NYU's Move To Make Medical School Free For All Gets Mixed Reviews
Not All Teaching Hospitals Alike in Training Quality for Doctors
3-D Space Gives New Life to Dead Bodies
Medical Student Suicides Prompt Schools to Finally Take Action
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His public radio pieces have appeared on NPR, the World, Marketplace and the California Report.","avatar":"https://secure.gravatar.com/avatar/79417fe15fb540a8a1edb0aadefee19b?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["author"]},{"site":"science","roles":["author"]},{"site":"quest","roles":["editor"]}],"headData":{"title":"David Gorn | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/79417fe15fb540a8a1edb0aadefee19b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/79417fe15fb540a8a1edb0aadefee19b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/dgorn"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_444061":{"type":"posts","id":"futureofyou_444061","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444061","score":null,"sort":[1535144412000]},"guestAuthors":[],"slug":"nyus-move-to-make-medical-school-free-for-all-gets-mixed-reviews","title":"NYU's Move To Make Medical School Free For All Gets Mixed Reviews","publishDate":1535144412,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>New York University's School of Medicine is learning that no good deed goes unpunished.[contextly_sidebar id=\"NsiSrL9RDjMOi9nyPvNgRoT4Pxfwz6iJ\"]\u003c/p>\n\u003cp>The highly ranked medical school announced with much fanfare this month that it is raising $600 million from private donors to \u003ca href=\"https://www.npr.org/2018/08/17/639467023/nyu-medical-school-says-it-will-offer-free-tuition-to-all-students\" target=\"_blank\" rel=\"noopener\">eliminate tuition\u003c/a> for all its students — even providing refunds to those currently enrolled. Before the announcement, annual tuition at the school was $55,018.\u003c/p>\n\u003cp>NYU leaders hope the move will help address the increasing problem of student debt among young doctors, which many educators argue pushes students to enter higher-paying specialties instead of primary care, and deters some from becoming doctors in the first place.\u003c/p>\n\u003cp>\"A population as diverse as ours is best served by doctors from all walks of life, we believe, and aspiring physicians and surgeons should not be prevented from pursuing a career in medicine because of the prospect of overwhelming financial debt,\" \u003ca href=\"https://nyulangone.org/our-story/our-leadership/executive-leadership/robert-i-grossman-md\" target=\"_blank\" rel=\"noopener\">Dr. Robert Grossman\u003c/a>, the dean of the medical school and CEO of NYU Langone Health, said in a \u003ca href=\"https://nyulangone.org/press-releases/nyu-school-of-medicine-offers-full-tuition-scholarships-to-all-new-current-medical-students\">statement\u003c/a> released by the university. NYU declined a request to elaborate further on its plans.\u003c/p>\n\u003cp>The announcement generated headlines and cheers from students. But not everyone thinks waiving tuition for all med students, including those who can afford to pay, is the best way to approach the complicated issue of student debt.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"As I start rank-ordering the various charities I want to give to, the people who can pay for medical school in cash aren't at the top of my list,\" says Craig Garthwaite, a health economist at Northwestern University's Kellogg School of Management.\u003c/p>\n\u003cp>\"If you had to find some cause to put tons of money behind, this strikes me as an odd one,\" says \u003ca href=\"https://theincidentaleconomist.com/wordpress/about/about-aaron/\" target=\"_blank\" rel=\"noopener\">Dr. Aaron Carroll\u003c/a>, a pediatrician and researcher at Indiana University.[contextly_sidebar id=\"yL41mObfPR0lBjTvBa84Y4Ui3t2xzWmm\"]\u003c/p>\n\u003cp>Still, medical education debt is a big issue in health care. According to the Association of American Medical Colleges, which represents U.S. medical schools and academic health centers, 75 percent of graduating physicians in 2017 had \u003ca href=\"https://members.aamc.org/iweb/upload/2017%20Debt%20Fact%20Card.pdf\" target=\"_blank\" rel=\"noopener\">student loan debt\u003c/a> as they launched their careers, with a median tally of $192,000. Nearly half owed more than $200,000.\u003c/p>\n\u003cp>But it is less clear how much of an impact that debt has on students' choice of medical specialty. The AAMC's data suggest debt does not play as big a role in specialty selection as \u003ca href=\"https://journalofethics.ama-assn.org/article/educational-debt-and-specialty-choice/2013-07\" target=\"_blank\" rel=\"noopener\">some analysts claim\u003c/a>.\u003c/p>\n\u003cp>If debt were a huge factor, one would expect that doctors who owed the most would choose the highest-paying specialties. However, that's not the case.\u003c/p>\n\u003cp>\"Debt doesn't vary much across the specialties,\" says \u003ca href=\"https://www.aamc.org/cim/435632/contactus.html\" target=\"_blank\" rel=\"noopener\">Julie Fresne\u003c/a>, AAMC's director of student financial services and debt management.\u003c/p>\n\u003cp>Garthwaite agrees. He says surveys in which young doctors claim debt as a reason for choosing a more lucrative specialty should be viewed with suspicion.\u003c/p>\n\u003cp>\"No one [who chooses a higher-paying job] says they did it because they want two Teslas,\" he says. \"They say they have all this debt.\"\u003c/p>\n\u003cp>Carroll questions how much difference even $200,000 in student debt makes to people who, at the lowest end of the medical spectrum, still stand to make six figures a year. \"Doctors in general do just fine,\" he says. \"The idea we should pity physicians or worry about them strikes me as odd.\"\u003c/p>\n\u003cp>Choice of specialty is also influenced by more than money. Some specialties may bring less demanding lifestyles than primary care, or more prestige. Carroll says when he opted for pediatrics, his surgeon father was not impressed, calling it a \"garbageman\" specialty.\u003c/p>\n\u003cp>There is also an array of government programs that help students afford medical school or that forgive student loans, although usually such programs require the new doctors to serve several years either in the military or in a medically underserved location. The federal \u003ca href=\"https://bhw.hrsa.gov/loansscholarships/nhsc\">National Health Service Corps\u003c/a>, for example, provides scholarships and loan repayments to medical professionals who agree to work in mostly rural or inner-city areas that have a shortage of health care providers. And the Department of Education oversees the \u003ca href=\"https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service\" target=\"_blank\" rel=\"noopener\">Public Service Loan Forgiveness\u003c/a> program, which cancels outstanding loan balances after 10 years for those who work for nonprofit employers.\u003c/p>\n\u003cp>Medical schools themselves are addressing the student debt problem. Many — \u003ca href=\"https://med.nyu.edu/education/md-degree/accelerated-three-year-md\" target=\"_blank\" rel=\"noopener\">including NYU\u003c/a> — have created programs that let students finish medical school in three years rather than four — reducing the cost by 25 percent. And the \u003ca href=\"http://portals.clevelandclinic.org/cclcm/About-the-College\" target=\"_blank\" rel=\"noopener\">Cleveland Clinic\u003c/a>, together with Case Western Reserve University, has a tuition-free medical school program aimed at training future medical researchers. It takes five years, but grants graduates with both a doctor of medicine title and a special research credential or master's degree.\u003c/p>\n\u003cp>This latest move by NYU, however, is part of a continuing race among top-tier medical schools to attract the best students — and possibly improve a school's national rankings.[contextly_sidebar id=\"i4jKckSF3mAh5YMO9p60jhWlOpsZAUJQ\"]\u003c/p>\n\u003cp>In 2014, \u003ca href=\"http://medschool.ucla.edu/body.cfm?id=1158&action=detail&ref=35\">UCLA\u003c/a> announced it would provide merit-based scholarships covering the entire cost of medical education (including not just tuition, but also living expenses) to 20 percent of its students. \u003ca href=\"http://newsroom.cumc.columbia.edu/blog/2018/04/11/vagelos-college-of-physicians-and-surgeons-launches-scholarship-program-to-eliminate-medical-school-loans-for-students-with-financial-need/\" target=\"_blank\" rel=\"noopener\">Columbia University\u003c/a> announced a similar plan earlier this year, although unlike NYU and UCLA, Columbia's program is based on a student's financial need.\u003c/p>\n\u003cp>These programs are funded, in whole or in part, by large donors whose names brand each medical school — entertainment mogul David Geffen at UCLA, former Merck CEO P. Roy Vagelos at Columbia, and Home Depot's co-founder, Kenneth Langone, at NYU.\u003c/p>\n\u003cp>Economist Garthwaite says it is all well and good if top medical schools want to compete for top students by offering discounts. But if their goal is to encourage more students to enter primary care or to steer more people from lower-income families into medicine, waiving everyone's tuition \"is not the most target-efficient way to reach that goal.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>,\u003c/em>\u003cem> a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=NYU%27s+Move+To+Make+Medical+School+Free+For+All+Gets+Mixed+Reviews&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"New York University students cheered, but critics say waiving tuition isn't the best way to ease student debt or boost the number of primary care doctors from diverse backgrounds.","status":"publish","parent":0,"modified":1535066592,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":1004},"headData":{"title":"NYU's Move To Make Medical School Free For All Gets Mixed Reviews | KQED","description":"New York University students cheered, but critics say waiving tuition isn't the best way to ease student debt or boost the number of primary care doctors from diverse backgrounds.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"NYU's Move To Make Medical School Free For All Gets Mixed Reviews","datePublished":"2018-08-24T21:00:12.000Z","dateModified":"2018-08-23T23:23:12.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444061 https://ww2.kqed.org/futureofyou/?p=444061","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/08/24/nyus-move-to-make-medical-school-free-for-all-gets-mixed-reviews/","disqusTitle":"NYU's Move To Make Medical School Free For All Gets Mixed Reviews","nprByline":"Julie Rovner, NPR","nprImageAgency":"Cargo/Getty Images","nprStoryId":"641034202","nprApiLink":"http://api.npr.org/query?id=641034202&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/08/23/641034202/nyus-move-to-make-medical-school-free-for-all-gets-mixed-reviews?ft=nprml&f=641034202","nprRetrievedStory":"1","nprPubDate":"Thu, 23 Aug 2018 05:00:00 -0400","nprStoryDate":"Thu, 23 Aug 2018 05:00:18 -0400","nprLastModifiedDate":"Thu, 23 Aug 2018 05:00:18 -0400","path":"/futureofyou/444061/nyus-move-to-make-medical-school-free-for-all-gets-mixed-reviews","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>New York University's School of Medicine is learning that no good deed goes unpunished.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The highly ranked medical school announced with much fanfare this month that it is raising $600 million from private donors to \u003ca href=\"https://www.npr.org/2018/08/17/639467023/nyu-medical-school-says-it-will-offer-free-tuition-to-all-students\" target=\"_blank\" rel=\"noopener\">eliminate tuition\u003c/a> for all its students — even providing refunds to those currently enrolled. Before the announcement, annual tuition at the school was $55,018.\u003c/p>\n\u003cp>NYU leaders hope the move will help address the increasing problem of student debt among young doctors, which many educators argue pushes students to enter higher-paying specialties instead of primary care, and deters some from becoming doctors in the first place.\u003c/p>\n\u003cp>\"A population as diverse as ours is best served by doctors from all walks of life, we believe, and aspiring physicians and surgeons should not be prevented from pursuing a career in medicine because of the prospect of overwhelming financial debt,\" \u003ca href=\"https://nyulangone.org/our-story/our-leadership/executive-leadership/robert-i-grossman-md\" target=\"_blank\" rel=\"noopener\">Dr. Robert Grossman\u003c/a>, the dean of the medical school and CEO of NYU Langone Health, said in a \u003ca href=\"https://nyulangone.org/press-releases/nyu-school-of-medicine-offers-full-tuition-scholarships-to-all-new-current-medical-students\">statement\u003c/a> released by the university. NYU declined a request to elaborate further on its plans.\u003c/p>\n\u003cp>The announcement generated headlines and cheers from students. But not everyone thinks waiving tuition for all med students, including those who can afford to pay, is the best way to approach the complicated issue of student debt.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"As I start rank-ordering the various charities I want to give to, the people who can pay for medical school in cash aren't at the top of my list,\" says Craig Garthwaite, a health economist at Northwestern University's Kellogg School of Management.\u003c/p>\n\u003cp>\"If you had to find some cause to put tons of money behind, this strikes me as an odd one,\" says \u003ca href=\"https://theincidentaleconomist.com/wordpress/about/about-aaron/\" target=\"_blank\" rel=\"noopener\">Dr. Aaron Carroll\u003c/a>, a pediatrician and researcher at Indiana University.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Still, medical education debt is a big issue in health care. According to the Association of American Medical Colleges, which represents U.S. medical schools and academic health centers, 75 percent of graduating physicians in 2017 had \u003ca href=\"https://members.aamc.org/iweb/upload/2017%20Debt%20Fact%20Card.pdf\" target=\"_blank\" rel=\"noopener\">student loan debt\u003c/a> as they launched their careers, with a median tally of $192,000. Nearly half owed more than $200,000.\u003c/p>\n\u003cp>But it is less clear how much of an impact that debt has on students' choice of medical specialty. The AAMC's data suggest debt does not play as big a role in specialty selection as \u003ca href=\"https://journalofethics.ama-assn.org/article/educational-debt-and-specialty-choice/2013-07\" target=\"_blank\" rel=\"noopener\">some analysts claim\u003c/a>.\u003c/p>\n\u003cp>If debt were a huge factor, one would expect that doctors who owed the most would choose the highest-paying specialties. However, that's not the case.\u003c/p>\n\u003cp>\"Debt doesn't vary much across the specialties,\" says \u003ca href=\"https://www.aamc.org/cim/435632/contactus.html\" target=\"_blank\" rel=\"noopener\">Julie Fresne\u003c/a>, AAMC's director of student financial services and debt management.\u003c/p>\n\u003cp>Garthwaite agrees. He says surveys in which young doctors claim debt as a reason for choosing a more lucrative specialty should be viewed with suspicion.\u003c/p>\n\u003cp>\"No one [who chooses a higher-paying job] says they did it because they want two Teslas,\" he says. \"They say they have all this debt.\"\u003c/p>\n\u003cp>Carroll questions how much difference even $200,000 in student debt makes to people who, at the lowest end of the medical spectrum, still stand to make six figures a year. \"Doctors in general do just fine,\" he says. \"The idea we should pity physicians or worry about them strikes me as odd.\"\u003c/p>\n\u003cp>Choice of specialty is also influenced by more than money. Some specialties may bring less demanding lifestyles than primary care, or more prestige. Carroll says when he opted for pediatrics, his surgeon father was not impressed, calling it a \"garbageman\" specialty.\u003c/p>\n\u003cp>There is also an array of government programs that help students afford medical school or that forgive student loans, although usually such programs require the new doctors to serve several years either in the military or in a medically underserved location. The federal \u003ca href=\"https://bhw.hrsa.gov/loansscholarships/nhsc\">National Health Service Corps\u003c/a>, for example, provides scholarships and loan repayments to medical professionals who agree to work in mostly rural or inner-city areas that have a shortage of health care providers. And the Department of Education oversees the \u003ca href=\"https://studentaid.ed.gov/sa/repay-loans/forgiveness-cancellation/public-service\" target=\"_blank\" rel=\"noopener\">Public Service Loan Forgiveness\u003c/a> program, which cancels outstanding loan balances after 10 years for those who work for nonprofit employers.\u003c/p>\n\u003cp>Medical schools themselves are addressing the student debt problem. Many — \u003ca href=\"https://med.nyu.edu/education/md-degree/accelerated-three-year-md\" target=\"_blank\" rel=\"noopener\">including NYU\u003c/a> — have created programs that let students finish medical school in three years rather than four — reducing the cost by 25 percent. And the \u003ca href=\"http://portals.clevelandclinic.org/cclcm/About-the-College\" target=\"_blank\" rel=\"noopener\">Cleveland Clinic\u003c/a>, together with Case Western Reserve University, has a tuition-free medical school program aimed at training future medical researchers. It takes five years, but grants graduates with both a doctor of medicine title and a special research credential or master's degree.\u003c/p>\n\u003cp>This latest move by NYU, however, is part of a continuing race among top-tier medical schools to attract the best students — and possibly improve a school's national rankings.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In 2014, \u003ca href=\"http://medschool.ucla.edu/body.cfm?id=1158&action=detail&ref=35\">UCLA\u003c/a> announced it would provide merit-based scholarships covering the entire cost of medical education (including not just tuition, but also living expenses) to 20 percent of its students. \u003ca href=\"http://newsroom.cumc.columbia.edu/blog/2018/04/11/vagelos-college-of-physicians-and-surgeons-launches-scholarship-program-to-eliminate-medical-school-loans-for-students-with-financial-need/\" target=\"_blank\" rel=\"noopener\">Columbia University\u003c/a> announced a similar plan earlier this year, although unlike NYU and UCLA, Columbia's program is based on a student's financial need.\u003c/p>\n\u003cp>These programs are funded, in whole or in part, by large donors whose names brand each medical school — entertainment mogul David Geffen at UCLA, former Merck CEO P. Roy Vagelos at Columbia, and Home Depot's co-founder, Kenneth Langone, at NYU.\u003c/p>\n\u003cp>Economist Garthwaite says it is all well and good if top medical schools want to compete for top students by offering discounts. But if their goal is to encourage more students to enter primary care or to steer more people from lower-income families into medicine, waiving everyone's tuition \"is not the most target-efficient way to reach that goal.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://khn.org/\" target=\"_blank\" rel=\"noopener\">\u003cem>Kaiser Health News\u003c/em>\u003c/a>\u003cem>,\u003c/em>\u003cem> a nonprofit news service, is an editorially independent program of the Kaiser Family Foundation, and is not affiliated with Kaiser Permanente.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 Kaiser Health News. To see more, visit \u003ca href=\"http://www.kaiserhealthnews.org/\" target=\"_blank\" rel=\"noopener\">Kaiser Health News\u003c/a>.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=NYU%27s+Move+To+Make+Medical+School+Free+For+All+Gets+Mixed+Reviews&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444061/nyus-move-to-make-medical-school-free-for-all-gets-mixed-reviews","authors":["byline_futureofyou_444061"],"categories":["futureofyou_1"],"tags":["futureofyou_190","futureofyou_61","futureofyou_1256"],"featImg":"futureofyou_444062","label":"futureofyou"},"futureofyou_440967":{"type":"posts","id":"futureofyou_440967","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440967","score":null,"sort":[1524596434000]},"guestAuthors":[],"slug":"the-next-generation-of-doctors-may-be-learning-bad-habits-at-teaching-hospitals-with-many-safety-violations","title":"Not All Teaching Hospitals Alike in Training Quality for Doctors","publishDate":1524596434,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The patient’s breaths had become labored. He struggled to pull air from his mouth to his lungs. It got so bad late one Saturday night that he decided to say something about it the next time his nurse made rounds at Jackson South Community Hospital.\u003c/p>\n\u003cp>The complaint traveled from the nurse to a doctor, who looked at the patient’s records and quickly saw the problem: a feeding tube had been placed into the side of his lung. An anesthesiology trainee had inserted the tube without proper supervision, a federal health inspection later determined, and over the coming weeks, the patient developed pneumonia and sepsis related to the medical error. He was in the hospital two months longer than initially planned.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Sometimes they’ll find minor violations. But the things that are really a threat to patients being alive, it’s hard to discount those.'\u003c/aside>\n\u003cp>Teaching hospitals like Jackson South, located in metro Miami, are where physician trainees get practice treating patients. They prepare the next generation of doctors, and they have a reputation as places of cutting-edge patient care, given their ties to academic institutions.\u003c/p>\n\u003cp>But at some of these hospitals, residents may be learning bad habits. A STAT analysis of federal inspection data finds that there’s a wide gap in the quality of training at teaching hospitals, as shown by how frequently these hospitals are cited for deficiencies by the Centers for Medicare and Medicaid Services. While the majority of the roughly 1,200 teaching hospitals received no citations each year from 2014 to 2017, others racked up dozens of safety violations in that time period — putting patients at risk, and compromising the training that students receive.\u003c/p>\n\u003cp>“In the places where young doctors-in-training practice, what they learn can affect how the person will practice for decades to come,” said Rosemary Gibson, a patient safety advocate and the author of the book “Wall of Silence.” “They’re developing habits … and it’s essential for trainees to learn in clinical settings where patient safety is baked into the system.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>At Jackson South, even before the hospital received a citation from CMS, administrators were analyzing how the feeding tube mistake happened and how to prevent similar errors in the future. They realized that the issue had to do with the initial reading of the X-ray, which is used to make sure doctors don’t misplace feeding tubes. The hospital put in place a pilot program to verify that feeding tubes are properly placed.\u003c/p>\n\u003cp>“We take every deficiency seriously and thoroughly investigate each safety violation,” a Jackson spokesperson said in a statement. “We implement plans to correct them.”\u003c/p>\n\u003cp>Teaching hospitals are making some positive changes, and according to STAT’s analysis, that’s led the average number of violations per teaching hospital to drop to its lowest point in three years, following a major spike in 2015 and 2016. But experts worry that the remaining mishaps mean that America’s future doctors aren’t always being prepared to practice medicine safely.\u003c/p>\n\u003cp>“If residents train in a program where patients aren’t receiving safe care, [they’re] likely at increased risk of burning out or leaving clinical medicine entirely, or providing not as good of care if they stay in clinical medicine,” said Dr. Sumant Ranji, chief of the division of hospital medicine at the Zuckerberg San Francisco General Hospital.\u003c/p>\n\u003cp>Hospitals that participate in Medicaid or Medicare must follow federal safety regulations, and the agency sends inspectors to verify that they are doing so every three to four years, or when a complaint triggers the need for an investigation. Those regulations cover everything from the storage of drugs and supplies to the protection of patient rights.[contextly_sidebar id=\"7lJLROPoNI8V35CnfpV5eDACtFqnGekB\"]\u003c/p>\n\u003cp>Inspections by CMS represent a fraction of all the inspections that hospitals undergo. Independent accreditors and state agencies perform the majority of routine hospital surveys, but rarely make detailed findings public. So STAT’s analysis was based only on the CMS reports.\u003c/p>\n\u003cp>“When [CMS] inspections are done and violations are found, especially the more severe violations, they’re important,” said Dr. Ashish Jha, professor of health policy at the Harvard T.H. Chan School of Public Health. “Sometimes they’ll find minor violations. But the things that are really a threat to patients being alive, it’s hard to discount those.”\u003c/p>\n\u003cp>STAT’s review — aided by the Association of Health Care Journalists’ HospitalInspections.org database — looked at medical facilities that fit the CMS definition of a teaching hospital: those that received Medicare direct graduate medical education or indirect medical education payments from the agency between 2014 and 2017. Collectively, more than 5,500 safety violations occurred at teaching hospitals over that four-year span. In each of those years, more than a quarter of the roughly 1,200 teaching hospitals had at least one safety violation documented.\u003c/p>\n\u003cp>The highest number of citations went to West Valley Medical Center in Idaho (45 violations), Regional Health Rapid City Hospital in South Dakota (44), Howard University Hospital in Washington, D.C. (37), and Jackson Memorial Hospital (36), which is part of the same health care system as Jackson South. Among the others cited were some of the nation’s most prestigious medical centers — including ones affiliated with Columbia, Harvard, and Case Western Reserve universities — as well as rural hospitals that dot the western half of the United States.\u003c/p>\n\u003cp>[contextly_sidebar id=\"THZMAaNUzKC8OTx4ttfJlX7FiRQBtJZy\"]Many teaching hospitals STAT contacted for interviews declined to provide information about their violations. The spokespeople who responded generally said administrators had taken appropriate action to address deficiencies cited by CMS.\u003c/p>\n\u003cp>Some violations, like the Jackson South one, directly concerned medical trainees, while others implicated the leaders responsible for overseeing their education. Jha said CMS inspection reports, known as 2567 forms, provide valuable insight into hospital safety — particularly regarding the quality of training and oversight for medical trainees.\u003c/p>\n\u003cp>In the neonatal intensive care unit of Cooper University Hospital in Camden, N.J., pediatric residents shadow staff physicians as they care for newborns in precarious health. Before entering, staff and visitors are required to wash, rinse, and lather their hands for at least 15 seconds and decontaminate personal items such as cellphones, according to hospital policy.\u003c/p>\n\u003cp>But over a three-hour period last April, an inspector observed nearly a dozen doctors and nurses break those rules. Additionally, the inspector could find no evidence that, after an infant in the ward contracted a superbug, the staff took these precautions to limit the spread of infection.\u003c/p>\n\u003cp>“Unfortunately, these types of infections are not uncommon in NICUs around the country due to the highly fragile nature of this patient population,” Cooper University Health Care spokeswoman Wendy Marano told STAT. “Cooper promptly reported the infections to the New Jersey Department of Health. … We have not experienced any recurrence of MRSA cross-contamination in the NICU.”\u003c/p>\n\u003cp>In the spring of 2017, inspectors cited Montefiore Medical Center in the Bronx after two patients committed suicide in an eight-day period. One of those patients was a 76-year-old man who had collapsed in grief after attending a friend’s funeral. Upon admission to Montefiore, doctors didn’t record a plan for psychiatric treatment, even though hospital policy called for suicide screenings in cases of potential emotional or behavioral disorder. Three days later, the man hanged himself in a shower at the hospital.[contextly_sidebar id=\"LQm8J4f2TTS7MUuL7J4WTevB2RamynKs\"]\u003c/p>\n\u003cp>“Yes, he would have been someone who we would have liked to have seen before he died,” one doctor told an inspector.\u003c/p>\n\u003cp>A spokesperson told STAT that Montefiore is “singularly focused on providing the best education and training for the doctors of tomorrow.”\u003c/p>\n\u003cp>Medical trainees were at the center of some of the violations listed in reports STAT reviewed. A team of NewYork-Presbyterian Hospital residents didn’t notify an attending physician for hours about a patient’s rapid heart rate and drop in blood pressure, and the patient died the following morning. And a resident started a fire in a Nebraska Medicine operating room by accidentally bringing a cautery too close to a flammable liquid medical adhesive. In that case, hospital spokesperson Taylor Wilson told STAT, no patients were harmed. But the incident spurred “new, stronger safety measures” that included training of all surgical staff and trainees, Wilson said.\u003c/p>\n\u003cp>Experts caution that inspection reports don’t tell the whole story. Dr. Tejal Gandhi, chief clinical and safety officer for the Institute for Healthcare Improvement, said each of the leading ways to assess quality and safety “alone won’t give you an overall view” of hospital performance. Matt Austin, a professor of anesthesiology and critical care medicine at Johns Hopkins University’s medical school, said they reflect an “important, but not a complete, picture of patient safety” in hospitals.\u003c/p>\n\u003cp>“If you find the problem on an inspection, it’s worrisome,” Jha said. “If you fail to find problems, it’s not a get-out-of-jail-free card.”\u003c/p>\n\u003cp>For many decades, preventable medical errors in hospitals were chalked up as an inevitable cost of training new doctors, according to Peter Rivard, associate professor of health care administration at Suffolk University in Boston. If something went awry, health administrators reprimanded trainees or their supervisors instead of focusing on the underlying systems that allowed for a mistake to occur in the first place.\u003c/p>\n\u003cp>Then in 1999, the Institute of Medicine released the landmark “To Err Is Human” report, which concluded that as many as 98,000 Americans were killed in the process of receiving medical care. Hospitals scrambled for answers: They began tracking errors more closely, hiring airline pilots as safety consultants, and expanding patient safety as a subject of medical education. But by the mid-2000s, only 54 percent of residents surveyed knew how to report errors at their facilities.\u003c/p>\n\u003cp>Ranji, at San Francisco General, said a “pernicious old-school culture” still pervades much of medical education and espouses minimal oversight of trainees, in addition to the belief that learning happens through making mistakes.\u003c/p>\n\u003cp>In part due to their frequent turnover, medical trainees told STAT that they don’t always feel empowered like permanent staffers to suggest improvements to hospital safety.\u003c/p>\n\u003cp>Trainees who are involved in medical errors can experience “profound psychological consequences,” Ranji said.\u003c/p>\n\u003cp>“The patients I remember best were the adverse ones,” he added. “Those experiences made me more cynical, and sucked the joy out of patient care for me. If something bad happened to patients, [the mindset was to] sweep under the rug, and keep your chin up. But they were profound emotional experiences.”\u003c/p>\n\u003cp>Recognizing that teaching hospitals present specific challenges for patient safety, the leading medical education accreditation group has stepped up its oversight policies.\u003c/p>\n\u003cp>Since 2012, the Accreditation Council for Graduate Medical Education — which accredits more than half of the nation’s teaching hospitals — has sent staff to these hospitals to conduct an evaluation that includes interviewing administrators, observing doctors, and walking the halls with residents.\u003c/p>\n\u003cp>[contextly_sidebar id=\"mRbgvSyd1XTMQNaYv6256AYB0fx6mOsY\"]Dr. Kevin Weiss, senior vice president of institution accreditation for the ACGME, said these mandatory site visits are intended to “increase awareness of residents in formal patient safety activities” like reporting medical errors or participating in debriefs of those errors after the fact, something that makes trainees more mindful of practicing medicine safely.\u003c/p>\n\u003cp>And teaching hospitals are taking matters into their own hands.\u003c/p>\n\u003cp>At the University of Chicago Medical Center, every resident must undergo patient safety training. As part of it, they must spot medical errors in a simulated environment dubbed the “\u003ca href=\"https://news.aamc.org/medical-education/article/patient-safety-residency-training/\" target=\"_blank\" rel=\"noopener\">horror room\u003c/a>.” They’re also strongly encouraged to report adverse patient events or “near misses,” and are expected, in collaboration with superiors, to reverse engineer incidents where patients were harmed under their watch.\u003c/p>\n\u003cp>“We’re really focused on changing behavior,” said Dr. Vineet Arora, director of graduate medical education clinical learning. “It’s important that someone raises their hands, wherever they are on the hierarchy, and can say, ‘I see a problem.’ That’s a mindset change.”\u003c/p>\n\u003cp>Participation in this curriculum, Arora noted, was associated with “three times more event reports by those programs.” University of Chicago Medical Center hasn’t received a safety violation in over two years.\u003c/p>\n\u003cp>Meanwhile, researchers at Boston Children’s Hospital created \u003ca href=\"http://www.childrenshospital.org/news-and-events/2012/april-2012/i-pass-standardizing-patient-handoffs-to-reduce-medical-errors\" target=\"_blank\" rel=\"noopener\">“I-PASS,” a mnemonic device\u003c/a> that’s bundled with training and lectures in order to help \u003ca href=\"https://www.statnews.com/2016/02/01/communication-failures-malpractice-study/\">improve patient handoffs\u003c/a>. A resident whose shift is ending relays information to his or her successor by running through five pieces of information: illness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by receiver.\u003c/p>\n\u003cp>It’s worked so well in pediatric units — one study found its use was associated with a \u003ca href=\"https://www.medpagetoday.com/hospitalbasedmedicine/generalhospitalpractice/48817\" target=\"_blank\" rel=\"noopener\">23 percent drop in medical errors\u003c/a> — that \u003ca href=\"http://app.ihi.org/FacultyDocuments/Events/Event-2613/Presentation-12369/Document-10285/Presentation_C12_FINAL.pdf\" target=\"_blank\" rel=\"noopener\">Massachusetts General Hospital\u003c/a>decided to adopt it throughout the institution. Dr. Elizabeth Mort, senior vice president of quality and safety at Mass. General, said the program led to a “fivefold increase” in safety reporting from trainees.\u003c/p>\n\u003cp>“An understanding of patient safety is something we’re not born with,” said Dr. Anai Kothari, a fourth-year surgery resident at Loyola University. “But it can be learned and applied — and can make a difference when we do it well.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/04/20/doctors-learn-bad-habits-teaching-hospitals/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Special report finds that by the mid-2000s, only 54 percent of residents surveyed knew how to report errors.","status":"publish","parent":0,"modified":1524693356,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":44,"wordCount":2337},"headData":{"title":"Not All Teaching Hospitals Alike in Training Quality for Doctors | KQED","description":"Special report finds that by the mid-2000s, only 54 percent of residents surveyed knew how to report errors.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Not All Teaching Hospitals Alike in Training Quality for Doctors","datePublished":"2018-04-24T19:00:34.000Z","dateModified":"2018-04-25T21:55:56.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440967 https://ww2.kqed.org/futureofyou/?p=440967","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/24/the-next-generation-of-doctors-may-be-learning-bad-habits-at-teaching-hospitals-with-many-safety-violations/","disqusTitle":"Not All Teaching Hospitals Alike in Training Quality for Doctors","source":"Health","nprByline":"Max Blau\u003cbr />STAT News","path":"/futureofyou/440967/the-next-generation-of-doctors-may-be-learning-bad-habits-at-teaching-hospitals-with-many-safety-violations","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The patient’s breaths had become labored. He struggled to pull air from his mouth to his lungs. It got so bad late one Saturday night that he decided to say something about it the next time his nurse made rounds at Jackson South Community Hospital.\u003c/p>\n\u003cp>The complaint traveled from the nurse to a doctor, who looked at the patient’s records and quickly saw the problem: a feeding tube had been placed into the side of his lung. An anesthesiology trainee had inserted the tube without proper supervision, a federal health inspection later determined, and over the coming weeks, the patient developed pneumonia and sepsis related to the medical error. He was in the hospital two months longer than initially planned.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Sometimes they’ll find minor violations. But the things that are really a threat to patients being alive, it’s hard to discount those.'\u003c/aside>\n\u003cp>Teaching hospitals like Jackson South, located in metro Miami, are where physician trainees get practice treating patients. They prepare the next generation of doctors, and they have a reputation as places of cutting-edge patient care, given their ties to academic institutions.\u003c/p>\n\u003cp>But at some of these hospitals, residents may be learning bad habits. A STAT analysis of federal inspection data finds that there’s a wide gap in the quality of training at teaching hospitals, as shown by how frequently these hospitals are cited for deficiencies by the Centers for Medicare and Medicaid Services. While the majority of the roughly 1,200 teaching hospitals received no citations each year from 2014 to 2017, others racked up dozens of safety violations in that time period — putting patients at risk, and compromising the training that students receive.\u003c/p>\n\u003cp>“In the places where young doctors-in-training practice, what they learn can affect how the person will practice for decades to come,” said Rosemary Gibson, a patient safety advocate and the author of the book “Wall of Silence.” “They’re developing habits … and it’s essential for trainees to learn in clinical settings where patient safety is baked into the system.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>At Jackson South, even before the hospital received a citation from CMS, administrators were analyzing how the feeding tube mistake happened and how to prevent similar errors in the future. They realized that the issue had to do with the initial reading of the X-ray, which is used to make sure doctors don’t misplace feeding tubes. The hospital put in place a pilot program to verify that feeding tubes are properly placed.\u003c/p>\n\u003cp>“We take every deficiency seriously and thoroughly investigate each safety violation,” a Jackson spokesperson said in a statement. “We implement plans to correct them.”\u003c/p>\n\u003cp>Teaching hospitals are making some positive changes, and according to STAT’s analysis, that’s led the average number of violations per teaching hospital to drop to its lowest point in three years, following a major spike in 2015 and 2016. But experts worry that the remaining mishaps mean that America’s future doctors aren’t always being prepared to practice medicine safely.\u003c/p>\n\u003cp>“If residents train in a program where patients aren’t receiving safe care, [they’re] likely at increased risk of burning out or leaving clinical medicine entirely, or providing not as good of care if they stay in clinical medicine,” said Dr. Sumant Ranji, chief of the division of hospital medicine at the Zuckerberg San Francisco General Hospital.\u003c/p>\n\u003cp>Hospitals that participate in Medicaid or Medicare must follow federal safety regulations, and the agency sends inspectors to verify that they are doing so every three to four years, or when a complaint triggers the need for an investigation. Those regulations cover everything from the storage of drugs and supplies to the protection of patient rights.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Inspections by CMS represent a fraction of all the inspections that hospitals undergo. Independent accreditors and state agencies perform the majority of routine hospital surveys, but rarely make detailed findings public. So STAT’s analysis was based only on the CMS reports.\u003c/p>\n\u003cp>“When [CMS] inspections are done and violations are found, especially the more severe violations, they’re important,” said Dr. Ashish Jha, professor of health policy at the Harvard T.H. Chan School of Public Health. “Sometimes they’ll find minor violations. But the things that are really a threat to patients being alive, it’s hard to discount those.”\u003c/p>\n\u003cp>STAT’s review — aided by the Association of Health Care Journalists’ HospitalInspections.org database — looked at medical facilities that fit the CMS definition of a teaching hospital: those that received Medicare direct graduate medical education or indirect medical education payments from the agency between 2014 and 2017. Collectively, more than 5,500 safety violations occurred at teaching hospitals over that four-year span. In each of those years, more than a quarter of the roughly 1,200 teaching hospitals had at least one safety violation documented.\u003c/p>\n\u003cp>The highest number of citations went to West Valley Medical Center in Idaho (45 violations), Regional Health Rapid City Hospital in South Dakota (44), Howard University Hospital in Washington, D.C. (37), and Jackson Memorial Hospital (36), which is part of the same health care system as Jackson South. Among the others cited were some of the nation’s most prestigious medical centers — including ones affiliated with Columbia, Harvard, and Case Western Reserve universities — as well as rural hospitals that dot the western half of the United States.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Many teaching hospitals STAT contacted for interviews declined to provide information about their violations. The spokespeople who responded generally said administrators had taken appropriate action to address deficiencies cited by CMS.\u003c/p>\n\u003cp>Some violations, like the Jackson South one, directly concerned medical trainees, while others implicated the leaders responsible for overseeing their education. Jha said CMS inspection reports, known as 2567 forms, provide valuable insight into hospital safety — particularly regarding the quality of training and oversight for medical trainees.\u003c/p>\n\u003cp>In the neonatal intensive care unit of Cooper University Hospital in Camden, N.J., pediatric residents shadow staff physicians as they care for newborns in precarious health. Before entering, staff and visitors are required to wash, rinse, and lather their hands for at least 15 seconds and decontaminate personal items such as cellphones, according to hospital policy.\u003c/p>\n\u003cp>But over a three-hour period last April, an inspector observed nearly a dozen doctors and nurses break those rules. Additionally, the inspector could find no evidence that, after an infant in the ward contracted a superbug, the staff took these precautions to limit the spread of infection.\u003c/p>\n\u003cp>“Unfortunately, these types of infections are not uncommon in NICUs around the country due to the highly fragile nature of this patient population,” Cooper University Health Care spokeswoman Wendy Marano told STAT. “Cooper promptly reported the infections to the New Jersey Department of Health. … We have not experienced any recurrence of MRSA cross-contamination in the NICU.”\u003c/p>\n\u003cp>In the spring of 2017, inspectors cited Montefiore Medical Center in the Bronx after two patients committed suicide in an eight-day period. One of those patients was a 76-year-old man who had collapsed in grief after attending a friend’s funeral. Upon admission to Montefiore, doctors didn’t record a plan for psychiatric treatment, even though hospital policy called for suicide screenings in cases of potential emotional or behavioral disorder. Three days later, the man hanged himself in a shower at the hospital.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“Yes, he would have been someone who we would have liked to have seen before he died,” one doctor told an inspector.\u003c/p>\n\u003cp>A spokesperson told STAT that Montefiore is “singularly focused on providing the best education and training for the doctors of tomorrow.”\u003c/p>\n\u003cp>Medical trainees were at the center of some of the violations listed in reports STAT reviewed. A team of NewYork-Presbyterian Hospital residents didn’t notify an attending physician for hours about a patient’s rapid heart rate and drop in blood pressure, and the patient died the following morning. And a resident started a fire in a Nebraska Medicine operating room by accidentally bringing a cautery too close to a flammable liquid medical adhesive. In that case, hospital spokesperson Taylor Wilson told STAT, no patients were harmed. But the incident spurred “new, stronger safety measures” that included training of all surgical staff and trainees, Wilson said.\u003c/p>\n\u003cp>Experts caution that inspection reports don’t tell the whole story. Dr. Tejal Gandhi, chief clinical and safety officer for the Institute for Healthcare Improvement, said each of the leading ways to assess quality and safety “alone won’t give you an overall view” of hospital performance. Matt Austin, a professor of anesthesiology and critical care medicine at Johns Hopkins University’s medical school, said they reflect an “important, but not a complete, picture of patient safety” in hospitals.\u003c/p>\n\u003cp>“If you find the problem on an inspection, it’s worrisome,” Jha said. “If you fail to find problems, it’s not a get-out-of-jail-free card.”\u003c/p>\n\u003cp>For many decades, preventable medical errors in hospitals were chalked up as an inevitable cost of training new doctors, according to Peter Rivard, associate professor of health care administration at Suffolk University in Boston. If something went awry, health administrators reprimanded trainees or their supervisors instead of focusing on the underlying systems that allowed for a mistake to occur in the first place.\u003c/p>\n\u003cp>Then in 1999, the Institute of Medicine released the landmark “To Err Is Human” report, which concluded that as many as 98,000 Americans were killed in the process of receiving medical care. Hospitals scrambled for answers: They began tracking errors more closely, hiring airline pilots as safety consultants, and expanding patient safety as a subject of medical education. But by the mid-2000s, only 54 percent of residents surveyed knew how to report errors at their facilities.\u003c/p>\n\u003cp>Ranji, at San Francisco General, said a “pernicious old-school culture” still pervades much of medical education and espouses minimal oversight of trainees, in addition to the belief that learning happens through making mistakes.\u003c/p>\n\u003cp>In part due to their frequent turnover, medical trainees told STAT that they don’t always feel empowered like permanent staffers to suggest improvements to hospital safety.\u003c/p>\n\u003cp>Trainees who are involved in medical errors can experience “profound psychological consequences,” Ranji said.\u003c/p>\n\u003cp>“The patients I remember best were the adverse ones,” he added. “Those experiences made me more cynical, and sucked the joy out of patient care for me. If something bad happened to patients, [the mindset was to] sweep under the rug, and keep your chin up. But they were profound emotional experiences.”\u003c/p>\n\u003cp>Recognizing that teaching hospitals present specific challenges for patient safety, the leading medical education accreditation group has stepped up its oversight policies.\u003c/p>\n\u003cp>Since 2012, the Accreditation Council for Graduate Medical Education — which accredits more than half of the nation’s teaching hospitals — has sent staff to these hospitals to conduct an evaluation that includes interviewing administrators, observing doctors, and walking the halls with residents.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Dr. Kevin Weiss, senior vice president of institution accreditation for the ACGME, said these mandatory site visits are intended to “increase awareness of residents in formal patient safety activities” like reporting medical errors or participating in debriefs of those errors after the fact, something that makes trainees more mindful of practicing medicine safely.\u003c/p>\n\u003cp>And teaching hospitals are taking matters into their own hands.\u003c/p>\n\u003cp>At the University of Chicago Medical Center, every resident must undergo patient safety training. As part of it, they must spot medical errors in a simulated environment dubbed the “\u003ca href=\"https://news.aamc.org/medical-education/article/patient-safety-residency-training/\" target=\"_blank\" rel=\"noopener\">horror room\u003c/a>.” They’re also strongly encouraged to report adverse patient events or “near misses,” and are expected, in collaboration with superiors, to reverse engineer incidents where patients were harmed under their watch.\u003c/p>\n\u003cp>“We’re really focused on changing behavior,” said Dr. Vineet Arora, director of graduate medical education clinical learning. “It’s important that someone raises their hands, wherever they are on the hierarchy, and can say, ‘I see a problem.’ That’s a mindset change.”\u003c/p>\n\u003cp>Participation in this curriculum, Arora noted, was associated with “three times more event reports by those programs.” University of Chicago Medical Center hasn’t received a safety violation in over two years.\u003c/p>\n\u003cp>Meanwhile, researchers at Boston Children’s Hospital created \u003ca href=\"http://www.childrenshospital.org/news-and-events/2012/april-2012/i-pass-standardizing-patient-handoffs-to-reduce-medical-errors\" target=\"_blank\" rel=\"noopener\">“I-PASS,” a mnemonic device\u003c/a> that’s bundled with training and lectures in order to help \u003ca href=\"https://www.statnews.com/2016/02/01/communication-failures-malpractice-study/\">improve patient handoffs\u003c/a>. A resident whose shift is ending relays information to his or her successor by running through five pieces of information: illness severity, patient summary, action list, situation awareness and contingency planning, and synthesis by receiver.\u003c/p>\n\u003cp>It’s worked so well in pediatric units — one study found its use was associated with a \u003ca href=\"https://www.medpagetoday.com/hospitalbasedmedicine/generalhospitalpractice/48817\" target=\"_blank\" rel=\"noopener\">23 percent drop in medical errors\u003c/a> — that \u003ca href=\"http://app.ihi.org/FacultyDocuments/Events/Event-2613/Presentation-12369/Document-10285/Presentation_C12_FINAL.pdf\" target=\"_blank\" rel=\"noopener\">Massachusetts General Hospital\u003c/a>decided to adopt it throughout the institution. Dr. Elizabeth Mort, senior vice president of quality and safety at Mass. General, said the program led to a “fivefold increase” in safety reporting from trainees.\u003c/p>\n\u003cp>“An understanding of patient safety is something we’re not born with,” said Dr. Anai Kothari, a fourth-year surgery resident at Loyola University. “But it can be learned and applied — and can make a difference when we do it well.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>This story was originally published by \u003ca href=\"https://www.statnews.com/2018/04/20/doctors-learn-bad-habits-teaching-hospitals/\" target=\"_blank\" rel=\"noopener\">STAT\u003c/a>, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440967/the-next-generation-of-doctors-may-be-learning-bad-habits-at-teaching-hospitals-with-many-safety-violations","authors":["byline_futureofyou_440967"],"programs":["futureofyou_54"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_190","futureofyou_61","futureofyou_177","futureofyou_80","futureofyou_1256"],"featImg":"futureofyou_440969","label":"source_futureofyou_440967"},"futureofyou_440290":{"type":"posts","id":"futureofyou_440290","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440290","score":null,"sort":[1521646230000]},"guestAuthors":[],"slug":"3-d-space-gives-new-life-to-dead-bodies","title":"3-D Space Gives New Life to Dead Bodies","publishDate":1521646230,"format":"image","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Eric Smith has just gained new appreciation for the pancreas.\u003c/p>\n\u003cp>It’s “so unassuming,” he says. Pulling the pancreas out of the gastrointestinal tract and holding it in mid-air, he regards it with a sense of awe.\u003c/p>\n\u003cp>“In surgery people always say don’t touch the pancreas, and I thought it would be this ugly thing. ... But it is cute. It looks like a shrimp.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Medical schools are weighing the advantages of teaching students anatomy with the help of virtual reality.\u003c/aside>\n\u003cp>Smith, a first year medical student at UC San Francisco, then tucks the “cute” organ back in place, between the liver and the large intestine. He’s not using gloves, a scalpel or a surgical mask. Instead of having a cadaver in front of him, he’s moving around a large room in a 3-D headset. On the wall-mounted 72-inch screen in UCSF’s virtual anatomy learning center Smith sees a skeleton with stomach, intestines and liver attached to the bones.\u003c/p>\n\u003cp>Fellow student Sheyda Aboii is helping him study the digestive system.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"7355EazHRrQLdJAifTzwdkXCkQhYWDkV\"]“The coronary ligament attaches the liver to what structure?” Aboii asks.\u003c/p>\n\u003cp>“Anterior abdominal wall?” Smith hesitates.\u003c/p>\n\u003cp>“No.” Aboii responds. “What lies right above?”\u003c/p>\n\u003cp>“Oh, the diaphragm!” Smith says.\u003c/p>\n\u003cp>Smith and Aboii are part of a new generation of doctors-in-training who are learning anatomy with the help of Virtual Reality. The VR lessons allow students to see a complete three dimensional picture of body parts, easily move virtual organs in and out of the body and memorize medical terms — each organ displays its name tag once you hover over it.\u003c/p>\n\u003cp>Running a 3-D learning center is also less expensive than a cadaver lab and less toxic to be around, say proponents. However, some medical professors believe the benefits of learning anatomy through real bodies will never be replaced. VR doesn’t give students the same experience they get from a human body with its unique structure.\u003c/p>\n\u003cp>https://www.youtube.com/embed/4z3zdjbZdQU\u003c/p>\n\u003cp>\u003cb>VR Arrives on the Scene\u003c/b>\u003c/p>\n\u003cp>For over a 100 years medical students in the United States have been studying anatomy on cadavers. Curriculums hadn’t really changed much until about five or six years ago, with the introduction of VR technology as a new educational option.\u003c/p>\n\u003cp>Derek Harmon, an assistant adjunct professor at UCSF’s Department of Anatomy, who has been teaching the VR course for over a year, says virtual reality brings an important technological innovation to medical students.\u003c/p>\n\u003cp>They can walk around the virtual model in the 3-D space getting the 360-degree view of the body they can’t get in the lab: the cadaver lies facing up or down providing only a 180-degree view.\u003c/p>\n\u003cp>Dissecting virtual organs and tissues is easier, and does not require surgical finesse. Students can move tissues apart and back together as many times as they want, while in the lab they have to keep organs in place so the next group of students can study on the same body.\u003c/p>\n\u003cfigure id=\"attachment_440301\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440301\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi.jpg\" alt=\"Two women in a room with a large screen.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Stacey Yu, assistant manager of the anatomy lab at UCSF, guides Sheyda Aboii, a student, while she uses virtual reality to study the GI, or digestive, system at the UCSF School of Medicine. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sometimes virtual reality can give students motion sickness, but Harmon says it only affects about 20 percent of them.\u003c/p>\n\u003cp>A virtual learning center may also be a healthier place to study, as it has no smell of formaldehyde used for embalming dead bodies. Formaldehyde inhalation triggers dry mouth, eye and throat irritation.\u003c/p>\n\u003cp>The 3-D space revolution has already engulfed dozens of American medical colleges that have introduced not only virtual, but also augmented and mixed reality to their curriculum.\u003c/p>\n\u003cp>The University of Nebraska Medical Center teaches on \u003ca href=\"https://www.youtube.com/watch?v=QpkiKzNnJ1w\" target=\"_blank\" rel=\"noopener\">virtual dissection tables\u003c/a>; California’s Western University is actively using holographic displays and Oculus rift stations.\u003c/p>\n\u003cp>Western University’s College of Dental Medicine built their \u003ca href=\"https://westernu.smugmug.com/Virtual-Reality-Learning/i-PNhZJzK/A\" target=\"_blank\" rel=\"noopener\">virtual reality learning center\u003c/a> for just about $120,000, while the cost of maintaining the cadaver lab runs at about $2 to 4 million a year, according to the college Associate Dean of Simulation, Immersion and Digital Learning Robert W. Hasel.\u003c/p>\n\u003cp>Hasel is one of the most vocal critics of cadaver labs, because of their high operational cost and use of toxic chemicals like formaldehyde recognized by the American Cancer Society as carcinogenic. Chemical compounds used for embalming bodies have not changed in 100 years.\u003c/p>\n\u003cp>He also questions learning efficiency in cadaver labs. He says students leave the bodies so “hacked up” that it is hard to recognize organs and tissues. As a result, “students make mistakes, and you can't recover,” says Hasel.\u003c/p>\n\u003cp>According to Hasel, since Western University introduced VR technology in its curriculum about five years ago, students’ grades on their anatomical sciences national board exams have gone up 15 to 20 percent.\u003c/p>\n\u003cfigure id=\"attachment_440305\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440305\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi.jpg\" alt=\"Two students, one with a VR headset on.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Medical students Sheyda Aboii (left) and Eric Smith use virtual reality to study the GI, or digestive, system at the UCSF School of Medicine. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Traditional Anatomy Classes Here to Stay, For Now\u003c/b>\u003c/p>\n\u003cp>The numbers don’t convince Douglas Gross, professor of cell biology and human anatomy at UC Davis, who likes to stick to the good old practice. He has been teaching anatomy for 42 years and believes that 3-D could be valuable adjunct, but not a replacement for studying a human body.\u003c/p>\n\u003cp>He says programs that try to get rid of their dissection studying labs are doomed to a “pretty dismal failure.”\u003c/p>\n\u003cp>Gross says it is important for students to touch and feel a real human body as they learn anatomy, literally squeeze the organs in their fingers. Lack of this tangible experience won’t allow them to become good doctors.\u003c/p>\n\u003cp>Beyond that, “changing curriculum in a medical school is like moving a glacier,” says Gross. Faculty members, scientists and clinicians often have different opinions on teaching strategies. And even small changes take a lot of time.\u003c/p>\n\u003cp>\u003cb>An Appreciation for Cadavers\u003c/b>\u003c/p>\n\u003cp>Aboii just like the majority of medical students at UCSF welcomes VR lessons. But she sees them as a useful fun tool and doesn’t admire them as much as she does the traditional anatomy classes.\u003c/p>\n\u003cfigure id=\"attachment_440359\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440359\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi.jpg\" alt=\"A GI track appears on a large screen.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">VR anatomy lessons are gaining popularity, but traditional learning using cadavers isn't going away any time soon. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She says the smell of formaldehyde doesn’t bother her. And knowing that the bodies students work on were donated for research and education fills her respect.\u003c/p>\n\u003cp>“There is a certain gravity to that,” Aboii says. “Each of the cadavers is unique. In life, they were unique human beings, and now they are unique donations. For a trainee, like myself, it's good to start getting used to that spectrum of life and death.”\u003c/p>\n\u003cp>[contextly_sidebar id=\"FwbyNhLT7uzLhRDlXYonilNTpUsv3z8Y\"]Virtual lessons help memorize and review, but they don’t show “the unique human variability,” she says.\u003c/p>\n\u003cp>“You get almost like an average idealized artistic rendering of what the human body looks like,” says Aboii. However in real life things might be different. Arteries, for example, may not always be connected in the same way on a cadaver.\u003c/p>\n\u003cp>Harmon is convinced cadaver labs are here to stay, at least for now, but the number of VR platforms in medical schools will skyrocket in the next couple of years and will be especially useful for medical professions that use a lot of 3-D scans in their practice, like radiologists.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“VR in medicine is going to explode,\" says Harmon. \"And it is exciting.\"\u003c/p>\n\n","blocks":[],"excerpt":"A new crop of doctors-in-training are learning anatomy with the help of virtual reality.","status":"publish","parent":0,"modified":1521645604,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1307},"headData":{"title":"3-D Space Gives New Life to Dead Bodies | KQED","description":"A new crop of doctors-in-training are learning anatomy with the help of virtual reality.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"3-D Space Gives New Life to Dead Bodies","datePublished":"2018-03-21T15:30:30.000Z","dateModified":"2018-03-21T15:20:04.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440290 https://ww2.kqed.org/futureofyou/?p=440290","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/21/3-d-space-gives-new-life-to-dead-bodies/","disqusTitle":"3-D Space Gives New Life to Dead Bodies","source":"Virtual Reality","nprByline":"Julia Vassey","path":"/futureofyou/440290/3-d-space-gives-new-life-to-dead-bodies","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Eric Smith has just gained new appreciation for the pancreas.\u003c/p>\n\u003cp>It’s “so unassuming,” he says. Pulling the pancreas out of the gastrointestinal tract and holding it in mid-air, he regards it with a sense of awe.\u003c/p>\n\u003cp>“In surgery people always say don’t touch the pancreas, and I thought it would be this ugly thing. ... But it is cute. It looks like a shrimp.”\u003c/p>\n\u003caside class=\"pullquote alignright\">Medical schools are weighing the advantages of teaching students anatomy with the help of virtual reality.\u003c/aside>\n\u003cp>Smith, a first year medical student at UC San Francisco, then tucks the “cute” organ back in place, between the liver and the large intestine. He’s not using gloves, a scalpel or a surgical mask. Instead of having a cadaver in front of him, he’s moving around a large room in a 3-D headset. On the wall-mounted 72-inch screen in UCSF’s virtual anatomy learning center Smith sees a skeleton with stomach, intestines and liver attached to the bones.\u003c/p>\n\u003cp>Fellow student Sheyda Aboii is helping him study the digestive system.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>“The coronary ligament attaches the liver to what structure?” Aboii asks.\u003c/p>\n\u003cp>“Anterior abdominal wall?” Smith hesitates.\u003c/p>\n\u003cp>“No.” Aboii responds. “What lies right above?”\u003c/p>\n\u003cp>“Oh, the diaphragm!” Smith says.\u003c/p>\n\u003cp>Smith and Aboii are part of a new generation of doctors-in-training who are learning anatomy with the help of Virtual Reality. The VR lessons allow students to see a complete three dimensional picture of body parts, easily move virtual organs in and out of the body and memorize medical terms — each organ displays its name tag once you hover over it.\u003c/p>\n\u003cp>Running a 3-D learning center is also less expensive than a cadaver lab and less toxic to be around, say proponents. However, some medical professors believe the benefits of learning anatomy through real bodies will never be replaced. VR doesn’t give students the same experience they get from a human body with its unique structure.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/4z3zdjbZdQU'\n title='//www.youtube.com/embed/4z3zdjbZdQU'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cb>VR Arrives on the Scene\u003c/b>\u003c/p>\n\u003cp>For over a 100 years medical students in the United States have been studying anatomy on cadavers. Curriculums hadn’t really changed much until about five or six years ago, with the introduction of VR technology as a new educational option.\u003c/p>\n\u003cp>Derek Harmon, an assistant adjunct professor at UCSF’s Department of Anatomy, who has been teaching the VR course for over a year, says virtual reality brings an important technological innovation to medical students.\u003c/p>\n\u003cp>They can walk around the virtual model in the 3-D space getting the 360-degree view of the body they can’t get in the lab: the cadaver lies facing up or down providing only a 180-degree view.\u003c/p>\n\u003cp>Dissecting virtual organs and tissues is easier, and does not require surgical finesse. Students can move tissues apart and back together as many times as they want, while in the lab they have to keep organs in place so the next group of students can study on the same body.\u003c/p>\n\u003cfigure id=\"attachment_440301\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440301\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi.jpg\" alt=\"Two women in a room with a large screen.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29317_ANATOMYVR_020818_037-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Stacey Yu, assistant manager of the anatomy lab at UCSF, guides Sheyda Aboii, a student, while she uses virtual reality to study the GI, or digestive, system at the UCSF School of Medicine. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Sometimes virtual reality can give students motion sickness, but Harmon says it only affects about 20 percent of them.\u003c/p>\n\u003cp>A virtual learning center may also be a healthier place to study, as it has no smell of formaldehyde used for embalming dead bodies. Formaldehyde inhalation triggers dry mouth, eye and throat irritation.\u003c/p>\n\u003cp>The 3-D space revolution has already engulfed dozens of American medical colleges that have introduced not only virtual, but also augmented and mixed reality to their curriculum.\u003c/p>\n\u003cp>The University of Nebraska Medical Center teaches on \u003ca href=\"https://www.youtube.com/watch?v=QpkiKzNnJ1w\" target=\"_blank\" rel=\"noopener\">virtual dissection tables\u003c/a>; California’s Western University is actively using holographic displays and Oculus rift stations.\u003c/p>\n\u003cp>Western University’s College of Dental Medicine built their \u003ca href=\"https://westernu.smugmug.com/Virtual-Reality-Learning/i-PNhZJzK/A\" target=\"_blank\" rel=\"noopener\">virtual reality learning center\u003c/a> for just about $120,000, while the cost of maintaining the cadaver lab runs at about $2 to 4 million a year, according to the college Associate Dean of Simulation, Immersion and Digital Learning Robert W. Hasel.\u003c/p>\n\u003cp>Hasel is one of the most vocal critics of cadaver labs, because of their high operational cost and use of toxic chemicals like formaldehyde recognized by the American Cancer Society as carcinogenic. Chemical compounds used for embalming bodies have not changed in 100 years.\u003c/p>\n\u003cp>He also questions learning efficiency in cadaver labs. He says students leave the bodies so “hacked up” that it is hard to recognize organs and tissues. As a result, “students make mistakes, and you can't recover,” says Hasel.\u003c/p>\n\u003cp>According to Hasel, since Western University introduced VR technology in its curriculum about five years ago, students’ grades on their anatomical sciences national board exams have gone up 15 to 20 percent.\u003c/p>\n\u003cfigure id=\"attachment_440305\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440305\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi.jpg\" alt=\"Two students, one with a VR headset on.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29319_ANATOMYVR_020818_025-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">Medical students Sheyda Aboii (left) and Eric Smith use virtual reality to study the GI, or digestive, system at the UCSF School of Medicine. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cb>Traditional Anatomy Classes Here to Stay, For Now\u003c/b>\u003c/p>\n\u003cp>The numbers don’t convince Douglas Gross, professor of cell biology and human anatomy at UC Davis, who likes to stick to the good old practice. He has been teaching anatomy for 42 years and believes that 3-D could be valuable adjunct, but not a replacement for studying a human body.\u003c/p>\n\u003cp>He says programs that try to get rid of their dissection studying labs are doomed to a “pretty dismal failure.”\u003c/p>\n\u003cp>Gross says it is important for students to touch and feel a real human body as they learn anatomy, literally squeeze the organs in their fingers. Lack of this tangible experience won’t allow them to become good doctors.\u003c/p>\n\u003cp>Beyond that, “changing curriculum in a medical school is like moving a glacier,” says Gross. Faculty members, scientists and clinicians often have different opinions on teaching strategies. And even small changes take a lot of time.\u003c/p>\n\u003cp>\u003cb>An Appreciation for Cadavers\u003c/b>\u003c/p>\n\u003cp>Aboii just like the majority of medical students at UCSF welcomes VR lessons. But she sees them as a useful fun tool and doesn’t admire them as much as she does the traditional anatomy classes.\u003c/p>\n\u003cfigure id=\"attachment_440359\" class=\"wp-caption aligncenter\" style=\"max-width: 539px\">\u003cimg class=\"size-full wp-image-440359\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi.jpg\" alt=\"A GI track appears on a large screen.\" width=\"539\" height=\"360\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi.jpg 539w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/03/RS29325_ANATOMYVR_020818_030-sfi-520x347.jpg 520w\" sizes=\"(max-width: 539px) 100vw, 539px\">\u003cfigcaption class=\"wp-caption-text\">VR anatomy lessons are gaining popularity, but traditional learning using cadavers isn't going away any time soon. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>She says the smell of formaldehyde doesn’t bother her. And knowing that the bodies students work on were donated for research and education fills her respect.\u003c/p>\n\u003cp>“There is a certain gravity to that,” Aboii says. “Each of the cadavers is unique. In life, they were unique human beings, and now they are unique donations. For a trainee, like myself, it's good to start getting used to that spectrum of life and death.”\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Virtual lessons help memorize and review, but they don’t show “the unique human variability,” she says.\u003c/p>\n\u003cp>“You get almost like an average idealized artistic rendering of what the human body looks like,” says Aboii. However in real life things might be different. Arteries, for example, may not always be connected in the same way on a cadaver.\u003c/p>\n\u003cp>Harmon is convinced cadaver labs are here to stay, at least for now, but the number of VR platforms in medical schools will skyrocket in the next couple of years and will be especially useful for medical professions that use a lot of 3-D scans in their practice, like radiologists.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“VR in medicine is going to explode,\" says Harmon. \"And it is exciting.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440290/3-d-space-gives-new-life-to-dead-bodies","authors":["byline_futureofyou_440290"],"categories":["futureofyou_1","futureofyou_1063"],"tags":["futureofyou_1474","futureofyou_1275","futureofyou_1256","futureofyou_23","futureofyou_35","futureofyou_113"],"featImg":"futureofyou_440299","label":"source_futureofyou_440290"},"futureofyou_379855":{"type":"posts","id":"futureofyou_379855","meta":{"index":"posts_1591205157","site":"futureofyou","id":"379855","score":null,"sort":[1493738548000]},"guestAuthors":[],"slug":"suicides-push-medical-schools-to-finally-address-student-mental-health","title":"Medical Student Suicides Prompt Schools to Finally Take Action","publishDate":1493738548,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{"term":54,"site":"futureofyou"},"content":"\u003cp>\u003cem>This post was updated May 22 to include the radio version, which you can listen to by scrolling down.\u003c/em>\u003c/p>\n\u003cp>Last year, all of the accumulated data pointing to the poor mental health of medical students in general suddenly became more than just numbers at USC's Keck School of Medicine.\u003c/p>\n\u003cp>A Keck student, 25-year-old Sean Petro, had failed to show up for a clinical rotation. Eventually, campus police found his body in a closet of his apartment, where he had hung himself. In addition to attending medical school, Petro had just become an officer in the Navy Reserve, and had hopes of becoming a flight surgeon.\u003c/p>\n\u003cp>At Keck, he was just one year shy of graduating.\u003c/p>\n\u003cp>His suicide shocked Ranjita Raghavan, now in her third year at the medical school, a year behind Petro.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"It’s really scary,\" she says, speaking about medical school suicides in general. \"It’s one of those things that’s really alarming.\"\u003c/p>\n\u003cp>[audio src=\"http://www.kqed.org/.stream/anon/radio/science/2017/05/WEBSuicideDocsGorn170522.mp3\" title=\"Click on the play button below to listen to the radio story\" program=\"Future of You\" image=\"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/05/SciencePlayer_BG.jpeg\"]\u003c/p>\n\u003cp>Her own schedule illustrates how daunting a medical student's life can be. Six days a week, she rises at 4:30 a.m. and doesn't return home till 7 p.m. Whatever free time she has is used to study and eat.\u003c/p>\n\u003cp>\"No one said medical school’s going to be easy,\" she says. \"But you just don’t know from the outside. I come off as a happy person, but it was really tough for me the first two years.\"\u003c/p>\n\u003cp>She says although she is generally upbeat about her medical school experience, she still can't quite get her mind around all the data that shows so many students are exhibiting signs of burnout, not to mention thinking about suicide.\u003c/p>\n\u003cp>\u003cstrong>A Known Risk\u003c/strong>\u003c/p>\n\u003cp>After aspiring doctors receive a prized acceptance letter to medical school, they face a daunting reality.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is so much buzz in our circle right now, in the academic and physician circle, and now it’s reaching a level that can no longer be pushed under the rug. It’s becoming scandalous.'\u003ccite>Dr. Andres Sciolla, psychiatrist, UC Davis School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>Get ready for 80-hour work weeks for the next seven years of med school and residency. Get ready for trying to commit a crush of information to sleep-deprived brain cells. Get ready for little time spent with family and friends. Oh, and by the way, get ready for making decisions resulting in life and death.\u003c/p>\n\u003cp>And get ready for, potentially, thoughts about ending your own life.\u003c/p>\n\u003cp>No one knows the exact number of medical students or residents who have killed themselves in the U.S.; there is no requirement to report suicide rates in medical school or residency programs. But multiple studies have shown these doctors-in-training are at risk for suicide, and the reality of poor mental health among the population is well-known.\u003c/p>\n\u003cp>Last year, a\u003ca href=\"http://jamanetwork.com/journals/jama/article-abstract/2589340\" target=\"_blank\" rel=\"noopener noreferrer\"> meta-study \u003c/a>published in the \u003cem>Journal of the American Medical Association\u003c/em> looked at 117,000 medical students around the world. The findings: 11 percent had considered ending their lives.\u003c/p>\n\u003cp>A 2008\u003ca href=\"https://www.med.upenn.edu/gastro/documents/Dyrbye.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> study\u003c/a> of over 4,000 students at seven U.S. medical schools found as high as 13 percent having suicidal thoughts. For comparison, in the U.S., the rate of suicidal ideation among the general population is just 7 percent for 18 to-25 -year-olds, according to 2013 \u003ca href=\"https://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">numbers\u003c/a> from the U.S. Centers for Disease Control and Prevention. For 26- to 49-year-olds, it is 4 percent.\u003c/p>\n\u003cp>And while a 2014 \u003ca href=\"http://journals.lww.com/academicmedicine/Fulltext/2014/03000/Burnout_Among_U_S__Medical_Students,_Residents,.25.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> found a slightly lower rate of suicidal ideation among medical students, residents and young doctors compared to others in their age group, it found significantly higher rates of depression and burnout.\u003c/p>\n\u003cp>\u003cstrong>Schools, Programs React\u003c/strong>\u003c/p>\n\u003cp>The data, combined with a number of actual suicides by medical students and residents, have prompted schools and residency programs across California and the country to initiate programs to reduce stress, require mental-health screenings and offer counseling.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I don’t know that we recognized the need. I think medicine traditionally has been a profession that says, ‘You just do it.’ ”\u003ccite>Donna Elliott, senior associate dean of student affairs, USC\u003c/cite>\u003c/aside>\n\u003cp>The programs have been instituted over just the last several years; traditionally, stress and mental health problems are not issues the institutions have specifically addressed, mental health experts say.\u003c/p>\n\u003cp>That's changing because Petro's death is only one of several recent suicides by medical students and residents around the country, says Andres Sciolla, a psychiatrist at the UC Davis School of Medicine.\u003c/p>\n\u003cp>Sciolla says the suicides of two doctors-in-training in New York City in 2014 galvanized the idea among the medical community that something needed to be done.\u003c/p>\n\u003cp>\"It’s a very big topic that the general public just doesn’t know about,” Sciolla says. “There is so much buzz in our circle right now, in the academic and physician circle, and now it’s reaching a level that can no longer be pushed under the rug. It’s becoming scandalous.”\u003c/p>\n\u003cp>Sciolla helped institute a mental health program at UC Davis to catch problems before they can turn into crises. Residents fill out an online confidential survey to help identify those who are dealing with high levels of stress. Those individuals are contacted and offered counseling and other resources so they don't have to suffer in silence.\u003c/p>\n\u003cp>At the Keck School of Medicine, administrators started to address student mental health even before Petro's death. That's partly because in 2014, the same year national attention focused on the resident suicides in New York, another medical student who was enrolled at USC disappeared and was never found. That same year, a faculty physician took his own life.\u003c/p>\n\u003cp>Donna Elliott, the senior associate dean of student affairs at USC, says those local and national incidents were a loud wake-up call.\u003c/p>\n\u003cp>“There's a strong need in medical schools now in supporting students’ mental health,\" Elliott says. A big first step in that direction, she says, is the need to change the culture of shame and stigma around burnout, depression and suicide.\u003c/p>\n\u003cp>USC has hired a director of medical student wellness, instituted mandatory \"Keck Check\" mental health\u003cem> \u003c/em>evaluation sessions and now requires students to take several mental-health days off every year.\u003c/p>\n\u003cp>\u003cstrong>'Slow Going'\u003c/strong>\u003c/p>\n\u003cp>In the past, Elliott says, \"I don’t know that we recognized the need. I think medicine traditionally has been a profession that says, ‘You just do it.’ ”\u003c/p>\n\u003cp>Indeed the stigma and shame of suicide is more pronounced in the medical community, says Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention.\u003c/p>\n\u003cp>Moutier, while working at UC San Diego, was the driving force behind the first med school suicide prevention program in California, \u003ca href=\"https://healthsciences.ucsd.edu/som/hear/Documents/suicide-prevention-depression-awareness.pdf\">back in 2009\u003c/a>.\u003c/p>\n\u003cp>\"At the time, it felt like few were doing that work, and it felt like swimming upstream to get it done,\" Moutier says. \"And it became even more difficult when I would take ideas to the regional or national level. It was slow going.\"\u003c/p>\n\u003cp>Moutier points to the irony that those attending to people’s health are facing their own health crisis. “It’s such a disconnect that health professionals don’t take this seriously,” she says.\u003c/p>\n\u003cp>She calls the problem a public health crisis–not just for the medical providers, but for their patients as well.\u003c/p>\n\u003cp>“This is a major problem,” Moutier says. “I mean, if you’re looking at the fact that almost a \u003ca href=\"http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2467822\" target=\"_blank\" rel=\"noopener noreferrer\">quarter of interns\u003c/a> are thinking of suicide, what kind of care are they giving patients?”\u003c/p>\n\u003cp>A national movement is now afoot to address the issue. The Accreditation Council for Graduate Medical Education last year \u003ca href=\"https://www.acgme.org/Portals/0/PDFs/JointReleaseFinal_Letterhead.pdf\">launched an initiative\u003c/a> to prevent medical school and residency suicides, and it hopes to require residency training programs to have wellness initiatives in place starting in July.\u003c/p>\n\u003cp>However, a \u003ca href=\"http://www.acgme.org/Portals/0/PDFs/Nasca-Community/Section-VI-Memo-3-10-17.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">recent ACGME decision\u003c/a> raised the\u003ca href=\"https://www.nytimes.com/2017/03/10/health/us-doctors-residents-24-hour-shifts.html\" target=\"_blank\" rel=\"noopener noreferrer\"> number of continuous hours\u003c/a> first-year residents can work, from 16 to 24.\u003c/p>\n\u003cp>Among other medical schools across the state, UCSF now requires third-year medical students, who typically spend up to 80 hours a week on hospital rotations, to attend check-in mental-health sessions. Stanford School of Medicine has a similar program to identify and help those who might be struggling with stress and burnout. One residency program at Stanford also offers stress-reduction perks like free delivery of groceries to residents' homes and time to exercise.\u003c/p>\n\u003cp>All of these efforts are a good start, but just a start, says Sidney Zisook, director of the psychiatry residency program at UC San Diego.\u003c/p>\n\u003cp>“There’s been a code of silence throughout the years. Places have tried to cover this up and hush it up, no question,\" Zisook says. “I do think things are moving in a positive direction now. But certainly institutions need to take a much more serious look at this.”\u003c/p>\n\u003cp>Raghavan, the third-year medical student from USC, says she recognizes the support she is getting from the school.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"On your own, you never have enough time to sit and think about what you need. I mean, when do I have time to do that?\" she says with a laugh. \"So I appreciate the school thinking about that for you, and trying to do something about it.\"\u003c/p>\n\n","blocks":[],"excerpt":"Suicides in medical schools, as well as studies showing an alarming number of medical students consider ending their lives, have prompted schools and residency programs to provide more support for mental health.","status":"publish","parent":0,"modified":1495490914,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":45,"wordCount":1669},"headData":{"title":"Medical Student Suicides Prompt Schools to Finally Take Action | KQED","description":"Suicides in medical schools, as well as studies showing an alarming number of medical students consider ending their lives, have prompted schools and residency programs to provide more support for mental health.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Medical Student Suicides Prompt Schools to Finally Take Action","datePublished":"2017-05-02T15:22:28.000Z","dateModified":"2017-05-22T22:08:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"379855 https://ww2.kqed.org/futureofyou/?p=379855","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/05/02/suicides-push-medical-schools-to-finally-address-student-mental-health/","disqusTitle":"Medical Student Suicides Prompt Schools to Finally Take Action","audioUrl":"http://www.kqed.org/.stream/anon/radio/science/2017/05/WEBSuicideDocsGorn170522.mp3","path":"/futureofyou/379855/suicides-push-medical-schools-to-finally-address-student-mental-health","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This post was updated May 22 to include the radio version, which you can listen to by scrolling down.\u003c/em>\u003c/p>\n\u003cp>Last year, all of the accumulated data pointing to the poor mental health of medical students in general suddenly became more than just numbers at USC's Keck School of Medicine.\u003c/p>\n\u003cp>A Keck student, 25-year-old Sean Petro, had failed to show up for a clinical rotation. Eventually, campus police found his body in a closet of his apartment, where he had hung himself. In addition to attending medical school, Petro had just become an officer in the Navy Reserve, and had hopes of becoming a flight surgeon.\u003c/p>\n\u003cp>At Keck, he was just one year shy of graduating.\u003c/p>\n\u003cp>His suicide shocked Ranjita Raghavan, now in her third year at the medical school, a year behind Petro.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"It’s really scary,\" she says, speaking about medical school suicides in general. \"It’s one of those things that’s really alarming.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audio","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio/science/2017/05/WEBSuicideDocsGorn170522.mp3","title":"Click on the play button below to listen to the radio story","program":"Future of You","image":"https://ww2.kqed.org/science/wp-content/uploads/sites/35/2017/05/SciencePlayer_BG.jpeg","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her own schedule illustrates how daunting a medical student's life can be. Six days a week, she rises at 4:30 a.m. and doesn't return home till 7 p.m. Whatever free time she has is used to study and eat.\u003c/p>\n\u003cp>\"No one said medical school’s going to be easy,\" she says. \"But you just don’t know from the outside. I come off as a happy person, but it was really tough for me the first two years.\"\u003c/p>\n\u003cp>She says although she is generally upbeat about her medical school experience, she still can't quite get her mind around all the data that shows so many students are exhibiting signs of burnout, not to mention thinking about suicide.\u003c/p>\n\u003cp>\u003cstrong>A Known Risk\u003c/strong>\u003c/p>\n\u003cp>After aspiring doctors receive a prized acceptance letter to medical school, they face a daunting reality.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There is so much buzz in our circle right now, in the academic and physician circle, and now it’s reaching a level that can no longer be pushed under the rug. It’s becoming scandalous.'\u003ccite>Dr. Andres Sciolla, psychiatrist, UC Davis School of Medicine\u003c/cite>\u003c/aside>\n\u003cp>Get ready for 80-hour work weeks for the next seven years of med school and residency. Get ready for trying to commit a crush of information to sleep-deprived brain cells. Get ready for little time spent with family and friends. Oh, and by the way, get ready for making decisions resulting in life and death.\u003c/p>\n\u003cp>And get ready for, potentially, thoughts about ending your own life.\u003c/p>\n\u003cp>No one knows the exact number of medical students or residents who have killed themselves in the U.S.; there is no requirement to report suicide rates in medical school or residency programs. But multiple studies have shown these doctors-in-training are at risk for suicide, and the reality of poor mental health among the population is well-known.\u003c/p>\n\u003cp>Last year, a\u003ca href=\"http://jamanetwork.com/journals/jama/article-abstract/2589340\" target=\"_blank\" rel=\"noopener noreferrer\"> meta-study \u003c/a>published in the \u003cem>Journal of the American Medical Association\u003c/em> looked at 117,000 medical students around the world. The findings: 11 percent had considered ending their lives.\u003c/p>\n\u003cp>A 2008\u003ca href=\"https://www.med.upenn.edu/gastro/documents/Dyrbye.pdf\" target=\"_blank\" rel=\"noopener noreferrer\"> study\u003c/a> of over 4,000 students at seven U.S. medical schools found as high as 13 percent having suicidal thoughts. For comparison, in the U.S., the rate of suicidal ideation among the general population is just 7 percent for 18 to-25 -year-olds, according to 2013 \u003ca href=\"https://www.cdc.gov/violenceprevention/pdf/suicide-datasheet-a.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">numbers\u003c/a> from the U.S. Centers for Disease Control and Prevention. For 26- to 49-year-olds, it is 4 percent.\u003c/p>\n\u003cp>And while a 2014 \u003ca href=\"http://journals.lww.com/academicmedicine/Fulltext/2014/03000/Burnout_Among_U_S__Medical_Students,_Residents,.25.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">study\u003c/a> found a slightly lower rate of suicidal ideation among medical students, residents and young doctors compared to others in their age group, it found significantly higher rates of depression and burnout.\u003c/p>\n\u003cp>\u003cstrong>Schools, Programs React\u003c/strong>\u003c/p>\n\u003cp>The data, combined with a number of actual suicides by medical students and residents, have prompted schools and residency programs across California and the country to initiate programs to reduce stress, require mental-health screenings and offer counseling.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I don’t know that we recognized the need. I think medicine traditionally has been a profession that says, ‘You just do it.’ ”\u003ccite>Donna Elliott, senior associate dean of student affairs, USC\u003c/cite>\u003c/aside>\n\u003cp>The programs have been instituted over just the last several years; traditionally, stress and mental health problems are not issues the institutions have specifically addressed, mental health experts say.\u003c/p>\n\u003cp>That's changing because Petro's death is only one of several recent suicides by medical students and residents around the country, says Andres Sciolla, a psychiatrist at the UC Davis School of Medicine.\u003c/p>\n\u003cp>Sciolla says the suicides of two doctors-in-training in New York City in 2014 galvanized the idea among the medical community that something needed to be done.\u003c/p>\n\u003cp>\"It’s a very big topic that the general public just doesn’t know about,” Sciolla says. “There is so much buzz in our circle right now, in the academic and physician circle, and now it’s reaching a level that can no longer be pushed under the rug. It’s becoming scandalous.”\u003c/p>\n\u003cp>Sciolla helped institute a mental health program at UC Davis to catch problems before they can turn into crises. Residents fill out an online confidential survey to help identify those who are dealing with high levels of stress. Those individuals are contacted and offered counseling and other resources so they don't have to suffer in silence.\u003c/p>\n\u003cp>At the Keck School of Medicine, administrators started to address student mental health even before Petro's death. That's partly because in 2014, the same year national attention focused on the resident suicides in New York, another medical student who was enrolled at USC disappeared and was never found. That same year, a faculty physician took his own life.\u003c/p>\n\u003cp>Donna Elliott, the senior associate dean of student affairs at USC, says those local and national incidents were a loud wake-up call.\u003c/p>\n\u003cp>“There's a strong need in medical schools now in supporting students’ mental health,\" Elliott says. A big first step in that direction, she says, is the need to change the culture of shame and stigma around burnout, depression and suicide.\u003c/p>\n\u003cp>USC has hired a director of medical student wellness, instituted mandatory \"Keck Check\" mental health\u003cem> \u003c/em>evaluation sessions and now requires students to take several mental-health days off every year.\u003c/p>\n\u003cp>\u003cstrong>'Slow Going'\u003c/strong>\u003c/p>\n\u003cp>In the past, Elliott says, \"I don’t know that we recognized the need. I think medicine traditionally has been a profession that says, ‘You just do it.’ ”\u003c/p>\n\u003cp>Indeed the stigma and shame of suicide is more pronounced in the medical community, says Christine Moutier, chief medical officer at the American Foundation for Suicide Prevention.\u003c/p>\n\u003cp>Moutier, while working at UC San Diego, was the driving force behind the first med school suicide prevention program in California, \u003ca href=\"https://healthsciences.ucsd.edu/som/hear/Documents/suicide-prevention-depression-awareness.pdf\">back in 2009\u003c/a>.\u003c/p>\n\u003cp>\"At the time, it felt like few were doing that work, and it felt like swimming upstream to get it done,\" Moutier says. \"And it became even more difficult when I would take ideas to the regional or national level. It was slow going.\"\u003c/p>\n\u003cp>Moutier points to the irony that those attending to people’s health are facing their own health crisis. “It’s such a disconnect that health professionals don’t take this seriously,” she says.\u003c/p>\n\u003cp>She calls the problem a public health crisis–not just for the medical providers, but for their patients as well.\u003c/p>\n\u003cp>“This is a major problem,” Moutier says. “I mean, if you’re looking at the fact that almost a \u003ca href=\"http://jamanetwork.com/journals/jamapsychiatry/fullarticle/2467822\" target=\"_blank\" rel=\"noopener noreferrer\">quarter of interns\u003c/a> are thinking of suicide, what kind of care are they giving patients?”\u003c/p>\n\u003cp>A national movement is now afoot to address the issue. The Accreditation Council for Graduate Medical Education last year \u003ca href=\"https://www.acgme.org/Portals/0/PDFs/JointReleaseFinal_Letterhead.pdf\">launched an initiative\u003c/a> to prevent medical school and residency suicides, and it hopes to require residency training programs to have wellness initiatives in place starting in July.\u003c/p>\n\u003cp>However, a \u003ca href=\"http://www.acgme.org/Portals/0/PDFs/Nasca-Community/Section-VI-Memo-3-10-17.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">recent ACGME decision\u003c/a> raised the\u003ca href=\"https://www.nytimes.com/2017/03/10/health/us-doctors-residents-24-hour-shifts.html\" target=\"_blank\" rel=\"noopener noreferrer\"> number of continuous hours\u003c/a> first-year residents can work, from 16 to 24.\u003c/p>\n\u003cp>Among other medical schools across the state, UCSF now requires third-year medical students, who typically spend up to 80 hours a week on hospital rotations, to attend check-in mental-health sessions. Stanford School of Medicine has a similar program to identify and help those who might be struggling with stress and burnout. One residency program at Stanford also offers stress-reduction perks like free delivery of groceries to residents' homes and time to exercise.\u003c/p>\n\u003cp>All of these efforts are a good start, but just a start, says Sidney Zisook, director of the psychiatry residency program at UC San Diego.\u003c/p>\n\u003cp>“There’s been a code of silence throughout the years. Places have tried to cover this up and hush it up, no question,\" Zisook says. “I do think things are moving in a positive direction now. But certainly institutions need to take a much more serious look at this.”\u003c/p>\n\u003cp>Raghavan, the third-year medical student from USC, says she recognizes the support she is getting from the school.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"On your own, you never have enough time to sit and think about what you need. I mean, when do I have time to do that?\" she says with a laugh. \"So I appreciate the school thinking about that for you, and trying to do something about it.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/379855/suicides-push-medical-schools-to-finally-address-student-mental-health","authors":["8656"],"programs":["futureofyou_54"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_190","futureofyou_80","futureofyou_1256","futureofyou_1254","futureofyou_1258"],"featImg":"futureofyou_381345","label":"futureofyou_54"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. Plus, KQED’s Bianca Taylor brings you the local KQED news you need to know.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Consider-This-Podcast-Tile-703x703-1.jpg","imageAlt":"Consider This from NPR and KQED","officialWebsiteLink":"/podcasts/considerthis","meta":{"site":"news","source":"kqed","order":"7"},"link":"/podcasts/considerthis","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1503226625?mt=2&at=11l79Y&ct=nprdirectory","npr":"https://rpb3r.app.goo.gl/coronavirusdaily","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM1NS9wb2RjYXN0LnhtbA","spotify":"https://open.spotify.com/show/3Z6JdCS2d0eFEpXHKI6WqH"}},"forum":{"id":"forum","title":"Forum","tagline":"The conversation starts here","info":"KQED’s live call-in program discussing local, state, national and international issues, as well as in-depth interviews.","airtime":"MON-FRI 9am-11am, 10pm-11pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Forum-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED Forum with Mina Kim and Alexis Madrigal","officialWebsiteLink":"/forum","meta":{"site":"news","source":"kqed","order":"8"},"link":"/forum","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/kqeds-forum/id73329719","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM5NTU3MzgxNjMz","npr":"https://www.npr.org/podcasts/432307980/forum","stitcher":"https://www.stitcher.com/podcast/kqedfm-kqeds-forum-podcast","rss":"https://feeds.megaphone.fm/KQINC9557381633"}},"freakonomics-radio":{"id":"freakonomics-radio","title":"Freakonomics Radio","info":"Freakonomics Radio is a one-hour award-winning podcast and public-radio project hosted by Stephen Dubner, with co-author Steve Levitt as a regular guest. It is produced in partnership with WNYC.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/freakonomicsRadio.png","officialWebsiteLink":"http://freakonomics.com/","airtime":"SUN 1am-2am, SAT 3pm-4pm","meta":{"site":"radio","source":"WNYC"},"link":"/radio/program/freakonomics-radio","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/us/podcast/freakonomics-radio/id354668519","tuneIn":"https://tunein.com/podcasts/WNYC-Podcasts/Freakonomics-Radio-p272293/","rss":"https://feeds.feedburner.com/freakonomicsradio"}},"fresh-air":{"id":"fresh-air","title":"Fresh Air","info":"Hosted by Terry Gross, \u003cem>Fresh Air from WHYY\u003c/em> is the Peabody Award-winning weekday magazine of contemporary arts and issues. One of public radio's most popular programs, Fresh Air features intimate conversations with today's biggest luminaries.","airtime":"MON-FRI 7pm-8pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Fresh-Air-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/fresh-air/","meta":{"site":"radio","source":"npr"},"link":"/radio/program/fresh-air","subscribe":{"npr":"https://rpb3r.app.goo.gl/4s8b","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=214089682&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Fresh-Air-p17/","rss":"https://feeds.npr.org/381444908/podcast.xml"}},"here-and-now":{"id":"here-and-now","title":"Here & Now","info":"A live production of NPR and WBUR Boston, in collaboration with stations across the country, Here & Now reflects the fluid world of news as it's happening in the middle of the day, with timely, in-depth news, interviews and conversation. Hosted by Robin Young, Jeremy Hobson and Tonya Mosley.","airtime":"MON-THU 11am-12pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Here-And-Now-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"http://www.wbur.org/hereandnow","meta":{"site":"news","source":"npr"},"link":"/radio/program/here-and-now","subsdcribe":{"apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=426698661","tuneIn":"https://tunein.com/radio/Here--Now-p211/","rss":"https://feeds.npr.org/510051/podcast.xml"}},"how-i-built-this":{"id":"how-i-built-this","title":"How I Built This with Guy Raz","info":"Guy Raz dives into the stories behind some of the world's best known companies. How I Built This weaves a narrative journey about innovators, entrepreneurs and idealists—and the movements they built.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/2018/05/howIBuiltThis.png","officialWebsiteLink":"https://www.npr.org/podcasts/510313/how-i-built-this","airtime":"SUN 7:30pm-8pm","meta":{"site":"news","source":"npr"},"link":"/radio/program/how-i-built-this","subscribe":{"npr":"https://rpb3r.app.goo.gl/3zxy","apple":"https://itunes.apple.com/us/podcast/how-i-built-this-with-guy-raz/id1150510297?mt=2","tuneIn":"https://tunein.com/podcasts/Arts--Culture-Podcasts/How-I-Built-This-p910896/","rss":"https://feeds.npr.org/510313/podcast.xml"}},"inside-europe":{"id":"inside-europe","title":"Inside Europe","info":"Inside Europe, a one-hour weekly news magazine hosted by Helen Seeney and Keith Walker, explores the topical issues shaping the continent. No other part of the globe has experienced such dynamic political and social change in recent years.","airtime":"SAT 3am-4am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Inside-Europe-Podcast-Tile-300x300-1.jpg","meta":{"site":"news","source":"Deutsche Welle"},"link":"/radio/program/inside-europe","subscribe":{"apple":"https://itunes.apple.com/us/podcast/inside-europe/id80106806?mt=2","tuneIn":"https://tunein.com/radio/Inside-Europe-p731/","rss":"https://partner.dw.com/xml/podcast_inside-europe"}},"latino-usa":{"id":"latino-usa","title":"Latino USA","airtime":"MON 1am-2am, SUN 6pm-7pm","info":"Latino USA, the radio journal of news and culture, is the only national, English-language radio program produced from a Latino perspective.","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/latinoUsa.jpg","officialWebsiteLink":"http://latinousa.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/latino-usa","subscribe":{"npr":"https://rpb3r.app.goo.gl/xtTd","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=79681317&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/Latino-USA-p621/","rss":"https://feeds.npr.org/510016/podcast.xml"}},"live-from-here-highlights":{"id":"live-from-here-highlights","title":"Live from Here Highlights","info":"Chris Thile steps to the mic as the host of Live from Here (formerly A Prairie Home Companion), a live public radio variety show. Download Chris’s Song of the Week plus other highlights from the broadcast. Produced by American Public Media.","airtime":"SAT 6pm-8pm, SUN 11am-1pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Live-From-Here-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.livefromhere.org/","meta":{"site":"arts","source":"american public media"},"link":"/radio/program/live-from-here-highlights","subscribe":{"apple":"https://itunes.apple.com/us/podcast/id1167173941","tuneIn":"https://tunein.com/radio/Live-from-Here-Highlights-p921744/","rss":"https://feeds.publicradio.org/public_feeds/a-prairie-home-companion-highlights/rss/rss"}},"marketplace":{"id":"marketplace","title":"Marketplace","info":"Our flagship program, helmed by Kai Ryssdal, examines what the day in money delivered, through stories, conversations, newsworthy numbers and more. 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