Nusheen Goshtasbi, MMSc ’19, Paige Ourada MMSc ’19, Sabrina Puvalowski, MMSc ’19, and Emily To, MMSc ’19, all conducted scientific research during college, and for each of them, the intensive research focus of Yale School of Medicine’s (YSM) Physician Associate (PA) Program was a significant factor in their decision to attend Yale.
For Goshtasbi, the PA Program’s strong emphasis on clinical research was “something that appealed to me based on the taste of research I had gotten previously.” To, who during college enjoyed the supportive and collaborative team environment in research and creating innovative solutions to complicated problems, hopes to stay active in the research community.
Ourada explains that “research has never been something that has come easily to me, so I was looking for a program that emphasized its importance and had a curriculum that would push me to improve my analytical skills,” while Puvalowski wanted to further her understanding of research, as keeping up with literature is essential for health care providers.
The PA Program’s research curriculum, which runs throughout the 28-month program, culminates with a required thesis project. Working closely with a faculty advisor from the School of Medicine, Public Health, or Nursing, each student conducts a thorough literature review, crafts a hypothesis, and designs a study that could be completed in the future.
On December 5, 2019, Goshtasbi, Ourada, Puvalowski, and To, who all had received an honors grade on their thesis work, were selected to present to classmates, advisors, friends, and family at the annual Outstanding Thesis event. PA Program director Alexandria Garino, PhD, PA-C, in welcoming remarks, stated “I am very proud of the program’s research focus. It sets us apart from other programs in the country. Our graduates go off and do great things, in part because of their research capabilities.”
Assistant Professor Rosana Gonzalez-Colaso, PharmD, MPH, who developed the research component of the curriculum, thanked faculty and staff colleagues, who play a critical role in the thesis program. This year, 39 faculty served as advisors— one for each student—volunteering significant time.
Notably, four faculty members have been advisors for six or more years: Matthew Burg, PhD, professor (six years); Huned Patwa, MD, professor; chief, VA Neurology Service (six years); David Cone, MD, professor; chief, Section of EMS (eight years); and Michael Medvecky, MD, associate professor; section chief of Sports Medicine (nine years).
Additionally, 83 faculty members were thesis readers, while YSM librarians, a scientific writing expert, and PA Program staff, played critical roles.
Each presenter shared that a significant benefit of the project was working with their advisor. To reached out to her advisor, associate professor Allen Hsiao, MD, “because I thought he would be an incredible person to work with since we shared similar interests in utilizing technologies to expand health care access and create effective solutions to optimize patient care and outcomes.” She added he was always extraordinarily kind, supportive, and insightful.
I really enjoyed researching the topic and recognizing all the progress that’s been accomplished thus far in the field, as well as developing a possible proposal that offers a possible solution to a critical problem.
Emily To, MMSc ’19
Goshtasbi explains that while she was already interested in researching non-alcoholic fatty liver disease (NAFLD), it wasn't until she met Assistant Professor Nicola Santoro, MD, PhD, a pediatric hepatologist, that “I realized how prevalent NAFLD was in pediatrics and how important it was to address this population of patients since they are the ones who have the greatest number of years to live with this chronic condition.”
Ourada, who had to switch topics fairly late in the process, contacted Medvecky about advising her, knowing he had advised many of her predecessors. “He met with me a day later and was eager to talk about potential topics. I am so thankful for his willingness to be my advisor despite the short time frame we had to work with, as well as his enthusiasm and patience.” Puvalowski similarly states, “I am so appreciative to Dr. Burg as he always was very responsive and helped things move along so smoothly and provided so much guidance and support.”
In their presentations, Goshtasbi, Ourada, Puvalowski, and To each reflected on a knowledge gap regarding an important medical issue, and wanting to help close that gap to improve treatment options.
For example, Ourada, who had torn her ACL while playing soccer in high school, crafted a study to investigate graft failure rates of young, active females receiving hamstring tendon autografts (HTA) for ACL reconstruction, currently the most common form of anterior cruciate ligament reconstruction for this population, compared to bone-patellar tendon-bone autografts. She hypothesized that the HTAs may have worse outcomes 18-months post-surgery, noting that benefits of this research include establishing a standard of care for this population, decreasing the burden of repeat reconstructive surgeries, and enabling shared decision making.
To explains, “my clinical experiences while on rotations really highlighted the strong demand our communities have for mental health help, especially in New Haven, and the unfortunate consequences that can occur because of this dramatic shortage in mental care providers and resources. This was even more disheartening whenever I encountered pediatric patients, particularly in the emergency room, who felt so depressed that they attempted suicide or other harmful behaviors.”
She designed a study to determine if cognitive behavioral therapy-based text messages may reduce suicidal ideation in adolescents with depression, compared to adolescents receiving informative text messages. “I really enjoyed researching the topic and recognizing all the progress that’s been accomplished thus far in the field, as well as developing a possible proposal that offers a possible solution to a critical problem.”
Goshtasbi focused on possible pharmacological treatments for Hispanic pediatric patients with NAFLD, the most common cause of chronic liver disease in pediatrics, with this population experiencing the highest prevalence of the disease. Puvalowski crafted a study to test ticagrelor therapy for patients with coronary microvascular disease and non-obstructive coronary artery disease, a condition that currently lacks treatment guidelines.
The students expressed a tremendous sense of accomplishment with the thesis project. As Puvalowski states, “one rewarding part of the thesis project was having the opportunity to learn so much about a topic I didn't know much about, then be able to present the idea to a room of fellow PA students and friends of the program and see how much I had learned and grown from the experience.”