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Treating Patients Without Operations or Prescriptions Thrills Medical Student

It was love at first sight the moment Adam Dmytriw was exposed to the practice of interventional radiology.

It was his first elective in neurosurgery as a first-year student at Dalhousie University Medical School in 2010 when he observed an aneurysm coiling procedure performed by Dr. Matthias Helge Schmidt. The young student was captivated by the elegance of the technique.

Inspired From The Start

“Dr. Schmidt opened the door for me right from the beginning and anyone who spends time with him wouldn’t be able to help falling in love with the specialty,” said Mr. Dmytriw.

Dr. Schmidt has mentored a number of undergraduate and graduate students at Dalhousie Medical School, providing a liaison between the basic sciences and clinical practice.

“Adam is tremendously motivated and intelligent. I know he’ll become a great physician and I suspect that he’ll continue to make original contributions to academic medicine,” said Dr. Schmidt. “The enthusiasm of the students I mentor fuels my excitement about academic medicine,” he added.

Mr. Dmytriw is unsure whether it was the grace of the procedure or Dr. Schmidt’s passion, but he credits his interest in diagnostic and interventional neuroradiology to the experience.

The young student, who is now 25, was doing his neurosurgery rotation when his mentor, Dr. Gwynedd Pickett, first introduced him to Dr. Schmidt. Impressed by the collegial environment of the angiography unit and Dr. Schmidt’s graceful execution of the procedure, he was enticed to follow up and learn under his guidance.

“Dr. Schmidt is a consummate role model and any physician would do well to be like him. He embodies the perfect combination of academia, patience, and compassion. I will have succeeded if I end up being anything like him when I am a practicing physician,” he said.

Joining Forces

One year later, Mr. Dmytriw was working side-by-side with Dr. Schmidt on a research project called PROPELLER-DWI in the Staging of Head and Neck Squamous Cell Carcinoma: A Pilot Study.

The Radiological Society of North America (RSNA) Research and Education (R&E) Foundation awarded a $3,000 research medical student grant to Mr. Dmytriw, and the radiology department at the QEII Health Sciences Centre has matched those funds for a total stipend of $6,000 to support his research.

“DWI is on the cusp of becoming a major contributor to the non-invasive assessment of cancer, but technical hurdles remain,” said Dr. HedvigHricak, chairman of the RSNA board of directors and a member of the R&E Foundation board of trustees.

“Mr. Dmytriw’s study is exactly the type of research needed to realize the great potential of this functional imaging modality in oncology,” he said.

The project’s focus is the diffusion weighted imaging (DWI) technology which is supposed to provide important imaging information for MRI patients. The PROPELLER sequence that Mr. Dmytriw and Dr. Schmidt are employing is designed to help enhance imaging results for patients with head and neck cancer who have difficulty remaining still during the entirety of an MRI scan.

“The biggest challenge with this technology is its age. It’s so new and takes time to get used to. PROPELLER-DWI is approved but not part of any standard protocol and we are trying to see if it could be,” said Mr. Dmytriw.

While DWI has existed for years, this particular MRI sequence isn’t frequently used and requires great understanding of the technology and comprehension of the anatomy of the head and neck.

Challenges exist as the research continues but Mr. Dmytriw is attracted to the potential of improving patient care and outcomes.

“I’m thrilled because I feel that just as after the Second World War when medicine was revolutionized by antibiotics, it’s now the age of radiology – its ability to have a massive impact on patients’ treatment plans and contribute to comprehension of disease is remarkable,” said Mr. Dmytriw.

“Being privy to the next wave of medical technology is fascinating and thrilling to me,” he added.

Journey to Medicine

Originally from Toronto, Mr. Dmytriw found his way to medicine by accident. It wasn’t until he messed up his application to study pharmacy that he considered applying to medical school. As a child he didn’t have an interest in becoming a doctor nor did he feel such expectations from his family.

“I think the reason why it took me so long to discover my interest in medicine is because of the outward image of a physician – someone who medicates or operates – which didn’t interest me,” said Mr. Dmytriw.

“It’s the non-traditional aspects of medicine that are thrilling to me,” he added.

In his third year of medical school studies, Mr. Dmytriw is enthusiastic about his interest in treating patients in ways that don’t require operation or prescription.

Before attending Dalhousie Medical School he was fascinated by his studies in clinical immunology at the University of Oxford where he earned a master’s degree in immunology specifically working on the development of HIV vaccines. He was struck by the simplistic beauty of treating patients with antibodies rather than traditional drugs. Since then, he has developed an admiration for hemodialysis, laser therapy and, finally, interventional radiology.

But it’s the humanity of medicine that he’s grown to cherish. For him, understanding a patient’s story, struggles, and motivations is a wonderful component to medicine that not all specialities or physicians get to embrace. In fact, his experience with the Medical Humanities program at Dalhousie Medical School tops his list of favourite memories since he began his studies.

The PROPELLER-DWI project is in addition to Mr. Dmytriw’s course work. Although he admits to often feeling overwhelmed, he takes great care to maintain a work-life balance. His advice is to not become a slave to one’s work regardless of your passion for it.

Mr. Dmytriw and Dr. Schmidt hope to publish their research findings in Radiology, a journal published by the Radiological Society of North America, and intend to present the findings at RSNA’s annual meeting in Chicago in 2013.

This is a reprint of a story that was originally published in the September 2012 issue of doctorsNS magazine.