CEAS senior and ROTC (Reserve Officers’ Training Corps) Mission Support Group Executive Officer, Matthew Gangidine, awaits spring 2013 graduation with bated breath and a list of accomplishments to take with him as he goes on to attend the Uniformed Services University of Health Sciences, the military medical school based in Washington, DC.
Gangidine is one of the very proud and few to be a student in both biomedical engineering and ROTC. This combination qualified him to work for the Institute for Military Medicine (IMM), which is run out of the Department of Surgery at the University of Cincinnati Medical Center (UCMC), for the past 3 years. He graduates this spring from CEAS and the University Honors Program with summa cum laude honors for his biomedical engineering degree and an acceptance USUHS.
Gangidine has always had an eye for engineering but during his high school career, he acquired a new taste—a taste for medicine. When he discovered that biomedical engineering combined the best of both realms, he entered his freshman year at CEAS planning to do strictly biomedical engineering with intentions to go into industry upon graduation. However, by mid-freshman year, Gangidine realized he wanted to go into medicine directly but he wanted to keep learning the engineering aspect of it all.
As fate would have it, one of Gangidine’s friends was an ROTC student with hopes to become a pilot and encouraged him to take a look into the military. Gangidine explains, “I had never even remotely planned on joining the military, but in the course of talking to him, I began to wonder what medicine in the military would look like. After checking it out, I decided it was the way to go! Luckily (and happily) I was still able to maintain my major of biomedical engineering as my plans shifted to a career in Air Force medicine.”
Gangidine began his co-op experience with the Institute for Military Medicine (IMM) in the spring of his sophomore year and has completed his co-op assignments there. Over the past 3 years, he worked closely with Dr. Alex B. Lentsch, PhD, Professor and Vice Chairman for Research at Children’s Hospital, and Director of the IMM.
Gangidine’s research has primarily focused on traumatic brain injury (TBI), which has been an area of high concern due to the large number of these types of injuries inflicted in Iraq and Afghanistan, mainly due to IED’s (improvised explosive devices). He conducted research to characterize an injury model in mice, working to quantify various injury patterns and their effect on certain chemical markers and cognitive abilities.
For his biomedical engineering senior capstone project, in conjunction with the IMM, Gangidine has been focusing on validating a system for closed loop [automatic] control of oxygenation to improve the mechanical ventilation of patients within the confines of harsh environments. Currently, Gangidine and his colleagues are validating a new system which will allow a ventilator to be automatically controlled and integrated with an oxygen concentrator. This should allow the use of less oxygen, less power, and consume less of health care workers' time.
Such research allows researchers to ensure that the nation’s soldiers, sailors, airmen, and marines, who are already sacrificing greatly for their country, are receiving the best possible care. These advances also translate into improved care for civilian trauma patient as well.
Many of the advancements made in military medicine have a huge impact on advancing our knowledge and understanding of care for trauma injuries. One example of this would be the use of tourniquets, which used to be considered quite taboo and an extreme last resort. However, their proper use in the military realm has shown to be greatly effective in saving lives. Since this revelation, the Cincinnati Fire Department has adopted the practice and tourniquets are used much more frequently, leading to better patient outcomes.
The results of research done in the Department of Surgery/IMM are regularly integrated into current practices of military and civilian medical care. Many of the results of Gangidine’s research are particularly applicable to military needs. For example, the aforementioned ventilator/concentrator system is actually only necessary in the harsh conditions encountered by the military because civilians would have unlimited resources in a hospital-type environment. A lot of the work at the IMM focuses on maximizing results in the unique challenges of the military medical environment.
Research results will also be used in the Air Force specific CCATT environment (Critical Care Air Transportation Teams). These 3-person teams transport critically injured patients on Air Force cargo planes to facilities providing higher levels of care. Gangidine’s TBI research deals with the effects that altitude exposure can have on the injury, and how to prevent exacerbation of the injury. To this end, a new altitude chamber was recently acquired and set-up at the UC Reading Campus to study altitude problems further.
This unique intersection of both elite civilian and military care—and its development—is what makes the University of Cincinnati Medical Center (UCMC) a leader in research and clinical training. By having such excellent resources in the Department of Surgery and the Division of Trauma and Critical Care, and by having numerous surgery faculty being either current or past Air Force members, UC provides an unparalleled environment for these ideas to be developed, tested, and taught. The fact that UCMC is a Level I trauma center makes it an ideal location for ground-breaking work. And having an office like the IMM allows researchers and doctors to focus on leading these areas. UC is providing important research in traumatic brain injury, ventilation techniques, blood resuscitation methods, and the effects of altitude on treatment.
Gangidine leaves UC with an abundance of experience. While in the ROTC, he has held notable positions including: Arnold Air Society Squadron Commander, Fall 2012 (he was “president” of this honorary, professional, service organization); Operations Groups Commander, Spring 2012 where he was in charge of all day to day and special operations for the 100+ person Cadet Wing; and Field Training Preparation Flight Commander, Spring 2011 where he prepared sophomores for ROTC “boot camp.”
In addition, Gangidine has received a pre-health designator to be able to attend medical school after finishing Air Force ROTC—only about 25 of these are given per year nationally and are shared between all three services (Army, Navy, Air Force). Gangidine was also accepted into the UC ROSE program (part internship, part early acceptance to medical school, and part mentorship program) to obtain early admission to UC's medical school, to continue doing research and ultimately, to get accepted into USUHS.
“One of the highlights for me, working out of the Department of Surgery/IMM, was being able to go to the ATACCC (Advanced Technology Applications for Combat Casualty Care) in August 2011. This is the Department of Defense's premier international military medical conference in Fort Lauderdale, FL and I presented a poster there on some of the TBI research I performed. I’ve also had the immense opportunity to participate in research leading to about 7 publications and 12 posters/presentations.
Being in ROTC and working at the IMM have definitely been experiences at the heart of shaping my time in college. At times, it’s been challenging to balance between my pursuits in ROTC and my pursuits in medicine/engineering. ROTC offered me the chance for unparalleled leadership training and development, and I wouldn't have traded it for anything. However, ROTC is a pretty uncommon background for going into military medicine, and so it may be challenging to adjust to medical school.
I had never anticipated going into research initially, and I didn't even know that the IMM existed when I started college or when I started Air Force ROTC. Learning that such a program existed in my own backyard was absolutely amazing, and the CEAS co-op program gave me the unique opportunity to really get to dive into it. I wasn’t just doing some random research, but rather, research that specifically related to my career in military medicine and this was such a blessing for me. Not only was it relevant, but I got to work on problems that affect patients who I think are so extremely worthy of our attention because of the great sacrifices they've made to defend our nation,” reflects Gangidine.
After graduation, Gangidine is set to marry his fiancé, Shayn Roeder, on June 21st. The couple will then move to Washington, DC so that he may begin military medical school. Gangidine is greatly looking forward to the new challenges that USUHS medical school has to offer him in the fall.
He foreshadows, “As I move to the next stage of my training at USUHS for medical school next year, I’m anxious to see how research continues to fit in. I can see myself focusing more on the clinical practice of medicine, but the research experience I've gained at UC has been absolutely invaluable. In fact, one of the main research areas that USUHS is tackling is TBI issues, so I’ll have to draw on my previous background in the subject and continue to pursue it there. The job experience at the IMM has definitely given me a research mindset, too—even if it's more clinical studies ahead for me rather than basic science, I'll always be inclined after this to go about documenting and quantifying patient outcomes in military medicine so that we can always keep improving.”
The IMM was officially named by the UC Board of Trustees in 2009 and was built upon the strong collaborations existing between the United States Air Force C-STARS (Center for the Sustainment of Trauma and Readiness Skills) program and the Division of Trauma & Critical Care in the Department of Surgery.
The IMM develops and applies innovations in clinical care, research, and education to allow for the improved surgical treatment of both civilians and soldiers, especially in the realms of trauma and critical care. This includes on-going work in a number of pertinent research areas funded by sources such as the US Department of Defense, Air Force, ONR (Office of Naval Research), NASA, and the National Institutes of Health (NIH). Additionally, UC is the site of on-going training for Active Duty Air Force medical personnel preparing to deploy, through the C-STARS program. C-STARS employs a cadre of experienced active duty (and retired) Air Force officers, and is one of only three such programs in the country.
UC and the IMM have been collaborating on a trauma research training program, within the Department of Surgery, for a solid 25 years. The program has been continually funded by NIH for over 20 years. The IMM seeks to: (1) to provide state-of-the-art training for those caring for our wounded soldiers; (2) to discover new knowledge to develop improved and innovative treatment approaches for the acutely injured patient; (3) to prepare and train the next generation of surgical leaders; and (4) to advance the care of the acutely injured patient.