Fall 2016 AUA Times

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TIMES

FALL 16

[ haiti ]

What began as a medical relief effort in 2009 is now a promising relationship between AUA, NOAH, and the people of Haiti. One major earthquake and seven years later, global exchange of resources and health care continues to grow.

global health �ATTERS

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The Big Picture

FEATURE: AUA Surgery co-Chair Leads Critical Missions to Haiti with AUA Students What began as a medical relief effort in 2009 is now a promising relationship between AUA, NOAH, and the people of Haiti.

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Left: Schoolgirls waiting outside their classroom, Fort-Liberté.

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The Case for Global Health LETTER: The Case for Global Health Local Roots, Global Presence Dr. Adam Isacoff responds to the impact of global health issues while treating patients.

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ADDRESSING THE NEED

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ENTERING THE INTERNATIONAL ARENA

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RESPONDING AS A GLOBAL CITIZEN

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RESEARCH MATTERS

Groundbreaking Programs in Partnership with FIU Welcoming Students to New Global MD Program Participating in Global Educational Exchange in Medicine and Health Professions (GEMx) AUA Joins UN-sponsored School Consortium Emergencies Only Emergency Services Personnel Attend Sessions in India and the Caribbean 2nd AUA Blood Drive Strengthens Bonds Between School, Community, Hospital

Student Research Presentations Accepted

by Two Conferences The Best of Both Worlds: Dr. Maharshi Rajdev A global perspective pairs research and practice

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Vitals

Q&A: Dr. Kimberly Mallin AUA Director of Health Services The Science of Self David Riley, AUA's Most Nontraditional Student Examines the Quantified Self

Driven to Serve

AMSA Hosts U.S. Army Recruiters on Campus Army of One Dr. Leilani Garcia Returns Home

The New Class

Calls to Action, Messages of Encouragement Highlights from the 2016 Commencement Ceremony Notable Residency Placements in 2016

Happenings

Research Day The Importance of Basic Sciences and Solutions for Cervical Cancer in the Caribbean Faculty Publications Show AUA’s Commitment to Research and Global Health Applications AUA Advisory Board Helps Shape Mission

The Case for Global Health

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am very pleased to inform you about American University of Antigua (AUA) College of Medicine’s latest educational initiative, the Global MD program, conducted in collaboration with Florida International University (FIU) Herbert Wertheim College of Medicine.

The program underscores AUA’s commitment to fulfilling its social responsibility, supporting underserved communities, and leading the next generation of physicians to respond to global health care needs.

As they work their way through a comprehensive and nuanced education rich in research opportunities, Global MD students will be introduced to the study of public and community health, primary care, epidemiology, social determinants of health, and the treatment of communicable and non-communicable diseases on a global basis. By developing expertise in global health issues, they will become more competitive as candidates for residencies and fellowships and uniquely positioned for careers involving patient care, service, policy-making, research, and education at a local or international level.

How can we understand global health today? And why should MD students pursue a global health certificate?

Why now?

Global Health has been defined by the Consortium of Universities for Global Health as “the area of study, research, and practice that places a priority on improving health and achieving equity in health for all people worldwide.” Epidemiology and infectious diseases are

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certainly components of global health, but the scope of this definition clearly contradicts the common misconception that global health refers only to the spread of infectious diseases across continents.

Using a broader, more modern understanding, global health is public health. Medicine is practiced in a multitude of ways, in settings ranging from rural, single-practitioner family medicine offices to highly specialized hospital care in academic medical centers, but all medicine, global and local, is rooted in the concerns of public welfare. Connections between global, public, and individual health have always existed. They form across social determinants like economics, migration, environmental stewardship, security, education, disease, nutrition, and prevention. Everyone in health care, from health care providers to patients to members of the community, participates in this dynamic.

But what makes pursuing an education and career specifically in global medicine so relevant at this particular moment?

The answer is simple and straightforward—in a globalized world, the urgency to give physicians, especially those in primary care, a wider understanding of the socioeconomic forces that shape their practice has never been greater.

As borders mean less and less and the physician shortage continues to intensify, the need for doctors who are more informed and better-prepared to treat diverse populations in a global setting is essential.

In an article that appears in the May 2016 issue of Academic Medicine (Vol. 91), Dr. Jennifer Kasper addresses what an increasingly globalized world means for education programs that aim to send physicians back into their communities: Fifty years ago, medical students seeking a broader foundation in the social sciences would have been told to enroll in a public health school‌In recent decades the line between public health and medicine has blurred. Recognition of the impact of noncommunicable diseases on population health globally has refocused attention in medicine on the social determinants of disease‌As behavioral interventions become more central to primary care, clinicians are engaging more often with social factors, including income, education, environment, and personal behavior, and their effect on the clinical encounter and health outcomes.

In designing the Global MD curriculum, we identified the necessity to provide individualized training to

future physicians, who must demonstrate a more sophisticated awareness of these issues and be better able to communicate with a greater number of patients. Looking at current demographics, for example, it becomes evident that a steady command of the Spanish language will be crucial for addressing the health care needs of a large patient population within the United States.

Undeniably, global health affects all of us, and students of the Global MD program will be shaped by a foundational understanding of how to respond to these concerns. This is an exciting time to study medicine from a truly global perspective. We look forward to leading the way.

Peter Bell, MD Vice President of Global Medical Education Executive Dean of Clinical Sciences FAL L 201 6 • AUA T I M ES

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THE CASE FOR GLOBAL HEALTH

LOCAL GLOBAL PRESENCE ROOTS

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THE CASE FOR GLOBAL HEALTH

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ith large Hispanic and Haitian populations and an airport nearby, patient care at Palm Beach Children’s Hospital demonstrates the global nature of public health. The medical center also receives children from Puerto Rico and the Bahamas who have taken day trips to the hospital just for treatment.

To ascertain how well certain medications alleviated symptoms or even how much breathing distress patients were actually experiencing, Dr. Isacoff needed to establish a baseline measurement to compare their symptoms against. Breathing measurements existed—spirometry, in which the patient breathes into a machine, as well as the subjective observation of a child’s breathing—but were not effective enough.

According to attending physician Dr. Adam Isacoff, “certain viruses [float] around all year that you don’t see in other areas of the United States,” due “Kids under [the age of ] six don’t do to South Florida’s climate. Though he well with measurement tools, because hasn’t seen many Zika cases so far, at they don’t know the right way to the time of this writing USA Today breathe into them, and if a kid is truly reported that a looming Caribbean in distress, you’re not going to make storm “would make it harder to control them breathe into a machine when the Zika outbreak, which has grown they’re not even breathing well at to 43 cases in Miami-Dade county,” as baseline,” explains Dr. Isacoff. well as neighboring Palm Beach County, where the hospital is located.

Dr. Isacoff set out to develop a measurement tool using ultrasound Dr. Isacoff isn’t one to shy away that could help establish the baseline from challenges, however. When he for healthy breathing, measure ER encounters a problem, he looks for patients’ experience of asthma attacks a solution until he finds one. At the and other breathing difficulties against University of Louisville School of that standard, treat them, and then Medicine, where he completed a highly measure again to determine how well competitive fellowship in Pediatric a particular intervention was working.

Emergency Medicine and received the However, while movement, breathing, Chairman’s Achievement Award with and circulation can be detected Honors for his research, the problem using ultrasound, none of these can was in quantifying breathing distress necessarily be measured. To address this, among young visitors to the ER. Dr. Isacoff looked for areas of the body he could quantify and found that the right jugular vein was most reliable.

DR. ADAM ISACOFF Class of 2008 Attending Emergency Medicine Pediatrician Palm Beach Children’s Hospital, West Palm Beach, FL Affiliate Assistant Professor of Pediatric Emergency Medicine Charles E. Schmidt College of Medicine Florida Atlantic University, Boca Raton, FL Clinical Assistant Professor, Department of Pediatrics University of Vermont College of Medicine, Burlington, VT

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“There’s a way you can put the probe on a child’s neck, trace it, and then do assessments in different modes to see exactly what the measurements are.

That way we can come up with a norm.”

He is now considering conducting a second phase of this novel approach at his current hospital but will have to go through their protocols before resuming his research.

THE CASE FOR GLOBAL HEALTH

THE PASSION TO DO GOOD & A STRONG FOUNDATION MAKE THE DIFFERENCE. Dr. Isacoff is one of 150 members of his medical group, which includes about 30 ER doctors spread across five hospitals. Dr. Isacoff spends 12hour shifts at the hospital with the highest volume of patients, who come in for everything from urgent care and upper respiratory infections to poisonings and seizures. “There’s a lot of oncology, a lot of sickle cell disease, high and low acuity, a little bit of everything,” he says.

Dr. Isacoff’s earliest exposure to patient care was while visiting Kings County Hospital in Brooklyn, where his father, a psychologist, worked as the director of an adolescent

development program. “You could truly see the structure of an outpatient and inpatient center there,” says Dr. Isacoff.

Growing up on Long Island, he volunteered as a counselor at a camp for mentally and physically disabled kids and adults. “I felt like I was doing something productive, something good,” Dr. Isacoff says. He worked at other camps as well and volunteered at his hometown’s local hospital compiling data for the ER. Since his undergraduate days at the University of Maryland, becoming a doctor was always his plan. But,

despite many positive experiences working with kids, he wasn’t sure he wanted to specialize in pediatrics.

Finally, a rotation and a subinternship in pediatrics at Wycoff Heights Medical Center in Brooklyn solidified his decision.

Dr. Isacoff attended AUA in its earlier days when the program was smaller, but he sees no difference between the education he received there and what he might have gotten at a U.S. medical school. “The professors are excellent, and the foundation is there.

Ultimately, the passion to do good and a strong foundation make the difference.” ■

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Groundbreaking Programs in Partnership with FIU [ Clinical Core Clerkship Certificate Program ] [ AUA–FIU Global MD Program ]

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n a landmark agreement two years ago, AUA and Florida International University’s Herbert Wertheim College of Medicine (FIU HWCOM) designed the Clinical Core Clerkship Certificate Program (“Core Clerkship Program”). This unique program offers an innovative approach to core clinical training for AUA medical students.

After finishing Basic Sciences on AUA’s campus, students accepted to the Core Clerkship Program are able to complete all 44 weeks of core rotations under the instruction of FIU faculty at FIU-affiliated clinical sites in Florida. This is followed by 34 weeks of elective rotations that students may take at FIU and AUA-affiliated clinical sites throughout the United States.

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Once again, AUA is the only Caribbean medical school to offer a program of this kind, which consists of five intensive two-week sessions on global health topics conducted before each of the first five semesters. Before Basic Sciences coursework even begins, students are given research opportunities and instructed by AUA and FIU faculty, along with top international lecturers and researchers. This early exposure allows students to develop their research skills and cultivate relationships with FIU faculty as they progress to Clinical Sciences.

The program was a win for both universities but a huge success for the students who participated, of which 95% matched to a residency program in 2016.

The program also includes a formal course in medical Spanish and other longitudinal studies by way of didactics, field trips, and research projects, putting students at an advantage when applying for residencies. After Basic Sciences, Global MD students transition to the Core Clerkship Program. Faculty-led international relief projects, in particular, offer students a greater opportunity to enrich their education in global medicine.

This response, coupled with the shared goals of AUA and FIU’s mission statements, led to the expansion of this partnership with yet another innovative program, the AUA–FIU Global MD program.

Graduates of the Global MD program receive their MD degree and Global Health Certificate from AUA, as well as a transcript and Certificate of Completion of the Core Clerkship Program from FIU. ■

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THE CASE FOR GLOBAL HEALTH

95 PERCENT

Clinical core

c l e rk sh i p c e r t i f i c at e

STUDENTS M ATC H E D —— in a —— RESIDENCY

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THE CASE FOR GLOBAL HEALTH

AUA Welcomes Students to New Global MD Program

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Joint Program with Florida International University Offers Rigorous Medical Training with an International Focus

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THE CASE FOR GLOBAL HEALTH

As pandemics, climate change, economic forces, and political dynamics converge to affect the communities we live in, primary care is increasingly at the forefront of global health. A new Global MD prgram was created by AUA and FIU to reflect both institutions’ fundamental belief that primary care is public health, and public health is global health.

Antigua and Barbuda. Sir Clare, who has made major contributions to the nation of Antigua and Barbuda in the areas of human rights, youth development, and law, spoke to students about human rights in the context of global health.

Global MD students visit Mount St. John's Medical Center, Antigua's main hospital.

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semesters for the Global MD. They can then complete all of their core clinical rotations at FIU HWCOMaffiliated sites.

The purpose of the Global MD program is to guide students to develop expertise in global health issues while preparing them for careers involving patient care, service, policymaking, research, and education.

They will also be introduced to community and public health studies, primary care, epidemiology, and the treatment of communicable and noncommunicable diseases.

The first block, held July 26th through August 9th on the AUA campus, included lectures and training in cultural competency, medical Spanish, infectious diseases, epidemiology, the role of government in healthcare, and environmental and social determinants of public health. Students also completed Basic Life Support training and visited Mount St. John’s Medical Centre, a government hospital.

Global MD students are exposed to the FIU faculty during their education at AUA. For the first two years of the program, AUA students take their Basic Sciences component in Antigua as they normally would, completing intensive coursework in between

Guest lecturers included former Antiguan Senator and Solicitor General Sir Clare Roberts, Caribbean HIV/AIDS expert Dr. Prince Ramsey, and Lionel Michael, Chief Public Health Inspector for the Ministry of Health and the Environment of

he inaugural student cohort of this comprehensive program arrived on campus in July for their first block of training, lectures, and relevant excursions.

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Dr. Ramsey is known as the “father of all AIDS fighters” in the Caribbean. Among his long list of accomplishments and distinctions, he is credited with bringing the first private x-ray and ultrasound facilities to Antigua and Barbuda. He spoke to students about his medical practice and advocacy work, which has taken him to over 20 Caribbean countries, the United States, and Canada.

Chief Inspector Michael discussed the impact of the environment on global health, with a special focus on Zika.

This summer, he had to consider the threat of the Zika virus when planning for the Antigua Carnival.

In addition to guest lecturers, AUA faculty presented material drawn from their time in clinical and field settings.

Surgery co-chair Dr. William Lois shared his experiences in Haiti in the aftermath of the 2010 earthquake and his role in developing sustainable health care in the country. Dr. Dewey Meyers, PhD, MD, who teaches Behavioral Sciences and Neuroscience, gave a lecture on mental health from a global perspective.

THE CASE FOR GLOBAL HEALTH

AUA Vice President of Global Medical Education and Executive Dean of Clinical Sciences Dr. Peter Bell said collaborative projects initiated through the new Global MD program will give back to Antigua and Barbuda by broadening the scope of health care within the community: “This is likely to attract more students to Antigua and encourage further collaboration between the university and all stakeholders in Antiguan and Barbudian health care.”

For starters, with the assistance of FIU’s disaster response unit, AUA plans to host a disaster management seminar with Antigua & Barbuda’s emergency divisions.

FIU HWCOM Health Associate Dean and International Affairs Associate Professor Dr. Eneida Roldan commended AUA for establishing and offering the Global MD program to students. “Physicians must have knowledge of and cultural sensitivity towards diversity and the diseases

aligned to specific environments and populations,” she said.

By launching the Global MD program, AUA will lead future generations of doctors to address the health of populations in their own communities and throughout the world. ■

Group picture of Global MD students with faculty: Dr. Walwyn, course director; Dr. Ramsey, visiting faculty; Dr. Roldan, FIU; Dr. Bell, VP of Global Medical Education.

PHYSICIANS MUST HAVE KNOWLEDGE OF AND CULTURAL SENSITIVITY TOWARDS DIVERSITY AND THE DISEASES ALIGNED TO SPECIFIC ENVIRONMENTS AND POPULATIONS. FAL L 201 6 • AUA T I M ES

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THE CASE FOR GLOBAL HEALTH

Participating in Global Educational Exchange in Medicine and Health Professions (GEMx)

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ew GEMx partner, AUA, proudly shows its commitment to global collaboration, student exchange, expanded elective choices, and research opportunities.

The challenges and possibilities of medicine are increasing as community health care providers find themselves more and more in a globalized field.

With this in mind, educational exchange on an international level will be a powerful tool for readying the next generation of physicians.

Those enrolled at AUA can now study abroad and choose from clinical and research-oriented electives offered by

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partner institutions around the world.

In 2014, The Education Commission for Foreign Medical Graduates (ECFMG), a credentialing nonprofit that prepares international medical graduates for residency, launched GEMx. In addition to promoting global partnership and student exchange opportunities in undergraduate medical education, the network also offers a centralized, paperless process for researching, applying to, and managing elective exchanges.

This summer, GEMx created a student ambassador network.

Student ambassadors promote GEMx programs to their fellow students and provide support to students enrolled in GEMx electives.

The opportunity to engage in global dialogue at international conferences and the potential for global and public health observerships, which may be added to the GEMx curriculum, are especially relevant to students participating in AUA’s Global MD program. ■

THE CASE FOR GLOBAL HEALTH

AUA Joins UN-Sponsored School Consortium Global Health, Sustainability & Human Rights High on List of Priorities for Members

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ith its recent acceptance into the United Nations Academic Impact (UNAI), AUA has partnered with like-minded institutions around the world that recognize the convergence of public and global health. It is proud to join universities and colleges that are fostering a shared culture of intellectual responsibility and furthering the goals and principles of the UN through activities, events, and research.

Member activities are often coordinated around UN holidays: a smoking cessation campaign in observance of World Cancer Day (February 4), a campus blood drive for World Blood Donor Day (June 14), and a panel discussions on World Day for Cultural Diversity for Dialogue and Development (May 21).

As a condition of membership, schools are required to hold initiatives that support UNAI’s ten foundational commitments to: • Uphold principles and values inherent in the United Nations Charter • Champion human rights, among them freedom of inquiry, opinion, and speech • Provide educational opportunity for all people regardless of gender, race, religion, or ethnicity • Provide the opportunity for every interested individual to acquire the skills and knowledge necessary for the pursuit of higher education

• Build capacity in higher education systems across the world • Encourage global citizenship through education • Advance peace and conflict resolution through education • Address issues of poverty through education • Promote sustainability through education • Foster inter-cultural dialogue and understanding and the “unlearning” of intolerance through education. ■

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emergencies Only. only

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o further its commitment to global health and awareness, AUA held first responder training courses in India and Antigua for firefighters, police officers, and EMTs. The sessions were held at Rajasthan University of Health Sciences (RUHS) and Ravindra Nath Tagore Medical College in Rajasthan from April 18th through 22nd.

Emergency personnel received instruction in Advanced Life Support, CPR, and First Aid from AUA’s Emergency Medicine Training Centre (EMTC) faculty members, including AUA Vice President for Administrative Services and Community Affairs and EMTC Director Vernon Solomon, campus physician and instructor of Clinical Medicine Dr. Courtney Lewis, and EMTC and Laboratory Services Manager Marlon Destin.

“Those who participated in these rigorous lessons, having received immersive training in

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effective emergency response, will potentially save millions of lives,” said Gulab Chand Kataria, Honorable Home Minister of Rajasthan, who was instrumental to the event’s coordination.

“After the success of the inaugural program, first responder training will be done in all parts of the state and across the nation in an effort to save the innocent lives that are needlessly lost in road accidents and other emergencies,” said Dr. Ajay Lodha, now President of the American Association of Physicians of Indian Origin (AAPI).

The EMTC faculty plans to return to Rajasthan to educate a team of instructors who will lead future training sessions. “AUA is happy to contribute to this initiative by providing knowledge and instruction to first responders,” said Par Prem Kumar, Special Projects Advisor to AUA President Neal Simon.

THE CASE FOR GLOBAL HEALTH

IMMERSIVE TRAINING IN EFFECTIVE EMERGENCY RESPONSE WILL POTENTIALLY SAVE MILLIONS OF LIVES.

Top to bottom: Udaipur police dept. first responders learn CPR; junior doctors from government hospitals in Udaipur learn ACLS; Home Minister Gulab Chand Kataria praises the AUA/AAPI collaboration for bringing the program to India.

AUA has also begun providing first responder training locally. Noticing the number of emergency incidents at primary and secondary schools in Antigua and Barbuda, Director Solomon initiated discussions with the Ministry of Education about a program for teachers in the community, with Mr. Destin presenting.

In June, AUA instructed approximately 100 teachers in First Aid and CPR. In July, AUA invited various security personnel from other parts of the Caribbean for Basic Life Support training. “It was a great initiative that allowed us to get more involved,” Mr. Destin said.

All faculty and first year students are required to be certified in Basic Life Support, and Mr. Destin estimates that 80 percent of AUA staff are trained in CPR. He hopes to start holding First Aid training sessions for staff and faculty between semesters, beginning this winter. ■

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THE CASE FOR GLOBAL HEALTH

2nd AUA Blood Drive Strengthens Bonds Between School, Community, Hospital

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he blood drive, held on campus, was initiated by third-semester student Armin Edalatpour, current President of the AUA Emergency Response Team (ERT). Afterwards, AUA transferred the blood to Mount Saint John’s Medical Center (MSJMC).

As a paramedic in the United States, Edalatpour was attuned to the availability of resources in hospitals and emergency services departments. After becoming aware of the increasing disparity between supply and demand for blood in the Antiguan community, he began to organize the drive. The success and enthusiasm for these events underscore the altruistic spirit of AUA students, faculty, and staff.

Other key leaders who put the event together included students Htet San, Monica Sheinin, and Leah Grossman.

The team partnered with local Red Cross and AUA faculty members to acquire equipment and recruit phlebotomists.

Grossman thanked the AUA community for its participation.

“We are grateful for all the support that made this a most successful blood drive. We had more donors than allocated supplies,” she said.

“The partnership between MSJMC and AUA provides students, staff, and faculty with the opportunity to donate blood in a hospitallike setting, right here on campus, without the constraints of transportation and time.”

AUA hopes to conduct blood drives on campus each semester and to be prepared to organize them on short notice when there is an immediate need at MSJMC. ■

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THE CASE FOR GLOBAL HEALTH

Student Research Presentations Accepted by Two Conferences Selection Highlights Success of AUA-FIU Relationship

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ne major advantage to AUA’s partnership with Florida International University (FIU) is that students in the Clinical Core Clerkship Certificate Program complete their core rotations at FIUaffiliated clinical sites throughout Florida and have greater exposure to research opportunities.

Experience” (AAFP FMX) this past September in Orlando, FL. They will present the same poster at the International America’s Network For Chronic Disease Surveillance conference (AMNET-BCOM), “Chronic Diseases: Borderless,” this November in Las Cruces, NM.

Fourth-year AUA students Fernando Del-Rey, Shilpa Chode, and Aspan Shokrekhuda benefited from this firsthand when they learned that research they conducted while completing a research elective rotation on FIU’s Miami campus had been accepted into two conferences.

“This is another example of the benefits of our collaboration with FIU,” Dr. Peter Bell, AUA’s Vice President of Global Medical Education and Executive Dean of Clinical Sciences, said.

The study is entitled, “Effect of glycemic control (HbA1c<7%) on in-hospital mortality in Puerto Rican patients admitted with acute myocardial infarction.” They found that there was no association between HbA1c<7% (glycated hemoglobin) on in-hospital mortality in the population they studied.

In addition to their manuscript, the students produced a poster explaining their research, which they presented at the American Academy of Family Physicians’ “Family Medicine

Del-Rey credits AUA with preparing him and his classmates for their clinical rotations, largely due to the amount of personal attention students receive from faculty.

“From what I’ve seen, I think AUA, compared to other schools, supports the student a lot more,” he said. “This research project is evidence of that.”

Having only attended conferences as a spectator, Del-Rey is excited about presenting at both. “I think it’s going to be a great learning experience and

a good challenge,” he said. “We are proud to represent AUA, and we are so grateful for all the opportunities AUA has given us on our path to becoming physicians.”

Students Sharon George and Thomas Campi will also be presenting a poster at the New Mexico conference based on their research, “Effect of Charted Mental Illness on Reperfusion Therapy in Hospitalized Patients with an Acute Myocardial Infarction (AMI) in the State of Florida.” The study looked at how often patients with documented mental illness were receiving reperfusion, a type of treatment that seeks to restore blood flow through blocked arteries, usually after a heart attack.

They found that these patients were 30 percent less likely to receive the treatment than myocardial infarction patients without documented mental illness. In their conclusion they write that “the findings highlight future policies to prioritize medically vulnerable AMI patients (CMI, females, black race) in order to remove disparity in AMI management.”

Having research accepted to conferences raises AUA’s profile as an institution, and having research experience increases students’ chances of obtaining a prestigious and competitive residency after graduation. AUA congratulates these students on their achievements and is extremely proud of their work! ■

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THE CASE FOR GLOBAL HEALTH

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THE BEST of BOTH WORLDS A global perspective pairs research and practice.

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THE CASE FOR GLOBAL HEALTH

DR. MAHARSHI RAJEV Valedictorian, Class of 2016 General Surgery Resident, Mayo School of Graduate Medical Education Rochester, MN Radiology-Diagnostic Resident Case Medical Center at Case Western Reserve University School of Medicine in Cleveland, OH (Beginning July 2017)

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esearch is a key component of the AUA curriculum, often starting early on and continuing throughout each student’s medical education. With a grounding in research, the career possibilities for AUA graduates are endless. One such graduate was this year’s valedictorian, Maharshi Rajdev.

In his valedictory address, Dr. Rajdev spoke of the humanity essential to being a great doctor as opposed to a highly skilled technician with a medical degree. Though a scientist at his core, Dr. Rajdev considers patient care a holistic process. “The more you learn about science, the deeper you realize your ignorance to the world around you,” he says. “There is so much in nature that remains to be seen and revealed, and learning the intricate relationships between organ systems on a gross, microscopic, and molecular level allows one to take a small glimpse into the vastness of nature.”

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At AUA, Dr. Rajdev discovered that the key to academic success was “learning how to learn.” The how is different for every student, so he set about testing different methods objectively. He found that using his seniors as a resource, especially his TAs, worked best for him. “I knew this method of learning worked for me, because I was not only able to retain the information, I was able to apply it and measure my performance by answering questions,” Dr. Rajdev says.

“Whether it was online question banks or answering questions in class, I knew that I could retain the information being presented to me.

Once I learned how to learn, I just absorbed knowledge from everywhere I could.” This included everything from textbooks, to family members, to professors, to recorded lectures, to review books.

Dr. Rajdev’s research regarding the application and delivery methods of adult stem cells in kidney regeneration while at AUA “made a huge difference” in obtaining a residency in radiology, but his work on and passion for research in general goes back much further. He began working as a volunteer researcher at the Renal Research Institute at New York Medical College while still a high school student in Westchester, NY. Through relationships developed there, he continued participating in these studies during his undergraduate years at the University of Vermont and at AUA. In 2010 and 2015, findings from this research were published in The American Journal of Pathology, American Journal of Physiology, and Stem Cells Translational Medicine.

THE CASE FOR GLOBAL HEALTH

Despite his fascination with research, Dr. Rajdev ultimately chose to pursue a career in medicine instead. “In research you get to be on the cutting edge of discovery, but the application of your work in a meaningful and practical way is sometimes lost. This doesn’t mean it’s any less worthy,” he explains. “It just takes time, sometimes a lifetime, to see your work actually help people.”

The turning point came during his undergraduate years at the University of Vermont. He took some classes at the university’s medical school during his final semester there, which opened his eyes to the possibilities that being a medical doctor offered.

“These classes had a stronger emphasis on the clinical application of the basic scientific principles I had been exposed to for the past four years. And there is an immediate gratification you experience when you can use your knowledge to help people.”

Dr. Rajev found himself gravitating towards the highly competitive field of radiology, which he knew would require an impressive GPA and STEP scores, since he would be up against plenty of U.S. med school graduates for a limited number of spots. “The extra work in obtaining residency in a competitive field is effortless if it is for the right reasons,” he says.

For him, those reasons stem from the awareness that radiology is at the heart of almost every major clinical decision in medicine. Its very nature indulged his love of problem solving and interpretation. “I find it absolutely captivating to be able to perceive things that my colleagues aren’t able to identify, even though we’re looking at the same images.”

Dr. Rajdev’s radiology residency at Case Western Reserve will begin next summer, but in the meantime he has been completing a residency in general surgery that began in June 2016 at the Mayo School of Graduate Medical Education in Rochester, MN.

He was inspired by the hold the TA leading the workshop had on his audience and his ability to make them understand the material he was teaching. It wasn’t long before Dr. Rajdev was AUA’s head teaching assistant.

Like any good scientist, he is aware of patterns and connections between things. In his first week at the Mayo Clinic, the fellows and chief residents allowed him, under their guidance, to place tunneled central venous catheters from incision to closure.

Although Dr. Rajdev selected the hospital over the lab, he envisions a career that will allow him to combine his interests in clinical medicine and research: academic medicine. He credits AUA’s TA program with giving him valuable presentation and public speaking experience, and he hopes to teach once his residency is complete.

“It was surprising that these leaders in the field are so approachable and willing to give residents autonomy in the operating room,” he says, pointing out that this particular procedure is one he will perform regularly as an interventional radiologist.

“I did not expect to be given the freedom to gain operative experience so early into residency.” That freedom reminded him of his first TA training session, which he calls “the seminal event that propelled me on the path to success.”

In his view, the connection between practicing medicine and teaching is unmistakable. The role of a doctor is to educate patients about various treatment options and to teach his or her students about the principles and ethics of medicine. “Academia lies at the heart of medicine,” Dr. Rajdev says. “The two go hand in hand.” ■

THE EXTRA WORK IN OBTAINING RESIDENCY IN A COMPETITIVE FIELD IS EFFORTLESS IF IT IS FOR THE RIGHT REASONS.

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BIG picture the

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One major earthquake and seven years later, global exchange of resources and health care continues to grow.

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DR. WILLIAM LOIS General Surgery co-Chair, AUA Chairman of Surgery, Kingsbrook Jewish Medical Center Brooklyn, NY (2002–Present) Assistant Clinical Professor, SUNY Downstate (1993–Present) Board Certified General Surgeon The New York Times, “Top Surgeons in the Nation” (2011–16) Kingsbrook Jewish Medical Center, “President Award” (2010) NOAH NY, Distinguished Medical Service Award (2010) Homero Rosado Leadership Award (2008)

Previous page: Children of Fort-Liberté; right: Patients waiting in line to be seen by a doctor.

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n that first trip to Haiti in June 2009, a young woman just out of surgery complained of light-headedness. She was Dr. William Lois’ 20th patient that day, and it had been hours since she had eaten anything. He reached into his bag and gave her a granola bar and a bottle of water, then offered her a seat. She looked at the granola bar and then at Dr. Lois, AUA’s Surgery co-Chair and Chairman of Surgery at Kingsbrook Medical Center. “I’ve seen these before,” she said. “I’m going to take this home to my children because they have nothing to eat.”

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The encounter reminds Dr. Lois of how fortunate Americans are to live in a culture of abundance, while the opposite is true in places like Haiti.

GO WHERE THE NEED IS

Earlier that spring, Dr. Lois had been recruited by Dr. Henry Paul, a Haitian-born doctor and nephrologist working in Brooklyn who had already led two smaller mission trips to his home country. Dr. Paul wanted future missions to include surgery and OB/ GYN consultations and needed a partner with Dr. Lois’ experience and resources.

THE CASE FOR GLOBAL HEALTH CATEGORY - USE TITLE OF BELL LETTER

Dr. Lois had always been interested in international relief work, but as a young doctor with a family, it wasn’t possible to get involved in initiatives like these. When he got the call from Dr. Paul, though, his children were already grown, and the timing seemed right. While he never expected to be traveling to Haiti, he recognized that he could meet a very real need and was impressed by the efforts of Dr. Paul, who is also the president of the National Organization for the Advancement of Haitians, New York (NOAH NY).

This was an opportunity he couldn’t pass up.

PREPARE TO DO A LOT WITH A LITTLE

The team Dr. Lois assembled, which included another surgeon and a gynecologist, performed 110 procedures in Haiti, from treating minor injuries to performing a nephrectomy, all with only the most basic supplies. In fact, when they arrived at the small hospital in FortLiberté, the only sutures available were the ones they brought with them. Though the mission was only a week long, Dr. Lois fell in love with Fort-Liberté and formed friendships with key personnel at the hospital.

“It was one of the best experiences of my life,” he tells The AUA Times.

“There’s nothing like going to a place where everyone can use your help.”

The 2009 trip would be the first in a series of evolving medical missions to Haiti that Dr. Lois continues to lead each year. In January 2010, as Dr. Lois helped organize the group’s second trip, the worst earthquake to strike Haiti in over 200 years left 200,000 Haitians dead and almost 1.5 million homeless. A flurry of phone calls ensued while Dr. Lois and his team brainstormed ways to continue their work in the face of

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THE CASE FOR GLOBAL HEALTH

this catastrophe. Chief among their concerns was finding a place to work that was not just safe but would allow them to gather and store enough supplies. Though they were able to get tents, bedding, food, and volunteers within five days, transportation proved to be much more challenging.

“We could not get a flight into Port-Au-Prince, but the outpour of charity from the American public was incredible,” he says.

After setting up a field hospital, they started seeing about 50 to 60 patients per day. By day five, they were seeing over 300 patients per day. Dr. Lois and his team stayed for the first two weeks, then hired Haitian nurses and physicians to take over operations, aided by a mix of volunteers that included residents and American university students. Prior to the earthquake, these nurses had been working at hospitals that'd collapsed.

Ultimately, after Dr. Lois gave an interview with WNYC, a generous listener donated their private jet to the mission. The team ended up flying into the Dominican Republic and then took a 12-hour bus ride to Haiti. By the time they arrived at the campsite—an old amusement park selected in part for the security its surrounding wall offered—they had been traveling for about 20 hours.

“We weren’t there to take jobs away from Haitians but to help those displaced from their homes, communities, workplaces,” Dr. Lois says. The field hospital operated for another six months, with Haitianborn doctors from Kingsbrook making periodic site visits. The mission also conducted its regularly scheduled trip that July.

Patients at one of the NOAH NY field hospitals.

RECOGNIZE THAT THE GIFT IS ITS OWN REWARD

Over the next several years, Dr. Lois led missions to Fort-Liberté every 6-12 months. This past year, though, a strike shut down the hospital where they usually work. Dr. Lois sent a limited mission to a nearby hospital but scaled down to avoid interfering with the labor dispute in progress.

Since 2009, the program has evolved significantly. “We began as a merry band of physicians who didn’t mind traveling to places with some of the harshest conditions,” he recalls. Now each mission is staffed with medical students from many different schools and every day begins with a teaching program. Surgical residents are sometimes flown in to treat patients and review cases as well.

AUA students have participated in these missions for the last four years. Dr. Lakshmi Kallur (Class of 2015, currently an internal medicine resident at East Tennessee State University) joined the 2014 mission to Haiti and worked closely with Dr. Lois on the surgical service side.

She was surprised by the impact the group had on patients and especially liked the interdisciplinary nature of the project. “Most medical missions are centered purely on medicine or surgery, one or the other,” she says.

“But this mission brings everyone together. You have OBs on the trip. You have pediatricians. You’re essentially transporting the manpower of a clinic or mini-hospital to Haiti.”

Dr. Kallur recalls the challenges of working with limited resources, when the ratio of patients to surgeons,

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combined with the scarcity of equipment and supplies, forced procedures to be conducted in close quarters. “We would literally be running two procedures parallel to each other in the OR, just trying to help as many people as we could.”

At times, the team would find themselves scrambling to come up with an unusual solution to a common problem. A failure-tothrive baby was brought into the OR suffering from malnourishment. He wasn’t gaining weight, was in generally poor health, and kept ripping out an IV he needed. Dr. Kallur and Dr. Lois searched the hospital until they found something useful: two pieces of cardboard normally used to hold abdominal gauze and a roll of surgical tape. With that, they created a splint to stabilize the IV.

DOCTORS WHO GO TO HAITI ARE BETTER FOR IT...THEY LEARN TO RETURN TO THE ROOTS OF MEDICINE.

Apart from the benefits provided to the local population, Dr. Kallur believes medical missions present an opportunity for med students to experience a degree of autonomy that is unusual when training in a U.S. hospital where supervision is constant, even for minor procedures.

Volunteer pediatrician conducts evaluation of child seated beside her mother.

THINK BIGGER

Today there are more nurses, more doctors, and more specialists at the hospital in Fort-Liberté. Dr. Lois points out the remarkable difference in the amount of equipment. “We learned the hard way when we arrived to find no sutures that first year.”

Now the mission is building a new hospital in Caracol. A medical center, where patients can visit family

medicine specialists and soon dentists, is already open. In November 2015, Haitian First Lady Sophia Martelly cut the ribbon at the hospital’s groundbreaking ceremony. The mission recognizes the gift of this land and the medical center as a gesture of goodwill by the Haitian government.

Dr. Lois is hoping to expand the project. The mission is currently in discussions with “large donors,” one of

whom has promised to donate a CAT scan machine and about $200,000 for construction. Reaching their goal of $250,000 would allow them to finish building the surgical and X-ray suites, but they’d also like to raise funds to build a dorm on the property for mission personnel. Often Dr. Lois and his colleagues end up sleeping on cots or the hospital floor. He once took a two-hour nap in someone’s car.

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Patients have typically never seen a doctor and may wait in line for 24 hours to see mission doctors who examine them with the most basic equipment. Taking part in this work is hugely beneficial for physicians as well, who “grow in their appreciation of what it means to be a doctor and save lives.”

He shares a story about a mission colleague, family medicine specialist Dr. Steven Liverpool. Upon visiting another small town in Haiti, Dr. Liverpool learned that residents had a very high death rate. He quickly

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discovered that though everyone in the community had extremely high blood pressure, hypertension was not the root cause of death.

Through interpreters and community leaders, he learned that residents were drinking seawater from a well that was contaminated with cholera. Dr. Liverpool made sure the well was treated and that patients were not only cared for, but also taught that it’s unsafe to drink seawater. “I don’t know how many people he saved just from that one trip,” Dr. Lois says.

“Doctors who go to Haiti are better for it, because they learn how to take

care of patients with their hands and their brain and not with unlimited supplies and gadgetry. They learn to return to the roots of medicine.”

A common misperception the public has about global health, Dr. Lois says, is that it’s detached from their own experience. Ebola, the 2016 cholera outbreak in Haiti, and similar events can seem like isolated news items, “but in a global culture where it’s relatively easy to travel between continents, awareness of global health is, I know it sounds corny, beneficial for the overall health of

Previous page: Elderly woman having her vital signs taken.

Top: Dr. Henry Paul, Deeta Denis, and Dr. Cary Daniel preparing the on-site pharmacy; bottom: mission volunteer hosts art class for children.

the planet.” He explains that when there’s high evidence of disease in a region, civil war can break out, pointing to Sudan’s recent history. “As a physician, all of this is part of your vocation.”

KNOW YOU’VE MADE AN IMPACT

Dr. Lois gets as much out of the missions as patients do, another sentiment that may “sound corny” but rings true. His experiences on these trips are now an integral part of who he is. He talks about a young

stabbing victim he was able to treat despite multiple wounds inflicted during a robbery. The following year, he was approached by an unfamiliar older man who gave him a huge hug and bag full of mangoes. Through a translator, the man said, “I don’t know what to give you, but you gave me my son back.” Dr. Lois realized this was the father of the stabbing victim they had saved the year before.

On almost every trip, Dr. Lois performs high-risk baby deliveries, and over the years, he has met many of these children and watched them

grow. The parents often name their children after him, which he finds amusing. One year, a woman was brought in with a ruptured uterus, caused by becoming pregnant too soon after having a C-section the year before. Despite working in a sweltering operating room, Dr. Lois was able to safely deliver her baby, a girl. She and her mother are healthy and continue to visit him when he’s in Haiti. “You can’t put a price on that.” ■ ____________________________ All photographs that appear within this article are credited to NOAH NY.

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DR. KIMBERLY MALLIN AUA Director of Health Services, January 2014–Present AUA Assistant Professor, Behavioral Sciences and Counseling Services, June 2011–June 2012

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Q& A VITALS

TALKING WITH: DR. KIMBERLY MALLIN

Dr. Kimberly Mallin, who runs AUA’s campus clinic, had her hands full on the day she spoke to The AUA Times.

That morning, a student came to her with a problem that an ultrasound confirmed would require off-island surgery, and Dr. Mallin had been going back and forth with insurance companies and medical professionals to get permission to send the student to New York. When we sat down to talk, she was literally out of breath, having just returned from a run. An active member of Antigua’s running community, she has been busy organizing an updated version of AUA’s triathlon. Formerly known as “Tinman Rohr,” the event is named for Jonathan Rohr, an AUA student and one of the race’s founders. He had been training to compete in the race but died in his sleep from hypertrophic cardiomyopathy before he had the chance.

“This year we formed our own committee to put on a new triathlon with myself and two regional promoters,” says Dr. Mallin. “We’re calling it the AUA Rohrman Triathlon,

and it’s going to take place in March. I think this’ll be a larger race. We’re hoping to get some international interest.

The race director is from France. We’ve also got two pros coming: one from America, one from England.”

She is married to Dr. Robert Mallin, AUA’s Executive Dean, who was first recruited to chair the Clinical Medicine Department in 2011. The Mallins stayed for a year and then returned to the Medical University of South Carolina, where Robert had been working since 1997 and Kimberly since 1999. By 2014, the challenges of strengthening AUA’s academic program as Executive Dean for Robert, and building a campus clinic from the ground up for Kimberly, not to mention the lure of returning to island life, brought the couple back for an indefinite stay.

“We’ll be here until Robert reaches his goal for AUA to become the best medical school in the Caribbean, but even then, my husband will never retire, so we might work here, to some degree, forever.” (continued on next page)

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IT SOUNDS LIKE YOU WEAR A LOT OF HATS.

The protocol for running a clinic is different here than in the States. So when we need to coordinate with facilities in the States for patient care, it can get complicated. In addition to the clinic, I started the Wellness Committee last year. It’s responsible for promoting Drug and Alcohol Awareness week, Interpersonal Violence and Sexual Assault week, as well as the availability of bi-weekly stress-relieving classes for everyone on the AUA campus— Zumba, yoga, meditation, Brazilian Jiu Jitsu. And I’m the medical director of the Emergency Response Team (ERT), which provides student-led emergency response services. Basically they’re a group of students who were nurses, EMTs, flight nurses, firemen, etc. prior to coming here. From 9AM to 9PM daily, they volunteer to be first responders to any on-campus accidents, illnesses, or other emergencies.

THIS SPRING YOU SPOKE ABOUT THE ZIKA VIRUS AFTER THE FIRST CASE WAS REPORTED HERE. WHAT IS THE STATUS OF ZIKA ON ANTIGUA NOW?

When Zika was first identified in the Caribbean, both AUA and Antigua became very proactive, spraying daily for mosquitoes and providing public health education.

We have posters on campus, bulletin boards with information regarding prevention of transmission, as well as emails with CDC updates that we distribute to faculty and students. Zika really hasn’t been an issue on campus, and I haven’t heard of recent cases in Antigua.

WHAT ARE YOUR FAVORITE AND LEAST FAVORITE THINGS ABOUT WORKING HERE?

One of the things I really like about AUA is that there’s a lot of enthusiasm for teaching and helping our students.

It’s been fun to build the clinic from the ground up.

I’d never started from scratch before, and that’s been overwhelming at times. Also, you really have a lot of opportunities here to get outside and enjoy the beauty of this place. And I like the fact that life on the island really is slower than in the United States.

EVEN THE SOUTH?

Yes, definitely.

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JUST KIDDING.

Dr. Mallin examines a student at the AUA clinic.

No, seriously. I was laughing. I was in Charlotte this past weekend because I went to see the Dixie Chicks with my sister. And as I was waiting for my coffee order, I noticed that the woman serving us had an accent, and I was trying to figure out where she was from. Meanwhile, the person behind me was getting really impatient with her. She was tapping her fingers on the counter. She said, “doesn’t she know she can make more than two cups at a time?,” and the person next to her snaps, “she’s taking forever!” I know that prior to living on Antigua, I would’ve been tapping my fingers and in a hurry as well, but I’ve learned that stuff’s not important. You can slow down. I like that part. I do miss the ability to just get in the car and drive up to the mountains for the weekend though. I suppose you could fly to a local island, but that takes more planning. I love living here anyway. It’s easier and more rewarding.

YOU’RE PROBABLY SO BUSY YOU DON’T HAVE TIME TO GET ISLAND FEVER.

Well, I also end up going back to the U.S. every two or three months to pick up supplies for the clinic. But the clinic has really gotten busy, so there’s no time to get bored. It’s been extremely demanding for the last six months, to the point where we’re hoping to expand.

“EXPAND” IN TERMS OF PERSONNEL OR THE ACTUAL FACILITIES?

The whole thing. I’m hoping to add a couple of rooms.

I’ve got an RN here, and she also teaches at the ACLS (Advanced Cardiac Life Support) skills lab. We’re only open from 8:30AM to 2:00PM, so she can go to her classes.

I would like to get another part-time nurse and perhaps another part-time physician. It would be nice if we could have occasional evening hours, because some of the students get out of class at 5PM, and one of our goals is to limit the amount of times students visit outside clinics, where they aren’t able to use their insurance.

WHAT’S IT LIKE WORKING WITH YOUR SPOUSE?

It’s actually nice. What we do is very separate, but it’s lovely being able to see him if I need to. And he’s often the second opinion I seek when I’ve got a patient

over here. He enjoys that, because although he’s an administrator now, it gives him the chance to ‘practice’ medicine a little bit too.

ARE YOU DOING ANY RESEARCH CURRENTLY?

I’m working with a couple of students on some papers, one of them about the emergency response team we have here. Actually, myself and Dr. Sadacharan, one of the faculty, just had a paper published on something I’m sure you’ll find fascinating—umbilical pilonidal cysts. I’m also working with one of the students on the ERT to evaluate the team’s effectiveness and ways to improve. And I’m doing a survey with Dr. Chitra Pai, our Associate Dean of Research and a Professor of Microbiology/Immunology, on student awareness, perception, and knowledge of STIs. WHAT DO YOU THINK THE EXPERIENCE IS LIKE AT AUA COMPARED TO A LARGE MEDICAL SCHOOL IN THE STATES?

When you spend a lot of time at a teaching university, you see how professors have to bring in grants. They’ve got to do a certain amount of teaching on the ward, so they’re unable to really focus 100% on trying to teach students

basic sciences. Our students have a greater opportunity for individual teaching and guidance than students at a U.S. facility would. The students also benefit from early handson experience in our simulation lab. Keep in mind that in running the clinic, I haven’t done much basic sciences instruction, which is mainly what’s taught here on campus.

But compared to the basic sciences teachers that I knew at the Medical University of South Carolina and other places, those here are far more dedicated. If you consider where AUA graduates have matched and what they’re doing today, it’s a testament to the preparation and mentorship they receive here.

WHAT STARTED YOU ON THE PATH TO BECOMING A DOCTOR?

When I was 14 years old, I fell at school, broke my nose, and had to go to the hospital. I was in the emergency room, scared, and in a lot of pain. And this man in a long white coat said, “don’t worry, we’ll fix it and take care of you.” Right then I decided I wanted to be the person in the long white coat that could take care of people’s problems.

So that was my initial childish thought, but with that, I did volunteer work throughout college, then went on to medical school and residency, and now here I am. ■

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The SCIENCE of Self [ 35 |

AUA’s most nontraditional student and the Quantified Self

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o thrive in medical school, students must stay motivated, organized, and self-disciplined. Last, but certainly not least, medical students who want to succeed must take care of their bodies: eating right, exercising regularly, and getting as much sleep as possible.

Many students have the academic will power needed to thrive but struggle with taking care of themselves personally, especially when it comes to sleep. Then there’s David Riley, a third semester AUA student, who happens to be 57.

“Historically, I’ve slept very little,” David says. This comment, along with others he makes throughout his conversation with The AUA Times, is an understatement.

He is narcoleptic and has obstructive sleep apnea. He also suffers from congestive heart failure, coronary artery disease, hypertension, metabolic syndrome, diabetes, Hashimoto’s Thyroiditis, autoimmune B-12 deficiency, and autoimmune dry eyes syndrome.

This September, the AUA-produced television series “Healthy Perspectives,” in which members of the AUA faculty and staff along with members of the Antiguan community discuss important public health topics, returned to Antigua’s National Broadcast Station and the web with its 11th season. Its first episodes will focus on childhood obesity and Alzheimer’s disease. (continued on next page)

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DAVID RILEY, BS, PA Class of 2019 Hometown: Marshall, Missouri Owner, Enaptics Consulting, LLC, 2005–Present Chief of Informatics, Harris Health Care Solutions, 2012–14 President, The Alembic Foundation, 2011–13 Bachelor of Science, Allied Health Physician Assistant Studies, University of Nebraska, 1993 Physician Assistant, United States Air Force 1985–77

Earlier this year, David appeared in an episode entitled “Genetics & the Heart” to discuss how he stays healthy while maintaining a full course load, despite a medical history that has included several close calls. The episode, in which he spoke to AUA physiology professor Dr. Richard Millis, has made him something of a local celebrity.

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These days when he’s out running errands, members of the community recognize him and tell him that thanks to his episode, they now understand the severity of sleep apnea or that they benefited from watching in some way or another. Others, who usually pass him on his daily walk to or from campus, which he does for exercise, now slow down to offer him a ride.

In his teenage years, David averaged about four hours of sleep a night, in part due to his then undiagnosed narcolepsy, which disrupts the sufferer’s sleep patterns. “It drove my parents crazy, because I’d be up until 3AM and then up again at 7AM for school,” he says.

In an odd way, insomnia served him well. He found himself reading “enormous amounts of material” on a wide variety of topics, because he had so much extra time on his hands. He compares the sensation he gets when he learns something he’s been struggling to understand, “that moment of insight,” to the intense high an addict must feel when getting

VITALS

Previous page: Riley monitors vitals during his sleep cycle; bottom: he analyzes the data collected from his previous night’s sleep.

“that first squirt of dopamine.”

That thirst for new information and understanding has led him on a career path that has gone from healthcare to IT and entrepreneurship, and back to healthcare. Originally a nurse, David worked in neurosurgical, trauma, and cardiac intensive care units. He eventually worked as a flight nurse in the U.S. Air Force before becoming a physician assistant and serving in an Air Force clinic.

From there, David, who built his first computer in the 1970s, was transferred to The Pentagon, where he oversaw the creation of an electronic medical records system that allowed the Department of Defense and the Veterans Administration to share medical information for the first time.

The program is still in use 16 years later and operating within the original $4 billion budget he put together.

After leaving the military, he ran his own Health IT consulting company and operated construction and plumbing businesses with his father and brother. He has also run more than one nonprofit.

David describes himself as someone who’s always been a “long-term planner,” another understatement.

While many people make fiveyear plans, his, made on his 50th birthday, was a five-decade plan. He was determined to live well past the point that others who have suffered heart attacks have and to become a doctor, with the goal of working in personalized medicine, possibly back in Missouri, where his mother still lives.

Since getting his MD will help him accomplish only one part of this ambitious plan, he hopes to follow it up with a PhD to pursue what he calls “health engineering.” He says our healthcare system diagnoses and charts the progression of a disease “towards its inevitable conclusion” but doesn’t look at a patient’s genetics in order to provide preventative treatment before symptoms even appear. “It’s really a disease care system.” In his view, illnesses should be mapped out before they manifest, not after the fact.

With this in mind, he keeps his own “healthcare problems” list, which includes conditions he and his family have experienced. Seven years ago he had his and several family members’ genes sequenced. A father and a grandfather, David now has 13 data sets: one set for each problem on the list, across four generations.

David’s classmates, most of whom are not much older than his eldest grandson, refer to him as “Grandpa Dave” and “Papa Dave.” He has fewer distractions than they do and sees that as an advantage. “Mating rituals, many of life’s decisions—I’ve been there already, I’ve done that.” A teaching assistant and tutor, he is happy to be a

resource to his fellow students but tries to be as unobtrusive as possible.

As intense as he is, David meditates, reads, and most recently, has become passionate about cooking. Of course he speaks about “neurogastronomy” when asked about his new hobby and explains he’s now trying to understand the food he prepares on a molecular level.

Before he got to AUA, David gave several conference presentations on personalized medicine. After presenting a case study, he would reveal that he was the patient whose symptoms were discussed. The response from audiences was positive, and this influenced his decision to appear on “Healthy Perspectives.”

He hopes his participation on the show helped students understand they don’t have to hide their conditions or disabilities, especially older ones, who he figures may be dealing with similar issues. “The important thing is, we can get through this. Medical school is still very doable, even if you have other issues,” David says. “You have to do additional things that other people don’t have to do, but you can still get through it and be successful.” ■

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AMSA Hosts U.S. Army Recruiters on Campus Event highlights the advantage of being a U.S. Army Physician and the need for specialists

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any international medical graduates overlook serving in the Armed Forces as a career path. This spring, for the first time, AUA students met face to face with military recruiters in an event hosted by the AUA chapter of the American Medical Student Association (AMSA).

A presentation entitled “U.S. Army Medicine in Action” introduced them to the benefits and incentives available to U.S. Army Physicians and the impact of military medicine on global health, prevention, security and safety and the delivery and maintenance of quality community medicine.

Sergeant First Class Ryan Covington, Army Medical Department (AMEDD) Recruiter of the U.S. Army Medical Recruiting Command in Lexington, KY, spoke about shortages in specific specialty areas such as trauma surgery, anesthesiology, and neurology. He also outlined the opportunities available to AUA graduates who are not U.S. citizens.

Captain Rosciae Savior, a Medical Intelligence Officer from San Antonio, TX, introduced students to the ongoing global health issues that impact world health care, policy, strategic allocation, logistics, and public health for civilians and service members.

Sergeant Covington and Captain Savior also covered military residency, research opportunities at the Centers for Disease Control and Prevention, and services provided to Veterans Administration hospitals and clinics during both peacetime and war.

When financial aid information was presented, students expressed particular interest in the loan repayment program available to graduates of international medical schools.

“We are excited about the success of the overall event, says AUA Chapter President Samuel Lee. “It aided those who have already served in the U.S. military services and those who have not yet experienced the benefits and lifetime camaraderie the U.S. Army Medical Corps offers.”

The AUA chapter of AMSA is committed to involving its members in the social, moral, and ethical obligations of the medical profession to promote active progress in medical education.

Locally, the group is dedicated to improving health care and its delivery. Globally, AMSA assists in the improvement and understanding of world health problems and aims to bring awareness to certain preventative measures that can be taken to boost personal health and create a sustainable environment. ■

Left to Right: Stephanie Lau, Maria Saba, Brian Darzi, Shane Conway, Sushant Sunkaraneni, Samuel Lee, Rosciae Savior, Htet San, Aman Kaur

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t is an auspicious time for Dr. Leilani Garcia. When she spoke to The AUA Times in late August, she was just weeks away from beginning her new role as Director of Carthage Area Hospital’s Internal Medicine Hospitalist program, where she’s been a hospitalist since completing her residency in 2015.

The path Dr. Garcia’s career has taken is a prime example of AUA’s mission. She has gone back into a community that has a great need for her skills, knowledge, and compassion.

This summer Dr. Garcia was awarded a $100,000 loan repayment award by Doctors Across New York, a New York State program devoted to training and placing physicians in underserved communities. For Dr. Garcia, the award, which she applied for over a year ago during residency, was just one incentive for working in upstate New York.

Carthage Area Hospital is also located only 20 miles from the town of Philadelphia (this one’s in New York), where she attended high school. (continued on next page)

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THE STRENGTH OF YOUR MEDICAL TRAINING MAKES A BIG DIFFERENCE. Her father, a veteran of both Gulf Wars, had a long career as an Army physician assistant, with multiple overseas deployments and time in the Special Forces. He moved his family for a reassignment to nearby Fort Drum shortly before 9/11. They were used to moving around but liked the community so much they decided to stay permanently.

Now retired from the military, Dr. Garcia’s father is a PA in Carthage Area’s emergency room, and many

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of the staff are family friends. Dr. Garcia’s mother is on the hospital’s foundation committee as well.

Though she completed her internal medicine residency at a large Pennsylvania hospital, Dr. Garcia always intended to return home or at least work in a small community that supports the military. Spread across 1,300 miles, Jefferson County, where Carthage Area Hospital is located, has a population of only 119,000 people according to the most recent

Census figures, with Fort Drum as its largest employer. After 9/11, the military community grew rapidly, and today Fort Drum is the largest Army installation in the Northeast.

With 25 beds for 83,000 patients, a maternity unit of just six birthing beds and two observation rooms for new and expectant mothers, and a location almost three hours from the nearest major metropolitan area, the demand for resources and resourcefulness at Carthage Area Hospital is crucial.

DRIVEN TO SERVE

DR. LEILANI GARCIA Class of 2012 Director, Internal Medicine Hospitalist program Carthage Area Hospital in Carthage, NY Residency in Internal Medicine Pinnacle Health Systems in Harrisburg, PA Bachelor of Science, Biology, Pre-Med State University of New York at Albany

From day one, it was obvious Dr. Garcia would be serving a very real need. During her first shift, a patient came in from a nursing home with a septic infection that required emergency surgery. Because it was a procedure Dr. Garcia knew how to perform, she was able to stabilize him before he was transferred to an ICU facility. “You can see how much you’re needed in these small places.

The strength of your medical training makes a big difference.”

Dr. Garcia occasionally refers patients to specialized clinics, but she’s the first and last point of contact for those with a wide range of symptoms and conditions. “There’s a big difference working in a rural hospital,” say says.

“You have to be confident in your skill set because there’s no one looking over your shoulder.”

Dr. Garcia is the primary physician for patients ranging from adolescents to seniors, and while she doesn’t work directly with pediatric or OB/GYN patients, she is often consulted on their cases. She revises and develops policies and protocols for the hospital, assists with nursing education, and works closely with the clinical

pharmacy to improve prescribing practice. To improve quality control and expedite the admissions process, she has created order sets (physician-developed lists that provide standardized treatments and procedures) for the 15 most common diagnoses.

She is also active in community outreach events. “I don’t mind the extra work,” she says. “I love the independence and sharing the experience I’ve gotten from working at a larger facility.”

Being the primary resource in a small facility forces you to acquire new skills in unexpected areas. Although Dr. Garcia’s specialty is internal medicine, she has had to take on a majority of the patients at Carthage Area’s nursing home. She says, “It’s an often overlooked population. It can be challenging to work with a patient who has dementia or has multiple comorbidities. A lot of the time, people don’t want to deal with geriatric patients because it’s complicated and because they may be very confused. But I actually really enjoy working with those patients because it presents a different

challenge for me, and I know that there’s a need.”

Dr. Garcia is as much a resource to her colleagues as she is to her patients.

She also works with clinical students from neighboring institutions and teaches them how rural hospitals operate and the unique position they occupy. “You don’t hear a lot about these types of hospitals, but they need physicians badly,” she says.

Dr. Garcia stresses the importance persistence played in her success. “I never had a 4.0 GPA. I was always a 3.7, 3.6, so, I didn’t know if I could get into a U.S. med school,” she says.

Her first year after college, she applied to U.S. medical schools and was waitlisted by five.

At the suggestion of a friend, she applied to AUA and went on to become the president of her class for two semesters. If she could impart anything to incoming or current AUA students, it would be to “utilize their time on the island. There are so many opportunities to build your CV and get involved with the local community.” ■

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Highlights from the 2016

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O AC T I O N

NCOURAGEMENT Commencement Ceremony

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he AUA Class of 2016 gathered at the New Jersey Performing Arts Center on June 2nd for the annual commencement ceremony. Celebrating along with nearly 300 graduates and AUA faculty and administration, was a host of on-stage dignitaries, from the Governor General of Antigua and Barbuda to a Harvard University Medical School Physician Educator. The ceremony included an address by Valedictorian Maharshi Rajdev, a keynote speech by U.S. Congressman Eliot L. Engel, and an address by alumni speaker Radha “Rani” Padhy.

Maharshi Rajdev earned his B.S. in Biology at the University of Vermont. In the Fall of 2011, he enrolled in AUA, where he developed a passion for teaching as a Teaching Assistant for anatomy, physiology, neuroscience, ICM, and pathology. During his final semester, he was appointed Head Teaching Assistant. During his last two years of medical school, Dr. Rajdev completed clinical rotations at hospitals around the country and

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achieved outstanding scores on both the USMLE STEP 1 and STEP 2 CK. He obtained a diagnostic radiology residency at University Hospitals Case Medical Center in Cleveland, OH that will start in 2017. In the interim, he is completing his preliminary year of General Surgery at the Mayo School of Graduate Medical Education in Rochester, MN. Dr. Rajdev spoke about medicine being an art as well as a science, stressing the importance for doctors to remember their patients’ humanity even when the pressure’s on.

“When your pager won’t stop buzzing, when you get that new consult five minutes before your shift is up, when you see the same patient come through the emergency room for the third time in three days, pause, take a breath, and remind yourself that you have been given the gift of knowledge and the resources to help those in their most dire times of need,” he said.

THE NEW CLASS Governor General of Antigua and Barbuda Sir Rodney Williams with Antiguan citizens and recipients of AUA's Antiguan Tuition Grant Ariel Moulon (left) and Whitfield Lews (right).

REMIND YOURSELF THAT YOU HAVE BEEN GIVEN THE GIFT OF KNOWLEDGE AND THE RESOURCES TO HELP THOSE IN THEIR MOST DIRE TIMES OF NEED.

AUA President Neal Simon introduced Congressman Eliot L. Engel, who represents the Bronx and Westchester, NY, as a true advocate of international medical school students and diversity in medical education. President Simon described how, unlike the other elected officials he approached, Engel was responsive to the issues concerning AUA students and the need for more physicians in his district.

During his address, Engel himself mentioned the projected U.S. physician shortage and the Affordable Care Act’s value, despite its problems. He also urged AUA graduates to get involved in politics and vote in the upcoming U.S. presidential elections, whatever their political leanings.

He warned them against apathy, saying, “the future of the country and the world depends on you.”

Alumni speaker Dr. Radha “Rani” Padhy (Class of 2013) is now an OB/GYN Resident at Staten Island University

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Hospital and a member of the American Congress of Obstetricians and Gynecologists and the Society of Gynecologic Oncology. After completing a year of gynecologic pathology research at Johns Hopkins in Baltimore, MD, she recently received a grant from the American Society for Colposcopy and Cervical Pathology (ASCCP) to support her research on HPV and cervical cancer. The award will be recognized in the July issue of The Journal of Lower Genital Tract Disease, and she will present her research at the 2017 International Federation of Cervical Pathology and Colposcopy (IFCPC) World Congress.

In December, she will participate in the Felix Rutledge Fellowship in Gynecologic Oncology at the University of Texas MD Anderson Cancer Center. This extremely competitive fellowship is only available for third-year OB/GYN residents. Dr. Padhy credits AUA in large part for her success and challenged the class of 2016 not to underestimate themselves as graduates of a Caribbean medical school. “Never, for a moment, think that you are at a disadvantage,” she said. “I am a resident physician because of the hard work of all my professors and the

administrative staff at AUA, and that is why I stand in front of you today … I can tell you with the utmost certainty that the real-life experiences, academic training, and technical skills you have gathered here will help you tremendously in any specialty you choose.”

Governor General of Antigua and Barbuda Sir Rodney Williams addressed the graduating class as well, calling good health “a fundamental human right.” He spoke about the contributions AUA has made to his country since the school’s founding in 2004 and expressed his gratitude on behalf of the nation. “There is no question that your school has added value to our country,” he said. “AUA has been an outstanding corporate citizen and has proven itself to be a premiere medical school.”

This vote of confidence makes AUA’s positive local impact clear. With graduates practicing all over the United States and Canada and new initiatives, such as the Global MD program, AUA is also expanding its reach and making its mark internationally. We are proud of our graduates and everything they’ve done to help us grow as an institution and center for medical education. ■ The Class of 2016 pictured at the New Jersey Performing Arts Center

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NOTABLE RESIDENCY PLACEMENTS IN 2016 This year, AUA graduates secured residencies at several prestigious institutions throughout the United States and Canada. In keeping with AUA’s mission, which emphasizes a commitment to supporting underserved communities and addressing the impending physician shortage, most placements were in primary care. However, AUA graduates also landed many residencies in a variety of subspecialties.

As AUA’s reputation continues to grow, these placements show that our graduates are making their mark on the field of medicine.

Here’s a sample of some of the most competitive residencies secured by our graduates: • Albert Einstein College of Medicine/Montefiore Medical Center, NY­ Physical Medicine and Rehabilitation • Case Western Reserve University/University Hospitals Case Medical Center, OH – Radiology-Diagnostic • Carilion Clinic -Virginia Tech Carilion School of Medicine, VA –Neurology • Mayo Clinic College of Medicine, MN – Surgery • Rush University Medical Center, IL – Anesthesiology • Rutgers Robert Wood Johnson Medical School, NJ Emergency Medicine • Stony Brook Medicine/University Hospital, NY Psychiatry • SUNY Upstate Medical University, NY – Anesthesiology • University of British Columbia, Canada Family Medicine • University at Buffalo, NY – Anesthesiology • University of Kansas School of Medicine, KS – Neurology • University of Nebraska College of Medicine, NE Anesthesiology • University of Pittsburgh Medical Center, PA Internal Medicine • University of Saskatchewan, Canada – Family Medicine • University of Texas Health Science Center, TX Child Neurology • Western Reserve Health Education/NEOMED, OH General Surgery FAL L 201 6 • AUA T I M ES

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Research Day: The Importance of Basic Sciences and Solutions for Cervical Cancer in the Caribbean

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he entire AUA and AICASA faculties celebrated Research Day on April 12th with several Antiguan dignitaries present, including the Governor-General.

Research Day is held on campus every semester during Basic Sciences to celebrate faculty research, engage with guest researchers, and encourage AUA students to pursue research of their own.

After Dr. James Rice, Associate Dean of Student Affairs and Admissions, welcomed students to the event, Executive Dean Dr. Robert Mallin gave the opening remarks. He stressed the importance of research in medicine and the need for innovative approaches to basic sciences. Dr. Chitra Pai, Professor of Microbiology/ Immunology and AUA’s Associate Dean of Research, introduced the evening’s two keynote speakers: The University of Toronto’s Anne Agur and AUA’s Dr. Leslie Walwyn.

Dr. Agur, who gave a talk entitled, “Development of a clinically based research program in basic science: from the lab to clinical trial,” founded the University of Toronto’s Musculoskeletal Anatomy Laboratory in 1990. A researcher and teacher for 35 years, this professor in the Division of Anatomy and Department of Surgery holds cross appointments in the Division of

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Physiatry and the Departments of Physical Therapy, Occupational Science, Occupational Therapy, Biomedical Communications, and the Institute of Medical Science. Dr. Agur is also the co-author of Essential Clinical Anatomy, the current editor of Grant’s Atlas of Anatomy, and the winner of numerous teaching awards.

Her research interests include skeletal muscle form and function, clinicallyapplied neuroanatomy, and anatomy education.

Pan American Health Organization (PAHO) consultant, gave the keynote address. A longtime family private practitioner, Dr. Walwyn has a passion for public health and disease prevention. Her research focuses on diabetes, cervical cancer, and mental health. In a segment of the day devoted to covering the social determinants of health, she gave a presentation that proposed costeffective ways to treat cervical cancer in the Caribbean.

The structure of medical learning programs is an area of great interest to Dr. Agur. In June 2016, Dr. Agur co-authored a study published in Perspectives on Medical Education entitled, “Exploring cognitive integration of basic sciences and its effect on diagnostic reasoning in novices.”

In her study “Cost-effectiveness of HPV vaccination in Belize,” which was published in the journal Vaccine, Dr. Walwyn looked at women in Belize, a country where cervical cancer is the leading cause of cancer deaths among women and two forms of an HPV vaccine are licensed. Because Dr. Walwyn and her team found that “routine vaccination would be highly cost-effective in Belize,” they recommended expediting the introduction of this vaccine into Belize’s national immunization program.

The study compared two groups of basic sciences students, one which received clinical instruction on a pathology only, while the other was exposed to the underlying causes of the problem as well as the clinical features. The students in the second group demonstrated a superior understanding of the topic, supporting integrated curriculums such as AUA’s for basic sciences courses.

Dr. Leslie Walwyn, Associate Professor of Clinical Medicine at AUA and

With faculty, alumni, and a network of physicians at other institutions with rich research backgrounds, AUA is poised to be at the center of scientific and clinical understanding and growth. ■

HAPPENINGS

Recent Faculty Publications Show AUA’s Commitment to Research and Global Health Applications

Pemminati Sudhakar, PhD, MSc (Pharm), Pharm. D., Associate Professor of Pharmacology

Chakravarthy Marx Sadacharan, MSc, PhD Assistant Professor of Anatomy Dr. Sadacharan published studies on the morphometrics (measurements, usually of individual organisms, including masses, lengths, widths,

Dr. Sudhakar published a study in the Journal of Clinical and Diagnostic Research for Doctors that concerns Type 2 Diabetes Mellitus (T2DM).

According to the International Diabetes Federation (IDF), the number of people with Type 2 diabetes is rapidly growing worldwide due to aging populations, economic development, increasing urbanization, unhealthy diets, and reduced physical activity. The World Health Organization (WHO) reports that Type 2, the most common form of the disease worldwide, is now being seen

more and more in children, whereas it was previously found only in adults.

angles, ratios, areas, and the factors affecting change on those measurements) and anthropometrics (which looks at human body measurements on a comparative basis across populations) of Indian Americans.

measurement, and that Indian Americans most closely resemble Malaysian Indians. The vermilion is the red/pink area of the lip. The differences between Indian Americans and other ethnic groups across these measurements led him to conclude “the same standards cannot be used on different populations for cosmetic surgery.”

In a study that appeared in the International Journal of Advanced Science and Research entitled, “Lip morphometric study on Indian Americans and its clinical applications,” Dr. Sadacharan compared the lip measurements of Indian men to those of women and of both groups to those of other ethnic groups. He found that both Indian American men and women tend to have a higher lower lip vermilion measurement than upper lip vermilion

In his study “Are the Newer Antidiabetic Agents Worth the Cost?” Professor Sudhakar and his co-authors call for further research, pointing out that there is still much to be learned about the safety of newer, more expensive antidiabetic drugs. He advises that “newer is not necessarily better,” especially because the older, more affordable antidiabetics have been effective in increasing longevity and quality of life for patients.

Professor Sadacharan sees this data as useful to Indian Americans who need plastic surgery in the United States, specifically “if they need to undergo surgical reduction and reshaping of the labia, and surgical improvement of lips’ fullness through enlargement.” ■

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AUA Advisory Board Helps Shape Mission

Top doctors, scientists, community leaders inform and guide medical education programming.

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he board’s role is to advise and consult senior administration on fulfilling AUA’s mission to provide a learner-centric education of the highest quality, grant opportunities to underrepresented minorities, foster a diverse academic community, and ensure that graduates develop the skills and values of lifelong learning, compassion, and professionalism.

The members of AUA’s Advisory Board are carefully selected individuals who have distinguished themselves in the fields of medicine and public service. At the most recent meeting, they discussed establishing AUA’s identity as a leader in addressing the physician shortage. By placing an emphasis on primary care and sending qualified doctors back into the community where they're needed most, AUA is making a real impact on access to health care and minority representation in the medical field.

Dr. Seymour Schwartz, Provost and Professor of Surgery, characterized AUA students as “more passionate than U.S. medical students” and AUA faculty as “equally passionate and dedicated to teaching.”

“Visiting the campus and meeting so many students of diverse backgrounds who are succeeding in the field of medicine was impressive,” said Alice Huffman, President of California’s NAACP. “Knowing AUA students will likely become primary care physicians gives me hope that one day they’ll be able to provide medical services to the inner city as well as rural communities in America where medical deserts now exist. They may be our best hope for fulfilling the promise of prevention as was ensured by the Affordable Health Care Act.”

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AUA Advisory Board Members Under Alice Huffman’s leadership, the California NAACP, which she has presided over since 2000, has become one of the most influential organizations in the state’s policy arena. She is also a member of the organization’s National Board of Directors. Huffman was appointed by former Governor Arnold Schwarzenegger to the State Parks and Recreation Commission and the California Complete Count Committee for the 2010 Census. She is President of Future PAC, a national organization that supports the election of progressive African American women, and serves on the Board of the Center for Democratic Participation. A member of the California Democratic Party Executive Committee and the Democratic National Committee, she also serves on the Help America Vote Advisory Committee and the Wells Fargo Company Advisory Committee.

Since 1998, Dr. Larry Griffith has been a medical director at Johns Hopkins Medicine International. He trained in surgery and internal medicine at Strong Memorial Hospital in Rochester, NY, and cardiology at the Johns Hopkins Hospital (JHH). In 1971, Dr. Griffith joined the full-time faculty at the School of Medicine and was promoted to Professor in 1988. During his time at JHH, Dr. Griffith has been the Director of the Adult Catheterization Laboratory and was a clinician on the Arrhythmia Service when Implantable Cardioverter-Defibrillators were used for the first time. Dr. Griffith was director of the Physical Diagnosis Course for second year medical students for 22 years and, since 1996, director of a large initiative to improve communication with community physicians.

Serving New York’s 1st Congressional District, Former Representative Timothy Bishop served six terms in the House of Representatives. He is now a Distinguished Professor of Civic Engagement and Public Service at St. Joseph’s College in Patchogue, New York, and was appointed by New York State Governor Andrew Cuomo to direct the New York State Environmental Facilities Corporation. He sits on the Board of Directors of Social Accountability International and The Sergeant Sullivan Center. Both board commitments allow Bishop to continue two of his top priorities in Congress: working to ensure workplace protections and providing service to veterans, particularly in the area of post-deployment health.

Dr. John Hansen is a Professor of Neurobiology and Anatomy and Associate Dean for Admissions at the University of Rochester School of Medicine and Dentistry. Dr. Hansen has a PhD in Anatomy from Tulane University and has received numerous teaching awards from three different medical schools. Notably, he was the first recipient of the Presidential Diversity Award at the University of Rochester. Dr. Hansen has been a consultant on various aspects of medical school basic sciences curriculum design at 14 U.S. and five foreign medical schools. In addition to more than 110 research publications, book chapters, and books, and over 90 meeting abstracts, Dr. Hansen is also co-editor of Clinical Anatomy, the lead consulting author of Netter’s Atlas of Human Anatomy, and author of Netter’s Clinical Anatomy, Netter’s Flash Cards, and the Essential Anatomy Dissector.

Dr. Ebrahim Kermani is a Distinguished Life Fellow of the American Psychiatric Association and Triple Board Certified in General Psychiatry, Forensic Psychiatry, and Child and Adolescent Psychiatry. He is currently a Clinical Professor of Psychiatry at NYU School of Medicine and an attending physician at NYU’s Tisch Hospital. He has published numerous scientific papers in peer-reviewed journals, and his opinions have been cited in several textbooks and academic journals. In addition, Dr. Kermani was Chairman of Psychiatry at Ross University School of Medicine (RUSM), where he developed a psychiatric curriculum that he oversaw at the affiliated teaching hospitals.

Dr. Robert Wilmouth was named president of Rocky Mountain College in April 2013. Dr. Wilmouth has extensive leadership experience with interests in fundraising, cost containment, and marketing outreach services. From 1991-2004, Dr. Wilmouth, who received his medical degree from the University of Illinois, worked as a cardiac, thoracic, and vascular surgeon for Billings Clinic. During his time at Billings Clinic, Dr. Wilmouth also served as Medical Director and Chief of Cardiac Services. Since 2005, he has been on the faculty of the Institute for Healthcare Improvement in Cambridge, Massachusetts. He has also devoted time to numerous organizations and committees, including Mountain-Pacific Quality Health Foundation, Cambridge Health Resources, RiverStone Health Foundation, American Medical Directors Association, Montana Medical Association, and the Society of Thoracic Surgeons. ■ FAL L 201 6 • AUA T I M ES

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Cover Photo Credit: FMSC | Staff Trip - Northwest Haiti Mission (Released) | January 3, 2012 | Flickr Creative Commons

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