New Chapter

Doug Simonetto, M.D. (I1 ’10, I ’12, GI ’15, HEPT ’16, CTSA ’24), became intrigued with research being conducted at Mayo Clinic when he was a medical student in Brazil. He did an away rotation at Mayo in 2007 and says he was blown away by the people, culture, patients and resources. He didn’t want to train anywhere else and says he’s grateful Mayo Clinic gave him an opportunity. Mayo’s investment seems to have paid off. During internal medicine residency, Dr. Simonetto received two ACE (Attitude, Commitment and Excellent) Awards from his peers and the Emerging Liver Scholar Award from the American Association for the Study of Liver Diseases (AASLD). During his fellowships in gastroenterology and hepatology and transplant hepatology, he received two travel awards, the AASLD Resident/Fellow Ambassador award and Advanced/Transplant Hepatology Fellowship Award, the Golden Plunger Award from his division peers and the Eugenie Bolz Award for excellence in patient care. Now he is program director for Mayo Clinic’s Gastroenterology and Hepatology Fellowship and an active researcher in the areas of portal hypertension and alcohol-associated cirrhosis. We have a feeling he’s just getting started.

“I applied for an away rotation. I came to Rochester for a month in November 2007. It was a fantastic experience. I was blown away by the faculty, people, culture, patient care and resources. Having fallen in love with Mayo Clinic, I returned home to Brazil, graduated from medical school and applied for internal medicine residency. There’s nowhere besides Mayo that I wanted to go to.”

Where are you from?

I grew up in Caxias do Sul, a small town in the mountains of Brazil. I later moved to Porto Alegre, the state capital, to attend medical school.

What led you to a career in medicine?

I have no physicians in my family, and my first contact with one was through my mom’s primary care physician, who also cared for my sister and me. He was a compassionate physician with an extremely busy practice who always took his time to listen to his patients. I have also always been intrigued by science and research, and so I thought medicine would give me the best of both worlds — providing care for others and engaging in medical research.

Why did you choose gastroenterology and hepatology to specialize in?

During the second year of medical school, I did a rotation in gastroenterology and hepatology. My first inpatient rotation was the liver ward, which was always overflowing with extremely sick patients admitted with complications of decompensated cirrhosis. I became intrigued by the pathophysiology of liver disease and cirrhosis and the prospect of liver transplant. I saw how transformative transplant was. I shared with one of my professors at the time that I was interested in research, and he became my clinical research mentor. His wife happened to be a renowned basic scientist who ran a research laboratory on cirrhosis, so I also joined her lab as a research trainee on my spare time.

What led you to Mayo Clinic?

My school offered away elective rotations in our last year of medical training. Through my research, I had learned about Mayo Clinic and its amazing faculty and research productivity. I applied for an away rotation. I came to Rochester for a month in November 2007. It was a fantastic experience. I was blown away by the faculty, people, culture, patient care and resources. Having fallen in love with Mayo Clinic, I returned home to Brazil, graduated from medical school and applied for internal medicine residency. There’s nowhere besides Mayo that I wanted to go to. I knew it would be a challenge, coming from a medical school outside of the U.S. Fortunately, Mayo Clinic is open to people from different backgrounds and provides opportunities for trainees who show promise. I’d like to think that they saw potential in me during my away rotation and that I could be part of Mayo’s system of care.

Who are your mentors at Mayo Clinic?

Vijay Shah, M.D. (GI ’98), chair, Department of Medicine, and Patrick Kamath, M.D. (GI ’92). Both do research in areas I was interested in during medical school — portal hypertension and complications of cirrhosis. I’d read about their exciting work, which is one of the reasons I wanted to do an away rotation at Mayo Clinic.

Dr. Shah has a basic science lab in portal hypertension. Dr. Kamath does clinical research. In 2002, he developed the MELD score used around the world for liver graft allocation. The MELD score research came out when I was in medical school. When we implemented it, I was able to appreciate how impactful and more fair it was compared to the previous model.

When I arrived at Mayo for my rotation, I met a resident who worked with Dr. Shah and asked him if we could talk over coffee. He told me, “People are very friendly here,” and introduced me to Dr. Shah. I was in awe of the resources in the lab and how approachable everyone was. I expressed to Dr. Shah that I very much wanted to come to Mayo Clinic for residency and would love the opportunity to work with him. He told me to come see him if I matched at Mayo and said he’d gladly mentor me. I notified him the moment I matched. I arrived in Rochester on June 23, and he’s been my mentor ever since.

What important lesson have you learned at Mayo Clinic?

It sounds like a cliché, but the needs of the patient come first. Everything we do at Mayo Clinic is about the patients, including our research. We don’t make new discoveries solely to get published or get promoted. Rather, we do it in the hope of translating our findings to improve patient care.

What advice do you have for trainees?

Take advantage of all the amazing resources, opportunities, and people who are approachable and willing to mentor you. Training at Mayo Clinic is a unique experience, different from anywhere else. The Mayo Model of Care informs the culture and mindset of everyone here.

You’re program director of the Gastroenterology and Hepatology Fellowship. Tell us about that.

My focus had always been on patient care and research. However, I always enjoyed teaching and working with residents and fellows. When the division was searching for an associate program director a few years ago, some fellows approached me and suggested I apply. They said they’d support me. Simultaneously, a colleague in the division also suggested I consider the position. So I did and was successful. I was associate director to Laura Raffals, M.D. (GI ’11), for a couple of years and took over as program director in January. It’s great working with the fellows and brings me much joy. I learn so much from them.

Tell us about your work.

My areas of clinical and research interest are complications of portal hypertension and alcohol-associated liver disease. I’m developing a niche in the application of artificial intelligence (AI) to predict and monitor complications of cirrhosis. To help me gain knowledge and expertise in this growing field, I am enrolled in a master’s program with a concentration in AI. I have been fortunate to secure internal and external funding to pursue my research interests, thanks to my fantastic mentors.

What’s your career goal?

I want to continue to grow in what I’m doing and be successful as program director. I want to grow the reputation of the fellowship and innovate in how we train the next generation of gastroenterologists and hepatologists. I also want to continue to do innovative and impactful research that will translate into better treatments and patient care.

How do you maintain work-life balance?

That’s an important topic. The more hats we wear, the more difficult balance is. I make sure to have time to do things I enjoy — being outdoors, and spending time with friends and family. I enjoy long-distance running races, including trails and ultra-marathons. It’s a way to decompress. I get ideas and come up with solutions to problems when I’m running — in a way I can’t do while sitting at a desk. I also practice mindfulness on a regular basis, which helps me focus when I need to

What do you do when you’re not working?

My husband, who is a scientist at Mayo Clinic, and I got married in St. Paul, Minnesota, in June of this year. We were supposed to get married in 2020 but postponed it due to the pandemic.

We met at a liver conference where we were both presenting our work. He lived in San Diego, so we did long distance for two years. He moved to Rochester a couple of years ago. When it’s possible, we enjoy traveling, skiing, rock climbing and running together.

When I was training at Mayo, I didn’t share much of my personal life with colleagues and staff. I worried how it would be accepted, which I regret in some ways. I gradually let people know by bringing my husband to division events and introducing him as my partner. People have been nothing but extremely supportive.

See past New Chapter stories here.