John Metcalfe, MD
|School||UCSF School of Medicine|
|Address||SFGH, Bldg NH|
My decision to become a doctor evolved out of volunteering at a hospice with AIDS patients in the pre-HAART era, and was further strengthened by work in a rural, government clinic in eastern Honduras. Through grants received for financial need and academic excellence, I enrolled at Tufts University School of Medicine in 1998 as an MD/MPH candidate, where I was honored with a Massachusetts Medical Society Scholar Award for community service.
Because of my commitment to work with critically underserved populations, I have been attracted to global health projects with programmatic relevance throughout my medical training. In Loreto, Peru, I worked on a project led by Dr. Bob Gilman (Johns Hopkins) using molecular diagnostics and active case finding to map unstable, seasonal malaria transmission. As a fourth year medical student I accepted an eight month field assignment in eastern Democratic Republic of Congo as an assistant epidemiologist with the International Rescue Committee. There, I applied probability sampling methods to measure health clinic utilization and mortality in a rural region of over 360,000 people, and managed a World Health Organization Roll Back Malaria field site enrolling 300 children in a prospective anti-malaria drug efficacy trial. During residency in Internal Medicine at UCSF, I designed a case-control study for the Brazilian Ministry of Health to investigate a sharp increase in severe leptospirosis associated with alveolar hemorrhage occurring in Brazilian slums.
In 2003, drawn to the moral, economic and political issues surrounding provision of HIV care to Africans, I developed a clinical elective in Durban, South Africa, where I worked with Enhancing Care Initiative and the Harvard AIDS Institute to train healthcare workers on the eve of the public sector rollout of antiretrovirals. This experience played a critical role in my decision to approach my interests in infectious diseases and epidemiology from a pulmonary medicine perspective.
In my second year of fellowship training in Pulmonary and Critical Care Medicine, I concurrently enrolled in the UC Berkeley doctoral program in epidemiology (2008-present) with tuition paid through a competitive Chancellor’s Fellowship for Graduate Study. Also concurrent with fellowship training, I worked as an international technical consultant to the Pan American Health Organization (PAHO), Program for Appropriate Technology in Health (PATH), and USAID in national TB program evaluations in three countries and an operational plan for scale-up of multidrug resistant tuberculosis management in Zimbabwe.
I currently attend on the Pulmonary Consult Service and in the Intensive Care Unit at the San Francisco General Hospital. I am an Assistant Professor in the Division of Pulmonary and Critical Care Medicine at UCSF and a doctoral candidate in the Division of Epidemiology at the University of California, Berkeley. My research interests focus on the diagnosis, management, and transmission of drug resistant tuberculosis, domestically and in high HIV-burden settings. Further areas of specialization include diagnostic test evaluation, risk prediction, and causal inference. With collaborators at the Biomedical Research and Training Institute (http://www.brti.co.zw/) and the University of Zimbabwe/UCSF Clinical Trials Unit, we work to improve early detection of drug resistant TB, validate use of low cost, accelerated phenotypic assays, assess current international clinical care standards for persons at risk for drug resistant TB, and estimate the contribution of microbial and human genomic factors on drug resistant TB transmission in Harare, Zimbabwe.
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