Dynamic Opportunities for Medical Students to Assume the Roles of "Medical Teacher".

The traditional undergraduate medical education curriculum focuses on bolstering knowledge for practice and building clinical skills. However, as future clinicians, medical students will be tasked with teaching throughout their careers, first as residents and then as attendings. Here, we describe teaching opportunities for students that foster their development as future teachers and potential clinician educators. These offerings are diverse in their focus and duration and are offered across various levels of the curriculum - including course-based learning, longitudinal electives, and extra-curricular opportunities for medical students who have a passion for teaching.

Mentors and Role Models: the Role Female Medical Educators Serve for Female Medical Students.

Discussion of diversity, equity, and inclusion (DEI) has moved to the forefront in medical education, and in particular, efforts toward gender equity have emphasized the need for more women faculty and physicians. Gender parity was recently achieved for medical students matriculating into US allopathic schools during the 2017-2018 academic year1. However, this documented increase in women attending medical school as students is not matched by an increase in women teaching in the undergraduate medical education (UME) curriculum. In 2020, the faculty employed by medical schools across the USA (totaling 186,311) includes 43% women; this percentage drops significantly when considering the rank of full professor, of which only 26% are women [1]. For faculty representing graduate programs in science, technology, engineering, and math (STEM), many of which teach in the pre-clerkship phase of UME, less than 25% are women [2], according to the 2019 AAMC statement of gender equity. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01776-1.

Impact of Experiential Learning of Nutrition Therapy on Medical Students.

Despite the recognition that nutrition is a critical component of health and disease, many medical schools struggle to incorporate nutrition education into their dense curriculum. We designed this study to determine whether a brief, experiential learning project would be an effective option for teaching this content. Medical students voluntarily enrolled in the study, agreeing to (1) attempt a 2-week "medically prescribed" diet and (2) participate in small group lunch discussions related to their diet experience. Data on student perception of nutrition in medicine was collected through validated surveys. Custom surveys were designed to capture student confidence in using nutrition counseling, while qualitative analysis of lunch discussions revealed themes of experiential learning. Participants reported an overall positive sentiment and named the most impactful learning component as actively attempting the diet. Student participants showed a variety of adherence to their assigned diet, yet as a cohort demonstrated increased confidence over their non-participant peers in the use of nutrition counseling in a clinical setting. In addition, diet participants demonstrated an increased perception of the importance of physician efficacy and the physician-patient relationship in the broader landscape of nutrition in patient care (compared to the control group). This study demonstrates the educational value of a short, immersive, extracurricular opportunity in bolstering an already demanding undergraduate medical education curriculum.

Completely humanizing prolactin rescues infertility in prolactin knockout mice and leads to human prolactin expression in extrapituitary mouse tissues.

A variety of fundamental differences have evolved in the physiology of the human and rodent prolactin (PRL) systems. The PRL gene in humans and other primates contains an alternative promoter, 5.8 kbp upstream of the pituitary transcription start site, which drives expression of PRL in "extrapituitary" tissues, where PRL is believed to exert local, or paracrine, actions. Several of these extrapituitary PRL tissues serve a reproductive function (eg, mammary gland, decidua, prostate, etc), consistent with the hypothesis that local PRL production may be involved in, and required for, normal reproductive physiology in primates. Rodent research models have generated significant findings regarding the role of PRL in reproduction. Specifically, disruption (knockout) of either the PRL gene or its receptor causes profound female reproductive defects at several levels (ovaries, preimplantation endometrium, mammary glands). However, the rodent PRL gene differs significantly from the human, most notably lacking the alternative promoter. Understanding of the physiological regulation and function of extrapituitary PRL has been limited by the absence of a readily accessible experimental model, because the rodent PRL gene does not contain the alternative promoter. To overcome these limitations, we have generated mice that have been "humanized" with regard to the structural gene and tissue expression of PRL. Here, we present the characterization of these animals, demonstrating that the human PRL transgene is responsive to known physiological regulators both in vitro and in vivo. More importantly, the expression of the human PRL transgene is able to rescue the reproductive defects observed in mouse PRL knockout (mPRL(-)) females, validating their usefulness in studying the function or regulation of this hormone in a manner that is relevant to human physiology.

Estrogen regulation of the dopamine-activated GIRK channel in pituitary lactotrophs: implications for regulation of prolactin release during the estrous cycle.

Prolactin (PRL), synthesized and secreted from lactotrophs of the anterior pituitary gland, is tonically inhibited by hypothalamic dopamine (DA) throughout the female reproductive (estrous) cycle. Our laboratory has shown that DA hyperpolarizes these cells by activating G protein-coupled inwardly rectifying K(+) (GIRK) channels; however, this response is only observed on proestrus. While the cellular mechanisms that allow for functional expression of this unique DA-signaling pathway are unclear, we hypothesized that activation of the DA-GIRK effector pathway is due to the rise in circulating estrogen (E2) during the preceding day of diestrus. Thus, we examined the effects of E2 on primary lactotrophs isolated from female rats. Treatment with a physiological concentration of E2 (40-80 pg/ml, in vivo or in vitro) induced a proestrous phenotype in diestrous lactotrophs. These cells exhibited a DA-induced membrane hyperpolarization, as well as a secretory rebound of PRL following DA withdrawal (characteristic of proestrous cells). Internal dialysis of GTPγS demonstrated that E2 exposure enabled functional expression of GIRK channels, and this regulation by E2 did not involve the D2R. The effect of E2 was blocked by the receptor antagonist, ICI 182,780, and by the protein synthesis inhibitor, cycloheximide. Single-cell analysis revealed increased mRNA expression of GIRK channel subunits in E2-treated lactotrophs. While E2 is known to have multiple actions on the lactotroph, the present findings illuminate a novel action of E2 in lactotrophs-regulation of the expression of a DA effector, the GIRK channel.