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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 7, Issue 2
December 2012

 

Sponsored by: The National Institute on Aging, MetLife Foundation, the John A. Hartford Foundation, the Lillian R. Gleitsman Foundation, and several individual donors.

 

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. Apply for the 2013 MSTAR Program!
2. John A. Hartford and MetLife Foundations Renew Funding
3. Hartford Foundation Trustees Provide Student Stipend Support
4. MSTAR Alumni Survey Results
5. Spotlight on a Former MSTAR Student: Lillian Min, M.D.
6. 2013 Summer Institute in Geriatric Medicine at Boston University Medical Center
7. Interview with a Site Director: Mark Supiano, M.D., University of Utah
8.Helpful Links / Geriatrics Recruitment and Student Opportunities

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Apply for the 2013 MSTAR Program!

AFAR is now accepting applications for the 2013 MSTAR program. The MSTAR program provides medical students with an enriching experience in aging-related research and geriatrics, under the mentorship of top experts in the field. Students will receive stipends to conduct full-time research for a period of 8 to12 weeks during the summer.

 

Allopathic or osteopathic medical students in good standing, who will have successfully completed one year of medical school at a U.S. institution by June 2013, are invited to apply. About 140 scholarships will be awarded in 2013.

 

For detailed guidelines and application instructions, please visit www.afar.org/research/funding/mstar. Applications are due on January 31, 2013. Applicants will be notified of the decision around mid-March, 2013.

 

Please contact us at medicalstudent@afar.org if you have any questions.

 

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John A. Hartford and MetLife Foundations Renew Funding

AFAR is pleased to announce that the John A. Hartford Foundation and MetLife Foundation have renewed their generous commitments to the MSTAR program.

The Hartford Foundation will provide more than $600,000 to enable three additional years of support, exposing more than 400 medical students over the next three years to aging research and geriatric medicine.

MetLife Foundation, a major MSTAR partner for the past three years, has renewed its commitment for a fourth year in the amount of $220,000. That support will pay stipends for 40 to 45 MSTAR students.

“MetLife Foundation is pleased to support this initiative to attract more students to enter geriatrics training programs,” said Dennis White, president and CEO of MetLife Foundation. “This support addresses the growing health problem of too few doctors to care for a rapidly aging population.”

Founded in 1929, the John A. Hartford Foundation is a committed champion of health care training, research, and service system innovations to ensure the well-being and vitality of older adults. Its mission is to improve the health of older Americans. Today, the Foundation is America’s leading philanthropy with a sustained interest in aging and health. For more information, go to www.jhartfound.org.

MetLife Foundation is involved in a variety of aging-related initiatives addressing issues of caregiving, intergenerational activities, mental fitness, health and wellness programs, and civic involvement. For more than 20 years, MetLife and MetLife Foundation have invested millions of dollars for Alzheimer’s research and public information programs. To learn more about MetLife Foundation, go to www.metlife.org.

AFAR would like to thank the John A. Hartford Foundation and MetLife Foundation for their renewed commitments to the MSTAR program. They are key to the program’s success!

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Hartford Foundation Trustees Provide Student Stipend Support

The MSTAR program provided research scholarships to 142 medical students in 2012 thanks in large part to the support of our foundation sponsors. But the generosity of several individual donors also helped us meet that goal.

Six Hartford Foundation trustees directly sponsored MSTAR students this past summer. Kathryn Wriston, who was the first trustee to sponsor a student in 2011, provided support for another student this year. Peggy Wolff and Lile and John Gibbons each supported one student, while Bill and Natalie Comfort sponsored two students. The donors provided $3,500 per student to cover their summer stipends. Another Hartford trustee, Charlie Dana, has already committed $7,000 to support two students in 2013. AFAR would like to thank these individuals for their generous support of MSTAR students.

For information on how you can sponsor an MSTAR student, please contact Nancy O’Leary, AFAR’s director of development, at (212) 703-9977. You can also go online and direct your gift to the MSTAR program at http://www.afar.org/give/mstar. Thank you!

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MSTAR Alumni Survey Results

 

AFAR recently sent an Alumni Survey to former MSTAR Scholars to learn more about their MSTAR experiences, their career paths following the program, and their current work. A total of 431 alumni—from the start of the program in 1994 to some of our most recent 2011 Scholars—responded to the survey. They are now at various points in their career and work in a wide range of specialties at institutions across the U.S.

 

Here are some of the survey results:

61% of respondents have participated in additional education, rotations, research, or programs in geriatrics and gerontology since taking part in MSTAR.

 

42.5% chose or are planning to pursue a career in geriatrics or an aging-research related field. 22% are currently practicing geriatric medicine.

 

• Out of 184 alumni who answered the question, 98% said their MSTAR participation at least somewhat influenced their career choice, and 25.5% said it was a major contributor.

 

Nearly 100% of the respondents said their MSTAR participation at least somewhat affected their attitude towards the care of older adults, increased their desire to care for older patients, increased their sensitivity to the needs of older patients, and made them feel better prepared to care for older adults.

 

The survey also asked alumni for their input on how to help increase the number of medical students who might consider careers or extra training in geriatrics. Some of the most popular responses include:

 

More exposure to geriatrics in medical school, especially in the first and second years.

 

More programs like MSTAR (“The more students see that this is a rewarding field with a huge amount of opportunities, the more it will expand,” wrote one alumnus.)

 

Higher salaries and loan forgiveness for geriatricians.

 

More promotion of the job security, balanced lifestyle, and career satisfaction of geriatricians (One former MSTAR Scholar suggested that “In the medical school curriculum and during rotations, reflect that geriatrics is [a field] that offers significant intellectual challenges and a great sense of contribution to individual persons’ lives and to the public health.”)

 

An emphasis on the importance of geriatrics training (“Help people understand that geriatrics is a part of every field/specialty of medicine,” one alumnus wrote. “Students don’t realize that their primary patient population is going to be geriatric citizens, and the importance of taking time to appreciate this population.”)

 

Strong mentors who are passionate about geriatrics.

 

AFAR would like to thank all of the MSTAR alumni who took the time to fill out the survey.  

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Spotlight on a Former MSTAR Student: Lillian Min, M.D., M.S.H.S.

Dr. Lillian Min, a 1996 MSTAR Scholar, credits the MSTAR program with fostering her passion for aging research. After her MSTAR summer experience at her home medical school, UCLA’s David Geffen School of Medicine, she completed an internal medicine residency at Johns Hopkins Bayview Medical Center, then returned to UCLA for three years of geriatric medicine clinical and research fellowship. In 2005, Dr. Min joined the research faculty of UCLA, where she assisted with the MSTAR program. She moved to the University of Michigan—a Hartford Center of Excellence—in 2010, where she currently serves as an assistant professor of geriatric medicine, conducts her own research, and runs the Hartford CoE research program, which enriches the summer experience for University of Michigan MSTAR students. Dr. Min took time out of her busy schedule to talk to us about her own MSTAR experience, her research interests, and her quest to expose more medical students to geriatrics.

How did you choose your MSTAR project, and what was it about?

My mentor, Dr. David Reuben, introduced me to research on primary care in nursing homes. One piece he was interested in was the number of medications and inappropriate medications that were prescribed to long-term care residents. My project looked at which residents got more medications and more inappropriate medications. We found that higher numbers of medications were associated with people with more diseases, and that congestive heart failure, hypertension, depression, anxiety, and diabetes were also predictive. The only independent predictor of more inappropriate medications was higher numbers of routine medications. Our paper was published in the Journal of the American Medical Directors Association (JAMDA) in 2000.

What are “inappropriate” medications?

We used the early Beers Criteria, which are used to flag medications that we should not be prescribing to older patients because they’re associated with side effects. A medication that might be okay for a younger patient may be inappropriate for an older patient because of his or her physiology.

How did you become interested in geriatrics research?

As an undergraduate public policy major, I became really interested in how the country was going to provide long-term care for the aging baby boomers: Whose responsibility was it, and how could we make it possible for people who had developed functional impairments to be able to stay in their homes and out of nursing homes?

Did the MSTAR program increase that interest?

The MSTAR program was pivotal in my decision to pursue research. Most medical schools don’t offer any kind of research training, and the typical path to becoming a clinical geriatrician does not include a research year as a mandatory part of training. So the MSTAR program is the only opportunity available to get any sort of enrichment or exposure.

What did you take away from the MSTAR program?

It was a terrific program at UCLA! MSTAR introduced us to geriatrics office visits, the different types of research in geriatrics, and fundamental skills in clinical research, such as how to read a paper and write an abstract. That model exists there today. After MSTAR I went through another three years of medical school, three years of residency, and another year of geriatric fellowship. And at the end of those seven years, I still really wanted to do geriatrics research—an attestation to the power of that one summer to change my career.

What was really appealing was learning how to develop a research question, use research methods to find my answer, and write about how the results can be used for future improvement of care and health outcomes. Now, as a research faculty, I am still pursuing health services research, trying to link what we practice in clinical care to health outcomes that matter to older patients. If we can link some types of care, such as better medication-prescribing practices, to better outcomes, then this care should be prioritized.

Tell me about your current research.

My main area is identifying which quality indicators in ambulatory care are best linked to functional improvement over the long term. I have three other spin-off areas as a result of pursuing this one major research question. The first is determining how patients’ medical conditions affect the quality of care they receive. The second is using functional status to predict more functional decline and survival over the long term. And the third area is in surgery for older patients. I’ve been working with trauma and general surgeons on how to apply all of the research I’ve done on ambulatory care patients to their inpatients, using quality measures to measure care and then predict outcomes.

Why did you want to become involved with MSTAR again?

There aren’t enough geriatricians, so we have to be the voice of geriatrics for all specialties. All adult primary care physicians and specialists are now caring for older patients. Geriatricians must teach what we know to other doctors and introduce the concepts early to medical students, even if they don’t end up being geriatricians. At the University of Michigan, we have five or six MSTAR students every year whom we expose to clinical geriatrics, geriatrics research, and basic research principles. Hopefully out of those five, we’ll have one person who wants to go into geriatrics.

If it weren’t for the MSTAR program, students at most medical schools would get limited clinical exposure in geriatrics. The University of Michigan does include mandatory geriatrics clinical training in medical school, but my efforts to help them get MSTAR funding, get basic research lectures throughout the summer, tour a continuing care facility, and meet geriatrics faculty greatly enriches their clinical research exposure.

How does it feel to now be an MSTAR mentor rather than a mentee?

 I feel more responsibility because I had such a good mentoring experience, and I know the potential impact one MSTAR summer can make. I have a pretty high expectation of what the MSTAR students should accomplish. I expect that by the end of their summer, they have a product such as an abstract or paper they can put on their resume and get into whatever field they end up going into.

Are more students interested in geriatrics now than when you were a student?

No. People are now more aware that aging is happening, but the medical environment has never been friendly toward developing interest in geriatrics. It’s always been an uphill battle. I don’t think it has gotten better. In fact, medical student debt has gone up, so geriatrics has become an even worse prospect than ever. Geriatrics is the only subspecialty of internal medicine with a lower salary than not subspecializing. With student debt going up, there has to be some additional student loan relief to make it possible for students to go into geriatrics.

The upside is that most of the residents who do go into geriatrics fellowships have a rare passion and interest. They’re not in it for the money. They are in it because they see a need clinically. They all have a side interest that makes them want to go into geriatrics, whether it is long-term care, rehab, or hospice or palliative care. Geriatrics also has the highest job satisfaction of all of the adult medical fields.

While it’s rare for a young person to want to go into a field where their whole day is spent with old patients, my approach is to encourage all medical students to maintain their interest in aging. So, even if they’re going into a specialty like cardiology or endocrinology, I remind them that they are going to have a lot of aging patients, and it is imperative that they understand the principles of aging and clinical care for these older patients.

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2013 Summer Institute in Geriatric Medicine at Boston University Medical Center

The Summer Institute in Geriatric Medicine is a week-long conference sponsored by the American Geriatrics Society (AGS) and the Boston University School of Medicine (BUSM), with funding from the National Institute on Aging (NIA). This fully-funded program is for students entering their 3rd or 4th year of medical school in July 2013, and is designed to promote interest in academic geriatric medicine and geriatric research.

Applications and instructions can be found on the AGS website at http://www.americangeriatrics.org/health_care_professionals/trainees/bu_summer_institute.

For additional information you may also contact the BU office directly at (617) 638-6155 or the AGS office @ 212-308-1414. Applications are due January 7th, 2013.

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Interview with a Site Director: Mark Supiano, M.D., University of Utah

Dr. Mark A. Supiano was interested in geriatric medicine before geriatric medicine even existed. Inspired by his grandfather—who lived to age 90 despite being born when men’s life expectancy was only 45—and motivated by the needs of a growing aging population, Dr. Supiano became one of the first physicians to receive certification in the field in 1988. He is now the Chief of the Division of Geriatrics at the University of Utah School of Medicine and Director of the VA Salt Lake City Geriatric Research, Education, and Clinical Center.

In addition to carrying out his clinical practice and conducting clinical research on sympathetic nervous system function in aging adults, Dr. Supiano has devoted a great deal of his efforts to getting more medical students interested in geriatrics. From 2001 to 2005, he ran the University of Michigan’s MSTAR program and led a D.W. Reynolds Foundation-sponsored program that incorporated geriatrics into the medical school curriculum there. He joined the University of Utah in 2005.

“One of my objectives in moving here was to… create opportunities for medical students to get involved in geriatrics and aging research,” Dr. Supiano says.

To that end, one of the first things he did was establish a Geriatric Medicine Interest Group. Soon after, the University of Utah received Reynolds Foundation funding, and Dr. Supiano set about getting more geriatrics content into the medical school curriculum. When Reynolds-funded sites became eligible to host MSTAR students, he brought the MSTAR program there and became its director.

It wasn’t his first experience with MSTAR. Dr. Supiano had been involved with the program since its inception, working with and later directing it at the University of Michigan.

“I’m very passionate about the MSTAR program,” says Dr. Supiano. “I want to have our MSTAR students get an outstanding experience.”

To meet that goal, Supiano makes sure the students—an average of two each summer—are embedded in the University of Utah’s broader aging research community through its Center on Aging. Students participate in the Center’s clinical and research conferences. They shadow geriatricians in the clinical or nursing home setting and conduct home visits. And, of course, they work with mentors on research projects, which they present at Utah’s division research conference and often at the annual meeting of the American Geriatrics Society.

“We’ve dramatically expanded the research infrastructure within our Center of Aging program over the last seven years, so students have an abundance of research opportunities to connect with.”

Once their MSTAR experience ends, students remain active in the Geriatric Medicine Interest Group. They are also encouraged to take Utah’s fourth-year geriatrics elective, which allows them to graduate with the University of Utah’s graduate certificate in gerontology.

Despite all of that, Dr. Supiano says it’s still difficult to convince the students to choose geriatric medicine as a specialty. One of the biggest reasons they give him for not wanting to enter the field is that it pays less than other specialties. But he points out to them that geriatricians have the highest job satisfaction of any of those specialties.

“So they have to decide … do they want to make the most money, or do they want to have the most personal satisfaction with what they’re doing?” says Dr. Supiano. “I and many others are in geriatrics because…we can have such a huge impact on patients that we care for.”

Even if students choose other specialties, though, he says it’s crucial for them to familiarize themselves with geriatric medicine. “Regardless of whether or not they specialize in geriatrics, the reality is they will be caring for older people,” he says. “So our goal as a faculty is that every single one of our graduates is competent to care for older people.”

The MSTAR program, says Dr. Supiano, is a big part of that goal. “I hope it will continue to be supported as it has been,” he says. “I want to see it continue to prosper.” 

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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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