A journey with research and Ophthalmology

A journey with research and Ophthalmology

Mar 3, 2021 0
challenges,innovation,onthepods,ophthalmology,research

Tom Ayton chats to Michelle Sun about her journey with research and Ophthalmology which has culminated in her incredible achievements thus far. Michelle also provides some tips for anyone considering a future in Ophthalmology.

 

Summary Writer:  Eloise Sobels

Script Writers:  Tom Ayton, Michelle Sun

Editors:  Michelle Sun, Evangelie Polyzos

Interviewee:  Michelle Sun

About Dr Michelle Sun

Michelle is an early career ophthalmic surgeon-scientist with broad interests in ophthalmology. She completed her PhD in 2017 with a Dean’s commendation for Doctoral Thesis Excellence and has close to 50 peer-reviewed publications. She has also attracted over $500,000 in research funding, having previously been a recipient of an Avant research grant. In recognition of her achievements, she was recently awarded a highly competitive fellowship at Stanford University where she will continue to develop her clinical, surgical and research skills in Ophthalmology. Michelle is also a past Board Director of the Sight For All Foundation, a South Australian charity focused on sustainable health care projects in neighbouring developing countries.

About Dr Tom Ayton

Tom is a Resident Medical Officer at Liverpool Hospital, Sydney, Australia. He is from Albany in Western Australia and has a background in exercise physiology and sport. During his postgraduate medical training Tom became interested in medical education, which he completed his course research in, as well as medical student teaching and Junior Medical Officer advocacy. Tom loves the beach, keeping healthy and is a very poor surfer.

A journey with research and ophthalmology

With Dr Michelle Sun, Ophthalmologist, PhD scholar, Fellow at Stanford University and Avant research scholarship holder, South Australia, Australia

 

Introduction

Ophthalmology is a highly recommended specialty. Despite its numerous exams and subsequent late nights, it provides for a very rewarding specialty. Adding research into this mix gives variety to a clinician’s career. Dr Michelle Sun talks of her journey with research and ophthalmology which has culminated in her incredible achievements thus far. Michelle finishes the podcast with tips for anyone considering a future in ophthalmology.

  • Completed medical degree as an undergraduate student at the University of Adelaide
  • I decided to do an elective in India at the end of first year where one week was spent in an ophthalmology department. Two doctors in this department happened to be visiting from Adelaide.
  • I started research with these doctors once back in Australia as a second year medical student. I was lucky that I had found this interest early in my career so that I could start on research.
  • Then I pursued a PhD once I had graduated from medical school.
  • Internship was at the Royal Adelaide Hospital (RAH) and I also completed one year abroad working at Oxford. I then completed more training at the RAH which was followed by my Ophthalmology training.
  • I was completing my general year. As part of the requirements for ophthalmology, you have to complete two years of non-ophthalmic time.
  • From first year onwards Ophthalmology was it. I don’t think I could do anything else. It’s the best specialty.
  • The surgery is neat.
  • It’s incredibly rewarding. The outcomes are wonderful for patients. You can make a huge difference in someone’s life, especially the elderly, as for them a lot of interventions don’t improve quality of life. To be able to improve their quality of life, in their later life and change their ability to be independent is quite rewarding.
  • Ophthalmology also involves also a lot of research, which is a particular interest of mine.
  • It’s a rewarding specialty in medicine and one that is overlooked. You don’t get a lot of exposure to Ophthalmology during medical school. It’s the best kept secret.
  • I was a resident medical officer at the time, and had just finished my PhD where we looked at making an alternate cartilage tissue using bioengineering techniques.
  • There is such a high rate of skin cancer in Australia, a lot of it occurs in the eyelids and when you remove the skin cancer often there is a very big defect, and not a lot of cartilage that is similar to eyelid cartilage.
  • We were looking at making a bioengineered eyelid cartilage and for that you need a scaffold which is biocompatible and biomechanical similar to eyelid cartilage. Then you need to be able to culture the cells from the eyelid onto the scaffold.
  • At the time we had just started the process but with the scholarship we were able to advance that further into animal studies. Which was found to be quite biomechanically and biocompatible.
  • Since then, we’ve been able to progress that further and potentially looking at human trials in the next year or so, so that’s quite exciting.
  • Bioengineering and tissue culture has so many applications in so many fields.
  • In Ophthalmology we are looking at applying these techniques to progressively more complex tissue.
  • Since eyelid cartilage, we’ve been working on lacrimal gland culture. We have been able to take a biopsy sample of lacrimal gland and propagate the cells which have been found to secrete tears. This is a huge step towards being able to regenerate a functional gland.
  • There are still many steps to go but we are hoping in the future to progress that area and also move onto more complex tissue like the retina. That’s the end game and would have huge implications for being able to treat a wide variety of blinding conditions.
  • We have finished all the animal studies for the cartilage tissue and we’ve now obtained medical-grade scaffold material to hopefully progress that to human trials in the next year or so.
  • Then We are going to progress the lacrimal gland studies into animal trials, hoping in the future then we can apply that to human studies.
  • At the moment, we are starting to propagate retinal cells, but we are at the beginning phases of that.
  • What 2020 has taught us is that there are so many things you can do remotely. We have a great team of researchers and a lot of the work we are doing in Australia is similar to Stanford who are leaders in neuro-regeneration, and they’ve got a very active glaucoma research department there.
  • Hopefully I can continue the research over in America and bring back more skills when I come home.
  • I started this research project as a medical student and was lucky to find Ophthalmology quite early in my career, which meant I could start research at the same time as completing my medical studies.
  • This is something that has really been 10 years in the making. That is the thing about research, it can take a really long time, but it is certainly quite rewarding.
  • I think COVID has hiccupped everyone. Last year, we were lucky enough to get an NHMRC grant for our lacrimal work. Because of COVID, things have been very slow.
  • The other thing is, anything to progress to human trials takes not just time but a lot of balances. You need to make sure that it is compatible in animals and you need to make sure all your materials are FDA/TGA approved. All of those things make it quite slow.
  • It is definitely not instantly rewarding, it is the long game you play.
  • A lot of hoops to jump through, but that’s ultimately to keep patients safe.
  • Once you have demonstrated it’s safe in animals it is a bit easier thereafter. But certainly, all material needs to be checked multiple times.
  • Itis worth it in the long term, but it does take a long time.
  • As doctors, as clinicians, everything we do is based upon research that someone else has done.
  • To be at the top of your game and keep you career interesting you need to be across all the latest research in your area.
  • It is the best way to make a lasting contribution to your field and it makes your career much more interesting. You are not just treating patients you’re thinking about how to treat their problems in new and different ways.
  • Ophthalmology is the best specialty, but it has the most exams of any specialty. Going to America, and also sitting the USMLEs, you have to accept that you may not have much of a life outside of that.
  • In this sense research becomes more of a hobby.
  • I am looking forward to America settling down. Hopefully by July when I head over there, COVID will have settled. Maybe, we could be in a position where we can travel again.
  • To get to America and start work will be an achievement in itself based on the way things are at the moment.
  • I would like to have a clinical academic role.
  • Working in a public hospital with some research time, having some research fellows, teaching registrars and doing some private work.
  • It is hard to fit in any hobbies, I used to really like to travel. We did spend a lot of time in the UK and travelled on the weekends. Obviously now no one can travel.
  • I have two dogs, old English sheep dogs mixed with poodle – ‘Sheepdoodles’ – which keep me busy. It’s nice to go out for walks when I’m not – studying for exams.
  • Ophthalmology is a great choice, and it is worth every late night. It is such a wonderful, fulfilling, worthwhile and rewarding specialty.
  • I enjoyed my job every day as a registrar, probably 90% of the time. I think you would be hard pressed to find another trainee who feels that way about their specialty.
  • Contribute to research because it’s so rewarding and gives you some variety.

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Tags: #Avant,#bioengineered tissue,#careers in medicine,#Doctors in Training,#eye disease,#eyelid,#ophthalmologist,#ophthalmology,#reconstructing eyelids,#research,#skin cancer,#tarsus

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