Exchange Observeship
Program

Introduction

The Exchange Observership Program at Faculdade Israelita de Ciencias da Saude Albert Einstein (FICSAE) offers selected medical students the opportunity to participate in one or more visiting observership rotations at Albert Einstein Hospital or one of the FICSAE-affiliated facilities in Sao Paulo, Brazil.

São Paulo is a cosmopolitan city located in the Southeast region of Brazil. It is the world’s 4th largest city by population, and the largest economy by GDP in the southern hemisphere. Although students may sometimes expect getting in contact with tropical and neglected diseases when they select Brazil as their destination, this is not the case for the Albert Einstein Hospital rotations. Albert Einstein Hospital is a non-profit, 630-bed academic tertiary hospital ranked as one of the world’s best hospitals by the NEWSWEEK magazine in 2020, 2021 and 2022. It excels in implementing state-of-the art medical technologies in several medical specialties, including robotic surgery, solid organs and stem cell transplant, oncology, cardiology, neurology, orthopedics, and intensive care. Albert Einstein Hospital is also engaged in activities in the public sector, operating 22 public health units; the Family Health Strategy alone has over 1000 professionals working in 82 teams.

The program is open to international students from medical schools affiliated to the AAMC’s Visiting Student Learning Opportunities (VSLO) program, and to academic medical institutions based on prior collaboration agreement.

Each observership rotation comprises a 4-week experience. Our goal is to offer English or Portuguese-speaking international students advanced clinical and research experiences in FICSAE-affiliated facilities based on affinity and placement availability. Due to limited slots, applicants are allowed to submit requirements for up to 2 rotations for the same period, indicating their first and second options. Whenever possible, selected students will be placed in their first rotation option. Additionally, applicants may request approval for participation in more than one rotation of the program, completing more than one 4-week rotation either consecutively or intermittently. However, concurrent placement in more than one rotation is not feasible and not permitted.

Selection will be based on the applicant’s academic and extracurricular records. FICSAE will make all efforts to implement fair and equitable selection of applicants based on gender and race.

Faculdade Israelita de Ciencias da Saude Albert Einstein, São Paulo, Brazil
Academic years 2022-2024

Contact E-mail: exchange.program@einstein.br

Program coordinator: Vivian Avelino-Silva, MD PhD
vivian.avelino@einstein.br

Program manager: Bianca Barreto
bianca.barreto@einstein.br

Observership rotations

1. Course coordinator: Clarissa Willets, MD PhD (e-mail: clarissa.willets@einstein.br )

2. Clerkship description: The observership provides experience in ambulatory/primary care issues in Family Medicine. This experience includes home visits and community-based consultations for vulnerable populations living in underprivileged areas and favelas (slums), highlighting how community factors, neighborhood and social contexts influence patient care. Students can expand existing skills in medical interviewing and physical diagnosis while developing additional skills in differential diagnosis, health care maintenance, patient counseling, and psycho-social issues, with preceptor supervision.

3. Pre-requisites: The Primary Care/Family Medicine rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: TBD

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: April and September, early. NOT available for the 2022 academic year.

7. Other information: Students will be required to evaluate the course and sites.

Primary Care/Family Medicine rotation program:

  • TBD

1. Course coordinator: Luis Fernando Aranha Camargo, MD PhD (e-mail: luis.camargo@einstein.br ).

2. Clerkship description: The observership provides experience in ambulatory/hospital care issues in Infectious Diseases, with a focus on the diagnosis and clinical management of immunocompromised patients and antimicrobial therapy prescription, with preceptor supervision. This rotation includes visits to the clinical laboratory, which provides a unique opportunity to expand existing skills in the investigation of differential diagnosis for the immunocompromised patient using innovative laboratory technologies.

3. Pre-requisites: The Infectious Diseases rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: Hospital Albert Einstein; Vila Mariana unit.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: February to November yearly.

7. Other information: Students will be required to evaluate the course and sites.

Infectious Diseases rotation program:

ActivityMondayTuesdayWednesdayThursdayFriday
Week 1MorningInpatient HIAEInpatient HIAEInpatient HIAESeminar and
case discussions
Inpatient HIAE
AfternoonScientific meetingLab activitiesLabLab activitiesOutpatient unit
(Vila Mariana)
Week 2MorningInpatient HIAEInpatient HIAEInpatient HIAESeminar and
case discussions
Inpatient HIAE
AfternoonScientific meetingLab activitiesLabLab activitiesOutpatient unit
(Vila Mariana)
Week 3MorningInpatient HIAEInpatient HIAEInpatient HIAESeminar and case
discussions
Inpatient HIAE
AfternoonScientific meetingLab activitiesLabLab activitiesOutpatient unit
(Vila Mariana)
Week 4MorningInpatient HIAEInpatient HIAEInpatient HIAESeminar and
case discussions
Inpatient HIAE
AfternoonScientific meetingLab activitiesLabLab activitiesOutpatient unit
(Vila Mariana)

1. Course coordinator: Luci Hidal, MD MSc (e-mail: luci.hidal@einstein.br ).

2. Clerkship description: The observership provides experience in ambulatory/hospital care issues in Otolaryngology (ear, nose, and throat - ENT) and Head and Neck surgery. This experience includes clinical evaluations of a diversity of conditions, diagnostic investigation using laboratory, radiology and anatomopathology resources, as well as observation of small and large surgical procedures.

3. Pre-requisites: The Otolaryngology rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: Hospital Albert Einstein.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: February to November, yearly.

7. Other information: Students will be required to evaluate the course and sites.

Otolaryngology/Head and neck surgery rotation program:

ActivityMondayTuesdayWednesdayThursdayFriday
Week 1MorningAudiology unitSurgical center
Radiology + head
and neck meeting
Surgical centerSurgical center
Head and neck
tumor board
Surgical center
AfternoonVisit to UBS with
local student
Project Scientific
project –Dr Fabio
Visit M’Boi MirimTelemedicina visitOutpatient unit
(clinica cuidar)
Week 2MorningAudiology unitSurgical center
Radiology + head
and neck meeting
Surgical centerSurgical center
Head and neck
tumor board
Surgical center
AfternoonVisit to UBSProject Scientific
project –Dr Fabio
Visit M’Boi MirimFreeOutpatient unit
(clinica cuidar)
Week 3MorningAudiology unitSurgical center
Radiology + head
and neck meeting
Surgical centerSurgical center
Head and neck
tumor board
Surgical center
AfternoonVisit UBSScientific projectVisit M’Boi MirimFreeOutpatient unit
(clinica cuidar)
Week 4MorningAudiology unitSurgical center
Radiology + head
and neck meeting
Surgical centerSurgical center
Head and neck
tumor board
Surgical center
AfternoonVisit UBSScientific projectVisit M’Boi MirimOutpatient unit
(clinica cuidar)

1. Course coordinator: Nelson Hamerschlak, MD PhD (e-mail: hamer@einstein.br )

2. Clerkship description: The observership provides experience in ambulatory/hospital care in Hematology, including the clinical management of patients with hematological cancers, blood bank and cell therapy. This experience includes visits to the clinical laboratory, which provides a unique opportunity to expand existing skills in the investigation of differential diagnosis for patients with hematological diseases using innovative laboratory technologies.

3. Pre-requisites: The Hematology rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: Hospital Albert Einstein.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: February to November, yearly.

7. Other information: Students will be required to evaluate the course and sites.

Hematology rotation program:

Week 1: Hematology unit - inpatient care

Week 2: Bone Marrow Transplantation unit - inpatient care

Week 3: Hematology and Bone Marrow Transplantation - outpatient care

Week 4: Blood bank and cell therapy

1. Course coordinator: Rafael Kaliks, MD PhD (e-mail: rkaliks@einstein.br ).

2. Clerkship description: The observership provides experience in ambulatory/hospital care in Oncology, with a comprehensive overview of diagnostics and care, including cancer genetics, radiology, radiotherapy, immunotherapy, palliative care, and pathology. Students will also participate in clinical rounds and department meetings (Tumor Boards).

3. Pre-requisites: The Oncology rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: Hospital Albert Einstein.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: February to November, yearly.

7. Other information: Students will be required to evaluate the course and sites.

Oncology rotation program:

ActivityMondayTuesdayWednesdayThursdayFriday
Week 1MorningInpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAE
AfternoonRadiotherapyCancer geneticsBreast cancer clinicGeneral oncologyLung cancer
clinic
Week 2MorningInpatient HIAEInpatient HIAEInpatient HIAEInpatient
Palliative care HIAE
Inpatient HIAE
AfternoonRadiotherapyOutpatient clinicBreast cancer clinicGeneral oncologyLung cancer
clinic
Week 3MorningInpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAEGeneral oncology
AfternoonPathologyCancer geneticsBreast tumorsGeneral oncologyLung cancer
clinic
Week 4MorningInpatient HIAEInpatient HIAEInpatient HIAEInpatient
Palliative care
Inpatient HIAE
AfternoonPathologyOutpatient clinicBreast tumorsGeneral oncology

1. Course coordinator: Fernando Bacal, MD PhD (e-mail: fernando.bacal@einstein.br ).

2. Clerkship description: The observership provides experience in ambulatory/hospital care for patients with advance heart failure and patients enlisted for heart transplant, as well as patients who underwent a heart transplant. This experience provides a unique opportunity to expand existing skills in the care of patients with severe cardiac insufficiency; it also provides an overview of the management of post-transplant immunosuppression and post-transplant complications.

3. Pre-requisites: The heart failure and heart transplant rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: Hospital Albert Einstein, Vila Mariana Unit.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: February to November, yearly.

7. Other information: Students will be required to evaluate the course and sites.

Heart failure and heart transplant rotation program:

ActivityMondayTuesdayWednesdayThursdayFriday
Week 1MorningInpatient HIAE
Department meeting
Inpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAE
AfternoonOutpatient clinicOutpatient clinicInpatient HIAEInpatient HIAEInpatient HIAE
Week 2MorningInpatient HIAE
Department meeting
Inpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAE
AfternoonOutpatient clinicOutpatient clinicInpatient HIAEOutpatient clinic
HIAE
Inpatient HIAE
Week 3MorningInpatient HIAE
Department meeting
Inpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAE
AfternoonOutpatient clinicOutpatient clinicInpatient HIAEInpatient HIAEInpatient HIAE
Week 4MorningInpatient HIAE
Department meeting
Inpatient HIAEInpatient HIAEInpatient HIAEInpatient HIAE
AfternoonOutpatient clinicOutpatient clinicInpatient HIAEOutpatient clinic
HIAE
Inpatient HIAE

1. Course coordinator: Ronaldo Baroni, MD PhD (e-mail: ronaldo.baroni@einstein.br ).

2. Clerkship description: The observership provides experience in image analysis comprising a range of medical specialties and conditions. This experience aims to clarify indications, contraindications, and interpretation of imaging procedures, elucidating their role for diagnosis, therapeutic planning, and evaluation of treatment response. The rotation includes reading sessions of multiple types of imaging exams (X-rays, ultrasound, CT, MRI, nuclear medicine including PET-CT and PET-MR, and also the observation of intervention radiology procedures, a unique opportunity to expand existing knowledge regarding innovative treatment technologies using medical image resources. Students will also participate in clinical rounds and department meetings.

3. Pre-requisites: The Radiology rotation accepts medical students who have completed at least three years in four-year medical schools and four years in six-year medical schools.

4. Sites: Hospital Albert Einstein.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: February to November, yearly.

7. Other information: Students will be required to evaluate the course and sites.

Radiology rotation program:

ActivityMondayTuesdayWednesdayThursdayFriday
Week 1MorningMusculoskeletalMusculoskeletalMusculoskeletalNeuroNeuro
Afternoon
Week 2MorningNeuroAbdomenAbdomenAbdomenIntervention
radiology
Afternoon
Week 3MorningIntervention
radiology
ThoraxThoraxThoraxUltrasound
Afternoon
Week 4MorningUltrasoundNuclear medicineBreastHead and NeckHead and Neck
Afternoon

1. Course coordinator: Erika Rangel, MD PhD (e-mail: erika.rangel@einstein.br ).

2. Clerkship description: The observership provides experience in bench and translational research, allowing students to shadow experienced investigators while conducting lab experiments. Students will also participate in lab meetings and seminars.

3. Pre-requisites: The basic and applied research rotation accepts medical students who have completed at least two years in four-year medical schools and three years in six-year medical schools.

4. Sites: Hospital Albert Einstein.

5. Grading: Students will be evaluated according with attendance, participation, professionalism, and development of clinical competence as demonstrated in oral clinical presentations, in clinics, and during preceptor sessions.

6. Course availability: Subject to lab slots (see below).

7. Other information: Students will be required to evaluate the course and sites. Specific trainings may be requested for this rotation.

Basic and Applied Research rotation program – Option A

PI: Érika B Rangel, MD, PhD

Recruiting: 2 students throughout the year.

Project: Treatment of diabetic kidney disease with mesenchymal stem cells and empagliflozin Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease (CKD) worldwide. Despite the current treatment with inhibitors of renin-angiotensin-aldosterone 30-40% of the patients still progress to CKD. Therefore, the search for novel therapies is of paramount importance. In this setting, the treatment of DKD with inhibitors of sodium-glucose cotransporter-2 and mesenchymal stem cells is promising, as they can decrease oxidative stress, inflammation, fibrosis, and cell death, whereas angiogenesis and mitochondria biogenesis are enhanced. We aim to verify the expression of klotho, an anti-aging protein, and the markers of angiogenesis, oxidative stress, and mitochondria biogenesis in a model of DKD using the transgenic mice BTBR, which are knockout for leptin and develop proteinuria and kidney damage in a time-dependent manner.

Students will be involved with:

  • Extraction of RNA and real-time PCR
  • Immunohistochemistry
  • Microscopy
  • Mice handling

Basic and Applied Research rotation program – Option B

PI: Érika B Rangel, MD, PhD

Recruiting: 2 students throughout the year.

Project: In vivo modulation of kidney-derived stem cells in a model of acute kidney injury Acute kidney injury (AKI) may affect people of all ages, genders, and races. AKI has multifactorial etiology and may progress to chronic kidney disease (AKI). Thus, novel strategies to avoid the transition from AKI to CKD are further warranted. The aim of this project is to evaluate the therapeutic potential of sodium-glucose cotransporter-2 and mesenchymal stem cells in a model of AKI due to glycerol-induced rhabdomyolysis using transgenic mice, including cell death and oxidative stress signaling pathways.

Students will be involved with:

  • Extraction of RNA and real-time PCR
  • Immunohistochemistry
  • Confocal microscopy
  • Mice handling

Basic and Applied Research rotation program – Option C

PI: Patricia de Carvalho Aguiar, MD, PhD

Recruiting: 1 student in July/ August, 2022.

Project: Applied clinical neurophysiology (fMRI, EEG and fNIRS) studies in patients with movement disorders).

Students will be involved with:

  • Students will experience multimodal brain image methods applications for the study of the pathophysiology of movement disorders

Basic and Applied Research rotation program – Option D

PI: Patricia Severino

Project: Investigating the role of gut microbiota in health-care associated infections and cancer.

Recruiting: 2 students
The community structure of microorganisms (microbiota) living in the gastrointestinal tract of healthy individuals provides protective functions. When patients are critically ill, the composition of the microbiota and patterns of the microbiome (the genomes of microorganisms) change and have been associated with unfavorable clinical outcomes. In cancer, such alterations have been implicated in resistance to chemotherapy and immunotherapy. We use culture-independent, high-throughput sequencing techniques to describe the microbiota residing in the human intestinal tract of cancer patients, and in silico analysis and in vivo models to pinpoint genetic features of bacteria contributing to the transition from colonization in infection in healthcare associated infections.

Students will be involved with:

  • DNA and RNA sequencing approaches to investigate the human microbiota
  • 16S and metagenomic analysis
  • Bacterial whole genome sequencing and analysis
  • Development of experimental infection models

Basic and Applied Research rotation program – Option E

PI: Patricia Severino

Project: Investigating the role of gut microbiota in health-care associated infections and cancer.

Recruiting: 2 students
The community structure of microorganisms (microbiota) living in the gastrointestinal tract of healthy individuals provides protective functions. When patients are critically ill, the composition of the microbiota and patterns of the microbiome (the genomes of microorganisms) change and have been associated with unfavorable clinical outcomes. In cancer, such alterations have been implicated in resistance to chemotherapy and immunotherapy. We use culture-independent, high-throughput sequencing techniques to describe the microbiota residing in the human intestinal tract of cancer patients, and in silico analysis and in vivo models to pinpoint genetic features of bacteria contributing to the transition from colonization in infection in healthcare associated infections.

Students will be involved with:

  • DNA and RNA sequencing approaches to investigate the human microbiota
  • 16S and metagenomic analysis
  • Bacterial whole genome sequencing and analysis
  • Development of experimental infection models

Application directions

The applicant must submit the following documents at least 120 days prior to the beginning of the program:

1. Declaration of the medical institution of origin, stating that the applicant is regularly affiliated and describing the expected date of graduation.

2. Signed version of the Letter of Commitment.

3. Letter of support from a mentor/supervisor.

The applicant must submit the following documents up to 6 weeks after approval in the selection process:

1. Proof of healthcare insurance.

2. Proof of vaccination for the following agents:

  • SARS-CoV-2 (>=2 dose regimen)
  • Hepatitis B (3 dose regimen or proof of positive antibody to hepatitis B surface antigen – HbsAb)
  • Hepatitis A (1 dose)
  • Yellow Fever (1 dose)

Application and tuition fees:

Application and tuition fees will be applied as described in the AAMC’s Visiting Student Learning Opportunities (VSLO) program, or according to the administrative agreement established between institutions.