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									A periodic publication for SR-AHEC alumni                                                  volume 2 summer 2003




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     Welcome to the second edition of     in medical education. We still have           Direct an e-mail to:
 the Duke/ Southern Regional AHEC                                                       carol.russell@sr-ahec.org
                                          five questions, again answered by
                                                                                        In the subject line, put
 Family Practice Residency Program        a member of the class of 1999. (I
                                                                                        ALUMNI.
 Alumni newsletter!                       promise the next set of five questions        In the body, put your first
     A lot has happened since our first   will be asked of someone from a               and last name.
 issue came out in November — we’ve       different graduation class.) In future
 graduated another class of residents,    issues we will tell you a little about    It’s easy! And we promise not to
 we held a fun and informative Alumni     some of the faculty members that were     send you superfluous mail.
 CME event and we have begun              here when you were here and what
 orientation for a whole new group of     they are now doing. If you’ve got a
 residents. In this issue we will show    favorite faculty member that you would
 you some pictures from the alumni        like to know more about, drop me an
 get together and tell you what all       e-mail or give me a call.
 happened, and we will try to explain         Enjoy!
 what’s new, exciting or challenging          Lenny



    Announcing ...                                                                 Thanks, Alumni................... 2
                                                                                   Worst Practices .................. 3
            The Alumni Web Page!                                                   Q&A Questions................... 3
                                                                                   Alumni Reunion .................. 4
   www.SouthernRegionalAHEC.org/residency/alumni.htm
                                                                                   Building A Residency ..... 6, 7
                                                                                   About the Match ................. 8
            An exciting new place to go!
            • Review current and past newsletters in                               Family Practice Trends....... 9
               Acrobat PDF format.
                                                                                   What’s New ...................... 10
            • Cruise alumni news, photos and memories.
            • Contact us with any questions.                                       Q&A Answers ................... 10
            Check it out! You may find yourself or someone you
                                                                                   ACGME Competencies .... 12
             know there!
                                                                                   Pat Lowry.......................... 12
      For information on any of our CME programs, go to
       For information on any of our CME programs, go to
    www.southernregionalahec.org/reis/cme_medicine.htm                             Let’s Party......................... 14
    www.SouthernRegionalAHEC.org/reis/cme_medicine.htm
 2
 2

                                   It Was Great
                                       To Have You Here!
                                       Thanks to all the alumni and       Alumni
                                   faculty who returned to SR-AHEC
                                   to reunite, remember and forge new     Susan Aycock (1990)
                                   relations among us. We are grateful
                                                                          Karen Barefoot (1990)
                                   for the special energy you brought
                                   to the day’s professional events and   Sandra Carr (1999)
                                   celebrations. It was our pleasure to
                                                                          Martina Dockery (2000)
                                   have you as our guests, and
Marla Berg-Weger talks about       we hope you will return again          Stephanie Gillette
driving and dementia.              next year!
(Oh dear, am I driving?)                                                     (Littrell, 1987)
                                                                          Ben Hardin
                                                                             (1980 – First Graduating Class!)

 Faculty                                                                  Nicole Holman (2001)
                                                                          Darlene Johnson-Oduyelu
                                                                             (2000)
Marla Berg-Weger, former director of behavioral science program;
                                                                          Leila Kahwati (1999)
Chris Manasseh, former member of residency medical faculty;
                                                                          Catherine Kelly (1993)
Lars Larsen, former residency director.
                                                                          Gail Margerum (1989)
                                                                          Pamela Murphy (2001)
                                          At left, Darlene
                                          Johnson-Oduyelu;                Tandeka Nix (2002)
                                          Below, PDA Boot Camp:           Lenny Salzberg (1991)
                                          power users in the making!      Janine Scott-Lowe (1999)
                                                                                                                            3

           By Amy Vega
        Director of Allied Health
         Education, SR-AHEC
                                             Worst Practices
    We spend a lot of time talking                  Don’t sweep mistakes under the carpet ;
about the things that we do well. It’s
only natural to claim bragging rights               Share the valuable lessons you have learned.
when we are successful and we
love to share our best practices with        she and I worked diligently with other     that before and it just doesn’t work.” It
others. But why is it that when we           folks from Coastal, Eastern, Area L        was through our sharing of flops and
make mistakes or do things less than         and Wake AHEC to plan a conference         failures in program planning that we
perfectly, we sweep it under the carpet      that was designed to reach a small         somehow discovered the formula for
and move on? There are so many               group of educators across the state        developing and delivering a nearly
valuable lessons to be learned from          of North Carolina — but drew a much        perfect conference.
our “worst practices,” and it’s too bad      larger crowd than we had expected,              It was only fitting that we hosted
that we don’t make more of an effort         from seven different states across         a panel discussion at this conference
to share them.                               the country.                               titled “Flops and Failures in Healthcare
    SR-AHEC recently co-sponsored a               We were pleasantly surprised, and     Education,” in which four people
conference with four other AHECs, the        one has to wonder where this windfall      from various settings in healthcare
North Carolina Healthcare Educators          of success came from. I truly believe      education told stories about their own
Summit. Myself and Andrea Novak              that we owe a lot of it to the fact that   “worst practices” — things that they
from REIS served on the planning             in our planning meetings, we shared        tried, but just didn’t work, for whatever
committee as the SR-AHEC                     lots of ideas and we were quick to         reason.
representatives. For the past year,          tell each other, “Sorry, but I’ve tried                           Continued on page 5



 Make a difference through your charitable contribution:
                                    Donate and help SR-AHEC develop and
                                    support the health care workforce.

                                    Contribute in memory of a person or for a                    Answers on Page 10
                                    specific purpose consistent with the SR-AHEC
                                    mission; or                                         1. If you read a newspaper,
                                                                                           which part of the newspaper
                                    Bequeath your contribution.
                                                                                           do you read first?
 If you would like to make a contribution, please contact Deborah Teasley,
 (910) 678-7230, or Lynn Greene at (910) 678-7232.                                      2. Where can you get the
                                                                                           best barbecue?


  Credits                                                                               3. What were you doing on
                                                                                           September 11th when the
 The Rotations newsletter is published by Southern Regional AHEC,
                                                                                           first plane hit?
 1601 Owen Drive, Fayetteville, NC 28304. If you have items of interest that
 you would like included in an upcoming issue, please contact Sherry Stafford           4. What is your favorite
 at (910) 678-7234 or e-mail Sherry at sherry.stafford@sr-ahec.org.                        vegetable?

         Lenny Salzberg, publisher                                                      5. If you had to choose a
         Sherry Stafford, editor and graphic illustrator                                   different medical specialty
         Donna K. Bridges, page designer                                                   to practice, which would
                                                                                           you choose and why?
 4



                                                             Alumni Day
                                                              ... And Night



Day — Learning!
Stephanie Gilette, dispelling the PDA mystique!



        Lively topics,
 lots of chatter dominate
   first alumni reunion
                                                             Night — Catching Up!
                                                             From left to right, Marla Berg-Weger, Susan
                 By Sherry Stafford                          Aycock and Lenny Salzberg.
CME Conference
     What do thyroid, dementia and congestive heart         Our wall of excited chatter and laughter rocked the loft
failure have in common? They were all morning               section! Some lingered long over lunch or reunited with
lecture topics at the 2003 Alumni Conference! Dr.           old acquaintances at SR-AHEC. Others hurried back for
Lars Larsen spoke (Update on Thyroid Disease),              the afternoon class.
Dr. Marla Berg-Weger presented “The Family and                  A strong gathering of new PDA users acquired
Community Perspective on Driving and Dementia,”             skills and received answers to setup problems they
and then Dr. Chris Manasseh updated us on                   had encountered in PDA Boot Camp, a three-hour
congestive heart failure. Breakfast goodies and             crash course on the use of personal digital assistants
lively conversation filled the breaks in between. After     (palm computers). Dr. Joyce Copeland, assistant
all, this was the first event of the first-ever gathering   clinical professor at Duke University Medical Center,
of SR-AHEC alumni! All agreed that the lectures             demonstrated the power of the PDA as a reference tool for
were very well done. (Three CMEs down and three             physicians. Saundra Stanley, SR-AHEC ORPCE director,
to go.)                                                     helped attendees get a handle on Graffiti (handwriting
     So what could follow a successful first act? A         recognition system used by the Palm operating system).
delightful lunch for 30, catered at a stylish downtown      Sherry Stafford, SR-AHEC IT specialist, demonstrated
mini-brewery! Although the food and atmosphere              PDA software installation and file management.
were great, they took a back seat to conversation.
                                                                                                 Continued on next page
                                                                                                              5


        Alumni
From page 4
Everyone left with some                                                           “Women
exciting new skills and ideas for                                                 Ironing”
customizing PDAs. The class                                                       by Edgar
dispersed to various corners of                                                   Degas,
Fayetteville to get ready for the
graduation celebration.
                                                                                  Musee
    Graduation Dinner                                                             d’Orsay,
    The first event of the gala was                                               Paris 1884
an open cocktail bar and, if noise
level was any indication, it was
very successful in stimulating
conversation. Carol Russell’s
                                              Worst Practices
creativity was evident throughout     From page 3
the ballroom (red-white-blue              One speaker talked about the    When the public health workers came
ribbons, flowers and floating         dilemmas that were experienced      back in for follow-up, the men in the
balloon centerpieces decorated        when a large conference on          community showed them that they had
the tables) and in the menu.          women’s health was hosted, but      been doing just what they had been
With all the guests seated and        the two-stall women’s restroom      instructed to do — placing condoms
served, the cocktail din leveled      quickly ran out of toilet paper.    over poles before intercourse.
to a pleasant tone of dinner          The attendees spent the rest             After much laugher, the audience
conversation.                         of the day so upset over the        jumped in to volunteer stories of
    Dessert was followed              inadequate bathroom facilities      their own. Then, the panel followed
by a round of diplomas and            that they missed the key            up with an open discussion, inviting
acknowledgment for the                objectives of the conference.       conference attendees to offer their
graduates: James W. Brook, DO;        Another presenter talked about      guesses as to why the “flops and
Tanya J. Canfield, MD; Norman         a “Breast Health Awareness”         failures” had occurred, and how we
D. Means, MD; Jorge A. Sabin,         campaign, which went afoul          can practice in reverse for success.
MD and Robert G. Townsend III,        when the marketing group                 We heard from several participants
DO. Each graduate was received        that published their materials      that the “Flops and Failures in
by representatives of the Duke/       left out the word “Health” and      Healthcare Education” was the best
SR-AHEC Family Medicine               instead implemented a “Breast       session of all at our conference. I
Residency: Dr. Deborah Teasley,       Awareness” campaign.                think that it speaks volumes to what
SR-AHEC president and CEO;                Not to be outdone, another      we have to gain from sharing our
Dr. Lenny Salzberg, SR-AHEC           panelist volunteered his            “worst practices”. A wealth of lessons
residency program director; and       experience from working with        lie in the mistakes that we make. We
Dr. Joyce Copeland, assistant         a project to introduce condom       can either choose to tuck it away and
clinical professor at Duke            usage to a tribal population        forget that we failed — or share what
University Medical Center.            overseas. When public health        we’ve learned with others and pass
    The final event is always the     workers taught men how to           on the wisdom that we’ve gained.
most fun — dancing! DJs provided      correctly put on a condom           Better yet, we can laugh — when it’s
music that inspired a throng          (using poles as the model),         appropriate — and remind ourselves
of participants in line dancing,      the leaders of the tribe were       that we’re all imperfect, and worst
electric boogie slide, shag, swing    enthusiastic about implementing     practices are written into our job
and slow dancing. You need            what seemed like a fairly easy      descriptions as human beings.
only look at the photos to feel the   intervention. Only they weren’t          So when you finish reading this
festivity. (See www.sr-ahec.org/      so happy a year later, when         article, make it a point to go tell a
residency/alumni.htm). With that      they reported back to the public    co-worker, or call a colleague, or drop
many people dancing, you’d            health community that their birth   an email to an old friend — about your
better carve out your territory and   rate had risen dramatically.        own worst practices. You’ll be glad
keep in step!                                                             you did.
6

Building A Residency


           Winter 1974              July 1974                August 1974
          Charter of the           Incorporation             Buildings and
        NC AHEC program              of FAHEF               land purchased




         August 1974             August 1974               January 1975
                              Nursing program grows;         Dr. William Hall
    V.A., Womack civilian
                            Barbara McGrath (not shown)     becomes the first
    cooperation planned
                               becomes first director        FAHEC director




          March 1975               June 1975               February 1976
     Dermatology Clinic           FAHEF becomes             Family practice
      started at UNC             affiliated with Duke     residency approved
                                                                                             7




         July 1976                   September 1976                    January 1977
 Duke OB and FP residents          Drs. Godwin and Goldstein          Dr. Koek (shown)
to Cape Fear Valley Hospital             come aboard                   and Dr. Howiler
                                                                          recruited




      February 1977                 April 1977                    Fun is timeless...
      CME began                  Dr. Willis recruited          Some things never change



  Residents pictured below are: Clark Hammer, Ben
  Hardin, Frank Hoffman and Steve Weigand.




              July 1977              Followed by 25 years of              June 2003
                                         Learning...             The residency program
         First family practice                                    begins its 26th year,
          residents entered                Teaching...          now under the direction of
             the program                     Healing              Dr. Lenny Salzberg
 8



About The Match
March 27, 2003
        By Lenny Salzberg
       Residency Program Director


    There are several moments in
my life that stay with me forever: the
first time I played “spin the bottle,”
pitching and winning a little league
championship game, reading the
Haftorah at my Bar Mitzvah, my
wedding day and the birth of my
three beautiful children. Two other
moments that have helped shape me
professionally are when I was fired
from a job as a waiter and when I
matched with FAHEC on Match Day.
Getting fired is a whole other story;
today I’d like to talk about the Match.                   The New Residents: Class of 2006
    Match Day is a big day for medical      Southern Regional AHEC’s Class of 2006 is, from back, left to right:
students. It is when we find out where      Jeremy Ackermann, DO; Brad Butler, MD; Johnnie Moultrie, MD;
we are going to spend the next three        DeShonta Springs, MD; Samar Elgendy, MD; and Lori Haigler, MD.
years of our lives. As students, we
have big decisions to make. What type
of specialty will we practice?” “What       it isn ’t Mac-and-Cheese or Ramen          Fayetteville and teaches our residents
part of the country would we like to live   Noodles)?”                                 in a practice that is owned by Cape
in?” “Should we eat Mac-and-Cheese               I’m writing this one week after       Fear Valley Hospital. One of our new
and Ramen Noodles for two more              applicants for residency programs          residents grew up in Fayetteville,
weeks in order to afford to interview       found out where they matched for the       and his father still works at Cape
at one more program?” For most of           coming year. So much has happened          Fear Valley Hospital. Two of our new
us Match Day is the first day that          in one week that it is hard for me to      residents rotated with us for a month
we know we’ll be a “real doctor” and        believe that so little time has passed.    and did a great job. Both of them play
actually have a job the following year.          We filled three of six positions in   ultimate Frisbee.
    For residency programs and              the match. We filled three of three            Finding good residents is not easy.
program directors, Match Day is also        positions in the scramble. We are very     I think we’ve done a very good job
huge. Questions that run through            happy with our six new residents. Four     of adding to our FAHEC/SR-AHEC
our minds include, “Will we fill all our    of the new residents went to medical       family.
positions in the Match?” “Will we fill      school in North Carolina. One of the           By the way, I had a mandarin
any unfilled positions we may have          new residents will be the second           chicken wrap from “What’s for Lunch?”
on the ‘Scramble?’ ” “Will we get           resident ever in our AOA approved DO       on the day of the scramble, but I do
good residents?” “What will I eat for       internship. One of our new residents is    eat Mac-and Cheese quite frequently
lunch if we have to scramble (I hope        married to a pediatrician who lives in     (my children love it!).
                                                                                                                              9



Family Practice Trends                                                                   expenditures of more than $1.1 trillion
The following is edited from http://             Fill rate falls short                   each year. For 16 measurable health
www.aafp.org/match/nrmpinfo.html.
                                                   for residencies                       indicators, the U.S. recently ranked
                                                                                         12th of 13 countries in an international
    The 2003 national fill rate for family       in family practice                      comparison. These critical failings
practice residency positions is 2,239                                                    of our current health care system
positions filled out of 2,940 positions      had experienced three consecutive           were confirmed by a separate WHO
offered (76.2%). This represents a           years of increased positions filled from    study which ranked the United
decrease in the percentage of family         1998 to 2001, followed by a decrease        States 15th among 25 industrialized
practice residency positions filled          in 2002, increasing again in 2003.          countries. While arguments have
through the NRMP over 2002. Forty-               Emergency medicine offered 41           been offered that lifestyle choices
three fewer family practice positions        more positions in 2003 (1,114 vs.           are the primary cause of our poor
(1.4%) were offered in 2003 than             1,073), representing an increase of         national health status, these have not
in 2002. About 118 fewer positions           3.8%. In 2003, the fill rate was 96.3%      been demonstrated to have merit in
(5.0%) were filled in 2003 compared          compared with 98.0% in 2001. U.S.           comparison to other nations. The crisis
with 2002 (2,239/76.2% vs. 2,357/            seniors accounted for 77.1% in 2003         of our health status, while certainly
79.0%).                                      compared with 80.7% in 2002 (859            multifactorial, appears to hinge on
    Some 179 fewer positions (12.7%)         vs. 866).                                   the failings of our system to provide
were filled with U.S. seniors in 2003        Discussion                                  adequate, appropriate primary care
compared with 2002 (1,234/42.0%                  Medical students in 2003 continue       to meet the needs of our nation.
vs. 1,413/47.4%). Of U.S. seniors            to demonstrate a preference for             Improving access to care can only
participating in the 2003 NRMP, 8.6%         medical subspecialties over primary         improve health so long as the access
matched in family practice compared          care practice when compared with            is to the appropriate care. Recent
with 9.9% in 2002. Similarly, of U.S.        data from the past few years. This          studies clearly demonstrate that the
seniors matching, 9.2% matched               trend is apparent among graduates of        higher the primary care physician-to-
in family practice compared with             both MD and DO medical schools.             population ratio in a state, the better
10.5% in 2002. 2003 is the sixth                 As seen in the past five years,         the health outcomes. Furthermore, of
consecutive year since 1998 that a           graduates are selecting careers that        the seven countries with the highest
smaller percentage of U.S. seniors,          offer more flexible lifestyle choices       average health rankings, five have
participating and matching through           and potential for greater financial         strong primary care infrastructures.
the NRMP, matched in family practice         incentives. They are also choosing              Of particular concern is a recent
than the previous year.                      practice environments that provide          study indicating that, of physicians
Contrast With Other                          fewer external productivity pressures       practicing rural primary care, U.S.
Specialty Trends                             and more generous third party-payer         medical graduates are more likely
   Two marker disciplines,                   reimbursement. Strikingly similar,          to choose family medicine, whereas
anesthesiology and diagnostic                Canadian medical students cite              international medical graduates are
radiology, experienced increases in          low pay, high student debt and low          more likely to choose rural internal
both positions offered and filled in         prestige among the reasons for not          medicine or rural pediatric practices. In
2003. In anesthesiology, about 40            selecting family medicine careers.          2003, the trend of fewer U.S. medical
more positions (10.7%) were filled in        Family medicine in the United States        graduates entering family practice
2003 compared with 2002 (415 vs.             has experienced a decline in fill rate to   residencies has worsened, ultimately
375) and 14 more (4.6%) were filled          the levels of approximately the 1993        translating into fewer rural family
with U.S. seniors (321 vs. 307). This        Match. The result of this disturbing        physicians. Because family physicians
represents the seventh consecutive           trend is a health care delivery system      provide the vast majority of patient
year of increases in anesthesiology.         that is severely compromised in its         care in rural areas of the nation, the
   Eight additional positions (6.4%)         ability to meet the growing needs of        decline in U.S. graduates choosing
were filled in diagnostic radiology in       our nation.                                 family medicine may have the most
2003 compared with 2002 (133 vs.                 The United States population            dramatic impact in our nation’s
125), with eight more U.S. seniors           does not have the best health status        greatest areas of need.
(7.4%) entering diagnostic radiology         indicators, as determined by the World
(116 vs. 108). Diagnostic radiology          Health Organization (WHO), despite                            Continued on page 14
10




                                          Valley Hospital in Fayetteville, N.C.           This issue’s answers from
   The Graduates of 2002                  Kyndall was 7 lbs., 13 ounces and 21
                                          inches.                                      Tracy Hamill M.D., class of 1999

Dr. Tandeka Nix has been named            Dr. Thuy Keriakes has a 7-month-
the Director of Women’s Health            old, Stephen. Thuy and her husband          1. If you read a newspaper,
and Director of the Women’s Health        live in Fort Worth, Texas.                     which part of the newspaper
Fellowship at East Carolina University.
She completed both Women’s Health                                                        do you read first?
and Faculty Development Fellowships           The Graduates of 2001                      Front page (then the
June 21, 2003.                                                                           obituaries).
Dr. Jorge Rodgriquez has                  Dr. Pamela Murphy is the director
completed two fellowships at East         of Osteopathic Medical Education            2. Where can you get the
Carolina University — Sports Medicine     for the Southern Regional Area                 best barbecue?
and Faculty Development, June 21,         Health Education Center’s Family
                                          Medicine Residency Program. She                The Smokin’ Pit, Tell City, IN
2003. He also published the cover
article for the April 1, 2003, edition    was instrumental in developing the
of “American Family Physician.” His       program’s osteopathic internship, the       3. What were you doing on
article is entitled “The Prevention and   first osteopathic internship in the state      September 11th when the
Treatment of Common Eye Injuries          of North Carolina. She, her husband
                                          Dr. Eric Fisher, and their two children,       first plane hit?
in Sports.” The web address for Dr.
Rodriquez’s article is www.aafp.org/      Maggie and Rebecca, are doing well.            Getting ready for work.
afp/20030401. He received an award
for “Best Two Minute Presentation”            The Graduates of 2000                   4. What is your favorite
April 2003 at the Annual American
Medical Society for Sports Medicine.                                                     vegetable?
This summer he will give a talk on        Dr. Stella King and Dr. Bradley                Corn-on-the-cob.
eye injuries for the NCMS Annual
Sports Medicine Conference. Jorge
                                          Turner were wed September 7, 2002,
                                          in Fair Haven, NJ. The couple settled       5. If you had to choose a
now practices in Cary, N.C. His group
                                          in Sarasota, Fla.
is comprised of five family physicians                                                   different medical specialty
with fellowships in sports medicine.                                                     to practice, which would
They are the team physicians for the          The Graduates of 1999
Carolina Hurricanes and their family                                                     you choose and why?
members. They also have other                                                            Although the money would
affiliations with high school, college    Dr. Janine Scott-Lowe and her                  be better with almost
and professional athletes in the area.    husband Randy are expecting their              anything else, I think I would
                                          second child. Janine also has started
                                                                                         get bored without the
Dr. and Mrs. John Ray welcome             practicing at Primary Care Plus in
                                          Fayetteville after recently leaving First      variety of Family Practice.
their first child Kyndall Ashlyn. She
was born May 7, 2003 at Cape Fear         Health in Raeford.
                                                                Continued next page           Questions, Page 3
                                                                                                                   11




        What’s New                      Dr. Leila Kahwati and her husband
                                        Dr. Richard Oh have moved back to
                                                                                       Above, left: Dr. Pamela
                                                                                       Murphy’s children; Above,
From page 10                            the United States from Germany. In             Avani Mitra, daughter of Dr.
                                        2002, Dr. Kahwati began a Primary              Sapna Mitra and her husband,
                                        Care Research Fellowship concurrent            Nitin.
                                        with a Preventive Medicine/Public
                                        Health Residency and Epidemiology
                                        MPH degree at UNC-Chapel Hill.
                                        They just had their first child, Caroline,
                                        born July 22, 2003, at 1:30 p.m.
                                        She weighed 8 lbs., 13 ounces and
                                        measured 21-1/8 inches long. They
                                        live in Durham.


                                           The Graduates of 1998

                                        Dr. Shana James married in May               Above, Dr. Leila Kahwati and
                                        2002. She and her spouse Paul reside         her husband, Dr. Richard Oh,
Above, Dr. Sandra Carr                  in Rock Hill, S.C.
                                                                                     with their firstborn, Caroline.
and her fiance, Al Johnson.
                                           The Graduates of 1990
Dr. Sandra Carr is engaged to Al
Johnson. The couple celebrated
their engagement with a reception       We regretfully share that Dr. Susan
at the Rainbow Room in Downtown         Aycock’s husband Kenneth Charles              Send us your news
Fayetteville in February. Sandra and    Lennon passed away Sunday,
Al plan to marry next spring. Sandra    May 25, 2003 at Columbus County
                                                                                     If you have news that you
also was recently named assistant       Hospital in Whiteville, N.C. Susan
                                        and Kenneth have three sons, Noah,           would like published in
program director for the residency.
                                        Jacob and Solomon Lennon. In lieu            the “What’s New” column,
Dr. Sapna Mitra and her husband         of flowers, the family requests that         please contact Sandra Carr,
Nitin have welcomed their first child   donations be sent to Bladen County           MD, at (910) 678-7203 or
Avani just a few months ago. The        Hospital Foundation Fund, P.O. Box           sandra.carr@sr-ahec.org
couple recently bought a home in New    3098, Elizabethtown, N.C. 29377, or
Jersey. Sapna has started a new job     to the Mt. Zion Baptist Church Building
in New Jersey as well.                  Fund, 9494 Red Hill Road, Whiteville,
                                        N.C. 28472.
 12


ACGME Competencies
   Main Entry: com·pe·tent
   Function: adjective
   Etymology: Middle English, suitable, from Middle French &
   Latin; Middle French, from Latin competent-, competens,
                                                                                        and improve understanding of how
   from present participle of competere                                                 effective our teaching is. We are
   Having requisite or adequate ability or qualities                                    borrowing from the business world
                                                                                        and doing a 360-degree evaluation
                                                                                        — all people with whom the resident
                                             competence. The Accreditation              works (faculty, peers, nurses,
                                             Council of Graduate Medical                staff, patients) will evaluate his/her
                                             Education (ACGME) has mandated             performance. The faculty will more
                                             that all residencies must demonstrate      frequently evaluate the residents in
                                             competence in 6 core areas to              different situations (call, clinic and
By Dr. Bethany Picker                        continue being accredited. The             chart review). The residents will be
    Developing competent physicians          osteopaths have issued similar             responsible for documenting many of
— this is the goal of residency. It is the   standards, but added a seventh             the activities they are already doing
output of a successful residency. But,       area that is specific to osteopathic       (procedures, reading evidence-based
how do you know when you are doing           manipulative therapy.                      medicine, etc.) Through all of these
it? Even worse, how do you identify               The six broad areas are: patient      activities, we will be able to document
when you are falling short? And, until       care, interpersonal and communication      competence by graduation.
recently, does it really matter?             skills, systems-based practice, medical        This task has been painful at
    Of course it matters. It has always      knowledge, professionalism and             times, but the “no pain, no gain”
mattered. Future communities,                problem-based learning. Each broad         motto seems to have held true. The
patients and colleagues depend               goal has several associated objectives     changes should enhance resident
on residencies to adequately train           that must be measured. It is quite a       feedback and education, ensure that
residents and ensure they are                challenge.                                 we are using appropriate teaching
producing and graduating capable                  How are we doing it all? With some    methods for individual residents and
physicians. Now, the difference is,          difficulty. Actually, we have found that   keep us in business. Plus, all of your
our future accreditation depends             the new instruments we are utilizing       future colleagues will definitely be
upon documentation of resident               will improve feedback to the residents     competent!




Pat Lowry
       Part of SR-AHEC’s Foundation
    Pat Lowry began working at               rock has sat on Pat’s desk for 28
FAHEC on January 5, 1976, when               years, commemorating both the birth
the Family Medicine Center was only          of the Family Medicine Center and
a dream and a set of blueprints! Two         the beginning of Pat’s long career
months later, when the foundation was        at FAHEC.
dug and trucks arrived with building
materials for the center, Pat collected
a rock that she still has today. Serving                       Continued on page 14     Pat Lowry with her “special” rock.
as a paperweight, the fist-sized white
                                                                                                                       13

        Family Practice Trends
From page 9                                                                            of Teachers of Family Medicine,
                                           for family practice, recent studies         is engaged in a comprehensive
    Specialty choice is often shaped       conducted by the University of Arizona
by experiences during medical school.                                                  evaluation of the strategic direction
                                           compared a number of variables for          of family medicine. As part of the
While many of today’s students are         the 12 medical schools with the largest
being offered a primary care clinical                                                  ongoing Future of Family Medicine
                                           increase in production of graduates         (FFM) project to ascertain future
experience early in their medical          to family practice with the 12 medical
education, they also are being                                                         health care and technology needs of
                                           schools with the largest decrease           patients, the AAFP is addressing the
exposed to medical school cultures         in family physician production
that actively discourage careers in                                                    decline in medical student interest in
                                           during 1998-2000. Analyses were             primary care. FFM initiatives include
primary care. In addition, despite         also conducted of graduate survey
overall satisfaction with their work,                                                  developing an open-source electronic
                                           data collected by the Association           health record system, providing a
family medicine faculty report an          of American Medical Colleges for
increasing amount of time spent in                                                     future oriented residency curriculum
                                           these 24 medical schools. Results of        and continuing to provide physicians
providing direct patient care and          the studies indicate that a negative
less time in teaching and advising                                                     with educational resources designed
                                           medical school culture, low perceived       to meet the individual needs of life-
medical students. The expectations         prestige of the specialty, interactions
of this environment coupled with                                                       long learners throughout their careers.
                                           with dissatisfied faculty role models
perceived issues of inadequate             and concerns about the breadth
prestige, declining reimbursement          of knowledge required of a family
and demanding lifestyles may result        physician all play a pivotal role in
in medical school experiences that         whether medical students pursue a
cause students to choose subspecialty      family practice residency.
careers over primary care.                     As a result of these findings, the
Outlook for Family Practice                AAFP Commission on Resident and
    Medical student membership in          Student Issues in conjunction with the
the American Academy of Family             Commission on Education, the Society
Physicians (AAFP) approaches               of Teachers of Family Medicine, the
20,000. In 2003, 17,823 members            Association of Departments of Family
are in Liaison Committee on Medical        Medicine and the Association of
Education (LCME)-accredited                Family Practice Residency Directors
                                                                                       Pat found this special rock when
U.S. medical schools, while 1,792          are developing several initiatives          the Family Medicine Center was
members are in American Osteopathic        to be implemented next academic             being built.
Association (AOA)-approved colleges        year. These efforts are directed at
of osteopathic medicine. Thus, nearly      ensuring the admission of medical
one-third of all students in LCME-
accredited U.S. medical schools are
                                           students most likely to choose family
                                           medicine, strengthening curricula to
                                                                                                Lowry
members of the American Academy of         prepare students for careers in family      From page 12
Family Physicians. Third-year students     practice, assisting faculty in their work
who are members of the AAFP total                                                      Pat and her pet rock may be the
                                           as mentors and role models, and
5,976 compared with 5,411 graduating                                                   only remaining witnesses to all the
                                           encouraging support of legislative
seniors. The predictive value of this                                                  changes her job has undergone
                                           mandates to produce adequate
information in forecasting future trends                                               during her 28 years at FAHEC (now
                                           numbers of family physicians to meet
in family medicine must be considered                                                  SR-AHEC). She has done everything
                                           the needs of our country.
cautiously, however. Inexpensive                                                       from teaching coding to residents to
                                               In addition, the American Academy
membership and the benefit of an                                                       helping graduates set up their medical
                                           of Family Physicians, together with the
enormously popular journal (American                                                   offices. Today Pat handles in-patient
                                           American Board of Family Practice,
Family Physician) among medical                                                        insurance, but she still needs a
                                           the Association of Departments of
students may indeed be attracting                                                      good paperweight. And she has one
                                           Family Medicine, the Association of
student members with little interest in                                                — vintage 1976.
                                           Family Practice Residency Directors,
a primary care career.                     the North American Primary Care
    In an effort to understand this        Research Group and the Society
trend of declining residency fill rates
14


               Congratulations, Grads ...

     Let’s Party!
      Scenes from the 2003 graduation celebration.

								
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