best medical specialities :: Article CreatorUNLV Trained These Medical Students. Where Are They Going Next?
UNLV medical students learned where they will take the next step in their journey to become doctors.
Medical schools across the country, including UNLV's Kirk Kerkorian School of Medicine, held their Match Day on Friday for the class of 2024. Medical students learned where they will go for their residency training for the next 3-7 years.
UNLV said its 61 students were matched with programs in 18 states across the United States. The majority of the students — 57 percent — were matched with programs in Nevada, including the Valley Health System, Sunrise Health and UNLV's program at University Medical Center and other locations in Southern Nevada.
During a Match Day ceremony before the students learned their assignments, Dr. Marc Kahn, dean of the medical school and vice president for health affairs at UNLV, urged the students who weren't staying in Nevada to return after their residencies.
"This school was founded … really with the purpose of training doctors for the state of Nevada," Kahn said. "We rank between 45th and 49th in every specialty of medicine. We've got to get more docs here."
Thirty-one percent of the students matched in primary care specialties. Other top specialties included psychiatry (14.8 percent), anesthesiology (9.8 percent) and emergency medicine (8.2 percent).
Contact Paul Pearson at ppearson@reviewjournal.Com.
Common Challenges When Medical Device Manufacturers Automate High-precision Assembly
An automated high-resolution line scan inspection.
Sponsored by Invio Automation.
Researchers at the renowned Brigham and Women's Hospital recently made a miracle advancement in brain cancer treatment. Researchers at the Boston-based hospital developed a grain-size implant that delivers nano-doses of anti-cancer drugs directly into a patient's brain tumor. To do so, clinicians implant the MicraTM, a pacemaker the size of a vitamin capsule, directly into the heart, and then place the world's smallest medical implant, the iStent inject®, into the eye during cataract surgery to relieve inter-ocular pressure.
The clinicians and their suppliers are now confronted with the challenge of producing these microscopic devices and the specialty tools involved in the procedure.
Fortunately, that help is here.The increasingly complex geometries of micro-medical devices present manufacturers with new challenges. When a final product is only millimeters wide, the components inside must be made at the microscale and are often invisible to the naked eye. The diameter of a wire within the device may be .002 inches and may weigh as little as 1/10 of a milligram, with tolerances as small as 1/1000th of an inch. Other drug delivery devices and different products like point-of-care test units, hypotubes, implant and wearable medical devices may have other, more demanding production requirements.
Producing components with such extraordinary precision, at a cost that makes sense for the manufacturer, requires specialized automation equipment and techniques. That's where Invio Automation comes in. For 65 years, the company has designed, implemented and sustained automation for the largest medical device and life sciences operations in the world. They pride themselves in truly partnering with manufacturers to solve big challenges by exploring, testing and customizing the latest manufacturing technology.
"The world of microdevices is relatively new to everyone. Even top medical OEMs don't have a lot of in-house experience to rely on, let alone emerging or smaller manufacturers," says Charlie Shortridge, Sales Engineering Manager at Invio Automation. "Because the level of up-front commitment is so high, investing in manufacturing technologies and equipment to produce these devices focuses on risk. This also explains why early production relies on manual processes — because the cost/risk ratio is lower. When demand grows, manual processes are no longer possible and so custom automation systems are brought in by necessity. With high investment costs and long lead times for custom equipment, the stakes associated with this transition are extremely high."
Automated medical device component processing and assembly for needles and wearable drug delivery devices.
Inside the Invio difference
A high-volume production process can be the most capital-intensive step in the lifecycle of bringing a medical device to market. During initial development, the focus is often on material selection, component costs, process validation and even software development for many new medical devices. It is easy to underestimate manufacturing and assembly costs of the device without having direct experience with similar products, components and processes.
While innovation and new automation companies are a huge part of driving the industry forward, nothing beats the value of having met similar and specific requirements in the past. Companies like Invio Automation are in demand because they can reach back to past projects and leverage experience to help their customers plan for the right costs as well as stagger and defer investment in an intelligent way. Capital efficiency is the name of the game for scaling micro-assembly operations.
Invio accurately estimates the costs of developing, testing, prototyping, and delivering new automation systems and presents options to maximize capital efficiency. Drawing on patented process technologies allows for significantly faster and lower cost solutions than truly starting from scratch. Even when starting from scratch, Invio has been able to develop processes and automation systems to manufacture products ranging from in vitro diagnostic (IVD) products to test kits to blood glucose monitors.
Faster TTM and ROI through automation partners
When a manufacturing process introduces a defect to a medical product, the costs can be enormous. The amount of regulatory oversight, financial impact and public perception concerns mean that quality is the single biggest factor for commercial success. A quality issue likely dictates the overall Time To Market (TTM) and Return on Investment (ROI) for the development of any medical device.
In an effort to mitigate the outsized impact of a quality issue, all automation includes impressive amounts of cameras and inspection systems, to the point that most automation companies have in-house experts and labs used to ensure these systems perform as required. New technologies are introduced every day to make the inspection process faster and more accurate.
Internal resources like vision labs and dedicated experts make companies like Invio Automation essential partners for manufacturing technology selection and integration. This includes ultra-HD cameras that collect visual data and use AI and advanced algorithms to analyze images for irregularities or specific attributes. Implementing these technologies can impact manufacturers by allowing for 100% inspection of high-volume products, as is the case for single use devices (such as syringes or catheters) as well as the more complex implantable devices (such as protheses or cardiac devices).
In this area, the right automation partner will bring experience with testing, proof-of-concepts, and validating all type of inspection and test systems as they collaborate with manufacturers to plan out an automation roadmap.
"Invio Automation has the deep expertise that comes with more than 65 years of automation across our locations, and thousands of successful installations," Shortridge says. "We specialize in custom automation solutions for medical and life sciences manufacturers — dealing with the exact areas where manufacturers have trouble."
To learn more about Invio's capabilities, please email charlie.Shortridge@invioautomation.Com or visit Invio Automation.
Specialties Address Common Health Risks
Submitted photo Tom Takubo, D.O., was named to West Virginia Executive magazine's Health Care Hall of Fame in 2022.
LEWISBURG — If you think pulmonologists always focus on a patient's lungs, you'd be wrong.
Tom Takubo, D.O., of the West Virginia School of Osteopathic Medicine's (WVSOM) Class of 1999, said many people don't realize how intimately the lungs are intertwined with other organs involved in the breathing process.
"As a pulmonary specialist, you do learn the lungs at a much greater level," Takubo said. "But the body has a lot of redundancy, and you can sometimes lose a third of your lung function before you notice a problem. When patients come to me, I'm often diagnosing heart problems, because the lungs are just one piece of the process. Lungs put oxygen into the blood, the heart has to push that blood, the blood has to carry it, and then it has to be able to jump from the blood to the tissue. If there's a problem in any of those areas, it's going to make you short of breath. So figuring out why oxygen isn't getting there often falls to a pulmonologist."
Takubo, a pulmonologist and critical care specialist, is a founding physician and partner in Pulmonary Associates of Charleston, W.Va., a lung center that was the first in the state to incorporate electromagnetic navigation bronchoscopy (ENB), a procedure that changed the way lung cancer is diagnosed. ENB allows physicians to more accurately guide endoscopic tools through the bronchial pathways.
"In the past, if you had a spot on your lung, most of the time they would have to remove a piece of the lung to biopsy it," Takubo explained. "Half the time it was benign, but lung cancer is so dangerous that you didn't take a chance. Because there are so many twists and turns as the airways divide, a bronchoscopy only gave you about a 14 percent chance of getting where you wanted to go. When ENB was introduced in 2008, it was a game changer. If someone had a suspicious-looking spot on the lung, you could now triangulate your exact position and get to the spot without cutting the person open."
Takubo, who is also majority leader for the West Virginia state Senate and recently became executive vice president of provider relations for the West Virginia University Health System, completed an internal medicine residency with WVU and a pulmonary and critical care fellowship at East Tennessee State University. He said the specialties of pulmonology and critical care have enough in common that physicians considering these fields have multiple options once they finish an internal medicine residency.
"There's a lot of overlap between what a pulmonologist does and what a critical care doctor does. Because of that, you can do a two-year fellowship and become a pulmonologist, or you can do two years and become a critical care specialist — or you can combine them and do three years. The overlap allows you to shorten your fellowship," Takubo said.
He said one of the advantages of specializing in pulmonary medicine or critical care is that it can address one of the problems many of today's physicians face: the potential for burnout.
"If you're a trauma surgeon or emergency room doctor, it's exciting, but more excitement means more adrenaline, and more adrenaline means more fatigue," he said. "With pulmonary medicine, you get a mixture of office work, where you're not worrying about your pager, and higher intensity things like the hospital or intensive care unit. Having that mix extends your shelf life. You're not doing something with full intensity all the time. And critical care was challenging in the past because being on call was so difficult. But now it's changed, and most critical care is shift work, similar to what ER physicians do, which is better for quality of life."
It's especially important that medical schools produce physicians who become pulmonologists in the Mountain State, where, according to the West Virginia Division of Tobacco Prevention, 25.2 percent of adults are smokers, compared with 15.5 percent nationally. Takubo said that's just one of several reasons the demand for the specialty is high in the state.
"West Virginia has the highest incidence of smoking in the nation, and we have the coal industry, which can be damaging to the lungs because of silica dust. We're also in the 'Histo belt' — histoplasma capsulatum is a fungus dropped by birds and bats, and it ends up in the soil. It causes histoplasmosis, which leaves nodules in the lungs that doctors have to do imaging on because they look identical to lung cancer. All these things keep pulmonologists busy," he said.
Takubo, who was named to West Virginia Executive magazine's Health Care Hall of Fame in 2022, recommends that students enter medical school without preconceived ideas about their future specialty.
"Prior to or during medical school, you may be fixated on what you think you want to do. I would instead pay attention to what you love," he said. "I love being a pulmonary and critical care doctor and taking care of patients. I love the feeling you get when you're at a restaurant or store and somebody stops you and says, 'You saved my family member's life,' or even 'My family member didn't make it, but thank you for taking care of them.' Families see how hard we work to give everybody the best chance we can, and that's rewarding."
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