A first-year house officer at KK Women’s and Children’s Hospital, Dr Michelle Ko is responsible for caring for patients aged under 19 years old in the paediatrics department. Her main priority is making sure that her young patients are comfortable during medical examinations.
During her third year at Duke-NUS Medical School, she analysed data from young patients admitted to the paediatric intensive care unit (PICU), which heightened her awareness of the impact of medical procedures and experiences on children.
Drawing on studies done in the US, Canada and Europe, she found that as many as 88 per cent of children younger than 18 years old admitted to PICU for at least three months were reported to have at least one psychological disorder, and early intervention is recommended for high-risk patients.
Although PICU procedures are life-saving and necessary for children with serious conditions, the 26-year-old says the unfamiliar environment and medical procedures could lead to bad memories. While her research highlights the potential psychological effects of PICU admission to a child, she explains that more studies are needed to determine effective intervention strategies.
Dr Ko was able to conduct her study as a student, thanks to Duke-NUS' unique focus on providing an intensive mentored research experience for students in their third year.
Students at Duke-NUS are trained not just to be adept clinicians but also to lead the fight against diseases by pioneering innovative developments in medicine. Professor Scott Compton, the school’s associate dean for medical education, says: “Our mission goes beyond teaching doctors to practise medicine – in fact, I like to say that our goal is to nurture students into doctors who can improve the practice of medicine.
“We want our students to not only have technical research skills but also the intellectual curiosity, humanistic compassion and a fierce internal drive to want to solve unmet healthcare needs to improve the lives of patients everywhere.”
He adds, “Someone must create the new medicines and treatments of tomorrow – our aim is that someone will be our graduate.”
Dr Ko, an alumna from the Class of 2023, clearly fits such a profile.
With a first degree in life sciences and a minor in psychology, she wanted to leverage her psychology background in doing her research. Dr Ko was particularly interested in paediatrics because she found it fulfilling when children got better.
“My research will help healthcare providers develop follow-up clinics for children who were discharged from the PICU. The clinics can use the data to look out for specific conditions for different demographics,” notes Dr Ko, who has gone on to present at academic conferences like the European Society of Paediatrics and Neonatal Intensive Care in 2021.
But seeing her research findings published in the Journal of the American Medical Association Pediatrics (JAMA Pediatrics) in 2022 remains the highlight for her.
“Now, everyone, not just the local paediatric department, can access findings and potentially have an impact on clinical practice and programmes which will benefit children,” Dr Ko says.
Guided by experienced clinicians and researchers
During their research year, Duke-NUS students are taught scientific research methods and statistical skills. They are also given the opportunity to choose from a large pool of highly qualified research mentors to guide them. Together, the student and the mentor craft a research project which addresses a need in the medical field.
In Dr Ko’s case, she was paired with Dr Lee Jan Hau, a senior consultant in KK Women’s and Children’s Hospital. With Dr Lee’s network, Dr Ko was able to collaborate with a team across two academic sites, including a research librarian, a statistician, doctors and nurses, to review over 9,000 scientific papers for her research.
While working on her research on treatment options for liver cancer patients, Ms Zou Zhao Zhen (left) was mentored by Prof Pierce Chow, a senior consultant in the division of surgery and surgical oncology at the National Cancer Centre Singapore and Singapore General Hospital, and a tenure professor at Duke-NUS. PHOTO: ZOU ZHAO ZHEN
Like Dr Ko, Ms Zou Zhao Zhen also benefited from the guidance of a seasoned mentor and clinician. As a current fourth-year student at Duke-NUS, Ms Zou conducted research on optimal treatment options for hepatocellular carcinoma with portal vein tumour thrombosis (PVTT), a type of liver cancer.
Under the mentorship of Professor Pierce Chow, a senior consultant in the division of surgery and surgical oncology at the National Cancer Centre Singapore and Singapore General Hospital, and a tenure professor at Duke-NUS, Ms Zou compared the health outcomes of two different treatment options for PVTT.
The first option was removal of the cancerous tumour via surgery. The second option, called Y90 radioembolisation, was a minimally invasive procedure where very small radioactive glass beads are inserted into the blood vessels to target the tumour with radiation therapy.
Although it has been around since the 1990s, Y90 radioembolisation was still considered a relatively new therapy, and there was a clinical need for research into its efficacy compared to other treatments.
“Patients with Type I PVTT (an earlier stage of the condition) who were treated with Y90 had better survival outcomes compared to the group who received surgery,” notes Ms Zou, who already holds a joint degree in philosophy and pre-health from the University of Notre Dame in the US. The research findings, which she derived by analysing the medical records of liver cancer patients, will benefit patients suffering from PVTT to make more informed decisions on their treatment options.
Ms Zou is grateful to Prof Chow for his valuable suggestions and connections. “Prof Chow recommended me to take a class on a statistics software programme for my data analysis work. Additionally, when I faced a technical issue, he connected me with one of his collaborators who provided me with helpful advice,” recounts the 25-year-old.
Prof Chow’s advice extended beyond medical practice into life lessons: “Prof Chow told me that ‘It all comes down to people and communication skills, and ultimately, it's about showing people who you are and making yourself memorable.’ I find his advice very relevant to various aspects of my life.”
For both Ms Zou and Dr Ko, having a good mentor makes all the difference in an aspiring doctor’s career.
“Being connected with someone senior in the medical field is very useful even after the research project ends. You can tap on that relationship and it is a potential source of help and advice. Your mentor is someone who can guide you in your future career,” says Dr Ko.