GRADUATE MEDICAL EDUCATION Review

February 2014

Residency

Dr. Joan Meek, Associate Dean / Designated Institutional Official (DIO), GME, speaks with a medical student about our FSU Residency Programs located throughout the state. Currently, FSU is the sponsoring institution for a Pediatric and Obstetrics & Gynecology Residency Program located at Sacred Heart Health System in Pensacola, an Internal Medicine Residency Program located at Tallahassee Memorial HealthCare, a Family Medicine Residency Program located at Lee Memorial Health System in Fort Myers, and a Procedural Dermatology Fellowship Program in Tallahassee.

ADVANCING KNOWLEDGE. TRANSFORMING LIVES.

1115 W Call St. | Tallahassee, FL 32306

Graduate Medical Education (GME) LIVING THE MISSION...(see Pages 2-5)

Page 2Our mission is to educate and develop exemplary physicians who . . .

Dr. Christy Cavanagh, FSU Family Medicine Residency Faculty

nHow well would you say you know the College of Medicine mission as an FSU residency faculty member?I’d say pretty well! We are referring to it continuously as we recruit our first class of residents, so it is well-integrated into our thoughts. In my own words, our mission is about training excellent physicians

that are going to take care of their patients from all backgrounds, but especially those who are underserved, doing so in a patient-centered way where they are integrated into their community. FSU is unique in having students spread out in communities across the state. In our FSU residency program, our goal is to integrate residents so well into the community in which they’re serving, that they recognize that they are caring for their neighbors, their friends, their co-workers. Physi-cians can approach their patients differently when they see them as human beings. It adds a humanistic side to their care and meets the patients’ whole-person needs. Patients appreciate this patient-centered approach and feel that their health care providers truly care.

nDid you consciously choose the College of Medicine mission as you pursued your residency faculty position?The residency program I was with in South Carolina had lots of opportunity to serve migrant farm workers, being near many local farms. Global health opportunities were also available to me there and I wanted to continue living out that mis-sion, while also coming back home to South Florida. It was a no-brainer for me! I have always wanted to treat every-body, but have also especially been drawn to caring for the Hispanic population. This probably began when, as I was growing up in South Florida, my parents would arrange for me every Christmas to go through all my toys and choose ones I would give away to the Hispanic kids in a nearby clinic. I have fond memories of playing with these kids with my/their toys, and I know in part that inspired me to go into Family Medicine and work with minority groups.

nHow would you say you live out the College of Medicine mission as an FSU residency faculty member?As a teacher, I want to train our residents with this same mission and to develop that joy of fulfillment that comes from serving underserved populations. As a clinician, I want to continue serving the Hispanic panel of patients I have, as well as continue serving on the global mission trips to Nicaragua.

nDo you anticipate living out the College of Medicine mission across your career?Yes! I want to continue to see my patients as people, and especially as people who are important to me in my community. At least once a year, I’d like to continue going on an overseas mission. What I would really like to see is our residency graduates staying in this area and incorporating these goals into their personal mission. In the short-term, I’d like to help ensure that by making them feel at home and being a part of their community and building a commitment to that community.

Practice patient-centered health care

Internal Medicine Residency: Scholarly ActivityAbstract Posters: (All Submitted for March 2014 Competition - FL Chapter ACP, Orlando, FL)

Clark, B.; Todd, G.; Shashaty, R.; DeNunzio, M.: Know Thy Patient: Not Just Another Game of Telephone. Quality Improve-ment-Patient Safety Research Project. Latimer, J.; Todd, G.; Clark, B.; Incorporating a Dedicated Breast Curriculum Can Improve Resident Confidence in their Ability to Properly Perform a Clinical Breast Exam. Quality Improvement-Patient Safety Research Project. Ahmad, S.; Todd, G.; Shashaty, R.; Latimer, J.; Endocarditis with Multiple Cerebral Emboli. Clinical Vignette.Rosadzinski, K.; Todd, G.; Shashaty, R.: High Protein Diet with Excessive Alcohol Consumption Leading to Metabolic Acidosis. Clinical Vignette.Clark, B.; Todd, G.; Wayal, V.; Rosadzinski, C.; Not Just Another Belly Ache. Clinical Vignette.Satyanarayana, P.; Fernandez, A.; Todd, G.: Disseminated Nocardiosis in an Immunocompetent Person. Clinical Vignette.

Page 3

Dr. Raina Ferenchick, FSU Obstetrics and Gynecology Residency Alumnus

nHow well would you say you knew the College of Medicine mission as an FSU resident?I have always been focused on service to rural populations and so I knew that the FSU College of Medi-cine mission emphasized this. I attribute this to my up-bringing.

Respond to community needs, especially through service to rural populations

nDid you consciously choose the College of Medicine mission as you pursued your residency training?I am from a small town in NW Georgia, and so growing up I knew what it was like to have to leave the county to get ade-quate health care. I attended Mercer University’s med school, which also had a community-based program, so when it came time for residency I wanted a similar focus. I knew that a program sponsored by FSU would advance my goals of practicing rural medicine – a program where I knew I could be well-trained, not a program where I would have had exposure to just five hysterectomies.

nHow would you say you live out the College of Medicine mission as an FSU residency alumnus?I am practicing as the only OB/GYN in Grady County, Georgia, which has a population of about 25,000…and I am the only OB/GYN that has practiced in this county for quite some time. I don’t have an ultrasound in my office. The instruments I was used to I don’t necessarily have. We have no interventional radiology. I am learning to get around not having those instruments and not having the backup I’m used to. One of the consequences of that is it allows me to continue learning new methods. And despite these realities of rural medicine, having an OB/GYN available for patients here locally definitely offers them better access and makes them happy that they can have these services provided right at home. It’s rewarding for me to hear patients share their positivity about my being here.

nDo you anticipate living out the College of Medicine mission across your career?First off, we are very happy here in Cairo. It’s a good fit for us as a family. We enjoy the community and have found a good church home and good child care for our young daughter. Relationships are easier to make in rural communities like this. When I come into town and everybody knows me, it’s an amazing feeling! We’re happier here than we had even hoped for. All this is to say that we are hoping as a family that I can build up my practice enough to make this our lifetime work. Fam-ily medicine docs have been doing the bulk of OB/GYN care here, so I am slowly developing trust with them and casually offering insights into what I can add to their level of service. The key is to be flexible! I hope to have at least a partner or two over the course of my career here.

Procedural Dermatology Fellowship: Scholarly ActivityPublications:Cognetta, AB.; Wolfe, CM.; Green, WH.; Hatfield, HK.: A Possible Chemopreventive Role for Photodynamic Therapy in Gorlin’s Syndrome: A Report of Basal Cell Carcinoma Reduction and Review of Literature. Australas J Dermatol. 2013, Vol 54: 64-68.

Cognetta, AB.; Mendenhall, WM.; Green, WH. (contribut-ing): Radiation Therapy for Skin Cancer. Springer Publica-tions, 2013.

Presentation:Cognetta, AB.: Dermatology Across the Spectrum. Osher Life-long Learning Institute, FSU Pepper Center, 11/15/2013.

Pediatric Residency: Scholarly ActivityPublications: Glatstein, MM.; Friedman, S.; Wolyniez, I.; Mitelpunkt, A.; Vala, S.; Scolnik, D.: Choking Caused by a Homeopathic Drug: in a Previously Healthy Infant. Can Fam Physician. 2013 Aug; 59(8):848, 845, 850-1.

Taylor, S.; Peter, J.: Becker Muscular Dystrophy:Diagnosis and Lifelong Management. Consultant for Pediatri-cians. September 2013. www.PediatricsConsultant360.com.

Pediatric Journal Club hosted by Dr. Wilkinson on Nov. 5.

(cont. Page 7)

Page 4

nDid you consciously choose the College of Medicine mission as you pursued your residency training?Yes! I remember really liking the College’s mission statement and the Sacred Heart Health System affiliation with Catholic charities really embodying that mission. In part, I live by the belief that to whom much is given, much is required. Especially as a woman, I recognize that the majority of women in the world do not have what I have. Women physicians, in particular, have a responsibility to give back. I believe this probably started when I was a small child, experiencing people giving me and my family so much.

nHow would you say you live out the College of Medicine mission as an FSU resident?The program in general is very conducive to living out the College of Medicine mission. The majority of patients we serve have very few resources, so we provide as many social resources as we do medical resources. A pregnant woman is also, by nature, one who is underserved. This month I have the opportunity to go to the Philippines for disaster relief, and locally I am also involved in Healthy Start to help make resources available to women and children. I had the great privilege to do an elective rotation in Rwanda at the Human Resources for Health Program working on a maternal mortality project where I worked with maternal fetal medicine specialists. While there, I noticed that they had 80 maternal deaths in a one-year time period. I conducted a research project where I analyzed the cause of death and its contributing factors across these 80 cases, and discovered that post-partum Sepsis following C-section was the major cause. I believe this work has the capacity to af-fect global health and advance knowledge of sterile techniques in Rwanda and elsewhere through these findings.

nDo you anticipate living out the College of Medicine mission across your career?I am hoping to apply for a maternal fetal fellowship and work with underserved populations in my local community and globally…and take others with me! I would love to be a Fellow and Attending and be able to take medical students along. I also see myself working in a hospital with a charity fund or maybe even starting one. It’s a privilege to be working in a residency program where these mission opportunities are even offered.

Dr. Jessica Jackson, FSU PL-3/PGY-3 Obstetrics and Gynecology Resident

nHow well would you say you know the College of Medicine mission as an FSU resident?I can’t honestly say that I know the mission statement by heart, but I DO very much resonate with the importance of working with the underserved population, which is a central part of our mission.

Discover and advance knowledge

Poster Presentation:Gesnyr, O.; Joseph, G.; DeCesare, J.; Flynn, H.: The Relationship of Centering Prenatal Care on Depression and Birth Outcomes. Presented at National Network of Depression Centers, Ann Arbor, Michigan, October 2013. Research Presentations & Awards:Poe, A.; Ripps, B.; Amin, R.: Advancing Endometriosis Stage is As-sociated with a Decline in Anti-Mullerian Hormone Independent of Age and Tobacco, ASRM Annual Meeting presentation, Boston, Massa-chusetts, October 2013. *Poe, A.; Ripps, B.; Amin, R.: Advancing Endometriosis Stage is As-sociated with a Decline in Anti-Mullerian Hormone Independent of Age and Tobacco, ACOG District XII Meeting, West Palm Beach, Florida, August 2013. *Recipient of the “Florida Society Reproductive, En-docrine & Infertility (REI) Best Resident Research” Award.

Dr. Jackson and Dr. Hill working on maternal mor-tality project in Rwanda.

OB/GYN Residency: Scholarly Activity

Page 5

Dr. Tangra Broge, FSU PL-3/PGY-3 Pediatric Resident

nHow well would you say you know the College of Medicine mission as an FSU resident?I actually think I know it pretty well! When I was in med school at the American University of the Carib-bean in St. Martin, I was President of our chapter of the Christian Medical and Dental Association and

Respond to community needs, especially through service to minority and underserved populations

had many opportunities to do local mission work on St. Martin. That helped shape my direction for residency training, and the FSU College of Medicine mission very much resonates with me.

nDid you consciously choose the College of Medicine mission as you pursued your residency training?The mission of the FSU College of Medicine and its program at Sacred Heart definitely had a lot to do with my choice of program – a place where I could practice mission-based medicine. Escambia County has one of the poorest populations in the state of Florida, and so I chose this program because I knew it would not only be a place to be a resident, but also to be a servant. I have also always been especially interested in global health, and knew that this program would offer me those opportunities.

nHow would you say you live out the College of Medicine mission as an FSU resident?I would say that the most amazing experience was being able to facilitate an away elective in American Samoa. During my time there, I identified a disproportionate prevalence of streptococcal skin infections in children with rheumatic fever and rheumatic heart disease. Tropical medicine is a major interest of mine, so being able to pursue that while addressing the medical needs of an underserved population was a tremendous opportunity.

nDo you anticipate living out the College of Medicine mission across your career?Absolutely! When I graduate from the residency program in June, my family and I will begin a two-year stay in American Samoa, where I plan to further my emphasis on Tropical Medicine. My hope is to then complete an Infectious Diseases fel-lowship upon my return. I also believe that a commitment to global medicine and serving the underserved in undeveloped areas requires that one’s whole family is on board. My husband and I have three children, so we all have to be committed to this mission to serve the needs of others over the long term!

GME Administration: Scholarly ActivityPublications: Meek, JY.: Contributor to Schanler, R, Editor-in-Chief, American Academy of Pediatrics/American College of Obstetricians and Gynecologists. Breastfeeding Handbook for Physicians, 2nd Edition, Elk Grove Village, 2013.

Mulrooney, CP.: Florida State University College of Medicine Chairs Leadership Development Workshop, Tallahassee, Florida: The Four Circle Organizational Model, July 2013.

Brummel-Smith, KV.; Mulrooney, CP.; Wilson, D.: LeadingAge Florida Annual Convention & Exposition, Orlando, Florida: Medical Home Geriatric Outpatient Clinics, July 2013.

Presentations:

Meek, JY.: Florida Breastfeeding Coalition Webinar, Orlando, Florida: The Provider’s Role in the Baby Friendly Journey, July 2013.Meek, JY.: Arnold Palmer Medical Center, Pediatric Grand Rounds, Orlando, Florida: The Physician’s Role in the Baby Friendly Journey, August 2013.Meek, JY.: Baby Steps to Baby Friendly Hospital Summit, Connecting Evidence to Practice, Ft. Lauderdale, Florida: The Baby Friendly Journey; Physicians Using Evidence and Improving Outcomes, September 2013.Meek, JY.: American Academy of Pediatrics National Webinar: Breastfeeding Assessment During the 48-72 Hour Visit, Sep-tember 2013.Meek, JY.: American Academy of Pediatrics National Conference and Exhibition, Orlando, Florida: What You Always Wanted to Know about Breastfeeding (Basic Breastfeeding Support Skills) 10-26-13; You, Too, Can be a Breastfeeding Guru (Ad-vanced Breastfeeding Clinical Support Skills) October 2013.Meek, JY.: Academy of Breastfeeding Medicine 18th Annual International Meeting, Philadelphia, Pennsylvania: What Ev-ery Physician Needs to Know about Breastfeeding Basic Breastfeeding Course, Course Director: Resources and Strategies to Train Others, November 2013.

Just a GLIMPSE into our Programs . . .

Page 8Page 7Pediatric Residency: Scholarly Activity(All Submitted for February 2014 Competition - Southern Society of Pediatric Research, New Orleans, LA)

Patel, S.; Shipon, C.; Warner, R.; Burns, J.; Walck, J.: The Relationship Of Mantrel Score To Appendiceal Perforation in Pediatric Patients: A Retrospective Review.Patel, S.; Shipon, C.; Warner, R.; Burns, J.; Walck, J.: Does Obesity Contribute To Missed Diagnosis Of Appendicitis In Children and Adolescents: A Retrospective Review.Vala, S.; Taylor, S.; Burns, J.: A Newborn Presenting with a Constellation of Symptoms Diagnosed with Joubert Syndrome. Waite, S.; Leysath, A; Burns, J.: Clinical Features Of Newborns Readmitted to the Hospital for Management of Hyperbilirubine-mia. Leysath, A.: Burns, J.; Lee, A.; Linear and Whorled Hypermelanosis: An Interesting Newborn Finding. Platform Oral Presentations:Salz, N.; Lopez-Beyer, A.; Burns, J.: Perceived Pain with HPV Vaccine Compared to Other Recommended Vaccine for Adolescents: What Causes The Biggest "Ouch".Burns, J.; Amin, R.; Broge, T.; Hommeida, S.; Onuebgu, P.; Taylor, S.: Relationship Between Wind Direction and a Temporal Kawasaki Disease (KD) Cluster. Broge, T.; Gorman, S.; Neemuchwala, F.; Patel, S., Haggett, K.: Benzocaine Blues: A Case of Severe Methemoglobinemia In-duced by Topical 20% Benzocaine in a Pediatric Patient. Broge, T.; Gorman, S.; Marrone, J.; Burns, J.: Prevalence of Streptococcal Skin Infections in American Samoan Children with Rheumatic Fever and Rheumatic Heart Disease.Onuegbu, P.; Taylor, S.; Lee, A.: Two Cases of Mycoplasma Encephalitis: Early Suspicion Required for this Underestimated Patho-gen.

Poster Presentations:

Family Medicine Residency: Scholarly ActivityPresentations:Reyes, E.: Invited Panel: Health Symposium with State Surgeon General – Obesity. Florida Rural Health Association 20th Annual Educational Summit Gainesville, Florida, November, 2013.Reyes, E.: Integrated primary care: The Path to Access for Behavioral Services for the Rural Latino Population. Keynote Address, Plenary session of the National Rural Health Association Multiracial and Multicultural Annual Meeting, San Antonio, Texas, December, 2013.Goforth, G.: OB training- Assisted Vaginal Delivery and Shoulder Dystocia. Florida Academy of Family Physicians, Winter Forum. December, 2013.

Publications:Gerend, MA; Zapata, C.; Reyes, E.: Predictors of HPV Vaccination among Daughters of Low-Income Latina Mothers. American Psychological Association, Honolulu, Hawaii, August 2013.Fashner, J; Gitu, A.: Common Gastrointestinal Symptoms: Dyspepsia and Helicobacter Pylori. FP Essent. 2013 Oct; 413:24-8. Review. PubMed PMID: 24124704.Fashner, J.; Gitu, A.: Risks of Long-Term Proton Pump Inhibitor Therapy. Common Gastrointestinal Illnesses. American Academy of Family Physicians. FP Essentials. October 2013. PMID: 24124705.Gerend, MA; Zapata, C.; Reyes, E.: Predictors of Human Papillomavirus Vaccination Among Daughters of Low-Income Latina Mothers: The Role of Acculturation. J Adolesc Health. 2013 Nov; 53(5):623-9. doi: 10.1016/j.jadohealth.2013.06.006. Epub 2013 Jul 19. PMID: 23871803.Fashner. J.; Gitu, A.: Common Gastrointestinal Symptoms: Dysphagia. FP Essent. 2013 Oct; 413:11-5. Review. PMID: 24124702. Fashner, J.: Food-borne Illness. Core Content Review. 2013.Fashner, J.; Gitu, A.: Irritable Bowel Syndrome. Common Gastrointestinal Illnesses. American Academy of Family Physicians. FP Essentials. October 2013. PMID: 24124703.Cavanagh, C.; Goforth, G.; Fashner, J.: What is the Best Way to Prevent Ulcers Caused by Non-steroidal Anti-inflammatory Drugs? Evidence-Based Practice. 2013; accepted for publication.Karel, D.; Cavanagh, C.: Are there Iron Supplement Formulations that are Better Tolerated than Ferrous Sulfate? Evidence-Based Practice. 2013;16(10):E12.

Page 8Page 8

Suggestions? Contact the *Editor

Joan Meek, M.D. | Associate Dean / Designated Institutional Official | joan.meek@med.fsu.edu | 407.835.4103Chris Mulrooney, Ph.D. | Assistant Dean | chris.mulrooney@med.fsu.edu | 850.645.9646

Connie Donohoe, MPH | Program Manager (*Residency Review editor) | connie.donohoe@med.fsu.edu | 850.645.6867Jessee Graham | Program Associate | jessee.graham@med.fsu.edu | 850.645.9977

GME Office Staff

Special Kudos:Pediatric Residents:Dr. Anacani Fonseca—Fellowship match at the Medical University of South Carolina/ Developmental-Behavioral Pediatrics Dr. Amy Lee—Fellowship match at University of Texas Southwestern/Pediatric Critical Care

Pediatric Faculty:Dr. Kristy Haggett - Selected by Independent News as ‘a Rising Star’Dr. Sarah Waite - New addition to the family, a baby BOY!

Dr. Mina Hakim - Recognized by a family for amazing work via Facebook page (‘Super’ Mario!)Dr. Sona Patel - Recognized by Dr. Rex Northup at recent Safety Huddle for outstanding ‘teamwork’Drs. Fatima Neemuchwala and Salim Hommeida - Recognized by Dr. Farinholt for excellent work in the Pediatric ED during a near record period of high volume and high acuityDr. Tangra Broge- Recognized by Ms. Pam Hale, Assistant Patient Care Manager, for her stellar work transitioning to Couplet Care for Newborns

Closing Comments from our DIO: Joan Younger Meek, M.D.

As you can see from this edition of our Residency Review, we are highlighting the work that our residency faculty, residents, and graduates do to

support the mission of the FSU College of Medicine. We take pride in furthering the mission and hope you have enjoyed reading about a few of the physicians in our pro-grams who practice patient-centered health care, discover and advance knowledge, and are responsive to commu-nity needs, especially through service to elder, rural, mi-nority, and underserved populations. Our GME poster and slide show were part of the FSU Col-lege of Medicine “Live the Mission” Encounter on Janu-ary 13. Thanks to Dr. Chris Mulrooney, Connie Donohoe, and Jessee Graham for helping to assemble our stories and photographs and setting up our display to present some of our GME contributions to the mission. I recognize that many more of our GME faculty, staff, and residents live the mission on a regular basis and wish we had the time and space to acknowledge all of you. It was exciting to share our enthusiasm for the mission with medical students, as well as other staff and faculty, and also to learn about how

other Divisions and Departments of the College of Medi-cine live the mission. Our other area of emphasis in this edition is the schol-arly activity of our faculty and residents. As you can see, many in our Graduate Medical Education programs are engaged in research, quality improvement, publications, and presentations to discover and advance knowledge. We are past the midpoint of the academic year and look forward to the 2014 Main Residency Match in March. Our programs have interviewed some high-quality candi-dates, so we look forward to finding out soon which resi-dents will join our programs in July. As of that month, all of our residency programs will have transitioned into the Accreditation Council for Graduate Medical Education’s Next Accreditation System. Also, at that time our Family Medicine Residency at Lee Memorial Health System in Fort Myers will be training its inaugural residents. We all share their excitement, as they transition some upper -level transfers from other programs this spring and wel-come their first interns in July.

Dr. Sarah Varghese - New addition to the family, a baby BOY!

OB/GYN Resident:Dr. Kathryn Petro McKinney—New addition to the family, a baby BOY!

OB/GYN Residents: Excerpts from Patient Surveys“Dr. Kathyrn Petro McKinney is great. She is caring, compassionate, & concerned for my well-being and care. I appreciate everything she has done for me.”“Excellent care and service. Loved Dr. Lakeema Bruce! She was very comforting and patient.”Pediatric & OB/GYN Residents:

Drs. Brett and Crystal Tidwell—New addition to the family, a baby BOY!