Choices, trade-offs and accomplishments at the Women in Medicine and Science event – Scope

The path was rarely straight. The steps were neither easy nor obvious. Nonetheless Persis Drell, PhD, navigated the mostly male landscape of academic sciences to become Stanford's thirteenth provost. As the chief academic and chief budgetary officer, she holds a key position in setting university priorities and allocating funds to support them.

At the Stanford Medical Alumni Association's Women in Medicine and Science event, Drell, along with Stanford Medicine leaders, talked about her path to leadership -- a winding one that began as an undergraduate at Wellesley College.

"The smartest woman in every class was a woman," Drell said."You never asked, 'Do I belong?' Of course I belonged."

Graduate school, however, wasn't as welcoming. Studying physics at the University of California, Berkeley, Drell was the only woman in her class when she arrived as a student. Despite the challenges, Drell said she learned to be resilient. She built her own community and did her part to change the culture, celebrating small successes along the way, like creating the first gender neutral bathroom in the basement filled with research labs.

As Drell launched her academic career, well-meaning colleagues told her to wait until she had secured tenure before starting a family. Drell ignored the advice and interviewed at Cornell University with a six-week-old under her arm.

"Throughout your career," Drell told the room full of School of Medicine graduates and students. "You will have to make choices -- some of them will be difficult. For me, it was extremely important to chart a career path that allowed for family. That came with particular challenges and trade-offs but I owned those choices. They were my choices."

Drell loved teaching -- still does -- but along the way, she realized she liked serving in leadership positions too. "I discovered that I like to solve problems -- all kinds: structural, organizational and mission-related."

After 14 years at Cornell, Drell moved to Stanford into a laboratory leadership role, eventually becoming the director of the SLAC National Accelerator Laboratory. In 2014, she became dean of Stanford's School of Engineering and provost in 2017.

Drell's advice to the women in the room? Make the toughchoices, don't get discouraged, and build a strong network.

Mary Leonard, MD; Leslee Subak, MD; and Suzanne Pfeffer, PhD, who chair the pediatrics, obstetrics and gynecology, and biochemistry departments respectively, seconded Drell's advice.

Each told of their owns paths, which like Drell's, were not linear. They talked about the choices they made and the barriers they overcame -- which included at least one literal wall of men.

Subak told of her undergraduate studies at Dartmouth University, where her class was only the fifth to include women. In large lecture courses, the men would stand to create a physical barrier between the professor and the women. "When a woman raised her hand to ask a question," Subak said, "the men would stand around her so she couldn't be seen."

Undeterred, Subak graduated with a degree in earth sciences and economics. She found jobs as a geologist and in banking before a volunteer role at a health clinic inspired her to apply to medical school. She graduated from Stanford's School of Medicine in 1991.

During the question and answer session, the conversation turned to the perceptions of leaders and how men are often described as strong or forceful while women get tagged with less complimentary language. The department chairs also talked about the advantages they have as women in leading their departments.

"I could bringconsensus to a room," Pfeffer said. "I think we do that better than the guys."

Women are now the majority of students entering medical school nationally. A majority of bachelor's degrees earned in biological and biomedical sciences are earned by women. In medical schools, the future may, in fact, be female.

Recordings from the event will be available.

Photos by Steve Fisch

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Choices, trade-offs and accomplishments at the Women in Medicine and Science event - Scope

Electronic Medical Records, Burnout, And Mans 4th Best Hospital – Forbes

Overworked doctor trying to focus.

Graduating from medical school in 1978, I started my hellish internship while reading Samuel Shems classic, The House of G-d, a scathing indictment of medical education and the mercenary incentives in patient care. I found it shocking, crude at times and disillusioningbut at its core, absolutely correct about what was happening in medicine that was so wrong.

Thus it seems fitting that I received a review copy of Shems new book, Mans 4th Best Hospital, as my medical career is coming to a close. Once again, Shem nails where medical care has lost its way. Physician burnout and dissatisfaction are increasing in step with patients unhappiness.

Much of the blame can be attributed to two thingscorporate greed and electronic medical records, which are like conjoined twins. Theres no small irony that this is what is forcing many experienced physicians, like myself, out of practice prematurely, contributing to a waste of both talent and experience that is needless and costly.

Electronic Medical Records (EMRs)

Come with me as I describe some of the changes in my own career that are reflected in Shems writing.

In the olden days, for example, I used to graph out when each antibiotic wasstarted and stopped on the TPR sheetthe hand written graph the nurses charted the patients vital signs on with temperature, pulse and respiratory rate. Sometimes I noted a new medicine or a positive blood culture. This visual display of quantitative information was invaluable to me in following the course of my patients illnesses and puzzling things out when they didnt respond as expected to therapy. For example, you could regularly see that a new fever corresponded to the addition of a particular new medicine, rather than infection.

No more. Even the early EMRs eliminated such graphics, replacing them with rows of data. While some have a generic graphical display option, among the half dozen EMRs Ive had personal experience with, none could be annotated with what I need, as I did by hand.

That was decades ago. Back then, the lab would call doctors with critically abnormal labs. For me, the emphasis was on abnormal blood and spinal fluid cultures. EMRs are not without any redeeming qualities. Meditech, my first hospitals system, had one valuable module. I could readily see my patients positive cultures including those from previous admissions. They were flagged and easily visible. None of the other half dozen systems Ive used in the past decade has had that capability.

In mid-career, I conducted many clinical trials for pharmaceutical companies, working (primarily) to develop new antibiotics and other treatments for life-threatening sepsis. Electronic gadgets replaced people who actually measured a temperature, felt a patients pulse, or counted the respiratory rate. These mechanically generated results were often wildly inaccurate, but were recorded automatically and could not be readily edited. This made identifying patients for trials, or following their course accurately on the trial, nearly impossible. Shem had number of Laws of the House of G-d. The applicable one here was #10 If you dont take a temperature, you cant find a fever.

Those EMRs were problematic, but nothing like the new generation.

Epic and newer EMRs

HAMILTON, MA - JULY 2: The pop-up on this fictitious patient's electronic health record shows ... [+] drug-disease interactions. Dr. Hugh Taylor , with Family Medicine Associates, in Hamilton, talks about records, on Wednesday, July 2, 2014. (Photo by Pat Greenhouse/The Boston Globe via Getty Images)

EMRs have lost their way, along with the rest of medicine. The initial idea dating back to ~2008 was to have interoperability and to gather data, which could be used to improve care. What has happened to that more idealistic goal?

(Note, I will refer to Epic, since I have the most recent experience with it and it is named Best in Klas, but my current criticisms could be leveled against most, if not all, EMR systems).

EMRs no longer seem to even pretend to be about patient care. The goal is to optimize billing through upcoding. You do that, in part, by documenting more, through check boxes and screens that you cant skip. The more you upcode and the more quickly you get patients discharged, the more profits go to the corporate overlords.

Physicians now spend two hours on the computer documentation for every hour with the patient on site. Many have 2-3 more hours pajama time EMR work at home. Notes used to be concise and problem lists useful. Now there is needless bloat.

The EMR in fictionalized Mans 4th Best Hospital is HEAL, described by its President Krashinsky, For billingwe monetize.As protagonists Dr. Roy Basch and Berry reminisce,

The choice in medicine back then? The Fat Mans Dream or the Money. The money won. The money wins. Not just in medicine, in pretty much everything American now, and worldwide

UPMC case study

Shortly after UPMC bought Lancaster Regional Medical Center (LRMC), where I had been working, EPIC training began in late 2017. This was an extraordinarily time-consuming and expensive process. One physician told me the conversion cost $20 million; I am awaiting confirmation from the hospitals. Six months after the launch, Epic was upgraded, requiring additional training.

UPMC announced closure of LRMC in Dec 2018. More than 500 employees were affected, though it's unclear how many lost their jobs. Its also unclear how Lancaster General, the other hospital in town, can absorb the additional patientsas well ashow patients, particularly those who are poor, will manage to reach care in a different part of the city.

Most of the staff I worked with disliked Epic and felt it hurt patient care. I saw some instances where its rigidity hurt patients. Some physicians said they were retiring rather than learn such a complicated and time-consuming system. (For a bonus, humorous thread on Epic, see Eye Contact is Evil and EPICParodyEMR on Twitter.)

EMRs and physician burnout

This complaint, that EMRs are a huge time sink was not limited to Epic. At Susquehanna, some physicians complained that their EMR system, NextGen,lowered their productivity by a third. Since their pay was tied to performance, they were not happy about either pay cuts or angry administrators. By far the worst system I had to learn was the Armys AHLTA; I hear pretty good things about the VAs EMR.

A study from the Mayo Clinic found that over 50% of physicians experienced at least one symptom of burnout and that the frequency has been increasing.

As Dr. Atul Gawande stressed in Why Doctors Hate their Computers, Mayo found that one of the strongest predictors of burnout was how much time an individual spent tied up doing computer documentation.

Gawande observes, I began to see the insidious ways that the software changed how people work together. Theyd become more disconnected; less likely to see and help one another, and often less able to.

Man's 4th Best Hospital cover

Shem nails these problems with EMRs and money-driven medical care in spades, and more graphically than all the medical journal articles. He explained to me,

Its not burnout. Its placing doctors in a moral bind. Its like being in a war you dont believe in. That kind of thingIts abuse of doctors, simply put. Because we cant practice the way we want to. Were hirelings.

He stressed that electronic records are probably a pretty good thing. It is the way they are linked to money that is the problem.

Many physicians miss caring for patients. We are now regarded by many large health systems as interchangeable widgets and shift workers. EMRs have destroyed our relationship with patients, as we are forced to interact with the computer screen rather than our patient.

In this sequel, Shem emphasizes the danger of isolation from patients and coworkers and the healing power of good connections. He waxes more philosophical and Buddhist threads run through the narrative. Basch muses,

its our job, being with patients at the crucial times in their lives, yes, illness, old age, and deathwell suffer less, spread less suffering around andheal. Heal both ways. Us and them.

The Laws of the House of G-d were funny, cynical with apt insider jokes about medical training, like Law VIII. They can always hurt you more and XIII The delivery of good medical care is to do as much nothing as possible. EMRs, practice guidelines and fear of liability pushes towards doing more. We would be better if we remembered the Fat Mans mantra, that sometimes Less is more.

The Laws of Mans 4th arent as catchy, but reflect a wise maturity in how we should respond to the crisis in health care. II. Isolation is deadly; connection heals. VIII Squeeze the money out of the machines. IX. Put the human back in medicine.

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Electronic Medical Records, Burnout, And Mans 4th Best Hospital - Forbes

About the School | Lewis Katz School of Medicine at Temple …

Founded in 1901 as Pennsylvanias first co-educational medical school, the Lewis Katz School of Medicine has attained a national reputation for training humanistic clinicians and biomedical scientists. The school attracts students and faculty committed to making a difference in patient care, research, education and public service at home and across the globe.

The School of Medicine and Temple University Hospital (TUH), its chief clinical training site, provide care for patients from throughout the region seeking advanced tertiary- and quaternary-level care. In addition, TUH serves one of the most vulnerable populations in the nation, providing more free and under-reimbursed care than any other hospital in Pennsylvania.

With clinical training sites that include other member hospitals and specialty centers of the Temple University Health System and educational affiliates of the School of Medicine, medical students gain experience in a variety of urban, suburban, and rural in- and out-patient settings. They learn to provide culturally competent, interprofessional care to a diverse population of patients with simple conditions as well as highly complex ones.

The Lewis Katz School of Medicine is a school that prizes not just technical excellence but diversity, equality and inclusion. It teaches the true art and science of doctoring. Moreover, its educational strategic plan, Improving Health Through Innovation in Medical Education, keeps pace with new medical knowledge and with emerging trends in care delivery.

The schools home base in Philadelphia is a spectacular 11-story, 480,000 square-foot medical education and research building that features state-of-the-art facilities and technologies for medical education and research. It opened in 2009. With specialized research centers focused on population health, metabolic disease, cancer, heart disease and other strategic priorities, the school conducts investigations to break new groundand trains future generations of researchers to follow suit.

On October 13, 2015, Temple's medical school was officially dedicated as the Lewis Katz School of Medicine ahistoric milestone in the schools history. Thousands of people participated in events celebrating this change which,Dean Dr. Larry Kaiser said, "joins our schools legacy to the values that Lewis lived by, and the values which we have always tried to instill in our students hard work, dedication, service."

The Lewis Katz School of Medicine is part of Temple University Health System, a $1.6 billion enterprise. It is one of seven schools of medicine in Pennsylvania and the ninthmost-applied-to medical school in the United States.

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Aaron Craft to retire at the end of Euro League season to enroll in medical school: Buckeye Breakfast – cleveland.com

COLUMBUS, Ohio -- Former Ohio State basketball player Aaron Craft will reportedly be playing his final basketball season as a professional.

According to the Italian magazine Corriere della Sera, Craft will retire at the end of the EuroLeague season and will begin medical school at Ohio State. He currently plays for Trento, where he has competed in both the Euro Cup and the Lega Basket Serie A league in Italy. He has career averages of 8.5 points and 4.3 assists while playing for five teams since 2015.

The passion for medicine is something I have cultivated since I was a child, Craft said, after translation. "At the end of my life I want to be more than a player who has chased a ball. My goal is to help others and serve the society in which I live.

Craft also played for the Buckeyes alumni team Carmens Crew over the summer helping them win the $2 million cash prize for the first time. He played for the Buckeyes from 2010-14 compiling a 99-37 record 52-20 in the Big Ten and reaching the final four in 2012.

He averaged 9.8 points, 4.7 assists and 2.3 steals while starting in 113 of 148 games.

Cassius Winston is the only consensus Preseason All-American in college basketball

Here is a look at the preseason Associated Press All-American team for the 2019-20 season:

Cassius Winston, Michigan State: 18.8 points, 3 rebounds, 5.2 assists, and one steal per game

Markus Howard, Marquette: 25.0 points, 4.0 rebounds, 3.9 assists and 1.1 steals per game

Jordan Nwora, Louisville: 17.0 points, 7.6 rebounds and 1.3 assists per game

Myles Powell, Seton Hall: 23.1 points, 4.0 rebounds, 2.9 assists and two steals per game

James Wiseman, Memphis: 25.8 points, 14.8 rebounds, 5.5 blocks and 1.3 steals per game at Memphis East HS

A look at TCUs jerseys for its matchup with Texas on Saturday

Catch up on the latest Ohio State news

Imagining Urban Meyer as the coach of the Dallas Cowboys (or any other team)

What is Ohio State footballs level of Wisconsin worry, with Joel Klatt of Fox Sports: Buckeye Talk Podcast

If Ohio State football limits Jonathan Taylor, how else can Wisconsin attack?

Could other Ohio State football players enter the Heisman Trophy race? Heisman Watch

How Chris Olave bounced back from one of his worst games as an Ohio State football player

Ohio State vs. Wisconsin for football, tuition, academics, sports money and more, by the numbers

Why Ohio State is so effective on third down and its importance against Wisconsin

Scouting Ohio State football vs. Wisconsin: Q&A with Jeff Potrykus

How Wisconsins best running backs have fared against Ohio State from Ron Dayne to Jonathan Taylor

Urban Meyer says he wont be on the field for OSU-Wisconsin: Buckeye Breakfast

Key Dates

Ohio State vs. Wisconsin 2 days, Saturday, noon.

Ohio State at Michigan: 37 days, Nov. 30

Big Ten Championship: 44 days, Dec. 7

College Football Playoff Semifinal: 65 days, Dec. 28

College Football Playoff National Championship: 82 days, Jan. 13, 2020

Get Buckeyes Insider texts in your phone from Doug Lesmerises: Cut through the clutter of social media and communicate directly with the award-winning OSU football reporter, just like you would with your friends. Sign up for insight on the Buckeyes in your phone for $3.99 per month.

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Aaron Craft to retire at the end of Euro League season to enroll in medical school: Buckeye Breakfast - cleveland.com

Acupuncturist hoping to make mark in county – Times Herald-Record

FRANKFORD - An internship led a Newton High School graduate to the field of acupuncture, and she has brought her skills to Sussex County with the opening of her second office location.

Kayleigh Kovonuk is the owner of Lifestyle Acupuncture of New Jersey, which opened on Route 206 in Augusta earlier this year as an addition to its other location in Rockaway.

Kovonuk said that acupuncture is based on traditional Chinese medicine, which focuses on providing nutrients to cells in the body and taking out waste. As such, her practice treats physical pain as well as mental health and a variety of other ailments by addressing different pressure points.

The basic premise of (acupuncture) is that, whenever there's imbalance or disease in the body, it's due to stagnation or a lack of flow of energy in blood, Kovonuk said. The reality of it in the physiological sense is that it's basically moving oxygen in the body, it's moving blood, it's getting circulation and cells to the areas that need help, and it's helping the body heal itself.

Kovonuk, who graduated with a degree in psychology from The College of New Jersey, had no knowledge of acupuncture prior to interning at a substance abuse center for teenagers in her senior year. There, she began to seek out ways to treat the patients other than what the center normally described.

Basically these 15, 16-year-olds were just given medications that were so similar to their drugs of abuse that they were just replacing one addiction with another, Kovonuk said. I was looking into alternative ways to help people from psychological conditions, whether it be addiction, anxiety, depression, and I looked into acupuncture.

Incidentally, the husband of Kovonuks medical director at the internship was an acupuncturist and was able to provide more information on the field. Before long, Kovonuk was enrolled at New England School of Acupuncture, where she studied for two years before transferring to Pacific College of Oriental Medicine in New York City to focus on orthopedic and sports medicine.

Kovonuk worked at a Morristown practice during and after medical school, where she performed a variety of behind the scenes work that helped her learn the ins and outs of the industry. With plenty of experience under her belt, she partnered with a colleague to open Lifestyle Acupuncture in Rockaway in May 2016.

While her business was thriving, Kovonuk, a Newton High School graduate, always knew she wanted to move back where she grew up to practice acupuncture. She obtained the lease for the Augusta building, a former massage office, last November and opened the facility in February.

Lifestyle Acupunctures two main specialties, according to Kovonuk, are pain and emotional treatment, with new partner Arik Cohen specializing in stroke rehabilitation. The practice also treats pediatric patients, a demographic often overlooked in the field.

Since I've had kids, that part of my practice has grown a lot, Kovonuk said. As I go further, I kind of want to focus more on emotional health, women's health and pediatrics because there's so much going on in today's society, especially with kids.

Kovonuk now lives in Frankford with her husband Evan, daughter Scarlett, 5, and son Austin, 1. For her practice, she joked that her long-term plan is to "take over Sussex County," possibly by adding another practice in Sparta when the time is right.

More to the point, Kovonuks goal is to be the go-to place for acupuncture in Sussex County, rather than splitting her week between Augusta and Rockaway like she does now. Having built up a family-like atmosphere among her clientele in the past three years, she is ready to focus it in the community she knows best.

I really eventually just want to be up here, Kovonuk said. This is just the beginning. I have lots of ideas, but they all are going to be in Sussex County because once you live up here, you just don't want to leave.

Lifestyle Acupuncture of New Jersey is located at 47 Route 206 in Augusta. Its hours are 10 a.m. to 3 p.m. Monday, 9:30 a.m. to 12:30 p.m. Tuesday and Saturday, and 9:30 a.m. to 5:30 p.m. Thursday.

For more information, call the office at 973-300-3180 or visit http://www.lifestyleacupuncturenj.com.

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Acupuncturist hoping to make mark in county - Times Herald-Record

Madison doctor headed to new Idaho medical school – Rexburg Standard Journal

REXBURG A local doctor has been chosen to help head Idahos first medical school.

Dr. Rodney Bates, a former hospitalist at Madison Memorial Hospital, will become the chair of the Primary Clinical Department at the Idaho College of Osteopathic Medicine.

In an interview with Madison Memorial Hospital public relations specialist Lucas Handy, Bates said he was excited for the opportunity to join the medical school.

Its a neat opportunity for Idaho to serve the students and work with them, he said.

Bates first moved to Rexburg with his family 12 years ago after finishing his residency. He said when he moved to Rexburg, he didnt expect to find the family atmosphere that he will miss when he leaves.

It just feels like a big family, especially the (hospital) staff, he said. As far as Rexburg goes, thanks for letting me be a part of your lives.

Bates added that working at the hospital has been a great training opportunity for me.

They call it a medical practice for a reason, he said.

Bates' absence at Madison Memorial Hospital was not unplanned for. Stepping in for Bates will be Jack Clark, M.D. Clark attended medical school at the University of Utah School of Medicine and completed his residency at Penn State University Hershey Medical Center in Pennsylvania.

Doug McBride, head of Madison Memorial Hospital public relations, said Bates will be missed.

We are really excited for this new adventure hell be going on, McBride said, but well be sorry that hes gone. Hes been a wonderful asset to the hospital. We couldnt be more happy for what hes done.

McBride said Bates encouraged focusing on patients while at the hospital and hopes that Bates will take that mindset with him to the new medical school.

His whole philosophy is patient-oriented. If he can train those students to be anything like he is, well have a really good thing going, he said.

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Madison doctor headed to new Idaho medical school - Rexburg Standard Journal

Primary Care Physician Secaucus NJ Family and Internal …

Our practice, operating in the heart of Secaucus, NJ, with an on site lab, is nationally recognized as a Patient Centered Medical Home because we have some of the top primary care physicians Secaucus has to offer. As leading primary care doctors, Riverside Medical Group provides patients with exceptional care thanks to our family physicians and attentive staff. As internal medicine doctors, our general and family practitioners build meaningful community relationships with patients while upholding the principles of adult medicine.

Our Practice Approach

Unlike any other Secaucus PCP center, we practice a highly focused approach to adult and geriatric carewhich means internal medicine patient education is highly important to us. This honest-and-true approach reflects everything we do here. Our mission at Riverside Medical Group of Secaucus is to bridge patient concerns with the best physicians to manage patient healthcare.

Serving all ages from newborns and up, our general and family practitioners at Riverside Medical Group of Secaucus have trained at some of the best schools and institutions in the country. We have a strong commitment to the wellness of each and every patient. We strive to create an atmosphere that is comfortable and friendly to help relieve the anxiety that often encompasses a visit to the doctor. You can be assured that, as a patient in our practice, you will be seen and cared for by a doctor, who knows you and treats you like a person, not a number.

Importance of Picking the Right Practice

At Riverside Medical Group of Secaucus we pride ourselves on being a part of the neighborhood for over 35 years and continually having the best interest of our patients at heart. Whether a patient is long-standing or new, we know the importance of picking a trusted practice that is the right fit for you. Walk-ins and new patients are kindly welcomed and we offer same day appointments, with all insurances accepted. EMR access and medical records access is right at your fingertips when needed via MyChart for patients. We welcome you to contact us with any questions. To set up an appointment please call 201-865-2050. We look forward to seeing you soon, neighbor!

Adult MedicineProviders:

Iyad Baker, MDNagarani Ramasubramaniam, MDAdam Atoot, MDMabel Trigoura, APNOffice Manager:Korene Chung-WhiteSpecialties:Preventive HealthChronic CareOther Services Offered:Comprehensive and free birthing/prenatal classesPhysical therapyENTPodiatryPediatricsAddress:714 Tenth StreetSecaucus, NJ 07094Get directionsContact:Phone: 201-865-2050Fax: 201-865-0015Adult Medicine Hours:Monday Sunday: 7am to 12am

365 Days a Year

Riverside Medical Group

info@riversidemedgroup.com(201) 865-2050

714 10th St.

Seacaucus, NJ. 07094

Board Certified in Pediatrics

Board Certified in Pediatrics

Board Certified in Pediatrics

Board Certified in Pediatrics

714 Tenth StreetSecaucus,New jersey07094

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Medical School – University of Buckingham

Welcome to the University of Buckingham Medical School

Applications for our January 2020 intake are now open. Click here to apply.

The University of Buckingham Medical School is the UK's first independent not-for-profit Medical School. Our guiding philosophy is to produce highly ethical, honest and compassionate doctors who will put the patient first.

Our curriculum is derived from a well-established MB ChB programme that has been refined over 20 years to provide optimum learning experience. Every aspect of it has been engineered to fully equip our students with the skills necessary to start their journey as medical practioners.

The Medical School embraces The University of Buckingham ethos of focusing on student experience. This has allowed the University to lead the National Student Survey for Student Satisfaction for the past eight years.

MB ChB Course

Please use the diagram below to navigate through the MB ChB Course:

Please click on the diagram below to get more general information about the MB ChB at Buckingham

(Please note that this clickable diagram needs a minimum monitor resolution of 1200px width with the browser in full screen to work correctly. You can also use the navigation on the left hand side if you experience any problems)

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Medical School - University of Buckingham

UI med school appoints 2 Carle doctors as clinical directors – Champaign/Urbana News-Gazette

Photo by: Carle Illinois College of Medicine

Jarrod Almaroad

Image

URBANA The new Carle Illinois College of Medicine is rounding out its executive team, appointing two physicians to direct the clinical side of the operation.

The college announced Thursday that Dr. Blair Rowitz will be associate dean for clinical affairs, after serving in the job on an interim basis since November.

Dr. Jarrod Almaroad, a Carle anesthesiologist and associate medical director of perioperative services, will be the first permanent director of clinical science for the engineering-based college of medicine.

Rowitz will oversee clinical partnerships to allow the integration of the college's research and academic activities into the patient-care side of the operation. The role is crucial to the college's goal of transforming regional health care delivery and innovation, officials said in announcing the news.

Almaroad will be the principal administrative officer for clinical science, guiding it into an academic department within the college. He will manage the clinical side of the engineering-based M.D. degree curriculum, including students' experiences working with physicians and patients in clinical settings and the involvement of physician-educators.

"Dr. Rowitz and Dr. Almaroad have the right expertise to oversee these crucial areas for the Carle Illinois College of Medicine," said Dr. Matthew Gibb, chief medical officer for the Carle health system.

Gibb called Rowitz "a skilled clinician, a valued administrator and trusted mentor to many." And Almaroad has a unique perspective as a physician and provider directly involved with many disciplines of care, he said.

Rowitz, a Carle surgeon, researcher and UI faculty member, holds faculty appointments in the Department of Nutritional Sciences and the UI College of Medicine's regional campus in Champaign-Urbana. He is also medical director of surgical services at Carle.

King Li, dean for the new medical school, said their leadership will be "critical to training the first generation of physician-innovators who will re-engineer the delivery of health care."

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UI med school appoints 2 Carle doctors as clinical directors - Champaign/Urbana News-Gazette

Taking time off in medical school – Scope (blog)

Like many of my classmates, I took the last year off from medical school. Some of us enrolled in different graduate programs to pursue a dual degree while others did a research year. The trend is becoming more common the proportion of students who take more than four years to graduate and the number in dual degree programs are at all-time highs.

Over the past few months, several students have asked me about my experience and whether I would recommend they do the same. While the short answer is, It depends, I think there are three questions worth thinking about while deciding whether towalk away from medical school for a year.

What do you want to get out of taking time off?

This first question sounds obvious but goes unanswered surprisingly often. Anecdotally, many people take time off because everyone else is doing it. A majority of Stanford med students take 5+ years to graduate, creating a social norm around taking an additional year.

Its important to pause and consider what exactly you want to achieve during this time. In my case, I wanted to develop new skills and obtain a degree that would serve my professional interests. Other commonly cited reasons include increasing competitiveness for residency or personal factors.

Of course, its possible to develop skills, build a competitive residency application, and more in the traditional four years of medical school. Most schools (including Stanford) also provide a substantial amount of elective time during the fourth year. We can use this time for the same type of personal development that many students prioritize during a year off. Its therefore helpful to articulate how you will be different at the end of your time off compared to when you started.

What is the best way to achieve your goals?

If youve decided that you have compelling reasons to take time off, the next question is how to achieve your goals. I think there are two critical decisions. The first is whether to do a degree program (e.g. MBA, MPH, etc.) or to work full-time (with work meaning research, an internship, or starting an organization, among other possibilities). A degree carries the advantage of formal teaching and would offer an additional credential. But at the same time, it requires you to spend a certain amount of time going to classes and doing homework and that time might be better spent elsewhere.

The second decision is whether you want to take just one year off or are willing to step away from med school for multiple years. This choice affects what options are available. For example, some degrees can be completed with one additional year of school while others require multiple (e.g. PhD, some Masters degrees). Similarly, some projects can be completed quickly while others have multi-year time horizons. All those considerations must be taken into account.

How will you stay connected to the medical school during your time away?

Finally, its important to reflect on the relationship you will have with medicine during your time off. In some cases, it is easy to stay engaged with the medical school many students doing clinical research work with the same physician mentors and continue to interact with patients on a regular basis. But students who leave the medical school environment (e.g. to do an MD/MBA, work in an external job, etc.) must think about how to stay connected, whether it is through ongoing research projects, a continuity clinic, or something else.

The ability to take time off and pursue other interests during medical school is a privilege. But before acting on it, students should give careful thought to how to make the most of the opportunity.

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

Akhilesh Pathipati is a fourth-year MD/MBA student at Stanford. He is interested in issues in health care delivery.

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Taking time off in medical school - Scope (blog)

Trauma course added to medical school curriculum – News from Tulane

Tulane University School of Medicine third-year students in surgery rotations practice bleeding-control techniques as part of a new trauma course. (Photo from Tulane School of Medicine)

When a gunman attacked members of Congress at a baseball practice in June, a lawmaker who served in Iraq was able to deliver critical aid to victims before emergency responders arrived. The veteran had learned bleeding-control techniques designed to save the lives of those critically wounded on the battlefield.

Now all third-year students at Tulane University School of Medicine will get similar training thanks to a new program launched by trauma surgeons. Students will be required to complete a "Stop the Bleed" course, designed by the American College of Surgeons Committee on Trauma, during their surgery rotation.

"We want to make sure anybody who graduates knows how to stop bleeding whether they have seen it in real life or not," said Dr. Rebecca Schroll, assistant professor of trauma and critical care, who is leading the program. "To our knowledge, we are the first medical school in the country to incorporate this course into the standard medical student curriculum."

The Stop the Bleed program was designed to teach police and first responders how to use tourniquets and other techniques to stop bleeding from gunshot wounds or other life-threatening injuries after an active-shooter or mass-casualty event. The idea to train first responders in trauma care was championed by legendary Tulane trauma surgeonDr. Norman McSwain.

Schroll hopes that students will pass the knowledge on to others after they graduate by becoming certified instructors.

"Our intention is that all Tulane graduates will be competent in bleeding-control techniques and can comprise a network of qualified instructors who can go out into communities to educate an exponentially expanding number of the lay public, who will be able to stop life-threatening bleeding and save lives.

Like this article? Keep reading: TUPD learns skills to save lives in active shooter events

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UIW Osteopathic Medical School Wins Mental Health Grant – Texas Public Radio

The Hogg Foundation for Mental Health is awarding San Antonios newest medical school a grant of more than $400,000. The University of the Incarnate Word School of Osteopathic Medicine will use the money to tackle mental health issues on the citys south side.

Physical illness isnt eliminated with simple clinical intervention. Thats the philosophy of UIWs new osteopathic medical school, which plans to send its students into the community to work with families in District 3, the south side where the campus is located.

Director of Public Health for the School, Anil Mangla, MS, Ph.D., MPH, FRSPH, said these future doctors will be addressing depression, stress and anxiety as well as blood sugar levels and amputation risk. "And if we can assist patients in getting their mental health in control, that indirectly may also help their chronic health," he added.

Osteopathic doctors embrace a holistic approach to health. Life expectancy in south San Antonio is years less than on the north side of the city.

Mangla says his school is on a mission to make an impact on this glaring disparity.

"Economically, theres a large amount of poverty," Mangla pointed out. "Its almost 70 to 75 percent Hispanic. And so thats the population that is at highest risk when we look at data on diabetes."

Construction crews manning Bobcats and backhoes continue work on the campus at Brooks. 162 students will come to the new campus for orientation later this month. Classes start August 1, 2017.

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UIW Osteopathic Medical School Wins Mental Health Grant - Texas Public Radio

Lifeguarding leads to medical school – Fairborn Daily Herald

FAIRBORN Justin Kelley is a fourth-year medical student at the Wright State Boonshoft School of Medicine.

When Justin Kelley was 16, he became a lifeguard at his hometown YMCA. He never dreamed that lifeguarding would lead him to medical school.

I wanted a job, and I thought being a lifeguard was cool, said Kelley, a fourth-year medical student at the Wright State University Boonshoft School of Medicine. Lifeguarding was rewarding, exciting and full of responsibility.

At 17, he became a lifeguarding instructor. I found something that filled my life with purpose and meaning, said Kelley, who is from Washington Court House, Ohio. My work as a lifeguard and instructing health and safety courses for the American Red Cross led me to medicine.

After graduating from high school, Kelley attended Wright State University, where he earned a bachelor of science in biological sciences in 2013. He enjoyed studying biology and participating in the University Honors Program, where he was a University Honors Scholar. During his undergraduate thesis project, he learned about the M.D./M.P.H. dual-degree program at Wright State.

When I explored the master of public health degree, it seemed like a perfect fit, Kelley said. In lifeguarding, the focus is on prevention. You strive to prevent drownings and injuries. I was already in public health. I knew I had to pursue the M.D./M.P.H. dual degree.

Through his undergraduate courses, he learned about the Boonshoft School of Medicine and took a few classes in White Hall.

The Boonshoft School of Medicine professors also taught some of my undergraduate courses, he said. I thought they were excellent teachers.

He applied to the Boonshoft School of Medicine.

I was happy and excited to be accepted to the Boonshoft School of Medicine, Kelley said. I feel I have benefited from connections and opportunities at the Boonshoft School of Medicine that I would not have had at other schools.

Scholarships have eased the burden of paying for his undergraduate and medical education. He is the first person in his family to pursue a medical degree. His mother and stepfather are small business owners.

Neither my family nor I have the resources to pay for medical school, let alone a dual-degree, Kelley said. I am grateful for the scholarships I have received throughout my years as an undergraduate student at Wright State and now as a medical student at the Boonshoft School of Medicine.

After his first two years of medical school, Kelley took a year to earn his M.P.H. degree through the Physician Leadership Development Program (PLDP), a dual-degree program in which medical students obtain a masters degree in public health or business while pursuing their medical degree over five years.

As part of his M.P.H. experience, Kelley worked closely with local and state public health professionals on reducing the diabetes burden in the Dayton area. He developed a continuing medical education activity for physicians to increase referral to the Centers for Disease Control and Prevention Diabetes Prevention Program.

My ultimate life goal is to work with the Centers for Disease Control and Prevention, Kelley said. I believe that my involvement with the PLDP and work in public health training taught me leadership skills and gave me extensive experience in planning programs and systems thinking that will serve me well as I pursue a medical career in health policy and management.

During his M.P.H. year, he promoted LGBTQA health as president of Boonshoft Pride. He partnered with university and community advisory boards, created a human sexuality curriculum for the second-year reproduction course and presented a poster on improving sexual health competency at the Ohio Public Health Combined Conference.

I have worked to integrate my clinical and public health knowledge to address health disparities and improve health statuses of all individuals, Kelley said.

Kelley has started his fourth year of medical school and will graduate in May 2018. He plans to apply for a residency in pathology.

Pathology combines my interests and preferences, including problem solving, analytical thinking and collaboration, he said.

However, public health will be a fundamental part of his profession.

As a physician, you are limited to the patients under your care, he said. As a public health professional, you impact the lives of the entire population and future generations.

Kelley believes public health is where he can do the most good.

I want to keep the population healthy and well, prevent illnesses and injuries, and enable healthy lifestyles, he said. The Physician Leadership Development Program, the Boonshoft School of Medicine and the scholarships have enabled my journey.

Justin Kelley

http://www.fairborndailyherald.com/wp-content/uploads/2017/07/web1_Kelley.jpgJustin Kelley

Story courtesy of Heather Maurer and Wright State University.

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Stopping the Spread – Touro College News

TouroCOM Middletown students volunteered at the Orange County Department of Health.

This week, students from the Middletown campus volunteered with epidemiologists at the Orange County Department of Health to reach out to residents who tested positive for COVID-19. (Another group of students are volunteering to answer the public health phone line in Orange County.) Students called residents after they had been informed by their primary care physician that they tested positive for the disease. Students answered any questions residents had along with reiterating basic guidelines for quarantining and self-isolating to contain the spread of the disease.

We made sure that people understood what they had to do once they tested positive, said OMS-I John Zakhary. We explained how long they had to be quarantined and isolated from the date of diagnosis and what their family members had to do as well. We also told them when they could come out of isolation after they had become asymptomatic.

We also told them that their quarantine was mandatory, and a court order would be in the mail, added OMS-III Steven Silverman.

After discussing the necessary precautions, students then gave the patients lengthy questionnaires about their occupation, travel history, and who they might have interacted with over the course of their illness. Students then collated lists of individuals who might have been exposed to the disease that they gave over to the Orange County medical staff. Several students likened the experience to becoming a medical detective.

Our clinical rotations have been halted so this was a nice way to give back, said OMS-III Bahadar Srichawla. Many individuals were anxious and scared, so in some cases we were able to provide reassurance. Seeing the public health aspect of medicine is quite beneficial. Hopefully we wont have another pandemic, but as future physicians its great to know the public health perspective.

OMS-11 Oksana Levchenko spoke with three residents who tested positive for the virus. One resident refused to discuss who he had been in touch with.

As students we stare in books all day so there are a lot of eye-opening moments when youre actually dealing with this firsthand and seeing it unfold, said Levchenko. My general feeling is that theres probably no better way to get experience and understand medicine than taking part in something like this. Times like these are why were in medical school and its moving to see the effects our profession can have on the future of a lot of people.

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Brody to push ahead with plans to expand medical school class sizes – WNCT

GREENVILLE, N.C. (WNCT) Following the passage of the new state budget, Brody School of Medicine officials are encouraged by the emphasis state lawmakers are putting on expanding medical education in the state.

Brody will continue to receive $8 million a year to help cover the cost of training and teaching future doctors. But, that money doesnt cover the cost needed to fulfill one of the biggest future goals of the school expanding class sizes.

There are not enough physicians today to take care of our population, and that will only get worse in the years ahead, said Interim Dean Dr. Nicholas Benson.

Benson said the school remains committed to moving towards growing class sizes. This year, they will add one or two additional spots, bringing the total size up to 82 students.

That increase, that very minimal increase, is not going to be able to really make a positive impact on the healthcare of people across the state, Benson said.

To make that bigger impact, Benson said classes must be expanded much further. The goal for Brody is to have classes expand from the current 80 students a year, to 120 students.

Benson said he was encouraged to see the General Assembly set aside $1 million for UNCs Medical School to expand their current facility.

In order to expand Brodys class sizes, Benson said they would need to hire additional instructors, and also construct a new building, which would cost millions of dollars and take years to complete.

Another obstacle to overcome is the lack of residency and fellowship spots in the East.

Were lagging behind because were younger, said Dr. Herb Garrison, the Associate Dean for Graduate Medical Education.

Whereas medical schools at Duke and UNC have between 750 and 1,000 residency and fellowship spots, Greenville only has around 400. Garrison said you cant bring on more students until you have a place for them to train following graduation.

He wants to expand the number of spots in the East for one simple reason.

Youre more likely to stay where you train, so thats why keeping them here is more likely, he said.

Improving access to care in the East is one of the big driving factors in wanting to expand in the first place. Garrison was excited that in the new budget, the General Assembly allotted money to expand residency programs in rural areas.

If you train in a rural areas for two years, you get to know the community and you become part of the community, youre more likely to stay in that community and thats what we really want to see, he said.

Rep. Greg Murphy (R-Pitt) said he requested and additional $2.5 million for Brody in the new budget to help cover planning cost for an expansion. However, that money was not put in to the finalized budget.

Benson said local fundraising efforts to start getting money in line for a new building have already begun. He hopes to continue receiving support from the state moving forward.

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Brody to push ahead with plans to expand medical school class sizes - WNCT

Want a medical degree in three years? It’s an option at UC Davis, Kaiser – Sacramento Bee


Sacramento Bee
Want a medical degree in three years? It's an option at UC Davis, Kaiser
Sacramento Bee
For most medical school students, summer means fun in the sun and a much-needed break from studies. But Aljanee Whitaker was hard at work in mid-June, having just started a year-round UC Davis program that fast-tracks primary care doctors to graduate ...

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Arcturus Therapeutics and Duke-NUS Medical School Partner to Develop a Coronavirus (COVID-19) Vaccine using STARR Technology – Yahoo Finance

Collaboration seeks to conduct pre-clinical testing followed by first-in-human clinical trials

SAN DIEGO and SINGAPORE, March 04, 2020 (GLOBE NEWSWIRE) -- Arcturus Therapeutics (the Company, NASDAQ: ARCT), a leading messenger RNA medicines company,and Duke-NUS Medical School (Duke-NUS), a research intensive, graduate entry medical school, today announced their partnership to develop a Coronavirus (COVID-19) vaccine for Singapore. The development of a COVID-19 vaccinewill be based on the Companys STARR technologyand will take advantage of a unique platform developed at Duke-NUS allowing rapid screening of vaccines for effectiveness and safety.

The STARR Technology platform combines self-replicating RNA with LUNAR, a leading nanoparticle non-viral delivery system, to produce proteins inside the human body. Due to superior immune response and sustained protein expression, Arcturus STARR Technology is expected to produce a vaccine response at much lower doses compared to traditional mRNA vaccines. This could lead to the ability to treat many more people with a single GMP-manufactured production batch, thereby greatly increasing efficiency and reducing time required to produce sufficient quantities of vaccine for large populations.

We have observed STARR technology in pre-clinical models to be effective at extraordinarily low doses -- greater than 30-fold more efficient than traditional mRNA. The Arcturus manufacturing process has been applied in multiple large GMP batches of highly pure RNA in our LUNAR-OTC program. If successful, Arcturus could develop a vaccine capable of vaccinating millions of people for a fraction of the cost of traditional mRNA vaccines, said Joseph Payne, President & CEO of Arcturus Therapeutics.

Duke-NUS has been on the front lines in the fight against COVID-19, developing the first serological tests for COVID-19 and was among the first groups to isolate and culture the virus. The partnership with Arcturus Therapeutics combines complementary strengths as we work together to fight this global outbreak, said Professor Thomas M. Coffman, Dean of Duke-NUS Medical School.

COVID-19 belongs to a family of coronaviruses that can cause serious respiratory disease. Arcturus plans to apply its STARR Technology toward the development of a vaccine to protect against COVID-19. The self-replicating RNA-based therapeutic vaccine triggers rapid and prolonged antigen expression within host cells resulting in protective immunity against infectious pathogens.

There is a tremendous urgency to develop an effective prevention for the current Coronavirus crisis. The Duke-NUS and Arcturus partnership could expedite a solution to this urgent need as we utilize STARR Technology to bring a vaccine candidate for clinical testing in the shortest time possible, said Professor Ooi Eng Eong, Deputy Director of the Emerging Infectious Diseases programme at Duke-NUS.

Arcturus Corporate Deck has been updated accordingly, and is available at ArcturusRx.com

For more information and potential collaboration opportunities regarding Arcturus Coronavirus vaccine, please contact Arcturus by email at Vax@ArcturusRx.com

About STARR TechnologyThe STARR technology platform combines self-replicating RNA with LUNAR, a leading nanoparticle delivery system, into a single solution to produce proteins inside the human body. The versatility of the STARR technology affords its ability upon delivery into the cell to generate a protective immune response or drive therapeutic protein expression to potentially prevent against or treat a variety of diseases. The self-replicating RNA-based therapeutic vaccine triggers rapid and prolonged antigen expression within host cells resulting in protective immunity against infectious pathogens. This combination of the LUNAR and STARR technologyTM is expected to provide lower dose requirements due to superior immune response, sustained protein expression compared to non-self-replicating RNA-based vaccines and potentially enable us to produce vaccines more quickly and simply.

About CoronavirusCoronaviruses are a family of viruses that can lead to respiratory illness, including Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Coronaviruses are transmitted between animals and people and can evolve into strains not previously identified in humans. On January 7, 2020, a novel coronavirus (2019-nCoV) was identified as the cause of pneumonia cases in Wuhan City, Hubei Province of China, and additional cases have been found in a growing number of countries.

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About Duke-NUS Medical SchoolDuke-NUS is Singapores flagship graduate entry medical school, established in 2005 with a strategic, government-led partnership between two world-class institutions: Duke University School of Medicine and the National University of Singapore (NUS). Through an innovative curriculum, students at Duke-NUS are nurtured to become multi-faceted Clinicians Plus poised to steer the healthcare and biomedical ecosystem in Singapore and beyond. A leader in ground-breaking research and translational innovation, Duke-NUS has gained international renown through its five signature research programmes and eight centres. The enduring impact of its discoveries is amplified by its successful Academic Medicine partnership with Singapore Health Services (SingHealth), Singapores largest healthcare group. This strategic alliance has spawned 15 Academic Clinical Programmes, which harness multi-disciplinary research and education to transform medicine and improve lives.For more information, please visit https://www.duke-nus.edu.sg/

AboutArcturus TherapeuticsFounded in 2013 and based in San Diego, California, Arcturus Therapeutics Holdings Inc. (ARCT) is an RNA medicines company with enabling technologies LUNAR lipid-mediated delivery, Unlocked Nucleomonomer Analog (UNA) chemistry, STARR technology and mRNA drug substance along with drug product manufacturing. Arcturus diverse pipeline of RNA therapeutics includes programs to potentially treat Ornithine Transcarbamylase (OTC) Deficiency, Cystic Fibrosis, Coronavirus (COVID-19), Glycogen Storage Disease Type 3, Hepatitis B, and non-alcoholic steatohepatitis (NASH). Arcturus versatile RNA therapeutics platforms can be applied toward multiple types of nucleic acid medicines including messenger RNA, small interfering RNA, replicon RNA, antisense RNA, microRNA, DNA, and gene editing therapeutics. Arcturus technologies are covered by its extensive patent portfolio (182 patents and patent applications, issued in the U.S., Europe, Japan, China and other countries). Arcturus commitment to the development of novel RNA therapeutics has led to collaborations with Janssen Pharmaceuticals, Inc., part of the Janssen Pharmaceutical Companies of Johnson & Johnson, Ultragenyx Pharmaceutical, Inc., Takeda Pharmaceutical Company Limited, CureVac AG, Synthetic Genomics Inc., Duke-NUS, and the Cystic Fibrosis Foundation. For more information visit http://www.Arcturusrx.com

Forward Looking StatementsThis press release contains forward-looking statements that involve substantial risks and uncertainties for purposes of the safe harbor provided by the Private Securities Litigation Reform Act of 1995. Any statements, other than statements of historical fact included in this press release, including those regarding strategy, future operations, collaborations, the likelihood of success of the Companys Coronavirus (COVID-19) vaccine or other products, the status of preclinical and clinical development programs and the planned initiation of clinical trials are forward-looking statements. Arcturus may not actually achieve the plans, carry out the intentions or meet the expectations or projections disclosed in any forward-looking statements such as the foregoing and you should not place undue reliance on such forward-looking statements. Such statements are based on managements current expectations and involve risks and uncertainties, including those discussed under the heading Risk Factors in Arcturus Annual Report on Form 10-K for the fiscal year ended December 31, 2018, filed with the SEC on March 18, 2019 and in subsequent filings with, or submissions to, the SEC. Except as otherwise required by law, Arcturus disclaims any intention or obligation to update or revise any forward-looking statements, which speak only as of the date they were made, whether as a result of new information, future events or circumstances or otherwise.

ContactArcturus TherapeuticsNeda Safarzadeh(858) 900-2682IR@ArcturusRx.com

LifeSci Advisors LLC Michael Wood (646) 597-6983 mwood@lifesciadvisors.com

Duke-NUS Medical School CommunicationsLekshmy Sreekumar, Ph.D. (+65) 6516-1138lekshmy_sreekumar@duke-nus.edu.sg

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Arcturus Therapeutics and Duke-NUS Medical School Partner to Develop a Coronavirus (COVID-19) Vaccine using STARR Technology - Yahoo Finance

School of Medicine physicians, researchers tackle coronavirus Washington University School of Medicine in St. Louis – Washington University School of…

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Clinical teams ready; research for vaccines, drugs underway

Postdoctoral researchers Brett Case, PhD, (left) and Adam Bailey, MD, PhD, wear full personal protective equipment to study the COVID-19 virus. Washington University School of Medicine in St. Louis physicians and researchers are preparing for COVID-19 cases and working on drugs and vaccines to fight the disease.

Soon after a novel coronavirus first appeared in China in late 2019, researchers, doctors and staff at Washington University School of Medicine in St. Louis began preparing for the possibility of an outbreak. Infectious disease physicians started planning how to respond if a person with suspected exposure to the virus arrived on campus, and researchers set to work finding drugs or vaccines to treat or prevent COVID-19, the name given to the illness caused by the virus.

New infectious diseases emerge every so often, and we have to be vigilant, said Steven J. Lawrence, MD, an associate professor of medicine. Over the last few decades weve had HIV, Ebola, SARS, Zika and now COVID-19. Such diseases usually arise when an animal virus manages to jump into people because of close contact between people and animals. The chance of preventing that happening anywhere in the world is probably zero. What we can do is be prepared to respond as rapidly as possible when it happens.

In December, China reported the first cases of a mysterious illness characterized by fever, a dry cough and difficulty breathing. Within weeks, Chinese scientists had identified the cause as a never-before-seen member of the coronavirus family. Coronaviruses typically cause mild infections such as the common cold. But in 2002, a newly emerged strain of coronavirus caused an outbreak of severe acute respiratory syndrome (SARS) that killed nearly 1,000 people before it was contained.

It quickly became evident that the 2019 coronavirus strain, named SARS-CoV-2, was more like SARS than the common cold. By late January, tens of thousands of people in China were infected. At the time, the only cases in the U.S. were believed to be in people who had been infected while traveling in China.

In January and February, we had a brief moment of opportunity to contain this outbreak in the U.S. by knowing where people had traveled, Lawrence said. Thats why the efforts to identify and isolate people with the virus were so robust, even though we had such few cases. Once the virus started spreading from person to person in the U.S., it became much, much more complicated.

Washington University infectious disease physicians (from left) Stephen Y. Liang, MD, Steven J. Lawrence, MD, Hilary M. Babcock, MD, and David K. Warren, MD, are preparing for the possibility of COVID-19 cases in St. Louis. Pictured is the team, in 2014, discussing emerging infectious diseases.

Hilary M. Babcock, MD, a professor of medicine and medical director of the Infection Prevention and Epidemiology Consortium for BJC HealthCare, and David K. Warren, MD, a professor of medicine and the medical director for infection prevention at Barnes-Jewish Hospital, did not wait for the virus to start spreading in the U.S. In January, they established a virtual incident command center at BJCHealthCare and called twice-weekly meetings to develop a coronavirus outbreak response plan for all BJC hospitals, including hospitals and clinics staffed by Washington University physicians. The team started by dusting off a plan developed in 2002 for SARS and adapting it to COVID-19 as more information emerged.

The data on mortality for COVID-19 remains a moving target and continues to be assessed. So far, people who are older and those with underlying health conditions, such as heart disease, lung disease or with compromised immune systems, have a higher risk of death. Early data suggests that the illness is more deadly than seasonal flu. Like SARS and the flu, COVID-19 spreads easily through droplets released when infected people cough or sneeze. The viruss contagiousness means that proper use of personal protective equipment is crucial to protect health professionals caring for coronavirus patients.

Communication is one of the most important tools at a time like this, Babcock said. We needed to make sure that our front-line clinicians can very quickly recognize that someone might be infected, and that they know what to do if a potentially infected person presents at their clinic. We also developed guidance regarding which personal protective equipment to wear when working with a patient suspected of having COVID-19 mask, gloves, eye shield, respiratory equipment, and gown how to put it on so it is most effective, and, most importantly, how to take it off without contaminating yourself.

Babcock and Warren also are keeping a close watch on outbreaks in other countries and implemented new travel screening recommendations across the university as the virus has spread to other countries, notably South Korea, Italy and Iran.

We are ready, Babcock said. Weve been ready for weeks. Its only a matter of time before we get our first case.

Building the toolkit to fight COVID-19

Across campus, a team led by Sean Whelan, PhD, the Marvin A. Brennecke Distinguished Professor and head of the Department of Molecular Microbiology, and Michael S. Diamond, MD, PhD, the Herbert S. Gasser Professor of Medicine, is looking for ways to treat COVID-19 or reduce its spread.

We had a discussion in early January and decided then to work on advancing therapeutics and vaccines for coronavirus, because it had the potential to be a significant problem, said Whelan, who took over as head of the molecular microbiology department on Jan. 1. It is our responsibility as part of the biomedical research community to do this. The consequences of this virus in places where there isnt a good health-care system could be dire.

Whelan called weekly meetings to coordinate the School of Medicine coronavirus research effort. He and Diamond have special expertise in emerging viral infections. Diamond led the School of Medicine response to Zika virus, during which he and others developed a mouse model of Zika infection and identified an antibody that is now used as part of a diagnostic test. While on the faculty at Harvard, Whelan studied Ebola and identified a critical protein that the virus exploits to cause deadly infections.

Whelan and Diamond built a research team including influenza experts Jacco Boon, PhD, an associate professor of medicine, and Ali Ellebedy, PhD, an assistant professor of pathology and immunology, who provided advice and scientific tools for studying respiratory viruses; structural immunologist Daved Fremont, PhD, a professor of pathology and immunology, who has begun studying the interactions of coronavirus proteins with antibodies and other human proteins to facilitate vaccine design and improved diagnostics; David T. Curiel, MD, PhD, the Distinguished Professor of Radiation Oncology,who began designing a potential vaccine; and Siyuan Ding, PhD, an assistant professor of molecular microbiology, who is investigating whether the virus also can be transmitted through the fecal-oral route.

The team is analyzing the structure of the viruss proteins to find possible targets for drugs or vaccines, looking for antibodies that might protect against disease, creating potential vaccines using multiple strategies, and developing a mouse model that can be used to test potential drugs and vaccines.

In addition, geneticist Ting Wang, PhD, the Sanford and Karen Loewentheil Distinguished Professor of Medicine, and members of his lab built a genome browser to help researchers study the genetics of the COVID-19 virus and compare different strains. Greg Bowman, PhD, an associate professor of biochemistry and molecular biophysics whose work focuses on how proteins take their shape, has mobilized his crowdsourced Folding@home Consortium to find the shape of coronavirus proteins to inform drug and vaccine development.

The speed of research on coronavirus has been extraordinary, Diamond said. Chinese scientists identified the virus, sequenced its genome, identified the probable animal source, and released the genomic sequence to the public in a matter of weeks. Groups around the world have been creating and sharing the tools we need to interrogate this virus. But even so, these things take time. Every day, the U.S. is seeing new cases. We are racing against the clock.

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, ranking among the top 10 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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Students note the challenges of medical school debt and look toward tuition options – The Daily Tar Heel

The costs of applying

Hernandez, who comes from a lower-middle class family, graduated from Duke University in 2016. Although he received a full-tuition scholarship for medical school, he said he still took out around $20,000 in loans to cover other living costs like housing, food and insurance.

Hernandez said he felt early on that he was part of a minority, both in terms of socioeconomic background and ethnicity. Most importantly, he said in many of his premed classes, he was surrounded by peers from legacy physician families.

And so what I think that does, is it sets up this disparity of people that know the plan to get into med school, like people that know you have to volunteer, you got to shadow, you gotta they know what boxes to check to get into med school, Hernandez said.

The Association of American Medical Colleges offers a Fee Assistance Program to help students address potential financial barriers in the application process. Hernandez said while fee assistance did lower the price of the MCAT and provide some study resources, he took out a $1,000 loan to pay for books.

He said as a student of lower socioeconomic status, these additional costs are constantly in the back of his mind.

It pervades every thought throughout med school of when you see that stethoscope and youre like, Damn, you know, thats a lot of money, those kinds of things, he said.

According to the Office of Financial Aid & Scholarships, the cost of attendance per year at UNC School of Medicine is $70,920 for in-state students and $98,314 for out-of-state students. The "cost of education", or COE, takes into account expenses for items like school supplies, transportation and room and board.

Like Hernandez, first-year UNC medical student Noelani Ho believes the financial burden of attending medical school begins in the application process. She co-authored an article on the issue, which was published in October in the New England Journal of Medicine. Ho said the cost of applying can be daunting, and acts as a barrier to increasing diversity in the profession.

Our argument there was like, it's great that we're starting this conversation about free tuition, we definitely think thats the direction we need to be going in and it's definitely helping the cause, Ho said. But we also need to address the fact that the pool of applicants that medical schools are picking to give this free tuition to, is in and of itself not as diverse as it needs to be, both in terms of race and socioeconomic status.

Addressing education debt

Admissions officers at 70 medical schools in the U.S. and Canada were surveyed in a separate Kaplan poll, in which only 4 percent of officers said they believed their institution would be able to offer free tuition in the next decade.

Jeff Koetje, Kaplan Test Preps director of pre-health programs, said moving toward tuition-free options involves a number of factors.

"What is within the realm of possibility for a school is going to depend on what is that mix of sources of funds that are currently available to the school to support its operations, and tuition is a pretty significant aspect of that, Koetje said. The elimination of tuition or the reduction in tuition coming into the school means that the school really needs to think about how is it going to make up that loss of that particular source of funds.

UNC School of Medicine currently offers a number of scholarships and financial aid to its students, although the majority of awards are loans. 78 percent of UNC medical school students received scholarships, according to 2017-2018 data from the Liaison Committee on Medical Education.

Beat Steiner, senior associate dean for medical student education, said UNC School of Medicine supports trying to find ways to reduce tuition burden for students.

I think it's important to note that were a state-sponsored school, right, so were a state medical school, Steiner said. And if it was the will of the citizens of North Carolina to go in the direction of tuition free, that would be just wonderful.

Steiner said two-thirds of UNCs cost of education is paid for by student tuition, while the remaining one-third is funded by state and donor support to the School of Medicine. He said one way the school tries to reach students of underrepresented backgrounds is by encouraging professional development in state high schools.

Obstacles for free tuition

Julie Byerley is the vice dean for academic affairs in the UNC School of Medicine. She said although she supports lowering students debt, she has also heard the argument that its unfair to single out education debt in medicine given the number of other valuable professions in the United States. But she also said one reason medical education may be more costly is because it happens in an apprenticeship sort of way, and is therefore expensive to carry out.

She also said increasing tuition-free options could lead to a potential devaluation of initiatives that incentivize students to go into needed areas of medicine, like the Kenan Primary Care Medical Scholars Program. The program offers financial support and opportunities to students pursuing careers in rural medicine and primary care.

Ariel Harris, a first-year in UNCs School of Medicine and first-generation college student, said when she was applying to UNC, the school placed a lot of emphasis on going into primary care.

Harris said she received a $20,000 scholarship for medical school, but like Hernandez, she had to take out loans to cover the other parts of the cost of education. Both Harris and Hernandez said despite the benefits of the fee assistance program, the costs of applying limited the schools they chose to apply to.

Ho said perhaps one way to level the playing field for prospective medical school students is for the Association of American Medical Colleges to place a cap on the number of schools students can apply to or for schools to encourage more virtual interviews to cut down on travel costs.

Harris said she hopes medical schools can be more transparent about costs, particularly at events like pre-health fairs for undergraduate students.

They talk about all the great things that come with their school, but then you see this really big price tag, and then people kind of shy away, Harris said.

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Students note the challenges of medical school debt and look toward tuition options - The Daily Tar Heel

When a colleague struggles with burnout, here’s how to reach out – American Medical Association

It isnt always easy to detect when a friend or colleague is suffering from burnout, and even if you do, it can be uncomfortable to speak up about it. But while it may be difficult conversation, speaking up can make all the difference for a struggling physician.

In the second of two AMA Moving Medicine podcast episodes featuring a panel discussion on burnout, the AMA's team of experts on physician burnout discuss what to do if you think a friend or colleague is dealing with burnout and how the health care system can cultivate physician resiliency. Kathleen Blake, MD, MPH, leads the panel with Marie Brown, MD, Jan Kief, MD, Ryan Ribeira, MD, MPH, and Hunter Pattison, MD.

Below is a lightly edited full transcript of the presentation. You can tune in on Apple Podcasts,Google PlayorSpotify.

Dr. Blake: I'm going to just, from a personal anecdote, share the fact that going into residency or into internship, my husband and I made a pact. And it might seem silly, but it worked. And the pact was that during that year that we knew would be incredibly stressful, we were not going to make a baby, we were not going to change religions, and we were not going to know the word divorce.

So, literally, what we did is we just said, "Park it." And like I say, it might seem silly. But I would tend to ruminate. And I could have ruminated myself probably into changing religions, possibly getting a divorce. Probably not making a baby. But it's something where you just say, Certain thingsthey can wait.

I'm going to go to Hunter next and ask our third question, which is, what do you do if you are starting to observe that a friend or colleague and you think they might be about to burnout? Or they're acting in a way that you think they've already reached that stage?

Dr. Pattison: No one is walking around with a low-battery logo above their head. People will experience burnout differently. And you may not always recognize that. A lot of times, the most common ways that people will say residents and medical professionals will burn out will be with patient care or being late to meetings or late to reply on things, big changes in personality and things like that.

If you're starting to see that and starting to recognize that, I think it's important to point it out to the person, because they may not realize what's going on. They may not realize that they are burning out or they're experiencing symptoms of burnout in their system. And the same goes with you as well. You may not realize that you're burning out, but you are being less efficient in your clinical duties and your other duties. Or you're not finding satisfaction in the things that you used to get a lot fulfillment out of. I think trying to be that helping hand and trying to connect people to wellness resources or encourage them to seek out those wellness resources is important.

But again, it puts the blame of burnout on the person in that, when you think about burnout, it's not the person, it's not the fact that they're weak or they aren't able to get through the system or through their training and become the doctor that they're supposed to be. It really is a systems issue. I think the best advice would be to try and realize what's causing that burnout. Whether it's shift scheduling, or whether it's administrative tasks. Or if its extremely burdensome with the EHRthings like that. And work with your community and your organization to try and fix that.

Because that's the only way you're going to prevent burnout is by trying to help fix the system that's causing it. I also would definitely put in a plug for state involved organized medicine too, because I think coming to meetings like this and staying involved in your communities and your hospital organizations, state organizations, things like that, that's how you can make a difference. And that's why I think everyone on the panel is still involved, because they feel like they can help make a difference in the system.

Dr. Blake: Jan, Marie, Ryan, anything you'd like to add to that?

Dr. Brown: I think depersonalization, saying something really negative about the patient. They're not Mrs. Jones in room two, they're that train wreck. We know, looking back, depersonalizing the patients and playing silly games where you've got points for certain hits that you got that night: that was depersonalization. We didn't know it at the time, but that was us dealing with burnout. If you see that, and somebody's really angry, there is a script and talking points on STEPS Forward. Because those are hard conversations because you're struggling toobut say something. ...

If you say, "I'm really struggling, I just feel whatever," reflect and then see what comes from that other person. But if you don't feel comfortable, bring it on to the program director or your medical student, the clerkship director, or whoever is a safe person for you. I know when I was in residency during internship, now the CEO of Rush was my chief resident. And one of my colleagues was burned out, my dearest friend, and I didn't know that she was burning out. So, he had the two of us come over for beers and pizza to just have a quiet time.

The people whoI'm afraid some of you are in this roomwho say yes to everything, and are the least likely to be considered burning out because you're always happy, you always say yes, you're the go-to person, you can go to the AMA, you can run this meeting, you can make everybody else better.

That person, we've seen across the country, without anybody knowing, that perfect medical student, that perfect resident, that perfect doctor, we found out with some horrific event when they just let it go. So, watch out for yourself, if you're the yes person, and you know somebody who's always the yes person. Say: "We might be adding to that person's burnout because they may be the last person that you think."

Dr. Blake: Thank you. Last question, and we'll start with Ryan to answer this one. How do we cultivate resiliency throughout our medical career? And are there any particularly useful toolswe've heard a bit about some of them alreadythat you've encountered to enhanceand I'm going to modify the question a little bitnot just your personal resiliency, but the resiliency of the people around you, so that this is a more systems approach?

Dr. Ribeira: Yeah. I'm glad that you said that, because my first response to this question was that I kind of object. Generally speaking, I object to utilizing the term resiliency in these conversations too much. I think it is a worthwhile concept, but always needs to be coupled with the fact that providing tools for resiliency is just to help you get through a system that really needs an overhaul until we can fix it. We talked about cultivating resiliency through your medical career. I think, honestly, currently the way that medical training is structured does a disservice for us, kind of, for the rest of our lives.

And this has really been punctuated for me having recently finished my residency. I talked to my friends who are in other fields and they say, "Oh, how are you doing?" And I say, "Oh, it's pretty good, I'm pretty busy. I usually travel for my business Monday, Tuesday. I do administrative meetings Wednesday, Thursday. I do shifts Friday, Saturday and Sunday. And they're like, "Oh, that sounds like a nightmare." And I'm like, "Oh well, I guess. It's way better than residency." And I really, in my mind, I'm always comparing my life to the 90 hours a week or so that you are doing residency, and this seems way better.

I think by taking people through their very formative years of life, and then for three to nine years making them work 80 to 90 hours a weekand never go to the dentist, and never work out, and eat like garbage, and all these thingshow do we expect them then, for the rest of their lives, to reverse all those horrible habits that we have forced upon them and live a normal and mentally healthy life? I think it is the system itself that is ingraining in us those bad habits.

Consequently, I think the solutions that are most appealing to me are solutions that facilitate the development of good habits during training. Some of the things I've seen that have been successful: At Stanford, in our residency program, in lieu of mandatory wellness lectures, once they kind of got the message around, they said, "Well, you know what we're going to do? We're going to give you residency conference credit for doing wellness activities. So instead of going to conference, you can go work out for an hour. And you'll get an hour of conference credit for that."

Or, "You can go to the dentist, or you can go get a massage, or you can go do whatever you want to do for your own personal wellness, and we'll give you conference credit for that as if you were there." That kind of solution I think is excellent. It helps foster those good life habits.

Also at Stanford, the surgery program just started scheduling people for days to meet with their primary care doctor and giving them the day off. They're like, "Hey, we gave you Thursday off. And we also scheduled an appointment with your primary care doctor. You don't have to go if you don't want to. But you know, just to help you out a little bit." Things like that, that help you develop those good habits and those life skills that are going to be important for the rest of your life, I think are some of the more useful interventions.

Dr. Blake: Great. Are there comments from the panel? Jan?

Dr. Kief: I've got a couple of comments. Those are very good, Ryan. You do have to have a very supportive institution. And this issue of burnout, it's lifelong. There are diverse factors. But there are certain things you can do yourself. Then, certain things, like organized medicine, where you can hopefully change the system, or with teams, you can suggest that things at your institution be changed.

One of my dear friends is an astronaut at the International Space Station, Kjell Lindgren. Hes also a physician. The astronauts adhere to this program of self-care, then team care, and then the mission. Self-care: you can't show up being a mess. Tell yourself: Three aspects of gratitude a day. Religiously practice that. My students think that is a huge thing. Always: Three things that you are so grateful for every day. Science has proven that's more effective than SSRIs. Take care of yourself in nutrition, your health. Have a personal physician. All of that stuff, you just have to do. So, self-care, that's No. 1.

Then team care. We really need the efficient, empoweredyou have to be able to innovate, that makes you happyphysician-led teams. And that's going to take a lot of the administrative burden off. It's going to make you have fun at your work every day and give you a sense of purpose so that, you look at the three pillars of burnout, it's going to help alleviate those. So self-care, team care, and then the mission will be able to happen. ... There are toolkits out there with all sorts of things you can do in your institution and in your personal life.

Dr. Blake: Other comments?

Dr. Brown: Many of you may be going back, and hopefully your organization is looking to you for some ideas. I had the opportunity to spend a couple of days at Penn State last year and the medical student group had some very good ideas that I'll share with you that'll be posted up on Steps Forward in the not-too-distant future. One was they had the therapy dogs that are there for patients, and they just had them in the student lounge, and it was so popular.

And then, you're also experiencing what the patient might experience or when the patient says, "No, I don't want to do this." She said, "Well, I did it. It really feels good." And the other thing they did as a group, they made teddy bears or sewed some things for the pediatric ward, and they phrased it more as surgical suture technique and sewing. So, there are things you can do on site that are pretty creative.

Dr. Pattison: I'll just make it quick. I know we do talk a lot about like the systemic burnout, but at the end of the day, if you are feeling burned out or if you know someone who is feeling burned out, a lot of it comes down to that person trying to do stuff for their own wellness. Are you taking control and trying to do stuff to make you feel less burned out and give you that life satisfaction, or those things in your life that can bring you that fulfillment?

I remember starting out residency and people were like, "Oh, don't forget to cook food and go to the gym every day or go to gym every week and still enjoy the things that you want to do and take time to do that." And one month in, I was like, "How do people have time to do this?" All I wanted to do was sleep when I got home. And I'm sure that a lot of you feel that same way in medical school too, but it really takes a conscious effort to still maintain those aspects of your outside life that allow you to be the person that you are.

So, I think making that conscious effort to, if you like running, still try and run three times a week. Maybe not every day, or if you like gardening, or if you like reading, or if you like watching Netflix or anything, just taking that time to yourself and taking that little bit of control that back into your own hands, I think will help.

You can listen to this episode on Apple Podcasts,Google PlayorSpotify.

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When a colleague struggles with burnout, here's how to reach out - American Medical Association