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October 1, 2010

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Message from Paul Ramsey

Paul G. Ramsey

Summit in Spokane to address regional residency training 

Dear Colleagues: 

Considerable national attention has focused on an impending physician shortage. Many physicians are reaching retirement age at the same time that health-care needs are expanding. Health-care reform is expected to result in further demand for physicians as the numbers of uninsured shrink and health care becomes more widely available; primary-care physicians will be in particular demand. Rural regions, including our WWAMI region, will be hardest hit by a physician shortage. 

The response nationally has been an expansion of medical school positions, new branch campuses, and opening of some new medical schools. However, there is an equally strong need for residency training slots. The location of one’s graduate medical education (GME) is the most influential driver of where a physician chooses to practice and has a more immediate impact than medical school positions. In addition, the presence of residency training programs adds an important, dynamic element to both the operations of regional hospitals and clinics and to the training of medical students.

We have excellent affiliated residency training programs throughout the WWAMI region.  The long-standing Family Medicine Residency Network provides support for 18 family medicine residencies region-wide. The Department of Medicine has a new three-year internal medicine residency program starting in July 2011 based at the Boise VA and has a program affiliation in Spokane. The Department of Psychiatry & Behavioral Sciences has advanced clinician residency tracks in Spokane and Boise. In addition to these programs, residents in many clinical programs complete rotations at WWAMI sites. For example, all pediatrics residents spend two months of their R2 year at a regional primary-care site outside of Seattle. 

Despite the presence of these outstanding programs and rotations and the relative success of the WWAMI program in retaining physicians, we need to do more. There are insufficient numbers of residency training programs and positions to accommodate the present and future need for physicians in the region, especially in primary-care specialties. Increasing residency training programs and positions must be a key priority.

To address the strong need in eastern Washington, Suzanne Allen, vice dean for regional affairs, and Larry Robinson, vice dean for clinical affairs and graduate medical education, convened a community-based committee to identify GME opportunities in April 2010.  This committee will sponsor a regional conference on graduate medical education in Spokane on Friday, Oct.15, on the WSU Riverpoint campus.

The GME Summit will explore key issues in residency training in the region and will feature national speakers outlining development of new residency expansion opportunities. More than 100 participants, from all five WWAMI states, will attend the meeting.  Summit speakers include Jeanne Heard, senior vice president at the Accreditation Council for Graduate Medical Education (ACGME) and Karen Fischer, senior director for health care affairs at the Association of American Medical Colleges (AAMC). Speakers from the UW include Mark Doescher, director of the Center for Health Workforce Studies and Rural Health Research Center, Larry Robinson, vice dean for graduate medical education and clinical affairs, and Frederick Chen, assistant professor in the Department of Family Medicine. Breakout sessions and region-specific sessions will be held, as well as a reception the evening before.

For more information about the GME Summit, please contact Kellie Engle at 206.543.2249 or kaengle@uw.edu


PGRamsey Signature2


Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington




 Roy Martin and Yoky Matsuoka to receive Inventor of the Year honors Oct. 26 

Photo of Roy MartinRoy Martin and Yoky Matsuoka will be honored at UW Medicine’s 2010 Inventor of the Year Award celebration, from 5:30 to 7:30 p.m., Tuesday, Oct. 26, at the Seattle Asian Art Museum in Volunteer Park

Martin, research professor emeritus in bioengineering, will receive the 2010 Inventor of the Year award, and Matsuoka, a Torode Family Endowed Career Development Professor in the Department of Computer Science and Engineering, will receive the 2010 Emerging Inventor of the Year.

The Inventor of the Year Award is given to individuals who have translated research from the bench, through partnerships with the biomedical industry, to a product or process that has had a major impact on health care.

Martin holds more than 25 issued U.S. patents.  His devices have improved the diagnosis and treatment of a variety of medical and dental conditions. Among them is a method for detecting air emboli during neurosurgery. He worked on 3D ultrasound cardiac imaging and performed some of the pioneering studies in this important field that have led to improved quantitative cardiac imaging to study myocardial contractility and cardiac output. He also worked on focused high-intensity ultrasound to detect and treat bleeding from injuries such as abdominal trauma. In addition, Martin was one of the inventors of the Sonicare toothbrush, a device which is very successful and is used by millions of people to improve their dental hygiene. In January 2004, Martin left joint appointments as research professor in anesthesiology and bioengineering. He became research professor emeritus in 2005. 

Photo of Yoky MatsuokaYoky Matsuoka, director of the UW Center for Sensorimotor Neural Engineering, develops artificial devices that augment human capabilities under neural control. She is developing an anatomically correct robotic hand to investigate the neural control of human hand movements. Her work is highly interdisciplinary and includes the development of implantable neural interfaces, as well as the mechanical, electrical, and computer systems needed to operate and control such devices. She has also developed a hand exoskeleton to restore the ability of patients with upper spinal cord injuries to pinch, point and grasp, as well as a robotic manipulator that can improve hand movement rehabilitation for victims of stroke. Matsuoka was the recipient of a MacArthur Fellowship in 2007.

RSVP for the complimentary Inventor of the Year Award celebration by Oct. 14. Contact Hazelruth Adams at adamsh@uw.edu or 206.616.3504 for more information.  

   Pediatric Guideline Adherence and Outcomes grant targets traumatic brain injury 

Monica S. Vavilala, UW associate professor of anesthesiology and pediatrics, has been awarded a $2.7 million grant to examine how to increase the adoption of the national pediatric guidelines to improve outcomes for children with traumatic brain injury.

The National Institute of Neurological Disorders and Stroke is funding the five-year Pediatric Guideline Adherence and Outcomes (PEGASUS) project. Vavilala is the project’s principal investigator.

In 2003, the “Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury (TBI) in Infants, Children, and Adolescents" was released as the evidence-based care pathway to improve outcome for children with TBI. Although traumatic brain injury is the leading killer of children over one year of age, there are no data on how systems can best adopt the guidelines and improve patient outcomes.

The PEGASUS project will examine how to increase adherence and reduce barriers to adoption of the pediatric guidelines. Valvilala and colleagues will determine if adherence by innovators/early adopters of the guidelines is higher than among other adopter sites nationally. Using surveys, focus groups, and value stream mapping, investigators will also examine the sources of barriers to adoption of the pediatric guidelines across the full spectrum of hospital sites. The team will develop microsimulation models and, based on findings, will create a targeted blueprint that may not only improve the adoption of the 2003 pediatric guidelines, but may be important to increasing the adoption of other evidence-based guidelines for the care of acutely injured patients. The long-term goal is to examine the effect of the targeted blueprint on patient outcomes in children with TBI.

Co-investigators are Richard Ellenbogen, professor and chair of neurological surgery; Frederick Rivara, professor of pediatrics; Douglas Zatzick, associate professor of psychiatry and behavioral sciences; Pamela Mitchell, professor of biobehavioral nursing and health systems; Linda Boyle, associate professor of industrial and systems engineering; and Mary Kernic, research associate professor of epidemiology. 


Clinical Care

 UW Medicine Employee Giving Program brings in $2.9 million

Faculty and staff contributed $2.9 million to the 2010 UW Medicine Employee Giving Program in FY 2010. The program supports education, research and patient services at Harborview Medical Center, UW Medical Center, UW Medicine Neighborhood Clinics, the UW School of Medicine and Airlift Northwest.

Central to the success of the UW Medicine campaign were program chairs Kamal S. Ajam, former UW acting instructor of medicine; Raghu Durvasula, UW assistant professor of medicine; Ross H. Ehrmantraut, R.N.; Patrick L. Green, assistant administrator, UW Medical Center; Tom E. Norris, vice dean for academic affairs; and Ed O’Shaughnessy, director, finance and administration, Department of Urology.  

    Military health system leaders visit Division of Pain Medicine

UW Medicine’s Division of Pain Medicine hosted leaders from the U.S. military health system last month in Seattle. Physicians and officials from UW Medicine, VA Puget Sound Health Care System, Washington State Department of Social and Health Services and Bastyr University covered topics including primary care, outcomes research, pain management and integrative medicine.

UW Medical Center Executive Director Stephen Zieniewicz welcomed the medical officials following an early morning tour of the Center for Pain Relief at UWMC-Roosevelt. Alex Cahana, chief of the division of pain medicine in the Department of Anesthesiology, also provided opening remarks and an overview of UW Medicine’s pain management system. “The challenges we are witnessing today are results of a poor understanding of pain management,” he said.

The day-long meeting comes on the heels of the June 23 announcement from Lt. Gen. Eric B. Schoomaker, Army Surgeon General, regarding Army Pain Management Task Force recommendations on synchronization of the regional medical plan for the treatment of chronic pain throughout the military health system.



Education and Training

    David Irby, former UW Center for Medical Education Research director, to receive Karolinska Prize

Photo of David IrbyDavid Irby, former principal investigator and director of the UW Center for Medical Education Research in the Department of Medical Education, will receive the 2010 Karolinska Institutet Prize for Research in Medical Education for innovative application of quantitative and qualitative methods within medical education research. He shares the prize with Richard Reznick, dean of the Faculty of Health Sciences at Queen’s University in Kingston, Ontario, Canada.

The award and $50,000 prize will be presented at a ceremony in Stockholm, Sweden, on Nov. 3. Each prize winner will give lectures at the Institutet in Stockholm on Nov. 2. Irby’s speech is titled, Rethinking Clinical Teaching from the Ground Up.

Irby was selected for the honor, in large part, based on his work at the UW. As principal investigator and director of the UW Center for Medical Education Research, Irby and his team initiated a series of studies associated with the cost and quality of ambulatory education, medical student specialty choice, and minority recruitment and retention programs. Irby’s research demonstrates that clinical teachers’ medical expertise is necessary, yet insufficient, to foster learning. Efficient and inspiring teaching is also about knowing how to teach, understanding the learners, and adapting instruction to meet the learner’s needs. Enthusiasm, clarity and professionalisms are other important factors.

Irby, currently vice dean for education and professor of medicine at the University of California School of Medicine in San Francisco, has used the result of his research to create clinical teaching assessment instruments, design faculty development workshops and guide curricular reform.

Commenting on his prize, Irby said: “This prize affirms my personal mission of transforming medical education into an inspiring process and brings great honor to my colleagues at UCSF and the University of Washington.”

Irby received his doctorate in education from the UW in 1977 and was a UW faculty member until 1997 in the Department of Medical Education (now the Department of Medical Education & Biomedical Informatics), when he joined the UCSF faculty.   

Clinical faculty and staff attend 2010 AWARE retreat

The School of Medicine hosted more than 140 clinical faculty and staff  to the third clinical All WWAMI Academic Retreat for Education (AWARE) meeting on Sept. 12-13 at the Health Sciences Building.

Plenary sessions included a guest speaker from the AAMC Careers in Medicine program who discussed career guidance counseling resources. Roger Strasser, founding dean and professor, Northern Ontario School of Medicine, took part in a panel discussion about the challenges and opportunities of integrated clerkships. There was also an overview of the School’s curriculum.

Following the plenary sessions, faculty and staff had the opportunity to attend two of twelve workshops offerings ranging from service learning to teaching tips for clinical teachers.  In addition to the general conference offerings, faculty and staff were able to attend department-specific clerkship meetings with the clerkship directors taking place on Sunday and Monday afternoon.

For those faculty and staff unable to attend this meeting, video recordings and PowerPoint presentation materials are available for download at the AWARE post-conference website. Please note that a UWNetID is needed to access these resources.

AWARE is held once every other year and is an important faculty development meeting for faculty and staff involved in undergraduate medical education throughout the WWAMI region. The next AWARE meeting is tentatively scheduled to take place in June 2012.


WWAMI Regional News

   Alaska WRITE program expands to Kodiak

Kodiak Alaska MapThe Alaska WWAMI Rural Integrated Training Experience (WRITE) program will expand to the ancestral home of the Alutiiq Tribe and the third busiest fishing port in the United States – Kodiak.

The WRITE Program is a clinical medical education program developed by the UW School of Medicine as a means to help meet the need for rural primary care physicians in the WWAMI region. The impetus for creating WRITE was to expand primary care and rural training options at the UW; develop additional training experiences in the WWAMI states, including rural Washington; foster the primary care mission of the UW; and provide more physicians for rural practice in the Pacific Northwest. The WRITE Program is designed to give selected third-year medical students an appropriate mix of ambulatory and hospital experience during a 20-week clinical education experience at a rural primary care teaching site.

The clinical training will be based at the Kodiak Island Medical Associates (KIMA) in the city of Kodiak and will also include clinical experiences at the Kodiak Area Native Association (KANA) Clinic, the tribally operated clinical program for the Alutiiq Tribe.

The Kodiak Island Medical Associates is a primary care clinic consisting of four family physicians, two internists, and one physician assistant. It is a full-service family medicine clinic that includes coverage of the hospital’s emergency room.

The island’s hospital is Providence Kodiak Island Medical Center and is staffed by a mix of primary care physicians, surgeons and specialists who provide family medicine, internal medicine, obstetrics, radiology and general practice. It features 25 acute care beds, including 4 birthing suites and 2 psychiatric care beds. In addition, there is a Care Center, an extended care facility that has 19 long-term care beds.

KANA’s program included direct services to seven tribal clinics in the Kodiak Villages as well as tribal members who live in the city. The Alutiiq people have lived in the Kodiak archipelago for more than 7,500 years. Their language is part of the Eskimoan language family.

The site director, Paul Zimmer, a family physician, has worked at the Kodiak Island Medical Associates for 12 years. He took a sabbatical two years ago and received his MPH from the Harvard School of Public Health.  He has an active interest in international health care and just returned from a three-month clinical assignment in Mozambique.

"Kodiak is a great place to live and to practice family medicine. We look forward to hosting a UW student and sharing the special challenges and rewards of practicing in coastal Alaska," Zimmer said.

   New TRUST program caps eventful year

The new School of Medicine Targeted Rural Underserved Track (TRUST) celebrated a successful year with a day-long meeting at the UW Arboretum Visitors Center on Sunday, Sept, 12. TRUST marks a concerted effort to focus many of the School's successful rural and urban underserved efforts under one program with a separate admissions process to support and encourage students interested in a career of service. With support from a Health Resources and Services Administration grant and the Montana Area Health Education Centers, the UW has launched successful programs in Montana and Washington State. Regional assistant deans Jay Erickson and John McCarthy have played key roles in getting TRUST started in Montana and Washington, respectively. With the entering class of 2011, 15 students from the two states will be admitted to the program. Other WWAMI states have also expressed interest in joining the program.

At the September 12 meeting, faculty were oriented to the third year longitudinal integrated clerkship called WWAMI Rural Integrated Training Experience (WRITE). This 20-week program provides a continuity training program at one site and students earn credit for their required family medicine clerkship and earn other credit towards requirements in internal medicine, pediatrics, psychiatry and elective time. Faculty in all the related programs heard from the School of Medicine's UW sponsored Walker Ames Scholar, Roger Strasser. Strasser is the founding dean of the Northern Ontario School of Medicine (NOSM) which has aims similar to TRUST. Strasser's school has produced two classes of students since the first class entered in 2005. From the first graduating class in 2009, 70 percent of students selected family medicine residencies and many of those were in rural or small urban underserved areas. Other graduatess chose careers in primary care. Strasser provided in-depth information about his school and encouraged the WWAMI states to join the TRUST program.

Sunday afternoon was devoted to faculty development and getting a better understanding of student and faculty experiences in the TRUST program to date. Groups of students and then faculty reflected on faculty feedback and on student TRUST and faculty experiences to date with TRUST. The day-long meeting ended over a dinner presentation about the recently passed health care reform legislation by Ted Epperly, director of the Family Medicine of Idaho residency program in Boise. Epperly is the immediate past president of the American Academy of Family Physicians and current AAFP board chairman.

Visit the TRUST website for more information. Or contact Tom Greer, TRUST co-director, at tomgreer@uw.edu; Suzanne Allen, vice dean for regional affairs and TRUST co-director, at suzaalle@uw.washington.edu; or Jaime Grocock, TRUST program coordinator at trustcoordinator@fammed.washington.edu.


Upcoming Events

The following is a listing of some upcoming events that may be of interest to the UW Medicine community. Additional events are listed on the UW Medicine events calendar. 

UW Medicine teams support 2010 American Heart Walk, Oct. 2

UW Medicine faculty and staff are joining the UW Medicine Regional Heart Center and the American Heart Association in the 2010 American Heart Walk at the Seattle Center on Saturday, Oct. 2.  To register or to make a donation, visit the Heart Walk website.

New Investigator Science in Medicine Lecture, Oct. 4

Obesity, Diabetes and the Brain by Gregory Morton, noon, Monday, Oct. 4, Turner Auditorium, UW Health Sciences Building, D-209. Morton is UW research assistant professor of medicine in the Division of Metabolism, Endocrinology & Nutrition and is affiliated with the Diabetes and Obesity Center of Excellence. The lecture is open to all faculty, staff and students. No registration is required. The lecture will be simulcast to other locations. For more information, contact Viola Brown at violab@u.washington.edu or visit the 2010-2011 Science in Medicine website.

UW Medicine & The Seattle Public Library Medical Lecture Series begins Oct. 6

Lessons in Lessening Your Migraine Pain by Sylvia Lucas, founder and director of the Neurology Headache and Multiple Sclerosis Center at UW Medical Center. Learn what triggers migraine headaches and chronic headaches, how to control them and the medications available for treatment. Lecture takes place at 6:30 p.m., Wednesday, Oct. 6, Microsoft Auditorium, Central Public Library, 1000 Fourth Ave., Seattle. Contact Julie Collier at 206.685.1933 or jcollier@u.washington.edu for more information. Or visit the Seattle Public Library website.

Tumor Vaccine Group Open House, Oct. 14

You and Your Immunity: Fighting Cancer Biologically. Join faculty and staff for a look at current research developments and advancements in cancer, 5 to 9 p.m., Thursday, Oct. 14, UW Medicine Research South Lake Union, 815 Mercer Street.  Activities include lab tours, panel discussion on clinical trial participation, and presentations by Mary L. (Nora) Disis, director and founder of the Tumor Vaccine Group and professor of medicine, and members of the TVG Clinical and research teams.  Free and open to the public. For more information, visit Tumor Vaccine Group  or call 206.543.8557.

Continuing Medical Education, October

Otolaryngology Update for Primary Care, Oct. 9; Vascular and Interventional Radiology, Oct. 15-17; Pain Management Frontline Pharmacological and Behavioral Strategies, Oct. 22-23. Visit Continuing Medical Education  for more information or to register.



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