Category: Featured

ER Care for Sexual Assault Victims, BUSM prof’s NEJM article calls for sensitivity, thoroughness

September 28th, 2011 in Featured

Judith Linden says that in treating sexual assault victims, “it's most important to make sure that patients are believed, understood, and get the care they need and asked for.” Photo by Cydney Scott

Judith Linden says that in treating sexual assault victims, “it's most important to make sure that patients are believed, understood, and get the care they need and asked for.” Photo by Cydney Scott

Nearly a third of women are sexually assaulted at some point in their lives, but less than half will seek medical care for their injuries. For those who do, emergency care often fails to conform to established protocol.

For the past 15 years, Judith Linden has worked to improve and streamline evaluation and treatment of adult sexual assault victims seeking care at hospital emergency rooms. The School of Medicine associate professor of emergency medicine has written an overview, published in the September 1 issue of the New England Journal of Medicine, of the evolving state of that care, which increasingly involves the use of sexual assault nurse examiners (SANEs).  SANEs are quick-responding, specially trained, certified professionals who perform forensic medical-legal exams. When cases go to trial, the SANEs are available to testify. The program was pioneered at Boston Medical Center and there are now 650 nationally, according to Linden. Some—for example in San Diego—are at freestanding sites.

Linden’s review study points out that especially in the absence of physical injury (about half of all cases), victims “are often frightened, emotionally traumatized, and embarrassed. They often fear that they will not be believed, and they may also fear for their safety if they know the assailant or if the assailant has access to their personal information.” And she also reports that many rape victims doubt that their cases will be prosecuted successfully, a justified fear in light of the fact that in the United States fewer than half of rape cases end in convictions. Medical providers should understand, Linden stresses, that “it is not their responsibility to determine whether a sexual assault has occurred, since such a determination can rarely be made on the basis of examination alone.”

The U.S. Department of Justice , the World Health Organization, and the American College of Emergency Physicians have issued guidelines for the treatment of patients after sexual assault. Linden underlines the importance of following consistent procedures, from evaluation of traumatic physical injuries to emotional support to evidence collection. Although every sexual assault case is different, maintaining protocol is crucial, she says, noting that cases where SANE-trained nurses gather forensic evidence end in a 92 to 95 percent prosecution rate.

BU Today spoke recently with Linden about the demands of caring for sexual assault victims, how emergency medical staff is rising to that challenge, and what improvements can be made.

BU Today: Is the medical response to adult sexual assault close to being standardized or does it vary widely?

Linden: I don’t think it’s standardized at all. The beauty of having a SANE program or response team is that it establishes protocols. There are still a lot of community hospitals that don’t follow the same protocols.

What are some of the problems hospitals face in establishing sexual assault protocols?

I think staffing is a difficult issue. These cases can take a long time; it can take up to six hours for an exam, longer to make sure victims have proper treatment and the counseling they need. The ER is very unpredictable—traumas come in, and you have to prioritize patients. Sexual assault patients’ injuries may not be life-threatening. Each hospital, unless it’s SANE-certified, comes up with its own protocol. We’ve gotten to the point where EMS will often triage to SANE sites.

Are there common mistakes ER staff make in handling sexual assault cases?

The first common mistake is that some of the staff can be very judgmental. Often they may question the history given by the patient, who may be intoxicated. Some of the patients may be sex workers. As far as mistakes in treatment, people are often confused about the amount of time that can elapse before evidence degrades. In Massachusetts it’s 120 hours, a limit of five days for the vaginal exam; after that it’s less likely there will be evidence, and we don’t recommend doing a rape kit after that. For oral or anal assault it’s 20 hours.

Boston Medical Center has SANE examiners. What impact has the SANE program had?

That’s the million-dollar question if you want continued funding. Our SANE program funding is cut every year; last year it almost became unworkable, but it was restored in a supplemental budget. We’re hoping lawmakers will approve another supplemental budget. You want to show that these programs improve patient care and treatment, but you also want to prove that they’re cost-effective. Are they getting criminals out of the system, or are we saving the state money? Are they (the culprits) pleading out? Not that many studies have looked at this. There was one done in Massachusetts and several other states showing an increased prosecution rate. Anecdotally, in our SANE program there’s a 97 percent success rate when SANE is involved. Different districts don’t share information.

You write that it’s not the medical team’s responsibility to determine whether a sexual assault has occurred. Does that mean that every person arriving at an ER saying she or he is a sexual assault victim, regardless of degree of physical injury, gets the same response?

The response is the same for every woman or man who presents complaining of sexual assault. When practitioners perform a sexual assault exam they probably won’t be able to tell if there’s been an assault just from the exam. A practitioner isn’t asked to decide whether it did or did not happen. He or she is collecting evidence, and the whole thing gets passed on to the justice system. Sometimes people come in and say, “Can you tell me if I was assaulted? I passed out; I woke up with my clothes off.” My point is, it really doesn’t matter. When someone comes in with chest pain, it’s not alleged chest pain. You treat these people as sexual assault victims. It’s very rare that someone will go through this whole embarrassing, invasive questioning if nothing happened. One reason these cases are so scary to clinicians is they’re not familiar with them, and they’re scared of the justice system. They worry that they’ll have to testify. I try to bring it back to the care. We have to offer good medical care based on the latest protocol.

What happens first when a sexual assault victim comes to the ER? Is he or she afforded privacy? Do victims sometimes have to wait a long time for attention?

At least in our emergency department, they’re given top priority triage and get a room immediately. You don’t know if the attacker has followed them to the ED. Does this always happen? Maybe not. Best practice is they should not wait out in the waiting room. The other problem we have is, we take them back, close the door, and the practitioner will just leave them there. I don’t want that to happen either. What we can’t see, for example, is strangulation injuries. The victim may have bruising or difficulty breathing. I don’t want that person to sit in the waiting room.

After sexual assault victims are released, what kind of follow-up is there currently and what role does the hospital play in ensuring a victim’s safety once he or she leaves?

That’s where we ask for social worker colleagues. Safety planning is very complex. What we try to do, if the victim has identified the person (and most of the time they can’t identify the person), is we try to get creative, have them stay with friends or family. One of the more complex situations is if they live in a dorm—that’s where lawyers and crisis counselors are involved. Authorities can have a suspected attacker moved out of the dorm. Safety planning is not a cookie-cutter solution.

Which of your concluding recommendations is the most urgent?

First and foremost, to make sure that patients are believed, understood, and get the care they need and asked for. It’s important to treat them for STDs and possible pregnancy. In Massachusetts, it’s the law: we must offer all rape victims emergency contraception. And it’s important for them to know where to access services in the future.

How has your role evolved as clinician advocate for sexual assault victims?

I came to Boston Medical Center after my residency and never left. When I joined BMC 15 years ago it was right when the SANE program was being formed, and I loved the program because it was very nurse-driven. To me, it is incredibly important that we continue training our young doctors to offer accurate and compassionate treatment. I felt if I didn’t get myself trained as a SANE, my residents would be missing out. It’s important to train our future doctors, who may not have done a SANE exam by the time they graduate. It’s important that they go off to community hospitals with this knowledge. I keep up-to-date on all the latest protocols and treatments; I serve as a 24-hour resource to them and make sure that the medical community stays involved.

More information about support for sexual assault victims and reporting sexual assault can be found here.

This BU Today story was written by Susan Seligson.

William B. Kannel, MD, Pioneer in Cardiovascular Epidemiology, 1923-2011

August 22nd, 2011 in Featured

William B. Kannel, MD

William B. Kannel, MD

William B. Kannel, MD, died Saturday, Aug. 20, 2011. He made the courageous decision to refuse medical interventions for cancer and chose to die with dignity with the help of hospice, family and friends. He is survived by his wife, four children, 12 grandchildren and 23 great-grandchildren.

Dr. Kannel was born in 1923 in New York, where he attended high school, and then graduated from the Medical College of Georgia in Augusta in 1949. He was trained in internal medicine in the US Public Health Service at Staten Island, New York, and was a fellow of the American Heart Association, the American College of Cardiology, the American Epidemiology Society, the American College of Epidemiology and the American College of Preventive Medicine. Dr. Kannel was Emeritus Professor of Medicine and Public Health at the Boston University School of Medicine (BUSM). He was a past Chairman of the Council of Epidemiology of the American Heart Association and a past Chief of the Section of Preventive Medicine and Epidemiology in the Department of Medicine at BUSM. He was a recipient of numerous national and international awards and honorary degrees, notable among which were the AHA Distinguished scientist award (2006), the Lifetime Achievement award from the New York Academy of Medicine (2006), and the Joseph Stokes Award from the Board of the American Society for Preventive Cardiology (2011). Other important awards received by him include the Dana Award in Preventive Medicine (1972), the Dutch Einthoven Award (1973), the Canadian Gairdner Award (1976), the CIBA Award for Hypertension Research (1981), the James D. Bruce Memorial Award of the American College of Physicians (1982), and the Charles A. Dana Award for Pioneering Achievement in Health (1986). He served on the editorial board of numerous scientific journals, including Hypertension, the American Journal of Cardiology, and the American Heart Journal.

Dr. Kannel has been active in the field of cardiovascular epidemiology for more than 60 years and led the way for the world famous Framingham Heart Study to become the leader in cardiovascular epidemiologic research that it is today. He joined the Heart Study in 1950 and in 1966, he became the NIH Director of the Heart Study, replacing Dr. Thomas R. Dawber, the original architect of the study, serving in this capacity until 1979. Between 1979 and 1987, as Professor of Medicine at Boston University, he served as the Principal Investigator of the Framingham Study. Subsequently, he continued work as the senior-most investigator at the Heart Study until his recent illness curtailed those efforts.

The Framingham Study has been acknowledged among the top ten medical advances in the last century in several reports, in no small measure attributable to Dr. Kannel’s scientific contributions. He published over 600 medical articles, numerous editorials and book chapters in premier texts. His work at the Framingham Study established the utility of population-based research for seeking out correctable predisposing conditions for cardiovascular disease (CVD), putting prevention at the forefront of cardiology. Dr. Kannel coined the medical term ‘risk factor’ in 1961 in a landmark publication in the Annals of Internal Medicine, and promoted the concept that CVD is multifactorial in origin, that is, that there is no single cause that is essential or sufficient by itself for CVD occurrence. He promoted the notion of combining information about multiple risk factors mathematically to estimate risk of CVD (the Framingham risk score). His research established the importance of distinguishing between usual (average in the population) and optimal risk factor levels. He described the risk factors for both heart attacks and brain attacks (stroke), and identified the importance of irregular heart beat (atrial fibrillation) as a precursor of stroke and high blood sugar (diabetes) as a risk factor for CVD.

In several seminal papers he dispelled the concept of “benign essential hypertension” and showed the systolic component of the blood pressure to be no less important than the diastolic level. Pioneering work conducted by him also identified risk factors for the individual components of CVD, including sudden death, heart failure, and peripheral artery disease. Data collected by Dr. Kannel and his colleagues at the Heart Study in the late 1950s and early 1960s determined CVD population incidence at a time when only mortality statistics were available. In 1971 (approximately three decades before the completion of the human genome project), Dr. Kannel began the second generation study called the Framingham Offspring Study that quantified the hazard of a family history of CVD based on observations on parents and their offspring. His research on the two generations of Study participants provided path-breaking insights on mechanisms of atherogenesis (build up of cholesterol plaques in the blood vessels), including: LDL and HDL dyslipidemia, obesity-induced clustering of CVD risk factors, importance of physical activity in CVD prevention, and smoking as a trigger for heart and brain attacks. His research stimulated national campaigns against smoking, high cholesterol, high blood pressure, and obesity.

There are few areas in cardiovascular disease epidemiology Dr. Kannel did not explore. His research highlighted the lethal nature of congestive heart failure and a thick left ventricular wall, the frequent occurrence of clinically silent myocardial infarction and the factors predisposing to sudden death, which until then had been under-appreciated. His research warned in 1985 of the lack of efficacy and danger of estrogen replacement for preventing CVD. In 2008, along with his colleagues he formulated the ‘Framingham General CVD risk score’, a profile that enables primary care physicians to pull together risk factor information to assess the global risk of heart attacks, failure, strokes, and peripheral artery disease.

By his example, Dr. Kannel influenced several generations of cardiologists and physicians and was one of a handful of “founding fathers” of preventive cardiology utilizing prospective observations to draw conclusions usually readily applicable to clinical practice. He also trained scores of postdoctoral research fellows at the Heart Study who are following in his footsteps inspired by the depth and breadth of his research.

All are welcome at the funeral, which will be held at 11 a.m. Tuesday, Aug. 23, at Temple Beth Am, 300 Pleasant St., Framingham, MA. Burial will be private.

Contributions may be made in Dr. Kannel’s memory to the Friends of the Framingham Heart Study, 73 Mt. Wayte Ave., Suite 2, Framingham, MA 01702.

William B. Kannel, MD, Pioneer in Cardiovascular Epidemiology, 1923-2011

William B. Kannel, MD, died Saturday, Aug. 20, 2011. He made the courageous decision to refuse medical interventions for cancer and chose to die with dignity with the help of hospice, family and friends. He is survived by his wife, four children, 12 grandchildren and 23 great-grandchildren.

Dr. Kannel was born in 1923 in New York, where he attended high school, and then graduated from the Medical College of Georgia in Augusta in 1949. He was trained in internal medicine in the US Public Health Service at Staten Island, New York, and was a fellow of the American Heart Association, the American College of Cardiology, the American Epidemiology Society, the American College of Epidemiology and the American College of Preventive Medicine. Dr. Kannel was Emeritus Professor of Medicine and Public Health at the Boston University School of Medicine (BUSM). He was a past Chairman of the Council of Epidemiology of the American Heart Association and a past Chief of the Section of Preventive Medicine and Epidemiology in the Department of Medicine at BUSM. He was a recipient of numerous national and international awards and honorary degrees, notable among which were the AHA Distinguished scientist award (2006), the Lifetime Achievement award from the New York Academy of Medicine (2006), and the Joseph Stokes Award from the Board of the American Society for Preventive Cardiology (2011). Other important awards received by him include the Dana Award in Preventive Medicine (1972), the Dutch Einthoven Award (1973), the Canadian Gairdner Award (1976), the CIBA Award for Hypertension Research (1981), the James D. Bruce Memorial Award of the American College of Physicians (1982), and the Charles A. Dana Award for Pioneering Achievement in Health (1986). He served on the editorial board of numerous scientific journals, including Hypertension, the American Journal of Cardiology, and the American Heart Journal.

Dr. Kannel has been active in the field of cardiovascular epidemiology for more than 60 years and led the way for the world famous Framingham Heart Study to become the leader in cardiovascular epidemiologic research that it is today. He joined the Heart Study in 1950 and in 1966, he became the NIH Director of the Heart Study, replacing Dr. Thomas R. Dawber, the original architect of the study, serving in this capacity until 1979. Between 1979 and 1987, as Professor of Medicine at Boston University, he served as the Principal Investigator of the Framingham Study. Subsequently, he continued work as the senior-most investigator at the Heart Study until his recent illness curtailed those efforts.

The Framingham Study has been acknowledged among the top ten medical advances in the last century in several reports, in no small measure attributable to Dr. Kannel’s scientific contributions. He published over 600 medical articles, numerous editorials and book chapters in premier texts. His work at the Framingham Study established the utility of population-based research for seeking out correctable predisposing conditions for cardiovascular disease (CVD), putting prevention at the forefront of cardiology. Dr. Kannel coined the medical term ‘risk factor’ in 1961 in a landmark publication in the Annals of Internal Medicine, and promoted the concept that CVD is multifactorial in origin, that is, that there is no single cause that is essential or sufficient by itself for CVD occurrence. He promoted the notion of combining information about multiple risk factors mathematically to estimate risk of CVD (the Framingham risk score). His research established the importance of distinguishing between usual (average in the population) and optimal risk factor levels. He described the risk factors for both heart attacks and brain attacks (stroke), and identified the importance of irregular heart beat (atrial fibrillation) as a precursor of stroke and high blood sugar (diabetes) as a risk factor for CVD.

In several seminal papers he dispelled the concept of “benign essential hypertension” and showed the systolic component of the blood pressure to be no less important than the diastolic level. Pioneering work conducted by him also identified risk factors for the individual components of CVD, including sudden death, heart failure, and peripheral artery disease. Data collected by Dr. Kannel and his colleagues at the Heart Study in the late 1950s and early 1960s determined CVD population incidence at a time when only mortality statistics were available. In 1971 (approximately three decades before the completion of the human genome project), Dr. Kannel began the second generation study called the Framingham Offspring Study that quantified the hazard of a family history of CVD based on observations on parents and their offspring. His research on the two generations of Study participants provided path-breaking insights on mechanisms of atherogenesis (build up of cholesterol plaques in the blood vessels), including: LDL and HDL dyslipidemia, obesity-induced clustering of CVD risk factors, importance of physical activity in CVD prevention, and smoking as a trigger for heart and brain attacks. His research stimulated national campaigns against smoking, high cholesterol, high blood pressure, and obesity.

There are few areas in cardiovascular disease epidemiology Dr. Kannel did not explore. His research highlighted the lethal nature of congestive heart failure and a thick left ventricular wall, the frequent occurrence of clinically silent myocardial infarction and the factors predisposing to sudden death, which until then had been under-appreciated. His research warned in 1985 of the lack of efficacy and danger of estrogen replacement for preventing CVD. In 2008, along with his colleagues he formulated the ‘Framingham General CVD risk score’, a profile that enables primary care physicians to pull together risk factor information to assess the global risk of heart attacks, failure, strokes, and peripheral artery disease.

By his example, Dr. Kannel influenced several generations of cardiologists and physicians and was one of a handful of “founding fathers” of preventive cardiology utilizing prospective observations to draw conclusions usually readily applicable to clinical practice. He also trained scores of postdoctoral research fellows at the Heart Study who are following in his footsteps inspired by the depth and breadth of his research.

All are welcome at the funeral, which will be held at 11 a.m. Tuesday, Aug. 23, at Temple Beth Am, 300 Pleasant St., Framingham, MA. Burial will be private.

Contributions may be made in Dr. Kannel’s memory to the Friends of the Framingham Heart Study, 73 Mt. Wayte Ave., Suite 2, Framingham, MA 01702.

Study of Academic Productivity Among U.S. Neurology Faculty Ranks BUSM’s Department of Neurology in the Top 20 U.S. Programs

August 19th, 2011 in Featured

Carlos Kase, MD

Carlos Kase, MD

A study published in the August 2011 Archives of Neurology ranks BUSM medical education and neurology residency training programs among the top 20 of 120 U.S. programs examined by the researchers in producing academic neurologists. The analysis assessed the impact of the medical schools and residency training programs on the decision to pursue a career in academic neurology as well as an estimation of the most productive medical schools and residency programs based on the academic productivity of their respective graduates.

BUSM medical education and neurology residency programs ranked 15 and 13 respectively by number of graduates, their rank and h-index that measures an author’s most cited articles and the number of citations each of the articles receive. “I am proud to see that we came within the 15 top spots among 120 US institutions,” said Carlos Kase, MD, professor and chair of the Department of Neurology.

“I am delighted that we made both lists, clearly competing with the best medical schools and residency programs in the country,” said Dean Karen Antman, MD. “Dr. Kase and his department have done a great job to motivate our students and residents.”

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Addiction Expert Designated White House Champion of Change. BUSM’s Daniel Alford has a question for you: How often do you drink?

August 3rd, 2011 in Featured

The White House is honoring Daniel Alford for his work with addiction.

The White House is honoring Daniel Alford for his work with addiction.

President Obama’s father was an alcoholic whose drunken driving killed a friend and put the elder Obama in the hospital with two broken legs. 
That unfortunate bit of history may help explain the White House’s interest in addiction, which includes honoring BU addiction expert Daniel Alford with a visit there on August 5.

Alford (SPH’86, MED’92), a School of Medicine associate professor, is the medical director of MASBIRT (Massachusetts Screening, Brief Intervention, Referral and Treatment), a federally funded program at Boston Medical Center and seven other hospitals and community health centers in the state that screens for risky alcohol, tobacco, and drug use. “When you come to see your doctor for your diabetes management or hypertension or just for your annual visit, you’ll be asked questions about unhealthy substance use,” Alford says.

Alford will be in Washington Friday, courtesy of Obama’s Champions of Change program, which hosts weekly White House visits for innovators in various fields. He’ll participate in a roundtable with federal drug policy experts, write a short blog entry about his work, and film a short biographical piece for the White House website.

Through MASBIRT, BMC and participating organizations now have trained health promotion advocates, who work throughout the institutions, from primary care offices to emergency rooms, screening people for risky substance use and assessing what the next step should be to help those with problems. The goal is to identify people at risk of addiction before the addiction consumes them, an approach that Alford says has been overlooked by the medical establishment. “If we waited for patients with kidney disease to need dialysis, that would be malpractice,” he says. “That’s kind of what we’ve done with addiction. We basically ignore unhealthy substance use until the person’s coming in with alcoholism or drug addiction.”

Alford, who joined the BU faculty in 1996, also leads BMC’s program to train medical residents in a new (for nonpsychiatric doctors) subspecialty, addiction medicine. BMC recently appointed its first addiction resident, one of only 20 such residents nationwide. BU Today spoke with Alford about his work and Friday’s event.

BU Today: My doctor asks me, “Do you smoke? Do you drink?” Is that a result of MASBIRT?

Alford: Certainly some doctors were doing it before. But there are ways of asking it, and then there are ways of asking it. You can say, “You don’t drink or use drugs, right?” as opposed to asking it with questions that have been shown to be more reliable. When you phrase a question as, “How often do you do something?” it normalizes it, and patients feel more comfortable answering.

The state would like to expand this approach. The majority of our work this past year has been, how do we sustain these efforts? Is it trying to sustain this health promotion advocate model? Nurses, medical assistants, docs could probably ask those questions. It’s probably going to be different, depending on the treatment center.

Is training in addiction medicine feasible when there are so many addictions out there? Being addicted to drugs or alcohol is different from being addicted to gambling or the Internet or sex.

There’s a lot of commonality, no matter what the substance or behavior. Addiction starts to disrupt someone’s life, despite negative consequences. It turns out that a lot of the neurobiology—what’s happening in the brain—that reinforces those unhealthy behaviors is similar as well. And they respond to a lot of treatments in a similar way.

Have there been advances in treating addiction?

The answer’s definitely yes. A perfect example is methadone maintenance. Methadone was developed for pain, but was found to be effective in treating opiate addiction. There’s a lot of stigma around it and people who don’t believe in methadone for treatment, but there’s more evidence over the last 40 years showing efficacy around methadone than pretty much anything else that I do in primary care.

A lot of behavioral therapies can be effective in treating lots of addictions as well as behavioral addictions, like gambling. All of the medications work better when you include nonpharmacological therapy, like counseling. In order for treatment to work, it needs to be continued. Historically, people got treatment, they stopped using, they then got discharged, they relapsed, and we said, “Aha, the treatment doesn’t work because they relapsed,” as opposed to saying, “The treatment works; it just needs to be continued.” Some people are cured permanently and don’t require extensive treatment. But the large majority needs sustained treatment.

What got you interested in addiction?

When I finished my residency, there was an opportunity, part-time, to be the medical director of a methadone maintenance program at the Boston Public Health Commission. I loved it immediately. I realized there were a lot of success stories within that treatment model that we as physicians didn’t know about.

This BU Today story was written by Rich Barlow. He can be reached at barlowr@bu.edu.

School of Medicine Receives LCME Reaccreditation

June 28th, 2011 in Featured

BUSM faculty, staff and student members of the LCME self-study and site-visit team

BUSM faculty, staff and student members of the LCME self-study and site-visit team

BU President Robert Brown and School of Medicine Dean Karen Antman received notification from the Liaison Committee on Medical Education (LCME) that the School of Medicine has been reaccredited for the next eight years.

The LCME is the only nationally recognized accrediting body for all medical education programs in the U.S. leading to the medical education degree. Accreditation signifies that national standards for structure, function, and performance are met by a medical school’s education program.

“The School of Medicine is a leader in education, research and clinical training,” said Antman. “The LCME accreditation confirms the quality and the standards that we have developed and continually refine and enhance. My colleagues at the School have my sincerest congratulations on this recognition.”

The School received high marks from the accreditation survey committee for the strong support provided by central administration for the teaching mission; the robust series of faculty development activities that are well attended by MED faculty; the mission-based allocation model that allows all components of the School’s mission to be strongly supported by department chairs and faculty; and the dedicated leadership at the School’s affiliated hospitals that strongly support its educational mission.

“Receiving this accreditation is an endorsement of the quality of the education we provide, our pedagogical process, and the outcomes—our graduates who are highly prepared both clinically and scientifically to contribute to health care at the bedside and in the laboratory,” said Antman.

Students and graduates of LCME-accredited medical schools are eligible to take the United States Medical Licensing Examination (USMLE). These graduates are also eligible to enter residencies approved by the Accreditation Council for Graduate Medical Education (ACGME). Graduating from an LCME-accredited U.S. school and passing the national licensing examinations are accepted as prerequisites for medical licensure in most states. LCME accreditation establishes eligibility for select federal grants and programs, including Title VII funding administered by the Public Health Service. The accrediting body comprises medical educators and administrators, practicing physicians, public members and medical students.

Hundreds of faculty, staff and students participated in the three-year self-analysis that preceded the site visit by an LCME evaluation team in February, providing the platform for the LCME team to comprehensively examine our institutional setting, governance, academic and student support programs, as well faculty development and evaluation and educational resources. About 120 participated in the actual visit.

“I was very impressed by the dedication and hard work of the BUSM community,” Antman said. “The outstanding effort of the hundreds of faculty, students and staff involved in conducting the self-study illuminated our strengths as an academic institution. We have extensive and purposeful student involvement especially in service learning; a deep sense of collegiality among faculty, students, and staff; responsive institutional structures; mission-based budgeting that reinforces our emphasis on quality teaching; diverse clinical opportunities for our students; and a cutting-edge research program fully open to our students that enriches their educational experience.”

US News & World Report: DASH Diet Number One, BU-created plan tops magazine’s list

June 9th, 2011 in Featured

Want the inside scoop on dieting? Ask BU’s Thomas Moore. The Medical Campus associate provost helped create the best diet plan going, according to US News & World Report.

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The DASH diet was codeveloped by BU’s Thomas Moore. Image courtesy of US News & World Report.

DASH (Dietary Approaches to Stop Hypertension) topped 19 other diet plans in the magazine’s “Best Diets Overall”  category, beating out such popular plans as Atkins, Jenny Craig, and Slim-Fast. The accolade is eye-catching for two reasons: DASH hasn’t been commercially marketed like those other plans—you don’t “see it at halftime during the football game,” notes Moore, a School of Medicine professor. And it wasn’t even designed to shrink waistlines. Rather, it’s a doctor-devised regimen to help people lower high blood pressure.

Several studies have confirmed DASH’s calorie-cutting potential, including this  one by researchers who looked at adolescent girls using the diet. The plan was devised in the 1990s in a multi–medical center trial led by Moore, who was a Brigham and Women’s Hospital researcher at the time. Since then, it has anchored a BU-developed weight reduction regimen offered free to University employees. Moore says several companies, including CVS, offer DASH to workers.

The benefits of DASH, which is similar to the Mediterranean diet, won’t surprise followers of nutrition news. The diet stresses fruits, vegetables, whole grains, and avoiding high-fat dairy products and high-sugar foods. Cutting salt intake enhances the diet’s potency. DASH’s key insight is that a nutritional diet can reduce high blood pressure, just as losing weight and cutting your salt intake can. It also recommends exercise as a complement to the menu.

“DASH is really better known to the medical community,” says Moore. “To get it out in the lay press like this is always lots of fun,” not to mention great publicity: the day US News announced its rankings, traffic to the DASH website jumped 20-fold, he says.

“It’s OK to ease into DASH,” US News writes. “Try adding just one vegetable serving to a meal, and a fruit serving to another. Go (sort of) vegetarian by preparing two or more meat-free dishes each week. And start using the herbs and spices hiding in the back of the pantry—they’ll make you forget the salt’s not on the table.”

Thomas Moore

Thomas Moore

“Because DASH emphasizes so many healthful foods, it can easily support weight loss,” the magazine writes, adding that the diet also improves heart health: “Rigorous studies show DASH can lower blood pressure, which if too high can trigger heart disease, heart failure, and stroke.…It’s also been shown to increase ‘good’ HDL cholesterol and decrease ‘bad’ LDL cholesterol and triglycerides, a fatty substance that in excess has been linked to heart disease. Overall, DASH reflects the medical community’s widely accepted definition of a heart-healthy diet.”

The magazine includes some caveats: people seeking to lose weight above all else might prefer to choose plans from its “Best Weight-Loss Diets” category, since DASH’s primary goal is to reduce hypertension. (The magazine also graded the “Best Diabetes Diets.”) Moore’s plan can cost a bit more than some, it adds, since fresh produce is more costly than the processed foods beloved by Americans and larded with ingredients subsidized by the government.

“We worried about that from the time we did the research,” says Moore. “You can eat cheaper than this, but it’s not by any means off the charts.” He and his colleagues found that a week’s worth of groceries under the DASH plan fell in the middle-price range. Dieters can save some money, he says, by replacing fresh produce with frozen varieties.

This BU Today article was written by Rich Barlow.  He  can be reached at barlowr@bu.edu.

BUSM Instructional Building Lobby Renovations Start Monday, May 23

May 19th, 2011 in Featured

Renovations to the BUSM Instructional Building, also known as the L-Building, begin Monday, May 23. During this initial phase some items in the lobby will be removed.

Lobby Closed to Pedestrians May 27 – August 8

Image A

Image A- Exterior view temporary entrance

Image B

Image B - Interior view temporary exit

Beginning Friday, May 27, access to the lobby will be closed to all pedestrian traffic. This will be in effect until completion of the renovation, which is expected on or about August 8.


New Temporary Entrances
There will be a handicapped ramp at the entrance between the L and Evans buildings (see image A). This doorway also may be used as the temporary main entrance for the entire complex. Image B shows this door from the interior of the building.

A-building Access
A-building occupants may use the door closest to East Concord Street as shown in image C. There will be an ID-card reader installed to allow access as well as a vision panel so that people on either side of the door are visible. Picture D shows this door from inside the building. This entrance should be available by May 23.

Visitors to A-Building may enter the complex through the new temporary entrance between the L and Evans buildings. They may take the L-building elevators to the basement and follow the  hall past Chequers  to the staircase at the end of the hall on the right. Then visitors  may take these stairs to the first floor and follow the corridor past Bakst Auditorium to the A-building elevators.

Image C

Image C - A-Building occupants may use this entrance

Image D

Image D - Interior view of exit for A-Building

Lobby Statues
The statues that had been displayed in the lobby are being carefully packed by a company that specializes in moving delicate materials. They will be stored off-site and will be reinstalled at a later time.

If you have any questions about the renovation, please contact John Barton at 638-4211. For urgent issues, please call the Control Center at 638-4144.

Topping Off Ceremony Held at New Student Residence

May 18th, 2011 in Featured

A significant milestone has been reached at the new Student Residence — the topping off ceremony marking the completion of the steel erection phase was held on Friday, May 13. Participants in the ceremony signed the beam and then it was raised. Following the raising of the beam, iron workers shared a meal and received a shirt commemorating the event. This is traditional practice in the industry dating back to the turn of the century.

The topping off ceremony means that the crane is now no longer required on the site and can be dismantled.  Other work recently completed includes the top track layout for the wall studs on the second and third floors.

Topping off ceremony participants, May 2011

Topping off ceremony participants. BU representatives included Gary Nicksa, Bill Gasper, David Flynn, Derek Rodgers, John Barton. (May 2011)

Topping off ceremony -- signing the final beam. (May 2011)

Topping off ceremony -- signing the final beam. (May 2011)

Raising the final beam. (May 2011)

Raising the final beam. (May 2011)

Dismantling the crane. (May 2011)

Dismantling the crane. (May 2011)

The plumbing and the roof steel frame work have been started. Pouring of the concrete on the fifth floor begins on Friday, May 20. Fireproofing the basement has begun and will move to the first floor on Monday, May 23. In addition duct work layout will start of the first floor on Monday, May 23.

Please keep in mind that Albany Street roadwork starts Wednesday, June 1.

The nine-story, $40 million structure is designed by Beacon Architectural Associates with a brick and limestone façade. Its 104 two-bedroom suites that include bath, kitchenette and living spaces will accommodate 208 students, each with individual bedrooms, the standard for graduate student housing. Walsh Brothers is the contractor for the building, which is expected to take 18 months to complete.

Click below to see earlier updates on the student residence construction.

Student Residence May Update

May 12th, 2011 in Featured

Significant progress has been made at the new student residence on Albany Street. Many phases of the construction are now nearing completion including:

  • First and second floor slabs – completed!
  • Steel framing – complete by May 13!
  • Crane work – complete by May 13!

    Student residence - last week of crane on site. (May 10, 2011)

    Student residence - last week of crane on site. (May 10, 2011)

Close up of steel frame. (May 10, 2011)

Close up of steel frame. (May 10, 2011)

The steel framers are onsite and their work should be completed by the end of the week. This is the last week to see the crane onsite, as it should come down on Friday. The third and fourth floor slab work are scheduled for this week. Top frame tracking in the basement and the first floor has begun. It is anticipated that backfilling will be complete by May 20.

Up to this point all work has been contained on the site of the residence. Beginning June 1 Albany Street road work will begin.

The nine-story, $40 million structure is designed by Beacon Architectural Associates with a brick and limestone façade. Its 104 two-bedroom suites that include bath, kitchenette and living spaces will accommodate 208 students, each with individual bedrooms, the standard for graduate student housing. Walsh Brothers is the contractor for the building, which is expected to take 18 months to complete.

Click below to see earlier updates on the student residence construction.

Student Residence Update: First Floor Steel Work Complete! Slab Work to Begin!

April 21st, 2011 in Featured

Despite the rainy weather of April, progress at the student residence at 815 Albany Street on the Boston University Medical Campus (BUMC) continues.

April 20, 2011

Slightly rainy view of steel. (April 20, 2011)

The first floor steel work that began on April 11 will be completed by April 22. In addition, both the first and second floor slab work is expected to begin the week of April 25.  If weather permits, a floor slab will be poured every four days.

April 20, 2011

Steel on a clear afternoon. (April 20, 2011)

The nine-story, $40 million structure is designed by Beacon Architectural Associates with a brick and limestone façade. Its 104 two-bedroom suites that include bath, kitchenette and living spaces will accommodate 208 students, each with individual bedrooms, the standard for graduate student housing. Walsh Brothers is the contractor for the building, which is expected to take 18 months to complete.

Click below to read other student residence stories

Early April update

Late March story

Feb/March progress

Mid January update

Ground breaking event