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10 Costs to Expect When Applying to Medical School – Yahoo Finance

Posted on January 29, 2020 by Danzig

Costs to apply to med school can stack up.

While most prospective students might be focused on the overall price tag of attending medical school, the cost to apply can often amount to thousands of dollars. "An applicant to 15 medical schools can easily spend over $10,000 in the application process," says Dr. McGreggor Crowley, a medical school admissions counselor at IvyWise, a New York-based admissions consulting company. For prospective students interested in applying to medical school, here are some expenses to expect.

Preparing for the MCAT

While the cost of the MCAT exceeds $300 for those who do not qualify for fee assistance, prospective students can spend much more preparing for the exam. "Many students benefit from test prep services -- those can range from a couple of hundred dollars for practice tests and questions to several thousand dollars for in-person, extended prep courses," says Dr. Sylvie Stacy, a board-certified physician who graduated from the University of Massachusetts--Worcester medical school in 2011.

Taking the MCAT

Prospective students can save money by registering early. The MCAT costs at least $320. For those who register within eight days before the test date, the cost is $375. MCAT test-takers outside the U.S., Canada, Guam, the U.S. Virgin Islands and Puerto Rico pay an additional international registration fee of $115.

Access to the MSAR database

Admissions experts recommend using the online Medical School Admission Requirements database compiled by the Association of American Medical Colleges. The MSAR database is a resource that lists information provided by admissions offices at U.S. and Canadian medical schools. The cost to access the database, which is published each spring, is $28 for a one-year subscription.

Primary application fees

The American Medical College Application Service, or AMCAS, is a centralized medical school application clearinghouse. The AMCAS primary application fee is $170 for sending materials to one school and $40 for each additional school. Aspiring doctors who are interested in osteopathic medical schools can file applications via AACOMAS, the American Association of Colleges of Osteopathic Medicine Application Service. AACOMAS bills $195 for the first primary application and $45 for every additional primary application. Meanwhile, those who want to attend a public medical school in Texas can submit their primary application materials via the Texas Medical & Dental Schools Application Service, or TMDSAS, which charges a flat fee of $185.

Secondary application fees

After students apply, schools may respond by asking them to submit a secondary application. These vary from school to school, and most require students to pay an additional application fee. "These, of course, have fees associated with them ranging from $75 to over $100," says Dr. Crowley from IvyWise. Harvard Medical School, for instance, charges M.D. hopefuls without an AMCAS fee waiver $100 to file a secondary, or supplemental, application. Students with AMCAS fee waivers do not need to pay this fee.

College registrar services

Most colleges charge a former student a fee for sending transcripts to medical schools. This service might cost around $10 for each transcript, according to Artem Volos, chief financial officer and chief operating officer at ClutchPrep.com, a Florida-based test prep service he co-founded.

Interview travel costs

Medical school interviews can be the most expensive part of the application process, Dr. Crowley says. "Depending on how many schools a student interviews at, it can cost upwards of $500 to $1,000 per school, and interviews at the schools in the same city can be difficult to coordinate for the same trip."

Interview attire

Another expense associated with in-person interviews is clothing, which usually has to be business attire. Justin Hahn, a medical student at the Dr. Kiran C. Patel College of Osteopathic Medicine at Nova Southeastern University in Florida, wrote in an email: "Buying a suit and paying for alterations also incurred a large one-time expense. However, I was able to reuse the suit for multiple interviews, which helps make up for the expensive cost."

Admitted student campus visit

Students who receive admissions offers are usually invited to campus to take a second look. For example, the medical school at the University of Michigan--Ann Arbor holds a two-day second-look weekend for admitted students in the spring. "If a student is admitted to a medical school, they may want to travel back to that school for an admitted student experience, again footing the bill themselves for transportation, food and lodging," Dr. Crowley says, comparing the costs of a second-look experience with traveling for school interviews.

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Acceptance deposits

Some medical schools require a deposit, often nonrefundable, to hold a spot. The fee usually will keep an acceptance in place until May while an applicant decides where to attend. The medical school at Georgetown University, for instance, charges $500 for a deposit. Hahn, the Nova Southeastern student, says a prospective student "can spend anywhere from $500 to $3,000 for deposit fees."

The new coronavirus: What we do and don’t know – Harvard Health Blog – Harvard Health

Posted on February 1, 2020 by Danzig

Editors note: Because the situation around the 2019-nCoV coronavirus is changing rapidly, the most recently updated information will be available from these sites:

Summary of outbreak and response from the CDCInformation on symptoms, prevention, and treatment (CDC)US situation summary (CDC)International summary (World Health Organization)

A rapidly evolving health story broke in late December when a novel illness originating in Wuhan, China made the news. Reports of the number of infected people swiftly rose, and isolated cases of this new coronavirus dubbed 2019-nCoV by scientists have appeared in several countries due to international travel. At this writing, almost 1,300 confirmed cases and over 40 deaths have occurred in China, according to an article in the New York Times.

Fortunately, public health officials in many countries, including the US, have put measures in place to help prevent further spread of the virus. These measures include health screenings at major airports in the US for people traveling from Wuhan. In China, travel restrictions are in effect.

With information changing so quickly and every news report about the virus seeming to raise the stakes, you may be wondering how worried you should be. Heres a primer on what we do and dont know about this virus and what it may mean for you. While there is much we dont yet understand about the virus, public health officials, medical experts, and scientists are working in collaboration to learn more.

Coronaviruses are an extremely common cause of colds and other upper respiratory infections. These viruses are zoonoses, which means they can infect certain animals and spread from one animal to another. A coronavirus can potentially spread to humans, particularly if certain mutations in the virus occur.

Chinese health authorities reported a group of cases of viral pneumonia to the World Health Organization (WHO) in late December 2019. Many of the ill people had contact with a seafood and animal market in Wuhan, a large city in eastern China, though it has since become clear that the virus can spread from person to person.

The symptoms can include a cough, possibly with a fever and shortness of breath. There are some early reports of non-respiratory symptoms, such as nausea, vomiting, or diarrhea. Many people recover within a few days. However, some people especially the very young, elderly, or people who have a weakened immune system may develop a more serious infection, such as bronchitis or pneumonia.

Scientists are working hard to understand the virus, and Chinese health authorities have posted its full genome in international databases. Currently, there are no approved antivirals for this particular coronavirus, so treatment is supportive. For the sickest patients with this illness, specialized, aggressive care in an intensive care unit (ICU) can be lifesaving.

Unless youve been in close contact with someone who has the coronavirus which right now, typically means a traveler from Wuhan, China who actually has the virus youre likely to be safe. In the US, for example, only two cases of the virus have been confirmed so far, although this is likely to change.

While we dont yet understand the particulars of how this virus spreads, coronaviruses usually spread through droplets containing large particles that typically can only be suspended in the air for three to six feet before dissipating. By contrast, measles or varicella (chickenpox) spread through smaller droplets over much greater distances. Some coronaviruses also have been found in the stool of certain individuals.

So its likely that coughs or sneezes from an infected person may spread the virus. Its too early to say whether another route of transmission, fecal-oral contact, might also spread this particular virus.

Basic infectious disease principles are key to curbing the spread of this virus. Wash your hands regularly. Cover coughs and sneezes with your inner elbow. Avoid touching your eyes, nose, or mouth with your hands. Stay home from work or school if you have a fever. Stay away from people who have signs of a respiratory tract infection, such as runny nose, coughing, and sneezing.

In the US, the average person is at extremely low risk of catching this novel coronavirus. This winter, in fact, we are much more likely to get influenza B the flu than any other virus: one in 10 people have influenza each flu season. Its still not too late to get a flu shot, an easy step toward avoiding the flu. If you do get the flu despite having gotten the vaccine, studies show that severe illness, hospitalization, ICU admission, and death are less likely to occur.

Given the current spread of this virus and the pace and complexity of international travel, the number of cases and deaths will likely to continue to climb. We should not panic, even though we are dealing with a serious and novel pathogen. Public health teams are assembling. Lessons learned from other serious viruses, such as SARS and MERS, will help. As more information becomes available, public health organizations like the Centers for Disease Control (CDC) in the US and the World Health Organization (WHO) will be sharing key information and strategies worldwide.

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The new coronavirus: What we do and don't know - Harvard Health Blog - Harvard Health

Technology Is Helping Combat Kidney Stones: Brown Alpert Medical School Expert on Latest Innovations – GoLocalProv

Posted on February 2, 2020 by Danzig

Sunday, February 02, 2020

Smart Health on GoLocalProv

"Its a very common disease I see patients from all walks of life and ages and genders with kidney stones, it tends to be a very acute event in their lives. Its usually one thats associated with a lot of pain most of my patients will describe it as worse than childbirth, said Thavaseelan.

Thavaseelan is an associate professor of surgery in urology and at the Brown Warren Alpert Medical School, as well as the section chief of urology at the Providence VA Medical Center and the residency program director at Rhode Island Hospital. She is also a practicing physician at Brown Urology.

Kidney stones tend to present very acutely and dramatically with significant pain usually in the back of the body, met with nausea and vomiting and then sometimes urinary symptoms blood in the urine, or going more frequently or urgently. They can also mimic the symptoms of a urinary tract infection, having burning with urination or other discomfort while passing the urine, she said. Sometimes you dont have any of those symptoms at all we call those asymptomatic kidney stones. And then there are a number of health conditions such as diabetes, chronic bowel disease, previous surgeries like gastric bypass that can all put you at risk.

Advancements in Treating Stones

"Based on imaging, if the stone is under 4 millimeters in size, thats usually around an 85% chance of being able to pass," said Thavaseelan. "Now, thats not without pain, grief, and discomfort, but probably without an operation. If imaging suggests they have a great chance of passing it on their own, we might try at-home medications, to help pass the stone with relaxation of the ureter."

"Urology has always been a field where weve incorporated technology and innovation. Thats been at the forefront of our surgery discipline," she added. "So starting from opening up a patient, to using miniaturized telescopes -- it's a really huge evolution in terms of recovery and speed of which we can get patients back to their normal lives. This last decade, for example, when I do surgery through the back, Im now doing a procedure where we make a much smaller opening, and then not to leave tubes coming out of the back, and have a kind of quicker recovery or at least less time in the hospital."

Rising Temps a Factor

"Theres a lot of interest in trying to look at the relationship between climate change and rising temperature and kidney stone disease in general," said Thavaseelan. "I think the fundamental issue is one of dehydration and rising temperatures being associated with dehydration might predispose those patients who are at risk to make stones, to having a higher incidence in folks who suffer from kidney stones."

A specialist in endourology, Thavaseelan was nominated and chosen to be a Rhode Island Medical Society 4 under 40 Award winner in 2019.

About Alpert Medical School -- and Smart Health

Since granting its first Doctor of Medicine degrees in 1975, the Warren Alpert Medical School has become a national leader in medical education and biomedical research.

By attracting first-class physicians and researchers to Rhode Island over the past four decades, the Medical School and its seven affiliated teaching hospitals have radically improved the state's health care environment, from health care policy to patient care.

"Smart Health" is a GoLocalProv.com segment featuring experts from The Warren Alpert Medical School GoLocal LIVE.

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Technology Is Helping Combat Kidney Stones: Brown Alpert Medical School Expert on Latest Innovations - GoLocalProv

Mount Sinai Named Among Nation’s Top Health Care Employers for Diversity by Forbes – Yahoo Finance

Posted on January 24, 2020 by Danzig

The Mount Sinai Health System has once again been ranked among America's "Best Employers for Diversity" by Forbes and research firm Statista.

NEW YORK, Jan.23, 2020 /PRNewswire-PRWeb/ -- The Mount Sinai Health System has once again been ranked among America's "Best Employers for Diversity" by Forbes and research firm Statista.

Mount Sinai was ranked No. 3 in the "Healthcare & Social" category and No. 19 overall among 500 companies across more than 20 industries. The Health System is New York City's largest academic medical system, including eight hospitals, a leading medical school, and a vast network of ambulatory practices.

"This ranking reflects our ongoing commitment to diversity and inclusion, a representation of our compassionate and caring staff that continues to mirror the diverse communities we serve," said Kenneth L. Davis, MD, President and Chief Executive Officer of the Mount Sinai Health System. "We are honored to be part of this list of forward-thinking and inclusive groups who value our differences to strengthen our organizations."

"Groundbreaking initiatives at our medical schoolfrom the creation of the first-ever Dean for Gender Equity to the launch of the Diversity Innovation Hub to address underrepresented groups in medicine and innovationdemonstrate our unparalleled dedication to inclusion," said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and President for Academic Affairs of the Mount Sinai Health System. "This recognition underscores Mount Sinai's continued efforts to promote gender equity and diversity in medicine."

Statista surveyed more than 60,000 employees working for businesses with at least 1,000 employees apiece in the United States. Participants rated their organization on topics including age, gender, ethnicity, and disability. Underrepresented groups, including women and ethnic minorities, also provided their views on other employers within their industry. Diversity across leadership including top executives and boards, and access to public information, such as a designated chief diversity and inclusion officer, contributed to a company's overall score.

About the Mount Sinai Health System

The Mount Sinai Health System is New York City's largest integrated delivery system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. Mount Sinai's vision is to produce the safest care, the highest quality, the highest satisfaction, the best access and the best value of any health system in the nation. The Health System includes approximately 7,480 primary and specialty care physicians; 11 joint-venture ambulatory surgery centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. The Icahn School of Medicine is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools", aligned with a U.S. News & World Report's "Honor Roll" Hospital, No. 12 in the nation for National Institutes of Health funding, and among the top 10 most innovative research institutions as ranked by the journal Nature in its Nature Innovation Index. This reflects a special level of excellence in education, clinical practice, and research. The Mount Sinai Hospital is ranked No. 14 on U.S. News & World Report's "Honor Roll" of top U.S. hospitals; it is one of the nation's top 20 hospitals in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Geriatrics, Gynecology, Nephrology, Neurology/Neurosurgery, and Orthopedics in the 2019-2020 "Best Hospitals" issue. Mount Sinai's Kravis Children's Hospital also is ranked nationally in five out of ten pediatric specialties by U.S. News & World Report. The New York Eye and Ear Infirmary of Mount Sinai is ranked 12th nationally for Ophthalmology, Mount Sinai St. Lukes and Mount Sinai West are ranked 23rd nationally for Nephrology and 25th for Diabetes/Endocrinology, and Mount Sinai South Nassau is ranked 35th nationally for Urology. Mount Sinai Beth Israel, Mount Sinai St. Luke's, Mount Sinai West, and Mount Sinai South Nassau are ranked regionally.

For more information, visit https://www.mountsinai.org or find Mount Sinai on Facebook, Twitter and YouTube.

SOURCE Mount Sinai Health System

An ER doctor was charged with abusing his baby. But 15 medical experts say there’s no proof. – NBC News

Posted on January 29, 2020 by Danzig

Dobrozsi hated to leave town on May 6, one month into her maternity leave, but she and her parents had been planning a trip to Washington, D.C., for months. They were taking the boys to an event hosted by the national Spina Bifida Association, to lobby Congress for improved health care funding. Dobrozsi said she had no concerns about leaving their newborn with her husband, a pediatric physician and experienced father.

On the evening of May 8, one of Coxs friends came over to watch the Milwaukee Bucks game. Cox held the baby the entire night, the friend recalled in an interview, doting on his new daughter. It was almost annoying, he said. Like, John, can you put her down so we can watch the game? You could tell he was genuinely in love.

The baby woke up in her bassinet at around 5 the next morning, as she did most days, Cox said. He picked up the baby and held her in bed until she fell back to sleep, he said. Then he made the mistake of getting himself more comfortable.

We were chest to chest, cuddling, Cox said. I distinctly remember thinking, This is nice. I havent gotten this yet with my daughter.

Cox said he was disoriented when he awoke about an hour later to the sound of the babys cry. His heart raced as he came to the realization that his body had shifted, Cox said, and that he was partially on top of her, his weight pressing the babys shoulders together.

At Dr. Al Pomeranzs office later that morning, Cox recounted the same sequence of events that hed described to his wife on the phone that morning, and he shared his concern that hed broken her clavicle. The baby appeared to be moving both arms normally at that point, Pomeranz noted in her medical records, and initial X-rays came back negative for signs of a collarbone injury. But while examining the girl, Pomeranz spotted two tiny marks on the insides of her arms, and another on the middle of her back, according to the records.

Cox hadnt noticed them before then, he said. The marks on her arms could have come from when he picked the baby up abruptly that morning, when he initially thought hed smothered her, Cox told the doctor, but he couldnt say for sure.

Pomeranz, who had helped train both Cox and Dobrozsi when they were medical residents, teared up, Cox recalled, and later, in a letter, he would describe what followed as the most difficult decision of his 38 years in medicine.

Doctors in Wisconsin, as in all states, are legally required to report to authorities when they have concerns that a child may have been abused. Pomeranz told Cox and later Dobrozsi that he didnt have that concern, but he wanted to make sure that he did the right thing, treating them no differently than he would anyone else. So he contacted the hospitals in-house child abuse specialists known as the child advocacy team at Childrens Wisconsin to make them aware of the situation.

Cox tried to stay calm as Pomeranz explained his reasoning. As an ER physician, Cox knew the importance of flagging suspicious injuries. During his fellowship training, hed worked on a research project that aimed to improve the early detection of child abuse in the emergency room. But over the years, hed also grown uneasy with what he described as an aggressive approach by his colleagues in child advocacy anytime a child arrived with difficult-to-explain injuries, especially bruises.

I knew in the back of my mind that this could spin out of control, Cox said. But I dont think I realized just how bad it could get.

Later that day, a child abuse pediatrician, Dr. Hillary Petska, examined the baby, and she, too, noted three small bruises, according to records. Dobrozsi had arrived back in Milwaukee by then and was in the room as Petska looked the baby over. As part of the standard child abuse workup, Petska ordered a slew of additional tests, including full body X-rays and labs to screen for bleeding disorders that could lead to easy bruising.

The baby screamed as a hospital staff member pricked the bottom of her foot and squeezed it to draw a blood sample that afternoon, Dobrozsi recalled. Finally Dobrozsi was cleared to take her home.

That night, after Cox and Dobrozsi had gotten the kids to bed, two investigators with Child Protective Services knocked on their front door. They asked to see the baby.

Cox hadnt expected the state to get involved so quickly, he told them, given that the hospital hadnt even completed its evaluation. Dobrozsi got the baby out of bed and undressed her. The child welfare workers examined her arms and back, looking for the reported bruises.

Well, Cox and Dobrozsi recalled one of the workers telling them before leaving that night, those are underwhelming.

Small bruises might seem insignificant, but to Dr. Lynn Sheets, they sometimes signal something more ominous. As the top child abuse pediatrician at Childrens Wisconsin and the medical director of its child advocacy team, Sheets has gained national acclaim for her work studying the ways small, seemingly trivial injuries can foreshadow serious abuse.

Sheets has preached the same message for years: If doctors can better recognize early warning signs of abuse, they might be able to save lives. Her 2013 research into these sentinel injuries a term she coined and popularized found that nearly a third of seriously abused children had previously suffered minor injuries, such as bruises.

In 2019, the research became the inspiration for federal legislation now working its way through Congress. The bill would provide funding to perform exhaustive medical examinations, including full-body X-rays and CT scans, on infants who come to hospitals with bruises and other common injuries.

One of the things we realized is, if you just call it a bruise, everyone has bruises," Sheets told The Milwaukee Journal Sentinel last year, after the bill was introduced. Everyone thinks about it as a minor injury, including the doctors, including child welfare. So we needed to change the way people are thinking about these minor injuries in young infants.

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But some doctors, defense lawyers and parental rights advocates have criticized the effort to redefine minor injuries as beacons of future danger. They warn that it opens the door for increased prosecutions of innocent families, especially people of color, who are more likely to be flagged as abuse suspects, and parents of children with rare disorders that predispose them to bruising.

In interviews, several emergency room doctors at Children's Wisconsin said theyve seen firsthand the unintended consequences of the philosophy.

I agree that children are abused and that we need to protect them, one physician said. But it seems theres a total disregard for the harm done to the child and family when theres a complete medical workup done and charges brought when its not really abuse.

Several Childrens Wisconsin physicians said they had concerns about the work of child advocacy specialists prior to Coxs ordeal, but after watching the handling of his case, they are seeing many of the teams practices in a new light.

For example, several staff members told a reporter that child abuse pediatricians at the hospital routinely review medical records of children whove been admitted to the ER even when no doctor has asked for their opinion and then weigh in on whether Child Protective Services should be called. Sometimes child abuse specialists send notes scolding ER physicians for failing to flag children, even though those physicians did not believe the child had been abused, several doctors said.

In at least three instances, according to interviews and two sets of internal messages reviewed by a reporter, some child abuse pediatricians have gone so far as to ask treating physicians to edit a childs medical records, deleting or amending passages in which they had initially noted little concern for abuse.

In one such case, Sheets suggested amending a medical record because she was concerned that, without language noting a concern for abuse from the initial treating physician, Child Protective Services would stop investigating, according to messages between doctors.

Sheets did not respond to an email from a reporter, and hospital officials did not respond to detailed written questions about internal concerns raised by members of the medical staff.

Diane Redleaf, a family law attorney in Illinois who wrote a paper on the ethics of expert physician testimony in child abuse cases, said the practice of editing medical records to assist with state child welfare investigations is unethical and shocking.

Doctors are not supposed to be advocates for a result, especially a legal result; doctors are supposed to be providing medical information, Redleaf said.

Keith Findley, a professor at the University of Wisconsin Law School who co-founded the Wisconsin Innocence Project, said that when physicians work in concert to shape the message sent to investigators, it undermines the legal systems access to full truth.

What theyre really doing is shaping the evidentiary record, and in fact deliberately hiding from the legal system inconsistent opinions that might be useful to the legal fact finders who are working to determine what actually happened, Findley said. Its deeply problematic.

Sheets and her team have shaped more than just hospital practices; her vigilance for seemingly minor injuries has also permeated the child welfare and criminal justice systems in Milwaukee.

After Child Protective Services workers initially visited Cox and Dobrozsi at their home, one of them noted in her written report that the babys bruises were very small and unremarkable, according to a motion filed by Coxs lawyer in Milwaukee County Circuit Court arguing that the state lacked enough evidence to bring charges. But, due to a concern about sentinel injuries, Cox and Dobrozsi later learned, the workers Child Protective Services supervisors determined that additional action needed to be taken.

The next morning, Cox received a call from a different case worker, Jessica Barber, who explained that higher-ups at Child Protective Services and the hospital had decided that the baby needed to immediately undergo an additional evaluation with another child abuse specialist, Cox said. And this time, she told Cox, neither he nor his wife could attend. Cox was at work and relayed the message to his wife.

An agency spokesman declined a reporters request to interview Child Protective Services staffers who worked on Coxs case.

Barber showed up at their home 20 minutes later. Dobrozsi pleaded with her: Why cant I come? I dont understand why this is happening.

Barber told her that it was normal procedure for parents to be blocked from attending appointments with child abuse specialists, Dobrozsi recalled. Later, she said Barber gave a different explanation: They werent allowed to attend, because as doctors, they would be in a position to ask hard questions and challenge the assessment.

As a pediatric oncologist, that didnt sound right to Dobrozsi. One of the most important steps in making an accurate diagnosis is talking to patients or their parents. How could someone assess the credibility of Coxs story if they didnt bother to hear it?

Barber asked Dobrozsi if she had her consent to take the baby.

It sounds like I dont have a choice, Dobrozsi remembered saying.

She cried as Barber loaded the girl into her car and drove away.

Nearly two hours later, Barber called Dobrozsi and told her she could come meet her at the hospital. As she sat with the caseworker that afternoon, awaiting additional test results, a police officer entered the room and explained that someone at the hospital had reported a baby with unexplained injuries.

Dobrozsi was stunned. She said she turned to Barber and demanded to know what had happened during the medical examination that morning.

It turns out, a nurse practitioner on the hospitals child abuse team, Rita Ventura, had examined the baby and concluded that her body was covered in more than a half dozen bruises, including along the backs of her arms.

Those are birthmarks! Dobrozsi remembers telling Barber. Plus, she said, none of the doctors whod examined the baby a day earlier had noticed any other bruises.

Det. James Donovan spent hours questioning both Dobrozsi and Cox separately at the hospital that Friday afternoon, they recalled in an interview. He also reviewed the medical findings and examined the baby. Afterward, he asked to speak privately with one of the Child Protective Services caseworkers.

Donovan told the worker he wasnt sure why they were even out there as he did not see anything criminal, the worker wrote in her notes, according to a motion filed as part of the criminal case.

A spokesman for the Wauwatosa Police Department declined a request to interview Donovan, citing a department policy of not commenting on pending criminal matters.

Despite the officers initial reservations, Cox and Dobrozsi entered into a safety agreement with Child Protective Services that evening. While child welfare workers and police continued their investigations, Dobrozsis parents would move in with them and supervise them at all times when they were with their children.

If they just followed the rules and continued to tell the truth, Cox and Dobrozsi told themselves, everything would be OK.

Two days later, at the urging of Pomeranz, their pediatrician, they took the baby to see a pediatric dermatologist at Children's Wisconsin, Dr. Yvonne Chiu, for a second opinion.

Chiu examined the girl and reviewed photos taken during her initial doctors visit with Pomeranz on the morning of the incident. Chiu, who as a dermatologist is an expert in differentiating bruises from other skin marks, concluded that the baby had suffered only the three small bruises Pomeranz had originally noticed, which had mostly resolved over the weekend. The other marks on her body were birthmarks or other benign lesions that are common in newborns, Chiu wrote.

Chiu believed that the two arm bruises could have been the result of the way Cox picked the baby up when he was panicked. And the bruise on the babys back appeared to match Coxs wedding band and was located in the spot where he normally patted her back while burping her, according to Chius report.

Like Pomeranz, Chiu had no concerns that the girl had been abused. She shared her findings with Child Protective Services and police. Later, six other dermatologists reviewed the medical records and agreed that Ventura had been mistaken when she reported widespread contusions.

But when Cox and Dobrozsi later filed a grievance with Childrens Wisconsin administrators over Venturas finding, child advocacy team leaders responded that they were better equipped than dermatologists in these matters: Differentiating accidental from inflicted injuries is the primary focus of child abuse medical professionals and is not usually a primary focus of dermatologists, they wrote.

Kate Judson, a lawyer in Madison and executive director of the Center for Integrity in Forensic Sciences, reviewed the case at NBC News request and said it follows a familiar pattern that shes observed over the years. Child abuse specialists, she said, sometimes overstate their expertise while minimizing the expertise of other subspecialists.

Whats striking to me is that you have these leaps in logic that are unsupported, Judson said. So you have a nurse practitioner here saying, Well, I can determine with accuracy and certainty that this bruise was intentionally inflicted. And then you have a dermatologist, who is unquestionably an expert in the examination of skin lesions, whos saying, Well, this isnt even a bruise.

Authorities in Milwaukee took Venturas word for it.

On May 24, two weeks after the initial incident, Child Protective Services workers returned to Cox and Dobrozsis home. They had come to take the baby, and this time they wouldnt be bringing her back.

Cox and Dobrozsi said they pleaded with the caseworker, Amy Scherbarth, the same one who they said weeks earlier had described the babies injuries as underwhelming. What about the dermatologists report? Shouldnt her opinion carry more weight than a nurse practitioner who never heard Coxs account of what happened or talked to anyone whod cared for the baby?

Why couldnt Dobrozsis parents continue to supervise them? What had changed?

Scherbarth said she understood the dispute over whether some of the babys birthmarks had been confused for bruises, Dobrozsi recalled, but the worker said nobody could explain the bruise on the bottom of the babys foot.

What bruise? Dobrozsi demanded. There was never a bruise on her foot.

Youre taking my child from me and you cant answer any of my questions, Dobrozsi remembered saying.

And then she looked me in the eye and said, Youre not her mother.

Dobrozsis parents and Cox were all present and attested to her description of the exchange.

Afterward, Dobrozsi asked her mom to shove some diapers and formula into a bag. Dobrozsi grabbed the babys stuffed unicorn and a pacifier. Then she and Cox sat on the floor with her and took turns holding her as they sobbed.

We told her that we loved her, Dobrozsi said, and that we would do everything we could for the rest of our lives to try to get her to come home.

A few minutes later, she was gone.

Night after night, for weeks afterward, Dobrozsi would wake up in a panic, terrified that her children were in danger. She would get out of bed to check on each of the boys, placing her hand on them as they slept.

Then she would go to the babys room and stand over her empty crib, before curling up on the nursery floor and crying herself to sleep.

Because the adoption had not yet been finalized, Cox and Dobrozsi were not granted the same legal rights as other parents. They could not visit the baby, and the state did not allow her to stay with family members.

During the day, between their busy work schedules and taking care of their boys, Cox and Dobrozsi tried to fight the allegations. They hired a lawyer and began digging through medical records.

Dobrozsi said she soon identified a series of mistakes and misstatements by Ventura, the nurse practitioner whod reported numerous bruises to authorities, and Petska, the child abuse pediatrician whod initially seen the baby a day earlier.

Neither Ventura or Petska responded to messages seeking comment.

They both inaccurately described Coxs account of what happened not surprising, Dobrozsi said, considering that neither of them ever spoke with him in person.

They both also wrongly reported that the baby had suffered an earlier bruise on her face, twisting an account provided by Dobrozsi, who at one point mentioned noticing a mark on the girls face weeks earlier that lasted just a few hours, after shed slept on a pacifier clip. Dobrozsi said she never described the earlier mark as a bruise, but highlighted it as evidence that the babys skin was sensitive.

And most notably, both Petska and Ventura had incorrectly reported that the results of the babys initial lab tests were negative for a bleeding disorder that could cause easy bruising. Dobrozsi, who as a pediatric hematologist oncologist is an expert in assessing children for bleeding disorders, was outraged when she read the test results.

The labs indicated a delay in how quickly the babys blood formed clots, which suggested a possible bleeding disorder and should have resulted in a referral for more extensive testing, according to four hematologists, including the medical director of the Comprehensive Center for Bleeding Disorders at Childrens Wisconsin, who have since reviewed the records.

Instead, Petska reported to authorities that the blood tests were normal. And Ventura wrote, Results available at this time indicate no concern for a clinically significant bleeding disorder.

Cox and Dobrozsi have shared the expert hematology reports with Child Protective Services, the county prosecutor and hospital administrators, but as far as they know, no follow up testing has been completed.

The girl did undergo additional X-rays in the weeks after Child Protective Services took her, and one of the scans seemed to bolster Coxs case. It showed a healing collarbone fracture, not only confirming the initial concern that prompted Cox to take the baby to the doctor, but according to four orthopedic surgeons who have since reviewed the medical records, validating the account he gave to authorities.

But child abuse specialists and state authorities saw it differently, according to documents filed as part of the criminal case. They concluded that the broken collarbone was further evidence of abuse, seeming to contradict medical literature on the subject. Numerous published studies say collarbone fractures are common in infants and are not particularly concerning for abuse.

Honestly, wrote Dr. Matthew Wichman, one of the orthopedic surgeons who reviewed the medical records, this all seems quite preposterous.

In response to complaints filed last year by Cox and Dobrozsi over the hospitals handling of their case, Dr. Michael Gutzeit, chief medical officer at Childrens Wisconsin, defended the work of the hospitals child abuse specialists.

In this rapidly unfolding situation, a good faith effort was made to protect the child, individuals involved in the process and the rights of those involved, Gutzeit said in the Aug. 1 letter. It is my opinion that all involved in the case have attempted to provide compassionate, competent care focussing on the best interests of [the child].

The most unsettling error wasnt revealed until November, five months after the state had taken the baby. Thats when Child Protective Services finally provided Cox and Dobrozsi with photos that Ventura took during her examination, which inexplicably had been stored outside of the childs medical records and shared only with investigators.

Dobrozsi and their lawyer scrolled through the images on his computer. Her heart sank when they reached the picture of the bottom of the babys foot.

The child welfare worker had been right; there was a bruise on the babys heel. And once Dobrozsi saw it, she knew immediately how it had gotten there.

Ventura initially had a hunch, telling Child Protective Services that the bruise could have been the result of a heel prick, according to a motion filed by Coxs lawyer in his criminal case. But Ventura said that was an unlikely explanation since it had been a month since the baby had blood drawn for her newborn screening, according to the motion.

If Dobrozsi had been allowed to attend the appointment, she could have helped Ventura solve the mystery. Shed been in the room, just a day earlier, when a hospital worker pricked the babys foot to collect a blood sample ordered by Petska the same lab work that pointed to a potential bleeding disorder, but that doctors failed to read correctly.

Dobrozsi cried, angry at herself for not making the connection sooner.

The injury that a Child Protective Services worker cited as the primary basis for taking her baby had been inflicted, not by Cox, but by staff at Childrens Wisconsin.

In mid-January, Cox was notified that despite the outside medical opinions, despite the repeated mistakes by medical staff, despite the fact that investigators never even interviewed the friend whod been with him just hours before the incident the county was preparing to file criminal charges.

Cox was booked at the county jail on Thursday and released.

Read this article:
An ER doctor was charged with abusing his baby. But 15 medical experts say there's no proof. - NBC News

Health care news to follow in 2020: UT Health Austin expands, Dell Medical School offers new program – Community Impact Newspaper

Posted on January 29, 2020 by Danzig

Dell Medical School will add a new program in the fall 2020 semester, while UT Health Austin will open an ophthalmology and its Ambulatory Surgery Center in 2020. Jack Flagler/Community Impact Newspaper

In 2020, UT Health Austin will continue its growth by opening an ophthalmology clinic and its Ambulatory Surgery Center, adding two to the 17 specialty clinics now offered.

Additionally, UT Health Austins Multiple Sclerosis clinic will relocate to the first floor of the Health Transformation Building this year.

Meanwhile, beginning in August of 2020, the University of Texas will begin offering a one-year masters program in Design in Health. The program is offered jointly through UTs College of Fine Arts and Dell Medical School.

Our health care system is intrinsically flawed, and we need a new generation of care providers and design thinkers who can creatively solve health cares most wicked problems from the inside, said Stacey Chang, executive director of Dell Medical Schools Design Institute for Health, in a media release. Applications for the program are open through May 2020.

Street Medicine program launches at Oakland University William Beaumont School of Medicine – News at OU

Posted on November 24, 2019 by Danzig

Students from Oakland University William Beaumont School of Medicine are taking to the streets of Pontiac through a new program aimed at helping individuals who are homeless and need medical care.

OUWBs Street Medicine program the first of its kind in Oakland County begins Friday, Nov. 22, when the first group of students will be helping those in need at the Hope Hospitality & Warming Center in Pontiac.

More than 70 OUWB medical students attended the programs orientation on Nov. 15 the culmination of about two years of work led by third-year OUWB students Lexie Ranski and Tori Drzyzga.

Ranski said the intent is for Street Medicine to be a permanent OUWB program.

The benefit that this is going to bring to people in the community is going to be huge, Ranski said. Weve been working so hard on this. Its going to be amazing.

Drzyzga said it feels surreal to be on the verge of launching the program. The two M3s have been working on developing the program since October of their first year at OUWB.

Health care is not a privilege but a right for everyone to have, Drzyzga said. If we can bring it, at least someones getting it to them.

Were helping in any way we can, she added.

Meeting a need

By definition, the concept of street medicine is a collaboration of health and social services that address the unique needs and circumstances of the unsheltered homeless. Today, programs exist in more than 85 cities and 15 countries across five continents.

Ranski and Drzyzga were first exposed to street medicine while they were undergrads at Wayne State University. That program focuses on people who are homeless in Detroit.

We fell in love with serving people experiencing homelessness and working with the underserved, Ranski said. I was like Wow, when I go to med school I really want to do this, too.

The duo saw an opportunity to start a program at OUWB almost as soon as they started attending the school. Ranski said they identified a significant need in Pontiac a city about 10 minutes west of OUWBs Rochester campus.

A strong need exists for such a program in Pontiac, said Jason Wasserman, Ph.D., associate professor, Department of Foundational Medical Studies and Department of Pediatrics, OUWB.

Pontiacs been hit every bit as hard as Detroit with factors like the declining manufacturing industry, massive inflation that began in the 1970s, and, especially, declines in affordable housing, said Wasserman, who serves as advisor to OUWBs Street Medicine program.

All of these factors exacerbate the problem of homelessness and Pontiac has faced all of these problems, he said.

Wasserman said it makes sense that the idea of an OUWB Street Medicine program was met with enthusiasm by various organizations that work with the homeless population in Pontiac.

Those organizations included Oakland County Homeless Healthcare Collaboration, a group of community partners led by the Oakland County Health Division who serve homeless and vulnerable populations to discuss their experiences, identify concerns, share ideas, and develop a plan to address the needs of these clients.

Another organization that welcomed OUWBs Street Medicine program is the Gary Burnstein Community Clinic, a Pontiac-based nonprofit that provides free medical care to the uninsured.

The clinic will serve as a home base for the street medicine program. Further, the program will use the clinic for storage as well as its emergency medical records (EMR) system for documenting care provided to patients.

Im ecstatic about ittheyve been working on this for so long, said Justin Brox, M.D., executive director of the Gary Burnstein Community Health Clinic, who attended the orientation (see photo). Its going to meet a big need in the community.

Other organizations involved in sponsoring or contributing to the program are Beaumont Health and employees at Meridian Health Plan of Michigan. Additionally, OUWBs Street Medicine program has received grants from Blue Cross Blue Shield of Michigan, and a Community Service Mini-Grant from Compass, OUWBs department for community engagement.

Program origins

Wasserman said Ranski and Dryzyga are the third group of students who have presented the concept of a street medicine program at OUWB. Based on their commitment and passion for the project early in the process, Wasserman said he knew they had a real shot at getting it done.

That was important, he said, because he knew it would require a substantial amount of work and effort.

Its a complex thing for an institution to back for a number of reasons, he said. They primarily need to make sure students are safe, and that they are conducting themselves in a way that represents the institution well and ethically.

I think (approval of the project) is a testament to what Lexie and Tori built out and how they put this all together, including drawing on best practices of the national organization, Wasserman said.

Ranski has served as a member of the Street Medicine Institute Student Coalition (SMISC), the student portion of the National Street Medicine Institute. She also recently attended the International Street Medicine Symposium in Pittsburgh.

Those experiences, along with her and Dryzygas previous exposure to street medicine as an undergrad, have prepared them to deliver a meaningful street medicine program, Ranski said.

In short, they know it involves much more than simply finding people who are homeless.

(People who are homeless) dont utilize a lot of resources in the community, dont stay in the shelters, dont use clinics, are very shy of the medical system in fact, theyre not very trusting of the medical system, she said. Thats what street medicine is its really going out and meeting people where they are, with what they have, and listening to their priorities and what they want.

Building a program

Initially, a team of four OUWB students will go out with a physician and representatives from Projects for Assistance in Transition from Homelessness (PATH), a street outreach team that is part of Community Housing Network and also works to help people who are homeless.

Its a good connection for OUWBs Street Medicine program because (PATH representatives) know the streets, where people are going to be, and already have established relationships, Wasserman said. We can piggyback on what theyve already built.

Teams will provide acute medical care, and help individuals with basic needs like clothing and food. Theyll have over-the-counter medications, such as ibuprofen, aspirin, Benadryl, Sudafed, and Claritin, and be able to provide other services, like wound care. (They will be identified by wearing shirts like the one in this photo featuring Ranksi and OUWB student Andrew Lee.)

Early sessions in the program will be held at Hope Hospitality & Warming Center as a way of introducing OUWBs program to the homeless community. Once the presence of OUWBs Street Medicine program is established within the community, teams will move beyond the shelter and into the streets.

Ranski said as more physicians come on board with the project, more teams will be able to provide care.

As the program consistently provides care and grows, Ranksi and Dryzyga said they expect the value of the program will increase for all involved.

You really form relationships with people when you see them every week, Ranski said. You get to know their names, hear their stories about why theyre in the position theyre in.

I would hear all these horrible experiences they had when they went to a physician or ER or that they couldnt go to a clinic because there arent a lot in the city, she said. I felt it was not right that there are these disparities for people who cant control their situations. I wanted to give back in a bigger way that wasnt just handing out hot coffee.

Dryzyga added that when people who are homeless receive care from OUWBs Street Medicine program, it has the potential to have an impact larger than the moment.

I think it helps bridge the gap between this population and the medical system, she said. Because if they can at least trust somebody, then maybe when were not there in the future they can have some trust in the health care system.

Street Medicine Pontiac at OUWB has a Facebook page at @streetmedicinepontiac.

For more information, contact Andrew Dietderich, marketing writer, OUWB, atadietderich@oakland.edu.

Follow OUWB on Facebook, Twitter, and Instagram.

Excerpt from:
Street Medicine program launches at Oakland University William Beaumont School of Medicine - News at OU

Doctors are turning to YouTube to learn how to do surgical procedures, but there’s no quality control – CNBC

Posted on November 24, 2019 by Danzig

When Dr. Justin Barad was a medical resident, he would often encounter a problem he'd never managed or be asked to use a device without much training.

So he'd turn to YouTube.

Barad, who completed his surgical training at UCLA in 2015, said YouTube has become a fixture of medical education. He'd often get prepped by watching a video before a procedure. Sometimes he'd even open a YouTube video in the operating theater when confronted with a particularly challenging surgery or unexpected complication.

"I don't know a surgeon who hasn't had a similar experience," said Barad, who has now started a surgical training company called Osso VR.

CNBC found tens of thousands of videos showing a wide variety of medical procedures on the Google-owned video platform, some of them hovering around a million views. People have livestreamed giving birth and broadcast their face-lifts. One video, which shows the removal of a dense, white cataract, has gone somewhat viral and now has more than 1.7 million views. Others seem to have found crossover appeal with nonmedical viewers, such as a video from the U.K.-based group Audiology Associates showing a weirdly satisfying removal of a giant glob of earwax.

Doctors are uploading these videos to market themselves or to help others in the field, and the amount is growing by leaps and bounds. Researchers in January found more than 20,000 videos related to prostate surgery alone, compared with just 500 videos in 2009.

The videos are a particular boon for doctors in training. When the University of Iowa surveyed its surgeons, including its fourth-year medical students and residents, itfound that YouTubewas the most-used video source for surgical preparation by far.

But residents and medical students are not the only ones tuning in. Experienced doctors, like Stanford Hospital's vascular surgeon Dr. Oliver Aalami said he turned to YouTube recently ahead of a particularly difficult exposure.

"It was helpful, but I kept thinking that some of these videos should be verified," he said, "A bit like Twitter and its blue badges."

There's one problem with this practice that will be familiar to anybody who's searched YouTube for tips on more mundane tasks like household repairs. How can doctors tell which videos are valid and which contain bogus information?

For instance, one recent study found more than 68,000 videos associated with a common procedure known as a distal radius fracture immobilization. The researchers evaluated the content for their technical skill demonstrated and educational skill, and created a score. Only 16 of the videos even met basic criteria, including whether they were performed by a health-care professional or institution. Among those, the scores were mixed. In several cases, the credentials of the person performing the procedure could not be identified at all.

Even more concerning, studies are finding that the YouTube algorithm is highly ranking videos where the technique isn't optimal. A group of researchers found that for a surgical technique called a laparoscopic cholecystectomy, about half the videos showed unsafe maneuvers.

Medical experts say this content hasn't been particularly well curated, in part because it's an expensive process. Massive-scale internet platforms like YouTube limit expenses by stressing that they are a platform with some basic rules, and they don't vet or add editorial notes to content. YouTube doesn't claim to be accredited for medical education, and therefore can surface content based on popularity and not on quality.

YouTube did not return a request for comment about its surgical content. Google Health declined to comment.

One solution would be paying a group of doctors to do the work of vetting surgical videos, suggests Dr. Joshua Landy, a Canadian physician who developed an Instagram-like service for doctors called Figure 1. "You'd need to be experienced to distinguish between the surgeries done properly and the technique is the most up-to-date and safe," he said.

For patients watching the surgeries to get a sense for what happens once they go under, that kind of heavy-handed curation might not be necessary. But it's a pressing need for inexperienced physicians, who rely on the videos to fill gaps in their medical education before they perform the procedures.

"Seeing cases is what makes you better at medicine because there's always unusual things you'll have to navigate," said Landy. "So many doctors will watch these videos over and over again for thousands of hours."

Google seems to be aware of the problem. But so far, the company has only made some small steps to provide some rules around graphic medical videos. Those uploading the videos must share descriptive titles, so users know what they're in for, and the purpose must be to educate rather than to offend or surprise a viewer. One thing that's not allowed, for instance, is footage from a procedure featuring open wounds where there's no clear explanation to viewers.

But the company might deviate from its hands-off policy to do more in the coming months. Google's vice president of health, David Feinberg, noted at a recent medical conference in the fall that a lot of surgeons are flocking to YouTube. He implied, without sharing specifics, that his team would look to do a better job of managing the content as part of its broader focus on combating health misinformation across Google.

Medical experts say they're more than willing to work with YouTube to help curate medical content.

Many academic medical centers, notes Jefferson Health's chief executive Dr. Stephen Klasko, are still using the same, age-old methods to train doctors and have not evolved for the digital age.

"We recognize that technology will transform health care, but what member of any medical school faculty understands things like coding or social media at the level of their students?" he said.

Klasko sees potential for YouTube in medical training. Moreover, he notes, surgeons are increasingly being asked to use sophisticated hardware that requires a lot of additional training. One particularly popular type of content on YouTube is an instruction manual for Intuitive's da Vinci surgical robots, which can take months of practice to master. (This one, on how to suture a grape with a da Vinci, is particularly special.)

"These surgical robotics companies will go out of the way to credential people quickly," said Klasko. "But it's a tough skill to pick up."

In the interim, some doctors, like Jefferson Health's chief medical social media officer, Dr. Austin Chiang, who works for Klasko, recommend that their peers check whether a video is associated with a well-regarded hospital or medical society before they watch it or recommend it to others.

In the long run, he said, YouTube should promote this content over others. "One thing Google could do tomorrow is partner with these official societies," he said.

Follow @CNBCtech on Twitter for the latest tech industry news.

The rest is here:
Doctors are turning to YouTube to learn how to do surgical procedures, but there's no quality control - CNBC

MD Program Admissions Requirements – Katz School of Med

Posted on October 10, 2019 by Danzig

An individualized holistic review of each complete application includes a variety of objective and subjective factors. The academic record, the college attended, MCAT scores, recommendations, extracurricular activities, work experience, medically related experience, and community service activities are all taken into account when selecting candidates for interview. While not required, many students have participated in research activities.

There is no academic cutoff for consideration.

Applicants should demonstrate preparation for the rigors of medical school and competency in the sciences achieved through a broad range of science coursework and the MCAT exam. While there are no absolute course requirements, it is recommended that students complete coursework in Biology, Chemistry (both general and organic), Biochemistry, Physics, Psychology and Sociology. The Office of Admissions will only evaluate courses completed at a US or Canadian University.

If recommended coursework in Biology, Chemistry or Physics has been completed online, at a community college or through a study abroad program, we prefer to see classroom-based, upper-level science coursework in that discipline. Similarly, we prefer to see classroom-based, upper-level science coursework in Biology, Chemistry or Physics if students complete entry-level coursework in these subjects using AP credits.

Applicants must submit the Medical College Admissions Test (MCAT) of the Association of American Medical Colleges; LKSOM will consider applicants for entering 2020 with MCAT scores from 2017, 2018, and 2019. The last MCAT we will consider for the Entering 2020 application cycle is September 14, 2019.

Applications are considered with the most recent MCAT results (both section and total).

Applicants have the option to provide SAT & ACT scores and upload copies of the scores via the supplemental application.

MCAT Prep: Learn more about Temple Universitys MCAT Biochemistry Online course.

The supplemental application is used to help us identify your unique interest in Lewis Katz School of Medicine at Temple University.An $90 non-refundable application fee is collected online when you submit your LKSOM supplemental. The supplemental application fee is waived for candidates who were approved for the AAMC FAP program prior to submitting an AMCAS application.

Through your supplemental application, applicants can:

LKSOM participates in the AMCAS Letters of Evaluation Program. Letters can be sent to AMCAS through the AMCAS Letter Writer Application or Interfolio. All letters should be on letterhead and contain the letter writer's signature.

If LKSOM is designated as a recipient of the letter on the AMCAS application, AMCAS will release the electronic copy to LKSOM. All letters designated for LKSOM must be received before your application will go under review.

LKSOM will consider letters of recommendation from a premedical committee, a packet from a school letter compilation service, or three (3) individual letters.

If submitting a compilation packet or individual letters, we prefer, but do not require, two (2) letters from professors with whom you completed course work from the AMCAS course classification of Biology, Chemistry, or Physics.

At any point in the application process, you are welcome to submit additional letters to support your application and encouraged to use the AMCAS letter service to transmit these letters.

Applicants who indicate that they were the recipient of an institutional action on the AMCAS application are required to contact the school where the institutional action occurred to provide an official statement. This document should outline the details of the event and the outcome of the institutional process.Applicants with an institutional action will not be placed Under Reviewuntil this letter has been received.

Applicants who receive an institutional action after the AMCAS application has been submitted are required to send a letter to the Office of Admissions with details of the event. We will only accept Institutional Action statements mailed directly to our office from the appropriate institutional official (Dean of Students, Judicial Officer, etc.). A statement about the Institutional Action in your pre-health committee letter does not meet our requirement.

All applicants to the MD program are required to complete an online assessment (CASPer), to assist with our selection process. CASPer is an online, video-scenario based test which assesses for non-cognitive skills and interpersonal characteristics that we believe are important for success in our program and will complement the other tools that we use for applicant selection.

Applicants can register for the US Professional Health Sciences test (CSP10101) atwww.takeCASPer.com. If you have any questions about the test, contactsupport@takecasper.com.

CASPer test results are valid for one admissions cycle.LKSOM will consider your 2020 application with CASPer tests taken between May 14, 2019 and January 9, 2020.

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MD Program Admissions Requirements - Katz School of Med

Conversations: Medicine and mentoring with Joan Smith-Maclean – Davis Enterprise

Posted on October 28, 2019 by Danzig

Davis physician Joan Smith-Maclean has lived most of her life in town and is a leader in training future doctors. Robin Affrime/Courtesy photo

Joan Smith-Maclean is a popular physician in town. She has lived in Davis almost all of her life and has been a leader in training future physicians.

Robin: Where were you born?

Joan: I was actually born in Fort Campbell, Ky. My dad was a dentist in Davis and he was called to serve in the Korean War. When I was 4 months old, my family moved back to Davis and became longtime residents here. They lived the rest of their lives in Davis. I also have a younger sister, Janet.

What schools did you go to?

I went to Central Davis Elementary through fourthgrade. Then I attended North Davis Elementary for two years. Davis Junior High was on both sides of B Street when I attended there. Then it became Emerson Junior High. Half of the students went to Emerson and half went to Holmes Junior High. The school is now administrative offices on one side, and City Hall on the other side of B Street.

Everybody went to Davis Senior High School.

Tell us about your medical training and desire to be a physician.

I always knew that I wanted to be a doctor, ever since I was little. I liked the sciences. I went to UCD undergrad. Then I continued on to get a masters degree in exercise physiology and went to Michigan State because they had a program in this.

I worked in cardiac rehab for three years in Michigan and just knew that it was now or never to go back to train as a physician. I went to medical school at Michigan State. When I graduated, I applied to several residency programs, including UCD. That was my first choice, particularly since I already had a baby and my mom and dad were in Davis.

I did get accepted and returned to go to the UCDMC Family Medicine Residency Program. I chose family medicine because I like pediatrics, internal medicine and OB. In family medicine, you get to do everything. You also get to know your patients and often the whole family.

We met when you were chief resident in family medicine and supervised medical students at the Davis Community Clinic. You were wonderful to work with. You supervised second-year medical students in the evening clinics and volunteered for a few years after. What is the role of a chief resident?

The Chief Resident is a liaison between the residents and faculty, helps with scheduling issues, call coverage issues, educational opportunities and inter-resident issues.

You also are very athletic and in terrific shape. What sports did you participate in at college and what sports do you do now?

At UCD, I participated in gymnastics. I also swam as a young kid. However, I really loved water polo. It was sometimes difficult to find a place to play, because then it was not recognized as a sport for women. Now I swim with the Davis Aquatics Masters.

Tell us about practicing family medicine after residency.

I was lucky to be able to join Joe Scherger and Betty Pattersons family practice. We had offices in Dixon and Davis and were affiliated with Sutter Health. Joe was very interested in starting a residency program here.Instead, he moved to San Diego to start a residency program for a large health care system there.

When he left, he asked me to take over the project of starting the Sutter Health Family Medicine Program which began in 1995. I love teaching and was excited to start a program housed in community-based practices. We now have 21 residents, six in Davis and 15 in Sacramento.

We have been able to recruit many of our fine graduates to practice in our community.

I know that you are involved in leadership positions in Sutter Health.

I was chief of staff at Sutter Davis Hospital for two years. I was on the Sutter Health Sacramento-Sierra Regional Board for 11 years and on the board of Sutter West Medical Group for several years. I am now in my eighthyear on the Sutter Health Board of Directors.

I know that the residency program as well as participation in hospital committees and the Sutter Board take time away from your practice.

Yes, now I am 30% direct patient care and 70% teaching and administration.

Can you tell us a little more about your family.

My husband is Gerry Maclean. He is a building contractor. My daughter, Hayley, is an OB/GYN in practice in Sacramento. She and her family also live in Davis. She had two babies during her residency (also at UCD). My grandsons are now 4 and almost-2 years old.

You must be very proud of her. That is not easy to do, as you know.

Yes, she is exceptional.

Please tell us about your contribution to The Davis Enterprise.

In 1971 during my senior year of high school, I did an internship with The Enterprise. It was like that column no longer exists; it was like Comings & Goings. After I graduated, I became the society editor of the paper for two weeks, while the real editor was on vacation. It was a fascinating experience, covering local events and interviewing new people in town.

What do you like most about Davis?

It was a great place to grow up. The people are wonderful down-to-earth, engaged in the community, caring. So many are well traveled and educated in a variety of fields. We can always learn from each other.

I love our neighborhood as well. We have lived there for 26 years. Davis is in such a great location, with easy access to Lake Tahoe, San Francisco and the Napa Valley. It is a great town to bike in. I also love the Davis Aquatic Masters.

Actually, a lot of the above describes you. You are humble and down-to-earth. You are caring and interesting. You have contributed so much to the health of our community. I am glad to have known you for many years. Thank you for your time.

Robin Affrime is a longtime resident of Davis and a recently retired health care executive. You can reach her at [emailprotected] for comments or suggestions of people you would like to know more about. This column publishes every other month.

Previous Conversations:

Conversations: A view of Davis history with Kathy Cello

Conversations: Skinner has watched community evolve

Conversations: Hoops and social justice with John Pamperin

See the article here:
Conversations: Medicine and mentoring with Joan Smith-Maclean - Davis Enterprise

Talk about it, fight the stigma – SRU The Online Rocket

Posted on November 16, 2019 by Danzig

A graduate of medical school, Alyse Schacter travels to have conversations about mental health and its stigma.

As part of IZE Week, Schacter spoke to more than 20 students in attendance about her mental health journey and how to be open about the conversation.

Schacters mental health hasnt always been a smooth road. Developing significant OCD at the age of 12, Schacter dealt with intrusive impulsions and worries about hurting inanimate objects.

Schacter said her passion about mental health stemmed from her journey with her own mental health. She began traveling at the age of 16 to discuss the mental health stigma.

Schooling was never an easy time for Schacter. She said her intrusive impulsions made her act in ways that would seem odd to her fellow seventh grade classmates.

I would be worried I was hurting the ground when I walked, Schacter said. I would get on my hands and knees and feel the ground, because I felt bad.

Not sure what to do or how to talk to her peers, Schacters mom talked to her classmates about OCD and what Schacter was going through.

While Schacter noted that some friends werent as understanding, many of her classmates were incredibly supportive of her, creating a schedule to give her piggyback rides to class so she didnt have to touch the floor.

Schacters parents preached a culture of openness, encouraging her to talk openly about her struggles to those she became close to.

Not everyones willing to help, but people that are, are fantastic, Schacter said.

Despite setbacks in grade school, Schacter attended adult high school at the age of 19, eventually getting accepted into medical school to work towards her dream of becoming a doctor.

Still practicing opennessabout her mental health, Schacter wondered how she would manage her journey. Going to school to become a doctor, Schacter said she felt ashamed that she was helping other people when she needed help herself.

Looking back, Schacter said that professionals questioned if medical school was the right option for her with her OCD.

Its like a trap, Schacter said. Its like theres something inherently wrong with me.

Schacter isnt the only person to carry that mindset. She said that shes open about her struggles because if she doesnt do it, then she doesnt expect others to be open about it.

Schacter understands that sometimes it can be hard to openup to others and believes its because not many people know what to say to someone who is struggling.

Engaging with the campus community is one way that Schacter believes people can become more open. She also emphasized being more aware of those around, thinking about your friends and challenging ourselves to ask how others are doing.

You dont want to deal with it alone, Schacter said. You shouldnt have to.

Although Schacter said there were times during medical school where she felt alone, she had a roommate who supported her throughout her journey.

There was a period during medical school where Schacter was doing poorly and went home, not sure if she would have to leave school. She said she left her room a disaster, but when she returned, her roommate had reorganized and cleaned her entire room.

Schacter said that her roommate wasnt the type of person to verbally ask if Schacter was okay but found that helping Schacter clean was something she could do to help her during her journey.

I dont know if I could have finished medical school without her, Schacter said.

Helping others and being a support system for them is something that Schacter agrees with, but also made sure that students know they need to care for themselves too.

Students in attendance said that they use the resources they preach to others, share struggles with a group of friends and remind themselves that its okay to not be okay.

Schacter said that people rarely sit in silence and think about themselves and how theyre doing. She said its important to remind yourself that its alright to feel bad sometimes.

We try to push emotions aside, Schacter said. But you dont try to push aside a stomachache. You cant.

Similarly to not ignoring or pushing down physical conditions, Schactersaid people need to embrace their authenticity and be real, making it easier to talk about their challenges.

However, asking others to open up may not come easy for everyone Schacter reminded the audience. Some people may reject help, which Schacter said could be a reflection of what theyre going through.

Schacter said that even if people reject approaches of help, it is always important to be kind and check on them.

Anytime you show someone kindness, it becomes part of their DNA, Schacter said. Although from a medical perspective that doesnt make any sense.

Schacter encourages students to not only check in on their friends and classmates, but to become educated on mental health, providing the CDC page on mental health as an excellent choice for resources and information.

We dont have an excuse anymore to not be educated on mental health.

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Talk about it, fight the stigma - SRU The Online Rocket

EXCLUSIVE: Inside look at UIW’s new School of Medicine – WOAI

Posted on August 22, 2017 by Danzig

UIW School of Medicine.JPG

SAN ANTONIO - The newly opened University of the Incarnate Word School of Osteopathic Medicine is already filling a void on the city's South East side.

News 4 San Antonio was given an exclusive look inside.

The School of Medicine is already playing a big role in the South Side renaissance.

"The medical school is ready the students are here," said Precinct 4 Bexar County Commissioner Tommy Calvert.

The campus officially opened a month ago, at Brooks City Base in South East Bexar County.

Commissioner Tommy Calvert says in time, The School of Medicine will have an overall $1.5 billion impact over the next decade, by providing mental and physical health care services to an area, he says has historically been under-served.

"A lot of the amenities we're used to seeing in other parts of town are going to find some parity and that's what we for so many generations have been fighting for," Calvert said.

The area near Brooks City Base is projected to see a large amount of new housing, shops, restaurants, and manufacturing businesses.

"It really is a dynamic mixed use community and the medical school is really the crown jewel," Calvert said.

Leaders at UIW are proud neighbors.

"It's an important opportunity that we have here to really be integrated into this community," said UIW Dean Robyn Phillips-Madson.

Commissioner Calvert says the medical school will help boost economic equality on the South Side, because medical professionals will likely move there.

"When I talk to the developers I say we've got to make homes for the doctors and the nurses so we're boosting the income level in the southern sector," said Calvert.

The School of Medicine will also help ease traffic congestion on the North West side.

"Anything to get rid of some of the traffic," said Larry Milsted. "The traffic is here because the people have to get here."

Larry Milsted drives to the Medical Center twice a month.

"Whatever you need medical-wise it's here," Milsted said.

Commissioner Calvert is already thanking leaders at UIW for expanding access to health care to Precinct 4.

"They're going to see their legacy ripple even bigger than the great legacy they've left at the medical school," Calvert said.

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EXCLUSIVE: Inside look at UIW's new School of Medicine - WOAI

How Much Does Medical School Cost? – ThoughtCo

Posted on May 14, 2019 by Danzig

Everyone knows that medical school is expensive but exactly how much is it? Although tuition varies greatly by year and has significantly increased over the last decade, medical school averages $34,592 per year and $138,368 per degree for in-state students at public schools and upwards of $50,000 per year or well over $200,000 for private institutions as of 2018.

Worse yet, due to the demanding schedule and curriculum of medical schools, students graduating programs in the field often find themselves in debt of over 75% of their tuition. For some, it takes years of working in the field to even out and start benefitting from the hiring paying salaries of professionals with medical degrees.

If you areapplying to medical school, you should first seriously consider your dedication to the field, the time it takes to earn your degree and how prepared you are to manage the debt of medical school in the early days of your residence and professional medical career.

According to the Association of American Medical Colleges(AAMC), the median tuition in 2012-2013 was $28,719 for resident students at public institutions, $49,000 for nonresident students at public institutions, and $47,673 for students at private institutions.With fees and insurance, the cost of attendance is $32,197 and $54,625 for resident and nonresident students at public institutions and $50,078 at private institutions. Overall, the four-year median cost of medical school in 2013 was $278,455 for private schools and $207,866 for public institutions.

This alone is not all that different from others seeking to pursue post-graduate degrees in other fields. However, due to the demanding nature of the medical school and lack of time to make supplementalincome, students often slip into debt during their medical degree program. The median education debt for indebted medical school graduates in 2012 was $170,000, and 86 percent of graduates reported having education debt. Specifically, in 2012 the median debt at graduation was $160,000 at public institutions and $190,000 at private institutions. In 2013, that number rose significantly to over $220,000 median debt.

With residence programs immediately following most medical school programs, recent graduates rarely have a chance to earn a full doctor's salary and it can take upwards of six years for these new medical professionals to clear their debt and start earning a true doctor's salary.

Fortunately, there are a variety of financial aid solutions for students hoping to start medical can seekto help mitigate these costs. The AAMC compiles a helpful list for counselors every year that details scholarship opportunities for medical students, specific to each year of the medical professional's educational career. Among them, the American Medical Association awards start-out scholarships for tens of thousands of dollars a year, including the Physicians of Tomorrow Award.

Hopeful medical students should consult their high school, undergrad, or graduate school counselor or financial aid office for more information regarding scholarships, especially those specific to in or out of state students. Most students who graduate medical school, despite the initial debt, do manage to pay off their student loans by their 10th year in the professional field. So if you have the drive, the patience and the passion to become a doctor, apply for medical school and start your career.

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How Much Does Medical School Cost? - ThoughtCo

UofSC Med School in Greenville, United Way and Prisma Health – 106.3 WORD

Posted on April 14, 2020 by Danzig

Released by Prisma Health.

The University of South Carolina School of Medicine Greenville and United Way of Greenville County are teaming up with Prisma Health to help ensure community partners and healthcare partners have the supplies they need during the COVID-19 pandemic.

Partners are asking the community to help by donating new, unopened supplies and personal protective equipment. Items requested include disinfectant wipes, unopened bottles of bleach, 16-ounce and 24-ounce trigger-spray bottles.

Also requested for donation are surgical masks, N95 or KN95 masks, face shields and ear guards.

The COVID-19 drive-through donations drop-offs will run this Thursday, April 16, through Saturday, April 18, at Greer Memorial Hospital and Patewood Memorial Hospital.

The events will be 11 a.m.-5 p.m. on those days. To protect the donors and student volunteers, collections will be drive-through only.

The donated items should be placed in car trunks, where they will be removed by volunteers wearing masks and gloves.

For medical school students such as Allie Conry, an incoming first-year student, I wanted to be a part of the donations drive-through in order to help support our community-based organizations.

In this unprecedented time of uncertainty, it is important to come together and support our community in whatever way we can.

By helping organize this drive, I hope to give community members a safe way to show their support and know that they can also make a difference in the response to COVID-19, said Conry.

Throughout this crisis, the people of Greenville County continue to step up and ask how they can help, said Meghan Barp, president and CEO of United Way of Greenville County. This supply drive will allow essential community programs to safely continue their work, and help keep our community moving forward, said Barp.

Said Prisma Healths Dr. Alain Litwin, We are reaching out to the public in order to make sure that our community partners have adequate personal protective equipment, including gloves and masks. We really appreciate your donations, said Litwin, vice chair of academics for the Prisma Health-Upstates Department of Medicine.

For more information on Prisma Healths COVID-19 response, visit http://www.PrismaHealth.org/coronavirus.

Stay informed with updates from Prisma Health experts:

Got a story for 106.3 WORD? Contact emily.gill@1063word.com.

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UofSC Med School in Greenville, United Way and Prisma Health - 106.3 WORD

Medical schools incorporate population health to train doctors of the future – FierceHealthcare

Posted on August 18, 2017 by Danzig

More medical schools are incorporating population health into the education of future doctors, including a handful of programs that have radically changed their curricula.

Schools need to do more than create a department of population health or add a few classes, David Nash, M.D., founding dean of the Jefferson College of Population Health at Thomas Jefferson University, the nations first college of population health, told Hospitals & Health Networks.

For instance, Dell Medical School at the University of Texas at Austin has given up on the traditional type of curriculum and designed its program to train doctors to work in a healthcare system focused on population health and the transition away from volume-based or value-based care, according to another H&HN report.

RELATED: No old school for one medical school

Thats part of a trend in medical education to stress health concerns of communities and value-based care. What I see going on around the country is a belated but welcome recognition that this is important. Weve been creating a physician who doesnt understand current market forces. We have to build a different kind of doctor for the future. That means changing the factory floor, Nash said.

Rather than the typical medical school curriculum that involves 2 years of classroom work in basic sciences and 2 years of clinical experience, schools are moving to expose students to patients early on in their studies. At Dell, for instance, students in their second year begin 40-week clinical clerkships where they follow patients from admission to post-discharge.

RELATED: Med school seeks culture change to support trainees after student suicide

Kaiser Permanente is slated to open its medical school in 2019, with a programdesigned so that its integrated system becomes the primary learning tool for students. Our whole design model is based upon taking a medical school and embedding it into our system of care, Marc Klau, M.D, vice dean of education and clinical education, told H&HN.

Its not only new medical schools that are revolutionizing physician education. Schools, both old and new, are making changes to train doctors to work in the changing healthcare environment. For example, starting this year, the University of Vermonts Larner College of Medicine will phase out lectures in favor of whats known as active learning.

Albemarle native earns top medical school scholarship – Stanly News & Press

Posted on August 20, 2017 by Fredricko

An Albemarle native has been awarded the most prestigious scholarship available at East Carolina Universitys Brody School of Medicine.

Lindsey Burleson is one of three students in the medical schools Class of 2021 chosen for the Brody Scholar award, valued at approximately $112,000.

She will receive four years of medical school tuition, living expenses and the opportunity to design her own summer enrichment program that can include travel abroad. The award will also support community service projects she may undertake while in medical school.

Burleson is a 2016 graduate of Western Carolina University Honors College, where she earned a degree in chemistry. She was a student athlete on the WCU Womens Basketball team for four years and a recipient of the Curtis and Enid Meltzer Endowed Scholarship.

Burleson was involved in multiple WCU medical research efforts and volunteered at Blue Ridge Health (formally known as Jackson County Good Samaritan Clinic) throughout her undergraduate education and subsequent gap year.

Burleson has known she wanted to work in healthcare since she was young. During her time at WCU she was given opportunities to explore the clinical and laboratory research side of medicine and credits the experience for helping her make the decision to attend medical school.

She plans to become involved in more research with clinical implications during her time at Brody.

In addition to her love for research, Burleson has another focus when it comes to healthcare.

I am particularly passionate about providing healthcare to women in underserved populations, said Burleson. I someday hope to be able to dedicate a portion of my career to providing free care for women and educating populations on healthcare disparities in rural communities.

Being named a Brody Scholar is a huge honor and I feel blessed to have the support of the Brody Family and their commitment to the students and future physicians of North Carolina, Burleson added. As someone who has attended North Carolina public schools for my entire life, I am consistently blown away and inspired by the willingness of North Carolina residents to educate and mentor their students.

In its 35th year, the Brody Scholars program honors J.S. Sammy Brody. He and his brother, Leo, were among the earliest supporters of medical education in eastern North Carolina. The legacy continues through the dedicated efforts of Hyman Brody of Greenville and David Brody of Kinston. Subsequent gifts from the Brody family have enabled the medical school to educate new physicians, conduct important research and improve health care in eastern North Carolina.

Since the program began in 1983, 137 students have received scholarships. About 70 percent of Brody Scholars remain in North Carolina to practice, and the majority of those stay in eastern North Carolina.

In her spare time, Burleson enjoys cooking and baking and stays active by running and continuing to play basketball.

She is the daughter of Jeff and Kathy Burleson and a graduate of North Stanly High School.

B. J. Drye is editor of The Stanly News & Press. Contact him at (704) 982-2121 ext. 25, bj@stanlnewspress.com or PO Box 488, Albemarle, NC 28002.

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Albemarle native earns top medical school scholarship - Stanly News & Press

Coronavirus or not, these new doctors are matched and ready to work – Houston Chronicle

Posted on March 26, 2020 by Danzig

Andrew Jensen received the email three minutes before 11 a.m.

His fiance Annie Crea gasped in joy: Yeah!

The email contained life-changing information about Jensens future: Where he will spend the next four years in residency as a new medical doctor. Jensen was just one of 40,000 new doctors learning his future on Friday, simultaneously across the country. The event, called Match Day, reveals which institution these doctors are assigned to for their residencies, a commitment that can last as long as seven years.

Jensen, a 26-year-old medical student at Baylor College of Medicine, has matched to stay at Baylor for the duration of his residency in anesthesiology. This means he can remain near his parents who live in Sugar Land, in the same state as Crea, who attends law school in Austin.

I matched with Baylor, my No. 1 choice. This is perfect, I get to stay home, Jensen said as he sat in his parents dining room Friday. Im very relieved. This is exactly what I wanted, and definitely my goal from the beginning.

Pandemic-induced social distance requirements changed Baylors annual ceremony, as well as how students like Jensen feel about entering the health care field at this uncertain point in history. Every new doctors residency begins July 1.

If anything, Jenses said he feels readier to help tackle COVID-19.

Everyone is excited and thrilled about how far theyve come, but were also realizing what were getting into, he said. It goes back to the root of why we got into medicine. We want to do the best we can to help our fellow people. Theres an air of seriousness about what were about to get into, but we are ready for it and prepared.

The medical students want to be part of solutions, said Dr. Joseph Kass Baylors associate dean of student affairs.

Theyre sad this is happening to the world, he said. People who have chosen to join this profession are not scared about the disease from a normal perspective. Theyre more frustrated they cant be part of the solution when people are suffering and the (health care) system is getting overloaded.

Many medical schools, including Baylor, host a celebration for the graduating class. It typically starts with brunch, followed by speeches and, finally, a ceremonial envelope-opening.

On HoustonChronicle.com: Disaster expert: 13 things every Houstonian should know during coronavirus pandemic

The ceremony had to be different this year though, due to of COVID-19, the new coronavirus.

The school hosted a virtual Match Day with pre-recorded speeches by Dr. Paul Klotman, president of the college, Dr. Alicia Monroe, provost, Dr. Jennifer Christner, dean, and Kass.

Jensen, the class president, also offered words of encouragement to his classmates in the video.

(We are) united by the unique and unforeseen circumstances that happened with our class such as Hurricane Harvey, and this coronavirus worldwide pandemic, he said. Today is the day we find the results of all that hard work. We have worked so hard to get to this point, and that should absolutely not go unnoticed.

In the days since campus was cleared for safety, Kass said hes received emails from students asking on what they can do to help from home: tutoring, volunteering, grocery shopping for faculty members or residents who cant go home.

On HoustonChronicle.com: New meds, new fears: Houston coronavirus update from disease expert Peter Hotez

Some come from engineering backgrounds, and all are dynamic, solution-oriented and compassionate, he said.

Im very proud, he said of the 194 students in the graduating class, 191 of whom applied for the match program. Seventy-one matched with Texas programs; 33 with with Baylor.

More than half of the class will become primary care residents, like internists, family doctors and pediatric doctors. The other half chose specialties.

Jensen shadowed doctors in surgical operating rooms between his graduation from University of Notre Dame in 2016 and the start of medical school. It was there he realized he wanted to be a part of a team with one common goal: get the patient through the procedure as safely as possible.

People ask in surgery about going to sleep and not waking up, Jensen said. You are giving someone such power and responsibility over your own body. An anesthesiologist has to acquire trust immediately when they meet someone, so having that skill and ability is fascinating.

Kass remembers opening his Match Day envelope on the campus of Baylors medical school in 2001. He was 33 a non-traditional student after he decided to switch careers.

On HoustonChronicle.com: Match Day 2019 at Baylor College of Medicine

He also matched with Baylor and was able to stay in Houston where he had put down roots with his wife and daughter who was a toddler at the time. Their extended family lived nearby as well, which made the match an even better one.

Its a much bigger deal now; parents and families fly in. In some ways, its a bigger deal than graduation because you find out where youre going to be for the next seven years, Kass said. In college, you get multiple choices. With this, you get assigned to the place; theres no A, B or C.

Not all residencies are the same, but a typical one lasts four to seven years. Some doctors decide to go into their own practice afterward, and some pursue fellowships. But all have M.D. after their name, Kass said.

Each year, he shares a poem for the graduates that he writes based on his knowledge and time spent getting to know them. This years was slightly different: he read the poem virtually rather than on stage.

Lets imagine were in that courtyard, sitting with your families, faculty, mentors and students and everybody here who cheers you guys on, he began. With that visual image, lets get started.

julie.garcia@chron.com

Twitter.com/reporterjulie

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With an Eye to the Future – Duke Today

Posted on March 26, 2020 by Danzig

Kind and supportive classmates. Inspiring mentors. Life-changing interactions with patients. These are all facets of the Duke University medical school experience that graduating students will take with them when they move to their residency programs later this year.

We interviewed five members of the Class of 2020 about their favorite memories from their time at Duke and their aspirations for the future.Match Day 2020 article

Hometown: Rio de Janeiro, Brazil

Specialty: Pediatrics

Match: Emory University

Q: What inspired you to become a doctor?

A: Unlike many of my peers I did not always know I wanted to become a doctor. What first brought me to medicine was my interest in science and the wonders of the human body. At the time I was still quite young and did not yet fully understand that being a doctor involved so much more than that. As I decided to explore medicine volunteering with patients in a clinic by taking their vital signs and initial histories I realized how rewarding it is to be able to help others and to have their trust in such delicate aspects of their lives. I would say the connection I felt with patients is what really made me decided to pursue medicine.A;

Q: In what area of medicine do you hope to practice?

A: This was a bit difficult for me to choose as I enjoyed working with both adults and children in a primary care setting. The decision ultimately came to what brings me most joy, and that is working with children, so I have chosen to go into general pediatrics.

Q: What is your favorite memory from medical school at Duke?

A: Its hard to choose among so many, but if I had to choose a clinical one it would be the birth of a child whose mother I followed in the Centering Pregnancy Program, which is group prenatal care. In this program, health appointments occur throughout pregnancy with the same providers and the same group of other pregnant women. I got to know the patients and families intimately throughout nine months of appointments; therefore, it was a magical moment to be able to not only witness the children I cared for in the womb come to this world but also be there for the families. One particularly rewarding moment was when one of my patients had a labor complication, and I was there to support her. Her partner later told me that when entering the room and seeing the sea of stranger faces he felt comforted by the fact that a familiar one, mine, was there with them.

Q: How do you hope to impact patient care and/or research in your career?

A: Im originally from Brazil. My family and I moved here when I was 18, and my mother is not fluent in English. As a result I have accompanied her to many health appointments. Watching this once fierce and independent woman become helpless in the face of a health care system not designed for non-English speakers was what first made me realize I wanted to enter healthcare to serve the Hispanic community and non-English speakers. As I learned more about health disparities and got interested in the longitudinal aspect of primary care I knew I wanted to work in general pediatrics helping the Hispanic community with many of the challenges they face in accessing care.

Hometown: Stanton, California

Specialty: Neurosurgery

Match: Massachusetts General Hospital

Q: What inspired you to become a doctor?

A: Unlike some of my peers, I never experienced the Eureka effect. While I cannot pinpoint a particular moment when medicine became my purpose, I have vivid memories and deep admiration for the exceptional physician role models, remarkable people, and special relationships that have iteratively guided me toward committing my life to medicine.

Family: It starts with my parents, the two hardest working, most selfless people I have ever known. As a first-generation college student, my parents sacrificed everything to ensure I could run full speed toward any dream I could conjure. No matter what that dream was, as long as I was happy and working toward making a positive difference around me, they constantly do everything in their power to enable my dreams. I am blessed with two extraordinary parents, three spectacular sisters, and the greatest family imaginable.

Physicians: At eight years old, with my grandmother dying of an incurable brain tumor, I watched a tremendously caring neurosurgeon get on his knees in front of her wheelchair, hold her hands, look into her kind, terrified eyes and beg her, Please, princess, just one final surgery. I promise this will be the last one. Two days earlier her speech had disappeared. As time was dwindling, her ability to communicate with my family had vanished. She adamantly shook her head in refusal. She had already undergone one brain surgery. She was scared, tired, and defeated. The doctor remained on his knees and continued to plead. She relented. The next day she was taken back for a second brain surgery to remove more of the tumor. While she died a month later, for two of those weeks she spoke perfectly. She was able to tell my grandpa, mom, and the rest of the family everything that was in her heart. The surgeon gifted my family closure: peace of mind that continues to have an indelible impact to this day.

As a fifteen-year-old kid with life aspirations limited to obtaining a D1 basketball scholarship and playing professionally, I suffered a catastrophic knee injury. Called in from home at 10pm on a Saturday, an exuberant orthopedic surgeon burst into a small community hospital ED, brimming with energy, and seemingly making the entire room brighter, he found his way to me and exclaimed Its Quad-zilla gesturing toward my bulging legs and mangled left knee. While he wheeled me to the operating room to fix the physical damage, he saw a vulnerable, distraught teenager who had just lost his dream. For the next month, he sent daily text messages or called me to check in, tell me a joke, and lift my spirits. An exorbitantly busy surgeon realized that my injury was no more physical than it was emotional and took time out of his hectic days for weeks to ensure that a kid with a broken heart got better.

Relationships: Having a sister with special needs, I have been immersed within this community for most of my life. Between starting summer camps, Special Olympics teams, and teaching initiatives, most of my life outside of medicine has been dedicated to seeking ways to help enrich the lives of and defy prognoses assigned to people with special needs. Countless times over the years, I have seen the power of love and effort obliterate limitations. My sister was fated to never live autonomously, go to college, drive, or hold a job. Instead, she has held the same job for over a decade, owns a condo, and is entirely independent. Triumphs like these urged me to find a career where such meaningful changes could be replicated. I found that it is not always practicable to spend years of love and care to affect such change, and in the process discovered neurosurgery. I will never forget the first case I ever witnessed. A 14-year-old boy, incapacitated by dozens of seizures every week, underwent a procedure where after carefully mapping his brain, a small piece of cortex was removed the nexus for where his seizures originated. For the next two years he did not have a single seizure. He was empowered to fully engage in school, date, drive, and thrive as any teenager should be allowed. It clicked that this is exactly what I was meant to do with the rest of my life.

Q: In what area of medicine do you hope to practice?

A: In meeting a person who requires neurosurgery, one encounters a person staring down the absolute cruelest, most distressing face life can wear. I cannot imagine a greater personal fulfillment than to earn the trust and privilege to walk hand-in-hand with these patients. Often times there is an answer that resoundingly defeats such a menace, but not uncommonly it must be conceded that the limits of science have been reached. Remaining hand-in-hand with patient and family as they march down lifes most unnerving path is a privilege I eagerly look forward to working tirelessly to defend. Harvey Cushing, a pioneer of modern neurosurgery, said, A physician is obligated to consider more than a diseased organ, more than even the whole man he must view the man in his world. This principle captures the foundation upon which I hope my career lies. Beyond preventing death and treating symptoms, neurosurgery, distinct from so many other vocations, addresses what makes us human, what it means to live. I believe that understanding the person behind the patient is more salient in neurosurgery than any other practice, making the infinite learning curve that lies ahead not just technical and operative, but humanistic. This profound nuance excites me more than anything I have ever known and compels me to dedicate my lifes work to learning and refining the art of neurosurgery.

I imagine no matter how much I prepare for a life in this field, I will feel unsettled countless times throughout my career. As an intern at 3 a.m, a patients life will depend on an answer that I do not immediately have. As a junior level attending, the safety net will vanish. Without such gifted people bolstering me, do my abilities warrant a human life be entrusted to my hands? Throughout my entire career, there will be cases and outcomes imploring what I should have done differently. And no matter how much experience I amass, I hope there never comes a day that I am impervious to the insecurity of not knowing. I anticipate that in dedicating my life to neurosurgery there will certainly be occasional feelings of failure and frequent feelings of unease. At times, this will be because, as a field, the answer is yet to be found; other times, it will be a failure that lies squarely upon my shoulders. But should this not be the case in choosing a life where missteps are not only mortal, but worse, destine someone to live as a mere vestige of who he or she once was? The immense complexity, the privilege to restore not only the nervous systems function, but to safeguard what makes someone human, is exactly why I want to spend the rest of my life working to advance this humbling practice.

Q: What is your favorite memory from medical school at Duke?

A: Duke is an intensely special place. This specialness repeatedly distills down to the people that call Duke home. Since arriving to Durham over five years ago, I have been continually awestruck by my extraordinary peers. I have been lucky to call some of the smartest, most caring people I have ever met my classmates. The pervasive culture of collaboration and the facultys sincere concern with student development and future career success have made my time as a Duke medical student an immeasurable privilege. Early on in medical school, I realized that I had two unrelated interests within neurosurgery. The faculty graciously worked with me to allow me to do two separate masters degrees, one of which led me to Uganda multiple times and the other to live in Toronto, the global epicenter for my research, for two years. Without such supportive classmates and mentors, I would be nowhere near where I am today.

Q: How do you hope to impact patient care and/or research in your career?

A: As a medical student, I discovered distinct passions bounding the poles of the neurosurgical spectrum: how to better stimulate the nervous system and how to better deliver neurosurgery to low resource settings and bridge the socioeconomic chasm in care. During my research fellowship at the University of Toronto, I was able to work with brilliant people while studying how to use signals we record from the human brain to improve how we stimulate circuits deep in the brain to treat limbic, metabolic, cognitive, and movement disorders such as depression, obesity, Alzheimers disease, and Parkinsons disease. In Uganda, I am working to improve neurosurgical capacity in low-resource settings via innovative neuroimaging in traumatic brain injury patients. While technically dissimilar, a common thread has trussed each patient to the other: some part of who they once were, an integral element of how they identified with their world, internally, outwardly, or both, has ebbed or vanished.

Above all, I hope to become the most competent, compassionate, and complete neurosurgeon I am capable of one who never stops striving to do better for patients. With my love for neurophysiology, global health, and palliative care, scientifically, I hope to carve out a career I can help to innovate technology to more precisely modulate diseases of the central nervous system. In terms of shifting practice, I want to remain intimately involved in reducing disparities in neurosurgical care globally and, as my career progresses, remain cognizant of how we wield and deliver ever-evolving technologies and treatments and, accordingly, how we approach end of life care in patients as these changes emerge.

Hometown: Orlando, Florida

Specialty: Orthopaedic Surgery

Match: Stanford University

Q: What inspired you to become a doctor?

A: Growing up with Medicaid, my family experienced the long waits and delays in receiving healthcare which became especially difficult when my father had cancer. Our quality of life was severely impacted by factors that were out of our control, and it motivated me to be at the front lines as a physician addressing this issue at some capacity.

Q: In what area of medicine do you hope to practice?

A: I am pursuing a residency in Orthopaedic Surgery with a strong interest in specializing in oncology or adult reconstruction (i.e. hip and knee replacements). Its a field where quality of life is the main issue we address in our clinical and surgical encounters, and I believe there is room for growth in how we treat and manage patients from underprivileged backgrounds.

Q: What is your favorite memory from med school at Duke?

A: Rather than a specific event, I remember the people I met from Duke during medical school who will be my lifelong mentors and friends. No matter what I was going through, they were there 24/7 and gave me the confidence and guidance to succeed down the path I chose.

Q: How do you hope to impact patient care and/or research in your career?

A: In addition to practicing at an academic institution where patient care is less dictated by their insurance, I hope to get involved in clinical trials and improve accessibility and education for patients of different socioeconomic backgrounds.

Hometown: Prince Georges County, MD

Specialty: Cardiology

Match: Johns Hopkins University

Q: What inspired you to become a doctor?

A: Becoming a doctor, for me, was a calling. I have overcome many trials and tribulations throughout my life that fueled my passion for medicine. Being a patient in this healthcare system as a young child, and remembering the gentleness, the compassion, and the care that some doctors exuded towards me inspired me to become a doctor. I want to impact patients just as those physicians did for me.

Q: In what area of medicine do you hope to practice?

A: I plan to practice Cardiology in the future. Heart disease is the number one cause of death in our country, and underrepresented individuals and groups are impacted disproportionately. I plan to care for all patients and work vigorously to impact health outcomes.

Q: What is your favorite memory from med school at Duke?

A: I love DUKE! I have so many amazing experiences and memories from my time here at Duke. From working with amazing attendings, residents, and fellows to interacting with great patients. I specifically recall a patient who was dealing with tremendous financial hardships while battling numerous illnesses; she just wanted to give up on everything. After a few tears had been shed, we were able to make great strides in her health. The mere act of being personable and empathic and how that impacted her outlook on life and health will forever be one of my favorite memories here at Duke.

Q: How do you hope to impact patient care and/or research in your career?

A: I love interacting with patients. While my career will be focused around the care I provide to patients, I hope to impact patient care by focusing on improving representation and Health Disparities. Representation matters bringing diversity to the team, and different perspectives to many topics can impact the care we provide to our patients. Differences in health outcomes and health disparities remain a challenge. I plan to continue research efforts in not only identifying health disparities but providing actionable ways in which we can attain health equity.

Hometown: Accra, Ghana

Specialty: Orthopaedic Surgery

Match: Washington University in St. Louis

Q: What inspired you to become a doctor?

A: I am blessed to have been raised by my incredible mother, who is a professor and pediatrician back home in Ghana. Her selflessness is unparalleled, and it is hard to witness that manifest so perfectly in her work and not have a strong desire to emulate her. In addition, I grew up near a large hospital back home, and saw pretty early on how the lack of accessible healthcare can impact those less fortunate in society. Moving here for university meant that I quickly learned how universal the issue of health disparities is. I am hoping that I can tailor my career as a physician and surgeon to help alleviate some of these disparities, particularly as a minority.

Q: In what area of medicine do you hope to practice?

A: Ill be going into Orthopaedic Surgery. I am currently unsure as to what I will end up sub-specializing in, but hopefully something that is translatable and necessary in the global health setting.

Q: What is your favorite memory from medical school at Duke?

A: Broadly, my time serving on the board of and fellowshipping with the Duke chapter of SNMA has been grand. The Student National Medical Association (SNMA) is a national organization aimed at supporting underrepresented minority medical students and working with underserved communities. I am grateful for all the relationships SNMA has helped me foster!

Q: How do you hope to impact patient care and/or research in your career?

A: Entering into a specialty that is not nearly as diverse as it should be, I am excited to play my part in making our workforce more reflective of the populations we serve. I aspire to contribute to improving healthcare access both locally by serving the underserved, and globally, particularly in Ghana. My research will depend largely on my chosen subspecialty, but I do hope I can partake in global health research and innovation in those spaces.

Yale doctor was named ‘diversity and inclusion’ chair after being accused of sexual harassment, lawsuit says – NBC News

Posted on March 12, 2020 by Danzig

Yale University promoted an award-winning doctor to lead diversity and inclusion efforts in a medical school department last summer despite receiving complaints that he had sexually harassed multiple women he supervised, according to a federal lawsuit filed Thursday.

Six female doctors say in the suit that Dr. Manuel Lopes Fontes a high-ranking professor who was division chief of cardiac anesthesiology at Yale New Haven Hospital and director of clinical research for Yale School of Medicines anesthesiology department behaved inappropriately, including forcibly kissing them, giving them unwanted neck massages at work and making inappropriate comments about their bodies.

One woman in the case, an anesthesiology fellow, says she was berated by Fontes when she resisted his advances, while another, an assistant professor, alleges that her work assignments were changed in retaliation for complaining about Fontes.

Fontes, through an attorney, denied all allegations of misconduct against him.

According to the lawsuit, after Dr. Roberta Hines, chair of Yales anesthesiology department, received a complaint about Fontes in 2018 from an assistant professor who said he had discriminated against her because of her pregnancy, she excused his behavior, saying he was just being a boy. And after receiving a complaint from an anesthesiology resident in 2019 who said Fontes made suggestive comments and gave her unwanted massages, Hines said that boys will be boys, according to the lawsuit. Shortly afterward, Hines announced Fontes promotion to lead diversity efforts in the anesthesiology department.

It seems as though Yale has yet to take the same steps as the rest of society, said Michael J. Willemin, one of the womens attorneys, referring to the #MeToo movements workplace reckoning.

Hines, who is not named as a defendant in the suit, referred a request for comment to a Yale spokeswoman. Yale did not answer specific questions about the case, but insisted it handled the case appropriately.

In the summer of 2019, the university was approached by three of the six plaintiffs and took appropriate action, offering them Yales Title IX resources of support, inclusive of guidance on filing a complaint with the university, said Karen Peart, a Yale spokeswoman. None of the plaintiffs chose to file a formal complaint; Yale has nonetheless been working to resolve the issues raised. As in all such cases, Yale is working to ensure that the processes we use to find and act on facts are fair to all involved parties.

In a statement, Robert B. Mitchell, an attorney for Fontes, said that Dr. Fontes has been vilified without a fair opportunity to defend himself against what has been a vindictive backroom campaign of scandalous and vicious falsehood, rumor, and innuendo. This will be remedied now that his accusers have decided to come out into the open. Dr. Fontes will respond and the truth will shame them as well as those who have prejudged him without affording him even a hint of due process.

Fontes no longer holds leadership roles at Yale, and is now listed only as a professor of anesthesiology. After the women hired lawyers last fall, Yale removed Fontes from his role leading diversity and inclusion efforts, according to the womens attorneys.

The civil complaint and a related filing with the U.S. Equal Employment Opportunity Commission obtained by NBC News, which is pending alleges that Fontes inappropriate behavior began immediately after Yale hired him in 2015 and continued through last year. The suit alleges that Fontes was accused of sexual harassment at his previous job at Duke University, and Yale administrators knew about those allegations. Duke declined to comment. NBC News was unable to confirm additional details about any accusations against Fontes at Duke.

The message is if youre a victim of sexual harassment or sexual misconduct, Yales urgency to remedy that situation will come second to their willingness and desire to protect the harasser as long as that individual is economically beneficial to the instution, Willemin said.

The suit seeks an unspecified amount of damages from Yale for violating the gender equity law Title IX, and damages from Fontes for claims of assault, battery and invasion of privacy.

Let our news meet your inbox. The news and stories that matters, delivered weekday mornings.

The women named in the lawsuit declined to speak on the record, citing concerns about professional consequences, but their accounts are detailed in Thursdays court filing.

Dr. Elizabeth Reinhart, a pediatric anesthesiology resident at Yale, said Fontes flirted with her at a work dinner last May, pressured her to drink more alcohol and tried to kiss her on the lips, according to the lawsuit. The following month, during a department graduation ceremony, Fontes came up behind her, hugged her by the waist and said, I cant wait to see you at Barcelona, referring to a bar, the suit says. Then, in July, Fontes, without asking, began to massage Reinharts back and shoulders in a campus break room, according to the civil complaint.

Reinhart was so uncomfortable and disgusted by Fontes behavior, the suit says, that she reported these incidents to two supervisors in the anesthesiology department, who then told Hines, the department chair.

About a week later, on Aug. 7, Hines sent a department-wide email to announce that Fontes had been promoted. He would become the departments inaugural Vice Chair of Diversity, Equity, and Inclusion, and lead an initiative aimed at promoting a departmental culture that values and supports diversity, equity and inclusion. As far as Reinhart knew, there had been no investigation yet of her complaint.

Before Reinhart complained, other women had already raised concerns about Fontes, according to the lawsuit, and they say they faced retaliation.

Dr. Ashley Eltorai alleges in the suit that Fontes declined to help her with work she needed to do for a research project in late 2018, saying that her planned maternity leave, which was still more than six months away, would interfere. After Eltorai complained to department leadership that she felt punished for being pregnant, according to the civil complaint, Fontes and other administrators called her into a meeting to give her vague criticisms about her performance and communication, and then banned her from working in the intensive care unit once she returned from maternity leave last year.

At a dinner for graduating anesthesiology fellows in June 2019, after Eltorai had her baby, Fontes attempted to spoon-feed her, according to the lawsuit. She said he told her, Oh wow, you look good, and upon noticing that Eltorai wasnt wearing her wedding ring, he remarked we should go out, just the two of us, and have a bottle of wine and I can tell you all my wisdom about life and divorce. The next month, Fontes gave Eltorai an unwanted neck massage in the breakroom, the suit states.

Eltorai says she complained about Fontes to an attorney on the Yale University-Wide Committee on Sexual Misconduct last summer. But after speaking with someone from the committee, Eltorai declined to press forward with a formal investigation because of concerns about how impartial it would be, according to her attorneys.

Dr. Mia Castro, a pediatric anesthesiology fellow at Yale, also complained about Fontes, according to the lawsuit. She says that Fontes repeatedly put his arms around her shoulders and waist when they worked together in operating rooms, and after she resisted his advances, he berated her over minor issues like picking up a syringe cap, according to the lawsuit. Castro complained in an evaluation last summer that Fontes inappropriately touched colleagues, but no one followed up with her to get more information, according to her attorneys.

Three other women Drs. Heidi Boules, Jodi-Ann Oliver and Lori-Ann Oliver, all attending physicians in the department say that Fontes forcibly kissed them at work dinners in 2018 and 2019, according to the lawsuit.

The suit also alleges that shortly after Fontes started at Yale in 2015, he forcibly kissed a woman, a doctor who is not part of the lawsuit, and the incident was reported to an associate dean. The next summer, several people witnessed Fontes dance provocatively with and grope a clearly drunk female subordinate, the suit states. A video of the incident was shared with department leadership, according to the suit, which prompted Hines to remind attending physicians in a faculty meeting not to drink alcohol with residents.

Women now make up a majority of new medical students. Yet, surveys have found that more than half of all female medical students and doctors say that theyve been sexually harassed during their careers. Most of them dont report it to administrators, with concern about retaliation being a significant factor. At Yale, a recent survey found that nearly a third of graduate and professional students from all fields had been harassed by a faculty member.

Medicine is a field where the fellowships you get, or jobs you get later on, are so dependent on recommendations, said Melinda Manning, an administrator at the University of North Carolina Hospitals who has written about sexual harassment in medical schools. That in itself is a great barrier for people coming forward with complaints.

The six Yale women spent months trying to avoid Fontes by taking different hallways and exits, or skipping meetings where they knew hed be present, according to their lawyers. They had concerns about what would happen to them after reporting Fontes, given that he had so much influence in the department, and they hoped to continue their careers at Yale.

People need to feel like they'll be protected and not penalized for coming forward, Tanvir Rahman, another one of the womens lawyers, told NBC News.

For decades, Yale has faced a series of accusations over its handling of sexual misconduct.

The first lawsuit to test whether the gender equity law Title IX protects women from sexual harassment was brought in the late 1970s by Yale students who complained that the university had no way to report harassing professors at the time. In the years since, students have continued to blast Yales response to sexual violence as ineffective. People have complained about cases in which the university declined to investigate allegations against star professors. Even former President Jimmy Carter knocked Yales approach to sexual assault cases as too lenient on offenders in 2014.

Yales medical school has faced those criticisms, too. In 2018, over 1,000 medical school students, trainees, alumni and faculty members signed a letter lambasting Yales decision to give a cardiology professor a prestigious title after finding he had harassed a postdoctoral researcher. Last August, the university revealed that a longtime professor of medicine sexually assaulted five students over decades, including after administrators investigated allegations against him in 1994.

These cases are cited in the lawsuit against Fontes as evidence that Yales promises to eradicate sexual violence have been mere lip service.

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Yale doctor was named 'diversity and inclusion' chair after being accused of sexual harassment, lawsuit says - NBC News

How the Pandemic Will End – The Atlantic

Posted on March 26, 2020 by Danzig

Editors Note: The Atlantic is making vital coverage of the coronavirus available to all readers. Find the collection here.

Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nations psyche.

A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. What if? became Now what?

So, now what? In the late hours of last Wednesday, which now feels like the distant past, I was talking about the pandemic with a pregnant friend who was days away from her due date. We realized that her child might be one of the first of a new cohort who are born into a society profoundly altered by COVID-19. We decided to call them Generation C.

As well see, Gen Cs lives will be shaped by the choices made in the coming weeks, and by the losses we suffer as a result. But first, a brief reckoning. On the Global Health Security Index, a report card that grades every country on its pandemic preparedness, the United States has a score of 83.5the worlds highest. Rich, strong, developed, America is supposed to be the readiest of nations. That illusion has been shattered. Despite months of advance warning as the virus spread in other countries, when America was finally tested by COVID-19, it failed.

Anne Applebaum: The coronavirus called Americas bluff

No matter what, a virus [like SARS-CoV-2] was going to test the resilience of even the most well-equipped health systems, says Nahid Bhadelia, an infectious-diseases physician at the Boston University School of Medicine. More transmissible and fatal than seasonal influenza, the new coronavirus is also stealthier, spreading from one host to another for several days before triggering obvious symptoms. To contain such a pathogen, nations must develop a test and use it to identify infected people, isolate them, and trace those theyve had contact with. That is what South Korea, Singapore, and Hong Kong did to tremendous effect. It is what the United States did not.

As my colleagues Alexis Madrigal and Robinson Meyer have reported, the Centers for Disease Control and Prevention developed and distributed a faulty test in February. Independent labs created alternatives, but were mired in bureaucracy from the FDA. In a crucial month when the American caseload shot into the tens of thousands, only hundreds of people were tested. That a biomedical powerhouse like the U.S. should so thoroughly fail to create a very simple diagnostic test was, quite literally, unimaginable. Im not aware of any simulations that I or others have run where we [considered] a failure of testing, says Alexandra Phelan of Georgetown University, who works on legal and policy issues related to infectious diseases.

The testing fiasco was the original sin of Americas pandemic failure, the single flaw that undermined every other countermeasure. If the country could have accurately tracked the spread of the virus, hospitals could have executed their pandemic plans, girding themselves by allocating treatment rooms, ordering extra supplies, tagging in personnel, or assigning specific facilities to deal with COVID-19 cases. None of that happened. Instead, a health-care system that already runs close to full capacity, and that was already challenged by a severe flu season, was suddenly faced with a virus that had been left to spread, untracked, through communities around the country. Overstretched hospitals became overwhelmed. Basic protective equipment, such as masks, gowns, and gloves, began to run out. Beds will soon follow, as will the ventilators that provide oxygen to patients whose lungs are besieged by the virus.

Read: The people ignoring social distancing

With little room to surge during a crisis, Americas health-care system operates on the assumption that unaffected states can help beleaguered ones in an emergency. That ethic works for localized disasters such as hurricanes or wildfires, but not for a pandemic that is now in all 50 states. Cooperation has given way to competition; some worried hospitals have bought out large quantities of supplies, in the way that panicked consumers have bought out toilet paper.

Partly, thats because the White House is a ghost town of scientific expertise. A pandemic-preparedness office that was part of the National Security Council was dissolved in 2018. On January 28, Luciana Borio, who was part of that team, urged the government to act now to prevent an American epidemic, and specifically to work with the private sector to develop fast, easy diagnostic tests. But with the office shuttered, those warnings were published in The Wall Street Journal, rather than spoken into the presidents ear. Instead of springing into action, America sat idle.

Derek Thompson: America is acting like a failed state

Rudderless, blindsided, lethargic, and uncoordinated, America has mishandled the COVID-19 crisis to a substantially worse degree than what every health expert Ive spoken with had feared. Much worse, said Ron Klain, who coordinated the U.S. response to the West African Ebola outbreak in 2014. Beyond any expectations we had, said Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. As an American, Im horrified, said Seth Berkley, who heads Gavi, the Vaccine Alliance. The U.S. may end up with the worst outbreak in the industrialized world.

Having fallen behind, it will be difficultbut not impossiblefor the United States to catch up. To an extent, the near-term future is set because COVID-19 is a slow and long illness. People who were infected several days ago will only start showing symptoms now, even if they isolated themselves in the meantime. Some of those people will enter intensive-care units in early April. As of last weekend, the nation had 17,000 confirmed cases, but the actual number was probably somewhere between 60,000 and 245,000. Numbers are now starting to rise exponentially: As of Wednesday morning, the official case count was 54,000, and the actual case count is unknown. Health-care workers are already seeing worrying signs: dwindling equipment, growing numbers of patients, and doctors and nurses who are themselves becoming infected.

Italy and Spain offer grim warnings about the future. Hospitals are out of room, supplies, and staff. Unable to treat or save everyone, doctors have been forced into the unthinkable: rationing care to patients who are most likely to survive, while letting others die. The U.S. has fewer hospital beds per capita than Italy. A study released by a team at Imperial College London concluded that if the pandemic is left unchecked, those beds will all be full by late April. By the end of June, for every available critical-care bed, there will be roughly 15 COVID-19 patients in need of one. By the end of the summer, the pandemic will have directly killed 2.2 million Americans, notwithstanding those who will indirectly die as hospitals are unable to care for the usual slew of heart attacks, strokes, and car accidents. This is the worst-case scenario. To avert it, four things need to happenand quickly.

Read: All the presidents lies about the coronavirus

The first and most important is to rapidly produce masks, gloves, and other personal protective equipment. If health-care workers cant stay healthy, the rest of the response will collapse. In some places, stockpiles are already so low that doctors are reusing masks between patients, calling for donations from the public, or sewing their own homemade alternatives. These shortages are happening because medical supplies are made-to-order and depend on byzantine international supply chains that are currently straining and snapping. Hubei province in China, the epicenter of the pandemic, was also a manufacturing center of medical masks.

In the U.S., the Strategic National Stockpilea national larder of medical equipmentis already being deployed, especially to the hardest-hit states. The stockpile is not inexhaustible, but it can buy some time. Donald Trump could use that time to invoke the Defense Production Act, launching a wartime effort in which American manufacturers switch to making medical equipment. But after invoking the act last Wednesday, Trump has failed to actually use it, reportedly due to lobbying from the U.S. Chamber of Commerce and heads of major corporations.

Some manufacturers are already rising to the challenge, but their efforts are piecemeal and unevenly distributed. One day, well wake up to a story of doctors in City X who are operating with bandanas, and a closet in City Y with masks piled into it, says Ali Khan, the dean of public health at the University of Nebraska Medical Center. A massive logistics and supply-chain operation [is] now needed across the country, says Thomas Inglesby of Johns Hopkins Bloomberg School of Public Health. That cant be managed by small and inexperienced teams scattered throughout the White House. The solution, he says, is to tag in the Defense Logistics Agencya 26,000-person group that prepares the U.S. military for overseas operations and that has assisted in past public-health crises, including the 2014 Ebola outbreak.

This agency can also coordinate the second pressing need: a massive rollout of COVID-19 tests. Those tests have been slow to arrive because of five separate shortages: of masks to protect people administering the tests; of nasopharyngeal swabs for collecting viral samples; of extraction kits for pulling the viruss genetic material out of the samples; of chemical reagents that are part of those kits; and of trained people who can give the tests. Many of these shortages are, again, due to strained supply chains. The U.S. relies on three manufacturers for extraction reagents, providing redundancy in case any of them failsbut all of them failed in the face of unprecedented global demand. Meanwhile, Lombardy, Italy, the hardest-hit place in Europe, houses one of the largest manufacturers of nasopharyngeal swabs.

Read: Why the coronavirus has been so successful

Some shortages are being addressed. The FDA is now moving quickly to approve tests developed by private labs. At least one can deliver results in less than an hour, potentially allowing doctors to know if the patient in front of them has COVID-19. The country is adding capacity on a daily basis, says Kelly Wroblewski of the Association of Public Health Laboratories.

On March 6, Trump said that anyone who wants a test can get a test. That was (and still is) untrue, and his own officials were quick to correct him. Regardless, anxious people still flooded into hospitals, seeking tests that did not exist. People wanted to be tested even if they werent symptomatic, or if they sat next to someone with a cough, says Saskia Popescu of George Mason University, who works to prepare hospitals for pandemics. Others just had colds, but doctors still had to use masks to examine them, burning through their already dwindling supplies. It really stressed the health-care system, Popescu says. Even now, as capacity expands, tests must be used carefully. The first priority, says Marc Lipsitch of Harvard, is to test health-care workers and hospitalized patients, allowing hospitals to quell any ongoing fires. Only later, once the immediate crisis is slowing, should tests be deployed in a more widespread way. This isnt just going to be: Lets get the tests out there! Inglesby says.

These measures will take time, during which the pandemic will either accelerate beyond the capacity of the health system or slow to containable levels. Its courseand the nations fatenow depends on the third need, which is social distancing. Think of it this way: There are now only two groups of Americans. Group A includes everyone involved in the medical response, whether thats treating patients, running tests, or manufacturing supplies. Group B includes everyone else, and their job is to buy Group A more time. Group B must now flatten the curve by physically isolating themselves from other people to cut off chains of transmission. Given the slow fuse of COVID-19, to forestall the future collapse of the health-care system, these seemingly drastic steps must be taken immediately, before they feel proportionate, and they must continue for several weeks.

Juliette Kayyem: The crisis could last 18 months. Be prepared.

Persuading a country to voluntarily stay at home is not easy, and without clear guidelines from the White House, mayors, governors, and business owners have been forced to take their own steps. Some states have banned large gatherings or closed schools and restaurants. At least 21 have now instituted some form of mandatory quarantine, compelling people to stay at home. And yet many citizens continue to crowd into public spaces.

In these moments, when the good of all hinges on the sacrifices of many, clear coordination mattersthe fourth urgent need. The importance of social distancing must be impressed upon a public who must also be reassured and informed. Instead, Trump has repeatedly played down the problem, telling America that we have it very well under control when we do not, and that cases were going to be down to close to zero when they were rising. In some cases, as with his claims about ubiquitous testing, his misleading gaffes have deepened the crisis. He has even touted unproven medications.

Away from the White House press room, Trump has apparently been listening to Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases. Fauci has advised every president since Ronald Reagan on new epidemics, and now sits on the COVID-19 task force that meets with Trump roughly every other day. Hes got his own style, lets leave it at that, Fauci told me, but any kind of recommendation that I have made thus far, the substance of it, he has listened to everything.

Read: Grocery stores are the coronavirus tipping point

But Trump already seems to be wavering. In recent days, he has signaled that he is prepared to backtrack on social-distancing policies in a bid to protect the economy. Pundits and business leaders have used similar rhetoric, arguing that high-risk people, such as the elderly, could be protected while lower-risk people are allowed to go back to work. Such thinking is seductive, but flawed. It overestimates our ability to assess a persons risk, and to somehow wall off the high-risk people from the rest of society. It underestimates how badly the virus can hit low-risk groups, and how thoroughly hospitals will be overwhelmed if even just younger demographics are falling sick.

A recent analysis from the University of Pennsylvania estimated that even if social-distancing measures can reduce infection rates by 95 percent, 960,000 Americans will still need intensive care. There are only about 180,000 ventilators in the U.S. and, more pertinently, only enough respiratory therapists and critical-care staff to safely look after 100,000 ventilated patients. Abandoning social distancing would be foolish. Abandoning it now, when tests and protective equipment are still scarce, would be catastrophic.

Read: Americas hospitals have never experienced anything like this

If Trump stays the course, if Americans adhere to social distancing, if testing can be rolled out, and if enough masks can be produced, there is a chance that the country can still avert the worst predictions about COVID-19, and at least temporarily bring the pandemic under control. No one knows how long that will take, but it wont be quick. It could be anywhere from four to six weeks to up to three months, Fauci said, but I dont have great confidence in that range.

Even a perfect response wont end the pandemic. As long as the virus persists somewhere, theres a chance that one infected traveler will reignite fresh sparks in countries that have already extinguished their fires. This is already happening in China, Singapore, and other Asian countries that briefly seemed to have the virus under control. Under these conditions, there are three possible endgames: one thats very unlikely, one thats very dangerous, and one thats very long.

The first is that every nation manages to simultaneously bring the virus to heel, as with the original SARS in 2003. Given how widespread the coronavirus pandemic is, and how badly many countries are faring, the odds of worldwide synchronous control seem vanishingly small.

The second is that the virus does what past flu pandemics have done: It burns through the world and leaves behind enough immune survivors that it eventually struggles to find viable hosts. This herd immunity scenario would be quick, and thus tempting. But it would also come at a terrible cost: SARS-CoV-2 is more transmissible and fatal than the flu, and it would likely leave behind many millions of corpses and a trail of devastated health systems. The United Kingdom initially seemed to consider this herd-immunity strategy, before backtracking when models revealed the dire consequences. The U.S. now seems to be considering it too.

Read: What will you do if you start coughing?

The third scenario is that the world plays a protracted game of whack-a-mole with the virus, stamping out outbreaks here and there until a vaccine can be produced. This is the best option, but also the longest and most complicated.

It depends, for a start, on making a vaccine. If this were a flu pandemic, that would be easier. The world is experienced at making flu vaccines and does so every year. But there are no existing vaccines for coronavirusesuntil now, these viruses seemed to cause diseases that were mild or rareso researchers must start from scratch. The first steps have been impressively quick. Last Monday, a possible vaccine created by Moderna and the National Institutes of Health went into early clinical testing. That marks a 63-day gap between scientists sequencing the viruss genes for the first time and doctors injecting a vaccine candidate into a persons arm. Its overwhelmingly the world record, Fauci said.

But its also the fastest step among many subsequent slow ones. The initial trial will simply tell researchers if the vaccine seems safe, and if it can actually mobilize the immune system. Researchers will then need to check that it actually prevents infection from SARS-CoV-2. Theyll need to do animal tests and large-scale trials to ensure that the vaccine doesnt cause severe side effects. Theyll need to work out what dose is required, how many shots people need, if the vaccine works in elderly people, and if it requires other chemicals to boost its effectiveness.

Even if it works, they dont have an easy way to manufacture it at a massive scale, said Seth Berkley of Gavi. Thats because Moderna is using a new approach to vaccination. Existing vaccines work by providing the body with inactivated or fragmented viruses, allowing the immune system to prep its defenses ahead of time. By contrast, Modernas vaccine comprises a sliver of SARS-CoV-2s genetic materialits RNA. The idea is that the body can use this sliver to build its own viral fragments, which would then form the basis of the immune systems preparations. This approach works in animals, but is unproven in humans. By contrast, French scientists are trying to modify the existing measles vaccine using fragments of the new coronavirus. The advantage of that is that if we needed hundreds of doses tomorrow, a lot of plants in the world know how to do it, Berkley said. No matter which strategy is faster, Berkley and others estimate that it will take 12 to 18 months to develop a proven vaccine, and then longer still to make it, ship it, and inject it into peoples arms.

Read: COVID-19 vaccines are coming, but theyre not what you think

Its likely, then, that the new coronavirus will be a lingering part of American life for at least a year, if not much longer. If the current round of social-distancing measures works, the pandemic may ebb enough for things to return to a semblance of normalcy. Offices could fill and bars could bustle. Schools could reopen and friends could reunite. But as the status quo returns, so too will the virus. This doesnt mean that society must be on continuous lockdown until 2022. But we need to be prepared to do multiple periods of social distancing, says Stephen Kissler of Harvard.

Much about the coming years, including the frequency, duration, and timing of social upheavals, depends on two properties of the virus, both of which are currently unknown. First: seasonality. Coronaviruses tend to be winter infections that wane or disappear in the summer. That may also be true for SARS-CoV-2, but seasonal variations might not sufficiently slow the virus when it has so many immunologically naive hosts to infect. Much of the world is waiting anxiously to see whatif anythingthe summer does to transmission in the Northern Hemisphere, says Maia Majumder of Harvard Medical School and Boston Childrens Hospital.

Second: duration of immunity. When people are infected by the milder human coronaviruses that cause cold-like symptoms, they remain immune for less than a year. By contrast, the few who were infected by the original SARS virus, which was far more severe, stayed immune for much longer. Assuming that SARS-CoV-2 lies somewhere in the middle, people who recover from their encounters might be protected for a couple of years. To confirm that, scientists will need to develop accurate serological tests, which look for the antibodies that confer immunity. Theyll also need to confirm that such antibodies actually stop people from catching or spreading the virus. If so, immune citizens can return to work, care for the vulnerable, and anchor the economy during bouts of social distancing.

Scientists can use the periods between those bouts to develop antiviral drugsalthough such drugs are rarely panaceas, and come with possible side effects and the risk of resistance. Hospitals can stockpile the necessary supplies. Testing kits can be widely distributed to catch the viruss return as quickly as possible. Theres no reason that the U.S. should let SARS-CoV-2 catch it unawares again, and thus no reason that social-distancing measures need to be deployed as broadly and heavy-handedly as they now must be. As Aaron E. Carroll and Ashish Jha recently wrote, We can keep schools and businesses open as much as possible, closing them quickly when suppression fails, then opening them back up again once the infected are identified and isolated. Instead of playing defense, we could play more offense.

Whether through accumulating herd immunity or the long-awaited arrival of a vaccine, the virus will find spreading explosively more and more difficult. Its unlikely to disappear entirely. The vaccine may need to be updated as the virus changes, and people may need to get revaccinated on a regular basis, as they currently do for the flu. Models suggest that the virus might simmer around the world, triggering epidemics every few years or so. But my hope and expectation is that the severity would decline, and there would be less societal upheaval, Kissler says. In this future, COVID-19 may become like the flu is todaya recurring scourge of winter. Perhaps it will eventually become so mundane that even though a vaccine exists, large swaths of Gen C wont bother getting it, forgetting how dramatically their world was molded by its absence.

The cost of reaching that point, with as few deaths as possible, will be enormous. As my colleague Annie Lowrey wrote, the economy is experiencing a shock more sudden and severe than anyone alive has ever experienced. About one in five people in the United States have lost working hours or jobs. Hotels are empty. Airlines are grounding flights. Restaurants and other small businesses are closing. Inequalities will widen: People with low incomes will be hardest-hit by social-distancing measures, and most likely to have the chronic health conditions that increase their risk of severe infections. Diseases have destabilized cities and societies many times over, but it hasnt happened in this country in a very long time, or to quite the extent that were seeing now, says Elena Conis, a historian of medicine at UC Berkeley. Were far more urban and metropolitan. We have more people traveling great distances and living far from family and work.

After infections begin ebbing, a secondary pandemic of mental-health problems will follow. At a moment of profound dread and uncertainty, people are being cut off from soothing human contact. Hugs, handshakes, and other social rituals are now tinged with danger. People with anxiety or obsessive-compulsive disorder are struggling. Elderly people, who are already excluded from much of public life, are being asked to distance themselves even further, deepening their loneliness. Asian people are suffering racist insults, fueled by a president who insists on labeling the new coronavirus the Chinese virus. Incidents of domestic violence and child abuse are likely to spike as people are forced to stay in unsafe homes. Children, whose bodies are mostly spared by the virus, may endure mental trauma that stays with them into adulthood.

Read: The kids arent all right

After the pandemic, people who recover from COVID-19 might be shunned and stigmatized, as were survivors of Ebola, SARS, and HIV. Health-care workers will take time to heal: One to two years after SARS hit Toronto, people who dealt with the outbreak were still less productive and more likely to be experiencing burnout and post-traumatic stress. People who went through long bouts of quarantine will carry the scars of their experience. My colleagues in Wuhan note that some people there now refuse to leave their homes and have developed agoraphobia, says Steven Taylor of the University of British Columbia, who wrote The Psychology of Pandemics.

But there is also the potential for a much better world after we get through this trauma, says Richard Danzig of the Center for a New American Security. Already, communities are finding new ways of coming together, even as they must stay apart. Attitudes to health may also change for the better. The rise of HIV and AIDS completely changed sexual behavior among young people who were coming into sexual maturity at the height of the epidemic, Conis says. The use of condoms became normalized. Testing for STDs became mainstream. Similarly, washing your hands for 20 seconds, a habit that has historically been hard to enshrine even in hospitals, may be one of those behaviors that we become so accustomed to in the course of this outbreak that we dont think about them, Conis adds.

Pandemics can also catalyze social change. People, businesses, and institutions have been remarkably quick to adopt or call for practices that they might once have dragged their heels on, including working from home, conference-calling to accommodate people with disabilities, proper sick leave, and flexible child-care arrangements. This is the first time in my lifetime that Ive heard someone say, Oh, if youre sick, stay home, says Adia Benton, an anthropologist at Northwestern University. Perhaps the nation will learn that preparedness isnt just about masks, vaccines, and tests, but also about fair labor policies and a stable and equal health-care system. Perhaps it will appreciate that health-care workers and public-health specialists compose Americas social immune system, and that this system has been suppressed.

Aspects of Americas identity may need rethinking after COVID-19. Many of the countrys values have seemed to work against it during the pandemic. Its individualism, exceptionalism, and tendency to equate doing whatever you want with an act of resistance meant that when it came time to save lives and stay indoors, some people flocked to bars and clubs. Having internalized years of anti-terrorism messaging following 9/11, Americans resolved to not live in fear. But SARS-CoV-2 has no interest in their terror, only their cells.

Years of isolationist rhetoric had consequences too. Citizens who saw China as a distant, different place, where bats are edible and authoritarianism is acceptable, failed to consider that they would be next or that they wouldnt be ready. (Chinas response to this crisis had its own problems, but thats for another time.) People believed the rhetoric that containment would work, says Wendy Parmet, who studies law and public health at Northeastern University. We keep them out, and well be okay. When you have a body politic that buys into these ideas of isolationism and ethnonationalism, youre especially vulnerable when a pandemic hits.

Graeme Wood: The Chinese virus is a test. Dont fail it.

Veterans of past epidemics have long warned that American society is trapped in a cycle of panic and neglect. After every crisisanthrax, SARS, flu, Ebolaattention is paid and investments are made. But after short periods of peacetime, memories fade and budgets dwindle. This trend transcends red and blue administrations. When a new normal sets in, the abnormal once again becomes unimaginable. But there is reason to think that COVID-19 might be a disaster that leads to more radical and lasting change.

The other major epidemics of recent decades either barely affected the U.S. (SARS, MERS, Ebola), were milder than expected (H1N1 flu in 2009), or were mostly limited to specific groups of people (Zika, HIV). The COVID-19 pandemic, by contrast, is affecting everyone directly, changing the nature of their everyday life. That distinguishes it not only from other diseases, but also from the other systemic challenges of our time. When an administration prevaricates on climate change, the effects wont be felt for years, and even then will be hard to parse. Its different when a president says that everyone can get a test, and one day later, everyone cannot. Pandemics are democratizing experiences. People whose privilege and power would normally shield them from a crisis are facing quarantines, testing positive, and losing loved ones. Senators are falling sick. The consequences of defunding public-health agencies, losing expertise, and stretching hospitals are no longer manifesting as angry opinion pieces, but as faltering lungs.

After 9/11, the world focused on counterterrorism. After COVID-19, attention may shift to public health. Expect to see a spike in funding for virology and vaccinology, a surge in students applying to public-health programs, and more domestic production of medical supplies. Expect pandemics to top the agenda at the United Nations General Assembly. Anthony Fauci is now a household name. Regular people who think easily about what a policewoman or firefighter does finally get what an epidemiologist does, says Monica Schoch-Spana, a medical anthropologist at the Johns Hopkins Center for Health Security.

Such changes, in themselves, might protect the world from the next inevitable disease. The countries that had lived through SARS had a public consciousness about this that allowed them to leap into action, said Ron Klain, the former Ebola czar. The most commonly uttered sentence in America at the moment is, Ive never seen something like this before. That wasnt a sentence anyone in Hong Kong uttered. For the U.S., and for the world, its abundantly, viscerally clear what a pandemic can do.

The lessons that America draws from this experience are hard to predict, especially at a time when online algorithms and partisan broadcasters only serve news that aligns with their audiences preconceptions. Such dynamics will be pivotal in the coming months, says Ilan Goldenberg, a foreign-policy expert at the Center for a New American Security. The transitions after World War II or 9/11 were not about a bunch of new ideas, he says. The ideas are out there, but the debates will be more acute over the next few months because of the fluidity of the moment and willingness of the American public to accept big, massive changes.

One could easily conceive of a world in which most of the nation believes that America defeated COVID-19. Despite his many lapses, Trumps approval rating has surged. Imagine that he succeeds in diverting blame for the crisis to China, casting it as the villain and America as the resilient hero. During the second term of his presidency, the U.S. turns further inward and pulls out of NATO and other international alliances, builds actual and figurative walls, and disinvests in other nations. As Gen C grows up, foreign plagues replace communists and terrorists as the new generational threat.

One could also envisage a future in which America learns a different lesson. A communal spirit, ironically born through social distancing, causes people to turn outward, to neighbors both foreign and domestic. The election of November 2020 becomes a repudiation of America first politics. The nation pivots, as it did after World War II, from isolationism to international cooperation. Buoyed by steady investments and an influx of the brightest minds, the health-care workforce surges. Gen C kids write school essays about growing up to be epidemiologists. Public health becomes the centerpiece of foreign policy. The U.S. leads a new global partnership focused on solving challenges like pandemics and climate change.

In 2030, SARS-CoV-3 emerges from nowhere, and is brought to heel within a month.

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How the Pandemic Will End - The Atlantic

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