Molecular Biology
No Other Way Out for Iron
Infectious Disease
Milestone Reached, But Campaign Against Polio Continues
Developmental Biology
Stem Cell Niche Discovered in Placenta
Medical Practice
Dual Loyalties at Abu Ghraib: Squeezing Ethics out of Care
Leak-patching Protein Shuts Down Tumor Growth, Swelling
Specialization Seen in Chromatin Remodelers
Study Plays Cat and Mouse with Development of the Visual Cortex
Proceedings of the HMS
Faculty Council
Donor Funds Labs for Aging Research
MassCURE to Advocate for Regenerative Medicine
Lemelson Prize Awarded for Innovations in Cancer and Stroke
Match Day Links One Third of Fourth-years to Internal Medicine Residencies
Honors and Advances
Consortium Formed for RNA Interference
AIDS and Isolation Among the Navajo
Proceedings of the HMS Faculty Council
The summary of the minutes below describes discussions at the Dec. 8 meeting, which preceded the meeting summarized in the March 11 issue of Focus.
Community Outreach
Joan Reede, dean for diversity and community partnership, explained that
her efforts have been centered
on bringing the community and HMS together.
Reede discussed the Boston Research Health Care and Training Institute, an initiative designed to train community residents for jobs at HMS and affiliated institutions, as well as increase the skills of incumbent HMS workers in the lower grades.
She also discussed Project Success, a summer internship program involving HMS faculty and local area high school students. Ninety-nine percent of the program’s students matriculate to college, and 10 percent matriculate to Harvard. The majority of these students are underrepresented minorities. Another initiative she mentioned was the Biology Scholars program for juniors and seniors at Brighton High School, Economics and Business Academy, and English High School. The enrollment at these schools is almost 85 percent minority.
Core Competencies
Charles Hatem, HMS professor of medicine at Beth Israel–Deaconess,
said that the notion of core competencies has been espoused by many
organizations, including the Accreditation Council for Graduate Medical
Education (ACGME).
These competencies are patient care, medical knowledge, practice-based
learning and improvement, professionalism, interpersonal and communication
skills,
and systems-based practice.
In an article published in Academic Medicine in October 2000, David Stevens posed three questions for the Liaison Committee on Medical Education: 1) How can the measurement of outcomes be most effectively employed in the accreditation of medical schools? 2) How can medical school accreditation better align with the public’s expectations? 3) Can sound evidence be developed on which to base the standards and processes for accreditation?
Hatem suggested that each of the ACGME core competencies could be put on an upcoming docket, but requested help from the council in identifying who might be invited to help in the discussion of this material and in the development of programs, insights, and interventions.
Professional Development
Miles Shore, the Bullard professor of psychiatry at McLean Hospital,
addressed the issue of “professional maturation at HMS,” asking what HMS
is doing to produce students at the very highest level of the profession.
He noted that a very small number of HMS students have difficulties, and
in those cases, the statutory basis for the Promotion and Review Board’s
actions is the HMS Student Handbook.
Shore remarked that the Student Handbook includes nothing about professional behavior, integrity, or values, or about the role of medicine as a service profession that is conducted by fulfilling obligations and through privileges granted by society.
Shore and Eugene Beresin, HMS associate professor of psychiatry at Massachusetts General Hospital, drafted an “Introduction to HMS” that will be sent to all incoming first-year students. The goal is to set a series of expectations and aspirations while conveying the educational values of the institution.
Shore identified five dimensions of growth: intellectual; physical, including self-regulation, health, judicious use of substances often abused and easily available to students under great stress; emotional, both one’s own and in relation to patients; social; and moral.
The question then becomes, how might HMS adopt a reasonable trajectory toward professional behavior? A truism of organizational culture is that values are conveyed by performance appraisal. Currently, three committees are working on revising the forms that HMS uses to assess its students.
Jules Dienstag, associate dean for academic and clinical programs, presented the Dean’s Report to the council. He underscored Dean Joseph Martin’s commitment to the medical education reform initiative. He stressed that the shape and timing of the reform was not a fait accompli, and he reiterated that input from faculty and students and the HMS community would help shape the ultimate curriculum.
Medical Ed Reform
Dienstag reported that the reform was based on fundamental principles
and assumptions that include specific curricular changes relating
to professionalism
and ethics; the need for a new model of clinical education with
longitudinal clinical experiences; supervision, mentoring, and assessment;
a reengagement
of the faculty in the educational process and a need for a cadre
of committed teachers; improved integration of the scientific
basis of
medicine into
all four years; and the development of a scholarly, in-depth,
capstone experience.
The topics that the five faculty design groups are working on are Introduction to the Profession, Fundamentals of Medicine, the Principal Clinical Experience, an Advanced Clinical Clerkship, and the In-depth Scholarly Experience/ Concentrations that would begin during the first two years and intensify in the third, fourth, and an optional fifth year.
Donor Funds Labs for Aging Research
Philanthropist Paul Glenn has committed $5 million to HMS over five years to launch the Paul F. Glenn Laboratories for the Biological Mechanisms of Aging. “We are proud to be teaming up with Mr. Glenn and the Glenn Laboratories,” said David Sinclair, HMS associate professor of pathology and the Glenn Laboratories’ new director. “Like us, Paul is dedicated to finding the molecular answers to the aging process so we can understand the mechanisms of normal aging and develop interventions to delay its onset and decline, thereby extending the healthful years of human life.” The new resources are intended as a magnet to attract further support for the potential creation of a larger Institute for Aging Research at HMS. Two more faculty members will be recruited to focus on aging research, and labs with advanced research technology and animal models will be built. In addition, research pilot grants will be awarded by a steering committee to investigators wanting to investigate novel areas of molecular research addressing critical questions in the normal aging process. “In pursuing the underlying molecular mechanisms involved in the aging process, the Glenn Laboratories will be supporting the broad mission of the School,” said Nancy Andrews, dean for basic sciences and graduate studies.
MassCURE to Advocate for Regenerative Medicine
Paul Levy Photo by Constance Brown |
The immediate goal of MassCURE is passage of this legislation, which would clarify current state law. In addition to explicitly legalizing somatic cell nuclear transfer, or therapeutic cloning, the proposed bill would make reproductive cloning illegal.
Moderated by Paul Levy, president and CEO of Beth Israel Deaconess Medical Center, the press conference presented the medical, personal, political, and economic case for human embryonic stem cell research. Paul Guzzi, president and CEO of the Greater Boston Chamber of Commerce, said there are three primary reasons to support this research in the state. The possibility for curing now incurable diseases like Parkinson’s and Alzheimer’s is the “overwhelming reason,” he said. Another is economic. Boston is a leader in life sciences research, and growth in regenerative medicine would strengthen the city’s leadership, attracting more top scientists to the region. Finally, he said, the area has talented researchers, and the bill before the Massachusetts legislature “is a signal to them that we want them here.”
The president and CEO of the Civil Society Institute, Pam Solo, cited figures from a recent survey the institute commissioned, showing that 81 percent of Massachusetts adults support the stem cell bill. “The conclusion that we’re drawing is that support is broad and also very intense,” she said. It is certainly no more intense than among patients and their families who suffer from diseases that might be addressed by therapeutic cloning. Tom Shea, a board member of the Juvenile Diabetes Research Foundation, New England Chapter, described his family’s life with diabetes, the nighttime blood checks for his daughters, the restrictions on their activity, and their shortened life expectancy.
HMS researcher Jeffrey Macklis, associate professor of surgery at Massachusetts General Hospital, said he has been struck by the misinformation muddying the issue of therapeutic cloning. He and colleague William Lensch, an HMS research fellow in biological chemistry and molecular pharmacology at Children’s Hospital Boston, explained the complementary nature and scientific promise of adult and embryonic stem cell work. One point Macklis made about somatic cell nuclear transfer was that it can “model human genetic diseases and give very, very important information about those diseases that we can’t get from mouse studies.” He also argued that current state law involving stem cell research is ambiguous and worrisome. “Many experiments are on hold now because of Massachusetts legislation,” he said.
Levy closed the press conference, saying, “This is a budding field with tremendous potential. Why would we want to limit our options?” He stressed that Massachusetts is in competition with other parts of the country. If the state does not foster an environment supporting the most creative stem cell scientists, he said, “They will go elsewhere.”
To find out more about MassCURE or to join the coalition, see the website.
Lemelson Prize Awarded for Innovations
In Cancer and Stroke
 David Berry Photo courtesy of Lemelson-MIT |
In addition, Berry’s studies of internalized heparin have led to a promising new technique for treating cancer. The polymer–heparin conjugate he developed attacks tumors while leaving healthy tissue alone, avoiding the familiar side effects of chemotherapy.
Match Day Links One Third of Fourth-years to Internal Medicine Residencies
Photo by Justin Knight
On the 53rd annual Match Day, held on March 17, Alanna Morris and Dayle Whiteman (center left and right) were among the 146 HMS fourth-years who learned where they will spend their residencies. Half of the students will remain in Massachusetts, almost all of these (96 percent) working for HMS programs. Of the rest, 22 percent will head to California and 11 percent will go to New York. Internal medicine was by far the most popular specialty, attracting almost a third of the fourth-years. Pediatrics, which picked up 11 percent of the students, was the second most popular, closely followed by emergency medicine, which picked up 10 percent. Compared to last year’s fourth-years, dermatology, psychiatry, and radiology saw a decrease while family practice, orthopedics, and general surgery saw an increase.
Honors and Advances
Mei-Ling Ting Lee, HMS associate professor of medicine (biostatistics) and associate professor in the Department of Biostatistics at HSPH, was recognized as the “2005 Mosteller Statistician of the Year” by the Boston Area Chapter of the American Statistical Association at a dinner in her honor on February 16. The award was presented to Lee in recognition of her contributions to biostatistics and her service to the profession.
Elizabeth Rider, HMS assistant professor of pediatrics at Children’s Hospital Boston, was inducted into the National Academy of Practice in Medicine this February. Rider was recognized for her teaching and scholarship in improving medical education and interdisciplinary practice. The National Academies of Practice, founded in 1981 in recognition of the need for interdisciplinary collaboration in health care, comprise academies of distinguished practitioners and scholars from ten primary health professions. In addition, Rider was appointed to the executive committee of the Ambulatory Pediatric Association’s education committee.
Consortium Formed for RNA Interference
Massachusetts General Hospital and the Dana–Farber Cancer Institute are two of 11 biomedical organizations that are contributing to the formation of an $18 million, three-year, public–private consortium to create a comprehensive library of gene inhibitors for use by the entire scientific community. “These 11 world-class entities will make common cause in a unique collaborative group to create a public good: a comprehensive set of reagents to be used in thousands of laboratories,” said Eric Lander, HMS professor of systems biology and director of the Broad Institute, where the consortium will be based. The goal of the RNAi Consortium is to create widely applicable research reagents composed of short RNA hairpin sequences carried in lentiviral vectors, which work through the mechanism of RNA interference. These can be used in a wide range of cellular and animal studies to discover the key genes underlying normal physiology and diseases, including cancer and diabetes.