Marisa Reynolds spent months anticipating the pandemics effects on her final year of medical school. Her clinical clerkship was delayed, and her research stint at the National Institutes of Health was canceled. So were parts of the fourth-year board exam Reynolds expected to take and the option to participate in an out-of-state clerkship crucial opportunities students are typically afforded before applying for post-graduate residency programs.

The pandemic is not something in our control, but its frustrating, to put it lightly, that it will have these long-term effects on our careers and lives for years to come, said Reynolds, a Michigan State medical student seeking out internal medicine residencies. Its a high-stakes process, and despite the logistical challenges that affected the quality of Reynoldss and her peers application such as late test scores and a shortened residency interview timeline there is no option to try again next year.

She is also worried that the pandemic has made the process less equitable: Some students didnt receive as many interviews as others, and there was limited time to make a strong impression on their program of choice.

Youre basically entering a career marriage for the next however many years of your life, she told Vox. My internal medicine residency is about three years long, but for someone in neurosurgery, it could be seven years.

For many young people, the pandemic has solidified their commitment to working in health care, even as it adversely impacts their career progression. The ongoing public health crisis might seem to benefit hospitals, or at the very least, job prospects for those in the medical industry. That couldnt be further from the current reality, and young, entry-level workers are often the first to witness that.

The coronavirus has led many to reassess the risks and sacrifices that come with the job, and how consequential health care will be in a post-pandemic world. Simultaneously, people are recognizing the longstanding weaknesses and inequalities of Americas medical system. Prospective and current medical school students, too, have become concerned about issues of access and equality, in their field of study and their programs.

Theyve also had to confront the paradoxes emerging in medicine: Health care workers are more necessary than ever, but working nurses and doctors are on the verge of burnout amid the months-long third surge of infections. As of late January, more than 100,000 patients are currently hospitalized across the country with Covid-19. Hospitals, especially those in major metropolitan areas, are overcrowded and short-staffed.

Despite the deluge of patients, medical workers have had to contend with hiring freezes, layoffs, contract negotiations, and shortage of personal protective equipment. About 1.4 million health care jobs were lost in April 2020, and while employment has recovered as states opened back up, the pandemic placed enduring strain on how the US health care system operates.

Young adults in the health care industry or those preparing to enter it are aware theyre at the foot of the ladder. Many college graduates take on low-paying or volunteer roles in clinics and hospitals, and might not even receive priority for vaccines. (At Stanford, nearly all of its medical residents and fellows, who regularly treat Covid-19 patients, did not receive vaccine priority.) On the other hand, medical students eager for patient experience have lost out on clinical opportunities. Medical school applicants, residents, clinic assistants, and nursing graduates recognize how entry-level jobs are harder to come by across the board, and for many, the lesson of the pandemic is learning to settle for less-than-ideal positions to guarantee employment.

Briana, a former medical assistant from Phoenix, Arizona, felt that the pandemic was a sudden but necessary reality check for her career. Briana, who asked to not publish her last name out of privacy concerns, is immunocompromised and works for a clinic that primarily serves the Native American population in Arizona. However, her transition from a patient-facing position to a departmental role took two months, and she felt pressured to be in the office or risk losing her job.

I felt that [my managers] didnt really care that I had an autoimmune disorder, Briana told Vox. They obviously should care more about the patients, but if they dont have any healthy employees, then theyre not going to be able to treat them.

For Jasmine Wong, a recent graduate and working nurse in the Bay Area, risk was top-of-mind while she was interviewing for openings. I asked during my interviews with different hospitals if there was enough PPE provided, she said. Navigating the job hunt during Covid was already very difficult because hospitals were on hiring freezes, and many just didnt have a budget to train new nursing grads.

While most job interviews were conducted over Zoom, a departure from traditional norms, Wong felt that the roles were competitive, especially for nursing positions in adult ICUs. In pre-pandemic times, cinching a job after nursing school depended on a persons professional network relationships at hospitals theyve previously volunteered at. Despite Wongs volunteer work at UCLA Medical Center, the hospital wasnt hiring, and she eventually accepted an offer in a pediatrics ICU elsewhere.

I feel like about 75 percent of people I know from our program have found jobs, but I dont think people got positions they necessarily wanted, she said. Most of us didnt have ICU experience, so it was difficult to compete with those who do. Some of her peers are in non-hospital settings, and some are swabbing at local Covid-19 testing sites.

Funding from Congress has provided some relief for hospital systems across the country, but many are losing money as a result of halting elective surgeries. According to the Washington Post, monthly patient revenue has declined by tens of millions of dollars, and many were already losing money on patient care prior to the pandemic. There is this conception that nurses are needed, but many want experienced nurses and not new graduates, Wong said.

Meanwhile, medical school admissions officers are boasting record-level increases in applicants. They are attributing renewed national attention toward health care to the coronavirus pandemic, dubbing the phenomenon the Fauci effect. (The Association of American Medical Colleges did not share specific figures with Vox, but said that applications are 18 percent higher than they were at this time last year.)

Some applicants, however, say the pandemic has thrown a wrench in a time-intensive and financially draining process. They are challenging the premise that it had any significant effect on present-day admissions, and that its highly improbable for people to apply to medical school on short-term notice.

I spent two years saving up money to take three months off work and to afford the application fees, said Erica Crittendon, who received an offer from the University of Washington. She applied to 28 schools and invested thousands of dollars into the process, which she described as one of the most grueling periods of her life. Crittendon was simultaneously reeling from several Covid-19 losses in her family, and as a Black applicant, felt affected by the summers protests over police brutality.

A person needs to be incredibly privileged to pull off a last-minute application, she told Vox. The pandemic narrative is just highlighting privileges that are detrimental to medicine and health equity.

Rachel Lutz, a University of Oregon graduate who is awaiting an offer, said that her MCAT exam was rescheduled and canceled several times between March and August, which delayed her application. Schools werent consistent about dropping the MCAT exam requirement, which meant most applicants needed to still take the exam to apply to a range of programs.

Lutzs clinical opportunities were canceled, and she moved in with her parents to save money. Applying was very stressful and upsetting at times, but I was privileged in that I didnt have to seriously consider not going through with it, she told me. I dont think taking another gap year would outweigh future earnings for me, but I know people had to make that tough decision.

Some say the circumstances of the pandemic and the lack of leniency from admissions officers and schools have excluded hundreds of prospective applicants. According to the advocacy group Students for Ethical Admissions, only those with significant amounts of financial privilege and economic support can manage to apply amid the many changes in the process.

There are many students who are now lost to the application process, a spokesperson for SEA told Vox. Thats a loss of diversity, of competent and capable individuals, just because the application process was so woefully mismanaged. The Association of American Medical Colleges published a response addressing applicants concerns in July, but students felt that the acknowledgment changed little about the process. The pipeline in medicine is already very leaky, said the SEA spokesperson. Its disappointing that this year, the academic medicine community seems to have shrugged its shoulders.

The applicants and health care workers who spoke with Vox firmly believe that medicine is their vocation. Yet, the coronavirus has stymied their pursuits at almost every level, from delaying licensing exams and required tests to eliminating opportunities for key clinical work that would aid their job search. The pandemics lasting effects on their careers and livelihoods wont easily be forgotten.

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Covid-19 disrupts plans of medical school students and young health care workers - Vox.com

Donald Alcendor, an associate professor of microbiology and immunology at Meharry Medical College, a historically Black medical school in Nashville, Tenn., is studying an antiviral treatment for COVID-19 in his lab. But his work isnt confined to the lab: hes also community liaison for Meharrys Novavax vaccine trial. In that role he goes out to businesses, barbershops and beauty salons frequented by African Americans and Latinos to talk to community members about the COVID-19 vaccines and answer their questions in what he describes as a transparent and culturally competent way.

Theres a fair amount of vaccine hesitancy out there, particularly among brown and Black communities, said Alcendor, who is Black. They want their questions answered, and they want their questions answered by someone who looks like them, if you know what I mean. The idea is Meharry Medical College is an important place to do just that -- to answer their questions and to provide them with a vaccine or be part of a vaccine trial.

Academic medical institutions and public health schools, including minority-serving institutions like Meharry, are taking leading roles in confronting vaccine hesitancy in minority communities. African Americans, Latinos and Native Americans are far more likely to contract COVID-19 and to die if they do compared to their white counterparts. Black Americans are 1.4 times more likely than white Americans to contract COVID, 3.7 times more likely to be hospitalized and 2.8 times more likely to die from it. Latinos are 1.7 times more likely to contract COVID, 4.1 times more likely to be hospitalized and 2.8 times more likely to die.

But as the first two COVID vaccines from Pfizer and Moderna have become available, members of underrepresented minority communities report higher rates of vaccine hesitancy. New data released last week by the Kaiser Family Foundations COVID-19 Vaccine Monitor project show that while the share of people who want to get vaccinated as soon as possible has increased across different racial and ethnic groups since December, it is still substantially higher for white adults (53percent) compared to Black (35percent) and Hispanic adults (42percent).

Other data from a multi-university research group finds that Black and Hispanic survey respondents are more likely to believe misinformation about the vaccine, and are more likely than Asian Americans and whites to believe that certain false statements about the vaccine -- for example, that it contains microchips that can track people -- were accurate.

Experts point to a wide range of reasons for higher rates of vaccine hesitancy among Blacks and Hispanics, including the medical professions sorry legacy of mistreatment of Black people, the fear vaccination could be used for immigration enforcement purposes and the inequities minority communities continue to face in terms of access to health care.

David M. Carlisle, the president of the Charles R. Drew University of Medicine and Science, a historically Black graduate institution in Los Angeles, said he was struck by how often laypeople cite the unethical Tuskegee syphilis experiments performed on Black men between 1932 and 1972 as cause for concern.

Its only natural that communities of color that have been underserved by the health-care system would be suspicious about something new, Carlisle said. In December, Carlisle joined with the presidents of the nation's other three historically Black medical schools, along with the presidents of the National Black Nurses Association and the National Medical Association and others, in signing A Love Letter to Black America, affirming respect for Black lives and urging Black Americans to join us in participating in clinical trials and taking a vaccine once its proven safe and effective.

Our community is being ravaged disproportionately by COVID-19, said Carlisle. This is a situation thats very personal, and thats why we want to assure people that the way we can beat back COVID-19 is by optimizing participation in vaccination programs to the fullest extent possible.

"This is really about saving our lives," said Anita Jenkins, CEO of Howard University Hospital, in Washington, D.C. "Too many of us have died."

Howard created a public service announcement about the vaccines aimed at Black Americans. Across the country, academic medical professors and leaders and public health scholars are engaged in advocacy, outreach and research on the issue of vaccine hesitancy.

A research initiative at the City University of New York Graduate School of Public Health & Health Policy, CONVINCE USA, is seeking to better understand and address public concerns about COVID-19 in order to better inform the development of communication and outreach strategies.

"Clarity and transparency and consistency in the message is very important," said Ayman El-Mohandes, the dean CUNY's public health graduate school. "We have found that in many instances people are less certain of accepting a message if there are conflicting messages and if they feel like decisions are being made without full transparency and without the community understanding the science base or the evidence base."

Health professionals routinely emphasize the importance of working with community groups and religious and political leaders to get the message out. The University of Texas Health Science Center at Houston held an event last weekend at one of its clinics in a largely minority community, livestreamed on Facebook, where a number of elected officials received vaccines.

We have to build on the relationships we have with many respected leaders in the community and use them as partners to help educate the community, said LaTanya Love, interim dean of education of McGovern Medical School at the University of Texas Health Science Center at Houston and executive vice president of diversity for UTHealth. We did an event with former heavyweight boxer champion George Foreman; he received his vaccine at one of our clinics. It was a way to use a well-respected celebrity figure in the community to reassure people who are hesitant.

Shiva Bidar-Sielaff, vice president and chief diversity officer for UW Health, the academic medical institution for the University of Wisconsin, said the health-care center has partnered with community groups to organize conversations about the vaccines with doctors who are trusted in the Black and Latino communities.

"Making sure this information is given by trusted sources within the community itself is really critical," Bidar-Sielaff said. She added that the health-care system is in the process of hiring COVID vaccine patient educators to reach out directly to primary care patients, including two each who will focus on Black and Latinx patients and one who will target to Hmong patients.

"It boils down to what we call right message, right messenger work," said Virginia Davis Floyd, an associate professor of clinical community health and preventive medicine at the school of medicine at Morehouse University, a historically Black institution in Atlanta. The medical school received a $40million federal grant to coordinate a network of national, state, territorial, tribal and local organizations to deliver COVID-19-related information to racial and ethnic minority communities who are being hardest hit by the pandemic.

"We have to be consistent with our messaging, and we have to be out there for the long term," said Amelie G. Ramirez, professor and chair of the Department of Population Health Sciences at the University of Texas Health Science Center at San Antonio, a Hispanic-serving institution, and director of the Institute for Health Promotion Research there.

"For the long term, this is an issue we cant ignore," Ramirez said. "COVID has just put a spotlight on health disparities. We need to look to the future and look at what does systemic racism look like in our health-care system and what can we do to improve that so we can provide more equitable health care to our entire population?"

Link:
Academic medical institutions address issues of vaccine hesitancy through research and outreach - Inside Higher Ed

Breanna Ngyuen, 27, a medical student at the University of Pittsburgh School of Medicine, had just finished her second year of medical school coursework when the coronavirus pandemic took hold last spring.

Nguyen, of Orlando, FL, had been preparing to enter what many consider one of the most challenging and important years of the medical school journey, when students have several exams and complete clinical work in order to graduate.Instead, Nguyen decided to take a year off and conduct outside research because all in-person instruction and testing centers closed.

I know this caused a lot of stress for me and many of my classmates, and this was definitely one of the biggest challenges as a medical school student during the pandemic, Nguyen said.

Ngyuen says one of the things she misses most about in-person instruction was getting to interact with patients and classmates. Because Ngyuen is taking a year off, shes no longer in the same graduating class as when she began her medical school career.

With COVID and rotations together, it can get really isolating," Ngyuen said.

Ngyuen has been able to conduct in-person research at the Biomedical Science Tower in Oakland since the facilitys reopening in June, but the work requires physical distancing, temperature checks upon entering the building, and lots of sanitization.

Despite the hardships so many medical students have faced through the pandemic, Ngyuen said she's optimistic.

Overall Im extremely impressed with how adaptable everyone has been and how well people have been adhering to guidelines and so that we can keep each other safe," she said. "And progress our research at the same time. My research year has been really rewarding thus far, and Im looking forward to continuing out the year in the lab and returning to rotations in the late spring and summer."

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'A Lot Of Stress': Medical Student Shares Her Experience Through The Pandemic - 90.5 WESA

Being a doctor or another front line health care worker is a tough job, especially in the last year. But health care workers have been an inspiration during this unprecedented pandemic.

Just in case theyve gotten you thinking about becoming a doctor one day, we asked two doctors at the University of Iowa Hospitals and Clinics to share some advice for aspiring docs.

Its important to remember youll have to spend several years in school before becoming a doctor, first in medical school and then training in a specific field of medicine. Patients expect their doctors to have the knowledge and skills to care for them.

But the key is a love of learning, said Dr. Ericka Lawler, orthopedic surgeon. If youre willing to work hard and spend a lot of time studying, then you can be successful, she said.

Its equally important doctors be compassionate and be able to build good relationships with their patients, said Dr. Sharon Beth Larson, a cardiothoracic surgeon.

In medicine, it truly is not only preserving but improving the quality of life for your patient, Larson said.

Nowadays there are plenty of opportunities to subspecialize in a field of medicine. For example, you dont just have to be a heart doctor. You can be a heart doctor for children, or you can specialize in heart transplants.

You dont have to know what youre interested in right now. Larson said medical school will expose students to many different fields they might not have considered before, both in hospital and clinic settings.

Anyone interested in health care should take advantage of volunteer opportunities at hospitals or nursing homes, or opportunities to shadow doctors on the job. Students also can explore the field through STEM programs offered at schools or through colleges and universities.

Even if it turns out you dont want to be an MD, there are many different jobs in health care and numerous careers that use science and medicine that might catch your eye.

Comments: michaela.ramm@thegazette.com

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What's up, doc? Advice for aspiring medical professionals - The Gazette: Eastern Iowa Breaking News and Headlines

The School of Medicines Huntsville campus will expand the availability of clinical trials for residents of northern Alabama.

Richard C. Shelton, M.D.Internationally recognized physician-scientist Richard C. Shelton, M.D., is joining the Huntsville Regional Medical Campus of the UAB School of Medicine as its first director of Research, a new position to help establish clinical investigation and clinical trials in Huntsville.

Shelton is the Charles Byron Ireland Professor in the Department of Psychiatry and Behavioral Neurobiology and founding director of the UAB Depression and Suicide Research Center. He joins the Huntsville campus March 1, 2021, as a professor of psychiatry and will continue to serve as director of the research center in Birmingham.

In Huntsville, Shelton will launch a new research affiliate of the Depression and Suicide Research Centers clinical trials program, which will bring new treatment interventions and therapeutic options to patients in Huntsville and north Alabama.

After establishing the program in psychiatry, campus leaders hope to expand the research enterprise to create a network of affiliated research sites in Alabama that will conduct research across a range of medical disorders.

We are excited to welcome Dr. Shelton and his wealth of knowledge to the Huntsville campus, said Roger Smalligan, M.D., dean of the Huntsville Regional Medical Campus. His expertise in psychiatry, along with his depth of experience developing and operating successful research programs, will be an incredible resource for north Alabama.

Shelton has over 35 years of research program experience, spending 26 years at Vanderbilt University before joining UAB in 2012. He and his colleagues have had more than 130 research studies funded by the National Institutes of Health and other federal agencies, along with foundations and industry.

Sheltons research focuses on the development of new ways to treat and prevent depression and suicide. This work includes testing new treatments, prevention of serious mental illnesses and suicide, and identifying biomarkers of both disease and treatment response. Recent research studies include participating in two large-scale pharmacogenomics trials that study the effectiveness of ketamine and esketamine intranasal treatment in patients with resistant depression.

Huntsville is the most rapidly growing region in Alabama, and theres relatively little clinical medical research happening in the outpatient environment, Shelton said. With the growing population, there are needs we can address through clinical research. The presence of clinical trials will provide patients access to treatments and tests otherwise unavailable.

Shelton attended medical school at the University of Louisville in Kentucky. He was then a resident at a Harvard Medical School-affiliated hospital in Boston. After residency, he was a research fellow at the National Institutes of Health Intramural Program in Washington, D.C., before joining the faculty of Vanderbilt University School of Medicine.

Clinton Martin, M.D., regional chair of Psychiatry in Huntsville, says recruiting Shelton to the Huntsville campus will not only enhance the clinical research and patient care in Huntsville, but also enhance medical training. The campus trains third- and fourth-year medical students and is home to the Huntsville Internal Medicine Residency and Family Medicine Residency programs.

More here:
Shelton joins Huntsville Regional Campus as first-ever director of Research - UAB News

More than 80 percent of U.S. physicians reported that people with significant disabilities have worse quality of life than nondisabled people, an attitude that may contribute to health care disparities among people with disability, according to recent research published in the February issue ofHealth Affairs.

The first-of-its-kind study surveyed 714 practicing physicians from multiple specialties and locations across the country about their attitudes toward patients with disabilities.

That physicians have negative attitudes about patients with disability wasnt surprising, said Lisa I. Iezzoni, lead author of the paper and a health care policy researcher at Harvard-affiliated Massachusetts General Hospital (MGH). But the magnitude of physicians stigmatizing views was very disturbing.

For more than 20 years, Iezzoni has studied health care experiences and outcomes of people with disability and is herself disabled by multiple sclerosis diagnosed in 1980, her first year in medical school.

Only 40.7 percent of surveyed physicians reported feeling very confident about their ability to provide the same quality of care to patients with disabilities as their other patients received. And just 56.5 percent strongly agreed that they welcomed patients with disabilities into their practices. The physicians who reported being most welcoming to patients with disability were female and practiced at academic medical centers. The Americans with Disabilities Act of 1990 requires that people with disability receive equitable health care.

That most surveyed physicians did not give socially desirable answers about their perceptions of people with disability indicates their certainty in their beliefs, said Iezzoni. We wouldnt expect most physicians to say that racial or ethnic minorities have a lower quality of life, yet four-fifths of physicians made that pronouncement about people with disabilities. That shows the erroneous assumptions and a lack of understanding of the lives of people with disability on the part of physicians.

Our results clearly raise concern about the ability of the health care system to ensure equitable care for people with disability, added senior author Eric G. Campbell, professor of medicine and director of research for the Center for Bioethics and Humanities at the University of Colorado Anschutz Medical Campus.

Studies of people with disability show that most dont view their lives as tragic.

Lisa I. Iezzoni

The paper cites examples from Iezzonis and others research demonstrating that individuals with disabilities often receive inferior care. Many surgeons assume, for example, that women with early-stage breast cancer who use wheelchairs want a mastectomy instead of breast-conserving surgery, believing that women with disability dont care about their appearance. And during the surge of the COVID pandemic in March, when resources such as ventilators were scarce, the Office for Civil Rights at the U.S. Department of Health and Human Services felt compelled to issue a warning to health care providers that people with disabilities should not be denied medical care on the basis of disability or perceived quality of life.

The research is a wake-up call for physicians to recognize their biases so they dont make erroneous assumptions about the values of patients with disability, thereby limiting their health care options and compromising care, said Iezzoni, a professor of medicine at Harvard Medical School.

Studies of people with disability show that most dont view their lives as tragic, she added. Theyve figured out how to get around in the world that wasnt designed for them and view their lives as good quality.

The authors call for all levels of medical education, including continuing education for practicing physicians, to include training about disability. Currently, most medical schools dont include disability topics in their curricula. Implicit Association Tests (which measure unconscious bias) related to disability can also raise physicians awareness of how their perceptions about disability may be affecting how they practice medicine.

In future research, the investigators plan to explore the extent to which physicians perceptions about people with disability contribute to disparities in care, said Campbell. Our ultimate goal is to ensure equality in care for people with disabilities.

Funding for this research was provided by the Eunice Kennedy Shriver National Institute for Child Health and Human Development.

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Survey finds doctors have negative perception of patients with disability - Harvard Gazette

Savannah Morning News| Savannah Morning News

Join us for an open discussion about the facts and myths of the COVID-19 vaccine, featuring local medical professionals and historians.

In-personcapacity will be limited to comply with CDC recommendations. The program will be live-streamed at facebook.com/savannahnow and savannahnow.com.

You canRSVP herefor the event.

Participants:

Moderators:Rana L. Cash, Savannah Morning News; Tanya Milton, Savannah Tribune

DanielBrownparticipated in the COVID vaccine clinical trials that made the emergency approval of the vaccine possible. He isan emeritus member of the 100 Black Men of Savannah.

Dr. Bonzo Reddick, a Savannah native and son of Judge Bonzo and Betty Reddick, is a 1994 graduate of Windsor Forest High School. A graduate of Morehouse School of Medicine, Reddick is a primary care physician at JC Lewis Health Center. He is also on the faculty in theDepartment of Family Medicine at Mercer Medical School at Memorial.

Dr. Cecil Bennettis a family practice physician at Newnan Family Medicine Associates. A graduate of Morehouse School of Medicine, Dr. Bennett has served on the Board of Trustees of the Georgia Academy of Family Medicine. He was a recent presenter for the African American Newspaper organization to warn of the danger of COVIDs and to provide information on the coronavirus vaccine.

Beatriz Seversonis a registered nurse and advocate for Hispanic communities in Savannah. She serves as a community volunteer for the Coastal Georgia Indicators Coalition, Health and Mental Health Teams; the Savannah Prevention Coalition, under the leadership of Beyond the Bell; and HOLA, a task force created by Savanah Mayor Van Johnson.

Tammi Brownworks for the Georgia Department of Health as the Chatham County Nurse Manager. She was integral to setting up and managing the successful COIVD testing program at the Savannah Civic Center and was among the first people in Georgia to receive the Pfizer vaccine when it became publicly available in the state.

Dr. Karla-Sue Marriottserves as Interim Chair of the Chemistry and Forensic Science Department at Savannah State University. Dr. Marriott has studied the history of vaccines around the world and its effects in communities of color.

This event is presented by the Savannah Morning News, Savannah Tribune, E-93 and Magic 103.9.

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Join us for a panel discussion on the COVID vaccine in the Black, Latino communities in Savannah - Savannah Morning News