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November 15, 2013
Table of contents
Committee advances professionalism throughout UW Medicine
The UW School of Medicine Committee on Continuous Professionalism Improvement (CPI) was created and charged in 2007 with overseeing and advancing professionalism throughout our many settings. Carlos Pellegrini, the Henry N. Harkins Endowed Professor and Chair of the Department of Surgery, has led the committee since its inception. Committee members include medical students, residents, fellows, faculty and staff at all levels.
In its first six years, the CPI has led many advances in professionalism. The committee was instrumental in developing and implementing the UW Medicine Conflict of Interest Policy and the Code of Professional Conduct. I urge you to regularly review these documents that are vital to our work.
In 2010, as a result of growing concern regarding our learning environment identified from sources such as internal student surveys and the AAMC Graduation Questionnaire, I asked the CPI to develop plans for improvements. As a result, the CPI and many partners in the School of Medicine have undertaken an aggressive multi-pronged approach to understanding the perspectives of teachers and learners related to the learning environment and to address areas of challenge with transparency and rigor.
Ongoing efforts to improve the learning environment have included:
- Focus groups with medical students to better understand the student experience at the UW SOM;
As a result of the work of the CPI and many individuals and groups throughout our settings, the learning environment for medical students, residents and faculty has improved substantially. This was most recently evident in significantly improved results on the 2013 AAMC Graduation Questionnaire regarding the learning environment for students at the UW School of Medicine, as reported by graduating fourth year students. Our work is not done—we must continue to improve the learning environment as a top priority. The maintenance and continuous improvement of professional behavior among our faculty, staff, residents and students is vital to everything we do. I appreciate the hard work and continued attention of our community members to this important area.
Carlos Pellegrini informed me recently that he will step down as chair of the CPI committee as a result of many competing commitments, including serving this year as president of the American College of Surgeons. I would like to thank Dr. Pellegrini for his outstanding leadership of the CPI Committee—under his founding leadership, the committee has become central to our endeavors.
I am very pleased to report that Molly B. Jackson, assistant professor of medicine in the Division of General Internal Medicine, has agreed to assume the chair position. Since the committee began, Dr. Jackson has had a key role on the committee in advancing initiatives to improve the learning environment. She will become the CPI chair on December 1. Under her leadership, the committee will continue to play a major role in our efforts to emphasize professionalism and improve the learning and working environment for our students, residents, faculty and staff.
Thank you to Drs. Pellegrini and Jackson for their superb work on the CPI committee. Thank you also to all members of the committee and our community for your continued focus on improving the learning environment and advancing professionalism throughout UW Medicine.
Paul G. Ramsey, M.D.
Fred E. Silverstein, clinical professor of medicine, was honored at UW Medicine’s 2013 Inventor of the Year Award celebration, Thursday, Nov. 7, at the UW Medicine South Lake Union campus. The theme of the event was “A Celebration of Engineering and Medical Collaboration.” Silverstein was recognized for consistently collaborating with talented technical and engineering partners on his inventions.
The Inventor of the Year Award is given to individuals who have translated laboratory research, through partnerships with the biomedical industry, into a product or process that has had a major impact on healthcare and the local economy.
Silverstein was selected for the award for his groundbreaking contributions to the invention and development of a variety of medical devices that have positively impacted the work of gastroenterologists and their patients worldwide. He has been instrumental in the development of products varying from catheters that coagulate bleeding ulcers, to catheters that detect blood flow, to tools to prevent contamination of endoscopes. He helped found two companies: Vision Sciences, a company dedicated to improving endoscopic cleaning to reduce risk of cross-contamination in patients; and Lucent Medical Systems, which is developing magnetic location systems for vascular access and for positioning of the CNS shunt valve. He was a general partner at Frazier Healthcare, where he advised on intellectual property assessment, clinically oriented aspects of healthcare service companies, and the evaluation of medical device companies. He has also served as an advisor to and on the boards of many prominent healthcare companies.
Silverstein holds over 50 patents, with eight pending. These products are still on the market and have returned in excess of $1M to the University of Washington. In developing these devices, he worked closely and consistently with technical and engineering partners by leading the processes, communicating clinical needs, and participating in testing. This model of partnership is becoming a standard and a requirement for success.
Silverstein earned a bachelor’s degree from Alfred University in Alfred, New York, and his medical degree from Columbia University. He completed his internship and residency at Harborview Medical Center and UW Hospital (now UW Medical Center). A four-time recipient of the School of Medicine’s Teacher of the Year award, Silverstein was named “Teacher Superior in Perpetuity” in 1994. He is currently working on new medical device projects and developing courses for engineering students on “Engineering in Medicine.”
A growing body of evidence suggests that the brain plays a key role in glucose regulation and the development of type 2 diabetes, researchers wrote in the Nov. 7 issue of the journal Nature. If the hypothesis is correct, it may open the door to entirely new ways to prevent and treat this disease, which is projected to affect one in three adults in the United States by 2050.
In the paper, lead author Michael W. Schwartz, UW professor of medicine and director of the Diabetes and Obesity Center of Excellence, and his colleagues from the Universities of Cincinnati, Michigan, and Munich, note that the brain was originally thought to play an important role in maintaining normal glucose metabolism. With the discovery of insulin in the 1920s, the focus of research and diabetes care shifted almost exclusively to insulin. Today, almost all treatments for diabetes seek to either increase insulin levels or increase the body’s sensitivity to insulin.
“These drugs,” the researchers wrote, “enjoy wide use and are effective in controlling hyperglycemia [high blood sugar levels], the hallmark of type 2 diabetes, but they address the consequence of diabetes more than the underlying causes, and thus control rather than cure the disease.”
New research, according to the researchers, suggests that normal glucose regulation depends on a partnership between the insulin-producing cells of the pancreas, the pancreatic islet cells, and neuronal circuits in the hypothalamus and other brain areas that are intimately involved in maintaining normal glucose levels. The development of type 2 diabetes, the authors argued, requires a failure of both the islet-cell system and this brain-centered system for regulating blood sugar levels.
In their paper, the researchers reviewed both animal and human studies that indicate the powerful effect this brain-centered regulatory system has on blood glucose levels independent of the action of insulin. One such mechanism by which the system promotes glucose uptake by tissues is by stimulating what is called “glucose effectiveness.” As this process accounts for almost 50 percent of normal glucose uptake, it rivals the impact of insulin-dependent mechanisms driven by the islet cells in the pancreas.
The findings led the researchers to propose a two-system model of regulating blood sugar levels composed of the islet-cell system, which responds to a rise in glucose levels by primarily by releasing insulin, and the brain-centered system that enhances insulin-mediated glucose metabolism while also stimulating glucose effectiveness.
The Institute of Medicine issued a report Oct. 30 reviewing the science on youth concussions and recommended actions to reduce their occurrence and consequences.
The report cautioned that, while existing research provides useful information, much still is unknown about the extent of the problem, how to diagnose, manage and prevent concussions, and their short- and long-term effects. These areas remain confusing and controversial for parents, coaches, physicians and policy-makers alike.
UW injury expert Frederick Rivara, holder of the Seattle Children’s Endowed Chair in Pediatrics, was vice-chair of the committee, which was chaired by Robert Graham, director of the National Program Office of Aligning Forces for Quality at George Washington University.
Several sponsors supported the Institute of Medicine and the National Research Council in convening the committee. These included the Centers for Disease Control and Prevention and the CDC Foundation, which received funding for the study from the National Football League. Other sponsors were the Department of Defense, Department of Education, U.S. Health Resources and Services Administration, National Academies, National Athletic Trainers Association Research and Education Foundation, and National Institutes of Health.
The committee examined current findings on sports-related concussions in youth from elementary school age through young adulthood. They looked at studies, too, of concussions in military personnel and their dependents.
The data available on the incidence of sports concussions suggest that, among male athletes in high school and college sports, football, ice hockey, lacrosse, wrestling and soccer led in the incidence of concussions. Among female high school and college students, soccer, lacrosse, basketball and ice hockey were linked with the highest rates of concussions. The frequency of concussions among younger athletes, or those in intramural and club sports, is not known.
The lack of data on the overall incidence of sports-related concussions in youth prompted the Institute of Medicine committee to call for the Centers of Disease Control and Prevention to establish a national surveillance to collect information on concussive injuries, including those in youth age 5 to 21.
UW Medicine’s top research awards have been listed for July through September 2013. The list draws from all awards, including those for new projects and for an additional installment to an existing project. Awards granted during January through March 2013 and April through June 2013 are also available online.
UW Medical Center and Harborview Medical Center have been named top performing hospitals, according Improving America's Hospitals: The Joint Commission's Annual Report on Quality and Safety 2013. They are among 1,099 Joint Commission-accredited "Top Performer on Key Quality Measures®" hospitals to receive the designation.
The Top Performer designation is based on performance related to accountability measures for heart attack, heart failure, pneumonia, surgical care, children’s asthma care, inpatient psychiatric services, venous thromboembolism (VTE) care, stroke care, and immunization. Hospitals are required to select and report on four measure sets, and each of the recognized hospitals had to achieve cumulative performance of 95 percent or above for all reported accountability measures. Both Harborview and UW Medical Center were recognized for providing excellent care in the categories of heart attack, heart failure, pneumonia, and surgical care.
The UW Medicine Health Insurance Exchange and Medicaid Expansion Task Force has released an update on how the changing healthcare landscape impacts UW Medicine, which is proactively taking the initiative to partner with patients for the best transition possible. Read the most recent update here.
Jeffrey and Susan Brotman are the recipients of the 2013 Gates Volunteer Service Award. The award is presented annually by the University of Washington and the UW Foundation to recognize and honor individuals whose long-term volunteer efforts of time, service and philanthropy have encouraged others to similarly support the University of Washington.
Together, the hard work and commitment of the Brotmans have transformed the University of Washington. An example is the time Jeff, co-founder of Costco Wholesale, rallied the community, raising $1 billion as chair of UW Medicine’s portion of Campaign UW: Creating Futures. Another is the leadership Susan brought as chair, vice-chair and director of the UW Foundation Board over her 20 years of service.
Influenced by family tradition, the Brotmans have dedicated their lives to helping others, especially underrepresented students who excel academically, but who struggle to afford tuition on their own. The Brotmans have established several scholarships on campus and in 2000, with the help of Costco’s co- founder Jim Sinegal, created the Costco Scholarship Fund. More than a thousand undergraduates at the UW and Seattle University count the Costco Scholarship as a life-changing opportunity to pursue their dreams.
The Brotmans have supported dreams at the UW and encouraged others to follow in their footsteps. Whether it’s the Law School or the Henry Art Gallery, UW Medicine or the Board of Regents, the Brotmans typify the civic glue that brings philanthropy and education together, touching countless lives along the way.
Read more about the Brotmans and the Gates Volunteer Service Award on the UW Foundation website.
Thirty-seven UW medical students were elected to Alpha Omega Alpha (AOA) National Medical Honor Society over the last calendar year.
Alpha Omega Alpha Honor Medical Society recognizes and advocates for excellence in scholarship and the highest ideals in the profession of medicine. The society’s values include honesty, honorable conduct, morality, virtue, unselfishness, ethical ideals, dedication to serving others, and leadership.
Alpha Omega Alpha is to medicine what Phi Beta Kappa is to letters and the humanities and Sigma Xi is to science. The top 25 percent of a medical school class is eligible for nomination to the society, and up to 16 percent may be elected based on leadership, character, community service, and professionalism. Members may also be elected by chapters after demonstrating scholarly achievement and professional contributions and values during their careers in medicine. Distinguished professionals may also be elected to honorary membership.
This fall, 25 UW students were elected to AOA. They are:
Nicole Bates, Nina Bozinov, Lindsay Braun, Prashoban Bremjit, Daniel Bushyhead, Daniel Carlson, Terry Chen, Jay Conhaim, Kendra Coonse, Jacquelin Foss, Anne Gayman, Natalie Hale, Adam Knappe, Kyle MacQuarrie, Eriberto Michel, Ana Moreno, Ryan Murphy, Gail Norton, Derek Paul, Kara Sawyer, Shannon Son, Megan Turner, Hao (Christina) Wang, Scott White and Bryan Wilson.
These new members join the following 12 UW students who were elected this past spring, during the 2012/2013 academic year.
Emily Cedarbaum, Michelle Christopher, Nathan Furukawa, Alexandra Graham, Derek Hill, Forrest Jespersen, Amy Kennedy, Derek Khorsand, Kate Khorsand, Catherine Louw, Sarah McGuffin and Isis Smith.
Medical school curricula are changing across the nation. Two-thirds of U.S. medical schools have undergone or are planning curriculum reform. New curricula reflect understanding of modern educational theory and practice, changes in the healthcare environment, expanding medical knowledge, and technological advances in communication.
The UW School of Medicine is immersed in strategic plans for curriculum renewal after careful self-study and national accreditation review and analysis. More than 400 faculty, staff, residents, and students have been involved in the multi-year initiative. Plans for the new curriculum include a continuous quality improvement approach that will keep the curriculum contemporary and dynamic.
In September, the UWSOM’s curriculum renewal process entered a new phase during which the structure of the new curriculum is being designed. Teams are underway, charged by Paul Ramsey, CEO of UW Medicine and dean of the UW School of Medicine, and Ellen Cosgrove, vice dean for academic affairs. These teams include:
Foundations Design Committee charged with making recommendations concerning integrated courses for the scientific foundations phase of the curriculum and chaired by Tom Montine, chair of pathology, and Robert Steiner, professor of obstetrics & gynecology and physiology & biophysics;
Patient Care Design Committee charged with developing recommendations for a new model for clerkships and for an expanded longitudinal integrated clerkship experience and chaired by Richard Veith, chair of psychiatry & behavioral sciences, and Mark Whipple, associate professor of otolaryngology;
Immersion, Transitions and Scholarship Design Committee charged with developing the structure and plans for intersessions, transitions to clerkships and residency experiences, and a meaningful scientific scholarship experience and chaired by Norm Beauchamp, chair of radiology, and Conrad Liles, associate chair and professor of medicine.
The groups began their work over the past month and will meet intensively through February 2014, when they will submit recommendations to Dr. Cosgrove and a steering committee.
The curriculum renewal initiative has focused on ensuring participation of the diverse faculty of School of Medicine and the WWAMI community. Under the leadership of Drs. Montine and Steiner and in an effort to incorporate ideas from all quarters, the Foundations Committee will issue a School-wide request for proposals (RFP) to the faculty, staff, and students for the design of the Foundations Phase of the renewed curriculum. Proposals may be developed and submitted by individual faculty or teams. The RFP will be issued soon and will culminate in a poster session at which proposals may be presented and critiqued.
Dr. Cosgrove also asked two previous committees to reconvene and continue their work. The Governance Committee, chaired by Wylie Burke, chair of bioethics & humanities, is continuing its work to develop recommendations for a governance structure for the new curriculum, and the Evaluation Committee, chaired by Sara Kim, research professor of surgery, and Jan Carline, professor of biomedical informatics and medical education, is focused on developing plans for evaluating student experiences under the new curriculum and developing competency assessment criteria. A new Themes Committee will be charged soon with integrating the recommendations of Theme committees from the last phase. This committee will focus on incorporating the themes (diversity and community engagement, ethics and professionalism, health equity, interprofessional education and communication, lifelong learning, primary care, and quality and safety) throughout the curriculum.
Drs. Ramsey and Cosgrove also recently charged a Curriculum Renewal Steering Committee, chaired by Drs. Steiner and Whipple, and consisting primarily of the chairs of these committees. The steering committee will meet regularly to ensure close integration across the curricular phases and activities and to review committee recommendations.
The current phase will be completed in spring 2014, when recommendations will be issued, considered, vetted and approved. Committees will subsequently be convened for specific content development for the courses, clerkships, intersessions and other experiences developed in the current phase. The start of the new curriculum is planned for 2015.
A recent article in Online News provides more information about the curriculum renewal process. The curriculum renewal website is currently being redesigned and updated. In the near future, committee membership and meeting minutes will be posted. For more information about the curriculum renewal, please contact any of the committee chairs, Michael Ryan at firstname.lastname@example.org or Ellen Cosgrove at email@example.com.
The following article was written by Doug Nadvornick, WSU Medical Sciences, and John McCarthy, UW School of Medicine assistant regional dean.
When family medicine clerkship coordinators from around the WWAMI region gathered at Washington State University Spokane for their end-of-quarter meeting in early October, they received a refresher course on helping students apply for residencies.
“The competition to get into the most respected programs has always been fierce, but given the growing number of medical school graduates and the static number of open residency slots, students have to work harder to set themselves apart from other candidates”, said Jeanne Cawse-Lucas, associate director for the UW School of Medicine's Family Medicine Clerkship.
That means they look for help wherever they can get it. They frequently turn to physician-mentors for help. Some physicians enjoy that advisory role and are good at guiding students; for others, the work is not something at which they’re particularly skilled.
Many of the doctors at the Spokane meeting live and work in small cities and towns in the WWAMI region. The workshop they put on was designed to improve their skill levels so when students seek their help and advice they can provide a similar level of information and support to faculty in Seattle.
While most residency directors rely heavily on the students’ scores on the U.S. Medical Licensing Examination (USMLE) when they evaluate candidates, other factors are in play too, said Cawse-Lucas. Those include the students’ grades in their third- and fourth-year clerkships and their extracurricular experiences.
Cawse-Lucas advised the physician mentors about how to help students prepare for their residency interviews. “Make sure you make personal connections. It’s important to write a personal statement, but tell the students not to get carried away”, she advised. “And have them mention their memberships and leadership roles in student and medical-oriented organizations in interviews”, she said.
“Encourage students to practice by doing mock interviews,” said Cawse-Lucas. “If you’re not able to do that with them, have them call us and we can have someone do a mock interview via Skype.”
Students also ask their physician mentors for letters of recommendation. “When you sit down to write those, think about what the residencies are looking for”, advised Cawse-Lucas.
“They want to know if someone’s smart, if they work hard and is a pleasant person to be around,” she said. “Would you want that student working in your residency or specialty? If yes, say so.”
In the Northwest, new family medicine residencies have recently opened in eastern Pierce County in Washington and in Missoula, Mont., with another program scheduled to open in Coeur d’Alene, Idaho next summer. Residency possibilities in other specialties are also being explored, including discussions for a new psychiatry program at Providence Sacred Heart Medical Center, in collaboration with Spokane’s Veterans’ Affairs Medical Center.
The following events may be of interest to the UW Medicine community:
Medical team volunteers needed for Seattle Marathon, Dec. 1
UW Medicine is looking for medical and administrative volunteers for the Seattle Marathon, Sunday, Dec. 1. Led by Mark Harrast, Seattle Marathon medical director, medical teams will manage seven stations along the course and two at the finish line. More than 10,000 runners are expected to participate in the Marathon and Half-Marathon races during the Thanksgiving Holiday weekend. For more information, contact Mia Coleman at firstname.lastname@example.org.
Science in Medicine Lecture, Dec. 4
Kidney Disease and the Public Health: Problems, Progress and Prospects, 1 to 2 p.m., Wednesday, Dec. 4, Health Sciences Bldg., Turner Auditorium, D-209. The lecture will be given by Jonathan Himmelfarb, UW professor of medicine and the Joseph W. Eschbach M.D. Endowed Chair in Kidney Research. Himmelfarb is also the director of the Kidney Research Institute. His research interests include the development of a wearable artificial kidney and a human ‘kidney-on-a-chip;’ risk biomarkers in acute and chronic kidney diseases; and oxidative stress, inflammation and insulin resistance pathways in kidney diseases. Himmelfarb is the director of the Kidney Research Institute. The session will be simulcast to several locations. For more information, visit the Science in Medicine website or contact Heather Hawley at email@example.com or 206.221.5807.
Colin Powell to give keynote address at Prostate Cancer Survivors Celebration Breakfast, Dec. 5
Former U.S. Secretary of State and retired four-star U.S. Army Gen. Colin Powell will be the keynote speaker for the 2013 Prostate Cancer Survivors Celebration Breakfast, which supports the Institute for Prostate Cancer Research, a collaboration between UW Medicine and Fred Hutchinson Cancer Research Center. The 2013 Prostate Cancer Survivors Celebration Breakfast will take place at the Seattle Sheraton Hotel, from 7:30 to 9 a.m., Thursday, Dec. 5. For more information, visit the Prostate Cancer Survivors Breakfast site.
Continuing Medical Education
Visit Continuing Medical Education for information on upcoming classes.
Save the Date: Paul Ramsey’s Annual Address, Feb. 6, 2014
Paul Ramsey, CEO, UW Medicine, executive vice president for medical affairs and dean of the School of Medicine, University of Washington, will review progress at UW Medicine over the past year and cover challenges and opportunities for the upcoming year. The address will be held from 4 to 5 p.m., Thursday, Feb. 6. Look for more details in upcoming issues of Online News. For more information, contact Julie Monteith at firstname.lastname@example.org or 206.543.7718.
Fall UW Medicine magazine available online
The fall issue of UW Medicine is now available online. Read about amazing advances made by the Institute for Health Metrics and Evaluation in understanding the global burden of disease, UW Medicine's sports medicine, the annual Report to Donors, and more.
UW Medicine 2012 Report to the Community