Application Guidelines and Template for an Interventional Radiologist to Host a
Summer Medical Student Intern
The Society of Interventional Radiology Foundation is a not-for-profit organization
dedicated to fostering research in interventional radiology for the purposes of
advancing scientific knowledge, increasing the number of skilled investigators,
and developing innovative therapies that lead to improved patient care and
quality of life. The Foundation is committed to fostering the development and
enhancement of innovative, minimally invasive, image-guided therapies from
inception to mature clinical application and to conduct educational programs in
the service of its mission.
In alignment with its mission, the Foundation has created a summer medical
student internship program in order to orient medical students early in their
studies with research and development.
This application is for interventional radiologists who would like to apply to the
SIR Foundation in order to sponsor a medical student summer intern.
Eligibility:
The sponsor must be committed to teaching and mentoring a medical student
research intern during the summer months. Selected sponsors will be required
to sign a grant agreement.
Costs:
The SIR Foundation will provide a $4,500 stipend to the medical student for the
medical student’s living expenses.
Application Instructions and Criteria:
Institution Name: __________________MD Anderson Cancer
Center___________________
Responsible mentoring physician: Dr. Erik Cressman__________________
Length of proposed curriculum: The internship should be 8 weeks and at least 40
hours per week.
A. Please provide a brief description of how each of the following curriculum
elements will be demonstrated/taught through your program. Provide details of
the instructional setting and methodology (laboratory, classroom), description of
any educational resources (PowerPoint presentations, textbooks, selected
readings), and assessment techniques (question and answer sessions, tests) to
be used in the process of instruction:
Mandatory elements:
1. Concept development – distillation of a clinical question into elemental
components:
The student will learn about intrahepatic malignancies such as colorectal
carcinoma and hepatocellular carcinoma (HCC) through a multifaceted approach,
with the underlying question of how can we improve diagnosis, treatment, and
prognosis?. Included will be 1) observation of clinical cases at an internationally
known oncology center, 2) participation in weekly tumor conferences, 3) a
foundation literature on cancer in and of the liver, and treatment methods
including ablation and transarterial methods, 4) hands-on experience in a lab in
ultrasound-mediated imaging and therapy (Prof. Richard Bouchard) and weekly
group meetings, and 5) a research skills curriculum intended to serve as a tool
set for future educational and career needs. The skills curriculum will include
comprehensive literature searching and use of bibliographic software such as
OVID and EndNote, available online through the University of Texas system.
With a background in these areas, the student will then be able to develop a
sense of context for the nature of the problem and the opportunities to improve
on existing therapies. They will learn about the scope of the problem in terms of
epidemiology, radiologic manifestations, response evaluation criteria, clinical
course of the disease for individual patients, effect of comorbidities and need for
stratification, and the costs to society. The University of Texas MD Anderson
Cancer Center has an extensive online capability, as one would expect of any
large institution that will be available including online journals, searching
capabilities, and e-books for relevant readings.
2. Experimental design and statistics, including proof of concept, steps in
validation of new technique:
Through observation in an ongoing project on measuring the effects of focused
ultrasound in tissue using photoacoustic-ultrasonic (PAUS) imaging, the student
will learn about appropriately powering a study to see differences between
controls and experimental groups. Sample variation will be analyzed with
emphasis on time-intensity exposure profiles and inter- and intra-group variation.
Since this project is in the early stages, the student will see first-hand the effort
required in order to establish proof of concept. Proper use of controls for each
experiment will be emphasized. The student will then devise a hypothesis and
aims under the scope of focused ultrasound with relevance to liver malignancies.
Fresh degassed ex vivo tissues and ultrasound phantoms will be readily
available for use. The student will then perform experiments, determine and then
analyze the results.
3. Techniques in the basic science lab
High-intensity focused ultrasound (HIFU) combined with PAUS imaging will be
the basis for experimentation. The student will learn about ultrasound physics,
photoacoustics, and their function, application, and limitations. The student will
be exposed to the basics of ultrasound-mediated imaging, including transducer
phased array design, phantom development, basic image analysis, and image
registration to gross pathology, and the differences between diagnostic and
therapeutic transducers for image-guided noninvasive surgery. The student will
also be introduced to the time-tested attributes of ultrasonic imaging along with
the new and cutting-edge potential of photoacoustic imaging. Differences
between ablative techniques and low-intensity, mild hyperthermia techniques will
be emphasized. They will also learn about developing ultrasound techniques that
allow temperature measurement without the constraints imposed by MRI and in
ways to measure tissue changes in real time using the photoacoustic effect (i.e.,
probing molecular changes resulting from denaturation as a more direct
measurement of tissue damage). If interested, the student may also participate
with and learn about temperature imaging using MRI (proton resonance
frequency shift imaging) with Prof. Jason Stafford, an internationally known
expert in this field ,and thus be able to compare and contrast the methods.
4. Data collection, statistics, and meaningful analysis of data
HIFU and photoacoustic data will be collected regarding time/intensity profiles in
different tissues and correlated with changes observed in gross pathology.
Exposures will be analyzed by sectioning and digital imaging. Time/intensity that
exceeds a minimum thermal coagulation threshold without causing cavitation will
be of particular interest in determining which parameters have the greatest
effects. In concert with these efforts, simultaneous PAUS imaging will be
employed to optimize visualization of lesions as they form and before
overexposure occurs. Data analysis will be performed with existing MATLABbased processing software, will allow the student to easily calculate statistical
PAUS imaging metrics, including signal-to-noise ratio, contrast, and contrast-tonoise ratio, within a specified region of interest.
5. Constructing a well-written scientific paper
Suggested/optional elements:
1.
Clinical trials design and regulatory approval/obstacles/legal
considerations
These are early stage experiments. However, part of the curriculum will
cover an introduction to trials design and regulatory issues to provide
context.
2.
Design and conduct of animal research and observation of animal
research
These will likely be in vitro and ex vivo experiments. However, there will
be ongoing in vivo experiments in which the student will be encouraged
to observe and participate in to the maximum extent allowable under
institutional guidelines.
B. Please provide a brief outline of available research topics, one of which the
student will select for completion as part of the program. Projects should be of a
scope appropriate for completion within the limited time frame provided.
1) Focused ultrasound for tissue ablation in conjunction with PAUS thermal
imaging. Here the student will study the effects of different parameters on
temperature imaging, lesion configuration, gross pathology, and imaging.
2) Focused ultrasound for tissue ablation in conjunction with multiwavelength PAUS imaging for assessment of localized cell damage.
3) Focused ultrasound in conjunction with PAUS imaging for thermal
monitoring of non-ablative hyperthermia (i.e., for targeted delivery of
thermally sensitive drugs).
The student will be asked to make an oral presentation at the Medical Student
Brunch at the SIR Annual Scientific Meeting in 2016.