2024 | Volume 25 | Issue 3

Vascular Surgery Trainee Dr Odette Hart, the 2023 RACS Reg Worcester Research scholarship recipient, is grateful for the support the scholarship provided toward the successful completion of her PhD.

"The scholarship was vital during the last year of my full-time PhD as it enabled me to take time off work. Research on diabetic foot disease typically does not attract any funding, making the RACS scholarship my sole financial support," says Dr Hart, who is based in Aotearoa New Zealand (AoNZ).

In her PhD research, Dr Hart focussed on defining the epidemiology of diabetic foot disease and limb-threatening ischemia in AoNZ, uncovering gender-based treatment and outcome discrepancies. She also investigated nationwide disparities in major limb amputation rates between Māori and non-Māori patients.

Conducting a prospective study across three tertiary centres in Australia and AoNZ, she explored the use of wound scoring systems to predict diabetic foot disease outcomes. Also, her research delved into techniques for assessing lower limb perfusion, aiming to ensure that interventions to improve blood flow to the foot occur promptly.
With the research almost complete, Dr Hart notes the potential implications it may have on clinical practice or healthcare policies.

“I've delivered more than 20 presentations, and as a result, numerous collaborators have approached me to join them. This surge of interest in the field is encouraging, but the real impact lies in engaging with patients. It involves collaborating with multidisciplinary teams, including podiatrists and vascular specialists, to improve patient care,” she says.

Even before pursuing her PhD, Dr Hart noticed the absence of a multidisciplinary diabetic foot care team at Waikato Hospital in Hamilton. Assisting with implementing this approach became a focal point of her research, leading to weekly meetings where podiatrists, endocrinologists, infectious disease specialists, and vascular experts convene to discuss diabetic foot disease cases.

"And that’s now an established practice resulting from this research," she says.

Dr Hart found her specialty during her internship, witnessing the significant impact of diabetic foot disease on patient outcomes.

Recognising the challenges in achieving favourable long-term outcomes—especially with frequent readmissions and the risk of limb loss—Dr Hart was motivated to address these issues.
She was particularly motivated by the disparities she observed, which disproportionately affect individuals with poorly controlled diabetes, limited access to lifestyle prevention strategies, and those from low socioeconomic backgrounds or marginalised ethnicities.

Dr Hart says, “The issue with diabetic foot disease is that prevention is crucial before patients reach the need for vascular surgery. By the time they come to see me, the disease is already established, with calcification throughout their blood vessels and advanced diabetes.

“I believe the real impact in improving care in this area happens well before patients reach me. It involves collaborating with hospital teams, primary care providers, and implementing policy changes. This focus on preventive measures will be my focus throughout my career.”

With her PhD recently completed, Dr Hart has returned to her first year of training at Auckland City Hospital. She acknowledges that research will continue to be an area of interest for her and encourages everyone to apply for the RACS scholarship.

Her advice: “Make sure you submit a strong application and have your research well-supported, so you can explain to the interviewer why your research is significant. Put in the effort and take it seriously.”

Finding balance is quite challenging now that life is consumed by full-time work for Dr Hart. “While I enjoy training to become a vascular surgeon, pursuing my PhD was a time when I could devote myself to something else that I loved. I found it fulfilling to juggle research during the flexible hours when the kids were at preschool and after they went to bed.”

Despite the demands of her busy schedule, Dr Hart is confident that balancing clinical work and research will continue to be a vital part of her career.