
Lucy Eletel has been investigating infant mortality related to birth setting for her Scholarly Pursuit and Thesis project.
Advancing Medicine
The Scholarly Pursuit and Thesis program gives students a competitive edge.
HOME BIRTHS ARE SKYROCKETING. The U.S. Centers for Disease Control and Prevention attributed the 12 percent nationwide increase between 2020 and 2021 to Covid-19 and concerns about delivering in a hospital.
But the trend has persisted. In 2023, more than 46,900 U.S. women opted for home births, the most in three decades and up more than 29,000 from seven years earlier, per data in a study published in the Journal of Perinatal Medicine.
Is the cultural shift leading to increased risk for newborns? The problem is close to home for students and faculty at the Anne Burnett Marion School of Medicine at Texas Christian University.
Lucy Eletel, a third-year student at Burnett, has been investigating infant mortality locally with the mission of improving out-of-hospital birthing procedures.
“Something I’ve always been passionate about is women’s health, and I am curious as to the reasoning behind their choices to birth in a center, at home or at a hospital,” Eletel said. She arrived at a central question: “How are out-of-hospital births contributing to the higher infant mortality rate and complications we are seeing?”
Eletel and Dr. David Riley, her project mentor and a neonatologist, constructed a retrospective study evaluating 132 neonatal intensive care unit admissions at one Fort Worth hospital from 2020 to 2022.
The research is integral to Eletel’s education at the Burnett School of Medicine. The work is an outgrowth of the school’s Scholarly Pursuit and Thesis program, required of all TCU medical students. The program tasks the future physicians with conceiving, designing and completing an in-depth research study on a topic of their choice.
“As medical students, you have to be driving those next sets of questions,” Eletel said. “We’re the next generation of researchers and investigators.” Eletel and Riley hypothesized that infants born outside of the hospital have higher complication and mortality rates.
After analyzing the data, the researchers found that infants born at birthing centers, which emphasize natural pain management and are often staffed by midwives, nurses and sometimes doctors, experienced fewer complications such as respiration issues or bacterial infections compared with those born at home.

“I see myself being more clinical, but I could always see myself involved in research,” Lucy Eletel said. “It’s a passion of mine.”
Next, the researchers want to evaluate birthing centers with high rates of sending newborns to neonatal intensive care units to pinpoint factors that could lead to improved deliveries.
“The hope is that, ultimately, we can set up a standardized approach in all of these birthing centers,” Eletel said, “maybe even something as simple as a resuscitation kit or tool station they could have at every birth.”
She said that birthing centers, by and large, lack consistent guidelines. “If we can help in that,” Eletel said, “I think that would significantly reduce the complications they experience.”
Though Eletel has yet to wear the mantle of doctor, her passion has sparked a project with lifesaving implications.
FORWARD-LOOKING LEARNING
The Scholarly Pursuit and Thesis program was introduced at TCU by Dr. Stuart D. Flynn, the founding dean of the Burnett School of Medicine; he implemented a similar program as founding dean of the University of Arizona College of Medicine Phoenix.
“It is a unique requirement for medical schools,” said Gregory Kearns, associate dean for research at the Burnett School of Medicine and assistant director of the program. “Most do not require the completion of a research thesis for the awarding of an MD degree.”
The years-long project contributes to what Kearns describes as a “mentor-guided, functionally integrated research experience in problem-solving that aligns with the Burnett School of Medicine’s patient-centered curriculum emphasizing communication and empathy training.”
“Many of our students graduate and their desire is to practice clinical medicine,” Kearns said. “But I tell students this all the time: If that is what you’re going to do for your career, having gone through this experience improves your skill as a physician.”
Medical students set the stage for the longitudinal — meaning long-term — research during the first half of the first year.
“I was fortunate enough to have a couple of acceptances, and I chose TCU, even though it was a newer medical school, because of its longitudinal curriculum. Having protected research time within the curriculum is huge.”
Ethan Vieira
“We want the students to struggle, do the research and do the analysis themselves because they get so much more out of it,” said Michael Bernas, director of the research program. “When they go to residency interviews, they’re able to really speak in depth about a project, so that’s why we call it a longitudinal project, because it’s really over the years they’re here at the school with us.”
Early milestones include collaborating with faculty to crystallize a scientific question, conducting a literature review and critical appraisal, and completing human subjects training.
During the second half of that year, each student crafts a research proposal before partnering with a professional mentor to pursue the study.
Most medical students arrive with undergraduate research experience, Bernas said. “But they’ve only walked into the lab, and they’ve got a project where the professor says, ‘OK, we’re going to run these gels … do this analysis.’ They’ve never started it from the beginning, where they requested to do that research project.”
During Years 2 and 3 of medical school, students work with mentors to advance their individual projects. “The timetables vary, depending if you’re doing prospective or retrospective, or can you collect the data?” Bernas said. “Many of our students who work at hospitals are only allowed to use the hospital health record system when they’re at the hospital.”
Students’ capstone theses, ranging from 20 to 70 pages, are due midway through the fourth year of medical school. That final spring, the soon-to-be doctors share projects at a research symposium, allowing fellow students and faculty to learn more about the topics that most interest them.
Now a fourth-year student applying for residency placement in pediatrics, Ethan Vieira said the Scholarly Pursuit and Thesis program was a differentiator when, in 2021, he was weighing options for medical school.
“I was fortunate enough to have a couple of acceptances, and I chose TCU, even though it was a newer medical school, because of its longitudinal curriculum,” Vieira said. “Having protected research time within the curriculum is huge.”
For his project, Vieira worked with his mentor, Dr. Charles West of Texas Health Harris Methodist Hospital Fort Worth, to identify trends in surgical outcomes for patients undergoing procedures related to median arcuate ligament syndrome. The affliction is a rare condition in which the median arcuate ligament, a fibrous band connecting the diaphragm to the spine, compresses the celiac artery, a major blood vessel supplying the stomach, liver and other abdominal organs.
Throughout the four-year research experience, students develop skills in research methodology, critical thinking and scholarly communication, bolstering their chances at competitive and often limited residency spots.
“As a person who has interviewed applicants for residencies,” Kearns said, “when I see that they have research experience, I spend a lot of time in the interview having them tell me about it.”
He calls the research experience “the coin of the realm” for future Horned Frog physicians. The four-year program enables students to be immersed in their chosen research topic and helps them develop critical thinking skills by using the scientific method to solve a problem. In some instances, it can launch a student into undertaking additional research and potentially be formational in the development of a young physician who chooses a career in academic medicine, he said.
“If you spend four years doing any one thing, you are invested in it,” Kearns said. “You can see that they’re really engaged.”
SPANNING THE SPECTRUM
Scholarly Pursuit and Thesis project topics run the gamut. Per the medical school’s website, any project that can be “researched effectively, includes some sort of intervention or examination, has a good plan for analysis of results, and will include a discussion of the results with potential application and questions for the future” is fair game.
Past students have worked with TCU’s Neeley School of Business to examine the intersection of public health and financial literacy, Bernas said. “One of the projects was, ‘Does financial education for people who are in a free clinic help them with their medical treatment later on?’ Let them see what the options are for buying supplies and purchasing prescriptions. … Does any education in managing money help them with that?”
Students have access to an ever-expanding network of more than 240 mentors across North Texas who specialize in everything from chemistry and physics to nursing and kinesiology, biology and behavioral research.
Mentors come from TCU’s main campus, the University of North Texas Health Science Center at Fort Worth and the University of Texas at Arlington. The Burnett School of Medicine has also partnered with physicians from Texas Health Harris Methodist Hospital Fort Worth, Baylor Scott & White All Saints Medical Center-Fort Worth, Cook Children’s Medical Center and private practice physicians.
Still, students have the option to identify new mentors for their projects and pitch entirely novel research concepts.
“It is amazing what the students bring,” Bernas said.
COVID AND DIABETES?
Katelyn Bowman said she considers herself a nontraditional medical school student, having majored in business administration as an undergraduate at TCU before earning a master’s in accounting.
But her interest in medicine was reflected in an undergraduate research project she completed as a student in the John V. Roach Honors College. Alongside her research mentor at the time, Elizabeth Plummer, professor of accounting, Bowman examined the Affordable Care Act and its implications for small-business owners.
As it turns out, Bowman’s undergraduate project was just the beginning of her research journey.
The Scholarly Pursuit & Thesis course “forces you to do a research project, which helps bring your medical knowledge and clinical experience full circle,” said Bowman, now in her third year at Burnett.

Third-year medical student Katelyn Bowman’s Scholarly Pursuit and Thesis project focuses on whether there is a link between a patient’s history of Covid-19 infection and the onset of diabetes. Bowman earned TCU undergraduate and graduate degrees in accounting before launching into medical school.
Bowman said data collection has been the predominant time-consumer for her project — “SARS-CoV-2 and New-Onset Type 1 Diabetes in Pediatric Populations: A Retrospective Study” — for which she and Dr. Paul Thornton, an endocrinologist at Cook Children’s, found no correlation between an individual’s history of Covid-19 infection and a rise in the incidence of Type 1 diabetes among the charts that were reviewed based on selective inclusion criteria.
“Ultimately, the [Scholarly Pursuit and Thesis] project lets you take a research project from start to finish,” Bowman said.
Networking opportunities, forged under the pressure cooker of the four-year research process, prove invaluable.
“The mentor becomes your biggest advocate,” Bowman said.
PASSION PROJECT
Fellow third-year student Lauren Hui also saw the value of a research-centric curriculum when she was a prospective medical student. “I really liked that it was a longitudinal research project because I think most medical students know that you usually don’t get data in one year; you get a good set of data over a long period.”
Hui worked with her mentor, Dr. Richard Miller, who was then the chair of the department of surgery at John Peter Smith Hospital, to study the Surgical Optimization Clinic, which improves patient well-being before an operation.
A research team of Hui, Miller and nurse practitioner Diane St. Pierre studied ties between patient frailty, pre-surgical optimization and surgical outcomes.
“The problem is that the geriatric population in the United States is growing exponentially,” Miller said in a 2024 video discussing the team’s preliminary results. “A good percentage of these people will be frail. And frailty associated with surgery carries a high complication rate and a high mortality rate.”
The researchers also evaluated how clinic staff assess patients for other risk factors, such as smoking, malnourishment, high body-mass index and heart and lung problems, Hui said. “Patients can be referred to this surgical optimization clinic if they’re not cleared for surgery right away.”
Nurse practitioners will work with the patient on necessary steps to prepare for surgery, whether an exercise program, nutrition regimen, blood sugar control or smoking cessation. “And they’ll try and see if they have the green light or if they should be exploring other options,” Hui said.

The Burnett School of Medicine plugs into a network of roughly 1,500 faculty around the Tarrant County area, most of whom are practicing physicians, said Gregory Kearns, assistant director of the research program.
Hui and Miller’s initial manuscript evaluated 2020-2023 data from the John Peter Smith Hospital pre-surgical optimization clinic. The work was published in the Journal of the American College of Surgeons.
They found that patients determined to be less frail were more likely to proceed to surgery and confront fewer cancellations or delays. The team measured infection rates, complications and 30-day emergency department readmissions for people who did go forward with a procedure.
Hui said she faced her share of challenges. Having never written a research proposal, she said she was unsure how to start the undertaking. As is common with program participants, she also faced hurdles in general time management and schedule coordination with busy mentors.
Faculty periodically check in to gauge progress with students and project mentors, but ultimately the students must balance research commitments with other coursework.
“You have to keep moving the ball down the field,” said Tristan Tayag, assistant director of Scholarly Pursuit and Thesis. “So we just encourage the students: When you’re available, keep in contact with your mentor.”
Bowman handled the time crunch by getting creative with her calendar. “I have probably spent over 80 hours collecting data,” she said. “We don’t have set time to go collect data for two weeks straight. So I utilized weekends for the most part, or holidays.”
Despite the demanding nature of the research component of a TCU medical education, students are completing projects, Tayag said. “I think for the most part, they find the projects really interesting because they choose them.”
“It’s something that you can talk about, that you’re passionate about, that you took from infancy, this one idea,” Vieira said. “There’s something about that that makes you proud, that you were able to come up with an idea that will have future impacts on the literature.”
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