Keeping a hand in translational research

Ruby Grewal

For Dr. Ruby Grewal, there is nothing more rewarding in her work than seeing the tangible effect of her efforts right before her eyes. 

From a successful surgery that immediately changes a patient’s quality of life to a research finding that will improve an elderly patient’s prognosis, it is this impactful work and research that has motivated Dr. Grewal throughout her career.

An associate professor in the Department of Surgery, and co-director of the clinical research lab, Dr. Grewal sat down with us to discuss the reasons she enjoys her work at the Hand and Upper Limb Centre, why she followed the specific career path she did, and what she finds enjoyment in outside of the office.

Where were you born and raised?
I was born and raised in Vancouver, British Columbia and lived there until I moved to London, Ontario to complete my fellowship training.

What is your education background?
My first fellowship was at the Hand and Upper Limb Center here in London, and the second fellowship was at the Royal North Shore Hospital in Sydney, Australia. During my 18-month fellowship in London, I completed a Master’s degree in Epidemiology and Biostatistics.

What brought you to Schulich Medicine & Dentistry?
I first came here as a fellow, because of the training and research opportunities available. The Hand and Upper Limb Centre is one of the only centres in Canada where trainees get a comprehensive upper limb fellowship, which was another attractive feature for me.

Tell us about your current research.
I am predominantly focused on clinical outcomes research — looking at how patients are doing based on the procedure we are offering them. My focus has been on distal radius and scaphoid fractures. We have done a lot of research looking at what aspects of those fractures determine outcomes and the effects of those fractures on the older population, as they develop osteoporosis and are more prone to potential future fractures.

What is the potential impact of this clinical research?
For an elderly person, a wrist fracture may not seem like a significant injury. However, if they fracture their hip that is a big deal — it’s often the point where they go from living independently to requiring care. We are looking at the distal radius fracture as an opportunity to identify patients that may have osteoporosis and be at risk for more serious future fractures at an time where there is still a chance to intervene. If we are able to act in a preventative way and use this risk factor as a warning sign, we can potentially help these high-risk patients prevent future fractures. We can focus on improving their bone health, balance and even knowledge of osteoporosis.

Why did you decide to go into this specific field of work?
I was drawn to hand and upper limb surgery because I really enjoy the anatomy and the diversity of procedures. In some areas of orthopaedics you’re always working on the same anatomical area, but the hand is quite different because we work on bones, nerves and tendons. We see a wide variety of anatomy and techniques.

Why was it important for you to work on research that has a translational component?
I think because my background is clinical, I was always more interested in the clinical implications of research and how that will affect day-to-day practice and patient care.

Why are you passionate about the work you do?
It’s very rewarding to be able to see the difference you’re making in the lives of patients. One of the nice things about orthopaedics, and one of the things that originally drew me into this field, is that there is a tangible effect of your efforts. You can literally see the change you’re making before your eyes. There are some surgeries we do where immediately after the patient is better — they couldn’t move their finger and now they can. That cause and effect relationship is really apparent and the difference you can make in patients' lives is really remarkable. I find it rewarding to help patients improve their quality of life.

Do you enjoy working as a teacher and a mentor?
As part of the Department of Surgery, we are all involved with training medical students, residents and graduate trainees. It is a really great experience working with trainees who are keen and engaged and are really interested in learning. We’re lucky to attract trainees and fellows from across the country — they're coming here for the same reason I originally did.

What is your advice for those who are interested in following a similar path that you did?
I think the most important thing is to make sure you end up doing something that you really enjoy. Being able to look forward to going to work is a real treat. I also think enjoying your job makes you happier in your overall life, so choosing a path that you will find enjoyment in will make your time away from work better as well.

What do you enjoy doing when you’re not working?
I really enjoy spending time with my kids — low-key things like going to the park. Those day-to-day things become really fun when you have children. I’ve also always been involved in sports and athletics, so that’s still an outlet for me and I make time for that a couple times a week.