Postdoctoral Scholar Spotlight: Luca Cristin, MD
Forging the Road Less Traveled
“I’m not afraid to try new things,” said Luca Cristin, MD, a postdoctoral scholar in the lab of echocardiographer Francesca Nesta Delling, MD, MPH. “I’d be way more scared to have everything planned out for the next 30 years of my life.”
That spirit of adventure has led Dr. Cristin far from his hometown of Padua, Italy. His interest in medicine began early, when he was born with a heart defect and received surgical care and a pacemaker to correct the condition. “I’m very grateful to the people who helped me, and I wanted to give back by becoming a doctor and researcher,” he said.
He graduated from a science-focused high school with the highest possible exam score, then earned his medical degree from the University of Verona with honors and academic distinction. Dr. Cristin served as a research assistant for an investigator in Rome at the Fondazione Policlinico Gemelli, contributing to research about the role of an immunosuppressant called mTOR inhibitors on patients with liver cancer who received a liver transplant as well as signaling pathways related to the development of non-alcoholic steatohepatitis. “Those were my first experiences with research,” said Dr. Cristin. “Even though they were not in my specific field of interest of cardiology, I tried to learn as much as possible about how to write a paper, do a meta-analysis and conduct a systemic review.”
Dr. Cristin also worked in the lab of a cardiology professor at the University of Verona, writing his thesis about the use of strain analysis in valvular heart disease, and echocardiographic evaluation of patients who receive replacement valves without surgery through transcathether aortic valve implantation (TAVI). “Our research focused on identifying how the left atrium function is affected by severe aortic stenosis,” he said. “We found that atrial function closely reflects both ventricular performance and symptom burden, offering valuable insight into patient status beyond traditional metrics.”
Persisting through Rejection
Though he learned a lot, research opportunities were sometimes limited by structural challenges. “In Italy, much of the clinical research is led by hospital-based physicians who balance it alongside their clinical duties,” said Dr. Cristin. “Resources can sometimes be more constrained and as a result, learning opportunities can be harder to come by.”
He knew the U.S. would have the most opportunities for the kind of research he wanted to do. “Starting in my fifth year of medical school, I started looking for research opportunities in the U.S. through my professors,” said Dr. Cristin. “There wasn’t a program to help me – it was up to me to arrange all this.”
To gain exposure to the U.S medical system and build connections, he applied for clinical rotations at American medical schools. “Most of my applications were rejected,” said Dr. Cristin. “Because the Italian medical school curriculum is different from the American one, it’s hard for programs to assess whether international applicants are a good fit. I sent hundreds of emails and got hundreds of rejections, and more often no reply at all. There’s a system in place that allows international applicants to connect, but access was limited because my university wasn’t part of it. Plus, this was during the end of COVID in 2021 and 2022, and everything was mostly closed down to international students. It was very difficult.”
However, Dr. Cristin persisted. His thesis advisor wrote him a letter of recommendation, which is highly unusual in the Italian educational system. Because he had to still be enrolled in medical school to qualify for clinical rotations abroad, he completed all his required medical school rotations without a break and passed his exams with top marks, leaving several months before graduation when he was available to do rotations abroad.
To pay for all his applications and save money for living overseas, he worked 15 to 25 hours a week during medical school for a Swedish startup called Hypocampus, an online platform that helps medical trainees prepare for exams to enter residency and fellowship. “The platform teaches you how to memorize more things in less time, using an algorithm to help you retain the concepts better,” said Dr. Cristin, who served as the company’s chief editor and marketing executive in Italy. “I was their first employee for the Italian platform and it was my first non-medical job. I did a bit of everything, from content review to team coordination, and it helped me to develop skills in communication, project management and teaching.”
His persistence with applying for opportunities in the U.S. paid off, and Dr. Cristin secured clinical rotations at Columbia University, the University of Illinois Chicago, and UCSF. Before coming to the U.S., he had also applied to do a postdoctoral fellowship in the lab of Dr. Delling, who is also originally from Italy. She is a leading expert in abnormal heart rhythms related to mitral valve prolapse, a condition in which the leaflets of one of the valves in the heart fail to form a tight seal and allow blood to flow backwards.
During his UCSF rotation Dr. Cristin interviewed with Dr. Delling, and she hired him to return to her lab as a postdoc after graduating from medical school that summer. “In the end, you just need one acceptance to change everything,” he said. “I’m incredibly grateful to Francesca for giving me that opportunity.”
A World of Opportunity
Dr. Cristin began his postdoctoral fellowship in August 2023. It was a steep learning curve, but Dr. Delling and Lionel Tastet, PhD, a more experienced postdoc, helped him develop new skills. “Dr. Delling’s lab has a really big and comprehensive database of people with arrhythmic mitral valve prolapse, including detailed echocardiographic, CMR (cardiac magnetic resonance) and genetic data,” he said. “It’s been an amazing opportunity – I started to learn about statistics, genetics, advanced imaging, and how to develop hypotheses that bridge clinical insight with data analysis. It’s exciting to connect my medical background with research in such a hands-on way.”
One of the other skills he developed was how to read scientific papers with a critical eye. “I realized it’s not enough to focus on the abstract and conclusion, since they usually reflect the narrative the author wants to show,” said Dr. Cristin. “I started paying more attention to the methodology and asking myself why certain analyses were chosen, what might have been left out, and whether there were alternative approaches that could yield different insights. This has been especially important when reading papers related to my own work, like those on pedigrees or mitral annular disjunction.”
He also truly appreciates his lab colleagues and the environment that Dr. Delling has created. “Beyond the research itself, I’ve learned a lot about how people are different, and that everyone has something to teach me,” said Dr. Cristin. “Everyone brings a different perspective, and I’ve come to appreciate how much you can learn by simply observing how others think, communicate and respond. Francesca has created a truly cohesive team – we’re not just colleagues, we’re friends. We always eat together – the clinical research coordinators, other postdocs, and Francesca. I am happy to go to work, both because I really enjoy research and because I get to share it with people I really care about. For me the human connection is the most important part.”
Dr. Cristin is deeply grateful for the opportunity to do this postdoctoral fellowship at UCSF. “In Italy, clinical research is often done alongside clinical duties, which can make it challenging for young researchers to obtain dedicated time and support,” he said. “At UCSF, I was able to focus entirely on research in a well-resourced environment. That kind of protected time and mentorship is rare back home, especially early in one’s career…. It’s also inspiring to be in a place where collaboration is so accessible. Francesca regularly discusses potential projects with researchers from institutions like Harvard and Mount Sinai. That kind of network and openness really accelerates learning and broadens your perspective.”
He also values the support and autonomy he has as a postdoc. “They gave me a lot of independence, and that helped me grow a lot and take responsibility for my learning,” said Dr. Cristin. “Francesca gives me freedom to try things. She’ll send me detailed comments and responses on draft manuscripts, which has helped me a lot. I was able to become the first author on publications. If something goes wrong, she never scolds us – she’ll say, ‘Let’s see what’s wrong, understand why, and learn for the next time.’ At UCSF, people really try to sponsor you, but don’t micromanage. The attitude is, ‘You go, but still, I guide you.’”
In the first two years of his postdoctoral fellowship, his efforts have translated into multiple manuscripts and reviews in high-impact cardiology journals. Dr. Cristin published first-author articles about multimodality imaging of arrhythmic risk in mitral valve prolapse as well as a study of imaging results of patients with arrhythmias related to their mitral valve prolapse and their family members. He was also awarded best oral presentation at the 2024 Heart Valve Society meeting and the Alan S. Pearlman Research Award for the highest scoring early career investigator abstract at the 2024 American Society of Echocardiography Scientific Sessions.
“Luca reached out to me as a medical student from the University of Verona, Italy to work in my lab as a postdoctoral student,” said Dr. Delling. “Unlike other junior investigators coming from abroad with expertise in cardiology and clinical research, Luca lacked experience in the field. Despite this, he very quickly gained skills in statistical analysis, medical writing, oral presentations and scientific knowledge in the field of mitral valve prolapse, imaging and epidemiology. I don’t think I’ve ever encountered such a fast learner and such a driven individual. He immediately became a vital member of my research team, helping clinical research coordinators, PhDs and other medical students.”
The Upside of Discomfort
After completing his postdoc, Dr. Luca plans to return to Italy to complete his cardiology fellowship. He hopes to continue learning from and collaborating with the Delling Lab, and wants to return to the U.S. for another research year during residency. He plans to pursue a career as a cardiologist who conducts research at the intersection of cardiac imaging and intervention.
Outside of the lab, Dr. Luca enjoys playing tennis, working out at the gym, and riding his motorcycle on Highway 1 and around the Bay Area. He also values spending quality time with his partner, Letizia.
His advice for others seeking to follow a less conventional path? “Be ready for challenges and don’t believe that it will be easy, but don’t get discouraged,” said Dr. Cristin. “There isn’t anything I could tell you that would make you happy to receive rejections or no response, but they are part of the journey, and they don’t define your worth or potential. Sometimes it helps me to look at things from the other side; people are often busy or overwhelmed, and it’s rarely personal. Most importantly, focus on the growth and learning something new – even a little bit – every day. The goal is never to be the smartest person in the room, but to surround yourself with people who inspire you and help you become better.”
He continues to push himself to grow. “The first time I gave an oral presentation at a conference, I was worried and uncomfortable,” said Dr. Cristin. “But every time I’m uncomfortable, it’s satisfying – not because I like being uncomfortable, but because it shows me that I’m alive and I care about what I’m doing.”
- Elizabeth Chur