I’m a Student, and Even I Know That

July 29, 2010

Ever since I moved to New York City for my clerkship (part of the clinical training in medical school) at the Lincoln Health Center, I wake up every morning in a great mood. And that’s saying a lot because I have never been a morning person. After years of hitting the books, I am just so excited to finally try my hand at real medicine. So in spite of sleep deprivation, everyday I look forward to going to work, meeting patients, learning new cases, and performing minor procedures. Ok, to be fair, I shouldn’t call it “work” since I’m not actually getting paid for my training, but it just sounds better.

Real hospital life is not Grey’s Anatomy (for those who don’t know, it’s a medical drama), however. Not everyday is exciting or even interesting. As a matter of fact, some days, such as today, can be painfully mundane and frustrating. The Lincoln Medical and Mental Health Center, located in the South Bronx, caters to a rather unique subpopulation of America. Most, if not all, of our patients are on Medicaid, or have no insurance. Many don’t speak English, which I actually quite enjoy because I get to practice my Spanish with my patients, but it can sometimes make history-taking challenging, in which case we call for a translator. Unfortunately, due to the fact that many cannot afford to see a primary care physician (the equivalent of our family doctors in Canada), they show up in our Emergency Room (ER) for everything and anything because by law, we cannot turn them away.

As many of you undoubtedly already know, a major difference between practicing medicine in Canada and in the U.S. is liability. Doctors here have to constantly worry about covering their posteriors. The combination of people’s financial difficulties, lack of education, and doctor’s over-cautiousness from fear of lawsuits resulted in this patient that I saw today: A middle-aged woman who showed up in the ER because of a skin lesion on her foot. She was subsequently admitted by the ER physician to our department in Internal Medicine, meaning that she was hospitalized for further assessment and treatment. As I read her chart in the morning before going to see the patient, I perused different possible diagnoses in my mind: cellulitis (a type of skin inflammation and infection), angioedema (rapid swelling of the skin and underneath the skin), dermatitis (itchy inflammation of the skin)…

When I saw the patient and examined her, I was flabbergasted and befuddled. What exactly are we looking at here? Where is the lesion that was severe enough to warrant hospitalization? Then my attending physician pointed the culprit out to me. Ladies and gentlemen, please hold onto your seat because you will not believe this. The “emergency case” was a callus! That’s the thick, hard skin that you get when you wear shoes that are too tight! I was absolutely stunned and stayed so for the rest of the day. This woman was there, taking up bed space, billing thousands of dollars to the government, when what she really needed was a pedicure!

Why was this patient not sent home by the ER physician? Maybe he or she wanted (us) to make sure that it was not something more serious out of paranoia; you don’t want to get sued for negligence later on, or maybe the emergency doctor was just functioning on auto-pilot that day and admitting all the patients, sending them off to different departments. Who knows? But when I asked my team of physicians why this woman was here because she shouldn’t be, their answer was: You’re a student, and even you know that.

Melody Ko

How To Stay Sane in Graduate School!

May 24, 2010

Being a graduate student is an exciting journey that definitely has its ups and downs. The roller coaster ride comes from the highs and lows of the many experiments that are performed with usually only a fraction of them resulting in positive results. When you perform several experiments and spend countless hours in the lab only to find out your efforts do not lead to an expected outcome, frustrations can rise frequently. However, when   a positive result is finally obtained, the feeling is so rewarding that it often makes all the aggravations worth it.

One way in dealing with the many frustrations that arise along the way in research is by surrounding yourself with a solid network of people who can provide advice and mentorship. As a graduate student you learn to optimize experiments and being vocal to other colleagues and friends about the problems you are experiencing can often lead to insightful ideas that you would not have thought of on your own.

Additionally, I feel that although keeping a strong focus on your research project is very important, it is also key to become involved in other extracurricular activities. It is often these other activities that provide some breathing room from the normal day to day research problems and can also help create a great network of friends and mentors.

Being actively involved in other activities can provide a strong skill set that will most likely prove valuable even after graduating. As a student there are several opportunities to become involved such as by joining different societies or even taking on a teaching assistant position. Becoming a teaching assistant is a great way to discover if teaching in academia is something you want to pursuer after graduating.

Furthermore, amongst the busy schedule you may have due to your research committments and other activities, it is important to remember have some fun and enjoy yourself! Taking time to relax can allow you to clear your head and sometimes even lead to great research ideas!

On the whole, I think graduate school can be one of the best times of your life and it is all about being able to stay passionate about your research project and learn as much as you can, but also stay actively involved in other activities and have some fun along the way.

Vaneeta Verma

Not Research. Now what? – Alternative career paths outside a lab for people with a background in life science

May 20, 2010

You have finished your degree in an area of life science. Perhaps lab research does not look like a good career option for you, or you just simply want to try something different. You ask, “ Not research. But now what? ”

There are many answers to that question. You do not have to spend the rest of your life in a lab like you did in your last year of undergraduate study or through your graduate school. There are lots of opportunities outside laboratories for you to choose from. Here are some options.

1. Journalism and writing

If you have good writing skill and communication skill, you could consider becoming a science journalist for newspaper science/technology/medicine section, popular science magazines such as Scientific American, or for online science websites. A career in journalism will expose you to the lasted development in biotech and the latest discoveries in life science. It is a stimulating job.

2. Education

This option includes teaching at different levels. If you enjoy teaching high school biology, attend teacher’s college and obtain a bachelor’s degree in education. If university is what you prefer, you could become a lecturer. Also, there are online education programs that need scientists. Consider teaching an online course or getting involved in the making of educational software. Additionally, you could teach for private companies. For example, become an MCAT biology instructor for companies like Kaplan and Princeton Review.

3. Software engineering

If you are good at programming or math, why not work in biocomputing or bioinformatices. You do not have to join a research lab and analyze data for other biologists. You could design computational tools or biologists. Either Write and patent your own software independently, or join a software company, for example, the MathWorks, and help engineers develop software.

4. Art

Artists are needed for illustrations in scientific papers, textbooks, magazines and educational software. Try to combine your life science background and your artistic talent to help out scientists illustrate their ideas in research papers or help educate the public with your drawings.

5. Public policy

Scientists can get involved in policy making at the federal level in various areas, for example, drug approval, natural health product regulation, public health risk assessment, environment conservation, etc. Such a job will usually involve a large amount of literature research.

6. Law

This path requires you to attend law school. Your background in science gives you an edge to practice medical laws and patent laws. You are not limited to working for a law firm. You could work as a lawyer for a biotech or pharmaceutical company as well.

7. Patenting

A patent agent is a person that represents patent applicants and helps them get their innovations patented. You do not need a law degree. To peruse this path, you need a year of on-the-job training as a patent trainee at a law firm, and then pass the qualifying exam. A technical background and good writing skill are necessary for success in this area.

8. Healthcare

Another option is to become a health care professional by attending professional schools such as medical school, dental school, pharmacy school and optometry school. Admission is competitive and the training is long. However you science background definitely helps. The job stability and good salary are attractive to many people. Let’s not forget about pursuing a graduate degree in the allied health sciences, for a career as a Physiotherapist, Occupational Therapist, Dietitian, Speech Language Pathologist or Physician Assistant, just to name a few.

9. Marketing and Sales

The easiest way to go into sales is to work for a biotech or pharmaceutical company. A sales representative is usually well compensated. Since it is performance-based, your commission can potentially exceed your base salary. To succeed in sales, you need good people skill. As a sales representative once told me, “ it is all about networking.” Also be prepared for frequent travelling.

10. Investment banking

Investment banking is very hard to enter. There are only 20,000 positions worldwide every year. A six-figure base salary is guaranteed. A performance-based bonus can reach up to million dollars. Get an M.B.A. or another degree in Finance first, and then get into investment banking. There is an increasing need for scientists in this area, as healthcare banking is becoming more and more important. Training in science can usually help an investment banker to predict if a drug or medical device business would succeed or not.

11. Technology transfer

Help evaluate a research innovation and turn it into a business. A lot of new technologies in life science can be turned into business and change our daily life. You could specialize in areas such as biomedical science, biomedical engineering, agricultural innovation, etc. To enter technology transfer, you need some business background. You might want to consider getting an M.B.A.

12. Philosophy/Bioethics

If you have a passion for philosophy, you could combine it with your science training and become a bioethicist. There are not many job openings in this area. You are most likely to become a university professor or book authors.

Laboratory is not the only place for a life science graduate. Remember your training in life science is just a start. You can combine it with almost anything you are interested in! Go for something you are passionate about because it is your passion that will lead you to your success.

By Candyce Sun

Nature vs. Nurture- Adding more fuel to the fire

November 30, 2009

The debate of what is more important in human development- nature or nurture-has been going on for decades with scientists and psychologists constantly finding new ways to develop strategies to regulate human behavior. Interestingly, a new article published earlier this month in the Toronto Star, stands on the nurture side of things. In the article, the writers claim that many scientists now believe that 20% of a person’s life outcome is the result of their biology, or innate brain capacity. That means that the other 80% is determined by what happens after you are born! So what does this all mean? It means that a person’s behavior, life goals (i.e. becoming a rockstar vs. an aerospace engineer) and overall success is determined by your parents, schooling and early socialization. The article goes on to argue that even more interesting is that a male brain and a female brain at birth- are exactly the same. They even went on to give a biological reasoning behind this similarity. The authors argue that the newborn brain contains about 100 billion neurons and that the only difference between the adult and newborn brain is the number and types of synapses made – the total number of neurons however, stays the same. Further, the more synapses you make, the smarter you are. The authors argue that social factors at a young age, as well as throughout life are the major reason for differences in synapse formation. These findings have huge implications for the field of neuroscience as well as sociology. Essentially, they are arguing that gender roles and identities, that is the understanding that a male is different from a female and that there are different social norms and expectations attached to each- are all learned. This raises the importance of early childhood education and school curriculum. Specifically, the authors want to incorporate a concept known as “neuroeducation”, that is, that people deal differently with information, and that schools should adopt customized learning strategies to stimulate different types of brains. In all, these findings have important implications for our understanding of human behavior, and for the emphasis that we put on a child’s early home and school environment.

by Alisha Jamal, University of Toronto

Please let us know you opinion!  email submit@cslsr.ca

Breakthrough in Breast Cancer- A Canadian Contribution

October 8, 2009

Breast Cancer is the most common cancer in Canada. According to the Canadian Breast Cancer Foundation in 2009, an estimated 5,400 women and 50 men will die from breast cancer in Canada. It is also one of the most well researched cancers. In the last few years we have seen a number of breakthrough treatments for breast cancer such as Herceptin, a drug that targets the Her2 receptor. The Her2 receptor has been shown to be constitutively “on” in breast cancer, and is responsible for promoting cell growth, survival, adhesion and migration. Thus, by targeting the Her2 receptor, tumor growth and metastasis is severely hindered. However, not all breast cancers have the Her2 receptor overexpression phenotype and will therefore not be affected by the Her2 receptor phenotype. Although chemotherapy remains a leading treatment for cancer therapy, it is likely that a combination of drug treatments as well as chemotherapy offer the best chance of success. Interestingly, it is also well known that many cancers become resistant to drug therapies. These characteristics combined continue to plague scientists and hinder the development of effective cancer treatments. There is hope though. We can thank Canadian scientists from a B.C cancer agency for a novel breakthrough. Researchers here sequenced the genome (all 3 billion bases) from a patient’s original breast tumor, and a recurring tumor that arose in her pleural cavity nine years later. Surprisingly, they found that the genetic makeup of the two tumors were remarkable different. But they didn’t stop there. They then went on to look at the DNA from the tumors and found 32 different mutations among the 3 billion base pairs. This is a huge finding because scientists can now look into each one of these mutations, find what they encode (protein, mRNA, etc) and then see if they can develop drug therapies to target them. Most important is knowing the endogenous function of these genes and their importance in the normal functioning of a body cell. Hopefully, some proteins will show differential expression (or up/down regulation) between the normal body cell and the tumor cell. These can then be targeted for drug therapies. These seminal findings were published in Nature Journal earlier this week, and provide new hope into developing therapies and treatments to combat breast cancer.

by Alisha Jamal, University of Toronto

Could Prostate Cancer be caused by a VIRUS?

September 19, 2009

Researchers based at the University of Utah and Columbia University Medical schools recently published a paper in PNAS providing evidence that a virus has been found in a large number of human prostate cancer cells. Can viruses cause cancer? Yes. These viruses are known as oncoviruses. One of the most well known viruses that cause cancer is the Human Papillomavirus Virus (HPV) which has been most commonly liked to causing cervical cancer. Its highly controversial vaccine, Gardasil, is now available to all Grade 8 girls across the Province of Ontario. In the PNAS paper, researchers found the “Xenotropic murine leukemia virus-related virus” or XMRV for short, in 27 % of the prostate cancers they examined, and were generally associated with the more aggressive tumours. According to the Canadian Cancer Society, prostate cancer, aside from skin cancer, is the most prevalent cancer among Canadian men. Although this paper provides an interesting finding regarding the role of this particular virus and prostate cancer, it does not show causality. Future studies will need to address how the virus is transmitted, if it is in fact, causal (i.e. contracting the virus leads to cancer) or if it just an association. Regardless, this paper brings us one step closer to understanding the cause of some forms of prostate cancer, and hopefully will bring us closer to developing vaccines and treatments.

By Alisha Jamal, University of Toronto

New hope in the fight against HIV

September 7, 2009

Human Immunodeficency Virus ( HIV) infection , which is responsible for taking the lives of more than 25 million people from 1981- 2006, has long troubled scientists because of its extremely high mutation rate: approximately 3 x 10−5 per nucleotide base per cycle of replication. This has made the possibility of vaccines very unlikely, as it would be next to impossible to keep up with the viral mutation rates and new vaccines would have to be developed constantly. However, in a seminal paper published yesterday in the journal of Science has provided evidence that a vaccine may be possible in the near future.  Researchers have found a segment on the viral organism, which remains unchanged through more than 75% of the HIV mutations.  Even more promising, the researchers showed that two antibodies, which they called PG9 and PG16 were able to neutralize HIV infections in almost 80% of all cases. These antibodies were first discovered in the blood of an African AIDS patient. So what is next?  The researchers have said that they hope to to find the region on the HIV virus that the antibodies correspond to, and then recreate it in a harmless form so that it can be used as a vaccine. In an interview with the Toronto Star, Dennis Burton, a senior author on the paper said that this would be the most difficult part. Nonetheless, the finding of this paper is very exciting because for the first time ever, the possibility of a vaccine used to kill one of the most potent, and harmful viruses in our present day may be possible.

By Alisha Jamal, University of Toronto