1
|
Ding JL, Christophers B, Rupert DD, Tang CY, Serafini RA, Jansen CS, Curtis MDE, Chesebro AG, Waldman AD. How to diversify the dwindling physician-scientist workforce after the US affirmative action ban. Nat Med 2024; 30:635-637. [PMID: 38291299 DOI: 10.1038/s41591-023-02787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Affiliation(s)
- Jessica L Ding
- Michigan State University MD-PhD Program, East Lansing, MI, USA.
- American Physician Scientists Association, Westford, MA, USA.
| | - Briana Christophers
- American Physician Scientists Association, Westford, MA, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Deborah D Rupert
- American Physician Scientists Association, Westford, MA, USA
- Stony Brook University Medical Scientist Training Program, Stony Brook, NY, USA
| | - Cynthia Y Tang
- American Physician Scientists Association, Westford, MA, USA
- University of Missouri School of Medicine, Columbia, MO, USA
- University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Randal A Serafini
- American Physician Scientists Association, Westford, MA, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Caroline S Jansen
- American Physician Scientists Association, Westford, MA, USA
- Emory University Medical Scientist Training Program, Atlanta, GA, USA
| | - Micaila D E Curtis
- American Physician Scientists Association, Westford, MA, USA
- Department of Biochemistry and Molecular & Cellular Biology, Georgetown University, Washington, DC, USA
| | - Anthony G Chesebro
- American Physician Scientists Association, Westford, MA, USA
- Stony Brook University Medical Scientist Training Program, Stony Brook, NY, USA
| | - Alex D Waldman
- American Physician Scientists Association, Westford, MA, USA
- Emory University Medical Scientist Training Program, Atlanta, GA, USA
| |
Collapse
|
2
|
Williams DKA, Christophers B, Keyes T, Kumar R, Granovetter MC, Adigun A, Olivera J, Pura-Bryant J, Smith C, Okafor C, Shibre M, Daye D, Akabas MH. Sociodemographic factors and research experience impact MD-PhD program acceptance. JCI Insight 2024; 9:e176146. [PMID: 38329127 DOI: 10.1172/jci.insight.176146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
The 2014 NIH Physician-Scientist Workforce Working Group predicted a future shortage of physician-scientists. Subsequent studies have highlighted disparities in MD-PhD admissions based on race, income, and education. Our analysis of data from the Association of American Medical Colleges covering 2014-2021 (15,156 applicants and 6,840 acceptees) revealed that acceptance into US MD-PhD programs correlates with research experience, family income, and research publications. The number of research experiences associated with parental education and family income. Applicants were more likely to be accepted with a family income greater than $50,000 or with one or more publications or presentations. Applicants were less likely to be accepted if they had parents without a graduate degree, were Black/African American, were first-generation college students, or were reapplicants, irrespective of the number of research experiences, publications, or presentations. These findings underscore an admissions bias that favors candidates from affluent and highly educated families, while disadvantaging underrepresented minorities.
Collapse
Affiliation(s)
- Darnell K Adrian Williams
- Albert Einstein College of Medicine, Medical Scientist Training Program, Bronx, New York, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
- American Physician Scientists Association, Westford, Massachusetts, USA
| | - Briana Christophers
- American Physician Scientists Association, Westford, Massachusetts, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York, USA
| | - Timothy Keyes
- American Physician Scientists Association, Westford, Massachusetts, USA
- Stanford University Medical Scientist Training Program, Stanford, California, USA
| | - Rachit Kumar
- American Physician Scientists Association, Westford, Massachusetts, USA
- Perelman School of Medicine at the University of Pennsylvania, Medical Scientist Training Program, Philadelphia, Pennsylvania, USA
| | - Michael C Granovetter
- American Physician Scientists Association, Westford, Massachusetts, USA
- University of Pittsburgh-Carnegie Mellon University Medical Scientist Training Program, Pittsburgh, Pennsylvania, USA
| | - Alexandria Adigun
- American Physician Scientists Association, Westford, Massachusetts, USA
- Perelman School of Medicine at the University of Pennsylvania, Medical Scientist Training Program, Philadelphia, Pennsylvania, USA
| | - Justin Olivera
- Albert Einstein College of Medicine, Bronx, New York, USA
- American Physician Scientists Association, Westford, Massachusetts, USA
| | - Jehron Pura-Bryant
- Albert Einstein College of Medicine, Bronx, New York, USA
- American Physician Scientists Association, Westford, Massachusetts, USA
| | - Chynna Smith
- Albert Einstein College of Medicine, Medical Scientist Training Program, Bronx, New York, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
- American Physician Scientists Association, Westford, Massachusetts, USA
| | - Chiemeka Okafor
- American Physician Scientists Association, Westford, Massachusetts, USA
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Mahlet Shibre
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Dania Daye
- American Physician Scientists Association, Westford, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Interventional Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Myles H Akabas
- Albert Einstein College of Medicine, Medical Scientist Training Program, Bronx, New York, USA
- Albert Einstein College of Medicine, Bronx, New York, USA
- Departments of Neuroscience and Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| |
Collapse
|
3
|
Gonzalez V, Grant MG, Suzuki M, Christophers B, Rowland Williams J, Burdine RD. Cooperation between Nodal and FGF signals regulates zebrafish cardiac cell migration and heart morphogenesis. bioRxiv 2024:2024.01.05.574380. [PMID: 38260277 PMCID: PMC10802409 DOI: 10.1101/2024.01.05.574380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Asymmetric vertebrate heart development is driven by an intricate sequence of morphogenetic cell movements, the coordination of which requires precise interpretation of signaling cues by heart primordia. Here we show that Nodal functions cooperatively with FGF during heart tube formation and asymmetric placement. Both pathways act as migratory stimuli for cardiac progenitor cells (CPCs), but FGF is dispensable for directing heart tube asymmetry, which is governed by Nodal. We further find that Nodal controls CPC migration by inducing left-right asymmetries in the formation of actin-based protrusions in CPCs. Additionally, we define a developmental window in which FGF signals are required for proper heart looping and show cooperativity between FGF and Nodal in this process. We present evidence FGF may promote heart looping through addition of the secondary heart field. Finally, we demonstrate that loss of FGF signaling affects proper development of the atrioventricular canal (AVC), which likely contributes to abnormal chamber morphologies in FGF-deficient hearts. Together, our data shed insight into how the spatiotemporal dynamics of signaling cues regulate the cellular behaviors underlying organ morphogenesis.
Collapse
Affiliation(s)
- Vanessa Gonzalez
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, USA, 08544
| | - Meagan G. Grant
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, USA, 08544
| | - Makoto Suzuki
- Amphibian Research Center, Graduate School of Integrated Sciences for Life, Hiroshima University, Higashihiroshima, Hiroshima, Japan, 739-8526
| | - Briana Christophers
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, USA, 08544
| | - Jessica Rowland Williams
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, USA, 08544
- Current affiliation: National Institute for Student Success, at Georgia State University, Atlanta, GA 30303
| | - Rebecca D. Burdine
- Department of Molecular Biology, Princeton University, Princeton, New Jersey, USA, 08544
| |
Collapse
|
4
|
Geiger G, Kiel L, Horiguchi M, Martinez-Aceves C, Meza K, Christophers B, Orellana P, Pinzon MM, Lubner SJ, Florez N. Latinas in medicine: evaluating and understanding the experience of Latinas in medical education: a cross sectional survey. BMC Med Educ 2024; 24:4. [PMID: 38172800 PMCID: PMC10765906 DOI: 10.1186/s12909-023-04982-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/16/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND The percentage of physicians identifying as Latina has not improved despite improvements in recruitment of Latina medical students, suggesting barriers to retention and career advancement. Discriminatory experiences and mental health inflictions throughout training may contribute to difficulties in recruitment, retainment, and advancement of Hispanic/Latinx trainees, a notably understudied population. METHODS An anonymous, online survey was distributed to Latinas in the continental U.S. between June 22 to August 12, 2022. Eligibility criteria included: self-identifying as Hispanic/Latina, female/woman, and completing or have completed medical school, residency, or fellowship in the continental U.S. in the past 10 years. Recruitment was done via the Twitter account @LatinasInMed and outreach to Latino Medical Student Association chapters. Descriptive statistics summarized the self-reported experiences. RESULTS The survey included 230 Hispanic/Latinx women, mostly medical students (46.9%). A majority (54.5%) reported negative ethnicity-based interactions from patients and/or patients' families; 71.8%, from others in the medical field. High rates of depression (76.2%) and anxiety (92.6%) during training were reported by Latinas, especially medical students. Feelings of imposter syndrome and burnout were high at 90.7% and 87.4%, respectively. CONCLUSIONS This is the first study evaluating the unique experiences of Latinas in medicine, who reported discrimination and mental health struggles, specifically during medical school, at alarmingly high rates. Our findings could aid in creating the needed interventions to support Latinas in medical training to reduce the existing exodus of Latinas from medicine.
Collapse
Affiliation(s)
- Gabriella Geiger
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Lauren Kiel
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Miki Horiguchi
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | | | - Kelly Meza
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Briana Christophers
- Weill Cornell/Rockefeller/Memorial Sloan Kettering Tri-Institutional MD-PhD Program, New York City, NY, USA
| | | | - Maria Mora Pinzon
- Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sam J Lubner
- Division of Hematology, Medical Oncology and Palliative Care, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Narjust Florez
- Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Lowe Center for Thoracic Oncology, Harvard Medical School, Dana-Farber Cancer Institute, 450 Brookline Ave - DA1230, 02215, Boston, MA, USA.
| |
Collapse
|
5
|
Christophers B, Leahy SN, Soffar DB, von Saucken VE, Broadie K, Baylies MK. Muscle cofilin alters neuromuscular junction postsynaptic development to strengthen functional neurotransmission. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.11.21.568166. [PMID: 38045306 PMCID: PMC10690168 DOI: 10.1101/2023.11.21.568166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Cofilin, an actin severing protein, plays critical roles in muscle sarcomere addition and maintenance. Our previous work has shown Drosophila cofilin (DmCFL) knockdown causes progressive deterioration of muscle structure and function and produces features seen in nemaline myopathy (NM) caused by cofilin mutations. We hypothesized that disruption of actin cytoskeleton dynamics by DmCFL knockdown would impact other aspects of muscle development, and, thus, conducted an RNA sequencing analysis which unexpectedly revealed upregulated expression of numerous neuromuscular junction (NMJ) genes. We found that DmCFL is enriched in the muscle postsynaptic compartment and that DmCFL deficiency causes F-actin disorganization in this subcellular domain prior to the sarcomere defects observed later in development. Despite NMJ gene expression changes, we found no significant changes in gross presynaptic Bruchpilot active zones or total postsynaptic glutamate receptor levels. However, DmCFL knockdown results in mislocalization of glutamate receptors containing the GluRIIA subunit in more deteriorated muscles and neurotransmission strength is strongly impaired. These findings expand our understanding of cofilin's roles in muscle to include NMJ structural development and suggest that NMJ defects may contribute to NM pathophysiology.
Collapse
Affiliation(s)
- Briana Christophers
- Weill Cornell-Rockefeller-Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, 10065, USA
- Biochemistry, Cell & Developmental Biology, and Molecular Biology (BCMB) program, Weill Cornell Graduate School of Medical Sciences, New York, NY 10065, USA
- Developmental Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering, Cancer Center, New York, NY 10065, USA
| | - Shannon N Leahy
- Department of Biological Sciences, Vanderbilt University and Medical Center, Nashville, TN 37235, USA
| | - David B Soffar
- Developmental Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering, Cancer Center, New York, NY 10065, USA
| | - Victoria E von Saucken
- Weill Cornell-Rockefeller-Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, 10065, USA
- Biochemistry, Cell & Developmental Biology, and Molecular Biology (BCMB) program, Weill Cornell Graduate School of Medical Sciences, New York, NY 10065, USA
- Developmental Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering, Cancer Center, New York, NY 10065, USA
| | - Kendal Broadie
- Department of Biological Sciences, Vanderbilt University and Medical Center, Nashville, TN 37235, USA
- Kennedy Center for Research on Human Development, Vanderbilt University and Medical Center, Nashville, TN 37235, USA
- Vanderbilt Brain Institute, Vanderbilt University and Medical Center, Nashville, TN 37235, USA
| | - Mary K Baylies
- Biochemistry, Cell & Developmental Biology, and Molecular Biology (BCMB) program, Weill Cornell Graduate School of Medical Sciences, New York, NY 10065, USA
- Developmental Biology Program, Sloan Kettering Institute, Memorial Sloan Kettering, Cancer Center, New York, NY 10065, USA
| |
Collapse
|
6
|
Obradovic A, Toubat O, Chen NW, Siebert A, Jansen C, Christophers B, Leveille E, Noch E, Kwan JM. Impact of COVID-19 Pandemic on Physician-Scientist Trainees to Faculty One Year into the Pandemic. Res Sq 2023:rs.3.rs-3478814. [PMID: 37986886 PMCID: PMC10659556 DOI: 10.21203/rs.3.rs-3478814/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Purpose Physician-scientists play a crucial role in advancing biomedical sciences. Proportionally fewer physicians are actively engaged in scientific pursuits, attributed to attrition in the training and retention pipeline. This national study evaluated the ongoing and longer-term impact of the COVID-19 pandemic on research productivity for physician-scientists at all levels of training. Methods A survey of medical students, graduate students, and residents/fellows/junior faculty (RFJF) was conducted from April to August 2021 to assess the impact of COVID-19 on individual stress, productivity, and optimism. Multivariate regression analyses were performed to identify associated variables and unsupervised variable clustering techniques were employed to identify highly correlated responses. Results A total 677 respondents completed the survey, representing different stages of physician-scientist training. Respondents report high levels of stress (medical students: 85%, graduate students: 63%, RFJF: 85%) attributed to impaired productivity concerns, concern about health of family and friends, impact on personal health and impairment in training or career development. Many cited impaired productivity (medical students: 65% graduate students: 79%, RFJF: 78%) associated with pandemic impacts on training, labs closures and loss of facility/resource access, and social isolation. Optimism levels were low (medical students: 37%, graduate students: 38% and RFJF: 39%) with females less likely to be optimistic and more likely to report concerns of long-term effects of COVID-19. Optimism about the future was correlated with not worrying about the long-term effects of COVID-19. Since the COVID-19 pandemic, all respondents reported increased prioritization of time with family/friends (67%) and personal health (62%) over career (25%) and research (24%). Conclusions This national survey highlights the significant and protracted impact of the COVID-19 pandemic on stress levels, productivity, and optimism among physician-scientists and trainees. These findings underscore the urgent need for tailored support, including mental health, academic, and career development assistance for this biomedical workforce.
Collapse
Affiliation(s)
| | - Omar Toubat
- O.T, Hospital of the University of Pennsylvania
| | | | | | | | | | | | | | | |
Collapse
|
7
|
Mabeza RM, Christophers B, Ederaine SA, Glenn EJ, Benton-Slocum ZP, Marcelin JR. Interventions Associated With Racial and Ethnic Diversity in US Graduate Medical Education: A Scoping Review. JAMA Netw Open 2023; 6:e2249335. [PMID: 36595293 PMCID: PMC9856938 DOI: 10.1001/jamanetworkopen.2022.49335] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
IMPORTANCE Racially and ethnically minoritized individuals remain underrepresented in graduate medical education relative to their proportion in the population. While many programs and initiatives have been developed to address this problem, there is little consensus regarding strategies that work to improve representation across specialties. OBJECTIVE To examine and synthesize evidence-based practices that have been used to increase the proportions of underrepresented in medicine (URiM) trainees at US residency and fellowship programs. EVIDENCE REVIEW The authors searched PubMed, Google Scholar, Embase, PsycInfo, ERIC, Cochrane Reviews, Cochrane Trials, CINAHL, Scopus, and PROSPERO electronic databases to identify relevant studies published through January 2022. They screened all titles and abstracts for relevance and read full-text articles to identify articles reporting reliable data describing the outcomes of interventions to improve racial and ethnic diversity among trainees. FINDINGS Twenty-seven articles were included in this review. Two studies reported on fellowship programs. The most common interventions included holistic review (48%), decreased emphasis on United States Medical Licensing Examination Step 1 scores (48%), and explicit institutional messaging regarding the importance of diversity (37%). A combination of interventions was associated with an increased number of URiM applicants, interviewees, and matriculants across various medical and surgical specialties. CONCLUSIONS AND RELEVANCE In this scoping review, approaches and interventions associated with increased diversity in residency and fellowship programs were identified. Continued efforts are necessary to sustain such efforts and assess long-term outcomes.
Collapse
Affiliation(s)
- Russyan Mark Mabeza
- David Geffen School of Medicine at the University of California, Los Angeles
| | - Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York
| | - Sophia A. Ederaine
- Department of Dermatology, University of California Irvine School of Medicine, Irvine
| | - Emily J. Glenn
- McGoogan Health Sciences Library, University of Nebraska Medical Center, Omaha
| | | | - Jasmine R. Marcelin
- Division of Infectious Diseases, Department of Internal Medicine, University of Nebraska Medical Center, Omaha
| |
Collapse
|
8
|
Kwan JM, Noch E, Qiu Y, Toubat O, Christophers B, Azzopardi S, Gilmer G, Wiedmeier JE, Daye D. The Impact of COVID-19 on Physician-Scientist Trainees and Faculty in the United States: A National Survey. Acad Med 2022; 97:1536-1545. [PMID: 35921163 PMCID: PMC9547818 DOI: 10.1097/acm.0000000000004802] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Physician-scientists have long been considered an endangered species, and their extended training pathway is vulnerable to disruptions. This study investigated the effects of COVID-19-related challenges on the personal lives, career activities, stress levels, and research productivity of physician-scientist trainees and faculty. METHOD The authors surveyed medical students (MS), graduate students (GS), residents/fellows (R/F), and faculty (F) using a tool distributed to 120 U.S. institutions with MD-PhD programs in April-June 2020. Chi-square and Fisher's exact tests were used to compare differences between groups. Machine learning was employed to select variables for multivariate logistic regression analyses aimed at identifying factors associated with stress and impaired productivity. RESULTS The analyses included 1,929 respondents (MS: n = 679, 35%; GS: n = 676, 35%; R/F: n = 274, 14%; F: n = 300, 16%). All cohorts reported high levels of social isolation, stress from effects of the pandemic, and negative impacts on productivity. R/F and F respondents were more likely than MS and GS respondents to report financial difficulties due to COVID-19. R/F and F respondents with a dual degree expressed more impaired productivity compared with those without a dual degree. Multivariate regression analyses identified impacted research/scholarly activities, financial difficulties, and social isolation as predictors of stress and impaired productivity for both MS and GS cohorts. For both R/F and F cohorts, impacted personal life and research productivity were associated with stress, while dual-degree status, impacted research/scholarly activities, and impacted personal life were predictors of impaired productivity. More female than male respondents reported increased demands at home. CONCLUSIONS This national survey of physician-scientist trainees and faculty found a high incidence of stress and impaired productivity related to the COVID-19 pandemic. Understanding the challenges faced and their consequences may improve efforts to support the physician-scientist workforce in the postpandemic period.
Collapse
Affiliation(s)
- Jennifer M Kwan
- J.M. Kwan is a cardiologist, Yale School of Medicine, New Haven, Connecticut, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4715-1848
| | - Evan Noch
- E. Noch is a neurologist, Weill Cornell School of Medicine, New York, New York, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-4561-1169
| | - Yuqing Qiu
- Y. Qiu is a biostatistician, Weill Cornell School of Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-4561-1169
| | - Omar Toubat
- O. Toubat is an MD-PhD student, University of Southern California, Los Angeles, California; ORCID: https://orcid.org/0000-0002-3377-1384
| | - Briana Christophers
- B. Christophers is an MD-PhD student, Weill Cornell Medicine, New York, New York; ORCID: https://orcid.org/0000-0001-5248-069X
| | - Stephanie Azzopardi
- S. Azzopardi is an MD-PhD student, Weill Cornell Medicine, New York, New York; ORCID: https://orcid.org/0000-0002-9585-9234
| | - Gabrielle Gilmer
- G. Gilmer is an MD-PhD student, University of Pittsburgh, Pittsburgh, Pennsylvania; ORCID: https://orcid.org/0000-0002-9039-4183
| | - Julia Erin Wiedmeier
- J.E. Wiedmeier is a hematology/oncology fellow, Mayo Clinic Arizona, Phoenix, Arizona; ORCID: https://orcid.org/0000-0001-9434-5269
| | - Dania Daye
- D. Daye is an interventional radiologist, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, and director, Board of Directors, American Physician Scientists Association, Westford, Massachusetts; ORCID: https://orcid.org/0000-0002-2230-7199
| |
Collapse
|
9
|
Macedo B, Christophers B, Barrere-Cain R, Albrecht YS, Granovetter MC, Kumar R, Daye D, Bhoj E, Brass L, Rodrigues JA. The Virtual Summer Research Program: supporting future physician-scientists from underrepresented backgrounds. J Clin Transl Sci 2022; 6:e120. [PMID: 36285020 PMCID: PMC9549583 DOI: 10.1017/cts.2022.447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Physician-scientist training programs expect applicants to have had extensive research experience prior to applying. Even at the best of times, this leaves individuals from underserved and underrepresented backgrounds at a competitive disadvantage, especially those remote from major academic centers. The COVID-19 pandemic exacerbated that disadvantage by closing research laboratories and suspending summer research opportunities. Methods The Virtual Summer Research Program (VSRP) was designed to combat this shortfall by helping participating students become better informed and better prepared for applying to MD/DO-PhD programs. 156 participants were recruited from historically black colleges and universities and from national organizations for underrepresented trainees. Participants were paired with medical school faculty members and current MD/DO-PhD students from 35 participating institutions. The program lasted for at least 4 weeks and included a short research project, interactive sessions, journal clubs, social events, and attendance at a regional American Physician Scientists Association conference. Results In follow-up surveys, participants reported improvements in their science-related skills and in their confidence in becoming a physician-scientist, applying to training programs, and navigating mentorship relationships. A follow-up study completed one year later indicated that participants felt they had benefited from an enhanced skill set, long-term relationships with their mentors, and connections to the physician-scientist community at large. Discussion The results suggest that VSRP met its primary goals, which were to provide a diverse group of trainees with mentors, provide skills and resources for MD/DO-PhD application and matriculation and to support the development of longitudinal relationships between VSRP mentees and APSA. VSRP provides an approach that can be applied at an even larger scale when the constraints caused by a global pandemic have lifted.
Collapse
Affiliation(s)
- Briana Macedo
- Princeton University, Princeton, NJ, USA
- American Physician Scientists Association, Westford, MA, USA
| | - Briana Christophers
- American Physician Scientists Association, Westford, MA, USA
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | - Rio Barrere-Cain
- American Physician Scientists Association, Westford, MA, USA
- University of California, San Francisco, CA, USA
| | - Yentli Soto Albrecht
- American Physician Scientists Association, Westford, MA, USA
- Medical Scientist Training Program of the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Michael C. Granovetter
- American Physician Scientists Association, Westford, MA, USA
- University of Pittsburgh-Carnegie Mellon University Medical Scientist Training Program, Pittsburgh, PA, USA
| | - Rachit Kumar
- American Physician Scientists Association, Westford, MA, USA
- Medical Scientist Training Program of the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Dania Daye
- American Physician Scientists Association, Westford, MA, USA
- Harvard Medical School, Cambridge, MA, USA
| | - Elizabeth Bhoj
- Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Lawrence Brass
- American Physician Scientists Association, Westford, MA, USA
- Medical Scientist Training Program of the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Jose Alexandre Rodrigues
- American Physician Scientists Association, Westford, MA, USA
- Michigan State University College of Osteopathic Medicine, East Lansing, MI, USA
| |
Collapse
|
10
|
Christophers B, Marr MC, Pendergrast TR. Medical School Admission Policies Disadvantage Low-Income Applicants. Perm J 2022; 26:172-176. [DOI: 10.7812/tpp/21.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, NY, USA
| | - Mollie C Marr
- Oregon Health & Science University, Medical Scientist Training Program, Portland, OR, USA
| | | |
Collapse
|
11
|
Abstract
Nemaline myopathy is a skeletal muscle disease that affects 1 in 50 000 live births. The objective of this study was to develop a narrative synthesis of the findings of a systematic review of the latest case descriptions of patients with NM. A systematic search of MEDLINE, Embase, CINAHL, Web of Science, and Scopus was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using the keywords pediatric, child, NM, nemaline rod, and rod myopathy. Case studies focused on pediatric NM and published in English between January 1, 2010, and December 31, 2020, in order to represent the most recent findings. Information was collected about the age of first signs, earliest presenting neuromuscular signs and symptoms, systems affected, progression, death, pathologic description, and genetic changes. Of a total of 385 records, 55 case reports or series were reviewed, covering 101 pediatric patients from 23 countries. We review varying presentations in children ranging in severity despite being caused by the same mutation, in addition to current and future clinical considerations relevant to the care of patients with NM. This review synthesizes genetic, histopathologic, and disease presentation findings from pediatric NM case reports. These data strengthen our understanding of the wide spectrum of disease seen in NM. Future studies are needed to identify the underlying molecular mechanism of pathology, to improve diagnostics, and to develop better methods to improve the quality of life for these patients.
Collapse
Affiliation(s)
- Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | | | - Vandana A. Gupta
- Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Mary Baylies
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
- Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
12
|
Titanji BK, Abdul-Mutakabbir JC, Christophers B, Flores L, Marcelin JR, Swartz TH. Social Media: Flattening Hierarchies for Women and Black, Indigenous, People Of Color (BIPOC) to Enter the Room Where It Happens. Clin Infect Dis 2022; 74:S222-S228. [PMID: 35568478 PMCID: PMC9107375 DOI: 10.1093/cid/ciac047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Social media platforms are widely used to connect people across multiple settings, including country of origin, profession, race/ethnicity, sexual orientation, gender identity, seniority, and training. Groups that have been marginalized or historically excluded from decision-making encounters may lack formal mentors/sponsors because of a lack of representation of women and Black, Indigenous, People Of Color (BIPOC) in senior leadership positions. This can serve as a barrier to professional advancement at all stages of career development. Identifying and connecting with these potential mentors/sponsors outside of one's institutional space can be challenging. For this reason, leveraging social media to develop these professional relationships through flattened hierarchies can allow for professional networking beyond traditional mechanisms. Here we aim to describe how individuals can connect through social media to advance their careers and scientific and clinical expertise, advocate for communities, and provide high-quality communication to the public.
Collapse
Affiliation(s)
- Boghuma K Titanji
- Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jacinda C Abdul-Mutakabbir
- Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, California, USA.,Department of Basic Science, Loma Linda School of Medicine, Loma Linda, California, USA
| | - Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York, USA
| | - Laura Flores
- University of Nebraska Medical Center, College of Allied Health Professions, Omaha, Nebraska, USA
| | - Jasmine R Marcelin
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, Nebraska, USAand
| | - Talia H Swartz
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
13
|
Liao J, Nishath T, Thevuthasan S, Nieblas-Bedolla E, Christophers B, Starks H, Jackson M, Pagalilauan G. Race/Ethnicity Trends Among U.S. Internal Medicine Residency Applicants and Matriculants: A Cross-Sectional Study. Ann Intern Med 2022; 175:611-614. [PMID: 35073150 DOI: 10.7326/m21-3287] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
| | | | | | | | - Briana Christophers
- Tri-Institutional MD-PhD Program, Weill Cornell Medical College/The Rockefeller University/Memorial Sloan Kettering, New York, New York
| | - Helene Starks
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington
| | | | | |
Collapse
|
14
|
Christophers B, Marin BG, Oliva R, Powell WT, Savage TJ, Michelow IC. Trends in clinical presentation of children with COVID-19: a systematic review of individual participant data. Pediatr Res 2022; 91:494-501. [PMID: 32942286 PMCID: PMC7965792 DOI: 10.1038/s41390-020-01161-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/27/2020] [Accepted: 08/20/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND There are sparse patient-level data available for children with novel coronavirus disease (COVID-19). Therefore, there is an urgent need for an updated systematic literature review that analyzes individual children rather than aggregated data in broad age groups. METHODS Six databases (MEDLINE, Scopus, Web of Science, CINAHL, Google Scholar, medRxiv) were searched for studies indexed from January 1 to May 15, 2020, with MeSH terms: children, pediatrics, COVID-19, SARS-CoV-2. 1241 records were identified, of which only unique papers in English with individual patient information and documented COVID-19 testing were included. This review of 22 eligible studies followed Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data guidelines. RESULTS A total of 123 patients from five countries were identified. 46% were females. The median age was 5 years (IQR = 8). At presentation, 62% had a fever, 32% had a cough, 58% had a single symptom, and 21% were asymptomatic. Abnormal chest imaging was seen in 62% (65/105) of imaged and 76.9% (20/26) of asymptomatic children. A minority of children had elevated platelets, CRP, lactate dehydrogenase, and D-dimer. CONCLUSION Data from this independent participant data systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom. IMPACT This systematic review revealed that the majority of children with COVID-19 presented with either no symptoms or a single, non-respiratory symptom. By using an independent participant data approach, this analysis underscores the challenge of diagnosing COVID-19 in pediatric patients due to the wide variety of symptoms and seemingly poor correlation of imaging findings with symptomatic disease. The data presented from individual patients from case series or cohort studies add more granularity to the current description of pediatric COVID-19.
Collapse
Affiliation(s)
- Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA.
| | | | - Rocío Oliva
- Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Weston T. Powell
- Division of Pulmonary and Sleep Medicine, Seattle Children’s Hospital, Seattle, WA,Department of Pediatrics, University of Washington, Seattle, WA
| | - Timothy J. Savage
- Division of Infectious Diseases, Department of Pediatrics, Boston Children’s Hospital, MA,Harvard Medical School, Boston, MA
| | - Ian C. Michelow
- Warren Alpert Medical School of Brown University, Providence, Rhode Island,Department of Pediatrics, Division of Infectious Diseases and Center for International Health Research, Rhode Island Hospital, Providence, Rhode Island
| |
Collapse
|
15
|
Affiliation(s)
- Briana Christophers
- Briana Christophers, AB, is an MD-PhD Student, Weill Cornell/Rockefeller/Memorial Sloan Kettering Tri-Institutional MD-PhD Program
| | - Narjust Duma
- Narjust Duma, MD, is Assistant Professor and Thoracic Oncologist, Department of Medicine, University of Wisconsin
| | - María C. Mora Pinzón
- María C. Mora Pinzón, MD, is a Research Fellow, Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health
| |
Collapse
|
16
|
Christophers B, Macedo B, Nieblas-Bedolla E, Marr M, Andersen OS, Boothroyd C. First-generation physician-scientists are under-represented and need better support. Nat Med 2021; 27:752-755. [PMID: 33958798 PMCID: PMC8211032 DOI: 10.1038/s41591-021-01352-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Briana Christophers
- Weill Cornell-Rockefeller-Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA.
| | | | | | - Mollie Marr
- Oregon Health & Science University Medical Scientist Training Program, Portland, OR, USA
| | - Olaf S Andersen
- Weill Cornell-Rockefeller-Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Catharine Boothroyd
- Weill Cornell-Rockefeller-Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| |
Collapse
|
17
|
Kwan JM, Henry ML, Christophers B, Tamirisa K, Thamman R, Sadler D, Aggarwal NR, Cheng R, Parwani P, Dent S, Ismail-Khan R, Fradley MG, Brown SA. The Role and Impact of Social Media in Cardio-oncology During the COVID-19 Pandemic. Curr Oncol Rep 2021; 23:99. [PMID: 34259950 PMCID: PMC8278372 DOI: 10.1007/s11912-021-01081-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW To give an overview of the role of social media (SoMe) in cardio-oncology during the COVID-19 pandemic. RECENT FINDINGS SoMe has been critical in fostering education, outreach, awareness, collaboration, dissemination of information, and advocacy in cardio-oncology. This has become increasingly evident during the COVID-19 pandemic, during which SoMe has helped share best practices, community, and research focused on the impact of COVID-19 in cardiology and hematology/oncology, with cardio-oncology at the interface of these two subspecialty fields. A strength of SoMe is the ability to amplify a message in real-time, globally, with minimal investment of resources. This has been particularly beneficial for the emerging field of cardio-hematology/cardio-oncology, a field focused on the interplay of cancer and cardiovascular disease. SoMe field especially during the COVID-19 pandemic. We illustrate how social media has supported innovation (including telemedicine), amplification of healthcare workers' voice, and illumination of pre-existing and continued health disparities within the field of cardio-oncology during the pandemic.
Collapse
Affiliation(s)
- Jennifer M Kwan
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Briana Christophers
- Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD program, New York, NY, USA
| | | | | | | | - Niti R Aggarwal
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Richard Cheng
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | | | - Susan Dent
- Division of Medical Oncology, Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Roohi Ismail-Khan
- Cardio-Oncology Program, H. Lee Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | - Michael G Fradley
- Cardio-Oncology Center of Excellence, Division of Cardiology, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Sherry-Ann Brown
- Cardio-Oncology Program, Division of Cardiovascular Medicine, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, 53226, USA.
| |
Collapse
|
18
|
Nieblas-Bedolla E, Christophers B, Nkinsi NT, Schumann PD, Stein E. Changing How Race Is Portrayed in Medical Education: Recommendations From Medical Students. Acad Med 2020; 95:1802-1806. [PMID: 32379145 DOI: 10.1097/acm.0000000000003496] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The medical community has been complicit in legitimizing claims of racial difference throughout the history of the United States. Unfortunately, a rigorous examination of the role medicine plays in perpetuating inequity across racial lines is often missing in medical school curricula due to time constraints and other challenges inherent to medical education. The imprecise use of race-a social construct-as a proxy for pathology in medical education is a vestige of institutionalized racism. Recent examples are presented that illustrate how attributing outcomes to race may contribute to bias and unequal care. This paper proposes the following recommendations for guiding efforts to mitigate the adverse effects associated with the use of race in medical education: emphasize the need for incoming students to be familiar with how race can influence health outcomes; provide opportunities to hold open conversations about race in medicine among medical school faculty, students, and staff; craft and implement protocols that address and correct the inappropriate use of race in medical school classes and course materials; and encourage a large cultural shift within the field of medicine. Adoption of an interdisciplinary approach that taps into many fields, including ethics, history, sociology, evolutionary genetics, and public health is a necessary step for cultivating more thoughtful physicians who will be better prepared to care for patients of all racial and ethnic backgrounds.
Collapse
Affiliation(s)
- Edwin Nieblas-Bedolla
- E. Nieblas-Bedolla is a second-year student, University of Washington School of Medicine, Seattle, Washington; ORCID: http://orcid.org/0000-0001-5879-1800
| | - Briana Christophers
- B. Christophers is a second-year MD-PhD student, Weill Cornell/Rockefeller/Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York; ORCID: http://orcid.org/0000-0001-5248-069X
| | - Naomi T Nkinsi
- N.T. Nkinsi is a second-year MD-MPH student, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0002-0504-696X
| | - Paul D Schumann
- P.D. Schumann is a second-year student, University of Washington School of Medicine, Seattle, Washington
| | - Elizabeth Stein
- E. Stein is a second-year student, University of Washington School of Medicine, Seattle, Washington; ORCID: https://orcid.org/0000-0002-1820-3821
| |
Collapse
|
19
|
Nieblas-Bedolla E, Williams JR, Christophers B, Kweon CY, Williams EJ, Jimenez N. Trends in Race/Ethnicity Among Applicants and Matriculants to US Surgical Specialties, 2010-2018. JAMA Netw Open 2020; 3:e2023509. [PMID: 33136131 PMCID: PMC7607442 DOI: 10.1001/jamanetworkopen.2020.23509] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPORTANCE Surgical programs across the US continue to promote and invest in initiatives aimed at improving racial/ethnic diversity, but whether this translates to changes in the percentage of applicants or matriculants from racial/ethnic minority groups remains unclear. OBJECTIVE To examine trends in the percentage of applicants and matriculants to US surgical specialties who identified as part of a racial/ethnic group underrepresented in medicine from the 2010-2011 to 2018-2019 academic years. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study examined trends in self-reported racial/ethnic identity among applicants and matriculants to US residency programs to evaluate demographic changes among surgical programs from 2010 to 2018. Data were obtained from the Association of American Medical Colleges. RESULTS The study population consisted of a total of 737 034 applicants and 265 365 matriculants to US residency programs, including 134 158 applicants and 41 347 matriculants to surgical programs. A total of 21 369 applicants (15.9%) and 5704 matriculants (13.8%) to surgical specialties identified as underrepresented in medicine. There was no statistically significant difference in the percentage of applicants underrepresented in medicine based on race/ethnicity for all surgical specialties combined in 2010 vs 2018 (15.3% [95% CI, 14.7%-15.9%] vs 17.5% [95% CI, 16.9%-18.1%]; P = .63). Thoracic surgery was the only surgical specialty in which there was a statistically significant change in the percentage of applicants (8.1% [95% CI, 4.9%-13.2%] vs 14.6% [95% CI, 10.2%-20.4%]; P = .02) or matriculants (0% [95% CI, 0%-19.4%] vs 10.0% [95% CI, 4.0%-23.1%]; P = .01) underrepresented in medicine based on race/ethnicity. Obstetrics and gynecology had the highest mean percentage of applicants (20.2%; 95% CI, 19.4%-20.8%) and matriculants (19.0%; 95% CI, 18.2%-19.8%) underrepresented in medicine among surgical specialties. Thoracic surgery had the lowest mean percentage of applicants (12.5%; 95% CI, 9.46%-15.4%) and otolaryngology the lowest mean percentage of matriculants (8.5%; 95% CI, 7.2%-9.9%) underrepresented in medicine. CONCLUSIONS AND RELEVANCE In this cross-sectional study, overall US surgical programs had no change in the percentage of applicants or matriculants who self-identified as underrepresented in medicine based on race/ethnicity, but the proportion remained higher than in nonsurgical specialties. Reevaluation of current strategies aimed at increasing racial/ethnic representation appear to be necessary to help close the existing gap in medicine and recruit a more racially/ethnically diverse surgical workforce.
Collapse
Affiliation(s)
| | - John R. Williams
- Department of Neurological Surgery, University of Washington, Seattle
| | - Briana Christophers
- Weill Cornell Medicine–Rockefeller–Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York
| | - Christopher Y. Kweon
- Department of Orthopaedics and Sports Medicine, University of Washington, Seattle
| | | | - Nathalia Jimenez
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle
| |
Collapse
|
20
|
Soret R, Schneider S, Bernas G, Christophers B, Souchkova O, Charrier B, Righini-Grunder F, Aspirot A, Landry M, Kembel SW, Faure C, Heuckeroth RO, Pilon N. Glial Cell-Derived Neurotrophic Factor Induces Enteric Neurogenesis and Improves Colon Structure and Function in Mouse Models of Hirschsprung Disease. Gastroenterology 2020; 159:1824-1838.e17. [PMID: 32687927 DOI: 10.1053/j.gastro.2020.07.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/25/2020] [Accepted: 07/10/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS Hirschsprung disease (HSCR) is a life-threatening birth defect in which the distal colon is devoid of enteric neural ganglia. HSCR is treated by surgical removal of aganglionic bowel, but many children continue to have severe problems after surgery. We studied whether administration of glial cell derived neurotrophic factor (GDNF) induces enteric nervous system regeneration in mouse models of HSCR. METHODS We performed studies with four mouse models of HSCR: Holstein (HolTg/Tg, a model for trisomy 21-associated HSCR), TashT (TashTTg/Tg, a model for male-biased HSCR), Piebald-lethal (Ednrbs-l//s-l, a model for EDNRB mutation-associated HSCR), and Ret9/- (with aganglionosis induced by mycophenolate). Mice were given rectal enemas containing GDNF or saline (control) from postnatal days 4 through 8. We measured survival times of mice, and colon tissues were analyzed by histology, immunofluorescence, and immunoblots. Neural ganglia regeneration and structure, bowel motility, epithelial permeability, muscle thickness, and neutrophil infiltration were studied in colon tissues and in mice. Stool samples were collected, and microbiomes were analyzed by 16S rRNA gene sequencing. Time-lapse imaging and genetic cell-lineage tracing were used to identify a source of GDNF-targeted neural progenitors. Human aganglionic colon explants from children with HSCR were cultured with GDNF and evaluated for neurogenesis. RESULTS GDNF significantly prolonged mean survival times of HolTg/Tg mice, Ednrbs-l//s-l mice, and male TashTTg/Tg mice, compared with control mice, but not Ret9/- mice (which had mycophenolate toxicity). Mice given GDNF developed neurons and glia in distal bowel tissues that were aganglionic in control mice, had a significant increase in colon motility, and had significant decreases in epithelial permeability, muscle thickness, and neutrophil density. We observed dysbiosis in fecal samples from HolTg/Tg mice compared with feces from wild-type mice; fecal microbiomes of mice given GDNF were similar to those of wild-type mice except for Bacteroides. Exogenous luminal GDNF penetrated aganglionic colon epithelium of HolTg/Tg mice, inducing production of endogenous GDNF, and new enteric neurons and glia appeared to arise from Schwann cells within extrinsic nerves. GDNF application to cultured explants of human aganglionic bowel induced proliferation of Schwann cells and formation of new neurons. CONCLUSIONS GDNF prolonged survival, induced enteric neurogenesis, and improved colon structure and function in 3 mouse models of HSCR. Application of GDNF to cultured explants of aganglionic bowel from children with HSCR induced proliferation of Schwann cells and formation of new neurons. GDNF might be developed for treatment of HSCR.
Collapse
Affiliation(s)
- Rodolphe Soret
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada; Centre d'excellence en recherche sur les maladies orphelines-Fondation Courtois (CERMO-FC), Université du Québec à Montréal, Montréal, Québec, Canada
| | - Sabine Schneider
- Department of Pediatrics, the University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania
| | - Guillaume Bernas
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - Briana Christophers
- Department of Pediatrics, the University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania
| | - Ouliana Souchkova
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada; Centre d'excellence en recherche sur les maladies orphelines-Fondation Courtois (CERMO-FC), Université du Québec à Montréal, Montréal, Québec, Canada
| | - Baptiste Charrier
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada; Centre d'excellence en recherche sur les maladies orphelines-Fondation Courtois (CERMO-FC), Université du Québec à Montréal, Montréal, Québec, Canada
| | - Franziska Righini-Grunder
- Division de gastroentérologie, hépatologie et nutrition pédiatrique, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Ann Aspirot
- Division de chirurgie pédiatrique, Centre hospitalier universitaire Sainte-Justine, Montréal, Québec, Canada; Département de pédiatrie, Université de Montréal, Montréal, Québec, Canada
| | - Mathieu Landry
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - Steven W Kembel
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada; Centre d'excellence en recherche sur les maladies orphelines-Fondation Courtois (CERMO-FC), Université du Québec à Montréal, Montréal, Québec, Canada
| | - Christophe Faure
- Centre d'excellence en recherche sur les maladies orphelines-Fondation Courtois (CERMO-FC), Université du Québec à Montréal, Montréal, Québec, Canada; Division de gastroentérologie, hépatologie et nutrition pédiatrique, Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada; Département de pédiatrie, Université de Montréal, Montréal, Québec, Canada
| | - Robert O Heuckeroth
- Department of Pediatrics, the University of Pennsylvania Perelman School of Medicine and The Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania
| | - Nicolas Pilon
- Département des Sciences Biologiques, Université du Québec à Montréal (UQAM), Montréal, Québec, Canada; Centre d'excellence en recherche sur les maladies orphelines-Fondation Courtois (CERMO-FC), Université du Québec à Montréal, Montréal, Québec, Canada; Département de pédiatrie, Université de Montréal, Montréal, Québec, Canada.
| |
Collapse
|
21
|
Affiliation(s)
- Briana Christophers
- Weill Cornell/Rockefeller/Memorial Sloan Kettering Tri-Institutional MD-PhD Program, New York, New York, USA
| | - Ruth Gotian
- Mentoring Academy and.,Department of Anesthesiology, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
22
|
Hsiao CJ, Fresquez AM, Christophers B. Success and the next generation of physician-scientists. J Clin Transl Sci 2020; 4:477-479. [PMID: 33948222 PMCID: PMC8057406 DOI: 10.1017/cts.2020.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/02/2020] [Accepted: 06/04/2020] [Indexed: 12/05/2022] Open
Affiliation(s)
- Chu J. Hsiao
- Department of Anthropology, University of Florida MD-PhD Program, College of Medicine and College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, USA
| | - Adriana M. Fresquez
- Chicago Medical School and School of Graduate and Postdoctoral Studies, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA
| | - Briana Christophers
- Weill Cornell/Rockefeller/Memorial Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| |
Collapse
|
23
|
Salazar Mather TP, Gallo Marin B, Medina Perez G, Christophers B, Paiva ML, Oliva R, Hijaz BA, Prado AM, Jarquín MC, Moretti K, González Marqués C, Murillo A, Tobin-Tyler E. Love in the time of COVID-19: negligence in the Nicaraguan response. Lancet Glob Health 2020; 8:e773. [PMID: 32272083 PMCID: PMC7270778 DOI: 10.1016/s2214-109x(20)30131-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/27/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Thais P Salazar Mather
- Office of Medical Education and Continuous Quality Improvement, Providence, RI 02912, USA.
| | | | | | - Briana Christophers
- Weill Cornell Medicine-Rockefeller-Sloan Kettering Tri-Institutional MD-PhD Program, New York, NY, USA
| | - Marcelo L Paiva
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
| | - Rocío Oliva
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
| | - Baraa A Hijaz
- College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | | | | | | | | | - Elizabeth Tobin-Tyler
- Department of Family Medicine, Providence, RI 02912, USA; Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|