Year in review: Reflections on my first four medical clerkships – Scope

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I spent the first two days of my winter break thinking about what I wanted to write in this post. I'm at this pausing point, five months into rotations in my third year of medical school, and it feels like I should have something to say in the way of a summary, some idea or lesson to cap off this first chunk of clerkships. But honestly, I'm at a loss to write about any singular topic. I have too many scenes, dynamics and ideas rolling around in my head to sit down and produce one digestible post.

Instead, since this is the time of year for recaps, I thought I'd provide one of my own.

These are my clinical experiences of 2019:

At this point, I've finished my clerkships in OB/GYN, emergency medicine, ambulatory medicine, and most recently, in surgery. During ambulatory, I worked in the clinics of oncologists, cardiologists, hypertension and urgent care physicians. On surgery, I rotated through plastics, endocrine and colorectal surgery specialties.

I'm starting to get the hang of doing medical student tasks. I write notes, give presentations, call consults and suggest (tentative) care plans.

I've gotten my hands dirty to say the least. On OB/GYN, I delivered babies. In the ED, I used a big needle to draw fluid from a man's belly and sharp knives to incise and drain abscesses. On ambulatory, I listened to the lungs of a patient who proceeded to sneeze on my face. On surgery, I cut through skin and fascia, then sutured it back together. I'll spare you the nitty gritty details from my month with the colorectal service.

I've managed my time in new ways. I've worked weekends, overnights, woken up at 3:30 a.m., and crashed just minutes after getting home from a long day. I've learned to squeeze studying into the quiet minutes between seeing patients or while eating dinner at night.

I've seen a lot already. A lot of diseases. A lot of different patients -- across all ages, and from many different backgrounds. I've witnessed care plans that worked, and others that fell short. I've seen new life and dealt with a couple of difficult deaths.

I've learned more than I can put into words -- about specific diseases and illnesses, about techniques and skills, but also about communication, generosity, compassion and trust. I've worked with many different team members at all levels of training, and have gathered little lessons from each one -- I pick and choose from their mannerisms, expressions, explanations and perspectives, taking those that I want to carry forward myself.

I'll adopt one intern's foresight to sit with a "difficult" patient in the evening, answering the patient's questions. This assuaged her anxiety, while also ensuring that the team wouldn't stall in her room during 5:30 a.m. rounds the next morning when we had 20 other patients to visit.

I'll practice giving off the warmth one resident exuded when talking to patients or team members, and work to accept criticism -- even when delivered brusquely -- with the same genuine appreciation he felt.

I'll aspire to mirror one attending's sense of humor, which always put her patients at ease, and aim to deliver bad news with the unflinching and honest expression of another.

In review, it's been a lot --and there's a whole lot more to come in 2020. But before the next wave begins, I plan to relax, rejuvenate and process the past few months.

On New Year's Eve, I'll be thinking about a woman I met on my surgery rotation. She told me her goal was to recover from her operation in time to throw confetti from the rooftops in Times Square as the ball drops. I looked into it and learned that revelers toss 3,000 pounds of confetti -- large chunks of multicolored paper -- several seconds before the ball descends. Many of them write messages on individual pieces of paper, recording their hopes and wishes for the year.

I have many hopes for the new year, and one of them is that my patient will be there, in the heart of Times Square as the clock strikes midnight, throwing handfuls of confetti over her shoulders, hugging her family and friends.

Wishing everyone a happy and healthy New Year.

Stanford MedicineUnplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unpluggedcategory.

Orly Farber is an undifferentiated third-year medical student from the East Coast. She loves reading and writing about medicine. Her written work has been featured online inSTAT NewsandThe Intima,as well as in print inThe Boston Globe.In between hospital shifts, you can find Orly running The Dish or making a mess of dishes in her kitchen.

Photo by Dave Hunt

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Year in review: Reflections on my first four medical clerkships - Scope

When Living With Serious Illness, What is Considered Courageous? – Curetoday.com

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With the start of a new decade, a brain cancer patient discovers what may be the most courageous way to move forward in his life.

Jeremy Pivor is a graduate student in the UC Berkeley-UC San Francisco Joint Medical Program. He was diagnosed with a brain tumor at the age of twelve, had a recurrence when he was 23, and is now undergoing experimental treatments for another life-limiting recurrence. In addition to being passionate about climate justice and ocean conservation, Jeremy advocates for the brain tumor and young adult cancer communities through writing, speaking, fundraising, and lobbying with groups like the National Brain Tumor Society, Dana Farber, UCSF and others. You can follow his journey at jeremys-journey.com or on Twitter @JeremyPivor.

When living with serious illness, what is considered courageous?

"Don't let cancer define you," is one of the most common expressions among the cancer community. Throughout my journey living with brain cancer since the age of 12, I have felt pressured to prevent cancer from changing the direction of my life. I thought that persevering in spite of my diagnosis was a courageous act.

As the new decade begins, I've reflected more on the meaning of courage as I embark on an enormous transition in my life. For the past two and a half years, I have been living in California while studying in a joint medical and master's degree program at UC Berkeley and UC San Francisco. My goal coming into this program was to become a physician to work at the intersection of human and environmental health. However, my path took a turn when I was diagnosed with a second recurrence of brain cancer in March 2018, just nine months into my studies. Two months later, I had an awake brain surgery.

Since learning of my diagnosis that spring, I have contemplated whether to continue with my medical degree. I finished my first year as if everything was normal, but after surgery and receiving the news that the remaining parts of the tumor were more aggressive than previously thought, I decided to transition to school part-time. While I still wanted to move forward in my studies, I needed to focus on my recovery and maintain a decent quality of life. This meant putting my medical degree aside while I focused on my masters. Still, I had every intention though to return to my medical studies.

When my first treatment following surgery proved unsuccessful, I questioned my decision to remain in medical school, but ultimately felt I should keep pushing forward with my plans, or at least keep that door open. Countless times I would receive comments such as, "You're going to be such a great doctor" or, "It's so courageous you're continuing with medical school while being a patient." I internalized these opinions, which made me feel like I had a duty to stay in medical school. I had two identities, patient and medical student, that could help shape me into a thoughtful physician.

While I originally planned to write my Master's thesis on the mental health impacts of forest fires on California youth, my medical experiences and exploration of the illness narrative genre drawing upon inspirations such as Julie Yip-Williams' The Unwinding of the Miracle,inspired me to pivot, turning my thesis into a book-length narrative about my journey with illness in medical school. Writing and reflecting on living with terminal illness strengthened my understanding of my values. I wanted, first and foremost, to prioritize my relationships with my family and my partner. Second, I wanted to use my experiences and privilege to help others.

As I neared completion of my Master's thesis, I came to a decision point of whether to continue with medical school. Over the past year, I had come to see that when living with life-limiting illness, it is not courageous to push forward blindly. Increasingly, I saw that I needed to recognize how my illness had helped to shape my values and, in turn, my path forward.

My values have guided me to put medical school aside and move back to the East Coast where my family and partner live. As a medical student, graduate student, and patient living in the Bay Area, I connected with colleagues, advocates, patients, and communities who taught me an important lesson: I do not need to be a physician to form deep, holistic connections with other people. I can do that through my own writing, advocacy, and experiences.

Every person living with a serious illness will respond uniquely to their diagnoses. The trope, "Don't let cancer define you," potentially prevents individuals from discovering new parts of themselves: aspects of their identity that could help them evolve to become someone they never thought was possible.

On New Year's Eve, when the clock struck midnight to start the new decade, I made a resolution to listen and respond to my values. While I have no idea where that will lead me, moving forward in this manner may be the most courageous act I can do for myself.

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When Living With Serious Illness, What is Considered Courageous? - Curetoday.com

Medical students take to the streets to give free care to Detroits homeless – WGNO New Orleans

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DETROIT, MI Armed with care packages, clothes, and clinical supplies, medical students in Detroit are learning outside the classroom. They are bringing their knowledge to the streets, providing free health care to the citys homeless.

Each week, students under the supervision of a registered physician or nurse practitioner get on their bikes and look for those in need.

One of the first experiences I had in the world of street medicine was with a young man who had gotten into an accident and broken his arm, said Ellie Small, a second-year medical student at Michigan State University and president of Detroit Street Care. He was put into a cast the day before, though nobody had seen to the road-rash that covered half of his forehead and the side of one of his legs.

Small and a group of volunteers went to work removing the dirt, stones and debris from the grateful patients wounds.

Its a job that Small describes as making invisible people visible.

The medical students treat wounds, check vital signs and provide patients with blood pressure medicine, insulin and antibiotics. Perhaps more importantly, they connect with people experiencing homelessness on a personal level.

Youre seeing them in their home, whatever that home might look like. We teach all our volunteers to be eye level with patients. If your patient is sitting on the ground, you need to sit on the ground. It goes a long way for their comfort, Small said. We need to realize whats most important medically might not be the most important thing in their life at that current time. Thats unique to this population. We always ask about someones housing status.

Programs such as Michigan State Universitys Detroit Street Care, Wayne State Universitys Street Medicine Detroit, and the University of Michigans Wolverine Street Medicine work together to treat as many of the citys homeless as possible.

According to the Homeless Action Network of Detroit, there were over 10,000 people experiencing homelessness in the city in 2018.

Members of the programs compare notes on patients and map out routes to ensure all pockets of the city are covered. They also host clinics at shelters and work with organizations to place people in housing whenever they are ready.

Jamie Wojahn, Director of Homeless Recovery Services at the Neighborhood Service Organization, said programs like these are crucial to the homeless population.

If it wasnt for all these schools and all these volunteers, there would be so many more people dying, Wojahn said. They are giving vaccines on the streets to people who havent had vaccines in several years. They give a lot of basic medical needs to people who have diabetes and hypertension that have been unaddressed for years.

Jedidiah Bell, a fourth-year med student at Wayne State University and president of Street Medicine Detroit, said seeing issues from lack of health care access in his home country of Zimbabwe made him want to participate.

When I moved to the states for university and medical school, I saw the similar things [lack of access] with the homeless population, Bell said. When I saw street medicine, I appreciated the model of how can we take medical care to the street and build up trust to bridge the gap between the homeless and the medical world.

While the programs provide a vital service to the community, Bell said the real-world experience teaches students things classrooms and clinics cant.

It teaches medical students to hone-in on, not just medical conditions of patients, but to be able to sit down and form relationships and discuss other things that might be contributing to [patients] health but might not come up during a traditional medical encounter, he said.

Bell said theres a widespread belief that students take away more from people on the streets than they take away from us.

Anneliese Petersen, a second-year medical student at Wayne State University and volunteer with Street Medicine Detroit, said the experience also shows upcoming medical professionals another side of health the social determinants.

Things that are not strictly medical-based but have a strong impact on health and well-being. Income, access to health care, access to medication, being able to eat well, sleep well, to be able to relax and not be under chronic stress, she said.

Learning to see how patients live outside a doctors office could help the students provide better treatment once they begin working inside one. But the main goal for the students remains with those on the streets.

If we can improve the situation for the person sitting in front of us and even just make their day or afternoon a little bit easier, were serving our purpose, Small said.

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Medical students take to the streets to give free care to Detroits homeless - WGNO New Orleans

2019 Physician Writing Contest: The hope of living better – Medical Economics

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I met Mr. AR for the first time in September of my intern year. He was a 70-year-old gentleman admitted to the hospital with nausea, vomiting, and abdominal pain. CT scans revealed an obstructing mass in the head of his pancreas. The rest of the workup yielded a frightening diagnosis of pancreatic cancer, prompting his primary medical team to consult usthe surgical oncology service. Although another resident had already seen him the day before, the patients daughter had only just arrived today, having traveled over 300 miles to be with her father. Mr. AR knew only that he needed to have surgery, so his daughter asked the nurse to page the surgery team, asking for someone to explain the proposed procedure.

I felt my heart pounding as I listened to the nurse relaying the request. I was barely three months out from graduating medical school, but my senior residents were operating (and so was the attending physician), so there was no one but me to walk to the north wing of the hospital, frantically studying diagrams on my phone as I made my way over. I made silent promises to myself that it would be okay to say, I dont know, because I truly didnt know. How long would he have to stay postoperatively? When could he eat normal food? What activity could he do afterward? Would he be cured? Would he still need chemotherapy? These were questions Id ask if I were the patient, and yet I had none of the answers.

Up until that day, I had decided that I hated surgical oncology. The patients were ill to begin with, having spent some time fighting a malignancy prior to presentation, then some of them would be weakened by neoadjuvant chemotherapy, sustaining neither nourishment nor exercise, and then we would throw them into the gauntlet of a major surgical resection. Much of a surgical interns time is spent on the inpatient floor following postoperative patients, and I felt a crushing gloom entering the ward every day looking in on how sickly the patients seemed to be. Watching them die was even worse. The promise of more time to live, however long, didnt seem worth it, and I struggled to care about these patients when everything seemed so futile to me.

Despondent, I knocked gently and pushed the door open, peering in. Mr. AR and his daughter looked up from their conversation, smiling brightly and asking if I was the surgery person. I stumbled over my greeting, taken aback by the sunny atmosphere. They were so glad that someone had come. He looked nothing like my patients: no temporal wasting, no ribs showing through his side, no exhaustion in his eyes. I drew pictures of the anatomy that would be altered during the procedure in order to remove the cancer. I apologized where I had no answer and reassured them that the attending surgeon would be by to fill in the gaps.

I also found out that he and his daughter came from my hometown, and by the time we were done chatting about more than just his diagnosis, an hour of my afternoon had drifted by. They thanked me for the information that I could give, and as I left the room, I couldnt hide my own smile at having shared a positive connection with another human being.

The next time I saw him, Mr. AR had undergone his surgery and relocated to our surgical postoperative floor. His recovery was not without complications. He endured a prolonged course of ileus, a string of electrolyte derangements, fluid collections requiring percutaneous drains, and an infection requiring antibiotics. Despite that, he greeted me cheerily every morning, even if I came to bother him at five or six oclock. When I caught him pushing a rolling walker in the halls, he wanted to show off his dance moves, weak as he was. The optimistic attitude he and his daughter shared was contagious, and it motivated me to continue working hard to get him better after every setback. By the time he left the hospital, he looked more like the cancer patients I was used to seeing, frail and thin, but he didnt stop smiling.

Months later, a stranger tapped me on the shoulder. I almost didnt recognize him. He was a far cry from the last Id seen him: normal clothing, filled out cheekbones, standing on his own. Apparently he was there following up with his oncologist and was doing very well on his adjuvant chemotherapy. He thanked me for the care he had received and expressed that I must continue doing so for others. I left that encounter with a renewed sense of purpose: the care I was providing no longer seemed futile.

Though progress was slow, I began to see how Mr. AR had changed me. As an intern, I had focused on the nitty-gritty details: the diagnosis, the pathophysiology, the workup, the treatment, the answers to difficult questions from the attending, the right orders to input into the computer. As a second-year resident, I found that the knowledge and workflow were now second nature, and I began to really see the patients for who they were. I saw new patients, anxious about their symptoms, fearful of the c word.

I saw survivors, racking up years free of cancer, eating well and living normal lives. I saw beyond the details of the treatments and began realizing the principles and patterns guiding the care of cancer patients. I assisted in surgeries big and small, where some patients were cured with a small excision and others like Mr. AR had to face the gauntlet. For these latter patients, I could now picture where they would be a few months following their surgery, strolling down to the hospital cafeteria for a snack after their infusion.

But they wouldnt get there on their own. Motivated by their stories, I challenged myself to take ownership of their care, to read as much as I could, to be able to answer their questions where I couldnt answer before. I presented patients I had seen at the multidisciplinary tumor board. I took notes on my clinic patients the night before so that I could spend more time with them in person and less with the computer. I stayed past shift changes to struggle through difficult cases with my attending. So imagine the surprise when third year rolled around, and I said with certainty, I want to go into surgical oncology.

Mr. AR is still alive today, and the lesson I learned from our shared experience is still with me as well. He showed me a different perspective of caring for cancer patients. Where I had once viewed it as a process of dying and merely delaying the inevitable, now I view it through his lens, as a process of living for the hope of living better, no matter what length of time we can give them. He had the strength to face every day with joy and positivity, and now I can do the same for my patients who dont have that strength themselves. This is what has helped me become a better doctor.

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2019 Physician Writing Contest: The hope of living better - Medical Economics

AMA Calls for Health Economics Classes in Medical Schools – The Heartland Institute

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The AMA does not define the term in its press release on the announcement, but it said schools should include information on fee-for-service, managed care and other payment structures.

The policy was adopted by the AMAs House of Delegates at its meeting in mid-November. The AMA says it has spent several years trying to integrate health systems science into the curriculum and it should be a third pillar in addition to basic and clinical science.

Medical students and residents with a deeper understanding of cost, financing, and medical economics will be better equipped to provide more cost-effective care that will have a positive impact for patients and the health care system as a whole, stated Barbara McAneny, M.D., spokesperson and past president of the AMA.

Concerned About Bias

Teaching medical students about the highly regulated profession they are about to enter can be a positive step, says Beth Haynes, M.D., a board member of the Benjamin Rush Institute, a nonprofit organization that helps students learn more about free-market medicine.

My concern is that medical schools will fail to be balanced in their presentation of economic theories, said Haynes. Schools may emphasize [the late economist John Maynard] Keynes and other supporters of significant government intervention while ignoring free-market, limited-government theories like [those of Milton] Friedman and [Ludwig] von Mises.

Economics can be a touchy subject in medical school, says Chad Savage, M.D., owner of the Michigan-based direct primary care practice YourChoice Direct Care and a policy advisor to The Heartland Institute, which publishesHealth Care News.

There is an implicit understanding in medical schools that it is for some reason taboo that physicians should discuss or have any expectation of compensation, said Savage. It is somehow unseemly to expect compensation, and this engenders the belief that the only way to partake of medical care is via governmental transaction.

Hoping for Balance

The AMA says it has published a study tool and developed several teaching models so medical educators can provide a better understanding of health care economics.

The AMAs announcement is welcome news to third-year medical student Anthony Fappiano.

I happen to love economics, so this is a topic I would have loved to learn about more, especially in school, said Fappiano, who attends the University of New England College of Osteopathic Medicine.

Fappiano says he hopes the presentation will be balanced, but a recent conference he attended was not encouraging.

It was a panel with a lobbyist for some single-payer company and two physicians who supported single-payer systems, said Fappiano. Not exactly a broad set of opinions.

Calls for Consumer Emphasis

Fappiano says he would like to learn more about consumer-driven care models.

I think it would be important to emphasize the ways that we as upcoming doctors can lower costs for patients more effectively, said Fappiano. We need to stress the importance of inexpensive treatments like lifestyle changes, hands-on medicine like physical therapy and osteopathic manipulation, and generic drugs, rather than jumping to topline drugs or surgery. This is rarely emphasized in medical school, and the board exams reinforce the idea that expensive tests are a necessity, when that is not always the case.

Fappiano says he learned about direct primary care from a faculty member who had such a practice, which does not accept insurance or government payments.

It gives the patient more flexibility and unlimited access to their physician, said Fappiano. It is lower-cost than most insurance, and the quality of care is the same or better.

The AMA has a strong influence on the nations medical schools, and policy announcements can be an indication of where the organization stands on political issues. In June 2019, the AMA announced it wants medical schools to introduce climate change into the curriculum, and an amendment to stop formally opposing single-payer health care was defeated by three votes.

AnneMarie Schieber(amschieber@heartland.org)is managing editor ofHealth Care News.

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AMA Calls for Health Economics Classes in Medical Schools - The Heartland Institute

Dean Of USD Medical School Honored For Advancing Careers Of Women in Medicine – Yankton Daily Press

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VERMILLION Mary Nettleman, M.D., dean of the University of South Dakotas Sanford School of Medicine and vice-president of USDs Division of Health Affairs, has been named the 2019-2020 recipient of the Elizabeth and Emily Blackwell Award for Outstanding Contributions to Advancing the Careers of Women in Medicine, presented by the American College of Physicians.

Nettlemans own career as a clinician, researcher, academic and as a medical school leader has demonstrated an ongoing commitment to womens health issues and to promoting women in health and medical careers. Prior to her duties as dean of USDs medical school that began in 2012, Nettleman was a professor of medicine and chair of the department of medicine at Michigan State University. There, and at other institutions including the University of Iowa and Indiana University, she distinguished herself in the field of health services research, particularly regarding diseases and conditions related to women.

Under Nettleman, USDs medical school has initiated concerted efforts to encourage South Dakota high school and college students to pursue education and training in medicine and health sciences. Increasing the number of women serving as physicians in South Dakota is a central objective.

Nettleman has pursued this objective not by creating preferential treatment, but by identifying and removing barriers that disproportionately hinder women. Nationally, she was the first person to identify gendered language in letters of recommendation written by medical schools for their students applying for residencies, and she led efforts to eliminate such bias. Nettleman has also led efforts at the school of medicine to implement policies recognizing the needs of women who are both mothers and medical students. At USD she has recruited women into faculty positions and administrative roles at the medical school. Nearly half of the schools leadership is now female.

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Dean Of USD Medical School Honored For Advancing Careers Of Women in Medicine - Yankton Daily Press

SMD – Queen Mary opens the doors on a new medical school building in Malta – QMUL

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28 October 2019

The four-storey 8,100 square metre building, including a roof terrace, is situated on the island of Gozo in Malta, next to Gozo General Hospital. It includes:

The building also hosts a library, student support facilities, a large canteen and social space, and offices.

Professor Anthony Warrens, Dean for Education at Barts and The London School of Medicine and Dentistry, Queen Mary University of London, said: This marks a significant new chapter in Queen Marys presence in Malta. This state-of-the-art facility will be a boon for students and staff alike, creating an excellent teaching and learning environment while also providing additional areas for students to study and relax.

The new building adds to Queen Marys Malta campus which includes an Anatomy Centre, which opened in December 2018 and features a dedicated area for teaching anatomy through dissection. It is equipped with facilities for clinical imaging, as well as office accommodation for academic, technical and administrative staff.

Queen Mary launched a five-year Bachelor of Medicine, Bachelor of Surgery (MBBS) programme taught on the Mediterranean islands of the Maltese Republic two years ago. It has now accepted its third cohort of students for the 2019/20 academic year.

The MBBS is taught by Barts and The London School of Medicine and Dentistry at Queen Mary and has been designed to provide students with the medical knowledge, clinical skills and professional attitudes that are required to become a competent Foundation Year (FY1) Doctor.

The programme is taught in English, using the same curriculum as the MBBS in London, and results in the award of a Medicine MBBS from Queen Mary University of London. Arrangements have also been made to make junior doctor (Foundation Year 1 and 2) positions in Malta available to our graduates.

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SMD - Queen Mary opens the doors on a new medical school building in Malta - QMUL

Medical Billing & Coding Schools in South Carolina

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Medical Billing and Coding Jobs in South Carolina

Three significant employers of medical billing and coding professionals in South Carolina are:

Open since 1950, ACH currently has 200 employees on staff. The hospital specializes in cardiology, emergency, family practice, internal medicine, pathology, podiatry, and radiology. Their John E. Harter Nursing Center employs approximately 155 full time employees. The perks at ACH include tuition assistance, disability insurance, a 403b with employer match, and vision, health and dental coverage.

Opened in 1975, Trident Medical Center is a 313-bed major medical care facility. Its services include heart and vascular care, a nursery, senior health, a burn clinic, and womens and childrens health services. Benefits at Trident include dental, health, vision and life coverage, disability, a 401(k) plan, a day care flexible spending account, and other perks.

BCHNC employs 22 physicians among its staff, servicing an area of 4,000 residents. Some of the services they provide include emergency medicine, anesthesia services, and a variety of inpatient services such as family medicine, obstetrics, and more. The benefits package at BCHNC includes dental, health, vision and life insurance, supplemental life and disability, a pension plan, retirement packages with employer match, and tuition reimbursement.

According to the U.S. Bureau of Labor Statistics (BLS), South Carolinas unemployment rate was at 3.9% inSeptember 2016, down from 4.5% the year before. During that same period, employment in the education and health services sector increased by around 2.5%.

Overall, the employment of medical records and health information technicians is expected to increase by 15% in the U.S., according to the BLS. This demand is anticipated due to the nations aging population, which tends to require more medical tests, treatments, and procedures to be performed. For a sense of how medical billers and coders currently fare in South Carolina, please refer to the most recent city stats below.

More than 83,000 healthcare professionals around the country are certified in medical coding by the AAPC. According to the BLS, most employers prefer to hire credentialed medical coders. To become certified, candidates must pass a credentialing exam. An online program in medical billing and coding can help prepare students to take this exam, and some may even allow students to take it during the program.

Listed below, compiled with information from the BLS, are the top cities for medical billing and coding employment in South Carolina.

There are approximately 710 medical billers and coders in the Charleston-North Charleston metropolitan area, according to theBLS. The average hourly wage is $19.15, and the average yearly wage is $39,830.

Columbia is home to 490 medical billers and coders, according to the BLS. The average worker makes the most money here: $20.04 hourly and $41,670 annually.

The Greenville-Anderson-Mauldin metropolitan area employs3 70 medical billers and coders, according to theBLS. The average wage is $17.28 hourly and $35,950 annually.

In Spartanburg there are approximately 220 medical billers and coders who make an hourly mean wage of $16.57 and an annual mean wage of $34,460, according to theBLS.

In Florence, there are approximately 150 medical billers and coders, according to theBLS. On average, they make $19.20 per hour and $39,940 per year.

The Myrtle Beach-Conway-North Myrtle Beach metropolitan area has about 110 medical billers and coders, according to theBLS. They make an hourly mean wage of $15.13. The annual mean wage is $31,480.

TheHilton Head Island-Bluffton-Beaufortmetropolitan area has about 60 medical billers and coders, and they make an hourly mean wage of $19.60 and a yearly mean wage of $40,760, according to the BLS.

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Medical Billing & Coding Schools in South Carolina

A College Specializes In Medicine And Health And Finds Itself Revived – WBUR

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Part 4 in a series.

Many liberal arts colleges in a demographic and financial trap have sought escape by seeking applicants elsewhere traveling the country, accepting more international students or adjusting their programming or their pitch.

But Regis College, based in Weston, has thrived over the past 15 years, in part by becoming more than a college.

"One has to be smart, not beat your head against the wall to try to continue to grow undergraduate education right now," says Antoinette Hays, the college's president since 2011.

Instead, over the course of the past decade, Regis has become a university with a diversified base of students roughly equal parts undergraduate, graduate and online with the overall majority focused on nursing or public health.

You can see Regis's growth is not on its main campus in Weston, but 35 miles north. Since 2013, Regis staff and students have shared space with Northern Essex Community College (NECC) in the center of Lawrence, and in 2017 theyrenovated that space.

Big parts of the building are given over to hospital-like rooms: a mock intake desk and beds full of high-tech medical mannequins. Some appear to breathe; at least one can "give birth."

Part of educating nurses is getting them habituated to interacting with real people from placing catheters, taking EKGs, to responding to a heart attack. Brenda Lormil, on the "Regis North" faculty, says the mannequins which are owned by the community college are an excellent teaching tool toward that end, even if they are a little unsettling. ("I never stay here past six," Lormil laughs.)

One of Regis's biggest programs at its Lawrence campus is an accelerated, 16-month program to earn a bachelor's degree in nursing. The program, for students who've received a prior bachelor's degree, is intense. But it allows working people to shift quickly into a career that pays well and many students say speaks to the soul.

Lormil understands the deep attraction of nursing; the profession pulled her in despite herself. As a teenager, Lormil says,"I wanted to be an international business woman" so she enrolled at Johnson and Wales University.

Freshman year, Lormil was assigned to a group project. As they presented, it became pretty clear she had done all the work. Her professor wasn't impressed.

"He told me that business is not for me," Lormil remembers. "Because, 'it's a dog-eat-dog world, and your character doesn't fit.' "

Lormil, then 18, was crushed. But she dropped out and applied to Regis College to study the same trade as her mother and her aunt."I detoured, purposefully. I was trying to be ... the different person.But it was always nursing."

Today, Lormil obviously loves her work. She's a nurse practitioner at an oncology ward at Massachusetts General Hospital, and she teaches the subject at her alma mater.

Still, Lormil says she's been impressed by the drive of the students she sees at Regis North. These are students going to college for a second time: "Their why is much deeper. Theres a lot more on the line.

Regis itself has gone through a similar process. In the early 2000s, the college then small, still single-sex was struggling. Given demographic and social trends, they could only expect things to get worse.

"Being a focused liberal arts institution became challenging," says Hays, who was in charge of the school's small nursing program at the time."People were starting to look at, 'what are the job prospects?' And we didn't have many professional programs."

So in 2007 the same year Lormil came to campus as a student-- Regis went co-ed. And they also doubled down on a bet: expanding graduate education and opening a standalone nursing school, of which Hays was the first dean. Nurses can receive a range of credentials, from associates up to doctoral degrees. Regis has conferred nearly 7,000 nursing degrees in the past 33 years, with 592 of them coming this past year.

Teddy Richards who's enrolled in the accelerated program is aiming to get his bachelor's next spring. Richards grew up in Liberia and Ghana, always with one particular dream: "to go to medical school to be a doctor. That was my thing."

But after he came to the United States at 18, Richards sayshe balked at the time and expense between him and doctoring. Now nearly 30 and with several years of work as an EMT, he's adjusted his dream. He now wants to become a nurse practitioner as soon as possible.

Walking through campus, Richards is glad the accelerated program in Lawrence sets him up to do that,without what he sees asneedless detours in the name of liberal arts.

"Colleges should be very focused," Richards says. He looks backon his time studying biology at UMass Lowell: "Kids [are] doing all these other classes that they're not really interested in. It's like, 'Why I am doing this if I'm not gonna end up using that in my work?' "

Twelve years on, Regis's bet on nursing has apparently paid off.

The college's annual revenue from tuition has doubled, while undergrads still pay relatively little to attend. Graduate and online students now make up two-thirds of Regis's enrollment, and many pay their own way. Regis is now a college in name only.

But they're not alone in this corner of the market. Other small schools, like Curry College, and much larger ones including Northeastern University and UMass Boston offer their own accelerated nursing programs.

It's not clear how much longer this boom can go on. Judith Par, head of nursing at the Massachusetts Nurses Association, the state's largest nurses' union, says thatwhile there may still be a national shortage of workers in her field, this stateis becoming an exception.

Par saysshe cautions her own students: "If you want to stay working in the Commonwealth, you may need to apply on average to 60 or 70 positions before you will find an opening."

But at least for now, Regis is growing, with health careers leading the way.Hays, the president, is determined to keep it that way. With the worst financial moment behind it, Hays has pushed expansion not just to Regis North, but alsothe acquisition of Mount Ida College's former dental-hygiene program,complete with 13 faculty and staff and nearly 80 students.

Hays is restrained, but ambitious. She frequently invokes a mission statement inherited from the Sisters of St. Joseph,who founded the college: to "care for the dear neighbor without distinction."Hayspitches both expansions in that spirit: the dental-hygiene program is now set up to give low-cost dental care at a new facility in Waltham that opened earlier this month. And Regis Northwill give a career-ready option to the underserved, and predominantly Latino, community around it with courses on medical Spanish planned for the year ahead.

At the same time, Hays and her team keep their eye always on the ever-changing world of hospitals and companies outside.

"We're very industry-driven," she says, "and we want to be sure that when our students graduate that they have employment."

Hays is confident in where Regis is now, and that it can continue to turn out hundreds of work-ready nurses each year in close cooperation with Greater Boston's medical establishment.

Do you have questions about small private colleges in Massachusetts? Fill out the form below:

Illustration by Chris Cerrato for WBUR.

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A College Specializes In Medicine And Health And Finds Itself Revived - WBUR

Roseman University of Health Sciences Driving the Future of Medicine – Nevada Business Magazine

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On Oct. 24 Roseman University of Health Sciences sponsored a special symposium on the Future of Medicine featuring some of the best and brightest thinkers in healthcare and education. The event is part of Roseman Universitys 20th anniversary celebration as a comprehensive health science university. Roseman will open a state-of-the-art private medical school in 2023.

Paul Umbach, a nationally recognized moderator and community health pioneer introduced distinguished speakers who shared their vision and passion regarding the transformation of population health, technology, policy, and practice in medical schools. Leaders in the Las Vegas community from all sectors of the economy in attendance participated in an open dialog about the transformation of medicine in southern Nevada. With two new medical schools in the Las Vegas in various stages in development (UNLV opened its doors in 2018 and Roseman University anticipates welcoming its first class in 2023), this program was especially timely and important to the health and well-being of the region.

According to Paul Umbach, founder of Tripp Umbach, who was instrumental in the development of more than 15 new medical schools over the past 20 years, medicine is undergoing its greatest evolution in centuries moving from a focus on sickness and disease to health and wellness.

Keynote speaker Dr. Pedro Greer, shared share lessons learned from starting a new medical school in Miami and from a career as a national and internationally recognized speaker and medical education visionary. Author of Waking Up in America, an autobiographical account about his experiences, from providing care to homeless persons under bridges to advising U.S. Presidents George Bush Sr. and Bill Clinton, Joe challenged the audience to think differently about the role of the new Roseman University College of Medicine in transforming the Las Vegas community.

Roberto Vargas Vice Dean of the Charles R. Drew University of Medicine and Science, a nationally recognized expert in addressing Population Health shared his research underway in underserved South Los Angeles, where a new minority serving private medical school in under development. Dr. Doug Miller, who has served as Dean of medical schools in New York, Georgia, and Canada explored the intersection of medicine, advanced technology, and artificial intelligence.

The program was as a springboard for Roseman Universitys plans to bring a private MD-granting medical school to Las Vegas and the beginning of Rosmans celebration of 20 years.

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Mizzou medical school will produce more doctors to address shortage – STLtoday.com

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Not all enrollment trends at the University of Missouri-Columbia are down the medical school has increased its class size by one-third this year.

The expansion, to a class of 128 from 96, is aimed at addressing a looming physician shortage created by an aging population. Most of Missouri is considered to have a shortage of health professionals, particularly rural parts of the state. The state needs an additional 367 doctors to accommodate its population, according to Kaiser Family Foundation data.

In 2006, the Association of American Medical Colleges recommended medical schools increase their enrollments by 30 percent in the following decade. The same year, St. Louis University increased the number of first-year students to 175 from 150, making it the largest medical school in the state.

Washington Universitys medical school enrollment has stayed between 120 and 124 students per class. There are no plans to increase the size of the class, which is partly influenced by the number of faculty and available space, according to the dean of admissions.

Mizzou started looking at expanding its class size soon after the 2006 recommendations, said Weldon Webb, an associate dean.

Were the No. 1 provider of practicing physicians in Missouri, so if somebody was going to increase, it should probably be Columbia, he said.

The expansion of the medical school includes a new $42.5 million classroom and laboratory building on the Columbia campus. A clinical campus opened last year in Springfield where some third- and fourth-year students train, aided by a partnership with CoxHealth and Mercy hospitals. About 44 percent of the medical schools students stay in Missouri after graduation, Webb said.

The growth of the medical school contrasts with undergraduate enrollment in Columbia, which dropped by about 14 percent this fall. The incoming class of about 4,000 freshmen is the smallest in nearly 20 years.

Reports of racism and a lack of diversity at Mizzou contributed to the drop in undergraduate enrollment and have also caused troubles for the medical school.

The medical schools credentials are at risk if it doesnt train more minority doctors, according to a 2016 report from the Liaison Committee on Medical Education, the accrediting organization for U.S. medical schools. The committee previously cited the school for its lack of diversity in 2001 and 2008.

The committees most recent recommendations give the school until 2018 to increase the number of black, Hispanic and Native American medical students, among other requirements.

Last year, less than 4 percent of Mizzous medical students belonged to one of the three underrepresented minority groups, according to national data. In the incoming class, 9 percent of students identify as black, Hispanic or Native American, school officials said.

The increased diversity of the incoming class tops St. Louis University, where 7 percent of medical students are in the three minority groups. The accrediting body placed SLUs medical school on a two-year probation in February in part for its problems recruiting and retaining low-income and first-generation students.

Washington Universitys rate of underrepresented minority medical students is 9 percent. University of Missouri-Kansas City has the states most diverse medical student body, with 12 percent.

Ebony Page of St. Louis joined Mizzous class of 2021 because of the medical schools growth and the opportunities to work in underserved communities after graduation, she said.

For me, growing up in the inner city and knowing the health disparities, a lot of it has to do with access to care, said Page, 27. To see the shortage firsthand made it important to go to an institution where it was important to them.

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About the School: Medical School UT Southwestern, Dallas, TX

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UT Southwestern Medical School is one of four medical schools in the University of Texas System and one of the nations top medical schools. UT Southwestern admits approximately 230 students each year, and admission is highly competitive. Were looking for the best and the brightest, the most intellectually curious, and the most caring and compassionate future physicians.

Since our founding in 1943, weve graduated more than 11,000 physicians. This year alone, the Medical School will train about 950 medical students and 1,300 clinical residents.

Our graduates have distinguished themselves at top medical facilities around the world, advancing the cause of medicine, furthering their careers, and adding luster to a UTSouthwestern degree. In fact, one Medical School graduate won a Nobel Prize.

The Medical School is located in the 387-acre Southwestern Medical District, just minutes from downtown Dallas. The medical district is home to two UTSouthwestern University Hospitals, William P. Clements Jr. University Hospitaland Zale Lipshy University Hospital; as well as Parkland Hospital one of the nations top public hospitals and Children's Medical Center, a national leader in pediatric care. All are used to train Medical School students.

Along with educating the physicians of tomorrow to care for future generations of patients, UT Southwestern is a leading research facility ($427.3 million in annual funding). We are home to some of the countrys foremost medical minds. UTSouthwestern's faculty includes more members of the prestigiousNational Academy of Sciencesthan all other academic medical centers in Texas combined.

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About the School: Medical School UT Southwestern, Dallas, TX

UW medical school in Spokane won’t get bigger classes – The Spokesman-Review

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University of Washington President Ana Marie Cauce, left, shows off her Gonzaga pen while she and Gonzaga University President Thayne McCulloh, right, sign the formal agreement after the announcement that Gonzaga University would host UW medical students on campus, starting in the fall of 2016. The announcement was Wednesday, Feb. 24, 2016 at Gonzaga University. (Jesse Tinsley / The Spokesman-Review)

For now, at least, the University of Washingtons medical school in Spokane will have classes of just 60 students.

Through a partnership with Gonzaga University, UW welcomed 60 first-year and 40 second-year medical students in Spokane last fall. Earlier this year it asked the Legislature for $9.3 million to add 20 students per graduating class.

But lawmakers were juggling other expensive obligations, including a court order to invest more in K-12 education, so UW received just $5 million for the biennium, enough to support two more classes of 60 medical students.

Our long-term goal is to get to 80 students, said Ian Goodhew, UWs government affairs director. Thats what weve been working on for several years.

Washington State University, which received $10 million for its fledgling medical school in Spokane, also is authorized to serve classes of 60. UWs medical school served significantly fewer students at WSU Spokane before that partnership splintered several years ago.

Goodhew said UW is satisfied with the amount it received. He said lawmakers recognized that the partnership with Gonzaga is off to a pretty great start.

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UW medical school in Spokane won't get bigger classes - The Spokesman-Review

Why Kaiser added tech execs to its med school board – San Francisco Business Times

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San Francisco Business Times
Why Kaiser added tech execs to its med school board
San Francisco Business Times
The roster includes Kaiser medical executives and Silicon Valley technology leaders, including Anne Wojcicki, CEO of 23andMe, and Mary Hentges, former chief financial officer of PayPal and CBS Interactive. Dr. Holly J. Humphrey, dean for medical ...

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Interested in med school? UMSL signs articulation agreement with UMHS in St. Kitts – UMSL Daily (blog)

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At the table (sitting from left to right) UMSL Pre-Professional Advisor and Program Coordinator Joseph Sutherland, UMHS President Warren Ross and UMSL Associate Teaching Professor of biology Marc Spingola sign the articulation agreement between UMSL and UMHS in St. Kitts. There to witness the signing was (standing from left to right) Dr. Thomas Last, Earl Mainer, Dr. Edwin Purcell and Michelle Peres, all of UMHS. (Photos courtesy of Scott Harrah)

University of MissouriSt. Louis students wishing to pursue medical school can look forward to the benefits of a freshly signed articulation agreement between UMSL and the University of Medicine and Health Science in St. Kitts.

The agreement creates a direct recruitment pipeline from UMSL to UMHS, offering qualified students a simplified admission process to the Caribbean medical school. Instead of multiple interviews, qualified UMSL students can do a single interview via Skype.

Applying to medical school can be incredibly expensive, and for the students that meet the requirements but would otherwise be considered non-competitive for mainland schools, this is a very good way to take the stress out of the admissions process, UMSL Pre-Professional Advisor & Program Coordinator Joseph Southerland told The UMHS Endeavour news publication.

The agreement, signed this month, creates a direct recruitment pipeline from UMSL to UMHS, offering qualified students a simplified admission process to the Caribbean medical school.

Southerland and Marc Spingola, an associate teaching professor of biology at UMSL, visited St. Kitts to negotiate and sign the agreement this month.

Interested students must meet a number of requirements to apply for admission, some of which include maintaining a high GPA, taking traditional pre-requisite science and math courses and passing the Medical College Admissions Test. For a full list of requirements click here.

While students complete coursework on the UMHS campus in St. Kitts, stateside clerkships are open to them.

There arent any clerkships in Missouri yet, Southerland said, but there are several in the Midwest, so after their time on the island, they wouldnt be as far from home during their rotations.

On top of the clerkship options, UMSL students considering UMHS will also have access to a modern medical facility.

You can judge a lot about a medical school by the quality of their anatomy lab, and UMHS has a gem, Southerland said. [UMHS President] Warren Rosss commitment to providing his students with up-to-date technology and resources was apparent in all the rooms that we visited. In short, everything they need to be successful is offered on the campus.

UMHS is built on the tradition of the best U.S. universities and focuses on individualized student attention, small class sizes and recruiting high-quality faculty. Its considered a top choice among Caribbean medical schools.

For more information contact Joe Southerland at 314-516-6260 or SoutherlandJ@umsl.edu.

Short URL: https://blogs.umsl.edu/news/?p=69580

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AAMC launches new initiative to address and eliminate gender inequities – AAMC

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While women have made up almost half of graduating medical students since 2004, they represent just 35% of active physicians. Female physicians make 76 cents and female scientists make 90 cents for every dollar earned by men, even after adjusting for age, years of experience, and specialty. Fewer than 20% of medical school deans and department chairs are women.

These and other systemic disparities have prompted the AAMC to launch a bold new initiative on gender equity, calling on medical schools, teaching hospitals, and academic societies to step up their efforts to identify and address the discriminatory practices that have led to stark gender differences in pay, promotion, and representation among specialties, among other areas.

For too long, gender inequities have persisted in our communities, limiting the contributions and the promise of many of our colleagues and learners.

David Skorton, MD, AAMC president and CEO

This week, the AAMC issued a statement and call to action on gender equity, the first in a series of efforts designed to encourage academic medical institutions to take meaningful and effective actions to correct the inequities that have led to manywomen leaving or being forced to abandon medical and scientific careers.

For too long, gender inequities have persisted in our communities, limiting the contributions and the promise of many of our colleagues and learners, David Skorton, MD, AAMC president and CEO, wrote in a letter to the nations medical school deans, teaching hospital CEOs, and academic society leaders. As leaders, you play a critical role in setting the tone and creating accountability for achieving [gender equity] within your institutions and organizations, as well as across your learning environments.

Led by David A. Acosta, MD, AAMC chief diversity and inclusion officer, and endorsed by the AAMC Board of Directors, the initiative calls oninstitutionsto address seven types of inequities in four primary areas: the physician and scientific workforce, leadership and compensation, research, and recognition.

Women continue to be underrepresented in the physician and scientific research workforce despite near parity in entering and graduating students. Indeed, women have comprised almost 50% of medical school graduates since 2004, but they make up just 35% of the physician workforce. Likewise, women represent half the graduates of STEM programsbut represent less than 25% of STEM faculty.

Within medical specialties, women represent far higher numbers of physicians entering primary care specialties than nonprimary care specialties. For instance, 63% of pediatricians are women, compared to just 18% of cardiologists and 5% of orthopedic surgeons.

We know that many women are pushed out of medical and scientific careers because of gender bias, harassment, and abusive cultures that actively exclude them, says Diana Lautenberger, a research director at the AAMC who is co-leading the gender equity project under Acostas leadership. Its time for our profession to change the narrative so that we can address these issues head-on.

Women are not promoted as quickly or to the same levels of leadership as men. While women are the majority of faculty at the instructor level, their numbers decline at each subsequent rank of assistant professor, associate professor, full professor, department chair, and dean. About 18% of department chairs and deans are women.

Women are offered less in starting salary, negotiated pay, and other forms of compensation (e.g., resources and bonuses) than men despite equal effort, rank, training, and experience. A recent AAMC reportfound that women in clinical departments make 76 cents on the dollar compared to men. That same report found that women in basic science departments earn 90cents on the dollar compared to men.

The exclusion of women from, and the concentration of men in, leadership positions creates extreme power differentials in academic medicine. These power differentials have an impact on the culture and climate of an institution and make it that much more difficult for women to reach parity in pay and promotion, Acosta says.

There is a gender gap in authorship of peer-reviewed publications, especially in high-impact journals. Indeed, women are much less likely to be first or second authors on the papers they publish, and their work appears less often in prestigious journals. This could be partly because editorial boards are overpopulated by men, and partly because most submitted papers are reviewed exclusively by men.

Male researchers receive more research funding than their female peers. While men and women receive grants at about the same rate, the amount awarded to women is consistently less than that given to men.Again, this could be partly because grant review panels consist mostly of men.

Women and racial and ethnic minorities also receive less mentorship and guidance when applying for grants, says Laura Castillo-Page, PhD, senior director of diversity policies and programs at the AAMC and co-lead of the gender equity project with Lautenberger. We need to do a better job of ensuring all women, including women from racial and ethnic minority backgrounds, are given the time to pursue research and the guidance to publish that research in the most prestigious journals.

Women receive less recognition through honors, speaking invitations, and awards than their male counterparts. Female faculty are less likely than men to receive awards from professional societies, be invited to speak about their research, or be introduced with their professional titles.

Leaders need to be intentional in recognizing the contributions of all and think critically about who they mentor and sponsor, says Lautenberger. Often, minoritized groups are not just ignored, but penalized, because theyre not in the club.

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AAMC launches new initiative to address and eliminate gender inequities - AAMC

Aging eyes and the immune system – Science Magazine

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A central promise of regenerative medicine is the ability to repair aged or diseased organs using stem cells (SCs). This approach will likely become an effective strategy for organ rejuvenation, holding the potential to increase human health by delaying age-related diseases (1). The successful translation of this scientific knowledge into clinical practice will require a better understanding of the basic mechanisms of aging, along with an integrated view of the process of tissue repair (1).

The advent of SC therapies, now progressing into clinical trials, has made clear the many challenges limiting the application of SCs to treat disease. Our duty, as scientists, is to anticipate such limitations and propose solutions to effectively deliver on the promise of regenerative medicine.

Degenerating tissues have difficulty engaging a regulated repair response that can support efficient cell engraftment and restoration of tissue function (2). This problem, which I encountered when trying to apply SC-based interventions to treat retinal disease, will likely be an important roadblock to the clinical application of regenerative medicine approaches in elderly patients, those most likely to benefit from such interventions. I therefore hypothesized that the inflammatory environment present in aged and diseased tissues would be a major roadblock for efficient repair and that finding immune modulators with the ability to resolve chronic inflammation and promote a prorepair environment would be an efficient approach to improve the success of SC-based therapies (2, 3).

Immune cells, as sources and targets of inflammatory signals, emerged naturally as an ideal target for intervention. I chose to focus on macrophages, which are immune cells of myeloid origin that exist in virtually every tissue of the human body and which are able to reversibly polarize into specific phenotypes, a property that is essential to coordinate tissue repair (3, 4).

If there is an integral immune modulatory component to the process of tissue repair that has evolved to support the healing of damaged tissues, then it should be possible to find strategies to harness this endogenous mechanism and improve regenerative therapies. Anchored in the idea that tissue damage responses are evolutionarily conserved (5), I started my research on this topic using the fruit fly Drosophila as a discovery system.

The fruit fly is equipped with an innate immune system, which is an important player in the process of tissue repair. Using a well-established model of tissue damage, I sought to determine which genes in immune cells are responsible for their prorepair activity. MANF (mesencephalic astrocyte-derived neurotrophic factor), a poorly characterized protein initially identified as a neurotrophic factor, emerged as a potential candidate (6). A series of genetic manipulations involving the silencing and overexpression of MANF and known interacting partners led me to the surprising discovery that, instead of behaving as a neurotrophic factor, MANF was operating as an autocrine immune modulator and that this activity was essential for its prorepair effects (2). Using a model of acute retinal damage in mice and in vitro models, I went on to show that this was an evolutionarily conserved mechanism and that MANF function could be harnessed to limit retinal damage elicited by multiple triggers, highlighting its potential for clinical application in the treatment of retinal disease (2).

Having discovered a new immune modulator that sustained endogenous tissue repair, I set out to test my initial hypothesis that this factor might be used to improve the success of SC-based therapies applied to a degenerating retina. Indeed, the low integration efficiency of replacement photoreceptors transplanted into congenitally blind mice could be fully restored to match the efficiency obtained in nondiseased mice by supplying MANF as a co-adjuvant with the transplants (2). This intervention improved restoration of visual function in treated mice, supporting the utility of this approach in the clinic (7).

Next, my colleagues and I decided to address the question of whether the immune modulatory mechanism described above was relevant for aging biology and whether we could harness its potential to extend health span. We found that MANF levels are systemically decreased in aged flies, mice, and humans. Genetic manipulation of MANF expression in flies and mice revealed that MANF is necessary to limit age-related inflammation and maintain tissue homeostasis in young organisms. Using heterochronic parabiosis, an experimental paradigm that involves the surgical joining of the circulatory systems of young and old mice, we established that MANF is one of the circulatory factors responsible for the rejuvenating effects of young blood. Finally, we showed that pharmacologic interventions involving systemic delivery of MANF protein to old mice are effective therapeutic approaches to reverse several hallmarks of tissue aging (8).

A confocal fluorescence microscope image of a giant macrophage shows MANF (mesencephalic astrocyte-derived neurotrophic factor) expression in red.

The biological process of aging is multifactorial, necessitating combined and integrated interventions that can simultaneously target several of the underlying problems (9). The potential of immune modulatory interventions as rejuvenating strategies is emerging and requires a deeper understanding of its underlying molecular and cellular mechanisms.

One expected outcome of reestablishing a regulated inflammatory response is the optimization of tissue repair capacity that naturally decreases during aging (3). Combining these interventions with SCbased therapeutics holds potential to deliver on the promise of regenerative medicine as a path to rejuvenation (1).

PHOTO: COURTESY OF J. NEVES

GRAND PRIZE WINNER

Joana Neves

Joana Neves received undergraduate degrees from NOVA University in Lisbon and a Ph.D. from the Pompeu Fabra University in Barcelona. After completing her postdoctoral fellowship at the Buck Institute for Research on Aging in California, Neves started her lab in the Instituto de Medicina Molecular (iMM) at the Faculty of Medicine, University of Lisbon in 2019. Her research uses fly and mouse models to understand the immune modulatory component of tissue repair and develop stem cellbased therapies for age-related disease.

PHOTO: COURTESY OF A. SHARMA

FINALIST

Arun Sharma

Arun Sharma received his undergraduate degree from Duke University and a Ph.D. from Stanford University. Having completed a postdoctoral fellowship at the Harvard Medical School, Sharma is now a senior research fellow jointly appointed at the Smidt Heart Institute and Board of Governors Regenerative Medicine Institute at the Cedars-Sinai Medical Center in Los Angeles. His research seeks to develop in vitro platforms for cardiovascular disease modeling and drug cardiotoxicity assessment. http://www.sciencemag.org/content/367/6483/1206.1

FINALIST

Adam C. Wilkinson

Adam C. Wilkinson received his undergraduate degree from the University of Oxford and a Ph.D. from the University of Cambridge. He is currently completing his postdoctoral fellowship at the Institute for Stem Cell Biology and Regenerative Medicine at Stanford University, where he is studying normal and malignant hematopoietic stem cell biology with the aim of identifying new biological mechanisms underlying hematological diseases and improving the diagnosis and treatment of these disorders. http://www.sciencemag.org/content/367/6483/1206.2

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Older People Need Geriatricians. Where Will They Come From? – The New York Times

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That describes Dorothy Lakin, 93, whose recent medical history includes heart failure, macular degeneration, falls, colon cancer and heart valve surgeries, and a stroke.

Shes had a zillion trips to the E.R., one after another, said her daughter Mary Ellen Lakin, 70, who lives in Newton, Mass. I thought, lets see if theres a way to make her life easier.

Mary Ellen Lakin found her way to Dr. Laura Nelson Frain, a geriatrician at Brigham and Womens Hospital in Boston, who has gently steered mother and daughter through the past year. She reduced the number of medications Dorothy Lakin took and the specialists she saw, stayed in touch with Mary Ellen and sent a geriatric nurse-practitioner to make house calls.

Its less of Lets order this med, lets order that procedure, more of a holistic approach, Mary Ellen Lakin said. Her mother recently entered hospice care.

Nevertheless, given the numbers, were not going to address this growing older population through some miraculous influx of specialized geriatricians, Mr. Petriceks said.

Leaders in geriatrics agree, and while they continue working to bolster their numbers, theyre also adopting other strategies. Dr. Mary Tinetti, chief of geriatrics at the Yale School of Medicine, has called for geriatricians to serve as a small, elite work force who help train whole institutions in the specifics of care for older adults.

The most important thing geriatricians can do is make sure all their other colleagues understand these patients needs, she said, including nurse-practitioners, physician assistants, therapists and pharmacists.

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Older People Need Geriatricians. Where Will They Come From? - The New York Times

UI at 150 & Beyond: ‘Going to the U of I meant getting freedom’ – Champaign/Urbana News-Gazette

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Among the 1,985 former students and faculty members featured on our Gies College of Business-powered UI at 150 & Beyond website: the Class of 2003s SHAILA KOTADIA, director of culture and inclusion at Stanfords School of Medicine.

The UI is where Shaila Kotadia earned the bachelors degree in cell and structural biology that led to positions at two of Americas most distinguished academic institutions.

Its also where she got a keepsake from Campustown.

Going to the U of I meant getting freedom. And one choice I wasnt allowed, even away from home, was having my belly button pierced, says the Cal-Berkeley STEM equity planning director-turned-Stanford Medical School director of culture and inclusion.

I remember there was this trendy store on John Street that my friends and I would sometimes shop at and they had piercings. So, one day, gripping the hands of my friends friends I still have today too tightly, I experienced the pain of freedom.

Recently, I had a baby and the piercing had to come out. But I still have a scar to keep the memory alive.

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UI at 150 & Beyond: 'Going to the U of I meant getting freedom' - Champaign/Urbana News-Gazette

Irraj Iftikhar: Connecting with patients on their worst days – American Medical Association

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The AMA Members Move Medicine series profiles a wide variety of doctors, offering a glimpse into the passions of women and men navigating new courses in American medicine.

On the move with: Irraj Iftikhar, a medical student at the University of South Carolina School of Medicine Greenville.

AMA member since: 2017.

What inspired me to pursue a career in medicine: As a child, my exposure to medicine was annual physicals and occasional colds, until the day I found myself in the emergency department, bleeding profusely and needing stitches.

Amazingly, when I think back, its not the pain or fear that I remember. Its the warmth, kindness and silly jokes that my doctor used to distract me. It was then that I realized that most people dont go to a physician on their best day. Instead, they go when they are worried, hurt, frustrated and confused. In pursuing medicine, I hope to be able to make those difficult days better for my patients, just like that doctor did for me so many years ago.

How I move medicine: By using my unique voice to advocate for myself, my peers and my future patients. I aim to empower others to do the same by emphasizing that advocacy and change can start anywhere, even with one person making one change. Medicine is ever evolving, and I believe that the best way to create positive change is making sure that there are avenues for everyones voice to be heard.

Career highlights: Organized medicine is a great way to get involved in making changes on many different levels. Since joining the AMA, I have been involved in my school, state and regional AMA Medical Student Section leadership.

Something I find particularly important is making it more accessible for people to have their voices heard. As advocacy chair for my region, one way Im working toward this is by creating the infrastructure for our schools to be able to hold annual voter-registration drives. It is a change that can have a wide impact and can help so many more voices have a say in what occurs in medicine and society as a whole.

Advice Id give to those interested in pursuing a career in medicine: My advice would be to find a dream to strive for and a why to keep you grounded. Having a dream keeps you motivated as you move through your career. And knowing why you want to achieve that dream will be a valuable reminder when things get tough.

How I give back to the community: By staying involved in the community I am serving. Through my local free clinic, I have been fortunate enough to connect with a family interested in implementing healthy lifestyle changes. By bringing them a healthy meal every other week and spending time with them, I was able to learn about their culture, their challenges and their hopes, all while helping them make healthy adjustments.

Experiences such as this remind me that every person has a unique situation to consider, and this helps me be a better advocate for every patient I interact with.

Aspect of my work that means the most: The bond that is created with every patient that I interact. I strive to leave every patient feeling confident that I am really listening to them and that I will advocate for them. I hope to never take for granted their willingness to share their lives with me.

My hope for the future of medicine: That, even as technological innovations in medicine continue to be implemented, we still allow time for a physician to simply listen to what the patient has to say. Additionally, I hope that there will be a time when no patient is forced to decline treatment simply due to cost.

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Irraj Iftikhar: Connecting with patients on their worst days - American Medical Association