Medical student’s simple request leads to warm response

SUNY Upstate Waters Center Cancer

Connor Stanton, 10, talks with Upstate medical student Shunqing Zhang at the Waters Center for Children's Cancer and Blood Disorders. Shunqing's e-mail to the New Era Cap Co. resulted in regular donations of caps and hats to pediatric patients at Upstate. Photos by Jim McKeever.

It started with a simple, two-word compliment.

Upstate second-year medical student Shunqing Zhang was volunteering at Ronald McDonald House last summer when he saw a young boy wearing a cap with the logo of the Cleveland Cavaliers professional basketball team.

“Nice cap!” Shunqing told him.

Shunqing learned that the boy was being treated at the Upstate Cancer Center. And that the cap was a gift from Cancer Center staff, who would regularly buy them for patients who lose their hair from chemotherapy.

“They pay out of their pockets, which is nice,” Shunqing said.

But also expensive.

Shunqing thought it would be nice if someone else could donate the caps and hats. He sought advice from fellow Upstate student/Ronald McDonald House volunteer Michael Rosenthal, and reached out to a Child Life Specialist at the Cancer Center.

And he came up with a plan.

Shunqing, who did his master’s degree research at Roswell Park Cancer Institute in Buffalo, recalled an event where he had met a representative from Buffalo-based New Era Cap Co. — Michelle Ostrander, a Syracuse University graduate. So he sent her an e-mail.

“My request was well-received,” Shunqing said, unable to suppress a smile. More e-mails and phone calls to the company followed. “I told them a variety (of professional and college team caps) is always welcome,” Shunqing said.

A box of three or four dozen now arrives each month at the Upstate Cancer Center – caps in warm weather, and hats now that November is upon us. Patients at Upstate Golisano Children’s Hospital also benefit.

“The moral of the story is,” Shunqing said, “if you want to do something, try it. Maybe it won’t happen every time, but I had amazing luck and it pushed me into motion.”

On a recent afternoon in the Waters Center for Children’s Cancer and Blood Disorders at the Cancer Center, Child Life Specialist Sarah Buck and Shunqing showed a collection of New Era hats to patient Connor Stanton, 10.

Connor was especially pleased to find one with the National Football League’s Seattle Seahawks logo as he talked with Shunqing about professional sports teams.

Shunqing, who is from China, plans to specialize in cancer as a physician. It’s in part because his grandfather died from the disease, and because he finds cancer intriguing from a research and clinical perspective.

Before coming to Upstate, Shunqing earned a bachelor’s degree in biology from Cornell University and a master’s degree in interdisciplinary science at the University at Buffalo’s Roswell Park Cancer Institute Graduate Division.

He specialized in oncology research and is first author of a book chapter on cancer imaging and therapy in “Topics in Heterocyclic Chemistry,” published in 2014.

In addition to the demands of medical school and his volunteer work at Ronald McDonald House, Shunqing has found time to continue with his research. He worked last summer in the lab of Juntao Luo, PhD, assistant professor of pharmacology, and was selected to give one of three oral presentations at the 2015 Northeast Regional Meeting of the American Physician Scientists Association last month.

Away from the lab and second-year lectures, Shunqing said volunteering at Ronald McDonald House has led to meaningful talks with children and their parents. He feels fortunate to be around them.

“Some of the conversations are unlike what you’d have in a medical setting,” he said. “There are sad stories as well as joyful ones. Those are really . . .” — he paused – “. . . It makes me better. I see things differently. I really appreciate the center and want to be there. I want to keep talking to people, and helping people. It keeps me balanced.”

Shunqing also credits his wife, Janet Lai, a graduate student at Syracuse University’s Whitman School of Management who is active in local refugee assistance and sustainability efforts.

The two were high school sweethearts in their native Shanghai. “She is my inspiration,” Shunqing said.

SUNY Upstate Waters Center Shunqing Zhang

Upstate medical student Shunqing Zhang talks with Rebecca Quilty, mother of Connor Stanton, at the Waters Center for Children's Cancer and Blood Disorders. Shunqing's initiative led to donations of caps and hats for Upstate pediatric patients.

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A glimpse at ’rounding’ with a third-year medical student

SUNY Upstate

Third-year medical students Emily Kellogg and Rosemarie Mastropolo, at left, and Nathan Jones, upper right, join Dr. Carmen Martinez MD and other physicians on patient rounds in Upstate University Hospital.

Rosemarie Mastropolo probably will choose pediatrics as a career, but like all other third-year medical students at Upstate, she’s sampling different specialties during weeks-long clerkships in clinical settings.

It’s very different from her undergraduate days at Rensselaer Polytechnic Institute in Troy, where she majored in biomedical engineering.

“I liked engineering,” Rosemarie said. “It’s hands-on problem solving that translates well to medicine. But I missed the human interaction.”

At Upstate, Rosemarie has finished clerkships in pediatrics, psychiatry, neurology and OB/GYN, and is currently in internal medicine. Family medicine and surgery await.

Earlier this fall, Rosemarie was immersed in the five-week neurology clerkship, which included a different subspecialty each week. The stroke subspecialty included daily rounds on the neurology unit of Upstate University Hospital.

SUNY Upstate College of Medicine

Rosemarie Mastropolo

On a Friday morning, Carmen Martinez, MD, assistant professor of neurology, led a team of eight to check in on several patients on 9E. Rosemarie was joined by classmates Emily Kellogg and Nathan Jones, plus a handful of medical residents and observers.

The first stop was the room of a seriously ill patient. Fifteen minutes later, the team emerged and met privately with a family member to discuss the patient’s prognosis.

Outside the room of a second patient, Rosemarie briefed Dr. Martinez on the symptoms she had observed on “pre-rounds” earlier that morning. Emily and Nathan stood nearby, and other members of team listened or examined laptop screens on the portable workstations they wheeled from room to room.

Dr. Martinez listened and offered her insights into what Rosemarie reported. The patient wasn’t in her room at that moment (she was examined a short while later), so the team went to check on a newly admitted patient down the hall.

Another physician met with the team in the crowded hallway to review the patient’s brain scan images. The man had been brought in to the Emergency Department the previous day after becoming ill while grocery shopping.

After consulting with the other physician outside the patient’s room, Dr. Martinez explained why she was about to show the patient the images from his brain scan. “We always show them the pictures, so we’re on the same page,” she said.

Dr. Martinez met with the patient and went over his scan and his prognosis. She then watched and assisted as Rosemarie and Emily tested the patient’s responses to applied pressure on his hands, arms, face, legs and feet.

“Getting to round on patients and challenge ourselves to think of differential diagnoses is always intellectually stimulating and enjoyable,” Rosemarie said. “(So) much more occurs in neurology than just strokes, like so many people think.

“It was incredible to see how much can be done for the patients and how caring the staff was to patients, their families and their colleagues,” she said. “For me, neurology was a return to a clinical medicine based rotation and a reminder of why I entered medical school.”

Rosemarie’s first clerkship this year was pediatrics, which she thoroughly enjoyed, citing Drs. Ann Botash and Khalia Grant as great mentors. Rounding in the pediatric emergency department, Rosemarie was especially impressed by Dr. Grant, who showed “no bias, and was just very kind and non-judgmental,” she said.

Other influences run deeper, to Rosemarie’s family in Rockland County.

An aunt is a Nurse Practitioner (Rosemarie shadowed her while an undergraduate) and another aunt and uncle are physicians. Her mother is a special education teacher who “instilled a love of working with children and helping others,” said Rosemarie, who’s been a babysitter, camp counselor and Special Olympics volunteer.

“I’ve always loved caring for kids,” she said. “I’ve always wanted to be a pediatrician.”

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‘Cornerstone’ program eases debt worries for Upstate students

SUNY Upstate financial aid

Michelle "Shelley" Stock, assistant director of admissions and financial aid, discusses loan repayment plans and money-saving ideas with Upstate medical students Kethia Eliezer and Finny John. Photo by Jim McKeever.

Student loan debt is not on anyone’s list of favorite conversation topics, but Michelle Stock is making it easier for Upstate students to discuss.

Stock, Assistant Director of Admissions and Financial Aid, has launched Cornerstone, a financial literacy program on campus. The name is a nod to the cornerstone of Weiskotten Hall, placed in 1936 by President Franklin D. Roosevelt.

Students who have met one-on-one with Stock and attended small-group presentations are grateful for the program, which is open to students in all four colleges at Upstate.

“As a first generation college graduate, an immigrant, and daughter of immigrants,” said Class of 2017 vice-president Kethia Eliezer, “it is important for me to know what the best loans, scholarships, and repayment plans are out there for me since the bulk of my education costs will be paid by loans.”

Kethia’s classmate Alan Shum agreed.

“Saying that we graduate with a lot of debt is like saying ‘the sky is blue,’” he said. “But learning that this debt doesn’t have to define my career choices? That’s life changing. And exactly the reason why we need the Cornerstone program.”

The Class of 2016’s Finny John said halfway through medical school, he began to get e-mails from his loan server about the total he owed for his undergraduate and medical school education.

“I would quickly glance at the six-figure number, uncertain of how to feel about it,” Finny said. “What I was certain of was my lack of understanding about how I could repay this huge sum.”

Finny said he took a step in the right direction when he reached out to several physicians as well as to Stock. Classmate Adam Green concurred.

“After a year of accruing the debt necessary to pursue my goals of medical education I began to realize how little I knew about the loans I signed onto,” Adam said. “I looked to the Office of Financial Aid and Shelley, along with an attending physician, responded by offering two separate lectures that covered all of the basics of my loans and the best way for students to be prepared to repay them upon graduating.”

Stock said Cornerstone takes a three-pronged approach – educate, practice, empower – so that students can implement what they learn and make informed decisions about their financial future. (There are eight different loan repayment options, for instance.)

She tells students, “Ask me anything.” If a question is one they’d rather not voice in public, Stock encourages them to send her a text or stop by her office in 0217 Weiskotten Hall.

Students seem to prefer individual sessions, Stock said.

“We discuss the student’s specific educational indebtedness and calculate what their monthly payment will be in all repayment options available to them,” she said. “Then we come up with a short plan of action given their career path, life goals and projected lifestyle five years, 10 years and 20 years out.  This includes discussion on consolidation and loan forgiveness options.”

Regularly scheduled presentations and other information are on the Cornerstone website:

“Financial literacy is something we can all benefit from at all stages of life,” Kethia said. “But as a medical student, making thoughtful and informed decisions about my finance is as important as ever.”

DID YOU KNOW . . . ?

a.  Educational loan debt has surpassed consumer debt.  It is more than $3 trillion nationwide.

b.  The national default rate (non-payment on loan debt) is the highest in history.

c.  Upstate students’ total indebtedness (including prior educational loans) ranges from $18,000-$250,000.

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Student pursuing MD/MPH dual degree a voice for change

Upstate medical student Lizzy Wei McIntosh has been selected as student representative to the American Academy of Family Physicians Foundation board of trustees, the academy’s philanthropic arm.

The AAFP Foundation funds activities such as “Tar Wars,” in which medical students teach fourth- and fifth-graders about the dangers of using tobacco. (Upstate’s Family Medicine Student Organization participates in Tar Wars at Dr. Martin Luther King Elementary School in Syracuse.)

SUNY Upstate

Lizzy Wei McIntosh. Photo provided by AAFP Foundation.

The foundation also sends hundreds of students to the annual AAFP national conference, where they learn more about the specialty of family medicine and various residency programs.

Lizzy, a 2012 graduate of the Massachusetts Institute of Technology, also is pursuing a Master of Public Health degree at Upstate.

“I was briefly interested in doing nuclear medicine or radiology, but realized that my true passion is for primary care — specifically family medicine — because that is where the need is in health care today,” Lizzy said.

“Although I have strayed pretty far from my undergraduate training (nuclear engineering), one thing I did take away from those years at MIT is how important government policies and public perception are to any field’s development and growth,” she said.

Lizzy is spending her third year of medical school at Upstate’s Clinical Campus in Binghamton. She’ll receive her MD and MPH in 2017.

“My goal is to do residency in family medicine and then be a family physician in a rural town,” she said. “I’d be happy at pretty much any of the small towns in upstate New York or eastern Ohio. I want to really know my patients and also to be involved in my community, and to help plan public health outreach efforts beyond just office visits.”

Her dream, she said, is “to help to make the primary health care in my community so good that it becomes a model for other places to learn from.”

Lizzy has several reasons for pursuing an MPH in addition to the MD degree:

* The United States spends almost twice as much per person on health care compared to the next highest OECD (Organization for Economic Cooperation and Development) country, but with worse results. “There are a lot of changes that still need to happen in healthcare delivery, and I want to be able to contribute to those discussions,” she said.

* Primary care providers and public health professionals need to team up to significantly change how the U.S. approaches prevention.

* The family medicine “pipeline” needs to improve, in part by changing the attitudes of the medical community (and of the public) toward family doctors, and changing the financial incentives for family medicine.

“We currently have a shortage of primary care and mental health providers in the United States that is projected to get even larger over the next decade,” Lizzy said. “A lot of that has to do with the current fee-for-service system and differences in Medicare reimbursement for different kinds of work. My MPH training has also helped me to understand more of that picture and where the opportunities are for change in this area.”

As a native of Cincinnati, Ohio, Lizzy said people often ask her how she ended up in Central New York.

“My husband is a PhD student studying philosophy at Cornell,” she said.  “Also I was interested in primary care and I liked how Upstate emphasized that in its education.”

SUNY Upstate

Lizzy Wei McIntosh with her research poster at the Society of Teachers of Family Medicine conference in Orlando, Fla.

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Upstate student’s cancer research project makes journal cover

SUNY Upstate

Stephen Shinsky, center, and the Cosgrove lab at Upstate. From left, lab manager Susan Viggiano; post-doctoral associate Nilda Alicea-Velazquez; Stephen; Associate Professor Michael Cosgrove, PhD, and graduate student Kevin Namitz.

A research project led by Upstate graduate student Stephen Shinsky made the cover of the Oct. 23 Journal of Biological Chemistry and will pave the way for further studies of a protein linked to causing – and possibly treating – cancer.

While conducting research into the Mixed Lineage Leukemia protein-3 complex (MLL3), Stephen “noticed this weird finding and really took charge, coming up with experiments on his own,” said his mentor Michael Cosgrove, PhD, associate professor of Biochemistry & Molecular Biology.

“The structure of the MLL3 protein complex presents a significant technical challenge,” Cosgrove said. “It’s big, with five components. Working on one protein is hard. Working on how one interacts with another, the challenges increase exponentially.”

But Cosgrove had faith in Stephen, who recently received his PhD and accepted a post-doctoral position at the University of North Carolina at Chapel Hill.

SUNY Upstate

The Oct. 23, 2015 Journal of Biological Chemistry features Stephen Shinsky's research project on the cover.

“He was the guy to handle it,” Cosgrove said. “It’s gratifying as a mentor when a student becomes independent and takes charge.”

What Stephen found was that a subunit that interacts with the MLL3 protein known as WDR5 behaves differently in the MLL3 complex than it does in MLL1 and MLL2 complexes.

“We expected similar behavior, but Stephen found out otherwise,” Cosgrove said. The discovery can help researchers understand the regulation of activity in cells implicated in aggressive leukemias that affect infants and, in some cases, adults taking anti-cancer medication.

“The amount of MLL3 mutations that have been found in cancers in recent years is astounding,” Stephen said. “However, how these mutants affect MLL3 is not really known. Our work lays the groundwork for understanding the MLL3 core complex.”

Researchers can “easily now generate the MLL3 cancer mutants and perform studies like those in my paper and compare how cancer mutants affect the MLL3 core complex in vitro,” Stephen said.

It took many nights and weekends in Weiskotten Hall to get to that point.

“I had to do a lot of experiments to prove that the WDR5 subunit was indeed inhibiting MLL3,” Stephen said. “WDR5 does not appear to inhibit any of the five other highly related proteins in the same family as MLL3.”

That finding was included in an earlier paper Stephen authored, but what he really wanted to do was craft an entire paper around it. That project, with Cosgrove’s assistance, became the JBC cover article with Stephen as first author.

“Dr. Cosgrove was supportive in letting me direct an entire project myself and finally that came to fruition with the latest paper,” Stephen said.

An additional element of the MLL3 research is the possibility that it can act as a tumor suppressor and prevent cancer progression.

“Our discovery that the WDR5 subunit inhibits the enzymatic activity of MLL3 may suggest that agents designed to interfere with the interaction of WDR5 and MLL3 could stimulate activity and be therapeutic,” Stephen said. “Of course it would have to be shown that the enzymatic activity of MLL3 is required for its tumor suppressor capabilities.”

The Cosgrove lab previously developed agents that interfere with WDR5 binding to MLL3 family members. Stephen has shown that these agents increase the enzymatic activity of MLL3, “so it may be that these agents could be used to treat cancers where MLL3 mutations reduce enzymatic activity,” he said.

SUNY Upstate

Stephen Shinsky and research advisor Dr. Michael Cosgrove at Commencement.

Where can this work with MLL3 lead?

Perhaps to a successful result similar to the structure-based design and development of HIV protease inhibitors to treat AIDS, and tyrosine kinase inhibitors such as Gleevec that target the BCR-Abl oncogene in previously fatal chronic myelogenous leukemias, Cosgrove said.

“The key is targeted therapeutics,” he said. “That’s what this is about. Understanding the intricacies of how these proteins work at the molecular level will lead to new and better treatments.”

The Cosgrove lab will continue Stephen’s project while he tackles cancer research at the University of North Carolina at Chapel Hill, working on different aspects of gene expression. He has nothing but praise for Upstate and the Cosgrove lab.

“I had a lot of freedom to work independently but was able to check in with Dr. Cosgrove as often as I’d like,” Stephen said. “Sometimes I was in his office 10-plus times a day showing him data and discussing my next experiments.

“We really worked very well together and were able to accomplish a lot in a short amount of time,” Stephen said, referring to his relatively short four-year path to a PhD.

“I learned a lot from him and not just about science, but about how to think problems through. I will certainly miss working with him. Our ability to coordinate our different work styles into a synergistic force was really responsible for the success of this cover article and our other publications.”

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