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Charting a new course in medical education

As I mentioned in my 2004 State of the School address this fall, we have begun to rigorously re-examine the content and structure of our curriculum so that it better meets the needs of an ever-changing health care environment, surpasses other top-notch schools, and provides a quality and effective education for each new generation of doctors. Dr. Jack Shulman, Senior Advisor to the Dean for Curriculum Development, is ably guiding us in this process. "Our primary goal is to continue to turn out outstanding clinicians while providing the flexibility that students need to develop into future leaders in their varied areas of interest, such as research, public health, or clinical medicine," he says.

For the past year, Dr. Shulman has spent long hours with a number of department chairs, course directors, and other educators to gather their input and examine our many strengths, define the desired qualities of a medical graduate, evaluate our current culture, and create a broad outline of new approaches to our curriculum. Additionally, he and I have surveyed available literature on curriculum reform and visited other medical schools where reform is under way or being planned.

So what can future medical students expect? One thing is clear: We need to integrate basic science with clinical instruction throughout all four years of medical school. Several ideas on the table include beginning clinical instruction on day one of medical school, using simulators to present certain cases and clinical technological skills, and partnering small groups of students who have specific interests with faculty mentors. The current two years of early basic science instruction can be shortened to three semesters (with additional advanced basic science instruction during the M3 and M4 years) to allow the clinical clerkships to begin midway through the M2 year. This would allow time for students to have structured scholarly clinical, public health, or research experience before the M4 year at the various schools within Emory, at the CDC, or at other professional schools in Atlanta or elsewhere. This structure will give students more time than they have now to vigorously pursue their chosen fields and work closely with key faculty members.

While we have many valuable resources available, we are aware that this new vision will require the commitment of faculty as well as technology, additional staff, and a system of quality assurance. We also have great hopes, providing we have the funding for a new medical education building, to provide the facilities we need to support the new curriculum. A steering committee for curriculum development, comprised of faculty and students, has been formed to lead this major effort. The committee is co-chaired by Dr. Stephen Warren, Chair of the Department of Human Genetics, and Dr. Carlos del Rio, Professor of Medicine, and advised by Dr. Shulman. Members will create a final report by August 1, 2005. We plan to introduce our new curriculum by July 1, 2006, implementing it one step at a time over four years.

A picture-perfect day

An overflow crowd of family and friends filled the WHSCAB Auditorium as our 113 M1 students donned their white coats for the first time in October. To accommodate the large audience, the annual White Coat Ceremony was telecast to seminar rooms in the WHSCAB. "Today, we have a TV audience," Dr. Ira Schwartz, Associate Dean for Student Affairs, told guests with characteristic good humor. "You can watch this on the TV screen or turn to the Braves game if you get bored."

Of course, no one gave the Braves game a second thought as Dr. Jack Shulman described for students the challenges, wonder, and beauty of becoming a physician. "There are two things we can guarantee-growth and change in knowledge, and growth and change in yourself," he said.

As Dr. Schwartz, Dr. Bill Eley, Executive Associate Dean for Medical Education and Student Affairs, and Dr. Robert Lee, Associate Dean for Multicultural Student Affairs, helped students don their white coats, cardiologist and writer Dr. John Stone presented each student with a copy of the book On Doctoring, a collection of stories, poems, and essays that he co-edited.

Appropriately, in his keynote address, Dr. Stone described language as the requisite of the human condition and of medicine. As medical students progress through school, they will learn to speak the languages of medicine, science, and patients. "What a privilege it is to walk into patients' lives and hear their stories," said Dr. Stone. "The white coat should remind us all of this privilege. I hope you will make your own commitment today to become a good listener."

Alumni honors

During Homecoming Weekend last month, the Medical Alumni Association (MAA) presented two SOM alumni with honorary awards. Dr. Garland Perdue, 48C, 52M, former Medical Director of Emory University Hospital and Director of The Emory Clinic, received the Award of Honor. Dr. Perdue served with distinction for 40 years as a faculty member in the Department of Surgery and was the primary surgeon on the state's first kidney transplant in 1966. The Distinguished Achievement Award was presented to Dr. Warner Webb, 57M, a pediatric surgeon in Florida. A pioneer in his field, Dr. Webb holds faculty appointments at the University of Florida College of Medicine and Mercer University School of Medicine. The Webb Center in Jacksonville, Florida--named in his honor--serves children and young adults with spina bifida and other disabilities.

For the first time, the MAA presented distinguished achievement awards to two resident alumni. Dr. Andre Churchwell, a cardiologist in Nashville, Tennessee, was the first African-American chief resident at Grady in the mid-1980s. Dr. Sheldon Taub, a gastroenterologist in Jupiter, Florida, has been cited as one of the top doctors in South Florida and the nation. Dr. Taub completed his residency in internal medicine at Emory in 1976.

Research funding success

Research funding in the SOM grew by 10% in FY04 from $246.5 million in FY03 to $273.2 million in FY04. "It is a considerable achievement during a year in which the NIH budget grew by only 3.6%," says Frank Stout, Emory Vice President for Research. Over the past five years, from 1999 to 2004, sponsored research funding at Emory has grown by more than 71%. In FY04, the Woodruff Health Sciences Center received $328.9 million, or more than 93% of the university total. Most of the departments leading Emory in this stellar rise were in the SOM, including Medicine, Psychiatry and Behavioral Sciences, Pathology and Laboratory Medicine, Microbiology and Immunology, the Winship Cancer Institute (WCI), Surgery, the Vaccine Research Center (Yerkes), and Neurology.

Some important research projects that have contributed to the rise in funding include $10 million in NIH grants for cancer nanotechnology that scientists at Emory and Georgia Tech are using to establish a Bioengineering Research Partnership to develop nanoparticles for diagnosing and treating prostate cancer. With a $10 million grant from the Department of Defense, WCI scientists are leading a consortium of 13 universities from eight states in identifying new therapeutic targets for treating advanced prostate cancer, while a $7.6 million National Cancer Institute grant is helping WCI researchers uncover the pathways of prostate cancer metastasis. An Atlanta coalition of hospitals and universities led by the WCI is using a $3.7 million NIH grant to address health disparities among minorities at the new Grady Center for the Reduction of Health Disparities. A new Exploratory Center for Interdisciplinary Research in Vaccinology, part of the NIH Roadmap initiatives, combines key research centers throughout Emory and in partnership with Georgia Tech and the Institute for Systems Biology in Seattle, Washington.

Cr�me de la cr�me

As usual, our faculty continue to earn national recognition for their many contributions to the field of medicine. Here are some of our more recent accolades:
* Rick Himelick (Physician Assistant Program) has received the Georgia Association of Physician Assistants (PA) Rural PA of the Year award. As Director of Community Projects at Emory, he has directed Emory's involvement in the South Georgia Farmworker Health Project for nine years.
* Dr. Anthony Stringer (Rehabilitation Medicine) has received board certification from the American Board of Professional Psychology in neuropsychology, a certification attained by only 400 neuropsychologists in the United States and seven in the state of Georgia. He also is the first African American to achieve this board certification.
* Dr. Sharon Weiss (Anatomic Pathology and Laboratory Medicine) has been elected a Trustee of the American Board of Pathology.

Finally, I recently was appointed to the Board of Directors for the Liaison Committee for Medical Education (LCME), the American Medical Association and the Association of American Medical Colleges (AAMC) group that accredits medical schools in the United States and Canada. I sit on the subcommittee on policy review, which promotes LCME standards. I also serve on the Administrative Board of the AAMC's Council of Deans.

National honors

The Institute of Medicine (IOM) has elected three Emory faculty and two adjunct/clinical faculty members to its new class of leading national health scientists. Dr. Mahlon DeLong (Neurology), Dr. Stephen Warren (Human Genetics), and Dr. Ruth Berkelman (Rollins School of Public Health) are the newly elected faculty members and Dr. Julie Gerberding (Director, CDC) and Dr. James Marks (CDC) are the newly elected adjunct faculty.

This brings Emory's total IOM membership to 18, including adjunct professors, and is an increase from just one member only a decade ago. Election to the IOM is considered one of the highest honors in medicine.

Student accolades

Krista Powell and Grace Prakalapakorn, both M4 students enrolled in the MD/MPH program, are this year's recipients of the O.C. Hubert Epidemiology Intelligence Service 50th Anniversary Fellowship awards. They are participating in the CDC Elective Rotation in Applied Epidemiology. This rotation provides an experience, where possible, as a member of a CDC team investigating a global public health problem. The program is supported by a generous gift from the O.C. Hubert Charitable Trust to the CDC Foundation.

Style and prose

The 2003-2004 edition of The Styloid Process, the SOM's literary magazine, is available in the resident's lounge on the 14th floor of Grady Hospital. Students, faculty, and staff may now submit entries to the magazine for next year's edition. Please email your submission to Esther Han (ehan@emory.edu). Also, let her know if you can't find a copy of the magazine or would like to serve on the editorial staff (M1 or M2 students are especially needed).

Thomas J. Lawley, MD
Dean, Emory School of Medicine








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