UPMC Physician Resources

Archives for Pediatrics

Childhood Cancer Focus of St. Baldrick’s Foundation Research Grant to Children’s Hospital of Pittsburgh of UPMC

PITTSBURGH, Nov. 21, 2014 – To improve information flow about childhood cancers, Jean M. Tersak, M.D., an oncologist in the Division of Pediatric Hematology/Oncology at Children’s Hospital of Pittsburgh of UPMC, has been awarded a one-year, $50,000 grant from the St. Baldrick’s Foundation, a volunteer-driven charity dedicated to raising money for childhood cancer research.

Dr. Tersak’s is one of 40 infrastructure grants totaling more than $2.5 million awarded by St. Baldrick’s to support pediatric oncology research. These grants provide resources to institutions to conduct more research and enroll more children in ongoing clinical trials.

The funding will help to support efforts to enhance website communication of research activities to make information more easily accessible to potential patients, families, and referring physicians. Additionally, funding will support the transition to a new database to increase efficiency and refine ability to query the database as a more effective tool to conduct institutional research.

“This generous grant from St. Baldrick’s will help us to be sure that our medical treatments are more widely known and available to anyone who may need them to battle a diagnosis of cancer as a child or young adult,” said Dr. Tersak, who also directs the Survivorship Program at Children’s Hospital. “The grant will increase the efficiency of our program and increase awareness of novel treatments available to patients form our region and beyond.”

“These grants are critically important to saving children’s lives, and would not be possible without our dedicated volunteers and generous donors who believe kids deserve better than medicine is currently able to provide,” said Kathleen Ruddy, chief executive officer for the St. Baldrick’s Foundation.

“Each day in my work, I encounter patients who have been helped along the way through the tremendous efforts of St. Baldrick’s,” added Dr. Tersak, also principal investigator, Children’s Oncology Group.

Dr. Tersak has a special interest in caring for survivors of childhood cancer, including evaluation for medical late effects of treatment and the quality of life in these survivors. She is involved in national research to better understand late effects, ways to prevent them, and early intervention when they do occur.

The Division of Pediatric Hematology/Oncology at Children’s provides diagnosis, treatment and complete follow-up for children, adolescents, and young adults with cancer and blood disorders. The division is the largest, most comprehensive pediatric cancer and blood disease center in western Pennsylvania, eastern Ohio, and northern West Virginia and has been a member of the Children’s Oncology Group, a multi-institutional pediatric cancer research organization sponsored by the National Cancer Institute, since 1961. It’s one of the top-rated pediatric cancer programs in the United States as ranked by U.S. News & World Report.

For more information about Dr. Tersak, please visit www.chp.edu.

Early Diagnosis and Cord Blood Transplantation Prevents Permanent Brain Damage From Rare Inherited Disease, Children’s Hospital of Pittsburgh of UPMC Study Finds

PITTSBURGH, Nov. 19, 2014 – Umbilical cord blood from unrelated donors can halt the progression of the neurodegenerative disease Hurler syndrome if performed before the affected child is less than 9 months old, according to a Children’s Hospital of Pittsburgh of UPMC study that appears online in Annals of Neurology. The findings emphasize the need for early diagnosis of the condition, preferably through newborn screening programs.

Hurler syndrome is the most clinically severe form of an inherited disorder in which the patient lacks a key enzyme needed to break down complex sugars called glycosaminoglycans. The sugar buildup results in progressive organ deterioration and death in childhood. Affected children may not have symptoms until age 3, but the brain undergoes damage before symptoms present.

Umbilical cord blood transplantation from unrelated donors has previously been shown to improve neurological outcomes of children over 2 years of age and prolong life. Hematopoietic stem cells from the cord blood transplants provide a source for the normal enzyme that is donated to the deficient cells decreasing the accumulation of gycosaminoglycans.

Key findings of this study show that treatment of Hurler syndrome with umbilical cord blood transplantation before 9 months of age leads to normal cognitive development. The researchers found children transplanted at 12 and 25 months of age functioned cognitively at a level 2 to 5.3 years below that of those transplanted at 4 months. Early transplantation also predicted better outcomes for language skills and adaptive behaviors.

“The purpose of the study was to determine whether age at transplantation can predict cognitive outcomes,” said Maria Luisa Escolar, MD, MS, director, Program for the Study of Neurodevelopment in Rare Disorders, Children’s Hospital, and associate professor of pediatrics, University of Pittsburgh School of Medicine. “This study highlights the importance of early detection of brain diseases in babies and infants when brain growth is the most accelerated in life, placing them at increased vulnerability for permanent damage.”

Between June 1997 and February 2013, 31 children with Hurler syndrome underwent umbilical cord blood transplantation and were evaluated every six to 12 months thereafter for an average of seven years. Median age at transplantation was 13.8 months. The youngest babies in the study were diagnosed due to family history of the condition.

“Identification of asymptomatic children through statewide newborn screening programs is the only way to diagnose early and prevent brain damage to babies with no family history of Hurler syndrome,” Dr. Escolar said.

“Unfortunately, early diagnosis is often difficult as their initial symptoms may be common in the general population,” added Dr. Escolar. “Therefore, there is a need for newborn screening for Hurler syndrome and similar neurodegenerative diseases that can identify children before symptoms appear, giving the best opportunity for prompt intervention and optimal outcomes.”

Collaborators with Dr. Escolar on the study were Michele Poe, PhD, and Sarah Chagnon, MD, both with Children’s Hospital of Pittsburgh of UPMC.

Financial support for this work was received from the Caterina Marcus Foundation.

For more information on Dr. Escolar and the Program for the Study of Neurodevelopment in Rare Disorders, visit www.chp.edu/ndrd.

Cyber Dating Abuse Common Among Teens, Children’s Hospital of Pittsburgh of UPMC Study Finds

PITTSBURGH, Nov. 17, 2014 – Two in five teens surveyed experienced cyber dating abuse, which involves the use of technology to control, harass, threaten or stalk another person in the context of a dating relationship, in the previous three months, according to a Children’s Hospital of Pittsburgh of UPMC study that appears online today in Pediatrics.

The study is the first about cyber dating abuse among a group of young people who are using school-based health services, said senior investigator Elizabeth Miller, M.D., Ph.D., chief, Division of Adolescent and Young Adult Medicine at Children’s Hospital.

Done in collaboration with the California Adolescent Health Collaborative of the Public Health Institute, California School-Based Health Alliance and Futures Without Violence, the study was conducted at eight school-based health centers in California where students receive confidential clinical health services, including annual check-ups, sports physicals and birth control. The study, conducted during the 2012-2013 school year, assessed teens ages 14 to 19, for exposure to cyber dating abuse, adolescent relationship abuse, sexual behavior, and care-seeking for sexual and reproductive health.

Key findings showed 41 percent of teens reported experiencing this form of abuse within the last three months, with more females than males reporting such victimization. Most commonly, their partners used technology including mobile apps, social networks, texts, or other digital communication to repeatedly contact them to see where they were and who they were with.

“These findings underscore that cyber dating abuse is an emerging concern,” said Dr. Miller, also an associate professor of pediatrics, University of Pittsburgh School of Medicine. “We need to support prevention efforts that increase education about the many different forms of abuse in adolescent relationships, and to encourage parents, teachers, coaches and others to talk to young people about what healthy relationships look like.”

Like previous research examining this form of abuse, the researchers found that teens exposed to cyber dating abuse were more likely to also experience other forms of physical and sexual dating abuse, such as being slapped, choked or made to have sex by a dating partner, and also non-partner sexual assault. Additionally, greater exposure to cyber dating abuse was associated with less contraceptive use among adolescent girls.

“It is concerning to see such a large number of young people reporting these cyber dating abuse experiences, and to learn that experiencing this form of abuse is associated with other unhealthy behaviors such as not using any method of contraception for birth control,” said Rebecca Dick, MS, clinical research coordinator, Division of Adolescent and Young Adult Medicine at Children’s, and the first author of the study.

“Professionals should take cyber dating abuse seriously and actively ask teens if they are being monitored, threatened or sexually coerced by their partner using technology-based communication,” added Dr. Miller. “Given the prevalence of cyber dating abuse in this sample of adolescents, we recommend that relationship abuse prevention education include cyber dating abuse and that such education and counseling be integrated into health assessments in clinical settings.”

Collaborators with Dr. Miller on the study were: Rebecca Dick, MS, Heather L. McCauley, Sc.D., Kelley Jones, MPH, all with Children’s Hospital of Pittsburgh of UPMC; Daniel J. Tancredi, Ph.D., University of California Davis School of Medicine; Sandi Goldstein, MPH, Alison Chopel, DrPH, California Adolescent Health Collaborative, Public Health Institute; Samantha Blackburn, RN, MSN, PNP, California School-Based Health Alliance and California State University Sacramento School of Nursing; Erica Monasterio, RN, MN, FNP-BC, University of California San Francisco School of Nursing; Lisa James, MS, Futures Without Violence; and Jay G. Silverman, Ph.D., University of California, San Diego School of Medicine.

The study was supported by Award No. 2011-MU-MU-0023, awarded by the National Institute of Justice, Office of Justice Programs, U.S. Department of Justice.

For more information on Dr. Miller and the Division of Adolescent and Young Adult Medicine, visit www.chp.edu/CHP/am.

FDA Approves Blood Test Developed by UPMC Researchers to Predict Rejection in Organ Transplant Recipients

PITTSBURGH, Nov. 5, 2014 – A first-of-its-kind, personalized blood test to predict the likelihood of organ rejection in children with liver or intestine transplants has received U.S. Food and Drug Administration (FDA) approval. The test was developed by researchers at Children’s Hospital of Pittsburgh of UPMC to determine a personalized rejection-risk index with cell-based technology.

Cellular rejection affects half of all transplant recipients in their lifetime. If unchecked, rejection can lead to progressive loss of function of the transplanted organ. Therefore, predicting whether rejection will occur is an essential part of the recipient’s care, and has been an unmet need until recently. A biopsy is used to detect ongoing rejection, but this surgical procedure cannot predict rejection.

The research team led by Rakesh Sindhi, M.D., F.A.C.S., co-director, pediatric transplantation, at the Hillman Center for Pediatric Transplantation at Children’s, began work on this test system in late 2006. The technology was licensed by the University of Pittsburgh to Plexision, a Pittsburgh-based biotech company, for development.

Pleximmune, as the test is named, predicts acute cellular rejection with an accuracy approaching or exceeding 80 percent under a variety of conditions. This performance has been established in a study involving more than 200 children who received liver or intestine transplants at Children’s Hospital.

“A common theme in every encounter with our patients is an assessment of whether that child is at risk for rejection and whether this risk will be affected by the planned treatment,” said Dr. Sindhi, who is also director of pediatric transplant research. “It is hoped that the information from such personalized blood tests will improve clinical decision-making and benefit patients in the long run.”

“Our whole philosophy here at Children’s Hospital centers on improving outcomes after transplantation and achieving the goal of a normal life for all the children we transplant,” said George Mazariegos, M.D., F.A.C.S., chief, pediatric transplantation. “This test is a step toward achieving that goal. And it is doubly exciting that the research in Dr. Sindhi’s lab is affecting children at the bedside so directly.”

The Hillman Center for Pediatric Transplantation at Children’s Hospital maintains one of the busiest and most experienced pediatric transplant centers in the United States. The center was established in 1981 under renowned transplant pioneer Thomas E. Starzl, M.D., Ph.D., as the nation’s first pediatric transplant program. Children’s is one of the most active transplant centers for infants, children and adolescents with referrals from all over the world. The team specializes in heart, lung, liver, intestine, multivisceral, kidney, and blood and marrow transplants, and achieves patient outcomes that rank among the world’s best.

Dr. Sindhi is the inventor of technology licensed to Plexision, on which this test system is based. The University of Pittsburgh holds equity in the company; Dr. Sindhi has an unpaid consulting relationship with the company.

For more information on Dr. Sindhi and the Hillman Center for Pediatric Transplantation, visit www.chp.edu/transplant.

Brain Care Institute Members Among Most Prolific Authors on Traumatic Brain Injury Worldwide

PITTSBURGH, Oct. 30, 2014 – A study into research on traumatic brain injury (TBI) over the last 15 years by ScienceWatch—a Thomson Reuters open Web resource for science metrics and research performance analysis—revealed that the volume of research has increased markedly in recent years, spurred by the wars in Iraq and Afghanistan, as well as sports-related brain injuries. ScienceWatch determined that the most prolific of authors in the TBI dataset is Patrick Kochanek, MD, professor and vice chairman in the Department of Critical Care Medicine at the University of Pittsburgh School of Medicine, who contributed to 300 reports that have resulted in almost 3,800 citations. Among Dr. Kochanek’s co-authors on more than one-third of the papers is Robert S.B. Clark, MD, chief of Pediatric Critical Care Medicine at Children’s Hospital of Pittsburgh of UPMC. Both Dr. Kochanek and Dr. Clark are members of the pediatric critical care team at the Brain Care Institute at Children’s Hospital of Pittsburgh of UPMC.

Among institutions, the University of Pittsburgh topped both the list of most prolific and the list of most-cited institutions. Other highly cited University of Pittsburgh authors are Dr. Clark and Michael “Micky” Collins, PhD, UPMC Sports Medicine.

The volume of papers on TBI has increased significantly over the years. In 2001 just over 1,100 research papers were published — a number that nearly quadrupled in 2013. Similarly, in 2010 TBI was a diagnosis in more than 280,000 hospitalizations and 2.2 million emergency room visits, and a cause in more than 50,000 deaths, according to the Centers for Disease Control and Prevention. Between 2001 and 2009, the rate of emergency room visits for sports or other injuries with a diagnosis of TBI rose 57 percent in those 19 or younger.

For more information on the study, please visit the Special Topic: Traumatic Brain Injury page.

Pitt Public Health Finds Association Between Air Toxics and Childhood Autism

PITTSBURGH, Oct. 22, 2014 – Children with autism spectrum disorder (ASD) were more likely to have been exposed to higher levels of certain air toxics during their mothers’ pregnancies and the first two years of life compared to children without the condition, according to the preliminary findings of a University of Pittsburgh Graduate School of Public Health investigation of children in southwestern Pennsylvania.

This research, funded by The Heinz Endowments, will be presented today at the American Association for Aerosol Research annual meeting in Orlando, Fla.

“Autism spectrum disorders are a major public health problem, and their prevalence has increased dramatically,” said Evelyn Talbott, Dr.P.H., principal investigator of the analysis and professor of epidemiology at Pitt Public Health. “Despite its serious social impact, the causes of autism are poorly understood. Very few studies of autism have included environmental exposures while taking into account other personal and behavioral risk factors. Our analysis is an addition to the small but growing body of research that considers air toxics as one of the risk factors for ASD.”

Dr. Talbott and her colleagues performed a population-based study of families with and without ASD living in six southwestern Pennsylvania counties. The researchers found links between increased levels of chromium and styrene and childhood autism spectrum disorder, a condition that affects one in 68 children.

“This study brings us a step closer toward understanding why autism affects so many families in the Pittsburgh region and nationwide – and reinforces in sobering detail that air quality matters,” said Grant Oliphant, president of The Heinz Endowments. “Our aspirations for truly becoming the most livable city cannot be realized if our children’s health is threatened by dangerous levels of air toxics. Addressing this issue must remain one of our region’s top priorities.”

Autism spectrum disorders are a range of conditions characterized by social deficits and communication difficulties that typically become apparent early in childhood. Reported cases of ASD have risen nearly eight-fold in the last two decades. While previous studies have shown the increase to be partially due to changes in diagnostic practices and greater public awareness of autism, this does not fully explain the increased prevalence. Both genetic and environmental factors are believed to be partially responsible.

Dr. Talbott and her team interviewed 217 families of children with ASD and compared these findings with information from two separate sets of comparison families of children without ASD born during the same time period within the six-county area. The families lived in Allegheny, Armstrong, Beaver, Butler, Washington and Westmoreland counties, and the children were born between 2005 and 2009.

One of the strengths of the study was the ability to have “two types of controls, which provided a comparison of representative air toxics in neighborhoods of those children with and without ASD,” said Dr. Talbott.

For each family, the team used the National Air Toxics Assessment (NATA) to estimate the exposure to 30 pollutants known to cause endocrine disruption or neurodevelopmental issues. NATA is the Environmental Protection Agency’s (EPA) ongoing comprehensive evaluation of air toxics in the U.S., most recently conducted in 2005.

Based on the child’s exposure to concentrations of air toxics during the mother’s pregnancy and the first two years of life, the researchers noted that children who fell into higher exposure groups to styrene and chromium were at a 1.4- to two-fold greater risk of ASD, after accounting for the age of the mother, maternal cigarette smoking, race and education. Other NATA compounds associated with increased risk included cyanide, methylene chloride, methanol and arsenic. As these compounds often are found in combination with each other, further study is needed.

Styrene is used in the production of plastics and paints, but also is one of the products of combustion when burning gasoline in vehicles. Chromium is a heavy metal, and air pollution containing it typically is the result of industrial processes and the hardening of steel, but it also can come from power plants. Cyanide, methylene chloride, methanol and arsenic are all used in a number of industries or can be found in vehicle exhaust.

“Our results add to the growing body of evidence linking environmental exposures, such as air pollution, to ASD,” said Dr. Talbott. “The next step will be confirming our findings with studies that measure the specific exposure to air pollutants at an individual level to verify these EPA-modeled estimates.”

Additional investigators on this study were Vincent Arena, Ph.D., Judith Rager, M.P.H., Ravi Sharma, Ph.D., and Lynne Marshall, M.S., all of Pitt.

Children’s Brain Care Institute Researcher to Be Featured in Documentary on Multiple Sclerosis

PITTSBURGH, Oct. 15, 2014 – A researcher from the Division of Child Neurology at Children’s Hospital of Pittsburgh of UPMC, will be profiled in an upcoming documentary produced by the National Multiple Sclerosis (MS) Society. Sharyl L. Fyffe-Maricich, PhD, assistant professor of pediatrics at the University of Pittsburgh School of Medicine, will be one of four female researchers who work in MS featured in the film.

MS is the most prevalent neurodegenerative disease in young adults, affecting more than 2 million people worldwide. The mission of the National MS Society is to mobilize people and resources to drive research for a cure and address the challenges of everyone affected by MS.

Dr. Fyffe-Maricich’s lab is interested in understanding the molecules and signaling pathways that are essential for controlling the onset of myelination and determining the thickness of the myelin sheaths that are generated. The importance of myelination becomes obvious in diseases such as multiple sclerosis where autoimmune-mediated demyelination throughout the central nervous system (CNS) results in devastating functional disability. Her lab is interested in learning more about these processes both during development and after demyelinating injuries in the adult.

To investigate, Dr. Fyffe-Maricich and her colleagues use a variety of techniques, including rodent behavioral analysis, immunohistochemistry, electron microscopy, cell culture, and biochemistry to analyze various genetic mouse mutants. The ultimate goal of Dr. Fyffe-Maricich’s work is to develop new treatment approaches for patients with MS.

Children’s Hospital of Pittsburgh of UPMC Partners with Tampa Hospital to Provide Cardiothoracic Services

PITTSBURGH, Oct. 2, 2014 Children’s Hospital of Pittsburgh of UPMC today announced a partnership with St. Joseph’s Children’s Hospital in Tampa, Fla., to assist their team with pediatric cardiothoracic services. Surgeons from the Heart Institute at Children’s Hospital of Pittsburgh will provide highly specialized cardiovascular care for patients.

The partnership will be led by Victor Morell, M.D., co-director of the Heart Institute at Children’s Hospital of Pittsburgh of UPMC and chief of the Division of Pediatric Cardiothoracic Surgery.

Children’s Hospital of Pittsburgh’s pediatric cardiovascular surgery program has the lowest overall four-year surgical mortality rate among all medium- and high-volume programs with a rate of 1.1 percent, according to the latest data compiled by the Society of Thoracic Surgeons (2008-2012).

“We are grateful for the opportunity to bring our unique expertise in pediatric heart surgery to families in Florida,” said Dr. Morell. “We share a commitment with St. Joseph’s Children’s Hospital to provide the absolute best possible pediatric care to patients and families from the Tampa area and beyond.”

In addition to collaborating with St. Joseph’s Children’s Hospital’s cardiac team on surgical and non-invasive cardiology services, Children’s Hospital of Pittsburgh’s experts will provide support to patients, families and caregivers in St. Joseph’s Children’s Hospital’s cardiac intensive care unit via telemedicine.

Children’s Hospital of Pittsburgh is leading the way in the development of telemedicine services to meet the needs of young patients regionally and around the world with video conferencing technologies that provide complex pediatric cardiac care through remote and virtual examinations — whenever and wherever expertise is needed.

For nearly two decades, St. Joseph’s Children’s Hospital has provided a full spectrum of pediatric cardiac services, from less-invasive diagnostic catheterization, nonsurgical valve replacement and electrophysiology studies, to cardiovascular surgery for the rarest and most complex congenital heart defects. St. Joseph’s Children’s Hospital has been home to one of the largest pediatric cardiovascular programs in the southeast and is a regional referral center for the diagnosis and treatment of congenital heart defects.

Prior to joining Children’s Hospital of Pittsburgh of UPMC in 2004, Dr. Morell led the pediatric cardiac surgical team at St. Joseph’s Children’s Hospital.

“This partnership brings the expertise of some of the country’s top-ranking pediatric heart physicians to our community, providing families across Florida with unprecedented access to the highest level of pediatric heart care available,” said Kimberly Guy, president, St. Joseph’s Children’s Hospital.

Third Mellon Scholar Appointed to The Richard King Mellon Foundation Institute for Pediatric Research at Children’s Hospital of Pittsburgh of UPMC

PITTSBURGH, Sept. 17, 2014 – Bernhard Kühn, M.D., a physician-scientist whose research focuses on heart failure, has been named a Scholar within the Richard King Mellon Foundation Institute for Pediatric Research and Director of Research for the Division of Cardiology at Children’s Hospital of Pittsburgh of UPMC.

Dr. Kühn is the third physician-scientist in the Mellon Scholars Program, which enables promising researchers in the early stages of their careers to pursue potential breakthrough research projects in biomedicine.

Dr. Kühn is a board-certified and practicing pediatric cardiologist whose research focuses on regenerative therapies for the heart. The long-term objective of his research is to provide novel approaches and molecular targets for the treatment of heart failure, primarily by studying the mechanisms of growth and regeneration of the myocardium, the muscle tissue of the heart.

“The recruitment of Dr. Kühn will bring in one of the leading researchers in heart regeneration to further explore heart cell growth and to give hope to advancing  treatments for heart failure, said Jay Kolls, M.D., director. “He will be an outstanding addition to the Mellon Scholar Program to continually increase our understanding of the causes and treatment of pediatric diseases.”

Dr. Kühn, also associate professor of pediatrics at the University of Pittsburgh School of Medicine, earned his medical and doctoral degrees from Freie Universität Berlin in Germany. He completed his post-doctoral fellowship at Boston Children’s Hospital where he then established an independent research lab in 2005.

In a landmark paper published in the highly prestigious journal Cell, Dr. Kühn showed that heart muscle cells, previously thought to be incapable of proliferating, could be induced to divide with the growth factor neuregulin1. This research has opened up the possibility of using this growth factor to stimulate heart regeneration. In a follow up study published in the Proceedings of the National Academy of Sciences, the Kühn lab showed that in humans, heart muscle cell proliferation is a mechanism of heart growth in infants and children. Together, these two papers provide the foundation for administering the growth factor to stimulate heart regeneration in pediatric patients with heart failure.

Scholars are selected on the basis of work that is highly innovative, delivering new expertise to the biomedical research community; likely to lead to major breakthroughs; and capable of having a long-lasting impact on the practice of medicine.

Stephen Maricich, M.D., Ph.D., and Timothy Sanders, M.D., Ph.D., were the first two physician-scientists recruited for the Mellon Scholars Program.

Established through a groundbreaking gift from the Richard King Mellon Foundation, the Institute is an incubator for research that challenges conventional wisdom and can lead to paradigm shifts in pediatric medicine. This kind of high-risk, high-impact investigation is not typically funded through government or conventional sources, placing Children’s Hospital in a unique realm of pediatric research centers. Dr. Kolls’ goal is to recruit a total of five scholars.

Located within the John G. Rangos Sr. Research Center on Children’s main campus, the Institute’s faculty and programs are a part of the University of Pittsburgh School of Medicine. For more information on The Richard King Mellon Foundation Institute for Pediatric Research, please visit www.chp.edu/mellon.

UPMC Residency Programs Rank Nationally

Physician network Doximity, along with U.S. News & World Report, announced the first comprehensive national evaluation of residency programs. In these results, 11 UPMC programs ranked in the top 10.

To determine the rankings, 3,691 residency training programs were evaluated by combining over 50,000 peer nominations from board-certified US physicians. U.S. News & World Report, nationally known for their education and health care rankings, consulted on the methodology.

Here is a listing of UPMC programs in the top 10:

  • Anesthesiology: No. 10
  • Obstetrics and gynecology: No. 3
  • Plastic surgery (integrated): No. 3
  • Otolaryngology: No. 4
  • Emergency medicine: No. 7
  • Physical medicine and rehabilitation: No. 7
  • Psychiatry: No. 7
  • Orthopaedic surgery: No. 8
  • Pediatrics: No. 8
  • Neurological surgery: No. 9
  • Surgery: No. 10

The results are used in a free tool from Doximity called Residency Navigator. The tool is designed for third- and fourth-year medical students.

Page 1 of 9:1 2 3 4 »Last »