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Biomedical subjects

E J Stemmler

Publications and source records attributed to E J Stemmler.

14 recordsLinked to original sources
PubMed1989

The medical school--where does it go from here?

Two developments profoundly modified the single mission of U.S. medical schools to educate physicians: the decision of the federal government to develop federal research programs within the nation's universities rather than in separate research institutes; and the entry of the federal government into the purchase of health services through the Medicare and Medicaid programs. The presence of biomedical research in the schools has created dilemmas for educators and administrators. The schools need to deploy large amounts of capital for research, they find a decreasing relevance of new research knowledge to medical practice, and they see a great need to increase interdepartmental collaboration. These factors create a new kind of tension that may make the medical school of the next generation less attractive as the exclusive institution in which biomedical research is conducted within the university. At the same time, cuts in federal funding for health services have caused medical schools to organize their faculties into practice plans. If the plans feel cuts in income because of federal reimbursement mandates, there will probably be controversy among faculty members about the plans' continuing contributions to the schools. A hypothetical scenario illustrates the plight of a medical school faced with a significant reduction in funds to support health services.

Education, Medical↗
PubMed1988

Competency requirements. A new approach to medical school admissions.

The faculty of the University of Pennsylvania School of Medicine, Philadelphia, have substituted definitions of knowledge and skills for course requirements as requirements for admission. The school expects that this action will allow students more flexibility in the development of their undergraduate academic programs, while guiding them specifically to the necessary preparation in the sciences. It is further hoped that this action will encourage the faculties of undergraduate schools to examine the way in which they prepare students for careers in medicine. This article describes the approach used for bringing about this change in policy and presents the new admissions requirements.

Curriculum↗
PubMed1986

Managing medical education at the University of Pennsylvania.

In meeting the challenge of educating students to be physicians in the 21st century, schools of medicine must develop management systems that promote change and encourage innovation. In this paper, the authors describe the approach used by the University of Pennsylvania School of Medicine over the past five years for managing its programs. The major elements of this management scheme are centralization of administrative functions concerned with medical education; networks for communication about education problems and issues; a system for obtaining consensus among the institution's constituencies on the goals of the school's educational programs; a system for including information on teaching performance as an element in the promotion process; and multiple systems for providing the faculty, students, and administration with information about the quality of the school's educational activities.

Administrative Personnel↗
PubMed1984

Development of clinician-educator faculty track at the University of Pennsylvania.

As resources grow scarcer , universities have become reluctant to increase the long-term institutional commitments involved in faculty appointments with tenure. The restrict tenured appointments, universities in recent years have adopted more stringent criteria for approving them and in many cases have set a limit on the number of new appointments and promotions with tenure. The educational and service missions of the medical school, however, necessitate a large cadre of clinical faculty members. The establishment and evolution of the clinician-educator faculty track at the University of Pennsylvania provide a case study of a process taking place in many medical schools to meet the need for nontenured full-time faculty appointments.

Faculty, Medical↗
PubMed1968

Longitudinal distribution of vascular resistance in the pulmonary arteries, capillaries, and veins.

A new method has been described for measuring the pressure and resistance to blood flow in the pulmonary arteries, capillaries, and veins. Studies were performed in dog isolated lung lobes perfused at constant flow with blood from a donor dog. Pulmonary artery and vein volume and total lobar blood volume were measured by the ether plethysmograph and dyedilution techniques. The longitudinal distribution of vascular resistance was determined by analyzing the decrease in perfusion pressure caused by a bolus of low viscosity liquid introduced into the vascular inflow of the lobe. The pulmonary arteries were responsible for 46% of total lobar vascular resistance, whereas the pulmonary capillaries and veins accounted for 34 and 20% of total lobar vascular resistance respectively. Vascular resistance was 322 dynes .sec.cm(-5)/ml of vessel in the lobar pulmonary arteries, 112 dynes.sec.cm(-5)/ml in the pulmonary capillaries, and 115 dynes.sec.cm(-5)/ml in the lobar pulmonary veins. Peak vascular resistivity (resistance per milliliter of volume) was in an area 2 ml proximal to the capillary bed, but resistivity was high throughout the pulmonary arterial tree. The pulmonary arteries accounted for approximately 50% of vascular resistance upstream from the sluice point when alveolar pressure exceeded venous pressure. The method described provides the first measurements of pulmonary capillary pressure. Mid-capillary pressure averaged 13.3 cm H(2)O, pulmonary artery pressure averaged 20.4 cm H(2)O, and pulmonary vein pressure averaged 9.2 cm H(2)O. These techniques also provide a way of analyzing arterial, capillary, and venous responses to various pharmacologic and physiologic stimuli.

Animals↗
PubMed1968

Differential reactivity in the pulmonary circulation.

A new method for relating regional intravascular resistance to pulmonary arterial, capillary, and venous pressure and volume was used to evaluate local differences of reactivity in the pulmonary blood vessels in the isolated lung lobe of the dog. Intravascular infusion of isoproterenol caused active dilatation of pulmonary arteries and veins. Capillary conductance (1/resistance) and volume increased, possibly as a result of the opening of previously closed capillaries. Serotonin infusion caused active constriction of both the pulmonary arteries and veins. A low dose of serotonin (1.5 mug/min per kg) caused predominant constriction of whichever vessels were upstream (arteries during forward perfusion, veins during reverse perfusion). A high dose of serotonin (4.5-5.0 mug/min per kg) caused constriction of both upstream and downstream vessels. Metabolic inactivation of serotonin by the lung is suggested as an explanation for these observations. Histamine infusion caused predominant venous constriction whether veins were upstream or downstream. Capillary volume and conductance decreased during forward and reverse perfusion, perhaps as a result of pericapillary edema formation. Large arterial vessels constricted slightly, whereas small arterial vessels appeared to be passively dilated.

Animals↗