Oct 29, 2013
The Conquer Cancer Foundation of ASCO is committed to increasing the number of medical students underrepresented in medicine to better reflect the needs of our increasingly diverse society. Since 2009, the Conquer Cancer Foundation of ASCO has supported 40 students through the Medical Student Rotation for Underrepresented Populations (MSR) program.
In 2013, 12 medical students were selected to receive the award, which provides an eight- to 10-week clinical or clinical research oncology rotation for U.S. medical students interested in pursuing an oncology career. Among them was Jenny Ruiz, who completed a pediatric oncology rotation at Columbia University with Julia Glade Bender, MD, between June and August. In addition to the rotation, Ms. Ruiz also helped to conduct a collaborative research project co-developed by Jennifer Levine, MD, MSW, and Jennifer Oberg, EdD, MA, titled “Assessing Knowledge and Perceptions of Whole-Genome Sequencing Among Pediatric Oncology Patients, Survivors, and their Families.”
Personal experience formed early interest in oncology
Ms. Ruiz became interested in a career in medicine in high school when she helped care for her grandfather after his kidney transplant, sometimes driving him to his doctor appointments.
“Most of my life, I saw first-hand my grandfather’s daily struggle with renal failure and dialysis,” she explained in an interview with ASCO Connection. “Since his English was limited, I often acted as an interpreter. This was where I first saw the patient-doctor interaction and how easily it could be complicated by cultural and communication barriers.”
As a premed student in college, Ms. Ruiz had several positive experiences in pediatrics, but it wasn’t until her infant cousin was diagnosed with leukemia that she considered a career in pediatric oncology.
“I realized that an oncologist played a critical role in not just medical care of the child, but also in assisting in the whole family psychosocially through an incredibly hard time in their life,” she said.
During her pediatric oncology rotation, Ms. Ruiz saw how important it was to work as a team. Her mentor, Dr. Glade Bender, not only collaborated with nurses and other physicians, but also with social workers and psychologists.
“The patient and their family always had a dedicated team looking out for the physical and psychosocial health of the patient,” Ms. Ruiz explained. “This relationship didn’t end with the end of medical care, rather it continued years after being cured. In a unique and beautiful way, everyone in the team became part of the patient’s family.”
She also developed clinical research skills, gained exposure to a research-oriented pediatric oncology practice, and garnered the interpersonal and communication skills necessary to become a caring and professional physician.
“Because of [the rotation] I now have a much better understanding of what it means to work in academic medicine in pediatric oncology,” she said. “My knowledge grew by attending the fellows teaching conference/journal club and research lectures. I was able to listen and observe verbal presentation skills of fellows and physicians during divisional rounds, which without a doubt will aid me as I progress in medical school.”
For her research project, Ms. Ruiz focused on whole-genome sequencing of pediatric tumors—a technology that will hopefully one day allow for precise, personalized treatment of childhood cancers.
“By finding the specific mutations that are contributing to the cancer, we can find a specific drug that targets that mutation,” she explained. “The aim of my project was to investigate the knowledge, attitudes, and beliefs of patients about whole-genome sequencing in childhood cancer, with the overall goal of developing an educational prototype to aid families in making informed decisions about participating in whole-genome sequencing studies.”
To accomplish this, Ms. Ruiz and Drs. Levine, Oberg and Glade Bender conducted focus groups with parents of children with cancer and semi-structured interviews with parents of healthy children. The topic guide included questions on genetic research, whole-genome sequencing, timing of consent, reporting of incidental findings, and types of educational materials.
Although the project is not yet complete, preliminary analysis showed that parents of patients had limited knowledge of whole-genome sequencing and some knowledge of genes.
“Participants seemed willing to enroll their child in whole-genome sequencing but wanted to learn more about it and suggested one-on-one conversations, videos, and pamphlets for disseminating information,” Ms. Ruiz explained. “Most participants wanted to be told about incidental findings but also acknowledged the potential psychosocial burden of having those results. The majority of participants described the initial shock stage at diagnosis and liked the idea of a two-step consent process. Several parents brought up privacy concerns as a potential barrier to enlisting in whole-genome sequencing research.”
When asked about working with Ms. Ruiz, Dr. Glade Bender called her “pretty extraordinary.”
“She’s what I’d call a perfect shadowing medical student; she’s very quiet but incredibly attentive,” Dr. Glade Bender continued. “She doesn’t say anything until the moment is right, and then she comes in with an astute, nuanced question. She’s a keen observer. There is no doubt she will become a leader in the field.”
Dr. Julia Glade Bender is Associate Professor of Pediatrics at Columbia University Medical Center and Director of the Pediatric Cancer Foundation Developmental Therapeutics Program. She led the first pediatric trials of bevacizumab, an anti-VEGF monoclonal antibody, and pazopanib, a multi-tyrosine kinase inhibitor, in children with relapsed solid tumors and is recognized as a clinical leader in the field of pediatric antiangiogenesis. She is a supporter of the Conquer Cancer Foundation and one of the founders of the James B. Nachman ASCO Junior Faculty Award in Pediatric Oncology.
Interested in donating to the Conquer Cancer Foundation to help support medical students like Jenny Ruiz? Visit the Foundation website to learn more.