Aboli Rane (arane@bioeng.ucsd.edu)

Graduate Program:  Bioengineering
Lab PI: Dr. Karen Christman
Undergraduate Institution: Cornell University
Med-into-Grad clinical training area: Cardiology
Main clinical mentors:
Dr. Kirk Knowlton  kknowlton@ucsd.edu
 Dr. Sotirios Tsimikas stsimikas@AD.UCSD.EDU
 

Quote:  “I was interested in Cardiac MRI because I am interested in using this technique for some of my future studies.  I contacted Dr. Andy Kahn and he was more than willing to show me the procedure and teach me how to read MRI’s. It was during an MRI reading that I came up with a research idea for developing a novel method to treat aortic aneurysms“.

Rational for Med-into-Grad training: 
My thesis is the use of injectable polymers for the treatment of myocardial infarction. This is a translational area of research and I felt that the HHMI program in Cardiovascular Diseases would be an immense resource in understanding how laboratory research and animal studies can be translated into a clinically applicable treatment.  I wanted to learn the various opportunities for treatment of myocardial infarction.  By understanding biological components of the disease, operating conditions, and needs of the patients, I wanted to gain a broad perspective of the current clinical setting of MI and incorporate some of these learnings in my Ph.D thesis.

Medical training and identification of medically-relevant research issues: 
I would like to break down the clinical experience into the following different components:

• CCU: Cardiac Care Unit (Rounds along with Attending, Fellow, Residents, Interns, and Medical students)
• Cardiac Clinic: (Observe follow-up visits, physical exams, patient history etc with Fellows and Attendings)
• Echocardiography Lab: (Observe and help diagnose echocardiographs of the heart and determine valve, wall, functional abnormalities)
• Cardiac Catheterization Lab: (Observe diagnostic as well as interventional catheterizations, occasionally you can scrub in on the procedure)
• Electrophysiology Lab: (Observe cardiac ablation and cardioversion procedures)
• Cardiac MRI: (Observe the procedure and look and help analyze the films)
• Cardiology Grand Rounds: (Listen to interesting lectures pertaining to current topics in cardiac research and management)
• Cardiac Cath Conference: (Discuss interesting cath cases and how the case was handled and what alternative methods could have been used)

The key is to take initiative to see and be involved in these various opportunities. For example, I was interested in Cardiac MRI because I am interested in using this technique for some of my future studies.  I contacted Dr. Andy Kahn and he was more than willing to show me the procedure and teach me how to read MRI’s. It was during an MRI reading that I came up with a research idea for developing a novel method to treat aortic aneurysms.

Potential Research collaborations:
During my clinical rotation, I became interested in aortic aneurysms and methods to treat them. I observed a patient with a large aneurysm in the ascending and descending portion of her aorta. The treatment options for this patient were limited. This led me to developing a research proposal to treat aortic aneurysms using an injectable polymer treatment.  I will be collaborating with research groups in the school of medicine to further pursue this idea and make it a part of my thesis.

Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs:  This training program did a superb job in training me in different diagnostics and therapeutics in cardiology. It was interesting and informative to see the state of the art including ablation procedures for atrial fibrillation, stent procedures and pacemaker implants. I also saw cardiothoracic procedures such as coronary artery bypass and pulmonary thromboendarterectomy as well as a clinical trial.

Diagnostic & Therapeutic collaborations:  Cardiac Ablation procedures can take up to 6-7hours. The time limiting step in this process is to identify the locations of abnormal firing. During this procedure I became interested in optimizing this method and am currently thinking about ways to tag these abnormally pacing cells. I spoke briefly to Dr. Felds and expert in EP procedures at UCSD. He expressed that there may be some challenges with developing such a method, but in general was in support of the idea.

Long term impact: This clinical rotation has been influential in providing me a fundamental understanding of cardiology and clinical applications of cardiac medicine. This program has helped me develop novel ideas in this field along with valuable clinical contacts that I hope to work with in the future.

Student-specific experiences:  The med-to-grad experience definitely strengthened my motivation and desire to be at the forefront of cutting edge research. This experience really helped me realize the collaborative effort necessary for success of the medical field. It really is a combination of new therapeutics developed by scientists on the research scale and the application of these by medical professionals.

Advice for new trainees--Autumn preparatory quarter:
The best thing to prepare for the rotation is to start going to Cardiology Grand rounds on Monday at 5:30pm in the Thornton Hospital. I found this extremely valuable in understanding some of the relevant topics and terminology. Also introduce yourself to the other doctors in the room, because these are the people that you will work with in the winter quarter.

I also would recommend taking an active interest and reading about general cardiology topics; such as auscultation, echo, pharmacology etc. One resource I found particularly helpful is called Clinical Cardiology made ridiculously simple by Michael Chizner. It can be purchased in the UCSD bookstore for around ~$30.

Advice for new trainees—Winter clinical training quarter:
My biggest piece of advice is to be proactive. Definitely ask questions and take the time and effort to see what you would like to see. Really, the biggest factor in how much you will get out of the program is you so make the most of this great opportunity. I would definitely try to see some cardiothoracic procedures along with the planned clinical rotation. It was very fascinating. I also suggest writing down all the new terminology you hear in the hospital and look it up during down time. Uptodate is on all the hospital computers and it is a very good resource. Also, I would purchase a stethoscope; this will allow you to be more involved in the physical exam process.

Take home perspective on Med-into-Grad at UCSD: 
I am very happy I decided to participate in the Med-to-Grad program at UCSD. It definitely has added significantly to my understanding of cardiology and the unmet needs in the hospital. I would highly recommend it to any interested graduate student. They will not be disappointed!