六九色堂

It鈥檚 always fascinating hearing about what 六九色堂 students are doing in clinicals, and we recently spoke with Aaron Vazquez about his work at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. Mr. Vazquez was one of the co-authors of an eating disorders study published in Psychotherapy Research last year, 鈥淓ffects Of Providing Patient Progress Feedback And Clinical Support Tools To Psychotherapists In An Inpatient Eating Disorders Treatment Program: A Randomized Controlled Study.鈥�

Mr. Vazquez told the 六九色堂 Pulse last summer that he became interested in psychology and psychiatry because he has always been fascinated by human behavior. We caught up with Mr. Vazquez to talk about his work with the Neuropsychology team and the Clinical Trials Department at the Cleveland Clinic, and what students at American and Caribbean medical schools should know about the shortage in psychiatry in the USA.

六九色堂 Pulse: You became involved in volunteer research at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas last year. What initially attracted you there?

Aaron Vazquez: I was doing my Family Medicine clerkship at a hospital one mile away. I became aware of their Lunch-n-Learn program offered free of charge to the community and I began eating my lunch over there. It was a great decision. I discovered how passionate the clinicians were about community education and was very impressed with how approachable they were.

Within the Neurological Institute, you are working on a few projects. Tell us about some of the important things that the Neuropsychology Department does there.

They do different cognitive tests on a wide array of patients suffering from Dementias, Aphasias, MS, Movement Disorders and other brain diseases. They play a critical role in research and provide education and support to family members of patients.

In what capacity do you work with the Neuropsychology team?

They have very skilled professionals on staff. I play an ancillary role to help free up some time for them. I organize and transfer data from cognitive assessments and radiological studies in order to make it usable in potential publications. In the grand scheme, my role is quite narrow, but I am learning a lot about various scales and measures, which will help me in my career. I鈥檓 grateful for the opportunity.

You are volunteering as well within their Clinical Trials Dept. How did that happen?

I walked up to the Senior Director of Research and said, 鈥淚鈥檇 like to help.鈥� She was able to match up my professional tech background nicely with a project they needed help on.

You are working on developing a centralized platform of technology that will enhance future clinical trials. Can you tell us about that?

Currently, vital data is gathered from study participants in a cross-sectional way, across multiple checkpoints during the course of the study. There are a few disadvantages to this practice. For one, there could be changes that occur between the checkpoint intervals that we are not capturing. Furthermore, some of the data we collect is subjective in nature and therefore, subject to recall bias or other flaws if not collected in a timely manner. We are preparing to improve this aspect of clinical trials by deploying existing technology into participants鈥� homes so that the data is collected in real time and in a continuous manner. As physicians and researchers, we want the most up-to-date and precise information in order to make accurate conclusions.

What is the biggest challenge so far in accomplishing this?

This project is a big undertaking. It can be difficult to identify potential partners that can support the level of service that we demand. It is also challenging to integrate different types of technology into one centralized platform so that it can be monitored with one Dashboard and make it seamless and simple to the end user. Many can relate to the frustration of a printer not working properly with a single PC. Now imagine trying to get: Activity Trackers, Wireless BP Monitors, Electronic Pill Bottle Monitors, Blue Tooth Pulse Oximeters, Wireless Weight Scales and more to work flawlessly with participants who will have dementia. It鈥檚 a fun project!

What was the best thing about the experience?

I love the autonomy and challenge that I鈥檝e been given. I was basically told conceptually what was needed and then tasked to bring it to life. I have also learned a lot more about how clinical trials operate in and of themselves.

What is the plan to bring this experiment to life? Can you talk about that now?

A proof-of-concept study is in the works. We will start with a few participants and monitor closely how the participants and their caregivers respond to the technology. From there, the quirks can be worked out and further implementation can be addressed on a study-by-study basis.

Everyone says there is a shortage of primary care physicians, but we ran an article recently that there are also looming shortages in psychiatry and neurology. Do you agree and if so, what should medical students and future doctors know about these areas of medicine?

Many might not like my answer to this, but regardless, here it is. I have been aware of the shortage in psychiatry since undergrad. It is one aspect that drew me to the field. I just returned from the American Psychiatric Association Annual Conference where this shortage was spoken of in nearly every lecture. The shortage in Child and Adolescent Psychiatry is particularly worrisome. When there is a mismatch between supply and demand in any market, the problem can be addressed in two ways.

Solution 1 (Commonly argued): Increase the supply of psychiatrists. It is commonly proposed that psychiatry needs better compensation so that medical students are swayed in that direction. I don鈥檛 necessarily disagree with that argument (as it would be self-defeating) but the type of medical students who are easily swayed by financial incentives may not be the best clinicians to work with this highly vulnerable population.

Solution 2 of the supply/demand mismatch is almost never mentioned by anyone. We need to decrease the demand for psychiatric services. It is well established that many mental illnesses are 鈥渢riggered鈥� by life events and that psychosocial factors are very relevant in the onset and progression of mental illness. Psychiatry should be equally focused on addressing this aspect of the supply/demand problem, particularly with our young ones, whose trajectory in life may still be altered towards positive outcomes. Sadly, there is no money to be made in promoting the improvement of our families and community organizations. Their role is both formative and supportive to mental, spiritual and emotional well-being. I鈥檝e become aware that discussing the need to decrease the need for psychiatric services is not popular in many circles. Suggesting that as a society, we should become better community leaders, parents, siblings and children is now highly politicized.

What type of work and research do you want to do in the future?

My goal this year is to apply to a residency program that is exceptional at teaching clinical skills. I have already augmented my medical education with research so any scholarly work in residency would be secondary. Although Neurology is fascinating in so many ways, my calling is to enter Psychiatry. This is one of the last frontiers in medicine. The room for discovery and improvement is enormous in mental health. There is still so much we don鈥檛 know and that is the great appeal to me.

(Top photo) 六九色堂 clinical student Aaron Vazquez in front of the Lou Ruvo Center for Brain Health at the Cleveland Clinic in Las Vegas, NV. Photo: Courtesy of Aaron Vazquez

六九色堂:

Built in the tradition of the best US universities, the University of Medicine and Health Sciencesfocuses on individual student attention, maintaining small class sizes and recruiting high-quality faculty. We call this unique approach, 鈥減ersonalized medical education,鈥� and it鈥檚 what has led to our unprecedented 96% student retention rate, and outstanding residency placements across the US and Canada. 六九色堂 is challenging everything you thought you knew about Caribbean medical schools.