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School of Medicine discoveries

August 2014 Archives


Medical School debuts Cadaver Rounds for first-year students

Cadaver Rounds

The Class of 2017’s Kymia Khosrowani, Kaila Redifer and Andy Green discovered an unusual structure in the course of their dissection. They sent a biopsy to the pathology lab to determine if it was an enlarged lymph node or a mis-shaped adrenal gland as they suspected.

In an era when some other medical schools have dropped or limited the gross anatomy lab, it’s more pertinent than ever on the MCV Campus.

Just as in years past, first-year medical students learn from their “first patient.” But now they have an unprecedented opportunity to expand beyond their anatomical observations. For the first time, they can send suspicious tissue biopsies to the pathology lab and even submit the cadaver itself for a full body CT-scan. In return, as first-year sleuths, they’re asked to assemble a plausible clinical picture of the cadaver from their different observations.

It’s called Cadaver Rounds.

“Each cadaver is different and has a different medical life history,” says M. Alex Meredith, Ph.D., course director and professor of anatomy and neurobiology. “Studying the cadaver has been so valuable in helping students develop a visual picture of the body’s 3-D structure and to see the body’s variability. Now, we are pushing those observations further to estimate – from discovered things like scars, shunts, implants, tumors and the like – what that person’s health profile was like and how those problems may have impacted their lives.” ”

Working in teams, the students dissect the cadaver with intensive study of 20 different regions of the body. Along the way, they make daily logs of important anatomical or pathological findings as well as suspected medical problems from scars, implants and tumors.

M. Alex Meredith, Ph.D.

M. Alex Meredith, Ph.D.

Meredith points out “Some clinical syndromes exhibit multiple pathologies.” By spotting and recording clues along the way, students eventually may be able to correlate separate observations to a single disease process. The reports from pathology and radiology provide an opportunity to confirm, enhance or even refute or explain the students’ observations.

The dissection experience culminates in August, when the student teams formally present their findings to their classmates. They’ll be expected to describe any major clinical problems identified, the typical prognosis of diseases found, suggest clinical or lab tests relevant to the case and, finally, a likely cause of death. As a result, the whole class will have the chance to learn from 32 “first patients.”

Through Cadaver Rounds, students have early exposure to new skills. For example, they test out their dexterity with a scalpel as they slice biopsies and prepare them for the pathology lab. Once submitted, the Pathology Department prepared the slides and Davis Massey, M’96, PhD’96, H’01, associate professor of pathology, read each specimen and provided a standard Path report.

Students also learned how to read a CT-scan thanks to the Class of 2006’s Peter Haar, M.D., Ph.D., who is now on faculty in the Department of Radiology, who arranged the CT scans for all 32 cadavers. He also organized tutorials by the radiology staff for the students to examine and interpret the scans.

Meredith says Cadaver Rounds will ultimately prepare students for participating in Grand Rounds. A medical school staple, in Grand Rounds a physician presents a patient’s case or a new medical advance to an audience consisting of doctors, residents and medical students. Less common now, traditionally the patient would also attend the session.

The four teams who earn the highest scores on their presentation will receive the distinction of “Best Cadaver” along with a copy of the recently published biography Medicine’s Michelangelo: The Life & Art of Frank H. Netter, M.D. Netter was described in a NY Times book review as “possibly the best-known medical illustrator in the world.”

Meredith was a medical illustrator himself (Hopkins, 1978) before completing his Ph.D. in anatomy on the MCV Campus in 1981. He says “Cadaver Rounds has moved what was a purely anatomical experience into the clinical realm.”


Alumna Mary Beth Steinfeld recalls her father’s tenure as Dean of the Medical School

Jesse Steinfeld, former dean of the medical school and former U.S. Surgeon General

Jesse Steinfeld, former dean of the medical school and former U.S. Surgeon General

Jesse Steinfeld, M.D., the 11th Surgeon General of the United States and former dean of the School of Medicine, died Aug. 5 at age 87.

Never reluctant to take a controversial stance when he knew he was right, he stood up for the health of the nation in Washington, D.C., and for the role of the physician in Richmond, said his daughter, Mary Beth Steinfeld, M.D., a graduate of the Class of 1981.

“He spoke to our class on the first day of medical school. He remarked on the general appearance of the class. He said, ‘You all wore suits and were clean-shaven and professional looking when you came for interviews. Here you are now in shorts with long hair and beards. You don’t look like the same people.’ He told us our appearance and behavior will reflect on MCV. If we were going to be physicians we needed to look the part. It embarrassed me at the time, but later I realized how appropriate it was.”

He wasn’t one to mince words for a cause he believed in. Jesse Steinfeld’s passionate and outspoken fight against tobacco use put him on the national radar – and eventually led him to the MCV Campus.

A cancer researcher and top official at the National Cancer Institute, he was named Surgeon General in 1969 by President Richard Nixon. In office, he was outspoken about the dangers of smoking.

Under his leadership, cigarette manufacturers were required to strengthen the label on cigarette packs to the familiar, “Warning: The Surgeon General has determined that cigarette smoking is dangerous to your health.” He advocated for a ban on smoking in restaurants, airplanes and other public places, a visionary concept that took several decades to come to fruition.

By all reports, it was for these radical ideas that he was forced out of office by the Nixon administration.

When recruited onto the MCV Campus to be dean, Steinfeld had reservations about taking a job in the heart of tobacco country, said his daughter. “It was remarkable, given he was the former surgeon general and so prominent in his anti-tobacco stance.

“He questioned the Board’s wisdom. One of the board members told my dad that they wanted to prove that MCV was an academic center with academic freedom and that they had the power to appoint whomever they wanted. “I knew it was a big deal, but I didn’t realize how conscious the people who recruited him were about that freedom,” said Mary Beth Steinfeld, who serves as an associate clinical professor of pediatrics at the UC Davis School of Medicine.

And surprisingly, said his daughter, Steinfeld had no conflicts or confrontations with area tobacco companies during his time in Richmond.

“I’ve been working in academic medicine most of my career and so over time I’ve come to appreciate how remarkable his jobs and achievements were.”

Jesse Steinfeld with his wife Gen and their daughters (left to right) Susie, Mary Beth and Jody

Jesse Steinfeld with his wife Gen and their daughters (left to right) Susie, Mary Beth and Jody

Steinfeld’s tenure on the MCV Campus, which ended in 1983, was marked by significant achievements, including increased research funding, increasing the number of residency positions, equalizing practice plans and stressing preventative medicine.

Though always professional and demanding of excellence in his students and staff, Steinfeld had a lighter side, recalled his daughter. “My class was full entertainers. They made up songs about our med school experiences.

“My mom and dad enjoyed having the med students over to their house at graduation for a barbecue, with chicken, beans and so on. The students seemed to like it, too.”

And so the Class of 1981 composed “Cold Beans at the Dean’s.”

“My father loved that song,” recalled Mary Beth Steinfeld.

Leaving Richmond for the Medical College of Georgia was a bittersweet time for the family, said Mary Beth Steinfeld. “They really liked Richmond.”

One of her fondest memories is sitting with her family at dinner, discussing ideas and people. “We had an ongoing habit of constantly debating ideas, and we were always trying to make our father laugh and be proud of us.”

Jesse Steinfeld was proud of Mary Beth’s medical career. “On my first clinical rotation, I took care of an elderly woman who was hospitalized due to heart failure. She needed to gain weight, so I stayed by her side and fed her a milkshake and talked to her. It took hours.

“I remember feeling sad for her when she told me her family didn’t visit. The next morning I told the intern, with pride, that she’d gained five pounds! The intern panicked, saying, ‘Oh no, her lungs are filling with fluid due to congestive heart failure!’

“Nevertheless, my father always remembered that I took the time to feed her that milkshake and listen to her. I think it made him proud of me.”

Jesse Steinfeld was a tireless advocate for preventative care and the importance of diet and exercise. When he was leaving in 1983, he told The Richmond News Leader, “As a faculty, we have to have both the time and the inclination to teach preventative medicine. Physicians, as a rule, think somebody else is telling patients about prevention….Kids are supposed to learn about health in school. But grade schools do a very poor job in teaching about the body and health.”

In later years Mary Beth Steinfeld learned that her father liked to share the benefits of his role as dean. Harold Maurer, M.D., then-Chairman of Pediatrics, recalled that when Main Hospital was built in 1982, Steinfeld got control of the emptied East Hospital. Mauer wrote to Mary Beth Steinfeld to share a memory: “He called a chairs meeting, at their house, to distribute the space. I took two floors, which allowed me to recruit a new division of cardiology. I recruited students to paint the floors on the weekends. Hal Fallon (Chair of Internal Medicine) took two floors and Lazar Greenfield (Chair of Surgery) took two floors. Cary Suter (Chair of Neurology) didn’t want any. What heady times! There are many great stories about Jesse as Dean at MCV.”

This is an expanded version of an article by Lisa Crutchfield that first appeared in the fall issue of 12th & Marshall.


Last seat holds great honor

Bentley Massey

Bentley Massey

Bentley Massey had given up hope of entering medical school this fall, convincing himself instead that the delay was the best thing for him.

“I kept telling myself that it gave me time to mature, to work and to spend time with my family,” he said.

Bentley had been on the waiting list at VCU since early this year, but with July nearly gone and no call, he figured he’d stay in North Carolina, continue teaching middle school science and perhaps enter EMT school. But then, on July 21, Michelle Whitehurst-Cook, M’79, now associate dean for admissions, called with exciting news.

“She asked me how I’d feel about coming to VCU,” Bentley said. “I was so excited, I think I actually started stuttering.”

A typical response from students on the waiting list, Whitehurst-Cook said.

“He was so happy,” she said. “The competition is very heavy, so when they make it, it is very exciting. It’s life changing for them. For me, it’s exciting to be part of that.”

Bentley was not only off the waiting list, but was named the recipient of the Dr. Miles Hench Scholarship. Endowed by Larry Schlesinger, M’71, the scholarship is awarded to the last person admitted to the incoming medical school class on the MCV Campus.

“That last seat has true honor,” said Schlesinger, the last student selected for his class, but who graduated tied for first in class. “It certainly doesn’t define you as least. The last student selected is ahead of thousands of others who will never deliver a baby or help save a life.”

Bentley isn’t sure of his specialty quite yet, but plans to take Schlesinger’s advice to study hard, sit in the front row and wear a tie to class.

The class of 2018

Total number of applications: 7,830
Total number of interviews: 1,024
Total number of students accepted: 216

“I’m just so proud to be here,” Bentley said. “Whether you are the first one in or the last, it doesn’t matter. What matters is what you do once you are here.”

He can only hope that the next four years go as smoothly as his first few weeks. Because he was not accepted until July, Bentley had a little more than a week to move from his hometown of Wilson, N.C., to Richmond. He wasted little time. He found an apartment on the first day he visited, and a week later his father and girlfriend helped him move. He even got an assist from an unexpected source.

“We were trying to get this big couch up the stairs, and I wasn’t quite sure we were going to make it,” he said. “Then I saw these two athletic guys walking down the sidewalk, so I asked if they could help. They carried that thing right up there and got it situated for us.”

He offered them each $20, but both declined. Then Bentley discovered who they were – Washington Redskins’ cornerback Bashaud Breeland and wide receiver Ryan Grant, in town for training camp.

“Boy, did I feel silly offering them $20!” Bentley said “They were so nice and gracious. I love Richmond!”

Bentley, 24, was a double major – chemistry and math – at Barton College in North Carolina, where he also played baseball. He is an avid volunteer, working with youth baseball groups, Meals on Wheels and with dementia and Alzheimer’s patients. He has shadowed orthopedic surgeons including the Class of 1995’s Robert N. Satterfield who also lives in Wilson.

“I have always dreamed of being a doctor, and now that dream is coming true,” Bentley said. “I’m starting a new chapter in my life, and I couldn’t be more excited. I don’t think I’d be here without the support of my family and friends. I’ve had so many people on my side pulling for me. I just want to make them proud.”

By Janet Showalter


M3 Shikha Gupta is featured columnist in the Richmond Times-Dispatch

Shikha Gupta and JFStrauss IMG_6110

Class of 2016’s Shikha Gupta with Dean of Medicine Jerry Strauss, M.D., Ph.D. and the Strauss Cup

The Aug. 3 edition of the Richmond Times-Dispatch featured the Class of 2016’s Shikha Gupta as a guest columnist.

Her first-person account describes how the medical school’s new curriculum and the new McGlothlin Medical Education Center are changing the way medicine is taught. She writes: “the architecturally inventive and academically advanced McGlothlin Medical Education Center – the new (and vastly improved) home of the medical school.”

As a third-year medical student who began her studies in 2012, Shikha has experienced what medical school is like both before and after the opening of the McGlothlin MEC. As a result, she has speaks from personal experience about the transformation that is taking place.

You can read her column, The evolving education of our medical wizards, that was adapted from the spring 2014 edition of Ramifications, a quarterly publication of the Richmond Academy of Medicine.


Class of 2016’s Maximilian Jameson-Lee named to G. Watson James III, M.D. Scholarship

The Class of 2016’s Maximilian Jameson-Lee

Class of 2016’s Maximilian Jameson-Lee

On May 1, more than 40 students participated in the annual Medical Student Research Day.

This year’s Research Day saw a dramatic increase in the number of students presenting as a result of a change to poster session format. “In the past we had oral presentations and, because of limited time, only about 10 to 15 of the submitted abstracts were chosen for presentation,” said Gordon Archer, M.D., senior associate dean for research and research training in the School of Medicine. “This year the poster session format – and the poster printer purchased by our office – made it possible for everyone who did any summer research to present their work.”

Some of the presenters were past participants in the school’s Student Summer Research Fellowship Program, a two-month program between the M1 and M2 years in which students perform research under the guidance of a faculty member in the medical school. Other medical student presenters conducted research under the guidance of a medical school faculty mentor outside of the summer program.

Each year, three awards are given for the most outstanding presentations and research projects. The $1,000 first prize is made possible by the G. Watson James III, M.D. Scholarship Endowment that carries the name of a 1943 graduate of the medical school who went on to become Chairman of the Division of Hematology. At his death in 2001, James’ friends and family established the scholarship that goes to the medical student who wins the research competition, a fitting legacy for the outstanding physician-scientist. The second prize of $500 and $250 third prize are funded by the School of Medicine’s Dean’s Office.

Judges assessed the competition through various criteria in order to determine the top three presentations, including a coherent hypothesis, the presenter’s understanding of the background information of their research topic and the level of their participation in the experimental work. Finally, the judges scored the students based on the quality of their poster presentation and their ability to articulate findings and conclusions.

This year’s James Scholarship winner is the Class of 2016’s Maximilian Jameson-Lee. After earning a bachelor’s degree at the University of Florida, he went on to the National Institutes of Health to conduct infectious disease research. He then completed a Ph.D. in Immunology and Cancer from the University of Virginia and post-doctoral studies at Naval Research Labs in Washington D.C.

At Student Research Day, Max presented findings from a bone marrow transplant study that sought to refine the match between bone marrow donors and recipients for improved outcomes. Max explains that, today, bone marrow transplants are matched at 8 genetic locations and for blood type. For approximately the same price, whole exome sequencing looks at over 20,000 loci, which opens the door for a much more individualized approach. Less expensive than whole genome sequencing, exome sequencing analyzes just the coding regions of the genome.

Working in the research lab of Amir Toor, M.D., Max’s team performed whole exome sequencing on nine bone marrow donor/recipient pairs, searching for genetic differences. These differences could potentially cause the new immune system from the donor to recognize the recipient as foreign, thereby triggering an immune response that could produce adverse events such as graft vs. host disease. His research group found large differences on the genomic level but were not able to correlate those differences with transplant outcomes.

By Anish K. Desai


M.D.-Ph.D. candidate Julie Bonano attends 64th Annual Nobel Laureate Meeting

Chair of surgery

At the 64th Annual Nobel Laureate Meeting, Julie Bonano met Nobel Prize winner Ferid Murad, M.D., Ph.D., a clinical pharmacologist whose studies were the basis for much of Julie’s early coursework.

Julie Bonano felt a rush of excitement and then a little apprehension when she spotted Nobel Prize winner Ferid Murad, M.D., Ph.D., across the room. This, after all, was a man she deeply admired.

It also was the chance of a lifetime. So Julie, an M.D.-Ph.D. candidate in the medical school, took a deep breath and introduced herself. In a matter of seconds, the butterflies fluttering around in her stomach had vanished.

“He immediately invited me to sit down with him at the table,” she said. “We talked for close to an hour about his research and his career. It was incredible.”

Julie, who will graduate in 2017, met Murad during the 64th Annual Nobel Laureate Meeting in Lindau, Germany, earlier this summer. She was one of 600 young researchers from 80 countries selected to attend. Ahmad Altarifi, Ph.D., who graduated from VCU in 2013 and is now an assistant professor in Jordan, was also chosen.

“Having two VCU students selected is significant,” said Steve Negus, Ph.D., professor of pharmacology and toxicology and mentor to both Julie and Altarifi. “Julie is a very talented student and is certainly representative of the top tier of student here. She is special.”

Julie works in Negus’ lab and is studying the behavioral effects of designer drugs of abuse, including the principal ingredients in bath salts. After completing her M.D.-Ph.D. program, she hopes to pursue a residency in anesthesiology and a fellowship in pain management while continuing her research on drug addiction.

“I love taking care of patients and I love research,” she said. “For me, it’s always been about helping people.”

Julie, 26, grew up in Raleigh, N.C., and graduated from the University of North Carolina at Chapel Hill in 2010 with a double major in biology and Spanish. During the second week of her freshman year, she joined a cell and developmental biology lab, studying infertility. She later moved to cancer research, exploring how cancer invades the brain.

“I wanted to explore the brain more, which led me to investigating how drugs affect the brain,” Julie said. “It’s become a passion of mine.”

Julie at meeting

Connecting with other young researchers from around the world, Julie says, was one of the best parts of the meeting. “We all come from different places and from different backgrounds. Yet we all have the same passion for science. It was so inspiring to be a part of that.”

That passion, Julie said, began in high school during a stem cell research project.

“That really opened my eyes to science and what science can achieve,” she said. “It’s amazing to think of the possibilities – how science can improve our world.”

During her trip to Germany, Julie met dozens of other students who also want to make a difference. They all had the chance to meet some of the 37 Nobel Prize winners in attendance and sit in on lectures and panel discussions.

“When I was chosen, I was excited, shocked and humbled,” Julie said. “I knew it would be incredible, but the actual experience exceeded every single expectation I had. I was surrounded by people who have made the greatest scientific contributions to our society – to have them all in one place at the same time was unbelievable.”

Perhaps even more outstanding, Julie said, was making friends with other young researchers from around the world.

“We all come from different places and from different backgrounds,” she said. “Yet we all have the same passion for science. It was so inspiring to be a part of that. It reinforced what I want to do, and I left there with a new energy to make a difference.”

By Janet Showalter

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