CoSMO Turns 1
A PILOT PROJECT ENVISIONED AND IMPLEMENTED BY STUDENTS with faculty volunteers reached a milestone in March.
The Columbia Student Medical Outreach — CoSMO — is a center where students treat uninsured patients who can't afford care in other settings.
The center, open every Saturday, has grown since its opening day in March 2004 and now boasts 120 student and 30 attending physician volunteers who recorded 213 clinical encounters during its first year.
|Seen cutting the cake at CoSMO's first birthday party are, from left,
Andrea Sesko'05, co-chair of CoSMO's 2004-2005 governing council;
Roberto Jerez from the Faculty Club;
Dr. Mary McCord, associate clinical professor of pediatrics and of population and family health and a member of CoSMO's advisory board;
and Stephanie Wethington'05, co-chair of the 2004-2005 governing council.|
The center is making strides toward its ongoing goal to provide neighborhood residents with comprehensive primary care so patients can reduce their reliance on the emergency room.
The students also refer eligible patients to insurance programs.
The center has 102 current patients.
Community groups, including Alianza Dominicana, St. Elizabeth's Church, and Isabella Geriatric Center, refer patients to CoSMO to be seen by teams of medical, public health, nursing, and social work students and an attending physician.
A patient is seen by students (firstand second-year students are paired with third- and fourth-year students) who take a medical history and examine the patient.
Students go over the findings with the patient and present a report to the attending physician, who also examines the patient.
The students and the physician decide on the needed care plan, prescriptions, and follow-up.
The center uses space in New York-Presbyterian Hospital's UrgiCare Center at 21 Audubon Ave.
The program has been a joint effort of Columbia University Medical Center and New York-Presbyterian Hospital in partnership with many neighborhood organizations and businesses.
The program's web site — http://www.cosmoprimarycare.org/ — has more information and a full list of participants.
The students have received grant funding from the Arnold P. Gold Foundation, the Laura Vogler Foundation, and the New York Academy of Medicine.
More than 50 private donors also support the effort.
Besides making it beyond the pilot period, the students are also proud of a cancer screening program, with pap smears to screen for cervical cancer and referrals of patients for prostate, breast, and colon cancer screening.
Neuroscientists Named Howard Hughes Investigators
TWO COLUMBIA SCIENTISTS WERE AMONG 43 RESEARCHERS named as Howard Hughes Medical Institute investigators this year: Oliver Hobert, Ph.D., a neuroscientist and geneticist, and Rafael Yuste, M.D., Ph.D., a neuroscientist and biophysicist.
The designation recognizes the nation's most promising biomedical scientists.
|Oliver Hobert, left, and Rafael Yuste|
Dr. Hobert is assistant professor of biochemistry and molecular biophysics at P&S.
His research focuses on molecular mechanisms that create and maintain cellular diversity in the nervous system.
His goal is to understand how neurons are genetically programmed to adopt their specific anatomical and functional features.
For a neuron to fulfill its function in the nervous system, it must express a set of proteins that allow it to be wired correctly, to communicate with its environment, and to communicate with other neurons.
"Being appointed to HHMI will allow me to further deepen the genetic approaches we have initiated in the past, but now on a larger scale.
Furthermore, we will expand our neuronal cell fate analysis to other parts of the nervous system," says Dr. Hobert.
Dr. Yuste is associate professor of biological sciences at Columbia's Morningside campus and a faculty member in the doctoral program in neurobiology and behavior.
He works to understand the cortical microcircuit, the basic element of cortex architecture.
By first unraveling the dynamics of specific cortical microcircuits and the interactions among those circuits, he hopes to build a better understanding of how the whole cortex works.
Along the way, Dr. Yuste aims to identify potential drug targets for treating epilepsy.
"This award will enable my group to focus on longterm projects, such as the analysis of the cortical microcircuitry, and also risky projects, such as the development of new techniques or approaches, which are unlikely to be funded through conventional mechanisms," says Dr. Yuste.
The latest appointments bring the number of HHMI investigators at Columbia University to 12.
Other members of this prestigious group include two Nobel laureates, Dr. Richard Axel and Dr. Eric Kandel.
Other HHMI investigators are Stephen Goff, J. Eric Gouaux, Iva Greenwald, Wayne Hendrickson, Barry Honig, Thomas Jessell, Steven Siegelbaum, and Gary Struhl.
After 26 Classes of P&S Students, Linda Lewis To Leave Post
AS PER TRADITION, THE P&S CLUB STAGED A FUN-FILLED Supernight program on the night before residency match.
This year's program included a tribute to Linda Lewis, M.D., who has served as dean of students since May 1979.
Dr. Lewis has announced her intention to leave the student affairs post June 30, 2005.
|Dr. Lewis and Dr. Lewis and Dr. Lewis and ... After a chorus line of students dressed as inda Lewis launched the 2005 Supernight, Dr. Lewis (she's the one without the white coat) posed with the other Dr. Lewises.|
"Linda Lewis has been a superb Dean of Students, having shepherded a generation of P&S students from entry to medical school to residency.
She has performed this role with skill and elegance, being both supportive and at the same time maintaining a standard of excellence of all P&S graduates," says Gerald D. Fischbach, M.D., executive vice president and dean.
Dr. Lewis was named associate dean for student affairs in 1979 and promoted to senior associate dean in 2002.
Her office oversees orientation, graduation, academic records, student promotions, student research programs, dual degree programs, student support services, the P&S Club, and the residency match.
She oversees a busy staff, holds daily walk-in hours for students, and writes recommendation letters for every graduate of P&S.
She also takes on special projects, most recently a pilot project on women faculty career development.
During her tenure, she developed many innovative programs to support students through their years at P&S, including the AIMS (Addiction Illness: Medical Solutions) program, the Student Success Network, the Wellness Center, and the Advisory Deans program profiled in the Winter 2005 issue of P&S.
Her study of roles of women faculty at P&S set the stage for the task force on women which reported to the dean this spring.
She will remain on the P&S faculty as clinical professor of neurology and continue to see patients at the Neurological Institute.
Dr. Lewis was born in Columbus, Ohio, and attended Bethany College in West Virginia, graduating magna cum laude.
She earned an M.D. degree from West Virginia University School of Medicine, where she was a member of Alpha Omega Alpha, the medical honor society.
She received an honorary doctorate from Bethany College in 1989.
After an internship at the University of Wisconsin, Dr. Lewis became an assistant resident in internal medicine, then a resident, at St. Luke's Hospital Center in New York.
After a year as an assistant resident in neurology at Case
Western Reserve University in Cleveland, she became a neurology resident at Columbia.
She was chief resident in neurology before joining the P&S neurology faculty in 1971. She became full professor in 1987.
Before becoming student dean, she was chief of the neurology clinics from 1971 to 1979.
Dr. Lewis has been honored as a teacher and a doctor, twice winning the Distinguished Teacher Award from P&S and earning designation as Outstanding Woman Doctor of the Year by P&S.
She is listed in multiple "Who's Who" volumes, including "Who's Who in American Universities," "Who's Who in American Women," "The World's Who's Who of Women," "Who's Who in the East," and "Who's Who in the World."
Supernight 2005 included a tribute to Dr. Lewis because "she has become somewhat of a living legend at P&S," says Kate Nellans'06, co-chairwoman of the event and co-president of the P&S Club.
"We knew we needed a very special tribute to Dr. Lewis at our Supernight.
Certain aspects of her office hours, career advising, and strict rules about no scrubs outside the hospital were captured in video skits, but as soon as the idea of 12 dancing Dean Lewises was suggested, we knew it would be awesome."
Twelve students, complete with silver wigs, glasses, hoop earring, and white coats, danced to "New York, New York" with Jay Lefkowitch'76 lip-synching as Frank Sinatra.
"It brought the crowd to its feet," says Ms. Nellans.
"I hope our Supernight tribute let her know just how much she will be missed by the students."
A profile of Linda Lewis and her impact on a generation of P&S students is planned for the Fall 2005 issue of P&S. Readers who want to submit descriptions of her impact on them should send e-mail to firstname.lastname@example.org.
Presidential Treatment: A Return Visit
THE MEDIA SPOTLIGHT RETURNED TO NEW YORK-PRESBYTERIAN Hospital/Columbia University Medical Center in March 2005 when former president Bill Clinton underwent a second cardiothoracic surgery.
Mr. Clinton's first operation, a coronary artery bypass in September 2004, was performed by Craig R. Smith, M.D., the Calvin F. Barber Professor of Surgery at P&S and chief of cardiothoracic surgery at New York-Presbyterian.
The elective follow-up surgery in March was performed by Joshua R. Sonett, M.D., associate professor of surgery and director of the lung transplant program at New York-Presbyterian.
In the March operation, Dr. Sonett removed fluid and scar tissue from Mr. Clinton's chest cavity.
The fluid and tissue buildup, a rare complication of coronary artery bypass surgery, had reduced Mr. Clinton's lung capacity by approximately 25 percent.
In the New York Times, Dr. Smith speculated that the complication from Mr. Clinton's quadruple heart bypass operation in September could have been related to antecedent medications.
The surgeons in September delayed the surgery a few days to allow any such effects to wear off.
During the operation in September, Dr. Smith used blood vessels taken from Mr. Clinton's chest wall and leg to bypass the blockages and restore an adequate flow of SPRING/SUMMER 2005 P&S 7 blood to the heart muscle.
Surgeons use bypass procedures, or coronary artery bypass grafts (CABGs), to provide new vessels to carry blood to areas of the heart served by blocked arteries.
According to Dr. Smith, the blockages in some of Clinton's arteries were "well over 90 percent," placing the 58-year-old former president at a high risk for a major heart attack.
Mr. Clinton had not experienced any substantial damage to his heart muscle before his surgery.
Allan Schwartz, M.D., a 1974 P&S graduate who is chief of cardiology at P&S and New York-Presbyterian Hospital, was Mr. Clinton's cardiologist during his hospitalization.
Mr. Clinton, who lives in Westchester County north of New York City, went to Northern Westchester Hospital in Mount Kisco last September with chest discomfort.
Doctors there thought the pain might be from angina pectoris associated with underlying coronary heart disease.
Ronald Wallach, M.D., a 1970 P&S graduate, examined Mr. Clinton and scheduled an angiogram for him the next morning at Westchester Medical Center in Valhalla.
When the angiogram showed severe blockage in several arteries, Dr. Wallach suggested Mr. Clinton have bypass surgery at Columbia, where Dr. Wallach received his training in cardiology as an intern and resident.
Dr. Smith, a graduate of Case Western Reserve University's medical school, came to Columbia as a fellow in cardiothoracic surgery and joined the P&S faculty in 1984.
He was named Practitioner of the Year for 2004 by the Society of Practitioners, a 550-member physician advocacy group that addresses patient care issues, physician-hospital and physician-university relations, physician practice models, managed care issues, and malpractice insurance at the Columbia campus of New York-Presbyterian Hospital.
The society chose two practitioners for 2004 — Dr. Smith and Dr. Ralph Blume. Ellen Danetz, director of the Society of Practitioners, said Dr.
Smith was chosen before the Clinton surgery — the awards dinner was in June 2004 — and added, "We had our eye on him way before that.
Dr. Smith is truly at the peak of his career."
Dr. Sonett earned his M.D. degree at East Carolina University and completed his thoracic surgical fellowship at the University of Pittsburgh and Memorial Sloan-Kettering Cancer Center, where his interests in lung transplantation and thoracic oncology were nurtured.
He completed a residency in general surgery at the University of Massachusetts Medical Center.
Dr. Sonett joined Columbia and New York-Presbyterian in 2001 from the University of Maryland in Baltimore, where he was associate professor of surgery, director of the lung transplantation program, and co-director of the Photodynamic Therapy Treatment Center.
He also was chief of thoracic surgery at Baltimore Veteran's Affairs Medical Center.
In the five days after the September 2004 quadruple bypass procedure, Mr. Clinton received more than 85,000 get well messages.
The Clinton family issued a message that thanked the well-wishers, doctors, and hospital staff members.
"We are indebted to all the wonderful doctors, nurses and staff who have been so helpful to us."
Dispatch From Brazil
PETER "BUZZ" MARCOVICI'06 TOOK A YEAR OFF AFTER HIS THIRD year and is in Brazil to learn how to do clinical research and apply the skills to underserved populations and understudied diseases of the developing world.
He is participating in a program run by the Fogarty International Center at the National Institutes of Health.
The Fogarty Center combined funding from the Ellison Medical Foundation to create a one-year training program called the Fogarty-Ellison Fellowship, a year of mentored clinical research immersion experience.
While other programs are similar — the Howard Hughes, Doris Duke, NIH clinical research training fellowships — the Fogarty-Ellison Fellowship offers training in a developing country.
Buzz sent this summary from Brazil in March:
|Peter "Buzz" Marcovici'06 takes a break from his research fellowship to explore a mountainous area of Bahia, Brazil.|
Salvador, Brazil — I arrived here in August 2004.
It was supposedly winter in the southern hemisphere, but the tropics don't seem to follow seasonal trends.
It was hot, and humid, and actually, it still is. It always is.
If it weren't for the sea breeze blowing off the Bay of All Saints, the place would be intolerably hot.
But just when you think you can't take it, just when you need to lie down in the shade and poor ice water all over your head, the lovely breeze comes, the trees sway, and life returns to your limbs.
This happens everyday in Bahia (Salvador is commonly referred to by the namesake of its state).
My first two months were spent getting to know the range of projects that are being done here.
I was posted to spend the year at the Brazilian Ministry of Health's research arm, called the Oswaldo Cruz Foundation, under the mentorship of an American professor of medicine who works here.
The overall purpose of this group is to address pressing public health problems in the community, through research, education, and the development of new treatment strategies.
Also, and not a minor task for me, I had to learn a new language.
Because I had only a few weeks of notice that I would be posted to Brazil, I didn't have time to learn the language before arriving here.
(I could just as easily have been posted to a fellowship site in Asia or Africa.)
I started studying Portuguese intensively upon arrival, and after about seven months here, I can speak.
Not beautifully by any means, but with the graciousness of the people here, I manage to get by just fine.
I chose to work on leptospirosis, a bacterial infectious disease that the Oswaldo Cruz Foundation works to address using lab research to community education to hospital-based interventions.
It affects local communities in epidemic patterns, largely due to open sewers and flooding during heavy rains.
The bacteria are transmitted to humans via dirty water contaminated by the urine of rats (the main animal reservoir).
My project objectives are to localize where cases of infection occur, on digitally rendered maps.
Each week we go to "the field" — the urban slums in the city.
These "favelas" have poor to no sanitation and trash services.
The homes themselves are poorly constructed, made of brick or any other leftover materials, and many don't have running water or connection to a sewer system.
Rats, which carry the infection in their kidneys, flourish here.
Generally men who work in the open sewers, walk barefoot in the mud, or are exposed to flood water get the infection.
When I return to the research center each day, we use a suite of spatial and mapping programs, collectively called Geographic Information Systems (aka "GIS") to understand the temporospatial patterns of disease.
I've learned a lot about both the medical issues and the greater socioeconomic patterns that contribute to this public health threat.
In addition, I have learned to use nontraditional medical research methods (i.e., GIS).
I have learned much from the geographer I work with, and we hope to be able to identify sources of transmission for this disease and apply the information to prevention measures.
In addition to my research, I've been loving living in Brazil.
I spend weekends exploring the vast coastlines and islands of Bahia.
Besides the urban slums in Salvador, I've seen tiny traditional fishing villages and forest dwelling communities tucked into the remaining wild lands.
Most villages, even the most remote, have small town squares and one-room churches (religion here is a mix of African deities and Catholicism, collectively called "candomble").
Among these various settings, I've been exposed to diverse ways of Brazilian life.
In fact, Brazil is one of the most socioeconomically diverse countries in the world: from flashy and modern apartments overlooking the bay, to vast crowded favelas, to tiny river-side encampments of villagers, all in surprisingly close proximity to each other.
In summary, my year in Brazil has been an adventure in research, in exploring new language and cultures, and in reflecting on the problems that continue to create tragic public health challenges.
News in Brief
Steven J. Corwin, M.D., was named executive vice president and chief operating officer of New York-Presbyterian Hospital in January 2005. Dr. Corwin has served as senior vice president and chief medical officer since 1998.
Dr. Corwin graduated summa cum laude from Northwestern University's medical school. He completed both his internal medicine residency and cardiology training at Columbia.
He joined the hospital's management team in 1991 and has served in various management capacities.
"Dr. Corwin is a skilled and innovative leader with an unwavering commitment to high quality and compassionate patient care," said Herbert Pardes, M.D., president and CEO of New York-Presbyterian Hospital, in announcing Dr. Corwin's appointment.
. . . An interdisciplinary team at Columbia has received a $10 million grant from the Department of Defense to assess why breast cancer remains undertreated among black women and to better understand the disparities in survival rates.
Despite the substantially improved survival rates of women who receive adjuvant therapy following surgery, studies have shown that 30 percent or more of breast cancer patients fail to receive complete treatment, and that black women are as much as 10 percent less likely than white women to receive the optimal recommended doses.
"Identifying the barriers to optimal treatment will enable us to intervene to reduce racial disparities and to improve survival for all women with breast cancer," says Alfred I. Neugut, M.D., Ph.D., professor of medicine and epidemiology, co-director of cancer prevention at New York-Presbyterian Hospital/Columbia, and principal investigator of the DOD-funded Breast Cancer Center of Excellence. Dawn Hershman, M.D., assistant professor of medicine and epidemiology and director of the clinical breast oncology program at New York-Presbyterian/Columbia, is co-principal investigator.
|The center will be a collaboration of experts from P&S, the Mailman School of Public Health, and New York-Presbyterian Hospital and will bring together experts in medical and surgical oncology, epidemiology, biostatistics, behavioral oncology, communications research, consumer advocates, health outcomes research, and molecular genetics.
. . . The Spinal Muscular Atrophy Foundation has given Columbia more than $3 million for research on spinal muscular atrophy, a neuromuscular disease that is the leading genetic killer of infants and toddlers.
The funding will enable Columbia to significantly expand its substantial SMA research.
The SMA Foundation's donation to Columbia University research is part of its broader strategy to integrate basic, translational, and clinical research efforts at leading institutions into coordinated efforts aimed at facilitating drug discovery.
Loren Eng, co-founder and president of the SMA Foundation, called Columbia an obvious place to launch the foundation's research effort.
"One-third of all Columbia researchers study the brain and nervous system and they generate more research funding than any other group of neuroscientists in the country.
Given the strengths of the institution and its people, it was evident that Columbia was the place for us to develop an SMA research nucleus."
. . . In March 2005, hundreds of people and their families affected by Parkinson's, juvenile diabetes, spinal cord injuries, and other life-threatening diseases — New Yorkers for the Advancement of Medical Research — came together with advocates, business leaders, and scientists to ask the New York state legislature to fund life-saving stem cell research, including research involving embryonic stem cell research, a type of science that may help more than 100 million Americans.
The group included Gerald Fischbach, M.D., executive vice president and dean.
While in Albany, the adults and children involved in the outreach met with legislators to request their support for legislation that includes an affirmative state policy on embryonic stem-cell research and state funding in the form of $100 million per year for 10 years.
New Yorkers for the Advancement of Medical Research is a coalition of 24 organizations, including the Parkinson's Disease Foundation, Juvenile Diabetes Research Foundation, Hadassah, AMDeC, Columbia University Medical Center, the Christopher Reeve Paralysis Foundation, and the Michael J. Fox Foundation.
. . . P&S, New York- Presbyterian Hospital, and Weill Cornell Medical College have entered into an affiliation with Hallym University Medical Center in Seoul, Korea.
The international four-way affiliation grows out of an existing clinical and research relationship between Hallym and Columbia University.
The agreement is the first international medical affiliation of its kind in Korea.
The exchange of medical expertise is central to the affiliation agreement.
Physicians and scientists from Hallym will train in New York and vice-versa.
The medical centers will engage in joint research and help each other better serve the Korean population in the United States and South Korea.
Hallym University Medical Center, the largest private health-care system in South Korea, has five hospitals, 4,600 physicians, and 3,162 beds.
In 2003, Hallym recorded 95,000 inpatient discharges and 1.8 million outpatients.
"Today's medical challenges are not isolated within national or continental borders and neither should be the research and education that is addressing these global health issues," says Gerald Fischbach, M.D., executive vice president and dean.
"Through global collaborations like this one, we have the power to bring together the greatest minds in the world to eradicate diseases, address policy issues, and improve the lives of people everywhere."