In recent decades, the United States has seen a dramatic increase in opioid prescribing for chronic pain. That growth has been associated with increasing misuse of these medications, leading to alarming increases in unintentional opioid overdose deaths.
In a perspective in this week’s New England Journal of Medicine, Daniel Alford, MD, MPH, associate professor of medicine and assistant dean of Continuing Medical Education and director of the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) program at Boston University School of Medicine (BUSM), recommends that prescriber education is the best approach to addressing the prescription opioid-misuse epidemic, allowing for individualized care on the basis of a patient’s needs after a careful benefit–risk assessment.
According to Alford, a key problem is that clinician education around pain management and safe opioid prescribing has been lacking. As opposed to blunt regulatory solutions that decrease access to opioids in an indiscriminant way, education is a more finely tuned approach that can empower clinicians to make appropriate, well-informed treatment decisions for every patient at each clinical encounter. “Education has the potential to both reduce overprescribing and ensure that patients in need retain access to opioids,” explained Alford, who is also medical director of Boston Medical Center’s Office-based Opioid Treatment (OBOT) program.
Alford points out clinicians have limited tools at their disposal to help patients with severe chronic pain and the reimbursement system favors the use of medications alone, despite evidence supporting multimodal pain management. Moreover, whereas clinicians can use objective measures to guide their management of other chronic diseases, here they must rely solely on the patient’s (or family’s) reports of benefits (such as improved function) and harms (such as loss of control).
Alford believes voluntary prescriber education may be insufficient to address this problem and that mandatory education may be required. “If so, it will be important to link mandated education to medical licensure to avoid having clinicians opt out — since that could lead to reduced treatment access, as well as burnout among the clinicians who opt in,” he added.
Alford believes that the medical profession is compassionate enough and bright enough to learn how to prescribe opioids, when they are indicated, in ways that maximize benefit and minimize harm. “Though managing chronic pain is complicated and time consuming and carries risk, we owe it to our patients to ensure access to comprehensive pain management, including the medically appropriate use of opioids.”
Leading expert on health consequences of mass trauma, conflict
SPH Dean Sandro Galea has studied the health impacts of the trauma of the September 11 attacks, Hurricane Katrina, conflicts in sub-Saharan Africa, and combat in Iraq and Afghanistan. Photo by Dan Aguirre
Sandro Galea, dean of the School of Public Health, has been appointed Boston University’s Robert A. Knox Professor. The professorship supports a BU faculty member who demonstrates excellence in scholarship, research, and teaching, as well as impact on society.
“Professor Galea’s energetic leadership and foundational research in the health of urban populations are sparking important new conversations and producing tangible results in communities across the globe,” says Jean Morrison, University provost and chief academic officer. “His work exemplifies the impactful, multidisciplinary approach at the core of this distinguished professorship.”
Galea says he is honored by the professorship. “I am thrilled that this professorship joins other endowed professorships held by scholars who are part of our school community,” he says.
Galea’s current research interests focus on the social production of health in urban populations. He examines the causes of brain disorders, particularly common mood-anxiety disorders and substance abuse. He is also a leading expert on the health consequences of mass trauma and conflict, and has studied the health impacts of the September 11 attacks, Hurricane Katrina, conflicts in sub-Saharan Africa, and combat in Iraq and Afghanistan. His most recent book, Population Health Science, coauthored with Katherine Keyes, is forthcoming from Oxford University Press.
His work has been supported by the National Institutes of Health, the Centers for Disease Control and Prevention, and several foundations, including the Robert Wood Johnson Foundation, which gave him a 2006 Investigator Award in Health Policy Research. He is an elected member of the National Academy of Medicine and of the American Epidemiological Society.
The second faculty member to receive the professorship, Galea is also the second from SPH. The previous Robert A. Knox Professor was Jonathon Simon, former director of the BU Center for Global Health & Development.
The Robert A. Knox Professorship was established through a 2012 $2.5 million gift from the Robert and Jeanne Knox Foundation, a philanthropic entity cofounded by Robert Knox (CAS’74, Questrom’75), chair of the BU Board of Trustees, and his wife, Jeanne, who heads the BU Parents Leadership Council.
This BU Today story was written by Michelle Samuels.
MLK & Kazi Nazrul Islam: The Spirit of Inclusion
Wednesday, Jan. 20, Noon-1 p.m., Hiebert Lounge
Open to Medical Campus students, faculty and staff
Refreshments will be provided.
Winston E. Langley
Provost and Vice Chancellor for Academic Affairs
Professor of Political Science and International Relations
University of Massachusetts Boston
Kazi Nazrul Islam is the national poet of Bangladesh. His writings explore themes such as love and freedom. He opposed all bigotry and assailed fanaticism in religion. Many of his works were devoted to the principle of human equality, vigorously assaulting religious extremism and the mistreatment of women, provoking condemnation from Muslim and Hindu fundamentalists.
Professor Langley is the author of “Kazi Nazrul Islam: The Voice of Poetry and the Struggle for Human Wholeness.” He is considered the first Western scholar to study Nazrul and will explore features of the poet’s thinking with that of Martin Luther King, Jr.
This event is brought to you by BUSM Office of Diversity and Multicultural Affairs in collaboration with the BMC Events Committee, Henry M. Goldman School of Dental Medicine Office of Diversity, BU School of Public Health and the BMC Minority Recruitment Program.
Students, faculty and staff are invited to
“Medical Ethics in the Shadow of the Holocaust: The Nazi Doctors, Racial Hygiene, Murder and Genocide”
Wednesday, Jan. 20
BUSM Instructional Building, L109 A/B
This talk is being given in memory of Robert Berger, MD, BUSM ’56, Distinguished Alumni Award recipient 1982, former Chief of Cardiac Surgery at BUSM and Director of Cardiovascular Research at Beth Israel Deaconess Medical Center. Dr. Berger was a holocaust survivor who analyzed the science behind the hypothermia experiments that took place in a Nazi concentration camp during World War II. His paper, which was published in the May 1990 issue of The New England Journal of Medicine, found that the methods used by Nazi researchers were unsound, their approach erratic, the resulting reports “riddled with inconsistencies.” Dr. Berger found evidence of data falsification and suggestions of fabrication.
Michael A. Grodin, MD
Professor of Psychiatry; Family Medicine; Health Law, Bioethics and Human Rights, Boston University
Co-director, Joint Project in Jewish Legal Bioethics of the Institute of Jewish Law
Professor, Jewish Studies, Elie Wiesel Center for Jewish Studies
Director, Project on Ethics and the Holocaust
An internationally recognized expert on the Holocaust, Grodin received a special citation from the United States Holocaust Memorial Museum in recognition of his “profound contributions – through original and creative research – to the cause of Holocaust education and remembrance.” Grodin was the 2000 Julius Silberger Scholar studying Holocaust Survivors and was granted the 2014 Kravitz Humanitarian award of the Psychoanalytic Institute. He has delivered more than 400 invited national and international addresses, written more than 200 scholarly papers, and edited or co-edited seven books including ” Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation” and “Jewish Medical Resistance in the Holocaust.” He has just completed a first draft of a new book “Jewish Spiritual Resistance in the Ghettos During the Holocaust.”
This presentation is sponsored by three student groups: the Maimonides Society, the BUSM Student Historical Society and the Student Internal Medicine Group.
Life is full of challenges. While we often have no choice over the challenges we encounter, we do have some control over how we respond. BUMC faculty and staff are invited to a free wellness workshop, Tuesday, Nov. 17. (Register at firstname.lastname@example.org)
This presentation will focus on cultivating psychological resilience – the ability to cope effectively with crises and bounce back quickly from setbacks.
In this interactive workshop participants will:
- Explore the concepts of resilience and of mindfulness and the ways in which mindfulness boosts resilience
- Sample mindfulness practices including mindful eating, meditation, and mindful stretching
- Learn about other simple activities demonstrated to boost resilience
- Identify free resources available for use in cultivating mindfulness and resilience
Nov. 17 Resilience and Mindfulness Workshop
Tuesday, Nov. 17
BUSM Instructional Building, Room L209
Please register at email@example.com.
Boston University Henry M. Goldman School of Dental Medicine (GSDM) hosted students and faculty from three Schools of Stomatology in China this summer, during three separate 14-day visits. The visits were part of an ongoing Global Externship Exchange with three Chinese institutions that began in October 2013. The exchange allows fourth-year DMD students to spend three weeks—guided by a GSDM faculty member—at three Chinese dental schools, gaining clinical and cultural experience as well as course credit. The exchange also allows for students and faculty from the Chinese schools to visit GSDM. These corresponding visits have been taking place each year since 2013.
Dean Jeffrey W. Hutter and Dr. Laisheng Chou with Dr. Yumei Zhang, Dr. Jing Gao, and Dr. Lingzhou Zhao from FMMUSS
The three groups of Chinese students and faculty that visited GSDM this summer were from Shanghai Jiaotong University School of Stomatology (SJUSS), Peking University School of Stomatology (PKUSS) and the Fourth Military Medical University School of Stomatology (FMMUSS). The visitors were each in Boston for 14 days this summer, touring GSDM and the city of Boston while observation all of GSDM’s academic and clinical programs, as well as the school’s other various scholarly and research activities.
The Chinese visitors participating in this cultural exchange program all specialize in postdoctoral programs, and many of the visiting Chinese students had specific interest in rotations of GSDM’s postdoctoral clinic such as Orthodontics, Endodontics, Periodontology, Prosthodontics, Oral Surgery and Pediatric Dentistry. Therefore, each 14-day schedule was tailored to the interests of the visitors.
Visiting first, from June 25 to July 7, were Dr. Ming Cai, Ying Chen (student), and ZhouXi Ye (student) from SJUSS in Shanghai.
Visiting second, from July 8 to July 19, were Dr. Yumei Zhang, Dr. Jing Gao, and Dr. Lingzhou Zhao from FMMUSS in Xi’an.
Visiting third, from August 24 to September 3, were Meili Dong, Keang Fan (student), Donghao Wei (student), and Jihao Zhang (student) from PKUSS in Beijing.
“I am delighted to see that this important cultural and academic exchange between GSDM and our partner institutions continues to be both immensely beneficial as well as enjoyable for everyone involved” said Dean Jeffrey W. Hutter. “It was a pleasure to get to know all of the visitors from SJUSS, FMMUSS, and PKUSS during their visits.”
The exchange program is overseen by GSDM’s Office of Global & Population Health. Dr. Laisheng Chou, Professor and Director of Oral Medicine and Professor of Biomaterials, and Consultant to the Dean on Far Easter Programs serves as the Program Director.
The exchange program started with SJUSS and FMMUSS in 2013 and expanded quickly to include PKUSS in 2014. In 2015, the program continues to grow. Both Tokyo Medical and Dental University in Tokyo, Japan, and Chulalongkorn University Faculty of Dentistry, in Bangkok, Thailand were recently added to the exchange program, with students from GSDM visiting those schools in September 2015, and students from the respective schools set to visit GSDM in the summer of 2016.
This means that visiting international students—from five schools—will be on GSDM’s campus for a combined length of nearly two months in the summer of 2016. At the same time, GSDM will continue to send its fourth year DMD students to five dental schools in Beijing, Shanghai, Xi’an, Tokyo and Bangkok for their global externship program.
The rapidly growing program is incredibly beneficial to GSDM students. The students who are selected to participate—only eight students can be selected into the program each year from a very competitive pool of applicants—receive fantastic exposure to the workings of international dental schools while also experiencing different cultures.
“The quantity and variety of the cases our students are exposed to at the dental schools in China, Japan and Thailand are remarkable,” said Dr. Chou. “It would certainly be unlikely for the students to experience the same type of cases in their short four-year DMD program in the United States.”
The schedules of the 14-day visits for this year’s incoming visitors from SJUSS, PKUSS and FMMUSS were jam-packed with events and activities designed to fully expose the Chinese faculty and students to the workings of GSDM, and help them explore any curiosities they may have about GSDM’s programs.
Each visit included a special dinner at Dean Hutter’s home, at which Dean Hutter personally welcomed the scholars and students from China to Boston, and thanked them for their continued support of the exchange program.
The Saturday and Sunday of each visit was reserved for sightseeing around Boston and the greater Boston area. DMD students were tasks with touring the Chinese visitors around the city. The DMD students who took part in these city tours were: Wenyu Qu DMD 17, Annie Xiaomeng DMD 17, Sen Wang DMD 17, Nic Branshaw DMD 16, Mohamed Bayoumy DMD 16, Kayla Cuddy DMD 16.
While the weekends of each of the visits this year were filled with laid-back, fun activities, the weekdays were packed tight with presentations and events designed to showcase GSDM to the Chinese visitors. Each group of Chinese scholars and students was given a tour of GSDM and the Medical Campus before immersing in their dense schedule of presentations and other activities.
The visitors were also able to observe GSDM’s Grand Rounds presentations and enjoy a lunch with the Boston University Asian Dental Student Organization (ADSO).
Faculty members participating in the SJUSS visit (faculty previously mentioned in this article will not have titles in the following list):
- Assistant Professor in the Department of Oral & Maxillofacial Surgery Hussam Batal
- Clinical Associate Professor in the Department of General Dentistry, Assistant Dean of Students, and Director of Geriatric Dental Medicine Joseph Calabrese
- Laisheng Chou
- Professor in the Department of Health Policy & Health Services Research and Associate Dean for Global & Population Health Michelle Henshaw
- Assistant Professor in the Department of Oral & Maxillofacial Surgery and Director of the Preliminary Internship Program Timothy Osborn
- Clinical Associate Professor in the Department of Periodontology Dr. Mingfang Su
Faculty members participating in the FMMUSS visit (faculty previously mentioned in this article will not have titles in the following list):
- Clinical Associate Professor in the Department of Restorative Sciences & Biomaterials and Clinical Director of the Advanced Specialty Education Program in Prosthodontics Alexander Bendayan
- Clinical Associate Professor in the Department of Oral & Maxillofacial Surgery Ishwar Bhatia
- Clinical Assistant Professor in the Department of Oral & Maxillofacial Surgery and Director of Credentialing at Boston Medical Center Steven J. Bookless
- Laisheng Chou
- Associate Dean for Clinical Affairs and Clinical Professor in the Department of General Dentistry John Guarente
- Michelle Henshaw
- Clinical Instructor in the Department of General Dentistry Eric Mandelbaum
- Assistant Professor in the Department of Endodontics Ramzi Sarkis
Faculty members participating in the PKUSS visit (faculty previously mentioned in this article will not have titles in the following list):
- Assistant Professor in the Department of Oral & Maxillofacial Surgery and Director of Faculty Practice Clinical Services Hussam Batal
- Assistant Professor in the Department of General Dentistry Louis Brown
- Joseph Calabrese
- Associate Professor and Director of Research in the Department of Oral & Maxillofacial Surgery Radhika Chigurupati
- Laisheng Chou
- Clinical Professor and Director of Pre-doctoral Education in the Department of Oral & Maxillofacial Surgery and Vice Chairman of Dentistry and Oral & Maxillofacial Surgery at Boston Medical Center Richard D’Innocenzo
- Clinical Assistant Professor in the Department of General Dentistry and Clinical Assistant Professor in the Department of Orthodontics & Dentofacial Orthopedics Yael Frydman
- Professor of Oral and Maxillofacial Pathology and Head of the Division of Oral and Maxillofacial Pathology George Gallagher
- John Guarente
- Associate Professor in the Department of Restorative Sciences & Biomaterials Russell A. Giordano
- Michelle Henshaw
- Clinical Assistant Professor in the Department of Restorative Sciences & Biomaterials Ali Khiblil
- Professor in the Department of Molecular & Cell Biology and Associate Dean for Research Maria A. Kukuruzinska
- Eric Mandelbaum
- Professor in the Department of General Dentistry Carl McManama
- Professor and Chair of the Department of Oral & Maxillofacial Surgery and Associate Dean for Hospital Affairs Pushkar Mehra
- Clinical Professor in the Department of General Dentistry and Director of the Division of Pre-doctoral Removable Prosthodontics Ronni Schnell
- Clinical Assistant Professor in the Department of Oral & Maxillofacial Surgery and Director of Quality Assurance and Ambulatory Operations at Boston Medical Center Bradford Towne
Other GSDM community members participating in the PKUSS visit:
- Advanced Education in General Dentistry (AEGD) Resident Gaby Bonilla
- Advanced Education in General Dentistry (AEGD) Resident Natalia Lopez
Photos from the visits from SJUSS, FMMUSS and PKUSS visits can be found on Facebook and Flickr.
Submitted by GSDM Communications.
Gratitude, excitement and anticipation – these three words describe the 2015 BUSM Scholarship Dinner on Thursday, Sept. 24.
In a candle-lit room at the Hotel Commonwealth in Boston, 18 medical students gathered together to meet – for the first time – their scholarship donors.
Dean Antman with students Adam Johnson (Class of 2017) and Karanda Bowman (Class of 2016)
“Today is really important,” said Nick Smith, BUSM Class of 2016. “Getting to meet the face behind who’s doing this for me – it’s really special.”
To his surprise, Smith’s donor was Aram Chobanian, MD, President Emeritus, Boston University and Dean Emeritus of the School of Medicine.
“It’s terrific,” said Smith. “The weight that I’ll have in terms of debt going forward is that much less. Every little bit counts.”
Thanks to scholarships established by generous donors, every year students who otherwise could not afford a BUSM education can pursue their dream of becoming a physician.
According to Emir Morais, co-interim director of BUSM’s Student Financial Services, the cost of medical education presents a high barrier for many applicants – and a significant burden for many graduates. In fact, the Association of American Medical Colleges reports that 79 percent of medical students have debt of $100,000 or more after medical school.
“Scholarships help relieve some of the financial burden put on these students during and after their medical education,” said Morais. “These funds support their education and their intellectual, professional and personal development. It gives them the opportunity to attend a medical school that fits their passions and a chance to choose a field they care about.”
Over dinner and dessert, the students and donors were greeted by Dean Karen Antman, MD, who introduced Karanda Bowman, Class of 2016, and Adam Johnson, Class of 2017. Both students spoke about how their scholarships were a critical component in attending medical school.
“You haven’t just given me a gift,” said Johnson. “You’ve given my family a little more hope that everything really will be alright.”
As the students parted ways with their donors, handshakes and hugs were exchanged. Pleasantries and advice about medical school filled the room. But as this writer will attest, two common, contagious sentiments elevated this event – honor and gratefulness.
“We have to give kids the opportunity to be able to go to medical school without worrying about huge debts,” said Elaine Kirshenbaum, a BU donor since 1983. “It’s an honor to be able to support them.”
View the Facebook album.
Students find a welcome, but want a few changes
Students seated during the 2015 Professional Ceremony
Four-year DMD 19 and two-year AS DMD 17 students from Boston University Henry M. Goldman School of Dental Medicine (GSDM) marked the end of their first week of orientation on Friday, July 31, at one of the most significant events in the educational careers of our dental students, the annual Professional Ceremony.
The students marched into the ceremony grounds, the Talbot Green, and took their seats under a large white tent. Hundreds of friends and family members looked on and cheered as the DMD 19 and AS 17 students participated in the 2015 Professional Ceremony.
Assistant Dean of Students Dr. Joseph Calabrese welcomed the crowd under the packed tent.
Dean Jeffrey W. Hutter as well as Boston University Medical Campus Provost and Boston University School of Medicine Dean Dr. Karen Antman delivered the opening remarks, while student anxiously anticipated receiving their BU pins.
The Keynote Address was delivered by Professor in General Dentistry Dr. Carl McManama. Dr. McManama began his now 39 year dental career at GSDM as a Clinical Instructor in the Department of Operative Dentistry in 1976. He was later promoted to Clinical Assistant Professor, Associate Professor, and Professor. He Chaired the Department of Operative Dentistry from 1986 to 1995.
After Dr. McManama’s speech, Assistant Dean for Admissions and Associate Professor in Health Policy & Health Services Research Catherine Sarkis took to the podium to present the DMD Class of 2019 and AS Class of 2017 to Dean Hutter.
Five faculty members then stood on the stage to present the pins to the DMD 19 and AS 17 students. The faculty members were: Dr. Calabrese; Dr. Sarkis; Associate Professor in the Department of General Dentistry Dr. Stephen Dulong; Professor in the Department of Periodontology, Associate Dean for Academic Affairs, and Professor in the Department of Molecular & Cell Biology Dr. Cataldo Leone; and Clinical Professor in the Department of General Dentistry and Faculty Liaison for the Advanced Standing Program Dr. Janet Peters.
Each DMD 19 and AS 17 student shook hands with Dean Hutter and Provost Antman before exiting the stage. When each new student had received their pin, the Professional Oath was read.
One paragraph of the Professional Oath reads: “I will conduct myself with the highest ethical and professional behavior in the classroom, the clinic, and in all areas of my life. I will promote the integrity of the profession with honest and respectful relations with other health professionals. I will strive to advance my profession by seeking new knowledge and by reexamining the ideas and practices of the past.”
After Dean Hutter delivered his closing remarks, the students and attendees stayed for a reception under the tent for a reception on the Talbot Green.
“The Professional Ceremony is one of the most important moments in these students’ dental educations here at GSDM,” said Dean Hutter. “I know that each of the students who received pins today will go on to make me, and everyone else at GSDM, very proud over the next four years.”
Photos from the Professional Ceremony can be found on Facebook and Flickr.
Submitted by GSDM Communications.
A family of peregrine falcons have made a nest on a window ledge atop the Solomon Carter Fuller Mental Health Building. Photos by Anita DeStefano, PhD, professor of Biostatistics and associate director of the BUMC Genome Science Institute.
High above Talbot Green a pair of watchful eyes scopes the concrete canyon below looking for its next prey. This isn’t a scene from Mission Impossible. It’s more like a National Geographic documentary.
Perched on a window ledge atop the Solomon Carter Fuller Mental Health Building, two peregrine falcons have decided to make the BU Medical Campus their home.
“It’s simply fascinating that such beautiful wildlife can exist in this urban area,” said Anita DeStefano, PhD, professor of Biostatistics and associate director of the BUMC Genome Science Institute.
DeStefano noticed the male and female falcons in late spring and began taking pictures of the birds from the rooftop of the medical campus parking garage. In early summer, she observed two falcon chicks in addition to the adults. After reading a recent article on BU Today about another pair of falcons on the Charles River campus, DeStefano contacted Ursula and Dave Goodine, certified volunteer observers for Massachusetts Division of Fisheries and Wildlife.
That evening, DeStefano met with the Goodines to point out the nest site and to observe the adults with one of their fledglings.
According to Ursula Goodine, peregrine falcons are the fastest flying birds in the world – reaching speeds of 200 miles per hour during a dive. They feed on pigeons and other small birds.
In 1964 nesting pairs of Peregrines were extinct in the eastern United States, but over time, conservation success was responsible for changing them from “endangered” to “protected” status. There are now more than 30 nesting pairs in Massachusetts.
Contrary to popular belief, peregrine falcons do not build a nest. They lay their eggs on cliffs.
“As the falcon population increased, some birds looked for other territories and began using tall buildings instead of the natural landscape of cliffs and quarry ledges to raise their young,” said Goodine. “This just reveals how adaptable peregrines have become in order to perpetuate their species.”
In an effort to help facilitate a safer environment for the birds, experts from the MassWildlife Natural Heritage and Endangered Species program have set up simple wooden “nest-boxes” lined with gravel in several locations throughout the city.
The Goodines now are working on a plan to have one installed on the BU Medical Campus this fall to give the birds time to acclimate to its presence. They hope the pair of falcons will use it next spring.
“Reintroduction programs have helped Peregrines make an amazing recovery,” said Goodine. “While city living poses all kinds of dangers to these birds, they are resilient and their population has rebounded quite well.”