From basic science laboratory to Peruvian TB clinic: Scarlet Shell, UCSD doctoral candidate in Biomedical Sciences and graduate of the Med Into Grad program.
When Scarlet Shell leaves UCSD this year, she’ll have a new doctorate in biomedical sciences and an unforgettable grounding in the real world of infectious disease.
Deeply interested in tuberculosis diagnosis and treatment, she’s headed for postdoctoral research in a TB laboratory at Harvard.
And, thanks to the Med Into Grad program, she knows exactly what it’s like to diagnose and treat TB with scant resources, time-consuming tests, and trial-and-error antibiotic therapy.
Last year, UCSD’s Med Into Grad program took her to clinics and laboratories in Peru, where TB is a major health problem.
She accompanied healthcare workers to remote clinics, assisted Peruvian laboratory researchers, and met patients face to face.
“It makes it all real,” she says, “in a way that never quite happens from reading about it or hearing about it.”
Med Into Grad is a science education program that gives basic scientists a clinical experience during their doctoral training. The goal is to help medical researchers focus directly on improving patient care in their future work.
Each student is placed for three to six months in a clinical setting that matches his or her research interests.
“My Med Into Grad experience has provided a big picture view of the problem of TB and all its different facets,” Scarlet says.
“I think it’s important for setting research priorities: what questions can we ask to get the information we need to tackle this problem?”
She says the experience confirmed her decision to change her research focus and intensified her desire to find better ways to detect and treat TB.
“I was in the right place
at the right time –
or Med Into Grad was.”
Scarlet did most of her graduate studies in Dr. Richard Kolodner’s cancer research laboratory investigating DNA mismatch repair.
Dr. Kolodner is Professor of Medicine, Adjunct Professor of Cellular and Molecular Medicine and head of the Cancer Genetics program at the Moores UCSD Cancer Center.
As time went on, Scarlet became increasingly interested in infectious disease, particularly tuberculosis and malaria.
She read extensively about TB and decided she wanted to change her research focus, but didn’t know how the transition was going to happen.
Then she heard about Med Into Grad. “I was in the right place in the right time,” she says. “Or the Med Into Grad program was.”
Last April, she left her laboratory bench on the UCSD campus for Peru. The opportunity came through Dr. Joseph Vinetz, Professor of Medicine in the Division of Infectious Diseases at UCSD.
Dr. Vinetz is an expert in tropical infectious diseases including malaria and leptospirosis. In addition to his UCSD laboratory, he collaborates with Peruvian and other U.S. investigators in a lab in Iquitos, a rural city in the Peruvian Amazon rain forest.
Scarlet spent several weeks in Dr. Vinetz’s malaria laboratory in Iquitos.
She visited the local hospital with nurses and other health workers. There, she had her first up-close encounters with infectious disease patients.
“I got to see what kinds of diseases people came in for, how they were diagnosed, and how they were treated,” she said.
She went on to Lima, the capital city, where she worked in laboratories operated by collaborators of Dr. Vinetz under the auspices of the Universidad Peruana Cayetano Heredia.
The laboratories conduct basic and clinical research in improving TB diagnosis and drug sensitivity testing. The aim is to find techniques that do not require costly equipment or extensive resources, so that they can be used in underdeveloped countries.
“Being in that environment
made the barriers to treatment
Until she went to Peru, her career had involved an entirely different kind of interaction – with yeast, the organism used as a model system in her laboratory studies.
Now she had the chance to see how Peruvian mothers juggled transportation and child care issues as they went through the slow and arduous process of TB testing and treatment.
“Being in that environment made the barriers to treatment really obvious,” she says.
She watched how patients and doctors wrestled with logistics. TB diagnosis takes several clinic visits, and often takes many weeks. Drug therapy has to be given several times a week for at least 6 months.
“Most people don’t have cars,” she said. “The patients face choices day by day – do I go to the clinic for my treatment, or do I go to work?”
She saw how greatly the situation would improve if there were a way to diagnose TB more rapidly, and treat it with a shorter course of medicines.
In Lima, Scarlet took part in clinical research in the laboratory and she helped analyze a large database of experimental results from a clinical study.
She worked with Dr. Carlton A. Evans, an English infectious disease researcher from Imperial College London, who spends most of his time in the field in Peru.
Last November, she presented some of the Peruvian TB research data at the annual meeting of the American Society of Tropical Medicine and Hygiene in Philadelphia.
On to Harvard
with “another level of motivation”
At Harvard, Scarlet will choose her research studies in light of her Med Into Grad experience. She’s considering investigations of how TB evades the immune response to persist inside the host, or why treatment takes so long.
Med Into Grad has given her “another level of motivation,” she says.
It has also given her research connections and projects to help establish her career.
She helps with data analysis for the Lima laboratory on her own time now. It’s part of her own connection with a healthcare effort that has become personally significant to her.
“I got to see how they did what they do,” she says. “It was a really cool experience to actually get to participate.
“It makes it all real. TB is a disease that causes so much death and so many problems. There is a need for better diagnosis and better treatment.”
About Med Into Grad at UCSD
“The Med Into Grad program gives a basic science student the chance to witness firsthand the opportunities where science can improve clinical medicine,” says Dr. Ken Kaushansky.
Dr. Kaushansky and Dr. Mark P. Kamps are founders and co-directors of the Med Into Grad program at UCSD.
Dr. Kaushansky is Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine. Dr. Kamps is Professor and Director of the Graduate Program in the Department of Pathology.
UCSD is one of several leading universities to offer Med Into Grad. The program is funded by a science education grant from the Howard Hughes Medical Institute (HHMI), a nonprofit research institution.