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.

Cancer-associated Mutations are Common in Patients with Unexplained Low Blood Counts

November 4, 2015

Researchers use genetic tools to propose a new diagnostic category —

Patients with unexplained low blood counts and abnormally mutated cells who do not fit the diagnostic criteria for recognized blood cancers should be described as having clonal cytopenias of undetermined significance (CCUS), suggest University of California, San Diego School of Medicine researchers in a recent paper published in the journal Blood. The researchers found the condition surprisingly common in older patients with low blood counts. … Read the full story from the UC San Diego Newsroom


Dr. Rafael Bejar

Dr. Rafael Bejar

The senior author of the study is Rafael Bejar, MD, PhD, Assistant Professor of Medicine in the Division of Bone Marrow Transplantation.

Read Article Abstract

Dr. Bejar was one of 41 UC San Diego Health physicians named on the list of San Diego’s Top Doctors for 2015. The annual list is compiled by the San Diego County Medical Society and San Diego Magazine.

Protein’s Impact on Colorectal Cancer is Dappled

In early stages, it acts as tumor suppressor; later it can help spread disease —

Researchers at University of California, San Diego School of Medicine have discovered a cell signaling pathway that appears to exert some control over initiation and progression of colorectal cancer, the third leading cause of cancer-related death in the United States. A key protein in the pathway also appears to be predictive of cancer survival rates. … Read the full story from the UC San Diego Newsroom


Dr. Pradipta GhoshThe study’s senior author is Pradipta Ghosh, MD, associate professor of medicine in the Division of Gastroenterology.

At the Nexus of Substance Abuse and HIV

UC San Diego Researcher Wins Major Award to Study New Treatments and Preventions —

Dan Werb, PhD, an internationally noted epidemiologist at University of California, San Diego School of Medicine, has been named one of four inaugural recipients of the Avenir Award, a prestigious $1.5 million research grant from the U.S. National Institute on Drug Abuse, part of the National Institutes of Health (NIH). … Read the full story from the UC San Diego Newsroom

Jill P. Mesirov Appointed Associate Vice Chancellor for Computational Health Sciences

UC San Diego School of Medicine recruits world leader in computational biology —

Leading computational biologist Jill P. Mesirov, PhD, has been appointed associate vice chancellor for computational health sciences and professor of medicine at University of California, San Diego School of Medicine and Moores Cancer Center. Mesirov most recently served as associate director and chief informatics officer at the Broad Institute of MIT and Harvard, where she directed the Computational Biology and Bioinformatics Program. … Read the full story from the UC San Diego Newsroom


Dr. Mesirov joins the Department of Medicine as a professor in the Division of Medical Genetics.

New Biomarkers Might Help Personalize Metastatic Colorectal Cancer Treatment

Low levels of two genes predicts positive response to chemotherapy and longer survival times —

Metastatic colorectal cancer patients tend to live longer when they respond to the first line of chemotherapy their doctors recommend. To better predict how patients will respond to chemotherapy drugs before they begin treatment, researchers at University of California, San Diego School of Medicine conducted a proof-of-principle study with a small group of metastatic colorectal cancer patients. The results, published June 17 in PLOS ONE, revealed two genes that could help physicians make more informed treatment decisions for patients with this disease. …Read the full story from the UC San Diego Newsroom

Paul Fanta, MD, MS

Paul Fanta, MD, MS

Senior author of the study is Department of Medicine oncologist Paul Fanta, MD, MS, Health Sciences associate clinical professor in the Division of Hematology-Oncology. Dr. Fanta is a researcher in the Solid Tumor Therapeutics Program at the UC San Diego Moores Cancer Center.

Read the article in PLOS ONE (Open Access)

Dietary Trans Fat Linked to Worse Memory

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

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

Medicine 401 Teaching Award Winners Announced

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

The winners:

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

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

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

The medical students’ comments included the following.

Dr. Michelle Pearlman

Dr. Michelle Pearlman

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

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

Dr. Tyler Woodell

Dr. Tyler Woodell

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

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

Clinical Trial Launched to Assess Safety and Efficacy of Autism Drug Treatment

UC San Diego researchers open first study of suramin in children with autism —

Researchers at the University of California, San Diego School of Medicine have launched a clinical trial to investigate the safety and efficacy of an unprecedented drug therapy for autism.

The phase 1 clinical trial, which is recruiting 20 qualifying participants, will evaluate suramin – a century-old drug still used for African sleeping sickness – as a novel treatment for children with a diagnosis of Autism Spectrum Disorder (ASD). Previous published research by Robert K. Naviaux, MD, PhD, professor of medicine, pediatrics and pathology at UC San Diego School of Medicine, and colleagues reported that a single injection of suramin reversed symptoms of ASD in mouse models. …Read the full story from the UC San Diego Newsroom


Robert Naviaux, MD, PhD, is professor of medicine in the Division of Medical Genetics and professor in the departments of pediatrics and pathology.

He co-directs the Mitochondrial and Metabolic Disease Center at UC San Diego.

More about research in the Naviaux laboratory

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.