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Nanoparticles allow for creation of CAR T cells in vivo
Researchers say they have developed biodegradable nanoparticles that can be used to genetically reprogram T cells while they are still in the body.
The nanoparticles were able to program T cells with genes encoding leukemia-specific chimeric antigen receptors (CARs).
The resulting CAR T cells were able to eliminate leukemia or slow the progression of disease in a mouse model of B-cell acute lymphoblastic leukemia (B-ALL).
Researchers reported these results in Nature Nanotechnology.
“Our technology is the first that we know of to quickly program tumor-recognizing capabilities into T cells without extracting them for laboratory manipulation,” said Matthias Stephan, MD, PhD, of Fred Hutchinson Cancer Research Center in Seattle, Washington.
“The reprogrammed cells begin to work within 24 to 48 hours and continue to produce these receptors for weeks. This suggests that our technology has the potential to allow the immune system to quickly mount a strong enough response to destroy cancerous cells before the disease becomes fatal.”
Dr Stephan and his colleagues designed their nanoparticles to carry genes that encode for CARs intended to target and eliminate B-ALL. The nanoparticles are coated with ligands that make them seek out and bind to T cells.
When a nanoparticle binds to a T cell, the cell engulfs the particle. The nanoparticle then travels to the cell’s nucleus and dissolves.
The CAR genes integrate into chromosomes housed in the nucleus, making it possible for the T cells to begin decoding the new genes and producing CARs within 1 or 2 days.
Once they determined their CAR-carrying nanoparticles reprogrammed a noticeable percentage of T cells, the researchers tested the T cells’ efficacy in a mouse model of B-ALL.
The team infused the nanoparticles into 10 mice and found the treatment eradicated tumors in 7 of the animals. The other 3 mice “showed substantial regression” of leukemia, the researchers said.
On average, mice that received CAR-carrying nanoparticles had a 58-day improvement in survival compared to control mice.
Mice that received the nanoparticles also had “dramatically reduced” B-cell numbers in their spleens. The researchers noted that this is consistent with the reversible B-cell aplasia observed in patients who receive conventional CD19 CAR T-cell therapy.
Dr Stephan and his colleagues also tested conventional CAR T-cell therapy in the B-ALL mouse model. The mice received cyclophosphamide followed by CAR T cells created ex vivo.
These mice had significantly better survival than controls, but their survival was comparable to that of the mice that received the CAR-carrying nanoparticles.
Although these nanoparticles are several steps away from the clinic, Dr Stephan said he imagines a future in which nanoparticles transform cell-based immunotherapies into easily administered, off-the-shelf treatments that are available anywhere.
“I’ve never had cancer, but if I did get a cancer diagnosis, I would want to start treatment right away,” Dr Stephan said. “I want to make cellular immunotherapy a treatment option the day of diagnosis and have it able to be done in an outpatient setting near where people live.” 
Researchers say they have developed biodegradable nanoparticles that can be used to genetically reprogram T cells while they are still in the body.
The nanoparticles were able to program T cells with genes encoding leukemia-specific chimeric antigen receptors (CARs).
The resulting CAR T cells were able to eliminate leukemia or slow the progression of disease in a mouse model of B-cell acute lymphoblastic leukemia (B-ALL).
Researchers reported these results in Nature Nanotechnology.
“Our technology is the first that we know of to quickly program tumor-recognizing capabilities into T cells without extracting them for laboratory manipulation,” said Matthias Stephan, MD, PhD, of Fred Hutchinson Cancer Research Center in Seattle, Washington.
“The reprogrammed cells begin to work within 24 to 48 hours and continue to produce these receptors for weeks. This suggests that our technology has the potential to allow the immune system to quickly mount a strong enough response to destroy cancerous cells before the disease becomes fatal.”
Dr Stephan and his colleagues designed their nanoparticles to carry genes that encode for CARs intended to target and eliminate B-ALL. The nanoparticles are coated with ligands that make them seek out and bind to T cells.
When a nanoparticle binds to a T cell, the cell engulfs the particle. The nanoparticle then travels to the cell’s nucleus and dissolves.
The CAR genes integrate into chromosomes housed in the nucleus, making it possible for the T cells to begin decoding the new genes and producing CARs within 1 or 2 days.
Once they determined their CAR-carrying nanoparticles reprogrammed a noticeable percentage of T cells, the researchers tested the T cells’ efficacy in a mouse model of B-ALL.
The team infused the nanoparticles into 10 mice and found the treatment eradicated tumors in 7 of the animals. The other 3 mice “showed substantial regression” of leukemia, the researchers said.
On average, mice that received CAR-carrying nanoparticles had a 58-day improvement in survival compared to control mice.
Mice that received the nanoparticles also had “dramatically reduced” B-cell numbers in their spleens. The researchers noted that this is consistent with the reversible B-cell aplasia observed in patients who receive conventional CD19 CAR T-cell therapy.
Dr Stephan and his colleagues also tested conventional CAR T-cell therapy in the B-ALL mouse model. The mice received cyclophosphamide followed by CAR T cells created ex vivo.
These mice had significantly better survival than controls, but their survival was comparable to that of the mice that received the CAR-carrying nanoparticles.
Although these nanoparticles are several steps away from the clinic, Dr Stephan said he imagines a future in which nanoparticles transform cell-based immunotherapies into easily administered, off-the-shelf treatments that are available anywhere.
“I’ve never had cancer, but if I did get a cancer diagnosis, I would want to start treatment right away,” Dr Stephan said. “I want to make cellular immunotherapy a treatment option the day of diagnosis and have it able to be done in an outpatient setting near where people live.”
Researchers say they have developed biodegradable nanoparticles that can be used to genetically reprogram T cells while they are still in the body.
The nanoparticles were able to program T cells with genes encoding leukemia-specific chimeric antigen receptors (CARs).
The resulting CAR T cells were able to eliminate leukemia or slow the progression of disease in a mouse model of B-cell acute lymphoblastic leukemia (B-ALL).
Researchers reported these results in Nature Nanotechnology.
“Our technology is the first that we know of to quickly program tumor-recognizing capabilities into T cells without extracting them for laboratory manipulation,” said Matthias Stephan, MD, PhD, of Fred Hutchinson Cancer Research Center in Seattle, Washington.
“The reprogrammed cells begin to work within 24 to 48 hours and continue to produce these receptors for weeks. This suggests that our technology has the potential to allow the immune system to quickly mount a strong enough response to destroy cancerous cells before the disease becomes fatal.”
Dr Stephan and his colleagues designed their nanoparticles to carry genes that encode for CARs intended to target and eliminate B-ALL. The nanoparticles are coated with ligands that make them seek out and bind to T cells.
When a nanoparticle binds to a T cell, the cell engulfs the particle. The nanoparticle then travels to the cell’s nucleus and dissolves.
The CAR genes integrate into chromosomes housed in the nucleus, making it possible for the T cells to begin decoding the new genes and producing CARs within 1 or 2 days.
Once they determined their CAR-carrying nanoparticles reprogrammed a noticeable percentage of T cells, the researchers tested the T cells’ efficacy in a mouse model of B-ALL.
The team infused the nanoparticles into 10 mice and found the treatment eradicated tumors in 7 of the animals. The other 3 mice “showed substantial regression” of leukemia, the researchers said.
On average, mice that received CAR-carrying nanoparticles had a 58-day improvement in survival compared to control mice.
Mice that received the nanoparticles also had “dramatically reduced” B-cell numbers in their spleens. The researchers noted that this is consistent with the reversible B-cell aplasia observed in patients who receive conventional CD19 CAR T-cell therapy.
Dr Stephan and his colleagues also tested conventional CAR T-cell therapy in the B-ALL mouse model. The mice received cyclophosphamide followed by CAR T cells created ex vivo.
These mice had significantly better survival than controls, but their survival was comparable to that of the mice that received the CAR-carrying nanoparticles.
Although these nanoparticles are several steps away from the clinic, Dr Stephan said he imagines a future in which nanoparticles transform cell-based immunotherapies into easily administered, off-the-shelf treatments that are available anywhere.
“I’ve never had cancer, but if I did get a cancer diagnosis, I would want to start treatment right away,” Dr Stephan said. “I want to make cellular immunotherapy a treatment option the day of diagnosis and have it able to be done in an outpatient setting near where people live.”
Health Canada expands approval of daratumumab in MM
The drug is now approved for use in combination with lenalidomide and dexamethasone or bortezomib and dexamethasone to treat MM patients who have received at least 1 prior therapy.
Health Canada granted daratumumab priority review for this indication due to a high unmet medical need in patients with MM.
When a drug is granted priority review, Health Canada aims to complete its review of the drug within 180 days from the time an application is submitted.
Health Canada grants priority review to products intended for the treatment, prevention, or diagnosis of serious, life-threatening, or severely debilitating diseases or conditions.
About daratumumab
Daratumumab is a human IgG1k monoclonal antibody that binds to CD38, which is highly expressed on the surface of MM cells.
The drug is being developed by Janssen Biotech, Inc. under an exclusive worldwide license from Genmab.
Daratumumab received conditional approval in Canada last year.
In June 2016, Health Canada issued a Notice of Compliance with Conditions approving daratumumab for MM patients who had received at least 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or patients who are refractory to both a proteasome inhibitor and an immunomodulatory agent.
Phase 3 trial data
Health Canada’s expanded approval for daratumumab is based on data from the phase 3 POLLUX and CASTOR trials.
In the POLLUX trial, researchers compared treatment with lenalidomide and dexamethasone to treatment with daratumumab, lenalidomide, and dexamethasone in patients with relapsed or refractory MM.
Patients who received daratumumab in combination had a significantly higher response rate and longer progression-free survival than patients who received the 2-drug combination.
However, treatment with daratumumab was associated with infusion-related reactions and a higher incidence of neutropenia.
Results from this trial were published in NEJM in October 2016.
In the CASTOR trial, researchers compared treatment with bortezomib and dexamethasone to treatment with daratumumab, bortezomib, and dexamethasone in patients with previously treated MM.
Patients who received the 3-drug combination had a higher response rate, longer progression-free survival, and a higher incidence of grade 3/4 adverse events than those who received the 2-drug combination.
Results from this trial were published in NEJM in August 2016.
The drug is now approved for use in combination with lenalidomide and dexamethasone or bortezomib and dexamethasone to treat MM patients who have received at least 1 prior therapy.
Health Canada granted daratumumab priority review for this indication due to a high unmet medical need in patients with MM.
When a drug is granted priority review, Health Canada aims to complete its review of the drug within 180 days from the time an application is submitted.
Health Canada grants priority review to products intended for the treatment, prevention, or diagnosis of serious, life-threatening, or severely debilitating diseases or conditions.
About daratumumab
Daratumumab is a human IgG1k monoclonal antibody that binds to CD38, which is highly expressed on the surface of MM cells.
The drug is being developed by Janssen Biotech, Inc. under an exclusive worldwide license from Genmab.
Daratumumab received conditional approval in Canada last year.
In June 2016, Health Canada issued a Notice of Compliance with Conditions approving daratumumab for MM patients who had received at least 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or patients who are refractory to both a proteasome inhibitor and an immunomodulatory agent.
Phase 3 trial data
Health Canada’s expanded approval for daratumumab is based on data from the phase 3 POLLUX and CASTOR trials.
In the POLLUX trial, researchers compared treatment with lenalidomide and dexamethasone to treatment with daratumumab, lenalidomide, and dexamethasone in patients with relapsed or refractory MM.
Patients who received daratumumab in combination had a significantly higher response rate and longer progression-free survival than patients who received the 2-drug combination.
However, treatment with daratumumab was associated with infusion-related reactions and a higher incidence of neutropenia.
Results from this trial were published in NEJM in October 2016.
In the CASTOR trial, researchers compared treatment with bortezomib and dexamethasone to treatment with daratumumab, bortezomib, and dexamethasone in patients with previously treated MM.
Patients who received the 3-drug combination had a higher response rate, longer progression-free survival, and a higher incidence of grade 3/4 adverse events than those who received the 2-drug combination.
Results from this trial were published in NEJM in August 2016.
The drug is now approved for use in combination with lenalidomide and dexamethasone or bortezomib and dexamethasone to treat MM patients who have received at least 1 prior therapy.
Health Canada granted daratumumab priority review for this indication due to a high unmet medical need in patients with MM.
When a drug is granted priority review, Health Canada aims to complete its review of the drug within 180 days from the time an application is submitted.
Health Canada grants priority review to products intended for the treatment, prevention, or diagnosis of serious, life-threatening, or severely debilitating diseases or conditions.
About daratumumab
Daratumumab is a human IgG1k monoclonal antibody that binds to CD38, which is highly expressed on the surface of MM cells.
The drug is being developed by Janssen Biotech, Inc. under an exclusive worldwide license from Genmab.
Daratumumab received conditional approval in Canada last year.
In June 2016, Health Canada issued a Notice of Compliance with Conditions approving daratumumab for MM patients who had received at least 3 prior lines of therapy, including a proteasome inhibitor and an immunomodulatory agent, or patients who are refractory to both a proteasome inhibitor and an immunomodulatory agent.
Phase 3 trial data
Health Canada’s expanded approval for daratumumab is based on data from the phase 3 POLLUX and CASTOR trials.
In the POLLUX trial, researchers compared treatment with lenalidomide and dexamethasone to treatment with daratumumab, lenalidomide, and dexamethasone in patients with relapsed or refractory MM.
Patients who received daratumumab in combination had a significantly higher response rate and longer progression-free survival than patients who received the 2-drug combination.
However, treatment with daratumumab was associated with infusion-related reactions and a higher incidence of neutropenia.
Results from this trial were published in NEJM in October 2016.
In the CASTOR trial, researchers compared treatment with bortezomib and dexamethasone to treatment with daratumumab, bortezomib, and dexamethasone in patients with previously treated MM.
Patients who received the 3-drug combination had a higher response rate, longer progression-free survival, and a higher incidence of grade 3/4 adverse events than those who received the 2-drug combination.
Results from this trial were published in NEJM in August 2016.
Inhibitor exhibits activity against hematologic malignancies
A dual kinase inhibitor is active against a range of hematologic malignancies, according to preclinical research.
Investigators found that ASN002, a SYK/JAK inhibitor, exhibited “potent” antiproliferative activity in leukemia, lymphoma, and myeloma cell lines.
ASN002 also inhibited tumor growth in mouse models of these malignancies and proved active against ibrutinib-resistant diffuse large B-cell lymphoma (DLBCL).
The investigators presented these results at the AACR Annual Meeting 2017 (abstract 4204).
The work was conducted by employees of Asana BioSciences, the company developing ASN002.
The investigators tested ASN002 in 178 cell lines and found the drug exhibited “strong antiproliferative activity” in a range of hematologic cancer cell lines, including:
- Leukemia—HEL31, HL60, Jurkat, MOLM-13, and MOLM-16
- Lymphoma—KARPAS-299, OCI-LY10, OCI-LY-19, Pfeiffer, Raji, Ramos, SU-DHL-1, SU-DHL-6, and SU-DHL-10
- Myeloma—H929, JJN3, OPM2, and U266.
In addition, ASN002 was active against ibrutinib-resistant clones derived from the DLBCL cell line SU-DHL-6.
In a SU-DHL-6 xenograft model, the combination of ASN002 and ibrutinib was more effective than either compound alone.
The investigators also found that ASN002 alone demonstrated “strong tumor growth inhibition” in mouse models of DLBCL (Pfeiffer and SU-DHL-6), myeloma (H929), and erythroleukemia (HEL).
The team pointed out that ASN002 is currently under investigation in a phase 1/2 study of patients with B-cell lymphomas (DLBCL, mantle cell lymphoma, and follicular lymphoma) as well as solid tumors.
The investigators said that, to date, ASN002 has been well tolerated and has shown encouraging early evidence of clinical activity and symptomatic benefit in the lymphoma patients.
A dual kinase inhibitor is active against a range of hematologic malignancies, according to preclinical research.
Investigators found that ASN002, a SYK/JAK inhibitor, exhibited “potent” antiproliferative activity in leukemia, lymphoma, and myeloma cell lines.
ASN002 also inhibited tumor growth in mouse models of these malignancies and proved active against ibrutinib-resistant diffuse large B-cell lymphoma (DLBCL).
The investigators presented these results at the AACR Annual Meeting 2017 (abstract 4204).
The work was conducted by employees of Asana BioSciences, the company developing ASN002.
The investigators tested ASN002 in 178 cell lines and found the drug exhibited “strong antiproliferative activity” in a range of hematologic cancer cell lines, including:
- Leukemia—HEL31, HL60, Jurkat, MOLM-13, and MOLM-16
- Lymphoma—KARPAS-299, OCI-LY10, OCI-LY-19, Pfeiffer, Raji, Ramos, SU-DHL-1, SU-DHL-6, and SU-DHL-10
- Myeloma—H929, JJN3, OPM2, and U266.
In addition, ASN002 was active against ibrutinib-resistant clones derived from the DLBCL cell line SU-DHL-6.
In a SU-DHL-6 xenograft model, the combination of ASN002 and ibrutinib was more effective than either compound alone.
The investigators also found that ASN002 alone demonstrated “strong tumor growth inhibition” in mouse models of DLBCL (Pfeiffer and SU-DHL-6), myeloma (H929), and erythroleukemia (HEL).
The team pointed out that ASN002 is currently under investigation in a phase 1/2 study of patients with B-cell lymphomas (DLBCL, mantle cell lymphoma, and follicular lymphoma) as well as solid tumors.
The investigators said that, to date, ASN002 has been well tolerated and has shown encouraging early evidence of clinical activity and symptomatic benefit in the lymphoma patients.
A dual kinase inhibitor is active against a range of hematologic malignancies, according to preclinical research.
Investigators found that ASN002, a SYK/JAK inhibitor, exhibited “potent” antiproliferative activity in leukemia, lymphoma, and myeloma cell lines.
ASN002 also inhibited tumor growth in mouse models of these malignancies and proved active against ibrutinib-resistant diffuse large B-cell lymphoma (DLBCL).
The investigators presented these results at the AACR Annual Meeting 2017 (abstract 4204).
The work was conducted by employees of Asana BioSciences, the company developing ASN002.
The investigators tested ASN002 in 178 cell lines and found the drug exhibited “strong antiproliferative activity” in a range of hematologic cancer cell lines, including:
- Leukemia—HEL31, HL60, Jurkat, MOLM-13, and MOLM-16
- Lymphoma—KARPAS-299, OCI-LY10, OCI-LY-19, Pfeiffer, Raji, Ramos, SU-DHL-1, SU-DHL-6, and SU-DHL-10
- Myeloma—H929, JJN3, OPM2, and U266.
In addition, ASN002 was active against ibrutinib-resistant clones derived from the DLBCL cell line SU-DHL-6.
In a SU-DHL-6 xenograft model, the combination of ASN002 and ibrutinib was more effective than either compound alone.
The investigators also found that ASN002 alone demonstrated “strong tumor growth inhibition” in mouse models of DLBCL (Pfeiffer and SU-DHL-6), myeloma (H929), and erythroleukemia (HEL).
The team pointed out that ASN002 is currently under investigation in a phase 1/2 study of patients with B-cell lymphomas (DLBCL, mantle cell lymphoma, and follicular lymphoma) as well as solid tumors.
The investigators said that, to date, ASN002 has been well tolerated and has shown encouraging early evidence of clinical activity and symptomatic benefit in the lymphoma patients.
50 years of pediatric residency: What has changed?
When Eileen Ouellette, MD, graduated from Boston’s Harvard Medical School in 1962, she was one of seven women in her class of 141 students. She went on to become one of only three women in pediatric residency at Massachusetts General Hospital later that year.
Free room and board was included in the program, Dr. Ouellette recalled, but her cramped room was poorly insulated and so small that she had to kneel on the bed to open her chest of drawers. The young doctor also soon learned that the women residents made less money than their male counterparts.
Dr. Ouellette, 79, now can laugh at the memory of her tiny room and tinier paycheck. The pediatric residents of today are entering a vastly different environment, she said. For starters, the average pay for medical residents in 2017 is $54,107. Women pediatric residents today far outnumber male residents. And most residents enjoy standard-sized rooms or apartments when completing their residencies.
Technology, for instance, greatly aids pediatric residents in their education today, said Renee Jenkins, MD, a professor at Howard University in Washington and a past AAP president.
Fewer hours, more hand-offs
During Dr. Ouellette’s residency from 1962 to 1965, sleep became a luxury. Of 168 hours in a week, residents were sometimes off for only 26 of them, she said.
“That was absolutely brutal,” she said. “You could not think of anything other than sleep. That became the primary focus of your whole life.”
“It didn’t seem crazy at the time,” said Dr. Stanton, founding dean of Seton Hall University Hackensack Meridian School of Medicine, South Orange, N.J. ”You developed the kind of bond with these families that it wouldn’t occur to you to go home.”
In the 1960s, there were no explicit limits on duty hours, according to Susan White, director of external communications for the Accreditation Council of Graduate Medical Education (ACGME). A “Guide for Residency Programs in Pediatrics,” published in 1968, recommended that “time off should be taken only when the service needs of the patients are assured and that “night and weekend duty provides a valuable educational experience. ... Duty of this type every second or third night and weekend is desirable.”
The guide predates the existence of the ACGME – established in 1981 – but it originated from a committee approved by the American Academy of Pediatrics, the American Board of Pediatrics, and the Council on Medical Education of the American Medical Association, according to Ms. White. While some residency programs changed their work hours over the years, the first mandated requirements for duty hours came in 1990 when ACGME set an 80-hour work week for four specialties: internal medicine, dermatology, ophthalmology, and preventive medicine. The council also limited on-call to every third night that year. In 2003, ACGME put in place duty hour requirements for all specialties.
“The pediatric requirements currently in effect provide safeguards for the resident, guidelines for educational programs, specific competencies and medical knowledge, as well as communication skills, professionalism requirements, and standardized assessment,” Ms. White said.
Current limitations for duty hours are beneficial in terms of resident safety, but the restrictions can be a double-edged sword, Dr. Jenkins said.
A changing gender demographic
By the time Dr. Stanton graduated from Yale in 1976, about 15% of her class were women, a marked shift from just a few years earlier, she said.
“In my residency program, women made up a quarter of our group,” she recalled. “That was a big change.”
The number of women going into pediatric residency has steadily increased in the last 5 decades, now far surpassing the number of men. Of 8,933 pediatric residents from 2015 to 2016, 67% were female and 25% were male, (with 8% not reporting), according to ACGME data.
“
Pediatrics is a natural selection for women, especially for those who plan to raise families, said Antoinette Eaton, MD, a retired pediatrician who completed her residency in the late 1950s at what is now Nationwide Children’s Hospital in Columbus, Ohio. Pediatrics is a prime specialty for career and family balance, she said.
“I worked part time a lot during my career,” said Dr. Eaton, a past AAP president. “Always being responsible as a mother and to the house were very high priorities.”
Dr. Stanton agrees that pediatric practices are much more tolerant of part time work, allowing women to better juggle children and career. However, she notes that the decline of male pediatricians also can be negative for the field overall.
New focus, growing debt
The curriculum focus for pediatric residency, meanwhile, has changed significantly over the years, pediatricians say. Dr. Eaton recalls her residency being almost entirely focused on inpatient care. In fact, insurance companies often refused to pay for outpatient care in sharp contrast to today, she said.
“You had to admit the patient if you wanted insurance to pay for it,” she said. “For example, if you had a patient with cerebral palsy or special needs, I had to admit that patient for 3, 4, 5 days. It was really different than what you have today.”
As time has passed, pediatric requirements have changed to emphasize the need for balance between inpatient and outpatient care, with a focus on continuity of care in either setting, Ms. White said. Newer additions to the requirements include the competencies of professionalism, communication, and life-long learning.
“Over the years these setting have expanded to include inpatients in hospitals, clinics, emergency centers, intensive care units, and in the community, [including] schools and other settings,” she said. “The requirements have always emphasized the importance of having high-quality, board-certified faculty to provide bedside teaching and deliver lectures at conferences.”
Another marked change for pediatric residents is the accumulation of debt. After her medical education, Dr. Jenkins owed about $1,500, she recalls.
“Today, that’s a drop in the bucket,” she said. “For the most part, you stayed out of [debt] trouble. It was nothing compared to that kids have to pay now.”
In 2014, the average medical school student graduated with a median debt of $180,000, according to data from the Association of American Medical Colleges. The wide debt differences are attributed to more expensive medical education today, Dr. Jenkins said.
While debt has risen, clinical responsibilities for residents have dropped as physician extenders and advanced equipment have become commonplace.
When Dr. Ouellette was a resident in the 1960s, there were few technicians to assist and no CT scans or MRIs for imaging. Residents drew blood from and gave blood to patients themselves. They took x-rays and developed them, she said.
“We had to use our brains and figure out what was going on,” she said. “People don’t think so much now. They send x-rays or scans to someone else, rather than figuring out the answer. Medicine may not be as much fun now as it was back then.”
Dr. Eaton added that residents have more technical demands today, more regulations to follow, and more paperwork to complete than the residents of the past. However, she believes pediatrics remains a worthwhile medical path. Three of her four children became doctors, one of whom went into pediatrics.
“I’m very disturbed when people try to convince children not to go into medicine,” she said. “I think it’s still a wonderful and rewarding career.”
[email protected]
On Twitter @legal_med
*Clarification made on 4/21/17
When Eileen Ouellette, MD, graduated from Boston’s Harvard Medical School in 1962, she was one of seven women in her class of 141 students. She went on to become one of only three women in pediatric residency at Massachusetts General Hospital later that year.
Free room and board was included in the program, Dr. Ouellette recalled, but her cramped room was poorly insulated and so small that she had to kneel on the bed to open her chest of drawers. The young doctor also soon learned that the women residents made less money than their male counterparts.
Dr. Ouellette, 79, now can laugh at the memory of her tiny room and tinier paycheck. The pediatric residents of today are entering a vastly different environment, she said. For starters, the average pay for medical residents in 2017 is $54,107. Women pediatric residents today far outnumber male residents. And most residents enjoy standard-sized rooms or apartments when completing their residencies.
Technology, for instance, greatly aids pediatric residents in their education today, said Renee Jenkins, MD, a professor at Howard University in Washington and a past AAP president.
Fewer hours, more hand-offs
During Dr. Ouellette’s residency from 1962 to 1965, sleep became a luxury. Of 168 hours in a week, residents were sometimes off for only 26 of them, she said.
“That was absolutely brutal,” she said. “You could not think of anything other than sleep. That became the primary focus of your whole life.”
“It didn’t seem crazy at the time,” said Dr. Stanton, founding dean of Seton Hall University Hackensack Meridian School of Medicine, South Orange, N.J. ”You developed the kind of bond with these families that it wouldn’t occur to you to go home.”
In the 1960s, there were no explicit limits on duty hours, according to Susan White, director of external communications for the Accreditation Council of Graduate Medical Education (ACGME). A “Guide for Residency Programs in Pediatrics,” published in 1968, recommended that “time off should be taken only when the service needs of the patients are assured and that “night and weekend duty provides a valuable educational experience. ... Duty of this type every second or third night and weekend is desirable.”
The guide predates the existence of the ACGME – established in 1981 – but it originated from a committee approved by the American Academy of Pediatrics, the American Board of Pediatrics, and the Council on Medical Education of the American Medical Association, according to Ms. White. While some residency programs changed their work hours over the years, the first mandated requirements for duty hours came in 1990 when ACGME set an 80-hour work week for four specialties: internal medicine, dermatology, ophthalmology, and preventive medicine. The council also limited on-call to every third night that year. In 2003, ACGME put in place duty hour requirements for all specialties.
“The pediatric requirements currently in effect provide safeguards for the resident, guidelines for educational programs, specific competencies and medical knowledge, as well as communication skills, professionalism requirements, and standardized assessment,” Ms. White said.
Current limitations for duty hours are beneficial in terms of resident safety, but the restrictions can be a double-edged sword, Dr. Jenkins said.
A changing gender demographic
By the time Dr. Stanton graduated from Yale in 1976, about 15% of her class were women, a marked shift from just a few years earlier, she said.
“In my residency program, women made up a quarter of our group,” she recalled. “That was a big change.”
The number of women going into pediatric residency has steadily increased in the last 5 decades, now far surpassing the number of men. Of 8,933 pediatric residents from 2015 to 2016, 67% were female and 25% were male, (with 8% not reporting), according to ACGME data.
“
Pediatrics is a natural selection for women, especially for those who plan to raise families, said Antoinette Eaton, MD, a retired pediatrician who completed her residency in the late 1950s at what is now Nationwide Children’s Hospital in Columbus, Ohio. Pediatrics is a prime specialty for career and family balance, she said.
“I worked part time a lot during my career,” said Dr. Eaton, a past AAP president. “Always being responsible as a mother and to the house were very high priorities.”
Dr. Stanton agrees that pediatric practices are much more tolerant of part time work, allowing women to better juggle children and career. However, she notes that the decline of male pediatricians also can be negative for the field overall.
New focus, growing debt
The curriculum focus for pediatric residency, meanwhile, has changed significantly over the years, pediatricians say. Dr. Eaton recalls her residency being almost entirely focused on inpatient care. In fact, insurance companies often refused to pay for outpatient care in sharp contrast to today, she said.
“You had to admit the patient if you wanted insurance to pay for it,” she said. “For example, if you had a patient with cerebral palsy or special needs, I had to admit that patient for 3, 4, 5 days. It was really different than what you have today.”
As time has passed, pediatric requirements have changed to emphasize the need for balance between inpatient and outpatient care, with a focus on continuity of care in either setting, Ms. White said. Newer additions to the requirements include the competencies of professionalism, communication, and life-long learning.
“Over the years these setting have expanded to include inpatients in hospitals, clinics, emergency centers, intensive care units, and in the community, [including] schools and other settings,” she said. “The requirements have always emphasized the importance of having high-quality, board-certified faculty to provide bedside teaching and deliver lectures at conferences.”
Another marked change for pediatric residents is the accumulation of debt. After her medical education, Dr. Jenkins owed about $1,500, she recalls.
“Today, that’s a drop in the bucket,” she said. “For the most part, you stayed out of [debt] trouble. It was nothing compared to that kids have to pay now.”
In 2014, the average medical school student graduated with a median debt of $180,000, according to data from the Association of American Medical Colleges. The wide debt differences are attributed to more expensive medical education today, Dr. Jenkins said.
While debt has risen, clinical responsibilities for residents have dropped as physician extenders and advanced equipment have become commonplace.
When Dr. Ouellette was a resident in the 1960s, there were few technicians to assist and no CT scans or MRIs for imaging. Residents drew blood from and gave blood to patients themselves. They took x-rays and developed them, she said.
“We had to use our brains and figure out what was going on,” she said. “People don’t think so much now. They send x-rays or scans to someone else, rather than figuring out the answer. Medicine may not be as much fun now as it was back then.”
Dr. Eaton added that residents have more technical demands today, more regulations to follow, and more paperwork to complete than the residents of the past. However, she believes pediatrics remains a worthwhile medical path. Three of her four children became doctors, one of whom went into pediatrics.
“I’m very disturbed when people try to convince children not to go into medicine,” she said. “I think it’s still a wonderful and rewarding career.”
[email protected]
On Twitter @legal_med
*Clarification made on 4/21/17
When Eileen Ouellette, MD, graduated from Boston’s Harvard Medical School in 1962, she was one of seven women in her class of 141 students. She went on to become one of only three women in pediatric residency at Massachusetts General Hospital later that year.
Free room and board was included in the program, Dr. Ouellette recalled, but her cramped room was poorly insulated and so small that she had to kneel on the bed to open her chest of drawers. The young doctor also soon learned that the women residents made less money than their male counterparts.
Dr. Ouellette, 79, now can laugh at the memory of her tiny room and tinier paycheck. The pediatric residents of today are entering a vastly different environment, she said. For starters, the average pay for medical residents in 2017 is $54,107. Women pediatric residents today far outnumber male residents. And most residents enjoy standard-sized rooms or apartments when completing their residencies.
Technology, for instance, greatly aids pediatric residents in their education today, said Renee Jenkins, MD, a professor at Howard University in Washington and a past AAP president.
Fewer hours, more hand-offs
During Dr. Ouellette’s residency from 1962 to 1965, sleep became a luxury. Of 168 hours in a week, residents were sometimes off for only 26 of them, she said.
“That was absolutely brutal,” she said. “You could not think of anything other than sleep. That became the primary focus of your whole life.”
“It didn’t seem crazy at the time,” said Dr. Stanton, founding dean of Seton Hall University Hackensack Meridian School of Medicine, South Orange, N.J. ”You developed the kind of bond with these families that it wouldn’t occur to you to go home.”
In the 1960s, there were no explicit limits on duty hours, according to Susan White, director of external communications for the Accreditation Council of Graduate Medical Education (ACGME). A “Guide for Residency Programs in Pediatrics,” published in 1968, recommended that “time off should be taken only when the service needs of the patients are assured and that “night and weekend duty provides a valuable educational experience. ... Duty of this type every second or third night and weekend is desirable.”
The guide predates the existence of the ACGME – established in 1981 – but it originated from a committee approved by the American Academy of Pediatrics, the American Board of Pediatrics, and the Council on Medical Education of the American Medical Association, according to Ms. White. While some residency programs changed their work hours over the years, the first mandated requirements for duty hours came in 1990 when ACGME set an 80-hour work week for four specialties: internal medicine, dermatology, ophthalmology, and preventive medicine. The council also limited on-call to every third night that year. In 2003, ACGME put in place duty hour requirements for all specialties.
“The pediatric requirements currently in effect provide safeguards for the resident, guidelines for educational programs, specific competencies and medical knowledge, as well as communication skills, professionalism requirements, and standardized assessment,” Ms. White said.
Current limitations for duty hours are beneficial in terms of resident safety, but the restrictions can be a double-edged sword, Dr. Jenkins said.
A changing gender demographic
By the time Dr. Stanton graduated from Yale in 1976, about 15% of her class were women, a marked shift from just a few years earlier, she said.
“In my residency program, women made up a quarter of our group,” she recalled. “That was a big change.”
The number of women going into pediatric residency has steadily increased in the last 5 decades, now far surpassing the number of men. Of 8,933 pediatric residents from 2015 to 2016, 67% were female and 25% were male, (with 8% not reporting), according to ACGME data.
“
Pediatrics is a natural selection for women, especially for those who plan to raise families, said Antoinette Eaton, MD, a retired pediatrician who completed her residency in the late 1950s at what is now Nationwide Children’s Hospital in Columbus, Ohio. Pediatrics is a prime specialty for career and family balance, she said.
“I worked part time a lot during my career,” said Dr. Eaton, a past AAP president. “Always being responsible as a mother and to the house were very high priorities.”
Dr. Stanton agrees that pediatric practices are much more tolerant of part time work, allowing women to better juggle children and career. However, she notes that the decline of male pediatricians also can be negative for the field overall.
New focus, growing debt
The curriculum focus for pediatric residency, meanwhile, has changed significantly over the years, pediatricians say. Dr. Eaton recalls her residency being almost entirely focused on inpatient care. In fact, insurance companies often refused to pay for outpatient care in sharp contrast to today, she said.
“You had to admit the patient if you wanted insurance to pay for it,” she said. “For example, if you had a patient with cerebral palsy or special needs, I had to admit that patient for 3, 4, 5 days. It was really different than what you have today.”
As time has passed, pediatric requirements have changed to emphasize the need for balance between inpatient and outpatient care, with a focus on continuity of care in either setting, Ms. White said. Newer additions to the requirements include the competencies of professionalism, communication, and life-long learning.
“Over the years these setting have expanded to include inpatients in hospitals, clinics, emergency centers, intensive care units, and in the community, [including] schools and other settings,” she said. “The requirements have always emphasized the importance of having high-quality, board-certified faculty to provide bedside teaching and deliver lectures at conferences.”
Another marked change for pediatric residents is the accumulation of debt. After her medical education, Dr. Jenkins owed about $1,500, she recalls.
“Today, that’s a drop in the bucket,” she said. “For the most part, you stayed out of [debt] trouble. It was nothing compared to that kids have to pay now.”
In 2014, the average medical school student graduated with a median debt of $180,000, according to data from the Association of American Medical Colleges. The wide debt differences are attributed to more expensive medical education today, Dr. Jenkins said.
While debt has risen, clinical responsibilities for residents have dropped as physician extenders and advanced equipment have become commonplace.
When Dr. Ouellette was a resident in the 1960s, there were few technicians to assist and no CT scans or MRIs for imaging. Residents drew blood from and gave blood to patients themselves. They took x-rays and developed them, she said.
“We had to use our brains and figure out what was going on,” she said. “People don’t think so much now. They send x-rays or scans to someone else, rather than figuring out the answer. Medicine may not be as much fun now as it was back then.”
Dr. Eaton added that residents have more technical demands today, more regulations to follow, and more paperwork to complete than the residents of the past. However, she believes pediatrics remains a worthwhile medical path. Three of her four children became doctors, one of whom went into pediatrics.
“I’m very disturbed when people try to convince children not to go into medicine,” she said. “I think it’s still a wonderful and rewarding career.”
[email protected]
On Twitter @legal_med
*Clarification made on 4/21/17
Apply By May 1 for International Scholarships for Surgical Education
Two international scholarships focused on surgical education and sponsored by the American College of Surgeons (ACS) Division of Education and the International Relations Committee will offer faculty members from countries outside the U.S. and Canada the opportunity to participate in a variety of faculty development activities. All application materials and supporting documents are due May 1.
The scholars will participate in the Surgical Education: Principles and Practice Course at the Clinical Congress 2017, October 22–26 in San Diego, CA. In addition, the scholars will attend plenary sessions and courses that address surgical education and training across the continuum of professional development. The scholars, in turn, will use the knowledge and skills they acquire to improve surgical education and training in their home institutions and countries. The scholarships include a stipend of $10,000 to cover travel, per diem expenses, and the cost of Clinical Congress courses. The registration cost for Clinical Congress and fees for the surgical education courses will be provided free to the scholars.
View the scholarship requirements and access the application on the ACS website at facs.org/member-services/scholarships/international/issurged. Direct questions to the ACS International Liaison at [email protected].
Two international scholarships focused on surgical education and sponsored by the American College of Surgeons (ACS) Division of Education and the International Relations Committee will offer faculty members from countries outside the U.S. and Canada the opportunity to participate in a variety of faculty development activities. All application materials and supporting documents are due May 1.
The scholars will participate in the Surgical Education: Principles and Practice Course at the Clinical Congress 2017, October 22–26 in San Diego, CA. In addition, the scholars will attend plenary sessions and courses that address surgical education and training across the continuum of professional development. The scholars, in turn, will use the knowledge and skills they acquire to improve surgical education and training in their home institutions and countries. The scholarships include a stipend of $10,000 to cover travel, per diem expenses, and the cost of Clinical Congress courses. The registration cost for Clinical Congress and fees for the surgical education courses will be provided free to the scholars.
View the scholarship requirements and access the application on the ACS website at facs.org/member-services/scholarships/international/issurged. Direct questions to the ACS International Liaison at [email protected].
Two international scholarships focused on surgical education and sponsored by the American College of Surgeons (ACS) Division of Education and the International Relations Committee will offer faculty members from countries outside the U.S. and Canada the opportunity to participate in a variety of faculty development activities. All application materials and supporting documents are due May 1.
The scholars will participate in the Surgical Education: Principles and Practice Course at the Clinical Congress 2017, October 22–26 in San Diego, CA. In addition, the scholars will attend plenary sessions and courses that address surgical education and training across the continuum of professional development. The scholars, in turn, will use the knowledge and skills they acquire to improve surgical education and training in their home institutions and countries. The scholarships include a stipend of $10,000 to cover travel, per diem expenses, and the cost of Clinical Congress courses. The registration cost for Clinical Congress and fees for the surgical education courses will be provided free to the scholars.
View the scholarship requirements and access the application on the ACS website at facs.org/member-services/scholarships/international/issurged. Direct questions to the ACS International Liaison at [email protected].
From the Washington Office: Advocacy in Action
Fellows frequently ask how they can get more involved in the advocacy efforts of the ACS. Whether you are new to the arena of policy and advocacy or an experienced veteran of innumerable efforts directed at ensuring access to quality surgical care, I can think of no better way to learn new skills and exercise old ones than by attending the ACS’ annual Leadership and Advocacy Summit.
The 2017 Leadership and Advocacy Summit will take place May 6–9 at the Renaissance Washington, DC Downtown Hotel. More than 300 individuals have already registered and you can join them by registering via the link found here: https://www.facs.org/advocacy/participate/summit-2017/register
The Advocacy Summit portion of the meeting will kick-off on the evening of May 7 with a reception and dinner featuring bestselling author, MSNBC political analyst, and former Communications Chief for President George W. Bush, Nicolle Wallace as the Keynote Speaker.
A robust agenda is planned for Monday, May 8. The morning will lead off with a panel entitled, Perspectives on 2017 Health Care Reform, featuring health policy experts from the Georgetown University Law Center, the George Washington University Milken Institute School of Public Health, the American Enterprise Institute, and the Heritage Foundation. The Monday agenda will also feature a panel of senior staffers from Capitol Hill discussing issues of particular interest to Fellows, a Medicare physician payment panel, and an address from a leading authority on effective communications strategies designed to make your interaction with legislators and their staff more effective.
The luncheon speaker for Monday will be Fox News contributor and Washington Examiner columnist, Lisa Boothe. The afternoon agenda will conclude with a series of issue briefings from ACS staff (in preparation for the Hill visits to legislator’s offices scheduled for Tuesday, May 9) and remarks from several United States Senators. ACSPA-SurgeonsPAC will host a reception on Monday evening, May 8 for all 2017 PAC contributors and a guest.
On Tuesday morning, May 9, attendees will be transported to Capitol Hill to visit the offices of their individual Member of Congress, Senators and staff with visits concluding in time to make flights out of Washington that afternoon.
I encourage all Fellows who are able to set aside time for the event to do so as I believe all will find the program educational and the experience rewarding.
For information about the Leadership Summit, contact Connie Bura at [email protected], or 312-919-5290. For information about the Advocacy Summit, contact Michael Carmody at [email protected], or 202-672-1511.
Until next month ….
Dr. Bailey is a pediatric surgeon, and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, DC.
Fellows frequently ask how they can get more involved in the advocacy efforts of the ACS. Whether you are new to the arena of policy and advocacy or an experienced veteran of innumerable efforts directed at ensuring access to quality surgical care, I can think of no better way to learn new skills and exercise old ones than by attending the ACS’ annual Leadership and Advocacy Summit.
The 2017 Leadership and Advocacy Summit will take place May 6–9 at the Renaissance Washington, DC Downtown Hotel. More than 300 individuals have already registered and you can join them by registering via the link found here: https://www.facs.org/advocacy/participate/summit-2017/register
The Advocacy Summit portion of the meeting will kick-off on the evening of May 7 with a reception and dinner featuring bestselling author, MSNBC political analyst, and former Communications Chief for President George W. Bush, Nicolle Wallace as the Keynote Speaker.
A robust agenda is planned for Monday, May 8. The morning will lead off with a panel entitled, Perspectives on 2017 Health Care Reform, featuring health policy experts from the Georgetown University Law Center, the George Washington University Milken Institute School of Public Health, the American Enterprise Institute, and the Heritage Foundation. The Monday agenda will also feature a panel of senior staffers from Capitol Hill discussing issues of particular interest to Fellows, a Medicare physician payment panel, and an address from a leading authority on effective communications strategies designed to make your interaction with legislators and their staff more effective.
The luncheon speaker for Monday will be Fox News contributor and Washington Examiner columnist, Lisa Boothe. The afternoon agenda will conclude with a series of issue briefings from ACS staff (in preparation for the Hill visits to legislator’s offices scheduled for Tuesday, May 9) and remarks from several United States Senators. ACSPA-SurgeonsPAC will host a reception on Monday evening, May 8 for all 2017 PAC contributors and a guest.
On Tuesday morning, May 9, attendees will be transported to Capitol Hill to visit the offices of their individual Member of Congress, Senators and staff with visits concluding in time to make flights out of Washington that afternoon.
I encourage all Fellows who are able to set aside time for the event to do so as I believe all will find the program educational and the experience rewarding.
For information about the Leadership Summit, contact Connie Bura at [email protected], or 312-919-5290. For information about the Advocacy Summit, contact Michael Carmody at [email protected], or 202-672-1511.
Until next month ….
Dr. Bailey is a pediatric surgeon, and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, DC.
Fellows frequently ask how they can get more involved in the advocacy efforts of the ACS. Whether you are new to the arena of policy and advocacy or an experienced veteran of innumerable efforts directed at ensuring access to quality surgical care, I can think of no better way to learn new skills and exercise old ones than by attending the ACS’ annual Leadership and Advocacy Summit.
The 2017 Leadership and Advocacy Summit will take place May 6–9 at the Renaissance Washington, DC Downtown Hotel. More than 300 individuals have already registered and you can join them by registering via the link found here: https://www.facs.org/advocacy/participate/summit-2017/register
The Advocacy Summit portion of the meeting will kick-off on the evening of May 7 with a reception and dinner featuring bestselling author, MSNBC political analyst, and former Communications Chief for President George W. Bush, Nicolle Wallace as the Keynote Speaker.
A robust agenda is planned for Monday, May 8. The morning will lead off with a panel entitled, Perspectives on 2017 Health Care Reform, featuring health policy experts from the Georgetown University Law Center, the George Washington University Milken Institute School of Public Health, the American Enterprise Institute, and the Heritage Foundation. The Monday agenda will also feature a panel of senior staffers from Capitol Hill discussing issues of particular interest to Fellows, a Medicare physician payment panel, and an address from a leading authority on effective communications strategies designed to make your interaction with legislators and their staff more effective.
The luncheon speaker for Monday will be Fox News contributor and Washington Examiner columnist, Lisa Boothe. The afternoon agenda will conclude with a series of issue briefings from ACS staff (in preparation for the Hill visits to legislator’s offices scheduled for Tuesday, May 9) and remarks from several United States Senators. ACSPA-SurgeonsPAC will host a reception on Monday evening, May 8 for all 2017 PAC contributors and a guest.
On Tuesday morning, May 9, attendees will be transported to Capitol Hill to visit the offices of their individual Member of Congress, Senators and staff with visits concluding in time to make flights out of Washington that afternoon.
I encourage all Fellows who are able to set aside time for the event to do so as I believe all will find the program educational and the experience rewarding.
For information about the Leadership Summit, contact Connie Bura at [email protected], or 312-919-5290. For information about the Advocacy Summit, contact Michael Carmody at [email protected], or 202-672-1511.
Until next month ….
Dr. Bailey is a pediatric surgeon, and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, DC.
2017 Claude H. Organ, Jr., MD, FACS Traveling Fellowship Applications due June 1
The family and friends of the late Dr. Claude H. Organ, Jr., established an endowment through the American College of Surgeons (ACS) Foundation to provide funding for an annual fellowship to be awarded to an outstanding young surgeon from the Society of Black Academic Surgeons, the Association of Women Surgeons, or the Surgical Section of the National Medical Association.
The fellowship, in the amount of $5,000, enables a U.S. or Canadian Fellow or Associate Fellow under age 45 who is a member of one of the above societies to attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests.
Past awardees have used their fellowships to develop their careers in creative ways. The 2016 fellow, Stephanie Bonne, MD, is researching a successful hospital-based violence program in San Francisco in order to develop one at her home institution.
View the full requirements for the Claude H. Organ Traveling Fellowship at facs.org/member-services/scholarships/special/organ. The deadline for receipt of all application materials is June 1, with decisions to be made by August 2017. Questions and application materials should be submitted to the attention of the ACS Scholarships Administrator at [email protected].
The family and friends of the late Dr. Claude H. Organ, Jr., established an endowment through the American College of Surgeons (ACS) Foundation to provide funding for an annual fellowship to be awarded to an outstanding young surgeon from the Society of Black Academic Surgeons, the Association of Women Surgeons, or the Surgical Section of the National Medical Association.
The fellowship, in the amount of $5,000, enables a U.S. or Canadian Fellow or Associate Fellow under age 45 who is a member of one of the above societies to attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests.
Past awardees have used their fellowships to develop their careers in creative ways. The 2016 fellow, Stephanie Bonne, MD, is researching a successful hospital-based violence program in San Francisco in order to develop one at her home institution.
View the full requirements for the Claude H. Organ Traveling Fellowship at facs.org/member-services/scholarships/special/organ. The deadline for receipt of all application materials is June 1, with decisions to be made by August 2017. Questions and application materials should be submitted to the attention of the ACS Scholarships Administrator at [email protected].
The family and friends of the late Dr. Claude H. Organ, Jr., established an endowment through the American College of Surgeons (ACS) Foundation to provide funding for an annual fellowship to be awarded to an outstanding young surgeon from the Society of Black Academic Surgeons, the Association of Women Surgeons, or the Surgical Section of the National Medical Association.
The fellowship, in the amount of $5,000, enables a U.S. or Canadian Fellow or Associate Fellow under age 45 who is a member of one of the above societies to attend an educational meeting or make an extended visit to an institution of his or her choice, tailored to his or her research interests.
Past awardees have used their fellowships to develop their careers in creative ways. The 2016 fellow, Stephanie Bonne, MD, is researching a successful hospital-based violence program in San Francisco in order to develop one at her home institution.
View the full requirements for the Claude H. Organ Traveling Fellowship at facs.org/member-services/scholarships/special/organ. The deadline for receipt of all application materials is June 1, with decisions to be made by August 2017. Questions and application materials should be submitted to the attention of the ACS Scholarships Administrator at [email protected].
Access new surgeon and resident well-being resources
Personal and professional well-being are vital to the success of members of the American College of Surgeons (ACS) and your patients. Many health care professionals experience periods of distress, yet few physicians seek help. In an effort to provide relief to interested surgeons, the ACS has compiled several resources to support surgeons and residents as they confront the challenges associated with surgical care.
Visit the ACS Surgeon Well-Being page at facs.org/burnout to learn more about the tool and how to access it, as well as to review other helpful resources.
Personal and professional well-being are vital to the success of members of the American College of Surgeons (ACS) and your patients. Many health care professionals experience periods of distress, yet few physicians seek help. In an effort to provide relief to interested surgeons, the ACS has compiled several resources to support surgeons and residents as they confront the challenges associated with surgical care.
Visit the ACS Surgeon Well-Being page at facs.org/burnout to learn more about the tool and how to access it, as well as to review other helpful resources.
Personal and professional well-being are vital to the success of members of the American College of Surgeons (ACS) and your patients. Many health care professionals experience periods of distress, yet few physicians seek help. In an effort to provide relief to interested surgeons, the ACS has compiled several resources to support surgeons and residents as they confront the challenges associated with surgical care.
Visit the ACS Surgeon Well-Being page at facs.org/burnout to learn more about the tool and how to access it, as well as to review other helpful resources.
Three days in the life of a surgeon
By sheer happenstance, I was visiting a surgery program on the day after “the Match.” As all of you know, four days before the official release of the placement of every new surgical trainee, both the medical students involved and the programs affected are informed as to whether they have been matched. Students don’t know where they are going, just that the last rung of training is now in place. They have a job and a relatively secure future. Those who have not been matched and those programs that did not fill all their slots now enter into a scramble (officially called SOAP) to find students for the remaining slots. This year, the scramble occurred on a Wednesday and was orchestrated by a set of rules I’d never been privy to before.
On Tuesday night, all the programs in need of students for their open slots, whether categorical or preliminary, looked over the list of candidates remaining and made their choices. So did the students now hoping to find a place. At 10 a.m., the offers went out to students in the first round. Next, in precisely timed order, the programs found out who had accepted the offers. And, if slots were left over, the programs had a short time to put up another set of offers – and so on throughout the day until all the slots were gone. Like a game of musical chairs, the music finally stopped and the Match was over for the entering class of residents for 2017.
Dr. Hughes is clinical professor in the department of surgery and director of medical education at the Kansas University School of Medicine, Salina Campus, and coeditor of ACS Surgery News.
By sheer happenstance, I was visiting a surgery program on the day after “the Match.” As all of you know, four days before the official release of the placement of every new surgical trainee, both the medical students involved and the programs affected are informed as to whether they have been matched. Students don’t know where they are going, just that the last rung of training is now in place. They have a job and a relatively secure future. Those who have not been matched and those programs that did not fill all their slots now enter into a scramble (officially called SOAP) to find students for the remaining slots. This year, the scramble occurred on a Wednesday and was orchestrated by a set of rules I’d never been privy to before.
On Tuesday night, all the programs in need of students for their open slots, whether categorical or preliminary, looked over the list of candidates remaining and made their choices. So did the students now hoping to find a place. At 10 a.m., the offers went out to students in the first round. Next, in precisely timed order, the programs found out who had accepted the offers. And, if slots were left over, the programs had a short time to put up another set of offers – and so on throughout the day until all the slots were gone. Like a game of musical chairs, the music finally stopped and the Match was over for the entering class of residents for 2017.
Dr. Hughes is clinical professor in the department of surgery and director of medical education at the Kansas University School of Medicine, Salina Campus, and coeditor of ACS Surgery News.
By sheer happenstance, I was visiting a surgery program on the day after “the Match.” As all of you know, four days before the official release of the placement of every new surgical trainee, both the medical students involved and the programs affected are informed as to whether they have been matched. Students don’t know where they are going, just that the last rung of training is now in place. They have a job and a relatively secure future. Those who have not been matched and those programs that did not fill all their slots now enter into a scramble (officially called SOAP) to find students for the remaining slots. This year, the scramble occurred on a Wednesday and was orchestrated by a set of rules I’d never been privy to before.
On Tuesday night, all the programs in need of students for their open slots, whether categorical or preliminary, looked over the list of candidates remaining and made their choices. So did the students now hoping to find a place. At 10 a.m., the offers went out to students in the first round. Next, in precisely timed order, the programs found out who had accepted the offers. And, if slots were left over, the programs had a short time to put up another set of offers – and so on throughout the day until all the slots were gone. Like a game of musical chairs, the music finally stopped and the Match was over for the entering class of residents for 2017.
Dr. Hughes is clinical professor in the department of surgery and director of medical education at the Kansas University School of Medicine, Salina Campus, and coeditor of ACS Surgery News.
Legends Come to Lunch
A highlight of the Postgraduate Symposia at the AATS Centennial will be the Legends Luncheons. This year, renowned cardiothoracic surgeons, William I. Norwood, MD, Valerie W. Rusch, MD, and Magdi H. Yacoub, MD, will share their experiences at the interactive luncheons on Sunday at each of the Postgraduate Symposia. You must be registered for a Sunday Postgraduate Symposia to attend the Legend Luncheons, but you may select any luncheon to attend.
William I. Norwood, MD (Congenital Heart Surgery)
Dr. Norwood trained in cardiac surgery at the University of Minnesota as well as at Brigham and Women’s Hospital. He took a staff position at Boston Children’s Hospital in 1976. In 1981, he and his colleageues first reported the hypoplastic left heart syndrome (HLHS) procedure that bears his name.
HLHS is congenital heart defect in which one or more of the left-sided cardiac structures are underdeveloped and unable to support the systemic circulation. Dr. Norwood’s operation, improved over the years with subsequent stages and refinements, alleviated the universally fatal condition, allowing survivors to live functional lives, even if restricted to varying degreess.
Dr. Norwood became chief of cardiac surgery at Children’s Hospital of Philadelphia, after which, he and Aldo Castaneda, MD, established a private clinic in Geneva, Switzerland in 1994. Dr. Norwood later moved to Nemours/Alfred I. duPont Hospital for Children, from which he retired from clinical practice in 2003.
Valerie W. Rusch, MD (General Thoraic Surgery)
Dr. Rusch is the Vice Chair for Clinical Research, Department of Surgery, and Miner Family Chair in Intrathoracic Cancers at Memorial Sloan Kettering Cancer Center. Dr. Rusch was a pioneer among women in cardiothoracic surgery, and was among the first women in the country to be board certified. In 2015, Dr. Rusch was elected Chair of the Board of Regents of the American College of Surgeons, one of the most prestigious positions a surgeon can attain.
Dr. Rusch specializes in the diagnosis and treatment of patients with a variety of thoracic cancers, including lung, esophageal, mediastinaal, chest wall, and pleural.
She is a national leader in clinical trials for thoracic malignancies, and has received the Thoracic Surgery Foundation for Research and Education Socrates Award. Dr. Rusch is co-author on more than 260 papers and numerous book chapters and invited texts and has received numerous teaching and patient-care excellence awards.
Magdi H. Yacoub, MD (Adult Cardiac Surgery and Transplantation)
Dr. Yacoub is Professor of Cardiothoracic Surgery at the National Heart and Lung Institute, Imperial College London, and Founder and Director of Research at the Magdi Yacoub Institute, Harefield Heart Science Centre, which focuses on tissue engineering, myocardial regeneration, stem cell biology, end stage heart failure, and transplant immunology. He is also Founder and Director of Magdi Yacoub Research Network which has created the Qatar Cardiovascular Research Center in collaboration with Qatar Foundation and Hamad Medical Corporation.
Dr. Yacoub was born in Egypt and held an assistant professorship at the University of Chicago. He was a British Heart Foundation Professor of Cardiothoracic Surgery for over 20 years, and a consultant cardiothoracic surgeon at Harefield Hospital from 1969-2001 and Royal Brompton Hospital from 1986-2001.
Dr. Yacoub established the largest heart and lung transplantation program in the world (in the United Kingdom) where more than 2,500 transplant operations have been performed. Among his many other accomplishments, he pioneered a live-saving surgical technique for treating infants born with transposition of the great arteries.
Dr. Yacoub was knighted for his services to medicine and surgery in 1991, awarded Fellowship of the Academy of Medical Sciences in 1998 and became a Fellow of The Royal Society in 1999.
Dr. Yacoub is author or co-author on more than 1,000 articles
A highlight of the Postgraduate Symposia at the AATS Centennial will be the Legends Luncheons. This year, renowned cardiothoracic surgeons, William I. Norwood, MD, Valerie W. Rusch, MD, and Magdi H. Yacoub, MD, will share their experiences at the interactive luncheons on Sunday at each of the Postgraduate Symposia. You must be registered for a Sunday Postgraduate Symposia to attend the Legend Luncheons, but you may select any luncheon to attend.
William I. Norwood, MD (Congenital Heart Surgery)
Dr. Norwood trained in cardiac surgery at the University of Minnesota as well as at Brigham and Women’s Hospital. He took a staff position at Boston Children’s Hospital in 1976. In 1981, he and his colleageues first reported the hypoplastic left heart syndrome (HLHS) procedure that bears his name.
HLHS is congenital heart defect in which one or more of the left-sided cardiac structures are underdeveloped and unable to support the systemic circulation. Dr. Norwood’s operation, improved over the years with subsequent stages and refinements, alleviated the universally fatal condition, allowing survivors to live functional lives, even if restricted to varying degreess.
Dr. Norwood became chief of cardiac surgery at Children’s Hospital of Philadelphia, after which, he and Aldo Castaneda, MD, established a private clinic in Geneva, Switzerland in 1994. Dr. Norwood later moved to Nemours/Alfred I. duPont Hospital for Children, from which he retired from clinical practice in 2003.
Valerie W. Rusch, MD (General Thoraic Surgery)
Dr. Rusch is the Vice Chair for Clinical Research, Department of Surgery, and Miner Family Chair in Intrathoracic Cancers at Memorial Sloan Kettering Cancer Center. Dr. Rusch was a pioneer among women in cardiothoracic surgery, and was among the first women in the country to be board certified. In 2015, Dr. Rusch was elected Chair of the Board of Regents of the American College of Surgeons, one of the most prestigious positions a surgeon can attain.
Dr. Rusch specializes in the diagnosis and treatment of patients with a variety of thoracic cancers, including lung, esophageal, mediastinaal, chest wall, and pleural.
She is a national leader in clinical trials for thoracic malignancies, and has received the Thoracic Surgery Foundation for Research and Education Socrates Award. Dr. Rusch is co-author on more than 260 papers and numerous book chapters and invited texts and has received numerous teaching and patient-care excellence awards.
Magdi H. Yacoub, MD (Adult Cardiac Surgery and Transplantation)
Dr. Yacoub is Professor of Cardiothoracic Surgery at the National Heart and Lung Institute, Imperial College London, and Founder and Director of Research at the Magdi Yacoub Institute, Harefield Heart Science Centre, which focuses on tissue engineering, myocardial regeneration, stem cell biology, end stage heart failure, and transplant immunology. He is also Founder and Director of Magdi Yacoub Research Network which has created the Qatar Cardiovascular Research Center in collaboration with Qatar Foundation and Hamad Medical Corporation.
Dr. Yacoub was born in Egypt and held an assistant professorship at the University of Chicago. He was a British Heart Foundation Professor of Cardiothoracic Surgery for over 20 years, and a consultant cardiothoracic surgeon at Harefield Hospital from 1969-2001 and Royal Brompton Hospital from 1986-2001.
Dr. Yacoub established the largest heart and lung transplantation program in the world (in the United Kingdom) where more than 2,500 transplant operations have been performed. Among his many other accomplishments, he pioneered a live-saving surgical technique for treating infants born with transposition of the great arteries.
Dr. Yacoub was knighted for his services to medicine and surgery in 1991, awarded Fellowship of the Academy of Medical Sciences in 1998 and became a Fellow of The Royal Society in 1999.
Dr. Yacoub is author or co-author on more than 1,000 articles
A highlight of the Postgraduate Symposia at the AATS Centennial will be the Legends Luncheons. This year, renowned cardiothoracic surgeons, William I. Norwood, MD, Valerie W. Rusch, MD, and Magdi H. Yacoub, MD, will share their experiences at the interactive luncheons on Sunday at each of the Postgraduate Symposia. You must be registered for a Sunday Postgraduate Symposia to attend the Legend Luncheons, but you may select any luncheon to attend.
William I. Norwood, MD (Congenital Heart Surgery)
Dr. Norwood trained in cardiac surgery at the University of Minnesota as well as at Brigham and Women’s Hospital. He took a staff position at Boston Children’s Hospital in 1976. In 1981, he and his colleageues first reported the hypoplastic left heart syndrome (HLHS) procedure that bears his name.
HLHS is congenital heart defect in which one or more of the left-sided cardiac structures are underdeveloped and unable to support the systemic circulation. Dr. Norwood’s operation, improved over the years with subsequent stages and refinements, alleviated the universally fatal condition, allowing survivors to live functional lives, even if restricted to varying degreess.
Dr. Norwood became chief of cardiac surgery at Children’s Hospital of Philadelphia, after which, he and Aldo Castaneda, MD, established a private clinic in Geneva, Switzerland in 1994. Dr. Norwood later moved to Nemours/Alfred I. duPont Hospital for Children, from which he retired from clinical practice in 2003.
Valerie W. Rusch, MD (General Thoraic Surgery)
Dr. Rusch is the Vice Chair for Clinical Research, Department of Surgery, and Miner Family Chair in Intrathoracic Cancers at Memorial Sloan Kettering Cancer Center. Dr. Rusch was a pioneer among women in cardiothoracic surgery, and was among the first women in the country to be board certified. In 2015, Dr. Rusch was elected Chair of the Board of Regents of the American College of Surgeons, one of the most prestigious positions a surgeon can attain.
Dr. Rusch specializes in the diagnosis and treatment of patients with a variety of thoracic cancers, including lung, esophageal, mediastinaal, chest wall, and pleural.
She is a national leader in clinical trials for thoracic malignancies, and has received the Thoracic Surgery Foundation for Research and Education Socrates Award. Dr. Rusch is co-author on more than 260 papers and numerous book chapters and invited texts and has received numerous teaching and patient-care excellence awards.
Magdi H. Yacoub, MD (Adult Cardiac Surgery and Transplantation)
Dr. Yacoub is Professor of Cardiothoracic Surgery at the National Heart and Lung Institute, Imperial College London, and Founder and Director of Research at the Magdi Yacoub Institute, Harefield Heart Science Centre, which focuses on tissue engineering, myocardial regeneration, stem cell biology, end stage heart failure, and transplant immunology. He is also Founder and Director of Magdi Yacoub Research Network which has created the Qatar Cardiovascular Research Center in collaboration with Qatar Foundation and Hamad Medical Corporation.
Dr. Yacoub was born in Egypt and held an assistant professorship at the University of Chicago. He was a British Heart Foundation Professor of Cardiothoracic Surgery for over 20 years, and a consultant cardiothoracic surgeon at Harefield Hospital from 1969-2001 and Royal Brompton Hospital from 1986-2001.
Dr. Yacoub established the largest heart and lung transplantation program in the world (in the United Kingdom) where more than 2,500 transplant operations have been performed. Among his many other accomplishments, he pioneered a live-saving surgical technique for treating infants born with transposition of the great arteries.
Dr. Yacoub was knighted for his services to medicine and surgery in 1991, awarded Fellowship of the Academy of Medical Sciences in 1998 and became a Fellow of The Royal Society in 1999.
Dr. Yacoub is author or co-author on more than 1,000 articles