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Upcoming Event: 37th Annual Resident Research Symposium

The J. Engelbert Dunphy Resident Research Symposium is an annual event which showcases the research of residents, fellows and medical students in the Department of Surgery, and honors the life and accomplishments of J. Engelbert Dunphy, M.D., a legendary surgeon and a former chair of the UCSF Department of Surgery.

Wednesday, May 8, 2024
7:00 AM – 4:15 PM
Location: CS-0101, Parnassus campus
This event will also be live streamed here.

Event Program and Abstracts

Joel L. Ramirez, MD

1. How did you get interested in your research topic?

I have always found aortic aneurysms to be fascinating and often dramatic. Their slow development over time allows for a clear window for treatment, yet operative management ca be very challenging and high-risk. Since my first days in the operating room with vascular surgery, I have wondered why we haven’t been able to develop a therapeutic to stop or reverse aortic aneurysm development. This ultimately has led me to want to better understand the role that the immune system plays in aneurysm development with the goal of identifying a target for a novel therapeutic.

2. How did you select your research mentorship team?

My research interests aligned well with the mission of Dr. Adam Oskowitz’s basic science laboratory. It was natural to work with him and our interests organically aligned. We then identified Dr. Alexis Combes as a collaborator given his laboratory’s extensive experience with single cell RNA sequencing and access to cutting edge spatial transcriptomics platforms.

3. How will you incorporate your research into your future career goals?

I hope to bridge the gap between patients, clinical data, and the laboratory. As a surgeon, I hope to be uniquely positioned to build trust with my patients, recruit them to participate in translational research studies, and increase our ability to build biobanks of blood and tissue samples to be studied. 

Nisha Parmeshwar, MD

1. How did you get interested in your research topic?

Early in my residency with a particular interest in reconstructive surgery, I started looking into outcomes of our breast reconstruction patients at UCSF. I noticed that despite many surgeons routinely giving extended courses of oral antibiotics to post-mastectomy patients after implant-based breast reconstruction, our data showed relatively high infection rates, as did the literature. It made us wonder about the utility of antibiotics then in truly protecting against infections, or potentially breeding resistance for more devastating, untreatable implant complications. The field of microbiome science is a novel way to study this problem which had never been seen before in plastic surgery, and our group hypothesized there could be individualized differences in the breast and gut microbiome of certain patients that could predispose one to develop an infection and/or to benefit from prophylactic antibiotics.  Given its broad application in all surgical fields I was extremely interested in helping to carry out our prospective randomized trial looking at the effect of prophylactic antibiotics on a patient’s microbiome, and breast reconstructive outcomes.

Similarly, I wondered about other ways to improve our outcomes, and was curious about the application of topical tranexamic acid (TXA), something that is used frequently off-label in aesthetic surgery and pediatric plastic surgery to decreased bleeding. I think it has the potential, with minimal associated risks, to improve hematoma and seroma outcomes in breast surgery. After systematically reviewing the literature for supporting evidence, I helped start a new trial looking at the use of topical TXA in breast reconstruction patients.

2. How did you select your research mentorship team?

I was fortunate to find an incredibly supportive research mentorship team of amazing female role models. I started working with Dr. Merisa Piper from my intern year with a few clinical outcome projects in breast reconstruction, and those projects looking at our institutional outcomes really served as the foundation for our inquiries on how/what we could do to improve our complication rates.  I was then connected with Dr. Laura Esserman as a result of previous microbiome work she had done among breast cancer patients, and she helped foster more creative thinking and design of studies to help solve our clinical problems. Additionally, Dr. Laura Barnes who is a plastic surgery resident one year above me spearheaded the microbiome project from the ground up, inspiring me to continue in her footsteps with this trial, and start another looking at TXA.

3. How will you incorporate your research into your future career goals?

I am interested in academic reconstructive plastic surgery and my dedicated research year in residency helped me develop translational research skills required to ask and answer questions that could affect clinical change, while working with multi-disciplinary groups to solve complex problems in health care. I am excited about the possibilities for microbiome science, and hope to leverage knowledge of this innovative area in my career for improved outcomes in the future.

Scott L. Hansen, MD, FACS

Scott L. Hansen, MD, FACS, was born in Tacoma, Washington, and spent his childhood in various locations, including North Dakota, Chicago, Wisconsin, and Virginia. After completing high school, he initiated his college journey at Radford University and later transferred to George Mason University upon choosing a Pre-Med major. Dr. Hansen continued his education at Eastern Virginia Medical School.

For his General/Plastic Surgery Training, Dr. Hansen chose UCSF as his destination. During this period, he undertook a significant 3-year NIH sponsored research fellowship with David Young in the SFGH Surgical Laboratory, focusing on the study of wound healing. Following the completion of his Plastic Surgery training, Dr. Hansen pursued a Hand and Microsurgery Fellowship at UCLA.

In 2007, Dr. Hansen returned to UCSF, taking on the pivotal roles of Chief of Plastic Surgery at ZSFG and Chief of Hand Surgery at UCSF. His clinical interests encompass a wide range, including hand and wrist surgery, microsurgery, and the treatment of sports-related injuries. Notably, he serves as the Hand and Wrist Surgeon for the San Francisco Giants baseball team.

Beyond his professional achievements, Dr. Hansen is happily married to Christyna and is a proud parent to four children, consisting of two girls and two boys. During weekends, he can often be found on the sidelines of various sports events, including basketball games, water polo matches, soccer fields, or swim meets.

1. How did you get interested in Plastic and Reconstructive Surgery? I became interested in Plastic Surgery during my first year at Eastern Virginia Medical School (EVMS).  I was interested in getting a research project and was paired up with a Plastic Surgeon doing wound healing and microsurgery research. I began shadowing him in the Operating Room and was immediately awestruck with Microsurgical Reconstruction.  I was able to observe complex nerve reconstruction with Dr. Julia Terzis who was one of the worlds experts at that time.  As it turns out EVMS had an incredibly prestigious Plastic Surgery program in the 90’s thus I was exposed to a wide breath of faculty and diverse cases.  I knew then that I wanted to pursue plastic surgery.

2. How were you inspired to train at UCSF and now become the Chief of Plastic Surgery?  Who was your primary mentor to achieve that position? When I was at EVMS, one of my mentors- Larry Colen, was a former UCSF Plastic Surgery resident and suggested that I do a Sub-I at UCSF.  I came to UCSF in 1996 for a Sub-I and was extremely impressed with the training program.  At that time Stephen Mathes was the Chief of Plastic Surgery and would become my mentor.  Dr. Mathes was a giant in the field of Plastic Surgery and inspired me to become an academic Plastic Surgeon. I was the first resident at UCSF to match into Plastic Surgery as an intern.  Up until me, UCSF only trained fellows who had completed General Surgery first.  After return from my fellowship at UCLA in 2007, I was further mentored by Dr. William Hoffman who helped me rise to be the current Chief of Plastic Surgery as of 2/2/2024.

3. What are your current research interests and what are some topical areas future Plastic surgeons should be investigate? Me and my research team study disparities in health care, specifically the care of patients with hand infections who are marginally housed or homeless.  We are doing a number of studies though our outpatient clinic at ZSFG (OASIS Clinic). Other areas of interest include sports-related injuries, upper extremity trauma, complex spine reconstruction, groin reconstruction and the surgical management of suppurative hidradenitis.  Our team collaborates with faulty in Dermatology, Vascular Surgery and Orthopaedic/Neurosurgical Spine surgery.  There many areas of Plastic Surgery to explore.  These include global health initiatives, lymphatic surgery, robotic plastic surgery and gender-affirming surgery.

PCSA 95th Annual Meeting

The PCSA 95th Annual Meeting was held on February 9-12, 2024, at the Westin Rancho Mirage Golf Resort & Spa. UCSF help an alumni dinner during the weekend and few Naffziger members were in attendance.

Julie Ann Sosa, MD MA FACS

BIOGRAPHY

Julie Ann Sosa, MD MA FACS is the Leon Goldman MD Distinguished Professor of Surgery and Chair of the Department of Surgery at the University of California San Francisco (UCSF), where she is also a Professor in the Department of Medicine and affiliated faculty for the Philip R. Lee Institute for Health Policy Studies. Dr Sosa came to UCSF in 2018 from Duke. Her clinical interest is in endocrine surgery, with a focus in thyroid cancer. She is an NIH- and FDA-funded investigator and author of more than 400 peer-reviewed publications and 80 book chapters and reviews, all largely focused on outcomes research, health care delivery, hyperparathyroidism, and thyroid cancer, with a focus on clinical trials. She has authored or edited 7 books. Dr Sosa is the immediate Past-President of the American Thyroid Association (ATA) and serves on the Board of Directors/Executive Council of the ATA and International Thyroid Oncology Group; for the ATA, she is chairing the committee responsible for writing the next iteration of differentiated thyroid cancer guidelines. She is the Editor-in-Chief of the World Journal of Surgery and an editor of Greenfield’s Surgery: Scientific Principles and Practice. She has mentored more than 90 students, residents, and fellows, for which she was recognized with induction as a full member to the American College of Surgeons Academy of Master Educators in 2020, and by the ATA with the Lewis E. Braverman Distinguished Lectureship Award in 2017 and its Distinguished Service Award in 2022. She received the Chancellor’s Diversity Award in 2022 for the Advancement of Women at UCSF. Dr Sosa was born in Montreal and raised in upstate New York. She received her AB at Princeton, MA at Oxford, and MD at Johns Hopkins, where she completed the Halsted residency and a fellowship.

1. How did you get interested in endocrine surgery? I spent 6 months during residency on the breast and endocrine surgery service at the John Radcliffe and Churchill Hospitals in Oxford as a specialist registrar and loved it. My Halsted residency training program made me into a pancreatic surgeon but I retooled myself into an endocrine surgeon – and I haven’t looked back!

2. How were you inspired to become a Chair of Surgery and who was your primary mentor to achieve that position? I had the strong sponsorship and encouragement of other women leaders who I’d met through ELAM and (literally) on a bus at a surgical meeting who counseled and supported me along the way. Becoming Chair of Surgery at UCSF is my dream job, and I’m so thankful.

3. You have had a rich and successful research history, what are your current research interests and clinical trials and what area should budding endocrine surgeons be investigating? I love science. My research interests have evolved over time. I continue to do health services research, now focusing more on things like the impact of paid sick leave on health care utilization, and multi-institutional registry work to better understand the natural history of a rare disease (medullary thyroid cancer). Our newest R01 is focused around trying to develop ways to effectively diversify the surgical work force.

Research Resident Profile- Alexis Colley, MD

1. How did you get interested in your research topic?

I first became interested in patient-doctor communication prior to medical school when I was volunteering at a local hospital. There, I began to see the importance of communication in shared decision-making and wondered about how to make things better for surgical patients. Since medical school, my research interests have centered around the role of patient preferences for care and integrating ethics into clinical practice.

In residency, I wanted to understand more about how to align patient preferences and goals with medical and surgical care, which led me to my interest in Advance Care Planning (ACP). ACP discussions can help align treatment intensity with patient preferences to balance the short-term risks vs. longer-term benefits of surgery and post-surgical complication management. I am particularly interested in the components of ACP that can facilitate a shared understanding of patient’s goals and preferences and how surgeons can incorporate that knowledge into their treatment recommendations.

2. How did you select your research mentorship team?

I am lucky to have an incredibly supportive multidisciplinary research mentorship team with Dr. Elizabeth Wick and Dr. Rebecca Sudore. I knew that I wanted to work with Dr. Wick because she is an expert in quality improvement, change management, and organizational culture as it applies to surgery. We were connected via our interest in ACP in surgery to Dr. Sudore, who is a geriatrician, palliative medicine physician, and clinician investigator. Dr. Sudore’s work has focused on improving ACP and medical decision making for culturally and ethnically diverse older adults. With their multidisciplinary expertise, Drs. Wick and Sudore have helped me to look at my research questions from varying perspectives. They have also supported me with my diverse professional interests, particularly advocating for me to take an additional professional development year to complete a clinical fellowship in Palliative Care.

3. How will you incorporate your research into your future career goals?

As a future colorectal surgeon, I see myself practicing in an academic setting where I can continue to work towards integrating palliative care and surgery both in my clinical work and in teaching the next generation of surgeons. Clinically, I plan to have a surgical practice focused primarily on caring for patients with colon and rectal disease, but given my interest in palliative care, I also see myself as caring for patients with a need for a surgical palliative procedure and/or complex decision-making for surgical care. I plan to continue working on improving communication between surgeons, the surgical care team, and patients, including expanding the use of goals and preferences, as well as integrating plain, patient-centered language into surgical consultation. 

Research Resident Profile- Nathan Brand, MD

1. How did you get interested in your research topic?

My interest in global health has always been inextricably tied to my interest in global health. As a middle schooler I was introduced to medicine while accompanying my father on medical trips to Nicaragua. In medical school my interest evolved, and I became focused specifically on helping to improve outcomes of cancer patients in low income countries. At UCSF I worked with my mentors Dr. Jablons and Dr. Ozgediz to create a unique research experience spending one year focused on developing novel therapeutics to treat esophageal squamous cell carcinoma, a disease that primarily effects people in low-income countries, and the second year on the ground in Tanzania working on assess the surgical oncology capacity and case volume in Tanzania, a lower-middle-income country in East Africa.

2. How did you select your research mentorship team?

UCSF provided me with an incredible team of mentors with an impressive diversity of expertise. During my rotations as a junior resident, I was introduced to both Dr. Jablons and Dr. Ozgediz. Each mentor was an expert in a specific skillset I wanted to acquire during my research time. The flexible and collaborative culture of UCSF then made it possible for me to pitch to both a non-traditional research experience based partially in the US at a basic science lab and partially in Tanzania working at a medical university.

3. How will you incorporate your research into your future career goals?

In the future, I aspire to become an academic colorectal surgeon with a primary focus on delivering healthcare to underserved patient populations, both within the US and abroad. Through my research experience, I have honed the ability to integrate a scientific and systems-based approach to enhance cancer care. My goal is to contribute by developing innovative treatments and bolstering healthcare systems to ensure that every patient receives the quality medical attention they rightfully deserve.

    Research Resident Profile-Audrey Brown, MD MAS

    1. How did you get interested in your research topic?

    I got really interested in the multidisciplinary nature of treating hepatobiliary malignancies in medical school and wanted to focus my research years on a topic in that space.  I was also particularly interested in learning how to manage and analyze large-scale datasets, particularly those involving genomics data.  With the help of my primary mentor, Dr. Stock, I put together a project focused on identifying patterns of differential gene expression in cirrhotic liver parenchyma that are associated with Hepatocellular Carcinoma development, which provided the perfect opportunity to marry both of those interests.

    2. How did you select your research mentorship team?

    I feel so lucky to have had the opportunity to work with truly excellent mentors from multiple different departments at UCSF.  My mentorship team included Dr. Peter Stock (Transplant Surgery), Dr. John Roberts (Transplant Surgery)., Dr. Zoltan Laszik (Pathology), Dr. Neil Mehta (Hepatology), and Dr. Emanuela Zacco (Laboratory for Cellular Analysis).  While completing a Masters degree in Biostatistics, I was also connected with Dr. Adam Olshen, who specializes in complex transcriptomics analyses and was extremely helpful in guiding my own analysis for this project.  

    3. How will you incorporate your research into your future career goals?

    In my future career, I hope to continue to focus on the applied use of transcriptomic analyses in clinical practice.  Several prognostic gene signatures are commonly used in treating patients with breast cancer and colon cancer and I would love to contribute to the devlopment of a similar test for patients with hepatobiliary malignancies.