Physician-Scientists, Nurse-Innovators and Community- Shapers: A Student Research Highlight

competitive. There are also more applicants entering the pool each year as it has become increasingly popular for graduates of foreign medical schools to come to the U.S. for residency. However, this may change in the coming years because the USMLE Step 1, an allopathic board exam, has become pass/fail. The COMLEX, the osteopathic equivalent, will remain a scored exam.

The match process itself, and the unknown element introduced by all these changes, puts a lot of pressure on applicants. I certainly shed lots of tears over the process because it felt like my whole life had led to something over which I had no control. I want to reassure any applicants reading this, it truly is not as bad as it seems. My advice is this: choose one factor that is most important and use that as a framework. For me, this was location. My husband would remain in Maine during my residency so I limited myself to programs between Maine and New Jersey. Those applying to a more competitive specialty, like dermatology or ophthalmology, will need to be flexible and apply more broadly.

My own match day was bittersweet. UMass was not my first choice and matching here meant that I had to move away from my then fiancé. At first, I was upset and it felt like the end of the world. However, I am thriving here at UMass and have no regrets about matching. I fit in incredibly well with my co-residents and I have made life-long personal and professional relationships. I have gotten married and weathered a global pandemic. My training here has broadened my horizons and challenged me in ways that will ultimately make me a better, more independent, and skilled physician.

If you do not match, all is not lost. A medical school classmate of mine failed to match, waited a year, got married, and couples-matched with his wife. One of my best friends also did not match and had to scramble into a residency in a specialty she did not intend. Now, three years later, she has found her calling in critical care and could not picture herself doing OBGYN as she had originally thought.

All this is to say that you can trust the process. Even though it did not feel like it at the time, I matched into the program that was best for me and, if I had it to do over again, I would not change the outcome. It simply takes a little strategy and a little resilience for young doctors to end up exactly where they are supposed to be. + Kate Freeman, DO, is a third-year Internal Medicine resident at UMass Memorial Medical Center. Email: catherine.freeman@umassmemorial.org

Compiled by Alexandra Rabin, University of Massachusetts Medical School Class of 2022

Though the primary focus of medical and nursing school is the acquisition of knowledge and clinical training, many students make time for exciting research projects. Medical and nursing students have historically contributed avidly to research. The Islets of Langerhans, the cells within the pancreas that produce insulin, were discovered by Paul Langerhans in 1869 while still a medical student. The availability and diversity of student research has grown exponentially since, as students participate not only in basic science research, but also in community-oriented and public health projects. At UMass, students are privileged to conduct research with formal faculty mentors and are supported by residents, fellows, basic scientists and more. This section highlighting student research displays the breadth of subject matter and applicability — both to the clinical setting and to the community at large — of several such projects.

Effects of the COVID-19 Pandemic on Firearm Injuries and Community Firearm Ownership

Julia Sherman, University of Massachusetts Medical School, Class of 2022 Drs. Michael Hirsh (Principal Investigator, Pediatric Surgery Research Group) and Max Hazeltine (Pediatric Surgery Research Fellow)

Beyond the enormous human toll of COVID-19, we have yet to fully grasp the social and economic consequences of the pandemic. Our study aims to assess the effect of the COVID-19 pandemic on firearm-related violence. It will do so by comparing the sales of firearms, rates of firearm-related injuries and fatalities, and turnout for the Goods for Guns program during the pandemic compared to years prior to the pandemic. Since 2002, the Goods for Guns program has allowed participants to anonymously surrender firearms to various community sites in exchange for gift cards, with the aim of eliminating unwanted firearms from homes and raising community awareness about gun safety. This study will also assess demographic and clinical factors associated with firearm-related hospital admissions and emergency department visits during the pandemic compared to prior years.

The findings of this study may ultimately have important public health implications, furthering our understanding of the determinants that underlie firearm-related violence and how these can be addressed through injury prevention programs.

The Role of Mental Illness in the Association Between Chronic Pain and Suicidality

Zachary Michaels, University of Massachusetts Medical School, Class of 2022 Celine Larkin, Ph.D.; April Sawko, MPH, CHES; Joseph Davenport, B.A.; Rachel Davis-Martin, Ph.D.; Bo Wang, Ph.D.; and Edwin D. Boudreaux, Ph.D.

Using survey data from a study about mental health and suicide risk, I found patients who reported experiencing chronic pain were not necessarily more likely to report suicidal ideation or behavior, despite a well-documented interaction between the two variables in the literature. However, patients struggling with daily chronic pain were more likely to have mental illness affecting their daily life and mental illness had a significant association with recent passive suicidal ideation. It is my hope that this impacts patient care, particularly in the need to continue to be vigilant in assessing suicide risk in acute and outpatient settings, especially in populations experiencing chronic pain and mental illness. As a result, in addition to other suicidality-facing research, I have dedicated time to training in different forms of suicide risk assessment and management such as Collaborative Assessment and Management of Suicidality, or CAMS, and Counseling for Access to Lethal Means, or CALM, and encourage other clinicians to do the same if at all possible.

Reducing Inter-Stroke Center Transfer Time Through Utilization of the VAN Tool

Jessica Ferreira, DNP, AGACNP-BC; University of Massachusetts Graduate School of Nursing, Class of 2021 Henry Ellis DNP, AGACNP-BC

Emergent Large Vessel Occlusions, or ELVOs, are life-threatening ischemic strokes associated with the highest rates of morbidity, mortality and long-term disability among all strokes. They require rapid identification in order to initiate the multiple time-sensitive interventions necessary to maximize the likelihood of positive patient outcomes. Poor recognition of ELVOs in the emergency department leads to prolonged inpatient hospitalizations, increased risk of mortality and higher incidence and cost of long-term disability. Our quality improvement project aimed to improve nursing recognition of ELVOs through an educational module introducing the Vision, Aphasia and Neglect, or VAN, tool. Used as an adjunct to the clinical neurologic assessment, this tool was designed to enhance rapid identification of ELVOs. Our results proved that implementation of this tool improved nurse recognition of ELVOs in emergency departments. The results of this quality improvement study have led to a change in Milford Regional Medical Center’s emergency-department stroke algorithm. Now, when potential stroke patients arrive, nurses will complete a VAN assessment and communicate their findings to an MD, prior to the patient being transferred to CT, so that the MD can decide whether a CT angiogram (CTA) is warranted and can be done at the same time as the CT head. This new step in completing the VAN assessment could lead to a decrease in door-to-CTA and subsequent door-totransfer times for ELVO patients.

Julia Gordon Arrowood (1900-1984): A Brilliant Anesthesiologist and a Woman of Many Firsts in Medicine

Kevin Makhoul, University of Massachusetts Medical School, Class of 2023

In my first year of medical school, I came across a prospective request by my mentor, Dr. Desai. She was looking for a student to work on a history project about a notable anesthesiologist. I have always been something of a history buff, but I had never imagined I could incorporate two of my great interests in this way. Medical history is a field of research whose impact is easily underestimated. When we delve into these stories, we often unearth important events and ideas that predict and contextualize present realities of our fields of study. History is taught to be rigid and unchanging because we need reliable references to justify current practices, but many of our histories are altered, abridged or missing from our collective memory. Many professionals who have contributed so much to medicine are underrepresented due to social biases, and their stories deserve to be told. Julia Gordon Arrowood is one such professional. During a time when the proportion of female physicians was in steep decline due to a patriarchal backlash, she rose through the ranks to become the first female resident of anesthesiology in Massachusetts — as well as the first female chief of a department at Massachusetts General Hospital, in addition to other distinctions. She contributed much to the field through her research on local anesthesia, spinal block and muscle relaxants. While her male colleagues have received much attention, her story is only now being told in full. Not only does her story contribute to our medical knowledge and inform future studies, it also demonstrates the importance of diversity in leadership as a lasting bulwark against institutionalized discrimination in medicine and beyond.