UC Irvine alumna, Kathleen Carlos, MD, PhD, earned her doctoral degree in public health with a focus on disease prevention with the Class of 2020 and went straight into medical school where she earned her medical degree with the Class of 2023. In a Zoom interview between her clinical rotations, she was able to share some words of wisdom about her journey and the issues she cares about most.
Tell us about what excites you for the future.
I’ve been working toward this goal for so long, it honestly feels surreal that I’ve finally reached residency. I’m just excited to learn as much as I can about the field of psychiatry and learn from the many distinguished attending physicians at UCI. I have many interests in psychiatry including child and adolescent psychiatry, first-break psychosis, treatment-resistant depression and suicidality, and interventional psychiatry such as electroconvulsive therapy and transcranial magnetic stimulation.
All to say, it has been a journey just to get to residency so I can’t wait to start this new chapter of my life and flex my clinical muscles!
Why did you choose to pursue a MD/PhD program?
To harken back all the way to 2012 when I applied to UCI’s dual MD/PhD degree program, I initially wanted the medical degree to inform my research interests. At one point I planned to not pursue residency at all, and instead take my training in a research-only route. During the clinical, patient-facing years of medical school however, I realized how much I enjoyed patient care. I have developed a passion for clinical service, especially in psychiatry, and feel fulfilled being able to be of service to patients through both practice and research. I am so thankful to my 2012 self for having the courage to apply to dual doctorate programs.
Can you share with us the impact of your research?
My dissertation, published in Frontiers in Public Health, focused on the behavioral and psychosocial factors related to mental distress among medical students. This study is not only incredibly important to me since I was once a medical student, but it shows that medical students have a higher prevalence of depressive symptoms and thoughts of suicide than the general population with key risk factors like sleep quality, imposter feelings, stress, and financial insecurity. Most notably, imposter feelings emerged as a prominent risk factor for depressive symptoms and thoughts of suicide. As a first-generation college student, I resonate with the struggles of coping with imposter syndrome and financial insecurity, and feel even more motivated to advocate for my peers.
I want to continue to think about expanding my dissertation work, which focuses on mental health in medical students, to residents and physicians later in training. I also have an interest in researching the effects of mental illness on inflammatory markers, specifically of interest is the c-reactive protein that is produced by the liver in response to systemic inflammation. Although c-reactive protein is not specific for any one condition, and is often thought of in the context of cardiac disease, research shows that elevation of this inflammatory marker is associated with depression and suicidality. I think this connection is worth exploring further, and that it may illuminate other lines of research that could potentially influence clinical practice.
Using biomarkers to inform treatment progress would be beneficial for both clinicians and patients because it can be difficult to subjectively describe symptoms of mental illness. It would be powerful to be able to pair an objective measure such as c-reactive protein or cortisol levels with the patient’s subjective report of symptoms. I think that finding biological markers that are associated with mental health conditions also has the potential to address mental health stigma. I believe people in general are more likely to believe in an illness or condition, if they can see that an associated laboratory value is abnormal – examples of this is include the use of the hemoglobin a1c level to diagnose diabetes, or atypical cells found on tissue biopsy used to diagnose cancer.
What is your message to current and/or prospective public health students?
For anyone interested in pursuing research or care around mental health, I cannot encourage you enough to do it. Mental health is a public health issue for everyone regardless of race, income, gender, etc. We need more interdisciplinary thinkers in the mental health field because of how complex and nuanced this collection of conditions are. Get lab experience, intern with community organizations, and look for mentors in this field to build your knowledge and expertise while in school.
For anyone figuring out what they are passionate about researching, my advice is to look inward first. Find that reason from a personal struggle or family story or among friends – that will be the power that fuels you on those long nights of sourcing literature reviews, writing papers, working in labs, etc.
For prospective and current doctoral students, one of the biggest worries we all have is funding. We think about how long we will be in school for and whether we can afford to sustain it. Having gone through a dual degree program, my advice is to not let those worries hamper any of your potential opportunities. Read as much as you can, find as many mentors as you can, learn how to find and apply for funding opportunities, and try not to think too much about the timing and money because, in some ways, the health of the public depends on people like you to pursue your goals and dreams.
