12345...102030...


Meet the Playwright Debuting 2 Plays in 1 Seasonand Going to Med School at the Same Time – Playbill.com

If you werent a playwright, what would you be?

Sylvia Khoury doesnt have to answer that question.

Because Khoury is a fourth-year medical student and a produced playwright making her New York stage debut with her play Power Strip at Lincoln Center Theaters LCT3. Yet, this demanding double life was never the master plan.

As a kid, Khoury actively felt like she wanted to be a doctor when she grew up. The arts werent a focus during her young life. Theatre was not formative for me, Khoury acknowledges, but reading was. I would take out 10 books from the library and then read them eachone chapter from this book, one chapter from this book, to try to make a bigger story.

And yet, when it was time for medical school, Khoury felt something gnawing at her. So she asked to defer med school for three yearsand they said yes. She used those three years to earn a Masters in playwriting from The New School. When she graduated, she could have chosen to leave writing behind and pursue her M.D.; she could have chosen not to go to med school and pursue theatre. Khoury chose not to choose.

It felt a little crazy to do [both], she admits, but then I was like, 'Its my life and I have one of them, so I might as well see what happens.'

Whats happened is shes become a member of the 20182019 Rita Goldberg Playwrights Workshop at The Lark; shes a member of Ensemble Studio Theatres Youngblood group; she is a former member of the Womens Project Lab and the Dramatists Guild Fellowship. Her play Selling Kabul premiered this past summer at the prestigious Williamstown Theatre Festival and will bow Off-Broadway in 2020. But before that, another play marks her New York stage debut: LCT3 puts on her Power Strip, currently running at the Claire Tow Theatre with an official opening October 21 directed by Tyne Rafaeli. And, of course, shes in her fourth year at Mount Sinai Medical School.

RewindIn hindsight, Khoury had always been living parallel lives. As a kid, she made movies with her friends using the camcorder her parents gave her in the sixth grade and geeked out on science and the human body. In high school she was captain of the math team and editor of the literary magazine.

If Im totally honest, the idea that the arts were a career choice was not a reality, says Khoury. I have a very early memory of my father asking me in the car driving back from school one day, What was your favorite class? I was in kindergarten. And I was like, I like drama. And he went, Well, I like to sing. She adds, It was actually very moving.

Born and raised in Westchester to a Lebanese father who emigrated to Paris and Parisian-born North African mother, Khoury felt an unspoken expectation of getting a secure job, something serious. I think a lot of that comes from the immigrant experience, she says. And yet, her path to become a doctor was never about pressure.

My fathers a radiologist, so at home he would have X-rays up. My mothers an oncologist and she would talk about what she was seeing at work, Khoury explains. When thats the language of your family, you internalize it. It was the fabric of our lives. It still is.

But a playwriting class she took in her senior year at Columbia ignited something in Khoury she hadnt known was theresomething she felt compelled to explore. I just really wanted to know if the part of myself that wanted to tell stories and connect to people was the part of myself that I could actually engage with the world in, she says. She knew ignoring the gut feeling would lead to regret.

During her first two years at Mount Sinaimainly classes and examsher studies dominated. (Though, to be fair, she wrote Selling Kabul when she should have been prepping for her physiology exam.) She took a year off after her second-year boards and mounted her first production. Then Khoury went back to med school for her third year of clinical rotations, which just finished earlier this summer, in time for Williamstown. (Khoury actually showed up for Day One of rehearsals, jetted back down to New York for her final week of Year Three, and went back to Massachusetts for the production.) Its been a carefully calibrated give-and-take, alternately prioritizing medicine and her art.

The thing that I want to emphasize is that I am by no means Superwoman, says Khoury. Memorizing all of these things for medical school is not immediate for me. Writing a play is hard. All of it takes time.

Self-examinationWhat Khoury found at The New School wasnt necessarily an answer to her introspective questions, but it was a starting point in discovering the building blocks of her voice. The pursuit of that voice, in part, drives her to write the plays she does.

She invests deeply in characters, while prioritizing a global perspective. Astutely aware of the concentration of decision-makers in New York, Khoury feels a responsibility to tell stories about places outside of the U.S., but affected by the U.S.

Power Strip, in particular, centers on Syrian refugee Yasmin and earns its name from the electric lifeline to which she tethers herself in her Greek refugee camp. Though she was a middle class student in her city, the civil war has rendered her a woman of survival. An intimate play of four characters, Yasmin and the three men circling her, it was very important to me to draw very nuanced portraits of these people because Im not interested in saying that men are evil and women are good, says Khoury. Its really an exploration of power dynamics at work in our everyday lives.

The examination of America through international eyes is a common thread through Khourys work, as is what it means to be a woman in mans world. Central to a lot of my work is the idea that women at the end of the day are really keeping society together, she says. Its very important to examine: What are we asking women to carry and how have we internalized that ourselves?

Perhaps what stirs Khoury most is probing for answersdiagnostic and existential.[Theatre]s the place society comes to examine itself, right? she says. Religion used to have that function and continues to have that function for some people, but, in my life, the place to really examine what it means to be a human and what our world is and what it could be, thats all in theatre.

For a kid who grew up reading and making movies, Khoury feels a deep allegiance to theatre. Its such a different experience to be sitting alongside your peers and all examining the same things in yourself silently, side by side.

With ReverenceThrough three years of medical school shes carried that awe with her. It fuels her desire not just to learn about medicine, but to practice it as a physician. Its a privilege to enter a room with someone and have them tell you everything about their life with trust and completely open-hearted, she says.

The rigor of medicine cultivates discipline in her writing. Theres the illusion with theatre that things just happen. [But] its as serious as studying for an exam. Its harder, actually, because youre trying to find the stuff that makes us human.

I also think that medicine, you really meet people in very vulnerable moments of their lives. And youre kind of confronted with humanity on a daily basis, she continues. Theres something about thatdefinitely not consciouslythat seeps into what I write.

Its hard not to feel like the two feed each other, she says.

Her PrognosisGoing into her fourth year of medical studywhich she will spread over the next two calendar yearsshe will complete a psychiatry rotation, a radiology rotation, an emergency medicine rotation and her intro to internship. She hasnt committed to a specialty, but today, psychiatry calls to her.

With psychiatry, its like the micro work that theatre is doing the macro work of, right? she posits. Its one person and examining how they operate and how they move through the world whereas theatre is more on a societal level.

Whether a patient in her exam room or a viewer at her play, we are all in great hands.

Go here to read the rest:

Meet the Playwright Debuting 2 Plays in 1 Seasonand Going to Med School at the Same Time - Playbill.com

If food is medicine, why isnt it taught at medical schools? – The New Food Economy

Students in medical schools across the country spend less than 1 percent of lecture time learning about diet.

Earlier this year, Mount Sinai, the biggest hospital network in New York City, invested in a meal delivery service. Though it seemed like an unusual move at the time, the networks decision makes sense if you consider the intrinsic relationship between food and healtha connection underscored by countless other recent examples of healthcare initiatives that harness diet as a tool to improve well-being.

At a California rehabilitation facility, for instance, doctors use the rituals of eating to help people recover from trauma. And over the past decade, cities across the country have launched food prescription programs that incentivize participants in the Supplemental Nutrition Assistance Program (SNAP) to buy fresh fruits and vegetables at farmers markets. A number of nonprofit organizations have launched medically-tailored meal services for people suffering from diet-related diseases.

Culturally and politically, were increasingly acknowledging that what we eat plays a major role in our health. Which is why its especially strange that healthcare providers know so little about it.

Medical curriculums have been developed historically, foregrounding disciplines like biology, behavior, and disease to the detriment of food and nutrition.

In a new report published by the Harvard Food Law and Policy Clinic, researchers write that, on average, students in medical schools across the country spend less than 1 percent of lecture time learning about diet, falling short of the National Research Councils recommendation for baseline nutrition curriculum. Neither the federal government, which provides a significant chunk of funding to medical schools, nor accreditation groupswhich validate themenforce any minimum level of diet instruction.

And it shows: While you and I might show up for our annual physicals expecting feedback on our what and how much we should be eating, just 14 percent of doctors feel qualified to offer that nutrition advice.

How did the gap get this wide? Much of it can be explained by the way medical curriculums have been developed historically, foregrounding disciplines like biology, behavior, and disease to the detriment of food and nutrition. Today, the legacy of this framework makes it hard for medical schools to retroactively integrate nutrition into their curriculums.

Because [nutrition] wasnt prioritized for so long, there arent a lot of faculty and medical schools that have any knowledge about nutrition and diet, says Emily Broad Leib, the reports lead author. To build it into schools now requires real investment in hiring and training.

People believe that nutrition is easy, when in reality, nutrition is most of medicineand then a lot more.

The report recommends a wide range of policy changes that could function as carrots and sticks in getting nutrition onto course outlines. They range from making federal funding contingent on nutrition training to performance-based incentives that encourage schools to include diet-related subjects in curriculums.

Why are we spending so much government money to educate physicians and residents, and yet were not getting any impact in terms of these this large set of [diet-related] diseases? Broad Leib asks.

The recommendations also implicate other players in the world of medicine, like accreditation organizations and licensing boards, for not requiring a baseline level of dietary expertise from schools and doctors, respectively. Part of the reason that may be is the prevailing attitude society has toward food as a soft science.

People believe that nutrition is easy, when in reality, nutrition is most of medicineand then a lot more, says Martin Kohlmeier, a professor of nutrition at the University of North Carolina-Chapel Hill. You have cultural, food production, and food safety issues. It is a challenge for physicians to learn enough.

Doctors with expertise in nutrition are more likely to spot diet-related issues earlier in a patients prognosis.

Kohlmeier leads the Nutrition in Medicine Project, a free, online nutrition curriculum tailored to medical students and doctors. Kohlmeier estimates that 150,000 students have participated in some aspect of the program since its launch in 1995. Nevertheless, he stresses, voluntary education is only a temporary fix for a systemic problem.

A lot of institutions have electives, all kinds of nice things that maybe 1 to 5 percent of their students use. And Im always saying: You are going to be treated by the physician who skipped those classes.

But why teach doctors nutrition and diet when there already exists a specialty in those fields? Nutritionists and dieticians are experts in the way our individual biologies are affected by what we eat. What role will they play if our general practitioners develop that same expertise?

Shoring up what doctors know about food wont render nutritionists moot, says Carol DeNysschen, a registered dietician and chair of the health, nutrition, and dietetics program at the State University of New York-Buffalo.

The more that [doctors] know, the more they realize what they dont know, and the more they realize how complicated it can be to develop an individualized nutrition plan for people and to get them the support they need to monitor or manage [issues like] their weight, their diabetes, DeNysschen says.

DeNysschen characterizes the relationship between doctors and nutritionists as a symbiotic one. Doctors with expertise in nutrition are more likely to spot diet-related issues earlier in a patients prognosis, and that could mean more referrals to diet experts. The more nutrition knowledge they have, the more theyre aware of looking for those areas where a nutritionist or dietitian could interject, she says.

Beyond the healthcare implications, the Harvard report also makes an economic case for teaching doctors about food. Taxpayer dollars fund most physician residencies in the United States through Medicare. (Medical school graduates train to become doctors via residency in a hospital.) Simultaneously, Medicare serves as the national insurance program for aging Americans, and thus, incurs the costs of diet-related diseases during that stage of our lives. Therefore, the report argues, requiring nutrition education in medical residencies is another way for Congress to trim its own bills.

Thats one element of the case that Broad Leib will likely make next week at a Congressional hearing. Though the report largely focuses on federal policy changes, some local lawmakers are introducing legislation that would require nutrition education among doctors within their jurisdictions. In New York, for example, state legislators recently proposed a bill that would require practicing physicians to receive six hours of nutrition coursework or training every two years. In Washington, D.C., municipal lawmakers introduced a bill that would require continuing education for doctors to be expanded to include nutrition coursework.

Poor diet continues to be one of the biggest contributors to chronic disease and mortality in the U.S., killing one in five Americans every year. Thats a higher rate than three other risk factorspollution, lack of exercise, alcohol and drug usecombined. As the tide continues to rise in favor of ideas and policies that combine food and healthcare, medical schools may be next to center nutrition in their work. Someones just got to prescribe it.

Continued here:

If food is medicine, why isnt it taught at medical schools? - The New Food Economy

Forget Free Tuition, Application Costs Are First Barrier – Medscape

Numerous medical schools have made news in recent years by offering free tuition, but that might not be enough to bolster diversity in medicine. It is also necessary to reduce the costs of applying to medical school, say authors of a perspective published online today in the New England Journal of Medicine.

Application fees; interview costs including clothing, transportation and lodging; test fees; and test preparation fees may keep qualified students from taking the first step, write Lorena Millo, BS, with the Margolis Center for Health Policy at Duke University in Durham, North Carolina, and colleagues.

"High application costs send a message that medical education isn't designed to be obtainable for low-income people, which could potentially deter some people from applying at all," they write.

While some schools are expanding scholarship programs and even waiving tuition costs altogether, Millo and colleagues note that similar improvements have not come to the application process.

And whereas medical school costs come with the high odds of making enough money as physicians to repay the debt, the application process requires a much bigger gamble.

Just taking the Medical College Admission Test (MCAT) costs $315 and 62.7% of students taking it buy practice exams that cost between $2000 and $10,000, the authors write.

In addition, most schools require a primary application using the American Medical College Application Service system, which costs $170 for the first school and $40 for each additional school. Secondary application fees can be as high as $200, the authors explain, noting that in 2018 applicants submitted a median of 15 secondary applications.

Millo and coauthors argue the application costs may help explain low numbers of underserved populations among the 2018 applicants.

"In 2018, only 9% of applicants identified as black or African American, 10% as Hispanic, and less than 1% as American Indian or Alaska Native," the authors write. "Nearly a quarter of first-year medical students come from families earning $250,000 or more per year, whereas only 5% come from families in the lowest household-income quintile (with incomes of about $24,000 per year or less)."

Increasing costs for applying come as average medical student debt rose to $200,000 last year, the authors note, a 4% increase over the previous year.

The authors point to two sources that help with application costs: hosting programs in which current medical students host applicants so they don't have to pay for a hotel, andthe Fee Assistance Program (FAP) run by the Association of American Medical Colleges (AAMC). That program reduces the MCAT cost, waives primary-application fees for up to 20 schools, and supplies free MCAT-prep materials. Additionally, most schools also waive secondary fees for those who qualify.

But the help does not go far enough, the authors write. It doesn't extend to interview costs, for one thing, and it doesn't help people who may not qualify by income but still can't afford the costs.

The costs can be a barrier, agreed Valerie Parkas, MD, senior associate dean of admissions at Icahn School of Medicine at Mount Sinai in New York City. In addition to the expenses listed in the article, she adds that doing the research, clinical work, and volunteer work to develop an application that's competitive can also be a barrier for those with fewer resources.

"I think for economically and educationally disadvantaged students, the whole process is more challenging," she told Medscape Medical News. That said, individual schools and the AAMC are actively working to achieve more equity in applications.

At Mount Sinai, for example, medical students host medical school applicants and alumni host applicants for residencies. The school also waives secondary fee applications and tries to accommodate those who want to interview on a day they are already interviewing in the area so as to avoid additional flights to the same region.

The school also has an early-assurance program called FlexMed, which allows 40 to 50 sophomores to know they are accepted so they don't have to go through the usual application process or take the MCAT.

"We also have an early assurance for our residency program for our students who know what field they want to get into," Parkas said. "They don't have to apply broadly for residency, again taking away all the travel and application fees."

Millo and coauthors offer three ideas for change. One is limiting the number of schools to which applicants could apply to level the field for those of different incomes.

The second is asking medical schools to screen applicants more thoroughly before inviting students to submit secondary applications. Currently, students are spending money to send secondary applications without knowing that the schools consider them serious candidates.

A third option is for schools to conduct virtual interviews, they write.

Each of these options has pros, Parkas says, but also cons.

Limiting the number of schools for applicants may disadvantage those who have not had as much access to advisers and mentors who could help them skillfully narrow their school choices, she said.

"I think that's worrisome," Parkas cautioned.

Virtual interviews are worth thinking about but they have a downside, she said. "You want students to see the school, get a sense of the learning climate, the culture of the school, talk to students, visit the city, and know if it feels like a 'good fit.'"

As to schools being more selective about secondary application invitations, Parkas said that recommendation probably makes the most sense.

However, she said, there are schools with so many applications they may turn to metrics as a way to be more selective in a short period of time and that may have the opposite effect of what the authors are promoting.

"Students who might have real adversity and reasons for academic challenges might not get a full holistic review," she said. "That may disadvantage the disadvantaged."

The authors and Parkas have disclosed no relevant financial relationships.

NEJM. Published online October 16, 2019. Perspective

Follow Medscape onFacebook,Twitter,Instagram, andYouTube

Read more from the original source:

Forget Free Tuition, Application Costs Are First Barrier - Medscape

Vaping: Natick and UMass Medical School join forces to tackle addiction – Wicked Local Franklin

Natick is a test case for a program to help students suffering with nicotine addiction from vaping.

NATICK A new program designed to help students quit vaping is planned for Natick schools, and could eventually be expanded to all school districts in the state.

The program goes online in Natick shortly after Dec. 2, when middle and high school nurses are trained, according to Katie Sugarman, prevention and outreach program manager for the town.

Based on results this academic year in Natick, the program could be adopted by every school district in the state, said Caroline Cranos, training program director at UMass Medical Schools Center for Tobacco Treatment Research & Training, where the program was developed.

The town's students will have access to four visits with a school nurse, plus learn behavioral strategies to beat their nicotine addiction from vaping.

Calling it Quits: Vaping," is an offshoot of the UMass Medical School center's program developed in 2007 to help adolescents conquer their nicotine addiction from cigarettes.

Treatment, not prevention, is the Natick programs emphasis, according to Cranos.

Natick contacted the center last year, after officials witnessed some students struggling with vaping.

Thirty-six percent of Natick High School students report vaping in their lifetime, and 24% in the past 30 days, according to the 2018 MetroWest Adolescent Health Survey. In grades 7 and 8, the numbers are 8% and 4%, respectively. The School Committee is expected to hear those numbers at an open meeting next month, according to Superintendent of Schools Anna Nolin.

Twenty of the 29 cases of vaping-related lung illnesses in Massachusetts reported to the Centers for Disease Control and Prevention are connected to THC, the chemical in marijuana that gives users the feeling of being high.

The Natick program is not designed to treat THC addiction from vaping, Cranos said.

We train people to treat nicotine dependence, Cranos said. However, behavioral strategies in the program could help students suffering with THC addiction, according to Cranos. They include helping a student understand why he/she wants to quit, tips to deal with withdrawal, and suggestions for activities to get one's mind off vaping.

Last month, Gov. Charlie Baker announced a four-month ban on all vape products to give public health officials time to determine a possible cause of the lung illnesses in Massachusetts.

Massachusetts has reported one vaping-related death, a Hampshire County woman in her 60s. Nationwide, 26 deaths and roughly 1,300 cases of lung injury were reported to the CDC as of Oct. 8.

No definitive cause of the illnesses has been determined, according to the CDC.

Henry Schwan is the health reporter for the MetroWest Daily News. Follow Henry on Twitter @henrymetrowest. He can be reached at hschwan@wickedlocal.com or 508-626-3964.

View original post here:

Vaping: Natick and UMass Medical School join forces to tackle addiction - Wicked Local Franklin

California is pushing back school start times. The move could sweep the nation or backfire. – NBCNews.com

After gaining speed slowly over the last two decades, a movement to start the school day later for middle and high school students just got a massive boost from California.

When Gov. Gavin Newsom last week signed the nations first state law mandating later school start times, which have been associated with a slew of health benefits for teens, he turned what has long been a local issue into one that could soon be hotly debated in statehouses across the nation.

"This is huge," said Judith Owens, a neurology professor at Harvard Medical School and the lead author of a 2014 policy statement from the American Academy of Pediatrics that called for schools to let students get more rest by better aligning school start times with teens biological sleep rhythms. Right now all of these school districts are debating this within their own communities and its a very painful process, but if we can get this done on a statewide level, then a lot of the objections go away.

Advocates hope that Californias new law, which over the next three years will bar most high schools from starting classes before 8:30 a.m., and most middle schools from starting before 8 a.m, will supercharge a public health campaign that has until now reached schools on a piecemeal basis, one district at a time.

But even as the new law has the potential to trigger sweeping policy changes across the country, it could also have the opposite effect. If too many California districts struggle with the logistical ramifications of the mandated change, it might spur a backlash that could imperil the effort.

Everyone is going to be watching to see what the results are going to be, said Deborah Temkin, senior director of the education program at Child Trends, a Washington-based research organization. California, as one of the largest states in the country, can really define policy movements across the country. If this turns out to be successful, with relatively few consequences, then I think its something that other states will likely consider.

But, Temkin warned, if this is implemented where its sort of just sprung on a community without taking the time to build in the necessary child care support and thinking through transportation issues, then I think we are much more likely to see negative consequences.

Research shows that later school start times can increase the duration and quality of adolescent sleep, which has been linked to health benefits such as lower rates of depression and a reduced chance a teen will be involved in a car crash. But the debate over school start times asks districts to balance those benefits against economic and social consequences for parents, students and teachers whose lives may be disrupted by changes to their schedules.

A later start to class can force parents to scramble for early morning child care before starting long commutes. In some districts that have moved start times, teens have struggled to find after-school jobs and were no longer available after school to watch younger siblings. Other communities grappled with scheduling sports practices, especially in the early darkness of winter, and districts have had to come up with extra funds to adjust bus routes or provide child care.

Thats why Californias major education groups, including those representing teachers and school administrators, opposed the new law.

We dont oppose later school start times, said Troy Flint, a spokesman for the California School Boards Association, which represents most of the states more than 900 school districts. We actually encourage districts to examine school start times to see if later times make sense for them. But what we object to is a one-size-fits-all unfunded mandate that discourages parental choice and doesn't take into account the diverse needs of various communities across the state.

Researchers started documenting the benefits of later school start times in the mid-1990s when a small, affluent district in Edina, Minnesota, was among the first to experiment with shifting the start of the school day, moving the high schools morning bell from 7:20 a.m. to 8:30 a.m.

Kyla Wahlstrom, a senior research fellow at the University of Minnesotas College of Education, said she was skeptical when the Edina superintendent first reached out her in 1996 to ask if shed study the effect of the new schedule.

She was familiar with what was then new research showing that adolescent sleep patterns were different from those of adults or younger children, with teens more likely to go to bed later at night and to get their most high-quality REM sleep later in the morning. Teens do not wake up and function until 8 in the morning, she said.

Let our news meet your inbox. The news and stories that matters, delivered weekday mornings.

But she doubted that a 50-minute change to a school's bell schedule would have much of an impact.

Then she started gathering research. Parents reported that their children were easier to live with and teachers found more assignments were coming in on time and that their students were more alert in class. The principal reported fewer disruptions in hallways and in the lunchroom.

I was dumbfounded, Wahlstrom said. Id walk into the school and the nurse would say: Are you the one doing the research? Ive gotta tell you, I have fewer kids coming into the nurses office.

And the counselor said she had fewer kids coming in with mental health issues, Wahlstrom said.

Those promising results led one of the states largest school districts, the Minneapolis Public Schools, to make similar changes. That enabled Wahlstrom to compare data from before and after a time change. In 2002, she published the first study in a major education journal that documented the connection between later school start times and improvements such as higher attendance rates, less sleeping in class and less depression.

It really started to show that this was a public health policy as much as an academic policy, she said. When I did the first study in 1996, the district was looking for it to improve academics, but while we found improvements in kids completing homework, more importantly, we were seeing incredibly important improvements in the physical and mental health of kids.

Since then, hundreds of school districts have pushed back their start times, including major cities like Seattle and large suburban districts like the Fairfax County schools in Virginia. As ongoing research has continued to document the benefits, many of the nations leading health organizations have endorsed the idea. In addition to the pediatricians group, the American Medical Association, the American Psychological Association and the Centers for Disease Control and Prevention have all issued statements calling on schools to push back start times.

But so far, all of the districts that have adopted these policies have done so voluntarily. Experts say the ones that have been most successful are those that have held extensive conversations with parents and teachers to work through logistics before making a change.

Temkin, from Child Trends, was among the researchers who documented the impact of the switch in Fairfax County. She said most of the concerns about transportation or child care were addressed with the community before changes were made. Schools then worked to respond to unanticipated issues such as students being dropped off at school before the doors had opened.

Other districts have had to come up with less-than-optimal solutions to new schedules, such as moving sports practices to before school, which defeats the purpose for students who participate in sports, or putting young children on the same buses with older kids.

Temkin worries that Californias decision to mandate school start times could create issues for communities that arent fully on board.

Its going to be interesting to observe how school communities react when they havent gone through a buy-in process and have been forced to do this through the legislation, Temkin said.

Such concerns are why mandatory school start time legislation hasnt yet caught on in other states.

Bills that would have required later school start times have failed in Minnesota, Maine and Rhode Island, said Sarah Pompelia, a policy researcher with the Education Commission of the States, a nonpartisan organization that tracks state education policy legislation. Other states, including Indiana and New Jersey, have passed laws calling for further study of the issue, while Maryland passed a law creating a program that recognizes schools with an orange ribbon for healthy school hours if they start elementary school after 8 a.m. or middle or high school after 8:30 a.m.

Now that California has become the first state to mandate these changes, Flint, from the California school board association, said his organization plans to provide resources to districts to help them adapt, but he worries that some communities will struggle. (The law provides an exemption for rural communities but doesnt define rural, so its not clear how many districts must comply.)

He notes that several California districts have experimented with a later school day only to return to their earlier schedules.

That also happened in Youngstown, Ohio, where the districts state-appointed CEO pushed high school start times to 9:15 a.m. two years ago in hopes of seeing academic and health benefits for students. But the later start time wasnt popular and the district dropped it this year. Now, school starts at 7:30 a.m and gets out at 2:32 p.m.

I definitely understand the research about the health benefits of a later start time, said Jeremy Batchelor, principal of Youngstowns East High School. But what we saw was almost an opposite effect here in Youngstown, for whatever reason.

The school saw absences and tardies climb rather than decline as they have elsewhere, he said, and students struggled to find after-school jobs since classes didn't end until 4:24 p.m. and many students had to wait for city buses to reach their jobs. The school wasnt able to implement the after-school tutoring program it thought students needed.

Batchelor said his students seemed to want to get to school early.

I think the early time is motivating for them, he said. They can come get done what needs to be done and can get out, can get jobs.

As the new California law is implemented over the next three years, opponents may try to highlight districts like these, but advocates say some of the challenges will be addressed through statewide implementation. A school district that is the only one in its area to change its schedule might put athletes in the position of missing class to attend games that are earlier in the day, and might put students looking for jobs at a disadvantage compared to students who could come to work earlier. But those problems go away if the whole state adopts a later schedule.

Advocates say theyre hopeful that the benefits will outweigh the negatives.

A bad implementation of something good does not negate the good and does not negate the truth of the matter, which is that this is a public health issue, said Maribel Ibrahim, operations director and co-founder of the Start School Later organization, which has lobbied districts and legislatures to back these changes.

The biggest obstacle to this change has always been fear of change.

Read the rest here:

California is pushing back school start times. The move could sweep the nation or backfire. - NBCNews.com

Our diets are killing us and doctors aren’t trained to help | TheHill – The Hill

What if your doctor failed to talk to you about the most important threat to your health? Wouldnt you worry about the quality of your health care? Poor quality diet is a leading cause of death in the United States, but it is unlikely that your doctor has the knowledge to even begin a meaningful conversation about your nutrition or to make an appropriate dietary referral.

Most doctors lack the knowledge necessary to offer nutrition advice to patients; indeed, fewer than 14 percent of physicians report feeling equipped to advise on diet or the connection between food and health. This is unsurprising given that, for example, 90 percent of cardiologists in a recent survey reported receiving minimal or no instruction on nutrition during medical training.

Yet it is also concerning. Obesity, type-2 diabetes, heart disease, cancer, and stroke, which are leading causes of death in the United States, all are closely linked to diet and nutrition.

Nearly 40 percent of adults and 18 percent of children are obese, and these numbers are increasing; almost 10 percent of Americans suffer from diabetes, compared with less than 1 percent just 50 years ago. Even more concerning, more than one-third of Americans have pre-diabetes.

A focus on treatment rather than prevention has led to medical education that ignores the central role that food plays in health. The average U.S. medical school devotes less than 1 percent of total lecture hours to nutrition. Accreditation requirements for medical residencies and fellowships do not include nutrition.

The standardized exams that medical students must pass to become board certified lack questions that test the ability to advise patients on diet. And to date, no state requires continuing medical education in nutrition or diet-related disease as part of the ongoing education for physicians to maintain licensure.

This dangerous gap in their education means that doctors do not learn the basic guidance in the U.S. Dietary Guidelines for Americans, or stay apprised of the latest nutrition science. Accordingly, they fail to recognize, and are unable to convey to patients, the importance of diet to health. This means fewer referrals to nutritionists, even when diet plays a vital role in their patients health.

The lack of nutrition education during medical training is also a costly mistake. Health-care spending has skyrocketed Medicare benefit payments exceeded $730 billion in 2018 and account for nearly 15 percent of all federal spending.

At its current rate, Medicare spending will exceed $1 trillion in the next 10 years. Diet-related diseases account for 5 of the 8 most common conditions among Medicare beneficiaries, so its clear that as the prevalence of diet-related diseases increase, health-care spending increases.

Fortunately, we can change this troubling status quo. Opportunities exist for policymakers at the state and federal level, as well as the bodies responsible for testing and accreditation, to make systemic changes to medical training.

For example, state legislatures and Congress can offer grants to medical schools to develop curricular content; the American Council of Graduate Medical Education can amend residency requirements to require competency in diet and nutrition; and testing organizations like the National Board of Medical Examiners and the American Board of Medical Specialties can incorporate nutrition-focused content on step and board examinations, respectively.

Perhaps the most logical and effective solution is to ask Congress to spend our health-care dollars more wisely. Medicare is the single largest source of federal funding for graduate medical education, providing more than $10 billion to eligible programs in fiscal year 2015.

This funding comes with no strings attached, i.e. no curricular requirements or performance benchmarks, and certainly no expectation that residents or fellows receive education in nutrition.

Rather than spend a whole lot more on Medicare to treat diet-related diseases down the road, Congress should leverage this funding to require nutrition education for residents and fellows. These policies and others are explored in a recent report from the Harvard Law School Food Law and Policy Clinic.

The education of doctors is a critical issue with universal implications for our national health. When it comes to the care we receive at each doctors visit, we reap what we sow. By not insisting that physicians receive at least foundational education in nutrition, we produce a medical system that is focused almost exclusively on drugs and devices, and in which the most costly diseases continue to grow.

Alternatively, by helping physicians understand the connection between food and health, we can produce better individual patient outcomes, improve population health, and change our nations health-care landscape for the better.

Emily M. Broad Leib, J.D., is an assistant clinical professor of law at Harvard Law School and the director of the Harvard Law School Food Law and Policy Clinic. Stephen Devries, M.D., is a preventive cardiologist and executive director of the nonprofit Gaples Institute for Integrative Cardiology. Walter Willet, M.D., Ph.D., is a professor of epidemiology and nutrition at Harvard T.H. Chan School of Public Health and a professor of medicine at Harvard Medical School.

Excerpt from:

Our diets are killing us and doctors aren't trained to help | TheHill - The Hill

Student volunteer for Griffith Family Foundation nominated to attend Congress of Future Medical Leaders in Boston | News, Sports, Jobs – Altoona…

Courtesy photoSierra Lombardi, president of Sideline Cancer at Hollidaysburg Area HighSchool, presented Sideline Cancer NYC T-shirts to Jack Andraka, Griffith Family Foundation Side-line Cancer ambassador.

HOLLIDAYSBURG Sierra Lombardi, a student volunteer for the Griffith Family Foundation and a senior at Hollidaysburg Senior High School, was attended as a delegate to the Congress of Future Medical Leaders in Lowell, Mass., June 23 to 25.

The Congress is an honors-only program for high school students who want to become physicians or go into medical research fields.

The purpose of this event is to honor, inspire, motivate and direct the top students in the country who aspire to be physicians or medical scientists, to stay true to their dream and after the event, to provide a path, plan and resources to help them reach their goal.

Sierras nomination letter was signed by Dr. Mario Capecchi, winner of the Nobel Prize in Medicine and the science director of the National Academy of Future Physicians and Medical Scientists to represent Hollidaysburg, based on her academic achievement, leadership potential and determination to serve humanity in the field of medicine.

During the three-day Congress. Sierra joined students from across the country to hear Nobel Laureates and National Medal of Science winners talk about leading medical research. She also was given advice from Jack Andraka, Ivy League and top medical school deans on what to expect in medical school: witnessed stories told by patients who arc living medical miracles; was inspired by fellow teen medical science prodigies; and learned about cutting-edge advances and the future in medicine and medical technology.

Sierra will attend the Digestive Disease National Coalition in Washington, D.C., March 7-8. She will sit on the DDNC Executive Board meetings representing the Griffith Family Foundation.

Sierra has attended the DDNC for the past three years with hopes to inspire other youth colleagues.

The 2012 Intel Science and Engineer Fair Winner Jack Andraka is a senior at Stanford University and is the Griffith Family Foundation Sideline Cancer ambassador.

Andraka was recently named National Geograph-ic Emerging Explorer and is helping detect cancer, fighting water pollution, identifying neglected tropical disease and redefining global health approaches.

Andraka is an inspiration to all students that attend this Medical Conference that allows medical leaders, scientists and professors to collaborate with the youth of today. He speaks every year at this youth event.

The National Academy of Future Physicians and Medical Scientists was founded on the belief that we must identify prospective medical talent at the earliest possible age and help these students acquire the necessary experience and skills to their ultimate goals.

State center retirees to meet Oct. 31The Pennsylvania State Retirees who worked at the Cresson, Altoona and ...

The Fall Scalefest Toy Train Show is scheduled for 9 a.m. to 2 p.m. Nov. 3 at the Blair County Convention Center, ...

The Altoona Duplicate Bridge Club has announced the names of the winners of its recent games.Oct. 9 Ed ...

EBENSBURG The Bishop Carroll Catholic High School Math Department will sponsor a bridal resale event from 11 ...

Read the original here:

Student volunteer for Griffith Family Foundation nominated to attend Congress of Future Medical Leaders in Boston | News, Sports, Jobs - Altoona...

Motherhood and medicine should mix. So why is it such a struggle? – STAT

Women who become doctors must often choose between motherhood and medicine. Im a mother and a surgeon. I never thought of choosing between the two, even though my employers often asked me to.

Today I work as a trauma surgeon in a busy practice. Its been a long journey since the day five years ago when I sat outside the office of the chairman of surgery at a prestigious hospital to interview for my first job.

As my husband and I dressed our children for day care that morning, I felt proud to show them that their mom could follow her dreams. After six years of grueling training, I was finally going to be a trauma surgeon.

advertisement

Wearing a long black skirt and matching hijab, I felt confident going into the interview. There was a shortage of trauma surgeons, and I had excelled in my training. My patients did well, my outcomes were good, my evaluations were outstanding. I had aced test after test.

Pregnant with my sixth child, I went to the interview knowing I could do the job, that I had survived all the times supervisors told me to quit because I couldnt be a mother and a surgeon.

The chairman of the department who conducted the interview didnt see things the same way I did.

Youve accomplished nothing over the past six years, he said, tossing my curriculum vitae across the long mahogany table. In spite of my recommendations, my publications, and my training, once I mentioned my children he felt that I didnt have the right focus to practice in an academic setting.

Ive learned to deal with the overt discrimination that comes with being a visual minority in medicine. When I was denied access to the operating room as a third-year medical student because of my hijab, I knew it was up to me to open the door. I learned to maneuver through the system until my presence became routine.

Resistance against motherhood, on the other hand, seemed to be a tornado that only gained strength with time. When I was a newlywed surgery intern, a senior female resident told me that anyone who chooses to get pregnant in a surgery residency is selfish. When I became pregnant with my first child a month later, there were no well wishes and I was told I should quit.

Its never been done, and itll never be done, a faculty member said. The last pregnant resident in the program was a third-year resident, and she still hasnt come back from maternity leave six years later.

When I asked about the maternity leave policy, I was told there was none. And when I asked why there wasnt a policy, especially with a previously pregnant resident in the program, I was answered with an embarrassed silence.

The opposition to my pregnancy made me anxious. I found it hard to sleep at night. I cried in moments of solitude. I wanted to share my fears about losing my residency position, but I didnt want to show weakness. Obsessively reading surgery textbooks late at night was the only thing that calmed my nerves.

When I returned from maternity leave, I was eager to improve, to show I was serious about my career. I asked the attending surgeons questions at every opportunity. They remained skeptical.

In response to one of my questions, a supervising surgeon responded, I dont know why youre going through the trouble. Youll never finish this training, and even if you do you wont be productive.

After I told my colleagues about my second pregnancy, another supervisor complained to one of my male resident colleagues, These damn girls! All they do is f things up by coming here and getting pregnant.

No matter how well I performed as a surgeon, my choice of motherhood was seen as a shortcoming. With each pregnancy, I was advised to pursue more family-friendly fields since my priorities had changed. But surgery remained my dream.

Although women have comprised more than 50% of medical students since 2017, motherhood continues to be a problem because the hospitals and clinics where we work havent changed to accommodate us. The decision to have a family is complicated by the fact that there is no standard approach to how the medical field deals with pregnancy, whether thats in medical school, residency, fellowship, or professional practice. Hospitals are chronically understaffed in residency training, and maternity leave is seen as an undue burden on residents colleagues. By the time most women finish residency, they may have only a few years left to get pregnant, and hundreds of thousands of dollars of debt to consider.

Even among women who dont plan to have children, the possibility they might have children can be used against them when being considered for a position. A mentee of mine was recently asked in a fellowship interview if she planned to start a family. Although such a question is illegal, there was no way for her to answer, or even report the question, without jeopardizing her career.

A recent JAMA article showed that young women physicians cut back their work hours at substantially higher rates than men in an effort to reduce work-family conflicts, especially if they have children. Fatherhood, on the other hand, is not an obstacle. My male colleagues were celebrated when they became dads, which I appreciated but found infuriating.

A New York Times article recently described medicine as a stealth family-friendly profession that offers flexibility and part-time work. Family-friendly is not the medicine I know. As a surgeon in training and a mother, I constantly had to push back against the suggestion that as a mother I could never be interested in a demanding field or work full time.

The Times article glorified the fact that hospitals and clinics allow women to work part-time, letting us care for our families and continue to work. It minimized the fact that we are paid thousands less for the same work as men (about $41,000 less a year in surgery). It also did not mention that part-time in medicine can easily mean 40 to 50 hours a week of work, much of it unpaid.

The article also missed the reality that while some women choose the part-time path, others must go that route because medicine continues to be an inflexible field. It forces some women to abandon their true passions and settle for scraps: lower pay, fewer opportunities, and less career advancement. Its no surprise that top leadership positions in medicine are still dominated by men.

The onus to fix these issues should not be on those who are affected by it. But unless women and their allies demand and drive the necessary changes, they will never happen.

The solutions start with acknowledging this discrimination and having honest conversations about how to do better, not by glorifying the status quo.

Qaali Hussein, M.D., is a board-certified trauma and acute care surgeon practicing in Florida and mother of six.

See original here:

Motherhood and medicine should mix. So why is it such a struggle? - STAT

What Pre-Med Students Can Expect From The MMI Interview – Forbes

The Multiple Mini Interview, or MMI, has become a popular interview format for medical schools and direct medical programs (BS/MD and BS/DO) and can be one of the hardest formats for students to prepare for. However, it is an effective way for the admissions panel to learn more about you and your values.

Students waiting for a multiple mini interview to start.

During a Multiple Mini Interview, you will be participating in various short problem-based stations. Each station will typically last for five minutes, and many times there will be a series of six to 10 interview stations. Sometimes the medical school will partition the auditorium into individual stations, whereas other times students will go into private classrooms to answer the prompts. You have two minutes to read the prompt beforehand and formulate your answer.

At each station, you will have to answer a variety of questions, often related to ethical dilemmas, dealing with difficult situations, and doctor-patient interactions. The students are sometimes tested on how to navigate issues that anyone might encounter in their everyday life. In addition, you should have some general knowledge about issues that a medical doctor might encounter regarding patient confidentiality and cultural competence.

The MMI format is unique because the applicant is given multiple opportunities throughout the interview to display their skills and values. Because each station has a different admissions committee member, the opinions of each interviewee carry equal weight. Therefore, if you feel like you didnt perform as well in one particular session, you have an opportunity to do better in the next. You essentially have the ability to make numerous first impressions throughout the process.

Virginia Commonwealth University (VCU) is one school that uses the MMI format to interview their direct medical students. VCU uses this type of interview to get to know the students better and because they feel that it puts less pressure on students than the traditional interview format. The interviewers never know the credentials of the applicants, and the scores that they give the students are based solely on the performance at each individual station.

According toMcMaster University, where the MMI was created, it was designed to provide students with diverse backgrounds the chance to convey their academic and personal experiences. Because it is impossible to give each potential doctor a trial run in a clinic to better understand their suitability for the medical field, the MMI format was designed to help the candidate paint a picture of themselves and who they will be as a physician. With that in mind, the medical school can better understand how the candidate would react in a clinical setting based on their responses.

Women speaking at a multiple mini interview

The students have already proven that they are academically qualified, so the MMI will not test specific knowledge of a particular subject. Instead, students are assessed on their ability to communicate and defend their personal opinions. There are no right answers for many of these situations, so the key is to define your position and then defend it.

There is no way you can pre-design answers for the majority of the MMI questions. However, what you can do is go through as many MMI prep questions as possible to better understand your own morals, opinions, biases and views on major public issues.

In general, there are four basic categories that you will encounter during an MMI interview. The first and most common is when the interviewee is presented with a scenario and then must answer specific questions.

The second category is a role-play situation, where the student must interact with an actor. The interviewer observes the situation. The third type of scenario the student will likely see is the simple tasks. Two applicants will come together in this scenario, and one student must perform a task with the second student guiding the first student.

The final category mirrors a traditional interview format, with one student and one interviewer. You might be asked more basic questions about your own experiences and aspirations.

What can be so off-putting about an MMI interview is the lack of interaction between the applicant and the interviewer. Often times, once the student gives his answer, the interviewer will not make a reaction and will try to stay neutral. As soon as the time at the station is over, the applicant must quickly switch gears and move to the next station. There is little time for small talk or conversation.

Station 1:You have just run over your neighbors dog on accident when backing your car out of the driveway. You have five minutes to tell him the news.

What this scenario tests: Your integrity, communication skills and empathy towards others.

Station 2:You are given the age, sex, and occupation of 15 individuals. A bomb is about to go off, and you can only save five of them. Which ones do you save and why?

What this scenario tests: Your ability to prioritize, think under pressure and solve problems.

Station 3:Explain how to tie shoelaces. However, you may not use your hands to describe or make any gestures.

What this scenario tests: Your verbal communication skills, ability to break down a task into actionable, smaller steps and your ability to give clear instructions.

Station 4:In 2015, a hospital put in place an influenza control policy which required all hospital staff members to either wear a mask during flu season or get the flu vacation. If you are on a committee deciding whether enacting a mandatory flu vaccination policy for all people working with patients in the healthcare industry in New York, what would you research before making a recommendation?

What this scenario tests: Your ability to think critically and analytically, your consideration of multiple perspectives and an understanding of ethical principles related to this issue.

Station 5:What experiences have you had that lead you to believe you would be a good physician? What insights did you gain from your experiences?

What this scenario tests: The thought you have put into the necessary qualities of a physician and your ability to support your claim with past experiences.

Student at a multiple mini interview

Read this article:

What Pre-Med Students Can Expect From The MMI Interview - Forbes

Dr. N. Thorne Griscom, radiologist and singer with perfect pitch on stage and in the lab, dies at 88 – The Boston Globe

Dr. Griscom, who wrote a history of pediatric radiology and trained generations of physicians, died Sept. 27 in Lexington. He was 88 and had been diagnosed with Parkinsons disease several years ago.

Boston Childrens Hospital established the N. Thorne Griscom endowed chair in radiology in 2014. He had retired after practicing for 49 years, during which he developed a technique to keep radiologists inquisitive.

In a 2002 article for the journal Radiology, he wrote about that approach, which he had taught his students: Review images before reading a patients medical history, because a preliminary diagnosis sometimes encourages physicians to look for results that merely confirm earlier findings.

Those of us fortunate enough to interpret images with Dr. Griscom know he practiced this method for every image he reviewed, often culminating in astonishing and miraculous diagnoses, his colleagues Dr. George A. Taylor, Dr. Carlo Buonomo, and Dr. Michael J. Callahan wrote in a tribute.

As Dr. Griscom wrote in his journal article, this approach keeps the radiologist engaged in the process it converts it into an intellectual game, turning a chore into fun and reminds him or her to consider rarities.

Dr. Griscoms gifts as a diagnostician and teacher were immediately obvious, Taylor, Buonomo, and Callahan wrote. They added, though, that for us, however, he was so much more; he was our moral compass.

As a teacher and diagnostician, no matter how senior he was as his career progressed, Dr. Griscom welcomed the opinions of those he worked with and those he mentored. And he still knew perfection might remain out of range, even when everyones judgments formed a sort of diagnostic harmony.

In his memoir, he said he had developed aphorisms to use as teaching tools. Among them: When dealing with images, four eyes are better than two, and six are better than four. And this, too: If all agree on a diagnosis, does that make it true? No, but it increases the odds.

Nathan Thorne Griscom was born in Philadelphia on June 21, 1931, and grew up in Moorestown, N.J., as part of a Quaker family that traced its presence in the region to an ancestors arrival from England in 1680.

His parents, David Davis Griscom and Helen Thorne, ran Cropwell a family farm that mostly grew apples and peaches, along with a few other crops in smaller supply.

The middle of three brothers, Dr. Griscom was named after Dr. Nathan Thorne, his maternal grandfather, who was a physician.

Sometimes naming does turn out to be destiny, Dr. Griscom wrote in his memoir, which he called Reminiscences.

It was always assumed that I would become a doctor, he added later, but it was seldom stated and never discussed, at least not with me.

As a boy he worked on the farm. Along with the fruit they sold, the Griscoms grew much of the food they ate. At first our pay was 25 cents an hour when we worked by the hour, Dr. Griscom wrote. We got 2 cents, later more, for each basket of potatoes we picked up when paid by piece-work.

In 1948, he graduated first in his class at Haddonfield High School, and won one of the states two Pepsi-Cola scholarships, which paid his full college tuition. He headed to Wesleyan University, from which he graduated with a bachelors degree in chemistry.

Dr. Griscom sang in his high school glee club and the All-State Chorus, and with various college music groups as well. Turning down an acceptance from Harvard, he went to medical school at the University of Rochester, where during his third year he met Joanna Starr.

They were both part of the Rochester Oratorio Society. She worked in the deans office at the medical school and seized the opportunity to examine my records, he wrote. I passed inspection.

They married the day after Christmas in 1955, during his fourth year in medical school.

The Griscoms, who lived in Lexington for many years, went on to sing in Boston with the Chorus pro Musica and the Cantata Singers she was a soprano, he was a tenor. Their performances included a memorable night at Symphony Hall with the Boston Symphony Orchestra in the early 1960s.

Mrs. Griscom, who also had been a producer of the WGBH music program Chamberworks, died in 2010.

After a pediatrics internship and residency at Massachusetts General Hospital, Dr. Griscom spent two years as an Army physician and moved into radiology. Returning to Boston, he was a radiology resident at MGH before joining the pediatric radiology department at Childrens Hospital.

During his career, Dr. Griscom was an early practitioner in fetal imaging, his colleagues wrote in their tribute, adding that his research in other areas made major academic contributions as well. He formerly was president of the Society for Pediatric Radiology, which named its excellence in teaching award after him. In 1997, the organization awarded him its Gold Medal for his career contributions.

And although as a college graduate he had turned down studying at Harvard Medical School, he was a longtime professor of radiology there.

With characteristic honesty, Dr. Griscom wrote in his memoir that he had both diagnostic triumphs and diagnostic stumbles.

My father is both the kindest and the most honest man Ive ever met, said his daughter, Dr. Nell Griscom, a veterinarian who lives in Los Gatos, Calif. I am sure that he never lied. It just never would have occurred to him.

Her father, she added, tended to demand more of himself than of others.

He always saw the best in other people, she said. His extraordinary thing was that he was a perfectionist for himself, but he was so kind to other people. He was very forgiving of what their faults were.

In addition to his daughter, Dr. Griscom leaves two sons, Dan of Melrose and Matt of Seattle; and seven grandchildren.

A memorial service will be held at noon Jan. 11 in First Parish Church in Lexington.

He was always so extraordinarily supportive of us, Nell said of her fathers approach to being a parent and a grandparent. No matter what we did, he acted like we were the best thing since sliced bread.

Dr. Griscom was modest, though, about his own abilities, including having perfect pitch a handy talent for starting songs when he sang with a cappella groups.

In a self-deprecating aside, he wrote in his memoir that really knowledgeable musicians realize it is mostly just an interesting parlor trick.

Bryan Marquard can be reached at bryan.marquard@globe.com.

See original here:

Dr. N. Thorne Griscom, radiologist and singer with perfect pitch on stage and in the lab, dies at 88 - The Boston Globe

Wilson: Henry Ford an institution to deepen partnership with – The South End

President M. Roy Wilson updated students and faculty on the halted Henry Ford Health Systems negotiations on Oct. 16 during his state of the university address.

The address was moderated by dean of the Irvin D. Reid Honors College, John Corvino, at the Bernath Auditorium in the David Adamany Undergraduate Library.

Wilson said a medical school like Wayne States School of Medicine cannot survive without a hospital providing support.

No medical center or medical school can function without the clinical enterprise whether thats the faculty practice plan or the hospital system subsidizing research and education, Wilson said. A purely community-based medical school that does no research might be able to but every other medical school in the country relies on the subsidization of research and education from the clinical enterprise.

President M. Roy Wilson speaking at his annual state of the university address

Wilson said WSU is not receiving the degree of support from Tenet Healthcare Corporation, the company that owns Detroit Medical Center and WSUs prime medical school partner.

Tenet is a for-profit corporation in which their main concern is shareholder profit, so we have to do something or change fundamentally what kind of medical school we have, Wilson said.

Due to several Board of Governors members shooting down a letter of intent for a partnership between the School of Medicine and HFHS, Wilson said WSU had to put some things on hold in terms of a full partnership with HFHS and the medical school.

Board members Dana Thompson, Sandra Hughes OBrien and Michael Busuito opposed the LOI.

Ultimately its all about trust, and we have to take baby steps at this point and continue to do things we can do to bring back that trust, Wilson said. At some point, the board will change again. Its an elected board and there are changes all the time. In the meanwhile, we will continue to educate the board on the importance of having a trusted clinical partner and continue to work on getting things accomplished.

In March 2019, Henry Ford suspended negotiations with Wayne States medical school after the BOG argued over HFHS and WSUs LOI.

In February 2019, Jack Sobel, dean of the medical school, and David Hefner, vice president of health affairs, announced their departures from WSU. Their positions would be merged into a single one after a replacement was found for both of them, said The South End.

Dean Corvino and Wilson

WSU is in the process of finding a replacement for the positions. Currently, the committee is in the second stage of interviews, which will lead to a select few wholl be interviewed by the provost and president, Wilson said.

Wilson said people have asked if tension and discord from the BOG have kept applicants from applying to the job. He said there are numerous applicants.

There are people out there who want a challenge and who think there are great opportunities here and in Detroit, he said. Who, like many Detroiters, just want to roll up their sleeves and get in there and get it done, and those are the type of people were getting.

The search for WSUs new dean of the School of Medicine will be finished by the end of the calendar year, Wilson said.

Wilson addressed the state of the BOG and how the university can move forward.

There have been some challenges on the board without getting into the specifics of the lawsuit, I think that its (lawsuit) pretty much a done deal, Wilson said. Were moving forward with decisions that have been made and my attitude is that as long as we can continue to move the university forward then we just continue to do what we do and try to keep the board politics at a minimum or at least private.

Half of the BOG sued the other half over decisions made at a June 21 BOG meeting where only three members were present.

OBrien, Thompson, Busuito and Anil Kumar sued board members Marilyn Kelly, Kim Trent, Mark Gaffney, Bryan Barnhill and Wilson. The lawsuit called to overturn decisions of a 3.2% tuition increase and the leasing of a $14 million building to WSU Pediatrics, according to The South End.

The lawsuit stated the meeting violated the Open Meetings Act. On Aug. 1, a judge ruled against those who sued and said the meeting did not violate the Open Meetings Act because university boards are not subject to it, said the Detroit Free Press.

From left to right, BOG members O'Brien, Busuito and Barnhill March 19

Junior Shirley Elfishawy said the event was realistic and authentic.

Its really nice our students get a chance to interact with our president and it brings an honest and realistic view on what students are going through and campus life too, she said. Having that direct connection with the administration isnt the most common thing with other universities, so its nice that we provide it.

2019 graduate and WSU employee Courtney Mansor said events like these are what bring transparency to the university.

There has been a lot of concern about the president and the board of governors so having that addressed right away was good, she said. I feel like having transparency is really really important so hearing and having our questions be answered, heard or at least emailed is really important.

Slone Terranella is the editor-in-chief at The South End. She can be reached at editorinchieftse@gmail.com

Cover photo by Jonathan Deschaine. Jonathan is the multimedia editor at The South End. He can be reached at jonathan.deschaine@gmail.com

See the original post:

Wilson: Henry Ford an institution to deepen partnership with - The South End

Climate change threatens firefighters and farmworkers. And that’s only the beginning. – AAMCNews

As an emergency medicine resident at the University of Washington School of Medicine, Zachary Wettstein, MD, has seen the effects of wildfires firsthand. On days when its really smoky, he says, Im not surprised that Im seeing more people with shortness of breath. Densely smoky days certainly are growing as wildfire season worsens, experts say, spurred in part by such environmental changes as earlier snowmelts that can cause drier, hotter conditions.

A few years ago, Wettstein and his colleagues suspected that raging fires and the smoke and fine particulate matter they spawn also were causing increased cardiovascular problems. Whenever we have a bad wildfire season like we did last summer here, it definitely seemed like we were seeing an uptick in the number of strokes, he says. So he decided to study the issue. Sure enough: Wildfires brought increased emergency department visits not only for stroke, but also for ischemic heart disease and pulmonary embolism.

Wildfires are just one way climate change threatens to unleash health problems, particularly for workers who face long hours working outdoors. For example, ozone depletion can spark asthma, rising temperatures can cause dehydration and related conditions, and insecticides can infect farmworkers as changing conditions fuel the spread of new pests. In addition, extreme weather events pose serious risks to rescue teams, mold remediators, and others.

Climate change will be the new crisis of the next generation. Physicians need to be prepared.

Todd Sack, MD, Physicians for Social Responsibility

Robert Harrison, MD, founder of the University of California, San Francisco, School of Medicines occupational and environmental health program,points to firefighters as one group thats particularly vulnerable to the health effects of climate change. Harrison worries about exposure to intense heat and other risks, noting that firefighters battling wildfires in 2017 kicked up spores that cause valley fever, a potentially deadly disease that sickened several of them. Over the past two or three years, weve seen huge fires in California. We expect thats going to continue in the future, because wildfire season is so much longer, he says. The impact of the changing environment and specifically heat on the outdoor workforce is a very real threat.

In fact, as occupational and environmental health experts and others look ahead, some predict that climate change will soon become a top public health challenge. Todd Sack, MD, a member of the board of directors of Physicians for Social Responsibility, compares the coming onslaught to the devastation of HIV/AIDS in the 1980s. Climate change will be the new crisis of the next generation, he says. Physicians need to be prepared.

If you are looking for some of the first signs of the health effects of climate change, look at people whose work makes them particularly vulnerable, experts say. I would expect to see potentially more heat illness, Wettstein predicts. I think air quality is going to be a big issue, not just from wildfire smoke, but things like pollen and particulate matter that affect respiratory and cardiovascular disease. We may see people who work outdoors or those who work indoors and dont have filtration systems with more work-related cardiovascular and respiratory issues.

Other experts point to such threats as increased allergens and growing numbers of disease-bearing ticks and mosquitoes that could endanger those who work outdoors in such fields as construction, landscaping, and agriculture.

What's more, many of these workers face an additional socio-economic disadvantage, Harrison says. Migrant farmers and others arrive in the U.S. and then they take jobs in this country that I characterize as particularly vulnerable, meaning that theyre the highest hazard jobs. They typically remain voiceless and unseen. Many may come into primary care clinics where the provider might see an agricultural worker exposed to pesticides or heat illness, or they have chronic kidney disease, now thought to be possibly linked to chronic dehydration.

The growth of such hazards means trainees and practitioners will need to better understand occupational and environmental health issues as workers start turning up in their offices, clinics, and emergency departments.

[T]he provider might see an agricultural worker exposed to pesticides or heat illness, or they have chronic kidney disease, now thought to be possibly linked to chronic dehydration.

Robert Harrison, MD, University of California, San Francisco, School of Medicine

Education will need to expand to meet those needs, says Sheri Weiser, MD, professor of medicine and internist at University of California, San Francisco, School of Medicines Division of HIV, Infectious Diseases and Global Medicine at Zuckerberg San Francisco General Hospital and Trauma Center. When I started medical school, there was a big push to understand the social determinants of health for example that poverty, inequality, and social discrimination are all drivers of poor health. Understanding that led to a big change in the way we were all trained as health professionals, she says.Today, Weiser believes, recognizing and applying scientific evidence on climate change as a driver of poor health is the next wave of how students need to be trained.

Despite the need, squeezing climate change health issues into an already over-stuffed medical school curriculum is challenging, says Carrie A. Redlich, MD, director of the occupational and environmental medicine program at Yale School of Medicine.

Occupational and environmental medicine generally has a tiny, tiny place in a medical school curriculum to begin with, she says. There is a struggle to get space because everybody thinks their area is what medical school students need to know about. Although climate change is extremely important, its not seen like the basic medical sciences or clinical fields such as medicine, surgery, or pediatrics.

Lisa Howley, PhD, AAMC senior director of strategic initiatives and partnerships, notes that schools need to identify where it makes sense to weave in climate-change-related information. This integration should happen within and across many types of existing curricula, she says.

Occupational and environmental medicine generally has a tiny, tiny place in a medical school curriculum to begin with. There is a struggle to get space because everybody thinks their area is what medical school students need to know about.

Carrie A. Redlich, MD, Yale School of Medicine

Such changes are worth the effort, Harrison says, since the health impacts of climate change are going to become part of many physicians day-to-day life. For one, he believes, including environmental and occupational health questions when taking a patients history can capture vital information. The social history includes things like smoking and alcohol and should also include an environmental and occupational history. It doesnt take very long, and it needs to be part of that social history, he says.

At a higher level, expanding occupational and environmental health curricula could improve physicians responses to climate change overall. We need people who understand and can interpret the scientific issues and can apply that information as credible spokespeople to impact policy, he believes.

To achieve such goals, Harrison says hed like to see the creation of a national environmental and occupational medicine scholars program that would connect interested students with advisors and mentors at other institutions. I want to create a pathway that could support students wherever they are and match them with suitable mentors.

These and other changes cant come soon enough, he believes, given the centrality of the subject. The health impacts of climate change are connected to so many clinical diagnoses and outcomes that are covered in medical school and subsequent residency training, he notes. I view education and training about climate change as the single most important poster child for occupational and environmental medical education.

Go here to read the rest:

Climate change threatens firefighters and farmworkers. And that's only the beginning. - AAMCNews

Jones: Ready to work, learn and help – Greenville Daily Reflector

As the newly sworn-in representative for House District 9 in the General Assembly, I am humbled and excited by the opportunity to get to work, learn and find ways to help the people of Pitt County.

In medical school, one of the most important steps in becoming a doctor is taking the Hippocratic oath. And one of the promises within that oath is first, do no harm.

My goal is to take that same commitment, drive and passion to Raleigh and work for the betterment of the people of Pitt County and citizens across this great state.

Like many, I have been frustrated by the constant partisan bickering and gridlock in both Raleigh and Washington, D.C. The hardworking people of this great state deserve better.

I love eastern North Carolina and I want to be an effective leader for our area.

There is plenty I need to learn, and I am working hard to learn as much as I can to be the best possible representative for our region.

As the urban-rural divide keeps growing, we need strong and effective leaders in Raleigh who will fight for the people of eastern North Carolina. Regardless of party, we must be unified in our efforts to make sure our region does not get left behind.

I believe there is tremendous opportunity, particularly in the medical field, for Greenville and Pitt County as North Carolina continues to grow and attract more residents.

I want to make sure East Carolina University and the Brody School of Medicine remain leaders in attracting top-tier medical students and professionals. This is critical to our region.

We need to continue to grow the long-standing partnership between Vidant and ECUs Brody School of Medicine, which is vitally important to providing quality health care for the people of eastern North Carolina.

I also want to focus on finding solutions that support rural economic development, help our agricultural communities, expand access to quality healthcare and improve education.

These issues are vital to our communities in eastern North Carolina.

While there will always be areas of disagreement, we need to make sure the people of this great state and their well-being are prioritized above political games and personal agendas.

Going forward, please know my office is always open. I want to hear from you and I welcome the opportunity to help the citizens of House District 9.

Dr. Perrin Jones is the representative for House District 9 in the North Carolina General Assembly. He was selected to replace newly elected-Congressman Greg Murphy. Dr. Jones is an anesthesiologist in Greenville.

Link:

Jones: Ready to work, learn and help - Greenville Daily Reflector

Forget Free Tuition, Application Costs Are First Barrier – Medscape

Numerous medical schools have made news in recent years by offering free tuition, but that might not be enough to bolster diversity in medicine. It is also necessary to reduce the costs of applying to medical school, say authors of a perspective published online today in the New England Journal of Medicine.

Application fees; interview costs including clothing, transportation and lodging; test fees; and test preparation fees may keep qualified students from taking the first step, write Lorena Millo, BS, with the Margolis Center for Health Policy at Duke University in Durham, North Carolina, and colleagues.

"High application costs send a message that medical education isn't designed to be obtainable for low-income people, which could potentially deter some people from applying at all," they write.

While some schools are expanding scholarship programs and even waiving tuition costs altogether, Millo and colleagues note that similar improvements have not come to the application process.

And whereas medical school costs come with the high odds of making enough money as physicians to repay the debt, the application process requires a much bigger gamble.

Just taking the Medical College Admission Test (MCAT) costs $315 and 62.7% of students taking it buy practice exams that cost between $2000 and $10,000, the authors write.

In addition, most schools require a primary application using the American Medical College Application Service system, which costs $170 for the first school and $40 for each additional school. Secondary application fees can be as high as $200, the authors explain, noting that in 2018 applicants submitted a median of 15 secondary applications.

Millo and coauthors argue the application costs may help explain low numbers of underserved populations among the 2018 applicants.

"In 2018, only 9% of applicants identified as black or African American, 10% as Hispanic, and less than 1% as American Indian or Alaska Native," the authors write. "Nearly a quarter of first-year medical students come from families earning $250,000 or more per year, whereas only 5% come from families in the lowest household-income quintile (with incomes of about $24,000 per year or less)."

Increasing costs for applying come as average medical student debt rose to $200,000 last year, the authors note, a 4% increase over the previous year.

The authors point to two sources that help with application costs: hosting programs in which current medical students host applicants so they don't have to pay for a hotel, andthe Fee Assistance Program (FAP) run by the Association of American Medical Colleges (AAMC). That program reduces the MCAT cost, waives primary-application fees for up to 20 schools, and supplies free MCAT-prep materials. Additionally, most schools also waive secondary fees for those who qualify.

But the help does not go far enough, the authors write. It doesn't extend to interview costs, for one thing, and it doesn't help people who may not qualify by income but still can't afford the costs.

The costs can be a barrier, agreed Valerie Parkas, MD, senior associate dean of admissions at Icahn School of Medicine at Mount Sinai in New York City. In addition to the expenses listed in the article, she adds that doing the research, clinical work, and volunteer work to develop an application that's competitive can also be a barrier for those with fewer resources.

"I think for economically and educationally disadvantaged students, the whole process is more challenging," she told Medscape Medical News. That said, individual schools and the AAMC are actively working to achieve more equity in applications.

At Mount Sinai, for example, medical students host medical school applicants and alumni host applicants for residencies. The school also waives secondary fee applications and tries to accommodate those who want to interview on a day they are already interviewing in the area so as to avoid additional flights to the same region.

The school also has an early-assurance program called FlexMed, which allows 40 to 50 sophomores to know they are accepted so they don't have to go through the usual application process or take the MCAT.

"We also have an early assurance for our residency program for our students who know what field they want to get into," Parkas said. "They don't have to apply broadly for residency, again taking away all the travel and application fees."

Millo and coauthors offer three ideas for change. One is limiting the number of schools to which applicants could apply to level the field for those of different incomes.

The second is asking medical schools to screen applicants more thoroughly before inviting students to submit secondary applications. Currently, students are spending money to send secondary applications without knowing that the schools consider them serious candidates.

A third option is for schools to conduct virtual interviews, they write.

Each of these options has pros, Parkas says, but also cons.

Limiting the number of schools for applicants may disadvantage those who have not had as much access to advisers and mentors who could help them skillfully narrow their school choices, she said.

"I think that's worrisome," Parkas cautioned.

Virtual interviews are worth thinking about but they have a downside, she said. "You want students to see the school, get a sense of the learning climate, the culture of the school, talk to students, visit the city, and know if it feels like a 'good fit.'"

As to schools being more selective about secondary application invitations, Parkas said that recommendation probably makes the most sense.

However, she said, there are schools with so many applications they may turn to metrics as a way to be more selective in a short period of time and that may have the opposite effect of what the authors are promoting.

"Students who might have real adversity and reasons for academic challenges might not get a full holistic review," she said. "That may disadvantage the disadvantaged."

The authors and Parkas have disclosed no relevant financial relationships.

NEJM. Published online October 16, 2019. Perspective

Follow Medscape onFacebook,Twitter,Instagram, andYouTube

Read more:

Forget Free Tuition, Application Costs Are First Barrier - Medscape

Black Men In White Coats: An Initiative To Increase The Number Of Black Men In Medical School – Forbes

Black Men in White Coatson a mission to show black youth that they can become doctors, too.

Mentoring, Mindset And Motivation For Black Youth

When Aaron Dotson was a young boy, he would accompany his mother to her physicians appointments. He was fascinated with the doctors instruments and asked lots of questions typical of a curious child. Over the years, the African American doctor mentored Dotson, allowing him to shadow his daily routine and encouraging him to study hard so that he, too, could become a doctor.

Not many young black men like Dotson, now in his fourth year of medical school, have a black man in a white coat to model the example of what they can become. But he and other black medical students and physicians volunteer their time to the organization Black Men in White Coats (BMWC), with the mission to increase the number of black men in the field of medicine by exposure, inspiration and mentoring.

Its important for black men to see themselves as being more than a stereotype, more than someone who can only plays sports, said Dotson. We have the ability to achieve and accomplish anything that we want to in this world, and those of us already doing it need to be there to mentor others.

It Takes a Village

Dr. Dale Okorodudu launched Black Men in White Coats in response to a 2013 report from the Association of American Medical Colleges that the already under-represented percentage of black men in medical school was dropping.

BMWC was the vision of Dr. Dale Okorodudu, who launched the BMWC website six years ago after seeing a 2013 Association of American Medical Colleges (AAMC) report that the already under-represented percentage of black men in medical school was dropping. While a 2017 AAMC report documented a 53 percent growth among black or African American female medical school graduates since 1986, male graduates had declined 39 percent. During the 2018-2019 academic year, the AAMC reported that medical school enrollment consisted of 7.1 percent black; however, less than half were men.

To become a black man in a white coat, you must first see yourself capable of becoming one, Okorodudu said. To create that vision, he has networked and partnered with students, physicians and medical schools across the country to expose black youth to the medical field and to provide necessary, ongoing mentorship.

On the BMWC website, Okorodudu posts podcasts and short video documentaries from both medical students and physiciansall expressly intended to inspire black youth that they, too, can become doctors. Hes written books for parents and children to further inspire and educate. Hes also created DiverseMedicine.org to increase ethnic and socioeconomic diversity within the field of medicine via mentoring and outreach.

More than 1,800 youth and parents attended the Black Men in White Coats Summit, exposing youth to careers in medicine.

Last year during Black History Month, Okorodudu and his team organized the first-ever BMWC Youth Summit at UT Southwestern Medical Center. Drawing more than 1,800 attendees, the daylong program offered info sessions for elementary through high school students and their parents and introduced different medical specialties.

Always seeking ways to amplify his efforts, Okorodudu redesigned the event to make it more affordable and easily replicated across the country. BMWCx is a branded Ted Talk-style summit that can be independently organized by community leaders anywhere.

Okrodudus next goal is a documentary film that will tear down the false stereotypes of black men in America and demonstrate their potential. Projected for release in February 2021, Okorodudus quest is that the film not only be educational and inspirational, but it will also be entertaining.

A recent Kickstarter campaign quickly produced the $100,000 he needed to begin. Theres still a long way to go, he said, but Im really excited by this project because it has the potential to make a huge impact.

Why BMWC Is Important

A recent Stanford Health Study showed that black men take more proactive health measures, such as flu shots and diabetes and cholesterol screenings, when treated by a black doctor. The randomized clinical trial among 1,300 black men in Oakland showed that 29 percent more were likely to talk with black doctors about other health problems and seeking more invasive screenings that likely required more trust in the person providing the service.

While African-Americans comprise about 13 percent of the population, only 4 percent of physicians and less than 6 percent of medical school graduates are black, according to the study.

It was surprising to see the results, said Marcella Alsan, an associate professor of medicine atStanford Medicine, a faculty fellow at the Stanford Institute for Economic Policy Research, andan investigator at the VA Palo Alto Health Care System. Prior to doing the study, we really were not sure if there would be any effect, much less the magnitude. The signal in our data ended up being quite strong.

Specifically, researchers calculated that increased screenings could total up to a 19 percent reduction in the black-white male cardiovascular mortality gap and an eight percent decline in the black-white life expectancy gap.

In curative care, the patient feels ill and then may seek out medical care to fix the problem, Alsan said. But in preventive care, the patient may feel just fine but must trust the doctor when he is told that certain measures must be taken to safeguard health.

Not only is there a shortage of black doctors, there is a shortage of physicians overall. An AAMC Health Care Utilization Equity analysis found that the U.S. would need an additional 95,900 doctors immediately if health care utilization patterns were equalized across race, insurance coverage, and geographic location. Black men, in particular, have the lowest life expectancy in the country.

To build a health care infrastructure that not only supports medical need but also aspires to reduce healthcare disparities, a pipeline of black male physicians is neededand that requires exposing, mentoring and advocating on behalf of black male youth.

Medical School is a Journey of Commitment

Aaron Dotson is in his fourth year of medical school at the St. Louis University School of Medicine. He knows what a long road it is to medicine and he actively mentors black youth to build a pipeline of future black doctors.

Dotson, who plans to become an ophthalmologist, was already set to become a doctor when he met Okorodudu at a pre-med conference in 2015. Recently graduated from UT Dallas, Dotson was so impressed with Okorodudu and the BMWC mission that afterward, Dotson introduced himself.

Since then, hes served as a strong mentor for me, going through a lot of my medical school applications and connecting me with plenty of doctors that I still keep in contact with today, said Dotson. In return, Ive supported the BMWC mission by mentoring dozens of students across the country.

Dotson majored in neuroscience as an undergrad before beginning medical school. Hes in the process of applying for an Ophthalmology residency, which means four more years on top of the eight hes already invested.

And I'm likely looking to do a fellowship after that, which will be another one to two years, so its a big commitment, he explained. Medical school is not cheap; St. Louis University can run you about $50,000 per year in tuition alone.

Dotson feels that the long commitment and financial obligation is one of the reasons black men never even consider becoming a doctor. When you're looking at the amount of loans that you have to take out over the years, and you're not able to make a decent living until residency fellowship and begin to pay those loans back, it seems impossible to so many black men. Its not an easy road at all; but for me, there is nothing on this planet that I want more than to become a doctor.

Leaving Legacies

Okorodudu wants better health outcomes for black communities, but hes thinking much bigger than that. Hes looking at impacting generations to come.

A big part of what I'm doing is changing the life of the person who becomes a physician. If I can convince a child that he can become a doctor, give him mentorship, guidance on how to access necessary resources and they become a doctor, that changes his life because he earns a physician's income. Now hes in the top five percent of society, and that changes his kids' lives, changes his grandkids' livesit changes his entire generational legacy.

Okorodudu openly shares that he guided by his Christian faith and belief that, To whom much is given, much is required. He is grateful for all he has achieved and is committed to paying it forward. His hope is that those on the receiving end will do the same and that, in time, the black mans world will look very different than it does today.

Read more:

Black Men In White Coats: An Initiative To Increase The Number Of Black Men In Medical School - Forbes

If food is medicine, why isnt it taught at medical schools? – The New Food Economy

Students in medical schools across the country spend less than 1 percent of lecture time learning about diet.

Earlier this year, Mount Sinai, the biggest hospital network in New York City, invested in a meal delivery service. Though it seemed like an unusual move at the time, the networks decision makes sense if you consider the intrinsic relationship between food and healtha connection underscored by countless other recent examples of healthcare initiatives that harness diet as a tool to improve well-being.

At a California rehabilitation facility, for instance, doctors use the rituals of eating to help people recover from trauma. And over the past decade, cities across the country have launched food prescription programs that incentivize participants in the Supplemental Nutrition Assistance Program (SNAP) to buy fresh fruits and vegetables at farmers markets. A number of nonprofit organizations have launched medically-tailored meal services for people suffering from diet-related diseases.

Culturally and politically, were increasingly acknowledging that what we eat plays a major role in our health. Which is why its especially strange that healthcare providers know so little about it.

Medical curriculums have been developed historically, foregrounding disciplines like biology, behavior, and disease to the detriment of food and nutrition.

In a new report published by the Harvard Food Law and Policy Clinic, researchers write that, on average, students in medical schools across the country spend less than 1 percent of lecture time learning about diet, falling short of the National Research Councils recommendation for baseline nutrition curriculum. Neither the federal government, which provides a significant chunk of funding to medical schools, nor accreditation groupswhich validate themenforce any minimum level of diet instruction.

And it shows: While you and I might show up for our annual physicals expecting feedback on our what and how much we should be eating, just 14 percent of doctors feel qualified to offer that nutrition advice.

How did the gap get this wide? Much of it can be explained by the way medical curriculums have been developed historically, foregrounding disciplines like biology, behavior, and disease to the detriment of food and nutrition. Today, the legacy of this framework makes it hard for medical schools to retroactively integrate nutrition into their curriculums.

Because [nutrition] wasnt prioritized for so long, there arent a lot of faculty and medical schools that have any knowledge about nutrition and diet, says Emily Broad Leib, the reports lead author. To build it into schools now requires real investment in hiring and training.

People believe that nutrition is easy, when in reality, nutrition is most of medicineand then a lot more.

The report recommends a wide range of policy changes that could function as carrots and sticks in getting nutrition onto course outlines. They range from making federal funding contingent on nutrition training to performance-based incentives that encourage schools to include diet-related subjects in curriculums.

Why are we spending so much government money to educate physicians and residents, and yet were not getting any impact in terms of these this large set of [diet-related] diseases? Broad Leib asks.

The recommendations also implicate other players in the world of medicine, like accreditation organizations and licensing boards, for not requiring a baseline level of dietary expertise from schools and doctors, respectively. Part of the reason that may be is the prevailing attitude society has toward food as a soft science.

People believe that nutrition is easy, when in reality, nutrition is most of medicineand then a lot more, says Martin Kohlmeier, a professor of nutrition at the University of North Carolina-Chapel Hill. You have cultural, food production, and food safety issues. It is a challenge for physicians to learn enough.

Doctors with expertise in nutrition are more likely to spot diet-related issues earlier in a patients prognosis.

Kohlmeier leads the Nutrition in Medicine Project, a free, online nutrition curriculum tailored to medical students and doctors. Kohlmeier estimates that 150,000 students have participated in some aspect of the program since its launch in 1995. Nevertheless, he stresses, voluntary education is only a temporary fix for a systemic problem.

A lot of institutions have electives, all kinds of nice things that maybe 1 to 5 percent of their students use. And Im always saying: You are going to be treated by the physician who skipped those classes.

But why teach doctors nutrition and diet when there already exists a specialty in those fields? Nutritionists and dieticians are experts in the way our individual biologies are affected by what we eat. What role will they play if our general practitioners develop that same expertise?

Shoring up what doctors know about food wont render nutritionists moot, says Carol DeNysschen, a registered dietician and chair of the health, nutrition, and dietetics program at the State University of New York-Buffalo.

The more that [doctors] know, the more they realize what they dont know, and the more they realize how complicated it can be to develop an individualized nutrition plan for people and to get them the support they need to monitor or manage [issues like] their weight, their diabetes, DeNysschen says.

DeNysschen characterizes the relationship between doctors and nutritionists as a symbiotic one. Doctors with expertise in nutrition are more likely to spot diet-related issues earlier in a patients prognosis, and that could mean more referrals to diet experts. The more nutrition knowledge they have, the more theyre aware of looking for those areas where a nutritionist or dietitian could interject, she says.

Beyond the healthcare implications, the Harvard report also makes an economic case for teaching doctors about food. Taxpayer dollars fund most physician residencies in the United States through Medicare. (Medical school graduates train to become doctors via residency in a hospital.) Simultaneously, Medicare serves as the national insurance program for aging Americans, and thus, incurs the costs of diet-related diseases during that stage of our lives. Therefore, the report argues, requiring nutrition education in medical residencies is another way for Congress to trim its own bills.

Thats one element of the case that Broad Leib will likely make next week at a Congressional hearing. Though the report largely focuses on federal policy changes, some local lawmakers are introducing legislation that would require nutrition education among doctors within their jurisdictions. In New York, for example, state legislators recently proposed a bill that would require practicing physicians to receive six hours of nutrition coursework or training every two years. In Washington, D.C., municipal lawmakers introduced a bill that would require continuing education for doctors to be expanded to include nutrition coursework.

Poor diet continues to be one of the biggest contributors to chronic disease and mortality in the U.S., killing one in five Americans every year. Thats a higher rate than three other risk factorspollution, lack of exercise, alcohol and drug usecombined. As the tide continues to rise in favor of ideas and policies that combine food and healthcare, medical schools may be next to center nutrition in their work. Someones just got to prescribe it.

More:

If food is medicine, why isnt it taught at medical schools? - The New Food Economy

Parents in medical research labs missing out on government help with conference travel – Physician’s Weekly

By Linda Carroll

(Reuters Health) Few medical schools allow doctor-scientists with children to take advantage of a government program to help with childcare expenses related to travel to professional meetings, a new study suggests.

There is a body of research showing there are gender disparities in academic medical leadership positions, grant funding and invitations to speak at conferences, said the studys lead author, Cora Ormseth, a medical student at the University of California, San Francisco, School of Medicine. A likely driver to explain this disparity is the need for childcare or care of other dependents.

Ormseth and her colleagues had heard about the federal program, which dates to 2014, that allows scientists traveling to meetings to pay for childcare costs that directly result from that travel, using money from the government grants that fund their research.

Even though that use of funds has been approved by the government, individual institutions need to change their travel rules for researchers to use grant money in that way, Ormseth said.

It didnt seem like many physician-scientists were taking advantage of the federal program, so Ormseth and her colleagues decided to survey the top medical schools to find out what their rules were.

As reported in JAMA Internal Medicine, the researchers made a list of 51 top institutions based on rankings from the National Institutes of Health and US News and World Report. After locating travel policies for those 51 medical schools, Ormseth and her colleagues reached out to the administrators of each school to make sure their interpretation of the policies was correct. One institution declined to participate.

As it turns out, five University of California medical schools (UCLA, UC Davis, UC Irvine, UC San Diego and UCSF) had policies that explicitly provide for reimbursement of the full range of dependent care permitted by the US Department of Health and Human Services Regulation (45 CFR 75.474), which states: Temporary dependent care costs above and beyond regular dependent care that results from travel to conferences is allowable.

At 32 schools (64%), travel policies either did not reference dependent care or explicitly classified it as non-reimbursable. Policies at the 13 other schools varied widely, the researchers reported. Six schools reported allowing for reimbursement if a physician-scientist provided justification for the departure from institutional policy.

Overall, just 10% of the 50 medical schools surveyed in 2019 had travel policies that implemented the 2014 government regulation.

Many of the schools didnt know about the regulation, Ormseth said. One said the travel policy needed to be consistent across all funding sources.

The new study might be the first time many doctor-scientists have heard about the federal policy, said Dr. Annie Im, an assistant professor of medicine in the department of hematology and oncology at the University of Pittsburgh Medical School.

I had never heard of this federal policy before, Im said. It was interesting to see how few institutions had incorporated it into their travel policies. Im glad this study is bringing awareness.

The federal regulation may help level the playing field, Im said.

Its helpful to know that there is federal support for parents who are in medicine, Im said. It speaks to the underlying gender disparity and I think its important that the government is willing to address this in some way. Its not the solution to everything but I think its a big step forward.

SOURCE: http://bit.ly/35vhriS JAMA Internal Medicine, online October 14, 2019.

See more here:

Parents in medical research labs missing out on government help with conference travel - Physician's Weekly

High-paying health care jobs that don’t require medical school – Fox Business

Fox News contributor Deneen Borelli weighs in on President Trumps health care plans.

If youre interested in working in health care, but the years of medical school and residency training feel too daunting -- not to mention potential student loans -- there are still plenty of jobs you can look into.

Many of those occupations are also high-earning positions, according to a recent report from HeyTutor.

The tutoring company published a report on the 10 highest-paying health care jobs that dont need a medical school degree.

The occupations that made the list all earn $75,000 per year or more, according to HeyTutor.

Using data from the Bureau of Labor Statistics (BLS) Employment Projections survey, HeyTutor also found that health care jobs is expected to grow by 15.3 percent, while the national average for job growth is 7.4 percent.

For its ranking of the highest-paying health care jobs, the company looked at Occupational Employment Statistics from the BLS.

GET FOX BUSINESS ON THE GO BY CLICKING HERE

HeyTutor only analyzed health care occupations that need a masters degree or less.

Here are the 10 highest-earning health care jobs that dont need a medical school degree, according to HeyTutor.

Dental hygienists typically clean patients teeth, take x-rays and assess general oral health, according to HeyTutor. (iStock)

According to HeyTutors findings, a dental hygienist makes a median annual wage of $75,000, or a median hourly wage of $36 per hour. Dental hygienists typically need an associates degree and a license, according to HeyTutor.

Nuclear medicine technologists make a median annual wage of $77,000, or a median hourly wage of $37 per hour, HeyTutor reported. They typically need at least an associates degree to do their job.

Speech-language pathologists help people with speech or swallowing disorders and typically work in schools or hospitals, according to HeyTutor. (iStock)

The median annual wage of a speech-language pathologist is $78,000. The median hourly wage for the occupation is $37 per hour, according to HeyTutor. In order to be a speech-language pathologist, a masters degree is typically required.

Genetic counselors -- who help people analyze the risk of genetic disorders by looking at their family medical history -- make a median annual wage of $80,000, or a median hourly wage of $39 per hour. The job typically requires a masters degree, according to HeyTutor.

Radiation therapists treat cancer and other diseases using radiation treatment, according to the BLS. (iStock)

According to HeyTutor, radiation therapists make a median annual wage of $82,000 or a median hourly wage of $40 per hour. In order to be a radiation therapist, an associates degree is typically needed.

Occupational therapists make a median annual wage of $84,000 or a median hourly wage of $41 per hour. A masters degree is typically necessary to be an occupational therapist, according to HeyTutor.

CLICK HERE TO READ MORE ON FOX BUSINESS

Nurse midwives diagnose and coordinate all aspects of the birthing process, either independently or as part of a health care team, according to the BLS. (iStock)

Nurse midwives make a median annual wage of $104,000 or a median hourly wage of $50 per hour, according to HeyTutor. According to the BLS, midwives need a masters degree specializing in nursing.

Nurse practitioners have similar responsibilities as physicians and can even be someones primary care provider, according to HeyTutor. (iStock)

According to HeyTutor, nurse practitioners make a median annual income of $107,000, or a median hourly wage of $51 per hour. The BLS says nurse practitioners need to be registered nurses and have a specialized masters degree.

The median annual wage of a physician assistant is $109,000. The jobs median hourly wage is $52 per hour, according to HeyTutor. PAs require at least a masters degree, the tutoring company said.

Nurse anesthetists give anesthesia to patients undergoing surgery, monitor their vital signs and oversee patient recovery, according to the BLS. (iStock)

Nurse anesthetists make a median annual wage of $168,000, or a median hourly wage of $81 per hour. In order to be a nurse anesthetist, you must have at least a masters degree, a license and a certification. According to HeyTutor, nurse anesthetists also have to take a certification program every four years.

View post:

High-paying health care jobs that don't require medical school - Fox Business


12345...102030...