US News and World Report recently featured St. George’s University medical student Tim Malone and the University’s CityDoctors program in an article that discussed scholarships for medical school.
“Malone says his full-tuition scholarship via the St. George’s CityDoctors scholarship program for future urban doctors makes it easier for him to consider the possibility of becoming a pediatric oncologist, despite the fact that salaries within that specialty are lower than within other fields of medicine,” the article stated.
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As the coronavirus pandemic brought the world to a halt, Eric Vail, MD ’13, went from cancer geneticist to COVID-19 diagnostician and researcher.
“New York had its major surge in March. We had ours in December,” said Dr. Vail, director of the clinical molecular pathology laboratory at Cedars-Sinai Medical Center in Los Angeles. “We’re a low-volume, high-specialty lab that normally does 1,300 next generation sequencing cancer tests a year. Since COVID happened, we have done over 100,000 diagnostic PCR tests over the last year alone.”
When the region experienced a dramatic uptick in cases, Dr. Vail and his team were asked to investigate its origin. Their findings were published in a recent edition of the Journal of the American Medical Association (JAMA), with Dr. Vail serving as the co-senior author.
What prompted the research, and what did it discover?
At Cedars-Sinai, both our ICUs and main floors were overflowing during the holidays. That’s when hospital administration asked if we had seen the UK variant in our population. When we analyzed sequencing data, we didn’t find that variant, but there were 70-80 cases that all had the same mutations. We said, “this is something different.”
It wasn’t documented in any of the public databases at that time. We did some more analysis and found a cluster of newer mutations in the spike protein—what gives the virus its “corona (crown)”—which is the portion of the virus that attaches to the human cell and allows entry. We then went back into the public databases and saw it just exploded in November right along with our local surge in cases.
What did you learn from this experience?
It’s important from a public health and epidemiological standpoint to know what this virus is doing and how it’s doing it. If the infectivity increases, we can tailor our recommendations around it, but if you don’t look for it, you’ll never know.
It also pointed out the lack of unified public sequencing being done in the United States. There’s a lot of sequencing being done, but it’s very disparate and disconnected. It’s being done in 50 different places without centralized command and control.
What are variants, and how do they come about?
Viruses, and especially RNA viruses, change. Over time, as they go into new people, they have replication errors. When that happens, most of the time it’s deleterious, there becomes less of it, and it goes away. Every once in a while, though, a mutation gets increased fitness for its environment.
Variants come from our behavior, which is, in my opinion, empowering. You have the ability to wear a mask, wash your hands, social distance, and do your part. The virus isn’t plotting its way to get around us. If we do all the things we’re supposed to do, these variants will not emerge.
How well will the current vaccines address these variants?
I think it’s very important not to turn these variants into “scariants.” We’re trying to empower everyone with knowledge, and the knowledge we have right now is that if you can get a vaccine, go get a vaccine. Multiple studies have shown limited to no difference in clinical or immunological change in response to the vaccines from variant to variant. If we all get vaccinated, we can stamp out the coronavirus and get out of the pandemic together.
– Brett Mauser
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As a former pediatric patient, Ava Omidvar has spent many years in and out of hospitals—to the point where she considers them to be her second home. Through the tireless efforts of her medical teams, she’s been given a second chance at life, and for the sake of her own patients, she’s committed to making the most of it.
“The award came as a complete surprise to me,” stated Ms. Omidvar. “I had no idea I was nominated but I felt incredibly honored to be noticed in such a positive way. Getting this award has provided me with even more motivation to continue this path I have chosen—not only to help those most vulnerable, but to also help those who come after me.”
It was given in recognition of her leadership and service as the president of the Emergency Medicine Club at SGU; her research project SAVED: Starting the Conversation of Death for Healthcare Providers, which she presented at the CENTILE conference in Washington DC; and her advocacy for policy topics relevant to the specialty of emergency medicine.
“The desire for giving through medicine is a lifelong passion that has guided me throughout my life,” said Ms. Omidvar, a third-year medical student at St. George’s University. “It has inspired me to take advantage of every educational avenue, job opportunity, and volunteer project available to me. These combined experiences have helped me turn my passion into expertise and my dreams into a reality.”
Currently studying for the USMLE Step 1 exam, Ms. Omidvar looks forward to starting her clinical rotations and getting back into the field as a volunteer firefighter and paramedic. Her plan is to use what she’s learned during her time at SGU to achieve her dream of becoming a pediatric emergency medicine physician in order to provide improved care to her community during a time when healthcare professionals are needed the most.
“My passion for medicine has taken me from the back seat of an ambulance in Baltimore, all the way to a small clinic in Kampala,” shared Ms. Omidvar. “From a classroom in Boston, a government facility in Maryland, a MEDEVAC helicopter over Washington, DC, to the clinics and hospitals of the beautiful country of Grenada. At each turn, I have come face-to-face with the patients and people who inspire me to continue this journey.”
– Ray-Donna Peters
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At a time when the world needs more physicians, St. George’s University graduates are prepared to answer the call. On Match Day 2021, more than 1,025 SGU students and alumni learned of where they’ll begin their residencies this summer, joining a vast network of physicians who have made an indelible impact on healthcare worldwide.
The newly matched residents will train in specialties that include neurology, pediatrics, emergency medicine, and more. Dozens more will secure residency positions in the days and weeks to come.
“Match Day marks an important step in the life of every doctor,” said Dr. G. Richard Olds, president of St. George’s University. “The entire SGU community is proud of the hard work our students have put in, and we wish them the very best as they prepare to start their careers officially.”
SGU continues to assist the US in addressing the projected doctor shortage of up to 139,000 physicians across primary and specialty care, according to the Association of American Medical Colleges (AAMC). On average, one in three St. George’s graduates work in medically underserved areas, which have been disproportionately affected by COVID-19. Many SGU alumni have bravely served on the front lines throughout the pandemic.
“The resilience and skill of countless SGU alumni has been on full display over the course of this pandemic,” Dr. Olds said. “We look forward to sending another talented group of students into the world to make a difference in the lives of patients.”
The 2021 match class shared their excitement as the next chapter in their careers came into focus.
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“As graduating students of 2021, remember that you survived … four years of medical school, Step 1 and 2, and a pandemic—you can definitely survive residency.”
That’s the advice that 2020 graduate Lauren Sussman, a pediatrics resident at Albany Medical Center, offered to newly matched residents. She is one of dozens of St. George’s University alumni who offered advice to incoming interns who will begin their first year of residency in the US this July.
Students and graduates of SGU find out on Friday where they matched for residency. They will enter the healthcare field at a crucial time in history as the COVID-19 pandemic continues to keep its grip on much of the country and around the world.
Check out the advice that alumni had for their SGU colleagues.
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Jeremy Aguinaldo, MD ’17, looks at disease not only from up close—with each individual patient—but from a bird’s eye view. A board-certified public health physician for Compass Care in the Georgia Department of Public Health, Dr. Aguinaldo identifies risk factors and problem areas for large populations, and implements programs to improve community health.
“The improvement of an individual’s health also requires improving the entire healthcare system,” said Dr. Aguinaldo, who recently completed his public health and preventive medicine residency at Morehouse School of Medicine.
While countries around the world deal with the coronavirus disease (COVID-19) pandemic, Dr. Aguinaldo is addressing a problem that continues to plague his community—the human immunodeficiency virus (HIV).
How serious is the current HIV problem in the United States?
More than a million people in the United States are living with HIV, and in 2018, there were about 36,000 new cases. Contracting HIV is no longer considered a death sentence as it was before. With the continued advancements of antiretroviral drugs to manage the virus, HIV had become a chronic illness, similar to how diabetes and blood pressure are managed.
What measures are you taking to help prevent the spread of HIV in your community?
When a patient initially tests positive for HIV, he or she is immediately sent to the clinic where they are linked to care and started on antiretroviral treatments. Patients who start on medication soon after diagnosis have shown to have better outcomes compared to those start much later. By taking the prescribed medications, the viral load (the amount of HIV in the body) is reduced. By reducing the viral load to such a level, it becomes undetectable by standard blood tests.
Patients who maintain an undetectable status will continue to be healthy and prevent transmission, which is referred to as “treatment as prevention.” This is key in preventing HIV spread in the community. The clinic also promotes the use of Pre-Exposure Prophylaxis (PrEP), which, when taken daily, is successful in preventing infection with HIV, greatly reducing the risk. It’s also important to raise awareness and educate the community on the benefits of using PrEP.
Dr. Aguinaldo as a medical student in Grenada
What social or economic trends are tied to HIV cases and transmissions?
There is a significant risk of HIV infection in those with mental health illnesses. The common conditions include depression, anxiety, bipolarity, post-traumatic stress disorder (PTSD), schizophrenia, and dementia. These issues make drug adherence much more difficult to comply with and increase high-risk behaviors such as illicit substance use and unprotected sexual activities.
Many individuals in the community I serve are homeless, unemployed, or lack health insurance and thus struggle to make ends meet. They consider their HIV status less of a priority until their own basic needs are met. This is where addressing those social factors, as well as managing them, clinically come into play.
Why has public health become the focus of your career?
When I was getting my master’s degree in public health, I learned from nurses, doctors, statisticians, researchers, engineers, and others who all shared a common goal: to improve the health of the population. Healing is more than just prescribing a simple pill but also collaborating with a team of multiple disciplines to help the patient.
Dr. Aguinaldo’s cancer research presentation as an SGU student
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Match Day is a monumental occasion for all aspiring doctors—the moment they discover where they are going for residency training. Through the basic sciences, through clinical training, they have had their sights set on this date for quite some time.
The best way to take part in the celebration is through using our hashtag—#SGUMatch.*
Simply add it to your post. It will appear on this page, and by clicking on it on any social media channel, you and your classmates will see the excitement that’s going on around you.
*By using our hashtag, you are giving us permission to share your photo. Due to privacy concerns, we do not recommend sharing the hospital that you matched at.
Share your exciting news using one of our Match Day signs and we’ll retweet/share
your posts on social media and on this page. Be sure to use the hashtag #SGUMatch.
Search terms like #MatchDay #SGUMatch #SGU #StGeorgesUniversity #Doctor #MD
to use these on Instagram Stories.
Playlist & Virtual Backgrounds
To use the Zoom backgrounds, click directly on the image to enlarge and then right click to save the image. Upload to Zoom as a background. Backgrounds can also be found in the downloadable signs file.
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Dr. Sylvie de Souza (front) and the emergency medicine team at The Brooklyn Hospital Center in New York. Photos provided by Sylvie de Souza
Dr. Sylvie de Souza, director of emergency medicine at The Brooklyn Hospital Center (TBHC), and a clinical assistant professor for St. George’s University, was on the front lines when it all began. The day was March 1, 2020, when the first COVID-19 case was reported in New York City.
As the coronavirus spread throughout the city, putting pressure on the people and the mechanisms to treat ill patients, she remembers as much about what happened as the way it made her and her colleagues feel. It reminded her another catastrophic event—September 11, 2001.
“We immediately went into preparedness mode while the memory of 9/11 lurked in the back of our minds,” Dr. de Souza said. “Although the nature of the event was different, we all sensed that something major and perhaps terrible was about to happen. The anxiety of the unknown heading our way was palpable.”
A year later, Dr. de Souza reflected on the entire experience, how she and her team weathered the storm, and the hope she has for—and sees in—future SGU medical students who she trains for the fast-paced world of emergency medicine.
St. George’s University: How would you describe the past year in the emergency department at TBHC?
Dr. Sylvie de Souza: In September 2001, many of us remember standing by and watching New York’s bravest selflessly run into the burning building when everyone was running out, running toward the danger, into the fire, to save as many as they could. Sadly, when the unthinkable happened, we were the ones who went to the firehouses, like most New Yorkers, to praise the bravery and console the unimaginable loss. As emergency workers, there was not much else we could do other than what we had been trained to do: treat the walking wounded and the first responders. And we did, for weeks to come. Our lives were never directly endangered on 9/11.
This all changed in March of 2020 when the danger came directly at us. The fire came to us, and it grew uncontrollably with each day that passed. We stood in it, day after day, for hours on end, with little sleep, food, or drink, hardly recognizable in our plastic gear, trying to help as many as we could, with our own fear in the pit of our stomach, watching some of us fall, victims of the vicious enemy we were fighting. Many came to help in every way they could, but everybody knew, as we did, that this time around, it was as though we were the ones standing in the burning building, right there among the victims we were trying to save.
What an amazing twist of fate it was that, this time around, it was us New York’s bravest who came to clap for every evening. If anyone knew what we were feeling, I thought, it would be them. They clapped with the rest of the bystanders, a daily incantation of sorts, to harness the courage they knew we needed to keep going.
Dr. Sylvie de Souza on the floors with her colleague at TBHC.
Medical supplies were of utmost importance as hospital staff worked around the clock to care for COVID-19 patients.
Makeshift hospital rooms were used to treat the overflow of patients showing COVID-19 symptoms.
Messages of support and gratitude poured in from people of all ages.
Like healthcare workers who came to the side of their patients, New York City backed doctors, nurses, and staff on the front lines.
National media outlets such as The New York Times, CNN, and People Magazine reached out to Dr. de Souza for her story on what it was like to meet the pandemic head on.
A clinical professor for St. George’s University, Dr. de Souza has found SGU students to be “driven, focused, and resilient.”
Dr. de Souza:I once read this sentence in a French publication. I do not recall who the author is, but it stayed with me: “Courage does not consist of doing the work that is expected of you; that is competence. Real courage is to conquer one’s fear and see the duty before the effort.”
I cannot recall a time in my entire career when this sentence rang truer or when I was, along with my colleagues, tested to honor the oath we had taken to come to the aid of others. It took all we had to overcome our own fears. We worked endless days and nights, not knowing what the fate of our patients would be, or our own, instead trusting that we were doing exactly what we were supposed to do—to follow our calling and answer the call of duty.
Many lessons were learned in the face of such adversity and uncertainty: 2020 was a year of great loss, but also a year filled with a sense of community, resilience, and hope. I face 2021 with a renewed sense of purpose and the knowledge that preparedness and togetherness are likely the most important tools we possess to confront adversity.
SGU: In what way has your role changed the most during the pandemic?
Dr. de Souza:With the restrictions imposed by NYC Department of Health at the beginning of the pandemic, no visitors were allowed in the hospital. Those measures were in place to protect those who were not yet infected.
As a result, we were no longer simply caregivers to the growing number of critically ill patients. We suddenly became their only “visitors,” their only connection to the outside world and their loved ones, their consolers, their prayer partners, their only and sometimes last human interaction, and most poignantly, the last ones to hold their hands as they slipped into unconsciousness or died. No amount of training could have prepared us to take on a responsibility of that scale. Watching patients die deprived of their loved ones or making their hastened last goodbyes on a video monitor was almost too much to bear.
Surrounded by all this despair and grief, we became closer as a team; we suddenly felt responsible for one another and supported each other through each day. As emergency workers, we had always known the importance of functioning as a team. This time, however, there was a whole new twist. We were now a team who had to operate in constant danger, facing mortality, that of those we cared for … and our own. We shared the same fears about our own unpredictable fate, fighting this vicious invisible enemy, not unlike a platoon sent to combat.
The Brooklyn Hospital Center. The oldest hospital in Brooklyn was one of many in New York City to combat the emerging COVID-19 crisis.
SGU: What can St. George’s University students rotating with the TBHC EM department expect to learn?
Dr. de Souza:Several faculty, myself included, partake in the weekly didactic conferences for EM residents and medical students. Our program has a dedicated clerkship director who organizes a series of didactic sessions and workshops where students receive direct feedback from the faculty. Aside from some exposure to a series of common complaints, medical students rotating through our department will leave the clerkship with a basic knowledge on the approach to the undifferentiated patient and introductory skills for the rapid recognition of the critically ill patient. We also place a lot of emphasis on the ability to communicate and function effectively in a team.
“As emergency workers, we had always known the importance of functioning as a team. This time, however, there was a whole new twist.”
Dr. Sylvie de Souza, emergency medicine clinical professor, SGU
SGU: Is there a personality trait that you find to be common among SGU medical students?
Dr. de Souza: I have had the pleasure of working many SGU students who rotated through our department over the years. Several of them became some of our most stellar residents. I have found them to be driven, focused, and resilient. Most salient is their overall ability to adapt and make the best out of any situation.
SGU: What is one piece of advice that you would give to a student who was considering a career in emergency medicine?
Dr. de Souza: During your ED rotations, immerse yourself in the ED life and culture. Merge with the ED team. It’s not about anyone of us and it’s not about you; it’s about the patient. When the team wins, and you participated, you won. Don’t worry so much about having all the answers. Be perceived as a vibrant, passionate, and compassionate member of the team—someone who anyone would want by their side in the trenches.
– Brett Mauser
Get to Know Dr. Sylvie de Souza
Video produced by The Brooklyn Hospital Center
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Dr. G. Richard Olds, president of St. George’s University, has committed his life to studying tropical and infectious diseases. All over the world, he has seen how viruses—these microscopic parasites that are invisible to the naked eye—can spread through a community, leaving damage in their wake.
One of the best methods to combat the virus is the use of vaccines. A version of the SARS-CoV-2 vaccine began being administered in Grenada last week, and a full program is currently being rolled out that places essential workers, elderly and Grenadian residents with pre-existing conditions on the priority list. Having long studied vaccines and their positive effect on healthcare, Dr. Olds is an ardent supporter of their implementation.
“I got my first COVID vaccine today,” he said.
Dr. Olds shed light on the vaccine that is currently being distributed in Grenada, what citizens can expect when receiving it, and the long-term outlook for COVID-19 in the country.
St. George’s University: What vaccine does Grenada currently have in stock? Is it being administered elsewhere in the world and how does it compare to other versions?
Dr. G. Richard Olds: Grenada is currently using the AstraZeneca vaccine, which is currently being used extensively in England. It was developed in partnership with Oxford University. In contrast to the two vaccines being used in the US, it is a chimpanzee adenovirus that has had the message for the spike protein placed within it. This vaccine can’t make humans sick, but it induces a high level of protection against COVID-2. Just like the mRNA vaccines used in the US, this vaccine requires two doses but has the advantage of being stored in cold but not freezing environments.
SGU: How exactly does this vaccine provide protection against SARS-CoV-2?
Dr. Olds: The COVID-2 virus attaches to human cells through a molecule on its surface called a spike protein. All current COVID vaccines target this molecule. Vaccinated people develop antibodies that block the binding of the spike protein to human cells. Unable to bind, the virus is unable to infect cells.
SGU: How long is the protection expected to last?
Dr. Olds: How long the vaccine will protect those who receive it is currently unknown, but it looks like all vaccines provide protection for at least a year and probably longer.
“If everyone doesn’t take the vaccine, we run the risk that COVID will circulate for a very long time.”
G. Richard Olds, SGU President
SGU: Is the vaccine available in one shot or does it require multiple shots over a period of time?
Dr. Olds: Most of the seven COVID vaccines require two shots, but the Johnson and Johnson vaccine only needs one shot. This is not currently available in Grenada. The interval between the two shots varies, but about a month is the most common. There are experiments in England now with the AstraZeneca vaccine with longer periods between the shots.
SGU: How safe is the vaccine that is available in Grenada? Are there any side effects?
Dr. Olds: All the COVID vaccines appear very safe. In blinded control studies, no difference was seen between vaccinated people and those that got sugar water in terms of long-term side effects. In the short run, vaccinated people will likely feel soreness in their arm, feel poorly for a few days, and may have a low-grade fever. None of these responses are serious, and they often respond to over-the-counter medicine.
The AstraZeneca vaccine currently in Grenada does not seem to cause severe allergic reactions. All minor reactions to the vaccine appear more commonly in reaction to the second vaccine, and are a sign that they are working.
SGU: Are there any pre-existing conditions that would prevent someone from getting it?
Dr. Olds: If a person is severely immune compromised—such as being infected with the AIDS virus, on high-dose steroids, getting chemotherapy, or having an organ transplant—they should consult a doctor before getting the vaccine.
SGU: Once an individual receives the vaccine, how will restrictions change for them?
Dr. Olds: Even after you get fully vaccinated, people will still need to wear a mask and socially distance until everyone on the island is vaccinated. That’s because vaccinated people are protected from dying from COVID, but they could still transmit the virus to others. Once everyone is vaccinated, life should return to normal.
SGU: Do you believe that all eligible individuals should receive the vaccine?
Dr. Olds: Everyone over 18 years of age should get the vaccine. Soon we will know if children over 12 should get the vaccine. The vaccine is very safe, and COVID can lead to serious illness or fatalities. In addition, COVID can cause long-term health issues for people. By now, millions of people in England have already received the vaccine currently available in Grenada without a problem.
If everyone doesn’t take the vaccine, we run the risk that COVID will circulate for a very long time, and the more the virus circulates, the greater the chance that a new variant will develop that the vaccine will not protect people from. It’s a race, and I hope this time humans win.
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SGU News caught up with John Washington, MD ’81, who with his charter class colleagues were the first to enter medicine as St. George’s University graduates. Dr. Washington has spent the last 35 years working as an emergency medicine physician in Macon, GA, and he looks back fondly on where his journey began.
St. George’s University: How did you end up choosing SGU?
John Washington: Going to SGU was the opportunity of a lifetime for me. We’re talking about a time when black individuals didn’t really have that kind of opportunity in medicine. For us, we had to go to Howard or Meharry, which is the oldest black medical school in the nation. Some schools weren’t letting black medical students in.
A friend of mine at one school told me some stories about how he was treated—and of the things that went on. It’s amazing he made it through. He isn’t alone either. When I compared my time in Grenada to the experience that he and others had elsewhere, it was completely different. SGU was a great fit for me.
SGU: How would you describe the camaraderie amongst the charter class?
Dr. Washington: The most important thing I remember is that everybody stuck together. It was a tight-knit group, and everybody helped each other out in any way they could. We studied hard, and it was easy to see who was committed to making it through and building a legacy for the school. Looking back at it now, we were able to lay the groundwork for what was then this completely new and unique school.
SGU: What’s it like for you looking back on the foundation that you and your classmates built?
Dr. Washington: It’s just been marvelous. I believe that SGU is the preeminent foreign medical school in the world, in terms of the training it provides and the opportunity it gives students to practice in the US. Graduates from SGU are everywhere now, and they’re doing well. I’m proud to have been part of the first class and to have helped physicians who followed in our footsteps.
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As the coronavirus pandemic brought the world to a halt, Eric Vail, MD ’13, went from cancer geneticist to COVID-19 diagnostician and researcher.
