rutgers robert wood johnson medical school secondary essays

Rutgers Robert Wood Johnson Medical School Secondary Essay Prompts

These are the secondary application essay prompts for Rutgers University Robert Wood Johnson Medical School. To put your best foot forward and maximize your chance of an interview invitation, visit our secondary application editing page .

about Rutgers University Robert Wood Johnson Medical School

Secondary Deadline : December 1, 2024 Secondary Fee : $80 FAP Waiver : Yes CASPer Required : Yes Screens Applications : Yes Accepts Application Updates : Yes

Robert Wood Johnson Medical School is dedicated to transforming health care for New Jersey and the nation through innovation and excellence in education, research, patient- and family-centered care and addressing the health of our diverse community.

Robert Wood Johnson Medical School will become the academic engine driving a new healthcare paradigm in New Jersey; the state’s first and largest academic high-value health care system.

Please complete the below essay questions. Please note that it is possible some questions may not apply to you. When this is the case, please indicate as such with NA.

1. RWJMS has identified the core values below as critical to our mission and vision. We strive to matriculate learners who embody these values. R — Respect, dignity and humanism for the diverse population we serve W — Wellness and resilience J — Joining learners hand in hand with care delivery M — Making patients first with safe, compassionate, high-quality care S — Science to advance human health In two paragraphs or less, identify which value you selected and reflect on one of your experiences to discuss how you have built a foundation for this value. (No limit)

2. RWJMS strives to matriculate a student body that supports and enriches each other and the learning environment. Please share a life experience, personal attribute, and/or perspective that will help contribute to this learning environment. (250 words or less)

3. Discuss a difficult or challenging situation you have encountered and how you dealt with it. Be sure to include the skills you called upon to resolve the dilemma, and the support person(s) from whom you sought advice. (Please keep this under 250 words)

4. Are you interested in applying for PACCE? (Yes/Maybe/No). If yes/maybe (No limits)

• What are the factors that drive your interest in primary care?
• Provide examples, experiences, or critical incidents that informed you about either the family medicine or pediatric specialty.

5. Please feel free to comment on any course grades, GPA trends, or MCAT scores and what you have learned about yourself. (No limit)

6. Please use this space if you would like to provide additional information to the admissions committee. (No limit)

1. If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA). (Word count not provided)

2. Please let us know how you prepared for your most recent MCAT. If you have taken the MCAT more than once let us know if you prepared differently for prior tests. (Word count not provided)

3. Were you, or are you, employed during the school year? If so please let us know the type of work, hours worked, etc. In addition, please indicate if you and/or your parents are/were employed by RWJSM. (Word count not provided)

4. If you have taken time off during your undergraduate training, or if you have already graduated, please please provide information to explain this time by providing a line-by-line description of activities or explanation delineated by month/year to month/year. (Word count not provided)

5. If you’re applying with a state of legal residence that is not New Jersey, please indicate your connection to New Jersey and explain this connection.  (Word count not provided)

1. If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA). (optional) (250 char)

2. Please let us know how you prepared for your most recent MCAT. If you have taken the MCAT more than once let us know if you prepared differently for prior tests. (optional) (250 char)

3. Provide a very short reflection of what you have learned about your preferred strategies for pursuing knowledge in areas of interest to yourself. (250 char)

4. If you have taken time off during your undergraduate training or if you have already graduated, please provide information to explain this time by providing a line-by-line description of activities or explanation delineated by month/year to month/year. (optional) (500 char)

5. Were you, or are you, employed during the school year? If so please let us know the type of work, hours worked, etc.(optional) (500 char)

6. Is there anything you would like to share to clarify your application? (optional) (500 char)

1. If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA).

2. If you have taken time off during your undergraduate training or if you have already graduated, please provide information to explain this time by providing a line-by- line description of activities or explanation delineated by month/year to month/year.

3. If you applied as a non-resident (i.e., your legal residency is a state other than NJ), please let us know if you grew up in NJ, attended school in NJ, have parents who reside in NJ, work in NJ, etc.

4. Please let us know how you prepared for your most recent MCAT. If you have taken the MCAT more than once let us know if you prepared differently for prior tests.

5. Were you, or are you, employed during the school year? If so please let us know the type of work, hours worked, etc. In addition, please indicate if you and/or your parents are/were employed by RWJMS.

6. Is there anything you would like to share to clarify your application?

Part 2 Take CASPer or in the next series of prompts, you will reflect upon experiences, activities or accomplishments that demonstrate each of the indicated pre-professional competencies.

Your response should be limited to one paragraph and include:

-The situation where you demonstrated the competency, -Your actions and the resulting consequence, and -What you learned as a result of your experience(s). Pre-professional Competencies: 1. Integrity and Ethics 2. Reliability and 3. Dependability 4. Desire to Learn 5. Commitment to serving others/volunteering 6. Social Interpersonal and Teamwork Skills 7. Cultural Competence 8. Resilience and Adaptability

The secondary application essay prompts from this medical school application cycle are the same as above.

Disclaimer: The information on this page was shared by students and/or can be found on the medical school’s website. Med School Insiders does not guarantee the accuracy of the information on this page.

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Rutgers (Robert Johnson) - Secondary Essay Prompts

Access our complete list of all Secondary Essay Prompts from Rutgers (Robert Johnson) in Piscataway , NJ for the 2018 - 2023 admissions cycles.

1 . RWJMS has identified the core values below as critical to our mission and vision. We strive to matriculate learners who embody these values. R -- Respect, dignity and humanism for the diverse population we serve W -- Wellness and resilience J -- Joining learners hand in hand with care delivery M -- Making patients first with safe, compassionate, high-quality care S -- Science to advance human health Please select a RWJMS core value that resonates the most with you. In two paragraphs or less, reflect on one of your experiences to discuss how you have built a foundation for this value and how it will contribute to our community of learners.

2 . Discuss a difficult or challenging situation you have encountered and how you dealt with it. Be sure to include the skills you called upon to resolve the dilemma, and the support person(s) from whom you sought advice.

3 . Please feel free to comment on any course grades, GPA trends, or MCAT scores and what you have learned about yourself.

4 . Please use this space if you would like to provide additional information to the admissions committee.

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• Secondary Essay Prompts

Secondary Essay Prompts – Rutgers, Robert Wood Johnson Medical School

Secondary Essay Prompts for the Rutgers, Robert Wood Johnson Medical School

Below are the secondary essay prompts for the Rutgers, Robert Wood Johnson Medical School in Piscataway, NJ.

2019 – 2020

• (Optional) If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA). (250 characters)
• (Optional) Please let us know how you prepared for your most recent MCAT. If you have taken the MCAT more than once let us know if you prepared differently for prior tests. (250 characters)
• Provide a very short reflection of what you have learned about your preferred strategies for pursuing knowledge in areas of interest to yourself. (250 characters)
• (Optional) If you have taken time off during your undergraduate training or if you have already graduated, please provide information to explain this time by providing a line-by-line description of activities or explanation delineated by month/year to month/year. (500 characters)
• (Optional) Were you, or are you, employed during the school year? If so please let us know the type of work, hours worked, etc. (500 characters)
• (Optional) Is there anything you would like to share to clarify your application? (500 characters)

2018 – 2019

This school requires CASPer (Computer Based Assessment for Sampling Personal Characteristics) as part of the medical school secondary application.

If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA). (optional) (250 char)

Please let us know how you prepared for your most recent MCAT. If you have taken the MCAT more than once let us know if you prepared differently for prior tests. (optional) (250 char) Provide a very short reflection of what you have learned about your preferred strategies for pursuing knowledge in areas of interest to yourself. (250 char) If you have taken time off during your undergraduate training or if you have already graduated, please provide information to explain this time by providing a line-by-line description of activities or explanation delineated by month/year to month/year. (optional) (500 char) Were you, or are you, employed during the school year? If so please let us know the type of work, hours worked, etc.(optional) (500 char) Is there anything you would like to share to clarify your application? (optional) (500 char)

Below are the secondary essay prompts for the Rutgers, Robert Wood Johnson Medical School.

2017 – 2018.

• The Rutgers, Robert Wood Johnson Medical School strives to ensure that its students become respectful physicians who embrace all dimensions of caring for the whole person. Please describe how your personal characteristics or life experiences will contribute to the Rutgers, Robert Wood Johnson Medical School community and bring educational benefits to our student body. (1000 characters)
• Is there any further information that you would like the Committee on Admissions to be aware of when reviewing your file that you were not able to notate in another section of this or the AMCAS Application? (1000 characters)
• Why have you chosen to apply to the Rutgers, Robert Wood Johnson Medical School and how do you think your education at Rutgers, Robert Wood Johnson Medical School will prepare you to become a physician for the future? (1 page, formatted at your discretion, upload as PDF)

2017 – 2018: NJMS Secondary Application

Full questions and directions can be found at the NJMS Secondary Application webpage.

• Please indicate if you have an interest in any of the following Dual Degree programs: MD/MPH     MD/MBA     MD w/Thesis     MD/PhD
• Have you previously participated or are you currently participating in any programs affiliated with NJMS? Yes No, GSBS Mini-Med NERA-MedPrep Research Programs SMART SMDEP/SHPEP Summer Youth Scholars Program (SYSP) Other Program
• Do you have any relatives currently attending or who have graduated from NJMS?
• Do you have any other connection to NJMS, UMDNJ, or Rutgers?
• Have you applied to NJMS before, either through AMCAS or an accelerated/combined degree program?
• Prior to July 1, 2017, have you met with either Dr. Heinrich or Ms. Rivero?
• We value qualities of integrity, humanism, and passion and are committed to fostering a climate for diversity and inclusion. We feel these factors are critical to your growth as a future physician-leader. How will you contribute to our medical school community? *Please see the important MedEdits note below.
• Please discuss any additional information you believe important for the screening committee to know about you. Feel free to elaborate on any special circumstances, personal examples of resilience, discrepancies in academic history, etc.
• Please share any other information you feel uniquely enriches your candidacy for admission to NJMS:
• If you don’t currently reside in NJ, please share connections (if any) you may have.
• If you will not be a full time student between June 2017-August 2018, please describe in detail your planned activities, including chronology and time commitment.
• Are you the first in your immediate family who will/has graduate(d) from a four year college?
• Are you the first in your immediate family who will attend medical school?
• How do you self-identify: Asian, Hispanic, Latino, or of Spanish origin, Black, White, Native Hawaiian or Other Pacific Islander, American Indian or Alaskan Native, Other

Rutgers Medical School Admissions 

Question number 7 is a classic admissions question.   how will you contribute to our medical school community   see our secondary essay resource center homepage to read an example answer to this type of question., rutgers, robert wood johnson medical school admissions requirements.

Learn more about this school:

Secondary essay webcast with Dr. Jessica Freedman, founder and president of MedEdits Medical Admissions.   Read more about Dr. Freedman.

Rutgers, Robert Wood Johnson Medical School Secondary Application

Topics covered in this presentation:

• When should I submit my secondary essays?
• Pay attention to the word/character limits.
• Can I recycle secondary essay prompts for multiple schools?
• Identify topics that you left out of your primary application.
• And, much more.

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*Data collected from MSAR 2022-2023, 2022 Osteopathic Medical College Information Book, and institution website.

Disclaimer: The information on this page was shared by students and/or can be found on each medical school’s website. MedEdits does not guarantee it’s accuracy or authenticity.

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Rutgers Robert Wood Johnson Medical School

QUICK LINKS

Gaining admission to Rutgers Robert Wood Johnson Medical School is Moderately Competitive. Applicants typically have an average GPA of 3.7 and an average MCAT score of 513.

📊 STATISTICS

To summarize, listed below are the most important academic statistics for Rutgers Robert Wood Johnson Medical School applicants:

Affording medical school can be tough, often requiring students to take on significant loans. Information about the yearly tuition for Rutgers Robert Wood Johnson Medical School is below.

For more information about tuition at Rutgers Robert Wood Johnson Medical School, visit the following link: https://scarlethub.rutgers.edu/financial-services/cost-of-attendance/rbhs-students-cost-of-attendance/robert-wood-johnson-medical-school/

😀 FRIENDLINESS

Some schools prefer in-state candidates, while others are more receptive to out-of-state or international applicants. View our school "friendliness" scores for Rutgers Robert Wood Johnson Medical School below:

🚗 OUT-OF-STATE

✈️ INTERNATIONAL

⭐️ MISSION STATEMENT

It is always important to read and understand a medical school's mission statement before applying. Often, you will find out what the medical school stands for, and if you fit in with the general "vibe" of the medical school. However, being honest, most medical schools have the same run-of-the-mill mission statement as everybody else. Anyways, you can be the judge. Below you can find the mission statement for Rutgers Robert Wood Johnson Medical School:

Rutgers Robert Wood Johnson Medical School Mission Statement:

For more information on the mission statement for Rutgers Robert Wood Johnson Medical School, visit the following link: https://rwjms.rutgers.edu/about_rwjms/mission-and-vision

🤷‍♂️ SITUATIONAL JUDGEMENT TESTS

Rutgers Robert Wood Johnson Medical School does not require the completion of either the CASPer® nor the AAMC PREview™ examinations.

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AAMC PREview™ Question Bank

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📅 DATES, DEADLINES, AND FEES

Throughout your application cycle, there are many dates to be cognizant of in order to ensure the successful completion of your application.

Below are some other helpful dates:

Medical School Interview Question Bank

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📚 PREREQUISITE COURSES

Most schools have a list of prerequisite courses that you need to have completed before matriculating. View information provided for Rutgers Robert Wood Johnson Medical School below:

Semester Hours:

🧪 CHEMISTRY

GenChem = General Chemistry

OChem = Organic Chemistry

Biochem = Biochemistry

GenChem Semester Hours:

GenChem Lab?

OChem Semester Hours:

Biochem Semester Hours:

Biochem Lab?

Not Required

GenBio = General Biology

HL Bio = Higher Level Biology

GenBio Semester Hours:

GenBio Lab?

HL Bio Semester Hours:

HL Bio Lab?

Biology or Zoology may fulfill general requirement. Anatomy and physiology, cell and molecular biology all recommended.

🔍 HUMANITIES & BEHAVIORAL SCIENCES

✍️ ENGLISH/WRITING

Must include one semester of a college writing course. Intensive-writing courses may substitute for English.

📈 MATHEMATICS/STATISTICS

Mathematics Semester Hours:

Statistics Semester Hours:

Any combination of 6 semester hours of stats/math. Biostatistics recommended.

OTHER REQUIRED COURSES

OTHER RECOMMENDED COURSES

Spanish language course recommended.

SOURCE: https://rwjms.rutgers.edu/education/medical_education/prospective-students/applying-to-rwjms

🎓 SPECIAL PROGRAMS

Many schools have dual-degree programs for motivated applicants. View the ones offered at Rutgers Robert Wood Johnson Medical School below:

MD+PhD (MSTP - Medical Scientist Training Program):

MD+MPH (Public Health):

MD+MBA (Business, Healthcare Administration):

MD+JD (Law):

MD+MA (Master of Arts):

MD+MS (Master of Science):

📲 CONTACT INFORMATION

View contact information (phone and email) available to contact Rutgers Robert Wood Johnson Medical School below:

[email protected]

📝 SECONDARY APPLICATION ESSAY PROMPTS

Below are the past secondary (supplemental) application essay prompts for Rutgers Robert Wood Johnson Medical School.

🙋‍♀️ INTERVIEW QUESTIONS

Below are common interview questions that you might encounter on your important day for Rutgers Robert Wood Johnson Medical School.

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Medical School Secondary Essay Prompts Database

Updating for 2024-2025 as Secondaries Come in!

ProspectiveDoctor has compiled a database of past and current medical school secondary essay prompts from past years to help you get a head start on your secondary applications. Select a school to discover their essay prompts.

Related posts:

• Creighton University School of Medicine Secondary Questions
• Emory University School of Medicine Secondary Questions
• A.T. Still University Kirksville College of Osteopathic Medicine
• Oklahoma State University Center for Health Sciences College of Osteopathic Medicine

rutgers secondary application

Rutgers Robert Wood Johnson Secondary Application Questions & Tips

Rutgers Robert Wood Johnson Secondary Application Essay Prompts by Year & Tips Add a header to begin generating the table of contents Most of our medical school applicants who receive interview invites and acceptances to Rutgers Robert Wood Johnson Medical School either have a home residency in New Jersey, grew up in New Jersey for […]

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Rutgers New Jersey Medical School Secondary Application Essay Prompts

Rutgers New Jersey Medical School Secondary Application Essay Prompts by Year Add a header to begin generating the table of contents Other than a strong academic performance (strong GPA, strong MCAT score, and strong letters of recommendation), the way to differentiate yourself is through submitting phenomenal Rutgers New Jersey Medical School secondary application essays. Rutgers

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2014-2015 Rutgers University - Robert Wood Johnson Application Thread

• Thread starter gettheleadout
• Start date May 27, 2014

gettheleadout

• May 27, 2014

CroatoanVaccine

Stress receptor.

• Jun 5, 2014

Socially awkward

Applying here as well! The "pre-professional competency" questions on the secondary are a doozy, though.  

Person0715 said: Applying here as well! The "pre-professional competency" questions on the secondary are a doozy, though. Click to expand...

TheCheerDoc

Full member.

Applying here, really hoping for some OOS love!  

• Jun 6, 2014

CroatoanVaccine said: Are you going off of last years thread or did you already receive a secondary? Click to expand...

• Jun 15, 2014

Can any current students offer what RWJ looks for in an applicant? Also what do you like about the school?  

• Jun 26, 2014

Bumping to get some current student opinions. Last year's secondary seems annoying.  

Writing about professional competencies is like pulling teeth.  

• Jun 30, 2014

Just received the secondary email. Same prompts as last year. This is one of the few that I am dreading, the prompt really is unusual. For the pre-professional competency questions, did you guys use the same experience for multiple competencies? @Person0715  

Lamel said: For the pre-professional competency questions, did you guys use the same experience for multiple competencies? @Person0715 Click to expand...

I repeated experiences for multiple competencies if the experience was appropriate. I don't think there's any harm in that.  

Lamel said: Just received the secondary email. Same prompts as last year. This is one of the few that I am dreading, the prompt really is unusual. For the pre-professional competency questions, did you guys use the same experience for multiple competencies? @Person0715 Click to expand...

Person0715 said: I repeated experiences for multiple competencies if the experience was appropriate. I don't think there's any harm in that. Click to expand...

So apparently, RWJ is not doing rolling admissions is that correct? If so, then phew. I need time for this secondary haha  

Is anyone else having trouble paying the app fee through the portal they provided?  

So how much are we allowed to write for these? Whatever fits in the box? I can easily resize the boxes in their secondary document so...  

Lamel said: So how much are we allowed to write for these? Whatever fits in the box? I can easily resize the boxes in their secondary document so... Click to expand...

Person0715 said: Is anyone else having trouble paying the app fee through the portal they provided? Click to expand...

CroatoanVaccine said: I am. I keep getting stuck on that page where it asks for "Application type" with the drop down menu that doesn't expand. Did you get it to work? Click to expand...

• Jul 1, 2014

They just emailed me back. They said they are looking into it and to just try again later.  

ZymurgySurfer

Would working during winter breaks count as being employed during the school year?  

Person0715 said: They just emailed me back. They said they are looking into it and to just try again later. Click to expand...

SliderK said: Just so everyone knows, it seems that the issue was cleared up. I was able to go in and process the payment this time. Click to expand...

• Jul 3, 2014

For admission term I'm assuming you guys said Academic Term 2015-2016 (this is for the online payment processing portal)?  

Hi guys, quick question on the following prompt: If your education has not been continuous, please provide information to explain the gap(s) by providing a line by line description to explain by month/year to month/year. 1 - are they referring to the continuity of our undergraduate education? or to gap years after graduation? 2 - by "line by line description to explain by month/year to month/year" do they mean a something simple like the following: May 2012 - May 2013 - Peace Corps XYZ Or do they want a blurb/mini-essay? Thanks guys!  

studentofsdn

• Jul 7, 2014

CTTR said: Hi guys, quick question on the following prompt: If your education has not been continuous, please provide information to explain the gap(s) by providing a line by line description to explain by month/year to month/year. 1 - are they referring to the continuity of our undergraduate education? or to gap years after graduation? 2 - by "line by line description to explain by month/year to month/year" do they mean a something simple like the following: May 2012 - May 2013 - Peace Corps XYZ Or do they want a blurb/mini-essay? Thanks guys! Click to expand...

jjtheairplane

sghos said: For admission term I'm assuming you guys said Academic Term 2015-2016 (this is for the online payment processing portal)? Click to expand...

robertrobinross

Hey all, this may be a dumb question but just wanted to double check. For the lovely pre-professional competencies section, does "service orientation" mean community service?  

robertrobinross said: Hey all, this may be a dumb question but just wanted to double check. For the lovely pre-professional competencies section, does "service orientation" mean community service? Click to expand...

Perfect, thank you!!!!  

Just submitted here today. hoping for some attention from RWJ!  

• Jul 8, 2014

Just got the complete email. Does anyone how when IIs come out?  

@Person0715 Are you complete with or without LORs?  

@Lamel , I am complete with LORs.  

For those who have received the application, has your AMCAS been verified? And has anyone received their secondary w/o being verified? Thanks  

• Jul 13, 2014

anyone have any input for what they put for the last "clarification of application" question?  

• Jul 16, 2014

Just got this secondary today, an hour after my primary was verified. First question, 1. If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA). Does this mean a B minus? Open or closed ends..  

jrzsurfer said: Just got this secondary today, an hour after my primary was verified. First question, 1. If applicable, please comment on any science grade(s) listed on your application for which you received grades lower than a B. If applicable, please comment if there is a downward trend in your science and/or total grade point average (GPA). Does this mean a B minus? Open or closed ends.. Click to expand...

studentofsdn said: I explained a B-. It can't hurt to be liberal with your explanation. Also, you don't want to risk looking bad if they actually did want you to explain a B- and you didn't. Click to expand...

• Jul 17, 2014
• Jul 18, 2014

Hello, does anyone know what is the character / word limit for each question? Good luck for everyone!  

• Jul 20, 2014

Do any current or upcoming students know when RWJ usually begins extending IIs?  

amitheonlyoneiknow

• Jul 24, 2014

This Secondary is MADNESS  

• Jul 27, 2014

Can someone post the prompts for this secondary please?  

johnnytest said: Can someone post the prompts for this secondary please? Click to expand...

Vain Brother

• Aug 2, 2014

kind of sucks that they have a question about being a non-resident but no question about why you want to go to their school if you're not a NJ resident  

• Aug 3, 2014

Person0715 said: Do any current or upcoming students know when RWJ usually begins extending IIs? Click to expand...

Sandmeezy said: +1 Click to expand...

• Aug 6, 2014

QUESTION.....for the "pre-professional competency" questions...is it ok if I bring up very specific experiences that I've had (more like a specific story)....experiences that did not occur during the ECs that I mentioned in my primary? ....just a simple story about how I showed "quality A"?  

Similar threads

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• TheDataKing
• Mar 1, 2020

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Early Outcomes in Children With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

Affiliations.

• 1 Kimberly A. Morishita, MD, MHSc, David A. Cabral, MBBS: British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
• 2 Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey.
• 3 Simon Fraser University, Burnaby, British Columbia, Canada.
• 4 Marinka Twilt, MD, PhD, Susanne M. Benseler, MD, PhD: Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada.
• 5 Rae S. M. Yeung, MD, PhD: The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
• 6 Akron Children's Hospital, Akron, Ohio.
• 7 Seattle Children's Hospital, Seattle, Washington.
• 8 Mother and Child Health Care Institute of Serbia, Belgrade, Serbia.
• 9 Rigshospitalet, Copenhagen, Denmark.
• 10 Nuffield Orthopaedic Centre, University of Oxford, Oxford, UK.
• 11 Joseph M. Sanzari Children's Hospital, Hackensack, New Jersey.
• 12 Tzielan Lee, MD: Stanford Children's Health, Stanford University School of Medicine, Stanford, California.
• 13 University of California at San Francisco.
• 14 Saint-Petersburg State Pediatric Medical University, Saint Petersburg, Russia.
• 15 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
• 16 IWK Health Centre and Dalhousie University, Halifax, Nova Scotia, Canada.
• 17 University of Utah, Salt Lake City.
• 18 University Children's Hospital, Muenster, Germany.
• 19 University of Florida, Gainesville.
• 20 Cohen Children's Medical Center of New York, New Hyde Park, New York.
• 21 Janeway Children's Health and Rehabilitation Centre, St. John's, Newfoundland, Canada.
• 22 Sirirat Charuvanij, MD: Siriraj Hospital, Mahidol University, Bangkok, Thailand.
• PMID: 28371513
• DOI: 10.1002/art.40112

Objective: To characterize the early disease course in childhood-onset antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and the 12-month outcomes in children with AAV.

Methods: Eligible subjects were children entered into the Pediatric Vasculitis Initiative study who were diagnosed before their eighteenth birthday as having granulomatosis with polyangiitis (Wegener's), microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis (Churg-Strauss), or ANCA-positive pauci-immune glomerulonephritis. The primary outcome measure was achievement of disease remission (Pediatric Vasculitis Activity Score [PVAS] of 0) at 12 months with a corticosteroid dosage of <0.2 mg/kg/day. Secondary outcome measures included the rates of inactive disease (PVAS of 0, with any corticosteroid dosage) and rates of improvement at postinduction (4-6 months after diagnosis) and at 12 months, presence of damage at 12 months (measured by a modified Pediatric Vasculitis Damage Index [PVDI]; score 0 = no damage, score 1 = one damage item present), and relapse rates at 12 months.

Results: In total, 105 children with AAV were included in the study. The median age at diagnosis was 13.8 years (interquartile range 10.9-15.8 years). Among the study cohort, 42% of patients achieved remission at 12 months, 49% had inactive disease at postinduction (4-6 months), and 61% had inactive disease at 12 months. The majority of patients improved, even if they did not achieve inactive disease. An improvement in the PVAS score of at least 50% from time of diagnosis to postinduction was seen in 92% of patients. Minor relapses occurred in 12 (24%) of 51 patients after inactive disease had been achieved postinduction. The median PVDI damage score at 12 months was 1 (range 0-6), and 63% of patients had ≥1 PVDI damage item scored as present at 12 months.

Conclusion: This is the largest study to date to assess disease outcomes in pediatric AAV. Although the study showed that a significant proportion of patients did not achieve remission, the majority of patients responded to treatment. Unfortunately, more than one-half of this patient cohort experienced damage to various organ systems early in their disease course.

© 2017, American College of Rheumatology.

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Tonsillectomy using electrocautery.

• Author: Conor Smith csurgeries
• Published: August 17, 2015
• Specialties: Oral Maxillofacial , Otolaryngology , Pediatric General Surgery
• Associations: Arkansas Children's Hospital
• DOI: http://dx.doi.org/10.17797/cb233d20mk
• Description

Contributors: Conor Smith (Arkansas Children’s Hospital)  and Gresham Richter M.d. (Arkansas Children’s Hospital)

The removal of tonsils is most often indicated by tonsillar hypertrophy contributing to obstructive sleep apnea or chronic/recurring throat infections from pathogens such as streptococcal bacteria. Electrocautery is the most commonly used technique to safely and effectively excavate the tonsils.

DOI: http://dx.doi.org/10.17797/cb233d20mk

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This video shows a transotic approach for a cochlear schwannoma in a 59-year-old female who presented with sudden sensorineural hearing loss in her left three years prior. She was found to have subsequent growth of her tumor on imaging and elected to undergo surgery. The transotic approach is a valuable approach within the armamentarium of a skull base team and differs from the transcochlear approach in the handling of the facial nerve. Techniques for ear canal overclosure, eustachian tube packing and mastoid obliteration are also highlighted.

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CAC (Coblation Assisted Cordectomy) in Bilateral Vocal Cord Palsy –tips & tricks

Here, we have a 39 yrs old female with complaints of noisy breathing for last two years post thyroidectomy. Flexible laryngoscopy confirmed bilateral vocal cord paralysis. She was planned for coblation assisted cordectomy.

Patient was taken up for procedure under general anaesthesia. She also  started having stridor after induction. Nasopharyngeal intubation with spontaneous breathing technique was used. Entropy leads were placed over forehead to monitor the depth of anaesthesia. Tube position was confirmed with endoscopic view and Benjamin lindohlm laryngoscope was suspended. As the patient was spontaneously breathing, the stridor became more prominent, with stable vitals and  the procedure was continued. The vocal cord retractor was fixed and coblation wand was then used with 7:3 settings for ablation and coagulation respectively.  The surgical limits were-anteriorly the junction between ant 2/3 and post 1/3 of the vocal cord, posteriorly just anterior to the vocal process of arytenoid to prevent cartilage exposure and post operative granulations. Superely till the ventricle and inferioly till the medial most surface of the subglottis. Laterally approx. 5 mm depth was defined to prevent injury to the superior laryngeal artery branch and further bleeding. Once the final airway was achieved , the topical lignocaine was used to prevent laryngeal spasm post extubation.

The patient was shifted to the ward without oxygen, the voice was assessed on post op day 2.

Patient was called for follow up on post op day 14th and good voice outcomes were achieved.

So lets have a look on some tips & tricks for the safe procedure—–

Nasopharyngeal insufflation technique with entropy monitor will give adequate and safe surgical field

2. Appropriate exposure will help you to delineate the surgical margins

3. Topical anaesthesia before and after the procedure will prevent sudden laryngeal spasm

4. Firm holding of coblation device will help to prevent injury to surrounding structures like    anterior 2/3 vocal cord, opposite side  vocal cord, medial surface of vocal cord or aryteroid posteriorly

5. Do not ablate more laterally to prevent bleeding, if at all it happens, use patties or coagulation switch for hemostasis.

6. And at the end of the procedure ,use catheter suction to suck out blood clots or saline from the  airway if any….

To Conclude-Coblation Assisted Cordectomy( CAC) can be performed safely with good outcomes in case of bilateral vocal cord paralysis using tubeless anesthesia technique without tracheostomy !

CAC (Coblation Assisted Cordectomy) in Bilateral Vocal Cord Palsy- Tips & Tricks

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