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Rural communities struggle to keep doctors

As much as he likes working in Heflin, Dr. Igor Bidikov said he has had a hard time recruiting doctors to work with him in Heflin. The doctors will come for a little while and then they leave, he said. The problem is a symptom of a statewide shortage of doctors that has hit rural areas especially hard, say representatives of the medical field.

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Faculty addresses food deserts

John Higginbotham, PhD, associate dean for research and health policy and director of the Institute for Rural Health Research at the College of Community Health Sciences, recently discussed the effects of food deserts on childhood obesity in a Crimson White article.

According to Higginbotham, children who grow up in food deserts have a higher risk of Type 2 diabetes and other health conditions associated with obesity and poor nutrition.

The U.S. Department of Agriculture defines food deserts as areas where a significant percentage of the population lives more than a mile from the nearest source of fresh, healthy food. For many people living in a food desert, the only sources of food they have access to are gas stations and convenience stores.

“Right now our adolescents and our young children, 31 percent of them are either overweight or obese,” Higginbotham told The University of Alabama student newspaper. “If we look at the adults, that number jumps to 69 percent in our state. These children are going to have the same problems with obesity that adults are having but at a younger age. There have even been some people who have said this may be the first generation that doesn’t outlive their parents if it continues to go in this direction.”

UA was awarded a $1 million grant from the National Center on Minority Health and Health Disparities that is funding Project UNITED, which works to reduce childhood obesity in Alabama’s Black Belt region. Through Project UNITED, a collaborative effort of the UA Colleges of Community Health Sciences and Communication and Information Sciences, Higginbotham and other UA researchers involved in the project are working to create lasting solutions to food deserts and obesity by customizing solutions that fit each individual community.

Read the full Crimson White article here.

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Economic impact of practicing rural obstetrics

According to the research of Dan Avery, MD, professor and chair of the Department of Obstetrics and Gynecology at the College of Community Health Sciences, a family physician practicing obstetrics in a rural community adds a nearly $1.5 million annual benefit to the local economy. The research article looking at this economic impact was published in the Journal of the American Board of Family Medicine (JABFM) earlier this month.

The project was a joint effort of several UA researchers, including: Dwight Hooper, MD, , a professor, and John McDonald, MD, an assistant professor, both in the College’s Department of Obstetrics and Gynecology; Melanie Tucker, PhD, an assistant professor in the Department of Family Medicine and director of clinical investigations for the College; Jason Parton, PhD, an assistant research professor of statistics in the Culverhouse College of Commerce and Business Administration’s Department of Information Systems, Statistics and Management Science; and Michael Love, MD, a 2014 graduate of the University of Alabama School of Medicine.

According to the article, obstetric care affects the economic development and sustainability of rural communities. The availability of maternity care affects young people moving to the community, local businesses and other medical and hospital services.

“When maternity care is lost in a community, negative effects occur on many levels,” Avery says.

The University of Alabama Family Medicine Obstetrics Fellowship was founded in 1986 by the College to help bring obstetrical care to Alabama’s underserved, rural communities and is one of the oldest fellowships of its kind in the United States.

Read the full JABFM article here.

Tucker joins Department of Family Medicine

130914_JH_CCHSMelanie Tucker, PhD, has joined the College’s Department of Family Medicine, where she was recently appointed an assistant professor of health education. Tucker has been with the College since 2005 as an assist professor in the Department of Community and Rural Medicine and as director of clinical investigations.

In her new role, Tucker will provide clinical health coaching to University Medical Center patients with chronic diseases. She will work directly with individual patients and patient groups to set behavior change goals and to help motivate them through the process. Tucker will also develop and implement a health education and health communications curriculum for the College’s medical students and family medicine residents.

“I will work directly with the students and residents in the clinic to improve patient health by providing health education and making effective use of a health educator,” says Tucker.

Keeping in line with her research background, Tucker will also work with the residents to complete their scholarly activity projects.

“I most look forward to being able to use my health education and health promotion background and experience to help patients make healthy lifestyle changes,” Tucker says. “Being able to plan and implement behavior change programs in the Family Medicine Department is exciting, and I hope some of these programs can be expanded to other departments.”

In addition to educating and providing clinical experiences for medical students and family medicine residents, the College operates University Medical Center, a multi-specialty primary care clinic serving The University of Alabama and West Alabama communities.

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Students elected to membership in honor medical society

Four University of Alabama School of Medicine students who are receiving their clinical education at the College of Community Health Sciences were elected members of the Alpha Omega Alpha Honor Medical Society.

The students, all in their fourth-year of medical school, are Chelsea Cernosek, Duncan Harmon, Jamie Leigh Powell and Nathan Wilbanks.

Alpha Omega Alpha is a professional medical organization that recognizes excellence in scholarship as well as outstanding commitment and dedication to caring for others. The top 25 percent of a medical school class is eligible for nomination to the honor society, and up to 16 percent may be elected.

“These students were elected based on their outstanding academic achievements, character, community service, and leadership,” says Heather Taylor, MD, an assistant professor in the Department of Pediatrics and director of Medical Student Affairs at the College. “We are very proud of them and all of their accomplishments.”

About 3,000 students, alumni and faculty are elected to Alpha Omega Alpha each year. The society has 120 chapters in medical schools throughout the United States and has elected more than 150,000 members since its founding in 1902.

In its role as a regional campus of the University of Alabama School of Medicine, the College provides clinical education to a subset of third- and fourth-year medical students. The students complete the first two years of basic science courses at the School of Medicine’s main campus in Birmingham, and then complete clinical rotations on the Tuscaloosa campus in the departments of Family Medicine, Pediatrics, Internal Medicine, Obstetrics and Gynecology, Neurology, Psychiatry and Surgery.

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College hosts lecture about Ebola outbreak

Even though the Ebola outbreak poses no substantial risk to the United States, Albert White, MD, area health officer for the Alabama Department of Public Health, said he has received calls from local health-care providers about the deadly disease.

“I have gotten a lot of questions in the last several weeks about Ebola,” he said.

White provided an update on the Ebola outbreak and related health information during a recent lecture hosted by the College of Community Health sciences at The University of Alabama and DCH Health System. The lecture for health professionals was held August 18 at DCH Regional Medical Center in Tuscaloosa. White is also medical director of Hospital Epidemiology for DCH Health System.

The Ebola outbreak originated in West Africa in March of this year and to date has claimed more than 1,400 lives and infected more than 2,000 people. Ebola has been fatal in 55 percent to 60 percent of cases reported in the current outbreak.

The outbreak has been declared a public health emergency “because people travel so much and so easily these days,” White said.

Ebola is spread by direct contact with bodily fluids, not through the air, food or water, and it is not contagious until symptoms appear, White said. The incubation period is two to 21 days. Symptoms include fever, headache, joint and muscle aches, sore throat, weakness, abdominal pain, vomiting, diarrhea, skin rash, red eyes, and internal and external bleeding. There is no proven treatment for Ebola.

Countries hardest hit by the Ebola outbreak in West Africa are Guinea, Sierra Leone, Nigeria and White’s native Liberia, where he still has family and friends. Liberia has recorded the highest number of cases and deaths of the four countries, more than 400.

White says Liberia is working to contain the outbreak and has closed its borders, restricted travel and has kept open only essential government offices. During the country’s recent Independence Day celebration, the words EBOLA IS REAL were printed on HAPPY INDEPENDENCE DAY signs.

White says difficulty in controlling the disease in West Africa is a result of a poor healthcare infrastructure that has deteriorated after years of civil war, a mistrust of the system and cultural habits regarding the dead and burial practices. People can become infected with Ebola by unprotected handling of contaminated corpses, White said.

The risk of Ebola spreading to the United States is very small, he said. “In the United States, we have the capability to isolate and do the testing we need to do to keep everyone safe.” In addition, travelers from West Africa are being screened prior to travel, and some commercial airlines have stopped their flights to the region.

White encouraged audience members to become familiar with information about Ebola that is contained on the U.S. Centers for Disease Control and Prevention’s website (http://www.cdc.gov).

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Medical students begin training in community settings

The first two students to participate in the Tuscaloosa Longitudinal Community Curriculum (TLC²) began with their preceptors this month.

TLC² is an innovative program that enables third-year medical students to train in community settings over a period of months under the supervision of experienced primary care physicians. The College provides clinical training for a cohort of third- and fourth-year medical students who complete their first two years of medical school at the University of Alabama School of Medicine, headquartered in Birmingham.

Elizabeth Junkin is working in Reform, Ala., under the supervision of Julia Boothe, MD, MPH, at Boothe’s practice, Pickens County Primary Care. Boothe is also an assistant professor and practices part-time in the Department of Family Medicine at the College of Community Health Sciences.

Katherine Rainey is working with Vernon Scott, MD, and Erica Day-Bevel, MD, at Alabama Multi-Specialty Group, P.C., in Tuscaloosa. Scott completed his residency at the College’s Family Medicine Residency in 1981. Day-Bevel was also a resident at the College and graduated in 2012.

“We’ve worked hard to create a unique, enriching experience for our two students participating in the TLC2 pilot and are excited now that it is finally starting after months of planning,” says Heather Taylor, MD, an assistant professor and director of Medical Student Affairs. “Kay and Elizabeth are two remarkable young women who were chosen for the pilot because of their maturity, strong interpersonal skills, and interest in community health. They will be great ambassadors for the program and for the college in their community sites.”

TLC² is a longitudinal integrated clerkship (LIC) model of medical education, which allows students to participate in the comprehensive care of patients over time. While LICs have been part of medical education for some time, medical schools are beginning to create these programs as the effectiveness and benefits of these programs accumulate.

The College’s LIC initiative is a direct product of a strategic plan that determined, in part, that the majority of the College’s stakeholders agree than an integrated, longitudinal program would provide a more effective education to medical students.

CCHS faculty, departments honored with Argus Awards

Joe Wallace, MD, professor and chair of the Department of Surgery, and the Department of Obstetrics and Gynecology were named winners of the 2014 Argus Awards by the students of the University of Alabama School of Medicine.

Joe Wallace, MD

Joe Wallace, MD

As a regional campus of the School of Medicine, which is headquartered in Birmingham, the College provides the clinical training for a subset of third- and fourth-year medical students.

The Argus Awards, created in 1996 to recognize faculty members, give medical students the chance to honor their mentors, professors, courses and course directors for outstanding service to medical education. Faculty members are nominated by course evaluations, and students vote to select award winners in each category.

Wallace was named Best Clinical Educator at the Tuscaloosa Regional Campus while Daniel Avery, MD, Kristine Graettinger, MD, Andrew Harrell, MD, John McDonald, MD, and Heather Taylor, MD, were also nominated for the award.

The OB/GYN Department was named Best Clinical Department at the Tuscaloosa Regional Campus. Also nominated were the Pediatrics and Surgery departments.

A ceremony to honor Argus Award recipients and nominees was held on Sept. 5, 2014, in Birmingham.

See the full list of winners here.

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UASOM receives full LCME accreditation

The University of Alabama School of Medicine received notification from the Liaison Committee for Medical Education (LCME) last month that the school has received the full eight-year accreditation, the highest level of accreditation any medical school in the United States can receive.

The College also serves as a regional campus of the School of Medicine, which is headquartered in Birmingham, for the medical education and clinical training of a subset of third- and fourth-year medical students.

The LCME commended the School of Medicine in two key areas: the diverse scope of medical electives the students are encouraged to explore, and the present and anticipated financial stability of the institution.

The accreditation came after an intensive site visit by the LCME last March.

LCME accreditation is a voluntary, peer-review process of quality assurance that determines whether the program meets established standards and fosters institutional and program improvement. Accreditation by the LCME establishes eligibility for selected federal grants and programs, and most state boards of licensure require that U.S. medical schools be accredited by the LCME as a condition for licensure of their graduates.

The College celebrated the achievement with a cupcake reception in late August.

Read the University of Alabama School of Medicine story here.

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Medical students lend a hand as part of orientation

First-year medical students, who will receive their third and fourth years of clinical training at the College of Community Health Sciences, spent a day late last month getting to know each other and Tuscaloosa by way of community service.

About 40 students spent the day sprucing up the grounds of the Arc of Tuscaloosa County, an agency that serves adults with intellectual disabilities, for First Year Fun Day, a part of the students’ medical school orientation.

One of the College’s functions is serving as the Tuscaloosa Regional Campus for the University of Alabama School of Medicine, headquartered in Birmingham. All medical students complete their first two years of medical school in Birmingham, and then a cohort of students move to Tuscaloosa for their clinical training.

In addition to trimming hedges and gardening outside the building, the students painted much of the interior. One of their biggest projects was covering a large activities room in a bright blue hue, which Donna Callahan, interim director of the Arc of Tuscaloosa, says will serve as the base for an aquarium-themed room to be completed by a local artist.

Callahan says that while the day is beneficial for the consumers at Arc of Tuscaloosa, she hopes it will impact students, too.

“Some people come in here who have not been exposed to people with intellectual disabilities before, and we want them to see that they can be funny or serious or clown around, just like you and I can,” Callahan says.

This is the second year first-year medical students have completed a day of community service at the Arc of Tuscaloosa, and the experience is meant to help them understand the importance that serving the community will play in their careers as physicians, says Brook Hubner, program director of Medical Education at the College.

“Connecting the students with the breadth of the Tuscaloosa community is very important to our mission and is a key component of their Patient, Doctor and Society course,” Hubner says.

After completing their projects, students mingled with College faculty over lunch and enjoyed a performance by Sounds of Joy, the Arc of Tuscaloosa choir. Heather Taylor, MD, director of Medical Student Affairs for the College, says getting to know the faculty is an important part of orientation, too.

“Working at the Arc gave the students an opportunity to get to know us and each other while helping out a great organization,” she says.

The students’ orientation and first class culminated with the White Coat Ceremony on Sunday, August 17, inside the University of Alabama at Birmingham Alys Stephens Performing Arts Center.

The ceremonial presentation of white coats to medical students, created by the Arnold P. Gold Foundation in 1993, includes the signing of the oath of commitment to patient care that reminds incoming students of the dedication necessary to complete a medical education and underscores the responsibilities inherent in the practice of medicine.

“The coat signifies camaraderie and shows that we’re officially part of the School of Medicine,” says one first-year medical student.