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Photos: Elisabeth Fall
by Mitzi Baker
Mitch Rosen, MD, says he wishes there had been a program similar to the Pathway to Discovery Program in Clinical and Translational Research (CTR) when he was a student.
“I never had the opportunity when I was in medical school to take time off to dedicate fully to a project,” says Rosen, a leader in reproductive endocrinology who directs the UCSF Fertility Preservation Program.
Time is exactly what the Pathways program offers. CTR is one of five scholarly concentrations providing coursework, training, mentorship and professional development for learners who want to improve health through clinical research. Learners in the program can choose to pursue research for a summer or an entire year.
For the last four years, Rosen has mentored UCSF medical students as they take on research projects in his field, which is preserving fertility for women undergoing cancer treatment.
“Pathways is a brilliant program,” says Rosen, “allowing medical students to immerse themselves in more than the typical piecemeal research. These are really big projects, and all the students I mentored are still involved and continue to contribute to the field in a meaningful way.”
Rosen feels responsible for giving each of his students maximum exposure to the research world. “For students to know if they want to pursue research in the future, they need to be able to complete something from start to finish and understand the full gamut of being a researcher,” he says.
That process involves designing a study, writing up a proposal, securing approval from the Committee on Human Research, obtaining and analyzing results and presenting them at conferences or through publication in scientific journals. “All of this process is the real opportunity,” Rosen says. “To just collect some of the data from somebody else’s project is not enough.”
Learners also benefit from witnessing how patient care in the clinic and research intertwine. “Seeing Dr. Rosen’s example of using the questions that come up in his patient encounters to inform his clinical research is the really exciting part of all of this,” says Sai-Wing Chan, a fourth-year medical student who took a yearlong research fellowship with the CTR Pathway. “Every day, questions come up that are potentially answerable through the research methods we are using.”
Rosen’s research is looking at the impact on quality of life because of decisions involving fertility made (or not) by cancer patients at the time of their treatment. Chan discovered Rosen’s work when he was seeking out a faculty mentor. He was wondering how to combine his desire to conduct research with his interest in a career in Ob/Gyn. “In medical school, we hear a lot about cancer diagnosis and treatment, but we don’t often hear about survivorship issues,” says Chan.
Medical students Danielle Cipres and Sai-Wing Chan discuss Cipres’ summer project at the January Pathways Explore Symposium. The decision-making study surveyed reproductive-aged women who have been recently diagnosed with cancer, and monitored their perspectives and concerns while making a decision about whether or not to undergo fertility preservation prior to their cancer treatment. “We hope to use this information to improve the quality of care for these women in this delicate situation in which they must make high-stakes decisions in a short time,” says Cipres.
Second-year medical student Danielle Cipres had barely any research experience before learning about Rosen's work through an Ob/Gyn Research presentation held for first-year medical students interested in summer opportunities. “I had not given much thought to doing research outside of my future clinical duties,” she says, but she was hooked on Rosen’s projects.
She began working with him during her Pathways Explore summer experience after her first year. “That summer was instrumental in improving my self-efficacy and knowledge with regards to performing research, and I hope to incorporate it into my future career,” she says.
For past CTR learner Erin Niemasik, MD, who is now a resident in Ob/Gyn at Weill Cornell Medical College, the program solidified her desire to pursue research. “I think that a program like CTR allows you to get comfortable with the research process at an early stage in your medical career and helps to make you a more critical thinker,” says Niemasik. “I have gained a lot of confidence in creating original research. I was also inspired to attend an academic residency program, and I hope to stay at an academic center for the rest of my career.”
Joseph Letourneau, MD, who is currently a resident in the Ob/Gyn department at the University of North Carolina School of Medicine, also took a yearlong research fellowship with the CTR Pathway between his third and fourth years of medical school, which greatly influenced his career choice. “The program helped to inform me that I would like to pursue a clinical career in reproductive endocrinology, same as my CTR mentor, Dr. Rosen,” says Letourneau. “It has further helped me understand that a career in clinical research seems right for me.”
CTR learners who come through Rosen’s lab effectively form a continuous interconnected flow of research, as the individuals overlap on projects. “I had the wonderful opportunity to be a part of three different projects at once,” says Cipres, who continued to work with Rosen after her Pathways Explore summer. “While there were a lot of moving parts, it was an educational and truly enlightening experience to be involved in clinical research projects at different time points in the research process.”
Working on multiple projects is part of Rosen’s teaching process, whereby a learner can experience the start-to-finish research process, which would not be possible within a single project in a summer or a year. Starting long-term projects allows Pathways learners to leave ongoing legacies that live on after the learners move on in their careers.
They also leave behind considerable contributions to the field. “All the medical students who have come through the Pathways program have significantly helped achieve the goals of my research program,” says Rosen. This involves presenting abstracts at national and international meetings, winning many awards and publishing papers.
One of Rosen’s goals is to increase awareness that cancer treatment can cause infertility. “From a medical perspective, this work has changed the way patients are counseled, and it has yielded significant ammunition from a political standpoint to initiate bills regarding insurance coverage of women’s reproductive expenses following cancer treatment.”