In 2019, Reinier Alvarez was one of only 50 medical students chosen to participate in the National Institutes of Health’s prestigious Medical Research Scholars Program. A third-year medical student at the Herbert Wertheim College of Medicine, he put his education on hold. And for a year, he worked alongside some of the best clinicians and scientists in the world, doing cutting-edge research at the NIH Clinical Center in Bethesda, Maryland.
Now Reinier is back to finish medical school and shares his experience.
What was it like?
It was an amazing experience. It was different from medical school as I was mostly in the lab every day. However, I still had the opportunity to participate in clinic and observe in the operating room.
What did you do?
I worked in the Neurosurgery Unit for Pituitary and Inheritable Disorders under the mentorship of Dr. Prashant Chittiboina. Our lab conducts translational and clinical research with an emphasis on Cushing's disease.
Cushing's causes the body to make too much of the hormone ACTH which leads to high levels of cortisol. Cortisol is an essential hormone and is very important to sustain life. However, if it's produced in excess, it has many adverse effects, including cardiovascular disease, diabetes, psychiatric issues, even early death. Fifty percent of patients die within five years of being diagnosed.
The current preferred treatment is surgery, but many patients fail surgery, or it recurs years later.
One of my projects consisted of understanding the molecular reprogramming that causes the pituitary gland tumors that cause Cushing's disease.
What did you learn?
This was an opportunity for me to appreciate and be a part of bench to bedside research. We started out with this curiosity to understand how these tumors form. And we were able to identify one of the causes and how to potentially reverse it. As a translational researcher, I learned the importance of persistence and keeping the end goal in mind—improving patient care and outcomes.
This set your graduation back a year. Was it worth it?
I think it was definitely worth it. And I would definitely recommend it to others if they are considering a career in academic medicine or as a physician-scientist. For me, it helped me solidify the trajectory that I want my career to take. The caliber of mentors and friends I was able to gain while at the NIH has been fantastic.
Have you decided on a specialty you want to pursue?
Yes, I've decided on neurosurgery.
Apart from the fact that the anatomy is amazing, neurosurgery encompasses everything I've enjoyed in other specialties. One of them is the privilege of creating meaningful and long-lasting relationships with patients. Unfortunately, neurosurgical patients can be very sick. They can present in dire circumstances, and I think that forges a deeper connection. You also tend to follow them over a longer time, allowing you to really get to know them and learn so much from them.
It is also a field that is challenging on many levels. It is challenging technically, cognitively, physically and emotionally. Unfortunately, the outcomes are not always what we would wish for, but those challenges provide opportunities to grow as a person, surgeon and scientist. Ultimately, that allows you to provide better care for your patients.
Reinier Alvarez is currently interviewing with residency programs across the country.