Dr Gergely Toldi specialises in paediatrics, including neonatology. This is the branch of medicine dealing with the physiology and pathology of healthy newborns and those born with abnormalities. In his research on immunology, he seeks to improve the diagnostic and therapeutic options for newborns, pregnant women, and patients with autoimmune diseases by answering questions arising from clinical practice. He has published extensively in his field, has lectured in many countries, and collaborates closely with researchers in Hungary, Australia, Germany, Finland, Japan and Ireland. Gergő is currently supervising PhD and undergraduate students at the Liggins Institute, The University of Auckland and is also involved in the practical training of medical students. In his clinical role, he works as a neonatologist in the neonatal intensive care unit (NICU) at Starship.
Aucklevél: After Budapest, Szeged and Birmingham, you have been living and working in Auckland for two years now. When you graduated from Semmelweis University, did you ever think that you would get the opportunity to do medicine and research on the other side of the world?
Dr. Gergely Toldi: No, New Zealand had never been on the agenda before, and I hadn't even been here until an excellent job opportunity came up three years ago. At that time the COVID pandemic was still going on, so it took me a year to get the paperwork done and organise the move.
Aucklevél: As a neonatologist, what are your responsibilities in your academic teaching and clinical medical roles? Do you experience any differences in European education/training and clinical practice compared to New Zealand?
Dr. Gergely Toldi: As New Zealand's largest and highest acuity neonatal intensive care unit, we work closely with Starship Children's Hospital and the specialities of obstetrics and fetal medicine. We care for many extremely low birth weight premature babies, under 1000 grams, and term babies born with cardiac, surgical, or other developmental and genetic problems, who often spend months in our centre. We receive patients with serious conditions from all over the country and even from countries in the Pacific. After hospitalisation, we closely monitor the development of these children during the first years of life.
In university education, the main emphasis is on practical training, and we try to show the daily work of the department to the medical students, explaining in detail some of the interesting conditions we see. We teach how to examine and resuscitate newborn babies, and how to solve common neonatal problems. This practice- oriented form of education is becoming increasingly important in Europe, but New Zealand is way ahead of the curve and medical students here benefit much more. Clinical practice is very similar to the UK, generally of a high standard, with close collaboration between different specialities.
Aucklevél: Your academic profile says that your research focuses on flow cytometry and that your work has contributed to the diagnostic and experimental development of this method. What exactly is this method and why is it important in neonatal medicine?
Dr. Gergely Toldi: With this method, cells in a liquid medium, mainly blood cells and immune cells, can be examined in large quantities, up to thousands of cells per second. The detectors in the device allow us to characterize what molecules are on the surface or inside the cells, which provides a lot of information about their state and function. So, from very small amounts of blood samples, even a few microlitres, we can get a picture of the immune system and different pathologies in a patient. This is a great advantage in the case of newborns and premature babies, because only a small amount of blood can be taken from them at a time.
Aucklevél: What is the biggest challenge for you in research, education and clinical practice? What are the current international trends that are most influencing the development and evolution of the field of paediatrics? Is there any ongoing research that could lead to leaps and bounds in your field in the coming years?
Dr. Gergely Toldi: The biggest personal challenge is time management, the combination of the three tasks. Neonatology is a relatively new specialty that has evolved rapidly. Unfortunately, as premature infant survival improves, the number of complications associated with prematurity is also increasing. The prevention and management of these complications will therefore be an important area. A better understanding of the immune system of preterm infants is also important in this respect. New drug treatment options will also be needed, considering the specific needs of this age group, as most of the drugs currently used in our field have been adopted from adult medicine and general paediatrics over several decades.
Aucklevél: Your work has been recognised internationally and you have won various awards. Could you tell readers about the awards you have received and what they mean to you? What is the main motivating factor that drives you forward in your career?
Dr. Gergely Toldi: I don't think that the prizes are very important, although of course it's nice to be recognised for your work. I would probably mention the 2015 Junior Prima award at home (Hungary) and the 2016 Medis Award for my scientific work. Last year, I won the André Mischke Young Academy of Europe Prize for Science and Policy, which recognises science policy and dissemination.
More than prizes, I am motivated by patient care and the joy of discovery and creation. And the combination of the two is a joy in itself. While scientific work often takes years to bear fruit, in medicine success is often immediate, especially in newborn babies, who have an incredible ability to heal compared to later stages of life. It's a good feeling when parents drop in, bringing their growing child back for a visit to the hospital where they often spent weeks or months in a serious condition.
Aucklevél: Have you had the chance to explore Auckland, and other parts of the country, and have you had time to travel for work? How at home do you feel in New Zealand?
Dr. Gergely Toldi: Yes, I have travelled to several places in New Zealand and Australia, both for work and leisure. I would definitely like to spend more time on the South Island. I found Coromandel on the North Island particularly interesting.
New Zealand is a pleasant, liveable country with beautiful natural treasures. I like the attention they pay to these assets. Two years on, I feel at home. The distance from Europe is something I haven’t quite got used to, but with modern communication channels, it is less of a problem.
Viola Vadász