Carolyn Meltzer bringing integrity, a collaborative spirit, and a sense of service to taking on the toughest health challenges | Keck School of…

The new Dean sees Keck School of Medicine of USC as uniquely positioned to lead the health care innovation of tomorrow with its academic excellence and diverse urban community.

By Laura LeBlanc

Coming up through the ranks in medicine over the last three decades, Carolyn Meltzer has been part of great change, both in her areas of specialty, neuroradiology and nuclear medicine, and in the culture of medicine itself. As the new Dean of the Keck School of Medicine of USC, she sees the opportunity for the school to play a leading role in driving the innovations needed in health care now to take on the toughest diseases and make the system equitable and accessible.

Prior to joining USC, she was at Emory University School of Medicine, serving as Chair of the Department of Radiology and Imaging Sciences, the Executive Associate Dean for Faculty Academic Advancement, Leadership and Inclusion, and the William P. Timmie Endowed Professor. We sat down with her to talk about where shes been and where see sees the Keck School going.

When did you realize you wanted to go into medicine?

I was good at math and science and from high school on I was always intrigued with the brain how it works, the connections between biology, neurobiology and our cognitive selves. So, I thought I would become a scientist. My dad, a Greek immigrant, would always say consider medicine. I had worked in many laboratories and knew I was excited about research. But I thought, What if I turn out to be a terrible doctor? Still, secretly I let myself think about it. In college I got involved in a group called Women in Medicine where I was exposed to speakers who were physicians and women role models and decided that was the way to go.

What drew you to neuroradiology, medical imaging focusing on abnormalities of the brain, spine, head, and neck?

When I did my clinical rotation in neurology at medical school, I was with a chief resident at the county hospital and all he wanted to do was go look at the imaging. He kept saying, There are so many cool things. And really, we cant diagnose a lot without the imaging. Then I did some research in neuroimaging, in PET imaging, and thought, This is what I want to do. The problem solving, the spatial piece, the technology neuroradiology combines all of it. I love technology and being challenged with things innovating constantly.

Youve mentored more than 70 undergraduate and graduate students. Why is mentoring important to you and what do you gain from it?

I was a first-generation college and medical student. I had no idea what I was doing. I had people who spent time with me, supported me, who taught me things that other students were much more prepared for. And thats had such an impact on my life as well as my career. For me, its about giving back. But I also feel I continuously learn from my mentees, the questions they ask, which helps me evolve in how I approach them.

How has your experience coming up through the ranks in the medical field informed your approach to creating a culture of diversity, inclusion and equity?

When I went to medical school, only about a third of my class were women. And there was this deeply embedded culture, of very traditional, systemic, second-generation gender bias. Not to say we didnt have a lot of really supportive people. But basically, there was a masculinity in all of the terminology, how strong you could be, how tough you could be. As I got more comfortable with who I was in medicine and what I was pursuing, I was more able to be my authentic self. And thats really important. I think with folks who are identified with groups that are historically underrepresented in medicine, theres this sense of code switching where you have to be a certain self at work and then you can be more comfortable at home. Considering that is this an institution where people feel like they can be their authentic selves, where they feel like they belong is part of the inclusion piece, of creating an inclusive climate.

What three words best describe your leadership style?

Collaborative Im not afraid to make decisions, but I really want a lot of input. I know Ill make better decisions if I have a diverse team of people who bring different experiences and feel comfortable speaking up. Integrity values-based leadership is really important to me. As a leader you need to know where your own red line is, your own sense of whats right and wrong, to ensure the decisions you make are true to it. Finally theres a servant aspect. Servant leadership means when you agree to lead, you agree to serve others.

What excites you most about your new role as dean here?

The opportunity for positive impact. The people here are incredible. Together with the investments and the strategic focus that President Folt has set forward with Steve Shapiro, theres an extraordinary opportunity for us, uniquely as an institution, to address some complex problems in health care. Our connection with the community in one of the most diverse urban areas in the world allows us to work with those we serve to find solutions to the tough problems improving treatments for complex disease, mitigating the effects of climate change,

Imaging is not only your vocation its also your art and your work has been featured in about 60 exhibitions in the US and Europe. Has it influenced the way you approach medicine or research?

Obviously, its related in terms of the medium, but I think its more about spending time doing something separate from medicine. Also feeling comfortable showing my work and saying, Yes, Im a physician. Yes, Im a photographer. I dont have to be one or the other. Ill tell you a funny story I was once on a flight to a medical meeting in Beijing and I had brought my tripod, all my equipment. The flight attendant helped me put my tripod in the bin and he said, Oh, are you a photographer? I said, Yes. And we chatted a little bit about photography. Then somebody got sick on the plane, and they called for a doctor, and I got up and he said, I thought you were a photographer.

Tell us about your family. I understand youre a dog person and that one of them can read!

My husband and I have four rescue dogs. Weve been doing rescue work for a long time. Neither of us has the ability to say no to the other when one wants to bring an animal home. Ive had two therapy dogs and worked with them in all kinds of settings a school for the blind, childrens hospitals, nursing homes. Library programs have been particularly rewarding. Its easier for a child to feel comfortable reading to a furry cuddly dog than to an adult who may be correcting them. So, I always say, My dog can read, so do you want to read with him? And theyll read together. But COVID made my therapy dog fat and lazy. He couldnt go into libraries for two years. Now he just wants to lie on the couch.

Follow Dean Meltzer on Twitter@DeanMeltzerand Instagramdeanmeltzer_keckschool.

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Hormones may explain link between excess weight and endometrial cancer – Medical News Today

Endometrial cancer is the most common cancer affecting the female reproductive tract in high-income countries. In the U.K., one in 36 women are estimated to be diagnosed with endometrial cancer in their lifetime.

Research has indicated that women with a high BMI are more at risk of developing endometrial cancer.

BMI is calculated using a persons height and weight and is used to determine if a persons weight is within a healthy range. A BMI score of 20-25 is considered healthy, a BMI over 25 is considered overweight, over 30 is considered obese, and over 40 is considered severely obese, as accepted by the NHS. BMI is an indirect measure of fat tissue and it is less accurate in some individuals, hence remains controversial.

Dr. Sarah Gray, a general practioner who specializes in womens health, told Medical News Today in an interview that 20 years ago she worked on developing guidelines at The National Institute for Health and Care Excellence (NICE) for women with heavy periods, which can be a symptom of endometrial cancer. The guidelines concluded that the chance of getting uterine cancer below the age of 45, was really very remote.

She explained that as rates of obesity had increased in the population, this had changed:

Ive got a colleague who is now occasionally seeing uterine cancer in women in their early 30s, she said.

Now, a study published in BMC Medicine has quantified the increase in the risk of endometrial cancer in women with a high BMI and has proposed a mechanism for the link.

A team led by researchers from the University of Bristol, with support from Cancer Research U.K., carried out an analysis of genetic samples and health information taken from the Endometrial Cancer Association Consortium, the Epidemiology of Endometrial Cancer Consortium, and the U.K. Biobank.

Of the 121,885 women largely of European descent (from Australia, Belgium, Germany, Poland, Sweden, the U.K., and the U.S.) included in this study, 12,906 of these women had endometrial cancer.

They found an increase of 5 BMI points was associated with an 88% increase in risk of developing endometrial cancer.

They also discovered that increased testosterone, increased fasting insulin, and decreased sex hormone-binding globulin were associated with an increase in the risk of developing endometrial cancer.

Further analysis by the researchers also found evidence that BMI had an effect on fasting insulin, sex hormone-binding globulin, bioavailable testosterone, and the inflammatory marker C-reactive protein.

The authors hypothesize that increased BMI indicated increased fat tissue, which leads to increased fasting insulin and reduced sex hormone-binding globulin. This, in turn, leads to increased bioavailable testosterone. This testosterone can then be converted into estrogen, which may also increase the risk of endometrial cancer.

Dr. Alpa Patel, senior vice president of population science at the American Cancer Society, explained the link between BMI and endometrial cancer risk wasnt necessarily a new one.

We do know that especially in visceral fat that surrounds an organ, [which] is quite metabolically active, [that] is what increases your risk of both insulin resistance and hyperinsulinemia or higher levels of insulin, which can affect endometrial cancer risk, she told MNT.

Dr. Patel also touched on how menopause and hormonal changes may affect cancer risk.

After menopause, in fat cells themselves, you have conversions, of androgen (such as testosterone) to estrogen through an enzyme called aromatase. And that [ultimately] increases the conversion to different types of estrogen, and estradiol, which increases your risk of endometrial cancer because it is a hormone-related cancer in women. Dr. Alpa Patel

Dr. Patel said there was a direct link between excess body weight after menopause, owing to the increases in the conversion of androgen to estrogen, which can also increase the risk of endometrial cancer.

So, its not the androgens like testosterone alone. Its the increased conversion of those to estrogen through aromatase after menopause, she added.

Dr. James Yarmolinsky, the lead author of the study from the University of Bristol Medical School, explained to MNT how the study could influence clinical practice.

We try to understand mechanisms. This potentially opens up the possibility of targeting these particular molecules implicated, so mainly insulin and testosterone, he said.

[There are] medications like metformin, for example, which we know can increase insulin signaling. [T]hey help in the management of type 2 diabetes, which, in principle, potentially, could be repurposed in some way for endometrial cancer chemoprevention, he suggested.

Dr. Yarmolinsky said that the findings alone couldnt say whether this was a viable approach but it was a first step in the right direction.

Dr. Gray, meanwhile, said the studys findings could prompt women with a high BMI to be more aware of the symptoms of endometrial cancer, so they seek medical help in a timely manner.

Women who are particularly obese need to be able to monitor their periods. If they go chaotic, erratic, or heavy, then the test is ever so simple. Its going to be an ultrasound and/or a sample taking, she said.

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Hormones may explain link between excess weight and endometrial cancer - Medical News Today

Racism in Medicine: But Where Do You Really Come From? – Medscape

Racism in medicine is real, with negative consequences for patients, physicians, and the public as a whole. This point is not in dispute. I have been a victim of racism on multiple occasions. Sometimes an interaction is so traumatic that I try to forget, to bury it and move on. The feeling that you're a second-class citizen makes it that much more difficult to carry out the day-to-day work of medicine.

Given the problem and prevalence of racism in medicine, it's time for a real overhaul one backed by concrete steps rather than symbolic ones. It doesn't matter if you change the name of a building or a street; what matters is the actionable steps taken to ensure that people are treated fairly.

That said, I wonder if we sometimes overreact to certain remarks because we assume, based on (traumatic) prior experiences, that they are coming from a bad place. I say this not to discount or diminish the very real racial discrimination suffered by myself and my colleagues every day. However, I've found that it's also possible to misinterpret certain questions or statements when we don't have more context.

I say this from my own personal experience. Let me share two examples.

This past December, a 74-year-old woman with colorectal cancer was waiting for me in the clinic. She has been on first-line chemotherapy of FOLFIRI for several months, but I was seeing her for the first time.

After I walk into the exam room, we chat a little to build rapport. Naturally, the discussion is about Canadian winter and Christmas.

Suddenly, she asks a question that takes me by surprise: "Are you allowed to celebrate Christmas?"

I am startled because the conversation so far has been pleasant. I reply rather tersely, "Apparently, it's not yet illegal in Canada for everyone to celebrate Christmas."

She doesn't pursue it further. We talk about blood work, toxicities, scans, the usual. Thankfully, there was no bad news before Christmas.

As I am about to wrap up our encounter, she launches into the topic again, saying, "My daughter-in-law never celebrated Christmas. She was a Hindu from India."

I stop. I am still a bit offended that she assumed I was from India (I am not), and that even if I were, she assumed I'd be a Hindu by default (though I am).

But at this point I'm also intrigued. I ask, "Was? You said your daughter-in-law 'was.' What happened?"

With tears in her eyes, she says, "She passed away young. She was nice. But she didn't know anything about Christmas and never celebrated one. I thought that was because of her religion."

I thought about this encounter for several hours after. I'd been offended by her suppositions and generalizations, but once home, I recalled that as children in Nepal, we referred to every White person as American, and every East Asian as Japanese. We were and still are surprised and amused when non-Hindus celebrate our festivals like Dashain and Holi alongside us in Nepal.

Now an argument can be made that this is merely lack of education, and that everyone, with the means, should educate themselves that such generalizations can be dangerous and hurtful. But in this case, I could see that the question had come from a place of genuine inquiry with the emotional overlay of her past experience. There was no intended slight against me.

On another day in December, I meet a 78-year-old man with metastatic prostate cancer, accompanied by his wife. The news isn't good. The scans show disease progression.

I am seeing them for the first time, and when I enter the exam room, I greet them. After some basic introduction, they ask me, "Where are you from?"

I immediately take offense at this classic line of racial stereotyping.

My response: "From Canada," hoping the two words would dead-end the conversation.

But they probe further.

"Now, where are you really from?" Again I answer "From Canada," wishing in this moment that masks and face shields could hide my identity.

And again: "No, where did you actually come from? Where were you born?"

By now I am irritated. I lie, saying, "In Canada. I was born in Canada." Not because I am not proud of my heritage (I am super-proud), but I have learned that people often ask these questions to racially profile, discriminate, and undermine.

At last, we turn to medical matters. I break the bad news, albeit not as well as I had hoped. To my surprise, they take it calmly.

The couple then asks about my holiday plans and mentions that one of their kids is coming back home and they are really excited.

And suddenly, they blurt out, "You know what, doc, we came here from the Czech Republic several years ago, and it has not been easy for us learning a new language and raising kids. This young son, he is now in medical school and will soon become a doctor. We are so proud of him. For immigrants like us, it really means a lot. This country has given us so much and we feel very grateful."

Wow. I realized that I had completely misunderstood them. They were asking about my roots because they saw their own son in me, as an immigrant. I had thought they must be Canadians because they looked White. The mistake wasn't theirs it was mine!

Finally, I told them that I was from Nepal. They were immediately interested, looking up Nepal in Google Maps. We embarked on a long discussion about different cultures. Toward the end of our conversation, they said they'd really like their son to grow up to be a doctor like me.

The biggest compliment came next: They asked if I could be their oncologist moving forward.

I'm relaying these encounters with patients not to generalize that all "Where are you from?" comments are innocuous. I have been on the receiving end of similar remarks from patients that were intended as microaggressions, or sometimes overt discrimination.

These interactions also made me recall that before I moved to North America, I always assumed that this kind of question came from a place of interest, and I took it as an opportunity to talk about my country and my culture. Only after moving to North America did I learn that these questions are not necessarily genuine or harmless.

However, after these two encounters with patients, I began to wonder whether I had transitioned from being unaware or less aware of the racial implications of certain questions to being overly sensitive. I also wondered whether I could channel this emotional energy into positive change.

And there's a lot of work to do. We need to address systemic racism in access to cancer care, cancer outcomes, healthcare workers' education, and career opportunities. We need to address deep-seated biases about people's appearances, ethnicity, and culture.

When racial minorities ask for equality, they are asking for equal access to education, treatment, career opportunities, and salary, as well as to justice, respect, and freedom. A world that doesn't address these issues but simply stops asking us where we come from is not the just world we are seeking.

Addressing these issues would go a long way toward creating a more level playing field, toward real equality. In such a world, being asked "Where do you come from?" would not feel so loaded with judgment about who I am. In that world, I might once again feel confident that this question comes from a genuine place of interest.

Bishal Gyawali, MD, PhD, is an associate professor in the Departments of Oncology and Public Health Sciences and a scientist in the Division of Cancer Care and Epidemiology at Queen's University in Kingston, Ontario, Canada, and is also affiliated faculty at the Program on Regulation, Therapeutics, and Law in the Department of Medicine at Brigham and Women's Hospital in Boston. His clinical and research interests revolve around cancer policy, global oncology, evidence-based oncology, financial toxicities of cancer treatment, clinical trial methods, and supportive care. He tweets at@oncology_bg.

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UAMS to Offer Mindfulness-Based Stress Reduction Program – UAMS News

View Larger Image UAMS is offering a Mindfulness-Based Stress Reduction (MBSR) Program online starting March 2.

Jan. 28, 2022 | LITTLE ROCK The University of Arkansas for Medical Sciences (UAMS) Mindfulness Program is offering the Mindfulness-Based Stress Reduction (MBSR) Program online starting March 2.

Participants learn mindfulness techniques that foster positivity, inner strength and peace, while providing useful skills for navigating difficulty, stress, illness and pain.

The program is an eight-week, nine-session training in mindful awareness and meditation skills. Classes meet weekly online for about two hours and for an all-day session toward the end of the course.

Orientation is 5:30-7 p.m. Wednesday, March 2. Classes one through eight meet from 5:30 p.m. to 8 p.m. Wednesdays, March 9 to April 27. The all-day class and retreat is 9 a.m. to 3 p.m. Saturday, April 16.

The cost for the course is $300 and covers materials. UAMS employees may take the course for $250. Couples or families can receive a group rate of $225 per person. Scholarships are also available.

To register or apply for a scholarship, visit Mindfulness.UAMS.edu. For questions, contact UAMSMindfulnessProgram@uams.edu.

MBSR was developed by Jon Kabat-Zinn, Ph.D., in 1979 at the University of Massachusetts Medical School and is a form of mindfulness and meditation that is well-documented and supported by scientific studies. Participants learn different meditative tools to mindfully explore healthier relationships with the day-to-day challenges and demands of life.

Elements include:

The course is taught by Feliciano Pele Yu Jr., M.D., a professor of pediatrics, biomedical informatics and public health at UAMS; associate director of the UAMS Mindfulness Program; and certified Koru Mindfulness teacher who has completed the MBSR Teacher Training Intensive through the University of California San Diego Mindfulness-Based Professional Training Institute.

Professor of Psychiatry Puru Thapa, M.D., is director of the UAMS Mindfulness Program, which offers Mindfulness teachings and courses to the UAMS community and the general public. For more information, visit Mindfulness.UAMS.edu.

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Interim Leadership Named at Dell Medical School – UT News – UT News – UT News | The University of Texas at Austin

The following is a letter from Jay Hartzell, president of The University of Texas at Austin, sent to campus on July 15, 2021.

Dear UT Community,

Last week, we announced that Clay Johnston was stepping down from his roles as Dean of the Dell Medical School and Vice President for Medical Affairs at UT. We are incredibly grateful to Clay for his stellar leadership and glad that his pursuit of exciting new opportunities will still permit him to play a key role on our transition team and to continue helping our transformation effort as we push the boundaries of how we think about health not just health care at Dell Med.

This transition also presents an opportunity for UT to consider how we build our leadership structure to support the next chapter of expansion, growth and excellence in our medical journey. After consulting with Clay, our leadership team, and other stakeholders at the medical school, we have decided to take the opportunity of this transition to separate the two roles of Dell Med Dean and UT Vice President for Medical Affairs.

The monumental growth at Dell Med during the past seven years makes this structural change both necessary and exciting. The school will continue to be one of the most innovative and transformative medical schools in America, attracting incredible students and faculty members who are drawn to its unique position. Similarly, UT Health Austin, our clinical practice,which has grown fivefold since 2018,will continue to provide increasing amounts of world-class care to our community.This change is also a testament to our deep commitment to investing in outstanding staff members who play a powerful role in our universitys mission.

To enable us to continue to grow and develop while we have some uncertainty about the timing of Clays next role, weve asked George Macones, M.D., chair of Dell Meds Department of Womens Health, to serve as interim Dean, beginning September 1. Also, Martin Harris, M.D., MBA, the schools Associate Vice President of the Health Enterprise and Chief Business Officer, has agreed to be our interim Vice President for Medical Affairs, beginning August 1.

Moving forward, well follow standard UT procedures for selecting a new dean, a process that begins with an election of faculty members to form the basis for a search committee that advises university leadership along the way. Well also begin the search for a Vice President for Medical Affairs by convening a second search committee that will be chaired by Professor Chuck Fraser, M.D., Dell Meds chief of the Division of Cardiothoracic Surgery, and Amy Shaw Thomas, Senior Vice Chancellor for Health Affairs with The University of Texas System.

Thanks to the work of Clay and countless others, our medical school is on an exciting trajectory. We look forward to engaging with the campus community during the coming months as we work together to write the next chapters of Dell Meds powerful and transformative story as a place that changes the impact and reputation of UT Austin and health in Austin, Texas, and ultimately, the world.

Sincerely,

Jay HartzellPresident

Sharon WoodExecutive VP and Provost Designate

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Interim Leadership Named at Dell Medical School - UT News - UT News - UT News | The University of Texas at Austin

Unraveling the Mystery of Touch | Harvard Medical School – Harvard Medical School

Some parts of the bodyour hands and lips, for exampleare more sensitive than others, making them essential tools in our ability to discern the most intricate details of the world around us.

This ability is key to our survival, enabling us to safely navigate our surroundings and quickly understand and respond to new situations.

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It is perhaps unsurprising that the brain devotes considerable space to these sensitive skin surfaces that are specialized for fine, discriminative touch and which are continually gathering detailed information via the sensory neurons that innervate them.

But how does the connection between sensory neurons and the brain result in such exquisitely sensitive skin?

A new study led by researchers at Harvard Medical School has unveiled a mechanism that may underlie the greater sensitivity of certain skin regions. The research, conducted in mice and published Oct. 11 in Cell, shows that the overrepresentation of sensitive skin surfaces in the brain develops in early adolescence and can be pinpointed to the brain stem.

Moreover, the sensory neurons that populate the more sensitive parts of the skin and relay information to the brain stem form more connections and stronger ones than neurons in less sensitive parts of the body.

This study provides a mechanistic understanding of why more brain real estate is devoted to surfaces of the skin with high touch acuity, said senior author David Ginty, the Edward R. and Anne G. Lefler Professor of Neurobiology at Harvard Medical School. Basically, it's a mechanism that helps explain why one has greater sensory acuity in the parts of the body that require it.

While the study was done in mice, the overrepresentation of sensitive skin regions in the brain is seen across mammalssuggesting that the mechanism may be generalizable to other species.

From an evolutionary perspective, mammals have dramatically varied body forms, which translates into sensitivity in different skin surfaces. For example, humans have highly sensitive hands and lips, while pigs explore the world using highly sensitive snouts. Thus, Ginty said this mechanism could provide the developmental flexibility for different species to develop sensitivity in different areas.

Moreover, the findings, while fundamental, could someday help illuminate the touch abnormalities seen in certain neurodevelopmental disorders in humans.

Scientists have long known that certain body parts are overrepresented in the brainas depicted by the brains sensory map, called the somatosensory homunculus, a schematic of human body parts and the corresponding areas in the brain where signals from these body parts are processed. The striking illustration includes cartoonishly oversized hands and lips.

Previously, it was thought that the overrepresentation of sensitive skin regions in the brain could be attributed to a higher density of neurons innervating those skin areas. However, earlier work by the Ginty lab revealed that while sensitive skin does contain more neurons, these extra neurons are not sufficient to account for the additional brain space.

We noticed that there was a rather meager number of neurons that were innervating the sensitive skin compared to what wed expect, said co-first author Brendan Lehnert, a research fellow in neurobiology, who led the study with Celine Santiago, also a research fellow in the Ginty lab.

It just wasnt adding up, Ginty added.

To investigate this contradiction, the researchers conducted a series of experiments in mice that involved imaging the brain and neurons as neurons were stimulated in different ways.

First, they examined how different skin regions were represented in the brain throughout development. Early in development, the sensitive, hairless skin on a mouses paw was represented in proportion to the density of sensory neurons.

However, between adolescence and adulthood, this sensitive skin became increasingly overrepresented in the brain, even though the density of neurons remained stablea shift that was not seen in less sensitive, hairy paw skin.

This immediately told us that theres something more going on than just the density of innervation of nerve cells in the skin to account for this overrepresentation in the brain, Ginty said.

It was really unexpected to see changes over these postnatal developmental timepoints, Lehnert added. This might be just one of many changes over postnatal development that are important for allowing us to represent the tactile world around us, and helping us gain the ability to manipulate objects in the world through the sensory motor loop that touch is such a special part of.

Next, the team determined that the brain stemthe region at the base of the brain that relays information from sensory neurons to more sophisticated, higher-order brain regionsis the location where the enlarged representation of sensitive skin surfaces occurs.

This finding led the researchers to a realization: The overrepresentation of sensitive skin must emerge from the connections between sensory neurons and brain stem neurons.

To probe even further, the scientists compared the connections between sensory neurons and brain stem neurons for different types of paw skin. They found that these connections between neurons were stronger and more numerous for sensitive, hairless skin than for less sensitive, hairy skin. Thus, the team concluded, the strength and number of connections between neurons play a key role in driving overrepresentation of sensitive skin in the brain.

Finally, even when sensory neurons in sensitive skin werent stimulated, mice still developed expanded representation in the brainsuggesting that skin type, rather than stimulation by touch over time, causes these brain changes.

We think we've uncovered a component of this magnification that accounts for the disproportionate central representation of sensory space. Ginty said. This is a new way of thinking about how this magnification comes about.

Next, the researchers want to investigate how different skin regions tell the neurons that innervate them to take on different properties, such as forming more and stronger connections when they innervate sensitive skin.

What are the signals? Ginty asked. Thats a big, big mechanistic question.

And while Lehnert described the study as purely curiosity-driven, he noted that there is a prevalent class of neurodevelopmental disorders in humans called developmental coordination disorders that affect the connection between touch receptors and the brainand thus might benefit from elucidating further the interplay between the two.

This is one of what I hope will be many studies that explore on a mechanistic level changes in how the body is represented over development, Lehnert said. Celine and I both think this might lead, at some point in the future, to a better understanding of certain neurodevelopmental disorders.

Co-investigators included Erica Huey, Alan Emanuel, Sophia Renauld, Nusrat Africawala, Ilayda Alkislar, Yang Zheng, Ling Bai, Charalampia Koutsioumpa, Jennifer Hong, Alexandra Magee, and Christopher Harvey of Harvard Medical School.

The research was supported by the National Institutes of Health (F32 NS095631-01, F32-NS106807, K99 NS119739, DP1 MH125776, R01 NS089521, and R01 NS97344), a William Randolph Hearst Fellowship, a Goldenson Fellowship, a Harvard Medical School Deans Innovation Grant in the Basic and Social Sciences, and the Edward R. and Anne G. Lefler Center for the Study of Neurodegenerative Disorders.

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Serving those who served – Northwestern Now – Northwestern University NewsCenter

Russell, you completed a large chunk of your clinical training at Jesse Brown. How did that come to be?

After I had my first medical school rotation at the VA, I chose the VA for every other rotation I could. All of my interactions there were just so positive. I looked forward to coming back during my residency in ophthalmology.

What about the experience drew and kept you there?

The vets are just incredible and they all have such amazing stories. They've all lived through so much. It's people coming from different walks of life, and being there is a very enriching experience. You really feel like you're helping people who have, first of all, served and given so much to everybody in the United States, and also people who really need your help.

Russell Huang

What kind of population do you work with?

Jesse Brown is definitely an inner-city VA. The pathology is very advanced for a lot of these guys. These are people who are struggling with PTSD and other issues. They haven't been able to take care of themselves for years. So, you know, honestly there's nothing better than really just connecting with one of these vets. And, especially as a medical student, you have the ability to do so much. Every little thing that you do for them is so meaningful to them, and it really empowers you as a medical student.

How is the VA experience part of your residency program?

As ophthalmology residents at the VA, we spend at least six months there. Were in the clinic two to three days a week. And by our fourth year, we're in the operating room half the time.

What types of procedures are you doing?

There's a very high incidence of glaucoma and also very advanced cases of cataracts. Many patients walk into our office legally blind from their cataracts. Doing cataract surgery on them is one of the most satisfying surgeries that we do because we can restore their vision.

You must hear interesting stories.

Before COVID, we used to have this big waiting room full of guys, and you could hear them trading war stories, talking to each other about their eyes, talking to each other about everything else that's going on, and cracking jokes. I treated one guy who was working on a screenplay. Its fun.

How is your clinical training different because it is at the VA?

You learn to be very independent very hands-on. The VA really pushes you. You're the doctor, and the buck stops with you. If you think there's something a patient needs, you have to get it done and, for better or worse, thats what makes the VA such a special place.

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Serving those who served - Northwestern Now - Northwestern University NewsCenter

This Medical School Has An Admission Rate Of Less Than 1%: Heres How To Get In – Forbes

Kaiser Permanente Bernard J. Tyson School of Medicine is one of the newer medical schools it matriculated its inaugural class of 50 students in 2020but it is already one of the most competitive programs in the United States. With nearly 10,500 applicants in 2020-21, the medical school acceptance rate hovers around 0.05%.

Medical school student preparing her applications

Moon Prep sat down with Dr. Lindia J. Willies-Jacobo, MD, the Senior Associate Dean for Admissions. This interview reveals what the new medical school is prioritizing in their applicants and how students can be competitive applicants with resumes full of meaningful experiences, even during a pandemic. The full interview can be viewed here.

Dr. Lindia Willies-Jacobo is the Senior Associate Dean for Admissions and Equity, Inclusion, and ... [+] Diversity; Professor at Kaiser Permanente Bernard J. Tyson School of Medicine

Kristen Moon: What are the advantages and disadvantages of attending a newer medical school like Kaiser Permanente Bernard J. Tyson School of Medicine?

Dr. Lindia J. Willies-Jacobo: It's something we talk with students about during recruitment. Students are extraordinarily risk-averse, making it more difficult to commit to a brand new med school. However, I would argue that being part of a new school allows students to be innovative at our school.

For example, one of the things we've said to our students is they get to provide us with a lot of feedback. As the inaugural class, they have a significant impact on the direction in which the school goes. It tends to be the class that leaves a legacy.

The other piece I point out to students is that when you are building something new, you can think out of the box. I think when one goes to a traditional school that's been around for 10 or 50 years, it's a lot harder to enact even simple changes. With a new medical school, I think of it as a blank canvas that students really get to paint on.

Moon: What was the motivation for offering free tuition for the first five enrolling classes?

Willies-Jacobo: At our school, we do have free tuition and fees for any student who enrolls with us from between 2020-24. Many new schools do something similar and have built into that some level of tuition remission.

When you look at the cost of medical school education, it's astronomical. By offering free tuition, it allows students from economically disadvantaged backgrounds the opportunity to consider coming to medical school.

It also allows the students the opportunities to select specialties that really align with their personal and professional values without thinking too much about how much they're going to be remunerated as physicians later on. The reality is there are loans to be paid off. Students who may want to pursue primary care may decide otherwise because then the remuneration for someone who does primary care is often quite a bit less than someone who does a surgical specialty or another specialty. This frees students up to make specialty decisions beyond thinking about loan payments.

Moon: In 2020-21, the medical school received more than 10,000 applicants, with an acceptance rate of 0.05%. What did you prioritize in your evaluation?

Willies-Jacobo: It's important to know and understand the mission of the school to which you're applying. When mentoring students or talking to pre-med students, I emphasize putting together a portfolio that demonstrates mission alignment.

I've had people say, Well, every application must look exactly the same, but it doesnt. We utilize a holistic approach, and what we are always looking at is whether the student's personal narrative coupled with the experiences they've listed on their application and supportive letters of recommendation fit together in ways that show us that they are mission-aligned.

We designed our secondary or school-specific application and interview process in a way that allows students to demonstrate if their professional and personal goals are aligned with those of the school.

Moon: Another interesting statistic is that 30% or more of your students are non-science majors. How can these non-science majors stand out?

Willies-Jacobo: Unlike when I went to med school when it seemed like everyone was a science major, we now know that depending on the school, you can have upward of 30-40% of non-science majors in your applicant pool. Each year, we see more and more of these types of students applying for medical school.

When we are assessing applicants for readiness for medical school, there are still prerequisites and recommended courses that every student has to take. We want to ensure that students who are non-same majors can also demonstrate readiness from a science perspective. Many non-science students are still academically strong, but they also bring so much value to the institution. Many non-science majors often see things very holistically and with an entirely different set of lenses.

Moon: Can you tell me about your interview process?

Willies-Jacobo: We use the hybrid model because we know that some students tend to thrive in one-on-one interviews, and others may do better in the Multiple Mini Interview (MMI). The hybrid method allows us to attract a diverse pool of students.

This past cycle, we did something very similar but pivoted to a virtual platform. To do so, we cut back on the number of MMI stations because we knew that Zoom fatigue is real. With the hybrid approach, we often will compare how they performed in the MMI versus the traditional interview.

We do find that extroverted students tend to do a lot better in MMI stations. You have to be a self-starter in terms of conversation, and we find that more extroverted students tend to warm up more quickly than introverted students who require a little bit more time.

Moon: How would you recommend students prepare for the hybrid interview?

Willies-Jacobo: Im a huge believer in practice. Of course, some people suggest that you cant practice, but I disagree with that.

I typically encourage students to meet with a mentor and review practice MMI stations or questions to have them practice responding to them. In a virtual space, it is a little harder to answer interview questions because youre not getting as many cues as you would in person.

I remind students that anything that they put in their application is fair game, so remember what you listed. For example, review your research experience, community-based experiences, extracurriculars because inevitably it's going to come on their interviews. There's nothing worse than applying in June, getting interviewed in November and having not a clue what you wrote down.

Moon: How many students do you interview each year and accept?

Willies-Jacobo: We interviewed a little over 700 candidates for about 50 spots. Typically it ends up being about a two-to-one ratio in terms of acceptance versus who ends up matriculating, which is about average for a school of our size.

Moon: How important is it to apply early in the cycle?

Willies-Jacobo: Please apply early. This past year, 60,000 candidates applied to med school, and in any given year, about 60% of students don't get into med school.

If you apply in September or October, it takes four to six weeks for the Association of American Medical Colleges (AAMC) to verify the files. Even though youre a phenomenal candidate, you might not get an interview because school runs out of interview spots.

Moon: How has Covid-19 affected the admission process for students?

Willies-Jacobo: On the national level, there was an 18% increase in applications. Personally, we had an 11% increase in our applications. But another thing that we saw was to make adjustments for the number of experiences that students list on their applications. Students had Fulbright Scholarships canceled. Students had research or volunteer experiences go virtual or canceled altogether. In-person shadowing was also completely off the table.

We did see an increase in students working as Covid-19 contact tracers or virtual medical scribes. Although they couldnt go into hospitals, they still found virtual experiences. We had a lot of students being innovative and really rose to the occasion and made do with what was a very, very challenging admissions cycle.

Moon: What type of services do you provide students to help them succeed?

Willies-Jacobo: Support comes from our Office of Student Affairs. Wellness is a core value, so we have the wellness program coordinator. We also have a clinical psychologist on-site, and one of the things we've tried to do at the school is to normalize mental health. We've encouraged every student to check in with our clinical psychologists at least two to three times in the first year.

We also have pretty robust academic support for the student. We have someone who works with them on study skills and strategies. I also want to highlight our coaching program; every student is paired with a physician coach. Students meet several times a year with their coaching groups. This is a pretty distinctive and forward-thinking aspect of our program.

Students can learn more about Kaiser Permanente Bernard J. Tyson School of Medicine and submit their application through the American Medical College Application System (AMCAS).

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This Medical School Has An Admission Rate Of Less Than 1%: Heres How To Get In - Forbes

Dean Jha named one of World’s 50 Greatest Leaders – The Brown Daily Herald

While an undergraduate at Columbia studying economics long before he would be named one of the Worlds 50 Greatest Leaders by Fortune Magazine Ashish Jha, dean of the School of Public Health, was a pre-med student in part because his parents really wanted him to go to medical school. Youre never supposed to tell (that to) anybody in medical school applications, Jha said, laughing.

But despite the initial feeling of obligation to parental expectations, Jha found a deep love for medicine and then public health while getting his MD at Harvard. I feel like its been such a huge part of my identity, Jha said. As a doctor, you get these very concrete skills that you can use to alleviate suffering, to take people who are in pain, to take people who are going through a difficult time and to make that better, he added.

Jha has been a cable news channel mainstay throughout the COVID-19 pandemic, focusing on helping viewers navigate the complex time by providing accessible commentary on the coronavirus and public health measures. He also maintained a popular Twitter account and a steady presence in prominent news media, both as a source and an author. In addition, Jha has been a guest on The Heralds COVID Pod, and published a Jan. 28 op-ed in The Herald.

Jha uses his widespread presence across platforms to broaden his audience. The people you reach through television are different than the people you reach through newspapers (who are) different from people you reach through social media, he said. If you want to communicate to a broad group of people, youve got to use multiple mediums.

Fortune Magazine named him one of the Worlds 50 Greatest Leaders in May for his focus on providing easy-to-understand analysis about the pandemic through multiple mediums with a healthy sprinkling of empathy.

Theres a whole group of people working on this tirelessly, and its really our collective effort that makes a difference, Jha said when asked about the accolade. For Jha, the idea of one person getting the credit for work done by a team of experts has always seemed odd.

One of the things I love about being at Brown is its incredible community of scientists, advocates, and we all work together in what seems like a one-person show, (but) is really an entire team working on all of these issues, he added.

Having come to the University less than a year ago from Harvard, where he was the faculty director of its Global Health Institute, Jha has already begun to build a team around him to drive the COVID-19 response and the work of the Public Health school.

He empowers others, said Stefanie Friedhoff, senior director of content, strategy and public affairs and professor of the practice at the School of Public Health. He has the ability to just bring really diverse voices to the table for a conversation focused on solving problems, she added.

He is a really great leader. He is both visionary, able to articulate where things should go and why, and he is someone who creates space for others to develop their own visions and strategies, Megan Ranney MPH10, professor of emergency medicine and associate dean of strategy and innovation for the School of Public Health, said.

Ranney first met Jha around a year and a half ago, before he had come to Brown and when both were working on providing public health guidance at the start of the pandemic. Soon they were co-writing an article in the New England Journal of Medicine and appearing together on television. (We) struck up a friendship, Ranney said. It was neat to be on (television) with another person who was intelligent and interesting and well spoken.

Now together at the School of Public Health, Ranney has found working alongside Jha a terrific experience. The two of us are strongly aligned in the importance of the research and education and scholarship that we do, she added. I feel very, very lucky to have him here its just such a delight to get to work with him.

Despite Jhas position as a leader in the public health field and his frequent appearances on television, he says he has shared the anxieties felt by many people throughout the pandemic. On a personal level, he said, there has been a lot of uncertainty, concern about making sure that my family is safe my immediate family, of course, my spouse and kids, but also my elderly parents and other friends and family.

But he has been nonetheless driven by a sense that everything he has done in the past year and a half is part of (his) job to communicate to people about what is happening with this disease and the pandemic.

I think theres a recognition that we as a society really are all in this together, Jha said. There is an understanding that everybodys fate is tied to everybody elses, he added. A recognition of our common humanity, not just within our country, but globally.

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Dean Jha named one of World's 50 Greatest Leaders - The Brown Daily Herald

Investigational Alzheimer’s drug improves biomarkers of the disease Washington University School of Medicine in St. Louis – Washington University…

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International clinical trial yields mixed results with unclear cognitive effects but promising biomarker results

Randall Bateman, MD, director of the Dominantly Inherited Alzheimer Network-Trials Unit (DIAN-TU), an ongoing international clinical trial to evaluate experimental Alzheimers drugs, speaks with DIAN-TU participant Taylor Hutton. One of the drugs tested in the DIAN-TU, gantenerumab, improved biomarkers of disease despite unclear cognitive effects, prompting study leaders to offer participants the option of continuing to receive the drug and participate in follow-up examinations as part of a so-called open label extension.

An investigational Alzheimers drug reduced molecular markers of disease and curbed neurodegeneration in the brain, without demonstrating evidence of cognitive benefit, in a phase 2/3 clinical trial led by researchers at Washington University School of Medicine in St. Louis through its Dominantly Inherited Alzheimer Network-Trials Unit (DIAN-TU). These results led the trial leaders to offer the drug, known as gantenerumab, to participants as part of an exploratory open-label extension. The researchers continue to monitor changes in measures of Alzheimers disease in those participants who are receiving the drug.

The DIAN-TU study (ClinicalTrials.gov Identifier: NCT01760005), published June 21 in Nature Medicine, evaluated the effects of two investigational drugs gantenerumab, made by Roche and its U.S. affiliate, Genentech, and solanezumab, made by Eli Lilly and Co. in people with a rare, inherited, early-onset form of Alzheimers known as dominantly inherited Alzheimers disease or autosomal dominant Alzheimers disease. Such people are born with a mutation that causes Alzheimers, and experience declines in memory and thinking skills starting as early as their 30s or 40s.

Gantenerumab had a major impact on Alzheimers biomarkers, said principal investigator Randall J. Bateman, MD, director of DIAN-TU and the Charles F. and Joanne Knight Distinguished Professor of Neurology at Washington University. The drugs ability to shift multiple Alzheimers biomarkers toward normal indicates that it is positively affecting the disease process. The effect was strong enough that we launched an open-label extension of the trial so participants have the opportunity to stay on the drug as we continue to study it.

Over the past few decades, scientists have pieced together the changes that occur as Alzheimers develops, a process that takes 20 years or more. First, the protein amyloid beta starts forming plaques in the brain. Later, levels of tau and neurofilament light chain rise in the cerebrospinal fluid that surrounds the brain and spinal cord, and the brain begins to shrink. Then, tangles of tau protein form in the brain. Only then do people with the disease start exhibiting signs of memory loss and confusion.

In this study, 52 patients were randomized to gantenerumab, which led to a reduction in the amount of amyloid plaques in the brain, and lowered soluble tau and phospho-tau, and slowed the rise of neurofilament light chain levels in the cerebrospinal fluid. Neurofilament light chain is a marker that reflects neurodegeneration. Overall, gantenerumabs safety profile in this trial was consistent with that from other clinical trials of the investigational medicine, and no new safety issues were identified.

The primary endpoint of the DIAN-TU study was the prevention or slowing of cognitive decline in people who are nearly certain to develop Alzheimers due to genetic mutations. Neither drug met the primary endpoint, although the study wasnt able to determine effects on thinking and memory in participants who entered the study without symptoms, because they exhibited little to no decline in cognitive function. The study also was unable to assess the effects of higher doses of the drugs, which were escalated to the desired levels late in the trial after a protocol amendment. Participants who received gantenerumab started on a low dose and only started ramping up to a fivefold higher target dose about halfway through the trial, prompted by observations from other studies of gantenerumab.

However, as a secondary endpoint, the study also evaluated the effect of the drugs on molecular and cellular signs of Alzheimers disease. On these measures, gantenerumab showed potential benefit.

These biomarker results suggest that gantenerumab had a favorable impact on the target and downstream markers of Dominantly Inherited Alzheimers Disease, said Rachelle Doody, MD, PhD, global head of neurodegeneration at Roche and Genentech. We support the continued scientific investigation of gantenerumab in Washington Universitys exploratory, open-label extension study to build on learnings from DIAN-TU-001, and are grateful to be a part of this close collaboration between industry, academia and patients as we continue to tackle the complex challenge of Alzheimers disease. We are encouraged by the advancements being made and look forward to continued progress for people with Alzheimers disease.

This trial followed 144 participants for up to seven years; the average follow-up was about five years. All participants carry a genetic mutation that causes a form of Alzheimers dementia at early ages. The researchers recruited participants who were expected to develop symptoms within 15 years or who already had very mild symptoms of memory loss and cognitive decline at the trials outset. In most cases, their brains already showed early signs of disease. Participants were randomly assigned to receive solanezumab, gantenerumab or a placebo.

Although the trial focuses on people with rare mutations, drugs that are successful in this population would be promising candidates for preventing or treating the forms of Alzheimers that occur more commonly in older adults. The destructive molecular and cellular processes in the brain are similar in both types of the disease, Bateman said.

Salloway S, Farlow M, et al. A Trial of Gantenerumab or Solanezumab in Dominantly Inherited Alzheimers Disease. Nature Medicine. June 21, 2021. DOI: 10.1038/s41591-021-01369-8

Data analyzed in this paper was obtained with the support of the National Institute on Aging of the National Institutes of Health (NIH), grant numbers U01AG042791, U01AG042791-S1, R01AG046179, R01AG053267-S1 and U19AG032438; the Alzheimers Association; Eli Lilly and Co.; Roche and Genentech, a member of the Roche group; Avid Radiopharmaceuticals; GHR Foundation; an anonymous organization; Cogstate; Signant; the German Center for Neurodegenerative Diseases; the Raul Carrea Institute for Neurological Research; the Japan Agency for Medical Research and Development; and the Korea Health Industry Development Institute.

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

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Investigational Alzheimer's drug improves biomarkers of the disease Washington University School of Medicine in St. Louis - Washington University...

In Memoriam: Jean Wilson, M.D., made scientific discoveries that led to effective prostate treatments, insights into sexual differentiation – UT…

DALLAS June 21, 2021 Jean D. Wilson, M.D., an internationally known endocrinologist whose scientific discoveries led to profound insights into the mechanisms underlying sexual differentiation and led to now widely used treatments for prostate disease, died June 13. He was 88.

Wilson, seen here in 1962, graduated from UTSouthwestern Medical School in 1955 and joined the faculty in 1960, where he began his studies of testosterone.

Wilson, professor emeritus of internal medicine at UTSouthwestern, was largely responsible for current understanding of the mechanisms by which steroid hormones induce male sexual differentiation. He also was instrumental in identifying the scientific underpinnings of a widely prescribed class of drugs known as 5-alpha-reductase inhibitors which include finasteride (Proscar, Propecia) and dutasteride (Avodart) to treat enlarged prostate and balding in men.

Wilsons discovery of 5-alpha-reductase and the identification of dihydrotestosterone as the primary hormone associated with the growth of the prostate transformed our understanding of prostate gland growth and paved the way for new effective treatment of prostate disease, says Daniel K. Podolsky, M.D., president of UTSouthwestern. His findings led to the first medical therapy for benign prostatic hyperplasia, and also provided the basis for understanding of the mechanism underlying the differentiation of male and female genital development. His legacy will be found in the legions of patients who have benefited from the therapy made possible by his discoveries.

Wilson, seen in 1978, was a popular and highly sought-after attending physician on the wards of Parkland Memorial Hospital, valued for his vast expertise in endocrinology and medicine in general.

Jean Wilson was one of the most critical and helpful sources of information concerning the development of two important drugs we were developing at Merck the statins, for control of LDL cholesterol, and Proscar, for treatment of benign prostate enlargement. Wilson was always available to wrestle with problems that often arise in drug development. I needed expert friends in those early days, and probably still do, says P. Roy Vagelos, M.D., former chairman, president, and chief executive officer of Merck & Co. and now chair of the board of Regeneron Pharmaceuticals.

Wilsons research included the study of cholesterol metabolism and steroid hormone action. The UTSouthwestern Medical School graduate and former National Institutes of Health (NIH) researcher earned international prominence for his investigations of testosterone including its formation from cholesterol as well as its metabolism and action. His efforts elucidated disorders resulting from genetic defects that lead to disruption in sex hormone biosynthesis with corresponding alteration in development.

Collaborations at UTSouthwestern with David Russell, Ph.D., professor of molecular genetics, led to the cloning of the 5-alpha-reductase (5AR) gene, development of animal models for 5AR deficiency, and eventually the finding that a 5AR inhibitor blocked prostate growth, which resulted in clinical trials led by Claus Roehrborn, M.D., chair of urology. The human androgen receptor later was cloned in 1989, allowing Wilson and colleagues to identify the receptor as a transcription factor that could regulate both the receptor and 5AR expression in prostate cancer. Other scientists at UTSouthwestern expanded upon his research, identifying androgen involvement in virtually all aspects of prostate development, alternate mechanisms of androgen synthesis, and other forms of androgens related to castrate-resistant prostate cancer.

Among his numerous awards, Wilson received the Kober Medal from the Association of American Physicians (1999); the Fred Conrad Koch Award from The Endocrine Society (1993); Gregory Pincus Award from the Worcester Foundation for Experimental Biology (1992); Henry Dale Medal from the Society for Endocrinology (1991); Amory Prize from the American Academy of Arts and Sciences (1977); and the Eugene Fuller Award from the American Urological Association. He was elected as a member of the American Academy of Arts and Sciences (1982), the National Academy of Sciences (1983), and the National Academy of Medicine (1994) as well as the American Philosophical Society and served as president of the Endocrine Society, the American Society for Clinical Investigation, and the Association of American Physicians.

Wilson, seen in 1992, was elected as a member of the American Academy of Arts and Sciences (1982), the National Academy of Sciences (1983), and the National Academy of Medicine (1994).

Wilson, who had held the Charles Cameron Sprague Distinguished Chair of Biomedical Research, was known as a collaborative colleague and empathetic adviser to students and fellows. His approach with students and trainees was threefold find out what they want to do, encourage them to do it, and develop pathways to fulfill their goals, he said in an interview with The Journal of Clinical Investigation. He also noted that some of the most difficult students to counsel turned out to be late bloomers who really were worth an investment of time and effort.

At UTSouthwestern, he served as the first director of the Medical Scientist Training Program, and it was recently announced that the Physician Scientist Training Program in Internal Medicine would be known as the Jean Wilson Society. The Jean D. Wilson Center for Biomedical Research and The Jean D. Wilson, M.D. Award, which honor excellence in scientific research mentorship, are named in his honor. The center was established with support from Dr. Wilson and his sister, the late Dr. Margaret Sitton, to promote research in endocrinology, developmental biology, and genetics, along with the J.D. and Maggie E. Wilson Distinguished Chair in Biomedical Research. In addition, he served among editors of two landmark medical textbooks Williams Textbook of Endocrinology and Harrisons Principles of Internal Medicine and as editor for The Journal of Clinical Investigation, among other journals. He authored The Memoir of a Fortunate Man, which chronicles his life growing up in the Texas Panhandle through his rise to pioneering academic physician and researcher.

Jean was a popular and highly sought-after attending physician on the wards of Parkland Memorial Hospital, valued for his vast expertise in endocrinology and medicine in general, say Nobel Laureates Joseph Goldstein, M.D, chair of molecular genetics, and Michael Brown, M.D., director of the Erik Jonsson Center for Research in Molecular Genetics and Human Disease. He founded a diabetic foot clinic at Parkland and spent hours each week clipping toenails and treating ulcers on the feet of elderly diabetic patients. After long days on the wards, he would retire to his modest laboratory where he would spend half the night meticulously dissecting rabbit fetuses. Often, when we were just starting our careers, we would sit by his side while he dissected, receiving sage advice about our careers as physician-scientists and life in general. Later, he extended his fatherly role to generations of M.D./Ph.D. students when he became the founding director of our M.D./Ph.D. program.

He had a rich life outside of the Medical Center as well. An avid opera buff, Wilson collected antique gramophones that could play every type of recording that had ever been produced. His extensive collection of 3,500 old 78-rpm operatic recordings included a 1917 disc of Enrico Caruso singing songs of Irving Berlin the only record that Caruso ever recorded in English, they note.

An avid opera buff, Wilson, seen in 2019, collected antique gramophones. His extensive collection of 3,500 old 78-rpm operatic recordings included a 1917 disc of Enrico Caruso singing songs of Irving Berlin the only record that Caruso ever recorded in English.

He took memorable trips to places like the North Pole, Antarctica, the Galapagos Islands, and the Easter Islands. He often incorporated science into his trips, visiting the Kangaroo Island in Australia to study sexual development in wallabies, and to Kenya to biopsy the phallus of the spotted hyena. Fearless in the pursuit of knowledge, he performed a rectal examination on a lion to estimate the size of the prostate, Goldstein and Brown say. A dedicated bird watcher, he traveled the world to many exotic places, hoping to spot that rare bird. But in the end, the rarest of that rare bird was Jean Wilson himself.

Born in Wellington, Texas, in 1932, Wilson obtained an undergraduate degree in chemistry from UT Austin and graduated from UTSouthwestern Medical School in 1955. As a student, he studied the control of urinary acid secretion by adrenal hormones, and as a resident, he investigated cholesterol metabolism. After residency, he spent two years at the NIH, where he studied ethanolamine biosynthesis. He joined the UTSouthwestern faculty in 1960 where he began his studies of testosterone, and worked in 1970 at Cambridge University. In all, he spent 60 years at UTSouthwestern and was named professor emeritus of UTSouthwesterns storied internal medicine department in 2011.

Jean Wilson leaves us with a remarkable legacy a quintessential physician-scientist whose scholarship both inspires and continues to serve as a foundation for new advances, says Podolsky, also professor of internal medicine.

In a career spanning six decades at UTSouthwestern, Dr. Jean Wilsons discoveries included:

Cholesterol metabolism

Dr. Wilson developed methods for quantifying cholesterol synthesis, absorption, degradation, and excretion in lab animals. Together, these analytical methods served as tools for understanding the feedback control of cholesterol synthesis and turnover. In addition, Dr. Wilson demonstrated that plasma cholesterol is synthesized in the intestinal wall and liver, findings that helped researchers define the contributions of diet and endogenous synthesis to cholesterol turnover in humans and other primates.

Male androgens

Concurrently, Dr. Wilson studied the action of male androgens, focusing on testosterone and its metabolite, dihydrotestosterone. Starting with a collaboration with his postdoctoral fellow, Nicholas Bruchovsky, in 1966, the researchers discovered that testosterone is converted inside prostate cells into dihydrotestosterone, a more potent androgen that is responsible for most of male sexual maturation and male sexual function. Dr. Wilson and his colleagues later showed that mutations that impair either the synthesis of testosterone, the conversion of testosterone to dihydrotestosterone, or the function of this metabolites receptor protein are the most common cause of birth defects associated with incomplete development of the male urogenital tract, affecting about four in every 1,000 boys. Cloning these responsible genes eventually allowed researchers to identify asymptomatic carriers of these mutations.

Dihydrotestosterone

Dr. Wilson also discovered that excess dihydrotestosterone is responsible for benign prostatic hyperplasia (BPH), or prostate enlargement, a condition that affects about 210 million men worldwide. Dihydrotestosterone is responsible for prostate growth in all male mammals, but in humans and dogs, prostate growth continues throughout life. Wilson and his colleagues showed that local excess of this potent androgen leads to prostate overgrowth. By curbing its production by inhibiting 5a-reductase, the enzyme that converts testosterone to dihydrotestosterone, they were able to prevent BPH in dog models of this condition. These findings have been developed into multiple 5a-reductase-inhibiting pharmaceuticals to treat this condition in human patients.

Brown, a Regental professor and director of the Erik Jonsson Center for Research in Molecular Genetics and Human Disease, holds The W.A. (Monty) Moncrief Distinguished Chair in Cholesterol and Arteriosclerosis Research, and the Paul J. Thomas Chair in Medicine.

Goldstein, a Regental professor and chair of molecular genetics, holds the Julie and Louis A. Beecherl, Jr. Distinguished Chair in Biomedical Research, and the Paul J. Thomas Chair in Medicine.

Podolsky holds the Philip OBryan Montgomery, Jr., M.D. Distinguished Presidential Chair in Academic Administration, and the Doris and Bryan Wildenthal Distinguished Chair in Medical Science.

Russell holds the Eugene McDermott Distinguished Chair in Molecular Genetics.

About UTSouthwestern Medical Center

UTSouthwestern, one of the premier academic medical centers in the nation, integrates pioneering biomedical research with exceptional clinical care and education. The institutions faculty has received six Nobel Prizes, and includes 24 members of the National Academy of Sciences, 16 members of the National Academy of Medicine, and 13 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,800 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UTSouthwestern physicians provide care in about 80 specialties to more than 117,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 3 million outpatient visits a year.

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In Memoriam: Jean Wilson, M.D., made scientific discoveries that led to effective prostate treatments, insights into sexual differentiation - UT...

Congratulations! | East Tennessee 19-year-old headed to medical school – WBIR.com

When Blake Ivey graduated high school at 17 years old, he already had his associate's degree from Roane State Community College.

KNOXVILLE, Tenn. When most people turned 19 years old, they were likely just starting college or entering the workforce. One East Knoxville teen is way ahead of that, already headed to medical school.

Blake Ivey started taking college courses while in high school. He graduated when he was 17 years old, and already had his associate's degree from Roane State Community College in hand. After high school, he transferred to the University of Tennessee.

He graduated from UT in May. Now, he is headed to Lincoln Memorial University to get started with medical school.

He accomplished all this after being born to a single mother in rural Campbell County. It was his dream ever since he was young to become a doctor, he said.

He said he started dreaming about being a doctor after seeing his grandfather pass away from a heart attack in 2010, while on a road trip with his family.

"That's the worst feeling you can ever have, is not being able to help somebody. And that's the inspiration for why I want to become a physician because I want to be the person who is able to solve that problem, being able to help those in need," he said.

He will start studying at LMU in July. He'll go there 4 years, and then will need at least 3 years of training before he can officially become a doctor. He said he hopes to become a family physician, but also said he is keeping his options open.

"First and foremost, you need to be able to believe in yourself," he said. "Another thing is, anything is possible. You need to have confidence in yourself, you need to have that hard work ethic and be able to get a support system."

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Congratulations! | East Tennessee 19-year-old headed to medical school - WBIR.com

Leadership Appointments Announced at Vagelos College of Physicians and Surgeons – Columbia University Irving Medical Center

Two appointments have been announced that will strengthen the education mission at Columbia Universitys Vagelos College of Physicians and Surgeons. Monica L. Lypson, MD, MHPE, a national leader in medical education now at George Washington University in Washington, D.C., has been named vice dean for education. Jonathan (Yoni) Amiel, MD, who served as interim co-vice dean for education since January 2020, has been appointed to a new role as senior associate dean for innovation in health professions education at VP&S. The appointments were announced by Anil K. Rustgi, MD,interim executive vice president and dean of the Faculties of Health Sciences and Medicine.

In making the announcement, Rustgi thanked Amiel and Lisa Mellman, MD, for their leadership as interim co-vice deans for education. Both are exceptional leaders, administrators, educators, mentors, and physicians whose commitment to VP&S and Columbia University is inspiring.

Mellman, the Rudin Professor of Psychiatry at CUMC, will continue her position as senior associate dean for student affairs.

In Amiels new role, he will convene stakeholders across VP&S, Columbia University Irving Medical Center, and the university to envision the emerging new roles of health care leaders (and those outside of health care) and design the interdisciplinary training they will need to lead change; integrate faculty development for educators in the health professions in partnership with the Office of Faculty Professional Development, Diversity and Inclusion, the Provost's office, and our clinical partners; mentor faculty in educational innovation and scholarship; and represent Columbia in national organizations (including the AAMC), foundations, and government to help shape policy in health professions education.

This position will build on Columbias unique institutional resources in health care, business, law, journalism, and beyond to establish VP&S as a national leader in cutting-edge health professions education.

Amiel, associate professor of psychiatry and senior associate dean for curricular affairs, is a leader in the field of competency-based medical education and holds important leadership positions with the Association of American Medical Colleges and the Gold Humanism Honor Society. A graduate of Yale College and VP&S, he joined Columbias psychiatry faculty in 2011 after serving as chief resident in psychiatry at the New York State Psychiatric Institute.

Lypson is professor of medicine, vice chair for faculty affairs, and director of the general internal medicine division at GW. At GW, she supports the academic careers of faculty members in the department by developing programming that helps each individual navigate professional development.

Before joining GW, Lypson coordinated a Department of Veterans Affairs education program as director of medical and dental education. Until she joined the VA, she was a professor of medicine at the University of Michigan Medical School, where she also served as assistant dean for graduate medical education and interim associate dean of diversity and career development.

As vice dean for education at VP&S, Lypson will oversee all aspects of the MD program, including admissions, financial aid, student affairs, curricular affairs, and student research. She has pledged to help foster a diverse and inclusive learning environment and to work collaboratively across CUIMC to ensure that learners engage in interprofessional didactic and clinical educational activities that address societal needs and promote equitable, high-quality health care for all patients.

Lypson, a graduate of Brown University, received her MD degree from Case Western Reserve University School of Medicine and her master of health professions education degree from the University of Illinois at Chicago. She is board-certified as a general internist who completed her training in the internal medicine-primary care residency program at Harvard Medical School and as a Robert Wood Johnson Clinical Scholar at the University of Chicago.

Her research interests include health professional trainee assessment, historical and contemporary trends in medical education, academic leadership, and the underrepresentation of minorities in academic medicine. Several of her invited presentations and papers have focused on clinical performance assessment of medical students and residents and on faculty development on issues of diversity and narrative assessment.

She has pursued multiple professional development programs, including the Hedwig van Ameringen Executive Leadership in Academic Medicine program at Drexel University. She has been an Aspen Health Innovator at the Aspen Institute in Washington since 2018. She currently is president-elect of the Society of General Internal Medicine.

She is the new associate editor for the journal Academic Medicine and recently co-authored an article titled Learning From the Past and Working in the Present to Create an Antiracist Future for Academic Medicine.

Columbia and VP&S are fortunate to have identified a candidate of Dr. Lypsons caliber, enthusiasm, and vision to fill this important role of vice dean for education, says Rustgi, who appointed a search team led by Rita Charon, MD, PhD, chair of the Department of Medical Humanities & Ethics at VP&S.Our medical school will only become stronger with Dr. Lypsons leadership.

I am honored to be appointed vice dean for education and look forward to applying my career-long work that focuses on the continuum of learning and workforce development for the diverse teams of the future, says Lypson.The vice dean must ensure that Columbia graduates are ready for the practice and science of medicine now and over the arc of their careers, and guarantee a diverse and inclusive learning environment across the continuum to assure equitable and quality health care for all patients.

My scholarship has been driven by my interactions with students and the educational environment and highlights discovery and health system science to articulate innovative strategies for learning. At Columbia, I will work collaboratively to ensure that learners across the Columbia University Irving Medical Center campus engage in inter-professional didactic and clinical educational activities, and that learning is addressing societal and patient needs.The Vagelos Education Center emphasizes simulation, arts, humanities, and inter-professional education and helps situate VP&S as a leader in cutting-edge health professions education.

Lypson will join Columbia June 1.

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Leadership Appointments Announced at Vagelos College of Physicians and Surgeons - Columbia University Irving Medical Center

School of Medicine students manage 150-person event with social distance can other parts of campus do the same? – The Stanford Daily

Students at Stanfords School of Medicine pulled off a University endorsed, socially distanced happy-hour event on Feb. 5 a model, students say, for how future student gatherings could take place on campus while still following safety guidelines.

As opposed to bending the rules, they worked directly with administrators to plan an in-person happy hour event that took place on Feb. 5. The event in total drew around 150 participants, split up into groups of no more than six students.

Omair Khan, a first-year medical school student and a social chair of his class, said careful planning, contact tracing and collaboration with the medical school administrators led to what he believes was a safe event.

Weve tried to think and come up with new innovative ways to make communities, he said.

The event stands in contrast to multiple recent campus gatherings that took place in violation of University and county health directives. This includes reports of ongoing rule-bending among GSB students and 100-person outdoor parties, and the University hit a new record for weekly student COVID-19 cases in January.

Such gatherings were cited in a controversial memo by Associated Students of Stanford University executives that recommended the University not open to juniors or seniors for spring quarter.

According to Khan, participants had to pre-register with a group of up to six other students prior to the event and indicate their preferences for drinks and snacks. Khan and his fellow social chair Andrew Berneshawi M.D. 24 then sent individual emails to each group confirming their members and preferences and determined staggered pickup times for food.

Khan said that they also had to coordinate which outdoor location each group went to after picking up their food to avoid groups being too close to each other and potentially merging into a larger group.

Its logistically been challenging because normally we just meet up at a field in a non-COVID era with a bunch of drinks and just kind of have a free-for-all, Khan said. It is a little more back-end work, but I think its worth it for the better so people dont screw this up by hosting a super spreader.

Medical school spokesperson Becky Bach confirmed that the event was allowed. She wrote in a statement to The Daily that small, outdoor, socially distanced, masked academic advising gatherings are permitted if individuals have completed a Health Check screening. Students are expected to stay in groups of 15 or fewer students and one student is assigned to track attendance.

Students who attended the event said that they thought it was a safe way to get to know their peers better and bond as a class, which they said was especially important given the recent passing of their classmate.

First-year medical student Brian Sweeney said the classmates death shook the entire med school pretty hard. He thinks that implementing safe in-person events helps provide community and an outlet to talk that students need.

Sweeney added that everyone at the event wore masks when they were not eating and tried to maintain distance. He also said that the vast majority of medical students have been vaccinated.

It doesnt give us any more leeway than the rest of the students here, he said, but it does give us kind of that added level of security.

Matt Grieshop, a second-year med student who also attended, agreed that the event was important for students wellness. He said that the gathering provided an opportunity for mentorship, referencing second-year students meeting with first-years to guide them through their studies.

He recalled hearing two first-year students tell each other its so nice to meet you in person while walking by another group. With sadness in his voice, he commented that it took until February for words like those to be said.

Contact Sam Catania at news at stanforddaily.com.

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School of Medicine students manage 150-person event with social distance can other parts of campus do the same? - The Stanford Daily

Virtual Objective Structured Clinical Examination | AMEP – Dove Medical Press

Introduction

Examinations are ubiquitous in the lives of medical students. The Objective Structured Clinical Examination (OSCE) is a high-stake clinical assessment that evaluates a broad range of competencies, including history taking, physical examination, communication/interpersonal skills, professionalism, clinical reasoning, and telemedicinewhich has gained importance since the COVID-19 outbreakand the ability to integrate these skills. Effective summative assessment using OSCE (sOSCE) is a time consuming, demanding, and costly operation. OSCEs are exceptional and distinctive in assessing competencies that are difficult to evaluate using other methods. OSCEs have superior psychometric properties. The psychometric attraction of the OSCE is that it assesses the shows how level of the Millers Pyramid with reliability and validity.1 The tips provided are based on available literature and authors expertise in managing formative, summative, and virtual OSCE experiences. Formative OSCEs are assessments FOR learning; they do not count toward a final grade and are for self-assessment purposes only. Summative OSCEs are assessments OF learning that count toward a grade. It has been said that When the cook tastes the soup, thats formative; when the guests taste the food, thats summative.

In view of the current times, the severity of the COVID-19 pandemic, and its effect of the administration of all types of OSCE experiences, face-to-face OSCEs have been converted to an online or hybrid format; as a result, tips on virtual OSCEs (vOSCE) have been provided as well. The pandemic has presented educators and learners with several challenges in conducting realistic OSCE experiences. Medical schools have become very adept in using technologies for the continuation of this educational experience. vOSCE is an emerging model for administration of OSCEs. The majority of medical schools in North America have avoided face-to-face learner/Standardized Patient (SP) contact. Very few medical schools provide telemedicine/TeleOSCE instruction to medical students.2 Despite the impediments posed by COVID-19, telemedicine has flourished, and it has been a glimmering highlight that advances medical students knowledge of this new technology through virtual OSCEs. Transitioning to a virtual videoconferencing mode, will necessitate dramatic changes to the administration of vOSCEs. Assessment endpoints needs to be consistent, thus educational objectives need adaption to the virtual milieu. Attributes of digital communication and webside manners need to be introduced. Furthermore, standardized patient training methodologies will require translation from in-person to the new environment as well. In the virtual environment, the medical history is obtained from the standardized patient, and the intended physical examination maneuver is verbalized by the learner. Virtual OSCEs necessitate the use of reliable digital videoconferencing technologies. Numerous commercial platforms are available. Training needs to be provided to learners, SPs, staff, and faculty for a seamless experience. Pre-brief session instructions are delivered in a virtual waiting room. Subsequently, each dyad (learner and SP) enters a timed virtual breakout room. A major challenge to overcome for the learner is optimization of engagement and non-verbal communication. This can be mitigated by explaining the encounter steps to the SP as the session evolves. Optimal camera positioning for appropriate framing will enhance the experience.

SPs are actors/laypersons who are highly trained to portray patients in OSCE stations for the purpose of teaching and assessment. Their performance is routinely monitored, evaluated, and reviewed by SP trainers and faculty. This is different from peer role play, in which the participants have no prior training. SPs do not replace real patients, are faithful to the standardization of the scenario case portrayal and are not supposed to express personal originality or inventiveness.

Most formative OSCEs and some sOSCEs utilize non-binary checklists3 as well as various global rating instruments. Notwithstanding the use of checklists by SPs for grading, it should be noted that an OSCE assessment is not a prescriptive checklist performance, as every encounter is distinctive, has its own climate, and needs to be customized to the door note/SP presentation. A successful OSCE depends on having a growth mindset and adjusting the process to the content.

Over the years, the evaluation of medical students clinical skills and performance has evolved from direct observation to OSCEs.1 With the exception of cost, this assessment format optimizes a number of variables such as objectivity, reliability, validity, and feasibility. The reliability of the summative OSCE, covering a wide curriculum, is increased by a large number of stations. The number of OSCE stations that are sampled vary from one medical school to another, from 5 to more than 15.4 However, 12 to 16 stations will cover a good range of content and provide an acceptable level of reliability (0.6 to 0.7).5 Rigorous training and assessment of SPs and the use of checklists ascertain the objectivity of an OSCE station. OSCEs have modest validity.6 In order to be valid, OSCE stations must assess a wide array of knowledge, skills, and attitudes that reflect the scope of the curriculum. Faculty will not conduct OSCE experiences on aspects that are not clearly defined in the medical schools course objectives or suited to the learners level of experience. The complexity of the scenarios can vary reasonably by faculty to accommodate the training level of the learners. To be feasible, an OSCE station, to some extent, needs to be straightforward and easy to manage. OSCEs are very resource intensive and take an astonishingly long time develop; it has been said that instructional systems designs traditionally follow a multistage, iterative model.7 This four-step process includes: Needs Assessment, Program Development, Design and Implementation, and Evaluation.7 Consideration should also be given to time, complexities of case development, number of available SPs, and faculty training.

The following compilation of 20 tips and pointers can help guide medical students preparing for OSCEs:

Most medical students and residents are successful in OSCEs. Although some face challenges and a few even fail OSCEs, the best solution is preparation and deliberate practice. Based on the experience of the authors, they can conclude that the most participants who have challenges in OSCEs need additional deliberate practice.

Know the environment of the clinical center and the OSCE venue. Take a tour before the OSCE experience. Most centers will be happy to give you a tour.

The door note used to be a clipboard; however, these days, it is a screen document. In some centers it may still be written on a clipboard. This is one of the most common causes of applicants not performing well in OSCEs. Because the door note is the road map of the station, time should be taken to read it carefully and follow its instructions. Do not do more than is asked or less than is directed. You must follow it exactly as you are told. If the instructions ask you to verbalize your physical examination in virtual OSCEs, you may use clinical terminology. If the instructions ask you to perform a toe examination, do not waste your time reviewing the history or the management. The SPs are provided with a pre-determined checklist and grade your performance accordingly. No extra grade is given. More is not always better.

It is imperative to avoid the use of medical jargon. Learners need to use simple laypersons language that will be understandable to someone with a fifth-grade education. Do not ask: Why were you admitted to the sickyou (SICU) after surgery? Instead, ask: Where were you admitted after surgery? If you use medical jargon, the SPs will act confused and may seek further explanation.

Avoid asking multiple rapid-fire questions strung together. In such situations, SPs are advised to answer only the last question put forth to them. An example of such a multiple, rapid-fire question would be: You seemed to be concerned about lung cancer. Do you smoke, drink, or cough up blood? Incidentally, what kind of work do you do and for how long have you been doing it?. This line of questioning is confusing to the patient and does not give the SP adequate time to mentally process what is being asked.

The mnemonic device WIPERS can be used after you enter the room and close the door. Establish rapport early, at the beginning of the encounter. Let the patient talk and do not interrupt; where appropriate, express empathy.

Patients are clued to the nonverbal behavior of the providers; thus, this mnemonic will be very helpful when dealing with SPs. Moreover, these are easy points in the checklist.

The SOFTEN mnemonic is used to enhance nonverbal behavior during the SP encounter.

SOFTEN nonverbal communication skills.

As the HPI: Timeline, not a Time Machine reveals,10 time is the main organizational element. Always begin with a starting point in mind: When were you well before all this started? The chronology of the story should begin at the baseline state of health and the narrative should develop and flow smoothly, in an insightful and judicious fashion, while managing the psychological safety of the patient. A diagnosis cannot be made without taking an all-inclusive and appropriate HPI. That being said, you cannot take the HPI without knowing how to do it. Do not forget to enquire about the setting and its effect on the patients day to day activities. Taking the HPI is probably the most important and difficult requirement of the OSCE. Always use a structured, fluent, and laser-focused approach.

An SP is an actor who has been faithfully trained to simulate a patient in the domains of history and physical, communication, and other necessary clinical skills with an authenticity that often cannot be distinguished by expert clinicians. In reality, the OSCE is a staged play11 that requires certain predetermined skills to be learned. Remember that SPs are actors, most of whom have been recruited from local theaters. That being said, this is not a mindset that medical students want to have. The key to success is think of SPs as real patients. SPs take their tasks very seriously, have to pass competency tests for each case, and are even re-assessed after performances if learners fail or if there are complaints.

An OSCE is an immersive experience and it is imperative to treat the SPs as real patients. Additionally, it is crucial to accept the SPs chief complaint as real and immerse oneself into the medical context of the simulation. In reality, the SP should be treated as the question in an examination. It is important to note that SPs rarely go off-script and will not provide all answers unless they are asked.

ICEing the patient at the end of the HPIusing the mnemonic ICE for Ideas/Impact, Concerns, and Expectationsinvolves asking the patient what s/he thinks is happening and how it has impacted his/her daily life as well as identifying what is worrying him/her and determining his/her expectations from treatment.

Signposting imparts structure and organization to the OSCE experience. It engages the SP and lets him/her share your thoughts. Acknowledge what you have discussed and use it to link the topic you will be asking subsequently (eg: So you have talked to me about your chest pain; next, I would like to discuss your risk factors for coronary artery disease).

Before you start the physical examination, it is useful to consider the mnemonic device SET UP:

At the end of the OSCE experience, a summary statement is expected and should be discussed with the SP. The summary statement heralds the end of the session, with the aim of restating the important salient information that you have obtained and is needed for continuity of care. It should always explain the next steps that will be taken. This will give the SP a chance to clarify the information if necessary. An example would be:

I know that, until now, I have given you a lot of information; at this time, I will summarize and discuss my findings, which will give you a chance to clarify the information and ask questions as well.

A concise summary statement will bring the session to a smooth close.

Interviewing real psychiatric patients is time consuming; instead of 60 minutes, your interview will have to be completed in 8 minutes in OSCEs! Remember that OSCEs are mock situations, with SPs, simplified scenarios, and impractical time constraints. The core framework of the psychiatric interview makes undergoing an OSCE station a challenging experience. The key to success is reading the door note carefully, watching the clock, and ensuring not to waste time. Do not perform a mental status examination unless the door note instructs you to do so.

Efficiency is the key to psychiatric interview stations; always enquire about the following:

Interactions with patients via videoconferencing are referred to as ones webside manner. This is a new competency domain for vOSCE sessions and a modern twist on bedside manner. Appropriate webside manner12 will add to patient satisfaction and better outcomes.12 The key elements of webside manner are: proper set up, acquainting the participant, maintaining conversation rhythm, responding to emotion, and closing the visit.13 Enquiries should be made as to whether the SP can hear or see with technology. You should be patient-centered and focused at all times, and all distractions with the computer interface should be explained in real time. When reviewing the electronic health record (EHR), verbalize what you are doing. Similar to bedside manner: possessing nuanced verbal and nonverbal webside manner skills is essential to conducting serious illness conversations during virtual visits.7 After your summary, ask the SP to echo back your recommendations.

It is important to understand the difference between an OSCE and a Clinical Skill Assessment (CSA), also known as an integrated OSCE (iOSCE). The CSA assesses the medical learners ability to integrate and apply multiple skills in each station, e.g., communication, physical exam, diagnostic, and professionalism.14 This why it is of utmost importance to read the door note carefully.

OSCEs are performance-based assessments that present all candidates with the same challenge. Scoring, when performed by SPs, is accomplished using checklists. The SPs ratings are improved using non-binary ratings. SPs rate whether an action/question was not done, attempted, or done. It is important for learners to verbalize what they are performing during the physical examination to get the point in the checklist and, thus, improve the overall score. As noted earlier, global rating scores may be used when grading is done by trained examiners.

OSCE stations are either dynamic or static. Dynamic stations assess clinical competency skills, are manned with an SP, and are interactive. Static/ question stations are called pseudo-OSCEs and assess knowledge. Although learners interpret electrocardiograms (EKGs), chest X-rays (CXRs), arterial blood gases (ABGs), and other tests, no actual clinical tasks are involved. The approach to pseudo OSCEs should be the same as answering a multiple-choice question. These types of OSCE pretender stations are not being used frequently and, in reality, contravene the sound educational underpinnings of a solid clinical skill assessment program. Studies on the reliability and validity of OSCEs are based on learners performing clinical tasks.

OSCEs are reliable and valid instruments of assessment for medical students and residents. They can be formative or summative. Success in OSCEs (in-person and virtual) is process and content dependent. We have encapsulated a series of practical and actionable approaches for medical students and residents. Understating theses specific tips and strategies will improve and optimize the OSCE experience.

All authors contributed to data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

The authors have received no funding.

The authors declare that there is no conflict of interest.

1. Khan KZ, Ramachandran S, Gaunt K, Pushkar P. The Objective Structured Clinical Examination (OSCE): AMEE Guide No. 81. Part I: an historical and theoretical perspective. Med Teach. 2013;35(9):e1437e1446. doi:10.3109/0142159X.2013.818634

2. Nesbitt TS, Dharmar M, Katz-Bell J, Hartvigsen G, Marcin JP. Telehealth at UC Davisa 20-year experience. Telemed J EHealth. 2013;19(5):357362. doi:10.1089/tmj.2012.0284

3. Pugh D, Halman S, Desjardins I, Humphrey-Murto S, Wood TJ. Done or almost done? Improving OSCE checklists to better capture performance in progress tests. Teach Learn Med. 2016;28(4):406414. doi:10.1080/10401334.2016.1218337

4. Barzansky B, Etzel SI. Educational programs in US medical schools, 20032004. JAMA. 2004;292(9):10251031.

5. Gruppen LD, Davis WK, Fitzgerald JT, McQuillan MA. Reliability, number of stations, and examination length in an objective structured clinical examination. In: Scherpbier AJJA, van der Vleuten CPM, Rethans JJ, van der Steeg AFW, editors. Advances in Medical Education. Dordrecht: Springer; 1997;441442. doi:10.1007/978-94-011-4886-3_133.

6. Carraccio C, Englander R. The objective structured clinical examination: a step in the direction of competency-based evaluation. Arch Pediatr Adolesc Med. 2000;154(7):736741. doi:10.1001/archpedi.154.7.736

7. Hastie MJ, Spellman JL, Pagano PP, Hastie J, Egan BJ. Designing and implementing the objective structured clinical examination in anesthesiology. Anesthesiol. 2014;120:196203. doi:10.1097/ALN.0000000000000068

8. Roper TA. Time for a sinister practice. BMJ. 1999;319(7223):1509. doi:10.1136/bmj.319.7223.1509

9. Qayyum MA, Sabri AA, Aslam F. Medical aspects taken for granted. McGill J Med. 2007;10(1):4730.

10. Packer CD. Presenting Your Case: A Concise Guide for Medical Students. Springer; 2018.

11. Michaels J. History Taking for Medical Finals. Banbury, UK: Scion Publishing; 2018.

12. McConnochie KM. Webside manner: a key to high-quality primary care telemedicine for all. Telemed J EHealth. 2019;25(11):10071011. doi:10.1089/tmj.2018.0274

13. Chua IS, Jackson V, Kamdar M. Webside manner during the COVID-19 pandemic: maintaining human connection during virtual visits. J Palliat Med. 2020;23(11):15071509. doi:10.1089/jpm.2020.0298

14. Gerzina HA, Stovsky E. Standardized patient assessment of learners in medical simulation. In StatPearls. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546672/. Accessed August 20, 2021.

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Virtual Objective Structured Clinical Examination | AMEP - Dove Medical Press

Penn researchers to study the impact of environmental and economic interventions on reducing health disparities in Black Philadelphia neighborhoods…

PHILADELPHIA In an unprecedented effort to address the harmful effects of structural racism on health, 60 predominantly Black neighborhoods in Philadelphia will be part of an ambitious study to assess the impact of a multi-component intervention addressing both environmental and economic injustice on health and well-being, led by Penn Medicine researchers Eugenia C. South, MD, MHSP and Atheendar Venkataramani, MD, PhD.

At the community level, the study includes tree planting, vacant lot greening, trash cleanup, and rehabilitation of dilapidated, abandoned houses. For households, the study will help connect participants to local, state, and federal social and economic benefits, including food, unemployment, and prescription drug assistance, provide financial counseling and tax preparation services, and offer emergency cash assistance.

This randomized controlled trial (RCT), is funded by a nearly $10 million dollar grant (1-U01OD033246-01) from the National Institutes of Health (NIH), awarded to researchers at the Perelman School of Medicine at the University of Pennsylvania through the NIH Common Funds Transformative Research to Address Health Disparities and Advance Health Equity initiative, the NIH announced 11 grants totaling $58 million over five years for highly innovative health disparities research across the U.S.

Previous efforts to reduce racial health disparities have been less impactful than we would like because they often only address a small number of the many mechanisms by which structural racism harms health, said Atheendar Venkataramani, an assistant professor of Medical Ethics and Health Policy and director of the Opportunity for Health Lab. Our multi-component intervention is designed to address these multiple mechanisms all at once.

Recent research illustrates that the roots of poor health in Black neighborhoods arestructural, resulting from decades of disinvestment and neglect. The impacts of structural racism are evident from neighborhood-level factors such as crumbling houses, lack of greenspace, trash build-up, and declining economic opportunity. The impact on the health of individuals living in those communities is profound, and includes increased rates of depression, post-traumatic stress disorderandheart disease compared to their White counterparts.

The researchers also aim to make it easier for individuals to navigate the process of determining their eligibility and getting help from multiple providers through development of a platform that makes collaboration between community financial service agencies simpler and more efficient. Community partners, including the Pennsylvania Horticultural Society, Campaign for Working Families, Benefits Data Trust, and Clarifi will implement the interventions.

Black communities are centered in this proposal, said Eugenia South, MD, MSHP, an assistant professor of Emergency Medicine, and faculty director of the Penn Urban Health Lab. Collectively, our team has spent a significant amount of time talking and working with leaders and community groups in Black Philadelphia neighborhoods and with this study we are committed to being responsive to the economic and environmental needs they have identified. We will also be hiring four full-time community members to the Penn Medicine team to advise on the entire process and lead recruitment.

The researchers will enroll 720 predominantly Black adults across the 60 study neighborhoods, half of whom will receive the proposed interventions. The study will meet participants where they are via door-to-door recruitment, rather than relying on clinic referrals or responses to flyers, which may exclude the most vulnerable adults. Investigators will use standardized surveys to evaluate the overall health and wellbeing of participants at multiple times over the course of the trial. They will also evaluate the impact on violent crime.

The overall goal is to show that deeply entrenched racial health disparities can be closed by concentrated investment in Black neighborhoods. Researchers are hopeful their interventions will be successful improving the health not just of participants in the study, but other members of the household and of the whole community. The findings of this bold project could serve as evidence to policymakers that these sweeping, big push interventions work, and should be implemented broadly.

Co-investigators on the study are: George Dalembert, MD MSHP, an assistant professor of Clinical Pediatrics, Courtney Boen, PhD MPH, an assistant professor of Sociology, Meghan Lane-Fall, MD MSHP, an associate professor of Anesthesiology and Critical Care, and Epidemiology in Biostatistics, and Epidemiology, and the Director of Acute Care Implementation Research at the Penn Implementation Science Center, Kristin Linn, PhD, an assistant professor of Biostatistics, John MacDonald, PhD, a professor of Criminology and Sociology, Christina Roberto, PhD, an assistant professor of Medical Ethics and Health Policy, and Charles Branas, PhD, an Adjunct Professor of Epidemiology in Biostatistics and Epidemiology.

###

Penn Medicineis one of the worlds leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of theRaymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nations first medical school) and theUniversity of Pennsylvania Health System, which together form a $8.9 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according toU.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $496 million awarded in the 2020 fiscal year.

The University of Pennsylvania Health Systems patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Centerwhich are recognized as one of the nations top Honor Roll hospitals byU.S. News & World ReportChester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nations first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 44,000 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2020, Penn Medicine provided more than $563 million to benefit our community.

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Penn researchers to study the impact of environmental and economic interventions on reducing health disparities in Black Philadelphia neighborhoods...

Insider insights on getting into, and thriving, during medical school | University of Michigan – Michigan Medicine

Its no secret that getting accepted into medical school is highly competitive, and for those who are admitted, making the choice of which school to attend can feel overwhelming.

Hearing insights and advice directly from those who have successfully navigated the process and are currently thriving in medical school ahead of you, though, can be invaluable.

Here, five University of Michigan medical students share their experiences for current and future applicants, breaking down some of the most asked about elements of the process (you can also watch their livestream Q&A video above.).

Kelsey, fourth-year medical student: I think it's important to think about your most important experiences to you. I would pick three or four things that feel really meaningful. I was an EMT prior to coming to medical school. I made sure I really had crafted my story around that and what was important for me to share. I also was a middle school teacher. I thought through those experiences and what valuable lessons I learned from those and what I want to convey to an interviewer. It's important to practice with friends and family.

In general, there's kind of standard interview questions that get asked at a lot of different interviews: what are your strengths, what are your weaknesses, what's a challenge you have overcome. Having a couple of prepared answers will help alleviate a lot of stress when youre interviewing.

Chelsie, second-year medical student: I had never in my life been interested in cardiology. Now I'm interested in doing a cardiology fellowship. It was due to me being able to reach out to faculty and talk to them about their experiences. It's not like having to beg or pull teeth. Michigan is a great institution with brilliant faculty members. People who are leading their fields. To be able to work with these people, learn from them, hear about their backgrounds and how they got to where they are, in hopes of maybe me getting there one day, it's so inspiring. It gives you more fuel to keep going when you have faculty who validate you constantly.

Matt, first-year medical student: One thing that is unique or nearly unique about Michigan Medical School is we only do one preclinical year. It is a true pass or fail. I've been blown away the first few weeks of school. We had a quiz after the first week and folks were sending their big study guides they put together in our class group chats. The preclinical year is six blocks. Those are little terms, with midterms in there. You have a final block exam at the end of each of those blocks, which range from four weeks to ten weeks.

Kelsey: Clinical year is great. We do it the second year versus the third year. You do a bunch of rotations. You have so much responsibility if you want it. You answer pages, you go see your patients, and you really get to own them. But, at the end of the day, I have residents, an intern, a senior faculty and an attending faculty who are all looking over my shoulder and making sure I'm not making mistakes when it comes to taking care of the patient. It's incredible learning without the scary pressure that youre going to mess anything up.

I can wholeheartedly say the Michigan process works, and you learn a lot. I feel really ready and excited for residency.

SEE ALSO: What does it take to get into Michigans medical school? Just ask the new dean

Quintin, fourth-year medical student: Not only are we getting the experience of being able to perform things, write notes, come up with differential diagnoses, and fully manage our patients as best we can with a lot of the guidance that was discussed, but we are also allowed to flex our teaching minds.

You realize as a medical student that its really helpful to have a resident who is interested in teaching, and I am one of those people who is very interested in it. So it was nice to work on that now, see what works and see what I can carry forward or what would I change as I move forward into residency.

Xinghao, second-year MSTP student: Our learning community, M-Home, has a lot of spirit. It's about support and community, and that's important. My house counselor, Christine, Ive cried to her on multiple occasions. I will admit that. If you end up in Fitzbutler House, you probably will cry to her too. Medical school is hard. Life is hard. Definitely having a support system that cares about your emotions and how happy you feel in school makes it all worth it.

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Insider insights on getting into, and thriving, during medical school | University of Michigan - Michigan Medicine

Fauci supports medical group’s call to mask 3-year-olds and older in school: ‘Reasonable thing to do’ – Fox News

Media top headlines July 19

The White House getting blasted for supporting Big Tech 'collusion' on banning COVID 'misinformation' spreaders, a reporter's candid assessment of progressives on Cuba, and President Biden getting roasted on MSNBC round out today's media headlines.

Dr. Anthony Fauci argued Monday that the decision by the American Academy of Pediatrics (AAP) to recommend all children aged 3 years and older wear masks when schools reopen regardless of vaccination status was "a reasonable thing to do."

Appearing on CNN's "At This Hour," Fauci said that because there was a "substantial proportion of the population" that was unvaccinated, he understood why the organization would make such a decision.

DESANTIS SAYS FLORIDA CHOSE FREEDOM OVER FAUCI-ISM, URGES CONSERVATIVES TO HAVE A BACKBONE

"I think that's along the same lines as what weve seen with the health authorities in Los Angeles that when you have a degree of viral dynamics in the community, and you have a substantial proportion of the population that is unvaccinated, that you really want to go the extra step, the extra mile, to make sure that there's not a lot of transmission, even breakthrough infections, among vaccinated individuals," Fauci said after host Kate Bolduan asked what he thought about the AAP's decision.

"For that reason, you can understand why the American Academy of Pediatrics might want to do that. They just want to be extra safe," he added.

Fauci admitted the recommendations by the AAP were a "variance" from the official CDC guidance on wearing masks, but he said the CDC "always leaves open the flexibility" for local agencies, enterprises and cities to make their own judgment calls.

FORMER SURGEON GENERAL SAYS CDC MASK GUIDANCE PREMATURE AND WRONG

"So, I think that the American Academy of Pediatrics, theyre a thoughtful group, they analyze the situation and if they feel that that's the way to go, I think that's a reasonable thing to do," he said.

Bolduan suggested the contradiction between the AAP's recommendations and official CDC guidance could cause confusion, and that the CDC should be "leading a little harder" after receiving criticism for unvaccinated people following guidelines intended for those who've been vaccinated.

"That is an understandable criticism," Fauci said, adding it made sense for more localized groups to want "to be more safe rather than sorry."

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"But youre absolutely correct, that does lead to some sort of confusion sometimes when people see an organization making one recommendation, in general, for the whole country and then local groups, local enterprises, local organizations, in order to get that extra step of safety, say something different. And youre right, that does indeed cause a bit of confusion," he said.

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Fauci supports medical group's call to mask 3-year-olds and older in school: 'Reasonable thing to do' - Fox News

Top Insights Into The College Of New Jerseys 7-Year Medical Program – Forbes

High school students committed to a path to medicine might be considering direct medical, or BS/MD programs. These programs allow students to matriculate directly to the partnered medical school after earning their bachelors degree, making it an attractive option to students who are positive they want to pursue their medical degree. One such program is The College of New Jersey (TCNJ)s 7-Year Medical Program. Students earn their undergraduate degree from TCNJ in three years and then matriculate to the New Jersey Medical School.

Students can gain admission to medical school when they are still in high school through the 7-Year ... [+] Medical Program at The College of New Jersey

Moon Prep sat down with Dr. Sudhir Nayak, professor and co-director of the 7-Year Medical Program at the College of New Jersey. The interview sheds light on the admission process and how students can be competitive BS/MD candidates, even in the coronavirus era. The full interview can be viewed here.

Kristen Moon: What advice do you have for students applying to your program this year? Has the pandemic altered your process?

Dr. Sudhir Nayak: I would tell students to stop worrying. If you were a good student before Covid-19, you're going to be a good student after Covid-19. We look at the population of applicants in a relative sense. Students still have to meet the minimums set by the medical school, but thats it.

Most of the questions that we've gotten from parents and students imply that we think they're robots. We understand that you're going to have limited access to certain experiences that you potentially could have had. For example, as a part of our application evaluation process, we've had to deemphasize a couple of things. Shadowing a doctor is not possible right now. Most hospitals have just shut down their volunteering system completely. We expect that students applications are going to be a little bit different this year than usual.

Some things we haven't changed. We've always offered Zoom or Google Meet interviews for our out-of-state students or in-state students with accessibility issues. We do not expect there to be any differences in the number of students admitted.

We evaluate the program every year. I anticipate that the repercussions of the pandemic will last for a year or two.

Moon: What type of student are you looking for?

Nayak: We're not looking for students who would just burn right through the program; we're looking for students who want to be part of TCNJ by sharing its values for a cooperative learning environment. We specifically look for eager learners who have challenged themselves in high school and want to continue to do so in college.

Some of the other highlights we're also looking for are students who want to be in a liberal arts college. While this is a Bachelor of Science degree, we want people who have nontraditional premed experiences, see value in diversity and have plans to study abroad.

We look for students who have diverse interests who have long-standing interests in music, business or law, but they dont have to be hyper-focused. In fact, we tend not to focus on the hyper-focused.

Finally, I would say the only thing we actively dont want is students in a rush. We think that the third year of the undergraduate program is critical for personal and professional development. Not every candidate who would make a good accelerated candidate is the right fit for our program.

Moon: What is the selection process?

Nayak: The first step is validating that students are hitting the minimums for the program. While getting 1550 versus 1510 on the SAT might seem to be a significant advantage, it's not for this program. As long as theyve met those minimums, they are in the pool to be evaluated.

The second step is what I call a micro screening. In no particular order, we look at the transcript. They must've taken challenging courses, in STEM, in particular, to indicate that they would be a good fit for an accelerated program.

But the caveat is that we're not looking for perfect grades. Getting a couple of Bs here and there doesn't matter. I cannot emphasize this enoughthat's not how our evaluation process works. We look at the transcript overall: did they take a variety of challenging courses, and then did they test themselves? Did they take AP exams or any other types of achievement tests?

Next, we look at activities, and here's where I think that students have the biggest misconception. They believe that putting a lot of activities on their transcript is good when it's actually counterproductive. What we are specifically looking for at TCNJ is deep involvement in a few things. For example, are you an Eagle Scout, do you have a black belt in TaeKwonDo or are you an EMT? Have you been in band or Future Business Leaders of America (FBLA) for two or three years? Are you an athlete? Those are the types of things we look at, but you don't have to have all of those things. You just need one or two.

Next, we look at recommendations and evaluate to see if the student is exceptional.

We also look for direct exposure to the healthcare profession. Students could gain this experience by working as an EMT, becoming certified in CPR, shadowing a doctor or volunteering at a hospital. However, some students are more focused on biomedical research, and here at TCNJ, you can come in as a biomedical engineer. Those students tend to have a slightly different profile and have done internships at biomedical research companies or developing orthopedics. No experience is less valuable than another.

We also like to see something where they're working toward the greater goodvolunteering through a church, school, some formal organization or starting something on your own like a food drive or nonprofit. This one is important because one of TCNJs core values is giving back.

Next, we read their essay, and that does take quite a while. We evaluate their personal statement and secondary essays for thoughtfulness, completeness, ability to answer the question directly and expand on it and provide evidence. It's a new essay question every year.

One of the final aspects would be the interview. We are evaluating whether the person on the paper is the person we see in real life. We also check if they are a good fit for TCNJ and our specific seven-year program.

Moon: What are the average stats of your accepted students?

Nayak: We don't look at GPAs that carefully because they are weighted in so many different ways, and there can be grade inflation at some schools and not at others. When available, we use class rank. Students in our program are generally ranked in the top 3% of their class; they were among the best students at their school. The SAT average is generally between 1530 and 1550; it was 1535 for the last cycle. The ACT was around 34 for the students who took it.

Moon: How many students do you interview and accept into the program?

Nayak: We get between 300-400 applications each cycle. There is no fixed number of seats for our programs, and its ranged from 10 to 25 over the last 30 years. In the past five years, the number has varied from 13 to 20 students. I believe we have 18 students in the previous cycle.

We interview about a hundred, and then we submit around 60 to 80 to the medical school to evaluate the candidates. Then, 40 of those students are ultimately admitted.

Moon: Whats the MCAT policy?

Nayak: They have to take the MCAT, but there is no minimum score required. The only exception is if a student is on probation because they dropped below the 3.5 GPA. Then, they might have an MCAT minimum imposed on them by the medical school.

Moon: Can you tell me some of the highlights of the program?

Nayak: I think the most important part about the TCNJ program is the flexibility. You don't have to major in biology; you can major in whatever you want, within reason. For example, some options are biomedical engineering, chemistry, physics, math, or computer science. Some non-STEM majors are even approved, like English, philosophy, history and Spanish. You can also design your major at TCNJ, provided it's approved.

Another way TCNJ is flexible is because we encourage our students to study abroad to expand their sense of self and develop as a person. This is one reason we keep that third year of undergraduate because I think two years is not enough to grow and mature. Our graduates are a little more mature than others because they've been interacting with diverse populations for an extended period. We want students to have a meaningful undergraduate experience, which means they can join clubs and activities.

Moon: Can you share any insights into the accomplishments of past applicants?

Nayak: Once they finish medical school, the students land tremendous residencies. And when they are TCNJ, they are also achieving amazing things. The EMS crew on TCNJ was started by seven-year students in the late nineties. It's an all-volunteer EMS squad that has run since then, and they integrated with the rest of the campus, campus police, emergency services, and rescue services.

Another thing that is neat that seven-year students created is the Alpha Zeta Seven-Year Medical Society. Theyve unified the students in the program because they're in different majors. They bring in alumni and coordinate events where students can talk and get advice from alumni.

The application deadline for TCNJs 7 Year Medical Program is November 1 each year. For more information, visit here.

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Top Insights Into The College Of New Jerseys 7-Year Medical Program - Forbes

Meg Hansen: Reviving the art of medicine: Why aren’t we treating COVID-19? – Brattleboro Reformer

No greater opportunity, responsibility, or obligation can fall to the lot of a human being than to become a physician. Harrisons Principles of Internal Medicine, 1950.

Though a medical school graduate possesses the same repository of knowledge as a physician with years of experience, they are poles apart as practitioners. Clinical experience hones information into learned intuition, transforming the practice of medicine from an applied science to an art. The doctor-patient relationship forms the crux of the art of medicine, wherein the patient is not an amalgam of symptoms, signs, and abnormal functions, but a fellow human being in need of care and comfort. Medicine as an art prioritizes patient welfare by balancing science with empathy, compassion, and ethics. It is rooted in humility that welcomes continual learning and respects patient autonomy.

However, as medical imaging, bioinformatics, robotics, and other breakthrough advancements revolutionize modern medicine, technologists and researchers have been increasingly seeing physicians as sources of error. In this shifting paradigm, human dynamism is seen as unpredictability, an urgency to help patients as irrational emotionality, and clinical judgment as witchcraft. The doctor-patient relationship no longer claims primacy (only large-scale Randomized Control Trials/RCTs count), and the art of medicine becomes a romanticized and obsolete relic of our analog past.

The objective then is to limit the scope of damage that physicians can unleash by standardizing their activities as per guidelines issued by administrators and regulatory bodies. The resulting bureaucratization of American medicine has been recasting doctors from expert clinicians to paper-pushers with technical know-how bound by top-down orders. In Vermont, the Green Mountain Care Board, the members of which lack medical training but exert comprehensive authority over the states healthcare landscape, epitomizes this phenomenon. Another example is OneCare Vermont an experiment that has failed to achieve its goals to reduce healthcare costs and improve the overall health of Vermonters, but keeps increasing its yearly multimillion dollar budget to support its flourishing administrative size.

This subservience of the humanistic approach in medicine to biotechnology and red-tape reached its apogee when the COVID-19 pandemic broke out. Blind adherents of RCTs who maintain a literal and intellectual distance from the I.C.U., and find it hard to believe that sound medical practice can originate at the bedside, discounted the observations and assessments of doctors on the front line. When a group of maverick clinicians applied their expertise, as pulmonologists and I.C.U. specialists, to repurpose existing generic drugs in treating COVID, they were ridiculed. Paul Marik, MD (Chief of Pulmonary and Critical Care Medicine at the Eastern Virginia Medical School) who formed the Front Line COVID-19 Critical Care Alliance (FLCCC) deserves special mention.

Off-patent drugs have been around for decades, carry well-known safety profiles, and are easier and cheaper to produce widely. Yet, neither the government nor pharmaceutical companies have invested in exploring generic drugs for antiviral and virucidal activity against SARS-CoV-2. Why not? Developing and bringing new drugs to market delivers an enormous pay off to multiple stakeholders. For example, Merck has struck a $1.2 billion deal with the US government to develop a coronavirus treatment.

In contrast, existing drugs make no money. As RCTs cost tens of millions, such trials become prohibitive for drugs that have a poor return on investment. By insisting on RCTs as the only acceptable evidence of efficacy, authorities can delay and derail the process of approving repurposed drugs for COVID treatment. Bryant et al. conducted a meta-analysis of fifteen trials to investigate the role of repurposed medicines in reducing mortality caused by SARS-CoV-2 (American Journal of Therapeutics, July-August 2021). They argue that arbitrary and impossibly high standards have been imposed on their effort. One the one hand, global health agencies approved corticosteroids as the standard of care for COVID based on one RCT of dexamethasone, but on the other hand, they have disregarded two dozen RCTs in support of low-cost, generic drugs that offer an equitable and feasible global intervention against COVID.

Once the focus of health care shifts from healing the patient (who seeks relief and reassurance) to chasing the next blockbuster medicinal product, it follows that financial gain should supersede efforts to eliminate this virus. Not surprisingly, it has been twenty months since SARS-CoV-2 first surfaced in China and health authorities still cannot recommend any treatment for persons that contract COVID.

In the U.S. alone, the current seven-day moving average of daily new cases is 14,885. According to the CDC and NIH, non-hospitalized patients should avail of supportive care (Tylenol and Motrin), isolate to prevent transmission, and seek medical attention if they turn blue. COVID is not the harmless common cold. Providing no treatment causes needless suffering and is dangerous because it does not prevent patients from developing life-threatening complications and long-term lung injuries. Most hospitalized patients that need ventilators either die or if they survive, become respiratory cripples unable to breathe without the machine.

Further, around 25 percent of patients that recover from active COVID infection develop prolonged illness (lasting several months) in its aftermath. This condition is called Post-COVID syndrome or long haul COVID, and presents as a wide spectrum of persisting symptoms including fatigue, cough, shortness of breath, headache, and joint pains. This February, the NIH launched an initiative to study the condition; six months later, no treatment recommendations have been made. The CDC advises healthcare professionals to share information about patient support groups and online forums to long haulers.

Abandoning clinical treatment altogether, instead choosing to rely on one form of prevention, amounts to negligence and absolutism both of which have no place in medicine. Denying alleviation of suffering to tens of thousands with active and long COVID, in spite of access to low-cost, safe drugs that kill this virus (as proven in numerous clinical trials across the world) can only be described as reprehensible.

Meg Hansen is the former executive director of Vermonters for Health Care Freedom, a health policy think tank. She ran for state-level public office in 2020. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.

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Meg Hansen: Reviving the art of medicine: Why aren't we treating COVID-19? - Brattleboro Reformer