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08
2014

Cadaver Rounds moves what was a purely anatomical experience into the clinical realm

Cadaver Rounds animation

Table 19 used animation to showcase the unique opportunity they had to CT scan our cadavers. “We used the full coronal CT view of our cadaver as a reference to present each of our findings,” explains team member Abrahm Behnam. A screenshot of the webportal through which the students accessed their CT images serves as the starting point of their presentation. Images courtesy of the Class of 2017′s Abrahm Behnam.

A new twist on the traditional gross anatomy course is giving medical students an unprecedented opportunity to expand beyond basic anatomical observations. For the first time, they can send suspicious tissue biopsies to the pathology lab and even obtain a full body CT-scan of the cadaver itself.

Along with observations made during dissection, those results help them assemble a plausible clinical picture of the cadaver – a picture they then present to their classmates in “Cadaver Rounds.” In the culmination of the gross anatomy course, teams of students describe their cadavers’ major clinical problems, the typical prognosis of possible diseases found, suggest clinical or lab tests relevant to the case and, finally, a likely cause of death.

“Cadaver Rounds has moved what was a purely anatomical experience into the clinical realm,” says M. Alex Meredith, Ph.D., course director and professor of anatomy and neurobiology. The course now challenges students to observe structural anomalies in the body and then ask “what that person’s health profile was like and how those problems may have impacted their lives.”

That’s in line with larger curriculum changes the medical school debuted last year. The new course of study is clinically driven, using the preclinical years to encourage students to think of the patients they will encounter in the future.

With access to reports from pathology and radiology, students now have a self-directed opportunity to confirm, enhance or even refute or explain their observations in the gross anatomy lab. And in August, after all the dissections and other observations are completed, the student teams presented their findings to their classmates.

Cadaver Rounds animation

Table 19’s objective findings, integration and case scenario were presented along with animations describing the pathologic and diagnostic findings. Images courtesy of the Class of 2017′s Abrahm Behnam.

For Meredith, it was “perhaps the best day I’ve ever had as a teacher. The presentations were more than we could have imagined they would be both in content and in style.”

Susan R. DiGiovanni, M.D., assistant dean for preclinical medical education, was on hand for the presentations, too.

“I so wish we had something like this when I was a student,” she says. “I liked anatomy, but we didn’t much feel like future doctors as we toiled in the lab for hours trying to identify nerves, tendons, arteries and veins that had little meaning to us because we had no way of knowing how it related to patient care. There has never been anything like Cadaver Rounds.”

She remembers her own classmates discovering an abnormality during dissection and running over to other tables to compare it to what ‘normal’ looked like. “We never put the story together to think about our cadaver as a patient. Cadaver Rounds has the students looking at their cadavers in whole new light. They thought of them as a person. They wondered what their story was. They played sleuth to put the clues together much as pathologist would.

“I was astounded at the professionalism of the students’ evaluations and how carefully they thought about their ‘first patient’ in such detail. I couldn’t believe their creativity and incredible use of technology. They put many faculty to shame!”

The four teams who earn the highest scores on their presentation received the distinction of “Best Cadavers” along with copies of the recently published biography, “Medicine’s Michelangelo: The Life & Art of Frank H. Netter, M.D.”

2014 Cadaver Rounds Award Winners

Baughman Society Winner: Anatomy Dissection Table 10
Christopher John Hagen
Rebecca Anne Maddux
Lindsey Marie McKissick
Shreya Jagdish Patel
Samay Sappal
Metul Ketan Shah
Sherna Sarvajna Sheth

Benacerraf Society Winner: Anatomy Dissection Table 25
Claiborne Downey
Diane Denise Holden
Sarah Louise Hughes
Vanessa Monique Mitchell
Olga Mutter
Andrew Percy
Taylor Magruder Powell

Harris Society Winner: Anatomy Dissection Table 22
Jamaal Christopher Jackson
Michael Christopher Krouse
Andrew David Lyell
Ye Ri Park
Katherine Ann Pumphrey
Advaita Punjala
Megan Elizabeth Shaffer

Warner Society Winner: Anatomy Dissection Table 7
Harnek Singh Bajaj
Mark Raymond Cubberly
Maria George Hadjikyriakou
Samuel Micah Orwin
Vikash Parekh
Sarah Elizabeth Pauli Smith

08
2014

AAMC features the Class of 2017′s Clay Downey in its Aspiring Docs series

Class of 2017's Clay Downey

Clay Downey has been featured on the AAMC website for his interesting, non-traditional path to medical school

The medical school has a reputation for welcoming non-traditional medical students onto the MCV Campus. One of them is the Class of 2017′s Clay Downey, whose inspiring story has been featured by the AAMC in its Aspiring Docs series.

Their website proclaims: “Clay had a business degree, no science prerequisites, and no experience in a health care setting, but he decided to pursue a career in medicine anyway.”

The feature got its start when the AAMC put out a call for non-traditional applicants to tell their stories. Clay saw it and volunteered.

“I thought it would be a great opportunity to share my thoughts about the process,” he said. “I wasn’t sure if my story could apply to others out there, so I went ahead and gave it a shot.”

The AAMC’s web feature takes the form of a Q&A in which Clay talks about what sparked his interest in medicine and how he took it “one step at a time” on the challenging path to prepare to apply and enter medical school.

“I think being a non-traditional pre-med applicant and waiting to take classes later turned out to be a huge advantage,” Clay told the AAMC. “I already had a degree in business administration, so I was able to schedule only the classes that interested me. I tried to put together classes that fed into each other (i.e., physiology and anatomy), and I think it gave me a much stronger foundation coming into medical school than if I needed to work other classes into my schedule.”

Clay’s process interested the AAMC so much that they worked with him on a second story about his experiences as a medical scribe.

“I worked as an emergency department scribe for two years before medical school. This was the perfect job for me because it gave me incredible exposure to the day-to-day life of a physician, and really reaffirmed my decision to go to medical school.”

15
2014

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.”

04
2014

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

03
2014

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.

01
2014

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