Resident and Fellow Research Drives Patient Care Forward

When rheumatology fellow Dr. Hira Imran meets one of her lupus nephritis patients, she knows the greatest challenge ahead of them will be figuring out which treatment will work best.

The second-year fellow specializes in autoimmune diseases like lupus. And she's improving the ability to pinpoint the most effective biologic therapy for each patient because of her research.

"I needed to see which out of the five drugs is the better among all five of them," says Hira Imran, MD. "This is what a network meta-analysis is."

Srishti Sareen, MD, chief fellow in hematology oncology at the University of Tennessee Health Science Center, is also driven by a commitment to translate clinical questions into research that improves patient care, focusing on cancer treatment. Her recent work homed in on preventing life-threatening complications in African American male cancer patients.

Hira Imran, MD Srishti Sareen, MD

Due to their quests for clarity and subsequent research, Drs. Imran and Sareen earned the Top Poster Presentation and Best Oral Presentation, respectively, at the UT Health Sciences College of Medicine's second annual Residents and Fellows Research Day.

Physician trainees at UT Health Sciences, like Drs. Sareen and Imran, are asking clinical questions in the morning and finding answers by evening that will help shape patient care, as well as mentor the next generation of physician-scientists. This research-driven approach reflects the university's rare R1 Carnegie designation for top-tier research activity, impacting health care for Tennesseans and beyond, now and in the future.

A Platform for Clinical Advancement

The college's Research Day has expanded rapidly since its first year. This second event drew 145 participants and 89 abstract submissions, featuring 76 poster presentations and four oral presentations.

"Since the inaugural College of Medicine Residents and Fellows Research Day, we've grown significantly in the number and quality of submissions," says Natascha Thompson, MD, associate dean for the university's Graduate Medical Education department. "This speaks volumes to the great work the residents and fellows are doing."

Trainees collaborate closely with faculty mentors, though residents and fellows often drive the research questions themselves, she adds. Sometimes the projects include medical students too.

From Analysis to Application

Dr. Imran's meta-analysis tackled a pressing clinical dilemma in rheumatology. In lupus, there are currently two FDA-approved biologic therapies, while several additional agents have been studied in clinical trials against placebo. Her project used a network meta-analysis approach to indirectly compare these therapies, since most had not been studied head-to-head. The goal was to better understand how different options may perform relative to each other and guide patient treatment decisions.

She explains how lupus is a heterogeneous disease, and treatment decisions remain nuanced and individualized. These indirect comparisons provide additional information that can help clinicians think about relative effectiveness while research in the area continues to evolve.

"We've already started applying this information to our patients already in the hospital," she says.

Rheumatology deals with complex autoimmune diseases, where standard treatments work for only about 30% of patients. Choosing the right therapy matters enormously when the alternatives carry serious risks.

"I don't think research and clinical work are competing priorities," Dr. Imran says. "Patient care shapes the questions I ask, and research helps me take better care of my patients."

Addressing Health Disparities

Dr. Sareen took home the Best Oral Presentation honor for research that could save the lives of African American male cancer patients. Her prospective study examined G6PD deficiency, an enzyme disorder affecting roughly 10% of African American males. Certain chemotherapy drugs can trigger severe hemolysis, the dangerous breakdown of red blood cells, in patients with this condition.

"These drugs can cause life-threatening hemolysis," Dr. Sareen says. "If we know ahead of time a patient has G6PD deficiency, we can modify the dose or avoid those drugs entirely."

The study compared standard enzyme testing with comprehensive pharmacogenomics panels. Dr. Sareen found the genomic approach revealed additional genetic variations affecting drug metabolism and safety beyond G6PD status alone.

She enrolled 186 African American male veterans at the Lt. Col. Luke Weathers, Jr. VA Medical Center, addressing a research gap in this historically underrepresented population. The research has immediate clinical applications, guiding treatment decisions to prevent adverse reactions before they occur.

Cultivating a Research Culture

Both physicians emphasize how UT Health Sciences' research platform strengthens their work. Dr. Sareen went on to present findings at the American Society of Hematology and American Society of Clinical Oncology conferences.

"Having a platform like this gives you the opportunity to collaborate with so many like-minded people," she says.

Dr. Sareen later won Best Submission at the San Antonio Breast Cancer Symposium for separate disparity-focused research. She plans to expand her patient population for cost-effectiveness analysis and measure how pharmacogenomic testing reduces chemotherapy-related complications. A future fellow will carry the work forward as she transitions to practicing breast oncology with a Memphis group after graduation. She'll continues to serve local organizations such as Think Pink, increasing breast cancer awareness.

"I remain deeply committed to carrying this work forward by mentoring the next generation of researchers, including residents and students, and actively collaborating with them on ongoing research initiatives," she says.

Having completed both residency and fellowship at UT Health Sciences, Dr. Imran is excited to continue practicing at Baptist Memorial Hospital-Memphis after graduation.

"Every case surprisingly turns into a case report," Dr. Imran says, describing the intricacy of autoimmune diseases.

She's currently researching why certain biologics work better in male versus female patients with axial spondylitis (chronic inflammatory arthritis targeting the spine and pelvis), driven by patterns she noticed while treating patients in the region. Her curiosity has taken her to a Nashville oral presentation for the Tennessee Rheumatology Society and to the European Alliance of Associations for Rheumatology (EULAR) conference in Barcelona, Spain.

"Research just finds its way because I have those questions," she says.

The university's most recent Graduate Medical Education award recipients delved into research topics ranging from extremely low birth-weight infants to safe urology discharge procedures.

2nd Annual Residents and Fellows Research Day Award Recipients

Best Oral Presentation

• Srishti Sareen, MD - The Importance of Routine G6PD Screening in Oncology Patients: A Prospective Comparative Study in African American Males (AAM) Highlighting the Additional Benefits of Pharmacogenomics (PGx) Panels Over Standard Enzyme Assay

Outstanding Submissions and Selection for Oral Presentation

• Omar Ahmed, MD - SLC34A3 Variants Associated with Urinary Stone Disease and Hypercalciuria in the Mayo Clinic Biobank
• J. Michael Ruth, Jr., MD - Effects of Obesity on Outcomes of Pediatric Polytrauma Patients
• Aamir Saeed, MD - Acute Necrotizing Pancreatitis is Associated with an Increased Risk of Venous Thromboembolism and Worse Clinical Outcomes: A Systematic Review and Meta-Analysis

Top Poster Presentations

• Hira Imran, MD (First Place) - Efficacy and Safety of B Cell-Targeting Biologics in Lupus Nephritis: A Meta-Analysis
• Aamir Saeed, MD (Second Place) - Comparison of Novel Self-Assembling Peptide Gel and Conventional Techniques for Endoscopic Hemostasis in Post-Sphincterotomy Bleeding: A Systematic Review and Meta-Analysis
• Sharvari Shyam, MD (Third Place) - Validation Study of the Accuracy of Echocardiographic Measurements of Hemodynamically Significant Patient Ductus Arteriosus in Extremely Low Birth Weight Infants
• Will Fry, MD (Fourth Place) - Analyzing the Safety and Effectiveness of Transurethral Resection of Prostate (TURP) with Same Day Discharge: A Five-year, Single Institution Experience
• Jimmy Latham, MD (Fifth Place) - Safety and Outcomes of Same-Day Versus Non-Same-Day Discharge Following Percutaneous Nephrolithotomy: A Single-Institution Comparative Analysis