I started blogging almost 13 years ago (!!!) to share my MD/PhD application personal statements and begin to help others 1) learn about this pathway (especially if they did not know this pathway even existed like me as an undergrad) and 2) navigate entering and staying in the physician-scientist pathway. I remember how challenging it was to write my personal statements at that time and wanted to share my (now *cringe*) personal statements to help others out.
Fortunately, I again had the opportunity to share a personal statement after successfully applied to internal medicine residency and physician-scientist training programs.
Once again, I have a personal statement to share! After my first year of residency, I applied to gastroenterology fellowship and am about to now complete my first year of fellowship! It has been a wild ride and I am so glad for the path I have taken to get there!
Hanna’s Gastroenterology Personal Statement
My first year of residency has taught me incredibly many things. Including this one irrefutable fact: Patients with cirrhosis are sick. Really truly sick. Among the sickest patients we care for, often needing ICU level care. Residency has also taught me another related fact: Liver transplantation saves lives and changes near death into vitality before our eyes. This was crystalized for me through the case of a young man with primary sclerosing cholangitis/autoimmune hepatitis overlap who had just been transferred to the general medicine floor from the ICU – skin yellow, belly bloated, mind altered. Despite his initial improvement and despite my best efforts, over the next week his condition worsened. He had already experienced the disappointment of two liver transplant offers falling through earlier in the year. He was high on the transplant list again, but we remained cautiously optimistic. Luckily, this time was in fact the charm, and he went to surgery late on a Saturday night. Two days after surgery, I visited him in the ICU. He looked like a completely different man. We both had tears in our eyes before he could even mutter “thank you.” Being able to care for patients with complex sequelae of liver disease and seeing the impact of getting them to this life-saving treatment motivates me to pursue a career in gastroenterology.
The significance of this moment was heightened by my long-term interest in the liver, which began as a graduate student. I initially pursued a PhD to better understand how normal cells can be transformed into cancer cells, growing independently of the body’s eloquent feedback mechanisms. Studying this process in the context of hepatocellular carcinoma, I grew to appreciate that the development of cancer was a late stage of disease, as most cases arise in patients with cirrhosis, which itself is a result of progressive inflammation, metabolic changes, and fibrosis that occur over decades. As the liver is a source of many diseases, I became interested in understanding common pathways that could contribute to the progression of liver disease and therefore be potential therapeutic targets, ultimately reducing the need for liver transplantation, an opportunity available for so few. This led me to study a scaffolding protein that is regulated by bile acids, which accumulate in many liver diseases and function as signaling molecules in addition to their role in fat absorption. During my PhD, I showed that upregulation of this protein could be protective in the context of metabolic and cholestatic liver injury but at the same time promoted the growth of hepatocellular carcinoma. I was awarded a NIH NRSA F30 Individual Predoctoral MD/PhD Degree Fellowship from the National Cancer Institute to support this work, which has resulted in 2 first/co-first author publications. There is still so much to learn about how these adaptive and maladaptive pathways interplay in the progression of liver disease, and I am excited to continue to explore these questions throughout my career.
My goal is to become an academic physician-scientist who specializes in the care of patients with liver disease and with a research focus on the metabolic pathways that contribute to the pathophysiology of liver disease. I want to address the gaps in these areas from both the bench and the bedside by leading an active research laboratory, caring for patients, and using my expertise to impact others through advocacy, education, and outreach. I am looking for a gastroenterology fellowship program that can be a home for my next phase of training by providing intensive clinical training while also fostering my development as a physician-scientist. [Institution] would be an excellent home for my training, with local researchers including [researcher #1], [researcher #2], and [researcher #3].
This last sentence is perhaps one of the most important (and sometimes most difficult) parts.
Why is it important? 1) It shows the program that I am interested enough in their program to have done the research about their program to have identified potential research mentors. 2) It shows how the program is a good fit for me because they have people doing research in topics that I would want to work on, so that they can realistically help me achieve my career goals in the way that I want to achieve them – you need to be a good fit for them but they also need to be a good fit for you.
Why is it difficult? You may not know what you want to do! It’s hard to have a perfect vision of your future and its scary to commit! Don’t worry, you always have the chance to change your mind, but I think having a specific vision (if you’re able to articulate it) truly makes a personal statement impactful. Even though I had just applied to residency 2 years prior and my future goals have not significantly wavered, I still had a period of time while preparing my fellowship application where I was wondering if my purpose was the same and if I was articulating it in the most impactful way. Now I am a year into fellowship and have started my research with a great mentor and am confident that I made the right choice for me.
MD, PhD To Be 
HannaYou continue to impress! Jane