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School of Medicine Virginia Commonwealth University VCU Medical Center
School of Medicine: Message From the Dean

June 17, 2013

Strauss shares views via Richmond Times-Dispatch

The Richmond Times-Dispatch has published a commentary piece from Dean of Medicine Jerry Strauss III, M.D., Ph.D., on the newspaper’s Op-Ed page. Strauss weighed in on a proposal by the House of Representatives’ Appropriations Committee that could result in a dramatic 20 percent decrease to the budget of the National Institutes of Health.

Published in the June 12 newspaper, Strauss wrote, “A 20 percent cut represents a significantly greater funding reduction than what is proposed for every other area of domestic spending. From my vantage point as a physician, researcher and dean of the VCU School of Medicine, I am dismayed at the potential consequences of that decision.”

He went on to describe the impact that such a reduction would have on patients, medical schools and the economy and asked legislators to collaborate on a budget solution that protects our patients and preserves the life-saving research.

Read Strauss’ full op-ed online.

March 25, 2013

A Letter to the Medical School’s Alumni, Students and Faculty

To the medical school’s alumni, students and faculty,

When I joined VCU in 2005, I knew I was coming to a school steeped in tradition and with a history I would take pride in. It has been one of my great pleasures over the past eight years to learn about the accomplishments of alumni, faculty and students who have shaped our medical school’s reputation and the rich legacy of the Medical College of Virginia.

Since 1968 our history has been conjoined with the Virginia Commonwealth University’s. The merger between MCV and RPI that created the university was necessary for our future in an era when free-standing medical schools were vulnerable. Being part of a larger university has benefited our school in many ways, but you know there have been growing pains along the way.

SOM Diploma

You may know that we recently encountered another hurdle when the Medical College of Virginia Campus designation was removed from the university’s diplomas. When the students learned of this decision, many contacted the university’s administration to urge them to reconsider. These students are proud of our school’s long history, just as our alumni and faculty are. Many of the alumni spoke up, too, and I know that university administrators heard from many families whose connections with the MCV Campus span multiple generations.

I, together with other leaders at the university, listened carefully to the concerns of our students and alumni. Today, I am pleased to report to you that this issue has been resolved in a manner that I believe we can all be pleased with. Our students will now be able to elect to receive a “legacy diploma” which includes “Medical College of Virginia Health Sciences Division” on the diploma as specified in the Code of Virginia when VCU was created. This option will be available to all students who are eligible to receive degrees from a health science program at VCU.

I try to see issues like these as opportunities to remind our community that MCV’s history is one of VCU’s crowning jewels. To be sure, our medical school benefits from the relationship, especially now, as we witness a new wave of mergers between stand-alone medical schools and universities. We have been fortunate: the strong engineering school on VCU’s Monroe Park Campus opens important and productive opportunities for our faculty and students. The School of Education has collaborated with faculty at the medical school to sharpen teaching skills. And VCU Arts – the nation’s top public arts school – is our partner in creating a unique standardized patients program that will give our students regular and intense case-based training.

Our recent conversations have encouraged a new appreciation for the respect and affection that the MCV name inspires. It is a unifying connection among thousands of physicians and scientists. As it happens, this is the perfect year to celebrate that tradition, as we mark the medical school’s 1838 founding. It is a point of particular pride for me that the celebration is not limited to the medical school. The whole university will embrace the 175th anniversary.

In this milestone year, we will add new accomplishments to our storied tradition. In April, the McGlothlin Medical Education Center will open its doors to generations of future physicians who will train in innovative, clinically based learning spaces. This building is a testament to the support that our alumni have shown their alma mater – making $190 million in gifts and pledges that have fueled the first phase of what will clearly be the most successful fundraising campaign in the medical school’s history.

This year we will also establish the 1838 Fund. Representing the second phase of the medical school’s campaign, the 1838 Fund will build a scholarship endowment on par with those at our peer medical schools. We must provide meaningful scholarship support to medical students who study in the tradition of the Medical College of Virginia.

In my conversations with those students, it’s clear that they love the MCV tradition. They also feel a responsibility to live up to what one student described as “a bar set by 175 years of history.” Thank you for what you’ve done to raise that bar.

Sincerely,

Jerome F. Strauss, III, M.D., Ph.D.
Executive Vice President of Medical Affairs, VCU Health System
Dean, School of Medicine

January 4, 2013

End-of-Year Letter to the Alumni

This year, we will celebrate the 175th anniversary of our school’s 1838 founding. Over those years, we have enjoyed many accolades and awards, most recently the announcement that U.S. News and World Report had ranked our medical center as the No. 1 hospital in Virginia. The ranking was propelled by four programs — nephrology, pulmonology, orthopaedic surgery and urology — that ranked among the country’s top 50. Of the nation’s roughly 5,000 hospitals, fewer than 150 have even one ranked specialty.

Each year, Dean of Medicine Jerry F. Strauss III, M.D., Ph.D., sends greetings to the alumni body in the form of an end-of-year letter. This is the 2012 edition, full of the latest happenings from the MCV Campus.

You — who trained in our clinics and learned from the physicians and scientists on faculty — know this ranking is a product of the clinical experience found on the MCV Campus. The unmatched breadth of clinical exposure challenges our skills and keeps us on the leading edge of medical advances. The promise of that kind of training continues to draw students today. This year, the largest applicant pool in the school’s history vied for a seat in the Class of 2016. We received more than 7,000 applications, including one submitted by Akeem George.

The Virginia Beach native has always known he wanted to be a physician and to serve, specifically, his hometown. We like to see that our applicants have a genuine enthusiasm for and knowledge of what medical practice is like. Mr. George was exceptional on that score, volunteering in free clinics in both Virginia Beach and Richmond. Now, a few months into his medical studies, he’s still finding time to give back as a mentor to a 12-year-old boy in Church Hill. We’re not the only ones who think highly of him. This fall, he learned he had been chosen by the Britt Scholarship Fund in Hampton Roads to receive its $10,000 scholarship, renewable for each of his four years in medical school. This is a particularly proud honor because the scholarship carries the name of L.D. Britt, M.D., who was the first African-American to be appointed a professor of surgery in Virginia and one of Mr. George’s role models for his dedication to his community.

With the Class of 2016, we’ve debuted fmSTAT, a dual-admissions program for high-quality students interested in family medicine and primary care. A half dozen students were chosen from the more than 100 who applied. These students will benefit from hand-picked mentors as well as unique training experiences. And they will be in good company. Nearly half of our 800 students registered as members with the American Academy of Family Physicians, making our family medicine student-interest group the largest in the state. The group actively stirs up interest in the field and this year, for the seventh time since 2004, it was one of just nine groups in the U.S. recognized with the AAFP’s Program of Excellence Award.

All of our students are looking forward to the opening of the James W. and Frances G. McGlothlin Medical Education Center. At the heart of the MCV Campus, the facility will provide new training experiences, including earlier clinical exposure and unique twists to integrate the basic sciences into those experiences.

We are already changing the curriculum to incorporate the kind of teamwork you see today in health care. Alan Dow, M.D., is using the support he receives as one of five Macy Foundation Scholars in the nation to create a simulation-based training project for fourth-year nursing and medical students. The experience teaches them skills for collaborating across professions, how to work together to assess and treat patients with an acute change in clinical status, as well as how and when to hand off a patient. We want our students to be prepared for real-world practice on the first day of their residencies.

Experiences like that will become more common through all four years of medical school and in residency training once the Center for Human Simulation and Patient Safety expands to two floors in the new building. Part of the space will house our new standardized patient program, complete with two-way mirrors, video recorders and observation rooms. In this project, we’ve benefited from our proximity to VCU’s renowned arts program, creating a partnership that may be the only one of its kind in the U.S. Our faculty has teamed up with the Department of Theatre to write patient cases, cast and train would-be patients and orchestrate the exercises. Our theatre colleagues coach actors of various ages and demographics on specific medical cases so they can reliably present the history, body language and physical symptoms as well as patients’ emotional and personal characteristics. They’ll even customize cases according to the needs of different departments and specialties.

The McGlothlin Medical Education Center will be the third significant addition to the MCV Campus since 2008’s opening of our Critical Care Hospital. That was followed a year later with the opening of the Molecular Medicine Research Building. Now that the Medical Education Center is nearly complete, we’re moving forward with plans for a new pediatric ambulatory care facility set to open in 2015. This $168 million, 640,000-square-foot Children’s Pavilion will be the region’s largest and most advanced outpatient facility dedicated to children. It’s a product of our recent partnership with the Children’s Hospital of Richmond and will bring under one roof the majority of our hospitals’ outpatient pediatric services.

Populating these buildings are faculty members who use their expertise to benefit their fields and ultimately patients on a broad scale including:

  • PonJola Coney, M.D., director of the Center on Health Disparities: the medical school’s fifth member elected to the Institute of Medicine of the National Academy of Sciences
  • Chair of Obstetrics and Gynecology, David Chelmow, M.D.: who led work on the new Pap test guidelines recently issued by the American Congress of Obstetricians and Gynecologists
  • Stephanie A. Call, M.D., MSPH: one of just 10 program directors across the country honored by the ACGME with the Parker J. Palmer Courage to Teach Award for her innovative approaches to training internal medicine residents
  • Pathologist Greg Miller, Ph.D.: who is wrapping up his presidency of the American Association for Clinical Chemistry
  • Internal Medicine’s Domenic A. Sica, M.D.: president-elect of the American Society of Hypertension

So many of these achievements are due in part to you, the members of our alumni body. The Medical Education Center, for example, would not be possible without your generosity. Your support of the facility fueled the success of the first phase of our Campaign for Medicine, which has raised more than $44 million. That is a remarkable and unprecedented milestone in our school’s history.

I hope you will make a point of returning for Reunion Weekend in the future because I look forward to showing you the physical transformation taking place on the MCV Campus. In my view, our new facilities reflect the superior training, compassionate care and curiosity for discovery that have always been hallmarks of our school.

June 13, 2012

Timeless Teachings

In May, I stood on the stage before the Class of 2012. They were bright and clever in the classroom, and adept at mastering clinical skills. But most of all, they had taken to heart the concept of humanism in medicine. The principles their faculty shared through programs such as Project HEART — like treating patients with respect and empathy — came naturally to them.

Convocation 2012

The Dean of Medicine, Jerry Strauss, M.D., Ph.D., addresses the Class of 2012 at the medical school’s convocation ceremony.

So with their diploma, we offered the Class of 2012 a last reminder of those principles, which we hope all our students will embrace. It was in the form of a 10-page pamphlet entitled “Advice for the Journey from M.D. to Physician.” It was brought to our attention by Walter Lawrence, M.D., professor emeritus of surgery. He recommended it because it offers sound advice on the nuts and bolts of being a physician — some timeless teachings.

The authors are Charles L. McDowell, M.D., and William H. Bowers, M.D., pioneers in upper extremity surgery and longtime friends. They are now retired from private practice, but continue as clinical faculty in our Department of Orthopaedic Surgery and in their responsibilities for patients and teaching at the McGuire Veterans Affairs Medical Center. Together, they have more than 90 years of collective experience. Some of that wisdom has been passed on through journal articles and textbooks, and they’ve been invited to lecture at elite medical schools in the U.S. and Europe.

A few years ago, they decided to collect their views on what it takes to grow into a successful physician. Dr. McDowell says their goal was to encourage young physicians to keep studying, and take pleasure in the profession they had worked so hard to enter. They shared their early drafts with peers who told them they should write a book. But they felt strongly that their target audience would never read a whole book on this topic. Instead, they distilled it down so that it could be read in one sitting.

The pamphlet is full of wisdom drawn from their collective experiences, and from their personal role models. In fact, first among their recommendations for newly minted M.D.s is to find their own role models to emulate. There’s also practical advice on listening to patients, eliciting detailed histories and sharpening the powers of observation — skills that are vital for forming an accurate diagnosis. It is a compilation of many of the issues that we talk about during a student’s training, but never have articulated in a concise and approachable form.

Drs. McDowell and Bowers were very generous to donate copies of their pamphlet for us to share with our graduating students. Chris Woleben, M.D., a member of the medical school’s Class of 1997, is now the School of Medicine’s Associate Dean of Student Affairs. In his remarks at our convocation ceremony, he suggested the graduates read it the night before they begin residency training. And while I do hope they’ll get a good night’s sleep on June 30, I also hope they’ll stay up late enough to follow that piece of advice.

Advice For The Journey From M.D. To Physician

In their pamphlet, Drs. McDowell and Bowers include nearly 20 reading recommendations. They note: “The list is an introduction to the literature of human striving, observation and humor with an emphasis upon the doctor’s experience.” The list includes:

  • Aequanimitas and A Way of Life, Sir William Osler (essays on maturation of physicians)
  • The Citadel, A. J. Cronin (the story of a young physician under external pressures; a novel)
  • Arrowsmith, Sinclair Lewis (a story of a physician dealing with family and professional choices; a novel)
  • Middlemarch, George Eliot (a novel)
  • Tender is the Night, F. Scott Fitzgerald (a novel)
  • Ten Fingers of God: The Life and Work of Paul Brand, D. C. Wilson (biography)
  • The Cry and the Covenant, Morton Thompson (fictionalized story of Ignatz Semmelweis’ struggles with science and peers in the early days of understanding the true nature of infection)
  • How Doctors Think, Jerome Groopman, M.D.
  • When All the World Was Young, Ferroll Sams, M.D. (humorous experiences of maturation by a general surgeon)
  • Lives of a Cell: Notes of a Biology Watcher, Louis Thomas
  • The Death of Ivan Ilych, Leo Tolstoy (an example of remarkable skills of observation; a novella)
  • An Enemy of the People, Henrik Ibsen (a principled physician in a serious dilemma; a play)
  • Ozymandias, P. B. Shelley (a poem describing overweening hubris)
  • The Love Song of J. Alfred Prufrock, T. S. Eliot (a poem describing the regrets of a man who did not grasp an essential meaning of life)
  • On Doctoring, 3rd Edition, R. Reynolds, M.D. and J. Stone, M.D., 2001 (compendium of stories and poems)
  • Medicine in Quotations, 2nd Edition, E. J. Huth and T. J. Murray, American College of Physicians, 2006
  • Bartlett’s Familiar Medical Quotations, Maurice Strauss, Little Brown, 1988
  • The Hospital, movie, black comedy starring George C. Scott (performance nominated for Academy Award)

January 13, 2012

The White House Comes to Richmond

It’s not every day that you get to share the stage with the First Lady.

Dean Jerry Strauss shared the stage with First Lady Michelle Obama

Dean Jerry Strauss shared the stage with First Lady Michelle Obama. He represented the 101 medical colleges that signed a pledge to support the Joining Forces initiative.
Photo courtesy of VCU Creative Services

In fact, one of our students was much more precise when she told me afterwards that it was a once in a lifetime experience.

It’s an enormous source of pride for me that our university had the honor of hosting Michelle Obama for her announcement of the Joining Forces initiative. The White House said we were selected because we are a national leader in TBI research and a strong partner with the Hunter Holmes McGuire VA Medical Center.

Medical students at the Joining Forces announcement

About 200 of our medical students were on hand for the Joining Forces announcement, some in the audience and others on stage, sitting shoulder-to-shoulder with service members from Fort Lee.
Photo courtesy of medical student Sneha Kondragunta

The First Lady spoke powerfully about the need to conduct new research in the areas of Post-Traumatic Stress Disorder and Traumatic Brain Injury. And more than 50 deans from the country’s other medical schools were on hand as a visible demonstration of our commitment to doing so.

Today we have a far better understanding of combat-related injuries than when I first learned about them some 40 years ago as a medical student. That was during the Vietnam conflict. Little was known at the time, and there was no formal medical education related to these significant issues. I remember the uncertainty and frustration of caring for the warriors, whose lives had been changed dramatically because of their injuries and battle experience.

Joining Forces

The White House chose VCU for the site of its Joining Forces announcement because our medical center is a national leader in TBI research and a strong partner with the Hunter Holmes McGuire VA Medical Center.
Photo courtesy of VCU Creative Services

However, physicians working in the combat zones were developing new approaches to manage TBI. Some of them, like our chair of Neurosurgery, Dr. Harold Young, applied what they’d learned when they returned to America. Dr. Young partnered with basic scientist Dr. John Povlishock, our chair of Anatomy and Neurobiology. Their research, and that from faculty at other medical schools across the nation, has positioned us today to commit to our service men and women that they will receive the medical care they deserve.

Partnering with Veterans Administration Medical Centers, of course, is vital to meeting that goal. We on the MCV Campus are fortunate to be affiliated with the Hunter Holmes McGuire VA Medical Center and to have Dr. David Cifu leading that partnership. His Department of Physical Medicine and Rehabilitation is one the country’s top programs, and it works alongside the VA to conduct groundbreaking research and to establish nationally recognized clinical programs, like the polytrauma center that treats seriously injured American soldiers and Marines.

I had the honor of standing behind the podium this week. But I could only do so knowing that I was speaking on behalf of our faculty, our students and our alumni who have and will play such significant roles in delivering and improving the care that our veterans and service members receive.

See photos from the announcement.

Watch highlights from the Joining Forces Announcement. (2:11 minutes)

Watch the announcement in its entirety. (33:38 minutes)

August 18, 2011

The Class of 2015: Chosen for their Potential

There are 200 new medical students on the MCV Campus this week. These students were chosen from more than 6,450 applications — our highest number ever, and an incredible increase from the 4,200 applicants to the school in 2005.

White Coat Ceremony

The selection of the Class of 2015 involved more than one year of work by Michelle Whitehurst-Cook, M.D., associate dean for admissions, and the Admissions Committee. Each individual was chosen for their accomplishments and, even more important, their potential.

In this age of health care reform, it is potential that occupies all our minds. We face a projected shortage of physicians in the primary care fields and face much uncertainty over the medical profession at large. For the moment, there is no national plan on the horizon to fix the global workforce problem. And so I believe that our solutions will have to be local. That is the argument I have made in an article published in the summer issue of the Richmond Academy of Medicine’s newsletter.

In it, I describe our school’s plans for encouraging primary care careers, teaching population disease management and forging interdisciplinary training with nursing, pharmacy and allied health that will help to build consensus over scope of practice. Our school already has made progress on these and other fronts, always with our commitment to our patients at the core of our planning.

That message of patient-focused care is what we wanted to impress upon the Class of 2015 at last week’s White Coat Ceremony. This year’s keynote speaker was Internal Medicine Professor Peter A. Boling, M.D., and there is no one better able to inspire future physicians with the message of what a privilege it is to care for patients in times of illness and distress.

Boling joined our school’s faculty after completing his internal medicine residency training on the MCV Campus in 1984. In the early 1990s, he began making house calls, carrying a practice load of several hundred patients, some of whom he has now treated for more than a quarter century.

He champions the house calls approach at the national level and, in a very personal way, here on the MCV Campus. He leads our school’s program that provides in-home primary care for more than 5,000 home-bound, frail adults. It is through his program that each one of our medical students is introduced to this approach to patient care.

Boling could have educated his White Coat audience with a plethora of stats supporting the value of house calls. But instead he told a story. Of a 97-year-old woman who is a master gardener and a retired teacher whose accomplishments sometimes landed her in the local newspaper. These are pieces of her life, he told his audience, of which he would have never learned, except that he visited her in her home.

In her home, he tracked and treated her chronic illness. In her home he met her adult daughter who serves as her care-giver. And it was in her home that he built a years-long relationship with the two of them.

They returned the favor at our White Coat Ceremony when they took the stage to share their wisdom with our medical students. They exhorted the students to listen to their patients, and reminded them that caring for patients sometimes extends to caring for the whole family.

But nothing spoke more strongly than their very presence on the stage, standing alongside the physician who has grown to know them so well.

______________________

Read Dean Strauss’ article published in the Richmond Academy of Medicine’s summer issue of its newsletter, Ramifications: The Physician Workforce: A National Problem Requiring Local Solutions.

April 28, 2011

A New Home for the Medical School

James W. and Frances G. McGlothlin Medical Educatio Building rendering

The medical education building that is currently under construction at 12th and Marshall streets will be named the James W. and Frances G. McGlothlin Medical Education Center in honor of that couple’s remarkable and longtime generosity to the medical school.

Today was unlike any other. Any other in my own personal experience. Any other in our medical school’s history.

Today we announced the latest example of the extraordinary generosity of Jim and Fran McGlothlin. This couple has been longtime friends of the medical school and, specifically, of Dr. Harry Young and his neurosurgery team.

Inspired as they were by his compassionate and skillful patient care, they wanted to make a contribution to the training of future generations of physicians. And with a gift of $25 million, they have made a powerful statement of support for our own medical school’s future.

In recognition of the McGlothlins’ generosity, the Board of Visitors will name the medical education building that is currently under construction at 12th and Marshall streets as the James W. and Frances G. McGlothlin Medical Education Center.

The building will be an important addition to Richmond’s architectural heritage. I.M. Pei’s internationally acclaimed architectural firm, Pei Cobb Freed & Partners, has designed a landmark that, much like the Egyptian Building, will continue to draw visitors more than 160 years after its completion.

And just like that historic structure, our new facility will attract not only because of its design, but also because of the influence it will exert in the field of medicine. Its interior has been thoughtfully crafted to house the most significant renovation to the school’s curriculum seen in 30 years.

This new facility will allow us to help meet the projected physician shortage by accommodating an increase in class size from 200 to 250, increasing the total medical student body to 1,000. Just as importantly, the building will allow opportunities for small-group and even individualized learning. With a focus on team-based, clinically-driven problem solving, two floors will be devoted to the Center for Human Simulation and Patient Safety, where high-tech advances create a low-risk setting for students to confront situations physicians face in clinical practice.

Learning studios

Learning studios are designed for flexibility, with team-based, clinically-driven problem solving in mind.

In addition, the top floors of the new building will house the Massey Cancer Center’s Research Pavilion, which will serve as a hub for clinical trials as well as cancer prevention and control.

In this building, we will pioneer new approaches to training physicians and to research. Even before the McGlothlins’ announcement, it had won the support of alumni and friends who had committed $8.2 million to the medical school’s campaign that encompasses the building as well as scholarships and professorships. With this announcement, we move into a more public phase of our campaign and expect to expand our cadre of supporters who will join the McGlothlins and other donors in making a statement of support for our vision of medical education’s future.

August 25, 2010

New Beginnings

Dr. Jerome Straus III and new student at the 2010 White Coat Ceremony

At the 2010 White Coat Ceremony, Dean Jerry Strauss helped incoming students into their first white coats.

Some people say it’s like drinking from a fire hose. And it’s true. Over the next four years, our first-year medical students must absorb an enormous amount of material about the human body and human disease.

But I say that’s not the real challenge. The true test is learning how to turn all that knowledge into wisdom. Wisdom that will equip them to provide compassionate and skilled care for their future patients.

When I welcomed this year’s incoming students to campus, I reminded them that they are well prepared for this challenge. After all, 6,350 applicants were competing for the 200 seats available in the Class of 2014. This is a highly select group, chosen not just for their test scores, but also for a demonstrated passion for the health care field.

Now that they are here, they will take advantage of an exceptional learning environment. The past five years have brought important changes to the VCU Medical Center, with more than three-quarters of a billion dollars of investment in new and planned facilities, people and programs.

Our new students will first benefit from the renovations to the Gross Anatomy Lab and to the Larrick and Hunton Student Centers. Soon they will also see patients in the Critical Care Hospital — a facility that is visited on a monthly basis by leaders from other medical centers who want to duplicate its innovations. The Goodwin Research Labs, the Molecular Medicine Research Building and renovations to research space in Sanger Hall will give students with an interest in biomedical research an outstanding arena for their studies.

The Richmond community itself will become a place for learning as they find ways to serve its citizens through health screenings, free clinics and even K-12 tutoring.
Those experiences together create an environment for education, healing and discovery. An environment that transforms knowledge into wisdom.

March 22, 2010

Match Madness 2010

When it comes to milestone moments, there’s nothing like Match Day.

Envelopes handed out a noon. Fourth-year students wondering where they’re headed for the next stage of their training. It’s high drama.

And for our students, the celebration that followed was unprecedented.

Ninety-seven percent of our students who were eligible to start a residency program matched successfully. Their success exceeds the national 93 percent Match rate. I count that as a particularly noteworthy achievement because this was the largest Match ever with more than 30,500 applicants competing for not quite 23,000 first-year positions.

Many of our students are headed to some of the most competitive programs across the nation:

  • One matched into Cardio-Thoracic Surgery, taking one of the country’s only 10 such positions.
  • Six matched into Otolaryngology and seven into Orthopedic Surgery, which were two of the most competitive fields for applicants this year.
  • Thirty-six have chosen programs in the VCU Medical Center and dozens more are going to other prestigious programs like the Cleveland Clinic, Johns Hopkins, Emory, Duke, Yale, Brown, NYU, UT Southwestern and the Mayo Clinic and Georgetown.

And we’re equally proud of the 82 students who are going into primary care related specialties. Against the backdrop of the health-care reform debate in Washington D.C., these students are devoting themselves to careers that are essential for delivering compassionate, cohesive care to America’s aging population.

On the VCU Medical Center side of the Match, it was great to see that for the second year in a row our residency programs were totally filled with outstanding candidates. In this respect, too, we are making connections with premiere schools. First-year residents who start in July will come from programs like Dartmouth, Hopkins, Penn, and UNC. The class looks amazing and their board scores and other measures are incredible.

Congratulations to all our students, those going and those coming. Graduation is around the corner, but nothing quite compares to Match Day with its excitement, camaraderie and hope for the future.

September 10, 2009

International Experience Shapes Perspectives on American Health Care

Veronica Sikka, M.D.

Back in the U.S., Sikka is now training in the Department of Emergency Medicine residency program.

When Veronica Sikka, M.D., returned from a month’s rotation in Chandigarh, India, she told me that she had a new appreciation for how the South Asian country had learned to practice very sophisticated medicine with minimal resources.

During the spring of her fourth year in medical school, Sikka traveled to the world’s second-most populous country under the auspices of VCU’s partnership with the Post Graduate Institute of Medical Education and Research. The Institute is located in Chandigarh, a northern city that boasts the highest per capita income in the country and some of the brightest clinical minds in India.

Nevertheless, Sikka found limited beds and staffing and strained financial resources at the Institute, which serves as the city’s Level I Trauma Center. In her experience however, those limitations did not translate into diminished health care quality.
Assigned to the emergency department, Sikka worked long hours, seeing patients and discussing their differential diagnoses and treatment plans with attending physicians. In the midst of her experience, she was reminded of a 2006 Institute of Medicine report that emphasized that U.S. emergency physicians work in a fragmented system of emergency care with limited interhospital and out-of-hospital care coordination, too few on-call specialists, minimal disaster readiness, strained inpatient resources and inadequate pediatric emergency services.

“If we could take the efficiency India has achieved with their access to modern technology but increased emphasis on basic clinical exam skills,” wrote Sikka, “and combine it with American’s current health care resources that are far more abundant than what is available in India, we have awesome potential to address many of the problems highlighted in the IOM’s recent report.”

She offers this as an example: “Rather than immediately resorting to imaging and labs, the physicians there are great clinicians first and foremost—using their clinical skills and acumen to guide patient management as opposed to a lab value or image. Sometimes we get so dependent on tests and imaging here that we forget that perhaps the best judge of a patient’s disposition is not necessarily a blood value or an x-ray but the clinician’s sixth sense of what he or she feels is going on with the patient.”

VCU International Partnership Universities

Our medical school established its partnership with the Institute in 2006 to foster just this kind of experience. Already yielding faculty collaboration in the fields of psychiatry, genetics and internal medicine, it is one of 15 partnerships that VCU has established with international universities and one of three international agreements forged by the medical school.

Psychiatry Professor Ananda Pandurangi, M.D., is director of our partnership with the Institute. He says that it’s a great learning place for our students and residents in various disciplines because of three unique qualities. “They are a top-ranked academic medical center in India, a tertiary care hospital with 64 different medical-surgical specialties and yet they also see a significant number of patients receiving care for the first time from two surrounding states.”

With a bachelor’s, two master’s, a Ph.D., and M.D. to her credit, Sikka’s connection to VCU now spans more than a decade and is ongoing. She is now training in the Department of Emergency Medicine residency program. “VCU is one of a kind in its strong commitment to ensuring students and residents are given access to ample opportunities that will enrich their education and training. I had many opportunities to transfer to other institutions throughout my educational and residency training, but VCU is difficult to match.”

She says that this experience was a wonderful opportunity to “gain a unique insight into how healthcare is delivered in countries that were once third world nations and today are on the cutting edge of medical technology. As we enter a historical era in our country where we are starting to question our healthcare system and determine what we can do to make it better, it is helpful to have an international perspective to inform our national debate.” Wanting to eventually pursue a career that combines both academic emergency medicine and health policy, Sikka believes global perspectives such as the one gained in India will position her well for the coming years.