Eliminating medical student-loan burdens for future physicians with financial needs can create a more diverse medical school applicant pool, student body and health care workforce, says a JAMAHealth Forum article examining the impact of efforts at a New York medical school.

The article, "Debt-Free Medical EducationA Tool for Health Care Workforce Diversity," looks at Weill Cornell Medicine's commitment to making medical education debt-free, which started in 2019, and the early results that it has produced.

To understand the impact of this program on the incoming Class 2024, Weill Cornell compared medical student applicants and matriculants in 2020 with those from the 4 previous years (2016-2019). In 2020the first full admissions cycle in which the program was in placeWeill Cornell Medical College's applications rose 11%. "Among matriculating students we observed statistically significant increases in the percentage of students from groups underrepresented in medicine (from 20% to 29%)," wrote the authors, YoonKang,MD, and Said A.Ibrahim,MD, MPH, both of Weill Cornell Medicine.That equates to a 45% increase.

The state of debt

Cornell's program is being funded with an initial $160 million endowment. The article points out that additional funding will be necessary to keep the program intact in perpetuity.

The program's aim of eliminating medical student-loan burden is ambitious. Three out of four 2019 medical school graduates had debt, according to data from the Association of American Medical Colleges cited in the article. The median education-related debtincluding application fees, fees for testing and test preparation, and expenses for professional attire and travel to medical school and residency interviewswas $200,000, and those numbers were more daunting for certain underrepresented groups, with the article noting that "not only did a higher proportion of Black students graduate with debt (91% of Black students vs. 73% of all students), but the median debt was higher ($230,000 for Black students vs. $200,000 for all students)."

Learn how a record-setting gift may help tomorrow's Black physicians.

Addressing debt, physician representation

Cornell's program aims to offer all attendees a debt-free education. Although many schools have offered full tuition scholarships to under-represented students, Cornell's debt-free program goes a step further to include costs of attendancetuition and living expenses, such as housing and health insurance. A survey of students entering the medical school indicated that they were aware of the program and counted it as a factor in their decision to apply.

About three-quarters of incoming students in Cornell's most recent class qualified for the debt-free program, which is based on financial need. The authors offered the early returns on the program as, at the very least, anecdotal evidence that debt-free medical education can help meet the needs of the patient population.

"Our preliminary observations indicate that the implementation of a debt-free medical education program for students with proven financial need might offer yet another potential approach to help to diversify medical school enrollment," the authors wrote. "This is an essential step in addressing socioeconomic and racial/ethnic disparities in health care."

The article's lead author said that decreasing the debt burden is a first step in expanding the diversity of the physician body.

"Effective diversification of the physician workforce requires a "long-lens" approach," said Dr. Kang, Cornell's senior associate dean for education. "We need increased focus on the early stages of the pipeline into medical school and increased diversification of the applicant pool."

Find out why this Black medical resident, a grandfather, worked many years as mechanic.

Making physician diversity a priority

The AMA is looking to address physician diversity on several fronts. The AMA Accelerating Change in Medical Education Consortium has worked with Morehouse and other member medical schools to share strategies for enhancing recruitment, fostering viable pathways into medicine, promoting holistic admissions processes and creating inclusive learning environments. The ultimate goal is to generate a physician workforce that more closely resembles that of the nation.

The group has shared a process ofinstitutional diversity and inclusion self-studyand issued a statement toprotect diverselearners during educational disruptions related to COVID-19.

TheAMA Doctors Back to School program, meanwhile, introduces children to professional role models and shows kids of all ages from underrepresented racial and ethnic groups that a career in medicine is attainable for everyone. Learn more about the AMA Minority Affairs Section, which gives voice to and advocates on issues that affect minority physicians and medical students.

Launched last year, theAMA Center for Health Equityhas a mandate to embed health equity across the organization so that health equity becomes part of the practice, process, action, innovation and organizational performance and outcomes.

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How this New York medical school boosted diversity by 45% - American Medical Association

Veteran Duke scientist and executive R. Sanders Sandy Williams has been named interim Vice President for Research and Innovation effective February 1, President Vincent E. Price announced Thursday. He will succeed Lawrence Carin, who is leaving Duke to become the provost of King Abdullah University of Science and Technology in Saudi Arabia.

There are few people who know Duke as well as Sandy Williams, said Price. He has insight into every aspect of research at the university and Duke Health, from the laboratory bench to compliance and regulation, to the interface between academia and industry. I am grateful to Sandy for stepping back into a leadership role at Duke during this important transition period.

Price added that an international search for a permanent Vice President for Research and Innovation would be launched during the spring semester.

As interim Vice President, Williams will work closely with Provost Sally Kornbluth, Chancellor for Health Affairs A. Eugene Washington, deans and faculty to oversee a wide rangeofservices and activities, includingformulation ofresearch policy, compliance, scientific integrity,government agency interactions, the Office of Licensing and Ventures and coordination of research across the institution.

One of the countrys leading physician-scientists and biomedical executives, Williams most recently served as president of the Gladstone Institutes in San Francisco and professor of medicine at the University of California at San Francisco from 2010 to 2018. His experience at Duke spans more than 50 years, including service as professor of medicine, Dean of the Duke School of Medicine and founding Dean of the Duke-NUS Medical School in Singapore.

A graduate of Princeton and the Duke School of Medicine, Williams has also been chief of cardiology at University of Texas Southwestern Medical Center and held fellowships at Duke, Massachusetts General Hospital, Oxford University and Cold Spring Harbor Laboratory. He is on the board of Amgen, Laboratory Corporation of America, and several early-stage biotechnology companies.

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Former Medical School Dean R. Sanders Williams Named Interim Vice President for Research and Innovation - Duke Today

Jaila Campbell, seen here as part of the Warrior Strong campaign, is a Wayne State University medical student and a graduate of the Post-Baccalaureate Program.

February is Black History Month through the United States. The Wayne State University School of Medicine has a storied history of African Americans of its own that dates back to a mere year after the medical school was founded. Joseph Ferguson, M.D., graduated from what was then Detroit Medical College, in 1869. He became the first Black man in Detroit and most likely in Michigan to earn a medical degree.

Fast forward more than 150 years, and the school hit another milestone in 2019 the 50th anniversary of the Post-Baccalaureate Program, founded in 1969 to ensure that qualified minorities continued to have the opportunity to enter medical school. It was the first of its kind in the nation. Initially launched to address the dearth of Black students entering medical schools, the free program immerses students into a year-long education in biochemistry, embryology, gross anatomy, histology and physiology. Many who graduated from the program were accepted into the WSU School of Medicine, but the program also served as a major pipeline for Black students into medical schools across the nation. Today, the program accepts students from a category deemed underrepresented in medicine, which includes African Americans, Hispanic/Latino, Native American and students from socio-economically disadvantaged backgrounds.

In between, the school continued to play a major role in addressing the physician workforce in America and bridging the gap in health disparities and health outcomes.

The WSU School of Medicine was founded in 1868 by four Civil War veteran physicians. At the same time, the first medical school in the county that was open to all people, Howard University Medical Department, opened in Washington, D.C., under the direction of Civil War veteran and Commissioner of the Freedmens Bureau, Gen. Oliver Howard. One year later, in 1869, the Detroit College of Medicine and Howard University graduated their first Black physicians.

Albert Henry Johnson, M.D., became the third Black graduate of the Detroit College of Medicine, in 1893. Dr. Johnson was one of the founders of Dunbar Hospital, the first Black non-profit hospital in Detroit.

In 1926, Chester Cole Ames, M.D., graduated from the Detroit College of Medicine and Surgery. He was the first Black physician to obtain an internship in Urology at a white hospital in Detroit, but he was never allowed to join staff. Dr. Ames was Detroit's first Black intern, resident and member of the Wayne University medical faculty. He cofounded three Black hospitals in Detroit, but was never granted privileges to practice his specialty in white hospitals.

Some 17 years later, Marjorie Peebles-Meyers, M.D., graduated from the Wayne University College of Medicine, the schools first Black female graduate. She was also the first Black female resident at Detroit Receiving Hospital, the first Black chief resident at Detroit Receiving Hospital, the first Black female appointed to the WSU medical faculty and the first Black female to join a private white medical practice in Detroit. After retiring, she began a second career as the first Black female medical officer at Ford Motor Co. World Headquarters. Dr. Peebles-Meyers received many awards and honors, including induction into the Michigan Womens Hall of Fame.

The same amount of time elapsed before Black physicians Thomas Flake Sr., M.D., Class of 1951; Addison Prince, M.D.; William Gibson, M.D.; and James Collins, M.D., were appointed to the staff at Harper Hospital, thereby integrating the Detroit Medical Center hospital staff.

Only five years later, Charles Whitten, M.D.,became the first Black physician to head a department in a Detroit hospital when he was selected clinical director of Pediatrics at Detroit Receiving Hospital. He was also a founder of the aforementioned Post-Baccalaureate Program.

In 1981, Alexa Canady, M.D., became the first Black neurosurgeon in the United States. Dr. Canady went on to serve as professor in the WSU Department of Neurosurgery. She was named one of the countrys most outstanding doctors by Child magazine in 2001.

Around 1988, two School of Medicine students Don Tynes, M.D. 95, and Carolyn King, M.D. 93, -- established Reach Out to Youth to introduce children 7 to 11 in underrepresented populations to the possibility of careers in science and medicine. Since then, the hands-on, workshop- and activity-focused program has been presented annually by the School of Medicines Black Medical Association, a chapter of the Student National Medical Association.

In 1995, Professor of Pediatrics and Sickle Cell Detection and Information Center Founder Charles Vincent, M.D., was appointed to the Membership Committee of the American Medical Association, making him the first Black doctor appointed to the committee in the AMAs 147-year history.

In 2017, Cheryl Gibson Fountain, M.D., F.A.C.O.G., a 1987 graduate, was named the president of the Michigan State Medical Society. The obstetrician/gynecologist served a one-year term as the societys first Black female president.

Last November, an anti-racism educational effort led by School of Medicine Class of 2024 medical student Cedric Mutebi and third-year Internal Medicine-Pediatrics resident Selena Rodriguez, M.D., aimed at stopping racial disparities through reimagined medical education won a $10,000 grant from the Association of American Medical Colleges. The grant allowed the team to develop Healing Between the Lines, a sub-curriculum targeting upstream structural inequities that drive downstream disparities.

Today, the push for more diversity, more inclusion and the elimination of health disparities continue to shape the future of the School of Medicine, from student-led efforts to longitudinal research projects dedicated to the health of Black Americans.

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Black History Month: Monumental moments at the WSU School of Medicine - The South End

Due to the COVID-19 pandemic, the healthcare system has been strained to its limits as it attempts to accommodate a rapid influx of patients. Many hospitals are at or near capacity and facing issues related to understaffing. Meanwhile, a record number of pre-medical students submitted applications this year, hoping to one day join the medical field.

Medical school applications require both a rigorous course load as well as a slew of extracurriculars that often include research, clinical shadowing and volunteering. Additionally, and perhaps most importantly, students are required to take the Medical College Admissions Test, a seven-and-a-half-hour standardized test on science fundamentals.

The COVID-19 pandemic greatly disrupted every part of the application process with classes and volunteer opportunities shifting online. MCAT exams were canceled and the format of the exam was shortened to accommodate these circumstances.

In order to learn more about how the pandemic impacted pre-medical students, the Daily Wildcat spoke with junior physiology major and Alpha Epsilon Delta social chair Nadia Clarke about her experience navigating both a competitive application process and a global pandemic.

Daily Wildcat: Can you tell me a bit about where you are in your pre-med journey so far?

Nadia Clarke: Im a physiology major and a biochemistry and public health minor, so I do have a majority of my credits done. I plan to take the MCAT in March, so Im currently studying for that. After that, Ill be applying, and the deadline for applications is towards the end of June, so I have to have everything completed like my applications, my rec letters, my MCAT scores before then. Im currently volunteering. Im currently doing research, all that good stuff.

DW: How would you describe how COVID-19 has impacted your ability to build an application for med school?

NC: A lot of the things I participated in were canceled. For example, all the undergrads were kicked out of the lab I was working with. So that was a little hard to hear. Then, I know Banner [Hospital] shut down. Ive been volunteering at the hospital since I was a junior in high school.

Im currently volunteering at a clinic in South Tucson. Its called Clinica Amistad, and theres a lot more precautions, obviously. We have to separate appointment times a lot more, and were doing temperature checks, and now everyone does a COVID-19 questionnaire prior to coming in to check for symptoms.

Im also a volunteer at another Tucson organization called Tu Nidito. I work with kids who are either grieving the loss of a loved one or are trying to make sense of a diagnosis. We would go in and sit with these kids and give them an environment where they feel comfortable to be able to talk about death and the permanence of death. But now, with everything happening and since they are so high risk, we have to do it over Zoom.

That can be extremely difficult because they are kids. As college students its been difficult enough for us to sit in front of a classroom for an hour-and-a-half, but to make a three-to-six-year-old try to sit in front of a Zoom and talk about subjects such as death; thats been especially difficult and heartbreaking overall.

DW: Schools across the nation have transitioned to mostly online learning. Do you feel like this has affected your academic experience?

NC: Its been weird because there have been pros and cons to being on Zoom. For example, I can be in multiple places at once. I can be writing an email, and I can be in a Zoom meeting. That has actually helped greatly because Im taking 26 credits. So its been a lot easier to focus on multiple things at once. Especially being a premed, that was one of the biggest difficulties being in person like you cant be at multiple places at once.

But while it has been nice being flexible, it has also been difficult because Im not getting in-person instruction. To even go as far to how the medical school process has changed for applications, a lot of times if youre getting interviewed, we would have MMIs which are Multiple Mini Interviews.

We would go and you would act out scenarios with the person interviewing you. Besides your MCAT score and extracurriculars, the interview is such a huge factor in you actually getting into med school. So not being able to have that emotional connection does make it a little bit more difficult. Its not the same as being in person.

DW: Being in a pandemic, we are seeing a bit more of the perspective and struggles of health care workers. Do you think this has impacted your attitude towards health care professions and what you want to do?

NC: Its really opened my eyes to how little people care about the actual health of health care workers even though frontline workers are praised at the moment.

You go on social media, you go on all these platforms and you see people partying one moment, and then you see a healthcare worker crying that they have to hold the hands of someone dying. Its such a weird dichotomy.

I think its been really tough to see people who are premeds just also not care. Thats the weirdest part for me. You will see some people just blatantly not care about the fact that theres a pandemic despite them wanting to go into a healthcare field which is so contradictory.

DW: What has your quarantine experience been like?

NC: I currently live alone. Its been really hard to be in a constant environment where I have to keep focusing. Ive been here for the last year just stuck in one place.

What Ive found helpful is going to the medical library on campus. Obviously, theyre really following the strict CDC [Center for Disease Control and Prevention] guidelines. I think just changing up my environment every so often has really helped.

DW: Do you have any advice for pre-medical students that are feeling lost?

NC: Its been great how dynamic the healthcare field has actually been. I know over the summer, I participated in a few Zoom shadowing opportunities where you can go in and watch a health professional do their surgery. Coursera was offering courses for free, so you could go in and get a certificate regarding healthcare or public health.

Just finding those online resources and definitely being in contact with your advisors is helpful. Academically, if you want to do [a] small thing like declaring a minor, theres so many options, and that kind of gives you a bit of an edge.

Doing those small things really adds to your resume. One of the biggest things going into this cycle is [that] you cant just go in there and say, Well, it was the pandemic, so I couldnt do this.

Medical schools are flexible to a certain extent, but theyre not going to take that excuse. Theyre looking for the people who were able to adjust because thats what medicine is: learning to adjust and be flexible to whatever situation youre faced with.

For example, one thing that I did to counter the fact that I was not able to do research is I ran for social chair at AED. It has given me a level of leadership. All these things can accumulate into your application as examples of characteristics that schools want: hard work, drive and dedication. Thats what youre trying to portray, and theres so many ways you can do that. Yes, theres been a hindrance to the ability to do so, but theres always a way to work around that.

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Premed in a pandemic: The student perspective of applying to medical school in the age of COVID-19 - Arizona Daily Wildcat

The Wayne State University School of Medicine and Michigan Healthcare Professionals have announced an agreement that makes one of southeast Michigans largest multi-specialty medical groups the schools newest affiliate for the training of medical students.

The affiliation, launched Jan. 1, will see WSU medical students train with physicians in the 169 outpatient offices and diagnostic centers of Michigan Healthcare Professionals, which has more than 450 health care providers serving all the hospitals in the tri-county and metropolitan Detroit areas.

Wayne State Universitys 1,200 medical students, the largest class of medical students in Michigan, receive inpatient training in affiliated hospitals in southeast Michigan. Michigan Healthcare Professionals now expands critical training in outpatient settings.

We look to establish a national leadership in medical school-group practice affiliation that sets a new paradigm in health care training in outpatient settings with Michigan Healthcare Professionals, said Mark E. Schweitzer, M.D., dean of the WSU School of Medicine. This will be a national model for health care education. We anticipate that this affiliation will be further developed into a more comprehensive system that encompasses both medical school and residency training opportunities in the future.

It is a privilege to enter into this partnership with Wayne State, said Jeffrey Margolis, M.D., president of Michigan Healthcare Professionals and board member and lead physician of the Oakland Medical Group Oncology Division. Its the highest honor when a medical school recognizes your excellence in clinical care and entrusts you to educate future generations of doctors.

With the future of medicine focused on population health and enhanced wellness-based care models, MHPs network of highly-trained physicians will provide students with advanced training in community outpatient settings, where the majority of patient primary and specialty physician encounters occur. MHP providers are nationally known for several specialties including oncology and radiation therapy.

MHPs guiding philosophy of physicians taking more responsibility for the outcomes of medical care and the overall well-being of patients, patient care protocols guided by well-defined clinical trials, an emphasis on preventive medicine and related wellness programs, and a team concept in which physician care is augmented by ancillary health care workers, aligns with the School of Medicines goal of developing and training a diverse student body through high-quality education, clinical excellence, pioneering research, and investment in the community to prepare physician and biomedical scientific leaders who transform the promise of equal health into a reality for all.

The affiliation broadens the medical student experience beyond inpatient settings and provides students with the opportunity to understand the continuum of care in a patient-centered care model from wellness and prevention through to chronic and acute illness and injury.

About Wayne State UniversityWayne State University is a premier urban research institution offering more than 350 academic programs through 13 schools and colleges to nearly 27,000 students.

About Michigan Healthcare ProfessionalsMichigan Healthcare Professionals is a physician-led and administered organization. Our mission is to develop improved health care systems that are high quality, efficient, coordinated, appropriate and cost effective.

Media contacts:

Wayne State University School of Medicine Philip Van Hulle 586-206-8130

Michigan Healthcare Professionals Lynda Glasser 248-851-3300

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Wayne State University School of Medicine extends outpatient education with Michigan Healthcare Professionals - The South End

According to the Association of American Medical Colleges (AAMC), the number of students applying to enter medical school in 2021 is up 17% from last year. Most are motivated to join the field that is currently at the forefront of creating solutions for COVID-associated challenges.

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%, reports the AAMC.

In fact, nearly two dozen medical schools have seen applications jump by at least 25% this year, according to AAMC data. So far, there are more than 7,500 additional applicants nationwide, according to data from the AMCAS. Thats an increase of nearly 17%.

Medical school aspirants all over the world are witnessing the challenges being faced by healthcare workers and the suffering of those infected. Those with a lifelong passion for the field have been inspired by the heroism and are ready to take the leap and get involved.The first step to do so usually involves a standardised exam.

Third year medical students at The Gordon Center for Research In Medical Education, University of Miami, attend a class where they work with Harvey, the cardiopulmonary patient simulator. Source: Joe Raedle / Getty Images / AFP

For medical admissions, it is the Medical College Admission Test (MCAT) a multiple-choice, computer-based exam that is a prerequisite for admission to medical schools across the US and Canada. Every year, over 85,000 sit for the exam.

The MCAT is developed and administered by the AAMCand serves as a tool for medical schools to compare qualifications and determine the preparedness of a candidate for over 90 years. Scores are typically assessed alongside academic records and supporting materials.

The exam is broken down into four sections: Chemical and Physical Foundations of Biological Systems (95 minutes), Critical Analysis and Reasoning Skills (90 minutes), Biological and Biochemical Foundations of Living Systems (95 minutes) and Psychological, Social, and Biological Foundations of Behavior (95 minutes). Applicants can expect to spend over 7.5 hours taking the MCAT, with optional breaks scheduled in between.

The MCAT is designed to test students in general chemistry, organic chemistry, general biology, biochemistry, physics, psychology, and sociology. A high score in the MCAT is crucial to stand out in a competitive applicant.

The test is structured in a way that tests an applicants skills and critical analysis and reasoning as well. Applicants will need to know what they are in for before studying for the test itself and copious amounts of preparation is key to achieving an above-average score.

When it comes to scoring, it is important to target your goals based on which medical schools you are planning on applying to. Each MCAT section is scored from 118 to 132, with the mean and median at 125. A total score ranges from 472 and 528, with the mean and median at 500. Results are rendered 30 to 35 days post-exam.

The top 10% often achieve a score between 514 and 528. In order to secure a score in this range, participants should spend around three to five months preparing before their test date. Kaplan recommends between 300 and 500 hours of test prep to excel.

In 2021, there will be 31 MCAT testing dates between Jan. and Sept. On the week of Feb. 15, 2021, registration will officially be open for those who wish to take the test in Apr., May, or June.

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The MCAT: What aspiring medical students should know - Study International News

Thousands of Firsts campaign celebrates students, faculties early memories of program

COURTESY OF ELSON S. FLOYD COLLEGE OF MEDICINE

Weve been conceiving this idea for nearly four years now, to capture all of these firsts, all of these amazing moments that have occurred since the start of the medical school, said Christina VerHeul, director of communications, marketing and strategic operations at WSUs College of Medicine.

WSUs Elson S. Floyd College of Medicine will graduate its first class of medical students at the end of the spring 2021 semester.

In 2017, the colleges dean welcomed the first class of students, said Christina VerHeul, director of communications, marketing and strategic operations at WSUs College of Medicine. The dean shared a quote during the event: The beauty of the first time is that it leads to 1,000 firsts.

VerHeul said this inspired a campaign to capture all the thousands of firsts that will happen for the students and the school. The college has been collecting students and faculties first memories since then.

It is the largest and most expensive ad campaign the college has done. This milestone is a significant moment for the college and it needs to be celebrated, she said.

Weve been conceiving this idea for nearly four years now, to capture all of these firsts, all of these amazing moments that have occurred since the start of the medical school, VerHeul said.

This is not just about the medical school, she said. They want to share the success of the students with every Washingtonian. Everyone from the taxpayers and patients to health care professionals were involved in making this medical school a reality.

We really wanted to bring the state together, especially in this really difficult time, particularly in the health care community, VerHeul said. Theres a little bit of light out there this year that we feel is such an exciting thing.

Senior medical student Christie Kirkpatricks story is incorporated into the campaign. Her story is just one of the many firsts from the students, VerHeul said.

Christie had this incredible first where she delivered her first baby alongside the doctor who delivered her, she said.

Kirkpatrick said she realized in college that medical school was a good fit for her. It felt like a natural starting point because she had grown up in a family of medical doctors.

Working as my fathers medical scribe made me realize I wanted to pursue medicine, she said.

Kirkpatricks favorite memories include seeing her father care for patients and clue into what they really need. She said she would like to practice primary care and specialize in internal medicine.

Part of the reason I am choosing my specialty is because we get to do everything, she said. If I had to pick my favorite, I like preventative medicine and lifestyle changes, so thinking about metabolic disease.

Kirkpatrick said the COVID-19 pandemic is emotionally challenging for her, but she thinks it will make her a better doctor in the long run.

She acquired a greater appreciation for life and became more resilient. Kirkpatrick said this pandemic really showed her where the problems are within the medical system.

She said she hopes to be a pillar for her patients and to be compassionate and comforting. She is encouraging everyone to not lose hope, to keep their heads up and to know they are loved.

The campaign for the medical school can be viewed on the WSU Elson S. Floyd College of Medicine website and YouTube channel.

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WSU's first class of medical students will graduate this spring - The Daily Evergreen

The ability to understand others hidden thoughts and beliefs is an essential component of human social behavior.

Now, neuroscientists have for the first time identified specific neurons critical for social reasoning, a cognitive process that requires individuals to acknowledge and predict others hidden beliefs and thoughts.

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The findings, published in Nature, open new avenues of study into disorders that affect social behavior, according to the authors.

In the study, a team of Harvard Medical School investigators based at Massachusetts General Hospital and colleagues from MIT took a rare look at how individual neurons represent the beliefs of others. They did so by recording neuron activity in patients undergoing neurosurgery to alleviate symptoms of motor disorders such as Parkinsons disease.

The researchers focused on a complex social cognitive process called theory of mind. To illustrate this, lets say a friend appears to be sad on her birthday. One may infer she is sad because she didnt get a present or she is upset at growing older.

When we interact, we must be able to form predictions about another persons unstated intentions and thoughts, said senior author Ziv Williams, HMS associate professor of neurosurgery at Mass General. This ability requires us to paint a mental picture of someones beliefs, which involves acknowledging that those beliefs may be different from our own and assessing whether they are true or false.

This social reasoning process develops during early childhood and is fundamental to successful social behavior. Individuals with autism, schizophrenia, bipolar affective disorder, and traumatic brain injuries are believed to have a deficit of theory-of-mind ability.

For the study, 15 patients agreed to perform brief behavioral tasks before undergoing neurosurgery for placement of deep-brain stimulation for motor disorders. Microelectrodes inserted into the dorsomedial prefrontal cortex recorded the behavior of individual neurons as patients listened to short narratives and answered questions about them.

For example, participants were presented with the following scenario to evaluate how they considered anothers belief of reality: You and Tom see a jar on the table. After Tom leaves, you move the jar to a cabinet. Where does Tom believe the jar to be?

The participants had to make inferences about anothers beliefs after hearing each story. The experiment did not change the planned surgical approach or alter clinical care.

Our study provides evidence to support theory of mind by individual neurons, said study first author Mohsen Jamali, HMS instructor in neurosurgery at Mass General. Until now, it wasnt clear whether or how neurons were able to perform these social cognitive computations.

The investigators found that some neurons are specialized and respond only when assessing anothers belief as false, for example. Other neurons encode information to distinguish one persons beliefs from anothers. Still other neurons create a representation of a specific item, such as a cup or food item, mentioned in the story. Some neurons may multitask and arent dedicated solely to social reasoning.

Each neuron is encoding different bits of information, Jamali said. By combining the computations of all the neurons, you get a very detailed representation of the contents of anothers beliefs and an accurate prediction of whether they are true or false.

Now that scientists understand the basic cellular mechanism that underlies human theory of mind, they have an operational framework to begin investigating disorders in which social behavior is affected, according to Williams.

Understanding social reasoning is also important to many different fields, such as child development, economics, and sociology, and could help in the development of more effective treatments for conditions such as autism spectrum disorder, Williams said.

Previous research on the cognitive processes that underlie theory of mind has involved functional MRI studies, where scientists watch which parts of the brain are active as volunteers perform cognitive tasks.

But the imaging studies capture the activity of many thousands of neurons all at once. In contrast, Williams and colleagues recorded the computations of individual neurons. This provided a detailed picture of how neurons encode social information.

Individual neurons, even within a small area of the brain, are doing very different things, not all of which are involved in social reasoning, Williams said. Without delving into the computations of single cells, its very hard to build an understanding of the complex cognitive processes underlying human social behavior and how they go awry in mental disorders.

Adapted from a Mass General news release.

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Theory of Mind | Harvard Medical School - Harvard Medical School

As hospitals nationwide struggle with the latest COVID-19 surge, its not so much beds or ventilators in short supply. Its the people to care for the sick.

Yet a large, highly skilled workforce of foreign-educated doctors, nurses and other health practitioners has gone largely untapped due to licensing and credentialing barriers. According to the Migration Policy Institute think tank in Washington, D.C., about 165,000 foreign-trained immigrants in the United States hold degrees in health-related fields but are unemployed or underemployed in the midst of the health crisis.

Many of these workers have invaluable experience dealing with infectious disease epidemics such as SARS, Ebola or HIV in other countries, yet must sit out the coronavirus pandemic.

The pandemic highlights licensing barriers that predate COVID-19, but many believe it can serve as a wakeup call for states to address the issue for this crisis and beyond. Already, five states Colorado, Massachusetts, Nevada, New Jersey and New York have adapted their licensing guidelines to allow foreign-trained health workers to lend their lifesaving skills amid pandemic-induced staff shortages.

These really are the cabdrivers, the clerks, the people who walk your dog, said Jina Krause-Vilmar, president and chief executive officer of not-for-profit Upwardly Global, which helps immigrant professionals enter the U.S. workforce. They also happen to be doctors and nurses in their home countries, and theyre just not able to plug and play into the system as its set up.

Thats left doctors such as Sussy Obando, whos 29 and from Colombia, jumping through hoops to become physicians in the United States. In 2013, Obando graduated after six years of medical school in Colombia, then spent a year treating patients in underserved communities. But when she arrived in the United States, her credentials and experience werent enough.

Licensure guidelines vary by state. But foreign-trained doctors typically must pass a medical licensing exam that costs them more than $3,500 and then complete at least a year of on-the-job training, known as a residency, in the United States. For many, including Obando, that means brushing up on English and learning the relevant medical terminology. She also needed U.S. clinical experience to qualify for a residency, something that U.S.-trained doctors achieve through rotations during medical school.

If you dont know anyone in this field, you have to go door-to-door to find somebody to give you the opportunity to rotate, Obando said.

She tried emailing Hispanic doctors she found online to see whetehr she could complete a rotation with one of them. She ended up paying $750 to enter a psychiatry rotation at the University of Texas McGovern Medical School in Houston.

I tried to go into internal medicine, Obando said. But because psychiatry was less expensive, I have to go for that.

She also worked for almost a year as a volunteer at Houstons MD Anderson Cancer Center, and is now assisting with clinical trials for COVID vaccines at the Texas Center for Drug Development. She has applied for a residency through a national program that matches medical school graduates with residency slots. But its difficult for foreign-trained physicians to secure a spot because many are earmarked for U.S. med school graduates. And many residency programs are open only to recent graduates, not those who finished medical school years ago.

Its competitive for people who trained in the United States to get into a residency program, said Jacki Esposito, director of U.S. policy and advocacy for World Education Services, a nonprofit that helps immigrants find jobs in the United States and Canada. If youre trained outside the United States, its even harder.

Thats why states such as Colorado have eased the requirement for a residency during the pandemic. Early on, Colorado officials realized they couldnt license doctors and other health workers because coronavirus lockdowns had canceled required licensing exams. Under an executive order from Democratic Gov. Jared Polis in April, state officials created a temporary licensing program, allowing medical school graduates to begin practicing under supervision for six months and then extended that through June 2021.

Officials created a similar pathway to temporary licensure for foreign medical school graduates who lacked the minimum year of residency.

Colorado also created temporary licenses for foreign-trained nurses, certified nurses aides, physician assistants and many other health professionals. All of those licenses require supervision from a licensed professional and are valid only as long as the governors public health emergency declaration remains in effect.

The state relaxed the scope-of-practice rules for those health workers, too, allowing them to perform any task their supervisors assign to them.

So if youre an occupational therapist, you can give vaccinations as long as they are delegating to you, and theyre confident you have the skill and knowledge, said Karen McGovern, deputy director of legal affairs for the professions and occupations division for the Colorado Department of Regulatory Agencies. You can exceed your statutory skill and practice to what needs to be done during the pandemic.

Through mid-December, the state had received 36 applications from foreign-trained doctors seeking temporary licenses, though only one applicant met all of the criteria.

New Jersey, in contrast, received more than 1,100 applications for temporary medical licenses last year.

Michigan also issued an executive order allowing temporary licenses, but it later was rescinded.

Many of the medical professionals stuck on the sidelines have skills and experience that would be invaluable during the pandemic.

Victor Ladele, 44, finished medical school in Nigeria and treated patients during a drought in Niger in 2005, in the midst of the Darfur genocide in Sudan in 2007 and after a civil war in Liberia in 2010. His family moved to the United States a few years later, but Ladele was recruited to help with the Ebola outbreak in West Africa in 2014. What he thought would be a three-month stay turned into a two-year mission.

Now back in Edmond, Oklahoma, working with a U.N. program that helps new business ventures get off the ground, Ladele has found that the challenges of the coronavirus pandemic parallel many of his past experiences. He saw how a program for Ebola contact tracing told people with a cough or fever to call a hotline, which would direct them to a care center. But as soon as the initiative went live, rumors began to spread on social media that European doctors at the care centers were harvesting organs. It took months of outreach to tribal and religious leaders to instill confidence in the system.

He has seen similar misinformation spread about COVID and masks.

If, in Oklahoma, the public health officials had done outreach to all the pastors in the churches and gained their support for masking, would there be more people using masks? Ladele said.

Ideally, he said, he would like to spend about half of his time seeing patients, but the licensing process remains a challenge.

Its not insurmountable, he said. But when I think of all the hurdles to credentialing here, Im not really sure its worth the effort.

Upwardly Global which has offices in New York, Chicago, Washington and San Francisco helps health professionals navigate that unfamiliar application and credentialing system. Many foreign-trained health workers have never had to write rsums or interview for jobs.

While the pandemic has temporarily eased entry in five states, Krause-Vilmar and others believe it could be a model to address workforce shortages in underserved areas across the country. As of September, the federal Health Resources and Services Administration had designated more than 7,300 health care shortage areas, requiring an additional 15,000 health care practitioners.

Weve had a crisis in access to health care, especially in rural areas, in this country for a long time, Krause-Vilmar said. How do we start imagining what that would look like in terms of more permanent licenses for these folks who are helping us recover and rebuild?

KHN (Kaiser Health News) is an editorially independent, nonprofit news service covering health issues.

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Amid COVID-19 shortage of doctors, other health workers, foreign-trained professionals are left on the sideli - Chicago Sun-Times

The Class of 2021 will continue the School of Osteopathic Medicines proud tradition of having approximately 10 graduates per year enter military residency programs. Eleven students slated for graduation in May 2021 matched into residency programs this month where they will serve in the United States Armed Forces while caring for soldiers, veterans and their families from Fort Bragg, North Carolina to Madigan Army Medical Center in Tacoma, Washington.

As they celebrated this milestone, the students shared what lead each of them to pursue military medicine.

Air Force2LT Augustus E. FloydPsychiatrySan Antonio Military Medical Center, San Antonio, TXI have always had a fascination with military history and the experience of those who have taken up arms to defend our country.The psychological toll of warfare cannot be understated, and mental health fervently impacts the choices that affect every other aspect of wellness. I believe this career path will allow me to help improve the lives of service-members and empower them in our mission to win in air, space, and cyberspace!

2LT Hunter GalloglyFamily Medicine and Operational MedicineMike OCallahan Medical Center, Nellis Air Force Base, NVI chose military medicine because I truly believe the men and women who serve our country every day should be our first priority. Those in Uniform risk their health for this country, so I am happy and honored to be given the chance to serve those who serve.

2LT Ashley Murphy ShawObstetrics and GynecologyNaval Medical Center, Portsmouth, VAService:Itsanhonor to serve those who serve our country.Tradition:I will soon be the second Air Forcephysicianin my family.TheAir Force core values:Integrity first. Service before self. Excellence in all we do.

Army2 LT Peter V. ChoiFamily MedicineNational Capital Consortium, Fort Belvoir, VAI applied to Family Medicine at Ft. Belvoir in hopes of obtaining an excellent education and to be near family.

2LT Adrienne CourseyFamily MedicineWomack Army Medical Center, Fort Bragg, NCI chose Family Medicine because I want to be able to provide front-line, full-spectrum primary care and to serve others with a focus on compassion, solidarity, holism, and developing relationships. I have a passion for working directly with Soldiers and know continuing my medical education at Fort Bragg will allow me the opportunity to pursue a career in supporting military operations and to grow as an osteopathic physician in the military community.

2LT Rosina DardenPsychiatryWalter Reed Military Medical Center, Bethesda, MDI chose to be an army physician so I could serve and give back to the country that has afforded me so many opportunities. I am honored to be joining the Psychiatry program at Walter Reed and look forward to working with the men and women serving our country.

2LT Anthony LucidoPediatricsWalter Reed Military Medical Center, Bethesda, MDPediatrics has always been my specialty of choice since beginning medical school. I enjoy working with the patient population and feel the biggest impact on health is made in the earliest years of life. I have always felt a desire to serve a country which blessed me with so much. All my brothers and I are in the Army in one fashion or another, so it was only natural to continue the tradition.

2 LT R. Logan PhillipsInternal MedicineMadigan Army Medical Center, Tacoma, WAI chose military medicine because I have always valued giving back, both to my country and to its people. Serving in the military has always been a goal of mine, so serving the military as a physician has been a great opportunity for me to be able to combine the two ways to serve.

NavyJon McGill, ENS MC USNREmergency MedicineNaval Medical Center, Portsmouth, VAI am very excited to get the opportunity to start my career in the Navy in my top choice program and specialty. I have always had a desire to serve my country. Upon learning about the ability to do so while pursuing a career in medicine, I did not hesitate to sign up. The Navy particularly holds a special place in my heart as my father was also a Physician in the Navy Medical Corp. I am proud to be able to follow in his footsteps with all he has provided me. Emergency Medicine has been my passion since beginning my journey into medicine. First as and EMT and next as an Emergency Room Technician, I am extremely excited to continue my career in a field I love and enjoy.

ENS, Joseph McNamaraTransitional ResidencyNaval Medical Center, Portsmouth, VAInspired by a long line of Naval officers in the family, military medicine immaculatelypairs my own passion of serving others through medicine with this rich tradition offering a chance to help those who may sacrifice everything for our country.

ENS John PetersenInternal MedicineNaval Medical Center, Portsmouth, VAI really look forward to being at Naval Medical Center Portsmouth again after I had an away rotation there. I chose medical training in the Navy because of the unique experiences and training. The patients and the people you get to work with are great.

Class of 2019 Alumnae, Air Force Captain Julia Timm Intili, an internal medicine resident at Brooke Army Medical Center, shared her pride in having more Campbell graduates heading into military medicine.

Im proud we have so many Class of 2022 Camels heading to train in our military hospitals!

I love training at a military hospital. We were able to participate in Operation Warp Speed and were among the first to get the COVID vaccine. We get patients from war zones and deployments overseas, as well as World War II veterans with no shortage of war stories.

It is a privilege to serve these heroes, and I am well prepared thanks to my education at CUSOM. I always appreciated CUSOMs respect for the military, especially given its close proximity to Fort Bragg and Seymour Johnson Air Force Base.

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Eleven Class of 2021 members will enter military medicine residency | News | Campbell University - Campbell University News

In September 2009, the H1N1 swine flu had arrived in Portugal, Spain, and the UK, so France braced itself for cases of the infection.

Indeed, the number of people in France with respiratory symptoms soon increased. But they did not seem to have H1N1. France registered only sporadic positive tests for the new swine flu for most of that September and the first half of October. When H1N1 finally took hold in France, it was much later in the fall than expected. And that got scientists thinking: Why?

A flurry of papers since then have narrowed in on a beguiling hypothesis: The pandemic flu was deflected by the common cold.

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For many people, Covid-19 has revealed, in terrifying detail, the bizarre nature of viruses. Beneath the surface of our daily lives is a constantly shifting ecology of pathogens that often behave in unexpected ways. In France in 2009, infections by rhinoviruses, which usually cause colds, were spiking when H1N1 was expected to arrive, and when they petered out, the pandemic flu took off. Since then, studies have found that instances in which people have two viruses at once are rarer than chance alone would predict. That suggests that having one protects you from the other, at least for a while somehow.

During the Covid-19 pandemic, cases of many other respiratory infections have plummeted. This is likely a result of social distancing protocols, but its also possible that viral interference, the phenomenon of viruses affecting each other, may be involved. This insight could offer a head start on fighting future pandemics. With a deeper understanding of our viral ecology, what if, someday, we could use viruses against each other?

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In recent years scientists have developed a much more sophisticated picture of what bacteria do to us and for us. Theyve been exploring how our health is shaped by the mix of beneficial and dangerous bacteria in our microbiomes. Now viruses may merit a reexamination as well.

The idea that viruses might interfere with each other is old as old as vaccination. Edward Jenner, the English doctor who helped develop the practice of inoculating against smallpox in the 18th century, noticed it. Inoculation involved infecting a person with the milder cowpox virus. But if the patient had herpes, then it did not work as well. It was as if having two active infections at once altered how the immune system responded.

Over the next two centuries, scientists reported more and more situations in which it was clear that infections didnt operate in a vacuum. One 1950 review article even called it a well-known fact that having one virus could inhibit the growth of another.

The topic is not frequently discussed these days, though. Viral interference that protects people can be difficult to study and is generally overlooked, says Stacey Schultz-Cherry, an infectious disease researcher at St. Judes Hospital in Memphis, Tenn. Thats because, she explains, situations in which simultaneous infections cause a worse prognosis are so much better known. The flu, for instance, is notorious for opening the door to bacterial pneumonia. Small studies from the beginning of the pandemic suggest having both the flu and Covid-19 is worse than having either alone.

But the worst-case scenarios might mask something profound about what often happens as our immune systems encounter viruses all day, every day, says Michael Mina, an epidemiologist at Harvard Medical School and Brigham and Womens Hospital. Viral infections may actually protect people from other viral infections or bacterial infections by stimulating immune responses, by keeping our innate immune system on its toes all the time, with these constant little pushes and nudges, he says. They are like training for us, he suggests.

Adaptive immune defenses target specific pathogens, and these are what protect us after weve been vaccinated. But innate immunity is more all-purpose. After studying the H1N1 flu, Ellen Foxman, an immunologist at the Yale School of Medicine, and colleagues released a paper in October suggesting that once the innate immune system is activated by one pathogen, the body can repel another invader.

To model what might have been happening during the swine flu pandemic, the researchers grew human airway tissue in the lab and infected it with rhinovirus. Then, three days later, they gave it the H1N1 flu. They were intrigued to see that the flu virus just fizzled out, and they determined that the rhinovirus had switched on a number of genes that produce innate immune proteins. Suspecting that molecular messengers called interferons had flipped those switches, they treated the tissues with a drug that blocked interferons and ran the experiment again. Lo and behold, the influenza grows just fine, says Foxman. Interferons produced to fight the rhinovirus had been beating back the flu.

A number of viruses trigger the interferon response, and its possible that any of them could make the body put up stiff resistance to a new infection for some period of time. For instance, the team didnt test whether having the flu first would stop a rhinovirus in its tracks, but its plausible, says Foxman. That might explain why flus and colds have alternating peaks every year. There are a lot of reasons why one virus might take center stage over others, including human behavior, school schedules, and climate. But you really wonder if viral interference is one missing piece of that equation, Foxman says.

In the current pandemic, the same questions are at play. While social distancing and masks are reducing the incidence of seasonal flu, perhaps the prevalence of Covid-19 is cutting it down further. Or, says Schultz-Cherry, maybe the flu would have slowed down Covid-19. Theyre questions that can only be answered with further research, but they are worth asking.

Because the new research demonstrates how one infection can stop another, it hints at the possibility of unusual new therapies somewhere down the road. One can imagine viruses engineered to provoke just enough of a response to protect us against more dangerous things for, say, the next week a benign infection to block an immediate threat. On a more practical level, says Schultz-Cherry, a protective interferon response might someday be generated in just the right places in the body by something like a nasal mist. For people at high risk, interference might provide a shield.

On the larger scale, these immune responses are the result of eons of coevolution between humans and viruses. Is it possible that after our long dance with these self-replicating snippets of genetic code, there are viruses that do us more good than harm? Mina suspects that medical researchs focus on the negative outcomes of viral infections may have blinded us to that reality.

We miss these beautiful interactions that probably, evolutionarily, are completely working for and with us as humans, and not against us, he continued. The microbiome is a great example. . . . We saw bacteria everywhere and thought, maybe theyre good. Turns out theyre essential.

Veronique Greenwood is a writer whose work has appeared in The New York Times, The Atlantic, and National Geographic, among other publications. This article was originally published by The Boston Globe.

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A viral mystery: Can one infection prevent another? - STAT - STAT