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The Cleveland Clinic Lerner of College of Medicine of Case Western Reserve University (CCLCM) is a five-year program dedicated to developing the next generation of physician investigators. Students are assigned dedicated physician and research advisors to help ensure they reach their goals. In their fourth year, students work with a mentor to develop a master’s-level thesis in basic science, translational medicine, clinical medicine or health systems. When the students graduate, they each receive an MD with Special Qualification in Biomedical Research from Case Western Reserve University.
The research in which students are involved is critical, timely and often results in presentations at national conferences and publication in scholarly journals. The examples below briefly describe two students’ research projects, one that involves effective yellow fever disease prevention in pregnant populations and another that involves equitable access to breast reconstruction following mastectomy:
“My research, conducted in the lab of Suan Sin Foo, PhD, focused on investigating the maternal and placental immune response to the YFV-17D yellow fever vaccine. With changing climates, mosquito-borne diseases like yellow fever are becoming more of a global issue. The yellow fever vaccine is an excellent way to protect people from infection, morbidity and death. The vaccine, however, is live-attenuated, meaning populations including pregnant women are currently recommended against receiving it. Our research team sought to investigate how the maternal and placental immune system respond to vaccination. We did in vitro experiments on human villous trophoblasts (HVTs) and ex vivo experiments on whole blood obtained from both non-pregnant women and women in different trimesters of pregnancy.
Our results showed that HVTs are highly susceptible to infection from the YFV-17D live-attenuated yellow fever vaccine. When exposed to the vaccine, HVTs exhibited a robust inflammatory response that reduced growth factor and angiogenic expression. Additionally, we observed activation of immune cells called monocytes in the second and third trimester of pregnancy. We therefore concluded that the YFV-17D vaccine may be associated with negative pregnancy outcomes during the second and third trimesters. I hope that this research can be useful in paving the way to safe, effective yellow fever disease prevention in pregnant populations.”
-Chineme Onwubueke (’25)
“For my research thesis, I worked with Graham Schwarz, MD, and my research committee to examine how the Affordable Care Act (ACA) has impacted access to breast reconstruction after undergoing mastectomy. Using data from the National Surgical Qualitative Improvement Project, we analyzed over 200,000 patients to uncover persistent racial disparities in reconstruction access before the ACA passed. After the passage of the ACA, we still saw persistent racial disparities, but we also saw improvements in some areas.
One thing we found is that Hispanic women are now more likely to undergo breast reconstruction compared to their non-Hispanic counterparts. This demonstrates that while racial barriers still exist, it is possible to make breast reconstruction access more equitable in the United States. I think every single person deserves to be able to have breast reconstruction surgery if they choose. Reconstruction can have a huge impact on quality of life for mastectomy patients, yet right now we're seeing that some groups can access it more than others. Our analysis will hopefully lead to more targeted initiatives exploring how to increase access so that we as a medical community can advocate for meaningful change.”
-Rachel Schafer (’25)
