Surprising finding distinguishes med student’s research project
Published on Monday, December 18, 2017
By: Gary Pettus
Second-year medical student Kaitlyn Salter is set on becoming a physician times three: pediatrician, psychiatrist and child psychiatrist.
“Being triple-board certified would mean I could balance my day as a physician,” she said. “Love on babies who need shots in the morning and then deal with much worse problems the rest of the day.”
Salter got more than a mere taste of her future, three-course career after winning a prestigious fellowship that funded her summer research project on medications used to treat attention-deficit/hyperactivity disorder in overweight or obese children at the University of Mississippi Medical Center.
Her unexpected discovery elevated the Lucedale native to the national stage last fall in the nation’s capital, where she was invited to make a poster presentation at the annual meeting of the American Academy of Child and Adolescent Psychiatry, the source of her fellowship.
“Kaitlyn's proposal not only won her the fellowship, it earned the highest score of all of the submissions from all of the other programs, including Yale and Harvard,” said Dr. Philip Merideth, professor of psychiatry, co-director of the Student Counseling and Wellness Center, and one of Salter’s mentors.
Apparently, Salter is the first student from the university’s School of Medicine to receive AACAP’s Summer Medical Student Fellowship Award since its inception in 2008, said Anneke Archer, the organization’s manager of training and education.
Salter, 27, was still a first-year student when she learned in April that she was a recipient of the AACAP fellowship, which provides awardees up to $3,500 for eight to 12 weeks of clinical or research training under a child and adolescent psychiatrist mentor.
But, after the framework of her original hypothesis collapsed from lack of available supporting data, Salter regrouped and renovated.
“I looked at children with obesity and their prevalence rate of ADHD,” she said, “and how prescribed medications affect them physically.”
As she plunged into her project, “Prescribed Medication and Health Outcomes in Youth with Obesity and ADHD,” Salter expected to eventually surface with this verdict: Children with ADHD who did not receive treatment with drugs would have a higher Body Mass Index (BMI), a reference that relates weight to height.
“Instead, the children who had been treated with drugs had the higher BMI’s, which contradicts a current proposed theory,” she said.
Salter worked from May through August with her primary research mentor, Dr. Crystal Lim, assistant professor of psychiatry, and assistant director of the Wellness and Weight Clinic at UMMC. That connection made Salter privy to the medical records of 755 children, ages 1 to 18, who had been seen at least once within the previous three years at the pediatric obesity clinic.
Lindsay Shepherd, a research assistant in the Department of Psychiatry and Human Behavior, collected the data vital to Salter’s study. “She worked really hard to get the information to me,” Salter said, “and a lot of my time was spent mining it. Without her, there would not have been a project to present.”
She also spent time in Lim’s outpatient clinic, observing group meetings with families whose children have been unable to take off weight after six months of treatment.
“It was eye-opening,” Salter said. “Some of the children and their family members would come up with reasons they couldn’t follow the weight-loss program: ‘I don’t like anything green, so I can’t do that.’
“You wanted to help them, and they wanted help, but they also wanted a quick solution.”
Salter made another discovery: “We need more child psychiatrists in Mississippi. It’s sad that there aren’t more,” she said.
To Lim, a psychologist, it was encouraging to see a medical student become so passionately involved in research.
“I believe it’s important for physicians to learn how to evaluate research information, and part of that is doing their own research,” Lim said. “It may inform your practice as a physician and help you become a better one for your patients.
“Kaitlyn brought a new kind of energy to the work. It was fun seeing that. She has the desire to improve people’s lives.”
Salter’s passion is, in part, personal; she has seen relatives battle for years with obesity and mental disorders. And, she said, “proposed connections have been made with obesity and internalizing disorder like depression and anxiety for years. But only recently has anyone considered how other mental disorders like ADHD can affect, or be affected by, obesity.
“I’d like to know more about that, so I’m prepared to make a positive impact on the health of my future patients in Mississippi.”
Salter’s study is a preliminary one that future projects can build on – looking at how certain medications affect appetite and eating behaviors, for instance, Lim said. “It can be used to support future grant applications.”
Among the conclusions Salter listed on her presentation poster was a finding that the rate of ADHD was 12.2 percent of the 700-plus youths in the study who were overweight or obese. That is more than double the ADHD rate of five percent in all children, as reported by the latest edition of the Diagnostic and Statistical Manual of Mental Disorder, DSM-V.
Salter’s study showed as well the need for careful use of medications when treating ADHD, especially in the presence of other health conditions, including obesity.
She illustrated and submitted her conclusions for her poster presentation as one of 11 summer medical student fellows from various schools invited to the 2017 AACAP Annual Meeting, Oct. 23-28 in Washington, D.C.
“It was like a book fair,” Salter said,” where you set up posters about the books you’re reporting on, and people stop by and discuss them. One lady from Sweden was incredulous. She couldn’t believe our obesity rate. She said, ‘We have trouble getting our children to eat.’”
Salter’s fellowship summer not only developed her research chops, it introduced her to the Department of Psychiatry and Human Behavior, chaired by Dr. Scott Rodgers, and a variety of mentors, including Dr. Beverly Bryant, associate professor of psychiatry.
“Without the fellowship, I wouldn’t have had the mentors I’ve been able to meet and work with,” Salter said. “Dr. Merideth and Dr. Lim, among others, were fantastic. Dr. Lim was extremely patient with my research inexperience, while Dr. Merideth encouraged me to explore all avenues of child psychiatry.
“I had never interacted with the Department of Psychiatry before. They leave a great impression.”
AACAP offers two medical student fellowships:
For more information and assistance in connecting with a mentor, contact AACAP at firstname.lastname@example.org. Medical students may apply for both awards, but may accept only one if selected for both.