Wednesday, October 02, 2019

Smart Health on GoLocalProv

Samuels will discuss the role of harm reduction in helping patients with opioid dependency and efforts to get emergency room patients into treatment.

Samuels was a co-author of the publication, A Quality Framework for Emergency Department Treatment of Opioid Use Disorder.

Marshall, whose work at the School of Public Health focuses on substance use epidemiology, serves as an expert adviser on the Governors Overdose Prevention and Intervention Task Force, which meets monthly.

Marshall will provide an update as to how health professionals are working with medical experts in Rhode Island.

About Warren Alpert Medical School

Since granting its first Doctor of Medicine degrees in 1975, the Warren Alpert Medical School has become a national leader in medical education and biomedical research.

By attracting first-class physicians and researchers to Rhode Island over the past four decades, the Medical School and its seven affiliated teaching hospitals have radically improved the state's health care environment, from health care policy to patient care.

"Smart Health" is a GoLocalProv.com segment featuring experts from The Warren Alpert Medical School GoLocal LIVE.

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Brown Alpert Medical School Opioid Experts to Join Smart Health LIVE Wednesday at 4 - GoLocalProv

PEMBROKE PINES, Fla.--(BUSINESS WIRE)--

AUC School of Medicine offers aid to help address Canadas healthcare workforce shortage

With an ongoing doctor shortage in Canada, American University of the Caribbean (AUC) School of Medicine is providing scholarships of approximately $73,000 (CAD) per student for Canadians accepted to the university.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20190930005440/en/

Currently, more than 150 Canadian students attend AUC School of Medicine, the overwhelming majority of whom received scholarships totaling more than four million Canadian dollars. Over the past two decades, the school has helped hundreds of Canadians become practicing physicians, many with the help of scholarships.

Our medical students from Canada, whether they choose to study at our campus in Sint Maarten or at our new campus in the U.K., are important assets to our community at AUC School of Medicine. They take advantage of the opportunities for community engagement, and many take on leadership roles within the student body, said Dr. Heidi Chumley, executive dean of AUC School of Medicine. Many wish to return to Canada to practice and help address crucial healthcare workforce and access issues, such as the doctor shortage.

While 15% of Canadians aged 12 and older dont have a regular healthcare provider1, the problem is much worse in in rural regions, which attract just 10% of the nations doctors.2

The AUC School of Medicine Canadian scholarship is available to incoming Canadian students who qualify, and is renewable each semester when the student maintains good academic standing. To learn more visit: aucmed.edu.

About American University of the Caribbean School of Medicine

American University of the Caribbean School of Medicine (AUC School of Medicine) is an institution of Adtalem Global Education (ATGE), a global education provider headquartered in the United States. AUC School of Medicines mission is to train tomorrows physicians, whose service to their communities and their patients is enhanced by international learning experiences, a diverse learning community, and an emphasis on social accountability and engagement. Founded in 1978, AUC School of Medicine has more than 7,000 graduates, many of whom work in primary care or underserved areas. Dedicated to developing physicians with a lifelong commitment to patient-centered care, AUC School of Medicine embraces collaboration, inclusion and community service. With a campus in Sint Maarten, affiliated teaching hospitals in the United States and the United Kingdom, and internationally recognized faculty, AUC School of Medicine has a diverse medical education program for todays globally minded physician. For more information visit aucmed.edu, follow AUC School of Medicine on Twitter (@aucmed), Instagram (@aucmed_edu) and Facebook (@aucmed).

About Adtalem Global Education

The purpose of Adtalem Global Education is to empower students to achieve their goals, find success and make inspiring contributions to our global community. Adtalem Global Education Inc. (NYSE: ATGE; member S&P MidCap 400 Index) is a leading workforce solutions provider and the parent organization of Adtalem Educacional do Brasil (IBMEC, Damsio and Wyden institutions), American University of the Caribbean School of Medicine, Association of Certified Anti-Money Laundering Specialists, Becker Professional Education, Chamberlain University, EduPristine, OnCourse Learning, Ross University School of Medicine and Ross University School of Veterinary Medicine. For more information, please visit adtalem.com and follow us on Twitter (@adtalemglobal) and LinkedIn.

1 Statistics Canada, 2018 Data 2 Review of family medicine within rural and remote Canada: education, practice, and policy, 2016.

View source version on businesswire.com: https://www.businesswire.com/news/home/20190930005440/en/

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American University of the Caribbean School of Medicine Offers Medical School Scholarships to Canadians - Yahoo Finance

A student from Oakland University William Beaumont School of Medicine has been named 2019 Michigan College of Emergency Physicians (MCEP) Outstanding Medical Student of the Year.

M4 Amanda Amen is set to receive the award Dec. 4.

According to MCEP, the award annually recognizes an outstanding medical student from a Michigan medical school who demonstrates excellence in his/her studies and displays a genuine enthusiasm for pursuing a career in emergency medicine.

I feel really proud to have this recognition, and incredibly grateful, Amen said. Im really excited to represent OUWB in this way.

Amen is from Dearborn, Michigan. She attended Dearborn High School before earning her undergraduate degree from Washington University in St. Louis, Missouri.

Amen said she was drawn to OUWB because of what she called a sense of community early on.

During my Interview Day, I could tell community was a primary focus, she said. That was something I was really looking for in a medical school.

Once at OUWB, Amen said she considered many different specialties.She decided to go into emergency medicine for numerous reasons, including mentors who heavily influenced her in their respective approaches to the profession.

Theyre not just role models for the kind of doctor I want to be, but for the kind of person I want to be, she said.

Also, Amen said she loves that in emergency medicine youre taking care of people from all walks of life.

Its a really versatile specialty that I think puts you in a position to really impact your community, Amen said.

A member of MCEP for three years, Amen said the organization is incredible for what it does for medical students in the state of Michigan. Among other things, MCEP has a Medical Student Council (MSC) and hosts a medical student forum at a winter symposium.

Theyre very involved in trying to support medical students and Im very proud to have been involved in it, she said.

According to Belinda Chandler, executive director, MCEP, nominees for the Outstanding Medical Student of the Year must be current members of MCEP, the national American College of Emergency Physicians (ACEP) as well as the Emergency Medicine Residents Association (EMRA); enrolled and in good standing as student at an accredited school or college of medicine in Michigan; with an intent to pursue graduate medical education in an emergency medicine (or EM-combined) residency program.

Additionally, the recipient will have exemplified leadership and service to medical organizations, humanism/professionalism, scholarly achievement, community service and research/publications.

Chandler said Amen was nominated by Jacob Manteuffel, M.D., emergency health physician, Henry Ford Health System, and a past president of MCEP who works closely with the organizations student council.

Amen served as the chair of the MSC in the last academic year. She has been a leader within the MSC since her first year as a medical student, and has served as vice chair.

Amanda put in countless hours over the last two years, with each year culminating with our Medical Student Forum at the MCEP Winter Symposium, said Manteuffel. Strong leadership is essential to the continuity of the council and Amanda was heavily involved to make the Medical Student Forum a great success.

Amen gave a lot of credit for the nomination and award to those who have helped her develop, including my mentors and family.

In addition to Manteuffel, two others mentors shesaid were important to her were Michael Gratson, M.D., instructor, Department of Emergency Medicine, and Bradford Walters, M.D., associate professor, Department of Emergency Medicine.

David M. Thomas, Ph.D., interim associate dean for Pre-Clinical Medical Education, andassociate professor, Department of Foundational Medical Studies, said Amen embodies all we hope to foster in our students.

She has wonderful medical knowledge, and she has the kindness, caring, and compassion that we hope to see in our graduates," Thomas said.

Thomas said he could tell early on that Amen was going to find success at OUWB. He said within the first few weeks of school she was, among other things, "very attentive, and very engaged."

"It was clear that she was on her way to where she is now," Thomas said.

In addition to being presented with the MCEP award Dec. 4, Amen is set to be inducted into the Alpha Omega Alpha Honor Medical Society along with 19 other classmates on Oct. 22 at Meadow Brook Hall.

Thomas said he is confident Amen will find success when she graduates from OUWB.

"To have the medical knowledge in conjunction with the softer skills we try to nurture...she's a complete physician and she'll be whatever she aspires to be, in my view," he said.

For more information, contact Andrew Dietderich, marketing writer, OUWB, atadietderich@oakland.edu.

Follow OUWB on Facebook, Twitter, and Instagram.

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Emergency physicians group names OUWB student 'Outstanding Medical Student of the Year' - News at OU

Whats the news:A recently published survey finds that about one in four hospitals and one in six physician practices screen their patients for socialconditions thataffecthealth,such asfoodaccess, housingstability, utilityand transportationneeds,and interpersonal violence.

Results of the cross-sectional survey of 2,300-plus physician practices and nearly 800 hospitalswere published inJAMA Network Open, and they highlight barriers to discovering the factors outside the exam room or hospital wall that can affect health or interfere with patients engagement in their clinical care.

Why it matters for patients and physicians:Unmet social needs have a significant impact on a persons health, affect patients access to care and hinder their ability to adhere to treatment plans.

The AMA recognizes the importanceof addressingsocial conditions thataffecthealth, and a recently announcedcollaboration between the AMA and UnitedHealthcarewill work tostandardizedata collection on SDOH to help address individuals unique needs.

The two organizations are supporting the creation of 23 newICD-10 codesrelated to social determinants. ICD-10 codes are typically used to record diagnosis, symptoms and procedures. Social factors that the new codes would capture include:

We are clear that 80% of what creates health happens outside of the doctors office, therefore it is critical that physicians know and can be responsive to the full context of patientslives to ensure optimal health outcomes,Aletha Maybank, MD, MPH, theAMAs chief health equity officer, said in an interview.

Whats next:The AMA has adopted forward-looking policy along several dimensions of healths social determinants to address the implications for tomorrows doctors, payment and healthinformation technology.

In medical education, theAMA supports:

The AMA alsosupports payment reform policy proposalsthatencourage screening for socialservice needsand referral to community support systems.

And the AMA is urgingEHR vendors to adopt SDOH templatesthat arecreated with input fromthe Association, medical specialty societies and others with expertise in socialdeterminantsof health metrics and development.

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How to improve screening for social determinants of health - American Medical Association

NEW MEDICAL EDUCATION CENTER There was a special ceremony that took place yesterday in Shreveport as officials from LSU Health and Ochsner LSU Health Shreveport were joined by state and local officials for the groundbreaking of the new Center for Medical Education. The new 5-story facility to be located on the south side of LSU Health Shreveports campus and will expand the LSU Health Shreveport medical school class size to 200 students by 2023. Among those who spoke briefly at the ceremony was Shreveport Mayor Adrian Perkins.

"Healthcare is the leading industry of our area and Shreveport is the healthcare center hub of the Arklatex,"said Perkins."This new center of medical education is a welcome and much needed addition to

our healthcare corridor."

The Center for Medical Education is a $60 million public-private capital project which Governor John Bel Edwards said is part of a huge investment for improving Healthcare in Louisiana.

"And when you take this $60 million dollar investment and you put it with the $40 million in the Saint Mary's facility, that means we have $100 million invested in this medical school right now," explained Edwards. "That is just so far removed from the reality that we faced just a few years ago that I just can't help but be excited about the future of our great state and this medical school."

The ceremony also marked the first year anniversary of the partnership between Ochsner Health and LSU Health Shreveport. A year ago the public-private partnership between Ochsner Health System and LSU Health Shreveport was formed to oversee and coordinate activities between the health sciences center and the healthcare delivery system in Shreveport and Monroe, La.

NEW MEDICAL EDUCATION CENTER There was a special ceremony that took place yesterday in Shreveport as officials from LSU Health and Ochsner LSU Health Shreveport were joined by state and local officials for the groundbreaking of the new Center for Medical Education.

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New Center For Medical Education Breaks Ground In Shreveport - Red River Radio

(WBAY) -

You may have heard the buzz surrounding "integrative medicine," but do you know what it means? Local doctor Lynn Wagner defines it as the bridge between traditional and alternative medicine. Dr. Wagner believes it can improve the physical and mental health of people who incorporate it into their own health care. Dr. Wagner is a BayCare Clinic M.D. and Urgent Care physician who has made integrative medicine part of the care she provides.

Dr. Lynn Wagner decided to pursue medicine when she was an undergrad at University of Minnesota. She went to medical school at the Medical College of Wisconsin and completed her residency in California. Dr. Wagner determined that she wanted to pursue emergency room medicine because she liked the variety and pace of providing treatment.

When Dr. Wagner personally dealt with post-partum depression after the birth of her daughter, she sought out other non-traditional healing methods. Practices like energy healing, meditation, yoga and changing her diet made her feel better. When Dr. Wagner realized it could do the same for her patients, her integrative medical practice grew.

Here I am working in the E.R., and I have these patients coming in, and they are on 10-15 different prescription medications. They are miserable, theyre in pain, theyre lonely, and no one is telling them there is a better way. So I had to do something else.

Dr. Wagner says prescription medications do have a place in her practice, but its also important to her to find out the cause a physical or mental ailment while they are treating the symptom.

In our Get 2 the Point podcast, hear more from Dr. Lynn Wagner about the ways that integrative medicine is becoming part of traditional health care and learn more about integrative lifestyle medicine at BayCare Clinic at http://www.lynnkwagner.com.

Listen on your favorite podcast apps and sites:

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Get 2 the Point: Integrative Medicine - WBAY

Cadavers have been a "cornerstone" of medical education for centuries, but cost concerns and clinical limitations are leading some medical schools to stop using cadavers and instead uses virtual reality (VR), Bahar Gholipour reports for Scientific American.

Innovation 101: Cheat sheets for today's digital world

Training with cadavers has been regarded as essential to western medical education for nearly a millennium, Gholipour reports. Frederick II, the Holy Roman Emperor who ruled over much of Europe, in the 13th century issued a decree that schools that trained doctors must hold a dissection with a cadaver every five years.

But while the practice has endured for centuries, it's not without its limitations, one of which is the cost. Cadavers can be expensive to keep at a medical school, Gholipour reports. They require a cadaver laboratory, which can cost millions of dollars.

And while cadavers are donated, medical schools bear the cost of preparing the bodies and maintaining them and later burying them, Gholipour reports.

The cadavers can also be difficult to obtain, according to a 2018 study, as many countries face a shortage of cadaver donations and often must rely on unclaimed bodies for dissection, Gholipour reports.

Along with potentially prohibitive costs, cadavers come with clinical limitations, Gholipour writes. For instance, a dissection is time consuming, and in some instances, body parts can be so hard to reach that they're destroyed during dissection.

The insides of cadavers also don't look exactly like the insides of live human beings, Gholipour reports.

James Young, chief academic officer of the Cleveland Clinic Lerner College of Medicine noted that he experienced a "massive disconnect" between his anatomy education in the 1970s and what he saw during his clinical training in cardiology. "They're totally different," Young said. "The embalmed cadaver has a very flat, compressed organ presentation. The colors are not the vibrant colors of a living human." That difference can distract from learning, Young said.

That's why some schools, like Young's Lerner College, are going "cadaverless," and instead, are relying on virtual anatomy tools, Gholipour reports.

These tools, like VR headsets or augmented-reality goggles, provide students with a more realistic view of living organs, and students are able to examine the organs from every angle, Gholipour reports. They can even select views that add different organs to the circulatory and nervous systems to see how structures are related.

Mark Schuster, dean of Kaiser Permanente School of Medicine, said he "was amazed" by the tools. "I wished I had that when I'd been learning anatomy," he said. "It really helped make it all come together." Kaiser, which will host its first class in 2020, will have a cadaverless curriculum for its first-year students.

However, virtual anatomy tools are not without their drawbacks, Gholipour reports. For example, it can be difficult to develop a depth perception of a virtual body, and students won't be able to see the natural anatomical variations that occur in bodies, according to Darren Hoffman, an assistant professor of anatomy and cell biology at the University of Iowa Carver College of Medicine.

Students also won't have the emotional and potentially philosophical impact of working with an actual body, Gholipour reports. "There's a sort of awe and respect that comes from that," Hoffman said. "You recognize how amazingly cool and intricate the human body is, and you start to realize that everybody on the planet is this amazingand so am I."

There's also the question of how well students learn with digital tools, Gholipour reports. Educators are currently studying whether replacing older techniques with new technology actually improves education rather than harms it.

Still, educators like Young see a significant shift happening. "We're at the beginning of a paradigm shift, no question about that," Young said. "That shift is going to take several years. But if you asked me how is anatomy education going to be done in a decade? It's not going to be done with cadavers. That's my prediction" (Gholipour, Scientific American, October 2019).

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Will cadavers in medical school soon be a thing of the past? - The Daily Briefing

Omar Sahak failed his first college biology class. The second time, he got a C. And by the end of college, he was pretty sure medicine was a failed dream. But thanks to a few people who believed in him, he eventually did get that MD -- along with a master's degree in public health -- and he's now a second-year resident in psychiatry at Stanford.

Sahak shared his story with me:

Where did you grow up?

I lived in Flushing, Queens until I was about 10 years old. My parents had escaped Afghanistan, and they had one friend in New York. Everybody was an immigrant in our neighborhood. My dad got a coffee truck and sold coffee and bagels on the street from 2 a.m. to 2 p.m. Then we moved to California -- Marin County -- and I totally stood out. That was uncomfortable.

When did you get interested in science and medicine?

When I was a kid, I loved memorizing things because I could do it really quickly. I remember being excited to read that the sun was 93 million miles from the earth.

By the end of high school, my intuition was to study film, but I wanted to do something that helped other people. I listened to my family and my parents, who told me I could study science and have a good career. My mom was a nurse and one of my aunts was a pharmacist, and they said medicine could be a good fit for me.

Ultimately, they were right, but when I tried to actually do pre-med at the University of California, Santa Cruz, I didn't know how to study or ask for help. I was trudging through the mud in my science classes, getting an F and then taking it again and getting a C. My guidance counselor told me, "You're never going to get into medical school." He saw me as a failure.

By the time I was a senior, I was getting B's and A's in my science classes, but I didn't have the GPA to apply to medical school.

So how did you get in?

After graduation, I was doing community organizing work for a nonprofit in Sacramento, and doing really well. My boss, who was always looking out for me, gave me a flyer for a master's of public health distance-learning program at San Jose State University. The director looked at my college transcript and said, "It looks like when you wanted to do well, you did well." I thought, here was this man really seeing me.

I never worked that hard in my life. I was working full-time and writing these papers I didn't feel qualified to write. I would spend hours and hours writing one page, but after each paper, I kept getting better. It was very validating. I got straight A's. I left that program with a totally different brain and attitude. I felt like I could do anything I want -- I just had to figure out what I want to do.

So then I thought about medicine again. I knew in my bones I could be a really good doctor.

I had done a ton of volunteer work and public health policy work, but I had to prove myself academically. I enrolled in an organic chemistry class -- which I had failed many times -- and for the first time, it made sense. I took one class after another and was getting A's and finally finding mentors.

I was accepted at University of California, Davis, where my mom was a nurse. The year I graduated was the year she retired. It was kind of like passing a baton.

Why did you choose your specialty, psychiatry?

Psychiatry brought together a lot of interests I had. I naturally think about people's inner worlds and how their life experiences affect them.I could see myself being motivated over decades to go to work.

What do you do for fun?

What I really like is unstructured time. Once the weight of expectation comes off, other things start to come up --like general musings about life and what I'm seeing around me. Medical school gave me so much to think about and worry about, so when I have unstructured time, I take it.

Where do you see yourself in the future?

I'd like to go to an urban, underserved area that's associated with an academic center, where I can live in that community and also serve as an advocate for it. I want kids coming home from school to be like, "Hey Doc," and come up to me and ask me for help.

Photo by Daphne Sashin

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In the Spotlight: 'You're never going to get into medical school' - Scope

Photo by Wikimedia | The Daily Targum

Located on the second floor of the Robert Wood Johnson Medical School Research Building on Busch campus, the institute oversees more than 270 neuroscience labs at Rutgers

The Rutgers Brain Health Institute was formed five years ago under the guidance of director Dr. Gary Aston-Jones. Since then, Aston-Jones has been creating centers for neuroscience research and investing in both talent and technology under the institutes umbrella.

Located on the second floor of the Robert Wood Johnson Medical School Research Building on Busch campus, the institute oversees more than 270 neuroscience labs at Rutgers, Aston-Jones said.

The institute was formed a year after the consolidation of UMDNJ (University of Medicine and Dentistry of New Jersey) and Rutgers, which created a very large neuroscience environment, he said. Two medical schools, two psychology departments, two biology departments its a lot.

During the consolidation, Robin Davis, a professor in the Department of Cell Biology and Neuroscience, and Teri Wood, a professor in the Department Of Pharmacology, Physiology and Neuroscience, started connecting the neuroscience landscape at the University.

I took off of where they had started and created the Brain Health Institute, Aston-Jones said.

His first year as director was spent talking to senior leaders in Rutgers neuroscience to identify four areas of strength that could be further developed: neurodevelopment, neurodegeneration, motivational and affective neuroscience and cognitive and sensory neuroscience, Aston-Jones said.

What I'm doing to develop each of those areas is creating centers in each area and hiring directors for the centers, he said. Then those directors for the centers will grow and recruit other faculty.

Within the neurodegeneration focus area, The Rutgers Brain Health Institute has already started an Alzheimers disease research center based in Newark. The center is searching for a director, Aston-Jones said.

All of it is supported by philanthropy from Herbert Klein and his wife Jacqueline, who had Alzheimer's disease. He was a Rutgers graduate, so he's been very generous with us and that's allowed us to put that research center together, he said.

The Rutgers Brain Health Institute also collaborated with Princeton University to create the Center for Cognitive Computational Neuropsychiatry (CCNP). Addressing the focus area of cognitive and sensory neuroscience, this center is funded by both universities and is based at Rutgers.

It's a space in the basement of the research tower. It's basically three behavioral testing rooms where patients with different disorders are tested with a computer task that investigators design with a particular disorder in mind, Aston-Jones said. Its a way of probing cognitive abilities and disabilities in people that have depression or addiction or OCD (Obsessive Compulsive Disorder), or any number of neuropsychiatric disorders.

Within the next few years, two more centers will be created to address the motivational and affective neuroscience and neurodevelopment focus areas. For example, the institute is currently recruiting faculty for a new addiction research center.

Chris Pierce from the University of Pennsylvania will join us in January and weve got a couple other recruitments in mind. We are right now searching for a director for that center I actually just got off the phone with a candidate for that, Aston-Jones said.

In neurodevelopment, the center will also be opening an autism research center on Easton Avenue. The Rutgers University Center for Autism Research, Education and Service (RUCARES) will be separate from the New Jersey Center of Autism Excellence (NJACE), which is a state-funded research initiative, Aston-Jones said

That will be directed by Wayne Fisher who will come in December. His colleague Brian Grier is already here he arrived a couple of weeks ago. This center is a collaboration with Children's Specialized Hospital. It has a lot of autism patients, more than Rutgers. It's a great collaboration, he said.

In addition to these centers, the Rutgers Brain Health Institute coordinates animal and human preclinical work, Aston-Jones said. Beyond preclinical work, the institute aims to include clinical research and clinical trials.

I named the effort the Brain Health Institute because I wanted to emphasize the importance of translational approaches. Everything we do has some clinical goal in mind, he said. All the basic research is basic research, but it has some clinical, therapeutic endpoint.

The rapid growth of the Rutgers Brain Health Institute is in part due to the consolidation between UMDNJ and Rutgers as well as Rutgers recent partnership with RWJBarnabas Health, Aston-Jones said.

In a way, we were very fortunate to already have in the process a lot of recruiting and center development. Now this new support comes along to further support that effort that already had a lot of momentum. So, it'll keep going even faster, he said.

Please note All comments are eligible for publication in The Daily Targum.

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Rutgers' Brain Health Institute continues to expand its research capabilities - RU Daily Targum

There is a great deal of institutional interest among health professions students in joining global health programs, with more than 25% having participated during their training. Health professions schools offer global health immersion learning opportunities in poor countries, which reinforces a students sense of calling while also fostering cross-cultural sensitivity. However, when programs rely on short-term fixes to long-standing infrastructure and resource deficits, some of the worlds most vulnerable, poor patients can be exploited.

The September issue of theAMA Journal of Ethics(@JournalofEthics) features numerous perspectives on ethics of global health immersion in health professions education and gives you an opportunity to earn CME credit.

Articles include:

Who Is Served Best by Health Professions Service Learning Trips?If not planned and executed thoughtfully, immersions might not provide much benefit to communities they seek to serve.

How Should We Decide Whether and When Some Care Is Better Than No Care?Single-procedure interventions with minimal follow-up and clear quality-of-life gain are well suited for surgical mission trips. But not all risks and benefits are easily assessed.

Facilitating Critical Self-Exploration by Global Health Students. Awareness of ones own interests is critical to successfully engaging in global health immersions.

How Should Schools Respond to Learners Demands for Global Health Training? In the past decade, more students than ever entered medical school with the desire, if not the expectation, of participating in meaningful global health experiences.

In the journals September podcast, experts from Concern AmericaExecutive Director John Straw and Field Program Director Cat Quinndiscuss how global health outreach programs can be both sustainable and educational. Listen to previous episodes of the podcast, Ethics Talk, or subscribe in iTunes or other services.

TheAMA Journal of EthicsCME module, How the Social Contract Can Frame International Electives isdesignated by the AMA for a maximum of1AMA PRA Category 1 Credit.

The module is part of theAMA EdHub, anonline platformthat brings togetherhigh-qualityCME, maintenance of certification,and educational contentinone placewithrelevant learningactivities,automated credit tracking and reporting forsome states and specialty boards.

Learn more aboutAMA CME accreditation.

The journals editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians.Submit a manuscriptfor publication. The journal alsoinvitesoriginal photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The AMA Journal of Ethics John Conley Art of Medicine Contest and John John Conley Ethics Essay Contest for U.S.-based medical students, residents, and fellows are now open.

Upcoming issues of theAMA Journal of Ethicswill focus on insights on value and values from decision science for clinical ethics, and ethics of assessing quality of life in reconstructive transplantation.Sign upto receive email alerts when new issues are published.

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Global health programs in medical school: Who benefits? - American Medical Association

About a decade from now, public health statistics will begin to show a substantial decrease in cervical cancer in the United States and other developed countries. Thats because in 2006, young people began receiving vaccines against a sexually transmitted virus, HPV, that causes cervical cancer. By preventing HPV infections today, those vaccines have the potential to avert hundreds of thousands of cervical cancer cases.

The HPV vaccine exists because Dr. Douglas Lowy, a physician, and his research collaborator Dr. John Schiller recognized the potential for it after more than a decade studying the family of infectious agents to which HPV belongs.

Unfortunately, Dr. Lowys career transition from stethoscope to microscope might not be as feasible today as it was a few decades ago. The number of physicians able to engage in scientific research either alongside a medical career or after medical training has waned greatly. Physician education in medical school has shifted away from basic science. In addition, federal funding has declined. After adjusting for inflation, the 2013 N.I.H. budget was 21.9 percent below its 2003 level. These and other trends have driven the proportion of medical doctors engaged in scientific research to a paltry 1.5 percent of the physician work force.

Time and again, physician-scientists have changed the history of medicine by identifying a problem in the clinic and taking to the lab to address it. Alexander Fleming watched men die of sepsis during World War I while serving in the Royal Army Medical Corps, then returned home to create penicillin. Sidney Farber, a young physician at Childrens Hospital in Boston, committed himself to finding treatments for childhood leukemia, and laid the foundation for modern cancer chemotherapy.

In the 1970s, the physicians Michael Brown and Joseph Goldstein set out to understand how a young childs arteries could be as clogged as those of an overweight septuagenarian. This patient-inspired research led to the discovery of LDL-cholesterol receptors, and paved the way for the statin drugs that are taken by millions of people every year in the United States alone.

And more recently, the research efforts of two physicians, Brian Kobilka and one of us, Dr. Lefkowitz, seeking to understand how hormones conferred their biological effects, led to the discovery of a large family of receptors that have formed the basis for the development of hundreds of F.D.A.-approved medications.

The biomedical research establishment has long recognized the importance of clinical experience to medical research. In the 1950s and 1960s, during the Korean and Vietnam Wars, physicians were conscripted within a few years of their medical school graduation. Of those young physicians commissioned as officers in the United States Public Health Service, a small fraction was posted to the N.I.H., where they cared for patients and also learned to perform laboratory research.

This program essentially trained an entire generation of medical professors, and its graduates went on to engage in research that has produced major insights into cancer, infections and heart disease, forming the basis for lifesaving therapies. Indeed, physician-scientists account for 37 percent of Nobel Prizes in Physiology or Medicine.

Of course, medical doctors are not the only people who can make great medical discoveries. The discoverers of the structure of DNA and the developers of CT scans had no medical background. But there could not be a worse moment than now to allow the vital role of physician-scientists to disappear. Trends like an aging global population and the resurgence of infectious disease have increased the need for medical advances.

Meanwhile, science is becoming more relevant to medical practice with the emergence of innovations like precision medicine, which requires a detailed understanding of disease mechanisms and genetic data in order to determine the best treatment for each individual patient. More than ever, we need doctors who are competent at both the lab bench and the hospital bedside.

Unfortunately, the career path of the physician-scientist has become longer and a lot less appealing. In the United States, about 20,000 graduates emerge from medical school each year, many with significant debt. Many physicians are well into their 30s by the time they complete their clinical training. Doctors who decide to take the research path face the daunting prospect of many more years struggling to win grants and establish a lab. According to N.I.H. statistics, researchers with medical degrees on average receive their first major N.I.H. grant only at age 45.

Recognizing the problem, the National Institutes of Healths Physician-Scientist Workforce report, published in 2014, laid out a road map to address it. Nonetheless, the number of young doctors pursuing research continues to wane.

In response, six physician-scientists from across the country have formed a nonprofit organization, the Physician-Scientist Support Foundation, to raise funds to support the research efforts of talented young medical students and physicians. The foundation aims to mentor and inspire new doctors to undertake research programs to solve unmet medical needs.

Physician-scientists are among the most highly trained investigators in the research enterprise. Their efforts will be crucial to improving health care. Our world needs a growing, corps of professionals who bring a human understanding of patients to medical research, and a researchers expertise to improving patients lives.

We need to ensure that the brightest young doctors can contribute to further advancements in their field, or we risk stalling the engine that consistently delivers better medicine, longer lives and a stronger economy for Americans and people around the world.

Mukesh K. Jain is a cardiologist at University Hospitals and a professor at Case Western Reserves medical school. Tadataka Yamada formerly served as president of global health programs at the Bill & Melinda Gates Foundation and oversaw research and development at Takeda Pharmaceuticals. Robert Lefkowitz is a professor at Duke Universitys medical school who won the Nobel Prize in Chemistry in 2012. They are board members of the Physician-Scientist Support Foundation.

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We Need More Doctors Who Are Scientists - The New York Times

The presidents of the School of Law, Miller School of Medicine, and Graduate School student associations share their insights on the future of their organizations.

Each of them is impacting the University of Miami.

Now, Alvaro Ruiz Emparanza, Octavious Buiey Jr., and Leah Colucci want to serve their constituents this academic year as president of the Graduate School, School of Law, and the Leonard M. Miller School of Medicine student associations, respectively.

The three serve as a liaison between the administration and the students they represent. From surgery rotations, to working at a criminal defense law firm, to conducting civil engineering research, they juggle all of this while maintaining their individual responsibilities with a similar mission: to increase graduate student involvement at the University.

Meet the graduate student leaders:

Buiey has been a voice for others since middle school when he was a member of his student government cabinet. Now a third-year law student, the North Florida native is passionate about making changes for all.

As Buiey stepped into his new role, one of his main priorities is creating a student government that is focused on action. He is also focused on creating a space for happy and successful lawyers as mental health awareness was at the forefront of his campaign platform.

We wanted to create an avenue for all students to be involved, said Buiey, an aspiring criminal defense lawyer. We recently passed some constitutional amendments that have been in the works for years.

One of those amendments is the creation of a transfer student seat on the senate.

We have some transfer students and they are often times kind of forgotten. And we wanted to make their concerns heard, said Buiey. So, now as opposed to running against other 1Ls, 2Ls, or 3Ls, they now run against other transfer students. Thats big.

Buiey is also focused on facilities for students in the School of Law. He recently met with Anthony E. Varona, the new dean of the School of Law. The two are working toward bringing a state-of-the-art courtroom into the School, to create a more authentic experience for future litigators to hone their skills.

I think its a beautiful campus, but our space is a little outdated, said Buiey. One of the things we talk about is how can we update the law school to get it to match the quality of our law students.

This year, Buiey also has plans to introduce the Toppel Career Centers Sebastians Closet program, a free business professional clothing rental service for students to use for their interviews, to the School.

When he came to the University as a civil engineering Ph.D. candidate, Ruiz Emparanza didnt anticipate being as heavily involved in leadership as he isbut as his academic career advanced, so did his involvement.

Compared to Europe, a lot of importance is placed on leadership, said Ruiz Emparanza, a native of Legazpi, a little town in the Basque region of Spain, who first became involved with student government as a senator. I have been heavily involved in the Graduate Student Association (GSA), Engineering Student Council and the UM American Concrete Institute student chapter, being the president of each of them at a certain point during my academic career at UM. Other leadership roles include being the Engineering Student ambassador, Graduate Student Representative and voting member at the Graduate Council.

In his role as the president of GSA, interacting with other students within the Graduate School is a priority for Ruiz Emparanza. On Sept. 7, he led efforts to host the GSA Kick Off Cruise, a networking event on a luxurious cruise around Miami for 300 graduate students.

You dont know who youre going to meet while at one of our networking events, said Ruiz Emparanza. Im trying to bring the idea that life is not only work. Its about meeting people and being connected to others, its not just you and your advisor.

Other important issues to Ruiz Emparanza are environmental awareness, political awareness, sharing research, and bridging a gap between the undergraduate and graduate community.

I am passionate about the environment, said Ruiz Emparanza, who as a child would get in trouble with his parents if he were caught not recycling. Within GSA we are also planning beach clean-ups and are also collaborating with the City of Coral Gables to do a street clean up.

Ruiz Emparanza will join forces with the undergraduate student government executives on a Homecoming event to bring undergraduates, graduates, and alumni together.

I am trying to do more with them because we believe that we could benefit from each other, he said. They bring the energy and youthfulness, and we can serve as mentors.

As his studies and campus involvement at UM progresses, Ruiz Emparanza credits time management as a major key to his success. When Ruiz Emparanza isnt meeting with the administration on ways to better life for graduate students across all disciplines, he is searching for various solutions to extend the service life of infrastructures by using alternative reinforcing materials, such as composites, under the guidance of his advisors Antonio Nanni and Francisco De Caso from the Department of Civil, Architectural and Environmental engineering.

As Ruiz Emperanzas final year comes to an end, he hopes to leave GSA better than he found it. He recently began to establish the groundwork for a public speaking academy for graduate students.

Public speaking is a big part of research, Ruiz Emparanza said. Training students how to break down their research for people outside of your research to understand is important and necessary.

Third year medical student Leah Colucci said she was destined to be a Cane. In 2017, she earned a bachelors degree in neuroscience and marine science, and by 2021 she will be a triple alumna when she earns her masters degree in genomic medicine in addition to a medical degree.

My mom was a huge fan of UM and would bring me to campus and take me to football games when I was a kid, said Colucci, who also serves as student trustee on the Universitys Board of Trustees. Her passion for UM and all it has to offer is evident to her peers and others.

I am passionate about the opportunities of medical students as a whole, said Colucci, a member of the Miller Mentor program, a collaboration between undergraduate and graduate students and the Miller School of Medicine that connects motivated premedical students with a medical student mentor.

Theres all these students coming from different places so they didnt have the same connection to the University that I had. In this role I was tasked with showing them all the different resources that we have to offer.

Coluccis friends encouraged her to run for president of the Miller School of Medicine Student Government. Her peers and Dr. Hilit Mechaber, the associate dean for student services, felt she was the perfect candidate for the role.

This semester, Colucci is working on a big task that will impact future generations of medical students at the Miller School of Medicine.

One huge thing that is at the forefront of my mind and other students minds is radically changing our curriculum, said Colucci. I have been helping faculty by giving a lot of feedback. We are a top 50 medical school and we want to stay a top 50 medical school.

Coluccis people-oriented attitude and enthusiasm make her an ideal person for the job. She is constantly making sure students are aware of new and existing resources not just on the medical campus, but at the University.

As president, Im trying to connect our medical students to campus life so that they dont feel like theyre just here to work and they dont really become a part of the UM community, she said. Its really sad when I come across a friend who is depressed, so we are constantly trying to update our wellness efforts as well.

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Graduate student leaders focused on change - University of Miami

Even with recent efforts to increase diversity among physicians, there is a deficiency in black, Hispanic, and American Indian or Alaskan Native representation in medical school matriculants, according to a recent article published in JAMA Network Open.

The authors of this study examined the demographic trends in medical school classes to assess the progress of new diversity accreditation guidelines set in 2009 by the Liaison Committee on Medical Education. These guidelines were made in an effort to diversify the physician workforce and were specifically centered on racial and ethnic groups that are underrepresented in medicine. Using data on US allopathic medical school applicants and matriculants from 2002 to 2017 as well as total enrollment by state from 2017 to 2018, the authors compared trends in the proportions of race/ethnic groups and sex within the student body and with respect to US and local populations of a similar age. The data used were publicly available from the Association of American Medical Colleges.

Using representation quotients (RQ), the authors compared the makeup of racial/ethnic subgroups of medical students to the corresponding makeup of that racial/ethnic among the US population and in the corresponding states participants lived in. The results show that both the number of applicants and matriculants increased from 2002 to 2017 by 53.6% and 29.3%, respectively. In addition, the proportion of matriculants from most underrepresented race/ethnic groups (men and women who are black, Hispanic, and Native Hawaiian or Other Pacific Islander) increased, but their RQs were still considered to be underrepresented (RQ<1) among medical school matriculants. There was a decrease in the proportion of white men and women matriculants; however, white men still follow the trend of overrepresentation among medical school matriculants (RQ>1). Furthermore, the authors found that the proportion of Asian matriculants has increased for both sexes, and that both sexes have been consistently overrepresented (RQ>3) among medical school matriculants. On a state level, underrepresentation was still found in all race/ethnic groups, except for those who identify as white or Asian.

Study limitations include the fact that data collection methods changed in 2012, which may have resulted in inconsistent race/ethnicity categories. Furthermore, the data set was limited by categories set by researchers. This study also did not include contributions to healthcare by professionals without an MD degree.

The authors of this study concluded that there is a persistently deficient representation of black, Hispanic, and [American Indian or Alaskan Native] medical students, and that most states do not train physicians who are demographically representative of the surrounding population. As a response to their findings, the authors call for more effective policies to improve representation to create high-quality, high-value, culturally effective care.

Reference

Lett LA, Murdock HM, Orji WU, Aysola J, Sebro R. Trends in racial/ethnic representation among US medical students [published online September 4, 2019]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.10490

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Changes in Racial/Ethnic Representation in US Medical School Matriculants - Medical Bag

Encouraging a wider participation in medicine, these institutions hope to plug the shortage of GPs, says Catherine Lally

Five new medical schools are opening in England, offering more opportunities for young people to study medicine. As well as addressing a shortage of NHS doctors, it is hoped that these schools will boost the numbers from disadvantaged backgrounds entering the profession. The middle class has long had a stranglehold on medicine, and demands for applicants to have extensive work experience is not helping it to diversify.

Several of the new medical schools are in areas with significant GP vacancies and the hope is that a proportion of qualified doctors will remain in the area.

Our philosophy is built around deconstructing the barriers that prevent students from accessing medicine, says Professor Scott Wilkes, the head of Sunderlands new medical school, which opens this autumn with

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New medical schools open to disadvantaged pupils | Good University Guide 2020 - The Times

MARQUETTE, Mich. (WLUC) - Like father like son, is a common description we have heard many times but for the Marquette Family Medicine Residency Program, this phrase is verbatim. For the first time in the programs history, a child of an alumnus will follow his fathers footsteps. Michael Piggott, DO, began his first year of residency, following his fathers footsteps, Kevin Piggott, MD, MPH, who completed the program thirty years ago.

For the Piggott family this represents the third generation of physicians. Kevins father (Michaels grandfather) was also a physician. The senior Piggott graduated from the University of Michigan Medical School in 1956 and held an academic appointment at Wayne State University School of Medicine in the Department of Psychiatry. Even with this tradition of physicians, Michael did not feel pressured to pursue medicine.

I dont ever recall a time where our father encouraged us to go into medicine, said Michael, likely because he wanted us to find our own paths.

Michael explained that while his fathers influence extended far beyond the field of medicine, becoming a physician was the only career he ever considered seriously.

Although I allowed myself to explore other subjects and I was able to develop many interests, it seemed that those topics always fell into the category of a hobby and not a profession, he said.

While Michael was indirectly inspired to follow his fathers footsteps through example and actions, his own experiences helped solidify his direction.

What cemented my goal to becoming a physician was when I was finally able to experience the field of medicine, he said, first in high school as I took a health occupations course, and then through volunteer work in hospitals, interactions with patients and experiences with many skilled hospitalists during my undergraduate studies.

When Kevin entered medical school, his path was undecided. The broadness of knowledge needed to practice family medicine was vast -- his first thoughts were to pursue internal medicine with an intent to specialize. But an experience changed his mind.

In my third year I did a family medicine rotation with Dr. Jerry Luoma in Calumet, said Kevin, I saw full spectrum family medicine being practiced competently and compassionately. It changed the trajectory of my career.

After Kevin did an elective in family medicine at the Marquette Family Medicine Residency Program early in his fourth year, he knew that family medicine was for him.

Michael, however, knew immediately that family medicine was the specialty for him. The idea of forming special one-on-one relationships with patients to create an individual approach to their healthcare was appealing.

Being able to sit down with people and listen to their stories, be a part of their team to promote health, and being able to help make a difference, were the biggest draws to medicine for me, he said.

Over the years, Dr. Kevin Piggotts roles in healthcare included being a family physician, an assistant director for the Marquette Family Medicine Residency Program, medical director at the county health department, a hospital administrator and a preceptor for both medical students and resident physicians. He earned his medical degree from Wayne State University School of Medicine in 1986 and held an academic appointment at Michigan State University College of Human Medicine. He completed a fellowship at the University of Michigan and earned a masters degree in public health in 2009. Dr. Kevin Piggott retired from practice in 2016 leaving a fulfilled career.

I most enjoyed my practice in Trenary, it was a small practice in which I could provide a more personalized form of medical care, he said. Although I did not live in the community, I very much felt that I was an integral part of the community and in the lives of the people that entrusted their care to me. I truly felt it was a privilege to be there, it was very fulfilling.

Michael earned a Doctor of Osteopathic Medicine, DO, degree from Michigan State University College of Osteopathic Medicine in 2019. He earned his undergraduate degree at Michigan State University. The legacy of pursuing the same career at the same place as his father has had an impact.

Michael explained:Following in my fathers footsteps and earning a spot in Marquettes Family Medicine Residency is a great milestone in my life for many reasons. Professionally, I get to work with many of the same talented colleagues and friends he got to work with, I get to see many of the same patients that he saw, and in time itll be my goal to be able to provide the same level of care. Personally, I get to carry on the legacy that started when my grandfather first became a physician. The generations of family members before me have gifted me with the responsibility and drive to do my best for others, and it will be my privilege to work hard so that those principles continue-on to the generations after me.

The residency program has embraced this first experience. The strength of the program is evident when a child of an alumnus follows the same path into the Marquette Family Medicine Residency Program. Its rewarding to see the programs roots continue to spread the family tree keeps growing. Faculty and staff at the program look forward for the next child/parent path to reveal itself. Will we see another father/son footprint? Or will it be mother/daughter? Only time will tell. But should the trend continue, it is very fitting to think that continuity of care and values spanning generations of providers has taken root.

The MSU College of Human Medicine Upper Peninsula Region Campus works in conjunction with the UP Health System-Marquette to coordinate the training of family medicine residents and Michigan State University College of Human Medicine medical students. Since its inception in 1974, 298 medical students and 204 resident physicians have graduated from the two programs. Currently, approximately 30 percent of the students who graduated from MSU College of Human Medicine UP Campus and 39 percent of family medicine resident graduates are practicing across the Upper Peninsula Region.

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Family medicine becomes family tradition - UpperMichigansSource.com

LOS ANGELES--(BUSINESS WIRE)--Female high school and medical students interested in pursuing careers in medicine and engineering will receive a boost to their professional aspirations by being part of a very special hands-on program conducted Sept. 27-28 at Orthopaedic Institute for Childrens downtown Los Angeles campus. The event is part of the nationally acclaimed Perry Initiative Outreach Program, which works to inspire young women to be leaders in these fields and to foster their understanding of and appreciation for the career that may lie ahead.

The Medical Student Outreach Program (MSOP) attracts women in their first or second year of medical school who are undecided about specialty choice or have expressed interest in exploring a career in orthopaedics. Approximately 45 participants at the Friday event will hear lectures from local women surgeons, network with industry leaders, and perform hands-on skills modules and mock orthopaedic surgeries.

The following day 40 young women from high schools (grades 10 and above) will attend a one-day program where they hear from women leaders in the fields of medicine and engineering and receive hands-on experience by performing mock orthopaedic surgeries and biomechanics exercises.

Since its founding in 2009, the Perry Initiative Outreach Program has touched more than 10,000 students nationwide; and we are honored to once again be the Los Angeles host site for this prestigious program, said Jennifer Beck, M.D., director of outreach and research at OICs acclaimed Center for Sports Medicine. It is always invigorating to see the excitement on the faces of the attendees, and we hope that this event helps inspire them to pursue these important career paths.

Despite the increasing number of women entering medical and graduate school, a 2018 study from the American Academy of Orthopaedic Surgeons reported that women comprise only 5.8% of all practicing orthopaedic surgeons as compared to 92.2% being male (and 2% not indicating a gender). In the face of these numbers, the Perry Initiative was created in 2009 in honor of Dr. Jacquelin Perry, one of the first female orthopaedic surgeons in the country and a mentor to countless women and men in the field throughout her celebrated career, which spanned from 1952 to 2013.

About Orthopaedic Institute for Children

Orthopaedic Institute for Children was founded in 1911 as Los Angeles Orthopaedic Hospital and today is the largest pediatric orthopaedic facility on the west coast focused solely on musculoskeletal conditions in children. In alliance with UCLA Health and with the support of the OIC Foundation, we advance pediatric orthopaedics worldwide through outstanding patient care, medical education and research. Our locations in downtown Los Angeles, Santa Monica, Westwood and Calexico treat the full spectrum of pediatric orthopaedic disorders and injuries. For more information, visit us at ortho-institute.org.

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Female High School and Medical Students Take Part in Perry Initiative Outreach Program at Orthopaedic Institute for Children - Business Wire

Early on in my clerkship year, I had the opportunity to rotate at the Ob/Gyn residents' clinic at the Hospital of the University of Pennsylvania. The clinic offers low-cost services to members of the Philadelphia community, and yet nearly half of appointments are missed on a daily basis. Speaking with patients who were able to make their appointments, sometimes after several months of missed appointments, I learned that the limiting factors in their healthcare and at times, that of their expected child were logistical difficulties traveling to the clinic, getting out of work, or gathering the funds to hire a babysitter so that they could visit the hospital without having to worry about their children. In other words, the rate-limiting step in these patients' healthcare was not their medical condition but their social and economic condition.

In a recent Wall Street Journal article, a former associate dean at the Perelman School of Medicine at the University of Pennsylvania shared his opinion on the increase in medical school curricula that discuss the social determinants of health, or the conditions in which an individual is born, grows, and works that can influence health. In his op-ed, Dr Stanley Goldfarb outlines his concern that medical schools are increasingly focusing on these social factors and their "tangential" relationship to healthcare. These curricular elements, he believes, detract from students' learning of the basic scientific knowledge needed to practice medicine, which he worries will result in worse physicians in the future.

Dr Goldfarb is correct in one regard: medical schools are increasingly incorporating coursework on the social determinants of health. Before we get into why this shift in medical school education is not only a good thing, but necessary, I should address Goldfarb's central claim: that teaching the social determinants of health comes at the cost of future doctors' basic scientific knowledge. If that were true, we would expect the increased time spent on social determinants of health in medical school classrooms to be correlated with a decrease in scientific knowledge needed to practice medicine but it's not. In recent years, student scores on national board exams which are designed and validated to measure understanding the scientific knowledge needed to practice of medicine and have been linked to both higher physician quality and lower rates of patient complaints have continuously improved, including on the practical clinical knowledge exam. While I am not trying to make a causal claim and say that teaching social determinants of health improves basic scientific knowledge, these trends should reassure readers that future doctors are not compromising their education on the biological underpinnings and treatment of disease in favor of learning about the social and economic determinants of health. Medical school education is not a zero-sum game: it seems that medical students are capable of learning about both the biology of disease and the context in which it develops.

There is an expansive and growing body of literature outlining how social factors impact health, as well as how doctors who are familiar with this impact can work to address it. From the negative health effects of chronic stress from racial discrimination to growing up in a ZIP code with a lower average income or limited access to fresh food, the circumstances in which one lives have a demonstrated impact on access to healthcare and overall length of life. For future physicians, awareness of these factors or of ones own implicit biases can help to inform interventions and treatment recommendations as well as eliminate barriers to access and ultimately improve health outcomes. In other words, by preparing medical students to account for and address the contextual factors that can affect health, including their own behaviors,, medical schools provide their students with the skillset and knowledge needed to provide better, more holistic care to their future patients.

Doctors who learn about the social determinants of health are not only taught how to deal with these issues on a case-by-case basis: they are also empowered to address them on a larger scale by drafting and supporting policy changes. Physicians hold a privileged place in society. Their voices are heard and trusted, and they see and treat the effects of social issues like gun violence and racial discrimination firsthand. In fact, when surveyed, a majority of physicians agreed that their patients' social needs are as important as their medical conditions and that the health system should be better equipped to address those needs. Poised to propose and influence policies that impact the overall health of society at large, physicians have a responsibility to advocate for potentially health-improving policies and to combat existing structures that underlie poor health outcomes. Coursework that teaches trainees effective communication strategies and increases awareness of nonbiological factors that affect health is critical to empower physicians to fulfill this responsibility. And the medical schools that produce these doctors have an obligation to educate their students on these issues so that they may better identify and address them in the future.

Medical school is a time of professional development when students learn how to be a physician in addition to the knowledge necessary to practice medicine. Medical schools are responsible for teaching us to be caregivers as well as scientists, medical professionals who see the person behind the patient. Teaching the social determinants of health is crucial to mold practitioners who treat their patients as more than a collection of symptoms or a unifying diagnosis, but as members of society with unique experiences and limitations that may affect their health or healthcare. This is especially true in a time when medical students are increasingly found to become less empathetic during medical school and when effective curricular activities have been identified that can prevent this "erosion of empathy." The curricular components that best accomplish this goal, however, are not the traditional basic science courses but rather the experiential training, dedicated coursework on health inequalities, and extracurricular activities that cannot be found in a biochemistry or pathology textbook.

As one of the curriculum representatives at the Perelman School of Medicine at the University of Pennsylvania, I've seen the substantial effort that the school's administration has put into integrating education on the social determinants of health into our curriculum. Through our Doctoring course, for example, students are provided with a curated curriculum and space to learn about and discuss the social determinants of health. The school's various community clinics are a venue for students to apply the clinical knowledge they have gained in the classroom in order to provide basic healthcare to members in the community who have limited access to the healthcare system. Nearly on a daily basis, speakers are invited to educate students on issues ranging from human rights to racism in medicine. And just as Penn was the first medical school in the nation, it also has been a leader and innovator in education on how social conditions can influence health.

The art of medicine is in both diagnosis and dialogue. Just as humans cannot be viewed simply as a collection of biological processes, so too are patients more than their symptomatology. For medical practitioners to best improve health overall, they must understand the various factors that can influence health, both biological and nonbiological. Medical school classes on these issues don't detract from traditional medical knowledge but enrich it. After all, medical school is the stage of training that is meant to teach students about how disease develops, how it can be treated, and how it can be prevented. This makes medical school the ideal time for students to learn about the social determinants of health. These determinants represent important mediators of disease that can be addressed at both an individual and societal level to reduce the overall burden of disease.

Encourage medical schools to continue teaching their students about the social determinants of health. Dr Goldfarb's viewpoints overlook the tremendous influence of social context on an individual's health. Teaching future doctors about these social determinants of health doesn't make for worse physicians, but better ones, doctors who understand their patients, where they come from, and how to best help them. And that's better for everyone.

Ramie Fathy is a third-year medical student and curriculum representative at the Perelman School of Medicine at the University of Pennsylvania. The opinions expressed in this perspective are his own.

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No, Practicing Medicine Is Not Just About Basic Biology - Medscape

Major physical changes occurred in the human heart as people shifted from hunting and foraging to farming and modern life.As a result, human hearts are now less apelike and better suited to endurance types of activity. But that also means those who lead sedentary lives are at greater risk for heart disease.

Those are the main conclusions from a unique study led by Aaron Baggish, Harvard Medical School associate professor of medicine and director of the Massachusetts General Hospital Cardiovascular Performance Program. Baggish and his collaborators examined how ape hearts differ from those of humans, why those differences exist and what that means for human health.

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The researchers measured and compared heart function in apes and four groups of humans, ranging from sedentary to elite runners and including indigenous subsistence farmers. Their research is presented in the Sept. 2019 issue ofPNAS.

Baggishs collaborators on this paper include Daniel Lieberman, Department of Human Evolutionary Biology, Harvard University, and Robert E. Shave, School of Health and Exercise Sciences, University of British Columbia

Chimpanzees are humans closest known relatives, based on genetics and evolutionary studies. There are, of course, some stark differences between the species. For example, in terms of exertion, chimpanzees mainly engage in short bursts of activity, such as climbing and fighting, which puts intense pressure on the heart but only for a limited time.

In contrast, its believed that up until the industrial revolution, humans were active for longer periods of time in order to hunt and farm. Survival of pre-industrial humans, it is thought, depended on moderate-intensity endurance activity (e.g., hunting and gathering and then farming).

It is also well established that some physical features of the heart change in response to certain physical challenges. Walking and running, for example, require more blood to be pumped to deliver fuel to active muscles.

In contrast, brief but intense exertion from activities such as climbing or fighting creates pressure in heart, which over time can make the heart chambers develop stiffer and thicker walls.

The heart remodels in response to two main forces: pressure and volume, said Baggish. As a result, humans have longer, thinner and more flexible-walled hearts, while chimps have smaller hearts with thicker walls.

What Baggish and his collaborators wanted to know was, could those differences have evolved in response to humans new activity levels? And if so, what implications does that have on human health today?

Using a group of more than 160 study participants, the researchers carried out detailed heart function studies, including measuring blood pressure and using ultrasound to examine the hearts structure and function during many different activities.

The subjects were fairly evenly divided into elite runners, American football players, indigenous Mexican subsistence farmers and people who engage in little physical activity.They made similar measurements in about 40 semi-wild chimpanzees and five gorillas.

The goal was to compare heart structure and function in each typewhether the subject was very active to barely active, said Baggish.

In addition, the investigators sought to determine whether adaptation to either pressure or volume comes at the expense of the ability to handle the alternative form of stress. This was done by giving the pressure adapted subjects (football linemen) and volume adapted subjects (long-distance runners) a volume challenge, by a large intravenous saline infusion and a pressure challenge, by a sustained, forceful handgrip, and simultaneously measuring heart function.

The goal was to see whether there is a tradeoff between having a heart adapted for endurance versus one that performs better for short bursts of intense activity. Or could the heart adapt to both?

Baggish and his collaborators found that human hearts appear to have evolved to be better at handling endurance activity.The researchers also confirmed that people who train specifically for endurance sports have hearts with longer, larger and more elastic left ventricles, the part of the heart that pumps the blood out to the body.

Those features, and others, make the heart better able to cope with pumping higher volumes of blood over a sustained time. In contrast, sedentary people, even at a relatively young age, have hearts that appear more apelike and are better suited to cope with short bursts of high activity.

These findings help answer the question about the hearts evolution. The human heart has evolved over hundreds of thousands of years as our activity levels gradually became more sustained, said Baggish.

We now understand that the human heart, coupled with changes in the musculoskeletal and thermoregulatory system, evolved to facilitate extended endurance activity rather than spurts of intense exertion.

This study has important implications for understanding heart health today. For example, people who live a sedentary lifestyle appear to develop more apelike hearts and are more prone to hypertension.

This study is unique for several reasons, said Baggish. Not only were we able to study heart function in three types of primates, but we also had the opportunity to work with people who are among the last groups of truly subsistence-based farmers, the Tarahumara in Mexicos Copper Canyons.

Adapted from a Mass General news release

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Built to Endure | Harvard Medical School - Harvard Medical School

Though he is serving as interim president, Wynnes primary job is dean of the UND School of Medicine and Health Sciences, which is how the event got started.

The annual Joggin with Josh began in 2010 when Wynne reminded medical and health sciences students not only to encourage their future patients to live healthful lifestyles but also practice what they preach, the medical school said in a press release.

Before the informal 5K/10K/one-mile walk, jog or run began Tuesday, Wynne addressed the crowd.

"We talk about having a healthy lifestyle, we talk about exercise, so let's do it," he said.

Becca Perry and Samantha Peterson, faculty members in the medical labratory science department, said this is their first time participating in the Joggin' with Josh event, but look forward to future years.

"I think it's a great way to advocate health and like Dr. Wynne said, practice what you preach," Peterson said.

Numerous studies have shown that there are benefits to regular exercise, including reducing the risk of heart disease and diabetes, improving mental health and adding years to a persons life, the release said.

The event is being held in conjunction with UNDs Healthy Campus Week. The weeklong push, with Partnership for a Healthier America's Healthier Campus Initiative, is focused on promoting the great work PHA's campus partners are doing to make healthier choices easier for students, faculty and staff, according to UNDs website.

Faculty and staff can receive a free membership pass to the UND Wellness Center this week. In addition, students can get any equipment rental from the Outpost for half price all week.

UND also is highlighting its Health Hawks initiative this week, which aims to enhance the campus experience by making the healthy choice the easy choice for students, faculty and staff, UNDs website said.

There will be a number of other campus activities centered around Healthy Campus Week, including a visit from the Mobile Farmers Market Trolley and drunk goggles dodgeball on Wednesday. On Friday, health and wellness staff will be driving around campus, handing out school-colored fruits and vegetables for National Fruit and Veggie Friday.

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Joggin' with Josh advocates healthful lifestyles - Grand Forks Herald

When the UNLV School of Medicine recently welcomed its third class to the profession of medicine, it was done largely through a ritual that is now seen as a rite of passage for new medical students the White Coat ceremony, during which each student is presented with the garment that symbolizes their entrance into the medical profession.

Theceremony includes speakers and a student-written oath (below) that is recited in front of family members, school leadership, and peers to acknowledge their central obligation of caring for patients. Each class prepares its own oath.

Earlier in the month the students had been presented stethoscopes, another ritual symbolizing their entrance into the medical profession.

The white coat ceremony tradition is relatively new in the world of academia.The first took place in 1993at the Columbia University College of Physicians and Surgeons. It was the brainchild of Dr. Arnold Gold, a professor of clinical neurology and clinical pediatrics, whobelieved thepractice then of having students wait until the end of their training to formally announce their adherence to expectations and responsibilities appropriate to the medical profession occurred four years too late. Golds idea caught on quickly.

In just a few years, the ceremony was adopted by nearly every medical school in North America. At UNLV,the UNLV School of Dental Medicine welcomed its first class in 2002 with a white coat ceremony and continues the tradition. This year's will be held Sept. 20.

What surprises many people, as Dr. Mark S. Hochberg wrote in the AMA Journal of Ethics in 2007, is that prior to the late 19th century doctors wore black. Hochberg points out that Black attire was, and is, considered formal (e.g., todays tuxedo). Consequently, until about 1900, physicians wore black for their patient interactions since medical encounters were thought of as...formal matters. He said an additional or alternative possibility for the dark garb might be that until the late 19th century, seeking medical advice was usually a last resort and frequently a precursor to death.

How members of the medical profession came to wear white to symbolize cleanliness was part of a presentation by Dr. Neil Haycocks, the UNLV School of Medicines interim vice dean of academic affairs and education at the recent ceremony.

The period when the white coat became a symbol of medicine is bookended by two works by renowned American artist Thomas Eakins, Haycocks said.

The first, produced in 1875, is an oil painting titled 'The Gross Clinic.'It depicts famed academic trauma surgeon Dr. Samuel Gross, then 70 years old, lecturing Jefferson Medical College students while his assistants surgically treat a young man for osteomyelitis of the femur. Everyone in attendance is dressed in black, which was the typical medical attire of that time

The second Eakins work, also in oil, is 'The Agnew Clinic.'It was commissioned by the University of Pennsylvania medical class of 1889 to honor famed surgeon and anatomist Dr. David Hayes Agnew upon his retirement. Like Gross before him, Agnew stands in a medical amphitheater lecturing medical students while his assistants undertake an operation, this time a mastectomy. The attire, however, is different, with Dr. Agnew wearing a white smock, his assistants likewise dressed in white, and the patient covered by a white sheet.

"The contrast between these two paintings indicates that in a relatively brief span the color of medicine had gone from one extreme to the other. The explanation for this dramatic change resides with a British surgeon named Joseph Lister."

In the late 1800s, Lister was a professor of surgery at the University of Glasgow and interested in Louis Pasteur's early advancements in microbiology andgerm theory.Lister began applying germ theory to surgical practice, eventually adopting the use ofthe antiseptic phenol and documenting a dramatic decrease in the incidence of post-surgical infections.

"The implementation of antisepsis contributed to the transition of medicine to a science-based discipline," Haycocks said."Cleanliness became a core tenet of medical practice, reflected in the pure white attire now inextricably linked with the profession."

As he concluded, Haycocks urged the new class of medical students to examine their new white coats. "This is quite literally the cleanest they will ever be. Take a mental snapshot, it will provide an interesting contrast to what they will accumulate by the end of third year: crumbs from hastily eaten snacks, stains from hastily consumed energy drinks, pen and pencil marks from hastily scribbled notes, and evidence of encounters with various bodily substances that I will not enumerate here. Remember, bleach is your friend.

I am honored to offer this oath upon the inception of my medical career. I fully recognize the moral responsibilities of my chosen profession, as I affirm:

Each patient is a person, to be treated with dignity, humanity, and empathy. I will respect life, honor patient autonomy, and protect privacy.

The well-being of my patients is entrusted to me. I will be an advocate for my patients and use the medical skills and knowledge necessary to do so.

All patients are equally deserving of my skill and care. I will foster an environment of inclusivity and diversity in medicine.

Honesty and integrity are foundational to my practice. I will acknowledge my inevitable limitations and failures, be open to guidance from others, and always strive to become a better physician.

Others have paved the path that is before me. I will value and respect what has been given me by my mentors. I will teach others what I've been taught, give back what I've been given.

Medicine is demanding and ever-changing. I will be a lifelong learner. I will practice self-care as a responsibility to myself and patients.

The obligations of medicine require me to hold myself and others to the highest standard of accountability. I will be an ambassador of medicine, represent the profession well, and continue to earn society's trust.

I affirm this declaration and pledge to faithfully uphold these values.

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White Coats Presented to Med School Class of 2023 - UNLV NewsCenter