The Breast Care Center

I've done a poor job posting about my Project 55 position at the UCSF Breast Care Center (BCC), but am trying to change that this weekend. I'll start with a general post about the internship program, and then follow it up with posts about my specific work and life in San Francisco.

I began work at the BCC at the beginning of July. The collaboration with Project 55 is just part of a broader BCC intern program. There is another fellow from Princeton, a few from Harvard (they have a similar partnership), and then a number from other schools. In total, there are 10 interns. One just took the MCAT, and will be applying to med school next year, but the other 9 are all applying now.

The program really is set up as a nice 1 or 2 year commitment for students who might be interested in medicine, and it's viewed more as an educational opportunity than a strict job. At the beginning of the year, we had talks with different doctors in the clinic on breast oncology, surgery, reconstruction, pathology, and more. We are encouraged to go to the weekly meetings such as Tumor Board and other lectures that take place at UCSF (there have been a few on health policy, for example).

The student interns are involved in a number of different trials that go on at the Breast Care Center. Some of them are breast cancer drug trials, such as I-SPY 2 (which is what I am working on). Another big project is the ATHENA Breast Health Network, a UC-wide collaboration that aims to follow women screened for breast cancer and generate a repository of risk and outcome data. There are also quality of life studies, including yoga classes to prevent lymphadema and scalp cooling caps to be worn during chemotherapy to reduce hair loss. Within each of these trials, interns also take on different roles. Some are clinical coordinators, and do a lot of the work to consent patients for the trials, schedule appointments, follow up with patients, and make sure that the trial generally runs smoothly. Other interns are involved in laboratory work, policy research, and health economics research. Since there are so many different positions, and so much to be done at the BCC, there is the opportunity to tailor projects to your own strengths and interests (computer science majors, for example who work on the IT side of trials). Most of these projects have websites and other information online, so I would encourage anyone applying to get a sense of which projects most interest them. Of course, the day-to-day work on any given project may not entirely recapitulate the overall aims of the research. These studies are often long-term, and clinical trials do involve a lot of data collection/entering, paperwork, and so on.

The one constant for everyone in the internship is Decision Services, which is a sort of patient advocacy program. A lot of patients coming into the BCC have treatment options, such as the choice between a mastectomy or a lumpectomy with radiation. Especially for women who have been recently diagnosed, these appointments come at an emotional, stressful time, and can include an overwhelming amount of information. We work with many of these patients, calling them before appointments to help them to generate a written list of questions for their doctor. We then accompany the patients to their appointment, taking notes for them and making an audio recording. Patients really appreciate the service, and the comfort of having someone navigate the process with them. It's also informative and powerful for us as interns, because we really get to know the patients and become intimately aware of their priorities, goals, and fears about treatment. Someone once said that it is more like shadowing the patient than shadowing the doctor, and I certainly agree with that assessment.

I'll follow this post up with more details about my specific work and experience in San Francisco. If you can't tell from this post, though, I'm having a great time at the BCC. It's certainly a good deal of work, but I've had a lot of new experiences and have learned a tremendous amount.