Reforming Medical Education

Pre-med education is fundamentally flawed. This is something that the Medical Education community has known and written about for decades but has never acted upon. There are three critical problems:

  • Pre-med science requirements were established almost 100 years ago and have not changed since then despite extraordinary advances in clinical medicine and biomedical science.
  • These requirements consume an enormous amount of time and energy, detracting severely from what should be an enriching, stimulating college education.
  • The Medical College Admissions Test (MCAT) is an expensive (between the tests fees and pre courses), time-consuming hurdle that perpetuates the need to focus on memorization of facts and competition for grades.

More than 100 years ago, Abraham Flexner reformed medical education throughout the nation. He was considered visionary and is responsible for establishing what we currently consider to be the gold standard for how medicine is taught, both in medical school and in preparing for medical school. Since then, medicine and science have changed more rapidly than any other field, with the possible exception of information technology. Yet educators at both the college and medical school levels have failed to refresh his vision and align the physician training with society’s needs. We’ve also perpetuated the notion that everyone has to be taught the same requirements in lockstep, with little room for flexible, individualized, and self-directed learning.

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Geri ED Turns 1

This Saturday, February 23rd, marks the 1-year anniversary of the Geriatrics Emergency Department at Mount Sinai. Recognizing that the US population is aging, and that existing emergency departments were too often designed around provider’s needs – rather than that of their older patients – Mount Sinai emergency medicine researcher Ula Hwang was one of the first to describe the compelling need for specialized geriatric emergency care. Transforming that vision into a reality involved years of planning, construction and even specialized programming of our electronic systems.

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The NeuroTouch Simulation Project

As a first-year neurosurgery resident at Mount Sinai, I am continuously reminded of the seamless integration of innovative surgical technology and its ability to positively affect the outcomes of our patients. In fact, when I was a medical student at the Albert Einstein College of Medicine, I remember being fascinated by the “high-tech” feel of a neurosurgical operating room. Everything, from the microscope, to the cranial and spinal navigation systems seemed like something straight out of a science fiction movie. I realized that neurosurgery was a rapidly evolving field that was fueled by cutting-edge technology. It is one the reasons why I ultimately decided to join the ranks of the neurosurgeons I always idealized as a medical student. With this in mind, I am excited for the opportunity to describe my experiences with the launch our neurosurgery department’s NeuroTouch Simulation Project.

To provide a bit of background, in 2009, the National Research Council of Canada introduced the NeuroTouch, a one-of-a-kind physics-based virtual simulator for cranial micro-neurosurgery training. The development of similar virtual reality simulation devices within the past decade has enabled residents to practice basic surgical procedures in a risk-free environment. These devices have progressively increased in sophistication, playing an increasingly important role in the education and training of new surgeons. In September 2012, The Department of Neurosurgery at Mount Sinai Medical Center became the first in the United States to purchase the NeuroTouch Simulator.

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Mount Sinai Advances Research into Diabetes and Heart Disease

Valentin Fuster, MD, PhD, Director of Mount Sinai Heart, presented landmark research on diabetes and heart disease at the American Heart Association (AHA) Scientific Sessions 2012. During the conference, the AHA also honored Dr. Fuster with its 2012 Research Achievement Award for his many significant contributions to cardiovascular medicine.

“With a laser-like focus on translational research, Dr. Fuster has added greatly to our understanding of the pathogenesis of coronary artery disease and thrombosis,” says AHA President Donna Arnett, PhD, MSPH. “Among his laboratory’s provocative advancements in medical science are numerous ‘firsts,’ including the original understanding of the role of platelets in heart disease and the revelation that plaque composition plays a crucial role in propensity for a heart lesion to rupture.”

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New Device Helps Paralyzed Patients Walk Again

A wearable, battery-powered robot called the Ekso™, or exoskeleton, is helping paralyzed patients walk again at The Mount Sinai Hospital’s new Rehabilitation Bionics Program, the only program in New York State that uses this device.

The Ekso, manufactured by Ekso Bionics, based in Richmond, California, is strapped over the patients’ clothing, and enables them to stand and walk with the help of a microprocessor that controls movement and a battery that provides power.

“Patients find it extremely gratifying to stand up and ambulate,” says Kristjan T. Ragnarsson, MD. “With this device, the power comes from a rechargeable battery that is carried in a backpack, and it allows patients to walk in a more natural way.” He says patients report that it is much less strenuous to walk with the device than with traditional leg braces.

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Study Finds Food-Allergic Children Subject to Bullying

Children with food allergies are frequently bullied by classmates but experience less psychological distress when their parents are aware of it, according to researchers at The Mount Sinai Medical Center, who surveyed 251 families during their visits to Mount Sinai’s Jaffe Food Allergy Institute in 2011.

The study—published online in the December 24, 2012, issue of Pediatrics—found that as many as 45.4 percent of the children, ages 8-17, reported being bullied, and 31.5 percent reported that food allergy was the reason.

“Parents and clinicians need to ask children with food allergies if they have been bullied,” says the study’s lead author Eyal Shemesh, MD, Chief of the Division of Behavioral and Developmental Health in the Department of Pediatrics at The Mount Sinai Medical Center. “Bullying is prevalent. Kids often don’t tell their parents, and it is important to know this is an issue.”

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Big Apple Circus Event Supports Pediatric Patients

The Mount Sinai Children’s Center Foundation (CCF) hosted its 26th annual Big Apple Circus benefit in November, raising more than $735,000 to support the Department of Pediatrics at the Kravis Children’s Hospital at Mount Sinai.

Over the years, the benefit has raised more than $14.7 million for the Department of Pediatrics. The proceeds have been used to renovate the Pediatric Intensive Care Unit (PICU) and undertake current renovations in the Neonatal Intensive Care Unit (NICU).

Each year, children who attend the benefit receive a backpack loaded with donated products such as books, DVDs, stuffed animals, and toy trucks. This year, the CCF donated 100 extra backpacks to children living in two Brooklyn communities devastated by Hurricane Sandy, Gerritsen Beach and Sheepshead Bay.

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Not your typical Emergency Room visit

Philip Abrams didn’t want to go to the Emergency Department.

He’d never felt this way before. What at first seemed like a simple headache just kept getting worse. Though he couldn’t see his regular doctor, the covering doctor suspected sinusitis, and started an antibiotic. When things progressed, he was referred to an ENT specialist, who noted an emerging rash on his nose and forehead, and suspected shingles. He got an anti-viral medication and pain meds, but couldn’t sleep because of the increasing pain.

When his eye started to get involved, his wife persuaded him to go to Mount Sinai’s new geriatric emergency department. “It was the last thing I felt like doing. I felt horrible, I hadn’t eaten anything in the past couple of days, and I didn’t want to move…”

But soon after his arrival, things started looking up. “I wasn’t there more than a few minutes before I was whisked out of that space and ushered to another area where my blood pressure was taken… I was promptly seen, and the physician’s assistant gathered info about me, asked if I had eaten, and promptly brought me a turkey sandwich and drink.”

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