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.

In Memoriam: Timothy D. Bigby, MD

An announcement from Wolfgang H. Dillmann, MD, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine

Dr. Timothy Bigby

Dr. Timothy Bigby

It is with great sadness that we announce that Dr. Timothy D. Bigby passed away the morning of April 4, 2016, following a long illness.

Dr. Bigby joined UC San Diego and the Veterans Affairs San Diego Healthcare System in 1989 as Assistant Professor of Medicine and Staff Physician, retiring last month after serving as Chief of the Pulmonary and Critical Care Section at VASDHS and Professor of Clinical Medicine in the Division of Pulmonary, Critical Care and Sleep Medicine at UC San Diego.

As a staff physician and scientist, he educated and mentored countless medical students, undergraduate trainees, house staff, fellows, and junior faculty while attending to patients in the Pulmonary Consult Service and Medical Intensive Care Unit. In addition to his scientific discoveries in the areas of innate immunity and signaling; asthma and airway biology; and, most recently, basic mechanisms in pulmonary hypertension, he served in various roles that promoted the education of physicians and scientists, including service as Co-Director of the Physician-Scientist Training Pathway of the Department of Medicine at UC San Diego, faculty mentor in the Biomedical Sciences Graduate Program at UC San Diego and reviewer and chairman for multiple scientific granting agencies, study sections, and journals. He received numerous awards for both his teaching and his investigative efforts. He also served as an Associate Editor for the American Journal of Physiology-Cell Physiology and as a reviewer for over 16 journals as well as the National Institutes of Health and the US Department of Veterans Affairs.

Dr. Bigby received his medical training at Baylor College of Medicine, his training in internal medicine at the University of Colorado, and his training in pulmonary and critical care at the University of Colorado and the University of California, San Francisco. He also had clinical expertise in infectious disease medicine, and had received former fellowship training in infectious diseases.

He served patients, students, and trainees tirelessly. He will be greatly appreciated and remembered by many, and his leadership, his smiling face, and his wise counsel will be missed.

A celebration of life is planned and will be announced in the near future. In Tim’s honor, we have initiated the Tim Bigby VA Research Fund – please consider contributing in lieu of flowers.

Donors may send gifts in Dr. Bigby’s memory in two ways:

  1.  Send a check to the attention of:

Brian Zumbano
Health Sciences Advancement
9500 Gilman Drive, #0937
La Jolla, CA 92093-0937

Please make your check out to UC San Diego Foundation, and write in the memo section: For the “Tim Bigby, MD, Pulmonary Research Fund” (F-2719) in memory of Dr. Bigby.

2.  Make a gift online. Visit:

https://giveto.ucsd.edu/

In the “Explore more giving options” field, search for “Bigby.” You’ll be taken to a page that contains the online giving form for the Tim Bigby Pulmonary Research Fund (2719).

At the bottom of the form, please make sure to indicate that your gift is in honor of Dr. Bigby.

Short Overnight Fasting Linked to Increased Risk of Breast Cancer Recurrence

Researchers suggest increasing duration of nightly fasting may improve prognosis —

In patients with breast cancer, a short overnight fast of less than 13 hours was associated with a statistically significant, 36 percent higher risk of breast cancer recurrence and a non-significant, 21 percent higher probability of death from the disease compared to patients who fasted 13 or more hours per night, report University of California, San Diego School of Medicine researchers.

The study, publishing online in the Journal of the American Medical Association Oncology on March 31 … Read the Full Story from the UC San Diego Newsroom

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

Dr. Kim Kerr Named Attending Physician of the Year at UC San Diego Health

Dr. Kim KerrDr. Kim Kerr, Clinical Professor of Medicine in the Division of Pulmonary, Critical Care and Sleep Medicine and Medical Director of the Thornton Intensive Care Unit, has been selected as the Attending Physician of the Year for 2015-2016 at UC San Diego Health.

On National Doctors Day each year, UC San Diego Health honors its physicians for their commitment and service in health care. The Attending Physician of the Year award recognizes an attending faculty member for particular excellence in the many facets of patient care and clinical teaching.

Kim M. Kerr, MD, attends on the pulmonary thromboendarterectomy (PTE), ICU and pulmonary consult services. Her chief clinical and research interests are in chronic thromboembolic pulmonary hypertension and critical care.

Dr. Kerr has been named on the San Diego’s Top Doctors list every year for the past seven years.

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

Countdown To Twin Astronaut’s Return – UC San Diego Readies Next Steps in Landmark Study

Study of identical twin astronauts advances NASA’s preparations for mission to Mars —

When astronaut Scott Kelly returns to Earth on March 1, half of NASA’s first-of-its-kind study of twin astronauts and long duration space flight, researchers at University of California, San Diego School of Medicine and elsewhere will launch the mission’s next phase.

UC San Diego School of Medicine researchers are part of a national collaboration between NASA’s Human Research Program, the National Space Biomedical Research Institute and 10 investigative teams around the country, all seeking to better understand the effects of extended space travel by analyzing blood, urine and other samples from identical twin astronauts, Scott and Mark Kelly. … Read the Full Story from the UC San Diego Newsroom


Kumar Sharma, MD, FAHA

Kumar Sharma, MD, FAHA

Kumar Sharma, MD, Professor of Medicine in the Division of Nephrology and Hypertension, is a collaborator in the NASA twins study.

Dr. Sharma is Director of the Institute of Metabolomic Medicine at UC San Diego School of Medicine.

Identical Twin Astronauts Mark and Scott Kelly. Credit: NASA.

Identical Twin Astronauts Mark and Scott Kelly.
Credit: NASA.

E-Cigarette Vapor Boosts Superbugs and Dampens Immune System

In lab and mouse experiments, exposure promotes bacterial virulence and inflammation, while blocking the body’s ability to fight infection —

Researchers at the University of California, San Diego School of Medicine and Veterans Affairs San Diego Healthcare System report data suggesting that e-cigarettes are toxic to human airway cells, suppress immune defenses and alter inflammation, while at the same time boosting bacterial virulence. The mouse study is published January 25 by the Journal of Molecular Medicine.

“This study shows that e-cigarette vapor is not benign — at high doses it can directly kill lung cells, which is frightening,” said senior author Laura E. Crotty Alexander, MD, … Read the full story from the UC San Diego Newsroom


Laura E. Crotty Alexander, MD

Laura E. Crotty Alexander, MD

Senior author Laura E. Crotty Alexander, MD, is Assistant Professor of Medicine in the Division of Pulmonary, Critical Care & Sleep Medicine in the Department of Medicine and staff physician at the Veterans Affairs San Diego Healthcare System.

The article reporting the findings was published first online on January 25, 2016.  Article abstract  |  Full text of article (UC San Diego Only)

UC San Diego Designated an Alpha-1 Foundation Clinical Resource Center

Alpha 1-antitrypsin deficiency is a little-known genetic cause of pulmonary disease. The Alpha-1 Foundation has named UC San Diego an Alpha-1 Foundation Clinical Resource Center, a designation that will channel more funding to UC San Diego pulmonary disease researchers for translational research and clinical trials to identify new treatments.

 

$5 Million ResMed Gift Supports Sleep Medicine at UC San Diego

October 29, 2015

The University of California, San Diego today announced a $5 million gift from locally based medical device company, ResMed Inc., to support sleep medicine research and care at the UC San Diego School of Medicine. The donation was made to the university in honor of ResMed’s founder and chairman of the board, Peter C. Farrell, PhD, DSc. ResMed is the global leader in pioneering new and innovative solutions for the diagnosis, treatment and management of sleep-disordered breathing, chronic obstructive pulmonary disease (COPD), and other key chronic diseases.

The funding, totaling $5 million, will establish the Peter C. Farrell Sleep Center of Excellence, in addition to the Peter C. Farrell Presidential Chair in Pulmonary Medicine. ResMed’s donation to establish the endowed chair was matched with an additional $500,000 from the University of California as part of the UC system’s Presidential Match for Endowed Chairs. … Read the full story from the UC San Diego Newsroom


Atul Malhotra, MDAtul Malhotra, MD, pictured at left, is professor and chair of the Division of Pulmonary and Critical Care Medicine and Director of Sleep Medicine at UC San Diego.