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September 30, 2011

Table of contents

Message from Paul Ramsey

Paul G. Ramsey

Graduate medical education implements new initiatives

Dear Colleagues:

Over the last 18 months, the Office of Graduate Medical Education (GME) in the UW School of Medicine has developed a new mission statement and implemented several new initiatives. The mission — to Guide, Motivate and Enlighten UW trainees and GME program directors — aspires to build more cohesion among UW’s residency and fellowship programs.

UW GME comprises about 1,200 residents and fellows training in 92 programs accredited by the Accreditation Council on Graduate Medical Education (ACGME) — 26 core programs and 66 subspecialty fellowship programs — and in two fellowships approved by the American Board of Obstetrics and Gynecology (ABOG). Among nearly 700 sponsoring institutions nationally, UW ranks 5th in number of programs and 10th in number of trainees. Trainees are located at four primary teaching sites in Seattle and at over 170 participating institutions throughout the Washington, Wyoming, Alaska, Montana and Idaho (WWAMI) region.

One of the new initiatives enhances the education of program directors, the individuals responsible for leading the training programs for residents and fellows. In response to a needs assessment conducted in 2009, the GME Office created an orientation program for new program directors and established educational workshops to improve their knowledge and skills.

The semi-annual New Program Director and Administrator Orientation is a day-long session for program directors and program administrators who have been in their positions for less than three years. The orientation familiarizes these individuals with topics related to their respective roles, including an overview of the ACGME and UW GME, curriculum development, performance assessment, ACGME site visits, affiliation agreements and remediation. Program directors and administrators who have demonstrated expertise in the foundations of teaching, mentoring trainees and building strong programs provide the majority of lectures.

The Program Director Development Series (PDDS) was also initiated last year to help program directors keep apprised of current GME happenings, especially focusing on providing competency-based education for and outcomes-based assessment of residents and fellows. The curriculum occurs annually over a two-month period in fall and spring and covers diverse topics such as feedback, evaluation, mentorship and leadership. The PDDS, which has been very popular among UW program directors, will be presented as a workshop at the Annual ACGME Educational Conference in March 2012 in Orlando, Florida.

With these new initiatives and the superb leadership of UW’s program directors, I am confident that our residency programs will advance even further. The quality of UW residency and fellowship program directors and administrators has already been well demonstrated in national arenas. A total of eight UW GME program directors have received the ACGME Palmer Parker Courage to Teach Award — more than any other institution nationally. This prestigious award is granted each year to only 10 program directors nationwide to recognize GME excellence. UW awardees are: Harold Johnston, UW Family Medicine Residency Network program director for Alaska Family Medical Residency (2003); Teresa Massagli, physical medicine & rehabilitation (2005); Deborah Cowley, psychiatry (2006); Karen Horvath, general surgery (2008); Richard Shugerman, pediatrics (2008); Ron Maier, surgical critical care (2010); Byron Joyner, urology (2011); and Karen Souter, anesthesiology (2011). In addition, one UW program administrator has received the GME Program Coordinator Excellence Award: Michelle Rickard, pathology residency and fellowships (2011). I congratulate all ACGME awardees, as well as all of our program directors and administrators, for their outstanding work.

I have been very impressed with the commitment of the GME Office to building a strong educational community for program directors and other medical educators. Under the guidance of Larry Robinson, vice dean for clinical affairs and GME, Byron Joyner, associate dean for GME, and Amity Neumeister, assistant dean for GME, the leadership team has been extremely effective in advancing the quality of UW GME programs. In addition, as announced in this issue of Online News, Susan Johnston has recently been hired as director of education for GME, and will play a critical role in assisting program directors in developing and enhancing competency-based curricula and improving their performance assessment systems.

Please join me in congratulating the entire GME team, including the program directors and administrators, for their superb work on behalf of our trainees.


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




Intranasal insulin therapy may benefit adults with cognitive impairment or Alzheimer's disease

S. CraftIntranasal insulin therapy appears to provide some benefit for cognitive function in patients with amnestic mild cognitive impairment (aMCI) and Alzheimer's disease, according to a report published online Sept 12. by Archives of Neurology, one of the JAMA/Archives journals.

According to background information in the article, insulin plays a role in a number of functions of the central nervous system. The importance of insulin in normal brain function is underscored by evidence that insulin dysregulation contributes to the pathophysiology of Alzheimer's disease, a disorder characterized in its earliest stages by synaptic loss and memory impairment, the authors write. Insulin levels and insulin activity in the central nervous system are reduced in Alzheimer’s.

Suzanne Craft, UW professor of psychiatry and behavioral sciences who practices at the Veterans Affairs Puget Sound Health Care System, and her colleagues conducted a randomized controlled trial to evaluate the effects of intranasal insulin therapy on cognition, function, cerebral glucose metabolism and cerebrospinal fluid biomarkers in adults with aMCI or Alzheimer’s.

Study participants were randomized into one of three treatment groups, with 36 participants receiving 20 IU (international unit) of insulin daily, 38 receiving 40 IU of insulin daily, and 30 participants receiving placebo daily for four months. All treatments were administered using a nasal drug delivery device. The authors evaluated the effects of treatment on delayed story recall (how well participants could recall a story told to them immediately after, and after a short time lapse) and the Dementia Severity Rating Scale (DSRS) scores of participants.

Compared with participants in the placebo-controlled group, those receiving 20 IU of insulin daily showed improved delayed story recall; however no improvement was observed for participants receiving 40 IU of insulin.

The results of the pilot trial demonstrate that the administration of intranasal insulin stabilized or improved cognition, function and cerebral glucose metabolism for adults with aMCI or Alzheimer’s disease, the authors write. The findings provide an impetus for future clinical trials of intranasal insulin therapy and for further mechanistic studies of insulin's role in the pathogenesis of Alzheimer’s disease.

Read more about this study in UW Today.

Depression management program PEARLS receives Archstone Award

Mark SnowdenThe UW Health Promotion Research Center’s program (HPRC) to motivate depressed older adults will be awarded the 2011 Archstone Foundation Award for Excellence in Program innovation. Mark Snowden, UW associate professor of psychiatry and behavioral sciences and medical director of Harborview Mental Health Services, will receive the award on behalf of the Program to Encourage Active and Rewarding Lives for Seniors (PEARLS). The award will be presented at the 139th American Public Health Association Annual Meeting in Washington, D.C., in November.

PEARLS is a home-based depression management program developed collaboratively by HPRC and its community partner, Seattle-King County's Aging and Disability Services. The program includes 19 weeks of home visits for problem-solving therapy, behavioral activation, and pleasant events scheduling; six months of brief, monthly, follow-up phone calls; and clinical oversight by a psychiatrist at depression management team sessions. PEARLS has demonstrated its effectiveness with older adults and people with epilepsy.

Snowden is the principal investigator for several research projects related to the dissemination and implementation of the PEARLS program. Paul Ciechanowski, UW associate professor of psychiatry & behavioral sciences, led randomized controlled trials to establish the evidence base for PEARLS with older adults and with people with epilepsy and also leads PEARLS training efforts. PEARLS was conceived by Edward Wagner, UW professor of health services in the UW School of Public Health.

The Public Health and Aging section of the American Public Health Association (APHA) created the Archstone Award to recognize best practice models in gerontology and geriatrics, particularly innovative programs that have been effective at linking academic theory with applied practice in the field of public health and aging. 

Research by Connie Celum, Jared Baeten and Evan Eichler cited in TIME's 100 New Scientific Discoveries

Research by Connie Celum and Jared Baeten is included in TIME’s new book 100 New Scientific Discoveries: Fascinating, Unbelievable and Mind Expanding Stories. Celum and Baeten are, respectively, director and medical director of the UW International Clinical Research Center, which coordinates multi-center infectious diseases prevention trials. They are among authors of a recent landmark study report showing that pre-exposure prophylaxis with antiretroviral medication can substantially reduce the risk of HIV transmission in serodiscordant heterosexual couples. Celum, UW professor of medicine and global health, was principal investigator and protocol co-chair of the study, and Baeten, UW associate professor of medicine and global health, was medical director and protocol co-chair. 

TIME also cited findings on the genetic distinctions between human and Neandertal genomes that may reveal what set ancient humans apart from the now-extinct, human-like beings, who died out about 30,000 years ago. Researchers in Evan Eichler's genome sciences lab contributed to this international effort.

Read more about these and other UW discoveries in UW Today

Genome sciences researcher Christine Queitsch receives NIH Director's New Innovator Award

Christine Queitsch, UW assistant professor of Genome Sciences, is among 79 scientists to receive one of this year's NIH Director's Pioneer, New Innovator, and Transformative Research Projects Awards. Queitsch received a 2011 NIH Director’s New Innovator Award. The NIH recently announced its $143.8 million in awards to challenge the status quo with innovative ideas that have the potential to propel fields forward and speed the translation of research into improved health for the American public. Queitsch’s research focuses on developing DNA-based biomarkers to help make it easier to predict disease susceptibility in individuals, moving scientists closer to determining why and how a person acquires a particular disease.


Clinical Care

Saurabh Khandelwal named medical director of UW Medicine Bariatric Surgery Program

Saurabh KhandelwalSaurabh Khandelwal, UW assistant professor of surgery, has been named medical director for the UW Medicine Bariatric Surgery Program. 

Khandelwal has been on faculty since 2009. He has taken on progressively more administrative responsibility for day-to-day functioning of the program and is known as an excellent educator of residents, staff and patients. He actively participated in the promotion of and planning for the future of the Multidisciplinary Bariatric Program at UW Medicine.

The program has been in operation since 1978. It was certified by the American College of Surgeons as a Level 1 program in 2006, the first year the certification was available, and was recertified in 2010. The program has grown significantly in the last 3 years and now serves approximately 300 new patients each year.

Level 1 bariatric surgery centers provide complete care devoted to bariatric surgery. These centers can manage the most challenging and complex patients with optimal opportunity for safe and effective outcome. They have high-volume practices conducted by professional services of breadth and depth.

The UW Center for Bariatric Surgery has a multi-care approach that extends beyond surgery. Team members are from various disciplines — including nutrition, social work, and physical therapy — in order to offer the best care before and after this life-changing surgery.

Why adults need immunizations

The following was adapted from an article by Edward Dy, published by the Journal Media Group Sept. 5, 2011. Dy is a board-certified internal medicine doctor at the UW Neighborhood Clinic in Kent/Des Moines and a UW clinical assistant professor of medicine.

In the United States, children get vaccinated to protect against serious diseases such as measles, mumps, polio and whooping cough at set intervals from birth to age 18. But the need for adults to get vaccinated is not always recognized. According to the Centers for Disease Control and Prevention (CDC), the result is that “far too many adults become ill, are disabled, and die each year from diseases that could easily have been prevented by vaccines.”

While adults may assume that childhood vaccines offer lifelong protection, the reality is more complex. For some diseases, they need newer vaccines that were not available when they were children. Other vaccines are not given to children because they target diseases that are more common and more serious for older people.

Although immunization decisions should be made in consultation with your health care professional, you can learn about them by checking the CDC’s Recommended Adult Immunization Schedule or taking its Adolescent and Adult Vaccine Quiz. Both of these tools are posted on the CDC website. As a general guideline, all adults are encouraged to get immunizations for the following vaccine-preventable diseases: shingles, pneumococcal disease, influenza, tetanus, diphtheria and pertussis.

Read the original article.

Influenza immunization clinics will be held at variuos locations throughout UW Medicine through Nov. 11. For more information, contact Employee Health Services at emhealth@uw.edu or 206.598.7971.

Education and Training

Tom Norris appointed chair of Department of Family Medicine

Tom NorrisTom E. Norris, UW professor of family medicine, has been named chair of the UW Department of Family Medicine. Norris had served as interim chair of the department since December 2010, when James Davis stepped down from the position and a national search was launched.

Norris, who is also an adjunct professor in medical education, global health, and health services, is a recognized national leader in family medicine, primary care medicine, and rural healthcare. The American Academy of Family Physicians (AAFP) recently honored Norris with the 2010 John G. Walsh Award for his lifetime leadership contributions to the advancement of family medicine. Among his numerous achievements, Norris helped establish the UW Medicine Neighborhood Clinics — UW's network of community-based primary care clinics. He also developed rural family medicine residency programs in Montana and a rural family medicine fellowship at MultiCare Health System’s Tacoma Family Medicine, which is affiliated with the UW School of Medicine.

From 2004 to 2010, Norris was vice dean for academic affairs and in that role was responsible for all aspects of medical student education at the UW School of Medicine. He has served as president of the Montana and Washington Academies of Family Physicians and the American Board of Family Medicine. He currently serves as vice chair of the board of directors of the American Board of Medical Specialties. 

Susan Johnston named GME Director of Education

The UW Office of Graduate Medical Education (GME) has announced that Susan S. Johnston joined the School of Medicine as the new Director of Education for GME on Sept. 12, 2011.

Johnston spent the last six years in UW Professional and Continuing Education. In that role, she worked with the Department of Health Services in managing and administering a group of healthcare-related graduate programs, including the Executive Masters in Health Administration (EMHA) and Masters in Health Administration (MHA). She has also worked with several departments in the School of Medicine to develop new programs and courses.

Johnston holds a Doctor of Education in Curriculum, Instruction and Technology from Temple University. Her career has focused on teacher training and curriculum development in higher education. She has directed a graduate program for teachers as a Fulbright senior lecturer in Turkey; served as an educational specialist in curriculum development, educational assessment, and teacher training for the U.S. Department of State at several international universities; worked as an educational consultant for multi-national corporations; and co-authored textbooks for Harcourt, Brace, Jovanovich, and Heinle & Heinle Publishers.

"I look forward to contributing to the continuous development of quality educational systems and processes for UW graduate medical education,” Johnston said, “and to working with an engaged and committed GME leadership to achieve the mission of 'guiding, motivating, and enlightening the next generation of physicians.'"

Johnston will be responsible for assisting the GME office and GME program directors in developing outcomes-based curriculum and making program assessment systems more comprehensive and consistent. She will also be responsible for enhancing current and developing new educational programs for residents and fellows on a variety of topics, including the business of medicine, life after residency, and completing a chief residency. Johnston has particular interest in applying research-based educational approaches, methods and theories to curriculum development, educational assessment and learning environments. She can be reached at 206.543.6806 or ssjohn2@uw.edu.

UW Medicine encourages student, staff and faculty wellness

Training and working to help others can be demanding and stressful. UW Medicine is dedicated not only to its patients and families but also to the health and well-being of its students, trainees, faculty and staff. Several programs and resources are available to help UW Medicine community members cope with issues in the academic, professional and personal areas of their lives.

Resident and Fellow Wellness Program

An experienced licensed counselor is available to help residents and fellows develop strategies to cope with the stress of residency and fellowship training. Confidential support and counseling services are available free of charge through the Graduate Medical Education office.

The Resident and Fellow Wellness Program offers:

  • Individual and couples counseling to help deal with issues such as depression, anxiety, stress, relationship, and marital concerns.
  • Workshops on life skills such as sleep hygiene, stress and anger management, accepting and giving feedback, and identifying depression.
  • Resident and Fellow Counseling Service referral to wellness resources within the community including couples counseling, and psychiatric, substance abuse, and psychological counseling.

For a complete listing of services visit the Resident and Fellow Wellness webpage. For more information about the Resident and Fellow Wellness Program, contact Mindy Stern, director of Resident and Fellow Wellness, in the Office of Graduate Medical Education, at mindywho@uw.edu  or 206.543.6408.

UW CareLink Faculty and Staff Assistance Program

UW CareLink services are available nationwide for benefits-eligible UW faculty and staff, their dependents, and household members. UW CareLink offers a wide range of services that can help individuals manage through the different stages of life, develop a healthy lifestyle, create a quality work environment, and save time by providing easy access to trusted experts, including counselors, attorneys, financial advisors, and child and adult/elder care consultants.

Physician Suicide Webinars

With concern about physician burnout and stress growing, the American Medical Association is addressing the issue of physician suicide through a series of three free webinars. For more information, visit the AMA Physician Health webpage 



WWAMI Regional News

New scholarship fund established for Alaska WWAMI students

The Robert Fortuine Scholarship Fund has been established in honor of the late Robert Fortuine, long-time teacher of the Introduction to Clinical Medicine course at the University of Alaska Anchorage. The scholarship, which was announced Sept. 10 at the WWAMI 40th Anniversary celebration, supports medical students from rural areas who are interested in working in the Alaska Tribal Healthcare System.

Fortuine was known by his colleagues as a physician, administrator, medical historian and teacher in the University of Alaska Anchorage WWAMI program. He spent much of his career in the Alaska Tribal Healthcare System, where he served as director of Kanakanak Hospital, director of the Bethel Hospital and director of Alaska Native Medical Center. As part of his career with the US Public Health Service, he also spent three years in Geneva, Switzerland as the U.S. Representative to the World Health Organization.

Fortuine wrote numerous articles and seven books about healthcare among Native peoples in the Arctic Regions. Two of his books led to awards as Alaska Historian of the Year: Chills and Fever, Health and Disease in the Early History of Alaska and Must We All Die? Alaska’s Enduring Struggle with Tuberculosis. Fortuine was also the recipient of the John Phillips Award, “For Service to the Public Good”, the Trudeau Award, the Jack Hildes Medal, and an honorary Doctorate of Science degree from University of Anchorage Alaska.

Fortuine taught the Introduction to Clinical Medicine course for medical students at University of Alaska Anchorage from 1989 until 2004 and then continued to provide guest lectures in that course until his death in 2009. He was clinical professor of family medicine at the University of Washington School of Medicine and affiliate professor of health sciences at University of Alaska Anchorage.

For more information on how you can support the Robert Fortuine Scholarship Fund, visit: www.uaa.alaska.edu/wwami40/dr-robert-fortuine-scholarship.cfm.



Upcoming Events

The following is a listing of some upcoming events that may be of interest to the UW Medicine community.

2011 Presidential Entrepreneurial Faculty Fellows Lecture Series

Wake Up to the Possibilities, a new lecture series about merging academic research with entrepreneurship. The series, which began Sept. 13, is hosted by the UW Center for Commercialization (C4C) in partnership with the Office of the President and the Center for Innovation & Entrepreneurship (Foster School). Series lecturers include: Rodney Ho, UW professor of pharmaceutics, High on UW Start-ups: Fueling Innovations in a New Climate of Entrepreneurship, 8 a.m., Tuesday, Oct. 4, in the Walker-Ames Room in Kane Hall, Seattle campus; Buddy Ratner, UW professor of bioengineering and chemical engineering, An Academic in Entrepreneurship Land: 10 Lessons Learned, Some from the Mad Hatter and March Hare, 10 a.m., Tuesday, Nov. 8, Walker-Ames Room, Kane Hall, Seattle campus; and Carla Grandori, UW professor of pharmacology, Cures for Cancer – Hidden in Plain Sight? An Enterprise to Accelerate their Discovery, 8 a.m., Tuesday, Nov. 29, Walker-Ames Room, Kane Hall, Seattle campus. To see other lectures in the series or to register, visit the lecture series webpage

Faculty Development Workshop, Oct. 21

“You Got Promoted to Associate Professor – Now What?” 8 a.m. to noon, Friday, Oct. 21, UW South Campus Center, Room 316. While this workshop is geared to midcareer faculty, all are welcome to attend. Speakers include UW School of Medicine faculty members Chris Surawicz, Robb Glenny, Deb Schwinn, Larry Robinson, Anna Wald, Grace John Stewart, Tueng T. Shen and Josh Benditt. The UW Medicine Office of Faculty Development is sponsoring the workshop. For information, contact Michelle Walter at mmwalter@uw.edu or 206.543.6232.

Future of Contraception Conference, Oct. 29 – 31

The Future of Contraception Initiative, a three-day conference, Oct. 29-31, Edgewater Hotel, 2411 Alaskan Way, Seattle. International experts will address global needs, new developments in male and female contraception, and recent research in reproductive biology. UW Department of Medicine Chair William J. Bremner is chair of the organizing committee and local host for the conference. Register online. For more information, contact foci2011@uw.edu or call 206.543.1537.

Northwest Genome Engineering Consortium Workshop, Nov. 8

The fourth annual Northwest Genome Engineering Consortium Workshop on Genome Engineering takes place Tuesday, Nov. 8, in Seattle. The workshop is a forum on genome engineering concepts, methods, and applications under study in both consortium and non-consortium laboratories. Register online. Visit the Northwest Engineering Consortium website or contact Andre Durudas, consortium project coordinator, at 206.884.7399 or andre.durudas@seattlechildrens.org for more information.

Continuing Medical Education

Visit Continuing Medical Education for more information on upcoming classes.