Category Archives: Medical School

Public release date: 21-Feb-2012
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Contact: Jim Fessenden
james.fessenden@umassmed.edu
508-856-2000
University of Massachusetts Medical School

WORCESTER, Mass. ? Clinical researchers at the University of Massachusetts Medical School (UMMS) are combining an innovative constellation of technologies such as artificial intelligence, smartphone programming, biosensors and wireless connectivity to develop a device designed to detect physiological stressors associated with drug cravings and respond with user-tailored behavioral interventions that prevent substance use. Preliminary data about the multi-media device, called iHeal, was published online first in the Journal of Medical Toxicology.

According to the study's authors, many behavioral interventions used to treat patients are ineffective outside of the controlled clinical settings where they are taught. This failure can be attributed to several factors, including a patient's inability to recognize biological changes that indicate increased risk of relapse and an inability to change their behaviors to reduce health risk.

Edward Boyer, MD, PhD, professor of emergency medicine at UMass Medical School and lead author of the study, worked with colleagues at UMMS and at the Massachusetts Institute of Technology, to design a mobile device using so-called "enabling technologies" that could be used to make behavioral interventions for substance abusers more effective outside the clinic or office environments. The result of their work, iHeal, combines sensors to measure physiological changes and detect trigger points for risky health behaviors, such as substance use, with smartphone software tailored to respond with patient-specific interventions.

Individuals with a history of substance abuse and post-traumatic stress disorder were asked to wear an iHeal sensor band around their wrist that measures the electrical activity of the skin, body motion, skin temperature and heart rate ? all indicators of stress. The band wirelessly transmits information to a smartphone, where software applications monitor and process the user's physiological data. When the software detects an increased stress level, it asks the user to annotate events by inputting information about their perceived level of stress, drug cravings, and current activities. This information is then used to identify, in real-time, drug cravings and deliver personalized, multimedia drug prevention interventions precisely at the moment of greatest physiological need.

Boyer and his teams examined the iHeal system architecture, as well as preliminary feedback from initial users, to identify key attributes and assess the device's viability. Their analyses suggest a number of technical issues related to data security, as well as the need for a more robust and less stigmatizing version before the device could be worn in public.

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About the University of Massachusetts Medical School

The University of Massachusetts Medical School, one of the fastest growing academic health centers in the country, has built a reputation as a world-class research institution, consistently producing noteworthy advances in clinical and basic research. The Medical School attracts more than $277 million in research funding annually, 80 percent of which comes from federal funding sources. The mission of the Medical School is to advance the health and well-being of the people of the commonwealth and the world through pioneering education, research, public service and health care delivery with its clinical partner, UMass Memorial Health Care. For more information, visit http://www.umassmed.edu.

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Preventing and treating drug use with smartphones

Every doctor has to start somewhere. Now they can make it MidMichigan Health.

The health care system welcomed its first class of medical students from the Michigan State University College of Human Medicine last summer. Third- and fourth-year students at the MidMichigan are completing a core competency program and several clerkships in departments, gaining clinical experience as they train for full-time jobs as doctors.

So far, the experience has surpassed the expectations of the medical professionals and students involved.

‘Demanding in a great way’

John Evans, a Flint native who chose to come to the MSU College of Human Health Midland Regional Campus after a site visit, said the demanding schedule was expected, but the experiences he has had are beyond what he anticipated.

“Even when it’s demanding, it’s demanding in a great way,” he said. “What else would I be doing?”

On a typical day the students shadow an attending physician in family medicine, internal medicine, pediatrics, obstetrics and gynecology, surgery and psychiatry. MSU sets the curriculum and MidMichigan staff offers instruction, letting the students observe and participate in medical care.

Evans said the students start work early in the morning and most days could be done by 5 p.m., but they typically want to stay to continue patient care, follow up on something interesting that happened or study for tests that come after each clerkship ends.

“You want to be here, you want to have access,” Evans said.

Evans was in awe reflecting on the 10 babies that he was the first person to ever touch in the world. He said he got emotional about the first delivery because that’s a major milestone in a doctor’s life.

“I had been gearing up that, and there it was,” he said. “It was incredible.”

After medical school, the students will earn an M.D. and will complete a residency, during which they gain specialized knowledge in the area in which they will practice.

Delivering the babies put OBGYN into Evans’ top three options for his residency program, with general surgery at the top and the emergency room as the third option.

Evans said joining a new program means coming at a time when there is a lot of enthusiasm to teach and learn. Students at other campuses have told Evans that they haven’t had the same access to real-life experiences.

“The way we were embraced by the MidMichigan Health system is incredible and something we weren’t really expecting,” he said, describing support and encouragement from staff at every level. “You don’t feel like you’re bothering anybody. You feel like they want you there and they encourage you.”

Fresh skills, top recruits

Dr. Paula Klose, community assistant dean for the new campus, said the staff loves working with the students and feel like they’re helping set up the new campus for long-term success.

Klose said when physicians teach it can help to keep their skills up, meaning better care for patients. Having a teaching component also helps recruit physicians, some of whom only want to work at a medical center where they can teach. The local instructors were selected based on having an interest in teaching and qualifications for the job.

This year, students are spending most of their time at MidMichigan Medical Center-Midland, with some time also spent at MidMichigan Medical Center-Gratiot. Klose said as the program expands, students also could spend time in MidMichigan’s medical centers in Gladwin and Clare.

This year there are three third-year students and five fourth-year students at the Midland campus. Klose said next year, another six third-year students will be added to the program. It could build up to nine to 12 students each year as the program grows.

The program is expected to offer more electives as time goes on and could lead to the development of a simulation center, medical research and residency opportunities at the medical centers.

Klose hopes the students will find residencies to gain in-depth knowledge in a specific medical field and then choose to return to MidMichigan Health because of their experiences as students.

Evans said after spending time in the “fantastic community,” he can see how that hope could turn into reality.

“That’s a very high likelihood,” he said. “It’s growing on me and is such a nice community.”

‘This is our community now’

Medicine was the first thing to appeal to Evans. After an uninspiring education in the Flint school system, he moved to New York and earned a master of fine arts degree. Now, he wants a career where he can see results and know he is making a difference in people’s lives.

“There’s the traditional path, the non-traditional path and then there’s my path,” Evans said with a laugh.

His easy-going demeanor works well with patients, which is a skill doctors need in addition to medical knowledge.

Evans said most patients are fine with a student being with a physician during a medical exam, but some may want privacy.

He said the patients don’t benefit from a vast new source of medical knowledge when a student is present because they are still learning everything, but students can be up-to-date on new practices or research that can help a patient.

One benefit some patients experience from having a student present is the additional time the students can spend with them when the residents or physicians are required to move to the next patient.

“It increases face time, and patients really like that,” Klose said, noting the current group of students have been great at interacting with patients.

Evans said some patients have felt their care is more thorough, which is good for the patient and the Health System. He said the MSU College of Human Medicine stresses not just the medical care, but the human side of medicine.

“They get the medical care they want and the attention that they need,” he said of patients.

Being able to spend more time with a patient also allows Evans to better remember all the things that must be asked and checked. He said the more times people does something, the faster they become.

The students also hope to become more involved in community initiatives. Evans said MSU’s core competency program includes learning about health disparities in a community. Mike Krecek, director of the Midland County Health Department, spoke to the students about Midland County’s medical needs, including access to medical care for the county’s rural residents.

“We really want to be involved in outreach services,” Evans said. “This is our community now. We don’t just want to be at the hospital and then go to sleep. We want to be a part of the community.”

Copyright 2012 Midland Daily News. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Medical practice: Michigan State University launches regional campus for medical school

Not so long ago, many medical school graduates entered residency burdened with large amounts of student loan debt. And just when you thought that was the worst of it, many residency-related student loan deferments for federal loan repayments were phased out in the early 1990s, leaving many residents with relatively large monthly loan payments while still in training.

The federal government has embarked upon programs aimed at attracting medical residents to work in HPSAs (Health Professional Shortage Areas) for three years after graduation, at which time they would receive tuition and stipend reimbursements for each year of HPSA service. The government recently expanded the program, after it announced that almost 20 percent of Americans live in underserved areas, ranging from isolated rural areas to areas many would be surprised are considered underserved, including the Venice Beach and West Hollywood/Hollywood areas of Los Angeles.

[Learn how to go to medical school for free.]

Students can apply for healthcare loan repayment programs through the National Health Service Corps (NHSC), which asks medical residents for a flexible commitment of working for at least two or three years in an underserved area of the United States in a primary care specialty. The government would then repay up to $120,000 in debt. From 2008 to 2011, the program has nearly tripled its enrollment from 3,600 physicians to more than 10,000. Additional loan repayment support is available if physicians choose to work longer.

U.S. Secretary of Health and Human Services Kathleen Sebelius recently announced a newer initiative toward student loan repayment. This new loan repayment program, to which Sebelius committed $9.1 million, is targeted at recruiting current medical students, particularly those in their fourth year, who are dedicated to specifically designated specialties.

[Check out rankings of medical school primary care specialties.]

The announcement of this additional option makes the following federal scholarship and loan repayment avenues available:

• NHSC Scholarship: In this program, students entering medical school—or those who haven't yet completed their fourth year of medical school—receive tuition scholarships and monthly stipends. The students sign a commitment to spend one year working in an underserved area for each year of support received. There is a limit of four years of funding per student.

This program can sound tempting—after all, what is four years if your entire medical school tuition is paid in advance? But if you happen to change your mind after graduation and you don't enter or finish residency, the penalty can be steep. You must repay the government tuition costs plus penalties and interest within a specified period of time. In rare cases, the government has disciplined doctors who did not repay these costs in time.

• Students to Service Program: With the recently announced funding, this program allows fourth-year medical students who have solidified their career choice down to a primary care specialty (internal medicine, family medicine, pediatrics, geriatrics, obstetrics and gynecology, and general psychiatry) the opportunity for loan repayments.

[Find out which public medical schools award the most financial aid.]

• Commitment after residency: If you complete a residency in one of the primary care specialties above, you can work in a HPSA for as long or as little time as you desire. Each year you spend working 32 or more hours per week seeing patients, a certain percentage of your loans will be repaid.

A half-time work option is also available. After three full (or six half-time) years, these physicians have the option to continue on for more substantial support. Physicians who terminate the program without NHSC approval face substantial financial penalties (usually more than $100,000).

Keep in mind that these programs, as they're federally administered, do not tax funds given to these physicians for the purpose of loan repayment. Programs outside the NHSC that offer these benefits may report the repayment to the IRS, which then taxes the physician.

For those premeds who find current medical school tuition figures daunting, these programs offer a great way to become debt-free in a shorter amount of time than for most graduates. Premeds can still get a fairly competitive salary at the same time. Just be sure to read all the fine print, especially if you are committing early.

Ibrahim Busnaina, M.D. is a graduate of the University of Pennsylvania School of Medicine and coauthor of "Examkrackers' How to Get Into Medical School." He has been consulting with prospective medical school applicants, with a special focus on minority and other nontraditional candidates, since 2006.

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Explore New Options to Repay Medical School Loans

Published: Thursday, April 18, 2002

Updated: Thursday, March 3, 2011 16:03

High school students wanting to enter into the medical field may have the reinforcement they need with the Pre-Health Reinforcement and Enrichment Program or PREP.
The Quillen College of Medicine Office of Student Affairs determined that the best way to aid their potential students with basic courses was to start early.
This year Yvonne Buford, PREP program coordinator, decided to invite high school to participate in the summer program and continue with the program throughout high school and college.
"After two summers of watching senior college students struggle through basic science classes, I thought I could be more helpful by going back to the high schools and working with counselors to help them understand what the students need before they get to this level," Buford said.
PREP is designed to strengthen students' academic skills and to increase the opportunity for students to get into the medical school of their choice. Students will live on campus and meals will be provided.
"We have workshops planned, speakers coming in and we'll be doing job shadowing," she said.
Buford said that this type of a program could have a great effect on the students' admissions to a medical school.
"The admissions has offered to put out information about the program," she said. "And during the school year we will have first-year med students as tutors."
Buford has received a lot of feedback from the students who have participated in the program and believes the program will be beneficial to all who attended.
So far 26 high school students and 45 college students have applied for the program.
"If all goes as planned we'll be working with the students for eight years each," Buford said. "We want to carry them through high school, bring to college and take them to the exam."
Call Buford at 439-5655 for more information about the program.

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Summer program to prepare students for medical school

Upstate Medical University's medical school was placed on probation Thursday by an accrediting organization after concerns were raised about the school's curriculum.

The Liaison Committee on Medical Education recommended Upstate be placed on probation last fall, but State University of New York academic medical center officials appealed the recommendation last week, according to an article published in The Post-Standard on Saturday.

The committee made its final decision to follow through with the sanction Thursday, according to the article.

Upstate joins five other schools placed on probation by the LCME and will have two years to fix all problems identified by the organization, according to the article. The committee accredits a total of 136 U.S. medical schools.

Losing accreditation may be detrimental to the school, as it would no longer be allowed to distribute medical degrees. David Duggan, interim dean of the medical school, told The Post-Standard the chances of this happening were extremely slim.

Duggan said the school remains fully accredited and is working to address the committee's concerns, according to the article.

Duggan could not be immediately reached for comment.

The LCME acts as the nationally recognized accrediting authority for medical education programs leading to a degree in the medical field in the United States and Canada. The organization is sponsored by the Association of American Medical Colleges and the American Medical Association, according to the article.

Accreditation shows that a medical school is meeting national standards, and graduating from an LCME-accredited school is required for a medical license in most states, according to the article.

LCME's largest criticism against Upstate was the lack of a central committee with the authority to make changes to the school's curriculum, according the article.

The organization was also bothered by a cheating incident that occurred last year involving fourth-year medical students who assisted each other on online quizzes in a medical literature course, according to the article. Upstate suspended the course for at least one year to try and improve it.

Duggan told The Post-Standard that Upstate's sanction was not "based on any shortcomings in the quality of its medical students or their accomplishments." Upstate has alerted all prospective applicants about the school's probation, Duggan said, but so far it has had no effect on the applicant pool.

In recent years, the LCME became stricter and is taking more severe actions against medical schools it does not believe to be meeting standards, according to the article.

The medical school exists within Upstate Medical University Hospital. The hospital was placed on a "watch list" for the hospital's high frequency of safety concerns, complications and patient deaths in September.

The Niagara Health Quality Coalition, a hospital performance research group, included University Hospital along with 20 other New York state hospitals on the list as part of an annual report card. The report stated statistics of patient deaths, patient dissatisfaction and complications.

egsawyer@syr.edu

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Upstate Medical University placed on probation

It was an exercise on how to interview for admission to medical school.

Not even Darcie Spresser, a 24-year-old undergraduate at Wichita State University who volunteered to be interviewed in front of others, knew how real and how emotional it would be. It was just an exercise, but Spresser nailed it.

It happened Saturday during a day-long program in Wichita that brought about 340 undergraduate students and advisers from Kansas and surrounding states. The program, co-hosted by KU School of Medicine-Wichita and Wichita State University, was designed to help them know what to expect about medical school and help them prepare for the challenges.

James Kallail, professor and associate chairman for research in the Department of Internal Medicine at KU School of Medicine-Wichita, conducted the interview exercise in an amphitheater at the Wichita medical campus as about 35 students watched. Kallail, a member of the admission committee for the medical school system, told Spresser he wanted her to be as open and honest as possible.

“Tell me why you want to be a physician,” he asked in a calm, clear voice.

“My heart lies there,” she said, explaining that she had tried another career but realized that caring for others as a doctor is what she decided she had to do. She now works as a phlebotomist, drawing patients’ blood at Via Christi Hospital on St. Francis, so she sees all kinds of patients. A defining moment came one day when she walked into a cancer patient’s room to take a blood sample from her.

Sunshine from a window was hitting the ill woman in the face.

“Oh, honey, let me close that blind down for you; the sun is in your eyes,” Spresser told the woman.

“That’s OK,” the patient said. “I’m just glad God gave me another day to see the sun rise.”

Spresser’s voice caught, and she teared up as she recounted it to Kallail. She apologized for getting emotional. He said it was OK, to continue. The other students listened intently.

Spresser, a native of Selden in northwest Kansas, also talked about donating a kidney to a relative two years ago. Kallail said it was quite a sacrifice.

She said that because of her Christian faith, it is important for her to help people, that it is who she is.

As Kallail and the students critiqued the interview afterward, Spresser conceded she was nervous and emotional, that it “just came out.”

It’s natural to be a little nervous during an interview, Kallail said. “It’s an anxiety-provoking situation.”

But Kallail told her she came across as genuine, that the emotion came as part of her credible, compelling story.

The students discussed whether her mention of religion could be controversial in the context of a medical school interview. But Kallail said he didn’t take it that way, that it’s OK to bring up faith if it is relevant during an interview.

The test, he said, is if religious belief gets in the way of treating a patient.

A score of 6 is the top interview score, he said. “I’d give her a 6. This was a star interview. I don’t see interviews like this very often.”

In another session – a panel discussion in which current medical students shared what it takes to get into medical school and succeed there – one of the panel members told the undergrads to make sure they know how they will answer the question interviewers always ask: “Tell me about yourself.” It’s not always easy to answer.

Whatever you say, you have to be yourself and be genuine, the med students said.

As for what classes to take, the message was: Get a degree in what really interests you, not what you think will look good on paper. Still, some specific course areas, like biochemistry and anatomy, are especially important.

Many of the med students exposed themselves to the profession by shadowing doctors – learning what is really involved, by seeing surgeries and other procedures first-hand.

Someone asked if it’s doable to start families while attending medical school. The answer: Some med students do have small children, but it forces them to closely budget their time.

Med school, they said, is a full-time job.

Reach Tim Potter at 316-268-6684 or tpotter@wichitaeagle.com.

Read more:
A prospective KU med school student speaks from the heart