Revving the Engine – Harvard Medical School

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The hearts ability to beat normally over a lifetime is predicated on the synchronized work of proteins embedded in the cells of the heart muscle.

Like a fleet of molecular motors that get turned on and off, these proteins cause the heart cells to contract, then force them to relax, beat after life-sustaining beat.

Now a study led by researchers at Harvard Medical School, Brigham and Womens Hospital and the University of Oxford shows that when too many of the hearts molecular motor units get switched on and too few remain off, the heart muscle begins to contract excessively and fails to relax normally, leading to its gradual overexertion, thickening and failure.

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Results of the work, published Jan. 27 inCirculation,reveal that this balancing act is an evolutionary mechanism conserved across species to regulate heart muscle contraction by controlling the activity of a protein called myosin, the main contractile protein of the heart muscle.

The findingsbased on experiments with human, mouse and squirrel heart cellsalso demonstrate that when this mechanism goes awry it sets off a molecular cascade that leads to cardiac muscle over-exertion and culminates in the development of hypertrophic cardiomyopathy (HCM), the mostcommon genetic diseaseof the heartand aleading causeof sudden cardiac death in young people and athletes.

Our findings offer a unifying explanation for the heart muscle pathology seen in hypertrophic cardiomyopathy that leads to heart muscle dysfunction and, eventually, causes the most common clinical manifestations of the condition, said senior authorChristine Seidman, professor of genetics in the Blavatnik Institute at Harvard Medical School, a cardiologist at Brigham and Womens Hospital and a Howard Hughes Medical InstituteInvestigator.

Importantly, the experiments showed that treatment with an experimental small-molecule drug restored the balance of myosin arrangements and normalized the contraction and relaxation of both human and mouse cardiac cells that carried the two most common gene mutations responsible for nearly half of all HCM cases worldwide.

If confirmed in further experiments, the results can inform the design of therapies that halt disease progression and prevent complications.

Correcting the underlying molecular defect and normalizing the function of heart muscle cells could transform treatment options, which are currently limited to alleviating symptoms and preventing worst-case scenarios such as life-threatening rhythm disturbances and heart failure, said study first authorChristopher Toepfer,who performed the work as a postdoctoral researcher in Seidmans lab and is now a joint fellow in the Radcliffe Department of Medicine at the University of Oxford.

Some of the current therapies used for HCM include medications to relieve symptoms, surgery to shave the enlarged heart muscle or the implantation of cardioverter defibrillators that shock the heart back into rhythm if its electrical activity ceases or goes haywire. None of these therapies address the underlying cause of the disease.

Imbalance in the motor fleet

Myosin initiates contraction by cross-linking with other proteins to propel the cell into motion. In the current study, the researchers traced the epicenter of mischief down to an imbalance in the ratio of myosin molecule arrangements inside heart cells. Cells containing HCM mutations had too many molecules ready to spring into action and too few myosin molecules idling standby, resulting in stronger contractions and poor relaxation of the cells.

An earlier study by the same team found that under normal conditions, the ratio between on and off myosin molecules in mouse heart cells is around 2-to-3. However, the new study shows that this ratio is off balance in heart cells that harbor HCM mutations, with disproportionately more molecules in active versus inactive states.

In an initial set of experiments, the investigators analyzed heart cells obtained from a breed of hibernating squirrel as a model to reflect extremes in physiologic demands during normal activity and hibernation. Cells obtained from squirrels in hibernationwhen their heart rate slows down to about six beats per minutecontained 10 percent more off myosin molecules than the heart cells of active squirrels, whose heart rate averages 340 beats per minute.

We believe this is one example of natures elegant way of conserving cardiac muscle energy in mammals during dormancy and periods of deficient resources, Toepfer said.

Next, researchers looked at cardiac muscle cells from mice harboring the two most common gene defects seen in HCM. As expected, these cells had altered ratios of on and off myosin reserves.The researchers also analyzed myosin ratios in two types of human heart cells: Stem cell-derived human heart cells engineered in the lab to carry HCM mutations and cells obtained from the excised cardiac muscle tissue of patients with HCM. Both had out-of-balance ratios in their active and inactive myosin molecules.

Further experiments showed that this imbalance perturbed the cells normal contraction and relaxation cycle. Cells harboring HCM mutations contained too many on myosin molecules and contracted more forcefully but relaxed poorly. In the process, the study showed, these cells gobbled up excessive amounts of ATP, the cellular fuel that sustains the work of each cell in our body. And because oxygen is necessary for ATP production, the mutated cells also devoured more oxygen than normal cells, the study showed. To sustain their energy demands, these cells turned to breaking down sugar molecules and fatty acids, which is a sign of altered metabolism, the researchers said.

Taken together, our findings map out the molecular mechanisms that give rise to the cardinal features of the disease, Seidman said. They can help explain how chronically overexerted heart cells with high energy consumption in a state of metabolic stress can, over time,lead to a thickened heart muscle that contracts and relaxes abnormally and eventually becomes prone to arrhythmias, dysfunction and failure.

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Revving the Engine - Harvard Medical School

Why isn’t there a vaccine for staph? – Washington University School of Medicine in St. Louis

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New approach points to untapped immune cells, early immunization

A study from Washington University School of Medicine in St. Louis may help explain why previous attempts to develop a staph vaccine have failed, while also suggesting a new approach to vaccine design that focuses on activating an untapped set of immune cells, as well as inoculating against staph (pictured) in utero or within the first few days after birth.

Staph bacteria, the leading cause of potentially dangerous skin infections, are most feared for the drug-resistant strains that have become a serious threat to public health. Attempts to develop a vaccine against methicillin-resistant Staphylococcus aureus (MRSA) have failed to outsmart the superbugs ubiquity and adaptability to antibiotics.

Now, a study from Washington University School of Medicine in St. Louis may help explain why previous attempts to develop a staph vaccine have failed, while also suggesting a new approach to vaccine design. This approach focuses on activating an untapped set of immune cells, as well as immunizing against staph in utero or within the first few days after birth.

The research, in mice, found that T cells one of the bodys major types of highly specific immune cells play a critical role in protecting against staph bacteria. Most vaccines rely solely on stimulating the other main type of immune cells, the B cells, which produce antibodies to attack disease-causing microorganisms such as bacteria.

The findings are published online Dec. 24 in The Journal of Clinical Investigation.

Across the globe, staph infections have become a pervasive health threat because of increasing antibiotic resistance, said senior author Juliane Bubeck Wardenburg, MD, PhD, director of the universitys Division of Pediatric Critical Care. Despite the medical communitys best efforts, the superbug has shown a consistent ability to elude treatment. Our findings indicate that a robust T cell response is absolutely essential for protection against staph infections.

Highly contagious, staph survives and thrives on human skin and can be spread through skin-to-skin contact or exposure via contaminated surfaces. Generally, the bacteria live harmlessly and invisibly in about one-third of the population. From their residence on the skin, the bacteria can cause red, pus-filled sores. Ever persistent, the superbug will deliver recurrent infections in about half of its victims.

Staph strains can enter the bloodstream, bones or organs and lead to pneumonia, severe organ damage and other serious complications in hundreds of thousands of people each year. More than 10,000 people die in the U.S. from drug-resistant staph infections annually.

The focus in the vaccine field for Staphylococcus aureus during the past 20 years has been on generating antibody responses, not on specific T cell responses, Bubeck Wardenburg said. This new approach shows promise.

For nearly 15 years, Bubeck Wardenburg has studied a single toxin called alpha-toxin made by staph. This toxin plays a role in tissue damage in multiple forms of infection. An important thing about the alpha-toxin is that it is found in all staph strains, meaning those that are and are not antibiotic-resistant, she said. Understanding this allowed us to devise studies in mice that examined the effect of alpha-toxin on the immune response in minor skin infections as well as in more serious infections that spread in the bloodstream.

The researchers found that the immune cells did not protect mice that had minor staph infections on their skin. However, mice that were exposed to life-threatening staph infections in the bloodstream did develop protection. We discovered a robust T cell response targeting staph in the bloodstream, Bubeck Wardenburg said. By contrast, T cells were diminished in skin infections as a result of the toxin. Because skin infection is very common, we think that staph uses alpha-toxin to prevent the body from activating a T cell response that affords protection against the bacteria.

In terms of the big picture, Bubeck Wardenburg said blocking the toxin in skin infections may yield a healthy T cell response.

Further, protecting the T cell response from the time of birth may reprogram the bacterias overall effect on the immune system. This bug is deliberate and acts in a sinister way early on, she said. The bug appears to be using the toxin to shape the T cell response in a way thats favorable for the bug but not for humans.

Previous vaccine development efforts have focused on adults. However, Bubeck Wardenburg said, a vaccine may be more likely to succeed if administered before infants first encounter staph. Therefore, immunization should happen before initial exposure to staph, to block the toxin and generate a vigorous T cell response.

We envision two strategies, Bubeck Wardenburg said. One is immunizing pregnant women so they can transfer antibodies that protect infants against the toxin at birth. The second involves immunizing infants within a day or two after birth. Neither of these strategies has been considered for staph vaccines to date.

Lee B, Olaniyi R, Kwiecinski J, Bubeck Wardenburg J. Staphylococcus aureus a-toxin suppresses antigen-specific T cell response. The Journal of Clinical Investigation. Online Dec. 24, 2019.

The study was supported by the National Institutes of Health (NIH), grants AI097434 and T32 HD007009; the Burroughs Wellcome Foundation Investigators in the Pathogenesis of Infectious Disease Fellowship; and the University of Chicago Growth, Development, and Disabilities Training Program.

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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Why isn't there a vaccine for staph? - Washington University School of Medicine in St. Louis

Providing resources and education for underrepresented groups in medicine – AL DIA News

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Natalia Ortiz-Torrents childhood in Hato Rey, Puerto Rico, was filled with closeness, familiarity and generosity.

Her father was the owner of a department store in their hometown of Cayey.

I practically grew up in that business, said Ortiz-Torrent, noting that oftentimes in addition to raising her and her younger sister at home, her mother would also work in the store.

Being around the business proved to be very valuable for the young Ortiz-Torrent.

I learned the value of money, the value of responsibility... and the value of helping others, she said.

Those values, coupled with a love for science, would soon become the avenue to her current career path in the medical profession.

Originally, Ortiz-Torrent studied chemistry at the University of Puerto Rico in Ponce as a safer route than medical school, with the goal of becoming a licensed chemist.

However, she later learned that she was accepted into the Ponce School of Medicine, one of three medical schools in Puerto Rico that were LCME accredited, shortly before passing the board exams and earning her license to become a licensed chemist.

I didnt get a chance to practice because I started studying medicine, she said.

Upon graduating from the Ponce School of Medicine, Ortiz-Torrent moved to the U.S. mainland and began training at the Temple University Psychiatry Department for four years, later transitioning into her current area of expertise in consultation and liaison psychiatry in 2005.

Ortiz-Torrent said she decided to enter into the psychiatric field during rotations as a third-year medical student.

When I sat down and started talking to patients, listening to their stories, helping them and learning about the root of their problems, and how the behaviors or emotions were affecting their medical illnesses, and how the medical conditions affected their behaviorsI said, Ok, this is perfect. This is what I want to do, Ortiz-Torrent recalled.

Her area of consultation and liaison psychiatry, in which she serves as the medical director of the program at Temple University Hospital, analyzes the interface between how the brain, mind, spirit, culture and psychology interact amongst each other.

In addition to her role at Temple University Hospital, Ortiz-Torrent is very active in volunteering and philanthropic endeavors. This is most highlighted in her role as president of SILAMP (the Society of Ibero-Latin American Medical Professionals).

SILAMP is an association of Latino medical professionals and health providers in the tri-state area who are interested in sharing their ideas, resources and successes with their communities.

We want to advance and promote education, and open the opportunities to education in healthcare careers to the Latin American population living in the United States or wanting to practice in the United States, said Ortiz-Torrent.

In both roles, Ortiz-Torrent says the most gratifying part is the ability to make a difference. She really enjoys working with her patients and building trust in her patients.

In psychiatry, trust is not easy to gain all the time, but theres ways in which that can be accomplished, she said about her role at Temple Hospital, adding that mentoring students and helping the community with SILAMP as other gratifying ordeals.

Overall, Ortiz-Torrent wants to be a leader who helps build the bridge for students of color who want to enter into the medical profession and help provide access to valuable resources that can help that aspiration become a reality.

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Providing resources and education for underrepresented groups in medicine - AL DIA News

Warren is right. Presidents have the power to address drug pricing without congressional help. – PolitiFact

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On the presidential primary campaign trail in Iowa, Sen. Elizabeth Warren (D-Mass.) brought out a favorite talking point: ways the president can bring down drug prices without waiting for Congress.

Its not the first time Warren and other candidates have referenced this alleged power. In this case, she pointed to insulin, EpiPens and HIV/AIDS drugs as possible targets.

We asked the Warren campaign for the basis of her claim and they directed us to her "Medicare for All" transition plan. It identifies two legal mechanisms "compulsory licensing" as outlined in 28 U.S. Code Section 1498 and the so-called march-in rights provision of the 1980 Bayh-Dole Act.

We spoke to legal and pharmaceutical policy experts about whether those mechanisms could be used to bring down drug prices, as Warren described. The answer? Yes. But its complicated and controversial.

The legal mechanisms

Of the two legal levers, Section 1498 is perhaps more straightforward.

The law says the government can intervene to take over patents without a companys permission, if the price is too high. The government can then create competition to bring down prices by importing those products from abroad, or manufacturing them. The original manufacturer can sue for damages but cannot stop Washington from breaking the patent.

"What they would do is announce they are taking other bids from other companies to supply the product" to government programs such as Medicare, said Aaron Kesselheim, a professor of medicine at Harvard Medical School who researches drug pricing laws and has written extensively about Section 1498.

The provision has been used before in the 1960s to procure cheap generic drugs and was invoked as recently as 2001, as a threat to get a better price on Ciprofloxacin, a high-powered antibiotic used to treat anthrax. It also was used in 2014 in non-pharmaceutical contexts, such as by the Defense Department to acquire lead-free bullets.

Invoking this part of the U.S. code wouldnt necessarily apply to all drugs, said Jacob Sherkow, a professor at New York Law School. But products such as the ones Warren mentioned insulin and EpiPens, for instance, which are patented in the United States and abroad, and cost far less in other countries would qualify. And that could send a message to other drug manufacturers.

"If youre a particularly aggressive president, you can find some low-hanging fruit, and use 1498 to show other pharmaceutical companies youre damn serious," Sherkow said.

There are other caveats. Sherkow noted that licensing a competing drug is only part of the equation; competition often brings down drug prices, but not always. In addition, not all drugs have equivalent patents here and abroad, which complicates importation. But many of the technical obstacles are surmountable, argued Amy Kapczynski, a professor at Yale Law School.

The march-in rights authority a little trickier. Bayh-Dole, the law that created march-in rights, suggests the government can "march in" when a drug isnt available amid concerns over public health, such as an epidemic. It applies only to pharmaceuticals for which the government holds all the patents because it funded the research that led to their development. An example could be Truvada for PrEP, the HIV prevention pill, Kesselheim said.

Unlike Section 1498, march-in rights have never been used to negotiate a lower price despite multiple petitions to the National Institutes of Health, the federal agency that would approve and oversee the process.

The question is whether high prices can constitute both a barrier and a public health concern having rendered a drug unavailable. Sherkow, for one, expressed skepticism.

NIH has historically opted against making this determination. For one, its directors have typically argued that cost isnt within their area of expertise. And, for another, they have suggested that "marching in" would discourage pharmaceutical companies from using government-funded research ultimately leading to fewer breakthrough drugs being developed.

"That is a matter of culture, and I think a president could alter that perspective," Kesselheim said.

Doing so, though, would require political capital. Even though Congress isnt required to vote on the matter, the president would have to, for instance, appoint officials willing to change the NIH perspective and those leaders do require Senate confirmation. "Youd probably have to defend it in court," Kesselheim added.

Finally, these mechanisms would also draw sharp pushback from the pharmaceutical industry. Given the fervor over the drug pricing debate, neither Section 1498 nor march-in rights should be used ubiquitously, Kesselheim said.

"It is a complicated enough and politically charged enough procedure, that its something that should be reserved as a safety net for real public health emergencies," he said. "I think Sen. Warren is identifying some of those cases."

Theyre all talking about it

Warrens proposals are part of a larger pattern Democratic presidential candidates including Vermont Sen. Bernie Sanders and former South Bend, Indiana, Mayor Pete Buttigieg have talked about ways to bring down drug prices without congressional action.

Minnesota Sen. Amy Klobuchar also referenced such action during the January presidential primary debate.

"I have a plan of 137 things I found that a president can do herself in the first 100 days without Congress that are legal. And one of those things is that you can start bringing in less expensive drugs from other parties," she said.

According to Klobuchars campaign, she was referring to a list she published on Medium in June 2019 in which she wrote that she would use "existing Food and Drug Administration authority to grant a waiver that allows people to import safe prescription drugs for personal use from countries like Canada to decrease drug costs for seniors and all Americans."

Sherkow said this is indeed another example. Section 804 of the Federal Food, Drug, and Cosmetic Act authorizes the HHS secretary to order the importation of specific drugs if it would impose no additional risk to the publics health and safety and would result in a significant cost reduction. But this example also highlights the complexities involved and why it is not necessarily fast or easy.

He pointed out that the president would have to nominate a candidate for secretary, get that person confirmed, then have the secretary make this order in respect to specific drugs, certify that the drugs are safe and would result in cost reduction then have the importation take place.

"Kudos to anyone for trying that in the first 100 days," Sherkow said.

Our ruling

Warren said, ""The president of the United States already has the legal authority to reduce the price of many commonly used prescription drugs." Multiple presidential candidates have talked about ways to bring down drug prices without new legislation.

We focused on Warrens argument: that the president already has this legal authority for many drugs, and that the power stems from Section 1498 and the march-in rights provision of a 1980 law. On these points, she is on firm ground.y

Legal experts agreed that laws on the books do, in some cases, give the president that executive power and the cases Warren outlined are viable candidates, especially for "compulsory licensing." The same experts also pointed out that even with this authority, the politics and logistics could be tricky, and that using these mechanisms wouldnt address the entire drug pricing issue.

We rate this statement True.

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Warren is right. Presidents have the power to address drug pricing without congressional help. - PolitiFact

University of Arizona Colleges of Medicine Will Offer Free Tuition… – Diverse: Issues in Higher Education

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November 25, 2019 | :

The University of Arizona Colleges of Medicine in Phoenix and Tucson are trying to tackle two problems with one scholarship program: medical student loan debt and a lack of primary care physicians in the state.

The medical schools will offer free tuition to students who work in underserved areas in the state, starting in spring 2020.

Eligible students need to be Arizona residents and commit to working in communities with primary care doctor shortages for two years after their residencies, started within six years of graduation and completed within 10 years of graduation.

Currently, Arizona meets only 40% of demand for primary care physicians, according to the Health Resources and Services Administration.

Students who graduate from the University of Arizona want to tackle important issues and meet big challenges in society, said University of Arizona President Dr. Robert C. Robbins. The physician shortage is a major issue facing the state and nation, and I am excited that the University of Arizona will provide scholarships for qualified medical students and get more primary care physicians into underserved areas across the state.

The Arizona Legislature appropriated $8 million in annual funding in May, which could provide scholarships for 100 students at the two medical schools. The rest of the funding will go toward growing the class size at University of Arizonas medical school in Phoenix.

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University of Arizona Colleges of Medicine Will Offer Free Tuition... - Diverse: Issues in Higher Education

Women Make Up the Majority of US Med Students for First Time – Medscape

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This year, for the first time, more women than men are enrolled as US medical students, according to the Association of American Medical Colleges (AAMC).

This progress builds on a milestone reached in 2017, when, for the first time, women comprised the majority of first-year medical students, as reported previously by Medscape Medical News.

Recent years have seen an increase in the number of female medical students from 46.9% in 2015 to 49.5% in 2018. In 2019, women comprise 50.5% of all medical school students, according to the AAMC.

"The steady gains in the medical school enrollment of women are a very positive trend, and we are delighted to see this progress," David Skorton, MD, AAMC president and chief executive officer, said in a news release.

According to the AAMC, the number of applicants to US medical schools rose by 1.1% from 2018 to 2019, to a record 53,371, and the number of matriculants (new enrollees) grew by 1.1%, to 21,869. Across applicants and matriculants, the number of women increased while the number of men declined.

As in previous years, medical school enrollees in 2019 have strong academic credentials, with an average undergraduate grade point average of 3.78. They range in age from 15 to 53, and 131 are military veterans. This year's entering class also has a strong commitment to service, cumulatively performing more than 14 million community service hours.

US medical schools continue to make "modest" gains in attracting and enrolling more racially and ethnically diverse classes, the AAMC said, although these groups remain "underrepresented" in the overall physician workforce.

Applicants who identify as Hispanic, Latino, or of Spanish origin increased 5.1% to 5858 and matriculants from this group grew 6.3% to 2466.

The number of black or African American applicants rose 0.6% to 5193 and matriculants increased by 3.2% to 1916. Among black or African American men, applicants and matriculants increased 0.5% and the total enrollment of black or African American men rose 3.7% to 3189.

American Indian or Alaska Native applicants grew by 4.8% to 586 and matriculants rose 5.5% to 230.

Skorton said that the "modest increases in enrollment among underrepresented groups are simply not enough. We cannot accept this as the status quo and must do more to educate and train a more diverse physician workforce to care for a more diverse America."

Continued growth in the number of applicants to US medical schools shows that interest in a career in medicine remains high, the AAMC said, which is "crucial," given the projected shortage of up to 122,000 physicians by 2030.

To address the projected shortage, medical schools have expanded class sizes, 20 new schools have opened in the past decade, and the total number of enrolled medical students has grown by 33% since 2002, the organization said.

However, increasing the number of federally funded residency training positions will be required to boost the overall supply of physicians in the United States. The AAMC supports legislation that would add 15,000 residency slots over 5 years to ensure that all patients have access to the care they need, as reported by Medscape Medical News.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

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Women Make Up the Majority of US Med Students for First Time - Medscape

In new milestone, the majority of U.S. medical students are now women – FierceHealthcare

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Female medical students have hit a milestone.

They now comprise the majority of enrolled U.S. medical studentsfor the first time, according to the Association of American Medical Colleges (AAMC).

The 2019 data (PDF) released Tuesday build on the milestone reached in 2017 when women comprised the majority of first-year medical students, the AAMC said.

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Now, in 2019, women comprise 50.5% of all medical school students, the data showed. That number has been increasing in recent years from 46.9% in 2015 to 49.5% in 2018.

The data also showed modestgains by U.S. medical schools in attracting and enrolling more racially and ethnically diverse students, the AAMC said, although these groups are still underrepresented in the physician workforce.

The steady gains in the medical school enrollment of women are a very positive trend, and we are delighted to see this progress, said David Skorton, M.D., AAMC president and CEO, in an announcement.

However, the modest increases in enrollment among underrepresented groups are simply not enough. We cannot accept this as the status quo and must do more to educate and train a more diverse physician workforce to care for a more diverse America, he said.

While the statistics are encouraging for women,study after study shows female physicians still earn lesssometimes a lot lessthan their male counterparts. That salary gap extends to racial pay disparity in medicine.Studiesshow that a racial imbalance in wages has been a pervasive issue that exists among physicians in the same medical specialty.

RELATED: Salary negotiationsAdvice for female physicians who want equitable pay

This year also saw a record number of applicants to medical schools, which was up by 1.1% from 2018 to 2019. Some 53,371 people applied to medical school, and the number of new enrollees grew by 1.1% to 21,869. Across applicants and matriculants, the number of women increased while the number of men declined, the AAMC said.

Medical schools saw small increases in minority students. The AAMC released the following statistics:

The growth in the number of medical school applicants shows interest in a career in medicine remains high, important as the nation faces a shortage of physicians that the AAMC projects could reach 122,000 doctors by 2030.

To help address the shortage, medical schools have expanded class sizes, 20 new schools have opened in the past decade and the total number of enrolled medical students has grown by 33% since 2002, the AAMC said.

RELATED:3 ways doctors say can help break the 'fiberglass ceiling' and close the startling gender pay gap

The organization once again called for Congress to increase the number of federally funded residency training positions to produce more doctors to meet the needs of a growing and aging population. The AAMCsupports bipartisan legislationthat would add 15,000 residency slots over five years toensure all patients have access to the care they need.

Enrollment in medical schools remained competitive. Medical school students in 2019 had an average undergraduate grade point average of 3.78. Enrollees range in age from 15 to 53, and 131 are military veterans. Additionally, this years entering class demonstrates a strong commitment to service, cumulatively performing more than 14 million community service hours.

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In new milestone, the majority of U.S. medical students are now women - FierceHealthcare

Dell Medical School Dean Clay Johnston Elected to National Academy of Medicine – UT News | The University of Texas at Austin

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AUSTIN, Texas Dean Clay Johnston, M.D., Ph.D., of Dell Medical School at The University of Texas at Austin has been elected to the prestigious National Academy of Medicine (NAM) one of the highest honors in the fields of health and medicine. The academy recognizes leaders noted for extraordinary professional achievement and commitment to serving others.

The NAM announced Johnstons election along with 99 other new members at its annual meeting today in Washington, D.C.

When Clay started at UT, we had just begun construction on our new medical school. Over the last five years, he has transformed Dell Med and UT Health Austin into one of the most dynamic and innovative centers for health and health care in the nation, said Gregory L. Fenves, president of The University of Texas at Austin. He has shown remarkable leadership, innovation and creativity throughout his career in medicine, and his election to the National Academy is very well deserved.

Johnston joined Dell Med as its inaugural dean in 2014. Since then, his vision for

building the medical school and academic health system of the future has taken shape through innovative models of care, collaboration within a complex health ecosystem of partners and initiatives focused on high-value health care and community impact.

Clays election reflects his important contributions to understanding strokes, his leadership as founding dean of Dell Med and his contributions to patient care. All of these have been accomplished with the energy, enthusiasm and creativity for which he is so admired, said Kenneth Shine, M.D., a Dell Med professor of internal medicine and former president of the Institute of Medicine, now the National Academy of Medicine.

A neurologist specializing in stroke care and research, Johnston was associate vice chancellor for research at the University of California, San Francisco before coming to Austin. He also directed UCSFs Clinical and Translational Science Institute and founded its Center for Healthcare Value, where he led efforts to improve the quality of care while also lowering costs.

Johnston graduated from Amherst College and Harvard Medical School. He performed his residency and training in vascular neurology at UCSF, where he eventually directed the stroke service and was a professor of neurology and epidemiology.

In 2016, Johnston was named Austinite of the Year by the Greater Austin Chamber of Commerce for leading health transformation in Austin and beyond.

Other Dell Med faculty members who are members of the National Academy of Medicine are Karen DeSalvo, M.D., MPH; George Macones, M.D., MSCE; Mark McClellan, M.D., Ph.D.; Charles Nemeroff, M.D., Ph.D.; William Sage, M.D., J.D.; Kenneth Shine, M.D. (professor emeritus); and William Tierney, M.D.; as well as University of Texas at Austin faculty members George Georgiou, Ph.D., and Nicholas Peppas, Sc.D.

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Dell Medical School Dean Clay Johnston Elected to National Academy of Medicine - UT News | The University of Texas at Austin

Geisinger medical school will provide free tuitionwith a catch – FierceHealthcare

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Add Geisingers medical school to those offering free tuition as an incentive toincrease the number of primary care doctors.

Geisinger Commonwealth School of Medicine announced Wednesday that it will provide free tuition to students who commit to practice primary care after their residency at its affiliated health system Geisinger Health.

Geisinger will fund the program, which will offer debt-free medical school and living assistance to 40 students each year through its Primary Care Scholars Program.

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At Geisinger, weve been able to prove that by focusing on primary care we can improve outcomes, lower costs and improve satisfaction among patients and providers, Jaewon Ryu, M.D., president and CEO at Geisinger, said in an announcement.

These scholars have the opportunity to learn and later work in Geisingers innovative primary care environment without the worry of how they will pay for their education, he said.

Medical schools have been looking at ways to encourage more students to pursue careers in primary care, where a shortage of physicians is predicted. Geisinger said the primary care shortage is projected in the areas it serves, and it hopes that by removing the financial burden of medical school it will make it easier for more students interested in primary care to enter the field.

Last year, New York Universitys medical school became the first to offer free tuition to all its students to encourage more primary care doctors. And since then others have come up with their own programs. For instance, Kaiser Permanente announced earlier this year it would offer free tuition to all the medical students in its first five graduating classes.

Nationally, medical students carry an average of $200,000 in debt, which drives many to seek careers in higher-paying specialties.

Geisinger's plan is different in that it requires students to commit to primary care and also to practice within its health system. To be eligible for the scholarship program, students must agree to remain at Geisinger for four years after completing residency. The program will select 40 students in each incoming medical class through a competitive application process. Criteria will include financial need, academic merit, diversity, experience serving their communities and predictors of whether the applicant is likely to stay in Geisingers service area, the school said. The program will cover the full tuition and fees plus a living stipend of $2,000 per month for the four years of medical school.

The program is being offered to current first- and second-year medical students. In incoming classes, medical students will be invited to apply for the program.

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Geisinger medical school will provide free tuitionwith a catch - FierceHealthcare

Medical School Admissions – Accepted.com

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Words cannot describe the impact that Alicia made on my medical school applications. Being a non-traditional student, I didnt have access to a traditional pre med advisor and for much of my application process, I relied on things that I read on the internet as well as anecdotal advice from others. When I began working with Alicia, she essentially became my pre med advisor. From my personal statement, to secondary applications, and eventually interviews - I was able to conquer each hurdle of the medical school application process with new gained insights and confidence as I worked with Alicia.

Unlike others from whom I had sought help from, Alicia was able to connect with me and understand my unique perspective being an older, non-traditional applicant. She helped me find my voice - which was now one that demonstrated confidence and readiness for the rigors of a medical school education. She helped me focus my responses on my secondary application prompts and made sure I highlighted my most unique qualities and strengths. This continued during our Skype sessions once I had been offered interviews. The techniques that Alicia taught me during our mock interview sessions were incredible, and I will continue to use these throughout my life.

I have no doubt that if it werent for the expert advice I received from Alicia, I would not have been successful in my journey to medical school. All in all, I was accepted to 5 medical schools including my top choice and am forever grateful of the truly incredible guidance and help that I received from Alicia.

- JM

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Best Medical Schools in New York | Top Med Program

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Medical schools in the state of New York are exceptionally competitive institutions. Applicants will need to hold an acceptable bachelor or master degree from an accredited university plus achieve an acceptable Medical College Admission Test (MCAT) score. Students in New York will discover the core of a med school degree will take 4 years to complete. Designations you will hold upon completion of this phase of the program will be either a Doctor of Osteopathic Medicine (D.O.) or Doctor of Medicine (M.D.). Students will then pivot to a residency and internship program at an approved hospital or healthcare institution to gain practical experience. Next, you will be required to successfully pass a written examination and a practical test before applying for a medical license in New York state. Visit our med school degree portal to learn more about a degree in medicine or our PreMed portal today.Access vital educational on the best med schools in New York today by leveraging our search technology or the state listing below. Educational resources you will find with MatchCollege are designed with you in mind and will assist your journey to discover how to become a doctor in New York. Additionally, you can readily find career pathways in similar fields of study such as entomology, neuroscience, biomedical science, cytotechnology, genetics, and bioinformatics. Get matched to the best med school in New York today with our expansive tools and resources.

The New York medical schools listed below are accredited by the Liaison Committee on Medical Education, which is an organization that provides accreditation for medical education nationwide.

Schools are sorted by size with the largest medical schools first, based on the number of medical student graduates per year.

Visit the website for SUNY Downstate Medical Center at http://www.downstate.edu/

Visit the website for New York Medical College at http://www.nymc.edu

Visit the website for Yeshiva University at http://www.yu.edu

Visit the website for New York University at http://www.nyu.edu

Visit the website for Upstate Medical University at http://www.upstate.edu

Visit the website for Columbia University in the City of New York at http://www.columbia.edu

Visit the website for University at Buffalo at http://buffalo.edu/

Visit the website for Mount Sinai School of Medicine at http://icahn.mssm.edu

Visit the website for Stony Brook University at http://www.stonybrook.edu

Visit the website for Albany Medical College at http://www.amc.edu

Visit the website for University of Rochester at http://www.rochester.edu

Visit the website for Weill Cornell Medical College at http://www.med.cornell.edu

Visit the website for Hofstra University at http://www.hofstra.edu

Physicians can work in many types of specialties which may cause a large range in salary expectations. Here is a list of average annual salaries for general practitioners working in major cities in New York.

+330% Above State Median Income

+397% Above National Median Income

Doctor's in New york take home an average 88.48 per hour. Annual earnings for Doctor's working in the State of New york average $184,050 which is 330% above the state median income and 397% above the national median income for all occupations. Employment for a Doctor makes up just 0.02% of the working population in New york and is limited due to the specific qualifications required along with the schooling involved in this career path. The increasing demand for qualified Doctors coupled with the educational barrier to enter the field is met with a steady supply of eager college graduates anxious to make a long-lasting impact in the lives of others in and around New york.

Notes: Tuition & fee amounts are for both New York in-state residents and out of state students, unless noted otherwise. The tuition information displayed is an estimate, which we calculated based on historical data and should be solely used for informational purposes only. Please contact the respective doctor school for information about the current school year.

Source: IPEDS Survey 2012-2015: Data obtained from the US Dept. of Education's Integrated Postsecondary Education Data System (IPEDS). Data may vary depending on school and academic year.

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Best Medical Schools in New York | Top Med Program

LKSOM White Coat Ceremony | Calendar of Events

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Friday, August 10, 2018

10:00 a.m.

Temple Performing Arts Center

Broad and Polett Walk

PARKING

Liacouras Center Parking Garage

The Liacouras Center Arena is located in North Philadelphia on the corner of Cecil B. Moore and N. Broad Street in North Philadelphia, PA, about a mile and a half north of city hall. The venue has a 1,200--space indoor parking garage attached to the facility (at Cecil B. Moore and North 15th Street), and parking lots located throughout the main campus.View map.

About the White Coat Ceremony

The White Coat Ceremony, initiated in 1993 at Columbia University College of Physicians and Surgeons with the support of the Arnold P. Gold Foundation, has become common practice in US medical schools. The ceremony is a rite of passage for first year medical students, designed to inculcate the values of professionalism, humanism, and compassionate patient care. It is the official welcome to the medical profession and to the Temple family.

In the ceremony, students are "cloaked" in their first white coats in the presence of family members, friends and school faculty. The program includes greetings by medical school deans; explorations of the meaning of professionalism by an array of speakers representing the perspectives of medical school faculty, alumni, the community, patients and ethicists; and taking of an oath based upon the 1948 Declaration of Geneva.

For students, it provides a vivid realization that they are, in fact, medical students and future physicians and serves as a rite of passage into the profession of medicine.

The LKSOM White Coat Ceremony is a ticketed event; each student receives an alottment of tickets for their chosen guests.

A reception will immediately follow the ceremony in the Mitten Hall Great Court, located beside the Temple Arts Center.

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LKSOM White Coat Ceremony | Calendar of Events

UNLV medical school graduate students ‘train with the best’ – Las Vegas Review-Journal

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The victim, a 20-something-year-old woman, is found outside a bar after being attacked. When she arrives by car at the hospital emergency room, she appears woozy, has very low blood pressure, and her heart and respiratory rates are both well above normal. She could die if her injuries arent diagnosed quickly and accurately.

The good news not just for this victim but for all Nevadans is that this battery case was feigned for the benefit of a class of graduate student-resident physicians attending a UNLV School of Medicine course on trauma assessment.

Their instructor, Dr. Deborah Kuhls, a highly respected trauma surgeon at University Medical Center and a UNLV professor, said she feels privileged to be leading the class.

I had great teachers, and I want to teach what Ive learned to others, she said. I want to pass it on.

While the schools initial freshman class of 60 students has received most of the attention during its brief existence, the nearly 300 graduate medical students attending UNLV are expected to make a more immediate impact on the states shortage of trained physicians. State officials are counting on many of them staying in Nevada, which ranks 48th in the nation per capita for physicians across all specialties and 50th for primary-care physicians.

Training with the best

The doctors who attended the July 30 class at the Clinical Simulation Center of Las Vegas, which sits off Shadow Lane just across from UMC Medical Center and Valley Hospital, are mostly recent medical school graduates from around the country taking graduate courses in emergency medicine and general surgery. They also see patients at UMC during their supervised clinical training.

Dr. Nick Schulack, who attended medical school in Oregon, said he decided to take his three-year graduate emergency medicine training at UNLV because of the clinical training at UMCs trauma center. The center is renowned nationally, with National Trauma Data Bank statistics showing that while many people arrive with less than a 1 percent chance to live, an amazing 96 percent survive.

I want to work with, and be trained by, the best, Schulack said before the class began.

Kuhls began the demonstration by letting the class know that the assault scenarios fictitious hospital has a surgeon, but it isnt like UMC, with its huge trauma center and wide assortment of specialists available 24 hours a day. It sounds more like one of the hospitals found in Nevadas small, rural towns, which have long been difficult to staff.

After she reads off the victims vital signs, student-resident physicians Lian Farino and Schulack volunteer to assess the patient.

Where does it hurt? Farino asks the victim, who appears to be swaying as she stands in front of the room.

There is no answer and soon, Gigi Perez, a young actress wearing makeup to look as if shes been stabbed, appears to faint. Farino and Schulack place her on a table at the head of the class.

Can you wiggle your fingers and toes? Farino asks.

Again, no answer.

A crucial realization

Farino, playing the lead physician, tells Kuhls the patient needs IV fluids and blood and a chest tube insertion to help her breathe. Bleeding must be stopped in the thorax or chest area, where the stab wound was discovered.

After Kuhls reveals that fluid is leaking from the patients nose and ears and she has dilated pupils, Farino says it appears the patient has a brain injury.

Farino declares that once the hospital surgeon stops the bleeding and stabilizes the patient, she must be transported to a hospital with a neurosurgeon to handle a possible brain bleed.

Kuhls is visibly pleased. After class she said that a main point of the dramatization was for the student physician to realize that the patient needed a higher level of care than the scenarios community hospital could provide.

Students were later tested on patient assessment through multiple-choice questions and in simulations similar to what Farino did in front of the class.

That Kuhls became a trauma surgeon, and then a professor at a medical school, wasnt a sure thing. She started as a banker. It wasnt until her 30s, she said, that she re-examined her life and realized that she had always had a passion for helping people overcome life-threatening injuries.

After completing her medical training in Maryland in her 40s, she came to UMC 17 years ago. She began teaching soon after coaching many students from the University of Nevada, Reno, medical school who received their clinical training in Las Vegas.

Since then, she has held patients hearts in her hands as she worked to stop the bleeding from gunshot wounds and horrific accidents.

We cant save everyone

It is very rewarding to save lives, she said. But I also tell students that we have to accept the fact that were human and not God. We have to realize that we can do our best in our hearts we know weve done our best but we cant save everyone. And sometimes we have to tell someone that their loved one has died. We have to convey that information in a very empathetic way. It is not easy.

Dr. Dale Carrison, chief of staff at UMC and chairman of emergency medicine at the medical school, calls Kuhls brilliant in the operating room and in the classroom.

Her passion for her second profession has impressed the graduate students.

Dr. Krystle Tuano, a resident who plans to be a plastic surgeon, said Kuhls taught her that the best doctors dont stop helping patients after acute care is finished.

Shes a great patient advocate, always trying to find resources to help a patient out in the community after leaving the hospital, she said.

Farino, who has worked with Kuhls at UMC, said Kuhls shows that teaching is an art.

She can distill the jargon down from the very high level she practices at to something medical students can understand, he said. That takes a particular skill that not very many people can do. Its something I hope I can do.

Contact Paul Harasim at pharasim@reviewjournal.com or 702 387-5273. Follow Follow @paulharasim on Twitter.

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UNLV medical school graduate students 'train with the best' - Las Vegas Review-Journal

Med School Curriculum Kicks Off With a Patient’s Story – Northwestern University NewsCenter

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David Rush was interviewed by Josh Hauser, MD.

Hip-hop artist and motivational speaker David Rush kicked off the first day of medical school for Feinbergs Class of 2021, discussing his experience with focal segmental glomerulosclerosis, a life-threatening kidney condition that eventually forced him onto dialysis.

Rush was interviewed onstage by Josh Hauser, MD, associate professor of Medicine in the Division of Hospital Medicineand of Medical Education, as part of Feinbergs first-week curriculum, called Introduction to the Profession.

According to Rush, the first signs of trouble appeared when he was in 10th grade, during a school-mandated physical for football. High protein levels indicated poor kidney function and he was prescribed medication, which he took throughout high school. But when Rush moved to Georgia to attend the Art Institute of Atlanta, he left his self-care at home in New Jersey.

I forgot about the medical side living away from your parents and your doctors, youre not really thinking about what your blood pressure is or what your creatinine levels are, Rush said. Youre thinking, How much is Wendys again?

It wasnt until Rush underwent a physical at the urging of a friend that he discovered just how poorly his kidneys were functioning. His doctors told him he needed to start dialysis or he could die within a year. Still, Rush delayed starting the treatment. After 10 months had elapsed without treatment, Rush was discovered passed out in his sisters apartment.

He woke up in the emergency room, connected to a dialysis machine.

It was scary, I didnt want to be there, Rush said. But thats how I started dialysis.

These days, Rush spends three hours a day hooked up to a dialysis machine. While it can make him feel like hes pressed for time, he said, its also given him insight into how much patients sacrifice to receive medical care.

Patients time is taken the time they spend at hospitals, the time they spend in doctors offices and the time they spend on treatment, he said. So when youre seeing patients, you have to think about how theyre spending their time. When they finally see you it may be the seventh hour theyve been spending on this. They might come in a little edgy, but were not mad at you, but we need you to understand us.

First-year medical student Balaji Veluswamy said he appreciated hearing about Rushs experience. I havent heard that perspective before: the point of view of a patient who had time taken away from them. The patient is who you learn from the most. I find that fascinating.

Introduction to the Profession week familiarizes students with the roles of medical student and physician, connecting them to the competencies that constitute the core of the Feinberg curriculum. These competencies include ethics, teamwork, communication, patient-centered care, quality improvement, and personal awareness and self-care.

The first week also serves as an opportunity for medical students to learn about the informal curriculum the attitudes and values conveyed by Feinberg education practices and culture.

I like to think of it as the things that happen before and after class, on your way to class, and when youre talking to friends and colleagues, Hauser said. When I look back on my time as a medical student, those things are every bit as important as the more explicit goals.

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Med School Curriculum Kicks Off With a Patient's Story - Northwestern University NewsCenter

USC’s dean drug scandal could take a costly toll on the school’s legal battle with the UC system – Los Angeles Times

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Six months after Dr. Carmen Puliafito stepped down as dean of USCs medical school, he was called by the university to give sworn testimony as a witness in a lawsuit the institution was facing.

It was a sensitive matter with hundreds of millions of dollars potentially at stake, and two attorneys for the university sat with him as he answered questions.

Almost immediately, the opposing lawyer hit on a topic that was a closely guarded secret at USC: The circumstances of Puliafitos abrupt resignation in March 2016.

The former dean had a ready explanation, saying he had taken advantage of a unique opportunity at a biotech company. The response was succinct, matter-of-fact and, in light of recent revelations about his drug use and troubled tenure at USC, far from the whole story.

Paul Pringle, Harriet Ryan, Adam Elmahrek, Matt Hamilton and Sarah Parvini

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Of the many consequences of the Puliafito scandal for USC, few are as high-stakes as the possible effect on the court case that prompted his testimony last year.

Puliafito was expected to play a role in defending USC in the legal battle with the University of California over the defection of a star UC Alzheimer's disease researcher.

Puliafito helped woo the scientist and dozens of other prominent academics as part of a strategy by USC President C.L. Max Nikias to vault the university into the ranks of elite research institutions.

UC is seeking $185 million in damages along with a punitive award that could be several times that amount.

With all thats out there about him, hes going to have a serious problem coming off as credible and being believed, said Los Angeles attorney Brian Panish, a civil litigator who has represented clients in suits against both schools.

A Times investigation published last month revealed that Puliafito partied and used drugs with a circle of criminals and addicts while serving as dean. Puliafito engaged in this behavior during the period in 2015 in which he was recruiting the researcher, according to interviews with his associates and text messages they exchanged with him.

A UC spokeswoman said the school would not discuss its legal strategy other than to say we are vigorously pursuing this case against USC.

An attorney for USC said no decision had been made on whether to call Puliafito as a witness, but insisted the former deans testimony was not important to the universitys defense.

Hes a bit player in this, said attorney John Quinn.

In court filings earlier this year, lawyers for USC highlighted a portion of the deans testimony in arguing that the case should be dismissed.

Puliafito testified that the university wanted UC San Diego researcher Paul Aisen to join the faculty whether or not he brought along hundreds of millions of dollars in grant funding, a rejection of UCs claim that USC was motivated by money in recruiting the scientist.

Legal experts said that even if USC decides not to use Puliafitos testimony, UCs legal team could ask for copies of his personnel record and attempt to make an issue in court of his conduct. That would set up a fight between USC and UC over whether jurors should be told about the skeletons in Puliafitos closet if the case went to trial.

The trial judge would have to decide whether the prejudicial, inflammatory value is outweighed by the probative value, said Manhattan Beach civil lawyer John Taylor, who has represented clients with legal claims against USC.

The judge, Taylor added, might say, Suppose he was out partying like a rock star? How does that make it more or less believable to a jury?

USC is anticipating that UC will try to make Puliafitos drug use a line of attack.

I believe that they would do anything they could to try to poison the well, including introducing the deans personal problems, USC lawyer Quinn said, adding that he expected a judge to reject such attempts as irrelevant.

The case is on hold while USC appeals a U.S. district judges ruling that moved the suit from federal court to San Diego County Superior Court, where it was originally filed. No trial date has been set.

By the time Puliafito was scheduled to be questioned under oath, the case was in its second year and UC had brushed off entreaties by USC to settle the matter out of court. USC deputy general counsel Stacy Bratcher and other university lawyers met with the former dean three times to prepare him for the deposition, he later testified.

On the day of his testimony, Bratcher and another lawyer sat with him at a downtown law firm as he was questioned for about six hours, according to a transcript of the testimony. Portions of the transcript were redacted at the request of USC.

Puliafito said he had been deposed 20 times in his life, including in court cases where he was a medical expert. On a video recording of part of the deposition, he appears self-assured, offering short, precise responses and brushing aside many questions as hypothetical and difficult to answer.

A few minutes into his testimony, he was asked for the circumstances of your ceasing to be dean of the medical school. An attorney for USCs outside law firm, Viola Trebicka, initially protested that the question was overbroad and vague objections a judge would rule on a later date and then directed him to go ahead and answer.

I had a unique opportunity in the ophthalmic biotechnology industry, and I was able to continue my employment at USC on sabbatical and work for this biotech company, he said.

The full story was more complicated. USC acknowledged after The Times report that the dean quit his post during a confrontation with the university provost about his behavior and job performance. That showdown capped years of complaints from faculty and staff about Puliafitos drinking, temper and public humiliation of colleagues, according to interviews with former co-workers and written complaints to the administration.

He was not offered the biotech job at Ophthotech, a firm run by two longtime friends, until more than a month after he resigned, according to a company spokesman.

Quinn said he did not know whether lawyers for USC and Puliafito discussed how he would answer questions about his resignation before the deposition. He said that attorneys for his firm would never sponsor false testimony. We would never knowingly permit a witness to lie. In a statement, a USC spokesman said the university general counsels office, where Bratcher works, would never encourage a witness to perjure himself.

Experts said UC could ask a judge to reopen the deposition in light of the new information about Puliafitos past conduct.

I would get the personnel file and also question him about what happened. Maybe there is more that is not out there yet, Panish said.

The court fight is being closely watched in academic circles. UC took the highly unusual step of suing its academic rival in 2015 after years of frustration over USCs recruitment of faculty members who were the recipients of big research grants. These grants are an important income source for the state system.

These transformative faculty, as they are known at USC, have been key to President Nikias strategy for raising the universitys national reputation. Puliafito spearheaded the effort during his eight-year tenure as dean, recruiting more than 70 academics from the UC schools, Stanford, Harvard and other prestigious rivals.

After Puliafito helped woo away two well-funded UCLA neurology researchers in 2013, UC administrators were outraged, and complained to government regulators, according to court filings. It was not unusual for professors to move to other institutions, often with the first university cooperating in the transfer of grant funding to the new school. But in UCs view, USC had acted beyond accepted norms by targeting academics based on grant funding and strategizing secretly with those researchers while they were still employed by UC about moving grants to USC. The schools reached a confidential settlement requiring USC to pay UCLA more than $2 million, according to a copy of the agreement obtained through a public records request.

Late the next year, the dean set his sights on another UC prize: Alzheimers expert Paul Aisen. The UC San Diego neurology professor was a global leader in the search for a cure for the disease, and federal agencies and drug companies were expected to send more than $340 million in research grants to the lab he ran over the next five years

Nelvin C. Cepeda

Alzheimer's researcher Dr. Paul Aisen.

Alzheimer's researcher Dr. Paul Aisen. (Nelvin C. Cepeda)

I am going to get more involved in this personally and quarterback the process, he wrote in an email to Provost Michael Quick in April 2015. We need this to happen.

USC offered Aisen annual compensation of $500,000 a salary bump of $110,000 along with a home loan and other perks. He moved to USC in June 2015.

The loss reverberated at the highest levels of the UC system. President Janet Napolitano unsuccessfully lobbied the head of drug company Eli Lilly, a major funder of Aisens work, to keep its grant money at UC.

In July 2015, UC sued USC, Aisen and his lab colleagues for breach of fiduciary duty, interference with contracts, computer crimes and other claims. The university said USC had conspired with the researcher while he was still working for UCSD to interfere with the public universitys contractual relationships with grant funders and to seize control of critical clinical trial data.

Subsequent filings suggested the depths of the hard feelings. In one, UC complained that the departing scientists had even made off with paper clips paid for by UCSD. In another, their lawyers described USC as a predatory private university with a law-of-the-jungle mind-set.

Astrid Riecken / Getty Images

University of California President Janet Napolitano

University of California President Janet Napolitano (Astrid Riecken / Getty Images)

USC and Aisen countersued for defamation and other charges. Their lawyers wrote in the complaint that they were ready to settle the litigation and suggested the blame rested with UC for failing to fund Aisens work adequately. When he found a school that would, they wrote, UC engaged in petty academic politics, including trying to make him sign a loyalty oath and cutting off his email and phone service, tactics that they claimed endangered patient safety.

Aisen, Puliafito and other USC administrators insisted in depositions that the university had done nothing wrong. In his sworn testimony, the former dean testified that he was prepared to offer Aisen a faculty position even if his lucrative research grants stayed behind at UCSD.

You were indifferent to whether or not the grant funding transferred with Dr. Aisen, the UC lawyer asked.

Yes, Puliafito said, adding: Thats the risk we were willing to take.

San Francisco lawyer Stephen Hirschfeld, who has defended UC and other universities in civil suits, said the involvement of other officials in Aisens recruitment could blunt the impact of Puliafitos credibility issues.

The university provost, a faculty chair, medical school administrators, and human resources officers played key roles in luring Aisen, according to court filings and deposition testimony.

You could have a situation where the dean says one thing and several other administrators confirm that it is true, Hirschfeld said. Focusing too much on Puliafito, he said, might make UC look cruel or desperate to the jury.

Youve got to think really hard if its worth it to attack this guy in this way, he said.

Taylor, the Manhattan Beach lawyer, said that jurors could see Puliafito as a reflection of the values of the university and the decision makers there.

If terrible evidence comes in about him, it is terrible evidence for the school, he said.

The deposition offers tantalizing clues about the relationship between Puliafito and USC. At one point, the former dean was asked when he had last looked at the USC ethics code.

Six months ago, he replied. The deposition was on Sept. 23, 2016 just a day short of the six-month anniversary of the meeting at which the provost confronted him with complaints from colleagues about his behavior.

harriet.ryan@latimes.com

Twitter: @latimesharriet

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An overdose, a young companion, drug-fueled parties: The secret life of USC med school dean

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USC's dean drug scandal could take a costly toll on the school's legal battle with the UC system - Los Angeles Times

Rutgers expert weighs in on altered sense of smell, taste caused by viral infections – RU Daily Targum

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Photo by Rutgers.edu | The Daily Targum

Rachel Kaye, an assistant professor of otolaryngology at Rutgers New Jersey Medical School, is beginning to study the connection between lost senses and coronavirus disease, according to a press release.

Anosmia, the loss of the sense of smell, or dysgeusia, the distortion of taste, could be early signals of coronavirus disease (COVID-19), according to a statement on the American Academy of Otolaryngologys (AAO) website.

Anecdotal evidence is rapidly accumulating from sites around the world that anosmia and dysgeusia are significant symptoms associated with the COVID-19 pandemic, the AAO said, according to the statement. Anosmia, in particular, has been seen in patients ultimately testing positive for the (COVID-19) with no other symptoms. We propose that these symptoms be added to the list of screening tools for possible COVID-19 infection.

The AAO said people with these symptoms should consider getting tested for COVID-19 regardless of whether these symptoms are accompanied by respiratory conditions, according to the statement.

Rachel Kaye, an assistant professor of otolaryngology at Rutgers New Jersey Medical School, is beginning to study the connection between lost senses and COVID-19, according to a press release.

Since these people do not show other symptoms, they wont know to self-quarantine, which could spread the virus, Kaye said, according to the release.

She said it is common for viral infections to alter senses. Viruses often inflame the lining of the nasal cavity, which can lead to congestion that affects an individuals ability to smell. Some evidence also shows viral infections cause neurologic damage to smell receptors or neurons, according to the release.

Kaye said individuals who lose their sense of smell do not necessarily have COVID-19 and may be dealing with a different type of upper respiratory infection, bacterial infection or viral infection. She said other reasons people may lose their sense of smell include medication side effects, sinus disease, neurologic disorders, aging and smoking, among other things, according to the release.

Kaye said individuals with these symptoms should talk to their primary care doctor otorhinolaryngologist about any specific symptoms they are experiencing. She said those who experience these symptoms and have been exposed to COVID-19 may consider self-isolating until they have definitive test results, according to the release.

That being said, although the anecdotal evidence is increasing, there have not yet been any scientific studies published regarding this, and so strict protocols for people experiencing these symptoms are lacking, Kaye said, according to the release.

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

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Rutgers expert weighs in on altered sense of smell, taste caused by viral infections - RU Daily Targum

At Harvard’s graduate Schools, reinvention on the fly – Harvard Gazette

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When the coronavirus crisis hit, we started trying to think about ways to maintain closeness and community amidst growing physical distance both small-scale (social distancing and campus closures in Cambridge) and large-scale (as Sarah returned to Canada while I stayed in Cambridge), Williams said via email. We thought that making our conceptual podcast a real podcast could be one way to do this.

In addition to their usual humor, the pair discuss the psychological aspects of coping with the pandemic and share some tips they learned in a Harvard University Health Services workshop, Managing Emotions.

I just love this because its so good for mental health and well-being, Yun said of the fellows latest effort. Its hard enough to be a Ph.D. student; it is so incredibly isolating and our population has a tendency to isolate because the work that theyre doing is asking the big questions in lonely libraries. So Im just so grateful that our students are trending forward trying to say, We need to stay connected to each other during this time.

With so many feeling overwhelmed by the abrupt changes and confused by the rapid pace of information coming at them from so many disparate sources about the COVID-19 pandemic or where to find help for difficulties, graduate students Gwendolyn Lee, M.D./M.P.P. 20, and her sister, Alexandria Allie Lee, M.S. 20, thought students could use a central repository to find and share the most accurate, useful information and more easily communicate with each other. Ideally, they hoped this would empower students to take action to begin solving the many challenges of the current public health crisis.

On March 13, the student-run group Students vs. Pandemics created a Google Sheet with sections on how to stay healthy, where to find resources, ideas for having fun or bringing about systemic change, and complain + fix, where problems are identified, and then go about trying to fix them. Students are encouraged to add ideas and share information on the spreadsheet. So far, more than 30 students have contributed, and theyre hoping to recruit others. Ideas include starting a COVID-19 hackathon for students to identify digital solutions, drafting policy memos to send to the Massachusetts Legislature, and helping other universities launch similar task forces.

We talked with many friends and classmates who felt like so many changes were happeningtous andthatotherswere making significant decisions affecting our lives. That often happens in times of crisis, and we wanted to empower more students torespondandact. Students are very good at identifying needs and gaps, and we wanted to give them a platform to connect with others to innovate solutions, said Gwendolyn Lee, whos studying health policy at Harvard Kennedy School while also pursuing a medical degree at UCLA. Allie Lee is earning a masters degree in epidemiology at the Harvard Chan School of Public Health.

Even as the group confronts the immediate COVID-19 crisis, Gwendolyn Lee said its also building institutional knowledge so that its better prepared for future disease outbreaks, epidemics and pandemics.

More fundamentally, we would like to work toward building a model of prevention, she said. Students vs. Pandemics hopes to advocate for and help achieve preventive behavior so we wont find ourselves in a situation like the one we face today.

In times of struggle, many take comfort and refuge in religious and spiritual gatherings. With that currently out of the question, some religious groups at Harvard Divinity School (HDS) are considering alternatives. The HDS Disciples and United Church of Christ Worship have begun shifting the weekly worship services and prayer times online, connecting everyone via Zoom. The first online service begins today.

Early last week, HDS students began contributing inspirational posts to the Office of the Chaplain and Religious and Spiritual Lifes Facebook page and Instagram accounts. So far, the posts have drawn on a variety of texts, from the Bible to Harry Potter.

Harvards move to online teaching and learning presents challenges for disciplines where the work is almost entirely physical and doesnt easily translate to 2D formats such as video at least not without sacrificing essential components of the work.

At Harvard Graduate School of Design (GSD), Dean Sarah Whiting and the faculty have been taking advantage of the popular Zoom platforms draw-over and annotation tools, particularly for crits, the one-on-one sessions in which a professor reviews and critiques individual student work, said GSD spokesman Travis Dagenais. Rather than hanging project renderings on the usual pin-up boards, theyre turning unused laptops into digital pinboards so professors can review the work on one screen while conducting the crit on another.

I was just so impressed that even though all of their lives were sort of cast into chaos they still were really committed to building community and finding ways to continue to connect GSAS students.

Jacqueline Yun, executive director, GSAS Student Center

The School is still determining how faculty juries will conduct final reviews, which typically involve models, large drawings, and other physical elements, without being able to see these components in real life.

For those already tired of looking at home-office backdrops on Zoom, or who just want things to go back to normal even for a few minutes, a cheeky pair of Masters in Design Studies students have created an assortment of colorful Zoom backgrounds from spaces in and around Gund Hall. The backgrounds have become a minor hit with students and even a dean or two.

One unexpected positive is that prior to the campus closure, GSD offered only one online course, the popular The Architectural Imagination on edX. Now, suddenly there are dozens of GSD courses going online, adapted and produced in short order and being tweaked in an ongoing manner. Its been a tall order. That contrast in number and scope illustrates our challenge as designers: Design pedagogy is uniquely difficult to conduct in a purely digital format, and this shift has been nothing shy of fundamental for us, said Dagenais.

For fourth-year students at Harvard Medical School (HMS), the third Friday in March is a date they have dreamed about and worked toward for many years. On Match Day, the National Resident Matching Program notifies graduating seniors at medical schools across the country where they will serve their clinical residencies. At Harvard, the milestone usually takes place in the atrium of the Tosteson Medical Education Center at HMS, with students and their loved ones gathered, waiting for the dean of students traditional bell ringing at noon that kicks off the envelope-tearing, excited squeals, and hugs. This year, the matches will arrive via email, and Dean Fidencio Saldaas bell will be livestreamed to the approximately 165 seniors. The School has set up a social media account so students can share their celebrations, but from a safe distance.

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At Harvard's graduate Schools, reinvention on the fly - Harvard Gazette

Cedar Rapids Family Medicine Residency, created to address shortage, will close in July – The Gazette

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CEDAR RAPIDS A longtime Cedar Rapids-based medical training program, meant to address the shortage of family medicine physicians in the area, will be closing its doors permanently.

The Cedar Rapids Family Medicine Residency Program will be discontinued effective July 1, at the end of this academic year, Mercy Medical Center and UnityPoint-St. Lukes Hospital jointly announced earlier this week.

Both Cedar Rapids hospitals have supported the Cedar Rapids Medical Education Foundation, which was established in 1971 to oversee the three-year residency program, the stage of a physicians training that follows medical school.

There are no other family medicine residency programs in Cedar Rapids.

The foundation was established to address the shortage of family medicine physicians in Cedar Rapids, operating with the hope that graduates would stay and practice in the community, according to a statement from the hospitals.

However, in the past five years only 31 percent of family medicine residents in this program have remained in Cedar Rapids after graduation, officials said.

As a result, Mercy and St. Lukes Hospital have developed robust recruiting programs to bring medical providers to the Cedar Rapids area, according to the statement.

The decision will affect 21 current residents of the Family Medicine Residency Program, only seven of whom will finish their final semester and graduate this summer.

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Officials say the foundations program directors have posted notice of the closure on a nationwide residency program director listserv, and has reached out to program directors based in Iowa.

So far we are told these communications have been encouraging as several programs in the state have expressed interest in adding some of the Cedar Rapids Medical Education Foundation residents to their programs, according to a joint statement from Mercy and St. Lukes. In addition, the residents are encouraged to pursue leads on their own in locations desirable to them.

The statement added that program slots are available in Iowa City, Waterloo, Mason City, Des Moines, Sioux City and Davenport.

Federal funding allocated to the Cedar Rapids Medical Education Foundation per resident as their sponsoring institution will travel with the family medicine residents, which we hope will help these residents find placement, officials said.

The closure also affects 12 faculty and staff members employed by the foundation. Local hospitals human resources department will work with these individuals to assist with their transition, according to the joint statement.

Training sites of the three-year residency program include both Cedar Rapids hospitals, the University of Iowa Hospitals and Clinics and Vinton Family Medical Clinic as well as the Eastern Iowa Health Center, a Federally Qualified Community Health Center that tailors its care to underserved populations.

The Cedar Rapids-based Eastern Iowa Health Center has been the outpatient continuity clinic for the program since the clinic was established in 2006, allowing family medicine residents to gain hands on experience by caring for the centers patients.

As a Federally Qualified Community Health Center, the Cedar Rapids provider receives a higher federal reimbursement to be a safety net provider for underserved populations, such as low-income or Medicaid-eligible families.

Though they were separate organizations, Eastern Iowa Health Center officials said the Cedar Rapids Medical Education Foundation has been a collaborative partner in ensuring the organizations together serve as a vital component of the communitys health care safety net.

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We are grateful for the years of partnership with Cedar Rapids Medical Education Foundation faculty and residents, Eastern Iowa Health Center President and Chief Executive Officer Joe Lock said in a statement.

They have served the community and underserved patients tirelessly and we are saddened by the news that the program will be closing.

Eastern Iowa Health Center will recruit a mix of primary care providers to fill the vacancies caused by the foundations closing, Lock said in an emailed statement.

Due to the nature of a residency program, their time in clinic is limited, Lock said. As a result, we will recruit the number of providers necessary to take care of the patients that are currently being seen by residents. Recruitment has already started.

Lock said health center officials plan to continue working with training students in many disciplines, including nurse practitioners, nurses and dentists, among others.

The shortage of family medicine physicians and other primary care physicians is a nationwide issue that is expected to continue to worsen, according to recent research.

The United States will see a shortage of nearly 122,000 physicians by 2032 as the demand for doctors grows faster than the supply, according to a 2019 study from the Association of American Medical Colleges, the accrediting body for all U.S. medical schools.

The projected shortfall of primary care physicians is expected to range between 21,200 and 55,200 physicians by 2032.

A growing older population is a likely to be a major factor driving demand for physicians, the report said. The U.S. Census Bureau estimates Americans over the age of 65 will increase by 48 percent by 2032.

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Additionally, the aging population will affect physician supply, since one-third of all currently active doctors will be older than 65 in the next decade, the report stated. When these physicians decide to retire could have the greatest impact on supply.

Iowa, to maintain current rates of utilization, will need an additional 119 primary care physicians by 2030, according to research from the Washington, D.C.-based Robert Graham Center. That is a 5 percent increase to the states 1,996 total primary care physician workforce in 2010.

However, officials from both Cedar Rapids-based hospitals are confident their recruitment programs will fill the gap of family medicine physicians in the area.

Thats how weve been able to successfully meet the physician needs of our community, the joint statement said. Mercy and St. Lukes recruit two-thirds of all the family practice providers in our area. Both hospitals plan to continue those efforts.

Both hospitals have robust recruitment programs and are able to fulfill the health care provider needs of the community, the statement said.

Comments: (319) 368-8536; michaela.ramm@thegazette.com

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6 things they don’t tell you about life in medical school – American Medical Association

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Entering medical school, there are a number of curricular expectations for which medical schools prepare incoming students. Still, some things are bound to catch new students off guard. Medical students and medical school faculty spoke with the AMA to cover a few key topics that may surprise aspiring medical students.

Youre bound to spend more time studying than you did in your undergraduate studies. Still, if you prioritize your time, you can meet new people and have a social life.

Often, premeds are told their life will be over for four to five years, said Lindia J. Willies-Jacobo, MD, associate dean for admissions and professor at Kaiser Permanente School of Medicine, which will welcome its first class of medical students in the fall. Thats by no means true. They can continue to socialize and build community with their peers and also have a life outside of medical school.

Avani Patel is a forthcoming graduate of the University of Mississippi School of Medicine in Jackson. Earlier on in her medical school career, she had exams every Monday. That meant that weekends were typically not her time to catch up with friends or go out. She instead started to make plans on Monday nights and attend events during the week that were put on by her school.

Its up to you if you want to be socially active, Patel said. But you are going to have to make priorities and be strategic about it to balance your commitments.

Some students say medical school is comparable to high school in some of the not-so-beneficial ways.

Im from the South, so its already cliquey down here, said Patel. Its your choice if you want to be cliquey or not. I like to have multiple friend groups and get to know people on all levels.

From day one of medical school, your colleagues are your support system but could also be seen as competitors for those ultra-competitive residency slots. That can make for some interesting social dynamics.

I thought I found a great friend group my first year, and they were wonderful people. I realized that they were very high-performing and that became unhealthy for me, Patel said. I doubted myself; I felt bad about myself. We would talk about grades and compare test scores, and that was toxic for me. It had nothing to do with them and everything to do with me. I found I needed to separate myself from them.

I ended up finding another group of friends, and we never talked about grades and supported each other, and thats really what I needed.

As much as they want you to succeed in medical school, your friends may not totally understand the time and emotional energy that goes into medical school. When you start missing marquee events such as weddings and birthdays, they may take it personally, Patel said.

Youre so busy that its really difficult to make the time, Patel said. Theres a give and take, and some friends understand, those are the people you can pick up where you left off with.

Your classmates and students in the classes ahead of you have a rare ability to relate to the daily grind you'reexperiencing. That can be a very valuable resources to cope with stress.

Its really nice to have people who are going through the same things you are to be there to provide support, Patel said. We have an M1-M2 buddy system, and I think most med schools do, so a lot of people utilize their upperclassman friends as a sound board. Its very helpful to talk to them about what you are struggling with since they have gone through the same things.

Medicine can be a career that is both challenging and highly rewarding, but figuring out a medical schools prerequisites and navigating the application process can be a challenge into itself. The AMA premed glossary guide has the answers to frequently asked questions about medical school, the application process, the MCAT and more.

Have peace of mind and get everything you need to start med school off strong with the AMA.

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6 things they don't tell you about life in medical school - American Medical Association

$80 million medical school to be built in north St. Louis | ‘Its a need in our community’ – KMOV.com

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$80 million medical school to be built in north St. Louis | 'Its a need in our community' - KMOV.com