Attending - Pitt Med - University of Pittsburgh

ATTENDINGRuminations onthe medical lifeIMAGINATIONUNLEASHEDAs traditions go, the University of Pittsburgh Schoolof Medicine’s Scholarly Project is relatively new.When it was initiated in 2004, this concept ofa mandatory, multiyear, research-driven, limited-onlyby-the-bounds-of-the-imaginationundertaking was alsonovel. Fast-forward to today, and scholarly projectsare becoming a rite of passage at other med schools,including Harvard’s.That doesn’t surprise David Hackam, an MD/PhD,associate dean of medical student research, WatsonFamily Professor of Surgery, and associate professor ofcell biology. He’s been overseeing the program since2010. (To learn about this prof’s promising breakthroughsfrom his other roles as a pediatric surgeon andscientist, see p. 24.) For Hackam, the goal is simple: “Wewant our students to look beyond textbooks and developcritical-thinking skills and the ability to test hypotheses.”Students choose individual topics that interest themand then, in most cases, begin research over the summerbetween their first and second years so that theycan officially begin their Scholarly Projects by sophomoreyear. By graduation, Hackam asserts, they becomeexperts in their areas of research and, as a result, arehighly sought after for residencies. That fact has notgone unnoticed by aspiring physicians. According toHackam, “Informal surveys indicate that a significantnumber of our students are coming here because of theScholarly Project.”—Compiled and written byBarbara Klein and Joe Miksch—Illustrations by Michael LoteneroSUMMER 2013 31

The 144 students who marched to the strains of “Pompand Circumstance” this spring represented just the sixthgraduating class to complete Pitt’s Scholarly Project course.Among the topics? Students researched the “feasibility ofa text-message-based behavioral intervention to reduce sexualrisk behaviors in young adults that present to the emergencyroom,” explored the “effects of glucocorticoid receptorneural progenitor cells on cerebral cortex development,”and investigated “attitudinal predictors of waterpipesmoking in U.S. college students.”TALKINGTHE TALKAs if med schoolweren’t time-consumingenough, these gradsalso played roles in234 national andinternational presentations.WRITES OF PASSAGEThis year’s crop of ScholarlyProjects produced 134 publishedarticles—with 43 boasting firstauthorships. Those journals includedArchives of Internal Medicine,The Journal of the American MedicalAssociation, Hepatology, and Annalsof Surgery.NEAR AND FARScience knows no borders, and a few projectswere international in scope (like “the dry seasonprevalence of Tungiasis in the rural communitiesof Beira, Mozambique”) while others stayedcloser to campus (“the development of a healthresources guide for older adults in Braddock,Pa.”). Others managed to merge global and local(“barriers to health care utilization among newlyresettled Bhutanese refugees in Pittsburgh”).THANK YOU,THANK YOU VERY MUCHThe class of 2013 took home 39 nationalawards (for example, the CDC ExperienceApplied Epidemiology and the Doris DukeClinical Research fellowships), as well as39 local awards (like Pitt’s Clinical ScientistTraining Program Research Fellowships).32 PITTMED

OH, O’MALLEYS!Bert O’Malley (BS ’59/MD ’63) is one of the University ofPittsburgh School of Medicine’s many success stories. His honorsinclude winning the National Medal of Science and membershipin the National Academy of Sciences. O’Malley is credited withestablishing the field of molecular endocrinology and now chairsthe Department of Molecular and Cellular Biology in the BaylorCollege of Medicine, where he is the Thomas C. ThompsonProfessor of Cell Biology. In 2010, heand his wife, Sally (whose ’59degree is in education from Pitt),Colby Croft found anopportunity to augment Pittmed’s curriculum relatedto the health of lesbian,gay, bisexual, and transgender(LGBT) people. HisO’Malley-winning ScholarlyProject—under the guidanceof Pitt mentor MelanieGold—resulted in animproved workshop ongender identity and sexualorientation for incoming medstudents, the creation of astandardized patient casefeaturing a same-sex couple,and an expanded workshopon human sexuality for thereproductive biology course.Past life: Croft’s interestin curriculum developmentgrew at Pitt. But since highschool there was never atime that he did not want tobecome a physician. Duringhis undergrad years, he volunteeredas an emergencydepartment scribe and intriage at a free clinic. “[Theseexperiences] opened my eyesto the exciting challengesand rewards of patient care,”he says.What’s next: A continuedfocus on LGBT issuesand curriculum developmentand a psychiatry residency atthe University of California,San Francisco. Afterward, onto a career in academic medicine,working to promotethe health of LGBT youth.Something goes wrongwith the colon. It becomesinflamed. At the same time,the bladder shows signs ofdysfunction, but there areno obvious signs of diseasein that organ. JocelynFitzgerald set out tounderstand why. Under theguidance of Pitt’s Chet deGroat, she implicated themast cell (an immune cellof the bladder and colon),an enzyme it produces, andthe proximity of mast cellsto the sensory nerves ofthese pelvic organs in thisdisorder, called “pelvic organcross-sensitization.” Herrats with irritated colonshad significantly increasedbladder activity, and shefound that blunting both themast cell and its downstreamtargets can reverse theinflammation and calm theoveractive bladder.Past life: Fitzgeraldbecame interested in scienceand women’s health issuesin high school. Then shewas a double major in biologyand women’s studies atPenn State’s Schreyer HonorsCollege. She combined theseinterests in her honors thesis,which drew from theTremin Research Program onWomen’s Health, an almost80-year-old generationalstudy of women’s healththroughout the lifespan.What’s next: A residencyin obstetrics and gynecologyat Johns Hopkins Hospital andfurther research into chronicpelvic pain, which she calls“an undertreated and debilitatingproblem with a significantvoid in both research andproviders.”created the Bert and Sally O’Malley Awardsfor Outstanding Medical Student Research to recognize lesserknownsuccess stories. The award, whichcomes with a $500 stipend, honorsa select few who exceled in theirScholarly Project research whilepursuing their MDs at Pitt. Wepresent the 2013 O’Malleys . . .Some of us use Nintendo’sWii gaming system to loseto our nephews in variousMario Brothers games.Kellie Middletonsuspected that the gamingsystem might have a highercalling. Her project foundthat, as the title statesplainly, “Playing the NintendoWii improves non-dominanthandedness in surgicallynaive student performanceon a virtual-reality surgicalsimulator.” (So a little timewith Super Mario Bros. mightnot be a waste of time for anaspiring surgeon.)Past life: Crushingsoftballs. Middleton playedvarsity ball at Notre Dameand the University of Georgia,and she played professionallywith the Akron Racers. Whilewith the Racers, she workedin public policy in Berkeley,Calif., and cofounded a nonprofitto provide opportunitiesfor underserved girls throughathletics.What’s next: A residencyin orthopaedic surgeryat UPMC and continuedresearch in orthopaedics,surgical education, and publichealth.Traumatic brain injury (TBI)—whether suffered on the battlefieldor the football field—is ahot topic. Thomas Phelps,in the lab of Pitt’s AnthonyKline, used his Scholarly Projectto find out whether the antipsychoticdrug aripiprazole mightbe an effective treatment forTBI. (Many antipsychotics currentlyused to treat TBI impairmotor and cognitive recovery.)Aripiprazole, Phelps found,did no harm to his rats’ cognitiveabilities, and it improvedtheir spatial-learning abilityand memory. “If aripiprazole isfound to improve spatial learningand memory in humans, itmay have further rehabilitativepotential to improve cognitiverecovery in TBI patients,”Phelps says.Past life: Phelps served inthe Army and was deployed toIraq as an M1A1 tank commander.This experience helped moldhis medical interests. “TBI hasbecome a signature injury forthe war in Iraq . . . As a result,many young men and women,while lucky to be alive, mustnow learn to cope with longlastingdisabilities,” he says.What’s next: After hisemergency medicine residencyat Case Western ReserveUniversity and Cleveland Clinic,Phelps plans to continue hisPennsylvania National Guardservice as a medical corpsofficer.Rachel Orler Reidrecognized that it’s notalways easy to determinewhich docs provide the bestcare in clinic. Over the courseof her Scholarly Project,which included work at RANDCorp.—in conjunction withAteev Mehrota, MD associateprofessor of medicine—Reidexplored the relationshipbetween the information peopleuse to select doctors andclinical quality. The work ledher to delve deeper into therelationships between perception,cost, and quality ofcare while at the U.S. Centersfor Medicine & MedicaidServices. A related paperwas published in The Journalof the American MedicalAssociation in January 2013.Past life: Rowing. Lotsof it. She was the assistantcaptain of Harvard women’slightweight crew. And beforecollege, what was then theGovernor’s School programin Pitt’s School of Medicinehelped solidify her careerpath.What’s next: Aninternal medicine residencyat Brigham and Women’sHospital in Boston andfurther investigations ofhow cost and informationare related to the choiceswe have to make abouthealth care.A SHOUT OUT Mentors, by their very nature, provide support,guidance, and experience, as well as the occasional dose of tough love.Scholarly Project mentors take on a three-year commitment to individualstudents. For the first time, graduates returned the favor by nominatingtheir mentors for special recognition. And the Excellence in MedicalStudent Research Mentoring Awards went to Giselle Hamad, an MD andassociate professor of surgery; Brian Klatt (MD ’97, Res ’02), assistant professorof orthopaedic surgery; Ateev Mehrotra, an MD/MPH and associateprofessor of medicine; and Vu Nguyen, an MD and assistant professor ofplastic surgery.SUMMER 2013 33