Students Take Advantage of the "Last Summer"
It’s called “the last summer,” the gap between the first and second years of medical school when students at the George Washington University School of Medicine and Health Sciences have several weeks of freedom from classes and rotations. Some take the opportunity for R and R; others travel on medical missions; and a few, like the students below, welcome an immersion in research.
Brown, a native of the Sunshine State, returned home to work with Orlando Health Systems, specifically the Arnold Palmer Hospital for Children (APH) and the Winnie Palmer Hospital for Women and Babies, as well as with William DeCampli, MD, PhD, chief of pediatric cardiac surgery at APH.
DeCampli, Brown said, was working on a retrospective chart review that focused on identifying risk factors for adverse outcomes in the deliveries of pregnant women with congenital heart defects (CHD); when she called looking for a research opportunity, he invited her onboard.
“I find cardiology, and CHD specifically, extremely interesting,” explained the second-year MD student. “I was definitely interested in the chance to see how it affects both adult and pediatric patients.”
The premise behind the research, she added, is that significant advancements have been made for infants with CHD – more than 90 percent now survive past adolescence – which has emphasized the need for health care services for this growing population of adult patients, particularly pregnant women. To contribute to recommendations for how to manage such patients, Brown and DeCampli began collecting data on patients at the two Orlando-based hospitals, classifying them into different levels of complexity and severity.
Brown, now back at GW, is working remotely to finish the project, which she hopes will lead to publication. “We hear a lot about evidence-based medicine throughout our first year at medical school, and I’m beginning to understand the importance of using studies like this one, when you’re dealing with your patients, making recommendations for their health,” she said. “It was good to see it from the other side of how these studies come into being.”
Elyssa Sham spent her summer at Washington D.C.’s Children’s National Health System (Children’s National) working to improve show rates to Children’s Health Center (the primary care office at Children’s National) psychologists and psychiatrists for the primarily low-income patient population they serve. Sham conducted a Plan-Do-Study Act cycle, for which she made reminder phone calls to patients before their appointments and developed a mental health referral sheet; the sheet was designed to spur conversation between health care providers and families to enhance understanding about the referral and what to anticipate for a meeting with a mental health provider.
For her project, Sham worked with Melissa Long, MD, a general pediatrician at Children’s National. Sham praised Long for her mentorship. “I really enjoyed working on this project with Dr. Long. I had the opportunity to shadow [her] with her general pediatrics patients and also with her work on the Healthy Generations program, which serves teenage mothers and their children,” Sham said.
“I am very passionate about mental health, so this was a great opportunity to learn from experts in the field and help them advance their efforts on integrating mental health into primary care,” she added.
Danny Lee, a member of the Clinical and Translational Research scholarly concentration, also conducted a research project at Children’s National this summer. Lee’s research objectives included learning to perform genotyping and analyzing the results. He analyzed specific gene variations, called single nucleotide polymorphisms (SNPs), to see if a variant of the GSTP1 gene and the AXIN1 gene were associated with lower measures of bone mineral density in young adults and children.
Lee says he became interested in the project because he wanted to use basic science to add to a body of knowledge directly effecting clinical decisions.
“If more concrete associations can be made between SNPs and lower qualities of bone measure, then more aggressive preventive measures can be taken to preserve bone health and quality of life for those who actually carry these variants of the genes,” Lee said. “By working in a lab, I was able to explore genetics and their impact on medicine.”
In addition to doing bench research, Lee said his mentor, Laura Tosi, MD, an orthopaedic surgeon at Children’s National, was very gracious in allowing the students there for the summer the freedom to shadow the Orthopaedic and Sports Medicine Department to learn in the clinic and in the operating room.
Linda Yang and Max Ruben
Yang and Ruben, interns with the Washington, D.C., Department of Health (DOH), took a broad approach to health care. With their supervisors, they conducted site visits to local community-based organizations receiving grant funding from the DOH and also sat in on talks by DOH board members at several medical centers and clinics.
“Being part of office meetings and learning how government works, that’s been really interesting to me,” Yang said.
She and Ruben also collaborated on a research project, assessing Hepatitis C treatment from a provider perspective. Ruben surveyed D.C.-based primary care physicians to gauge how they treat patients with the disease, while Yang conducted an overview of the Medicaid coverage criteria for residents of Maryland, Virginia, and D.C. Together, the two are using their data to create a toolkit to help physicians cross any barriers to providing Hepatitis C care and treatment. The toolkit will eventually appear on the Department of Health website.
“The idea is that we’ll have this toolkit of resources that will make a provider who’s new to treating Hepatitis C feel more comfortable treating [patients] moving forward,” Yang said.