At Tulane University School of Medicine in New Orleans, applications for admission to the class of 2025 are up more than 35% compared to the same time last year. At Boston University School of Medicine, theyve risen by 26%. And at Saint Louis University School of Medicine, admissions officers have seen applications increase by 27%.

In fact, nearly two dozen medical schools have seen applications jump by at least 25% this year, according to AAMC data.

Final tallies wont arrive for another month or so all schools application windows must close first but early numbers are striking. So far, there are more than 7,500 additional applicants nationwide, according to data from the American Medical College Application Service (AMCAS), which processes submissions for most U.S. medical schools. Thats an increase of nearly 17%.

Consider some edifying context: In the past decade, the year-over-year increase has averaged less than 3%.

Weve been experiencing a leveling off in recent years, so the large increase was quite surprising, says AAMC Chief Services Officer Gabrielle Campbell. Its also inspiring.

Experts don't know exactly what's behind the increase, but they point to several likely factors. Some are rather mundane, including students having more time to focus on applications as college classes moved online. But at least some of this year's applicants are driven by COVID-19 patients terrible suffering and front-line providers extraordinary heroism.

I make an analogy to the time after 9/11, when we saw an increase in those motivated to serve this country militarily, says Geoffrey Young, PhD, AAMC senior director for student affairs and programs. This certainly seems like a significant factor this year.

Even in a usual cycle, applying to medical school is no simple matter. Candidates spend many months preparing for the MCAT exam, writing essays, and collecting recommendations. Applying for entry in 2021 meant completing the AMCAS application in the spring or summer of 2020, followed by individual schools required secondary applications. Once applications are completed, applicants anxiously await interview invitations, which could extend into the spring of 2021.

I make an analogy to the time after 9/11, when we saw an increase in those motivated to serve this country militarily. This certainly seems like a significant factor this year.

Geoffrey Young, PhDAAMC senior director for student affairs and programs

Now, many candidates wonder if increased competition will make landing a seat tougher than ever. For their part, schools say theyre determined to review all candidates fairly, especially given the upheaval many applicants faced during COVID-19. That means admissions teams are working longer hours, extending timelines, adding interview slots, and offering some sage advice to worried candidates.

Schools want to make sure that when they accept someone, its a good fit for both the school and the applicant, Campbell says. They also want to be sensitive to the many applicants who have been hit particularly hard by the pandemic. Thats a lot of work, but theyre highly committed to it.

The larger application numbers to date likely stem from several factors, among them that some applicants are seeking a reliable profession in uncertain times. Some aspects of the application process also got easier as medical schools extended deadlines. And of course, theres the motivation to help patients and communities in a time of crisis.

During COVID-19, my hunger to help continues to grow, says Alan Mauricio De Leon of Houston, who teaches at a majority Hispanic charter school impacted by the pandemic. One student, he recalls, slept in his familys car to avoid infecting them. I want to be a change agent to bring equitable, effective care to my community, he says.

Creson Lee is among the applicants motivated at least in part by the dedication of front-line providers. Lee, 24, was deeply impressed by hospital staff when her research job took her to a Penn Medicine COVID-19 testing site to enroll study participants this summer.

Testers would be out there all day under the sun wearing full gear, drenched in sweat, recalls Lee. Theyd always try to keep positive, sometimes putting on a silly PPE fashion show in the driveway. Lee, who already knew she wanted to be a doctor, fleetingly considered waiting for a more typical year to apply. Ultimately, though, it was important to me to run with this inspiration to pursue medicine right now, she says.

During COVID-19, my hunger to help continues to grow. I want to be a change agent to bring equitable, effective care to my community.

Alan Mauricio De Leon Medical school applicant

Some candidates likely were influenced by more practical considerations.

For some people, the job market looked too uncertain, and a lot more people might not have taken a gap year because there were fewer opportunities, says Valerie Parkas, MD, senior associate dean of admissions for the Icahn School of Medicine at Mount Sinai in New York. And then there were helpful changes to the application process. For example, most schools decided early on to move this years interviews online. Its a lot easier and less expensive to put on a nice shirt and log into Zoom than to travel across the country, she says.

For her part, Joanna Wasvary appreciated the extended application deadlines. That, plus my classes going online, means I can give my applications a lot more attention, says the University of Michigan senior. Wasvary therefore decided to forgo her planned gap year and potential work as a medical scribe. Itll be great to be a doctor one year earlier, she adds.

At Boston University, admissions officers have received more than 11,000 applications for 125 spots. Still, Associate Dean of Admissions Kristen Goodell, MD, doesnt think shell need to enlist additional reviewers. One reason is a protocol released last year that guides reviewers to keep certain criteria in mind. The process was designed for fairness, to reduce unconscious bias, says Goodell. But it turns out that knowing what to focus on also helps move through applications faster.

Other schools are building in more time to process applications. Tulane University, which has 16,000 applicants vying for 190 seats, is taking longer to extend interview invites. It just made sense to ensure that were reviewing the majority of applications before we give away all our interview spots, Woodson explains.

Kristen Goodell, MDAssociate deanof admissions at Boston University School of Medicine

One step medical schools dont plan on taking, though, is greatly increasing class sizes. Thats because substantial expansion requires approval from the medical school accrediting body, the Liaison Committee on Medical Education no simple matter. Plus, there's the issue of resources.

Schools usually decide their class size well in advance because they want to be spot-on in matching spaces with resources like clinical training sites, says Young. They dont want to find that they cant adequately train any additional students.

As aspiring doctors face more intense competition this year, admissions officers also offer their advice on some of candidates key concerns:

The increased numbers really shouldnt impact someones decision to apply. If they feel ready, they should apply. If they think their application needs bolstering, theres always next year, says Parkas. Careers are marathons.

Like many other admissions directors, Ivy Nip Asano, MD, director of admissions at the University of Hawaii at Manoa John A. Burns School of Medicine, reminds applicants that she is sensitive to extenuating circumstances this year. We understand that we need to take into consideration the effects of the pandemic on students ability to secure opportunities and experiences, she says.

At Boston University, Goodell emphasizes that she is seeking the same traits and abilities shes always sought and never uses some rigid checklist.

Weve already embraced admissions based on competencies. That means applicants dont need specific courses in a certain area, for example. They just need to demonstrate their abilities in that area, she says. This approach offers flexibility, which comes in really handy at a time like this. In addition, Goodell notes that Boston University uses holistic review, which considers an applicants full range of attributes and experiences.

For his part, Tulane Universitys Woodson advises applicants to make clear why they selected his school. Of course, we want people who will be a good fit for us, but with so many applicants, we also want to focus on those who will actually come here if accepted, he says.

Asano sums up her advice simply: I hope that applicants will share their authentic selves.

If you are a super-strong candidate, youre always going to get interview invitations. If youre a bit weak, no matter what the year, you wont get many. Then there is the group in the middle. For them, applying to more schools might increase the chances of an interview invite, Goodell says. A prehealth advisor can help you figure out which group youre in.

Could all the setbacks this year mean that fewer applicants from underrepresented backgrounds wind up in medical school?

We were concerned that all the disruptions could discourage people from racial and ethnic minority groups or lower socioeconomic backgrounds from taking the MCAT, says Cynthia Searcy, PhD, AAMC senior director of MCAT research and development. But the percent of those examinees actually mirrored those from 2019.

So far, application numbers also look encouraging.

To date, racial and ethnic minorities are applying to medical school in higher numbers compared to the same time last year," says the AAMCs Campbell. "For example, weve seen double-digit increases in the number of Black and Latino applicants.

This could still change, but given the stresses of the pandemic and social unrest that weve seen across the country, this is a positive early sign," she adds.

Once those applications land, holistic review should help ensure that schools consider the full picture of a candidates attributes and experiences, Young notes. He encourages admissions teams to use the AAMCs equity-related resources, including a recent webinar on how to prevent implicit bias in virtual interviews.

Other steps have helped support lower-income applicants. This year, the AAMC dramatically broadened its Fee Assistance Program, which provided $9.1 million worth of support last year. Qualifying applicants can receive a waiver for all AMCAS fees for one application submission with up to 20 medical school designations as well as MCAT benefits.

This year we raised the poverty level cut-off [so more potential candidates could benefit from the program], says Campbell. So far, weve had a 54% increase in [Fee Assistance Program] applications and a 76% increase in approvals.

Meanwhile, Goodell sees a quest for racial and social justice as helping to spur some of the rising application numbers.

So many people have seen that different groups in our country are facing such different effects from COVID-19 based on their ZIP code or their race, she says. This year, applicants are motivated to get out there and fix societal problems. Theyre saying, I need to do something to make this country more equitable, and I think the best way for me to do that is through medicine.

Excerpt from:
Applications to medical school are at an all-time high. What does this mean for applicants and schools? - AAMC

By Rolling Out Dr. Kimberly Gilbert, a board-certified Atlanta-based physician has penned a new book, So When Do I See the Doctor? The book is about her journey to becoming a physician and the challenges she faced as a result of her race and gender and how she found the strength to complete medical school, residency, and beyond despite hardship.

What inspired you to write So When Do I See the Doctor?

When I started my journey to becoming a physician, there were not any easily accessible stories to read that spoke candidly about the trials that many Black students and doctors, especially Black females, would experience from different perspectives on the road to success. More physicians are starting to tell their stories online, in magazines, and on TV, but I wanted to also give something a little old school in the form of a book. I wanted it to be comprehensive and honest. I also wanted it to be inspirational. The book not only addresses racism and sexism but also intra-racial and intra-cultural issues, and how people in positions of influence can oftentimes encourage or destroy whoever is listening to them.

What is the story behind the title?My first patient in private practice was an older White male. After clearly introducing myself when I entered the patients room wearing my long white coat and name tag, spending over one hour with him listening to his concerns, examining him, reviewing imaging studies with him, and discussing my recommendations, he told me that I had a great plan before asking, So when do I see the doctor?

Name three takeaways for the reader from the book. Despite how society may portray us, Black people are equal and worthy of the same safety, education, respect, and opportunities for success as anyone else. Our ancestors are the reason why we have the opportunities that we have today, and our decisions each day will determine the opportunities of tomorrow for those who follow our paths. No matter what struggles you go through on your journey to success, you can not only persevere but also maintain who you are along the way.

At what point did you know it was time to write this book, was it a deliberate decision or did it evolve?

My husband and friends have been telling me to write a book for years, after hearing my stories as they happened, telling me that very few people outside of medicine think Black female physicians also go through race and gender bias because our accomplishments and career are so prestigious. When the pandemic hit, it exposed so much racial injustice in America, I felt it was the perfect time to bring awareness of its existence in health care.

What is the best piece of writing advice that you received?Be authentic

For more on the original article visit: https://rollingout.com/2020/10/19/dr-kimberly-gilbert-chronicles-her-experience-in-medical-school-in-new-book/

Original post:
Dr. Kimberly Gilbert Chronicles Her Experience in Medical School in New Book Free Press of Jacksonville - Jacksonville Free Press

The Wayne State University School of Medicine will hold its second annual Medical Education Research and Innovation Conference on Dec. 8 to showcase completed and in-progress medical education research and innovation projects conducted by students, residents, staff and faculty.

Last years inaugural conference saw more than 80 posters and oral presentations submitted, said Jason Booza, Ph.D., assistant dean of Continuous Quality Improvement and Compliance.

The virtual conference will take place from 2 to 6 p.m.

Featured speakers include Holly Gooding, M.D., associate professor of Pediatrics at the Emory University School of Medicine and co-director of the Harvard Macy Program for Educators in the Health Professions; and Anna Cianciolo, Ph.D., associate professor of Medical Education at the Southern Illinois University School of Medicine and editor in chief of Teaching and Learning in Medicine.

Submit abstracts for a completed or in-progress project using the links below:

Medical Education Research:Research related to the learning process that occurs within a medical education setting. Topics include, but are not limited to, learner characteristics, optimizing the learning process, assessment and evaluation, professional development, instruction design, technology in the learning environment and wellbeing. Research at any level (undergraduate, graduate, practitioner, faculty) of medical education is welcome. Medical education research can also include quality improvement projects.

Medical Education Innovation: Innovative curricula that address a current issue within medical education. The innovation should be based on learning principles and be designed to meet a specific need. Examples include, but are not limited to, health and wellness, quality improvement, patient safety, interprofessional education and service learning. You can submit a project as Works in Progress," which includes research and innovation projects that are being developed or have yet to be completed. In place of results in the abstracts, please submit your analysis plan and lessons learned thus far.

To attend the conference, RSVP here.

Contact Dr. Booza @ jbooza@med.wayne.edu for additional information.

More:
Abstracts now accepted for Medical Education Research and Innovation Conference - The South End

Even setting aside the once-in-a-lifetime impact of the pandemic, the physicians role in 2020 is substantially different than it was a decade ago. Todays patients are often sicker, and illness is compounded by numerous nonbiomedical factors, such as inadequate social support to comply with treatment plans and avoid unnecessary hospitalizations.

The COVID-19 pandemic is complicating things further by stalling many clinical research and quality improvement efforts. But a project funded by a grant from the AMA Accelerating Change in Medical Education initiative continues training students at four U.S. medical schools to incorporate a new history and physical (H&P) modelthe H&P 360to collect biopsychosocial data, better manage chronic disease and address social determinants of health.

The four medical schools receiving the H&P 360 implementation grants are the University of Michigan, Eastern Virginia Medical School, Florida International University and University of Chicago.

While the H&P is the primary process through which a physician obtains key subjective and objective patient information, the traditional H&P was developed decades ago when the physicians role was more limited.

Medical practice is necessarily undergoing a paradigm shift, and the new paradigm has to do with accounting for social determinants and behavioral health, said Brent Williams, MD, MPH, director of the Global Health and Disparities Path of Excellence at University of Michigan Medical School.

The H&P 360 is meant to help physicians stop making the mistakes that are in built into the old medical paradigm, which is based exclusively on biomedical disease diagnosis and treatment, Dr. Williams added. It pushes them to take a realistic view of why so many patients bounce back into the hospitalfor example, because they didn't have access to their medications or they didn't take them appropriately.

Based on a format developed at University of Michigan Medical School, the H&P 360 was expanded and refined by the AMAs Chronic Disease Prevention and Management interest group in 2017 and piloted at four medical schools in 2018.

The idea behind the H&P 360 is that by including at least a few questions in each of six domains besides the traditional biomedical information in the routine history, physicians care of patients will improve.

Those additional domains are:

For example, in the relationships domain, students are being trained to assess the level of support available to their patients. They might ask questions such as:

The effectiveness of the H&P 360 is supported by a 2019 randomized-controlled trial with standardized patients. Nearly 160 third- and fourth-year medical students at four medical schoolsUniversity of Michigan, University of North Dakota, University of Connecticut and University of California, Daviswere randomly assigned to either the traditional H&P or the H&P 360 and further randomized to either see a patient with hypertension or a patient with type 2 diabetes.

For each encounter, a standardized patient doubled as a trained observer and completed a grading rubric that measured:

Analysis of the data demonstrated average total scores on the performance rubric were substantially higher among the intervention group in both cases, at all four schools and across all four standardized patients.

Dr. Williams noted that the grant groups students have returned to clinical settings and are now implementing H&P 360 during both in-person and virtual visits.

While the pandemic has disrupted or delayed some of the work, it has also made it easier to apply the H&P 360, he said. With video visits, medical students are drawn more directly into patients living environments and social support systems.

No matter the type of visit, however, what makes the H&P 360 such a practical tool is that its not a checklist that has to be included in every visit, Dr. Williams added. By gathering just two or three pieces of information each time, the physician will gradually get a more complete picture of a patients health and the paths to improvement.

The long-term goal for H&P 360 is to make it the standard tool in medical practice for improvement of all aspects of chronic disease prevention, diagnosis, treatment and management. The H&P 360 template and supporting materials are available for use at all medical schools.

The rest is here:
Revising the history and physical for new era in medicine - American Medical Association

Students attend the first day of school in the small town of Labastida, Spain, on Sept. 8. A recent study found no link between coronavirus spikes and school reopenings in the country. Alvaro Barrientos/AP hide caption

Students attend the first day of school in the small town of Labastida, Spain, on Sept. 8. A recent study found no link between coronavirus spikes and school reopenings in the country.

Despite widespread concerns, two new international studies show no consistent relationship between in-person K-12 schooling and the spread of the coronavirus. And a third study from the United States shows no elevated risk to childcare workers who stayed on the job.

Combined with anecdotal reports from a number of U.S. states where schools are open, as well as a crowdsourced dashboard of around 2,000 U.S. schools, some medical experts are saying it's time to shift the discussion from the risks of opening K-12 schools to the risks of keeping them closed.

"As a pediatrician, I am really seeing the negative impacts of these school closures on children," Dr. Danielle Dooley, a medical director at Children's National Hospital in Washington, D.C., told NPR. She ticked off mental health problems, hunger, obesity due to inactivity, missing routine medical care and the risk of child abuse on top of the loss of education. "Going to school is really vital for children. They get their meals in school, their physical activity, their health care, their education, of course."

While agreeing that emerging data is encouraging, other experts said the United States as a whole has made little progress toward practices that would allow schools to make reopening safer from rapid and regular testing, to contact tracing to identify the source of outbreaks, to reporting school-associated cases publicly, regularly and consistently.

"We are driving with the headlights off, and we've got kids in the car," said Melinda Buntin, chair of the Department of Health Policy at Vanderbilt School of Medicine, who has argued for reopening schools with precautions.

Emerging evidence

Enric lvarez at the Universitat Politcnica de Catalunya looked at different regions within Spain for his recent co-authored working paper. Spain's second wave of coronavirus cases started before the school year began in September. Still, cases in one region dropped three weeks after schools reopened, while others continued rising at the same rate as before, and one stayed flat.

Nowhere, the research found, was there a spike that coincided with reopening: "What we found is that the school [being opened] makes absolutely no difference," lvarez told NPR.

What we found is that the school [being opened] makes absolutely no difference.

Enric lvarez, researcher at the Universitat Politcnica de Catalunya

Spain does extensive contact tracing, so lvarez was also able to analyze how much schools are contributing to the spread of the coronavirus. lvarez said his research suggests the answer is: not much. He found that, for all the students and staff who tested positive, 87% of them did not infect anyone else at the school. They were single cases.

"We are not sure that the environments of the schools may not have a small and systematic effect," said lvarez, "But it's pretty clear that they don't have very major epidemic-changing effects, at least in Spain, with the measures that are being taken in Spain."

These safety measures include mask-wearing for all children older than 6, ventilation, keeping students in small groups or "bubbles," and social distancing of 1.5 meters slightly less than the recommended 6 feet in the United States. When a case is detected, the entire "bubble" is sent home for quarantine.

Insights for Education is a foundation that advises education ministries around the globe. For their report, which was not peer reviewed, they analyzed school reopening dates and coronavirus trends from February through the end of September across 191 countries.

"There is no consistent pattern," said Dr. Randa Grob-Zakhary, who heads the organization. "It's not that closing schools leads to a decrease in cases, or that opening schools leads to a surge in cases."

Some countries, such as Thailand and South Africa, fully opened when cases were low, with no apparent impact on transmission. Others, such as Vietnam and Gambia, had cases rising during summer break, yet those rates actually dropped after schools reopened. Japan, too, saw cases rise, and then fall again, all while schools were fully reopened. But the United Kingdom saw a strong upward trend that started around the time of reopening schools.

"We're not saying at all that schools have nothing to do with cases," Grob-Zakhary said. What the data suggests instead is that opening schools does not inevitably lead to increased case numbers.

What about the U.S.?

On Oct. 14, the Infectious Diseases Society of America gave a briefing on safe school reopenings. Bottom line? "The data so far are not indicating that schools are a superspreader site," said Dr. Preeti Malani, an infectious disease specialist at the University of Michigan's medical school.

One place in the U.S. where systematic data gathering is happening Utah seems to echo the conclusions drawn by the new international studies. Utah's state COVID-19 database clearly reports school-associated cases by district. And while coronavirus spread is relatively high in the state, State Superintendent of Public Instruction Sydnee Dickson believes that schools are not, for the most part, driving spread.

"Where you see cases on the rise in a neighborhood, in a county, we see that tend to be reflected in a school," Dickson said. "[But] we're not seeing spread by virtue of being in school together."

Tom Hudachko of the state's health department said that after both colleges and schools reopened in early September, there was a rise in cases among the 15-24 age group. But with targeted public health messaging those cases have started to come down.

For the most part, Hudachko said, K-12 school clusters have been concentrated at high schools. "We have had some outbreaks in middle schools. They've been far less frequent. And elementary school numbers seem to be one-offs here and there."

And these clusters including one large reported outbreak with at least 90 cases have largely been traced to informal social gatherings in homes, not to classrooms. (lvarez, in Spain, also said that clusters among young people there have been traced to social gatherings, including rooftop and beach parties).

Few states are reporting school-related data as clearly as Utah. And that's a shame, said Buntin at Vanderbilt. "One might argue that we're running really a massive national experiment right now in schools," Buntin said, "and we're not collecting uniform data."

The largest centralized effort at such data collection in the United States the unofficial, crowdsourced COVID-19 School Response Dashboard has gotten a lot of publicity. But it is self-reported, not a representative sample of schools.

Buntin and other experts said it's likely that the dashboard is biased toward schools that are doing an exemplary job of following safety precautions and are organized enough to share their results. Also, the dashboard doesn't yet offer the ability to compare coronavirus cases reported at schools with local case rates.

In the absence of data, there are scary and tragic anecdotes of teachers around the country dying of COVID-19. But it's hard to extrapolate from these incidents. It's not immediately clear whether the educators contracted the virus at school, whether they are part of school-based clusters, or what safety precautions were or were not followed by the schools in question.

A recent study from Yale University could potentially shed some light on these questions. It tracked 57,000 childcare workers, located in all 50 states, Washington, D.C., and Puerto Rico, for the first three months of the pandemic in the United States. About half continued caring for very young children, such as the children of essential workers, while the other half stayed home. The study found no difference in the rate of coronavirus infections between the two groups, after accounting for demographic factors.

Walter Gilliam, lead author of the study and a professor of psychology at the Yale Child Study Center, cautioned that it's difficult to generalize this report to a K-12 schools setting, because the children were mostly under the age of 6 and kept in very small groups and, he said, the childcare workers were trained in health and safety and reported following strict protocols around disinfection. However, he said, "I think it would be great to do this study with school teachers and see what we can find out."

Risk and benefit

When you add up what we know and even what we still don't know, some doctors and public health advocates said there are powerful arguments for in-person schooling wherever possible, particularly for younger students and those with special needs.

"Children under the age of 10 generally are at quite low risk of acquiring symptomatic disease," from the coronavirus, said Dr. Rainu Kaushal of Weill Cornell Medicine. And they rarely transmit it either. It's a happy coincidence, Kaushal and others said, that the youngest children face lower risk and are also the ones who have the hardest time with virtual learning.

"I would like to see the students, especially the younger students, get back," said Malani at the University of Michigan. "I feel more encouraged that that can happen in a safe and thoughtful way."

Chicago Public Schools, one of the largest districts in the country, seemed to take that guidance into consideration when it announced recently a phased reopening starting with pre-K and special education.

Kaushal said it's important to keep in mind that Black, Latinx and Native American communities are much more severely affected by COVID-19. And that many of the "children that are at the severest risk of disease, are also at the severest risk of not having a school open, whether it be for food security, adult time, security, losing the time to learn or losing the skills that they have acquired over the last year or so."

Any decision made on school reopening, she said, has to focus on equity as well as safety. There are no easy trade-offs here.

Link:
Research Finds Few Links Between Schools And COVID-19 Cases - NPR

Stan Gerson will serve as interim dean of Case Western Reserve Universitys School of Medicine for an additional year. His term will end June 30, 2022.

We knew Stans deep familiarity with the medical school and its hospital partners would give him distinct advantages as he started in this role, Interim President Scott Cowen said in an Oct. 20 media release. But his ability to apply them in such an engaging and inclusive way has far exceeded even our heightened expectations. We are delighted he will helm the school throughout the 2021-2022 academic year.

Gerson accepted the interim role after President Emerita Barbara R. Snyder stepped down Oct. 1.Snyder and Provost Ben Vinson III wanted the universitys next president to select its next permanent dean.

Once we decided to appoint an interim dean, Stan quickly emerged as a top choice, Vinson said in the news release. Not only is he a renowned researcher in his own right, but he also has helped elevate our cancer center to distinguished prominence, making it among the nations most highly regarded programs.

Gerson is leading the cancer center while serving as interim dean with assistance from the centers leadership team. In the release, Gerson said he is honored by the extension and looks forward to continuing to work with our faculty, staff, students and hospital partners to advance education, research and our communitys well-being during the next 20 months.

Continued here:
Gerson to continue as interim CWRU medicine school dean for another year - Cleveland Jewish News

During the last decade, there has been a strong initiative by medical schools around the nation to integrate medical humanities into their curriculum. This movement seeks to train resilient medical students with holistic approaches that will better address the complexities of healing diverse patients.

The University of Arizona College of Medicine Tucson has made its mission to be in the forefront of this movement. At UACOM-T, the Medical Humanities Program provides students with enrichment electives that serve as a journey through medical humanities in order to learn and practice the tools that will aid [students] in becoming more compassionate and empathic physicians.

This academic year the "Healers Art" elective has been a favorite amongst students. The purpose of this course is to allow students to explore areas not fully addressed in the curriculum and feel connected to the real reasons for becoming a physician, said Dr. Patricia Lebensohn, professor of Family and Community Medicine and director of the Healers Art elective.

During each session, students get together to discuss mindfulness, grief, the meaning of service and the awe of medicine. Through these conversations, students share personal stories, beliefs and experiences that have impacted their ongoing journey through the medical profession. These conversations are enhanced by faculty mentors and physicians who contribute their personal experiences and share valuable lessons with students.

I think it is a precious opportunity to have physician mentors who can share their unique life stories inside and outside of medicine, said Hannah Korah, a first-year MD/PhD student. It is truly a humbling experience to see physicians be human beings who are vulnerable and so emotionally strong after everything they have gone through.

As expected, many of these conversations can be difficult. Students often share how emotional experiences such as the passing of a loved one or a personal failure have shaped or continue to shape their lives.

Rosemarie Turk, a second-year medical student at the UA, is grateful to participate in these conversations.

"I was not quite sure what to expect going into the elective. Now that we are half way through, I feel like I have learned that people carry so much with them in their everyday lives and don't always have an outlet to express it," Turk said. "I feel very grateful to gain more perspective through the Healer's Art elective."

Another common topic for students is the physical and mental demands of medical education.

During each session we are able to talk about particularly stressful days in medical school and our mental wellbeing, said Jarrod Rulney, a first-year medical student. It is very comforting to know that we all have a common struggle. Everyone is very supportive and eager to help.

Conversations about mental health have proven especially important. Decades of research has repeatedly shown an increasing rate of burnout, cynicism and anxiety amongst medical students and new practicing physicians.

Healers Art has taken initiative to address the vulnerability of being a medical student and physician, Korah said. The emotional toll of what we are dedicating our lives to is often hidden under shadows of textbooks, lectures, and clinical skills. This course teaches me to embrace the struggle, keeps me grounded, and reminds me that I am not alone on this journey.

By emphasizing the ways medial humanities can improve student wellbeing, UACOM-T hopes to mitigate burnout and mental health concerns early in training. Lebensohn said that she believes that Healers Art will serve as an antidote to the hidden curriculum that over time make students less empathic, more jaded and burned-out.

Around the nation, similar efforts have shown promising results. A recent study by University of Washington School of Medicine suggests that the integration of humanities education into their medical school curriculum has led to an increase in student performance, well-being and empathy.

The Healers Art elective has also served as way for students and faculty to appreciate and share a common passion for the humanities. The intersections between medicine, music and art are frequently explored during each session, adding greater depth to already complex conversations.

Turk explained that cultivating her interest in the humanities will make her a better physician.

The humanities are important in every aspect of life. They are embedded [in] everyone's life because, after all, we live a human experience. With such rich and unique experiences and different ways of processing them, the humanities allow us to better understand our patients and one another," Turk said.

Lebensohn said she shares these sentiments. In her personal life, she reads non-medical fiction, enjoys music and explores cinema. She believes that these interests make her a more complete and compassionate professional.

The humanities are an integral part of my role as a physician and how I connect at a human level with [my] patients. They are an important part of my personal and professional life," Lebensohn added.

Ultimately, renewed interest in medical humanities highlights the need to address curricular gaps that push non-medical courses to the sidelines. Educators around the country recognize that medical students need training beyond the scientific principles of medicine to become competent physicians. Through courses like Healers Art, UACOM-T seeks to close this gap in training.

For students like Rulney, Healers Art brings a refreshing focus to the humanistic foundations of medicine.

Courses like Healers Art remind me why I wanted to pursue medicine in the first place. At its core, this profession is about connecting with people, understanding their human experiences and collaborating with them to improve their quality of life. Healing is incomplete without a humanistic approach," Rulney added.

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Original post:
Healer's art: Integrating the humanities into medical education - Arizona Daily Wildcat

October 24, 2020 1:43 PM

CNN

Posted: October 24, 2020 1:43 PM

For months Dr. Jinendra Satiya has faced fears on the frontlines of a deadly pandemic, treating coronavirus patients.

But now the doctor, on a fellowship at a Boston hospital, is facing a new anxiety: that new immigration restrictions could make it harder for him to stay in the country.

Satiya is one of thousands of foreign doctors who came to the United States on a visa that recently landed in the Trump administrations crosshairs.

A proposed rule could make it more difficult to renew J-1 exchange visitor visas, which allow scholars, doctors and others to live temporarily in the US while they study or receive training.

On the surface, it may sound like a small bureaucratic move. But Satiya and organizations representing doctors across the country warn it could affect medical care for Amjericans at a time when the country needs resources to fight the coronavirus pandemic.

For Satiya, 30, who grew up in India and came to the US in 2016, it also throws his immediate future in the US into jeopardy.

You are anxious, you are nervous, youre stressful, Satiya said about waiting to see what happens with his visa. But you know, you keep on doing what youre doing. You go to work every day you see your patients and you just hope for the best.

Satiya is one of about 12,000 doctors who are foreign nationals in the United States on a J-1 visa, according to the Educational Commission for Foreign Medical Graduates (ECFMG). Visitors on J-1 visas are admitted to the US for the length of their training program for doctors, its typically a one-year contract at a hospital, renewed annually for the duration of their residency.

When physicians on J-1 visas complete their competency reviews and get their contracts extended for another year, they then apply for visa renewal through the ECFMG.

But under the proposed rule, the annual visa renewal would require an additional step applying through US Customs and Immigration Services. That processing time could take 5 to 19 months, according to the USCIS website, and interrupt doctors ability to continue working at their hospitals.

The Department of Homeland Security, which oversees USCIS, says the change is needed for federal officials to more closely monitor these visitors while they are in the US to address a potential for increased risk to national security.

This regulatory change, which will establish a fixed period of admission for F, J and I nonimmigrants, aims to help DHS enforce our nations immigration laws and promptly detect national security concerns, while protecting the integrity of these nonimmigrant programs, a DHS spokesperson said in a statement.

The ECFMG and other major medical organizations around the country have asked the DHS to make an exception for medical trainees.

The DHS is seeking public comments on the rule and has received more than 23,000 of them so far.

Foreign med-school graduates like Satiya go through an extensive selection process to get their positions in the US, providing the talent and expertise President Trump has said he wants in the countrys immigrants.

Public comments responding to the DHS proposal include testimonials from medical educators concerned about the potential impact. Other commenters have argued that during a period of high unemployment its not fair to displace thousands of qualified American medical school graduates with residency training positions for foreign doctors.

But the numbers suggest that American physician jobs arent threatened by foreign medical graduates. Almost 94% of graduates from US medical schools in 2020 were matched with a residency, according to data compiled by the National Resident Matching Program, a private, nonprofit organization that seeks to provide a fair mechanism for matching budding doctors with residency positions.

And the Association of American Medical Colleges projects a shortage of up to 139,000 physicians in the US by 2033.

Dr. John Andrilli, program director for Internal Medicine Residency at Mount Sinai Hospital in New York City, said he fills a third of his annual 42 slots with foreign medical graduates. But he gets 6,000 applications from abroad, he said.

We really are getting the best and the brightest from around the world, Andrilli said. So it doesnt make a lot of sense to me why this change would happen.

The ECFMG fears that if the rule change is approved, many foreign doctors may look to do their residencies in other countries instead of the US.

There are other opportunities for training around the world where they could go, said Dr. William Pinsky, president and CEO of ECFMG.

Pinsky said he shares the concerns of those who worry about national security and want to make sure visa recipients are in the country for their allotted time. But he added, having diminished access to health care is as much a security risk as anything else, frankly So this is creating a problem when theres not a problem.

Slightly more than half of J-1 physicians choose internal medicine, which boosts the primary care workforce. And many J-1 physicians work in rural or underserved areas, filling a need not met by American medical graduates alone, according to ECFMG.

Tracy Wallowicz, an assistant vice president at ECFMG, said the change would create unnecessary chaos.

Ive been at ECFMG for 25 years. And I have never been told of a J-1 physician overstaying (their visa), she said.

For Satiya, the rule change could upend his thriving medical career in the US. He completed residencies in Miami and New York City before coming this year to Boston, where he specializes in liver diseases at Beth Israel Deaconess Medical Center, a teaching hospital of Harvard Medical School.

Satiya spent the early weeks of the pandemic as a chief resident in New York facing fast-changing information about how to fight the virus along with the scarcity of PPE, ventilators and available hospital beds. Like all health care providers, he went through a wide range of emotions on a daily basis.

Now he faces a new uncertainty. But hes trying to remain positive.

We take something known as the Hippocratic oath (to do no harm) and we all felt like we were living this oath out, you know, in the middle of this pandemic, he said. Were all, at the end of the day, very proud to be able to serve the American community in these troubled times.

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Some doctors fighting the pandemic now have another thing to worry about - Channel3000.com - WISC-TV3

Initial preliminary efficacy and safety data are expected sometime next year, stated Aditya Bardia, MBBS, MPH, breast medical oncologist, Massachusetts General Hospital, Harvard Medical School.

Initial preliminary efficacy and safety data are expected sometime next year, followed by dose expansion and a phase 2 trial, explained Aditya Bardia, MBBS, MPH, breast medical oncologist, Massachusetts General Hospital, Harvard Medical School.

Transcript

What is the timeline for the phase 1B portion of the ASCENT trial investigating sacituzumab govitecan (SG) and talazoparib?

It is still ongoing. And we hope to have at least preliminary efficacy and safety tolerability data early next year, and then after that, the trial would expand to dose expansion as well as a phase 2 trial to further confirm the efficacy and safety tolerability. But in terms of initial preliminary data, sometime next year we should have those results.

Is there a timeline for the phase 1B portion?

In part that would depend on the efficacy of the data, how robust the results look, and that would help guide for the development of phase 2 or even phase 3.

Have additional patient safety measures been implemented with flu season and the coronavirus disease 2019 (COVID-19) pandemic overlapping?

Oh, it started absolutely in March of 2020 when Boston got hit with COVID-19. The institutions in the Boston region, including MGH, implemented a number of procedures to ensure that patients with cancer are safe, and those measures remain in place. We've not seen nosocomial or hospitals spread of COVID-19. And despite the pandemic, the clinical trial with SG plus [a] PARP inhibitor continued to enroll, and we had patients enrolled even when the pandemic was at its peak.

In Boston, weve not seen any COVID infection in patients who were treated with this agent, in part because of the preventive measures that have been instituted at our institution. One thing to consider is that neither SG nor [a] PARP inhibitor necessarily would increase the risk of either flu or COVID. But we know that triple-negative breast cancer is an aggressive disease, so its important to control the disease while ensuring that we take whatever precautions are needed.

We actually wrote a report about this as a CPC, or clinical pathological conference, in the New England Journal of Medicine that was published in July, talking about a patient with breast cancer during the COVID pandemic and how it could have an impact. And the bottom line was, we have to weigh the risks and benefits and take whatever precautions are needed, but at the same time, ensure that the anticancer treatment or the care of patient with breast cancer is not compromised.

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Dr Aditya Bardia Forecasts What's to Come for the ASCENT Trial in Triple-Negative Breast Cancer - AJMC.com Managed Markets Network

RENO, Nev. For 50 years, Renown Health and the University of Nevada, Reno School of Medicine have had a long history of working together to improve healthcare in Northern Nevada.

This year, the notorious 2020, when an unprecedented pandemic hit every corner of the globe and caused more than 1 million deaths, Renown and UNR Med recognized they could better serve Reno-Sparks if they did more than occasionally collaborate.

Were now at a pivotal point where we believe we could advance the work that were doing together, Dr. Anthony Slonim, CEO of Renown, said in a phone interview with the NNBW. And well be better if we advance it together for the benefit of the community.

With that, in late August, Renown Health and UNR Med announced their intent to develop a long-term partnership that both entities say will greatly enhance the states medical education system while expanding clinical research capacity across greater Northern Nevada.

Our strategic plan that we created with our board calls into execution the focus on what were calling destination health programming, Slonim explained. We want to be the place where through amazing clinical care and service we are keeping people who need to be cared for in our community, right at home.

And you cant do that if you dont have a medical school with you. You have to have the research and the training capabilities because it makes everybody on the team better. It allows you to recruit better, it allows you to educate better. It raises the bar for everybody.

Slonim pointed to Renown and UNR Meds previous collaboration in pediatrics as an example of what high-level partnerships can produce. UNR Med doctors and residents provide care in general pediatrics (and a host of other services) at Renown Childrens Hospital, which opened in 2009, the first and only childrens hospital in the region.

Were doing the same thing in other services cardiovascular care, cancer care, neuroscience care as we continue to demonstrate that world-class kind of care, Slonim noted.

Bringing those high-level services will not be possible without the school of medicine developing new residency training programs, fellowships and clinical research studies, said UNR Med Dean Dr. Thomas Schwenk andaccess to Renowns large health system would enable UNR Med to do just that.

It opens a host of possibilities, he told the NNBW. And all of those feed back to increasing the access to care and increasing the high-level nature (of care) and to develop care that does not now exist in the community.

Both organizations in early September executed a Letter of Intent for their partnership, said Schwenk, who later presented it to the Nevada System of Higher Education (NSHE) Board of Regents, which gave its stamp of approval.

Currently, the entities are in a due diligence phase of laying out and examining the partnerships governances, financial flow and operational structure, Schwenk said, as well as culture, employment, human resources and other details.

Once ironed out, a final agreement between UNR Med and Renown will be taken to their boards for approval in December or January.

If approved, implementation details would be fine-tuned through the first half of 2021, with the goal of officially launching a partnership by July 1, Schwenk he said.

Were creating a new entity, he said. Its not just us joining Renown or Renown joining the school. Its actually a new integration of what you might call an academic health system or a teaching-and-research health system. What we get to do, if this goes through, is have a much larger influence on the care and the community.

The integration, Schwenk said, would make Reno-Sparks an even more attractive area to companies considering relocating or expanding to the region.

This is what new businesses want to see when they move into the community, and this is what employees want to see when they are recruited to the community, he said. And so I think, ultimately, this is about the quality of life, the quality of the business climate, and the overall economic success of the community. And healthcare is a major driver of that.

According to Renown and UNR Med, their planned integration resembles other partnerships such as Yale New Haven Health System, Penn Medicine, RWJ-Barnabas-Rutgers and the Washington University-Barnes Jewish Health System in St. Louis.

I think the world of healthcare now is built on collaboration and partnership to improve the way that weve historically delivered on care, Slonim said. So, were very excited to partner with the medical school. We think it will not only make the school better, it will make Renown better. And together, we think we can bring a higher level of care to the community as we move forward.

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Renown, UNR Med working to finalize new 'destination health' partnership - Northern Nevada Business Weekly

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Johns Hopkins School of Medicine, Stanford University School of Medicine, and Siemens Healthineers to Lead the Global Medical Education Market

The report provides the profiles of leading players operating in the global medical education market. These include Gundersen Health System, GE Healthcare Institute, American College of Radiology, Healthcare Training Institute, New Jersey, Olympus America, TACT Academy for clinical training, Zimmer Biomet Institute, Harvard Medical School, Johns Hopkins School of Medicine, Stanford University School of Medicine, Apollo Hospitals, CAE Healthcare, and Siemens Healthineers.

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Medical Education Market projected to expand at a CAGR of more than 4% from 2019 to 2027 - The Think Curiouser