2016 Update: A Lasting Solution for Healthcare in Mozambique

Mozambique highlighted on a map of Africa There is a critical shortage of practicing doctors and medical educators in Mozambique, where the life expectancy is less than 42 years and the rate of HIV infection in adults is 16%. UC San Diego is teaming with the nation’s flagship medical school to create a long-term solution.

Mozambique’s Universidade Eduardo Mondlane (UEM) and UCSD have won a five-year, $12.5-million award from the U.S. Medical Education Partnership Initiative (MEPI). The project will strengthen the nation’s medical education system by building infrastructure in several ways.


“We hope this will be a demonstration project for the rest of Africa.”
— Dr. Robert Schooley


Dr. Emilia Virginia Noormahomed, a co-investigator on the UCSD-UEM MEPI project.UEM’s principal investigator is Emilia Virginia Noormahomed, MD, PhD, a former dean of the UEM School of Medicine. Dr. Noormahomed (pictured at left) is now Assistant Professor of Parasitology at UEM and Assistant Professor of Medicine at UC San Diego.

Sam Patel, MD, Professor of Medicine at UEM and UC San Diego, is a co-investigator. In the photo below, he is pictured on the right.

View photo captions and credits

Dr. Bill Detmer, at left, demonstrates iPad mobile digital device preloaded with medical programs for doctors’ use in the hospital. Dr. Manuel Joaquim Tomás is at center and Dr. Sam Patel at right. Sam Patel, M.D., co-investigator on the MEPI project, is Professor of Medicine at UEM and UCSD. Bill Detmer, M.D., M.Sc., a MEPI project consultant, is Assistant Adjunct Professor of Clinical Informatics at the University of Virginia and President and Chief Executive Officer of Unbound Medicine.

MEPI is a joint initiative of the National Institutes of Health and the President’s Emergency Plan for AIDS Relief (PEPFAR). Under the MEPI program, UEM receives the bulk of the funding and uses it to build capacity in medical training, research, and technology.

A smaller amount of funding comes directly to UC San Diego, supporting time and travel for the partners and mentors who will help UEM meet its goals.

M. Wilson Tilghman, M.D., UCSD’s on-site faculty member in Mozambique, consults with a UEM internal medicine resident at a patient’s bedside. Instituting the use of wirelessly-accessed medical reference material in the hospital is one of the UCSD-UEM project goals.“This is an experiment in medical education for UEM and for the U.S. government,” said Robert “Chip” Schooley, MD, who is coordinating the UC San Diego side of the project. “It puts the funding into the hands of the African universities and allows them to invest it in ways that are beneficial to them.”

Dr. Schooley is Professor and Academic Affairs Vice Chair in the Department of Medicine and Chief of the Division of Infectious Diseases.

“I’m hopeful this will become a model for other kinds of aid,” he said.

Dr. Schooley and colleague Constance Benson, MD, have long experience in partnering with Mozambique and other African nations, and they have collaborated with Dr. Noormahomed in research projects for several years. Dr. Benson is Professor of Medicine, Director of the UC San Diego Antiviral Research Center, and Director of the Fellowship Program in Infectious Diseases.

The UEM-UCSD MEPI project expands some of the educational efforts that have been going on since July 2009 in the Internal Medicine Residency Program’s Global Medicine elective.

UC San Diego’s visiting faculty and residents have helped UEM adopt academic medical practices such as morning report and teaching conferences that strengthen the educational program.

MEPI biomedical informatics team members at October conference at UEM in Maputo.

MEPI biomedical informatics team members at October conference at UEM in Maputo.

The MEPI partnership relies heavily on biomedical informatics to accomplish its goals. This component of the program is led by Lucila Ohno-Machado, MD, PhD, Professor of Medicine and Chief of UC San Diego’s Division of Biomedical Informatics. The division will provide expertise for the partnership’s information technology projects.

Dr. Kathy Promer, a 2013 graduate of the UC San Diego Internal Medicine Program, is the current infectious diseases fellow at UC San Diego on rotation at UEM’s Maputo Central Hospital. In the photo below, she is standing, second from the right.

Dr. Kathy Promer (standing, second from the right), 2013 Graduate of the UCSD Internal Medicine Program and current infectious diseases fellow at UCSD on rotation at UEM’s Maputo Central Hospital.

Smartphones and iPad mobile digital devices have been deployed on the wards at Maputo Central Hospital, UEM’s primary teaching hospital and the only tertiary care center in Mozambique. With these devices, the Mozambican doctors are able for the first time to consult online medical literature at a patient’s bedside. Soon they will have immediate access to data generated by the hospital’s clinical laboratories.

“These efforts really have changed the character of the residency program at Maputo Central Hospital,” said Dr. Schooley.

Through training and partnership with UC San Diego, UEM will also increase its capacity to do operational, epidemiological, translational and clinical research. Another program goal calls for UEM to set up a biomedical informatics infrastructure and connect with SEACOM, the new fiber optic broadband internet service in South and East Africa.

Students in UEM medical school class.UEM will also take steps to enhance its support of two new medical schools recently established by the Mozambican government in Nampula and Tete. These two new medical schools were launched in the past 3 years to address the profound shortage of physicians in the country.

Another key UC San Diego figure in the project is Stephen Bickler, MD, who will work to improve the nation’s surgical capacity in rural areas via a linked MEPI project, “UEM-UCSD Surgery Partnership.” Dr. Bickler is Associate Professor of Surgery and Pediatrics.

A number of other UC San Diego faculty members will contribute to the MEPI effort as well.

Medical school class   UCSD internal medicine resident Dr. Bethany Karl

Above left, a medical school class at Universidade Eduardo Mondlane. Right, Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital. Dr. Karl graduated from the UC San Diego Internal Medicine Program in 2010 and is currently a nephrology attending. Photo courtesy of Robert T. Schooley, MD

Project leaders expect to double the number of graduating doctors in Mozambique in the next 10 years. They also hope to inspire more doctors to devote their careers to medical education.

With a greater number of highly-trained doctors and a better infrastructure to support them, Mozambique will increase its capacity to deliver health care to its citizens and to fill the faculties of two new medical schools in Nampula and Tete.

The doctors training today in Mozambique will be the specialists, medical school faculty members, and government Ministry of Health policymakers of the future.

“We hope this will be a demonstration project for the rest of Africa,” Dr. Schooley said.

Read the UC San Diego News press release about our MEPI project.

Read about the project in “The Great Beyond,” Nature magazine’s blog
for breaking news in the sciences.


Photo Captions and Credits:

Dr. Emilia Virginia Noormahomed, co-principal investigator on the UCSD-UEM MEPI project.Dr. Emilia Virginia Noormahomed, co-principal investigator on the UC San Diego-UEM MEPI project. Photo courtesy of William M. Detmer, MD, MSc.

Drs. Detmer, Tomás, and PatelDr. Bill Detmer, left, demonstrates iPad mobile digital device preloaded with medical programs for doctors’ use in the hospital. Dr. Manuel Joaquim Tomás is at center and Dr. Sam Patel at right. Sam Patel, MD, co-investigator on the MEPI project, is Professor of Medicine at UEM and UC San Diego. William M. Detmer, MD, MSc, a MEPI project consultant, is Assistant Adjunct Professor of Clinical Informatics at the University of Virginia and President and Chief Executive Officer of Unbound Medicine. Photo courtesy of Dr. Detmer.

Dr. Tilghman and Mozambican residentM. Wilson Tilghman, MD, UC San Diego’s on-site faculty member in Mozambique, consults with a UEM internal medicine resident at a patient’s bedside. Instituting the use of wirelessly-accessed medical reference material in the hospital is one of the UC San Diego-UEM project goals. Photo courtesy of Robert T. Schooley, MD.

MEPI biomedical informatics team members at October conference at UEM in Maputo. MEPI biomedical informatics team members at October conference at UEM in Maputo. From left: Lucila Ohno-Machado, MD, PhD; Eli Aronoff-Spencer, MD, senior postdoctoral fellow in infectious diseases at UC San Diego; Eng. David Bila, Network Director for the Informatics Center at UEM; Heimar de Fátima Marin, RN, PhD, Professor of Health Informatics at Universidade Federal de São Paulo; and Eng. Francisco Mabila, Director of the Informatics Center at UEM. Photo courtesy of William M. Detmer, MD, MSc.

Dr. Kathy Promer (standing, second from the right), is a 2013 graduate of the UC San Diego Internal Medicine Program and is the current infectious diseases fellow at UC San Diego on rotation at UEM’s Maputo Central Hospital.

Students in a medical school class at UEM.Students in a medical school class at UEM. Photo courtesy of William M. Detmer, MD, MSc.

A medical school class at UEM.A medical school class at UEM. Photo courtesy of William M. Detmer, MD, MSc.

UCSD internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital.UC San Diego internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital. Photo courtesy of Robert T. Schooley, MD.

Trademark Credit Notices:

iPad is a trademark of Apple Inc., registered in the U.S. and other countries.

Thomas Savides, MD, Named Chief Experience Officer for UC San Diego Health System

Thomas Savides, MD, has been named as the first Chief Experience Officer at UC San Diego Health System. In the newly created role, Savides will be responsible for the strategy, leadership and implementation of the plan to improve the total health care experience of patients, families, providers and staff. … Read the full story from the UC San Diego Newsroom

San Diego’s 2014 Top Doctors List Includes 44 from Department of Medicine

Forty-four physicians from the Department of Medicine are among over 100 UC San Diego Health System doctors named to the 2014 San Diego Top Doctors list. See the list for UC San Diego Health System.

Not present on that list are two additional internal medicine physicians who practice at the VA San Diego Healthcare System: Charles Goldberg, MD, and Simerjot Jassal, MD. Dr. Jassal directs the Internal Medicine Residency Program.

The Top Doctors list comes from the annual “Physicians of Exceptional Excellence” survey from the San Diego County Medical Society and San Diego Magazine.

Read the UC San Diego Health System press release

UC San Diego Health System Retains #1 Ranking

US News & World Report Cites Region’s Only Academic Health System Among Nation’s Best 

UC San Diego Health System remains among the nation’s best, according to the U.S. News & World Report’s 2014-15 issue of “America’s Best Hospitals,” released this week. The magazine’s widely cited findings again placed UC San Diego Health System first in the San Diego metropolitan area and fifth in California, with national rankings in 11 specialties, up from 10 last year. This is comparable to the country’s most prestigious health care institutions.  Read the full story from the UCSD Newsroom


Sulpizio Cardiovascular CenterUC San Diego Health System is nationally ranked in eleven medical specialties, including seven in the Department of Medicine:  Cancer, Cardiology, Endocrinology & Diabetes, Gastroenterology, Geriatrics, Nephrology, Pulmonology and Rheumatology.

Molecular Tumor Board Helps in Advanced Cancer Cases

With accelerating development of personalized cancer treatments matched to a patient’s DNA sequencing, proponents say frontline physicians increasingly need help to maneuver through the complex genomic landscape to find the most effective, individualized therapy.

In a paper published in the May 5 online issue of The Oncologist, researchers at the University of California, San Diego School of Medicine and Moores Cancer Center detail their experience evaluating 34 patients between December 2012 and June 2013 using a molecular tumor board – a new type of advisory group comprised of multidisciplinary experts, including those in the fields of tumor genetics, basic science and bioinformatics. … Read the full story from the UC San Diego Newsroom

UC San Diego Health System Excels in Patient Safety

Awarded an “A” in Spring 2014 Hospital Safety Score

Designed to rate how well hospitals protect patients from accidents, errors, injuries and infections, the latest Hospital Safety Score honored UC San Diego Health System with an “A” – its top grade in patient safety. The Hospital Safety Score is compiled under the guidance of the nation’s leading experts on patient safety and is administered by The Leapfrog Group (Leapfrog), an independent industry watchdog. …Read the full story from the UC San Diego Newsroom

U.S. News & World Report Names UC San Diego Graduate Programs Among Nation’s Best

School of Medicine and Jacobs School of Engineering both ranked at 14. Other top 20 programs include biological sciences (14), computer science (15), earth sciences (16), and physics (16)

The 2015 edition of the U.S. News & World Report’s Best Graduate Schools guidebook, released today, highly ranks the University of California, San Diego’s professional schools in engineering and medicine, as well as its academic Ph.D. programs in the sciences. … Read the full story from the UC San Diego News Center

UC San Diego-Human Longevity Inc. Agreement Seeks to Accelerate Medical Science

Thousands of patient genomes expected to fuel diverse medical research, beginning with cancer

The new collaborative research agreement between Human Longevity Inc. (HLI) and the University of California, San Diego, announced today, represents a significant and necessary step in efforts to research and translate the potential of the human genome into novel and real treatments and therapies able to change and improve the human condition.

“This agreement brings together the resources of two entities that, in combination, may ultimately help improve countless lives,” said David A. Brenner, MD, vice chancellor of health sciences at UC San Diego and dean of the UC San Diego School of Medicine. “HLI aims to bring leading-edge thinking in genomics technologies. UC San Diego boasts some of the world’s finest researchers and physicians working at places like the Moores Cancer Center. Together, we will collaborate to marshal the people, the tools and the resources to really make a difference in human health.” … Read the full story from the UC San Diego News Center

High Rankings for Internal Medicine Specialties in 2013-2014 “America’s Best Hospitals” Report

Internal medicine subspecialties received high rankings and played a large part in UC San Diego Health System’s excellent showing in the U.S. News & World Report “America’s Best Hospitals 2013-2014” guide released July 16.

Clinical efforts of Department of Medicine divisions are either partly or completely responsible for 7 of the 10 UC San Diego Health System adult specialties that ranked in the nation’s top 50 this year and 1 of the 4 ranked as high performing:

In addition, Rheumatology is ranked as high performing once again (Division of Rheumatology, Allergy & Immunology).

Last year, three Department of Medicine specialties ranked in the nation’s top 50 and five were rated high performing.

Wolfgang H. Dillmann, MD“We can be very proud of achieving such a significant rise in our specialty rankings in one year,” said Wolfgang H. Dillmann, MD, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine.

In an announcement to the Department of Medicine faculty, he said, “Thank you for your hard work and your dedication in your patient care activities.

“Your efforts play a major part in distinguishing UC San Diego Health System as one of the finest hospitals in the country, and the top hospital in the San Diego metropolitan area.”

Details of the rankings for UC San Diego Health System are published online here. |  More about the methodology

Dr. David Brenner Speaking at Grand Rounds March 13

David A. Brenner, MD Speaking at Medicine Grand Rounds on March 13 is Dr. David A. Brenner, vice chancellor for health sciences, dean of the UCSD School of Medicine and professor of medicine in the Division of Gastroenterology.

A physician-scientist, Brenner is widely respected for his translational research in liver disease. He will speak at Grand Rounds on new approaches to therapy for fibrosis.

Brenner is a member of numerous honorific societies including the American Society of Clinical Investigation, the American College of Physicians and the Association of American Physicians, of which he is immediate Past President. Last year, he was elected to the Institute of Medicine.

UC San Diego press releases about his recent research:

Read Dr. Brenner’s School of Medicine Biography

About Medicine Grand Rounds

UCSD’s Medicine Grand Rounds is held weekly on Wednesday mornings, 7:30 – 8:30 a.m., in the Liebow Auditorium, second floor, Biomedical Sciences Building on the UCSD School of Medicine Campus. There is a hiatus in summer.

To see this year’s schedule and find video viewing information, visit the Medicine Grand Rounds page on the Department of Medicine website.