Faculty Provide Summer Students with Valuable Research Opportunities

• Lauren Clarfield supervised by Dr. Sarah Ferguson

• Noroh Dakim supervised by Dr. Anne Berndl

• Natasha Dhingra supervised by Dr. Rachel Spitzer

• Susan Dong supervised by Dr. Paulina Cybulska

• Leah Drost supervised by Dr. Claire Jones

• Cara Elliott supervised by Dr. Lindsay Shirreff

• Rachel Lee supervised by Dr. John Snelgrove

• Madalina Maxim supervised by Dr. Crystal Chan

• Natalie Phung supervised by Dr. Wendy Wolfman

• Lyon Qiao supervised by Dr. Nucelio Lemos

• Leonor Separi supervised by Dr. Sebastian Hobson

• Harris Sheikh supervised by Dr. Colleen McDermott

• Melissa Tigert supervised by Dr. Lilian Gien

• Jane Zhu supervised by Dr. Tomer Feigenberg

• Julia Dmytryshyn supervised by Dr. Amanda Selk

• Fabiana Ferreira supervised by Dr. Nir Melamed

• Abirami Kirubarajan supervised by Dr. Sony Sierra

• Xinglin Lyn Li supervised by Dr. Patricia Lee

• Victoria Mintsopoulos supervised by Dr. Liat Hogen

• Darian Perruzza supervised by Dr. Rose Kung

Lauren Clarfield supervised by Dr. Sarah Ferguson

This summer I had the privilege of working with Dr. Sarah Ferguson on a systematic review investigating sentinel lymph node biopsy versus complete lymphadenectomy in high-grade endometrial cancer. The objective of the study was to determine whether sentinel lymph node biopsy is a suitable replacement diagnostic staging tool for high-grade endometrial cancer patients, in the context of common negative outcomes related to complete lymphadenectomy including lymphoedema. I took part in the systematic review from level 2 screening through to data extraction, risk of bias assessment and manuscript writing. I thoroughly enjoyed working with this research team and am grateful for the opportunity to have done so!

One of my favourite takeaways from this summer’s CREMs project was my exposure to incorporating quality of life considerations in treatment plans and research. Despite pelvic lymphadenectomy being known to be an effective staging tool, this review sought to explore whether an alternative method of staging with lesser negative outcomes on quality of life might also be appropriate. My medical learning thus far has been primarily focused on diagnosis and prolonging life, however, working on this project has highlighted for me the importance of considering quality of life in patient care moving forward. In addition, I was able to learn valuable systematic review skills which will enable me to carry out future projects in this realm.  Finally, while having prior exposure to obstetrics and gynaecology research, this project enabled me to gain exciting exposure to the field of gynaecologic oncology. Ultimately, this was an awesome summer experience and I feel privileged to have worked under Dr. Ferguson and her research team, while solidifying my passion for ObGyn, and specifically gynaecologic oncology, as a specialty. This was an invaluable opportunity to understand, actualize and disseminate scientific ideas that form the basis of a career in medicine. 

Noroh Dakim supervised by Dr. Anne Berndl

The goal of my research project this summer was to investigate reproductive and pregnancy outcomes in women with spina bifida. Women with spina bifida appear to undergo more caesarean sections compared to women without spina bifida, however, the reason for this has not been elucidated. Therefore, this summer, I examined the indications for caesarean sections in women with spina bifida. This project was part of an international study that distributed online anonymous questionnaires to women with spina bifida across various countries. I contributed to this project by analyzing data and extracting pertinent information collected from participants. I created charts, graphs and tables summarizing our key findings. I also wrote and submitted reports for publication. The results from this study revealed some of the pregnancy concerns and challenges faced by women with spina bifida. Our findings also highlighted some of the gaps in the management of reproductive health in women with spina bifida.

At the beginning of medical school, one of the questions I dreaded being asked was “what specialty are you interested in?” My answer to this question always sounded like a never-ending chaotic list of all the specialties listed on the CaRMS website. As the first year of medical school progressed, I explored several specialties through shadowing, interest group nights and information sessions. With time, I realized that I gravitated towards surgical specialties. Unfortunately, I was still conflicted as some of my core passions - equity and advocacy - did not appear to be well represented in surgical specialties. This CREMS program, however, offered me a different perspective. Investigating modes of delivery in women with physical disabilities demonstrated to me that advocacy and surgery can co-exist. Additionally, working with a supervisor, who has dedicated a major part of their clinical and research career to reproductive care in women with physical disabilities, reinforced the idea that I can choose to make advocacy work my central focus, irrespective of specialty.  This summer was special because I no longer dread being asked my specialty of interest. I am grateful for this opportunity, because I enhanced my research skills and garnered a deeper understanding of the clinical and research opportunities ObGyn has to offer. ObGyn is truly one of those specialties where surgery and advocacy intersect.

Natasha Dhingra supervised by Dr. Rachel Spitzer

The first research project I have been working on is titled “Short- and Long-Term Implications of Second Trimester Dilation and Evacuation – A Retrospective Cohort Analysis”. This is a multidisciplinary collaboration, and the primary objective is to assess the outcomes of second trimester D&E amongst patients with prior maternal illnesses or fetal diagnoses at Mount Sinai Hospital. I completed a literature review to help develop our research questions, sought feedback on the protocol from various colleagues, and am now in the final stages of drafting the REB application. I have also been working with Drs. Spitzer and Miller on drafting a webpage document for the Society of Obstetricians and Gynaecologists of Canada, titled “Reproductive Care for Newcomers to Canada”. The aim of this resource is to better equip physicians in addressing the needs of new immigrants and refugees, by providing information on areas ranging from clinical screening recommendations to healthcare coverage plans. We have likewise been working on documents supporting the fertility needs of this patient population. I look forward to contributing to the "Retrospective Review of Patients Referred to the Women’s College Hospital Women's Equity Clinic" project, which has been under REB amendment review this summer. The project aims to describe the needs and experiences of underserved and refugee patients referred to the WEC for gynaecological care. Finally, I participated and presented at the weekly obstetrics and gynaecology journal club “learn-in” meetings initiated by Dr. Spitzer; this group included students and healthcare providers both in Toronto and Kenya.

My work this summer has been extremely valuable in exposing me to areas of academic research that have built upon my previous experiences and education. Specifically, I am very passionate about global health, women’s health and health policy. Prior to starting medical school, I completed an internship at the World Health Organization in Geneva as part of the Country Cooperation Unit; my main project was an inter-departmental initiative focused on developing abortion programs in LICs. After this internship, I was very interested in learning more about the clinical aspects of women’s health. The development of the D&E project proposal, with the support of such diverse and skilled physicians, has really further supported my academic interest in learning about methods to address complex clinical cases. Indeed, global health impacts us at both an international and domestic level; the SOGC project reinforced my passion for global health research by looking at issues that impact women locally. Finally, Dr. Spitzer and her colleagues have provided incredible mentorship, and have exposed me to valuable skills in medicine which I hope to emulate as a physician in the future. For example, the team demonstrated the skills of flexibility and adaptability remarkably in the process of conducting research during the pandemic. Also, the importance of being an effective team-player and collaborator was emphasized in all projects, and was key to improving and moving initiatives forwards. Overall, it was an incredible CREMS experience that has shaped my professional and academic aspirations!

Susan Dong supervised by Dr. Paulina Cybulska

This summer, I had the amazing opportunity to work with Dr. Paulina Cybulska, a gynaecologic oncologist at Princess Margaret Cancer Centre.  Together, we worked on two cohort studies in elderly women with endometrial and ovarian cancer. The incidence of these two gynaecological malignancies increases with age, but we see older patients tend to perform poorer and are more likely to receive modified and less-aggressive treatment modalities compared to their younger counterparts. There is a paucity for standardized treatment algorithms for the care of elderly patients, and we must be careful not to rely on a patient’s age as the sole consideration in tailoring care. We wanted to look at differences in treatment, perioperative complications and survival outcomes, and whether any of the comprehensive baseline functional and demographic factors we collected could have a bearing on these outcomes. Ultimately, we hope results of our work can contribute to describing and defining the unique challenges faced by elderly women during their cancer treatment, pave way for opportunities in perioperative optimization, and aide in the development and implementation of a program tailored to addressing the unique needs of our elderly population.

All of our work took place virtually this summer, but Dr. Cybulska ensured I had a rich and meaningful learning experience, nonetheless. Through our countless Zoom meetings, I became more familiar with the work of a gynaecological oncologist, and the village of interdisciplinary providers involved in the scope of care: from community providers who first notices a bump during a routine physical exam, to the geriatric oncologists who conducts a detailed functional assessment and makes recommendations for tailoring care, to the radiation oncologist who provides and carefully monitors daily doses of radiation treatment, and many more. I am excited to apply what I have learned both about the field of gynaecological oncology, and the importance of patient centered care to my future clinical endeavors and beyond! I am grateful to the CREMS Summer Student Program, the Lela Parlow Memorial Cancer Research Fellowship, and the Department of Obstetrics and Gynaecology for this opportunity. And finally, thank you Dr. Cybulska for the mentorship and learning opportunities I received this summer!

Leah Drost supervised by Dr. Claire Jones

The research projects I worked on this summer were two qualitative needs assessment studies on egg freezing: one exploring elective (“social”) egg freezing in women seeking to delay childbearing, and the other exploring egg freezing in the context of preserving fertility prior to risk-reducing salpingo-oopherectomy after a BRCA mutation diagnosis. In both contexts, making a decision about egg freezing can be difficult for patients, and supporting these decisions can be challenging for the providers caring for them. Therefore, both projects aimed to explore the deliberations and considerations that go into these decisions about egg freezing; we also aimed to identify gaps in decision support. Each project involved semi-structured interviews with patients who had gone through making these decisions, and with healthcare providers supporting them. In my role, I recruited many of the participants (emailing healthcare providers, calling patients who had been identified previously), and conducted many of the provider and patient interviews over the phone for both projects, after which I transcribed the interviews into text. Later in the summer once we had reached data saturation, I conducted qualitative coding for both projects. Finally, I helped write the manuscripts for both projects and will continue to be involved in authorship of future papers from these projects as I return to school.

My involvement in the CREMS program this past summer has affected my career trajectory in numerous ways, influencing both my interest in research as well as my decisions about specialties. First, although I had previous quantitative research experience, I had never been so involved in qualitative research, and I discovered this summer how much I enjoy the process and outcomes of this type of research. I am inspired to conduct qualitative research in the future as a physician, as I have now been exposed to its importance and impact in a way I never had been before. Secondly, and more significantly, my experience this summer has really encouraged me that ObGyn is the specialty that I can most see myself in. Although I have been interested in the field for some time, having the opportunity to immerse myself in it through research this summer was extremely influential and truly gave me clarity that it is a specialty I would love to practice someday. Furthermore, working closely with both a staff and a resident physician in ObGyn through these projects gave me unique insight into the field that I may never have had otherwise. I learned a great deal working with both of these inspiring physicians, and the career advice and mentorship they both gave me over the summer was instrumental in helping me think about my career trajectory and what type of physician I see myself becoming. I am very grateful to have had this amazing opportunity this summer!

Cara Elliott supervised by Dr. Lindsay Shirreff

This summer, I worked primarily with Dr. Lindsay Shirreff on the Surgical Gynaecology Scorecard project, a quality improvement initiative based out of Mount Sinai Hospital. Scorecard is a database of over 4000 hysterectomies performed by ~100 surgeons from Southern Ontario hospitals. Information from this database is compiled into a scorecard of hysterectomy metrics and distributed to surgeons biannually for quality improvement. It can also be used for research purposes, as it is an up-to-date, large, high-quality database of Canadian gynaecological surgery cases. As a CREMS student, I completed data input and analysis for two separate studies affiliated with Scorecard. In the first project, I inputted retrospective hysterectomy operative room time data from Health Canada into the Scorecard database. This data will be used to compare incision and closure times across different procedures, surgical training, and surgical indications. I was then given the opportunity to take the lead on a second project which compared the rate of hysterectomies for benign indications to the post-operative pathology report of unexpected malignancies. To do so, I was tasked with finalizing the literature review, creating a statistical plan to collaborate with a statistician, analyzing the data, and writing up the results for publication. To-date, no Canadian data on this topic exists, and we hope that our results will guide pre-operative patient counselling and intraoperative procedural planning. We anticipate this project will be published in late 2020.

My work this summer as a CREMS student with the Department of Obstetrics and Gynaecology solidified my passion for ObGyn as a career path. My research required me to have access to gynaecological patient charts, allowing me to read real clinical cases and understand the indications, complications, and logistical planning around hysterectomies. Under the guidance of Dr. Shirreff and Dr. Murji, I was also able to comprehensively learn about the subtypes of gynaecological cancers and their respective staging and scoring systems, prevalence, and prognoses. Not only did this confirm my interest in the medicine of ObGyn, I was reminded of how much of a privilege it is to service women with simple to complex indications for hysterectomies and the vast difference such a procedure may have on their quality of life. Moreover, this experience helped me appreciate the interdisciplinary nature of clinical research and experience first-hand how creating a skilled team from across different fields allows for the creation high-quality, robust, scientific research. The entire research team was wildly impressive, from their intelligence, enthusiasm for research and medicine, to their unbounding empathy and flexibility. The welcoming and supportive environment fostered by Dr. Shirreff and her team has set high expectations for standard of work environment I would like to participate in and contribute to.  Especially during the uncertainty and the stress of COVID, I feel very fortunate to have been a part of such an amazing team, and for all the mentorship and guidance I received.

Rachel Lee supervised by Dr. John Snelgrove

This summer I had the pleasure of working with Dr. Snelgrove to study the effects of marginal placental cord insertion on birthweight and fetal growth in IVF pregnancies. I started by designing database search strategies to conduct a literature review. This allowed me to familiarize myself with the existing body of work and envision the design of our project. While constructing our data analysis plan, I learned how to identify the demographic variables and covariates that will be critical to accurately analyzing the data. I was also able to use what I learned in my literature review to highlight important outcomes to include in our study. Experiencing first-hand the meticulous work involved in designing a sound project taught me to appreciate clinical research that much more. Furthermore, I was able to develop my written communication skills by drafting the introduction for the manuscript. This was a great opportunity to consolidate what I had learned in my literature review and present it in a coherent and concise format. Overall, my CREMS experience this summer has given me many transferrable skills, and I am looking forward to sharing our work at the 2021 Medical Student Research Day.

As a medical student, the CREMS program has given me important exposure to academic medicine and its role in influencing medical practice. By participating in clinical research, I was able to see how patient data is transformed into meaningful conclusions about health, disease, or the healthcare system. As a future medical professional, it is important to understand how individual patient interactions contribute to promoting the health of a community. Through my experience, I gained valuable insight into how the medical profession cultivates and propagates knowledge in order to improve the care we deliver to patients and their families. The CREMS program has also given me a wonderful mentor. Whether it was a research question or career advice, Dr. Snelgrove’s guidance was always exceedingly kind and sincere. He prioritized my personal goals for the summer and helped me achieve them. It was such a pleasure to learn from a skilled clinician who is committed to his patients, as well as his research and education responsibilities.

Madalina Maxim supervised by Dr. Crystal Chan

I had the opportunity to work on a few projects with my research team. The main project I was responsible for was a retrospective chart review surrounding adenomyosis and donor egg transfer outcomes. The goal of the study was to determine the prevalence of signs of adenomyosis on ultrasound in the population receiving donor egg transfer and to see if there were any associations between adenomyosis and transfer outcome (ie. live birth, pregnancy, miscarriage rate). I was responsible for collecting the data points and organizing them into a chart, and I will be contributing to the data analysis and writing phase of the project. Additionally, I was working on a survey study whose goal was to determine the perceptions and strategies of Canadian gynaecologists in regard to adenomyosis. I collected the data, analysed it, and contributed to the writing of the manuscript. Lastly, I wrote a review on adenomyosis targeting the primary physician. This review focuses on pathogenesis, prevalence, diagnosis, and management and will be sent for publication soon.

This summer project was my first interaction with the world of clinical research. In my undergrad, I was mostly involved in wet lab research and I wanted to experience what a more clinical perspective would be like. This project and my amazing supervisors taught me an exceptional amount when it comes to the world of clinical research. They re-sparked my interest in research as a part of my medical career, and showed me that it was possible, and quite rewarding, to be involved in both. I have found that my research interests lie in clinically applicable patient-centered topics and I am excited to see how I can integrate research into my career. Not only that, but this summer project helped solidify my interest in obstetrics and gynaecology as a career. Although I did not have the opportunity to have many in person experiences with patients, my supervisors taught me about their day to day, told stories about patient interactions, and really helped me get a gauge of this awesome and intriguing field. I look forward to continuing my work with this research team and to learning even more about clinical research in the world of ObGyn.

Natalie Phung supervised by Dr. Wendy Wolfman

This summer, I had the exciting opportunity of working with Dr. Wolfman on a project exploring whether cannabis safely improves symptoms of menopause. This project was initiated given the sparse literature on associations between cannabis and menopausal women as well as the notable increases in patients of Mount Sinai’s menopause clinic who report using cannabis to alleviate their menopausal symptoms. My contributions to this project were two-fold. First, I completed literature searches to better understand our field of study, clarified our study methodology, and ultimately, supported the completion of our study’s research ethics board application. Secondly, I worked with our team to begin a formal systematic review to thoroughly explore what studies have examined the impact of cannabis use on menopausal symptoms in peri- and/or post-menopausal women. With guidance from my team (i.e. Dr. Wolfman, Dr. Murphy, Dr. Gomez, and Ms. Philippopoulos), I created our systematic review protocol. Specifically, I formulated our research question, defined the inclusion and exclusion criteria, and created the appropriate search strategy. I then screened the located studies based on our eligibility criteria, extracted the data of the included studies, and worked on assessing study quality. We are currently in the process of analyzing and interpreting study results and writing the manuscript.

The CREMS program allowed me to further explore obstetrics and gynaecology, gain insight into its various specialties, and discover the abundance and diversity of research prospects in this field. Although I always had an interest and considered entering the field of ObGyn for my medical career, my previous research interests lied predominantly in mental health/illness. Through my CREMS project, I was able to bridge my research and medical interests by exploring the physical and emotional effects of using cannabis on menopausal symptoms for peri- and post-menopausal women. Furthermore, my supervisor provided me with virtual educational opportunities to learn more about the various aspects and impacts of working as an ObGyn, particularly in her specialized field of menopause and mature women’s health. I also had the opportunity to meet, learn, and network with various other professionals who worked in similar areas. The work I completed this summer not only improved my research skills and competence, but more importantly, broadened my understanding and increased my interest in the field of ObGyn. Ultimately, the CREMS program was a fun and highly rewarding experience that has significantly impacted my medical and research interests and my career trajectory.

Lyon Qiao supervised by Dr. Nucelio Lemos

This summer, I worked with Dr. Lemos and his clinical research team to identify, measure, and compare the clinical outcomes of patients diagnosed with intrapelvic nerve entrapment and treated with laparoscopic neuronavigation surgery. Building on the work of previous medical students, I extracted clinical data from patient clinical questionnaire responses stored in an online database. To enhance the overall quality of the clinical data collected from patients, I assisted in the redesign of a new patient clinical questionnaire that included menstrual and obstetrical history and new patient-centric privacy disclaimers. Given the need to streamline our research workflow, we aimed to develop a new research database using RedCap; I assisted with debugging and validating the database in collaboration with another research assistant. By the end of the summer, I had begun entering patient data collected prior to the development of the new database into RedCap and aim to complete a preliminary analysis of the data once the dataset is complete.

Beyond providing me with a broader understanding of clinical research methodology and questionnaire design, this CREMS experience helped me gain an appreciation of the administrative processes involved in clinical research, including navigating the research ethics board and collaborating with the Privacy Office. The almost-daily research challenges made this experience enriching and exciting. Most importantly, this research experience provided me with an opportunity to learn more about how patients may perceive clinical research and the specific language that we as researchers employ; stated otherwise, it is important to consider how language can be tailored, especially around sensitive topics, including sexual function. As a hopeful clinician-scientist, I hope to continue applying these lessons throughout my future career. I am appreciative of the CREMS program for providing me with an opportunity to continue exploring my career interests in obstetrics and gynaecology through research.

Leonor Separi supervised by Dr. Sebastian Hobson

This summer I had the privilege of working with Dr. Sebastian Hobson on a study developing a novel MRI and ultrasound-based scoring system to diagnose and risk-stratify Placenta Accreta Spectrum Disorder (PASD). PASD is an iatrogenic condition that results when trauma to the uterine lining, like from a previous caesarean section, compromises the decidua’s integrity and allows an overlying placenta to anchor itself inappropriately in the myometrium. In severe cases, the placenta can penetrate the uterus and attach to surrounding viscera. PASD is on the rise given the increase in caesarean deliveries and poses potential significant maternal complications, including massive postpartum haemorrhage and damage to surrounding organs/vessels. Prenatal detection of PASD is crucial to reducing maternal and fetal morbidity and mortality and has hitherto mainly relied on ultrasound with some use of MRI. Despite many studies investigating the effectiveness of these modalities, few have assessed their combined effectiveness. This 11-year retrospective cohort study aims to develop a detailed and comprehensive scoring algorithm that integrates both ultrasound and MRI. The goal is to generate a sensitive tool for PASD detection capable of differentiating the three classic subtypes of PASD invasiveness—a task that has proven difficult to perform prenatally with current tools but would prove beneficial as it could help direct pre-operative planning. I conducted a literature review and a chart review for our patient cohort. I then input scores from case and control ultrasound assessments into our database and coded this data for statistical analysis to be conducted this fall.

My experience on the PASD project was exciting and enlightening! The mentorship of Dr. Hobson was invaluable for learning about maternal-fetal medicine and clinical research. I come from a pure basic-research background, so it was rewarding to contribute to a body of work with direct clinical application. The perspectives that I’ve gained from clinical and basic science research will help me significantly in my future career, whether I am at the bench or bedside. I want to thank Dr. Hobson and Anjana Chandran, the amazing research coordinator on this project, for fostering a positive environment where I always felt supported, encouraged, and heard. I am excited to continue to contribute to this and additional projects over the coming year! I also wanted to acknowledge that this summer was unlike anything we could have expected. The COVID-19 pandemic has had a profound impact on patients, staff, and learners—for a while it seemed that CREMS programs might not have been available. To this, I want to thank everyone who worked hard to make this program a reality this year. Although students couldn’t go into the clinic or OR, having the opportunity to work on a project for the ObGyn Department and make a small clinical contribution in a time where learners can feel out of place in a clinical setting has been incredibly motivating and uplifting.

Harris Sheikh supervised by Dr. Colleen McDermott

This summer I had the wonderful opportunity to work with Dr. Colleen McDermott on a research project evaluating the cost-effectiveness of common bladder catheterization strategies to address acute urinary retention for patients who have undergone pelvic organ prolapse surgery. A large percentage of patients develop acute urinary retention following pelvic organ prolapse surgery; these patients often require some form of bladder catheterization in the acute post-operative period. My role was to determine the costs associated with each form of bladder catheterization, including equipment costs, nursing costs, clinic costs, and any costs that may be incurred to the patient. The comparisons were also conducted across sites in various clinical settings, such as the operating room, the ward and the clinic. We hope that our study will help better elucidate for stakeholders the benefits and risks associated with different catheterization strategies. Ultimately, our goal is to inform the patients’ decision-making process and improve their overall experience.

The CREMS program allowed me to transition from my basic science background in organic synthesis to clinical research; I am thankful to my amazing colleagues, Anouk Benseler and Eliya Zhao, for making this an easy transition and all their contributions to the project. I am incredibly grateful to have had the privilege to learn from Dr. McDermott and have her as a resource for not only career advice, but also for mentorship for life outside of work. Working alongside such a dedicated team has been an honour and their passion has been contagious. As an MD/MEng student, I am thrilled to have had the chance to learn more about medical devices and further refine my coding skills. My outstanding experience with CREMS this summer has only increased my interest in the project and the specialty of urogynaecology itself.

Melissa Tigert supervised by Dr. Lilian Gien

This summer, I had the wonderful opportunity to assist with a research project investigating the ability of sentinel lymph node frozen sections to predict the final pathology of these nodes in patients with vulvar cancer. In addition, the project’s secondary objective is to determine whether the accuracy of these frozen sections has an impact on morbidity, such as additional visits to the operating room for further surgical resection or full inguinofemoral lymph node dissection and cancer recurrence. We are also exploring the impact of these frozen sections predictive ability on overall survival. I was responsible for data extraction from the charts, organizing the data, and assisting with preliminary statistical analyses.

I am extremely grateful for the opportunity to engage in gynaecologic oncology research which has been a fantastic learning experience both content wise and also from a research perspective. I have been able to participate in all components of the project so far and have gained a fantastic sense of the planning, execution, and deliverable preparation for a retrospective chart review. In addition, I have gained exposure to the intricacies of managing vulvar cancer, and the severe impact it can have on one’s life. As we have little exposure to vulvar cancer in the pre-clerkship curriculum, this was an exceptional way for me to ask questions, learn about cancer staging, management, and also about the inter-specialty teams that can be part of a single patient’s cancer journey. I have gained a vast amount of knowledge from discussions with Dr. Gien, my supervisor, as well as from independent research on the topic. I believe that this research experience has solidified my interest in continuing to seek out a career in Obstetrics and Gynaecology, as well as renewed my excitement regarding research within the field. I have gained important insight into how I can continue to incorporate research into my remaining educational career and the role that I would like it to play in my future.

Jane Zhu supervised by Dr. Tomer Feigenberg

This summer, I had the opportunity to work on a project titled “The impact of minimally invasive surgery for the management of advanced stage ovarian cancer." Ovarian cancer, particularly epithelial ovarian cancer, accounts for the highest fatality ratio of gynaecological cancers in the developed world. Recently, the use of minimally invasive surgery (MIS), including laparoscopy and robotics, has become increasingly prevalent in the management of early ovarian cancers. However, the lack of data surrounding the use of MIS in advanced stage ovarian cancer has limited its potential use in many centres.  With this in mind, the goal of my project was to evaluate the impact of MIS in the management of patients with stage III-IV ovarian cancer. This was performed through a multi-centre, retrospective, non-randomized trial which seeks to compare data between two centres (Sunnybrook Health Sciences Centre and Trillium Health Partners) with different approaches to MIS in the context of advanced-stage ovarian cancer.  My primary tasks for the summer were to (1) review all patients who had surgical procedures performed by a gyn-oncologist to assess for eligibility for inclusion in the study, and (2) to extract data from patient files. This data included information about procedure lengths, intra and post-operative complications, conversion rates, length of hospital stay, and other factors. While I mostly focused on reviewing files and extracting data at Credit Valley Hospital this summer, the ultimate goal is to complete similar data collection from Sunnybrook and compare results to produce a presentation and manuscript.

The CREMS program has provided funding for me to perform retrospective data extraction and analysis of outcomes for patients diagnosed with advanced-stage ovarian cancer, with the goal of comparing data across multiple centres to evaluate the impact of MIS on the management of these patients. I hope that this work will result in valuable information on the future treatment of patients with advanced-stage ovarian cancer, and eventually, contribute to better outcomes for those battling the disease. Personally, this work has greatly expanded my knowledge of this field and has allowed me to develop valuable data analysis and extraction skills that will be invaluable in my future career as a student, and as a clinician. I am extremely grateful for the opportunity to perform this research, and to have develop valuable skills in chart review, data extraction, and analysis. This opportunity has not only honed my research skills, but has also provided exposure to a field which combines a multitude of my medical interests - obstetrics and gynaecology, and surgery. My CREMS supervisor provided careful guidance and support for the completion of this project as well as for the cultivation of my interest in this field. I am hopeful that this experience will contribute positively to my growth as a medical student in honing not only my research abilities but also clinical gestalt and professional growth.

Julia Dmytryshyn supervised by Dr. Amanda Selk

This summer I was given the very exciting opportunity to continue my research on podcasting within the field of gynaecology under the supervision of Dr. Amanda Selk. Last summer we worked together to create a medical podcast series entitled “The Vulva Diaries” for vulvovaginal disease education, and this project has grown to become a great passion of mine. Over the past year we have continued to publish a new episode every two weeks and I have presented our podcasting initiative to several committees and at local and national conferences. I’m proud to say that currently “The Vulva Diaries” has over 13,000 downloads and listeners in over 60 countries! This summer, my project was called “Learning on the Go: assessing knowledge gained from medical podcasts created for vulvovaginal disease education.” The goal of my project was to evaluate “The Vulva Diaries” as a novel learning tool to address the healthcare provider knowledge gap regarding vulvovaginal disease education. I conducted a literature review to determine how to best measure the success of our podcast and created pre- and post-podcast surveys to assess knowledge gained and general attitudes about podcasting in medical education. I then went through the process of writing and submitting a detailed research protocol, consent form and REB application from start to finish. Overall, I’m very thankful to have gained this experience, as I’m sure it will serve me well in my future research endeavours.

Carrying this project through from its inception to currently conducting a study evaluating the success of our new learning tool has been extremely gratifying and informative. I have learned so much about research design and processes, all the while learning a great amount about vulvovaginal diseases. Editing and posting these podcast episodes every other week has been an amazing way for me to improve my knowledge in this area. I definitely plan on carrying forward the valuable advice from the many international expert interviewees we have hosted to provide the most comprehensive care to my future patients. Being involved in this project has also allowed me to act as an advocate for women’s healthcare, promoting patient empowerment and awareness, and improved healthcare provider and medical learner education. After participating in the Chair’s program over the past two years, I feel this program has affected my career as a medical and research professional. I am eager to continue producing and researching medical educational podcasts, as I believe they are a useful and innovative resource, and to continue working in obstetrics and gynaecology. Dr. Selk has been an incredible mentor and role model and has definitely shown me how amazing a career in ObGyn can be. Entering clerkship this year I am strongly considering pursuing a career in ObGyn and women’s health and am very grateful to have had an opportunity such as this to inspire and embolden my career aspirations.

Fabiana Ferreira supervised by Dr. Nir Melamed

This summer I had the pleasure of working with Dr. Nir Melamed on his research project in the Department of Evaluative Clinical Sciences at Sunnybrook Research Institute. My contributions to the project included data entry of placental pathologies and various newborn statistics for cases of singletons and twins. I used the program Microsoft Excel to organize the data into corresponding spreadsheets for two studies. One study analyzes the effectiveness of Doppler ultrasound, and its ability to predict placental pathologies among singletons and twins. The second aimed to determine if smallness in twins is a normal adaptation or if it is due to placental insufficiency that results in a growth restriction. Another part of my role was to analyze data, I used the statistical software SPSS to perform various calculations: including chi-square tests, mean and standard deviation, and percentiles. The goal of the analysis I completed was to determine if abnormal Doppler results coincide with cases with documented placental abnormalities.

I am currently a student in my second year at Western University studying Medical Sciences with an end goal of achieving a Doctorate in Medicine. Having this position as a summer student on my Curriculum Vitae will help me explore a career in the field of research and advance to more positions in the future. I have gained so much from this experience, as I learned about data entry and analysis, participated in training for clinical research, and improved my knowledge on pathology in gynaecology and obstetrics. I am so grateful to be a part of the 2020 Chair's program I would like to thank Dr. Nir Melamed for giving me this amazing opportunity.

Abirami Kirubarajan supervised by Dr. Sony Sierra

It was an honor to work with Dr. Sierra on Reproductive Endocrinology & Infertility research. Our research summer had several components. Mainly, I finished two systematic reviews on LGBTQ2+ and racial equity within fertility care. Along with an ObGyn resident, we explored how to improve cultural competence for historically underserved populations. At the moment, our systematic reviews are in the editing phase and are seeking publication. Additionally, I am assisting Dr. Sierra on a retrospective chart review on Anti-Mullerian hormone and Reproductive Pregnancy Loss. This chart review is ongoing and due to the incredibly positive experience I had with Dr. Sierra and her team, I am continuing my involvement into the Fall semester as well. The focus of our projects is knowledge translation, so that we are able to disseminate our findings for a broader audience. This is especially relevant for our papers on cultural competence, as there is a growing need to improve patient-centeredness in fertility care. Our ultimate goal is to create a set of guidelines and papers to assist future residents, learners, and practitioners.

This summer was incredible! It was a fantastic learning opportunity to start and finish a research project, under the supervision of a mentor and alongside an ObGyn resident. I loved how flexible the program was and how we could really take ownership of our research. As someone who is interested in reproductive justice and equity, I loved the opportunity to continue my own learning. As a future physician, I hope to represent a diverse patient population with both competence and humility. Our research in cultural competence was a great opportunity for self-reflection on my own gaps of knowledge, as well as the systemic gaps of our overall profession. In each of the research projects, I was able to connect the academic work to specific patients and practical care - it felt very impactful. I also appreciated the opportunity to improve my research skills including manuscript writing, literature searches, and collaboration within a research team.

Xinglin Lyn Li supervised by Dr. Patricia Lee

I had such an amazing experience working at Sunnybrook under the supervision of Dr. Patricia Lee over the summer of 2020. I wrapped up the retrospective chart review I started last summer, comparing outcomes between four different procedures used to treat stress urinary incontinence (SUI). While mid-urethral sling mesh procedures are the most commonly performed surgery for SUI in women due to their high efficacy, low risk, and low cost, they have become less appealing to patients due FDA-issued warnings. However, these warnings were specifically regarding the use of mesh in pelvic organ prolapse procedures and not SUI procedures. At Sunnybrook Health Sciences Centre, mid-urethral slings remain the standard of care and are used extensively with good results. We hope the our study results can help dispel some of the current negative perceptions towards the use of mesh in SUI surgical procedures and encourage the use of synthetic mesh mid-urethral sling procedures as the gold standard for treatment of SUI. I also had the opportunity to start a systematic review investigating barriers and facilitators to help-seeking for urinary incontinence in older women. Despite it being a treatable condition, millions of women worldwide continue to suffer from detrimental physical, psychological, and social impacts due to barriers for seeking treatment. The results of the review revealed five categories of barriers: lack of knowledge, stigma/embarrassment, health care provider-related barriers, logistical barriers, and fear of assessment/treatment. This information can help design more targeted interventions to increase care-seeking in these populations.

This is my third summer as a Chair's Summer Research Student, and I could not be more grateful for the opportunities that this has provided me. I am so fortunate to have had the support and opportunity to have worked on three different projects, which have allowed me to gain experience in clinical research, a field that I had not had much experience with prior to starting medical school. The retrospective chart review I started last summer was the first project I was involved in from beginning to end and this year, I will be presenting our final results at an international meeting, the American Association of Gynaecologic Laparoscopists Virtual Global Congress on Minimally Invasive Gynaecological Surgery. I also had the opportunity this summer to formulate my own research topic for a systematic review and am currently in the process of completing the manuscript for publication. I have learned so much from this whole experience and gained many valuable research skills, and I am so grateful to everyone who contributed to my amazing summer at Sunnybrook.

Victoria Mintsopoulos supervised by Dr. Liat Hogen

Over the summer, I had the pleasure of working with Dr. Liat Hogen on a project titled “Clinical characteristics and outcome of endometrioid ovarian cancer: a retrospective study.”. The goal of this study was to determine the clinical and pathological characteristics and the treatment-related outcome of endometrioid ovarian cancer. The primary treatment is surgery with adjuvant chemotherapy offered to all patients except those with grades 1 and 2 with FIGO stage IA. However, the clinical benefit of adjuvant chemotherapy for grades 1 and 2 with FIGO stage IB and IC remains unclear.  In order to achieve this goal, I reviewed EPRs of UHN patients who had pathology-confirmed diagnosis of endometrioid ovarian cancer. I assessed for clinical and pathological characteristics, surgical information, adjuvant treatment information, recurrence data, and survival details. Once the chart review was assessed in its entirety, I began working on the statistical analysis for the study. I first prepared descriptive analysis tables comparing early and advanced stage patients, then assisted in creating an outline for further analysis to be completed by a statistician. Dr. Hogen was an amazing supervisor and someone I have looked up to this summer. At the beginning of the project she did a great job at explaining the field and made sure I understood the goal of the study. Dr. Hogen would schedule weekly meetings where we would go over the completed data. She would also answer any questions I had whether it was during our meetings or outside them.

My research background thus far is consumed mostly of basic science research. Although I enjoyed my experience, I could not see myself running and managing my own basic science lab while also practising as a physician. During my experience conducting a chart review this summer and learning more about clinical research, I began to see how I could incorporate research into my practice as a physician. Throughout my experience working with Dr. Hogen, I grew to appreciate how her clinical work and research aligned. It was evident to me how they aided each other, as Dr. Hogen would be able to run a study based on her clinical work that would not only better her practice, but also those world-wide. I appreciate how these types of studies can quickly be implemented into practice to improve patient care. In addition, working with Dr. Hogen on a study focused on endometrioid ovarian cancer has influenced me to consider gynaecological oncology, which is a field of ObGyn that I did not consider prior to this summer. Actually, before medical school I never thought I would ever consider going into any field of oncology however, this research study has made me aware of how challenging, revolutionary and rewarding oncology can be. This summer, Dr. Hogen has inspired me to pursue an ObGyn residency and has influenced me to incorporate clinically-focused research within my future medical practice.

Darian Perruzza supervised by Dr. Rose Kung

This past summer I had the opportunity to work with Dr. Rose Kung and Dr. Patricia Lee in the urogynaecology division at Sunnybrook Health Sciences Centre. I joined their research team two summer ago as a CREMs summer student and was then a Chair’s Summer Research Student the following year. This year I have had the pleasure of continuing my work with this fantastic team as a Chair’s student. I had two main roles this summer. The first was a continuation of our previous RCT: efficacy of Laser treatment for stress urinary incontinence. It has been fantastic being able to follow some of the patients in this study through their time in the project. I have been involved in both patient recruitment, follow-up, and data entry. While this has been a fantastic learning experience, I have also had the unique opportunity to help with a new study evaluating risk of COVID-19 to surgical teams caring for COVID positive patients. This study will also look at whether SARS-CoV2 is present in the female reproductive tract, the peritoneal surface, surgical smoke and/or surgical masks. I have helped with the preliminary research, including a literature search, for this study, and have set up of the database that will be used as the study continues. While COVID-19 has been a significant struggle for both staff and patients, I am grateful to have had this experience and have gained significant knowledge through my participation in the initial stages of this project.

When I started looking into summer research projects two years ago, I was hoping to find a project that would further develop my communication skills, help me become more comfortable with the creation and use of databases for RCTs, and gain experience with data analysis. I am fortunate to have ended up joining an incredibly supportive team of physicians, including Dr. Kung and Dr. Lee, that has helped me achieve these goals. Through my experiences as both a CREMs and Chair’s student, I have become more confident and proficient with both patient care and the technical components of research, especially in the field of obstetrics and gynaecology. However, beyond these clinical and research skills, I have also had the chance to observe patient interactions and procedures performed by an incredible interprofessional team. The physicians and nurses I have worked with have provided an example of the future health care provider that I want to be. I have witnessed the immense respect and care they give to each individual patient. I have also had the pleasure of watching them use an incredibly difficult situation, such as COVID-19, to develop new research projects that will have positive contributions to patient and physician safety in the future. This desire to learn more and continue to add knowledge to their field is something I hope to emulate in my future career. I am very appreciative for this opportunity and look forward to participating in the ongoing work for these projects.