June 26, 2014
The educators who attended the Ross Med Education Summit, held in Miami June 11-12 were focused on the topic of how to better integrate basic science into clinical training. Last February a Summit took place in Dominica to discuss improving the integration of clinical knowledge into the basic sciences’ curriculum. At both events, clinical clerkship directors, clerkship chairs and program directors from RUSM’s hospital affiliates around the country engaged in dialogue with RUSM’s department chairs, deans and faculty members from Dominica, where the basic science curriculum is taught. They explored ways to enhance the student learning environment and to increase opportunities for student success.
“We are one team and one school, but that doesn’t mean that we are of one opinion, and that’s great, that’s how we work,” said Joseph A. Flaherty, MD, RUSM Dean and Chancellor. “There was a good dialogue during the presentations and the small group breakout sessions.”
The keynote speaker, Aaron McGuffin, MD, talked about the efforts to achieve such integration at his institution, Marshall University Joan C. Edwards School of Medicine in West Virginia. “Teaching the same lectures without interdisciplinary collaboration is not integration,” he said. “Integration requires conversations that are uncomfortable.” What is needed is curriculum mapping, so that, as Dr. McGuffin put it, “Each lecture doesn’t start with, ‘I don’t know if you’ve had this before…’”
Alison Dobbie, MB, ChB, MRCGP, RUSM’s Senior Associate Dean for Medical Education, who organized the two Education Summits, said that one of the “good takeaways,” from the Miami Summit was the fact that the basic science chairs requested access to the Essential Patient Encounters that are used in the core clerkships, “to have that in their educational armory.” These materials were quickly provided to them.
Dr. Dobbie said that RUSM would be looking at doing a curriculum-mapping pilot project in one integrated module of the basic science curriculum.
(Photo caption: Dr. Aaron McGuffin and Dr. Alison Dobbie at the Education Summit.)
June 20, 2014
By Joseph Flaherty, MD, Dean and Chancellor
The looming shortage of primary care physicians in the US is an urgent problem. In the State of Florida, for example, that will mean a situation in which there will be 4,671 fewer primary care physicians than we need by the year 2030, according to a recent study released by the American Academy of Family Physicians’ Robert Graham Center. Similar data is coming from all states for two reasons: the Affordable Care Act is insuring more of the population and the large group of Baby-Boomer doctors is starting to retire. If you think it is difficult now to find a family medicine physician or a pediatrician and to schedule an appointment quickly, try to imagine a time when there are 38 percent fewer of these doctors, as is projected in Florida, to serve the population of patients who need them.
Numerous potential remedies to relieve the primary care shortage have been put forward—from financial incentives for those who practice in underserved areas, to a review of how medical students are selected. There are also discussions about reducing the total education time from medical school through primary care training. It is encouraging to see primary care receiving serious attention, and I believe we can expect to see greater numbers of medical students entering primary care upon graduation.
More than 70 percent of the RUSM graduates who enter residency this year will enter primary care fields. I am confident that we will continue to see large numbers of our graduates going into and staying in primary care. Why? Because at RUSM we strive to create a culture in which the day-to-day responsibilities and rewards of primary care practice are highly valued. Many of our teachers and some of our deans are primary care doctors. Our students start clinical skills training in their first semester in Dominica, which places a continuing emphasis on the personal communication with patients.
June 19, 2014
Combining classical, cadaver-based teaching with a high-technology emphasis on medical imaging, the Ross University School of Medicine (RUSM) anatomy lab is more than a lab; it is a Facility for Anatomical Sciences and Medical Imaging. Medical imaging serves as the bridge between the basic sciences and clinical medicine. An average of four students are assigned to each table with access to the hi-tech equipment including, high definition cameras, projection screens and 45 computers, so that students “have what they need to find the answer to any study question,” said Sheila Nunn, Ph.D., the Department of Anatomy’s interim chair and professor. The facility also houses an osteology study room, and a medical imaging room, as well as a separate neuroscience lab suitable for the study of central nervous system specimens.
To ensure the facility is conducive for both the students and faculty, the facility is designed as a complex, or a center. It is fitted with a 60-ton special air-handling system that replaces the air in the lab every ten minutes with fresh air. The lab temperature is closely monitored by a series of sensors, which are remotely monitored over the internet. The cadavers are all donated through the Willed Body Program in the U.S. and shipped inside a refrigerated container to Dominica. To ensure the integrity of these cadavers, every cadaver is carefully handled by a team of dedicated technicians. In the lab, the bodies are maintained in stainless steel deep tanks.
The cadaver lab helps the students to actively learn anatomy and provides an opportunity to develop other important skills including professionalism, teamwork, stress management, leadership and communication. For example, each member of the dissection table participates in reading, dissecting and demonstrating to other members in a “learn-one, do-one and teach-one” model.
“Students also get to see anatomical variation,” said Nunn. Students can conduct research projects if they find something of interest, and many have presented posters based on their findings at the school’s Research Day events as well as national conferences. Small-group learning, discussion, and teamwork are integral to the work at the dissection tables.
The imaging room is fitted with an interactive smartboard, a 3D flat screen and computer projector screen, a variety of anatomical technological platforms including the visual human dissector, OSIRIX (medical imaging resource) and various atlases. The students can therefore don 3-D glasses for viewing the visual human dissection images in 3D, which allows them to understand relationships between structures more easily than from a 2D image. This activity “makes the learning process fun,” said Nunn. This tool is utilized by the students in the first weeks of their study of anatomy.
Sandor Vigh, M.D., professor of anatomy and former chair, said that the facility combines, “traditional values, high-tech equipment emphasizing medical imaging, and highly-trained faculty.” Students are free to use the medical imaging tools from early morning until late at night.
“All of this technology is here for students to use whenever they want. They can turn on the computers and get access to everything,” Vigh said. There are also student clubs devoted to radiographic and medical imaging, whose members use the facility and the database of cases.
June 17, 2014
By Wm. Lynn Weaver, MD, FACS, Senior Associate Dean, Dominica Campus
Why does medicine still inspire me? I think of the many patient encounters that have made a lasting impact on me and the memories that continue to make me smile. But what I want to share with you is not a great success story, not a miracle of science and technology, and not a story of divine intervention. In fact, it is a story about what I initially felt was a failure. I thought it was a failure to do what Dr. LaSalle LeFall, the great Howard University surgeon, asserted when he spoke at Meharry Medical College where I was a medical student. He said, “A doctor can give people their greatest possessions, their health or their lives.” This was what I believed I had failed to do with one patient.
While on general surgery call I saw a 66 year-old man in the ER with an acute, board-like abdomen, but initial studies failed to reveal a source. I examined him and we immediately went to the OR, knowing only that something bad had happened. On opening the abdomen we encountered dead bowel, from the ligament of Trize to the descending colon. My initial thought was to just close and not wake him up, to let him expire without pain or misery. Also at that time the idea of small-bowel transplant was not yet a reality and at the patient’s age, 66, he would not have been a candidate. My final consideration was that patients his age did not do well on hyper-alimentation.
After a few moments of contemplation I realized I could not just close, so I resected the dead bowel, and informed his family of what I found and what I did. Twelve hours later I got a call from the resident who told me that our patient has no pulse in either leg despite post-op heparin therapy, so we went back to the OR for embolectomy, which failed, necessitating amputation of his right leg above the knee. Thirty-six hours later this was followed by amputation of his left leg.
On my rounds, twice a day, for two months, I would see him and his family in the SICU, and then in his room. Every time I saw him I questioned myself: why didn’t I just close and prevent him and his family these months of pain and suffering? I was plagued with guilt and recriminations for the decisions I had made.
One night, after finishing a late case, I stopped by his room, and to ease my conscience, I sat down to talk to him about my decision to not to just let him pass during that first operation.
He held my hand and said, “Dr. Weaver, I could never thank you enough for what you have done for me. You gave me what everybody wants, a little more time to do and say what they should have done or said before. I am so thankful you did not let me die, but you gave me time to say good-bye to my wife and children, to hug my daughter and tell her how proud I am of her and how much I loved her and ask her to forgive me for the times I had to work and missed being there for her. We are all at peace now thanks to you. God bless you.” He passed away a few weeks later. I attended his funeral and sat with his family.
I have come to realize that even though I failed to give back that man’s health or save his life, I had given him the precious gift of time, for which I was blessed by him and his family. I know of no other occupation where you can make a difference this profound. It is an honor to be called Doctor.
NOTE: This post was adapted from a presentation by Dr. Weaver at the American Medical Association’s Inspirations in Medicine event on June 6, 2014.
June 17, 2014
Hello. I’m Dr. Paula Wales, Senior Associate Dean of Student Affairs at Ross University School of Medicine, and I’m very pleased to announce the launch of the ROSS advisory model – ROSS as an acronym for Rely On Student Services. The purpose of this new clinical advisory model is to help ensure that students who are dispersed throughout the country keep connected, stay on track in terms of their clinical timelines, and receive the career and match advising they need to succeed.
In the new model there is a coordinated team of six advisors for each student. Every advisor has had training in functional areas, such as registrar, career development, and clinical advising. They have also had cross-training and additional training in skills like teambuilding and customer service. Each team also partners with a financial aid advisor in N.J., making for a wrap-around model of services.
When a student calls, he or she will be directed to a specific advisory team, based on alphabetical criteria. That way, the team and the student will get to know one another over time, fostering better understanding and resulting in better service, whether there are questions about the Match, Step scores, electives, letters of reference, personal statements, or anything else.
In addition, we are also extending the hours of service during which clinical students may phone their advisory team. The extended hours are 8 a.m. to 8 p.m. Monday through Friday, and 10 a.m. to 2 p.m. on Saturday.
We want our clinical students to know that they have a career advisory team standing by, ready to help them. The team will also be proactive, reaching out to each student every month, to check in and ask: how’s it going? Do you need any help?
Watch out for future blog posts where I’ll introduce you to some of the wonderful people on our ROSS clinical advisory teams.
Tags: Student Services
June 09, 2014
Group: Dr. Vicki Coffin, left, Dr. Wm Lynn Weaver, Dr. Kathryn A. Cunningham, Dr. Peter W. Klivas, Dr. Lorenzo Leggio, and Dr. Stanley White, at Research Day.
The timely topic of Developing Medications to Treat Addiction: Challenges for Science and Practice, was the focus of the 51st Research Day at Ross University School of Medicine (RUSM) on May 23, 2014. Some of the questions addressed by the three renowned guest speakers were: Why is addiction so hard to treat? What are the predictors of who will become addicted to a drug? How can pharmacotherapies be combined for the management of alcoholism?
The presenters were Dr. Peter Kalivas, Distinguished Professor and Founding Chair, Department of Neuroscience, Medical University of South Carolina; Dr. Kathryn Cunningham, Distinguished Professor of Pharmacology, University of Texas Medical Branch and Director of Center for Addiction Research; and Dr. Lorenzo Leggio, Associate Professor of Behavioral and Social Sciences, Chief of National Institutes of Health Section on Clinical Neuropsychopharmacology.
“Personalized medicine is quite important; the combined pharmacotherapies for management of alcoholism,” said Leggio. Yet, during a panel discussion among the presenters it was agreed that many physicians do not know that there are medications they can prescribe for patients, and so they don’t even ask questions that would identify alcoholics.
Directed by research committee vice-chair Dr. S.J. White, and organized by Dr. Vicki Coffin, the symposium also featured a poster session by students, based on their research activities. Fourth-semester student Matthew Gardy, and a group of his peers, created a poster on a discovery they made in the anatomy lab. “There was a tumor encapsulating the entire heart,” Gardy explained. “Most of these types of cancer are not known until the autopsy. They are extremely rare.”
The winner of the student poster competition for research conducted at RUSM was, "A Clinical Pathologic Study of the Identification, Diagnosis and Treatment of a Lymphangioma" by Afshan Ahmed, Aparna Reddy, Stephanie Riviere, Selvin Jacob, Ankit Bhandari, Amir Asaseh & Richard Hanley. For research conducted prior to coming to RUSM the winner was, "Separation of Mechanisms in Kidney Podocytes: Mechanical Stretch Sensitivity vs Endogeonously Activation in TRPC6 Calcium Currents" by student Justin Khine, M. Anderson, and S.E. Dryers.
In his closing remarks, RUSM’s Dr. Gerald Grell, dean for clinical and community affairs, said, “We want our students to feel that they are in an institution that encourages research activities.”
June 06, 2014
Ross Med is committed to maintaining a close and caring partnership with the Commonwealth of Dominica, the campus’ host country, and its people, neighbors and friends. As part of the university’s involvement with the community, Ross Med is pleased to contribute a variety of resources to local groups.
This past year Ross Med has donated more than $24,000, as well as supplies and other assistance to organizations and institutions in the realms of education, sports, culture, and other endeavors. They include, for example: Paix Bouche, Colihaut, Canefield/Massacre and Bense primary schools; Dublanc Sports Club; Waitukubuli Dance Theatre Company; Carnival activities; Bureau of Gender Affairs; Nature Island Literary Festival & Book Fair; and many more.
In February, the Hon. Ian Douglas, chairperson of Carnival’s Northern Festival Committee, and Member of Parliament for the Portsmouth region, was presented with a check by Senior Associate Dean Wm. Lynn Weaver, MD, FACS. He applauded Ross Med for its contributions and noted that after more than 35 years, the university is no longer a guest, but rather a member of the community.
(Photo: The Hon. Ian Douglas accepts a Carnival contribution from Dr. Weaver.)
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