Seeking Parity for Women in Academic Medicine: A Historical Perspective

In this Invited Commentary, the author applies a historical lens to explore a fundamental paradox in U.S. medical education: the fact that long after women gained parity with men in matriculation to medical school, women remain highly underrepresented in leadership positions in academic medicine. The reasons for this are many and complex, but at the core are the subtle but hurtful indignities ("microinequities") experienced by women physicians and an academic culture that expects single-minded dedication to work, regardless of the costs to faculty members' personal lives. Achieving parity for women in academic leadership will require changing the culture of medical schools and teaching hospitals to correct these 2 fundamental obstacles. In recent years, many medical schools and teaching hospitals have made efforts to improve opportunities and satisfaction for women trainees and physicians, enacting reforms to improve work-life balance for all faculty. It is plausible to imagine a future in which flexible time frames to achieve tenure and promotion are universally available to both women and men, with high scholarly standards firmly maintained. If this occurs, it will represent a profound legacy for women in academic medicine, for their generations of professional sacrifice and advocacy for a more equitable culture will have changed its culture.

Race, Kidney Transplants, Immunosuppression Research, and White Supremacy under Apartheid, 1960-80

This paper uses the history of kidney transplantation in South Africa as a lens through which to write a racialized, micro history that illustrates the politics of medical discoveries and medical research at one of South Africa's most prestigious medical research universities, the University of the Witwatersrand (Wits) in Johannesburg. Between 1966 and the 1980s, the Wits team became the most advanced and prolific kidney transplant unit in the country. Yet the racist, oppressive Apartheid system fundamentally shaped these developments. Transplantation, as this paper shows, became an elite medical procedure, performed by a select group of white doctors on mostly white patients. For these doctors, transplantation showed their medical prowess and displayed the technical advancements they were able to make in research and clinical practice as they strove to position South Africa as a significant international player in medical research, despite academic boycotts and increasing sanctions. Transplantation became a symbol of white supremacy in a country where the black majority were excluded from anything but the most basic health care.

A Perspective on the Baltimore Freddie Gray Riots: Turning Tragedy Into Civic Engagement and Culture Change in an Academic Department of Medicine

PROBLEM

The Johns Hopkins University School of Medicine Department of Medicine (DOM) sought ways of enhancing community engagement after the death of Freddie Gray and consequent unrest in Baltimore City.

APPROACH

The DOM launched a five-part noon lecture series in May 2015-"Journeys in Medicine"-to facilitate discussion among DOM faculty, staff, trainees, and community residents regarding the city's unrest. This evolved into a department-wide civic engagement initiative in July 2016 to enhance employee and community engagement. The civic engagement committee is composed of two collaborative steering committees: Staff Engagement and Community Engagement.

OUTCOMES

The DOM has sponsored and/or participated in programs to address major concerns raised during the Journeys in Medicine series-improving the strained relationship between police and the community, mentoring young people, involving more DOM employees in community activities, sharing research results with the community, and addressing cultural differences to enhance relationships and communication. To enhance staff engagement, a Nursing Diversity Council, complementing the Faculty Diversity Council, has been established. DOM faculty and staff have participated in and championed several disease-focused physical activity endeavors (e.g., walks) that, collectively, have raised over $40,000. Community service projects include supporting registration and screenings at a local health fair, a professional clothing drive, and DOM Days of Service.

NEXT STEPS

The Johns Hopkins University School of Medicine DOM is developing an administrator leadership program and continuing to participate in meaningful activities, leading to tangible outcomes designed to strengthen connections to the surrounding neighborhood and enhance engagement among all DOM employees.

Social contract of academic medical centres to the community: Dr Howard Atwood Kelly (1858-1943), a historical perspective

Academic medical centres have traditionally been bastions of teaching and research. Outreach to the community at large and involvement in community affairs have sometimes been lacking in the overall mission and activities of academic medical centres. This paper provides an historical perspective first on the numerous achievements of a physician and surgeon and then on the topic of involvement in community affairs by reviewing the many contributions of America's pioneer gynaecological surgeon and one of the four physician founders of the Johns Hopkins Hospital and School of Medicine in 1889 - Dr Howard Atwood Kelly.

[Navy medical academy (to the 75th anniversary of establishment)]

The article is devoted to the history of the creation in 1940 of the Naval Medical Academy on the basis of the 3rd Leningrad Medical Institute and the Institute for sanitary-chemical protection of the People's Commissariat of the USSR. The structure of this institution included, faculties management staff of the medical service, medical and sanitation, Higher Naval Medical School, the Marine Research Institute Medical, higher courses for officers of the medical service, clinical naval hospital. During the period of its activity (1940-1956), the staff of the Naval Medical Academy made a great contribution to the naval medicine and practical public health. The merit of the Academy is not only a beautifully staged academic, medical, research process, but also in the creation of the spirit of the high sea camaraderie, accomplishment and pride for the work which its graduates have dedicated their lives.

[THE CENTURY OF WAGNER PERM STATE MEDICAL UNIVERSITY]

Perm City is the large industrial, scientific, educational and cultural center in Volga Federal District. Also it is one of the oldest and the most attractive Ural cities. Higher medical education on the West Ural was founded in 1916. The main stages of the development of Perm State Medical University are lightened in the article. Perm State Medical University is the peculiar school of experts of different medical specialties, scientific and educational personnel, specialists of the middle range of the health care system. The history of the university is full of historical, professional and creative traditions. 2016 year is the century of the higher medical education on the West Ural and the anniversary year for Perm State Medical University by E.A. Wagner.

[93 YEARS OF CLINICAL EMPATHY, STATE-OF-THE-ART MEDICINE AND RESEARCH EXCELLENCE]

This issue of Harefuah is devoted to articles and reviews written by the medical staff of Bnai Zion Medical Center in Haifa. Celebrating 93 years since its inception, Bnai Zion Medical Center is home to the oldest public hospital in Haifa, and a founding affiliate of the Technion's Faculty of Medicine. Known for its centers of excellence and the impactful clinical and basic research developed, the hospital has a reputation for state-of-the-art medicine, both conventional and complementary. Bnai Zion prides itself as an innovation leader in medical and nursing education, with its staff's empathetic and personalized approach to patient care, and the center's dedication to applying emotional intelligence to medicine.

[Four stages in the history of the Centro Médico Nacional Siglo XXI of the IMSS]

This document presents four stages in the history of the Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century) of the Instituto Mexicano del Seguro Social. The first stage started at the end of the third decade of the twentieth century and ended in 1961, it corresponded to the conception, planning and construction of what was to be the Centro Médico del Distrito Federal (Centro Médico of the Distrito Federal) belonging to the Secretaría de Salubridad y Asistencia (Ministry of Health and Assistance). The second stage began when the Center was acquired by the Institute, then was known like Centro Médico Nacional (Centro Médico Nacional ), being put into full operation in 1963, more than twenty-two years later, in 1985, an earthquake virtually ended it, immediately began its reconstruction, finishing the second stage. In 1989 began the third stage, different and new buildings complemented or replaced the structures damaged or destroyed by the earthquake which formed the now Centro Médico Nacional Siglo XXI (Centro Médico Nacional XXI Century). In 2004 the fourth stage opened when the four hospitals of the Center were categorized like Unidades Médicas de Alta Especialidad (High Specialized Medical Units).

A history of innovation: cardiac surgery in Minnesota

For centuries, the heart was believed to be an inoperable organ. Through the development of new technologies and techniques, the initial difficulties inherent with operating on a moving organ began to fade. But as surgeons in the last century pushed the boundaries of cardiac repair, new problems arose. To solve them, they enlisted the help of physiologists, residents and engineers. By taking a multidisciplinary approach, sharing information and ideas, and working collaboratively, University of Minnesota and Mayo Clinic investigators found themselves at the forefront of cardiac surgery. This article reviews Minnesota's contributions to the field.

[Spiritual ties of the Military Medical (Medical and Surgical) Academy]

Before the revolution in its educational, research and clinical potential of Military Medicine (medical and surgical) Academy was on the head position among European institutions. Not less outstanding position among all secular institutions Russian Academy held by the number and wealth of churches, chapels and baptisteries. In the temples of the academy was concentrated a significant number of miracle-working icons and of the particles holy relics, there served some of faith and piety devotees and some of them were canonized. The article presents a brief historical overview of the major Academy shrines--spiritual ties of the different generations.

Department of Surgery/College of Medicine University of South Alabama: historical and contemporaneous perspectives

Many members of the medical profession in Mobile, Alabama, have exemplified a strong commitment to the education of their colleagues and successors, a tradition (L., traditio, "to hand over") that dates from the early 18th century. The Mobile General (city/county) Hospital (1830 to 1970) and its successor, the Medical Center, University of South Alabama (1971 to the present), were the institutional foci of those endeavors. Because it is individuals who create, design, and vitalize institutions, this monograph is an acknowledgment of the accomplishments of those who gave that endeavor purpose, direction, and meaning, particularly with reference to the evolution of surgical education. Numerous clinical and societal forces--cultural, economic, political, and social-influenced that evolution. This compilation gives attribution to a legacy of commitment to health and medical/surgical care, education, and research within southern Alabama.

HISTORY OF MEDICINE, SURGERY AND UROLOGY IN BRESLAU/WROCLAW

The development of medicine in Breslau from the 14th century has been described and its famous physicians, above all Silesians, are introduced. The aim of the study is to present the development history of hospital services and the teaching of medicine, and also the development of urology in Breslau. Well known Breslau surgeons who were interested in surgery of the genitourinary system are also presented. The aim of the study is to present a brief history of Breslau medicine and surgery from its beginning to the end of World War II. The development of urology and its separation from surgery after World War II is also briefly described. Professor Florian Nowacki, Breslaus's first urologist, is also introduced. Extensive research was undertaken for the collection of literature and documents in German and Polish archives and libraries to prepare this study.

Antoni Christian Bryk (1820-1881) - professor of forensic medicine at Jagiellonian University (1852-1860), and director of the surgical clinic of Jagiellonian University in Cracow (1860-1881)

scientific discipline. In the 19th century two milestones revolutionised surgery: the development of narcosis, which enabled painless surgery, and the introduction of antisepsis and asepsis. The author presents the beginnings of academic surgery in Cracow. Its pioneer surgeons are presented. Extensive research was undertaken to collect the literature and documents in Polish, Austrian and German archives and libraries in order to prepare this study. Biographical details of the director of the Surgical Clinic, Prof. Antoni Bryk, are provided. He was the first person in Poland to introduce antisepsis and galvanocautery as routine procedures in the Cracow Clinic. The introduction of antisepsis contributed to a reduction in infection during surgery, and a reduction in postoperative mortality in Cracow Surgical Clinic. In this way Professor Bryk became the first Polish surgeon to apply Lister's antiseptic method in the treatment of wounds. Thus enlarged, the scope of surgery for intracranial, bone and other procedures became routine. Surgery is the oldest discipline in medicine. Poland's first university chair of surgery was established in the 18th century. Surgery, which until then had been the domain of barbers and bath house attendants, became a clinical,

Odo Bujwid - an eminent Polish bacteriologist and professor at the Jagiellonian University

To celebrate the 650th Jubilee of the Jagiellonian University, we would like to give an outline of the life and work of Odo Bujwid, known as the father of Polish bacteriology. The intention of the authors is to recall the beginnings of Polish bacteriology, the doyen of which was Professor Odo Bujwid, a great Polish scholar who also served as a promoter of bacteriology, a field created in the 19th century. He published about 400 publications, including approx. 200 in the field of bacteriology. He is credited with popularizing the research of the fathers of global bacteriology - Robert Koch and Louis Pasteur - and applying it practically, as well as educating Polish microbiologists who constituted the core of the scientific staff during the interwar period.

[Between interdependence and separation: the history of medicine as an academic discipline in divided Germany (1945-1959)]

The article traces the development of the history of medicine as an academic discipline in divided Germany between 1945 and 1959. During this time period the core of the field--the German association for the history of medicine, the scientific journal and, as well, many scientists--shifted from East to West Germany. The fate of the formerly renowned chair of the history of medicine in what was now East Berlin and the difficulties to find a candidate willing to fill in the position indicate the problems in establishing a socialist historiography of medicine. The 1950s was a lost decade for the historiography of medicine in East Germany. In the meantime the historiography of medicine in West Germany, based on better starting conditions, consolidated institutionally.

[The Karl-Sudhoff-Institute in Leipzig and the academic discipline history of medicine in the GDR]

Developmental trends, focus of research and the methods by which work in the field of the History of Medicine was organised in the German Democratic Republic (East Germany) is presented through the example of the Karl Sudhoff Institute in Leipzig, the largest Institute for the study of the History of Medicine in the GDR. The article follows the succession of the Directors, and includes, in addition to descriptions of research and publishing activities, appendices on the work of the Society for the History of Medicine in the German Democratic Republic as well as the historical medical collections.

[Paul Diepgen as a senior within his field after 1945]

Paul Diepgen (1878-1966), professor emeritus in Berlin in 1945, remained a leading figure within the field of German medical historians from 1947 onwards in his capacity as "guest professor" in Mainz. The present article focuses on two areas in which Diepgen was particularly active within his academic field as documented in his extensive correspondence: firstly the resumption of contacts with émigrés and other foreign colleagues which was hampered by Diepgen's ambivalent relationship to the National Socialist regime and secondly the establishment of the history of medicine as a full academic discipline. Up until 1961, he continued to nominate his pupils who had been politically "incriminated" during the Nazi period for academic positions, but simultaneously encouraged younger colleagues and campaigned for the establishment of a comprehensive academic degree course in the history of medicine. An examination of the confrontation between Diepgen and Werner Leibbrand additionally reveals Diepgen's not always uncontroversial concept of the history of medicine.

History of the Department of Surgery at Albany Medical Center

Surgeons have always played an integral role in the history of the Albany Medical Center and Albany Medical College. In addition to supporting vital patient care and teaching programs, the Department of Surgery has played an important administrative role providing the college with five deans. The origins of the Department of Surgery reach back to 1910 when the American Medical Association-sponsored Flexner report proposed dramatic changes in the structure and format of medical education in the United States. In response to the recommendations of the report, the medical center restructured its faculty and curriculum to meet the demands of a rapidly advancing profession. One result of this reorganization was the formation of the Department of Surgery in 1912. Dr. Arthur Elting was named the first Chair of the Department in 1915. This report will review the history of the Department, focusing on the eight surgeons who have served as Chair.

University cardiology clinic

In distant 1972, within framework of the Internal Clinic, a cardiologic department was organized which was soon, on 29.XII.1974, transformed into the Cardiology Clinic, later the Institute for Heart Diseases, and in 2008 was renamed the University Cardiology Clinic. The greater part of its foundation was possible owing to Prof. Dimitar Arsov and Prof. Radovan Percinkovski, who was the clinic's first director in the period from 1974 to 1984. In 1985, the Clinic moved into its own new building, and in that way was physically detached from the Internal Clinics. Until its move to the new building, the Clinic functioned in the Internal Clinics building, organized as an outpatient polyclinic and inpatient infirmary department with clinical beds, a coronary intensive care unit and a haemodynamics laboratory equipped with the most modern equipment of that time. Today the Clinic functions through two integral divisions: an inpatient infirmary department which comprises an intensive coronary care unit and fourteen wards which altogether have 139 clinical beds, and the diagnostic centre which comprises an emergency clinic and day hospital, a communal and consultative outpatients' clinic functioning on a daily basis, through which some 300-350 patients pass every day, and diagnostic laboratories with a capacity of nearly 100 non-invasive and 20-30 invasive diagnostic procedures daily. The Clinic is a teaching base, and its doctors are educators of students at the Medical, Dental and Pharmacy Faculties, and also of students at the High School for Nurses and X-ray technicians, but also for those in Internal Medicine and especially Cardiology. The Clinic is also a base for scientific Masters' and post-doctoral studies, and such higher degrees are achieved not only by doctors who work here, but also by doctors from Medical Centres both in the country and abroad. Doctors working in this institution publish widely, not only a great number of books and monographs, but also original scientific papers published in indexed medical journals.

Department of Nephrology at the Medical Faculty, Ss. Cyril and Methodius University, Skopje--creating nephrology protection for the citizens of the Republic of Macedonia

In January 1975, de facto, the Nephrology Department was founded at the Medical Faculty in Skopje as the first institution of such a type in former Yugoslavia. The Nephrology Department was the driving force for the further development of nephrology in the Republic of Macedonia. D. Hrisoho was the first Director of the Department, and its subsequent Directors were G. Masin, M. Polenakovic, K. Zafirovska and currently A. Sikole. Prior to the establishment of the Nephrology Clinic there had been considerable experience in the diagnosis and treatment of renal patients. The first haemodialysis (HD) in the Republic of Macedonia (RM) was performed in 1959 on a patient with acute renal failure (ARF) using a Kolff-Brigham rotating drum artificial kidney at the Blood Transfusion Institute in Skopje. In 1965 the Renal Unit at the Department of Medicine, Medical Faculty, Skopje obtained a new, modern "Websinger" artificial kidney with a sigma motor pump and possibilities for the use of a disposable Kolff "twin coil" dialyser. Between 1959 and 1971, HD was performed only on patients with ARF. In May 1971, a Unit for Chronic HD was founded at the Renal Unit and the programme of maintenance haemodialysis (MHD) was started with five Stuttgart Fresenius machines and 12 patients dialysed on twin coil dialysers. That was a great incentive for the development of HD in the Republic of Macedonia enforced by the great number of patients with end stage renal disease. Thus in 2007 we have 18 HD centres in the Republic of Macedonia, with 1183 patients. Treatment of the patients with MHD is the greatest success achieved in the Republic of Macedonia in nephrology concerning patients with end stage renal disease. Prior to the treatment with MHD patients were destined to die, whereas now, with this type of treatment, they have a normal life and families. Patients with kidney diseases are examined in outpatients clinics as well as treated in the wards of the Department. All types of vascular accesses, renal biopsies, bone biopsies, kidney ultrasound, plasmapheresis and other investigations are performed every day at the Nephrology Department of the Medical Faculty. On the basis of the results of renal biopsy, a classification of parenchymal renal diseases has been established, as well as appropriate immunosuppressive and other treatments. The nephrology doctrine for primary, secondary and tertiary healthcare has been prepared and has been distributed to all medical centres in the Republic of Macedonia. The first (living donor) renal transplantation was performed in July 1977. Later, living and cadaver donor transplantations were performed, so the Department of Nephrology was complete concerning dialysis and renal transplantation, and it became part of the European centres for diagnosis and therapy of kidney disease. Doctors from the Nephrology Department are among the most productive scientific workers in the Republic of Macedonia and their papers can be found on the internet Pub Med. The Department of Nephrology, together with the Nephrology Association, was the source of knowledge in the area of nephrology and the transfer of knowledge from abroad into Macedonia and vice versa. The Nephrology Association has made a great contribution in the development of nephrology in our country. The most famous European and world nephrologists have participated in the work of our association and have contributed to the development of nephrology not only in Macedonia, but on the Balkans as well.

Development of the clinic of pulmonology and allergy

University Pulmology and Allergy Clinic was founded in 1975 when the Depertment of Internal Medicine, directed by Prof. Dr. Dimitar Arsov, later member of the Macedonian Academy of Sciencies and Arts, was divided into eight separate and independent clinics. The first head of the Pulmonology and Allergy Clinic was Prof. Dr. Ljubomir Kotevski. He had a very difficult goal: to establish and further develop the newly formed clinic. The Clinic flourished and became one of the leading Clinics in the Clinical Centre during the directorship of Prof. dr. Dejan Dokic.. He completely rebuilt and refurbished the Clinic, which became a modern Clinic providing excellent working conditions for the employees and, most importantly, provided a first class service to the patients. During his mandate he obtained a grant from the Japanese Government worth $1,000,000 which was used to obtain a new, modern and sophisticated medical equipment. Since the establishment of the clinic, many national and international scientific projects were carried out and many scientific papers were published as well as many monographs, and chapters in scientific books. As a result of continuous education, of the total number of 24 doctors there are 16 subspecialists in respiratory medicine and 4 specialists in internal medicine. There are 9 professors in internal medicine at the University of Pulmonology and Allergy Clinic lecturing at the Medical Faculty in Skopje. The University Pulmonology and Allergy Clinic has an international reputation due to many contacts with famous European Institutions. All these international interrelations have resulted in honouring 3 professors: Prof. Dr. Gert Kunkel from Berlin, Germany, Prof. Dr. Robert Loddenkemper from Berlin, Germany and Prof. Dr. Peter Howard from Southampton, UK.

University Clinic of Toxicology--historical note and present work

The University Clinic of Toxicology (UCT) in Skopje was founded as the Clinic for Toxicology and Emergency Internal Medicine on January 15th 1976. Today UCT has a modern building with office space of 1,300 m2 on 4 floors, 40 hospital beds and 72 employees including 18 doctors. UCT works in accordance with the public healthcare services in the Republic of Macedonia through the use of specialist/consultative and hospital healthcare for people over the age of 14 years. The Clinic also provides services in the field of emergency internal medicine, acute poisoning with medications, pesticides, corrosives, poisonous gases and mushrooms, heavy metals and other chemicals. The Clinic takes an active part in the detoxification programme for users of opiates and psychotropic substances, protocols for enteral and parenteral nutrition and guides for home treatment. Yearly there are more than 14,000 ambulance admissions, over 1,400 hospitalized patients, over 4,000 urgent EHO checks, more than 1,000 urgent upper endoscopies and over 700 other toxicological analyses and other interventions. The educational services and activities are realized through the chair for internal medicine. The Clinic offers undergraduate and graduate level education for medical students and dentists, for medical nurses, radiology technicians, speech therapists and physiotherapists. Over 300 papers and reports have been published to date by the medical staff at the UCT in the form of abstracts and integrated projects in the Republic of Macedonia and aboard. 8 doctorates have been successfully completed by employees from the Clinic as well as 4 master's theses and 1 in-depth project. UCT employees are the authors of some textbooks and monographs. UCT have undertaken some scientific projects. Employees from the Clinic of Toxicology are members taking an active part in many domestic and international associations.

Development of the Clinic of Endocrinology, diabetes and metabolic disorders

The Clinic of Endocrinology, diabetes and metabolic disorders was founded in 1975 by Prof d-r Alexandar Plashevski. Healthcare, educational and scientific activities in the Clinic of Endocrinology are performed in its departments. The Department for hospitalized diabetic and endocrine patients consists of the metabolic and endocrine intensive care unit, the department for diagnosis and treatment of diabetics and endocrine patients, day hospital, the department for education of diabetic patients, and the national center for insulin pump therapy. The Center for Diabetes was established in 1972 by Prof d-r Dimitar Arsov. In 1975, Prof d-r Alexandar Plasheski broadened the activities of the Center for Diabetes. It was dislocated in 1980, with new accommodation outside the clinic. Since then the Center has consisted of several organized units: two specialist outpatient clinics for diabetic patients, biochemical and endocrine laboratory, sub-departments for: diabetic foot, cardiovascular diagnosis, ophthalmology, and urgent interventions. The Department of Endocrinology and Metabolic Disorders for outclinic endocrine patients was established in 1980, and it integrates the following sub-departments: thyrology, andrology, reproductive endocrinology, obesity and lipid disorders and sub-department for osteoporosis. The educational staff of the Clinic of Endocrinology organizes theoretical and practical education about Clinical Investigation and Internal Medicine with credit transfer system course of study of the Medical Faculty, Faculty of Stomatology, postgraduate studies, specializations and sub-specializations. Symposiums, 3 congresses, schools for diabetes and osteoporosis and continuous medical education were also organized. The Clinic of Endocrinology was initiator, organizer, founder and the seat of several medical associations.