Shelby Howard and Aditi Talkad might be in their first year at Medical College of Georgia but the two have been at Augusta University working toward a medical degree for three years.

The two are among 29 students who began the seven-year BS/MD program in 2014, 18 of whom are now in their first year of medical school. The combined undergraduate and health sciences programs were envisioned as one of the fruits of consolidating Augusta State and then-Georgia Health Sciences universities in 2013. Dr. Paul Wallach, vice dean for academic affairs at MCG, brought the program with him five years ago after creating similar programs at the University of South Florida.

This is my brainchild, he said, and it benefits both the students and the university.

The advantage for the student is they have a clear pathway into medical school, Wallach said. The advantage for the institution, which I thought was considerable as we were going through our consolidation, is it creates a premier program for recruitment into the undergraduate campus and permits very highly performing students to be recruited to Augusta University.

Both Howard and Talkad were considering other, larger universities in Georgia and had not heard much about Augusta prior to learning about the program. Now that has changed.

Augusta is a lot more on the map from at least when I started college, Howard said.

I think the program has put it on the map, Talkad said. There are people applying from out of state, from California, to come here to come to Augusta. She and Howard both talk to high school students about the program and its advantages.

The students along the way have had to meet the same or higher standards for others getting into medical school, including taking the Medical College Admission Test and interviewing with the Admissions Committee. The difference with these students is they had to face the committee when they were college freshmen. But they got a lot of support from the medical school faculty before they had to do it, including three mock interviews.

They groomed us for that interview, Howard said. It also let them know the level of professionalism and standards they would need to succeed in medical school, Talkad said. Some of their new classmates may just now be finding out they are surrounded by people with similar interests and passions but weve been doing that for the past three years, she said. That was a huge benefit of coming here.

It also spared them the anxiety of applications and months of waiting to find out if they would get in or not. Howard took an MCAT preparation class with students going through that process and they were so stressed out of their minds, she said. It saved us that, which I am grateful for.

And a year, Talkad added. That will be important down the road especially with how much time goes into becoming a doctor, Howard said.

The experience has also bonded them into a close-knit group that is family to each other, Talkad said.

Especially because college is such a time of personal growth and figuring out who you are so weve gone through those growing periods and growing pains with each other, Howard said.

And they expect it to stay that way.

You grow up so much with them that you dont lose track of that, Talkad said.

Reach Tom Corwin at (706) 823-3213

or tom.corwin@augustachronicle.com.

Read more from the original source:
Program paves way for medical school - The Augusta Chronicle

Unbeknown to most patients, their race is incorporated into numerous medical decision-making tools and formulas that doctors consult to decide treatment for a range of conditions and services, including heart disease, cancer and maternity care, according to a new paper published Wednesday in the New England Journal of Medicine.

The unintended result, the paper concludes, has been to direct medical resources away from black patients and to deny some black patients treatment options available to white patients.

The tools are often digital calculators on websites of medical organizations or in the case of assessing kidney function actually built into the tools commercial labs use to calculate normal values of blood tests. They assess risk and potential outcomes based on formulas derived from population studies and modeling that looked for variables associated with different outcomes.

These tests are woven into the fabric of medicine, said Dr. David Jones, the papers senior author, a Harvard historian who also teaches ethics to medical students.

Despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice, he wrote.

The paper is being published at a tense moment in American society as black communities, disproportionately affected by the coronavirus, protest unequal treatment in other areas of their lives.

Dr. Jones said he believed the developers of the tools, who often are academic researchers, are motivated by empiricism, not racism. But the results, his analysis found, have often led to black patients being steered away from treatments or procedures that white patients received.

The paper included a chart listing nine areas of medicine where there are race-based tests, and it analyzed the consequences. For example, it reported, labs routinely use a kidney function calculator that adjusts filtration rates for black patients. With the adjustment, black patients end up with slightly better rates than whites, which can be enough to make those with borderline rates ineligible to be on a kidney transplant list.

An online osteoporosis risk calculator endorsed by the National Osteoporosis Foundation, among others, calculates chances of a fracture differently for black and white women. Black women end up having a score that makes them less likely to be prescribed osteoporosis medication than white women who are similar in other respects.

An obstetric calculator based on observational data concludes that black women who had a previous cesarean birth are less likely to have a successful vaginal birth in a subsequent pregnancy.

Dr. Jones added that it is time to stop what amounts to racial profiling in medicine. We need to get off this train, he said.

The New England Journal paper built on a collection of recent findings and assessments, including those in a recent paper about kidney function by Dr. Nwanaka Denise Eneanya and her colleagues at the University of Pennsylvania.

To determine how well kidneys are working, doctors use a blood test that measures a protein called creatinine to estimate kidney filtration rate. Low filtration rates indicate a kidney problem.

Dr. Eneanyas team noted that patients with a filtration rate of less than 30 were referred to kidney specialists. They gave an example of a white patient whose level was 28, according to the calculator. A black patient with the same creatinine level would get a race correction under the formula that raises the level to 33. Consequently, the black patient would not get a referral to a specialist.

The same effect could make some black patients ineligible to be put on a list for a kidney transplant those with filtration rates of 20 or above are ineligible.

The formula originated with data from a federal study more than two decades ago that asked if a low-protein diet reduced the risk of kidney disease (it did not, the study showed). The study included precise measures of kidney function and creatinine levels, which let researchers use creatinine to estimate kidney function. The formula fit the data best when they included an adjustment for black patients.

In a more recent paper, in 2009, the researchers combined data from a number of studies to devise an improved formula, asking which variables made the formula best fit the data. Race popped up again.

The formula was widely adopted, said Dr. Melanie Hoenig, a kidney specialist at Harvard Medical School.

One of its principal authors, Dr. Lesley Inker, a kidney specialist at Tufts Medical Center, said she hears the critics.

What we say is, Youre right. I understand the difficulty in assigning race, Dr. Inker said.

She is working on developing a more accurate formula that does not include race. She added that black patients should be told that their race alters the calculation and should be given an option to have their race excluded.

But, she says, the current formula also can be an advantage for black patients. Those with filtration rates below 30 are ineligible to be prescribed metformin, the first line drug for diabetes, and SGLT2 inhibitors, a more recent class of diabetes drugs.

One problem, is that it is not clear how race is determined. It shows up in medical records but, said Dr. Peter Reese, a kidney transplant specialist and epidemiologist at the University of Pennsylvania, I worry that in some situations they look at you and assume.

With the formulas, there is no accounting for people of mixed race, as the authors of the New England Journal paper and other doctors have noted.

Even if race does have a real affect on lab values for creatinine, why assume it is because of the genetics that determine skin color, some experts asked.

It could be diet or any of a number of things, Dr. Hoenig said, noting that a large protein-heavy meal can temporarily raise creatinine levels.

One often cited explanation is the belief that black people are more muscular than white people, and muscles can release creatinine into the blood. In a recent paper, Dr. Vanessa Grubbs, a kidney specialist at the University of California, San Francisco, tried to trace the origins of that belief and found only a few decades-old studies that did not even measure muscle mass directly, including one saying black children are thinner than white children.

A group of medical students at Harvard has been trying to change the approach to assessing kidney function, with some success.

The group, including Leo Eisenstein, Danika Barry and Cameron Nutt, had heard Dr. Jones in lectures saying race was a social construct and then went into the clinic, where they were told to use a formula that corrects for race in assessing kidney function.

Instead of complaining, Dr. Hoenig told the students, why not go to the leadership and suggest a change? Labs could simply not list race when sending in blood tests for creatinine in that case the formulas default would be the level for whites. Or they could give results as a range and explain to patients that the numbers are an estimate.

A few years ago, Dr. Hoenig and the students made the rounds to executives at Beth Israel Medical Center.

We went to the chief of medicine, we went to the head of clinical labs, we went to the head of the kidney division, we went to a lot of people and spun our story, she said. They were open to it.

In 2017, Beth Israel dropped the race factor in calculating kidney function. But despite pleas for a change, no other hospitals have followed suit.

Recently though, San Francisco General has replaced race as a factor with a choice of values for kidney function depending on the doctors assessment of whether the patient was muscular or not.

Advocates of change like Dr. Hoenig say they think part of the problem is resistance to changing a system that has become part of medicine.

Dr. Darshali A. Vyas of Massachusetts General Hospital, who is first author of the New England Journal paper, said the ultimate goal is for doctors and researchers to rethink the assumption that they can use a patients race in making medical decisions.

This is a challenge to the field about how we think about race and what our default assumptions are about race, she said.

Excerpt from:
Race Is Used in Many Medical Decision-Making Tools - The New York Times

When Washington State University opens the doors to its first class of medical students Wednesday, many of them wont know and most may not care about the political maneuvering that first made this day difficult, and then made it possible.

Just over two years ago, it wouldnt even have been legal for WSU to have its own medical school.

A 1917 law gave the University of Washington the sole authority to operate a medical school in the state, a result of the Legislature settling a turf war over academic majors between the schools in Seattle and Pullman. The state had only so much money to spend on its public colleges, and wasnt about to pay for duplicating expensive programs. UW got architecture, law, journalism and aeronautical engineering; what was then Washington State College got veterinary medicine, almost anything related to agriculture and rural life.

A medical school, when one was built, would be exclusively the right of UW, the law said in another section. That didnt happen for another 28 years, when the Legislature came up with $3.7 million for the university to set up schools of medicine and dentistry as World War II was ending.

That law stayed on the books, and UW School of Medicine expanded as Washington grew. The fact that it was the only medical school at a public university in Washington probably didnt seem so strange because the nearby states of Wyoming, Alaska, Montana and Idaho had none at all. In the 1960s, the university set up a cooperative arrangement with those states to educate their med students as well in a program called WWAMI, which takes its acronym from the first letters of the five states.

WWAMI had a presence in Pullman for years, but in the 1990s, local leaders began angling for expanded medical education in Spokane to complement one of the citys biggest growth industries, health care. One problem was they didnt have a place to put it.

Todays new medical students may look around and marvel at the grassy hillsides and river walkways of Riverpoint campus, but should realize that 25 years ago that was just a stretch of debris-strewn rail lines between Gonzaga University and Trent Avenue. The area began to change when local leaders persuaded the Legislature to build the Spokane Intercollegiate Research and Technology Institute, which was a cooperative effort between local public and private colleges. The state later built classrooms nearby for WSU and Eastern Washington University.

In 2006, WSU broke ground on a new Intercollegiate College of Nursing at Riverpoint, moving the coordinated nurses training from its old quarters near Spokane Falls Community College.

Five years later, city leaders had a new ask: a building for medical students at Riverpoint. While it was often called a med school by locals, its official title was the Biomedical and Science Center.

That was late 2011. The state still was trying to recover from the recession, and the $70 million structure wasnt in then-Gov. Christine Gregoires early budget proposal. But WSU President Elson Floyd made the hard sell and Spokane had some powerful allies in the Legislature, including then-Senate Majority Leader Lisa Brown, a Spokane Democrat whose district included Riverpoint. The final capital budget had $35 million for the building, with the understanding that the next year, the state wouldnt walk away from the project halfway through, and the rest of the money would be in the 2013-15 capital budget. It was.

Brown retired at the end of 2012 and took the job of chancellor at WSU-Spokane.

Before that building was complete, however, friction between WSU and UW got hot enough to start a brush fire.

For the 2013 school year, UW was given enough money to send 20 medical students to WWAMI in Spokane; it sent 17. Floyd said UW didnt recruit enough students to fill the slots. UW President Michael Young said the school could only find 17 students who wanted to go to Spokane. Floyd countered that if UW wouldnt cooperate, WSU would start its own medical school.

Good luck, said Young, adding that Floyd didnt know how a medical school is run. What came to be known as the medical school Apple Cup was on.

Gov. Jay Inslee a Husky alum married to a Cougar alum tried to stay out of the rivalry, and wrote a budget in late 2014 that didnt have new money for either medical school. He let the universities make their pitches to the legislative committees that would write the final budgets.

Although UW had plans to eventually have a new class of 80 med students each year at WWAMI in Spokane, it was Floyd who put on the full-court press starting in January 2015 for WSU to have its own medical school. He made repeated trips to Olympia, wowed lawmakers during committee hearings and charmed them in private meetings. He slowly made inroads into the strong support UW traditionally has from Seattle-area legislators, and his pitch for a new school with a different system to train doctors for family medicine and rural practice resonated with those from rural areas who were seeing a shortage of health care practitioners. It would be part of an overall strategy that included more medical residencies in rural hospitals and clinics and more financial aid for students who would practice in those areas.

Floyd also had some powerful allies like Mark Schoesler, the Ritzville Republican whose district includes the Pullman campus and parts of Spokane County and who by then was Senate majority leader.

When the Legislature held hearings on rewriting the 1917 law, UW said it didnt object to the change as long as money for the new school didnt come out of the WWAMI budget and hurt that program.

In March 2015, the Legislature passed a bill that gave WSU the legal authority although not the money to have its own medical school. In legislative budgets that were released a few weeks later, UW was allotted $9.7 million to expand WWAMI in Spokane and WSU was given $8 million over the next two years to cover the costs of seeking accreditation and getting ready for its first class of med students.

On April 1 of that year, Floyd, Brown and a group of smiling legislators stood behind Inslee as he signed the WSU medical school authorizing bill. There were cheers all around, but the loudest were for Floyd.

Two months later, university officials announced Floyd was taking a leave of absence to battle colon cancer. He would lose that battle before the end of the month.

In what may have been the easiest decision of the 2015 session, the Legislature moved within days to name the new medical school for Floyd.

UW would later break off its arrangements with WSU for WWAMI and enter into an agreement with nearby Gonzaga University. The competition for funding has decreased slightly as the need for doctors the two schools can produce has increased. The states 2017-19 operating budget has a total of $15 million for medical education in Spokane between the two schools.

Based on plans for the two programs, Spokane could go from having no medical school at the beginning of this decade to at least 240 med students in two schools at the end of it.

Read more:
100 years after legislators barred WSU from starting medical school, WSU's first class of medical students start ... - The Spokesman-Review

Researchers in the Blavatnik Institute at Harvard Medical School and at Brigham and Womens Hospital are adapting an antibody-detection tool to study the aftermath of infections by the novel coronavirus that is causing the current global pandemic.

Get more HMS news here

The tool, called VirScan, detects antibodies in people's blood that indicate active and past infections by viruses and bacteria. It was developed in 2015 by Stephen Elledge, the Gregor Mendel Professor of Genetics and of Medicine at HMS and Brigham and Womens, and two PhD candidates in the lab, George Xu and Tomasz Kula.

Because it takes 5 to 10 days for a person to develop antibodies, Elledge emphasized that VirScan would not be used to provide real-time diagnoses of infection with SARS-CoV-2, the virus that causes COVID-19.

Rather, the goal is to analyze blood samples from people who recover from infection to learn about how the virus affects the immune system and the epidemiology of the disease.

Once underway, the effort will join others around the world attempting to study post-infection blood samples. The results could lead to better estimates of true infection and lethality rates by capturing cases that may have gone undetected and could inform the development of vaccines. They could also reveal new insights into the fundamentals of human immunity.

"The situation right now is extremely difficult, but it's great to be in a position to apply all these new methods to an important human health problem," said Elledge.

How does VirScan work? How is it different from diagnostic tests?

From a single drop of blood, VirScan tests for antibodies against more than 1,000 different strains of viruses and bacteria that may have infected a person, whether around the time of testing or decades earlier. This differs from typical blood tests known as ELISA assays, which look for one pathogen at a time.

It also differs from the tests currently used to diagnose COVID-19. Those tests rely on mucus swabs from the nose and throat and look for nucleic acids that signal that the SARS-CoV-2 virus is contained in the sample.

"The CDC and other testing facilities are looking for the presence of the virus, which is critical," said Elledge. "Our assay can detect whether someone's immune system has engaged the virus. We can tell when someone has harbored the virus but doesn't have it anymore."

To create VirScan, Elledge, Kula and Xu built a library of epitopes: short protein fragments derived from the surfaces of viruses. If a person has encountered a particular viral strain, their immune system has generated antibodies against it. Those antibodies will then recognize the epitope in the VirScan library and bind to it, giving a positive result.

Elledge's lab included epitopes from several different coronaviruses in the original VirScan collection. The team is now adding epitopes from the new coronavirus as well as all other known coronaviruses not already included.

Can VirScan be used to test whether people currently have COVID-19?

For several reasons, including the fact that it takes at least a week to generate results, VirScan can't be used as a real-time diagnostic test.

"It's not feasible as a point-of-care test," said Elledge. However, he added that his team might be able to use the information gained to generate a faster version of VirScan.

When the project gets up and running, it will be critical to ensure that blood samples are taken only from people who have recovered fully from SARS-CoV-2 infections, so that vials do not contain active coronavirus particles when they enter the lab.

"We don't want to infect our researchers," said Elledge.

How can the work improve estimates of infection and fatality rates?

So far, limited testing has meant that an unknown number of people in the U.S. and beyond have been infected with SARS-CoV-2 but remain uncounted. Some may not have had symptoms. Some symptoms may have been attributed to other causes. This not only leaves individuals wondering about their infection and immunity status but also obscures the true infection rate across the population. And without knowing how many people have been infected, it's impossible to calculate the fatality ratehow likely the new coronavirus is to kill a person it infects.

Running VirScan analyses on blood, or serum, from a sizeable segment of the population can provide "a reliable estimate" of how many people were infected in a given geographic area, said Elledge. Cross-referenced with medical records of those who tested positive and died, that information can illuminate the virus's true lethality rate.

"Because right now they say, 'this many people came in and tested positive,' and 'this many died,' but if there are a lot of people who are not sick enough to go to the hospital and who don't get tested, it makes the virus look more lethal than it might be," said Elledge.

How can VirScan inform vaccine development?

VirScan promises to help Elledge and colleagues identify which parts of the virus the immune system responds to.

Recent work from his group suggests that people all over world infected with a particular virus make antibodies against the same proteins"even the same amino acids"on that virus, Elledge said.

That's surprising, considering how many epitopes viruses have and how many antibodies are in the body's arsenal, said Elledge. The findings led him to suspect that some epitopes are, in effect, decoys, and therefore, that not all antibodies have the desired neutralizing effect.

"The immune system may be sending out all these antibodies like shooting a shotgun and hoping some of the spray will hit the target, neutralizing some critical part of the virus," he said.

In principle, said Elledge, VirScan could indicate which epitopes are useful targets against the new coronavirus and which are just noise. Then researchers could eliminate the useless ones from vaccines they're developing.

How else is the lab working to assist vaccine efforts?

Antibodies aren't the only objects in the body that attack invaders. Immune cells called T cells also react to specific epitopesnot on viruses, but on the surfaces of infected cells. Alerted to danger by these epitopes, T cells can kill virus-infected cells and limit the number of viruses made in the body.

In 2005, Elledge's lab built a tool, T-Scan, that can detect these epitopes. He would now like to teach T-Scan to detect the epitopes made when cells are infected by the new coronavirus. But since cells infected by different viruses and bacteria sprout different epitopes, he first needs to know what the epitopes look like for infections with this coronavirus. That would require obtaining not only blood but also T cells from people who recover from SARS-CoV-2 infection, he said.

The goal: to identify the epitopes that trigger T-cell attacks so researchers laboring to develop COVID-19 vaccines can include them in the mix.

"T-cell epitopes are often important players in vaccines and in preventing viral infections," said Elledge. "You want to encourage T cells to kill the infected cells."

How can VirScan illuminate what SARS-CoV-2 does to the immune system?

Last year, the team used VirScan to help reveal how measles infection wipes out the immune system's memory of past infections by other viruses and bacteria. VirScan could similarly illuminate whether people develop immunity to the new coronavirus, how long they remain immune and whether infection causes more widespread damage to the immune system like measles does.

Or the virus may have other surprises in store, said Elledge.

What about the likelihood that there are different strains of the new coronavirus?

Although many mutations in the virus have been documented around the world to date, these variations "wouldn't affect antibodies much," so VirScan's results should still apply, said Elledge.

Whose samples would be analyzed?

For the initial study, Elledge envisions collecting samples from about 100 volunteers who've recovered from COVID-19. The best-case scenario would be having samples from people before and after infection, he said, although he recognizes that that would be hard to arrange.

"Many people in the lab have given samples in the past, so if anyone gets sick, we'll have a before and after, but of course we hope that doesn't happen," he said.

When will all of this be ready?

Most HMS labs have transitioned to remote work following institutional guidance aimed at containing the spread of the virus, but some have been granted permission to continue on-site work for COVID-19-related projects, including a portion of Elledge's lab.

Elledge anticipates that VirScan could be deployed to analyze samples in mid-April. Then it would be a matter of obtaining institutional review board approvals for human research and arranging the logistics of collecting the samples. Elledge is currently in talks with contacts across the HMS and broader Boston communities.

What else is in the works?

At the same time, Elledge's team is working to detect antibodies against the new coronavirus with even greater sensitivity using a tool they developed in 2014 called PLATO. Whereas VirScan uses short, linear protein fragments, PLATO uses full-length proteins known as open reading frames, or ORFs, which have a more developed 3D structure. (PLATO stands for ParalleL Analysis of Translated ORFs.)

Who is funding this work?

Elledge is an investigator of the Howard Hughes Medical Institute.

Follow this link:
Learning from the Recovered - Harvard Medical School

HONOLULU (KHON2) The shortage of personal protective equipment (PPE) for health care workers in Hawaii is increasing, and members within the University of Hawaii are working to help supply it.

A UH Manoa professor at the John A. Burns School of Medicine and the faculty, students, and staff of the UHM Department of Theatre and Dance are sewing fabric masks.

This effort is in response to the Centers for Disease Control and Preventions guidance that fabric masks are a crisis response option when other supplies have been exhausted.

According to JABSOM professor Angel Yanagihara, the masks will be pleated for a better fit and made of 100 percent densely woven breathable cotton with pockets that can be inserted with a disposable near N95 non-woven filter material, Professor Yanagihara said.

After use, the cloth masks may be treated with regular laundry soap then laundered and reused.

The first batch of cloth masks will be distributed through the University Health Partners of Hawaii, the faculty practice plan of the UH medical school, with priority given to providers and staff in primary care and emergency care specialties, who provide first-contact care for the majority of patients.

JABSOM medical students are assembling plastic face shields that are needed by frontline health care workers.

With public contributions to materials, it is hoped that these masks and shields can be extended for the support of other primary care providers (including those assessing nursing home patients) across the state of Hawaii.

Contribution to these efforts may be made here.

See the original post here:
UH Manoas theatre department, School of Medicine aid in supply of personal protective equipment - KHON2

So, were being conscripted?

On Tuesday, the health secretary, Matt Hancock, announced that 5,500 final year medical students would be joining the frontline of the NHS. On hearing this news, I rushed down the stairs of my flat to my equally bewildered housemates. We had just finished six years of medical school and had completed our hurriedly reorganised final exams remotely. But we werent supposed to officially qualify and start as doctors until August. NHS staff shortages and a hugely increased demand for care mean that we will be reaching for the scrubs early.

Starting on the lowest rungs, foundation training is the term for the first two years working as a doctor and serves as the culmination of a journey spanning over half a decade of medical school. Becoming a doctor is a dream I have had since I was 14 years old. But I can think of few things more nightmarish than starting my career in the middle of a global pandemic.

I certainly feel a strong moral obligation to assist however possible in the midst of this unprecedented struggle. Many medical students, including those at my university, have completed their final examinations and were already actively seeking ways to volunteer before this was announced.

This sense of duty is nonetheless matched by fear and trepidation. A lack of testing means many healthcare workers are self-isolating at a time when demand looks set to soar. There is an overwhelming sense that the health service is heading towards a cliff edge, about to experience several months that will dwarf the winter crisis that has become an annual occurrence.

Indeed, despite being highly trained, foundation doctors the most junior of junior doctors in a hospital still require significant senior supervision to support their development. I worry that the approaching challenges could place myself or one of my peers in a position where that support is not available, risking jeopardising patient safety through no fault of our own.

Meanwhile, rumours continue to filter through of the previously fit and well patients now finding themselves on ventilators and I question if my colleagues pleas for adequate personal protective equipment will continue to fall on deaf ears.

I speak to my dad, whos back in Grimsby, on the phone. Stephen, its like the war. You need to roll your sleeves up and get to work. Hes right. Our medical schools would not graduate us, nor would the General Medical Council register us to work, if they had any doubts about our competence. Were not being conscripted, but this does feel like a battle in which we all have our part to play. I, for one, am ready.

Stephen Naulls is a final-year medical student at Imperial College London

See the article here:
I'm a final-year medical student being rushed to the frontline. I'm nervous but I'm ready - The Guardian

Medical students of today can be the agents of change in bringing nutrition discussions into the GP surgery. Take what you learn today to the doctors already in practice who are struggling with confidence in how to discuss nutrition.

These were the words ofElaine Macaninch, a nutrition medical educator for Brighton and Sussex Medical School (BSMS) and nutrition lead and director ofCulinary Medicine UK,an initiative devoted to educating medical students in the basics of nutrition.

She spoke at anEducational Conference on Food,Nutrition and Health, hosted by medical student society Nutritank, at the Royal Society of Medicine inLondon, on Saturday (March 7th),where delegates received a wealth of tips on the best ways to communicate nutrition advice to their patients.

Describing the problem to the conference room full of training doctors, nutritionists, dietitians and other health experts, she revealed the results of a 'Time for Nutrition' paper from theNeed for Nutrition Education Programme (NNEdPro), due to be published shortly in 'BMJ Nutrition, Prevention and Health' whichdescribes the opinions thatdoctors and medical students have about their nutrition training.

Co-authored by Dr Luke Buckner, the papertakes data from 840 doctors and medical studentsfrom Nutritank and NNedPro led projects and some data from Brighton Medical school andshows most participants agree that nutrition is important to health but more than 70% reported receiving less than two hours worth of training in nutrition.

Just 26% of doctors said they were confident in their nutrition knowledge and 74% gave nutrition advice less than once a month.

Macaninch'srole as nutrition medical educatoratBSMSis being developed as a case study that can be replicated in other medical schools.But herportfolio goes further still - She is also executive member ofNNEdPro and ispart of the UK Nutrition in Medical Education Review Board, which sits with the Association for Nutrition and is tasked with writing a nutrition curriculum to be implemented across the UK.

Speaking at the conference, she pointed out how difficult it currently is for doctors to give their patients nutrition advice, not just because they lack the training but because they are so time restricted.

As doctors, you have about 10 minutes to talk about everything from A-Z of every health problem your patient has in the world whereas a dietitian generally has 30 minutes per consultation just to discuss nutrition.

She added that she is hopeful for change because dietitians are now part of the GP contract meaning they can refer to dietitians directly.

"With this in place, dietitians hope to be able to help reduce hospital care and help doctors prescribe supplements and reduce demand on GP's."

However, the system requires a significant boost in the number of registered nutritionists and dietitians in order to make this opportunity an effective reality -WHO's 2017 figures show there are just 2.3 nutrition professionals per 100,000 population.

The problem is that GPs will often think the waiting list is so long, whats the point in bothering to refer a patient. We would request that GP's please continue to refer and perhaps even point out the need for more dietitians!

"Im looking forward to a future, I hope, where there is more access to dietitians within primary care."

Culinary Medicine, founded by NHS GP DrRupy Aujla,works to develop nutrition training within medical schools withinteractive sessions designed to make the education as relevant and practical as possible.

We ask students to cook a meal for case studies,"explains Macaninch."For example, a patient with a high risk of cardiovascular disease or type 2 diabetes, or someone with IBS."

The programme mostly teaches individual modules to qualified doctors on weekends using the facilities at Westminster Kingsway culinary school but has also taught intensive four week modules to Bristol University Medical students as part of their undergraduate training.

The team is also is working to create a completely online version of the course.

Also speaking at the event in London,Professor Sumantra Ray, medical doctor, registered nutritionist, and founding chair and executive director of the NNEdPro, discussed the importance of nutrition for reducing lifestyle-led diseases such as type 2 diabetes.

He said its imperative that anyone giving nutrition advice makes it as individual focused as possible.

You cant just make sweeping statements and start encouraging people to cut out things like whole grains and cereal fibre and a lot of other things that low-carb evangelismhas led to as then you start to cut out phytochemicals and fibre and so forth.

Its important not to treat the numbers but to treat the individual patient. The advice needs to be holistic - we cant address food alone.

"We know that when it comes to public health interventions that have gone a bit wrong that the low fat aim has often ended up in much higher sugar and carb content which is not helpful.

Individual level action is essential and education holds the key to that sort of action."

Elizabeth Thompson, holistic doctor for the National Centre for Integrative Medicine, added that nutrition impacts people emotionally, as well as physically.

"It's important to realise we have a bit of a crisis with emotional and mental wellness and we know food can support our mental processes in a real way.

"Tart cherry, for example, has been shown to raise levels of melatonin. So before we jump tozopiclone we should realise there are other things to try."

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Nutrition advice from the GP? "Medical students of today can be the agents of change" - NutraIngredients.com

This past Friday was Match Day for most of the nations fourth-year medical students.

A record-high 40,084 applicants submitted program choices for 37,256 positions. The group of trainees who found out about their future homes included thousands of AMA members, a few of whom offered their thoughts on the process of Matching and their ambitions moving forward.

Student: Baillie Bonner.

Medical school: University of New Mexico School of Medicine.Specialty and residency program: Obstetrics and gynecology at Rush Medical Center.

What are you looking forward to most about residency?

Im really looking forward to being part of a team and being able to contribute more. One of the most frustrating parts of being a medical student for me was feeling like I could do more, but not having the credentials or power to do so.

How will you move medicine during your residency training?

I plan to stay involved in organized medicine and since Im moving to Chicago, I am excited that I can move medicine through the AMA. I am excited to be able to not only be involved in advocacy, but also to have medical students that hopefully can also get plugged in to fighting for patients on a larger scale.

Learn how Ms. Bonner helps tackle the underlying barriers to care.

Student: Avani K. Patel.

Medical school: University of Mississippi School of MedicineSpecialty and residency program: Psychiatry at the University of Mississippi Medical Center.

What was the biggest factor in your specialty choice?

A little before this time last year, I didnt know what I wantedlet alone what specialty I was meant to pursue, so I actually withdrew from match and delayed graduation to pursue a number of other opportunities such as a Masters in Health Care Administration. I came into medical school absolutely determined to pursue Anesthesiology. However, during my fourth year, I realized it may not be the career path meant for me. I really enjoyed my Psychiatry rotation during my third year, and one of my attendings convinced me to spend a month-long fourth year rotation in Child and Adolescent Psychiatry. Needless to say, that month changed my life.

How will you move medicine during your residency training?

Having grown up in a state with the highest physician shortage in the country and a rural area at that, I have seen first-hand what health disparities looks like, especially in mental health. I hope to be a part of the solution in closing the gap and de-stigmatizing mental health care. Serving my community and home state is the greatest gift and matching into training at my number one program is the greatest blessing!

Learn how Ms. Patel is working to improve the culture of medicine.

Student: Deena Kishawi.

Medical school: Stritch School of Medicine Loyola University Chicago.Specialty and residency program: Obstetrics and gynecology at St. Josephs Hospital.

What are you looking forward to most about residency?

Im excited for quite a few things about residency, but at the top of my list is finally being a doctor in a specialty that Im passionate about. I also cant wait to work with patients in a field where together, we can make an impact and improve womens health. Im able to work in my Chicago community, and my patients are from all backgroundssome are Chicago natives like myself, others are immigrants or refugees, others are just passing through for temporary visits in the U.S.so its fulfilling to be able to give back to the community I call home. And as you can imagine, this has been something Ive been working towards throughout all my education, and Im finally not a student!

How will you move medicine during your residency training?

Im looking forward to continuing my work with health policy while Im a resident. Ill have different insight since Ill be taking care of patients directly, which will allow me to better understand their needs and how healthcare can better serve them. With that, Id be able to shift the discourse regarding health policies about womens health and continue to advocate for my patients. Im most excited about working with women and embarking on a journey of healthy practices and reproductive justice as we write policies that can better serve my future patients.

Learn how Ms. Kishawi is mentoring young Muslim women.

Originally posted here:
These 3 AMA medical student members have met their Match - American Medical Association

Having a coach can be valuable at any stage in ones medical career. But why should you prioritize coaching while youre in medical school? When and how should you meet? And what exactly should you talk about? A handbook from the AMA provides useful answers.

Following are highlights from How can I get the most out of my coaching sessions? Chapter 5 of It Takes Two: A Guide to Being a Good Coachee, a learner handbook focusing on what learners need to know to get the most out of a coaching relationship, produced by the AMA Accelerating Change in Medical Education Consortium.

An academic coach may sound very similar to an adviser or mentor, but there are distinct differences, wrote Christine Thatcher, EdD, associate professor of family medicine and associate dean for medical education and assessment at University of Connecticut Health, and Antea DeMarsilis, a medical student at University of Connecticut School of Medicine.

Ideally, conversations with a coach are safe, meaning that as a learner, you can explore ideas, dreams and goals with your coach to become the better you, they added. Regardless of stage in your career, from early learner to professional, a coach is someone who will 'guide from the side, facilitate change and help celebrate when goals are met.

Ideally, the first few meetings will be face-to-face, the authors wrote. It is essential to establish a relationship and to build trust. Take time to get to know each other. By sharing a CV and/or a personal bio, you may find similar interests, and it will help you engage in deeper conversations.

Once you establish a relationship with a coach, set regular meetings. These could be by phone, video or email if the question or update is brief or urgent. But no matter the format, communicate regularly and try not to cancel, the authors emphasized.

You might also set intermittent meetings to accommodate issues and achievements as they arise.

Your coach may see a red flag appear in evaluations, you may receive difficult feedback or a board score may come in that changes your outlook, the AMA handbook says.

Likewise, you can set transition meetings for when your needs and goals shift, such as after you reach a major milestone.

Reflect on your goals, the authors advised. Have you met them within the timeframe you intended at the outset? Has this relationship helped you to make changes and move forward? Is this the time to close this relationship and look for a new coach? Or will you continue together? This is the time for tough conversations that will ultimately shape future goals.

From the beginning, you should discuss what the relationship will look like, the authors wrote. You should drive this discussion and decide how the coach can be helpfulwhat are the areas you want to improve? You may consider clinical performance, communication skills, wellness or academic difficulties such as time management as just a few examples.

You can structure coaching sessions in many ways too, but there are several core agenda items to consider including in each meeting. These include:

The chapter includes a checklist of potential coaching session topics, descriptions of how coaching might change throughout training and ways to make your coaching sessions high yield, such as practicing self-reflection prior to meetings.

A corresponding text, Coaching in Medical Education: A Faculty Handbook, provides a coaching framework for educators, as well as tools to provide professional development and assistance to learners in medical education.

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Get the most out of your medical school coaching sessions - American Medical Association

February 11, 2020 Joseph Brain, Cecil K. and Philip Drinker Professor of Environmental Physiology at Harvard T.H. Chan School of Public Health, recently co-authored the book The Education of Alice Hamilton (Indiana University Press). Hamilton, Harvards first female faculty member, was appointed assistant professor of industrial medicine at the Medical School in 1919. She and the rest of the Division of Industrial Hygiene became part of the School of Public Health in 1922, when it replaced the Harvard MIT School for Health Officers.

In addition to marking the centennial of Alice Hamiltons appointment, what inspired you to write a book about her?

I first heard about her when I was a graduate student at Harvard, first in the Division of Engineering and Applied Physics, now known as SEAS, and then here at Harvard T.H. Chan School of Public Health. The more I learned about her, the more I admired her. By the time she was recruited by Harvard, she had been doing groundbreaking studies in occupational health and toxicology for 20 years. Moreover, she was not just a great scientist and epidemiologist, she was a pacifist and a suffragist, and shaped labor protection laws.

In the book, after describing her Harvard years, we then go back and look at what shaped her scientific skills and her commitment to social reform.

What did you learn about her during your research?

Dr. Hamilton was self-educated and home-schooled. She was raised by strong women who instilled in her independence and the importance of giving back. She and her three sisters all remained singlea sensible option at the time for women who wanted careers. All went on to be very accomplished in their respective fields.

Alice was always attracted to science and medicine. When she asked her father for permission to go to medical school, he questioned whether she was tough enough. They made a bargain. She would first study for a year at a small medical school in Fort Wayne, Indiana, near their home. She was more than up for the challenge. A year later, her father agreed that she should have access to the best medical education open to women. She went on to excel at the University of Michigan and Johns Hopkins, and continued her studies in Germany with Paul Ehrlich, who went on to win a Nobel Prize.

A very important part of her education came during the years she spent at Hull Housethe renowned settlement house in Chicago made famous by Jane Addams. There she lived with immigrants and the poor. As she provided medical care, she came to realize that jobs were a major source of injury and illness for workers and their families. For example, men who worked with asbestos or lead exposed their families through the work clothing they brought home to be washed.

She and her colleagues collected and analyzed a remarkable amount of data on the population they servedincluding demographics, income, ethnicity, and disease outcomes. The epidemiological maps they made look like the kind of maps we make today with spatial analysis technologies.

When the founders of our School realized that they needed a leader in occupational health, they discovered that Alice was by far the best candidate. The University at first said that Harvard only educates menand of course, only men can educate men. But our schools leaders persisted. Future SPH Deans David Edsall and Cecil Drinker, who were with HMS at the time, persisted in advocating for her and for breaking the gender barrier. In the fall of 1919, the University relented.

Alice had a very distinguished 20-year career here. When she retired, she was still an assistant professorthose of us in the Alice Hamilton fan club wonder why. For another 30 years, she continued to make U.S. factories and mines safer.

What can Alice Hamilton teach todays public health students?

She is a model of the responsibilities of privilege, which is a combination of adequate wealth and education. If you have both, you need to deploy them to make permanent positive inclusive change for all.

Dr. Hamiltons whole life was about making a difference. She wasnt just interested in learning about and measuring injury and disease caused by occupations. Her work was unfinished until she translated her science into action and national policy. And thats the kind of research we should do and the kind of careers we should seek.

Learn more

Op-ed: Celebrating Alice Hamilton, who pioneered national safety standards (Harvard Chan School news)

Public health pioneer Alice Hamilton documented dire health conditions in post-World War I Germany (Harvard Chan School news)

Amy Roeder

Photo: Kent Dayton

Originally posted here:
The education of occupational health pioneer Alice Hamilton - HSPH News

You go girl!

LaShyra Lash Nolen made history by becoming the first Black woman to be elected as class president of Harvard Medical School, Teen Vogue reports.

The Compton native says she was always inspired by the Black women around her, particularly her grandmother and mother who had Nolen at just 18-years-old and raised her as a single mom while pursuing her masters degree andworking multiple jobs. Nolen says she owes most of her drive to her upbringing.

The city of Compton is one of the most resilient in the world. Growing up and watching [my mother and grandmother] struggle and work so hard to give me what I had in my life, I couldnt help but do everything in my power to make them proud. I feel like Compton made me scrappy. Im hungry for opportunity, Im hungry for justice. Im hungry to see my people win. So, when you put someone like me at a place like Harvard Medical School, Im going to do whatever it takes to make that vision a reality.

Nolen said that she always had big dreams for her life and knew very early in age that she wanted to do something in the medical field. It was the motivation from her mother and grandmother that ultimately got her there, and she never forgets it. Mom pursued life with grit and a desire to win. She would tell me, Ill see you at the top. My grandma would tell me that whatever I wanted to do, we were gonna make it happen. After telling her I wanted to become a surgeon, she would tell me to protect my hands.

It was that instilled foresight that would ultimately carry Nolen all the way to Harvard. She is currently a Fulbright Scholar, activist, and a leader in the medical field. Her election as class president, while historical, is something that she believes is much bigger than her.

For me it means opportunity - opportunity in the sense that it will allow me to create a pipeline for others who look like me to hold positions of leadership at Harvard Medical School. When applying to HMS, I didnt see people who looked like me in student council or positions of leadership at that level. I think it is important to show that Black people can also be the face of a university, she said.

As class president, Nolen is currently working on various community outreach events that help to shape a new narrative about who should be highlighted at Harvard. She hopes that through her story and work, she can inspire other Black girls who are pursuing their dreams.

Go get it. Our society has a way of implicitly reminding young Black girls what they cannot achieve and what they cannot be...And there are so many young girls out there who are excellent and deserve access to opportunity, but wont take the leap because society tells them that its not for them. So no matter how crazy it might sound, no matter if someone in your family has done it or not, just go get it, because you miss 100% of the shots you dont take, Nolen said.

Congratulations President Lash! We wish you all the best in your endeavors!

Photo Courtesy of Gretchen Ertl/Teen Vogue

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Meet Lash Nolen, Harvard Medical School's First Black Woman To Be Elected Class President - Because of Them We Can

Walking 10,000 steps a day isa good baseline to help you stay fit, but it isn't the one-size-fits-all goal you might think.

Fitness trackers such as Fitbit usethe number as a default goal, but fitness experts suggest tailoring a step goal to an individual. Researchers traced the origins of the 10,000-step practiceto a marketing gimmick from the 1960s and suggested some people don't greatly benefit from walking so much.

Harley Pasternak, a celebrity personal trainerwho works with Fitbit,sets the goal of at least 10,000 steps for his clients. He explained in an email to USA TODAYthat the step requirement, if it includes 30 minutesat a moderate intensity,satisfies guidelines for exercise set by the Centers for Disease Control and Prevention 150 minutes of moderate-intensity exercise a week.

I recommend to strive for 14,000 if youre trying to lose weight, he said.

Pasternak cautioned that the suggestionvaries based on lifestyle, and for some people, setting a lower goal would be ideal.

A Harvard study of nearly 17,000 women ages 66 to 78 found that those who walked 7,500 steps or more had the lowest mortality rate.

Even women who walked 4,400 steps had a lower mortality rate than those who were the least active and walked only about 2,000 steps. There were few, if any, additional benefits for the women who walked more than 7,500 steps.

I-Min Lee, a professor of medicine at Harvard Medical School and the lead researcher in thestudy, told USA TODAY the 10,000-steps-a-day recommendation was developed in the 1960s by early pedometer makers.

"It got started as a marketing tool for a Japanese company," Leesaid, referring to a Japanese pedometer released in 1965called the "10,000 steps meter." She said there haven't been any scientific studies backing up that number. Asked why it became standard, she explained simply,"It's an easy number to remember."

Lee suggestedwalking 2,000 more steps than you normally walk every day.

You'll meet health guidelines by walking 10,000 steps daily and it's not bad advice for younger people or those who have more experience with a fitness regimen. But Lee said that for older peopleand those who are less fit, the so-called magicnumber is demoralizing. She notedthat for people who are inactive,setting too high a standard may discourage them from exercising entirely.

"If you're inactiveand your goal is to become more active, then set a reasonable goal," she said.

The average American, according to Lee, gets 4,000 to 5,000 steps every day.

Although the Department of Health and Human Services lists a 150-minutes-a-week requirement, it makes it clear that any physical activity no matter how slight is better than none.

Follow Joshua Bote on Twitter: @joshua_bote

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Do you really need to walk 10,000 steps a day? Experts say there's a better goal - USA TODAY

Hundreds more high school students are going to be able to kick off careers in health care.A school expansion in Butler County is giving them new opportunities.Students who are already taking classes at Butler Tech's Bioscience Center said Tuesday the expansion is welcome and necessary."We needed more space, basically," junior Kirsten McMillen said. "There's a lot of kids here and each year we're accepting more students, so we kind of needed more space. We needed bigger classrooms as well."The Bioscience Center opened five years ago and is already out of room.On Tuesday, the school revealed a new second-floor addition with more than 4,600 square feet of learning space."We had students sitting on the floors, crammed together in classes. We had tables under the stairwells. We were packed," Principal Dr. Abbie Cook said.Dr. Cook said the medical field is booming and the demand continues to grow, especially in Southwest Ohio, where careers are always in demand.Enrollment at the school is skyrocketing."We've been here for five years and we have grown 1/3 of our population in that time," Dr. Cook said. "We were crammed for space and our teachers and students and myself are thrilled to have space we've grown into available for our students. We were really packed."Cook said the school is ready to continue to grow."We actually have room to put a third floor on and it's prepared for that, so keep an eye out because that will be happening hopefully soon," Cook said.Cook said BSC is a blended-learning campus that helps students transition into the real world, while getting them ready to take on a new career in the medical field.

Hundreds more high school students are going to be able to kick off careers in health care.

A school expansion in Butler County is giving them new opportunities.

Students who are already taking classes at Butler Tech's Bioscience Center said Tuesday the expansion is welcome and necessary.

"We needed more space, basically," junior Kirsten McMillen said. "There's a lot of kids here and each year we're accepting more students, so we kind of needed more space. We needed bigger classrooms as well."

The Bioscience Center opened five years ago and is already out of room.

On Tuesday, the school revealed a new second-floor addition with more than 4,600 square feet of learning space.

"We had students sitting on the floors, crammed together in classes. We had tables under the stairwells. We were packed," Principal Dr. Abbie Cook said.

Dr. Cook said the medical field is booming and the demand continues to grow, especially in Southwest Ohio, where careers are always in demand.

Enrollment at the school is skyrocketing.

"We've been here for five years and we have grown 1/3 of our population in that time," Dr. Cook said. "We were crammed for space and our teachers and students and myself are thrilled to have space we've grown into available for our students. We were really packed."

Cook said the school is ready to continue to grow.

"We actually have room to put a third floor on and it's prepared for that, so keep an eye out because that will be happening hopefully soon," Cook said.

Cook said BSC is a blended-learning campus that helps students transition into the real world, while getting them ready to take on a new career in the medical field.

Continued here:
Need for medical careers helps West Chester school thrive and expand - WLWT Cincinnati

Gifty Kwakye, 38, an assistant professor of surgery at the University of Michigan, was told by her medical school classmates that she was too nice for surgery. She never questioned her own drive to operate, but she did worry that it would be difficult to balance her work with dreams of being a mother. She hoped to start a family during the research phase of her training, when she had more control over her schedule, but things didnt go as planned. Overcoming medical problems, she became pregnant three months before she was scheduled to return to clinical residency.

Transitioning from maternity leave back to clinical work felt like having cotton wool stuck in your brain, Dr. Kwakye said. She woke up every two hours at night to feed her baby. She was so dazed that she covered her home in sticky-note reminders: Bring the pump to work, the nipple protectors, the ice packs to keep the milk cold.

Worst was the guilt she felt spending 12-hour shifts away from her child. When Dr. Kwakye squeezed in a pickup at day care to relieve her husband, she watched her daughter run to the teacher and call her Mommy. That prompted a day care administrator to ask Dr. Kwakye whether she was on the list of adults approved for pickup, and the doctor had to explain that she was indeed the mother.

The kid didnt want to go to me, and I was like O.K., I deserved that, that was fair, you have no idea who I am, Dr. Kwakye said. But what that does to a mother is painful. I had a moment when I was like, I cant do this anymore; Im failing as a resident and Im failing as a mom.

One morning she sat in her car crying because she didnt want to leave her baby. She wondered if she should have heeded the warnings not to pursue surgery. She told herself, Maybe they saw something you didnt see and youre not tough enough.

As health care providers, surgeons are painfully aware of the ways in which their professional commitments can harm their own health and their familys. Alex Moore, a surgical resident at Brigham and Womens Hospital, said that spending long days away from her 6-month-old baby was especially upsetting because she has studied the medical importance of mother-child bonding. Returning to the operating room after a 10-week leave felt like your soul is getting ripped out, she said.

A surgeons schedule isnt just psychologically taxing, it also takes a physical toll. A resident spends most of the day on her feet. She may go eight to 12 hours without eating, or even drinking water. As one surgical resident put it, health often comes down to Do as I say, not as I do for doctors in training. Dr. Rangel, who had two babies, both born prematurely, wondered whether she was to blame for neglecting her health while pregnant.

Read more here:
When the Surgeon Is a Mom - The New York Times

For the first time in history, more women than men are poised to become doctors. According to an announcement from the Association of American Medical Colleges (AAMC), women now comprise 50.5% of all medical school students in the United States. That number has grown from 46.9% in 2015. This is out of a record 53, 371 students applying to medical schools in 2019.

In addition to the increase in female medical students, this years data indicates that there have also been slight increases in the number of racial and ethnic minority students in U.S. medical schools. Single digit percentage increases have been recorded in applications from several historically marginalized groups.

In 2019, applicants who are of Hispanic, Latino or Spanish origin increased 5.1% to 5,858, and graduates from this group grew 6.3% to 2,446. The number of black or African American applicants rose 0.6% to 5,193, while matriculants (those who end up enrolling) increased by 3.2% to 1,916. American Indian or Alaska Native applicants also grew by 4.8% to 586, while graduates in that group rose 5.5% to 230.

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The steady gains in the medical school enrollment of women are a very positive trend, and we are delighted to see this progress, David J. Skorton, MD, AAMC president and CEO, said in the press release. However, the modest increases in enrollment among underrepresented groups are simply not enough. We cannot accept this as the status quo and must do more to educate and train a more diverse physician workforce to care for a more diverse America.

An August 2019 study published in the journal JAMA Network Open found that female physicians are more likely than their male counterparts to either downgrade to part-time work or stop working completely a few years after beginning to practice. The study also showed that women are more likely than men to name family as an influence on their career decisions.

Getty Images | Scott Olson

However, this may be less a result of womens desires and more a by-product of societal expectations on women to have it all. Work-family conflict may be a culprit, the studys authors noted.

Its very common for people to see this and say some women are just choosing to put family first which is wonderful and a great choice for anyone who wants to make that, Elena Frank, lead author of the study and the director of the University of Michigans Intern Health Study, said in a statement earlier this year. But in reality, what were seeing is that often there isnt choice. Medicine has a big opportunity, and really, an obligation to set an example for how to support women and families.

This is good news, especially since theres evidence that both men and women do better healthwise when they see female physicians. For women, that may be in part because symptoms of disease or illness in women are often not the same as mens, yet medical doctors are trained to diagnose mens symptoms.

For those reasons, its great to see more progress in reducing the gender and racial disparities within the medical profession.

Excerpt from:
Women Now Make Up The Majority Of Medical Students In The U.S. For The First Time In History - Simplemost

With a new year just begun, we take a moment to look back at the most popular articles of 2019 reflecting innovations, breakthroughs, and new insights from the MIT community. The following 10 research-related stories published in the previous 12 months received top views onMIT News. A selection of additional top news that you might have missed follows.

10.Weve seen a black hole.An international team of astronomers, including scientists from MITs Haystack Observatory, announced the first direct images of a black hole in April. They accomplished this remarkable feat by coordinating the power of eight major radio observatories on four continents, to work together as a virtual, Earth-sized telescope.

9.The kilo is dead. Long live the kilo!On World Metrology Day, MIT Professor Wolfgang Ketterle delivered a talk on scientists new definition of the kilogram and the techniques for its measurement. As of May 20, a kilo is now defined by fixing the numerical value of a fundamental constant of nature known as the Planck constant.

8.A new record for blackest black.MIT engineers led by Professor Brian Wardle cooked up a material that is 10 times blacker than anything previously reported. The material is made from carbon nanotubes grown on chlorine-etched aluminum foil and captures at least 99.995 percent of incoming light. The material was featured as part of an exhibit at the New York Stock Exchange that was conceived by Diemut Strebe, MIT Center for Art, Science, and Technology artist-in-residence, in collaboration with Wardle and his lab.

7.Further evidence that Einstein was right.Physicists from MIT and elsewhere studied the ringing of an infant black hole, and found that the pattern of this ringing accurately predicts the black holes mass and spin more evidence that Albert Einsteins general theory of relativity is correct.

6.Understanding infections and autism. MIT and Harvard Medical School researchers uncovered a cellular mechanism that may explain why some children with autism experience a temporary reduction in behavioral symptoms when they have a fever.

5.A step toward pain-free diabetes treatments.An MIT-led research team developed a drug capsule that could be used to deliver oral doses of insulin, potentially replacing the injections that people with type 1 diabetes have to give themselves every day.

4.Da Vincis design holds up.Some 500 years after his death, MIT engineers and architects tested a design by Leonardo da Vinci for what would have been the worlds longest bridge span of its time. Their proof of the bridges feasibility sheds light on what ambitious construction projects might have been possible using only the materials and methods of the early Renaissance.

3.A novel kind of airplane wing.MIT and NASA engineers built and tested a radically new kind of airplane wing, assembled from hundreds of tiny identical pieces. The wing can change shape to control the planes flight, and, according to the researchers, could provide a significant boost in aircraft production, flight, and maintenance efficiency.

2.Simple programming for everyone.MIT researchers created a programming system withartificial intelligence that can easily be used by novices and experts alike. Users can create models and algorithms with the system, Gen, without having to deal with equations or handwrite high-performance code; experts can also use it to write sophisticated models and inference algorithms that were previously infeasible.

1.A new way to remove carbon dioxide from air.MIT researchers developed a system that can remove carbon dioxide from a stream of air at virtually any concentration level. The new method is significantly less energy-intensive and expensive than existing processes, and could provide a significant tool in the battle against climate change.

In case you missed it

Additional top research stories of 2019 included a study findingbetter sleep habits lead to better college grades; a meta-study on theefficacy of educational technology; findings thatscience blooms after star researchers die; a system forconverting the molecular structures of proteins into musical passages; andthe answer to life, the universe, and everything.

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Top MIT research stories of 2019 - MIT News

When Margaret Lawrence 36 arrived in Ithaca in 1932, she was the only black student in her class. Denied on-campus housing due to her race, the future psychoanalyst and pediatrician once slept in an attic, working as a live-in maid to help pay for her Cornell degree.

Lawrence whose name was Margaret Cornelia Morgan at the time applied in her senior year to the medical school to continue her education at Cornell, but was denied, since twenty-five years ago there was a Negro man admitted, a dean explained, and it didnt work out. That student had died from tuberculosis.

The Cornell Daily Sun June 12, 1936

Of this roster of graduates published in 1936, Margaret Lawrence 36 was the only black student.

Columbia University did accept Lawrence, propelling the alumna to eventually direct the Therapeutic Developmental Nursery at Harlem Hospital and becoming chief of the Developmental Psychiatry Service for Infants and Children for 21 years.

When Lawrence who would be known for her empathy for children patients, according to The New York Times was in medical school, she continually faced the compounded difficulty of sexism and racism as one of 10 women, and the only black woman in her class.

At Cornell, Lawrence was a skilled archer, scoring in the top eight and snagging a spot on the archery team, according to archived editions of The Sun.

She would chronicle these challenges in a book titled Balm in Gilead: Journey of a Healer, written by her daughter, Prof. Sara Lawrence-Lightfoot, sociology, Harvard University. In one recollection, Lawrence described how when she turned 21 and went to register to vote, she was asked to take a literacy test.

The Cornell Daily Sun on May 22, 1934

During her time at Cornell, Lawrence was involved in archery, repeatedly scoring among the top.

Lawrences story resonated with former Cornell University President Frank H. T. Rhodes, who reportedly heard her struggles and penned a short apology letter for the discrimination in 2008.

He wrote her a short letter of sincere and serious apology for the assaults ofdiscrimination and racism she had suffered, Lawrence-Lightfoot said.

According to The New York Times, Lawrence-Lightfood said that her mother appreciated the respectful and heartfelt apology.

Lawrence died on Wednesday in Boston at an assisted living center at the age of 105.

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Margaret Lawrence '36, Who Was Rejected From Cornell's Medical School Because She Was Black, Dies at 105 - Cornell University The Cornell Daily Sun

When we talk about medical school, our conversations tend to gravitate to a few key issues, particularly undergraduate grades, MCAT scores, and school prestige. These are undeniably major concerns the average medical school student had an undergraduate GPA of 3.79 for the 2018-2019 admission cycle, demonstrating just how hard it is to get a prime placement but theres a lot more to the future of the profession than who gets into the top few schools.

A meaningful conversation about medical education also needs to tackle issues like diversity, population-level health needs, and soft skills like compassion and collaboration. More than who attends Harvard or what residency students earn later on, these are the factors that will influence how well future doctors serve their communities.

How Money Shapes Medicine

Medical school is expensive; the median debt load is $200,000, and many students carry more than that. Meanwhile, the average first year resident makes about $55,000, hardly enough to start repaying those loans, and many students dont feel comfortable taking on that amount of debt, often on top of undergraduate debt, in the first place. This influences who goes to medical school and what communities they eventually choose to serve.

One structure that could increase access to medical education is offering students the opportunity to swap their loans for an income share agreement (ISA). A number of fields, including many trades, offer students the opportunity to participate in an ISA, in which an investor takes on the students debt in exchange for a set percentage of their income in the future. While the default rate on medical school loans is actually quite low, offering students the option of an ISA could encourage a greater number of low-income students to pursue medical education.

More Students Than Matches

After completing their basic medical education, students spend several years as resident, essentially trainees practicing under close supervision. Like everything else about medical education, residencies are highly competitive; medical students rank residency programs and are matched through a national placement algorithm based on specialty, location, and other factors. Where students match for residency has a major impact on where they choose to practice later in life but there are a number of problems with this system.

First, despite a national physician shortage, thousands of students arent matched with a residency each year. There just arent enough slots, even though the country is in desperate need of those doctors and many of the students who fail to match have great potential. Offering alternative paths to licensure, such as allowing graduates to practice under physicians in underserved areas, could increase the supply of doctors and give smart, eager students a chance to utilize their knowledge and training.

Distribution Issues

In addition to students failing to match with residencies, those who do match tend to be clustered in specific areas. Residencies are often based at teaching hospitals, which are in turn often in major cities or expensive suburbs. This is exacerbating the physician shortage in rural areas since students who are trained in well-equipped urban hospitals may feel unprepared to be one of a few doctors on call in a low-income, rural community. Medical residencies need to be redistributed or new residencies created in areas with major shortages and students need support and encouragement to pursue those areas.

Diversifying The Field

Finally, most industries reflect their leadership in terms of make-up. If a field is dominated by men at the upper levels, then men are most likely to enter the industry. The same divisions occur along racial lines. At the rate things are going right now, medicine wont reach racial or gender parity for many decades, and that has a lot to do with who is in charge of medical schools.

Because of changes at the undergraduate level, more than 50% of medical school students are now female, which makes it seem like medical education is on the right track. Thats true in some regard, yet because of deeply rooted disparities, it will be 50 years until half of all doctors are women. Of long-term medical school deans, only 7% of deans serving more than 12 years are women.

For healthcare to adequately serve patients, it needs to better reflect those it serves and that means looking beyond grades. Thats only a small part of who these students are and what theyll be capable of as medical professionals.

This article does not necessarily reflect the opinions of the editors or management of EconoTimes.

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Beyond Academics: What Our Conversations About Med School Overlook - EconoTimes

Roughly four in ten Americans will receive a cancer diagnosis in their lifetime. Many of those folks will never meet the doctors most instrumental in their treatmenttheir pathologists.

Pathologists operate behind-the-scenes. They help diagnose patients and provide treatment recommendations to other doctors.

The United States will need thousands of additional pathologists to meet patient demand over the next decade. They're likely to come from international medical schools.

International medical graduates are entering pathology in increasing numbers. Many of them are U.S. citizens who traveled abroad to receive their education. The United States should welcome them home to practice.

RELATED:With $160M lab project, Michigan Medicine takes pathology out of the basement

Pathologists examine body tissues, cellsand organs in order to study the causes and nature of everything from cancer and blood disorders to HIV/AIDS and cardiovascular disease.

Say a doctor suspects that her patient has breast cancer. She may collect a piece of breast tissue for analysis. From there, the sample goes to the pathologist, who conducts a thorough examination and makes a diagnosis. The pathologist also often conducts additional tests to determine which therapies are most likely to kill the cancer cells of that particular patient.

That work is absolutely crucial. Consider the importance of early detection of breast cancer. Women diagnosed with the disease at the earliest stage are more than six times likelier to live past five years than those diagnosed at the most advanced stage. Potential delays in that initial diagnosis could lead to delays in treatmentand a decrease in survival rates.

That's why the pathologist shortage is so concerning. The number of U.S. pathologists decreased by nearly 18%between 2007 and 2017. During that time, the "diagnostic workload per pathologist" rose by almost 42%.

That's taken its toll. One-third of active pathologists are "burned out," according to Medscape's 2019 survey.

And many pathologists are on the road to retirement. In a 2013 study, researchers found that more than 40% of pathologists were 55 or older. They predicted that retirements would reach their apex in 2021.

Consequently, by the end of next decade, the United States will be short more than 5,700 pathologists.

Graduates of international medical schools are poised to close that gap. They already account for nearly one-third of the U.S. pathologist workforce. That figure is set to increase over the next several years. Nearly 45% of active pathology residents graduated from an international medical school.

RELATED:AI could prompt merge of radiology, pathology into one specialty

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This year, 4% of international medical graduates selected residencies in pathology. That might not seem like a large numberbut it's nearly four times the share of U.S. med school graduates who chose pathology. Further, the percentage of U.S. grads selecting pathology has declined over the last five years.

Graduates of the school where I teach, St. George's University, are increasingly deciding to pursue careers in pathology. Twenty-three of our graduates just began pathology residencies in states nationwideeverywhere from California and Pennsylvania to Texas and New York. Over the past five years, more than six dozen of our grads have entered pathology programs.

The growing demand for pathologists must be addressed. Graduates of international medical schools will be the ones to meet that need.

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Industry VoicesThe shortage of invisible doctors and the expected fix - FierceHealthcare

In the early 1990s, Joost Elffers, a successful Dutch book packager, met an American expatriate living in Amsterdam named Gary Goldschneider.

Mr. Goldschneider was a brilliant but scattered polymath who completed his studies at Yale medical school but never practiced medicine and later became a concert pianist. He once played all 32 of Beethovens sonatas in one sitting for a crowd at a Philadelphia shopping mall, telling a reporter he was spiritually guided to give the concert.

Perhaps unsurprisingly, he was also into astrology.

For years, Mr. Goldschneider had asked people he met for their sun sign and date of birth, assembling a database of personality traits he supposed were natally based. Mr. Elffers, now 72, turned his ideas into a book, The Secret Language of Birthdays.

Until then, most astrology books, like Linda Goodmans Sun Signs, told you about yourself only in the broad strokes of the 12 zodiac signs: Sagittarians are purportedly free spirits, Scorpios are passionate, and so on.

But now, each day of the year was branded with highly specific information about character traits. The Secret Language of Birthdays tapped into something even older than the practice of astrology: human vanity (and suggestibility).

Its the book for the ultimate narcissist, said Megan Newman, the vice president and publisher of Avery, the imprint of Penguin Random House that publishes the book. You can look up yourself, the ex-boyfriend youre still stalking on Facebook, your mother-in-law.

This year is the 25th anniversary of the birthday book, as its referred to by fans, though its publisher isnt printing a special edition. Aron Goldschneider, Gary Goldschneiders son and the books editor, was unaware of the occasion until reminded recently. And of course anniversaries dont mean much anyway, right?

Still, like the Bible, the birthday book is always there, selling 1.5 million copies and counting, according to the publisher, with little promotion (it remains a No. 1 best seller in the Numerology category on Amazon), living for years on home library shelves and popping up randomly in the culture.

In a 2001 New Yorker profile of Jim Carrey, it was revealed that the actor and spiritual seeker (born Jan. 17, The Day of the Heavyweight) brought the birthday book to film sets to entertain the cast and crew.

More recently, Alexa Chung, the British TV host, model and fashion designer (Nov. 5, The Day of Actuality), gushed to a writer from Harpers Bazaar that the 365 detailed personality profiles are so spot on, its insane.

Ms. Newman said, Were still selling tens of thousands of copies a year, and she expects the book to have a renaissance, because of the interest among millennials in astrology, the secret lives of plants and other New Age subjects.

Stevie Anderson, 30, a host of the astrology podcast Whats Your Sign?, said the birthday book was her first introduction to astrology as a child back in the late 1990s.

My mom, who is the most Virgo person on the planet, always had the birthday book out, she said. It was a talking point. Any guest who came over, she would open up the book and talk about their day.

Ms. Anderson remembers her entry (May 2, The Day of Human Observation) as being very on the nose about how I felt about myself: Youre fun and productive, but also a dictator, basically. As a teenager, she would read aloud from the book during sleepovers with her girlfriends to better understand their personalities.

I have similarly used the birthday book as an interpersonal reference guide ever since a college buddy (and fellow Libra) gave me a copy 20 years ago. Though otherwise a fact-based person, I have a soft spot for the pseudoscience of astrology.

And over the years, I have looked up friends, relatives, romantic partners, my wife and son, as though gleaning some truth about their deepest traits.

Certain sentences from my own entry (Sept. 29, The Day of the Charged Reactor) rattle around my head. Reading that Sept. 29 people seem to have difficulty getting it together is one reason I spent my 20s laser focused on my career.

The parting meditation for my day reads, What do you see when you live at the center of the cyclone? an ominous phrase Ive been trying to parse for two decades.

If the birthday book is entertainment, not provable fact, its form nevertheless lends it a degree of authority. At 832 pages, it has the heft of an encyclopedia, and its designed like a reference book, down to the formal serif typeface.

Each day of the year gets a two-page spread chock-full of information, including 20 notable people born on that day, the position of the suns transit in the sky, the sign and corresponding element (fire, earth, air and water).

The design was Mr. Elfferss masterstroke. If you have a book of fake news, you have to go for a very conservative typography, he said. So I imitated the layout of the American Heritage Dictionary. Because that is the truth.

Mr. Elffers does not believe in astrology. He said his rational Dutch upbringing prevents such magical thinking. When I told him over lunch near his home in Greenwich Village how I had used his book to gain insight into loved ones, he responded bluntly.

For me, I find that horrifying, he said. And if you stress another time how much you love the book, I will defriend you and never see you again.

And yet, when Mr. Elffers was asked about his own birthday (Nov. 21, The Day of Elegance), he started talking like it was the dawning of the Age of Aquarius. Im a cusp. And Gary has a special place for the cusp, because thats the mixture of two and therefore theres a lot of turmoil and creativity.

The trouble with a Scorpio is they have no interest in any other sign, he went on about himself. They think theyre the only one.

The real magic of the birthday book is in the writing. Horoscopes arent a form known for their literary quality, but each of Mr. Goldschneiders personality profiles is incisive, direct and specific, yet with the necessary mystery.

Until recently, Mr. Goldschneider lived in a Dutch nursing home in increasingly poor health; he died earlier this month at age 80. It was Aron Goldschneider who revised his fathers writing until it was crystal clear, Mr. Elffers said.

Aron, 56, said the basic content came from his father, but he added complexity to the character sketches and balanced those that were too unflattering, filling out the positive side.

My father would write a page one day because of his experience with three people people he didnt even like that were born on a certain day, said Aron, a lawyer who lives in Philadelphia. Yoost would say, Gary, this is not a blessing.

Like Mr. Elffers, Aron does not believe in astrology. But he has heard from countless people over the years, he said, who have marveled at the way the birthday book gets to the heart of their favorite subject: themselves.

And he admitted that his own entry (Oct. 31, The Day of Attentiveness) rings true. Perhaps because his father wrote it.

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The Joy of Kooky - The New York Times