Entering medical school, there are a number of curricular expectations for which medical schools prepare incoming students. Still, some things are bound to catch new students off guard. Medical students and medical school faculty spoke with the AMA to cover a few key topics that may surprise aspiring medical students.

Youre bound to spend more time studying than you did in your undergraduate studies. Still, if you prioritize your time, you can meet new people and have a social life.

Often, premeds are told their life will be over for four to five years, said Lindia J. Willies-Jacobo, MD, associate dean for admissions and professor at Kaiser Permanente School of Medicine, which will welcome its first class of medical students in the fall. Thats by no means true. They can continue to socialize and build community with their peers and also have a life outside of medical school.

Avani Patel is a forthcoming graduate of the University of Mississippi School of Medicine in Jackson. Earlier on in her medical school career, she had exams every Monday. That meant that weekends were typically not her time to catch up with friends or go out. She instead started to make plans on Monday nights and attend events during the week that were put on by her school.

Its up to you if you want to be socially active, Patel said. But you are going to have to make priorities and be strategic about it to balance your commitments.

Some students say medical school is comparable to high school in some of the not-so-beneficial ways.

Im from the South, so its already cliquey down here, said Patel. Its your choice if you want to be cliquey or not. I like to have multiple friend groups and get to know people on all levels.

From day one of medical school, your colleagues are your support system but could also be seen as competitors for those ultra-competitive residency slots. That can make for some interesting social dynamics.

I thought I found a great friend group my first year, and they were wonderful people. I realized that they were very high-performing and that became unhealthy for me, Patel said. I doubted myself; I felt bad about myself. We would talk about grades and compare test scores, and that was toxic for me. It had nothing to do with them and everything to do with me. I found I needed to separate myself from them.

I ended up finding another group of friends, and we never talked about grades and supported each other, and thats really what I needed.

As much as they want you to succeed in medical school, your friends may not totally understand the time and emotional energy that goes into medical school. When you start missing marquee events such as weddings and birthdays, they may take it personally, Patel said.

Youre so busy that its really difficult to make the time, Patel said. Theres a give and take, and some friends understand, those are the people you can pick up where you left off with.

Your classmates and students in the classes ahead of you have a rare ability to relate to the daily grind you'reexperiencing. That can be a very valuable resources to cope with stress.

Its really nice to have people who are going through the same things you are to be there to provide support, Patel said. We have an M1-M2 buddy system, and I think most med schools do, so a lot of people utilize their upperclassman friends as a sound board. Its very helpful to talk to them about what you are struggling with since they have gone through the same things.

Medicine can be a career that is both challenging and highly rewarding, but figuring out a medical schools prerequisites and navigating the application process can be a challenge into itself. The AMA premed glossary guide has the answers to frequently asked questions about medical school, the application process, the MCAT and more.

Have peace of mind and get everything you need to start med school off strong with the AMA.

Read more from the original source:
6 things they don't tell you about life in medical school - American Medical Association

Evidence of the effectiveness of coaching in medical education has been mounting over the last decade, leading educators and administrators to look for resources to help them create coaching programs of their own. A survey of medical schools reveals that nearly all had a coaching program or were developing one. The majority of established programs were still young, having been implemented in the last five years.

The authors of the study published in Medical Education Online surveyed more than 30 medical schools participating in the AMA Accelerating Change in Medical Education Consortium to describe existing coaching programs and help other institutions develop their own.

The AMA offers two free handbooks, Coaching in Medical Education: A Faculty Handbook, and It Takes Two: A Guide to Being a Good Coachee, to help educators and administrators create programs for coaching medical students.

Learn more with the AMA about how medical students can benefit from coaching in medicine.

Medical schools listed the following goals for the established programs and those being implemented in the next year:

Other goals cited, in descending frequency, were well-being, community building, leadership, development of lifelong learning skills, remediation and clinical skill development.

In terms of content, 92% of programs reported academic performance, 88% cited professional development and 88% mentioned goal-setting. Other domains covered, in descending frequency, were well-being, reflection, interpersonal communication, time management, clinical performance, specialty selection, learner-driven content and decision-making abilities.

All of the programs surveyed had multiple goals rather than a single focus.

Although this approach makes intuitive sense, literature to date has largely focused on coaching interventions with a singular goal, says the study. This finding has important implications for how institutions structure new coaching programs and select their coaches. For example, if a coaching program has multiple goals, coach-coachee dyads will need adequate time to address multiple goals and coaches will need to be well versed in multiple content areas.

The study was co-written by Maya M. Hammoud, MD, MBAthe AMA's special adviser on medical education innovation and professor of learning health sciences at University of Michigan Medical Schooland colleagues Margaret Wolff, MD, MHPE, Sally Santen, MD, PhD, Nicole Deiorio, MD, and Megan Fix, MD, from the University of Michigan Medical School, Virginia Commonwealth University School of Medicine and University of Utah School of Medicine, respectively. All these medical schools are members of the AMA consortium.

These results do not suggest one particular approach to coaching in undergraduate medical education but rather highlight variables each school can carefully consider when developing a coaching program, the study says.

Read more from the AMA about how medical students can make the most of an academic coaching relationship.

"The cornerstone of coaching is the coach-coachee relationship, the authors wrote, noting that the relationship is different from mentoring and advising. In this study, the majority of respondents correctly identified the coaching relationship as one in which the coach helps the student find a strategy through asking clarifying questions.

Most programs surveyed, 80%, made use of attending physicians as coaches, but residents and fellows and non-physicians were also utilized. In addition, while the number of students assigned to each coach varied, the majority of coaches, 64%, received 525% full-time equivalent effort to support their role.

The authors also provided insights on program development, implementation and evaluation, advising a six-step approach.

This process should begin with problem identification and a needs assessment to determine if there are unmet student needs that may be filled by a coaching program, the study says.

Limitations of the study include respondents being biased toward early adoption of education innovations, heavy representation of large academic medical centers and variability in how coaching is defined.

Read more here:
Why academic coaching is catching on in medical schools - American Medical Association

Graduate medical education is critical to the training of physicians. Residencies are where most new medical school graduates train for the specialties they have chosen.

By the time a residency is completed, a physician should be ready to practice without supervision and lead a team in taking care of patients. It isnt easy 80-hour weeks are often the norm but often a residency is the last step in making their career dream come true. For some, the road doesnt end there. Because of the complexity of some areas of medicine, additional graduate medical education (GME) in the form of fellowships is required.

At the UNLV School of Medicine, Dr. Kate Martin, associate dean of graduate medical education, currently oversees 20 post-graduate training programs with 321 residents/fellows. The overall program is accredited by the Accreditation Council for Graduate Medical Education (ACGME). Dr. Martin and her staff do everything from helping keep residents/fellows healthy to dealing with funding mechanisms for post-graduate education.

She previously served as afamily medicine residency program director and director of community engagement in the school. A graduate of the UNR School of Medicine, where she also completed her family medicine residency, Martin went on to complete a teaching and learning fellowship with the USC Keck School of Medicine and as well as aNational Institute for Program Director Development fellowship with the Association of Family Medicine Residency Directors.

A 2002 UNLV summa cum laude graduate who earned her bachelors degree in biology, Martin was UNLV's 2016 Honors College Alumna of the Year.

Today, she says because of her staffs two-year team effort, two more fellowships were added by the ACGME in 2019 one in pediatric emergency medicine and another in geriatrics. This means we can recruit new fellows to start in July 2020, she said. We are also currently applying for accreditation to start a fellowship program in forensic psychiatry and adult endocrinology.

How important are new fellowships to the people of Southern Nevada? According to a recent report by the Nevada Health Workforce, they are critical, given that many physicians stay to practice where they finish their GME training. The authors wrote:

One key finding of this report is that 35 of the 43 physicians pursuing additional training (81.4%) are leaving the state for fellowship and subspecialty training that does not exist or is in short supply in Nevada. This finding suggests that the development of fellowship programs in Nevada holds the potential for increasing the number and percent of GME graduates who ultimately remain in Nevada to begin practice.

At present, about 50 percent of those who complete residencies/fellowships in Southern Nevada stay here.

Martin pointed out that during her tenure the ob/gyn, psychiatry, critical care medicine, and critical care surgery GME programs have expanded as the result of funding provided by Nevada governors office of science, innovation and technology.

Here, Martin expands on the importance of graduate medical education.

GME is the next step after someone graduates medical school in order to become a practicing physician. Without it, you can't prescribe medications or treat patients. You need to complete a residency/additional training to obtain a medical license and be able to practice.

GME programs average three to five years in length, but sometimes are much longer, depending on the specialty and additional fellowship training pursued. For example, a cardiologist spends three years doing an internal medicine residency, then another threeyears in a cardiology fellowship, then possibly another one to two years in a second fellowship to become an interventional cardiologist who performs angiograms to open blocked arteries when someone is having a heart attack.

Sponsoring institutions that participate in GME, such as UNLVs School of Medicine, have a mission, according to the ACGME, to improve the health of the public, specifically to reduce health disparities. People from socioeconomically disadvantaged groups should have the opportunity to live long and healthy lives like everyone else. GME helps level that playing field through the vulnerable populations it reaches, elevating their quality of care, while training the next generation of physicians.

Starting a new residency or fellowship program requires funding, lead time, and community support. University Medical Center (UMC) is our primary teaching hospital, serving as the home base for nearly all of our GME programs. UMC is the largest financial supporter. GME funding is complex. Although UMC receives partial financial assistance from the Centers for Medicare and Medicaid Services (CMS), the hospital makes up the difference to pay resident and fellow salaries and benefits. We have recently increased our involvement with the Veterans Administration Health System and the U.S. Air Force to sponsor some resident and fellow positions, and we also receive support from several other community partners.

With the right funding, we could grow graduate medical education in Southern Nevada on a larger scale and bring even more specialties to the area with the goal that these new doctors would remain to practice in our community.

I should also point out that, in order to get there, it takes at least two years, as this requires a team of people to come together and submit an application to the ACGME. Faculty are needed in the chosen specialty to lead the program, including a program director, and additional physicians to teach the residents, along with administrative support for the program. These are the minimum ACGME requirements, so that is where we start from. The possibilities are really only limited by our passion to meet the communitys health care needs.

Residents take and study for yearly in-training exams throughout residency to prepare for the test they will take at the end of their training in order to become board-certified in their chosen specialty for instance internal medicine, pediatrics, psychiatry. (The in-training exam is a practice version of the board certification exam, so they study regularly for this. They also take licensure-related exams, called Step exams, to complete a series, i.e. Step 1, 2 and 3, which they start in medical school. Step 3 is the last step and that is taken during residency, so that is another exam that they study for, in addition to their clinical work.)

Residents and fellows are evaluated throughout the year based on the following six core competencies determined by the ACGME:

The evaluation system uses milestones that the residents and fellows must achieve in order to get to the next level and be promoted within their program, and ultimately graduate. All of this relies on feedback from their attending physician faculty, staff members, patients, and peers.

Most new residents and fellows are selected through the National Resident Matching Program. (Some fellowship programs do not participate in this, but nearly all residency programs and most fellowship programs do.) Medical students submit their applications in the fall of their fourth year of medical school, travel for interviews typically in the fall/winter months, then submit a rank list of where they would like to go. Programs submit a rank list of the applicants they want to recruit. The results are released in mid-March on Match Day, when everyone finds out where they are going to be for residency on July 1. On Match Day, the GME office goes to work to start on-boarding the next class of new residents and fellows.

I would like to see every specialty and subspecialty of adult and pediatric medicine offered in our GME programs in Southern Nevada. Our community has grown to deserve (and should demand) this level of care and medical expertise.

It depends on the program, but the application numbers have gone up in recent years due to increased competition. Fourth-year medical students typically apply to at least several programs (ranging from four to eight), but some can apply for many more.

The ACGME specifies that faculty must be board-certified (or have equivalent qualifications) in their specialty or subspecialty field, so they are held to that standard for competency. The residency and fellowship program faculty have a passion for teaching, often years of experience in an academic setting, but all have some alignment with our mission of education, research, and clinical service in a GME setting.

Per ACGME requirements, residents may work no more than 80 hours per week with one day off in seven, averaged over a four-week period. The GME office and residency/fellowship programs monitor work hours closely and make schedule adjustments to stay in compliance.

Yes, and so we are working on bringing more fellowships online and are already expanding our current programs in psychiatry, ob/gyn, critical care medicine, and critical care surgery.

The GME team provides support through their individual roles. In addition, the GME office serves as a safe space for residents and fellows to bring concerns and have issues addressed that may be going on within their programs or the institution at-large. Our office also provides assistance with processing of loan deferment requests, acts as a liaison with HR, sponsors several subcommittees on topics important to the residents/fellows, such as well-being, space/learning environment, and policy creation/review.

We also carry out the Graduate Medical Education Committee (GMEC) meetings, which bring the core residency program directors, program coordinators, and residents together to discuss important accreditation, program, and institutional issues every other month. The GME office hosts an annual resident/fellow research day, a chief resident retreat (for the new/incoming senior-level residents), and institution-wide orientations for new residents and fellows each year. We have an annual program director retreat for the faculty as well. The GME office also funds residents and fellows to travel around the country to present their research at national conferences.

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What's After 4 Years of Med School? Graduate Medical Education - UNLV NewsCenter

The Friends of the Hyde Park Branch Library have started raising funds for a gravestone for Rebecca Lee Crumpler, who graduated from the New England Female Medical College in Boston in 1864 and whose body currently lies in an unmarked grave in Fairview Cemetery in Hyde Park.

The Friends are hoping to raise between $3,000 and $5,000 for a tombstone for Crumpler. They've collected some info on Crumpler, of whom no known image survives: Born in Delaware in 1831, she grew up in Pennsylvania, but she eventually moved to the Boston area, where she took classes at West Newton English and Classical School and settled in Charlestown. In 1864, she earned her medical degree. After serving time following the Civil War with the Freedmen's Bureau in Richmond, VA, she moved back to the Boston area with her husband, Arthur, and eventually settled in Hyde Park - near the cemetery where she is now buried.

In 1883, she write a book of medical advice for "mothers, nurses, and all who may desire to mitigate the afflictions of the human race," A Book of Medical Discourses in Two Parts.

Donations towards a tombstone can be made to:

Friends of the Hyde Park LibraryFor: Crumpler Fund35 Harvard Avenue, Hyde Park, MA 02136

Go here to see the original:
The first African-American woman to graduate from medical school in the US is buried in an unmarked grave in Hyde Park - Universal Hub

Last week, DocWire News covered a study which suggests that medical students lose empathy as they progress through medical school.

We spoke with lead researcher Mohammadreza Hojat, PhD, who detailed what prompted him to undertake this study. As a psychologist by academic training, I became interested in exploring the effects of human relationships in health and illness, said Dr. Hojat, of the Sidney Kimmel Medical College at Thomas Jefferson University.

This interest shifted to a more specific area of patient-doctor relationship when I started a career in medical education research about 40 years ago. The questions of why some health professionals are more capable than others to form empathic relationship with patients, what are the factors that contribute to the development of empathy, and what are the outcomes of empathic engagement in patient care prompted me to search for answers.

The study comprised 10,751 medical students (3,616 first-year, 2,764 second-year, 2,413 third-year, and 1,958 fourth-year students) enrolled in 41 campuses of DO-granting medical schools in the US while comparing preexisting data from students of MD-granting medical schools. All participants were asked to complete a web-based survey at the end of the 2017-2018 academic year.

The results showed a decline in empathy scores between medical students in the pre-clinical years (first-and-second year students) and medical students in the clinical years (third-and-fourth year students). Furthermore, the researchers observed that the pattern of empathy decline was similar among DO students, but the magnitude was less pronounced.

The findings of the study raise a red flag for medical education leaders, said Dr. Hojat. Among implications of the findings is a call for the development and implementation of targeted educational programs in medical schools to enhance and sustain empathy in physicians-in-training.

Dr. Hojat noted that the study did have a limitation its design. As a cross-sectional study, the baseline empathy at the start of medical school may be different for students in different years, thus variation in empathy in different years could be attributed to the baseline differences, and not necessarily to changes during medical school.

He feels that a more desirable study design would be a longitudinal study, in which a cohort of students is followed up (for four years) during medical school and changes in their empathy scores are compared as the cohort progresses through medical school.

Moving forward, to attenuate this limitation, Dr. Hojat is currently undertaking a five-year longitudinal study of a national cohort of osteopathic medical students from the 2019-2020 entering class. He plans to follow (the students) from matriculation to graduation to examine yearly changes in empathy, reasons for such changes, and to explore approaches to enhance and sustain their empathy.

This Project in Osteopathic Medical Education and Empathy (POMEE), according to Dr. Hojat, is sponsored by the American Association of Colleges of Osteopathic Medicine (AACOM), the American Osteopathic Association (AOA), and the Cleveland Clinic in collaboration with the Sidney Kimmel Medical College at Thomas Jefferson University.

Dr. Hojat added that: In addition to examining empathy, we plan to study changes in orientation toward holistic, integrative, and patient-centered care, attitudes toward interprofessional collaboration, lifelong learning, and burnout experiences as the cohort progresses through medical school.

Originally posted here:
Ask the Authors: Dr. Mohammadreza Hojat Speaks on the Erosion of Empathy Exhibited by Medical Students - DocWire News

Rutgers Biomedical and Health Sciences Chancellor Brian Strom made a case for the merger in a Jan. 31 letter to the executive committee of Rutgers University Senate.

A controversial proposal to merge the two Rutgers University medical schools into a single entity spread over two cities 30 miles apart may be gaining momentum, despite concerns among some faculty and staff about the process and potential risks involved.

The Rutgers University Senate is scheduled today to consider permitting leaders at Robert Wood Johnson Medical School (RWJMS) in New Brunswick and New Jersey Medical School (NJMS) in Newark to start exploring what is needed to unify these colleges under a single mission and governance structure with one educational system, research agenda and clinical practice.

Rutgers Biomedical and Health Sciences Chancellor Brian Strom, who oversees both medical schools, made a case for the merger in a Jan. 31 letter to the executive committee of the senate, a legislative body with some regulatory functions. Strom said a combined school would increase Rutgers access to research dollars and provide new opportunities for students, scientists and patients. Faculty and students at the two schools treat patients at teaching hospitals, clinics and private offices in both cities.

I believe we have the opportunity to pursue a bold and transformational change in medical education at Rutgers University that may prove to be an influential model across the United States, the RBHS chancellor wrote. He also stressed that if the schools were combined, one campus would not be a satellite or subordinate of the other.

In his letter, Strom underscored that no final decision has been made, but he asked for the senates input before faculty committees are appointed to dig into the mechanics of a merger; it is not clear how long the senate executive committee will take to make a decision. His letter does float a possible name for the combined entity Rutgers Medical School and hints that it could attract a transformational philanthropic gift.

If the Senate panel does give its go-ahead, and the faculty can find a way to make it work, the final decision would essentially be left to the Liaison Committee on Medical Education (LCME), a national committee that accredits medical schools, according to the letter. Stroms team has already been in touch with the liaison committee about the potential change, which could result in the largest medical school in the U.S. (Each program now includes more than 700 students and thousands of faculty and staff.)

Thus, my request to the Senate is to approve the merger now, with the explicit recognition that we are continuing a process where the end result may be the integration of RWJMS and NJMS into a single accredited school, the final arbiter of course being the LCME. However, an irrevocable decision to merge has not yet been made, pending that work by the faculty, he wrote.

The process outlined in Stroms letter raised concerns for some medical school faculty and staff, who believe there should be more transparency around the planning and greater input from the Rutgers community and the public. And elected officials representing Newark are particularly concerned about the impact any merger would have on clinical care there, including at the citys University Hospital, north Jerseys only Level 1 trauma center.

The merger of Rutgers medical schools should not take place without input from the public, bargaining with unionized workers and oversight from New Jersey regulators, said Debbie White, a nurse and president of the Health Professionals and Allied Employees union, which represents close to 1,000 clinicians and other staff at the two schools.

New Jersey made a commitment to preserve the medical school in Newark and promote the institution as a premier teaching facility. We must hold Rutgers and the state to that commitment before allowing a merger to move the future of health care in a direction that puts Newark in the back seat, White said.

Diomedes Tsitouras, executive director of the American Association of University Professors chapter that represents some 1,500 faculty in Rutgers biomedical program, has urged the chancellor to take his time with any decision, especially given all the other changes the schools are currently experiencing. (Some of the AAUP units are engaged in contract disputes with Rutgers.)

The (university) senate should put a hold on this until details can be figured out, Tsitouras said. Theres no rush to go to the LCME.

But Strom and other Rutgers officials insist that there is now a unique opportunity for change. Our intention is to facilitate a bold transformation of medical education at Rutgers and to set a new standard for the country, said Associate Vice Chancellor Zach Hosseini, who handles marketing and communications. To do that, we are engaging with key partners, like the Rutgers University Senate and the Liaison Committee on Medical Education (LCME), to ensure we follow the necessary and appropriate steps to explore the transformation that the committee envisioned, he added, referring to a faculty panel report unveiled last week.

The current system is the result of former Gov. Chris Christies reform in 2012 that dismantled the former University of Medicine and Dentistry of New Jersey, in Newark, and restructured medical education across the state. That led to the creation of NJMS in Newark and RWJMS in New Brunswick, which were united under Rutgers umbrella biomedical program with five other health-related colleges. (The reform also shifted an osteopathic program in Camden from Rutgers to Rowan University.)

In recent years, the two Rutgers medical schools have grown closer, collaborating on a number of clinical institute programs, and they now share a single leader. In January 2019, NJMS Dean Dr. Robert L. Johnson was also appointed interim dean at the New Brunswick school RWJMS when the previous dean departed. The two schools are also combining their graduate medical education programs. In 2017, RBHS signed an agreement with RWJBarnabas Health, one of the states largest provider networks, to improve the universitys clinical practice.

Strom has suggested that integrating the two medical schools would enable the states university to attract more research funding and scientific expertise, while making the program more attractive to potential students, health care employers, and other partners. In his letter to the senate panel, he notes that Rutgers is now one of only five universities in the country with more than one medical school, and the other four are separated by hundreds not dozens of miles.

Further, this separation hurts our national rankings substantially, since our grant portfolio, a large part of the ranking, is divided between the schools, Strom wrote.

To explore the future options, Strom created a 12-member commission (six from each school) to study various scenarios, from maintaining the status quo to a full merger with two co-equal campuses. In a report distributed last week, the committee focused on two choices: remaining as two schools, but with greater collaboration, or combining into one entity. It did not endorse one option over the other, but warned that any change would be costly, complicated and require significant planning and stakeholder input.

Strom insists that no decision has been made in his letter to the senate panel, but in framing the work to come, he focuses almost exclusively on efforts needed to explore and carry out a merger. There is no mention of a process to determine if that path is preferable to more limited collaboration.

Based on the recommendations of the (12-member) Committee, our next steps are to continue and expand careful and thorough deliberations on the potential structure, governance, curriculum, research, and clinical care of a future combined Rutgers Medical School. (The final name of a combined school remains to be decided), Strom wrote. Incidentally, a worksheet provided to the senate panel included the same potential name and noted that a merger would not require additional funding, at least early on.

If this change is viewed as sufficiently transformational, we may be presented with an opportunity for a potentially transformational philanthropic gift, he wrote. No additional information on the potential gift was available Thursday afternoon.

Please consider accepting this process and with it the possibility that we will completely integrate the two medical schools into a single model school and the potential to create the brightest future for academic medicine, one that will serve our students, patients, and communities while advancing our scholarship, research, and the profession of medicine, Strom wrote.

Read the original here:
Another Step Toward Controversial Merger of Med Schools - NJ Spotlight

February 11, 2020 Joseph Brain, Cecil K. and Philip Drinker Professor of Environmental Physiology at Harvard T.H. Chan School of Public Health, recently co-authored the book The Education of Alice Hamilton (Indiana University Press). Hamilton, Harvards first female faculty member, was appointed assistant professor of industrial medicine at the Medical School in 1919. She and the rest of the Division of Industrial Hygiene became part of the School of Public Health in 1922, when it replaced the Harvard MIT School for Health Officers.

In addition to marking the centennial of Alice Hamiltons appointment, what inspired you to write a book about her?

I first heard about her when I was a graduate student at Harvard, first in the Division of Engineering and Applied Physics, now known as SEAS, and then here at Harvard T.H. Chan School of Public Health. The more I learned about her, the more I admired her. By the time she was recruited by Harvard, she had been doing groundbreaking studies in occupational health and toxicology for 20 years. Moreover, she was not just a great scientist and epidemiologist, she was a pacifist and a suffragist, and shaped labor protection laws.

In the book, after describing her Harvard years, we then go back and look at what shaped her scientific skills and her commitment to social reform.

What did you learn about her during your research?

Dr. Hamilton was self-educated and home-schooled. She was raised by strong women who instilled in her independence and the importance of giving back. She and her three sisters all remained singlea sensible option at the time for women who wanted careers. All went on to be very accomplished in their respective fields.

Alice was always attracted to science and medicine. When she asked her father for permission to go to medical school, he questioned whether she was tough enough. They made a bargain. She would first study for a year at a small medical school in Fort Wayne, Indiana, near their home. She was more than up for the challenge. A year later, her father agreed that she should have access to the best medical education open to women. She went on to excel at the University of Michigan and Johns Hopkins, and continued her studies in Germany with Paul Ehrlich, who went on to win a Nobel Prize.

A very important part of her education came during the years she spent at Hull Housethe renowned settlement house in Chicago made famous by Jane Addams. There she lived with immigrants and the poor. As she provided medical care, she came to realize that jobs were a major source of injury and illness for workers and their families. For example, men who worked with asbestos or lead exposed their families through the work clothing they brought home to be washed.

She and her colleagues collected and analyzed a remarkable amount of data on the population they servedincluding demographics, income, ethnicity, and disease outcomes. The epidemiological maps they made look like the kind of maps we make today with spatial analysis technologies.

When the founders of our School realized that they needed a leader in occupational health, they discovered that Alice was by far the best candidate. The University at first said that Harvard only educates menand of course, only men can educate men. But our schools leaders persisted. Future SPH Deans David Edsall and Cecil Drinker, who were with HMS at the time, persisted in advocating for her and for breaking the gender barrier. In the fall of 1919, the University relented.

Alice had a very distinguished 20-year career here. When she retired, she was still an assistant professorthose of us in the Alice Hamilton fan club wonder why. For another 30 years, she continued to make U.S. factories and mines safer.

What can Alice Hamilton teach todays public health students?

She is a model of the responsibilities of privilege, which is a combination of adequate wealth and education. If you have both, you need to deploy them to make permanent positive inclusive change for all.

Dr. Hamiltons whole life was about making a difference. She wasnt just interested in learning about and measuring injury and disease caused by occupations. Her work was unfinished until she translated her science into action and national policy. And thats the kind of research we should do and the kind of careers we should seek.

Learn more

Op-ed: Celebrating Alice Hamilton, who pioneered national safety standards (Harvard Chan School news)

Public health pioneer Alice Hamilton documented dire health conditions in post-World War I Germany (Harvard Chan School news)

Amy Roeder

Photo: Kent Dayton

Originally posted here:
The education of occupational health pioneer Alice Hamilton - HSPH News

Baylor Scott & White All Saints Medical Center Fort Worth and the TCU and UNTHSC School of Medicine are teaming up to train 150 physicians each year through an accredited resident program.

This year, the Accreditation Council for Graduate Medical Education accredited program will select the first group of medical school graduates who will do their residencies at Baylor Scott & White Fort Worth in 2021. The goal is to have 150 residents in the program by the 2027-2028 academic year.

We are honored to be working alongside a like-minded organization in Baylor Scott & White Fort Worth, said Stuart Flynn, MD, dean of the TCU and UNTHSC School of Medicine via release. With the combination of both organizations available resources and aligned mission, we can create a robust and rich academic environment in the Fort Worth community.

Residencies will be in internal medicine, emergency medicine, OB/GYN, general surgery, anesthesia, and the program is considering fellowship training programs in cardiology, oncology, hepatology, and nephrology.

I am so excited to see this collaboration between the TCU and UNTHSC School of Medicine and Baylor Scott & White All Saints Medical Center Fort Worth. This is the kind of announcement we envisioned happening when the new medical school opened, said Mayor Betsy Price, City of Fort Worth via release. This will further the citys ability to attract and retain the best minds in medicine, keeping our community healthier. We aspire to show Fort Worth as a city where medical innovation is not only taking place, but evolving.

Adding residencies in Texas can help address the growing physician shortage here, which is one of the worst in the country. Texas ranks 41 out of the 50 states for physicians per capita, with 219.4 physicians per 100,000 residents. The national median is 257.6, according to the American Association of Medical Colleges.

The shortage is exacerbated by the growth in medical school graduates without accompanying residency slots. Enrollment in Texas medical schools has increased by 32 percent over the last decade, but residency slots have only increased by 19 percent. This means graduates have to go elsewhere to receive training, decreasing the chances they will end up working in the state. In Texas, 59 percent of residents stay in state after training, and if they do both medical school and residency here, 81 percent stay in Texas. Baylor Scott & White offers nearly 800 residencies statewide.

With our ongoing dedication to excellent patient care, this collaboration will further opportunities for medical education and research, benefitting the community as a whole, said Mike Sanborn, president, Baylor Scott & White All Saints Medical Center Fort Worth via release. Our goal is to build upon this foundation that echoes the pillars of outstanding teaching hospitals: patient care, education, and research.

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150 Medical Residencies are on the Way to Fort Worth - D Magazine

PHILADELPHIA The proportion of high school students who identify as a sexual minority lesbian, gay, bisexual or questioning doubled in the past several years, according to a new study published Monday.

Yet those greater numbers have not necessarily meant they have found greater acceptance or peace. The study, based on data from a federal survey, found that those teens attempted suicide at a rate nearly four times higher than their heterosexual peers.

The research, published in the journal Pediatrics, was based on data from the Youth Risk Behavioral Surveillance Survey from 2009 to 2017. The findings were based on survey information from Delaware, Illinois, Massachusetts, Maine, North Dakota, and Rhode Island, the only six states that continuously collected sexual orientation data for all those years.

These new findings, particularly the disproportionate rate of suicide attempts, dramatically point out the need for increased efforts to assist and support these young people, according to the researchers.

Large disparities in suicide attempts persisted even as the percent of students identifying as LGBQ increased. In 2017, more than 20% of LGBQ teens reported attempting suicide in the past year, said lead study author Julia Raifman, an assistant professor with Boston Universitys School of Public Health.

Its critical that health and educational institutions have policies and programs in place to protect and improve LGBQ health, such as medical school curricula and high school health curricula that are inclusive of sexual minority health, Raifman said.

According to the study, 14.3% of U.S. teens identified as a sexual minority in 2017, compared with 7.3% in 2009. Adolescent girls in 2017 were twice as likely as boys to identify as a sexual minority.

The research also found that many more high schoolers are engaging in or at least experimenting with same-sex sexual contact. Their numbers increased from 7.7% of teens in 2009 to a little over 13% in 2017.

The sexual contact numbers were based on data from Delaware, Connecticut, Illinois and Rhode Island, the four states that continuously collected that information from 2009 to 2017.

As troubling as the high rate of suicide attempts for sexual minority teenagers compared to heterosexual kids is, the rate at the beginning of the study period was even worse.

In 2017, a little over 20% of the high schoolers who identified as sexual minorities reported attempting suicide, compared to 26.7% in 2009. The reported suicide attempt rate for heterosexual kids was about 6% for both those years.

Our paper indicates that an increasing number of teenagers are identifying as LGBQ and will be affected by anti-LGBQ policies that may elevate these already very high rates of suicide attempts, Raifman said.

Raifman said previous research she was involved in show a correlation between public policies and LGBQ suicide attempts and mental health.

In one 2017 study, Raifman and colleagues found a 7% reduction in suicide attempts in high school students, particularly those identified as sexual minorities, in states that allowed same-sex marriage. A 2018 study led by Raifman found increased mental health distress among sexual minority individuals in states where there had been publicized cases of anti-gay discrimination.

Suicide is the second leading cause of death for young people ages 10 to 24.

In addition to Boston University, the study authors include researchers from Boston Childrens Hospital, Harvard Medical School and the School of Public Health, Johns Hopkins School of Medicine, Brown Universitys School of Public Health and medical school, along with other hospitals.

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More high school students than ever are coming out, but their despair remains acute - TribLIVE

The survey by BMJexamined how political and current events have impacted the moods and stress levels of young doctors over time. The survey looked at nine political events and eight non-political events between 2016 and 2018 and questioned 2,345 participants on their mood from their time as medical interns to their time as residents.

The survey found statistically significant mood declines of at least 25 percent after the 2016 presidential election and subsequent inauguration, with women experiencing more than twice the mood decline as men following both events. Developments of a conservative political nature, such as the Muslim travel ban and the confirmation of Justice Brett Kavanaugh to the Supreme Court, also correlated with a decline in mood. By contrast, events of a more liberal political nature prompted a positive mood shift. The margin of error for the poll was plus or minus five percent.

The directionality of these findings is consistent with evidence that young voters and voters with postgraduate education tend to identify as liberal leaning, and supports previous work showing a strong left shift in political affiliation among physicians over the past 25 years, the report stated.

Politics in Medical School

The findings raise a key question of whether more left-leaning individuals are pursuing the medical profession or if medical schools are making students identify more as progressive. The answer is both, say two physicians and a medical student.

I think young doctors are getting a heavy dose of indoctrination in medical schools, partly from the student section of American Medical Association, said Jane Orient, M.D., executive director of the Association for American Physicians and Surgeons and policy advisor to The Heartland Institute, which publishesHealth Care News.In fact, social justice is now insinuated in bioethics and protocols concerning resource stewardship and the like.

Orient says she doesnt recall politics being a part of her medical school education at Columbia University in the 1970s. Now, students at medical schools increasingly engage in political activism from a decidedly leftist perspective, Orient says.

Indoctrination and immersion and peer pressure work, Orient said. Conservatives fear career damage.

Origins in Undergraduate Programs

Anthony Fappiano, a third-year medical student at the University of New England College of Osteopathic Medicine and an out-of-the-closet conservative, traces the lefts influence back even further than medical school.

In my opinion, this is due to four years of college education with predominantly liberal professors, Fappiano said. Additionally, the MCAT (medical school entrance exam) is putting more emphasis on traditionally liberal dominated topicsespecially sociologyrather than pure science.

The spike in liberal-leaning students and faculty suggests that science and medicine are no longer immune to politics, a trend Orient says should alarm patients.

The system comes first, and somebody elses idea of justice, instead of the patient, Orient said. It also means less time is available for learning medicine.

Viewpoints Change with Age

There may be reason for hope, says Chad Savage, M.D., founder of YourChoice Direct Care and policy advisor to The Heartland Institute.

While the study shows that young physicians tend to be liberal, the findings could simply reflect the students age and the fact that progressive politics tend to be more popular with young people, Savage said.

Fappiano says he agrees.

I have found that the working doctors I do my rotations with are more level-headed and at most, will gripe about their political ideology but never act on it, Fappiano said. The students are much more active in pushing political goals whether it's through clubs, bringing in speakers, or changing course teaching.

In the end, it may take the free market to truly break the liberal bias that has taken root in academia, Fappiano says. The first step is to lift the licensing restrictions currently in place, says Fappiano.

The entire health care industry is controlled by the two licensing agencies, the National Board of Medical Examiners and the National Board of Osteopathic Medical Examiners, as well as the AMA, Fappiano said. If schools were able to create their own curriculum and prerequisites it would allow the emphasis to be put back on medicine, rather than political goals. This would require large institutional changes and deregulation of the field of medicine.

Madeline Peltzer(mpeltzer@hillsdale.edu)writes from Hillsdale, Michigan.

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Presidential Politics Taking Toll on Young Doctors, Study Finds - The Heartland Institute

The upcoming $113 million Dell Childrens Specialty Pavilion will open spring 2021 with cardiovascular, neuroscience and cancer programs, according to the pediatric hospital. (Rendering courtesy Dell Childrens Specialty Pavilion)

The Dell Childrens Medical Center campus in Mueller is set to break ground on an expansion plan following the announcement of significant investment over the next three years.

The pediatric hospital Feb. 10 announced a $300 million investment in capital, equipment and programming over the next three years, made possible due to a substantial investment by Ascension, as well as a $30 million matching grant from the Michael & Susan Dell Foundation, according to a company news release.

The time is now to continue expanding complex pediatric care in Central Texas, said Christopher Born, the president of Dell Childrens Medical Center, in the Feb. 10 news release.

Dell Children will use $113 million of the investment funds to construct its new pediatric outpatient facility, which will house cardiovascular, neuroscience and cancer programs, as previously reported by Community Impact Newspaper.

The four-story, 161,000-square-foot facility, named Dell Childrens Specialty Pavilion, is slated to break ground soon and open its doors to patients in spring 2021.

Investment dollars will also go to provide backing for a new partnership with Dell Medical School at The University of Texas to develop a maternal fetal medicine program that will add a delivery unit and neonatal intensive care unit expansion at Dell Childrens Medical Center, according to the news release.

Dell Childrens Medical Center announced it will additionally add more cardiac ICU beds at its main hospital, allowing for the expansion of its pediatric heart program to include heart transplant surgery.

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Dell Children's Medical Center to spend more than $300 million over next 3 years to expand Mueller campus - Community Impact Newspaper

The total compensation for Atrium Healths top executive, Gene Woods, jumped nearly 20% in fiscal 2019, the Charlotte health care system reported Friday.

Woods received $7.25 million in total compensation, led by $2.67 million in salary, $2.44 million in bonuses and a separate $1.08 million in incentives.

By comparison, Woods received $6.06 million in total compensation in fiscal 2018.

Atriums compensation and other corporate financial aspects has taken on new interest in the Triad because of a pending, limited-defined partnership with Wake Forest Baptist Medical Center that is expected to be unveiled by March 31.

The official message since the not-for-profits April 10 memorandum of understanding announcement is they are jointly creating a next-generation academic health-care system headlined by a Charlotte medical school campus debuting in 2021 or 2022.

The systems told bondholders in a November notice the regulatory review process with the Federal Trade Commission is expected to be complete by or before early 2020.

Atrium also recently ended a management services agreement with Greensboros Cone Health in which Cones top executive, Terry Akin, had become an Atrium-compensated employee. Akin received $2.18 million in total compensation in 2019. Dr. Mary Jo Cagle, chief operating officer at Cone, received $1.2 million in total compensation.

Dr. John McConnell moved from chief executive to executive director of Wake Forest Healthcare Ventures on May 1, 2017. He had been chief executive for nearly nine years. His total compensation for 2017 was $2.15 million, down 6.5% from fiscal 2016, according to the IRS Form 990 filing.

Meanwhile, the 2017 compensation of $1.2 million for chief executive Dr. Julie Ann Freischlag reflects from when she took over as chief executive on May 1, 2017. Freischlag became permanent dean of the medical school in February 2018 after serving as interim deal for seven months.

Freischlags first full year of compensation in both roles will not be reported by Wake Forest Baptist until May 15, 2020.

In November, Wake Forest Baptist and Atrium pledged to build a multi-faceted tower and an eye institute in Winston-Salem.

The tower would house the emergency department, operating rooms and intensive care unit services and will be built on the main Ardmore campus atop an existing parking deck. It will feature new operating rooms with adult intensive care units, along with radiology, pathology and other related services.

The systems have not ruled out a much larger collaboration during their period of exclusive negotiations.

The open-ended nature of negotiating a potential medical partnership between Wake Forest University and Atrium has raised concerns about the future of Wake Forest Baptist and its medical school in Winston-Salem.

The local concern about the Charlotte campus is that it could eventually draw resources from the Winston-Salem campus or even lure the medical school itself from Winston-Salem. Wake Forest Baptist is the largest employer in Forsyth County with more than 13,000 workers.

Freischlag said April 10 that she and the majority of the existing medical school faculty would remain in Winston-Salem and that the Charlotte medical school would gain new faculty and utilize providers within the Atrium hospital system.

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Atrium Health top executive receives 20% boost in 2019 compensation - Winston-Salem Journal