who have gone into the pharmaceutical industry tell me they enjoy the collegiality of teamwork that may come more naturally. Several of my prior students now enjoy scientific writing careers. It is worth looking into a variety of options before committing.

What are some of your plans or goals? 

Although I’m now past retirement age, I continue to have new ideas that excite me. I see no reason to stop working as long as I can continue to secure funding.

In my academic lab, I plan to follow-up on some of the genes identified in my ocular hypertension screen with the goal of understanding the glaucoma disease process better, as well as how to prevent it. I am also investigating efficacy of a novel small molecule that appears to protect the cornea against toxic chemical exposure with NIH grant funding from the federal Countermeasures Against Chemical Threats (CounterACT) Program. This is a strategy to advance the nation's medical and public health preparedness for, response to, and recovery from disasters and emergencies involving chemical and biological threats.

In my biotech company, I hope to advance Protearin to a clinical trial in the next few years. I am also working with another biotech company to advance a novel small molecule for both dry eye and the treatment of viral infection.  

Conclusions and questions for further thought:

We thank Prof. Fini for demonstrating, once again, how fortunate we women leaders are to be able to pursue our STEMM passions while benefiting society and the world at large. Here are some questions for our readers:

·       If you are a senior woman leader, how has the funding environment changed in your discipline over the course of your career and how might that affect a junior or mid-career woman today?

·       If you are a senior woman in STEMM, are you still excited about research?  How does this affect your retirement plans?

·       As a senior woman leader, what are you doing to help more junior women obtain leadership training?

References and notes

[1] https://gsbs.tufts.edu/faculty-research/m-elizabeth-fini-lab

[2] https://www.proterisbiotech.com/

[3] https://www.epistimi.org/blog/the-joys-of-being-a-senior-woman-leader

[4] Note: these links are active as of July 2024 but programs and options may change over time. Inclusion of courses does not constitute endorsement by EPISTIMI.

[5] https://www.aamc.org/career-development/leadership-development/midwims

[6] https://drexel.edu/medicine/academics/womens-health-and-leadership/elam/about-elam/

[7] https://www.aamc.org/career-development/leadership-development/organization-leadership-program

[8] https://executiveeducation.wharton.upenn.edu/for-individuals/all-programs/finance-and-accounting-for-the-non-financial-manager/