Scholarly Project Profile: Jahnavi Shriram

The Scholarly Project — a four-year, longitudinal research experience — is a key component of the college’s curriculum. Requiring medical students to complete a substantiative research project promotes greater medical information literacy, encourages life-long learning, and inspires students to practice evidence-based medicine and ethics. It also serves as a key differentiator during the residency interview process.

Meet Jahnavi Shriram

As an undergraduate at the University of Texas at Austin, Jahnavi Shriram double majored in neurobiology and humanities. She noted that the combination of disciplines was great for her because she has always been deeply interested in the underlying neurological basis of the human consciousness, behavior and personality.

That interest pushed her to apply to medical school, eschewing her original plan to pursue public health. It also led her to the University of Arizona College of Medicine – Phoenix. A major factor in her decision to attend the college was the immediate sense of warmth and support she felt from all the school administration and students.

Once Shriram began her studies at the college, it was not long before she realized neurology was the specialty that interested her most. Since then, her love for the field has only grown, as it has allowed her to both investigate the neuroscience underpinning these disease processes, as well as immerse herself in patients’ stories. During the Class of 2024 Match Day, she successfully matched into neurology at Barrow Neurological Institute.

Shriram credits many mentors that have inspired her throughout this journey. But she is especially grateful to her research mentors, including her Scholarly Project mentor Michael Malek-Ahmadi, PhD, who — alongside his day job of making critical and invaluable contributions to medicine — invested in Shriram.

Shriram’s fellow medical students served as a source of inspiration, as well. She has no doubt that every single one of them will be future leaders in health care.

About Her Research

What did you think about completing a four-year research project as part of your medical education?

Since I am personally interested in pursuing research in my future career, I appreciated that there was a structured process to complete a manuscript embedded into the curriculum. I thought that it was a gratifying, informative process, and it allowed access to resources such as a database of primary investigators willing to mentor students on research projects, the IRB office and the Biostatistics team.

I also really value my relationship with my mentor, who has been such a guide and advocate for me. If I were not planning to pursue research in my future career, I can imagine that this process could have been stressful as there are many variables that can influence the course of completing a manuscript. However, I think that it still provides insight into the research production process that can help a clinician understand how medical information is generated and disseminated. This can definitely be relevant to day-to-day practice.

What did you learn from the research process?

One of the most valuable lessons was understanding the ecology of how research investigations are disseminated to the medical community. Many of us had to write manuscripts in some form as an undergraduate, such as for lab-based courses, but there was perhaps less exposure to how to distribute the results. It was helpful to learn aspects of this process — such as selecting a conference that would be a good fit to present the poster and what the back-and-forth dialogue with journal reviewers after manuscript submission can look like.

How did you choose this specific research focus and what was the aim of the project?

Patients with Alzheimer’s disease have pathogenic changes in the brain long before their clinical symptoms become overt — for example, when they start displaying ‘Mild Cognitive Impairment’ or full-blown dementia. It is very likely that most effective interventions to reverse or prevent Alzheimer’s would occur in early pathogenic stages when patients are essentially cognitively unimpaired.

The trick is to accurately detect it in those early, silent stages. There are new amyloid and tau protein biomarkers for Alzheimer’s that have been released in the last year or so, but we believe that these can be strengthened by additional biomarker molecules that together increase the likelihood that a person has early-stage Alzheimer’s as opposed to a different dementia etiology — or no disease at all. We are investigating a class of possible candidate molecules, Histone Deacetylase proteins, by assessing whether their serum expression was correlated with amyloid burden in cognitively unimpaired individuals.

This project was an extension of prior work done by my mentor, Dr. Malek-Ahmadi, at Banner Alzheimer’s Institute. We felt that this would be a good fit as I had an early interest in possibly becoming a dementia neurologist in my future career and because it would require statistical programming for data manipulation and analysis, in which I had rudimentary skills.

And what was the outcome of the research?

We had interesting results — one of the Histone Deacetylase probes had increased serum expression in patients with high cerebral amyloid burden. We examined this relationship in two different ways, and it persisted to a degree with both approaches. It’s hard to say what this truly means, as the analytical approach included a broad array of simultaneous assessments, which theoretically increases the chance that our ‘positives’ were incidental.

Still, it was exciting for me that out of many simultaneous tests, our two positive results were coherent with each other, occurring in the same probe and having the same direction of relationship. We initially presented these results as a poster for the Society for Neuroscience conference in 2021, and the manuscript is now essentially ready for journal submission.

Did your research influence your choice of specialty for residency?

Early on in medical school, I was pretty confident that I was going to pursue neurology after graduation, and this was solidified primarily by clinical experiences that reassured me of a truly sustainable love and interest for this patient population. I do feel that conducting research related to Alzheimer’s dementia opened my eyes to how many fascinating mysteries there are in this subspecialty and how urgent and timely they feel, given recent advances in biomarkers and disease-modifying therapies for Alzheimer’s. I would say my Scholarly Project and similar projects focused my excitement on behavioral/cognitive neurology, as I feel that there is a really beautiful dovetail these days between both research and clinical frontiers in this field.

How do you think this project helped to prepare you for your career in medicine?

Besides invaluable insight into details of the research production process in general, this project reinforced my enthusiasm for doing large database studies. I had very basic skills in data science-based research from my gap year job, and I was able to apply and expand those for this project, which used data extracted from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), a multicenter database.

My mentor, Dr. Malek-Ahmadi, was able to provide mentorship both on the neuroscience and the biostatistics components of this project. He really inspired me to continue developing these skills and discovering new ways that they could be applied in a clinician-researcher’s career — not only to perform retrospective studies, but in care delivery science, quality improvement, health equity and other operational areas.

If there is one piece of advice you could give to incoming medical students about this project, what would it be?

There is so much variability in mentorship styles, project content and relevance to students’ careers that it is extremely difficult to give a single, unifying piece of advice! I think that a major part of what allowed this process to be so fun and rich for me was that I had a wonderful relationship with my mentor.

I think that a good mentor fit is perhaps the most important factor in pursuing research, particularly for this graduation requirement.

To gauge whether a mentor is a good fit, it would be helpful to identify early on what you hope to get out of the process — and how you can leverage it to build your residency application, even if you are not envisioning a research-focused career. If you find that you can be upfront with your mentor about these personal goals and create a plan for how to meet them, as well as school timeline requirements and mentors’ needs, that is a very promising start to work from.

One final point: I found that a cycle of having a milestone met and a meeting planned every four months was the most congruent with the ebb and flow of our primary curriculum.