Medicine Meets Micro-gravity

When Jonathan Steller, MD, was an undergraduate and then a medical student at UC Irvine, space medicine wasn’t yet on his radar. But during his residency in obstetrics and gynecology, Steller attended a space-themed birthday party where he mingled with a group of people working in the aerospace industry.

“I had this aha moment: If we’re planning to go to Mars or colonize space, we’ll need to understand the effects of spaceflight on reproductive health and fetal development,” says Steller, now an assistant clinical professor of obstetrics and gynecology at UC Irvine who specializes in caring for high-risk pregnancies as a maternal-fetal medicine physician. That spark led to investigating how the environment beyond Earth’s atmosphere influences gynecologic and reproductive health, as well as roles with NASA and Vast Space, a private company aiming to launch a commercial space station next year.

Now Steller hopes to give future doctors an earlier liftoff into the world of space medicine. In collaboration with Ariana Nelson, MD, an associate clinical professor of anesthesiology at UC Irvine who also works with NASA and Vast Space, Steller is co-developing a space medicine, engineering and design program in the School of Medicine. The zenith of the program is Concepts of Space Medicine and Orbital Systems 401, a four-week elective course that immerses students in the science of space medicine. COSMOS 401 kicked off in the 2024-25 academic year to rave reviews. Steller spoke with The Anteater contributor Kirsten Weir about its successful launch – and where its flight path is headed next.

What was your goal in creating the SpaceMED program and COSMOS curriculum?

Currently, there’s only one aerospace medicine residency in the country, at the University of Texas Medical Branch. That’s the only pathway to becoming a NASA flight surgeon. That means there’s no clear path for people who do residencies and fellowships in other specialties – whether OB-GYNs or internal medicine specialists like cardiologists or endocrinologists – to study space medicine unless you do both residencies.

And that’s been fine, because NASA flight surgeons take care of NASA astronauts, who are chosen, in part, because they’re the healthiest humans on the planet. We haven’t needed lots of cardiologists to care for astronauts with heart problems or endocrinologists who understand how space affects people with diabetes or thyroid disease. But that’s all changing now. As the commercial spaceflight industry continues to grow, there’s a greater diversity of people going to space. We’ll need more doctors who have baseline space medicine knowledge to help them stay healthy.

Our program is meant to be both foundational and inspirational. For students who do want to be flight surgeons, this program will give them a strong foundation and, hopefully, make them competitive candidates for this aerospace medicine residency. Some might become specialists who can consult with flight surgeons or commercial spaceflight companies. But others might go on to do important space research related to their specialty. We want to give students the knowledge to contribute in a variety of ways as humans expand into space.

What does the program entail?

During the first two years, SpaceMED covers a lot of introductory concepts, including systems engineering and human systems integration. Traditionally, NASA built spaceships first and then decided how to fit the humans inside them. The new and better approach is putting humans first and building the spaceship around them — in other words, thinking about their health and safety from the beginning instead of trying to fix things later. So in COSMOS 101, we talk about engineering and design and also introduce students to space-related insults like radiation, microgravity, and the vibration and acceleration that astronauts experience during takeoff.

During the second year, each lecture coincides with topics students are learning about in their standard medical school curriculum. So when they’re learning about hematology, COSMOS 201 participants will also learn how space affects the blood. When they learn about cardiovascular and pulmonary health, we’ll be teaching them about what happens to the heart and lungs in space. We’ll do that for every system of the body. Then, in the third and fourth years, students get much more hands-on experience, visiting aerospace industry facilities and conducting their own capstone research projects in space medicine.

How did the first year go?

Initially, we planned to launch the program with COSMOS 101, for first-year students. But the commercial spaceflight industry turned out to be really interested. They were eager to have students come do electives with them, so we decided to also roll out COSMOS 401, for fourth-year students, last year. Two students from the School of Medicine participated, spending a month visiting NASA and several private spaceflight companies. They met with astronauts and aerospace medicine physicians, toured spaceflight facilities and took a parabolic flight to experience some of the g-forces astronauts feel when traveling to space.

The students loved it, and they’re excited about the possibilities. One decided to do a combined MD–PhD program and is now studying space radiation and neurobiology. Another student launched the first regional chapter of the Organization for Space Medicine, Engineering and Design and is now planning its first local event – a “hackathon” where engineers will collaborate to miniaturize X-ray machines for space. Other students have started a research project to look at how the space environment affects pharmaceuticals.

What’s next for SpaceMED?

We hope to develop SpaceMED into a full mission-based program. We’re continuing to build it out to make it as rich as we possibly can. We don’t need every doctor in the world to understand what the space environment does to the human body, but with the expansion of human spaceflight, we will need some. We designed this program so future doctors can gain the knowledge and skills they need to help push space medicine forward.