New Chapter

Spyridoula Maraka, M.D. (CTSA ’16, ENDO ’16), found her research passion at Mayo Clinic. While an endocrinology fellow, she discovered a gap in the knowledge about subclinical hypothyroidism during pregnancy and became determined to fill the gap. Her studies led to high-impact publications, requests for presentations of her work, national media coverage and citations in international treatment guidelines. Today she’s an assistant professor of medicine at the University of Arkansas for Medical Sciences (UAMS), the UAMS endocrinology fellowship director and a Mayo Clinic research collaborator. She describes her time at Mayo Clinic as a golden opportunity. That certainly seems to have been the case for her.

“The first time I walked in to Mayo Clinic … I had an overwhelming feeling in my bones that it was the place to be. I got goosebumps and tears in my eyes. I can recall that moment very vividly. … I realized that something very big was happening in my life. Having seen the unique place that Mayo Clinic is, I knew anywhere else would be second best. Mayo became No. 1 on my list.”

How did you become interested in medicine?

Growing up in Kalamata, Greece, I was curious about how our bodies work and how to help people overcome illness. As a child, I experimented with flowers in my grandfather’s garden, pretending to develop a cure for cancer. I also watched a lot of “ER” on TV.

What led you to Mayo Clinic?

After medical school in Greece, I’d decided to pursue endocrinology but also was interested in research. I decided to go to the U.S. to continue training. I did postdoctoral clinical research at Northwestern University in Chicago, and internal medicine residency at the University of Connecticut. I wanted an endocrinology fellowship that was clinically strong but that also would provide me with the knowledge necessary to become a successful researcher.

The first time I walked in to Mayo Clinic, I saw the piano playing in the Gonda Building lobby and had an overwhelming feeling in my bones that it was the place to be. I got goosebumps and tears in my eyes. I can recall that moment very vividly. I had the same feeling when I toured Mayo Clinic labs. I realized that something very big was happening in my life. Having seen the unique place that Mayo Clinic is, I knew anywhere else would be second best. Mayo became No. 1 on my list.

I spent three years at Mayo Clinic doing my fellowship and simultaneously completing a master’s in clinical and translational science. The latter was a great addition to my toolbox. Four years later, I continue to collaborate with Mayo Clinic on research.

What valuable lesson did you learn at Mayo Clinic?

Besides the obvious — the needs of the patient come first — I learned the importance of being aware of others’ perceptions about your behavior and work. In a world that’s so diverse and multicultural, make sure your behavior is aligned with that and doesn’t leave space for misunderstanding by patients or colleagues. Mayo did a great job teaching that.

Who were your mentors at Mayo Clinic?

Victor Montori, M.D. (I ’99, CMR ’00, CLRSH ’01, ENDO ’02; Division of Endocrinology, Diabetes, & Metabolism), was and still is a research mentor. He’s an amazing human being — generous and kind. When I first met with him to discuss my research year, he was open to my ideas and encouraging even when it wasn’t initially clear that my plan was the right one. I still run ideas and study design by him.

Two others from the department were mentors too. Robert Tiegs, M.D. (ENDO ’85), was my career mentor; and Marius Stan, M.D. (ENDO ’07, CTSA ’11), played an important role in my research studies. I was a co-investigator on one of his trials.

How did you decide on endocrinology?

In medical school during our endocrinology rotation, a confident, inspiring professor who had trained in the U.S. addressed us. I was so impressed by her drive and thought I’d like to be like her. Then, when studying for exams and reviewing endocrinology curriculum, I found it easy to understand and a pleasure to read. It wasn’t like studying; it resonated with me. I always aced those exams.

What does it mean to have Mayo Clinic on your CV?

It’s key to opening a lot of doors. Everyone knows Mayo Clinic is the No. 1 hospital in the U.S. and a symbol of quality, knowledge and skill. People automatically presume you must be good.

I refer to Mayo Clinic with pride and can see respect in others’ eyes even before knowing me because I came from Mayo.

Tell us about your work.

I’m an endocrinologist at the University of Arkansas for Medical Sciences and Central Arkansas Veterans Healthcare System, an assistant professor of medicine at the university, program director for the endocrinology fellowship, and a research collaborator at Mayo Clinic.

In clinical practice, I focus on thyroid diseases, including thyroid cancer in veterans. The focus of my research is the treatment of subclinical hypothyroidism in pregnancy and in the elderly.

During my fellowship, I became interested in subclinical hypothyroidism after I saw a patient who had been overtreated. In reviewing the treatment guidelines, I realized that the existing evidence was of low quality. I did multiple studies on the topic. My first paper was published in Thyroid and selected as a leading high-impact paper. I presented at conferences and received awards for that work, and it became well known. A subsequent paper published in the British Medical Journal led to national media coverage. Many of my papers on the subject have been cited in international guidelines.

I also collaborated on a diabetes drone project with Derek O’Keeffe, M.B., B.Ch., M.D., Ph.D. (ENDO ’15), from University Hospital Galway in Ireland. Our fellowships overlapped, and we worked on some projects together. There had been adverse weather events in Ireland that prevented people from getting the medications they needed. We brainstormed about ways to address it in the future, and the diabetes drone project was born, resulting in the first drone delivery of insulin to patients in a remote area. The autonomous drone also picked up blood samples from the patient and delivered them back to the team of scientists. We now know that an unmanned aircraft could be used to deliver medicine and supplies to persons in remote areas during natural disasters or a pandemic. The project attracted worldwide attention.

How is life after training?

Amazing! When I was at Mayo Clinic, I worked very hard to learn as much as possible, which helped me in the next step. I joined the faculty at the University of Arkansas immediately afterward. This is the job I dreamed of. I have time for patients, dedicated time for research, and I’m the program director for the endocrinology fellowship. I’m doing what I love and what Mayo prepared me for.

I have time to enjoy life. Arkansas offers warm weather for swimming, picnics and relaxing outdoors in parks and lots of green space. I also have time to participate in professional organizations and committees.

What do you do in your spare time?

I exercise and try to develop new skills. Before the pandemic, I was taking tango lessons. I’ve spent time learning to speak Spanish and French. I like to do things that are productive and make me a better person.

How do you maintain work-life balance?

When I completed training, I set a rule for myself to not work after 5 p.m. or on weekends. I’ve broken the rule, of course, but I’ve tried to set limits; sometimes a deadline has to be met. I really protect my weekends; unless I’m on call, I won’t set foot in the office.

A few years ago, I had a big health adventure, which made me slow down a bit and appreciate life. It made me realize the importance of working somewhere that respects you and cares for you, taking care of yourself no matter how busy you are and doing work you love.

What advice do you have for trainees?

Work hard, and take advantage of any opportunity that’s offered. At Mayo, I felt like a kid in a candy shop. Everything was tasty, shiny and colorful, and I wanted to try it all — and I did! I did different research projects with different people to improve my skills, went to multiple national conferences each year to present my work and network, taught in the medical school, gave presentations to become a better educator, and got my master’s degree to boost my research skills. Very few places in the world offer you the resources available at Mayo Clinic. It’s a golden opportunity. Invest this time during your training because the return will be huge.

What are you most proud of on your CV?

I received an award from the Lown Institute in 2015 in its first “Do Not Harm Project Competition: Recognizing the Harms that Patients May Experience Due to Medical Overuse and Sharing Ideas for Improvement of Health Care Delivery.” I presented a case that dealt with a pregnant woman who was treated for mild thyroid disease, which resulted in side effects. That case motivated all of my research studies for subclinical hypothyroidism. It was the beginning of my research career.

What would people be surprised to know about you?

When I was in Greece studying for the USMLE, I became a physician for Greek soccer teams. I attended six matches per weekend. It was rewarding and fun, and I learned a lot about soccer. I’d previously been a sprinter representing my region in the nationals but couldn’t combine the sport with medicine and had to give it up. Being a soccer team physician was a way to incorporate sport into my life.

See past New Chapter stories here.