New hires and promotions in the metro Augusta business community.

Kelly McCauley

Employer: Cherry Bekaert LLP

Title: Senior Manager

Responsibilities: Provide comprehensive tax compliance and provision services, particularly in the manufacturing and technology industries

Experience: Is a licensed as certified public accountant in Georgia and has more than 13 years of public accounting experience working with clients throughout the Southeast

Mallory Eickhoff

Employer: Cherry Bekaert LLP

Title: Senior Manager

Responsibilities: Serving clients representing nonprofit organizations, manufacturing and distribution companies, financial institutions and captive insurance companies

Experience: Was previously a manager for the firm; has more than 10 years of experience in both public accounting and private industry; is licensed as a certified public accountant in Georgia

Timothy Lansdowne

Employer: Cherry Bekaert LLP

Title: Manager

Responsibilities: Providing tax compliance services for individuals, partnerships, S-Corporations and C-Corporations

Experience: Was previously a tax senior with the firm; has more than five years of public accounting experience for clients in sectors including real estate, construction, manufacturing, distribution, technology and professional services

Dr. Michael Hocker

Employer: Medical College of Georgia at Augusta University

Title: Senior Associate Dean for Graduate Medical Education

Responsibilities: Develop, implement and assess programs and services to meet strategic goals for residency and fellowship programs; also will serve as MCG's designated institutional official, leading the medical school and health system's 51 residency and fellowship programs

Experience: Was previously vice chair of clinical operations and business management for the Department of Emergency Medicine

Dr. Michael Groves

Employer: Medical College of Georgia at Augusta University

Title: Associate Dean for Graduate Medical Education

Responsibilities: Develop, implement and assess programs and services to meet strategic goals for residency and fellowship programs; also will serve as MCG's assistant designated institutional official, helping leading the medical school and health system's 51 residency and fellowship programs

Experience: Is an otolaryngologist who directs the Department of Otolaryngology-Head & Neck Surgerys residency training program

Dr. Stephen Shiver

Employer: Medical College of Georgia at Augusta University

Title: Vice Chair of Clinical Operations for the Department of Emergency Medicine

Responsibilities: Supervising all clinical care provided within the department, including the emergency rooms at AU Medical Center and the Childrens Hospital of Georgia, pre-hospital clinical care and emerging telehealth initiatives

Experience: Previously served as the department's residency program leader

Dr. Natasha Savage

Employer: Medical College of Georgia at Augusta University

Title: Vice Chair for Academic Affairs for the Department of Pathology

Responsibilities: Oversee the departments academic endeavors, including continuing to direct the residency program, engaging residents in scholarly pursuits, advising medical students who are pursuing a career in pathology and helping build out the pathology and hematology parts of MCGs new curriculum; will also serve as chief of staff elect for Augusta University Health

Experience: Serves as residency program director in the Department of Pathology

Submit your news: Send in On The Move and Biz Bits items to augustachronicle.com/send-us-your-news.

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On The Move: New hires and promotions in the metro Augusta business community - The Augusta Chronicle

Years of medical school, graduate school and clinical hours are meant to make doctors ready for anything. But no number of disaster-scenario trial runs or years of on-the-ground experience could have prepared health care professionals for the early weeks of the COVID-19 pandemic.

Nothing like whats happened with COVID-19 prepared us for what was coming, says Parveen Wasi, associate dean of postgraduate medical education at McMaster University.

Even in Toronto, with its handling of SARS1 in 2003 and H1N1 flu in 2009, the learning curve has been steep.

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The disease and the pattern [of the viruses] are different, but the principles were familiar, and we had some structures in place, explains Glen Bandiera, associate dean of postgraduate medical education at the University of Toronto. The magnitude of this response was bigger and the threat [the pandemic] posed to the system was greater because of the sheer numbers of [patients], the lack of personal protective equipment and the impact on the health work force.

Medical schools were doubly hit: Not only were they responsible for the continuance of studies and keeping student residents safe, they also had to change the way medical education was being delivered, and quickly. Medical students were pulled from all clinical settings in March across Canada and didnt start returning until August, which meant a large number of training hours had to be made up.

And while residents are still in training, theyre also hospital employees and, therefore, essential workers. We had to start from ground zero in terms of how we protected our residents and then how we planned education around the pandemic, Dr. Wasi says.

This meant identifying gaps in the system, such as issues around PPE. For example, health care professionals using N95 respirators are required to be fitted every two years. At some hospitals, many of the residents had never been fitted and there was no documentation to confirm who had. As PPE use is exacting, protocols must be followed to protect patients and health care workers; how its done changes, depending on the level of exposure to infectious agents.

I mask-fitted two years ago, but when I actually had to use one, I wasnt 100 per cent sure how to, Dr. Wasi says. Training for PPE how to don and doff appropriately, how to put on an N95 mask was hit and miss prior to this.

The pandemic has also highlighted the need for more training in infection control for postgraduate students. We just assumed it would also occur in the hospital setting, Dr. Wasi adds. So, lesson learned.

Over all, the response by medical schools to the new world has been overwhelmingly swift and often innovative. While U of Ts medical school includes pandemic planning in its curriculum, a specific COVID-19 curriculum was constructed for third-year students returning to clinical environments in the summer. The new program includes PPE instruction, a mask-fit for N95 and an in-depth study of the virus itself.

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Dr. Patricia Houston, vice-dean of medical education at the University of Toronto.

Thomas Bollmann/The Globe and Mail

Patricia Houston, vice-dean of medical education at U of T, says students learn about ethical concepts, palliative care and virtual delivery of health care. We give them tips about how the hospital [is] different in these pandemic times. We also help them to deal with it personally and talk about being resilient.

Within a week of COVID-19 being declared a pandemic, Dr. Houston says the school had moved lectures, small-group learning sessions and even clinical skills courses online. Our pivoting is all strategic, and [the changes] will form the new normal, which have to be robust enough and responsive enough to future needs.

Since mid-March Roger Wong, vice-dean of education at the faculty of medicine at the University of British Columbia, has been adapting the curriculum, beefing up sections on public health, social determinants of health and disease-specific treatment strategies, as well as developing COVID-19-specific sessions for final-year medical students.

UBC also moved to a blended mode of curriculum delivery, virtual and in-person when possible. It developed a free online learning module for medical and health professional students on how to use PPE appropriately. And over the summer, Dr. Wong and his team created a virtual anatomy lab, offering students three-dimensional scans of specimens to study at their leisure.

Its fair to say that everyone around the world is learning actively as the situation evolves, he says. [The pandemic] has catalyzed a large number of innovations in medical education that would have taken decades to happen otherwise. It would be almost unimaginable.

Alim Pardhan, assistant professor of emergency medicine at McMaster, says flexibility for medical schools, doctors and hospitals is key, for example, changing the focus of the health care system from a single discreet event with lots of patients to a longer-term event that might last a year or two where you have higher volumes, fewer beds available and extra precautions with certain patients.

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All agree that COVID-19 will have an enduring impact on health care. Dr. Houston hopes the experience of the past six months will increase the support for, and understanding and appreciation of, public health.

Were always looking for the next cutting-edge medicine, she says, but we need to understand how we can better take care of not just individuals, but populations and communities. And thats something public health teaches us to do.

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Medical schools pivot to prepare and protect students for front-line work - The Globe and Mail

Dr. Alan Koffron joins Erlanger Kidney Transplant Center as its new surgical director. Dr. Koffron works alongside Dr. Kenneth Kokko, kidney transplant center program and medical director. Dr. Koffron earned his medical degree from the University of Iowa College of Medicine. Following medical school, he completed residency training in general surgery at Chicago Medical School University of Health Sciences. Dr. Koffron completed two fellowships a multiple-organ transplant surgery and hepatobiliary surgery fellowship at Northwestern University Medical School in Chicago and a pediatric liver transplant surgery and hepatobiliary surgery fellowship at Children's Memorial Hospital in Chicago.

Matthew McKenney joins HHM Wealth Advisors, LLC as client service administrator. With deep roots in the community, McKenney joined HHM Wealth Advisors after earning a Bachelor of Science in Finance from Rhodes College. He had several internships over the last four years, preparing him to serve as client service administrator. Matthew supports HHM Wealth's lead advisors with research, trading, and retirement analysis. He is also dedicated to ensuring customer satisfaction in every encounter he has with clients.

E'tienne Easley joins Family Promise of Greater Chattanooga as the director of development. Easley leads the work of fundraising and grant writing, as well as managing communication efforts. Family Promise is a nonprofit organization that offers four programs to prevent, reduce and end family homelessness in the Chattanooga area. Easely has extensive experience in leadership, managing grant funds, strategic planning and implementation, volunteer recruitment and building effective and long-standing community partnerships. She is a certified grant writer, and her background includes being Hamilton County Department of Education's family partnership specialist, community engagement manager and health program manager, as well as the employment career specialist at Signal Centers.

Joel Henderson is named as the new executive director for Volunteers In Medicine of Chattanooga. VIM serves the health and wellness needs of the medically underserved by providing quality, compassionate, personal care in a faith-based environment. Henderson previously served as director of communications and marketing since 2017 at the Cleveland/Bradley County Chamber of Commerce and previously served as vice president of communications at North American Credit Services Inc. Henderson is a 1994 graduate from Southern Adventist University and a 2013 graduate of Leadership Chattanooga.

Anne Najjar joins the team at Second Story Real Estate Management, Chattanooga's full-service property management group. A skilled negotiator with a reputation for creating successful outcomes for investors, tenants and landlords alike, Anne Najjar brings over 15 years of commercial investment, development and brokerage experience. In 2018, CoStar awarded Najjar their Power Broker award for being a top broker for the Chattanooga MSA area. Her experience ranges from acquisitions and dispositions to leasing and financial and market analysis for clients. She played an integral part in the redevelopment of the Southside from acquisitions of historical buildings, becoming knowledgeable on grants, understanding the conservation of buildings and finding tenants to fill the newly refurbished buildings. Najjar will be mainly working on retail, restaurant, medical and office representation, as well as investment, acquisition and disposition with Second Story.

Kira Wheat joins HHM Certified Public Accountants, a CPA and consulting firm with locations in Chattanooga and Memphis. Wheat brings more than 16 years of experience to the firm's tax practice. As a senior tax manager, Wheat will assist high net worth and closely held business clients in the areas of tax compliance, tax planning and staff and project management. Wheat comes to Chattanooga from a Chicago-based public accounting firm where she worked her way up to Senior Tax Manager. Wheat is a graduate of North Central College and is a Quickbooks Proadvisor.

Tim Cook, who joined the Legacy Senior Living family as director of chaplaincy earlier this year, is promoted to executive director of its hometown facility, Legacy Village of Cleveland, after a successful expansion of the network's chaplaincy program this summer. In his new role, Cook oversees the day-to-day operations of Legacy Village of Cleveland, which provides a home-like environment to more than 70 Bradley County seniors and is part of a network of 14 senior living communities based in Cleveland.

Amir Hamad, BSN, MHA, RN, CCRN, is named chief nursing officer of Parkridge East Hospital. Hamad brings 12 years of healthcare experience to the position, including nursing roles in emergency medicine and cardiac critical care. Most recently, Hamad served as associate chief nursing officer at Reston Hospital Center, in Reston, Virginia. Prior to that, he served as director of the cardiac and medical Intensive Care Unit (ICU) at LewisGale Medical Center, in Salem, Virginia, where he also served as clinical team lead in the cardiac ICU and as clinical coordinator of the Emergency Department. Hamad earned a master's in healthcare administration from Grantham University, in Lenexa, Kansas, and a bachelor's in nursing from Radford University, in Radford, Virginia. He also earned a bachelor's in biology from Virginia Tech University.

Sam Montgomery, a certified financial planner and certified Kingdom advisor, is promoted from paraplanner to associate financial advisor. at Riggs & Associates, a private wealth advisory practice of Ameriprise Financial Services, Inc. that is led by Jody B. Riggs. Montgomery started working for Riggs & Associates in July 2017. As an associate financial advisor, he will provide comprehensive financial planning services to clients, and provide investment solutions to meet clients' financial needs. Montgomery holds a bachelor's in Financial Planning from Liberty University.

Tony Sanders joins the board of Habitat for Humanity in Chattanooga, which works to provide affordable housing in the area. Sanders is a certified public accountant and certified fraud examiner with more than 30 years of experience in the public and private sectors. He received his bachelor's degree from the University of Tennessee at Chattanooga and an MBA from Tennessee Tech University. He currently works for Unum as a manager in the Benefits Financial Services area. Sanders serves a commissioner for the Tennessee Wildlife Resources Agency.

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EDGE: On the Move - Chattanooga Times Free Press

BOSTON, January 2, 2021 Reports of possible allergic reactions to the COVID-19 vaccines produced by Pfizer-BioNTech and Moderna, both recently approved for emergency use by the U.S. Food and Drug Administration (FDA), have raised public concern. A team of experts led by allergists at Massachusetts General Hospital (MGH) has now examined all relevant information to offer reassurance that the vaccines can be administered safely even to people with food or medication allergies. The groups review is published in theJournal of Allergy and Clinical Immunology: InPractice.

In response to accounts of potential allergic reactions in some people following COVID-19 vaccination in the United Kingdom, that countrys medical regulatory agency advised that individuals with a history of anaphylaxis to a medicine or food should avoid COVID-19 vaccination. After closer review of the data related to allergic reactions, however, the FDA recommended that the vaccines be withheld only from individuals with a history of severe allergic reactions to any component of the COVID-19 vaccine, and the Centers for Disease Control and Prevention advised that all patients be observed for 15 minutes post-vaccination by staff who can identify and manage such reactions.The U.S. agencies do not recommend that people with food or medication allergies avoid vaccination.

To provide insights from allergists perspectives, Aleena Banerji, MD, clinicaldirector of the Allergy and Clinical ImmunologyUnit at MGH and associate professor at Harvard Medical School, and her colleagues have summarized whats currently known about allergic reactions to vaccines like those developed against COVID-19, and they have proposed detailed advice so that individuals with different allergy histories can safely receive their first COVID-19 vaccine. They also outline steps on safely receiving the second dose in individuals who develop a reaction to their first dose of COVID-19 vaccine.

As allergists, we want to encourage vaccination by reassuring the public that both FDA-approved COVID-19 vaccines are safe. Our guidelines are built upon the recommendations of U.S. regulatory agencies and provide clear steps to the medical community on how to safely administer both doses of the vaccine in individuals with allergic histories, says Banerji.

The experts note that allergic reactions to vaccines are rare, with a rate of about 1.3 per 1 million people. They stress that COVID-19 vaccine clinics will be monitoring all patients for 15 to 30 minutes and can manage any allergic reactions that occur. Banerji and her co-authors recommend that individuals with a history of anaphylaxis to an injectable drug or vaccine containing polyethylene glycol or polysorbate speak with their allergists before being vaccinated. They stress that patients with severe allergies to foods, oral drugs, latex, or venom can safely receive the COVID-19 vaccines.

Cosenior authors of the review are MGHs Kimberly G. Blumenthal, MD, MSc, and Elizabeth Phillips, MD, of Vanderbilt University Medical Center. Other co-authors include Paige G. Wickner, MD, of Brigham and Womens Hospital; Rebecca Saff, MD, PhD, Lacey B. Robinson, MD, MPH, Aidan A. Long, MD, and Anna R. Wolfson, MD, of MGH; David A. Khan, MD, of the University of Texas, Southwestern Medical Center; Cosby A. Stone Jr., MD, MPH, of Vanderbilt University Medical Center; and Paul Williams, MD, of the University of Washington School of Medicine.

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Allergists offer reassurance regarding potential allergic reactions to COVID-19 vaccines - YubaNet

By Leslie Gibson McCarthy

Executive News Editor

St. Louis, Mo., Oct. 28, 2020- Senior football and track & field student-athlete Andrew Whitaker was featured in the "Washington People" section ofThe Record on this date.

Whitaker has spent his undergraduate career at Washington University in St. Louis giving back.

Abiomedical engineering majorat the McKelvey School of Engineering, he has danced and played with kids who have cerebral palsy so they can put on a dance recital through Dance CPSR (Cerebral Palsy Sports Rehabilitation).

A two-sport athlete infootballandtrack, he has spent weekends with kids on the autism spectrum, guiding them through exercises to improve coordination and social skills through the Bear Cubs running program.

AnAnnika Rodriguez Scholar, he has traveled to Honduras for a week, helping doctors assist patients with basic medical needs through a program called Global Brigades. He also has been involved in the McKelvey Takes Responsibility Campaign and WU BLAC.

Yet when Whitaker who recently was selected as one of 22 college football players from all three NCAA divisions for the prestigiousAllstate American Football Coaches Association (AFCA) Good Works Team is asked what, if any, of these experiences had the most meaning for him, he responds, "Whatever I'm doing now."

Right now, that would be his work with the local nonprofit Asthma & Allergy Foundation of St. Louis, helping kids afflicted with a disease of the lungs that is even more dangerous in this time of COVID-19.

What began as an internship this past summer has turned into a project near and dear to this defensive back's heart. With the help of the Gephardt Institute for Civic & Community Engagement, for which he also serves as aBob and Gerry Virgil Civic Scholar, Whitaker spearheaded a project to send medical supplies to every school district in the St. Louis area. He set up and managed a website through the foundation that school nurses could access and request kits to have on hand. And when the kits were ready to send, he enlisted his football teammates to help assemble boxes.

"It was good to know that when schools opened this fall, there were kids with asthma who had a fighting chance against COVID because of these kits," he said.

All from a senior who, like his teammates and classmates, admittedly is having the toughest year of his undergraduate career. Much of his campus life this semester has been experienced from his nearby campus apartment, and the football team only recently began socially distanced practices on Francis Olympic Field. He's also just starting to work out with the track team.

"The whole year has been humbling, and it gives you so much time to reflect on what matters," he said, referring not only to the pandemic but also the social unrest that erupted this summer in the wake of the death of George Floyd.

"I'm a senior in college, and I don't want to waste any more time," he said. "Simply being around friends is meaningful the games we play, the meals we eat together. These things really matter.

"And as a senior on the football team, as a captain on the track team, I now feel like if I can inspire someone, I should," he said. "If I can share my experiences about being Black and get my teammates to look at things through a different lens in terms of the social injustices going on, I will."

Whitaker, a native of Cincinnati, said medical school is likely in his future, but he hopes to take a year off after he graduates to travel, maybe participate in an international fellowship of some kind, and figure out his next step.

More information about the Good Works nomination is available here, including an opportunity to vote himteam captainthrough Nov. 22. Meanwhile, the honors keep coming. Whitaker also recently was named a semifinalist for theCampbell Trophy, awarded by the National Football Foundation & College Hall of Fame. Like the Good Works award, it spans all NCAA divisions and recognizes an individual as the absolute best football scholar-athlete in the nation for his combined academic success, football performance and exemplary leadership.

He continues to take all the accolades and honors in stride. "You never expect to be honored at all when you're simply helping people," he said.

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Whitaker Featured in The Record - WUSTL Athletics - Sports News from Washington University in St. Louis

John Sherwood, left, and Daniel VanZweden, are second-year medical students who co-wrote the winning poster.

Service learning is an integral part of the curriculum at the Wayne State University School of Medicine. While the COVID-19 changed the way medical students at WSU approach the subject, the pandemic gave students the opportunity to be part of the team behind the retool.

The efforts, presented in poster format, were nationally recognized at the 17th annual Learning Communities Institute Conference as the best student presentation by unanimous vote.

Learning Communities: Service Learning amid COVID-19, was written by second-year students Daniel VanZweden and John Sherwood, with assistance from Director of Community Engagement Jennifer Mendez, Ph.D., an associate professor of Internal Medicine; and Co-Director of Service Learning LaTonya Riddle-Jones, M.D., an assistant professor of Internal Medicine.

The poster describes how, in less than a month, faculty and students worked together at the School of Medicine to transform the service-learning curriculum into a safe and structured telecheck-in experience. Learning Communities, or LCs, comprised of six students each, used telecheck-ins to contact families in the community and used a standardized questionnaire as a guide for assessing needs. LCs then designed a resource guide and presented it to their families. A reflection was completed to share what they learned about telecheck-ins in general. Survey results show most teams spent 10 to 30 minutes with their family. Food-related resources were one of the most common requests.

The virtual conference was hosted by the University of Texas Southwestern Medical School on Oct. 24. Designed for faculty, students and administrative staff, the conference featured a plenary address, workshops, oral presentations and a poster session. This years theme was Supporting Learning Communities in a Virtual Setting.

Service learning is part of the School of Medicines Patient, Population, Physician course, which includes clinical hours, project hours, outreach hours and seminars with reflections. The projects demonstrate the ability to work as a team, educate clients and/or patients during a health-screening event and reflect on the experience of care.

The poster details how we scrapped the original plans for service learning and over the course of a month designed a new curriculum that would engage medical students with community members while maintaining social distancing, VanZweden said. Telehealth was used to connect teams of students, organized by their learning communities, with the local community, and students identified any needs that families and members of the community had. They then compiled a resource guide to help families and members of the community with any problems they had during COVID-19. This was a valuable experience to serve the community, as well as educate students about social determinants of health and problems in the local community during COVID, as well as the resources available to solve some of those problems.

The winning research also was accepted by theAmerican Medical Association Health Systems Science Student, Resident and Fellows Impact Challenge and will be includedin the 2020 edition of Medical Students, Residents and Fellows Making an Impact. In June, it was featured in a keynote presentation at the Academy for Gerontology in Higher Education, where it also received a special mention from the conference organizers.

All medical schools in the United States are required by the Association of American Medical Colleges to incorporate service learning into curriculum, but the School of Medicine takes the requirement several steps further, seeing it as an opportunity to make a real difference in the community while also bolstering longitudinal mentorship among the four classes, including pairing first-year learning communities with second-year students.

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Students and faculty praised for collaborative project transforming curriculum amid pandemic safety concerns - The South End

Medicine always needs good people, but never more so than during a pandemic.

During a recent Ethics Talk videocast from the AMA Journal of Ethics (@JournalofEthics), the journals editor-in-chief, Audiey Kao, MD, PhD, revisited a video interview he conducted with the late Edmund Pellegrino, MD, then-professor emeritus of medicine and medical ethics at Georgetown University and widely considered to be one of the founders of American bioethics. The 2003 interview provides enduring reminders of what makes a good physician in times of crisis.

The question is often asked, Whats the most important thing in the ethics of medicine? And I always say it's the character of the physician, Dr. Pellegrino said. The kind of person the physician ought to bethats what virtue ethics concerns itself with.

Virtue ethics emphasizes the centrality of moral character, in contrast with the other normative ethics of deontology, which specifies duties or rules, and consequentialism, which focuses on the outcomes of actions. Principlismwhich encompasses the familiar four key ethical principles of autonomy, beneficence, nonmaleficence and justiceis an applied ethics approach.

The virtues I've been talking aboutnamely, fidelity to trust, compassion, intellectual honesty, courage, benevolence, for exampleare necessary because without those personal characteristics, the physician cannot truly heal, cannot make whole again, Dr. Pellegrino said.

Read the AMA Principles of Medical Ethics.

By the time of his 2013 death, Dr. Pellegrino had written or co-written more than 600 articles and 23 books on medical science, philosophy and ethics, and helped pioneer the teaching of humanities in medical school. He also served as chair of the President's Council on Bioethics under President George W. Bush. Watch this AMA video about Dr. Pellegrino, whose career was marked with distinction.

Dr. Pellegrino was particularly critical of the commercial nature of medicine in the U.S., noting that health care is seen as a commodity, which presents challenges to the physicians character.

I've been challenged by physicians who say, Dr. Pellegrino, youre a fool an idealistic fool. You know it's a business. Why don't you call it such and stop all of this blather about ethics and virtue? he said. A significant number of physicians feel that way. I'm happy to say a large number do not and still want to do the right thing. They are the hope for the future.

Read the AMA Declaration of Professional Responsibility.

Young people contemplating a career in medicine should be aware that physicians are not defined by their credentials, but also by their commitments, Dr. Pellegrino noted.

We enter the profession of medicine not when we get the degree of medicinethats only a certificate of exposure to an education, he said. We enter the profession when we take an oath, and we say, I declare to everyone here that I am committed to the ideals of medicine.

Before embarking on their medical education, aspiring physicians should ask themselves some diagnostic questions, Dr. Pellegrino advised.

For the young person contemplating medicine today, they should step back and ask themselves what kind of life they want to lead in a general way, he said. More important than that, ask themselves: do they want to do something which is more challenging than they can ever meet fully in their whole livessomething which will lead them to a body of information which is bigger than they can encompass, which will bring them into duties and obligations which are larger than most people in this world face?

This includes needing to understand that as a physician you can do much good, but also enormous harm, he added.

If they can say yes to those things, they want to think about medicine.

This Ethics Talk videocast is CME activity designated for 0.25 AMA PRA Category 1 Credit. Check outprevious episodesof the Ethics Talk podcast or subscribe to the series iniTunesor other services.

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What kind of person should the physician be? - American Medical Association

October 5 2020 - Allan R Tunkel, Senior Associate Dean for Medical Education and Chief of Medical Education at the Brown University Alpert Medical School, will be presenting, The Impact of COVID-19 on Medical Education on Thursday, October 8, 6-7:30 p.m.nPresented by the Palm Beach County Medical Society (PBCMS) as part of the annual Future of Medicine Summit, the event is free to participants, who may register at:

Started in 2007 by Jose Arrascue, MD, the Future of Medicine Initiative brings together community leaders to define issues, establish partnerships and implement strategies for change. At the annual Summit, national and community health care leaders gather to explore the "hot topic" issues facing healthcare.

He received a Ph.D in experimental pathology before earning a medical degree at the College of Medicine and Dentistry of New Jersey in Newark. He completed a Residency in internal medicine at the Hospital of the Medical College of Pennsylvania in Philadelphia and an Fellowship in infectious diseases from the University of Virginia Health Sciences Center in Charlottesville. He has been at Brown since 2013 and previously taught at the Drexel University College of Medicine for a decade.

For more information and the Future of Medicine, Contact Katherine Zuber at KatherineZ@pbcms.org or 561-433-3940.

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Brown University Medical School Dean to Lead Second Session of Five-Part Virtual Future of Medicine Summit : SF STAT! - South Florida Hospital News

Newswise PHILADELPHIAThe international hunt to find more genetic risk markers for testicular cancer is expanding. A team of researchers led by Katherine L. Nathanson, MD, deputy director of the Abramson Cancer Center and the Pearl Basser Professor for BRCA-Related Research in the Perelman School of Medicine at the University of Pennsylvania, was recently awarded $5.4 million over five years from the National Institutes of Health to continue the long-standing genomics work of the TEsticular CAncer Consortium (TECAC).

A total of nearly $7 million has been awarded to TECAC, which includes researchers from 27 institutions around the world, whose collaborative goal is understand the genetic susceptibility to testicular germ cell tumors (TGCT).

TGCT are the most common cancer in the United States and Europe in men between the ages of 15 to 45, and the number of cases has continued to rise over the past 40 years. Approximately 50 percent of the risk of disease is due to genetic factors, higher than for other cancer types.

To date, TECAC has identified 22 novel susceptibility alleles, bringing the total number of risk markers to 66. Nathanson led a study in 2017 published in Nature Genetics that identified eight of those markers in previously unknown gene regions, as well as four in previously identified regions.

Members of TECAC also were the first to identify CHEK2, a moderate penetrance gene for TGCT. Penetrance refers to the proportion of people with a mutation in specific gene. Unlike other solid tumor types (e.g. breast, ovarian), the inherited risk of TGCT is likely due to multiple variants rather than any single gene.

Our work has revealed critical roles for genetic variants and mutations in testicular germ cell tumors and defined the biology of TGCTs as associated with defects in maturation of male germ cells, but theres still much more to discover with this highly heritable disease, Nathanson said. This grant will allow us to continue to pool our resources and expertise to better understand its biology and etiology, as well as provide data that can help identify men at higher risk of the disease and in need of surveillance.

The latest round of funding will focus on three projects: identify rare and common variants using whole exome genetic sequencing from biosamples of more than 2,000 men; conduct a transcriptome-wide association study, or TWAS, to identify novel candidate susceptibility genes in nearly 250,000 men (the largest to date); and further evaluate any variants or gene discovered from those two projects using tools, such as CRISPR, in cells.

Other Penn collaborators on this grant (R01 CA164947 A1) include David Vaughn, Linda Jacobs, Li-San Wang and Mingyao Li.

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Penn Medicineis one of the worlds leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of theRaymond and Ruth Perelman School of Medicine at the University of Pennsylvania(founded in 1765 as the nations first medical school) and theUniversity of Pennsylvania Health System, which together form a $8.6 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according toU.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $494 million awarded in the 2019 fiscal year.

The University of Pennsylvania Health Systems patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Centerwhich are recognized as one of the nations top Honor Roll hospitals byU.S. News & World ReportChester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nations first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 43,900 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2019, Penn Medicine provided more than $583 million to benefit our community.

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Penn Medicine Researchers Receive $5.4 million Grant to Find Genetic Drivers of Testicular Cancer - Newswise

As physicians, we are well-conditioned to deliver difficult truths to our patients whenever the situation demands it. We are not as comfortable accepting such truths about ourselves, even when we know that physicians can suffer from the same physical and emotional ailments that affect our patientsincluding depression and suicide.

The third annual observance of National Physician Suicide Awareness Day on Sept. 17 offers an opportunity to shine a light on this troubling issue, strip away the stigma that surrounds it, and encourage physicians and other health care professionals who are struggling with burnout and depression to seek the help they need.

The facts are devastating. U.S. physicians have one of the highest rates of suicide of any profession. Multiple factors fuel this tragic situation. The modern working environment for physicians and other health professionals can best be described as high-stakes dysfunction. Physicians are under increasing demands and scrutiny to deliver quality care amid ever-changing rules and administrative hassles that interfere with their primary mission.

Starting in medical school, or even earlier at the undergraduate level, an emphasis on physical stamina and mental toughness leads to a normalization of high levels of stress, sleep deprivation, excessively long workdays and a lack of free time to spend with family or friends.

Many physicians face anxiety that stems from crushing levels of student debt, the hassles posed by a poorly designed digital workplace, administrative burdens and red tape, and a host of other stress-inducing factors, plus the added strain that comes with raising children and other responsibilities in the home.

All of this and more leads to higher levels of stress, burnout and depression within our physician ranks. Such feelings of stress and anxiety may never factor into a persons decision for self-harm. But it is also true that our profession is becoming more complex, more burdensome and more challenging by the day.

The COVID-19 pandemic has exacerbated this situation and brought physician wellness to a crisis point through increased social isolation, reduced access to community support and fewer opportunities to seek counseling or other mental health resources, among other factors.

Our AMA is well aware of the physical and mental demands that modern medicine places on medical students, residents, practicing physicians and their colleagues. We continue to speak out against the long-held stigma placed against those who might otherwise choose to seek care for behavioral health issues, partly because they fear doing so might jeopardize their medical licenses and careers.

Long-standing AMA policy encourages state licensing boards and other credentialing bodies to ensure confidentiality when physicians seek out counseling or other services to address their feelings of burnout, career fatigue, stress or depression. A physicians mental health should only factor into licensing and credentialing when it currently adversely affects his or her ability to practice medicine in a competent, ethical and professional manner.

Earlier this year, the Medical Society of Virginia played a key role in securing a new state law creating the SafeHaven program, which provides confidential behavioral health resources and ongoing wellness support to physicians in a manner that does not place their medical license at risk, except in extraordinary circumstances.

Texas, Idaho and other states provide confidentiality protections for physicians undergoing the care of a mental health professional; these protections should be available to physicians in every state. The AMA has also drafted model legislation to raise awareness of this critical issue and to influence policymakers.

Additional resources designed to reduce stress and foster well-being can be found in our AMA STEPS Forward practice-improvement strategies and elsewhere on the AMA Ed Hub. For example, one of the evidence-based online modules focuses on assessing risk factors and warning signs for suicidal ideation, while another helps identify at-risk physicians with an emphasis on prevention strategies and facilitating access to care.

Finally, I urge physicians to join the movement to change the way we talk about suicide. A great deal of stigma and a sense of shame surrounds the phrase to commit suicide. The verb commit frequently has a negative connotation, and is often used when discussing crimes or sins. It needlessly distinguishes a self-inflicted death from all other types of death, conveys guilt and culpability, and depicts the person who died as an offender rather than a victim of a mental health condition. Saying that someone died by suicide helps dispel the sense of shame that still surrounds it.

If we are to end the devastation wrought by physician suicide, a single day that calls attention to this crisis is merely a starting point. We must be vigilant for signs of burnout and depression within ourselves and among our colleagues, and we must not hesitate to seek help when we recognize something is amiss. Physicians have resilience and self-reliance in abundance, but when we rely on those traits above all others, we put our own well-being and that of our patients and colleagues at risk.

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Now's the time to have a difficult talk about physician suicide - American Medical Association

With a lack of certainty surrounding the future, being and feeling healthy may help bring the security that you need during these unpredictable times.

When it comes to your health, there is a direct relationship between nutrition and physical activity that play an enormous part in physical, mental, and social well-being. As COVID-19 continues to impact almost every aspect of our lives, the uncertainty of the future may seem looming. Sometimes improvisation is necessary, and understanding how to stay healthy and fit can significantly help you manage your well-being during these times.

Gyms, group fitness studios, trainers, and professionals can help you to lay out a plan that will either keep you on track through all of the changes and restrictions or help you to get back on the ball so that all of your health objectives are met.

Most facilities and providers are setting plans to provide for their clients and customers to accommodate the unpredictable future. The key to remaining consistent is to have solid plans in place. This means setting a plan A, plan B, and perhaps even a plan C. An enormous amount is on the table for this coming fall and winter; if your gym closes again, what is your plan? If outdoor exercising is not an option due to the weather, what is your plan? Leaving things to chance will significantly increase your chances of falling off of your regimen and will make consistency a big problem.

The key to remaining consistent is to have solid plans in place. This means setting a plan A, plan B, and perhaps even a plan C.

The rise of stress and anxiety as a result of the uncertainty around COVID-19 has affected everyone in some way. Staying active by exercising helps alleviate stress by releasing chemicals like serotonin and endorphins in your brain. In turn, these released chemicals can help improve your mood and even reduce risk of depression and cognitive decline. Additionally, physical activity can help boost your immune system and provide long term health benefits.

With the new work-from-home norm, it can be easy to bypass how much time you are spending sedentary. Be aware of your sitting time and balance it with activity. Struggling to find ways to stay active? Start simple with activities like going for a walk outside, doing a few reps in exchange for extra Netflix time, or even setting an alarm to move during your workday.

If you, like many others during the pandemic shift, have taken some time off of your normal fitness routine, don't push yourself to dive in head first, as this may lead to burnout, injury, and soreness. Plan to start at 50 percent of the volume and intensity of prior workouts when you return to the gym. Inactivity eats away at muscle mass, so rather than focusing on cardio, head to the weights or resistance bands and work on rebuilding your strength.

Be aware of your sitting time and balance it with activity.

In a study published earlier this year, researchers found drug-resistant bacteria, the flu virus, and other pathogens on about 25 percent of the surfaces they tested in multiple athletic training facilities. Even with heightened gym cleaning procedures in place for many facilities, if you are returning to the gym, ensuring that you disinfect any surfaces before and after using them is key.

When spraying disinfectant, wait a few minutes to kill the germs before wiping down the equipment. Also, don't forget to wash your hands frequently. In an enclosed space where many people are breathing heavier than usual, this can allow for a possible increase in virus droplets, so make sure to wear a mask and practice social distancing. Staying in the know and preparing for new gym policies will make it easy to return to these types of facilities as protocols and mutual respect can be agreed upon.

From work to working out, many routines have faltered during the COVID pandemic. If getting back into the routine seems daunting, investing in a new exercise machine, trainer, or small gadget can help to motivate you. Whether it's a larger investment such as a Peloton, a smaller device such as a Fitbit, or simply a great trainer, something new and fresh is always a great stimulus and motivator.

Make sure that when you do wake up well-rested, you are getting out of your pajamas and starting your day with a morning routine.

Just because you are working from home with a computer available 24/7 doesn't mean you have to sacrifice your entire day to work. Setting work hours, just as you would in the office, can help you to stay focused and productive.

A good night's sleep is also integral to obtaining and maintaining a healthy and effective routine. Adults need seven or more hours of sleep per night for their best health and wellbeing, so prioritizing your sleep schedule can drastically improve your day and is an important factor to staying healthy. Make sure that when you do wake up well-rested, you are getting out of your pajamas and starting your day with a morning routine. This can help the rest of your day feel normal while the uncertainty of working from home continues.

In addition to having a well-rounded daily routine, eating at scheduled times throughout the day can help decrease poor food choices and unhealthy cravings. Understanding the nutrients that your body needs to stay healthy can help you stay more alert, but they do vary from person to person. If you are unsure of your suggested nutritional intake, check out a nutrition calculator.

If you are someone that prefers smaller meals and more snacks throughout the day, make sure you have plenty of healthy options, like fruits, vegetables and lean proteins available (an apple a day keeps the hospital away). While you may spend most of your time from home, meal prepping and planning can make your day flow easier without having to take a break to make an entire meal in the middle of your work day. Most importantly, stay hydrated by drinking plenty of water.

While focusing on daily habits and routines to improve your physical health is important, it is also a great time to turn inward and check in with yourself. Perhaps your anxiety has increased and it's impacting your work or day-to-day life. Determining the cause and taking proactive steps toward mitigating these occurrences are important.

For example, with the increase in handwashing, this can also be a great time to practice mini meditation sessions by focusing on taking deep breaths. This can reduce anxiety and even lower your blood pressure. Keeping a journal and writing out your daily thoughts or worries can also help manage stress during unpredictable times, too.

While the future of COVI9-19 and our lives may be unpredictable, you can manage your personal uncertainties by focusing on improving the lifestyle factors you can controlfrom staying active to having a routine and focusing on your mental healthto make sure that you emerge from this pandemic as your same old self or maybe even better.

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5 Most Desirable Medical Specialities Around the Globe - SWAAY

The Foster School of Medicine class of 2024 will receive their firstwhitecoats as part of the time-honoredWhiteCoatCeremony on Saturday.

Due to the COVID-19 pandemic, this will be the first year that the schools future doctors will not have their coats placed on them by deans of the medical school. Instead, each of the 116 students in the class of 2024 will approach the podium and give a short message of gratitude to those who have helped them reach this milestone.

Gordon Woods, M.D., associate professor of Internal Medicine and college mentor, will give the keynote address.

At this years ceremony, the Foster School of Medicine continues its own tradition with its twelfth class. The Class of 2024 will be welcomed by faculty and staff, the El Paso community and fellow Texas Tech University Health Sciences Center El Paso students.

TheWhiteCoatCeremonyis a traditional rite of passage for entering medical students. Started in 1993 by Arnold P. Gold and his foundation, theceremonyis designed to remind students of the humanism inherent in their chosen field.

Since its inception at the Columbia University College ofPhysicians and Surgeons, thewhitecoattradition has expanded to97% of medical schools throughout the U.S. and Canada.

The Foster School of Medicine, marking its 10th anniversary in 2019, held its firstWhiteCoatCeremonyin 2009 to welcome an inaugural class of four-year medical students.

What:Foster School of MedicineWhiteCoatCeremony

When:9 a.m. Saturday, Sept. 26

Where:Medical Sciences Building (MSB) II, TTUHSC El Paso campus,5001 El Paso Drive

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Foster School of Medicine to welcome Class of 2024 with White Coat Ceremony - El Paso Herald-Post

You dont deserve abuse because youre a medical student.

You dont have to tough it out because youre a medical student.

You dont have to sit in silence and painfully nod along with an attendings racist, misogynistic lectures because youre their medical student. You dont need to pick the skin off your cuticles to stop yourself from replying. You dont need to learn how to hide your grimaces behind your mask because you know youll have to listen to them attack your identity for the next several weeks.

My first interaction with my new attending immediately set off alarm bells in my head: when I introduced myself, he commented on what a difficult name I had and asked twice if he could call me Abby. Throughout the day, he would go on to flippantly joke about mental illness, insist COVID-19 was a liberal political ploy, scoff openly at the message of the Black Lives Matter movement and call every female in the office (including patients as well as myself) inappropriate pet names like baby girl and little lady.

As he casually spouted countless racist or sexist views, I held my tongue and hid my discomfort. He was a white male attending in a suburban clinic and worked exclusively with other white male attendings; it didnt appear he had ever been challenged about his views or his behavior. As a woman of color and a student, I certainly wasnt going to speak up myself. This rotation was 1:1 with the attending and without other medical students, interns or residents to validate my concern, I convinced myself I would just have to make it through the next two months.

From just one day in the clinic, I had compiled a list of 13 bullet points that outlined the most flagrantly inappropriate comments and actions from my attending. But I still didnt trust my experience was I overreacting? Was I being too sensitive? Was I going to ruin this attendings life by voicing my concerns? As just a med student, did I even deserve the right to feel uncomfortable?

When I tentatively mentioned to colleagues and mentors the litany of offensive, problematic statements my attending physician had said during the first two days of my rotation, a common response was, welcome to medicine. That struck a nerve. I didnt want to accept that statement as fact, I didnt want to accept this environment as inevitable, and I didnt feel that we, as the next generation of physicians, should have to. More than my own discomfort, it was the frustrating complacency of that welcome to medicine statement that finally convinced me to reach out to my school about the attending.

I wasnt alone in my hesitancy to bring my concerns to my administration. The 2019 graduation questionnaire by the American Association of Medical Colleges (AAMC) noted that though 40.1% of graduating medical students experienced mistreatment during their time in medical school, only 23.2% of those students reported their experience. Students cited fear of retaliation, doubt that an event was important enough to report and the belief that nothing would be done about the situation as reasons for not reporting.

These were all thoughts that ran through my head; at the bottom of the hierarchy of medical education, we dont trust ourselves enough to believe that what feels wrong might actually be wrong. Most insidiously, a 2018 study found that one of the leading reasons medical students dont report mistreatment during their clinical years is the perception that mistreatment is a normal part of medical education, a rite of passage if you will Welcome to medicine.

When I came forward, I realized I was lucky because I had the most supportive medical school administration I could have hoped for. When I tentatively asked, Is this really that bad? they replied with a resounding YES! making it clear that they were on my side. They took me seriously and removed me from that rotation the minute they heard my concerns. I felt like my safety was their highest priority and Im grateful for that.

While my medical school acted swiftly in my defense, I later learned that other medical professionals were less supportive. After I left my rotation, I heard from students working in the same office that the other attending physicians were whispering about that poor medical student who did the right thing by leaving the clinic. Those physicians discussed amongst themselves how that attending had been becoming increasingly problematic, how his conspiracy theories were getting increasingly incredulous and he was becoming increasingly irreverent towards patients and students. They had known before my name had ever even shown up in the office inbox that this attending was a questionable teacher and provider, but never brought their concerns to the attending himself or the schools who subjected their students to him.

I struggled with pangs of betrayal and loneliness: these physicians had nodded to me in public and had gossiped about that poor medical student in private. While I was fielding microaggressions one-on-one across a desk, berating myself to get a grip, fighting against my own instincts, they had known all along that I was going to struggle and left me to flounder anyways. Those white male physicians, who held the most power in that clinic and would face few consequences by speaking up about a sexist and racist colleague, did nothing.

It genuinely baffled me that they could have these discussions about how inappropriate this attending was and still smile at me walking beside him every morning. I cant help but wonder- perhaps they were so complacent because they didnt see this as an anomaly in medicine. Perhaps they thought it was something students needed to get used to. Perhaps they too thought, Welcome to medicine.

I didnt learn much medicine the first week of my rotation, but I learned something else: I dont want to subscribe to the culture of medicine that makes students believe they have to tough it out. Medicine isnt an old boys club anymore. If we cant expect attendings to speak up on our behalf, then we will have to advocate for ourselves. I dont mean to say that there arent thoughtful, supportive attendings that continue to fight for us there are, and Ive had the privilege of working with many of them.

This experience has shown me, however disappointing the thought may be, that I cant necessarily count on that. But the old guard is not the future of medicine we are. Even as medical students, when we see things that we believe are wrong whether that is sexist and racist comments from attendings, overly harsh treatment of trainees or impolite comments about patients we have both the opportunity and the responsibility to act on them by bringing them up to the administration that oversees medical education. And when we eventually find ourselves in those positions of power as senior residents, attendings or medical school faculty, we must remember what it felt like to be at the bottom of the hierarchy and speak up for those below us. We can work towards a better system than, Welcome to medicine.

Image Credit: Best Shoes for Nurses(CC BY 2.0)bygm.esthermax

Contributing Writer

Saint Louis University School of Medicine

Apshara Ravichandran is a third-year medical student at Saint Louis University School of Medicine in St. Louis, MO. In 2018, she graduated from Williams College with a Bachelor of Arts in anthropology and chemistry. She enjoys reading, running, and going to the local dog park in her free time. After graduating medical school, Apshara would like to pursue a career in a pediatric specialty or child psychiatry.

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"Welcome to Medicine" in-Training, the online peer-reviewed publication for medical students - Pager Publications, Inc.

Oakland University William Beaumont School of Medicines Anesthesiology Interest Group was recently named the American Society of Anesthesiologists Outstanding Anesthesia Interest Group for 2019-20.

It was the fourth consecutive year that OUWB students in the Anesthesiology Interest Group (AIG) were awarded a top honor from the American Society of Anesthesiologists (ASA). (The announcement came just a couple of weeks after OUWBs Pediatric Interest Group was named Pediatric Interest Group of the Year by the American Academy of Pediatrics.)

According to the society, awards are presented annually to those AIGs that show an exceptional level of participation, enthusiasm, program quality, professionalism, and involvement in their university, community, and at (ASAs) annual meeting.

The OUWB AIG currently at about 240 members edged out similar organizations from medical schools across the U.S., including last years winner from University of California San Francisco. (OUWB was named ASAs Most Innovative AIG in 2019.)

Through this award, the American Society of Anesthesiologists recognizes OUWB as an outstanding school for what we do in our group and the opportunities that we provide for students, said Alan Nguyen, the OUWB student who served as president for 2019-20. This lets program directors and other students know that (OUWB) is a contender.

The fact that weve won an award four years in a row is really saying something about our students and the dedication that they put into events, he added.

OUWBs AIG, launched in 2013, is designed to increase awareness of the spectrum of clinical practice in anesthesiology as well as encourage medical students to explore career opportunities within the field of anesthesiology.

The group aims to go beyond whats available through the OUWB curricular experience by providing opportunities for mentorship, education, and hands-on experience with anesthesiology faculty and residents.

Anesthesiology is one of those specialties where you might not get that much exposure in your first and second years (of medical school), said Paul Patel, current president of OUWBs AIG. The role we play in offering those anesthesiology-related connections and activities is crucial in providing early exposure to a field they otherwise might not get until their fourth year.

Patel said the group aims to hold an event once a month. Among other events held by OUWBs AIG in the last year were:

We put a lot of effort into making events that participating students, residents, and doctors will enjoy, said Nguyen. To get the Outstanding AIG Award offers proof positive that our hard work really does pay off.

Prior to last year, ASA annually awarded three schools an Outstanding AIG Award.

In 2018, OUWB shared the honor with the University of Miami Miller School of Medicine and the University of Oakland College of Medicine.

In 2017, OUWBs AIG was named outstanding alongside the University of Oklahoma College of Medicine and Vanderbilt University College of Medicine.

Nguyen said ASA changed the program starting in 2019. Changes included having only one school named Outstanding along with categories for Best New AIG and Most Innovative AIG.

Stacie Griebahn, president, ASA Medical Student Component, ASA, congratulated OUWBs AIG on being one of the top AIGs in an email announcement.

Your AIG deserves recognition as a model AIG that exemplifies the mission of the ASA Medical Student Component to encourage medical student participation in anesthesiology, provide resources for medical students pursuing careers in anesthesiology and providing leadership, research and education in the field of anesthesiology within your school, she said.

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

Follow OUWB onFacebook,Twitter, andInstagram.

NOTICE: Except where otherwise noted, all articles are published under aCreative Commons Attribution 3.0 license. You are free to copy, distribute, adapt, transmit, or make commercial use of this work as long as you attribute Oakland University William Beaumont School of Medicine as the original creator and include a link to this article.

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OUWB Anesthesiology Interest Group wins top honor in US - News at OU

Although the problem is slowly being addressed, McKinley-Grant says it is crucial that health care providers are trained in recognizing diseasesand subtle changesin all skin types.

Almost every mother, regardless of the ethnicity or age of her child, can tell when they are pale and not feeling well, she says. The underlying hues of the skin are not only the result of the presence of melanin, but also reflect red blood cell counts and oxygen levelsmeasures that are vital signs for all humans. We need to train our health care providers to recognize changes in hue in all skin types, including the skin of Black and brown people.

When we invite people for lectures or to contribute to a textbook or health care literature, she adds, we need to start making it almost mandatory that they show a diversity of ethnicity and skin color in the presentation, with images of disease in black and brown skin.

Rashes that may look red on a light-skinned patient tend to appear darker brown or purple on brown or black skin. Anemia appears as gray on dark skin rather than ghostly pale on light skin, while the darkening of skin associated with hyperpigmentation, itself a sign of Addisons disease and other conditions, may go unnoticed on dark skin. For inflammation, says McKinley-Grant, its important to ask the patient where the warmth and pain is and whether the area in question looks like their normal skin color.

Dermatologists also discern problems in people with darker skin tones by looking for patterns. Pattern recognition is a huge part of our training, says Freeman. We get 12,000 to 16,000 hours of supervised patient care. That allows us to learn to recognize patterns. So if you see a pattern but dont know how to interpret it, call a dermatologist.

That may be easier said than done these days. Since 1999, American Academy of Dermatology surveys have steadily shown that skin doctors themselves report there are not enough of them to go around, especially with the increasing demands on the profession as a result of population aging and rising rates of skin cancer and other cutaneous diseases.

Dermatology is one of the highest paying fields of medicine, and it has one of the lowest burnout rates. The ever-increasing market for cosmetic dermatologywhich is paid for out-of-pockethas put an even greater burden on residency programs.

At Harvard, 70 percent of our residents stay in medical or academic dermatology, says Freeman, but were probably the only school in the country with that statistic. Not everyone who wants to is able to match into the field, and these are really good students. Its common to take a year off from medical school and do a year of dermatological research just to get in.

Many schools are combining residencies in internal medicine and dermatology. Dermatologists look at a rash and then develop a differential diagnosis, then ultimately get a history, says Loscalzo. Internists do just the opposite, gathering a lot of history, looking at all aspects of the patients physical exam, and then trying to correlate whats going on with the skin to whats happening internally. Its a totally different heuristic, and a combined residency is a great way to learn both worlds.

To train AI at high levels of accuracy, you need an enormous collection of photos, and even the largest dermatology photo libraries dont have standardized diagnoses where a group of dermatologists agree.

Continuing medical education, workshops, and events like Mass Generals annual Dermatology Bootcamp, hosted by Kourosh, are helping to bridge the gap. Through programs like this, dermatologists at HMS are always more than ready to teach and give lectures to other providers and trainees in our hospital system and the community, Kourosh says.

In addition, the use of telehealth has helped extend expertise. Although its use increased 53 percent between 2016 and 2017, according to a 2019 article from the American Medical Association, its use has expanded again. Earlier this year, the AMA detailed extensive changes to telehealth, all allowed for in the Coronavirus Aid, Relief, and Economic Security Act of 2020. Among those changes: expanding the list of services that can be delivered remotely, ensuring payment of physician fees for those services, and updating the requirements for accessing remote care to permit physicians to conduct telehealth visits from their homesand patients to access them from theirs.

These changes have been especially useful for dermatology and are increasing access to health care in all specialties, particularly for underserved patients in rural areas and elsewhere, for members of the military, and, during this pandemic, for patients sheltering in place, says McKinley-Grant.

Apps and artificial intelligence also hold promise, though, according to Kourosh and others they have a long way to go. To train AI at high levels of accuracy, Kourosh says, you need an enormous collection of photos, and even the largest dermatology photo libraries dont have standardized diagnoses where a group of dermatologists agree. Add to that the dearth of patients of color represented in most collections. Multiple efforts are being made now to do this correctly and safely for patients, but it may take years, she adds.

Until then, internists, primary care doctors, and other specialists remain patients first line of defense. Its true that time is a bigger limitation than in the past, admits Loscalzo, but if youre not carefully considering skin symptoms, youre not being a thorough physician.

Elizabeth Gehrman is a Boston-based writer.

Images: Juti/Essentials Collection/Getty Images (top); John Soares (Freeman); Mark Finkenstein (McKinley-Grant)

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Attuned to the Signs of Trouble | Harvard Medicine magazine - Harvard Medical School

As flu season approaches some people are asking if it is possible to contract COVID-19 and the flu at the same time.

Unfortunately, yes, you can have both viruses, says Dr. Carl S. Goldstein, Clinical Professor of Medicine at Rutgers-Robert Wood Johnson Medical School.

These are different viruses and because they are structurally different, there is no cross-immunity, Goldstein says.

And if you have both? The risk of respiratory failure requiring a ventilator or cardiopulmonary death is much greater, he says.

The concern is that both of these diseases converge on respiratory failure, Goldstein explains. So COVID independently can lead to ventilator-dependent respiratory failure, as can influenza, and influenza notoriously can set the stage for a bacterial pneumonia occurring on top of influenza. So the risk is that if you are infected with both COVID and influenza, they will both exact harm independently and, likely, synergistically.

Goldstein says those who are already at risk for poor outcomes from COVID are exactly the same people who are at risk for poor outcomes when it comes to the flu.

"That population over 65, underlying cardiac or pulmonary disease, chronic kidney disease, diabetes, HIV, AIDS, cancer or cancer chemotherapy, organ transplant recipient that whole list of people who are at-risk people,' now become at really high risk people, he says, but adds that the the strategies which protect against COVID (masks, hand hygiene and physical distance) are "exactly the same strategies that protect against influenza, making these protective behaviors even more important.

How to tell whether you have COVID-19, the flu or both is a call best made by your physician, Goldstein says, adding that early intervention is critical for high-risk patients.

Clinically they both may present with fever, cough, muscle aches and pains. You cannot rely on symptoms to discriminate between these two diseases or between more common viral infections, he says. And if youre a person at risk and you develop respiratory symptoms any of them: fever, chills, cough, congestion shortness of breath, any of them if those symptoms are anything other than really ordinary, that probably deserves medical assessment because both influenza and COVID can get really ugly, fairly quickly.

And if its just the flu, an early diagnosis can often lead to effective therapy with Tamiflu or other antiviral agents, which, in some cases, could be lifesaving, Goldstein says.

Tell us your coronavirus stories, whether its a news tip, a topic you want us to cover, or a personal story you want to share.

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Jessica Remo may be reached at jremo@njadvancemedia.com.

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Can you have both COVID-19 and the flu at the same time? - NJ.com

By N.C. Education Lottery

Raleigh, N.C. On Saturday night, Kaila Moore of Durham had a dream that shed bought a scratch-off ticket. Acting on that dream led her to buy her first lottery ticket and a $100,000 win.

Ive never bought a lottery ticket ever in my entire life, said Moore. I literally had a dream that I bought a scratch-off. So, when I woke up I went and bought one.

She went to the Food Lion on West Main Street in Durham Sunday morning, paid $20 for the $4,000,000 Gold Rush game, then took her ticket home to scratch it.

Her reaction to realizing shed won? Excitement.

I was with my mom, said the East Carolina University student. She was more excited about it than me!

They both knew this money was going to go toward Moores education.

I plan to go to medical school and medical school is not cheap! she said. Im going to invest some of it in a mutual fund and the rest Im just going to save.

Moore claimed her prize Wednesday at lottery headquarters in Raleigh. After required federal and state tax withholdings she took home $70,756 but said she wouldnt celebrate until after her physics class and studying.

The $4,000,000 Gold Rush game launched in August with three top prizes of $4,000,000 and six $100,000. Two $4,000,000 and three $100,000 prizes remain.

Ticket sales from scratch-off games make it possible for the lottery to raise more than $725 million per year for education. For details on how $13.1 million raised by the lottery made a difference in Durham County in 2019, visit http://www.nclottery.com and click on the Impact section.

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Durham student with dreams of med school wins $100,000 in lottery game - WRAL.com

The ongoing pandemic is putting a spotlight on mental health as depression and anxiety continues to affect millions of Americans. But even before COVID-19, concern about the well-being of medical students was on the rise. About one in three medical students report symptoms of depression, and one in nine experiences suicidal ideation.

The University of New Mexico School of Medicine (UNM) recognized the need for some sort of intervention and developed a multilevel approach to help destigmatize mental illness among health care workers and raise awareness about support opportunities. UNM wanted to make it normal for medical students to talk about mental health and make it culturally acceptable to ask for help.

To make that happen, UNM had to start the conversation early. Before the schools formal white coat ceremony, the assistant dean for professional well-being would spend almost an hour talking about mental health with the family members of UNMs incoming students.

During that conversation, family members would receive a booklet about supporting their loved one during medical school. The booklet shares important things to know about medical schoolranging from the expected time commitment to the fact that it will likely be an emotional roller coasteras well as tips for communicating with medical students and suggestions for spouses, partners, or significant others. There is a page on random acts of kindness and support, and two pages breaking down the alphabet soup that is the language of medical training and medicine.

There also is a page titled When Students Should Seek Help. Included in the list of 14 scenarios are more obvious signs such as using alcohol or illicit drugs to self-medicate or having thoughts of self-harm, but also included are subtler signs such as when:

The success of UNMs work is spotlighted in an AMA STEPS Forward module, Normalizing Mental Health Care During Medical Student Training.

During orientation, medical students hear from upper-level students who have accessed the schools health and wellness resources about why they felt they needed help, whether they found the experience helpful and whether they faced any repercussions for seeking assistance.

First-year students have taken part in an annual wellness retreat that features a panel of three or four physicians who are in recovery from addiction. These panelists have been primary care physicians, cardiologists, residents, psychiatrists, anesthesiologists and infectious disease specialists, demonstrating that addiction can strike anyone. The first-year students hear firsthand about the signs and symptoms of substance-use disorder, as well as the recovery process.

In addition, the wellness dean would meet with small groups of students to discuss the adjustment to medical school and remind them of the resources available to all students.

Students also have had the opportunity to meet with the CEO and chief medical officer of the New Mexico Medical Board, as well as with program directors and the associate dean for graduate medical education to discuss concerns over reporting mental health history as well as ongoing issues they face related to mental health. These conversations led the director of graduate medical education to craft a list of frequently asked questions about mental illness and whether there are any subsequent repercussions handed down.

Overall, feedback for the schools wellness work has been positive, and in the past five years, the program has grown from three part-time positions to six part-time rolesfour faculty, one psychiatrist and one psychologistas well as a full-time program coordinator.

TheAMAs STEPS Forward open-access modules offerinnovative strategies that allow physicians and their staff to thrive in the new health care environment. STEPS Forward is part of theAMA Ed Hub,an online platform that brings together allthe high-quality CME, maintenance of certification,and educational contentyou needin one placewith activities relevant to you, automated credit tracking and reporting forsome states and specialty boards.

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How to help medical students keep tabs on their mental health - American Medical Association

Sy is the aspirational mentor that we all want to emulate, said Dr. David Linehan, chairman of the surgery department at the University of Rochester Medical Center, who also holds the title Seymour I. Schwartz professor of surgery. Dr. Linehan praised Dr. Schwartz for his towering intellect, spirit of collegiality, indefatigable work ethic, unending curiosity and enduring relevance.

Dr. Craig R. Smith, the chairman of the surgery department at NewYork-Presbyterian Hospital/Columbia University Medical Center, recalled Dr. Schwartzs insatiable intellectual curiosity and called him a polymath of the first order who was much, much more than just another academic surgeon.

Seymour Ira Schwartz was born on Jan. 22, 1928, in the Bronx, to parents from Jewish immigrant families. His father, Dr. Samuel Schwartz, was a physician who taught anatomy at Polyclinic Hospital in Manhattan and whose family was from what is now Belarus. His mother was Martha (Yampolsky) Schwartz, who managed her husbands medical practice and whose parents were from Poland.

A gifted actor in student productions at DeWitt Clinton High School, Sy was encouraged by his father to pursue a theatrical career, but decided to become a surgeon instead. Accepted by Yale but unable to afford the tuition, he enrolled at the University of Wisconsin on a scholarship and completed his pre-med degree in two years.

He began medical school at Syracuse University, earned his degree from New York University and, in 1950, completed his internship at the University of Rochester School of Medicine and Dentistry.

In the 1960s, while serving on the University of Rochesters admissions committee, he was appalled to learn that a highly qualified candidate was being rejected because he was Jewish. Dr. Schwartz inquired how he, a Jew from New York, had been admitted and was told that school officials had mistaken him for Sidney Schwartz, a young tennis star from Brooklyn.

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Dr. Seymour Schwartz, Who Wrote the Book on Surgery, Dies at 92 - The New York Times