Research on and in medical education

Dr. George Lister of the University of Texas Southwestern Medical Center delivered the Lee E. Farr Lecture on Student Research Day on May 9, 2011. This day focused on the dissertation work of Yale School of Medicine MD students, whose research opportunities for prospective physicians were recently examined and critiqued by Yale's Committee to Promote Student Interest in Careers as Physician Scientists. Lister's talk served to highlight the importance of communication between the laboratory and the clinic in optimizing diagnostics and treatments, effectively affirming the validity of the Committee's objectives.     

Reflections on a Life in Biomedicine: Leading Change

Dr. Elizabeth Nabel delivered the following presentation as the Lee E. Farr Lecturer on May 7, 2013, which served as the culmination of the annual Student Research Day at Yale School of Medicine. Dr. Nabel is President of the Brigham and Women’s Hospital in Boston, Massachusetts, and Professor of Medicine at Harvard Medical School. Her lecture to Yale medical students portrayed her own personal and professional journey through medicine as a series of opportunities. Dr. Nabel focused on the roles and responsibilities of physicians to recognize need and to make change through focused advocacy.     

An appreciation of A.E. Malloch,MB, MD (1844-1919): a forgotten surgical pioneer

Dr. Archibald Edward Malloch was a surgeon whose life and work were greatly influenced by Joseph Lister and his revolutionary system of antiseptic surgery. This paper describes how a young Canadian medical man came to introduce Lister''s system to North America in 1869 and studies his career in the light of Lister''s surgical epoch.     

Four Children and Yale: The Making of a Human Geneticist: The Grover Powers Lecture 2014

Dr. Leon E. Rosenberg delivered the following presentation as the Grover Powers Lecturer on May 14, 2014, which served as the focal point of his return to his “adult home” as a Visiting Professor in the Department of Pediatrics. Grover F. Powers, MD, was one of the most influential figures in American Pediatrics and certainly the leader who created the modern Department of Pediatrics at Yale when he was recruited in 1921 from Johns Hopkins and then served as its second chairman from 1927 to 1951. Dr. Powers was an astute clinician and compassionate physician and fostered and shaped the careers of countless professors, chairs, and outstanding pediatricians throughout the country. This lectureship has continued yearly since it first honored Dr. Powers in 1956. The selection of Dr. Rosenberg for this honor recognizes his seminal role at Yale and throughout the world in the fostering and cultivating of the field of human genetics. Dr. Rosenberg served as the inaugural Chief of a joint Division of Medical Genetics in the Departments of Pediatrics and Internal Medicine; he became Chair when this attained Departmental status. Then he served as Dean of the Medical School from 1984 to 1991, before he became President of the Pharmaceutical Research Institute at Bristol-Myers Squibb and later Senior Molecular Biologist and Professor at Princeton University, until his recent retirement. Dr. Rosenberg has received numerous honors that include the Borden Award from the American Academy of Pediatrics, the McKusick Leadership Award from the American Society for Human Genetics, and election to the Institute of Medicine and the National Academy of Sciences.     

Biomaterials in medical devices: an interview with Jörg Vienken of Fresenius Medical Care, Germany

Biomaterial and biopolymer research have significant impact on the development as well as application of biotechnology. Biotechnology Journal recently attended the "Nanomaterials for Biomedical Technologies 2012" conference. We were privileged to have the opportunity to ask Prof. Dr. J?rg Vienken, VP of BioSciences at Fresenius Medical Care, a few questions relating to medical devices, the importance of publishing for industry, and also his advice for young scientists/engineers looking for a career in industry.     

Some mathematical aspects of the diagnostic process. II: A mathematical model of electrocardiographic diagnosis

In a previous paper (Bartholomay, 1971), a general mathematical model of the medical diagnostic process was described. The present paper amounts to a relization of that process in terms of conventional 12-lead electrocardiographic diagnosis as enunciated by Dr. Harold D. Levine (1966) in the course of a collaborative study by Dr. Levine and the present author at the Peter Bent Brigham Hospital of the Harvard Medical School between 1963 and 1966. The main details of the cognitive component of that model are described in detail here. The model has been programmed onto a computer system consisting of an analog-digital converter and general purpose digital computer and amounts to a simulation of Dr. Levine’s electrocardiographic analysis procedure.     

The Tissue Culture Laboratory of Dr. George Otto Gey 60 yrs ago as recalled by a former student

George Otto Gey was a pioneer in tissue culture, having introduced the roller drum, the HeLa cell line, and the use of human fetal cord serum and beef embryo extract. During his career (1920s–1960s), the field of tissue culture was in its infancy and not yet dependent upon commercial biological supply houses. While the early techniques of cell culture have been greatly improved upon, of historical interest may be personal observations of the Gey Tissue Culture Laboratory, Johns Hopkins Medical School, as recalled by a medical student working there in the 1950s. Dr. Gey served as a founding member and executive of the Tissue Culture Commission (TCC) and became the first president of the Tissue Culture Association (TCA).     

From structure to solutions: the role of basic research in developing anthrax countermeasures: Microbiology Graduate Program Seminar: Anthrax toxin

Dr. John Collier traced the discoveries that elucidated the structure and function of the anthrax toxin in his talk "Anthrax Toxin," which was part of the Microbiology Graduate Program Seminar Series at Yale School of Medicine on February 23, 2012. Dr. Collier, Professor of Microbiology and Immunobiology at Harvard University, began by noting the advantages to studying anthrax pathogenesis in a biosafety level-1 lab. This designation does not merely facilitate his research, but also reflects a larger trend of basic research being leveraged to develop translational applications. Basic research on toxin structure has led to the development of a vaccine by Dr. Collier's group. Next-generation prophylactics also may stem from recent discoveries uncovering a role for cellular cofactors that mediate toxin function. Finally, basic research into the toxin substructure has facilitated efforts to change the receptor tropism to target dysregulated cells for therapeutic purposes. The urgency around biodefense agents makes the choice of research priorities a salient issue. As such, this author submits that basic research occupies a unique and lucrative niche driving clinical applications.     

In situ hybridization comes of age

Dr Coulton is a lecturer in the Department of Biochemistry at Charing Cross and Westminster Medical School, London W6 8RF. His principal research interest is in the molecular and cellular basis of inherited disease of skeletal muscle.     

Harvey Cushing's ghosts: death and hauntings in modern medicine

The passing of Yale School of Medicine's 2010 Bicentennial occasions a moment of reflecting on the past, present, and future of medical education and research at Yale and beyond. Last June, a ribbon-cutting ceremony inaugurated the opening of the Cushing Center in the Cushing-Whitney Medical Library. Named after Harvey Cushing, an early 20th-century neurosurgeon and former Yale College alum, the dual education/exhibition space now houses hundreds of gross brain specimens constituting the Cushing Tumor Registry. Originally a personal collection, Cushing donated his numerous medical specimens, photographs, and other medical relics from his deathbed, relinquishing the brains to Yale only under the condition that a suitable space be erected to preserve the many specimens. Some 70 years later and after nearly being destroyed, Cushing's wish is fully realized: The once desiccated, hidden brains have been painstakingly restored and are now on view in the Cushing Center. The brains express Cushing's singular and spectral worldview as a surgeon, artist, athlete, soldier, book collector, and historian.     

Eric Kandel: the future of memory

Watching ice floes glide by on the Hudson River from Eric Kandel's office, one gets a sense of placid reflection tempered by constant action-an apt analogy for Kandel's ability to calmly manage several ongoing projects and commitments at once. In addition to his well-lauded, ongoing research at Columbia University Medical Center's New York State Psychiatric Institute, Kandel has written several books on neurobiology, behavior, and memory. In addition to being a Nobel Laureate Scientist, he is well-known as an editor of the seminal textbook Principles of Neural Science. He and his colleagues are in the midst of working on a new edition of Principles, and he is working on a scientific autobiography. MI sat down with Dr. Kandel and discussed with him a range of topics including childhood and early career influences, intramural research at the NIH, the HHMI, ethical considerations of altering memory and, of course, Aplysia.     

Pediatric grand rounds: a tribute to Norman J. Siegel, M.D

At ceremonies held in Baltimore Maryland on May, 4, 2002, Dr. Howard A Pearson, Professor of Pediatrics, was awarded the John A. Howland award of the American Pediatric Society, probably the most prestigious award of American Pediatrics. Dr. Pearson had been nominated for the award by Dr. Norman Siegel. The Department of Pediatrics Grand Rounds on Wednesday noon, October 26, 2002 was originally scheduled as a repetition of the presentation by Dr. Siegel and the acceptance by Dr. Pearson for those who could not be in Baltimore. However; in a number of meetings, unknown to Dr. Siegel, it was unanimously decided that it would be very appropriate to instead honor him as he stepped down from his position as Vice- and Interim Chairman of Pediatrics, and to formally thank him for his long and faithful service to the Department of Pediatrics, the Yale University School of Medicine, and the Yale New Haven Hospital.     

The future of genomic medicine is here

A report on the 6th annual Future of Genomic Medicine conference, held at the Scripps Seaside Forum, La Jolla, CA, USA, March 7-8, 2013.On his flight over to San Diego to lead the Future of Genomic Medicine (FoGM) conference, Dr Eric Topol (Scripps Translational Science Institute, USA) used a heart monitor device attached to his smartphone to diagnose a distressed passenger with atrial fibrillation. Already, mobile technologies such as this one are beginning to transform medicine, and genome sequencing, with its rapidly decreasing costs, is no exception. As we get closer to mini-sequencers and what George Church (Harvard Medical School, USA) termed ''wearable sequencing'', a future of genomically informed medicine becomes possible. The FoGM conference integrated the patient-oriented perspective of genomic medicine, along with cutting-edge technologies and data integration, and developing methods and models in the aim of clinical utility.     

The Blout laboratory at Harvard Medical School from 1957 to 1972

Elkan R. Blout's laboratory at the Children's Cancer Research Foundation and Harvard Medical School pioneered many approaches to the synthesis, conformation and structural studies of polypeptides, biopolymers and selected proteins. Here the early days (1957-1972) of his research group are remembered.     

Dean Milton C. Winternitz at Yale

Milton Winternitz led Yale Medical School as its Dean from 1920 to 1935. An innovative, even maverick leader, he not only kept the school from going under, but turned it into a first-class research institution. Dedicated to the new scientific medicine established in Germany, he was equally fervent about "social medicine" and the study of humans in their culture and environment. He established the "Yale System" of teaching, with few lectures and fewer exams, and strengthened the full-time faculty system; he also created the graduate-level Yale School of Nursing and the Psychiatry Department, built numerous new buildings, and much more. It is a loss to 21st-century medicine that his dream of an Institute of Human Relations, envisioned as a refuge where social scientists would collaborate with biological scientists in a holistic study of humankind, lasted for only a few years, before falling victim to the more obvious triumphs of medical science and technology. It is sad, too, that he is remembered largely as a Jew presiding over a medical school that, like most others, restricted the number of Jewish students, rather than for his contributions to American medicine.     

On the trail of Dr. Fifer.

A gift from a patient drew Hope, BC, family physician Gerd Asche irrevocably into the local medical history of the 1858 Fraser River Gold Rush. Because of his interest in Dr. Max William Fifer, Asche undertook research missions in British Columbia, England and the US, converted his computer room to a research and writing centre, and wrote a biography of his predecessor and colleague. He recounts his experience and the growing satisfaction provided by his interest in medical history.     

The buttressing coalition of the PNGIMR: an example of international collaborative research

Good partnerships are based on mutual benefit. This also applies to international partnerships in medical research. The Papua New Guinea Institute of Medical Research (PNGIMR) has had many successful research collaborations, from which an interactive coalition has been built that is committed to supporting the PNGIMR without jeopardizing its integrity. This coalition also involves policy-makers from the Department of Health, teachers at the Medical School of Papua New Guinea and the Medical Research Advisory Committee of PNG. The PNGIMR's Buttressing Coalition supports research and training, but also assists the process of transferring research results into policy. The concept of "buttressing" is explored and the activities of the Buttressing Coalition are briefly described here. The idea of the Buttressing Coalition is a response from the international medical research community to globalization, and could be applied elsewhere, following the model developed in PNG.     

Sino-U.S. partnerships in research,education, and patient care: The experience of the University of Pittsburgh and UPMC

In 2011, the University of Pittsburgh School of Medicine (UPSOM) and Tsinghua University formed a partnership to further the education of Tsinghua medical students. These students come to UPSOM as visiting research scholars for two years of their eight-year MD curriculum. During this time, the students, who have completed four years at Tsinghua, work full-time in medical school laboratories and research programs of their choice, essentially functioning as graduate students. In their first two months in Pittsburgh, the scholars have a one-week orientation to biomedical research, followed by two-week rotations in four labs selected on the basis of the scholars’ scientific interests, after which they choose one of these labs for the remainder of the two years. Selected labs may be in basic science departments, basic science divisions of clinical departments, or specialized centers that focus on approaches like simulation and modeling. The Tsinghua students also have a brief exposure to clinical medicine. UPSOM has also formed a similar partnership with Central South University Xiangya School of Medicine in Changsha, Hunan Province. The Xiangya students come to UPSOM for two years of research training after their sixth year and, thus, unlike the Tsinghua students, have already completed their clinical rotations. UPSOM faculty members have also paved the way for UPMC (University of Pittsburgh Medical Center), UPSOM’s clinical partner, to engage with clinical centers in China. Major relationships involving advisory, training, managerial, and/or equity roles exist with Xiangya International Medical Center, KingMED Diagnostics, First Chengmei Medical Industry Group, and Macare Women’s Hospital. Both UPSOM and UPMC are actively exploring other clinical and academic opportunities in China.     

Q & A: Till Roenneberg

Till Roenneberg is Professor of Chronobiology at the University of Munich. He studies the circadian clock from its cellular/molecular mechanisms up to the consequences of shift work. He received his education in Munich and London, and worked in the 1980s with Woody Hastings at Harvard. Since then, he has built up the Centre for Chronobiology at the Munich Medical School. For many years, he has coordinated circadian research and education in Germany and in Europe. He is also involved in reforming the University curriculum, incorporating problem-based approaches. He has received international prizes for both his research and his teaching.     

In memoriam Professor Enrique Ega?a, MD (1912-1997).

Enrique Ega?a-Barahona. Born Santiago, Chile, 10 March 1912. Deceased Santiago, Chile, 23 November 1997. MD, University of Chile, 1936. Rockefeller Foundation Fellow at Harvard University Medical School, 1940-1944. Professor of Pathophysiology, 1963; Director, Institute of Experimental Medicine, Faculty of medicine, University of Chile. Author of a Textbook on General Pathophysiology (1963) and of many scientific articles in Chilean and American medical journals. Strong supporter of evidence-based medicine as well as of medical education by involving students in short research projects.