Education Residency

R25 Residents reaching their stride

The annual Outcomes Research Office retreat provides another great opportunity for R25 residents to engage with their research colleagues.

The R25 Physician-Scientist Training Program at WashU Medicine Otolaryngology provides a wealth of opportunities for residents interested in research or a career in academic medicine.

These opportunities include exposure to many different research studies, coursework in statistics, research conduct and oversight, a monthly Academic Career Development Conference and special courses like CREST and Critical Appraisal.

photo of Jay Piccirillo
WashU Medicine Otolaryngology Vice-Chair for Research and R25 Director Jay Piccirillo, MD.

According to Vice-chair for Research Jay Piccirillo, MD, the program is designed to give residents the time, mentorship, and resources to truly develop as physician-scientists. Over two years, the residents move beyond simply participating in research – they learn how to ask important questions, design rigorous studies, analyze and communicate their findings, and begin developing an independent research program.

“Importantly, they become part of a community of mentors and colleagues who are invested in their long-term success,” he said. “For medical students who are considering a career that combines clinical excellence with research and academic medicine, the R25 offers a unique opportunity to build that foundation early in their careers.”

We checked in with our two second-year R25 residents to see their progress and get a better appreciation of the depth of the experience they’re acquiring in the program.

photo of James Bao, MD

James Bao, MD, MSCI

Primary study: Development and Validation of an Automated Large Language Model-based Application for Triage of Dizziness

Mentor: Matthew Shew, MD, MSCI

Significance to human health: Dizziness is a very common and diagnostically challenging presenting symptom to triage to the correct specialties, leading patients to unnecessary appointments, wait times and testing.

Main goals: To improve and enhance existing triage pathways, getting patients with dizziness where they need to go more precisely and faster.

Current status: We are currently analyzing data that’s been collected.

Other studies:

  • Association of Radiographic Features of Structural Brain MRI with Speech Perception Outcomes after Cochlear Implantation
  • Determination of Clinically Meaningful Differences in Speech Perception Scores after Cochlear Implantation
  • Features of Intracochlear Electrocochleography in Cochlear Implant Recipients
photo of Chad A. Nieri, MD

Chad Nieri, MD

Study title: The Sleep Burden Index: A Multidimensional Staging System for Obstructive Sleep Apnea

Mentor(s): Jay Piccirillo, MD, Miranda Lindburg, MD, Dorina Kallogjeri, MD, MPH, Sebastian Jara, MD, MPH

Significance to human health: Obstructive sleep apnea severity is traditionally defined by the apnea-hypopnea index (AHI), which measures respiratory events but does not capture the full burden of disease. Patients with similar AHIs may differ substantially in hypoxemia, symptoms, comorbidity burden, and long-term outcomes. The SBI aims to provide a more clinically meaningful, multidimensional approach to OSA severity classification.

Main goals: Develop and validate the Sleep Burden Index (SBI), integrating physiologic sleep measures, symptoms, graded comorbidity burden, and individual patient characteristics into a unified OSA staging system. Evaluate whether the SBI improves risk stratification beyond AHI alone, initially using all-cause mortality as a clinically meaningful outcome, and subsequently evaluate its ability to characterize response to sleep surgery beyond modified Sher’s criteria.

Current status: Our initial cohort includes 385 patients with 63 deaths. Preliminary analyses demonstrate that age, nocturnal hypoxemia, and ACE-27 comorbidity burden are important mortality predictors, while multidimensional models discriminate mortality substantially better than AHI alone. SBI staging and validation analyses are ongoing.

Other studies:

  • Comorbidity Scale for Obstructive Sleep Apnea (COSA-13), a primary vs secondary OSA classification
  • Qualitative Characterization of CPAP Intolerance: Drug-induced Sleep Endoscopy Phenotyping/reliability
  • DISE and MRI Assessment of Upper-airway Obstruction
  • Sleep-surgery/HGNS Outcomes using Multidimensional Measures of Treatment Response