Medical resident well-being: What helps, what hurts? – American Medical Association

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Outside-of-work wellness activities pursued by residentswith the notable exceptions of exercise and alcohol consumptionappear to have little effect on resident well-being and the prevalence of burnout and wellness problems, a recent study published in the Journal of Surgical Education found.

The study included responses from more than 5,000 ob-gyn residents across four years of training. Nearly half of all respondents indicated they had experienced burnout and 32% reported showing symptoms of depression.

The Journal of Surgical Education studyAssociations Between Residents Personal Behaviors and Wellness: A National Survey of Obstetrics and Gynecology Residentsasked residents to identify the activities they did to improve wellness. The most common activities respondents indicated they participated in at least twice a week were:

Among activities in that group, respondents who exercised regularly were less likely to report a problem with well-being. That was the only activity that fell into the positive category.

It may as much be a flag that people who are exercising are doing well, said Abigail Winkel, MD, one of the studys authors. Its probably true that there are mental health benefits of exercise, but it might be that the residents who are making time to exercise are doing so because they are not the ones feeling burnt out or depressed.

Almost half of residents reported regular alcohol use. The data found that alcohol use was an activity had the strongest association among survey respondents who reported any wellness problem.

Respondents who said they drank four or more times weekly were three times likelier to report wellness problems. The study also found that the rate of binge drinking rose from 8.8% among first-year residents to 14.4% among fourth-year residents.

As she was conducting research, these results made Dr. Winkela program director, at the timerethink the social programming in place for residents.

As a program director, I stopped funding happy hours, said Dr. Winkel, vice chair of education and assistant director of the institute for innovations in medical educations at New York University School of Medicine. I said: We like the social benefits of you all getting together and youre young people, and drinking is common. But were also not going to say that with our programming that we put in place to try to support healthy residents that we should be putting our money into other kinds of social events.

We didnt want our residents to think that alcohol is a good tool to combat work-related stress, Dr. Winkel added.

Outside of the positive benefits of exercise and the negative results for those who drank heavily, most activities survey respondents did at least twice a week showed no association, or a slightly negative association, with well-being.

Still, Dr. Winkel warns against reading into the finding that some activities, such as cooking, charted as an activity linked to a higher likelihood of reporting a wellness problem.

The fact that many activities have no association [with increased wellness] speaks to the fact that burnout is caused by chronic stresses in the workplace, she said. These things we do and engage in in life are really important to improve sanity, probably in a lot of other ways. Improving burnout is going to require addressing the root causes of burnout, which these activities cant fix.

But is it still worth having a social life, a healthy body and being mindful? she asked. Yes, its very much worth all those things.

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Medical resident well-being: What helps, what hurts? - American Medical Association

Atrium Health top executive receives 20% boost in 2019 compensation – Winston-Salem Journal

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The total compensation for Atrium Healths top executive, Gene Woods, jumped nearly 20% in fiscal 2019, the Charlotte health care system reported Friday.

Woods received $7.25 million in total compensation, led by $2.67 million in salary, $2.44 million in bonuses and a separate $1.08 million in incentives.

By comparison, Woods received $6.06 million in total compensation in fiscal 2018.

Atriums compensation and other corporate financial aspects has taken on new interest in the Triad because of a pending, limited-defined partnership with Wake Forest Baptist Medical Center that is expected to be unveiled by March 31.

The official message since the not-for-profits April 10 memorandum of understanding announcement is they are jointly creating a next-generation academic health-care system headlined by a Charlotte medical school campus debuting in 2021 or 2022.

The systems told bondholders in a November notice the regulatory review process with the Federal Trade Commission is expected to be complete by or before early 2020.

Atrium also recently ended a management services agreement with Greensboros Cone Health in which Cones top executive, Terry Akin, had become an Atrium-compensated employee. Akin received $2.18 million in total compensation in 2019. Dr. Mary Jo Cagle, chief operating officer at Cone, received $1.2 million in total compensation.

Dr. John McConnell moved from chief executive to executive director of Wake Forest Healthcare Ventures on May 1, 2017. He had been chief executive for nearly nine years. His total compensation for 2017 was $2.15 million, down 6.5% from fiscal 2016, according to the IRS Form 990 filing.

Meanwhile, the 2017 compensation of $1.2 million for chief executive Dr. Julie Ann Freischlag reflects from when she took over as chief executive on May 1, 2017. Freischlag became permanent dean of the medical school in February 2018 after serving as interim deal for seven months.

Freischlags first full year of compensation in both roles will not be reported by Wake Forest Baptist until May 15, 2020.

In November, Wake Forest Baptist and Atrium pledged to build a multi-faceted tower and an eye institute in Winston-Salem.

The tower would house the emergency department, operating rooms and intensive care unit services and will be built on the main Ardmore campus atop an existing parking deck. It will feature new operating rooms with adult intensive care units, along with radiology, pathology and other related services.

The systems have not ruled out a much larger collaboration during their period of exclusive negotiations.

The open-ended nature of negotiating a potential medical partnership between Wake Forest University and Atrium has raised concerns about the future of Wake Forest Baptist and its medical school in Winston-Salem.

The local concern about the Charlotte campus is that it could eventually draw resources from the Winston-Salem campus or even lure the medical school itself from Winston-Salem. Wake Forest Baptist is the largest employer in Forsyth County with more than 13,000 workers.

Freischlag said April 10 that she and the majority of the existing medical school faculty would remain in Winston-Salem and that the Charlotte medical school would gain new faculty and utilize providers within the Atrium hospital system.

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Atrium Health top executive receives 20% boost in 2019 compensation - Winston-Salem Journal

Laurent Duvernay-Tardif: The first medical doctor playing in the NFL is in Super Bowl LIV – KAKE

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(CNN) -

This doctor has one of the most important jobs in Super Bowl LIV, but he's not part of the team's medical staff.

Instead, Laurent Duvernay-Tardif, who earned his doctor of medicine degree from McGill University in Canada in 2018, plays right guard on the Kansas City Chiefs offensive line. He is tasked with protecting superstar quarterback Patrick Mahomes as well as trying to deliver the Chiefs their first Super Bowl win in 50 years.

Duvernay-Tardif, the first practicing medical doctor on an NFL roster, will soon become the first medical doctor set to play in a Super Bowl.

"When I stepped on that stage at McGill University and got my MD last year, it was probably the best moment of my life -- after the one I'm going to live (Sunday)," a laughing Duvernay-Tardif, alluding to Sunday's Super Bowl LIV, said to CNN on Monday.

Duvernay-Tardif, 28, stands at 6 feet, 5 inches and is listed at 321 pounds. When he speaks English, the Montreal native's French accent is evident while also giving a warm smile.

"I think I want people to see me as one of the best student athletes in the world," said Duvernay-Tardif, in his sixth NFL season and in the midst of a five-year, $42.4 million contract. "Of course you want to be the best football player. You want to be the best doctor. But to be able to combine both at the highest level ... I think that's my biggest accomplishment."

Sometimes his teammates may occasionally call him doc or doctor, but they also call him Larry, and it's evident his intellect transfers to the gridiron.

"Without a doubt, especially with the offensive line position," Chiefs tight end Travis Kelce said Tuesday. "You have to be a very smart dude. There's a lot of stuff that goes into protections, and how we're going to identify the run game. Larry's stepped in. He figured it out early in his career, and he has just taken it for a ride ever since."

Said Chiefs offensive tackle Eric Fisher on Tuesday: "He's a doctor. He's a football player. I think he's got two passions in life, and he's a professional in both of them. How many of us can say that? Usually everyone's just a professional with one thing. He's a professional with two. Pretty crazy things that not many people can do. What he's accomplished up to this point in life is pretty amazing."

Duvernay-Tardif before an NFL preseason game between the Houston Texans and Kansas City Chiefs on August 9, 2018 at Arrowhead Stadium in Kansas City, Missouri.

Duvernay-Tardif was no lock to reach the NFL -- and he had a bit of a scare getting into medical school as well.

Because he had entered the incorrect date on his calendar, Duvernay-Tardif, whose first language is French, missed the deadline to get into French-speaking medical schools in Quebec. At McGill, one of three English-language universities in Quebec, he didn't initially join the football team until later during his freshman season, as he worked on his English to keep up in class.

Meanwhile, Duvernay-Tardif wasn't playing for a typical powerhouse program that produces NFL players. Previously, just one other player had been selected in the NFL draft from McGill -- defensive tackle Randy Chevrier, who was drafted in the seventh round by the Jacksonville Jaguars in 2001.

As Chiefs general manager Brett Veach once alluded on February 7, 2019, "When Tardif came out, he had some tape from McGill that wasn't Alabama or Auburn. It was Canadian tape and looked like Division II or III football."

Chiefs head coach Andy Reid explained it further on Tuesday at the team hotel in Aventura, Florida.

"You have to understand where he came from," Reid said. "McGill University is a great university. However, the football maybe might not be the same level that you see at the college level in the States here.

"There was quite a gap that he had to climb there to be an NFL player, and he attacked that, probably just like he did becoming a doctor with the tough classes that he had to take.

"But that's the way he's gone about it. He's worked his tail off. He's strong. He's smart. He loves to play the game."

Duvernay-Tardif was in his third year of medical school when the Chiefs drafted him in the sixth round in 2014. There was also a Chiefs tie to Duvernay-Tardif's alma mater: Reid's mother graduated with a medical degree from McGill.

With his head coach's blessing, Duvernay-Tardif continued his studies, returning to Montreal during offseasons to fulfill his clinical rotations in pediatrics, obstetrics, geriatrics and his preferred specialization, emergency medicine.

"I was confident in my ability to play in the NFL for sure," Duvernay-Tardif said. "You look at the stats, and how long is an average career and all that stuff, with studying medicine I didn't know what was going to happen, but everything turned out great. I think Coach Reid is a big part of that, too. He understood what I was trying to do with my study. He gave me the chance to balance both. If it was not for him I would have (just) got my MD and I would not be here this week for sure."

To prepare for his final exams, Duvernay-Tardif isolated himself in an apartment outside of Montreal and studied up to 14 hours a day. And on May 29, 2018, he earned his medical doctorate after an eight-year journey, wearing a white lab coat after the ceremony with his uniform number 76 stitched on the back.

"It was a grind," Duvernay-Tardif said to CNN. "It was a lot of sacrifice, but at the end of the day it was worth it."

After that, he was right back with the Chiefs for training camp. Now, more work lies ahead this week in Miami.

"I don't get any feeling that he's ready to become a doctor right now and go that direction," Reid said. "I look for more years with him and continued growth."

Residency indeed does remain on hold for Duvernay-Tardif, and it's hard to say when it will begin.

"Because I want to do emergency medicine, and they only take anywhere between five and six students at McGill per year, it would put too much stress on the rest of the cohort," Duvernay-Tardif told CNN, adding that he is in contact with the faculty of medicine at McGill.

"We'll find a way," he continued, "but I think this year I wanted to focus more on football."

But, he says, "The good news is that I didn't do an undergrad before getting into medical school. So I'm still really young. I'm 28. A lot of people are not done with their residency, or haven't even started their residency, when they were 28. I still have plenty of time. The most important thing is to stay up to speed with the knowledge, for sure."

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Laurent Duvernay-Tardif: The first medical doctor playing in the NFL is in Super Bowl LIV - KAKE

Doctors on TikTok Try to Go Viral – The New York Times

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For decades, sex education in the classroom could be pretty cringey. For some adolescents, it meant a pitch for abstinence; others watched their teachers put condoms on bananas and attempt sketches of fallopian tubes that looked more like modern art.

On TikTok, sex ed is being flipped on its head. Teenagers who load the app might find guidance set to the pulsing beat of Sex Talk by Megan Thee Stallion.

A doctor, sporting scrubs and grinning into her camera, instructs them on how to respond if a condom breaks during sex: The pill Plan B can be 95 percent effective, the video explains.

The video is the work of Dr. Danielle Jones, a gynecologist in College Station, Tex., and so far has racked up over 11 million views. Comments range from effusive (this slaps) to eye-rolling (thanks for the advice mom and maam, Im 14 years old).

My TikTok presence is like if you had a friend who just happens to be an OB/GYN, Dr. Jones said. Its a good way to give information to people who need it and meet them where they are.

Dr. Jones is one of many medical professionals working their way through the rapidly expanding territory of TikTok, the Chinese-owned short-form video app, to counter medical misinformation to a surging audience. The app has been downloaded 1.5 billion times as of November, according to SensorTower, with an audience that skews young; 40 percent of its users are ages 16 to 24.

Although medical professionals have long taken to social media to share healthy messages or promote their work, TikTok poses a new set of challenges, even for the internet adept. Popular posts on the app tend to be short, musical and humorous, complicating the task of physicians hoping to share nuanced lessons on health issues like vaping, coronavirus, nutrition and things you shouldnt dip in soy sauce. And some physicians who are using the platform to spread credible information have found themselves the targets of harassment.

Dr. Rose Marie Leslie, a family medicine resident physician at the University of Minnesota Medical School, said TikTok provided an enormous platform for medical public service announcements.

It has this incredible viewership potential that goes beyond just your own following, she said.

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Dr. Leslies TikToks on vaping-associated lung diseases drew over 3 million views, and posts on the flu and HPV vaccines also reached broad audiences beyond her hospital.

Striking a chord on TikTok, Dr. Leslie said, means tailoring medical messaging to the apps often goofy form. In one post, she advised viewers to burn calories by practicing a viral TikTok dance. She takes her cues from teen users, who often use the app to offer irreverent, even slapstick commentary on public health conversations. She noted one trend in which young TikTokers brainstormed creative ways to destroy your e-cigarette, like running it over with a car.

TikToks executives have welcomed the platforms uses for medical professionals. Its been inspiring to see doctors and nurses take to TikTok in their scrubs to demystify the medical profession, said Gregory Justice, TikToks head of content programming.

Dr. Jones, the gynecologist, said she was hopeful the platform could help young people develop trust in medical practitioners and view them as more accessible. Back in the old days, there was a town doctor and everyone knew where he lived, and you traded milk and eggs for health care, Dr. Jones said. You had trust in your doctor because you trusted them as a person first. TikTok, she said, can help to humanize doctors shes seen that some of her own patients feel more comfortable with her because they have seen her playful social media posts.

But some doctors are also encountering responses to their videos that they did not expect.

Earlier this month, Dr. Nicole Baldwin, a pediatrician in Cincinnati, posted a TikTok listing the diseases that are preventable with vaccines and countering the notion that vaccines cause autism.

Her accounts on TikTok, Twitter, Facebook and Yelp were flooded with threatening comments, including one that labeled her Public Enemy #1 and another that read, Dead doctors dont lie.

A team of volunteers that is helping Dr. Baldwin monitor her social media has banned more than 5,200 users from her Facebook in recent weeks.

Dr. Baldwin said she started out feeling enthusiastic about the opportunity TikTok provides to educate adolescents, but her experience with harassment gave her some pause.

Theres a fine line physicians are walking between trying to get a message out that will appeal to this younger generation without being inappropriate or unprofessional, Dr. Baldwin said. Because of the short content and musical aspect of TikTok, what adolescents are latching onto is not the professional persona we typically put out there.

A spate of recent TikToks have further stirred questions about the potential for the apps abuse. One recent TikTok post featured a medical professional speculating as she lip synced to the Rex Orange County lyric How Could I Ignore You? that her patients chest pain could have been caused by cocaine. Another showed an emergency room doctor mocking patients who sought treatment in the E.R. rather than from a primary care physician.

Sarah Mojarad, a lecturer who teaches a course on social media for scientists at the University of Southern California, said she has seen physicians either bashing their patients on the app or whitecoat marketing, a term that refers to the use of medical prestige to market inappropriate products like unauthorized supplements.

The youth of TikToks audience also raises the stakes when medical professionals misuse the platform.

With a young audience, its really important to make sure that the content getting out is professional and accurate, Ms. Mojarad said. People may think some of it is medical humor, but it impacts care.

TikToks community guidelines state that the platform does not permit misinformation that may cause harm to an individuals health, such as misleading information about medical treatments. The company expanded its rules of conduct earlier this month, as its user base has grown.

Some physicians worry that TikToks brief, playful clips can blur the line between general education and patient-specific medical advice.

Dr. Austin Chiang, a gastroenterologist and chief medical social media officer at Jefferson Health in Philadelphia, said he has been asked about specific symptoms on TikTok and has to refer users to established medical sources, or directly to their doctors.

Dr. Christian Assad, a cardiologist in McAllen, Tex., said he sometimes scripts his TikToks, given the potential for confusion when he compresses a 60-minute talk on low-carbohydrate dieting into a 60-second musical clip.

Ignoring the platform isnt an option, especially given the prevalence of disinformation on the app, Dr. Chiang said. Two of his more popular posts have countered the use of essential oils to cure diseases and exposed the failings of the celery juice fad diet.

If were not there to be a voice for evidence-based medicine, whos going to do that for us? Dr. Chiang said. Anti-vaxxers are already using social media to their advantage. By putting doctors on social media, were able to be a source of more accurate information.

Still, for doctors turned influencers, the TikTok learning curve can be steep. Dr. Matthew Schulman, a plastic surgeon in New York, said the slightly older users of Instagram and Snapchat have been vital to his private practice, helping to drive roughly 80 percent of consultations. He often streams live from the operating room. Buttock augmentation is really popular on social media, he said.

But TikTok has presented him with cause for additional concern. The virality upside is massive: A post he made earlier this month discussing celebrity clients drew over 6.8 million views. But as he has watched his 10-year-old daughter use the app, he realized that he must exercise more caution in producing content.

The demographic of TikTok is very young, and as a plastic surgeon I dont feel comfortable marketing my services to children, Dr. Schulman said. Simultaneously, he knows the app is growing fast. I dont want to be caught playing catch-up. In two or three years the platform could change, and if I already have an established account Im ahead of the game.

In the meantime, he said, he relies on top-notch TikTok editors his kids.

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Doctors on TikTok Try to Go Viral - The New York Times

Our top 10 news stories of 2019 – AAMCNews

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Medical school in 3 years. The pros and cons of making the USMLE pass/fail. New research into the doctor shortage and, in particular, the shortage of surgeons. These and other top AAMCNews stories of 2019 offer a glimpse into some of the most pressing issues facing students, residents, and faculty at our nations medical schools and teaching hospitals.

In case you missed them, here are our 10 most-read stories of the year:

1. Why women leave medicine

Research shows that almost 40% of women physicians go part-time or leave medicine altogether within six years of completing their residencies. Heres whats behind the early exodus and what pioneering institutions are doing to entice more women to stay.

2. New findings confirm predictions on physician shortage

In April, the AAMC released its annual report on physician supply and demand in the United States. The report shows that the U.S. could see a shortage of up to 122,000 physicians by 2032, impacting patient care across the nation.

3. What happens when a teaching hospital closes?

When Hahnemann University Hospital in Philadelphia announced in June that it was filing for bankruptcy, it set in motion a chain of events that affected everyone from students and residents to program directors, faculty, and patients. Heres how the closure affected not only the 550trainees displaced, but the academic medicine community at large.

4. Should the USMLE be pass/fail?

USMLE Step 1 scores get far more weight than they deserve in the residency selection process, experts say, and thats harming students. Now for the first time, key stakeholders have come together to reform USMLE and the entire selection process.

5. Med school in 3 years: Is this the future of medical education?

Accelerated programs cut student debt and produce grads faster to address physician shortages. But some worry they might sacrifice valuable learning and professional development.

6. DACA students risk everything to become doctors

Nearly 200 undocumented students and residents are training in U.S. medical schools and teaching hospitals. AAMCNews talked to 10 DACA medical students and residents about their journeys to medical school, the challenges they faced as the undocumented children of immigrants, and the passion that drives them to pursue a career in medicine despite tremendous obstacles.

7. So youve matched: Now what? 9 things all residents should know

Value your team. Ask for help. Remember that it gets better. Medical school deans and teaching hospital CEOs offer their best advice for new residents.

8. SWAT doctors

They rush into active shooter scenes and other unimaginably dangerous situations. What it's like to train and serve as a physician on a special operations team.

9. How well does the MCAT exam predict success in medical school?

Researchers spent years studying thousands of students to assess the new MCAT exam. Here are some of their key and surprising discoveries.

10. Desperately seeking surgeons

By 2032, the United States will lack as many as 23,000 surgeons. That will have a dramatic impact given a growing, aging population with increasingly complex health needs.

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Our top 10 news stories of 2019 - AAMCNews

I made promises to the people that I lost How the Iraq war forged a Navy SEALs path to Harvard Medical School and NASA – Task & Purpose

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Navy Lt. Jonny Kim went viral last week when NASA announced that he and 10 other candidates (including six other service members) became the newest members of the agency's hallowed astronaut corps. A decorated Navy SEAL and graduate of Harvard Medical School, Kim in particular seems to have a penchant for achieving people's childhood dreams.

However, Kim shared with Task & Purpose that his motivation for living life the way he has stems not so much from starry-eyed ambition, but from the pain and loss he suffered both on the battlefields of Iraq and from childhood instability while growing up in Los Angeles. Kim tells his story in the following Q&A, which was lightly edited for length and clarity:

Task & Purpose: What made you go for the Navy SEALs rather than Special Forces or Marine Force Recon or something like that?

Jonny Kim: The military for me was never in the picture. My parents wanted me to go to college and get a well-paying job from there, but there's something inside of me that knew I just wasn't ready for that and I didn't want to do that. And I wanted to be a part of something bigger than myself.

I was in martial arts class when I was 16 years old and my friend Keith, who I went to Santa Monica High School with, told me his life goal was to be a Navy SEAL. I'm trying to set the scene that this was 1999, before 9/11, before anyone knew what a Navy SEAL was.

When I listened to Keith talk about this passion, this dream, it was so inspiring to me: a group of warriors that worked in the night that had the hardest military training, and did these operations that no one else would or could do. The most important part of it was that they never sought recognition or advertised the nature of their work. And it was so profound, that level of humility, and professionalism, that I knew that that's what I wanted to do.

I had heard about the Special Forces and I didn't really know much about Marine Recon but there was something that enamored me about the training to be a SEAL, and about Hell Week and all these grueling tasks that I felt that I needed to do.

And a lot of it was for my own selfish needs, like I needed to discover myself and my identity. I didn't really know who I was, and I didn't really like the kind of person that I was growing up to become. And I thought that this was a drastic move for me to kind of reset my life, to reorient what I wanted to do or what I thought I could.

T&P: I can relate to that lack of confidence and wanting to forge your own identity. Can you tell me more about that lack of confidence, was it kind of like a shyness or an insecurity type of thing?

I mean, I don't know how appropriate it is for me to go into detail, but I didn't I didn't have the most stable childhood. And I think a lot of my insecurity and my inability to talk to people and form close relationships stemmed from just childhood instability. That's a large reason why I didn't have big dreams growing up. I didn't have that type of healthy confidence or security, and also maybe this kind of inner frustration that I know I can do something I just, I just need to believe in myself. And I didn't have that.

For me, becoming a SEAL, it was the biggest reset.

T&P: Just to make sure I'm following you are you talking about not having many resources growing up, and feeling like you didn't have many options because of that?

Certainly not financial resources. We were middle class; it would be inaccurate to say that I came from a poor household. But the familial relationships we had in the home were a little unstable. And I think that led to a lot of low confidence growing up.

I'm naturally a pretty private person. But I understand that ... I almost owe it to the next generation of children. One of the biggest reasons why I wanted to be an astronaut was I wanted to be able to inspire young kids.

I feel I owe a duty that I am a little bit more open about where I came from. Because I want young kids to understand that they're capable of achieving their hopes and dreams even if they didn't come from the best place.

T&P: When you decided to become a SEAL, was combat something that you looked forward to? I don't mean that pejoratively, I know that's part of the deal, but was combat something you looked forward to, and how did the actual experience of it measure up to what you imagined it would be?

I don't think I've ever been asked that. I think it's a very profound and astute question. Yes, I think as a naive 18-year-old kid, when I first joined the Navy, I had these grand dreams of going to combat and expecting it to be a certain way, maybe influenced by what I had seen in Hollywood movies or read in books.

But war was not anything that I thought it would be. And it was ugly. And it was painful. And there was a lot of suffering.

And I did find a lot of good out of it. There were some of the most compassionate acts that I've ever seen of love for your fellow man and woman. It gave me a perspective that I don't think I would have achieved any other way. This perspective of the ugliness, but at the same time the beauty of humanity gave me a lot of hope that we can make this world into a better place.

A lot of my inspirations, really all of my inspirations for wanting to do good things in my lifetime, to contribute something positive to the world, were born on the battlefield. I would have to say all of it was.

I mean, I miss my friends dearly that I'll never see again. But I wouldn't trade these experiences for anything.

T&P: I'm new to covering the military beat, and I'm surprised that could be taken away from the battlefield experience, like after seeing all that ugliness and wanting to do something profoundly helpful for people in the world.

Is it okay if i share a story with you?

T&P: Sure, I was about to ask for one, go right ahead.

I think one of the greatest acts of love that a human can show for another is to sacrifice themselves for the life of another and that happened many times. One time that was profound for me, was a young man named Michael Monsoor, who was operating on a combat mission in Ramadi, on September 29, 2006.

A grenade was thrown into his general area and he was the only person among his teammates that could have escaped the blast without harm. But instead, he jumped on a grenade, smothered it completely with his body, absorbing all the impact and died from that last act. And he didn't have much time to make that decision.

I would like to think that I would do the same thing if I was in the same position, but I don't think anyone knows, until they are thrust into that position, what they would do. I know Mike was scared. I know he didn't want to die. But I am so inspired that the love he had for his fellow teammates was greater than his fear of death. And to me, that is an inspiring act that has stayed with me.

There's not too many places I've seen that act of love for someone else.

T&P: You deployed to Iraq twice, and it sounds like they were incredibly difficult deployments to Ramadi and Sadr City How did that path lead you to become an officer and move on to medical school?

I was the combat medic of my platoon and I had the fortunate opportunity to treat my fellow platoon mates, civilians and sometimes the enemy. But there was a limit to what I could do to help people. I was trained to stabilize patients long enough for them to reach a hospital and be treated by a physician, a surgeon, as the definitive care. And I was inspired a lot by the physicians that I worked with. I know a lot of my friends owe their lives to those doctors and their medical staff.

I made promises to a lot of the people that I lost, that I would spend the rest of my life doing something good, something positive for the world, because they left a void when they died, and I know that they would have been successful, making the world a better place had they lived. Those are big shoes for me to fill. At that point in time, I felt medicine was a good platform to spread that goodness, to leave that positive contribution.

T&P: I imagine it must have been a sharp pivot to go from the SEALs, this very intense fraternity, and then go into a civilian setting like Harvard Medical School.was that a difficult transition for you?

It was. It was probably one of the more difficult things for me. It's a different set of tools you need to be successful in the SEAL teams versus in a civilian institution. As much as I like to think of myself as a grounded person with a wide perspective, I had narrow experiences up until that time.

At the age of 18 after high school, I joined the military and I was indoctrinated into that lifestyle. And I learned so much from it. But in a way, I hadn't seen the rest of the world. In a way, I had a unique set of life experiences that no one else, that the majority of people in this world would never, ever experience.

But that is a bubble in itself a little bit, right? So getting outside of that comfort zone, going to a civilian institution and interacting with people of various experiences, some people who were just 18 going to college. That was, that didn't come naturally to me. I had to learn how to do that. And it's hard to find similar experiences, especially if you've had extreme set of experiences in a wartime environment.

And you layer all that with I don't say that I had post traumatic stress disorder. You can call it whatever you want. But the truth is, I was angry after the war.

I had a lot of traumatic experiences. A lot of veterans deal with these traumatic experiences in their own way. And for me, a lot of it was anger that not necessarily directed at any one person or anything, but just having that anger inside and, and trying to try to have a healthy way to to cope with it, cope with all that trauma and all that loss I had.

All the while I'm trying to fulfill my obligations as an officer candidate and work a part time job and also my son was born at that time. It was really one of the hardest transitions in my life ... but I became a lot stronger for it, in a different way.

I don't think strength is purely defined as physical strength or your ability to endure immense amounts of pain or mental trauma. I think strength comes in various forms. And one of them is learning to adapt, and be honest with yourself and be vulnerable. That was one of the hardest things for me is learning to be vulnerable and open up to others.

Because that wasn't something that I really learned in the SEAL teams.

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I made promises to the people that I lost How the Iraq war forged a Navy SEALs path to Harvard Medical School and NASA - Task & Purpose

‘We’ve Rounded the Mark’ – Harvard Medical School

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Heading into his third year at the helm of Harvard Medical School, Dean George Q. Daley said in his annual State of the School address this week that although HMS has been fighting financial headwinds in recent years as it worked to balance its budget while advancing its mission, the School is now on a much firmer financial footing, giving him confidence for the future.

Now, after a lot of diligence by our administrative and financial teams, working in concert with departmental and University leadership, I believe weve rounded the mark, Daley said. We have wind in our sails. I am excitedand cautiously optimisticthat the wind will be with us from here on out.

Get more HMS news here

In a 40-minute address to a packed audience in the campus Armenise Amphitheater on Jan. 22, Daley said the Schools more stable finances are the result of efficient management practices, greater success in obtaining National Institutes of Health grants, successful real estate transactions and other financial measures.

As a result, he said, HMS has reduced its deficit from $49 million in FY 2016 to $10 million in FY 2019, and while it still has a projected deficit of $4 million in FY 2020, administrators are predicting a cash flow break-even in the next year or two. Daley added that the Schools achievement of balancing its books was accomplished without any financial assistance from the University or the $200 million 2018 Blavatnik Family Foundation commitment. That commitment, in fact, included assurances the School would address its debts before receiving the funds.

He cautioned that although the HMS financial picture has brightened considerably, the School should remain prudent stewards of our resources, especially in light of uncertainty in financial markets.

Complacency or a lack of discipline will invariably lead us back to structural deficits, Daley said.

Collaboration, innovation and investments

As a result of the Schools improved financial circumstances, Daley said we are now poised to deliver more powerfully than ever on the promise of this amazing institution. He described recent strategies being taken to maximize collaboration across and between personnel on the Quad, at the Schools affiliates and throughout the University, mentioning theDeans Innovation Awardsas a primary way HMS is catalyzing collaborative research.

To date, Daley said, the awards program has granted more than $29 million to 92 collaborative projects involving 169 investigators across the community; the vast majority of the funding is supporting fundamental, curiosity-driven research with 25 percent involving co-investigators at affiliated hospitals and research institutions.

An additional awards program for innovation in education, administrative efficiencies, and diversity and inclusion drew 79 proposals, he said, with $3 million in grants awarded to 33 projects involving 98 individuals.

Daley said another program designed to bolster research productivity involves investments in shared research platforms, such as the 30-plus research cores around the Quad. The new Foundry Program is involved in a plan to upgrade existing cores and create new ones, he said, providing more than $11 million to enhance and expand 14 existing facilities and support development of seven new technologies.

One example he cited is the Cryo-Electron Microscopy Center for Structural Biology, a joint effort between the University, HMS, Boston Childrens Hospital, Dana-Farber Cancer Institute and Massachusetts General Hospital.

Over the past year, HMS structural biologists have used cryo-EM to understand the molecular anatomy of proteins that play critical roles in human health and disease, Daley said. The addition of cryo-EM to the structural biology toolbox has opened our eyes to a breathtaking, new level of structural complexity.

Daley added that HMS is investing heavily in data science and computational biology in every Quad department, aided by the new Center for Computational Biomedicine, where working groups are focusing on single-cell analytics, novel imaging modalities, and data science and analytics support for the broader community. One pilot project involves developing a suicide-prevention app and another involves the creation of an app to aid in more precise prescribing of opioids.

The Schools new Therapeutics Initiative, supported by the Blavatnik commitment, is promoting efforts to develop novel and effective therapeutics, Daley said, by helping to overcome barriers between academia and industry through grants targeted to therapeutics development, core platform investments and educational programs.

To highlight an important milestone in the development of this initiative, Daley introduced Mark Namchuk, the new executive director of therapeutics translation, who comes to HMS from a 20-year career in the pharmaceutical industry and whose job will involve integrating the various components that will contribute to the initiative, such as the new Blavatnik Harvard Life Lab Longwood, to be built in Building C on the Quad.

Education and diversity

Turning to education, Daley lauded the School for the successful completion of its review by the Liaison Committee on Medical Education, which awarded HMS full accreditation for another eight-year term. The LCME praised the School for its pioneering Pathways curriculum, Daley said, expressing his gratitude to the many people at HMS who contributed to the successful review.

He mentioned that plans are underway to reform the structure of the core clinical clerkship year and to review the Schools Health Sciences and Technology curriculum. Daley called out new Graduate Education Dean Rosalind Segal, who is overseeing HMS masters and PhD programs. Daley said the HMS Office for External Education is continuing to create pioneering educational offerings, making the latest insights in science and medicine accessible to an ever-growing range of learners worldwide.

Despite the success and growth of the Schools education programs, Daley said he continues to be concerned about student debt, adding that even with more than 70 percent of MD students receiving need-based financial aid, many continue to graduate with considerable debt. To further address student debt issues, Daley said the School is redoubling its efforts to seek philanthropic support for financial aid. To support doctoral programs, he said, fundraising for graduate student fellowships has now been made a University-wide priority.

Despite the challenges that may lie ahead, Daley said his spirits are lifted by the earnest work done across the HMS community on a daily basis. He said he was particularly inspired by last falls diversity and inclusion 50thanniversary symposium, which marked the movement in the late 1960s in which a group of HMS faculty successfully campaigned for the creation of 15 scholarships for students from minority backgrounds. As a result of that initiative, he said, the School has since graduated more than 1,350 students from backgrounds underrepresented in medicine who have gone on to distinguished careers, influencing medicine across the country and the world. He added that last years entering class of HMS medical students was the most diverse ever.

In closing his address, Daley said, Please know that it is your energy, your drive and your achievements that compel me to work harder and strive to do better.

As we set out for 2020 together, with the wind at our backs, Im excited to see what this coming year will bring, he said.

Image: GretchenErtl

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'We've Rounded the Mark' - Harvard Medical School

Fall River man spreading awareness of rare cancer that killed his wife – SouthCoastToday.com

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FALL RIVER Itll be nine years Dec. 10 since Harry Proudfoot said goodbye to his wife, and in that time he hasnt forgotten the love of his life or slowed his efforts to increase awareness of her rare form of cancer.

Its a disease theyre still not talking about in medical school, Proudfoot said. If you dont know it exists, then you cant suspect it at all.

Proudfoot, a Fall River resident, never suspected that his wifeJane Dybowskiwould die at the age of 56 from neuroendocrine cancer, a debilitating disease, after having been so active and vital.

The couple met as teachers at Westport High School. She died six months before their planned retirement, leaving Proudfoot to mourn their future.

He described his wife as an intelligent and proud woman with a big heart. She was passionate about science, loved writing and literature, and was athletic and courageous.

Proudfoot said he watched Jane suffer for months as the disease took away her independence.

Her life over the last year shrunk until it was the size of a hospital bed, he said.

A neuroendocrine tumor is a cancer of the neuroendocrine cells, which have similar traits as nerve cells and cells that produce hormones.

There may no symptoms of the disease at all, or symptoms can include fatigue, a lump, pain, losing weight, diarrhea, dizziness, shakiness, skin rash and more, according toMayo Clinic.

Roughly 12,000 people in the United States are diagnosed with neuroendocrine cancer each year. The disease is often fatal because of the lack of screening tests and knowledge, and its symptoms that can be similar to other conditions.

For those reasons, Proudfoot works to educate others about neuroendocrine cancer, including the public, physicians, nurses and medical journals.

Its a very different disease, he said.

Proudfoot is just wrapping up a 30-day campaign to spread the word through #30NET cancer facts in 30 days.

Each day throughout November, Proudfoot is posting facts about neuroendocrine cancer on social media including that new diagnoses of the cancer are on the rise in the United States, increasing six-fold since 1973 to 6.98 per 100,000 people today.

In the coming weeks and months, he will send pamphlets about the disease to primary care practices and medical schools around the country.

Proudfoot said he feels he must do something, especially if it can lead to more research or a cure. He said there is no army fighting for an end to neuroendocrine cancer.

I dont ever want anyone to go through that, Proudfoot said. If I can play even a tiny role in preventing even one person from going through that, its my job.

Proudfoot works five days a week advocating for research and helping patients through Walking with Jane, a foundation dedicated to preserving Dybowski's name and funding research, understanding, diagnosis and treatment of neuroendocrine cancer.

Walking with Jane offers an annual walk and golf tournament. It has funded research papers, raised more than $170,000 for the Jimmy Fund Walk and $500,000 for the Pan Mass Challenge, has established a fund for primary physician education, distributed scholarships at Westport High School and Bridgewater State University, offered outreach at local craft fairs, dinners and other events, and more.

Proudfoot said his job isnt always easy, especially when he continues to lose people with whom he grows close to cancer.

Sometimes, I feel like Im standing at the base of a mountain throwing tiny stones up, hoping to cause an avalanche, Proudfoot said. So, we just keep throwing rocks.

To learn more, follow Walking with Jane on social media. To reach Proudfoot, email walkingwithjane@gmail.com.

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The science of scheduling: When to do key medical school rotations – American Medical Association

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When you enter the clerkship phase of medical schooltraditionally during the third yearyou are getting exposure to your future in the form of your core clinical rotations.

Lasting between four and eight weeks, at most schools, the core clinical clerkships consist of internal medicine, surgery, obstetrics and gynecology, pediatrics, family medicine, psychiatry, neurology and radiology.

Students have autonomy in their clinical rotations in that they can schedule them as they see fit. Is there a right way to do it? A medical student and resident offered insight on that question.

Kevin Perez is a second-year medical student at A.T. Still University School of Osteopathic Medicine in Arizonaone of 37 member schools of theAMA Accelerating Change in Medical Education Consortium.

When Perez begins his clinical rotations, he plans to start with the ones that are the most broadly applicable.

Im going to pick the most holistic ones first, Perez said. So, Im probably going to pick family medicine. Its slower paced, and it gives you a better understanding of what being a doctor is. So, surgery and EM [emergency medicine] would probably be what Ill do toward the end.

According to Luke Burns, MD, a second-year ob-gyn resident at Michigan Medicine, the rotations that give you the best knowledge base to build upon are going to depend on your preferred medical specialty.

If you want to do ob-gyn, youre going to want to do surgery first, so youre really good at surgery and know how to scrub into a case, Dr. Burns said. Likewise, if you want to do pediatrics, maybe do medicine first, so you have some inpatient experience before you go to the wards.

Perez is planning on going into emergency medicine. Because of that, he plans to do that rotation later in his training.

It's graded kind of subjectively, Perez said. Because of that, your performance and how much you know coming in, are going to define how well you do. If you want to do EM, you want to do well in that rotation for when you apply to EM residencies later. Picking it as your first one wouldnt be a great idea, unless you are truly ready. You only get one shot.

The key metric on which clerkship performance is evaluatedand one which residency programs take into considerationis a medical students scores on shelf exams, which come at the conclusion of a core rotation.

One really important thing I didnt realize would happen is I got better at taking shelf exams, Dr. Burns said. My shelf scores improved as the clinical year went by. If you feel a little shaky taking exams, theres some advantage to making it so your most important exams come at the end.

You may not know what you want to do when youre entering clerkships. But youre likely to know a few specialties you dont want to do. It makes sense to load those at the front of your clerkship schedule.

The common philosophy is to schedule the things you dont want to do first, Dr. Burns said. If you dont want to be a pediatrician, do that rotation first. Because its the one youll cut your teeth on, youll mess up on it, and by the time you get to the next thing, the theory goes, youll know what to do and how to impress attendings and residents.

In Dr. Burns case, he scheduled his ob-gyn rotation as his second-to-last rotation.

That was always the plan, he said, because then it would mean that it wasnt the very last thing, so I had time to change my mind and I had time to get my [subinternships], those important rotations for my fourth year, in order.

When thinking about scheduling core rotations, Dr. Burns acknowledged that it can be a difficult for people who dont know what they want to go into. But, he added, its not the end of the world if medical students wind up doing clerkships early on in specialties they decide to pursue for residency.

For additional tips on a number of relevant medical school topics, including scheduling clinical clerkships, visit the AMA Career Planning Resource.

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The science of scheduling: When to do key medical school rotations - American Medical Association

The Gujarat government proposes 5 new medical schools to increase MBBS seats – education – Daily Gaming Worlld

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The Government of Gujarat will seek approval for the establishment of five new medical schools in Panchmahal, Gir-Somnath, Devbhumi-Dwarka, Botad and Morbi districts as part of a central government program, Deputy Prime Minister Nitin Patel said on Wednesday.

He said the estimated total cost of setting up the college would be 1625 rupees, of which the central portion would be 60 percent.

Patel said that every new medical school has 100 seats for MBBS.

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The total admission of MBBS to Gujarat would exceed 6,300 after the center approved the five new medical schools, he said.

Speaking to reporters in Gandhinagar, Patel said existing state hospitals in Panchmahal, Gir-Somnath, Devbhumi-Dwarka, Botad, and Morbi districts would be added to the new colleges after they were approved by the Medical Council of India (MCI) have been upgraded.

The Union government has identified 75 districts in the country that do not have a medical school. A few months ago we sent a proposal to build medical schools in the Narmada, Porbandar and Navsari districts. Now were sending the center another proposal to approve medical schools in these five districts, said Patel.

In order to operate a medical university, the connected hospital must have at least 300 beds in accordance with the MCI standards.

Therefore, the state government will first upgrade these five hospitals according to the standards before building medical schools, Patel said, adding that each college would cost 325 billion rupees, bringing total spending to 1625 billion rupees.

The proposed medical colleges are located in the city of Godhra in Panchmahal, in Khambhalia in Devbhumi-Dwarka, in Veraval in Gir-Somnath and in Botad and Morbi.

According to the central system, 60 percent of the cost of 1625 rupees for the five colleges will be borne by the center, while the state government would contribute 40 percent. We will make the country available free of charge. Each college will have a capacity of 100 MBBS, said Patel.

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Sit, Heal: Dog Teaches Military Med Students The Merits Of Service Animals – Kaiser Health News

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The newest faculty member at the Uniformed Services University of the Health Sciences has a great smile and a wagging tail.

Shetland, not quite 2 years old, is half golden retriever, half Labrador retriever. As of this fall, he is also a lieutenant commander in the Navy and a clinical instructor in the Department of Medical and Clinical Psychology at USUHS.

Among Shetlands skills are hugging on command, picking up a fallen object as small as a cellphone and carrying around a small basket filled with candy for harried medical and graduate students who study at the militarys medical school campus in Bethesda, Md.

But Shetlands job is to provide much more than smiles and a head to pat.

He is here to teach, not just to lift peoples spirits and provide a little stress relief after exams, said USUHS Dean Arthur Kellermann. He said students interacting with Shetland are learning the value of animal-assisted therapy.

The use of dogs trained to help their human partners has ballooned since studies in the 1980s and 1990s started to show how animals can benefit human health.

But helper dogs come in many varieties. Service dogs, like guide dogs for the blind, help people with disabilities live more independently. Therapy dogs can be household pets who visit people in hospitals, schools and nursing homes. And then there are highly trained working dogs, like the Belgian Malinois that recently helped run down Islamic State leader Abu Bakr al-Baghdadi.

Shetland is technically a military facility dog, trained to provide physical and mental assistance to patients as well as interact with a wide variety of people. His military commission does not entitle him to salutes from his human counterparts.

The ranks are a way of honoring the services [of the dogs] as well as strengthening the bond between the staff, patients and dogs here, said Mary Constantino, deputy public affairs officer at Walter Reed National Military Medical Center.

USUHS, which trains doctors, dentists, nurses and other health professionals for the military, is on the same campus in suburban Washington, D.C., as Walter Reed. Two of the seven Walter Reed facility dogs Hospital Corpsman 2nd Class Sully (the former service dog for President George H.W. Bush) and Marine Sgt. Dillon attended Shetlands formal commissioning ceremony in September as guests.

The Walter Reed dogs, on campus since 2007, earn commissions in the Army, Navy, Air Force or Marines. They wear special vests designating their service and rank. The dogs visit and interact with patients in several medical units, as well as in physical and occupational therapy, and help boost morale for patients family members.

But Shetlands role is very different, said retired Col. Lisa Moores, USUHS associate dean for assessment and professional development.

Our students are going to work with therapy dogs in their careers, and they need to understand what [the dogs] can do and what they cant do, she said.

As in civilian life, the military has made significant use of animal-assisted therapy. When you walk through pretty much any military treatment facility, you see therapy dogs walking around in clinics, in the hospitals, even in the ICUs, said Moores. Dogs also play a key role in helping returning service members with post-traumatic stress disorder.

Students need to learn who the right patient is for a dog, or some other therapy animal, she said. And by having Shetland here, we can incorporate that into the curriculum so its another tool the students know they have for their patients someday.

The students, not surprisingly, are thrilled by their newest teacher.

Brelahn Wyatt, a second-year medical student, said the Walter Reed dogs used to visit the schools 1,500 students and faculty fairly regularly, but having Shetland here all the time is optimal. And not just because of the hugs and candy.

Wyatt said the only thing she knew about service dogs before is that youre not supposed to pet them. But Shetland acts as both a service dog and a therapy dog, so he can be petted.

That helps medical students see theres a difference. What does that difference look like in the health care setting? said Wyatt.

Like his colleagues Sully and Dillon, Shetland was bred and trained by Americas VetDogs. The New York nonprofit provides dogs for stress control for active-duty military missions overseas, as well as service dogs for disabled veterans and civilian first responders. Many of the puppies are raised by a combination of prison inmates (during the week) and families (on the weekends), before returning to New York for formal service dog training. National Hockey League teams such as the Washington Capitals and New York Islanders also raise puppies for the organization.

Dogs can be particularly helpful in treating service members, said Valerie Cramer, manager of Americas VetDogs service dog program. The military is thinking about resiliency. Theyre thinking about well-being, about decompression in the combat zone. Often people in pain wont talk to another person but will open up in front of a dog. Its an opportunity to start a conversation as a behavioral health specialist, she said.

While service dogs for individuals are trained to perform both physical tasks like picking up dropped items and emotional ones like waking a veteran having a nightmare, facility dogs like Shetland are special, Cramer said. That dog has to work in all different environments with people who are under pressure. It can work for multiple handlers, it can go and visit people, can go visit hospital patients, can knock over bowling pins to entertain or spend time in bed with a child.

The military rank for the dogs is no joke. They can be promoted as Dillon was from Army specialist to sergeant in 2018 or demoted for bad behavior.

Said Kellermann, So far, Shetland has a perfect conduct record.

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First times in the emergency department – Scope

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First times are hard to forget.

They make for great stories -- nostalgicand self-deprecating reminders of who we were before we became who we are now.Medical school is the setting for many first times; stories of jittery firstblood draws, or students nodding along to heart sounds that they didn'tactually hear, are ubiquitous. However, I wish we would more directly address themistakes that can happen in these first times.

I have just stepped out of my second procedures shift in the emergency department, where I have the opportunity to practice skills like placing IVs, doing electrocardiograms and placing sutures on patients with real medical issues ranging from shortness of breath to hemorrhage. I've attended a formal training session and then conducted these procedures on several patients, but every new patient still feels like the first time for me.

I wear a false cloak of confidence each time I introduce myself as a medical student, and politely ask if a patient is willing to let me perform the procedure on them -- earlier today, it was an IV. I used small talk as a distraction from the sharp needle I was about to puncture into the patient's arm -- a distraction that worked well for both of us and further masked my inexperience.

As I drove the needle forward, I was well aware of the gamble I took -- I had no clue if there would be a flash of blood to indicate I was where I needed to be. While the anxiety burned my fingertips, I continued to coax the patient through this procedure, managing to compose a steadiness in my voice that I wished would exist everywhere else.

I found a vein --but sometimesI don't. I always make eye contact with a nearby nurse, letting the panic settlein my eyes. They confirm my successes with a slight nod or my failures with aswift take-over. I avoid eye contact with the patients, hoping they'll continueto be blind to my unease.

Perhaps that is the true skill I am learning to hone during these shifts -- "fake it 'til you make it," as they say. This makes me uncomfortable. I want the patient to trust me and believe that I know what I am doing, but do they deserve to know that I don't actually feel this way?

I am lucky that the patients I have worked with have been so encouraging of my learning process and understanding of my imperfections. I remember one patient waving off his concerned son after I could not get my IV in on the first try: "Let her learn. I feel fine!" he said, before giving me the thumbs up to try again. But I know that not every patient will be so forgiving.

The idea of "practicing" on realpatients is discomforting. When I make mistakes, the patients will have to dealwith the repercussions -- a bruise from a failed blood draw or an uneven scarfrom an imperfect suture. This lingering guilt makes the failure that much moreformidable for me. It is difficult to place my learning above a patient's needfor the best care possible; and when I ask nurses if I can perform a procedurerather than them, I feel as if I am robbing a patient of that care.

I realize that as a medical studentI will one day be responsible for patients as a full-fledged doctor, with few peopleabove me on the ladder of support to call for help. These moments of uncertaintythat I traverse through now are my investment into my ability to care forpatients in the future; I am asking the patients I see today to make thatinvestment in me as well.

Their investment is an act ofaltruism that they may not even be aware of. I wish I could repay their faithin my future self, but I can't. With each of these acts of altruism, though, Ifind the vein a little quicker, and hold the needle a little more steadily.

One day, it will stop feeling like the first time.

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

Tasnim Ahmed is a second-year medical student from Bangladesh and Queens, New York. She has a background in cognitive neuroscience and education. Her interests include global health, women's health, and embroidery (for her own health).

Photo by josh

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First times in the emergency department - Scope

MEDICAL SCHOOL – 4 Years EXPLAINED

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The four years of medical school are no joke. Unlike college and your pre-med years, life as a medical student varies highly yet is very structured year to year. In this video, we'll explore each year of medical school and what you should expect.

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Disclaimer: Content of this video is my opinion and does not constitute medical advice. The content and associated links provide general information for general educational purposes only. Use of this information is strictly at your own risk. Kevin Jubbal, M.D. and Med School Insiders LLC will not assume any liability for direct or indirect losses or damages that may result from the use of information contained in this video including but not limited to economic loss, injury, illness or death.

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MEDICAL SCHOOL - 4 Years EXPLAINED

Climate Change Curriculum in Med School Is a Waste of Time and Money – Somewhat Reasonable – Heartland Institute

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The coalition claims climate change has unleashed an epidemic of disease to which doctors must now pay particular focus. What are these exotic illnesses, you may ask? Asthma, heat stroke, Lyme disease, allergies, and respiratory and cardiovascular conditions are some of the ailments listed by the leaders behind the climate change in med school movement. Climate change is really the greatest health danger of our century, said Mona Sarfaty of the Medical Society Consortium on Climate on Health.

Epidemics and disease have existed since the beginning of time, regardless of the political and social context. Imagine how ridiculous it would be to learn that doctors in the Middle Ages were required to pass a test on the intricacies of the feudal system prior to treating the plague! There are any number of professionalsscientists, epidemiologists, climatologists, and so forthwhose job it is to figure out why disease is happening. Medical schools should be focused on thehowof treating disease, not being indoctrinated with politically tinged subjects such as climate change.

When medical schools engorge their curriculums with political fare, it comes at the expense of something else. For example, few doctors now learn anything about running a practice in todays over-priced, over-regulated, and overly complex health care market. If doctors want to learn about operating a practice that can thrive outside of the clutches of insurance companies or government payers, they must learn it on their own.

Organizations such as The Benjamin Rush Institute, which promotes service to patients, not government, have run into numerous obstacles setting up chapters in medical schools. Medical students themselves have too much on the line to speak out. In the words of one student who spoke on the condition of anonymity, business is a dirty word on medical school campuses. Even if there were professors willing to create and teach such a course, the student said, who would hire them or let them teach it?

When they complete medical school and residency,physiciansfeel freer to discuss the narrow scope of their training, one that is hospital-centric. Physicians in direct primary care will tell you they had to learn about this model on their own. Management, negotiation, and finance are rarely covered at the residency level.

When primary care doctors arent taught how to make a practice thriveone that can truly serve patientsthey gravitate instead to fields where their considerable time and investment will pay off. The United Stateswill face a shortage of nearly 122,000 physiciansby 2032, and while the aging population explains part of the scarcity, there is no question medical schools and residency programs need to do more to make medicine an attractive profession.

Todays doctors do not relish spending 18-hour days coding and documenting patient care for third-party payers. They would be much better served by being exposed to new models that work in the evolving marketplace, where technology is changing the face of medicine, and consumer patients demand more value for their buck. Bolstering primary care is key; doctors on the front lines can nip complex and expensive ailments in the bud.

Because so much medical training is subsidized by the health care industry and government, its no wonder they have so much influence in determining what is and what is not taught in medical school. Hospitals, drug makers, and the AMA itself profit from the status quo,and the last thing they want is for doctors to go rogue. Big players, however, arent stuck with the bills from todays astronomical health care costs.

There is no room today in our daunting health care system to be wasting time and money teaching doctors about climate change. As taxpayers and consumers who foot the bills, we should demand medical schools focus on something less worldly but more criticalthe patient.

[Originally Published at the Epoch Times]

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Climate Change Curriculum in Med School Is a Waste of Time and Money - Somewhat Reasonable - Heartland Institute

Coronavirus Tests: Lab At University Of Washington Was Ready : Shots – Health News – NPR

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"Access to testing is really the major tool we have right now to fight this new coronavirus," says Dr. Keith Jerome, who runs a University of Washington lab in Seattle that can now test for the virus. Jonathan Hamilton/NPR hide caption

"Access to testing is really the major tool we have right now to fight this new coronavirus," says Dr. Keith Jerome, who runs a University of Washington lab in Seattle that can now test for the virus.

It's been a busy week at the virology lab run by UW Medicine, which includes the University of Washington's medical school and hospitals.

"We've already gone to three shifts," says Dr. Keith Jerome, a professor in the department of laboratory medicine who runs the lab. "People are going to be here basically all the time."

The lab is processing about 100 coronavirus tests a day. But it's prepared to do more than 1,000 a day immediately and could quickly increase that to 4,000, Jerome says.

The demand for tests is rising. Seattle is at the center of a coronavirus outbreak that has already claimed the lives of 10 people in Washington state.

One reason the lab is ready to test lots of people is its state-of-the-art equipment, including twin devices that extract genetic material from specimens.

"That all happens robotically," Jerome says, as he gives me a tour of the lab's testing area. "You can see the arms here moving back and forth. This robot is working on 96 specimens at a time. We have two of them. This is part of the magic of moving so many specimens through this laboratory."

In another area of the lab is a room full of instruments that take bits of genetic material from a virus and make millions of copies. That's critical for detecting an infection, Jerome says.

"Right now this is our limiting factor," he says, adding that they've already asked to borrow more of the instruments from other labs affiliated with the university.

But the lab's readiness also is the result of months of planning.

Jerome and other virologists started the process in January, after hearing reports about the coronavirus outbreak in China.

"Our opinion was, this is probably not going to be a problem, this is probably going to be a waste of our effort and some money, but we owe it to the people of our area to be prepared," he says.

So the scientists developed an assay and began using it test specimens sent in for research purposes.

At first, the tests found no infections, says Dr. Alex Greninger, the lab's assistant director. Then, on Feb. 28, one came back positive.

"That was on Friday at 4 p.m.," he says. "And then Saturday morning the FDA came out with a new regulation that allowed us to perform testing."

The change at the Food and Drug Administration was a new policy that allowed sophisticated labs like the one at UW Medicine to develop and use their own coronavirus tests before the agency had reviewed them.

On Monday and Tuesday, the lab quietly began accepting specimens for clinical use and preparing for high-volume testing.

"It was intense," Greninger says, adding that he and colleagues were working past midnight to make sure the system functioned properly.

But the hard part wasn't the testing itself, Greninger says, but the logistics.

For example, "how many swabs you're going to take from each patient, how you're going to handle sending results and samples to the state public health lab," he says.

Then on Wednesday, Jerome and Greninger held a press conference to announce that the lab was officially open for business.

Now they are expecting an avalanche of specimens. And that's a good thing, Jerome says.

"Access to testing is really the major tool we have right now to fight this new coronavirus," he says

Even with the lab's increased capacity, though, testing remains limited to people who have symptoms including fever and a dry cough.

"My goal is everyone who needs a test can get one," Jerome says. "And that might be different than everyone who wants a test."

Local doctors say the lab will make a huge difference.

"It's a game changer," says Dr. Seth Cohen, medical director for infection prevention at UW Medical Center Northwest. "Previously when we would send those tests to the [Centers for Disease Control and Prevention] in Atlanta it was taking three to five days to get those tests back."

Now results often come back the same day. And that means doctors and hospitals can focus resources on the patients who are truly infected.

Conserving scarce resources will become critical if the coronavirus continues to spread, Cohen says.

"We did not plan on being at the epicenter of one of the outbreaks in the United States," Cohen says. "And we are preparing for the worst."

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Coronavirus Tests: Lab At University Of Washington Was Ready : Shots - Health News - NPR

Medical schools considering early graduation for students – CNN

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New York University started offering this option on Tuesday, becoming the first medical school to do so. And now other medical schools are considering doing the same.

"While the AAMC has not yet surveyed its member medical schools, the [Liaison Committee on Medical Education] has been working with several other schools that are considering or offering their students the option of graduating early," said Dr. Alison Whelan, chief medical education officer for the Association of American Medical Colleges.

In Massachusetts, all four medical schools are in discussions with Massachusetts Health and Human Services to have a fast-track option. Tufts University School of Medicine, University of Massachusetts Medical School, Boston University School of Medicine and Harvard Medical School are all contemplating the idea, said Massachusetts HHS Secretary Marylou Sudders on Thursday.

Dr. Whelan confirmed that they have been working with the deans of the medical schools in Massachusetts to graduate students early.

Whelan told CNN that they are aware that nearly every school in the US is thinking about early graduation to battle the coronavirus pandemic.

In New Jersey, Cooper Medical School of Rowan University also sent an email to its senior medical students to see if they were interested in early graduation.

And it's not just young doctors who want to pitch in and help. In Illinois, retired healthcare workers are stepping up to the plate. Illinois governor J. B. Pritzker tweeted that 450 retired and former healthcare workers have signed up to work during the pandemic. Those that rejoin the workforce will help staff hospitals and health care centers throughout the state, the tweet said.

The governor had issued a call last week for former healthcare workers to rejoin the work force during this crisis.

Around the US, physicians who are not infectious disease specialists or pulmonologists are training and joining the frontlines.

"We are hearing that there are individuals from other specialties being drawn into clinical care," said Dr. Janis Orlowski, chief health care officer for the AAMC on Friday.

Orlowski added that they are being trained very quickly to get them up to speed in the use of personal protective equipment and ventilators. These additional trainings will ensure that physicians are safe to work in areas that might not be their specialty.

"Safety and quality remains a high priority -- the number one priority -- even though people are having to work fast and work smart," Orlowski added.

The US has now reported more coronavirus cases than any other country in the world, according to CNN's tally. It has surpassed China and Italy.

CNN Health's Minali Nigam and Gina Yu contributed to this report.

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Concern over NIH cuts unites Worcester’s medical school, political leaders – Worcester Telegram

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Cyrus Moulton Telegram & Gazette Staff @MoultonCyrus

WORCESTER - Concerned with President Donald J. Trumps proposal to cut National Institutes of Health funding by 22 percent, UMass Medical School officials, researchers and local political leaders gathered Wednesday to discuss the scientific and economic importance of robust NIH funding.

Were deeply concerned with the proposed cuts by the president and the impact it could have on innovation, medical progress, the health and well-being of patients and our local innovation economy, said Michael F. Collins, chancellor of UMass Medical School.

Dr. Collins estimated that the presidents proposal could cost the school between $45 million and $73.5 million annually and cost the local economy from $100 million to $170 million annually. This is a critical time in our country in terms of the future viability of the research and development environment, and its a critical time for our institution and our city, given how important this sector is to our economy.

In his 2018 budget request, Mr. Trump proposed cutting the NIH, the nations preeminent and largest funder of biomedical research, by $7.7 billion from its final budget in 2017.

That has the local scientific community worried, as UMass Medical School currently receives more than $150 million annually from 344 NIH funding awards and nearly $53 million from other federal funding sources. NIH funding is more than half of the nearly $254 million in total research funding the medical school receives from all sources.

This funding has helped lead to the development of lifesaving drugs for cystic fibrosis and supported work by Nobel Prize winner Craig Mello. It has also helped the medical school produce 148 licenses with 109 private companies and file hundreds and hundreds of patents, virtually all of which are attributable to NIH-funded research, according to Dr. Terence R. Flotte, executive deputy chancellor, provost and dean at UMass Medical School.

Also attributable to NIH funding is work by researcher Beth McCormick to improve chemotherapies and develop new anti-inflammatory treatments based on a study of how salmonella causes disease.

All of this was really launched by NIH, Ms. McCormick told the local leaders.

Aside from the scientific advances, the funding is also crucial to the local economy. A 2015 study by United for Medical Research showed that each dollar of NIH funding to Massachusetts institutions has an estimated economic impact of approximately $2.30, meaning UMass Medical Schools NIH-funded research contributes $347,971,099 to the Massachusetts economy.

Scientific research to Massachusetts and Worcester is what citrus growing is to Florida or auto production is to Michigan, said U.S. Rep. James P. McGovern, D-Worcester. He noted that Massachusetts ranks first in per-capita research funding from the NIH and second in total NIH funding behind only California.

He called the proposed cuts a threat to this citys and this states ability to thrive in the face of global competition, noting several other countries recent increases in medical research funding.

Dont be fooled into thinking this is just a Boston thing. Worcester does incredibly well, Mr. McGovern continued, noting that the NIH awarded a total of 369 grants worth nearly $165 million to Worcester institutions in 2016.

And city leaders want to ensure that this continues, especially as the city grows. Both Mayor Joseph M. Petty and City Manager Edward M. Augustus Jr. said that Worcester is experiencing a resurgence that they attribute to the citys institutions of higher learning and research community.

If there is anything that has the potential to limit or slow the work youre doing, it limits the ability for this city to grow and to thrive and limits the hope that the people who live in this city and around the world see in the work that youre doing, Mr. Augustus said. Your health and vitality as an institution are inextricably linked to our health and vitality as a city.

As for the likelihood of the proposed cuts being enacted, Mr. McGovern and Dr. Collins both noted that the NIH receives bipartisan support. In fact, Congress recently boosted the 2017 NIH budget by $2 billion despite the Trump administrations proposal for next year.

But local leaders arent taking any chances.

We need to really redouble our resolve, that the values of our nation invest in medical research and continue to bring hope to the human condition, Dr. Collins said. And all of us at UMMS will work with our governmental leaders to advocate for that funding."

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Concern over NIH cuts unites Worcester's medical school, political leaders - Worcester Telegram

A-State Explores Partnership with Adtalem Global Education to Deliver First In-State Veterinary Medicine School – ASU News

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01/31/2020

Those participating in the announcement included (from left) Dr. Jerry Miller of Paragould, Dr. Bud Kennedy, Dillon Lechak of Hot Springs, Aubrey Miller of Hot Springs, Katherine McGinness of Little Rock, Caylee McGuire of Batesville, Dr. Alan Utter, and Dr. Kelly Damphousse.

Watch the announcement:https://www.facebook.com/ArkansasState/videos/171667867446506/

JONESBORO Arkansas State University announced an agreement to collaborate with Adtalem Global Education (NYSE: ATGE) to explore the feasibility of creating the first in-state veterinary medical school, Chancellor Kelly Damphousse said Friday.

Damphousse spoke with Faculty Senate prior to announcing that the university is exploring a public-private partnership with Adtalem, a global workforce solutions provider based in Chicago, with expertise educating veterinarians to AVMA-accredited standards. Provost Alan Utter, who will be the lead contact for the 180-day exploration period, briefed the university deans.

The demand for veterinarians is significant as more households enjoy pet ownership, and Arkansas livestock producers have acknowledged a shortage of veterinarians for large animals, said Damphousse. This is a concern that our College of Agriculture faculty and others across the region have expressed to us. I am excited to begin the discussion on our campus. We plan to work closely with veterinarians throughout Arkansas as we move forward in the development of this new college.

From practical experience, we know the need exists for more veterinarians, especially large animal practitioners, across our region and state, Professor of Animal Science and Interim Dean of the College of Agriculture Dr. Donald Bud Kennedy said. With the current resources that Arkansas State can bring to this process, we believe we can have a tremendous positive impact for the veterinarian profession and our agricultural industry.

Damphousse also announced to the university faculty the creation of a Veterinary College Task Force to work with him in the vetting process, and named Kennedy as the task forces chair.

When Bud and our former dean Tim Burcham first approached me with the idea, I was very supportive because it speaks to our core mission for Arkansas and the region, Damphousse said. I want to stress that we are at the beginning stages. Along with chairing our Task Force, I have asked Dr. Kennedy to assist with selection of participants and request that they return with a recommendation later this year.

The proposed veterinary medicine program would enroll classes of approximately 120 students each year. Accreditation for any A-State College of Veterinary Medicine would be sought by the university, and graduates would have Arkansas State academic credentials. Adtalem, the parent company of AVMA-accredited Ross University School of Veterinary Medicine, would provide expertise related to veterinary program management and accreditation, as well as capital and operating expense funding.

Adtalem Global Education has a demonstrated history of filling critical workforce needs, particularly as it relates to the veterinarian profession, said Kathy Boden Holland, group president of Medical and Healthcare for Adtalem Global Education. Partnering with Arkansas State University is an excellent opportunity to provide an exceptional veterinary education in Arkansas, giving students a pathway to become skilled veterinarians with the support of a well-respected institution of higher education. Adtalem is proud to support this initiative and looks forward to supporting A-State with our academic excellence, operational expertise and employer partnerships and as we move forward in this endeavor.

The ASU System is also supportive of the addition of the program at Arkansas State. System President Charles Welch said a veterinary school would positively impact the university and state beyond addressing workforce shortages within the veterinary profession.

We see opportunities to work with student programs such as 4-H and the National FFA Organization, as well as food safety initiatives, Welch said. It would also complement our agriculture and biotechnology-related programs, the long-standing two-year veterinary technician program at ASU-Beebe and our red wolf conservation efforts.

The Memorandum of Understanding signed on Friday, Jan. 31, between Arkansas State University and Adtalem Global Education is subject to approval by the ASU System Board of Trustees and ATGE Board.

The nationwide critical shortage of veterinarians has significantly impacted the availability of animal care across the U.S. Furthermore, in a recent annual report, the Arkansas Farm Bureau emphasized a need specifically for large animal veterinarians and announced its support of a veterinary school in the state of Arkansas.

About Adtalem Global Education

The purpose of Adtalem Global Education is to empower students to achieve their goals, find success and make inspiring contributions to our global community. Adtalem Global Education Inc. (NYSE: ATGE; member S&P MidCap 400 Index) is a leading workforce solutions provider and the parent organization of Adtalem Educacional do Brasil (IBMEC, Damsio and Wyden institutions), American University of the Caribbean School of Medicine, Association of Certified Anti-Money Laundering Specialists, Becker Professional Education, Chamberlain University, EduPristine, OnCourse Learning, Ross University School of Medicine and Ross University School of Veterinary Medicine. For more information, please visit adtalem.com and follow us on Twitter (@adtalemglobal) and LinkedIn.

About Arkansas State University

Focusing on its mission to educate leaders, enhance intellectual growth and enrich lives, Arkansas State University (A-State) is the catalyst for progress in the Mid-South. Founded in 1909, Arkansas State is the second-largest university in the state, and located near Crowleys Ridge in Jonesboro. A Research 2 university, A-State hosts the first osteopathic medical school in the state of Arkansas, New York Institute of Technology College of Osteopathic Medicine, and opened the first U.S.-style residential campus in Mexico, A-State Campus Queretaro, in fall 2017. Through the combination of research and a long tradition of student-friendly instruction, Arkansas State offers more than 150 degree areas of study, including a robust online program, and a diverse student body from across the nation and the world. Among national universities, A-State leads Arkansas in undergraduate teaching and social mobility and is highly ranked in these categories by US News.

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A-State Explores Partnership with Adtalem Global Education to Deliver First In-State Veterinary Medicine School - ASU News

Compton Native Is The First Black Woman To Be Elected Harvard Medical Schools Class President – News One

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Black women are displaying excellence in academia and making history in the process. According to Teen Vogue, LaShyra Lash Nolen became the first Black woman elected as Harvard Medical Schools class president.

For the Compton nativewho is an activist and Fulbright Scholarher journey in medicine is equally about increasing racial and gender representation in the sector as it is about healing the health ailments of individuals. Nolens infatuation with STEM started at an early age. In third grade, she took home the first-place prize at a science fair. While coming of age in California she didnt see many examples of Black women leaders in the field that she wanted to pursue. However, her motherwho was a single teen parentexemplified determination and perseverance by overcoming the odds and earning her masters degree; a drive that would stick with Nolen throughout her academic journey.

The lack of representation was also present among the student leadership roles at Harvard Medical School, which motivated her to change the narrative. A lot of Nolens work is centered on exploring how injustices are interconnected with health and human rights. She has conducted investigative research surrounding how systemic racism impacts the health narratives of people of color. Many of the illnesses that we see in clinics and hospitals across the country are symptoms of racism, she told Teen Vogue. At the very inception of this country, black people did not have access to the privileges of owning land, accessing health care or adequate housing. We continue to see systemic racism manifest through policies from the federal to the local levels, which is the reason we have health disparities today. The only way that my community will truly have sustainable, positive, health outcomes, is through our societys reckoning with the systemic and historical wrongs committed against Black people.

Nolenwho credits Serena Williams, Michelle Obama and Ida B. Wells as sources of inspirationhopes her accomplishment inspires a wave of Black girls to pursue careers in STEM stating that there are young girls who are excellent and deserve access to opportunity, but wont take the leap because society tells them that its not for them.

Black students are breaking barriers at Harvard. In 2018, Kristine E. Guillaume became the first Black woman president of its student newspaper.

SEE ALSO:

Harvard Crimson Appoints First Black Woman President

Harvard University To Honor Queen Latifah

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Compton Native Is The First Black Woman To Be Elected Harvard Medical Schools Class President - News One

Jacobs School students ditch their white coats for chef’s coats – UB Now: News and views for UB faculty and staff – University at Buffalo Reporter

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Campus News

Medical students work in the Culinary Arts department kitchens of SUNY Erie Community College as part of the Introduction to Culinary Medicine pilot course. Photos: Meredith Forrest Kulwicki

By ELLEN GOLDBAUM

A new, interprofessional course being taught this month to UB medical students doesnt take place in a lab or a classroom. Instead, its happening in the Culinary Arts department kitchens of SUNY Erie Community College. And instead of white coats, the students wear chefs coats and toques.

Along with UB graduate student dietitians, theyre taking Introduction to Culinary Medicine, a pilot course in the Jacobs School of Medicine and Biomedical Sciences at UB thats helping them understand food and health in a new way.

They apply their lessons immediately, preparing meals every Wednesday afternoon in the kitchens of the Culinary Arts department at SUNY Eries City Campus. Theyre also learning about some of the things that prevent patients from eating healthfully.

Mealtime is a special time

The idea for the course came together as culinary medicine was emerging both nationally and locally. But faculty member Helen Cappuccino, clinical assistant professor of surgery in the Jacobs School, traces her interest in the food/health connection back to her childhood.

Being raised in an Italian family, so much of our family life was transacted around the table, says Cappuccino, who is also assistant professor of oncology in the breast surgery division at Roswell Park Comprehensive Cancer Center. Eating good foods that were flavorful and nourishing was always important, but it wasnt just about getting calories in. It was about the family bonding at the table, about moderation, about trying new things. Mealtime is a very special time for laughing, for loving and savoring at once.

As a breast cancer surgeon, Cappuccino keeps current with studies of how different foods might impact cancer. Her patients often bring it up.

A cancer diagnosis often shakes people to their foundation, she says. It makes them introspective and questioning of everything they did and thought they knew. Diet is no exception. I spend a lot of time talking to them about factors they can control, including diet, smoking cessation, physical activity, maintaining optimal body weight and alcohol.

In 2014, Cappuccino had the opportunity to attend a course at the Goldring School for Culinary Medicine at Tulane University. When she found out that SUNY Erie faculty members Kristin Goss, associate professor and chair of the Culinary Arts department, and Dorothy Johnston, assistant professor in the department, had attended the same course, they began to discuss how to bring culinary medicine to Buffalo.

All three knew each other as members of the Buffalo chapter of the Chanes des Rtisseurs, the local chapter of an international food and wine society.

Kristen Goss,associate professor and chair of the Culinary Arts department at SUNY Erie Community College, gives some guidance to a student as he shreds carrots.

Bringing culinary medicine to Buffalo

Through the same food and wine group, we connected and began our mission to bring a culinary medicine course to the Jacobs School, Cappuccino says.

SUNY Erie culinary arts faculty had begun developing a curriculum not just for their own students, but also to share with local medical and dietetics students. The goal is to eventually make this kind of curriculum available to local health care providers.

A cancer diagnosis and realization of what I could change personally and professionally started this initiative five years ago, Goss says. I shared an office with our department chair at the time, Dorothy Johnston, and honestly stated, I need to make our culinary nutrition class better and this is where I want to start.

With assistance from Johnston and Cappuccino, who has supported the SUNY Erie Culinary Arts program through her affiliation with the Chanes des Rtisseurs, Goss says they began to develop the course, with Nicole Klem, program director of the dietetic internship in UBs Department of Exercise and Nutrition Sciences, and Lisa Jane Jacobsen, associate dean for medical curriculum at the Jacobs School, spending countless hours coordinating between the institutions in order to make the course a reality.

This recent collaboration has been a tremendous gift, Goss says.

Chef instructor Kyle Haak watches as students chop vegetables.

Intensive elective

The Jacobs School pilot course is being offered as an intensive, month-long elective. Students do modules online about the science of food, why food is medicine, and then they go to SUNY Erie to learn about healthy recipes and the principles of food preparation, explains Jacobsen clinical associate professor of obstetrics and gynecology.

The curriculum involves a journal club, a standard aspect of many medical school courses where students meet to discuss the latest scientific papers in a particular field. They also practice what theyve learned on standardized patient volunteers, individuals trained to simulate real patients with specific conditions.

They learn to elicit nutrition histories and how to counsel patients on nutrition, Jacobsen says, adding that, as with much of the medical school curriculum, the course includes an emphasis on understanding the factors that prevent patients from living as healthfully as they might want to.

In the module on food insecurity, the students are given a very limited budget. They will be expected to take the bus to the supermarket, buy food for a family and come back to the kitchen to prepare it, she says. They need to learn about barriers to healthy eating, which could be financial, or transportation, a lack of knowledge. All these cultural influences could have an impact.

Jacobsen notes that physicians are often called upon to discuss nutrition with their patients, whether the patient is diabetic or pregnant or has hypertension or a common gastrointestinal complaint.

Culinary medicine and nutrition are subjects that most medical schools dont dedicate enough time to, Cappuccino says. Together with my medical, culinary and dietetics colleagues, we are committed to changing that.

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