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.

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

New Drug Combination Treats Hepatitis C Patients Also Infected with HIV

Novel treatment has 97 percent success rate in co-infected patients —

Roughly 20 to 30 percent of patients with hepatitis C virus (HCV) are also infected with human immunodeficiency virus type 1 (HIV). Both blood-borne viruses share the same modes of transmission, but many HCV medications currently have significant limitations due to adverse interactions with HIV treatments. Researchers at University of California, San Diego School of Medicine report a new combination that effectively treats HCV in patients co-infected with HIV. … Read the full story from the UC San Diego News Center


David L. Wyles, MD, is lead author of the New England Journal of Medicine article that reports the results of the multi-center study. Dr. Wyles is associate professor of clinical medicine in the Division of Infectious Diseases.

Read the article online:

Wyles D.L., Ruane P.J., Sulkowski M.S., et al. Daclatasvir plus Sofosbuvir for HCV in Patients Coinfected with HIV-1. New England Journal of Medicine July 21, 2015, 10.1056/NEJMoa1503153.  Free full text

Drs. Joachim Ix, Davey Smith Elected to American Society for Clinical Investigation

Two Department of Medicine physician-scientists have been elected to the American Society for Clinical Investigation (ASCI) this year.

Dr. Joachim Ix

Dr. Joachim Ix

Joachim H. Ix, MD, MAS, FASN, a nephrologist and epidemiologist, is professor and chief of the Division of Nephrology-Hypertension. He holds a secondary appointment in the Division of Preventive Medicine, Department of Family and Preventive Medicine.

Dr. Davey Smith

Dr. Davey Smith

Translational research virologist Davey M. Smith, MD, MAS, professor of medicine in the Division of Infectious Diseases, directs the Center for AIDS Research Translational Virology Core and is medical director of the Early Intervention Program at the UC San Diego Antiviral Research Center.

ASCI membership is a distinction that recognizes the nation’s most outstanding physician-scientists.

Dr. Jamila Stockman to Receive Linda Saltzman New Investigator Award

Dr. Jamila Stockman

Dr. Jamila Stockman

Jamila Stockman, PhD, MPH, has been selected to receive the Linda Saltzman New Investigator Award, which recognizes a single outstanding new investigator in the field of gender-based violence and health.

Dr. Stockman, an infectious disease epidemiologist, is assistant professor in the Division of Global Public Health. She focuses her work on intimate partner violence (IPV) and substance abuse among low-income, underserved, vulnerable women.


Read the UC San Diego Newsroom press release


Said Dr. Steffanie Strathdee, chief of the Division of Global Public Health, “This is, without question, the most prestigious scholarly award in this field of study. Dr. Stockman’s selection indicates that she, at a very early stage in her career, is recognized as a national leader in this area.

“It is a true mark of excellence for the Division of Global Public Health, the Department of Medicine and the Center on Gender Equity and Health at UC San Diego to include Dr. Stockman among our faculty,” she said.

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

Gender-based violence is increasingly recognized as central to health and development globally, Strathdee said.

Dr. Stockman holds a PhD in Epidemiology with a focus on infectious diseases from the Johns Hopkins Bloomberg School of Public Health and a Master’s degree in public health from the George Washington University School of Public Health and Health Services. She is an alumna of the UC San Diego National Center of Leadership in Academic Medicine.

She currently holds a UC San Diego Clinical and Translational Research Institute Academic-Community Partnership Pilot Grant for her project, “The Role of Peer Navigators and Social Support in the HIV Care Continuum: Perceptions of HIV-Positive Women.”

For the Linda Saltzman New Investigator Award, the Centers for Disease Control’s National Center for Injury Prevention and Control solicits nominations from senior investigators in the field and convenes a committee of experts to select an outstanding individual to receive this national award once every two years.  Candidates for the award have 2-10 years of experience in their field.

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

Hannah Carter Receives NIH Early Independence Award

CTRI Helps Launch Career of Bioengineer Hannah Carter

November 22, 2013 – With support from UC San Diego’s Clinical and Translational Research Institute (CTRI), bioengineer Hannah Carter, PhD, received the highly prestigious NIH Early Independence Award and recently began began her transition to a junior faculty position at UC San Diego.

Presently she is acquiring a research team and computational resources to delve into her project: Network approaches to identify cancer drivers from high-dimensional tumor data. … Read the full story from CTRI News & Events


Hannah Carter, PhDHannah Carter, PhD, is assistant professor of medicine in the Division of Medical Genetics. Her project is Network Approaches to Identify Cancer Drivers from High-Dimensional Tumor Data.

She is now recruiting postdoctoral fellows for her project, which is funded for five years.

Carter Laboratory website

 

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.