ALUMNI
medicine.emory.edu
FALL 2018
news EMORY UNIVERSITY DEPARTMENT OF MEDICINE
INSIDE >> • Residency Program receives “StARR Award” to increase physician scientists • Emory hospitals receive top rankings • Residency and fellowship match results • Emory nephrologists improve dialysis patient care • Remembering H. Kenneth Walker, MD
Breaking the barriers:
minority women in medicine DIVERSITY HAS BECOME A FUNDAMENTAL PRIORITY AMONG INDUSTRIES ACROSS THE NATION, HOWEVER ACADEMIA HAS BEEN SLOW TO CHANGE.
Stacy Higgins, Janice Lea, and Jada Bussey-Jones, professors of medicine in the Department of Medicine
The benefits of a diverse and inclusive employee base and company culture are increasingly recognized by today’s work force. However, women, especially minority women, still face barriers. According to a survey conducted by Rock Health, 86 percent of African-American women, 52 percent of Asian and Asian-American women, and 49 percent of Hispanic and Latina women said their race is very much a barrier to career advancement. According to The Chronicle of Higher Education, on average, 75 out of every 100 fulltime faculty members at four-year colleges are white. Five are black, and even fewer are Hispanic. While women represent over half of assistant professors and are near parity (44.9 percent) among associate professors, they accounted for less than a third (32.4 percent) of professors in 2015, according to the National Center for Education Statistics. The numbers are much lower for minority women. Based on data collected by the Association of American Medical Colleges in 2015, out of 7,758 women full professors in medical schools across the United States, only 179 were African American women.
DEPARTMENT OF MEDICINE
Dear colleagues, In early 2018, I returned to my position as chair of the Department of Medicine after serving as interim dean of the Emory University School of Medicine. During my absence, I watched the department continue to excel in our tripartite mission areas of research, patient care, and education. Since my return, it has been a joy David S. Stephens, MD to witness that incredible growth continue, and I am proud to close out yet another successful fiscal year. As we embark on FY2019, I am excited to share with you some of the Department of Medicine’s major accomplishments. We have expanded our clinical reach, brought in a record number of research dollars, and introduced a number of new innovative programs and resources. This newsletter only touches on our achievements, so we invite you to stay in touch via social media and our website for all Department of Medicine updates. Our success is not possible without your support, and we thank you for your continued contributions to the Department of Medicine and Emory University. I am proud to once again serve as your chair. Sincerely, David S. Stephens, MD Chair, Department of Medicine
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In the world of healthcare and higher education, minority women have for years altered people’s perception of leadership with their proven ability to break gender and racial discrimination and to pave a new path for generations to come. In the Department of Medicine, the growth of diversity is seen in the stories of its own professors of medicine. Janice Lea, MD, professor of medicine in the Division of Renal Medicine, started her career at Emory three decades ago as a medical intern. As one of the very first African-American women to hold the position of professor of medicine at Emory, Lea was initially attracted to nephrology due to the high rates of kidney disease from diabetes and hypertension in the AfricanAmerican community. “Throughout my 30-year career at Emory, I have seen it become more diverse with respect to securing more women and minorities in faculty positions, which is vital to Emory’s growth and attraction of exceptional diverse medical students, residents, and faculty,” says Lea. She urges others to not let any stereotypes keep them from achieving their dreams and to always seek out role models to help along the way. “Emory is a place that fosters inclusion, encourages mentorship, and allows faculty to be engaged to the extent they want,” she says. “There are a tremendous amount of resources at Emory to succeed, but one must have the initiative to take advantage of these opportunities.” Stacy Higgins, MD, professor of medicine in the Division of General Medicine and Geriatrics, started her first job at Emory because of the medical education opportunities and the ability to work in both inpatient and outpatient settings. When asked about her advice for other minority women who are entering the medical field, Higgins says, “Find a mentor who can help you negotiate the field and advancement. This could be someone of similar background, but might also be someone who you connect with but is not an ethnic minority or female. Be open to new opportunities, to challenge and push yourself in areas where you have a strong skill set but didn’t necessarily envision the position.” According to Rock Health, more than a third of practicing physicians today are women, compared to just 17 percent in
1990. Witnessing the evolution of diversity first hand could empower minority women to seize opportunities that may not have been available years ago. Jada Bussey-Jones, MD joined Emory as a physician educator in 1999 and worked at least nine sessions per week, including evenings and weekends, in Grady’s primary and urgent care centers. Now she serves as the chief of general medicine and geriatrics on the Grady campus and professor of medicine in the Division of General Medicine and Geriatrics. Bussey-Jones used to discuss her work and career with her grandparents, who received only a grade school education because there were no high school options for African-Americans in rural Georgia at that time. “My similarities with many of the patients we serve at Grady have driven my passion for health equity and care for the underserved,” says Bussey-Jones. “I also feel there is a tremendous message about opportunities to support and promote diverse women at Emory and beyond. This achievement means a great deal to the individual faculty but also the students, trainees in the pipeline who can envision themselves in similar careers.” As a junior faculty member and a woman of color, Jessica Alvarez, PhD, assistant professor of medicine in the Division of Endocrinology, says it is empowering for her to see such brilliant women in high-ranking positions in medicine. “We still have a long way to go before we truly see equal representation across the board, including Latina women, but I appreciate the strides Emory has made,” Alvarez says. The rise in minority women leaders in the Emory University Department of Medicine echoes the nationwide equity and diversity movement. However, much work is ahead. The unwavering commitment of these leaders to their profession serves as a strong reminder that the future of medicine is bright and inclusive. “It isn’t enough to just hire a diverse staff. There must be representation in leadership,” says Kimberly Manning, MD, associate professor of medicine in the Division of General Medicine and Geriatrics. “The Department of Medicine is also preparing to appoint an associate vice chair of diversity, equity, and inclusion, which is a huge step in the right direction.” n
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DEPARTMENT OF MEDICINE
Emory Hospitals receive top rankings from U.S. News & World Report For the seventh year in a row, U.S. News & World Report has ranked EMORY UNIVERSITY HOSPITAL THE NO. 1 HOSPITAL in Georgia and metro Atlanta in its 2018-2019 Best Hospitals Guide. Emory Saint Joseph’s Hospital ranked No. 2 in Georgia and metro Atlanta, while Emory University Hospital Midtown ranked No. 10 in Georgia (4-way tie) and No. 7 in metro Atlanta (2-way tie). Emory University Hospital also ranked either nationally or was considered high performing in the following Department of Medicine specialties: Gastroenterology & GI Surgery, Geriatrics, Nephrology, and Pulmonology. Emory Saint Joseph’s Hospital ranked high performing in Gastroenterology & GI Surgery, Geriatrics, and Nephrology.
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Emory’s departments of medicine and surgery collaborate to form Health Services Research Center IN EARLY SPRING, EMORY’S DEPARTMENTS OF MEDICINE AND SURGERY CAME TOGETHER TO CREATE A COOPERATIVE HEALTH SERVICES RESEARCH CENTER (HSR CENTER) COMMITTED TO ADVANCING HEALTHCARE ACCESS, QUALITY OF HEALTHCARE DELIVERY, AND HEALTH OUTCOMES OF PATIENTS AND POPULATIONS.
The center supports health services research studies that aim to enhance, improve, and revise healthcare systems so that they can perform at the highest quality and deliver the best patient outcomes. The goals of the initiative are to positively impact Emory University and Emory Healthcare’s missions, and also create a paradigm for clinical/ research institutions nationwide. The HSR Center is designed to deliver patient-centered outcomes through the promotion of health services research that aligns academic research with clinical care delivery. Faculty experts in three major domains of health services research are a critical component of the center and serve as mentors and advisors to trainees and junior HSR faculty. These domains, or areas of concentration, are defined as patient-level, which is concerned with disease prevention and management; micro-system level, which understands the local provision of care; and macro-system level, which focuses on the healthcare delivery system. The center will be led by Rachel Patzer, PhD. After receiving her PhD in epidemiology at Emory, Patzer joined the Division of Transplantation of the Emory Department of Surgery with a joint appointment in the Rollins School of Public Health and an appointment in the Department of Medicine in 2011. She quickly became well recognized on the national stage of health services research, amassing a significant body of work involving her interests in disparities in access to transplantation, community-based participatory research, predictive analytics, health care quality, medication adherence and self-management, mobile health technology, patient education, and healthcare resource utilization. To maximize its location in a multi-organizational, high achievement environment, the center will nurture collaborative efforts in health services research across the Emory School of Medicine, Rollins School of Public Health, Nell Hodgson Woodruff School of Nursing, the Centers for Disease Control and Prevention, Grady Memorial Hospital, Children’s Healthcare of Atlanta, the Atlanta VA Medical Center, and other related Emory departments and school areas that do similar research. n
Department of Medicine residents will address the need for physician scientists.
Emory’s Internal Medicine Residency Program receives “StARR Award” to increase number of physician scientists engaged in infectious diseases, microbiology, and immunology research EMORY’S J. WILLIS HURST INTERNAL MEDICINE RESIDENCY PROGRAM IS ONE OF ONLY THREE INSTITUTIONS NATIONWIDE SELECTED TO RECEIVE A R38 AWARD FROM THE NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES (NIAID) TITLED “STIMULATING ACCESS TO RESEARCH IN RESIDENCY” (STARR) AWARD TO ADDRESS A NATIONWIDE SHORTAGE OF PHYSICIAN SCIENTISTS.
According to the American Medical Association (AMA) and the Association of American Medical Colleges (AAMC), only approximately 12-18 percent of US physicians are employed in academic research or teaching of any form. Emory’s StARR initiative will address the need for physician scientists by providing resident physicians with in-depth research experiences early in their training to prepare them for careers in the biomedical research workforce. The Emory StARR program’s approach will include development of a
structured research training program that offers in-depth training in the fundamentals of clinical and translational research, as well as creation of an Emory R38 specific mentoring program that is tailored to the training needs of resident physicians. The program will provide individualized didactic and mentored research training by a multidisciplinary team of preceptors and dedicated time to gain skills and expertise in clinical and translational research. Training will range from one to two years depending on the resident’s needs and future career plans. The research curriculum will be spread across residency program years two and three in three-month blocks, and will also include an additional 12 months as a “chief year in research” focused on mentored research and educational leadership after the third residency year. StARR participants will also complete the requirements for board certification via the American Board of
Internal Medicine and will be prepared to apply for a K38 grant upon completion of the program. The research curriculum will include selected short coursework, seminars, and workshops focused on the fundamentals and ethics of clinical and translational research; practical research skill acquisition; effective communication; time management; understanding the flow of research funds in an academic health center; building a successful research team; job negotiation; identifying grant opportunities; and navigating an IRB and/ or animal protocol. The program’s preceptors will have mentoring experience and federally-funded research projects in the program’s target areas, including transmission; prevention; basic and applied immunology and microbiology; end-organ complications; disease management; therapeutics; pharmacology; and vaccinology. n
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DEPARTMENT OF MEDICINE
“It often starts with a fall” OFFICE OF EDUCATION “WE OFTEN FIND THAT THE STORY OF HOW SOMEONE COMES TO ASSISTED LIVING OR A NURSING HOME IS A FALL – THAT’S THE BEGINNING. It shrinks your world, you
don’t want to leave your house, you don’t get as much exercise, which makes you more unsteady on your feet and more likely to fall again,” says Ann Vandenberg, PhD, MPH. As a gerontologist working in the area of implementation research, Vandenberg prides herself on identifying problems and working towards solutions to improve care for older adults. Many of Vandenberg’s projects directly or indirectly address one cross-cutting problem in the older population: falling. Vandenberg’s recent research Ann Vandenberg, PhD, MPH, improves patient care includes Bed Exit, a pre-implementation for older adults. study assessing the use of fall prevention technology with fall risk patients in Dutch and U.S. nursing homes. The study found that a the context in which these patients were living, instead of commonly installed technology to prevent falls, position just a lab result. Knowing the story of the fall suggests ways monitors, can potentially agitate residents who are at risk to provide support in the home, bolster social support, and of falling, putting them at further risk of falling. She’s also maybe add physical therapy to improve balance and strength.” involved in the implementation and dissemination of the Vandenberg’s participation in the End-of-Life in Assisted ongoing Enhancing Quality of Prescribing Practices for Living: Links between Structure, Process, and Outcomes Older Adults in the Emergency Department (EQUiPPED) project involves fieldwork and interviews with assisted program, which uses education and computer decision tools living residents, family caregivers, staff, and administrators to encourage providers to avoid prescribing potentially to gain multiple perspectives on quality of end of life in the inappropriate medications for older adults discharged assisted living setting. Here too falls are a part of the resident from the Emergency Department. This project also can context. “We often find that the story of how someone comes help decrease the risk of adverse drug events such as falls. to assisted living or a nursing home is a fall – that’s the Vandenberg’s pre-implementation work as part of the Instant beginning. It shrinks your world, you don’t want to leave Functional Outcomes Report for Meaningful Encounters your house, you don’t get as much exercise, which makes in Dialysis (INFORMED) team developing a functional you more unsteady on your feet and more likely to fall again,” assessment report to facilitate communication between says Vandenberg. A common story, she says, is an older providers and patients in the dialysis clinic suggested that woman who will experience the loss of her husband, manage asking about falls can elicit rich and useful detail providers for a few years in the home where she is living, and then could use to help patients. The fall section of the report experience a fall that points to underlying vulnerability “provoked narrative descriptions with lots of detail about or frailty. Vandenberg is now pursuing an interest in their home, their social support, the activities they were doing implementing discussions of frailty in shared decision when they fell. It’s a rich way of getting data and capturing making in geriatric care. n
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2018 Residency Match Day by the Numbers Match Day is the culmination of the Department of Medicine’s annual recruitment season. It celebrates a defining moment in the careers of young Emory physicians. In July, the J. Willis Hurst Internal Medicine Residency Program welcomed 56 interns to its residency program. The candidates were selected from a record number of 5,700 applications and 500 interview spots. Take a closer look below at our new class:
44 Categorical track residents 8 Primary care track residents internal medicine/ 2 Combined psychiatry track residents 2 Research track residents of incoming residents 16 Percent are members of the Alpha Omega Alpha Honor Medical Society
have advanced 11 Residents degrees (PhD, MPH, MBA, MHS) REPRESENTING:
34 from international 3 Graduates medical schools from Emory 9 Candidates University School of Medicine Medical schools from across the country
2018 Fellowship Match Results Fifty-one talented candidates joined the Emory University Department of Medicine’s sub-specialty fellowship training as first-year fellows. Fellowship programs within all Department of Medicine divisions provide state-of-the-art education and training for future physicians, attracting hundreds of applications from across the country each year. The department’s access to a large and varied patient population provides fellows with intriguing and often unique training opportunities.
CARDIOLOGY:
INFECTIOUS DISEASES:
11 clinical track fellows 5 fellows 1 basic science RENAL MEDICINE: research track fellow 7 fellows 6 clinical investigator research track fellows ENDOCRINOLOGY:
3 fellows DIGESTIVE DISEASES:
5 fellows
PULMONARY, ALLERGY, CRITICAL CARE, AND SLEEP MEDICINE:
7 fellows RHEUMATOLOGY:
3 fellows
GENERAL MEDICINE AND GERIATRICS:
3 fellows
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DEPARTMENT OF MEDICINE
Emory launches new initiative to improve dialysis patient care
Clinical Highlights • THE EMORY CLINIC opened a new dialysis clinic on North Decatur Road offering incenter hemodialysis and peritoneal dialysis to patients who require dialytic therapies. The state-of-the-art facility includes 22 hemodialysis stations, and four peritoneal dialysis training rooms.
EMORY HEALTHCARE NEPHROLOGISTS ARE PILOTING TWO NEW INITIATIVES TO IMPROVE THE LIVES OF DIALYSIS PATIENTS ACROSS GEORGIA.
OFFICE OF RESEARCH
Research, Major Grants, and Publications • THE DEPARTMENT OF MEDICINE RECEIVED A RECORD $113.4 MILLION in research funding for FY18. • Department of Medicine faculty members had 543 PUBLICATIONS IN FY18. • In FY18. Department of Medicine faculty had 19 ACTIVE NIH K AWARDS and 62 ACTIVE RO1S. • The Department of Medicine had 418 ACTIVE CLINICAL TRIALS WITH A TOTAL OF 7,097 ENROLLEES.
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Emory Nephrology recently launched a telemedicine program to provide acute renal consults for hospitals in rural Georgia, including Taylor Regional Hospital (Hawkinsville) and Memorial Hospital and Manor (Bainbridge). These acute telenephrology consults are designed to care for patients with kidney disease in rural hospitals that do not have on-site nephrologists or in-house dialysis services. Prior to this initiative, patients in rural hospitals who needed dialysis or had kidney problems that required nephrology care would have to be transferred to other hospitals, often resulting in delay of timely care. Sanderling Renal Services (SRS) provides telemedicine services in each of these hospitals, and Emory provides physician oversight and primary nephrology services via telemedicine in these hospitals. Emory clinicians and researchers are able to track rural health populations using SRS analytics. SRS also provides acute dialysis services to the rural hospitals under the guidance of Emory Nephrology. Participating Emory nephrologists include Drs. Janice Lea, Jason Cobb, Anees Quyyumi, Tahsin Masud, James Someren and Jose Navarrete. “Emory Nephrology has never offered this service before, but we have very high expectations,” says Lea, medical director of the program and a professor of medicine in the Emory University Division of Renal Medicine. “It encompasses and advances Emory’s missions of patient care, education and research. If the pilot goes as well as we think it will, we plan to expand the telenephrology program to include more Emory faculty and additional locations.” Emory Nephrology has also recently partnered with Emory Cardiology to provide echocardiograms to patients undergoing dialysis. An echocardiogram is a type of ultrasound test that uses high-pitched sound waves to detect how well a patient’s heart
is functioning. This partnership will help outpatient Emory dialysis clinics screen for cardiovascular disease in this high risk population and make treatment more convenient for patients. Knowledge of heart disease in dialysis patients will also lead to better dialysis care. Every dialysis patient is recommended to have an echo within three months of starting treatment and then again at three-year intervals. Renal transplant and diabetic patients, as well as non-diabetic patients at high risk for heart disease, should be screened more frequently. “Normally, patients have to schedule their dialysis and echo appointments separately, which can be pretty time-consuming,” says Lea. “When you perform them simultaneously, we’re talking about improved patient care, quality improvement opportunities and convenience. A lot of our patients undergo dialysis for several hours, several days a week. Any time we can give back to them is precious.” With both the telenephrology program and their recent collaboration with Emory Cardiology, Emory Nephrology aims to enhance the care provided to dialysis patients and to increase access to medical specialty services. n
• THE DIVISION OF DIGESTIVE DISEASES opened a new gastroenterology lab at the Atlanta VA Medical Center to serve a large number of veterans in metro Atlanta and neighboring areas. The ten-thousand square feet state of the art facility has the latest endoscopy equipment, six procedure rooms, and a total of twenty pre-operative and post-operative beds. Procedures done in the unit include general endoscopy, advanced endoscopy, and specialized procedures like manometry. • THE DIVISION OF HOSPITAL medicine established direct care services at Grady Memorial Hospital. • THE DEPARTMENT OF MEDICINE launched the Diabetes Management Program. • THE DIVISION OF DIGESTIVE DISEASES launched a new physician practice and ambulatory surgery center at Emory Spivey Station and expanded the Emory Clinic gastroenterology services to Emory John’s Creek Hospital. • THE DIVISION OF RHEUMATOLOGY established scleroderma, vasculitis, and lupus subspecialty clinics, as well as a Lupus Clinical Trials Unit at the Emory Clinic.
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DEPARTMENT OF MEDICINE
Remembering H. Kenneth Walker, MD In early 2018, the Emory University community lost H. Kenneth Walker, MD, beloved professor of medicine and neurology in the Emory University School of Medicine, and professor of global health in the Rollins School of Public Health. Walker’s connection to Emory ran deep. He earned his associate’s degree from Emory’s Oxford College, graduated from Emory College, and then earned his MD from Emory School of Medicine. Just before his passing, he was named a recipient of the Emory Medal – Emory’s highest alumni award – from the Emory University Alumni Association. His 60-year career included an unrivaled dedication to Grady Memorial Hospital. His connection to Grady began in 1958 when he was a third-year medical
Legendary educator H. Kenneth Walker, MD, MACP, FAAN has been a faculty member in the
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student. He completed his residency training at Grady and remained there until 1965, only leaving to serve two years in the U.S. Air Force in southeast Asia during the Vietnam War. Walker returned to Grady in 1967 and H. Kenneth Walker became a faculty member in 1970, where he eventually served as the assistant chief of the Emory medicine service at Grady. He was honored during last year’s Grady White Coat Gala for more than 40 years of service to the hospital. Visit bitly.com/kenneth-walker-memorial to support Walker’s legacy by making a memorial gift in his honor.
Emory University Department of Medicine and on staff at Grady Health System since 1963.
Selected Faculty and Staff Awards, Honors, and Accomplishments • ANNE TOMOLO, MD, MPH, associate professor in the Division of General Medicine and Geriatrics appointed associate chief of staff for education for the Atlanta VA Health Care System. • REENA HEMRAJANI, MD, associate professor in the Division of Hospital Medicine, named an associate program director for the J. Willis Hurst Internal Medicine Residency Program. • GUILLERMO UMPIERRIEZ, MD, professor of medicine in the Division of Endocrinology, Health Care received the Atlanta Business Chronicle’s Health Care Heroes Lifetime Achievement Award for his commitment to fighting diabetes, his dedication to underserved populations, and his acclaimed research into this chronic disease.
• JEFF M. SANDS, MD, Juha P. Kokko professor of medicine and physiology, and director of the Division of Renal Medicine, named 91st president of the American Physiological Society. Sands also received an honorary doctorate (Doctorum Medicinae Honoris Causa) from Aarhus University in Denmark for his contribution to experimental nephrology research. • SRILATHA EDUPUNGANTI, MD, RUSSELL KEMPKER, MD, and NADINE ROUPHAEL, MD associate professors in the Division of Infectious Diseases, elected as fellows of the Infectious Diseases Society of America. • STEVEN GORBATKIN, MD, associate professor in the Division of Renal Medicine named chief of medicine specialty service for the Atlanta VA Health Care System.
• CAMILLE VAUGHAN, MD, MS, assistant professor of medicine in the Division of General Medicine and Geriatrics named as associate vice chair of research and faculty development. • CHARLES SEARLES JR., MD, associate professor of medicine in the Division of Cardiology named associate vice chair of research and space management. • JOSEPH DEE named executive administrator for clinical affairs and administration. He also holds the title of vice president of medicine services for Emory Healthcare. • MONICA FARLEY, MD, professor of medicine and director of the Division of Infectious Diseases, named the first holder of the Jonas A. Shulman Professorship in Infectious Diseases.
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