Richard W. Dow Student Research Scholarship in Surgery
The Department of Surgery is pleased to announce the availability of scholarship support for Geisel students who chose to do surgical research during the summer between their first and second year. An education fund supported by faculty and former residents in surgery had been created in memory of Dr. Richard Dow, former Chair of the Department of Surgery. Dr. Dow was a committed educator who was recognized with the Parker J. Palmer “Courage to Teach” Award from the ACGME in 2005. The fund established in his name is designed to promote student and resident education in surgery.
The Dow Student Scholar program will offer $2500 to up to 3 Geisel students to support their time doing research mentored by a surgery faculty member during their break between Year 1 and 2. A number of research opportunities are available in different surgical sub-specialties, such as those outlined below. In addition, other surgical faculty may be available as research mentors. Students who are interested in pursuing this opportunity should contact a surgery faculty member to discuss the research opportunity. After this discussion, the student should submit the following information as an application to Sara Chartier in the Department of Surgery by February 10, 2023 (Sara.L.Chartier@hitchcock.org):
- A one-page statement explaining their interest in the specific research project, their overall career plans and background, and a description of how the funds will be used (which can be for personal support).
- A copy of their Curriculum Vitae.
Applications will be evaluated by the Dow Education Fund Advisory Committee. Up to 3 students will be selected to receive a scholarship.
Interested students should meet with potential mentors this fall to determine interest. Applications (above) are due February 10, 2023. Notification of scholarship recipients will occur by February 28, 2023.
Please address any specific questions about this program to Jack L. Cronenwett, MD, Department of Surgery (j.cronenwett@dartmouth.edu). A list of faculty members who have mentored students, with a description of their research interests, is below. If you desire to participate, but don’t know which faculty mentor might be most appropriate, please email Dr. Cronenwett outlining your research interests and he will provide advice about a potential mentor.
Surgery Education:
Meredith Sorensen, MD (Meredith.J.Sorensen@hitchcock.org)
Project: Public/Patient Perception of Topics in Surgical Education
Medical students have an opportunity to participate in research projects in the Department of Surgery, Section of General Surgery under the direction of Meredith Sorensen, MD. Projects may include a variety of topics related to the public and/or patient perception of participation in surgical care by surgical residents and medical students. Research techniques will be qualitative, survey-based, or mixed methods. Depending on student interest and faculty collaborator availability, there may also be an opportunity for a project analyzing mass media coverage of surgical trainees. Previous medical student summer projects have studied the patient perception of resident involvement in their surgeries and the public perception of required minimum volume standards for surgeons. Students are encouraged to take a leadership role in projects, including the study design, institutional review process, data collection and analysis, and/or drafting of presentations, abstracts, or manuscripts related to the research.
General Surgery
Alexandra Briggs, MD (Alexandra.Briggs@hitchcock.org)
Active Projects:
- Social Determinants of Health Screening for Trauma and Acute Care Surgery Patients
This project focuses on the process of SDOH screening (assessing financial insecurity, housing instability, transportation challenges, etc) for patients admitted to the TACS service. Students would be involved with assessing the implementation of an iPad based survey for screening, and analyzing the data resulting from screening. Patients with positive SDOH screens are offered social work referral while inpatient in order to address areas of concern.
- Vulnerability Screening in Geriatric Patients with Emergency Admissions
This project focuses on the assessment of vulnerabilities in patients aged 75+ who are urgently/emergently admitted to the hospital. This includes screening for cognitive impairment, frailty, activities of daily living, delirium risk, malnutrition, and other factors that can affect surgical outcomes. Students would help to implement screening on the TACS service, with opportunities to expand to other services based upon pilot data.
- Spiritual needs of Geriatric Surgery Patients
This project focuses on the spiritual needs of geriatric surgery patients as assessed by chaplaincy during postoperative visits, using an existing framework.
Students participating in any of these projects would receive mentorship from Dr. Briggs as well as from residents helping with this work. Smaller projects related to these could also be opportunities for research (one example being related to healing arts interventions for delirium prevention in older adults). Students are encouraged to lead projects in terms of data collection plans, data analysis, and submission of abstracts/manuscripts based on the work.
Neurosurgery:
Jennifer Hong, M.D. (Jennifer.Hong@hitchcock.org)
Project 1: Understanding the relationship between interhospital transfer and surgical outcomes.
This is a clinical research project that builds on earlier work which discovered that patient outcomes for acute surgical diagnoses are worse for patients who are transferred from outside hospitals compared to those who present primarily to the emergency department, even after adjusting for other predictors of poor outcome such as disease severity. I am interested in analyzing data from national and institutional databases to better understand why inter-hospital transfers are associated with poor outcome and to identify ways to improve the mechanisms for transfer in healthcare delivery. This is particularly important in rural academic healthcare systems which have a high rate of transfers. A student who is involved in this project would be working closely with me to review patient charts, plan analyses and write and present findings.
Project 2: Pten deletion to accelerate peripheral nerve regeneration
This is a translational research project, using an animal model for nerve regeneration (the mouse sciatic nerve), to assess the effects of Pten deletion to accelerate nerve growth after injury. I use viral-mediated gene therapy approaches to conditionally inactive Pten in peripheral nerves. The goals of this student project are to 1) assess viral (AAV) infection rates in mice, 2) analyze live-imaged primary neuron cultures, and 3) perform detailed behavioral analyses in mice to assess sciatic nerve function. A background in basic science research is preferred, but I will directly supervise and train any student.
Otolaryngology:
James Saunders, MD (James.E.Saunders@hitchcock.org)
Project: Student Research Opportunity in Global Health and Hearing Loss
Medical students have an opportunity to participate in research projects in the Department of Surgery, Section of Otolaryngology under the direction of James Saunders, MD. Projects may include a variety of topics related to the etiology and epidemiology of hearing loss in low resource environments. Students may choose to work in the Upper Valley on projects related to hearing loss such as developing tablet / smart phone based technologies for testing hearing in these environments or cost-effective analysis on different treatment modalities. Alternatively, students may elect to perform in-country research on hearing loss in Nicaragua, Mexico or Zimbabwe. Previous medical student summer projects have studied the prevalence of hearing loss in newborn infants in rural Nicaragua and the investigation of a novel hearing screening technology in Nicaraguan schoolchildren. Some potential in-country projects could focus on heavy metal toxicity and hearing loss, cytomegalovirus related hearing loss in newborns, measuring the effect of a public awareness campaign for ototoxic medications. Students are encouraged to take a leadership role in projects with exposure to all aspect of the research project, including the study design, institutional review process, data collection and analysis.
Surgical Oncology:
Andrew P. Loehrer, MD, MPH (Andrew.P.Loehrer@hitchcock.org)
Dr. Loehrer is a surgical oncologist and health services researcher whose work focuses on health equity, specifically evaluating the intersection of public policy, social determinants of health, and exploited and oppressed populations. Medical students will have an opportunity to participate in one or multiple studies including 1) evaluation the influence of federal and state health policy on the equity of cancer and surgical care delivery, 2) understanding the influence of residential redlining on equity of cancer care and 3) determine the influence of local and state public spending on equity of cancer care delivery. Students with various degrees of prior research experience are welcome. For students with minimal prior exposure to research, there are opportunities to participate in study design, conducting literature reviews, participation in interpretation of data, and composition of abstracts and manuscripts. For those students with more experience in research methodology and data analysis, we will work to start developing their own portfolio and/or expand expertise in advanced methodologies. All students will complete research ethics and confidentiality training. Additional educational materials will be utilized to strengthen students’ foundational knowledge of surgical health services and policy research.
Urology:
Florian R. Schroeck, MD (Florian.R.Schroeck@dartmouth.edu)
The student will be involved in research activities related to the recently funded “ImpRaBS” project, "Implementing Risk-aligned Bladder Cancer Surveillance" in the Department of Veterans Affairs. We are currently piloting interventions to improve bladder cancer surveillance across 4 sites within the Department of Veterans Affairs. Further information on the project can be found here: https://www.hsrd.research.va.gov/research/abstracts.cfm?Project_ID=2141707037
Depending on interest and timing, the student will get experience in participant recruitment, data abstraction/collection, qualitative or quantitative data analyses, mixed-methods analyses, literature research related to the project, or drafting of presentations, abstracts, or manuscripts related to the research. It is important to note that a commitment is needed at least 3 months prior to the start of the summer break, so that we can assure all necessary training and privileges are in place for the student to get access to VA data and participate in VA research activities.
Vascular Surgery:
Jocelyn M. Beach MD (Jocelyn.M.Beach@hitchcock.org)
Characterization of Inflammatory Mechanisms of Peripheral Artery Calcification
Peripheral artery disease (PAD) places patients at increased risk of major amputation, other major cardiovascular events, and death. In patients with PAD, a strong correlation of vascular calcification with more severe disease and high risk of amputation has been noted. Vascular inflammation may be a potent driver of arterial calcification, this pilot project is to characterize peripheral vascular calcification and its associations with inflammation or other drivers to further inform future work in development of clinically meaningful therapies for PAD.
This study involves enrollment of patients who will be undergoing above and below knee amputations as part of their clinical care. Arterial and soft tissue specimens will be harvested and prepared for transport to collaborators to perform histopathology and proteomic analysis as well as biomarker analysis. Clinical data and radiographic images will also be evaluated and correlated to histological findings. The student will be involved with collecting patient data from medical records, evaluation and measurements from CT imaging, and assist with dissection of amputated limbs to harvest vessels, document specimens, and prepare for further analysis.
Jesse A Columbo, MD, MS (jesse.a.columbo@hitchcock.org)
Dr. Columbo is an early career vascular surgeon at Dartmouth-Hitchcock, where he also completed his residency in vascular surgery. He holds appointments at both the Geisel School of Medicine at Dartmouth, and at The Dartmouth Institute. He works with students in a variety of ways. He is an active preceptor for the On Doctoring program, is the clerkship director for the third-year rotation in vascular surgery, and serves as co-mentor to PhD students. Students working with Dr. Columbo will participate in one of his active ongoing research projects (see below), where the student would have the opportunity to work on existing projects, including data collection, data analysis, and abstract and manuscript preparation, depending on the interests of the student. In addition, students will have the opportunity to be embedded in an ongoing research effort that includes weekly meetings with research fellows, PhD candidates, biostatisticians, and economists.
- Studying stroke after carotid revascularization
Carotid revascularization surgery, including carotid stenting and carotid endarterectomy, are some of the most common procedures performed by vascular surgeons in the United States. There is ongoing debate regarding a variety of aspects in the management of these patients, including what type of surgery patients should undergo, whether they should undergo surgery at all, and how they should undergo surveillance. Addressing these questions is a primary focus of Dr. Columbo’s research efforts. Example publications: PubMed IDs: 36172943; 31941366; 29914828; 28190714; 33616666
- Patterns of stress test utilization before vascular surgery
The use of preoperative stress testing for cardiac risk-assessment before vascular surgery is highly variable. Despite recommendations from the American Heart Association and American College of Cardiology, testing demonstrates wide variation across centers, with little differences in the baseline characteristics of patients. Dr. Columbo is investigating the impact of this variation, and ways to reduce it. Example publications: PubMed IDs: 36036487; 33684471; 32247699
- Reintervention and aneurysm related mortality after endovascular abdominal aortic aneurysm repair
Abdominal aortic aneurysms are a common diagnosis among vascular surgery patients, and endovascular abdominal aortic aneurysm repair is one of the most common procedures performed by vascular surgeons across the world. Patients who undergo endovascular surgery (minimally invasive repair with stent-grafts) as opposed to traditional open replacement of the aorta, are subject to a variety of important considerations. These include the risk for reinterventions to shore up the aneurysm, and the feared complication of late aneurysm rupture related to failure of the implanted graft. Measuring these complications and defining their risk factors is an important component of quality assurance for patients with abdominal aortic aneurysms. Example publications: PubMed IDs: 36283705; 36036487; 35090989; 35090992; 31290764; 32150470; 31471231
- Development and use of advanced biostatistical methods to study outcomes in surgical care
Sometimes existing biostatical methodology is limited in its ability to address certain research questions. These include but are not limited to, situations with time-variant exposures (such as repeated measurements of carotid ultrasound prior to surgery), or situations where a randomized controlled trial is not possible or unlikely to happen in the near future (such as with transcarotid artery revascularization versus transfemoral carotid artery stenting). In these situations, advanced methods can improve upon traditional strategies for risk adjustment, allowing enhanced inference and stronger validity of study findings. Dr. Columbo works closely with a group of biostatisticians and economists who investigate novel applications and methods to address these challenges. Example publications: PubMed IDs: 36172943; 33616666; 31165658; 30354571; 30646140
Philip Goodney, MD, MPH and David Stone, MD (philip.p.goodney@hitchcock.org; david.h.stone@hitchcock.org)
Drs. Goodney and Stone have collaboratively mentored Geisel students in health services research in topics related to surgical care, especially vascular care, but other topics have been investigated as well. These projects range from case series, to large observational analytic projects, to literature review/meta analyses, as well as methodologic and developmental projects. Students interested in this work can read more at www.dartmouthcesc.org, www.mdepinet.org/vision-crn/, and www.vaoutcomes.org. Partnership with Drs. Sandra Wong, Andrew Loehrer, Joga Ivatury, Florian Schroeck, Alex Iribarne, and other surgical health services researchers in the Department of Surgery and Heart and Vascular Center are included in these summer research experiences. Students will be assigned a role in an existing project of their choosing, report their findings at the end of the summer experience, and share their work in regional and national meetings and publications.
Rebecca Scully, MD, MPH (Rebecca.E.Scully@hitchcock.org)
- The impact of patient sex/gender on endovascular aneurysm repair outcomes and postoperative surveillance
Sex-based differences in outcomes after endovascular aortic aneurysm repair (EVAR) for abdominal aortic aneurysms (AAA) have been noted with women experiencing increased mortality and increased re-intervention rates over time. The goal of the project is to evaluate differences in adherence to recommended post-operative surveillance protocols between male and female patients and to determine if such disparities impact EVAR outcomes. The project is an opportunity to work with data from the Vascular Quality Initiative (VQI) dataset and to work with health services researchers in the Department of Surgery and within the Heart and Vascular Center.
- Gender-based differences in compensation model preferences among surgeons
Differences in compensation between male and female physicians is a well-established issue however physician preferences around compensation models based on gender are less well understood. Data surrounding best practices to address and close the gender pay gap are also lacking. Using a mixed methods approach, the goal of the current work will be to design and distribute a survey and to also perform structured interviews with early, mid, and late career surgeons employed under a variety of compensation models.