PHMI Blog - Blog from Partners Harvard Medical International

Partners Harvard Medical International (PHMI), in association with the Medical Education Unit of the National University of Singapore (NUS) Yong Loo Lin School of Medicine, will present a continuing education course entitled “A Systems Approach to Assessment in Medical Education.” The course, based on programs developed by the Harvard Macy Institute, is the fifth jointly offered education program of PHMI and NUS. During the four-day course, faculty and participants will focus on the critical assessment issues facing medical educators today, including how to measure and access the effectiveness of educators, departments, and institutions.

Participant Objectives

• Develop an institutional vision and mission
• Understand and apply the principles of assessment theory
• Analyze approaches to assessment
• Translate educational goals into measurable outcomes
• Design assessment systems that support continuous quality improvement

Program Co-Directors

• Elizabeth Armstrong, PhD, Senior Consultant at PHMI and Clinical Professor of Pediatrics at Harvard Medical School
• H. Thomas Aretz, MD, Vice President of PHMI and Associate Professor of Pathology at Harvard Medical School

Dates: October 20-23, 2008 

Registration: Registration for the course is on a first-come, first-serve basis, with a deadline of August 15, 2008. To register, please contact Jocelyn Kwan via email at jocelynkwan@nus.edu.sg or by telephone at 6516 8123.

Lebanese newspaper The Daily Star reports that construction has begun on the LAU Medical School. From the article:

Once completed, the 12,500-square-meter 21st-century structure will house both the new medical school and the Alice Ramez Chaghoury School of Nursing. The $18-million state-of-the-art complex will be the nation’s most technologically advanced medical school - a world-class facility with video streaming, videoconferencing, digitized collections of microscope slides, multi-disciplinary laboratories, an electronic library, and 24/7 cyber cafe.

The new medical school will contain a simulation and skill assessment center for patient encounters, including a mock-up laboratory, full-scale-simulation surgical-procedure room, multi-purpose bays and control room.

“The underlying concept behind the design is to build the medical and nursing school around people rather than just technology. Fundamental human needs like comfort, and social ambiance will take prominence. The blueprint allows for ample natural light and large windows to maximize daytime illumination for a motivating atmosphere and inspirational view,” said LAU’s public relations director Christian Oussi.

. . .

Since becoming LAU’s president in 2004, professor Joseph G. Jabbra has been the driving force behind LAU’s aggressive and unprecedented $100 million expansion campaign.

“The establishment of the Medical School is an integral part of our exceptional achievements; building upon past successes,” said Jabbra. “The Medical School was also established to fill the void created by not having proper indigenous disease research in the region,” he added.

See additional coverage from this blog and revisit the beginnings of the LAU-PHMI collaboration.

Back in the September/October 2007 issue of PHMI WORLD, we reported that then-Harvard Medical International was advising the Springfield Land Corporation on the development of a new health care and education project in Springfield, a suburb of Brisbane, Australia:

The Springfield Land Corporation (SLC) has tapped HMI to assist with the strategic planning of an integrated health, wellness, and education campus that will be part of a community expansion in the state of Queensland . . .  

. . . HMI’s role thus far has been to facilitate collaboration between the key stakeholders, including not only SLC and provider groups in the health care community, but also the Queensland government and its Department of Health. HMI is also helping SLC explore how education programs will be integrated into the campus. Dowton and other HMI team members have conducted a series of site visits aimed at synthesizing the perspectives of the groups involved and advising SLC on its long-term strategic plan.

Now the Springfield group has unveiled the blueprint for the Springfield Health City, which “will be a revolution in the approach to health care and wellness in Australia, and provide all the necessary services for the rapidly growing population of Greater Springfield and its surrounds,” according to City chairman Professor John Hay. Hay said the plan for the Health City was based on research conducted by HMI, which recommended a Health City concept with a private/public partnership incorporating all forms of health care including primary care, acute care, alternative care, integrated residential including aged care, retirement living and hotels, education, research and E-health, underpinned by a strong focus on training future health workers.”

Complete release from Greater Springfield

The opening date of the new medical school at the Lebanese American University (LAU) is still more than a year away. Yet LAU, now in the second year of its collaboration with Partners Harvard Medical International (PHMI), is already establishing itself in the Lebanese academic medical community. In April, the school gathered leaders from the country’s other medical schools for a lively dialogue on the future of education in the Middle East.

The panel discussion was part of a three-day event that included a workshop for new LAU medical faculty led by Dr. N. Lynn Eckhert, PHMI Director of Academic Programs, PHMI Senior Consultant Dr. Constance Bowe, and Dr. Zeinat Hijazi, Assistant Dean for Medical Education at LAU. A highlight of the workshop was a small-group, problem-based learning exercise conducted with eight pre-medical students at LAU.

The event culminated in a day-long symposium on medical education, featuring a keynote address by Dr. Eckhert and an introduction to the LAU curriculum by Dr. Hijazi. The panel discussion gave voice to the rich diversity of medical education traditions in Lebanon. In addition to Dr. Kamal Badr, the founding Dean of LAU’s medical school, the speakers included representatives from the country’s six other medical schools, including five school deans.

The LAU School of Medicine, which will be based in Beirut and Byblos, will feature an American-style curriculum. Its first class of medical students will commence in September 2009.

Read more and view photos from the event on the LAU website: http://www.lau.edu.lb/news-events/news/medical_workshop/

UPDATE: Event featured in PHMI WORLD

The Cay Compass  reports that PHMI Director N. Lynn Eckhert recently gave the commencement address at graduation ceremonies for the St. Matthews University School of Medicine in Grand Cayman. This graduating class began their studies just days before Hurricane Ivan hit Grand Cayman in September 2004. The hurricane caused widespread damage in the islands and left much of Grand Cayman unhabitable for several months. St. Matthews medical students wound up taking classes on the school’s campus in Maine campus.

From the article:

Dr. Eckhert reminded the students that being a physician meant that their learning was not over because medical knowledge, technology and procedures were progressing constantly.

“It means that you will still be studying far into the future and as long as you have a career in medicine,” she said.

“Your graduating from medical school is just one more step in your education, for you will need to keep up with the current state of medicine in your area of expertise.”

St. Matthew’s Dean of Clinical Sciences Dr. John Randall said he was proud of the graduating class, many members of which had to go to study in Maine after Hurricane Ivan, until repairs to the dormitories and campus here could be made.

“You probably could be called Ivanites,” he said.

In the wake of the Institute of Medicine’s call for more geriatric medicine training, the Wall Street Journal’s Health Blog highlights how Hebrew SeniorLife, an organization that operates two nursing homes in Boston, is providing opportunities for students at Harvard Medical School and other Boston-area institutions to learn how to address the health care needs of our rapidly growing elderly population.

HMI WORLD correspondent Natalie Engler wrote about this topic in a 2006 Forum article. Read “Meeting the health care needs of an aging population.” An excerpt:

What’s the solution? Simply churning out thousands of geriatricians clearly won’t solve the problem, even if such a thing were possible. If geriatric training was required in every medical school today it would take more than 40 years for all practicing physicians to be replaced by those with geriatric training, says Greg O’Neill, PhD, director of the National Academy on an Aging Society. He adds that new geriatricians, like people in other medical specialties, tend to cluster, leaving an oversupply in some areas while others remain underserved.

 

Some geriatricians—like ILC-USA’s Robert Butler, and Dr. Lewis Lipsitz, chief of gerontology at Beth Israel Deaconess Medical Center, vice president for academic medicine and co-director of the Institute for Aging Research at Hebrew SeniorLife, and professor of medicine at Harvard Medical School—advocate for geriatrics as an academic specialty.

“My approach, and that of my colleagues, is to train the trainers. We want to train the academic leaders who are training the medical students and residents, so that every emerging doctor has a basic knowledge of geriatrics—the way every medical doctor has a working knowledge of cardiology,” explains Lipsitz. “In this way, geriatricians become the researchers who generate new knowledge, as well as the teachers and consultants who disseminate it to the existing  health care workforce”—including physicians, nurses, therapists, pharmacists, and social workers.

Last year, while working with MEDEX Global Group to develop health information for travelers, our Communications group learned quite a lot about malaria: the conditions that allow it to thrive, the mosquitoes that transmit it, and the parts of the world where you really have to protect yourself against it.

There are an estimated 500 million malaria infections every year, a fifth of which are fatal.

This week a piece in the New York Times Health section looks at the possibility of eradicating malaria. The Bill and Melinda Gates Foundation has put $1.2 billion towards that objective, but if they really believe that malaria can be relegated to the lab, like smallpox, then they are in the minority:

Dr. Regina Rabinovich, the foundation’s head of infectious disease, said the Gateses knew it was a long-term undertaking, not possible without more money, better health systems and probably a vaccine, which is still far off.

Dr. Arata Kochi, the W.H.O. malaria chief, went further than other skeptics, arguing that the specter of eradication is counterproductive. With enough money, he said, current tools like nets, medicines and DDT could drive down malaria cases 90 percent.

“But eliminating the last 10 percent is a tremendous task and very expensive,” Dr. Kochi said. “Even places like South Africa should think twice before taking this path.”

False hopes, he said, lead governments to hope for miracles instead of accepting the mundane budget-draining control policies that he endorses. For example, health officials from Rwanda and Zanzibar, having drastically cut malaria within their borders, have asked him about seeking money for elimination.

Even relatively wealthy countries rarely succeed at that. South Africa, Saudi Arabia and Mexico all control cases but see new ones imported — from Mozambique, Yemen and Guatemala, respectively, he said.

Dr. Awash Teklehaimanot, director of the malaria program at the Earth Institute of Columbia University, said he worried that calls for eradication raised expectations too high, inviting frustration and a loss of political will.

“Maybe 10, 15 years from now, we should consider this,” he said.

A research team at Harvard Medical School has developed a toolkit that isolates five primary aspects of mitochondrial function and analyzes how individual drugs affect each of these areas. From the “Research Roundup” on the Harvard Medical School website:

Over the last few decades, mitochondria have increasingly been understood as a key determinant of cellular health. On the other hand, mitochondrial dysfunction can lead to many neurodegenerative conditions as well as metabolic diseases such as diabetes. Since mitochondria are responsible for turning the food we eat into the energy that drives our bodies, these and other connections are logical. Nevertheless, there has not yet been a systematic method for thoroughly interrogating all facets of mitochondrial activity.

“Historically, most studies on mitochondria were done by isolating them from their normal environment,” says Harvard Medical School assistant professorVamsi Mootha, who is also a member of the Center for Human Genetic Research at Massachusetts General Hospital. “We wanted to analyze mitochondria in the context of intact cells, which would then give us a picture of how mitochondria relate to their natural surroundings. To do this we created a screening compendium that could then be mined with computation.”

In order to thoroughly analyze these organelles, Mootha and his team zeroed in on five basic features of mitochondria activity, looking at how a library of 2,500 chemical compounds affected mitochondrial toxic byproducts (like all “chemical factories” mitochondria produce their own toxic waste), energy levels, speed with which substances pass through these organelles, membrane voltage, and expression of key mitochondrial and nuclear genes. (Mitochondria contain their own genome, consisting of approximately 37 genes in humans.)

“It’s just like taking your car in for an engine diagnostic,” explains Mootha. “The mechanic will probe the battery, the exhaust system, the fan belt, etc., and as a result will then produce a read-out for the entire system. That’s analogous to what we’ve done.”

For more on what’s happening in laboratories around Harvard Medical School and its affiliated teaching institutions, check out the Research Roundup.

Gulf Region publication Trade Arabia details plans to develop a medical simulation center in the new home of the Harvard Medical School Dubai Center Institute for Postgraduate Education & Research. HMSDC, launched in 2004, is the focal point of efforts to develop high-quality education infrastructure and training in the Gulf Region. Since its inception, its Continuing Medical Education programs have been attended by thousands of physicians, nurses, and allied health professionals in the region.

The medical simulation center will be the first in Dubai. Occupying over 20,000 square feet in the new HMSDC facility, it will provide postgraduate medical trainees and other health care professionals the opportunity to undergo simulation-based training in rooms designed to replicate operating theaters, intensive care units, emergency rooms, and inpatient ward rooms. Dr. Robert L. Thurer, Chief Academic Officer at HMSDC, said the simulation center would help “support Dubai Healthcare City in its efforts to become the regional center of excellence in health care informed by education and research.”

Today the February 2008 issue of leading academic journal Academic Medicine is online and in mailboxes. The theme of this issue is global health, and the lead article is authored by Robert K. Crone, MD, the founding president and chief executive officer of HMI.

Entitled “Flat Medicine? Exploring Trends in the Globalization of Health Care,” the article presents the context in which we at HMI collaborate with our partners around the world. Drawing on examples from our work in Dubai, Turkey, and India, the article describes a global health care landscape that is undergoing a major transformation, with ramifications for patients, providers, and governments not only outside the United States, but in our own  local communities.

From the article abstract:

Trailing nearly every other industry, health care is finally globalizing. Highly trained and experienced expatriate health care professionals are returning to their home countries from training in the West or are staying home to work in newly developed corporate health care delivery systems that can compete quite favorably with less-than-perfect providers in Europe and North America. In turn, these health care systems are attracting patients from around the world who are interested in exploring high-quality, lower-cost health care alternatives. Much of this activity is occurring in the emerging economies of the Middle East, South and Southeast Asia, and beyond. Three Harvard Medical International collaborations-in Dubai, Turkey, and India-highlight these trends and demonstrate the potential for new models of global health care, as well as potential ramifications for patients and providers in the established economies of the West, including the United States. Although globalization is not a cure-all solution to achieving universal access to health care, it is not only a significant first step for patients in these emerging economies, but may also present alternative solutions for those patients in wealthier nations who nonetheless lack adequate health care coverage. The increase in health care quality and competitiveness around the globe is important, but these improvements will need to be matched by the development of comprehensive payer solutions, to benefit as many people as possible.