Resident Research Subcommittee Has Played a Key Role in Expanding the Department of Psychiatry’s Research Culture

It’s a warm spring day in Palo Alto, Calif., where Dr. Michael Martyna is wrapping up the final few months of a one-year clinical fellowship at Stanford University.

“Due to COVID I work out of my apartment most days on Zoom,” says Dr. Martyna, who completed the Resident Program in the Department of Psychiatry at the University of Alberta last spring, before starting his fellowship in June.

“The Stanford campus is just 10 minutes away by bike, and I work out of the Stanford Health Care Hospital about one day a week. It’s been a great opportunity to come here and see some of the research they do.”

Dr. Martyna was awarded the fellowship partly due to the research he did in his PGY-4 and PGY-5 years as a Resident, under the supervision of Dr. Richard Camicioli, a Professor in the Department of Medicine, Division of Neurology at the U of A.

Since the Royal College of Physicians and Surgeons of Canada mandated in 2015 that Psychiatry Residents engage in scholarly activity along with their clinical training, Dr. Martyna and dozens of other Residents have completed research projects.

Some, like Dr. Rejish (Reji) Thomas, who is now an Assistant Clinical Professor at both the University of Calgary and the U of A, used their research to earn a Master’s degree in the Department of Psychiatry Graduate Program before they finished Residency.

“The expectations around research engagement during Residency substantially increased in 2015 when the Royal College’s requirements for scholarly activity changed,” says Dr. Maryana Kravtsenyuk, an Assistant Clinical Professor in the Department of Psychiatry and Chair of the Resident Research Subcommittee.

“Dr. Xin Min Li, who in 2015 was Chair of the Department of Psychiatry, promptly responded to these changes by securing funding for Residents to really foster a scholarship mentality, and to value academic development among trainees. Dr. Roger Bland (who died in July 2018) chaired this subcommittee prior to my involvement, and graciously gave me an opportunity to chair it once he stepped down, so I would like to recognize both of them for their important contributions.”

Residents’ scholarly activities are wide-ranging, says Dr. Kravtsenyuk, encompassing everything from literature reviews and front-line data collection to data analysis, quality improvement studies, and the publication of research findings in peer-reviewed scientific journals.

“Five Residents have completed Master’s degrees since this initiative was launched. Since 2018, about 36 Residents have successfully completed their scholarly activity, and 23 projects were funded by our subcommittee for such things as disseminating data, attending conferences or purchasing equipment,” she explains.

“We have a number of clinicians in the department who are involved in research and serve as mentors for our trainees, so when they enter their first (PGY-1) year of training we’re able to provide each Resident with a list of available research projects. The content of the project and the research is defined by the supervisor, but the Resident is free to pick the supervisor they want to work with or the projects they want to do.”

Dr. Martyna’s project was part of an $8.4 million nationwide Dementia study called COMPASS-ND (the Comprehensive Assessment of Neurodegeneration and Dementia Study), funded by the federal government through the Canadian Institutes of Health Research (CIHR) and a dozen partner organizations.

“I was studying the MRI (Magnetic Resonance Imaging) brain scans of patients with Parkinson’s disease, using a specific type of imaging called Diffusion Tensor Imaging (DTI). It allows you to see the connected tracts (or neural circuits) in the brain so you can determine if those tracts are degrading,” he explains.

“I was looking at a specific region of the brains of patients with Parkinson’s disease, to see if degradation in that part of the brain was related to conditions like Depression or Anxiety. I was given protected time for the research in my fourth and fifth years as a Resident, so having that protected time was a big incentive and it enabled me to do a project with real depth and breadth.”

That view is echoed by Dr. Thomas, who along with his academic appointments at the U of C and the U of A also serves as an Inpatient Psychiatry staff member at Calgary’s Foothills Medical Centre, and as an Inpatient / Outpatient Psychiatry staff member at Edmonton’s Grey Nuns Community Hospital.

“In the Resident research track they provide a half-day per week of dedicated research time, when you’re free of clinical duties. That’s the key. If you don’t have that dedicated time, you just can’t be as productive. You also get the support of the Resident Research Subcommittee’s members. For a new Resident it may be hard to get a mentor, but in this program there were more preceptors than Residents, so I had a choice.”

Dr. Thomas’s research – focused on the experimental drug Ketamine as an emerging treatment for Major Depressive Disorder – was done under the supervision of Dr. Serdar Dursun, a Professor in the Department of Psychiatry, and Dr. Glen Baker, a now-retired Professor of Psychiatry who once served as Director of the Neurochemical Research Unit (NRU), among many other roles.
“The Grey Nuns Psychiatry group were early adopters of Ketamine for treatment- resistant Depression and had a clinic that they wanted to add a research component to, so we did an effectiveness study on low-dose Ketamine and its response rate in ultra-resistant Depression, and we also looked at (statistical) predictors,” he says.

“A total of 50 people were included in the study over a two-year period (2015-2016).  The response rate was 44%, which was similar to what researchers at Harvard and Yale found, and the remission rate was 16%. We also looked at the side effects, and those who responded to Ketamine versus those who didn’t, to identify any similarities and get a more complete picture of who might be most suitable for this treatment.”

Their findings were published in May, 2020 in the scientific journal, Journal of Psychopharmacology.

For his part, Dr. Martyna’s research on whether there is any evidence among individuals with Parkinson’s disease that links the degradation of specific brain regions – such as the fornix – with conditions like Depression resulted in “negative findings,” as he describes it.

“It showed that there was not an association between the degradation of these specific brain tracts and the person’s Neuropsychiatric symptoms, so their Anxiety, Depression and Apathy were not related. But as a secondary finding – and I didn’t set up the project to actually look at volume measurements – we did find an association with decreased volume of specific brain regions, notably the nucleus accumbens and hippocampus, and having Neuropsychiatric symptoms,” he says.

“I’m working on a publication now so there isn’t a paper out yet, but I’ve done a presentation for the CCNA (Canadian Consortium on Neurodegeneration in Aging), and this week I presented a poster at the American Neuropsychiatric Association Annual Meeting, which is their big annual conference.”

As Chair of the Resident Research Subcommittee, Dr. Kravtsenyuk stresses that the role of the subcommittee is to facilitate the appropriate connections between Residents and mentors, so trainees can capitalize on the research opportunities that are available and achieve their academic goals.

“If you asked me, what is the goal of this subcommittee for the next several years, I think it’s really to continue to foster that culture of the clinician-scientist, and potentially to provide additional avenues for our Residents to pursue research.”