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28
2016

Flying Physicians

There IS a Doctor on Board.

For many, the feeling of soaring among the clouds in an aircraft is an unrivaled experience. And if the views weren’t enough, some even find a way to use aviation to serve their fellow man.

Douglas Johnson, M’79

Douglas Johnson, M’79, with the experimental Lancair IV-P that he built himself.

Flying can be a great opportunity for physicians to blend two passions, says Douglas Johnson, M’79. “Physicians go into medicine because they want to help people,” he says. “We want to do a good job at what we do, and want to provide a service that not just anybody can provide. Pilots are the same way.” Johnson is one of a number of medical school alumni who use their aviation skills and knowledge to extend the care they provide.

“Give both groups—pilots and physicians—a psychological profile,” Johnson says, “and you’ll see a lot of similarities, including a drive for success, attention to detail and high ethical standards.” Professionally, there are parallels, too. Cockpit resource management techniques have influenced the way physicians practice medicine today, successfully incorporating checklists, teamwork training, briefings and debriefings, incident reporting, simulator training and standardization.

Johnson, a radiation oncologist in Jacksonville, Fla., is immediate past president of the Flying Physicians Association, a nationwide organization whose members use their love of flying to continue learning and help others.

“We help directly,” says Johnson, who is also an assistant professor of oncology with Mayo Clinic. “We can take supplies and help rebuild after hurricanes, earthquakes and natural disasters.

“After the earthquake in Haiti [in 2010], we were contacted by a hospital there that was short on medical supplies. We got a list of the supplies they needed—and we doubled it. We filled 24 aircraft and flew down to the Dominican Republic, where we loaded them on one big UN helicopter. It flew across the mountain range and landed on the grounds of the hospital, so we knew our supplies got there and weren’t rotting somewhere or being pilfered.”

The Flying Physicians Association is just one of many organizations that encourage physicians to mix medical and aviation skills. Some others include Angel Flight, Fly for Good, Air Charity, Flying Samaritans and even Pilots N Paws, which transports animals.

Some of these groups transport patients for medical treatments, but Johnson cannot. Though he’s been flying it for nearly two decades, his Lancair IV-P is classified as experimental, and most humanitarian organizations do not want an experimental aircraft transporting patients.

It’s a pressurized-cabin aircraft he built himself. It took four and a half years, but he’s thrilled with the result. Building and owning a plane was a dream for Johnson, who was a skydiver during his undergraduate studies because he couldn’t afford flight school. “I was the guy who’d sit next to the pilot and watch. But of course, I never got to see a landing.” After completing his internship, he rewarded himself with flying lessons.

Douglas Johnson, M’79

Many organizations encourage physicians to mix medical and aviation skills. “We can take supplies and help rebuild after hurricanes, earthquakes and natural disasters.”

In addition to humanitarian flights, the Flying Physicians Association also holds CME events and raises funds for the Air Safety Foundation of the AOPA (Aircraft Owners and Pilots Association). Air safety is an important focus of the group, which acknowledges that sometimes physicians have a reputation as risk takers in the air.

Many at VCU remember the impact of the tragic death of Surgery Chair David Hume, M.D., in 1973. When his self-piloted plane crashed in California, its effects were felt for years on the MCV Campus and in the transplant community.

Keeping the nation’s skies safe is top priority every day for Keith Martin, M’80. Though he isn’t a pilot himself, his work as co-founder and chairman of Aviation Medicine Advisory Service (AMAS) affects countless pilots, as he consults with and helps them obtain and maintain Federal Aviation Administration medical certification.

Like Johnson, Martin served in the military as a flight surgeon, tasked with ensuring the well-being of those who fly, control or jump from planes. Flight surgeons aren’t required to be licensed pilots, but do log numerous hours of flight time.

Martin contends with many of the same conditions that concern all physicians today, but in the air, the stakes can be higher. Pilots diagnosed with illnesses such as diabetes, coronary artery disease or depression, or those taking certain medications, until recently could be barred from commercial piloting—and thus lose their livelihood.

For example, he says, “Initially if you were diagnosed as HIV-positive, that was not a problem, but if you went on the treatments, that automatically disqualified you from flying. So what was a pilot to do? Not go on the medications?

“We were concerned that pilots would not seek the health care they needed,” he says. Fortunately, over more recent years, AMAS has worked with the FAA to develop protocols to allow pilots to return to flying in a safe, supervised way.

Several School of Medicine alumni work not only to ensure safety in the air, but also well above the earth’s atmosphere.

Richard Williams, M’79

Richard Williams, M’79, with his rare Nanchang CJ6 Chinese military training aircraft used by the People’s Liberation Army Air Force.

NASA’s Chief Health and Medical Officer Richard Williams, M’79, is responsible for the oversight of all health and medical activities at the nation’s space agency. He works on policy and oversight issues, but also focuses on astronaut health. “It’s a chance to contribute to the destiny of our species,” he says.

“We’re taking a long-range view. The work being done in human space flight, leading to human exploration beyond low Earth orbit, not only represents the ultimate frontier, but it will ultimately help assure our survival.”

On earth, Williams volunteers as a senior aviation medical examiner for the FAA, performing flight physicals for pilots near his home in Fredericksburg, Va. He’s also a private pilot who’s had about 18 different airplanes and logged over 4,000 hours flying single and multi-engine aircraft.

“I live on an airfield and currently own two airplanes,” he says. One is an experimental Lancair 360, the other a rare Nanchang CJ6 Chinese military training aircraft used by the People’s Liberation Army Air Force.

 

WHO ELSE IS UP IN THE AIR? 

Here’s a sampling of some medical school alumni who have used flying as a means to do good.

lillypaulPAUL LILLY, M’64, is a former member of the Air Force who flew more than 50 missions as a flight surgeon in B-52s in the Vietnam War in the late 1960s. Later he trained and qualified as a WSO (weapon systems officer) in the F-15E. He’s committed to caring for pilots and veterans, both as a medical examiner for aviators and a flight instructor. He and several others perform the missing man formation, an aerial maneuver used at funerals or memorials for veterans. Lilly also provides a special experience for veterans who have stopped to visit the D-Day Memorial near his home in Bedford, Va. “We’ll get together at a nearby airport,” he explained. “While the veterans are having lunch, we’ll fly over the memorial and do the missing man formation to salute them. It’s a privilege for us to honor the veterans.” Lilly often is spotted practicing aerobatic maneuvers in his single-engine two-seater RV-8 plane.

JOHN A. GOODNO, JR., M’55JOHN A. GOODNO, JR., M’55, served in the Air Force and has enjoyed volunteering with several organizations after retiring from his OB-GYN practice in California. “I had time to devote to some of these medical missions. I was invited by several groups to join them and go to Mexico.” With the Flying Samaritans and the Flying Doctors of Mercy (also known as LIGA), Goodno and other physicians fly their personal airplanes (his is a Cessna 210) to Mexico once a month to care for the underserved at two active clinics. “It’s been very rewarding. It’s been great experience to get involved with volunteer medicine.”

HARRY A. “BERT” WELLONS, M’61HARRY A. “BERT” WELLONS, M’61, has incorporated flying into his retirement activities. “I was looking for ways to use aviation – I still wanted to fly,” says the cardiothoracic surgeon who now lives in Charlottesville, Va., and currently flies a Piper Mirage. “I have, in the past, done Angel Flights transporting patients from remote locations for appointments at medical centers and a few missions with Veterans Airlift Command which provides transportation for wounded veterans.” He also volunteered to fly soldiers to and from Walter Reed National Military Medical Center.

OWEN BRODIE, M’62OWEN BRODIE, M’62, Brodie is a retired Richmond-area psychiatrist who served as president of the Flying Physicians Association in the late 1980s. Though he recently had to stop flying because of vision issues, he flew volunteer missions with Angel Flight in his Cessna 177RG. It also was a great way to get to meetings, he says.

RALPH RIFFENBURGH, M’47RALPH RIFFENBURGH, M’47, was an ophthalmologist, recreational pilot and FAA medical examiner for years. In addition, he volunteered with the San Bernardino Sherriff’s Department, scouring canyons near his California home for lost hikers and campers. Now 93, Riffenburgh fondly remembers getting a night job as an orderly on the psych ward to afford flight lessons while in medical school. It was the start of nearly 70 years of flying, which culminated with his receiving the prestigious Wright Brothers Master Pilot Award from the FAA for more than 50 years of safe flying.

LEON "SKIP” BEELER III, M’79LEON “SKIP” BEELER III, M’79, isn’t piloting, but like his classmate Richard Williams, is making sure NASA astronauts and employees stay healthy. He’s medical services manager at Florida’s Kennedy Space Center, the site of space shuttle launches until 2011. The massive complex is still active, with the Commercial Crew Program working toward launching Americans from Kennedy in 2017. Regular expendable launches of satellites and Space Station resupply missions are among the many programs and projects ongoing at America’s Spaceport. Working there has unique challenges, he says, like ensuring safety around rocket fuels and caring for the thousands of visitors who tour the site each year. “We ensure that astronauts and supporting staff are healthy enough to keep the program running.”
By Lisa Crutchfield
28
2016

New milestones for Pharmacology and Toxicology Department

Long-running training grant that propelled department to 310 graduates is renewed

When William Dewey, Ph.D., and Louis Harris, Ph.D., first stepped foot on the MCV Campus more than 40 years ago, they had high aspirations for a department struggling to make a name for itself.

They were not only excited by a vision for transforming the Department of Pharmacology and Toxicology into one of the best in the country, but confident they could.

William Dewey

A part of the department for over 40 years, William Dewey, Ph.D.,now serves as its chair. He takes great pride in the department’s success, but refuses to take any credit.

“We both had this goal of turning students into exceptional scientists, to put active scholars out there in the community,” Dewey said. “We were partners in this idea.”

The department traces its roots to the school’s 1838 founding, when pharmacology was an element of the curriculum. When Harris and Dewey arrived in 1972, from the faculty at the University of North Carolina at Chapel Hill, they would be an active part of the
department’s leadership for the next 44 years.

“We knew we had our work cut out for us,” Harris said. “We knew we had to put together a strong team and build a strong foundation.”

Within the first two years of their arrival, the number of students grew to 20 and has been climbing ever since. In May, the department hit an important milestone, marking the 310th scientist to earn a Ph.D. degree. The faculty has also grown, from about a dozen to nearly 40.

“We are very proud of what we have accomplished as a team,” said Dewey, who points to a strong faculty whose high profile research attracts students with great potential.

About two-thirds of the faculty are devoted to drug abuse research. Others are focused on cardiovascular, gastrointestinal and cancer pharmacology. None of their work would be possible without federal grant money, something that also has grown steadily over the years.

For fiscal year 2016, the department’s 64 federal grants totaled $14.2 million. One of the most important is the long-running training grant, renewed over the summer by the National Institutes of Health. The grant, specifically for training pharmacologists in drug abuse research, amounts to about $3 million over five years. It will pay the stipends for nine pre-doctoral students and six post-doctoral scholars.

“I would not be here if it weren’t for the training grant,” said Jacy Jacob, a third-year Ph.D. student. “A lot of us would not be able to pursue our dream without it.”

Jacob is working in Dewey’s lab with two other graduate students researching the effects of ethanol on reversing opiate tolerance. She accumulated student debt while earning her master’s degree in pharmacology and toxicology, also at VCU. She had no desire to add to it.

“This means everything to me,” she said.

Dr. Louis Harris

Department chair for 20 years, the influence of Louis Harris, Ph.D., continues to this day.

The department has held the training grant since 1976, making it one of the longest-running in the country. Over its 40-year history, the grant has supported the education of 174 scientists. And when it was reviewed for five more years, the committee gave the application a perfect score.

“Clearly this is a very prestigious thing for us. It puts us on the map as one of the largest departments in the country,” said Hamid Akbarali, Ph.D., co-director with Dewey on the training grant and vice chair and director, graduate education and postdoctoral training. “It helps us attract top-notch faculty. Scientists and scientists-in-training want to be here.”
Joel Schlosburg, PhD’10 (PHTX), still feels the pull. After spending the last six years in San Diego as senior research associate at the Scripps Research Institute, he headed back to the MCV Campus this fall as an assistant professor.

His time spent in Richmond as a graduate student convinced him there’s no place
like home.

“When it comes to things like drug abuse research, there are few places you can point to that have the same resources and the same collaboration as here,” he said.

“You have the most diverse group of people who bring their own backgrounds, ideas and expertise to the table. It’s incredible. I think that healthy environment is all thanks to the strong leadership of people like Dr. Dewey and Dr. Harris.”

Dewey first met Harris in 1959, when he worked under him as a lab tech in New York. They both served on the faculty at Chapel Hill, where Harris was tasked with creating a graduate program in pharmacology in the 1960s. When Harris accepted the challenge of building up the VCU program, he asked Dewey to come with him.

“We immediately started recruiting faculty and students,” Harris said. “We began applying for more grants to support our research. As the grants came in, we were able to recruit even more. It fed on itself. It’s been a real team effort.”

Harris stepped down as chair in 1992. George Kunos, M.D., Ph.D., currently the director of the National Institute on Alcohol Abuse and Alcoholism, assumed the post at that point, and Billy Martin, Ph.D., took over eight years later as the department entered the new millennium. Martin played a crucial role in building the department’s reputation for landmark research in drugs of abuse.

His primary focus was researching the effects of marijuana’s principal psychoactive ingredient, THC. Martin, who passed away in 2008, also made significant contributions to nicotine research.

With two-thirds of the faculty devoted to drug abuse research, others are focused in fields like cardiovascular, gastrointestinal and cancer pharmacology.

With two-thirds of the faculty devoted to drug abuse research, others are focused in fields like cardiovascular, gastrointestinal and cancer pharmacology.

“We’ve enjoyed strong, passionate leadership throughout the history of this department,” Akbarali said. “They have steered us in the direction we are now in. It really is like a little family here. I can’t imagine myself being anywhere else.”

Dewey has served as chair since Martin’s passing. Now 81, he continues to take great pride in the success of the department. But he refuses to take any credit.

“The chairman doesn’t do it,” he said. “The faculty does it. The people in this department are highly recognized across the country for their expertise.”

Over the years, faculty members have won numerous awards and published thousands of papers in international journals. They serve on national boards and as consultants for the courts. They are invited to lecture across the globe and work with the NIH to evaluate grants.

The students they mentor go on to pursue successful careers in research. Some work in private industry, on college campuses or for the federal government. Others have landed prominent positions with the Food and Drug Administration.

“During my graduate days, I remember my faculty advisor telling me it didn’t get any better than VCU,” said Frank Vocci, Ph.D., who completed his post-doctorate work at VCU in 1978. “He was right. I learned from the best and had the opportunity to conduct research in some fascinating areas of drug abuse.”

Vocci worked in drug abuse liability determination at the FDA and directed the NIDA medications development program before landing his current role as president/senior research scientist at the Friends Research Institute in Baltimore.

“VCU was extremely important to my career,” he said. “It was a great choice for me. They continue to have a reputation for turning out quality people.”

The training grant is tangible evidence of the culture of collaboration that alumni repeatedly reference. “I had heard great things about VCU before I came, but it was even better than I thought,” said Kathleen Brady, M.D., PhD’81 (PHTX), who today serves as vice president for research at the Medical University of South Carolina. “I had great mentors who were very involved in my work. Even the leadership of the department took a very personal interest in the graduate students. I wasn’t used to that.”

Since leaving Richmond, Brady continues to stay in touch with faculty and returns to the area regularly for drug abuse seminars and meetings. They have been pioneers in the field of pharmacology for a long time,” she said. “I am not surprised at all about their continued success.”

But Akbarali says, “There’s always room for improvement. As advances in techniques and technology continue, we are always looking forward.”

For years, Akbarali’s interest centered on Crohn’s Disease and colitis. Since coming to VCU 10 years ago, he has been working with Dewey on opiate-induced constipation research.

“That’s the strength of the faculty – we all were recruited because we brought an area of expertise that wasn’t here before,” he said. “We keep building. It’s all because of the passion and the commitment people have for the betterment of the department.”

For Dewey, that passion is stronger than ever, even after 40 years.

“I have had a ball,” he said. “It’s been so rewarding. I take a lot of pride in what this department has done. We don’t do this work for our egos. It’s always been about creating an atmosphere where we can conduct research that will one day improve the health of our
communities.”

Dewey knows all too well the importance of good health. He and his wife have a mentally disabled daughter and a son who lives with insulin-dependent diabetes. Dewey’s wife also suffers from diabetes and is battling breast cancer. “It really comes down to helping people,” he said. “Life is so wonderful. If we can improve it, what better thing can we do?”

  • The Department of Pharmacology and Toxicology’s first Ph.D. was awarded in 1952, making it the first awarded by MCV.
  • The department ranks 16th in the country in grant money received from the National Institutes of Health.
  • The training grant has supported 101 pre-doctoral students and 73 post-doctoral students since 1976.
  • With more than 300 Ph.D. graduates, the department’s alumni body is the largest of any of the medical school’s basic science departments.
  • The department was called the Department of Pharmacology from its creation until 1982, when Toxicology was added to the name.

By Janet Showalter

28
2016

Piece of the past

Dan Johnson, M’65, never expected to find anything of value as he cleaned out the attic of his Atlanta home.

Imagine his surprise when he came across a dusty box containing two surgical kits, one used for suturing and the other for dissection long before Johnson was born.

Dan Johnson, M’65's surgical kits

Dan Johnson, M’65, was surprised to find two surgical kits in his attic, including (top) a dissection kit used in cadaver labs before the turn of the century. Bottom: This leather-bound suturing kit from the late 1800s proclaimed a physician’s competence with its soft velvet lining and tortoise-shell handles. But since it could not stand up to sterilization, it fell out of use with the acceptance of germ theory.

“I thought it looked important, so I made some calls,” Johnson said.

He donated the items to the Tompkins-McCaw Library on the MCV Campus, and with help from Johnson, the staff uncovered as much as they could about the pieces.

“It is important to save these items because they help us document the changes in medicine that have taken place throughout our history,” said Andrew Bain, who manages the medical artifact collection at the library.

The suturing kit, manufactured between 1870 and 1881 in New York, offers a clear picture of a time before physicians saw patients in an office. Instead, they made house calls and used the knives, probes, tweezers and needles from their suturing kits to extract foreign objects from wounds and suture common cuts.

It was important for these physicians to convey a feeling of competence to patients, Bain said, so their instruments sported expensive tortoise-shell handles. The leather-bound kits were lined with soft velvet.

“While lovely, the tools were not very sanitary,” he said. “They couldn’t boil the instruments because the handles would crack.”

With the discovery of germ theory around the turn of the century, physicians opened offices where they could better control the environment, and the popularity of these kits faded.

The other kit Johnson discovered in his attic was typical of the kind used by medical students in cadaver labs in the late 1800s. Spotting the name of Glasgow Armstrong inscribed on the bottom of the wooden case, Bain investigated and learned Armstrong graduated in 1900 from New York University and later practiced in Staunton, Va.

“A lot of students threw their dissection kits away, so it’s wonderful to receive a donation like this one,” Bain said. “We are so grateful for every donation we receive.”

Of the 6,000 items in the library’s collection, more than half were donated by alumni, Bain said.

For Johnson, parting with the surgical kits was an easy call.

“I don’t think a lot of people realize how primitive medicine once was,” he said.

It is unclear how Johnson’s father-in-law, Walter Glenn Hardt, M’37, came to own both kits. He served in the Navy before opening a family practice in Bedford, Va. After his
passing in the 1970s, Johnson’s wife, Lucy Hardy, packed up her father’s belongings.

“For 30 years these boxes have been sitting here,” Johnson said. “When my wife passed away, I began cleaning things out. I never imagined I’d come across this, though. I guess
it just proves you never know what you might find in an old box in the attic.”

By Janet Showalter

This story first appeared in the fall 2016 issue of the medical school’s alumni magazine, 12th & Marshall. You can flip through the whole issue online.

21
2016

How to get a head start and a leg up

Pre-Matriculation Program

Four medical students, including Chris Filosa, are teaching assistants in the Pre-Matriculation Program. They’re giving participants a head start with coursework, tips and techniques for succeeding in medical school.

Wei-Li Suen has a master’s degree in piano performance from the Manhattan School of Music. In four more years, he intends to have his M.D. from VCU – a goal that came into focus more clearly as he worked his way through the Pre-Matriculation Program this June. “It was great practice to balance the course work with the piano performances I had in June,” he says.

Assistant Dean for Admissions Donna Jackson, Ed.D., nods her head in agreement. “This program is ideal for those students who need a head start for any number of reasons,” she explains, “often because they were liberal arts – not science – majors in college.”

Work/life balance. And so this year, 20 students chose to give up a month of their summer to plunge into the coursework that awaits all their first-year classmates who’ll matriculate in August. “It helped that these classes don’t factor into our medical school record,” confides Suen. It also helped that they were led by four inspiring teaching assistants. Medical students Chris Filosa, Jessica Li, Iffie Ikem and Jon Williams – all entering their second year on the MCV Campus — were pre-matric students themselves at this time last year, so they personally understand the challenges and rewards of the program.

“We want to make it a realistic experience for these students,” says Filosa. “In just one month, they get a good idea of what to expect. It’s tough, but they bond, and if you have a core group of friends, it becomes easier. We teach them not to sweat the small stuff.”

Pre-Matriculation Program

Rows of students line up to thump the classroom walls. They’re practicing a technique called percussion – using sounds to assess underlying structures. The studs behind the wall are a temporary stand in for students who’ll one day tap a patient’s back to listen and assess whether the lung is filled with air or fluid.

Find the studs. Despite all the technological advances in medicine, the hands-on physical remains important. Students are taught a technique called percussion – using sounds to assess underlying structures. Air, solids and fluid all have distinct noises, so when physicians tap a patient’s back to assess lung health, they can tell, for instance, if the lung is filled with air or fluid. That’s why rows of students line up to thump the classroom walls in order to locate the wooden studs underneath. It’s good practice — tapping the stud produces a different sound from tapping an empty wall.

One for all, all for one. After a month, the class has bonded, just as Filosa predicted. “Every small victory is a victory for all of us,” Ikem emphasizes. “Keep in touch with each other on the Facebook page. Say hi if you see us. We’re here for you. We’re paying it forward — that’s why we signed up for this.”

Five years in, the program is a success. “I do monitor these students,” Jackson says. “They tend to do better in med school. Many become student leaders. And they’re all better prepared for the daily rigor and the school/life balance. That’s good experience for them, and reflects back well on the school.”

By Susie Burtch

Name Pre-Matriculation Program
Purpose Exposure to the curriculum before starting med school
Founded 2011
Length Four weeks in June
Students 25 maximum
Courses Anatomy; Biochemistry; Physiology; Practice of Clinical Medicine (PCM)
Finances Housing, parking and gym access paid; stipend for food and incidentals
01
2016

The humble art of great teaching

Clint Thurber, PGY2, an internal medicine resident, was trying to give a brief presentation on different types of IV fluids to an audience of two interns and a medical student.

Things were not going well.

One of the interns was clearly interested, but the other appeared distracted, and impatiently interrupted Thurber. Could he cut to the chase? Could he just tell them the key points they needed to know? Meanwhile, however, the medical student seemed lost and unable to follow Thurber’s presentation. What was that term you used? Could you repeat that? Can you explain that?

Finally, Reena Hemrajani, H’10, stepped in. Associate program director for the internal medicine residency, on this day she was taking the role of facilitator in a two-day workshop on the art of effective teaching. The workshop participants were all second-year internal medicine residents, and the scenario that had just unfolded was a scripted role-play. The interaction was specifically designed to present the kinds of challenges and frustrations residents are likely to encounter in an actual teaching situation.

“How did it feel to be in the role of teacher?” asked Hemrajani.

“I think,” reflected Thurber, “that we often overshoot the knowledge base of our students.”

Hemrajani, who is an assistant professor in internal medicine, confirmed his idea. “The hardest part of teaching is remembering what they don’t know.”

During the workshop, roleplaying scenarios are videotaped so residents can analyze the challenges and frustrations that occur in actual teaching situation. They also get a chance to try simple behaviors for creating a more effective learning climate, giving feedback and organizing their teaching.

LEARNER AS TEACHER
By the time you graduate from medical school, you’ve spent years – almost your entire life – as a learner. Then you start your residency, and even though you’re called “doctor” now, you’re still fully aware of how much you have yet to learn. Suddenly you find yourself stepping into another new role you hadn’t really anticipated, a truly unfamiliar one that you might never even have thought about until the first day you’re expected to take it on.

Suddenly, you’re a teacher.

You’re a teacher, and that medical student who only a year ago was you is now looking at you for guidance. And you’re expected to know what to do.

“It is a huge mental shift, and when you think about being a physician, you really don’t think about the teaching part of it,” says Morgan Vargo, PGY2, who was taking part in the workshop. “Not only are you teaching in residency or if you become an academic practitioner, but you are always going to be teaching your patients too.”

In the Graduate Medical Education program on the MCV Campus, helping accomplished learners begin the journey to becoming effective teachers is the focus of the workshop in teaching skills. For a decade, it’s been offered annually to all second-year residents in internal medicine and, more recently, has been expanded to reach residents across the specialties.

The seminar is based on a framework developed by a Stanford internist. It focuses on seven categories — like feedback, communicating goals and promoting understanding and retention — that, though not necessarily intuitive, are essential for effective teaching.

“Most of student and intern education is from the senior residents when the attendings are not in the room, so teaching residents how to teach effectively is critical,” says Stephanie Call, M.D., who is the residency program director and associate chair for education in VCU’s Department of Internal Medicine.

Call has been facilitating the Stanford framework for more than a decade. The workshop offers an introduction to “really simple behaviors residents can use,” says Call, “particularly for creating a more effective learning climate, giving feedback and organizing their teaching.”

Beyond the skills it cultivates, the workshop also serves to reinforce to busy residents the School of Medicine’s commitment to creating not just great physicians, but also great teachers.

Gregory Trimble, M’03, another facilitator, is assistant dean for faculty at the VCU School of Medicine’s INOVA Campus in Fairfax. He notes that his own passion for teaching was discovered during residency and says that he emphasizes the important role residents play in medical education. “I remember coming out of medical school I felt well prepared entering residency,” he says, “and the people who were most influential as teachers were the house staff.”

John Greer, MD-PhD’13, is a third-year neurosurgery resident who completed the workshop earlier in the year. He says, “It was a good reminder that we are really positioned as residents to be teachers. Even when we are really busy and tired and there are lots of things we are still learning, we have to take the time and make the priority to teach the medical students and junior residents.”

Gregory Trimble, M’03 (center), is assistant dean for faculty at the VCU School of Medicine’s Inova Campus in Fairfax. He says he discovered a passion for teaching during residency. “I remember coming out of medical school I felt well prepared entering residency,” he says, “and the people who were most influential as teachers were the house staff.”

FACILITATING LEARNING
Central to the resident-teaching workshop are the roleplaying scenarios. They’re video-taped and analyzed in small-group sessions, giving the residents opportunities to try on different teaching situations, to see themselves in action, to think about what they might or might not do differently. As second-year resident Thurber contended with his restive audience of residents and medical student in one room, in another, Derek Leiner, PGY2, played the role of the impatient intern, checking his pager, taking a call on his phone.

Improvising, the resident taking the part of the teacher commandeered Leiner’s attention by engaging him and asking a question related to one of Leiner’s own patients. In the discussion that followed, Leiner acknowledged it was an effective tactic. “It was hard to pretend I had more important things to do when we were talking about my own patient,” he said.

Throughout the role-play, session facilitator Call was quick with warm praise: “Great job.” She posed thoughtprovoking questions: “How do you feel about giving reading assignments?” She offered helpful suggestions: “Develop little canned talks on something you are comfortable with, that you’re likely to have on your service.” She acknowledged challenges and limitations she’d faced in her own efforts to become a better teacher, like having to learn not to talk in a monotone when she was nervous.

Third-year neurosurgery resident John Greer, MD-PhD’13, makes a point of tailoring his teaching
to medical students’ career interests. That’s what he did with the Class of 2017’s Emily Kershner who’s considering emergency medicine as a career, but spent two weeks with Greer as part of her surgery rotation.

Animated, lively, enthusiastic, engaging, genuine — Call’s manner seemed anything but forced or scripted. Yet after the session, she pointed out that a great deal of thought and planning, refining and improving goes into every detail of how she and the other facilitators lead the workshop, that everything they do actively models and reinforces the very teaching strategies being learned. The residents, she says, “could label every behavior I used.”

Admitting her own limitations? The residents would call that creating a comfortable “learning environment.” Asking questions that lead to self-reflection? “Promotion of understanding and retention.” Even keeping the sessions on time — the role-play breakouts wrapped up right at 10:30 a.m., as the printed workshop schedule indicated — is part of the framework, under “control of session.”

“We think about everything, every aspect,” says Call, noting that every time she facilitates a workshop, she learns more herself.

“If we feel like the teaching is not going well, we adjust and ask ourselves, what are the behaviors I could use to make this go better?” adds Hemrajani — which is exactly what they want residents to learn to do as well.

SETTING THE STAGE
A few weeks later, second-year resident Leiner, looking back on the seminar, says he found the experience eyeopening. He’d gone into the workshop thinking he knew about teaching: his mother-in-law is a teacher, he has friends who are teachers, and of course, “I had been in school and seen plenty of teaching,” he says.

“But all the behind-the-scenes aspects of teaching I had never considered before, how there is so much more to teaching beyond the passage of knowledge. The learning climate, how you present yourself, how these factors relate to what you are trying to teach — I had not realized all these things are in play.”

Leiner says he took away strategies that he believes will be “very, very effective” in changing the way he will approach learners. “It showed me different techniques to use but also showed me that just the way I ask a question could change the way I pass on knowledge.”

Neurosurgery resident Greer says that he also found the experience immediately valuable. He notes, for example, that he now has medical students set goals at the beginning of a rotation and then provides them feedback on those goals at the end.

“Before this class I would never have walked in and said, ‘Hey, you have two weeks, what do you want to learn in that time?’” says Greer. “It was a good reminder about how we approach medical students and how we can give them the best education even though we only have them for a short time.”

Story by Caroline Kettlewell

Photography by VCU University Marketing

01
2016

Networking 101

Melissa Powell’s last job interview was in 2009 during her undergrad years — for a restaurant gig. But when she graduates next year with a Ph.D. in neuroscience, she feels empowered to land a great job in research or academics, thanks to a thorough education and a chance to hone her networking skills.

Powell and several dozen other graduate students from VCU’s School of Medicine attended Networking 101 last fall. The event offered tips to meet and mingle with potential employers — and then a chance to practice what they’d learned with members of the Virginia Biotechnology Association, a statewide non-profit trade organization representing the life sciences industry.

Katybeth Lee, associate director with Career Services at VCU, coordinated the event with the Graduate Student Programming Board on the MCV Campus.

“Last year, it became clear that students and post-docs are seeking opportunities to connect with professionals working in the bioscience field. Those professionals are looking to connect with the talent we have here at VCU, strengthening the bioscience workforce pipeline in Virginia,” she said. “This event was intended to meet both these objectives, capitalizing on VCU’s strong partnership with VABIO, our state bioscience association conveniently located on the MCV Campus.”

Many graduate students feel better equipped for the lab than getting to know potential employers in social situations. Sri Lakshmi Chalasani, a Ph.D. candidate in pharmacology and toxicology, noted, “We’re spending up to 14 hours a day on our work. Sometimes we don’t know what’s happening outside.”

At the networking session, Lee encouraged attendees to use those skills they’ve developed through years of study and labwork. “You are scientists,” she told the group. “Consider networking as an alternate form of data collection.”

“You are scientists. Consider networking as an alternate form of data collection.”

She encouraged students to be prepared with engaging conversation starters (“What’s the most interesting thing that’s happened today?”), a knowledge of reception etiquette (“If you’re drinking, hold the drink in your left hand so your right hand isn’t cold and clammy when you shake hands”) and a plan to break into conversations with others (“make eye contact with someone already in the group”).

And when it comes to conversation, “The key to networking is finding common ground,” Lee told students.

Pharmacology and toxicology’s Allen Owens, who earned his doctorate this spring, was active in programs for career development. “Being a part of these programs has helped me solidify career goals,” said Owens, who gained experience in an internship at the VCU Innovation Gateway.

Master’s and doctorate level graduates will not all end up in academia.

“It’s simply a matter of numbers,” said Jan Chlebowski, Ph.D., the medical school’s associate dean for graduate education. “However, the skill sets that these people are developing are very marketable in a wide variety of areas. Our students have a thirst for any kind of information about any alternatives that are out there.”

After the 30-minute Networking 101 crash course, students were released into a reception attended by dozens of VABIO industry representatives. They shook hands. They chatted. They collected contact info and made plans to stay in touch. VABIO organizations were pleased, said Chlebowski, and hope to keep communications channels open.

“Tonight is not a one-and-done,” Lee reminded students. “You’re here for the long haul.”

By Lisa Crutchfield

Photography by VCU University Marketing