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31
2015

“You don’t have to leave the United States to find a need.”

Kelli McFarling

This summer, the Class of 2018’s Kelli McFarling (second from right) traveled to both Honduras and Wise County, Virginia, to help provide health care to the underserved. She was struck by the similarities shared by the patients she met.

The Class of 2018’s Kelli McFarling knew the need for medical care was great in Honduras. But she had no idea how overwhelmed she would feel trying to do her part.

“I know any little dent we can make is a good thing,” said the rising second-year medical student. “But it’s frustrating to see how much needs to be done.”

Kelli was one of about 32 students from the VCU School of Medicine to participate this summer in HOMBRE (Humanitarian Outreach Medical Brigade Relief Effort). Started in 2006, this medical mission trip, organized by first-year students under guidance of faculty from the schools of medicine and pharmacy, takes place the summer before their second year. What began with mission trips just to Honduras has grown over the years to include four sites – Honduras – Norte; the Dominican Republic; Peru; and Honduras – Pinares.

“I learned so much about disease from both a pathological and population health perspective,” Kelli said. “It definitely makes me want to be a doctor even more.”

A few weeks after returning from Honduras, Kelli hit the road again, but this time she remained in the United States. As a member of the RAM (Remote Area Medical) team, she traveled to Wise County with 11 other medical students in July to a temporary clinic that provides free medical, dental and eye care to more than 2,500 patients from 16 states.

Did you know?

HOMBRE was first organized as the Honduras Outreach Medical Brigada Relief Effort when students and faculty were traveling only to Honduras. As HOMBRE grew to include more sites, the name changed last year to reflect that growth. HOMBRE is now known as the Humanitarian Outreach Medical Brigade Relief Effort.

“It was an incredible experience to go to both places and see what it was like to be in a third-world country, and then come right back here to Virginia and see the similarities,” Kelli said. “You don’t have to leave the United States to find a need.”

This marked RAM’s eleventh year at Wise. The 12 medical students were among 1,000 volunteers on this year’s RAM team that included physicians, nurses, dentists, pharmacists, podiatrists, respiratory therapists, lab technicians and radiologists.

“Our patients here don’t have access to medical care because the area is so rural,” said Kevin J. Lee, M’09, who led VCU’s RAM team this year. “In addition to not having health care facilities, many can’t afford health insurance, or the insurance they can afford has huge deductibles.”

The three-day clinic is an invaluable experience for students, Lee said, because it takes them outside their comfort zones.

Kevin J. Lee

Kevin J. Lee, M’09, has volunteered with Remote Area Medical in Wise County, Virginia, for five years. This summer he led VCU’s RAM team.

“They are seeing things they may not necessarily be exposed to otherwise,” he said. “For example, in school they generally listen to normal heart and lung sounds, or somewhat well managed chronic problems. Here, they tend to hear far more unusual murmurs or lung sounds, as well as complex medical conditions stemming from longstanding untreated chronic medical problems and a significant lack of resources.”

At this year’s clinic, many patients waited in line all day to see a doctor. When they first entered the triage area, they were seen by volunteer nurses. The general medical team then met with them, with third- and fourth-year medical students conducting interviews and evaluations under the supervision of attending physicians. From there, they were either set up with a treatment plan or directed to other specialties.

“I was all over the place,” Kelli said. “I helped with pelvic exams, I helped remove skin lesions and even assisted with tooth extractions. That’s what makes RAM so special – the interprofessional care. It was amazing as a student to have this kind of experience.”

HOMBRE provides interprofessional care as well, with medical, pharmacy and physical therapy students working alongside faculty from VCU’s Medical College of Virginia Campus to treat the medically underserved. This summer, for example, the Dominican Republic team treated about 900 patients over a 10-day period.

“We empower the students to be the primary care providers,” said Mark Ryan, M’00, a site leader for the Dominican Republic team and assistant professor for the Department of Family Medicine and Population Health. “We are asking a lot, but they answer to it. We have a lot of confidence in them.”

A working medical student

Twelve VCU medical students were among 1,000 volunteers on this year’s RAM team. Physicians, nurses, dentists, pharmacists, podiatrists, respiratory therapists, lab technicians and radiologists provided care to more than 2,500 patients from 16 states.

Students worked in pairs. A medical student might have been paired with a pharmacy student, for example, so they could experience team-based care. They conducted patient interviews, performed exams and presented their findings to faculty. They worked as a team to formulate a treatment plan. This approach allows student teams to independently evaluate patients, while ensuring necessary supervision and teaching takes place.

“They are not only providing meaningful service, but come out of it with significant professional growth,” said Ryan, medical director of the Hayes E. Willis Health Center. “They are seeing such a wide range of cases, which really builds their confidence.”

Whether the students are volunteering with RAM or HOMBRE, the cases they see can be quite similar. Patients are often suffering from hypertension, diabetes, high cholesterol, depression, chronic back issues, arthritis and tooth decay. In Wise, where long-term tobacco use is common, many patients also suffer from respiratory issues and even cancer.

“The similarities were shocking,” Kelli said. “In Honduras, I became appreciative of the aspects of health related to infrastructure. Lack of clean drinking water, working plumbing and health literacy were all major factors negatively impacting patients’ health. Lasting impacts in Honduras require more than just a few day’s work. In rural Virginia, the basic infrastructure was in place, but access to health care is limited by costs and distance.”

In both locations, patients return year after year, often seeking out the same doctor or student they saw the year before.

“This summer, a man I see every year came up and gave me a big hug,” said Lee, who has been traveling to Wise for five years. “He had this smile on his face as he told me he had found a job and would have health insurance. He was so proud.

“The best part was he was there this year to sign up as a RAM volunteer. After all those years of being the one in need, he was back to serve. That was so incredible to hear and very emotional for me. What a testament to how much the people in the community feel we are making a difference.”

By Janet Showalter

20
2015

Alumnus and faculty member Mark Hom teams up with cycling legend to spotlight the science of fitness

Mark Hom, H’92

His interest in physical fitness led Mark Hom, H’92, to write a book that focuses on the crucial role mitochondria play in exercise, disease prevention and nutrition. Here he’s pictured breaking away on a Richmond Area Bicycling Association club ride. Photo by Allan Cooper

As he approached his 50th birthday, Mark Hom, H’92, made a pact with his wife that they would try to stay in great shape as they got older. They both took up cycling and, after struggling to pedal only a few miles when they first began, they now log thousands of miles on their bikes each year. His interest in physical fitness, and in cycling specifically, led him to write a book on the subject. “The Science of Fitness: Power, Performance and Endurance” focuses on the crucial role mitochondria play in exercise, disease prevention and nutrition.

In a recent article in the Richmond Times-Dispatch by Louis Llovio, Hom described how mitochondria – the power plants of our cells – convert food and body fat into the energy we need to exercise. Mitochondria multiply in response to intense exercise and diminish from lack of activity. Because their role in fitness and health is so central, it’s important to take care of your mitochondria to ensure top physical performance and to prevent the diseases of the modern age such as type 2 diabetes, obesity and metabolic syndrome.

“My analogy is that since mitochondria are inside your body and inside your cells, it is up to you to be a good shepherd to your mitochondrial flock by feeding them, making them strong and protecting them.” That translates into supplying them with good nutrition and exercising with intensity, while avoiding toxins that might weaken them.

“The Science of Fitness: Power, Performance and Endurance” can be found online at Amazon.com. The book is also available in Richmond at Barnes and Noble’s Libbie and Short Pump locations.

When he began writing the book, Hom, an assistant professor of radiology at the School of Medicine, started thinking about examples to demonstrate the importance of mitochondria’s role in fitness. As a cyclist, his thoughts quickly turned to one of the sport’s legends: Greg LeMond. LeMond. The two-time World Champion and three-time Tour de France winner obviously had superior mitochondria to power those wins but also suffered a near-fatal hunting accident in 1987 that knocked him out of cycling at the peak of his career.

After he recovered from his wounds, LeMond rebuilt his fitness to win again, but later suffered from muscle weakness and a lack of endurance. A muscle biopsy revealed the hallmark ragged red fibers of mitochondrial myopathy.

Mark Hom, H’92

Mark Hom, H’92

Hom, familiar with LeMond’s story, says this diagnosis was a seminal event in mitochondrial disease awareness. The lead shotgun pellets from the accident leaked toxins into LeMond’s body, damaging his mitochondria and prolonging his recovery time. Diagnosed with mitochondrial myopathy, LeMond was forced to retire from bike racing in 1994 when he still should have been in his prime years.

Because LeMond’s story presents such a poignant example of the connection between mitochondria and fitness, Hom decided on a whim to send an early draft of his book to the famous cyclist.

To his surprise, LeMond responded with a long email and agreed to co-author the book. LeMond, who always sought coaches knowledgeable in physiology, says that physical training needs a more scientific approach as described in this book, something that trendy fitness books tend to lack. He has also gained a deeper understanding of how mitochondria shaped the high and lows of his cycling career.

Hom hopes that his book can be a guide for others looking to get in shape and understand the science behind fitness.

“My book is meant to help anyone at any age or fitness level to be as energetic and healthy as possible. We have different chapters on exercise, nutrition, maintaining muscle mass, slowing the aging process, and staying mentally sharp. Getting older is difficult enough. You don’t want to get old and have diseases too, especially diseases that can be largely prevented with exercise. For younger readers it explains why exercise should begin at an early age, in this era of childhood obesity.”

For his part, Hom plans to continue tending his mitochondrial flock on long, intense bike rides with his wife.

By Jack Carmichael

19
2015

Resident and student take top honors in skills competition at vascular surgery conference

Dan NewtonIn addition to participating in the surgical skills competition, third-year general surgery resident Dan Newton, M’12, presented original research: Contemporary Outcomes of Isolated Iliac Artery Aneurysm Repair.

Dozens of medical students and surgical residents faced off in a skills competition at the 2015 Vascular Annual Meeting. Organized by the Society for Vascular Surgery, the meeting was held June 17-20 in Chicago.

The clinical skills competition drew 40 residents and 48 fourth-year medical students. Dan Newton, M’12, and student Grayson Pitcher had known about the opportunity beforehand, but had not known what it would entail.

While there was no way to specifically prepare, “the vascular surgery rotation at the VA Medical Center gave my technical skills a huge boost,” said Newton, a third-year general surgery resident. “Out there we primarily work with Dr. Michael Amendola, who has been an incredible teacher and mentor, and really sparked my interest in vascular surgery.”

“Our residents get extreme exposure,” noted Amendola, M’02, H’07, F’09, pointing out that the McGuire Veterans Administration Medical Center has the fifth busiest vascular surgery schedule in the nationwide VA system.

Newton was one of three residents to receive perfect scores on five timed stations that tested different skills like suturing, suture identification and knot tying without putting any stress on the item being tied.

Newton plans to apply for a vascular surgery fellowship this year. “The field has a great mix of big open cases and minimally invasive endovascular procedures,” he said. “It is also based heavily in physics and geometry, so it just sort of clicks for me.”

Grayson Pitcher during the skills competitionRising fourth-year student Grayson Pitcher during the skills competition at the 2015 Vascular Annual Meeting.

Rising fourth-year student Pitcher also was awarded a perfect score along with two other student participants. The fourth-year medical student competition’s tasks included a two-minute station at which they had to tie knots to the tab of a lightly weighted soda can without moving the can from a designated circle. Another event involved closing a 3 cm slit on a plastic tube.

Dr. Rahul Anand does a phenomenal job with the M3 surgical clerkship,” Pitcher said. “Because of him and the rest of the surgical faculty, I believe every third-year student at VCU has an advanced set of surgical skills and knowledge after their clerkship.”

For Pitcher, though, the event was less about the competition and more about the ability to network with vascular surgeons who were assigned to judge each station. He met faculty from across the country and was able to learn more about vascular surgery programs at a number of medical schools. That knowledge will be useful when he applies to vascular surgery residencies this fall.

Pitcher grew up with a balance of art, music and sports in his life. As a result, “I love anything creative, and it reflects in my personality in that I am very patient and obsessive compulsive about projects and detail. I always thought surgery would be a great fit. I loved how intricate and meticulous the vascular procedures were.”

He, too, credits the mentorship of assistant professor Amendola for his success. “My experience inside and outside the operating room with him has been an instrumental reason for choosing vascular surgery.”

Amendola, in turn, points to his experiences when he was a trainee with Richmond vascular surgeon Ronald K. Davis, M’63, H’69, and his MCV-trained practice partners. Amendola emulates the examples they set and prioritizes his role as a mentor, knowing it’s one of the most influential factors when students choose a specialty.

“The real reward in academic medicine is influencing the surgeons of tomorrow,” he said. “Dan and Grayson are going to be fantastic vascular surgeons.”

29
2015

Dozen with ties to medical school played roles at ACP’s Internal Medicine 2015 meeting

The American College of Physicians is the second-largest physician group in the United States. Its annual meeting, also its centennial celebration, was held April 30 – May 2, 2015, in Boston, Mass. From behind the scenes to center stage, a dozen with ties to the medical school played roles at the meeting.

Fisher,John-M69

John F. Fisher, M’69, H’77

John F. Fisher, M’69, H’77, received the Jane F. Desforges Distinguished Teacher Award at the American College of Physicians’ national meeting in Boston, Mass., on April 30, 2015.

A professor emeritus of Georgia Regents University, Fisher’s academic career spans 38 years. The ACP honor is that latest of nearly five dozen teaching awards, including the Clinical Teacher Award from the Infectious Diseases Society of America, the ACP Georgia Chapter’s J. Willis Hurst Teaching Award and two dozen Educator of the Year awards from Georgia Regents University.

During residency training at VCU, he was given the William Harrison Higgins Award. As an infectious disease fellow, he received the Best Fellow Award two years in succession. Following his training, Fisher joined the faculty of the Medical College of Georgia (now Georgia Regents University), where he was professor of medicine and program director for the Infectious Disease Fellowship. He also served as chief of the Division of Infectious Diseases at the VA Medical Center in Augusta, Ga.

Fisher has served on the education committees for both the IDSA and the National Foundation for Infectious Diseases. He has 101 publications including 57 articles in refereed journals and 44 book chapters. At the ACP annual meeting, he was advanced from Fellow of the American College of Physicians to Master of the American College of Physicians.

Wenzel_Richard

Richard “Dick” P. Wenzel, M.D.

Richard “Dick” P. Wenzel, M.D., was the Massachusetts Chapter Lecturer at the ACP meeting. An emeritus professor and former chairman of the Department of Internal Medicine, Wenzel has been long been involved with the ACP and has frequently presented at the annual meeting, keeping physicians up to date with the latest information on topics in internal medicine and infectious disease. His topic at Internal Medicine 2015 was evidence-based physical diagnosis.

In 1988, the Massachusetts Chapter Award Lectureship was established to honor a distinguished Massachusetts internist and to honor an outstanding member of the annual meeting faculty. Today, the recipient of the award is selected by the chair of the Internal Medicine Scientific Program Planning Committee.

Robert Centor

Robert M. Centor, M’75

Robert M. Centor, M’75, concluded his one-year term as chair of the ACP Board of Regents at the annual meeting. The Board of Regents is the main policy-making body of the College.

A member of ACP since 1978, Centor was named a Fellow of ACP in 1985 and became a Master of ACP on October 1, 2014. He has served on the Board of Regents since 2008 and also on many of ACP’s committees, including the Membership Committee, Finance Committee, Strategic Planning Committee and the Health and Public Policy Committee, which he chaired from 2009-2011. Centor was awarded the Laureate Award for outstanding service to medicine and ACP from the Alabama Chapter of ACP in 2009.

He is currently professor of medicine and regional dean of the University of Alabama at Birmingham, Huntsville Regional Medical Campus. He was on the internal medicine faculty on VCU’s Medical College of Virginia Campus until 1993.

Ellis,Lisa-M01-H04

Lisa L. Ellis, M’01, H’04

Lisa L. Ellis, M’01, H’04, chaired the Scientific Program Committee that created a mix of small group sessions, classic lectures and hands-on activities for the annual meeting. Faculty presented new findings in internal medicine and its subspecialties, presented new approaches in practice management and discussed issues related to health care policy as well as lead sessions to hone leadership and teaching skills.

“When I attend each year, I bring back new ideas for managing patients as well as techniques for enhancing my own leadership style,” says Ellis who as the ACP Governor for Virginia represents the state on the ACP’s national Board of Governors. In that role, she helps implement national projects and initiatives at the chapter level and represents member concerns at the national level. Ellis also is on the Board of Governors’ executive committee, which advises the Board of Regents.

Ellis currently is the chief medical officer for the Medical College of Virginia Physicians at VCU and has an appointment as an associate professor in internal medicine and OB-GYN.

A student and young alumnus have taken leadership roles in the organization:

Khan,Ali-M09-Headshot-IAS-1

Ali M. Khan, M’09

Ali M. Khan, M’09, is chair of the ACP’s National Council of Resident/Fellow Members that represents the interests of over 22,000 residents and fellows-in-training. He’s been on the 11-member council since his intern year at Yale and has helped lead ACP’s High Value Care initiative that educates and engages physicians as well as resident and fellow members in how to practice in a value-sensitive, thoughtful manner for resource stewardship and patient engagement.

At the ACP’s annual meeting, he co-hosted the council’s marquee event, a TED talk-style national forum for promising innovations and bright ideas for teaching high-value care. Moderated by author Sandeep Jauhar, M.D., and the New York Times’ Lisa Sanders, M.D., the event showcased winners from the second annual Teaching Value and Choosing Wisely Challenge sponsored by the ABIM Foundation and the national non-profit Costs of Care.

“We’ve read articles, attended lectures and held forums making the case for value-based care delivery,” Khan says. “Now, however, those words are being bolstered by action – on the ground, at institutions all across the country, led by talented health professionals with the creativity and drive to effect the collective change we seek. Award Winning Innovations isn’t about making the theoretical case for value – it’s about sharing the best work being done nationally to make that case a reality.”

Cockburn,Chelsea-MD-PhD-student

MD-PhD student Chelsea Cockburn

MD-PhD student Chelsea Cockburn began her four-year term as a representative on the National Council of Student Members in April 2015. Council members organize programming for medical students at the national ACP conference every year, and Cockburn attended the annual meeting in Boston where she was looking forward to meeting the rest of the council members as well as internal medicine physicians.

As a member of the student council, Cockburn is 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.

ACP-meeting

ACP attendees with ties to the medical school reunited during the Internal Medicine 2015 meeting. Each year, the Department of Internal Medicine hosts a reception. This year it was held at Boston’s Atlantic Beer Garden overlooking the harbor.

A number of faculty from the Department of Internal Medicine presented at Internal Medicine 2015:

  • Stephanie A. Call, M.D., MSPH, professor in the Division of General Medicine and Primary Care.
  • Alan W. Dow III, M.D., associate professor in the Division of General Medicine and Primary Care.
  • Mary H. Hackney, M.D., associate professor in the Division of Hematology/Oncology.
  • Puneet Puri, M.D., assistant professor in the Division of Gastroenterology.
  • George W. Vetrovec, M.D., professor in the Division of Cardiology.

Others were honored at the meeting:

  • Wendy Klein, M.D., associate professor emerita, was awarded the designation of ACP master and was recognized as the Virginia ACP chapter’s 2015 Laureate winner. Klein was co-founder of the VCU Institute for Women’s Health and was the department’s first program director for an innovative residency in Women’s Health.
  • Curtis N. Sessler M.D., the Orhan Muren Distinguished Professor of Medicine, and professor in the Division of Pulmonary Disease, was named an ACP fellow.
  • John R. Strunk, M.D., assistant professor in the Division of General Medicine, was named an ACP fellow.
  • Darren Witte, M.D., in General Medicine and Pediatrics, was named an ACP fellow.
15
2015

Cardiology’s Ken Ellenbogen honored for exemplary teaching by Heart Rhythm Society

Kenneth A. Ellenbogen, M.D.

Kenneth A. Ellenbogen, M.D.

The Heart Rhythm Society has honored Kenneth A. Ellenbogen, M.D., with its Distinguished Teacher Award, one of five recognition awards it bestows each year.

Ellenbogen is professor and chair of the Division of Cardiology and director of clinical cardiac electrophysiology and pacing. He was nominated by his colleague of 15 years, Indiana University professor of medicine John M. Miller, M.D., who serves as director of clinical cardiac electrophysiology at Indiana University Health.

In his nomination, Miller wrote, “During [Dr. Ellenbogen’s] almost 30 years at MCV, dozens of fellows have benefited directly from his instruction, but his influence is much wider; he is an internationally-recognized leader in fellow education, participating in and chairing dozens of fellow training seminars. In addition, he is in the top echelon of highly-sought speakers at national and international symposia for audiences of academic and practicing electrophysiologists.”

Miller also praised Ellenbogen’s style of presentation and his dedicated mentoring of trainees who have gone on to be influential investigators and educators in their own right.

Ellenbogen has held the Hermes A. Kontos, M.D. Professorship in Cardiology since 2000. He has served the Heart Rhythm Society on its Board of Trustees and as course director of its Board Review Course as well as director of the Cardiology Advisory Board for the VA medical system.

Ellenbogen earned his medical degree at Johns Hopkins and continued his training in cardiology and electrophysiology at Duke University.

At Duke, he trained with G. Neal Kay, M.D., professor emeritus of the University of Alabama at Birmingham. Ellenbogen is a co-author with Kay and others on “Clinical Cardiac Pacing, Defibrillation and Resynchronization Therapy” a go-to resource for those in the field with technical question about implantable devices.

Kay presented Ellenbogen with the teaching award in May at Heart Rhythm 2015, the Society’s 36th Annual Scientific Sessions, held in Boston, Mass.

Kay wrote of his colleague and friend, “not only does Ken teach the art and science of cardiac electrophysiology, but he teaches the character traits needed to be a great physician. He teaches by the example of how he lives his life and how he cares for his patients. He teaches how all human beings are to be respected and he teaches the unique dignity and value of every human life. The very many fellows who have been fortunate enough to train under the mentorship of Dr. Ellenbogen have learned far more than just electrophysiology; they have learned what it means to be a person of true integrity, compassion, and honesty.”

Ellenbogen’s accomplishments are further detailed in an article on page 4 of the Department of Internal Medicine’s spring newsletter.

23
2015

Neurology’s Jack Pellock receives national honors for career-long dedication to the epilepsy community

John M. Pellock, M.D., H’73

John M. Pellock, M.D., H’73

John M. Pellock, M.D., H’73, a professor in the Department of Neurology, accepted the Epilepsy Foundation’s 2015 Champion of Epilepsy Award on April 23 at its “Race for Results” Reception in Washington, D.C.

A pediatric neurologist, Pellock is an internationally recognized expert in epilepsy drug therapy and clinical care. He has been principal investigator for more than 100 trials evaluating epilepsy treatments in children and adults, and has been involved in antiepileptic drug development and studying epilepsy in children for more than 30 years.

“Dr. Pellock’s pioneering work is a testament to his lifelong commitment to serving the epilepsy community and passion for the mission we all share,” said Philip M. Gattone, president and CEO of the Epilepsy Foundation in a news release. “We are grateful for his longtime support of the Epilepsy Foundation and individuals living with seizures, and we are privileged to honor him.”

The Epilepsy Foundation is a national non-profit with nearly 50 community offices throughout the United States. The Champion of Epilepsy Award celebrates individuals whose work has had a positive impact on epilepsy advocacy and awareness.

Pellock earned his medical degree from St. Louis University School of Medicine, in St. Louis, Mo., in 1971, completed housestaff training in pediatrics on VCU’s Medical College of Virginia Campus in 1973 and fellowship training in child neurology at Columbia Presbyterian Medical Center in 1976. He has been on the VCU faculty since 1978 and served as chairman of the division of child neurology from 1995-2014. In 2004, he received the J. Kiffin Penry Award for Excellence in Neurology from the American Epilepsy Society.