Some University of Arizona medical school students are gettingfree tuition in exchange for a promise to practicein underserved rural areas for at least two years after they graduate.

The scholarship money is from state funds earmarked to alleviate a physician shortage that is particularly acute in rural Arizona, where more than one-quarter of primary-care physicians plan to retire in the next five years.

Arizona currently ranks among the worst in the country 44th of 50 statesin its number of active primary-care physicians per capita, UA officials say.

Most primary-care doctors in Arizona work in heavily populated Maricopa and Pima counties, creating vast inequalities between provider coverage in urban and more rural areas of the state.

A combined 94 students who attend the UA College of Medicine-Tucson and the UA College of Medicine-Phoenix, which isnearly one-10th of the students at both medical schools, will receive free tuition in exchange for practicing in a rural area for at least two years,UA officials announced Friday morning.

The commitment must be started within six years of graduation from medical school and completed within 10 years of graduation. Once begun, service must be continuous. Students who don't fulfill the commitment will have to return the tuition money, UA officials confirmed.

"It is a huge deal. It is very exciting," saidDr. Jonathan Cartsonis, director of the rural health professions program at the UA College of Medicine-Phoenix. "... It's an investment in the future of Arizona and in ensuring that rural areas of Arizona have access to even basic medical care."

There's also a looming problem with what are known as "ob deserts" where rural expecting mothers can't remain in their community during the later stages of pregnancy because there is no one to deliver their baby.

"It's already happening," Cartsonis said.

La Paz and Greenlee counties have no maternal care, research from the UA Center for Rural Health shows. The same research shows Pinal, Graham, Cochise andSanta Cruz counties have limited access to maternal care.

Ensuring every Arizona resident, whether in rural communities or urban cities, has access to quality health care is a top priority for Arizona, Gov. Doug Ducey said in a written statement. The University of Arizona Primary Care Physician Scholarship is another example of the innovative steps the state is taking to address this critical workforce shortage facing Arizona and the entire nation."

Medical students can be reluctant to serve in rural areas because of a number of barriers, including student debt that can exceed $100,000 by the time they graduate. Rural health jobs, particularly in primary care, oftenpay less than those in urban areas,Cartsonis said.

Also, many students have grown up in urban areas and that's all they know, he said, stressing that the scholarships are only one component of getting providers into rural areas. Students need the righttraining, too, he said.

"In a vacuum, I'd say it might not be the best plan, to just drop a large amount of money to scholarships to go to rural areas to practice medicine," he said. "But that's not happening. We have our rural health professions program, which prepares students and supports a medical school track in rural medicine."

'A PIPELINE ISSUE':Rural Arizona wrestles with serious doctor shortage

The UA is already supporting clinical education from six weeks to more than six months in far-flung areas of the state, including Williams, Fort Defiance, Page and Williams.

Another key pieceis finding students who grew up in rural areas and want to serve their home communities as health-care providers, he said.

"Pipeline programs are really important. It's so important we identify the talented and motivated youthin rural areas who want to go into medicine," he said. "We're working hard to recruit at younger and younger ages students from underrepresented backgrounds, including geography."

The scholarships will be available to incoming first-year students, as well as students in their second, third and fourth year at both medical schools, UA officials said.To be eligible, applicants must be an Arizona resident.

Arizona needs nearly 600 primary-care physicians today, and the number is expected to grow to more than 1,900 by 2030, said Dr. MichaelDake,senior vice president for UAHealth Sciences.

As the states only two designated medical schools, the College of Medicine-Tucson and the College of Medicine-Phoenix are taking full advantage of the public investment approved by our state legislators, who recognize the time to address this shortage is now.

The money is coming from $8 million in annual funding appropriated by the Arizona Legislature in May. The remaining funding is being used to expand the UA College of Medicine-Phoenix's class size.

Under the new scholarship programs guidelines, a primary-care physician is someone who successfully has completed medical school at the UAand completed residency or fellowship training in one of the following specialties: family medicine, general internal medicine, geriatric medicine, general pediatrics, psychiatry, or obstetrics and gynecology.

The scholarships are a step in the right direction, but it will be important to carefully select the students who receive them, said Dr. Judith Hunt, who has been practicing internal medicine and pediatricsin Payson for the past 24 years.

Practicing medicine in a rural area is not urban medicine in a small community, she said. Students need to be prepared for what it means for themselves and for their families, she said.

"There are fewer job opportunities for their spouses. They may feel more isolated," she said. "Rural medicine takes an incredible amount of creativity."

There may not be specialists to consult and the work is demanding.

"We are slammed. We have probably half of the primary-care doctors that we need," she said. "For patients who are new to the community, it's difficult to get a primary-care doctor. So we have higher ER visits because patients don't have access to their doctors."

A graduate of the UA College of Medicine-Tucson, Hunt initially moved to Payson fromPhoenix Children's Hospital to fill a need Payson did not have a pediatrician.

"I fell in love with the community, became part of the community. It's my home, it's my daughter's home," she said.

PRESCRIPTION DRUG BOOM:Millions of opioid pills flooded Arizona communities

Thenext step in addressing the physician shortage should be creating more postgraduate residency spots inArizona, Cartsonis said.

Mostmedical school graduates who take residency positions in other states will notreturn to Arizona, data shows.

Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.

Support local journalism.Subscribe to azcentral.com today.

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When we talk about medical school, our conversations tend to gravitate to a few key issues, particularly undergraduate grades, MCAT scores, and school prestige. These are undeniably major concerns the average medical school student had an undergraduate GPA of 3.79 for the 2018-2019 admission cycle, demonstrating just how hard it is to get a prime placement but theres a lot more to the future of the profession than who gets into the top few schools.

A meaningful conversation about medical education also needs to tackle issues like diversity, population-level health needs, and soft skills like compassion and collaboration. More than who attends Harvard or what residency students earn later on, these are the factors that will influence how well future doctors serve their communities.

How Money Shapes Medicine

Medical school is expensive; the median debt load is $200,000, and many students carry more than that. Meanwhile, the average first year resident makes about $55,000, hardly enough to start repaying those loans, and many students dont feel comfortable taking on that amount of debt, often on top of undergraduate debt, in the first place. This influences who goes to medical school and what communities they eventually choose to serve.

One structure that could increase access to medical education is offering students the opportunity to swap their loans for an income share agreement (ISA). A number of fields, including many trades, offer students the opportunity to participate in an ISA, in which an investor takes on the students debt in exchange for a set percentage of their income in the future. While the default rate on medical school loans is actually quite low, offering students the option of an ISA could encourage a greater number of low-income students to pursue medical education.

More Students Than Matches

After completing their basic medical education, students spend several years as resident, essentially trainees practicing under close supervision. Like everything else about medical education, residencies are highly competitive; medical students rank residency programs and are matched through a national placement algorithm based on specialty, location, and other factors. Where students match for residency has a major impact on where they choose to practice later in life but there are a number of problems with this system.

First, despite a national physician shortage, thousands of students arent matched with a residency each year. There just arent enough slots, even though the country is in desperate need of those doctors and many of the students who fail to match have great potential. Offering alternative paths to licensure, such as allowing graduates to practice under physicians in underserved areas, could increase the supply of doctors and give smart, eager students a chance to utilize their knowledge and training.

Distribution Issues

In addition to students failing to match with residencies, those who do match tend to be clustered in specific areas. Residencies are often based at teaching hospitals, which are in turn often in major cities or expensive suburbs. This is exacerbating the physician shortage in rural areas since students who are trained in well-equipped urban hospitals may feel unprepared to be one of a few doctors on call in a low-income, rural community. Medical residencies need to be redistributed or new residencies created in areas with major shortages and students need support and encouragement to pursue those areas.

Diversifying The Field

Finally, most industries reflect their leadership in terms of make-up. If a field is dominated by men at the upper levels, then men are most likely to enter the industry. The same divisions occur along racial lines. At the rate things are going right now, medicine wont reach racial or gender parity for many decades, and that has a lot to do with who is in charge of medical schools.

Because of changes at the undergraduate level, more than 50% of medical school students are now female, which makes it seem like medical education is on the right track. Thats true in some regard, yet because of deeply rooted disparities, it will be 50 years until half of all doctors are women. Of long-term medical school deans, only 7% of deans serving more than 12 years are women.

For healthcare to adequately serve patients, it needs to better reflect those it serves and that means looking beyond grades. Thats only a small part of who these students are and what theyll be capable of as medical professionals.

This article does not necessarily reflect the opinions of the editors or management of EconoTimes.

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Beyond Academics: What Our Conversations About Med School Overlook - EconoTimes

Another International Survivors of Suicide Loss Day has passed. Its a day of remembrance started by former senator Harry ReidHarry Mason ReidImpeachment trial throws curveball into 2020 race Harry Reid: Early voting states Iowa, New Hampshire 'not representative of the country anymore' The Memo: Democrats confront prospect of long primary MORE after he lost his father to suicide. And again, we havent talked enough about physician suicide, which has become an epidemic.

One doctor dies by suicide every day and it is estimated that 135 people are affected by every suicide. Imagine how many people are affected when a doctor dies. Patients, colleagues, and the institution itself become the survivors to tell the story.

Multiple studies show that suicide rates are higher among physicans than the general public, the highest suicide rate of any profession, and this vulnerability manifests in providers throughout the course of training and practice.

Medical school is devastatingly expensive (up to $400,000) and physically, intellectually, and emotionally exhausting. Physicians emerge from medical school and residency into a profession that offers far less autonomy than most expect; care is micromanaged at every level-and more modest financial rewards than a generation ago.

The prestige, access, and wealth that once accompanied the a medical career are substantially diminished. However, we have failed to prepare our youngest providers for this new reality.

A review of 195 studies and 129,123 medical students concluded that at least 25 percent of medical residents report depressive symptoms and 11 percent struggle with suicidal thoughts. In recent studies, 40 percent of residents and 45 percent of physicians reported feeling burned out. While there is some controversy about what exactly burnout is, there is no doubt that providers who feel depressed, disengaged, and exhausted represent a serious public health crisis.

Institutions need to provide top-down changes in culture, structure, and strategy to effectively address this epidemic. The growth in wellness programs represents a small step in the right direction.

However, these programs focus disproportionately on individual self-care outside of work and school rather than cultural changes to help providers feel safe, supported, and connected in the workplace.

Medical schools need to reduce barriers to seeking help and implement support systems within the organization. The medical director of the American Foundation for Suicide Prevention (AFSP) says we need to change the culture of medicine. Likewise, state licensure boards must stop framing the mere fact of having received mental health services as a potential disqualifying factor.

We also need to break the stigma that still attaches to receiving mental health care. Ironic and sad as it may be, those in the helping profession may face the same or higher social stigma towards getting professional help especially in regards to mental health concerns.

Fear of reporting mental illness to a licensing board hampers help-seeking for even routine mental health issues. Moreover, respect for families privacy often hampers open discussion of completed suicides which may reinforce the shame and secrecy attached to suicidality.

Unfortunately, physicians and other health-care providers continue to routinely sacrifice their own self-care to care for others because, physicians are at their core, healers, and the work of medicine is inevitably hard and occasionally heartbreaking. We cannot address this issue by making medical training or practice easy. We can, however, foster resilience and help-seeking in our health workforce.

If you or someone you know needs help, please call the national suicide prevention lifeline 1-800-273-8255.

Jay Behel, Ph.D., is an associate dean of student affairs and assistant professor in the Division of Behavioral Sciences at Rush Medical College in Chicago. Jennifer Coleman, Ph.D., is a clinical psychologist with the Road Home Program at Rush University Medical Center.

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Doctors are dying by suicide every day and we are not talking about it | TheHill - The Hill

I am the lead author of a peer-reviewed manuscript that details how U.S. medical school diversity initiatives are leaving us behind. This is a summary of the article, which was published in Academic Medicine, and a call to action to improve our representation and the health of our communities

U.S. medical education diversity initiatives were born out of the Civil Rights Movement in an effort to increase the representation of African Americans in the physician workforce. Over the last 50 years, these efforts have evolved to include other minority groups that are underrepresented in medicine, and efforts to specifically identify and recruit African-American students have become obscured. African Americans thus remain significantly underrepresented in medicine, accounting for just 6 percent of graduates from U.S. medical schools and 3 percent of U.S. medical school full-time faculty.

Further complicating matters, demographic shifts resulting from recent immigration of black people from Africa and the Caribbean have both expanded the definition of African-American medical students and shifted the emphasis from those with a history of suffering under U.S. oppression and poverty to anyone who meets a black phenotype. Thus, while the majority of blacks in this country are African Americans defined as blacks born in the United States whose ancestors suffered under slavery and Jim Crow laws over half of black students entering medical schools are members of other black subgroups, i.e. African, Afro-Caribbean, and mixed race. African Americans have now become underrepresented amongst the underrepresented.

Besides being emblematic of a glaring scholastic achievement gap, why does all of this matter?

African Americans have a higher age-adjusted death rate than whites for 9 of the 15 leading causes of death in this country, and the life expectancy for African Americans (74.8 years) continues be lower than white Americans (78.5 years). The life expectancy for African-American men is 71.5 years.

Medical literature has consistently shown that black patients rate their healthcare experience as higher when paired with a black physician. This in turn has been proven to yield greater utilization of health services and improved compliance to plans of care. It can thus be asserted that the underrepresentation of African Americans in healthcare is a public health problem, and any health disparity initiative aimed at improving the health of African Americans should include African American physician pipeline programming at the core.

Diversity initiatives in U.S. medical school need refocusing. Educational environments with students of varying experiences and a myriad of backgrounds are certainly valuable, but identity-oriented initiatives that seek to improve African-American student presence and right societal wrongs should be underscored. In doing so, medical school admissions committees must consider and contextualize the genealogical heritage and ancestral legacy of minority students, particularly blacks.

Additionally, the corrosive effects of financial and social deprivation of African Americans should be considered, including those from high-income, two-parent homes. Simply competing for any phenotypically black student that clears lowered academic thresholds is incomplete and contributes to African Americans being underrepresented in medicine.

The responsibility should not fall solely on medical school admissions committees, which are largely white. The African-American community also needs to be called into action to adequately prepare African-American students to compete in the mainstream.

Here are some detailed solutions.

Academic expectations for African-American boys and girls need to be raised. The bar needs to be much higher than staying out of trouble and having good manners. Strong classroom performance, high standardized test scoring, and achievement of professional and STEM-based graduate degrees should be routine and normalized as opposed to seeming foreign.

We need to start educating African-American boys and girls outside of traditional school systems, which have largely proven to be insufficient in terms of helping us make collective academic progress. Just as athletic teenagers rely on AAU and club sports teams alongside their high school teams for preparation and showcasing of talent, schools should simply augment the academic efforts of African-American children. This is not uncommon amongst many Indian and Asian populations in the United States. Parental efforts and programs that teach and stretch the core academic potential of African-American youth should be created and prioritized.

African-American youth need immersion into the language of U.S. standardized tests. Once thought to be primarily related to economic status, race has become a greater predictor of SAT performance than parental education and family income. Blacks continue to lag behind all minority groups in ACT and SAT scoring, the Medical College Admissions Test (MCAT), and other graduate school entrance exams. Reading assignments for African-American adolescents and teens should routinely include publications such as Time Magazine and the Wall Street Journal. Familiarity with National Public Radio and related content should also be incorporated.

Collegiate selection needs to be more intentional. Parents and high school students need to look towards schools that have a proven track record of successfully preparing African-American students for academic success. The medical school application process is very complex, and medical school admissions committees look for specific scholastic and extracurricular profiles. The American Association of Medical Colleges lists the institutions with the highest numbers of African-American applicants to U.S. medical schools each year. Parents and high school students should reference this regularly in looking for and selecting the right institution of higher learning.

Finally, African-American students should be guided, mentored, and supported through college, medical school, residency, and beyond. Pre-medical and other students destined for graduate and professional school require nuanced financial support and experiences to be successful applicants for the next level. Pipeline programs should include parental education on the type of support African Americans need to clear hurdles along the way.

These are simple solutions, but they require a deliberate investment and collective effort. None of it is showy. None of it looks good on Instagram, Facebook, or LinkedIn. It does not make for good pictures or hashtags. Its not magic. Much like medical school admissions committees, our community-based efforts need to be about impact and not optics.

Dr. Kenneth Poole Jr. is the medical director of Patient Experience for Mayo Clinic Arizona, chair of the Mayo Clinic Enterprise Health Information Coordinating Subcommittee, and a member of the Mayo Clinic Alix School of Medicine admissions committee. He is a North St. Louis County native and a product of the Mathews Dickey Boys and Girls Club, Hazelwood Public Schools, Lutheran North High School, and Tennessee State University. The views expressed above are his own and do not represent those of the Mayo Clinic.

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Impact and not optics: How we can increase the number of African Americans in medicine - St. Louis American

Freshmen medical students get a taste of plant-based medicine

Kale. Chickpeas. Tahini. Dates.

Those were just a few of the ingredients in a Nov. 7 class held for the nearly 300 freshmen of the Wayne State University School of Medicine.

The topic was plant-based nutrition, and the new curriculum initiative equal parts cooking demonstrations, hands-on recipe making and clinical testimonials from patients is possibly the first of its kind at any of the nations medical schools.

Most deaths in the United States are preventable and are related to nutrition. Diet is a major cause of death and disability, yet the standard medical education curriculum has little to no emphasis on diet, and almost no medical schools present information on a plant-based diet, said second-year medical student Lakshman Mulpuri, president of the Plant Based Nutrition Group student organization.

The success of PBNGs Plant-Based Curriculum Enhancement will have national implications for the future of clinical care and medical education. Armed with a more comprehensive understanding of plant-based nutrition, these future physicians will be better prepared to combat the devastating effects of chronic disease that millions of Americans face every year, he added.

The half-day event, held throughout Scott Hall and the Mazurek Medical Education Commons, was organized and co-hosted by the student group, and faculty and staff of the medical school.

The event provided an in-depth understanding of the dramatic improvements in health and quality of life every patient has experienced when switching to a plant-based diet, Mulpuri said. We as a population are not doomed to suffer the debilitating and painful consequences of an unhealthy lifestyle. Physicians and patients have the power to change, and the plant-based curriculum enhancement facilitates this transformation.

The curriculum day included panel discussions and an immersive cooking demonstration, providing students with a better understanding of the humanistic value that lifestyle medicine can have, he said.

The curriculum also aligns with the first-year medical students overall educational experience.

The session complements what they are learning in basic sciences and provides additional ways to view how they can keep people healthy, said Nakia Allen, M.D., a pediatrician and director of the Population, Patient, Physician and Professionalism course.

As part of the class, health care professionals and patients from Michigan and Ohio who follow a plant-based diet shared their individual stories of struggle and triumph, from facing chronic disease to earnest discussion about the patient experience.

This was a great event and opportunity for students to see and understand other aspects of wellness can be through diet, said Detroit-based participating physician Gwendolyn Graddy-Dansby, M.D., who specializes in geriatric medicine. The group that I sat with was energized. We talked about how they would apply this to patient care, and discussed the importance of understanding how social determinants of health, such as food islands, impact health. Eastern medicine and Western medicine are partnering more and more, and the exposure to different diets and ways to prepare food for health was good for students.

Six local chefs also participated, providing students with recipes and ingredients that students then made in the cafeteria. Chef Amber Poupore, founder of the Cacao Tree Caf in Royal Oak, has been attending lunch and learn sessions at WSU for four years. She believes it is her lifes mission to educate people about how beneficial a plant-based diet can be, especially as a form of treatment.

Students were more receptive than I anticipated, and there was a lot of positive feedback from them, she said.

Organizers hope to integrate the curriculum enhancement into future medical student class years.

We think it would be particularly helpful teaching students how to counsel patients on improving their nutritional intake, so they can be ready for their clinical years. It is better to have a conversation than avoid it at altogether. We hope to have a nutritional assessment tool and will be providing additional evidence and basic science relevance in the coming weeks, Mulpuri said.

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When Dr. Justin Barad was a medical resident, he would often encounter a problem he'd never managed or be asked to use a device without much training.

So he'd turn to YouTube.

Barad, who completed his surgical training at UCLA in 2015, said YouTube has become a fixture of medical education. He'd often get prepped by watching a video before a procedure. Sometimes he'd even open a YouTube video in the operating theater when confronted with a particularly challenging surgery or unexpected complication.

"I don't know a surgeon who hasn't had a similar experience," said Barad, who has now started a surgical training company called Osso VR.

CNBC found tens of thousands of videos showing a wide variety of medical procedures on the Google-owned video platform, some of them hovering around a million views. People have livestreamed giving birth and broadcast their face-lifts. One video, which shows the removal of a dense, white cataract, has gone somewhat viral and now has more than 1.7 million views. Others seem to have found crossover appeal with nonmedical viewers, such as a video from the U.K.-based group Audiology Associates showing a weirdly satisfying removal of a giant glob of earwax.

Doctors are uploading these videos to market themselves or to help others in the field, and the amount is growing by leaps and bounds. Researchers in January found more than 20,000 videos related to prostate surgery alone, compared with just 500 videos in 2009.

The videos are a particular boon for doctors in training. When the University of Iowa surveyed its surgeons, including its fourth-year medical students and residents, itfound that YouTubewas the most-used video source for surgical preparation by far.

But residents and medical students are not the only ones tuning in. Experienced doctors, like Stanford Hospital's vascular surgeon Dr. Oliver Aalami said he turned to YouTube recently ahead of a particularly difficult exposure.

"It was helpful, but I kept thinking that some of these videos should be verified," he said, "A bit like Twitter and its blue badges."

There's one problem with this practice that will be familiar to anybody who's searched YouTube for tips on more mundane tasks like household repairs. How can doctors tell which videos are valid and which contain bogus information?

For instance, one recent study found more than 68,000 videos associated with a common procedure known as a distal radius fracture immobilization. The researchers evaluated the content for their technical skill demonstrated and educational skill, and created a score. Only 16 of the videos even met basic criteria, including whether they were performed by a health-care professional or institution. Among those, the scores were mixed. In several cases, the credentials of the person performing the procedure could not be identified at all.

Even more concerning, studies are finding that the YouTube algorithm is highly ranking videos where the technique isn't optimal. A group of researchers found that for a surgical technique called a laparoscopic cholecystectomy, about half the videos showed unsafe maneuvers.

Medical experts say this content hasn't been particularly well curated, in part because it's an expensive process. Massive-scale internet platforms like YouTube limit expenses by stressing that they are a platform with some basic rules, and they don't vet or add editorial notes to content. YouTube doesn't claim to be accredited for medical education, and therefore can surface content based on popularity and not on quality.

YouTube did not return a request for comment about its surgical content. Google Health declined to comment.

One solution would be paying a group of doctors to do the work of vetting surgical videos, suggests Dr. Joshua Landy, a Canadian physician who developed an Instagram-like service for doctors called Figure 1. "You'd need to be experienced to distinguish between the surgeries done properly and the technique is the most up-to-date and safe," he said.

For patients watching the surgeries to get a sense for what happens once they go under, that kind of heavy-handed curation might not be necessary. But it's a pressing need for inexperienced physicians, who rely on the videos to fill gaps in their medical education before they perform the procedures.

"Seeing cases is what makes you better at medicine because there's always unusual things you'll have to navigate," said Landy. "So many doctors will watch these videos over and over again for thousands of hours."

Google seems to be aware of the problem. But so far, the company has only made some small steps to provide some rules around graphic medical videos. Those uploading the videos must share descriptive titles, so users know what they're in for, and the purpose must be to educate rather than to offend or surprise a viewer. One thing that's not allowed, for instance, is footage from a procedure featuring open wounds where there's no clear explanation to viewers.

But the company might deviate from its hands-off policy to do more in the coming months. Google's vice president of health, David Feinberg, noted at a recent medical conference in the fall that a lot of surgeons are flocking to YouTube. He implied, without sharing specifics, that his team would look to do a better job of managing the content as part of its broader focus on combating health misinformation across Google.

Medical experts say they're more than willing to work with YouTube to help curate medical content.

Many academic medical centers, notes Jefferson Health's chief executive Dr. Stephen Klasko, are still using the same, age-old methods to train doctors and have not evolved for the digital age.

"We recognize that technology will transform health care, but what member of any medical school faculty understands things like coding or social media at the level of their students?" he said.

Klasko sees potential for YouTube in medical training. Moreover, he notes, surgeons are increasingly being asked to use sophisticated hardware that requires a lot of additional training. One particularly popular type of content on YouTube is an instruction manual for Intuitive's da Vinci surgical robots, which can take months of practice to master. (This one, on how to suture a grape with a da Vinci, is particularly special.)

"These surgical robotics companies will go out of the way to credential people quickly," said Klasko. "But it's a tough skill to pick up."

In the interim, some doctors, like Jefferson Health's chief medical social media officer, Dr. Austin Chiang, who works for Klasko, recommend that their peers check whether a video is associated with a well-regarded hospital or medical society before they watch it or recommend it to others.

In the long run, he said, YouTube should promote this content over others. "One thing Google could do tomorrow is partner with these official societies," he said.

Follow @CNBCtech on Twitter for the latest tech industry news.

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Doctors are turning to YouTube to learn how to do surgical procedures, but there's no quality control - CNBC

VALENCIA, Calif., MELBOURNE, Australia & AURORA, Colo.--(BUSINESS WIRE)--AVITA Medical (ASX: AVH, NASDAQ: RCEL), a regenerative medicine company with a technology platform positioned to address unmet medical needs in therapeutic skin restoration, and scientists at the Gates Center for Regenerative Medicine at the University of Colorado School of Medicine announced today a preclinical research collaboration to establish proof-of-concept and explore further development of a spray-on treatment of genetically modified cells for patients with epidermolysis bullosa (EB), with potential applicability to other genetic skin disorders.

The partnership will pair AVITA Medicals patented and proprietary Spray-On Skin Cells technology and expertise with the Gates Centers innovative, patent-pending combined reprogramming and gene-editing technology to allow cells to function properly. Under the terms of the Sponsored Research Agreement (SRA), AVITA Medical retains the option to exclusively license technologies emerging from the partnership for further development and commercialization. The Gates Center team is further supported by the EB Research Partnership in New York, the Los Angeles-based EB Medical Research Foundation, the London-based Cure EB Charity, and government grants in a collaborative effort to rapidly develop and translate this technology to the clinic for meaningful impact on patient lives.

The Gates Center is a leader in developing therapeutic approaches for genetic skin diseases. Researchers at the Gates Center have developed a powerful new approach for treating genetic skin disorders and improving the lives of patients with epidermolysis bullosa, said Dr. Mike Perry, Chief Executive Officer of AVITA Medical and adjunct professor at the Gates Center for Regenerative Medicine. We look forward to collaborating with the team at the Gates Center on the expanded use of our technology. This agreement marks an important milestone in AVITAs mission to harness the potential of regenerative medicine to address unmet medical needs across a broad range of dermatological indications, including genetic disorders of the skin.

Epidermolysis bullosa is a group of rare and incurable skin disorders caused by mutations in genes encoding structural proteins resulting in skin fragility and blistering, leading to chronic wounds and, in some sub-types, an increased risk of squamous cell carcinoma or death. There are no approved curative therapies, and current treatment is palliativefocused primarily on pain and nutritional management, itching relief, wound care, and bandaging.

Its very exciting to partner with AVITA Medical to help advance our epidermolysis bullosa program, said Director of the Gates Center for Regenerative Medicine Dr. Dennis Roop. Were looking forward to exploring a novel approach to delivering gene-edited skin cells to patients that addresses current treatment challenges.

We believe that Spray-On Skin Cells technology combined with our genetically corrected cells has the potential to be game changing in the treatment of this disease. This combination could reduce time to treatment, lower manufacturing complexity, reduce costs, and improve patient outcomes, said Dr. Ganna Bilousova, assistant professor of dermatology, who is a co-principal investigator on this research program.

ABOUT THE CHARLES C. GATES CENTER FOR REGENERATIVE MEDICINE

The Charles C. Gates Center for Regenerative Medicine was established in 2006 with a gift in memory of Denver industrialist and philanthropist Charles C. Gates, who was captivated by the hope and benefit stem cell research promised for so many people in the world. The Gates Center aspires to honor what he envisionedby doing everything possible to support the collaboration between basic scientific researchers and clinical faculty to transition scientific breakthroughs into clinical practice as quickly as possible.

Led by Founding Director Dennis Roop, Ph.D., the Gates Center is located at the University of Colorados Anschutz Medical Campus, the largest new biomedical and clinical campus in the United States. Operating as the only comprehensive Stem Cell Center within a 500-mile radius, the Gates Center shares its services and resources with an ever-enlarging membership of researchers and clinicians at the Anschutz Medical Campus, which includes University of Colorado Hospital, Childrens Hospital Colorado, and the Veterans Administration Medical Center, as well as the Boulder campus, Colorado State University, the Colorado School of Mines, and business startups. This collaboration is designed to draw on the widest possible array of scientific exploration relevant to stem cell technology focused on the delivery of innovative therapies in Colorado and beyond.

ABOUT THE UNIVERSITY OF COLORADO SCHOOL OF MEDICINE

Faculty at the University of Colorado School of Medicine work to advance science and improve care. These faculty members include physicians, educators, and scientists at University of Colorado Hospital, Childrens Hospital Colorado, Denver Health, National Jewish Health, and the Denver Veterans Affairs Medical Center. The school is located on the Anschutz Medical Campus, one of four campuses in the University of Colorado system. To learn more about the medical schools care, education, research, and community engagement, visit its web site.

ABOUT AVITA MEDICAL LIMITED

AVITA Medical is a regenerative medicine company with a technology platform positioned to address unmet medical needs in burns, chronic wounds, and aesthetics indications. AVITA Medicals patented and proprietary collection and application technology provides innovative treatment solutions derived from the regenerative properties of a patients own skin. The medical devices work by preparing a REGENERATIVE EPIDERMAL SUSPENSION (RES), an autologous suspension comprised of the patients skin cells necessary to regenerate natural healthy epidermis. This autologous suspension is then sprayed onto the areas of the patient requiring treatment.

AVITA Medicals first U.S. product, the RECELL System, was approved by the U.S. Food and Drug Administration (FDA) in September 2018. The RECELL System is indicated for use in the treatment of acute thermal burns in patients 18 years and older. The RECELL System is used to prepare Spray-On Skin Cells using a small amount of a patients own skin, providing a new way to treat severe burns, while significantly reducing the amount of donor skin required. The RECELL System is designed to be used at the point of care alone or in combination with autografts depending on the depth of the burn injury. Compelling data from randomized, controlled clinical trials conducted at major U.S. Burn Centers and real-world use in more than 8,000 patients globally, reinforce that the RECELL System is a significant advancement over the current standard of care for burn patients and offers benefits in clinical outcomes and cost savings. Healthcare professionals should read the INSTRUCTIONS FOR USE - RECELL Autologous Cell Harvesting Device (https://recellsystem.com/) for a full description of indications for use and important safety information, including contraindications, warnings, and precautions.

In international markets, our products are marketed under the RECELL System brand to promote skin healing in a wide range of applications, including burns, chronic wounds, and aesthetics. The RECELL System is TGA-registered in Australia and received CE-mark approval in Europe.

To learn more, visit http://www.avitamedical.com.

CAUTIONARY NOTE REGARDING FORWARD-LOOKING STATEMENTS

This letter includes forward-looking statements. These forward-looking statements generally can be identified by the use of words such as anticipate, expect, intend, could, may, will, believe, estimate, look forward, forecast, goal, target, project, continue, outlook, guidance, future, other words of similar meaning and the use of future dates. Forward-looking statements in this letter include, but are not limited to, statements concerning, among other things, our ongoing clinical trials and product development activities, regulatory approval of our products, the potential for future growth in our business, and our ability to achieve our key strategic, operational and financial goal. Forward-looking statements by their nature address matters that are, to different degrees, uncertain. Each forward- looking statement contained in this letter is subject to risks and uncertainties that could cause actual results to differ materially from those expressed or implied by such statement. Applicable risks and uncertainties include, among others, the timing of regulatory approvals of our products; physician acceptance, endorsement, and use of our products; failure to achieve the anticipated benefits from approval of our products; the effect of regulatory actions; product liability claims; risks associated with international operations and expansion; and other business effects, including the effects of industry, economic or political conditions outside of the companys control. Investors should not place considerable reliance on the forward-looking statements contained in this letter. Investors are encouraged to read our publicly available filings for a discussion of these and other risks and uncertainties. The forward-looking statements in this letter speak only as of the date of this release, and we undertake no obligation to update or revise any of these statements.

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AVITA Medical and the Gates Center for Regenerative Medicine at the University of Colorado Anschutz Medical Campus Enter into Collaboration to Explore...

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A new study published by The Journal of Pediatrics shows increased rates of implementation of hospital-based breastfeeding initiatives are associated with decreased rates of infant deaths in the first six days after birth, dispelling speculation that such practices might increase infant death.

The authors of the study examined trends in the percentage of births in baby-friendly hospitals between 2004-2016, as well as the implementation of skin-to-skin care in the first hour after birth in both the U.S. population and in Massachusetts. The authors looked at trends in Sudden Unexpected Infant Deaths (SUID), including deaths by asphyxia, in the first six days after birth during the same time period.

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Despite marked increases in both the percentage of newborns being delivered in baby-friendly facilities and in the percentage of newborns experiencing skin-to-skin care, there has been a significant decrease in deaths due to SUID within the first six days after birth.

These data come as welcome news and should reassure us that these initiatives are not resulting in any increase in infant deathsin fact, just the opposite is true, said study lead author Melissa Bartick, Harvard Medical School assistant professor of medicine and an internist at Cambridge Health Alliance.

Bartick noted that widespread speculation had arisen on whether such interventions could be deadly after an opinion piece citing Massachusetts infant mortality data was published in medical literature in 2016, followed by a national study in 2018.

Both of these publications were controversial, and the related mainstream media attention they garnered characterized such deaths as being relatively common. The new study by Bartick and colleagues found that fewer than 1 percent of sudden unexpected infant deaths during the first month of life actually occur during those first six days.

Bartick noted that the peak occurrence for SUID is in the first two to four months of life. Rates of skin-to-skin care rose to nearly 100 percent in Massachusetts, yet there were zero deaths from suffocation or asphyxia.

We now recognize that evidence-based maternity care practices to support breastfeeding are associated with a decreased risk of neonatal death, said study co-author Lori Feldman-Winter, professor of pediatrics at Cooper Medical School of Rowan University.

The authors noted that skin-to-skin care is now routine for all infants, regardless of feeding method.

An additional significant finding of the study was that deaths in the first six days of life occurred disproportionately among black infants, indicating that racial disparity in infant mortality begins as early as the first six days after birth.

Adapted from a Cambridge Health Alliance news release.

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Breastfeeding and Infant Mortality - Harvard Medical School

(Grand Canyon West Photo)

Snow at the Grand Canyon, a new free tuition program for University of Arizona medical students and a French-inspired restaurant moving into Scottsdale.

Here are some stories that headlined the news cycle, both locally and nationally, over the weekend.

The Grand Canyon is undoubtedly one of the most scenic natural habitats on the planet.

Can Arizonas beloved tourist attraction get even more gorgeous?

Beauty is in the eye of the beholder, but we think she looks especially nice with a dusting of snow to highlight her features.

Check out the photos, courtesy of Grand Canyon West, of the national park and its Skywalk observation deck during this weeks winter storm and see what you think.

The University of Arizona is taking on the states doctor shortage and student debt crisis with a new free tuition program for medical students.

The university announced Friday that its medical schools in Tucson and Phoenix will offer free tuition to in-state students who commit to practicing primary care in a designated Arizona community for at least two years.

In addition to the dire need for more primary care physicians in the state, the issue of student debt is a major roadblock for many people who have the potential to be great doctors, Dr. Michael D. Dake, senior vice president for UArizona Health Sciences, said in apress release. It keeps many individuals from even applying to medical school.

Foodies, get your December plans in order.

Expanding its reach to the Valley for the first time, French-inspired Zinque is planning to open its doors early next month.

The location will sit in the new luxury wing of Scottsdale Fashion Square Mall, with the cafe and wine bar set to open for breakfast, lunch, dinner and late-night gatherings.

Three outfitter guides have been banned from northern Arizona forests after being convicted of illegally operating commercial businesses.

Forest officials say the guides didnt have the required authorization or permits.

The three guides were sentenced to a year of unsupervised probation and ordered to pay up to $460 in restitution and up to $1,000 in fines. They also must remove any advertisements for tours on national forests within Arizona.

Officials say Mark Truesdell of Sacred Sites Journey, Georgina Rock of Air B&B Experience and Kurt Raczynski of Inner Journeys have been banned from the Coconino, Kaibab, Prescott and Apache-Sitgreaves national forests for a year.

The Glendale Police Department was investigating after an officer-involved shooting left a police K9 and the suspect dead Friday night, authorities said.

The incident occurred around 5:20 p.m. in the area of Grand Avenue and the U.S. 60, according to the El Mirage Police Department.

El Mirage officers were attempting to apprehend 38-year-old Joe Ruelas, who was wanted for aggravated assault. When they attempted to arrest Ruelas, he fled from the scene holding a handgun.

The police officers gave chase with a K9, Koki. The K9 was sent to apprehend Ruelas, who shot and killed Koki. The officers returned fire at Ruelas, who ran out of site.

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Weekend wrap-up: Here are the biggest Arizona stories from Nov. 22-24 - KTAR.com

OPINION:On Monday, professor Barry Taylor, dean of Otago Medical School, publicly stated that 53 students from University of Otago campuses in Christchurch, Dunedin and Wellington did not attend their 12-week placements at locations overseas and their qualifications would be withheld.

Instead, the soon-to-be doctors were on an overseas jaunt courtesy of taxpayers. The 12-week elective term is funded by a Government stipend of $6689 paid as part of the $26,756 awarded to medical trainee interns in their final year.

Fifty-three students amounts to one-in five of Otago's final-year medical students.

If I were a gambling man, I would bet this rort has been going on for years and there are plenty of practising doctors hoping it all goes away. The public would be naive to believe this behaviour is restricted to just this year's cohort of final-year medical students.

READ MORE:* Placement scam medical students 'let off with a slap on the wrist'* Auckland medical students to face scrutiny after Otago students faked placements* Medical student overseas placement holiday rort 'widespread' - GP

Stuff

One in five final-year University of Otago medical students will not graduate this year after faking documents for their overseas work placements.

Taylor admitted that himself, when he saidt: "If it has been happening it's probably been ... building up over two or three years". That could possibly be the understatement of the year, depending on how much is unravelled in the weeks to come.

According to Stuff, one doctor who graduated from Otago said: "[In] my graduating year I know 100 students who spent one week or less on actual elective placements". In other words, it could also be feasible that this practice was a rite of passage and Otago turned a blind eye to it, or worse still, unofficially condoned it.

Now, the University of Auckland the only other university offering the six-year bachelor of medicine and bachelor of surgery qualifications has stated it is also conducting an investigation into its students.

I hope Otago and Auckland conducts thorough investigations of overseas work placements from previous yearsand perhaps decades. This lot were busted because some of them couldn't resist posting photographs of their overseas jaunts on social media.

Ten or 20 years ago, no-one was uploading images online of themselves tiptoeing on the beach with a duckface, so the chances of doctors getting caught back then were slim in comparison to now, with the "look-at-me"era.

Also, why are taxpayers funding overseas "training"in the first place? Students can choose to do their placement in New Zealand or overseas some elect to do it overseas and we pick up the tab for it. If they want to "train"overseas, let them do it at their own expense.

We are short of doctors on the ground here, so unless they need to learn how to deal with non-routine injuries or illnesses they perhaps wouldn't be exposed to here, their training should be in New Zealand hospitals and medical centres.

After all, we the taxpayers fund three-quarters of the cost of their six-year medical training.

We also pick up ongoing costs when they graduate too. For example, back in 2013, Stuff reported that "on-duty resident doctors have not paid for a meal since 1948" and were clocking up "$9 million of taxpayer-funded free lunches a year". How dare we feed the hungry kids at schools the doctors must be fed first.

Further, being a doctor remains one of the highest-paid professions in the country, with senior doctors earning an average annual salary of about $200,000.

Yet, despite their forecast large salaries and free lunches, this bunch of privileged student doctors has lied about their taxpayer-funded overseas work placementand has been let off with a slap on the wrist.

I suppose a slap on the wrist was appropriate, especially since Taylor said those affected were "heartbroken". Taylor went on to say: "The students have been quite seriously affected by the investigation.The majority have seen themselves as really honest people doing medicine for the sake of other people".

Oh, diddums.

Honest people don't commit fraud. Yes, they committed fraud.

As we all know, the Government will not hesitate to prosecute beneficiaries for fraud relating to as little as $1000. However, if you come from the right background and are at medical school, the chances of being prosecuted for fraud are zero.

Let's prove me wrong, then. Taylor, please attend your nearest police station and make a formal complaint, naming the 53 students and how each misspent taxpayers' dollars earmarked for trainingto go on holiday.

Otago University has an ethical responsibility to the public of New Zealand to report this matter to the police. I wait with bated breath.

Steve Elers is a senior lecturer at Massey University, who writes a weekly column for Stuff on social and cultural issues

See the article here:
Medical school rort is fraud and students misusing taxpayer money should be reported to the police - Stuff.co.nz

Students from Oakland University William Beaumont School of Medicine are taking to the streets of Pontiac through a new program aimed at helping individuals who are homeless and need medical care.

OUWBs Street Medicine program the first of its kind in Oakland County begins Friday, Nov. 22, when the first group of students will be helping those in need at the Hope Hospitality & Warming Center in Pontiac.

More than 70 OUWB medical students attended the programs orientation on Nov. 15 the culmination of about two years of work led by third-year OUWB students Lexie Ranski and Tori Drzyzga.

Ranski said the intent is for Street Medicine to be a permanent OUWB program.

The benefit that this is going to bring to people in the community is going to be huge, Ranski said. Weve been working so hard on this. Its going to be amazing.

Drzyzga said it feels surreal to be on the verge of launching the program. The two M3s have been working on developing the program since October of their first year at OUWB.

Health care is not a privilege but a right for everyone to have, Drzyzga said. If we can bring it, at least someones getting it to them.

Were helping in any way we can, she added.

Meeting a need

By definition, the concept of street medicine is a collaboration of health and social services that address the unique needs and circumstances of the unsheltered homeless. Today, programs exist in more than 85 cities and 15 countries across five continents.

Ranski and Drzyzga were first exposed to street medicine while they were undergrads at Wayne State University. That program focuses on people who are homeless in Detroit.

We fell in love with serving people experiencing homelessness and working with the underserved, Ranski said. I was like Wow, when I go to med school I really want to do this, too.

The duo saw an opportunity to start a program at OUWB almost as soon as they started attending the school. Ranski said they identified a significant need in Pontiac a city about 10 minutes west of OUWBs Rochester campus.

A strong need exists for such a program in Pontiac, said Jason Wasserman, Ph.D., associate professor, Department of Foundational Medical Studies and Department of Pediatrics, OUWB.

Pontiacs been hit every bit as hard as Detroit with factors like the declining manufacturing industry, massive inflation that began in the 1970s, and, especially, declines in affordable housing, said Wasserman, who serves as advisor to OUWBs Street Medicine program.

All of these factors exacerbate the problem of homelessness and Pontiac has faced all of these problems, he said.

Wasserman said it makes sense that the idea of an OUWB Street Medicine program was met with enthusiasm by various organizations that work with the homeless population in Pontiac.

Those organizations included Oakland County Homeless Healthcare Collaboration, a group of community partners led by the Oakland County Health Division who serve homeless and vulnerable populations to discuss their experiences, identify concerns, share ideas, and develop a plan to address the needs of these clients.

Another organization that welcomed OUWBs Street Medicine program is the Gary Burnstein Community Clinic, a Pontiac-based nonprofit that provides free medical care to the uninsured.

The clinic will serve as a home base for the street medicine program. Further, the program will use the clinic for storage as well as its emergency medical records (EMR) system for documenting care provided to patients.

Im ecstatic about ittheyve been working on this for so long, said Justin Brox, M.D., executive director of the Gary Burnstein Community Health Clinic, who attended the orientation (see photo). Its going to meet a big need in the community.

Other organizations involved in sponsoring or contributing to the program are Beaumont Health and employees at Meridian Health Plan of Michigan. Additionally, OUWBs Street Medicine program has received grants from Blue Cross Blue Shield of Michigan, and a Community Service Mini-Grant from Compass, OUWBs department for community engagement.

Program origins

Wasserman said Ranski and Dryzyga are the third group of students who have presented the concept of a street medicine program at OUWB. Based on their commitment and passion for the project early in the process, Wasserman said he knew they had a real shot at getting it done.

That was important, he said, because he knew it would require a substantial amount of work and effort.

Its a complex thing for an institution to back for a number of reasons, he said. They primarily need to make sure students are safe, and that they are conducting themselves in a way that represents the institution well and ethically.

I think (approval of the project) is a testament to what Lexie and Tori built out and how they put this all together, including drawing on best practices of the national organization, Wasserman said.

Ranski has served as a member of the Street Medicine Institute Student Coalition (SMISC), the student portion of the National Street Medicine Institute. She also recently attended the International Street Medicine Symposium in Pittsburgh.

Those experiences, along with her and Dryzygas previous exposure to street medicine as an undergrad, have prepared them to deliver a meaningful street medicine program, Ranski said.

In short, they know it involves much more than simply finding people who are homeless.

(People who are homeless) dont utilize a lot of resources in the community, dont stay in the shelters, dont use clinics, are very shy of the medical system in fact, theyre not very trusting of the medical system, she said. Thats what street medicine is its really going out and meeting people where they are, with what they have, and listening to their priorities and what they want.

Building a program

Initially, a team of four OUWB students will go out with a physician and representatives from Projects for Assistance in Transition from Homelessness (PATH), a street outreach team that is part of Community Housing Network and also works to help people who are homeless.

Its a good connection for OUWBs Street Medicine program because (PATH representatives) know the streets, where people are going to be, and already have established relationships, Wasserman said. We can piggyback on what theyve already built.

Teams will provide acute medical care, and help individuals with basic needs like clothing and food. Theyll have over-the-counter medications, such as ibuprofen, aspirin, Benadryl, Sudafed, and Claritin, and be able to provide other services, like wound care. (They will be identified by wearing shirts like the one in this photo featuring Ranksi and OUWB student Andrew Lee.)

Early sessions in the program will be held at Hope Hospitality & Warming Center as a way of introducing OUWBs program to the homeless community. Once the presence of OUWBs Street Medicine program is established within the community, teams will move beyond the shelter and into the streets.

Ranski said as more physicians come on board with the project, more teams will be able to provide care.

As the program consistently provides care and grows, Ranksi and Dryzyga said they expect the value of the program will increase for all involved.

You really form relationships with people when you see them every week, Ranski said. You get to know their names, hear their stories about why theyre in the position theyre in.

I would hear all these horrible experiences they had when they went to a physician or ER or that they couldnt go to a clinic because there arent a lot in the city, she said. I felt it was not right that there are these disparities for people who cant control their situations. I wanted to give back in a bigger way that wasnt just handing out hot coffee.

Dryzyga added that when people who are homeless receive care from OUWBs Street Medicine program, it has the potential to have an impact larger than the moment.

I think it helps bridge the gap between this population and the medical system, she said. Because if they can at least trust somebody, then maybe when were not there in the future they can have some trust in the health care system.

Street Medicine Pontiac at OUWB has a Facebook page at @streetmedicinepontiac.

For more information, contact Andrew Dietderich, marketing writer, OUWB, atadietderich@oakland.edu.

Follow OUWB on Facebook, Twitter, and Instagram.

Excerpt from:
Street Medicine program launches at Oakland University William Beaumont School of Medicine - News at OU

There are connections between what we eat and how we feel, and the growing field of culinary medicine looks to capitalize on that link by joining the foundations of nutrition science with teaching people how to cook healthy, tasteful meals.

One North Country doctors office is taking it to the next level by offering patients cooking tips and techniques from a teaching kitchen thats part of their clinic.

Joe Wetterhahn, a family practice physician and his wife Gina, a physicians assistant, ditch their stethoscopes one night a month for a set of knives and cutting boards, teaching patients how to make tasty, healthy food.

The genesis of this whole thing?

"Gina one day in frustration saying 'nobody is getting better. Were spending time with people, doing the best we can, but the weight is going up, the blood sugars are going up, blood pressure is going up'," Wetterhahn said. "Its not just us, its obviously happening across the country. But the way to really impact that is at the plate."

So after a conference on culinary medicine introduced them to teaching kitchens, they pitched the idea to Samaritan Hospital in Watertown, which was building a new health center in Adams. And the hospital took it on, creating a restaurant grade fully equipped teaching kitchen right off their office.

"They invested into this to the point where you walk into our office, and you can sit down take out three cutting boards, grab a knife set and learn how to cook," said Wetterhahn.

So far, the program has grown to about 20 people per session. And Gina and Joe emphasize this is not like a visit to a nutritionist. While science does play a role in what dishes they teach, these classes are more practical.

"Heres something you could make and eat that will make you healthy, without talking about the milligrams of sodium, or the grams of fiber, or the things that dont really translate into how we put food on our plate," said Wetterhahn.

So instead of boiling squash, the 20 or so patients who come to the testing kitchen get a lesson in roasting veggies, like a delicata squash.

"With a delicata squash, the idea is that you eat the rind. Just pick it up and eat it. Because the rind is delate," the Wetterhahns said during a recent class.

Joe and Gina make up their menus the morning of class. Most are based on the Mediterranean diet. They do all the shopping at a local grocery store. So far they say there havent been any cooking busts, but they do admit, one of the biggest challenges is getting folks to try fish.

"Theres this hesitancy because of cooking fish that it wont turn out, or Im not going to like it and its expensive and I dont want to take a chance with it. So we try to integrate fish and seafood a lot in our menus," Wetterhahn said.

A recent class though turned some fish doubters into cod lovers.

"Sometimes certain fishes are fishy. Fishes are fishy. But cod is dense and not fishy," Gina said.

Wetterhahn said the field of culinary medicine is growing. There are teaching kitchens in tech companies like Google. Some medical school are offering classes in teaching kitchens. But hed like to see it in more communities like his, rural populations where studies show there are greater rates of obesity and diets higher in fat.

"The challenge is, again, getting it into areas like northern New York. Getting it into more rural areas, instead of having pockets in urban areas where you have a medical school and it doesnt filter out beyond that," Wetterhahn said.

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Growing field of culinary medicine helps people get healthy by teaching them to cook healthier foods - WRVO Public Media