Vital Signs

DMS's Paravati delivers from the podium

By David Corriveau

Paravati is in the M.D.-M.B.A. program.

For Dartmouth medical student Anthony Paravati, the invitation from the American Society for Therapeutic Radiology and Oncology (ASTRO) was a rare gift—wrapped in a challenge.

Paravati was thrilled to be asked to give a talk at ASTRO's annual meeting a few months ago on research he'd done under the guidance of radiation oncologist Candice Aitken, M.D. The challenge was that medical students aren't often asked to give talks at major meetings.

Paravati explains that "while [it is] not unusual for residents and sometimes medical students to give poster presentations," or to exhibit a placard describing a study's methods and findings, "it is highly unusual for a medical student to be awarded a podium presentation."

So "Dr. Aitken and I worked hard to make the presentation as lean as possible without losing the message of our work," Paravati continues. "Speaking about a complex topic, even to an educated audience for such a short time—seven minutes plus three minutes of questions—requires each line of your presentation to be absolutely essential to the main thrust of your work."

Year: Not that Aitken was worried about Paravati, who is spending this academic year as a Doris Duke Fellow at the University of Pittsburgh's Institute for Clinical Research Education. After he finishes the fellowship, he expects to complete, by 2012, his medical degree at DMS and his M.B.A. at Dartmouth's Tuck School of Business. Paravati arrived at DMS in 2006 with a B.S. in neuroscience from Allegheny College, where he investigated deep-brain stimulation for Parkinson's disease.

"The first time you meet him, he comes across as very persistent, very thoughtful, eager to take on every challenge," Aitken says. "We have very talented students here, but ones like him come along once every other year or three years."

Projects: By his second year at DMS, Paravati was doing research with Aitken as well as with neurosurgeon Alan Hartford, M.D., and neuro-oncologist Camilo Fadul, M.D.

The study that Paravati presented to ASTRO focused on Samarium, a radioactive drug given to patients with advanced cancer. At the suggestion of Aitken and Andrea Russo, a DMS '09 who is now a resident in radiation oncology at Harvard, Paravati looked at the prevalence of side effects not reported in previous studies. He and his collaborators found patients experiencing swelling of the lower legs, changes in the function of the nervous system, and a reduced ability to make new blood cells for bone marrow.

The data "suggests it could be important for physicians to think about the other treatments—chemo, external-beam radiation therapy—[that] patients are receiving in addition to Samarium," Paravati says. "Patients receiving combinations therapy may be more vulnerable."

Aitken notes that Paravati completed his presentation "right on schedule," with time for questions. "He's always ahead of schedule," she says.

In his fellowship at Pitt's Hillman Cancer Center, Paravati is studying the effectiveness of CyberKnife radiosurgery for skull tumors. In addition, he's completing some research projects he started at Dartmouth.

"[It's] quite a bit of work," he concedes. "However, I enjoy it very much. . . . I love the idea of trying to improve the patient experience in a larger way than one by one."

Fit: And how will that M.B.A. fit into his goals? "I have an eye for observing how . . . resources are modified and improved upon to create an end product," Paravati says. "I am hoping to . . . determine how to reduce waste and improve quality."

His mentors wouldn't put it past him. "It would be a very powerful combination," Aitken says. "You take care of patients in the best possible way, the most cost-efficient way."