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MSTAR

Volume 6, Issue 3
January 2012

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

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 and information about the Medical Student Research Training in Aging (MSTAR) Program to current and former student scholars, program directors, 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. Announcing the 2012 MSTAR Deadline
2. AFAR's "Diary of an MSTAR Student"
3. Thank You to an MSTAR Supporter: Kathryn Wriston
4. New Opportunity: Beth Israel and Harvard's Short-Track Internal Medicine Residency Program
5. Summer Institute in Geriatric Medicine at Boston University School of Medicine
6. MSTAR Scholar Success Story: Heather Whitson, MD, MHS
7.Loan Forgiveness for Geriatricians
8.MSTAR Student in the News: Mitch Eggers
9. Helpful Links / Geriatrics Recruitment and Student Opportunities

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Announcing the 2012 MSTAR Deadline

AFAR is now accepting applications for the 2012 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 are provided stipends to conduct full-time research during the summer for a period of 8 to12 weeks. 

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 2012, are invited to apply. As many as 130 scholarships will be awarded in 2012.
 
For detailed guidelines and application instructions, please visit www.afar.org/research/funding/mstar. Applications are due on January 31, 2012. Applicants will be notified of the decision around March 15, 2012. Please contact us at medicalstudent@afar.org if you have any questions.

AFAR would like to thank The John A. Hartford Foundation, MetLife Foundation, and the National Institute on Aging for their continued sponsorship of the MSTAR program!

Don't forget to get those applications in by the deadline! For more details, go to www.afar.org/research/funding/mstar.

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AFAR's "Diary of an MSTAR Student"

Last June, AFAR began the "Diary of an MSTAR Student" blog on our website. The blog gives readers a glimpse into the day-to-day lives of the MSTAR students. Many MSTAR Scholars submitted entries about their summer experiences in the lab, classroom, and clinic, also sharing what they learned about the field of geriatrics. Here are a few excerpts:

"As an MSTAR scholar working at Detroit Medical Center, I have had the opportunity to shadow geriatric fellows and attending physicians during their morning rounds this summer. This first-hand exposure to geriatric medicine has provided me with a much better understanding of the difficulties facing elderly patients, as well as the multidisciplinary approach that is needed to effectively address them."
—Caitlin Biedron, Wayne State University School of Medicine

"My experience has been a great one. As a primary investigator in [my] study and one who gets to interact with the subjects, I've gotten to meet and briefly get to know a small, but still diverse and interesting group of older adults with rich and active lives. Meeting these people would change anyone's outlook on what it means to age should it be a negative one. The older adults in my study… have undoubtedly been and will continue to be an inspiration to me as I continue this project."
—David S. Priemer, Saint Louis University School of Medicine

"This summer has … been full of firsts; my first one-on-one patient interview, the first time I heard a heart murmur, my first time consoling a dementia patient (she was convinced she owed me money). In the beginning I was terrified to help write notes or review medications; what if I messed something up? What if I was wrong? I realized quickly that it was okay to be wrong, and it was okay to try new things on my own. My mentor was always there to make sure things were going well. Yesterday I was given the task of getting updates and reviewing the labs on nursing home patients, and I suddenly felt like this medicine thing is something I can do. The patients are amazing, the cases are interesting, and there is always more to learn."
—Sydney Harvey, University of North Texas Health Sciences Center at Fort Worth
 
We hope the blog will inspire others considering careers in medicine, as well as educating the general public and journalists about the importance of geriatrics. To read more "Diary of an MSTAR Student" blog entries, go to www.afar.org/mstarblog/posts.

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Thank You to an MSTAR Supporter: Kathryn Wriston

Thanks to the generosity of our foundation sponsors, the MSTAR program was able to provide research scholarships to more than 140 medical students in 2011. But did you know that individuals can also directly sponsor a specific MSTAR Scholar?

Kathryn Wriston, President of the Hartford Foundation's Board of Trustees, did just that this past summer when she sponsored 2011 MSTAR Scholar Anthony Choi, of Weill Cornell Medical College. Choi's project focused on identifying and predicting chemotherapy toxicities in older adults.

"It's been very rewarding," Wriston says. "I've kept up with what he's doing, and I can put a face and personality to the name."

Wriston decided to support an MSTAR student because, she says, "MSTAR is one of the Hartford Foundation's star programs." Wriston cites statistics that illustrate the program's success: Of the roughly 1,500 students who have participated, 20 percent have remained in the geriatrics field, and an additional 9 percent have remained in academic geriatrics. "That 9 percent compares with only 1 percent of the medical student population in general," she says.  While Wriston would have sponsored any MSTAR student, it was a bonus for her to support someone in New York so that she could eventually meet the student. When we spoke with her, she was excited about her upcoming lunch plans with Choi.

Wriston looks forward to supporting another MSTAR Scholar in 2012. "There is a shortage of trained personnel to meet the medical needs of our elders, which differ from the needs of people who are not in that population," Wriston says. "I think it's terrific to be able to help fulfill that need by sponsoring an actual person."

AFAR would like to thank Kathryn Wriston for her support of Anthony Choi and the MSTAR program. For information on how you can sponsor an MSTAR student, please contact Nancy O'Leary in the AFAR development office at 212-703-9977, or you can go online and direct your gift to the MSTAR program at http://www.afar.org/give/mstar.

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New Opportunity: Beth Israel and Harvard's Short-Track Internal Medicine Residency Program

To help address the critical shortage of physicians with skills in both gerontology and basic research, Beth Israel Deaconess Medical Center (BIDMC) has created a special short-track internal medicine residency program. The program will allow successful candidates to complete their clinical training in two years, then conduct aging research with one of several well-established mentors at Harvard Medical School. Residents will become Board-eligible in internal medicine and skilled in basic gerontological research methods.

"Our expectation is that graduates of this program will go on to win career development and research awards from NIH and develop successful independent research careers," says Lewis A. Lipsitz, MD, professor of medicine at Harvard Medical School and Chief of Gerontology at BIDMC. "To our knowledge, there are no other medical residency programs in the U.S. that offer this in-depth focus on aging research."

Residents will participate in the academic activities of the Gerontology Division and the Department of Medicine. Coursework will include research methods, grant writing, and career development.

Applicants should use the Electronic Residency Application Service (ERAS) for applying for a residency position in Internal Medicine at BIDMC, and indicate their interest in the short-track research program. They should also send their CV and a letter of interest to Dr. Lipsitz at 1200 Centre St., Boston, MA 02131. The selection process will be the same as for all internal medicine residents.

If you have questions about the short-track internal medicine residency program, please contact Dr. Lipsitz at Lipsitz@hrca.harvard.edu .

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Summer Institute in Geriatric Medicine at Boston University School of Medicine

Third- and fourth-year medical students can gain exposure to academic and research careers in geriatrics at the Summer Institute in Geriatric Medicine at Boston University School of Medicine. The weeklong conference will take place May 21-25, 2012 and will include clinical and research seminars on geriatrics topics, group development of a research proposal, clinical visits, a career panel including information about internship and residency program selection, and social activities.

"It's very complementary to the MSTAR program," says Rebecca A. Silliman, MD, PhD, director of the Summer Institute and chair of the Boston Medical Center Section of Geriatrics. "It gives students a second dose of geriatrics."

Many past Summer Institute participants have gone on to fellowship training in geriatric surgery or geriatric psychiatry, then on to faculty positions as clinician educators or clinician researchers. "Either is great because both are needed very much," says Dr. Silliman.

The Summer Institute in Geriatric Medicine is sponsored by the American Geriatrics Society and the Boston University School of Medicine, with funding from the National Institute on Aging. To apply, students can visit www.americangeriatrics.org/health_care_professionals/trainees/bu_summer_institute. Applications must be received by January 9, 2012. Successful candidates will be notified by February 6.

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MSTAR Scholar Success Story: Heather Whitson, MD, MHS

Nearly 15 years ago, as a first-year medical student at Weill Cornell Medical College, Heather Whitson attended a lecture about geriatrics given by Dr. Mark Lachs. "He was so dynamic and seemed so happy that I thought, "Whatever I do, I want to be as happy as that guy!" Dr. Whitson recalls.

She approached Dr. Lachs after the lecture and told him she wanted to learn more about geriatrics. He suggested she apply for the MSTAR program, then called the Medical Student Geriatric Scholars Program. She did, and took part in the program that summer at Harvard Medical School's Beth Israel Deaconess Medical Center (BIDMC). Little did she know it would turn into a career path.

Dr. Whitson is now an Assistant Professor of Medicine and Ophthalmology in Duke University School of Medicine's Division of Geriatrics. Last month, while in Boston for the Gerontological Society of America's Annual Scientific Meeting, she took some time to speak with us about her MSTAR experience, her career, and her love for geriatrics.

Tell me a bit about your MSTAR project.
I worked with Dr. Susan Greenspan, who at the time was the director of the Osteoporosis Research Lab at BIDMC. My project was enrolling patients who were scheduled for elective hip replacements. We were using them as a model of hip fracture and looking at some of their bone biomarkers before and after the surgery. What we found was that there was what's called an uncoupling of bone turnover following the surgical trauma to their bones, which has implications for people who break a hip. The act of breaking a hip could actually disrupt bone metabolism so that it puts you at greater risk of bone loss in the future. This could partially explain why people who break one bone are at higher risk of breaking another bone.

How did the MSTAR program influence your career path? Did it increase your interest in geriatrics?
Oh, definitely. I got research experience and one-on-one mentorship from Dr. Greenspan, who is married to Dr. Neil Resnick. They're two aging-research luminaries, so I got two for the price of one! At that early formative stage, being able to train with both of them was a very unique experience. I was honored to have that much face time with them.

Also, Dr. Ed Marcantonio ran weekly sessions where we would come together and have lectures or talk about our research projects. I got a lot of exposure to geriatricians who seemed happy with what they did, and whom I could relate to as role models. They kept it so exciting and dynamic. They also did a really nice job of giving a real survey of the field and of highlighting the significant need for geriatric practitioners. There was a lot of talk even then about the aging of the population and projected workforce shortages. It was laid out clearly that the country was about to face a crisis in terms of the aging population, and that the health care system was not prepared to deal with the challenges. You almost left feeling like it was your patriotic duty to help prepare America for the aging population. I came away feeling like this is something that I would really like to do.

What else did you enjoy about the MSTAR program?
At that time, there were only a handful of institutions that supported an MSTAR program. There were 10 Scholars from different schools at Harvard for the summer. When we weren't in the hospital or in the lab, we hung out together and played in Boston. It was a really fun summer getting to know them.

As it turns out, three of us ended up with careers in academic geriatrics. I'm still very close to the other two. It's nice that we've been friends since we were MSTARs together.

What was your career path after you graduated from medical school?
After I graduated in 2000, I did my internship and residency at Duke. I became Chief Resident, then did a geriatrics fellowship there. I started out doing osteoporosis research. As my own research agenda evolved, I became interested in co-morbidity. Dr. Harvey Cohen became and remains my primary mentor. We received the Geriatric Health Outcomes Research Scholars Award from the Hartford Foundation. I also received a Paul Beeson Career Development Award in Aging Research in 2008.

Tell me about your Beeson research.
It's on vision and cognitive impairment. We've done a lot of work to describe cognitive patterns in patients with macular disease. We've developed and piloted a low-vision rehab program that is tailored for people with cognitive impairments in addition to vision impairment. Most recently we've started some work with brain imaging to try to understand the mechanism for the cognitive impairment. People who have macular degeneration have twice the risk of dementia compared to people in their 80s who don't have macular degeneration. Nobody really understands why they have such high rates of cognitive impairment. So right now I'm trying to get funding to do more MRI studies to better understand the mechanisms that would explain the link between cognitive impairment and macular degeneration.

As an assistant professor at Duke, have you ever worked with an MSTAR student?
I have! Rachel Rose-Cohen was a 2010 MSTAR Scholar, and I was one of her mentors.

What was it like to be the mentor and not the student?
When Rachel presented her poster at the AGS annual meeting, I had this throwback moment. I walked into the poster session and gave her a hug at her poster. I remembered when Dr. Greenspan came and found me at my poster and gave me a hug. I thought, "It's 15 years later and suddenly I'm the other person!" It is really nice. I am delighted to think that I can influence somebody's choice to go into geriatrics.

What do you love about geriatrics?
I really like the puzzle of medicine—the diagnostic challenges and the brainteaser aspect. And I think the puzzle is a lot more complicated in geriatrics. Geriatrics is more challenging and more fun. The patients often have lots of medical problems and take lots of medications. If you get someone who is a very complicated patient, and you can make some adjustments that really make them feel better, it's very rewarding.

Do you think more students are interested in geriatrics now as compared to when you were a medical student?
I definitely think that there are more students who know of geriatrics. We have made significant strides in terms of elevating the prominence of geriatrics education in medical education. But it's still an incredible challenge to recruit people to devote their career to geriatrics. I think a lot of that is a reimbursement issue.

What do you tell students to try to convince them to go into geriatrics?
If you want to go into something where you will always feel needed, and where you will always feel that people want your expertise, this is a great field to go into. It's a way that you can give back. If you like older patients, you like thinking about complicated medical problems, and you're gifted in internal medicine, this is a high-need area.

Do you have any advice for future MSTAR Scholars?
I would tell them to maintain contact with their mentors. There aren't many comparable programs where you get this chance to be paired with someone who's prominent in a field and get that much face-to face time and mentoring from them. They should also stay in contact with the other MSTAR Scholars they meet, because if it plays out like it did for me, those people may end up being some of their very valued colleagues 10 to 15 years later!

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Loan Forgiveness for Geriatricians

In 2005, more than 35 million Americans—roughly 12 percent of the U.S. population—were 65 or older. By 2030, that number will exceed 70 million (20 percent of the U.S. population). Yet there are only 7,345 certified geriatricians currently practicing in the U.S.—about half the number currently needed.


This critical shortage is due in part to the financial burden of pursuing a geriatrics career: While additional training leads to higher income in most fields of medicine, this is not the case in geriatrics. To address this problem, South Carolina passed legislation in 2005 that uses loan forgiveness as an incentive to recruit physicians into the field of geriatrics. So far, it is the only state to do so.


To help get similar legislation passed in other states, the American Geriatrics Society has created a Loan Forgiveness Toolkit for States. It includes information that will help you get involved at any step of the legislative process. Here are some key tips from the toolkit:

1. Gather partners. Find state legislators who are sympathetic to geriatric healthcare issues. Contact them and educate them about the shortage of geriatrics healthcare professionals. Share personal stories, keep materials concise, and be persistent. Reach out to your state's Office on Aging, representatives from aging services, medical educators and advocates, and your state's Silver Haired Legislature. It's also important to build a relationship with a state agency that serves older adults, such as the Governor's Office on Aging.

2. Draft legislation. The legislation should offer a meaningful amount of debt forgiveness, low program costs to the state, manageable program administration, and potential for expansion. You should also consider how the program would be paid for.

3. Find a sponsor and push the legislation through. There is some variation in the legislative process among states. Visit your state legislature's Web site to learn about the process in yours. Have the legislation reviewed by your allies—people who know how the system works—before submitting it. And, time it right. Examine state budget issues, as well as the receptiveness of the state legislature concerning aging issues, before you submit the legislation.

AGS members can view the full Loan Forgiveness Toolkit at www.americangeriatrics.org/ags_state_affiliates/state_affiliate_handbook/loan_forgiveness_toolkit.  If you are interested in becoming an AGS member, go to www.americangeriatrics.org/join/membership__dues.

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MSTAR Student in the News: Mitchell Eggers

Each year, roughly 100,000 Americans die from pulmonary embolism, the third leading cause of death in the U.S. 2011 MSTAR Scholar Mitchell Eggers is trying to change that. Eggers, a second-year student at Baylor College of Medicine, invented an absorbable medical device that is inserted into the vena cava to catch blood clots before they can travel into the lungs and cause a pulmonary embolism.

"I thought this made so much sense for MSTAR because the incidence for pulmonary embolism increases one thousand-fold from age 50 to 85, Eggers explains.

Traditional metal inferior vena cava (IVC) filters could not be removed, which caused long-term problems for many patients after they became clogged or migrated and pierced other organs. While newer metal filters are designed to be removed, 80 percent of patients do not return to the hospital to have them taken out. They can then migrate and pierce the aorta. Eggers' device solves those problems by remaining in the vena cava for six weeks, then absorbing rapidly into the body.

"It just breaks down into simple carbon dioxide and water, and within a matter of months it's completely eliminated from the body," Eggers says.

 


Eggers, who has a PhD in electrical engineering, conceived the idea while taking a pulmonary class last year and learning about the limitations of the metal IVC filters. After doing research and finding that no absorbable filter existed, he pursued the idea in greater detail and created a simple prototype during independent research hours at Baylor. Then he applied to — and was selected for—the MSTAR program.

For his MSTAR project, Eggers converted a spare room in his home into a lab so that he could test his absorbable filter. He built an engineered circulation system, powered by a blood pump, that mimics the human circulation system. He then placed the filters into the system and allowed it to run continuously for 10 weeks. Eggers monitored the system round-the-clock with the help of his mentor, Dr. Charles Reitman, head of orthopedic surgery at Baylor. The tests were successful.

Eggers then submitted an abstract based on his MSTAR research for inclusion in the annual American Medical Association Research Symposium. The abstract was selected as number one in the Surgery/Bioengineering Category. "I was blessed and fortunate," Eggers says. He got to present the device at the Symposium, which took place November 12-13, 2011 in New Orleans.


Now Eggers, who is studying to become an orthopedic surgeon, is hoping to quickly secure funding for the next phase of his research—testing his absorbable filter on animal models. "To wait too long [to test the device] is just unacceptable," Eggers says. "I think it has a high potential of saving lives."

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Helpful Links / Geriatrics Recruitment and Student Opportunities

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

MSTAR Toolkit:
www.afar.org/toolkit.html

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

Boston University Summer Institute in Geriatric Medicine:
www.bmc.org/geriatrics/education/medicalstudents-summerinstitute.htm

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:
www.services.aamc.org/careersinmedicine/

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