University of Minnesota Medical School researcher leads investigation into new 2018 heart donor allocation system

Minneapolis, MN, Nov. 20, 2019 (GLOBE NEWSWIRE) -- In an analysis of the new heart organ allocation system for transplant patients in the U.S., researchers have identified a signal of a decrease in heart transplant survival rates. The study, An Early Investigation of Outcomes with the 2018 Donor Heart Allocation System in the United States, is published as a rapid communication in the Journal of Heart and Lung Transplantation.

For the first time in over a decade, modifications were made to the U.S. donor heart allocation system in October of 2018, aimed at better distinguishing the most medically urgent heart transplant candidates. The old system, in place since 2005, led to overcrowding of the list, prolonged waiting times and consequent inequity in allocation across geographic regions. The new system was envisioned to allow more equitable organ allocation while providing an overall benefit to patients awaiting heart transplantation.

This is an early trend, however, it is concerning, said lead author Rebecca Cogswell, MD, who is an assistant professor at the University of Minnesota Medical Schools Department of Medicine in the Division of Cardiology and medical director of mechanical circulatory support with M Health Fairview. Cogswell and colleagues at the U of M and several institutions across the U.S., including Brigham and Womens Hospital and Harvard Medical School, undertook an early look at outcomes as a result of the new allocation system.

This early look is similar to the kind of surveillance that occurs in large clinical trials to ensure safety, Cogswell explained.

The authors found that the changed allocation system has resulted in an increase of sicker patients being transplanted with greater frequency as intended, however, unintended consequences are emerging. Organs are being retrieved from longer distances, and fewer patients supported on durable left ventricular assist devices are receiving heart transplants in the U.S.

The increase in mortality appears to be driven by the fact that patients who are receiving hearts are sicker than in the previous system, Cogswell reported.

The researchers found the waitlist mortality has decreased in the new system. Cogswell explained, As waitlist mortality in the previous system was relatively low, the absolute impact of this reduction in waitlist mortality is small compared to the increase in death after transplantation that we are observing in this early examination of the new system.

If these early observations of a substantial decline in heart transplant survival persist, and we certainly hope that they do not, several programs will be under stress for their very survival, said Mandeep R. Mehra, MD, senior author of this study, who is executive director of the Center for Advanced Heart Disease at Brigham and Womens Hospital and a professor of Medicine at Harvard Medical School.

Cogswell stated that more data will be needed to confirm these trends and to inform policy changes.

As a community, we have a responsibility to look at this data at regular intervals to determine if we need to implement changes sooner rather than later, Cogswell emphasized.

About the University of Minnesota Medical School

The University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. Visit med.umn.edu to learn how the University of Minnesota is innovating all aspects of medicine.

Krystle BarbourUniversity of Minnesota Medical School6126262767kbarbour@umn.edu

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New Research Finds Signal of Decreased Early Post Transplant Survival in the New Heart Transplant System - Yahoo Finance

NEW ORLEANS (TEGNA) This mother-daughter doctor duo are making history by undergoing residency training together.

Cynthia and Jasmine Kudji are the first mother and daughter to attend medical school simultaneously and match with a residency program at the same hospital, according to Cynthia's medical school.

Jasmine attended medical school at Louisiana State University in her hometown of New Orleans, while Cynthia attended the University of Medicine and Health Sciences based on the island of St. Kitts. They both matched with LSU Health in New Orleans for their residencies.

Cynthia is originally from Ghana and came to the United States at age 2, according to UMHS. She took a non-traditional path to becoming a doctor that started when she became pregnant with Jasmine as a 23-year-old student. At that time, she had to put her dream of becoming a doctor on hold, she told UMHS.

Instead, Cynthia became a nurse and worked for nearly a decade until a life-changing trip to visit relatives in Ghana, she told UMHS.

During the trip, while caring for a stranger's sick baby without proper medical supplies, Cynthia felt inspired to help others by becoming a physician.

She decided to pursue a career in family medicine internationally at UMHS at the same time Jasmine was studying to be a surgeon at LSU.

"I think initially it was difficult because my mom and I have always been really close, so I had to get used to the distance. We had to learn how to FaceTime and Skype each other, so we were Skyping each other every day and whenever I had struggles and she had struggles, we just had to learn to communicate from a distance," Jasmine told UMHS.

But after completing their schooling, the two were thrilled to find they were both matched at LSU Health for their residencies.

"I'm so very, very blessed and grateful to have my daughter," Cynthia said told UMHS.

"I just think she's smart and beautiful and it's been such a tremendous blessing to have her when I was studying."

"I always tell people we laugh together, we study together, we cry together," Jasmine said.

"I think medical school is one of those experiences that you don't truly understand until you're in it. Sometimes people struggle to find someone who relates to their struggles, so for that person to be my mom was extremely helpful."

The two are both passionate about helping patients during the coronavirus pandemic, particularly communities of color which have been disproportionately impacted by the virus.

"I think this is going to be a pivotal time for our physicians to promote positive change in our health care system, and it will give us a chance to really express our concerns and I think this time around, it will be received better," Jasmine told UMHS.

You can follow the two at their blog, The M.D. Life, here.

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Mother and daughter doctors matched at the same hospital for residency - WTHR

At the beginning of his senior year, the last place Samad Qawi would have expected to be on an October night is basketball practice with the Badgers.

Qawi, a kinesiology major in the School of Education and pre-med student from Racine, Wisconsin, joins the team this year as a walk-on after standing out at an open tryout. He credits blood, sweat, and tears with making his basketball dream a reality, capping a UWMadison career where hes already achieved much academically and as a student leader.

He started playing basketball when he was eight at his local YMCA and instantly loved the game. He was a promising player on junior varsity as a freshman and sophomore at Horlick High School in Racine, and was excited about moving to varsity as a junior.

In his first game, he said, I blocked the other teams player from a layup, and when I landed, it felt like my knee had exploded and I passed out from the pain.

Qawi had torn ligaments and his meniscus in addition to chipping his knee cap. He was out for the year, which was devastating.

With determination, he was able to get back on the court for his senior year. He had grown taller hes now 6-foot-6 and had a good vertical jump. Unfortunately, he hurt his leg and his back in the second game of the season. A pinched sciatic nerve limited his playing time to 20 minutes per game.

Though the doctor and his trainer both recommended he not play the rest of the season, Oawi wasnt ready to give up. In the playoffs, he landed awkwardly after a jump and had to be carried off the court because of his leg. That ended his high school basketball career.

While that was disappointing, Qawi was still high achieving in the classroom.

As a high school freshman, he became involved in UWMadisons PEOPLE program, which helps promising under-represented and first-generation college students prepare for college and complete their degrees. He took a neurology class at UWMadison and it changed his life.

It was just like that, Qawi told the Racine Journal Times in 2016. I was always interested in nerves and the brain and that class made it even better. I learned even more about the body.

At UWMadison, he became an intern at the UW Health Clinical Simulation Program, which gives patient care simulation training to health sciences students and professionals.

He also recently became the president of the Wisconsin Association of Black Men, a student organization that promotes social justice.

He still dreamed of playing with the Badgers basketball team. After tearing his ACL during a recreational game freshman year, he started to train in a different way.

Sophomore year I dedicated my exercise purely to weight lifting because I just didnt want to be injured anymore, Qawi said.

He was able to ease back onto the court junior year and at the start of senior year, which is when the news of the open tryout came.

Ive been training for the last two years so I knew I was physically able to do it. With blood, sweat, tears, and a lot of hard work, I was able to will myself on to this team, he said.

The transition has been made easier because everyone on the team and coaching staff has been very welcoming, he said, adding that he is grateful to be part of a family like this.

After graduation, Qawi is interested in continuing to play basketball, possibly overseas or in the NBA G League, before going to medical school. Ultimately, he wants to specialize in sports medicine.

The goal is to be able to spread knowledge about injuries to younger athletes because in middle school and high school we dont know how to take care of our bodies as we grow, he said.

He also wants to start a community center in Racine that gives young athletes an opportunity to train when they wouldnt otherwise be able to afford it.

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Hard work makes Wisconsin basketball dreams come true for Qawi - University of Wisconsin-Madison

The upcoming $113 million Dell Childrens Specialty Pavilion will open spring 2021 with cardiovascular, neuroscience and cancer programs, according to the pediatric hospital. (Rendering courtesy Dell Childrens Specialty Pavilion)

The Dell Childrens Medical Center campus in Mueller is set to break ground on an expansion plan following the announcement of significant investment over the next three years.

The pediatric hospital Feb. 10 announced a $300 million investment in capital, equipment and programming over the next three years, made possible due to a substantial investment by Ascension, as well as a $30 million matching grant from the Michael & Susan Dell Foundation, according to a company news release.

The time is now to continue expanding complex pediatric care in Central Texas, said Christopher Born, the president of Dell Childrens Medical Center, in the Feb. 10 news release.

Dell Children will use $113 million of the investment funds to construct its new pediatric outpatient facility, which will house cardiovascular, neuroscience and cancer programs, as previously reported by Community Impact Newspaper.

The four-story, 161,000-square-foot facility, named Dell Childrens Specialty Pavilion, is slated to break ground soon and open its doors to patients in spring 2021.

Investment dollars will also go to provide backing for a new partnership with Dell Medical School at The University of Texas to develop a maternal fetal medicine program that will add a delivery unit and neonatal intensive care unit expansion at Dell Childrens Medical Center, according to the news release.

Dell Childrens Medical Center announced it will additionally add more cardiac ICU beds at its main hospital, allowing for the expansion of its pediatric heart program to include heart transplant surgery.

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Dell Children's Medical Center to spend more than $300 million over next 3 years to expand Mueller campus - Community Impact Newspaper

The survey by BMJexamined how political and current events have impacted the moods and stress levels of young doctors over time. The survey looked at nine political events and eight non-political events between 2016 and 2018 and questioned 2,345 participants on their mood from their time as medical interns to their time as residents.

The survey found statistically significant mood declines of at least 25 percent after the 2016 presidential election and subsequent inauguration, with women experiencing more than twice the mood decline as men following both events. Developments of a conservative political nature, such as the Muslim travel ban and the confirmation of Justice Brett Kavanaugh to the Supreme Court, also correlated with a decline in mood. By contrast, events of a more liberal political nature prompted a positive mood shift. The margin of error for the poll was plus or minus five percent.

The directionality of these findings is consistent with evidence that young voters and voters with postgraduate education tend to identify as liberal leaning, and supports previous work showing a strong left shift in political affiliation among physicians over the past 25 years, the report stated.

Politics in Medical School

The findings raise a key question of whether more left-leaning individuals are pursuing the medical profession or if medical schools are making students identify more as progressive. The answer is both, say two physicians and a medical student.

I think young doctors are getting a heavy dose of indoctrination in medical schools, partly from the student section of American Medical Association, said Jane Orient, M.D., executive director of the Association for American Physicians and Surgeons and policy advisor to The Heartland Institute, which publishesHealth Care News.In fact, social justice is now insinuated in bioethics and protocols concerning resource stewardship and the like.

Orient says she doesnt recall politics being a part of her medical school education at Columbia University in the 1970s. Now, students at medical schools increasingly engage in political activism from a decidedly leftist perspective, Orient says.

Indoctrination and immersion and peer pressure work, Orient said. Conservatives fear career damage.

Origins in Undergraduate Programs

Anthony Fappiano, a third-year medical student at the University of New England College of Osteopathic Medicine and an out-of-the-closet conservative, traces the lefts influence back even further than medical school.

In my opinion, this is due to four years of college education with predominantly liberal professors, Fappiano said. Additionally, the MCAT (medical school entrance exam) is putting more emphasis on traditionally liberal dominated topicsespecially sociologyrather than pure science.

The spike in liberal-leaning students and faculty suggests that science and medicine are no longer immune to politics, a trend Orient says should alarm patients.

The system comes first, and somebody elses idea of justice, instead of the patient, Orient said. It also means less time is available for learning medicine.

Viewpoints Change with Age

There may be reason for hope, says Chad Savage, M.D., founder of YourChoice Direct Care and policy advisor to The Heartland Institute.

While the study shows that young physicians tend to be liberal, the findings could simply reflect the students age and the fact that progressive politics tend to be more popular with young people, Savage said.

Fappiano says he agrees.

I have found that the working doctors I do my rotations with are more level-headed and at most, will gripe about their political ideology but never act on it, Fappiano said. The students are much more active in pushing political goals whether it's through clubs, bringing in speakers, or changing course teaching.

In the end, it may take the free market to truly break the liberal bias that has taken root in academia, Fappiano says. The first step is to lift the licensing restrictions currently in place, says Fappiano.

The entire health care industry is controlled by the two licensing agencies, the National Board of Medical Examiners and the National Board of Osteopathic Medical Examiners, as well as the AMA, Fappiano said. If schools were able to create their own curriculum and prerequisites it would allow the emphasis to be put back on medicine, rather than political goals. This would require large institutional changes and deregulation of the field of medicine.

Madeline Peltzer(mpeltzer@hillsdale.edu)writes from Hillsdale, Michigan.

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Presidential Politics Taking Toll on Young Doctors, Study Finds - The Heartland Institute

A University of Minnesota medical student says the college wrongfully suspended him based on allegations of sexual misconduct last year.

In a lawsuit filed this week, Mehdijaffer Mulla says administrators from the medical school informed him in November that theyd received a complaint about him. The school immediately suspended him, without telling him the nature of the allegations or the individuals accusing him, then e-mailed the student body soliciting other allegations, which served to pre-emptively convict Mr. Mulla in the court of public opinion, according to the lawsuit.

Mr. Mulla was improperly suspended from the University of Minnesota and has been deprived of higher education and his contractual rights without due process or equal protection of the law, according to the civil complaint. Mr. Mulla was greatly damaged by being falsely cast as a stalker, a very public stigma he will never be able to escape.

Mulla is still under suspension and his request to address the allegations in a hearing at the college has been denied, the lawsuit states.

University spokesman Jake Ricker said the school has not yet been served with the lawsuit. As always, the university will review the details of the complaint and address the facts and governing law as appropriate, he said.

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University of Minnesota medical student sues school for suspension over sexual misconduct allegations - Minneapolis Star Tribune

This doctor has one of the most important jobs in Super Bowl LIV, but hes not part of the teams medical staff.

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

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

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

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

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

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

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

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

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

Because he had entered the incorrect date on his calendar, Duvernay-Tardif, whose first language is French, missed the deadline to get into French-speaking medical schools in Quebec. At McGill, one of three English-language universities in Quebec, he didnt initially join the football team until later during his freshman season, as he worked on his English to keep up in class.

Meanwhile, Duvernay-Tardif wasnt playing for a typical powerhouse program that produces NFL players. Previously, just one other player had been selected in the NFL draft from McGill defensive tackle Randy Chevrier, who was drafted in the seventh round by the Jacksonville Jaguars in 2001.

As Chiefs general manager Brett Veach once alluded on February 7, 2019, When Tardif came out, he had some tape from McGill that wasnt Alabama or Auburn. It was Canadian tape and looked like Division II or III football.

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

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

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

But thats the way hes gone about it. Hes worked his tail off. Hes strong. Hes smart. He loves to play the game.

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

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

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

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

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

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

I dont get any feeling that hes ready to become a doctor right now and go that direction, Reid said. I look for more years with him and continued growth.

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

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

Well find a way, he continued, but I think this year I wanted to focus more on football.

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

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

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

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

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

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

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

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

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

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

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

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

Imbalance in the motor fleet

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

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

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

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

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

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

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

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Revving the Engine - Harvard Medical School

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New approach points to untapped immune cells, early immunization

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Washington University School of Medicines 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Childrens hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Childrens hospitals, the School of Medicine is linked to BJC HealthCare.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

The legal mechanisms

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Theyre all talking about it

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

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

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

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

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

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

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

Our ruling

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

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

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

We rate this statement True.

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

November 25, 2019 | :

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Female medical students have hit a milestone.

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

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

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

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

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

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

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

RELATED: Salary negotiationsAdvice for female physicians who want equitable pay

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Link:
Geisinger medical school will provide free tuitionwith a catch - FierceHealthcare

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

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

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

- JM

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Medical School Admissions - Accepted.com

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

+330% Above State Median Income

+397% Above National Median Income

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

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

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

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Best Medical Schools in New York | Top Med Program

Friday, August 10, 2018

10:00 a.m.

Temple Performing Arts Center

Broad and Polett Walk

PARKING

Liacouras Center Parking Garage

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

About the White Coat Ceremony

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

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

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

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

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

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LKSOM White Coat Ceremony | Calendar of Events

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

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

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

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

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

Training with the best

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

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

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

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

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

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

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

Can you wiggle your fingers and toes? Farino asks.

Again, no answer.

A crucial realization

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

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

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

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

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

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

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

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

We cant save everyone

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

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

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

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

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

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

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

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

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