Research Intern with Tulane Urology at Tulane School of Medicine(Completing an internship: 5 points) - Mallory Wallace

 

                         

                         

This summer I had the privilege of serving as a student intern with Tulane Urology as a part of the Purposeful Infrastructure Promoting Equality Program.  The PIPE Program at Tulane School of Medicine offered me a very immersive experience that has been instrumental in my choice to pursue a career in medicine. This program provided valuable insight into the medical field while preparing me for early steps in the medical journey, including MCAT prep, personal statement and resume workshops, simulation days, didactics, and medical school application tips. This program not only surpassed my expectations, but but it also expanded my understanding of urology and allowed me to build meaningful relationships with urology doctors, residents, and medical students.I am truly grateful for the mentorship, lasting connections, and life lessons this prestigious program gave me. 

Our weeks in the PIPE program began with simulation (SIM) days, where we practiced surgical techniques. Our first SIM day focused on knot tying and suturing. We started with double and single handed knots using rope, which taught me how much precision and focus are required for surgical procedures. I was later able to observe these techniques in the OR, with residents allowing me to watch closely as they closed incisions. We also focused on laparoscopic surgery techniques, intubation and arterial line placement, ultrasounds, and urologic procedures, such as Foley catheter and stent placements. My favorite SIM involved the Da Vinci Surgical Robot, which I was able to use to perform a simulated robotic gallbladder resection. I was later able to see 3 robotic surgeries performed by the urologic oncologist.

Additionally, I was able to observe procedures such as ureteroscopies, stent placements, suprapubic tube placements, and cystoscopies with the attending urologists. One of the most memorable surgeries was an open cystoprostatectomy with ileal conduit creation performed by the urologic oncologist. The complex, six-hour surgery involved removing the bladder and prostate and using a segment of the small intestine to direct urine to the stoma, and eventually an ostomy bag. The expertise shown throughout this surgery was truly inspiring. Another procedure I found very exciting was a radical nephrectomy with the Da Vinci robot, where the entire kidney and ureter were removed from the body, along with surrounding lymph nodes. This patient had metastatic cancer, so the procedure was not straight forward. However, the surgeons adjusted and navigated the procedure beautifully, removing the kidney, ureter, and lymph nodes without complications. 

Lastly, the research offered me insight into the science behind the procedures I was able to observe. Our primary focus was Castration Resistant Prostate Cancer (CRPC), specifically metastatic CRPC, and the mechanisms behind Enzalutamide resistance. We explored the role of tumor-derived exosomes in drug resistance through drug efflux, which enhances cancer cell survival and metastasis. By introducing Ketoconazole and Tipifarnib in combination with Enzalutamide, our aim was to find drug concentrations that increased drug bioavailability within cells and reverse enzalutamide resistance. We tested various concentrations of these drugs using five CRPC cell lines. Through techniques such as cell culture, viability assays, and Zetaview analysis, we identified promising drug combinations that showed increased cell death in LAPC4, LNCaP, and C4-2B lines, along with the associated concentrations of exosomes.

Overall, the PIPE program offered me invaluable exposure, experience, and mentorship. One of my biggest takeaways was my newfound sense of confidence in myself. I learned to be proactive, speak up, ask questions, and build relationships. Most importantly, I learned that my journey is unique to me, and I should never compare it to others. Each path to medicine is different, and that’s what makes it powerful. I will forever be grateful to each and every person who made this journey meaningful. I look forward to carrying these lessons and connections with me as I work toward my goal of becoming a physician.

By Mallory Wallace