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:

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Internal Medicine Resident Drs. Noel Lee, Satya (Nanu) Das and Michele Pham Present Research at Medicine Grand Rounds

Three internal medicine residents who were among six winners at the First Annual Internal Medicine Residency Program Research Symposium on May 7 will present their research at Medicine Grand Rounds June 10:

Noel Lee, MD – The Prevalence of Coronary Artery-Pulmonary Artery Collaterals in Patients with Chronic Thromboembolic Pulmonary Hypertension

Satya (Nanu) Das, MD – The Role for Cell Free Circulating DNA in Detecting Secondary EGFR Mutations in Advanced Stage Non-Small Cell Lung Cancer Patients

Michele Pham, MD – Decreased BDNF in Aspirin Exacerbated Respiratory Disease

Dr. Tyler Woodell and Dr. Lawrence Ma Receive Arnold P. Gold Foundation’s Humanism and Excellence in Teaching Resident Awards

Dr. Tyler Woodell

Tyler Woodell, MD

Tyler Woodell, MD, left, a senior categorical internal medicine resident, and Lawrence Ma, MD, a fourth-year medicine-pediatrics resident, will receive the Arnold P. Gold Foundation’s Humanism and Excellence in Teaching Resident Award in a ceremony at the UC San Diego School of Medicine on May 15.

The award recognizes Dr. Woodell and Dr. Ma as role models for others in their compassion, dedication and humanism in their approach to patient care.

Dr. Lawrence Ma

Lawrence Ma, MD

“The Gold Humanism and Excellence in Teaching Resident Award is one of the greatest honors that can be bestowed upon a resident,” said internal medicine residency program director Dr. Simerjot Jassal. “Tyler is a beacon of professionalism. I think this is the most important quality a physician can possess.”

Simerjot K. Jassal, MD, MAS, FACP, is clinical professor in the Department of Medicine.

“This is a great honor that is given to only a handful of UC San Diego housestaff each year. Congratulations to both Lawrence and Tyler!” said Lori Wan, MD, director of the Combined Medicine/Pediatrics Residency Program. She is clinical professor of medicine and pediatrics.

Drs. Woodell and Ma were selected in a vote by third-year medical students and each is one of six recipients this year.

After graduating from the UC San Diego Internal Medicine Residency Training Program in June, Dr. Woodell will begin fellowship training in nephrology at Oregon Health and Science University.

Dr. Ma will start a fellowship in geriatrics at Stanford University in July, with the ultimate goal of practicing primary care across the age spectrum.

As award recipients, Dr. Woodell and Dr. Ma become lifetime members of the UC San Diego Gold Humanism Honor Society. One of their first actions as awardees is to speak to the rising third-year medical students at UC San Diego during Clinical Transition Week.

Kevin Shah, MD, Named 2015 House Officer of the Year

Dr. Kevin ShahSenior internal medicine resident Kevin Shah, MD, has been selected from all UC San Diego Health System house staff in all specialties as the 2015 House Officer of the Year. The honor was announced on March 30, National Doctor’s Day.

Also honored was Tyson Ikeda, MD, 2015 Physician of the Year. Dr. Ikeda is a Health Sciences clinical professor in the Department of Family Medicine and Public Health.

Read more about Kevin in the full story from the UC San Diego Health System Newsroom here.

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

 

 

 

Dr. Pradipta Ghosh Receives Clinical Research Mentorship Grant from Doris Duke Charitable Foundation

Dr. Pradipta Ghosh

Three years ago, Department of Medicine physician-scientist Dr. Pradipta Ghosh received a Doris Duke Charitable Foundation Clinical Scientist Development Award to support her in the transition from junior researcher to independent investigator.

The grant funded her research for three fruitful years as she moved from assistant to associate professor and landed a five-year R01 research grant from the National Cancer Institute.

Now, Ghosh has won DDCF funding again — this time a Clinical Research Mentorship Grant to support her in mentoring medical student Gary Ma in the project, “Molecular Rheostats in Type II Diabetes – Novel Therapeutic Targets for Insulin Resistance.”

The DDCF Clinical Research Mentorship program is a competitive grant program that supports the development of a mentoring relationship between a clinical scientist previously funded through the foundation and a medical student with an interest in becoming a future clinician investigator.

This DDCF program funded 10 mentor/mentee teams this year.

About Dr. Ghosh

Pradipta Ghosh, MD, MBBS, is associate professor of medicine in the Division of Gastroenterology. She is a graduate of the UC San Diego Internal Medicine Residency Training Program, the Gastroenterology Fellowship Training Program and the Department of Medicine Physician-Scientist Training Program.

In her laboratory, Ghosh investigates the cell biology of signal transduction to find new ways to understand and block the development and spread of cancer and other diseases. Her National Cancer Institute research grant supports the project, “Modulation of G Proteins by Growth Factors.”

Looking back at the development of her career, she cites two important mentors, Drs. Stuart Kornfeld and Marilyn Farquhar.

“Stuart Kornfeld and Marilyn Farquhar are spectacular examples of good mentors and what good mentoring involves,” she said. “Being accessible, empowering, ensuring the freedom to probe, to expand the horizon.”

Stuart Kornfeld, MD, is David C. and Betty Farrell Distinguished Professor of Medicine and Director of the Division of Hematology at Washington University in St. Louis, where he directs the Medical Scientist Training Program and co-directs the Physician-Scientist Training Program.

Marilyn Farquhar, PhD, is Distinguished Professor of Cellular and Molecular Medicine and Pathology at UC San Diego.

About Her Mentor/Mentee Research Project

Abstract of the Study, “Molecular Rheostats in Type II Diabetes – Novel Therapeutic Targets for Insulin Resistance.”

“The overall goal of the proposed research is to unravel the mechanisms by which [Gα-interacting, vesicle-associated protein] (GIV) maintains insulin sensitivity and how its phosphoinhibition generates Insulin resistance (IR). Insights gained will not only help determine whether GIV can serve as a therapeutic target and a marker for prognosticating response to therapy in patients with IR, but also help decipher, access, and manipulate the entire signaling network to restore physiologic insulin response.”

Drs. Philipp Wiesner, Benjamin Hulley Honored with 2013 Internal Medicine Residency Program Awards

Each year, the Internal Medicine Residency Program recognizes residents who embody the ideals of two highly esteemed faculty members, former Department of Medicine chair Dr. Ken Kaushansky, now at Stony Brook University, and the late Dr. Lee Rickman, associate clinical professor in the Division of Infectious Diseases, who died while training medical personnel in Lesotho in 2003.

Program director Elaine Muchmore, MD, presented the Kaushansky and Rickman awards on June 19 at the last session of Medicine Grand Rounds for academic year 2012-2013.

The awards followed Benjamin Hulley’s presentation, “Are Physicians Ethically Obligated to Utilize the Placebo Effect?”  |  Watch the video (UCSD only)

Kenneth Kaushansky, MD, MACP

Dr. Ken Kaushansky

Philipp Wiesner Receives Ken Kaushansky Award

Ken Kaushansky, MD, MACP, an esteemed physician-scientist, was Helen M. Ranney Distinguished Professor and chair of the Department of Medicine at UC San Diego from 2002 until 2010. He is now dean of the School of Medicine and senior vice president of Health Sciences at Stony Brook University in New York.

Seeking to enhance the training of general internists at UC San Diego, Kaushansky established the residency program’s 2-month dedicated elective research block. On that rotation, a resident selects a faculty mentor, conducts a research project and presents the results.

The elective has steadily gained in popularity, with about half the residents now participating annually.

This year, the program directors chose four residents to present their research projects at Medicine Grand Rounds and selected one of them to receive the Kaushansky Award.

Kaushansky_2013

Dr. Philipp Wiesner

The winner was second-year resident Philipp Wiesner, MD, who presented his research project, “Oxidized Phospholipids in Inflammation and Atherosclerosis,” at the May 15 session of Grand Rounds.  |  More about Wiesner’s research  |  Watch the video (UCSD only)

Wiesner, who plans to be an academic physician-scientist, has pursued research in atherosclerosis since he was in medical school.

In accepting the award, he said, “A young scientist can never do well without a nurturing environment. I had great mentors, Joe Witztum, Yury Miller and Sam Tsimikas.

“I also want to thank the residency program for giving me the great opportunity both to do research here and also start my residency and do my clinical training here.”

Benjamin Hulley Receives the Lee Rickman Humanism in Medicine Award

The Lee Rickman Humanism in Medicine Award is given each year to a resident whose work recalls the energy and devotion of Lee Rickman, MD, a UC San Diego residency program graduate and Department of Medicine faculty member who practiced infectious disease medicine with singular passion until his death in 2003.

Rickman was acknowledged as the hands-down winner in the number of teaching awards given to a Department of Medicine faculty member.

In introducing the award, Muchmore said, “Lee didn’t just delve into topics — a wide variety of topics — but then, with passion, he taught them. It was not a joke that if we had a sudden cancellation of a Grand Rounds speaker or a noon conference speaker, somebody would turn to Lee and say, ‘Could you substitute tomorrow?’ And he would say, ‘Of course.'”

Drs. Elaine Muchmore and Ben Hulley

Drs. Elaine Muchmore and Ben Hulley

“The Rickman Award is a very high honor in the residency program,” she said. “It gives me great pleasure to award it to Ben Hulley.”

Hulley is one of the five incoming chief medical residents for 2013-2014. He received his undergraduate degree in biology and economics from UC San Diego and his MD degree from the UC San Diego School of Medicine.

In his remarks, Hulley credited his father, also a physician, who had come from northern California to be present in the audience.

“Thanks to my Dad for being a great role model and helping me get this far,” he said.

Stephen B. Hulley, MD, MPH, is professor in the Division of Clinical Epidemiology, Department of Epidemiology & Biostatistics at UC San Francisco.

The four resident research presentations and the presentations from the five incoming chief medical residents will be available via on-demand video (UCSD only) all summer.

Medicine Grand Rounds: Looking Back, Looking Forward

After the last presentation of the 2012-2013 academic year on June 19, Medicine Grand Rounds is on hiatus for the summer and the schedule for next year is taking shape.

Dr. Elaine Muchmore

Dr. Elaine Muchmore

Program director Elaine Muchmore, MD, praised this year’s outgoing chief residents for the quality of the Grand Rounds program.

“I think it has been a wonderfully diverse set of topics and presentations,” she said. “I congratulate the outgoing chief residents for their hard work in making the series very, very informative for all of us.”

The research presentations and the presentations from the five incoming chief medical residents will be available via on-demand video (UCSD only) all summer.

Dr. Ian Jenkins

Dr. Ian Jenkins

Medicine Grand Rounds will resume on Wednesday, September 4, 2013, with a presentation by Ian Jenkins, MD, Health Sciences associate clinical professor in the Division of Hospital Medicine at UC San Diego.

The 2013-2014 schedule for Medicine Grand Rounds is posted here.

Presenting at Medicine Grand Rounds June 19: Dr. Benjamin Hulley

Benjamin Hulley, MD

Benjamin Hulley, MD

Incoming chief medical resident Benjamin Hulley, MD, presented at Medicine Grand Rounds on Wednesday, June 19. His topic: “Are Physicians Ethically Obligated to Utilize the Placebo Effect?”  |  Watch the video (UCSD only)

Hulley received his MD degree from UC San Diego.

Presenting at Medicine Grand Rounds June 12: Dr. Zack Permutt

Dr. Zachary Permutt

Dr. Zachary Permutt

Incoming chief medical resident Zack Permutt, MD, presents at Medicine Grand Rounds on Wednesday, June 12. His topic: “Millennials in Medicine.”  |  Watch the video (UCSD only)

Permutt received his MD degree from Washington University.