med ed
A newsletter for faculty, staff, and students of the University of Minnesota Medical School

No. 375, December 2004

Editor: Kathleen Watson, M.D., drwatson@umn.edu

Editorial Assistant: Allison Campbell, aac@umn.edu

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August 21-22, 2005, consultative visit by LCME officials

In late August 2005, LCME Secretary Frank Simon, M.D., and Assistant LCME Secretary Bob Eaglen, Ph.D., will visit our Medical School and its two campuses on a consultative visit. They will be observing progress made on areas of concern since the LCME accreditation visit. Although this visit may seem far in the future, there is much work to be done to prepare. Please be aware of this upcoming visit and ready to participate in the necessary preparations.

State of the Medical School available on the Web site

"Focusing on the future needs of the profession, we are making a difference in education," said Dean Deborah E. Powell during her State of the Medical School address last month. If you missed the talk, you can see and listen to it online or read her speech, via the link at www.med.umn.edu.

Leadership changes in Academy of Medical Educators

Many thanks are due to Thomas Mackenzie, M.D., for his significant leadership during his three years as head of the Academy of Medical Educators. Wesley Miller, M.D., will assume leadership of the 39-member group, each of whom has been honored for outstanding contributions to education of medical students and physicians. Among other activities, these distinguished educators help mentor Pre-Med Scholars.

Pre-Med Scholars chosen

Five University of Minnesota undergraduates who demonstrate outstanding potential as future medical students recently were named Pre-Med Scholars. This year's inductees are Patricia Dickmann, Rhonda Farah, Chad Ferguson, John Jochman, and Molly Yang. By the way, this year's entering class includes four members of the inaugural group of Pre-Med Scholars: Andrea Gaetz, Forum Kamdar, Benji Mathews, and Mohamed Moussa. Please join me in congratulating these current and alum Pre-Med Scholars.

Fresh faces at mentoring kick-off

One hundred and ten community-physician mentors met their matches in first- to fourth-year medical students during the Nov. 19 "Mentoring Kick-off Breakfast," sponsored by the Minnesota Medical Foundation at McNamara Alumni Center. The mentoring program, in its seventh year, pairs medical students with physicians who know the kinds of challenges medical students face as well as having experience in the rigors of practicing medicine. Ted Thompson, M.D., describes the program as a two-way street. "Both mentors and students learn a great deal from each other," he says. Students get a chance to see physician values and practice in action, while mentors often become reinvigorated working with students, he says. Sarah Nakib, a second-year medical student, says her mentorship last year with dermatologist Kristina Shaffer was "one of the most positive experiences in my school life." Nakib shadowed Shaffer at work, in addition to being invited to dinner on several occasions. Bailey Lee is a first-year medical student. She's been matched with Laura France, M.D., an ob/gyn practicing in Shoreview. Lee looks forward to the advice and guidance France will offer. Although Lee isn't sure what area of medicine she'll specialize in, France says that, even if it's not ob/gyn, she's certain she'd be able to connect Lee with someone in whatever field that may be. In the meantime, Lee will be able to see what it's like to be a practicing ob/gyn. The mentorship program helps students shape their careers, but Thompson adds that this is often only one component of their collaboration. "It is our hope that life-long friendships are developed, too."

New pediatrics fellowship for clinician researchers

Pediatrics' Division of General Pediatrics and Adolescent Health is accepting applications for a new fellowship, the Primary Care Fellowship in General Pediatrics. The overall purpose of this fellowship is to improve the status of children and adolescents by training a cadre of pediatric clinician researchers who will assume positions of leadership in general pediatrics within academic institutions, conduct the next generation of primary care research, and train a new generation of pediatricians who will be committed to serving children in low-income, high-need areas. The fellowship is two to three years and includes an integrated set of coursework leading to a Master's in Public Health, two half-days per week in clinics serving historically underserved populations of children, and mentored research experiences. The fellowship will be grounded in a division with an extensive research and publication record as well as 25 years of experience in post-graduate fellowship training. The fellowship is open to physicians who have completed a pediatrics residency program by the start of the program and are board-certified or board-eligible. Those from racial and ethnic communities underrepresented in medicine and primary care are encouraged to apply. To find out more, please e-mail Iris Borowsky, M.D., Ph.D., at borow004@umn.edu.

Virtual Clinic makes the News

Our Medical School's Virtual Clinic "offers doctors in training an experience that's much closer to the ever changing circumstances of actual patients than the typical textbook snapshot," reported the Oct. 18, 2004, U.S. News & World Report. The write-up on the Minnesota program developed by Catherine Niewoehner, M.D., and Stuart Speedie, Ph.D., also included virtual clinics and patient experiences at Harvard University and the University of New Mexico.

Course director close-up: James Nixon, M.D.

In the sixth grade, James Nixon knew he wanted to be a doctor. But he also knew that he wanted to teach. He now has responsibilities in both fields---as a physician and course director for medical students' medicine and pediatric clerkships. Nixon also teaches an advanced physical diagnosis course and is a master tutor to first- and second-year medical students. "What's great is that I'm able to see students all the way through their medical education," he says. "I meet them on their first day and four years later, I see them walk across the platform at graduation, as new doctors."

Nixon earned his M.D. from the University of Oklahoma, and in 1998, he completed his medicine and pediatric residency here at the University of Minnesota. He stayed on as a chief resident, "I thought it would be a great opportunity to see if I really wanted a career in teaching." He hasn't looked back.

As course director, Nixon is responsible for curriculum development in the required medicine and pediatric clerkships. It's a broad area, encompassing many elements. "For instance," he says, "what is the best way to teach our students? How much inpatient and outpatient experience do they need? How do we assess students' skills, separate from their knowledge? How do we evaluate their capabilities at the end of their clerkship, to know that they're ready for the next step in their careers?"

Nixon has helped develop innovative educational tools. In pediatrics, he introduced structured clinical observation cards for the students to use. He later introduced these on the medicine clerkship, eventually building up a medical student portfolio including educational prescriptions, case tracker, and a personal reflection tool to help the students document their learning and think about what they have learned.

"In college and the first two years of medical school students are used to relying on textbooks for answers," says Nixon. "But once they're out in practice, they need to know how to learn from their patients. The items they collect in their portfolio help them develop these skills." Nixon's own education continues, too. He is currently enrolled in a master's program in health professional education at the University of Illinois, Chicago. "Being a student again will help me be a better teacher and do a better job at being a clerkship director."

--Brenda Hudson

Editor's note: Unexpected implication of restricting duty hours

Errors decreased when residents' hours on-duty decreased, according to two studies in the Oct. 28, 2004 New England Journal of Medicine. Yet, even with the decrease, the rate of errors remained unacceptably high, wrote Jeffrey Drazen, M.D., in his accompanying editorial "Awake and Informed." Drazen served as an attending on one study. He noted that, while reducing hours for residents improved data, in the process of passing a patient from one team member to another, the building of a bond between patient and doctor also eroded. He wrote "we need to learn more about effective teamwork if we are to adapt to schedules that involve frequent handoffs. The key physicians on a team must learn the essential information about every patient, not just enough to get by."