Morgan Pence (morgan.pence@gmail.com)

Graduate Program:  Biomedical Sciences
Lab PI: Dr. Victor Nizet
Undergraduate Institution: University of Illinois at Urbana-Champaign
Med-into-Grad Clinical training area: Infectious Disease/Dermatology
Main clinical mentors:
Dr. Mary Bavaro
Dr. Susan Little   slittle@ucsd.edu
Dr. Rich Gallo   rgallo@ucsd.edu

Quote:   “Before my Med-into-Grad training, I wasn’t exactly sure what I wanted to do after finishing grad school, though I had a few ideas that I was contemplating. One of the ideas I had entertained was a career in Clinical Microbiology where I would eventually become the director of a microbiology lab in a hospital setting. Med-into-Grad helped me to confirm that this is in fact what I want to do, and I realized it was better suited for me than the other directions I had been considering."

Rational for Med-into-Grad training:
In my lab, I study virulence factors of Staphylococcus aureus and Streptococcus pyogenes to better understand innate immune resistance mechanisms utilized by the bacteria. Both S. aureus and S. pyogenes are major human pathogens, and methicilin-resistant S. aureus (MRSA) has become a severe problem in recent years, in both the U.S. and other areas of the world. After working with the bacteria, I became interested in the clinical manifestations of the diseases and wanted to obtain a better perspective of current treatments as well as how my lab’s research relates to disease management.

Medical training and identification of medically-relevant research issues: 
For infectious disease training, I was part of the infectious disease team at the VA for two weeks and subsequently at Hillcrest for two weeks. I also attended microbiology rounds three to four times a week and ID grand rounds weekly. The dermatology training differed greatly from the infectious disease training as all of the activities were outpatient as opposed to inpatient. I attended various outpatient clinics (general dermatology, pediatric dermatology and laser), Mohs surgery, dermatopatholgy sessions and dermatology grand rounds. All of these activities helped to give me a greater perspective of the different types of medical care that exist. Overall, I really enjoyed being able to interact with all of the attendings, fellows, residents, pharmacologists and medical students because it helped me to see the clinical side of things from different angles. I also enjoyed being able to talk with the patients and ask them questions to get a better idea of what it is like from their point of view, which is an important part of understanding disease as well.

Potential Research collaborations:
As I was involved in Med-into-Grad during my fifth year of grad school, I was already quite far along with my thesis work, and thus, I did not develop any new major collaborations. However, during one of the microbiology rounds sessions, we came across a very interesting isolate. It happened to be an unusual streptococcal strain, and Dr. Fierer, director of the microbiology lab at the VA, sent the strain back to the lab with me to investigate. I have since done a few experiments with the strain to characterize it.

Training in diagnostics & therapeutics, and identification of unmet diagnostic & therapeutic needs:
Diagnosis of infectious disease is done in the microbiology lab through a series of tests. Rapid tests have been developed for some infectious agents, but for the most part, it takes a day or more for bacterial cultures to grow, and an additional day to determine drug sensitivities, which slows down the diagnosis and effective treatment. Currently, there are many researchers looking into better and faster diagnostic methods, and this is something that will most certainly improve over time. Antibiotic resistance is a major therapeutic problem, and it is important to continually develop new antibiotics to combat this problem. However, antibiotic development isn’t as attractive as other therapeutics because it isn’t as profitable, so there isn’t as much progress as there could be.

Diagnosis of dermatological conditions is done by eye or by pathology and is very efficient. However, while diagnosis is proficient, there is still room for therapeutic development as not all patients respond to therapy or may develop severe side effects to current treatments.

Long term impact: 
The experience helped to really confirm the importance of biomedical research. Also, meeting the patients and realizing the limitations of medicine really put a perspective on what areas need to be researched most heavily.

Student-specific experiences:
Before the training, I wasn’t exactly sure what I wanted to do after finishing grad school, though I had a few ideas that I was contemplating. One of the ideas I had entertained was a career in Clinical Microbiology where I would eventually become the director of a microbiology lab in a hospital setting. Med-into-Grad helped me to confirm that this is in fact what I want to do, and I realized it was better suited for me than the other directions I had been considering.

Advice for new trainees--Autumn preparatory quarter:
I took the self-study histology course because I had already taken a full histology course as an undergrad. This was a great review for me, but someone who has never taken histology before may want to consider taking the course offered to the medical students. The other class that we took, Science Meets the Medical Patient, was a great way to get introduced to the clinical world as it combined patient interviews with a lecture on the science behind the disease. I thought it was an excellent course.

In addition to the courses, I also attended microbiology plate rounds at the VA as well as infectious disease grand rounds. The microbiology rounds were the more helpful of the two. ID grand rounds were a bit overwhelming at first because everything is in MD lingo, and no one explains anything in detail because everyone there understands. I would recommend taking notes and then going home and looking up things after each weekly meeting. This was very helpful, and I was able to grasp what was going on much faster this way.

Advice for new trainees—Winter clinical training quarter:
ASK QUESTIONS! All of the people I worked with were more than happy to answer questions, whether they were medical students, residents, fellows or attendings. (Attendings have more time than you think to answer questions, and at least the ones I encountered loved to teach!) Sure, you can go home and look things up, but I think asking questions is the best way to learn. Plus, the questions often lead to discussions on related topics, and you end up learning even more.

Secondly, tell people about the Med-into-Grad program and what you are doing. The doctors seemed excited to have someone with a more basic science background there and would ask a lot of questions about different concepts. Also, so many people were interested in what I do in the lab, and I had multiple discussions with people about ongoing research in the field.

Take home perspective on Med-into-Grad at UCSD: 
The Med-into-Grad training program is amazing, and we are extremely lucky to have such a program at UCSD. Most graduate students will never have this kind of opportunity. I would highly recommend this program to anyone who is interested in biomedical research and experiencing the clinical side of disease. It will definitely impact your life and research in a positive way!