Rural Medical Scholar studies church-based health promotion in Africa

Daniel Stanley, a Rural Medical Scholar and third-year medical student at the College of Community Health Sciences, spent most of September in Malawi, Africa, as part of a study on the effectiveness of church-based community health education and promotion.

Stanley, who is from Elmore County, Alabama, is studying the effectiveness of this type of health promotion as means of addressing health disparities in African-American communities in rural Alabama. He went to a rural area of Malawi to serve as a participant observer in a church-based health promotion program.

The Rural Medical Scholars program is exclusively for rural Alabama students who want to become physicians and practice in rural communities. The University of Alabama program includes a year of study, after students receive their undergraduate degree, that leads to a master’s degree in Rural Community Health as well as early admission to the University of Alabama School of Medicine. Rural Medical Scholars spend the first two years of medical school at the School of Medicine’s main campus in Birmingham and then return to the College, which serves as the Tuscaloosa Regional Campus for the School of Medicine, where they receive their third and fourth years of clinical education.

Stanley’s study is part of his required scholarly activity as a Rural Medical Scholar. He says he became interested in the topic during a family medicine rotation in Hale County.

“I really began to appreciate how the cultural perceptions of those living in rural west Alabama have molded their behavioral decisions, which has in some ways led to health disparities,” he says. “Another thing that I began to see was how this culture has led to a strong relationship between those living in such areas and the church. I began to consider how churches have served as a medium for health education and promotion.”

Because of his interest in mission-based, global health, Stanley looked for programs to observe abroad. Through the organization Community Health Evangelism, he was connected with a program in rural Lumbadzi, Malawi, that educates church leaders on health topics so that they can serve as health promoters in their faith community. Stanley says one of the main goals of the group was to address HIV misconceptions and provide education about testing and treatment.

“The program has been very successful in terms of addressing and correcting culturally-derived misconceptions about HIV,” he says. “There has been an increase in the number of people getting tested and seeking treatment in the villages where the program was introduced.”

Stanley also worked at a nearby hospital with its mobile clinic, visiting neighboring villages three times a week.

He says that while the medical issues he saw in Malawi were different from those in rural Alabama, he saw some common themes.

“There are some great similarities in that these are two marginalized populations with health disparities that can be reduced largely by behavioral modification,” he says.

Stanley says he hopes to share results of his study with local church leaders after completing his final report.


Geriatric Fellowship now open for applicants

The College of Community Health Science is now offering a geriatrics fellowship for family medicine physicians seeking additional training in caring for the aging population.

Applications are being accepted for the program, which is accredited for up to two fellows. The fellowship will start July 2016.

Fellows will be trained to collaborate interprofessionally, and they will have the opportunity to practice in nursing homes, assisted living homes, hospice and in behavioral health, says Dr. Anne Halli-Tierney, who will lead the fellowship. Halli-Tierney is assistant professor in Family Medicine and director of the geriatric clinic at University Medical Center, which is operated by the College.

The fellowship will also include training in a rural setting. Fellows will practice with Dr. Julia Boothe in Reform, Alabama, at Pickens County Primary Care.

“The rural education will be a combination of outpatient clinic work, inpatient geriatric psychiatry and nursing home care,” says Halli-Tierney.

Dr. Richard Friend, director of the College’s Family Medicine Residency, says the hope is for graduates of the fellowship to stay in the area and serve the needs of Alabama.

“We have very few geriatricians in our community, and we have an ever aging population,” says Friend. “These physicians will be specially trained to understand the complex problems of the geriatric population, and as the population in Alabama ages, they’ll be in the unique position to assist with those needs.”

Halli-Tierney says that about 300 geriatricians graduate from fellowship programs each year—not nearly enough to sustain the number of retiring practitioners who have training to care for the older population.

“And with baby boomer population surging toward old age, primary care practitioners definitely need training in how to deal with the problems of older adults,” she says.

The U.S. Census Bureau recently projected that the number of people 65 and older in the United States is expected to increase from 44.7 million in 2013 to 98.3 million in 2060.

The Center for Business and Economic Research (CBER) at The University of Alabama Culverhouse College of Commerce projected a trend in Alabama comparable to that of the United States. The CBER researchers projected that the number of Alabama residents 65 and older will increase from 721,166 in 2013 to 1.2 million in 2040.

Rural populations in particular have a higher percentage of of older residents than the United States in general, says Dr. Richard Streiffer, dean of the College. He and Dr. Thomas Weida, chief medical officer and dean of clinical affairs for the College, will serve as key clinical faculty for the fellowship.

The College offers fellowships in obstetrics, sports medicine, hospital medicine, behavioral health and rural public psychiatry. Many of these programs offer concentration on caring for rural areas.

Halli-Tierney says the addition of the geriatrics fellowship to the College furthers its mission.

“We are interested in preparing physicians who will go out into communities and practice and impact patients’ lives through direct care,” she says. “When the fellows graduate, they will be able to function effectively in multiples arenas, whether it be long-term care, end-of-life care, or quality primary care for elders in their communities. Patients in some rural areas may not be able to travel to see a specialist, so if their primary care provider has geriatrics training, this will help the elder receive aging appropriate care close to home.”

Family Medicine Residency Celebrates 40th Anniversary with Reunion Weekend

The College of Community Health Sciences is hosting a reunion weekend Nov. 13-15, 2015, to celebrate 40 years of its Family Medicine Residency.

The weekend will allow Residency alumni to reconnect with their classmates, the College and the University through social events and a lecture series for continuing medical education.

The Residency, one of the oldest and largest family medicine residencies in the United States, was founded in 1974 and to date has graduated 450 family medicine physicians. More than half of those graduates are practicing in 46 of Alabama’s 67 counties, and 48 percent are practicing in a rural area of the state.

One in seven family physicians practicing in Alabama graduated from the Family Medicine Residency. And 77 percent of the Residency’s alumni practice in a primary care physician shortage area.

The College’s mission is to improve and promote the health of individuals and communities in Alabama and the region, and part of how it accomplishes that mission is by addressing the physician workforce needs of Alabama and the region with a focus on comprehensive Family Medicine Residency training.

The anniversary celebration weekend will kick off with a cocktail party on Friday evening, Nov. 13, at the Tuscaloosa Museum of Art and will include guided tours of the museum’s Westervelt Collection.

A lecture series will be held at the College the morning of Saturday, Nov. 14. Continuing medical education credits will be offered, and the lectures will cover a variety of topics related to the specialty of family medicine. The series will also include a two-part presentation by John B. Sullivan, MD, MBA, a 1978 Residency alumnus well known for his work in toxicology, including the development of rattlesnake bite anti-venom serum, as well as development of medication safety caps following seven Tylenol-related deaths in Chicago in 1982 that were the result of product tampering.

A gala will be held Saturday evening at the North Zone of Bryant-Denny Stadium. The event will feature a formal dinner with guest speaker Glen Stream, MD, FACCFP, President of Family Medicine for America’s Health and former president of the American Academy of Family Physicians, followed by live music and dancing.

On Sunday, Nov. 15, a farewell brunch will be held at Sweet Home Food Bar in downtown Tuscaloosa.

Tickets for the weekend are $35 per person. More information about the weekend’s agenda, where to find accommodations and how to RSVP can be found at



Retired Student Health Physician and Wife Establish Scholarship

Dr. David H. Maxwell, a retired physician who worked at The University of Alabama’s Student Health Center for nearly 25 years, and his wife, Jeanne Maxwell, have pledged $25,000 to establish the Dr. Benjamin Collins Maxwell Endowed Scholarship at the College of Community Health Sciences.

The scholarship will give priority of consideration to fourth-year medical students at the University of Alabama School of Medicine’s Tuscaloosa Regional Campus, which is located at the College, as well Rural Medical Scholars who plan to practice primary care in a rural part of Alabama. Additional preference will be given to students who meet those criteria who have graduated from high schools in Escambia County, Alabama.

Dr. Benjamin Maxwell was Dr. David Maxwell’s uncle and his family’s primary care physician.

“‘Dr. Ben’ was a beloved family physician who served his hometown, Atmore, Alabama, for 43 years and was the personification of the compassionate, capable family doc,” he says. “As my family’s physician, he was an influence in my own decision to pursue medicine,

Benjamin Maxwell served in the US Navy after graduating high school in 1943. After WWII, he attended the University of Alabama and then attended medical school at the University of Alabama School of Medicine. After a one-year internship in Birmingham, he practiced in Atmore until retiring in 1996.

Jeanne Maxwell also knew Benjamin Maxwell when she was young. Her father was a physician in Mobile and she accompanied him to Atmore for consultations. Both Jeanne and David Maxwell attended The University of Alabama.

David Maxwell completed medical school at the University of South Alabama in Mobile and a family medicine residency at the University of Alabama at Huntsville. He then practiced in Atmore himself for six years before moving with Regina to Tuscaloosa in 1989, where he practiced at the Student Health Center until retiring in 2014. He says their children are fourth-generation University of Alabama students and graduates.

David Maxwell says the scholarship is not only a way to honor his uncle’s legacy in his community and in the state, but that of all primary care physicians.

“Its goal is in keeping with the mission of the Rural Medical Scholars program as well as that of the College. Both are vital in meeting the need for culturally competent physicians, particularly in the underserved communities and counties of Alabama,” he says. “As our medical students make their decisions to fulfill a medical calling, I hope they will be encouraged and enabled in part by such scholarships as well as by those physicians who have served before them. It is my particular wish that this can help fill the needs in our home area—rural Escambia County.”

Asthma education provided to Hale County students via telemedicine

The College of Community Health Sciences has launched a school-based asthma education program at Greensboro Elementary School in Hale County. The program, which is conducted via telemedicine, is the second of its kind to be offered by the College. The first was started in September 2014 in DeKalb County.

The program is being led by Dr. Karen Burgess, associate professor and chair of the Department of Pediatrics, and Beth Smith, a nurse practitioner in the Pediatrics Clinic at University Medical Center, which is operated by the College.

About 50 students have signed up to participate in the classes, which will be offered weekly for the students and their parents to learn about asthma symptoms, medications and treatments. Each class will meet a total of four times for 45 minutes.

“Because the school has so many students with diagnosed asthma, we project providing the education through the end of the school year,” says Amelia de los Reyes, technology coordinator for the College’s Telehealth Division.

The first classes were conducted via telemedicine on Thursday, Oct. 29. Ten fourth-grade students and 11 fifth-grades students made up the classes.

Before those first classes, the College educated teachers and support staff on Thursday, Oct. 22. Smith, via telemedicine, covered topics such as the signs and symptoms of asthma, the impact it can have on learning and how to control asthma and manage an attack.

The first school-based asthma education program was offered at Ruhama Junior High School in Fort Payne. The school was chosen because of its high rate of documented asthma cases, and Burgess and Smith referred to the National Asthma Prevention Program and the Alabama Department of Public Health’s asthma coalition when forming the curriculum.

The asthma education program is being funded with a $25,000 gift from BlueCross BlueShield of Alabama.

According to the US Centers for Disease Control and Prevention, an estimated 137,000 children in Alabama had asthma in 2007, a prevalence rate of 12.3 percent, which compares to the US rate of 9 percent.

Part of the gift was used to provide Ruhama Junior High School students with asthma spacers (add-on devices for inhalers that allow for easier and more effective administration of medication). Smith says the hope is that students at Greensboro Elementary School will also be provided with spacers if they do not have them.

Burgess says parents of the Ruhama Junior High School students reported improved symptoms of asthma in their children. She said she and Smith found the informal classroom setting (versus a medical examination room setting) to be helpful in engaging the students, even with the occasional “awkwardness” that comes with communicating with video conferencing equipment.

“We provide asthma education every day in the clinic, and never have had kids ask questions the way they do in the classroom,” she says.

CCHS has provided specialty health care via telemedicine across the state for a number of years, including: telepsychiatry services to West Alabama Mental Health Care Center, with sites in marengo, Choctaw, Greene, Hale and Sumter counties; and diabetes education via telemedicine to a number of rural Alabama communities in Sumter Picks and Clarke counties.

Innovative Program Pairs Med Students with Local Physicians

TUSCALOOSA, Ala. — Several University of Alabama medical students have paired with community physicians as part of an innovative medical education program promoting deeper connections with patients and stronger student-teacher relationships.

Third-year medical students at the School of Medicine’s Tuscaloosa Regional Campus, which is located at UA’s College of Community Health Sciences, are participating in a new medical education program — the Tuscaloosa Longitudinal Community Curriculum, or TLC².

TLC² follows an innovative model of medical education, a longitudinal integrated clerkship, which allows medical students an opportunity to follow patients over the course of their third-year of clinical education.