Medical student, future clinician, engineer, innovator in medicine. That’s how colleagues describe Nabeel Ali, a second-year medical student and young medtech researcher at Mass General, in his mission to become a catalyst for pioneering change in medicine.
Nabeel, a second-year medical student at Albany Medical College, just finished a research sabbatical year working as a research fellow in cardiac imaging at MGH. Nabeel’s research is funded by a grant from the Radiological Society of North America and has won numerous awards, including a first-place award from the Association of University Radiologists.
Nabeel‘s passion for technology has pushed him to the forefront of the med/tech scene in Boston, with invitations to speak as an expert panelist on Google Glass and to launch the technology section of in-Training.
In this interview, Nabeel talks about the novel cardiac imaging algorithm he and his team designed, as well as the experience of leading a research team as a physician-in-training.
Ajay Major (AM): You graduated from Rensselaer Polytechnic Institute in 2012 with a degree in biomedical engineering. Tell us a little about your undergraduate experience there.
Nabeel Ali (NA): It’s actually funny: I started out at RPI as an electrical engineering major for the first couple semesters before switching to biomedical engineering. When I thought about going to medicine, I thought biomedical engineering might be a better fit for me, and I started pursuing research in the biomedical engineering department. The work I was conducting in my first lab was in the realm of hemodynamic forces and their effects on endothelial cells, so we were looking at mechanical stress and how it affected endothelial cell function. It was basic science research, pipetting and all of that.
AM: How did you switch over to the clinical research that you’re doing now?
NA: Well, I also had a research stint over at UC Berkeley as an Amgen Scholar, doing cancer research. Again, more basic science research, with lots of pipetting and PCR. After both of those experiences, I honestly decided I just didn’t like basic research. They weren’t bad experiences, I just wanted more of a creative thought process. I really liked the idea of bringing tech solutions to the clinic, and that’s how I transitioned to clinical research at Mass General.
AM: Tell us about what you’re working on at MGH.
NA: The problem that I’m working on is coronary artery disease. It’s the number one killer worldwide. You have a buildup of plaques in the coronary arteries, and it’s very dangerous, because the underlying myocardial tissue can become dysfunctional or even die. It’s a very hot topic in the field of cardiac imaging. The question is, how do we identify the high-risk plaques that might result in an acute myocardial infarction or a heart attack?
AM: What makes it such a hot topic?
NA: There’s been a lot of work on the basic science side: what is the pathology of these plaques, what do they look like morphologically, how do they develop, things like that. But as imagers, we want to see how we can identify these plaques. So, currently what clinicians do is they use either optical coherence tomography or intravascular ultrasound. But the problem is that these are invasive. We want to move to noninvasive methodologies because it’s better for the patient.
So, we’re working on computed tomography, CT scans, which can produce high-fidelity images of these plaques in a completely non-invasive way. We’re exploiting this to identify signatures of high-risk plaques in the coronary arteries. The algorithm we’re designing will automatically go in and segment out the coronary arteries, generate cross sections of the coronary arteries, and then it will be able to automatically flag where a certain kind of high-risk plaque is.
AM: So, you’re the principal investigator on this project. What is it like to lead the team?
NA: Because of the grant, I’m technically the PI, but I wouldn’t refer to myself as that. I’m expected to hold my ground, just like all of the other investigators. The benefit is that I’m given the freedom. The greatest thing you can give to an academic is freedom, the freedom to engage and pursue their ideas. As a medical student, you are ultimately doing the research of your mentor. But as a leading investigator, what I’m able to do is I’m able to think of ideas and, as long as we have the funding, I can pursue those ideas freely.
AM: I’m sure having that freedom allows you to more fully engage your creative mind.
NA: Exactly. Innovation is a creative process, period. And in order to innovate, you have to have that freedom. Of course you can innovate under any circumstances, but the fewer restrictions you have, the more you can innovate to maximize your project’s outcome.
AM: You’ve already done considerable work on this project. What’s the next step for you?
NA: So, we’ve developed the algorithm, and I did the coding and conception and everything. The next step is validating the algorithm, basically to show the algorithm works in different cohorts of patients. We’re currently running validation studies and strengthening the proof of concept, because ultimately if this gets picked up by a company, they will be able to refine the algorithm much more robustly than I can, because they have professional coders. We’re academics – we want to get the proof of concept to show that this is potentially a great idea.
AM: So, aside from your research, what’s the plan your future career?
NA: That’s the question of the century for me. Here’s how I think about it: I’m a medical student, an engineer, and I’m passionate about innovation in medicine. That’s what I know right now. Primarily, I do want to be a practicing clinician, although I’m not exactly sure which field, maybe radiology or cardiology. Whatever I choose, I want to be a catalyst for innovation in that field. There are many avenues where I can realize the aspiration of being an innovator in medicine. Being a clinician-researcher is definitely an option for my future. And, there’s always the possibility of working for those tech giants, identifying problems in the clinic to be developed into novel imaging modalities. So aside from wanting to be a practicing physician, there are a lot of options: academic, consultant, and so forth. Post-residency is when I’ll figure that out.
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