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.

Remote Italian Village Could Harbor Secrets of Healthy Aging

Researchers will examine 300 Italian residents, all over 100 years old —

The average life expectancy in the United States is approximately 78 years old. Americans live longer, with better diets and improved health care, than ever before, but only 0.02 percent will hit the century mark.

To understand how people can live longer throughout the world, researchers at University of California, San Diego School of Medicine have teamed up with colleagues at University of Rome La Sapienza to study a group of 300 citizens, all over 100 years old, living in a remote Italian village nestled between the ocean and mountains on the country’s coast.

“We are the first group of researchers to be given permission to study this population in Acciaroli, Italy,” said Alan Maisel, MD … Read the Full Story from the UC San Diego Newsroom

Altman Clinical and Translational Research Building Makes Its Debut

New structure will be campus hub for advancing basic science to clinical applications —

Rising above Interstate 5 on the east campus of UC San Diego, the Altman Clinical and Translational Research Institute Building (ACTRI) officially opened its doors Friday in a ribbon-cutting ceremony under blue skies.

The new seven-story building of steel, glass and grooved concrete is home to the Clinical and Translational Research Institute (CTRI) at UC San Diego, established in 2010 as part of a national consortium of 60 medical research institutions created to energize bench-to-bedside efforts. … Read the Full Story from the UC San Diego Newsroom

Forty-One Department of Medicine Physicians Named on San Diego’s 2015 “Top Doctors” List

This year’s San Diego Magazine/San Diego County Medical Society Top Doctors list includes 41 Department of Medicine faculty clinicians. View photo gallery

Dietary Trans Fat Linked to Worse Memory

Higher consumption of dietary trans fatty acids (dTFA), commonly used in processed foods to improve taste, texture and durability, has been linked to worsened memory function in men 45 years old and younger, according to a University of California, San Diego School of Medicine study published online on June 17 in PLOS ONE. …Read the full story from the UC San Diego Newsroom

Principal investigator of the study is Beatrice A. Golomb, MD, PhD, professor in the Department of Medicine.

Medicine 401 Teaching Award Winners Announced

The winners of the 2015 Medicine 401 Teaching Awards were announced at an awards ceremony on May 27. Granted by the third-year medical students each year, the awards go to residents and attending physicians for their excellence in teaching on the wards at the Veterans Administration San Diego Healthcare System and the UC San Diego Medical Center in Hillcrest.

The winners:

VA Wards Resident Award: Dr. Tyler Woodell
Hillcrest Wards Resident Award: Dr. Michelle Pearlman

VA Wards Attending Award: Dr. Mara Zulauf
Hillcrest Wards Attending Award: Dr. Darcy Wooten

“There were many kind words of praise and admiration in the comments from the students who worked with Drs. Pearlman and Woodell,” said residency program director Simerjot Jassal, MD. “Congratulations to these outstanding doctors!”

The medical students’ comments included the following.

Dr. Michelle Pearlman

Dr. Michelle Pearlman

Of Michelle Pearlman, MD: … Really focused on teaching … worked hard during the rotation to make sure we were achieving our own goals and learning as much as possible … gave excellent feedback … made great teaching points during rounds … great example of professionalism … will make an excellent teacher … great role model … clear and detailed expectations … we knew exactly what to work on and how to succeed … one of the best residents with whom I have worked … gave frequent feedback enabling me to improve daily … strong leadership skills, a positive attitude, and a great work ethic … will make an amazing GI fellow and attending.

Dr. Pearlman has matched to a fellowship program in gastroenterology at University of Texas Southwestern Medical Center in Dallas.

Dr. Tyler Woodell

Dr. Tyler Woodell

Of Tyler Woodell, MD: Always made it a priority to have a teaching point every day … always willing to make sure all of our questions were answered and that we were engaged in patient care … went out of his way to make sure we had a good learning experience … an exceptional model physician who I would recommend to any student as a preceptor and any patient as a doctor … focused on making sure that we learned as much as possible … carved out time to talk through our assessment and plans with us … took time on rounds to talk through key issues with us …both a fantastic role model for compassionate patient care and bedside manner as well as an engaging teacher … clearly loved to teach … not only an outstanding teacher, but also very compassionate with patients.

Dr. Woodell has matched to a fellowship program in nephrology at Oregon Health & Science University.

Researchers Boost Body’s Inflammation-Reduction Mechanism to Combat Obesity-Fueled Disease

Researchers at University of California, San Diego School of Medicine and University College Dublin (UCD) have found that augmenting a naturally occurring molecule in the body can help protect against obesity-related diseases by reducing inflammation in the fat tissues. The study, published June 4 in the journal Cell Metabolism, focused on liver and kidney diseases, but the researchers believe it could lead to a new therapeutic approach for a variety of obesity-fueled conditions.

“This is a new way of reducing inflammation and protecting organs, using a compound that’s already produced by the body,” said co-senior author Kumar Sharma, MD, a professor of medicine and director of the Center for Renal Translational Medicine at UC San Diego School of Medicine. “Essentially, we’re boosting the body’s natural response for reducing inflammation and showing the benefit in obesity-driven diseases.” … Read the full story from the UC San Diego Newsroom

UC San Diego Health System, Scripps Health Partner in Hospice Care, Training and Research

UC San Diego Health System and Scripps Health are partnering to provide improved continuity of patient care, fellowship training and research in hospice and palliative medicine. Under a new five-year agreement, Scripps will work with UC San Diego to provide outpatient and inpatient hospice care for UC San Diego patients, allowing UC San Diego physicians to better coordinate post-acute care for patients with chronic illness. The joint fellowship program is the only physician training program of its kind in San Diego County …

… The hospice and palliative medicine training program is an extension of a fellowship that was previously offered through San Diego Hospice. Gary Buckholz, MD, UC San Diego, and Holly Yang, MD, Scripps Health, co-direct the joint fellowship program, which will be housed at UC San Diego beginning in July 2015. The program will engage faculty from both organizations, exemplifying the teamwork required to meet the physical, emotional, social and spiritual needs of palliative care and hospice patients and their families. … Read the full story from the UC San Diego Newsroom


Preventing Drug-Abuse-Related HIV in Tijuana by Educating Police

Dr. Steffanie Strathdee

Dr. Steffanie Strathdee

The NIH Record recently highlighted Dr. Steffanie Strathdee, Dr. Leo Beletsky, and their binational team for their efforts to prevent drug abuse-related HIV in Tijuana, Mexico, by changing the knowledge, attitudes and behaviors of the Tijuana police.

With support from the Open Society Institute and the UC San Diego Center for AIDS Research, the pilot phase of the project taught Tijuana police instructors how to prevent needle stick injuries by proper syringe handling, which advises them against breaking needles they apprehend from drug users. The training program is now being adopted by Tijuana’s police academy, whereby the police trainers will be teaching the program to their colleagues.

“We believe this program is the best way to reduce needle sharing among people who inject drugs, which is driven by policing practices,” Strathdee said.

The program will soon be tested in a newly funded grant by the National Institute on Drug Abuse, Proyecto ESCUDO (Project Shield): Harmonizing Law Enforcement and HIV Prevention through a Police Education Program.

Steffanie Strathdee, PhD, is Associate Dean of Global Health Sciences and Harold Simon Professor and Chief of the Division of Global Public Health and Director of the Global Health Initiative.

Strathdee co-leads Proyecto ESCUDO with Leo Beletsky, JD, MPH, adjunct assistant professor in the Division of Global Public Health at UC San Diego and assistant professor of law and health sciences at the Northeastern University School of Law.

UC San Diego School of Medicine Named One of Nation’s Top Residency Programs

Recognized by physicians for training leadership in Doximity report — 

UC San Diego School of Medicine was today named one of the nation’s top residency training programs in 10 specialties by Doximity. The Doximity report included more than 50,000 peer nominations from board-certified US physicians, and evaluated 3,691 residency training programs across 20 specialties.

“One of the most important functions of our academic health system is residency training for the next generation of physicians. The outstanding training of our residents guarantees great future physicians for San Diego and beyond,” said David A. Brenner, MD, vice chancellor for Health Sciences and dean of the UC San Diego School of Medicine.

UC San Diego School of Medicine placed in the top 10 for residency training in the West in the following specialties: internal medicine, anesthesiology, dermatology, obstetrics & gynecology, orthopaedic surgery, otolaryngology, pediatrics, psychiatry, radiology (diagnostic) and surgery. More than 900 post-graduate trainees, including interns, residents and fellows, train at UC San Diego each year…. Read the full story from the UC San Diego Newsroom


Dr. Simerjot Jassal

Dr. Simerjot Jassal

Simerjot Jassal, MD, MAS, FACP, pictured at left, directs the Internal Medicine Residency Training Program and its Preliminary Medicine track.

Dr. Jassal is clinical professor in the Department of Medicine.

Dr. Mark Ginsberg

Dr. Mark Ginsberg

Mark Ginsberg, MD, professor of medicine, directs the program’s research track, the Physician-Scientist Training Program.

In other Department of Medicine-related training, UC San Diego School of Medicine placed in the top 10 for residency training in anesthesiology, dermatology and pediatrics.

Dr. Jassal co-directs a new Combined Medicine-Anesthesia program track of the Internal Medicine Residency Training Program with Daniel Lee, MD, PhD, associate clinical professor of anesthesiology and pediatrics.

Dr. Lori Wan

Dr. Lori Wan

A Combined Medicine-Pediatrics Training Program track of the internal medicine program is directed by Lori Wan, MD, clinical professor of medicine.

Also rated in the top 10 is UC San Diego’s Dermatology Residency Training Program, directed by dermatology division chief Richard L. Gallo, MD, PhD, and Casey Carlos, MD, PhD, pictured below.

Dr. Gallo is professor of medicine and pediatrics and Dr. Carlos is assistant clinical professor in the Division of Dermatology in the Department of Medicine.

Dr. Richard Gallo

Dr. Richard Gallo

Casey Carlos, MD, PhD

Dr. Casey Carlos