Such professional threads are especially vivid where medicine is inseparable from the academic environment and continuous learning. The Faculty of Medicine at Vilnius University and Santaros Clinics have for many years been a space where science, clinical practice, and the experience of doctors from different generations meet. The professional connections formed here often grow into mentorship, joint work, and become an important part of a doctor’s professional path – forming a kind of professional chain – a connection where not only what is learned matters, but also what is later passed on to others.
This article is about three doctors connected by exactly such a bond: pediatric nephrologist, Vilnius University professor Augustina Jankauskienė – one of the generation of doctors in which pediatricians were trained as pediatricians.
Her student, pediatric nephrologist, Vilnius University Faculty of Medicine vice-dean Associate Professor Dr. Karolis Ažukaitis, who says that the path to choices and attitudes changed as he got acquainted with new disciplines: “I knew early on that I would not want a job where practical, hands-on skills were the most important. I needed an intellectual challenge – a discipline that strongly affects the body and requires understanding its complexity, the interaction of different organ systems, acute and chronic conditions, i.e., seeing the person as a whole.” The third link is pediatric diseases and pediatric neurology resident Kajus Merkevičius, who today continues his scientific path in New York.
According to him, this path was not planned in advance. Kajus was driven by curiosity, a desire to understand, and a search for how to use that knowledge to help people.
Why these three people in one story? Because their story is important not only for the specific specialty. They are united by the environment of Vilnius University, Santaros Clinics, scientific curiosity, and connection. Even more importantly – what one person receives from another does not end here: professional experience travels further – from Vilnius to Heidelberg, Salzburg, Sydney, or New York and back again.
First of all – curiosity
Professor Augustina Jankauskienė’s path as a doctor began with pediatrics. Her generation entered university having chosen not only medicine but essentially their future direction – the path of an adult or pediatric doctor. She began studying pediatric diseases from the third year, and preparation for pediatric work was longer and more consistent.
Today, the system of training doctors is different. The professor does not say that one system was good and the other bad, but she recalls the consistency of that time: the professional foundation was formed over a long period, gradually. In her opinion, today, when there are many more choices and information, it is important not to lose a broad pediatric perspective.
The professor herself initially did not even think about pediatric nephrology. While studying, she considered choosing another specialty – pediatric neurology. But life arranged a different plan: “I am very glad that I had the opportunity to work in many links – I even went through the experience of working as a primary care physician: visiting patients in the district, dealing with sick leave certificates and prescription forms.
That is now hard to imagine. And I can say that at that time I certainly did not think about nephrology, but I wanted something more, I needed a challenge,” the professor says.
Later, life led her to the Republican Children’s Hospital, which gradually merged into Vilnius University Hospital Santaros Clinics. Here another important part of her choice story becomes important – the people she met, personalities whose advice was extremely important.
Well-known pediatrician Professor Petras Kaltenis, famous for his modern approach, instilled in her the idea that a good doctor can be not only a doctor: he can also be a scientist, a person involved in university life, interested in the world, collaborating and constantly learning.
The professor recalls that this idea became one of the most important guidelines of her own professional path. “I think I inherited from him the desire to do scientific work, although the path to it was very difficult for me. I defended my dissertation externally – I did not have doctoral studies, I did everything while working, I had to pay for exams…,” the professor says. “There were absolutely no privileges, and there was no mentorship as we understand it today. But a person who has gone through difficult stages appreciates everything much more.”
Asked why she feels the importance of nurturing successors in her profession, the professor says that if you do something and there is no one to continue after you, the meaning of past work is lost: “We, pediatricians, definitely face this. It is not cardiology, not surgery, where there are other challenges, but many want to choose these specialties. The number of pediatricians is smaller. And pediatric nephrology in Lithuania is almost a niche profession.
This means you cannot afford the luxury of focusing entirely on one narrow field: you cannot be only a specialist in transplanted patients or only in dialyzed children, but this has encouraged seeking like-minded people worldwide.” These insights from the professor reveal how important it is to pass on accumulated experience, professional and international connections to the next generation – so that everything simply continues.
A teacher does not necessarily say what you must be
One of such students was Doctor of Science Karolis Ažukaitis – pediatric nephrologist, now Associate Professor and Vice-Dean at Vilnius University Faculty of Medicine.
Their acquaintance began quite simply: with a patient consultation, writing a medical history. “We talked and I thought: this is an interesting case, it should be used for a scientific article. I suggested to Karolis: ‘Let’s write an article.’ He agreed. Then I saw how well he writes, how meaningfully he thinks,” the professor recalls.
Thus began their collaboration, which, as A. Jankauskienė jokingly says, can be measured by the age of their shared patient, because when they met, she was only a few days old.
The professor quickly noticed not only Karolis’s talents but also his desire to delve deeper. “I proactively expressed my desire to get to know the world of science,” the professor is supported by K. Ažukaitis himself. “I liked such a scientific challenge, I liked the depth. I wanted it to be difficult.”
The professor says that seeing an active student, she sought to give the talented young person opportunities to realize his ambitions as early as possible. Through her connections with Heidelberg University, other professional opportunities opened up. About this experience, K. Ažukaitis says that in this scientific environment he learned very valuable things: “For example, to evaluate and measure echoscopic images. But that was not enough for me – I started to analyze them additionally myself.
Thus began communication with Professor F. Schaefer, who provided opportunities not only to work technically but also to understand how a mature scientific group and mentorship relationships operate.” During practice, he began to delve deeper, analyze more than was asked of him. Later he was given the opportunity to participate in a large international study and, while still a student, to become its regional coordinator.
Through these international experiences, as K. Ažukaitis says, he learned a lot because he worked with various complex cases and touched a very wide range of processes himself: “I am glad that the bar for knowledge was always high. This made me constantly be tense in a good way, striving for high results and standards. This shaped my attitude towards how science should be conducted. It beautifully connected with what I saw at Heidelberg University – high-level scientific methodology and scientific impeccability.”
What Karolis Ažukaitis says he received from his mentor Professor Augustina was not just specific medical knowledge. He highlights several important things. One of them is the ability not to feel the limits of a small country: “How not to feel smaller in abilities, quality, or potential even being from a small country. Another thing is networking: to bring back from each meeting not only knowledge but also a new contact that should turn into a joint project, professional friendship, clinical collaboration, or other meaningful activity. The greatest value is people, their mutual cooperation, and growing together,” says Karolis Ažukaitis.
“A mentor must show the paths but not lead by the hand”
Perhaps this is the true meaning of mentorship. Karolis Ažukaitis describes it very simply: a mentor must show the paths and, if necessary, open doors or windows to them and help navigate them. But he does not lead by the hand: “It is walking together,” he says. “It is important not to decide for another person but to help him understand what he wants and make decisions.” Perhaps that is why Karolis Ažukaitis’s role as a mentor naturally grew out of his own experience.
He says that encountering people who help find their path and improve without forcing creates a kind of debt to life. Not an obligation, but a desire to share what you yourself have received.
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Therefore, quite early Karolis Ažukaitis himself began to talk to students about science, sharing his experience. Later he joined a mentorship platform where younger people turned with very diverse questions – from doubts about whether it is worth going abroad for summer practice to questions about choosing a clinical career.
And one day Kajus Merkevičius joined his lecture at Vilnius University “Trust Experience.”
Kajus Merkevičius: “Science is interesting to me when it ultimately returns to the patient”
His own path began with curiosity and a desire to understand, and at the same time – the opportunity to change something with that understanding, to help a person.
“I was very inspired by the example of Karolis and Professor Augustina – how to combine the difficult work of a doctor with science, not forgetting that science ultimately must serve the patient,” says Kajus Merkevičius.
At the beginning of residency, Kajus met Karolis Ažukaitis, who not only combines clinical work with science but also shapes the future generation – exactly the kind of mentorship Kajus was looking for. During one conversation, mentioning interest in Professor Urtė Neniškytė’s research at the Life Sciences Center, Karolis encouraged him to contact her – thus Kajus got into his first practice in a scientific laboratory, whose projects always revolved around the human – early neurodevelopment and neuroplasticity research.
Later came the Austria stage – Professor Saskia Wortmann from the Salzburg center invited Kajus to work on rare neurometabolic diseases. It was there that the idea was born to apply a more innovative method – brain organoids, 3D brain models from patient cells, allowing better understanding of disease causes and evaluation of treatment effectiveness.
Austria lacked opportunities for this, but later, at a conference hearing Prof. Tamo Kozicz’s presentation about similar methods, Kajus shared the idea with the professor – and received an invitation to develop it in the USA, at Icahn School of Medicine at Mount Sinai.
Thus, the scientific idea born in Austria became the beginning of another professional path. Kajus says that many people contributed to the opportunity to go to the USA – Professor Augustina Jankauskienė, Karolis Ažukaitis, Vilnius University, the Future Biomedicine Foundation, Austrian scientists, and future supervisors in New York. Each of them in their own way opened doors to the next stage.
Recalling this challenge of K. Merkevičius, Karolis Ažukaitis says he sought opportunities to help Kajus realize his potential, involve him in scientific projects and international networks.
“But most importantly – the moment comes when the person you started communicating and working with at the beginning of his career path begins to walk this path independently. Kajus’s groundwork and abilities eventually allowed him to continue his scientific path independently.
Then my work as a doctoral supervisor focuses on providing necessary help when new challenges arise, helping navigate more complex situations, and responding to the needs he himself raises. Kajus himself established international connections, sought opportunities, and began to initiate scientific projects. I am very happy to see that a person to whom you once helped open one door later finds many other paths himself,” says K. Ažukaitis.
How can scientific research return to a specific patient?
Today Kajus Merkevičius’s scientific path continues in New York, at Icahn School of Medicine at Mount Sinai. His story contains a lot of complex science, but the idea itself is simple: the laboratory should not be separated from the patient.
“Our goal is to create models from patients’ cells with which we can better understand the disease and test treatment methods. We reprogram patients’ cells into stem cells, and from them create models of different tissues (organs) – the main object of my research is a 3D cellular brain model, or brain organoids – ‘mini brains’,” explains Kajus Merkevičius.
One case shows how this works in practice: a patient suffered from an extremely rare disease (only 50–100 such cases are known worldwide). Testing different treatment options in the culture created from her cells revealed that a drug described in the literature as possibly beneficial could actually further promote the harmful process. This allowed returning to the patient and abandoning ineffective, possibly even harmful treatment.
When science becomes help for the patient
Kajus Merkevičius’s story about his work in the laboratory shows the complex path from the patient’s problem to the answers, the search for which is still ongoing. However, Professor Augustina Jankauskienė believes that the balance between clinical work and scientific approach is especially important, especially when working with children, when it is necessary to see not only the disease but also the child, his parents, the whole family.
For Karolis Ažukaitis today, not only his own clinical and scientific activity is important. Being Vice-Dean for Science and Innovation at Vilnius University Faculty of Medicine, he seeks to contribute to the creation of a broader university science ecosystem, promoting focus rather than separation between disciplines and scientific topics, as well as the development of a culture of collaboration.
In health science research, it is especially important that practical medicine is not separated from academic science; these are two sides of the same system, and only thanks to them does the system constantly improve. In his own professional path, Vilnius University became a place from which paths to international cooperation opened, and today he himself helps others see those paths.
Vilnius University and Santaros Clinics – an environment where people meet. Where a student can come with a question, and a teacher or doctor mentor can notice a curious young person and help him seek connections, contacts, and opportunities.
Professor Augustina Jankauskienė began her professional path at a time when the university and pediatrics school were different. But for her, the most important thing remains the same today – continuity: “Continuity is only through people and the connections between them,” she says.
This thought very accurately describes Karolis Ažukaitis’s story as well. He received not only knowledge from his mentor but also the opportunity to see a broader world. Later he himself became a person who opens doors for others.
And Kajus Merkevičius’s story shows that what is passed on is not necessarily a specific specialty. Curiosity, the desire to delve deeper, the courage to reach out, the ability to seek answers, and the understanding that a doctor and scientist can walk the same path can be passed on. Knowledge travels through different generations further. And along with it, the most important value is passed on – the understanding that behind every discovery and refined methodology there is always a patient for whom completely different opportunities open up – more precise diagnostics, hopeful treatment, and doctors who care about his health.
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