Purpose by ghkgkyyt


									The Medical University of South Carolina

D E PA R T M EN T   O F   M E D I C I NE

         ANNUAL REPORT 2009
P can have anything you want -
   urpose Highlights

                 if you want it badly enough.

You can be anything you want to be,
   do anything you set out to accomplish
         if you hold to that desire
             with singleness of purpose.”

                                               - Abraham Lincoln

We chose this year’s theme, “Purpose” after reflecting on the challenges faced and
accomplishments achieved by the people that comprise the MUSC Department of
Medicine. This year brought with it many challenges, and many times we thought
to ourselves, “Why do we do what we do?” “What is our purpose in being here?”
Some of the answers we found are shared in this report.

                                                      Editor/Writer: Frances G. Glanville, MHA
                                                      Layout: Melissa C. Hughes
                                                      Photographer: Elizabeth Anne Thompson
                            Table of Contents

Chairman’s Message                    2   Our Divisions:

Dean’s Message                        5   Biostatistics & Epidemiology             30

Awards & Recognition                 6    Cardiology                               32

Medical Education                     8   Emergency Medicine                       34

The Purpose of Education             10   Endocrinology, Diabetes and
                                          Medical Genetics                         36

Patient Care                         12   Gastroenterology & Hepatology            38

Medical University Hospital          14   General Internal Medicine & Geriatrics   40

Ralph H. Johnson VA Medical Center   15   Hematology/Oncology                      42

The Purpose of Patient Care          16   Infectious Diseases                      44

Research                             18   Nephrology                               46

The Purpose of Research              20   Pulmonary & Critical Care Medicine,
                                          Allergy and Sleep Medicine               48

Business of Academic Medicine        22   Rheumatology & Immunology                50

Medicine Excellence                  24   Transitions                              52

The Purpose of Excellence            26   Looking Ahead                            54

Philanthropy                         28   By the Numbers                           55
             A Message from our Chairman

                                                    We are here to insure that the next
                                                    generation of physicians, scientists
                                                    and other health care leaders learn the
                                                    appropriate skills.

                                                    We are here to investigate scientific
                                                    mysteries and make discoveries that will
                                                    improve the quality of life for our patients,
                                                    neighbors and friends.

                                                    We are here to provide excellent, quality
                                                    patient care in a way that communicates
                                                    how much we value each individual.

                                                    Over the past year we have been
                                                    reminded time and again about the
                                                    financial difficulties facing our state, the
                                                    nation and our institution. As we have
                                                    learned of each new budget reduction,
                                                    made the necessary tough decisions, and
                                                    communicated those decisions to our
                                                    faculty, staff and trainees, we have done
                                                    so with the knowledge that our purpose
                                                    as members of the MUSC Department of
                                                    Medicine has not changed just because the
                                                    economy has changed.

                                                    Our faculty, staff, and trainees, our entire
                                                    Department, have worked together, with
                                                    purpose, to make the necessary changes to
                                                    not only keep the Department going, but
                                                    to continue our record of achievements!

                                                    At a time when the status quo might be
                                                    considered acceptable, our Department’s
                                                    clinical revenue continues to rise, our
                                                    number of grant applications have
                                                    increased, new and innovative educational
                                                    programs are being implemented and
John R. Feussner, MD, MPH
                                                    everyone is truly working together to
Chairman and Distinguished University Professor
                                                    accomplish great things!
                                                    Within the MUSC Department of Medicine

2   Depar tment of Medicine  2009 Annual Repor t
                 “The Secret of Success is Constancy of Purpose”
                                                    Benjamin Disraeli

we have expanded the traditional tripartite
mission of academic medicine to include
the Business of Medicine. In addition,
the MUSC Excellence initiative has been
woven into the fabric of everything we are
doing in the Department of Medicine.

Our education programs continually
evolve with an increased number of
internal medicine housestaff, a third
class of emergency medicine housestaff
rounding out our three year program,
implementation of our Education Value
Unit (EVU) program for incentivizing
faculty education contributions, and
expanded the departmental faculty
development series. Our faculty continue
to be recognized for their educational
achievements at a local, regional and                                               Nephrologist Dr. Michelle Shepard (right)
national level.

We have transformed our research efforts from a loose conglomeration of individual initiatives to a true
collaborative, connected department-wide research initiative. Our efforts have included: implementation of
the junior faculty internal study section for NIH proposals with external reviews also available; organization of
both clinical research and basic science operations committees comprised of faculty and staff representatives;
and our 3rd Annual Department of Medicine Research Day. Our investigators have purposefully increased the
number of applications submitted for funding.

Clinically, we have improved outpatient satisfaction scores from the 62nd to the 78th percentile, increased
arrived visits to our outreach locations by 20%, and implemented real-time feedback to our physicians

                 Faculty Growth                                              Clinical Revenue                         $42.3
                                                 304                                   (in millions)    $37.5
           240                253                                                          $29.4
  232                237


 FY05      FY06      FY07      FY08      FY09    FY10           FY02        FY04           FY06         FY08         FY09
             Other      Research      Clinical

                                                                        Medical University of South Carolina                    3
                                         Dr. Neal Christiansen
Purpose Highlights

Three faculty members
were promoted to Associate
Kristin Highland, MD, MSCR;
Marcelo Vela Aquino, MD, MS;
Cassandra Salgado, MD, MS

Professor Kathie Hermayer,
MD, MS was awarded tenure.

Thirty one new MD and/or PhD
faculty joined the Department.
                                     regarding inpatient documentation. Overall departmental clinical revenue
We expanded from 10 Divisions
to 11 Divisions with the
                                     has increased by approximately 10% this year alone.
addition of the Division of
Biostatistics and Epidemiology       The philanthropic support that our Department has received over the past
(DBE). Professor Yuko Palesch,       year will continue to provide benefits to the Department in years to come.
PhD has accepted the position        Several new endowed chairs, as well as other funds, have been donated in
of Division Director.                support of our educational, clinical and research programs. In addition,
                                     our Department has succeeded in having proposals for several Centers of
Our Internal Medicine                Economic Excellence approved. The endowments created through this
Residency Match was
                                     program will serve the citizens of South Carolina for years to come.
successful, 14 of the 33 slots
were filled with MUSC
graduates.                           Our Employee Satisfaction continues to improve. Part of this positive
                                     transformation can be attributed to our Employee Reward and Recognition
The Emergency Medicine               Program, as well as to our monthly employee rounding luncheons hosted
Residency Match, also                by our Vice Chair for Business and Administration. As we go to press, we
successful, filled 6 slots, 2 with   have just recognized our second MUSC Department of Medicine Employee
MUSC graduates.                      of the Year, Mr. Gerry Garza, Research Administrator for the Department of
19 of the 27 internal medicine
residents graduating from
                                     Of course, all of this transformation occurs against the backdrop of the
the program and 8 of 26 sub-
specialty fellows, are going to
                                     beautiful “Holy City” with its steeples piercing the skyline, historic charm
academic medicine positions,         and friendly people. We continue to treasure our history, our strengths
either sub-specialty fellowships     and our diversity while working toward a transformed future. I invite
or faculty positions.                you to review our annual report and to contact us with any questions. I
                                     look forward to meeting you personally should you visit our institution or

                                                                 John R. Feussner, MD, MPH
                                                                 MUSC Distinguished University Professor
                                                                 Chairman, Department of Medicine
4 Depar tment of Medicine  2009 Annual Repor t
                           A Message from our Dean

Through the hard work and ingenuity of many,
a number of outstanding achievements took
place this past year across the College and the
University--including NCI accreditation, as
well as the CTSA and NSF awards. Despite
recent fiscal threats and reductions, it is clear
that we are building our mutual future on a
solid foundation. We have enormous talent
in the form of our people in all their various
roles, whether they be staff, students, residents,
or faculty. In fact, it is exciting to imagine the
growing talent that resides within our College
and to understand that a critical role for us all is
to unlock that talent and allow each and every
individual to attain their full potential. In the
end that is the most fundamental mission of
any university: To see that everyone learns and
develops to the fullest extent possible. It is the
basis of our Pillars of Excellence.

Although the national economy has faltered
in recent months, there is still a great demand
for the services of our newest generation of
physicians. Medicine is now, always has been,
and always will be a profession of service to
others. We prepare each generation of medical
students and housestaff to serve and to care.
The faculty in the Department of Medicine hold
leadership roles across the educational spectrum
from undergraduate medical education to
graduate basic science courses, from providing
mentors to clinical and research fellows to
providing continuing medical education for
community physicians.

The Department of Medicine’s vibrant research
programs, community outreach clinics, and
innovative methods of achieving goals are
combined purposefully so that they might best
serve our Community, State and Nation for
generations to come.

With my sincerest thanks to each of you,

Jerry Reves, MD
Dean, MUSC College of Medicine
                                                       Medical University of South Carolina   5
                                                  Awards and Recognition

                                      Administration:                         Adner Pazo, MD (2nd year resident)
                                      John R. Feussner, MD, MPH               Medical Education Excellence Award
                                      Earl B. Higgins Diversity Award         MUSC College of Medicine
                                      Promoted to                             Endocrinology, Diabetes and
                                      Distinguished University Professor
                                                                              Medical Genetics:
                                      Cathy G. Wood, MBA
                                                                              John A. Colwell, MD, PhD
                                      MUSC Excellence in Action Award
                                                                              Order of the Palmetto
                                                                              State of South Carolina
                                      Board of Directors, Alliance for
John A. Colwell, MD, PhD              Academic Internal Medicine
                                                                              Julius Sagel, MD
Order of the Palmetto                 and
State of South Carolina                                                       Robert J. Glaser Distinguished Teaching
                                      President, Administrators of Internal
                                                                              Award nomination
                                                                              AOA Honor Medical Society
                                      Cardiology:                             2009 College of Medicine Faculty
  John A. Colwell, MD, PhD,
                                      2008 Bronze Recognition for             Excellence Award
  Professor Emeritus in our
                                      Quality work in Stroke, Coronary
  Division of Endocrinology,
                                      Artery Disease and Heart Failure
  Diabetes and Medical Genetics,
                                      American Heart Association              Gastroenterology & Hepatology:
  received the Order of the                                                   2009 US News & World Report
  Palmetto Award. The Order of                                                Best Hospital, Digestive Diseases
                                      Amy D. Bradshaw, PhD
  the Palmetto award is the State’s
                                      2009 MUSC Developing Scholar Award
  highest civilian honor awarded                                         Lawrence W. Comerford, MD, MS
                                      MUSC Foundation
  by the Governor of South                                               Excellence in Teaching Award
  Carolina.                                                              Medical University of South Carolina
                                      Valerian L.C. Fernandes, MD
                                      Medicine Teaching Award, MUSC
  In his letter to Dr. Colwell,                                               Mark H. DeLegge, MD
  Governor Mark Sanford                                                       Nan Couts Award for the Ultimate
                                      Promoted to Associate Professor
  cited Dr. Colwell’s position                                                Volunteer, Oley Foundation
  as outstanding physician                                                    and
                                      Pamela B. Morris, MD
  and leader in the medical                                                   Board of Directors of the American Society
                                      AHA Mid-Atlantic Board of Directors
  community; his dedication to                                                of Enteral and Parenteral Nutrition
  the cause of diabetes research,
  patient care and education; his     Emergency Medicine:                     David G. Koch, MD, MSCR
  vision for and guidance of the      Christine M. Carr, MD
                                                                              Masters of Science in Clinical Research
  establishment of the Diabetes       MUSC Excellence in Action Award
  Initiative of South Carolina; his                                           Joseph Romagnuolo, MD, MSc.,
  leadership in numerous medical      Lindy Carter
                                                                              MUSC Foundation Award for Teaching
  organizations and academic          National Program Coordinator of the
                                                                              Excellence –
  committees; his participation       Year, Emergency Medicine Residency
                                                                              Outstanding Educator-Mentor
  in various editorial boards, as     Association
  a manuscript reviewer, as a                                                 Marcelo F. Vela Aquino, MD, MS
  teacher, and invited lecturer,      Edward C. Jauch, MD, MS
                                                                              Promoted to Associate Professor
  and his many publications.          GTWG Silver Award for Stroke (Get
                                      with the Guidelines)
                                      American Heart Association              General Internal Medicine &
                                      Sam Kini, MD                         Jan N. Basile, MD
                                      2008 National Faculty Teaching Award President, Southern Medical Association
                                      American College of Emergency
6 Depar tment of Medicine  2009 Annual Repor t
    “There are no secrets to success. It is the result of preparation,
       hard work, and learning from failure.” - Colin Powell

Courtney Brady, MD                                                                    Rachel L. Sturdivant, MD
Excellence in Teaching Award                                                          Leonard Tow Humanism in
Medical University of South Carolina                                                  Medicine Award

Cathryn Caton, MD, MSCR                                                               Pulmonary & Critical Care
Masters of Science in Clinical Research                                               Medicine:
                                                                                      2009 US News & World Report
Patrick J. Cawley, MD, MBA                                                            Best Hospital, Pulmonary
President, Society of Hospital Medicine                                               Disorders
Fellow, Hospital Medicine                                                             Marc A. Judson, MD
                                                                                      United States and Canada Council
Jennifer K. Clark, MD                                                                 of Governors for the American
Medicine Teaching Award, MUSC                                                         College of CHEST Physicians
2009 Fellow, Harvard Medical School                                                   Steven A. Sahn, MD
Palliative Care Education and Practice                                                Alfred Soffer Award for Editorial
Fellowship                                                                            Excellence
                                                                                      American College of CHEST
Kimberly S. Davis, MD                                                                 Physicians
2009 Outstanding Clinician Award
                                          (l to r) Amy Bradshaw, PhD, Kim Davis,
MUSC Foundation
                                          MD and Joseph Romagnuolo, MD, MSc           Rheumatology &
                                          receive their MUSC Foundation Awards        Immunology:
Leonard E. Egede, MD, MS
                                          at Faculty Convocation                      2009 US News & World Report
Physician Faculty Scholars
National Advisory Committee                                                           Best Hospital, Rheumatology
Robert Wood Johnson Foundation              Keisuke Shirai, MD, MSCR
and                                         Masters of Science in Clinical Research   Marcy B. Bolster, MD
Promoted to Professor                                                                 Appeal Panel for Rheumatology
                                            Nephrology:                               by the Accreditation Council for
Allen H. Johnson, MD                        2009 US News & World Report               Graduate Medical Education.
Master,                                     Best Hospital, Kidney Disorders
American College of Physicians                                                        Lt. Col Robert Campell, Jr., Ph.D.
                                            P. Darwin Bell, PhD                       (Post-doctoral Fellow)
Pamela H. Pride, MD                         2010 Carl W. Gottschalk                   Defense Meritorious Service Medal
Fellow in Hospital Medicine                 Distinguished Lectureship
                                            of the APS Renal Section.                 Rodney S. Daniel, MD, MSCR
Jeffrey G. Wong, MD                                                                   Masters of Science in Clinical
Inducted, Gold Humanism Honor Society Caroline Counts, MSN, RN, CNN                   Research
                                      Award for Outstanding Contributions
Hematology/Oncology:                  to American Nephrology Nurses                   Gary S. Gilkeson, MD
National Cancer Institute Designation Association                                     Inducted into the Henry Kunkel
Hollings Cancer Center at MUSC                                                        Society
                                      Stephen Osaguona, MD (Fellow)
Robert M. Gemmill, PhD,               Gerald A. Beathard Fellow in                    Richard M. Silver, MD
Vincent A. Potiron, PhD,              Interventional Nephrology                       Honorary Director
Harry A. Drabkin, MD and                                                              Department of Rheumatology and
Joelle Roche, PhD                     Donna Sanders, DO (Fellow)                      Immunology
2008 Fundamental Research Prize       Arnold P. Gold Foundation Humanism              Nanjing Drum Tower Hospital,
at the Eurocancer Meeting             Honor Society at the Virginia College           Nanjing, China
                                      of Osteopathy Medicine

                                                                           Medical University of South Carolina           7
                                                     Medical Education

                                         With financial resources diminishing, academic medicine is increasingly
                                         self-supporting, relying on external funding for research and patient-
                                         generated revenue to maintain medical education. In this challenging
                                         environment, the Department of Medicine, in step with the College of
                                         Medicine, has re-focused on our core purpose: medical education.

                                         Department faculty members teach and guide MUSC students and trainees
                                         at all levels. In addition to Internal Medicine and Emergency Medicine
                                         residency programs, the Department is home to eleven sub-specialty
                                         programs. From serving as mentors for junior faculty to teaching medical
                                         and graduate students and leading major educational programs across the
E. Benjamin Clyburn, M.D.                campus, we provide core MUSC faculty. As a further sign of our dedication
Vice Chair for Education
                                         to education, this year 25 members of the Department earned additional
Associate Professor
General Internal Medicine & Geriatrics   academic degrees (2 Bachelors, 1 MHA, 8 MSCR’s, 5 MS’s and 9 PhD’s.)

                                         In 2009, after a long distinguished career, Dr. Julius Sagel, Vice Chair for

P With 10p o s eas MUSC’s g h t s
       u r years H i g h l i
  Internal Medicine Program
                                         Medical Education, retired. Dr. Sagel’s retirement created a need for re-
                                         alignment of our Department of Medicine Education Leadership Group.
                                         Going forward, Dr. Brad Keith, Assistant Professor in General Internal
  Director to his credit, Dr. Ben        Medicine and Geriatrics, will serve as Associate Vice Chair for Graduate
  Clyburn can be considered a            Medical Education and Dr. Deborah DeWaay, Assistant Professor in
  veteran. Dr. Clyburn has been          General Internal Medicine and Geriatrics, will serve as Clerkship Director.
  heard to advise incoming
  residents, “There are less             The new curriculum implemented over the past year will provide medical
  stressful ways to make money,          students greater flexibility in course selection, allowing them to craft
  as a rule, we don’t do this for        schedules that advance individual career goals. Clinical medicine is now
  the money. As educators, we            taught during the first year, making classroom studies more relevant. The
  often divide competency into           Department is playing a critical role in implementing the new curriculum.
  knowledge, attitudes and skills.
  All three of these are important,      Two popular educational enrichment activities were continued in 2009. The
  and the fact that you are sitting      Internal Medicine Career Day attracted more than two-hundred fifty
  here today attests that you possess    medical students interested in learning about the Department’s ten clinical
  the knowledge and skills to move       divisions and combined programs with Pediatrics and Psychiatry. Several
  forward in your training. I would      medical students participated in the Medicine Visiting Clerkship Program,
  argue that from this point forward     which is designed to increase the number of minority medical students
  that your attitude is far more         applying for residency.
  important than your knowledge or
  your skills.                           New clinical responsibilities at the recently opened Ashley River Tower
                                         (ART), in addition to those at the MUSC Medical University Hospital and
  The next several years will be the     VA Medical Center, keep our residents and fellows extremely busy. A new
  most challenging of your careers       computerized order entry system was launched, and our housestaff piloted
  and your approach to work,             the implementation led by our Chief Residents. Plans to present our
  patients and relationships will be     experience at the IHSS conference are underway.
  crucial to your success. Thomas
  Jefferson stated that “Nothing can     Resident training opportunities in our state-of-the-art simulation center
  stop the man with the right mental     increased this year as a course in lumbar puncture was developed. A
  attitude from achieving his goal;      central line simulation is under development, as well as others including
  nothing on earth can help the man      advanced airway management. Clerkship Director Dr. Deborah DeWaay
  with the wrong mental attitude.”       will be working with the College of Medicine over the next year to develop
                                         other scenarios such as heart attack, pulmonary embolus, and flash
                                         pulmonary edema.

8 Depar tment of Medicine  2009 Annual Repor t
   “The purpose of human life is to serve and to show compassion
                    and the will to help others”
                                                                           - Albert Schweitzer
This year, for the first time, our second year
residents, along with some interns and
third year residents, completed Quality
Improvement Projects. With the help of
faculty mentors, research projects were
designed, completed and presented. The first
projects are now being submitted to various
publications and conferences for publication.
Although there is still work to be done,
overall, the new program was a success.

Our Emergency Medicine Program
successfully added a third class of interns
this year, completing our complement of
18. An increased core of academic and
research faculty in the Division will insure
the continued success of the new residency
program. As a further indicator of the quality
of our new Emergency Medicine Residency
Program, Adner Pazo, MD, a 2nd year
Emergency Medicine Resident, received the
Medical Education Excellence Award from the                                    (left to right) Chief Resident Brandon Craft, MD,
MUSC College of Medicine, an honor usually               Associate Vice Chair for Graduate Medical Education Brad Keith, MD,
reserved for faculty-level educators.                                        Vice Chair for Education Benjamin Clyburn, MD,
                                                                                        Clerkship Director Deborah DeWaay, MD
                                                                                           and Chief Resident Clay Shamblin, MD

Internal Medicine Residents at the 2008 ACP Conference

                                                                      Medical University of South Carolina                    9
                                                    The Purpose Behind
                                                     Medical Education
                                       Recently, I told our incoming class of medical students to never forget
                                       that medical school is not an end in and of itself but merely the first
                                       necessary step on the way to ultimately becoming a physician. I
                                       believe there are two very important mind-sets that need to be
                                       established in today’s medical professional: “Learn to Collaborate, not
                                       compete”and “Get beyond the “what”.

                                       Medicine is, in fact, a team sport. Physicians rarely, if ever, take care of
                                       patients alone. The best care is very often a result of a well-coordinated
                                       highly functioning team of physicians, and other health professionals
Jeffrey Wong, MD                       all with the patient’s best interests at heart.
Senior Associate Dean
for Medical Education
Professor, General Internal Medicine   As medical students, and as future physicians, our trainees
                                       are devoting the next many years of their lives to learning and
  In 1910, when the Flexner            understanding the subjects of biomedical science. The structure, the
  Report was published,                function, and the dysfunction of human systems – from the necessary
  many medical schools were            interactions between submicroscopic molecules of life all the way up
  proprietary schools operated         to the macro-systems of diverse populations and cultures – and what
  more for profit than for
                                       opportunities they, as physicians, have at their disposal to intervene in,
  education. The Flexner Report
  opened the eyes of the medical
                                       hopefully, a positive fashion. This is an area of study so vast that no
  community, as well as the            one can ever hope to learn it all. The good news is that we’ll never be
  public, to the importance of an      bored as the opportunities for learning will never cease. The written
  organized, strenuous medical         tests we all took in medical school are quite limited and correctly
  science curriculum.                  answering a multiple-choice question is far from being able to care for
                                       a patient. This is what I mean by getting beyond the “what” of things
  The four years of medical            – get to the “how” and the “why”. Memorizing facts, while important
  school in the United States          and necessary, is by itself insufficient. We must constantly strive to
  were primarily based on a            develop a deeper understanding.
  basic science education in the
  1930’s - 1950’s. Exponentially,
  more information is available
  to today’s medical professionals
  and scientists, but they are
  still given only four years to
  complete their medical degree.
  Medical Education organized
  around body systems, with
  basic science taught as a
  foundation for patient care, is
  now the order of the day.

  In addition, there is increasing
  emphasis on “who we are”
  instead of “what we know”.
  The medical professional of
  today must be able to blend
  teamwork and people skills
  with their knowledge of the art
  and science of medicine.

10 Depar tment of Medicine  2009 Annual Repor t
“Learn to Collaborate, Not Compete and Get Beyond the ‘What’ ”

                                                                                           Dr. Jeffrey Wong with students

Patients want a physician for whom medicine is “not just a job”, but rather a passion, a calling, a reason for
being. Being a physician is not a “sometimes thing”. It is a 24 hours-a-day, 7 days-a-week thing. What I mean
is that the demarcation between who you are personally and what you do “at work”, perhaps more so than
any other profession, becomes increasingly blurred.

 I believe this is due to the nature of our work – the extremely high level of confidential intimacy and trust that
our fellow human beings grant us during each and every interaction -- is so profound as to be unlike any other
profession. It follows accordingly that their expectations for ethical and professional behavior are similarly
extremely high. And those expectations do not stop once the work day is over.

Medicine is arguably the most distinguished and noble of all professions and is unlike any other career. We
must never forget the amazing privilege bestowed upon us as physicians, in caring for another human being.
We must be mindful of the incredible trust that is placed in us, and our profession, and strive mightily to
maintain it.

                                                                     Medical University of South Carolina             11
                                                         Patient Care

                                      MUSC serves as a state and regional referral center and maintains
                                      an extensive outreach clinic program. Department of Medicine
                                      faculty physicians, mid-level providers, fellows and residents staff
                                      Medical University Hospital, and the Ralph H. Johnson Department
                                      of Veterans Affairs (VA) Medical Center and other hospitals across
                                      the state, as well as outpatient facilities, including MUSC Rutledge
                                      Tower and locations across the Lowcountry of South Carolina.

                                      In spring 2009, the Hollings Cancer Center was named a designated
                                      cancer center by the National Cancer Institute (NCI). This makes
Peter Zwerner, M.D.                   Hollings Cancer Center South Carolina’s only NCI-designated
Vice Chair for Clinical Operations    cancer center -- and one of only 65 in the country. Being an NCI-
Assistant Professor, Cardiology       designated cancer center means we can bring the best research,
                                      clinical trials, and new therapies to our patients. After all, the
                                      answers to cancer’s complex questions are pursued in the labs first
 With four of our Divisions           and then delivered to patients.
 recognized in US News and
 World Report’s Best Hospitals        In August 2008, we opened our East Cooper Infusion Suite in Mt.
 edition (Gastroenterology,           Pleasant. With newly recruited oncologists, nurses and an on-site
 Nephrology, Pulmonary                pharmacist, the site focuses on chemotherapy for breast cancer,
 and Rheumatology), 103               head and neck cancer, as well as bladder, kidney and prostate
 of our physicians voted
                                      cancers. Additional injections and infusions for rheumatology,
 “Best Doctors” and Medical
 University Hospital earning the      gastroenterology, endocrine, nephrology and internal medicine
 American Heart Association           patients are available as well. With 1,430 visits in the first eleven
 Triple Performance
 Achievement Award for Stroke,
 Coronary Artery Disease and
 Heart Failure, this has been
 a banner year for our clinical

 As one of South Carolina’s
                                                             Patient Care Visits
                                     160,000                                                             147,321   12,000
 three largest health systems,                                                             141,296
 and as a regional and national      140,000                                                                       11,000
 referral center, MUSC strives to
 maintain active, collaborative      120,000
                                                                             104,572                               10,000
 relationships with referring
                                     100,000                                                              8,879
 physicians in Charleston, in                   85,424     86,212                           8,579                  9,000
 small and rural hospitals, and        80,000
 in larger medical centers across                           7,647                                                  8,000
 the state.                            60,000    7,274

                                       20,000                                                                      6,000

                                           0                                                                       5,000
                                                 FY01        FY03             FY05           FY07         FY09
                                                         Outpatient visits             Inpatient Admissions

12 Depar tment of Medicine  2009 Annual Repor t
           “This has been a banner year for our clinical enterprise”

                                                                            Pulmonologist Dr. Patrick Flume (right)

months, the site exceeded financial expectations and broke even in the first year, even when including start-
up expenses in the calculations.

A Department-wide emphasis on the practice patterns of individual physicians has enabled us to improve
both the level of patient care and the productivity of our physicians. In spite of the recessionary climate
across the United States, our providers across the Department of Medicine were able to increase our
collections by approximately 10%.

In October 2008, the first ABIM sponsored certifying exam for Board Certification in Palliative Care was
offered. Three Department of Medicine faculty passed this exam representing an important milestone for
our Palliative Care Program. Dee W. Ford, MD, MSCR in the Division of Pulmonary, Critical Care, Allergy,
and Sleep Medicine, as well as Paul Rousseau, MD and Jerry Kurent, MD, MS, MPH from the Division of
General Internal Medicine and Geriatrics are all now board certified in this emerging field. We regularly
receive positive feedback from patients and their families in the form of letters and emails praising the skill
and compassion of our palliative care specialists during this most difficult time for their families.

                                                                     Medical University of South Carolina             13
                                                    Medical University
                                         Medical University Hospital is a 690-bed tertiary care academic medical
                                         center providing care for patients of Charleston and throughout the state
                                         of South Carolina. In addition to general medical and surgical services,
                                         MUSC offers a variety of specialty services including cardiothoracic,
                                         transplant and neurosurgery, level I trauma center, digestive disease,
                                         psychiatry and level III neonatal intensive care.

                                         A comprehensive facility, Medical University Hospital consists of four
                                         separate hospitals (the University Hospital, the Institute of Psychiatry, the
                                         Children’s Hospital, and the Ashley River Tower). The Medical Center
                                         includes centers for specialized care including the Heart Center, the
Patrick J. Cawley, MD, MBA
                                         Transplantation Center, the NCI designated Hollings Cancer Center, and
Executive Medical Director
                                         the Digestive Diseases Center. Department of Medicine physicians and
Medical University Hospital
Assistant Professor                      housestaff play an integral part in the leadership and daily operations of
General Internal Medicine & Geriatrics   these Centers.

                                         Within and beyond our centers, patient care at Medical University Hospital
  MUSC’s Hospitalist Program, an
                                         is provided within service lines to facilitate optimum patient care and
  inpatient service run exclusively
                                         satisfaction. These “patient-centric” service lines were created to improve
  by attending physicians and
                                         access to care, elevate the quality of care, facilitate greater collaboration
  unlike typical general services,
                                         between caregivers, and improve the satisfaction of patients, staff and
  was established to help meet
                                         physicians. Service Line Directors drawn from within the Department of
  the needs of general medicine
                                         Medicine include:
  patients throughout all areas of
  the hospital.
                                                 Mark H. DeLegge, MD, Digestive Disease Service Line
                                                 Eric R. Powers, MD, Heart & Vascular Service Line
  MUSC’s hospitalist team now
                                                 Alice M. Boylan, MD, Medical Acute & Critical Care Service Line
  includes 12 physicians who
                                                 Marcy B. Bolster, MD, Musculoskeletal Service Line
  specialize in inpatient care.
  The Hospitalist Service insures
                                         In addition, Department of Medicine faculty lead quality improvement and
  that an attending is available
                                         other initiatives across the Medical Center. This includes thirty medical
  24 hours a day. Hospitalist
                                         directors throughout the Medical Center.
  physicians expect to be called
  at any time regarding urgent
                                         MUSC is proud to offer some of the best medical care in the country. In
  patient care issues and are
                                         addition to the US News & World Report’s Best Hospital designation
  prepared to return to the
                                         awarded to several of our services, MUSC has been awarded the National
  hospital whenever necessary.
                                         Research Corporation’s (NRC) Consumer Choice Award for 13 years
                                         running. The award recognizes MUSC as the most preferred hospital in
  Hospitalists provide
                                         the area.
  patients with around-the-
  clock coordination of care.
                                         Premier Healthcare Alliance has recognized MUSC as one of the nation’s
  Hospitalists are not just
                                         top hospitals for commitment to high-quality patient care and operational
  specialists in patient care, but
                                         efficiency by awarding the Premier Award for Quality (AFQ). MUSC was
  are also experts in hospital
                                         one of 23 winners of this award, out of more than 3,796 eligible hospitals
  processes. They communicate
  often with patients and their
  families and can answer specific
  medical questions. Hospitalist
  programs have translated to
  better clinical outcomes, shorter
  hospital stays and fewer re-

14 Depar tment of Medicine  2009 Annual Repor t
          The Ralph H. Johnson
           VA Medical Center
The Department of Medicine is a primary partner of the Ralph H.
Johnson Veterans Affairs (VA) Medical Center. As a premiere teaching
hospital, VAMC Charleston provides a full range of services, with
state-of-the-art technology as well as education and research. The
Ralph H. Johnson VA Medical Center is a primary, secondary, and
tertiary care facility that serves more than 40,000 Veterans in 15
counties along the South Carolina and Georgia coastline in our main
medical center or one of four community-based outpatient clinics
in Myrtle Beach, SC; Savannah, GA; Beaufort, SC; and Goose Creek,
SC. Each year, VAMC Charleston funds nearly 90 medical and dental
resident positions. We offer residency training in all major medical and
surgical specialties and subspecialties. Included are comprehensive                 William W. Merrill, MD
clinical programs in medicine (including primary care and geriatrics),              Chief, Medicine Service, VAMC
                                                                                    Vice Chair, Veterans Affairs
surgery, psychiatry, neurology, as well as several allied health areas.
                                                                                    Professor, Pulmonary and Critical Care
Residents from MUSC rotate through all major clinical services.                     Medicine

Department physicians from all divisions care for our veterans. Several
                                                                                      According to Shakaib
department members hold leadership positions at the VA Medical
Center, including Chief of Staff Florence Hutchison, MD, Professor                    Rehman, MD, Chief
in the Division of Nephrology, Chief of Geriatrics Medicine, Donald                   of Primary Care at the
Courtney, MD, Associate Professor in the Division of General Internal                 Charleston VA Medical
Medicine and Geriatrics and Chief of Primary Care, Shakaib Rehman,                    Center, and Associate
MD, Associate Professor in the Division of General Internal Medicine                  Professor in General Internal
and Geriatrics.                                                                       Medicine and Geriatrics,

The Geriatric Service at the Charleston VA Medical Center operates                     “It gives me great satisfaction
a leading memory disorders clinic and provides palliative and end-                    to know that every day I
of-life care under the direction of Department of Medicine faculty
                                                                                      have the privilege to help my
physicians. Residents also rotate through all major clinical services at
the VA Medical Center, which funds 37 housestaff positions within the                 patients in making their health
Department of Medicine.                                                               better, assist my colleagues
                                                                                      to make their workplace more
The Ralph H. Johnson VAMC research program is closely interfaced                      productive, or mentor a student
with the diverse research program at the Medical University of                        or resident to achieve their
South Carolina. The close proximity and shared high regard for                        dreams.
research among these institutions provides a mutually beneficial
academic and clinical environment that strives for research excellence.               By educating others, the person
This collaboration provides additional research opportunities                         I help educate the most is
throughout MUSC and greatly expands the patient population served.
                                                                                      myself. I get newer inspiration
Researchers from the Department of Medicine conduct basic research
in cardiology, endocrinology, diabetes mellitus, hematology/oncology,                 every day from my patients, co-
rheumatology and nephrology. Department of                                            workers and students/residents.
Medicine investigators conduct clinical and health services                           I am so lucky to work in this
research in hypertension and aging. Within the Research Program                       great place called Ralph H.
at the Ralph H. Johnson VA Medical Center are a multitude of                          Johnson VA Medical Center and
collaborative research programs that are composed of investigators                    MUSC.”
whose studies are supported through VA awards as well as funding
through the National Institutes of Health, private industry, and other
federal and state agencies

                                                                           Medical University of South Carolina          15
                                                 The Purpose Behind
                                                    Patient Care
                                       Dr. Jennifer Peura originally came to MUSC as a Resident
                                       in Internal Medicine and spent an additional year as a Chief
                                       Resident, but then left to pursue fellowships in Cardiology,
                                       then Advanced Heart Failure/ Heart Transplant. While at the
                                       Washington University School of Medicine/Barnes Jewish
                                       Hospital, Dr. Peura was distinguished as a Rising Star in
                                       Cardiovascular Research and won the Caring Spirit Award.

Jennifer L. Peura, M.D.                As a young resident, Dr. Jennifer Peura says that she, “fell in
Assistant Professor                    love with the Cardiac disease process.” The study of cardiology
                                       relies heavily upon physiology which just fascinated her. In
                                       addition, the population of cardiology patients provided Dr.
                                       Peura with the opportunity to get to know her patients, to
                                       follow the same patients for an extended period of time and
  “When    I was young, I originally   develop a relationship with them.
  considered Medicine as a career
  because of my love for math
                                       While Dr. Peura found developing relationships with patients
  and science. I also wanted to
  find work where I could make         rewarding, she soon became frustrated by the medical
  a difference in people’s lives.      community’s inability to offer a real cure for advanced heart
  Medicine seemed to be the field      failure. This frustration led her to pursue additional basic
  that would allow me to do both.      research training in heart failure and turn her to focus on the
                                       use of the Left Ventricular Assistance Devices (LVADs). She
  I was drawn to Cardiology not        brought this new technology back with her to MUSC, and now
  only by the disease process,         serves as Medical Director of MUSC’s LVAD Program.
  which I find fascinating, but
  also by the patient population.      A new mechanical heart assist device, the Thoratec HeartMate
  In Heart Failure, caring for
                                       II LVAD, can serve as a bridge-to-transplant for patients
  patients over the course of their
                                       awaiting a heart transplant. The FDA-approved device restores
  diseases allows me to build a
  relationship and appreciate          blood flow by taking over the heart’s pumping action. A small,
  their progress over years. It        fast-spinning rotor allows the blood to circulate continuously,
  is rewarding to be there for         thus giving the patient an almost nondetectible pulse. The
  the ups and downs, and have          device prevents the consequences of heart failure such as
  the opportunity to improve           fatigue, swelling and multiple organ failure. An electronic
  patients’ lives with medicine        controller and batteries, which are worn in a holster outside
  and education.                       the patient’s body, power the rotor pump.

  What I discovered about being        Without the LVAD, patients may die before receiving a heart
  a doctor is that it is not really
                                       transplant. The HeartMate II allows patients to be mobile and
  all about the math and science
                                       enjoy a remarkable quality of life while awaiting transplant.
  – but actually little things,
  especially the words...that are      Since the 1980s, MUSC’s Heart Transplant program has cared
  really important.”                   for hundreds of heart transplant patients from across the

16 Depar tment of Medicine  2009 Annual Repor t
 “Being a doctor is not so much about math and science - it is about
 the little things, especially the words...those are really important.”

Palmetto state. Today, MUSC’s program boasts survival rates among the best in the nation thanks
to their multidisciplinary team that includes cardiologists, surgeons, nurse practitioners, physical
therapists, nutritionists, financial counselors and others.

While training in transplantation at the Washington University School of Medicine, Dr. Peura attained
skills in the clinical management of heart failure patients and the use of advanced heart failure
therapy including heart transplant and left ventricular assist devices. In addition, she gained expert
level training in heart biopsy and heart catheterization. Dr. Peura also spent time performing basic
research, an experience that prepared her to collaborate with MUSC’s basic scientists as they seek
to translate their discoveries into therapies for patients. Going forward, Dr. Peura plans to continue
her work in the LVAD program and plans to continue to perform research in the area of heart failure
collaborating with the basic science laboratories of the Gazes Cardiovascular Research Institute. As an
academic cardiologist, training the next generation of physicians remains a vitally important part of
Dr. Peura’s daily work. Her teaching efforts include bedside teaching in outpatient clinics, inpatient
wards and cardiac catheritization laboratory.

                                                              Medical University of South Carolina     17

                                         The Department of Medicine’s clinical and basic research capabilities and
                                         facilities are growing due to the aggressive push to recruit researchers and
                                         to expand and build an infrastructure for a successful research enterprise.
                                         With the addition of the Division of Biostatistics and Epidemiology, the
                                         Department of Medicine now participates in a broad spectrum of research
                                         endeavors, from basic science to clinical trials to epidemiology and
                                         statistical data analysis. Our records for FY09 reflect 104 investigators, 324
                                         active awards and total costs of $49,656,770.

                                         In FY2009, we submitted 356 grant proposals, including 53 proposals
                                         for $19.6 million in funding requests under the American Recovery and
Gary S. Gilkeson, MD                     Reinvestment Act of 2009. As we go to press, we continue to be notified
Vice Chair for Research                  of stimulus grant funding awarded to our Department of Medicine
Professor                                investigators. To date, 16 investigators in the Department of Medicine have
Rheumatology & Immunology
                                         received stimulus-related funding from the NIH directly (14) or as sub-
                                         contracts from other institutions (2). The total funding awarded to these
 Michael Janech, PhD, Assistant          investigators is more than $8.6 million, which is more than 27% of the total
 Professor in Nephrology,                stimulus funding received by the University so far.
 studies a diversity of research
 topics, in part due to his desire       The Center for Health Disparities Research was awarded a VA REAP
 to integrate health and basic           award for the Center for Disease Prevention and Health Interventions for
 sciences across disciplines.            Diverse Populations with a core budget of $1,324,000. Leonard Egede,
                                         MD, Director of the Center and Associate Professor in General Internal
 According to Dr. Janech, “One           Medicine and Geriatrics, is the principal investigator. Dr. Egede also was
 of the major reasons I decided to       recently awarded an R01 grant titled “Telephone Delivered Behavioral
 join the faculty at MUSC was the        Skills Intervention for African Americans with Type 2 Diabetes (T2DM).”
 strong commitment to teaching           The grant is awarded from 8/1/2008 – 6/30/2012 with a budget of
 and mentoring students, while           $2,066,132.
 maintaining an environment
 conducive to developing a
 competitive research program.“

 “I have been given many
 opportunities to grow and develop
 my research program with generous
 assistance from the senior faculty
 in the Division and Department. I
 feel fortunate and wish to express
 my gratitude to those individuals
 who have created an outstanding
 environment for academic research
 and teaching. They have provided
 a solid foundation from which I
 have been able to construct an
 integrative research laboratory to
 serve as a resource for students,
 trainees and faculty. Throughout, I
 have maintained a commitment to
 create an academic environment for
 the pursuit of scientific discovery.“

                                                                         Assistant Professor Dr. Michael Janech
18 Depar tment of Medicine  2009 Annual Repor t
     “The Department of Medicine participates in a broad spectrum
       of research endeavors, from basic science to clinical trials
             to epidemiology and statistical data analysis.”

As the Department enters the new
year, Dr. Gary Gilkeson, Vice Chair
for Research, and Dr. Ayad Jaffa,
Associate Vice Chair for Research will
work to enhance communication and
support to our clinical research/trials
infrastructure. One approach is to
expand membership on our Clinical
Research Operations Group (from
approximately 20 current members
to now almost 50 members). This will
also include representatives from our
new Biostatistics & Epidemiology
Division. Throughout the year,
the members will be discussing
issues and offering suggestions
to improve clinical research
support and operations within the
Department. The meetings are an
important opportunity to learn about
emerging clinical research resources
available thru the new MUSC South                              Hematologist and Coagulation expert, Dr. Charles Greenberg
Carolina Clinical and Translational
Research Institute (SCTR) and its SCTR Research Support Services unit (the SUCCESS Center) and other new initiatives/
opportunities within the Department of Medicine.

We have also established a Grant Study Section to provide department investigators with internal grant reviews by
senior investigators. The goal of the Grant Study Section is to provide objective input, direction, and suggestions for
junior faculty who have not had prior independent NIH funding. The initial focus will be on NIH R01, R03, R21, and
K proposals. We have also begun a program to provide external review for junior investigators submitting NIH grant

Overall, we experienced a 25.3% increase in Research Award dollars over FY08 including a 23% increase in Federal and
62% increase in Corporate Awards. This includes a 44% increase in NIH Funding Requests and a 37% increase in NIH
Awards. Nine of our Principal Investigators received new NIH R01 awards including:
        John Arthur, MD, PhD
        Maria Buse, MD
        Leonard Egede, MD, MS
                                                                      Research Awards
        Gary Gilkeson, MD                                                  (in millions)                 $49.7
        Dhan Kuppuswamy, PhD
                                                      $39.6       $40.0                    $39.6
        Louis Luttrell, MD, PhD                                                $37.4
        Donald Menick, PhD
        John Raymond, MD
        Maria Trojanowska, PhD

                                                       FY05         FY06         FY07          FY08         FY09
                                                                    Corporate   Federal   Other

                                                                           Medical University of South Carolina           19
                                                          The Purpose Behind
                                           Lina M. Obeid, MD is a renowned physician-scientist who pioneered the
                                           study of bioactive sphingolipids. Dr. Obeid’s research has focused on the
                                           role of novel lipid second messengers in the regulation of apoptosis and
                                           senescence. Dr. Obeid has two R01 grants; one of which is funded by the
                                           National Institute on Aging. She has a VA Merit Award, which is also
                                           related to her work in cell aging.

                                           As an undergraduate chemistry major, Dr. Obeid developed a love for
                                           science and experienced the excitement of discovery and the energy
                                           of being at the ‘bench’. But that was not enough. She also insisted that
                                           discoveries be relevant to human health and well-being. As a result, she
Lina M. Obeid, M.D.
Boyle Chair in Geriatric Medicine
                                           pursued a medical career, ultimately specializing in endocrinology and
Professor                                  geriatrics.
General Internal Medicine and Geriatrics
                                           Dr. Obeid then discovered that to make a difference, she needed to pursue
                                           the basic mechanisms of disease pathogenesis. She performed post
                                           doctoral training with Dr. Robert Lefkowitz at Duke University where she
                                           studied gene regulation of adrenergic receptors. She then worked with
 True to her own feelings                  Dr. Yusuf Hannun and developed her interests in studying fundamental
 about perpetual learning                  mechanisms of growth regulation with emphasis on aging and cancer.
 and collaboration, Dr. Obeid
 has made mentorship a                     Over the past 20 years, Dr. Obeid has developed an outstanding research
 priority throughout her                   program that focuses on the study of bioactive lipids. She was the first
 career.                                   to demonstrate the pro-apoptotic function of ceramide. Her group was

 To date, she has served as                           Dr. Yusuf Hannun, Melanie Boney, summer student, and Dr. Lina Obeid
 mentor to: 20 junior faculty
 members, 16 post-doctoral
 fellows, 4 MSTP students,
 5 graduate students and 5
 undergraduates as well as
 several medical students.

 Dr. Obeid has also served
 as thesis advisor to 9
 graduate students, served
 on 19 graduate student
 committees, as well as
 collaborating with three
 scientists from other
 institutions who were on

20 Depar tment of Medicine  2009 Annual Repor t
   “The best scientists have the ability to keep asking questions,
   you have to have alternative questions to ask and keep going”

also the first to relate ceramide metabolism to senescence (cell aging). She and her colleagues have gone on
to make a number of seminal contributions, including discovery and identification of several key enzymes
in the sphingolipid metabolic pathway in yeast and in humans. They then went on to demonstrate that these
enzymes are regulated in inflammation, cancer and aging. These ongoing discoveries have opened novel
venues for therapeutic development in inflammatory disorders and inflammation-related cancers such as colon

Dr. Obeid is highly acclaimed for these discoveries and this body of work, being elected to the American
Association of Physicians and as a Fellow of the American Association for the Advancement of Science. Dr.
Obeid is on the Scientific Advisory Board for the Paul Beeson Physicians Faculty in Aging Research Program.
She is also a permanent member of the NIH Study Section on Medical Biochemistry.

Dr. Obeid envisions her contributions at three levels. First, advancing basic knowledge and understanding
basic mechanisms of pathogenesis of aging, cancer and inflammation. Second, she is highly recognized for her
strong commitment to the new generation of physician scientists and basic investigators. Dr. Obeid teaches
medical students and housestaff at the Geriatrics outpatient clinic at the Ralph H. Johnson Veterans Affairs
Medical Center. She teaches several spring classes in Biochemistry and Lipids at MUSC. She also instructs and
mentors graduate students and junior faculty. She is Director of the Center of Biomedical Excellence (COBRE)
in Lipidomics and Pathology. Indeed, she is a formidable role model for aspiring women scientists and
academic physicians. Finally, she is committed to developing MUSC as an internationally recognized center of
academic medical excellence.
                                                                 Medical University of South Carolina     21
                                                 The Business of
                                                Academic Medicine
                                       The past fiscal year has brought significant challenges to the
                                       Department of Medicine. The Department was faced with budget
                                       cuts approaching two million dollars. Our state funds during
                                       the course of the year went from 7.8% of our total budget to
                                       4.7%. Additionally, as with most Departments of Medicine, our
                                       endowments experienced significant market losses reducing the
                                       payouts that support our many missions. In response, we had to
                                       step back from our strategic plan for the year and modify our efforts
                                       to face the challenges presented to us. We recognized the need to
                                       examine our expenses and cut where we could while preserving
                                       jobs and keeping the hardworking team we had in place. But most
                                       importantly, we needed to focus on finding new revenue sources in
                                       this challenging environment because we could not achieve these
                                       cuts and losses by only reducing expenses. Close to 87% of our
                                       budget is allocated in support of our Departmental workforce and
                                       given a 6 month period of time to recover from the cuts, it was not
                                       possible to make significant headway by reducing faculty and staff.
Cathy Wood, M.B.A.
Vice Chair for Finance and             The department’s leadership met in early 2009 to re-analyze
                                       our strategic plan for the year. The situation we faced included
                                       the decrement of funds for education, how to thrive with less
                                       dependency on state support, managing with fewer financial
                                       resources, working smarter with fewer personnel, and taking a very
  Commitment of Purpose                close look at our future planning. We needed to shift our focus to
                                       how we were going to not only reduce expenses but also to new
                                       programs that generated revenue, opportunities for sharing of
  When faced with financial            personnel and expenses, and changes in compensation methodology.
  adversity during the course
  of the year, our Department          From our revised strategic plan, we crafted five new focus areas:
  of Medicine leaders took the          Clinical Programs - new clinical procedures, expand existing
                                       programs and outreach, and marketing
  challenge seriously. Over
                                        Optimizing the Revenue Cycle- focus on coding, billing and
  30 Departmental faculty
  and staff stepped up to the          Philanthropy - expand our opportunities
  plate and took voluntary              Research- accentuate our research strengths and align manpower,
  furloughs. These personal            position department for increased federal research funding.
  sacrifices helped immensely          Focus on divisional operational efficiencies
  as we worked to face our
  budget shortfall.                    Throughout the year, we took a critical look at our business
                                       processes to identify areas where we could gain economies of scale
  The dedication and                   and streamline work being done. Endocrinology and Pulmonary
                                       decided to share financial staff and General Internal Medicine and
  commitment to excellence
                                       the Chairman’s office asked their staff to take on additional duties as
  by our faculty and staff has
                                       they did not fill vacant positions. We created workgroups for Basic
  been overwhelming!                   Science staff, Clinical Research staff, and Administrative staff from
                                       all of our Divisions to share best practices and provide peer support.
                                       From these groups, better processes have been shared and new ideas
                                       have been implemented.

                                       On the Clinical side, our physicians were busier than ever before,
                                       with a significant increase in clinical production that resulted in a

22 Depar tment of Medicine  2009 Annual Repor t
       “We cannot be separated in interest or divided in purpose.
                 We stand together until the end.”
                                                                    - Woodrow T. Wilson

13% increase in clinical revenue. Outpatient visits on-campus and at our five outreach clinics increased by more
than 10,000 visits from the previous year. Patient satisfaction rose to the 79th percentile, up 8 percentile points from
FY08. We also worked on our revenue cycle, identified missed billing opportunities, improved coding and billing,
as well as focusing on our denials.

Research awards increased 25.3% this year and the number of submissions increased over 20% due to American
Recovery and Reinvestment Act awards. As a result, we expect to receive stimulus bill money in FY10.
Additionally, our Development efforts have been focused on research dollars as several new endowed chair
funds were established as well as gifts that go directly to investigators in Pulmonary, Nephrology, Rheumatology,
Gastroenterology, and General Internal Medicine.

In the middle of all of these activities, we spent significant time working on the transition of our newest division,
Biostatistics and Epidemiology. We look forward to the upcoming year as we work closely with our new Division
Director, Dr. Yuko Palesch, and Division Business Administrator Christerphine Newburn. There will be challenges,
but our pursuit of excellence will persevere.

Our Division Business Administrators:
(Top Row from left) Dallas Ellis, Ted Wickman, Brian Collins, MHA, Derek Sanford, Steve Vinciguerra, MBA
(Front Row from left) Denise Mitchell, MHA, Debbie Collins, Cameron Craft, Cathy Wood, MBA, Sue Cwik, Donna Gerke

                                                                          Medical University of South Carolina             23
     “Endeavors succeed or fail because of the people involved.
Only by attracting the best people will you accomplish great deeds.”
	     	       	     	     	      	      	      	      	      	     	      	         -	Colin	Powell	

          Honor....Integrity....Loyalty....Determined....Detail Oriented....Positive....

The words above are just a few of the descriptors used in the more than 90 nominations we received
for the Department of Medicine Employee of the Quarter this fiscal year. This Employee Recognition
Program is just one component of our efforts at achieving “MUSC Excellence”. The purpose of MUSC
Excellence is to provide a great place for our faculty, staff and trainees to work and learn and, as a
result, provide excellent service to our patients, our students, and to each other every day. Even in
a challenging year, our second full year with a focus on excellence, we were able to increase staff
satisfaction which, in turn, improved our patient satisfaction.

                                            This year, we increased staff satisfaction
                                            from the 76th percentile to the 82nd
                                            percentile by targeting communication and

Employee satisfaction improvement efforts included:
   Monthly lunches provided the opportunity for staff to interact with each other and with
     administrators and to provide feedback
   Recognition of the Employee(s) of the quarter/year
   Communication regarding achievements and events across the department (and university)
     via our bi-weekly newsletter
   Regular meetings with small staff groups within each division
   Communication Boards in each staff area
   Encouraging administrators, faculty and staff to recognize and thank each other verbally and
     in writing

As a result of increased employee satisfaction, our outpatient satisfaction score for the department
went from the 71st percentile to the 82nd percentile in March 2009. As we go to press, our West
Ashley Cardiology Clinic has won the banner for best Outpatient Satisfaction for the 9th quarter in a

24 Depar tment of Medicine  2009 Annual Repor t
                                         MUSC Excellence

     2009 Employees                            2009 Employee of the Year: Gerry Garza, MBA
      of the Quarter                      Research Administrator for the Department of Medicine.

 Fall 2008:                              “Employee of the Year” is an honor bestowed on an individual
                                         who has gone beyond the expected to deliver excellence in the way
Debbie Collins
                                                he interacts with colleagues and how he represents
Administrator, Hematology/Oncology
Sue Gray                                     the Department of Medicine, and indeed, the University.
Registered Nurse, Pulmonary
Heidi Grund
Registered Nurse, Pulmonary
Tammy Hill
Admin Assistant, Nephrology
Kathy Wiita-Fisk
Admin Coordinator, Geriatrics

 Winter 2008:

Liezl de la Cruz-Tracy
Study Coordinator, Rheumatology
Beth Gunnells
Admin Assistant, Endocrinology
Matt McCoy
Information Technology, Administration
Meredith Stafford
Education Manager, Administration
LoriAnn Ueberroth
Study Coordinator, Rheumatology

 Spring 2009:

Chante Grant
Patient Coordinator, Cardiology
Margie Myers
Admin Assistant, GI & Hepatology
Jac Tepper
Supervisor, Medicine Scheduling
Steve Vinciguerra
Administrator, Cardiology

 Summer 2009:

Susan Caulder
Registered Nurse, Endocrinology
Gerry Garza
Research Administrator, Administration
Jackie Sebastian
Nurse Practitioner, Cardiology
Mary Ann Snell
Education Coordinator, Administration

                                                                    Medical University of South Carolina     25
                                 The People Behind
                                  Our Excellence

     Diane Kamen, MD, MSCR              Ben Rogers                            Meghan McQueeney
     Assistant Professor                Information Technology                Administrative Assistant
     Division of Rheumatology           Manager                               Department of Medicine
     and Immunology                     Department of Medicine

    “Working at MUSC is truly           ”Coordinating information             “I have the opportunity to make
    a privilege for many reasons.       technology provides the               a direct impact and difference
    Being a part of a healthcare team   opportunity to participate in         in the lives of patients every
    that shares a common mission        all three key missions of the         day through my support of
    of improving the quality of life    Department: Teaching, Research,       fundraising and philanthropic
    for our patients is tremendously    and Clinical Practice. MUSC is        efforts. The funds raised for
    rewarding, as is researching        an amazing engine to watch as we      research, education, and patient
    a disease for which I feel          turn our research into outcomes-      care gives our faculty and staff
    passionate about finding a cure.    based practice, educate the next      the means to improve quality
                                        generations of clinicians in that     of life by providing patients the
    I also enjoy the daily academic     practice, and as our scholarly and    best health care possible.
    interchange with my colleagues,     compassionate faculty and staff
    mentors, students and other         use informed clinical practice to      Raising money for research
    members of our lupus research       care for our patients. The cycle is   and education gives hope to
    team. I am proud to work at         highly virtuous and Information       our patients, which is a reward
    MUSC where excellence is a          Technology is the oil that keeps      within itself. Giving to MUSC
    part of the workplace culture.”     the engine running smoothly.          gives hope to our patients and it
                                        People are what make this all         also gives us the resources and
                                        happen and if we can make their       the opportunity to enhance the
                                        day just a little bit easier and      future of public health in South
                                        their jobs just a little bit faster   Carolina”
                                        or more accurate, you can really
                                        see that translate to improved
                                        patient care, better teachers, and
                                        innovative discoveries.”

26 Depar tment of Medicine  2009 Annual Repor t
                             “Efforts and courage are not enough
                               without purpose and direction.”
                                                            - John Fitzgerald Kennedy

Richard Bayer, MD                      Marcy Bolster, MD                      Jimmy Alele, MD
Internal Medicine Resident             Professor                              Assistant Professor
                                       Division of Rheumatology               Division of Endocrinology,
                                       and Immunology                         Diabetes & Medical Genetics

“Working at MUSC provides a            “I strive for excellence in             “It has been a true joy to be
truly collaborative environment        everything that I do. It is             numbered with the MUSC
between all aspects of patient         important for me to take the best       family of “healers”, people
care that fosters an atmosphere        care of patients, to pursue the         who truly enjoy their work
of collegiality amongst all            difficult diagnosis, to encourage       and care about the way they
employees, specialties, and            others to pursue excellence in          do it.
disciplines. When this type of         their own performance, and to
“team” approach is utilized,           enhance my own “training” as I          Recent institution-wide
learning, education, and most          continue to grow professionally.        emphasis on excellence
importantly patient care is                                                    has transformed the way
enhanced.                               I have learned that improved           healthcare delivery, teaching
                                       patient care stems from utilizing       and research are conducted at
Being able to work side by side        all of the resources available and      MUSC. Day-to-day challenges
with so many people dedicated to       we have a wealth of resources in        are just an opportunity for us
this ideal and patient care makes      our institution including primary       to prove ourselves. I believe
it a privilege to come to work         care, physician specialists and         that the sky is the limit..”
every day. As I progress further       technology. MUSC provides the
in my career, I hope to emulate        avenue for me to pursue these
the many mentors I have had the        ideals on a daily basis.”
privilege of working with here at

                                                                  Medical University of South Carolina         27

                                            The Department of Medicine benefitted from another exceptional year of
                                            philanthropic giving despite the challenging economic climate. As we reflect
                                            on our accomplishments, we would like to express our gratitude to the many
                                            donors who have made our mission their purpose for giving. This past year
                                            we have been inspired by the countless individuals who have chosen the
                                            Department of Medicine as a beneficiary.

                                            Highlights this year include the first endowed chairs for two of our Divisions.
                                            The Division of Endocrinology, Diabetes and Medical Genetics has recently
                                            established the James A. Keating, Jr. Endowed Chair in Diabetes. The
                                            Division of Pulmonary and Critical Care Medicine is the beneficiary of the
                                            Powers-Huggins Endowed Chair for Cystic Fibrosis. These endowed chairs
Jane McCullough                             will play an important role in helping the Department recruit and retain
Director of Development
                                            experts in their field.

                                            As the Department’s research enterprise continues to grow through
   The Purpose for Giving                   multidisciplinary partnerships and collaborations, we are grateful for our
                                            philanthropy partners who share our purpose of developing better therapies
     A $1.5 million gift from the estate
                                            to help treat our patients. The financial support of individuals like Robert
   of Delores M. Keating will endow
   the first chair for the Division         and Molly Tarr is critical at all levels, from our junior investigators like Drs.
   of Endocrinology to support a            Antine Stenbit and Monica Gupta (below) who are beginning their careers as
   nationally recognized diabetes           physician-scientists, to our more accomplished programs such as the Renal
   clinician/educator/research              Disease Biomarkers Center of Economic Excellence (CoEE) which is in its
   scientist.                               final stages of completing a $5 million campaign.

    Iris J. Powers and Jane and            Patient care is another critical mission of the Department. In addition to
   Rex Huggins have established             helping our patients manage their healthcare as effectively as possible,
   the Powers-Huggins Endowed
                                            preventative medicine has become an increasingly important tool for
   Chair for Cystic Fibrosis, the first
   of its kind for the Division of
   Pulmonary/Critical Care Medicine,
   to be used to support research,
   education, and clinical care
   associated with Cystic Fibrosis and
   other pulmonary related disorders.

    The recently established
   Spaulding-Paolozzi Endowed
   Chair of Clinical Women’s
   Cardiology will support the
   studies of women’s cardiovascular

    The Hematology/Oncology
   Fellowship fund received a
   $200,000 pledge in support of the
   Division’s fellowship program.

    Friends and family of the late
   Kitty Trask Holt have contributed
   more than $153,000 for the Kitty
   Trask Holt Endowed Chair in
   Scleroderma Research fund.
                                                 Mr. and Mrs. Tarr with Antine Stenbit, MD, PhD, John R. Feussner, MD, MPH, and
                                                 Monica Gupta, MD, MSCR

28 Depar tment of Medicine  2009 Annual Repor t
   “Many persons have a wrong idea of what constitutes true
happiness. It is not attained through self-gratification but through
         fidelity to a worthy purpose.” - Helen Keller

                                                                                       Mr. and Mrs. Robert Tarr
                                                                                      contributed $100,000 to fund
                                                                                      two junior investigators in the
                                                                                      Department of Medicine, Dr. Antine
                                                                                      Stenbit in Pulmonary and Critical
                                                                                      Care Medicine and Dr. Monika
                                                                                      Gupta in Nephrology.

                                                                                       Friends and Family established
                                                                                      the William J. Dalton Endowment
                                                                                      for Health Professional Education
                                                                                      Outcomes Research fund to
                                                                                      integrate the Department’s clinical
                                                                                      and research enterprises and
                                                                                      improve the training of our medical
University President Dr. Raymond Greenberg with Mr. and Mrs. Seinsheimer
                                                                                      students and interns, patient care
                                                                                      protocols and identify new solutions
our physicians and patients. With the recent establishment of the Seinsheimer         to address the complex issues
Cardiovascular Health Program, Walter and Beverly Seinsheimers’ passion and the       associated with healthcare delivery.
Division of Cardiology’s mission for helping people improve their health through
                                                                                       Department of Medicine Faculty
preventative medicine has become a reality. As a result of their giving, the          and staff contributed more than
Seinsheimer Cardiovascular Health Program offers comprehensive cardiovascular         $64,000 to various funds in the
exams, nutrition assessments, counseling, rehabilitation, weight management and       MUSC Foundation through the 2009
exercise as a means to improving cardiovascular health.                               Yearly Employee Support (YES)
The Division of General Internal Medicine and Geriatrics was the beneficiary of
the newly created William J. Dalton Endowment for Health Professional Education        Pulmonary and Critical Care
Outcomes Research Fund. The Division plays a major role in the education and          Medicine received more than
                                                                                      $30,000 from grateful patients to
training of the next generation of physicians. Many times, the significance of
                                                                                      establish the Sarcoidosis Research
our teaching mission is overshadowed by the complex issues associated with the        fund in support of Dr. Marc
delivery of health care. This fund embraces the Division’s mission of integrating     Judson’s research and to provide
both the clinical and research enterprises in a way that will develop new methods     state-of-the-art services in the
to improve the training of our medical students and interns, improve patient          diagnosis, treatment, education, and
care protocols and identify solutions for the many challenges posed by our            research of sarcoidosis.
healthcare system. Some of the most inspiring gifts have come from individuals
who are making donations in gratitude for the care they have received. We are          The Baur family made a $25,000
also touched by the many faculty, staff and residents who have contributed to         gift for scleroderma research in
                                                                                      honor of Dr. Richard M. Silver.
our philanthropic efforts in addition to all they do at the workplace. For example,
our Chief Residents, Drs. Laurel Bailey and Deborah DeWaay, were successful in         The Pate Foundation made a
raising more than $6,000 for the Internal Medicine Residents fund to support both     $12,000 gift to the IBD Support Fund
educational and social pursuits for the residents.                                    for Ulcerative Colitis Research.

As you review our annual report, I hope you will be proud of the work we are
doing and that you will consider how we can become your purpose for giving. For
more information on how you can support our philanthropic mission and make a
difference, contact Jane McCullough, Director of Development, 843.792.4280, toll-
free at 800.810.6872, via email at mcculloj@musc.edu or log onto www.medicine.

                                                                           Medical University of South Carolina          29
                                                  Division of
                                                      & Epidemiology
                                      In July 2009, Biostatistics and Epidemiology became the newest Division
                                      within the Department of Medicine as part of a College of Medicine-wide
                                      restructuring. The Division also welcomed Professor Yuko Y. Palesch,
                                      Ph.D. as the new Division Director.

                                      The Biostatistics and Epidemiology faculty continue to successfully
                                      pursue independent biostatistic methodology and epidemiological
                                      research as well as to collaborate with multiple investigators throughout
 Yuko Y. Palesch, PhD                 the Department, College, MUSC and beyond. In the months of May and
 Division Director and                June, 14 faculty members submitted their grant applications, for both
 Professor                            the regularly budgeted NIH funds and the ARRA funds, and 46 have
                                      contributed to grant submissions as co-investigators. Division faculty also
           Highlights                 played a key role in MUSC receiving the National Cancer Institute Cancer
                                      Center designation and the CTSA award.
  Welcomed two new
 Epidemiology faculty                 Dr. Elizabeth Garrett-Mayer leads the HCC Biostatistics Shared Resources,
                                      and Drs. Anthony Alberg, PhD, MPH and Marvella Ford, PhD co-direct
 members: Katherine R.
                                      the HCC Cancer Prevention and Control Program. Dr. Yuko Palesch, PhD,
 Sterba, PhD and Kristin              assisted by Associate Director, Paul Nietert, PhD, head up the Design,
 Wallace, PhD                         Biostatistics, Epidemiology, and Clinical Research Ethics Program of
                                      the CTSA. The division’s educational mission also remains solid with 27
  Recruited three additional         PhD and 3 MS students. Drs. Elizabeth Slate and Anbesaw Selassie are
 Assistant Professors: Emily          co-Directors of the Biostatistics and Epidemiology Graduate Training
 Kistner-Griffin, PhD, Jordan         Program.
 J. Elm, PhD and Miran
 Jaffa, PhD to promote and            With the dedicated support of division administrative staff, as well as of
 support the ever growing             the Department of Medicine Chair and staff, the Division looks forward to
                                      additional growth over the next few years.
 clinical research endeavors
 at MUSC.
                                     Professor Andrew Lawson, PhD consults and teaches spatio-environmental epidemiology
  Andrew B. Lawson, PhD
 received national recognition
 as Editor-in-Chief of the
 Elsevier Journal entitled
 “Spatial and Spatio-temporal

  Anthony J. Alberg, PhD,
 MPH was appointed to
 serve in the Epidemiology
 of Cancer (EPIC) NIH study

  Elizabeth H. Slate, PhD
 was invited to join the
 Biostatistical Methods and
 Research Design (BMRD)
 Study Section, a very special

30 Depar tment of Medicine  2009 Annual Repor t
“Our purpose is the study of living things plus the accumulation,
         tracking, analysis, and application of data.”

Collaborative Unit
Providing statistical and/or epidemiological
expertise to researchers throughout the university
on design, conduct, and analyses of studies is the
mission of the Division’s Collaborative Unit (CU)
led by Unit Director Paul J. Nietert, PhD. CU
members include all division faculty as well as staff
and advanced graduate students who collaborate
with investigators at MUSC and other research
institutions during the earliest stages of grant
development and through all stages of project
completion, including manuscript preparation. The
CU exists in parallel with the Design, Biostatistics,
Epidemiology, and Clinical Research Ethics Program
within the recently funded South Carolina Clinical
& Translational Research Institute. Through this
mechanism, the unit now also provides biostatistics
assistance with pilot projects and Clinical and
Translational Research Center protocols, often for
new investigators trying to establish their careers.
The Office of the Provost recognizes the CU as        Paul Nietert, PhD and Valerie Durkalski, PhD consult with a clinical investigator
a University Research Resource Facility whose
primary mission is to collaborate with MUSC investigators in developing competitive grant applications. Over the past
three years, the CU has provided over 8,700 hours of help to develop grants for investigators throughout MUSC.

Data Coordination Unit
Our Data Coordination Unit (DCU) is currently running 19 clinical research studies, most of which are NIH-funded,
multicenter clinical trials involving over 100 academic institutions, including MUSC, in North America, as well as
international institutions. Now in its sixth year, with the leadership of new Director Valerie L. Durkalski, PhD, the DCU
specializes in providing assistance with the design of clinical trials and analysis of data and in establishing,
implementing and maintaining data and project management systems for multicenter clinical trials. The DCU has
continued to collaborate with their clinical colleagues as the NINDS-funded Neurological Treatment Trials Network’s
SDMC on the NIH submission of 3 large multicenter studies of neurological emergencies. The DCU has also received
funding for submissions in the area of traumatic brain injury and will soon begin working with colleagues at Emory
University on this important study. As the Division of Biostatistics and Epidemiology begins anew in the Department of
Medicine, the division welcomes more collaborative opportunities and looks forward to working with the entire MUSC

Distinguished University Professor Associate Professors                Assistant Professors           Research Associates
David G. Hoel, PhD                 Anthony J. Alberg, PhD, MPH         Dipankar Bandyopadhyay, PhD    Nathaniel L. Baker, MS
                                   Valerie L. Durkalski-Mauldin, PhD   Joan E. Cunningham, PhD        Jaemyung Kim, MBA
Professor Emerita                  Marvella E. Ford, PhD               Stacia M. Desantis, PhD        Nicole M. Marlow, MSPH
Rebecca G. Knapp, PhD              Elizabeth Garrett-Mayer, PhD        Jordan J. Elm, PhD             Georgiana Onicescu, ScM
                                   Paul Nietert, PhD                   Mulugeta Gebregziabher, PhD    Stephanie R. Shaftman, MSc, MS
Professors                         Emily E. Pickelsimer, DA            Elizabeth G. Hill, PhD         Ann-Catherin Simpson, MSc
Daniel T. Lackland, DrPh           Anbesaw W. Selassie, DrPh           Kelly J. Hunt, PhD             Amy E. Wahlquist, MS
Andrew B. Lawson, PhD                                                  Emily Kistner-Griffin, PhD     Qi Wu, MS
Yuko Y. Palesch, PhD                                                   Jeffrey E. Korte, PhD          Eun-Sil Yim, MS
Elizabeth H. Slate, PhD                                                Renee H. Martin, PhD           Yusheng Zhai, MSPH
Robert F. Woolson, PhD                                                 Katherine R. Sterba, PhD
Jane M. Zapka, ScD                                                     Kristin Wallace, PhD           Division Administrator
                                                                       Sharon D. Yeatts, PhD          Christerphine Newburn
                                                                       Wenle Zhao, PhD

                                                                                  Medical University of South Carolina               31
                                                        Division of        Cardiology
                                       The Division of Cardiology continues to grow rapidly, adding new faculty and
                                       programs, while maintaining the commitments to outstanding patient care,
                                       education and research. Division faculty members have unique expertise in
                                       the treatment of arrhythmias, including the use of ablation, pacemakers and
                                       defibrillators. A comprehensive program for research and treatment of atrial
                                       fibrillation is being developed by Dr. J. Marcus Wharton.

                                       Innovative therapies available in the MUSC cath lab include ASD closures,
 Michael R. Gold, MD, PhD              percutaneous valve repair and alcohol septal ablation for hypertrophic
 Division Director and Professor       cardiomyopathy. Adrian VanBakel, MD, PhD leads a comprehensive program
 Associate Dean, Interdisciplinary     for Congestive Heart Failure with transplantation. The Division is active in the
 Clinical Programs                     implantation of LVADS, led by Jennifer Peura, MD; systolic heart failure, led
 Michael Assey Chair in Cardiology     by Michael Craig, MD and diastolic heart failure, led by Michael Zile, MD. A
                                       unique state-wide network is in place for research and clinical management of
 Dr. Christopher Nielsen leads         these patients.
 the MUSC interventional
 cardiac program. He has               Despite increasing competition, referrals to MUSC have increased dramatically
 conducted a large number of           over the past five years. Clinical services provided include general cardiology,
 clinical trials and has intro-        electrophysiology, cardiac catheterization, imaging, congestive heart failure
 duced an impressive number of         and cardiac transplant. A Stereotaxis Laboratory in the Heart & Vascular
 new interventional techniques         Center allows for magnetic navigation of catheters for arrhythmia and
 to MUSC. Dr. Nielsen is an            interventional applications. MUSC was one of the first five centers in the world
 active teacher with positive          to use a 64-slice CT machine for cardiac imaging and remains a leader in this
 evaluations by both students          field.
 and residents.
                                       Under the direction of Bruce W. Usher, Sr., MD, our fellowship programs
  According to Dr. Nielsen, “After     continue to grow. This highly competitive program receives over 300
 completion of my cardiology           applications annually for the six available slots. Graduates of the three-year
  fellowship at MUSC in 1996, I        General Cardiology Fellowship Program have a greater than 95 percent pass
 decided that I wanted to “spread      rate on their Cardiology Boards. Formal subspecialty training is also available
 my wings”, so I joined a private      in interventional cardiology and electrophysiology.
 practice. I learned alot about
 Cardiology and myself during this
 short period of time. Although it
 was a rewarding position, I found
 that it was not academic enough for
 my needs.

 Since returning to MUSC, I have
 developed the curriculum for our
 Interventional Cardiology
 fellowship and obtained accredi-
 tation from the ACGME. I also
 received the first Michael E. Assey
 Award for Clinical Teaching in
 2001. I am proud of my
 accomplishments as a teacher in

 I plan to help make MUSC one of
 the premier interventional cardiol-
 ogy programs in the country.”

32 Depar tment of Medicine  2009 Annual Repor t
 “We continue to grow rapidly, adding new faculty and programs,
             while maintaining the commitments to
       outstanding patient care, education and research.”

                     Daniel Steinberg, MD; Christopher Nielsen, MD and William Spencer, MD in the Ashley River Tower Cath Lab
George Cooper, IV, MD, MUSC Distinguished University Professor and Director of the Gazes Cardiac Research Institute
leads a flourishing basic research program. Recently, a $5 million grant was received from the State of South Carolina
to establish a Center of Economic Excellence for the early detection of congestive heart failure, with Michael R. Zile, MD
as Principal Investigator. To meet requirements of the grant, an additional $5 million in matching pledges has been
raised. Donald R. Menick, PhD, one of six full-time basic scientists in the Division, serves as Director of the Molecular and
Cellular Biology and Pathobiology Program (MCBP), and Director of the National Institutes of Health (NIH) Summer
Research Program for Minority Medical Students.

The Division also supports a successful clinical research program with 46 on-going trials in the areas of cardiac
arrhythmias, congestive heart failure, coronary intervention and cardiac transplantation. Division faculty members
currently serve as national or worldwide principal investigators on six multi-center clinical trials. Total clinical grant
funding exceeds $1.6 million annually.

Distinguished University      Eric R. Powers, MD          Assistant Professors                Mairan H. Taylor, MD
Professors                    William H. Spencer, III, MD Catalin F. Baicu, PhD               Peter L. Zwerner, MD
Peter C. Gazes, MD            George J. Taylor, MD        Amy D. Bradshaw, PhD
George Cooper, IV, MD         Bruce W. Usher, Sr., MD     Guangmao Cheng, MD, MS              Instructor
                              J. Marcus Wharton, MD       Valerian L.C. Fernandes, MD         Sundaravadivel Balasubramanian, PhD
Professors                    Michael R. Zile, MD         Joe E. Gaddy, Jr., MD
Salvatore A. Chiaramida, MD                               James A.L. Glenn, MD                Division Administrator
Michael Gold, MD, PhD         Associate Professors        D. Daley Gregg, MD                  Steve F. Vinciguerra, MBA
Grady H. Hendrix, MD          Dhandapani Kuppuswamy, MD Pamela B. Morris, MD
Robert B. Leman, MD           Christopher D. Nielsen, MD  Jennifer L. Peura, MD
Paul J. McDermott, MD         Terrence X. O’Brien, MD, MS Daniel H. Steinberg, MD
Donald R. Menick, PhD         Adrian B. VanBakel, MD, PhD J. Lacy Sturdivant, MD

                                                                                 Medical University of South Carolina               33
                                             Division of        Emergency Medicine

                                         In the rare moment when the rush in the Emergency Department subsides and
                                         one can look up from the paperwork, it is deeply satisfying to see our own
                                         Emergency Medicine residents hard at work beside us. Among the faculty, the
                                         energy is contagious. The new residency program attracted new faculty from
                                         across the country who wanted to be a part of fulfilling this purpose.

                                         Though young, the residency program received a number of awards in 2008-
                                         09. Program Director Dr. Sam Kini was one of seven physicians in the nation
  Laurence H. Raney, MD                  given a teaching award by the American College of Emergency Physicians.
  Division Director and                  Program Coordinator Lindy Carter received the Residency Coordinator of the
  Associate Professor                    Year award from the Emergency Medicine Residents’ Association. And from
                                         the College of Medicine’s Student Council, the teaching awards began to roll
Pick up any dictionary and beside
                                         in: Teacher of the month for Dr. Jeff Bush (Assistant Residency Director), Dr.
the definition of “whirling dervish”
                                         Christina Bourne (then-Associate Residency Director), and three of our PGY2s:
there will be a photo of Dr. Diann
                                         Dr. Bonnie Dellinger, Dr. Andrew Ross and Dr. Andy Pazo. Two core faculty
Krywko. Full of Michigan brass
                                         members, Dr. Keith Borg and Dr. Diann Krywko, were nominated for the
and gusto, Dr. Krywko gets things
                                         AMSA Golden Apple award.
done fast and done right and looks
back at you as if to say “Ya’ comin’
                                         With the retirement of Dr. Sam Kini, Dr. Christy Bourne took over leadership
or not?”
                                         of the residency program. Dr. Kini’s belief in our purpose was evident in his
                                         dedication to setting up the new program. Drs. Jeff Bush and Diann Krywko
Dr. Krywko arrived at MUSC
                                         were named Associate Directors. Training is, of course, a central core value.
in March 2008, fresh from the
                                         Our faculty members devote time to interviewing COM applicants, guiding
University of Michigan. In no
                                         COM students in their early years, advising the students’ Emergency Medicine
time, she won the residents’ hearts
                                         Interest Group, lecturing, and guiding them during their rotations in our ER.
as their advocate and mentor.
Though small in stature, Dr.
                                         There is another purpose to our life’s work, and it is shared by all of our
Krywko’s presence at the bedside
                                         medical colleagues here at MUSC: superior patient care. It is our hope that as
loomed large as she called the new
residents over to see a good case or
procedure. At the end-of-the-year
awards the residents gave her the
“Ultimate Fighter” award. She’s a
great lecturer, too, so she also won
the “Platinum Podium” award
for outstanding contributions in

Her patients love her. Always
smiling, always looking at you
as you talk, she applies her
considerable diagnostic skills to
the tender belly, the inconsolable
infant. They write letters of
commendation about her – the life
she saved, the mystery pain she

                                                Residency Program Leadership:
                                                Dr. Diann Krywko, Dr. Christy Bourne, Dr. Jeff Bush and Ms. Lindy Carter
34 Depar tment of Medicine  2009 Annual Repor t
“It is deeply satisfying to see our own Emergency Medicine residents
hard at work beside us. Among the faculty, the energy is contagious.”

our seniors graduate, some of them will choose to stay
in South Carolina. Customer satisfaction is important
to the Division of Emergency Medicine. In 2008-09,
we implemented a new door-to-doctor protocol,
reducing lobby wait times and “left without care”
rates. Our achievements in patient satisfaction and
other benchmarks have put us in the top quartile of the
University Hospital Consortium’s performance reports.

Over the past year the Division significantly increased
its efforts in developing collaborative research across
a spectrum of conditions and specialties. The past
year was particularly successful with several faculty
members being awarded research awards, several
for their first time, from funding agencies such as the
CDC, NIH, and biotechnology companies. Some of our
research initiatives include:
Cardiovascular Sciences: Dr. Gary Headden, Director
of the Chest Pain Center in the Ashley River Towers,
continues to develop an infrastructure for conducting              Dr. Edward Jauch addresses the NIH/CDC Stroke Champions
clinical trials in acute coronary syndromes in                     Information Session
collaboration with the Division of Cardiology.
Disaster Preparedness: Dr. Lancer Scott’s outcome data on his “Disaster 101” curriculum was recently included at
American College of Emergency Physicians (ACEP) Research Symposium and accepted for publication in JAMA’s
Disaster Medicine and Public Health Preparedness and the Journal of Emergency Medicine.
Infectious Diseases: Dr. Dag Shapshak is the Emergency Medicine Director for The Early Intervention Program - free HIV
screening in the ED. The program is entering its third year of funding and operation.
Healthcare Informatics: In 2008 Dr. Christine Carr, began collaborating with Dr. Frank Clark towards improving both
institutional and regional information systems. This initiative will link eight Charleston Emergency Departments
technologically to share patient information.
Neurosciences : Several of our faculty, including Dr. Keith Borg and Dr. Edward Jauch, have developed strong
collaborations with the Department of Neurosciences, in both clinical and basic science pursuits.
Quality Improvement and Patient Outcomes Research: Dr. Steven Saef’s primary research focus is in the delivery of
health care. He is investigating whether patients who routinely and solely utilize the ED for routine health care would
have improved health outcomes if they received primary care services from an ED-based follow up office.

These recent research accomplishments by faculty members of the Division of Emergency Medicine are the first strides in
developing a diverse active cadre of clinical and basic science researchers.

 Associate Professors      Gary F. Headden, MD            Simon C. Watson, MD          Division Administrator
 Edward C. Jauch, MD, MS   Diann M. Krywko, MD                                         Denise Mitchell, MHA
 Sarvotham Kini, MD        Erica L. Larson, MD            Instructors
 Laurence H. Raney, MD     Walter E. Limehouse, MD        Darlene Fischer, PA
                           Lawrence W. Manaker, MD        Pauline E. Meekins, MD
 Assistant Professors      W. Brett McGary, MD            Lisa Moore, PA, MMS
 Keith T. Borg, MD, PhD    Thomas A. Pollehn, MD          Amy C. Ramsay, MD
 Cristina L. Bourne, MD    Carl E. Queener, MD            Michael P. Ramsey, MD
 Jefferey S. Bush, MD      Steven H. Saef, MD             Crispin F. Reeves, MD
 Christine M. Carr, MD     Lance A. Scott, MD             Doug P. Schutz, PA
 Michelle M. Curry, MD     Dag Shapshak, MD               Kristen H. Stanely, PA
 Charles S. Gilman, MD     James H. Tolley, Jr. MD, MAT   David M. White, PA
 Neil R. Glover, MD        Yalani Vanzura, MD

                                                                                   Medical University of South Carolina   35
                                          Division of Endocrinology,  Diabetes
                                                      and Medical Genetics
                                          Diabetes accounts for more health care costs than any other disease in the
                                          United States, contributes to heart disease and stroke, and adversely affects
                                          minority populations. These hard realities make diabetes a major focus of
                                          the Division of Endocrinology, Diabetes and Medical Genetics, a program
                                          that annually attracts more than one hundred twenty applications for
                                          four fellowship slots.

                                          The estate of Delores M. Keating established the James A. Keating, Jr.
  Louis M. Luttrell, MD, PhD              Endowed Chair in Endocrinology (Diabetes Mellitus) this year, our
  Division Director and Professor         Division’s first. Division Director Louis Luttrell, MD, PhD will hold the
  MUSC Eminent Scholar                    chair. Philanthropic acts fuel research, fund educational programs, recruit
  James A. Keating, Jr Chair in           new faculty, and build and equip new facilities. The Division is extremely
  Endocrinology                           grateful to be the beneficiary of the tremendous generosity of our donors
                                          as it allows us to accelerate our growth and transform our future.
According to Dr. Beatrice Janu-
lyte, Instructor in Endocrinology,        The Division’s clinical service volume continues to exceed projections.
“Give a man a fish, and you feed him      In addition to our Diabetes Management Services for inpatients in the
for a day. Teach a man to fish, and       Medical University Hospital and the Ashley River Tower, the Division
you feed him for a lifetime (Chinese      operates six outpatient practice locations across the lowcountry.
proverb).” I apply this concept when      Conducting general endocrinology ambulatory clinics at all sites, the
I approach my patients. I deal with       Division also offers specialized outpatient clinics focused on thyroid
chronic disorders most of the time.       disease, lipid disorders, diabetes and osteoporosis.
My goal is to empower the patient,
by helping them to understand their       Patients with tumors of the pituitary or other endocrine glands are seen
condition and how we, the patient         in a multidisciplinary Endocrine Tumor Clinic located in the Hollings
and I, will treat it. Then the patients   Cancer Center, where the Division works with colleagues in Neurosurgery,
may take charge of their health and
improve their lifestyle.

Several factors have contributed to
my pursuit of medicine as a
profession. I grew up believing that
medicine is not only a respected
profession, but also a commitment to
society that is carried from generation
to generation. By listening and
communicating effectively, I can
learn more about my patients’s
problems, needs and lifestyles. I can
then make a major impact on their
health by practicing not only clinical
but also prophylactic medicine.

I continue to emphasize the
importance and magnitude of the
diabetes epidemic to my colleagues
through multiple venues, includ-
ing resident seminars, journal club
presentations and other contacts. I
think there is no better reward than
to be able to offer your knowledge to
                                                                                                  Dr. Beatrice Janulyte

36 Depar tment of Medicine  2009 Annual Repor t
                           “There is no better reward than to be able
                             to offer your knowledge to others.”

 Otolaryngology and Endocrine
 Surgery. This collaboration elevates
 the quality and increases the efficiency
 of care delivered to our patients.

 The John Colwell Diabetes Center,
 named for Division founder and
 Professor Emeritus, John Colwell, MD,
 PhD, provides intensive management
 programs for diabetes patients
 through the Intensive Diabetes
 Education and Awareness Lifestyle
 (IDEAL) Clinic. This clinic
 treats patients with difficult to
 manage type 1 and type 2 diabetes
 mellitus and those on insulin pumps.
 The IDEAL Clinic team composed of
 a physician, nutritionist, and nurse
 practitioner, collaboratively develops
 an individualized care plan for each

 Basic and clinical research on the
 causes and treatments of endocrine
                                                                                   Endocrinologist Soon-ho Kwon, MD, MS
 disease are a vital part of the
 Division’s mission. Our research strength lies in the following areas: the metabolic/molecular/genetic basis of obesity
 and diabetes mellitus, diabetes complications, lipid disorders and intracellular signaling. Our internationally recognized
 research faculty conduct research projects funded by the National Institutes of Health (NIH), the Department of
 Veterans Affairs (VA), Juvenile Diabetes Foundation International, American Diabetes Association, American Heart
 Association, and the State of South Carolina, as well as other private foundations and corporations.

 The research program is housed in nine laboratories in the Strom Thurmond Biomedical Research Center, including the
 Nancy Thurmond Diabetes Research Laboratories. Division members are actively engaged in clinical and basic research
 with emphasis on biological markers and genetic factors that determine the risk of diabetic micro- and macrovascular
 disease, mechanisms of insulin resistance, obesity, signal transduction, and healthcare delivery research. Division
 faculty employ state-of-the-art techniques in cellular and molecular biology, biochemistry, fluorescence imaging,
 immunoassays, proteomics and genetics. Faculty, fellows, students, and invited investigators present their work at
 regularly scheduled, well-attended research conferences.

Distinguished University    Professors                        Assistant Professors       Instructors
Professor                   Kathie L. Hermayer, MD, MS        Jimmy D. Alele, MD         Beatrice Janulyte, MD
Maria G. Buse, MD           Ayad A Jaffa, PhD                 Hesham M. El-Shewy, PhD    Anita N. Ramsetty, MD
                            Maria F. Lopes-Virella, MD, PhD   Jyotika K. Fernandes, MD
Professor Emeritus          Louis Luttrell, MD, PhD           Soon-ho Kwon, MD, MS       Division Administrator
John A Colwell, MD, PhD     Julius Sagel, MD                  Jeremy B. Soule, MD        Ted Wickman

                            Associate Professors
                            Yan Huang, MD, PhD
                            Richard L. Klein, PhD

                                                                             Medical University of South Carolina       37
                                               Division of         Gastroenterology &
                                          MUSC continues to be recognized for excellence in Digestive care. This is our
                                          13th consecutive year of acknowledgement by US News and World Report as
                                          a nationally prominent Gastroenterology program. We were ranked number
                                          20 this year and were cited in the top 10 in reputation score. This honor
                                          recognizes the strength of our clinical care, clinical research and reputation
                                          for advanced digestive care and therapeutic endoscopy. Individual faculty
                                          members were also recognized both regionally and nationally. Associate
                                          Professor Joseph Romagnuolo, MD, MSc was the University recipient of
 K. Mark Payne, MD                        the Award for Excellence in Teaching in the Educator-Mentor category, and
 Division Director and                    Professor Adrian Reuben, MD was honored with an invitation to give the
 Professor                                inaugural presentation of the Mayo Clinic Humanism in Medicine lecture
 Dr. Joseph Romagnuolo
 received the MUSC Foundation             Our second year in Ashley River Tower has allowed for the coalescence of
 Teaching Excellence Award and            clinical, education and research space in one location and placed us in close
 was honored with this                    proximity to our surgical colleagues, allowing more collaborative clinical and
 prestigious award at the Faculty         research efforts. The location has also facilitated clinical expansion. Over
 Convocation in August 2009.              10,000 endoscopic and motility procedures are performed at MUSC per year
 After learning of the honor, he          and approximately 4,000 new patients are seen in our clinics. The Division
 stated “I’m especially proud as I        initiated a quality project at the beginning of the fiscal year to review, revise
 am aware firsthand that there are        and revitalize our scheduling process to enhance patient satisfaction, and
 honestly far more deserving and          improve access to clinics and endoscopic procedures. Expansion of the clinical
 skilled teachers at MUSC than I;         faculty with growth in all areas has also helped improve patient access. As
 I am certainly honored to be listed      we continue to provide immediate emergent services, routine endoscopic
 with them this year.                     procedures can now be scheduled and accomplished within 24-48 hours when
                                          requested by consulting services.
 I believe strongly that teaching/
 mentoring other physicians,              While trying to improve our ability to see routine cases more quickly, we have
 researchers and nurses makes by far
 our biggest impact on health care,
 compared with the many other
 important things we do, and
 touches so many people’s lives,
 including the lives of the patients
 that our mentees take care of in
 their careers.

 If we are lucky enough to lead some
 of these mentees to eventually
 become mentors themselves, the
 impact is even greater. Remember-
 ing this “snowballing” concept
 at the times that we all have, that
 make us doubt whether teaching
 that one class or mentoring that
 one research student or leading
 that one meeting is really making a
 difference in the world, I believe, is
 powerful inspiration to move pas-
 sionately forward with our impor-
 tant jobs as educators and mentors
 at MUSC.”                                 Joseph Romagnuolo, MD, MSc (right) receives the prestigious MUSC Foundation Teaching
                                           Excellence Award from Provost John Raymond, MD and Associate Professor Karen Wager, DBA

38 Depar tment of Medicine  2009 Annual Repor t
  “If we are lucky enough to lead some of these mentees to become
           mentors themselves, the impact is even greater.”

maintained our ability to provided
cutting edge motility and endoscopic
services to patients in South Carolina
and throughout the southeastern
United States. Therapeutic ERCP
services, endoscopic ultrasound,
endoscopic mucosal resection
and Barr-x ablations are readily
available. Over 1,000 motility
and pH/impedance studies are
performed yearly by our Motility
unit, directed by Professor Donald
Castell. In addition, our Hepatology
section participates in an active liver
transplant program, with over 70
transplants performed last year.
Our GI fellowship continues to
grow. We now have a total of
12 fellows in training. This very
competitive program is known for
its clinical training in all aspects of
gastrointestinal care. The unique
curriculum allows GI trainees to focus                  Lawrence Comerford, MD, MS with GI Fellow, Andrew Brock, MD and patient
on specialized training or research
for six months during the third year of the program. In addition, Professor Peter Cotton, MD, MA directs an advanced
endoscopic program that provides additional ERCP and Endoscopic Ultrasound training to fellows and instructor level
faculty interested in pursuing careers in academia, therapeutic endoscopy and clinical investigation. This program enjoys
an excellent reputation and applicants are drawn from national and international venues.

The Division and the Digestive Disease Center have developed an integrated research structure that presently supports
51 clinical trials and 12 faculty investigators. Our research staff includes Dr. Joseph Romagnuolo as Director, and
supports a Research Program Manager, Research Grants Manager, and 6 Certified Clinical Trial coordinators. We have
24 corporate trials, 4 foundation-sponsored trials, 7 federally funded trials (including Department of Defense funding
and a multi-center NIH trial of Sphincter of Oddi dysfunction), and 16 investigator-initiated studies. Research efforts
resulted in 55 papers appearing in peer-reviewed journals in 2008-09. Research interests range from biliopancreatic
disease to esophageal reflux and Barrett’s, inflammatory bowel disease, colon cancer and polyps, liver disease and liver
failure, hepatopulmonary hypertension, gastrointestinal bleeding, nutrition and obesity, and natural orifice transluminal
endoscopic surgery (NOTES). Basic science and translational work in cancer proteomics and H. pylori is also active and
exciting. Finally, a clinical research curriculum for faculty and trainees has been developed with bimonthly meetings
comprising both research in-progress and a variety of topics in biostatistics and research design and methodology.
Professors:                  Associate Professors              Assistant Professors            Instructors
Donald O. Castell, MD        Frederick C. Brown, MD            Amit Agrawal, MD                Nancy O. Billings, PA
Peter B. Cotton, MD, MA      Joseph Romagnuolo, MD, MSc        Lawrence W. Comerford, MD, MS   Gregory F. Buck, PA
Mark H. DeLegge, MD          Marcelo F. Vela Aquino, MD, MS    Todd E. Dantzler, MD            Merriman L. Dowdle, PA, MS
Robert H. Hawes, MD          Ira R. Willner, MD                David G. Koch, MD, MSCR
Brenda J. Hoffman, MD                                          Christopher Lawrence, MD
K. Mark Payne, MD                                              Stacie Vela, MD
Adrian Reuben, MD                                                                              Division Administrator:
Adam J. Smolka, PhD                                                                            Dallas Ellis
Frederick Wilson, MD

                                                                             Medical University of South Carolina            39
                                                          General Internal
                                                   Division of
                                                     Medicine & Geriatrics
                                         The Division provides clinical and teaching services on inpatient services in
                                         the Medical University Hospital and the Ralph H. Johnson VA Medical Center
                                         (VAMC), and outpatient services at University Internal Medicine in Rutledge
                                         Tower and Mt. Pleasant, the VAMC, the Student Health Center, the Cholesterol
                                         Center, and the Rapid Access Clinic.

                                         The Division has a large teaching role, and this year we began implementation
                                         of the Aging Q3 Program. The wave of aging baby boomers will engulf South
 William P. Moran, MD, MS                Carolina in the next decade and since the training of physicians takes seven
 Division Director and                   or more years, our Internal Medicine physicians now need more training in
 Professor                               the management of syndromes that are prevalent as people age, such as falls,
 McKnight Chair for the Study of         poly-pharmacy and dementia. Aging Q3 is an educational and practice-based
 Aging                                   program to improve resident physician clinical competencies in Geriatrics and
                                         in turn improve the quality of care and quality of life for older adults. The
                                         three Qs represent the program goals: quality education, quality care and
 Kathy Wiley, MD, MS,                    quality of life. MUSC is one of 10 Academic Health Centers selected to receive
 Associate Professor, plays an           a $2M grant from the Donald W. Reynolds Foundation’s Aging and Quality
 active role in the Aging Q3             of Life program to train medical students, residents and practicing physicians
 Program.                                using educational and practice-based strategies.

 According to Dr. Wiley:                 With the recruitment of Paul Rousseau, MD and Donald Courtney, MD, we
 “I hear and I forget,                   have continued to develop palliative care services to address the needs of
  I see and I remember,                  patients with life-limiting disease. The Palliative Care programs at MUSC and
 I do and I understand.”                 the VAMC rely on an interdisciplinary approach to the many complex end of
 - Confucius.                            life issues. A team consisting of physicians, clinical nurse specialists, a nurse
                                         practitioner, care managers and chaplains are available to assist clinicians,
 “This philosophy of experiential        patients and families. The teams provide both a consultation service and an
 learning has been at the heart of my    inpatient service. The consultation service will see any patient hospitalized.
 teaching at MUSC for more than          The inpatient service accepts transfers from other hospital services, but does
 25 years. While caring for my own       not accept direct admissions. Any member of the healthcare team can call the
 patients is very important to me,       team - a physician is available for MUSC inpatient palliative care consultation
 teaching brings great joy to my life.   at all times.
 As a general internist and
 geriatrician, I have been
 privileged to teach hundreds of
 young physicians, medical students
 and residents, as they learned the
 art and science of medicine –                  Dr. Kathy Wiley
                                                 with Q3 chart
 beginning to see each patient as a
 unique individual affected by
 disease. It is teaching that allows
 me to amplify the impact of my
 medical training and practice to
 help prepare the next generation
 of physicians to care for future
 generations of patients.”

40 Depar tment of Medicine  2009 Annual Repor t
                “While caring for my own patients is very important
                   to me, teaching brings great joy to my life.”

Kimberly Davis, MD, Clinical Director of University Internal Medicine clinics,
also serves as Medical Director of Practice Partner, our electronic medical
records system. Although having a long-standing commitment to the Practice
Partner program at MUSC, Dr. Davis brought her devotion to excellence in
patient care and clinical leadership skills to the broader MUSC system when
she was appointed Medical Director of the Practice Partner Implementation
Team in 2008. Dr. Davis has broadened her impact on clinical processes in
other clinics with the goals of reducing medical errors, reducing duplication
of services and improving overall quality of care. In 2009, Dr. Davis was
appointed to the graduate faculty for her expertise in ambulatory electronic
health records. In August 2009, Dr. Davis was honored during the MUSC
annual faculty Convocation as the Outstanding Clinician Award from the
MUSC Foundation.

The Division has a growing research arm with established investigators and
promising new researchers. Basic and clinical research faculty members are
well published and present their work and conduct workshops at national
and regional meetings each year. Basic research is focused on cellular aging.
Clinical research targets areas such health care disparities, hypertension,
lipids, diabetes mellitus, access to care of underserved populations, aging and
geriatric care, professional education, quality of care and medical informatics.
Basic, Clinical and Health Services research is conducted in collaboration with
the Division of Biostatistics and Epidemiology and VAMC.

The Center for Health Disparities Research, directed by Leonard Egede, MD,
MS, brings together core faculty from several MUSC Colleges to develop
clinical research infrastructure and enhance MUSC competitiveness in
obtaining extramural research support in health disparities research. The center
emphasizes collaborative research to build bridges across colleges on campus
and across institutions within the state of South Carolina. Research within the
Center focuses on three main areas including: 1) primary, secondary, and
tertiary prevention of chronic diseases in diverse populations; 2) interventions
at the patient, provider, and health systems levels to reduce or eliminate racial/
ethnic, gender, and socioeconomic differences in quality of care and health
outcomes; and 3) novel interventions to improve health care delivery and
health outcomes for rural dwelling residents.

                                                                                          Dr. Kim Davis, University Internal Medicine

Professors                      Leonard E. Egede, MD, MS      Kimberly S. Davis, MD       Instructors
Jan N. Basile, MD               Donald L. Fox, MD             Leonard D. Delrosario, MD   Pamela L. Charity, MD
Brent M. Egan, MD               Leonard S. Lichtenstein, MD   Deborah DeWaay, MD          Jennifer K. Clark, MD
Jerome E. Kurent, MD, MS, MPH   Lynn M. Manfred, MD, EdD      Hans L. Hinson, MD          Ashley A. Duckett, MD
Lawrence C. Mohr, MD            Paul C. Rousseau, MD          Brad A. Keith, MD           Karleen Mcneal, MD
William P. Moran, MD, MS        James C. Thomas, MD           Cara Litvin, MD             Fletcher T. Penney, MD
Lina M. Obeid, MD               M. Kathleen Wiley, MD, MS     Cheryl P. Lynch, MD, MPH    William H. Shelley, MD
Jeffrey G. Wong, MD                                           Cungui Mao, PhD
                                Assistant Professors          Sergei Novgorodov, PhD      Research Associate
Associate Professors            R. Neal Axon, MD, MSCR        Pamela J. Pride, MD         Yuman Zhao, MS
Elisha L. Brownfield, MD        Anne Beddingfield, PhD        Shakaib U. Rehman, MD
Walter A. Brzezinski, MD        Laurence S. Blumenthal, MD    Leah Siskind, PhD           Division Administrator
Ernest B. Clyburn, MD           Cathryn Caton, MD             Deanna D. Vroman, MD        Brian Collins, MHA
Donald Courtney, MD             Patrick J. Cawley, MD, MBA    Tamara E. Wolfman, MD

                                                                                 Medical University of South Carolina               41
                                              Division of        Hematology and
                                         The MUSC Hollings Cancer Center earned the National Cancer Institute
                                         Cancer Center designation this year. One of only 64 NCI-designated
                                         cancer centers in America — it’s one of the nation’s leading cancer research
                                         centers. NCI-designated cancer centers are a major source of new cancer
                                         treatments and more effective approaches to cancer prevention and
                                         diagnosis. These cancer research centers deliver medical advances to
                                         patients and their families, educate health care professionals and the
                                         public, and reach out to underserved populations.
 Harry A. Drabkin, MD
 Division Director and                   The Division, in conjunction with the Hollings Cancer Center (HCC) and
 Professor                               the Ralph H. Johnson VA Medical Center, serves as a statewide referral
 Mary Gilbreth Chair in Clinical         center for solid tumor oncology, benign and malignant hematology and
 Oncology                                bone marrow transplant. Multidisciplinary clinics at the HCC allow
                                         patients with certain malignancies to see all of their physicians in one
 Dr. Luciano Costa, Assistant            appointment.
 Professor specializing in Ma-
 lignant Hematology and Bone             This past year, our hematology/oncology inpatient units moved to the new
 Marrow Transplantation, came            Ashley River Tower. Teaching rounds are held daily on all hematology
 to MUSC with a self-proclaimed          and medical oncology inpatients. The three-year Hematology/Oncology
 “passion for hematological malig-       Fellowship Training Program takes place in a network of clinical, research,
 nancies, enthusiasm for blood and       and educational facilities at the Medical University Hospital, the HCC
 marrow transplantations and a           and the Ralph H. Johnson Department of Veterans Affairs Medical Center.
 strong desire to fully engage in        Fellows are required to engage in at least two substantive research projects
 cutting edge clinical research,” that   during their training.
 have been the driving forces of
 his professional life thus far.         Our Clinical Cancer Research Network continues to grow. A collaborative
                                         effort with six medical centers that expands access to the HCC’s cancer
 According to Dr. Costa, “I am           therapies in local communities, the Network is part of the HCC’s mission
 fortunate to be in a field where        to improve access to the latest cancer protocols, address problematic
 the challenges are tremendous           cancers in the state and attract new research initiatives. Future plans
 and so are the opportunities and        include building an animal imaging core facility to study living animals
 the new developments. I want to                                                 Hematologist, Dr. Luciano Costa (right)
 deliver excellent care and share my
 enthusiasm with young physicians
 through dedicated teaching. I also
 realize there there is a need for
 agressive recruitment in clinical
 trials and innovative ideas that
 can improve the management of
 patients with lymphomas, myeloma
 and undergoing blood or marrow

 I will build a comprehensive re-
 search portfolio, generate contribu-
 tions to the field and involve young
 physicians in high quality research.
 By doing so, I will give continuity
 to a local tradition of hard work,
 productivity and prolific scientific

42 Depar tment of Medicine  2009 Annual Repor t
“I am fortunate to be in a field where the challenges are tremendous
     and so are the opportunities and the new developments.”

with cancer and develop new cancer drug therapies.

Faculty recruitment continued to be the top priority
of the Division this year and several outstanding
individuals were hired: Ali Golshayan MD (kidney,
bladder and prostate cancers), Charles Greenberg, MD,
(benign hematology and coagulation), Keisuke Shirai,
MD, (head, neck and lung cancer), Melanie Thomas, MD
(gastrointestinal cancer), Steve Chin, MD (Director of the
neuro-psych- Oncology Section in Behavioral Medicine
Division within the Department of Psychiatry and
specialist in GI oncology) and Rita Kramer, MD (breast
cancer), as well as researchers, Thung-Shen Lai, PhD
(neurodegenerative diseases and cancer resistance) and
Joelle Roche, PhD (lung cancer).

Dr. Charles Greenberg has made basic science and
clinical contributions to the field of hemostasis and                                       Dr. Rita Kramer, breast oncologist
thrombosis, discovering alternative therapies for
heparin thrombocytopenia (Danaproid) and completing clinical studies in sickle cell disease, post operative bleeding and
pulmonary embolism. Dr. Greenberg will continue basic and clinical research efforts with the goal of establishing a Center
in Hemostasis and Thrombosis to provide state-of-the-art clinical care for patients suffering from bleeding and thrombotic

Our Blood and Marrow Transplant (BMT) Center, an accredited center, provides expertise for allogeneic and autologous
transplants for patients with benign and malignant diseases. Dr. Luciano Costa joined the already very successful
hematological malignancies and blood and marrow transplantation program at MUSC in October, 2008. Since joining
the program, Dr. Costa has facilitated a significant increase in the number of bone marrow transplants, thus allowing the
program to serve a broader population.

Similarly, our breast cancer program has grown with the recruitment of Dr. Neil Christiansen and Dr. Rita Kramer. Dr.
Kramer collaborates with colleagues to strengthen the multi-disciplinary care of women with breast disease and breast
cancer and to improve the access of SC women battling the disease to state-of-the-art therapies by improving their access
to clinical trials. She also works to improve their recovery from treatment by partnering with colleagues to study the
issues which breast cancer survivors must face after the completion of surgery, radiation therapy and chemotherapy.

Funded by diverse sources, our scientists serve as principal investigators on more than eighty open clinical trials
as well as basic research. Division faculty’s research concentrates on areas such as gastrointestinal, genitourinary,
thoracic, neurology, head and neck, all solid tumors; medical informatics, breast, ethics, palliative and end-of-life care;
and hemoglobinopathies, including sickle cell anemia, bone marrow transplantation, antiemetic therapy, malignant
hematology and stem cell biology.
Honorary Faculty                   Associate Professors    Assistant Professors               Instructors
Senator Fritz Hollings (retired)   Lawrence B. Afrin, MD   Bo Cen, PhD                        Paul E. O’Brien, MD
                                   Rita Kramer, MD         Steve H. Chin, MD                  Vincent A. Potiron, PhD
Professors                         Carol A. Sherman, MD    Neil Christiansen, MD
Harry A. Drabkin, MD               Melanie B. Thomas, MD   Luciano J. Costa, MD               Division Administrator
Robert L. Fenning, MD                                      Ali Golshayan, MD                  Debbie K. Collins
Robert M. Gemmill, PhD                                     Patrick Nasarre, PhD
Charles Greenberg, MD                                      Keisuke Shirai, MD
Andrew S. Kraft, MD
Joelle Roche, PhD
Cliff W. Schweinfest, PhD
Robert K. Stuart, MD
                                                                                   Medical University of South Carolina       43
                                              Division of        Infectious Diseases
                                           Before joining MUSC, new Division Director Dr. J. Michael Kilby trained
                                           at UNC, Duke, and then focused on HIV care and research for nearly 15
                                           years at the University of Alabama at Birmingham. We also recruited: Sean
                                           Boger, MD, PharmD from Vanderbilt University (expertise in antibiotic
                                           stewardship/pharmacology; management of HIV-infected patients and other
                                           immunocompromised hosts); Claire Magauran, MD from Cleveland Clinic
                                           (infectious complications of transplantation; critical care infections); and
                                           Eileen Palmer, NP (intravenous catheter placement and management).
 J. Michael Kilby, MD
 Division Director and                     We have expanded services significantly. Out-patient clinical services
 Professor                                 are now available each weekday at Rutledge Tower. Specialty clinics are
                                           available for HIV patients, Travel Medicine, Bone and Joint Infections,
 “We are particularly proud that,          Transplant Patients and Women’s Care. The HIV Program provides
 despite the daunting economic chal-       multidisciplinary care and support services for nearly 1000 patients. A
 lenges of this past year, our Division    long-standing Ryan White Care Act program, administrated by Valerie
 was able to maintain financial stabil-    Assey, MSN, provides assistance to HIV-infected patients with limited
 ity while expanding and diversify-        resources. Inpatient consulting services for General Infectious Diseases also
 ing a number of critically important      expanded to 3 separate teams, providing around the clock consultations at
 clinical services, hiring new expert      MUHA, ART, the VA, and for Transplant ID cases at all campus locations.
 care providers, and dramatically im-      Reflecting the impact of these efforts and improvements, we received
 proving clinical care benchmarks and      special recognition for the Most Improved Service Area in Overall Patient
 patient satisfaction scores.              Satisfaction scores this year.
 Our growth reflects the dynamic and       Dr. Cassandra Salgado continues as Director of Hospital Epidemiology
 diverse nature of Infectious Diseas-      and Infection Control. Dr. Preston Church directs ID services and Infection
 es—from basic science to clinical care    Control at the VA Hospital. The newly established Antibiotic Stewardship
 to epidemiology—from classrooms to        Program— with Medical Directors Drs. Juanmanuel Gomez and Boger as
 clinics to bedside teaching—from the      well as hospital pharmacist Dr. Kelly Goodson—will focus on enhancing
 scope of global and public health pro-    patient care safety and efficiency while controlling unnecessary medical
 grammatic issues to the fundamentals      expenditures. Dr. Dannah Wray continues to coordinate Transplantation ID
 of one doctor focused on the concerns     services which now provide full-time outpatient and in-patient consult care.
 of one patient.

 A substantial part of our mission is
 service-oriented. Through partner-
 ships with and competitive grants
 from federal and state agencies, we
 are able to provide comprehensive care
 to the growing number of people with
 HIV infection in our area without
 incurring institutional debt. Nearly
 half of these HIV-infected patients
 have no insurance of any kind and
 many of the rest require partial
 funding support to make treatment
 feasible. The results can be breathtak-
 ing: a drastic reduction in hospital-
 izations, improved quality of life and
 returns to the workforce, and project-
 ed life expectancies indistinguishable
 from those of HIV-negative adults.”
            - Michael Kilby, MD
                                           Sean Boger, MD, PharmD, Kelly Goodson, PharmD and Juanmanuel Gomez, MD, MSCR

44 Depar tment of Medicine  2009 Annual Repor t
“The dynamic and diverse nature of ID—from basic science to clinical
 care to epidemiology—from global and public health programmatic
     issues to one doctor focused on the concerns of one patient.”

Dr. Salgado assumed the role of Fellowship Program Director this year.
In addition to our two year Fellowship Program, we also offer unique
opportunities for OB/GYN trainees to focus on Reproductive Infectious
Diseases (with co-mentoring from Dr. David Soper in OB/GYN) as well as
a variety of potential research training opportunities for graduate and post-
graduate students. Lectures are given in microbiology, physical diagnosis
and evidence-based medicine courses for medical students, and the
consultative teams and outpatient clinics provide learning opportunities for
medical students and housestaff.

Our Travel Medicine services are coordinated by Physician Assistant
Cameron Burch Oswald. They provide comprehensive assessments, guidance
and a full repertoire of vaccinations for travel to locations where exotic
infections may occur. Dr. Camelia Marculescu maintains expertise in the
clinical management of bone and prosthetic joint infections. Several of our
faculty pursue special interests in skin and soft tissue infections, endocarditis,
and nosocomial pneumonia and bacteremia.

At the Department of Medicine Research Day, Dr. Salgado received the Best
Junior Faculty Award and Dr. Eduardo Freitas (with mentor Dr. Christopher
Parsons) received the Best Clinical Fellow award. Several faculty members                  Cameron Oswald, PA
were again nominated for teaching excellence awards. Shawntina Prioleau,
our Fellowship Program Coordinator, was named Department of Medicine Employee of the Quarter.

Infectious Diseases traditionally has not been thought of as a procedure-oriented specialty, but under the direction of Dr.
Robert Cantey the Division has, for 16 years, placed peripherally inserted central (PICC) venous lines for use in long term
antimicrobial therapy, TPN, chemotherapy, pain management and for patients for whom venous access is difficult, such as
the massively obese (up to 1000 pounds). We currently place more than 800 such lines a year, using innovative techniques,
ultrasound and fluoroscopy. The lines may be antibiotic impregnated, tunneled or cuffed. For the difficult-to-access
patient, the axillary vein is often used. Line placement is available to outpatients as well as inpatients.

We are now poised for continued growth in academic and research excellence in addition to outstanding clinical and
public health services. Dr. Chris Parsons directs a laboratory with several graduate and post-graduate researchers,
focusing on Kaposi Sarcoma and viral pathogenesis. We are working closely with local non-profit services, state and
regional health departments to expand HIV services and clinical research opportunities in our area. Other active areas of
interest at this time are control of the spread of antibiotic resistant bacteria in the hospital setting, orthopedic infections,
endocarditis and opportunistic fungal infections. Finally, we are hosting a number of world-renowned HIV experts in
the coming months, including a Pfizer Visiting Professorship award to host Dr. Paul Volberding from UCSF for numerous
seminars and educational activities surrounding World AIDS Day.

Professors                     Assistant Professors            Division Administrator
J. Robert Cantey, MD           Sean M. Boger, MD, PharmD       Donna Gerke
J. Michael Kilby, MD           Juanmanuel Gomez, MD, MSCR
                               Christopher H. Parsons, MD
Associate Professors
L.W. Preston Church, MD        Instructors
Cassandra D. Salgado, MD, MS   Valerie H. Assey, RN, MSN
Dannah W. Wray, MD             Claire Magauran, MD
                               Cameron B. Oswald, PA
                               Camelia Marculescu, MD, MSCR
                                                                             Medical University of South Carolina            45
                                                           Division of           Nephrology

                                               The Division of Nephrology was founded by the late Dr. Arthur Williams, the first
                                               physician to perform dialysis in South Carolina, and expanded to a nationally
                                               recognized program over the past 22 years. We have been selected as a “Top
                                               Fifty” kidney program in the United States again this year by US News and World
                                               Report. Our ranking has, in fact, improved from 43rd in 2008 to 35th in 2009 - an
                                               excellent achievement for a single year. Our faculty have worked diligently to
                                               foster this reputation by providing excellent clinical care, building a nationally
                                               prominent research program, and creating a stimulating educational environment
                                               for future Nephrologists.
  David W. Ploth, MD
  Division Director and Professor              The Division is heavily involved in clinical care at the “Main” hospital and the new
  Arthur Williams Chair in Nephrology          Ashley River Tower as well as the Ralph H. Johnson Veterans Administration (VA)
                                               Hospital. Kidney patients are seen on a consulting basis at the East Cooper and
                                               Kindred Hospitals. Care of chronic kidney disease (CKD) patients has spread from
  According to Dr. Juan Carlos Velez,          MUSC and the VA Hospitals to outpatient clinics in Mount Pleasant and Goose
  “My responsibility as a physician is         Creek. Our Dialysis program has continued to grow and prosper in partnership
  to provide the best possible care to my      with Dialysis Clinics, Inc (DCI), a non-profit corporation based in Nashville. Our
  patients. While I view compassion            clinical faculty care for almost 500 chronic dialysis patients at six freestanding
  and humanism as tacit and essential          affiliated DCI dialysis units. Obvious growth has been observed in the clinic that
  components of patient care, I consider it    oversees dialysis (hemodialysis and peritoneal dialysis) in the home. The newest
  imperative to stay maximally educated        aspect of outpatient nephrology care is a kidney stone clinic, being developed
  about any new discovery pertinent to         jointly by Urology and Nephrology.
  my field. Our patients deserve to be
  treated by knowledgeable physicians.         Our Renal Anemia Clinic manages the anemia of patients with CKD. The clinic
  They expect it; they expect their doctors    is staffed by a clinical pharmacy specialist and a nephrology nurse practitioner,
  to know all the answers. I strive to be as   each of whom sees patients under a protocol approved by a physician medical
  prepared as I can to address their needs     director. This highly focused clinic, which utilizes an electronic medical record,
  and offer them the best treatment option     facilitates achievement of hemoglobin concentrations in the target range for CKD
  possible.                                    patients. The clinic has also been an ideal setting for industry-sponsored research
                                               on treatments such as intravenous iron compounds and erythropoietin stimulating
  As an academic medical practice,             agents.
  MUSC allows me to work surrounded
  by an incredibly talented group of pro-      The Division also directs the MUSC Apheresis Unit. This unit performs procedures
  fessionals. As an academician, I divide      to harvest cells for bone marrow transplantation, to remove plasma from patients
  my time among patient care, medical
  education and biomedical research. I         Nephrology Fellow, Heather Haley, DO with Assistant Professor Juan Carlos Velez, MD
  greatly enjoy - and take very seriously
  - the privilege of teaching future provid-
  ers, one of the cornerstones of my career.

  Chronic kidney disease continues
  to increase throughout the US and
  worldwide. Diabetes mellitus and
  hypertension lead to gradually pro-
  gressing kidney disease, ultimately
  resulting in complete kidney failure
  and the subsequent need for dialysis or
  transplantation. It is my objective to
  make a scientific contribution that may
  serve as the basis for future therapeutic
  modalities. In close collaboration with
  several of my colleagues, I am cur-
  rently involved in experimental research
  to understand the intricacies of the
  hormonal system called the intrarenal
  renin-angiotensin system as it relates to
  progressive kidney diseases.”

46 Depar tment of Medicine  2009 Annual Repor t
   “While I view compassion and humanism as tacit and essential
components of patient care, I consider it imperative to stay maximally
     educated about any new discovery pertinent to my field”
with a number of hematological, neurological, and renal diseases,
to facilitate red blood cell exchange for sickle cell patients, and
to achieve white blood cell depletion in patients with certain
blood cancers. Also MUSC and DCI have collaborated to set up
a program for lipopheresis, which can be lifesaving for patients
with very high cholesterol levels and vascular disease.

Our extremely active renal transplant program has grown over
the past thirty years to five full-time surgeons. The recruitment
of Drs. Francesca Egidi and Sarat Kuppachi to the medical side of
renal transplantation has strengthened the Transplant Program
by adding medical transplant expertise to the existing surgical
transplant excellence and increasing involvement in clinical
research in the renal transplant arena. The present Transplant
Program performs 175 to 200 renal transplants per year. MUSC
is the major transplant center in South Carolina and fifteenth
in size nationally. We have also been able to increase exposure
of our fellows to transplant medicine, to involve the fellows in
transplantation research, and to establish an accredited Renal
Transplantation Fellowship.

All of our faculty, thirteen MDs and nine PhDs, perform research.
Active collaborations between the clinical faculty and basic
scientists are ongoing, and collaborations with faculty from                             Assistant Professor Monika Gooz, MD, PhD
other divisions and departments are common. Strong expertise
is present in human and animal genetics, signal transduction, environmental toxicology, confocal microscopy, renal physiology,
proteomics, biomarkers of renal diseases, and role of the renin-angiotensin system in renal and vascular diseases.

The Division currently holds three endowed chairs, and the South Carolina Centers of Economic Excellence (CoEE) board has approved
a proposal by Dr. John M. Arthur, to support two additional endowed chairs as part of the creation of a CoEE for Renal Disease
Biomarkers. One of the chairholders will be an expert in biomarker discovery and the second in translational research. The objective
is to discover reliable and readily obtainable clinical samples for identification and prognostication of acute and chronic renal disease.
The project builds on existing strength at MUSC in proteomics, especially an NIH-funded Proteomics Center and two currently funded
proteomics-related CoEE’s.

Our Nephrology Fellowship Training Program has positions for two to four trainees each year in the Clinical Track (two-year program)
and two trainees in the Research-Clinical Track (three-year program). In inpatient and outpatient settings, the trainees learn about
renal diseases in these general areas: normal physiology, hypertension, fluid and electrolyte disorders, transplantation, acute renal
failure, CKD, and renal replacement therapy. In addition, introductions to basic laboratory methods are provided at the beginning
of each academic year. The different clinical and basic science research interests of our faculty provide trainees with an excellent and
intellectually challenging environment in which they learn to complement the clinical with the investigational. In March 2010, the
Division will sponsor our fourth annual continuing medical education conference, “Symposium on the Management of Chronic Kidney
Disease: An Update for the Primary Care Physician,” chaired by Assistant Professor Juan Carlos Velez.

Professors Emeritus             Associate Professors            Monika Gupta, MD, MSCR          Juan Carlos Velez, MD
Jovan Milutinovic, MD           John M. Arthur, MD, PhD         Courtney J. Haycraft, PhD       Zhi-Ren Zhang, MD, MS
                                Milos N. Budisavljevic, MD      Michael G. Janech, PhD
Professors                      Maria N. Garnovskaya, PhD       Peter Komlosi, MD               Division Administrator
P. Darwin Bell, Ph.D.                                           Sarat C. Kuppachi, MD           Cameron Craft
M. Francesca Egidi, MD          Assistant Professors            Deirdre K. Luttrell, PhD
Florence N. Hutchison, MD       Wayne R. Fitzgibbon, PhD        Thomas A. Morinelli, PhD
David W. Ploth, MD              Sonya Coaxum, PhD               Michelle M. Shepard, MD
John R. Raymond, Sr., MD        Andrew K. Gelasco, PhD          Rachel L. Sturdivant, MD
Michael E. Ullian, MD           Monika B. Gooz, MD, PhD         Erlandas Ulozas, MD

                                                                                   Medical University of South Carolina                47
                                                          Pulmonary &
                                                    Division of
                                                 Critical Care Medicine
                                          The Division of Pulmonary and Critical Care Medicine excels in patient
                                          care, teaching and research. This summer we were once again named
                                          in the top hospitals list by US News and World Report. With a team of
                                          eighteen nationally renowned faculty, we are able to provide expertise in
                                          the diagnosis and management of patients with acute and chronic diseases
                                          of the chest, sleep disordered breathing, and allergic diseases. Faculty
                                          members are board certified in internal medicine, pulmonary medicine,
                                          critical care medicine, sleep medicine, and allergy. Each year, the Division
 Steven A. Sahn, MD                       treats more than ten thousand patients from around the world and attracts
 Division Director and                    two hundred applications for four fellowship slots.
                                          The Medical University has opened Ashley River Tower, with 156 beds
 As a physician and a scientist,          including 32 ICU beds, 9 operating rooms, catheterization laboratories,
 Dr. Antine Stenbit has a passion         interventional radiology laboratories, endoscopy suites, imaging suites,
 for the pursuit of knowledge             and a specialized chest pain center, as well as out-patient offices. The
 and discovery that led her down          Division provides care for patients with acute respiratory failure and
 her current career path. Accord-         other critical illnesses in the Medical Intensive Care Unit at Ashley River
 ing to Dr. Stenbit, “I have known        Tower as well as the Medical University Hospital, the Ralph H. Johnson VA
 since my undergraduate days that         Medical Center, and outreach clinics in Mount Pleasant, Goose Creek, and
 basic science research would be          North Charleston. We also evaluate patients with end-stage lung disease
 a large part of my career. I have        for lung transplantation, including COPD, interstitial lung disease, and
 focused on increasing my exposure        cystic fibrosis and care for chronic “difficult to wean” ventilator patients at
 to clinically relevant research.         Medical University Hospital and Ashley River Tower.

 When I was a fellow, the director        Our state-of-the-art Sleep Center focuses on the comprehensive evaluation
 of the adult CF patient clinic, told     and management of a myriad of sleep disorders including obstructive
 me to come and see the clinic. I fell    sleep apnea, snoring, upper airway resistance syndrome, narcolepsy,
 in love with that particular patient     insomnia, restless leg syndrome, and sleep related problems. A
 population. You either ‘get’ CF,         multidisciplinary and comprehensive approach is taken in the evaluation
 or you don’t. The patients take a        of patients in collaboration with specialists in Otolaryngology (ENT),
 tremendous amount of energy and          neurology, and psychiatry. The 8-bed facility is designed to meet the
 dedication, but as much as you           rigorous standards of the American Academy of Sleep Medicine.
 give, they give back.
                                          The Division of Pulmonary, Critical Care, Allergy and Sleep Medicine is
 I realized that in caring for patients
 and working to further science I
 had found my purpose. I feel fortu-
 nate to be given the opportunity to
 pursue both basic and translational
 science and the clinical care of

 I not only get to interact with the
 medical students, residents and fel-
 lows but at MUSC I have had the
 opportunity to work with future
 pharmacists, physical therapists,
 and respiratory therapists to name
 a few. Teaching and mentoring the
 future health care professionals has
 a great purpose and is very fulfill-
                                                                               Pulmonologist Antine Stenbit, MD, PhD
48 Depar tment of Medicine  2009 Annual Repor t
                “The patients take a tremendous amount of energy and
                 dedication, but as much as you give, they give back.”

committed to the lifelong education and training of physicians,
patients, and the community through fellowships, publications,
symposiums, committees, health fairs and community outreach.
The division offers a three-year combined fellowship in pulmonary
 and critical care medicine. Fellowship training focuses on
developing clinical expertise, as well as research skills in
pulmonary disease, intensive care medicine, sleep medicine, and
allergic diseases of the chest. The fellowship program includes
two tracks – clinical research and clinical academic – to allow
fellows to meet their professional goals. At the end of three
years of training, the fellow is eligible for the American Board of
Internal Medicine certification in pulmonary disease and special
competency certification in critical care medicine.

In March 2009, the Division held its 19th Annual Pulmonary and
Critical Care Symposium in Charleston, SC. The annual
symposium is designed to provide an update in pulmonary and
critical care medicine, allergic lung disease, and sleep medicine for
the pulmonologist, critical care physician, internist, and thoracic
surgeon. The three, half-day course emphasizes a practical
clinical approach to patients using a pathophysiologic basis for the
institution of appropriate therapy.
                                                                           Critical Care Service Line Director, Alice Boylan, MD

The Division’s educational programs are far-reaching and include
teaching of medical students, internal medicine residents, anesthesia residents, and pulmonary and critical care fellows.
Since 1983, approximately twenty-five percent of the seventy-three fellows who have trained in the Division’s combined
Pulmonary and Critical Care Medicine fellowship have chosen careers in academic medicine. Fellowship training focuses
on developing clinical expertise, as well as research skills in pulmonary disease and intensive care medicine. Those
interested in academic careers obtain a Masters in Clinical Research. At the conclusion of the three-year fellowship,
trainees are eligible to sit for American Board of Internal Medicine certification in Pulmonary Disease and special
competency certification in Critical Care Medicine. Fellows with a particular interest in sleep medicine may structure a
program enabling them to sit for Sleep Board certification.

Several faculty members collaborate with the Division of Rheumatology investigating the association between
gastroesophageal reflux disease, aspiration, and interstitial lung disease in patients with scleroderma. Faculty are also
investigating the role of alveolar macrophage cytokines and chemokines in promoting scleroderma interstitial lung
disease and participating in the NIH-sponsored scleroderma lung study. The Pulmonary Hypertension Center provides
diagnostic studies and management of these patients in collaboration with the Rheumatology and Cardiology Divisions.
In the past year, faculty members published fifty-three peer-reviewed articles in such publications as American Journal of
Medical Science, American Journal of Respiratory and Critical Care Medicine, New England Journal of Medicine, Chest,
and Journal of Respiratory Disease.
Professors                    Associate Professors      Assistant Professors            Division Administrator
Patrick A. Flume, MD          Alice M. Boylan, MD       Dee W. Ford, MD, MSCR           Derek S. Sanford
Marc A. Judson, MD            Peter Doelken, MD         Laura B. Herpel, MD
William W. Merrill, MD        Michael D. Frye, MD       Kristin B. Highland, MD, MSCR
Steven A. Sahn, MD                                      J. Terrill Huggins, MD
Gerard A. Silvestri, MD, MS                             Robert Miller, MD
Charlie B. Strange, MD                                  Nicholas Pastis, MD
                                                        Antine E. Stenbit, MD, Ph.D.
                                                        Mary Jean Vogt, MD
                                                        Patricia M. Watson, PhD

                                                                             Medical University of South Carolina                  49
                                                  Division of Rheumatology
                                                           & Immunology
                                          The Division of Rheumatology & Immunology has a long tradition
                                          of providing outstanding care to patients of all ages who suffer from
                                          rheumatic diseases. Our commitment to patient care extends to active
                                          engagement in research designed to understand the pathogenesis of
                                          connective tissue diseases and to improve outcomes for patients with
                                          rheumatic diseases. The Division has earned an international reputation
                                          for its care and research relating to two autoimmune connective tissue
                                          diseases - Scleroderma and Lupus. We are honored to have been
 Richard M. Silver, MD                    recognized by our peers and ranked #16 among all US Rheumatology
 Division Director and                    programs by US News and World Report in 2009. Six of our faculty were
 Distinguished University Professor       named Best Doctors in 2009.

                                          Our patients are seen in specialized clinics located in the Rutledge Tower at
 According to Dr. Galina                  MUSC, as well as off-campus locations at the East Cooper Medical Office,
 Bogatkevich, Assistant                   North Area Specialty Clinic and West Ashley Bone & Joint Center. Last
 Professor, “When I came to the           year our outpatient clinics had nearly 14,000 outpatient visits. We staff a
 Department of Medicine, my               Rheumatology Clinic at the Ralph H. Johnson VA Medical Center (VAMC)
 mentor was Dr. Richard Silver. The       and provide in-patient consultation services at each of the hospitals
 research in Dr. Silver’s laboratory      served by MUSC - Medical University Hospital, Ashley River Tower,
 exposed me to the clinical environ-      MUSC Children’s Hospital, and the VAMC. A wide range of services are
 ment. All of my previous research        provided, including comprehensive consultative care, infusion therapies,
 experience had been in basic science,    bone density assessments and musculoskeletal ultrasound.
 particularly in pharmacology, and I
 found that interaction with medical      A unique aspect of the Division is our close relationship with and
 doctors and investigators broadened      longstanding commitment to Pediatric Rheumatology. Two board-certified
 my scope of thinking with regard to      Pediatric Rheumatologists, Dr. Natasha Ruth and Dr. Murray Passo, share
 fundamental biomedical questions         dual appointments in Pediatrics and Internal Medicine. Together, we
 and molecular basis of diseases.         strive to provide outstanding care to children with JIA and other rheumatic
                                          diseases and to enrich the education of our Rheumatology Fellows.
 I consider teaching to be a fun-
 damental part of learning, and,          We have a strong commitment to provide high quality patient care,
 therefore, career development. My        which in today’s world demands a multidisciplinary approach. This
 joint appointment in the College of      led us, nearly a decade ago, to establish the Bone & Joint Center where
 Graduate Studies at MUSC allows          patients can receive multidisciplinary care including Rheumatology and
 me to actively participate in gradu-
 ate student education, in addition                                                     Galina Bogatkevich, MD, PhD
 to my work with the Rheumatology
 clinical fellows.

 Dr. Silver encourages our research
 faculty to apply for joint appoint-
 ments in basic science departments
 and to further diversify our research
 interactions. There are great benefits
 in having a diverse group of basic
 scientists and clinical investigators
 having similar scientific goals and
 using different approaches to reach
 them. Our Division provides that
 unique environment.”

50 Depar tment of Medicine  2009 Annual Repor t
         “There are great benefits in having a diverse group of
   basic scientists and clinical investigators having similar scientific
         goals and using different approaches to reach them.”
Orthopaedics, as well as such services as Radiology,
Physical Therapy, bone density assessments and
biological infusion therapy. In addition to the Bone
& Joint Center, we are involved in the Pulmonary
Hypertension Center and are working to develop a
new Osteoporosis Center and a Vertebral Fracture
Clinic under the leadership of Dr. Marcy Bolster,
Director of the MUH Musculoskeletal Service Line.

We are engaged in both clinical and basic research.
Research funding remains strong and ranks among
the highest in the Department of Medicine. During
the past fiscal year, our faculty successfully competed
for over $5 million in research funding (total costs).
Active NIH research awards include funding for
a T32 training grant, 4 RO1’s, an R21, 3 K-awards
for junior faculty, and subprojects on several
multicenter projects. Our faculty receive funding
from the American College of Rheumatology, Lupus
Foundation, and Lupus Clinic Trials Consortium,             Rheumatologist Alan Brown, MD (right) discussing Dupuytren contracture
among others.
More than 50 articles were authored by Division faculty last year, including papers in leading medical and scientific
journals, e.g., Journal of Biological Chemistry, Arthritis & Rheumatism, and the Journal of Rheumatology. Faculty
members serve on numerous federal and private scientific review committees, editorial boards, and as officers of state
and national organizations. Dr. Jim Oates, Associate Professor of Medicine, is past President of the American Federation
of Medical Research (AFMR) and Secretary/Treasurer of the Southern Society for Clinical Investigation (SSCI). Dr. Diane
Kamen was elected Secretary/Treasurer of the AFMR Southern Section. Dr. Marcy Bolster is co-chairman of the ACR’s In-
Training Exam Committee and Training and Workforce Issues Committee.

Together with patient care and research, a third mission of the Division is to train the next generation of physicians and
investigators who will study and care for patients who suffer from rheumatic diseases. All Division faculty actively
participate in educating medical and graduate students, residents, clinical fellows and postdoctoral research fellows.
Our faculty are regularly nominated for departmental and institutional teaching awards. The Rheumatology Training
Program, under the outstanding leadership of Dr. Marcy Bolster, is fully accredited and comprised of 5 clinical and
research fellows selected from an increasingly competitive pool of candidates. Fellows are supported in part by an NIH
Training Grant (Gary Gilkeson, PI), and a Research Enhancement Award Program (REAP) grant from the Department
of Veterans’ Affairs. The Rheumatology Fellowship Training Program offers fellows the opportunity to see a wide array
of rheumatic disease patients in a variety of clinical settings, to participate in clinical and basic research, and to obtain
advanced training leading to a Master’s Degree in Clinical Research.

Distinguished University      Associate Professors          Assistant Professors             Instructor
Professor                     Alexander Awgulewitsch, PhD   Galina S. Bogatkevich, MD, PhD   Sergey L. Znoyko, MD, PhD
Richard M. Silver, MD         Alan N. Brown, MD             Pal Gooz, MD
                              Kristen Highland, MD, MSCR    Faye N. Hant, DO, MSCR
Professor Emeritus            James C. Oates, MD            Kusuman Joseph, PhD              Division Administrator
Hildegard R. Maricq, MD                                     Diane L. Kamen, MD, MSCR         Susan M. Cwik
                                                            Margaret Markiewicz, MD
Professors                                                  Holly C. Mitchell, MD
Marcy B. Bolster, MD                                        Jennifer J. Murphy, MD
Gary S. Gilkeson, MD                                        Tamara M. Nowling, PhD
Stanley R. Hoffman, PhD                                     Hideharu Sekine, MD, PhD
Edwin A. Smith, MD                                          Elena V. Tourkina, PhD
Maria E. Trojanowska, PhD                                   Xian-Kui Zhang, PhD
                                                                              Medical University of South Carolina                   51

 Internal Medicine Residents

 Jason Adams                       Fellowship, Pulmonary               MUSC
 Mary Elizabeth Alvarez            Mercy Family Ctr                    New Orleans, LA

PSarahrBozeman i g h l i g h t s
    u pose H
 Andrea Bryan
                                   Fellow, Allergy/Asthma
                                   Fellowship, Cardiology
                                                                       Univ of Mississippi
 Robert Christopher                Hospital Medicine                   Charleston, SC
 Brandon Craft                     Chief Resident, Internal Medicine   MUSC
 Melissa Cunningham                Fellowship, Rheumatology            MUSC
 Brian Davis                       Fellowship, Pulmonary               Mt. Sinai, New York City
 Laine Gawthrop                    Virginia Mason Medical Center       Seattle, WA
 Anjali Gopal                      Fellowship, Rheumatology            Univ of Chicago
 Andre Holmes                      Fellowship, Pulmonary               MUSC
 Bracken Lewis                     VA Medical Center                   Charleston, SC
 Matthew Luff                      Fellowship, Cardiology              MUSC
 Kristy McDonald                   Fellowship, Hematology/Oncology     MUSC
 Peter Netzler                     Fellowship, Cardiology              MUSC
 Nicholas Noblet                   Private Practice                    Charleston, SC
 Michael Oltmann                   Int Medicine & Peds Hospitalist     Charleston, SC
 Nicholas Paphitis                 Fellowship, Hematology/Oncology     MUSC
 Eli Penn                          Fellowship, Gastroenterology        University of Florida
 Sumana Reddy                      Hospital Medicine, Emory            Atlanta, GA
 Brad Sapp                         Hospital Medicine                   Trident Hospital, SC
 Clayton Shamblin                  Chief Resident, Internal Medicine   MUSC
 Andrew Taber                      Fellow, Gastroenterology            Univ of Louisville
 Jovanka Vuksanovic                Hospital Medicine                   North Platte, NE
 Evan Williams                     Hospital Medicine                   St. Louis, MO

52 Depar tment of Medicine  2009 Annual Repor t
 “I’m constantly awed by the intelligence and clinical skills that I see in my fellow
     residents. Their impressive skills in diagnosis and patient care constantly
           keep me on my toes and make me want to be a better doctor.”
                              - Anonymous Internal Medicine Resident, June 2009

Subspecialty Fellows

Timothy Alvin                Interventional Cardiology            Louisianna
Laurel Bailey                St. Vincent Hospital                 Indianapolis, IN
William Chafin               Rheumatology                         Orangeburg, SC
Rodney Daniel                Rheumatology                         MUSC
Deborah DeWaay               Gen Internal Medicine                MUSC
Matthew Forcina              Private Practice, Cardiac EP         Raleigh, NC
Eduardo Freitas              Infectious Disease                   North Platte, NE
Jason Goebel                 Fellowship, Cardiac EP               MUSC
Mario Gomez                  Pulmonary                            Weslaco, TX
Vinay Gudena-Sandusky        Hematology/Oncology                  University of Cleveland
Elizabeth Gunderson          Hematology/Oncology                  Virginia Beach, VA
Uchechi Iloka                Endocrinology                        Gastonia, NC
Bruce Kalmin                 Gastroenterology                     Atlanta, GA
Richard Ko                   Fellowship, Sleep Medicine           Rush University
Brian Lake                   Endocrinology                        Winter Haven, FL
Scott Lewis                  Rheumatology                         Jackson, MS
Aimar Mack                   Endocrinology                        Florence, SC
Stephen Osaguona             Nephrology                           Vernon Hills, IL
Alpesh Patel                 Gastroenterology                     Dallas, TX
Rory Priester                Cardiology                           Atlanta, GA
Roneka Ravenell              Rheumatology                         Penn State
Elizabeth Ronish             Hematology/Oncology                  Chesapeake, VA
Svetozar Tomov               Nephrology                           MUSC
Stacey Vallejo               Pulmonary                            Nashville, TN
Stephen Van Horn             Interventional Card                  Columbia, SC
Nitin Verma                  Hematology/Oncology                  Georgetown University
Jason Wilson                 Gastroenterology                     Charlotte, NC

                                                          Medical University of South Carolina   53
                        We Do This Every Day

54 Depar tment of Medicine  2009 Annual Repor t
                 2009 by the Numbers

        11                     186                              302
   Divisions in the           Number of                         of faculty
Department of Medicine   residents and fellows

     8,879               147,321                           549,204
      Inpatient            Outpatient Visits                    wRVUs

        68                 $49million                           169
   Total Number of                                          Corporate Study
    NIH Awards             Total Grant and
                           Contract Awards

        13                    26%of the
                         College of Medicine’s               Peer Reviewed
   Endowed Chairs
                          Research Awards                     Publications
  held by our faculty

                                                 Medical University of South Carolina   55
 96 Jonathan Lucas Street
          P.O. Box 250623
     Charleston, SC 29425

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