What to Expect in Medical School – AAMC for Students …

What will I learn in medical school?

Many medical schools organize their training into two parts: pre-clinical and clinical. In a traditional four-year curriculum, the pre-clinical phase includes two years of science training when you learn about basic medical concepts, the structure and functions of the body, diseases, diagnoses, and treatment concepts. Youll also learn the basics of doctoring, such as taking medical histories and other essential competencies. The clinical portion of the training, traditionally the last two years of medical school, involves clinical rotations, during which time you will receive basic instruction and hands-on experience with patients in the major medical specialties. The curriculum varies for each medical school, and some medical schools have a more integrated, multidisciplinary program and begin clinical training and patient interaction during the first week. You can review each medical schools About the Curriculum section in the Medical School Admission Requirements.

How students are graded varies from school to school. Some medical schools use a pass/fail system or an honors/pass/fail system, and others use a letter-grading system. There are even some that use a combination of a pass/fail system for the first year or two then switch to another system for the final two years. There are a small number of schools using a competency-based evaluation system that measures student progression in learning a certain set of competencies throughout the course of medical school. To see individual medical school policies on grading, see the Education section of theMedical School Admission Requirements. Regardless of which approach your school uses, its important to keep grades in perspective. Grades do matter in certain instances, but they are only one criteria by which you are evaluated during medical school.

Traditionally, medical students havent had many experiences with patients until their third year, but this is changing. Some schools introduce patient interactions early on (some in the first week!) or may have incoming students receive EMS or EMT certification before the beginning of classes.

Typically, you do clinical rotations, also called clerkships, during the third and fourth year of medical school. Rotations give you firsthand experience working with patients in various specialties under direct supervision of a faculty member, fellow, or resident. The types, number, and length of rotations vary from school to school, but training usually includes clerkships in internal medicine, family medicine, obstetrics and gynecology, pediatrics, psychiatry, and surgery. Your school may have different requirements. However, in your final year of medical school, you will be given the opportunity to take electives in different specialties and at different institutions according to your interests. TheMedical School Admission Requirementswebsite features information in the Education section about when students begin patient interaction and how clinical rotations work at each medical school.

Exploring your future career as a physician begins early in med school, with an ongoing examination of your interests and goals in the practice of medicine along with an exploration of the many specialty options available. Your third-year rotations will give you an opportunity to experience a number of specialties and determine how your interests, values, and skills fit with those specialties. There are also extracurricular opportunities for exploring specialties, such as specialty interest groups and student sections of medical specialty societies.

By the end of the third year, most students have chosen a specialty area (e.g. primary care, surgical care) or patient population (i.e., adults, children, or both) and begin preparing to apply for residency training to support that career direction. If youre not confident in a career direction, you may choose to take time to complete research, complete a dual degree (e.g., MD-MPH), gain further clinical experience, or otherwise spend time exploring your career options prior to choosing your specialty and applying for residency.

Choosing your specialty and applying for residency are not solitary activities. Work actively with career advisors at your medical school and find mentors to help guide you. Also, once you're in medical school, youll likely have access to AAMCsCareers in Medicinewebsite for more information and a detailed timeline (sign-in required).

Youll start the licensure process during the second year of medical school with the United States Medical Licensing Examination (USMLE) Step 1 exam. Step 1 covers the sciences fundamental to the practice of medicine. The Step 2 exam, which measures clinical knowledge and skills, is usually completed during the third or fourth year of medical school. The final exam for initial licensure, Step 3, occurs during the first or second year of residency training, after you have completed medical school and received your medical degree.

All medical schools share the goal of preparing their students for residency training and practicing medicine, and are required to adhere to national accreditation standards. However, each school has its own specific mission, curriculum, course format, and academic schedule. Before you apply to a school, research that schools mission statement to see how it aligns with your own goals. Also review the graduation requirements, such as community service, research experience, and specific coursework. You can find this information on each schools website or on theMedical School Admission Requirementswebsite.

Its okay to admit you need help managing the stress that comes with being a med student. In fact, its completely normal to reach out to a faculty member, dean, mentor, counselor, or spiritual advisor when youre feeling overwhelmed. Many medical students often cite the famous analogy that learning in medical school is like trying to drink from a fire hose. It sounds intense, but these same students also speak about learning new study techniques along the way that help them manage time better, integrate new knowledge, and excel as med students. Admitting that something is difficult, but doable, can really improve your outlook.

Rest assured that, yes, as a medical school student you are entering a demanding process, but every successful doctor was in your place at some point. Those anxious feelings are normal, temporary, and manageable.

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What to Expect in Medical School - AAMC for Students ...

A bill would spend $1 billion on diversifying medical schools to close the racial health gap – NBC News

Black doctors make up less than 6 percent of the physicians in America, and a recently introduced bill seeks to help encourage more young doctors of color through a $1 billion grant to several medical schools.

The Expanding Medical Education Act, introduced in the Senate last week by Tim Kaine, D-Va., was drafted to offer a pathway to "tackle the lack of representation of rural students, underserved students, and students of color in the physician pipeline," it says. The goal would be to reduce mistrust in doctors and health care institutions among marginalized communities, thus narrowing the gap in health care.

The legislation would encourage recruiting, enrolling and retaining Black students in medical schools and help fund programs for schools that mostly serve students from marginalized backgrounds.

The ultimate goal, Kaine said, is to increase the talent pool by making the path to medical school less arduous and more affordable. The idea is that if there are more Black doctors, more of them could tend to underserved communities.

"If this bill will add to the number of brown and Black doctors, then that's a good thing," said Donald Alcendor, an associate professor of microbiology and immunology at Meharry Medical College, a historically Black institution in Nashville, Tennessee. "There simply are not enough doctors who look like the patients in the underserved communities. And this systemic distrust [these] communities have for the medical system is something that is long-standing and has at least a chance of being overcome with Black doctors' presence to create a better patient-doctor relationship."

As a 2006 study cited by the National Institutes of Health outlines, Black populations say they distrust medical providers because of factors like perceived racism or greed. More broadly, systemic racial segregation cultivated a gap in health care, and several high-profile cases through American history were found to have used Black people for medical experimentation against their will or without their consent.

Black doctors agree that the need for more physicians of color is critical, for many reasons, and that funneling money and attention to historically Black colleges and universities, or HBCUs, is "a start," said Dr. Pierre Vigilance, an adjunct professor of health policy and management at George Washington University's Milken Institute School of Public Health.

"There's almost no choice but to diversify the pool," Vigilance said. "Teams that are diverse create better results. If you have only one type of demographic in physicians, you will get a certain set of outcomes. But if you have a diverse team that is willing to go into distressed areas, you can address some of these concerns. You can break barriers and you can improve outcomes."

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The Expanding Medical Education Act would:

The House version of the bill was introduced in January by Jim Costa, D-Calif., but it has not made any progress.

Javaune Adams-Gaston, president of Norfolk State University, the largest HBCU in Virginia, which boasts a renowned nursing program, said in a statement that she supports the bill and that it "will help to address these disparities and diversify the physician pipeline by providing the financial resources."

The four historically Black medical colleges Meharry, Morehouse School of Medicine, Howard University College of Medicine and Charles R. Drew University of Medicine and Science pride themselves on serving Black communities. Morehouse recently received a $40 million grant from the Department of Health and Human Services to work with communities of color in relation to the coronavirus pandemic.

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Vigilance, who led the District of Columbia's response to the H1N1 swine flu virus in distressed areas in 2009, however, warned against assuming Black doctors will want to work in poor or underserved areas.

"The assertion often made that these providers will go back to the community they serve also makes the assumption that they come from low-income communities," he said. "That's true for some but not all."

In the end, he said, the two goals remain to "make opportunities for more doctors of color and to build teams that are diverse because teams that are diverse create better solutions to challenges or problems. If you diversify that health care provider group or health system, and if you're truly about this notion of population health and community wellness. . . now have no choice but to diversify the provider pool."

Medical school enrollment was up by 31 percent last year, according to the Association of American Medical Colleges. But Blacks made up about 7 percent of medical college students in 2017 and Hispanics made up 6 percent. Enrollment in rural medical programs is also on the decline, which is a concern since the existing doctors in more remote areas are aging and retiring, and not being replaced fast enough.

The cost of medical school averaging at about $60,000 a year at a private college could also deter prospective Black students.

"Just applying for medical schools can be cost-prohibitive, let alone the interviewing process, pre-COVID-19, flying around the country," Vigilance said. He added that a typical student would apply to at least 10 medical colleges at $170 per application, with a second fee of around $41 for a secondary application. "So you're already well into the thousands of dollars just to apply."

Alcendor agrees. "If this bill can reduce some of the medical school debt that you incur going to medical school, this could be very helpful," he said. "To increase the possibility of people who don't have the means but have the talent to go to medical school is important. We had a student making straight As but couldn't pay for medical school and had to sit out."

As for Black doctors helping build trust in the medical system, it will always be a tough hurdle with African Americans people. "This bill is a start to perhaps making some inroads on a lot of areas," Vigilance said. "It doesn't have all the answers but it's a good piece. And that would be better than where we are."

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A bill would spend $1 billion on diversifying medical schools to close the racial health gap - NBC News

In the face of challenges posed by a pandemic and racism, the White Coat Ceremony underscores the importance of our shared humanity – AAMC

Since the mid-1990s, undergraduate medical education has been bookended by two memorable ceremonies: the White Coat Ceremony at the start of ones medical school career and graduation at its conclusion. In the age of COVID-19, these events, like all in-person gatherings, have been turned upside down. We realize the logistics are daunting. As tempting as it is to postpone, or to cancel, White Coat ceremonies altogether, we instead urge medical schools to forge ahead and adapt this ritual that highlights the importance of the human connection in health care.

Medical students deserve this essential touchpoint of humanism on their journey. Indeed, in the face of COVID-19 and great social unrest, the true message of the White Coat Ceremony becomes even more compelling and necessary. The White Coat Ceremony began in 1993, a brainchild of Arnold P. Gold, MD, a Columbia pediatric neurologist and co-founder of his namesake nonprofit organization. For years, Gold had observed medical students reciting the Hippocratic oath on graduation day, and he would turn to his wife (and co-founder), Sandra Gold, and shake his head: Its too late, he would tell her. They are already the physicians they will be.

Gold believed that as clinical responsibilities have moved closer to Day 1, the oath the traditional pledge to do no harm, to care for patients with compassion should come at the very beginning of medical education, not the end. And so, he envisioned a ceremony that would emphasize humanism at the start. Such a ritual would reflect and reinforce the deep belief in caring for fellow human beings the belief, in fact, that leads so many to apply to medical school.

White Coat ceremonies took off rapidly, and today, hundreds of schools around the globe hold such events. They have become an eagerly anticipated marker of the start of undergraduate medical education.

As the White Coat Ceremony has expanded over the years, the very point of this ritual risks being lost. At its core, the White Coat Ceremony is not about a piece of attire or public recognition, but rather about a physicians fundamental, intimate responsibility to care, heal, and protect others.

As such, White Coat ceremonies are acutely relevant as we face the dual challenges of COVID-19 and racism.

The world has watched, in this unprecedented time of COVID-19, how doctors and all health care team members have risen to the moment. Without a cure, without effective therapy, health care professionals have been caring for COVID-19 patients at the primary level of human-to-human. This essential human connection can be forgotten in the ordinary day-to-day reliance on the big data of intensive care units, in times of very brief appointments, and in the midst of routine protocols. In this heightened moment of so much uncertainty and fear, doctors and nurses have stepped in to be the epicenter of care, to fulfill the definition of humanism in health care that human interests, values, and dignity prevail.

The second of the threats, racism, is a foe of equal concern. Entrenched in our institutions, our unconscious minds, and our bodies, racism threatens to tear at the human connection we are all capable of, and which physicians rely on so heavily in their care of patients.

Incoming medical students who are witnessing and participating in these transformative times need to hear leaders of their schools acknowledge and reinforce the importance of the human connection in health care, the importance of anti-racism in health care and our world, and the essential compassion physicians must hold and protect in their care.

White Coat ceremonies can be one key piece of that ongoing message from the very start. While some ceremonies are being held in person with appropriate masking and social distancing, others have had to adapt to a virtual format.

Now how does this work?

We are still learning, but the white coat is a symbol of the beginners mind that is open to all possibilities. The spirit of approaching medicine and such logistical challenges that we face today with an open mind is essential to remaining compassionate throughout ones career.

As the entire academic community has begun experimenting with virtual graduations and other ceremonies, we can learn from their helpful lessons and the tools already in place. For example, with the help of a PowerPoint program framework and Zoom accounts, we have witnessed beautiful, moving celebrations of Gold Humanism Honor Society inductions.

One advantage of the virtual ceremony is that it crosses hundreds of miles in a single click. Leaders and orators have attended Gold Humanism Honor Society inductions all across the country, from Loma Linda University School of Medicine in California to East Tennessee State University James H. Quillen College of Medicine to the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in New York a possibility never imagined even last year. The virtual ceremonies also mean that relatives and friends from across the globe can join.

The AAMC and the Gold Foundation are committed to helping schools adapt their White Coat ceremonies as needed to conform with the necessity of physical distancing.

We realize this is an exceptional, historically challenging time that can be disorienting to experienced mentors and new students alike. Yet the principles of the human connection in medicine are sustaining, and we are grateful to medical school leaders for ensuring the White Coat Ceremony continues this fall. To incoming medical students, congratulations on your start of this great journey and thank you, in advance, for your deeply compassionate care of your future patients.

Richard Levin, MD, is president and CEO of the Arnold P. Gold Foundation. David Skorton, MD, is president and CEO of the AAMC.

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In the face of challenges posed by a pandemic and racism, the White Coat Ceremony underscores the importance of our shared humanity - AAMC

Pandemic acts as dress rehearsal for new medical school curriculum – Washington University School of Medicine in St. Louis

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Reaffirms emphasis on technology, community outreach

Eva Aagaard, MD, senior associate dean for education and the Carol B. and Jerome T. Loeb Professor of Medical Education at Washington University School of Medicine in St. Louis, demonstrates how a lightboard in the school's Instructional Design Studio allows instructors to face online viewers while writing on the board. Nearly a year old, the studio lets faculty record lectures with supplemental and interactive features. An essential part of the school's new curriculum, the studio also was instrumental in transitioning to remote learning during the COVID-19 pandemic.

Dozens of faculty, students and staff at Washington University School of Medicine in St. Louis have committed countless hours over the past three years to planning a new curriculum that will launch in September with the arrival of incoming medical students.

Although faculty, students and staff didnt know it, they also were preparing for the sudden, unprecedented jolt from in-person to remote learning that occurred in mid-March, when COVID-19 shuttered much of the country, including much of the Medical Campus.

The pandemic shutdown meant that first- and second-year medical students couldnt attend the required lectures and hands-on lab instruction in anatomy, pathology, histology, microbiology and other basic sciences. Nor could the students participate in small group classes that emphasized other essential medical skills such as communication, medical ethics and conducting patient exams.

Barnes-Jewish Hospital and St. Louis Childrens Hospital, where the MD students train, ceased virtually all nonessential medical procedures in order to curb virus transmission, preserve hospital beds and ventilators for COVID-19 patients and protect student health. This meant third-year students couldnt finish their clinical rotations a critical experience that helps physicians-in-training gain core clinical skills and discover the specialties theyre interested in pursuing during the final year of medical school and into residency.

Everything as we knew it had stopped, and we didnt know we still dont know the length or the severity of the pandemics impact, said Eva Aagaard, MD, the School of Medicines senior associate dean for education and the Carol B. and Jerome T. Loeb Professor of Medical Education. But we knew we had to continue educating our students so they could transition to the next year of training or to residency, and we know we have to deliver a new curriculum to our incoming students, and it all must be outstanding.

The new curriculum ensured such goals were met. Not to say there werent bumps, because there were. But the foundation of the new curriculum helped to ease the transition to remote learning while also providing an impromptu dress rehearsal that has allowed educators to troubleshoot, tweak and improve the curriculum before its rollout.

Designed to reflect the fast-moving changes in the health-care industry, the new curriculum was less than a year from launching when the pandemic hit. Two of its main pillars include expanding and enhancing technologyto promote innovative and effective teaching and learning, as well as fostering a better understanding of the social and economic factors that influence health.

Already in place was much of the medical schools upgraded, state-of-the-art technology supporting video-based education, as well as its commitment to ending health inequalities and expanding community health efforts. Planning for the new curriculum also had driven the medical schools collective mindset toward innovation and creativity.

The time we have spent on designing the new curriculum, and the investments in technology and other resources to support it, meant we were prepared in a way that many other places werent, Aagaard said.

Nearly a year ago, for instance, the medical school debuted the Instructional Design Studio, a 700-square-foot space in the lower level of Bernard Becker Medical Library. The studio includes a formal sound-proof video-recording studio with green-screen technology, as well as a smaller do-it-yourself studio. This allows faculty to record lectures with supplemental and interactive features that the medical school can archive in a digital library and students can access at any time.

Few medical schools have a studio and dedicated resources to develop and produce educational videos, said Carolyn Dufault, PhD, assistant dean for educational technology and innovation in the Office of Medical Student Education. We have spent the past few years working closely with faculty to examine how and why we will deliver parts of the new curriculum through video resources, and to create and produce dynamic, high-quality, clinically relevant video resources to enhance student engagement with course materials and promote meaningful, durable learning.

The relationships formed between faculty and the Instructional Design Studio team which includes Dufault; Erin Morris, an educational specialist and instructional designer; and Matt Rice, a veteran videographer have been invaluable during the pandemic, Dufault said. Mutual trust and respect had already been established, she said. This allowed for a quick pivot when we needed to help faculty move entire classes to a distance-learning format.

Added Morris: It especially helped because many of the faculty I had been working with already had the mindset of pushing creative boundaries and trying new things.

In March, the now ubiquitous Zoom was a novelty for many faculty, students and staff. Everyone just had to use it and learn, Morris said. But because the curriculum-building process has heavily emphasized innovation, faculty embraced ideas about customizing Zoom to their instructional needs for instance, accessing breakout rooms for small group discussions.

Third-year students used the breakout features on Zoom and other online technologies as private rooms to take summative exams, attend office hours with instructors and brainstorm with fellow students.

They trained via Zoom in the Wood Simulation Center, which comprises four rooms of the Farrell Learning and Teacher Center that resemble clinical settings and offer mannequins as patients. Led by registered nurse Julie Woodhouse, director of the medical schools immersive learning centers, the simulation classes involved quadrants on students electronic screens offering multiple vantage points of the patient and vital signs.

The formative, simulated clinical experiences gave students an opportunity to work through some acute scenarios in a safe setting and without a faculty or resident telling them how to manage the situations, Woodhouse said. They are allowed to determine diagnosis and patient management by relying on themselves. After each scenario, a faculty member debriefs the actions in the scenario what the students did well and what they could do to manage the situation better.

Brittany Novak, a simulation technician, operated the simulator and acted as the patients voice, while Woodhouse served as the bedside nurse, following the students patient-care instructions.

Students also participated virtually for the Objective Simulated Clinical Exams, which are required after each clinical rotation. They treated patients one on one in Zoom breakout rooms. Their patients were actors who followed a script. After the exam, students wrote patient assessments in an online learning management system called Canvas, while the patients scored students using a checklist in Qualtrics, an online survey platform.

The experiences may have felt artificial or awkward, but I asked the students to think of it like telehealth or an electronic intensive care unit, where the physician is in a separate location from the patient and bedside staff, Woodhouse said. The pandemic has put a spotlight on telehealth. Its likely to continue to play an increased role in patient care.

Besides the importance of telehealth, the switch to remote learning offered additional lessons for the new curriculum, said Thomas M. De Fer, MD, a professor of medicine and associate dean of medical student education. For example, students favor technology for lectures and test-taking, but they also crave in-person communications. Constant online meetings, known to cause whats referred to as Zoom fatigue, is real.

A positive point is that we can make these adjustments to the new curriculum, De Fer said. We can better provide a combination of virtual learning that involves interacting with others on Zoom, for example, and virtual learning that allows students to work on their own time, such as video lectures.

Additionally, the new curriculum will offer students a flexible learning format called hybrid, because it combines face-to-face learning and online learning. The emergent transition to teaching via an electronic platform did not give us months to think about fancy-schmancy things we might want to do, De Fer added. It was a crash course that gave us experience and confidence in online learning, and it taught us important lessons that we will use moving forward.

The suspension of clinical rotations caused logistical headaches and high anxiety among faculty and, especially, students. But during the three months from mid-March to mid-June, when the third-year students were authorized to complete final rotations, students were provided numerous opportunities in compassionate medicine through assisting community organizations and health-care workers responding to the pandemic.

From first years to fourth years, scores of Washington University medical students volunteered to deliver meals to at-risk quarantined people and COVID patients, babysit the children of health-care workers, and create thousands of face shields and masks. Among other activities, they also assisted with contact tracing at area health departments and offered educational outreach to St. Louis African-American and Latino residents, who are most vulnerable to COVIDs adverse effects.

As a medical student, it was difficult to watch from the sidelines as the pandemic became a worldwide crisis, said Connie Gan, a rising fourth-year student and president of the Class of 2021. Other students had similar feelings. This spurred a massive COVID-19 volunteer effort, and, though it wasnt patient care, it was satisfying to provide public health support to front-line health-care workers. We learned important skills individually and, as an institution, we saw firsthand the enormous impact of community engagement in the region. I believe this momentum will grow as we roll out the new curriculum.

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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Pandemic acts as dress rehearsal for new medical school curriculum - Washington University School of Medicine in St. Louis

International med students ease the path for others with new mentor group – STAT

Long before Azan Virji entered medical school, a college counselor back home in Tanzania tried to dissuade him from coming to the U.S. to pursue a medical degree. The odds, he was told, would not be in his favor. Fewer than 3% of medical school applicants in the U.S. are international students, and only 0.5% of all medical school enrollees are from abroad.

But because Virji, now a second-year student at Harvard Medical School, had always aspired to become a physician and knew the quality of the schools here in the U.S., he kept on. Now he and several other international medical students have launched a mentorship network that helps prospective and current international medical students wade through the application process, tackle the logistics of financing their education, and handle the pressures of school once theyre enrolled in a program.

In the three months since the start of F-1 Doctors named after the visa type that most international students need in order to study in the U.S. nearly 80 mentors from more than 30 countries have signed up to be a part of the program, as have more than 60 mentees.


A lot of the mentees are so happy to speak to someone who is an international student at a medical school they see themselves represented, Virji said.

U.S. citizens who are prospective medical students often have networks to tap into to navigate the difficult medical school application process, from premedical advisers at their undergraduate institution to family members or peers who have applied before. And while international students may also have these resources, the added complexities that they face due to their visa status often mean they dont have many others to turn to for guidance.


Virji, who earned his undergraduate and masters degrees from Yale University, said he constantly felt like his credentials werent good enough to get him into a U.S. medical school.

The anxiety of not knowing whether or not youd be able to get in was a lot, Virji said. And thinking that not getting in is due to your foreign-born status is the biggest anxiety factor.

Beyond that, Virji didnt feel like there were others whom he could ask for help.

I couldnt find anyone to speak to who would tell me that I would be OK, that I still had a shot, Virji said.

The stressors international medical students face were further heightened last month when U.S. Immigration and Customs Enforcement issued a now-rescinded rule requiring those on F-1 visas to leave the country if their school planned on only having classes online in the fall as a result of the Covid-19 pandemic.

Even without these uncertainties, however, international students who come to the U.S. with the hopes of attending medical school often have an uphill climb. Of the nearly 175 medical schools in the U.S., only 48 indicated in 2019 that they accept international students.

I would have students who are great candidates but wouldnt get accepted into [U.S. medical] schools because they had limited options, said Jennifer Kimble, who was a health careers adviser at Emory University and at Georgia Institute of Technology. Kimble, whos now the director of admissions at Vanderbilt University School of Medicine, also explained that most state medical schools dont accept international students because of how state funding is allocated. This, she said, drastically narrows the pool of schools that foreign-born students can apply to.

A lot of the mentees are so happy to speak to someone who is an international student at a medical school they see themselves represented.

Azan Virji, F-1 Doctors mentor and Harvard Medical School student

Some mentees said that simply wanting to know their chances of getting into medical school which can be a gamble regardless of citizenship status is a major reason why they signed up with F-1 Doctors.

Even something as easy as finding statistics, theres really not a lot of resources online about your chances, said Ziad Saade, a rising senior at Columbia University who is being mentored by Virji. Saade said Virji has already offered tips on preparing for medical school interviews, including how the topic of medical ethics may come up during those conversations.

Saade, who is originally from Lebanon and on a premedical track, said he heard about F-1 Doctors through a friend and that hes since felt much less alone in the application process.

I had never met an international student in medical school, but F-1 Doctors helped me do that. Ive met three different people who are currently in medical school or have been accepted to medical school, and one of them happens to be from Lebanon, Saade said.

Mentoring through F-1 Doctors looks different for everyone, which is why the program has prospective mentees look through a directory of mentors and reach out to those with similar backgrounds and interests. Some, like Saade, want to get a sense of the kinds of scores and qualities they should highlight in the application process. Mentors have also offered feedback on admissions essays.

For international students to be able to talk to others [like them] is always a good thing, said Kristin McJunkins, director of health careers advising at Yale University who now shares information about F-1 Doctors with any international students she works with.

But the process doesnt end when these students enter medical school. Figuring out how to pay for school which is also a big task for domestic students is especially complicated for non-citizens. Theyre not eligible for loans through the federal government because of their citizenship status, for instance, and many schools dont have big endowments to support students fully.

Larger institutions such as Harvard and Vanderbilt often have the funds to partially or in some cases fully support international students. Some smaller schools, however, not only have policies that deem international students ineligible for financial support, but also require students to pay multiple years of tuition upfront. That was the case with Pranav Somasekhar, a third-year medical student at Saint Louis University School of Medicine.

I had to pay all four years upfront, Somasekhar said. The total about $250,000 had to be put in a third-party escrow account before Somasekhar could begin his schooling.

One of F-1 Doctors goals is to be a resource for students such as Somasekhar who are navigating thorny financial issues. The groups website has information for students on different loan options, and is in talks to partner with at least one company that will host webinars on financing a medical education in the U.S. F-1 Doctors has also created a spreadsheet with different schools financial aid policies for international students.

Somasekhar, who mostly grew up in India, moved to the U.S. in 2008 and went to both high school and college here. But because of massive delays in immigration processes in recent years, Somasekhar aged out of being listed as a dependent on his parents green card application, and had to reapply to stay on in the U.S. as an international student.

There are very few people who have fallen through these cracks and are in a similar situation as me, Somasekhar said. But since joining F-1 Doctors as a mentor, Somasekhar has had a few others like him reach out for advice. The three or four mentees Ive talked to all say that Im the only person they know who is in a similar boat, which is exactly why Im doing this, he said.

Somasekhar is himself looking to take advantage of mentoring through F-1 Doctors, since the programs mentors include medical residents and attending physicians. Theres no information on matching [with residency programs] for medical school seniors on an F-1 visa, Somasekhar said.

F-1 Doctors now wants to expand to other health professions, including nurses and physician assistants. Already, there are some dental students in F-1 Doctors, and the group recently added its first mentor who is pursuing a doctor of osteopathic medicine degree (versus an M.D.). The program, which is currently based out of Brown University, is also looking to set up local chapters at other universities, so that mentors and mentees at the same school can get together in person after the pandemic. Brown University currently helps fund F-1 Doctors activities, including webinars for students across the globe. In future, F-1 Doctors may also consider hiring an immigration lawyer to help navigate visa rules.

Virji is hopeful that as more international students go through the medical school application process, theyll connect with F-1 Doctors.

It has been easy to get mentors so far because you know how hard it is, he said, and you want to be able to help those on the other side.

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International med students ease the path for others with new mentor group - STAT

Amid COVID-19 Pandemic, Morehouse School of Medicine Welcomes Its… – Diverse: Issues in Higher Education

August 7, 2020 | :

by B. Denise Hawkins

In June, most historically Black colleges and universities were racing against the clock to come up with a plan for what the fall semester would look like or rolling out and then revising strategies to safely re-open. But at Atlantas Morehouse School of Medicine (MSM), faculty, staff and most future physicians were already back training, teaching and learning virtually and in person.

Online learning only, school officials said, was never the plan for medical education. To master their craft, those studying to become medical doctors, physicians assistants and scientists at MSM need to touch their patients, listen to beating hearts, peer through a microscope and see those in the community who will depend on them for care. But during a pandemic, they said, a hybrid approach is needed. These are reasons that Dr. Valerie Montgomery Rice, MSMs president and dean, offered for bringing her students back to campus.

A medical student orientation at Morehouse School of Medicine.

We have not made the choice to return to campus lightly, Rice said, but we must live out our unique mission to give our students the hands-on instruction they will need to care for the people we are committed to serve. That kind of training, she added, will supplement her students virtual learning and will be delivered through small, in-person sessions.

For Stephen Green, a first-year medical student from Atlanta, adapting to virtual instruction so far, a mixture of Zoom and video lectures has been a stressor for him and his classmates, he said. But learning, like teaching in the COVID-19 era, is uncharted territory. Despite the struggles, Green said, it matters that the faculty are definitely trying their best, even as they navigate some of the same technical hurdles. Weve just got to push through.

Alternating workdays

Campus leaders like Rice and her team have mostly been on their own to devise plans for a safe re-entry and teaching and learning at an uncertain time in higher education. For two weeks in May, the medical school did a test run of its re-opening plan for faculty and staff. It offered COVID-19 testing, staggered start times for work and alternated days to be on campus or work remotely, said Dr. Monique Guillory, MSMs chief of staff and chief administrative officer. She is also helping to lead the medical schools fall re-opening.

The colors green and blue are being used to tag faculty and staff and to guide a physically distant work week. Those who are blue work on campus on Mondays and Wednesdays. Those who are green come on Tuesdays and Thursdays. And, on Fridays, they alternate, said Guillory of the plan MSM devised to help maintain low-density circulation when people are on campus.

That process went pretty smoothly, but Guillory told Diverse they had to pivot on the approach to COVID-19 testing, which at first was voluntary and only for faculty and staff. To try to keep the campus safe and the virus from spreading, MSM decided to make testing mandatory for all returning to the campus, including students, Guillory added. Mandatory testing was an important shift for us, she said.

However, in late June, as campuses wrestled with how to safely re-open, the Centers for Disease Control and Prevention (CDC) released updated guidance on COVID-19 for institutions of higher education. In it, the federal agency did not recommend testing for returning college students and issued an explicit statement of non-recommendation. Ahead of MSMs June 1 re-opening for everyone and a phased-in student return, 1,000 faculty, staff and students were tested. When asked, Guillory said seven tested positive, with most being clinical faculty and hospital staff a finding that didnt come as a surprise to her.

The importance of testing

COVID-19 testing at MSM continues to be the centerpiece of the plan for keeping those on the campus safe. Daily screenings for symptoms of coronavirus infection and temperature checks are essential to the process. Guillory said these are things that campuses have to do to stay vigilant during a pandemic. At MSM, the changes across the campus are visible. Chairs in classrooms and conference rooms, for example, are now roped off to create physical distancing. And signs on every door and in every room announce the maximum number of people allowed inside at one time. There is no way you can be on campus today and think that it is business as usual, Guillory added.

First-year medical students got their first introduction to the new normal before they arrived. Orientation for them took place over Zoom.

They are eager to get started and come to campus in July, Guillory said, but no

Dr. Monique Guillory

one can return or come to campus without first being tested. This is our approach to bringing our people on campus in the safest way possible.

Still, public health experts say that the process of screening and testing everyone on a campus cant guarantee safety from infection or prevent the rampant spread of the coronavirus. While Guillory agrees, she also credits mandatory and early COVID-19 testing at MSM for revealing seven positive cases and mitigating a possible virus outbreak.

Guillory, a veteran higher education administrator, began her new position as chief of staff in March, just as the virus forced MSM and campuses nationwide to close and operate remotely.

I started virtually, said Guillory, whose first big project was a plan to bring people back. We were among the first schools in the country to come back and to announce our plan.

But taking on that urgent task, she said, was as unexpected as the coronavirus pandemic. It was also serendipitous. She had practice. Before coming to MSM, Guillory had developed new health sciences degree programs, including those in nursing, that have launched.

Closing healthcare disparities

In July, as COVID-19 battered the South, Atlanta, like elsewhere in Georgia reported record high cases. This kind of news puts MSM on alert and makes Guillorys work on campus testing and screening more critical. Since the onset of the pandemic, COVID-19s grip on the majority Black city that is home to Morehouse School of Medicine has been tight and deadly. Elsewhere across the nation, the disease has also taken an uneven toll on those who are Black and burdened with chronic health conditions.

As doctors and academicians, we know that there are many systemic challenges to health care delivery in minority communities with higher incidences of heart disease, diabetes and obesity that may be contributing to more COVID-19 deaths among African Americans, says Rice.

Increasing the number of healthcare providers of color, she added, is a way to eradicate those health inequities. Looking nationally, though, the pipeline has been leaky, the Association of American Medical Colleges found. For decades, the country has struggled and failed to significantly increase the number of physicians from underrepresented communities. But for three consecutive years, MSM has been able to move the needle forward. In the middle of a pandemic, MSM admitted Stephen Green and 104 others, for its largest class. Nearly half of them are Black men and more than half of the class of 2024 is from Georgia.

This article originally appeared in the August 6, 2020 edition of Diverse. You can find it here.

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Amid COVID-19 Pandemic, Morehouse School of Medicine Welcomes Its... - Diverse: Issues in Higher Education

COVID-19 changing study of medicine on Long Island – Newsday

COVID-19 has delayed NYU Long Island School of Medicines expansion plansbutis allowing students at the regions newest medical school a rare opportunity to study a pandemic as it unfolds.

NYU Long Island opened a year ago with 24 students, tuition-free and with a focus on preparingstudents to become primary-care physicians. Those students are now starting hospital rotations, and 24 new students started in the program last weekwith lectures online.

This is a pandemic that is happening in real time, said Dr. Steven Shelov, the Mineola school's dean. Its not in a book theyre reading about.

NYU Long Island had held only online classes for the past few months and, with the state now allowing in-person classes with precautions, shifted discussion groups to a large conference room when first-year students began classes July 27, Shelov said. Likewise, students at other medical schools on the Island had been studying remotely, with plans for the upcoming term for a mix of in-person instruction and virtual learning.

Students at NYU Long Island are learning about vaccine and treatment development in their classes as they occur. Epidemiology classes will include COVID-19 cases. Students will assist with COVID-19 research by, for example, crunching numbers or helping sign up patients for clinical trials, Shelov said.

Second-year student Meenakshi Krishna, 25, who grew up in Williston Park, said entering the field at this time makes us appreciate the sacrifices of physicians and makes us realize how much goes into being a physician.

For Megan Bader, 26, a second-year student who grew up in Garden City, studying to become a physician during the beginningof the pandemic was humbling because students saw how doctors and scientists struggled to understand COVID-19 and how to best treat patients.

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Shelov said a key lesson from thisisthat doctors dont always have all the answers and, in the case of COVID-19, We learned from our mistakes.

First-year student Nabilah Nishat, 23, of Jamaica, Queens, said COVID-19's disproportionate effect on people of colorillustrates the toll of health disparities. Conditions such as diabetes and high blood pressure, which leavepeople more vulnerable to severe cases of COVID-19, stem in part from a lack of access to health care, especially preventive care, Nishat said. As a primary-care physician, Nishat wants to work to reduce disparities.

Mustapha Touray, 24, an immigrant from The Gambia and a first-year student, said the pandemic reinforced why we need diversity in medicine, and it highlighted my personal goals of going into medicine, to serve underserved communities.

People are more likely to adhere to physicians advice, and reduce their risk of conditions like high blood pressure, if they can relate to doctors, and coming from the same racial and economic background, their experiences will be similar, Touray said. So at the patient-doctor level, the interaction will be smoother.

Santiago Luis, 26, a first-year student who grew up in East Meadow and in Florida, said his only frustration with studying during the coronavirus era is that he cant yet start treating COVID-19 patients.

Most people who come into this profession are coming in with a want or desire, almost a biological desire, to help people, he said. Thats where my feelings are right now. I really want to get out there and start helping.

Luis is one of 24 new students who started classes last week, joining the 24 students from the schools inaugural class beginning their second year. NYU Long Islands original plan was to increase the size of this year's incoming first-year class to 32 and move to 40 first-year students in 2021, Shelov said. Long term, the school plans to have 40 students in each of the three graduating classes in the three-year program, for a total of 120. But increasing the number of new first-year students by eight this year would have made social distancing for in-person classes more difficult, he said.

Another barrier to expanding the first-year class by eight students is that it was unclear if enough money would have been raised to keep the school tuition-free, in part because revenue from NYU Langone physician practices that help fund the school have fallen during COVID-19, Shelov said.

NYU Long Island and the NYU Grossman School of Medicine in Manhattan are believed to be the only medical schools in the country to waive tuition for students, said Julie Fresne, senior director for student financial and career services at the Association of American Medical Colleges.

The pandemic also has changed the way students at Long Islands three other medical schools study.

At the New York Institute of Technology College of Osteopathic Medicine, the 280 first-year students will split into pods of 20 to 25, so they can attend discussion groups and labs in person while practicing social distancing, said Dr. Jerry Balentine, the colleges dean. In anatomy classes, there will be one student per cadaver rather than several, he said.

Pods will attend all in-person classes together, so if one student becomes infected with the coronavirus, only members of that pod would be quarantined, not the entire college, Balentine said.

At Stony Brook Universitys Renaissance School of Medicine, the 136 first-year students will learnonline through the end of the year, with a mix of online lectures and in-person, socially distanced discussion groups starting in January, said Dr. Kenneth Kaushansky, dean of Renaissance. Some labs will be in-person; others will be remote.

At the Zucker School of Medicine at Hofstra/Northwell, the 103 first-year students will for the first few weeks study two days on campus, three days remotely, and then transition to full-time in-person classes, with masks, social distancing and other precautions, Dr. Samara Ginzburg, the schools associate dean for case-based learning, said in an email. Second-year students will have all courses in-person.

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David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.

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COVID-19 changing study of medicine on Long Island - Newsday

Guntersville native joins Andrews Sports med team | Free Share – Sand Mountain Reporter

Marshall County native Daniel Smith has found his way back onto the playing field. Only this time his concern is each athletes health and well-being. A 2005 graduate of Guntersville, Smith was a standout in track and field, and would eventually go on to run track at the University of Alabama at Huntsville. While at UAH, he earned his bachelors degree in biology and went on to receive a medical degree from the University of South Alabama. He then earned a masters degree in chronic disease and exercise science from the University of North Florida in Jacksonville, Florida.

After his residency in family practice with the Phoebe Putney Health System in Albany, Georgia, Smith went on to complete a fellowship in primary care sports medicine at Andrews Sports Medicine through the American Sports Medicine Institute (ASMI) from 2018-2019.

Effective Monday, Smith will join the Andrews practice full time. Smith will serve alongside Samuel R. Goldstein, MD as a team physician for the following high schools: Hewitt-Trussville High School, Locust Fork High School, Oneonta High School, Pinson Valley High School, Southeastern High School, Springville High School, St. Clair County High School and Susan Moore High School.

A lot of doctors have to take calls while theyre at the hospital, or on home visits, Smith said. But my call is getting to go and watch sports. I couldnt be more excited about being able to join the team at Andrews, and work with student-athletes.

Smith said hes been around sports most of his life. However, sports medicine wasnt the first field he was looking to go in to.

I had vision trouble growing up so, I was always interested in optometry, he said. When I got into medical school, I shadowed some optometrist and decided it just wasnt for me. Thats when I remembered how much I love sports and decided then and there to do sports medicine.

Smith said hes looking forward to the unique relationships on field doctors

have with young athletes.

Young athletes put such an emphasis on sports, he said. And in a lot of ways its what they base their identity on. The ability to help athletes reclaim their identity after an injury is what Im really looking forward to.

Smith will treat patients of all ages and activity levels with a wide variety of injuries and conditions ranging from sprains, strains, fractures and osteoarthritis. The Andrews Sports Medicine team is excited to have the former Wildcat on board.

Were thrilled to officially welcome Dr. Smith to our Andrews Sports Medicine team of physicians, said Goldstein. Dr. Smith will be a valuable member of our practice as we continue to provide quality healthcare and service to our patients and student-athletes in Birmingham, Trussville and surrounding communities.

Dr. Smith is currently accepting new patients. To schedule an appointment, call 205-939-3699 or visit AndrewsSportsMedicine.com.


Guntersville native joins Andrews Sports med team | Free Share - Sand Mountain Reporter

Texas schools reopening mandate sets off another local control debate – The Texas Tribune

Need to stay updated on coronavirus news in Texas? Our evening roundup will help you stay on top of the day's latest updates. Sign up here.

Last week, Gov. Greg Abbott moved to block local health authorities from shutting down classrooms before the school year has started. Since then, he has repeatedly said he is trusting local school leaders to decide whether and how to bring students back to classrooms this fall.

Those actions have left local officials confused about the limitations of their authority as the debate over reopening schools in the state continues. Abbotts decision to curb the role of local health authorities has added to the ongoing conflict between the governor and local governments during the pandemic, with mayors and judges across the state voicing frustration over having their hands tied by the states response.

Some superintendents say that despite Abbotts statements to the contrary, their ability to respond to the pandemic is still limited, and many of their questions have gone unanswered even as school is slated to start in the coming weeks. They are worried their decisions could result in consequences from the state, including cuts to funding, and some say they would prefer high-stakes decisions affecting student and employee health to stay with medical experts.

Were going to make our decisions based on local scientific data, and were working with the health authority. Thats our guide, said Juan Cabrera, superintendent of the El Paso Independent School District. Nobody on our board, including myself and my administration, are medical doctors, so Im going to try to take their advice.

After about 18 local health authorities issued orders delaying in-person instruction because of coronavirus concerns, Abbott said last week that those health officials cannot issue blanket orders preventing all schools in their jurisdictions from opening classrooms before the academic year begins. His statement backed nonbinding guidance from Attorney General Ken Paxton released earlier that week.

Abbott also said school districts could ask for more time to limit the number of students learning in classrooms, on a case-by-case basis, beyond the current eight-week maximum set by the Texas Education Agency. And he reminded school officials that they could move their start dates later in the year with a school board vote, as long as they make up the time. This, he said, gives local school boards the most authority to determine when and how its safe to have kids back.

The Texas Education Agency has not yet released any specifics on which districts will be able to receive waivers to limit in-person instruction beyond eight weeks or under what circumstances. But it said it will not fund school districts for unlawful school closures, worrying superintendents who want more certainty of state support while handling an unpredictable pandemic.

After the eight weeks, theres a threat to withhold funding if schools dont have in-person learning. Theyve offered a waiver opportunity but it takes it out of the hands of the local school district beyond the eight weeks, and that is not local control, said Kevin Brown, executive director of the Texas Association of School Administrators and former superintendent of Alamo Heights ISD in San Antonio.

A spokesperson for Abbott, when reached for comment for this story, referred to the governors previous statements on the issue. Abbott has said that school boards are welcome to consult public health authorities as they make their decisions. And he said local health officials could shut down schools that have COVID-19 outbreaks after they reopen.

Some superintendents, especially in areas where the virus is rampant, balked at the idea of waiting for kids and teachers to get sick before shutting down their campuses in the middle of the year, instead of working with local health officials to close classrooms if cases spike again. And some still wondered: What options do they have if cases are still high after eight weeks?

Districts, I think, are very concerned about creating these rolling situations where people come back on campus and then get sick and then everybody has to leave again, said Joy Baskin, director of legal services for the Texas Association of School Boards, on a recent podcast explaining the states guidance.

Paxtons guidance and Abbotts subsequent statement were a boon for school leaders who wanted to open but were blocked by local health orders. Some of those that celebrated were private schools, with smaller class sizes and more resources.

Others were districts that straddle multiple counties: Boerne ISD has two schools in Bexar County, home to San Antonio, a hot spot for the virus, but most are in more rural Kendall County, where COVID-19 transmission is low. After Paxtons letter, Boerne ISD announced it would open those two schools in mid-August, going against the Bexar County order.

But school superintendents in regions where the virus is spreading quickly are balancing the fear of infection with concerns about how much vulnerable students will fall behind learning from home. Theyve run into some roadblocks with state guidance.

Once El Paso ISD schools open for in-person instruction, parents will be able to choose among entirely in-person instruction, entirely virtual instruction, or a hybrid version of in-person two days and virtual three days. Cabrera said that keeping school capacity to 50% would be the best way to keep kids safe, at least until a vaccine is available. Like many school superintendents, he is prioritizing younger students, those learning English and those with disabilities for in-person learning, groups otherwise at risk of falling behind.

Cabrera said hell roll out the plan to all the schools in his district, but TEA only allows that flexibility in limited circumstances, potentially putting Cabrera at odds with the state guidelines.

Whats driving my decision is requests from parents for social distancing. Im not forcing people into schools if I cant social distance, Cabrera said. That might be a contravention [of state guidance].

The frustration local leaders have voiced in recent weeks has been a nearly constant thread throughout the pandemic. At first, Abbotts response to the pandemic was to defer to local officials, and many issued their own versions of stay-at-home orders. Abbott resisted the growing number of calls to issue a statewide mandate before announcing at the end of March that he would order one.

A month later, the governor was overseeing the reopening of the state and in the process blocked local governments from being able to implement stronger restrictions, such as requiring people to use masks while in public. For weeks, the back and forth over masks continued, with local officials asking the governor for the power to require them or to issue a statewide order mandating them.

Eventually, one local official tried something new: Instead of requiring people to wear them, Bexar County Judge Nelson Wolff ordered businesses to mandate them. Wolff, the governor said in an interview soon after, had finally figured that out. The comment earned Abbott criticism from both his right and left about why he wasnt clearer about what locals had the power to enforce.

Then in early July, Abbott reversed himself, ordering Texans across the state to wear masks in public.

The friction between Abbott and local officials has continued into this latest debate over the reopening of schools. San Antonio Mayor Ron Nirenberg, in a July 31 tweet thread, criticized the statement on school reopenings from Abbott and other GOP leaders, saying that local leaders implement health-based protocols, the AG threatens them, and the State capitulates.

Every time [Paxton] issues an opinion, it confuses the guidance at the state level or attempts to roll back protections that have been proven to work at the local level, Nirenberg told The Texas Tribune earlier this week. And that seeds the kind of chaos that youve seen play out in this school situation that ultimately leads to the feeling that weve lost control of the virus.

Some health experts say it makes sense for local health authorities, who will be responsible for quashing outbreaks on campuses, to have outsized say in how schools can reopen. Theyre going to be the ones who are collecting the data and need to process it, said Michael Chang, an infectious disease pediatrician at UTHealths McGovern Medical School and UT Physicians.

I get it, theres a lot of questions about who has authority and whos got jurisdiction ... but ultimately I think the local health officials are best positioned to respond and best understand whats going to be the impact on local schools.

Its still unclear whether local health officials will enforce their orders to delay school. After Abbotts statement last week, Harris County Judge Lina Hidalgo continued to urge schools to keep their classrooms closed. No gathering should be taking place, much less a gathering in school. We are working with superintendents to figure out: When would it be okay and how would it be done? But whats relevant right now is right now, not any time soon, she said at a press conference this week.

Going the opposite direction, McLennan County, home to Waco ISD, rescinded its school order after Paxtons legal guidance. Athletic directors of school districts in the county moved to start strength and conditioning training right away.

At a San Antonio press conference this week, Abbott was asked whether hed make his authority on the matter clearer by issuing an executive order, rather than just a statement. If they want me to issue an executive order, I can cut and paste what weve issued and sign it, Abbott said, jokingly. If they just show up with a copy of it, Id be happy to sign it.

In the meantime, some local health officials and school districts are working together to come up with plans to open safely and address the needs of their most vulnerable children. In a virtual town hall Wednesday night, San Antonio Medical Director Junda Woo suggested using a few metrics, including the number of days cases have declined, to assess the risk of reopening schools. At a time of the highest risk, like now, schools would only be allowed to bring in small numbers of vulnerable children, such as those with disabilities or those who arent safe at home, she said.

Northside ISD Superintendent Brian Woods, who was at the meeting, told The Texas Tribune that superintendents want clarity as they plan for the upcoming year. And they want certainty that the state will support the decisions they make in order to keep students and staff safe as the pandemic continues beyond the first eight weeks of school.

What if, in some parts of the state, as we approach week eight, the public health situation is not good? he said. What ought to be the solutions? And it seems like we ought to be working on them now instead of waiting on a crisis.

Disclosure: The Texas Association of School Administrators and the Texas Association of School Boards have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.

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Texas schools reopening mandate sets off another local control debate - The Texas Tribune

Health Care Workers Of Color Nearly Twice As Likely As Whites To Get COVID-19 – WUSF News

Health care workers of color were more likely to care for patients with suspected or confirmed COVID-19, more likely to report using inadequate or reused protective gear, and nearly twice as likely as white colleagues to test positive for the coronavirus, a new study from Harvard Medical School researchers found.

The study also showed that health care workers are at least three times more likely than the general public to report a positive COVID test, with risks rising for workers treating COVID patients.

Dr. Andrew Chan, a senior author and an epidemiologist at Massachusetts General Hospital, said the study further highlights the problem of structural racism, this time reflected in the front-line roles and personal protective equipment provided to people of color.

If you think to yourself, Health care workers should be on equal footing in the workplace, our study really showed thats definitely not the case, said Chan, who is also a professor at Harvard Medical School.

The study was based on data from more than 2 million COVID Symptom Study app users in the U.S. and the United Kingdom from March 24 through April 23. The study, done with researchers from Kings College London, was published in the journal The Lancet Public Health.

Lost on the Frontline, a project by KHN and The Guardian, has published profiles of 164 health care workers who died of COVID-19 and identified more than 900 who reportedly fell victim to the disease. An analysis of the stories showed that 62% of the health care workers who died were people of color.

They include Roger Liddell, 64, a Black hospital supply manager in Michigan, who sought but was denied an N95 respirator when his work required him to go into COVID-positive patients rooms, according to his labor union. Sandra Oldfield, 53, a Latina, worked at a California hospital where workers sought N95s as well. She was wearing a less-protective surgical mask when she cared for a COVID-positive patient before she got the virus and died.

The study findings follow other research showing that minority health care workers are likely to care for minority patients in their own communities, often in facilities with fewer resources, said Dr. Utibe Essien, a physician and assistant professor of medicine with the University of Pittsburgh.

Those workers may also see a higher share of sick patients, as federal data shows minority patients were disproportionately testing positive and being hospitalized with the virus, Essien said.

Im not surprised by these findings, he said, but Im disappointed by the result.

Dr. Fola May, a UCLA physician and researcher, said the study also reflects the fact that Black and Latino health care workers may live or visit family in minority communities that are hardest-hit by the pandemic because so many work on the front lines of all industries.

The study showed that health care workers of color were five times more likely than the general population to test positive for COVID-19.

Their workplace experience also diverged from that of whites alone. The study found that workers of color were 20% more likely than white workers to care for suspected or confirmed-positive COVID patients. The rate went up to 30% for Black workers specifically.

Black and Latino people overall have been three times as likely as whites to get the virus, a New York Times analysis of Centers for Disease Control and Prevention data shows. (Latinos can be of any race or combination of races.)

Health care workers of color were also more likely to report inadequate or reused PPE, at a rate 50% higher than what white workers reported. For Latinos, the rate was double that of white workers.

Its upsetting, said Fiana Tulip, the daughter of a Texas respiratory therapist who died of COVID-19 on July 4. Tulip said her mother, Isabelle Papadimitriou, a Latina, told her stories of facing discrimination over the years.

Jim Mangia, chief executive of St. Johns Well Child and Family Center in south Los Angeles, said his clinics care for low-income people, mostly of color. They were testing about 600 people a day and seeing a 30% positive test rate in June and July. He said they saw high positive rates at nursing homes where a mobile clinic did testing.

He said seven full-time workers scoured the U.S. and globe to secure PPE for his staff, at one point getting a shipment of N95 respirators two days before they would have run out. It was literally touch-and-go, he said.

All health care workers who reported inadequate or reused PPE saw higher risks of infection. Those with inadequate or reused gear who saw COVID patients were more than five times as likely to get the virus as workers with adequate PPE who did not see COVID patients.

The study said reuse could pose a risk of self-contamination or breakdown of materials, but noted that the findings are from March and April, before widespread efforts to decontaminate used PPE.

Chan said even health care workers reporting adequate PPE and seeing COVID patients were far more likely to get the virus than workers not seeing COVID patients nearly five times as likely. That finding suggests a need for more training in putting on and taking off protective gear safely and additional research into how health care workers are getting sick.

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Health Care Workers Of Color Nearly Twice As Likely As Whites To Get COVID-19 - WUSF News

Dancing Wildcats Enjoy Smoother Transition to the Field of Medicine – UKNow

LEXINGTON, Ky. (Aug. 6,2020) The connection between art and medicine has been a focus of medical education institutions for decades.

In 1983,Yale School of Medicinecreated the Program for Humanities in Medicineto create better doctors and better patient relationships. Viewing a patient as a complete human beingwith stories outside of their symptoms or ailments can lead to more empathybetween doctors andpatients.Dozens of medical schoolshave been exposing residents toartto buildtheirobservation skills.In 2016,Harvard Medical Schoolbeganintegratingdrama, danceandliteratureinto their curriculumtoincreasestudentempathy and reflection.

Art translates across alldisciplinesin a way that can inform thelensthrough which we view the world.TheUniversity of Kentucky College of Fine Arts currently offers twodegrees thatspecifically address arts in health care,theMaster of MusicinMusic Therapyprogram,Kentuckys first and only graduate programof itskind,and theBachelor of Science inDigital Media Designprogramfor Pre-Med,suited for students interested in the latest advances inbio-technologiesrelated to data visualization and simulated environments. But future doctors are not only selecting these dedicated hybridprograms to expand their skills while pursuing their undergraduate studies at UK.

Our dance program also allows students tostudy both arts andhealth care,"UKDance ProgramDirector Susie Thielsaid.

During their time here, these alums used dance choreography combined with a scientific study to create dances and present their research, Thieladded. Topics ranged from the various shades of schizophrenia to how cortisol is produced in thebody when it perceives stressto the emotional and scientific findings of dementia. These dances were performed at theNational Conference of Undergraduate Research,theAmerican College of Dance Conferenceand at UK in 'Materialized'(student choreography concert) and the Showcase of Undergraduate Research.

Students frequently choose to study in theUK Deparment of Theatre and Dancebecause they can focus on two very diverse disciplines as undergraduates. Our dance students double major or minor in other disciples including communications, biology, chemistry, education, pre-med, journalism, accounting, computer science and nursing, to name a few, Thiel noted.

UK Fine Arts recentlycaught up with five former and current UK dance students who have stretched their artistic talents across disciplines into the field of medicine to learn more about their experiences.

Katelyn Cox(2020 agricultural and medical biotechnologybachelor's degree,minor in dance)

I absolutely think dance is what initially made me so interested in the human body and the amazing things it can do, Cox said.When I started college, I became fascinated with finding how dance overlaps with science and medicine. The program, specifically, allowed me to grow as a dancer in technique and appreciation, and helped me explore my ideas about the interdisciplinary overlap through choreography. Being a dancer made me stand out when I applied for medical school (and I think it helped me get in!), but has also kept me grounded by giving me a humanistic outlook, which I will carry with me as a future physician.

Cox'sfascination with science and medicine inspiredher interdisciplinary project "Finding the Common Essence: Using Dance as a Medium to Explore Analogies Between the Life Sciences and Our Everyday Lives,"whichplaced secondin the2019Oswald Research and Creativity Competition's Fine Artscategory.

ViewCox'sdance piece onlinehere.

Dr. Liza Belle Bastin(2019 graduate ofUK Collegeof Medicine,2015minor in dance)

The UK Dance Program was a vital part of my education, Bastinsaid.The program challenged me to think creatively, build confidence, act boldlyand respect both my mind and body. Each invaluable faculty member invested into me, daring me to growon a daily basisas an artist, a mover, a critical thinkerand as a human. During my undergraduate studies I participated in dance research by exploring the intersection of science and art, specifically through movement and the study of the human body. This provided me with many academic opportunities, such as presenting twice at theNational Conference on Undergraduate Research. I carried these unique experiences with me throughout my medical training, often catching attention of many within the field of medicine.

Duringher residency interviews, Bastinwas often asked questions about her experience as a dancer, sparking thoughtful conversations about theinterdisciplinary connection between dance and medicine.

The dance program was the perfect complement to my science and medical studies, allowing me to pursue all of my passions and be wellbalanced as a whole.

Kirstin Sylvester(2016 bachelor's degree inpsychology, minor in dance); recently completedmaster's degree in educational psychology at Georgia State University

"The University of Kentuckys Dance Program was a highlight of my undergraduate experience, Sylvestersaid.It not only served as a creativeoutlet butserved as a medium through which I grew personally and professionally.

"As a psychology and pre-med undergraduate, I was interested in the complexities inherent in psychological diagnosis and how that can be portrayed through dance.Director Susie Thiel supported the exploration of cross discipline work and encouraged me to submit a self-choreographed piece at the National Conference of Undergraduate Research. The work was selected and furthered my interest in psychotherapy. This is only one of the many opportunities the dance program provided me that aided in my professional development.Personally, the dance program provided an inclusive and supportive environment in making life decisions through prompts, improvisation and reflection. Since, I have completed my masters in clinical mental health counseling and will be pursuing my Ph.D. in counseling psychology in August. It is my hope to be a resource for hope, supportand change to others as the dance program was for me.

Alyssa Noell Conley(2016 bachelor's degree inbiology, minors inSpanishanddance)

Conleyis currently studying attheUniversity of PikevillesKentucky College of Osteopathic Medicineand attributes a lot of her success to her experience minoring in dance at UK.

Dance has always played a large role in my life, and I believe it is where I learned the dedication and perseverance necessary to pursue medicine, Conley said.It has also been the spark of my interest in the human bodys inner workings. During my timein the dance programI learned so much about creative problem solving that has benefited me in my medical education. My dance minor also promoted my engagement in meaningful research that I have presented. This research has been one of the most discussed experiences on my CV in my admission interviews as well as my residency interviews I think dance has shown me to be well-rounded and innovative in learning, which to me has been essential to completing medical school.

Olivia Grothaus(2020UK College of Medicine,2017 bachelor's degree inbiology,minor in dance)

Grothaus says her experience in the UK Dance Program has helped her in ways she never imagined.

I originally sought out the program to bring some diversity to my education, to learn new skillsand honestly to do something fun that would challenge me, she said.Going through the dance program was challenging, but that also helped prepare me for medical school. I gained a greater focus as I encountered new techniques orstylesI wasnt familiar with.

Grothausbelievesthat studying art can helpcreate better medical professionals. I also learned to listen in a different way than most andhomed in onobservation skills that I think ultimately allow me to take better care of patients.The creativity that dance fostered absolutely nurtured my critical thinking skills that are invaluable learning medicine, and the emotional connection within dance I believe makes me a better doctor to my patients.

While thepressure in the dance studioversusmedical schoolcan bedifferent,Grothausattributes her dance training to her physical resiliency during rigorous medical training.

"I already had so much practice with having to physically continue to push through challenges and try again and again, my resiliency in medical school wasdefinitely better for it.Thecorrection and scrutiny by my dance instructors taught me to pay attention to detail, understand what my body needed to do and make fine adjustments quickly. I learned how to be coachable, and as a future surgeon who has a lot to learn in the operating room, those skills will hopefully come through. Learning dancegaveme an appreciation for what the human body can do and convey that has persisted into my passion for medicine. Dancers and medical students I found to be much alike in their type A personality, constant chasing of perfection butoveralltheir passion and dedication to what they do."

The Department of Theatre and Dance, part ofUK College of Fine Arts, provides students hands-on training and one-on-one mentorship from professional theatre and dance faculty and renowned guest artists in acting, directing, playwriting, theatrical design and technology, and dance. From mainstage productions to student-produced shows, students have plenty of opportunities to participate on stage or backstage. Special programs include a musical theatre certificate, education abroad, as well as a thriving dance program that emphasizes technique, composition, performance and production.

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Dancing Wildcats Enjoy Smoother Transition to the Field of Medicine - UKNow

Kindness is the best medicine – Argus Leader

Joanie Holm, C.N.P., Prairie Doc Published 8:09 p.m. CT Aug. 6, 2020

Joanie Holm, C.N.P.(Photo: Submitted)

My name is Joanie Holm. I am a certified nurse practitioner in Brookings, South Dakota and I am the person fortunate to have been the life partner of the original Prairie Doc, Richard P. Holm, M.D. Rick and I were married for 40 years before his passing in March of 2020.

During those wonderful decades together, if I could point to one powerful action that strengthened our relationship with each other, with our family, our community and with our patients, it would be the act of kindness.

Thankfully, Rick was alive to see the recognition and formalization of kindness as an essential element of medical education. Medical schools across the country have started to offer courses on compassion and caring. One of the first to do so was the University of South Dakota Sanford Schoolof Medicine.

Dr. Mary Nettleman, dean of the USD medical school, explained why the school embraced kindness as part of its core curriculum. People want a physician who is not only competent, but also kind, so we will work to elevate this value throughout the school. By approaching this intentionally, we hope that students will learn how important kindness is in medicine and how they can incorporate it into their everyday practice.A culture of kindness can make us exceptional, said Nettleman.

I celebrate this awareness and elevation of kindness in medical education and I salute educators for enriching their medical students in this way.

Since Ricks death, I have received many wonderful notes of condolence that have been very meaningful to me and my family. With permission from the author of one such letter, I share the following message which further illustrates kindness.

Dear Mrs. Holm,

Im one of the people who knew your husband through his TV show, and I learned from him. I have cerebral palsy and sometimes its hard for people to understand me. One day, my mom and I were having dinner in Sioux Falls and you were seated close to us. When Dr. Holm walked by my table, I put my hand out and he stopped and talked to me. I wanted to tell him that we were praying for him and I will never forget how he made me feel. I have worked with many doctors and he was one of the best!

My dear husband practiced kindness in all he did. Regardless of our profession, may we all embrace acts of kindness and stop to hold the outreached hand of a fellow human being.

Prairie Doc can be seon SDPB most Thursdays at 7 p.m. central.

Read or Share this story: https://www.argusleader.com/story/news/brandon/2020/08/06/kindness-best-medicine/3315539001/

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Kindness is the best medicine - Argus Leader

Kindness is the best medicine | Coronavirus | rocketminer.com – Daily Rocket Miner

My name is Joanie Holm. I am a certified nurse practitioner in Brookings, South Dakota, and I am the person fortunate to have been the life partner of the original Prairie Doc, Richard P. Holm, M.D. Rick and I were married for 40 years before his passing in March of 2020.

During those wonderful decades together, if I could point to one powerful action that strengthened our relationship with each other, with our family, our community and with our patients, it would be the act of kindness.

Thankfully, Rick was alive to see the recognition and formalization of kindness as an essential element of medical education. Medical schools across the country have started to offer courses on compassion and caring. One of the first to do so was the University of South Dakota Sanford School of Medicine.

Dr. Mary Nettleman, dean of the USD medical school, explained why the school embraced kindness as part of its core curriculum. People want a physician who is not only competent, but also kind, so we will work to elevate this value throughout the school. By approaching this intentionally, we hope that students will learn how important kindness is in medicine and how they can incorporate it into their everyday practice. A culture of kindness can make us exceptional, said Nettleman.

I celebrate this awareness and elevation of kindness in medical education and I salute educators for enriching their medical students in this way.

Since Ricks death, I have received many wonderful notes of condolence that have been very meaningful to me and my family. With permission from the author of one such letter, I share the following message which further illustrates kindness.

Dear Mrs. Holm,

Im one of the people who knew your husband through his TV show, and I learned from him. I have cerebral palsy and sometimes its hard for people to understand me. One day, my mom and I were having dinner in Sioux Falls and you were seated close to us. When Dr. Holm walked by my table, I put my hand out and he stopped and talked to me. I wanted to tell him that we were praying for him and I will never forget how he made me feel. I have worked with many doctors and he was one of the best!

My dear husband practiced kindness in all he did. Regardless of our profession, may we all embrace acts of kindness and stop to hold the outreached hand of a fellow human being.

For free and easy access to the entire Prairie Doc library, visit http://www.prairiedoc.org.

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Kindness is the best medicine | Coronavirus | rocketminer.com - Daily Rocket Miner

Lindsey Criswell Named Director of National Institute of Arthritis and Musculoskeletal and Skin Diseases – UCSF News Services

Lindsey A. Criswell, MD, MPH, DSc

Lindsey A. Criswell, MD, MPH, DSc, vice chancellor of research at UC San Francisco, has been selected as the next director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), one of 27 institutes and centers that comprise the National Institutes of Health (NIH). She will assume the role in early 2021.

Having dedicated much of my career to studying and treating autoimmune disorders such as lupus and rheumatoid arthritis, I am tremendously honored to serve as director of NIAMS, said Criswell, professor of medicine in the School of Medicine, professor of orofacial sciences in the School of Dentistry and co-director of the UCSF Clinical & Translational Sciences Institute.

As NIAMS director, Criswell will oversee a federal institution with an annual budget of nearly $625 million and a mission to support scientific research, training and career development in the fields of rheumatology, muscle biology, orthopedics, bone and mineral metabolism, and dermatology, among others. Criswell was selected by NIH Director Francis Collins, MD, PhD, and will succeed Robert H. Carter, MD, who has served as acting NIAMS director since 2018 after long-time director Stephen I. Katz, MD, PhD, passed away unexpectedly in December 2018.

Dr. Criswell has rich experience as a clinician, researcher and administrator. Her ability to oversee the research program of one of the countrys top research-intensive medical schools, and her expertise in autoimmune diseases, including rheumatoid arthritis and lupus, make her well-positioned to direct NIAMS, said Collins. I look forward to having her join the NIH leadership team early next year.

Criswell will join NIAMS after having spent nearly the entirety of her career at UCSF. She arrived at UCSF in 1982 to pursue her medical education, and received her MD from the School of Medicine in 1986. After completing an internship and residency in Southern California, she rejoined UCSF in 1989 to begin a fellowship in rheumatology. She has been at the University ever since. Criswell was made full professor in 2007 and has served as vice chancellor of research since 2017.

Ive had the pleasure of working with Lindsey for nearly four decades. She has distinguished herself as one of UCSFs most accomplished clinician-scientists, as well as a devoted mentor and skillful administrator. Her incredible character and her talent as a leader make her an excellent choice for NIAMS director, said Dan Lowenstein, MD, executive vice chancellor and provost at UCSF.

In her role as vice chancellor of research, Criswell has helped define UCSFs overall research priorities and goals, and has also overseen research infrastructure, with a view to ensuring seamless and superior service to researchers across the University. As a scientist and clinician, Criswell has worked to understand and treat autoimmune disorders like rheumatoid arthritis and lupus, with a particular focus on the genetics, epigenetics and epidemiology of these diseases. She has authored more than 200 peer-reviewed scientific papers, and her efforts have contributed to the identification of more than 30 genes linked to these and other autoimmune disorders. Criswell is also a dedicated educator, who has trained and mentored dozens of students, medical residents, postdoctoral fellows and junior faculty.

Lindseys contributions to science have been tremendous, said Talmadge E. King Jr., MD, dean of the School of Medicine and vice chancellor for medical affairs. Her efforts have led to significant advances in our understanding of the underlying causes of and potential treatments for rheumatoid arthritis, lupus and other debilitating autoimmune disorders. Her influence can also be seen in the many talented young scientists and clinicians whom she has trained, and who are now establishing themselves as leaders in the field, thanks in large part to Lindseys mentorship.

Criswell has received many awards and honors, including the 2014 Resident Clinical and Translational Research Mentor of the Year; a Kirkland Scholar Award from the Mary Kirkland Center for Lupus Research; the Henry Kunkel Young Investigator Award from the American College of Rheumatology; a UCSF Faculty Development Award; and a Pfizer Scholars Award.

Criswell joins the ranks of other distinguished UCSF faculty who have served in leadership roles with the NIH. Eliseo Perez-Stable, MD, was a professor of medicine, chief of the Division of General Internal Medicine, and director of the Center for Aging in Diverse Communities (CADC) before assuming his current role as director of the National Institute on Minority Health and Health Disparities (NIMHD). Zach Hall, PhD, joined UCSF in 1976 and remained on the faculty until appointed director of the National Institute of Neurological Disorders and Stroke (NINDS) in 1994. Nobel laureate Harold Varmus, MD, was a UCSF faculty member for two decades before being appointed NIH director in 1993, and later serving as director of the National Cancer Institute (NCI).

Criswell earned her bachelors degree in genetics and her masters degree in public health from UC Berkeley. She later received a DSc in genetic epidemiology from the Netherlands Institute of Environmental Health Sciences in Rotterdam. Criswell is board certified in internal medicine and as a wilderness medicine first responder. Upon leaving UCSF, Criswell will be granted emeritus status.

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Lindsey Criswell Named Director of National Institute of Arthritis and Musculoskeletal and Skin Diseases - UCSF News Services

University of Minnesota expands clinical investigation of engineered iPSC-derived natural killer cells, opening U.S. clinical trial for the treatment…

The first patient has received treatment in a new clinical trial that has opened at the University of Minnesota to test whether a novel cell therapy currently under clinical investigation as a treatment for acute myeloid leukemia (AML) and lymphoma can be effective as a treatment for COVID-19. The first-of-its-kind, engineered iPSC-derived natural killer (NK) cell product candidate, FT516, may play a role in diminishing viral replication of the novel coronavirus. NK cells have been known to play a role in protecting the body against viral infection; however, it is not known whether NK cells will be able to safely control COVID-19, the infectious disease caused by the virus SARS-CoV-2.

The clinical trial Study of FT516 Safety and Feasibility for the Treatment of Coronavirus Disease 2019 (COVID-19) in Hospitalized Patients with Hypoxia, which is being supported by Fate Therapeutics, Inc., is being run locally by Joshua Rhein, M.D., Assistant Professor of Medicine in the University of Minnesota Medical Schools Division of Infectious Diseases and International Medicine.

The medical research community has been mobilized to meet the unique challenges that COVID-19 presents, said Rhein. There are limited treatment options for COVID-19, and we have been inundated daily with reports of varying quality describing the potential of numerous therapies. We know that NK cells play an important role in responding to SARS-CoV-2, the virus responsible for COVID-19, and that these cells often become depleted in infected patients. Our intent is to replenish NK cells in order to restore a functional immune system and directly target the virus.

Jeffrey Miller, M.D., Deputy Director of the Masonic Cancer Center, and Professor of Medicine in the Medical Schools Division of Hematology, Oncology and Transplantation, is a pioneer in the field of NK cells. As a collaborator on the trial, Dr. Miller will apply his decades of experience in NK cell biology and therapy in cancer to this international challenge.

One of the complexities of treating COVID-19 with cell therapy is the underlying inflammation that coincides with more severe cases of COVID-19 infection. The challenge is to carefully deliver off-the-shelf engineered NK cells at increasing doses to turn off viral replication without overly activating the immune system to make the lungs worse.

The study has been carefully designed with appropriate medical checkpoints to investigate the potential of NK cells in a manner which we believe to be safe in COVID-19 patients, said Miller. We will also track the immune response and duration of viral shedding to see if FT516 decreases shedding of COVID-19 in the respiratory tract. If successful, these off-the-shelf, iPSC-derived NK cells can be batch manufactured and sent nationwide to patients.

FT516 is manufactured from a master human induced pluripotent stem cell (iPSC) line that has been genetically engineered to enhance its binding to therapeutic antibodies. It was initially developed to attack AML and B-cell lymphoma, based on the groundbreaking research on stem cells and NK cells done at the Masonic Cancer Center.

FT516, which is being clinically developed by Fate Therapeutics for the treatment of advanced hematologic malignancies and solid tumors, was produced and manufactured at the U of Ms Molecular and Cellular Therapeutics (MCT) center, which offers full-service development and manufacturing of cell- and tissue-based products, monoclonal antibodies and other therapeutic proteins, as well as active pharmaceutical ingredients for use in Phase I, II or III clinical trials. M Health Fairview, the clinical partner of the Masonic Cancer Center, supports the MCT in the production of these molecules.


Read the original release about FT516 here.

About the Masonic Cancer Center, University of MinnesotaThe Masonic Cancer Center, University of Minnesota, is the Twin Cities only Comprehensive Cancer Center, designated Outstanding by the National Cancer Institute. As Minnesotas Cancer Center, we have served the entire state for more than 25 years. Our researchers, educators, and care providers have worked to discover the causes, prevention, detection, and treatment of cancer and cancer-related diseases. Learn more at cancer.umn.edu.

About the University of Minnesota Medical SchoolThe University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. Learn how the University of Minnesota is innovating all aspects of medicine by visiting http://www.med.umn.edu.

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University of Minnesota expands clinical investigation of engineered iPSC-derived natural killer cells, opening U.S. clinical trial for the treatment...

With academic health center, the imagined can be reality – Las Vegas Sun

Dr. Marc J. Kahn

Thursday, Aug. 6, 2020 | 2 a.m.

As he does every August, Brian Greenspun is taking some time off and is turning over his Where I Stand column to others. Todays guest columnist is Marc J. Kahn, dean of the UNLV School of Medicine.

For a moment, lets imagine Las Vegas as the premier city for health care in the U.S.

For a reality check, currently, according to the Commonwealth Fund, Nevada ranks 48th in the country for overall health care. Nevada is similarly 50th for access to and affordability of health care, 51st for prevention and treatment and 39th for the healthiness of the population. Clearly, we can and need to do better.

UNLV Photo Services

Dr. Marc J. Kahn

How do we get there?

We continue to grow an academic health center.

UNLV School of Medicine was founded in 2014 and its first class matriculated in the summer of 2017. The schools mission is to care for the community of Southern Nevada and to do this by working with the other UNLV health sciences schools including nursing, dental medicine, public health and integrative health. By also partnering with University Medical Center and other local hospitals, we are forming the valleys first academic health center.

Fortunately, we have a good foundation on which to build.

Consider how the medical school has responded to the COVID-19 pandemic: We engineered and maintained the longest continuously running curbside test sites, helping to diagnose more than 18,000 Nevadans, among the first testing facilities to help diagnose the disease in the valley.

The young medical school recruited a blood services partner to bring convalescent plasma to the valley to help treat the sickest people suffering from the virus. UNLV and its partners were also able to provide research and insight into the epidemiology of the infection and to help hotels and casinos open in a safer fashion.

We also have world-class researchers studying Alzheimers disease, a trauma center where 96% of patients estimated to have a less than 1% chance of survival actually go home, and we have a faculty member studying the role of stem cells to fight heart disease.

Academic health centers are more than buildings, hospitals and medical schools. They are a network of medical and research facilities staffed by caring health care professionals, men and women who work together to provide the best evidence-based care for patients. By their very nature, academic health centers are deeply embedded in the communities they serve. In addition to caring for patients, they engage in research to provide novel technologies to fight human diseases such as COVID-19. They provide quality health care 71% of the nations level-one trauma centers and 98% of the nations comprehensive cancer centers are in academic health centers. Although accounting for only 5% of all hospitals in the U.S., academic health centers provide over 40% of charity care consistent with their mission to serve their communities. Finally, studies have shown that patients treated in academic health centers have up to a 20% higher likelihood of survival.

Lets imagine what a mature academic health center could mean for the residents of Southern Nevada.

For our community, the UNLV School of Medicine and the academic health center as a whole, have plans for staffing clinics for the underserved of Southern Nevada, where patients will receive medical, dental, mental health and preventative services regardless of ability to pay.

Over time, the academic health center as a whole will be able to provide additional novel treatments for cancer, stroke, cognitive disorders, diabetes and heart disease, while employing vast numbers of Nevadans contributing significantly to the local economy.

Lets imagine a time when Nevada, known as a tourist destination, can attract patients from throughout the U.S. to get top-notch health care in one of the worlds most unique cities.

Lets imagine the future where the newest, most promising medical technologies are homegrown through colleges and universities right here in Nevada.

Lets imagine when our ability to care for all of our residents serves as a model for the rest of the country.

And it will not be just UNLV. The valley is fortunate to have Touro University, which has an osteopathic medical school. Las Vegas also has affiliated medical residencies in several hospital systems and plans to have a new medical school at Roseman University for the Health Sciences. All contribute to the welfare of our residents.

Are we there yet? No. But with the continued support of our state, colleges and universities, philanthropists and the residents of Las Vegas, we can get there. Thinking big, settling only for the best, garnishing all of our resources and being creative and nimble, we will get there sooner, rather than later.

Dr. Marc J. Kahn is dean of the UNLV School of Medicine, where he also serves as a professor.

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With academic health center, the imagined can be reality - Las Vegas Sun

Need to Take the MCAT? You’ll Still Have to Do It in Person – The New York Times

Dr. Skorton said the exam rooms are a low-risk, not a zero-risk environment. If youre going to go into medicine, youre going to go into a profession where there is no way to eliminate risk, he said.

There is no way to put people at zero risk that is the nature of the beast. Its different than other professions. What we do is take care of patients.

The estimated 100,000 people who will take the MCAT are years away from becoming physicians, and many will never make it: Just over 40 percent of the 53,371 applicants to American medical schools last year secured a spot.

The MCAT tests applicants knowledge of biology, chemistry, physics, psychology and sociology, as well as critical analysis and reasoning skills. The college canceled testing in mid-March, when much of the country was under lockdown, and resumed on May 29 with a shortened version of the seven-and-a-half-hour test. It is now five hours and 45 minutes, with no lunch break.

Many students were relieved the exams started up again, Dr. Skorton said, including some who were retaking it to boost their scores and others who had scheduled exam dates scuttled earlier this year.

To protect the health and safety of test takers, testing centers are positioning applicants at work stations six feet apart and requiring everyone to wear masks. They also are adopting protocols that call for rigorous cleaning and disinfection between testing sessions of every work station, keyboard, mouse, touch screen, headphone set, check-in station, chair arm, locker and doorknob.

The new testing schedule with exams given three times a day, at 6:30 a.m., 12:15 p.m. and 6 p.m. appears to leave little time for cleaning. But Scott Overland, a spokesman for Pearson VUE, which administers the MCAT at 290 centers in the United States, said that start times were staggered to prevent crowding and to allow for the cleaning of work stations, and that many test takers finished the exam early.

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Need to Take the MCAT? You'll Still Have to Do It in Person - The New York Times

Why isn’t ventilation part of the conversation on reopening schools? – STAT

Like every other parent with a school-age child, I want schools to reopen in the fall including the one Im attending.

On the best of days, my son can be described as spirited. After four months of being cared for by his grandparents, he is practically feral. He needs the physical and social outlet that school provides, and I need the anatomy lab to reopen because human dissection is an irreplaceable part of my medical education.

But I am also an epidemiologist, and after reading the Centers for Disease Control and Preventions guidelines for school reopening and the various accompanying news coverage and think-pieces, I cant convince myself that following its rules will keep my family or yours safe.


Why? Because the primary way Covid-19 is transmitted is through respiratory droplets that careen through the air, and yet the capricious nature of air circulation and the lack of filtration systems in our already underfunded public school systems is absent from the conversation.

Since New York state started reopening, I have received emails from my medical schools working group about the plan to bring us back to campus. Its plan is to follow the basic script seen in school reopening strategies all over the country: frequently sanitized high-touch surfaces, 6-foot distances, unidirectional hallways, reduced capacity elevators and classrooms, health questionnaires, and contact-free temperature checks upon entry (more on that in a minute).


My school is not negligent, but like many other educational institutions, its efforts are dangerously misdirected. We are collectively engaging in what Derek Thompson describes in the Atlantic as hygiene theater, in which organizations looking to reopen focus intensively on arduous decontamination strategies to mitigate surface transmission even though that is not the primary route for Covid-19 transmission, and some scientists argue that there is no direct evidence the virus spreads this way at all. Id also like to add temperature checks to the hygiene theater playbill, as they too fail to successfully screen potential Covid-19 carriers, but have somehow made their way onto every screening list Ive seen.

Why is this happening? The CDC is supposed to determine the national priorities for American health.

Of the eight bullet points in its staff safety section, four address surface transmission. The three bullet points dedicated to respiratory droplets warn people to stay 6 feet away from each other, cough into their elbows, and wear a mask.

The current CDC guidance about ventilation is as follows, Ensure ventilation systems operate properly and increase circulation of outdoor air as much as possible, for example by opening windows and doors. But if opening windows or doors increases the risk of asthma, or falling out the window, the guidelines go on to advise that they should be closed. That is all the guidance has to say. It does not mention air filtration, or the fact that we have pretty good data to suggest that without addressing air filtration and circulation, the 6-feet rule does not prevent transmission indoors.

Here are the things that caught my attention as an epidemiologist as schools played Tetris with classroom furniture and agonized over hybrid schedules.

On May 6, Erin Bromage, a microbiologist at the University of Massachusetts at Dartmouth, published a widely read article detailing the role of air circulation at three major indoor transmission events: a call center in South Korea, a restaurant in Guangzhou, China, and the infamous choir practice in Washington state. Each of these events taught us that transmission happens when you spend significant time indoors. Being 50 feet apart with a low dose of the virus in the air, over a sustained period, was enough to cause infection and in some cases, death. This happens because infectious particles from individuals are pushed by the ventilation system to the other side of the room. Bromages post appeared 127 days before the first day of school in New York City.

HEPA filters are able to effectively capture particles the size of SARS-CoV-2. The CDC currently recommends their use for this purpose in hospitals, but their capacity to prevent the spread of Covid-19 in other public buildings remains under-explored. Though the CDC has stayed silent on the use of HEPA filters outside hospitals, on May 25 a group of ENT doctors made the case for installing them in doctors offices where aerosol generating procedures are being performed, because of evidence they can help prevent the spread other infections such as SARS-CoV-1, measles, and influenza. That was published 108 days before the first day of school in New York City.

On May 27, a group of 36 scientists from around the world in a variety of fields penned an article in the journal Environment International titled, How can airborne transmission of Covid-19 indoors be minimised? As they wrote, Here, in the face of such uncertainty, we argue that the benefits of an effective ventilation system, possibly enhanced by particle filtration and air disinfection, for contributing to an overall reduction in the indoor airborne infection risk, are obvious. Its obvious to me as well, and deserves to be our primary concern in reopening schools, far more urgently than distance or Lysol. That was 106 days before the first day of school in New York City.

McKinsey & Company reviewed research regarding airborne spread of SARS-CoV-2 and on July 9 posted an article suggesting possible upgrades to existing heating, ventilation, and air conditioning (HVAC) systems. A key recommended change was to increase the number of times HVAC systems exchange air per hour, which would push the infectious particles outside and prevent them from being blown across the room. This article appeared 63 days before the first day of school in New York City.

When I mentioned these possibilities to a friend who teaches in the New York City schools, she replied, Dont worry about our HVAC systems. Theyre all broken.

Instead of using limited time and funding to engage in hygiene theater, we should be investigating how to address ventilation. Or at the very least, be honest with the public about some institutions inability to make interior spaces safe.

As a result of months of misapplied focus on surface disinfection, the importance of air circulation and the potential use of filtration is missing from the national debate on school reopening. My sons school and mine are both concerned with delivering our education safely. My sons preschool director was worried sick about not being able to adequately decontaminate on a daily basis because she loves both the kids and her school.

It shouldnt be her responsibility to research ventilation theory and filtration techniques and air flow patterns. Its not my job as a medical student to Google these things trying to get enough information to decide what to do about my sons school, and mine, starting imminently. And its not up to the administrators at my school, who I know have been working around the clock these last few months, to figure this out.

This is supposed to be done by the CDC. Here we are, about a month before public schools are supposed to begin, and the CDC is still failing to signal the crucial importance of addressing ventilation.

We need to include air circulation patterns and filtration options in the conversation. If were not willing or able to fund necessary upgrades to school ventilation systems, lets admit that. Until we have that public discussion, I am not comfortable exposing my family to schools. Because if I cant trust that the people making these decisions are reading the literature, how can I trust them with my familys health?

Alexandra Feathers is an epidemiologist and first-year medical student at SUNY Downstate.

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Why isn't ventilation part of the conversation on reopening schools? - STAT

A UT undergrad helped build the app that will assist students coming back to school this fall. Here’s what it can do. – UT News | The University of…

Henry Rossiter was planning the trip of the lifetime when the COVID-19 pandemic began sweeping across the United States, forcing people into isolation.

It was one of the many things in his life upended by the virus.

A UT computational engineering senior, Rossiter, 21, had planned to spend the summer mountain biking, completing an engineering internship and celebrating his last year in college. It didnt turn out that way.

Instead, the undergraduate who has a computer science background, has logged long hours working to build a mobile application that will help students and faculty safely return to campus this fall.

The app, called Protect Texas Together, will allow people to track their symptoms, record COVID-19 test results, get connected to medical resources and potentially, in the future even assist in contact tracing.

It will be available in the Apple App and Google Play stores starting in mid-August.

Rossiter says the change in plans was worthwhile. We have been pressed to develop this app in less than a month, which is fairly unusual in the app development world, he says of the team, which includes computer scientists, medical experts and engineers. Its been turbulent to say the least. But I hope we can minimize the spread of COVID on campus this fall.

As of this week, the United States has seen more than 4.6 million confirmed cases of COVID-19, roughly 450,000 of those in Texas. While the rate of new cases appears to have peaked in Texas in mid-July, the national rate continues to climb.

On Aug. 26, students will return to the UT campus to put some semblance of their lives back together. The university is one of many across the country and the world that will rely on technology to help that process.

A number of companies have put out mobile applications to help with things such as symptom tracking and contact tracing, which is the process of figuring out who is at risk for developing COVID-19 based on the people they have interacted with something normally done through interviewing.

Rather than adopt another companys technology, UT decided to develop something in-house so the application would fit its specific needs, says Cameron Craddock, associate professor of diagnostic medicine at Dell Medical School and project lead. It will allow the school of 51,000 students and an additional 25,000 faculty and staff members to navigate issues such as privacy more assuredly than it would be able to using someone elses technology.

The problem we are facing at UT is immense, Craddock says. And weve just seen an outstanding outpouring of UT talent to help address this problem pretty quickly.

The app, which will be available in Spanish and English, will have a symptom diary, where users can keep track of things such as fevers and coughs. If they are later diagnosed with an illness, they will have that information on hand to discuss with medical professionals.

The app uses an algorithm to determine, based on ones symptoms, whether it is safe to come to campus, then issues a digital day pass to that person if they are cleared.

It will also allow students, faculty and staff to get connected to health resources, find a testing location and track county and state COVID-19 statistics.

Additionally, the app will include a feature to help individuals record which rooms, including research labs and controlled access facilities, they have entered. This will help facilities and health teams identify spaces that potentially need to be decontaminated or isolated if someone working there tests positive for COVID-19. It will also assist with contact tracing to know who is in rooms at the same time.

Its really about helping members of the UT community do things that we know are important for staying healthy. In this case, that means having everybody check their symptoms on a regular basis and keep themselves at home if they have any symptoms, says software engineering professor Christine Julien, who is part of the development team.

Rossiter has been working to make the interface as user-friendly as possible. He is one of four undergraduates on the team and is leading front-end development. Three graduate students are also working on the app.

The project isnt a part of Rossiters computational engineering academic plan, but hes taken it up on the side because he sees the benefits of the technology for society.

I was eager to apply the computer programming skills I learned in school to solve real-world problems, he says. I enjoy seeing the impact that the technology I engineered has made.

Though the first iteration of the app will not include contact tracing, later versions likely will have that functionality. The development team is working on a plan that allows users to consent to having their location information stored within the app. Then, if people test positive for COVID-19, they will be able to pull up that data and see where they have been, so they can easily and confidentially share that information with medical professionals.

Ensuring privacy is the most important thing, Julien says. It would also be nice to get more data and information, but we would never do that if it meant we had to sacrifice individual users privacy in any way.

UT community members were able to move so quickly in building an app because they were already designing the technology infrastructure as part of the UT grand challenge Whole CommunitiesWhole Health.

The multiyear project has researchers working closely with local partners to understand more about the physical, environmental and emotional health of families living in Central Texas, particularly those who are part of historically marginalized communities. And technology is a huge component of the study.

The research team plans to retool the mobile application in the coming months for the grand challenge so it can study the effects of the COVID-19 pandemic on local communities. The app could send surveys directly to peoples phones, as well as show other health and behavioral information that participants want to know about.

The last time the U.S. has undergone a pandemic that involved social distancing to this scale was 100 years ago, so we have very limited information about the effects that had on people, Craddock says. The notion is to try to collect as much information as we can about what peoples experiences are so that 10 years from now, we can use that information to understand the impact that social isolation and the pandemic had on society.

Low-income and marginalized communities have been hit especially hard by the virus, largely because of underlying systemic conditions that contribute to poor health and health care inequities. At the same time, unemployment, stress and alcohol use have increased globally. New graduates are entering one of the worst job markets since the 2008 recession. Rossiter will likely be among them.

Its a turbulent situation at a turbulent point in my life, he says. Honestly, I dont really know what I am doing a week from now, so three months from now its impossible to say.

I just want to see the software I develop have a positive impact on society.

Original post:

A UT undergrad helped build the app that will assist students coming back to school this fall. Here's what it can do. - UT News | The University of...

Med School Professor Removed from Fellowship Director Post, Apparently for Publishing Anti-Affirmative-Action Journal Article – Reason

Hans Bader (Liberty Unyielding) reports (though you should read the whole thing):

The University of Pittsburgh hasremoved a program director at its medical center because he published a scholarly, peer-reviewed white paper discussing the pitfalls of affirmative action for black and Hispanic students. This violated the First Amendment, which protects even harsh criticism of affirmative action. The white paper was gentle in its criticism of racial preferences, merely arguing that lowering admissions standards for minorities can harm their prospect of academic success by putting them in a university they are not prepared to handle. It did not advocate discrimination against any minority group.

To my knowledge, Prof. Wang has not been removed from his faculty position, only from the administrative post; but public universities are generally not allowed to do even that, given the First Amendment, at least absent serious evidence that it would likely materially disrupt the functioning of the university. And if engaging in substantive academic criticism of race-based affirmative actiona matter that is the subject of a longstanding and substantive debate in the country and in universitiesis indeed seen as so disruptive, then something is badly wrong with the University of Pittsburgh.

(I should note that a university could rightly insist that its employees follow legally permissible university policies, including race-based affirmative action programs, whether or not they agree with them; and they could ask their employees for assurances that they would indeed follow such policies. But here, as I understand it, Prof. Wang was removed from the post simply for his public criticism of race-based affirmative action, and not for any statement saying that he wouldn't do his job.)

UPDATE: (1) Just to be clear, Pittsburgh is indeed a public university (and thus a "state actor") for purposes of applying the constitutional rules. (2) For an example of the First Amendment protections covering public employee speech about affirmative action, see Meyers v. City of Cincinnati (6th Cir. 1991) (later modified on other grounds) andDep't of Corrections v. State Personnel Bd.(Cal. Ct. App. 1997).

The rest is here:

Med School Professor Removed from Fellowship Director Post, Apparently for Publishing Anti-Affirmative-Action Journal Article - Reason