Education
> The Glenda Garvey Teaching Academy named its director and first 12 fellows (seven shown below left). Thomas Garrett, M.D. (in center of photo), professor of clinical medicine, will guide and coordinate the activities of the new fellows.
> A comprehensive review of the medical school curriculum goals and methods began with a two-day retreat in October 2005 and accelerated under the leadership of Ron Drusin, interim senior associate dean for education, in the latter half of 2006. A task force of students and faculty has begun considering “revolutionary change,” including a shortening of the pre-clerkship classroom curriculum, more team-based learning, “interludes” between clerkships to reinforce basic science and cross-cutting topics, and the introduction of “areas of concentration” in the third and fourth years.
> Columbia opened its doors and classes to five visiting third- and fourth-year medical students (two shown above far right) from Tulane University in New Orleans, who arrived at P&S for clinical rotations after being displaced by Hurricane Katrina. Four of the five students earned credit that transferred back to Tulane, while the fifth was accepted at P&S as a transfer student.
> Jeanine D’Armiento, M.D., Ph.D., (above center) was appointed associate dean for gender equity and career development. In this new position, she will guide the implementation of recommendations made by the Task Force on Women Faculty to enhance the role of women faculty and foster a climate of support and development for all faculty members.
> Thanks to a $9 million bequest from philanthropist Thelma Ewig to support clinical education, 12 Department of Medicine faculty were recognized for clinical excellence. The new honors will be awarded each year to four junior, four mid-career, and four senior faculty members.
> Minority enrollment levels have tripled at P&S since 2001, rising from 8 percent of the entering class that year to 21 percent of the fall 2006 entering class. P&S ranks among the top dozen medical schools in the nation for minority recruitment.
> “Enhancing Social and Behavioral Sciences in Medical School,” a five-year, $1.35 million grant from the NIH, will train P&S faculty in social and behavioral sciences, preparing them to better instruct students in issues such as patient behavior, health policy, and professionalism. The project will be led by Rita Charon, M.D., Ph.D., professor of clinical medicine and director of the Narrative Medicine program.
> Interest in public health has increased since 9/11, and biomedical informatics graduate programs reflect the increased interest. Several students are enrolled in a new academic track in public health informatics, conducted with Mailman School of Public Health faculty.
> Six P&S graduate students spent a week in New Orleans in June 2006, volunteering with Common Ground Relief, an organization founded in the wake of Hurricane Katrina. Common Ground Relief has evolved into a collection of bioremediation projects, legal aid centers, clinics, distribution centers, and one of the largest free house gutting projects in New Orleans.
> To help fourth-year P&S students develop the teaching skills they will need to instruct medical students during their residency years, the Center for Education Research and Evaluation and the Center for Family Medicine in the Department of Medicine cosponsored a series of workshops to help students hone their teaching skills and make the transition from medical student to resident/teacher.
> P&S has added a new mobile patient encounter (MPE) system to track third-year students’ experiences with their patients during core clerkships. Students enter information about their patient experiences via PDA, desktop, or laptop computer, allowing the clerkship director and the Office of Curricular Affairs to monitor each student’s activity and learning in each clerkship.
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> Faculty in the Center for Education Research and Evaluation, together with faculty from the emergency medicine and from Teachers College, have been awarded a two-year $150,000 grant from the National Board of Medical Examiners’ Stemmler Fund for Medical Education Research. It is the second time that CERE has received a grant from the Stemmler Fund within three grant cycles, and Columbia is one of only a few schools to have had this prestigious honor more than once.
> Richard B. Robinson, Ph.D., (below) professor of pharmacology, was appointed associate dean of graduate affairs. In overseeing graduate programs at P&S, he will take a leading role in training the next generation of scientists.
> In June 2006, TeamWoRx, a bonding event that traditionally marks the beginning of medical students’ third year – their clinical year – shifted its focus from its usual team-building athletic events to working in the community through service-learning projects. The transition week brought the class together for five full days of skill building and orientation to address the responsibilities of third year, including admitting and taking care of patients, working with hospital staff, drawing blood, reading EKGs, and learning more about professionalism.
> “Casa Columbia,” a new facility to house Columbia medical students and residents participating in the Columbia University International Family AIDS program in the Dominican Republic, opened its doors in the summer of 2006. It can accommodate about 11 students. The AIDS program is designed to offer insight into the medical, social, and economic challenges that global AIDS represents.
Research
> Two low-tech diagnostic tools can significantly reduce precancerous cervical lesions, overcoming traditional barriers to access of the more cumbersome and expensive Pap test for cervical cancer. In a large, randomized, controlled trial, the two screen-and-treat methods – papillomavirus (HPV) DNA testing and visual inspection with acetic acid (VIA), followed by treatment using cryotherapy for all eligible women with positive test results – performed as well as or better than the Pap smear for identifying high-grade cervical cancer precursor lesions. The methods are also cost-effective and well received by women. Thomas C. Wright Jr., M.D., principal investigator of the study and professor of pathology, predicts that they will help to reduce mortality from cervical cancer, which is highly treatable and an unnecessary cause of death in the developing world.
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> A simple, noninvasive test can identify the best candidates for implantable cardioverter defibrillators (ICDs) to stop potentially fatal heart arrhythmias, according to a large, multicenter trial led by Columbia researchers. The test, known as the Microvolt T-wave Alternans (MTWA) test, can detect an electrical signal that can identify a heart likely to generate a life-threatening rhythm disturbance, a signal too slight to be detected by the traditional electrocardiogram. Using the test, physicians can identify patients most likely to benefit from ICDs and those who are unlikely to be helped.
> Almost one-third of colon cancer patients stop chemotherapy prematurely, leading to a doubling of the death rate, report Columbia researchers Alfred I. Neugut, M.D., Ph.D., and Dawn L. Hershman, M.D. Using a national Medicare database to identify stage III colon cancer patients who received one to seven months of fluorouracil (FU)-based chemotherapy treatment, the researchers found that those who underwent five to seven months of treatment survived nearly twice as long as the 30.9 percent of patients who received only one to four months of treatment.
> Cognitive impairment appears to be common in people with ALS (amyotrophic lateral sclerosis), a progressive motor neuron disorder, according to a study led by Columbia scientists Yaakov Stern, Ph.D., and colleagues. ALS was previously thought to affect only the motor system, but it is becoming increasingly
clear that the symptoms are much broader: In the study, one-third of ALS patients showed cognitive impairment.
> Patients with carotid artery blockage have an increased risk of stroke, even when they show none of the usual symptoms, such as limb weakness and speech difficulties. Now, results from the largest-ever multi-center U.S. registry on the efficacy of carotid stenting show that the procedure is safe and beneficial in patients who are at high risk for standard surgical therapy. The trial, led by Columbia researchers and known as capture (Carotid acculink/accunet Post Approval Trial to Uncover Rare Events), is hoped to lead to re-examination, and eventual expansion, of current government coverage for this procedure for a greater number of patients in need of this promising technology.
> Despite costing roughly four times as much, four relatively new drugs show no substantial advantage over previous-generation antipsychotic medications used to treat schizophrenia. That was one of the key findings from the landmark NIMH-CATIE (Clinical Antipsychotic Trials of Intervention Effectiveness) trial, led by Columbia’s chairman of psychiatry, Jeffrey Lieberman, M.D. (above left) The trial provides key insights for practitioners to use in choosing medications for patients with schizophrenia and also highlights the urgent need for new therapeutic options.
> Columbia Professor of Radiation Oncology David Brenner, Ph.D., (above right) will lead a consortium developing new technologies to rapidly screen large numbers of people for radiation exposure in the event of a terrorist attack on a nuclear facility or the detonation of a radiological “dirty bomb.” The team will develop new devices that can assess, within a few days of a potentially catastrophic radiological incident, the radiation doses received by hundreds of thousands of individuals. The research, funded by a $25 million grant from the National Institute of Allergy and Infectious Diseases, capitalizes on Columbia’s long history of leadership in radiation sciences.
> The osteoporosis drug raloxifene is just as effective as tamoxifen in preventing invasive breast cancer in postmenopausal women at risk for the disease, according to the Study of Tamoxifen and Raloxifene (STAR), led by Victor Grann, M.D., clinical professor of medicine and epidemiology and health policy and management. Both drugs reduced the risk of developing invasive breast cancer by about 50 percent. In addition, women who took raloxifene had 36 percent fewer uterine cancers and 29 percent fewer blood clots than the women who were assigned to take tamoxifen. Unexpectedly, raloxifene was not as effective as tamoxifen in reducing the risk of noninvasive breast cancer. The next prevention trial, which will compare raloxifene with an aromatase inhibitor, should start in late spring 2007.
> PET imaging, already used widely in the study of the brain, may be used to track diabetes progression. For years, doctors have been stymied in efforts to develop a screening method to measure insulin-producing beta cells: The pancreas, located deep within the abdomen, is largely inaccessible to biopsies. Now, a preclinical study led by Paul Harris, Ph.D., a research scientist in the Department of Medicine, shows that beta cells can be noninvasively imaged in rats using PET. A clinical trial of the technique in humans has been launched at the Naomi Berrie Diabetes Center.
> Women are less likely than men to receive recommendations from their doctors for preventive therapies such as cholesterol-lowering drugs, aspirin therapy, and cardiac rehabilitation to protect against heart attacks and death, according to a study by Lori Mosca, M.D., Ph.D., associate professor of medicine and director of the Columbia Center for Heart Disease Prevention.
Patient Care
> Vagus nerve stimulation therapy for treatment-resistant depression is now available at Columbia, the first institution in the New York area to open a clinical Brain Stimulation Service offering this therapy in psychiatry. VNS – which stands for vagus nerve stimulation – is the first long-term therapy specifically approved by the Food and Drug Administration for treatment-resistant depression. Major depressive disorder affects nearly 19 million Americans every year, and approximately 4 million of those do not respond to multiple antidepressant treatments. In 2007, the FDA will convene a panel hearing on the second device-based therapy to be reviewed for the depression indication: transcranial magnetic stimulation, or TMS. The Columbia Brain Stimulation Division is a leader in TMS research for depression and other disorders and was the lead institution in the New York area for the TMS trial that generated the data the FDA will review.
> Peter Green, M.D., published “Celiac Disease: A Hidden Epidemic” (Collins Books), raising awareness of this little-known autoimmune disease. Celiac disease is estimated to affect some 3 million Americans, but only about 3 percent currently receive treatment. Columbia’s Celiac Disease Center provides comprehensive medical care, including nutrition, for adult and pediatric patients with celiac disease. The center diagnoses and treats more than 2,400 patients annually from around the world.
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> Faculty at Morgan Stanley Children’s Hospital and the Ambulatory Care Network of NewYork-Presbyterian Hospital run a new program called WIN for Asthma to reduce asthma-related emergency-department visits, hospitalizations, and school absences by 25 percent to 50 percent for high-risk children. The WIN for Asthma program, started through a $2 million grant, is just one of several community pediatrics programs administered by Columbia faculty.
> Columbia surgeons performed 106 heart transplants in 2006. NewYork-Presbyterian/Columbia has the largest heart transplant program in the country; more than 1,700 transplants have been performed since the inception of its heart transplant program in 1977. The 118 heart transplants performed at NewYork-Presbyterian in 2005 set a one-year record for any American hospital in the history of heart transplantation.
> P&S faculty working in NewYork-Presbyterian Hospital form one of the largest stroke centers in the nation. The hospital has received stroke center designation from the New York State Department of Health and is one of the first hospitals with a dedicated stroke center. Columbia and the hospital started offering comprehensive and coordinated care focused on stroke in 1983.
> Ground was broken (above) for NewYork-Presbyterian Hospital/Columbia’s new state-of-the-art Vivian and Seymour Milstein Family Heart Center. Former President Bill Clinton, who underwent two cardiac surgeries at Columbia in 2004, attended the ceremony. The Heart Center, in a 142,000-square-foot freestanding building with six levels, will connect to the Milstein Hospital Building and the Herbert Irving Pavilion (formerly the Dana Atchley Pavilion). It is expected to be completed in 2009.
> NewYork-Presbyterian Hospital ranked sixth in the nation and first in New York City in U.S. News and World Report’s 2006 listing of America’s best hospitals. In New York Magazine’s annual poll of the metropolitan area’s best hospitals, NewYork-Presbyterian was named the best hospital overall and best hospital in 10 areas of health care. In the annual ranking of New York City’s best doctors, Columbia physicians regularly are represented more than clinicians at other facilities.
> Columbia surgeon Lloyd Ratner led New York City’s first three-way kidney transplant at NewYork- Presbyterian Hospital. Dr. Ratner led 40 clinicians on six transplant teams who worked simultaneously in six operating rooms to transplant lifesaving kidneys into three patients without compatible donors.
> Columbia Professor of Social Medicine David Rothman, Ph.D., co-chaired a national group urging academic medical centers to restrict ties between drug companies and physicians. The group published its report in the Journal of the American Medical Association. Its recommendations included a ban on drug and device industry gifts, including drug samples, limits on individual relationships with industry, and firewalls insulating institutional pharmaceutical and device-related decisions from conflict. A number of medical schools have adopted the recommendations.
> Transient ischemic attacks, or “mini-strokes,” should be taken just as seriously as stroke and treated the same, according to new guidelines from the American Heart Association/American Stroke Association. Columbia Associate Chairman of Neurology and Professor of Neurology and Epidemiology Ralph Sacco, M.D., chaired the committee that authored the guidelines, which found that the greatest risk a stroke survivor faces is another stroke.
> To better serve the aging population of northern Manhattan and the Bronx and create a nexus for education and clinical research in geriatric medicine, Columbia has launched a new division of geriatric medicine and aging based at NewYork-Presbyterian Hospital’s Allen Pavilion in upper Manhattan. The new division, designed to prevent functional decline and promote healthy aging, will link experts from a wide spectrum of disciplines and turn the Allen Pavilion into a model of care for older adults.
> The Avon Foundation Breast Imaging Center and the Avon Foundation Breast Cancer Research Laboratory opened (below) in Columbia’s Irving Cancer Research Center. The two facilities will provide access to screening and diagnostic services to underserved and uninsured women and conduct innovative basic science research focused on improved understanding of the underlying mechanisms of the disease. The imaging center offers state-of-the-art screening and diagnostic technology, including digital mammography, ultrasound-guided core biopsy, stereotactic-core needle biopsy, and a mammography reporting system to track patient history and facilitate timely follow-up.
> The Faculty Practice Organization at P&S, made up of nearly 1,200 physicians who treat patients at Columbia and NewYork-Presbyterian Hospital, is the largest multi-specialty medical group between Boston and Baltimore. The FPO this year has taken steps to become more efficient and responsive to its members and to patients, improving the experience for both provider and patient. Hard-working committees have explored technology issues, patient services, malpractice insurance, and staff training. The FPO hired its first executive director, Michael Duncan, who, along with FPO president Richard U. Levine, M.D., (left to right above) clinical professor of obstetric and gynecology, is helping the organization integrate sound business practices into clinical practice.
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