Early graduation could send US medical students to virus front lines

The battle to treat an ever-growing number of patients infected with the new coronavirus just gained its newest recruits: soon-to-be medical graduates. Several medical schools in Massachusetts and New York announced this week that they intended to offer early graduation to their fourth-year students, fast-tracking them into front-line hospital care as the need for medical workers surges.

On Tuesday, the Grossman School of Medicine at New York University became the first in the United States to announce an offer of early graduation, in an email to students. That followed similar moves earlier this year in Italy and Britain, which advanced many final-year medical students into intermediate clinical service.

On Thursday, the medical schools at Tufts University, Boston University and the University of Massachusetts announced that they planned to move up their graduation dates to April from May, after a request from the state of Massachusetts to help expand the medical workforce. Harvard Medical School said it was “actively considering” the same step.

In Massachusetts, the state would provide 90-day provisional licenses for early graduates, allowing almost automatic entry into clinical work. The move would make some 700 medical students in Massachusetts eligible to offer patient care at least eight weeks earlier than expected.

Dr. Steven Abramson, vice dean for education, faculty and academic affairs at NYU Grossman, said the school’s decision came as its hospitals were overwhelmed with an increasing number of COVID-19 patient cases, including in critical care. He said several fourth-year students had approached school administrators to volunteer their service.

“We’re running into issues of manpower,” Abramson said. “That led us to conclude: Why not graduate students who are interested in serving in hospitals now? They’ve completed their requirements and they’re prepared.”

Most American medical schools last four years, at which point the medical degree is granted, followed by residencies and internships to develop the specialties of new doctors.

At NYU, Abramson said, fourth-year students would be able to graduate in early April and begin patient care at NYU’s hospitals, on medicine floors and in the emergency room. They would then depart in late June or July for the start of their scheduled residency programs, with a two-week quarantine in between. Of 120 fourth-year students surveyed this week, he said 69 responded that they would be interested in early clinical service.

While the Liaison Committee on Medical Education, or LCME, which accredits medical degree programs in the United States, has offered guidelines for early graduation, NYU’s decision awaits final approval from the New York State Department of Education.

A number of New York medical schools are still developing proposals for early graduations. Dr. David Muller, dean for medical education at the Icahn School of Medicine at Mount Sinai, said the school hoped to have a proposal ready to share with students by early next week. The early graduation would most likely occur in mid-April, he added, and would be voluntary, although details need to be worked out. Columbia University’s Vagelos College of Physicians and Surgeons and the Albert Einstein College of Medicine also are working toward early graduations.

Medical students around the country have spent recent weeks mobilizing to support local physicians. They have staffed coronavirus hotlines, coordinated meal deliveries and even offered their time as baby sitters to other medical workers. Many said they were excited to contribute their medical training.

“We see everything the physicians around us are going through and we’re excited we can bring some relief to the physicians who trained and mentored us,” said Greg Peters, a fourth-year student at Harvard who plans to start a residency in emergency care in Boston.

He added, though, that the prospect of early graduation and fast-tracked service came as a surprise. “My classmates and I are Type A people who plan everything out, and our plans are out the window,” he said. “We’re confident in our training, but we’re a little worried about getting thrown in there.”

The Association of American Medical Colleges, a research and advocacy group for medical schools and major teaching hospitals, said it supported the early graduations following LCME guidelines, but emphasized the importance of supervision for new graduates.

“As we think about what the role of these new graduates would be, it would need to be under supervision,” said Alison Whelan, the association’s chief medical education officer.

Abramson said he expected more medical schools around the country to move toward early graduations.

“We aren’t the only school that has needs for taking care of patients in this COVID environment,” he said. “I fully anticipate other schools will look at this and do it as well.”

c.2020 The New York Times Company

Hospital radiologists can help detect domestic violence, researchers say

NEW YORK - Radiologists, who typically interact little with patients, can play a key role in identifying victims of abuse by spotting patterns of injuries that point to domestic violence, researchers said on Tuesday.

Abuse victims, most often women, have more face, skull and arm fractures than other patients, combined with high rates of asthma, chronic pain and suicide attempts, a team at Brigham and Women's Hospital in Boston reported.

The signs of abuse can be detected by radiologists, who specialize in interpreting images such as X-rays, given that such victims undergo four times more emergency-related imaging exams than other patients, the researchers said.

The abuse can be physical, sexual and psychological, they said.

"There's a wealth of information that's available to us as radiologists," said Dr. Elizabeth George, chief resident in the department of radiology at Brigham and Women's Hospital and a lead researcher of the report.

"There might be indications on the prior imaging, and if you see a pattern, that could alert you to something else going on in this case, such as violence."

The World Health Organization reports that one in three women experiences physical or sexual violence in her lifetime.

The Violence Policy Center, a research and advocacy group focused on gun violence, reported that more than half the women murdered in the United States last year were killed by current or former romantic partners.

Signs of abuse can be easily missed in a busy hospital emergency department, George said.

The researchers also said hospital records may not identify or report certain injuries as abuse.

"Survivors need someone there who knows what's happening," said Ruth Glenn, head of the Colorado-based National Coalition Against Domestic Violence.

"That alone can plant the seed to find safety. The medical field is perfectly set up to do this."

Turning the findings into action to help victims will require a coordinated effort among radiologists, social workers, emergency room doctors and others, George told the Thomson Reuters Foundation.

More than 96 percent of U.S. victims of violence at the hands of an intimate partner are women, and the highest rates occur among black and Hispanic women, according to the report, published in Radiology, a journal of the Radiological Society of North America.

(Reporting by Kate Ryan; Editing by Ellen Wulfhorst. Thomson Reuters Foundation, the charitable arm of Thomson reuters, that covers humanitarian news, women's and LGBT+ rights, human trafficking, property rights, and climate chenge. Visit www.trust.org)

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Actor Kevin Spacey charged with indecent assault in Massachusetts

Oscar-winning actor Kevin Spacey has been charged in connection with an allegation that he sexually abused an 18-year-old boy at a Nantucket, Massachusetts, bar more than 2 years ago, the local district attorney said on Monday.

Spacey is scheduled to be arranged at Nantucket District Court on January 7 on a single charge of indecent assault and battery on a person who is least 14-years old, according to court documents and a statement issued by Cape and Islands District Attorney Michael O'Keefe.

An attorney for Spacey did not immediately reply to a request for comment. The actor, however, released a video on YouTube on Monday in which he adopts the persona of his character Frank Underwood in the popular Netflix TV series "House of Cards" and says, "I know what you want, you want me back ... You wouldn't rush to judgments without facts, would you?"

The 3-minute video makes no specific reference to the Massachusetts allegation.

The charge against Spacey, 59, whose full name is Kevin Spacey Fowler, was filed after a Dec. 20 hearing, O'Keefe said. The name on the complaint was Kevin S. Fowler.

The charge against Spacey follows an allegation in November 2017 by Boston television journalist Heather Unruh that her 18-year-old son was sexually assaulted by the actor at the Club Car restaurant and bar in Nantucket on July 7, 2016.

At a news conference in which she made the allegations, Unruh said her "star struck" son falsely told the actor he was old enough to drink when he met him at the bar. The legal age to drink alcoholic beverages in Massachusetts is 21.

'DRINK AFTER DRINK'

"Kevin Spacey bought him drink after drink after drink, and when my son was drunk, Spacey made his move and sexually assaulted him," Unruh said at the 2017 news conference.

The actor allegedly stuck his hands into her son's pants and grabbed his genitals, she said, adding it was "completely unexpected" and her son tried unsuccessfully to shift his body away from Spacey.

"He did not report the crime at the time, and that was largely because of embarrassment and fear," she said.

Unruh said her son filed a report with police in Nantucket, a resort island off the southern coast of Massachusetts, shortly before her news conference.

More than 30 men have said they were victims of unwanted sexual advances by Spacey, who became embroiled in controversy last year when actor Anthony Rapp accused him of trying to seduce him in 1986 when Rapp was 14. In October 2017, Spacey apologized for any inappropriate conduct with Rapp but has not commented since.

The fallout resulted in Spacey, who won a best actor Oscar in 2000 for “American Beauty,” being dropped from the final season of “House of Cards” and erased from the 2017 movie “All the Money in the World.”

Spacey is one of dozens of men in the entertainment industry and politics who have been accused of sexual misconduct, partly as a result of the #MeToo social media movement that began over a year ago.

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Boston gangster James ‘Whitey’ Bulger found dead in prison

James "Whitey" Bulger, who lived a double life as one of Boston's most notorious mobsters and as a secret FBI informant before going on the run for 16 years, was found dead at a federal prison in West Virginia, the Federal Bureau of Prisons said.

The Federal Bureau of Investigation was looking into Bulger's death, the Bureau of Prisons said in its statement.

Bulger's death at age 89 came a day after he was transferred to the high-security prison. Federal officials did not give a cause of death but the Bureau of Prisons said no other inmates or staff were injured. CNN and the Boston Globe reported that Bulger was killed without giving further details.

Henry Brennan, a defense lawyer for Bulger, said in an email he could not confirm or deny the reports.

Bulger was convicted in August 2013 of 11 murders, among other charges including racketeering, and sentenced to two consecutive life terms plus five years.

Prison had been something Bulger had gone to great lengths to avoid - killing potential witnesses, cultivating corrupt lawmen and living as a fugitive for 16 years. It all ended when a tip from a former Icelandic beauty queen led to his capture in June 2011 in Santa Monica, California, where he was living with a long-time girlfriend.

Bulger and his Winter Hill gang had operated for more than two decades in the insular Irish-dominated South Boston neighborhood, engaging in loan sharking, gambling, extortion, drug dealing and murder. They did so with the tacit approval of an FBI agent who looked the other way when it came to Bulger's crimes so that he would supply information on other gangsters.

Bulger, portrayed by Johnny Depp in the 2015 film "Black Mass," was feared for his short temper and brutality. Prosecutors said he strangled two women with his hands and tortured a man for hours before shooting him in the head with a machine gun.

"We took what we wanted," Kevin Weeks, a former Bulger lieutenant who would eventually testify against him, wrote in "Brutal," his memoir. "We made millions through extortion and loansharking and protection. And if someone ratted us out, we killed him. We were not nice guys."

Bulger was born Sept. 3, 1929, and grew up in South Boston. He was called "Whitey" because of his light blond hair but was said to detest the nickname and preferred being called Jimmy. As a teenager he joined a gang known as The Shamrocks, compiled an arrest record for assault and armed robbery and ended up in a juvenile reformatory.

Bulger was a bank robber early in his criminal career, which landed him in prisons such as the infamous Alcatraz, located on an island in San Francisco Bay.

Upon his release in 1965, he eventually fell in with the Irish mob in South Boston and worked his way through the ranks as a bookie and loan shark. He survived a gang war between two Irish mobs and was a leading figure in Boston's underworld by the early 1970s.

His career was boosted by his relationship with rogue FBI agent John J. Connolly, who Bulger had known since they were boys. Connolly was supposed to be in charge of getting information out of him and Bulger did provide information that helped the FBI go after his main rival, New England's Italian Mafia, as well as local criminals.

In return, Connolly let Bulger know about working investigations while Bulger and close associate Steve "The Rifleman" Flemmi carried on with impunity. After he retired from the FBI, Connolly tipped off Bulger about a coming indictment, sending the mobster on the run in 1995.

Connolly was convicted in 2008 of racketeering, taking bribes and second-degree murder for his role in the slaying of an accountant who Bulger and Flemmi feared would testify against them.

"A BAD, BAD, BAD GUY"

Bulger's former associates turned on him while he was at large and their information led to a 2000 indictment that originally charged him with 19 murders.

"The guy is a sociopathic killer," Tom Foley, who worked on Bulger cases for the Massachusetts State Police, told CNN. "He loved that type of life. He's one of the hardest and cruelest individuals that operated in the Boston area. He's a bad, bad, bad guy."

When Bulger fled, he first took Teresa Stanley, his girlfriend of 30 years, with him. After a few weeks at large, however, Stanley wanted to go home so Bulger dropped her off in the Boston area. He picked up another of his girlfriends, Catherine Greig, and disappeared again.

Bulger spent his final years of freedom in No. 303 of the Princess Eugenia apartment complex in Santa Monica with Greig.

One of their neighbors, Anna Bjornsdottir, a former U.S. television actress and Miss Iceland of 1974, earned a $2 million reward for turning in Bulger. She was watching a television news report about the Bulger manhunt when she recognized the man she knew by the name Charlie Gasko and notified the FBI.

At first he denied his identity but eventually told authorities, "You know who I am. I'm Whitey Bulger." More than $800,000 in cash and a cache of weapons was found hidden in the walls of his apartment.

Greig was sentenced to eight years in prison and fined $150,000 for helping Bulger evade capture. She is scheduled for release in September 2020.

Bulger's two-month trial for murder, extortion and drug dealing in 2013 was sometimes raucous. A parade of former associates testified against him, giving brutal details about how Bulger would kill enemies and then take a nap.

Sometimes Bulger sat silently at the defendant's table and at other times he engaged in profane shouting matches with witnesses such as Flemmi.

Bulger, who denied ever being an FBI informant, refused to testify on the grounds that the trial was a sham.

The U.S. Justice Department paid more than $20 million in damages to families of people killed by Bulger on the grounds that he was operating under government supervision while killing.

While Bulger was robbing banks and killing people, his younger brother Billy was acquiring political notoriety and power.

Billy served in the Massachusetts legislature for 35 years, including several years as president of the state Senate, after which he was president of the University of Massachusetts. He was forced to resign the latter job in 2003 after it was learned that eight years earlier he had spoken by phone with his brother, who at the time was a federal fugitive, and did not report it to authorities. (Reporting and writing by Bill Trott; additional reporting by Jonathan Allen, Sarah N. Lynch, Nate Raymond and Bernie Woodall; editing by Diane Craft and G Crosse)

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Clinton delivers stinging attack on Trump at graduation speech

NEW YORK, United States – Hillary Clinton launched a stinging attack on Donald Trump Friday, obliquely comparing him to former president Richard Nixon, who resigned in 1974 to escape impeachment, and savaging the Republican assault on fact-based politics.

The defeated Democratic presidential nominee made her remarks in a commencement address at her alma mater Wellesley College, a women's liberal arts college in Massachusetts, 48 years after her own graduation.

Never once uttering Trump's name, she urged the class of 2017 to get politically and socially involved, saying that the future of America depends on "brave, thoughtful people like you insisting on truth and integrity."

Coughing at one point before being passed a bottle of water and continuing briefly in a hoarse voice, the former secretary of state who made history as the first US woman to win a major party nomination for president was frequently interrupted by applause.

"Now, you may have heard that things didn't exactly go the way I planned, but you know what? I'm doing ok," she said of her electoral defeat. "I won't lie, Chardonnay helped a little too," she added to roars of delight.

Clinton implicitly compared Trump to Nixon, the Republican president brought down by the Watergate scandal. He sacked his attorney general in a move some have compared to Trump's firing of FBI director James Comey, who was investigating Russian interference in last year's election and possible collusion by Trump's campaign.

The former first lady said her class of 1969 was "furious" about the then-recent election of Nixon, "a man whose presidency would eventually end in disgrace with his impeachment for obstruction of justice."

- 'Assault on truth' -
"You are graduating at a time when there is a full-fledged assault on truth and reason. Just log on to social media for 10 seconds it will hit you right in the face," she said.

"People denying science, concocting elaborate hurtful conspiracy theories... Drumming up rampant fear about undocumented immigrants, Muslims, minorities, the poor," she added.

"Some are even denying things we see with our own eyes, like the size of crowds," she said, again alluding to but not naming Trump, who falsely accused the news media last January of misrepresenting the size of his inauguration crowds. "Then defending themselves by talking about quote unquote alternative facts."

Clinton called Trump's proposed federal budget "an attack of unimaginable cruelty on the most vulnerable" that "grossly underfunds" public education, mental health care, efforts to combat America's opioid epidemic and threatens to worsen climate change.

"It matters because if our leaders lie about the problems we face, we'll never solve them. It matters because it undermines confidence in government as a whole."

Much of her speech was a rallying cry for graduates to get politically involved and engaged with their communities.

"In the years to come, there will trolls galore, online and in-person, eager to tell you that you don't have anything worthwhile to say or anything meaningful to contribute, they may even call you a nasty woman," she said.

"You don't have to do everything, but don't sit on the sidelines."

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Obama, Bill Clinton play golf together on Martha's Vineyard

OAK BLUFFS, Mass. - U.S. President Barack Obama and former President Bill Clinton played golf together on Saturday ahead of an evening birthday celebration for Washington power broker and mutual friend Vernon Jordan.

The birthday bash reunites Obama and his former secretary of state, Hillary Clinton, the 2016 Democratic presidential candidate who is under fire for using a private email server during her time as the top U.S. diplomat.

Obama is vacationing with his family on the Massachusetts island of Martha's Vineyard and has spent much of the past week on the golf course. Jordan, who is turning 80, and former U.S. Trade Representative Ron Kirk rounded out the golf foursome.

The current and former U.S. presidents could be seen chatting amiably and gesturing with their hands while starting their game.

Wearing slacks and a white shirt, Obama waved and smiled at journalists who were allowed to take pictures as the men played.

Obama and Clinton have golfed together at least three times since the current president entered office, including January 2013, shortly after Obama's re-election.

Obama and the former president overcame a once-tense relationship stemming from the 2008 Democratic presidential primary race in which the then U.S. senator beat the former first lady for their party's nomination.

Bill Clinton campaigned hard for Obama's re-election in 2012 and Obama, while not endorsing anyone yet in the 2016 race, has expressed his admiration for Hillary Clinton, who is making her second White House bid and is the Democratic frontrunner.

The Obamas and Clintons crossed paths last year on Martha's Vineyard at a celebration for Jordan's wife, Ann.

That event came just after the former secretary of state criticized her one-time boss's foreign policy vision, prompting an apology and a pledge to reconcile by "hugging it out."

Clinton comes to Martha's Vineyard fresh from a campaign stop in Iowa, where she pushed back against criticism from Republican candidate Jeb Bush that Obama's policies on Iraq created instability that led to the rise of the Islamic State militant group.

Obama's victory in the 2008 Democratic primary contest in Iowa helped propel him to beat Clinton in that year's race.

(Editing by Alan Crosby)

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