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24
2015

MD-PhD student and young alumnus take leadership roles in country’s second-largest physician group

Ali M. Khan

Ali M. Khan, M’09

The Class of 2009’s Ali M. Khan and current M.D.-Ph.D. student Chelsea Cockburn have recently taken on leadership roles with the American College of Physicians, the second-largest physician group in the U.S.

Ali M. Khan, M’09, is chair of the American College of Physicians’ National Council of Resident/Fellow Members. He has served on the national council that represents the interests of over 22,000 residents and fellows-in-training since his intern year at Yale-New Haven Hospital. In his senior year of residency, Khan was elected by the 11-member council to serve as its chair-elect who represents the voices and interests of the resident and fellow members on the ACP’s Board of Governors. Now he has transitioned into the chair’s seat and serves on the Board of Regents, the ACP’s highest governing body.

“Since graduating, the bulk of my health policy and advocacy work has lived in the ACP,” says Khan who has also served on the ACP’s public policy and medical practice committees.

“Over the past five years, my work has focused primarily in two arenas: furthering the college’s role as a hub of leadership training and development for trainees and, accordingly, focusing our role as a council in catalyzing the value proposition and engagement opportunities for trainees.”

He’s helped lead ACP’s High Value Care initiative that educates and engages physicians as well as residents and fellows in how to practice in a value-sensitive, thoughtful manner for resource stewardship and patient engagement. At the ACP’s upcoming annual meeting, he’ll co-host the council’s marquee event, a TED talk-style national forum for promising innovations and bright ideas for teaching high-value care.

When he’s not serving at the ACP, Khan is a clinical innovator and director of physician engagement at Boston-based Iora Health. He practices general internal medicine at Iora’s super-utilizer clinic serving medically complex casino workers in Las Vegas and also serves on Yale’s clinical faculty.

M.D.-Ph.D. student Chelsea Cockburn

M.D.-Ph.D. student Chelsea Cockburn

In April, M.D.-Ph.D. student Chelsea Cockburn began a four-year term on the ACP’s National Council of Student Members, a 13-member group that advises the Board of Regents and Board of Governors on promoting internal medicine as a career and increasing the value of ACP membership to medical students.

She’ll be assigned a region of medical schools in the U.S. and will help advise the internal medicine interest groups at those schools to strengthen activities at the chapter level. She’s also been selected to represent the council on the ACP Education and Publication Committee that provides scientific and professional information to physicians, trainees and patients.

Council members organize programming for medical students at the national ACP conference every year, and Cockburn will attend the annual meeting in Boston later this month. “I’m really excited to get to meet the rest of the council members as well as network with Internal medicine physicians,” she says.

Originally from Harrisonburg, Va., Cockburn entered the M.D.-Ph.D. program in 2013 and in March 2015 began her graduate training in the Department of Microbiology and Immunology. She’s been an admissions tour guide and was a trip leader for HOMBRE, the annual student-led medical relief trip to Honduras. With a strong interest in global health, Cockburn plans on doing a fellowship in infectious disease after a residency in internal medicine.

The ACP is a national organization of internists and is the country’s second-largest medical-physician organization, behind only the American Medical Association. Its membership of 141,000 includes internists and internal medicine subspecialists as well as medical students, residents and fellows. An influential voice in American health care, it’s celebrating 100 years since its founding in 1915.

24
2015

Class of 83’s Wayne Reichman left Baltimore surgery practice to expand access to surgical care in Haiti

Wayne Reichman’s first trip to Haiti in 2013 left him speechless.

“When I got home, I couldn’t talk about the experience for a few days,” he said. “I needed some time to process it all.”

The rubble from the 2010 earthquake still littered the city of Jacmel. Many roads remained unpassable and homeless families continued to struggle.

“Haiti is the poorest country in the Western hemisphere,” said Reichman, M’83. “So many of these people literally have nothing. I simply wanted to do what I was trained to do as a doctor and surgeon – help the less fortunate.”

So Reichman began transitioning out of his vascular surgery practice in Baltimore two years ago to become the medical director of the Jim Wilmot Surgery Center in Jacmel, Haiti. Opened in 2012 and operated by the non-profit Community Coalition for Haiti (CCH), the center provides free surgical care for an impoverished area of 250,000 people and is a sustainable surgical training site for Haitian health care providers. It has three operating rooms, a physical therapy department, pharmacy and primary care clinic.

“The average family earns about $750 a year, so most patients could never afford surgery,” he said. “They are extremely grateful. It can get very emotional.”

Reichman runs the clinic logistics from Baltimore and is on site several a times a year. Other surgeons, nurses and primary care physicians from around the country rotate in monthly, and the clinic typically performs 30 to 40 surgeries a month. Beginning in October, that number will climb to about 75 when more surgeons from all over the U.S. are slated to join the monthly rotation. Each team can comprise student nurses, PT, OT and pharmacy students, med students and residents as well.

Cases include plastic surgical repair of cleft lip and palate, vascular surgery, orthopedics, general surgery, urology and GYN laparoscopic procedures.

“Our clinic is one of the most modern facilities in Haiti,” Reichman said. “We even have air conditioning in the operating rooms and recovery room as well as fluoro and ultrasound capabilities. We don’t have the advanced diagnostic equipment that one would typically expect in the United States. Working in this environment, you become a better diagnostician by relying mainly on your clinical skills,” he said.

“There are no MRIs in Haiti,” Reichman said, “and only one working CT scanner in Port-au Prince that serves a population of about 2.5 million.” The Jim Wilmot facility lacks an ICU ventilator, but he is hopeful two will be donated this year.

Currently eight clinics and hospitals throughout Haiti have partnered under CCH to form a health care alliance to work together to reduce operating costs, but Reichman hopes that number will climb to 12 in the near future. CCH is also planning to build the first pediatric hospital in Haiti to offer oncology, orthopedics, open heart surgery and more.

“It’s pretty amazing what we have accomplished so far,” Reichman said. “There is still so much more to do.”

It’s a good thing, then, that Reichman, 57, has no plans to retire.

“I’ve made a long term commitment to this organization,” he said. “There is a never-ending need.”

Helping the underserved of Baltimore has always been a part of his surgical practice. But completing medical school and his residency, starting a practice and raising a family monopolized his time so traveling to underdeveloped areas was difficult.

“My children are now grown, so it is a good time in my life for this type of service,” he said. “Life is unpredictable and fragile. I often remember the saying that God laughs at those who make plans. I believe that if you want to do something in your life, just go and do it so you have no regrets.”

His wife and two children have also accompanied him on past trips to Haiti teaching in the schools and shooting video for CCH. Vicky, his wife, is a potter and has worked with the schoolchildren teaching them how to make ceramics and their own cereal bowls. The students are ecstatic when their works of art are complete because it means they no longer have to eat off a Frisbee or piece of cardboard.

“This work in Haiti has become a large part of my life,” Reichman said. “It’s a very moving experience to be a part of this. I am more optimistic where this country is headed. I feel like I have re-established my faith in my craft. Being a doctor comes down to helping people.”

By Janet Showalter

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20
2015

Class of 74’s Tom Kerkering shares tragedies and challenges of fighting Ebola

Tom Kerkering, M’74

Tom Kerkering, M’74, returned to campus to talk about his experiences fighting Ebola in West Africa.

Thomas Kerkering, M’74, H’77, F’79, points to a picture of the tree that was ground zero for the recent Ebola epidemic. A two-year-old child playing near the tree caught Ebola from bat guano, and from there the virus spread to infect over 20,000 people in Guinea, Liberia and Sierra Leone and claim more than 10,000 lives.

The tree is just the beginning — of the outbreak and of Kerkering’s tale. As the keynote speaker of the VCU Global Health Showcase 2015, he would go on to tell some of the tragic, personal stories of the Ebola outbreak that he experienced during his time fighting the virus in West Africa. He offered an insider’s view on how devastating the outbreak was given the cultural differences and realities of providing health care in West Africa.

Long before the term global health was coined, Kerkering put it into practice. For decades the infectious disease specialist has traveled the world. First from a home base on the MCV Campus, later from East Carolina University and now from Virginia Tech’s Carilion School of Medicine, where the professor of internal medicine is also chief of infectious disease at the Carilion Clinic.

Fighting ebola with protective gear

From Tom Kerkering’s blog: There are no dull moments.

Fighting the Ebola virus was a challenge, said Kerkering, not only because of the lack of infrastructure and supplies in the affected countries, but also because of the nature of the virus itself.

“Ebola is unique, because it stood the Hippocratic Oath on its head,” he said. “We were all trained, and we all took an oath to see that the patient comes first. But with Ebola, the safety of the health care worker is paramount. If health care workers get infected, not only is there one less person to help the sick, but they risk infecting more people in the community.”

Kerkering dedicated his presentation to his “his fellow health care workers in West Africa, many of whom are no longer alive.” He feels a deep connection with the people he met during his time fighting Ebola. There was a 78 percent mortality rate among infected health care workers during his time in Africa – of the 138 workers who fell ill at his treatment center, 108 died. A video shot at the treatment center where Kerkering worked showed his friends and fellow heath care workers, many of whom had since succumbed to the virus.

Photo of a medical tent

From Tom Kerkering’s blog: Carilion physician helping fight the spread of Ebola in Africa.

Kerkering talked about the difficulties of accessing patients in remote locations, the tragedies of families ripped apart by the virus and the few miraculous recoveries that he witnessed. He met a couple who had to leave their three young sons behind and travel hours to the Ebola treatment facility. The father passed away, but the mother recovered and was able to return to her family and her village. “Nothing is absolute with Ebola,” he explained, “we don’t know why the virus kills some people and spares others.”

Kerkering also examined some of the precautions employed by health care workers to protect themselves from infection. When working with patients, health care workers donned protective suits that completely covered their bodies and left no exposed skin. The 20-minute process of taking off this protective gear was the window of highest possibility for infection. It made the most menial tasks complicated and time consuming. Kerkering and his colleagues had to develop special procedures for dealing with an itchy nose, a sneeze or a fly caught under the protective equipment – proof that when dealing with such a highly infectious disease even the mundane can be dangerous.

Informational billboard about Ebola

From Tom Kerkering’s blog: Ebola turns the Hippocratic Oath on its head.

Kerkering urged his audience to consider how response to the Ebola outbreak could have been improved. He said that many academic medical centers in the U.S. lacked a framework for responding to the outbreak of an infectious diseases as virulent and lethal as Ebola, and as a result their reaction was often too little and too late.

At the peak of the outbreak in Africa, a consistent lack of beds, ambulances and medical supplies crippled the health care worker’s ability to slow the disease. In many cases support arrived so late that it was no longer needed – treatment centers sat empty and supplies went unused after the number of cases had declined. He hopes that the lessons learned from Ebola can be applied to better prepare for the next outbreak of an infectious disease, and that the personal tragedies he witnessed in Sierra Leone can be better avoided in the future.

Kerkering wrote three blog entries about his experiences while in Sierra Leone. Follow the links below to learn more about his time fighting the Ebola crisis.

Carilion physician helping fight the spread of Ebola in Africa

There are no dull moments

Ebola turns the Hippocratic Oath on its head

By Jack Carmichael

17
2015

Class of 85’s Joe Sherman on “soul to role”

Joseph P. Sherman, M’85, H’88

Joe Sherman, M’85, H’88

Joseph P. Sherman, M’85, H’88, got an early start on Reunion Weekend, making the cross-country trip from Seattle a day early to talk to the M4 Capstone Course about avoiding burnout and maintaining a passion for the profession.

His launching point was the concept of work/life balance. “It’s a bit of a misnomer,” he said. “It implies work is on one side, life is on the other. But it’s all life. And working as a doctor is a role you play. Not who you are. It’s what you do.”

His own career includes a decade working as a general pediatrician at Children’s National Medical Center and Georgetown as well as two international stints. During the first in Kampala, Uganda, he conducted clinical drug trials in mother-to-child HIV transmission prevention. In the second, he went to Cochabamba, Bolivia, where he worked with the Maryknoll Lay Missioners serving the rural, indigenous population in the Andes.

He says those experiences taught him that the key to not just surviving but thriving is to discover who you are and why you do what you do.

Even during his international postings, he always managed to come back for Reunion every five years. His affection for his classmates is clear. He began his presentation with a series of slides from his own fourth year, a time he remembers as full of joy – joy found in a love of caring for patients and in a love of practicing together with his classmates.

But, at one point, he’d just about lost that joy. He and his family had returned from Bolivia where he’d practiced holistic medicine and loved caring for his patients, not just their health, but many facets of their lives. He couldn’t find a situation in America that would allow him to practice in that same way.

“I was disillusioned,” he says of that time in 2009. “I was ready to quit medicine.”

He’s not alone. He cited a shocking statistic that 40 percent of practicing physicians would quit tomorrow if they could afford it.

At his lowest point, he got a phone call from Richmond. It was a mother he’d met when he was an intern in the NICU. “When my baby was born,” she told him, “I was addicted to heroin. He was premature, sick. I was worried and felt guilty. You told me my baby would be ok.”

She explained how the conversation had changed her life. It motivated her to enroll in recovery. She went back to school, and now worked on the MCV Campus.

And her son? The three-pound baby had grown into a football lineman who was getting ready to graduate from college.

“I got into medicine to sit with people through crises in their lives,” Sherman explained. “I happen to know more science and medicine than they do. But that’s not the important part. I wanted to help people.”

Think of the time you first decided you wanted to become a doctor.

What were the circumstances?

What were your hopes and dreams?

What do you remember about your first day of medical school?

Why were you there?

Why were all those other people there?

Did your hopes and dreams change from when you first thought of being a doctor?

What did you notice happening to you as you progressed through medical school?

How were you influenced by your peers and supervisors?

Did you hopes and dreams change?

How are you different than when you started?

Now you are starting residency.

What do you expect will happen to you?

How will you continue to be molded by the expectations of your peers and supervisors?

How will you maintain your hopes and dreams?

That phone call reminded him he still could. So he stayed in medicine, choosing to work part-time in two pediatric clinics: one a safety net clinic and the second based on a hybrid model that is half Medicare patients, half fee-for-service on a sliding scale. “Blue collar concierge pediatrics” he calls it.

Sherman’s schedule allows him to be the primary parent at home for his two teenage children, and he stays active in international medicine through periodic trips to Latin America.

He also makes a point of sharing what he’s learned. He consults with physicians to improve morale and fight burnout by facilitating reflection groups and retreats on spirituality, meaning in medicine and working with integrity and authenticity in today’s health-care environment.

At the M4 capstone Course, he asked the students to recall when they first wanted to be a doctor. From there, he took them on a mental journey to the first day of medical school, to third-year clinical rotations and up to today, when they are ready to start residency. (see sidebar)

“Have your hopes and dreams changed from when you first thought of being a doctor?” he asked them. “In clinical rotations, you’re rewarded for morphing into what other people want you to be. There’s a danger of forgetting who you are and why you want to be a doctor.”

He warned that there would be a similar risk during residency and suggested that they take note of when there is a match of “soul to role” in their work. “Whether it’s in vascular surgery or on hem-onc rounds, take note when you say to yourself ‘I can’t wait to do that again!’”

To help spot these moments in the busy residency years, he suggested journaling or joining a reflection group.

“As time went on, I realized how much my identity as a doctor confused me,” he said, remembering an era earlier in his career. “It became who I am, not what I do. I want you to hold on to the thread that tells you ‘this is why I practice medicine’.”

14
2015

Class of 1975’s Bob Centor warns of wrong diagnoses and dangerously good limeade

Scientists from the symposium

Bob Centor, M’75 (center) was welcomed back to campus by Ed and Rose Marie Shaia. Ed Shaia and his brother Richard established the Harry and Zackia Shaia Lecture in 1965 in honor of their parents who owned the popular Skull and Bones restaurant that served the MCV Campus for so many years. In the 1940s, the couple turned it over to their sons.

For more than two decades, Bob Centor, M’75, says, the name Shaia meant one thing: “The best limeades in town.” It was his regular order when he’d stop in at the Shaia family’s popular Skull and Bones restaurant on the MCV Campus, first as a medical student and later as a faculty member.

Now dean for the Huntsville Regional Medical Campus of the University of Alabama at Birmingham School of Medicine, Centor was back in town to speak as the guest lecturer at the annual Shaia Lectureship, the latest chapter in his long connection with the Shaia family.

“It was my favorite lunch spot for 22 years,” Centor said of the well-known eatery that closed in the mid-1990s after 74 years of feeding hungry medical students and doctors. After so many years of patronage, he joked, “In my own way I helped contribute to this lectureship.”

Centor took time at the beginning of his lecture to recognize some other notables who contributed to his time on campus, although their help focused more on the academic than the gastronomic. He said that Al Zfass, M’57, Reno Vlahcevic, M.D., Harold “Hal” Fallon, M.D. and Orhan Muren, M.D., were important mentors during his time here and helped shape the course of his career. Centor is a past president of the Society for Medical Decision Making, and currently serves on the Board of Regents of the American College of Physicians.

The Shaia family has supported schools on the MCV Campus through the establishment of a number funds. The annual Harry and Zackia Lecture alternates between the Department of Internal Medicine and the School of Dentistry. In addition, medical students benefit from the Harry and Zackia Shaia Scholarship, the Thomas and Mary Shaia Family Scholarship and the Fred and Rose Shaia Scholarship.

Centor’s presentation, titled “Learning How to Think Like a Physician,” focused on the sometimes problematic ways doctors assimilate and analyze information to make diagnoses. He told the audience of students, faculty and residents about some common mistakes physicians run into when they encounter a patient whose symptoms and test results are difficult to explain.

Centor warned against manipulating diagnoses by choosing to ignore facts that conflict with your understanding of what’s wrong with a patient. Physicians, he cautioned, who often work long hours and see dozens of patients, can sometimes fail to take the time to gather enough information about each individual patient to make sure their diagnoses is correct.

Centor presented anecdotes of patients he has seen throughout his career, and asked the audience to guess their diagnosis. He went on to reveal how an undiscovered or unlooked-for piece of information altered the diagnosis drastically.

By Jack Carmichael

30
2015

MD-PhD alumnus Gerald Feldman named president of American College of Medical Genetics and Genomics

Gerald L. Feldman

Gerald L. “Jerry” Feldman, M’84, PhD’ 82

The American College of Medical Genetics and Genomics (ACMG) has named Gerald L. “Jerry” Feldman, M’84, PhD’ 82, president of the national organization for clinical and laboratory genetics professionals. During his two-year term, Feldman plans to embrace new technologies and treatments and improve organizational structure as the field of medical genetics continues to expand.

“Dr. Feldman has a long history with ACMG, and through his extensive committee work, he’s taken an active role in steering us to where we are today,” said Michael S. Watson, executive director of the ACMG, in a news release from his organization. “His institutional knowledge and experience working across the full spectrum of clinical genetics services and education will help our organization going forward, in an era when genomic information promises to play a bigger role in medicine than it ever has before.”

Feldman spent two years as president-elect of the ACMG, serving on various committees and taskforces while preparing for his role as president of the organization. Feldman also works as a professor of molecular genetics, pathology and pediatrics at Wayne State University in Detroit, Mich., where he directs the medical genetics residency and fellowship programs and serves as medical director of the Genetic Counseling Graduate Program.

His principal research focuses on diagnosing and managing patients with genetic disorders. He is co-investigator for the NIH program Inborn Errors of Metabolism Collaborative, which collects data and studies best practices in service of children with rare genetic disorders which prevent them from metabolizing certain fats, proteins and sugars.

Feldman also serves in several clinical roles, among them program director and lead investigator of the Newborn Screening Management Program at the Children’s Hospital of Michigan and director of clinical genetic services at Wayne State. Feldman’s combination of experience in clinical care, education and research makes him uniquely qualified to represent the diverse body of ACMG members.

“The era of the genetic and genomic revolution is here,” said Feldman. “New technologies, new treatments and identification of new genetic disorders will improve patient care in ways we could not have even envisioned a few years ago. I look forward to serving as president of the organization that is leading these efforts.”

The ACMG has more than 1,750 members, among them biochemical, clinical, medical and molecular geneticists, genetic counselors and other health care professionals. As the only nationally recognized medical organization dedicated to improving health through the practice of medical genetics and genomics, the organization seeks to promote medical genetics education, research and access while advocating for its members and other providers of medical genetics services and their patients.

By Jack Carmichael