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June 2010 Issue

Time spent as a CSA research fellow in emergency medicine has given Nitin Ubhayakar experience not commonly found in second-year students.
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Pre-Med School Experience Puts Student on Fast Track

By Katy Cosse
Published June 2010

As a second-year medical student, Nitin Ubhayakar already has quite the CV: one year participating in hospital-based research, two years as a counselor in UC Health University Hospital’s emergency department and now having his name in the pages of a major emergency medicine journal.

It’s the result of his time as a clinical study assistant (CSA) research fellow in UC’s emergency medicine department. Ubhayakar was the first fellow in the program, designed to expose students to research before they’re in medical school.

He completed the fellowship after graduating with a master’s degree in physiology at UC.

"We created the CSA fellowship to provide clinical research experience to students applying to medical school,” says Christopher Lindsell, PhD, director of research in emergency medicine.

"It’s an opportunity for students to develop an understanding of the clinical practice of emergency medicine as well as the theory and practice of research, all while interacting with patients, clinical staff and faculty.”

All fellows participate in a research education program, which covers designing a clinical study, writing the protocol, and eventually analyzing, interpreting and drafting the results for publication.

"It’s truly a unique experience,” says Ubhayakar. "I was able to work one-on-one with nationally recognized faculty while doing something clinically relevant in the emergency department.

Adding to that, the fellowship allowed me to attend the department’s grand rounds lectures so it was able to integrate everything related to what medicine’s all about.”

In his fellowship, Ubhayakar partnered with assistant professor Michael Lyons, MD, to design a new study within emergency medicine’s Early Intervention Program (EIP) HIV testing program.

The University Hospital-based program is one of just a few in the nation to offer free HIV testing to emergency department patients.

Ubhayakar looked to see if patients consenting to the HIV test were at more or less risk for the disease than patients who refused yet agreed to prevention counseling.

For 10 months, Ubhayakar participated in every aspect of the study, including serving as an EIP counselor, testing patients for HIV and providing risk reduction counseling. He liked the counseling so much, he continued with it through his first year of medical school.

"One of the first things you do in medical school is practice patient interviews—and I’d already done that with real patients,” he says.

The results of Ubhayakar’s study were published online March 26, 2010, in the American Journal of Emergency Medicine. They are expected to be published in the print edition this fall.

In the study, the research team found that there were no differences in risk of HIV between the patients who agreed to testing and those who did not.

"It tells us that new consent methods may be needed to promote testing among at-risk patients who decline to be tested,” says Ubhayakar.

"One of the main points that we found was that counseling and encouraging recognition of risk for those who declined testing doesn’t seem to do much in terms of changing patients’ minds to be tested.

Only four out of 60 patients we talked with decided to get testing after counseling.”

Ubhayakar presented his work at the 2008 National Summit on HIV Prevention, Diagnosis and Access to Care.

He still remembers the experience as "surreal.”

"You’re exposing your work, not just to other medical students and faculty, but to people who really matter in this field,” he says.

"I think that was the most rewarding experience of the fellowship, sharing our work with those who can use it to improve their own clinical practice.”

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