Julian Prosenz, specialist in internal medicine, gastroenterology and hepatology
Research, teaching and clinical practice: a career shaped by curiosity, chance and determination
As a specialist in internal medicine, gastroenterology and hepatology, alongside his role as a clinical researcher and lecturer at Karl Landsteiner University of Health Sciences, Dr Julian Prosenz applies and is continually striving to develop a range of medical perspectives. His everyday professional life spans three domains: practice, research and teaching.
Even early on, Julian Prosenz knew that he did not want to choose between clinical practice, research and teaching. As he sees it, all three areas are inseparable elements of academic medicine. After studying medicine at the Medical University of Vienna, he began his career in 2014 with a clinical research position in pain medicine and anaesthesiology at the Wilhelminenspital in Vienna, where he also began his PhD in neuroscience. Two years later, he transferred to the Department of Endocrinology at the University Clinic for Internal Medicine III at Vienna General Hospital and began his specialist training in internal medicine. Since his position was temporary, he decided to gain some international experience and continued his clinical career at the University Hospital of Zurich, one of the most renowned institutions in Europe. “I found the work there extremely interesting and educational, and it contributed greatly to my clinical career,” he says.
Return to Austria with a fresh perspective
After two and a half years in Switzerland, Dr Prosenz returned to Austria with the aim of dedicating more time to academic medicine, which also meant a greater focus on research and teaching. By chance, he came across an advertisement for a position at the Clinical Department of Internal Medicine II at University Hospital St. Pölten that matched his profile exactly. “In 2021, I transferred my specialist training there,” he recalls. “Together with the head of the department, Chief Physician Dr Andreas Maieron, I began building a small, dynamic endoscopy research team – the Gastrointestinal Endoscopy Quality Matters (GIEQM) working group. We aim to consolidate this field and increase its visibility in Austria and internationally through high-quality trial, structured training and the intelligent use of new technologies such as AI. We’re already seeing promising initial successes and the working group is growing steadily.” The combination of clinical practice, research and teaching at Karl Landsteiner University of Health Sciences has proven to be the ideal combination for Dr Prosenz. “Here in St. Pölten, I've been able to complete the remainder of my specialist training in internal medicine, gastroenterology and hepatology, and I’m now about to complete my PhD at Paracelsus Medical University in Salzburg.”
Research focus: safe sedation & artificial intelligence
Dr Prosenz’s research group focuses on safety and quality in gastrointestinal endoscopy. “Modern endoscopy involves complex, exacting medical procedures,” he explains. “The quality of examinations, technical challenges, sedation and safety aspects are all important factors.” Initially, the working group analysed and published retrospective data on quality of care for upper gastrointestinal bleeding and the performance of junior endoscopists during AI-supported colonoscopies (CADe). Building on this, they initiated prospective studies on the use of AI in colonoscopy training. These focused on the question of whether artificial intelligence can be used to help doctors in training reach the level of experienced specialists. Initial findings show that AI acts as an ‘experienced assistant’ that can detect and evaluate polyps – thus providing crucial feedback in real time. The research programme is being implemented as part of the AC-CADx project (Augmented Colonoscopy with Computer-Aided Polyp Characterisation). Initial findings have already been published in the American Journal of Gastroenterology – a significant achievement for the working group. The team’s high-quality research has won the national poster award at the Austrian Gastroenterology Congress three years in a row. Dr Prosenz believes that AI-supported training has enormous potential. “The technology provides trainees with immediate feedback and can help them achieve international quality standards more quickly, thereby ensuring the best possible outcomes for patients.”
Another focus of the group’s research is safety, particularly with regard to sedation-related complications during endoscopic procedures. “Here, again, we have processed data from our university hospital retrospectively,” he says. “Based on this knowledge, we launched a large-scale, randomised controlled trial in cooperation with the Medical University of Graz. We’re currently researching various monitoring methods during sedation for advanced endoscopic procedures. This year, the project received the national clinical research award from the Austrian Society for Gastroenterology and Hepatology. In other words, there’s plenty to be proud of when it comes to our research achievements.”
Teaching and promoting young talent
In addition to his clinical and research work, Dr Prosenz also teaches at Karl Landsteiner University of Health Sciences. He regularly supervises master’s degree theses, guiding students through what is often their first encounter with independent research work. “Of course, students here can also work in all major research areas alongside their master’s thesis,” he says. “Resource constraints mean that this can prove difficult for students, but our door is always open to them.”
Research in Austria: potential and challenges
Looking ahead, Dr Prosenz sees considerable scope for Austria to improve its clinical research, particularly in the funding of clinical trials. “Such trials are extremely demanding, both in terms of personnel and financing, but they provide us with clear answers as to whether a treatment is effective or not,” he says. “Without a clear commitment from sponsors and policy-makers – which go beyond mere declarations of intent, that is, we won’t make progress.” The same goes for healthcare research. Dr Prosenz sees great potential in endoscopy, including in colonoscopies. “Many key quality indicators are hardly being systematically recorded at the moment. We urgently need structured, standardised data collection and consistent evaluation. After all, what ultimately matters to patients – besides personalised, empathetic care – is whether they are being cared for properly. In countries such as the Netherlands, quality in healthcare and research into this area are strongly promoted at the institutional level. Unfortunately, this is not the case in Austria; we know relatively little about how positively preventive medical check-ups are actually viewed by patients and what it takes to get more people to attend them.”
Dr Prosenz sees the direct connection between theory and practice every day through his work in clinical practice, research and teaching. “It’s always nice to see how research can directly benefit patients – and almost everyone is happy to contribute to improving care for all by participating in trials.”
