Applying to medical school is an extremely stressful experience, and Michigan medical students know that firsthand. Thats why five students took time to share their insights with hundreds of prospective students during a recent video livestream Q&A.

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Topics ranged from curriculum and mentorship to application advice and much more. Below, read through a few highlights from the session or watch the full video above to get all the topics covered.

One thing I wish I knew was that all I needed to do to get into medical school was to be myself and not try to be anything other than that.

I think when you're preparing for a process where everything that you've done and who you are is going to be heavily judged, you try to be the best version of yourself, and sometimes that's not the most honest or truthful version of yourself. Now, being on the other side of this, I've realized that they don't want that perfect applicant. They really just want you. So I wish I knew that prior to applying. It would have saved me a lot of stress and trouble in the process.

I've been very pleasantly surprised by how much of a work-life balance I feel I have. Everyone was telling me, Med school is hard, you're not going to have a life, all you're going to do is study, which is sort of true. But on the other hand, I feel like I really do have time to go have dinner with friends during the week or go Up North for a weekend. The pass-fail curriculum is really important and really crucial to allow work-life balance, and I've really tried to embrace that.

For me it was about seeing that everyone was really enthusiastic about their place in medicine, but also just enthusiastic human beings in general. It's really nice to be in an environment where everyone else is as high energy as you are. That's what I felt on my interview day and pretty consistently throughout my first year and now in this Transition to Clerkship period. Everybody that I've worked with here just has that energy and passion and drive that is medically related, but they also just have that human, fun, personal life-related energy and passion as well, which was really important for me.

SEE ALSO: DOCUMENTARY - Reality Checks: Michigan Medical School Students Open Up

My partner moved to Michigan with me and started a master's program. Something I've really appreciated is, for students with significant others or families locally, there are a lot of activities relating to the med school where you can bring your people. That's been really helpful for me in trying to integrate those parts of my life. So, for many things, you can come alone or come be a part of those activities with your significant other so they can join that broader group.

After taking the Step 1 exam, you return early in your third year and do two month-long sequences of transitioning to Branches. You have to do an intensive care unit rotation, an emergency medicine rotation and a sub-internship rotation in a field that you're interested in. But there's a lot of flexibility. You can choose quite a few electives and even create your own. This past year one of my friends created an elective in veterinary medicine and had a fun time exploring that. You can really branch out in your interests and work closely with faculty members. And there's a good amount of time to do research or to do a dual degree.

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Students Share Medical School Details You Won't Find Anywhere Else | University of Michigan - Michigan Medicine

As the response to the COVID-19 pandemic restricted in-person activity, medical schools had to invent new ways to educate out of necessity. Some of those innovative methods may have staying power that go well beyond the pandemic, reshaping how tomorrows doctors are trained.

When you face a disruption on the order of this magnitude, it forces you to think about the principles by which we preserve the very essence of our work. We quickly learn that some strategies we assumed were the only way to do things can be changed without damaging the quality of our educational programs, said Catherine Lucey, MD. She is vice dean for education at the University of California, San Francisco, School of Medicine, one of the 37 member schools ofAMAs Accelerating Change in Medical Education Consortium.

A lot of changes were put in place to deal with COVID-19 disruption, but its also given us a new freedom to experiment with new models of education that may end up being better, Dr. Lucey said in an interview with the AMA.

Dr. Lucey and co-author S. Claiborne Johnston, MD, PhD, highlighted five potential COVID-19-related changes to medical education that may have staying power in a JAMA Viewpoint essay, The Transformational Effects of COVID-19 on Medical Education.

In response to the COVID-19 pandemic, medical schools have created electives giving medical students the chance to engage with the public health response. Learners also served as evidence-based ambassadors for the population at large.

The pandemic strengthened the partnership between health care delivery systems and public health professionals, Dr. Lucey said. The outbreak of the COVID-19 pandemic was acute and dramatic, but it made people reset their idea of what it means to alleviate suffering in our patients and improve the health of our communities.

Its not just doctors operating alone, and its not just a cardiologist and a basic science investigator working alone, she added. It requires everyonethat means doctors, nurses, public health experts, policy experts, all of those people are required to solve problems.

Dr. Lucey added that this type of approach could be applied to other public health crises such as the opioid epidemic and the ongoing pandemic of health care disparities.

Find out how medical schools innovated to engage medical students during the pandemic.

The pandemics onset was a teachable moment for any health professional. In her JAMA Viewpoint essay, Dr. Lucey outlined what that meant for medical students and how it could be adapted going forward.

The pandemic helped cement the shift to a philosophy of really focusing on the role of the physician in reasoning through ambiguous and unknown problems as the focus of education, rather than teaching students that the role of physician was to memorize a body of knowledge that was already in existence and good enough for what usually happens, Dr. Lucey said. Thats a really important philosophic difference. The first approach really creates physician problem-solvers who are capable of addressing both enduring and emerging threats to health.

Learn how med schools used 3 learning models to keep students on track during COVID-19.

When the physician workforce proved to be overwhelmed in certain hot spots, states called on medical schools to graduate their fourth-year students months early to help bolster the response. The measures required navigating somewhat cumbersome red tape but demonstrated that move could be an option in the future.

The pandemic showed us an example of why we need to think about early graduation for our students, and it showed us all the hurdles we will need to jump over to do it, Dr. Lucey said. Its a shock to the system that asks the question: if we are willing to attest that our students are competent to graduate early in the pandemic, could we not also do so as a matter of usual practice?

Find out how a med school in a COVID-19 hot spot deployed early graduates.

The pandemic caused the cancellation of most away or visiting rotations. That could create a more level playing field going forward, since not all students can access such experiences.

The opportunity to go around the country and do audition rotations is a clear legacy practice, Dr. Lucey said. When you talk with people about it, its not clear who it benefits the most. Does it benefit the students or the programs?

In spite of the absence of away rotations, I dont believe that programs will see a big difference in the quality of that they recruit and match into their programs, Dr. Lucey said. As such, it is possible that we will be rethinking whether these rotations should be restarted next season.

Get four expert tips on how 2021 residency applicants can succeed with video interviews.

Medical schools were proactive in communicating expectations and restrictions with students. Going forward, Dr. Lucey envisions a more dedicated approach to student outreach during turbulence. She pointed to the civil unrest surrounding police brutality that took place on the heels of the pandemic as a potential example of a time in which that new approach had paid off in medical education.

It created another really existential disruption to the way many of our learners were approaching their education, Lucey said. Our faculty of color and students of color, and the allies that work with them, were really shaken to the bone by this vivid reminder of the elements of structural racism that exist within our communities. In situations like this, leaders of educational programs need to be facile with crisis communication strategies that support all stakeholders during these crises.

Consider how to support diverse learners during disruption.

The AMA has curateda selection of resourcesto assist residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.

Link:

5 ways the pandemic may transform medical education - American Medical Association

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The doctor whos been treating President Donald Trump for the coronavirus has roots in Philadelphia. Its where he trained in medicine.

Dr. Sean Conley, the 40-year-old whos been at the forefront of national health updates lately, has been the presidents physician for two years. He grew up in Doylestown, and graduated from Central Bucks High School East in 1998. His medical degree comes from the Philadelphia College of Osteopathic Medicine.

The Philly higher ed institution is not your average medical school. Turns out Conley doesnt actually have an MD degree.

Instead, hes a DO a doctor of osteopathic medicine. With that certification, Conley can do everything a regular doctor can do, like prescribe medicine and perform surgery in all 50 states.

The training is different in that it takes a more holistic look at the body than traditional medicine. It emphasizes primary care, and practices that encourage the body to heal itself rather than the immediate prescription of medicine or use of surgery to correct problems.

At first, the practice was highly controversial. During the first decade of PCOMs existence, it wasnt even legal in Pennsylvania. Over the next two centuries, debates over osteopathy continued, with traditional physicians critiquing its more controversial practices like the in the late 1800s idea to shake a child to cure scarlet fever.

In recent years, the stigma has mostly dissolved as the training and practice have themselves become more legit. Now, earning a DO degree requires the same training as an MD, plus extra coursework.

Conleys Philly alma mater is considered a pioneer in the field, and helped see it through to the modern day.

The first person to bring osteopathic medicine to Philadelphia was a woman named Clara Martin. In 1899, the city directory listed her as an osteopath, working from an office on 67th Street near the Cobbs Creek Parkway, just south of Mount Moriah Cemetery.

That same year, two physicians named Snyder and Pressly founded what would become PCOM, then called the Philadelphia College and Infirmary of Osteopathy.

Philly was experiencing a general boom in medical institutions right then, notes a published history of the school called To Secure Merit, by Carol Benenson Perloff. Episcopal Hospital, German Hospital (now Lankenau), Jewish Hospital (now Einstein Medical Center) and Presbyterian Hospital were all founded between 1849 and 1882.

PCOM first opened at 12th and Market, filling two rooms inside a 13-story office tower. Within a year, it outgrew that space and relocated to the Witherspoon building at Juniper and Walnut.

Enrollment kept growing. Many students were people inspired by seeing osteopathic doctors step in after traditional medicine had failed.

Alum Arthur Flack, who graduated in 1906, said he got interested when he saw osteopathic medicine helped cure cases of typhoid fever amid an epidemic in his hometown of Butler, Pa.

When I first became a studentmy marvel was as to the intense devotion manifested by the small group of physicians headed by you, Flack said in 1925, according to Perloffs book. Without such sincere devotion, Osteopathy today would be only a memory in Pennsylvania.

Thing is, osteopathy wasnt even legally recognized when PCOM first opened its doors.

The first attempt to legalize it in Pennsylvania passed through the state legislature in 1905, but was vetoed by then-Governor Pennypacker. It wasnt until 1909 that a Governor Stuart signed the bill to allow osteopathic doctors to apply for state licensure, 10 years after the Philadelphia college was first founded.

Licensing made the practice more popular, and PCOM continued to outgrow its facilities. The school moved to Spring Garden Street, then to 33rd and Arch, and eventually to North Broad Street.

Some drama: Before the legalization of osteopathy, the college had raised about $3,000. But the founders continued not to pay faculty with actual money for their teaching they compensated them only with stock in the school.

In 1904, faculty started demanding payment. The founders refused, and there was a theatrical back-and-forth in which the schools deans threatened to resign unless the two founders resigned. Shockingly, both founders did resign, and a board of trustees was established that still exists today.

By 1910, PCOM was considered a pioneer when it became one of the first to adapt to new statewide legalization requirements, and create a four-year program, which it maintains to this day.

After those gazillion relocations and expansions, PCOM landed at its current campus on City Avenue at the Bala Cynwyd border.

The school currently has almost 2,000 students, across areas of study like clinical psychology, biomedical sciences and forensic medicine. Like osteopathic medicine schools nationwide, its really tough to get in. In 2019, nearly 7k students applied for just 441 spots in the program.

Dr. Conley, Trumps doctor, has a degree that takes four years to complete. The first two are spent learning basic and clinical sciences, and the second two doing hands-on work in teaching hospitals.

While enrolled, the Bucks County native likely got plenty of Philly experience, since students spend four months working in city neighborhoods at PCOMs Community Healthcare Centers.

After their four years, some students declare a specialty and spend more time in school. PCOM reports that a majority of its grads end up in family medicine, general internal medicine, OB/GYN or pediatrics.

In general, osteopathic medicine has grown in popularity in recent years seen as a more hands-on version of health care. DOs work to understand how all parts of the body are connected, and take a major focus on preventative and primary care.

An osteopathic medicine student in New York told the New York Times in 2014 she became interested in the practice after a standard MD said shed need surgery to correct her chronic ear infections but then she went to a DO, who corrected the problem by stretching her neck, she said.

The infection happened because of fluid in the ear, said the student, Gabrielle Rozenberg, and the manipulations opened up the ear canal.

The practice has become widespread enough that PCOM has opened two more campuses, both in Georgia. According to the American Association of Colleges of Osteopathic Medicine, about 25% of all medical students today are training at an osteopathic school.

See more here:

Trump doctor Conley degree from Philadelphia College of Osteopathic Medicine: What it means - On top of Philly news - Billy Penn

Throughout its 208-year history, The New England Journal of Medicine has remained staunchly nonpartisan. The worlds most prestigious medical journal has never supported or condemned a political candidate.

Until now.

In an editorial signed by 34 editors who are United States citizens (one editor is not) and published on Wednesday, the journal said the Trump administration had responded so poorly to the coronavirus pandemic that they have taken a crisis and turned it into a tragedy.

The journal did not explicitly endorse Joseph R. Biden Jr., the Democratic nominee, but that was the only possible inference, other scientists noted.

The editor in chief, Dr. Eric Rubin, said the scathing editorial was one of only four in the journals history that were signed by all of the editors. The N.E.J.M.s editors join those of another influential journal, Scientific American, who last month endorsed Mr. Biden, the former vice president.

The political leadership has failed Americans in many ways that contrast vividly with responses from leaders in other countries, the N.E.J.M. said.

In the United States, the journal said, there was too little testing for the virus, especially early on. There was too little protective equipment, and a lack of national leadership on important measures like mask wearing, social distancing, quarantine and isolation.

There were attempts to politicize and undermine the Food and Drug Administration, the National Institutes of Health and the Centers for Disease Control and Prevention, the journal noted.

As a result, the United States has had tens of thousands of excess deaths those caused both directly and indirectly by the pandemic as well as immense economic pain and an increase in social inequality as the virus hit disadvantaged communities hardest.

The editorial castigated the Trump administrations rejection of science, writing, Instead of relying on expertise, the administration has turned to uninformed opinion leaders and charlatans who obscure the truth and facilitate the promulgation of outright lies.

The uncharacteristically pungent editorial called for change: When it comes to the response to the largest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not abet them and enable the deaths of thousands more Americans by allowing them to keep their jobs.

Scientific American, too, had never before endorsed a political candidate. The pandemic would strain any nation and system, but Trumps rejection of evidence and public health measures have been catastrophic, the journals editors said.

The N.E.J.M., like all medical journals these days, is deluged with papers on the coronavirus and the illness it causes, Covid-19. Editors have struggled to reconcile efforts to insist on quality with a constant barrage of misinformation and misleading statements from the administration, said Dr. Clifford Rosen, associate editor of the journal and an endocrinologist at Tufts University in Medford, Mass.

Our mission is to promote the best science and also to educate, Dr. Rosen said. We were seeing anti-science and poor leadership.

Mounting public health failures and misinformation had eventually taken a toll, said Dr. Rubin, the editor in chief of The New England Journal of Medicine.

It should be clear that we are not a political organization, he said. But pretty much every week in our editorial meeting there would be some new outrage.

How can you not speak out at a time like this? he added.

Dr. Thomas H. Lee, a professor of medicine at Harvard Medical School and a member of the journals editorial board, did not participate in writing or voting on the editorial.

But to say nothing definitive at this point in history would be a cause for shame, he said.

Medical specialists not associated with the N.E.J.M. applauded the decision.

Wow, said Dr. Matthew K. Wynia, an infectious disease specialist and director of the Center for Bioethics and Humanities at the University of Colorado. He noted that the editorial did not explicitly mention Mr. Biden, but said it was clearly an obvious call to replace the president.

There is a risk that such a departure could taint the N.E.J.M.s reputation for impartiality. While other medical journals, including JAMA, the Lancet and The British Medical Journal, have taken political positions, the N.E.J.M. has dealt with political issues in a measured way, as it did in a forum published in October 2000 in which Al Gore and George W. Bush answered questions on health care.

But it is hard to imagine such a deliberative debate in todays acrimonious atmosphere, said Dr. Jeremy Greene, a professor of medicine and historian of medicine at Johns Hopkins University.

The Trump administration, he said, had demonstrated a continuous, reckless disregard of truth.

If we want a forum based on matters of fact, it strikes me that no form of engagement could work, Dr. Greene added.

Read this article:

In a First, New England Journal of Medicine Joins Never-Trumpers - The New York Times

October 5 2020 - Allan R Tunkel, Senior Associate Dean for Medical Education and Chief of Medical Education at the Brown University Alpert Medical School, will be presenting, The Impact of COVID-19 on Medical Education on Thursday, October 8, 6-7:30 p.m.nPresented by the Palm Beach County Medical Society (PBCMS) as part of the annual Future of Medicine Summit, the event is free to participants, who may register at:

Started in 2007 by Jose Arrascue, MD, the Future of Medicine Initiative brings together community leaders to define issues, establish partnerships and implement strategies for change. At the annual Summit, national and community health care leaders gather to explore the "hot topic" issues facing healthcare.

He received a Ph.D in experimental pathology before earning a medical degree at the College of Medicine and Dentistry of New Jersey in Newark. He completed a Residency in internal medicine at the Hospital of the Medical College of Pennsylvania in Philadelphia and an Fellowship in infectious diseases from the University of Virginia Health Sciences Center in Charlottesville. He has been at Brown since 2013 and previously taught at the Drexel University College of Medicine for a decade.

For more information and the Future of Medicine, Contact Katherine Zuber at KatherineZ@pbcms.org or 561-433-3940.

Originally posted here:

Brown University Medical School Dean to Lead Second Session of Five-Part Virtual Future of Medicine Summit : SF STAT! - South Florida Hospital News

A MEDICAL school has become the first in the UK to live-stream a human dissection as part of a new virtual teaching technique.

Year two and medical neuroscience students at Brighton and Sussex Medical School (BSMS) witnessed a brain being removed.

They also had an introduction session where they explored the muscles and bones of the chest.

Social distancing restrictions as a result of the pandemic have forced universities online, blending curriculum with a mix of face-to-face and virtual teaching.

Staff at BSMS have implemented a blended medical curriculum to ensure students still receive face-to-face teaching in key clinical area and also benefit from digital innovations to support their learning.

One of these innovations has been to bring the dissecting room, a highly regulated space, to students via streaming.

The procedure had been carefully planned, considering the Human Tissue Authority regulations, and only involved donors who had consented to the activity.

Professor Claire Smith, head of anatomy, said: In responding to the current restrictions, it remains imperative that medical and surgical teaching continues.

In anatomy teaching, Covid-related restrictions have been compounded by the medical school only receiving half the number of donated cadavers for teaching. We are so fortunate to have donors and my thoughts are always with those who have suffered loss at such a difficult time.

This new innovation has meant the donors wish to educate and inform future generations can still occur, albeit in a slightly different way.

It is not only medical students who are benefiting.

Last month, a week-long course was arranged by Dr Jag Dhanda, using the live stream to demonstrate surgical procedures on cadavers with virtual reality (VR).

Multiple camera angle perspectives in the virtual reality view were live-streamed to 350 surgeons from 26 countries around the world.

Surgeons were able to view the surgical techniques on cadavers through virtual reality headsets that allowed them to choose the camera angle perspective they wanted by moving their heads.

One student who attended the brain dissection said they gained a lot from the experience.

He said: Its definitely a learning curve with all the new tech tools, but I really felt that I gained incredibly valuable experience by being present during the session.

I know that I speak on behalf of all the medical neuroscience students when I say that we are very grateful for the opportunity to be included in something like this.

See the article here:

Human brain dissected live in front of medical school students - The Argus

When The New York Times, the Washington Post and news agencies across Maine have needed to understand the opioid epidemic and the policies emerging in response to it, they have often turned to a specialist in addiction medicine working in Portland, Dr. Mark Publicker. Unafraid to criticize redundant task forces and barriers to treatment, his advocacy led to better policy and saved lives, said those who learned of his impending retirement online.

As the pandemic complicates the more hidden challenge of addiction, Publicker, 70, will retire from his private practice at the end of the year, after 40 years in medicine. He recently spoke about his career and the changing upheavals of the opioid crisis. Today, synthetic opioids, including fentanyl, are the most common drugs involved in drug overdose deaths in the United States.

While people in Maine may have heard of drug dealers mixing deadly fentanyl with heroin, the public may not know that dealers are also increasingly mixing fentanyl with cocaine and fentanyl with methamphetamine and that methamphetamine use is rising, said Publicker, who is the past president of the Northern New England Society of Addiction Medicine. Given fentanyls potency, the drug combinations may be contributing to Maines increasing number of overdoses.

Indeed, deaths involving cocaine and methamphetamine have increased in the past few years, according to state figures. The vast majority of those deaths have also involved opioids such as fentanyl.

It complicates the crisis, Publicker said. It also makes expanding access to treatment and educating medical providers about addiction as important as its ever been, said Publicker, who is also a fellow of the American Society of Addiction Medicine and a diplomate of the American Board of Addiction Medicine.

The following is a transcript of a telephone interview with Publicker, of Gorham, on Monday, Oct. 5, which has been edited for length and clarity.

Erin Rhoda, BDN: I remember being in a community meeting several years ago. Someone had a question relating to addiction treatment, and someone else spoke up and said, Well, Maine has a top expert in that. Talk to Dr. Mark Publicker. How did you come to be an expert in addiction medicine?

Mark Publicker: I started my career as a family physician in a nonprofit HMO in Pittsburgh. It was in a community of steelworkers, and they had a whole range of medical signs and symptoms. They had evidence of liver disease. They had blood pressure that was hard to control, gout. And my thinking was it was evidence of industrial poisoning that nobody else had identified. I was quite excited by this. And somebody loaned me a book about alcoholism in doctors. I woke up after reading it, slapped my forehead and said, Oh my God, half my patients are alcoholic. Now what do I do? It just so happened the doctor who wrote the book was one of the countrys first addiction psychiatrists, and he was practicing in Pittsburgh. So I went to see him.

He told me I should go to [Alcoholics Anonymous] meetings, which was hard for me being a non-alcoholic doctor. I went, and I started to recognize and understand more about alcoholism. I started to talk with my patients about my concerns and encourage them to go to meetings themselves, and initially I would go to meetings with them, which is something I wouldnt recommend doctors to do now. About six months later I started to get God bless you letters from patients and their families. I went, Wow, diabetics never sent you God bless you letters.

That was that. I began to study, got involved in the countrys foremost addiction medicine society, developed an addiction treatment program for this HMO, got certified in addiction medicine and was recruited from Pittsburgh to Washington, D.C., to develop Kaiser Permanentes addiction treatment program. I was there for 10 years. Mercy Hospital recruited me here.

Even though Im in Portland, the vast majority of my patients are from midcoast or Down East, and I can name every single little town on the midcoast where I have a patient coming from. I have got some people coming as far away as Machias. Theyre lobstermen, and theyre oystermen, and theyre blood wormers, clammers. And then land-based patients, roof and carpentry.

My patients recovery just belies with what peoples beliefs are about people with addictive histories. These guys go out in the middle of the Gulf in January to fish. If the lobsters arent there, theyre roofing. And if theyre not roofing, theyre doing carpentry. If theyre not doing carpentry, theyre doing hardscaping.

Weve [my wife and I] lived in a lot of places we figure 10 places in our marriage. Ive never seen a work ethic like this. I have these frankly wonderful patients, and its hard now for me to be starting this process of saying goodbye to them.

ER: As a doctor at a family medicine practice in Pittsburgh in the 1980s, how did addiction manifest itself then compared with today?

MP: What happened in Pittsburgh is instructive because the steel industry collapsed, and, along with that, communities collapsed, and drugs came in. When communities and cultures are wounded, drugs are more likely to come in.

What weve seen is a trend from primarily alcohol dependence in the country, to cocaine and prescription opiates, followed by intravenous heroin, supplanted by intravenous fentanyl.

Now the scary thing that were facing is increases in combinations of fentanyl with cocaine, and fentanyl with methamphetamine. What the cartels are doing is combining fentanyl with cocaine. People may not be aware that theyre using fentanyl, which may be one of the reasons that can account for the increase in overdose death rate over the last year or so.

In this state weve been largely spared methamphetamine. But no longer. Over the last year and a half its flooded into the state. The drug problem is quite severe and not showing any signs of slowing. In the midst of all of this, hidden, is high rates of alcohol dependence. Attention to it has been orphaned by the prescription opiate epidemic. It definitely kills more people per year than opiates do.

ER: I hadnt heard about the increased mix of fentanyl and methamphetamine.

MP: Its interesting because at noontime today we just had a presentation that was given by Millennium labs, which is one of these reference labs. The September 18 issue of JAMA [the Journal of the American Medical Association] published the results of their surveys of their lab results, from not only Maine but across the country. What theyre showing are like 300 percent increases and 400 percent increases in drug screens positive for fentanyl plus methamphetamine or fentanyl plus cocaine.

The study that was done compared pre-COVID and post-COVID. So post COVID is when these rates of co-occurring drug use have exploded. Its likely stress, unemployment, the circumstances that tend to increase drug use.

ER: When you first started treating people for their alcohol use disorder, it sounds like you werent formally taught how to talk to and treat people with alcoholism, and later sought out training yourself.

MP: To this day there is little to no formal education of medical personnel on addiction. Its rare to find any real coursework in medical school. Residencies have very little, and medical schools have been resistant to introducing significant curriculum to address the deficits. If you think about what are the major causes of preventable morbidity and mortality, theyre addictions. Its anything from nicotine to alcohol to opiates and benzos.

The most interesting thing Im doing these days is participating in this project with the Lunder-Dineen foundation. [It] is an alliance to teach Maine health professionals on a variety of topics, everything from dental health to care for the elderly. Theyd approached me about six years ago, asking me for a suggestion for a project for addiction. My proposal was to help teach medical professionals how to initiate and have conversations with their patients about their concerns about their drinking.

Its not simply a matter of writing a prescription. How do we talk with people? If you have a concern about your patients alcohol, how do you approach that? This is a major project with project managers from Mass General. Its a five-year project. Its being piloted now in seven health centers, federally qualified centers around the state. This is all in Maine.

ER: Tell me more about how you learned to respond to people and how your initial experiences affected how you later developed addiction treatment programs.

MP: The first thing I learned is that treating people with care and respect allows patients to not respond defensively but at least to allow you to have a conversation to express your concerns. Contrary to my fear initially that if I spoke with patients about my concerns they would become angry, instead [what I found is] they might not agree, but I was able to continue expressing my concerns and, over time, get people to change.

There are a number of behavioral tools that are extremely effective in helping people become motivated to change. Not just change addictions, but it could change almost any behavior. I wish I had thought about using it with my teenagers when they were in school. Its called motivational interviewing. The principles are expressing empathy, not arguing, avoiding confrontation, emphasizing self-efficacy.

This was contrary to the old concept of treating addictions by confronting people and causing them to feel debased in order to build up their new selves. This was a revolutionary concept. It was one of the things that I did training and ultimately taught, was the use of this technique called motivational interviewing, which is now I think regarded as central to treatment.

ER: Mercy Hospital in Portland recruited you to be the medical director of the hospitals recovery center in 2003, and you helped develop a maternal addiction program there. Youve called it perhaps the most rewarding thing in your career. What was the work like?

MP: We recognized that we were seeing a lot of pregnant women coming into our detox unit. This is opiates. We kind of asked ourselves, Well, what are we doing? We have all these pregnant women. We need to come up with some formal way to treat them. So a number of us got together. Twenty-four hours a day, if a woman came into the recovery center, we would admit them to our inpatient unit, assess them, give them treatment options, generally begin them on buprenorphine [a medication used to treat opioid use disorder].

[Then wed] discharge, transition them into our partial hospital program, which was six hours a day, five days a week; then move them into our intensive outpatient treatment program, which was three hours a day, five days a week; then ultimately into a group we called the Moms Group that met for an hour-and-a-half every week with a counselor and a nurse, with participation of one of the three addiction doctors at the recovery center.

We would encourage women to continue in the group after they gave birth, so we had mothers breastfeeding, and we had babies crawling on the floor. We had peer support through that. It was wonderful.

My wife first started out by knitting baby outfits and then developed her own diaper bags that women still cherish. I still hear from them. Its very gratifying. I dont think I ever did anything that gave me as much professional satisfaction and pride as working at the moms program.

ER: Mercys recovery center closed in 2015 because it was losing money. How did you feel?

MP: Everyone who was working there was, I think, heartbroken. We were sad because we had a tremendous program. We understood why Mercy did it. Nonetheless it was a major loss. I would have worked there for the rest of my career. But along with it, our mothers program ended. I think we all wished that had continued.

At that point I was 65 and had always worked for nonprofit organizations, and suddenly I didnt have a job. I made the decision that I was going to go into private practice, which has been successful, but its not as gratifying as working with a group of people and a program.

ER: When you opened your own private practice in Portland, what did you learn about the needs of the state of Maine from your patients?

MP: Maybe 75 percent or more of my patients are uninsured. So even though MaineCare was expanded, Ive got a population of working people who dont have health insurance who make too little to qualify for the ACA [Affordable Care Act] and too much to qualify for MaineCare. Ive got a lot of patients who are uninsured, which severely limits their access to treatment.

Much of the treatment in the state is based on participation in outpatient treatment programs. There are patients who have been sober for years who dont need to be in group. For certain populations who are working people, a requirement that people participate in a group is a real impediment to access to care. If youre a lobsterman, and in order to get your prescription you have to show up at a group on a Thursday afternoon, for example, but your captains going out, youre not going to that group, and youre not going to get your prescription. That serves as a barrier.

ER: I was looking back through some of my emails. In 2016 you wrote to me, virtually everything that is being proposed or done is wrong in Maine when it came to combating the opioid epidemic. One thing that youve fought for is the recognition of the science that medication helps people with addiction. Have you seen progress on this front?

MP: This is a significant issue. Weve got this action plan for the state. If you read it, what youll see is its based on buprenorphine. That to me is a major error.

[Asked about it, Gordon Smith, the states director of opioid response, said the administration supports all types of medications. The state has increased the MaineCare reimbursement rate for methadone, for instance, he said, and is pursuing additional methadone clinics.]

ER: How do the other Food and Drug Administration-approved medications, methadone and Vivitrol, fill a gap that buprenorphine, commonly known by its brand name Suboxone, cant?

MP: Not everybody can manage a prescription medicine. Some people do better with greater structure. Adherence rates may be better for somebody on methadone.

What can happen and what often happens is, somebody continues to use opiates or is unable to stop while on buprenorphine, and theyre discharged. Theres no understanding that there are alternatives that you can offer to people other than simply to discharge them.

We know that methadone has been proven to be effective since the 60s. It should be part of our armamentarium. It also allows us to expand access to care. Vivitrol, which is an injectable form of the drug naltrexone, has also been shown to be very effective. All of the medications that are FDA approved should be part of our opiate response.

ER: As you know, the number of drug deaths rose in Maine as the pandemic shut everything down. What are your words of advice for what the state should do to slow the rate of death?

MP: It would be wonderful if I had the solution to this problem, which I dont. Let me start with that earned humility. No, I dont have an answer to this other than to recognize that our treatment programs may be so focused on opiates that we are forgetting that there are other drugs that may need to be addressed. Ill say this in regards to alcohol as a co-factor in deaths treatment isnt really available.

When I say to you, Gee, we have this tremendous increase in co-occurrence of fentanyl and methamphetamine, your answer is, I didnt know that. The knowledge that we have this problem isnt known yet, and that knowledge needs to be expanded. The fact that we have a methamphetamine epidemic is probably still not widely known. But we do. Cocaine is still prevalent.

The problem is more difficult, more complex and more resistant to solutions. I think we ought to try to solve what we can. Effective medication management is one such way, but that needs to be expanded to all medications.

If you look at the states action plan, education isnt part of it. In general, broader education of Maine health practitioners on addiction would improve our response to the epidemic. It should be included in our action plan.

[While we have not prioritized the education of future medical professionals on addiction, both medical schools have adopted new curriculum doing just that, said Smith, with the state. Plus, several family medicine residency programs are requiring all of their residents to get the needed approval to provide medication-assisted treatment, he said.]

ER: Maybe you could talk about why you decided to retire, and how you feel about it.

MP: Ive been debating this now for a year and a half. While there are a lot of rewards from private practice, it also has limited my ability to do things that I enjoy such as teaching and volunteering in the community.

Its time for me to figure out something else in addition to only practicing medicine for 40 years. Im not giving up medicine, but Im definitely moving to another stage in my life.

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After 40 years in medicine, here's what a Maine addiction expert has learned about alcohol, opioids and public health - Bangor Daily News

As if the situation surrounding Donald Trumps case of the coronavirus couldnt get any less predictable, it turns out that the presidents personal physician whos been under fire for telling apparent lies (go figure) graduated from the same medical school from which Dr. Umar Johnson earned his much-maligned doctorate.

That fact was an interesting twist to an already convoluted story centered onDr. Sean Conley, who has given the media conflicting reports about Trumps treatment (in other words, he lied) and has been accused of following the White Houses script to paint an optimistic picture of the presidents health that admittedly wasnt completely accurate.

While the fact that Conley and Umar Johnson both graduated from the Philadelphia College of Osteopathic Medicine is one tie that binds the two, the doctor of osteopathic medicine (D.O.) and his weekend of lying bore similarities to his doctor of clinical psychology counterpart, who has also been accused of telling lies albeit their lies having different degrees of urgency. (Yes, thats right, the presidents physician is not an M.D., or medical doctor.)

Conley admitted Sunday to lying a day before when he downplayed Trumps health prognosis to reflect the upbeat attitude that the team, the president, that his course of illness has had. Conley explained to reporters that he lied because he didnt want to give any information that might steer the course of illness in another direction.

Johnson, for is part, never really lied, per se, as much as just flat-out misrepresented himself as a doctor for years before earning his PhD in 2012. However, hes been accused of lying about raising money to purportedly build a school for Black boys. Hes reportedly helped raise hundreds of thousands of dollars (other rumors say as much as $1 million) in donations forthe construction of a schoolthat he seemingly never intended to build. For the record, he has insisted otherwise, as shown during the epic episode of NewsOne Now with Roland Martin from two summers ago.

Black Enterprise reported in 2014that Johnson launched an initiative to fund an all-Black boys school. At the time, Johnson said he was gaming to raise $5 million to buy St. Pauls College, an HBCU in Lawrenceville, Virginia, and convert it into a boarding school for young African American boys.

Five years later, Johnson announced in a video that he had finally raised the funds to buy property in Wilmington, Delaware, to house the Frederick Douglas Marcus Garvey Academy (FDMG).

However, Johnson said in a Labor Day video that he still needed money for the renovation of FDMG Academy. He said he already has the architectural plan but still needs money to pay for the electrician and HVAC and the fire alarm and the sprinkler company.

Conley, for his part, came under scrutiny in May for treating Trump with the drug hydroxychloroquine purportedly as a preventive measure against contracting the coronavirus despite medical studies suggesting the anti-malaria medication could be fatal and futile against Covid-19.

Still, Conley said at the time, he and Trump concluded the potential benefit from treatment outweighed the relative risks.

Five months later Trump is battling the coronavirus without any true indication of how severe it is both are no thanks to Conley and Johnsons school for Black boys remains unbuilt.

SEE ALSO:

Trump Has The Coronavirus: What His Pre-Existing Health Conditions Mean In The Long, Or Short, Run

Trump Planned To Use Black Woman As A Prop During Debate Before Racist Meltdown

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Trumps Lying Personal Physician And Dr. Umar Johnson Went To The Same Med School - News One

With growing interest in its potential health benefits and new legislation favoring legalization in more states, cannabis use is becoming more common among older adults.

University of California San Diego School of Medicine researchers report that older adults use cannabis primarily for medical purposes to treat a variety of common health conditions, including pain, sleep disturbances and psychiatric conditions like anxiety and depression.

The study, published online October 7, 2020 in the Journal of the American Geriatrics Society, found that of 568 patients surveyed, 15 percent had used cannabis within the past three years, with half of users reporting using it regularly and mostly for medical purposes.

Pain, insomnia and anxiety were the most common reasons for cannabis use and, for the most part, patients reported that cannabis was helping to address these issues, especially with insomnia and pain, said Christopher Kaufmann, PhD, co-first author of the study and assistant professor in the Division of Geriatrics and Gerontology in the Department of Medicine at UC San Diego.

Patients surveyed in the study were seen at the Medicine for Seniors Clinic at UC San Diego Health over a period of 10 weeks.

The researchers also found that 61 percent of the patients who used cannabis had initiated use after age 60.

Surprisingly, we found that nearly three-fifths of cannabis users reported using cannabis for the first time as older adults. These individuals were a unique group compared to those who used cannabis in the past, said Kevin Yang, co-first author and third-year medical student at UC San Diego.

New users were more likely to use cannabis for medical reasons than for recreation. The route of cannabis use also differed with new users more likely to use it topically as a lotion rather than by smoking or ingesting as edibles. Also, they were more likely to inform their doctor about their cannabis use, which reflects that cannabis use is no longer as stigmatized as it was previously.

Given the rise in availability of CBD-only products, which is a non-psychoactive cannabinoid in contrast to THC-containing products, the researchers said it is likely that future surveys will continue to document a larger proportion of older adults using cannabis or cannabis-based products for the first time.

Alison Moore, MD, chief of the Division of Geriatrics in the Department of Medicine at UC San Diego School of Medicine.

The findings demonstrate the need for the clinical workforce to become aware of cannabis use by seniors and to gain awareness of both the benefits and risks of cannabis use in their patient population, said Alison Moore, MD, senior author and chief of the Division of Geriatrics in the Department of Medicine at UC San Diego School of Medicine. Given the prevalence of use, it may be important to incorporate evidence-backed information about cannabis use into medical school and use screening questions about cannabis as a regular part of clinic visits.

The researchers said future studies are imperative to better understanding the efficacy and safety of different formulations of cannabis in treating common conditions in older adults, both to maximize benefit and minimize harm.

There seems to be potential with cannabis, but we need more evidence-based research. We want to find out how cannabis compares to current medications available. Could cannabis be a safer alternative to treatments, such as opioids and benzodiazepines? Could cannabis help reduce the simultaneous use of multiple medications in older persons? We want to find out which conditions cannabis is most effective in treating. Only then can we better counsel older adults on cannabis use, said Kaufmann.

Geriatrics at UC San Diego Health was recently ranked thirteenth in the nation in the 2020-2021 U.S. News & World Report survey. The geriatrics and gerontology team at UC San Diego Health is committed to providing top quality, evidence-based care to older adults.

Co-authors of the study include: Reva Nafsu, Ella Lifset, Khai Nguyen and Michelle Sexton, all at UC San Diego; and Benjamin Han and Arum Kim, New York University School of Medicine.

Funding for this study came, in part, from the National Institutes of Health (T35AG26757, K01AG061239, P30AG059299, K23DA043651), the Stein Institute for Research on Aging, the Center for Healthy Aging and the Division of Geriatrics and Gerontology at UC San Diego.

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Study Finds Older Adults Using Cannabis to Treat Common Health Conditions - UC San Diego Health

States should require doctors to seek informed consent before performing pelvic exams on anesthetized women.

More than three quarters of U.S. states do not require a womans consent before a doctor conducts an invasive procedure on her genitalia. State action is needed to curb the widespread practice of doctors performing pelvic exams on non-consenting women who are under anesthesia for other, non-gynecologic medical care.

Although medical codes of ethics emphasize the importance of obtaining consent before providing patient care, testimony from both patients and medical professionals shows that the troubling practice of unconsented gynecological examinations has existed for at least several decades.

A 2003 study of five Philadelphia area hospitals indicated that medical students completing fellowships on womens reproductive care were less concerned than other doctors with seeking consent for medical procedures. The study also revealed that 90 percent of students surveyed in these fellowships had apparently performed a pelvic exam on an unconscious, anesthetized woman without securing her consent.

One of the studys coauthors, Ari Silver-Isenstadt, became wary of this practice during his time as a medical student at the University of Pennsylvania. According to Silver-Isenstadt, an individual reported him to the medical schools dean for his efforts to avoid performing pelvic exams on women under anesthesia. Silver-Isenstadt had to make a personal arrangement with the dean to ensure he could avoid the practice and not flunk his course.

A pair of 2018 articles by biomedical ethicist Phoebe Friesenone scholarly article in the journal Bioethics, and an article for general audiences in Slatedrew an additional round of attention to the doctors performing pelvic exams on unconscious female patients without their consent. These articles inspired the hashtag #MeTooPelvic and have sparked a spate of investigative journalism reports published in early 2020.

Before 2019, only six states legally required that doctors seek informed consent to perform a pelvic exam. Five additional states passed bills in 2019 to require consent for the procedure, bringing the current total to just 11 states as of this spring.

To ensure that medical professionals conduct pelvic exams on explicitly consenting individuals, states have passed laws regulating the procedure. For example, California passed such a law in 2003. It requires that physicians, surgeons, and medical students obtain informed consent to perform a pelvic exam on an anesthetized or unconscious female patient. Otherwise, the patients pelvic exam must fall within the scope of care for treatment, or be necessary for an unconscious patients diagnosis. California also made breaking this law a crime.

Laws passed in other states contain similar language on pelvic exams, but do not always make violating the law a crime. For example, Marylands 2019 legislation requires that medical workers obtain informed consent before performing a pelvic exam on patients while they are under anesthesia or unconscious. The only consequences for breaking Marylands law, however, will be those meted out by a professional board housed in the Maryland Department of Health. The board can only punish violators through formal reprimands, probation, or the suspension or revocation of professional licenses.

Protecting female patients requires legislative action because women hoping to prevent the practice on their own face backlash. After a doctor performed a pelvic exam on a Wisconsin woman while she was under anesthesia for a 2009 abdominal surgery, the woman sought to prevent the same incident from happening during a 2018 procedure. She reportedly asked to draft a consent contract to prevent a pelvic exam, but hospital administrators told her to seek medical care somewhere else.

The reality is that pelvic exams on unconscious, non-consenting patients are not necessary. Doctors and medical students already have an existing system of knowledgeable, consenting, and conscious people on which they can practice pelvic exams. Female Genitourinary Teaching Associates (GUTA) are trained to guide health care trainees through sex-specific physical exams, and they use their own bodies as a demonstration and practice model.

Thirty-nine state legislatures are woefully late in recognizing that womens rights are not protected when they go into surgery. These states need to pass legislation to protect female patients from a practice and system that seems unconcerned with invading the most intimate parts of a persons body.

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My Body, Whose Choice? - The Regulatory Review

DULUTH, Minn. Researchers at the University of Minnesota Medical School Duluth are reporting they have found traces of the COVID-19 virus in water from four area beaches.

The group has been taking samples from eight local beaches since July.

Researchers have found evidence of the genetic makeup of the COVID-19 virus at Leif Erikson, Park Point, Brighton, and 42nd Avenue beaches between the weekend of September 11th and 18th.

It is still unclear where the source or sources are coming from, but experts say testing samples might help answers some unresolved questions about COVID-19 in the area.

By watching for its presence may be able to show how long it stays or if it goes away. It will help understanding lake processes and levels of infection, said Dr. Richard Melvin, assistant professor of Biomedical Sciences. All of those things will help us find out how the virus ends up in the water.

U of M Medical School researchers will be continuing to monitor and take samples from all beaches for the next four to eight weeks.

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U of M Medical School Researchers Found Traces Of COVID-19 On Beaches - FOX 21 Online