By Lindsay Lennox
Medical Student Bryan Nyzcz conducting original research
in the lab of Daniel Frank, PhD. Photo by Diana Ir.
(November 2016) As an undergraduate, Bryan Nycz heard a guest lecture about the human
microbiome by Daniel Frank, PhD, an infectious diseases researcher at
the CU School of Medicine.
Now, Nycz, a second-year medical
student, is doing original research in Frank’s lab, aimed at uncovering
connections between the microbiome and the infections often experienced
by young leukemia patients during chemotherapy.
“What we’re doing
now is all exploratory,” says Nycz. “We’re not really sure what we’re
looking for yet, which I kind of enjoy: waiting to see what the data
tells us. It’s actually kind of cool to wonder, in the future will our
findings turn out to matter?”
Nycz is one of twelve students who,
after completing the first year of medical school, spent the summer
conducting original research at the University of Colorado.
As participants in the Department of Medicine’s Research
and Equity in Academic Medicine (DREAM) program, these emerging
second-year medical students are working with CU mentors to generate
research results and present – and in some cases even publish – their
In addition to Frank, an assistant professor in the
Department’s Division of Infectious Diseases, Nycz’s summer project also
allowed him to work with Samuel Dominguez, MD, PhD, associate
professor of pediatrics, studying young leukemia patients who get gut
infections during chemotherapy, to identify risk factors and preventive
“Medical school is very cut-and-dried,” says Nycz.
“It’s very structured compared to this research work, where we’re using
new tools, we’re improving them as we go, and no one knows how it’s
going to turn out.”
“The DREAM program is meant to give aspiring medical professionals the opportunity to see how research
is done, and to understand the potential impact of research,” says
David Schwartz, chair of the Department of Medicine, who launched the
program in 2011. “Not only does the program allow them to participate in
research, it also helps them understand the research enterprise, and
how that enterprise is intimately connected with the way we take care of
The program’s goals are to increase the pipeline of
physician-scientists and to increase the number of students in the
pipeline who are from backgrounds underrepresented in medicine. Even if
participating students do not pursue research-related careers, they
stand to become better physicians after their experience in the DREAM
DREAM participants select mentors and develop research
projects, which they conduct in their mentor’s laboratory for 10 weeks
over the summer. Students each receive a $3,000 stipend from the
Department of Medicine. At the end of the summer, they present their
work to their fellow DREAM program participants and at the Department of
Medicine’s annual Research Day. About a quarter of the participants
will eventually publish their results.
The DREAM program was developed in part because of data showing a
large decrease in the number of physician-scientists.
Physician-scientists facilitate a team approach to medical research, in
which clinical insight from caregivers at all levels is combined with
basic science research from multiple disciplines.
spent ten years studying clinical medicine and disease processes has
something to offer the research effort, and that’s the interface where
progress will be made,” says John Repine, MD, Waring Professor of
Medicine, who has led the program since 2013.
Many medical students see the advantages of combining research with the practice of medicine.
really like the idea of being able to attack a clinical issue from both
sides, working to improve the treatments at the same time as working to
help individual patients,” says Tessa Harland, who worked last summer
with Aviva Abosch, MD, PhD, professor of neurosurgery, on a project
focused on recording signals in parts of the brain associated with
movement, to help target electrode therapy for Parkinson’s disease.
June 2014 report from the National Institutes of Health (NIH)
Physician-Scientist Workforce Working Group indicated that only 1.5
percent of American physicians consider research to be a primary focus
area, and less than 1 percent are principal investigators on NIH grants.
During the past 20 years, the percentage of NIH awardees who are
physicians has declined to 30 percent. Additionally, the report found
that the average age of the physician-scientist workface is rising, as
younger researchers have not emerged in significant numbers, presaging a
demographic crisis as this workforce eventually ages out of active
research and clinical practice.
One reason for the decline is
that new MDs typically have substantial student loan debt. Establishing a
career as a research scientist takes time. According to the NIH, the
average age at which physician-scientist investigators receive their
first independent federal grant is 45.
“That’s all the more
reason we want to start students in research earlier,” says Repine.
“Getting early experience, publishing early papers, they can develop a
real interest in research that will help take them through that long
process, and maybe even accelerate it a little. Starting late is very
Brooke Bredbeck, MD, who participated in the DREAM
program in 2013 and graduated from the CU School of Medicine in 2016,
worked in the laboratory of Neda Rasouli, MD, associate professor of
medicine, exploring the connection between angiogenesis and insulin
sensitivity in an obese population, and later presented her results at
the Western Student Medical Research Forum.
“I think research in
an academic environment has the potential to be either a vicious cycle
or a virtuous one,” says Bredbeck. “If you’ve never had any research
experience, it’s much harder to ever get started working in a lab,
since you need quite a bit of training before you can really contribute
to the group. But if you do have any sort of research training, it
makes it much easier to get a research job even if the focus area is
completely different – they know you understand the different way things
work in a research environment.”
A more diverse workforce of physician-scientists
and ethnic minorities comprise over a quarter of the U.S. population,
but only 6 percent of practicing physicians are Latino, African-American
and Native American. The NIH Physician-Scientist Workforce Working
Group found similar numbers among physician-scientists, reporting that
approximately 75 percent of physicians who receive independent NIH
funding were white, another 20 percent were Asian, and the remaining 5
percent were Latino, African-American or Native American.
the diversity of researchers, especially those who also see patients
clinically, is an important step in addressing health disparities, and
asking research questions about medical issues that disproportionately
impact minorities. To address this gap, the DREAM program recruits
medical students from underrepresented backgrounds.
Not all DREAM
participants will ultimately go on to careers in research medicine,
Repine notes, but this first-hand exposure enables participants to read,
interpret and critically evaluate research findings on their own, which
in turn, makes them better physicians.
In addition, the program also helps prepare participants for competitive residency programs, and connects them with mentors.
mentorship is probably the most important thing I gained from the DREAM
experience,” says Quan Bui, MD ’16, who worked in the laboratory of
Mark Geraci, MD, on a pulmonary hypertension project that extended into
his third and fourth years of medical school. Geraci is the former head
of the Division of Pulmonary Sciences and Critical Care Medicine in the
Department of Medicine and now chair of the Department of Medicine at
“In addition to Dr. Geraci, who was and
continues to be a great mentor to me, I also met fellows and other
pulmonary researchers, which is important because in ten or fifteen
years, I see myself in academia. I know I want to teach, and in terms of
research, it might not be basic science research but I will certainly
continue some kind of research activities, probably on the clinical or