College of Medicine

- Admissions Overview
- - MD Program
    UNMC's rigorous academics, diverse clinical experiences and supportive environment put you on the path to becoming a skilled, compassionate physician.
  - How to Apply
    UNMC prepares medical degree students to meet the needs of patients through clinical practice, biomedical science and research, problem-solving and compassion.
  - Contact Us
    Review contact information for the Office of Admissions and Student Affairs in the College of Medicine at UNMC.
  - Verification and State Licensure
    Review opportunities for state licensure following completion of the MD program in the College of Medicine at UNMC.
- - MD-MBA Program
    A combined MD-MBA degree equips you with the tools you need to become highly skilled in both management and medicine.
  - MD-MPH Program
    Pursue your passion for public health and medicine with a combined MD-MPH and help solve complex health problems.
  - MD-PhD Program
    Do you have a passion for caring for patients and for research? Consider the dual MD-PhD degree.
- Education Overview
- - Curriculum
    Our curriculum produces physicians whose foundation in basic, clinical, and health systems sciences prepare them to promote health and reduce patient suffering.
  - Graduation Requirements
    Review requirements for students pursuing an MD at the UNMC College of Medicine to graduate and receive their degree.
  - Objectives
    The objectives of UNMC's medical degree program are to prepare you for success in primary care or specialty fields.
  - Service Learning
    Active participation in community service provides critical opportunities to apply skills and knowledge gained in medical school and develop a sense of empathy.
- - Enhanced Medical Education
    Enhanced Medical Education Tracks offer medical students an opportunity to perform an in-depth study of an interdisciplinary field of medicine.
  - Enhanced Medical Education Tracks
    EMET applicants are selected for Tracks based on their interest in the topic and motivation to complete work above and beyond the primary MD curriculum.
  - MD Honor’s Thesis Program
    The MD honors thesis encourages students to engage in scientific research during medical education and become eligible to graduate with honors.
- Research Overview
- Internal Grants
  The College of Medicine has a variety of research-related grant and award opportunities available to UNMC faculty.
- Comparative Effectiveness Research
  The Comparative Effectiveness Research (CER) program identifies knowledge gaps in the effectiveness of clinical care and improves CER in these areas.
- Great Plains IDeA-CTR
  The Great Plains IDeA-CTR is a collaborative effort between nine regional institutions that provides training, resources. and funding to regional researchers.
- Research and Development Committee
  The Research and Development Committee handles funding opportunities for faculty, including the Bridge Funding program, and student research opportunities.
- Student Opportunities
  The College of Medicine provides a variety of research opportunities for both current and prospective UNMC students.
- Residencies & Fellowships Overview
- Graduate Medical Education Programs
  UNMC's dozens of programs--including nearly 20 in internal medicine--allow residents and fellows a variety of specialties.
- House Officer Resources
  Find information for residents and fellows, including salaries, benefits and nearby housing.
- House Officer Wellness
  Wellness resources for residents and fellows include an assistance program and a private wellness lounge.
- Research
  We aim to facilitate house officers’ involvement in research in the areas of patient safety, quality improvement, healthcare disparities and education research.
- Salary and Benefits
  Paid vacation and professional leave, health insurance and meal allowances are just a few of the benefits residents receive in addition to their yearly salary.
- Contact Us
  Reach out to the Graduate Medical Education office for information about benefits, contracts, orientation or graduation.
Departments

— College of Medicine — Department of Internal Medicine — Divisions — Infectious Diseases — Antimicrobial Stewardship Program — Protected Antimicrobials — Miltefosine (Impavido)

Miltefosine (Impavido)

Miltefosine was added to the formulary with restriction to use by the Infections Disease services. This agent is active against the pathogens outlined below and was added primarily to provide the ability to rapidly treat free-living amebic encephalitis, a highly fatal condition. All use must be approved by the Infectious Disease service.

Leishmaniasis: Miltefosine (MLT) is FDA approved for the visceral leishmaniasis (Leishmania donovani), cutaneous leishmaniasis (Leishmania braziliensis, guyanensis, panamensis), and mucosal leishmaniasis (Leishmania braziliensis) in adult patients (≥12 years) weighing ≥30kg. Information on MLT for use in leishmaniasis is readily available in tertiary references and in guidelines (The Infectious Disease Society of America’s Guidelines on Leishmania).
Free-living amebae: MLT has also been used on a case-by-case basis for treatment of free-living amoebas (FLA). Literature on the efficacy of miltefosine for use in FLA infections is scarce. Regardless, the CDC notes that miltefosine could be used for the treatment of Acanthamoeba, Balamuthis mandrillaris, and Naegleria fowleri infections.

Safety

Miltefosine has several contraindications for use; these include pregnancy, Sjogren-Larsson-Syndrome, and hypersensitivity to it or its components. Miltefosine has a black box warning for embryo-fetal toxicity. Gastrointestinal associated side effects are the most common (i.e., nausea, vomiting, diarrhea). These GI side effects can lead to volume depletion and decreased absorption of oral contraceptive agents.

Cost

This medication very expensive (>$15,000 per bottle) but is available through an Orphan Drugs on Site Program (consignment-like program).

See Attachment for Further Information.