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M.D.-Ph.D. student Audra Iness named president of American Physician Scientists Association

M.D.-Ph.D. student Audra Iness is the 2018-19 president of the American Physician Scientists Association.

M.D.-Ph.D. student Audra Iness is the 2018-19 president of the American Physician Scientists Association.

“When did you know you wanted to be a doctor?”

It’s a question that begins in medical school admissions interviews and lasts throughout a physician’s career. Many can point to an influential moment — whether it’s a family member’s illness, an encouraging mentor or a desire to give back.

Audra Iness is no exception. At 15, she sat by her older brother’s bedside as he battled chronic pancreatitis, a diagnosis that kept him in and out of the hospital for the better part of a year. It wasn’t until his surgeons collaborated with researchers on a special surgery that he found relief.

And his sister found her calling — not only as a physician, but as a physician-scientist.

“I saw the interaction between the physicians and surgeons and the research lab,” Iness says. “Seeing it all come together was amazing. It transformed his life and our family’s life. That’s why I’m not only interested in the clinical side but also the research. I want to transform medicine as a whole.”

The VCU School of Medicine M.D.-Ph.D. student has already started, serving as a national leader among the next generation of physician-scientists. In July 2018, Iness began a one-year term as president of the American Physician Scientists Association, an organization led by trainees, for trainees. APSA strives to be the student physician-scientists’ leading voice for improving educational opportunities, advancing patient-oriented research and advocating for the future of translational medicine.

“Audra is a remarkable individual who deeply cares about the future of clinical research in the U.S. and does everything she can to advance the pipeline of physician-scientists,” says Michael Donnenberg, M.D., senior associate dean for research and research training.

As APSA president, Iness promotes key initiatives including mentorship and establishing an international consortium of physician-scientist trainee organizations. She recently returned from a conference in Canada and regularly speaks with M.D.-Ph.D. students across the globe about the challenges they face and ways to learn from one another.

Strong peer relationships are especially critical for M.D.-Ph.D. students who spend an average of eight years earning their dual-degree. At VCU, their medical education begins with two years of preclinical, followed by three to five years of graduate studies, and then back to the M.D. program for two clinical years.

“The training path is long and challenging so it’s helpful to have the peer support as students and later as peers in our professional lives,” says Iness, who is in the final semester of the graduate phase of the program. “Starting to establish those relationships now is extremely valuable.”

In December 2018, Audra Iness will earn her Ph.D. in cancer and molecular medicine. Then she'll begin clinical rotations and complete her remaining two years of medical school.

In December 2018, Audra Iness will earn her Ph.D. in cancer and molecular medicine. Then she’ll begin clinical rotations and complete her remaining two years of medical school.

Iness joined the national APSA chapter when she entered medical school in 2013 and later resurrected VCU’s APSA chapter. She also founded Advocates for M.D.-Ph.D. Women at VCU to address the underrepresentation of women in the field.

“While the gap has closed for women in medical school — more females enrolled in medical schools in 2017 than males — that’s not the case for physician-scientists, where only about 30 to 40 percent of trainees are female,” Iness says. “We want to find out why and support the women who are here.”

Support throughout the VCU community is what brought Iness to the MCV Campus from her home state of California. “Accessibility to my advisor is huge,” Iness says. “I know who to go to and they’re happy to talk to me. The faculty here has made such a difference and encouraged me to be in national leadership positions.”

She’s also grateful for the M.D.-Ph.D. program’s financial support that covers her tuition costs and provides a stipend. In 2015, a $16 million gift from longtime benefactor C. Kenneth Wright named the C. Kenneth and Dianne Wright Center for Clinical and Translational Research at VCU and provided $4 million to fund the physician-scientist scholars program.

“We fully fund all our M.D.-Ph.D. students — many schools can’t claim that,” Donnenberg says. “It’s important to make that commitment to our students. This wonderful gift from Ken Wright allows us to attract even more students who share an equal passion for patient care and for science and research.”

In December, Iness will earn her Ph.D. in cancer and molecular medicine. She’s spent the last four years working in the lab of Larisa Litovchick, M.D., Ph.D. Her thesis project is focused on B-Myb, a recognized oncoprotein known for its role in cell cycle gene regulation.

High B-Myb levels are associated with a poor prognosis in many cancers, yet its role in ovarian cancer is not well understood. Iness’ research, funded by a National Institutes of Health grant, could help identify predictive markers and therapeutic targets for treatment of ovarian cancer.

Now she’s eager to apply what she’s learned in the lab when she returns to the medical school and begins clinical rotations in January.

“That’s what excites me the most — to see everything fall into place,” Iness says. “I’ve had a vision of working at the border between science and medicine, and seeing through patients what needs to be addressed in the research lab. Now I can take what I’ve learned in the lab and apply it in the clinic and see what happens. That back-and-forth is really the power of dual-degree training.”

By Polly Roberts


M2 Justin Chang returns to NIH to conclude eye research

The Class of 2021’s Justin Chang participated in the NIH Summer Internship Program studying a common cause of blindness.

The Class of 2021’s Justin Chang participated in the NIH Summer Internship Program studying a common cause of blindness.

Three years ago, the Class of 2021’s Justin Chang began working in the National Institutes of Health laboratory of Kapil Bharti, Ph.D., a Stadtman investigator at the National Eye Institute. They were trying to solve a tricky problem: proliferative vitreoretinopathy, or PVR, a growth of scar tissue that causes the detachment of the retina — and, for many, blindness.

It happens to between 5 percent and 10 percent of every person who undergoes retinal reattachment surgery. The only way now to treat PVR is another surgery, but that can be unsuccessful if it leads to more scar tissue growth behind the eye, a return of the original problem that causes the retina to detach again weeks or months later.

With a bachelor’s degree in biology from the University of Maryland, Baltimore County, and a master’s degree in biotechnology from Johns Hopkins University, Chang wanted to learn more about medical research and applied for the job in Bharti’s lab in 2015, before starting medical school last fall.

This summer, Chang returned as a member of the NIH Summer Internship Program to complete his research in PVR.

“This disease happens when there’s a puncture to the eye, or a retinal detachment,” Chang explains. A considerable number of current PVR patients are members of the military who have experienced battlefield injuries. Shrapnel or other debris can cause an eye injury, or even the shock of a blast may detach the retina, Bharti says.

Bharti’s lab focuses on pharmaceutical treatments that could prevent the destructive growth of diseased retinal pigment epithelium, or RPE, cells. While healthy RPE cells protect the retina’s photoreceptors, their unchecked growth can lead to PVR. “We’re interested in how these cells divide, proliferate,” Bharti says, “and how to prevent it.”

Chang spent two years as a post-baccalaureate research fellow at the Bethesda, Maryland, lab, conducting tests to see which medications repress or encourage growth of RPE cells.

Because PVR occurs so often among veterans, the Department of Defense has placed a high priority on its research, Bharti says. A medication that already has been approved by the FDA to treat metastatic cancers appears promising in the RPE study, he adds, and may be able to treat PVR and age-related macular degeneration.

Chang moved from Taiwan to Montgomery County, Maryland, when he was 14, and his father is an internal medicine physician who practices in Taiwan. Still, eye research wasn’t on his radar until he began working in Bharti’s lab.

“I was surprised by how complicated the eye is and how many diseases I didn’t know about,” Chang says. “Initially, I didn’t look at eye research when I got my master’s.” In addition to his lab work, he had the opportunity to shadow ophthalmologists in the NIH’s pediatric eye clinic and see firsthand some unusual conditions, including a type of juvenile macular degeneration and coloboma, in which a part of the eye is missing at birth.

As he returns to the MCV Campus to begin his second year, Chang says he especially appreciates his classmates. “They’re always willing to help you. We study together, have fun together.” He is still deciding on what specialty he’d like to pursue, although ophthalmology is now definitely in the running.

Bharti calls Chang a “very capable person. Not everyone is at the same level as Justin. If he wants to come back next summer, we’d love to have him.”

By Kate Andrews


VCU sends pair of students to prestigious Lindau Nobel Laureate Meeting

M.D.-Ph.D student Chelsea Cockburn (left) and Ph.D. candidate Katie Schwienteck (right) with Nobel Laureate Walter Gilbert, Ph.D., at the 68th Lindau Nobel Laureate Meeting in Lindau, Germany.

M.D.-Ph.D student Chelsea Cockburn (left) and Ph.D. candidate Katie Schwienteck (right) with Nobel Laureate Walter Gilbert, Ph.D., at the 68th Lindau Nobel Laureate Meeting in Lindau, Germany.

Katie Schwienteck set a goal several years ago to one day attend the Lindau Nobel Laureate Meeting in Lindau, Germany.

“I had heard how wonderful it was,” she says. “I thought it would be an awesome experience. As it turns out, it most definitely was.”

A Ph.D. candidate in the medical school’s Pharmacology and Toxicology Department who’s already earned an advanced degree from the School of Pharmacy, Schwienteck, Pharm.D., was one of two students from the School of Medicine to be selected to attend this year’s event. Dedicated to physiology and medicine, the 68th Lindau Nobel Laureate Meeting was held in June.

“It was a once-in-a-lifetime opportunity,” says M.D.-Ph.D. student Chelsea Cockburn, who also was selected to attend. “Just to meet all the laureates and hear their stories was incredible.”

Schwienteck and Cockburn were among 600 international students from 84 countries. Only 30 were from the U.S.

“I think that speaks highly of our graduate trainees,” says Mike Grotewiel, Ph.D., associate dean for graduate education in the School of Medicine. “There is no other gathering that comes close to this one, so this is extremely special for these students. We are very proud of them.”

The annual summer meeting gathered an all-time record 43 Nobel Laureates. They presented lectures on their scientific research, broke into smaller groups to discuss topics such as science diplomacy and careers in biomedical research and took students on “science walks” for more casual conversations.

“These Laureates are considered celebrities,” Cockburn says. “What was wonderful is how normal they really are and how willing they are to sit down with young scientists.”

Cockburn took a science walk with Nobel Laureate Randy Schekman, Ph.D., and the two discussed publishing scientific research. He stressed the importance of the quality of the research, not the size and prestige of a particular journal.

“It was really cool to get his perspective,” Cockburn says. “It should all be about the quality of your work, about good science.”

Cockburn, who earned a bachelor’s degree in biology from James Madison University, is on track to complete her Ph.D. in microbiology and immunology along with her M.D. in 2021. She plans to focus her career on infectious diseases and global health.

“Going to Germany really rejuvenated me,” she says. “As great as it was meeting the Laureates, getting to meet other young scientists from around the world was also invaluable. These people will be my future colleagues. They already are becoming my friends.”

Students exchanged ideas and discussed how medicine is practiced in their home country. They brainstormed solutions to roadblocks they face in their own research.

“You need diverse backgrounds, ideas and thought processes to produce the best science,” Cockburn says. “I think we sometimes forget that because we get caught up in our own bubble. But collaboration is so important.”

Schwienteck, who holds a bachelor’s degree in neuroscience from the University of Pittsburgh, also bonded with other young scientists while in Germany.

“There are so many dedicated people out there doing remarkable work,” she says. “It’s not just about what I’m doing.”

Schwienteck’s research is focused on studying potential treatments for opioid substance use disorder in the lab of Matthew Banks, Ph.D. Her science walk with Nobel Laureate Robert Lefkowitz, M.D., was perfect timing.

“I’m studying drugs that he helped develop,” she says. “That was pretty cool. He offered me very good advice related to career planning.”

Because of that advice, Schwienteck now plans to pursue a post-doctorate after completing her Ph.D. next year.

“Never be afraid to take risks because it is OK to fail,” she says. “It was so reassuring to hear how even Nobel Prize winners faced their own failures along the way.”

The key is to never stop trying.

“One common theme at the meeting was to never make winning a Nobel Prize the goal of your career,” Cockburn says. “Do what you love that will benefit humanity. That is more important than any award.”

By Janet Showalter


M2 Sarah Andrew spends immersive, weeklong internship at Hazelden Betty Ford Center

M2 Sarah Andrew (back row, fourth from right) participated in a one-week, immersive Summer Institute for Medical Students at the Hazelden Betty Ford Center

M2 Sarah Andrew (back row, fourth from right) participated in a one-week, immersive Summer Institute for Medical Students at the Hazelden Betty Ford Center in California.

Shadowing physicians is common practice for pre-med and medical students as a means to learn more about the medical field. Shadowing patients, on the other hand, introduces a unique perspective all its own.

The Class of 2021’s Sarah Andrew discovered its impact when she participated in the one-week, immersive Summer Institute for Medical Students at the Hazelden Betty Ford Center, the nation’s largest nonprofit addiction treatment provider.

At the center’s Rancho Mirage, California, location, Andrew and other medical students shadowed patients undergoing treatment for addiction, gaining an inside look at the dynamics of addiction and the process of healing from the patient perspective.

“This was the first time I was immersed in the patients’ recovery process,” Andrew says. “I shared my thoughts and emotions and reflected on lectures just like the women receiving treatment. Because I participated in the patients’ support groups and debrief sessions throughout the day, I felt that some of the customary physician-patient barriers were overcome. I learned much more from these women about how their addiction negatively affected their lives and how they were really doing in the recovery process.”

Each medical student was assigned to a specific patient treatment group and followed much of the group’s daily schedule: morning lecture and debrief on one of the steps in the recovery process, a counselor-led support group session, and lunch. Andrew was paired with an inpatient women’s treatment group of mostly middle-age women struggling with alcoholism and sometimes other drugs.

M2 Sarah Andrew (second from left) and other medical school internship participants found time to unwind and reflect on a sunrise hike in Palm Springs, California.

M2 Sarah Andrew (second from left) and other medical school internship participants found time to unwind and reflect on a sunrise hike in Palm Springs, California.

“I found the support groups to be incredibly powerful,” she says. “I felt honored to have even been able to hear some of the women’s stories and to participate in a portion of their recovery process. I learned so much about how addiction takes a toll on people’s lives and the importance of separating the person from the disease.”

This is a skill the future physician says she will carry with her as she interacts with patients and their families.

“Regardless of what field I specialize in, there will be patients or their family or friends who are struggling with addiction or in their recovery process. I hope that through this program, I will be able to approach these people with a bit more understanding and compassion, and that I will be able to provide resources and tools to aid them in their recovery process.”

The internship also included opportunities for classroom instruction, clinical observation and lectures on topics including the bio-psycho-social-spiritual aspects of addiction, evidence-based and holistic approaches to care, and 12-step recovery principles and practices.

Like many of the medical students who participated in the internship program, Andrew is no stranger to addiction. Her family has a history of alcoholism and she’s seen the opioid epidemic take the lives of former high school classmates.

“While I’d been exposed to the reality of addiction prior to my internship, the Hazelden Betty Ford Center truly enhanced my understanding of the complexity of the disease and the significant impact it can have on individuals struggling with the disease,” she says. “It is my hope that I will be able to apply this knowledge to care for and support my patients, colleagues, friends and family members in the years to come.”

By Polly Roberts


Student researches fallout in small towns after a family doctor leaves

Through his research, the Class of 2021's Paulius Mui hopes to capture what happens to patients when a rural physician leaves the community and use their perspective to inform policy and recruit physicians to low-population areas.

Through his research, the Class of 2021’s Paulius Mui hopes to capture what happens to patients when a rural physician leaves the community and use their perspective to inform policy and recruit physicians to low-population areas.

If you’re from a small town, you may have a family doctor who has been present at the most important moments of your life: birth, serious illness, a child’s broken arm, a parent’s death. So, what happens to patients when that doctor retires or moves?

That’s what the Class of 2021’s Paulius Mui is trying to uncover. Entering his second year as an fmSTAT student at the VCU School of Medicine this fall, Mui has spent considerable time driving to small localities in southwestern and eastern Virginia that have lost their primary care physicians, interviewing residents about the personal impact of these losses. Earlier studies have examined the doctors’ side of the issue, but Mui says there has been very little research into patients’ viewpoints.

“Some people are losing their best friend in that regard,” Mui says. “A rural physician really ties a community together.” His idea is to capture people’s perspectives and use them to inform policy decisions to attract and retain primary care physicians to low-population, sometimes isolated, places.

Mui’s project is funded by a microresearch grant from the Collaborative for Rural Primary care, Research, Education and Practice (Rural PREP), and he hopes to expand the interviews beyond Virginia with the help of other medical students he’s working to recruit across the country.

Born in Russia and raised in Vilnius, Lithuania, Mui moved to the Chicago suburbs with his mother when he was 14, and attended college at Boston University — so he’s never lived in a small town himself. Mui calls family medicine “the coolest specialty there is. You get to know a little bit about everything. It allows you to take care of anyone who walks in your door.”

After graduating with a bachelor’s degree in economics in 2013, Mui worked in administrative positions at the National Brain Tumor Society and the Harvard Medical School Center for Primary Care. The fmSTAT program is the main reason he decided to apply to VCU for medical school, Mui says.

In 2012, the School of Medicine started the Family Medicine Scholars Training and Admission Tract — or fmSTAT — as a dual-admission program for students certain of their goal to become family physicians. In an effort to attract and retain students, the fmSTAT Scholarship Fund aims to build an endowment to provide future fmScholars the equivalent of one year’s tuition.

Mui is already a standout fmScholar, regularly making suggestions to improve the medical school’s programs for students, says Judy Gary, M.Ed., assistant director of the Department of Family Medicine and Population Health’s medical education programs.

Mui’s line of study could have national implications, says Department Chair Anton Kuzel, M.D., M.H.P.E. Family medicine was VCU’s most popular specialty among 2018 medical school graduates, but that isn’t necessarily the case across the country.

Virginia prioritizes VCU’s, University of Virginia’s and Eastern Virginia Medical School’s family medicine programs in its state budget. Some other states do likewise, but there is concern that without more widespread attention to medical school admissions policies and addressing student debt for those who want to do primary care, there will not be enough family physicians and other primary care clinicians to care for an aging U.S. population. This will be particularly true in rural areas like the ones where Mui is conducting interviews.

VCU’s fmSTAT program and International/Inner City/Rural Preceptorship, which trains doctors for underserved areas in urban, rural and international locations, are somewhat unusual in the field, Kuzel says, and draw students like Mui who “by and large see medicine as a calling.”

Kuzel calls Mui’s project “by far the most ambitious” student study in his experience. Making connections with community leaders first is important in gaining other residents’ trust, which can be a lengthy process, Kuzel adds.

In June, Mui presented his early findings to a group of leaders from the National Organization of State Offices of Rural Health and Rural PREP, who were very encouraging and offered to advise him in the future.

“It was really an incredible opportunity for me to get guidance in very targeted ways to make this project more successful,” Mui says, and he feels he’s already succeeded in his personal objective to “put myself out there and leave my comfort zone.”

Despite Mui’s strong interest in local care, Kuzel predicts his student will one day go on to make a national impact: “His gaze is much bigger than that.”

By Kate Andrews


Associate Dean Sally Santen to lead evaluation of AMA initiative to improve medical education

Sally Santen, M.D., Ph.D.

Sally Santen, M.D., Ph.D.

Sally Santen, M.D., Ph.D., senior associate dean for assessment, evaluation and scholarship, will lead the evaluation of the Accelerating Change in Medical Education Consortium initiative through a contract with the American Medical Association. While at the University of Michigan Medical School, she was the co-principal investigator on a $1.1 million grant to transform the medical student curriculum starting for five years. As the grant evaluator, Santen will work with the AMA team to determine outcomes and publish the findings.

The Accelerating Change in Medical Education Consortium schools are working together to develop common solutions to transform medical education in key areas such as health system science, coaching and competency based education.

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Updated: 04/29/2016