Automated Investing Robo-Advisors 2019: Still Waiting for the Revolution – Investopedia

It turns out that automated portfolio advice is not the Field of Dreams.If you build it, they will come, has not worked out for the robo-advisory industry -- yet.

Just a few years ago, prognosticators gazed into their crystal balls and predicted that investors would pour their money into robo-advisors. In 2016, KPMG projected that assets under management would be $1.5 trillion in 2019 and $2.2 trillion in 2020. Juniper Research expects assets under management worldwide to hit $4.1 trillion in 2022. However, that is nowhere close to whats happening, and these projections seem to have fallen victim to the First Law of Forecasting: Give them a number, or give them a date, but never both.

The predicted size of the Robo-Advisor market by 2020, but assets under management are far lower as of September, 2019.

According to a variety of analysts, there is considerably less than $1 trillion worldwide managed by robo-advisors as of May 2019, and the $2.2 trillion mark wont be reached until 2022, according to some optimistic forecasts. Backend Benchmarking says $440 billion is managed by robo-advisory services as of mid-2019, while the Aite Group says its in the $350 billion range. Last fall, the research group Autonomous NEXT estimated that the market encompassed $660 billion in assets. To keep these figures in perspective, there is an estimated $22 trillion in investable assets out there--with over $9 trillion sitting in cash accounts, uninvested.

Granted, early predictions of worldwide adoption of robo-advisory services were extremely optimistic. But why arent more long-term investors moving their assets into automated investing? And why is there still so much cash sitting on the sidelines?

That's not to say that passive investing isn't a popular activity. Investors have adopted exchange-traded funds (ETFs) as a way to participate in market growth, and there is now over $4 trillion invested in these instruments as of September 13, 2019, up from $2.1 trillion at the end of 2015. But the assets under management for robo-advisors have not followed that same growth pattern, even though most robo-generated portfolios are built of ETFs.

The robo-advisor industry grew out of the market collapse in 2008-2009 as small investors pulled their money out of equities and sat on their cash. This flight from the market happened due to fear of additional losses and the feeling that stocks just were not safe. Unfortunately, interest rates fell to near zero, so the traditionally more secure financial spaces were not helping individual investors grow their wealth. Wealthfront and Betterment stepped into this void, encouraging investors to set themselves on a steady path, using algorithms to invest in portfolios designed to be diversified across asset classes and market sectors.

One factor that I believe keeps potential investors in cash rather than in the markets is pure, abject terror. During market upswings, they fear picking the wrong investments and missing out on what everyone else is getting -- or worse, picking a loser. During downturns, they roll up their cash and hide it under the mattress. Investors retreated at the end of 2018, afraid it was 2008 all over again.

For those not quite ready to talk to an advisor face-to-face, an all-digital experience can make getting started easier. One of the best things robo-advisors can do for their potential new clients is to provide an experience that generates trust and empowerment.Robo-advisors who target their services to young and new investors pepper their digital platforms with encouragement and forecasts of how much wealth they can accumulate.

Given the recent market volatility, such as the August cliff-dive of the Dow Jones Industrial Average, investors could be exercising caution, anticipating another recession. Bear markets offer opportunities, and not just for the stout of heart. Brian Barnes, M1 Finances co-founder and CEO says, We believe a bear market will actually accelerate the adoption of newer and lower-cost investment management offerings. He says that high fees are not felt as acutely when the portfolio is growing, but paying 1-2% to lose money like everyone else is tough to bear.

What does this industry need to attract more believers--and more assets? The Boston Consulting Group published a report entitled, Reigniting Radical Growth in June 2019 in their Global Wealth series in which they made several recommendations for wealth managers. The smart way for wealth managers to capture growth in assets under management (AuM) and revenue is to create specific strategies tailored to key segments and markets, the report recommends. The BCG believes that wealth managers can grow by focusing on affluent investors who are underserved -- those with $250,000 to $1 million to invest. They recommend a combination of digital and human engagement to offer a personalized and navigable one-stop shopping experience. Winners will accelerate product innovation and develop offerings that address the specific needs and preferences of affluent subsegments, they offer.

Many of the robo-advisors we surveyed offer tools for this underserved market, as well as for those who have less than $250,000 to invest.The big players in the online brokerage industry, including Charles Schwab, Fidelity, and TD Ameritrade, have focused their marketing efforts on what they call the mass affluent, with $100,000 or more in investable assets. Wealthfront and Betterment, the first pure-play robos, now offer banking services along with their advisories, which gives clients a place to earn higher interest on their uninvested cash.

The addition of human advice to previously all-digital offerings is an accelerating trend, as is subscription-based pricing rather than charging a fee based on assets under management.Charles Schwabs initial robo-advisor service, Intelligent Portfolios, is all digital as well as free. Earlier this year the firm introduced Intelligent Portfolios Premium, which adds on unlimited access to a financial planner for a $30 monthly subscription. New clients must have a balance of at least $25,000 and pay an initial planning fee of $300.Fidelity will join this trend, launching its premium advisory service, Fidelity Personalized Planning & Advice, by the end of 2019.

Premium level services that include personal advice is offered by a number of the firms we reviewed, including Betterment, Wealthfront, Ellevest, Merrill Edge, and TD Ameritrade. Its part of the package when you sign up with Personal Capital and Vanguard Personal Advisor Services, but those both require much higher minimums than others reviewed.

Heading in the other direction, Ally Invest just launched a new suite of managed portfolios that contain a "cash buffer" of 30% that will not carry a management fee. Cash in these portfolios will earn 1.9% interest. The idea behind this launch was to reduce anxiety and costs for new investors. Vanguard has quietly started testing a digital-only version of its robo-advisor service which we expect will roll out early in 2020, with much lower minimums ($3,000 rather than $50,000) and lower management fees (0.15%).

Of affluent millennials indicate 'Saving for Retirement' as the top reason they invest based on the results of our Affluent Millennials Survey.

How can the robo-advisor industry get its assets under management back on the initial track that was projected? They could do more to promote involvement in the markets, guided by a knowledgeable assistant, whether digital or human. A study by the University of British Columbia, published in July 2019, showed that naive investors tend to choose assets that have similar-looking returns, thus creating a portfolio that is actually riskier due to lack of diversification. Portfolios built using Modern Portfolio Theory help lower overall risk, so the concept of using a robo-advisor ought to be more appealing to newcomers to investing.

The Aite Group, in a report quoted by Charles Schwab, says they expect the number of Americans using robo-advisory services to grow from an estimated 2 million in 2018 to 17 million by 2025, based on a survey they conducted in mid-2018.58 percent of those surveyed say they will use some form of robo advice by the year 2025, and respondents say they are more likely to use robo advice than a number of other technologies in the headlines today including artificial intelligence, virtual reality, blockchain, and cryptocurrency. The main benefit of using a robo advisor, according to those surveyed, is taking the emotions out of investing. Their survey also generated the finding that nearly three-quarters of those who think they may utilize a robo-advisor also want access to a human financial advisor.

There are, of course, nay-sayers who do not believe that robo-advisory services offer any added value.Tom Sosnoff of tastytrade and tastyworks calls robos, jail for your money. He believes that learning to trade creates a mindset that is conducive to decision-making in all areas of ones life, and that just parking money in passive investing is a terrible idea.

Robo advisors could be doing more to get the cash on the sidelines into the game.The digital-only services with low minimum balances could be marketed to high school students as a way to encourage interest in investing. A way to transition from the passive acceptance of robo advice to a more active trading mindset could give new investors training wheels. There are opportunities to offer digital advice to retirees rolling their money out of 401(k)s.And offering a more flexible way to utilize human help, or to avoid it entirely depending on the clients preference, could draw more potential investors into the markets.

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Automated Investing Robo-Advisors 2019: Still Waiting for the Revolution - Investopedia

Beyond Cookies: Rebranding Tips for the Girls Scouts – prnewsonline.com

Weve all seen them sitting outside the local supermarket or hardware store in their adorable uniforms. Nearby is a table piled high with brightly-colored boxes and a homemade sign taped in front. Maybe youve encountered them through a coworker making annual rounds through the office, asking, How many boxes do you want this year?

Theyre Girl Scouts. We know the cookies: Samoas, Tagalongs, Thin Mints, and other delicious or not-so-delicious (yes, were looking at you, Trefoils). These cookies inspire serious devotion and, probably, unhealthy hoarding.

But how many of us, even former Girl Scouts, know that the Girl Scouts of the USA is far more than just an adorable way to distribute cookies?

The fact is that the organization has a rich history of empowering women and making America a better place.

For example, did you know that Girl Scouts were at the forefront of the Civil Rights movement? Or that Dr. Martin Luther King, Jr. called Girl Scouts a force for desegregation? Did you know that Girl Scouts helped train female pilots during World War II? That Girl Scouts has encouragedyoung women to get started in STEM since 1913?

Thats the problem. We know the Girl Scouts for cookies, but little else.

As the Boy Scouts (BSA) makes a well-publicized play to recruit girlsand changes its name to Scouts BSA, the Girl Scouts faces competition it hasnt seen since its founding 100+ years ago.Americas premier brand for young women is under threat from BSA and its splashy attempt at inclusion.

While the Girl Scouts have taken BSA to court, there is another way it can recapture the high ground and take back its narrative: rebranding.

An organizations brand is the story of who it is and what it stands for; and its the brand that people recognize and remember whenever they encounter an organizations name or members.

The Girl Scouts have an amazing story to tell. If the Girl Scouts is going to thrive for the next 100 years, it needs to rebrand. Now.

What would that new image look like? It would start with highlighting positive history. People and especially families trust brands with a long history and positive reputation. Parents want to know that their daughters are going to be educated and empowered. A rebranded Girl Scouts is the only organization with the historical pedigree to do that.

Highlighting history does not mean that a rebranded Girls Scouts would be backward-looking. Instead, it should focus on what the organization is doing for tomorrows women.

Do you want your daughter to get exposure to NASA or organizations like Lockheed Martin? Join the Girl Scouts. Do you want your daughter to realize she can be a pioneer in fields like robotics or cyber security? Entrepreneurship? Finance? Politics? Engineering? Web design? Theres a badge for each of them.

If the Girl Scouts want to compete with BSA, it must tell America what it stands for: girls. The Girl Scouts are for education and empowerment. In addition, Girl Scouts provide Americas young women with the safe, encouraging, and nurturing environment they need to discover who they are and who they want to be.

This is going to require outreach. No rebranding can succeed unless an organization makes a concerted effort to engage the public and the media press releases wont do it. Americas girls and their parents deserve to know the Girl Scouts and what young girls will gain by joining.

To be successful, Girl Scouts must deliver its message where people are: online and on social media. This is a difficult environment to navigate for any organization. Yet tomorrows women are digital natives. Todays parents are online almost as much as their kids. This is where the debates about womens issues happen. Girl Scouts needs to participate in these discussions when and, yes, where they happen.

The Girl Scouts will need some buzz, too. Scouts BSA made a big splash with its announcement about accepting girls.Girl Scouts needs to fight back with the truth that it is the sole organization keying on girls personal and professional development.

Rebranding will help the Girl Scouts win against new competition from BSA. In addition it will help the organization thrive in its second century. The key is to focus on what the Girl Scouts always has done best: empower young women to become everything they can and want to be.

Brittany Cover is communications director with Mair Strategies LLC

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Bye, Athleisure. Lululemon and Athleta Want You to Live Your Best Ath-Lifestyle – Fortune

Kelsey Coles closet is stuffed with Lululemon: a backpack, skorts in every color, and leggings she pairs with Stuart Weitzman boots for her job as a venture marketer. Not just her closet, but her top drawer is full too. Comfier Lululemon sports bras have all but replaced traditional underwire bras.

Kristin Marquet feels equally passionate about her Athleta clothing. More than 75 pieces of Athleta, mostly bought online, are her go-tos for running her branding and design firm, doing errands, and going on weekend date nights with her husband. For sure, my wardrobe has become more stretchy and sporty over the years, she said.

While traditional mall traffic dwindles and retailers trim back locations (according to Coresight Research, 7,567 stores will close this year), Lululemon and Athleta, a subsidiary of Gap Inc., have seen their fortunes rise and store traffic increase as athleisure becomes ath-lifestyle.

This goes beyond wearing yoga pants for Sunday brunch. The ath-lifestyle is about biking to work, powering through meetings and memos, and heading out to dinnerall while wearing one stretchy, sweat-wicking, SPF-providing, wrinkle-resistant outfit. Born from gym-wear, yes, but much sleeker.

I would never ever call either of our [personal] styles athleisure, Cole said, referring to how she and her partner, Angelo Dodaro, dress for work. Dodaro's been known to pair Lululemons ABC pants with a $1,400 John Varvatos blazer. Cole added: You really cant tell were in performance wear. No one has ever noticed.

The ath-lifestyle isn't just growing more polished, its showing up in high-end fashion. Chanel models wore bike shorts during the spring 2019 runway show, as did Fendi and Dior. Kim Kardashian and Kanye West have long proposed that Lycra is luxesee every Yeezy collection ever.

Thanks to consumers who love Lulemon's mix of function with a dash of fashion, the companys stock is up more than 50% this year, while its revenues are up 22% year-over-year. The $3.3 billion Vancouver-based companys comparable store sales, profit margins, and full-priced selling all rose during its second fiscal quarter.

Nobody has the loyalty and the ability to sell full-price the way that Lululemon does right now, said John Kernan, a research analyst with Cowen.

"We each spend at least $2,000 a year at Lululemon," said Cole, again including Dodaro. "With their focus on work wear now, that number could go up."

Athleta has grown at a 23% compound annual growth rate since 2012. The brand had revenues of $883 million in 2018 and are on track to reach a billion this year, said the company's chief marketing officer Sheila Shekar-Pollak. Parent company Gap Inc., which is spinning off Old Navy and shuttering 200 Gap stores, pegged Athleta as its growth vehicle in a presentation to investors earlier this month. The company opened 25 new Athleta stores this year, more than initially planned, and inked a deal to open Athleta franchises internationally.

Activewear, a roughly $57 billion market according to the NPD Consumer Panel, has been among the strongest and fastest-growing apparel sectors for the past decade.

A decade ago, we needed three or more wardrobesone for work, one for the weekend, and maybe a half-wardrobe for Saturday night. Now we want one wardrobe of multi-function pieces, said Matt Powell, sports industry advisor for NPD Group.

Both Lululemon and Athleta are bidding hard to provide that one, multitasking wardrobethe pieces that are easy-care, packable, lightweight, and stylish. Cole, who travels constantly for work, said Lululemon's leggings don't weigh down or take up too much space in luggage, and they can be hung to dry overnight in hotel rooms.

"Women are living busier and more fluid lives," said Athleta's Shekar-Pollak. "They need product that keeps up with their lifestyle and expect their wardrobe to deliver ultimate versatility."

In recent visits to Boston-area stores byFortune, both retailers had fashion-flavored pieces, such as drapey, tie-waist shorts and cropped pants, positioned at the front. On Athletas website, best-sellers include a $198 blazer (touted as packable, tear-resistant, and with 50+ ultraviolet protection) and $118 stretchy jeans (suggested use: hiking or climbing).

Athleta was first to the party in seeing that sport-inspired garments had everyday appeal, said Jane Hali of retail investment research firm Jane Hali & Associates. However, Lululemon is catching up fast.

Buoyed by its strong OTC (office, travel, commute) collection and ABC (anti ball-crushing) pants for men, Lululemon continues to explore what else loyalists might buy. A trial run of personal care items, including deodorant, dry shampoo, and moisturizer, was so well received that CEO Calvin MacDonald said in an analyst call that the company would add more products before the end of the year. Lululemon is also going to launch a sneaker line, but has not said when they will be available.

Rather than trying to bump each other out of the race, Athleta and Lululemon are developing differentiated but loyal audiences: a Coke versus Pepsi, if you will. To outsiders, the pieces look similar, but insiders switch loyalties less than youd think.

Nope. The brand doesnt resonate with me. I dont identify with that consumer, said Athleta enthusiast Kristin Marquet when asked if any of her $5,000 a year activewear spend goes to Lululemon.

Powell said, in general, Lululemon courts premium-spenders more actively than Athleta does. In July, Lululemon opened their "Sweat Life" brand embodiment: a multi-level store with a caf, studio classes, and shopping in Chicagos Lincoln Park neighborhood. A second experiential store will open in the Mall of America in Minneapolis.

While Lululemon aims for an insider experience, Athleta touts everywoman empowerment and sustainability. The brand has doubled down on providing clothing for women by extending size ranges to 3x. (Parent company Gap Inc. has, for the moment, addressed men's clothing through Hill City, a new performance-lifestyle brand.) In 2018, Athleta became a B Corp, which comes with fair trade, waste reduction, and sustainability pledges. In its investor presentation, Gap Inc. said seven of 10 customers said sustainability is important in purchasing decisions.

Of course, theres plenty of competition from other brands. Nike sells more womens activewear in the US than anyone else, according to NPD, and CEO Mark Parker said he is bullish on growing that business. And brands from Outdoor Voices (stretchy stuff for #DoingThings) to Ministry of Supply (performance workwear), have taken aim at the intersection of movement and comfort. Then there are newcomers including Epoquee Evolution (we believe in one wardrobe doing it all) founded by two former Athleta employees, and Aday, which offers technical, seasonless, sustainable clothing sold in travel-ready assortments.

Is the ath-lifestyle here to say? If you seize each day as Kelsey Cole does, the answer's yes.

Bottom line, we live in a fast moving world, Cole noted. Our clothing needs to match the pace at which we run. And let's face it, we're running in far more places than the gym these days.

Old Navy is about to sail away from Gap Inc.and into some choppy waters

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Embrace your womanhood and break the glass ceiling – Business Daily

Personal FinanceSunday, September 22, 2019 22:00

By NJERI MWANGI |

She is in a board room with her colleagues who are mostly men. Let us call her Samantha. Samantha is the one presenting to a potential new client. The first challenge she encounters is when the client enters the room, they think the guy with a dapper suit at the front is the speaker of the day.

The thing is, Samantha is new at her job and people dont expect so much from her. But when she starts speaking, all of a sudden everybody starts paying attention to her and people stop focusing on her clothes, movement of her lips or her swinging hips. The focus moves to what is on the screen and how well it is being explained to them.

This reminds me of the phrase that we hear being thrown all over women should be given a seat at the table but I think women should earn their place at the table.

When you are given something, it means it is not yours because it can be taken away from you anytime.

Young women in the corporate world should aim to earn their place in top positions. I believe this means doubling the hours, putting in the extra work and owning your work every step of the way.

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In Kenya, there is a push for gender neutrality. While there are policies that say boards should consist of at least 30 percent of women, there is still under-representation at more senior levels.

Some barriers make women still lag in the workspace other than performance.

In Kenya, young boys are nurtured and made to automatically believe that they are the leaders. It is already instilled in them and when they transition to men, they easily take up the leadership role with so much ease.

On the other hand, young girls are brought up knowing they are nurturers but a twist comes into play when they grow up into women and realise in the world they live in today, they also need to be leaders otherwise it becomes hard to survive.

The most recent World Economic Forums Global Gender Gap Indexwhich examines the gap between men and women in four fundamental pillars of economic participation and opportunity, educational attainment, health and survival and political empowermentestimates that it will take another 100 years to close the overall global gender gap in most countries.

Women have always been considered emotional creatures but maybe it's not a bad thing.

The approach should be for them to embrace their emotional side and use their minds to guide the process until it is done.

The first step is to ensure that as a woman goes to the office each morning she has a purpose and not I need to make ends meet mentality. She owes nobody an apology for wanting more for herself.

Another important thing is to pursue mentorship both upwards and horizontally. Upwards means finding someone who you connect with and they are in a space you aspire to reach. Allow yourself to be elevated to that point. Horizontally on the other hand refers to your mates with whom you share similar aspirations in life.

Kenyas private sector has an opportunity and responsibility to create a larger impact in achieving gender equality and women empowerment.

Though the two-thirds gender rule does not apply to the private sector, there are several positive initiatives geared towards realising diversity on boards.

Much as they take time to develop their employees, women also take time to develop their skills, to improve job performance and this resonates well with their employees as they lead by example, inspiring productivity.

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Embrace your womanhood and break the glass ceiling - Business Daily

Global health programs in medical school: Who benefits? – American Medical Association

There is a great deal of institutional interest among health professions students in joining global health programs, with more than 25% having participated during their training. Health professions schools offer global health immersion learning opportunities in poor countries, which reinforces a students sense of calling while also fostering cross-cultural sensitivity. However, when programs rely on short-term fixes to long-standing infrastructure and resource deficits, some of the worlds most vulnerable, poor patients can be exploited.

The September issue of theAMA Journal of Ethics(@JournalofEthics) features numerous perspectives on ethics of global health immersion in health professions education and gives you an opportunity to earn CME credit.

Articles include:

Who Is Served Best by Health Professions Service Learning Trips?If not planned and executed thoughtfully, immersions might not provide much benefit to communities they seek to serve.

How Should We Decide Whether and When Some Care Is Better Than No Care?Single-procedure interventions with minimal follow-up and clear quality-of-life gain are well suited for surgical mission trips. But not all risks and benefits are easily assessed.

Facilitating Critical Self-Exploration by Global Health Students. Awareness of ones own interests is critical to successfully engaging in global health immersions.

How Should Schools Respond to Learners Demands for Global Health Training? In the past decade, more students than ever entered medical school with the desire, if not the expectation, of participating in meaningful global health experiences.

In the journals September podcast, experts from Concern AmericaExecutive Director John Straw and Field Program Director Cat Quinndiscuss how global health outreach programs can be both sustainable and educational. Listen to previous episodes of the podcast, Ethics Talk, or subscribe in iTunes or other services.

TheAMA Journal of EthicsCME module, How the Social Contract Can Frame International Electives isdesignated by the AMA for a maximum of1AMA PRA Category 1 Credit.

The module is part of theAMA EdHub, anonline platformthat brings togetherhigh-qualityCME, maintenance of certification,and educational contentinone placewithrelevant learningactivities,automated credit tracking and reporting forsome states and specialty boards.

Learn more aboutAMA CME accreditation.

The journals editorial focus is on commentaries and articles that offer practical advice and insights for medical students and physicians.Submit a manuscriptfor publication. The journal alsoinvitesoriginal photographs, graphics, cartoons, drawings and paintings that explore the ethical dimensions of health or health care.

The AMA Journal of Ethics John Conley Art of Medicine Contest and John John Conley Ethics Essay Contest for U.S.-based medical students, residents, and fellows are now open.

Upcoming issues of theAMA Journal of Ethicswill focus on insights on value and values from decision science for clinical ethics, and ethics of assessing quality of life in reconstructive transplantation.Sign upto receive email alerts when new issues are published.

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Global health programs in medical school: Who benefits? - American Medical Association

We Need More Doctors Who Are Scientists – The New York Times

About a decade from now, public health statistics will begin to show a substantial decrease in cervical cancer in the United States and other developed countries. Thats because in 2006, young people began receiving vaccines against a sexually transmitted virus, HPV, that causes cervical cancer. By preventing HPV infections today, those vaccines have the potential to avert hundreds of thousands of cervical cancer cases.

The HPV vaccine exists because Dr. Douglas Lowy, a physician, and his research collaborator Dr. John Schiller recognized the potential for it after more than a decade studying the family of infectious agents to which HPV belongs.

Unfortunately, Dr. Lowys career transition from stethoscope to microscope might not be as feasible today as it was a few decades ago. The number of physicians able to engage in scientific research either alongside a medical career or after medical training has waned greatly. Physician education in medical school has shifted away from basic science. In addition, federal funding has declined. After adjusting for inflation, the 2013 N.I.H. budget was 21.9 percent below its 2003 level. These and other trends have driven the proportion of medical doctors engaged in scientific research to a paltry 1.5 percent of the physician work force.

Time and again, physician-scientists have changed the history of medicine by identifying a problem in the clinic and taking to the lab to address it. Alexander Fleming watched men die of sepsis during World War I while serving in the Royal Army Medical Corps, then returned home to create penicillin. Sidney Farber, a young physician at Childrens Hospital in Boston, committed himself to finding treatments for childhood leukemia, and laid the foundation for modern cancer chemotherapy.

In the 1970s, the physicians Michael Brown and Joseph Goldstein set out to understand how a young childs arteries could be as clogged as those of an overweight septuagenarian. This patient-inspired research led to the discovery of LDL-cholesterol receptors, and paved the way for the statin drugs that are taken by millions of people every year in the United States alone.

And more recently, the research efforts of two physicians, Brian Kobilka and one of us, Dr. Lefkowitz, seeking to understand how hormones conferred their biological effects, led to the discovery of a large family of receptors that have formed the basis for the development of hundreds of F.D.A.-approved medications.

The biomedical research establishment has long recognized the importance of clinical experience to medical research. In the 1950s and 1960s, during the Korean and Vietnam Wars, physicians were conscripted within a few years of their medical school graduation. Of those young physicians commissioned as officers in the United States Public Health Service, a small fraction was posted to the N.I.H., where they cared for patients and also learned to perform laboratory research.

This program essentially trained an entire generation of medical professors, and its graduates went on to engage in research that has produced major insights into cancer, infections and heart disease, forming the basis for lifesaving therapies. Indeed, physician-scientists account for 37 percent of Nobel Prizes in Physiology or Medicine.

Of course, medical doctors are not the only people who can make great medical discoveries. The discoverers of the structure of DNA and the developers of CT scans had no medical background. But there could not be a worse moment than now to allow the vital role of physician-scientists to disappear. Trends like an aging global population and the resurgence of infectious disease have increased the need for medical advances.

Meanwhile, science is becoming more relevant to medical practice with the emergence of innovations like precision medicine, which requires a detailed understanding of disease mechanisms and genetic data in order to determine the best treatment for each individual patient. More than ever, we need doctors who are competent at both the lab bench and the hospital bedside.

Unfortunately, the career path of the physician-scientist has become longer and a lot less appealing. In the United States, about 20,000 graduates emerge from medical school each year, many with significant debt. Many physicians are well into their 30s by the time they complete their clinical training. Doctors who decide to take the research path face the daunting prospect of many more years struggling to win grants and establish a lab. According to N.I.H. statistics, researchers with medical degrees on average receive their first major N.I.H. grant only at age 45.

Recognizing the problem, the National Institutes of Healths Physician-Scientist Workforce report, published in 2014, laid out a road map to address it. Nonetheless, the number of young doctors pursuing research continues to wane.

In response, six physician-scientists from across the country have formed a nonprofit organization, the Physician-Scientist Support Foundation, to raise funds to support the research efforts of talented young medical students and physicians. The foundation aims to mentor and inspire new doctors to undertake research programs to solve unmet medical needs.

Physician-scientists are among the most highly trained investigators in the research enterprise. Their efforts will be crucial to improving health care. Our world needs a growing, corps of professionals who bring a human understanding of patients to medical research, and a researchers expertise to improving patients lives.

We need to ensure that the brightest young doctors can contribute to further advancements in their field, or we risk stalling the engine that consistently delivers better medicine, longer lives and a stronger economy for Americans and people around the world.

Mukesh K. Jain is a cardiologist at University Hospitals and a professor at Case Western Reserves medical school. Tadataka Yamada formerly served as president of global health programs at the Bill & Melinda Gates Foundation and oversaw research and development at Takeda Pharmaceuticals. Robert Lefkowitz is a professor at Duke Universitys medical school who won the Nobel Prize in Chemistry in 2012. They are board members of the Physician-Scientist Support Foundation.

The Times is committed to publishing a diversity of letters to the editor. Wed like to hear what you think about this or any of our articles. Here are some tips. And heres our email: letters@nytimes.com.

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We Need More Doctors Who Are Scientists - The New York Times

Graduate student leaders focused on change – University of Miami

The presidents of the School of Law, Miller School of Medicine, and Graduate School student associations share their insights on the future of their organizations.

Each of them is impacting the University of Miami.

Now, Alvaro Ruiz Emparanza, Octavious Buiey Jr., and Leah Colucci want to serve their constituents this academic year as president of the Graduate School, School of Law, and the Leonard M. Miller School of Medicine student associations, respectively.

The three serve as a liaison between the administration and the students they represent. From surgery rotations, to working at a criminal defense law firm, to conducting civil engineering research, they juggle all of this while maintaining their individual responsibilities with a similar mission: to increase graduate student involvement at the University.

Meet the graduate student leaders:

Buiey has been a voice for others since middle school when he was a member of his student government cabinet. Now a third-year law student, the North Florida native is passionate about making changes for all.

As Buiey stepped into his new role, one of his main priorities is creating a student government that is focused on action. He is also focused on creating a space for happy and successful lawyers as mental health awareness was at the forefront of his campaign platform.

We wanted to create an avenue for all students to be involved, said Buiey, an aspiring criminal defense lawyer. We recently passed some constitutional amendments that have been in the works for years.

One of those amendments is the creation of a transfer student seat on the senate.

We have some transfer students and they are often times kind of forgotten. And we wanted to make their concerns heard, said Buiey. So, now as opposed to running against other 1Ls, 2Ls, or 3Ls, they now run against other transfer students. Thats big.

Buiey is also focused on facilities for students in the School of Law. He recently met with Anthony E. Varona, the new dean of the School of Law. The two are working toward bringing a state-of-the-art courtroom into the School, to create a more authentic experience for future litigators to hone their skills.

I think its a beautiful campus, but our space is a little outdated, said Buiey. One of the things we talk about is how can we update the law school to get it to match the quality of our law students.

This year, Buiey also has plans to introduce the Toppel Career Centers Sebastians Closet program, a free business professional clothing rental service for students to use for their interviews, to the School.

When he came to the University as a civil engineering Ph.D. candidate, Ruiz Emparanza didnt anticipate being as heavily involved in leadership as he isbut as his academic career advanced, so did his involvement.

Compared to Europe, a lot of importance is placed on leadership, said Ruiz Emparanza, a native of Legazpi, a little town in the Basque region of Spain, who first became involved with student government as a senator. I have been heavily involved in the Graduate Student Association (GSA), Engineering Student Council and the UM American Concrete Institute student chapter, being the president of each of them at a certain point during my academic career at UM. Other leadership roles include being the Engineering Student ambassador, Graduate Student Representative and voting member at the Graduate Council.

In his role as the president of GSA, interacting with other students within the Graduate School is a priority for Ruiz Emparanza. On Sept. 7, he led efforts to host the GSA Kick Off Cruise, a networking event on a luxurious cruise around Miami for 300 graduate students.

You dont know who youre going to meet while at one of our networking events, said Ruiz Emparanza. Im trying to bring the idea that life is not only work. Its about meeting people and being connected to others, its not just you and your advisor.

Other important issues to Ruiz Emparanza are environmental awareness, political awareness, sharing research, and bridging a gap between the undergraduate and graduate community.

I am passionate about the environment, said Ruiz Emparanza, who as a child would get in trouble with his parents if he were caught not recycling. Within GSA we are also planning beach clean-ups and are also collaborating with the City of Coral Gables to do a street clean up.

Ruiz Emparanza will join forces with the undergraduate student government executives on a Homecoming event to bring undergraduates, graduates, and alumni together.

I am trying to do more with them because we believe that we could benefit from each other, he said. They bring the energy and youthfulness, and we can serve as mentors.

As his studies and campus involvement at UM progresses, Ruiz Emparanza credits time management as a major key to his success. When Ruiz Emparanza isnt meeting with the administration on ways to better life for graduate students across all disciplines, he is searching for various solutions to extend the service life of infrastructures by using alternative reinforcing materials, such as composites, under the guidance of his advisors Antonio Nanni and Francisco De Caso from the Department of Civil, Architectural and Environmental engineering.

As Ruiz Emperanzas final year comes to an end, he hopes to leave GSA better than he found it. He recently began to establish the groundwork for a public speaking academy for graduate students.

Public speaking is a big part of research, Ruiz Emparanza said. Training students how to break down their research for people outside of your research to understand is important and necessary.

Third year medical student Leah Colucci said she was destined to be a Cane. In 2017, she earned a bachelors degree in neuroscience and marine science, and by 2021 she will be a triple alumna when she earns her masters degree in genomic medicine in addition to a medical degree.

My mom was a huge fan of UM and would bring me to campus and take me to football games when I was a kid, said Colucci, who also serves as student trustee on the Universitys Board of Trustees. Her passion for UM and all it has to offer is evident to her peers and others.

I am passionate about the opportunities of medical students as a whole, said Colucci, a member of the Miller Mentor program, a collaboration between undergraduate and graduate students and the Miller School of Medicine that connects motivated premedical students with a medical student mentor.

Theres all these students coming from different places so they didnt have the same connection to the University that I had. In this role I was tasked with showing them all the different resources that we have to offer.

Coluccis friends encouraged her to run for president of the Miller School of Medicine Student Government. Her peers and Dr. Hilit Mechaber, the associate dean for student services, felt she was the perfect candidate for the role.

This semester, Colucci is working on a big task that will impact future generations of medical students at the Miller School of Medicine.

One huge thing that is at the forefront of my mind and other students minds is radically changing our curriculum, said Colucci. I have been helping faculty by giving a lot of feedback. We are a top 50 medical school and we want to stay a top 50 medical school.

Coluccis people-oriented attitude and enthusiasm make her an ideal person for the job. She is constantly making sure students are aware of new and existing resources not just on the medical campus, but at the University.

As president, Im trying to connect our medical students to campus life so that they dont feel like theyre just here to work and they dont really become a part of the UM community, she said. Its really sad when I come across a friend who is depressed, so we are constantly trying to update our wellness efforts as well.

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Changes in Racial/Ethnic Representation in US Medical School Matriculants – Medical Bag

Even with recent efforts to increase diversity among physicians, there is a deficiency in black, Hispanic, and American Indian or Alaskan Native representation in medical school matriculants, according to a recent article published in JAMA Network Open.

The authors of this study examined the demographic trends in medical school classes to assess the progress of new diversity accreditation guidelines set in 2009 by the Liaison Committee on Medical Education. These guidelines were made in an effort to diversify the physician workforce and were specifically centered on racial and ethnic groups that are underrepresented in medicine. Using data on US allopathic medical school applicants and matriculants from 2002 to 2017 as well as total enrollment by state from 2017 to 2018, the authors compared trends in the proportions of race/ethnic groups and sex within the student body and with respect to US and local populations of a similar age. The data used were publicly available from the Association of American Medical Colleges.

Using representation quotients (RQ), the authors compared the makeup of racial/ethnic subgroups of medical students to the corresponding makeup of that racial/ethnic among the US population and in the corresponding states participants lived in. The results show that both the number of applicants and matriculants increased from 2002 to 2017 by 53.6% and 29.3%, respectively. In addition, the proportion of matriculants from most underrepresented race/ethnic groups (men and women who are black, Hispanic, and Native Hawaiian or Other Pacific Islander) increased, but their RQs were still considered to be underrepresented (RQ<1) among medical school matriculants. There was a decrease in the proportion of white men and women matriculants; however, white men still follow the trend of overrepresentation among medical school matriculants (RQ>1). Furthermore, the authors found that the proportion of Asian matriculants has increased for both sexes, and that both sexes have been consistently overrepresented (RQ>3) among medical school matriculants. On a state level, underrepresentation was still found in all race/ethnic groups, except for those who identify as white or Asian.

Study limitations include the fact that data collection methods changed in 2012, which may have resulted in inconsistent race/ethnicity categories. Furthermore, the data set was limited by categories set by researchers. This study also did not include contributions to healthcare by professionals without an MD degree.

The authors of this study concluded that there is a persistently deficient representation of black, Hispanic, and [American Indian or Alaskan Native] medical students, and that most states do not train physicians who are demographically representative of the surrounding population. As a response to their findings, the authors call for more effective policies to improve representation to create high-quality, high-value, culturally effective care.

Reference

Lett LA, Murdock HM, Orji WU, Aysola J, Sebro R. Trends in racial/ethnic representation among US medical students [published online September 4, 2019]. JAMA Netw Open. doi:10.1001/jamanetworkopen.2019.10490

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Changes in Racial/Ethnic Representation in US Medical School Matriculants - Medical Bag

Female High School and Medical Students Take Part in Perry Initiative Outreach Program at Orthopaedic Institute for Children – Business Wire

LOS ANGELES--(BUSINESS WIRE)--Female high school and medical students interested in pursuing careers in medicine and engineering will receive a boost to their professional aspirations by being part of a very special hands-on program conducted Sept. 27-28 at Orthopaedic Institute for Childrens downtown Los Angeles campus. The event is part of the nationally acclaimed Perry Initiative Outreach Program, which works to inspire young women to be leaders in these fields and to foster their understanding of and appreciation for the career that may lie ahead.

The Medical Student Outreach Program (MSOP) attracts women in their first or second year of medical school who are undecided about specialty choice or have expressed interest in exploring a career in orthopaedics. Approximately 45 participants at the Friday event will hear lectures from local women surgeons, network with industry leaders, and perform hands-on skills modules and mock orthopaedic surgeries.

The following day 40 young women from high schools (grades 10 and above) will attend a one-day program where they hear from women leaders in the fields of medicine and engineering and receive hands-on experience by performing mock orthopaedic surgeries and biomechanics exercises.

Since its founding in 2009, the Perry Initiative Outreach Program has touched more than 10,000 students nationwide; and we are honored to once again be the Los Angeles host site for this prestigious program, said Jennifer Beck, M.D., director of outreach and research at OICs acclaimed Center for Sports Medicine. It is always invigorating to see the excitement on the faces of the attendees, and we hope that this event helps inspire them to pursue these important career paths.

Despite the increasing number of women entering medical and graduate school, a 2018 study from the American Academy of Orthopaedic Surgeons reported that women comprise only 5.8% of all practicing orthopaedic surgeons as compared to 92.2% being male (and 2% not indicating a gender). In the face of these numbers, the Perry Initiative was created in 2009 in honor of Dr. Jacquelin Perry, one of the first female orthopaedic surgeons in the country and a mentor to countless women and men in the field throughout her celebrated career, which spanned from 1952 to 2013.

About Orthopaedic Institute for Children

Orthopaedic Institute for Children was founded in 1911 as Los Angeles Orthopaedic Hospital and today is the largest pediatric orthopaedic facility on the west coast focused solely on musculoskeletal conditions in children. In alliance with UCLA Health and with the support of the OIC Foundation, we advance pediatric orthopaedics worldwide through outstanding patient care, medical education and research. Our locations in downtown Los Angeles, Santa Monica, Westwood and Calexico treat the full spectrum of pediatric orthopaedic disorders and injuries. For more information, visit us at ortho-institute.org.

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Female High School and Medical Students Take Part in Perry Initiative Outreach Program at Orthopaedic Institute for Children - Business Wire

New medical schools open to disadvantaged pupils | Good University Guide 2020 – The Times

Encouraging a wider participation in medicine, these institutions hope to plug the shortage of GPs, says Catherine Lally

Five new medical schools are opening in England, offering more opportunities for young people to study medicine. As well as addressing a shortage of NHS doctors, it is hoped that these schools will boost the numbers from disadvantaged backgrounds entering the profession. The middle class has long had a stranglehold on medicine, and demands for applicants to have extensive work experience is not helping it to diversify.

Several of the new medical schools are in areas with significant GP vacancies and the hope is that a proportion of qualified doctors will remain in the area.

Our philosophy is built around deconstructing the barriers that prevent students from accessing medicine, says Professor Scott Wilkes, the head of Sunderlands new medical school, which opens this autumn with

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New medical schools open to disadvantaged pupils | Good University Guide 2020 - The Times

Family medicine becomes family tradition – UpperMichigansSource.com

MARQUETTE, Mich. (WLUC) - Like father like son, is a common description we have heard many times but for the Marquette Family Medicine Residency Program, this phrase is verbatim. For the first time in the programs history, a child of an alumnus will follow his fathers footsteps. Michael Piggott, DO, began his first year of residency, following his fathers footsteps, Kevin Piggott, MD, MPH, who completed the program thirty years ago.

For the Piggott family this represents the third generation of physicians. Kevins father (Michaels grandfather) was also a physician. The senior Piggott graduated from the University of Michigan Medical School in 1956 and held an academic appointment at Wayne State University School of Medicine in the Department of Psychiatry. Even with this tradition of physicians, Michael did not feel pressured to pursue medicine.

I dont ever recall a time where our father encouraged us to go into medicine, said Michael, likely because he wanted us to find our own paths.

Michael explained that while his fathers influence extended far beyond the field of medicine, becoming a physician was the only career he ever considered seriously.

Although I allowed myself to explore other subjects and I was able to develop many interests, it seemed that those topics always fell into the category of a hobby and not a profession, he said.

While Michael was indirectly inspired to follow his fathers footsteps through example and actions, his own experiences helped solidify his direction.

What cemented my goal to becoming a physician was when I was finally able to experience the field of medicine, he said, first in high school as I took a health occupations course, and then through volunteer work in hospitals, interactions with patients and experiences with many skilled hospitalists during my undergraduate studies.

When Kevin entered medical school, his path was undecided. The broadness of knowledge needed to practice family medicine was vast -- his first thoughts were to pursue internal medicine with an intent to specialize. But an experience changed his mind.

In my third year I did a family medicine rotation with Dr. Jerry Luoma in Calumet, said Kevin, I saw full spectrum family medicine being practiced competently and compassionately. It changed the trajectory of my career.

After Kevin did an elective in family medicine at the Marquette Family Medicine Residency Program early in his fourth year, he knew that family medicine was for him.

Michael, however, knew immediately that family medicine was the specialty for him. The idea of forming special one-on-one relationships with patients to create an individual approach to their healthcare was appealing.

Being able to sit down with people and listen to their stories, be a part of their team to promote health, and being able to help make a difference, were the biggest draws to medicine for me, he said.

Over the years, Dr. Kevin Piggotts roles in healthcare included being a family physician, an assistant director for the Marquette Family Medicine Residency Program, medical director at the county health department, a hospital administrator and a preceptor for both medical students and resident physicians. He earned his medical degree from Wayne State University School of Medicine in 1986 and held an academic appointment at Michigan State University College of Human Medicine. He completed a fellowship at the University of Michigan and earned a masters degree in public health in 2009. Dr. Kevin Piggott retired from practice in 2016 leaving a fulfilled career.

I most enjoyed my practice in Trenary, it was a small practice in which I could provide a more personalized form of medical care, he said. Although I did not live in the community, I very much felt that I was an integral part of the community and in the lives of the people that entrusted their care to me. I truly felt it was a privilege to be there, it was very fulfilling.

Michael earned a Doctor of Osteopathic Medicine, DO, degree from Michigan State University College of Osteopathic Medicine in 2019. He earned his undergraduate degree at Michigan State University. The legacy of pursuing the same career at the same place as his father has had an impact.

Michael explained:Following in my fathers footsteps and earning a spot in Marquettes Family Medicine Residency is a great milestone in my life for many reasons. Professionally, I get to work with many of the same talented colleagues and friends he got to work with, I get to see many of the same patients that he saw, and in time itll be my goal to be able to provide the same level of care. Personally, I get to carry on the legacy that started when my grandfather first became a physician. The generations of family members before me have gifted me with the responsibility and drive to do my best for others, and it will be my privilege to work hard so that those principles continue-on to the generations after me.

The residency program has embraced this first experience. The strength of the program is evident when a child of an alumnus follows the same path into the Marquette Family Medicine Residency Program. Its rewarding to see the programs roots continue to spread the family tree keeps growing. Faculty and staff at the program look forward for the next child/parent path to reveal itself. Will we see another father/son footprint? Or will it be mother/daughter? Only time will tell. But should the trend continue, it is very fitting to think that continuity of care and values spanning generations of providers has taken root.

The MSU College of Human Medicine Upper Peninsula Region Campus works in conjunction with the UP Health System-Marquette to coordinate the training of family medicine residents and Michigan State University College of Human Medicine medical students. Since its inception in 1974, 298 medical students and 204 resident physicians have graduated from the two programs. Currently, approximately 30 percent of the students who graduated from MSU College of Human Medicine UP Campus and 39 percent of family medicine resident graduates are practicing across the Upper Peninsula Region.

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Family medicine becomes family tradition - UpperMichigansSource.com

No, Practicing Medicine Is Not Just About Basic Biology – Medscape

Early on in my clerkship year, I had the opportunity to rotate at the Ob/Gyn residents' clinic at the Hospital of the University of Pennsylvania. The clinic offers low-cost services to members of the Philadelphia community, and yet nearly half of appointments are missed on a daily basis. Speaking with patients who were able to make their appointments, sometimes after several months of missed appointments, I learned that the limiting factors in their healthcare and at times, that of their expected child were logistical difficulties traveling to the clinic, getting out of work, or gathering the funds to hire a babysitter so that they could visit the hospital without having to worry about their children. In other words, the rate-limiting step in these patients' healthcare was not their medical condition but their social and economic condition.

In a recent Wall Street Journal article, a former associate dean at the Perelman School of Medicine at the University of Pennsylvania shared his opinion on the increase in medical school curricula that discuss the social determinants of health, or the conditions in which an individual is born, grows, and works that can influence health. In his op-ed, Dr Stanley Goldfarb outlines his concern that medical schools are increasingly focusing on these social factors and their "tangential" relationship to healthcare. These curricular elements, he believes, detract from students' learning of the basic scientific knowledge needed to practice medicine, which he worries will result in worse physicians in the future.

Dr Goldfarb is correct in one regard: medical schools are increasingly incorporating coursework on the social determinants of health. Before we get into why this shift in medical school education is not only a good thing, but necessary, I should address Goldfarb's central claim: that teaching the social determinants of health comes at the cost of future doctors' basic scientific knowledge. If that were true, we would expect the increased time spent on social determinants of health in medical school classrooms to be correlated with a decrease in scientific knowledge needed to practice medicine but it's not. In recent years, student scores on national board exams which are designed and validated to measure understanding the scientific knowledge needed to practice of medicine and have been linked to both higher physician quality and lower rates of patient complaints have continuously improved, including on the practical clinical knowledge exam. While I am not trying to make a causal claim and say that teaching social determinants of health improves basic scientific knowledge, these trends should reassure readers that future doctors are not compromising their education on the biological underpinnings and treatment of disease in favor of learning about the social and economic determinants of health. Medical school education is not a zero-sum game: it seems that medical students are capable of learning about both the biology of disease and the context in which it develops.

There is an expansive and growing body of literature outlining how social factors impact health, as well as how doctors who are familiar with this impact can work to address it. From the negative health effects of chronic stress from racial discrimination to growing up in a ZIP code with a lower average income or limited access to fresh food, the circumstances in which one lives have a demonstrated impact on access to healthcare and overall length of life. For future physicians, awareness of these factors or of ones own implicit biases can help to inform interventions and treatment recommendations as well as eliminate barriers to access and ultimately improve health outcomes. In other words, by preparing medical students to account for and address the contextual factors that can affect health, including their own behaviors,, medical schools provide their students with the skillset and knowledge needed to provide better, more holistic care to their future patients.

Doctors who learn about the social determinants of health are not only taught how to deal with these issues on a case-by-case basis: they are also empowered to address them on a larger scale by drafting and supporting policy changes. Physicians hold a privileged place in society. Their voices are heard and trusted, and they see and treat the effects of social issues like gun violence and racial discrimination firsthand. In fact, when surveyed, a majority of physicians agreed that their patients' social needs are as important as their medical conditions and that the health system should be better equipped to address those needs. Poised to propose and influence policies that impact the overall health of society at large, physicians have a responsibility to advocate for potentially health-improving policies and to combat existing structures that underlie poor health outcomes. Coursework that teaches trainees effective communication strategies and increases awareness of nonbiological factors that affect health is critical to empower physicians to fulfill this responsibility. And the medical schools that produce these doctors have an obligation to educate their students on these issues so that they may better identify and address them in the future.

Medical school is a time of professional development when students learn how to be a physician in addition to the knowledge necessary to practice medicine. Medical schools are responsible for teaching us to be caregivers as well as scientists, medical professionals who see the person behind the patient. Teaching the social determinants of health is crucial to mold practitioners who treat their patients as more than a collection of symptoms or a unifying diagnosis, but as members of society with unique experiences and limitations that may affect their health or healthcare. This is especially true in a time when medical students are increasingly found to become less empathetic during medical school and when effective curricular activities have been identified that can prevent this "erosion of empathy." The curricular components that best accomplish this goal, however, are not the traditional basic science courses but rather the experiential training, dedicated coursework on health inequalities, and extracurricular activities that cannot be found in a biochemistry or pathology textbook.

As one of the curriculum representatives at the Perelman School of Medicine at the University of Pennsylvania, I've seen the substantial effort that the school's administration has put into integrating education on the social determinants of health into our curriculum. Through our Doctoring course, for example, students are provided with a curated curriculum and space to learn about and discuss the social determinants of health. The school's various community clinics are a venue for students to apply the clinical knowledge they have gained in the classroom in order to provide basic healthcare to members in the community who have limited access to the healthcare system. Nearly on a daily basis, speakers are invited to educate students on issues ranging from human rights to racism in medicine. And just as Penn was the first medical school in the nation, it also has been a leader and innovator in education on how social conditions can influence health.

The art of medicine is in both diagnosis and dialogue. Just as humans cannot be viewed simply as a collection of biological processes, so too are patients more than their symptomatology. For medical practitioners to best improve health overall, they must understand the various factors that can influence health, both biological and nonbiological. Medical school classes on these issues don't detract from traditional medical knowledge but enrich it. After all, medical school is the stage of training that is meant to teach students about how disease develops, how it can be treated, and how it can be prevented. This makes medical school the ideal time for students to learn about the social determinants of health. These determinants represent important mediators of disease that can be addressed at both an individual and societal level to reduce the overall burden of disease.

Encourage medical schools to continue teaching their students about the social determinants of health. Dr Goldfarb's viewpoints overlook the tremendous influence of social context on an individual's health. Teaching future doctors about these social determinants of health doesn't make for worse physicians, but better ones, doctors who understand their patients, where they come from, and how to best help them. And that's better for everyone.

Ramie Fathy is a third-year medical student and curriculum representative at the Perelman School of Medicine at the University of Pennsylvania. The opinions expressed in this perspective are his own.

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No, Practicing Medicine Is Not Just About Basic Biology - Medscape

Built to Endure | Harvard Medical School – Harvard Medical School

Major physical changes occurred in the human heart as people shifted from hunting and foraging to farming and modern life.As a result, human hearts are now less apelike and better suited to endurance types of activity. But that also means those who lead sedentary lives are at greater risk for heart disease.

Those are the main conclusions from a unique study led by Aaron Baggish, Harvard Medical School associate professor of medicine and director of the Massachusetts General Hospital Cardiovascular Performance Program. Baggish and his collaborators examined how ape hearts differ from those of humans, why those differences exist and what that means for human health.

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The researchers measured and compared heart function in apes and four groups of humans, ranging from sedentary to elite runners and including indigenous subsistence farmers. Their research is presented in the Sept. 2019 issue ofPNAS.

Baggishs collaborators on this paper include Daniel Lieberman, Department of Human Evolutionary Biology, Harvard University, and Robert E. Shave, School of Health and Exercise Sciences, University of British Columbia

Chimpanzees are humans closest known relatives, based on genetics and evolutionary studies. There are, of course, some stark differences between the species. For example, in terms of exertion, chimpanzees mainly engage in short bursts of activity, such as climbing and fighting, which puts intense pressure on the heart but only for a limited time.

In contrast, its believed that up until the industrial revolution, humans were active for longer periods of time in order to hunt and farm. Survival of pre-industrial humans, it is thought, depended on moderate-intensity endurance activity (e.g., hunting and gathering and then farming).

It is also well established that some physical features of the heart change in response to certain physical challenges. Walking and running, for example, require more blood to be pumped to deliver fuel to active muscles.

In contrast, brief but intense exertion from activities such as climbing or fighting creates pressure in heart, which over time can make the heart chambers develop stiffer and thicker walls.

The heart remodels in response to two main forces: pressure and volume, said Baggish. As a result, humans have longer, thinner and more flexible-walled hearts, while chimps have smaller hearts with thicker walls.

What Baggish and his collaborators wanted to know was, could those differences have evolved in response to humans new activity levels? And if so, what implications does that have on human health today?

Using a group of more than 160 study participants, the researchers carried out detailed heart function studies, including measuring blood pressure and using ultrasound to examine the hearts structure and function during many different activities.

The subjects were fairly evenly divided into elite runners, American football players, indigenous Mexican subsistence farmers and people who engage in little physical activity.They made similar measurements in about 40 semi-wild chimpanzees and five gorillas.

The goal was to compare heart structure and function in each typewhether the subject was very active to barely active, said Baggish.

In addition, the investigators sought to determine whether adaptation to either pressure or volume comes at the expense of the ability to handle the alternative form of stress. This was done by giving the pressure adapted subjects (football linemen) and volume adapted subjects (long-distance runners) a volume challenge, by a large intravenous saline infusion and a pressure challenge, by a sustained, forceful handgrip, and simultaneously measuring heart function.

The goal was to see whether there is a tradeoff between having a heart adapted for endurance versus one that performs better for short bursts of intense activity. Or could the heart adapt to both?

Baggish and his collaborators found that human hearts appear to have evolved to be better at handling endurance activity.The researchers also confirmed that people who train specifically for endurance sports have hearts with longer, larger and more elastic left ventricles, the part of the heart that pumps the blood out to the body.

Those features, and others, make the heart better able to cope with pumping higher volumes of blood over a sustained time. In contrast, sedentary people, even at a relatively young age, have hearts that appear more apelike and are better suited to cope with short bursts of high activity.

These findings help answer the question about the hearts evolution. The human heart has evolved over hundreds of thousands of years as our activity levels gradually became more sustained, said Baggish.

We now understand that the human heart, coupled with changes in the musculoskeletal and thermoregulatory system, evolved to facilitate extended endurance activity rather than spurts of intense exertion.

This study has important implications for understanding heart health today. For example, people who live a sedentary lifestyle appear to develop more apelike hearts and are more prone to hypertension.

This study is unique for several reasons, said Baggish. Not only were we able to study heart function in three types of primates, but we also had the opportunity to work with people who are among the last groups of truly subsistence-based farmers, the Tarahumara in Mexicos Copper Canyons.

Adapted from a Mass General news release

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Built to Endure | Harvard Medical School - Harvard Medical School

Joggin’ with Josh advocates healthful lifestyles – Grand Forks Herald

Though he is serving as interim president, Wynnes primary job is dean of the UND School of Medicine and Health Sciences, which is how the event got started.

The annual Joggin with Josh began in 2010 when Wynne reminded medical and health sciences students not only to encourage their future patients to live healthful lifestyles but also practice what they preach, the medical school said in a press release.

Before the informal 5K/10K/one-mile walk, jog or run began Tuesday, Wynne addressed the crowd.

"We talk about having a healthy lifestyle, we talk about exercise, so let's do it," he said.

Becca Perry and Samantha Peterson, faculty members in the medical labratory science department, said this is their first time participating in the Joggin' with Josh event, but look forward to future years.

"I think it's a great way to advocate health and like Dr. Wynne said, practice what you preach," Peterson said.

Numerous studies have shown that there are benefits to regular exercise, including reducing the risk of heart disease and diabetes, improving mental health and adding years to a persons life, the release said.

The event is being held in conjunction with UNDs Healthy Campus Week. The weeklong push, with Partnership for a Healthier America's Healthier Campus Initiative, is focused on promoting the great work PHA's campus partners are doing to make healthier choices easier for students, faculty and staff, according to UNDs website.

Faculty and staff can receive a free membership pass to the UND Wellness Center this week. In addition, students can get any equipment rental from the Outpost for half price all week.

UND also is highlighting its Health Hawks initiative this week, which aims to enhance the campus experience by making the healthy choice the easy choice for students, faculty and staff, UNDs website said.

There will be a number of other campus activities centered around Healthy Campus Week, including a visit from the Mobile Farmers Market Trolley and drunk goggles dodgeball on Wednesday. On Friday, health and wellness staff will be driving around campus, handing out school-colored fruits and vegetables for National Fruit and Veggie Friday.

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Joggin' with Josh advocates healthful lifestyles - Grand Forks Herald

White Coats Presented to Med School Class of 2023 – UNLV NewsCenter

When the UNLV School of Medicine recently welcomed its third class to the profession of medicine, it was done largely through a ritual that is now seen as a rite of passage for new medical students the White Coat ceremony, during which each student is presented with the garment that symbolizes their entrance into the medical profession.

Theceremony includes speakers and a student-written oath (below) that is recited in front of family members, school leadership, and peers to acknowledge their central obligation of caring for patients. Each class prepares its own oath.

Earlier in the month the students had been presented stethoscopes, another ritual symbolizing their entrance into the medical profession.

The white coat ceremony tradition is relatively new in the world of academia.The first took place in 1993at the Columbia University College of Physicians and Surgeons. It was the brainchild of Dr. Arnold Gold, a professor of clinical neurology and clinical pediatrics, whobelieved thepractice then of having students wait until the end of their training to formally announce their adherence to expectations and responsibilities appropriate to the medical profession occurred four years too late. Golds idea caught on quickly.

In just a few years, the ceremony was adopted by nearly every medical school in North America. At UNLV,the UNLV School of Dental Medicine welcomed its first class in 2002 with a white coat ceremony and continues the tradition. This year's will be held Sept. 20.

What surprises many people, as Dr. Mark S. Hochberg wrote in the AMA Journal of Ethics in 2007, is that prior to the late 19th century doctors wore black. Hochberg points out that Black attire was, and is, considered formal (e.g., todays tuxedo). Consequently, until about 1900, physicians wore black for their patient interactions since medical encounters were thought of as...formal matters. He said an additional or alternative possibility for the dark garb might be that until the late 19th century, seeking medical advice was usually a last resort and frequently a precursor to death.

How members of the medical profession came to wear white to symbolize cleanliness was part of a presentation by Dr. Neil Haycocks, the UNLV School of Medicines interim vice dean of academic affairs and education at the recent ceremony.

The period when the white coat became a symbol of medicine is bookended by two works by renowned American artist Thomas Eakins, Haycocks said.

The first, produced in 1875, is an oil painting titled 'The Gross Clinic.'It depicts famed academic trauma surgeon Dr. Samuel Gross, then 70 years old, lecturing Jefferson Medical College students while his assistants surgically treat a young man for osteomyelitis of the femur. Everyone in attendance is dressed in black, which was the typical medical attire of that time

The second Eakins work, also in oil, is 'The Agnew Clinic.'It was commissioned by the University of Pennsylvania medical class of 1889 to honor famed surgeon and anatomist Dr. David Hayes Agnew upon his retirement. Like Gross before him, Agnew stands in a medical amphitheater lecturing medical students while his assistants undertake an operation, this time a mastectomy. The attire, however, is different, with Dr. Agnew wearing a white smock, his assistants likewise dressed in white, and the patient covered by a white sheet.

"The contrast between these two paintings indicates that in a relatively brief span the color of medicine had gone from one extreme to the other. The explanation for this dramatic change resides with a British surgeon named Joseph Lister."

In the late 1800s, Lister was a professor of surgery at the University of Glasgow and interested in Louis Pasteur's early advancements in microbiology andgerm theory.Lister began applying germ theory to surgical practice, eventually adopting the use ofthe antiseptic phenol and documenting a dramatic decrease in the incidence of post-surgical infections.

"The implementation of antisepsis contributed to the transition of medicine to a science-based discipline," Haycocks said."Cleanliness became a core tenet of medical practice, reflected in the pure white attire now inextricably linked with the profession."

As he concluded, Haycocks urged the new class of medical students to examine their new white coats. "This is quite literally the cleanest they will ever be. Take a mental snapshot, it will provide an interesting contrast to what they will accumulate by the end of third year: crumbs from hastily eaten snacks, stains from hastily consumed energy drinks, pen and pencil marks from hastily scribbled notes, and evidence of encounters with various bodily substances that I will not enumerate here. Remember, bleach is your friend.

I am honored to offer this oath upon the inception of my medical career. I fully recognize the moral responsibilities of my chosen profession, as I affirm:

Each patient is a person, to be treated with dignity, humanity, and empathy. I will respect life, honor patient autonomy, and protect privacy.

The well-being of my patients is entrusted to me. I will be an advocate for my patients and use the medical skills and knowledge necessary to do so.

All patients are equally deserving of my skill and care. I will foster an environment of inclusivity and diversity in medicine.

Honesty and integrity are foundational to my practice. I will acknowledge my inevitable limitations and failures, be open to guidance from others, and always strive to become a better physician.

Others have paved the path that is before me. I will value and respect what has been given me by my mentors. I will teach others what I've been taught, give back what I've been given.

Medicine is demanding and ever-changing. I will be a lifelong learner. I will practice self-care as a responsibility to myself and patients.

The obligations of medicine require me to hold myself and others to the highest standard of accountability. I will be an ambassador of medicine, represent the profession well, and continue to earn society's trust.

I affirm this declaration and pledge to faithfully uphold these values.

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White Coats Presented to Med School Class of 2023 - UNLV NewsCenter

Lake Wales graduates in high-demand fields came home this summer to practice medicine – The Ledger

Theres constant demand for primary care doctors in Polk County and nationwide.

Recruiting urologists has been a frequent need in Polk and urology is one of four surgical specialties in which a 2016 workforce analysis predicts the greatest shortages in 2025.

So, what led two young doctors in those fields to enter practice in Lake Wales within a month of each other?

Never discount the home-field advantage.

Dr. James E. Pilkington, urologist, and Dr. Amber Shepard, family practice physician, have strong emotional ties to the Southeast Polk city.

After I did my residency at the University of Mississippi, seeing the needs and discrepancies there, Shepard said, I realized Why would I fix someone elses situation when my own community needed my help?

Pilkingtons late mother, Linda, was a well-known health care advocate in Lake Wales, at Heart of Florida Regional Medical Center in Haines City and across Polk.

After her death, Pilkington felt a strong desire to locate near his father, Edward. He also has fond memories of his childhood and education in Lake Wales.

Being able to serve a community that shaped me is very important to me, said Pilkington, who began seeing patients the second week of September.

He and Shepard, each 32, graduated in 2005 from Lake Wales High School (where he was valedictorian.)

Now both are with AdventHealth Medical Group, at separate locations in Lake Wales, and have privileges at AdventHealth Lake Wales. (Until Sept. 1, those were Heart of Florida Physician Group and Lake Wales Medical Center.)

Shepard began treating patients in Lake Wales on Aug. 19. She treats infants through senior citizens.

Medicine, for me, was a calling, Shepard said. Ive always known its what my purpose was, even as a young child.

She chose family practice after realizing during her medical school rotations that she loved taking care of entire families.

Pilkington decided as a child, following my mother around the hospital, that he wanted to be a doctor. He discovered his attraction to urology during his third year of medical school.

Its technological advances robotics and minimally invasive surgeries attracted him, as did its balance between surgery, outpatient and inpatient care. Genitourinary surgery is among his specialties.

Nine out of 10 urologists practice in metropolitan areas, making his choice of a city the size of Lake Wales atypical. Thats fine with him.

Its a way of life, Pilkington said. I feel comfortable in a smaller community where I can be actively involved and know people.

Its more personable, Shepard said. Youre not a number.

Her mother and stepfather, Martha and Samuel Lamb, also are in Lake Wales, another attraction.

Polk has a severe shortage when it comes to primary care medicine, which includes family practice. Its ratio of residents to primary care doctor is 2,030 to 1, compared to 1,390 to 1 in Florida.

Reaching out early to medical students from your city may be key for smaller communities. A study reported in Family Medicine in 2007 found physicians from nonmetro hometowns 4.7 times as likely to locate their practices in a nonmetro location when compared to their peers from metropolitan areas.

And, for some, recruiters say the desire to be close to aging parents is a factor.

We do use a hometown connection to recruit physicians when possible, although it doesnt always produce results, said Kris Andrews, a physician recruiter for BayCare Medical Group.

Sometimes, physicians do want to go back to where they grew up to help the community that they love, and then there are those that want to venture out and find a new path.

Pilkington went to Florida State University College of Medicine after undergraduate studies at the University of Florida. He left the state for a surgical internship and a urology residency at Louisiana State University Health Sciences Center. Hes now at 407 S. 11th St.

Shepard got her medical degree at Ross University Medical School in Dominica, now Barbados, after undergraduate studies at the University of South Florida. Her residency was at University of Mississippi Medical Center.

She received scholarship help from the J.A. Wiltshire Foundation in Lake Wales and Take Stock in Children, a countywide program, which further deepened her ties to the community.

Its been a big deal (to me) to reach out to my community and help them heal, said Shepard, whose office is at 1255 State Road 60 E., Suite 500.

Prevailing wisdom says doctors are more inclined to set up practices in areas where they did residencies or other advanced medical training.

Legislators told FSUs medical school to focus on primary care doctors and encourage them to practice within the state.

That takes residency programs, which AdventHealth has in Central Florida, although not in Polk.

Winter Haven Hospital, BayCare Medical Group and FSU, however, are creating one in Winter Haven. WHH is part of the BayCare Health system.

Doctors are scheduled to start residencies in Winter Haven in July. The city already is benefitting from a Family Health Center at 1201 First St., S, Suite 100A.

Three primary care doctors, who will be faculty in the residency program, treat patients there now Wellness visits, sports medicine, osteopathic manipulative treatment, womens health care and treatment of sprains, strains and arthritis are among its services.

Residents will join them in treating patients there. Some, its hoped, will like Polk enough to stay permanently.

Robin Williams Adams can be reached at robinwadams99@yahoo.com

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Lake Wales graduates in high-demand fields came home this summer to practice medicine - The Ledger

AMA Awards Multiple Innovation Grants to Medical Schools – Medscape

The American Medical Association (AMA) on Wednesday awarded grants totaling $370,000 to 15 medical schools and institutions for innovative medical education projects that train physicians to succeed in the rapidly evolving healthcare system.

Announced on Wednesday, the first day of the AMA's ChangeMedEd 2019 conference in Chicago, Illinois, the grants support initiatives in areas ranging from telemedicine and augmented intelligence to population health and student well-being.

The Accelerating Change in Medical Education Innovation Grant Program is part of a 6-year-old, $30 million AMA effort to improve medical education. The initiative is led by a consortium of more than three dozen medical schools. The project has produced a textbook on health systems science that is used by many medical schools.

The AMA has worked with medical schools to create a more flexible approach to their curricula that encourages competency-based training. To achieve this goal, 2 years ago the AMA consortium released a handbook that teaches faculty members how to coach students and residents to prepare them for their next steps, Susan E. Skochelak, MD, AMA group vice president for medical education, told Medscape Medical News.

This year, she said, the consortium published a handbook for students to help them understand the coaching concept.

The most important advance has been in the teaching of health systems science, she noted. In 2013, when the consortium was launched, "medical schools and residency programs taught doctors very little about how the health system worked or where it was headed," she said. At most, a school might offer a one-off course on quality improvement or social determinants of health.

Today, in contrast, "more than 50% of medical schools are teaching [health systems science] or related topics," Skochelak estimated.

Physicians and healthcare leaders, she said, are enthusiastic about this new direction in medical schools, "because they need people who can function in this [value-based-care] environment." An editorial in Academic Medicine last December said that one of the quality markers for medical education is the teaching of health systems science, she added.

Another sign that the AMA's approach has gained traction is that the American Board of Medical Examiners now includes this subject in its licensing exam, she pointed out.

Population health management and social determinants of health are included in the agenda for the 3-day ChangeMedEd meeting. Also featured are presentations, panel discussions, and workshops on the residency selection process, resiliency of physicians to avoid burnout, healthcare transformation, medical business ethics, digital literacy, the use of apps in medical education, and "reimagining residency."

The latter concept is the keystone of a complementary AMA program named Reimagining Residency, as reported by Medscape Medical News. Announced in June, this program will award $14.4 million to support eight projects led by medical schools, residency programs, and healthcare systems that oversee graduate medical education. Some of these projects will also address health systems science.

Eleven medical schools were awarded $30,000 grants in the second annual iteration of the innovation grant program. They include the following:

Cleveland Clinic Lerner College of Medicine, in Ohio

Columbia University Vagelos College of Physicians and Surgeons, in New York City

H. Lee Moffitt Cancer Center and Research Institute, in Tampa, Florida

Uniformed Services University of the Health Sciences, in Bethesda, Maryland

University of Arkansas for Medical Sciences, in Little Rock

University of Texas Southwestern Medical Center, in Dallas

Beth Israel Deaconess Medical Center, Harvard Medical School, in Boston, Massachusetts

University of California, Irvine, School of Medicine, in California

Virginia Commonwealth University School of Medicine, in Richmond

Brody School of Medicine at East Carolina University, in Greenville

Rutgers Robert Wood Johnson Medical School, in New Brunswick, New Jersey

The following four schools will receive $10,000 grants:

Johns Hopkins University School of Medicine, in Baltimore, Maryland

University of Arizona College of Medicine Tucson

Virginia Commonwealth University School of Medicine, in Richmond

Rayos Contra Cancer, in San Francisco, California

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AMA Awards Multiple Innovation Grants to Medical Schools - Medscape

UM School Of Medicine’s Center For Vaccine Development And Global Health Receives NIH Contract Of Up To More Than $200 Million For Influenza Research…

BALTIMORE, Sept. 23, 2019 /PRNewswire/ --- Kathleen Neuzil, MD, MPH, Professor of Medicine and Pediatrics and Director of the Center for Vaccine Development and Global Health (CVD) at the University of Maryland School of Medicine (UMSOM) and Dean E. Albert Reece, MD, PhD, MBA, announced that CVD has been awarded a contract from the National Institute of Allergy and Infectious Diseases (NIAID), with total funding up to more than $200 million over seven years if all contract options are exercised.

This research contract is one of the largest ever awarded to UMSOM and includes an initial award of approximately $2.5 million to conduct clinical testing of influenza vaccines. Total funding over seven years could be as much as $201 million if all options are exercised in the NIAID contract.

CVD's research is aimed at testing improved seasonal influenza vaccines and conducting controlled human influenza challenge studies for NIAID Collaborative Influenza Vaccine Innovation Center (CIVICs) program, which has the ultimate goal of developing a universal vaccine to protect against emerging influenza strains as well as improvements to current seasonal vaccines.

The seven-year contract will be led by CVD's Dr. Neuzil, who is one of the world's leading and preeminent research scientists and advocates in the area of vaccine development and policy. For more than four decades, CVD has worked domestically and internationally to develop, test and deploy vaccines to prevent and protect against a range of diseases, such as influenza, cholera, typhoid fever, malaria, shigellosis (bacillary dysentery), and other infectious diseases. CVD has also taken global leadership roles in vaccines to protect against emerging pathogens such as Zika and Ebola virus.

The CIVICs program includes multidisciplinary research across a large network of institutions, supporting the development of vaccine candidates through testing in pre-clinical studies, clinical trials and human challenge studies. This new CVD funding will establish the CVD CIVIC Clinical Core, with the specific goal of evaluating improved seasonal influenza vaccines and ultimately developing a universal vaccine to protect against emerging influenza strains.

Influenza, a contagious respiratory illness, is one of the greatest infectious disease threats to health and well-being. The disease impacted 43 million people in the U.S. alone during the 2018-2019 season, according to the Centers for Disease Control and Prevention (CDC). While current vaccines are our best tool to protect against influenza and its complications, the CVD CIVIC will address the urgent need for novel vaccines that provide broad and long-lasting protection.

As Principal Investigator, Dr. Neuzil will serve as the primary liaison with NIH program officers, CIVICs partners and technical centers.

"Influenza virus is a common and serious infection that causes annual outbreaks in all age groups. While current influenza vaccines have been critical in reducing disease, the virus is constantly changing. The CIVICs program will address the need to develop and test influenza vaccines that protect against new and emerging strains, and ultimately prevent more disease," said Dr. Neuzil.

Under Dr. Neuzil's leadership, CVD has assembled an expert and accomplished team with extensive clinical research experience as well as virology, immunology, and influenza expertise. The research includes clinical trials and challenge studies in adults as well as in special populations, such as children, pregnant women, and the elderly.

Throughout her career, Dr. Neuzil has conducted clinical and epidemiologic studies on vaccine-preventable diseases, yielding high profile publications that inform policy decision and public health actions. At the global non-profit PATH enterprise, Dr. Neuzil was instrumental in the global introduction of vaccines against rotavirus, HPV and Japanese encephalitis. At CVD, she leads a large international, consortium funded by the Bill and Melinda Gates Foundation to accelerate the introduction of a typhoid vaccines into low resource settings worldwide. In addition, Dr. Neuzil has a robust influenza research program. She is dedicated to training and directs a n NIAID T32 Training Grant in Vaccinology, where she mentors and supports scientists around the global.

Dr. Neuzil's research capabilities are complemented by nearly 20 years of involvement in domestic and international policy, including membership on the CDC Advisory Committee on Immunization Practices (ACIP). She currently serves as the only U.S. member of the World Health Organization's (WHO) Strategic Advisory Group of Experts on Immunization (SAGE). In addition, Dr. Neuzil has contributed more than 200 scientific publications on vaccines and infectious diseases.

"This contract brings together a broad cross-section of researchers at UMSOM, who are experts in virology, vaccinology, and immunology. For decades, CVD has been a leader in researching and developing interventions for the most challenging diseases that impact the world's most vulnerable populations. With this generous funding, and Dr. Neuzil's expertise and leadership, CVD will be able to make pathbreaking discoveries, and test new vaccines against this persistent infection that affects millions of people around the world," said UMSOM's Dean Reece, who is also the Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor.

"The flu has deadly costs - from its human toll to its negative impact on our economy. We must devote the necessary resources to develop a universal vaccine. That's why I've introduced legislation in Congress to double our investment in this area -- and why I'm so proud to announce this funding today. Every day the University of Maryland School of Medicine conducts life-saving research in addition to preparing our future doctors and medical professionals for success. This investment -- and its potential -- underscore the importance of their work," said U.S. Senator Chris Van Hollen, (D-Md), who is a sponsor of legislation to expand flu vaccine research.

The CIVICs program was jointly developed by NIAID's Division of Allergy, Immunology and Transplantation and the Division of Microbiology and Infectious Diseases to advance development and clinical testing of improved seasonal and universal influenza vaccines that provide durable, broadly cross-protective immunity.

"This contract will unite the greatest scientific minds in our state and nation toward a mission to improve our national public health," saidU.S. Senator Ben Cardin (D-Md). "Both the University of Maryland School of Medicine's Center for Vaccine Development and Global Health and the National Institute of Allergy and Infectious Disease have made incredible contributions to critical and lifesaving developments in disease prevention and treatment. Influenza is a common, yet complex illness that continues to put our most vulnerable citizens at risk. Through this public-private partnership, researchers will be able to clear the path for advancements in vaccination to better prepare our society for 21stcentury health needs. I'm proud that it will take place right here in the great state of Maryland."

The CVD CIVIC program builds upon decades of clinical vaccine research at the CVD, much of which is contracted through the NIAID's-supported Vaccine and Treatment Evaluation Unit (VTEU) network. CVD, as a part of the VTEU network, is conducting vaccine trials against influenza and other diseases. In addition, CVD is studying vaccines to protect against malaria, anthrax, Dengue, Ebola virus, meningitis, and Hantaan virus. This project has been funded in whole or in part with Federal funds from the NIAID, NIH, and Department of Health and Human Services, under Contract No. 75N93019C00055.

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues today as one of the fastest growing, top-tier biomedical research enterprises in the world -- with 43 academic departments, centers, institutes, and programs; and a faculty of more than 3,000 physicians, scientists, and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished recipient of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1 billion, the School of Medicine works closely in partnership with the University of Maryland Medical Center and Medical System to provide research-intensive, academic and clinically based care for more than 1.2 million patients each year. The School has over 2,500 students, residents, and fellows, and more than $530 million in extramural funding, with most of its academic departments highly ranked among all medical schools in the nation in research funding. As one of the seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total workforce of nearly 7,000 individuals. The combined School and Medical System ("University of Maryland Medicine") has an annual budget of nearly $6 billion and an economic impact more than $15 billion on the state and local community. The School of Medicine faculty, which ranks as the 8th highest among public medical schools in research productivity, is an innovator in translational medicine, with 600 active patents and 24 start-up companies. The School works locally, nationally, and globally, with research and treatment facilities in 36 countries around the world. Visit medschool.umaryland.edu

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SOURCE University of Maryland Medical Center

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UM School Of Medicine's Center For Vaccine Development And Global Health Receives NIH Contract Of Up To More Than $200 Million For Influenza Research...

Unusual Suspect | Harvard Medical School – Harvard Medical School

Obesity affects approximately 40 percent of Americans, according to the U.S. Centers for Disease Control and Prevention. While obesity is known to be associated with increased risk of health conditions, such as heart disease, diabetes and gastrointestinal diseases, less is known about the relationship between obesity and abnormal bowel habits.

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In a comprehensive analysis of the relationship betweenbody mass index and bowel habits,published inAlimentary Pharmacology and Therapeutics,a team ofphysician-researchers at Harvard Medical School and Beth Israel Deaconess Medical Center found a strong association between obesity and chronic diarrhea independent of an individuals diet, lifestyle, psychological factors or medical conditions.

The findingscould have important implications for how physicians might approach and treat symptoms of diarrhea in patients with obesity.

While several previous studies have pointed to an association between obesity and bowel habits, all lacked data on whether dietary or other factors drive the connection, said corresponding authorSarah Ballou, HMS instructor in medicine and a health psychologist in the Division of Gastroenterology, Hepatology and Nutrition at Beth Israel Deaconess.

Our research confirms a positive association between obesity and chronic diarrhea and reveals for the first time that this relationship is not driven by confounding factors such as diet or physical activity level, Ballou said.

Using the 20092010 National Health and Nutrition Examination Surveya program of studies administered by the CDC designed to assess the health and nutritional status of adults and children in the United StatesBallou and colleagues analyzed the bowel-health questionnaire responses of 5,126 patients over the age of 20 years who did not report a history of irritable bowel syndrome, celiac disease or colon cancer.

The team compared the reported bowel habits of patients who had a BMI associated with being underweight, normal weight, overweight, obese and severely obese.

After controlling for dietary, physical activity, diabetes, laxative use and demographic factors, the team found that respondents who were obese or severely obese were 60 percent more likely to have experienced chronic diarrhea compared to those with normal bowel habits or constipation.

While the study reveals the association is not driven by confounding factors the team controlled for, questions still remain about what underlying causes may explain why obese individuals would be more likely than nonobese individuals to have diarrhea.

One possible explanation may be related to the link between obesityand chronic low-gradeinflammation,which may contribute to diarrhea. Future research clarifying this relationship and determining how obesity triggers inflammation could serve as a base for how physicians approach treating abnormal bowel habits with this patient population.

The treatment of obesity and obesity-related medical conditions requires multidisciplinary management, said senior authorAnthony Lembo, HMS professor of medicine and gastroenterologist in the Division of Gastroenterology, Hepatology and Nutrition at Beth Israel Deaconess.

Clinicians should be aware of the relationship between obesity and diarrhea, especially considering the potential negative impacts altered bowel habits can have on quality of life, Lembo said.

This work was supported by the National Institutes of Health (grant no. T32DK007760).

The authors declare no conflicts of interest associated with their manuscript.

Adapted from a Beth Israel Deaconessnews release.

Image: iStock/koto_feja

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Unusual Suspect | Harvard Medical School - Harvard Medical School

Valedictorian Who Battled Homelessness Starts School At Yale – News One

Atlanta native Chelesa Fearce is living proof that you can rise above your circumstances and overcome the odds. Despite battling homelessness throughout her high school years, she went on to be named valedictorian of her class, graduated from Spelman College and is now a student at Yale University, the Atlanta Journal-Constitution reported.

Fearce, 23, is currently pursuing her MDPhD degree at the Yale School of Medicine; a major step towards her goal of launching a career in psychiatry. Fearces journey to the prestigious Ivy League school was no easy feat. While attending Charles R. Drew High School in Riverdale, Georgia she and her family were homeless. She would often go without food and would use the stove lights at motels for her studying sessions. Despite living in those conditions, she earned a 4.5 grade point average and was named valedictorian of her class in 2013. Her academic accomplishments garnered her a full scholarship to Spelman College. After graduating from the historically Black college with a degree in biochemistry, she went on to work for a national health agency and started the next step in her academic journey at Yale last month.

Fearce says her experience with homelessness instilled values that she has taken with her throughout every stage of her life. Homelessness taught me how to work hard, always persevere and never let anything get in my way, she told the news outlet. It really helped show my resilience when I applied for college and medical school.

Fearce and her family have been dedicated to paying it forward and helping those in need. There was a scholarship named in her honor for homeless students determined to further their education. Her mother Reenita Shepherd has become the foster parent of four children and is currently serving as a caretaker for a former homeless shelter director.

SEE ALSO:

Will Smith To Help Raise $50 Million To Combat Global Homelessness

City Of Atlanta Raises $50 Million To Create Homes For The Homeless

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Valedictorian Who Battled Homelessness Starts School At Yale - News One