With all the excitement over the potential of stem cells to transform medicine, a key bottleneck is physician training.
Just how many doctors in the entire US have years of real experience and training in clinical use of stem cells….hmmm, let’s see….I can only think of a few in the whole country.
Yes, it’s really that bad.
I proposed recently that academic centers and hospitals establish formal, 1-year fellowship programs for physicians. The curriculum of that training program is detailed at right.
Unfortunately, most docs who are getting “training” in stem cells these days are not getting it at academic centers or hospitals with expertise.
Instead they are getting crash courses in stem cells over a couple days. Then they go and treat patients.
In fact a cottage industry has sprung up of relatively quick training for docs who end up getting a certificate that looks like a diploma (see example of a real anonymized one below).
What does this training actually qualify a physician to do?
It’s unclear.
Regenestem is one outfit selling such training.
Another is simply called Stem Cell Training.
On their website is a picture of a couple of people holding “diplomas” that look similar to the certificate above. The two upcoming trainings listed on the website are for 2 days each in Puerto Rico and Dominican Republic. Sounds more like a vacation than training to me.
The man behind Stem Cell Training is Dr. Joseph Purita, who did Bartolo Colon’s stem cell procedure in 2011.
Can two days really make a stem cell expert?
I don’t think so.
It takes years of experience and training.
Without such thorough training, in my opinion quick-trained doctors are putting patients at risk and their own medical practices in jeopardy from litigation and regulatory actions.
Would you get your cardiac bypass from a dermatologist who had only taken a weekend course in heart surgery? It boggles the mind.
The bottom line is that crash courses in stem cells do not make a doctor a “stem cell specialist”, but may very well lead to medical “crashes” where many patients get hurt by inexperienced doctors.
hello doctor Knoepfler, thankyou for your article, my opinion with respect to this is the following since every day there are more and more patients asking for stem cell treatments to be done for them,
After educating patients we should also be able to offer them a treatment so that they don’t go off and get something done somewhere else that may kill them (such as allogenic placental stem cells, embryonic stem cells or some culture grown stem cell procedure, or stem cells in a bottle). its correct to say that no stem cell treatment is 100% secure. But then again neither is any ones’ own body, who’s living stem cells may rebel any day and form what we know as cancer, or absolutely any medication which all have toxic capacities and are clinically safe until proven otherwise. I applaud that stemcelltraining.net shows interested physicians how to isolate adult stem cells since i believe it is safe to say that adult stem cells have one of the least probable tumorigenic capacities and, if are tumorigenic, it is because they were so prior to their isolation… because of this it is more likely that the worst negative effect directly caused by adult stem cell isolation and transfer to point of care is that nothing happens; that’s why in all cases an ethically made patient consent should be conducted explaining all of the possible risks, other than that patients are so eager to have these treatments done that they are even willing to fly to Thailand and china and elsewhere, pay more than 50 thousand dollars (which is flat out ridiculous) for a procedure that is as risky as it sounds where they use stem cells from another person where they don’t even know what they did with them prior to implanting them. They made these treaments so practical that depending on the need i have known of Doctors that offer these treatments for as little as 5000 dollars, where the median at world level is greater than 20 thousand. And yes they are delivering viable autologous adult stem cells in experimental therapeutic doses and patients are in majority satisfied with results. And dont tell me that majority is not enough, that you want numbers, pharmaceutical companies give dosing according to 50% of the population, if 50% are satisfied then thats a good product, believe me these procedures are receiving much more than 50% patient satisfaction, increase quality of life, and analitical traceable results. thats whyi am going to be signing up to their next “Vacation training” (as you said) here in santo domingo.
On second note,
Its odd that you would promote your personal fellowship program while or by speaking badly of another stem cell training program, i wont make any certain conclusions as to why (competition), but it sounds you are also concerned that these training courses will take potential trainees of your fellowship away from you, but in reality it is quite the opposite; maybe you can come in contact with these other training courses and see how you can help them, i know you are quite the expert in stem cells (from what ive read about you) and maybe they would appreciate you reaching out to them instead of just trying to defame. I am interested in stem cell treatments and a course like this one seems practical and very accessible for a busy doctor like me, maybe making it an intensive fellowship program applying some of their very techniques that you are bashing might make it a complete package… stem cells are a serious breakthrough, and what better way to investigate than to use the very patients that are personally soliciting these treatments as part of an international research campaign in stem cell treatments. we need more people of your expertise willing to help, but i guess that may take more fortitude than just blatantly hurting the reputation of any stem cell training company out there in an effort to cause their demise, it rubs off badly and may be confused for lack of character, wisdom, or integrity; i dare you to reach out to them and then post the feedback, but i guess that might go against your interests
idk doc i respect you as a scientist and investigator and any other teaching position you want to posses , but your methods for “protecton” of stem cell world are slightly questionnable in my opinion; i still appreciate your blog though
excuse my bad english in any cases.
Dr. Martinez
Why Dr Knoepfler, doctors are only supposed to go to Dominican Republic and Puerto Rico on vacations? You mean that there are no physicians in these countries that could be studying the world of stem cells ? what’s with the stereotype? I am a dominican physician and I already registered for the Stem Cell Training seminar as a first step on my path to give options to my patients !! I know a workshop of 2 days will not make me a specialist but I will learn a protocol to implement in my practice for patient funded investigation with due protocol implementation and thorough patient consent. I am aware of the amount of research and studying I need to do…as a matter of fact I would probably take also the fellowship you are promoting.
David,
Thanks for the comment. I was making a broader point that some of these training courses in the U.S. and other places are combined with recreational activities such as golf, fine dining, etc. that seem more like a vacation that a training course.
My own view is that more like a year-long course would be appropriate to gain thorough expertise so to me two days seems like a drop in the bucket.
Great info. Dr. Knoepfler I really appreciate both of your efforts. What both of you guys bring to the table is going to make all of our life healthier. And I applaud and respect your work and your contribution to Humanity. I can’t agree that anything that Stemcelltrainnig.net is doing is” Crash course stem cell training for docs puts patients at risk”
I’m my opinion any Doctor with any level of integrity knows the doctors performing the procedures are responsible for the patient. Stem Cell training is just that Training. To suggest anything else seem to be a bit irresponsible.
However as in the 60 Minutes Stem Cell episode I saw there will be Quacks out there and its important patients and doctors alike find and deal with reputable companies. But by the look of the responses above this actually seems to be a reputable company. Unfortunately all we can do is speculate on the credibility of these organizations but Nathan Katz , Wilfredo Samudio, and Ricardo bring up very logical point that actually point to the credibility of this particular organization.
Also 1yr curriculum for Stem Cells? Why would a doctor need to be a Stem Cell expert? From what limited knowledge I have on the subject it seems to me about like needing to be an engineer and know every facet of how a car works in order to drive the car.
I Vote you work with Ricardo, I bet somewhere in the middle you guys are both right and I bet you would have more to gain from a relationship working toward the good of mankind that at odds with one another.
Best of luck to both of you and I’m grateful for your hard work and dedication to bringing this technology to the main stream. Thank you!
Exactly how stupid you think doctors are? Do you really believe that we will expose ourselves to a lawsuit by doing a procedure that could endanger he life of a patient if we have not been trained for it ? I am a plastic surgeon, do you really think I would do a catheterization of a coronary artery on one of my patients without proper training? I have been looking into the stem cell treatments for a while. I have taken several seminars from the A4M in stem cell medicine after i sucessfully completed my fellowship there , and recently was in one of the Stem Cell Training courses. A4M is a recognized entity and they do only one day. I learned more from the 2 day course of Stem Cell Training , and it was hands on. I had the chance to do 2 patients under the supervision of the trainer.
I don’t think doctors are stupid, but I know many are reckless when it comes to doing stem cell procedures for which they are not properly trained and educated.
I do not believe that “looking into” stem cell treatments “for a while” constitutes appropriate training. Neither does taking a one or two day course here or there.
The curriculum that I have proposed is a year-long intensive fellowship training in stem cells.
While we applaud Dr. Knoepfler’s efforts to start a fellowship training to give the physicians in the US the opportunity to get some type of formal training; a response to his comments in regards to our company is in order.
The Stem Cells Training, Dr. Knoepfler is an independent company, affiliated to several schools of medicine and research centers outside the US. We have established fellowships and diplomates in cellular therapies and tissue engineering like the ones you would like to implement , in association with the following universities (Maimonides School of Medicine in Argentina, Universidad Autonoma de Nuevo Leon in Mexico, Far Eastern University School of Medicine in Philippines, and Universidad Nacional Pedro Henriquez Urena in the Dominican Republic) just to name a few.
As you read these lines there are hundreds of well-prepared scientists researching and making discoveries in cellular medicine all over the world. There are hundreds of physicians utilizing regenerative cellular therapies to improve the quality of life of their patients with documented positive results. We have been training physicians for the past 4 years in techniques of harvesting and reintegration of stem cells derived from adipose tissue and bone marrow. We have never made any claim of having the last word on these techniques. We are only giving physicians an introductory course on the basics of stem cells and teaching them a specific harvesting protocols. All doctors are scientists and they are aware of the amount of information they need to obtain, to increase their knowledge in order to implement these protocols into their practice. We invite you to reach out to us if you have any questions or concerns? You should consider attending one of our courses so you can see firsthand what it is we are teaching. Doctor Knoepfler we may be able to help you. If you join forces with us, you may find that we in fact cover all the proposed curriculum of your fellowship in our seminars . It is probable that we have already done the ground work that you are starting to do and together we can reach what we believe is your final objective: Give the US doctors and patients the best possible options.
…the concept of physician training is only one part of stakeholder education. Stakeholders are the patients, physicians, institutions, IRB’s, reimbursement agencies, research groups, investors and more. A ‘crash course” in a dermatology application (Fibrocell) is likely sufficient. These are not stem cells, they are cultured fibroblast cells for dermal regeneration and it is FDA approved. Cardiology is entirely different and the education requirements need to be established prior to patient treatment. Further, most if not all, of the autologous “adipose derived” cells depend far more on the secretory factors of the cells than the cells themselves. Upon transplantation, virtually all of the transplanted cells will apoptose in about 10 days to 30 days. That said, there is virtually no clinical in-human evidence that has ever been reported that indicate a safety issue with autologous cells produced under cGTP conditions. But, there is considerable anecdotal evidence that some autologous cell populations are safe and effective in multiple disease states with unmet clinical needs.
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How much stem cell training do medical students receive? My MD and consultant classmates do not deem this combined with a weekend course sufficient for understanding the complicated world of regenerative medicine and they would not feel competent or safe working in this field without substantial training or collaboration with scientific or academic researchers.
Dear Paul,
As everything the coin has two sides. Somebody should start somewhere. Of course, “crush” training can’t make you “specialist”. However, it provides you better background for understanding and development of the skills. The certificate obviously should state the fact of taking the course, not becoming the specialist. But the idea is quite positive, considering that there are no many choices of getting any kind of training.
Back in early 90-th, when human gamete micromanipulation has started to enter into in vitro fertlization practice, there was 3 days course in Brussels Free University for intracytoplasmic sperm injection. It’s extremely fine procedure, involving manipulation of the oocyte and sperm cells. Eventually this technique has become the model for nuclear transfer and cloning.
These tree days courses became the core education and training for hundreds of embryologists and scientists for next decade.
I can’t imagine what would had happened if somebody would criticized and stopped this program back then.
So, I would suggest to encourage any initiative of sharing the knowledge. Establishing institutional training could take decades.
Thanks for the comment and background, Nathan.
I have to somewhat disagree, however, that any initiative is a good thing.
I think this is one of those cases where paradoxically less training can maybe be better than more.
What do I mean?
I mean that in this kind of case a small bit of training over a weekend for example can make doctors think that they are then equipped to go out and start doing stem cell procedures on patients, when they really are not even close to being ready. So it can be enabling of dangerous behavior. In addition, the certificates, so I’m told, are sometimes used by doctors as pseudo diplomas to convince patients to get treatments from them.
If this kind of weekend training included a strict warning from the people running the course that this by no means makes attendees ready to do procedures, then I would feel more comfortable, but I’m guessing it is quite the opposite and that a selling point of these expensive courses is that they make docs ready to go out and make money by doing stem cell procedures.
I’m trying to learn more so I can make conclusions based on facts and at this point it is mostly speculation.