Gina Choi, MD with a student

Prioritizing mentorship of the next generation of medical professionals

Each summer, 5-8 high school students, undergraduates, medical students and medical residents spend three months as hepatology researchers in the UCLA Vatche and Tamar Manoukian Division of Digestive Diseases. Working part-time under the mentorship of the division’s hepatology faculty, and with their colleagues both in and out of the division, the participants take part in important clinical research and end up as co-authors on papers published in peer-reviewed scientific journals.

Between the clinical care and research he conducts as a hepatologist and professor in the division, Sammy Saab, MD, MPH, has a full plate of activities. But Dr. Saab decided to start the mentoring program, and continues to devote significant time during the summer to supervising the students and residents, to help shape the next generation of medical professionals.
“The idea is to expose participants to a world they might not otherwise see, in the hope that they will become excited about the possibilities and pursue a career in this area,” Dr. Saab explains. “A lot of people are interested in going into healthcare, but this introduces these individuals to another facet of medicine — research — that is critical to improving people’s quality of life and helping them live longer and better.”

In the six years since Dr. Saab established the program, every participant has been able to complete the work required to get on a publication as a co-author, Dr. Saab notes. “We design projects that allow these students and residents to be involved in the  entire process — forming a hypothesis, conducting medical literature searches, developing methods, collecting and analyzing data, and contributing to the manuscript,” Dr. Saab says. Although the focus is on clinical research in hepatology, he notes that the skills learned by the program’s participants can easily be applied to basic research, and to other biomedical fields.

The work of the participants has been significant. Two high school students, for example, were part of a team that generated a hypothesis for the treatment of HIV-positive hepatitis C patients, after finding that the cure rate for mono-infected patients and
co-infected patients was the same; their work led to a publication in the prestigious journal Hepatology. A UCLA undergraduate, working with Dr. Saab’s group as well as a radiologist who taught him how to read CT scans, contributed to a manuscript on the impact of muscle wasting on patients undergoing liver transplantation. A resident and an undergraduate collaborated on a study, accepted by Hepatology, putting forth an argument for how hepatitis C could be eliminated in the United States.

It’s especially exciting and rewarding for the students to get to work as a team,” Dr. Saab says. “For example, the high school students are not only exposed to the work of attending physicians like me, but they also get to work with medical students and residents. It gives them the confidence to go forward.”

Mentorship that steers talented young people toward careers in liverrelated medicine and research has public health benefits. “There’s a need for more hepatologists,” says Gina Choi, MD, an assistant professor in the division who specializes in transplant hepatology. Dr. Choi notes that antiviral medications now used to treat hepatitis C have made a huge difference, but fatty liver disease continues to be a major concern.

The UCLA Vatche and Tamar Manoukian Division of Digestive Diseases includes six full-time faculty members who are hepatologists — specially trained in both liver disease and transplant hepatology. “Many patients have abnormal liver tests which can be indicative of viral hepatitis, fatty liver and autoimmune liver disease,” Dr. Choi says. “We try to treat them, and if they develop liver failure, we can offer life-saving transplantation through one of the top programs in the country.”

As a group, the division’s hepatologists are internationally recognized for their clinical research. They are also heavily involved in educating medical students, residents, fellows, and the community. The Transplant Hepatology Fellowship Program, under the leadership of Steven-Huy Han, MD, a professor in the division, started in 2017, with one transplant fellow each year receiving advanced education in transplant hepatology. The annual UCLA Liver Diseases Symposium, held in Pasadena, is now in its 12th year, and the division will hold the 7th Annual UCLA-Mellinkoff Gastroenterology and Hepatology Symposium next spring.

While these efforts are providing hepatology education and training for health professionals who have already chosen their career path, the mentoring program continues to engage individuals during their formative years. Elizabeth Aby, MD, now a  UCLA Health chief internal medicine resident, went through the summer program and has now been mentored by Dr. Saab for more than three years, during which she has worked with him in the hepatology clinic, shadowed him during liver transplant meetings, rounded with him on the inpatient hepatology service, and collaborated on four research papers that have been published, along with a review article currently in progress.

“It has been an incredible experience,” Dr. Aby says. “Not only is Dr. Saab a fantastic clinician educator and mentor, he has also helped me grow as a researcher. His mentorship has been instrumental to my career.” Dr. Aby is currently applying to a
GI fellowship, with plans to become an academic hepatologist.

Matthew Ryan Viramontes was a firstgeneration college student at UCLA when he was drawn to the mentorship program, where he began to learn under the guidance of Drs. Saab, Aby and others. “I have been able to build lasting relationships and gain clinical and research experience that will help me in the future,” says Viramontes, who has begun applying to medical schools across the U.S. “This mentorship program has allowed me to see the life of GI and hepatology physicians and has steered me to aspiring to become a leader in the field.