BME Summer Immersion 2026

This week was full of continued shadowing in the OR and the clinic, and lab work, but was defined by two new and exciting challenges: conducting a peer review and starting a collaboration between my lab back in Ithaca and Dr. Spector’s lab here at WCM. During post-operative clinical visits and rounds, I was able to see progress in multiple patients, including the jaw reconstruction mentioned in last week’s post and multiple breast reconstructions. I have been learning a lot about wound healing, and have definitely come to appreciate the importance of vascularization in any sort of reconstruction or replacement in the body (read: everything depends on vascularization ). Dr. Spector’s dermal regeneration template, DermiSphere, continues to generate nothing but positive and, frankly, impressive results - it seems like it is going to completely change the paradigm for skin grafts and any procedure where dermal regeneration is necessary. Dr. Spector has been asked to review a manuscript sub...

 This week was very productive and busy week. I shadowed Dr. Reichman this week, and saw US guided biopsies, mammographic biopsies, and shadowed diagnostic procedures. I am starting to understand the various ultrasound positions that physicians use to orient themselves. I also learned that suspicious lesions are usually present during digital 2D tomosynthesis, where distortion and MR enhancements show an increased likeliness of a lesion. I also learned about the various views of a mamo, such as CC and MLO for locating calcs. Additionally, when calcs are located in the first few slices of a tomosynthesis, it usually means that it is the skin, and is not suspicious. I also saw some very interesting diagnostic cases. As for research, I prepared a presentation to give to the Kim Lab group that gave an overview on the on-going work that I have been doing. The presentation was received well, and was given constructive feedback to refine the presentation that I will give at the end of sum...

Yay, the estimated structural connectivities of the MRI data finally (partially) completed this week (it was running on the background for a couple of weeks but it takes a lot of time per MRI). This meant that I was able to use this to also estimate functional connectivities of the subjects, as well creating some preliminary models with these modalities to predict EDSS (a disability metric in MS) scores. The dataset I'm using of MS MRIs collected at Weill was also previously processed to include some MRI measurements, such as cortical thickness, lesion volume, thalamic volume, and cerebral volume, which I added to the models. It was really useful to update the lab during a meeting to get feedback on where to take it from here. We're hoping we can add to the dataset so that it becomes longitudinal, including 5 year MRIs and EDSS scores as well. It would be interesting to see how accurate it is to predict EDSS at a later time point but another idea is to use the first time point ...

Name: Pooja Nair Clinical Mentor: Dr. Jason Spector This week I’m highlighting one of the most complex reconstructive procedures I observed: a free fibula flap for mandibular reconstruction. The case involved a patient requiring restoration of the mandible after resection of a cystic jaw lesion or benign tumor. In this approach, a fibula free flap provides vascularized bone, soft tissue, and skin for rebuilding the jaw. Two surgical teams worked in parallel. The oral and maxillofacial surgery team performed the tumor resection and prepared the mandibular defect, while Dr. Spector and the plastic and reconstructive surgery team harvested the fibula along with its artery, vein, and overlying soft tissue. Preoperative planning was extensive, with custom titanium guides and cutting templates created for both the mandible and fibula to ensure precise alignment of the reconstructed segments and to support future dental implants. During the harvest, the central portion of the fibula was...

I just finished my fourth week of the summer immersion program at Weill Cornell, and the balance has shifted more toward research. Most of my time went toward refining my project and carefully reviewing the literature to identify the specific research gaps. The further I get into it, the more I am struck by how much remains unknown in the ADPKD world, particularly around what happens after a kidney transplant, which is what my project is trying to address. A large part of the week was spent labeling imaging data, which turned out to be more engaging than I'd anticipated. Moving through the scans sequentially, you can clearly see the disease progress in real time. Additionally, labeling the imaging data also gave me a much better sense of the practical differences between MRI and CT. The MRI images are noticeably less sharp, but they still capture the same clinically relevant information while avoiding the radiation exposure that comes with CT. For a disease like ADPKD, where you...

  Jada Okaikoi | Clinician: Dr. Jiwon Kim This week focused on cardiac CT imaging, where I spent time reading scans to identify and quantify mitral annular calcification (MAC). It was interesting to see how the amount and location of calcium can significantly influence treatment planning, as severe calcification can make both surgical and transcatheter valve procedures more technically challenging and increase the risk of complications. Seeing these cases reinforced how detailed imaging is essential for selecting the safest and most effective intervention for each patient. I also observed an open-heart surgery on a 3-month-old infant with an atrial septal defect (ASD), ventricular septal defect (VSD), and a subaortic membrane. Together, these defects allowed abnormal blood flow through the heart while the subaortic membrane obstructed blood leaving the left ventricle, placing additional strain on an already overworked heart. At such a young age, repairing these defects is critical ...

Alexandra Kot | Dr. Sandra Demaria 2026.06.22: Back to the clinic on Monday morning with significantly more cases than were seen last week. It is a slow process to get used to the histology slides, but compared to last week, I would like to believe I am getting closer to recognizing actual structures within the tissues as opposed to just passively observing. What I really appreciate about Dr. Demaria's approach is her dedication toward putting together the patient story before allowing the resident to make any conclusions about the slide. She makes an effort to understand the motivation behind a lumpectomy, a biopsy, or a mastectomy and compares everything to past patient experiences, other imaging like breast radiographs, and family history until she is able to see a full story. It is very evident that she is giving all patients ample attention and treatment.  One particular patient stood out to me. She had received a modified radical mastectomy after some neoadjuvant therapies. H...

It is hard to believe that this week marks the halfway point of summer immersion. It feels like both both a long time and yet that it has gone by too quickly.  This week, I continued making progress on my research project. I focused on compiling all of the work I created while conceptualizing the study into a navigable shared drive for the broader research team. Building on that work, I also finalized a first draft of the data analysis plan, which has lead to fruitful discussion with my summer immersion PI about potential analytical directions.  In addition, I conducted three more interviews. It was fascinating to hear the range of perspectives and areas of interests across participants. It was particularly interesting to hear what each interviewee highlighted as their primary concerns or key tension points within the healthcare system. While all agreed that the current healthcare system has flaws and is under significant stress, they emphasized different systemic issues that ...

This week I watched Dr. Fahey perform two robotic surgeries: a cholecystectomy (removal of the gallbladder due to a gallbladder stone) and an incisional hernia repair. I had watched these procedures last week as well, but it was interesting seeing the patient-to-patient differences. For example, the color of the gallbladders was different and they were holding different amounts of bile. The hernia repair patient had a lot of adhesions from previous surgeries, so Dr. Fahey spent time removing the adhesions so that the bowels could be pushed back into their correct location. The cases in the clinic seem to be more diverse than in the operating room, as even though the resulting procedure may be the same between patients, each of their situations that led them to that decision is very different. Two of the cases I saw were related to figuring out a diagnosis. Based on reports from other physicians and tests, Dr. Fahey and his team narrowed down potential diagnoses for the patients and ide...

 This week was a research heavy week, as I spent a few days in clinic but most of the days prepping to begin my research project. On Monday and Thursday, I was in the clinic observing Dr. Gomoll and I was able to see some post-operational patients who had undergone osteochondral allograft (OCA) surgery, as well as learn some new terms such as Lateral Extra-Articular Tenodesis (LET) which can tighten a patient's iliotibial (IT) band, allowing their ACL graft to be more stable, preventing rupture.  On Tuesday and Wednesday I prepped for, and carried out, my first experimental run-through for my project. To provide some background, osteochondral allografts have been used for a very long time to treat the so-called, "middle ground," of cartilage defects. This is to say, techniques such as arthroplasty or osteotomy are often used for widespread cartilage damage and in cases where it is not worth preserving the native articular cartilage. Techniques like osteochondral autograft...

This week was the fourth week of immersion and I have continued to experience a variety of opportunities this week. For research this week, I began to segment the patient scans. The primary goal of this segmentation is to isolate the patient's distal femur from the CT scans. Along with my research mentor (Dr. Quevedo), we developed a protocol for this segmentation to ensure consistency throughout the patient cohort. Once the distal femur is segmented, the greyscale values from the segment is exported as a txt file to be used for the BMD analysis. During the clinic this week, I saw a wide array of patients including bone health work-ups, pain follow-ups, post-ops, and others. Of all these cases, the one that stood out to me was a multifocal osteonecrosis patient. While I have seen patients with osteonecrosis before during my time shadowing, I had yet to see a patient with multifocal osteonecrosis. This type of osteonecrosis has multiple spots and is not confined to one bone. Interes...

I had the opportunity to observe a hernia repair surgery, and it was a very interesting experience! It was especially exciting to watch how the clinicians and residents used the robotic system during the procedure. They were able to guide the instruments through the scopes with a lot of control and precision. The patient undergoing this procedure had previously experienced an aortic aneurysm. Because of that, the stitches from an earlier surgery were not tight enough, which created small gaps. Over time, parts of the bowel became stuck in these gaps, leading to many adhesions. During the surgery, the clinician had to carefully cut through these adhesions to free the bowel. Watching this process made me realize how complex these cases can be and how much attention to detail is required. I also learned something new about the materials used in surgery. After removing the adhesions, the surgical team placed a mesh to prevent the bowel from sticking again in the future. I had originally as...

      Alessandra Coogan | Clinical Mentor: Dr. Scott Rodeo      I shadowed Dr. Thomas Fahey during a robotic-assisted cholecystectomy (gallbladder removal) for a patient with symptomatic gallstones and biliary colic. One of the first steps of the procedure was insufflating the abdomen with carbon dioxide gas, creating a working space between the abdominal wall and internal organs. Once the camera was inserted, it was surprisingly easy to identify the gallbladder nestled beneath the liver, which stands out prominently within the abdominal cavity.      One of the highlights was seeing the Da Vinci Xi surgical robot in action (Figure 1). Despite being an enormous machine, it is designed to perform incredibly delicate movements. The robot even announces its actions aloud and projects lasers onto the patient's abdomen to help align its arms before docking. The setup itself requires a coordinated team effort. While the surgeon operates from the con...

  Figure 1: Preliminary Convolutional Neural Network Performance Preliminary Image Classification Model           With the multimodal OCT and confocal fluorescence microscopy endoscope design mostly complete, I have started shifting my focus toward developing an image classification model for bladder tissue samples. The long-term goal is to classify bladder samples as normal, low-grade, or high-grade in real time using OCT and confocal microscopy images as inputs. For my current progress, I have begun developing and programming my model in Python using VS Code and training it with imported image datasets from TensorFlow. At this stage, the program works under a convolutional neural network. As shown in the figure above, my code currently includes three convolutional layers that perform feature extraction and learning through convolution operations and rectified linear unit activation functions, followed by dimensionality reduction and final classificat...

If I could describe this week in one word, it would be 'segmentation'. On Monday, I got the full radiology experience by shadowing a few interventional cardiologists reading cardiac MRI scans. It was interesting to see how different physicians had different methodologies for reading scans; some prefer to be completely 'blinded' and not read any patient history beforehand, whereas others swore by it to make sure they were looking for the right disease pathologies during their first impression. It was interesting to see how 'manual' and qualitative radiology readings are. For example, when determining whether or not a patient has septal flattening (either due to pulmonary hypertension or volume overload), it is up to the radiologist to visually assess whether the septal wall appears to be flat (this was quite tricky to an untrained eye - especially when it was a mild case of flattening). When reading with multiple radiologists, it was interesting to see the number...

I was out of town for a conference during week 3, so I do not have too many updates. Project-wise, the MRI lesion masks I'm using have been co-registered to MNI space (a standard template to make analyses possible), and the network modification tool which takes the lesion masks and estimates structural connectivity is finally almost complete (it's been running for about two weeks since each MRI takes a few hours to process and there are almost 900 patients in the dataset!). At the conference, I got exposed some more co-registration/structural/functional connectivity processing methodologies and some current connectivity MS research. 

Name: Pooja Nair Clinical Mentor: Dr. Jason Spector This week, I wanted to highlight a DIEP flap case performed for a patient with atypical hyperplasia undergoing bilateral breast reconstruction. The patient underwent a bilateral mastectomy followed by immediate reconstruction using an abdominal‑based perforator flap, the Deep Inferior Epigastric Perforator (DIEP) flap. In this approach, the deep inferior epigastric artery and vein supply blood to the lower abdominal skin and fat that form the flap. During a mastectomy, the breast gland is removed; in a DIEP reconstruction, vascularized abdominal tissue replaces that lost volume. Because this was a bilateral mastectomy, tissue from each side of the abdomen was used to reconstruct both breasts. The DIEP flap consists of skin and fat nourished by perforating vessels that pass through the rectus muscle. The surgeons dissected these perforators free while preserving the rectus muscle and fascia. Once isolated, the flap containing lower abd...

I just finished my third week of the summer immersion program at Weill Cornell. Most of my time went toward my research project, working through the literature review and setting up the research infrastructure, with the rest spent shadowing in Dr. Shimonov's clinic.   Clinic this week pushed back on how I'd been thinking about ADPKD. One of the patients had ADPKD with an IFT140 mutation, which I hadn't come across before. It tends to cause a milder, later-onset form of the disease, with fewer but larger cysts and kidney function that often holds up well into older age, unlike the more common forms, which can progress aggressively toward kidney failure. Learning that reframed the way I had been looking at ADPKD in my research project. The same ADPKD label, depending on the exact gene behind it, can mean very different things for how a patient is monitored, what they're told to expect, and whether they're treated at all. It also helped me understand why there's be...

 This week, I spent more time in the lab learning different kinds of cell culture. I am currently expanding my EndoC beta cells to grow as many cells as possible for downstream sequencing experiments in the lab. I also started culturing hESCs this week: MEL1 and H1 cell lines. So far, I am just focusing on changing their media (they require daily media changes) and passaging them to create my own frozen stock. I am also shadowing lab members as they perform beta cell differentiation from hESCs. Next week, I will be practicing hESC differentiation into macrophages to learn the protocol and start establishing a lab stock of hESC-derived macrophages. On the clinical side of the week, I watched a hemithyroidectomy that was performed due due to the presence of a large nodule and goiter. I was able to bring Mary in to watch Dr. Fahey's surgery with me, and we had the opportunity to touch the thyroid after it was taken out. The thyroid lobe was very large (~8 cm) due to the goiter, and ha...

This week, I spent more time focusing on my research project. I used a program called Purka to review past studies, which helped me better understand how to measure different pacing sites and evaluate peak left atrial (LA) pressure. The program is very useful for my work, but it is only available on one computer across three labs. Because of this, I often have to wait and keep checking to see when the computer is available. This can slow down my progress a bit, but I try to make the most of the time when I do get access. I also had the chance to attend an electrophysiology case study session. During the meeting, the team discussed a patient case from that week. Each clinician shared their thoughts and ideas on the best way to treat the patient. It was really helpful to see how everyone contributes and works together to make decisions. In addition, I observed two procedures called PVC ablations. One of the procedures used an appendage, while the other did not. Both cases were interestin...

 2026.06.15: Today was spent mostly preparing to share my research background in lab meeting tomorrow. However, I also did spend time splitting the cells for the CRISPR knockouts which we will be completing tomorrow. While not knocking out the TREX1 gene, this is a great opportunity to practice the procedure before the TREX1 sgDNAs I ordered show up to lab.   2026.06.16: Tuesday meeting  and Demaria lab presentation day! Today the cohort was visited by Dr. Matthew Greenblatt who shared with us a very curated crash course of various bone topics. We covered the developmental stages of skeletal cells, looking into topics like gastrulation and ossification, as well as the development of various structures within the skeletal system like cartilage, the neural crest, intervertebral discs, and the various organic structures and inorganic structures that contribute to bone strength. He also highlighted some recent results from his lab that have challenged the previously acce...

  It is the third week of our summer immersion program, and we are fully in the swing of things. This week, in addition to clinical shadowing and viewing the most intense surgical operation so far, I also completed a promising pilot study in the lab. Seeing patients in the clinic remains my favorite part of shadowing Dr. Spector, as I get to see patients work with their caregiver to decide on a best course of action or, alternatively, discuss the healing process that follows a successful operation. In addition to consultations and post-operation checkups, this week I also attended an in-office procedure to remove a benign lump from a patient’s upper abdomen, performed under local anesthesia. I chatted with the very friendly patient throughout the operation and, beyond finding that we both attended the same university and have family in the same town, I think our conversation helped this patient take their mind off the ongoing procedure. The human side of medical work that comes w...

  Jada Okaikoi | Clinician Mentor: Dr. Jiwon Kim This week provided a deeper look into both the clinical and imaging sides of cardiology. I continued observing electrophysiology procedures, including catheter ablations performed in the left atrium to treat abnormal heart rhythms. These procedures use specialized mapping systems to identify areas of disrupted electrical conduction and deliver targeted ablation therapy to restore normal cardiac signaling. I also had the opportunity to shadow a cardiologist and learn the fundamentals of cardiac magnetic resonance imaging (MRI) interpretation. A major focus was identifying normal cardiac anatomy across different imaging planes and understanding how structural abnormalities appear on MRI. One pathology we discussed was septal flattening, a finding in which the interventricular septum deviates from its normal curved shape and becomes flattened due to increased pressure within the right ventricle. This finding can be an indicator of right...