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IU Surgery residents gain valuable lessons to take back to Operating Room

Pictured left to right: Angela Chen, MD, Burcin Ekser, MD, Yujin Park, MD and Kevin Lopez.

General Surgery residents Angela Chen, MD, Yujin Park, MD, and Kevin Lopez, MD work in Burcin Ekser, MD's xenotransplantation lab during optional research years with the IU School of Medicine.

The Department of Surgery at the Indiana University School of Medicine offers optional research years to surgery residents that range from translational sciences to global health and surgical education after their second or third clinical year of residency. They dedicate a minimum of two years and have an opportunity to complete an advanced degree at no cost. During research years, residents gain valuable lab experience, opportunities to publish and present research, and the environment to build a professional network of colleagues to help navigate their future.

“I really hope they see this time as a growing period in which they can learn a lot in how to work with other people, how to critically evaluate scientific literature, and how to present their work to others,” said Troy A. Markel, MD, director of Pediatric Surgery Research and program director of General Surgery Resident Research for IU School of Medicine. “The resident becomes intimately associated with the body of literature of their interest,” he said, and they can “tease apart the scientific methodology. These lessons can help them when they return to their clinical duties as they learn to practice medicine based on the best evidence in the literature.”

When general surgery resident Angela M. Chen, MD walked into Burcin Ekser, MD, PhD’s Transplant Immunology and Xenotransplantation Research laboratory, she arrived with an interest in general surgery and transplant surgery – and wrapped up her research years with a master’s degree in clinical research and a firm direction toward the transplant surgery field. She recently matched into a transplant surgery fellowship at Columbia University in New York City, beginning July 2023.

“I was drawn to the 3D bioprinting projects that were happening and I had a series of projects that targeted both my interests in general surgery and transplant surgery, developing a liver transplant model for drug testing in the future,” Dr. Chen said. “I developed three models, two of them ended up in the bioprinting stage, where I was able to perfuse them with drug therapy for a week and take analyses.”Drs. Yujin Park, Angela Chen, and Kevin Lopez are residents participating in research years in Dr. Burcin Ekser's xenotransplantation lab.

She said time in the lab taught her how to be more resilient. “I learned how to fail and how to keep persisting, I think even beyond what I think I was used to clinically,” Dr. Chen said. “These cells in these experiments, you are the captain of the ship, and nothing happens without you driving it.”

Two other general surgery residents, Yujin Park, MD, and Kevin Lopez, MD, also benefited from Dr. Ekser’s mentorship in the lab, as they publish research and present at conferences.

In early June, Dr. Park presented at the podium as a Young Investigator Award recipient at the American Transplant Congress in Boston.

“The projects I have been working on involve these 3D liver organoids,” Dr. Park said. “We’re studying a disease called Nonalcoholic Fatty Liver Disease or Nonalcoholic Steatohepatitis and NAFLD and NASH.”

Dr. Park said she’s very interested in collaborating as a researcher and is considering pediatric surgery and possibly teaching. “Having experience in both translational science and clinical research is something that would be very helpful, so I know how to apply research findings when I’m taking care of patients,” Dr. Park said.

Dr. Lopez said he has enjoyed collaborating with Drs. Park and Chen, as well as Dr. Ekser as a mentor. “We all just keep each other happy and motivated,” he said. “I am really interested in the tissue engineering research we’re doing. I work on the xenotransplantation side of the lab.”

Their hope, Dr. Lopez said, is to test the efficacy of alternative to human organs because there remains a need for organs to save more lives. “I never thought I’d be working with things like CRISPR technology and knocking out genes and figuring out how these modifications are helping and changing how immunology plays in transplantation.”

During this time, he completed a master of science in Clinical Research from the Indiana Clinical and Translational Sciences Institute, a graduate certificate in medical management from IU Kelley School of Business and served in a consultant role for an industry life sciences internship. Dr. Lopez is now enrolled in the Executive MBA program at Kelley and can apply his business and science background to his Capstone project.

“We are all three getting our master’s degrees while we’re here,” said Dr. Lopez, who aspires to become a collaborator and administrator. “Dr. Ekser has always had our back on taking time for classes, finals and to meet the requirements we need to get that degree.”

Dr. Ekser is very proud of the progress of the surgery residents. “All three of them are working to overcome the main problem of organ shortage with the studies underway, with the 3D bioprinting liver, how we cure fatty liver disease, so we do less transplant for fatty livers, and can focus on other diseases, including alternative organs,” he said.

Surgery residents in Dr. Markel’s lab are focused on necrotizing enterocolitis, a rare condition in preterm infants that results in intestinal death and need for surgical intervention. Using in vivo models, they test novel cellular therapy techniques to treat NEC as well as techniques to predict the onset of the condition.

Pictured left to right: Fikir M. Mesfin, MD and Chelsea E. Hunter, MDFikir M. Mesfin, MD spent her first research year studying the application of stem cells to their NEC research. She and her colleagues are also studying the relationship between hydrogen sulfide and stem cells. “Research has shown stem cells have therapeutic potential in NEC mouse models,” Mesfin said. “I am working on knocking down specific proteins that are involved in the production of hydrogen sulfide in stem cells. Once we achieve this, we will study these cells in our in vivo NEC model.”

While Dr. Mesfin enjoys basic research, she wants to be active in clinical research, where treatments are evolving to improve outcomes for surgical patients. “What I learned in this lab will help me navigate the research-driven world of academic pediatric surgery,” she said.

Chelsea Elizabeth Hunter, MD recently concluded her research years in the Markel Lab. She tested novel therapies in in vivo models to see whether there is any protection against disease.

“I’ve presented at multiple conferences – both preliminary data and more finalized data, including the Academic Surgical Congress,” Dr. Hunter said.

She said she is leaning toward a career in academic medicine and that she has enjoyed the opportunity to build connections at IU. “Through my work with Dr. Markel's lab, I have had the chance to work with investigators throughout IU and I even worked on a collaboration with Purdue University to study NEC... I think what’s unique about IU’s surgery program is that there are so many different opportunities for research that you can find a lab that suits you, so if you’d rather do all clinical or all basic science,” you can, she said.

She also appreciates Dr. Markel’s mentorship and direction as a program leader. “I have learned the basic science side of research and what goes into developing new therapies, and have also presented at conferences, published manuscripts and accomplished the things that are needed to hopefully one day match into a competitive fellowship."

Dr. Hunter, a native Hoosier, said she interviewed at 19 surgery residency locations and still ended up listing IU as number one because of the people and the opportunities that IU offers. “There was no other program that matched having both" strong academics and great colleagues, she said. “IU is both strong academically and you’ll become a good surgeon, and also like the people you get to work with, who are just really awesome, hardworking, but nice and good at teaching, and have all the qualities that you want in a future residency.”

The views expressed in this content represent the perspective and opinions of the author and may or may not represent the position of Indiana University School of Medicine.
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Angie Antonopoulos

Angie Antonopoulos is a Communications Generalist for the Krannert Cardiovascular Research Center at the Indiana University School of Medicine. Previously she served the Department of Surgery and the Indiana Center for Regenerative Medicine and Engineering. She has more than a decade of experience in health communications for higher education, advocacy, government and contract research organizations.