Dear Medical College of Georgia Friends,

170 residents and fellows have joined the MCG family

It may be harder than usual to focus on the usual happenings in the life and times of our medical school with the reverberations of COVID-19 and larger societal issues ringing loudly in our ears. But I hope there is some comfort in knowing that we persevere in our missions of medical education, discovery and taking care of patients because we must and we should, even as we adjust our focus to the unprecedented times we are living in. That means that last week we officially welcomed 170 new residents and fellows in 51 graduate medical education programs we offer jointly with our Health System. As these new doctors come on board, we always have a patient safety course, focusing on basics like hand hygiene and more complex issues like safe placement of central lines to enable quick access for giving things like IV fluids or medications, as part of their orientation. Like so many things impacted by COVID-19, this year the course was conducted using social distancing and in full personal protective equipment, or PPE. Still it went off like clockwork. I want to thank MCG graduate Dr. Matt Lyon, vice chair of academics and research in emergency medicine and director of the Center for Ultrasound Education, and Dr. Matthew Tews, also an emergency medicine physician who is our associate dean for educational simulation, for making this course happen and for fine-tuning it for this year. Great job. I am also happy to share that this year the resident/fellowship lineup we offer includes for the first time a pediatric anesthesiology fellowship under the direction of Dr. Ellen Basile, chief of pediatric anesthesiology. We thank Dr. Basile and her colleagues in anesthesiology and the Children’s Hospital of Georgia for enabling this new program to educate more physicians who will improve the care of children, who, as we often say, are not just small adults.

Freshmen start classes July 29; orientation, classes will be a hybrid

On the medical student front, the first day of class for our freshmen is July 29, and orientations for both first- and second-year students will be a hybrid of in-person and virtual, Vice Dean Dr. Doug Miller tells us. A hybrid also probably best describes the classes they will be taking, with all in-person activities utilizing social distancing and PPE, Dr. Miller says.  Our rising third-years will start their clinical clerkships by the middle of this month; and our rising fourth-years are already finishing up their clinical training that was interrupted by COVID-19 a few months back.  At our Athens campus, we will be welcoming 50 students in the freshman class for the first time as part of our effort to educate more physicians for our state. The campus opened a decade ago with 40 students per class. This expansion was enabled by $1.36 million in new state funding for the Augusta University/University of Georgia Medical Partnership campus, and I want to thank our governor, legislators and the leadership of both universities for their support of this needed growth. All good news, and I appreciate each of you for staying on task and making adjustments where needed to ensure that our 192-year old tradition of excellence in medical education continues.

HIV changed society 40 years ago; science and medicine changed it  

Even most physicians have probably heard more about viruses in the past six months than in the previous six years, and the novel coronavirus is still very much an unfolding story. How many of you also remember when HIV was a similar mystery, with the first cases of AIDS in the United States reported in 1981 along with reports of young people dying, and with some populations, like those is sub-Saharan Africa, being particularly hard hit. HIV infection would also become a pandemic, and we would learn that HIV would attack our immune system, leaving many vulnerable to problems like pneumocystis pneumonia, which more typically leaves those of us with a sound immune system alone. The FDA approved the first commercial blood test for HIV infection in 1985 and the first antiretroviral treatment, AZT, two years later, and a preventive therapy in 2012. HIV would change a lot in our society back then, and with perseverance, we would change HIV to an infection that most people live with rather than die from. But the fight is not over.

Dr. Eric Belin de Chantemele receives $2 million NIH grant to explore obesity paradox, cardiovascular impact of HIV

Now our Dr. Eric Belin de Chantemele, physiologist in the Vascular Biology Center, is PI on a $2 million National Institutes of Health grant enabling new studies with a lot of twists and turns as we deal with current realities, like how cardiovascular disease is now the number one killer of individuals who are HIV positive, and how the virus itself likely is contributing to that disease. So is the fact that people are living so much longer now with the infection. One of the strange twists is that the earliest treatments, along with the virus itself, caused tremendous weight loss that actually contributed to cardiovascular risk. The newer medications, which are stellar at suppressing the virus, appear to be, in contrast, causing weight gain, which appears to be reducing cardiovascular risk. If you can keep up with all these turns, Dr. Belin de Chantemele and his colleagues are working in the lab to learn more about how the virus itself is contributing to cardiovascular risk and how the new drugs might reduce the risk. Much longer story short, they suspect that the hormone leptin, which our brains use to tell our body to stop eating because we are full (I try to listen) may be one answer to how the weight gain is protective. They suspect that the drugs may enable weight gain by being so good at reducing the viral load and inflammation, which reduces our body’s energy expenditures (calorie burning) which, as we all know from when we sit too much, can cause weight gain. Leptin is produced by fat, which the drugs are enabling, and leptin is good for our cardiovascular system at the right level … and bad for it at high levels and, you get the idea. There is still a lot to learn.

Small parallel clinical trial looks at impact of popular HIV drug on weight, cardiovascular health

Another great thing about this basic science work is that there are parallel, internally funded clinical studies to gain insight on the impact of weight gain on these patients. Physician Assistant Jonelle Poe and HIV Pharmacist Dr. Amber Ladak, both with our Ryan White Program, are monitoring patients when they start taking the commonly used HIV drug dolutegravir, which is widely associated with weight gain in patients. They are following them for six months, scrutinizing if they gain weight, where they gain weight and looking at other health indicators like lipid and cholesterol levels in the blood. Dr. Ryan Harris, clinical exercise and vascular physiologist at the Georgia Prevention Institute and a prolific collaborator, is analyzing the cardiovascular health indicators over the study course. Like great doctoring often comes from listening to our patients, this clinical study also came from listening to patients who were concerned and frustrated by their weight gain on these powerful drugs. Good collaborative work that will no doubt lead to more insight, more research and funding, and better treatment.

AU, Georgia State University partner to support health research in Georgia

These clinical studies in HIV are a good example of what we are doing with our fellow research university, Georgia State University. We are pursuing early work, funded jointly by the universities, by investigators from both universities, regarding health problems affecting many Georgians. We talked a few weeks ago about our emerging GRITS — Georgia Research Institute in Translational Science — partnership with Georgia State University and public health centers to target the “other Georgia.” In keeping with that spirit, AU and Georgia State are providing a total of $200,000 for four, one-year grants to get the ball rolling on some important work relevant to the health of our state. As an example, our Dr. Jose Vazquez, chief of the Division of Infectious Diseases, is working with Dr. Chris Basler, director of the Georgia State University Center for Microbial Pathogenesis, to look at genetic variations of the novel coronavirus infecting Georgians and the antibodies they produce in response. There is still so much to learn about this virus and this work should help us better understand how it works and how to better detect and treat it in our state. Good stuff and much more to come as these partnerships grow.

Dr. Chenault William Hailey, dermatologist, 1956 MCG graduate passes

Finally today, we note the passing of Dr. Chenault William Hailey. Dr. Hailey was a 1956 MCG graduate who would become a dermatologist and help found what is now Atlanta Dermatology. He was a leader in his field, serving as president of the Georgia Society of Dermatologists, the Dermatology Section of the Southern Medical Association and serving a term on the Georgia Composite Board of Medical Examiners. He served as president of both our MCG Alumni Association — during which time he said his biggest accomplishment was in rallying fellow alumni to become lifetime Alumni Association members — and the MCG Foundation. He helped our university find a new president in 1983, the former U.S. Surgeon General Dr. Jesse L. Steinfeld. Our thoughts, appreciation and thanks are with his family and friends for sharing Dr. Hailey with his alma mater.

Please continue to take good care of yourselves.