Charting a New Course for Future Physicians Curriculum reform takes shape at Georgetown School of Medicine
FROM THE ARCHIVES: Strictly Jacket and Tie In 1929, members of the School of Medicine Class of 1933 gather in the chemistry lab, located at the old medical school on H Street NW. Do you have historic photos or materials from old med school days? Contact us at GeorgetownMedicineMagazine@georgetown.edu to have your memorabilia featured in a future issue of the magazine.
Charting a New Course for Future Physicians 10 Curriculum reform takes shape at Georgetown School of Medicine
Three generations of Hoya orthopedic surgeons reflect on their training and practice
A researcher-turned-medical student gives back through clinical trials
The Gift of Teaching
New professorship honors the late Dr. Allan J. Goody
Check Up: News & Research Student Voice
Grand Rounds Revisited
READER FEEDBACK The Heart of Medical Education at Georgetown Having just received (and read with great interest) the Fall/Winter 2015 issue of Georgetown Medicine, I write to express my deeply sincere thanks to you and your colleagues whose articles frame and convey what it really means to live one’s medical professional life “At the Intersection of Faith & Healing.” As a graduate of Georgetown College and Medical School, one of Desmond Sylvester O’Doherty’s first residents in neurology, a colleague and friend of Andre Hellegers (who convinced the Kennedy Family to fund the Kennedy Institute) and also of Edmund Pellegrino (when we both were at the University of Kentucky), I am very grateful that the values I learned at those institutions and from those colleagues—values that define what it truly means to have the privilege of becoming and living the life of a real doctor—are still at the heart of medical education at Georgetown.
A publication for alumni and friends of Georgetown University Medical Center
Editor Jane Varner Malhotra
Contributors Daniel Coleman (M’17) Elissa Ernst Mary Furlong (MS’91, M’95, R’00) Melissa Maday Camille Scarborough Patti North Kat Zambon
Design Director Robin Lazarus-Berlin, Lazarus Design
University Photographer Phil Humnicky
I just thought you should know that. Most sincerely, Michael P. McQuillen, M.D., M.A. (C’53, M’57, R’60)
Executive Vice President for Health Sciences Edward B. Healton
Dean for Medical Education Stephen Ray Mitchell (W’86)
Bed Racing Days But a Dream Regarding the “From the Archives” image in the Fall/Winter 2015 issue: I saw that photo for the first time about 1955. It was identified as the O.R. in the university hospital, probably around 1900. It was the Sophomore Dorm when I lived there 1952-1953. The rooms all had hospital beds (hand cranked, of course), but the famous bed races had been discontinued, alas. This red brick building was “one block down, one block over” from the front gate.
Georgetown Medicine is published by the Georgetown University Office of Advancement Communications. The magazine welcomes inquiries, opinions and comments from its readers. Address correspondence to GeorgetownMedicineMagazine@ georgetown.edu or: Jane Varner Malhotra, Editor Georgetown Medicine Office of Advancement P.O. Box 571253 Washington, DC 20057-1253 Contact alumni records for address changes: firstname.lastname@example.org or 202-687-1994. For up-to-date information on Georgetown events and alumni news on campus and around the world, visit Georgetown Alumni Online: alumni.georgetown.edu. © 2016 Georgetown University Medical Center
Cover illustration: © Stuart McReath
John Agnew, M.D. (C’55, M’59)
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News & Research
After Concussion, Rest Is Best
ecent research at Georgetown suggests that several days of rest should be prescribed after a concussion. Georgetown University Medical Center neuroscientists say rest—for more than a day—is critical for the brain to reset neural networks and repair any short-term injury. The new study in mice also shows that repeated mild concussions with only a day to recover between injuries leads to mounting damage and brain inflammation that remains evident a year after injury. “It is good news that the brain can recover from a hit if given enough time to rest and recover,” says the study’s lead researcher, Mark P. Burns, associate professor of neuroscience at GUMC
does not undertake this rebalancing when impacts come too close together.” Published in the March 2016 issue of American Journal of Pathology, this Georgetown study, the first of its kind, modeled repeated mild head trauma to investigate brain damage that occurs after such an injury. Investigators developed a mouse model of repetitive, extremely mild concussive impacts conducted while the mouse is anesthetized. They compared the brain’s response to a single concussion with an injury received daily for 30 days and one received weekly over 30 weeks. Mice with a single insult temporarily lose 10-15 percent of the neuronal connections in their brains, but no inflammation or cell death resulted. With three
concussions, but the pattern is restored when a week of rest is given between each impact.
© National Library of Medicine
“Studies have shown that almost all people with single concussions spontaneously recover, but athletes who play contact sports are much more susceptible to lasting brain damage.” — Mark P. Burns and director of the Laboratory for Brain Injury and Dementia. “But on the flip side, we find that the brain
days of rest, all neuronal connections were restored. This neuronal response is not seen in mice with daily
“The findings mirror what has been observed about such damage in humans years after a brain injury,
especially among athletes,” Burns says. “Studies have shown that almost all people with single concussions spontaneously recover, but athletes who play contact sports are much more susceptible to lasting brain damage. These findings help fill in the picture of how and when concussions and mild head trauma can lead to sustained brain damage.” In addition to its Georgetown co-authors, colleagues from the Centre Hospitalier de l’Université Laval, Neurosciences, Québec, Canada, also contributed. n
Old Drug, New Promise in Clinical Trial for Parkinson’s Clinical and Translational Science. Preliminary data were presented at Neuroscience 2015, the annual meeting of the Society for Neuroscience, in October. Moussa conducted the preclinical research that led to the discovery of nilotinib for the treatment of neurodegenerative diseases, then partnered with Pagan for the clinical study. “To my knowledge, this study represents
The investigators report that one individual confined to a wheelchair was able to walk again; three others who could not talk were able to hold conversations. disease and Lewy body dementia. In addition, it led to statistically significant and encouraging changes in toxic proteins linked to disease progression. Charbel Moussa, director of Georgetown’s Laboratory of Dementia and Parkinsonism, and Fernando Pagan, director of Georgetown’s Movement Disorders Program, led the trial, which was supported by the Georgetown-Howard Universities Center for
the first time a therapy appears to reverse—to a greater or lesser degree depending on stage of disease—cognitive and motor decline in patients with these neurodegenerative disorders,” says Pagan. Investigators report that the six-month study of nilotinib, a treatment for chronic myelogenous leukemia or CML, produced benefit for all study patients who completed the trial (11 of 12), with 11 patients reporting meaningful
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Colored CT scan of a brain in Parkinson’s disease
clinical improvements. The study’s primary objective was to test safety. Researchers say that use of nilotinib, in doses much smaller than those used to treat cancer, was welltolerated with no serious side effects. Moussa and Pagan found that the drug penetrates the blood-brain barrier in amounts greater than dopamine drugs, but the observed efficacy in cognition, motor skills, and nonmotor function improvement for many patients was the most dramatic result. The investigators report that one individual confined to a wheelchair was able to walk again; three others who could
not talk were able to hold conversations. Alan Hoffman, a retired professor, was diagnosed with Parkinson’s disease in 1997 and has participated in several clinical trials with no benefit, he says, until he enrolled in Pagan’s study. Before nilotinib, he was unable to do simple household tasks, but after the trial he said, “Now, I empty the garbage, unload the dishwasher, load the washer and the dryer, set the table, even take responsibility for grilling.” In the three weeks prior to enrolling in the study, Hoffman says he fell eight times, but only fell once during six months on the study.
© GJLP/Science Photo Library
n a small scale study, Georgetown University Medical Center researchers have discovered that a drug used to treat leukemia improves the symptoms of Parkinson’s disease. In the early phase I clinical trial, 12 patients received nilotinib, an FDA-approved drug for leukemia. The drug improved cognition, motor skills, and non-motor function in patients with Parkinson’s
© Alexander Potapov | Dreamstime.com
His speech has improved, as has his thinking. “My wife says it’s life-changing for her and for my children and grandchildren,” Hoffman says. “To say that nilotinib has made a change in our lives is a huge understatement.” While the results of the small trial are promising, they should be interpreted with appropriate circumspection—there was no control group for comparison. Also, nilotinib was not compared with a placebo or other medications used to treat Parkinson’s in the study. Moussa and other Georgetown researchers are planning larger clinical trials with nilotinib for patients with Parkinson’s and other similar diseases including Alzheimer’s disease, likely to begin this year. Moussa is an inventor on a Georgetown University patent application for use of nilotinib for the treatment of neurodegenerative disease. Support for the next phase of the Parkinson’s trial includes a recent $1 million gift from the LaskyBarajas Family Fund to the Nilotinib Clinical Research Fund in the Translational Neurotherapeutics Program at Georgetown University Medical Center. The phase II Alzheimer’s trial also continues to receive funding from individuals and organizations including the Alzheimer’s Drug Discovery Foundation. n
Finding the Right Anti-Malarial Mix
lthough global malaria mortality rates fell by 60% over the past 15 years, drugresistant malarial parasites are on the rise. A single parasite is responsible for 80-90 percent of malarial deaths, but varying treatment regimens around the world are causing different strains to arise in each region. “We cannot use a single drug anymore to treat malaria—we must use combinations,” says Paul D. Roepe, co-director of the Georgetown Center for Infectious Disease. In December, the NIH
awarded Roepe and a team of scientists at Georgetown, Columbia, and UC San Diego $2.1 million to study mutations in two genes within the mosquito-borne protozoans that allow the parasites to rapidly overcome commonly used anti-malarial drugs. PfCRT and PfMDR1 are the best understood markers for drug-resistant malaria. Knowing more about them may lead to new therapies or to lethal combinations of existing therapies, Roepe says. Roepe and his team have posted results from
their drug screening work on the web, including dozens of combinations that are effective against drugresistant P. falciparum in an effort to facilitate global research sharing. “We hope this new study will provide additional critical information for rapidly identifying the best new therapies,” he says. n
Interaction network of synergistic combinations Iterative combination screens yielded many synergistic and additive drug combinations including approved antimalarials with ion channel modulators (e.g. nicardipine), novel mitochondrial targeting agents (e.g. ML238), drugs targeting human enzymes and receptors (e.g. BIX-01294, alvespimycin and NVP-BGT226), and agents currently undergoing single agent clinical assessment in malaria trials (e.g. tafenoquine). (n = Endoperoxides; n = HAL, LUM, MFQ, CQ, TFQ; n = hPI3K/mTOR; n = mitochondrial/DHODH; n = ion channel modulator; n = other)
Medical students and faculty step behind the velvet ropes to meet with the physician to the president and others in the White House medical care group.
Students Meet With White House Medical Team
n a wintry day in January, the White House medical unit opened its doors to 25 Georgetown medical students and faculty. Despite a historic blizzard in D.C., and the complex logistics involved in any visit to 1600 Pennsylvania Avenue, members of the Military Medicine Interest Group (MMIG) made the trip. The group includes students participating in the Health Professions Scholarship Program (HPSP), veterans,
and others interested in military medicine. Jett McCann, senior associate dean for knowledge management and director of Dahlgren Memorial Library at GUMC, described organizing the tour as a near miracle. “Over the past years, several HPSP students have tried to set this up and couldn’t pull it off,” said McCann, a retired Navy Captain and HPSP/MMIG adviser. Ensign Margaret McCarthy (USNR, M’18),
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MMIG vice president, and 2nd Lt. Rita Snyder (USAR, M’18), MMIG president, arranged the event. “The team at the White House medical unit was very enthusiastic about our visit and was incredibly generous with their time and in sharing their experiences and passion for their work,” McCarthy said. The students received a tour and met the director and deputy director of the medical unit, as well as the current and former
physicians to the president— an experience that Snyder described as “an unexpected and unbelievable privilege.” “Their words of encouragement, genuine love for medicine, and service to our country were truly inspiring,” Snyder said. “The visit was an invaluable experience for all of us as we continue our education at Georgetown, preparing for similarly challenging and rewarding careers serving those who serve our nation.” n
Addressing Oral Health in D.C.
aunted by the needless death of a local child, a Georgetown researcher is taking on oral health disparities in Washington, D.C., aided by a $1.2 million grant from the George E. Richmond Foundation of Chicago. After learning that the foundation was interested in oral health, Lucile AdamsCampbell, associate dean of community health and outreach and associate director of minority health and health disparities research at Georgetown Lombardi Comprehensive Cancer Center, created a plan to address the issue from the disparities perspective. Adams-Campbell recalls the story of a 12-year-old African-American boy who came home from school one
day complaining about a headache caused by an infected tooth. Less than two months later, the child died from complications related to the infection. “No one should die because of lack of access to or knowledge about oral health and dental care,” Adams-Campbell says. Disparity in health care for minorities is a recognized issue, particularly in urban areas. But few realize that disparities in dental care represent a crisis in the nation’s capital. As part of Georgetown’s Health Disparities Initiative, Adams-Campbell’s team will undertake research and community outreach projects led by the Office of Minority Health & Health Disparities
Research. The goal of the project—part of the O’Neill Institute for National and Global Health Law at Georgetown Law—is to conduct a community-based assessment of oral health needs, barriers, knowledge, attitudes, and behaviors in D.C.’s medically and dentally underserved areas. “Oral health is so important because it impacts systemic health,” Adams-Campbell says. “Poor oral health conditions have been linked to cancer, diabetes, stroke, cardiovascular diseases, and poor nutrition which are strongly associated with many health disparities seen in D.C.” Adams-Campbell’s innovative work will directly
Did You Eat Your Broccoli?
o you even remember if you ate your broccoli? No problem if you don’t! Georgetown researchers have developed a quick test to evaluate specific food compounds in urine. The method developed in the study may one day replace less reliable food logs used in population studies on the connections between diet and cancer.
Looking at potential lung cancer protection from cruciferous veggies—including cabbage, Brussels sprouts, bok choy, and broccoli— researchers at Georgetown Lombardi Comprehensive Cancer Center validated the new test using data from the National Institutes of Health’s Singapore Chinese Health Study.
engage affected communities, offering a manual of dental and oral care providers, clinics, and resources for the underserved along with dental health screenings and referrals. It will establish community research pilot programs, including an oral biorepository from saliva samples, presenting opportunities for future research for both diagnostic and preventive purposes. n
“We know these foods are beneficial to health, and the 10-minute method we developed, which can test for the presence of specific compounds linked to these vegetables, will help researchers quantify exactly how much of these molecules are being consumed,” says Marcin Dyba, research associate at Georgetown Lombardi. The study’s senior author is Fung-Lung Chung, professor of oncology. n
Excelling in Huntington’s Disease Care Through Cura Familia
he Huntington Disease Care, Education & Research Center at Georgetown has been designated as an HDSA Center of Excellence for 2016 by the Huntington’s Disease Society of America. The designation comes with a grant to support services for Huntington’s disease patients and their families at the center, a collaboration between Georgetown University Medical Center and MedStar Georgetown University Hospital with generous support from the Griffin Foundation. The Huntington Disease Center opened in 2012, making it the first comprehensive, multidisciplinary center in the D.C. area to focus on treatment, patient education, and research for Huntington’s disease. “We are thrilled to be designated a Center of Excellence,” says Karen E. Anderson, director of the center and a neuropsychiatrist with dual appointments in the departments of psychiatry and neurology. “This designation will promote our high quality of care and research to Huntington’s disease families in the region, since the HDSA is so widely recognized in the community.” According to the HDSA,
Karen Anderson and her student researcher test equipment for an ongoing clinical study on Huntington’s disease at Georgetown.
“Early on, we wanted the center to be built on a foundation bridging two major care needs of families coping with Huntington’s disease— psychiatric and neurologic.” — Steven A. Epstein the goal of the Center of Excellence program is to increase access to the best possible multidisciplinary clinical care and services for individuals affected by Huntington’s disease. In addition to clinical and social services, the centers provide professional and lay education in the geographic areas they serve, and are involved in clinical
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research, working with HDSA locally and nationally. “Our Georgetown Huntington Disease Center expanded quickly outside of Washington, so we could offer comprehensive services for patients and their families in Maryland and Virginia, too,” says Carlo Tornatore, chair of neurology at MedStar Georgetown and professor of
neurology at Georgetown School of Medicine. “All three host multiple services provided by a social worker, neurologist, neuropsychiatrist, neuropsychologist, genetic counselor, speech therapist, and occupational therapist. Patients also have access to clinical trials for emerging therapies.” The vast array of expertise is fostered by the collaboration
between the hospital and the university, and the team’s focus on providing support for family members and caregivers—cura familia. “Early on, we wanted
the center to be built on a foundation bridging two major care needs of families coping with Huntington’s disease—psychiatric and neurologic,” explains Steven
A. Epstein, chair of psychiatry at MedStar Georgetown and professor of psychiatry at Georgetown’s School of Medicine. “The team has done that, and with added
support services, our center is an exceptional model for Huntington’s disease centers across the nation. We are proud to have the HDSA designation.” n
New Medical/Surgical Pavilion
MedStar Georgetown University Hospital Plans Facility Expansion Improved pedestrian and traffic flow, new emergency department in the works
edStar Georgetown University Hospital is aiming to optimize its health care delivery with the design of a new, stateof-the-art facility to meet current needs as well as future healthcare demands. Through a series of key building enhancements and accessibility projects, the proposed expansion addresses the urgent age, capacity, and technology issues of the hospital today.
The proposed 477,000square-foot medical/surgical pavilion will house 156 private patient rooms, a new emergency department, larger operating rooms, a rooftop helipad with direct access to the emergency room, plus three levels of below-ground parking. By moving the surface parking underground, planners hope to maximize green space and improve the pedestrian experience.
MedStar has contracted with Wells and Associates to design transportation and programmatic plans to improve overall traffic safety, lessen congestion for neighborhood and on-campus users, and achieve a measurable reduction in traffic from existing levels. The goals of these solutions include off-site parking relocation, dispersion of parking for clinical and ancillary services,
reduction of impacts to Reservoir Road, and improvement of pedestrian and cycling pathways. n
For more information Visit the website: www.buildingmedi calexcellence.com
Charting a New Course for Future Physicians Curriculum reform takes shape at Georgetown School of Medicine By Jane Varner Malhotra
tudents settle into their seats in the dimly lit auditorium, flipping open laptops and chatting with classmates about housing arrangements and course schedules. The roughly 200 second-year medical students, just back from winter break, had three hours of lectures that morning in the same room. Now after lunch, with filled bellies and blood circulating again, they prepare for another 90 minutes of class. But something looks different. Not one but three white-coated professors confer near the podium. A classroom assistant stands nearby holding a pad of sticky-backed poster paper and a large bag of colored markers. Family medicine professor Yumi Jarris introduces the topic and format for the afternoon: a cross-disciplinary team-taught interactive module on kidney disease and health disparities in Washington, D.C. After a quick 30-minute overview of the medical data and risk factors associated with different populations, the students are asked to break into small groups to research and respond to questions as a team, addressing the problems in the greater Washington community. One student from each team comes up to get markers and poster paper to document the group findings, and then share out with the entire class. Clusters of 5-10 students spread out across the auditorium, in the aisles, up on the stage, and even out into the hallways, making use of wall and floor space to hang their posters and explore ideas together. The area buzzes with discussion and energy as students share their different perspectives and growing knowledge about the challenges of
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addressing health disparities. They consult laptops to review online data through links provided by the professors. They work on consensus-building and eventually put thoughts to paper, as the professors walk among groups, observing and answering questions. As the students flow back into the auditorium and take their seats, the air in the room feels refreshed. One by one, each group shares one or two results from their discussions. All the posters are photographed and posted to a class portal online for students and professors to review later. Although the room is not easily modified for group work, the students make the most of it and enjoy the lively, engaging format and the chance to discuss solutions with their classmates. “We have a lot of lecture hours, but I learn better by doing and talking to someone,” says Kristin Spitz (M’18). Over the past decade, faculty members have developed innovative approaches to teaching like this one, supported by CIRCLE grants (Curricular Innovation Research Creativity in Learning Environments) and other programs at the medical school. However, finding room to incorporate the best new ideas—and needed innovation—into the existing curriculum proved difficult, says Stephen Ray Mitchell, dean of medical education. Now a new approach to medical education is on the horizon at Georgetown School of Medicine, represented in part by classes like this one. Faculty members are working to design an educational path with a more integrated curriculum, blending clinical experience with basic science teaching over the four years. The new curriculum will also emphasize studentcentered, team-based, interactive learning, with less time in the formal lecture setting. Moving away from traditional lectures to a more inquirybased, learner-centered teaching style can prove challenging for professors. “Things can go in any direction,” says Jeff Weinfeld, associate professor of family medicine and one of the population and health disparities course co-teachers. “It’s hard to be thoughtful and to prepare to teach this kind of class, but the more interactive setting generates a lot of positive, creative energy.”
Curriculum for the next century For the past 100 years, medical schools in the U.S. have trained generations of physicians in generally the same four-year format. The first two years are classically spent in the lecture halls and labs, covering basic science. The third and fourth years are in the clinical setting, as students work alongside practicing
physicians, see patients, and learn more about the different specialties. This structure took shape based on sweeping medical education reforms recommended by the Carnegie Foundation’s famous Flexner Report of 1910. On the 100th anniversary of the historic overhaul, the Carnegie Foundation
Faculty members are working to design an educational path with a more integrated curriculum, blending clinical experience with basic science teaching over the four years.
Jessica Jones and Dean Mitchell stop by the third floor of Dahlgren Memorial Library to check progress on five new team-based learning classrooms under construction.
released a new examination of how best to train doctors for today’s evolving medical field, prompting schools across the country to revisit how they teach medicine. Outside the school walls, the practice of medicine in the U.S. is undergoing major change. Delivery of care is shifting with the rise of new technologies, a growing emphasis on disease prevention and wellness rather than procedures, and more reliance on team-based care. In addition, rapidly
advancing science and research are expanding medical knowledge, and the impact of global health continues to grow. Society’s expectations of doctors are changing too, says Jessica Jones, associate professor of biochemistry and molecular and cellular biology. “We have a much more diverse group of people who are becoming doctors, and the people who receive health care today are a more diverse group,” she says. “We no longer have the Dr. Kildare, the lone doctor who steps in and solves everyone’s problems. More than ever, doctors are part of a team; they don’t work alone. Each one has a certain set of knowledge, and in order for that to be useful it has to be placed
in the context of other people with different sets of knowledge, different professional skills.” In response to the changing field of medicine and the new Carnegie recommendations, medical schools including Georgetown School of Medicine are undertaking major curriculum reform. Curricular revision is nothing new at the school. In the Jesuit tradition, Georgetown has always placed a strong emphasis on teaching, and over the years has prioritized reflection and innovation in this arena. “We have had early clinical entry to ambulatory mentored settings for a long time,” says Mitchell. “And in 2003, we moved from teaching basic sciences in
departmental, disjointed lectures to modular content, integrating more logically from molecules and cells to an organ-based first year, with the second year integrated around disease. Even with this major change, 24 rigid months remained, and room for emerging innovation was lacking.” One charge of the second Carnegie commission is to create a competence curriculum that allows individualization of the career path for each student, says Mitchell, something Georgetown has been exploring for two decades. “Over the last 20 years, at least five groups of our faculty have proposed individual tracks, or journeys, built around a student’s individual passions, talents, and career targets,” he explains. “We
Above: Second-year medical students spill out into lounge space surrounding the lecture hall in order to conduct group research during an in-class project. Right: Eileen Moore, associate professor of medicine and associate dean for community education and advocacy, mentors students working with patients at the Hoya Clinic in D.C.
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have had students pursuing the Health Justice Scholar track, leading to creation of the HOYA Clinic. Students take the Population Health Scholar track to better understand health disparities and advocate for the underserved. Future teachers may choose the Medical Education track.” Student-directed options continue to expand.
Time for fostering intellectual curiosity Central to all the change rests Georgetown’s grounding principle of cura personalis, care of the whole person. “Always we must create mindful, reflective, resilient physicians who are sensitive, empathetic, and compassionate scientists as well,” says Mitchell. With this in mind, in the fall of 2014 the school established five Learning Societies in which every student is enrolled all four years in order to create mentor-rich environments for crowd-sourced learning of mindfulness, resiliency, professional authenticity, and leadership. Each Society is composed of four academic families. One academic family has 10 students and a faculty member, and forms the curricular unit for teaching a more active medical science curriculum going forward, explains Mitchell. These incremental innovations led faculty to pull back for a big-picture perspective on all four years of the student experience. In the summer of 2015, 80 faculty, alumni, and students gathered for a pivotal two-day retreat to envision a curriculum for the new century and consider how it would ideally take shape. “Inspired by an outstanding alumni class who had gathered for their 50-year reunion, we brainstormed about their enduring qualities that we value— qualities we want and must continue to develop in our Georgetown graduates,”
Although details of the new curriculum are still being finalized, the overall shift is designed to give students more time to foster intellectual curiosity.
recalls Mitchell. “We began to consider reductions in those pre-clinical 24 months to 18 months, with room to develop individual student journeys along individual tracks, including ‘deep dives’ back into medical science after clinical experience, offering long-term clinical exposure occurring earlier, followed by continued clinical responsibility under mentored supervision.” Although details of the new curriculum are still being finalized, the overall shift is designed to give students more time to foster intellectual curiosity, says Jones, who serves as chair of the Curriculum Reform Steering Committee. “That’s why we are shrinking the preclinical period and creating more time for customization during the clerkship period.
“By allowing students to direct more of their own learning, we hope they develop a new way of thinking so that they can continue to find what they need to know after they finish medical school,” Jones explains. “Undoubtedly 10 years after they’ve graduated, 50 percent of what we thought was true we will no longer think is true. Unfortunately there is no list of facts that you can memorize to become a doctor. You have to learn to continue to learn.” And so the faculty team designing Georgetown’s new curriculum is asking: How can we do better? Overall the curriculum will be more learnercentered, with the two major changes being an integrated curriculum with more early clinical experience, and
The Journey Begins: Proposed Longitudinal Curriculum Model
Orientation with Clinical Exposure
Preclinical Blocks and Inter-sessions
Pre-Clerking Boot Camp
Step One Journeys Segment 1
Capstone Activities Pre-Residency Boot Camp
Journeys Segment 3
more interactive and team-based learning.
Meshing clinical experience and basic science By the fall of 2017, the new curriculum will begin to phase in. The medical school class of 2021 will have had 18 months of preclinical basic science education rather than the traditional two years currently in place. By entering their clerkships in the spring of their second year, students will have an earlier opportunity to enter their clinical rotations in all basic specialties. The new curriculum allows them to work with cohorts with similar interests as they pursue their individual paths. During their two and half years of clinical training, students will come back for one- or two-week intersessions, immersing in basic science “deep dives” for a short time. The expectation is that the material will be even more meaningful when students can connect it to clinical experience they have already had. By weaving clinical experience in earlier and basic science back in later, the curriculum becomes more integrated overall.
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Acting Internships, EM Clerkship, Electives, Away Rotations, etc.
Kristin Spitz is glad to see the shift to earlier clinically based learning. “When we have the opportunity to hear from patients in person, either in clinical settings or on patient panels in the classroom, I remember more, and all the medical knowledge becomes relevant.” “The experiential learning is really helpful,” agrees Sam Fox (M’18), recalling the opportunity to meet patients during his ambulatory care sessions. The outpatient experiences for students take place during the second semester of the first year and continue into the first semester of the second year. “My first year I had very few clinical skills, but those opportunities were so useful. I remember all of those cases, and I know they will stick with me over the long term.” “When I was in medical school, we didn’t see or touch a patient until our third year,” recalls Edward Healton, executive vice president for health sciences at the medical center. “Of course that was back in the stone ages,” he laughs. Healton points to Georgetown University Medical Center’s expanding
Journeys Segment 2
Core Clerkships Three Selectives Inter-sessions
partnership with MedStar to broaden medical student opportunities for clinical training, including additional selectives and a new six-month primary care clerkship opportunity at MedStar Franklin Square Hospital in Baltimore. The pilot program will launch a new longitudinal integrated clerkship, which pairs each student with a primary care mentor who oversees the curriculum. A cohort of third-year medical students will spend half a year working with the same family physician every week, following patients into the hospital and doing their medicine, pediatrics, family medicine, and obstetrics training in a more longitudinal model, caring for a panel of patients over a longer period of time. This new approach allows students to learn more about evolving chronic conditions, putting the patient at the center. Students experience mentorship in the delivery of long-term primary care and observe the development of a physician-patient relationship. The students will begin with 10 patients and add more over the duration of their clerkship, including one who is
pregnant and expected to deliver during that timeframe. During the last two and half years in the new curricular format, students will also be able to experience more clinical “selectives” for better career exposure, and “bootcamps” before clerkships and before graduation, in preparation for residency training. “All of these experiences will allow students to more thoughtfully select the area of specialty for their residencies after medical school,” says Healton.
More interactive, competencybased, team learning Today’s medical student experiences a different classroom from that of just five or ten years ago. For example, the massive packet of shrink-wrapped course handouts has been replaced with a mostly paperless, digital experience. In a broader context, advances in education technology like lecture capture add convenience and adaptability according to a student’s learning style. Often the classroom experience is flipped, with students watching the lecture before class meets, offering time for a more interactive experience with the professor. Students use laptops to connect to flat screens at the front of the room, ready to discuss the content interactively, ask questions, solve problems, and engage with fellow students to deepen learning. Other advancements in the interactive learning model include increased opportunities for students to experience simulations. A new MedStar mobile van offers simulations on the go, wherever students rotate. Students see more standardized patients, as actors play an increasing role in teaching communication and diagnostic skills in both clinical and basic science principles. In response to the changing classroom experience, educators are looking at the campus facility for creative use of existing
teaching spaces. The new Proctor Harvey amphitheater might host basic science instructors and clinicians teaching side by side, says Mitchell. Work is currently underway in Dahlgren Memorial Library to reconfigure space for dedicated modular classrooms designed to better support
percent may still be lectures—they’re efficient. But 40 percent may be small groups where you collide with the material, you’ve done your homework, and you come prepared. Maybe 20 percent we take out of the curriculum and you’re going to learn that on your own.”
“Unfortunately there is no list of facts that you can memorize to become a doctor. You have to learn to continue to learn.” — Jessica Jones
Marcia Glass (M’03) conducts a tutorial for nurses in Ghana.
the small group, team-based learning with academic families. “The faculty have done a remarkable job planning for the new curriculum,” he says. “They own it, they are fired up, they have a timeline, and they are rolling it out. Now their pedagogy committee is asking: How do we teach this? Maybe it’s going to be 40-40-20. So 40
Mitchell notes that the concept of competence recently inspired the Student Medical Education Committee to complete evidence-based research on the impact of a graduated versus pass/fail grading scale for the basic science years. The students shared that of the 81 other schools in the nation who have done so, most have documented a drop in anxiety
and depression scales, and an increase in resilience in students, without a decline on National Board scores. After careful consideration, the administration adopted the student-led proposal.
Alumni work to improve academic medicine In addition to the students and faculty, nearly a dozen Georgetown School of Medicine alumni participated in the curriculum reform planning retreat last year. Many alumni have an interest in academic medicine and go on to become professors and curricular innovators at other schools after graduating. One such individual is Marcia Glass (M’03), associate professor of hospital medicine at the University of California San Francisco. She notes several changes in how students experience medical school today, and adapts her teaching in response. “A big change is how much work medical students are doing abroad,” she says. “Often they have very little preparation. They arrive in a country they’ve never been to and try to deliver good medical care, but they face many ethical issues on the job.” To address the need, she and her colleagues have designed curriculum that uses simulations with cultural and ethical challenges. Glass sees an increasing use of simulations for teaching, including at Tulane where she did her residency. Sometimes realistic mannequins are part of the experience, but in other scenarios such as the ethics training at UCSF, professional actors are hired. And the results for students can be dramatic. “The first time we conducted the ethics simulation, I was surprised by how into it the students got,” recalls Glass. “It was intense. Some students were in tears. And they asked for a debriefing, which we now have after all
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Derek Allison (M’14) explored medical education research while studying medicine at Georgetown.
our sessions.” In the end she hopes to help students become more aware of their own limitations, she says, so that they are prepared to learn during their global health experiences as much as they are there to help. Simulation experiences, inquirybased learning, integrated clinical and basic science content, and team-based learning are some of the approaches to teaching medicine that are attracting more attention today as schools across the country implement curriculum renewal. What really works and how do we know? Derek Allison (M’14) hopes to help figure that out. A pathology resident at Johns Hopkins, he joined the new Medical Education Research Scholar Track in his second year of medical school at Georgetown. The program introduces students to current topics in medical education, he explains, and helps them become informed producers and consumers of medical education literature. In the program, students collaborate with faculty mentors to formulate a scholarly question and research
project during their final two years in medical school. Allison sees a need for education reform, as medical science becomes more complex, but choosing the best path forward for teaching medicine is also complex. “Education reform requires innovation with new applications and techniques that incorporate new technology and novel learning opportunities,” he says. “This kind of curriculum development, however, needs to be evidencebased.” His interest in academic medicine drew him to the specialty track. “I decided to participate in the program to learn about the practices already in place, how to ask the right questions about education reform and, more importantly, how to solve them.” “With the increasing complexity of medical science and technology, medical schools, research programs, and teaching hospitals must change,” Allison says. But to do it well, he adds, more people need to be active producers and consumers of medical education scholarship.
What it’s all for Dean Mitchell views Georgetown’s carefully considered, faculty-driven curriculum reform from a wide lens, but also reflects on what is its simple, central purpose. “In the end, it’s about one patient and one physician— how we bring better science to that relationship, and how we nurture the mindfulness and compassion in that relationship.” n
Moving Toward a Modern, Student-Centered Curriculum By Mary A. Furlong, MD
eform and renewal are common words in the vocabulary of anyone in academics and higher education. To reform is to change to a better state; to renew is to make new, to revive, and to make effective. As a faculty member at the School of Medicine for many years, I have already been through one major curriculum reform. So when approached with the idea of yet another, the first question many of my fellow faculty members and I had was â€œWhy?â€?
Furlong shares Match Day news with her students.
The reasons are many. In our technologically advanced world, the rate at which new knowledge is generated in medicine and science is beyond what we can teach in the classroom. Our goal must be not only to provide a foundation in medical science but also to provide a foundation for our students to become critical thinkers. Our curriculum must be student-centered and flexible, while
actively engaging the learner. Early in the process, we intentionally sought consensus around key guiding principles: individualization, curiosity, and collaboration. Together we developed an aspiration for our reform and renewal: to unify the overarching academic standards of excellence with the underlying principles of justice and care of the whole person in order to prepare our students to excel and contribute meaningfully to society. The predictable stages of reaction to change include opposition, resistance, tolerance, acceptance, support, and enthusiastic engagement. Recognition of this process is important as faculty and students work together to move toward our common goal. As faculty, we reflect on concepts and our approach, and view ourselves as partners in the learning process. We ask the students to also consider themselves integral to the process, to take ownership of their education, to make decisions, and to actively engage in reflection. Our new curriculum will offer students increased choice and flexibility. Combining our preclinical education into a more cohesive and integrated framework will provide time for students to pursue areas of interest following the
clinical years. The proposed timeline includes approximately 18 months of foundational science, then early entry into clinical rotations followed by deep dives back to basic science. Students will choose areas of basic science that will enhance their specialty of choice. In addition, the curriculum allows time for students to complete independent scholarly projects. Proposals have been made to allow for more time in the traditional clerkship year for several two-week experiences in medical specialty areas such as dermatology, pathology, and rehabilitation medicine. Engaging students to make decisions early regarding their education is a progressive move toward a more student-centered curriculum. The process of change that began nearly a year ago has been a positive one. We started by forming a steering committee and followed that with a community retreat. Soon we had thoughtful and detailed reports on a workable timeline and active pedagogical methods to implement a renewed curriculum. Our current effort will move us into the next exciting phase: determining the foundational content with emphasis on core concepts, clinical application, and self-directed learning. Fundamental to our charge will be the formation of empathetic, socially aware, and reflective physicians who will make a difference in their practice of medicine. So it is with enthusiastic engagement that we embrace the challenge of curriculum reform and renewal at Georgetown University School of Medicine. We look forward to the journey ahead of us as we establish a modern, student-centered education that is in keeping with our Jesuit mission of leadership and service. n
Olde School, New Tricks By Daniel Coleman (M’17)
ometimes I wonder if we will ever be better than the physicians who came before us. You know, those names we only see at the end of a quote or engraved into a heavy-looking plaque. Osler, Weber, probably Rendau, too. The doctors of olde. The doctors of legend. Wise faces in sepia-tinged
America’s first medical school. Its initial curriculum included anatomy and chemistry, but also more colorfully named courses like “materia medica” (pharmacology) and “practice of physick” (medicine). Other institutions took root up and down the eastern seaboard, and in 1851, a new establishment sprouted up at the
Right now, it’s easy to get caught up in the minutiae, all the little facts we puzzle together to get a good score on that test. But do these things really change me? Are they really that formative?
photographs, eyes all-knowing founts of primal medical knowledge. How did they achieve greatness? Where did they learn medicine? And most importantly, can I ever be that good? Way back when, medical education was simply an apprenticeship. Young, 17th century doctors-to-be would append themselves to a practiced physician with the hope of learning the craft. Experience was paramount; evidence was anecdotal. Undoubtedly, the neophyte would be at the whim of his master, required to complete all manner of menial tasks, perhaps cleaning the bloodletting studio or mixing salves in a back room. The transition to formalized medical education was gradual, but in 1765 the University of Pennsylvania created
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corner of 12th and F in northwest Washington, D.C. It would later relocate and become the Georgetown University School of Medicine we know today. While all of these establishments had the same broad strokes, in reality, there was little uniformity in their standards. Some schools required only a high school diploma for admission and it took a mere two years to obtain a medical degree, although many followed Georgetown’s lead and extended this to three years in the latter part of the 19th century. Curricula also began to incorporate more practical experience, such as gross anatomy and physiology lab. But this wasn’t enough. At least not for Abraham Flexner, who in 1910 wrote a landmark report, formally titled Carnegie
Foundation Bulletin Number Four, about the state of medical education. Despite its proper title, the document was a searing criticism of the supposed depths to which medical education in the United States had fallen. Ultimately, he concluded that there were too many medical schools making too many physicians, and doing it poorly. Educational standards were lax and many new doctors were deficient in medical skills. Post-publication, a number of schools were shuttered. The survivors shored themselves up by requiring at least two years of college for admission, affiliating directly with universities, and extending the length of medical school to a full four years. Thus, in a very real way, the Flexner Report is responsible for the two years of pre-clinical science plus two years of clinical work that have haunted student-doctors for the past 100 years. It assured uniformity and rigor across the board, and the result was a yearly assembly line that produced a phalanx of highly trained physicians. Apparently, Flexner was right about some things. However, Flexner was also a racist who wanted to ensure that “The practice of the Negro doctor will be limited to his own race.” Some of his beliefs are out of touch with today’s ideals, including those regarding medical education. Of Georgetown, he wrote: “The equipment consists of a good dissecting-room, a single fairly well stocked laboratory for pathology, bacteriology, and histology, a fair equipment for experimental physiology, and an ordinary
chemical laboratory. There is no library accessible to students, no museum, and no pharmacological laboratory.” Few, if any, present-day medical students would point to these elements as markers of a “good” medical school. Recently, many schools have moved away from the “first patient” ideal of cadaveric dissection. Most students would find the prospect of doing their own pathology, bacteriology, and histology euphemistically amusing. Dahlgren Memorial Library may be called accessible, but basically, the things that made medical schools great in 1910 don’t necessarily hold true today. Over the past few decades, medAbraham Flexner ical schools have been brushing off the cobwebs and firing up the rusty gears of the innovation engine. Around the country, educators are developing new ways to teach, and giving prospective students the opportunity to customize their medical school experience. There is a medical school in New Jersey that spends the first eight weeks training new students to become EMTs. NYU has an accelerated three-year track for students pursuing primary care. UPenn, the sire of U.S. medical education, crams all of its pre-clinical work into 18 months, reserving the third year solely for research. This sort of a la carte approach to education allows prospects to find the program that meshes with the way they like to learn, whether it is more small groups, self-
directed learning, or an increased emphasis on real-world education. Georgetown has also made significant changes to the curriculum over the past decade, increasing its emphasis on early clinical experience and moving to a systems-based education. Recently, a measure was passed that will convert
Daniel Coleman (M’17)
preclinical classes to a pass/fail system, eliminating the honors, high pass, pass, low pass, and fail delineations that were hated by so many, loved by the top 10 percent in every class. Even more significant are reports that the first two years of medical school will be condensed into just 18 months. These are new tricks for an old school, and proof that our school is steeped in tradition, but not stifled by it. Of course, those doctors of legend did everything without flipped classrooms, electronic medical records, and the USMLE (despite the fact that many view it as some particularly cruel species of Medieval torture). I imagine they merely read a few books, and skills simply flowed forth like water from the
stone. Innate, ingrained medical powers. Can we ever be that good? Maybe. It’s tough to say, because I’m only three years into my education and medical school, whatever the format, only accounts for a small portion of my medical career. After all, what are four years compared to the 20, 30, 40 years I’m going to spend healing and helping? Right now, it’s easy to get caught up in the minutiae, all the little facts we puzzle together to get a good score on that test. But do these things really change me? Are they really that formative? I don’t know what the future holds but I do know that we are getting a terrific education no matter what. And in a way, these Georgetown years become our brand, our calling card. The deep history. The reputation for innovation. The glossy Blue and Gray. n
Student Voice Daniel is a member of the class of 2017 going into Emergency Medicine, with a particular interest in Wilderness Medicine. He founded the GUSOM Writers Group, and is a student editor and writer for In-Training.org. We are grateful for his current and future contributions to Georgetown Medicine magazine. He can be reached at Daniel.Coleman@georgetown.edu.
Enduring Lessons Three generations of Hoya surgeons reflect on their
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Three orthopedic surgeons practicing in Modesto, California represent what it means to attend medical school at an institution like Georgetown, where history can more easily be counted in generations than years. Doctors Donn Fassero (M’74), Todd Smith (M’91), and Richard Han (M’09) all graduated from the Georgetown School of Medicine in successive generations. The three Hoya doctors happen to be working together under one roof, in an orthopedic practice of six surgeons at Sutter Health, a network of physicians and hospitals in Northern California.
Studying medicine in an era of change
All photos on pages 20-24 Norbert von der Groeben
orthopedic common practice
A Seattle native, Donn Fassero did his undergraduate work at the University of Washington at the height of the Vietnam War. At the time, ROTC was mandatory for healthy male students at state schools. He became an officer after graduation. Fassero had an interest in science—his undergraduate degree is in pharmacy—but he didn’t think about becoming a doctor until he was stationed at the Brooke Army Medical Center in San Antonio, Texas, where he worked in the burn center. The new therapies being developed there for burned soldiers fascinated him, and his commanding officer encouraged him to consider a career in medicine. After three years on active duty, he decided to apply. He was in Kodiak, Alaska, working in a pharmacy there, when he got a call inviting him to a personal interview at Georgetown. He got himself on a plane and headed to Washington. He remembers hoping the interviewer was impressed that he had come so far just for the chance to attend the school. Georgetown had a reputation for seeking diversity in its student body. As a veteran and a little older than the typical applicant, Fassero thought he might have an advantage. He was admitted and started school in 1970. Fassero recalls Washington in the early 1970s as a very exciting place to be. The Watergate scandal as well as anti-war and civil rights movements were all playing out in Georgetown’s backyard. He worked at a pharmacy on P Street and filled prescriptions for members of Congress and Supreme Court justices. Capitol Hill and Pentagon staffers were among his neighbors. He frequented as many of the events on campus as he could and heard speakers from all walks of public life. “Some of the students were just exhausted from college and getting into med school, but I wanted to take advantage of all the opportunities.” During his second year, the D.C. government eliminated a subsidy that it had been offering to medical schools in the city. Fassero’s tuition doubled overnight to more than $20,000. He was able to continue on his own savings from his years in the work force, his part-time earnings at the pharmacy, and a small stipend from his GI benefits. By Patti North
In his fourth year, Fassero had an opportunity to intern in Johannesburg, South Africa. He worked in what was called the “non-European hospital” that served non-whites including Indians and Zulus, offering him the opportunity to see the impact of apartheid firsthand. “The ‘whites only’ atmosphere was appalling, but it was a beautiful country,” he recalls. “At the time it was peaceful, but you could see something was going to change soon.” He rotated through programs in the Veteran’s Administration, D.C. General Hospital, and the P Street Clinic, working there in psychiatry with a child who was a paranoid schizophrenic. “After six weeks I went to the professor and said, ‘I worked as hard as I could, but this poor soul is no better— in fact I think he is getting worse!’ It was so frustrating. I was resigned to failing the course, but the professor said, ‘Son, you have to have patience, and by the way, maybe you should consider surgery.’” His lack of an affinity for psychiatry notwithstanding, Fassero found that he did love surgery. George Hyatt taught orthopedic surgery, and was an early mentor, instrumental in honing Fassero’s interest in what has long been a very competitive field. Fassero notes that today many
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students learn orthopedics differently, with more subspecialties. “We were trained more as generalists—fellowships
going into practice in Modesto in 1979. “I think Georgetown has a lot of appeal for a lot of reasons. Two weeks after I started, I got a call from Yale where I had been waitlisted. They said there was an opening if I wanted to come. I said ‘I don’t think so.’ I just liked everything about Georgetown and I’d only been there two weeks. It was a great opportunity and a great education.”
Living Georgetown values
Donn A. Fassero (M’74)
were not typically available. We did everything—club foot deformities in children, all kinds of fractures, trauma, and knee replacements. Now you have a more restricted practice—shoulder, neck, or spine surgery or joint reconstruction.” After Georgetown he was accepted to the Mayo Clinic for his orthopedic training and completed both his internship and residency there, before
Todd Smith grew up an only child after his father passed away when he was small. His mother was a physical therapist, so from an early age he learned about rehabilitation. It was around junior high when he thought, “It might be cool to be a doctor.” Even so, he graduated from UC Berkeley, worked for a few years while getting an MBA, and married his childhood sweetheart before deciding that medical school was something he really wanted to pursue. He applied and was accepted to Georgetown, coming to Washington with his wife in the late 80s. Like Fassero, he had saved enough for his early tuition bills from his years in the work force. After that he managed on loans and his wife’s earnings, but incurred a fair amount of debt. “It was modest by today’s standards, but
basically the equivalent of a mortgage payment—without the house to go with it.” He was drawn to orthopedic surgery from the beginning. “They were the guys with plaster on their scrubs and scissors in their pockets. They looked like they were having fun—and it IS fun putting people back together again.” Smith also believes that orthopedic patients may be disproportionately grateful to their physicians. “By the time they get to see you, they have usually put up with not only pain, but lack of function in their lives. When you can fix those two things, it’s significant.” What Smith remembers most about medical school is, although it was rigorous academically, “Georgetown was a family—everyone was there to try to help you succeed. They taught you up front that this is not about being better than the guy next to you. This is about working together to make the patient better.” Smith also acknowledges the growing fragmentation in the field. “In Donn’s era, people were generalists who became subspecialists and now people aim at subspecialty initially. Many sports doctors only want to do sports when their practices need them to do some general as well.”
Though they attended Georgetown School of Medicine 20 years apart, Smith and Fassero had many of the same
Todd C. Smith (M’91)
teachers that are now legendary. “Proctor Harvey taught us to listen to the patient. He was such a wonderful clinician. He would get so much from talking to the patient before he ever put on a stethoscope. John Dillon was general surgery chair—with him you had to be prepared to sweat the small stuff. He broke down your assumptions. It’s not about knowing; it’s about understanding.”
Smith credits the medical school for teaching him to always focus on the patient first. “It permeated everything— the tests you order should confirm what you thought after examining the patient. Not the other way around. I recognize that quality in both Donn and Rich,” he says. Smith also recalls an emphasis on teamwork and leadership—you had to be good at both. “Being around Georgetown and in D.C., you were around leadership all the time—the concept of physicians as leaders and learning how to step up to that role. You had to be a respected member of the team to lead it. Leadership is about removing the barriers for the people you are trying to lead. To this day, I think about that when I am training new partners or physician’s assistants. It was the underpinning of how they trained us at Georgetown.”
The value of listening A native Californian, Han is the son of Korean immigrants who owned a deli and coffee shop in the Bay Area. He was motivated to work hard by his parents, who got up at 3 or 4 a.m. to open their shop. He has wanted to be a doctor for as long as he can remember. He earned his undergraduate degree from UC Berkeley, and like both
What Smith remembers most about medical school is, although it was rigorous academically, “Georgetown was a family—everyone was there to try to help you succeed.”
Fassero and Smith, spent time working before applying to medical school. He entered a one-year graduate program at Georgetown and while there, fell in love with the university and the city and applied to the medical school. He graduated in 2009, going on to an internship and residency at Temple University and a fellowship at University of California San Francisco Medical Center. He joined Sutter Health last year. He did not receive financial aid, and acknowledges that the debt is daunting, but he does not regret it. “A Georgetown education is a worthwhile investment,” says Han. “It’s a brand that is well-recognized. But the debt can make it hard to go into lesser paying fields.” Early on, his interest shifted from cardiology to orthopedics. “You can fix problems immediately, as opposed to managing problems over the course of a lifetime,” he says. Georgetown offers a strong support system, says Han. “It was a great community. No matter how competitive a field you wanted to go in, they would help you. After a test we would have a party on the lawn. It was a very ‘work hard/play hard’ atmosphere.” Han fondly recalls Jack Delahay, the legendary professor of orthopedic surgery, as “easily the greatest teacher I ever had
in my life—a character of characters. He was good at putting the pressure on and finding the humor in it, while making
Richard J. Han (M’09)
you want to step up and learn more.” Han speaks fondly of the relationships he made while at Georgetown, forging some of his closest friendships there. “We would spend hours studying together at school and then spend many hours enjoying the nightlife D.C. had to offer. And I met my wife Aimee there when she was a graduate student —a real Georgetown romance story.” Han believes that Georgetown’s
Jesuit principle of cura personalis guided his education and now his practice. “I met with a patient the other day who had been referred by her primary physician for her shoulder. She said, ‘You’re the only doctor who listened to me.’ There wasn’t much more I could do for her at that point but listen, but I learned the value of that at Georgetown. You have to listen to the patient. It’s not just a limb or an isolated problem—there’s a bigger picture.” As the new kid on the block, Han is impressed with his colleagues, both for their experience and their leadership. “Leadership is something we were challenged to take on at Georgetown. Donn is past president of the California Orthopedics Association and Todd is chair of the Sutter Health board, so I see the challenges coming,” he says. In the meantime, the proximity of his partners means Han can always call upon them. “When I have a tough case, Donn or Todd is always down the hall from me. That’s what medicine is —a constant learning experience.” n Patti North is the director of alumni communications in Georgetown’s Office of Advancement and an occasional contributor to Georgetown Medicine. She can be reached at email@example.com.
In the meantime, the proximity of his partners means Han can always call upon them. “When I have a tough case, Donn or Todd is always down the hall from me. That’s what medicine is—a constant learning experience.”
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Under Study Giving back through clinical trials By Elissa Ernst
ara-Grace Leventhal forged a connection to the Georgetown medical community years prior to being admitted to the 2018 School of Medicine class. “I was born at Georgetown Hospital, and some of my earliest memories are of appointments with my pediatrician at Georgetown,” says Leventhal. “I had a number of food allergies that my mother was struggling to diagnose and respond to, and after several doctors downplayed the condition and her instincts, my Georgetown pediatrician empowered her by saying, ‘You’re the mother. You know her best. What do you think?’” Leventhal says this memorable interchange exemplifies a common theme and mindset that runs through the Georgetown medical community: Yes, we know the science—but we also need and value the patient’s perspective. A few years later, when Leventhal was 9, her mother was diagnosed with an aggressive form of breast cancer, and joined a clinical trial offered at the National Institutes of Health (NIH). Through close monitoring and evaluation while on the trial, her medical team caught a secondary cancer very early on which was successfully treated. Leventhal credits the trial with saving her mom’s life. After that experience, Leventhal knew she wanted to work in health care. She earned her undergraduate
Kara-Grace Leventhal (M’18) began her multifaceted relationship with Georgetown University Medical Center in the hospital’s labor and delivery unit—as a newborn.
Little did she know that just two short years into her research assistant position, the tables would turn.
degree in psychology and took a job at Georgetown Lombardi Comprehensive Cancer Center as a research assistant, enrolling patients in clinical trials and coordinating genetic testing for breast cancer risk. In that position she had a close-up look at the patient experience during
cancer treatment. This perspective solidified her interest in becoming a doctor, in order to better influence treatment decisions and advocate for patients. Little did she know that just two short years into her research assistant position, the tables would turn.
From researcher to patient After being immersed in the clinical study of genetic mutations that make women highly susceptible to breast cancer (mutations of the BRCA1 and BRCA2 genes), Leventhal learned what she had begun to suspect: she was a carrier of this genetic mutation. It presents a 55-65% lifetime risk of developing breast cancer, in addition to increasing her chance for other cancers. “It seemed like a matter of when, and not if,” says Leventhal. In response to these grim cancer risk statistics, a woman who carries this genetic mutation encounters a host of overwhelming, life-altering treatment decisions: chemopreventative drugs that affect the ability to start a family; extensive and cumbersome surgeries that remove and reconstruct the breast prior to diagnosis; or the wait-and-see approach that focuses on diligent screening, to name a few. Each choice has its pros and cons, affecting the woman and her family in a myriad of ways, and the cost/benefit analysis process shouldn’t be faced alone, says Leventhal. “I received genetic counseling from my colleague at Lombardi Cancer Center and it was immensely helpful,” says Leventhal. “Both my husband and I met with her for an hour and a half
to discuss future plans and treatment implications.” The counselor also connected her to a support group for women in similar circumstances. Leventhal opted to be rigorous in her screening, but to also do what she could for future women facing such a diagnosis. She enrolled in a clinical trial exploring the effect of Vitamin D on those at high risk for breast cancer. The decision for her was an easy one. “I can’t control whether or not I have this mutation, whether it’s in my family, but I can contribute to better treatment and outcomes for other women.” Leventhal credits the nurse coordinator who oversaw the clinical trial as incredibly helpful as she struggled with confusing consent forms and navigated through additional biopsies and mammograms that came with enrollment in the trial. After one year of the experimental treatment, Leventhal went back for an additional biopsy and had developed a hematoma. Her doctor immediately removed her from the trial out of an abundance of caution. Even though she was unable to complete the trial, she would wholeheartedly recommend that others seek out these trials and participate in them.
“I can’t control whether or not I have this mutation, whether it’s in my family, but I can contribute to better treatment and outcomes for other women.” — Kara-Grace Leventhal
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“The statistic of less than 10 percent of cancer patients enrolling in clinical trials should horrify everyone. You’re going to benefit society at large so much by signing up for a trial and giving back,” says Leventhal.
Clinical trials in the U.S.— a lost opportunity? Medical advances depend on successful clinical research. More than 200,000 active clinical trials are underway in the United States today, according to the National Institutes of Health (NIH). However, the participation rate for cancer patients is just 3%. Additionally, almost 40% of clinical trials in the United States fail to enroll the minimum number of patients needed to complete the study, and end up closing before they are completed. Why are enrollments so low? NIH studies on the issue cite a number of different reasons that patients elect not to participate in clinical trials, including fear of a reduced quality of life, concern about receiving a placebo, potential side effects, and concern that the experimental drug might not be the best option. The single largest determining factor was physician influence. Filipa Lynce, associate professor and medical oncologist at Lombardi, notes another reason that the numbers are low: strict participation requirements eliminate some willing patients. Factors that take potential participants off the list include the presence of an additional disease or health condition, lab results that are deemed unacceptable, and patients who are on specific medications for another condition. Low participation rates also impact drug development, says Lynce. “Because so few patients participate in clinical trials, we are delaying and compromising the development of new
Leventhal is pictured with her parents at the Multiple Myeloma Research Foundation 5K earlier this year.
Almost 40% of clinical trials in the United States fail to enroll the minimum number of patients needed to complete the study, and end up closing before they are completed.
drugs that could save the lives of future patients. Our newest and best drugs recently approved for the treatment of breast cancer were developed through clinical trials which required thousands of women to enroll in order to show success,” says Lynce. She also sees practical roadblocks to enrolling a broad spectrum of potential participants. “Many trials have informed consent forms that are more than 20 pages long and may not be easy to read or understand. Other trials only have these forms available in English. I think there is a lot of work to do on the part of medical institutions to get clinical
trial enrollments to be more representative of the general population, including minorities,” says Lynce.
‘A gift I can never repay’ Leventhal is now a second-year medical student at Georgetown. One of her recent classes focused on cancer and provided statistics on multiple myeloma, a cancer of blood plasma cells. She learned that the life expectancy from time of diagnosis to death for the disease averaged three years. Two weeks after that class, her father was diagnosed with multiple myeloma. Much to her surprise, when meeting
with his oncology team she was told that the survival statistics had recently improved dramatically: the life expectancy with current treatments had risen to seven to 10 years, on average. The longer life expectancy for these patients, and her father, can be directly attributed to clinical trials. “Patients facing this disease 10 to 15 years ago were willing to enroll in clinical trials to study it,” notes Leventhal. “Thanks to those individuals, patients today are living three times as long. Participating in clinical trials helps future patients get back years of their lives. It’s a gift I can never repay.” n Elissa Ernst is the director of development for Georgetown Lombardi Cancer Center. She can be reached at firstname.lastname@example.org.
The Gift of Teaching
New professorship honors the late Allan J. Goody (C’92, M’96, R’00)
By Camille Scarborough
“He lived life with his foot on the accelerator,” says Georgetown School of Medicine Dean Stephen Ray Mitchell of Allan J. Goody. “Undaunted by renal failure since he was 12, he studied and worked here at Georgetown for over 20 years as a specialist in diagnosing and treating kidney disease while quietly undergoing his dialysis and transplants. He was an inspiration to all who knew him. I think he loved Georgetown students and residents as much as he loved Georgetown.” Shortly after his passing in 2011, a memorial cherry tree garden took root in his name, overlooking the hospital where he studied and later taught. A lectureship was also established to pay tribute to his love of teaching and lifelong learning. Thanks to an additional $1 million gift this year from his parents, John and Diane Goody, the beloved professor will now be remembered with the Allan J. Goody, M.D. Endowed Professorship in Medical Education.
‘Never any doubt’ “Allan was a young teen when he found out he needed a kidney transplant. He decided then that he wanted to be a doctor,” shares his father John Goody. “There was never a doubt in his mind.” He was equally sure that he wanted to attend Georgetown. A brilliant math and science student, he received offers—and scholarships—from other institutions, but he had his heart set on the Hilltop.
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“There were quips and humor but always fascinating medical teaching, using his incredibly deep fund of knowledge. He was beloved.” — Dean Stephen Ray Mitchell Goody, pictured above, is honored in a cherry tree grove outside Med-Dent, and through a new endowed professorship.
“Allan told me he loved Georgetown from the start, especially the friendliness of the students and the academic rigor of the classes,” recalls Diane Goody, his mother. He was also an avid fan of Georgetown basketball, following the players and rarely missing a game. But perhaps more than anything, he took the mission of women and men for others to heart, helping kidney patients with the same struggles he himself faced for years. He focused his studies on nephrology, completing his medical degree while on peritoneal dialysis after
his second kidney transplant failed.
‘The twinkle in his eye’ After earning his undergraduate and medical degrees, he began a three-year residency and a year-long nephrology fellowship—also at Georgetown. It seems that Georgetown loved him as much as he loved it. According to Dean Mitchell, “He won every teaching award in the internal medicine residency, multiple times, and won the Outstanding Teaching Fellow twice— because the fellowship only lasted two years.”
His students honored him with four Clinical Faculty Awards before he passed away—and a fifth just three months following his death. When his brother accepted the fifth award on his behalf, Dr. Goody received a standing ovation from all of the students and faculty in attendance. “Anyone who sat across the table at Virginia Hospital Center during his morning report watched the twinkle in his eye when he was speaking,” says Mitchell. “There were quips and humor but always fascinating medical teaching, using his incredibly deep fund of knowledge,” Mitchell adds. “He was beloved.”
‘Complete selflessness’ in life and work In addition to his work at Virginia Hospital Center and his role as an assistant professor at Georgetown School of Medicine, Dr. Goody volunteered once a month at the Arlington Free Clinic, a nonprofit facility for low-income residents in his Virginia suburb. After he passed away, his colleagues found out that he rarely took co-pays from those less fortunate. They also found out that he was undergoing dialysis during many of the years while he was at Georgetown, but he didn’t want to draw any attention to himself. “He just went upstairs to a little room and took care of it,” says Dean Mitchell. A colleague, Kate Dreger, remembers his courage. “He never complained. He never bemoaned his disease. He simply carried on. It was a part of him but he was above all that. He pursued medicine with determination … and was ever humble and grounded. He focused on his patients and really got to know them, even their social issues and financial constraints.”
“Allan had a very patient-centric approach,” shares his father. “He gave his patients hope and practical advice based on his experiences. I remember that he helped one patient manage a problem with the shunt that you would only know how to deal with if you had one yourself. He was very handson.” “Most doctors had given up on me and vice versa, but Dr. Goody saved my life,” shares one of his patients. “He made me determined to live—and later, to give birth to my son even though other doctors discouraged it. Dr. Goody saw me through my pregnancy and now my husband and I have a little boy. He believed in me and brought hope out of fear.”
Teaching the ‘scary smart’ students of Georgetown “Allan derived huge satisfaction from working with students and young doctors,” says his father. “He told us just how ‘scary smart’ the students and residents were at Georgetown. I’m sure that was part of the pleasure he got in his job.” Together with his wife Diane, John Goody endowed the new School of Medicine professorship in his son’s name so that medical students, residents, and fellows could all benefit. “I will say—on behalf of his extended family, friends, and colleagues—that we’d like his name to be seen in some small way at the institution he loved so dearly. He gave us all so much. We watched him battle insurmountable odds without complaint, and succeed.” n Camille Scarborough is director of communications and editorial services in the Office of Advancement. She can be reached at email@example.com.
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198 students in Class of 2016 Internal Medicine
(10/14 are women!)
Family Medicine Orthopedics
Physios at 40
The Special Master’s Program marks four decades of biomedical education in a medical school setting By Kat Zambon
n 2015, less than 3% of applicants for admission to Georgetown University School of Medicine were accepted. However, the competitiveness of the medical school applications process is not a new problem. Forty years ago, faculty and administrators at Georgetown chose to create a first-of-its-kind program to help promising students interested in careers in medicine demonstrate that they are prepared for the challenges of medical school. Since 1975, more than 4,000 students have graduated from Georgetown’s Special Master’s Program in Physiology (SMP), a ten-month master of science
in physiology program designed to help talented students enhance their academic records and ultimately gain admission to medical school. As the 40th class of students prepares for graduation, the SMP has made changes to accommodate even more students while maintaining the rigorous academics and dedication to student success that give the program its outstanding reputation. Students in the SMP—who call themselves physios—take graduate-level biomedical science classes in addition to first-year medical school classes, and are graded against medical students. “The first-year medical courses at
Above: “Physios,” as SMP students call themselves, gather for orientation to kick off the one-year program.
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Georgetown are some of the hardest in the country,” says Susan Mulroney, director of the SMP. “I believe we’re the only program that grades against the medical school students. It’s very powerful and deans understand that. Our graduates go on to be leaders in medical schools, match in excellent residency programs, and have outstanding careers.”
Strong emphasis on student support In addition to their heavy courseload, most SMP students apply to medical school during the program, forcing the physios to become experts in time
management. To help them keep up with classwork while interviewing for medical school, the SMP offers lecture capture, review sessions, and a notetaking service. “It feels like medical school with the pace and rigor, with the added challenge of interviewing and trying to get into medical school,” says Amy Richards, SMP assistant director. “With that extra stress, it can be a harder year for the physios than for the first-year medical students.” The support students receive from the SMP starts before they even begin the program, as the aspiring physicians sort through a complex world of options for post-baccalaureate training. “We get a thousand telephone calls a year with people asking, ‘Is this the right program for me?’” Mulroney says. “It can be a risky and costly endeavor to do the program,” explains Richards, who advises prospective students to consider the challenge with care. To succeed in the program, she says, “applicants need to really want it, and they need to be a good fit.” During the SMP, advisors help students identify and apply to the right medical schools for them. About half of each graduating class proceeds directly from the SMP to medical school. The rest participate in second year strategy sessions to determine next steps. Students are also encouraged to reach out to faculty for updated letters of recommendation or advice. Mulroney recalls one student who applied and was admitted to medical school nine years after completing the SMP. “It’s an ongoing process and we don’t give up on students,” Mulroney says. “If they want to continue, we will support their application. And lots of them get in and do great.” SMP applicants must have a minimum 3.0 GPA and have scored at least a
28 on the MCAT, though the average matriculant has a 3.3 GPA and a 31 score. Many SMP students attended highly competitive undergraduate
schools and struggled to juggle activities, athletics, and academics. Some SMP students worked their way through college. Others faced family or medical emergencies as undergraduates, including one student who donated a kidney to his father the summer before starting the program. “You’ve got these amazing stories from the students. Many have done exceptional work outside the country in health care and they bring those experiences with them,” Mulroney said. “They come from diverse backgrounds and that’s what makes this fun—finding out about them and giving them the chance to show what they can do in the program.”
Building confidence in future physicians
510 Class of 2016 average MCAT score
(31.7 in old scale)
Taking classes with first-year medical students gives the SMP students the confidence they need to succeed in
3.3 ~85 Class of 2016 average undergraduate GPA
Percentage of graduating class attending medical school
Minimum undergraduate GPA for admission
505 50-60 Minimum MCAT score for admission
(28 in old scale)
Percentage of graduating class immediately entering medical school
Most SMP students take classes, and work with study groups, at the medical school campus.
medical school. SMP graduates who go to medical schools other than Georgetown are usually required to retake the medical classes and frequently find them easier the second time around. While participation in the SMP does not guarantee admission to Georgetown School of Medicine, historically about 15% of SMP students are accepted by Georgetown each year. The SMP graduates who go to Georgetown are not required to retake the classes they took during the program, though they must take enough credits to maintain their status as full-time students. They use their time wisely, often serving as teaching assistants for first-year classes, starting research projects, or doing service activities. After being placed on a waitlist the first time she applied to medical school, Mary Jenkins (MS’15, M’19) was told she could improve her application by participating in a program like the SMP. Not only did that experience help her earn admission to medical
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“There is no doubt that the SMP is academically rigorous, but nothing prepares you for medical school like medical school.” — Maria Masciello (MS’16). school, it prepared her to serve as a teaching assistant in anatomy at Georgetown. “The program instilled a lot of confidence in my own intellectual abilities and confirmed even further my desire to be a doctor,” Jenkins said. “The preparation for medical school from the SMP was bar none,” said Vinny DiMaggio (MS’09, M’13), a resident physician in internal medicine and pediatrics at the University of Chicago Medical Center. “I walked into medical school on day one knowing exactly how to academically succeed in
a way unmatched by my peers.” “There is no doubt that the SMP is academically rigorous, but nothing prepares you for medical school like medical school,” said Maria Masciello (MS’16). “This program is the closest a person can be to getting a medical school experience without actually being enrolled.”
Expanding to new downtown campus The SMP has grown from a program that launched with about 40 students in 1975 to 211 students in the 2016 class today. The challenge of finding space at
Georgetown for the growing student body inspired Adam Myers, associate dean for special programs, to investigate creative alternatives. Building on experience gained at joint programs offered by Georgetown and George Mason universities at a remote site, the decision was made to develop a second section of the SMP using a “flipped classroom” model. In 2015, the SMP offered admitted students the option of taking classes at the Georgetown Downtown SMP, located at the Georgetown University School of Continuing Studies. Within hours of opening registration for the downtown program, it reached capacity. At the new downtown campus, SMP students learn the medical school content in flipped classrooms, where
they view a lecture and other material before class, then spend class time working through challenges. “There are clicker questions with formative responses, problem-solving workshops, and clinical cases to tie all of the material together and reinforce it,” Mulroney said. “It’s the SMP,” Richards says, “it’s just a different location. All content is the same.” The downtown campus has classroom sessions limited to two to four hours per day, four days a week, with Fridays left open for community service and clinical experiences. These experiences include going on ride-alongs with the D.C. Emergency Medical Service and Metro Police, shadowing in emergency departments, serving the community in food kitchens and teaching D.C. residents
hands-only CPR. The addition of the downtown SMP provides a new choice for the incoming students who like smaller classrooms, and want to engage in a different kind of learning environment. So far, the students at the downtown campus have been flourishing, Mulroney says. “They’re enjoying the experience, and at the same time we’re getting important information on flipped learning so that we can bring more of it to the main campus. It will inform a lot of what we do in the future,” she says. n Kat Zambon is communications director for GUMC. She can be reached at kat.zambon @georgetown.edu.
Volunteers with the Ovarian Cancer Network’s Survivors Teaching Students program meet with Georgetown M3s during their OB/GYN rotation in February.
Patients as Teachers Cancer survivors offer medical lessons through personal stories
n a short drive to the grocery store, Stacy had to pull over and find a bathroom. The frequent urination had grown from bad to worse, and now the busy 55-year-old found she could hardly get her errands done, let alone her job and caring for her family. She figured this was just the worst urinary tract infection she’d ever faced, and called her longtime OB/GYN for help. Rather than prescribe an antibiotic over the phone, he told her to come in. Stressed by the competing demands of a busy life, it was difficult for Stacy to make time for an in-person visit. But she did, and when she got there, her caring physician took time to ask a lot of questions. “I’m exhausted,” she told him. Once she stopped to think about it, she began to list a series of physical changes that
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she had recently experienced and dismissed, chalking them up to stress or the mystery of menopause. She had dull abdominal pain, constipation, pain during sex, and frequent urination. How frequent? To her frustration, she could no longer play more than four holes of golf without needing a bathroom break. The doctor listened with patience and concern. This sounded like more than a nagging UTI. He scheduled an internal ultrasound that revealed a small ovarian cyst. It needed to be removed, he explained. The surgery was scheduled quickly, and when she met with the surgeon a few days later, the vocabulary had changed. “He said the tumor needed to come out immediately,” recalls Stacy. “Apparently it was no longer a cyst!” The surgery confirmed that she had
Stage III-C ovarian cancer. She had a hysterectomy and had a portion of her diaphragm removed, plus a port inserted for chemotherapy infusions. Stacy endured 17 weeks of treatment, and today is a grateful survivor of ovarian cancer. “My OB/GYN is my hero,” she says. “Had my doctor just prescribed the antibiotic like I’d asked…,” she pauses and takes a deep breath. “He did the right thing and called me in.” Stacy shared her story with 20 Georgetown medical students through Survivors Teaching Students, a program organized by the Ovarian Cancer National Alliance. Three women present their personal cases to the third-year students during their OB/GYN rotation. The organization hopes to educate future physicians in all specialties and change
Once she stopped to think about it, she began to list a series of physical changes that she had recently experienced and dismissed, chalking them up to stress or the mystery of menopause. the old idea that ovarian cancer is the “silent killer” without recognized symptoms. Current research points to symptoms that can be confused with common conditions of menopausal women— bloating, pelvic or abdominal pain, difficulty eating or feeling full quickly,
and urinary symptoms such as urgency or frequency. Other symptoms include fatigue, indigestion, back pain, pain with intercourse, constipation, and menstrual irregularities. The survivors share stories of some health care providers who did things right, but of others who overlooked
problems or misdiagnosed symptoms as fibroids or gastrointestinal issues. “My only symptom was dull pain that grew worse over four years,” said Lynn, another survivor whose doctor had more of a wait-and-see approach that ended up delaying diagnosis until she was at Stage III-C. “Ovarian cancer patients look healthy. I’m here because I don’t want this to happen to more people and you guys are key.” The program concluded with a short Q&A, and gratitude. “Thank you for coming to speak with us,” said one student. “I’ve read about this but meeting you and hearing your personal stories makes it stick.” n
Medical Alumni Honored in Rome
his year two medical alumni are among the six recipients of Georgetown’s 2016 John Carroll Awards. The award recognizes extraordinary leadership and service to the university and is the Alumni Association’s highest honor. Alan Brett Leahey (C’82, M’87) is an ophthalmologist at the Lehigh Valley Eye Center in Allentown, Pennsylvania. He served previously on the Board of Regents and chaired the Medical Affairs Committee. He is also the Georgetown Scholarship Program Chair for the Class of 1982, chair of the alumni admissions program in his area, and a former Career Network member. He and his wife, Kathleen Smith Leahey (NHS’83), live in Greenville, South Carolina and have three Hoya children—Kelly (S’10), Colleen (C’11), and Jennifer (C’14).
Alan Brett Leahey (C’82, M’87)
Francis M. Palumbo III (C’68, M’72, R’75)
Francis M. Palumbo III (C’68, M’72, R’75) served for 10 years as Director of Georgetown’s Children & Youth Ambulatory Services before entering private practice at Spring Valley
Pediatrics in Washington, D.C. He also holds a faculty appointment in the Department of Pediatrics at Georgetown University Hospital. He has served as an advisor for the American Academy of Pediatrics and has appeared before Congress as an expert child advocate on the Task Force on Children and Television. A member of the Legacy Society, he and his wife, Sharon Love Palumbo, live in Arlington, Virginia. The awards were presented in April in Rome, Italy, during John Carroll Weekend, the beloved annual gathering of Georgetown alumni for social, cultural, and intellectual engagement. n
Georgetown alumni were honored at the John Carroll Awards Banquet in April: The Hon. Francis Rooney (C’75, L’78, Parent’13), Francis M. Palumbo III (C’68, M’72, R’75), Alan B. Leahey (C’82, M’87, Parent’10,’11,’14), The Hon. Arthur J. Gajarsa (L’67, H’12, Parent’99,’02,’08), Julia Farr Connolly (C’88, Parent’18), Martha Montag Brown (I’78, Parent’10,’14) and 2016 Patrick Healy Award winner James B. Reardon-Anderson (Parent’01).
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Learn more about how to connect with your classmates at alumni.georgetown.edu.
Susan Hockfield Chosen to Serve as AAAS President-Elect
Susan Hockfield (M’79)
he American Association for the Advancement of Science announced that Susan Hockfield, former president of Massachusetts Institute of Technology, has been chosen to serve as president-elect of the organization. Hockfield earned her Ph.D. in anatomy from the Georgetown University School of Medicine, with a concentration in neuroscience in 1979. She was an NIH postdoctoral fellow at the University of California, San Francisco and a member of the scientific staff at the Cold Spring Harbor Laboratory in New York. In 1985 she joined the faculty at Yale University, and later served as dean of the Yale University Graduate School of Arts and Sciences
and then provost before joining MIT in 2004. Hockfield was president of MIT from 2004 to 2012, currently holding a faculty appointment there as professor of neuroscience and a member of the Koch Institute for Integrative Cancer Research. Her research focuses on brain development and glioma, a deadly form of brain cancer. Hockfield pioneered the use of monoclonal antibody technology in brain research. “In all of these roles I came to appreciate the responsibility of academics to communicate their discoveries to the non-scientific community and to bring their perspectives into policy decisions,” Hockfield said. n
Alumna named a 2015 Washingtonian of the Year
© Jeff Elkins/Washingtonian
ediatrician Gloria A. Wilder (M’93), known to most as “Dr. Gloria,” was recently recognized by Washingtonian magazine for her emphasis on improving access to care in D.C. She told the magazine that her goal is for all Washingtonians to have wellness choices: “We’re in the best city on earth to demonstrate justice in access to health care.” Wilder is president and CEO of Core Health, a community health and wellness design firm providing outcome-focused solutions to the nonprofit sector, and dedicated to
assisting underserved populations. She has been recognized with honors and awards from a host of organizations, including the District of Columbia Primary Care Association, WETA, the Rotary Club, and Planned Parenthood. In 2004, George Washington University named Wilder physician humanitarian of the year. Dr. Wilder previously held positions as director of community pediatrics at Georgetown University Medical Center and chair of mobile health programs at Children’s National Medical Center. n Gloria A. Wilder (M’93)
GRAND ROUNDS REVISITED
Reflections on medicine with
Harry Jaffe (M’71, R’72) “Being a doctor is our family business. My dad, Daniel Jaffe, went to medical school at George Washington University, then taught medicine at Georgetown for many years. I graduated from Georgetown in ’71, my brother Mark in ’79, and my nephew Robert in 2010.” “I founded my practice here in Evanston, Illinois, on July 1, 1976, so I will celebrate my 40th anniversary this year.” “I’m just a workaday primary care doctor.” “When I arrived, Northwestern University was just putting together a department of general internal medicine, and so I was an original member. I teach at Evanston Hospital. I’ve been teaching students, interns, and residents since 1976.” “I love teaching. The students work so hard to get into medical school and so hard to get through it. There is nothing better than seeing one of your students become a good doctor.” “I do attending rounds, and a few years ago, on the first day of the rotation, I was on my way to meet my team and ended up walking behind two interns and a resident. One asked ‘Who is our attending?’ and his colleague replied, ‘Some guy named Jaffe.’ The first asked ‘Is he any good?’ and his friend replied, ‘I’ll let you know.’ As a teaching physician, you’re only as good as your last class. You’d better be on your toes.” “Medical education is tutorial—you learn it from the person above you. That hasn’t changed. Of course, technology has changed: it’s easier to know your diagnosis when you can punch it up on a handheld device instead of memorizing it, like we had to do.” “I’ve probably done more good for more people by teaching— by helping to produce good doctors—than I have by seeing patients over the years. The reach of teaching and training doctors is exponential.” “I think the number one thing that has changed is the limited work hours. We never had any restrictions.” “It’s harder for students today to be proficient at physical exams:
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there are so many layers (people, technology, protocol) between them and the patients. With shorter hospital stays, it’s harder for us to teach physical findings and physical diagnosis. When the patients were in the hospital longer, you had much better access for ongoing physical examination—a wonderful teaching tool.” “Today, you get through medical school, an internship, residency—and then when you practice, you’re not an independent professional. You’re an employee. The psychology is completely different than it used to be.” “It used to be said that physician practices were really hundreds of thousands of cottage industries. Back then, a big group practice was four people. Now, corporate and institutional entities employ thousands.” “I loved Georgetown. I spent four years with terrific classmates: we were all in it together. I did my residency there, too—a wonderful experience but it wasn’t easy. I remember the schedule of working 36 hours on and 12 hours off.”
“Getting into Georgetown was a great moment. It’s wonderful to realize, after a lot of hard work and waiting, that unless you putz it up, you’re going to be a doctor.” “With the Jesuits, Georgetown’s medical school was about producing doctors for the community. That was their goal, and they did it. The worst thing you can say to a Jesuit is you gave me a bad education—and, in the Jesuit tradition, Georgetown is focused on great education.” “What would my classmates be surprised to learn? That I finally developed a sense of humor once our surgical rotation was over.” “In the dual role of physician-teacher, it’s a constant challenge. To teach students to be good doctors, and take care of patients while you teach: those are two important and distinct roles.” “It’s so rewarding when you can look at yourself in the mirror every morning and know that you’re doing good work in the world.” n Interview by Melissa Maday
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While taking photos for Match Day 2016 (see page 30), Georgetown University photographer Phil Humnicky stumbled across this glorious display of springtime outside Med-Dent.
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