1. < Message from the Chair

A central goal of our department’s strategic plan is to develop the next generation of Leaders in Medicine. We aspire to build a bench and train the next generation of leaders who will shape the future of our field, that cut across our core goals of patient care, research, education and community engagement. This week, I share stories of some of our trainees who exemplify these tenets. They are an inspiration to all of us.

Qicong Sheng, MD Returns to His Roots to Present at QICC25

The UCLA Internal Medicine Residency Program has a strong track record of developing outstanding physicians whose work influences the field well beyond our national borders. This past November, IM resident Qicong Sheng, MD hopped on a 13-hour flight to his hometown of Hangzhou, China, to give an oral presentation at the 2025 Qianjiang Cardiovascular Conference (QICC25), an annual event that brings together international experts in cardiology to discuss the latest developments in atherosclerosis, hypertension, heart failure, arrhythmia, cardiovascular disease prevention and rehabilitation, technology and much more.

“JACC: Asia Pulse serves as a platform for international education and academic exchange, with the goal of improving cardiovascular care for the diverse patient populations across Asia and the global Asian diaspora,” Dr. Sheng said. “My work with the platform has highlighted the significant variations in clinical practices worldwide. By facilitating this exchange of knowledge, we can learn from the unique strengths of different medical systems to standardize cardiovascular care and improve patient outcomes globally."

Along with Dr. Sheng, the UCLA Department of Medicine (DoM) was also represented at QICC25 by cardiology division LEADERS Karol E. Watson, MD, PhD; Kalyanam Shivkumar, MD, PhD and Eric H. Yang, MD. The DoM has a partnership with Second Affiliated Hospital of Hangshou’s Zhejiang University, a deeply fruitful collaboration that has enhanced medical education and patient care for nearly two decades. This relationship facilitates ongoing global health opportunities for our trainees at the local hospital in Hangzhou.

Dr. Sheng was grateful for the support of his mentors, Dr. Yang and Ashley F. Stein-Merlob, MD, PhD and for the chance to gain new insights into a specialty he loves while visiting his hometown. He also expressed gratitude towards Lisa J. Skinner, MD and the UCLA Department of Medicine (DoM) for making the trip possible.

“The international conversations at QICC were very inspiring for me as a trainee. I have new ideas for my work at JACC Asia Pulse, and the experience reinforced my long-term career goals to bridge clinical collaboration between the U.S. and Asia,” Dr. Sheng said. “As I move towards cardiology fellowship, I am eager to continue this important crosstalk between medical communities.”

Thank you to Dr. Sheng and all of this year’s QICC25 attendees for their outstanding representation of our department!

Nikita Vashi Baclig, MD, MPH to Launch Pilot Project on Cancer and Aging with I-REACH Grant

The field of hematology-oncology has made tremendous progress in developing treatments to address and even cure many types of cancer, but questions remain about the effects these therapies have on the aging process. New faculty and STAR program fellow Nikita Vashi Baclig, MD, MPH will be at the forefront of answering some of them through a new pilot project supported by an Infrastructure for Research in Aging, Cancer and Health (I-REACH) grant, which is supported by the National Institute on Aging (NIA). I-REACH is a program that brings together the expertise of cancer hubs at Georgetown University, University of Maryland, Karmanos/Wayne State University and UCLA to make discoveries that improve the lives of older cancer survivors.

Dr. Baclig’s I-REACH grant will attempt to understand the trajectory of those age-related changes throughout the treatment course, with a specific focus on patients with muscle-invasive bladder cancer who undergo neoadjuvant or pre-surgical therapies like chemotherapy and immunotherapy before having their bladder removed. Her team will track their frailty at various intervals before and after treatment to see how it affects the aging process.

“For example, we want to understand if there are folks who start out pretty robust and then become frail and stay frail after treatment, or if there are folks who start out frail and stay frail throughout treatment,” Dr. Baclig said. “This will help us learn which patients would benefit most from interventions to help maintain their independence and physical functioning during treatment.”

The pilot project will last one year. After that, Dr. Baclig’s team will study frailty trajectories in a prospective cohort of patients at UCLA to validate the results from the pilot. They’ll also explore biomarkers of frailty in patients with bladder cancer.

Dr. Baclig views the experience as preparation for applying for more federal funding in the future.

“I think this is a really good opportunity for people who are early in their careers, who are thinking about making a transition into research, and it sort of sets you up for subsequent National Institutes of Health (NIH) grant funding in in the future because I-REACH is ” Dr. Baclig said. “It gives you sort of an early taste of what it feels like to be an NIH funded researcher."

Dr. Baclig noted that if it were not for the DoM, she might never have encountered this area of research. After she joined the STAR program to train in health services research, she found a new path in investigating cancer and aging thanks to her mentor Mina S. Sedrak, MD, MS, a pioneer in the field.

“He introduced me to a new way to really get at the mechanisms behind some of the survivorship issues that I was already seeing in the patients I was studying,” Dr. Baclig recalled. “UCLA’s size and infrastructure allows for these kinds of collaborations, which I don’t think would have been possible at another institution.”

Please join me in congratulating Dr. Baclig on this exciting achievement! I look forward to the results of this work.

Michael A. Raddatz, MD, PhD and Team Explain Mechanism Behind Genetic Mutations That Ups Risk of Aortic Valve Disease

In another outstanding example of what sets DoM trainees above the rest, Michael A. Raddatz, MD, PhD and a team of collaborators recently published a study in the Journal of Clinical Investigation that details how blood cell mutations known as “clonal hematopoiesis of indeterminate potential” (CHIP) mutations may increase the risk of cardiovascular disease. This important discovery opens a door to developing interventions that could prevent cardiac events like heart attacks in people with CHIP mutations, which are currently usually discovered by accident when a patient undergoes genetic testing for a different reason.

To understand what these genes might be doing to raise the risk of AVS, Dr. Raddatz and his team then conducted single cell RNA sequencing of immune cells from patients with AVS who had TET2 CHIP mutations, which revealed that a type of cells called monocytes had heightened inflammatory signatures and increased expression of factors that promote valve calcification, a pathology of AVS. Another set of experiments demonstrated that mice with a genetic propensity to atherosclerosis developed valve calcification after a bone marrow transplant with TET2-mutated cells.

“Together, these results demonstrate that monocytes with [CHIP mutations] promote aortic valve calcification and that patients with CH are at increased risk of AVS,” the authors wrote in their paper.

Dr. Raddatz feels that the paper presents an ideal roadmap for translational research projects because his team began with a clinical hypothesis — that CHIP increases the risk of AVS by altering macrophages — and were able to confirm it with animal models.

“We went from idea to confirmation of a phenomenon in humans, then testing the underlying cause in mice, all in one line of investigation,” Dr. Raddatz said.

CHIP mutations are being identified more often with the rise of genetic tests for other conditions. Dr. Raddatz would like to leverage these incidental findings with a CHIP clinic that will study them in depth. Already, the UCLA Cardio-Oncology Program led by Eric H. Yang, MD and Ashley Stein-Merlob, MD, PhD is helping patients with CHIP mutations optimize their cardiovascular care based on their specific mutations, regardless of the patients’ cancer status. Additionally, Dr. Raddatz and others in the cardiology division are collaborating with scientists and clinicians from the Jonsson Comprehensive Cancer Center to delve into the UCLA ATLAS biobank and identify more patients with CHIP mutations and attempt to intervene before they develop cardiovascular disease.

“Altogether, we have a very strong team of expert clinicians, basic scientists and geneticists who can take this type of work to the next stage and beyond,” Dr. Raddatz said.

A Day in the Life: Alexander T. Pham, MD

Residency is one of the most challenging periods in a physician’s career. Chief residents, like Grand Rounds Chief Alexander T. Pham, MD, are a guiding light for the next generation as they learn the ropes.

“Then I touch base with the residents who were here overnight, just to see if there were any issues that they want to bring up to us,” Dr. Pham said. Once all that is done, he dedicates a few peaceful moments to a must-do ritual: the New York Times crossword puzzle.

“I just put on some music and sit there alone in my thoughts to kind of decompress a little bit. It’s also fun to try and solve a puzzle at the same time,” he said. “I just find that it kind of takes me out of the chaos that chief year can be and gives me time to reflect a little bit on what’s been going on."

Next up is morning report, when the chiefs get together to facilitate discussions with the residents about the cases they’re seeing on rotations. The chiefs help the residents walk through the cases to build out their reasoning and diagnostic skills, pausing to ask questions throughout the process. For instance, after the presenter gives the patients’ history, the chiefs might ask if there are labs they would order, differential diagnoses they want to think about, or physical exam findings they would like to see.

“It's a comfortable, very low-key environment for everyone to just share their thoughts,” Dr. Pham said. “It's very low stakes, and it's just a great way for everyone to get together and learn from each other to build out their diagnostic and clinical reasoning skills."

Depending on the day, Dr. Pham might spend the next few hours seeing primary care patients for routine visits and annual check-ups. As a general internist, he thinks of himself as the quarterback on a football team composed of specialists who care for patients with chronic conditions. With so many different specialists responsible for different components of a patient’s care, it’s essential to have a central point of contact to help put the big picture together.

“I think that's where, as a general internist, our role really shines — we make sure that nothing falls through the cracks and that everyone's recommendations come together to make sense for the patient in front of us,” Dr. Pham said. He especially enjoys the variety; even typical conditions come with unique stories on account of his patients’ wide range of lived experiences. Plus, there is no shortage of unicorns.

“You can take the most common medical condition that you know millions of Americans may have, but every patient experiences it differently based on what they're going through in their life, what their social status is, what they do for work and how all of that interplays with their health,” he said. “I deal with mystery cases every single day, and this makes it intellectually very interesting for me.”

For Dr. Pham, the best part is the getting the chance to tailor care to suit the patient.

“I think what's really rewarding about working with patients is just seeing them as people,” he said. “Each patient has their own story, and I enjoy finding different ways to push myself to see how I can individualize care for them and individualize my own counseling and teaching to help in their understanding of their medical disease.”

After clinic, it’s time to convene with the chiefs and residents for noon conference. This daily meeting is a point of pride for the chiefs, who spend significant time designing a curriculum and bringing in speakers who can offer valuable, relevant insights. Some conferences are part of larger series that focus on a central theme; a cardiology series, for instance, might feature one cardiologist who specializes in valvular disease and another who manages heart failure. All presentations are based on real patient cases, and residents interact with each other and with faculty to discuss them. This makes for especially interesting conversations when cases are presented that engage residents at multiple sites, such as the Greater Los Angeles VA Medical Center and the UCLA Ronald Reagan Medical Center.

“We like to keep it practical, and we always keep board exams in mind as well,” Dr. Pham said.

The rest of Dr. Pham’s afternoon is typically spent in more meetings, but the topics may vary from week to week. Some meetings are spend discussing residency recruitment; others are dedicated to the chief residents’ mentorship program, which pairs residents with faculty who help support their career interests. One consistency is the weekly three-hour gathering of the Brady Bunch — the name adopted by this year’s chief residents — with program leaders and the medical education team to talk about ways to improve residency across all four sites. That can range from acute matters like adding support on certain rotations to more global issues, such as programming.

“This is something that brings me, personally, a lot of joy,” Dr. Pham said. “This is the meeting where we all come together to talk about all the sites, make sure that all of our residents feel supported and make sure that we’re constantly moving forward.”

After a (very) long day, it’s time to wind down. But that doesn’t necessarily mean going home: On the days the chiefs meet, they like to go for dinner at a local restaurant or at a co-chief's house. That might also include watching a Dodgers game or celebrating the holidays.

“One of my favorite parts of the week is getting to spend time with my co-chiefs,” Dr. Pham said. “Even though each chief has our own specific roles and specific sites, we come together every single week and really form a unified unit for our residents.”

Thank you, Alex and all the chiefs, for keeping our residency program strong, and at the forefront of innovation. With such leadership it is not surprising why so many of the best medical students in the country want to come to the DoM for their residency training.

Dale

P.S.

Last week, I spent a day in Washington D.C., on Capitol Hill to give a congressional briefing and advocate for increasing and sustaining NIH support for our research mission. Got in and out before the winter storms!

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