Harvard Medical School Launches Arts Initiative

Harvard Medical SchoolHarvard Medical School

After years of planning, Harvard Medical School this fall launched a formal initiative to integrate the arts and humanities into the traditionally hard-sciences focused campus in an effort to cultivate more empathetic medical professionals.

The “Arts&Humanities@HMS” initiative— planning for which began in 2011— supports the arts in part by raising money to create fellowships for Medical School affiliates interested in the intersection of art and medicine. The initiative also looks to create more opportunities for students to explore music, visual arts, and drama by hosting events, including case narrative readings and performances by the Longwood Symphony Orchestra.

The initiative, which the school approved in June, comes at a time when universities across the nation are reimagining medical education as a more holistic growth process. For example, increasing numbers of students are taking gap years before medical school to reflect on their goals. And this fall, the Medical School rolled out a drastic overhaul of its curriculum, which focuses on “active learning” teaching methods like flipped classrooms.

Students and faculty alike have already expressed interest in increasing the number of arts-based offerings at the school. A 2012 survey of Medical School affiliates indicated that “there are over 1,000 people who are interested in the role of arts and humanities in medicine,” according to professor David S. Jones, who has helped lead and donated to the arts initiative.

Jones said studying humanities will help aspiring doctors better relate to their patients.

“All the doctors who are involved in the arts will say [that the arts] make them better doctors,” he said.

Prior to the launch of the Medical School’s new initiative, the arts and humanities had already occupied an informal presence on campus, according to Ronald A. Arky, a professor there who has been involved with medical education for more than 20 years. For example, he said, a decade-old elective course “Training the Eye” offers first-year medical students the opportunity to critique art and apply those skills to a clinical setting.

“Even back in the 1980s, I’ve actually participated with students in visiting the Museum of Fine Arts, or museums in Cambridge, and so forth,” Arky said. “It’s been there, but needed to be brought to the fore.”

Currently, Jones said, he and others involved in the initiative are trying to gauge student interest to best tailor the arts to the Medical School. Ultimately he hopes to “foster a more artistically inclusive community” and curb the notion that, especially at Harvard, the arts and medicine are mutually exclusive.

“Students say they feel like they have to turn the humanities part of their brain off when they come to HMS,” Jones said. “One of our goals is to make sure that no one at our medical school ever says that again.”

—Staff writer Melanie Y. Fu can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.. Follow her on Twitter @MelanieYFu.

—Staff writer Jiwon Joung can be reached at This email address is being protected from spambots. You need JavaScript enabled to view it.. Follow her on Twitter @YunaJoung.

source: http://www.thecrimson.com

The most in-demand doctors and why Psychiatrists, PCPs see strong demand for their roles in chronic condition management

A new ranking of the most-sought specialties from physician recruiting firm Merritt Hawkins finds that population health management and a shift to team-based care are driving strong demand for primary care providers (PCPs), but that hospital recruitment of doctors has declined for the first time since 2003-2004.
The report is based on more than 3,100 physician and advanced practitioner search assignments the company received between April 1, 2014, and March 31, 2015. The most-recruited specialties were:

  1. Family medicine;
  2. Internal medicine;
  3. Psychiatry;
  4. Hospitalist;
  5. Nurse practitioner;
  6. Ob/gyn;
  7. Orthopedic surgery;
  8. Emergency medicine;
  9. Pediatrics; and
  10. General surgery.

Demand for PCPs, psychiatrists

Overall, six of the 10 most-recruited specialties were related to primary care. Kurt Mosley, VP of strategic alliances at Merritt Hawkins, says the demand for primary care positions reflects the rise of team-based care and population health management. "For a while the specialists were the key to everything because they generated inpatient revenues," he explains. "Now it is team-based health, the chronic care model."

The relationship between mental health and population health management is also driving increased demand for psychiatrists, Mosley says. The latest report ranks psychiatry higher than it has been in the 27 years tracked by Merritt Hawkins. Demand is expected to increase further, as almost half of psychiatrists are expected to retire over the next five years, according to Mosley.

Hospitals' physician recruitment declines

However, hospitals accounted for only 51% of total recruitment in the survey—down from 64% over the past two years, marking the first decline since 2003-2004. Merritt Hawkins attributed the drop to:

  1. Hospital closures, especially in rural areas;
  2. Budget sequestration;
  3. Declines in in federal disproportionate share payments;
  4. States deciding not to expand Medicaid through the Affordable Care Act; and
  5. Non-hospitals increasing their recruitment efforts.

"It's more of a diversified market," says Travis Singleton, a senior VP at Merritt Hawkins.

Singleton expects hospital recruitment of physicians will increase in the coming years because of the Supreme Court's recent ruling upholding the federal exchange subsidies in King v. Burwell. "We will see more and more hospitals get more into the game," he says. "The course is set."

Pay still lags behind demand

Despite high demand for PCPs, their compensation still lags behind other specialties. Merritt Hawkins found that the average primary care doctor it recruited made $198,000 last year, significantly less than most other specialists—such as urologists (ranked 14th most-recruited), who made an average of $412,000.
Don Beckstead, program director for Altoona Family Physicians Residency, hopes the pay gap will begin to narrow as the role of primary care doctors changes. "I would argue that family docs these days are seeing more and more difficult patients and handling more and more difficult patients and therefore should be reimbursed accordingly," he says (Commins [1],HealthLeaders Media, 7/15; Commins [2], HealthLeaders Media, 7/15; Henry, Healthcare DIVE, 7/21).

Source: https://www.advisory.com/daily-briefing/2015/07/22/the-most-in-demand-doctors

The Number Of Black Men Enrolling In U.S. Medical Schools Is Dwindling

Though college enrollment among black men has increased in recent decades, members of the group are entering medical schools at a slower pace. Now, the number of black men applying to U.S. medical schools is actually lower than what admissions offices recorded in 1978, according to the Association of American Medical Colleges’ latest report.

Data in the report shows a slight drop in the number of black male applicants between 1978 and 2014, even as other racial groups experienced an uptick. By 2014, only 1,337 black men applied to U.S. medical schools. In that year, 515 black men were enrolled in an institution, slightly less than was the case in the late 1970s.

Enrollment statistics for 2015 do show an 8 percent gain in black male admission into medical school. However, researchers consider such gains modest, barely making up for 35 years of poor admissions and enrollment trends. Solving this problem, they said, would require more mentoring programs, investments in K-12 public schools, an increase of financial aid options, and an agreement among medical schools to put less emphasis on MCATs and other standardized tests.

“The hope is that this report will prompt leaders in academic medicine to redouble their efforts to improve opportunities for minorities, with specific attention to African-American men,” reads the executive summary of the AAMC report. “They could rethink and renew their existing initiatives, including reviewing and updating current admissions policies and practices, thinking creatively about formal and informal efforts to engage black men and their communities, and conducting community outreach.”

Fewer than 20 percent of medical students identify as members of the black or Latino race. In 2012, the highest concentration of black doctors came from historically black institutions Howard School of Medicine and Morehouse School of Medicine. The disparity worsens among certain specialties including pediatrics, family medicine, and gynecology.

Increasing medical school admission and enrollment among black men could be a key in solving persistent public health issues. Graduates from underrepresented racial groups may be more likely to choose to serve their communities, which tend to be places in dire need of medical resources. Patients also respond to medical professionals with whom they share a common culture, race, language, and gender. That affinity provides a great opportunity to bridge a cultural gap and address race-specific skepticism about medicine.

But seeing this reality come to fruition will most likely require addressing key issues. For one, the allure of music and sports — two career fields marketed to black men significantly more than others — overpowers that of the medical field. A lack of financial resources and difficulties black men face when navigating academic environments counts as another impediment in strengthening medical school admission and enrollment numbers.

That’s why medical schools have taken extra steps to boost the black male presence in the industry amid an impending physician shortage that’s predicted to affect the U.S. medical industry by 2025.

For instance, black men eager to learn more about the profession can talk to black male doctors via webcam and other online communications tools, courtesy of Diverse Medicine, Inc., a program that aims to increases ethnic and socioeconomic diversity in the medical field. The AAMC has also jumped in, creating a training program for medical professionals and faculty members at medical schools that addresses implicit bias — attitudes that lead doctors or researchers to unconsciously treat people of color differently. Implicit bias has been found to affect not only the health care system, but also the black male experience at U.S. medical schools.

The #WhiteCoats4BlackLives movement has also spurred discussion about the link between institutional racism and health disparities. After students at 70 medical schools in the United States performed “die-ins” last year, members of the national organization hosted campus town halls. During those gatherings, participants expressed a growing sense of helplessness and reflected on personal experiences with racial discrimination. The events, in conjunction with a social media campaign, have shed light on the hurdles that black students face in completing their medical studies.

“There are some schools with an underrepresented minority patient population that are unable to provide a medical education to qualified students of color,” Walker Keenan, a member of #WhiteCoats4BlackLives, told ThinkProgress earlier this year. “Physicians of color are also more likely to see patients of color who are in need but no one is speaking for those populations. That’s why we have to increase financial aid and residency positions for students of color.”

Haze continues to spread throughout archipelago

As mitigation efforts have yielded minimal results, haze from raging wildfires in Indonesia continues to spread, with almost all major islands in the archipelago affected by the hazardous smoke, some of which has made it as far as the Philippines.

The National Disaster Mitigation Agency (BNPB) said on Saturday the haze had caused the air quality in the Philippines, Malaysia and Singapore to deteriorate.

“The haze from Sumatra and Kalimantan continues to spread,” BNPB spokesman Sutopo Purwo Nugroho said.

The Meteorology, Climatology and Geophysics Agency (BMKG) earlier reported that the Himawari satellite showed “a thin haze blanketing the Java Sea and parts of Jakarta”.

The report was quickly dispelled by the BMKG, saying the haze did not come from land and forest fires in Sumatra and Kalimantan, it was just regular haze.

“Today, Java is still relatively safe [from the haze],” BMKG spokesman Fachri Radjab said.

Another BMKG spokesman, Harry Tirto Djatmiko, said haze from land and forest fires usually hovered between altitudes of 3,000 and 5,000 meters. “For altitudes up until 3,000m, it’s just regular haze,” he said, explaining the characteristic of the haze in Jakarta.

While Java continues to be free from haze, almost all major islands in Indonesia have been affected, with Sulawesi being the latest casualty.

BMKG Southeast Sulawesi chapter in Kendari said haze from the southern part of Papua had traveled to some parts of the province, blanketing Kendari, Konawe, Bombana North Konawe, South Konawe, Baubau, Buton and Muna.

“Based on Himawari satellite images on Friday, the haze only covered Kendari and parts of South Konawe. But today, almost all of Southeast Sulawesi has been affected by the haze from Papua,” BMKG Kendari spokesman Aris Yunatas said.

 The haze has also disrupted flights across the Philippines, forcing carriers to cancel flights, close airports and ground small aircraft.

In separate advisories, Philippine Airlines (PAL) and Cebu Pacific said they had not been flying to Cotabato city in the southern island of Mindanao since Oct. 17.

This week, Cebu Pacific also cancelled two flights to General Santos city, also in Mindanao, on Thursday. On Friday, both airlines canceled flights to a third city, Dumaguete, in the central Philippines.

Cotabato, General Santos and Dumaguete are gateways to central and southern regions in the Philippines that are home to at least 10 million.

At least eight haze-affected airports, meanwhile, have grounded planes without instruments that will allow pilots to land and takeoff in low to near-zero visibility.

These include Clark airport, in the main island of Luzon, just two hours north of the capital Manila.

The others are in Cotabato, Davao, Laguindingan, Tambler and Zamboanga in Mindanao, and Mactan and Busuanga in central Philippines.

Thick layers of greyish clouds consistent with haze have been blanketing large parts of Mindanao and central Philippines this month.

Besides disrupting flights, the haze has put the lives of many people at risk, with more than 500,000 people suffering from respiratory problems due to the haze in six provinces in Indonesia.

 President Joko “Jokowi” Widodo on Friday ordered an immediate evacuation of babies, children and people vulnerable to worsening air quality.

To start the evacuation efforts, five ministers, including Coordinating Political, Legal and Security Affairs Minister Luhut Binsar Panjaitan and Health Minister Nila F Moeloek, flew to South Kalimantan.

Coordinating Human Development and Culture Minister Puan Maharani was not among the entourage, despite her position as the coordinator of several ministries in charge of the evacuation, such as the Social Ministry and the Health Ministry. - See more at: http://www.thejakartapost.com/

New curriculum teaches patient-centric practices for 21st-century docs


HERSHEY, Pa. -- Medical students at Penn State are now receiving training in health systems sciences and patient navigation, along with the traditional areas of medical education.

The Penn State College of Medicine is one of 11 schools supported by the American Medical Association actively working to update the way future physicians learn their profession. Each school is developing its own new curriculum. In the fall of 2014, Jed Gonzalo, associate dean for health systems education, and colleagues, all at Penn State, developed and implemented the Systems Navigation Curriculum (SyNC), which shifts focus from learning only about the basic and clinical sciences to basic, clinical and health systems sciences, and also engages students as "patient navigators" during their first year of medical school.

"We need to help students learn the health care system," said Gonzalo, also assistant professor of medicine and public health sciences. "We are moving from a physician-centric to a patient-centric model -- in most medical education curricula, students don't primarily learn about the patients themselves, the students mainly follow and observe the physicians in an apprenticeship model. By including patient navigation in their program, the students learn more directly about the patients."

A patient navigator acts as a liaison between patient and provider, helping patients navigate the health care system by educating them about medical issues, reducing delays in diagnosis and treatment, and helping to identify and remove impediments to care. Because this role can be performed without a medical degree, first-year medical students are in a prime position to serve as patient navigators, gaining first-hand experience in the health care system while doing so.

"We believe patient navigation provides students with a participatory role in providing value to the health care system in a way that parallels and enhances traditional clinical experiences," wrote Gonzalo and colleagues in an Academic Medicine paper online today (Oct. 21).

The researchers emphasize the importance of educating doctors-to-be and practicing physicians, as well as other health care providers, in health systems science moving forward.

"We are shifting from looking at an acute episode to looking at the whole, and helping the patient to live a better life," said Gonzalo.

Robin D. Wittenstein, chief operating officer of the Penn State Hershey Health System and assistant professor of public health sciences, and Terry Wolpaw, vice dean of educational affairs and professor of medicine, are the co-principal investigators who obtained the funding for this project. Gonzalo; Wittenstein; T. Wolpaw; Paul Haidet, professor of medicine, humanities and public health sciences and director of medical education research; Klara K. Papp, adjunct professor of medicine; Daniel R. Wolpaw, professor of medicine and humanities and director of the Kienle Center for Humanistic Medicine; and Eileen Moser, associate professor of medicine and associate dean for medical education, all at the Penn State College of Medicine, collaborated on this work.

The American Medical Association supported this research as part of the Accelerating Change in Medical Education Initiative.

Pendidikankedokteran.net @2014