Josh Fessel

Josh Fessel is a physician-scientist whose career has spanned academic medicine, the research laboratory, and senior science leadership in the federal government. Trained as a pulmonologist and critical-care physician with a doctorate in biomedical research, he was earlier on the faculty at Vanderbilt University Medical Center, where he ran an NIH-funded laboratory studying how the body’s use of energy shapes complex disease while maintaining an active clinical practice.

Fessel joined federal service as a medical officer in the Division of Lung Diseases at the National Heart, Lung, and Blood Institute, where he was deeply involved in the federal response to the COVID-19 pandemic. He later moved to the National Center for Advancing Translational Sciences (NCATS), where he served as senior clinical advisor and ultimately as chief medical officer and director of the Office of Translational Medicine, working to connect basic and clinical scientists and to improve how therapeutics are developed. He resigned from federal service in March 2025, and now works in clinical-research artificial intelligence at Dyania Health.

Fessel appeared on Open Door Salon alongside Frank Watanabe, president and chief executive of Arcutis Biotherapeutics, for a conversation on how the life-sciences enterprise can adapt to an unusually unstable funding and policy environment. Speaking from the academic and former-government vantage point, Fessel’s central warning was that too much of American biomedical research rests on a single point of failure: federal funding.

His advice was to diversify how research is supported, to think globally as other countries move to recruit US scientific talent, and to build resilience through partnership, what he called “co-opetition,” before it is needed rather than after. He also offered a constructive idea he has been developing: state-level “learning health systems” that knit together public universities, healthcare delivery, communities, and private-sector partners into engines of regional biomedical innovation.