Meet a Medical Scholar: Alison Swartz
M4 Medical Scholar Alison Swartz reflects on the unique opportunity to conduct her own year-long research project.
By: Kyra Letsinger
At Vanderbilt University School of Medicine, student research is woven into all four years of the MD curriculum, but often that research must fall within the confines of specific criteria, limited by funding and time. But what if there was a way for medical students to fully embrace their outside-the-box research ideas? To receive ample support in making those ideas a reality?
That is exactly the opportunity the Medical Scholars Program provides Vanderbilt School of Medicine and Meharry Medical College students. Once selected, Med Scholars receive a $30,000 stipend to carry out a proposed research project over the course of a fellowship year. Med Scholars are able to tap into exceptional resources, most importantly a seasoned mentor of their choosing to support them through the research process. And anywhere a student’s dream mentor is, is somewhere they can take their research, whether that is in Nashville or across the world in areas such as Barcelona, Spain or Lusaka, Zambia. The world is truly a Med Scholar’s oyster.
For M4 Alison Swartz, a Medical Scholar currently in her research year, the program has been an exceptional chance for her to learn the intricacies of conducting medical research and deep dive into some of her greatest field interests. She is eager for others to take advantage of the program’s unique offerings and the professional and personal benefits that come with it.
Q: What led you to pursue an MD at Vanderbilt?
A: I have kind of a roundabout path to medicine. I loved chemistry in high school, and I had a teacher who recommended that I go into pharmacy just because it’s very heavily tied to chemistry. So, I volunteered at a Walgreens my final year of high school, and after I graduated, I took the pharmacy technician licensing exam in Arizona. I then took a gap year, first working as a pharmacy technician to get some field experience, and then with an insurance company pharmacy benefits manager (PBM) – I know, ooohhh – doing prior authorizations. I started as a very naive 18-year-old, and it took me a while to realize… I was the bad guy. Once a nurse called me to try and get approval for an inhaler for a child–a child who obviously needed it–and it was denied by the insurance company,. I remember sitting there in shock at how ridiculous it was. So, I got out of there and moved over to CVS.
The vast majority of patients I worked with at CVS were on Medicaid as I was in a pretty impoverished neighborhood. It was wonderful being able to work with that population, but over time, I saw more and more cases of people being unable to access care and medication because they couldn’t afford it. I remember feeling so helpless, and I began to understand that if I wanted to be able to have an impact and to be able to provide care for anybody who walks through those doors, pharmacy was not the place for me. That’s when I started considering medicine. I went to college while working at CVS and around my sophomore year decided, “hey, medicine is going to be the path for me.”
Q: In your own words, what is the Medical Scholars Program?
A: The Medical Scholars Program is a one-year, funded research fellowship that allows you to do pretty much anything under the sun in terms of research. I think that’s part of what’s so powerful about the program; there are some projects that are really important and deserve to be done, but are hard to get funding for, especially if you don’t have any preliminary work behind them. Med Scholars not only offers you the flexibility as a student to just take a year out for research, but it gives you the ability to work on projects that aren’t necessarily traditionally funded.
Q: Why did you apply for the Medical Scholars Program?
A: I fell in love with research during undergrad, and I knew I wanted a little bit more time for it than what is built into our curriculum. I also knew that I wanted to become a physician scientist, but an MD/PhD was just a little bit too research-driven for me. I was really torn between getting a Master of Public Health in epidemiology and doing research on my own in this program, and then I came to realize: Although the classroom setting is wonderful, I think there’s something to be said for being self-taught. For me, I tend to catch onto and retain things a little bit better when it’s hands-on and self-guided, making me a more effective researcher down the line as a resident and fellow. I also ultimately decided on Medical Scholars because I knew I wasn’t going to get dedicated time to sit with a project for a whole year like this ever again.
Q: Was there any concern going into the program knowing you’d have to extend your studies a year?
A: I thought about it, but truly, there are nothing but benefits. We have to think in the context of an entire career. Taking a year now is much easier than spending an extra year when I’m a resident or taking an extra year of fellowship. It’s important to keep in mind that a year is not that much in the grand scheme of things. And honestly, from a [residency] application perspective, it can only serve to strengthen you.
I also think it’s important to acknowledge that medical school is really hard. It’s wonderful, we get to do amazing things, but honestly, I was pretty burned out by the end of third year, and right after I finished my AI (Acting Internship), I was just exhausted. Being able to do something that is self-motivated, learning the self-efficacy of how to design and set realistic goals (and though you have the help of a mentor, it’s really on you): I think that’s extremely valuable. Sometimes we forget how to have internal motivation because of outside pressures, and this is really a year you can take just for yourself to do things that you’re excited about.
Q: What is your research about?
A: My project is in epidemiology and I’m looking at people in the Vanderbilt system and their weights over time (about 800,000 people between 1997 and 2020). I want to see if people with large amounts of fluctuation in their weight have increased risk of things like diabetes, heart disease, and stroke as opposed to people who are weight stable. If we do see increased risk in those with weight fluctuation versus even people who have higher but more stable weights, maybe it’s time to start thinking of a harm reduction approach. When it comes to obesity, we realize that over 80% of people who lose weight are just going to gain it back and down the line we may find it’s better for people to focus on staying stable if they’ve really struggled to lose and maintain weight loss in the past. However, if we find there isn’t an increased risk with weight fluctuation and having a higher BMI (Body Mass Index) is the overall most important risk factor, that could also provide some comfort to people who have struggled to maintain a stable weight and fluctuate a lot. BMI isn’t a perfect measure—it is just a predictor like any other; it’s not 100% that you’re going to develop certain health issues, and I think more thoroughly understanding that relationship is valuable for all of us.
Q: Mentorship is a major aspect of this program. Can you tell me about finding your mentor and how she’s supported you managing your research?
A: I am doing research with Dr. Heidi Silver, she’s a dietitian at Vanderbilt and her PhD is in nutrition. I sought her out personally, not only because she’s really the only person at Vanderbilt who does this type of nutritional research, but also because I knew she had worked with several medical students over the years and that she ran a successful lab with a lot of full-time staff.
There’s sort of a hidden curriculum when it comes to being a faculty member at a research center, and I’ve learned so much about what it’s like to be a PI what it’s like to get grants. Even though Dr. Silver isn’t a physician and isn’t involved with the specialty I plan to go into, I think it’s extremely valuable to have a mentor who has so much institutional knowledge, and just personally, someone who really gets to know you.
Q: Who would you recommend apply for the Med Scholars Program?
A: I think that this program is valuable for a lot of people, even if they aren’t sure if they want to do research in the long-term. In particular, anyone who is in the same boat as me in terms of really liking research and wanting to include it in your future career, but not quite being on board with the research/clinical split of MSTP (Medical Science Training Program), I think this program is a great fit. Med Scholars is also a fantastic bridge for people who have developed an interest in joining MSTP. Because it’s so hard to get enough research in your first and second year, this is a really great way to show that you’re a passionate researcher who can produce quality work. I also think there’s also something to be said for taking a little bit of time to explore different things outside of medical school. Not only do I have time for research, but I’ve also been able to do things like shadow in the emergency department and I’m going to shadow in anesthesia later. That change of pace and being able to set your own schedule each day is really wonderful.
Q: How do you see yourself using what you’ve learned during this experience in the future?
A: Although I’ll probably be working on different projects in the future as I plan to go into emergency medicine, the skills I’m learning are applicable to anything I pursue. I’ve learned some advanced coding and regression modeling methods, how to pull data from the electronic health record, how to read a little bit of Structured Query Language (SQL), and how to interpret and process patient data, even when they’re part of massive datasets. These are all things that are helpful no matter what form of research you’re doing. I’ve also been able to work with biostatisticians here, which has allowed me to further broaden my overall skill sets. It’s been such an exciting opportunity!
Applications for the Medical Scholars Program are open now. Intent to Apply forms are due January 1, 2024, and applications are due February 1, 2024. For further questions regarding the Medical Scholars Program, please contact vms.research@vanderbilt.edu. Alison also encourages prospective applicants with questions about her experience to contact her email at alison.z.williams@vanderbilt.edu.