Rising pulmonary and critical care fellow Nandita, Singh, MD, is receiving the American College of Chest Physicians (CHEST) Top Rapid-Fire Case Report Award for her conference submission entitled “HIV in Lung Transplantation: A Single Center’s Experience.”
The awards were granted to one presenter in each rapid-fire case report session at the 2023 annual meeting of CHEST, which advances best patient outcomes through innovative chest medicine education, clinical research, and team-based care. The awards, which honor original scientific research and presentation, were selected by session moderators and reviewed by the organization’s scientific presentations committee.
“I had the incredible privilege to call Dr. Katie Young one of my mentors,” Singh said. “As a faculty member in Pulmonary and Critical Care Medicine and transplant pulmonologist, she gave me the opportunity to learn about our HIV positive, lung transplant patient population through a case series we presented at CHEST.”
Dr. Singh grew up in Dallas, Texas, a proud Cowboys fan by birth, attending Duke as an undergraduate where she majored in Hindi and global health. The dual degree helped influence her decision to pursue a master’s degree in bioethics at Harvard Medical School, a year that was extremely formative for her career path and influenced her decision to pursue a career path that would allow her to bridge the health literacy gap in non-English speaking and limited English-speaking proficiency patients.
Dr. Singh earned her medical degree at the University of Texas Health Science Center in Houston and then returned to Duke for her residency. She details her research interests in the following interview.
Q: We live in a fascinating time for moving medicine forward. How do you foresee contributing to medicine that will improve the health and well-being for all populations?
Dr. Singh: As a rising pulmonary and critical care fellow, I hope to create advances in how we leverage the field of microethics to improve patient health literacy and patient centered care at the bedside. With advancements in the field of critical care and pulmonary transplant improving the health outcomes of complex patients and increasing diversity in patient populations, I hope to optimize clinician communication to improve patient health literacy and increase a sense of agency in patients with complex care plans.
Q: Tell us about your clinical, academic, or research interest and why you are passionate about this topic.
Dr. Singh: During my master’s degree in bioethics studies, concepts such as informed consent continued to shape my path as I learned the concept of microethics or the everyday ethics of clinical practice. In order to more practically understand the microethical framework, I became involved in multiple experiences during both my MBE and medical school years. I learned about patient-centered informed consent in my MBE capstone project, observing and coding interactions between third year anesthesiology residents and standardized patients instructed to demonstrate pain cues. I gained a deeper understanding for barriers to augmenting patient health literacy at the bedside as a medical student in a Texas with largely non-English proficient patients and during my master’s degree in public health summer research project assessing patient health literacy surrounding gestational diabetes amongst women in an OBGYN ward in Lucknow, India. These research and clinical experiences bred a desire for a path that allowed me to operationalize informed consent, have frequent informative bedside interactions, and distill complex patient care in a palatable way to enhance a patient’s understanding of his or her own illness.
Q: How does the award support your work and career going forward? What is innovative about this work?
Dr. Singh: The case series we presented at CHEST was particularly important as it helped add to the body of data of HIV positive patients who successfully underwent lung transplantation and had minimal and expected post-transplant infectious complications. As our center works toward meeting the HIV Organ Policy Equity (HOPE) Act, which allows for research into transplanting organs from HIV-positive donors into HIV-positive recipients, protocols by transplanting five HIV positive patients – these initial four patients were encouraging in showing that HIV positive and HIV negative patients should be evaluated in the same lens for lung transplantation. In particular, the selected HIV positive patients had well controlled HIV and were already used to adhering to a medication regimen and regular clinic visits.
By working on this case series, I was able to gain a greater appreciation for the holistic care and interdisciplinary teams that work to build the patient health literacy of transplant candidates. In the future, I hope to continue to build my experience in the field of pulmonary transplant both clinically and through microethics based clinical research designed to optimize a patient’s understanding of their pre and post-transplant care.