Jon Gonzales (jcg002@ucsd.edu)

Graduate Program:  Bioengineering
Lab PI: Jeffrey D. Esko, Ph.D.
Undergraduate Institution: Colorado State University
Med-into-Grad clinical training area :  Diabetes and Metabolic Disorders
Main clinical mentors:
Sunder Mudaliar, M.D., (smudaliar@vapop.ucsd.edu)
Steven Edelman, M.D., (sedelman@ucsd.edu)
 

Quote:  “Overall, the MIG program was a unique and remarkable experience. Through my interactions with the physicians, pharmacologists, and patients, I gained a clinical perspective into the complicated nature of treating the morbidities involved in the Metabolic Syndrome. This experience will undoubtedly shape my future research goals. Ultimately, I’m still amazed that my clinical mentors were so accommodating and eager to discuss the complexities involved in clinical medicine. I will continue to recommend this program to many of my peers.”

Rational for Med-into-Grad training:   I’ve always been most interested in biomedical research, especially research that involves metabolic defects. Thus, I was very intrigued in the unique opportunity provided by the MIG program to have exposure to the clinical side of metabolic diseases. Currently, my thesis research is focused on the role of heparan sulfate proteoglycans in the transport of lipoprotein lipase, a critical enzyme in the regulation of lipid metabolism. Impairments in lipid metabolism are found many settings, including cardiovascular disease, diabetes, and obesity. However, prior to my joining the MIG program, there was not a specific clinical training area designed for impaired lipid metabolism. Fortunately, Mark and I were able to facilitate a training experience in which I would spend the majority of my time with the VA Endocrinology group studying lipid cases in diabetes and obesity, while still getting some training experiences with atherosclerosis in the UCSD Cardiology group.

Medical training and identification of medically-relevant research issues:  The focus of my MIG training consisted of the various clinical aspects involved in the diagnosis and treatment of the morbidities in the Metabolic Syndrome. The majority of my time was spent in the diabetes and lipid outpatient clinics, but I also attended endocrinology and cardiology grand rounds, diabetes and endocrinology case conferences, and the Dept. of Medicine Grand Rounds. The outpatient clinics were my favorite aspect of my training. I was able to directly interact with the patients, medical fellows, pharmacologists, and attending physicians. It was really helpful to hear the patients’ perspective, and then be able to discuss the case with the fellows and attending physicians.

Potential Research collaborations: Presently, no direct collaborations have been coordinated, but I did identify multiple research ideas and unanswered questions through my discussions with the attending physicians and medical fellows. Down the road, I intend to apply techniques developed in my thesis research to test some these unanswered questions.

Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs:  Since the majority of my training was focused in the endocrinology division, it was difficult for me to gain an in-depth understanding of the diagnostic and therapeutic needs in the cardiovascular aspects of the Metabolic Syndrome. However, in the diabetes and endocrinology aspects of my training, I learned that the current diagnostic and therapeutic treatments are very efficient. The current agents used, and the drugs “in the pipeline” are promising and extremely effective. Rather, it is the compliance and psyche of the patient that are the biggest deterrents in the treatment of the lipid-related morbidities in the Metabolic Syndrome.

Diagnostic & Therapeutic collaborations:
N/A

Long term impact: I think that this experience will have two long-term impacts in my career. First, it has encouraged me to continue to perform clinically relevant research and to find more ways to apply basic research to clinical questions. Secondly, this experience has shown me the potential benefits of collaborating with physicians, and how to go about setting up these collaborations. The insight and expertise of the physicians will be necessary to perform high-impact, clinically relevant research.

Student-specific experiences:  Outside of research, this MIG experience also had an impact on my nutrition and health. Daily interactions with patients who have diabetes, obesity, and/or cardiovascular disease encouraged me to eat a little healthier, and to run a couple of extra miles a week.

Advice for new trainees--Autumn preparatory quarter:  For the Autumn quarter, the preparatory training was sufficient to get you started in the Winter quarter. Although, it probably would be a good idea to review some of the relevant chapters in the textbooks provided by the program. It would also be helpful to be familiar with some of the current medications used to treat diabetes and dyslipidemia.

Advice for new trainees—Winter clinical training quarter:  In the first couple of weeks of training, I’d highly recommend making a reference sheet for all of the different medications and treatments used in the clinic. It’s especially important to be able to know the drug name, and trade name (or common name). They are used interchangeably and referenced quite often. A typical diabetic patient is taking three different oral agents and two forms of insulin treatment. Thus, it’s very useful to know each agent and it’s mechanism of action. I’d also suggest asking lots of questions during the “down-time” in the clinics. Most of the time the outpatient clinics are very hectic and there isn’t much time to ask questions, so it’s important to take advantage of the quiet times.

Take home perspective on Med-into-Grad at UCSD: Overall, the MIG program was a unique and remarkable experience. Through my interactions with the physicians, pharmacologists, and patients, I gained a clinical perspective into the complicated nature of treating the morbidities involved in the Metabolic Syndrome. This experience will undoubtedly shape my future research goals. Ultimately, I’m still amazed that my clinical mentors were so accommodating and eager to discuss the complexities involved in clinical medicine. I will continue to recommend this program to many of my peers.