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Category Archives: Medical School

Earned bachelor’s abroad? Key facts on U.S. med school admissions – American Medical Association

According to the Association of American Medical College (AAMC), 49 medical schools last year indicated that they accepted international applicants. In 2017, AAMC application data shows that about 15% of applicants who attended undergrad internationally were accepted and matriculated to U.S. medical schools.

What are the unique challenges you might encounter as an international applicant and how can you succeed in spite of them?

In short, if you are not a U.S. citizen or permanent resident who holds a green card, youll need to clearly state your visa status on your application.

Most schools require international students to have one of the types of visas that allows them to reside and study in the United States. Some schools may work with certain students to sponsor them for a student Visa.

Very few other countries have a grading system similar to that of U.S. undergraduate institutions. This likely means that if you are an international applicant, you will not have an undergraduate grade point average (GPA). It is possible to have a third-party turn your international marks into a GPA equivalentsome medical schools will require it.

In addition, you are likely to have to do additional coursework in the U.S. to get your prerequisites out of the way.

Luke Burns, now a second-year ob-gyn resident at Michigan Health, attended university in the U.K., but hoped to attend medical school in the U.S. and had to go this route.

I had to get the pre-requisites out of the way, so I went to a premedical post-baccalaureate program at Mills College in Oakland to do two years of premed sciences. he said. That gave me some knowledge of how American education works in the first place and it started me off with a GPA.

If youre an international student who doesnt have many connections in the U.S., it can be challenging to find the types of volunteer and shadowing opportunities medical schools value among applicants.

Dr. Burns noted that he didnt have any relatives who were doctors or physicians who had cared for me. ... Coming to a brand-new place, I had to find ways to get medical experience on my own.

The post-baccalaureate program Dr. Burns attended provided a few opportunities, such as a bulletin board where you could sign up for things, he said. Most of it was cold calling. I ended up doing research with a local pediatrician who was in private practice by finding him on my own.

Dr. Burns did spend some time in the U.S. growing uphe holds a green cardbut he was born abroad and spent much of his life away from the country. That, he believes, may have separated him from other applicants.

Many of my classmates spent their whole lives within the same 100 square miles, said Dr. Burns, who ended up earning his medical degree from the University of California, San Diego. I come from somewhere else. And its not just me. Many of my [international] classmates had really interesting things happen in their lives that informed why they wanted to become doctors.

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More Medical Students Are Disclosing Their Disabilities, and Schools Are Responding, Study Finds – Michigan Medicine

Meeks and her colleagues, including senior author Bonnielin K. Swenor, Ph.D., M.P.H., of the Johns Hopkins Universitys Wilmer Eye Institute, note that their results arent necessarily representative of all medical schools, because of lower participation in the survey by schools in the south and the studys focus on allopathic schools.

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However, the schools that participated represent more than 41,000 medical students in 2018.

Doctors with disabilities have a valuable perspective that can uniquely drive scientific innovation and improve patient care," says Swenor. "While our results signal a promising increase in representation of persons with disabilities in medicine, further work is needed to determine if representation translates to inclusion, which is critical to achieving diversity in medicine."

The new study comes at a time of increased attention to the issue of disability and health among medical trainees.

The AAMC is committed to working with leaders at the nations medical schools and teaching hospitals to shape the culture, establishing accountability and allocating necessary resources to enhance access and inclusion for individuals with disabilities, said Geoffrey Young, Ph.D., senior director of student affairs and programs at the AAMC.

The 2018 report, Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians With Disabilities, served as the first comprehensive examination of the experiences of medical learners with disabilities and gave a voice to medical students, residents and physicians with physical, psychological, sensory, learning or chronic health disabilities, he says. Since the publication of this report, we have begun collecting data on the percentage of students who self-identify as having a disability and whether they requested and received accommodations. We are using this data to provide enhanced support to students.

Meeks own institution has made a commitment to accommodating admitted students with disabilities.

SEE ALSO: A Seat at the Table: Why U-Ms Medical School Wants More Students with Disabilities

At Michigan, we are committed to a more inclusive learning environment in the fullest sense of the word, says Rajesh Mangrulkar, M.D., the associate dean for medical student education at the U-M Medical School. The crucial, ongoing research that Dr. Meeks and her team are doing show that we are beginning to move the needle on understanding the lived experience for our medical students who have both apparent and non-apparent disabilities. And while we are making progress, far more work is required for us to build the culture for these students to thrive and develop; all for the betterment of their future patients.

"Students with disabilities who have been admitted to medical school have already shown academic excellence to a significant enough extent to make them attractive candidates for admission," adds Steven Gay, M.D., M.S., assistant dean for admissions at the U-M Medical School. "A better understanding of their needs and potential accommodations they may require works to not only to insure their success, but to insure better healthcare to all of the diverse populations we hope to serve."

The authors are already conducting further research that will go beyond documenting the current rates of disability disclosure and accommodation. Theyre seeking to better understand issues such as the career trajectories and experiences of medical students with disabilities, and the potential benefit to patients of having a doctor who has a disability.

In addition to Meeks and Swenor, the papers authors include Ben Case, M.P.H., and Melissa Plegue, M.A., of U-M, and Kurt Herzer, M.D., Ph.D., M.Sc., of Johns Hopkins.

Paper cited: Change in Prevalence of Disabilities and Accommodation Practices Among US Medical Schools, 2016 vs 2019, JAMA. DOI: 10.1001/jama.2019.15372

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More Medical Students Are Disclosing Their Disabilities, and Schools Are Responding, Study Finds - Michigan Medicine

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I Have a Ph.D. in Not Having Money – The New York Times

Ms. Tomlinson said that with every expense she takes on now, such as a $20 dinner out, she calculates what she will have to pay off in 10 years, at 7 percent interest. She struggles to make rent on her student housing at Mount Sinai, which she said is more than she would pay for a family house in Oklahoma City, where she lived previously.

Randall Tassone, a medical student at Harvard, was raised in a low-income household in rural Pennsylvania. Now surrounded by wealthier classmates, many of them the children of doctors, Mr. Tassone has come to understand money as something intrinsic to medical school culture, structuring social as well as academic life. Earlier this year he walked past a classroom poster advertising a service trip; it included a student testimonial: It was nice to feel like we did something to help the poor community.

It was identifying the poor as outsiders who arent part of our community, Mr. Tassone said. It made him realize, he said, Ive been invited into this institution that favors rich people.

Mr. Johnson said he experienced almost daily reminders of his socioeconomic status. A professor recently asked students, as an icebreaker, to describe their favorite family vacation spot. Mr. Johnson began to sweat, racking his brain for an answer before awkwardly offering the truth: His family had never taken a vacation.

That top medical schools seem to favor the rich is especially disturbing to low-income students because they know that their diverse experiences and perspectives are an asset, not a liability. A 2018 study showed that black patients have better health outcomes when treated by black doctors. Mr. Johnson said that emergency room patients have told him they feel more comfortable having a doctor who is African-American and from Stockton, someone who, like them, struggles to afford his medication.

I have a Ph.D. in not having money, Mr. Johnson said. Thats not easy to explain.

When he graduates from medical school, Mr. Velasquez plans to work in an emergency room where he can treat patients who are homeless, undocumented and the poorest of the poor. He wants to treat patients who look like his family, he said. But already he has learned that the dream comes at a cost.

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I Have a Ph.D. in Not Having Money - The New York Times

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University of Arizona Colleges of Medicine Will Offer Free Tuition… – Diverse: Issues in Higher Education

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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Study finds increase in medical students’ disclosures of disabilities to their schools – News-Medical.net

The percentage of medical students who told their schools that they have a disability rose sharply in recent years, a new study shows.

Medical schools made changes, called accommodations, for nearly all medical students who disclosed the fact that they have a condition that qualifies as a disability, the study also finds. For instance, schools adjusted testing times, or the length of patient care training.

The reasons for the increase in medical students' disclosures of disabilities are not clear, according to authors of the new research letter in JAMA.

And even with the increase, students with disabilities still represent less than 5% of all future physicians, even when disability is defined as including physical, sensory, learning, psychological, and chronic health conditions.

Having more medical students with all categories of disability could improve the diversity of the physician workforce, reduce stigma and stereotypes about people with disabilities, and inform the care of patients, the researchers say.

Lisa Meeks, Ph.D., M.A., of the University of Michigan and her colleagues surveyed medical schools in 2016, and again in late 2018 and early 2019.

The second survey came after a major report by the Association of American Medical Colleges, or AAMC, giving medical schools a framework to reduce barriers facing aspiring physicians with disabilities.

In just three years, the percentage of students with disabilities rose from 2.7% to 4.6%, at the 64 medical schools that responded to the survey in both years.

This 69% relative rise was mainly due to growth in the percentage of students who disclosed a psychological disability or a chronic health condition. Psychological disabilities include anxiety, depression and eating disorders.

Meeks notes that the reasons for the rise still need further study, and may include many factors.

A constellation of events has likely contributed to the increase in disclosure. This may include increased awareness of the availability of accommodations, an increase in the number of students who have received accommodations throughout their education and are comfortable with their identities as a person with a disability, the creation of educational resources by AAMC, and the diligent efforts of medical education programs to improve accessibility."

Lisa Meeks, assistant professor of family medicine at the U-M Medical School

All the schools that responded to the 2019 survey said they had provided formal accommodations for students related to academic testing. Three-quarters provided accommodations such as note takers, and adjustments to tests of students' clinical skills.

One-third of schools said they had modified their clinical procedures for students. But the researchers note that all students still must complete the required clinical competencies to graduate, but that accommodations allow them to do so through an alternative, equally safe, approach.

Meeks and her colleagues, including senior author Bonnielin K. Swenor, Ph.D., M.P.H. of the Johns Hopkins University's Wilmer Eye Institute, note that their results aren't necessarily representative of all medical schools, because of lower participation in the survey by schools in the south, and the study's focus on allopathic schools.

However, the schools that participated represent more than 41,000 medical students in 2018.

The new study comes at a time of increased attention to the issue of disability and health among medical trainees.

"The AAMC is committed to working with leaders at the nation's medical schools and teaching hospitals to shape the culture, establishing accountability, and allocating necessary resources to enhance access and inclusion for individuals with disabilities," said Geoffrey Young, PhD, senior director of student affairs and programs at the AAMC.

"The 2018 report, Accessibility, Inclusion, and Action in Medical Education: Lived Experiences of Learners and Physicians With Disabilities, served as the first comprehensive examination of the experiences of medical learners with disabilities, and gave a voice to medical students, residents, and physicians with physical, psychological, sensory, learning, or chronic health disabilities," he says. "Since the publication of this report, we have begun collecting data on the percentage of students who self-identify as having a disability and whether they requested and received accommodations and are using this data to provide enhanced support to students."

Meeks' own institution has made a commitment to accommodating admitted students with disabilities.

"At Michigan, we are committed to a more inclusive learning environment in the fullest sense of the word," says Rajesh Mangrulkar, M.D., the associate dean for medical student education at the U-M Medical School. "The crucial, ongoing research that Dr. Meeks and her team are doing show that we are beginning to move the needle on understanding the lived experience for our medical students who have both apparent and nonapparent disabilities. And while we are making progress, far more work is required for us to build the culture for these students to thrive and develop; all for the betterment of their future patients."

The authors are already conducting further research that will go beyond documenting the current rates of disability disclosure and accommodation. They're seeking to better understand issues such as the career trajectories and experiences of medical students with disabilities, and the potential benefit to patients of having a doctor who has a disability.

Source:

Journal reference:

Meeks, L.M., et al. (2019) Change in Prevalence of Disabilities and Accommodation Practices Among US Medical Schools, 2016 vs 2019. JAMA. doi.org/10.1001/jama.2019.15372.

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UMass Med School gene therapy shows promising early results in tackling Tay-Sachs – Worcester Telegram

WORCESTER The fight against Tay-Sachs disease, a rare, progressive and fatal neurodegenerative disorder, showed progress based on preliminary results from a University of Massachusetts Medical School expanded access study presented last month.

This was the first time that Tay-Sachs gene therapy has been done in humans, as opposed to animal studies, and the first time gene therapy to correct the enzyme deficiency that causes Tay-Sachs has been inserted safely into the brain, according to Dr. Terence R. Flotte, dean of the medical school andCelia and Isaac Haidak professor of medical education.

Those were the two big things, he said in an interview.

The next step will be to test the therapy in increasing doses on more patients. An investigational new drug proposal has been submitted to the U.S. Food and Drug Administration and a phase 2 clinical trial is expected to start within a few months. Flotte will be the principal investigator in that study.

Axovant Gene Therapies, a Swiss company developing gene therapies for serious neurological diseases, last year licensed exclusive worldwide rights for the development and commercialization of the novel gene therapy programs.

Flotte reported at the European Society of Gene and Cell Therapy Annual Congress in Barcelona, Spain, that two patients with infantile Tay-Sachs disease, who were treated at UMass Memorial Medical Center with gene therapy developed at the medical school, showed signs that progression of their disease was modified.

The first patient, who has advanced disease, received treatment a year ago, at around age 2. An engineered virus containing corrective genetic material was injected into fluid surrounding the brain. The patient hasnt shown clinical improvement in functioning but biochemical changes were detected in the brain, indicating partial re-creation of the missing enzyme associated with Tay-Sachs, Flotte said.

The second patient, who was around 6 months old when some of the gene therapy was injected into the thalamus region of the brain, about six months ago, has not degenerated further since then.

Flotte said the thalamus is the master relay station for the brain, which allows the genetic material to spread to other parts.

Tay-Sachs, which results from the absence of beta-hexosaminidase (HexA) enzyme, is diagnosed in about 30 children in the United States each year, and there are an estimated 400 to 700 cases worldwide, according to medical school reports.

According to the Cure Tay-Sachs Foundation, the Tay-Sachs gene is carried by one in 27 Ashkenazi (Eastern European) Jews, French-Canadians or Louisiana Cajuns; one in 50 Irish-Americans; and one in 250 in the general population. If both parents carry the Tay-Sachs gene, there is a 25 percent chance their child will suffer from Tay-Sachs and likely die at a young age.

There is no cure for the disease.

In infantile Tay-Sachs, Flotte explained, babies start to develop typically, reaching milestones such as sitting up. But then as the disease progresses, they lose that ability and face other developmental challenges.

A home run would be to maintain the ability to sit and gain the ability to walk, Flotte said. Helping babies to gain those developmental milestones is really the goal.

Both patients in the study showed indication of enzyme being made in the brain after introduction of the therapy. But Flotte said it was too soon to know if stabilization of their condition will prolong life expectancy.

The median life expectancy for children with infantile Tay-Sachs or a similar inherited neurological disorder, Sandhoff disease, is about three to five years.

The process to insert the gene therapy with millimetric target precision into the skulls of very young children required extensive planning and computer modeling ahead of time, pediatric neurosurgeon Dr. Oguz Cataltepe said. A safe trajectory had to be mapped so that blood vessels wouldnt be harmed. A robotic arm was used with the insertion.

Patients also had to be given drugs to suppress their immune system so they wouldn't reject the gene therapy.

Cataltepe said the first patients procedure took about two hours. Subsequent insertions would take longer as more of the therapy is injected directly into the brain.

Flotte said the families faced the daunting procedure with trepidation, but I think some level of hope.

He said families felt because of the outcomes of Tay-Sachs in its natural rapid progression, it warranted the risk.

I think both of them have been very grateful to try the technology available, said Flotte. Still, They recognize these are very early steps.

He added that neither family in the study knew of any hereditary risk. Neither has Ashkenazi Jewish heritage, a group among those with the highest risk.

Flotte said he would like to see Tay-Sachs disease be part of standard newborn screening programs, particularly if therapy becomes available.

Mona Vogel of Groton, whose son, Owen, 6, was diagnosed with juvenile Tay-Sachs when he was about 3, also urges people to get screened for the disease.

Vogel, a single mother by choice, is not of Ashkenazi Jewish descent. She went to two different genetic counselors, and her risk for Tay-Sachs didnt come up. Her donors genetic profile also didnt highlight a risk.

Owen developed typically until he was 3, Vogel said in a phone interview. Then he started falling face-plant falling.

Vogel is active within the Tay-Sachs community and said there had been tentative excitement over apparent progress in previous animal studies, often to be met with disappointment in setbacks.

Theres this combination of excitement and reserved excitement, she said about news that a human gene therapy study shows promise.

The scary part for parents of children with Tay-Sachs is that they dont yet know what the criteria will be for inclusion in the clinical trial and whether they will get a chance to participate.

To come this far and not even have this opportunity is devastating, Vogel said. Theres a lot of consistently heightened emotions thats a mixed bag of all of the above.

Children accepted into the clinical trial will be treated with gene therapy at UMass Memorial, Flotte said. Their progress will be evaluated at Massachusetts General Hospital in Boston, for independent external assessment.

Vogel said shes trying to remain positive.

For me, I would be perfectly willing to risk it all (to be part of the research), she said. Just so I know we did everything we could do. And I promised this kid Id do it.

As the mother and aunt of a daughter and nephew who both died from infantile Tay-Sachs nearly 20 years ago, I am so grateful to the team at UMass that advanced the research towards treatments and where we are today, wrote Blyth Lord of Newton, founder of Courageous Parents Network, in an email.

In addition to the team at UMass, I credit families and the patient disease groups National Tay-Sachs and Allied Disease (NTSAD) and Cure Tay-Sachs that have channeled family support to research. You need the families, the patient disease groups, the researchers and the money to make this possible. Of course, we know this first phase therapy is early stage and there is still a long way to go, so we will all have to keep going too.

Researchers who collaborated on animal models and therapeutic approaches for Tay-Sachs and similar disorders also include: Miguel Sena-Esteves, associate professor of neurology at UMass; Dr. Heather Gray-Edwards, formerly of Auburn University and currently assistant professor of radiology at UMass; and Douglas Martin, professor of anatomy, physiology and pharmacology in the College of Veterinary Medicine and the Scott-Ritchey Research Center at Auburn University.

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