Planning to go to Medical School? Join the Great Lakes Applicant Workshop – University of Wisconsin-Madison

This years workshop was held virtually in partnership withMichigan State University College of Human Medicine,University of Wisconsin School of Medicine and Public Health, University of Minnesota Medical School- Duluth and Twin Cities, University of South Dakota Medical School, University of North Dakota Medical School, and University Of Illinois Medical School.This years applicant workshop featured a keynote address from Frank Animikwam, MD, mini-sessions covering the application process, MCAT overview and strategies, tips for writing a personal statement, and a medical student panel.

If you are planning on applying to medical school this cycle please reach out to our center directly for additional information, especially on how COVID-19 is impacting this years application cycle.

Clickhereto access NACHPs website and below is our phone and email address:608-262-7218nachp@hslc.wisc.edu

You can clickherefor the UW-Madison School of Medicine and Public Health admissions website.

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Planning to go to Medical School? Join the Great Lakes Applicant Workshop - University of Wisconsin-Madison

Mother-Daughter Duo Become First To Graduate From Medical School At The Same Time And Match At The Same Hospital – Because of Them We Can

Now this is a reason to celebrate!

A mother and daughter are making history, becoming the first to graduate from medical school at the same time and match at the same hospital, UMHS reports.

Dr. Cynthia Kudji and her daughter, Dr. Jasmine Kudji attendedmedical school at the same time, miles apart from one another. Cynthia attendedthe University of Medicine and Health Sciences (UMHS) St. Kitts and Maine and Jasmine attended Louisiana State University School of Medicine. After years apart, bothmother and daughter have matched at LSU, the first to do so, with Cynthia pursuing Family Medicine and Jasmine studying General Surgery.

The Ghana native said she always wanted to be a doctor, but after becoming pregnant with her daughter Jasmine at 23-years old, she put her dreams on hold. She workedas an RN and Nurse Practitioner for almost 10 years before deciding to apply to medical school at UMHS. A trip back home inspired her to pursue her dreams again after all those years.

My mom wanted us to have a family trip back to Ghana and there was an incident where we were in the village and somebody just walked up to us and said that their child had a fever and was sick and wanted my mom and I to help. We put the child in water, trying to get the temperature down...and I just remember being so frustrated that the mom had to come to a complete stranger to get access to health care. The only thing I knew that could change that situation was to be a physician, Cynthia said.

Her daughter Jasmine, simultaneously began med school at LSU. The two said the road hasnt been easy but they are glad to have finally completed a major part of their journey.

So, the only thing that makes it difficult as far as older students is if you havent been in school for a while, it takes some getting used to the volume of material. [Also,] you still have the responsibilities of an older individual, of a mom or a dad... So even though I was in medical school, I was still Jasmines mom. I still had to be there as mom regardless of whether I was in medical school or not, Cynthia shared.

Thanks to technology, the two were able to remain close andconnected.

I think initially it was difficult because my mom and I have always been really close so I had to get used to the distance, we had to learn how to FaceTime and Skype each other, so we were Skyping each other every day and whenever I had struggles and she had struggles, we just had to learn to communicate from a distance, said Jasmine.

Both mom and daughter are excited to finally be back together and look forward to continue leaning on each other as they enter this next phase of their careers.

I always tell people we laugh together, we study together, we cry together. I think medical school is one of those experiences that you dont truly understand until youre in it. Sometimes people struggle to find someone who relates to their struggles, so for that person to be my mom was extremely helpful, said Jasmine Kudji.

This is mom-daughter goals! Congratulations ladies!

Photo Courtesy of Dr. Cynthia Kudji

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Mother-Daughter Duo Become First To Graduate From Medical School At The Same Time And Match At The Same Hospital - Because of Them We Can

Its the American dream: Law school and medical school grads visit their grandpa at La Crescenta nursing home in emotional reunion amid pandemic – KTLA…

Vana Ebrahimi, a 25-year-old from Glendale, graduated from Loyola Law School on Sunday as her brother graduated from medical school. Although their in-person commencement ceremonies were canceled due to the coronavirus pandemic, they found a way to make the day special.

The pair went to visit their grandpa, Hayrik Abnous, at a La Crescenta nursing home, where he has been since January. In an effort to curb spread of the virus, the facility has been under a lockdown since March.

So Ebrahimi and her brother first generation college students got to see their grandpa through a glass door in an emotional reunion.

We just decided since were both graduating, lets go and surprise him and wear our cap and gowns, Ebrahimi said. It was a big deal for us to include him.

The video of the special moment shows Ebrahimi and her brother, who did not want to share his name or school information, in their gowns, waving to their grandpa while he looks at them in tears from his wheelchair.

It was heartbreaking but cute at the same time, said Ebrahimi, who was also in tears in the video. It was a surreal feeling for us both. Its the American dream.

Her parents and grandparents escaped war in Iran and went to Austria, eventually making it to the U.S. in 1993, just before she was born.

My mom and dad came here literally with no money and not knowing English, Ebrahimi said. For us to be able to not just go to college, but also get a graduate degree It was like the struggle of coming here and escaping war and doing all that was worth it. For us it feels like were finally paying them back.

Having her children graduate from law school and medical school has been emotional for her own mother too, Ebrahimi said. While her uncles were able to leave Iran during the war on student visas, her mother was not.

You dont just, you know, send your daughter to America on her own, Ebrahimi reflected. So my mom had to stay back, and she never got to go to college because the war happened and the schools closed.

As an Armenian American, she says the accomplishment has even more meaning for her as a minority.

From a culture thats had a genocide, were still here were still standing. Were pursuing our dreams and they didnt destroy us, she said.

Ebrahimi has been staying with her grandmother while her grandpa remains at the nursing home for a broken hip and a heart condition. She says she and her grandma were going to the nursing home every day before they closed their doors, and at the time of their graduation reunion, she hadnt been able see her grandpa in two months.

It was a huge deal to be able to have us all together to celebrate, even though it wasnt the type of celebration we wanted or imagined, she said. Quarantine has had its perks of having more intimate moments with your family.

Ebrahimi said her metspop, as she calls him, has never stopped smiling, even while in the hospital or the nursing home. He is the most easygoing patient, she said, always smiling.

As an Armenian immigrant family, this meant the world for my grandfather who came here with little to nothing and not knowing the language to see us accomplish the American dream, she said.

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Its the American dream: Law school and medical school grads visit their grandpa at La Crescenta nursing home in emotional reunion amid pandemic - KTLA...

Business Observer for the week of May 24 – Asheboro Courier Tribune

Achievements, Promotions and Recognition


Southeastern Regional Medical Center Intensive Care Unit Registered Nurse Tess McNeill has been honored as Southeastern Healths 2020 Baker Nurse of Excellence.

Poyner Spruill LLP has announced partner Mike McIntyre has been selected as the 2020 Liberty Bell Award recipient by the Young Lawyers Division of the North Carolina Bar Association. Serving as director of the firms government relations practice, McIntyre represents governments on the local, state and national levels. He also focuses on business, real estate, agribusiness, energy and environmental law, along with military, sports and entertainment law. Before joining the firm, McIntyre held the position of Congressman of North Carolinas Seventh Congressional District in the U.S. House of Representatives from 1997 until 2015.

Cumberland County Schools Superintendent Dr. Marvin Connelly Jr. was among 45 superintendents from across North Carolina to graduate from the NCSSA Next Generation Superintendent Development Program Cohort VII.


Former state representative and longtime attorney Ron Sutton has been appointed to the Board of Trustees at UNC Pembroke. Sutton was awarded the Order of the Long Leaf Pine in 2011 and previously served on the UNCP Foundation Board. Sutton served as a Democratic member of the N.C. General Assembly representing District 47, which includes Robeson and Hoke counties, from 1993 to 2011.

Strictly Business: A roundup of business and retail news right to your inbox.

In Business

Kampgrounds of America, located at 465 Kenric Road in Lumberton, off I-95 exit 17, has re-opened for RV travelers as COVID-19 restrictions are eased. The office and bathrooms will remain temporarily closed as a precautionary measure due to the pandemic. Only curbside check-in is available during office hours.

On the Job

Alan Zhu, M.D., has joined Southeastern Healths Southeastern Cardiology and Cardiovascular Clinic and Southeastern Health Heart and Vascular, providing general cardiology and electrophysiology. Dr. Zhu earned his medical degree from Tongji Medical University, in China. He earned a master of science degree in biometry from the University of Minnesota School of Public Health in Minneapolis, Minnesota. He completed an internal medicine residency at the University of Minnesota Medical School. He competed a fellowship in cardiology at Loma Linda University Medical Center, Loma Linda, California, and an electrophysiology fellowship at University of Minnesota. He is a fellow of the America College of Cardiology.

Southeastern Healths The Surgery Center at Southeastern Health Park has reopened for surgeries on Mondays and Wednesdays. Visitors will be limited and patients will be screened for COVID-19 symptoms and given a mask before entering the surgical facility. Employees of the center will also be screened before being allowed to report to work.

Dr. Toby A. Travis has joined The Village Christian Academy as the superintendent over PS-12. His previous school roles include teacher, coordinator, principal, academic director and head of school, serving in both Christian and international school settings.

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Business Observer for the week of May 24 - Asheboro Courier Tribune

Grad Profile: Med School valedictorian reflects on L.A. filmmaking past and a new future in medicine – Dal News

This article is part of a series focusing on the grads of the Dalhousie Class of 2020. Visit our Class of 2020 virtual space to share in the excitement with our newest graduates.

David Hung was sitting in Kanye Wests office when he learned he would be attending Dalhousie Medical School.

Born in Palo Alto, California, and raised in Halifax, David originally set his sights on becoming a skateboard video director. Armed with a camera at a young age, David and his friends started to make music videos, commercials, short films and even a feature film, in addition to medical education videos with his physician father.

I feel like in film theres these really fast-paced and high-stake environments, says David. That was where I thrived.

While working on filmmaking projects in Halifax, David completed a BA with Honours in Theatre at Dalhousie but decided to follow that need for high-stakes into a career as a paramedic.

Although working as a paramedic allowed him to follow his passion for a fast-paced environment, combined with his inherent interest in medicine filmmaking options in Halifax were limited.

David, and his friends Tyler and Jacob, made the incredible decision to move to Los Angeles to follow their filmmaking dreams. Over a span of two years, they made the right connections and began working with rap superstars such as Kanye West and Travis Scott, and celebrities like Kylie Jenner.

Tyler worked with Kanye West on tour, and then toured with Travis Scott, which eventually led to the Netflix original documentary, Look Mom I can Fly, which David worked on as an editor and cinematographer.

Even with this burgeoning success in the industry, the pull to practise medicine remained. So with the support of mentors such as Dr. Ron Stewart, who was supportive of Davids Arts career and passion for pre-hospital and emergency medicine, David finally decided to apply for medical school.

He was a huge inspiration for me to not only pursue this as a career but also to keep rooted in my creative outlets and mediums, says David.

Fast-forward to sitting in Kanye Wests office. At the time they were just finishing up work on the music video for the hit song Famous, but uncertain what the next job would be and where the next paycheque would come from.When I got that letter, it was a huge relief, says David. It was something that not only represented hard work and determination that everyone who applies puts in, but it represented stability which is something I think I was looking for at the time.

Four years later, and David is set to graduate from Dalhousie Medicine School as valedictorian of the Class of 2020 and preparing to start his residency in Emergency Medicine in Halifax.

Hes travelled the world learning what makes a strong leader and observed the collaboration it takes to make a hit record which is a nice correlation to working successfully in interprofessional teams.

While from the outside it seems that he has been chasing the thrill of filmmaking with stars, or the high-acuity world of emergency medicine, its been those closest to him that have kept him grounded and helped him survive medical school.

My wife-to-be, Meghan, was a huge part of my success. Being able to have a person to talk to, to go on adventures with and experience life together outside of the hospital was the key to my wellness, says David. Now we have a beautiful daughter, Violet, and spending time with her is all that matters.


Grad Profile: Med School valedictorian reflects on L.A. filmmaking past and a new future in medicine - Dal News

Answering the Call: Med school grads plan to practice in the Valley – Brownsville Herald

The University of Texas Rio Grande Valley recently graduated its first class of students from the School of Medicine. Those graduates entered the program when it opened in 2016 and many plan to stay in the Rio Grande Valley for residencies or will return to practice. Graduates spoke of their community ties and a desire to address the needs of underserved border residents who face unique social and cultural challenges requiring physicians to work collaboratively with patients.

Training doctors locally is essential in addressing the needs of underserved South Texas communities and has been the driving force behind a decades-long push to bring a medical school to the RGV, explained Dr. Leonel Vela, the School of Medicines Senior Associate Dean for Educational and Academic Affairs.

If we look at the number of physicians per 100,000 population nationally, we have roughly half of that ratio. Compared to the State of Texas, we have about a third of that ratio. Texas already ranks in the lower 10 out of the 50 states in terms of the number of doctors per 100,000 population. It gives you a perspective of the significant need there is here, he said.

UTRGVs med school was generations in the making and a major impetus of that push was to address the significant shortage of doctors locally. Vela came in as the founding dean at the Harlingen Regional Academic Center in 2000. Students from the UT Health Science Center in San Antonio would do clinical rotations until legislation was passed calling for the establishment of the medical school under UTRGV.

The programs pre-development brought expanded residency programs to students including internal medicine, psychiatry, family medicine, general surgery, obstetrics and gynecology, and even fellowships in cardiology, gastroenterology, hospice, and sports medicine.

Nationally, what we see is that physicians are almost three times as likely to stay in the area where they go to medical school and train. When you develop that locally, it becomes a nexus for attracting more physicians, more research. Weve seen interest in medicine expand locally. Now, for students in our public schools, its a dream they can achieve. For my generation, the only option was to leave the Valley, said Vela.

As for the students, graduates spoke enthusiastically about the benefits their training brings to South Texas. Ramiro Tovar, 26, grew up in the Valley and is pursuing family medicine because it allows him to get to know his patients on a personal level, enabling treatment thats responsive, effective, and sensitive to cultural practices and values. His mother wanted to be a doctor growing up and didnt get the chance, though interest in medicine was solidified only when an aunt he was close with had a burst aneurysm.

They told her the prognosis was terrible, but neurosurgeons stepped up with a surgery that could save her. She got another 16 years of life. She got to see her daughter married, her son grow up. As a physician you can walk in one moment and change an entire persons life, he said.

Another graduate, Daniella Concha, 27, will leave the area to complete a residency in NYC focused on internal medicine. After, she hopes to do a fellowship in cardiology. She echoed Tovars respect for RGV communities and in particular her home town of Donna.

There are so many hardworking people I encounter here who face so many limitations regarding access to healthcare and understanding their conditions. Ive seen my own family members struggle to understand whats going on with them because of the language barrier, she shared.

While there are many Spanish-speaking physicians here, many do not speak Spanish. I want to help these people understand whats going on with their bodies, how its happening, what the consequences of not following up with your doctor are.

Concha emphasized the power of community ties and cultural insight in making her a responsive physician.

I grew up in this culture. My mom once cracked an egg on my head and said, This is going to cure your stomach ache. A lot of the patients here practice folk medicine. Being able to incorporate both the patients beliefs and their culture with management thats within the literature of what evidence-based medicine is that is going to help a lot of people here and I want to be a part of that.

Other students opted to stay in the Valley not only to address healthcare access, but also to remain close to family. Joseph Garza, 26, is graduating into a residency at DHR Health in Edinburg and has a young daughter with his fianc, which only strengthened his resolve to practice locally.

Working in medicine, going through school, seeing hospitals I saw the health disparities. There are complicated patients here with hypertension and diabetes but not a lot of resources for a large community. I understand the culture here. I speak Spanish. Patients want a doctor that understands them and I feel like Im able to do that for my patients when I start seeing them in July, said Garza.

Graduate Ye Ji Choi, 27, grew up in Mission and will be joining Garza at DHR Health while training in obstetrics and gynecology. She said her four years at UTRGV were challenging and exciting as the program represented uncharted territory.

You gain a lot of experience and become aware of and exposed to the culture locally. You can hone in on and adapt to the needs of the community. Things like the language itself, body language, cultural implications. Being able to provide these services is crucial said Choi.

Some members of the graduating class completed their undergraduate degrees through UTRGVs BMED Scholar Program. The programs director, Dr. Hugo Rodriguez, noted that Tovar was also member of the first BMED graduating class in 2016, likely influencing his decision to stay. We did a lot of activities outside of the classroom community service, clinical experience, and professional development, said Rodriguez.

His philosophy has been to motivate students to push through their work, to be honest with themselves, and to have the will to learn from mistakes while embracing the journey as something joyful.

You chose a pathway and you need to be reading every day of your life. The field of medicine is constantly evolving. We need to plant that seed in the students from day one and nurture that seed, he said.

Students are encouraged by faculty to engage with the needs of the Valley. That might mean coming back to practice and it might not, but even those graduates who have chosen residencies cited a desire to return to practice. Veronica Trevino is one of them. She recalled realizing she wanted to be a pediatrician at three years old when she asked her parents about the work of her own doctor. Being born and raised in the Valley, this is a huge, huge deal for me, she said.

Trevino is from McAllen and is leaving to the closest place she possibly can while still practicing pediatrics Driscoll Childrens Hospital in Corpus Christi.

When babies get really sick, when kids get really sick, we send them to Driscoll. It has exceeded the capacity at which we can take care of them here. They have satellite clinics all over the Valley and we get to rotate at all of them, she added.

Trevinos education in medicine exposed her to the Valleys underserved colonias and the lack of basic infrastructure like running water and unpaved roads, which she referenced as an integral driver of her desire to practice locally. Her appreciation for medicine truly began at 11, however, when her dad suffered a heart attack and had open heart surgery. She said of the experience, As my dads daughter, that surgeon didnt do anything to me directly, but he completely changed my life because he gave me my dad back.

She thanked the community for welcoming the graduates with open arms and giving them the respect they needed to learn and thrive. It has been a really meaningful experience, said Trevino.

Her classmate and fellow graduate Shuemara Kates Ondoy, 25, will complete a residency in internal medicine at Valley Baptist Medical Center in Harlingen, her first choice placement. Ondoy has been a Valley resident since high school when her family settled here after relocating from the Philippines.

There were plenty of times during the last four years where you wonder, Am I going to make it? Do I have what it takes? said Ondoy of her graduation.

There was a stigma growing up in the Valley like the education you get down here is sub-par, which is why a lot of people want to leave after high school. That wasnt my experience in this program. I felt I could get the same education right here that I can get anywhere else. Its intrinsically important to have a medical school here in the Valley. As a student, youre putting the RGV on the map. Were giving the native people an opportunity to pursue that higher education so they dont have to leave.

Ondoy thanked the universitys faculty and staff for the programs success.

There were a lot of growing pains, being the first class. The passion and the dedication of our faculty and staff made the journey worthwhile. We would not be here without them; its their achievement just as much as ours.


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Answering the Call: Med school grads plan to practice in the Valley - Brownsville Herald

Chicago family holds backyard graduation for their medical student daughter and her friend – FOX 32 Chicago

Chicago family holds backyard graduation for their medical student daughter and her friend

A Morgan Park family is making sure their daughter and her friend get the ceremony they deserve for completing medical school.

CHICAGO - In the era of coronavirus, typical graduations have become non-existent.

So, one Morgan Park family is making sure their daughter and her friend getthe ceremony they deserve for completing medical school.

The front yard of Lindsay Howards home says it all. There is a banner and balloons, because she and her medical school roommate are both graduating virtually.

Lindsays family is making sure it is a moment they will never forget.

Ive been waiting for this moment for 24 years, Lindsay said.

Since she was 5-years-old, Lindsay dreamed of becoming a doctor. But graduating from the Medical College of Wisconsin during the coronavirus crisis was not quite what she expected.

I was really kind of bummed out when everything got canceled, Lindsay said.

That is when her family stepped in.

We had to find a way to still make it very special for her, Lindsays brother Larry said.

So, they turned on the music, got dressed up, put up some decorations, and held the momentous Hooding Ceremony from Lindsays backyard.

The Hooding Ceremony is just one aspect of them moving towards being conferred as a doctor, said Lindsays mother Gail.

During their socially distant celebration, family joined virtually from afar.

The Howards also honored Lindsays roommate, Brandy Norman, who is from Las Vegas and could not celebrate with her own family.

Its been amazing. A lot of med-school I wouldnt have gotten through without them, Brandy said.

Even a photographer was present to capture the unique milestone on camera.

I couldnt be more proud, brother Larry said.

Lindsay and Brandys virtual graduation ceremony will be held Friday.

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Chicago family holds backyard graduation for their medical student daughter and her friend - FOX 32 Chicago

From Medical School To Fighting COVID-19 On The Front Lines At Bellevue Hospital – NPR

Gabrielle Mayer graduated from medical school in April and began her residency early so she could help care for patients with COVID-19. Gabrielle Mayer hide caption

Gabrielle Mayer graduated from medical school in April and began her residency early so she could help care for patients with COVID-19.

Dr. Gabrielle Mayer took her Hippocratic oath during a virtual graduation ceremony last month. Just three days later, she was a resident at Bellevue Hospital in New York City.

Now, almost six weeks into her residency, she says she's been inspired by "seeing the medical community as a whole rally around the patients who needed us the most."

Mayer is one of 52 fourth-year students at New York University's Grossman School of Medicine who graduated early to help patients sick with COVID-19 and to provide relief for hospital staff stretched thin because of the health crisis. Medical students at other schools have similarly graduated and deployed early to begin residencies and help on the front lines of the coronavirus pandemic.

"Knowing that my community was in need and that the health care workers that I'd soon to be joining were strained already ... was a big motivation to go into the hospital," she told NPR last month the day before she graduated.

She had been set to start her residency in July. Instead, she began on April 6.

The toughest part so far, Mayer says, is that families can't visit loved ones at the hospital. She's been giving daily updates to patients' family members by phone.

"But I know my calls, even if well-intentioned, can't replace the feeling of holding your mother's hand as she goes through a large illness or a big moment in her life with her health," she told NPR's Mary Louise Kelly on Friday. "So I'm aware of the ways in which the suffering isn't just physical. There's also a component of it that's emotional."

Some patients she's been caring for have died, Mayer says, and there have also been both "great stories though of success" and some small but profound moments. She remembers she found a cellphone charger for one patient, who was then able to call family for the first time in three weeks. The patient thanked her profusely, with eyes filled with tears.

"I think it made me really remember the importance of these human moments of connection and how even as the medical challenges overwhelm us ... seeing someone for their humanity is just as important," Mayer says.

Listen to the All Things Considered conversation here.

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From Medical School To Fighting COVID-19 On The Front Lines At Bellevue Hospital - NPR

What Do Trump And Yale Medical School Have In Common? Both Were Duped About A COVID-19 Treatment – Forbes

Illustration picture shows a pharmacist holding a box of Plaquenil, Monday 06 April 2020. Belgium ... [+] goes into its fourth week of confinement in the ongoing corona virus crisis. There are lots of debate around the use of Chloroquine medecine te treat Covid-19.BELGA PHOTO BENOIT DOPPAGNE (Photo by BENOIT DOPPAGNE/BELGA MAG/AFP via Getty Images)

Hydroxychloroquine, promoted just a few short weeks ago as a cure for COVID-19,is useless.

Actually, it's worse than that. Hydroxychloroquinecauses heart arrythmias, which can be fatal. Data from early trials of hydroxychloroquine show that it is killing people, not saving them.

Why, then, are so many people talking about hydroxychloroquine? The answer is a tale of scientific hubris and incompetence bordering on fraud. It's also a tale of how Yale Medical School and the Trump administration both fell for it.

Part 1: the hubris of a French "science star."

Last week, theNew York Timesrana lengthy profile of Didier Raoult, a French microbiologist who the Times lauded as a "science star." Raoult vaulted into the public eye in March, whenhe published a very small studyclaiming that a combination of hydroxychloroquine, an anti-malarial drug, and the antibiotic azithromycin could cure COVID-19. Claimed Raoult:

"We know how to cure the disease" (Didier Raoult, quoted in theNY Times)

Actually, Raoult's proclamations began earlier, on February 25, when he posteda video on YouTubecalled "Coronavirus, game over." Not surprisingly, the world took notice. (Note that as the evidence for his so-called treatment evaporated, he re-titled the video "Coronavirus, towards a way out of the crisis.")

Raoult's study was deeply flawed, and it has been taken apart by multiple scientists, so I won't repeat all their points here. A good summary of many of the flaws was written by Elisabeth Bik,first on Twitterandthen in a blog article, back in late March. Among other flaws, the study dropped 6 of the 26 patients who were given hydroxychloroquine without explaining why. One of those patients died.

My results always look amazing if I leave out the patients who died, Bik commented.

Raoult is not happy with Dr. Bik. He recently called her a"witch hunter"on Twitter. This apparently is not unusual for Raoult; the NY Times compares his psychology to that of Napoleon. I wonder what he'll call me after this article appears.

In addition to its serious flaws, the paper was published in a journal whose editor-in-chief, Jean-Marc Rolain, was also a co-author on the paper. Even worse is the fact that,as the journal itself notes,the paper was accepted justone dayafter being submitted. Clearly, this paper did not undergo careful peer review, and it reeks of extremely sloppy science.

Since then, several larger, better-run studies have either found no benefit for hydroxychloroquine, or found actual harm. To be specific,a study of 368 patients in US Veterans Administration hospitalsfound that the mortality rate in patients given hydroxychloroquine was 27.8%. Patients who received both hydroxychloroquine and the antibiotic azythromycin had a mortality rate of 22.1%. But patients who did received neither one had a mortality rate of 11.4%.

In other words,giving patients hydroxychloroquine doubled their risk of dying.

One final note about Didier Raoult: he has a truly unbelievable number of scientific publications, over 2,800according to PubMed. From 2012-2019, he averaged 176 papers per year, or about one paper every two days. Speaking as a scientist, it simply isn't possible that he made any real contribution to the vast majority of these papers. TheNY Timesexplained that Raoult puts his name on every paper published by his institute, which employs hundreds of scientists. Again, speaking as a scientist, this is grossly unethical. No scientist should put his/her name on a paper unless they made a genuine scientific contribution to it. At many universities, Raoult's behavior would be grounds for dismissal.

Part 2: Trump and Yale Medical School fall for it.

As theNY Timesreported, and as most of the U.S. knows, Trump began touting the benefits of hydroxychloroquine at a news conference on March 19:

I think its going to be very exciting. I think it could be a game changer and maybe not. And maybe not," Trump said.

Right. Soon after that, the FDA, "under what appears to have been strong pressure from the Trump administration," issued an emergency use authorization for hydroxychloroquine.

Medical experts, including NIAID director Anthony Fauci, quickly injected a note of caution, pointing out that the evidence was very preliminary, and that we needed better studies. Nonetheless, Trump and his political allies ran with the news that a "cure" was available. They were wrong.

Perhaps most disturbing, though, was the behavior of some highly regarded doctors, who also fell for Didier Raoult's hype. One might excuse politicians for being fooledthey don't have the trainingbut the same excuse doesn't work for a medical expert.

And yet on March 26,Yale Medical School boldly tweeted outits "Treatment algorithm for COVID19," promoted with two megaphone icons:

Image taken from my own twitter feed

Attached to the tweet was a graphic of a flowchart, showing that the first steps in their treatment algorithm were hydroxychloroquine and atazanavir. At the time, I replied to their tweet and warned them that there was no good evidence for their recommendations.Their response:

"While there are no FDA approved treatments for COVID19, this protocol is based on available knowledge, personal observations & communications from other institutions. In the absence of firm evidence for best treatments, this is intended as a working document & subject to change."

Well, at least they responded. But in their response, they admit that their protocol is based on anecdotal evidence and little else. This is seriously disappointing, coming as it does from one of the nation's top medical schools. It also displays hubris not that dissimilar from Didier Raoult's.

Now that more evidence has emerged, and we know that hydroxychloroquine doesn't help and probably harms COVID19 patients, has Yale updated its treatment protocol? Well, yes:they tweeted out a new algorithm on May 15. Now it says:

"Consider hydroxychloroquine x 5 days with close cardiac monitoring."

This is truly appalling. The only evidence of efficacy was the small, badly-run study promoted by Didier Raoult, which has now been contradicted by much larger, better run studies. We now know that hydroxychloroquine is harmful. Others on Twitterquickly questioned the new Yale recommendation, but it's still there as of this writing.

So there you have it. Many so-called experts are still pushing the use of an ineffective, dangerous drug that doesn't help, and may harm, people infected with the SARS-CoV-2 coronavirus. A bogus claim promoted by a self-important, egotistical scientist who published a sloppy study in a journal run by one of his co-authors turned into millions of doses of medication wrongfully prescribed.

And for now, Yale Medical School still hasn't admitted any error. I'm waiting.

[Note: I am an alumnus of Yale University, and I have long been one of its biggest fans. I did not attend medical school there, but their unscientific behavior is nonetheless especially disappointing to me as an alum.]

Original post:

What Do Trump And Yale Medical School Have In Common? Both Were Duped About A COVID-19 Treatment - Forbes

Hartselle grad follows dream from pitcher’s mound to medical school – The Hartselle Enquirer – Hartselle Enquirer

Special to the Enquirer

When Hope Cain stood on the pitchers mound during her four-year softball career at the University of Mobile,sheknew my teammates always had my back. When I stood on the mound, I knew everyone behind me was there to work as a team and allow us to succeed as a team.

Her team of University of Mobile faculty, coaches and staff had her back, as well. The softball standout from Hartselle was accepted to two medicalschools andwasoffered an $80,000 scholarship. When she starts this fall at the University of Alabama-Birmingham School of Medicine, its because the support of professors like Dr. Randy Craig helped her realize her true passion to become a physician.

The University of Mobile has allowed me to follow my dream of playing college softball, strengthen my faith and help me understand what I was called to do in my life, she said.

A member of the UM Class of 2020, Cain earned a Bachelor of Science in pre-health biology.

The Christian university in Mobile is one of the few in the nation where undergraduate students like Cain can have hands-on learning experiences in a nationallyaccredited cadaver lab. UM studentstake part inas much as two full semesters of training on actual human specimens a tremendous benefit for students heading to medical school.

They also have small classes with professors like Craig, professor of biology and chair of the Department of Natural Sciences in the College of Arts and Sciences. A veterinary surgeon withmore thanthree decades of experience, Craig continues to perform complex surgeries students are invited to observe.

Whether pre-health students arepursuingcareers as physicians, dentists, pharmacists, veterinarians or researchers, the universitys faculty and curriculum will prepare them accordingly, Craig said.

A softball standout who was named the softball scholar-athlete of the year for the SSAC and honorable mention All-American for the NAIA for the 2019 season, Cain took advantage of the opportunities a small campus offers for students to become involved in a variety of activities. During her college career she was a peer leader, tutorandmember of Beta Chi. Sheserved on the Student Leadership Council and was president of the universitys chapter of Alpha Chi National Honor Society, as well.

Cainsaid attending the University of Mobile helped her further understand how to treat people with the Christ-like attitude her parents had taught her.

I also believe that by going to a Christian school, I have received a greater understanding and appreciation of how detailed and the perfect way that God created all of us, Cain added.When I practice medicine, I want to remember that it is God who gave me and my fellow doctors the abilities we have and that He is the ultimate healer and physician.

Cain is a member of Promise Land Church in Hartselle, where her father, Greg Cain, is pastor.

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COVID-19 is in our sewage. Duluth medical school researchers say that could be useful – Duluth News Tribune

Medical school assistant professors Glenn Simmons Jr. and Richard Melvin are testing samples of wastewater submitted by Minnesota treatment plants including the Western Lake Superior Sanitary District in Duluth, which treats sewage for more than 125,000 residents to better understand where COVID-19 is and, eventually, how many people in a certain population have it.

Its after several months of doing this and then conferring the data that we have with the data from the Department of Health and other officials, where we may be able to start developing a formula that can help us make sense of it and then help redirect medical resources and public services, Simmons said.

Its a method undertaken by other researchers, too.

David Hirschberg, founder and catalyst of Rain Incubator, a biotech nonprofit in Tacoma, Washington, has been testing wastewater there for traces of COVID-19 for about two months.

He said its important for other researchers across the country to do similar studies.

By doing this kind of standoff monitoring, I think we could constantly be ready ... to be able to inform vaccine manufacturers or hospitals on how many beds do you need, things like that, Hirschberg said. Because this is an indicator that, hey, this is in your environment."

When news of COVID-19 emerged, Simmons dove into the literature about the virus. He found a few articles about the SARS virus outbreak of 2003, which, like COVID-19, was also caused by a coronavirus. The literature said the virus was present in patients stools.

Then he came across a paper from the Netherlands that showed positive viral particles of COVID-19 were found in the countrys wastewater.

So now you have this connection between what we see with the coronavirus for SARS, and now you're seeing something that would basically indicate that a similar thing would be happening with the COVID-19 virus, Simmons said. And then from there, we basically just started asking the question: Can we pull that off in Duluth?

After working things out with the University of Minnesota and making sure the researchers werent competing for personal protective equipment or testing kit materials with other areas of the university that needed them, the answer was yes.

WLSSD and the Minnesota Environmental Science and Economic Review Board, which represents more than 50 wastewater utilities across Minnesota, were quick to sign on and provide regular samples to the UMD lab.

Were always happy to participate in a well-designed sample and to the extent ... that we can contribute to the knowledge in regard to this virus, we are very happy to do so, Marianne Bohren, executive director of WLSSD, said.

Joe Mayasich, WLSSDs director of environmental services, said WLSSD often collaborates on studies with universities and government agencies, including on several that have won national Environmental Protection Agency awards.

The studies typically focus on the environment, toxicology and designs of wastewater treatment technologies. This is the first time WLSSD has taken part in a study like this.

Its one of the reasons you go into science: to generate data and provide information for the good of mankind, if you want to say it that way, Mayasich said. But especially now that this is such an acute issue. To be able to step in and help out with something that really does look like it has utility and usefulness, it really is gratifying and rewarding.

Wastewater treatment plants regularly test wastewater, called influent.

WLSSDs daily tests typically look for the influents total suspended solids, the biochemical oxygen demand and other properties.

Now, workers are taking a little bit extra on their daily sample runs and sending it to the lab at UMD.

What were providing the UMD medical school is a split of our 24-hour total influent composite, so its a sample of what is coming into the plant collectively, and were giving them 250 milliliters a day sampled twice a week, Bohren said.

At the UMD lab, Simmons and Melvin test the samples for a very tiny amount of genetic material specific to the virus using polymerase chain reaction, or PCR, testing.

Right now, Simmons can detect whether COVID-19 is in the water a positive or negative result.

The next step, Simmons said, is being able to determine how much of the virus is in a sample. And from that, it might be possible to estimate how many cases are in the community served by the wastewater treatment plant.

Studying wastewater has worked in monitoring for other diseases.

In 2013, a sewage surveillance system in Israel detected a polio outbreak early on, allowing officials to contain the outbreak and quickly deploy a polio vaccine.

Detecting more virus in an areas wastewater could give health care officials a heads-up infections are rising, even before many people seek testing or medical attention.

It would potentially be what wed call a leading indicator as opposed to a lagging indicator because most people dont actually go get tested until they start seeing symptoms, Simmons said.

Additionally, data is showing people shed the virus in feces before they have symptoms and for up to a month after that, Simmons said.

Thats another reason why whatever we do has to be done for a long enough period so that we capture both that initial peak and then the trail-off in a given population that may be full of individuals who have already recovered, Simmons said.

Simmons said the big, audacious goal that we have is to gather enough data over time to make formulas and algorithms that could, based on the amount of viral particles in the wastewater and the number of confirmed COVID-19 cases the population served by the treatment plant, determine just how many people have COVID-19 in that area.

While some testing labs such as Biobot, a startup associated with the Massachusetts Institute of Technology, said it can quantify an estimate of infected individuals based on wastewater testing, Hirschberg said hes not sure thats possible.

But Hirschberg said it would be possible to gauge whether overall cases are increasing or decreasing, especially if data is collected over a long period of time, based on the amount of virus found in the sample.

Hirschberg likened wastewater testing to a smoke alarm or a dashboard warning light.

If those are positive weeks before patients start showing up in the hospital, thats a much better indicator when people are coming into the emergency room having trouble breathing, its too late, Hirschberg said.

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Medicine in Motion – Harvard Medical School

Chase Marso remembers the moment he realized Medicine in Motion, the fitness group he and threefriends started during their first year at Harvard Medical School, had truly taken on a life of its own.

It was August 2019, and Marso and 18 other members of the group had just finished Bike to the Beach from Boston to Newport, R.I., an annual ride benefiting autism awareness and research. Their team raised more than $15,000.

We had so many people that had very little biking experience on our team, and they committed to this 100-mile bike ride, Marso said. To see so many different people with varying levels of fitness going into the summer, commit to training together and to fundraising, that was a moment where I thought, What we've been doing is worthwhile and worth continuing to grow to have more moments like this."

It had been a long journey to that Newport beach from the gym at Vanderbilt Hall.

Thats where the studentsMarso, Logan Briggs, Mike Seward and Derek Soledmet in the fall of 2017. What started with informal group workouts grew into a student group called Docs Who Lift, and the four recruited other HMS students to register for endurance events, like Spartan Races and triathlons.

They had all been athletes before coming to HMS and had personally experienced the benefit of regular, intense physical activity.

For me, working out is the only thing that offers a mental respite from my other responsibilities, said co-founder Briggs. Activities like watching a movie or playing video games just leave this nagging thought in the back of my head that I should be doing something more productive. So, working out is really the only time where I feel liberated from all the other tasks on my plate and comfortable that I'm doing something productive for my body and my mind.

Co-founder Soled also sees regular physical activity as central to a balanced life for busy medical students and health care professionals.

A lot of people wrongly look at physical activity and they say, How do you have time to work out? You have these long days being a student or being a doctor, Soled said. But it's not like you're adding this time; it's that this time for physical activity is so integral to my day, and it's what I need to flourish in all my other activities.

In the summer of 2018, they, along with Katie Lantz, Sewards girlfriend and fellow Harvard College alum, signed up for the Pan-Mass Challenge. Together, they biked 200 miles over the course of two days, despite Briggs being the only member with any previous long-distance cycling experience.

They also gained fundraising experience as each collected donations towards the $5,500 registration fee to benefit Dana-Farber Cancer Institute. Together, racing as Docs Who Lift, they raised more than $30,000.

When that was over, we said, OK, now what? said Marso. How do we go about doing this in year two? How do we include others?

That fall, the founders hosted a meeting with other interested students from HMS, HSDM and other Boston-area medical schools to brainstorm ways to combine their interests in physical fitness, health care and philanthropy. Medicine in Motion was born.

Soled says Medicine in Motion has three goals.

First, we want to promote well-being in health care professionals through physical activity. Secondly, we want to foster a sense of community among health care professionals, at all stages of training and all types of health care. Finally, we want to use this time together to fundraise and give back.

To that end, Medicine in Motion registered as an official 501(c)(3) non-profit. The group grew to include chapters at HSDM, Boston University Medical School, Tufts University Medical School, Dartmouth Geisel School of Medicine, University of Massachusetts Medical School, and most recently, the University of Queensland in Australia.

In addition to organizing regular workouts and runs at their individual chapters, members also have also participated as teams in triathlons, long-distance bike rides and other endurance events.Within its first two years, Medicine in Motion recruited 684 medical professionals to take part in events, raising $50,000 for medical research initiatives.

Second-year HMS student Henry Ashworth, who has taken on a leadership role with the group, thinks the groups focus on community building has been key to its growth.

Its fun to do these things, but it's so much more fun when you're with someone else, he said. Its a much more meaningful experience if you feel connected to the people you're around.

Dylan Cahill, a first-year HMS medical student who has organized weekly group runs for Medicine in Motion, explained how the focus on physical activity provides an opportunity for medical students and health care workers of all levels to form connections.

Maybe while jogging next to someone, you learn a little bit about what they do for a living, what theyre passionate about, Cahill said. And you say, Hey, that's something I'm interested in, or, My buddy was looking to get into that sort of thing. Do you mind if I send you an email?

Soled also sees the opportunity to network with medical professionals at different points of their career as a benefit to the group.

It brings people together who otherwise may have never interacted but are following the same trajectory, he said. You get a first-year medical student sitting next to an attending who is 30 years older than them who is interested in the same field.

Medicine in Motion had been planning to cap off their third year with their first fully self-organized event: a 5k run along Bostons Esplanade that would be open to the public. Planning was underway when the Longwood campuses, Boston and much of the rest of the country shut down to slow the spread of the new coronavirus.

With members now separated by quarantine and finishing the semester online, planning for the 5k has been put on hold, and it seems unlikely the event will be held at the end of the summer as previously hoped.

But the group is finding ways to stay connected.

Cahill says many members use the mobile app Strava to share their runs, post selfies and leave encouraging comments for each other.

Ashworth with fellow second-year HMS student Niyi Odewade have started a workout of the day (WOD) program, devising fitness circuits people can easily do within their homes without gym equipment, encouraging people to use objects at handlike milk jugs or a backpack full of booksto take the place of weight equipment.

It provides a way for us to remain socially connected while physically distancing, which can take a toll on people's mental and physical well-being, said Odewade.

The two are creating a library of WODs on the Medicine in Motion website. Recently, the Dartmouth and Queensland chapters began leading weekly workouts on Zoom available to the public worldwide.

While the focus is on resistance and high-intensity interval training, Ashworth stresses that people should be sure to take the time for whatever self-care they find most necessary or useful.

Maybe doing an intense exercise at home is not what you need today, Odewade said. Maybe you need that extra time to yourself to relax, to just sit and read a book, to call a friend, to go for a walk. To just absolutely do nothing and eat food on the couch, because that's what you feel like you really want right then and there.

Looking ahead, group leadership would like to see chapters in every state and in more countries, with a central organization financially stable enough to provide funding to individual chapters to organize their own events.

Seward said its been most satisfying to see new members take on leadership roles, ensuring the group has a future beyond the co-founders graduation.

That was a goal for us this year: to get other people leading events, coming up with their own ideas, he said. Because we think if they can come up with their own ideas, they'll take responsibility and really run with it.

Soled sees the November 2019 Spartan race as a moment when Medicine in Motions new leadership took charge. More than 130 members participated in an endurance challenge at Fenway Park.

The four of us [third-year co-founders] had virtually nothing to do with it in terms of preparation, Soled said of the event, which was spearheaded by Medicine in Motions Tufts University School of Medicine chapter, captained by Jacob Klickstein. We like to think we're creating a model for years to come, and it was just very inspiring for us to see that.

Looking at how far Medicine in Motion has come, Soled is optimistic about where the group will go.

It's been a challenge, but an extremely rewarding experience to see people setting benchmarks and goals for themselves, he said. That's all we're about.

Related coverage in HM News: The Best of Who We Are

Images courtesy of Medicine in Motion.

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Medicine in Motion - Harvard Medical School

COVID-19 means a shorter MCAT: What aspiring med students must know – American Medical Association

For aspiring medical students preparing for the Medical College Admission Test (MCAT), the COVID-19 pandemic has thrown a curveballas it has for the entire medical school admissions process.

Administrations of the exam are on hold until May 29. In response to losing more than a month of prime test-taking time, the Association of American Medical Colleges (AAMC) is making changes to the exam that will accommodate additional test times.

What are those changes, and should they alter your preparation? One expert on the exam offered his opinion.

The single biggest change to the exam is that for the remainder of the 2020 testing cycle, it will be reduced in length. The typical MCAT test-taker is given seven hours and 30 minutes of test-taking time. Under the abridged format, the exams seat time is five hours and 45 minutes.

All the exams sections will feature fewer questions, and some passages will be removed. Still, the breadth of required knowledge remains the same, so its best to stick to your initial study plan.

The exam itself is going to be shorter, said Petros Minasi, senior director of prehealth programs at Kaplan Test Prep. But what hasnt changed is the proportionality in terms of the amount of time a student has per question. It isnt as though the exam has gotten harder or gotten easier. Even though it is a shorter exam, it is relatively the same difficulty as far as pacing.

To accommodate the need for more test takers to be able sit for the exam in a shorter window, the AAMC has moved from one administration of the exam per test day to three. The three times are 6:30 a.m., 12:15 p.m. and 6 p.m. None of those time frames include a meal break, which differs from the typical exam day schedule.

The spread on times means that students should identify their ideal time and test-taking location and register for it as soon as possible, according to Minasi.

The main thing for a student to really be considering is not just when they are selecting their testing time, but how they are going to incorporate the when of the exam into their overall preparation plannot in terms of the studying of questions and content, but as far as making sure they are physically and mentally ready to test at their exam time, Minasi said.

One recommendation Minasi offered to account for changes in exam times is to study and take practice exams during the window in which you will take the exam.

For the most part, Minasi said students should proceed as if they were taking the full-length MCAT exam. The one possible exception is taking practice exams. Doing that, a student should shorten the test-taking time and cut the number of questions in the exam to match the breakdown of the shortened exam.

Kaplan has suggestions on how to alter your practice exam to best fit the format you will encounter when you take it in the coming weeks.

Beyond that, the only thing a student should be altering is the mindset that they are going to be taking a shorter exam than the full-length exam that they have been preparing for, Minasi said. The content topics that would normally be tested are all still fair game.

Medicine can be a career that is both challenging and highly rewarding but figuring out a medical schools prerequisites and navigating the application process can be a challenge in itself. TheAMA premed glossary guidehas the answers to frequently asked questions about medical school, the application process, the MCAT and more. Prospective applicants should also be reassured that admissions offices are acutely aware of recent disruptions to historical processes and will be making adjustments to account for the realities of the current situation.

Have peace of mind andget everything you need to start med school off strongwith the AMA.

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UT Health Austin and Dell Medical School looking for volunteers interested in helping with COVID-19 contact tracing – KVUE.com

The goal is to help prevent the spread of COVID-19. Volunteers would work a minimum of 24 hours per week for four weeks.

Since March, UT Health Austin and Dell Medical School have had a program where volunteers can sign up to be contact tracers. The program partnered with Austin Public Health so they can cover different segments of Austin's population.

From making calls to taking down the data of COVID-19 cases, Dr. Darlene Bahvnani, an MPH epidemiologist with the Dell Medical School, said contact tracing can be effective in preventing the spread of COVID-19.

"What if you could cut off that chain of transmission by following that first case very carefully and trying to understand who they came into contact with and making sure that those contacts never spread the infection?" Dr. Bahvnani said. We started off with just a handful of medical students volunteers, and weve now grown to 76 active volunteers and 200 and some in [the] queue."

Anyone can sign up to volunteer, but it's noted that being a public health, social work, clinical or having bilingual experience is a plus.

I think this can be [a] very very effective approach to opening up Austin and opening up the rest of Texas. I think this is absolutely necessary if were going to start walking around and going about, Dr. Bahvnani said. I think it will be important to have volunteers sign up and come and do their part."

For the contact tracing program, a minimum of 24 hours per week for at least four weeks is expected, and there's also a home monitoring program.

According to UT Health Austin's website, volunteers must meet the following expectations:

Addison Allen, a UT Health Austin volunteer in the program, said she's been doing it for several weeks now. According to Allen, somewhere between 45 and 60 calls are made every day, but the weekends are a bit slower.

Allen said volunteers wil ask for things like the daily routine of the people they call.

"Go through their day, what did they do, who did they see did they go anywhere and just try to figure out if they had close contact with anyone before they started to self isolate," Allen said. "Seeing that a contact that became a contact had less contacts potentially because we reached out and I think that's really big."

The program is exploring possibly paying people for the work in the future but as of right now, it is all volunteer.

"If you do get a call from a contact tracer, please pick up and please try to cooperate because we're doing out best to keep you safe," Dr. Bahvnani said.


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UT Health Austin and Dell Medical School looking for volunteers interested in helping with COVID-19 contact tracing - KVUE.com

Doctors In Training Learn Hard Lessons During The Pandemic – NPR

Dr. Max Lazarus, a medical resident at a hospital on Long Island, N.Y., is one of some 130,000 medical residents in the U.S., many of whom have found themselves on the front lines of the COVID-19 pandemic. Max Lazarus hide caption

Dr. Max Lazarus, a medical resident at a hospital on Long Island, N.Y., is one of some 130,000 medical residents in the U.S., many of whom have found themselves on the front lines of the COVID-19 pandemic.

The coronavirus is leaving a lasting impression on a generation of young doctors.

In the U.S., there are some 130,000 medical residents doctors in their final years of training after medical school who make up a vital part of the workforce.

Now a global pandemic has become the centerpiece of their training.

Many are pulling long hours in emergency departments and intensive care units treating patients infected with the coronavirus, all while witnessing the health care system under unprecedented stress.

Their schedules are transformed. Family members must keep their distance. And some of the hallmarks of their clinical training suddenly feel tenuous.

Many recognize the pandemic as a formative moment, both for health care and their own careers. Some say it's also magnifying existing concerns about labor and mental health among doctors in training.

'Nothing is working'

Before the coronavirus crisis, Dr. David Lin, a second-year medical resident at the Mount Sinai Hospital in New York City, felt comfortable working in the intensive care unit.

Lin already knew how to manage a patient on a ventilator, when to adjust the settings, what to do if the person's kidneys needed help.

So much changed for him the day that coronavirus patients first streamed into his hospital, though.

"Every person that rolled in: tubed, unstable, respiratory failure, COVID ... anyone, young, old," he says. "It was just a deluge."

From then on, Lin was treating these critically ill patients all the time, week after week, as New York City hospitals saw a crush of coronavirus patients in March and April.

Lin soon discovered that some of the clinical know-how he had accumulated over years of training no longer applied in the same way to COVID-19. Instead of improving, patients would linger in the ICU for weeks, their recovery uncertain.

"You are trying to do something, and nothing is working," he says. "Now whenever I see someone intubated, you just know, 'Oh my God, they are probably going to die.' "

Day after day, Lin had the unsettling experience of leaving the hospital unsure of whether his efforts to help patients actually made a difference. "It has just been incredibly disheartening," he says.

Another challenge is that even Lin's attending physicians the seasoned doctors who train him don't have all the answers either.

"These leaders in critical care who I respect so much, they're telling me like, 'We don't know,' " he says. "That's terrifying."

"It reminds you there are always going to be things in medicine that you will never know," Lin says.

In Baltimore, Dr. Martha Frances Brucato, a second-year resident in pediatrics and internal medicine, says much of her education has emphasized that family members should be closely involved in a patient's care. But now hospitals generally bar visitors because the coronavirus is so contagious.

Dr. Martha Frances Brucato is a second-year resident in pediatrics and internal medicine in Baltimore. Martha Frances Brucato hide caption

"The really hard part of our jobs right now is how alone our patients are by necessity," she says.

The pace is different too. She can't rush to a patient's bedside without first putting on layers of protective gear: "That immediacy is such a part and parcel of ICU care, typically."

For many residents, the risk to their own health has never felt so immediate either.

Before working in the ICU with COVID-19 patients, Brucato made sure to remind her husband of her own medical wishes.

"Remember that I have a living will," she told him. "I would want to be ventilated as long as there was a chance for meaningful recovery."

That does not mean Brucato hesitated to be on the front lines of the pandemic.

In fact, she volunteered for the assignment.

Dr. Brendan McEvoy, an emergency medicine resident in Chicago, also jumped at the chance to work on COVID-19 in the ICU.

Then he caught the virus.

"There were a lot of people that were very concerned for me," he says.

It was nerve-wracking initially, he says, because he had seen otherwise healthy young people on ventilators during his shifts.

Soon after his recovery, he was put on a dedicated intubation team in the hospital.

"I hope we are going to look back at this like, 'How were we all not better prepared?' "

Pandemic magnifies labor concerns

For some residents, the pandemic is amplifying long-standing concerns about working conditions.

"It is really bringing to light a lot of the ways that residents have been mistreated for years," says Dr. Amy Plasencia, executive vice president of the Committee of Interns and Residents, a union representing more than 17,000 doctors in training.

Before the pandemic, the Committee of Interns and Residents was pushing for a bill of rights that focused on better pay, sick-time policies and other protections for residents.

"Now is the time that we most need those protections," says Plasencia, a resident at a hospital in Brooklyn, N.Y. "Because residents are really at the forefront doing so much of this work, they are in very large numbers becoming ill."

Generally, residents are reluctant to speak publicly out of concern that doing so could jeopardize their job and professional future. Since the pandemic began, more are taking to social media to air concerns about working conditions.

Medical residency is essentially a prolonged apprenticeship that generally stretches from three to seven years. Residents are expected to put in long hours as part of their education. The average salary is about $60,000 per year.

At the University of Washington, the union representing doctors in training is wrestling over a contract with the hospital system in an effort to get better pay and benefits.

"People can't work 80 hours a week, see really horrible things all day [and] not have access to mental health care, without having some sort of burnout," says Dr. Zoe Sansted, who is vice president of the University of Washington Housestaff Association.

Sansted, a family medicine resident in her third year, was assigned to work in the ICU as the pandemic spread in Seattle.

She says many residents are eager to work extra hours and be on the front line.

"These are wonderful instincts," she says. "Doctors are obsessed with professionalism, but it's also ripe for exploitation."

COVID-19 takes emotional toll

Before the pandemic, Dr. Murad Khan was already a bit nervous about his internal medicine rotation.

Khan is a psychiatry resident in his first year, known as an internship, at Yale New Haven Hospital. Suddenly his rotation coincided with a surge of COVID-19 patients.

Rules were changing constantly. At first, he says, it wasn't clear what residents would be asked to do or whether there would be enough personal protective equipment.

Dr. Murad Khan is a first-year psychiatry resident at Yale New Haven Hospital. Yvonne Uyanwune hide caption

"Initially, things were pretty frantic," Khan says. "I actually spent a lot of the first couple weeks having a hard time sleeping before going into work."

Khan says he found himself on edge, concerned that a COVID-19 patient would crash and he wouldn't know how to respond.

"There is something traumatic just about not knowing how sick a patient might get at any moment," he says.

Khan is much more comfortable working with coronavirus-infected patients since those early days of the pandemic in Connecticut. But he recognizes the psychological toll of caring for these sick patients, often being the only connection between them and their families.

"You are having these conversations on a regular basis. Do we want to focus on comfort care? Or do we want to focus on trying to make them live more?" he says.

Khan says the coronavirus has only underscored existing problems in American health care, from racial health disparities to the demands placed on medical residents.

"There was already an issue around how much residents work and how much they are supervised and whether or not that's good for their mental health," he says. "That's even worse now."

For many residents, the legacy of the coronavirus may be the emotional weight of so much unmitigated loss.

Dr. Max Lazarus, a resident at a hospital on Long Island, N.Y., went into emergency medicine exactly so he could respond to crises.

He remembers pushing stretchers around the lobby of Bellevue Hospital as a volunteer in the emergency room during Hurricane Sandy.

"This is what I signed up for," he says. "It forces you to grow in a way that I don't think anything else could."

Dr. Max Lazarus, a medical resident at a hospital on Long Island, N.Y., went into emergency medicine so he could help during crises. "This is what I signed up for. ... It forces you to grow in a way that I don't think anything else could." Max Lazarus hide caption

But Lazarus says nothing could fully prepare him to watch patients call their family members before going on a ventilator.

"You tell them that hopefully they will wake up but there is a chance they may not," he says. "It's not the way anyone should die, alone on a ventilator."

Lazarus, 29, still thinks about two patients he treated early in the pandemic one was a bit younger than he is, the other a bit older.

"And they died," he says. "They really stick out."

This story comes from NPR's reporting partnership with Kaiser Health News.

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Harvard Medical School Professor Burton ‘Bud’ Rose, the ‘Steve Jobs of Medicine,’ Dies at 77 | News – Harvard Crimson

Burton Bud D. Rose had already written a textbook that his colleagues referred to as the nephrology bible. Still, he wasnt satisfied.

Rose knew his book could only stay accurate for so long before hed have to update it which, for most volumes, happened every five years.

But Rose wanted to keep his textbook up to date constantly. So he asked his publisher if theyd assist him in transferring the textbook to a computerized format, which could be regularly updated. They refused so he decided to do it himself.

In 1992, aided by his wife, Gloria, Rose created a computerized database of medical information called UpToDate from their home. Today, the digital platform is used by over 1.5 million clinicians worldwide.

Aside from his online pursuits, Rose worked as a professor at Harvard Medical School and a nephrologist at Beth Israel Deaconess Medical Center. He died on April 24, from Alzheimers disease complicated by COVID-19, at the age of 77.

Theodore I. Steinman, a professor at Harvard Medical School and a senior physician at Beth Israel Deaconess Medical Center, called UpToDate the first living textbook.

He was probably the most influential person ever in the world with regards to medical information and education, Steinman said.

Mark L. Zeidel, a professor at Harvard Medical School and physician in chief and chair of the Department of Medicine at Beth Israel Deaconess Medical Center, often calls Rose the Steve Jobs of Medicine.

In part, that moniker stems from the fact that Rose created UpToDate with a piece of technology from Apple, the hypercard. But Zeidel also saw UpToDate as an example of disruptive technology like the computers and phones Jobs created.

Both Steinman and Zeidel said that Rose could have been in contention for a Nobel Prize in Medicine, which cannot be awarded posthumously.

He really was deserving of the Nobel Prize in Medicine because of his worldwide impact on medical education and medical information technology, Steinman said.

I regret that it never occurred to me, but we could have actually put him up for the Nobel Prize in Medicine and he might have won it because of the significance of this contribution, because people around the world are using it constantly, Zeidel said.

Zeidel said that most of the 170 interns and fellows at Beth Israel Deaconess regularly use UpToDate.

When I come in and do rounds, they don't quote the textbook, he said. They quote UpToDate. Because at two in the morning, they can call it up on a computer right at the point of attack where they're working, and they can look up what they need to find, find it quickly, and get the authoritative information.

Isaac Kohane, the chair of the Department of Biomedical Informatics at Harvard Medical School, said Roses creation revolutionized medicine.

Rose had a unique mix of vision and pragmatism that allowed him to create such an impactful technology, he added.

That resource was so singular, and the editorial process that was put together was so rigorous and so strongly academic, yet because of his leadership, so determinately practical and focused, that it became the unquestioned standard, Kohane said.

Despite the fact that UpToDate took more and more of his time, Rose remained active as a clinician and professor.

He always took time to be an attending physician on the renal service at Beth Israel Deaconess Medical Center, and he was always a wonderful one on one teacher, Steinman said.

Martin Pollak, a professor at Harvard Medical School and chief of the Division of Nephrology at Beth Israel Deaconess Medical Center, called Rose a beloved teacher.

He just had a very clear, concise way of breaking down complicated concepts, Pollak said, and he used his skills to teach medical students and patients alike.

He taught an annual course at the Medical School on kidney disease that people from all over the world flocked to, Pollak said. In 2009, the American Society of Nephrology granted him the Robert G. Narins Award, the highest award for education in nephrology.

Gloria Rose, his wife, said he approached pursuits outside the hospital with the same verve.

She recalled that, while at work, he was looking at the names of their immediate family members, and created the acronym Badgers short for Bud, Ann, Daniel, Gloria, and Emily Rose.

So then he started calling us the Badgers, Gloria said with a laugh. He was just always thinking outside the box, he was very funny in that way.

Rose was also a romantic, Gloria said. One day, he surprised her with flowers and a cake, announcing that it was the 10,000th day since they had met.

He was goofy in a good way, she said. He was very spontaneous.

He loved basketball and tennis, and spent hours at a time bettering his technique.

With everything that he did, it wasn't that he wanted to be the best. He wanted to improve his game. Always, Gloria said. He would go out on the driveway and keep shooting, until he just got it.

With UpToDate, Rose refined medicine, too.

Denise Basow, the CEO of Clinical Effectiveness at Wolters Kluwer, the company that currently runs UpToDate, wrote in a statement that his work changed the medical field over the last three decades.

Once he had the idea for UpToDate, he wouldnt let anything get in the way of pursuing it, Basow wrote. That pursuit has impacted the practice of medicine and the lives of patients for almost 30 years.

Staff writer Camille G. Caldera can be reached at camille.caldera@thecrimson.com. Follow her on Twitter @camille_caldera.

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Harvard Medical School Professor Burton 'Bud' Rose, the 'Steve Jobs of Medicine,' Dies at 77 | News - Harvard Crimson

Ode to Burton ‘Bud’ Rose, MD – Renal and Urology News

Likemany of my colleagues, I was very saddened to hear of the passing of Dr BurtonBud Rose on April 24, 2020 at the age of 77 years. There were two importantsides of Dr Rose: First, he was well known in the nephrology community asan extremely modest, brilliant nephrologist who published 2 important textbookson nephrology. Second, and more importantly, he was the founder and editor ofUpToDate.

DrRose was born in Brooklyn NY in 1942.He attended Princeton University,where he majored in history. He then attended New York University School ofMedicine, where he also completed his residency and fellowship.Afterserving in the US Navy as a nephrologist, he moved to Wellesley, Massachusettsand began his academic career, with positions at the University of MassachusettsMedical School in Worcester, Massachusetts, and Brigham and Womens Hospitaland Harvard Medical School in Boston.

Dr Rose seems to have touched everynephrologist of my generation.I first came across his work Pathophysiologyof Renal Disease, when I was a student on the nephrology rotation at BaylorCollege of Medicine in Houston.This book, as well as Clinical Physiologyof Acid-Base and Electrolyte Disorders, provided me with my foundation andinterest in nephrology. Dr Rose was known for his clear style, and especiallyhis ability to express complex nephrologic concepts in a way that a student,resident, and fellow like myself could understand.

When I was a fellow, 2 of his articles werealso of great importance to me.New approach to disturbances in theplasma sodium concentration, published in the American Journal of Medicine (1986;81:1033-1040), still helps me tounderstand pathophysiologic changes that occur with hypernatremia.His Kidney International Nephrology Forum ondiuretics (Diuretics, Kidney International (1991;39:336-352) was also well-readby me and many of my colleagues.It was a great privilege to have afellows lunch with Dr Rose when he visited the University of Pennsylvania in1991. He was extremely approachable and charismatic.During lunch, hedescribed his idea for UpToDate. Several fellows at the dinner were quite enthusiastic,but others thought it was not such a great idea.

In 1992, Dr Rose started his flagshipUpToDate.Like many of my colleagues, I would see him at American Societyof Nephrology annual meeting in his at first very small booth. Nephrology wasthe first component of UpToDate, and I was fortunate to be an author of severaltopic cards.UpToDate was not successful just because it was the firstcomputer access program for medical doctors.There were several thingsthat Dr Rose did to make it special:Topic cards were directed to busypractitioners and provided expert advice; Topic cards were updated regularly,at least annually; UpToDate was established without industry funding or support,which must have been quite hard early on when there were few subscriptions andvery little income; and UpToDate has an international outreach program that hasdonated subscriptions to clinicians and organizations providing care to poor orunderserved populations.

You know the rest: There are now 25specialties covered in depth, with more than 7,100 authors and editors. Some1.9 million doctors and 38,500 institutional sites worldwide use UptoDate.Thereare more than 50 million topic views per month.The median time to obtaininformation needed during a search is a little over a minute.It isestimated that UpToDate changes physician practices one-third of the time. Whatan impact!

I consider Dr Rose to be the most influentialclinical educator in the history of medicine, with an unsurpassed impact onphysician education and patients lives. While we keep alive the memories ofgreat historical figures like Hippocrates, Galen, and Osler, their impactlessens over time as medicine changes. In contrast,Dr Rosesaccomplishments will live on and his impact will become even more substantialwith each passing day and each new click leading a clinician to learn more atUpToDate.

While (thanks to Dr Rose) I may not be able toeffectively teach students about medical conditions like deep venous thrombosisor Hashimotos thyroiditis because they get to UpToDate before me, I can tellthem the history of UpToDate and how a kind, modest, brilliant nephrologist wasresponsible for much of the learning that occurs in medicine today. I hope thatwe will all keep alive the memory of Dr Rose and that someday he will berecognized for his unparalleled contribution to medicine and patient care.

I encourage you to watch the following youtubevideo, in which Dr. Rose discussed the origins of UpToDate https://www.youtube.com/watch?v=k4nQWM6U298

Anthony J. Bleyer, MD, MS, is Professor of Internal Medicineat Wake Forest University School of Medicine in Winston-Salem, North Carolinaand a member of Renal & Urology News editorial advisory board.

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Ode to Burton 'Bud' Rose, MD - Renal and Urology News

Wisconsin medical students are graduating onto the front lines of coronavirus – Milwaukee Journal Sentinel

Ali Jandal was the student speaker for the medical school graduation at UW-Madison.(Photo: Courtesy of Ali Jandal)

As he approached graduation and a move to the University of Vermont for the start of his career in medicine, Ali Jandal acknowledged that he was afraid.

"How I feel about it changesday by day," said Jandal, who is from La Crosse."I think I've always been a little scared, because viruses are easy to spread and it's really hard to keep yourself safe from them."

In their final weeks of medical school at the University of Wisconsin-Madison, Jandal and his peers had seen the world turned upside down.

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"I want to argue that the end of our medical school careers is poetic," Jandal said in an addressduring the school's virtual graduation. "And if any class was made for this challenge, it was us."

They were the first to navigate the medical program's new curriculum. They spent the last weeks of school at home, as thedoctors they knewfoughtCOVID-19 on the front lines. They celebrated Match Day the day they learn where they'll work their residencies and graduation from behind computer screens.

Now, they'll put their training to use.Working ininternal medicine, Jandalexpectsto see COVID-19 patients who aren't sick enough to be in an intensive care unit boththose who are getting better and those who mayget worse.

He'll be joined by the Class of 2020's newly-minted nurses, public health professionals and other health care workers as he wadesinto largelyuncharted territory. He knows that work comes with risk.

"I think the scariest part is I haven't actually worked with these people in the hospital yet. I haven't seen the people around me get sick," he said."To go from being a citizen, civilian, to being a front line workeris going to be dramatic and scary."

University of Wisconsin School of Medicine and Public Health Dean Robert Golden participates in the school's first virtual graduation ceremony held during the COVID-19 pandemic.(Photo: Todd Brown, Courtesy of UWMadison)

Wisconsin graduates of medicine, nursing and public healthsaid they're ready to get to work. They've been reading up on everything they can about an unpredictable disease.

The Class of 2020s educational experience has been capped by a global public health and medical crisis unlike any other we have experienced in the past 100 years," Robert Golden, dean of UW-Madison's school of medicine and public health, told medical school graduates.

Brianna Stankey, a senior nursing student at Alverno College, has yet to graduate, butshe's already hard at work.

When her school moved online and her clinical at Froedtert Hospital was canceled, Stankey, 22, started working full time in her training programas a certified nursing assistantat a local hospital, working primarily with cancer patients.

She plans to stay on as a nurse after graduation. Stankey, ofTrempealeau, has applied to work as a "grad nurse," working ona temporary permit that would allow her to work before she passes herlicensing exam. She'll stay in the same cancer unit.

RELATED: 'We need all hands on deck': Wisconsin considering emergency measures to put more nurses in the field

"I'm excited. I feel like there is no better time for me to get into this profession and to be working with these people," Stankey said. "It's hard being a new nurse because I don't know everything ... but it's exciting in the sense that I'm able to jump in and I'm able to help now."

It's also a bit scary, she said, and her life has changed significantly.Instead of kissing her boyfriendas she walks through the door, she runs straight tothe shower.

Work has changed, too. A mask hides the smiles she once loved to share withher patients and co-workers. Her patients arrive for treatments alone. She tries to take more time to sit with them and talk, knowing there's more to nursing than caring for people's physical needs.

"I can't imagine being a patient right now, and being at the hospital alone," she said.

There is an understandable fear in coming to the hospital during a pandemic,John Kopriva, a UW-Madison medical school graduate, said. Hospitals will need to work to reassure patients that they can seek treatment safely.

John Kopriva, center in cap and gown, is graduating from UW-Madisons medical school as an MD. At home with his family in Wauwatosa, they will be watching the graduation speeches on a laptop on the kitchen island while having brunch and celebrating the event. From left to right are his girlfriend Hailey Rowen, mother Angela, graduate John, father John, brother Joe, sister Katherine and brother David.(Photo: Michael Sears / Milwaukee Journal Sentinel)

This is true for the patients Kopriva anticipates seeing in orthopedic surgery at Emory University in Atlanta this summer. He expects he'll be busy with the backlog of elective surgeries postponed early in the outbreak. He knows there's a chance he'll run into COVID-19 as well, especially if there's a localsurge in cases.

"I think it's something that's going to define the time that I graduated," Kopriva said. "Hopefully when I'm an older attendingand looking back and giving advice to a younger medical student, I can tell them that 'Hey, that was the time when COVID was a problem. Look at all we've done since.' "

For recent graduateswho hope to find work in other areas less touched bythe pandemic response, the search is proving to be tough.

Kelly Hackett, ofWaukesha, graduated from UW-Madison with her master's degree in public health. But she's still struggling to find work formonths amid hiring freezes.

"I keep saying it's like I'm in a fragmented reality where everything around me all the news, social media, friends, family people are constantly talking about public health, whether or not they realize they're talking about public health," said Hackett.

"And yet, I'm looking at not having a job at the end of this, at a time when public health is critical."

Kelly Hackett and her family celebrate her graduation from UW-Madison.(Photo: Courtesy of Kelly Hackett)

She's still applying to jobs and interviewingwithin her expertise, which includes researchingsocial causes of health disparities factors that experts say have allowed the pandemic to affect some communities worse than others.

Ajay Sethi, an associate professor of population health sciences, said he's seen his students adapt and answer the call to help however they can.

"There is this national call to address this pandemic and public health departments everywhere are thinking of how to scale up contact tracing," Sethi said."And our students, even if they have otherinterests, many of them are eager to do that, just to answer that call."

Hackett acknowledgescontact tracing is not off the table.

"If contact tracing is what's needed and it's what is available, at least it's work and it's a way that Ican contribute," she said.

Geoffrey Watters, 50, earned his doctorate in nursing practice from UW-Madison this spring. He's feeling confident about job prospects, but others in his specialty ofpsychiatric nursingare struggling, especially in outpatient care. One of his classmates got a job, only to lose it when her employerfolded.

"There's a lot of uncertainty," Watters, of Milwaukee,said."It seems counter-intuitive that health care workers would be losing their jobs in the middle of a pandemic, but it's happening."

It shows how medical careextends beyondemergency rooms and ICUs, even in a pandemic.Mental health care remainsimportant for patients and health care providers alike, Watters said.

"Everyone is under a lot of stress and especially people who work in health care," he said.

Like so many members of the Class of 2020, there is a disappointment that comes with missing major milestones in theirfinal semesters. As is true forso many, the pandemic has exacted a personal toll.

For Stankey, missing out on the chance to celebrate the end of her senior year wasparticularly painful. Her undergraduate career was not without struggle: She spent most of it working two to three jobs to pay for school. She lost loved ones, including herfather. But she also made lifelong friends, who she's now separated from.

"As things were getting canceled, I was just whiting them out in my planner, like this is just so sad," she said. "I'm not getting that closure, of being done with school."

Jandal's wedding plans were canceled.He and his fiancee, also a new physician, will now marry in a small ceremony before they move to Vermont to start their residencies.

Hackett's father-in-lawdied the day before her graduation. He tested negative forCOVID-19. But thepandemic meant they had been unable to visit in recent weeks.

Still, each acknowledged the need for everyone to do their part to protect thosemost vulnerable to the virus.

"As talented and as smart and as many resources as you have, in a public health emergency, if you still have people who aren't convinced and won't be a part of the effort, the entire effort could fall apart," Jandal said.

Contact Devi Shastri at 414-224-2193 or DAShastri@jrn.com. Follow her on Twitter at @DeviShastri.


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Wisconsin medical students are graduating onto the front lines of coronavirus - Milwaukee Journal Sentinel

Using the power of peer support to positively impact medicine – American Medical Association

The COVID-19 pandemic has placed a tremendous burden on physicians and other health professionals. It is a burden that is cognitive, physical and emotional. One way to address this ongoing burden is through a peer support program, which can positively impact and shape the culture of medicine during the pandemic and moving forward.

Peer support is an organizational approach and an individual approach to being there for each other, Jo Shapiro, MD, FACS, an associate professor of otolaryngology-head and neck surgery at Harvard Medical School in Boston, said in an AMA webinar. When we think about our organizations and when we think about the way we practice medicine, we need to remind ourselves that the culture of medicine is very strong.

Much of the culture is wonderful, like the fact that we're healers and we put our patients first. That is beautiful, and no one will ever take that from us, but there is a dark side to this, said Dr. Shapiro. The culture has in some ways let us down over the years. Its been increasing our workload without actually increasing the support to front-line clinicians, and its minimized the emotional and physical well-being of physicians and other health care providers

Asking the question, How are we expected to sustain our work if we dont address these challenges to our well-being? Dr. Shapiro emphasized the importance of peer support. By implementing peer support in a health system or physician practice, it can help doctors and other health professionals open up about what is causing them stress.

Here are six fundamental elements for how to use peer support to provide guidance during a pandemic and beyond.

Peer support should be proactive, without waiting for peers to show signs of stress. It is important to put the invitation out there in a way that is destigmatizing, said Dr. Shapiro. Were checking in on you and offering peer support because thats what we do.

This is a routine part of what we do now, so the invitation needs to be given in that way, she said. Its not like were just calling people who we know are really not handling things well.

If youve ever been supported by anybody and that person is really giving their full caring attention to you in and of itself, that feels incredibly wonderful, said Dr. Shapiro. That is the basis of peer support. Being able to do that."

Once a peer support conversation has begun, it is important to practice empathic listening. This is because it shows that someone is really hearing what the peer is going through, she said.

Then, based on whatever they say, reflecting with the peer about what theyre feeling, what theyre experiencing and reflecting in terms of normalizing their emotions, because you wont be surprised to hear that most of the things that people say, many of us have experienced, said Dr. Shapiro.

The other part of reflecting is to validate and say, Its totally understandable that given what you just told me you were asked to do or you had to witness, that you would feel that way. That really makes sense.

And then sharing your experience when its relevant, said Dr. Shapiro. Theres this tension between you dont want to overshare because youre really there to support the peer, but sometimes if youve had a similar experience or had some kind of way to connect with the peer, it is perfectly appropriate to share to a degree.

When helping a peer, it is important to practice reframing. This allows the peer to put their emotions in context.

It also helps them to weave their emotions into the positive part of what they do, said Dr. Shapiro. The tricky part of this is you dont want to minimize their emotions, but you do want to help them see all the good that theyre doing.

Reframing is extremely important and while it can be difficult to do at times, it is key to guiding peer support.

Its helpful to encourage learning and teaching so people are learning and growing every day, pandemic or not, said Dr. Shapiro. But especially now where theres so much new information.

Im encouraging people to share what theyve learned and helping their colleagues not just get through this, but actually take better care of patients, she said. That feels good for us anytime something is learned and shared.

Encouraging learning and teaching benefits not only the individual, but the group as well. It allows the team to move through a problem together.

A key part of peer support is helping the peer reconnect to any positive coping mechanisms that they have used in the past so they can use these strategies in their current circumstances. Identifying these can help the peer work through emotions or problems blocking their path.

Interestingly or paradoxically, we often find that the coping mechanisms that the peer uses normally theyve stopped using during this especially stressful time, said Dr. Shapiro. There should be a gentle help for the peer to realize that this is such an important time to care for themselves.

It is also a time for peers to use their support systems, rely on their friends and family, and their colleagues to help them through, she said. We all need support. We all deserve support.

Connecting physicians and other health professionals to appropriate resources as needed is also vital to the success of a peer support program. Sometimes peer support is absolutely not enough, said Dr. Shapiro. We know health care providers, especially physicians, do not usually access mental health or other kinds of support.

One of the wonderful aspects of peer support is offering those resources to any of our peers, she said, adding that it can help to emphasize that sometimes a particular circumstance or environment at the moment is causing them to be especially stressed, and they may want further support

In that case, "you areas a peer supporterhappy to connect them with someone who can help them further, said Dr. Shapiro.

The AMA offers resources to help physiciansmanage their own mental healthand well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of theirphysicians and care teams during COVID-19.

The peer supporter should close with an expression of appreciation for the work the peer does and for sharing their thoughts with you. Because of the pandemic, peer support actually helps us reconnect and gives us back this feeling of solidarity, said Dr. Shapiro. We're in this together, and it's really important for us to remind ourselves that we are.

There's a lot we can do and are doing for each other, she said, adding that this is a very positive way of thinking about how we can support each other.

The AMA is offering afree survey to help health care organizations monitor the impact COVID-19has on their workforce during this pandemic. The survey can be used to track trends in stress levels, identify specific drivers of stress, and develop supportive infrastructures based on these drivers. Organizations that usethe surveywill receive free-of-charge support from the AMA in launching the surveys and access to data through an easy-to-use reporting dashboard.

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Using the power of peer support to positively impact medicine - American Medical Association

Global study to test malaria drug to protect health workers from COVID-19 – Washington University School of Medicine in St. Louis

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COVID-19 Therapeutics Accelerator to fund international trial of chloroquine

Clare Ridley, MD, an assistant professor of anesthesiology at Washington University School of Medicine in St. Louis, works in the intensive care unit at Barnes-Jewish Hospital during the COVID-19 pandemic. Researchers at the university are helming a global study of an estimated 30,000 health-care workers to establish whether the antimalaria drug chloroquine might prevent or reduce the severity of COVID-19 infections in such workers.

With $9 million in philanthropic support, an international group of physicians and scientists is establishing a research network to evaluate promising therapies for COVID-19. The group, called the COVID-19 Research Outcomes Worldwide Network (CROWN) Collaborative, is testing whether the antimalaria drug chloroquine can prevent COVID-19 infection or decrease its severity in front-line health-care workers. An estimated 30,000 such workers from across the globe will participate in the clinical trial, which the collaborative is calling the CROWN CORONATION trial.

The collaborative and the trial are funded by the COVID-19 Therapeutics Accelerator, an initiative with contributions from an array of public and philanthropic donors, intended to support research and development to bring effective, accessible COVID-19 treatments to market as quickly as possible.

Washington University School of Medicine in St. Louis is the clinical coordinating center for this ambitious international trial. The investigators comprising the CROWN Collaborative are from prominent research organizations in African, European, North American and South American countries, including Cameroon, Canada, Ireland, Ghana, Peru, South Africa, Switzerland, the United Kingdom, the United States, and Zambia.

Because of their repeated close contacts with infected patients, front-line health-care workers in all parts of the world have a higher risk of contracting COVID-19 than most members of the general public, said one of the studys principal investigators, Michael S. Avidan, MD, the Dr. Seymour and Rose T. Brown Professor and head of the Department of Anesthesiology at Washington University. In some places, more than 10% of those who have become infected are health-care workers. There is an urgent need to identify drugs that are effective at preventing infection or mitigating its severity.

The study will recruit front-line health-care workers globally, including those from lower- and middle-income countries. Thats important because in many such countries there are relatively few health-care workers per capita, and protecting them from severe COVID-19 infection would provide a substantial public health benefit.

An important way to protect the public at large is to do our best to protect the health-care workers, Avidan said It is very important that there is a global effort to protect health-care workers because when it comes to COVID-19, were all in this together. Finding ways to keep health-care workers from getting seriously ill is one of the most important ways to protect vulnerable people everywhere.

This new trial will be important because of its immense size and global reach, as well as its use of three different but well-established chloroquine dose schedules in healthy people. Health-care workers in the trial will be divided randomly into four groups. Three of the groups will receive chloroquine at various doses. The fourth group will receive an inactive placebo. The researchers want to learn whether the drug can prevent health-care workers from developing COVID-19 disease or decrease the severity of illness for those who do become infected.

The researchers also want to determine the lowest dose required to provide a benefit. Health-care workers in the study will receive lower doses of chloroquine than have been given in most other trials that have focused on treating patients already sick with COVID-19. That is important because lower doses of chloroquine should have fewer side effects. Plus, with a limited supply of chloroquine globally, if a lower dose turns out to be just as effective as a higher dose, many more people could benefit from the drug.

When people have to travel to parts of the world where malaria is a problem, they often take low doses of chloroquine to help prevent infection, said Avidan, also a professor of psychiatry and of surgery. We want to learn whether this drug might work in a similar fashion in the case of COVID-19, or at the very least, whether low-dose chloroquine might help prevent the severe and life-threatening complications associated with the illness.

Charge nurse Caroline Becker adjusts her face shield before entering a patients room at Barnes-Jewish Hospital.

The study will last five months. Health-care workers who participate will take chloroquine or a placebo for the first three months and will be monitored for another two months. Those previously infected with COVID-19 or those who have underlying medical problems that might make it unsafe to take chloroquine, such as heart ailments, will not be eligible to participate.

Data from the trial sites will be compiled at University College London. Laurence Lovat, MD, PhD, a professor of gastroenterology and biophotonics, is the study leader in the United Kingdom.

Our hypothesis is that chloroquine may decrease the COVID-19 burden by decreasing entry of the novel coronavirus into host cells and by inhibiting viral replication, Lovat said. Furthermore, with its anti-inflammatory properties, chloroquine might dampen the exaggerated and unregulated immune response in the host, which often is responsible for the unpredictable and severe complications of COVID-19.

The CROWN CORONATION trials other principal investigators are Ramani Moonesinghe, MD, a professor of perioperative medicine at University College London, and Helen Rees, MD, executive director of the Wits Reproductive Health and HIV Institute in Johannesburg.

In the African region, the health-care workforce is under-resourced and overstretched, and the impact of the COVID-19 pandemic will make this situation worse, Rees said. If an inexpensive drug such as chloroquine could help protect our health workers, it would provide important insurance for many countries whose health-care systems could collapse if large numbers of health-care workers were to become infected and could not care for others who were sick with COVID-19.

The investigative team at Washington University includes Avidan, Mary Politi, PhD, a professor of surgery in the Division of Public Health Sciences; Erik Dubberke, MD, and Elvin Geng, MD, both professors of medicine in the Division of Infectious Diseases; and Graham Colditz, MD, DrPh, the Niess-Gain Professor of Surgery and director of the Division of Public Health Sciences; George Kyei, MD, PhD, an assistant professor of medicine in the Division of Infectious Diseases; Victor Davila-Roman, MD, a professor of medicine, of anesthesiology and of radiology and associate director of the Center for Global Health in the Institute for Public Health.

There is quite a bit of interest in chloroquine for both the prevention and treatment of COVID-19 infection, Avidan said. It has shown promise treating patients with COVID-19, but the only way to determine accurately whether this drug actually works is to conduct rigorous, large-scale, randomized trials in multiple locations.

Politi, a leader in health decision-making, said she is particularly enthusiastic about the design of the study.

The trial will be focused on health-care workers and their safety so that they can continue to care for patients around the world, she said. In addition to helping us study whether chloroquine works, and at what dose, all participants will receive education about COVID-19 and will be screened for evidence of infection. The trial has an adaptive design to learn from early study results. After a certain time period, if at least two of the chloroquine doses are demonstrating a benefit, we could stop assigning people to take placebo.

COVID-19 Therapeutics Accelerator donors include the Bill & Melinda Gates Foundation, Wellcome, Mastercard, U.K. Department for International Development, Chan Zuckerberg Initiative, Michael & Susan Dell Foundation, Avast, Zhang Yiming, Alwaleed Philanthropies, EQT and Madonna.

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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Global study to test malaria drug to protect health workers from COVID-19 - Washington University School of Medicine in St. Louis