NIH Featured Story: Gene F. Kwan, MD, MPH
Better heart health through education: Q&A with Gene F. Kwan, MD, MPH
March/April 2024 | Volume 23 Number 2
Dr. Gene F. Kwan, a cardiologist and global health researcher, is an assistant professor at Boston University’s Chobanian & Avedisian School of Medicine. Since 2008 he’s worked in rural Rwanda and Haiti collaborating with each country’s ministry of health as well as with the organizations Partners In Health and Zanmi Lasante. He’s worked on projects in Malawi, Liberia, and India. He’s presented research and featured as a speaker at several American Heart Association conferences. He serves as a non-communicable diseases advisor for Partners In Health and is co-author of “The Partners In Health Guide to Chronic Care Integration for Endemic Non-Communicable Diseases.”
Why did you choose medicine and public health?
Being a doctor started with wanting to help people on an individual level—my mother was a nurse and I saw how important it was for her to make that contribution to other people's lives. I didn't really think about public health until I was in medical school and had experiences in other countries. Then I was able to see firsthand how medical care was delivered and, more specifically, how medical training was executed. It made me feel very fortunate for the education I had. I saw there weren’t the same opportunities for people in other parts of the world—or other parts of the country—just by virtue of the randomness of where people are born. There's inequity there. Through my work and research, I want to improve access to care not only by helping patients but also by helping providers.
What’s special about Partners In Health?
A lot of it is said in the first word of the name—"partners.” They very much collaborate with other organizations, other people, and even policymakers to help them and to understand what barriers and challenges they're facing. Partners In Health also has a tremendous interest in research and scientific discovery. Through its collaborations, it has tried to build the research skills of the clinicians and the health administrators. Partners In Health has even addressed social barriers that impact health, for example, by teaching people how to become carpenters or help with agricultural and improve farm yields. The organization focuses on rural areas of the countries in which it works. Such areas lend themselves to innovative ideas about improving access to care for patients who are most in need.
Did you work with Paul Farmer?
One of the last things he told me was “Don't forget Haiti.” Haiti is a very challenging place, particularly now, and it's easy to get disheartened about lack of progress or false starts or the barriers. But there are patients there who need help. There are providers and other partners there who are going above and beyond every day to make sure that patients get the care they need. We need to continue to collaborate in places where it’s difficult.
Tell us about your NIH-funded projects.
Oftentimes, as we've seen in Haiti as well as in Rwanda, there are a lot of patients admitted to the hospital with heart failure because the quality of care they initially received was limited. Some of that is due to the training and education of the clinicians… but in other cases, it’s because patients themselves face barriers.
My study funded by the National Heart, Lung, and Blood Institute (NHLBI), Identifying facilitators and barriers to heart failure care in Haiti to adapt a community-based intervention, aimed to understand the barriers patients face. Many patients were not returning to the clinic after a first diagnosis with heart failure, so we wanted to understand why and how we might change that. Patients take two days off from work, walk to a far-away clinic, wait in a really crowded waiting room, and then they get to see a clinician for 10 minutes. That whole experience can be disheartening! Partners In Health designed robust community health worker interventions and networks to improve care for patients. We've also been able to deliver education to patients, so they understand heart failure and how this chronic condition requires continuous medication to keep the symptoms controlled.
Our Fogarty-funded study, Simulator-Based simplified Focused Cardiac Ultrasound (sFoCUS) Training in Haiti, used simulators to train for cardiac ultrasound. There are about 10-15 cardiologists in all of Haiti, a country of 10 million people, and a lot (if not all) of them are working in the capital. So our resident trainees in the rural areas just don't have access to the same kind of cardiology training. There are simulators (mannequins) that help trainees learn the skill of obtaining and interpreting cardiac ultrasound images. Our program implemented this simulator training in rural areas. Keep in mind we applied for this before COVID, so our work was very timely!
Why do you emphasize implementation science?
In global health, a lot of the science is taking evidence that works in other contexts and trying to implement it in a new context with its unique barriers, constraints, challenges, and awareness levels. Implementation science helps us understand how to overcome all of these. A particular context may help an intervention be successful, so we need to understand contextual factors that create success. If you're going to disseminate or scale up in other places, you need to understand what inputs would be needed to be able to get things to work. Without studying the implementation of these interventions, a successful intervention can fail in a new context. There's a whole other science to understanding how to get interventions to the 95% of the world where it's particularly challenging.
What is important for other global health researchers to know?
One of my main messages to mentees is “be a very good listener first and foremost.” We need to listen to what our collaborators on the ground are telling us and often they also know what the solutions are. A researcher’s role is to help implement possible solutions and then study whether they're successful or not. My number two lesson for mentees is “be invited back.” You're not going to have long-term collaborations if you're not invited back! A lot of that boils down to being a good partner as opposed to coming in with preconceived ideas of what may or may not work. So always listen… and be invited back.
Global health is hard by nature and research is also very hard—putting those two together is extremely challenging so it takes grit and determination and resilience. There'll be many setbacks along the way. If you keep in mind that people throughout the world aren't getting the care they need and you can make some contribution to that—if you keep that as your long-term goal—it will help you get through the setbacks.
DoM Faculty Appointments and Promotions – May 2024
Congratulations to the following Chobanian & Avedisian School of Medicine faculty on their recent appointment or promotion.
Associate Professor
Christopher Heaphy, PhD, Medicine/Hematology & Medical Oncology, focuses on cancer biomarker discovery and validation with the aim to utilize novel tissue-based biomarkers to improve individualized prevention, detection and treatment strategies. In particular, he specializes in abnormal telomere biology as it relates to cancer initiation and tumor progression. His seminal study published in Science demonstrated the association between inactivating somatic mutations in two chromatin remodeling genes, ATRX and DAXX, and the activation of the Alternative Lengthening of Telomeres (ALT) phenotype, a telomerase-independent telomere maintenance mechanism. His laboratory also is working to elucidate the underlying mechanisms of cancer initiation and progression, as well as to understand how the interactions between the cancer and its tissue microenvironment may facilitate this process.
Zoe Weinstein, MD, MS, Medicine/GIM, specializes in two models of addiction care: Office Based Addiction Treatment (OBAT) and Addiction Consult Services. Her retrospective study of Boston Medical Center’s (BMC) OBAT program resulted in one of the largest and longest evaluations of treatment duration for patients on buprenorphine, which now has been cited 180 times. She currently is conducting a mixed methods prospective cohort study on the impact of COVID-19 on BMC’s OBAT population and has been invited to be first author on a manuscript, in development, on a NIDA clinical trials study on predictors of retention in addiction treatment. Dr. Weinstein helped establish and grow one of the leading Addiction Consult Services in the U.S., which serves as a national model, attracting trainees as well as attendings from around the country to learn from its work. From 2019-23 she served on the board of directors for the Association for Multidisciplinary Education and Research in Substance Use and Addiction, the leading national interdisciplinary organization in the field of addiction.
Clinical Associate Professor
Sohera Syeda, MD, Medicine/Pulmonology, Allergy, Sleep & Critical Care Medicine, specializes in COPD readmission prevention. Based at VA Boston Healthcare, she created the VA Boston COPD readmission reduction program. She is director of the pulmonary diseases module of the medical student PISCEs course, associate director of the pulmonary, sleep and critical care fellowship program and VA site director for the pulmonary and critical care medicine fellowship. In addition, Dr. Syeda is director of VA Boston’s Coordinated Care and Case Management Program for High-Risk Veterans with Heart Failure and Chronic Obstructive Pulmonary Disease and director of VA Bedford’s Enclave Pulmonary Clinic.
2024 DoM Evans Days Abstract Submission is Open!
Nominate A Staff Member for a DoM Annual Staff Award – Deadline June 10, 2024!
Submissions are now open through June 10th for our two Annual DOM Staff Awards! See details and links to submit below.
The David "Aaron" Freed Compassion & Excellence Award
Nomination Criteria
Nominee should be a non-faculty member of the Department of Medicine for at least one year who demonstrates the following qualities:
- Dedication to the community
- Selflessness
- Dependability
- Compassion
- Goes above & beyond expectations (outside of their job description)
Please be prepared to provide specific examples of your nominee for each of these categories as well as their overall impact on the DOM Community.
The Maria Antoinette Evans Staff Diversity Award
Nomination Criteria
Nominee should be a non-faculty member of the Department of Medicine for at least a year who exemplifies the following qualities:
- Models inclusive behavior
- Commitment to educating peers in DEIA topics
- Mentoring
- Creates, initiates or support DEIA program development
- Goes above and beyond (outside of their job description)
Please be prepared to provide specific examples of your nominee for each of these categories as well as their overall impact on the DOM Community.
Deadline for submissions is June 10, 2024.
Hollis D. Day, MD, MS, MHPE, Delivers Distinguished Professor in Geriatrics Keynote Lecture
Hollis D. Day, MD, MS, MHPE, associate professor of medicine, delivered the Distinguished Professor in Geriatrics (DPG) keynote lecture at the annual Society of General Internal Medicine (SGIM) meeting held recently in Boston. Day, who also is chief of geriatrics at Boston Medical Center (BMC), discussed the future of geriatrics and if it is a dying specialty. Her answer was an emphatic no. She proposed ways for geriatricians and general internists to become more actively engaged in the research, education and clinical care of the older adult.
Invited professors are general internists and/or geriatricians with nationally recognized expertise in education, research, and/or clinical care related to the care of older adults. The DPG program facilitates career development of SGIM members in academic fields directly related to older patients.
Day recently was accepted into the premier leadership program for women in academic health sciences in the country, the Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) program. Established in 1995, ELAM offers an intensive one-year fellowship of leadership training with extensive coaching, networking and mentoring opportunities aimed at expanding the national pool of qualified women candidates for leadership in academic medicine, dentistry, public health and pharmacy.
Day’s research interests include integrating geriatrics into the internal medicine curriculum at the student, resident and faculty development level; interdisciplinary team teaching; and inter-professional communication. Her clinical focus areas include dementia and delirium in geriatric patients and cognitive assessment in the primary care geriatric setting.
She is a member of the American Geriatrics Society, the Society of General Internal Medicine, and the American College of Physicians.
Day earned a bachelor’s degree in English from Johns Hopkins University, a master’s degree in anatomy from the University of Maryland and medical degree from the Medical College of Virginia. She also completed a master’s degree in health professions education from the University of Illinois, Chicago. She completed her residency in internal medicine at the University of Pittsburgh Medical Center and fellowships in general internal medicine and geriatrics at the Hospital of the University of Pennsylvania.
She came to BU/BMC from the University of Pittsburgh Medical Center (UPMC) where she specialized in geriatrics, and the University of Pittsburgh School of Medicine (UPSM) where she was advisory dean, associate professor of medicine and the medical director of the Advanced Clinical Education Center. While in Pittsburgh, she led the efforts to integrate geriatrics throughout the medical school curriculum at UPSM and was a Founding Program Director for the geriatrics track in UPMC’s internal medicine residency program.
The Society of General Internal Medicine (SGIM) is a global association of over 3,300 leading academic general internists dedicated to enhancing medical education, improving healthcare access, eliminating disparities, and advancing comprehensive, coordinated, and cost-effective care for adults through innovative education, research, and clinical practice.
DoM Faculty Appointments and Promotions – April 2024
Congratulations to the following Chobanian & Avedisian School of Medicine faculty on their recent appointment or promotion!
Associate Professor
Maureen Dubreuil, MD, MSc, Medicine/Rheumatology, specializes in spondyloarthritis, including the pharmacoepidemiology of spondyloarthritis. Her work has shown protective effects of medications on disease outcomes and comorbidities. She recently led a national project to develop referral recommendations for adults who may have spondyloarthritis. She serves as director of research training for the section of rheumatology and as faculty for the rheumatology fellowship program.
S. Reza Jafarzadeh, DVM, MPVM, PhD, Medicine/Rheumatology, specializes in the development of novel Bayesian methods and the application of causal inference methods in rheumatic diseases, critical care and infectious diseases. He applies innovative statistical methods to solve challenging research questions and has established a national reputation in the development of Bayesian methods in the evaluation of diagnostic tests and prevalence estimation in the absence of a reference standard. He developed a novel Bayesian approach that was more accurate than the CDC’s method to estimate the prevalence of arthritis in the U.S.
Karen Antman Stepping Down as BU’s Medical School Dean and Medical Campus Provost
Karen Antman, who led two transformative decades for Boston University’s Chobanian & Avedisian School of Medicine as dean of the school and provost of the Medical Campus, has announced plans to step down from those roles and return to the faculty at the BU medical school as a professor of medicine when her successor is named.
Antman, a leading expert on breast cancer, mesotheliomas, and sarcomas, also presided over the construction of BU’s first medical student residence, throwing an affordable housing lifeline to students facing medical education bills. Antman oversaw the renaming of the medical school in 2022 following a staggering $100 million gift from alum and philanthropist Edward Avedisian (CFA’59,’61, Hon.’22). She has led the Medical Campus since 2005 and says the pending inauguration of a fellow physician, Melissa Gilliam, as the new University president helped prompt her to step down from the school’s leadership.
“A new president—an MD—should pick their own new dean for the medical school,” Antman says. She also wants to spend more time with her family. “I plan to take a sabbatical. After a real vacation, I plan to collaboratively write infrastructure grants,” for the medical school, she says.
Kenneth Freeman, BU president ad interim, says information about appointing her successor will be forthcoming in the next several months.
“Dr. Antman has been consistently committed to facilitating faculty and student research,” he adds. “Faculty members have particularly appreciated the establishment of the Proposal Development office, which assists faculty in writing grants.”
Robert A. Brown, BU president emeritus, who worked closely with Antman during his 18-year tenure, says Antman “has been a wonderful leader of our medical school, demonstrating time and again her unwavering commitment to our medical students and the quality of their education. Her work has been recognized nationally, and she leaves the school well positioned to excel.”
The Medical Campus provost oversees the South End complex, which includes the medical school, the Henry M. Goldman School of Dental Medicine, the School of Public Health, and the University’s collaborative role with Boston Medical Center, BU’s primary teaching hospital and New England’s largest safety net hospital. (BMC has also just named a new president.)
Antman sums up her institution-changing tenure as “construction, fundraising, and recruiting the right leadership for the campus and school.”
The $100 million gift from Avedisian, an investor and for four decades a clarinetist with the Boston Pops and the Boston Ballet Orchestra, was a capstone to Antman’s tenure. Avedisian had suggested that the school be renamed after his lifelong friend Aram Chobanian (Hon.’06)—cardiologist, BU president emeritus, and dean emeritus of the medical school and provost of the Medical Campus. Neither man wanted his name on the school until they were persuaded to allow it to be named after both of them.
The gift will enable $50 million for scholarships for medical students, $25 million to support endowed professorships, and $25 million to the Avedisian Fund for Excellence, supporting cutting-edge research and teaching.
Brown said of the medical residence, at its 2010 groundbreaking: “This facility will make the burden of a medical education a little bit lighter to carry.” In recent years, MDs have been among the five degrees that account for most student debt.
Financial management of the medical school and Medical Campus involved more than the renaming gift, especially during the first decade of Antman’s tenure, a time of flat budgets at one critical funding source, the National Institutes of Health. Antman says she nevertheless managed to recruit “outstanding, grant-funded faculty to new and renovated campus facilities, paid for by moving faculty to campus from off-campus rental space, thus decreasing costs and significantly increasing our research funding.”
She is proud, she says, of the “better prepared, more accomplished medical and graduate students” that the medical school has attracted during her tenure. “We are now the top choice for many, and turned down for only the most competitive medical schools.”
Antman led in opening more than 20 new research cores (shared research facilities) “to provide access to expensive, state-of-the-art equipment,” she says, including the $8 million Center for Biomedical Imaging and the $4 million Cryogenic Electron Microscopy (Cryo-EM) Core Facility, opening this summer with a state-of-the-art electron microscope. Antman also cites the establishment of an office to assist faculty with grant writing.
BU’s Chronic Traumatic Encephalopathy (CTE) Center, created on her watch in 2008, has garnered international recognition for its research into the debilitating effects of repeated head traumas, in athletes and military especially. The center says its bank of 1,250-plus donated brains for study is “the largest tissue repository in the world focused on traumatic brain injury and CTE.”
Beyond new facilities, Antman oversaw a revised, team-based MD curriculum that necessitated “substantial renovations of every floor,” in the Instructional Building, she says, “including a 250-seat testing center, a 6,000-square-foot Team-Based Learning Lab, and completely renovated library floors.”
Before her BU service, Antman was deputy director of translational and clinical sciences at the National Cancer Institute. She also has been on the faculties of Columbia University College of Physicians and Surgeons (where she earned her MD and codirected the cancer care service line at New York–Presbyterian Hospital) and of Harvard Medical School, from 1979 to 1993. At Harvard, she had hospital appointments at Brigham and Women’s Hospital and Dana-Farber Cancer Institute.
She has edited five textbooks and monographs, authored or coauthored more than 300 publications, and written reviews and editorials on such topics as medical education, medical policy, and the effect that research funding and managed care have on clinical research.
As dean, Antman was elected a member of the National Academy of Medicine, an advisory group to the federal government, and chaired the American Association of Medical College Council of Deans. She also served on the board of the Educational Commission for Foreign Medical Graduates.
DoM STARDoM May Awardee!
Join us in congratulating this month's STARDoM Awardee, Ve Troung!! Ve Truong is a Senior Research Manager in General Internal Medicine.
"Ve Truong truly is a STAR employee. Her SERVICE is consistently exceptional – from expertly managing the start-up, transition and implementation of an NIH clinical trial from one international setting (Russia) to another (Uganda) to organizing a four-day annual immersion training for 30 incoming medicine chief residents and other physicians on state-of-the-art methods to diagnose, manage, and teach about addiction medicine – she consistently delivers exceedingly high-quality work. Her approach is THOUGHTFUL and wise. She treats all colleagues and trainees with kindness. Through her ACTIONS and exemplary work, she has demonstrated her dedication to substance use research and education. Despite her full plate, she is always willing to jump in to assist on other projects. She takes ownership of each project and is able to effectively navigate and identify solutions to complex problems. She is extremely positive, proactive, efficient, reliable, on top of the details and incredibly hard-working. Given her professional ethic, she is widely regarded by her co-workers as a ROLE MODEL of excellence."
How many years have you been at BUSM/BMC?
10 years in August 2024
Describe your role within the Department of Medicine:
I manage two research studies in Ukraine and Uganda.
What do you like best about your job?
What I like best about my job is my team and the way we work together so collaboratively. We support each other, share knowledge freely, and always step up to help one another when needed.
Favorite thing to do outside of work?
Outside of work, I like watching shows, Youtube videos, play video games and during the spring and summer, I like to play pickleball.
Tony Hollenberg, MD, John Wade Professor and Chair of the Department of Medicine, has been appointed President of Boston Medical Center
As we continue to reimagine how we deliver expert and equitable care to our patients and members as a fully integrated health system, we are excited to share that the BMC Board of Directors has voted to appoint Anthony “Tony” Hollenberg, MD, as President of Boston Medical Center. Dr. Hollenberg was selected following an extensive national search and currently serves as Physician-in-Chief at Boston Medical Center and the John Wade Professor and Chair of the Department of Medicine at Boston University Chobanian & Avedisian School of Medicine. He will assume the role of hospital President on June 3.
Dr. Hollenberg’s deep leadership experience at academic medical centers, demonstrated experience as a highly accomplished physician-researcher, and longstanding commitment to clinical excellence and health equity make him an ideal leader to lead Boston Medical Center as we bolster our reputation as a premier academic medical center. In this role, Dr. Hollenberg will provide strategic leadership across our hospital to further our delivery against institutional goals, advance a culture of high-quality patient care, and elevate our research endeavors.
Throughout his time leading the Department of Medicine — the largest clinical department at BMC — Dr. Hollenberg has partnered with colleagues from across the organization to drive healthier outcomes for our patients and communities by incorporating advancements in cutting-edge clinical practices, including innovative CAR T-cell therapies for cancer and gene therapies for patients living with sickle cell disease. Additionally, he has supported novel research that addresses the unmet medical needs of our patients and the broader communities we serve. Prior to joining BMC and BU, Dr. Hollenberg was the Chair of the Joan and Sanford I. Weill Department of Medicine at Weill Cornell Medicine and Physician-in-Chief at NewYork-Presbyterian/Weill Cornell Medical Center in New York City. He also previously served as Chief of the Division of Endocrinology, Diabetes, and Metabolism and Vice Chair for Mentoring at Beth Israel Deaconess Medical Center and Professor of Medicine at Harvard Medical School.
As a specialist in endocrinology, Dr. Hollenberg’s clinical work focuses on thyroid disorders, and his research has centered on investigating the physiological and molecular mechanisms by which thyroid hormones regulate metabolism, including body weight, as well as thyroid gland development. He has published more than 100 original studies in journals and contributed more than 30 book chapters and reviews.
Dr. Hollenberg, a native of Toronto, received his bachelor’s degree from Harvard College and his medical degree from the University of Calgary. He completed his residency in Internal Medicine at Beth Israel Deaconess Medical Center, followed by a clinical and research fellowship at Massachusetts General Hospital.
Karen Antman, MD, BUMC Provost and Dean, BU Chobanian & Avedisian School of Medicine, and I are grateful to Dr. Hollenberg for advancing the Department of Medicine since 2022. Dr. Hollenberg joins Heather Thiltgen, President of WellSense Health Plan, and Nicole Faucher, President of Clearway Health, as a leader of our health system’s largest entities.
We will be launching a search for a Chief and Chair to continue to advance the Department of Medicine’s rich history of clinical innovation. We are pleased to share that Sushrut Waikar, MD, Chief of Nephrology, will serve in an interim capacity and be supported by Dr. Hollenberg. Please join us in thanking Dr. Waikar for stepping into an interim leadership role.
Please also join us in congratulating Dr. Hollenberg on his new role as hospital President.
DoM Nurse Receives Nurses Week Provider Partner of the Year Award
Congratulations to DoM's Dr. Christopher Huang for winning one of this year's Nurses Week Provider Partner of the Year Awards, given to providers who are great partners to us in caring for our patients here at BMC! Quotes from nomination letters are below.
"Dr. Huang is the first to recognize exceptional teamwork and its affect on both patient care and patient experience. He frequently sends out full staff emails thanking them for the unit's work that day and encouraging all nurses to connect with him if they have ideas, suggestions, or concerns over anything.
Dr. Huang is inspiring in his perpetual friendly, constant, and can-do outlook on even the most pressing projects. He constantly contributes to collaborative problem solving for all elements of his practice. He is quick to volunteer to call a patient, nurse, or anesthesia provider to make the day run as smoothly as possible.
Dr. Huang has worked tirelessly, via a strong collaboration with administration and nursing leadership, to increase patient access to colorectal cancer screenings. He has continuously interfaced with clinic staff, his fellow endoscopists, and the GI charge nurses to make available the maximum amount of GI screenings possible to make progress on the backlog present since COVID closed many similar units. Dr. Huang utilizes his excellent communication skills to add patients, shuffle attending schedules, and give patients an excellent BMC experience."