Admissions committees prefer that you be well-rounded.

While you do need to gain exposure to your chosen field, you could also choose to join a student organization that focuses on an activity or cause you feel passionately about. For instance, if you are concerned about the environment, you could join Environmental Brigades. This will show another dimension of who you are. Plus, involvement in any type of student organization provides the same opportunity to develop skills in networking, collaboration and conflict resolution. The same goes for volunteer activities.

1. Get the required training. According to the BLS, medical transcriptionists must complete a two-year associate degree program in medical transcription. During this coursework, you’ll focus on medical terminology, health care legal issues, anatomy and health care documentation.

2. Get hands-on experience. During your associates program, apply to medical transcription internships. These internships can be found through your college’s career services department. This will give you hands-on experience working in a medical transcription environment.

3. Apply for certification. Although certification is voluntary, it will help you attract potential clients The Association for Healthcare Documentation Integrity (AHDI) offers the Registered Medical Transcriptionists (RMT) certification. To quality for this certification, you must have an associate degree in medical transcription and pass an exam. Contact the AHDI to request a study guide and set up an exam date.

4. Apply for the necessary licenses. At a minimum, you will you need to apply for a business license at your City Hall. Business licenses usually need to be renewed once a year. Contact your state’s licensing department to determine if additional licensing is required.

5. Find potential clients. According to the BLSs, the largest employer of medical transcriptionists is hospitals. Print business cards and visit local hospitals. Ask to speak with the medical office manager, which typically takes care of outsourcing overflow transcription work. Other companies to target include physician offices, medical diagnostic laboratories and speech therapists.

Tip

Set up an office space for your business. According to the BLS, medical transcriptions need very basic office equipment, such as a desk and computer. Contact prospective clients to determine what type of software they use. This will help you purchase the software that is most compatible with your target market as not all companies use the same products.

Warning

Don’t forget to gather references. References can include companies that you interned with in the past and college professors. After building your client base, you can use existing clients for references as well.

Unlike traditional high school courses, these programs provide a more technical knowledge base for specific professional fields and practical training and certification that helps students hone in on specializations earlier in their careers, according to the Texas Education Agency.

Rachel Behnke, director of CTE programs at NBISD, said Texas as a whole has been pushing for districts to develop these programs in accurate years.

“The Texas Education Agency developed these programs of study. In school districts, we made them applicable to our local courses in what we offer,” Behnke said. “The intent there is to kind of have multiple entry and exit points. So for example, if a student went through a program at high school and decided they want to go directly to work, they could go into that position. Or if a student wanted to keep furthering their education, they already have a leg up in a career route.”

A variety of state and federal funding is available to school districts for these programs through the continued reauthorization of the Carl Perkins Career and Technical Education Act of 2006, most recently reauthorized by Congress in 2018, according to the U.S. Department of Education.

State and federal funding is then allocated by the TEA based on local needs assessments submitted by school districts that gather data on local economic considerations, jobs available and student needs.

Advance CTE, a national nonprofit organization that represents state directors of CTE education and tracks data, found that in a 2022 survey of more than 300 employers, 77% hired an employee due to their CTE experience, and 84% reported it was “easy” to find qualified candidates based on their CTE experience.

In the most accurate school year, students in NBISD earned more than 500 certifications, and in CISD students earned over 1,500.

“We’re trying to increase the number of industry certifications that are available to students. Those are really prevalent in health science,” Behnke said.

Renee Martinez, director of career readiness in CISD, said the programs have grown partly because they are not monolithic, but instead offer several degrees of involvement—from clear sequences of courses throughout high school to students electing to take a course or two out of interest.

“CTE covers a lot of areas. If you have a kid that’s not in band, choir or athletics, their only other elective options fall in CTE, and even then you might have a kid that’s involved in one of these programs randomly taking a CTE class [such as] accounting or principles of health science,” Martinez said.

CISD offers more than 140 CTE courses throughout the district, and within those there are 35 programs of study that students can pursue through high school.

In NBISD there are more than 80 courses and 20 programs of study.

Career pathways

The specialization of CTE programs provides for a variety of paths into the workforce, and many students find themselves employed in their field of choice directly out of high school. Others use their experience to guide them down a path they might not have fully figured out while in high school, but the programs give them a leg up in finding the right career, according to the program directors at NBISD and CISD.

“Some kids come into my classroom having no idea what they want to do,” said Jennifer Thompson, a CTE teacher at New Braunfels High School who teaches courses in criminal justice, law enforcement, public safety, forensic science and other related courses. “They realized I don’t just focus on law enforcement. There’s other things in the criminal justice field that they could do. So it kind of gives them a brighter perspective of what they could actually do with their degree if they go into criminal justice.”

Thompson added that through her sequences of classes, former students have gone on to all aspects of law enforcement, such as working as a 911 dispatcher while studying criminal justice at Texas State University as well as several who became military police.

Jake Waldrip, a 2014 graduate of New Braunfels High School, said he always knew he would pursue a career in agriculture, and through the Future Farmers of America programs he had shown cattle since he was a child. He graduated from Texas State with a degree in animal science and now works for both his family’s business—Waldrip Bros. Cattle Co.—and in livestock trailer sales at D&D Texas Outfitters.

While Waldrip grew up in the trade, he said many students took some of the agriculture classes with him without any background.

“I had high school friends that didn’t grow up around it necessarily, and they showed some other species, but they would come and help us with the show cattle throughout the whole process ... as much as in depth as they wanted to get into, we were always willing to help and always had open arms,” Waldrip said. “So long as somebody is willing to show up and get their hands dirty and work hard, there’s a ton of people that are willing to teach and get kids involved in all aspects of the game.”

Mike Newkirk, an automotive tech teacher at Canyon High School, said some of his students go directly into the industry while others pursue postsecondary work in the field.

His students typically go through four years of automotive tech, from basic principles of the mechanics of cars to more advanced coursework. His classroom also serves as an auto shop for teachers and staff to bring their own parts and have the students work on their vehicles.

“I put them to work straight after school if they don’t want to go to postsecondary or college or you know if they want to do something else in life,” Newkirk said. “If they don’t want to go to college, I have industry leaders here [at] local dealerships from San Antonio to South Austin that will hire my guys as they come out of my program because we are accredited.”

One of those accurate graduates is James Robinson, who received a scholarship to UTI but chose instead to go right to work at Griffith Ford.

“Mr. Newkirk gave me the opportunity to get every certification I could at my age. I came out of the Canyon High School automotive program with over 20 certifications,” Robinson said.

“I wanted to just make money immediately; I didn’t want to have to owe it. So I decided that rather than having to wait to start my career and start at the bottom, I can start at the bottom now rather than in four years,” he said.

Careers in college

CTE pathways also provide a door into fields that allow students to work within the field they are pursuing a higher degree in to gain experience.

Sanjay Patel graduated from NBHS in 2016, and while in school knew he wanted to be in the medical field and took pre-dental coursework.

“I was aspiring to be a dentist, [but] I realized that dentistry is not where I want to be. I still knew I wanted to be somewhere in the health care field, and that’s when I started exploring what the different options I had in health care. I started looking toward administration,” Patel said.

After earning a bachelor’s degree in public health from the University of Texas at San Antonio and a master’s in business, he is now interning at a hospital in Carrollton.

The CTE course he took on medical terminology was also helpful, he said.

“[It helped] me learn more about the terminology that medical practices often use. I’d say the practicum course helped me out a lot. Close to my junior year and at the end of my junior year, I received my registered dental assistant certification. So during my senior year in high school, I was also working as a dental assistant in the office while doing school,” he said.

For students looking to enter the teaching profession, CTE programs such as Ready, Set Teach place high school students in a classroom a few hours a week to learn from current teachers and interact with students.

“I had kind of always known that I wanted to work with kids, but I wasn’t full-on sure if it was teaching I wanted to do, so I joined it my junior year, and I got to be in a classroom four days a week for two hours,” said Valerie Grona, a 2017 graduate of Smithson Valley High School and now a kindergarten teacher at Johnson Ranch Elementary School.

Grona said the experience showed her what being a teacher is all about and affirmed her interest in pursuing teaching as a career.

While participating in the Ready, Set Teach program, Grona was able to work at the elementary school she went to and now teaches in.

“That kind of came full circle for me,” she said “But really, it just kind of showed me what teachers do every single day and gave me a taste of it. It’s probably one of my most memorable things of high school was being ready to teach because it was the thing I looked forward to every day.”

Anchorage health director Joe Gerace resigned Monday, hours after Alaska Public Media confronted him and Mayor Dave Bronson’s office with evidence that Gerace had vastly overstated and misrepresented both his educational credentials and military background. 

A city press release attributed Gerace’s resignation to “severe health issues” including a stroke last week that left him hospitalized. He “suffered another event” on Monday, according to the release.

A joint investigation with American Public Media found that Gerace had falsely presented himself as a high-ranking officer in the Alaska National Guard with a pair of master’s degrees in business administration and physician assistant studies. Those credentials led Bronson to appoint Gerace director of the city’s Health Department last year, putting him in charge of the response to a global pandemic and a local homelessness crisis.

Gerace doesn’t have a master’s degree, let alone two, records show. And he isn’t a member of the National Guard, either. His lofty title of lieutenant colonel comes from his position in the Alaska State Defense Force, a group of volunteers that sometimes assists the Guard, but is not part of the U.S. Armed Forces. 

Reached by phone Monday morning, Gerace admitted that he was not in the Guard. He refused to say where he got one of his master’s degrees. And he claimed he got the other one from a school that didn’t offer master’s degrees at the time and has no record of him as a student. At times he insisted his resume was factual, and at other times admitted that statements in it were inaccurate. 

“I could see how they’d be misleading for some people,” he said. “If somebody asks me, I clarify them right away.” 

Gerace’s year as health director has been marked by a COVID-19 surge that overwhelmed the city’s two largest hospitals, a rash of staff resignations and a homelessness policy that critics say has led to a “humanitarian crisis.” 

Running the Health Department is a challenging job even for a qualified manager. It has more than 100 employees and a $15 million budget. In addition to COVID and homelessness, the department oversees such varied areas as food assistance, air quality monitoring, restaurant inspection and animal control. 

The mayor and other city leaders knew that one of Gerace’s former employees had raised questions about the accuracy of his resume before the Anchorage Assembly confirmed Gerace as health director. The former employee emailed her concerns to the Assembly. And she testified in a closed-door Assembly meeting that the mayor attended.

Despite her warnings in November, neither Bronson nor the Assembly stopped to verify Gerace’s credentials. Immediately following the hearing, the Assembly confirmed Gerace’s appointment to a job that pays nearly $120,000 a year and is responsible for some of the city’s most vulnerable residents.

Bronson did not respond to a list of questions about Gerace’s credentials earlier in the day Monday. In a brief phone conversation, Bronson spokesperson Corey Allen Young disputed some of the information presented about Gerace’s credentials. He said the city would not be able to provide answers by Monday afternoon because of Gerace’s medical emergency. He declined to be recorded. 

Military service

Gerace presents himself as a military man — both on his resume and in his personal life. Former employees at a COVID vaccination site he managed say he encouraged staff to address him as “Colonel Joe.” 

Gerace’s actual military experience is limited, and some of the claims he has made are misleading or false. 

Gerace hasn’t served in any part of the Army since the 1990s, according to Defense Department databases. He enlisted in the Washington National Guard in 1991 and then transferred to the Army Reserves. When he left the service in 1999, records show, his rank was just one step above private.

But in the Alaska State Defense Force, Gerace started as a lieutenant colonel. The ASDF is a volunteer-based organization that is largely made up of former military servicemen and women like Gerace. It has fewer than 200 members, compared to the roughly 3,800 soldiers and airmen in the Alaska National Guard. 

Unlike the National Guard, ASDF members are not part of the U.S. military, and they aren’t even employees of the state. Until recently, ASDF members were required to supply their own uniforms, which say “Alaska,” instead of “Army.” Under state law, the ASDF is considered part of Alaska’s “organized militia” along with the Guard and the Alaska Naval Militia. It uses ranks that mirror the military’s, but its regulations restrict members from using them outside of official communications. 

Records show Gerace not only uses his ASDF lieutenant colonel rank liberally, he has also stoked the misperception that he holds that position in the Alaska National Guard. 

In July 2021, Gerace falsely told the Bronson administration that he was a “Lieutenant Colonel – Alaska Guard.” He made the claim in an email obtained by Alaska Public Media that he sent to Bronson’s community engagement director. Two months later, Bronson nominated him for health director.

At an Assembly hearing in October, Bronson’s human resources director, Niki Tshibaka, repeated the falsehood, introducing Gerace as “a lieutenant colonel in the Alaska National Guard.” That echoed a press release from Bronson’s office describing Gerace as a commander for the Guard. Gerace said nothing during that hearing to correct the record.

“Wow, quite the introduction to follow,” Gerace said after Tshibaka spoke. 

Gerace said in a Monday phone interview that he did correct the record to Tshibaka later, in private.

“He is not a member of the Alaska National Guard,” its communications director Alan Brown said in an email Monday evening. “If [a] current member of the [Alaska Organized Militia] were found to have falsely represented their service, it could result in adverse action.”

Former servicemen and women who join the Alaska State Defense Force typically start at the same rank they had in the military. It is unclear how Gerace rocketed from E-4 specialist, an enlisted rank, to lieutenant colonel, a high-ranking officer.

Simon Brown II, commander of the Alaska State Defense Force, said Monday he was calling a special staff meeting to review and verify the documents Gerace submitted with his application, which would have included his military discharge paperwork and copies of his degrees. Brown submitted a letter recommending Gerace for the Health Department job, and Brown seemed troubled by the suggestion that Gerace had misrepresented himself.

“I’m hoping your information is wrong,” Brown said.

Alaska Public Media obtained a different resume that Gerace used in 2021 to get a job as vaccine operations director for Visit Healthcare in Anchorage. Visit Healthcare ran several COVID testing and vaccination sites around the city. 

The resume Gerace gave to Visit Healthcare includes a dubious depiction of his military accomplishments. It says “I had 24 years of service,” triple the amount of time the Army’s database shows. Gerace also claimed on the resume that he had “5 combat deployments.”

None of those deployments appear in the Army’s databases, and Gerace admitted during an interview that the claim on the resume was false. 

“I cannot explain that,” he said. “I never served in a combat zone.”

But he went on to explain that he had been deployed “through a lot of different agencies” like the Red Cross in “austere conditions, very, very bad conditions, disasters and other stuff.”

As for the 24 years of service, he said that referred to “mixed service” – including his time in the Alaska State Defense Force – not just his work in the military. The Alaska National Guard said he joined the ASDF in 2020. Combined with his time in the Washington National Guard and the Army Reserve, that would bring him to 11 years, not 24.

Education

Public records also contradict the educational achievements Gerace touted on the resume he submitted to the Anchorage Assembly last year. 

The resume says Gerace got a master’s in physician assistant studies in 1993 and a second one in business administration in 1998, on top of a bachelor’s of science in chemistry and chemical engineering in 1988. 

But his resume does not list the higher education institutions that supposedly granted him these degrees.

In a phone interview, Gerace refused to say where he got his master’s in physician assistant studies, promising to send documentation later. But he claimed he received his MBA from Henry Cogswell College, a small school in Everett, Washington, that went out of business 16 years ago.

Henry Cogswell College was not authorized to offer MBAs, according to records from the Washington Student Achievement Council, a state body that oversees higher education. David Smith, a business professor at Palm Beach Atlantic University who taught at Henry Cogswell College in 1998, when Gerace claims to have graduated, confirmed that.

“No MBAs during my time,” Smith wrote in an email. He also had no memory of a student named Joe Gerace.

The Washington Student Achievement Council took custody of Henry Cogswell College’s student transcripts when the school closed in 2006. It has no record of Gerace attending the school either. 

Confronted with these facts during an interview, Gerace was unable to explain how he could have gotten an MBA from a school that didn’t offer them or why the records showed no indication he was ever a student.

“I don’t know,” he said. “I’d have to ask them because there was some when the school closed, there was some heavy confusion about how to even get our stuff.”

On Monday, Gerace also acknowledged that he did not have two bachelor’s degrees, as he claimed on the resume he provided to the Assembly. He said he had only one – a major in chemistry. He said he minored in chemical engineering. 

Public records from Washington State, where Gerace lived for much of his adult life, also contradict the educational background he claimed on the resume. Records contain at least four instances in which he listed his educational credentials. None mention graduate degrees.

The records include a handwritten application to modify child support payments that Gerace filled out in 2000, because he was more than $10,000 behind on payments to his first wife. The document, which he submitted to a court under penalty of perjury, says that the highest level of education he completed was a bachelor’s of science. 

In other filings in the same case, he said he had a “bachelor’s degree” and that his highest level of education was “college.” That was two years after Gerace now says he earned his second master’s degree. 

And 11 years later, when he ran unsuccessfully for a city council seat in a suburb of Tacoma, Washington, Gerace wrote in his official candidate bio that he had a B.S. in business administration and a B.A. in history. No chemistry. No chemical engineering. No physician assistant studies. No mention of master’s degrees. 

Gerace said he left out his master’s degrees because he thought voters would judge him for having a lot of education. 

“People don’t want to hire an old guy that knows everything,” he said of the bio.

The resume Gerace used to get his earlier job at Visit Healthcare makes no mention of bachelor’s degrees, let alone master’s. Under education, the resume lists only a “paramedic certificate” from Northern Virginia Community College, also known as NOVA. The college confirmed that Gerace enrolled there in 1984, when he was 16, and left three years later. The college’s files show no evidence of Gerace receiving a paramedic certificate.

“We have no record of a degree conferred,” NOVA’s Freedom of Information Act Officer Kathy Thompson wrote in an email. 

Thompson said Gerace reapplied to the community college just two years ago, a few months before he got the job at Visit Healthcare. He sought to study emergency medical services and general studies with a focus on health science, Thompson said, but he didn’t end up enrolling. 

It would seem unusual for someone with a bachelor’s and two master’s degrees to pursue an associate’s degree from a community college.

Gerace claimed he reapplied to the college simply to access his transcripts and never had any intention of enrolling. 

The Alaska National Guard seemed under the impression that Gerace had attended the University of Virginia. It wrote a Facebook post about him in 2020 as part of a series called “faces of the Alaska State Defense Force” that said he “studied medicine” there. A profile of Gerace on the professional networking site RocketReach also claims he went there, in addition to NOVA and Henry Cogswell College.

The University of Virginia has no record of Gerace studying there, deputy spokesman Bethanie Glover wrote in an email. 

Alan Brown, the Alaska National Guard spokesman, said he was unable to determine why the Guard had posted that Gerace had studied medicine there.

“Normally, this type of information would come from a personal interview,” he wrote.

Gerace said he “corrected that too,” though as of Monday, the post still appeared on the Guard’s Facebook page. 

Gerace joins embattled Bronson administration

Mayor Dave Bronson is a conservative who narrowly defeated his progressive opponent by opposing COVID-19 health restrictions and vowing to address homelessness. His 13 months in office have been embroiled in controversy.

The mayor ordered workers at the city’s water treatment plant to stop adding fluoride to the water system, and then his administration misled the public about it. He spoke at a gathering of COVID-19 vaccine skeptics during one of the city’s deadliest waves of the virus. And he fired an official investigating alleged offensive comments made by his deputy library director. 

Several of his appointees faced tough confirmation battles because of questions about their qualifications. More than a third of the directors of city departments and divisions have resigned or been fired under Bronson, an analysis by Alaska Public Media found. Three have filed lawsuits against the administration saying they were wrongfully terminated. 

Bronson’s first choice for health director was a Republican insider with a background in health care finance. David Morgan came under fire for offensive Facebook comments and after he refused to acknowledge to an Alaska’s News Source reporter that a pandemic was happening. Morgan resigned after it became clear that the Assembly wouldn’t confirm him. 

That’s when Bronson turned to Gerace. He was already on the administration’s radar because of his role at Visit Healthcare. 

A few days after Bronson took office, Gerace sent an email to Portia Noble, the mayor’s community engagement director. The email referred to a previous phone conversation with Noble and included an extensive list of his qualifications.

In the July 12 email, Gerace claimed to be an officer in the Alaska Guard with two master’s degrees. He also said he’d been a physician assistant since 1992. 

If the Mayor’s office had searched freely available online licensing databases for physician assistants in the three states Gerace has called home — Virginia, Washington and Alaska — it would have found no record of him holding such a license.

Gerace said that his email was referring to the physician assistant’s degree he claims to have received in 1993. He said that his statement in the email that he was a physician assistant  “might be unintentional.”

Emily Ostereicher, a spokesperson for Visit Healthcare, said the company believed that Gerace was a PA when it hired him. 

A month after Morgan stepped aside, Bronson appointed Gerace. 

During Gerace’s confirmation process, Assembly members said they received about 10 emails and several phone calls from people who had interacted with Gerace at Visit Healthcare, Suburban Propane, where he managed customer service, the American Red Cross, where he volunteered, and even at the city health department during his brief time as unconfirmed acting director. The allegations included unprofessional management and favoritism, as well as concerns about his qualifications.

Emma Jacobson, a nurse who Gerace had fired from Visit Healthcare, told the Assembly that his resume didn’t add up.

“I am concerned with Mr. Gerace’s varying accounting of his own certifications,” she wrote in a November 8 email to Assembly members. “He has represented himself at times as a Physician’s Assistant or as a Paramedic; he has given accounts of his time as both in the military to many different people on many different occasions. I could not find evidence to support this in national databases.”

Tshibaka, Bronson’s human resources director, dismissed the complaints at the time as “false,” “inaccurate” and “pure character assassination.” He apologized to Gerace at an Assembly meeting for what he called the “disparagement of your sterling character.”

Jacobson was undeterred. She said she repeated her concerns during a closed-door Assembly meeting attended by Mayor Bronson. Jen Wallace, another former employee of Gerace’s who was present at the closed-door meeting, corroborated Jacobson’s account. The minutes from the portion of the meeting that was open to the public also show the mayor was present.

Jacobson said nobody seemed interested in following up on her concerns.

The Assembly confirmed Gerace in a 7-3 vote that same day.

“I was heartbroken, and I was tearful,” Jacobson said. “I was so afraid for the city.”

Gerace’s tenure as health director

In Gerace’s 10 months as health director, he led the department through a COVID-19 surge and a major transition in its response to homelessness. His tenure was rocky and contentious. 

Within a few months of Gerace’s confirmation, nearly all senior staff remaining from the previous administration resigned or were fired, costing the department decades of experience.

Last fall, two of Anchorage’s largest hospitals declared crisis standards — a protocol for rationing health care — during a surge of COVID cases. 

At the time, a department employee complained to Assembly members about links on the Anchorage Health Department website that suggested the antiparasitic drug ivermectin could help treat COVID-19, something major health organizations say is unproven.

More recently, the health department has come under fire for what advocates for the homeless say was a botched closure of the city’s main shelter at the Sullivan Arena. 

Gerace closed the shelter months before a new large-scale shelter space was scheduled to open. In the month leading up to the closure, his department told the shelter not to accept new guests. Homeless service providers say that left many people with nowhere to live except tent camps in city parks.

Police data show that move coincided with a sharp increase in the number of “outdoor deaths” in the city — which typically refers to homeless residents. Six people died outdoors in June, the highest one-month total in at least two and a half years and about four times the monthly average during that period. There were three additional deaths in July, also more than normal. 

Gerace said Monday morning that he had already decided to leave the administration but at the time, he didn’t specify a date. 

“Due to a accurate medical emergency,” he said, “I’m unable to perform the duties of health director. So I have submitted my resignation.”

He said he was proud of his time at the department and his career. 

“There’s never been a day in 40 years that I haven’t cared for people,” he said. “I truly care for people. And I don’t think anyone said that I’ve done anything bad with the city.”

Gerace’s real resume

The resume Gerace used to get the health director job is long on volunteer experience and short on actual employment. The only paid, full-time job it lists is the position at Visit Healthcare, which he held for just seven months in 2021. 

Still, Gerace touted his business experience. 

“I have made lots of money in business,” Gerace said in the phone interview. “That’s what I prefer to do.”

Gerace’s actual work history, compiled through public records, includes stints as a police officer, a firefighter and the sales manager for a construction supply company. He worked at a Chevy dealership, drove a tow truck and delivered building materials for Lowe’s. At one point, two years after he supposedly earned an MBA, he told a court he was working odd jobs for the owner of a mobile home in exchange for room and board. It was part of his explanation for failing to make child support payments.

Gerace’s own forays into running businesses have been troubled and short-lived. 

He opened a gun store in Renton, Washington, in 2000 but filed for bankruptcy personally and on behalf of the store just two years later. He filed again the following year but never completed the bankruptcy process.

In 2016, Gerace entered into an agreement to purchase a company that ran a Chevron gas station in Anchorage. Two years later, the man who had sold it to him filed a lawsuit claiming Gerace hadn’t made the agreed-upon payments. The case was settled out of court. 

The state environmental agency cited the Chevron station under Gerace’s management for not keeping records on its monitoring for leaks and not properly maintaining leak response equipment.

Gerace seemed to have “intentionally made a false representation regarding required leak detection records to the inspector, which is, in fact, willfully making a false statement to the state,” Cheryl Paige, who oversees the regulation of the state’s underground fuel storage tanks, wrote in a 2018 email obtained through a public records request. 

Gerace no longer operates the Chevron station. He disputed the claim that he had falsified records, saying his bad record keeping happened because he wasn’t properly trained by a former business partner. 

He also briefly leased a Shell station in Spenard for about a year, he said.

Gerace’s company was sued in small claims court for about $5,000 in unpaid bills by a contractor that installed a security system there.

Still, Gerace appears to be planning new ventures in the business world. Last year, he registered 10 new business names with the state including Alaska Medical Response, The EMT Academy, W.W.A.M.I. Fire & EMS Training, 5 Star Towing & Service, Big Joe’s and GI Joe’s. In April he incorporated Whittier Rescue Squad, a nonprofit organization created to provide ambulance service, according to its filing with the state. Its other directors are Gerace’s wife and his executive assistant. Whittier City Manager Jim Hunt said he only recently heard of the Whittier Rescue Squad and said it has no association with the city’s emergency response services. 

Gerace said that he got the business licenses in order to protect the names. 

The resume Gerace submitted to the Anchorage Assembly touts his work as a firefighter and paramedic, “at various agencies over many years.” Gerace is not licensed as a paramedic in Alaska, only an advanced EMT, which is a lower-skilled designation. He volunteered for just a few months — not years — at the Seward Volunteer Ambulance Department and Whittier Volunteer Fire Department, officials there say. 

Like almost every state, Alaska requires paramedics to be certified by the National Registry of Emergency Medical Technicians. Gerace is not listed in the registry as a paramedic. 

In 2020, however, he procured a paramedic license in Montana, one of only three states that does not require NREMT certification. 

Gerace said he applied for and received that license using his certifications as an EMT. It was later rescinded, he said, after an official realized the credentials he submitted did not qualify him to become a paramedic.

“I did nothing nefarious,” he said. “Someone down there reviewed it and said yes initially and then someone changed their mind.”

Washington State has no record of Gerace holding a paramedic license, either. He had an EMT license there in the early 1990s, but it expired in 1993.

Gerace has been divorced three times. His second wife accused him of forging documents he filed in court as part of their divorce. 

“During our marriage I found that Mr. Gerace was quite willing to do anything and say anything to achieve his ends,” RaeLea Olson-Gerace wrote in a court filing. “This included deliberate falsehoods and the post-dating and pre-dating of documents when it served his interests.” 

Olson-Gerace, who has since remarried and is now RaeLea Hurt, declined to comment for this story.

Jennifer Lu contributed to this story. It was produced as a collaboration between American Public Media Reports and Alaska Public Media. 

Correction: An earlier version of this story misstated the year Henry Cogswell College closed. It closed in 2006.

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The experts are pretty sure it’s going to take 100,000 psychedelic facilitators for the new industry to provide treatment to the masses. 

When we got the chance to ask The UC Berkeley Center for the Science of Psychedelics (BCSP) about its efforts last week, one of the popular syllabus was its work to increase the number of Psychedelic Facilitators for the tidal wave of FDA approval for the medical use of MDMA and psilocybin. During the call, Michael Pollan, who leads the center’s public education effort and just dropped the GOAT psychedelic docu-series on Netflix, noted he’d heard the industry would need about 100,000 facilitators to guide people through their quests for healing. 

We reached out to the Multidisciplinary Association for Psychedelic Studies’ (MAPS) founder, Dr. Rick Doblin, to get his take on the numbers. Doblin is one of the main figures to help usher in the new era. Since its founding in 1986, MAPS has taken the lead in pushing for more psychedelic research and reform. 

Additionally, few organizations have the body of knowledge on facilitation MAPS does, given their years of research, or analysis of the work of others. Doblin told L.A. Weekly, 100,000 is a very large number of therapists, but considering 12 million people suffering from PTSD and the 17 million or more suffering from depression, it’s not unreasonable.

“MAPS’ goal is to train 25,000 therapists in MDMA-assisted therapy for PTSD before 2030,” Doblin said. “There are so many other potential clinical indications for MDMA and psilocybin such as alcohol and substance abuse, social anxiety, phobias, etc., etc., that 100,000 therapists could be kept busy.” 

Doblin also noted what the final accepted models look like also will play a big number in figuring out how many facilitators will be needed. 

“The other key variable is group therapy, which if that works close to as well as individual therapy, it’s possible a lower number of therapists could meet the need,” Doblin said. 

Back in Berkeley, Tina Trujillo is leading the effort to get facilitators trained. In addition to serving on the BCSP’s leadership team, Trujillo is an associate professor at UC Berkeley’s School of Education. Her current work, where she explores tensions and commonalities among scientific, spiritual, and Indigenous ways of doing things, could not be more fitting. Equity in the psychedelic industry for indigenous practitioners has long been a part of the conversation; Trujillo will have a front-row seat to the attempt to put it into practice. She’s looking at the big picture.

“As a consequence of all of these developments, we’re finding that there’s an increasingly large need for professionally trained facilitators to provide safe, legal and effective psychedelic assisted therapy,” Trujillo said. “The field has recognized that these substances alone and not a magic pill, they’re part of a larger system of sophisticated and coordinated care.” 

Trujillo emphasized a key part of that system is a trained guide, or facilitator, who supports clients to prepare for, to undergo, and to integrate their psychedelic experiences into the rest of their lives. 

The BCSP will offer a 175-hour training program that lasts nine months and is designed for mid to late career advanced religious, spiritual-care, and health-care professionals. Participants will even get the chance to take part in an FDA-approved psilocybin study to better guide others in their own experiences.  

“We provide interdisciplinary training for advanced professionals, with an emphasis on both Western science and spiritual care traditions,” Trujillo said. “This coming September, we’ll launch our inaugural cohort for the certificate program in psychedelic facilitation. This first cohort is composed of 24 advanced licensed professionals that include chaplains, medical doctors, nurses, psychotherapists and social workers.”

Trujillo also noted the center has been able to diversify its enrollment to include members of historically underrepresented groups and lower-salary professionals, by offering financial assistance to qualified applicants. 

One major factor of the whole program is the fact it’s basically an unregulated field outside of the current policy shift in Oregon. 

“This means that universities have a major opportunity to rigorously bridge the worlds of research and practice, and in ways that emphasize accountability and systematic knowledge building,” Trujillo said. “So part of our mission in this program is to build this bridge between empirical knowledge bases in practice.”

Here in L.A., ketamine therapy has blown up in accurate years with thousands now having undergone treatment through a variety of centers. We asked Trujillo how much the body of knowledge built locally might help in the work in Berkeley and other places. 

“Yes, I think that there are lessons that can be transferred to other settings with other substances and then there are some properties of working with that particular substance that are unique to its profile,” Trujillo replied. 

She said things like the preparation that goes into a psychedelic experience, the intentional work that precedes it, the care that’s provided when somebody actually is taking the medicine, and then the follow-up, all of that can apply to a variety of settings.

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In a accurate study posted to the Preprints with The Lancet* server, researchers estimated the vaccine effectiveness (VE) of the primary and booster doses of coronavirus disease 2019 (COVID-19) vaccines against reinfection by Omicron BA.5 and BA.2 lineages and severe post-infection outcomes.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron sub-variant BA.5 was reclassified as a variant of concern (VOC) by the European Center for Disease Prevention and Control (ECDC) on May 12, 2022. Its prevalence accounted for around 37% of COVID-19 cases in Portugal in May 2022. The Portuguese National Institute of Health estimated a growth advantage of 13% per day for BA.5, which, coupled with a doubling time of about six days, would have made it the dominant lineage in Portugal.

Background

There is a conflict between the results from animal models, neutralization assays, cell cultures, and the early vaccination risk assessment comparing BA.5 with other Omicron lineages. Due to the lack of a negative control group, any study design that quantifies the relative effect of COVID-19 vaccination against Omicron reinfections among highly vaccinated populations could prove useful.

Study design

In the present study, researchers compared the VE of primary and booster vaccination between Omicron BA.5 and BA.2 lineages. They assessed how vaccination prevented breakthrough infection from Omicron lineages and estimated lineage-specific post-infection VE against COVID-19-related hospitalization and mortality.

They implemented two different approaches. In the first approach, they compared case-to-case the odds of the COVID-19 vaccine among individuals with breakthrough infection from Omicron BA.5 and BA.2. In the second approach, they followed BA.2 and BA.5 infected groups to assess lineage-specific post-infection VE (VEp) against COVID-19-related hospitalization and death. They compared VEp only between vaccinated- and unvaccinated-infected individuals to compare the risk of severe outcomes.

The study population comprised individuals diagnosed with COVID-19 from mainland Portugal between April 25 to June 10, 2022, via a positive by reverse transcriptase-polymerase-chain-reaction (RT-PCR), with positive samples subjected to S Gene Target Failure (SGTF) assessment or whole-genome sequencing (WGS).

The team considered only samples with nucleocapsid (N) and open-reading frame 1a (ORF1a) positive signals and cycle threshold (Ct) values ≤30 for SGTF-based classification. Based on the vaccination status, the study population comprised unvaccinated individuals and those who had received complete primary and booster vaccinations.

The researchers obtained COVID-19-related hospitalization data from Integrated Hospital Information System (SONHO) registry, which captures all information from the National Health Service (NHS) hospitals in Portugal. Likewise, the National Death Certificate Information System (SICO) issues a death certificate for each individual who dies in Portugal with COVID-19 as the primary cause of death for which the International Classification of Diseases (ICD)-10 code U.071 according to the World Health Organization classification is used.

Further, the researchers performed data extraction and deterministic linkage of electronic health records with laboratory data on July 12, 2022. Also, they collected age, sex, residence, and the week of swab collection via the national surveillance system SINAVE. Furthermore, the researchers used a logistic regression model adjusted for sex, age group, region of residence, and week of swab collection to estimate the odds of vaccination.

An odds ratio (OR) estimate greater than one and one suggested that VE was lower for BA.5 lineage than BA.2 and the same for both Omicron lineages, respectively. They interpreted OR for the previous infection similarly. Lastly, the team used penalized logistic regression to reduce the bias caused by hospitalization or deaths for VEp estimates against severe outcomes in BA.5 and BA.2 cases. The OR for the lineage and vaccination status interaction measured the ratio between relative VE to prevent severe outcomes among those infected with BA.5 compared with BA.2.

Study findings

Between April 25 and June 10, 2022, there were 15,396 BA.2 cases and 12,306 BA.5 cases. Compared to BA.2 cases, BA.5 cases were slightly younger and resided frequently in Alentejo and Centro regions. Additionally, the proportion of cases with a previous COVID-19 infection was higher in BA.5 than BA.2 cases (10% vs. 5.6%). Regarding vaccination status, both groups had 4 to 5% non-vaccinated cases, but BA.5 had a higher proportion of individuals who had received primary vaccination series (20.6% vs. 15.8%), and BA.2 had more individuals who had received a booster dose (80.1% vs. 74.7%). Moreover, there were 106 COVID-19 hospitalizations and 42 deaths.

The odds of complete primary vaccination or booster dose (aOR=1.07 vs. 0.96) among the BA.5 cases were similar to the BA.2 cases, suggesting no relevant differences in VE against infection for the BA.5 lineage compared to BA.2. The authors noted higher odds of the previous infection in BA.5 cases compared with BA.2 (aOR=1.44). Combining primary vaccination and prior infection status, the estimated aOR of BA.5 was 1.70 times higher than for a BA.2 reinfection. For booster vaccination, a higher reduction in risk of hospitalization was observed either for BA.2 or BA.5, representing post-infection VE of 93% and 77%, respectively.

The interaction term that allows comparison between BA.5/BA.2 lineage VE was 3.36, suggesting reduced post-infection protection induced by booster dose against hospitalization for BA.5 compared to BA.2. The ratio of post-infection complete primary VE in BA.5 vs. BA.2 cases was 2.06 with a wide confidence interval (CI). As for booster dose, the aOR for death suggested higher risk reduction than unvaccinated for BA.2 (VEp=94%) than for BA.5 (VEp=88%), with overlapping CIs. For the death outcome, the interaction term that allowed for comparison of post-infection VE between BA.5/BA.2 lineages was 0.43 for complete vaccination and 1.98 booster dose, both with very imprecise CIs.

Conclusions

Overall, the VE against BA.5 and BA.2 infection was similar. However, the SARS-CoV-2 Omicron BA.5 lineage was associated with higher odds of the previous infection when compared to BA.2, suggesting a reduction in the protection conferred by the prior infection against BA.5 compared to BA.2. Moreover, against hospitalization outcomes, VE was lower post-BA.5 infection booster dose than post-BA.2 infection booster dose. In addition, among BA.5 infected patients, the protective effect of the first booster on reducing the odds of hospitalization outcome was higher than the primary vaccination (VEp=77% vs. 22%). Regarding death outcome, the authors estimated high post-infection VE of the booster dose for both BA.5 and BA.2 cases.

To summarize, vaccines currently used in Portugal were less effective in reducing the risk of severe outcomes for BA.5 than BA.2. The observed differences in primary vaccination and booster dose post-infection VE against severe outcomes observed for BA.5 and BA.2 lineages highlighted the significance of higher vaccination coverage in preventing severe COVID-19.

*Important notice

Preprints with The Lancet publish preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Rejection of student visa permits in Canada have been on the rise since the Covid-19 restrictions and air travel ban have been lifted  in 2021. However, students have seen a sharp rise in rejection, especially in the past few days. 

Reports have suggested that students who have IELTS scores of 6.5 to 7, good academic record and financial background have also been rejected. 

A CBC News report have said that of more than two million temporary resident and permanent residency (PR) applications pending in Canada, nearly a million came from India. The report also mentioned that at present, Canada has a backlog of more than 2.4 million immigration applications as of 29 June, up from 1.8 million applications in March.

This data was received from Canada’s Immigration, Refugees and Citizenship Canada (IRCC) department.

Here is why student visas are getting rejected

Experts have suggested that there has been a significant rise in visa application among students for Canada due to declining interest in Australia and New Zealand. 

The bulk rejections and delay in visa approval could be result of these sudden increase in visa application.  Notably, the visa application process for Canada has become a rather long process involving tedious process of 9-12 months. 

Experts have also cited high pendency rate of applications in different categories, fraud documentation by students in some cases, licensing issues with certain private colleges for the increased rejection of Visa permit for students.

Pending applications

A report of the Standing Committee on Citizenship and Immigration was tabled in the Canadian House of Commons in May titled ‘Differential treatment in recruitment and acceptance rates of foreign students in Quebec and rest of Canada’.

As per this report, in 2021, the total number of Study Permit Applications refused and processed from India were 91,439 and 225,402 respectively. The refusal rate was nearly 41%.

In the case of India, the number of PR applications stands at 96,378 and the number of temporary residence applications is 430,286. The total number of pending applications was 9,56,950, the highest across the world.

As per the report, the number of study visa permits increased by 52% from 2,64,625 in 2016 to 4,02,427 in 2019, which was the highest since Canada’s study visa programme started.

However, in 2020, owing to the effects of the Covid-19 pandemic on travel and access to services to submit the required documentation for a complete application, there was a 36% decrease compared to 2020, when Canada had issued 2,56,740 study permits.

Here is how you can avoid getting rejected

A foremost step to prevent your application from getting rejected is making sure you have all proper documents ready on time. According to the official website of the Government of Canada, while applying for student visa permit you should have the following documents ready

-A letter of acceptance from a designated learning institution (DLI) you’ll be attending

-If you’re under 18 and coming from outside Canada to study, you must study at a DLI with an approved COVID-19 readiness plan, unless you qualify as a fully vaccinated traveller.

-As many of the documents needed for a complete application as possible

-A letter of explanation for any documents that are missing due to Covid-19

-If you plan to study in Quebec, you must provide a valid Québec Acceptance Certificate (CAQ) or your letter of approval for your CAQ.

The website also warns, “We won’t be able to finalize your study permit until you’ve submitted a complete application. Waiting to submit documents will cause delays in processing."

Please also note that you must apply for a study permit before you come to Canada. Some people can apply for a study permit from within Canada

Here is a quick document check guide for your application

You need these documents to apply for a study permit:

-Proof of acceptance

-Proof of identity

-Proof of financial support

Here's how to apply for student visa permit in Canada

Students apply for study visas in Canada through Student Direct Stream (SDS) and non-SDS categories. Here are the steps to applying online for student visa permit. 

Step 1: Make sure you have what you need

To apply online, you’ll need:

-A scanner or camera to create electronic copies of your documents

-A valid credit or debit card

Step 2: Read the instruction guide

Even if you apply online, you should read the instruction guide before you complete your application. The guide will explain how to complete each field on the form.

Step 3: Prepare your answers for the online tool

Before you can upload your forms, you must answer some questions. These are used to create a personalized document checklist of the student.

Step 4: Know the fees you have to pay

In most cases, your fees will include:

-Processing fees for you and anyone you include on your application

-Biometrics

You have to pay these fees at the end of the application

Third-party fees

Depending on your situation, you may need to pay third parties for Medical exams, police certificates, language testing, and services at a visa application centre if you use one. 

You won’t pay these fees in your online account. You’ll pay them directly to the third party.

Biometrics fee

In most cases, you should pay a biometrics fee when you submit your application. Otherwise you may experience delays. The biometrics fee covers the cost of collecting fingerprints and a digital photo. Find out if you need to give your biometrics.

Step 5: Create your online account or sign in

You need an account to apply online. You can use your account to:

-Pay your fees

-Submit your application

-Check your status