athens advocate winter 2012

The Athens AdvocAteWinTER 2012www.medicalpartnership.usg.edu

A QuArterly PublicAtion of the GhSu/uGA MedicAl PArtnerShiP

ReseaRcheR BRings health home

georgia health sciences university and the university of georgia have partnered to create a four-year medical education program in athens to help alleviate a statewide shortage of physicians that threatens the health of georgians.

Oconee County native looks into the health disparity of high blood pressure

letteR fRom the Dean

The doldrums of winter have passed and with the beginning of March, the greening of the trees, and warmer days, the end of the academic year is within sight. In a short eight weeks, the Class of 2015 will scatter for research opportunities and clini-cal experiences both in Athens and beyond, service opportu-nities at home or abroad, vacation, and time with family and friends. The Class of 2014 will have a shortened break before beginning Phase III of the curriculum and the core clinical ro-tations in July. Prior to starting the clinical rotations, however, each student will need to pass the USMLE I (Part 1 of the Unit-ed States Medical Licensing Examination). This examination is not only a ‘rite of passage’ demonstrating each student has successfully passed the national standards for continuing into the clinical years, but it is a milestone for the Medical Partnership. This issue of the Advocate discusses many of the milestones by students and faculty in research, service to the community, and in professional service. Participation by a majority of the Partnership students and clinical faculty at the Mercy Clinic serves multiple pur-poses. The Medical Partnership nights at Mercy Clinic increases access to medical care for more people within the Athens community who lack access to Primary Care. By accepting all the roles of front desk check-in, back office check out, triage, and clinical assistant, the students learn how members of an office healthcare team work together to effect quality patient care. The students have the opportunity to work with students and faculty from the UGA College of Pharmacy, and the students working with the faculty clinicians practice their clinical skills and nascent diagnostic reasoning, often transferring the knowledge ob-tained in the classroom to the reality of patient care. Thanks to the energy of Amy Martin and the leadership of the Mercy Clinic for developing this special relationship with the Partnership. Amy will be transferring her leadership role to a team from the Class of 2015 beginning in May.

Medical education and medical research remain cornerstones to the continuing evolution of quality medical care. Dr. Scott Richardson describes the concept of the ‘spiral curricu-lum’ allowing students to return several times over four years to topics in the basic and clinical sciences which support the fundamentals of medical care. With each twist, the student develops a deeper and broader understanding of medical science.

Improvements in medical care also come from scientific research. Dr. Jonathan Murrow in collaboration with investigators from UGA, community practitioners, and patient vol-unteers, has begun clinical research in areas related to cardiac and vascular disease. Not only is his research directly related to the care of patients but he has involved many stu-dents introducing them to the process of clinical research and demonstrating the excite-ment and importance of medical discovery.

The Athens community continues to be supportive and welcoming to the Medical Part-nership. With expansion of the number of medical students in Athens, the students and faculty seize the opportunities to give back to the community.

Barbara L. Schuster, M.D.Campus Dean

GHSU/UGA Medical Partnership

Editor: Alison Bracewell-McCullick, MPA, :: Director of Outreach & Communications

Design and Layout: Jennifer Stowe, MS

Photography: Andrew Tucker and Dot Paul (UGA Photographic Services) Cr

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Inside This Issue...

:Letter from the dean

Page 3:Curriculum spotlight

Page 4 :ACCA Partnership

Page 5:New Faculty

Page 6 & 7:Faculty spotlight: researcher Brings Health Home

Pages 8 & 9: student-run Clinic

Page 10:student showcase

Page 11:Photos from student events

Page 12:Faculty Highlights2012 sGO Golf tournament

The GHSU/UGA Medical Partnership Campus is currently located at

279 Williams Street, Athens, Georgia

For more information, please visitwww.medicalpartnership.usg.edu

or call 706-369-5900

2 GHSU/UGA Medical Partnership

3The ATHENS ADVOCATE — Winter 2012 Issue

cuRRiculum spotlight

By W. Scott Richardson, MD

W. Scott Richardson, MD is the Campus Associate Dean for Curriculum at the

GHSU/UGA Medical Partnership.

Careful scrutiny of the curriculum at the Medical Partnership campus shows there are several spirals in the schedule. From a broad view, the curriculum of the first two years is organized into modules that cycle twice through all the major organ systems of the human body. In the first year’s turn of the spiral, we emphasize the normal structure and function by contrasting it with situations of abnormal structure and function. In the second year, we return to the same organ systems, adding new information and emphasizing the diseases and their treatments. In the third year of medical school, students rotate through all the major clinical disciplines, describing a complete turn on another spiral. In the narrower view from within each module, other spirals are visible. Each week has one or two cases that unfold over the week, that combine with lectures, laboratory sessions and other activities into one complete cycle. As the modules progress, these weekly cycles of themes, cases, and learning activities often return to prior topics and add new information with each return. The use of spiral curricula is starting to gain favor in educational settings, not only in higher education but also in grade schools, where it is also termed ‘vertical alignment’ [see diagram].

How do vertically aligned spiral curricula work, and why should we use this approach? The learning sciences are beginning to provide answers to these questions, which we’ll summarize in the following seven notions.

First, designing a vertically aligned spiral curriculum begins with the end, i.e. determining what students should know

and be able to do when they finish, and outlines where they should begin and how they should progress to reach those goals. Having these developmental milestones clarified ahead helps both teachers and learners identify when these milestones have been reached.

Second, building the first turn of the spiral as a simple but strong foundation upon which to build later cycles helps teachers avoid the traps in trying to teach everything about a topic or discipline on the first cycle, thereby avoiding overloading the students with too much information when they are trying to learn the basics.

Third, returning to the topic at a later time requires the student to recall the knowledge from long-term memory, the very act of which serves to reinforce this knowledge in memory.

Fourth, once recalled from memory, the ‘old’ knowledge can be used to understand the bits of ‘new’ knowledge that is to be added, so that both ‘new’ and ‘old’ are linked in memory for future use.

As a corollary of this, the fifth benefit is that ‘new’ situations and topics can be learned by analogy to previously

understood situations or topics. Learning by analogy can be very powerful, as long as it is coupled with careful attention to how the new situations compare and contrast with the prior ones.

Sixth, if the stimulus to recall the ‘old’ knowledge is a new problem that requires both the ‘old’ and some ‘new’ knowledge to solve, this creates a potent motivational force for learning, as students know enough to understand and engage with the problem, yet not

enough to solve it fully with existing knowledge. This state of ‘situational interest’ or ‘learning hunger’ helps students engage in the pursuit of further learning to solve the problem, at which time the interest or hunger subsides for this cycle. A vertically aligned spiral curriculum can create repeated cycles of learning hunger and learning fulfillment that should lead to sustained learning.

Seventh, the spiral curriculum also creates more opportunities for learning to be integrated

across the boundaries of discipline, time, and experience, in order to maximize the chances that students will be able to recall all the knowledge they need when they have to put it to use.

spiRal cuRRiculum Benefits


By Eve Anthony

Founded in 1967 by local citizens, the Athens Community Council on Aging, a non-profit 501 (c) 3 organization, aims to maintain and enrich the lives of older persons in the 12 counties of Northeast Georgia. ACCA’s programs enable older persons to live independently at home and offer opportunities for employment, volunteerism, and other activities. ACCA is a resource for education, information, referral, counseling, and general assistance. The mission of ACCA is to promote a lifetime of wellness through engagement, advocacy, education and support. Last year, ACCA was fortunate to begin a partnership with the GHSU/UGA Medical Partnership Community Health Program. First-year medical students worked with ACCA staff to identify a solution to decrease the risk of polypharmacy within our older adult population. Polypharmacy is defined as the use of more medications—both prescribed and over the counter—than is clinically indicated, and/or the use of more than 5 to 7 medications at any one time.

It was found that ACCA clients were taking an average of 9 to 11 prescription drugs, exceeding the national average for older adults of 2 to 9. The medical students developed interventions with an intended outcome to decrease these numbers within our population. The first intervention was a medication database, the Coordinated Health Intervention to Reduce Polypharmacy or CHIRP. The user-friendly database will provide a central location to store a client’s medications, allowing for a current medication list to be easily generated and shared with other

healthcare providers, especially his or her doctors. Most importantly, CHIRP highlights potentially inappropriate medications for the doctor’s review. The CHIRP database will eventually be used by all programs that directly serve clients at ACCA.

A second intervention included the development of an educational curriculum for professionals working with older adults that teaches about polypharmacy and its causes, risks of adverse drug interactions, the importance of drug reviews by healthcare providers, and how to share this information with clients and their caregivers.

Continuing with the service learning theme, students from the University of Georgia’s College of Pharmacy student learning class began implementing the program and entering client information into the database last summer. They work with staff nurses, clients, caregivers and area healthcare providers to ensure that the polypharmacy project will have the intended outcomes.

Service Learning is becoming part of many university and college curricula across the nation. ACCA has been fortunate to have great partners within our university community and with the Medical Partnership. The students working with us created interventions that will have a significant impact on our programs and the clients we serve. That is how a true service learning partnership

works! We look forward to a continued relationship with UGA and GHSU and to more exciting and creative projects in the future.

acca paRtneRs with ghsu/uga meDical paRtneRshipinteRvention finDs aDult Day clients exceeDeD national aveRage of pRescRiption DRugs

Eve Anthony is the Chief Operating Officer of the

Athens Community Council on Aging.


Dr. William J. Hardman iii received his MD from Emory University School of Medicine where he also completed his medical residency and a dermatopathology fellowship in the Department of Pathology. Board certified in dermatopathology and

anatomic and clinical pathology, Dr. Hardman has practiced in the Athens area since 1998 and is recently retired.

Dr. Thomas Kias, an Illinois native, began practicing Internal Medicine in Athens in 1975. He graduated from the University of Illinois in 1964 and Emory University School of Medicine in 1968. Dr. Kias did his residency at Grady Memorial

Hospital, 1968 through 1970, and then Charlotte Memorial Hospital, 1972 through 1975. Dr. Kias’s focus is on older patients with complex problems and clinical pharmacology.

Dr. Jeanne Marie Martin is an Internist and a Pediatric Physician with Athens Area Pediatrics. She received her medical degree from Lousiana State University Health Sciences Center. Following that, she completed her postgraduate training in internal

medicine and pediatrics at the residency program at the University of Maryland Medical Center.

Dr. Steven Lowman received his Bachelor of Science degree from the University of Georgia in 1988. Afterwards, he attended the Medical College of Georgia where he earned his MD. Dr. Lowman then attended the

University of Kentucky and completed an internship in Internal Medicine in 1993. He returned to the Medical College of Georgia for further training and pursued a fellowship in Cardiology, which he completed in 2002. Dr. Lowman is board certified by the American Board of Internal Medicine in Cardiovascular Disease, as well as Nuclear Cardiology. He is also a Fellow of the American College of Cardiology.

Dr. Rajiv Setia is a Pediatric Physician at Athens Area Pediatrics. Dr. Setia received his medical degree from Delhi University and completed his residency training in pediatrics and anesthesiology at Rush University Medical Center.

Dr. Glen Wiggans is a graduate of Bucknell University and Cornell University Medical College. He trained at Georgetown University Hospital and the Lombardi NCI Comprehensive Cancer Center at Georgetown University in Washington, DC. He

is board certified in medical oncology and internal medicine. He joined Northeast Georgia Cancer Care in 1985 and has been the principal investigator directing the group’s national research relationships and clinical trials since 2004.

new faculty

As the GHSU/UGA Medical Partnership student body grows, so too does the faculty. We welcome the faculty that have recently joined our campus. All are local physicians that bring years of experience and expertise to our students in Small Group Learning, Clinical Skills and Clerkships.

Thank You!We would like to thank our Volunteer “Simulated Patients” for all that they have done

for our student doctors over the past year.

If you are interested in joining and becoming a “Simulated Patient” or have any questions, please contact Ashley M. Townsend at: [email protected] or 706-369-5849.

Phot

o by

Che

lsea

Tol

edo

By Chelsea ToledoReprinted with permission

The ongoing shortage of doctors is an issue close to Georgia’s heart.

As cardiovascular disease is responsible for 20 percent of deaths in Georgia—and yet 30 percent of deaths for black Georgians—the state needs cardiolo-gists who’ll address its health dispari-ties.

Those disparities motivated cardiolo-gist Jonathan Murrow to return home to northeast Georgia. Since graduating from Emory University School of Medi-cine in 2001, the Farmington native has held cardiology fellowships at Johns Hopkins University and Emory and now teaches at the new medical campus in Athens.

“Growing up my wife and I were inter-ested in medicine,” said Murrow, “We always thought that Athens is great, but it would be perfect if they just had a medical school here so we could get involved in an academic medical envi-ronment…and it turns out, right as we were finishing our training, they opened a medical school in Athens. So it was a cosmic alignment of the stars.”

The “academic medical environment” in Athens gives doctors like Murrow ac-cess to the University of Georgia’s array of academic departments, where inno-vative research partnerships can form.

“The advantage of having the medical campus in Athens was the future op-portunity for collaboration between the medical campus and many of the col-leges at UGA… in which faculty con-cerned with health disparities reside,” said Barbara Schuster, Dean of the Georgia Health Sciences University/University of Georgia Medical Partner-ship.

Murrow, the first faculty member at the Medical Partnership to begin research, aims to learn more about why diseas-es such as high blood pressure weigh more heavily on the African American population and the poor. When he in-terviewed for a faculty position, he sought out people on campus looking to answer that same question.

“I think in clinical practice, you have certain questions that come up. One of those is why are some people—or some groups of people—disproportionately affected by diseases, and vascular dis-eases in particular,” said Murrow.Murrow’s research partners are equally interested in understanding why African Americans face a greater risk of high blood p r e s s u r e , which can lead to heart attack or stroke.

“My father and my mother ac-tually both had high blood pres-sure. They’re both deceased now. And I myself have been taking blood pressure medicine since the age of 36,” said Deborah Elder, assistant professor of pharmacy and biomedical sciences. “And the only thing that my physician and I could re-late it to is that it’s hereditary.”

Elder, along with kinesiology professor Kevin McCully, is collaborating with Murrow to determine whether mental stress is to blame for the disparity ex-perienced by African Americans when it comes to vascular diseases like high blood pressure.

So far, they’ve been able to confirm that mental stress alone can increase blood flow, an indicator of abnormality.

“Unfortunately, lower socioeconom-ic status is often associated with not

eating right, the fried chicken, lack of activity.” said McCul-

ly, “Even higher stress is as-sociated with less secure economic environment.”


faculty spotlight

ReseaRcheR BRings health home


As Athens-Clarke County has the highest poverty level in the country and 27 per-cent of its citizens are Black, the research-ers hope their findings will improve health on the home front. They hope to shed light on the intricate inner workings—or mech-anisms—causing some people to be sicker than others.

“I think the first question in this type of study is to understand the mechanism, and from that, to hope to identify the inter-vention next,” said Murrow. “That doesn’t necessarily mean it’s a pharmaceutical or drug intervention or lifestyle intervention, but without knowing the mechanism, it makes it tougher to target the problem in a meaningful way.”

Chelsea Toledo is a Graduate Student in the

Health and Medical Journalism program at UGA.


The Student-run Clinic provided a needed oasis during the middle of intense medical training. In the midst of read-ing, studying, and all things academia, the clinic allowed me to gain a renewed perspective on why I am in medi-cal school. Regardless of my competency in medicine, I could definitively see that patient care is still our main objective. Helping patients in tough medical and financial situations is and will always be our call as physicians. The patients believe they are receiving all of the benefits, but I know that the opportunity to practice clini-cal skills and learn will certainly prove invaluable to my career. I am thankful that the Student-run Clinic realigned my perspective.

Clay HartleyFirst-year Medical Student

Moultrie, GA

Medical school affords little time outside the week for any activity besides studying. When the proposition of being able to see real patients in my first year came up I was naturally excited. The experience came with a three hour time com-mitment on our only afternoon off. I attended my assigned session with apprehension but also a lot of excitement. Upon arriving, I found a very well organized and efficient clinic. The Mercy staff were very personal and it was great to see our school physicians put into practice what they taught the class only weeks earlier. The patients were great and very appreciative. It was a relief to know they would not judge us for our nervousness or missteps. Oh and that time commit-

ment I was worried about, I decided to stay an hour and a half longer than required. It is rare to be in a position to positively influence a person’s life that you are meeting for the first time. Although I was there to help the patients at the clinic, the inspiration to continue to grind through the rigors of Medical School routine far surpassed any care I provided that day.

Brian BrewerFirst-year Medical Student

Lilburn, GA

Volunteering at the Student-run Clinic has been a wonder-ful experience; I feel incredibly privileged to provide care to patients alongside my instructors and other members of the Athens medical community. As a first year student, I have the unique opportunity to parallel classroom clini-cal skills learning with actual clinical experience. Far too often I forget that the illnesses we learn about in the class-room have a tangible effect on the lives of other human beings; being able to interact with patients brings my mind out of the textbook and my attention to the human component of the medical profession.

Zach RohmFirst-year Medical Student

Roswell, GA

stuDent peRspectives: stuDent-Run clinic

stuDents tRavel to pResent acaDemic posteR

Joshua Hedrick and I traveled to Long Beach, California for the annual conference of the Society of Student Run Free Clinics on February 4-5. 2012. The goals of the conference were to increase communication to foster the sharing of ideas, to collaborate on research, to provide funding resources, and to expand the existing scope of clinics and cultivate the growth of new ones. We presented our poster on the abstract that I submitted about establishing our student run free clinic at the Mercy Health Center. This poster conveys how we

were able to set up a student run free clinic within an existing faith based clinic to expedite our clinical service to the community, despite our limited resources as a new institution. We hope to educate more students about this opportunity to give clinical outreach through a unique outlet when funds are limited.

By Amy MartinSecond-year Medical Student

Amy Martin and Joshua Hedrick traveled to California to present their poster at the annual conference of the Society of Student Run Free Clinics.


meRcy health centeR Receives supplies fRom stuDents

Since students arrived at the Medical Partnership in the fall of 2010, they were very interested in opening a student-run clinic that could provide care for underserved patients in the Athens area. Realizing that the most successful clinic would involve collaborating with another organization, the students were delighted that a partnership with Mercy Health Center was developed in the winter of 2011. A Medical Partnership student coordinator is responsible for coordinating the schedule each week, which includes confirming both student volunteers and clinical faculty, who provide primary care for the patients.

This relationship has given students from the Medical Partnership an excellent clinical and community service experience that has greatly affected their view of patient care. Originally open only two evenings a month, the student clinic is now a well-functioning teaching clinic allowing the students and faculty physicians to provide care every Wednesday night.

In large part because of the positive experience the students have had through the clinic, a decision was made to use a portion of the funds raised by the GHSU/UGA Medical Partnership Student Government Organization

2011 golf tournament to purchase various medical supplies for Mercy Health Center, including a computer for electronic health records, a new scale, and various disposable medical supplies used on a day-to-day basis.

The student-run free clinic coordinator, Amy Martin, said that “this clinic has been my favorite medical school experience, and it is because of all the wonderful people who have come together to make it possible.” These feelings have inspired many of the students to volunteer their time each Wednesday night at the clinic, providing good health care to those in need.

By Kris CookReprinted with permission from GEORGIA Medicine

Saumya Dave’s “what I did this summer” story reads more like a resume than a light read.

The 24-year-old first-year medical studentat the Georgia Health Sciences University/University of Georgia Medical Partnership in Athens won a writing contest that landed her a trip to Africa with a Pulitzer Prize-winning journalist famous for his columns on the continent’s human rights issues.

Saumya was watching The Oprah Winfrey Show two years ago, listening to New York Times columnist Nicholas Kristof discuss his latest award-winning book, “Half the Sky,” which he co-authored with his wife. The book highlights issues affecting women worldwide, citing the enormous untapped potential of those living in oppressive societies.

Saumya, a native of India who moved to the United States at age 2, was intrigued. She comes from a long line of doctors andwanted to follow in their footsteps. As an immigrant child in a new country, she battled her insecurities and fears through her insatiable appetite for reading and writing.

“From a young age, words have provided me with a comfort that I thought was only reserved for friends,” she said. “And although writing is a solitary exercise, it has actually shaped my modes of communication and molded me into an extrovert. Many writers tend to have the most insight into human nature becausethey inadvertently spend their time studying it.”

In 2010, Saumya entered the New York Times’ annual writing contest, “Win a Trip with Nick Kristof,” in which the winner would accompany the journalist on his multi-week travels and write about the experience. She was a runner-up.

This year, however, she won.

It was exactly what everyone says a dream come true is like,” she said. “It took days to absorb. And it still hasn’t sunk in.”

She and Kristof traveled and reported throughout Morocco, Mauritania, Senegal, Niger and Burkina Faso. The Times published Saumya’s blog postings, journal entries and winning essay.

“The entire experience has forced me to look backward and forward at the same time,” she said. “I learned how much I enjoy global health, collecting stories, and intertwining the two. I also saw how much untapped possibility and potential there is in this world.”

She acknowledges it will likely be “some time” before her next trip abroad, “but throughout my days,” she said, “I feel a tug to return and to try and make a mark, both through the arts of medicine and writing.”

saumya’s summeR: fiRst-yeaR stuDent’s essay eaRns tRip to afRica


stuDent showcase

ReaD heR Blog posts fRom the tRip at:http://kristof.blogs.nytimes.com/author/saumya-dave.


The Medical Partnership Intramural soccer team won the All-Campus Championship game. Pictured (left to right): Sierra Green, Kayla Koch, Ashley Austin, Cheney Fenn, and Cristina Elstad.

A group of Medical Partnership students ran a 30k/50k trail run at Vogel State Park (the Dune Ridge Trail Run). Said to be one of the toughest trail runs in Georgia, student Parker Smith came in second overall in the 50K, and Cristina Elstad came in fourth in the female category in the 30k.

The Second Annual Community Health Poster session was held in late January. The first-year students presented their research on a variety of community health problems.

Medical Partnership students volun-teered at the Clarke County Mentor Program Winter Carnival. They encouraged elemen-tary-aged children to eat healthy and exer-cise. Pictured are Brian Brewer and Rachel Taylor.

The second-year students participated in a memorial service to honor MCG Body Donors and their families. Rachel Taylor and Justin Brooten both spoke on behalf of their class and the Medical Partnership.

The Student Government Organization coordinated a holiday service project in December. Approximately 70 presents were gathered and wrapped for the entire kindergarten at Fowler Drive Elementary School. The highlight was delivering the gifts to the children.

Sign Up To Play!GHSU/UGA Medical Partnership Student Government Organization2nd Annual Golf Tournament

Saturday, March 24, 2012@ the University of Georgia Golf Course

Contact Alison Bracewell-McCullick at706-369-5923 or [email protected] to sign up.

Thank you to our participating

local sponsors!

faculty highlights

Julie K. Gaines, MLiSHead, Medical Partnership Campus Library

Ms. Gaines is the lead author of a manuscript that was accepted for publication in Medical Reference Services Quarterly. The title of the article is: Sharing MedlinePlus®/MEDLINE® for information literacy education (SMILE): a dental public health information project. The project focused on improving dental practitioners’ access to reliable information resources and integrating the best evidence into public health dental practice. Through its training program, SMILE cultivated a set of “power information users” among the dentists, dental hygienists, and community health workers (promotores) who provided public health preventive care and oral health education. The dental public health practitioners gained information literacy skills and increased their knowledge about reliable sites such as blogs, PubMed®, and MedlinePlus®. This project fostered opportunities for

expanded partnerships with public health personnel.

Barbara Schuster, MDCampus Dean

Campus Dean Barbara Schuster, Chair of the American College of Physicians Foundation Board of Trustees, served as Co-Chair of the Foundation’s Initiative on Atrial Fibrillation and Stroke Prevention. The Foundation recently debuted three interventions that will enhance the care and treatment of individuals with atrial fibrillation.

Donald Scott, MDDirector of Essentials of Clinical Medicine II

Dr. Scott was installed as a member of the Board of Directors of the Athens Community Council on Aging in October 2011.

Clive Slaughter, PhDBiochemistry

Dr. Slaughter is one of eight co-authors of a manuscript that has just been accepted for publication in PNAS, Proceedings of the National Academy of Sciences. The senior author is Hans Haecker, an immunologist at St. Jude. The title is: ABIN1 controls TLR-mediated C/EBP-beta activation and protects from inflammatory disease. The story concerns a protein, ABIN1, that we identified to be a component of the Toll-like receptor signaling pathway of innate immunity. It turns out that ABIN1 modulates inflammatory responses mediated by the pathway, since deletion of the ABIN1 gene in mice produces an inflammatory phenotype similar to lupus.

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