Claire Carlson

As it was always her interest to participate in heart research, she was eager to return to her alma mater this summer to conduct clinical research with the Lillehei Heart Institute.

Her primary project at the clinic focused on evaluating echocardiograms of patients with pulmonary arterial hypertension (PAH), a fatal cardiopulmonary disease that, Carlson describes, "has been slower in receiving dedicated research efforts."

Her remaining time was split between studying outcomes in both cardiovascular disease prevention and cardiac arrest. And once a week, she spent her time away from research, observing in outpatient cardiology clinic with the physicians and their patients. It was there, while watching the attendings perform physical exams on cardiac patients, that she came to an important realization.

"Everything for me shifted when I saw how much attention and weight they place on the patient physical exam. Their exam is so simple and elegant. The senior cardiologists can examine the neck and infer about five different things going on between the heart and lungs beyond the classic signs, and they are rarely wrong. It feels like there is such a push, today, for the advanced diagnostic modalities we have available in medicine, but the cardiologists proved to me that whether or not osteopathic methods are involved, what you need to know as the clinician is often sitting right in front of you. Observing them was an important motivator for me to work on my physical exam and osteopathic skills just as hard as my academic courses before I get to residency."

Carlson, who plans to pursue a career in academic medicine, says she felt lucky to have had this clinical research experience so early in her medical education. "Clinical research takes investigation from a laboratory or device design team and integrates it directly into caring for patients. This greatly expands the oversight and regulation needed to maintain safe care for research patients, which is a huge learning curve for young clinicians that are new to the process. I feel grateful to have had this exposure so early on, and I’m grateful to my physician mentors - Drs. Thenappan, Prins, Cohn, Duprez and Yannopoulos, along with the cardiology research staff at the University of Minnesota – who taught me all that I know at this point about conducting trials."

She is also thankful, she adds, to her first-year medical education at TouroCOM-Harlem—which gave her the tools necessary to be a successful intern. “I used material learned from Anatomy constantly for imaging research and identifying abnormalities in the heart and vasculature in multiple planes. If you can’t visualize the normal anatomy in your mind, you won’t be able identify the abnormal in a patient. Dr. Rich’s course made me want to take the time to understand why human anatomy is the way it is, instead of just frantically remembering Latin names from a flash card. Doing so was completely worth it. And as a pre-clinical student, I feel very fortunate to have already learned to interpret echocardiogram images - it’s a skill not even all cardiology fellows master! Pulmonary arterial hypertension progresses quickly, so identifying markers of early disease in the heart using imaging can be extremely important for a patient’s prognosis.”

Pathology was also heavily useful, she adds—it “integrated our basic science courses into understanding the progression of disease, and provided me a solid clinical vocabulary for reading academic research papers and interpreting patient data,” she says. “I could open a patient chart and be confident in understanding the significance of most findings, which is a very good feeling.”