10
Growing up on Long Island in the blue-collar community of Levittown, Dr. Michael Donnenberg was inspired by his mother, a nurse, and his older brother to pursue a medical degree. Dr. Donnenberg graduated from the State University of New York, Albany with a degree in Biology before attending medical school at Columbia University in New York City. His time at Columbia sparked his interest in basic science. Dr. Donnenberg spent the summer between the first and second years of medical school pursuing a student research project on plasmid stability and copy number maintenance. He then spent three months researching mechanisms of bacterial resistance to beta lactam antibiotics during his fourth year of medical school. After graduating from Columbia, Dr. Donnenberg came to Baltimore for his residency in Internal Medicine at JHU Bayview (called Baltimore City Hospital at the time). He Filling the newly-created Associate Director position of the MSTP Program, Dr. Achsah D. Keegan is a native of Maryland. Growing up, she and her family moved from Maryland to the Philippines while her father was on active duty with the US Marine Corps in Vietnam. She attended Duke University in North Carolina for her undergraduate degree. She chose Duke because of the school’s strong program in Marine Biology. At the time, studying biology at Duke meant choosing either Zoology of Botany as a major; she chose Zoology. Her introduction to scientific research took the form of a work- study program; she worked all four years in an Immunology lab and completed an independent study project on the ability of vitamin E to reverse damage from ozone in mice. After college, Dr. Keegan married, and worked at a biotech company for a year before beginning her PhD at Johns SMOOTH SHIFT IN MSTP LEADERSHIP, NEW DIRECTORS AIM TO EXPAND PATRICK KERNS, GS IV PATRICK KERNS, GS IV AN ENGINEERED MEET-AND-GREET: NEW PROGRAM DIRECTORS DR. MICHAEL DONNENBERG AND DR. ACHSAH KEE- GAN HOST AN EVENING OF HOR DOEUVRES, LIBATIONS AND MINGLING AT BALTIMORES ENGINEERS CLUB NOV. 12, 2012. D UAL D ECREE THE UNIVERSITY OF MARYLAND MEDICAL SCIENTIST TRAINING PROGRAM Baltimore Volume IV � Issue 1 � Winter 2013 Michael Donnenberg, M.D., accepts director- ship after 13 years as HDID course director Associate Director Achsah Keegan, Ph.D., offers students support with her extensive experience (continued on Page 3) (continued on Page 3)

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Page 1: The Dual Decree_Winter 2013

Growing up on Long Island in the blue-collar community of Levittown, Dr. Michael Donnenberg was inspired by his mother, a nurse, and his older brother to pursue a medical degree. Dr. Donnenberg graduated from the State University of New York, Albany with a degree in Biology before attending medical school at Columbia University in New York City. His time at Columbia sparked his interest in basic science. Dr. Donnenberg spent the summer between the first and second years of medical school pursuing a student research project on plasmid stability and copy number maintenance. He then spent three months researching mechanisms of bacterial resistance to beta lactam antibiotics during his fourth year of medical school.

After graduating from Columbia, Dr. Donnenberg came to Baltimore for his residency in Internal Medicine at JHU Bayview (called Baltimore City Hospital at the time). He

Filling the newly-created Associate Director position of the MSTP Program, Dr. Achsah D. Keegan is a native of Maryland. Growing up, she and her family moved from Maryland to the Philippines while her father was on active duty with the US Marine Corps in Vietnam. She attended Duke University in North Carolina for her undergraduate degree. She chose Duke because of the school’s strong program in Marine Biology. At the time, studying biology at Duke meant choosing either Zoology of Botany as a major; she chose Zoology. Her introduction to scientific research took the form of a work-study program; she worked all four years in an Immunology lab and completed an independent study project on the ability of vitamin E to reverse damage from ozone in mice.

After college, Dr. Keegan married, and worked at a biotech company for a year before beginning her PhD at Johns

smooth shift in mstp leadership, new directors aim to expand

Patrick kerns, Gs iV Patrick kerns, Gs iV

an enGineered meet-and-Greet: new program directors dr. michael donnenberg and dr. achsah kee-gan host an evening of hor d’oeuvres, libations and mingling at baltimore’s engineers club nov. 12, 2012.

dual decreethe university of maryland medical scientist training program

Baltimore � Volume IV � Issue 1 � Winter 2013

Michael Donnenberg, M.D., accepts director-ship after 13 years as HDID course director

Associate Director Achsah Keegan, Ph.D., offers students support with her extensive experience

(continued on Page 3) (continued on Page 3)

Page 2: The Dual Decree_Winter 2013

As I write my final column for The Dual Decree, it is natural for me to re-flect on the past 16 years in directing this program. I thoroughly enjoyed every day interacting with you all, catching up on your lives and training progress. It all seemed natural and energizing for me, and I am proud that many of you tell me that all of this input really helped you along the way. There is no better honor than to have the grati-tude and appreciation of your students.

Of course I have many wonderful mem-ories from these years, accompanied by deep satisfaction from the many steps forward. However, I want to leave you with one, largely unexpected, revela-tion that you, the MSTP students, have brought me: I now appreciate that you, the MSTP students, are the greatest asset of this training program. When we began to harness your energies, en-list your enthusiasm, and capitalize on your talents, great things happened.

Recruitment of outstanding new stu-dents was greatly enhanced when you all became actively involved. Your insights about new curricular elements, such as the M2M and clinical case studies cours-es, were critically valuable in establish-ing their success. The MSTP Student Council has been a thoughtful driving force in establishing policy and improv-ing the bonds between our students at all levels. The Dual Decree provides wonderful opportunity for you to con-tribute to our program. The endowed Max Lectureship is a perennial success due to your leadership of this event.

You have become important stake-holders in our program, and we are all much better for it. But with this power comes the inevitable responsibility. You are custodians of this program while

you are here, benefiting from those that came before and, critically, obligated to those that follow. So get involved and give of your great abundance. Make sure you leave this program in a better place than you found it. For if you do, this special program which we now en-joy will endure and continue to be a shin-ing opportunity for aspiring physician scientists for many years to come.

roger that!Farewell from TBR

terry roGers mstP director 1996-2012

dual decreethe university of maryland medical scientist training program

Baltimore � Volume IV � Issue 1 � Winter 2013

editor-in-chief:Aparna Kishor

Layout editor:Elise Ma

coPy editor:Carolyn Rosinky

contributinG editors:Kristi Chakrabarti

Monica CharpentierAdam Fisch

Patrick KernsJeffrey Kleinberger

contact us: [email protected] views expressed herein are solely those of the authors and do not necessarily repre-sent the views of the University of Maryland School of Medicine or any affiliated institution.

Winter 20132 the dual decree

Program Administrator Jane Bacon, Associate Director Achsah Keegan and Director Michael Donnenberg (left to right) enjoy beverages at the Engineer’s Club in Mount Vernon. The newly appointed directors organized a happy hour for all of the MSTP students and family on Nov. 12, 2012 in order to get to know everyone in the program. Drs. Keegan and Donnenberg have been working very hard over the past few months to meet individually with each student in the program as well as each class in order to make the transition as smooth as possible. Their office hours: Tuesday-Thursday from 2pm-4pm.

new program leadership:

Page 3: The Dual Decree_Winter 2013

Hopkins in the lab of Dr. Daniel Conrad. There, she investigated regulation of IgE production in B-cells by CD23. Following her graduate work, Dr. Keegan joined the Laboratory of Immunology at the National Institute of Allergy and Infectious Diseases (NIAID) at the National Institutes of Health as a research fellow. At NIAID, she worked with Dr. William Paul to define the structure and function of the interleukin-4 (IL-4) receptor and its downstream signaling cascades. Dr. Keegan joined the Holland Laboratory of the American Red Cross in 1994, where she continued her work on the IL-4 receptor.

In 2004, Dr. Keegan joined the Center for Vascular and Inflammatory Diseases at the University of Maryland with a faculty appointment in the Microbiology and Immunology program. She also has appointments as an Adjunct Professor at George Washington University Medical Center and in UMB’s Program in Oncology. Her laboratory’s research continues to revolve around IL-4, specifically IL-4 receptor structure and signaling. The lab has pursued this topic and its implications for several important human diseases, including allergic asthma and cancer cell avoidance of apoptosis.

In her spare time Dr. Keegan enjoys reading and antiquing. She especially enjoys murder mysteries and recently finished the Hunger Games trilogy. She occasionally goes hunting for antiques around the state with friends and family, especially in Frederick, MD. She hopes to travel more in the future and wants to visit Egypt, Morocco, and Scotland. Dr. Keegan is married to James Keegan, an Audit Manager in the Office of the Inspector General of the Federal Reserve Board, and has three children, two sons and a daughter. Her youngest son is a junior in college and recently completed the Schnaper Internship at UMB.

As the first Associate Director of the MSTP, Dr. Keegan will be personally involved with students throughout the program, and will be in charge of the Molecules to Medicine course. Dr. Keegan and Dr. Donnenberg will share the task of representing the program on occasions such as the physician/scientist seminar, organizational meetings, and ceremonies such as the White Coat Ceremony. Dr. Keegan is looking forward to working with Dr. Donnenberg again, having previously taught with him in the Host Defense and Infectious Diseases medical school course. Both she and Dr. Donnenberg intend to have office hours when MSTP students are free to drop by.

then moved to Tufts University to pursue further training that included twoyears of research training in addition to clinical duties. At Tufts (New England Medical Center), he completed a Fellowship in Infectious Diseases. During this time, Dr. Donnenberg did research in the laboratory of Dr. Jerry Keusch on Enteropathogenic E. coli (EPEC),

an organism that often causes life-threatening diarrhea in children in developing countries.

Having identified a series of avirulent mutants of EPEC during his fellowship, Dr. Donnenberg came to Maryland in 1989 for a post-doctoral fellowship with Dr. James Kaper.

Because several of the mutants he identified during his fellowship were deficient in production of the Bundle Forming Pilus (BFP), his research focused on investigating BFP’s role in pathogenesis. In 1990, he joined the faculty at the University of Maryland School of Medicine. Since that time, Dr. Donnenberg has mentored six graduate students (including two MD/PhD students), trained numerous post-doctoral fellows, and published more than 100 peer-reviewed articles. His lab has focused on research topics including BFP’s role in pathogenesis, and the structure and function of BFP’s component proteins, and secreted effector proteins such as EspB. More recently, his lab has begun a research project on Clostridium difficile and its pilin proteins.

In addition to his scientific work, Dr. Donnenberg continues to serve as an attending physician in the VA outpatient HIV clinic several mornings each month and on the VA Infectious Disease consult service for eight weeks per year.

Dr. Donnenberg also has spent significant time teaching both graduate and medical students. For 13 years he has been the course director for the second-year medical school course Host Defense and Infectious Diseases (HDID), an 11-week course covering Immunology, Microbiology, Virology, Mycology, and the pharmaceuticals used to treat diseases in these areas. He teaches in the Microbial Pathogenesis course for the Molecular Microbiology and Immunology graduate program, and designed and implemented a program for physicians to earn a PhD through a mentored research program.

(continued from page 1)KEEGANDONNENBERG

(continued from page 1)

(continued on page 7)

3mdphd.umaryland.eduWinter 2013

[MSTP Director] is a fantastic opportunity. I am committed to preserving the current program structure and recruiting high-quality applicants.”

Students are free to drop by during office hours [at the MSTP office].”

Page 4: The Dual Decree_Winter 2013

There are four new faces around the MSTP office lately. These newly white-coated members have diverse and interesting backgrounds, and they stopped studying long enough to share them with

Joshua comes to Baltimore from the hot Florida weather of Pensacola. He attended the University of West Florida (UWF), which he chose because he enjoyed the small-school atmosphere with a strong science background. Joshua studied biochemistry, and was actually the first student from his university to be accepted into an MD/PhD program.

Joshua almost did not apply to Maryland, until he heard a seminar from UMBC professor and UWF

alumni Dr. Michael Summers. Dr. Summers collaborates with University of Maryland on studies using 950MHzBrukerAvance III NMR, which is one of the most powerful Nuclear Magnetic Resonance instruments in the world. Joshua was drawn to this magnetic research, and he applied to the MSTP. He did a rotation this summer with Dr. Summers, during which he worked on “Obtaining direct NMR evidence of the HIV-1 duplex dimer.” His passion for this subject will surely lead him to many breakthroughs in the future.

Like many of the other MSTP students, Joshua uses the piano as a musical outlet. He also makes time to relax with video games like Halo. He is very active; he enjoys working out and mountain biking. On the more daring side, he enjoys going on adventures and doing things like taking trips to the Philippines. This multidimensional student with a passion for biochemistry will certainly be involved with big things in the future!

Magnetically attracted from a thousand miles

Joshua brown

ms1

4

Carolyn is the sole Maryland native in the incoming class. She grew up in Howard County, and then went on to do her undergraduate training at Johns Hopkins University. At Hopkins, Carolyn earned a double-major in Neuroscience and Cell/Molecular Biology. Although she enjoyed her experience there, she felt like something was missing from her undergraduate years.

Carolyn grew up with a love of music, but she felt she could not properly follow her musical aspirations in college. She decided to finish her undergraduate training a year early in order to pursue music further. She traveled to London where she completed a Music Masters in Cello Performance at Trinity College of Music. Besides cello, Carolyn also plays piano, and she was part of an a cappella singing group during undergrad. In addition to her musical talents, she also takes part in adventures like hiking, spelunking, skiing, and traveling, or relaxes by cooking, reading, or ice skating.

In regards to research, Carolyn has not narrowed down to a specific path yet. Her interest in biomedical research originally came from her experiences with family members suffering from illnesses. In high school and undergrad, Carolyn worked in cancer immunology and breast cancer research labs. However, she also enjoyed studying neuroscience, public health, and health policy. No doubt that with her talents, she will be successful in any of these fields.

Musician, Scientist, or Musicientist?

caroLyn rosinky

ms1

on the block:new KidsJeffrey kLeinberGer, ms ii.

the dual decree � Winter 2013 � mdphd.umaryland.edu

Page 5: The Dual Decree_Winter 2013

There are four new faces around the MSTP office lately. These newly white-coated members have diverse and interesting backgrounds, and they stopped studying long enough to share them with

Carolyn is the sole Maryland native in the incoming class. She grew up in Howard County, and then went on to do her undergraduate training at Johns Hopkins University. At Hopkins, Carolyn earned a double-major in Neuroscience and Cell/Molecular Biology. Although she enjoyed her experience there, she felt like something was missing from her undergraduate years.

Carolyn grew up with a love of music, but she felt she could not properly follow her musical aspirations in college. She decided to finish her undergraduate training a year early in order to pursue music further. She traveled to London where she completed a Music Masters in Cello Performance at Trinity College of Music. Besides cello, Carolyn also plays piano, and she was part of an a cappella singing group during undergrad. In addition to her musical talents, she also takes part in adventures like hiking, spelunking, skiing, and traveling, or relaxes by cooking, reading, or ice skating.

In regards to research, Carolyn has not narrowed down to a specific path yet. Her interest in biomedical research originally came from her experiences with family members suffering from illnesses. In high school and undergrad, Carolyn worked in cancer immunology and breast cancer research labs. However, she also enjoyed studying neuroscience, public health, and health policy. No doubt that with her talents, she will be successful in any of these fields.

Musician, Scientist, or Musicientist?

on the block:

Jeffrey kLeinberGer, ms ii.

Andrew is the member of the incoming class from the northernmost location. He comes from Buffalo, NY. For his undergraduate training, he went to the University of Rochester where he studied biomedical engineering. However, his scientific interests are not limited to his college major, as he

also enjoys learning about the fields of optics and aeronautics.

In regards to medicine, Andrew has an interest in cardiovascular medicine, and more specifically, heart failure systems. In fact, the prospect of working with top cardiovascular researchers was one of the factors that attracted Andrew to University of Maryland. This field intrigues him due to a family history of heart disease. He spent this past summer doing a rotation in Dr. Steve Fisher’s lab, where he studied “Vascular smooth muscle phenotype characterization by myosin phosphatase splice variant expression.” With his engineering background, he will definitely bring a critical perspective to this field.

Andrew has many other interests besides his scientific studies. He enjoys home improvement activities like landscaping. When it comes time to relax, Andrew likes playing poker with friends or following his hometown football team, the Buffalo Bills. He also enjoys outdoor activities all year round, with golf in the summer and snowboarding in the winter. There is no doubt that he will be able to get more practice on the links than in the half-pipe while here in Baltimore.

the dual decree � Winter 2013 � mdphd.umaryland.edu

Molly hails from Holland, PA, just outside Philadelphia. She did her undergraduate training at University of Scranton, where she studied Biochemistry and Cell and Molecular Biology. However, do not assume that she is one dimensional in any aspect. She absolutely loves reading, especially classic literature

or historical volumes. Molly believes that topics like philosophy act as “a training ground for the mind to stretch and develop its reasoning abilities.” Her bibliophilic tendencies allow her to approach her scientific studies with a broadened perspective.

Molly has had the spark for science since she was a child. She recalls her third grade science project as the pivotal event that drove her into the field of science. This was when she first learned about the nature of the scientific process through experimentation on various mineral samples to study geological properties. She was hooked. She chose to come to the University of Maryland MSTP because of the quality of both the scientific and clinical training as well as how well the two approaches are integrated.

Besides working in the lab or burying herself in a good book, Molly uses her violin as a musical outlet. She also enjoys hiking and running and recently ran the Baltimore City Marathon team relay with the University of Maryland MSTP team. Molly had glowing remarks on the current members of the program and how they are a major asset to the MSTP. We are glad to have Molly with us, and we are delighted for her to be an important part of our MSTP community.

From cold weather and Buffalo wings to life by the bay and Maryland crabs

“Science and literature are not two things, but two sides of one thing”

– Thomas Huxley

moLLy hritzo

ms1

7

andrew wescott

ms1

Page 6: The Dual Decree_Winter 2013

If you want to do malaria research in humans, you have to go abroad,” said GS1 Sarah Boudová, and that is exactly what she did this past summer for her rotation.

Sarah spent about two months in Blantyre, Malawi for her thesis work with Dr. Miriam Laufer, an associate professor in the Department of Pediatrics at the School of Medicine, who has multiple clinical trials established in Malawi. The main goal of Sarah’s trip was to gather samples from patients currently enrolled in a clinical trial to bring back to Maryland and analyze for her project.

Sarah is studying the effect of maternal antimalarial chemoprophylaxis or treatment on the immune system of the baby by collecting cord blood and serum from pregnant women at the time of delivery. She will isolate mononuclear cells from the cord blood and use the serum to determine the patient’s cytokine profile. In addition, she will be analyzing blood samples collected every three months from the patients’ babies for at least a year to monitor the children’s immune profiles. To prepare for her trip, Sarah shadowed an Ob/Gyn doctor to learn how to collect cord blood, and also spent time with Dr. Cristiana Cairo, an Assistant Professor at the Institute of Human Virology, to learn how to do mononuclear cell isolation.

Though Sarah is no novice in international research (she spent a previous summer in Malawi as well), she did face a new set of challenges this year. The major hurdle was that there was an unexpected and frustrating delay in getting ethical

approval for the study in Malawi due to a strike. As a result, it was not until a few weeks after her trip ended that samples for her project could be collected. Fortunately, her time was not entirely misspent as she was able to train nurses and technicians in the methods on practice samples.

Another obstacle Sarah had to overcome was that most of the deliveries in Malawi occurred at night, while the staff worked during the day. To manage this wrinkle, Sarah and the study staff, comprised of nurses, technicians and doctors, worked together to hire government nurses to specifically work the night shift at the government clinic. She then trained them in collecting cord blood. The next challenge Sarah faced was in the lab at the College of Medicine, where she worked with a lab technician and manager to isolate mononuclear cells from the cord blood. After numerous failures with cell isolation, Sarah realized that the centrifuge in the lab was not working properly so she moved her whole operation to a new facility operated by the Malawi-Liverpool Wellcome Trust. By working through these issues, Sarah is confident that she “established relationships to get things done in [her] absence.”

Despite these challenges, Sarah gained a deep appreciation for the people of Malawi. She stayed with six other students in a house owned by a doctor from Michigan where she lived mostly on rice and beans made by the house cook. She also spent some time in the villages. “There is a lot of poverty, but everyone is so nice. There are little children following you around,” Sarah

kristi chakrabarti, ms ii

rePubLic of maLawi

16.3million

percent

million

years47.5

6.0

people living in Malawi

population at risk for Malaria

Malaria cases treated per year

average life expectancy at birth

children die before their 5th birthday

bLood, sweat, and science: sarah boudova (left) gathers cord blood from sacs of placenta (center), centrifuges the fluid to isolate red blood cells (top right), and assesses the samples for malarial infection (bottom right).

RemedyingMalaria in Malawi

Winter 20135 the dual decree

(continued on page 7)

100

1in 9source: world health organization

Page 7: The Dual Decree_Winter 2013

remembers, adding that working with the researchers and study staff in Malawi was her favorite part of the trip. In addition, Sarah became more aware of the limitations in both medicine and research abroad. “You don’t really understand the constraints of your research until you go,” she said, which makes her trips to Malawi invaluable. She also saw over 30 deliveries in one tiny delivery room at the government clinic. “They don’t have ultrasound. Electricity is intermittent. There are no painkillers during the delivery or while suturing up. We also ran out of bleach one night,” she said. Her most memorable experience was helping to deliver a baby under candlelight while she held up a flashlight.

Sarah’s trip wasn’t just about delivering babies and fixing centrifuges. She was able to fit in some fun excursions around the country. She climbed Mount Mulanje, which is the highest peak in Malawi and swam with the cichlids (a tropical fish) in Lake Malawi. She spent her free time hiking, shopping, and even listening to reggae music at a jazz club. But the most unexpected experience was probably when she encountered a witch. A man brought his wife to the clinic

to determine if she was a witch because she was found naked on top of a coffin of a man who had died the night before. “There was a whole line of kids following her yelling, ‘witch! witch! witch!’,” Sarah laughs.

Based on her experiences in Malawi, Sarah wants to encourage students who are interested in doing research overseas to pursue working with PIs who have opportunities to send people abroad. “There are certainly a lot of frustrations that go along with doing international research, but it is possible for an MD/PhD student. The [program] is very accommodating,” Sarah said. She advises students to be “prepared for the frustrations” and also have “patience because things go wrong and take longer.” As far as preparation for going abroad, she had to organize transportation details, supplies, and logistics. Sarah also had to take her USMLE Step I exam a couple weeks earlier than her classmates. If she were able to do it again she thinks she would start planning a little sooner, including applying for ethical approval earlier. All in all, Sarah’s summer in Malawi was a truly educational experience that has helped enhance and shape her research and clinical goals. We wish her the best of luck!

6mdphd.umaryland.eduWinter 2013

Despite the rigors of his career combining science, teaching, and medicine, Dr. Donnenberg prioritizes spending time with his family. His wife, Dr. Paula Fernandes, is the founder/CEO of Global Scientific Solutions for Health, a company that works to train personnel for the establishment of standardized diagnostic laboratories throughout the world. He also has three sons: Aaron, currently studying for an MFA in Poetry at Emerson; Sam, a UM College Park Sociology major interested in social injustice; and Gabriel, a senior at Towson High School.

Dr. Donnenberg is also passionate about running, food, and wine. He has run a number of marathons, including the Baltimore and Boston marathons, and often joins medical and graduate students for runs in and around campus. Dr. Donnenberg enjoys cooking most nights for his family, and he particularly enjoys grilling, which he does year-round, “sun, rain, or snow.” He is a life-long New York Yankees fan and has been a supporter of the Baltimore Ravens since soon after moving to Baltimore in 1996.

Taking on the role of Director of the UMB Medical Scientist Training Program (MSTP), Dr. Donnenberg considers the position a “fantastic opportunity” and is committed to preserving the current program structure and recruiting high-quality applicants during this interview cycle. Continued funding of the program through the MSTP grant is also a top priority for Dr. Donnenberg. The exact division of responsibilities between Dr. Donnenberg and his Assistant Director, Dr. Keegan, is still being defined, but he currently plans on being personally involved with students in both the medical school and graduate school phases of the program.

a foLLowinG of LittLe chiLdren: sarah boudova greets and entertains the curious, lively children of blantyre, malawi during a summer rotation.

(MALARIA continued from page 6)

DONNENBERG (cont. from page 3)

Page 8: The Dual Decree_Winter 2013

In 1990, Robert Kosilek murdered his wife and was sentenced to a

prison term of life without the possibility of parole by the state of Massachusetts. Later, he was diagnosed with Gender Identity Disorder (GID) a condition defined by both identification as a member of the opposite gender and significant discomfort with the physical fact of the current gender. Instead of providing the female hormones prescribed by the diagnosing physician (the standard of care), the physician was fired and replaced with a doctor known to oppose treatment of GID with female hormones. Michelle (formerly Robert) Kosilek took the State of Massachusetts to court in 2000 to compel them to provide the prescribed hormones under her Eighth Amendment right to healthcare as a prisoner, and won.

The current standard of care for the treatment of transgendered individuals, as established by the World Professional Association for Transgender Health (WPATH), calls for a tiered approach to treatment for transgendered individuals ranging from counseling to hormone therapy to gender reassignment surgery. These treatment options are designed to be provided in that order to remedy the patient’s physiological anguish. For some, counseling and hormone therapy are sufficient, but others require gender reassignment surgery to alleviate their distress. The goal of the process is to promote “lasting personal comfort with their gendered selves1” and thereby prevent patients from engaging in self-destructive behaviors such as self-castration and suicide.

Following the 2000 case, Massachusetts Department of Corrections (DOC) physicians determined that Michelle Kosilek’s GID was severe enough to warrant gender reassignment surgery. This treatment was denied by DOC officials who claimed the security risk of providing the treatment was too high. Kosilek has twice attempted to kill herself and once attempted to castrate herself. In light of these and other facts, in September 2012, Judge Mark Wolf became the first US Judge to order that a state was required to provide gender reassignment surgery

to an inmate. In his decision Judge Wolf said that “the Commissioner's purported security concerns are a pretext to mask the real reason for the decision to deny [Robert Kosilek] sex reassignment surgery – a fear of controversy, criticism, ridicule, and scorn.”

In professional practice, physicians are expected to set aside certain aspects of their personal morality and to provide equal treatment for all patients on the basis of accepted standards of care. This principle is not binding for those in a position to prevent the provision of medical care by doctors to patients. Those individuals have other concerns to balance such as the cost of treatment (for an HMO) or security concerns (for a DOC Commissioner).

Even when doctors are placed in those positions of authority, they take on additional ethical responsibilities that may result in similar decisions.

Ensuring that patients receive necessary and appropriate medical care is a physician’s duty and is underpinned by all four principles of medical bioethics: beneficence, nonmalfeasance, justice, and autonomy. Beneficence requires the provision of aid to patients when the means exist. Nonmalfeasance and justice require that physicians not allow their personal non-medical judgments to impact the care of patients and that all patients be treated equally. The principle of autonomy requires that doctors treat patients who wish to be treated. So what should be done when a third party interferes?

Advocacy on behalf of patients is one way for physicians to discharge their duties to patients when competing demands such as money or public opinion interfere with the provision of necessary medical treatment. Taking action in society to remove impediments to medical care is a natural extension of the four principles. Society and its standards of decency have been evolving over the last few hundred years across numerous fronts such as voting rights and the prevention of animal cruelty. With the participation of physicians advocating for expanded access to medical treatment, society may stop discriminating against patients based on criteria such as prior criminal offenses or gender identity for the purposes of medical care.

prisoner health care & gender identity disorder

Patrick kerns, Gs iV

MEDICS on ETHICS

Winter 20138 the dual decree

“Ensuring that patients receive necessary and appropriate medical care is a physician’s duty.”

Page 9: The Dual Decree_Winter 2013

inthespotlight:

Kishor A, Tandukar B, Ly YV, Toth EA, Suarez Y, Brewer G, Wilson GM.Mol Cell Biol. 2013 Jan;33(1):71-84. Hsp70 Is a Novel Posttranscriptional Regulator of Gene Expression That Binds and Stabilizes Selected mRNAs Containing AU-Rich Elements.

Brotman RM, Bradford LL, Conrad M, Gajer P, Ault K, Peralta L, Forney LJ, Carlton JM, Abdo Z, Ravel J.Sex Transm Dis. 2012 Oct;39(10):807-12.Association between Trichomonas vaginalis and vaginal bacterial community composition among reproductive-age women.

publications

presentationsAdam Fisch, GS III

American Society of Human Genetics Annual Meeting

San Francisco, CA Nov 6-9, 2012

Mark Kvarta, GS II Society for Neuroscience

Annual MeetingNew Orleans, LA Oct 12-17, 2012

Julie Craig, GS V Federation of American Societies for

Experimental Biology (FASEB) Conference Snowmass Village, CO

July 15-20, 2012

medical student research dayseptember 27, 2012

first place:    Joshua Brown, MS I Kristi Chakrabarti, MS II Haley Simpson, MS II

third place:   Jeffrey Freiberg, MS II Alexander Tsai, MS II

doctoral dissertationnovember 6, 2012

Aparna KishorPh.D. Molecular Medicine Post-transcriptional control of gene expression by the major inducible heat shock protein Hsp70aParna kishor

ms iii

congrats!

women physician scientist interest group

Jessica Shiu, GS IV (center) and Monica Charpentier, GS III (right) chat with students of Johns Hopkins’ MSTP at a University of Maryland/Hopkins’ Women’s Networking Event on December 13, 2012. The evening, orchestrated by UMB’s Women Physician Scientist Interest Group founder Jess Shiu, took place at Hop-kins’ MD-PhD library and featured a presentation and career talk by UMB’s Cynthia Bearer, MD-PhD, Professor of Pediatrics and Associate Chair of Research in Neonatology. Dr. Bearer and UMB and Hopkins students engaged in discussion regarding careers as women physician-scientists, negotiating tactics, wom-en’s issues, personal science interests, and book recommendations.

UMB MSTP Women’s Interest Group formed in Fall 2012. Lunch meetings and networking events occur throughout the year.

9mdphd.umaryland.eduWinter 2013

Page 10: The Dual Decree_Winter 2013

On the cold, icy morning of January 24, Program Adminis-trator Jane Bacon slipped and broke her ankle for which she required orthopedic surgery. She continues her recovery with good spirits and an ad-mirably persistent work ethic.

Affix Mailing Label & Postage

council corner[representing] members

As always, the MSTP Council would love your input and ideas! Please send suggestions to [email protected]

february 27 David Kurland (GS I)

march 27

Josh Lieberman (MS IV)

april 17Molly Hritzo (MS I)

may 1 Adam Fisch (GS III)

february 26 Kristi Chakrabarti (MS II)

Faculty Leader: Richard Gallo march 5

& march 26Carolyn Rosinsky (MS I)& Joshua Brown (MS I)

Faculty Leader: Jonathan Bromberg

march 12Mark A. Travassos, MD

Pediatric Infectious Diseases

(tmt)

(m2m)

translational medicine topics

molecules to medicine

� � � dates & reminders � � �

We look forward to you joining us in some of the following upcoming events! Keep an eye out for emails with more

information on:

Vineyard tour and wine tastingHiking/outdoor event

Movie nightVolunteer activities

budget breakdown

Event Amt. Allocated # of Attendees Total

Heavy Seas Brewery Tour $5/person 15 $120

Marathon Registration $30/runner 12 $360Marathon T-shirts $12.50/runner 12 $150Post-seminar Happy Hours* $50-100/event 20-25 $400Dual Decree & Misc. $100*happy hours are cost-variable. Total $1230

Balance $370

[MS I] JoShua Brown

[MS II] KrIStI ChaKraBartI

[GS I] anthony ParK

[GS II] Latey Bradford

[GS III] KyLe wILSon

[MS IV] JoShua LIeBerMan

� march 15, 2013 - Class of 2013 Match Day

� april 22, 2013 - Max Lecture with Karl Deisseroth, MD, PhD

� tuesdays @ 12pm - Molecules To Medicine [HSF II, Rm. 400]

� wednesdays @ 12pm - Translational Medicine Topics [HSF II, Rm. 341]

&

GET WELL SOON, JANE!

Winter 201310 the dual decree