School of Medicine

Wayne State University School of Medicine
Fulbright Distinguished Scholar Dr. Vijay Mittal to examine standardizing surgical education globally
In Headlines on May 15, 2013
Vijay Mittal, M.D.

Vijay Mittal, M.D.

Vijay Mittal, M.D., knows first-hand what it’s like to emigrate to the United States after completing surgical training in India.

“Surgical training in other countries isn’t recognized in the North American system. So when I came here in 1974, after practicing as a general and transplant surgeon for three years in India, I had to start all over,” said Dr. Mittal, clinical associate professor of Surgery at the Wayne State University School of Medicine and program director of the General Surgery Residency Program at Providence Hospital in Southfield, Mich. “I had to do a surgical residency and fellowship in Detroit, as if I was just out of medical school.  My education and experience in India was not recognized.”

As a recent recipient of the U.S. Department of State’s Fulbright Award, Dr. Mittal will focus on changing that situation. His proposal to the Fulbright Commission, titled “Global Surgical Education Evaluation and Uniformity,” is one of 40 that earned their authors Fulbright Distinguished Scholar Awards in Teaching and Research, considered by many the most prestigious appointment in the Fulbright Program.

Dr. Mittal’s project will take him to India, where he will work with other surgical educators to enhance the country’s surgical training curriculum to bring it in line with that of the United States. “People who intend to return to India after training in the U.S. often fail. This is because they’re not trained in the same system in which they’ll eventually practice,” Dr. Mittal said. “In India, there are different disease processes, different resources, different technology and different socio-economic considerations that confront young surgeons when they return. It’s critical that their training involve the same group of patients and pathologies they will someday manage.”

U.S. Sen. William Fulbright founded the Fulbright Program in 1946 to increase mutual understanding and respect between the U.S. and other countries. Fulbright scholars are seen as cultural ambassadors to their host countries, and are expected to be involved members of the communities they visit. Fulbright alumni include 43 Nobel laureates, 78 Pulitzer Prize winners, 10 U.S. congressmen and 18 government heads of state.

The newly formed College of Surgeons of India, at the All Asian Institute of Medical Sciences New Delhi, will support Dr. Mittal’s effort. The college, Dr. Mittal said, plans to create a national organization similar to the American Board of Surgery, which centralizes evaluation of surgical education and certification. Dr. Mittal and representatives of the college will examine India’s surgical education system in comparison to systems in Great Britain and the U.S., and work to develop a standardized approach.

“It will be useful to both Indian and North American educators to share processes and information.” Dr. Mittal said. “Recently the Accreditation Council for Graduate Medical Education has established an international rotation for U.S. surgical residents and this will also create an interest in the exchange of residents and faculty members between our two continents.”

Dr. Mittal was recently approved by the ACGME for this new rotation between Providence Hospital and New Delhi’s All Indian Institute of Medical Sciences. He hopes eventually to launch a similar exchange program for faculty members.

Dr. Mittal has spent the last 35 years in the U.S. practicing general, vascular and transplant surgery. He has served as president of the International College of Surgeons, Detroit Surgical Association, the Academy of Surgery of Detroit and is president of the Michigan Chapter of the American College of Surgeons. He has been a longtime chair of the Surgical Education Committee of the Southeast Michigan Center of Medical Education consortium.

He will spend four months in India over the next year visiting five major postgraduate institutions and five private hospitals to compare their medical education programs.

“I want to give back to my home country something of value,” he said. “I hope to help eliminate obstacles for future Indian surgeons. I realize there are many differences between the two systems and I wish my Fulbright project will help us move closer to parity.”
Dr. Noa Ofen to chair symposia at Biological Psychiatry meeting
In Headlines on May 15, 2013
Noa Ofen, Ph.D.

Noa Ofen, Ph.D.

Wayne State University faculty member Noa Ofen, Ph.D., will chair and speak at a major selected symposium at the Annual Meeting of the Society of Biological Psychiatry, May 16-18, in San Francisco.

The two-hour May 16 symposia, "Memory Systems in Development, Risk and Disease: A Case-Study for R-DoC Applications in the Schizophrenia Diathesis,” will highlight through 30-minute presentations the challenges and value of applying the National Institutes of Health’s recent standard on Research Domain Criteria, or R-DoC, for understanding mechanisms underlying significant psychiatric illnesses.

National Institute of Mental Health Director Thomas Insel, Ph.D., announced in an April 29 post to the NIMH’s Director’s Blog that R-DoC will be the new standard by which the NIMH will assess funding proposals. He wrote that it launched the RDoC project to transform diagnosis by incorporating genetics, imaging, cognitive science and other levels of information to lay the foundation for a new classification system.

Dr. Ofen is assistant professor in the School of Medicine’s Department of Pediatrics, WSU Institute of Gerontology and Merrill Palmer Skillman Institute for Child and Family Development. She joined the faculty in 2011 with the goal of translating her expertise in pediatric functional magnetic resonance imaging in normal development to the study of neurodevelopmental disorders.

As chair, she will present the framework for the symposia in her introductory session comments.

WSU’s Vaibhav Diwadkar, Ph.D., associate professor of Psychiatry & Behavioral Neurosciences, also will present results from studies of disordered development of working-memory related brain networks in adolescent vulnerability for schizophrenia.

The studies are consistent with an R-DoC approach toward understanding disordered brain mechanisms and circuits that contribute toward risk and vulnerability for disorders, he said.

Dr. Ofen’s achievement in constructing such a major symposium is notable because she is a recent entrant into the world of Biological Psychiatry, Dr. Diwadkar said.

“Until as recently as 18 months ago, she had been primarily focused on studies in human neurodevelopment. This success is very revealing of her significant talent, her drive and her translational vision,” he said.

Dr. Ofen’s long-range research goal is to understand learning and memory networks in the developing human brain. Learning and memory are severely impaired in schizophrenia, and “it became quickly clear that studying at-risk population offers a unique opportunity to expand my research interests in the service of an important clinical and developmental question,” she said. “I am excited to present my new research direction in the Society of Biological Psychiatry and have already received excited advanced emails from meeting participants in anticipation of the symposium.”

She initially approached the presenters, who include Dr. Diwadkar and others from the NIH and University of California at Davis.

“I was fortunate to get enthusiastic responses from the presenters and was delighted to learn that the symposium was selected among the few to be presented in the conference. Presentations will cut across various stages, including typical development, childhood onset schizophrenia, adolescents at-risk, and affected adults, and offer convergence of both structural and functional neuroimaging methodologies,” he said.
WSU medical student Adam Milam, Ph.D., earns spot in national kidney scholars program
In Headlines on May 14, 2013
Adam Milam, Ph.D., Wayne State University School of Medicine Class of 2016

Adam Milam, Ph.D., Wayne State University School of Medicine Class of 2016

A Wayne State University scholar is one of the first medical students invited to join the American Society of Nephrology Workforce Committee’s Tutored Research and Education for Kidney Scholars program.

Adam Milam, Ph.D., Class of 2016, will attend the “Origins of Renal Physiology” course for medical students June 8-14, at the Mount Desert Island Biologic Laboratories in Bar Harbor, Maine. Kidney TREKS is an initiative for medical students designed to foster interest in careers in Nephrology and research through hands-on experiments.

Milam, a Detroit resident, earned his doctorate in Public Health in 2012 from Johns Hopkins University in Baltimore, his hometown. He completed his first year of medical school earlier this month.

“I think that this early exposure will allow students to further their knowledge from coursework and become engaged in Nephrology research early on. I think this is a great opportunity and I am fortunate to be able to participate,” he said.

Milam is interested in Nephrology research because kidney disease disproportionately affects minority populations. According to the National Institute of Diabetes and Digestive and Kidney Diseases, an estimated 23 million American adults have chronic kidney disease, and the total annual bill for treating kidney failure is approximately $1 billion per year.

“It is a huge health disparities issue. I am from Baltimore and now living in Detroit; both cities are predominately African-American with poor access to health care,” Milam said. “One in three kidney failure patients are African-American, so whether I practice in Detroit, Baltimore or any other major city, kidney disease will be a huge health issue. By attending this program I can get early exposure to ongoing research and innovations for prevention and treatment of kidney disease.”

Students who have completed at least one year of medical school were invited to attend the one-week course, taught by prominent nephrology clinician-scientists. Tuition, room and board are paid by the ASN. The scholarship includes membership in the society, with access to ASN website resources for students and opportunities to apply for Student Scholar Grants.

The program previously was open only to residents and fellows.

“I was glad to learn that this year they did open it up for medical students,” said WSU Professor and Program Director in Nephrology Noreen Rossi, M.D., F.A.S.N. “Adam was looking for an experience and applied. They only take about a 12 to 20 students nationwide… . The instructors come from the National Institutes of Health, Harvard, Yale and elsewhere, and are true experts in Renal Physiology and education.”

Dr. Rossi will continue to serve as Milam’s mentor, as program participants must be paired with a nephrologist mentor to maintain a connection with the field throughout their medical school training.

Milam also is invited to attend the American Society of Nephrology’s annual Kidney Week during his third or fourth year of medical school.
Dr. Joseph Wiener, former chair of Pathology, dies at age 85
In Headlines on May 14, 2013
Joseph Wiener, M.D.

Joseph Wiener, M.D.

Joseph "Jerry" Wiener, M.D., former chair of the Wayne State University School of Medicine’s Department of Pathology, died May 8, 2013. He was 85.

Dr. Wiener, of Franklin, Mich., graduated from the University of Toronto, Faculty of Medicine, in 1953. Following graduation he performed an internship at Detroit Receiving Hospital. He completed a residency at the Mallory Institute of Pathology at Boston City Hospital. In 1978, he joined the Wayne State University School of Medicine as a professor and chair of the Department of Pathology, a position he held until 1991. His major research interest was cardiovascular pathobiology.

He is survived by his wife, Judith Wiener; daughter, Carolyn Wiener; son Adam Wiener; grandson, Joshua Wiener; and sister, Pearl Keyn.

A funeral service will take place at the Ira Kaufman Chapel, 18325 W. Nine Mile Road, Southfield, Mich., May 17 at 3 p.m.. Rabbi Miriam Jerris will officiate.

The family suggests contributions in memory of Dr. Wiener the Jewish Federation of Metropolitan Detroit, 6735 Telegraph Road, Bloomfield Hills, MI 48301; the Barbara Ann Karmanos Cancer Institute, 4100 John R., Development-NCO6DS; Development Office, Detroit, MI 48201; or the Wayne State University School of Medicine, University Health Center 6F-12, 4201 St. Antoine, Detroit, MI 48201.

Seventy School of Medicine students earn graduate, Ph.D. degrees at May 9 commencement
In Headlines on May 10, 2013
Wayne State University graduates listen to President Allan Gilmour speak May 9, 2013.

Wayne State University graduates listen to President Allan Gilmour speak May 9, 2013.

Wayne State University graduated more than 3,500 students at its two spring commencement ceremonies, including 70 who earned degrees from the School of Medicine’s graduate and postgraduate programs.

Six candidates received doctoral  degrees during the morning ceremony held May 9 at Ford Field in Detroit, including Amy Boddy, Ph.D., Molecular Biology and Genetics; Jennifer Dittmer, Ph.D., Immunology and Microbiology; Megan Foldenauer, Ph.D., Anatomy and Cell Biology; Kelly Haagenson, Ph.D., Cancer Biology; Emilio Mottilo, Ph.D., Pathology; and Chaowen Wu, Ph.D., Anatomy and Cell Biology. Dr. Wu was a student in the school’s M.D./Ph.D. program, and will earn her allopathic medical degree at the School of Medicine’s commencement ceremony May 20 at the Fox Theatre in Detroit. She will begin a plastic surgery residency at the Medical College of Wisconsin later this year.

In addition to those earning doctorates, 64 School of Medicine students earned graduate degrees, including Master of Public Health, Master of Science (general), and Master of Science in Basic Medical Sciences, Genetic Counseling and Medical Research degrees.

“These men and women should be very proud of the fact that they accomplished so much,” said Ambika Mathur, Ph.D., interim dean of the WSU Graduate School. “They have acquired the skills to be successful and will represent Wayne State University where ever they go from here on, whether it is a postdoctoral position or otherwise. We celebrate their success.”

Dr. Mathur also is Professor of Pediatrics and director of the M.D./Ph.D. program and Office of Postdoctoral Affairs. She credits the quality of faculty and value of the graduate programs for WSU’s appeal with graduate applicants.

“The students are attracted to the reputation of the graduate faculty and their superb research programs. The School of Medicine is known for excellence in training,” she said.

Researchers' article suggests guideline revisions for multiple myeloma therapeutic agent lenalidomide
In Headlines on May 10, 2013
Researchers at the Wayne State University School of Medicine and the Barbara Ann Karmanos Cancer Institute have published an article on their study of the use of therapeutic agent lenalidomide on multiple myeloma patients and the decrease in adequate collection of peripheral blood stem cell collection for use in an autologous stem cell transplant.

Lenalidomide, or LEN, is a relatively new and effective induction therapy for multiple myeloma patients. It is, however, associated with an increased risk of inadequate peripheral blood stem cell, or PBSC, collection for a stem cell transplant, particularly when doctors use it with filgrastim, the most commonly used agent for PBSC mobilization. Adequate PBSC collection is critical in performing an autologous stem cell transplantation.

The article, “Evaluating the effects of lenalidomide induction therapy on peripheral stem cells collection in patients undergoing autologous stem cell transplant for multiple myeloma,” was published in the journal Support Care Cancer. To read the study, visit http://www.ncbi.nlm.nih.gov/pubmed/23591714.

Authors include Divaya Bhutani, M.D., fellow in the Department of Hematology/Oncology at Karmanos and the School of Medicine; Jeffrey Zonder, M.D., associate professor and leader of the Multiple Myeloma Subcommittee at Karmanos; Jason Valent, M.D., former fellow in the Department of Hematology/Oncology; Nishant Tageja, M.D., former Internal Medicine resident; Lois Ayash, M.D., clinical professor of Medicine; Abhinav Deol, M.D., assistant professor of Oncology; and Zaid Al-Kadhimi, M.D., assistant professor and associate scientific director of Bone Marrow Transplant and Immunotherapy.

Fellow authors include Judith Abrams, Ph.D., professor and director of the Biostatistics Core at Karmanos; Lawrence Lum, M.D., D.Sc., professor of Oncology, Medicine, and Immunology and Microbiology; Voravit Ratanatharathorn, M.D. and Joseph Uberti, M.D., professors and co-leaders of the Stem Cell and Bone Marrow Transplant Multidisciplinary Team; and senior author Muneer Abidi, M.D., associate professor and medical director of the Hematopoietic Stem Cell Laboratory.

Researchers conducted an analysis of 319 patients who underwent a variety of therapy modalities that included various mobilizing agents such as filgrastim; sargramostim and filgrastim; cyclophosphamide and filgrastim; and filgrastim and plerixafor. A total of 186 patients received LEN in addition to these mobilizing agents; 133 patients did not prior to PBSC collection.

The authors also administered various numbers of induction regimens prior to PBSC collection among the LEN positive and negative groups. They found that the median number of apheresis sessions required to collect adequate amounts of PBSCs were significantly higher in the LEN positive group as compared to the LEN negative group, indicating that LEN is associated with a higher risk of PBSC failure.

Recently published guidelines from the International Myeloma Working Group recommend PBSC collection after about four cycles of LEN induction therapy to minimize the risk of PBSC collection failure. The researchers, however, found that five or more prior cycles of LEN were associated with a drop in PBSC yield but did not pose a negative impact on the ability to collect the minimum amount of PBSCs required to perform an autologous stem cell transplant.

Study data show that filgrastim can be used to successfully mobilize PBSCs in multiple myeloma patients following LEN therapy. And, because researchers did not find that more than four cycles of prior LEN therapy had a negative impact on adequate PBSC collection for an autologous stem cell transplant, they suggest a re-evaluation of current guidelines they say erroneously limit the number of cycles of LEN induction therapy regardless of response.

They also demonstrated that multiple myeloma patients who received LEN induction therapy and then underwent a stem cell transplant with an adequate PBSC dose had normal marrow recovery.

“These issues must be addressed in prospective clinical trials as more multiple myeloma patients are exposed to prolonged durations of LEN in the setting of delayed autologous steam cell transplant and maintenance therapy,” the authors write.

The authors’ research also has been reviewed by the Myeloma Beacon, an online resource for multiple myeloma patients, their families and other interested parties. To read the article, visit http://www.myelomabeacon.com/news/2013/05/03/revlimid-lenalidomide-stem-cell-mobilization/.

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