Adam SimningAdam Simning, MD, PhD

CTSI Medical Scientist Training Program (MSTP)

Project: Anxiety and Depression in Older Adult Public Housing Residents: Prevalence, Correlates, and Implications for Care

Mentor: Edwin van Wijngaarden, PhD

Adam Simning, MD, PhD, is a 2013 graduate of the University of Rochester School of Medicine and Dentistry. As a student in the Medical Scientist Training Program (MSTP), he received support from the CTSI’s TL1 Predoctoral Training Program grant to identify levels of mental illness among older adults in the Rochester public housing community. Dr. Simning says his experience with the CTSI not only introduced him to community-based research, but also inspired him to pursue an academic career in geriatric psychiatry, through which he can continue to help improve the quality of care within the community.

Medical Scientist Training Program (MSTP)

The University of Rochester’s Medical Scientist Training Program (MSTP) offers doctoral-level training in both clinical medicine and research. Students earn both an MD and a PhD. The interdisciplinary program allows students to engage in interactive research and patient care with scientists and physicians in a variety of departments, while also providing each student with an individual mentor.

A Minnesota native, Dr. Simning graduated from Pomona College in Claremont, California with a degree in Molecular Biology. He interviewed at nearly a dozen medical schools, but ultimately chose the University of Rochester because of a gut feeling and Rochester's flexible and supportive approach to MD/PhD education.

“The University of Rochester just felt like a place I could come and really grow as a person. It seemed invested in each individual student, which is very important to me,” he says. “A lot of the other MD/PhD programs were more traditional – they would prefer that the students do basic science PhDs. Rochester was one of the few institutions at that time which seemed very excited about having its students do non-basic science PhDs, and so that was a major draw.”

Dr. Simning earned his PhD in epidemiology through the Department of Community and Preventive Medicine. He says he was drawn to the field because of its relevance to patient-level care and the opportunity to do research in the community.

“A lot of the research in basic science is a couple degrees removed from actually impacting patients often, so it was important to me to go where the patients are and see what we can do to help them directly,” he says. “With epidemiology, you can tie basic science and medical education training together, which was really quite exciting.”

Research with the Community, Not on the Community

Dr. Simning's dissertation research focused on mental health – particularly on anxiety and depression – in adults aged 60+ who reside in Rochester's public housing units. He collaborated with his mentors, Dr. Edwin van Wijngaarden in the Division of Epidemiology, and Dr. Yeates Conwell in the Department of Psychiatry. He says Dr. van Wijngaarden's expertise in research methodology and Dr. Conwell's expertise in working with community agencies allowed him to create his own scientifically-sound study. He worked with the Rochester Housing Authority, as well as with Eldersource – a local non-profit organization which provides care management guidance for senior citizens – to conduct his study in three local high rises. The goal was to determine the levels of mental illness among the residents and if there was anything that could be done to improve their quality of life.

“I wanted to get into the community because I think oftentimes, by the time patients reach the hospital, there is a lot that we could have done to have prevented them from going there,” he says. “I'm very interested in moving into the community and figuring out things we can do to help people in their homes.”

Dr. Simning's research concluded that there were high levels of anxiety and depression among the residents, but very few were receiving treatment. In addition, he found evidence of potentially high levels of cognitive impairment in the population. He says he is excited about the potential to provide services for these adults.

“The idea was to use the services that were already providing care to the residents and seeing if we could make those services more comprehensive to account for mental illness. Mental illness can impact how disease progresses or is managed. We are hoping to holistically treat the patients.”

Dr. Simning says he was moved by the residents' resilience.

“Their life courses open had a lot of trauma, and it was quite an amazing opportunity to have them share part of their lives with me. To see where they've been and how far they've come was very much an honor. For many of the residents, it was quite extraordinary to see how well they were doing.”

The research did not go unnoticed. Dr. Simning received the American Association for Geriatric Psychiatry's (AAGP) 2011 Member-in-Training Award for best original research performed by a medical student, resident, or fellow. He also received the Gerontological Society of America (GSA) Health Sciences Section 2010 Person-in-Training Award. Overall, as an MD/PhD student, Dr. Simning was the first, second, or third author on a total 12 publications.

Working with the CTSI

From the expertise and support of his mentors, to the funding for his travel and research, Dr. Simning says his experience with the CTSI was “fantastic,” and was instrumental in shaping his academic career.

He says the CTSI funding allowed him to concentrate on the scientific questions of his research, rather than how to pay for it. He was also able to apply for a pilot grant available through the CTSI. Although his project was not selected, he used the CTSI's feedback to conduct a pilot study and apply for a Health Services Dissertation Award (R36; Grant HS 018246) from the Agency for Healthcare Research and Quality, which he did receive. Furthermore, with his travel stipend, Dr. Simning was able to attend four AAGP national meetings where he presented his work and connected with many researchers in his field.

The Future

On Match Day 2013, Dr. Simning learned he will be completing his residency training at the institution that was his top choice: the University of Rochester Medical Center's Department of Psychiatry. He is excited about the opportunity to treat patients, and to use that knowledge to inform further studies in the community.

“There's more of a push to have a longitudinal relationship with the community, which I think is very critical and conducive for improving both the quality of the research and how that research impacts the participants,” he says. “I'm very excited to continue with that.”

Click here for a list of Dr. Simning’s publications on PubMed.

 

NIH Funding Acknowledgement ** Important ** All publications resulting from the utilization of CTSI resources are required to credit the CTSI grant by including the NIH FUNDING ACKNOWLEDGEMENT and must comply with the NIH Public Access Policy.