Physician Assistant Alum’s Capstone Solidified His Desire to Go into Orthopedics

Around the time he was choosing a topic for his capstone project, Gerald Miller, MMS ‘22, was also completing a rotation in orthopedic surgery. That experience got him thinking back to when his father had an accident and had broken his ankle.

“He was on the synthetic thyroid hormone for a while. I know there is a pathway the thyroid hormone takes that makes it possible to demineralize the bone,” said Miller. “I thought, is there something, if you’re on the synthetic version that has an impact or not on whether you have more of a chance to break any kind of bone.”

And, the idea for his capstone was born. Miller titled his project “Does Long-Term Synthetic Hormone Increase Risk of Bone Fractures in Adults?” and found that there weren’t a lot of long-term studies on the topic, and those studies that have been conducted don’t last past the five to seven-year mark.

But he did find that in overt hypothyroidism - low serum thyroid-stimulating hormone (TSH) concentrations and raised serum concentrations of thyroid hormones - an individual’s risk increases after the five-year mark of being on a synthetic thyroid hormone for that period. If patients are diagnosed with subcritical hypothyroidism – when peripheral thyroid hormone levels are within normal reference laboratory range but serum TSH levels are mildly elevated - their risk starts to increase around two years.

“It’s a little upsetting to find that somebody can be on this for decades and there just isn’t a lot of research on it,” said Miller.

Originally from Lebanon, Pennsylvania, Miller earned a degree in biology from Lebanon Valley College in 2017. After a gap year, he secured his master’s in Public Health from Thomas Jefferson University in Philadelphia before becoming a Physician Assistant (PA) Studies student at Salus. He recently accepted a position in an orthopedic services practice at the University of Pittsburgh Medical Center.

He said his capstone project solidified his desire to go into orthopedics.

“When I was going through this project, it was interesting to the point where I did not dread having to go into researching something like this,” said Miller. “Something major is going to have to happen to me to want to go into research, it’s just not my cup of tea. I’d rather read the articles that researchers have published and use that in practice.”