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2021 residents

Incoming residency class at Children’s National three times more diverse than national average

2021 residents

The new class of residents arriving at Children’s National Hospital on June 9, will be the hospital’s most diverse class ever. 51% of the incoming intern class identify with races and ethnicities underrepresented in medicine (UIM) including Black, Latino and Southeast Asian, a percentage that is more than three times the national average for diversity within residency programs.

“We have worked hard to make our residency class more diverse because we know that diversity among academic pediatricians helps dismantle systemic health care inequities faced by children,” said Aisha Barber, M.D., M.Ed., director of the Pediatric Residency Program at Children’s National. “Studies show that when patients see someone they identify with, it enhances patient trust and satisfaction. Diversity within medical ranks has also been associated with improved health care outcomes for patients from underrepresented backgrounds.”

Children’s National created outreach and pipeline programs designed to reach a larger more diverse group of medical students and to increase diverse students’ interest in academic pediatrics at Children’s National. Program leaders reach out through various student medical association meetings, nationally and regionally.

In 2015, the hospital developed Advancing Diversity in Academic Pediatrics, a scholarship program for senior medical students from backgrounds UIM to experience what a career in academic pediatrics might look like for them. Since the start of the scholarship program, the diversity of incoming resident classes has grown from 12% to the current 51%.

“This scholarship program changed my career trajectory as it introduced me to the field of pediatric academic medicine,” said Jessica Hippolyte, M.D., M.P.H., pediatric chief resident at Children’s National and graduate of the scholarship program. “I was paired with minority resident and faculty mentors, networked with senior program leadership, received guidance on the application process and gained tremendous insight on all the opportunities available to Children’s National residents.”

Under the scholarship program, fourth year medical students are invited for a month-long clinical rotation and given a stipend funded by the CEO’s office at Children’s National. The program’s curriculum not only focuses on the clinical experience, but through relationships with mentors, focuses on the development of interview skills and the creation of a competitive curriculum vitae, or CV.

Since the program began, there have been over 70 participants and a 25% match rate to the pediatric residency program at Children’s National. Four members of the 2021 class are graduates of the scholarship program.

Every March, medical students learn which residency programs they will train with on what is known as ‘Match Day’. Children’s National receives over 2,000 applications per year for 41 residency positions. That’s more than half of medical student applications in the U.S. for pediatrics. Applicants were recruited from some of the top medical schools in the U.S. including the University of Pennsylvania, Columbia University, University of California, San Francisco and University of California, Los Angeles.

In addition to the increases in the racial and ethnic diversity of the incoming residents, at least 10% of the incoming class identify as LGBTQ, which mirrors the percentage of adults in D.C. who identify as LGBTQ.

“There are many factors that indicate to us that someone will make a great resident and a great doctor,” said Dr. Barber. “At Children’s National, we strive to be sure our residents understand that they’re appreciated not for how they add to diversity statistics, but for who they are as a whole person and all they have to contribute to our community.”

 

Wayne Frederick

Celebrating Research, Education and Innovation Week at Children’s National Hospital

Wayne Frederick and Kurt Newman

Children’s National Hospital held its 11th Annual Research, Education and Innovation Week, which showcased the scholarly achievements of faculty, staff and trainees across all disciplines and the roles they play in advancing medical science and providing the highest quality care to children.

The week-long event included poster presentations, guest lectures, educational workshops and panel discussions. Eight acclaimed speakers were invited to deliver keynote lectures, including, Wayne A. I. Frederick, M.D., M.B.A., FACS, president of Howard University, James W. Collins, Jr., M.D., M.P.H., associate director for the pediatric residency program at Lurie Children’s Hospital of Chicago, Francis S. Collins, M.D., Ph.D., director of the National Institutes of Health (NIH) and Sally Allain, MSc, M.B.A., head of JLABS @ Washington D.C.  The themes for both Dr. Frederick’s and Dr. James Collins’s presentations were centered on diversity, equity and inclusion.

The keynote lecture “The State of Diversity in the Medical Profession” delivered by Dr. Frederick gave a voice to three often sidelined matters. First, the ongoing need to ensure greater equity and accessibility of health care for communities of color. Second, the unconscious biases that continue to permeate the medical profession, making it difficult for minorities to receive the health care they need. Third, how Historically Black Colleges and Universities in general, and Howard University in particular, shoulder an immense burden in developing African American doctors who enter the medical profession in this country.

To Dr. Frederick, progress begins with awareness and education. “I want people to understand why diversity is important, what challenges prevent it and what can be done to promote it. I also want each individual to understand the role he or she may play in fostering greater diversity,” said Dr. Fredrick. “These are institutional problems, but individual people have the power to change their environment. We will need to advocate for and work to bring about greater diversity. The more people giving momentum to this initiative, the further progress we will make.”

Dr. Frederick further explained that there are many obstacles to diversity. “Becoming a doctor requires time, money and resources. Aspiring Black doctors often forgo a medical career because they don’t have the resources to afford the education nor the luxury to defer earning a livable salary,” said Dr. Frederick. “To achieve diversity in all fields, but especially in the medical profession, we need to support students and the institutions that train them so they can make professional decisions based on their future goals rather than their immediate needs.”

The “The Racial Disparity in Adverse Birth Outcome: Zip Code Eclipses Genetic Code,” keynote lecture from Dr. James Collins shed light on African American women’s ongoing exposure to early-life impoverishment, racial discrimination and parental low socioeconomic status associated with adverse birth outcome.

“Racial disparities in certain U.S. zip codes persists even though it is known to negatively affect birth outcomes because it fails to eliminate the early-life—and generational—consequences of neighborhoods experiencing poverty and lifetime exposure to racial discrimination,” said Dr. James Collins. “We must eliminate the social and economic inequities that are the root cause of the racial disparity in adverse birth outcome.”

Children’s National faculty were also recognized for their high-quality research during the event. Awards for the best poster presentations were distributed according to the following categories:

  • Basic and Translational Research
  • Clinical Research
  • Community-Based Research
  • Education, Training and Program Development
  • Quality and Performance Improvement

The category winners conducted research on a variety of topics, including creating and applying telehealth innovation, developing educational intervention strategies, evaluating the impact of COVID-19 in the Washington Metropolitan area, using T-cell expansion for therapeutic use.

title slide for Dr. Frederick's talk

Francis Collins

Francis S. Collins, M.D., Ph.D. from NIH: The future of genomic medicine and research funding opportunities

Kurt Newman and Francis Collins

Genomic medicine, diversity, equity and inclusion (DEI), a world post-COVID-19 and pediatric research funding were among the topics discussed during the “Special Fireside Chat” keynote lecture at the 2021 Children’s National Hospital Research, Education and Innovation Week.

Francis S. Collins, M.D., Ph.D., director at the National Institutes of Health (NIH), is well known for his landmark discoveries of disease genes and his leadership of the international Human Genome Project, which culminated in April 2003 with the completion of a finished sequence of the human DNA instruction book.

The President and CEO of Children’s National, Kurt Newman, M.D., joined Dr. Collins during the “Special Fireside Chat” keynote lecture. Dr. Newman posed several health care-related questions to Dr. Collins over the course of 30 minutes. Dr. Collins’s responses shed light on what it takes to advance various research fields focused on improving child health and develop frameworks that advocate for DEI in order to foster a more just society.

Q: You have been involved with genomic medicine since its inception. You discovered the gene causing cystic fibrosis and led the Human Genome project. What do you see as the future of genomic medicine, especially as it relates to improving child health?

A: Thank you for the question, Kurt. First, I wanted to say congratulations on your 150th anniversary. Children’s National Hospital has been such a critical component for pediatric research and care in the Washington, D.C., area, and at the national and international levels. We at the NIH consider it a great privilege to be your partner in many of the things that we can and are doing together.

Genomic medicine has certainly come a long way. The word genomics was invented in 1980, so we have not been at this for that long. Yet, the success of the Human Genome Project and the access to cost-effective tools for rapid DNA sequencing have made many things possible. It took a lot of effort, time and money to discover the gene that causes cystic fibrosis. Kurt, if you look at what we did, while it was rewarding, it was a challenging problem that occupied the hearts of the scientific community in 1980. Now, a graduate student at Children’s National that has access to DNA samples, a thermal cycler, a DNA sequencer and the internet could do in about a week what it took us a decade and with 50 people.

We have been able to rocket forward as far as identifying the genetic causes of 6,500 diseases, where we know precisely the molecular glitch responsible for those conditions. While most of those are rare diseases, it leads to the opportunity for immediate diagnosis, which used to be a long and troubled journey.

DNA sequencing has increasingly become an essential tool in newborns, especially when trying to sort out puzzling diagnosis for specific syndromes or phenotypes that are not immediately clear. Additionally, DNA sequencing significantly impacted clinical care in cancer because it made it possible to look at the mutations driving the malignancy and its genetic information that can lead to interventions. This approach is going forward in the next few years in ways that we can see now. Although I am a little reluctant to make predictions because I have to be careful about that, it may be possible to obtain complete genome sequences that can be yours for life and place them into the medical record to make predictions about future risks and choices about appropriate drugs. This path costs less than any imaging tests.

Q: The racial justice movement that was brought back to the forefront this past year has, once again, reaffirmed that this country has so much more work to do in order to end systemic racism. You have been at the forefront of promoting diversity, equity and inclusion in research and at the NIH. What do you and the NIH plan to do further DEI efforts in research and in general so that we can be a more just and equitable society?

A: I appreciate you raising this, Kurt. Diversity, equity and inclusion (DEI) is an issue where everyone should be spending a lot of time, energy and passion. You are right. 2020 will be remembered for COVID-19. I also think it will be remembered for the things that occurred around the killing of George Floyd, and the recognition of the very foundation that is still infected by this terribly difficult circumstance of structural racism. I convened a group of about 75 deep thinkers about these issues, many of them are people of color from across the NIH’s different areas of activities. I asked the group to come forward with a bold set of proposals. This effort is how the program UNITE came together to work hard on this, which is now making recommendations that I intend to follow. We are determined to close that gap and pursue additional programs that will allow us to be more successful in recruiting and retaining minority groups, for example. We need to do something with our health disparity and research portfolio as well to ensure that we are not just looking around the edges of the causes for racial inequities. We are digging deeper into what the structural racism underpinnings are and what we can do about it. I am particularly interested in supporting research projects that test intervention and not just catalog the factors involved. We have been, at times, accused and maybe rightly so of being more academic about this, and, less kindly, we have been accused of admiring the problem of health disparities as opposed to acting on it. We are ready to act.

Q: COVID has affected us all in so many ways. Could you tell us what this past year has been like for you? Also, how is the NIH preparing for a soon-to-be post-COVID pandemic?

A: This is the time to contemplate the lessons learned as everyone knows that the last worst pandemic happened over a century ago. One thing that maybe will vex us going forward, which we already started to invest in a big way, is this whole long COVID syndrome, also referred to post-acute sequelae, to understand precisely the consequences and mechanisms like Multisystem Inflammatory Syndrome in Children (MIS-C). Before moving to the next pandemic, we must think about how we will help understand those who suffer from long COVID syndrome. As far as the broader lessons learn, Kurt, we must expect that there will be other pandemics because humans are interacting more with animals, so zoonosis is likely to emerge. We need to have a clear sense of preparation for the next one. For instance, we are working on this right now, but we need to have a stronger effort to develop small molecules of anti-viral drugs aimed at the major viral classes, so we do not have to start from scratch. We also need clinical trial networks warm all the time, ready to go and to learn how valuable public partnerships can be to get things done in a hurry.

Editor’s Note: The responses in this Q+A have been modified to fit the word count.

John Strang

Neuro- and gender-diverse teens find their voices

John Strang

“These autistic young people spoke a lot about their gender and gender needs and their descriptions of gender dysphoria were deeply emotional. One of the common characteristics of autism is reduced communication of feelings, yet many of these young people were very clear about the anguish that gender dysphoria caused for them and also their need for gender-related interventions,” says John Strang, Psy.D., director of the Gender and Autism Program at Children’s National Health System and study lead.

“They Thought It Was An Obsession” is the title of a qualitative study from the Journal of Autism and Developmental Disorders, that provides an unprecedented glimpse into the development, thoughts, perceptions, feelings and needs of this poorly understood but significant subgroup of transgender and gender minority teens.

The title is an accurate reflection of the study’s analysis, which finds that the accounts of gender dysphoria in autistic transgender youth parallel those of transgender young people without autism. These findings stand in contrast to previous studies asserting the idea that gender dysphoria in autistic youth is driven primarily by superficial autism-related interests.

“These autistic young people spoke a lot about their gender and gender needs and their descriptions of gender dysphoria were deeply emotional. One of the common characteristics of autism is reduced communication of feelings, yet many of these young people were very clear about the anguish that gender dysphoria caused for them and also their need for gender-related interventions,” says John Strang, Psy.D., director of the Gender and Autism Program at Children’s National Health System and study lead.

Additionally, the autistic characteristics of these young people – which may reduce their concern for social conventions – often lead them to express their gender in individual and sometimes surprising ways.

“A transgender autistic young woman may wear a full beard and understand her gender identity as something completely separate from her appearance,” says Dr. Strang. “The cooccurrence of gender identity-diversity and autism may reveal something of the deeper nature of gender when the overlay of social gender expectations is reduced.”

The study followed 22 autistic transgender teens over nearly two years. It is the first study of its kind to track and follow up with this many youth with the cooccurrence over a significant period of time. The authors believe the report can serve as a guide for how clinicians, peers and families can better support and understand teens who are both neurodiverse and gender diverse.

The study’s methodology is also novel, as it features the inclusion of a slate of autistic gender-diverse coanalysts and coauthors who partnered in the interpretation of the youth provided data.

The coauthor group also included a retransitioned (previously transgender) self-advocate coanalyst to help provide context regarding the experiences and trajectories of the few study participants who moved away from transgender identity during the study’s duration.

Reid Caplan of the Autistic Self-Advocacy Network, an autistic transgender self-advocate and one of the study’s coauthors noted, “Too often in medical literature, the overlap between autistic and transgender identities is described in a way that pathologizes both of these communities. As an autistic transgender young adult, I feel privileged to be a coauthor of research that puts the voices of autistic and gender-diverse youth at the forefront. By giving these youth control over their own narratives, this study exemplifies a key value of the self-advocate community: Nothing about us, without us!”

Cara Lichtenstein

Children’s Community Health Track receives prestigious APA Teaching Program Award

Cara Lichtenstein

“As a community-focused health system, one of our central missions is to train a new generation of residents to create successful community partnerships and integrate public health concepts into the everyday practice of medicine to improve the health of underserved communities,” says Cara Lichtenstein, M.D., MPH.

The Children’s National Community Health Track (CHT) has been recognized by the Academic Pediatric Association with its prestigious Teaching Program Award. The honor was made public at the Pediatric Academic Societies (PAS) annual meeting on May 7, 2018 in Toronto, Ontario. The purpose of the award is to foster interest in the teaching of general pediatrics by giving national recognition to an outstanding general pediatric program. The PAS selection committee chose Children’s CHT for demonstrating excellence in educational teaching methods, acceptance by the community, its adaptability and the outstanding quality of residents trained in the program.

“As a community-focused health system, one of our central missions is to train a new generation of residents to create successful community partnerships and integrate public health concepts into the everyday practice of medicine to improve the health of underserved communities,” says Cara Lichtenstein, M.D., MPH and director of Children’s Community Health Track.

Children’s CHT focuses on underserved populations and the development of skills in health policy, advocacy and community healthcare delivery. Residents spend their outpatient time learning to use public health techniques to identify and address community health needs, becoming a physician advocate and learning more about the sociocultural determinants of health and health disparities. Training for CHT is integrated with Children’s overall pediatrics residency program to ensure excellence in attainment of clinical skills, and to allow residents the opportunity to work with Children’s top-rated primary care, specialty and hospital-based physicians and care teams.

This is the third time in recent years that Children’s National has been honored by the Academic Pediatric Association. In 2013, Mary Ottolini, M.D., MPH and vice chair of medical education was recognized for her leadership of Children’s Master Teacher Leadership Development program. In 2009, Denice Cora-Bramble, M.D., MBA accepted the APA Health Care Delivery Award for the Goldberg Center for Community Pediatric Health at Children’s National.

Children’s offers up to eight residency positions each year designated as Community Health Track positions. The goals of the track are centered on the core competencies of community pediatrics as described by the American Academy of Pediatrics. Primarily to train residents to:

  • Grasp the breadth of diversity inherent in the pediatric population and be familiar with health-related implications of cultural beliefs and practices of groups represented in the community.
  • Recognize the role of the pediatrician in identifying needs and facilitating access to resources for patients, families and communities.
  • Be aware of the risks to health and barriers to care for underserved children in Washington, D.C., and demonstrate skill in improving access to continuous comprehensive health maintenance.
  • Appreciate key issues related to the pediatrician’s role and interactions with local community agencies and advocacy groups.
  • Value the role of schools and childcare settings in supporting the educational and psychosocial development of children and adolescents.
  • Apply key principles about health promotion and disease prevention for children and adolescents over a set period of time.
  • Observe, interpret and report observations about the communities in which they serve.

The fundamental difference in this track compared to the more traditional Categorical Track lies in the outpatient experiences that occur in all three years of training. The CHT utilizes these outpatient experiences to help residents to attain a well-rounded community pediatrics experience.

“Washington, D.C. is an incredibly diverse community with large numbers of vulnerable children and families from D.C. and all over the world. Given our location in our nation’s capital, residents and faculty have the unique opportunity to work with national professional and advocacy organizations that are influencing policy – both locally and nationally – as it relates to children, families and health care,” says Mark Weissman, M.D., chief of general pediatrics and community health at Children’s National. “We’re thrilled to be recognized with the Academic Pediatric Association’s Teaching Program Award and grateful to Dr. Lichtenstein for her leadership and commitment to improving the health of D.C.’s children and training the next generation of pediatricians and advocates.”

Research and Education Week awardees embody the diverse power of innovation

cnmc-research-education-week

“Diversity powers innovation” was brought to life at Children’s National April 16 to 20, 2018, during the eighth annual Research and Education Week. Children’s faculty were honored as President’s Award winners and for exhibiting outstanding mentorship, while more than 360 scientific poster presentations were displayed throughout the Main Atrium.

Two clinical researchers received Mentorship Awards for excellence in fostering the development of junior faculty. Lauren Kenworthy, Ph.D received the award for Translational Science and Murray M. Pollack, M.D., M.B.A., was recognized in the Clinical Science category as part of Children’s National Health System’s Research and Education Week 2018.

Dr. Kenworthy has devoted her career to improving the lives of people on the autism spectrum and was cited by former mentees as an inspirational and tireless counselor. Her mentorship led to promising new lines of research investigating methods for engaging culturally diverse families in autism studies, as well as the impact of dual language exposure on cognition in autism.

Meanwhile, Dr. Pollack was honored for his enduring focus on motivating early-career professionals to investigate outcomes in pediatric critical care, emergency medicine and neonatology. Dr. Pollack is one of the founders of the Collaborative Pediatric Critical Care Research Network. He developed PRISM 1 and 2, which has revolutionized pediatric intensive care by providing a methodology to predict mortality and outcome using standardly collected clinical data. Mentees credit Dr. Pollack with helping them develop critical thinking skills and encouraging them to address creativity and focus in their research agenda.

In addition to the Mentorship and President’s Awards, 34 other Children’s National faculty, residents, interns and research staff were among the winners of Poster Presentation awards. The event is a celebration of the commitment to improving pediatric health in the form of education, research, scholarship and innovation that occurs every day at Children’s National.

Children’s Research Institute (CRI) served as host for the week’s events to showcase the breadth of research and education programs occurring within the entire health system, along with the rich demographic and cultural origins of the teams that make up Children’s National. The lineup of events included scientific poster presentations, as well as a full slate of guest lectures, educational workshops and panel discussions.

“It’s critical that we provide pathways for young people of all backgrounds to pursue careers in science and medicine,” says Vittorio Gallo, Ph.D., Children’s chief research officer and CRI’s scientific director. “In an accelerated global research and health care environment, internationalization of innovation requires an understanding of cultural diversity and inclusion of different mindsets and broader spectrums of perspectives and expertise from a wide range of networks,” Gallo adds.

“Here at Children’s National we want our current and future clinician-researchers to reflect the patients we serve, which is why our emphasis this year was on harnessing diversity and inclusion as tools to power innovation,” says Mark L. Batshaw, M.D., physician-in-chief and chief academic officer of Children’s National.

“Research and Education Week 2018 presented a perfect opportunity to celebrate the work of our diverse research, education and care teams, who have come together to find innovative solutions by working with local, national and international partners. This event highlights the ingenuity and inspiration that our researchers contribute to our mission of healing children,” Dr. Batshaw concludes.

Awards for the best posters were distributed according to the following categories:

  • Basic and translational science
  • Quality and performance improvement
  • Clinical research
  • Community-based research and
  • Education, training and program development.

Each winner illustrated promising advances in the development of new therapies, diagnostics and medical devices.

Diversity powers innovation: Denice Cora-Bramble, M.D., MBA
Diversity powers innovation: Vittorio Gallo, Ph.D.
Diversity powers innovation: Mark L. Batshaw, M.D.

Promoting diversity and inclusion in pediatric academic medicine

Mary Ottolini

Mary Ottolini, M.D., M.P.H., ME.d., highlighted the Academic Pediatric Association’s efforts to promote more diversity and inclusion within pediatric academic medicine.

Data from the Association of American Medical Colleges on faculty promotion show a very low percentage of diverse assistant professors being promoted to associate professors, and a low percentage of diverse associate professors rising through the ranks to become full professors within academic medicine. Mary Ottolini, M.D., M.P.H., ME.d., vice chair for Medical Education at Children’s National Health System, professor of pediatrics at George Washington University School of Medicine and president of the Academic Pediatric Association (APA) addressed this problem at the recent Pediatric Academic Societies annual meeting. In her presentation, “APA approach to diversity-inclusion,” Dr. Ottolini explained various APA initiatives in place to assist underrepresented minority (URM) residents, fellows and junior faculty to advance academically in pediatric medicine.

The APA’s core value and strategic goal for diversity and inclusion is to increase diversity and engagement of its membership. To execute this initiative, New Century Scholars was created in 2004 as a national mentorship program to increase racial and ethnic diversity of academic pediatric medicine. The two-year program collaborates with the American Pediatric Society and utilizes junior and senior mentors to provide support to our URM residents with a special interest in health disparities, social determinants of health, cultural competency and minority child health and development.

Dr. Ottolini believes, “it’s important for our URM faculty to have early, strong mentorship that provides an idea of what it takes to be academically successful, by networking and collaborating with others.” She went on to say, “By forming these collaborations, they can transform an idea into a project that will be published, which strengthens their ability to achieve promotions.”

Research Academic Pediatrics Initiative on Diversity (RAPID), is another APA national program working to recruit, retain, and provide career development for diverse junior faculty in general academic pediatrics that are pursuing careers in the National Institute of Diabetes and Digestive and Kidney Diseases mission areas. RAPID targets applicants who are members of an underrepresented minority group and are disabled or from a socially, culturally, economically or educationally disadvantaged background.

“Diversity and inclusion is an issue that is important for patients and the field of academic pediatrics because we need to have a physician workforce that resembles the patient population that we are entrusted to take care of,” Dr. Ottolini says.

Dr. Ottolini also explained APA’s current special interest groups were put in place to bring awareness to the role of race in the practice of medicine, and to provide resources by which members can support the healthy development and optimal care for U.S. youth of color. The ultimate goal is to develop strategies for increasing diversity and retention among academic medical faculty across the United States, and develop best practices for caring for youth of color in the primary care setting.

The presentation concluded with a question-and-answer session and further discussion from the audience. Since her presentation, Dr. Ottolini has received offers from other doctors and national organizations to fund these initiatives.