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.

Progress: the UC San Diego – Universidade Eduardo Mondlane Medical Education Partnership Initiative

In this official video, Dr. Emilia Noormahomed describes the goals and progress of the UC San Diego—Universidade Eduardo Mondlane (UEM) Medical Education Partnership Initiative (MEPI) program in Mozambique.

Map of Africa showing location of MozambiqueEmilia Noormahomed, MD, PhD, is UEM principal investigator of the MEPI project, which is intended to strengthen Mozambique’s medical education system by building infrastructure to support medical training, research and technology.

Noormahomed is associate professor in the Parasitology Section, Department of Microbiology, at UEM and associate professor of medicine at UC San Diego.

In their partnership, UEM receives the bulk of the grant funding and UC San Diego provides partners and mentors to help UEM meet its goals.  |  More about UC San Diego’s role

The UC San Diego Internal Medicine Residency Training Program offers a global medicine elective in which residents rotate to the UEM’s Maputo Central Hospital in Mozambique for a four-week period.  |  More about the elective

MEPI is a joint initiative of the United States National Institutes of Health and the President’s Emergency Plan for AIDS Relief (PEPFAR).

More Information:

Internal Medicine Residency Training Program

Medical Education Partnership Initiative

Bringing Power of Prevention, Diagnosis to the People

“A Mercedes Benz isn’t designed to function in the Sahara Desert,” notes Dr. Eliah Aronoff-Spencer of the University of California, San Diego. “So why are we designing medical equipment for developing countries the same way we do for developed ones?”

It’s a question researchers at the new Distributed Health Laboratory in the California Institute for Telecommunications and Information Technology (Calit2) at UC San Diego aim to address, and eventually, to render moot. In collaboration with the UC San Diego School of Medicine and the Universidade Eduardo Mondlane (UEM) in Maputo, Mozambique, Calit2’s DH Lab is designing low-cost medical devices such as microscopes and wireless sensing devices that can be used by virtually anyone anywhere in the world to prevent and even diagnose illness. … Read the full story from the UCSD Newsroom


Co-directing the Distributed Health Laboratory is Eliah Aronoff-Spencer, MD, PhD, fellow in infectious diseases at UCSD and informatics coordinator for the Medical Education Partnership Initiative (MEPI) between UC San Diego and Universidade Eduardo Mondlane (UEM) in Maputo, Mozambique.

Eliah Aronoff-Spencer, MD, PhD with Dr. Manuel TomasThe photo at left shows Dr. Aronoff-Spencer with UEM physician Dr. Manuel Tomás (at right) on a patient ward at Maputo Central Hospital.

Dr. Aronoff-Spencer is also an organizer of the Biomedical Research Informatics for Global Health Training (BRIGHT) program, an international collaboration devoted to training the next generation of informatics researchers in partner countries.

The BRIGHT program, a Division of Biomedical Informatics project, is funded by grant D43TW007015 from the Fogarty International Center of the National Institutes of Health.

A graduate of the UCSD Internal Medicine Residency Program and Physician-Scientist Training Pathway, Dr. Aronoff-Spencer has completed a fellowship in clinical infectious disease and is now a fellow in research in infectious disease, global health informatics and decision making at UCSD. He is also a staff physician in infectious disease at the VA San Diego Healthcare System.

More information:

Dr. Philip Lederer Receives the 2011 Lee Rickman Humanism in Medicine Award

Dr. Philip LedererPhilip Lederer, MD, senior resident in the UC San Diego Internal Medicine Residency Program, received the 2011 Lee Rickman Humanism in Medicine award at Medicine Grand Rounds on June 8.

The award is given each year to the resident who most embodies 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.

“Phil has that same passion,” said Elaine Muchmore, MD, residency program director, in presenting the award. “It’s with pride and enthusiasm that I introduce him as this year’s Rickman award winner.”

When Dr. Lederer graduates from the program later this month, he will join the faculty as Health Sciences Assistant Professor in the Division of Infectious Diseases and Clinical Director of the UC San Diego Department of Medicine’s Maputo Central Hospital Educational Collaboration.

Living in Maputo, Mozambique, he will be the on-site UC San Diego faculty attending for residents on global medicine elective rotation.

He will play a major role in the Medical Education Partnership Initiative (MEPI), which unites UC San Diego and the Universidade Eduardo Mondlane (UEM) in an effort to build sustainable, local capacity for educating doctors in Mozambique and southeast Africa.

In accepting the Rickman award, Dr. Lederer reflected on the 30th anniversary of the HIV/AIDS epidemic. Thirty-five million people have died of AIDS, he said, and 75 million have been infected since the epidemic began, primarily in sub-Saharan Africa.

Africa carries 24% of the world’s disease burden but has only 3% of the world’s trained medical professionals, he said.

As clinical director in Mozambique, he will direct both UC San Diego and UEM residents in their training. He will also play myriad roles in the process of strengthening the UEM training program and developing research collaborations on topics of greatest concern to Mozambique.

He concluded his remarks by introducing Drs. Clotilde Nhatave Paiva and Ermenia Miguel Muthambe, internal medicine residents from the UEM training program in Maputo who are currently on rotation here at UC San Diego.

“They are the future,” Dr. Lederer said.

About Dr. Lederer

Dr. Lederer received his MD degree from the University of Pennsylvania School of Medicine. He has sought out opportunities for service in health and social justice since 2003, when he served as a full-time diabetes educator in a community health center after he graduated from Brown University.

In 2005, he co-founded the Guatemala Health Initiative to bring together University of Pennsylvania students and Guatemalan communities in efforts to improve public health, focusing on the Tz’utujil Maya town of Santiago Atitlán.

During his residency, Dr. Lederer has completed both the global medicine rotation in Mozambique and the Global Health in Local Populations rotation in San Diego.

He is currently conducting research studies in HPV and conjunctival cancer, rapid diagnostics for tuberculosis, and bacteremia in Mozambique.
About Dr. Rickman

Leland Rickman, MD, was a UC San Diego infectious disease specialist who graduated from the Internal Medicine Residency Program here in 1983. He completed his fellowship training in infectious diseases at the Naval Medical Center San Diego and served in naval hospitals until he returned to UC San Diego to join the Department of Medicine faculty in 1990.

Dr. Muchmore met Dr. Rickman at that time.

“I was struck by his passion for teaching and for clinical care and his meticulous attention to details,” she said. “He was a font of knowledge.”

Dr. Rickman was appointed Hospital Epidemiologist and Medical Director of the Epidemiology Unit in 1993.

“He dedicated himself to being the infection control physician for the hospital,” Dr. Muchmore said. “He bird-dogged things in a way that was truly awe inspiring.”

He received more UC San Diego teaching awards than anyone in the Department of Medicine, Dr. Muchmore said. The San Diego County Medical Society’s Physician Citizen of the Year award in 2003 was one of many acknowledgments of his service to the community.

Dr. Rickman died in June 2003 while traveling in Lesotho, Africa, to train local medical personnel in AIDS treatment and prevention. In that effort, he was working with Dr. Wm. Christopher Mathews, UC San Diego Professor of Clinical Medicine and Director of the Owen Clinic.

“His loss was not only to those of us at UCSD but to the world,” said Dr. Kenneth Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine at the time.

Dr. Kaushansky and the residency program faculty established the Rickman award in his honor in 2003.

Universidade Eduardo Mondlane Financial Analyst Carolina Chiau Visits UCSD

This is a companion story to “A Lasting Solution for Healthcare in Mozambique,” our main story about the Universidade Eduardo Mondlane-UCSD Medical Education Partnership Initiative program.

Department of Medicine database/fund manager Evelyn Olaes, left, and UEM Foundation financial analyst Carolina Chiau Like the state universities in California, Mozambique’s public universities manage their research funding through an auxiliary foundation. For several years, Universidade Eduardo Mondlane (UEM) Foundation financial analyst Carolina Chiau has managed private donor monies that have supported UEM-UCSD education and research projects.

Ms. Chiau will administer UEM’s Medical Education Partnership Initiative (MEPI) funds, which come from the U.S. National Institutes of Health (NIH), as well.

In August, UCSD Senior Pre-Award Grant Analyst Rachel A. Cook traveled to Mozambique to meet with Ms. Chiau. Ms. Chiau then came to the U.S. to spend a week with UCSD’s fund managers and grant analysts, who gave her a crash course in managing NIH funds.

UCSD’s grant specialists will remain available to answer any questions as the project unfolds. As in the other aspects of the UEM-UCSD MEPI program, UCSD’s faculty and staff members are serving as mentors for the staff members, medical trainees, and junior faculty at UEM.
Photo, above right: Department of Medicine database/fund manager Evelyn Olaes, left, and UEM Foundation financial analyst Carolina Chiau.

Photo below: UCSD financial managers and staff with Carolina Chiau. From left: Evelyn Olaes (Database/Fund Manager, Department of Medicine), Rachel Cook (Senior Pre-Award Grant Analyst, Health Sciences Sponsored Project Pre-Award Office [HSSPPO]), Clint Neilson (Chief Operating Officer, Department of Medicine), Andrea Rollins (Director, HSSPPO), Fernando Mares (standing; Fund Manager, Department of Medicine), Maureen O’Connor (Administrative Vice Chair, Department of Medicine), Dorothea Aguilar (Fund Manager, Owen Clinic), Debby Leedy (Human Resources Manager, Department of Medicine), and Carolina Chiau.

UCSD financial managers and staff with Carolina Chiau

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%. Now, UCSD 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, M.D., Ph.D., 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 UCSD.

Sam Patel, M.D., Professor of Medicine at UEM and UCSD, 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 UCSD, 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, M.D., who is coordinating the UCSD 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, M.D., 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 UCSD 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.

UCSD’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, M.D., Ph.D., Professor of Medicine and Chief of UCSD’s Division of Biomedical Informatics. The division will provide expertise for the partnership’s information technology projects.

UCSD infectious diseases fellow Eli Aronoff-Spencer, MD (left), and Dr. Manuel Joaquim Tomás, UEM internal medicine resident on hospital ward in Maputo.

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.

Elaine Muchmore, M.D., Professor of Medicine and Director of the UCSD Internal Medicine Residency Training Program, will work closely with UEM to strengthen and expand the Mozambican training programs.

Through training and partnership with UCSD, 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 UCSD figure in the project is Stephen Bickler, M.D., 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 UCSD 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, UCSD internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital in Mozambique.

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 UCSD 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 UCSD-UEM MEPI project. Photo courtesy of William M. Detmer, M.D., M.Sc.

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, M.D., co-investigator on the MEPI project, is Professor of Medicine at UEM and UCSD. William M. 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. Photo courtesy of Dr. Detmer.

Dr. Tilghman and Mozambican residentM. 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. Photo courtesy of Robert T. Schooley, M.D.

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, M.D., Ph.D.; Eli Aronoff-Spencer, M.D., senior postdoctoral fellow in infectious diseases at UCSD; 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, M.D., M.Sc.

UCSD infectious diseases fellow Eli Aronoff-Spencer, MD (left), and Dr. Manuel Joaquim Tomás, UEM internal medicine resident on hospital ward in Maputo.UCSD infectious diseases fellow Eli Aronoff-Spencer, MD (left), and Dr. Manuel Joaquim Tomás, UEM internal medicine resident on hospital ward in Maputo. Photo courtesy of William M. Detmer, M.D., M.Sc.

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

A medical school class at UEM.A medical school class at UEM. Photo courtesy of William M. Detmer, M.D., M.Sc.

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

Trademark Credit Notices:

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

Appreciation and a Fond Farewell to Dr. Ken Kaushansky

Kenneth Kaushansky, MD, MACPOn July 19, Dr. Ken Kaushansky officially begins his work as Senior Vice President for Health Sciences and Dean of the School of Medicine at Stony Brook University in New York.

When he announced his departure to the faculty and staff of the UCSD Department of Medicine on June 7, he described his new position as an opportunity to implement, on a larger scale, the successful programs that the Department of Medicine has instituted under his leadership here.

He called his years at UCSD a time of “incredible transition in our faculty, our leaders, our teaching programs, and our clinical impact.”

During Dr. Kaushansky’s tenure as Helen M. Ranney Distinguished Professor and Chair, the Department of Medicine expanded from 253 to over 420 faculty members, added four divisions, and recruited 11 division chiefs. Its annual budget grew from $86 million to nearly $150 million.

Dr. Robert Schooley“Dr. Kaushansky has been an outstanding Chair for this department,” said Dr. Robert “Chip” Schooley, Professor and Chief of the Division of Infectious Diseases and Vice Chair for Academic Affairs in the Department of Medicine.“

During his eight years as Chair, the medical house staff program became one of the most highly regarded programs in the country. New divisions in Hospital Medicine, Biomedical Informatics, Geriatrics, and Global Public Health were developed and research programs thrived throughout the Department,” Dr. Schooley said.

“In response to increasing interest in international medicine among the medical house staff, Dr. Kaushansky launched the Department’s Global Medicine Residency Program in 2009,” he said.“Dr. Kaushansky worked with his counterpart at the Universidade Eduardo Mondlane to establish a model program in international cooperation that has revitalized postgraduate medical training in the Republic of Mozambique.”


Dr. Kaushansky with Drs. Marisa Magaña, Emilia Noormahomed, and Robert Schooley in Mozambique Dr. Kaushansky on a global medicine planning trip to China.Dr. Kaushansky with Drs. Marisa Magaña, Emilia Noormahomed, and Robert Schooley in Mozambique (left); on global medicine program planning trip to China (right).

Since 2002, the Department’s NIH research funding has grown from $60 million to $113.6 million. It has more than twice as many complex multi-investigator program-project grants and career development awards granted to the junior faculty and fellows.

The Department has also boosted its showing in the “America’s Best Hospitals” rankings from U.S.News & World Report. In 2002, two subspecialty clinical programs ranked in the nation’s top 50: respiratory at 9th and cancer at 41st. In the most recent rankings, five subspecialties ranked in the top 50, including one (HIV/AIDS) in the top 10.

Dr. Greg Maynard“Ken was directly responsible for building up the strength of clinical care at UCSD,” said Dr. Greg Maynard (right), Health Sciences Professor of Medicine and Chief of the Division of Hospital Medicine.

“He recruited me here about 7-1/2 years ago, and in that time, the Hospital Medicine program has grown from 4 hospitalists to nearly 30, as just one example of that.”

“Dr Kaushansky nurtured my career here at UCSD,” said Dr. Pradipta Ghosh (below left), physician-scientist and Assistant Professor of Medicine in the Division of Gastroenterology.

Dr. Pradipta Ghosh“As a product of the Physician-Scientist Training Program,” she said, “I am one of those few who enjoyed special access to this busy department chair. His doors were always open. I recall having multiple consultations with him at various stages of my career as it grew here at UCSD.

“When the time came for me to choose where to spend the first decade of my young career as an independent investigator, it was his support and a match in our visions which tilted my decision in favor of UCSD,” she said.

“His tireless efforts at instilling the physician-scientist culture here in the Department of Medicine, both from top-down and bottom-up, have paved the path for many young folks like me to craft a career for themselves as physician-scientists,” Dr. Ghosh said.

Dr. John Carethers“Ken was the reason why I eventually accepted the GI Chief job at UCSD,” said Dr. John M. Carethers (right), now John G. Searle Professor and Chair of the Department of Internal Medicine at the University of Michigan.

When Dr. Kaushansky joined the UCSD faculty, Dr. Carethers was an associate professor of medicine in the Division of Gastroenterology. Dr. Carethers became division chief in 2004

“Ken … gave me enough autonomy to help grow the GI Division, gain a GI Center grant, coordinate well with the Cancer Center and other divisions, and allowed me to grow personally,” Dr. Carethers said. “The GI Division flourished under that mantra.

“We went to a clinical service chief structure, developed a new hierarchy for our administrative staff, started a robust web site, grew our fellowship, and survived many challenges over that time because of his support,” he said.

“Ken provided invaluable advice on my career,” Dr. Carethers said. “He was a great sounding board, not pretentious; encouraging, but never overprotective. I think he understood the value of growth and opportunity, something that is hard to come by these days.”

Dr. Patricia FinnDr. Patricia Finn (left), Professor and Chief of the Division of Pulmonary and Critical Care Medicine, described Dr. Kaushansky as “a tireless advocate for his faculty.”

“He is accessible 24/7 to offer support and guidance, which is huge to a new faculty member just moving cross country,” she said.

“On a personal note, when I had barely arrived here he was already nominating me for positions and committees to help me advance my career.”

Dr. Kirk Knowlton“His integrity, fairness, and open-mindedness built an environment of trust that allowed the substantial growth of the Department of Medicine during his tenure as Chair,” said Dr. Kirk U. Knowlton (right), Professor of Medicine and Chief of the Division of Cardiology.

“I am struck by how he has been able to hold the respect of so many people with widely disparate interests,” Dr. Knowlton said.

“This included people who were fully engaged in basic science and those who were busy taking excellent care of their patients; medical students and residents and post-graduate research fellows; administrators and faculty; and others over whom he might have had influence or who crossed his path.

“The people he has worked with knew that they could count on him to represent their interests in the context of the institution’s goals in a considered and reasonable manner while at the same time maintaining his vision of the future of the Department of Medicine.”

“He is a rare breed,” Dr. Maynard said. “I guess I’d call him a quadruple threat. An outstanding scientist, a superb clinician, a great educator, and an incredible leader and administrator to boot.

“While he is not really replaceable,” he said, “he has left an enduring legacy that stresses clinical and operational excellence, as well as research contributions.”

Dr. Finn said, “In addition to [his] world-class scientific reputation, Dr. Kaushansky is most respected for his character and vision.”

“He makes his department and faculty a priority, while striving to always do the right thing for the patients,” she said. “He will be most remembered for his infectious enthusiasm, upbeat attitude, and steady, insightful guidance of students and faculty.”

“He leaves an 8-year legacy that advanced the Department of Medicine in many ways,” said Dr. Carethers, “including growing faculty, changing the way residents learn, obtaining key recruitments for division chiefs and faculty, enhancing VA relations, and being an all out cheerleader for the Department.”

On June 21, Dr. Kaushansky was honored at a farewell reception hosted by David Brenner, M.D., Dean of the UCSD School of Medicine and Vice Chancellor, Health Sciences. In his remarks there, Dr. Kaushansky expressed his appreciation for “eight and a half years of good friends, challenges, and teamwork.”

Observing that he had been involved in recruiting many of the faculty members in the room, he said, “Everything at UCSD works toward recruiting great people.”

“It’s easy, at UCSD, to build things and to make a difference,” he said. “Everybody makes everyone else stronger.”

Dr. Kaushansky praised UCSD’s “incredible richness” of people, science, teaching, and clinical programs. “I’ve never seen more devotion to the three missions,” he said.

And now he looks ahead.

“In academic medicine, you get to re-craft yourself every ten years,” he said. “I’m looking forward to my newly-found steep learning curve.”

Dr. Kaushansky was honored at a tribute from the senior leaders of the Department of Medicine on July 11. There will be a tribute from all departmental staff, faculty, and house staff on a date to be selected.

“Although one could cite metric after metric by which his unceasing efforts strengthened the Department,” said Dr. Schooley, “what many of us think distinguished his tenure most was the way in which his ‘bottom up’ style of leadership brought out the best in all of us.

“The Department will benefit for many years to come from things he set in motion – as will each of its members from what we learned from his multifaceted demonstration of scholarship, integrity, imagination and dedication to his Department.”


Drs. Ken Kaushansky and Wolfgang Dillmann   Drs. Ken Kaushansky and Wolfgang DillmannDr. Kaushansky with newly designated Interim Chair Wolfgang Dillmann, M.D.

Early Successes: Global Medicine Update from Mozambique

Since it began last summer, the Global Medicine Program at UC San Diego has sent 11 internal medicine residents to Mozambique, sparked several new research projects, and stimulated learning on both sides of this unique international partnership.

The Republic of Mozambique. Map from CIA: The World Factbook.

The Republic of Mozambique.
Map from CIA: The World Factbook.

The Global Medicine Program is a two-way exchange of faculty and residents between UCSD and the Universidade Eduardo Mondlane in Maputo, Mozambique. It is part of the Department of Medicine’s efforts to expand its involvement in global health.

“I think the program has made absolutely incredible progress,” said Dr. Constance Benson, Professor of Medicine and Director of UCSD’s Fellowship Training Program in Infectious Diseases.

Dr. Benson is a faculty director of the program.

During their 3-week stay, the UCSD internal medicine residents rotate through four different wards at Maputo General Hospital. Dr. Michael Preziosi, Clinical Director of the program, serves as faculty attending physician on site in Maputo.

Mozambican internal medicine residents

Mozambican internal medicine residents (left to right) Drs. Clotilde Tilwene, Neusa Jessen, Marilia Vida. Photo by Mike Preziosi, MD

Working together with the Mozambican doctors, the UCSD residents are encountering diseases they have never seen before and far more advanced stages of diseases frequently seen in San Diego; schistosomiasis, for example, and full-blown tuberculosis.

In one 24-hour period, Dr. Preziosi said, his patients included one who had tetanus with lockjaw, one with a liver cancer caused by a fungus that grows on peanuts, and one who had an advanced case of pellagra.

Broadening UCSD’s Internal Medicine Residency Training Program is one of the goals of the Global Medicine Program. Promoting collaborative global health research is another.

Mozambican residents at a presentation

U.S. and Mozambican residents at a presentation. Photo by Mike Preziosi, MD.

In the past six months, UCSD residents, fellows, and faculty members have begun to partner with Maputo researchers in new studies of tuberculosis and other endemic diseases.

UCSD is also introducing tools and practices that will strengthen the medical education program at Universidade Eduardo Mondlane.

A weekly journal club, instituted by UCSD residents, has been very well received.

“On the wards with the Mozambican residents, what’s going on has been really inspiring,” said Dr. Preziosi. “We’re seeing them get excited about medicine again.”This, in turn, refreshes the American residents, he said.

“I think they are getting a renewed sense of the purpose and value of the educational activities they are helping to introduce,” Dr. Preziosi said, “and are participating in them with renewed energy.”

Mozambican and American residents

Mozambican resident Marilia Vida (left) with Dr. Sarah Fox, second-year UCSD resident. Photo by Mike Preziosi, MD.

Mozambican residents will begin rotations at UCSD later this year.

“What makes our program unique,” said Dr. Robert “Chip” Schooley, “is that the transfer of capacity is being done in a peer-to-peer fashion by people who are transferring knowledge about jobs they do all the time.“The Mozambican residents see our residents as counterparts who are sharing their own experiences.”

Dr. Schooley, a Faculty Director of the program, is Professor of Medicine and Chief of the Division of Infectious Diseases. “I think this program will break a lot of ground,” he said.

UCSD faculty appointments have been granted to Drs. Emilia Noormahomed and Sam Patel, the faculty leaders on the Universidade Eduardo Mondlane side of the Global Medicine Program.

UCSD is assisting with material needs in Maputo as well.

Last summer, a UCSD team brought a supply of modern tuberculosis protective masks for the Mozambican residents’ workroom at the hospital. There is a great shortage of other basic clinical supplies.

To help meet such needs and to sustain the Global Medicine Program, Dr. Schooley and colleagues are stepping up their fundraising efforts.

“We can make a real impact on the health of this country with a very modest investment,” said Dr. Kenneth Kaushansky. Dr. Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine, is Director of the Global Medicine Program.

As the U.S. and Mozambican residents care for patients and pursue their studies together, they lay groundwork for stronger healthcare systems in both nations. In the face of overwhelming need in Maputo, they press forward with the resources available.

Drs. Benson and Schooley are veterans of many successful efforts to improve healthcare delivery in Africa.

“You overcome,” said Dr. Benson. “One day at a time, one patient at a time.”

* * *

The Global Medicine elective rotation is open to second- and third-year residents and to Department of Medicine faculty members from all specialties.

For more information on the Global Medicine Program,
visit http://imresidency.ucsd.edu/GlobalMed.shtml.

Read our news story about the launch of the Global Medicine Program here.

Give to our Global Medicine Program.