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Axel Tullberg while giving a lecture.
Axel Stenmark Tullberg received the PhD Thesis of the Year award in 2022 at the Institute of Clinical Sciences. He has now traveled to California to engage in clinical work and research at Stanford.
Photo: Jakob Lundberg
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Axel Stenmark Tullberg received PhD Thesis of the Year award: ”The toughest part was switching off in the evening”

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Out of 39 dissertations, one was selected.
Axel Stenmark Tullberg shares his joy over receiving the PhD Thesis of the Year award at the Institute of Clinical Sciences. He talks about how his doctoral project consumed a significant part of his life. And the mixed feelings of nervousness and excitement as he prepares for his next adventure at Stanford, California.

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The cover page.
The cover of Axel Stenmark Tullberg's award-winning PhD thesis.

 

He was one of 39 individuals who completed their doctoral studies at the Institute of Clinical Sciences in 2022. Axel Stenmark Tullberg, 29, defended his dissertation on the significance of the immune response in tailoring breast cancer treatment more effectively at the individual patient level. His research may result in fewer patients needing radiation therapy.

You can read more about Axel Tullberg’s doctoral project here.

Six months after his defense, he received an email from the administrative coordinator at the Sahlgrenska Academy: ”Your dissertation has been selected as the Dissertation of the Year at the Institute of Clinical Sciences 2022, based on the recommendation of the assessment committee. You will be awarded 30,000 SEK. Congratulations on the prize!”

”I was extremely happy and surprised to receive the award. It was something I didn’t expect. It felt really exciting and truly brightened up that week.”

”It was quite nerve-wracking”

One Friday morning in October 2022, he stood in a lecture hall at Hälsovetarbacken in Gothenburg. Family and friends were present to observe and listen. His opponent was Per Hall, a professor of radiation epidemiology at the Karolinska Institute in Stockholm.

After three years as a full-time doctoral student, Axel Tullberg was about to prove himself.

”It was quite nerve-wracking. Here comes a very accomplished professor who has been working on breast cancer for many years, highly knowledgeable and very amiable. When I spoke with him before the defense, I felt that he was a good person, but it was still very nerve-wracking,” Axel recounts and continues:

”Now, several years of work culminated in some sort of two-hour interrogation. I had no idea what issues the opponent would raise. There was a wide range of possibilities, from statistics and methods to the actual conclusions. I could be asked some obscure question that I had no clue of. For instance, the physics behind radiation therapy, which is not exactly my area of expertise.”

And how did it go?

”It went well nonetheless. The dissertation defense was a positive experience. It was great to have loved ones present, listening, and being able to talk about the geeky stuff I’ve been immersed in for several years.”

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Portrait of Axel Tullberg
"The doctoral project was something I never really let go of, neither during evenings nor weekends, " says Axel Stenmark Tullberg.
Photo: Aykut Argun

”Going through a sort of crisis”

What is it like to live through such a multi-year research project?

”It becomes something you never really switch off, neither in the evenings nor on weekends. It consumes a lot of your energy and time, while also being very rewarding and interesting. It’s more than a full-time job. You constantly think about ways to move forward and build upon the findings. And when your findings don’t quite align with the existing literature, it’s almost like going through a crisis until you find an explanation. The biggest enemy is false discoveries. You don’t want to magnify things, only to later realize that what you found was due to chance.”

What was the most challenging aspect of your doctoral project?

”Switching off in the evening. Refraining from checking emails and stopping thoughts about the work, that was the most challenging part. And when you have digital meetings with American colleagues, in different time zones, the boundaries of when the workday should end blur.”

At the same time, his partner, Isabel, was also completing her doctorate in nanotechnology at Chalmers University of Technology. She defended her dissertation the week after Axel.

”She has been better at disconnecting, and I’ve learned a lot from her. She made me realize the importance of setting boundaries, putting the email on auto-reply and disconnecting in the evenings. In the long run, I believe this is crucial to avoid burnout.”

Building: Stanford Health Care
Stanford Health Care, located outside San Francisco, will be Axel Stenmark Tullberg's primary workplace for the next three years.
Photo: iStock

”Now or never”

On May 31st, a ceremony was held where the award-winning doctoral students of Sahlgrenska Academy received their honors.

The day after, Axel Stenmark Tullberg flew across the Atlantic. For the next three years, he will be employed at Stanford Health Care (affiliated with Stanford University), outside San Francisco. There, he will undergo a program that combines elements of the Swedish internship (AT) and specialist training (ST).

”I have mixed feelings of nervousness and excitement about coming to the US. It’s a fantastic opportunity and something I’ve worked hard for. I actually took the first United States Medical Licensing Examination (USMLE) in 2019, but at that time, I wasn’t sure if I wanted to go. Once again, it was my partner who influenced me. She had dreamed of working at NASA, and now it has become a reality as Isabel moved to Los Angeles in April. It’s a ‘now or never’ situation with opportunities like this. It will be an exciting few years where I’ll take it step by step. After that, I look forward to returning to Sweden as a more complete physician and researcher.”

What makes your US adventure nerve-wracking?

”Firstly, it means leaving the security of home in Gothenburg and adapting to something completely new. It’s a bit sad to have family and friends so far away. Additionally, the clinical service will be demanding. Lots of work at a high pace, long days, and six-day workweeks.”

Building: Stanford University
At Stanford University, Axel Stenmark Tullberg will continue his breast cancer research. He has been offered a fellowship in oncology.
Photo: iStock

You can really explore new avenues

During his time in California, Axel Tullberg doesn’t just want to become a specialist in oncology but also engage in research at Stanford University.

”In the first year, my primary focus will be on clinical work and after that, I’m determined to continue research in breast cancer. I have been offered a fellowship position at Stanford in oncology after my initial three clinical years. That would involve significant research time. Stanford is an excellent place to be as a researcher. I see the opportunities to join new groups and learn a lot of new things.”

What motivates you to pursue research?

”It’s rewarding to be creative in a different way than one can be as a clinically practicing physician. Clinical work is more routine-based. You follow guidelines and directly benefit the patients. Research, on the other hand, is more long-term and primarily benefits future patients. As a researcher, you can sit and contemplate, really exploring new avenues. There are no limits to how creative you can be,” says Axel Stenmark Tullberg, continuing:

”I want to make the most of how these two worlds complement each other. Eventually, I might devote the majority of my time to research, but it’s also important for me to have a professional life as a physician. In that setting, it’s easier to identify existing needs and crucial unanswered questions.”

Text: Jakob Lundberg

”UNUSUALLY HIGH SCIENTIFIC QUALITY”

Max Levin, Associate Professor and Senior Consultant in oncology, nominated Axel Stenmark Tullberg for the award, using these words:

”The findings presented may serve as the basis for a less aggressive treatment for certain breast cancer patients. This is likely to result in benefits such as improved quality of life and reduced risk of long-term negative side effects. In my opinion, Axel's thesis has an unusually high scientific quality and may contribute to more individualized breast cancer treatment in the future.”

And: ”During his defense, Axel demonstrated a very good understanding of the research subject’s methodology. The studies he conducted require advanced competence in statistics and modeling. Axel is highly knowledgeable in the theory and has developed much of the methodology used himself. I serve on many evaluation boards and encounter many talented doctoral students, but I was truly impressed by Axel’s knowledge and reasoning. He excelled in analyzing his own results, offering alternative interpretations, and nuancing the conclusions.”

When Axel hears the motivation read out, he says:

”That’s great, it’s the first time I’ve heard this read to me. I feel a deep sense of gratitude for receiving the award and would like to take this opportunity to thank everyone who has supported me.”