HHS surgical residents contribute to cutting-edge research
As a leading teaching hospital, Hamilton Health Sciences (HHS) welcomes about 250 new medical residents each year in partnership with McMaster University’s postgraduate medical education program. Combined with returning residents, this amounts to more than 1,200 residents working at HHS hospital sites at any one time. These new doctors spend two to six years or more in residency training, honing skills in the area of medicine they’re specializing in. Their contributions are essential to academic teaching hospitals like HHS, where they work as front-line providers for many patients, including round-the-clock shifts caring for in-patients.
HHS is also a top 10 Canadian research hospital, and residents interested in advancing health care through research have opportunities to work on studies with among the best investigators in the country, as well as lead their own research projects. Most HHS residents become involved in research or quality improvement projects as part of their training.
A passion for patient care and research
We’re pleased to introduce three senior surgical residents who, as well as caring for HHS patients, also contribute to leading-edge research. When their residencies are complete, they plan to work as surgeons as well as researchers, saving the lives of their patients while also exploring new and better treatments and cures to advance human health locally, nationally and globally.
“These individuals are already extremely busy training in highly specialized fields, yet they’re also dedicating time to leading-edge research projects,” says Dr. Alison Fox-Robichaud, director of medical education for HHS. Fox-Robichaud is a critical care physician, national sepsis expert and researcher at the Thrombosis & Atherosclerosis Research Institute (TaARI) of HHS and McMaster. She also holds the HHS chair in sepsis research.
“As someone who’s passionate about direct patient care and research, it’s extremely exciting and rewarding to support the next generation of clinician researchers,” says Fox-Robichaud.
Dr. Alison Michels, Fourth-year resident, vascular surgery
Dr. Alison Michels’ passion for research was sparked as an undergraduate, when she took part in studies about blood clots that block arteries, known as thrombosis. “This experience really shaped my view of research and how we can improve human health,” says Michels, who’s in her fourth year of a five-year vascular surgical residency and also has a PhD in molecular mechanisms of thrombosis. “The possibilities presented by research are exciting.”
Through her HHS residency, Michels met Fox-Robichaud who connected Michels to the TaARI research community. Michels discovered, through her own research project, that people with blood type O who experience an abdominal aortic aneurysm have less risk of clotting. An aneurysm is a bulging of a blood vessel wall, such as a vein or artery. If an aneurysm bursts, it can cause life-threatening internal bleeding. “An abdominal aortic aneurysm one of our vascular surgery emergencies that we fix for patients,” says Michels.
“The possibilities presented by research are exciting.”
Researchers know, from other studies, that patients with blood type O have a lower risk of artery and vein clots, says Michels. “But we don’t know how blood type influences the clot inside these aneurysms.”
Michels’ study looked at records from 150 HHS patients who underwent surgery to repair damage from an aneurysm. Specifically, the study looked at their blood type, and how much clot was inside their aneurysm.
“We found that there was less clot inside the aneurysms of patients with blood type O,” says Michels, who presented her findings at the Canadian Society for Vascular Surgery last fall.
“We think the clot inside the aneurysm plays a role in how fast the aneurysm grows and whether it ruptures, or parts break off and find their way into other arteries. By better understanding what contributes to a clot and its size, we believe that we can predict its growth and risk better, and help determine which patients need immediate surgery versus which ones may do better with regular monitoring.”
Dr. Veronica Stewart, Fourth-year resident, general surgery
As a child, Dr. Veronica Stewart dreamed of being the next Nancy Drew — Girl Detective. “I loved those books,” recalls Stewart, who’s in her fourth year of a five-year general surgery residency. “It was the first series I read from start to finish.” While sleuthing appealed to her, a career in policing didn’t. Instead, she became another type of investigator as a medical doctor with a passion for research.
“I’ve discovered through my residency that I’m passionate about research that puts patients first and hope to continue this work as part of my career going forward.”
“Medicine is a lot like detective work,” says Stewart, of piecing together a patient’s symptoms to determine a diagnosis and treatment plan. Research exploring leading-edge treatments and cures also satisfies her inner detective. She’s especially interested in sepsis research as this is a common, severe and sometimes overlooked complication experienced by general surgery patients.
Stewart connected with Fox-Robichaud, who is also the HHS chair in sepsis research and scientific director for Sepsis Canada. At Fox-Robichaud’s suggestion, Stewart is completing the Sepsis Canada Research Training Program, funded by the Canadian Institutes of Health Research (CIHR). The program is open to researchers, health care professionals, graduate students, postdoctoral fellows, patients and community members.
Stewart’s sepsis-related research work with TaARI is varied with a focus on surgical infections and post-sepsis recovery. The aim of her current project is to develop a registry of sepsis survivors, to help support improved follow-up care and a better quality of life.
“We’re building a database, to understand what life is like for sepsis survivors, and hopefully we’ll be able to provide them with interventions once we have this information,” says Stewart, who’s also auditing HHS in-hospital sepsis rates, reported to the Canadian Institute for Health Information, for comparison of HHS rates relative to the other acute care hospitals across the country.
“I’ve discovered through my residency that I’m passionate about research that puts patients first and hope to continue this work as part of my career going forward.”
Dr. Melissa Lannon, Fifth-year resident, neurosurgery
Dr. Melissa Lannon grew up in an isolated east-coast mining community several hours away from a large hospital like HHS. Community members needing to see a medical specialist at a large health care institution travel several hours for care, says Lannon, who is in her fifth year of a six-year neurosurgery residency and has a PhD in health research methodology.
“Equity is my touchstone.”
“I’ve always known that I wanted to be part of exciting new ideas through research, and bringing new treatments and cures to patients regardless of where in Canada they live,” says Lannon, who’s passionate about health-care equity.
“Every Canadian deserves access to the same basic care, including people in remote communities like the one I grew up in. For example, if my father or mother had an aneurysm and needed immediate surgery, they would never make it to a neurosurgeon in time because of where they live.”
One of the research projects she’s working on involves potentially developing a rapid, non-invasive test that could check for the likelihood of a ruptured aneurysm. If the test shows a strong indication of an aneurysm, the patient could be referred directly to a neurosurgeon at a major centre instead of waiting for additional tests, scans and consultations before a referral. This type of test could be a lifesaver by giving people in isolated communities faster access to a neurosurgeon.
Lannon is also researching deep brain stimulation to help patients with challenges like involuntary muscle contractions better control their movement. This includes a fellowship in functional and epilepsy surgery, focusing on using technology to modify the brain’s activity, giving patients some symptom relief from movement disorders, psychiatric disorders, and epilepsy.
While such leading-edge technology would be located at larger hospitals, she’s exploring ways to make it easier to access for all Canadians. And her PhD, which focused on needs assessment for deep brain stimulation related to movement disorders, across Canada, also involved a health-care equity lens.
“Equity is my touchstone. I always come back to this question – Is the research I’m doing going to help people across the country get the care they need in a timely way, regardless of where they live?,” says Lannon.
