Pulse Magazine Spring 2024

Page 26

PULSE

Joanna Sesti, MD’09:

“Happiest

Doing Surgery”

Supporting Students’ Mental Health

Professors Bring Industry to the Classroom

Novel Cell Therapy for Pancreatic Cancer

RUTGERS NEW JERSEY MEDICAL SCHOOL SPRING 2024

Learn more about Pingping Hou, PhD, who received a $3.5 million NCI grant to support her work in novel cell therapy for pancreatic cancer.

Learning Outside the Classroom

Students

Knee

PULSE SPRING 2024 Departments FYI  2 A Closer Look  4 NJMS People  18 Alumni Focus  22 End Page  24 SimMed From robots and manikins to “low-fi” standardized patients, clinical simulation allows learners to practice skills in a safe environment
Take a
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With more than 150
his name, Frederick F. Buechel, MD’72,
ankle, knee,
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take on research, educational initiatives, and other special projects,
by faculty members 8 12 16
mentored
Conquering Cancer
JOHN EMERSON
19

Since our country recently celebrated Women’s History Month, it seems timely that we look at the significant role women have played in advancing the practice of medicine. The midwives of ancient times laid the foundation for women like Elizabeth Blackwell, the first female to earn a medical degree in 1849, and 2023 Nobel Prize winners Katalin Kariko, PhD, whose research led directly to the first mRNA vaccines for COVID–19.

At NJMS, we have welcomed women physicians, researchers and educators ever since we opened our doors. We have encouraged them to advance in their fields and have provided opportunities for them to do so. As a result, we have many renowned female professionals whose work has had an impact across the country and around the world.

This issue of Pulse highlights only a few of these exceptional women. You can read about Pingping Hou, PhD, a cell biologist at our Center for Cell Signaling, who received a $3.5 million grant from the National Cancer Institute to use novel cell therapy to cure pancreatic cancer.

Another exceptional woman is Noa’a Shimoni, MD’04, MPH, associate professor of family medicine and director of student health for

A Message from the Dean

students enrolled in Rutgers Health programs in Newark. She has been appointed associate vice president for student health and wellness for the entire Rutgers population on the New Brunswick campus.

Finally, Patricia Morgan, MD,’95, now living and practicing in Hawaii, has specialized in the treatment of children who have experienced physical and/or sexual assault or abuse. In addition to treating and counseling patients and their families, Dr. Morgan wrote a book that teaches children about body safety.

These are only a few examples of the innovative, groundbreaking work our female faculty members and alumni are doing. We are extremely proud of our continuing support for every woman in the NJMS community.

In health,

Robert L. Johnson, MD, FAAP’72

The Sharon and Joseph L. Muscarelle Endowed Dean Rutgers New Jersey Medical School

DEAN

Robert L. Johnson, MD, FAAP’72

The Sharon and Joseph L. Muscarelle Endowed Dean, Rutgers New Jersey Medical School

ASSOCIATE EDITOR

LaCarla Donaldson

Manager, Marketing and Communications

SENIOR EDITOR

Mary Ann Littell

CONTRIBUTING WRITERS

Merry Sue Baum

Amanda Castleman

Katherine Gustafson

Nancy A. Ruhling

Lina Zeldovich

DESIGN

Sherer Graphic Design

PRINCIPAL PHOTOGRAPHERS

Keith B. Bratcher, Jr

John Emerson

KEEP IN TOUCH

Pulse is published twice a year by Rutgers New Jersey Medical School. We welcome letters and suggestions for future articles.

Send all correspondence to: Marketing and Communications

Rutgers New Jersey Medical School ADMC Building 11, Suite 1110 30 Bergen Street Newark, NJ 07107 or via email to: njmsmarketing@njms.rutgers.edu

ON THE COVER

NJMS alum Joanna Sesti has taken minimally invasive thoracic surgery to the highest level.

Get Social with Rutgers NJMS

1
njms.rutgers.edu
KEITH B. BRATCHER, JR.

FY i

WIC Grant of $597,638 Will Boost Awareness and Participation

The WIC (Women, Infants, and Children) Program at NJMS received a $597,638 grant to implement a WIC Community Innovation and Outreach Project. The funding will help NJMS spread local awareness of the WIC program and boost the number of local families participating, particularly among underserved Portuguese-speaking families and immigrant families in northern Newark. Raising awareness is necessary, because only half of eligible people nationwide participated in WIC in 2020, despite the notable benefits of the program, which include safer pregnancies, reduced infant mortality, and better nutrition and school performance for kids. In Essex County, WIC provides healthy food, nutrition education, breastfeeding counseling, and community support for income-eligible women who are pregnant or have infants or children up to five years old. WIC is supported by the USDA’s Food and Nutrition Service.

Pathway for Junior Scientists

Meet Robert Gross, MD, PhD, New Joint Chair of Neurosurgery

NJMS announces a new chair of neurosurgery, and the renowned neurosurgeon filling the role will also serve as chair of the Department of Neurosurgery at Robert Wood Johnson Medical School, as well as senior vice president for neurosurgical services at RWJBarnabas Health. Robert E. Gross, MD, PhD, is an expert in the use of neuromodulation and electrical impulses to target

Win-Win for Faculty and Rutgers-Newark Students

Early 2024 brought the start of a new collaboration between RutgersNewark and NJMS on the Pathway for Junior Scientists Program. The initiative offers biomedical research opportunities to Rutgers-Newark undergraduates who are highly motivated to pursue careers in

medicine or biomedical research, including in data sciences. Medical school faculty members will have the opportunity to identify and recruit promising students to work on their NIH-funded research, and students spend 10 hours per week in a lab to get valuable research experience and mentorship.

“It’s a win-win situation for the Newark research community,” says William Gause, PhD, professor of

medicine, senior associate dean for research, and director of the Center for Immunity and Inflammation. “I think it will expose young people to the excitement of biomedical research, potentially making significant discoveries, and it provides a resource for our laboratories to bring in young people to contribute to these research programs.”

The first cohort, which will begin work in mid-January, attracted 132 diverse applicants with a median 3.6 GPA, and drew the interest of about 30 NJMS labs. “We got such a large response,” says Gause. “It shows what interest there is in doing these kinds of activities.”

The program provides each student a stipend, supplied by the State of New Jersey and the Chancellor’s Office, and $2,000 for laboratory support. Faculty with active, well-funded laboratories are welcome to participate. NJMS’s plan is to expand the program to other colleges, such as NJIT, as well as to high schools and community colleges in Newark.

nerves within the brain as means of reducing symptoms of severe disorders. A world leader in functional neurosurgery, he led the surgical team at Emory University that was at the forefront of developing deep brain stimulation as a treatment for drug-resistant seizures in epilepsy. As an active researcher continuously funded by the National Institutes of Health since 2005, Gross will bring to Rutgers a new R01 grant–supported research project that aims to develop improvements to current neuromodulation treatments.

2 PULSE • SPRING 2024

National Academy of Inventors Honors

NJMS Professor

The National Academy of Inventors has named Fred Russell Kramer, PhD, as a 2023 fellow of the academy, the highest professional distinction for individual inventors. The fel lowship, which this year recognizes 162 academic inventors in 35 states and 10 countries, honors contributions to major advance ments in science and consumer technolo gies. Kramer is a professor of microbiology, biochemistry and molecular genetics at NJMS, and associate director of public health research for business development. The academy recognizes his efforts to help invent molecular

beacon probes that identify various genes that may be present in a clinical sample. These probes are used around the world in many clinical diagnostic tests, such as assays for tuberculosis, the AIDS virus, and COVID-19. He has also distinguished himself with work to develop sensitive assays to detect rare, mutated gene fragments arising from cancer cells to enable early detection of pre-symptomatic cancer from routine blood samples. “On behalf of my colleagues who are inventors on virtually all of my patents—and without whom none of these inventions would have been made—it is an honor to represent them as a fellow of the National Academy of Inventors,” Kramer said.

RBHS Celebrates its 10-Year

Anniversary

It has been a decade since Rutgers Biomedical and Health Sciences, now known as Rutgers Health, began working to deliver quality health care to New Jersey communities, particularly in underserved areas. It was conceived as an institution that could operate on the scale needed to transform communities and pursue life-saving discoveries. From the first, community engagement has been a priority, along with a commitment to providing care regardless of patients’ ability to pay. Rutgers Health has proved itself a research powerhouse, with faculty bringing more than $3.7 billion in awarded funding in the last decade. As we celebrate this 10th anniversary, we look forward to many more years of providing our communities quality care and groundbreaking research.

Helping

First-Gen College Students Find a Path to Medicine

For 16 years, NJMS has run the Northeast Regional Alliance (NERA) MedPrep HCOP National Ambassadors Program, which gives students from local colleges a chance to experience the medical field over the course of three summers. They spend six to seven weeks each summer taking introductory science courses, prepping for the MCAT, and gaining research exposure.

In many cases, these are firstgeneration college students who may not have the resources to enable their success in college and medical school. To guide students through these challenges, they receive one-on-one counseling, financial and wellness sessions. The program also does interventions to ensure that participants graduate from college.

“They have their first experience in the health care field,” says Humberto Baquerizo, MBA, EdD, program development specialist in the NJMS Office for Diversity and Community Engagement, which oversees the program. “They develop relationships at the hospital; they get to see people who look like them.”

In December 2023, Baquerizo gave a presentation about the program at the Student Success Conference, a Rutgers initiative to break down barriers to student success and provide students with inspiration, motivation, and validation. The presentation focused on how the grant-funded NERA program provides an equitable learning environment and gives participants the chance to develop student-tostudent peer relationships.

3 NJMS.RUTGERS.EDU

A New Integrated Mental Health Program Helps Students Cope

In 2022, NJMS student John Smith found himself struggling with the high demands of medical school. “I always thought that if I study hard and learn as much as I can, this will be reflected in my grades,” he says—but now it wasn’t working. Despite dedicated studying, Smith’s grades weren’t where he wanted them to be. “I wanted to know whether I was doing it wrong, or looking at the situation in the wrong way,” he says. “I really needed to talk to someone.”

Then, Smith (name has been changed to protect their privacy) remembered a presentation given by representatives from the NJMS Student Health Service (SHS) office during his medical school orientation. SHS, part of the Department of Family Medicine, provides a broad range of services to support students’ physical and mental health. The SHS team talked about a new program that provided mental health counseling. He made an appointment.

That pilot program, which integrates mental health services into the SHS office, was launched by Noa’a Shimoni, MD’04, MPH, to help students with the challenges of medical and graduate schools. The program’s goal is to offer students comprehensive health care in one place.

“We have two therapists located within our SHS office, as well as a collaborating psychiatrist,” explains Pooja Padgaonkar, MD, SHS medical director. Coming to SHS offers extra benefits, she notes. For example, if during a visit, an SHS physician notices a student might benefit from meeting with a

mental health provider, they can make this connection. And because these services are under the same logistical umbrella, getting an appointment is streamlined. “One big benefit is the ease with which you can get scheduled, because appointments are made by the same staff,” Padgaonkar adds. This allows timely evaluation and intervention in a familiar space. Ultimately, this model allows for collaborative care between the various providers. Many students come for help with organizational issues, time management, and handling stress—the common school challenges, says Shoshana Sperling, PsyD, one of the therapists. Also, in addition to the one-on-one visits, the staff offers group wellness sessions, bringing students together to talk about how they cope. “Often people come to us because it’s really hard to prioritize their time and manage the stress,” says Sperling. “Hearing how other people cope with similar issues can be beneficial. We wanted to give them a platform to talk to others and see that they’re not alone.”

Since August 2022, the program has counted 1,631 visits, reaching 221 students (not including the group sessions), and more are coming. “Often, a student would come in and say, ‘My roommate suggested that I schedule an appointment,’ so a lot of our referrals are word of mouth,” says Sperling—a good indicator that the pilot program is working well. “I would love the opportunity to expand the program to other schools and maybe even help students prepare for residency,” she adds.

For Smith, counseling proved a gamechanger as it helped him find workable solutions. The conversations reinforced his belief that he was on the right path even if his grades weren’t currently as high as he hoped. “It was enlightening because it verified that the things I was doing were for the reasons I wanted to do them,” he says. “I want to learn because I want to get better and gain the skills and knowledge that I need to be a good physician.” And with that came the strength to keep going. “I would absolutely recommend this to others,” he adds. ●

4 PULSE • SPRING 2024 a
closer look
Members of the NJMS SHS mental health care team (left to right): Shoshana Sperling, PsyD; Pooja Padgaonkar, MD; and Anna Schwartz, LCSW

Championing Urban Mental Health

Each autumn, the Department of Psychiatry welcomes experts and community leaders for its Urban Mental Health Conference. “Inner city popula tions face unique challenges, from social determinants of health to care ineq uities,” explains organizer Petros Levounis, MD, MA, professor and chair of psychiatry and chief of service at University Hospital in Newark. “We don’t simply present the latest medications and psychotherapies. We explore the context of how these trends unfold for our communities.

“NJMS doesn’t pay lip service to addressing disparities. It walks the walk. We’re delighted that our annual Urban Mental Health Conference contributes to this critical work and celebrates the spirit of the school.”

Levounis’ colleagues echo this sentiment, including NJMS’s executive vice dean and professor of medicine Maria L. Soto-Greene, MD, MS-HPEd, FACP. She says: “The 2023 Urban Mental Health Conference signaled to our community that together we can overcome inequities in care. This conference exemplifies NJMS’s long-standing commitment to sharing knowledge and best practices, which in turn improves access, engagement, and outcomes in health care.

“I am extremely proud of our outstanding faculty and all those who join us for the betterment of our communities and the state of New Jersey.”

Each year, participants focus on different issues; in 2023, they focused on the intersection of spirituality and mental health. Speakers included Rashi Aggarwal, MD, professor and vice chair for education and director, residency training program. The previous theme was

overcoming addiction in the age of fentanyl. Experts discussed developments ranging from the complex neurobiology of addiction to the disease’s co-occurrence with other psychiatric disorders. The conference also partnered with the American Academy of Addiction Psychiatry to provide federally approved buprenorphine training.

The Urban Mental Health Conference plans to continue offering such trainings periodically, Levounis explains, “allowing providers to treat patients with all the weapons available to modern medicine.”

Other topics have included transgender mental health and emerging modalities like nature therapy. In 2019, the conference tackled a new frontier: our growing reliance—and sometimes problematic overuse—of technology. “Most people do not know, or believe, that an all-encompassing, obsessive use of social media, texting, sexting, emailing, gaming, gambling, or eBaying can lead to a bona fide addiction,” Levounis said in an interview. “This conference create(d) opportunities for experts to develop new solutions to treat these emerging psychiatric conditions.” This autumn’s topic will likely focus on addiction as well.

The conferences welcomes physicians, nurses, nurse practitioners, psychologists, social workers, counselors, pharmacists, re-

searchers and community members, a group that often includes leaders, judges and peace officers. “We’re very grateful to the community leaders,” says Levounis. “Starting with the Urban Mental Health Conference, elaborate collaborations often blossom, especially through our Northern New Jersey Medications for Addiction Treatment (MAT) Center of Excellence.”

The conference, launched in 2013, averages 150 participants, and many return year after year, drawn by the combination of networking, exchanging ideas and deep-diving into the latest mental health trends. “It’s a continuing-education project as well as a community-building event,” Levounis says.

The conference has hit a mature and confident stride, and Levounis doesn’t predict it will change its format any time soon. “All of us talk about change, change, change. Doing something right and maintaining it is often harder. Maintaining your weight is tough. Retaining your wealth, sobriety and all kinds of other things is tough. And of course, preserving your mental and physical health may be one of life’s toughest challenges.” ●

The conference, held on the first Thursday in November, typically costs $50 for trainees and $100 for practitioners and community members. NJMS students may attend for free. Enrollment opens around Labor Day. Learn more at njms.rutgers.edu/psychiatry

5 NJMS.RUTGERS.EDU

closer look

Bringing Industry to the Classroom

A teaching award honors biopharma experts’ skills, innovation and commitment to students

Two alumni-turned-teachers have earned acclaim for guiding students and drawing industry expertise into their Rutgers courses: Ramez Labib, PhD’02, and Thomas Visalli, PhD’05.

The adjunct assistant professors of pharmacology, physiology and neuroscience teamteach Principles of Toxicology I and II, while holding full-time, demanding jobs elsewhere. And they’re sticking the landing, with each racking up a prestigious New Jersey Health Foundation Excellence in Teaching Award (EIT), which honor exemplary faculty within Rutgers Health.

6 PULSE • SPRING 2024
a
Scientist-teachers and alums Thomas Visalli, PhD’05 (left) and Ramez Labib, PhD’02 (center) have given so much to NJMS students through the years, says their department chair, Andrew Thomas, PhD (right).

“They’re great teachers and their courses are heavily enrolled each semester,” says Andrew Thomas, PhD, their department chair and the School of Graduate Studies’ senior associate dean. He nominated the team for the awards, which have been given for 34 years. “For 18 years they’ve been giving these courses while working professional day jobs. They’re really committed.”

The pair teach for the Biomedical Science Master’s Program, designed to enhance students’ credentials for admission to medical and dental schools, or advance their future

Labib and Visalli met years ago at NJMS, later collaborating at the beauty company Avon for several years. They then started team-teaching. “We decided to bring our industry experience into the classroom with real-life examples, since toxicology is very much an applied science,” Labib says.

biopharmaceutical careers. Both draw on a wealth of practical knowledge: Labib, as Avon’s executive director of global product safety and regulatory operations, and Visalli, as executive director and global head of the nonclinical regulatory group at Eisai. Avon needs no explanation. Eisai, a Japanesebased pharmaceutical company developing drugs for neurology and oncology indications, has U.S. corporate headquarters in Nutley, NJ.

The two professors said the EIT came as a surprise. They were celebrated at last year’s Lab Coat Ceremony, welcoming newly matriculated graduate students to the world

of research. Labib recalls: “I got my PhD a long, long time ago, but I still felt very proud to be there. It helps students understand that they’re taking an important journey in life and what they’re doing is critical.”

Labib was working on his dissertation when he first met Visalli, then a graduate student. A strong friendship flourished. Visalli wound up joining the same lab and continuing Labib’s research on cocaine and endotoxin, as the more senior scholar graduated and went to work at Avon. They later collaborated at the beauty company for several years and started teaching about organ-directed toxicity. “We decided to bring our industry experience into the classroom with real-life examples, since toxicology is very much an applied science,” Labib says. Three years in, they added a second class focusing on toxic agents like pesticides, poisons, and animal venoms.

“Because the courses are so popular, people sign up without even knowing what toxicology is! And almost every semester, one or two students ask, ‘What can we do to get a career in this field?’ It makes us feel like we’re not just helping people get into medical or dental schools, but also, we’re giving them a career path they weren’t thinking about before. That makes us very, very happy,” Labib says.

Pre-pandemic, the professors alternated delivering the dozen lectures for each course. But lockdown routed classes online, where they discovered a winning new formula. The pair began pre-recording their lectures and posting them a week or two early. This allows students to listen at their convenience, then engage in dynamic discussions during class time on Webex. Attendance shot through the roof once students didn’t have to contend with commuting. They also seem more comfortable asking questions, Visalli says.

And it turns out, the benefits flow both ways. Visalli explains that course creation drives the search for new literature, and staying current with topics and examples. “We’ve learned from teaching the course and also from the students. It’s incredibly rewarding to remain part of the Rutgers community from graduation until now.” ●

Calling All Aspiring Toxicologists!

NJMS offers a medical toxicology fellowship, sponsored by the Department of Emergency Medicine and housed within the New Jersey Poison Information and Education System (NJPIES). This dynamic and growing program, founded in 2019, offers an exciting opportunity to learn about poisons and their impact on human health. Our two-year program is fully accredited through the American Board of Emergency Medicine. We accept physicians who are board-eligible or board-certified in a variety of primary specialties. NJPIES, the statewide poison center, serves 9 million state residents, fielding more than 50,000 poisonrelated calls annually from the public and health care providers. Our medical toxicology division is staffed by accomplished faculty.

The fellowship accepts applicants on a yearly cycle (typically starting in August) through the National Resident Matching Program through the ERAS system (program ID 1183311002).

For more information, visit: njms.rutgers.edu/medical_toxicology

7 NJMS.RUTGERS.EDU

Sim

8 PULSE • SPRING 2024

Med

NJMS helps learners gain hands-on experience

The robots get all the glory.
Something about a talking, crying, bleeding manikin— which could cost up to $100,000—hogs the headlines.

But don’t overlook the whole spectrum of training devices, says Christin Traba, MD’06, MPH, associate professor of pediatrics and executive dean for education. “High-fidelity simulation can be wonderful,” she says. “However, low-fidelity simulation can be just as impactful in the learning process. We strive to utilize all aspects of simulation in training and assessing clinical skills, including manikins, standardized patients, and task trainers for procedural skills.”

Medicine has had abundant time to experiment. Indian practitioners developed leaf and clay models conceptualizing nasal reconstruction in 600 BCE. In China’s Song Dynasty (960–1279 CE), physicians taught acupuncture on life-sized bronze statues. By the 18th century, inventors practiced with fluid-filled glass uteruses and flexible fetuses and tried to mirror cardiovascular physiology. But a century passed before anesthesiologists created the “ancestors” of modern manikins.

The last three decades have been transformative, avoiding 60 to 90 percent of preventable deaths from errors, according

to an Institute for Medicine report. And as a bonus, learners pick up skills faster and more effectively.

Today, NJMS deploys many tactics, from interactive scenarios on paper to inflatable infants, “skin” made from silicone or pork, and laparoscopic video towers (think arcade game). The school also has low-fidelity manikins—like those used in CPR training— alongside higher-end ones. And it even uses augmented reality (AR), mixing virtual reality (VR) headsets with real-world spaces and tools.

Some instructors set up manikins in the OR and call codes to elicit real-world, adrenaline-fueled reactions. Others run escape rooms where players discover clues and solve puzzles: a learner-centered, team-based approach. And for peak realness, gynecological and urological teaching associates use themselves as models to instruct and help improve students’ skills, build confidence and reinforce appropriate bedside manners.

Here’s how various programs at NJMS are using this powerful learning technique.

9 NJMS.RUTGERS.EDU

Where Learning Meets Application

The NJMS Clinical Skills Center is a 10,000 square-foot facility that has administered Objective Structured Clinical Examinations (OSCEs) to thousands of students across decades. It includes a sim-training space and 12 exam rooms, which can be configured to resemble an ER, labor and delivery, or a patient’s hospital room with a bed. “Instruction, assessment, and feedback is needed to produce competent clinicians,” says administrative director Maria Laboy, MD. “Providing a safe and controlled venue for these immersive exercises does not come cheap, but is necessary in medical education.”

She adds: “Centers like ours are meant to be judgment-free learning spaces where students are encouraged to ask questions, make mistakes, practice skills, and learn to work as

a team. It’s a place where they can share and receive constructive feedback before they interact with real patients.”

Some useful tools include Laerdal’s SimMan 3G PLUS, which average around $80,000 and have interchangeable parts to mimic different ages and genders. Learners can measure its blood pressure and pulse oximetry, deliver medications with real devices and fluids, and train with live defibrillators. The center also has SimBabies, representing ninemonth-olds. Other devices rely on radio tags with smart barcodes to “administer” medications, reducing clean-up. Some models moan, cough or have speakers that trainers can broadcast through.

Scenario programming can provoke certain reactions from the sims. Laboy explains: “Manikins can appear to get better or worse, depending on the team’s actions. Vital sign

monitors attached to these manikins provide additional realism. These immersive exercises allow learners to practice in a way that doesn’t harm real patients. In a way, the simulator becomes the guinea pig!”

The center has an AR-compatible task trainer, the CAE Vimedix. A headset shows ultrasound animations of arteries and veins, and can imitate over 200 pathologies. But learners also get hands-on experience with other models, where they can practice skills like inserting IV lines.

“Simulation is embedded in all four years of medical education,” notes Sophia Chen, DO, MPH, assistant professor of pediatrics and associate dean for pre-clerkship education. “It provides a dynamic and interactive environment where students bridge content learned in the classroom with practical application.”

The Transition to Residency course contin-

“Simulation requires suspension of disbelief. You have to enter into a contract where you pretend things are real. Most students accomplish that. In fact, many say it feels realer than they expected.”
—SARAH DUNN, MD, MPP
10 PULSE • SPRING 2024

ues this work, explains Sarah Dunn MD, MPP, course director and assistant professor of emergency medicine. Her team adapted a scenario where students manage a SimMan mimicking an undifferentiated critical patient. “They also practice delivering serious news to patient’s families,” she says. When crafting playbooks, Dunn and her team gravitate towards high-risk situations that don’t occur often. “Students should experience being in charge since that’s something they’ll potentially face every day as residents,” she explains.

“Simulation requires suspension of disbelief. You have to enter into a contract where you pretend things are real. Most students accomplish that,” Dunn adds. “In fact, many say it feels realer than they expected.”

Departmental Highlights

Learners can practice complete birthing simulations in obstetrics, gynecology, and reproductive health, notes associate professor Lisa Pompeo, MD. NOELLE manikins allow users to check heart sounds and cervical dilation, correct shoulder dystocia, inspect placentas, manage uterine hemorrhages and resuscitate babies. Pompeo supplements high-tech toys with DIY ones, including faux body parts sculpted from chicken tendons, cow tendons, and car wash sponges with tubing. She explains: “Beef is the easiest to manipulate and feels closer to human tissue. Sites like MedEdPORTAL are good resources for this.” Her department runs multidisciplinary drills with nurses and techs at Rutgers School of Nursing too, stashing a NOELLE in labor and delivery, so learners can practice outside of the NJMS Clinical Skills Center’s hours.

Pediatrics also embraces the “practice makes perfect” ethos, says Kei U. Wong, MD, assistant professor of emergency medicine. “The populations are very vulnerable, and infant, child and adolescent physiologies differ from adults’,” she notes. “Responses also vary

to events like cardiac arrests, intubations and resuscitations, and not all learners have been adequately exposed to those during their clinical training.”

She praises VR and telesimula tion as innovative space-savers, especially for facilities that don’t have pediatric experts. “But we love the hands-on exercises that build muscle memory too,” Wong says. “It’s good to practice skills like placing an IV, because infant veins are so tiny. Simulators can also help highlight racial disparities and teach what veins, burns and eczema look like on different skin colors.”

ship. Fewer than 600 of these blazes ignite annually in the U.S., so they’re rare. But tests showed only 4.4 percent of doctors, nurses and anesthesiologists know how to address the situation. (Pro tip: turn off the oxygen!) Simulation training raised the pass rate to 79 percent.

Future Possibilities

Her team runs communication drills, including how to de-escalate, as health care practitioners are five times more likely to experience violence than workers overall.

Meanwhile, the Department of Surgery has expanded procedural-based skill-sessions, thanks to efforts by faculty like assistant professor Melissa Alvarez-Downing, MD. Students now practice suturing, catheterization, arterial puncture and nasogastric tube placement. Additionally, the department uses VR to mimic operating-room fires in its 1,100 square-foot simulation lab, explains Daniel Jones, MD, MS, professor and Benjamin F. Rush Jr., MD, Chair of Surgery; and assistant dean of simulation, innovation and scholar-

Some faculty dream of a new 5,000 to 10,000 square-foot, north-campus facility in addition to the Clinical Skills Center. “It’s the difference between having a bookshelf in your office versus the library,” Jones says. “This will take a $5 to $10 million infusion from donors first.” In the meantime, he hopes to forge research initiatives with science and engineering faculty to explore the use of VR and artificial intelligence in simulations that lead to safer surgeries.

Since 2010, the Society for Simulation in Healthcare has accredited more than 100 programs across ten countries, a process that requires contiguous and comprehensive centers. Traba says: “NJMS is committed to innovation and simulation, including plans for an updated clinical skills center. As we prepare for the future, we’ll evaluate requirements to be accredited in simulation.” ●

11 NJMS.RUTGERS.EDU
The NJMS Clinical Skills Center is a safe space where students ask questions, make mistakes, practice skills, and learn to work as a team. Daniel Jones, MD, MS (far right) is NJMS’s assistant dean of simulation, innovation and scholarship.
PULSE • SPRING 2024 12
Out

LESSONS FROM THE LAB

Classroom the Learning Outside

the COVID–19 vaccine rollout in late 2020 was accompanied by quite a bit of misinformation about its potential risks. One area of concern was whether the vaccine was linked to a higher risk of Guillain-Barré syndrome (GBS), as the U.S. Food and Drug Administration suggested. This rare neurological disorder can cause paralysis and death.

At the time, Mustafa Jaffry, MD’23, and Kranthi Mandava, MD’23, were NJMS students with a keen interest in research, going back to their high school days. (Read about Jaffry and Mandava’s backstory on page 15.) In light of the FDA warning, they decided to counter the public’s fear with facts.

Assembling a 10-member team, they collaborated with experts from Texas Tech to develop an artificial intelligence tool that they used to analyze the Vaccine Adverse Event Reporting System database. Evaluating more than 1,000 reports, the team concluded that there’s no significant increased risk of GBS in COVID-vaccinated individuals.

Because their team leader, Nizar Souayah, MD, NJMS professor of neurology, studies the correlation between Guillain-Barré syndrome and vaccines, “it was the perfect opportunity” for the COVID–19 study, says Jaffry. He notes that the study quickly went viral: their findings were widely reported in more than 77 major news outlets, including U.S. News & World Report and MSN.com.

Says Souayah: “It’s unusual for medical students to co-author a high-caliber paper like the GBS analysis. It took a lot of commitment on their part.”

Actually, it’s not such an unusual occurrence at NJMS, where many students have the opportunity to become involved with exciting research, educational initiatives, and other special projects, in collaboration with faculty members. Here is a look at some of these projects.

NJMS.RUTGERS.EDU 13 JOHN O’BOYLE

NIH R25 Program

The National Institutes of Health’s Research Education Program (R25) supports research education activities in certain mission areas of the NIH. Last summer, Rutgers Health celebrated two years of success with its R25 training program: “Multidisciplinary Opportunities in Research Education for Students in Health Professions.”

Through this innovative summer activity, students explore careers in research, gain valuable work experience, and develop relationships with faculty mentors who can provide career guidance. An area of focus is encouraging students from underrepresented groups to pursue further studies or careers in research. NJMS is one of four Rutgers Health schools participating in the program; the other participants are Rutgers School of Dental Medicine, the School of Health Professions, and Robert Wood Johnson Medical School.

R25 scholars work with some 30 faculty members, conducting 10 weeks of research in the fields of cardiology, pulmonology, and hematology. The students also engage in career development activities, participate in literature review, attend workshops, and visit pharmaceutical companies, visits that sometimes lead to internships.

NJMS student Sebastian Acevedo (pictured, top right) is enthusiastic about his R25 experience. “It’s an intensive program,” says Acevedo, whose family immigrated to the U.S. from Colombia when he was 4 years old.

Paired with a mentor, Rotem Naftalovich, MD, MBA, assistant professor of anesthesiology, Acevedo helped write a grant proposal for a project studying blood viscosity. While they did not receive that grant, the skills Acevedo acquired gave him the tools to successfully apply for a $5,000 Helping Hands grant from the American Psychiatry Foundation a year later. With this funding, he ran a 10-week workshop for Newark youth, designed to decrease the stigma of mental health.

“The level of support I have received at NJMS and through the R25 program is unparalleled,” says Acevedo, who is considering a career as an addiction psychiatrist.

Another participant, NJMS student Naana Kena (top left), says the R25 program taught her a different way to approach science—in her case, advancing her studies in congenital heart defects. “My experience being an R25 scholar was nothing short of amazing!” she says. “Before being in the program, I always envisioned myself as a purely clinical physician. But it opened my eyes to a whole new realm of possibilities for physicians.”

The R25 program is overseen by Valerie A. Fitzhugh MD’04, associate professor and chair of pathology, immunology and laboratory medicine; Diego Fraidenraich, MSC, PhD, associate professor of cell biology and molecular medicine; and Pranela Rameshwar, PhD’93, professor of medicine.

Putting Climate Change on the curriculum map

Working as a clinical research coordinator at a New York City hospital a few years ago, Victoria Ribiero (pictured below) saw firsthand the inequitable impact of climate change on patients. “Air pollution contributed to the disproportionately high asthma rates we saw in pediatric patients from the South Bronx,” she says. “When I enrolled at NJMS, I started looking at climate change from both a medical and health-justice point of view.”

To address this issue, Ribeiro, now an NJMS student, created a three-hour seminar on climate change, the school’s first on the subject, that’s part of the required Healing, Humanism, and Health Equity curriculum.

The seminar was Ribeiro’s project for NJMS’s Distinction in Medical Education program, one of seven extracurricular activities for students interested in exploring advanced studies in various areas, including bioethics and urban health. Her mentors for the project are Michelle DallaPiazza, MD, associate

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professor of medicine; and Novneet Sahu, MD, assistant professor of emergency and family medicine and interim chair of family medicine.

“Climate change’s effect on health has been mentioned in lectures, but this is the first time we have taken an in-depth look at the subject and formally added it to our curriculum,” says DallaPiazza. “We had always intended to include it, so Victoria’s timing was perfect.”

Riberio began her project by reviewing lectures and curricula from NJMS and other medical schools, along with information from medical societies and interest groups. The seminar she created focuses on the impact of climate change on socioeconomic systems, especially in Newark, where Ribeiro is from. Topics covered include the effect of climate change on medications, the exacerbation of chronic medical conditions, housing insecurity, mass migrations, and the burden on health systems.

“I made sure to look at every course that was published and to make note of major themes, what worked well and what did not,” says Riberio. Through lectures and interactive sessions, the seminar she created focuses on the impact of climate change on socioeconomic systems, especially in Newark, where Ribeiro is from, and elsewhere in New Jersey. It identifies solutions to patients’ climatechange-related medical needs, discusses the healthcare system’s contribution to climate change and outlines climate change mitigation strategies.

DallaPiazza, Ribeiro, and Sahu are studying the seminar’s effectiveness and plan to submit it for publication in an educational journal. Ribeiro hopes that the seminar helps students “see things from a different perspective and that they consider climate change when they are making management plans in clinical settings. Although one student can’t make a big change on a systemic level, education is the first step in spreading awareness and getting people to make a change.”

She hopes her seminar starts them down the path. ●

Making the Medical School Journey Together

Mustafa Jaffry, MD’23, and Kranthi Mandava, MD’23, are best friends, which is not surprising, given their shared interest in medicine, science, and research. But what is unusual is the duration of their friendship, spanning almost a lifetime. “We met in the sixth grade, when we sat at the same table in the cafeteria,” says Jaffry.

“At first, we didn’t hang out together that much,” says Mandava, picking up the thread. “We became good friends in middle school, and even better friends in high school. We went to Rutgers and did premed together, hung out pretty much every day. Then we went to NJMS. And now we’re both doing our residencies at NJMS.”

When asked whether this togetherness was intentional, they both pause. “It’s pure coincidence!” Mandava says. And then they laugh.

“Even with the match algorithm, which is completely unpredictable, what are the odds that we would end up at the same institution for our residencies?” asks Jaffry. “It defies explanation.”

He adds: “We’re actually in the same residency program now, because for ophthalmology, internal medicine is the first year of residency. So we’re not only both at NJMS, but we’re co-residents.”

While the two are best buds, no one will ever compare them to Beavis and Butthead. For one, they occupy the stratosphere of smartness, always outstanding students. Jaffry plans a career in ophthalmology, while Mandava is focusing on internal medicine, with plans to do a GI fellowship.

Jaffry was influenced by his father, an

infectious disease specialist. “My dad did an internal medicine residency at NJMS and encouraged me to follow in his footsteps,” says Jaffry. “I have a photo of myself—at age 1—with my father at his residency graduation. It was taken in the NJMS courtyard. Twenty years later, at my NJMS graduation, we took our photo in the exact same spot.” (See photos above.)

As undergraduates, the two worked in a lab at Rutgers Cancer Institute of New Jersey. This experience set the stage for their COVID–19 research project, guided by Nizar Souayah, MD, NJMS professor of neurology. “He had just started doing research on the COVID vaccine,” says Mandava. “We became involved, helping with the data analysis and interpretation.”

“When we published our paper on Guillain-Barré syndrome and COVID vaccine, it was widely covered in the national news and was the subject of hundreds of articles,” says Jaffry. “It was exciting, and totally unexpected.”

As part of the project, Mandava and Jaffry created the Neuromuscular and Electrodiagnostic Medicine (NEM) Research Institute. Comprised of former classmates, current and pre-med students, and undergrads, the institute has presented numerous papers at numerous conferences.

“Sharing this journey to becoming physicians has benefited both of us,” says Jaffry. “It’s great to have someone to study with and bounce ideas off of, who understands your struggles and responsibilities.”

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Take a n K

ee

Pioneering implant inventor isn’t resting on his laurels

Inventor and orthopaedic surgeon

Frederick F. Buechel, MD’72, rose to fame for revolutionizing ankle, knee, hip and shoulder joint replacements. Together with the late biomechanical engineer (and Rutgers alum) Michael Pappas, PhD, he holds more than 150 patents worldwide. Their showstopper: “the New Jersey Low Contact Stress Knee” (LCS), the first system to use mobile bearings. Innovations mimicked nature better and increased range of motion, and replacements could last 15 to 20 years, instead of the typical four or five.

Buechel grew up in West Caldwell and North Caldwell, NJ, where he witnessed several accidents as an Eagle Scout. This spurred him to perfect his first aid training. “Putting it into practice inspired me,” he recalls. “It

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seemed like helping people would be a very good life.”

Wrestling landed him a partial scholarship to Seton Hall University, where the pre-med scholar won three metropolitan championships and five state championships. He then attended NJMS, meeting Pappas, a mechanical engineering professor at New Jersey Institute of Technology. The pair taught biomechanics to orthopaedic residents and a close friendship ignited. “We rode motorcycles and visited bars, drawing implants and instruments on napkins and tablecloths,” he says.

Buechel served as NJMS’s director of orthopaedic anatomy for nine years, and the cadaver lab helped the team develop and test the instruments required to implant their devices. Proximity gave them a boost too. “Other surgeon-engineer teams would maybe meet for a couple hours here and there,” he recalls. “But we hung out at each other’s homes and were like family. The constant contact let us rapidly evolve implant and instrument designs. We shared our specialties and sort of worked as one mind.”

Not all the progress was swift, however. The FDA required 11 years of clinical trials for the LCS—a first for knee replacement systems—which wrapped in 1991. “It was a landmark device and probably one of the longest-running artificial joints (1977–2024),” Buechel says. “Manufacturer DePuy Synthes, Johnson & Johnson’s orthopaedics company, eliminated it this year, much to the chagrin of many surgeons. The industry can be fickle, and driven by sales and marketing, which make ‘new’ appealing.”

Ironically, the team had improved the LCS in 1991, correcting bearings that would spin out for one to two percent of patients. But this tiny adjustment would have required more costly, time-consuming FDA trials. So the implant, now called “the Buechel-Pappas,” found fresh life abroad. “It’s the premier knee replacement in India, which installs around 1,000 of these monthly,” he explains.

People in India aren’t the only beneficiaries, it turns out. “We may be the only design team to ever have our own implants installed: a knee for Pappas and two hip replacements for myself,” Buechel laughs. “That might be a world record!”

The New Jersey Inventors Hall of Fame inducted them both in 1998. They collaborated for 41 years total until Pappas’ death, the same year they updated their seminal work, “Principles of Human Joint Replacement,” in 2015.

A Floridian, Buechel frequently returns to New Jersey. He continues to explore his passion for alternative medicine, along with boating, fishing, squash, and scuba diving.

Technically he retired in 2023…but still wrote three papers. He often collaborates with his son Frederick F. Buechel, Jr., MD’95, an internationally renowned orthopaedic surgeon and expert in robotic knee replacements.

Daughters Bonnie Buechel, MD’17, and Kelly Buechel, ND (naturopathic doctor), followed him into medicine, while Holly, a national fencing champ, edits pharmaceutical videos.

Buechel used DePuy’s robust royalty stream to establish the Frederick F. Buechel Chair of Orthopaedic Research in 2002. “I stay fairly connected philanthropically to my educational institutions, but my big love is the med school,” he says. The endowed funds are managed by the department’s chairman, Joseph Benevenia, MD, a musculoskeletal oncologist who performs some of the most advanced surgical procedures to salvage limbs.

“The gift has helped the department in many ways,” says Buechel. “I’m very proud to have made this critical donation.”

An original New Jersey Knee is held at the George F. Smith Library of the Health Sciences in the History of Medicine’s Special Collections. ●

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njms people Bringing Health Care to the Students

Noa’a Shimoni, MD’04, MPH, remembers the day she decided to pursue medicine as a career. She had just earned a bachelor’s degree in mathematics and statistics from Rutgers University, but wasn’t sure what was next. “I had a job but not a career path that was meaningful to me,” she recalls. “And I remember standing in the kitchen with my mother and brainstorming about what career could have meaning for me.”

She had learned that her grandfather, a pharmacist by profession, had always wanted to study medicine. But in prewar Poland, which set a limit on how many Jewish students could enter medical school, he didn’t make the quota, despite his qualifications. “My mom asked if I ever considered medicine—and then something clicked,” Shimoni recalls. “Working with people, solving problems, I thought that it could be a really good fit.”

That kitchen chat proved pivotal. Shimoni returned to Rutgers for her medical degree, discovering along the way that she had varied interests. “At medical school I was really interested in procedures, infectious disease, women’s health and mental health care,” she says. “Family medicine was a huge draw because I could indulge in all of these interests and still develop my niche.”

With a fellowship in family planning and a master of public health in epidemiology from Columbia University Mailman School of Public Health, Shimoni indeed built her own specialty. “All that fit really nicely in the overall concept of health,” she notes. Consequently, she developed an all-encompassing, holistic view of health care and how it should be delivered.

“I wanted to promote the idea that students can have most of their care in one place. So whenever I or my colleagues had specific expertise…we were going to offer that to students.”

Shimoni joined Rutgers as an assistant professor of family medicine and medical director of Student Health Services in 2012. She applied her holistic health care vision to the needs of the students on campus. Her view is that undergraduate and graduate life is stressful and demanding. Students shouldn’t struggle to figure out where to go with a specific medical issue, but should have one place for everything.

“I wanted to promote the idea that students can have most of their care in one place,” she shares. “I didn’t want somebody to go to one place for an infection, to another

place for an IUD, and somewhere else for gender-affirming care. So whenever either I or my colleagues had the specific expertise within family medicine, we were going to offer that to students.”

Her big-picture thinking came handy during the COVID–19 pandemic, when implementing campus safety measures was crucial. Working with the university’s IT department, Shimoni led an effort to streamline COVID–19 testing at the operational level. “We built a process where students would grab a free test from a vending machine, and then, through a QR code, link that to their identifiers within our

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system,” she explains. “When those results came back, we knew whose results they were.” That allowed for a university-wide compliance snapshot at any given time, keeping students and faculty safe. Later, Shimoni led vaccination efforts on campus and beyond. “We worked with the New Jersey Department of Health to open vaccination sites at Rutgers in Newark, New Brunswick, and Camden,” she says. “We also ran some mobile clinics in the community and around the campus.”

Her next initiative wove yet another piece of the holistic health care puzzle into the campus canvas: mental health. In 2021, she assumed a role of acting vice president for student health services and launched a pilot program which allows students to see a mental health professional as part of NJMS’s Student Health Service (see story on page 4). “We live within complex and stressful environments, and mental health is an important part of people’s overall well-being,” Shimoni says. “I’m glad to have great support from senior leadership and my chair, Dr. Novneet Sahu, to grow the student health practice. The drive for me now is to bring health and wellness outside of the clinic. It should be accessible and available for all.” ●

Conquering Cancer

Pingping Hou, PhD, is not satisfied with the odds when it comes to pancreatic cancer. An assistant professor in both the Center of Cell Signaling and the Department of Microbiology, Biochemistry and Molecular Genetics, she knows that only 10 percent of those diagnosed with the disease will be alive in five years. She’s working hard to change that statistic.

Hou recently received a $3.5 million grant from the National Cancer Institute to support her work in novel cell therapy for pancreatic cancer. Her lab is engineering novel multifaceted cells that will become weapons and fight against the cancer cells. These cells will be able to migrate inside the tumor and engage other immune cells to join in the battle.

Hou believes that the disease is not only in the malignant tumor, but also in the cells surrounding the tumor, known as the microenvironment. Cancer cells educate the immune cells and stomal cells surrounding the tumor to become complicit in the cancer process. Hou’s lab has discovered the novel pathways that enable this to happen. Understanding these key communication networks that poison the neighborhood, she says, will prevent therapy resistance and/or tumor relapse.

“We’re hoping to remodel the microenvironment so that other immune cells can work cooperatively to attack the cancer cells,” she says. “We have almost completed the in vitro portion of our experiment and will soon be injecting these cells in tumor-bearing mice. I am very anxious to translate my research into therapies for patients suffering from this horrible disease.”

Hou has received numerous awards for her work, including the 2021 National Cancer Institute K22 Career Development Award, the 2022 AACR-Lustgarten Foundation Career Development Award, the 2023 New Investigator Award from Rutgers Cancer Institute of New Jersey, and the 2023 HealthXpress Award from Rutgers University.

The Center for Cell Signaling is a basic and translational research center at NJMS, directed by Raymond Birge, PhD, professor and vice chair, Department of Microbiology, Biochemistry and Molecular Genetics and director of the Center for Cell Signaling. Research there spans a number of disciplines, from biochemistry, biophysics, and molecular biology, to cell death, to zebrafish and model organisms, as well as aging and neurodegeneration. ●

For more information on the Center for Cell Signaling, visit njms.rutgers.edu/ccs

NJMS.RUTGERS.EDU 19

Health Care Goes Global

The patient, a mother with two young children, was in debilitating pain. A 35-pound fibroid in her uterus made it difficult for her to sleep or to even walk more than a couple of steps at a time.

In this painful condition, she rode for three hours by bus to reach the Tetteh Quarshie Memorial Hospital in Mampong, Ghana, to undergo a hysterectomy performed by an NJMS-led team that was on a global health care mission.

As others on the team frantically worked to stanch the bleeding, Rego tracked down the woman’s sister in the hospital’s hallway, and, with a local nurse, took her across the street to draw blood.

“It was scary,” says Rego, who participated in 10 surgeries during the trip, ran the ob-gyn floor and did post-op consults.

The experience was transformative for the patient—and for Rego.

“She was bleeding profusely during surgery,” says Erica Rego, a fourth-year NJMS student who is planning a career in ob-gyn. “Because there was no blood bank, patients were required to bring a unit of their own blood, but in her case, it wasn’t enough.”

“It helped me develop skills in a resourcelimited environment, and it made me appreciate how much we have in the U.S., in terms of tools and medical equipment,” she says. “And it was rewarding—we were able to make a difference for this woman and others just by spending a week there.”

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September’s mission was the brainchild of Ziad Sifri, MD, NJMS professor of surgery and director of the school’s Office of Global Health.

Since 2009, when he co-founded the all-volunteer nonprofit International Surgical Health Initiative (ISHI), Sifri has led 32 missions, eight of them to the Ghana hospital that treated the fibroid patient.

The missions, which include surgeons and supporting staff members from NJMS and around the country, encompass teaching and training sessions as well as donations of vital equipment ranging from anesthesia monitors to urinary catheters and personal hygiene packages. There are three missions a year. In addition to Ghana, the teams go to Sierra Leone and Peru. The organization is financed by private donations, and the volunteers on Sifri’s teams pay their own airfare. The tab for their food and lodging is picked up by ISHI.

The record 79 surgeries performed on the latest Ghana trip by the 25-member team included burn scar reconstructions with skin grafts—a first for ISHI. NJMS’s Edward S. Lee, MD, MS, associate professor of plastic surgery, performed 20 surgeries.

“One woman came in with a beautiful scarf tied around her neck,” says Lee. “She had been burned, and for three years, she had been covering up the fact that her chin was stuck to her chest on her right shoulder. And there was an electrician who had a fatty tumor the size of a football on his arm that prevented him from putting on his shirt, raising his arms or extending his fingers.”

The experience of helping these patients, he says, “was eye-opening and enlightening.”

Harsh Sule, MD, MPP, associate professor of emergency medicine and associate director of the Office of Global Health, has been to Ghana five times. In addition to doing pre-op and providing point-of-care ultrasound and other diagnostic tests, he conducted bedside teaching sessions and taught short courses,

training local personnel in relevant surgical and anesthesia techniques while on the clinical mission.

“Additionally, in 2019 we were asked to conduct a two-day course on disaster management, and in September 2023 a three-day course on point-of-care ultrasound,” says Sule. “Currently we are working on a potential expansion of the point-of-care ultrasound course to include a basic, intermediate and advanced level course as well as a train-thetrainer component.”

He adds: “The classes extend the reach beyond the individual patients who benefited

from the surgeries. And we keep in touch—we hold Zoom case conferences almost every week with the local team in Ghana, which allows faculty members from other specialties who have not taken the trips to contribute.”

Sifri hopes to expand the program and is recruiting and training other mission leaders for future trips. Although Rego was not on the next mission—to the Philippines in February— she’s hoping to land a residency with a global health care component.

“Going to Ghana was a unique opportunity,” she says. “I want to continue doing international work.” ●

21 NJMS.RUTGERS.EDU
Ziad Sifri, MD, co-founder of the all-volunteer nonprofit International Surgical Health Initiative (ISHI), has led 32 multidisciplinary missions overseas to bring surgical health care to people and countries in need.

alumni focus

Breaking Down Barriers

It’s hard to imagine that Joanna Sesti, MD’09, a renowned thoracic surgeon, nearly failed third grade. It’s even more difficult to believe when you learn she is the first female ever to be appointed northern regional director of thoracic surgery for RWJBarnabas Health, and is also chief of thoracic surgery at Cooperman Barnabas Medical Center in Livingston, NJ. Once you know her back story, however, it makes perfect sense.

Sesti, a native-born Cuban, emigrated to the U.S. with her family in 1989. They settled in Hudson County, NJ, and seven-year-old Sesti and her two brothers went off to school. Although some of the teachers were bilingual, Sesti’s third-grade teacher was not. “The language barrier made it very difficult for me to learn,” she recalls. “It was just sheer luck that I got through.”

It didn’t take long for Sesti to become proficient in her second language. She did well in school and like her older brother, was accepted at High Tech High School, a magnet school in North Bergen for students interested in careers in sciences or art. That’s where her AP biology teacher, Nina Lavlinskaia, PhD, inspired Sesti’s love of biology. Then as a junior at New York University (NYU), Sesti spent time doing lab work, which she found fascinating. That’s when she decided to become a physician-scientist. Her next stop would be at a medical school that could fulfill her dream.

NJMS was the first place she thought of, since it was close to home. During her interview and tour, she knew it was the place for her. “The students were doing a good deal of hands-on clinical training,” she says. “And I was very impressed with the physicians and teachers and the research that was being conducted.”

Sesti was accepted into the MD/PhD program, with the idea of spending most of her time in the laboratory and practicing medicine on the side. That changed when she started her clinical rotations during her second year. She was intrigued with the interaction of hormones with the body in endocrinology, and she enjoyed the surgical aspect of gynecology. She thought of perhaps focusing on one of those specialties. It was the surgical rotation however, that clinched it. “I donned a gown and gloves, and when I walked into the OR, I thought, ‘This is for me,’” she says. “A feeling came over me, and I knew I’d be happiest doing surgery.” Later, observing a thoracic

surgeon for the first time, she got that same feeling. “I was in awe as the surgeon opened the sternum and removed a large tumor,” she says. “That was what I wanted to do.” She dropped the PhD portion of the program. Back at NYU after graduation from NJMS, Sesti completed a combined residency/ fellowship in general and cardiothoracic surgery. She then headed to the University of Pittsburgh, where she did a one-year advanced minimally invasive thoracic surgery fellowship under James D. Luketich, MD, a pioneer of minimally invasive esophageal surgery. While there, she got a call one day from a nurse practitioner she had worked with at NYU, who told her there was an opening for a thoracic surgeon at Cooperman Barnabas Medical Center. She got the job and six years later was appointed chief of thoracic surgery and northern regional director.

“I’ve been so fortunate,” she says. “It seems trite to say this, but it took several strokes of good luck and simply being in the right place at the right time to get where I am. I’m so thankful to those who served as role models and to my parents who inspired me to take risks and dream. Not everyone gets to do what they love.” ●

COVER STORY
“I

donned a gown and gloves and when I walked into the OR, I thought, ‘This is for me.’ A feeling came over me and I knew I’d be happiest doing surgery.”

23 NJMS.RUTGERS.EDU

Powerful Tool to Fight Child Abuse

The statistics are devastating: one in three females and one in 20 males will encounter sexual abuse or sexual assault by the time they’re 17 years old. The notion that any adult would commit such a horrific act defies belief. “Sadly, it happens in all communities and at all levels of society,” says Patricia Morgan, MD’95.

Morgan specializes in child abuse, making it her life’s mission to help children who are victims of maltreatment and neglect. “Unfortunately, child abuse and maltreatment are prevalent in inner-city areas,” says Morgan. “I want to help these children. And just as important, I want to teach kids how to protect themselves.”

Morgan chose her career path 25 years ago as a pediatric resident, when she saw the traumatizing effects of child abuse. Her career has taken her from Newark, NJ, to Charlotte, NC, then across the country to Tacoma, WA, and ultimately, to Hawaii, where she currently lives and practices. She is medical director for the Kapi’olani Child Advocacy and Protection (KCAP) Center, part of the Kapi’olani Medical Center for Women & Children, located in beautiful Honolulu.

Growing up in Teaneck, NJ, Morgan knew she wanted to be a pediatrician by the age of 11. Earning straight A’s in high school, she was accepted into the joint BS/MD program at Howard University. Initially she planned to stay at Howard for medical school, but a death in the family propelled her home. She enrolled at NJMS. “Our class broke the record for the highest number of underrepresented students,” she says. “NJMS was a great place to learn. The faculty and staff were always so encouraging.”

After completing a pediatrics residency in 1999, she joined the staff of the Children’s

Hospital Abuse Management Program at Newark Beth Israel Medical Center. As this program grew, she was named medical director in 2005.

In 2008 she relocated to Charlotte, NC, taking a position as a child abuse pediatrician at Levine Children’s Hospital, where she served as medical director for 11 years. “That was a great time in my career,” she says. “But when COVID came, it changed my mindset about life. I decided I wanted to live differently. I wanted to work differently.”

In 2021 she learned about an opportunity to relocate to Hawaii. “In my desire for change, this was as different as it was going to get,” she says. “I’m part of a wonderful community. My work here is rewarding and I truly feel that this is where I’m supposed to be at this time of my life. As an added plus, I get to look at the water every day.”

The conversations she’s had behind closed doors with patients and families inspired her to write a book for children. “One way to prevent sex abuse is by teaching kids about body safety,” she says. “But by the time I see children who are victims of abuse, we may have missed the initial opportunity to teach them, and their parents, about prevention. I realized that it was important to bring this information out of the exam room and share it with other kids.”

So she wrote her book, found an illustrator, and then a publisher (Palm Enterprises LLC). “The Doctor Says: Let’s Talk About Body Safety” is available through independent and major book retailers, as well as the book’s website, www.TheDoctorSays.info.

“The book teaches empowerment to children in a child-friendly way,” she says. The main character, a female doctor based on Morgan herself, explains what parts of the body are private (what’s covered by a bathing suit), and tells children what to do if someone violates that privacy. “I teach them how to say no, and how to be brave and tell an adult.”

She has written different versions of the book for different audiences, including African American girls and boys. A third book features a Hawaiian child, and a fourth is in the works for the Latinx population.

Her work isn’t easy. “There are cases that are so sad, challenging and just plain hard,” she says. “But I am happy that I’m able to help patients. It also helps to work with a dedicated group of professionals who advocate for these children.

“Kids need to know that they have a voice too,” she adds. ●

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Patricia Morgan’s book teaches children the skills to protect themselves.

Shave& a Haircut

When you’re ill and hospitalized, it’s not easy to keep up with basic daily grooming—especially if your hospital stay is long and drawn out. For many people, not looking clean and neat may affect their mood, their happiness (or lack thereof), and even their outlook on life.

When confronted with this problem at Newark’s University Hospital (UH), fourthyear NJMS student Vaishali Ravikumar tackled it head-on. She’s the brains behind Bergen Barbers, a program providing haircutting and shaving services for hospitalized patients in UH’s trauma and medicine services. A small team of NJMS students does the grooming.

Ravikumar came up with the idea for Bergen Barbers as a third-year student, during her trauma surgery rotation. “A patient who had been hospitalized for many days became so frustrated that he was on the verge of checking himself out against medical advice,” she says. “His long, matted hair and unbrushed beard were making him very uncomfortable. My attending suggested I do something about it.”

Grabbing a few toiletries from hospital closets and supply rooms, she was able to give the patient a makeshift barber shop experience. “He requested a ‘fo-hawk’ and I did my best to deliver,” Ravikumar says. “We laughed and talked through the whole process and I learned a lot about him. When I finished, he was in much better spirits and trusted his health care team more than before. He ended up staying in the hospital for the duration and healed well.”

Pleased with the outcome, Ravikumar wanted to come up with a way to bring these services to other patients similarly facing extended hospital stays. She recruited a few NJMS student volunteers to help: M4 Matthew Del Signore; M2s Hetal Lad and Sowntharaya Ayyappan; and M1s Ivan Loncar and Shivani Srivastava.

They’d never cut hair before, “and I’d certainly never given anyone a shave,” notes Ravikumar. So they did what people do when trying to learn new skills: watched YouTube videos.

“We learned how to use a clipper and how to give a basic haircut,” says Ravikumar. “Using waterless shampoo with a small spray bottle of water, we dampen the hair, shampoo it, and towel it dry. For women, we do a straight cut. For men, we ask how short they want it.”

The nursing staff on the surgery and medicine floors guides patient selection, says Ravikumar. “We make sure patients are able to provide consent and do not have a TBI or any medical device in the head or face that might be an obstacle. Patients with severe blood clotting disorders are also ruled out.”

Thus far, they’ve had nothing but raves. Among the patient comments:

“My head feels cleaner and more comfortable. I can feel a breeze again!”

“Now I won’t have food stuck in my beard and mustache, which has been grossing me out.”

”I wish I had my wallet so I could pay you!”

The team plans to hold a fund-raiser to add more products to their arsenal: nail polish, after-shave, and products for textured and curly hair. They want to learn how to braid Black women’s hair, too—and hope to one day have manikins to practice on.

Bergen Barbers is part of the Pozen Scholars Program. Created in 2009, the program supports meaningful student-run community activities. The group is guided by faculty mentor Amy Gore, MD, assistant professor of surgery.

“It’s rewarding to feel that I contributed to the medical team and served my community with skills I learned on my own,” says Ravikumar. “I’m excited to continue our work and see our reach expand."

—Mary Ann Littell

BEFORE & AFTER

There’s nothing like a shave and a haircut—just ask UH patient Robert Urbanich, seen above before and after his grooming session.

THE BERGEN BARBERS Bergen Barbers helping patients with a shave and a haircut: NJMS students Vaishali Ravikumar (top) and Matthew Del Signore (bottom).

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South Orange Avenue Newark, New Jersey 07103
Non-Profit Organization US Postage Paid Rutgers University Permit No. 5287 Learning Outside the Classroom See story on page 12.

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