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Posted July 27, 2010 | comments Leave a comment

Trial run: Students help with hospital's clinical research

By Josette Keelor - jkeelor@nvdaily.com

WINCHESTER -- Normally she moves from one patient to another as she shadows physicians; she had not planned or expected to find out what would happen after the patient, who had been diagnosed with breast cancer, later returned for surgery.

"I shadowed Dr. Houck [III] about a month ago," said Chelsea Bradley. "That was when I first met the patient that had surgery with Dr. Minghini this morning, and then we followed the specimens down to pathology."

Though completely surprising, the experience was just another example of how the summer internship she had accepted was changing her life one day at a time.

"I really enjoyed being able to follow it step by step, because it put it in perspective."

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Bradley and Brittany Popko, summer interns with Valley Health at Winchester Medical Center, have an opportunity that few of their peers do -- the chance to gain knowledge about everything that goes on in a hospital, from birth until death.

They also get the unique opportunity to be involved with clinical research.

"This is not something that they get in medical school," said Jennifer Stanford, director of clinical research for Valley Health at Winchester Medical Center. "So this gives them a leg up [on other premed students]."

Besides being able to shadow other professionals like neurologists, obstetricians, pulmonologists and surgeons, Popko and Bradley, both premed students at Virginia Tech in Blacksburg, have been able to gain exposure to clinical research during their internships.

The students beat out 12 other applicants to earn the paid internship, Stanford said.

"It's a very competitive program," she said, because Valley Health takes only two summer interns each year. Despite the overwhelming wealth of knowledge and experience afforded to those selected, the program received few applicants. Nine of the 14 applicants were from Virginia Tech, conveying to Stanford that other schools failed to spread the word about the internship.

"They really get just this huge array of experience," she said. The benefits are endless.

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Now in its third year, the program began after Stanford started the clinical research department in Winchester six years ago following her move to the area from Dallas.
"Valley Health did not have a clinical research department," she said, and because she had seen success in similar programs elsewhere, she proposed beginning one at the medical center.

The clinical research department allows analysts within Valley Health to conduct studies on drugs and medical procedures in the process of being approved for national use, she said.

"Most of what we do are multicenter studies," she said, explaining that Winchester Medical Center is only one of several conducting similar studies in communities nationwide. Still, because typically only research hospitals conduct studies like these, this allows Winchester to treat patients it otherwise would not be able to.

"This sets us apart a little bit from other community hospitals," she said. "You don't have to go to Baltimore or D.C. to be involved in trials.

"[There have been] close to 100 different trials in the last six years through this office."

A drug goes through several stages of research before being approved for mass use, she said.

"Most of what we do is called Phase III research."

After the drug has been successfully tested on normal, healthy volunteers and then on a small number of patients with a disease it is believed to treat, Phase III begins.

Phase III covers "large, pivotal multicenter trials," Stanford said.

"I just thought it was a great program for the community, for the hospital to be involved in," she said.

The clinical research summer internship, sponsored by the Winchester Medical Center Foundation, makes a lot of the research possible because interns can help physicians who otherwise would not have time to contribute to the studies, she said.

It's a three-way win situation, helping interns gain firsthand experience in the medical field while also assisting physicians in their studies and helping treat patients with up-and-coming medical trials.

"It's good for the study, and it's good for Valley Health in the long run," Stanford said.

•••

They feel like they have seen it all this summer.

Bradley, who aspires to be an orthopedic surgeon, and Popko, whose passion lies in geriatrics, are keeping their options open after working alongside oncologists, pathologists, anesthesiologists and even pharmacists.

"I got to see a C-section yesterday," said Bradley, a senior biology major. It has been her favorite experience in the internship so far.

"It was incredible."

Understanding more about how life begins provides for her a much broader view of the scope of the medical field, she said. She has seen and heard many end-of-life conversations but was glad for the opportunity to witness the other end of the spectrum.

"Understanding all that makes you a more well-rounded medical student and physician," she said. "The internship has really opened my eyes to everything, but my interest is still in geriatrics and primary care. Considering the demographic changes in the next few years, there's a need. One in five by 2030 will be over the age of 65."

Bradley undoubtedly will use the knowledge she gained this summer in her later studies.
"There are geriatric patients in every specialty," she said. "I believe that [studying] under other specialties will help me to make decisions."

Popko, too, has viewed the medical world through various lenses over the last few weeks.
"Completely different than reading it in a book," said Popko, a junior biochemistry major.

"It's more than I expected."

The program has opened her mind to other options as well, though she still intends to pursue orthopedic surgery.

"I'm an athlete, so I'm really interested in orthopedics," she said.

Working with patients, especially when she can see the results of the tests and treatments, does not worry her.

"That's my favorite part of it, is actually working with people."


•••

"It's a great project; I mean it's a great opportunity for the students," said Dr. Lee Selznick, a neurosurgeon with Virginia Brain and Spine Center in Winchester. He and Dr. Paul Lyons, of Winchester Neurological Consultants, have been working with Bradley on an intractable epilepsy surgery research study this summer.

The patients have been referred to Selznick for epilepsy surgery based on the intractability of their seizures, Stanford said.

"Any time we start something new there's always an area to do research," Selznick said.

"The program's gone really well," Lyons said. "We've had really great outcomes."

Bradley has been compiling and studying results of functional neurosurgery on epilepsy patients who were suffering from seizures as often as every day, Lyons said.

"More than 90 percent are seizure-free," he said of those treated so far at Winchester Medical Center. "In some cases it's really transformed lives."

Of course, surgery is a last option for those suffering from epilepsy.

"The goal of the program is to do no harm, as it is in medicine," Lyons said. He ensures that when patients do decide to do surgery that "we're going to do it safely."

Popko has been working on colonoscopy miss rates with Dr. Nick Snow, a gastroenterologist with Winchester Gastroenterology. Their research is based around patients who are diagnosed with colon cancer fewer than five years after receiving a clean colonoscopy report.

"Catching colon cancer earlier so it's treatable" is the reason behind the study, he said.
"We think our miss rate is less than what literature is reporting," Stanford said. "We're just looking at our own miss rates here."

•••

Stanford believes that the clinical research internship will also aid the hospital in the future by spreading the word about the facility's work, drawing in doctors interested in participating in the studies as well as working with knowledgeable staff.

"We need good physicians to come here. ... Our medical staff here is top notch," she said.
"We all enjoy training future physicians," Lyons said.

"They get to talk to each of us and find out what our lives are like," Snow said. "When choosing a career, hopefully that'll help them."


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