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The newsletter of:

MSTAR

The Medical Student Training in Aging Research Program

Brought to you by: American Federation for Aging Research

Volume 8, Issue 1
June 2013

 

Sponsored by: William and Nathalie Comfort, the Charles A. Dana Foundation, the Jean and Louis Dreyfus Foundation, Lile Gibbons, the John A. Hartford Foundation, the Lillian R. Gleitsman Foundation, Audrey McNiff, MetLife Foundation, the National Institute on Aging, Kathryn Wriston, and Margaret Wolff 

 

Administered by: The American Federation for Aging Research (AFAR) and the National Institute on Aging (NIA).

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This online newsletter provides news, information, and updates about the Medical Student Training in Aging Research Program (MSTAR) to program directors, current and former student scholars, mentors, and others involved in the program.

 

PLEASE HELP US DISSEMINATE THIS NEWSLETTER to medical students and others in your institution. It is one of the best ways to promote this valuable program to potential applicants. Thank You!

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In This Issue

1. How You Can Help
2.
New Program Sponsor: Jean and Louis Dreyfus Foundation
3.
2013 MSTAR Program Update
4.
2013 AGS Annual Scientific Meeting
5.
Diary of an MSTAR Student
6.
Spotlight on a Former MSTAR Student: Linda DeCherrie, MD
7. MSTAR Student and Alumni Facebook Group
8. Helpful Links/ Geriatrics Recruitment and Student Opportunities

 

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How You Can Help the MSTAR Program

MSTAR will have several important milestones in the next few years, including reaching the program’s 20th anniversary and 2,000th student in 2014! In the next few months AFAR will kick off a twentieth anniversary campaign to build the MSTAR Fund, which will provide travel stipends for current scholars to attend the American Geriatrics Society meeting and support of additional Scholars. Please stay tuned for more information. If you would like to make a donation now to the MSTAR program, please go to http://www.afar.org/give/mstar/. Thank you!

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New Program Sponsor: Jean and Louis Dreyfus Foundation 

 

 

The MSTAR program provided research scholarships to 150 medical students in 2013 thanks to the generous support of several foundation sponsors and individual donors. This year, those supporters included a new foundation sponsor—the Jean and Louis Dreyfus Foundation.

 

The Jean and Louis Dreyfus Foundation was established in 1979 from the estate of Louis Dreyfus, a music publisher, and that of his wife, Jean. Its mission is to enhance the quality of life for the aging and disadvantaged in New York City.

 

“Geriatric practice and research is a longstanding interest of the Foundation,” says Jessica Keuskamp, program director of the Jean and Louis Dreyfus Foundation. “As the MSTAR program furthers the field of geriatrics and increases the potential of physicians to improve services to our aging population, it seemed a logical fit.”

 

The Foundation provided $25,000 to the MSTAR program, which will support the research of 6 MSTAR students.

 

We feel it is a great use of the Foundation’s grant monies to support a program which truly affects, and continues to show outcomes in, the field of aging,” says Keuskamp. “The Foundation hopes that its grant to MSTAR will help strengthen and expand the program so that any interested student can gain this valuable experience.”

 

AFAR would like to thank the Jean and Louis Dreyfus Foundation for its generous support!

 

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2013 MSTAR Program Update

 

The 2013 MSTAR Scholars will soon begin working on their summer research projects. This year’s students—150 in total—were chosen from a pool of 204 applicants. Of the awardees, 95 will conduct their research at NIA-funded National Training Centers. The other 55 will be supported by private funding.

 

The MSTAR Scholars were selected by a six-person National Selection Committee. Alison Moore, MD, MPH, of the David Geffen School of Medicine at UCLA, served as the Chair of the committee for the second year in a row. (Dr. Moore also runs the National Training Center at UCLA.) The other committee members were Julie Bynum, MD, MPH, Geisel School of Medicine at Dartmouth; Carol Capello, PhD, Weill Cornell Medical College; Ted Johnson, MD, MPH, Emory University School of Medicine; Ellen Roberts, PhD, MPH, University of North Carolina School of Medicine; and Rainier Soriano, MD, Icahn School of Medicine at Mount Sinai.

The selection committee uses a rigorous process to choose the MSTAR Scholars.

 

Dr. Moore says the reviewers look for three main things when scoring an application. The first two are the promise that the student will consider going into geriatrics and the potential that he or she will do aging-related research.

 

“Ideally we’d get people who want to be geriatricians and do research,” says Dr. Moore. “But if we get one or the other, it’s still a positive.”

 

The third component the reviewers focus on is the institutional support. The letter from the student’s home faculty mentor should be personalized.

 

AFAR would like to thank Dr. Moore and the rest of the members of the MSTAR National Selection Committee for their hard work and careful review of each application.

 

For a list of the 2013 MSTAR Scholars, visit www.afar.org/grantees/years/2013-grantees. Congratulations to all of this year’s awardees!

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2013 AGS Annual Scientific Meeting

 

The 2013 AGS Annual Scientific Meeting took place May 3 to 5 in Grapevine, Texas. More than 2,300 geriatrics health care professionals attended.

A total of 94 MSTAR students presented their research at the student poster session. Seven of those students received awards for their research. They are:

Best Poster (Presidential Poster Session):

  

Ranjith Babu, Duke University School of Medicine — “Surgery in Older Patients” category

 

Rebecca Fega, University of Arizona College of Medicine (did MSTAR at Harvard Medical School) — “Quality of Life” category

 

Heather Hassett, University of New England College of Osteopathic Medicine (did MSTAR at Johns Hopkins University School of Medicine) — “Rehabilitation” category

 

Grace Liao, Mount Sinai School of Medicine — “Geriatric Bioscience” category

 

Best Paper:

Christopher Su, Mount Sinai School of Medicine (did MSTAR at University of California, San Francisco) —“Living with Serious Illness” category

 

Konstantin Grigoryan, University of Cincinnati (did MSTAR at Harvard Medical School) — “Models of Care” category

 

Clinical Student Research Award:

 

Nerissa Duchin, University of Massachusetts Medical School

AFAR would like to thank the AGS for organizing another wonderful annual meeting, and for providing 30 MSTAR students with travel stipends so that they could attend the event. To see photos from the meeting, visit the new MSTAR Facebook page at www.facebook.com/groups/310807755702260. (Read more about the Facebook page below.)

The 2014 AGS annual meeting is set to take place in Orlando, Florida, May 15 - 17.

 

 

 

 

 

 

 

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Diary of an MSTAR Student 

For the past two summers, several MSTAR Scholars have blogged about their experiences in the lab, classroom, and clinic in AFAR’s “Diary of an MSTAR Student.” The blog has given readers a glimpse into the everyday lives of the students, who also share what they’ve learned about the field of geriatrics.

 

AFAR will bring back the blog this summer, when a new group of MSTAR students will write about their experiences. We hope it will continue to inspire others considering careers in medicine—as well as the general public and journalists—about the importance of geriatrics.

 

Here are a few excerpts from last year’s Diary of an MSTAR Student:

“As I wrap up my time at UNC Chapel Hill and my on-site work at the Center for Health Promotion and Disease Prevention … I remain extremely excited about prevention medicine and believe even more strongly that speaking to individuals about diet and exercise, and offering methods to change poor habits, is important. I feel privileged to have met so many inspired researchers and physicians. I hope to stay informed on the progress of the cardiovascular disease lifestyle intervention and the involved participants in Lenoir County, and I look forward to seeing the additional research and developments that come from this project. I’m also excited to apply what I’ve seen and learned through this opportunity during my second year of medical school. With all they have to teach us, medical schools do not focus enough on nutrition, or even preventative medicine as a whole, so I hope to share some of what I learned through this project with my peers and also further explore its application to the aging adult population.”

—Kerry Bertke, Ohio University Heritage College of Osteopathic Medicine

“My experience thus far in the MSTAR program has been both enlightening and motivating. I am currently doing glioblastoma (brain tumor) research at Duke University Medical Center and have been making good progress. I have identified a cohort for the basis of my projects and am performing chart reviews to extract the necessary data for analysis. [This] has vastly increased my knowledge in the treatments for glioblastoma, the side effects of medical and surgical therapy, and prognostic factors for survival. In addition to my clinical research, I have been going to a brain tumor clinic every week. This has been a profoundly inspiring experience [that] has refreshed my motivation for becoming an academic neurosurgeon. Interviewing patients and hearing their stories reminds me of the hardships that patients go through after being diagnosed with aggressive and devastating diseases such as glioblastoma. These research and clinical experiences have been both professionally and personally enriching. While I continue to toil away at the computer to finish my data collection, I will have the memories of the brain tumor patients pushing me forward.”

—Ranjith Babu, Duke University School of Medicine

“My shadowing experiences have been incredibly useful. I’ve learned that geriatrics is a field where a lot of different sides of medicine overlap. It is a challenging field because patients usually come in with multiple problems and it is necessary to manage the patient as a whole. It is important to take into account how many medications a patient is taking and to make sure this list does not get unmanageable. The end goal is to improve the quality of life for the patient and sometimes this may include tradeoffs. I am very grateful for the experiences that I am gaining because I am extremely confident that they will be valuable for me regardless of the field that I pursue. Furthermore, with each day I am attracted more and more to the field of geriatrics. I want to play a role in taking care of elderly patients one day; and the physicians that I have gotten to shadow are some of the best role models that I have encountered in the medical field.”

—Lalitha Kunduru, University of North Carolina

 

To read more student blog entries, go to www.afar.org/mstarblog/posts. Be sure to check back this summer for posts from our 2013 MSTAR Scholars!

 

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Spotlight on a Former MSTAR Student: Linda DeCherrie, MD

 

By the time Dr. Linda DeCherrie completed her summer project for the MSTAR program—then called the Medical Student Geriatric Scholars Program—in 1996, she knew for sure she wanted to go into geriatrics. After graduating from the University of Chicago Pritzker School of Medicine in 1999, Dr. DeCherrie did a primary-care residency at Boston University, during which she had a house-call panel of patients for one year and worked at a PACE (Program of All-Inclusive Care for the Elderly) site for one year. Dr. DeCherrie stayed on as Chief Resident at BU for another year, then went on to do a geriatrics fellowship at Mount Sinai from 2003 to 2005. She joined the faculty of Mount Sinai in 2005.

 

Dr. DeCherrie is now an Associate Professor of Geriatrics and Palliative Medicine at Mount Sinai’s Icahn School of Medicine. She also serves as the program director of Mount Sinai’s primary care internal medicine program, as well as the acting director of Mount Sinai Visiting Doctors, a program that provides primary and palliative care for homebound patients in Manhattan. Dr. DeCherrie has also mentored several MSTAR students. She recently took time out of her busy schedule to talk to us about house calls, Mount Sinai’s geriatrics program, and her experiences as an MSTAR Scholar.

 

Tell us about your MSTAR project and findings.

I worked with Dr. Michele Bellantoni at Johns Hopkins University. We looked at risk factors for osteoporosis. We studied patients who had been diagnosed with osteoporosis during a hospitalization and were now coming to sub-acute rehab. One of our major findings was that many of these patients had had a wrist fracture in the five years previous to their hospitalization, but no one had looked at that time to see if they had osteoporosis. Now when we see a wrist fracture in the elderly, we dig deeper because there probably is osteoporosis there.

 

Had you been interested in geriatrics before MSTAR?

Yes, I had. I did an elective in a geriatrics practice during my first year of medical school. That experience is what made me apply for MSTAR.

 

Did the MSTAR program increase your interest in going into geriatrics?

Oh, definitely! Before MSTAR, I had a really limited idea of what the field really meant. Sometimes people have that experience with a grandparent that makes them realize they want to do something better for geriatric patients, or they meet a geriatrician, or something like that. I didn’t have any of that. None of my grandparents live in this country. I didn’t experience any care with them. What I did know was that I wanted to do primary care and I wanted to see what the different kinds of primary care were, and that’s how I ended up in the geriatrics clinic at University of Chicago. I really enjoyed the patients there. That led me to apply for the MSTAR program, and it was set from then on: After that summer, I knew I’d go into geriatrics.

 

What did you enjoy about the MSTAR program?

I enjoyed that it was a combination of a research project and clinical work, and that there were also some classroom-based activities where I got to meet the other students who were doing the program. Clinically I got to see many different types of things that geriatricians did, like the sub-acute rehab, an office-based outpatient practice, and inpatient work. I got to see a lot of different aspects of geriatrics. I was very clinically involved in my project, too. I was interviewing patients, which was great.

 

Are you still doing your own research?

I am more of a clinician-educator. I’m particularly interested in my clinical work—house calls. We’re always doing quality improvement projects/research and trying to figure out the best model of doing house calls, how to do them more efficiently, and how to better take care of these patients. Because of that interest in the way the practice runs, I always want to study it and understand it. So that is the research I am involved in.

 

House calls aren’t as common as they were in the past, so it’s interesting that you focus on them.

Yes! Mount Sinai has the largest academic house-call program in the country, and I’m currently the acting director of it. We have 16 physicians in the program, (10 full-time equivalent), as well as a very interdisciplinary team of RNs, NPs, social workers, and administrative staff to care for the patients.

 

Are these house calls for elderly patients?

Our patients do not have to be elderly. We will take care of younger patients who are homebound because of psychiatric issues or morbid obesity, or because they happen to have another devastating illness that makes them homebound at a younger age. But over 85 percent of our patients are elderly.

 

Are there places in the U.S. where there are homebound patients, but no doctors that do house calls?

Unfortunately, yes—but the practice is growing. In 1910, there were tons of house-call doctors. Then the practice really went down, and probably the lowest rate was in the 1960s and 70s. But then it slowly started to come back. Medicare now has its own reimbursement codes for house calls. You have to be very strategic about how you plan a private practice to do that, but you can do it. It is financially viable to do it if you plan appropriately.

 

Every medicine resident at Mount Sinai spends a month on our house-call program, and every medical student does a week with us in his or her third year. Every geriatrics palliative medicine fellow spends more than a month with us as well. So we have a lot of trainees here, and that’s part of our model. We were designed to be a site for trainees because we feel that’s really important. Even though most will never do a house call later on in their lives, they need to know how to access services for patients in their homes, and how to take care of their own patients who might have temporary or permanent times when they’re homebound.

 

If patients don’t have access to a house-call doctor, how do they get to their appointments?

They go by ambulance or they go to a nursing home. Or, they don’t get care. There are a lot of homebound people who don’t really get much care.

 

Do you think house calls will continue to become more widespread again?

Yes, I think they will. Keeping people in the home is what many people want for their care and hopefully always financially doable. It’s very hard to survive by just billing Medicare for our visits, especially in an academic system. We need to do it by avoiding an unnecessary hospitalization—by taking care of things earlier on and not waiting for the crisis to happen.

 

You also teach geriatrics. Are all of your trainees already interested in it?

No, not at all! Most of them are not, and it’s exciting for me to spark that interest. I love the fellows, and I feel like they’re more like my colleagues. Of course we’re still teaching them, but they’re the ones who already decided to go into geriatrics. With the residents it’s fun. If I know someone is going to go into cardiology, I love to spin the case and say, “This person is in your cardiology practice and you’re seeing him for his heart failure, but you realize he can’t even walk across the room. How are you going to order a walker for him?” Or I’ll ask, “How are you going to get physical therapy for this person?” I think it’s really exciting to make it relevant to their future practice.

 

I don’t do a lot of inpatient work, but I teach the medicine interns about transitions of care. What can a nursing home do? What does a sub-acute rehab do? What’s a home hospice? What are all of these things that you discharge your patients into? Most of them don’t know a lot of that. So making it really relevant to what they’re currently doing or what their future will be is exciting.

 

Have most of your trainees already chosen their specialty?

There’s a combination. The medical students are not yet decided, so I can show them the value of going into geriatrics. I actually think the students at Mount Sinai are much more open to thinking about geriatrics as a career.

 

The residents have already made the decision to go into internal medicine when they arrive here, but they can sub-specialize in geriatrics. I have maybe three or four who are going to do that, which is exciting. But even if they don’t specialize or sub-specialize in geriatrics, all of my students are going to be taking care of elderly patients. So, I like to teach them how to do it the best way, with geriatric principles. They need to know when to refer to a geriatrician, how to get things for their patients, etc.

 

We’ve had a few students who had decided to do a specialty and then come back and do one year of geriatrics on top of that. So they’ll become a geriatric nephrologist, a geriatric oncologist, etc. I think people don’t always realize the extra skills you learn in geriatrics. They think it’s just internal medicine for older patients, but it’s so much more than that.

 

What do you love about geriatrics?

I love the stories patients tell. I think it’s so exciting to hear about their past and what their life is like now. I love being able to not only focus on their disease, but also on their hopes and goals for their future. If your hope and goal is to get to someone’s wedding, well—can you walk? What are we going to do to get you to the wedding? What do we need to do? That, I think, is really great, because you’re really focusing on what they want from their future.

 

What would you tell students to get them to try geriatrics?

Do an experience in geriatrics. Find a great mentor to work with, because most geriatricians are pretty friendly and open to having a trainee with them.

 

A large number  of the students who apply for the MSTAR program come from Mount Sinai. Why is that?

We have our own geriatrics department. We’re one of the largest groups of geriatricians in an academic center. We have a large house-call practice and a large outpatient practice in addition to inpatient work. Every medical student rotates through all of those types of practices as a required part of their training. The students, who are doing MSTAR at the end of their first year, haven’t even done those clinical rotations yet—but we still get them. And I think that is partly because of hearsay. Other people have had good experiences in MSTAR over the years, and they tell their friends to check out the program.

 

Second, our first- and second-year medical students participate in a longitudinal clinical experience where they get paired up with one patient that they follow for two years. Many of the faculty members who volunteer and bring a patient along for this are geriatrics faculty, so the students see us early.

 

Third, the MSTAR program at Mount Sinai is a very organized program. The students have to meet weekly as a group. They have other clinical experiences beyond their project. They have classes that they get together for. They have to turn in a project at the end of the summer. All of that makes it very organized. I was so impressed at AGS this year with how well all of the Mount Sinai students did on their presentations. They really did an amazing job!

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MSTAR Students and Alumni Facebook Group

Are you a current or former MSTAR Scholar who would like to connect with fellow MSTAR students and alumni? Join the MSTAR Scholars and Alumni Facebook group!

The group provides current and past MSTAR students with a forum in which to network and engage one another. Students and alumni can share stories, advice, opportunities, research ideas, and other information that could help them further their careers in geriatrics. The page will also provide helpful resources on career development and decision-making, updates on events, and lots more.

We are particularly excited to announce our new feature for the group, Ask the Expert.  Every month or two, we will feature a different MSTAR alum or supporter who has volunteered to take questions from current and past MSTAR students.  This month’s expert is Serena Lo, MD, a geriatrics attending physician at Kaiser Permanente Hawaii.  If you have questions about your residency, how to select your fellowship program, would like advice on pursuing a career in geriatrics, etc., we invite you to visit the group and submit them for Dr. Lo!

Visit www.facebook.com/groups/310807755702260 to join the MSTAR Scholars and Alumni Facebook group. We hope to see you there!

 

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Helpful Links/Geriatrics Recruitment and Student Opportunities

MSTAR information and online application:
www.afar.org/research/funding/mstar

MSTAR Toolkit:
http://www.afar.org/home/view/mstar-toolkit1

Diary of an MSTAR Student:
www.afar.org/mstarblog/posts

AGS  Mentoring Program:
www.americangeriatrics.org/health_care_professionals/trainees/find_a_mentor/

Profiles of careers in geriatrics:
www.americangeriatrics.org/health_care_professionals/profiles_in_geriatrics/

AGS student chapters and other information for medical students:
www.americangeriatrics.org/health_care_professionals/trainees/student_resident_chapters/

American Medical Student Association (AMSA) Geriatrics Interest Group:
www.amsa.org/AMSA/Homepage/About/Committees/Geriatrics.aspx

American Association of Medical Colleges (AAMC) Organization of Student Representatives:
www.aamc.org/members/osr/

AAMC Careers in Medicine program helps students select a specialty and apply to residency:
https://services.aamc.org/careersinmedicine/

AFAR 's Twitter account: https://twitter.com/afarorg

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