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Teaching students to be doctors: connections made

The Emory School of Medicine’s new curriculum was introduced in 2007 in order to create connections between faculty and students that last throughout the entire four years of medical school, “longitudinal” relationships much like those that should exist ideally between doctors and their patients.

Students practice providing exams

Students practice medical exams

Based on the kind of students who are attracted to Emory and on what they learn and model from their faculty mentors, these students are expected to grow not just in knowledge during their time at Emory, but also in compassion, curiosity, and commitment—and to use these traits wisely in serving their profession and community.

At the heart of the curriculum is a highly popular system of faculty advisers, each faculty mentor paired with eight or nine students.

These groupings are designated as “societies” named for historical medical luminaries—for example, Osler, Semmelweis, Lister, Harvey.

Faculty advisers who lead these societies in each class are chosen carefully, their salaries underwritten by the medical school so they can relinquish three half-days per week from their regular clinical and/or research duties to spend time with some or all of “their” students.

As the class of 2011 moves through the new curriculum, all now have completed the 18-month Foundations of Medicine phase, a whole-person approach section that combines clinical medicine and basic fundamentals of science, social sciences, humanities and public health.

This is not my father’s or mother’s medical school experience, students say. In the introduction-to-neuroscience module, for example, faculty share the classroom with a baseball player, who demonstrates and explains what a center fielder has to do to catch a fly ball or what a batter must consider before swinging at a ball leaving the pitcher’s hand at 95 mph.

Learn more about the curriculum in the 2009 Emory School of Medicine annual report, and more about the school in Emory Medicine. Read a message from Dean Thomas J. Lawley, MD.

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H1N1 pediatric flu vaccine clinical trials underway

Emory doctors discuss H1N1 flu vaccine testing

Emory doctors discuss H1N1 flu vaccine testing

Clinical trials are underway at Emory and Children’s Healthcare of Atlanta testing an investigational H1N1 flu vaccine along with the seasonal flu vaccine. Emory will enroll about 100 children, ages six months to 18 years, and up to 650 children nationally will participate in the study.

The study will look at the safety of and measure the body’s immune response to the H1N1 flu vaccine. In addition, it will help determine how and when the vaccine should be given with the seasonal flu vaccine to make it most effective.

Another important factor is learning if there are any potential problems by giving the vaccines together, such as whether one vaccine will undermine the protective power of the other.

The answer is important because experts are predicting that both strains of flu will circulate this fall and winter.

The clinical trial is part of the Vaccine and Treatment Evaluation Units (VTEUs), supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH). At Emory, this team is led by Mark Mulligan, MD, executive director of the Hope Clinic of the Emory Vaccine Center.

The Emory pediatric clinical trial is taking place at the Emory-Children’s Center. It is led by Emory VTEU co-directors Harry Keyserling, MD, professor of pediatric infectious diseases at Emory School of Medicine and Paul Spearman, MD, chief research officer for Children’s Healthcare of Atlanta and vice chair of research for Emory’s Department of Pediatrics, along with Allison Ross, MD, Emory assistant professor of pediatric infectious diseases.

Keyserling says that because children and young adults are considered among the most vulnerable populations for new and emerging strains of influenza, such as the current H1N1 pandemic, it is critically important that testing for a vaccine is quick and efficient.

The pediatric trial follows the launch of a VTEU-led adult clinical trial of the H1N1 and seasonal flu vaccines, which began at Emory’s Hope Clinic on Aug. 10 and will continue with followup visits for the next six weeks by a group of more than 170 volunteers.

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Jeff Koplan discusses H1N1 on panel

Experts on H1N1 influenza are collaborating all across the country to learn more about the virus and how to prevent its transmission. In a race against time, Emory studies are taking place in the lab and in human clinical trials to help find a vaccine that can be used in the near weeks to come.

Recently, Emory’s Jeff Koplan, MD, vice president for global health and past CDC director, participated in a Breakthroughs panel sponsored by Big Think, Pfizer and Discover to discuss the latest issues in pandemic and genomic science, fields that have not only made big headlines recently but also promise to be two of the most pressing topics in global science and medicine in coming years.

Jeffrey P. Koplan, MD, MPH

Jeffrey P. Koplan, MD, MPH

The panel focused on the real-time, round-the-clock scientific mission to understand the history, significance, and future of the new strain of flu that emerged suddenly this spring. Panelists included Koplan; Barry Bloom, Joan L. and Julius H. Jacobson Professor of Public Health at Harvard; Peter Palese, chairman of the microbiology department at Mt. Sinai Medical Center; and Michael Worobey, ecologist and evolutionary biologist at the University of Arizona.

View: Superbug – Are We Prepared for The Next Great Plague?


Emory began signing up several hundred interested volunteers several weeks ago for a clinical trial of the H1N1 vaccine along with the seasonal flu vaccine. About 170 adults have now been vaccinated in the trial, which will last about nine weeks and involve several vaccinations and blood tests. A clinical trial testing the H1N1 vaccine in children will begin at Emory and Children’s Healthcare of Atlanta in the next few days, followed by another adult clinical trial adding an adjuvant to the H1N1 vaccine.

In addition, a multi-pronged attack against the H1N1 virus by Emory researchers is using a new method of rapidly producing highly targeted monoclonal antibodies to develop a diagnostic test as well as a temporary therapy to stave off the H1N1 virus. The antibodies, which can be isolated from a small amount of the blood of humans infected with the virus, could be targeted against H1N1 and rapidly reproduced to detect or attack the virus.

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Remembering Grace Crum Rollins

Grace Crum Rollins

Grace Crum Rollins

She was quiet and small in stature but firm in her beliefs. Grace Crum Rollins made good on her late husband’s promise of helping construct a building to house Emory’s School of Public Health. In 1994, the Grace Crum Rollins Building became the permanent home for the school that Emory named for her extraordinary family.

Mrs. Rollins, whose generosity led the Rollins School of Public Health to become one of the nation’s premier schools in its field, died on August 8 at age 98.

Dean James Curran says, “Essentially, the school would not be what it is today without her family. Our faculty, students, and alumni are part of her legacy.”

Grace Crum married O. Wayne Rollins during the Depression. They worked hard, lived simply, and never bought anything on credit. When Wayne was hospitalized for an appendectomy, Grace knitted to pay his bill.

Years later, Forbes magazine would count him among the nation’s greatest business leaders. In what is considered one of the first leveraged buyouts, Wayne bought Orkin Exterminating in 1964. The family’s business grew to encompass oil and gas services, security systems, and real estate.

Also in 1964, Wayne and Grace moved to Atlanta with their sons Randall and Gary. The couple became involved at Emory through the Candler School of Theology and Wayne’s role as a university trustee. With a lead gift to the School of Medicine, they enabled construction of the O. Wayne Rollins Research Center, doubling Emory’s laboratory space. Upon learning that the School of Public Health needed a building, Wayne volunteered his support but died unexpectedly in 1991. Less than a year after his death, Grace and her sons fulfilled his promise by contributing $10 million for construction.

The Rollins attend an Emory event

Wayne and Grace Rollins attend an Emory event

Other gifts followed, including a $50 million lead gift through the O. Wayne Rollins Foundation for a second public health building. The Claudia Nance Rollins Building, which is named for Wayne’s mother, will open in 2010 and more than double the physical size of the school.

The idea of creating the first public health building appealed to Wayne Rollins’ entrepreneurial spirit. With just 20 faculty and 500 graduates, it was a risky endeavor, Curran says.

“Mrs. Rollins kept that commitment” notes Curran. “Today the school has 200 faculty and more than 5,000 alumni in 90 countries.”

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H1N1 flu clinical studies start at Emory today

Emory doctors discuss H1N1 studies

Emory doctors discuss H1N1 studies

Today Emory researchers began vaccinating volunteer participants in the first of several planned clinical trials of a new H1N1 vaccine. A morning press briefing attended by Atlanta and national media provided Emory a platform to inform the public.

The clinical trials are expected to gather critical information that will allow the National Institutes of Health to quickly evaluate the new vaccines to determine whether they are safe and effective in inducing protective immune responses. The results will help determine how to begin a fall 2009 pandemic flu vaccination program.

Emory began signing up several hundred interested volunteers about two weeks ago and has been screening the volunteers to make sure they fit certain criteria. Volunteers will receive their first vaccinations over the first week of the trial and will return several times over the course of nine weeks to receive additional vaccinations and blood tests.

H1N1 clinical trial volunteer

H1N1 clinical trial volunteer

The clinical trials are in a compressed timeframe because of the possible fall resurgence of pandemic H1N1 flu infections that may coincide with the circulation of seasonal flu strains.

The clinical trials are being conducted by the eight Vaccine and Treatment Evaluation Units (VTEUs), supported by the National Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health (NIH).

For more information about the Emory flu clinical trials, call 877-424-HOPE (4673) for the adult and senior studies, or 404-727-4044 for the pediatric studies.

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Cancer survivors may have psychological distress

Long-term survivors of cancer that developed in adulthood are at increased risk of experiencing serious psychological distress, according to a report in the July 27 issue of Archives of Internal Medicine.

The estimated 12 million cancer survivors in the United States represent approximately 4 percent of the population.

Commenting on this week’s study, Michael Burke, MD, clinical director of psychiatric oncology at Emory Winship Cancer Institute, says only recently has the emotional wellbeing of cancer patients been given serious consideration by physicians and patients. Yet, easing the disease’s emotional burden on patients and families may improve patients’ treatment and prognosis.

Michael Burke, MD

Michael Burke, MD

Burke has conducted studies focused on the effects of the disease’s emotional burden on patients and families and whether easing that burden can improve patients’ treatment and coping skills. Burke and his colleagues offer a collaborative approach toward therapies for the emotional, psychological, and physical symptoms associated with cancer and its treatment.

A history of cancer may affect current mental health in several ways, says the Archives study author and Brigham and Women’s Hospital and Dana-Farber Cancer Institute researcher. The researcher reports that cancer diagnosis and treatment can produce delayed detrimental effects on physical health and functioning such as secondary cancers, cardiac dysfunction, lung dysfunction, infertility, neurological complications and neurocognitive dysfunction. A cancer history, they continue, can also affect social adaptation, employment opportunities and insurance coverage. Adjusting to these functional and life limitations may create long-term psychological stress.

Emory’s Burke says to help patients cope with a diagnosis of cancer, he and his colleagues evaluate patients’ medical and personal history, environment and health behaviors, such as whether they’re getting enough exercise or increasingly using alcohol and tobacco.

Listen to Burke’s own words on Sound Science about how he helps patients cope with the emotional aspects of cancer.

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Health care reform: Wise allocation of resources key

Emory’s Chief Quality Officer William Bornstein, MD, PhD, says there are many issues that need to be tackled in order to achieve meaningful health care reform. He points out that one of the most fundamental questions that must be addressed is who decides about a treatment or diagnostic test that may be a little bit better than an alternative option but is much more expensive? If the patient has no “skin in the game,” he will almost certainly want the better/more expensive option.

William Bornstein, MD, PhD

William Bornstein, MD, PhD

The doctor has taken an oath to act in the best interests of the patient and this obligation takes precedence over any charge that society would like to impose to cast the Ray Ban Baratas physician in a fiduciary role for the national healthcare budget, says Bornstein, who also serves as chief medical officer for Emory Hospitals. And, the payer’s role is obviously conflicted, he says. If the patient does have skin in the that decision, Bornstein asks, are we prepared as a society to explicitly endorse the notion that “better” care that exceeds a certain cost threshold will only be available to those who can afford the additional cost?

There has been much talk about better care and preventative care being less expensive, but there are little data that support this as being a universal truth. Health care information ray ban outlet technology will also not solve this problem, he says. At some point in the near future, we need to have a national conversation about this challenge. In the past attempts to have such conversations have raised the specter of “rationing,” However, the time has come to confront the truth that our resources are finite and we need to allocate them wisely.

Bornstein is a recognized leader in quality, safety and the use of information technology in improving healthcare delivery. He has serves on national committees and advisory bodies in these areas including the University HealthSystem Consortium Clinical Evaluative Sciences Council Steering Committee, which he now chairs. He serves on the Professional and Technical Advisory Committee for the hospital accreditation process of The Joint Commission as vice-chair, and on the Information Architecture Steering Committee of the University HealthSystem Consortium staff leadership group of the Institute of Medicine Roundtable on Evidence Based Medicine.

Listen to podcasts with Bornstein on quality.

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U.S. News ranks Emory University Hospital

America's Best HospitalsToday, U.S. News and World Report issued the 2009-10 America’s Best Hospitals.

Emory University Hospital ranked among the nation’s best hospitals in 11 specialties. Overall, Emory is one of only 170 hospitals, out of more than 5,400 medical centers in the country to be named in even one of the magazine’s top 50 specialty rankings.

Emory is recognized in this year’s comprehensive report for excellence in:

Specialty and Rank
Ophthalmology – 9
Psychiatry – 10
Geriatrics – 13
Heart and Heart Surgery – 13
Neurology and Neurosurgery – 14
Ear, Nose and Throat – 22
Kidney Disease – 25
Diabetes/Endocrinology – 31
Gynecology – 44
Urology – 44
Cancer – 46

U.S. News says it looks at, “how well these institutions do in complex and demanding situations—replacing an 85-year-old’s heart valve, diagnosing and treating a spinal tumor, and dealing with inflammatory bowel disease, to name three examples. High-stakes medicine calls for more than the usual brand of doctoring.”

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Small, single incision for surgery helps young patients

Emory University and Children’s Healthcare of Atlanta pediatric physician Dr. Mark Wulkan is among the first surgeons in Georgia to perform single-site incision surgery on pediatric patients for routine surgeries.

Dr. Mark Wulkan

Dr. Mark Wulkan

Dr. Wulkan is using this method for multiple procedures, including appendectomy, removal of the spleen, and stomach surgery.

“Single-site surgery takes minimally invasive surgery (laparoscopic surgery) to the next level,” said Dr. Wulkan, is an associate professor of surgery and pediatrics in the Emory University School of Medicine and who performs surgery at Children’s Healthcare of Atlanta at Egleston. “Children leave the operating room with virtually no scars.”

Traditional laparoscopic surgical incisions are made in different locations on the abdominal wall, resulting in several small scars. The single-site method, however, is considered scarless because only one incision is made in the belly button and is typically difficult to see. Pediatric patients who undergo single-site procedures enjoy all the benefits of laparoscopic surgery, such as rapid recovery and less pain than that associated with traditional open surgery.

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Expert studies collective decision-making

Gregory Berns

Gregory Berns

Greg Berns, MD, PhD, is the Emory psychiatrist who heads the Center for Neuropolicy. The Center focuses on how the brain influences decision-making in politics, policy and business. The center involves School of Medicine, Emory College and Goizueta Business School researchers.

Berns says, “We all live in groups. Sometimes groups make good decisions, but groups often behave worse than any of its members would. We’re approaching the problem of collective decision-making from a new perspective by studying how the human brain functions in groups.”

Center members advise decision-makers of all kinds by conducting experiments focused on biologically based pressures that influence collective decision-making. Through their discoveries, researchers will better understand how culture, intelligence and environment influence the way decisions are made and how basic human tendencies drive judgment in certain situations.

As Berns points out, people also need to understand how religious and political ideologies become transformed in the brain and can subvert basic self-survival value judgments, a phenomenon that occurs in war and terrorism.

“Collective decision-making is political, but politics are biological,” says Berns. “The human brain evolved to function in social groups. By discovering how our brains are wired to behave in groups, we can find solutions to problems of global impact.”Berns is the author of Satisfaction: The Science of Finding True Fulfillment and Iconoclast: A Neuroscientist Reveals How to Think Differently.

Learn more in the Center media kit, Emory Health magazine or listen to a podcast.

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