St. George’s University Announces Partnership with St. Francis College

St. George’s University announced today two new programs that will allow qualified pre-medicine or pre-veterinary students at St. Francis College in Brooklyn, NY, to gain streamlined admission to the St. George’s University Schools of Medicine and Veterinary Medicine.

“We are excited to establish our first pathway program in New York City,” said Dr. G. Richard Olds, president of St. George’s University. “As the COVID-19 pandemic has shown, New York faces a shortage of physicians. We look forward to welcoming aspiring doctors from St. Francis and equipping them with the skills and knowledge they’ll need to serve their communities.”

Students in the “4+4” program will complete their four-year undergraduate degree at St. Francis in a pre-medicine or pre-veterinary medicine program and proceed directly to medical school at St. George’s in Grenada. Those pursuing a Doctor of Medicine degree, the final two years of this combined program consist of clinical rotations at SGU’s affiliated hospitals in the United States and/or the United Kingdom. The final year of the combined Doctor of Veterinary Medicine program consists of clinical rotations at SGU’s affiliated veterinary schools in the United States, United Kingdom, Canada, Australia, and/or Ireland.

Exceptional pre-medicine students can qualify for the “3+4” program, under which they complete their degrees in three years and then move onto medical school at St. George’s before spending the final two (2) years in clinical rotations at hospitals affiliated with SGU.

Students who wish to participate in one of the direct admissions partnerships must indicate their interest upon applying to St. Francis. Qualified students will be prioritized for interviews and admissions decisions, provided they meet the admissions criteria for both schools.

In order to proceed to St. George’s, applicants must maintain a 3.4 grade point average at St. Francis and obtain a competitive score on the MCAT. A 3.2 grade point average and competitive score on the GRE are required for entry into the St. George’s veterinary program.

Students accepted into the medical program will receive a $10,000 scholarship upon matriculating at St. George’s.

“We look forward to a very productive partnership with St. George’s University. Offering our students a direct pathway into advanced programs in medicine and veterinary science strengthens our commitment to support our students to reach their personal and career goals,” states SFC President Miguel Martinez-Saenz.

 

 

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Royal College of Pathologists Recognizes Longtime SGU Professor

St. George’s University pathology professor Shivayogi Bhusnurmath was recently honored with an RCPath Achievement Award by the Royal College of Pathologists for his outstanding contributions to pathology education. He was presented with his award virtually as part of the College Council meeting in November.

The College, which oversees the training of pathologists and scientists working in 17 different specialties, including hematology, clinical biochemistry and medical microbiology launched the awards to celebrate excellence in pathology practice and promote high standards in pathology education, training, and research.

Dr. Bhusnurmath attributes this award to the successful joint efforts in planning and execution of many educational innovations with his wife, Dr. Bharti Bhusnurmath, co-chair of the Department of Pathology and director of the medical pathology diagnostic laboratory at SGU’s School of Medicine.

“Winning the award from the Royal College of Pathologists is truly humbling,” said Dr. Bhusnurmath, dean of academic affairs, SGU. “The College has outreach throughout the globe, including Asia, Africa, Far East, and Australia. It is satisfying to see the recognition of the combined efforts of Dr. Bharti and I spanning four decades in pathology education worldwide.”

Drs. Bharti Bhusnurmath (left) and Shivayogi Bhusnurmath

Dr. Bhusnurmath and his wife are two of SGU’s longest-tenured faculty members, having joined the University in 1996. Their accomplishments include revolutionizing clinical problem-based teaching of pathology through the extensive use of clinical vignettes in lectures; initiating audience polling systems in lectures; introducing small-group learning activities with objectives related to communication skills and professional behavior; creating a unique international clinical tutor teaching fellowship program, which has benefitted over 300 international medical graduates to study pathology; and generating an interest in pathology that has resulted in dozens of SGU graduates entering pathology residency programs in the US each year.

“In many ways, this award represents the excellence in education platforms and innovations at SGU,” added Dr. Bhusnurmath. “It was achieved only with the support of visionary leaders such as Chancellor Charles Modica, former dean of basic sciences; Dr. Allen Pensick, former vice chancellor; Dr. Keith Taylor; Dr. Steve Weitzman, dean emeritus; and our energetic new dean full of exemplary educational ideas, Dr. Marios Loukas and his team. This award should allow the flag of SGU to fly high internationally and help more students achieve their dreams of becoming a doctor at our university.”

– Ray-Donna Peters

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SGU alumni rally around Grenada amid COVID pandemic

When the COVID-19 pandemic put Grenada back on its heels, St. George’s University alumni put their best foot forward, bringing hope to their one-time home and setting the country on a promising path.

In the span of mere weeks, more than 200 School of Medicine alumni have volunteered their medical services, helped to procure all-important supplies, and contributed more than $70,000 through its newly created Grenada Medical Assistance GoFundMe page.

The Grenada COVID Crisis Group (GCCG), led by SGU graduates Michele Friday, MD ’88, Dwight Matthias, MD ’92, and Lisa Radix, MD ’97, has spearheaded the campaign—facilitating in-person and online patient care and crowdsourcing both funds and supplies that will help healthcare workers on the ground treat those who have contracted the virus. In addition, they aspire to educate the Grenadian community about the benefits of adhering to health protocols and, above all else, they support the COVID-19 vaccine in the population to flatten the curve, lessen the effects of recurring COVID infections, and lessen the burden of long COVID syndrome in recovering patients.

While addressing COVID-19, Dr. Friday hopes that the support received in recent weeks is the start of a long-term healthcare solution in Grenada.

“This pandemic has given us an opportunity to impact the healthcare of our fellowmen and families on the island and has imparted in us the vision to continue with the existing momentum to grow a stellar medical environment in Grenada,” said Dr. Friday, an interventional cardiologist based in Kentucky. “We hope that this medical ideal that we are striving towards, is something that each and every one of our Grenada-trained doctors—who have been educated at SGU, live in Grenada, or who work off island but are Grenadian in heart—would be proud of.”

Raised in Richmond Hill, St. George’s, Dr. Friday is one of more than 60 Grenada-born physicians who have rallied to support their home country. Three grads—Philip Bonaparte, MD ’89, Molara Alexis, MD ’05, and Carina David, MD ’16—arrived on island last week to begin working with local doctors, nurses, and staff.

VIDEO: Dr. Alexis and Dr. David speak about COVID-19 vaccines in Grenada

“I felt that it was important to help in a meaningful way, with the reduction in the workforce as some members contacted COVID-19, the likely possibility of fatigue due to an increased volume of work related to the surge, and the opportunity to provide moral support to frontline workers,” said Dr. Alexis. “As an infectious disease physician, I was keen to share any knowledge and experience with my colleagues in Grenada and to continue to educate the general population regarding the importance of vaccination.”

They’ll also work on building up the telemedicine infrastructure so that hundreds of SGU graduates can provide personal care from afar. The network of volunteers spans a variety of specialties, including infectious disease, pulmonology, pediatrics, cardiology, and emergency medicine.

Supplies in demand

The wide alumni network has procured hospital supplies that specifically address needs in Grenada General Hospital and other clinics. These supplies—which began arriving in late September—include much-needed personal protection equipment (PPE) and oxygenation equipment, as well as pharmaceutical support such as monoclonal antibodies, antibiotics, and steroids.

The GCCG GoFundMe page has secured donations from more than 400 alumni and friends of SGU. These funds will be used to secure additional medications, supplies, and equipment to be sent to Grenada. GCCG is working closely with the Ministry of Health to monitor existing supply levels and secure fortifications as needed.

“You feel like you’re connected to a bigger thing that’s about to surround Grenada with all the love and help they can think of providing,” said Dr. Radix, a nephrologist who was born and raised in St. George and attended Anglican High School. “It’s great to be part of a group that has such an innate love for Grenada, Carriacou, and Petit Martinique.”

 

“As an infectious disease physician, I was keen to share any knowledge and experience with my colleagues in Grenada and to continue to educate the general population regarding the importance of vaccination.”

Dr. Matthias, who was raised in Belmont, St. George’s, added: “My colleagues, Dr. Friday and Dr. Radix, clearly epitomize the SGU alumni and have illuminated the spirit of Grenada national anthem—’we pledge ourselves… heads, hearts, and hands in unity…  As one people, one family.’ I’m so appreciative of the fellow alumni who have extended helping hands and made generous donations.”

Graduate contributions are part of a larger effort from the entire SGU community to provide care, spread information, and limit the spread of the COVID-19 virus. Working with the Government of Grenada, SGU faculty members have stepped up to volunteer in the Government’s most recent initiative—hosting mobile testing and vaccination clinics throughout the island. Students have also mobilized in response to the call for help, volunteering at testing and vaccination sites hosted by the Ministry of Health.

– Brett Mauser

 

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Dr. Carina David

Forbes: More med school candidates turning to Caribbean

Even though medical school applications have skyrocketed, the number of seats in US schools hasn’t kept pace. It’s led more and more qualified MD candidates to choose the Caribbean to continue their studies, this according to a recent story on Forbes.com.

“For decades, medical schools weren’t meeting the needs of an increasingly older U.S. population. Now, they’re forced to play a game of catch-up,” said Dr. G. Richard Olds, president of St. George’s University.

Read more about how SGU is helping to provide a foundation for aspiring physicians to enter medicine in the United States, in the places where healthcare is needed most.

America Needs More Doctors: SGU President Writes Op/Ed for The Hill

 

The Hill has published an op/ed by St. George’s University President Dr. G. Richard Olds titled “To get the doctors we need, expand their opportunities to train,” which focuses on the need to increase postgraduate opportunities in the US.

In the published piece, Dr. Olds stated that America will face a shortfall of up to 124,000 doctors by 2034, according to data from the Association of American Medical Colleges.

“This physician shortage will disproportionately hurt historically marginalized communities, where many people already struggle to find care,” Dr. Olds wrote. “Funding more residencies — so that more newly minted MDs can actually join the physician workforce — is the most straightforward solution to the doctor shortage.”

While the number of residency positions has been growing in recent years, “given the scale of the doctor shortage, we need even more,” he wrote.

 

Op-Ed: SGU President Dr. G. Richard Olds Featured on KevinMD

St. George’s University President Dr. G. Richard Olds recently penned an article on KevinMD.

The article, “Here’s how we can rebuild health care post-pandemic,” outlines the critical role that international medical graduates (IMGs) will play in the future physician workforce. Thousands of new doctors will soon begin residency programs at hospitals across the country. That includes 7,500 IMGs—more than 1,000 of which are SGU alumni.

“These newly minted doctors, many of whom are U.S. citizens who chose to study abroad, will play an outsized role in treating the underserved communities hit hardest by the pandemic,” Dr. Olds wrote.

He goes on to argue that internationally trained physicians are uniquely suited to address our country’s growing doctor shortage. They have a history of working in underserved areas, including rural regions and majority-minority communities.

“Internationally trained doctors are also more likely to treat people from historically marginalized groups. In areas where the population is 75 percent non-white, IMGs account for nearly 40 percent of the physician workforce. And according to a study published in the Journal of General Internal Medicine, IMGs often care for Medicare beneficiaries with more complicated needs than their domestically trained counterparts,” he wrote.

Grad Reflects on Role in World’s First Successful Face and Double Hand Transplant

Zoe Berman, MD ’17

More than a year of preparation came down to one day for one patient and the surgical team that was about to change his life. Joseph DiMeo, a 22-year-old man from New Jersey, had been severely injured in a motor vehicle accident, and in an effort to regain his independence, he turned to NYU Langone Health to perform the world’s first-ever successful face and double hand transplant.

Over the 23-hour operation last August, Zoe Berman, MD ’17, stood alongside the surgeons, confirming each critical step as the hands and face were detached from both the donor and Mr. DiMeo, and then the donor hands and face were carefully affixed to the recipient. For Dr. Berman, a reconstructive plastic surgery research fellow under world-renowned doctor Eduardo D. Rodriguez at NYU, the “groundbreaking” operation was a culmination of in-depth research and planning that she and her colleagues had contributed to in order to ensure its success.

After finishing up her fellowship at NYU, Dr. Berman will return to Maimonides Medical Center to complete a surgery residency this July, not without an experience she deemed “life-changing” just as it was for the patient. She shared what it was like to participate in the planning and execution of such an intricate procedure.

St. George’s University: How unique of an undertaking was this for Dr. Rodriguez and his team?

Dr. Berman: This was the first-ever hand transplant to be performed at NYU. There have been two face transplants done at the institution—one in 2015 and another in 2018—but NYU physicians had never done a hand transplant. Only 150 or so have been performed worldwide, and the combined face and double hand transplant procedure had never been done before successfully.

SGU: What was your role prior to and during the operation?

Dr. Berman: I was a part of the four-person research team that helped procured the necessary information to build the foundation for this procedure to happen. We started with a review of the peer-reviewed literature on hand transplant and other combined transplants, where we evaluated more than 1,800 articles and ended up critically appraising 93 of those articles to see how we could use that information to inform what our procedural steps were going to be, and how to execute the surgery safely and successfully. We were looking for what elements contributed to the successes of past surgeries, and perhaps even more importantly so, where the unsuccessful operations fell short—whether they were too ambitious in terms of the amount of skin that they took, the blood supply wasn’t adequate, or the patient simply wasn’t the best candidate. We then centralized all of this information and presented it to the surgical team.

Our research team also worked with the surgeons over a series of monthly rehearsals to develop the procedural steps for the hand transplant element. We created a surgical checklist to ensure adherence to every single agreed-upon step of the donor procurement, the recipient operation, and the re-attachment of the hands. Each operative sequence had between 30 and 50 steps and it took all the guesswork out of it.

SGU: Describe what it was like the day of the operation.

Dr. Berman: We had two adjacent operating rooms functioning simultaneously. Our team physically stood alongside the surgeons during all the cadaver rehearsals as well as the actual transplant to ensure that everyone was adhering to the procedural steps. When you’re talking about connecting multiple blood vessels, tendons, bones, and lot of different structures that meld together, it can make it a very complicated procedure.

  • Dr. Berman working with Dr. Rodriguez in the cadaver lab.

  • The NYU plastic surgery team

  • The research team

  • SGU grads Matthew and Zoe Berman, with father Peter

SGU: How has Mr. DiMeo fared since the procedure?

Dr. Berman: Joe is a very motivated young man. It was important to him to get back to work, get back to the gym, to be independent, and to really get back to the life that he was living before his accident. I think it’s the most remarkable thing about him and part of the reason why Dr. Rodriguez and the team thought he was an exceptional candidate for this surgery.

Since the operation, he’s done very well with his rehabilitation and continues to improve functionally every day. He has been monitored very closely for any signs of rejection and he continues to heal and to accept all three of his allografts (face and both hands).

SGU: What prompted you to pursue this fellowship at NYU?

Dr. Berman: My father is a head and neck surgeon, so I think I’ve always had that influence me to a degree. There’s something about the symmetry and the intricacies of that part of the body that I find extremely fascinating. I’ve always had an appreciation for the face and what it represents for a human being in terms of providing a sense of identity and an outlet to communicate verbally and emotionally. To help restore that identity is very meaningful in somebody’s life. When I learned about the remarkable things Dr. Rodriguez and his team were doing at NYU, I jumped at the opportunity to be a part of it. Face transplant is the ultimate reconstructive surgery.

SGU: How has being part of this procedure changed your life?

Dr. Berman: It has been an extremely unique, once-in-a-lifetime opportunity. I feel so fortunate to be able to partake in this incredible experience that has truly pushed the field of reconstructive surgery forward. To be a part of this patient’s journey, to see him continue to be so motivated and so beautifully supported by his parents has really been a privilege.

More so than anything, I’ve been so fortunate to have had the mentorship of Dr. Rodriguez, who is a real visionary. He put trust in me to be a part of this, and to be able to contribute to changing somebody’s life—that’s why I went into medicine in the first place—to give someone the opportunity to live a better life, a more fulfilling life, and to have a second chance.

SGU: Why did you choose to go to SGU, and how has it set you up for success in your career?

Dr. Berman: I would have never had the opportunity to do anything I’m doing if I hadn’t first made the decision to go to SGU to get my MD. At the time, I was ready to go to medical school, and I didn’t want to wait for another US application cycle.

The foundation that the education at SGU provided me has allowed me to grow beyond what I ever imagined to be possible. I think coming from SGU gives you a sense of humility that will serve anybody well in the medical field. I have never felt entitled to anything. For me, I’ve always considered being a doctor and working with vulnerable patients to be an unbelievable privilege.

There’s also something sacred and beautiful about the island. I met my husband there (Matthew Bushman, MD ’16), who’s now an anesthesiologist, and my brother (Matthew Berman, MD ’17) also followed me to the island a semester later, who met his wife there (Taylor Dodds, MD ’19), and they’re both in residency now and doing well. We all had an incredible time at SGU, and considering where we all are now, I would never change my decision to go there.

– Brett Mauser

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SGU professor looks back on one year combating COVID-19

Dr. Sylvie de Souza (front) and the emergency medicine team at The Brooklyn Hospital Center in New York. Photos provided by Sylvie de Souza

Dr. Sylvie de Souza, director of emergency medicine at The Brooklyn Hospital Center (TBHC), and a clinical assistant professor for St. George’s University, was on the front lines when it all began. The day was March 1, 2020, when the first COVID-19 case was reported in New York City.

As the coronavirus spread throughout the city, putting pressure on the people and the mechanisms to treat ill patients, she remembers as much about what happened as the way it made her and her colleagues feel. It reminded her another catastrophic event—September 11, 2001.

“We immediately went into preparedness mode while the memory of 9/11 lurked in the back of our minds,” Dr. de Souza said. “Although the nature of the event was different, we all sensed that something major and perhaps terrible was about to happen. The anxiety of the unknown heading our way was palpable.”

A year later, Dr. de Souza reflected on the entire experience, how she and her team weathered the storm, and the hope she has for—and sees in—future SGU medical students who she trains for the fast-paced world of emergency medicine.

St. George’s University: How would you describe the past year in the emergency department at TBHC?

Dr. Sylvie de Souza: In September 2001, many of us remember standing by and watching New York’s bravest selflessly run into the burning building when everyone was running out, running toward the danger, into the fire, to save as many as they could. Sadly, when the unthinkable happened, we were the ones who went to the firehouses, like most New Yorkers, to praise the bravery and console the unimaginable loss. As emergency workers, there was not much else we could do other than what we had been trained to do: treat the walking wounded and the first responders. And we did, for weeks to come. Our lives were never directly endangered on 9/11.

This all changed in March of 2020 when the danger came directly at us. The fire came to us, and it grew uncontrollably with each day that passed. We stood in it, day after day, for hours on end, with little sleep, food, or drink, hardly recognizable in our plastic gear, trying to help as many as we could, with our own fear in the pit of our stomach, watching some of us fall, victims of the vicious enemy we were fighting. Many came to help in every way they could, but everybody knew, as we did, that this time around, it was as though we were the ones standing in the burning building, right there among the victims we were trying to save.

What an amazing twist of fate it was that, this time around, it was us New York’s bravest who came to clap for every evening. If anyone knew what we were feeling, I thought, it would be them. They clapped with the rest of the bystanders, a daily incantation of sorts, to harness the courage they knew we needed to keep going.

SGU: How did 2020 change you as a physician?

Dr. de Souza: I once read this sentence in a French publication. I do not recall who the author is, but it stayed with me: “Courage does not consist of doing the work that is expected of you; that is competence. Real courage is to conquer one’s fear and see the duty before the effort.”

I cannot recall a time in my entire career when this sentence rang truer or when I was, along with my colleagues, tested to honor the oath we had taken to come to the aid of others. It took all we had to overcome our own fears. We worked endless days and nights, not knowing what the fate of our patients would be, or our own, instead trusting that we were doing exactly what we were supposed to do—to follow our calling and answer the call of duty.

Many lessons were learned in the face of such adversity and uncertainty: 2020 was a year of great loss, but also a year filled with a sense of community, resilience, and hope. I face 2021 with a renewed sense of purpose and the knowledge that preparedness and togetherness are likely the most important tools we possess to confront adversity.

SGU: In what way has your role changed the most during the pandemic?

Dr. de Souza: With the restrictions imposed by NYC Department of Health at the beginning of the pandemic, no visitors were allowed in the hospital. Those measures were in place to protect those who were not yet infected.

As a result, we were no longer simply caregivers to the growing number of critically ill patients. We suddenly became their only “visitors,” their only connection to the outside world and their loved ones, their consolers, their prayer partners, their only and sometimes last human interaction, and most poignantly, the last ones to hold their hands as they slipped into unconsciousness or died. No amount of training could have prepared us to take on a responsibility of that scale. Watching patients die deprived of their loved ones or making their hastened last goodbyes on a video monitor was almost too much to bear.

Surrounded by all this despair and grief, we became closer as a team; we suddenly felt responsible for one another and supported each other through each day. As emergency workers, we had always known the importance of functioning as a team. This time, however, there was a whole new twist. We were now a team who had to operate in constant danger, facing mortality, that of those we cared for … and our own. We shared the same fears about our own unpredictable fate, fighting this vicious invisible enemy, not unlike a platoon sent to combat.

The Brooklyn Hospital Center. The oldest hospital in Brooklyn was one of many in New York City to combat the emerging COVID-19 crisis.

SGU: What can St. George’s University students rotating with the TBHC EM department expect to learn?

Dr. de Souza: Several faculty, myself included, partake in the weekly didactic conferences for EM residents and medical students. Our program has a dedicated clerkship director who organizes a series of didactic sessions and workshops where students receive direct feedback from the faculty. Aside from some exposure to a series of common complaints, medical students rotating through our department will leave the clerkship with a basic knowledge on the approach to the undifferentiated patient and introductory skills for the rapid recognition of the critically ill patient. We also place a lot of emphasis on the ability to communicate and function effectively in a team.

 

“As emergency workers, we had always known the importance of functioning as a team. This time, however, there was a whole new twist.”

SGU: Is there a personality trait that you find to be common among SGU medical students?

Dr. de Souza: I have had the pleasure of working many SGU students who rotated through our department over the years. Several of them became some of our most stellar residents. I have found them to be driven, focused, and resilient. Most salient is their overall ability to adapt and make the best out of any situation.

SGU: What is one piece of advice that you would give to a student who was considering a career in emergency medicine?

Dr. de Souza: During your ED rotations, immerse yourself in the ED life and culture. Merge with the ED team. It’s not about anyone of us and it’s not about you; it’s about the patient. When the team wins, and you participated, you won. Don’t worry so much about having all the answers. Be perceived as a vibrant, passionate, and compassionate member of the team—someone who anyone would want by their side in the trenches.

– Brett Mauser

Get to Know Dr. Sylvie de Souza

Video produced by The Brooklyn Hospital Center

Under the Microscope: COVID-19 Vaccines in Grenada

Dr. G. Richard Olds, president of St. George’s University, has committed his life to studying tropical and infectious diseases. All over the world, he has seen how viruses—these microscopic parasites that are invisible to the naked eye—can spread through a community, leaving damage in their wake.

One of the best methods to combat the virus is the use of vaccines. A version of the SARS-CoV-2 vaccine began being administered in Grenada last week, and a full program is currently being rolled out that places essential workers, elderly and Grenadian residents with pre-existing conditions on the priority list. Having long studied vaccines and their positive effect on healthcare, Dr. Olds is an ardent supporter of their implementation.

I got my first COVID vaccine today,” he said.

Dr. Olds shed light on the vaccine that is currently being distributed in Grenada, what citizens can expect when receiving it, and the long-term outlook for COVID-19 in the country.

St. George’s University: What vaccine does Grenada currently have in stock? Is it being administered elsewhere in the world and how does it compare to other versions?

Dr. G. Richard Olds: Grenada is currently using the AstraZeneca vaccine, which is currently being used extensively in England. It was developed in partnership with Oxford University. In contrast to the two vaccines being used in the US, it is a chimpanzee adenovirus that has had the message for the spike protein placed within it. This vaccine can’t make humans sick, but it induces a high level of protection against COVID-2. Just like the mRNA vaccines used in the US, this vaccine requires two doses but has the advantage of being stored in cold but not freezing environments.

SGU: How exactly does this vaccine provide protection against SARS-CoV-2?

Dr. Olds: The COVID-2 virus attaches to human cells through a molecule on its surface called a spike protein. All current COVID vaccines target this molecule. Vaccinated people develop antibodies that block the binding of the spike protein to human cells. Unable to bind, the virus is unable to infect cells.

SGU: How long is the protection expected to last?

Dr. Olds: How long the vaccine will protect those who receive it is currently unknown, but it looks like all vaccines provide protection for at least a year and probably longer.

 

“If everyone doesn’t take the vaccine, we run the risk that COVID will circulate for a very long time.”

 

SGU: Is the vaccine available in one shot or does it require multiple shots over a period of time?

Dr. Olds: Most of the seven COVID vaccines require two shots, but the Johnson and Johnson vaccine only needs one shot. This is not currently available in Grenada. The interval between the two shots varies, but about a month is the most common. There are experiments in England now with the AstraZeneca vaccine with longer periods between the shots.

SGU: How safe is the vaccine that is available in Grenada? Are there any side effects?

Dr. Olds: All the COVID vaccines appear very safe. In blinded control studies, no difference was seen between vaccinated people and those that got sugar water in terms of long-term side effects. In the short run, vaccinated people will likely feel soreness in their arm, feel poorly for a few days, and may have a low-grade fever. None of these responses are serious, and they often respond to over-the-counter medicine.

The AstraZeneca vaccine currently in Grenada does not seem to cause severe allergic reactions. All minor reactions to the vaccine appear more commonly in reaction to the second vaccine, and are a sign that they are working.

SGU: Are there any pre-existing conditions that would prevent someone from getting it?

Dr. Olds: If a person is severely immune compromised—such as being infected with the AIDS virus, on high-dose steroids, getting chemotherapy, or having an organ transplant—they should consult a doctor before getting the vaccine.

SGU: Once an individual receives the vaccine, how will restrictions change for them?

Dr. Olds: Even after you get fully vaccinated, people will still need to wear a mask and socially distance until everyone on the island is vaccinated. That’s because vaccinated people are protected from dying from COVID, but they could still transmit the virus to others. Once everyone is vaccinated, life should return to normal.

SGU: Do you believe that all eligible individuals should receive the vaccine?

Dr. Olds: Everyone over 18 years of age should get the vaccine. Soon we will know if children over 12 should get the vaccine. The vaccine is very safe, and COVID can lead to serious illness or fatalities. In addition, COVID can cause long-term health issues for people. By now, millions of people in England have already received the vaccine currently available in Grenada without a problem.

If everyone doesn’t take the vaccine, we run the risk that COVID will circulate for a very long time, and the more the virus circulates, the greater the chance that a new variant will develop that the vaccine will not protect people from. It’s a race, and I hope this time humans win.

1,000 Residency Slots Approved by Congress: What it Means for Medical Students

Congress recently passed a measure to fund 1,000 postgraduate residency positions over five years as part of the Medicare-supported program—the first increase in nearly 25 years according to the American Association of Medical Colleges (AAMC). St. George’s University President Dr. G. Richard Olds explained to SGU News what the increase means for our medical students. In addition, Dr. Olds also recently appeared on Action News Jax (Jacksonville, FL) to discuss the new medical residency funding in the stimulus package.

St. George’s University: St. George's University President G. Richard OldsWhat does this mean for SGU medical students, especially those applying for residency?

Dr. Olds: This new legislation should help our students in the Match no matter what specialty they decide to go into. Also, these new slots are permanent in contrast to the teaching health center funds that have to be renewed by Congress every few years.

SGU: What specialties will be included?

Dr. Olds: Potentially all specialties are included, but an institution can’t just expand specialty slots. Half must be for primary care, which includes OB/GYN.

SGU: Residency positions in rural and underserved communities were highlighted as a particular focus in the legislation. Why is that important?

Dr. Olds: The population is both growing and aging. The real problem, however, is a maldistribution of doctors geographically and a maldistribution of doctors by specialty. The first issue points out that affluent urban and suburban areas of the US often have a surplus of doctors, while underserved rural and urban areas have severe shortages. In big states, for example, the surpluses in affluent areas often mask the severity of shortages in rural and poor urban areas.

The second problem of maldistribution by specialty is created by the fact that 70 percent of US medical students specialize. The country needs over half to go into primary care fields. To make this issue worse, primary care doctors as a group are older, and age and COVID-19 are driving them into retirement faster than specialists.

SGU: How and why did these positions become available?

Dr. Olds: The issue that is causing problems in the physician pipeline are residency slots—not medical schools and students. Although there are far too few US medical schools for the current need, 25 percent of all residents in US residencies are international medical school graduates (such as SGU grads), and there are far more doctors who want to train in the US than we have residency slots to accommodate them. The shortage of graduate medical education (GME) slots is driven by a decision made in 1997 to cap GME funding by Medicare. Pressure has been growing to increase GME slots because of the growing doctor shortage. This is the first time in over 20 years that Medicare has increased the GME caps on most teaching hospitals.

While the number of additional residencies will not be enough to solve the doctor shortage in the US, and only a percentage of these slots will go to rural primary care residencies where they are most needed, it’s a start.

SGU: What is the rough number of Medicare-funded residency positions now, and why is adding these residency positions such an important breakthrough?

Dr. Olds: Medicare currently funds about 90,000 GME slots, the US Department of Veterans Affairs funds about 12,000, and children’s hospitals fund about 7,000 each year. Remember that training in internal medicine or pediatrics takes three GME slots spread over three years; general surgery five GME slots, etc., since you need a funded slot each year of your training. If you crunch the numbers, we have the ability to train about 35,000 new residents each year, mostly through the Match.

While the addition of 1,000 slots spans five years, and some of those slots will go to big teaching hospitals that are currently over their cap, it’s the first time in decades the number of Medicare slots have increased. It’s a big deal.

 

– Laurie Chartorynsky