north dakota medicine

SPRING 2006VOLUME 31, NUMBER 2

Training Tomorrow’s Doctors

Team Work

Professionalism:The Responsibility of the White Coat

Prescription: Poetry

Crossing Borders Online

THE REVIEWUPDATED & REDESIGNED

2 NORTH DAKOTA MEDICINE Spring 2006

We are very excited to introduce the firstedition of our redesigned and renamedpublication, NORTH DAKOTA MEDICINE. We hope you will find thisformat both compelling and enlightening,and that it provides a deeper understandingof the crucial role the UND School ofMedicine and Health Sciences plays in theeducation and training of excellent healthcare providers. Please feel free to pass thisand future issues on to your friends andfamily or place them in the lobby or waitingroom at your workplace.

Energy is Abundant!Over the past year the academic units

of the School have worked tirelessly toprepare for our upcoming LCME accredita-tion. As you likely know, this board isresponsible for accrediting all 126 medicalschools in the country. I was a member ofthe committee for three years, and thoughit is a distinguished honor to serve, greatresponsibility lies in thorough evaluationand program detail - no stone is leftunturned! I am happy to report that theSchool fared very well through theprocess, and will provide you the detailswhen we receive the final report in July.

On the Road Again!As an ambassador for the School, I've

had the good fortune of traveling aroundthe country the past year and meeting withalumni and friends of the school. I'vegreatly enjoyed meeting members of ouralumni family and hearing their stories ofpersonal trials and triumphs. The detailschange from person to person and fromgeneration to generation, but a constanttheme emerges, "I wouldn't be where I amtoday if not for the medical school."

Learning is Everywhere!The School is alive with learning.

There is no time, day or night, that apasserby will not see cars in the parkinglot and lights on throughout the building.Students study alone and in small groupsnearly around the clock, the research laboratories are often monitored 24-7 anda good number of other faculty and staffwork well into the evening. The learningdoesn't end with the medical students,because the School has advanced degreesin the basic sciences, complete programsin the allied health sciences and about1,600 undergraduates pursuing courses innursing, biology, nutrition and other fieldsof study. Add the fact that our facultysponsors a medical school for the publicprogram each winter - now that's a fullschedule!

As you can tell, I couldn't be moreenthused about the education we offer ormore proud of our students, faculty, staffand alumni. We are confident our graduates leave here fully prepared to fulfill their personal and professional goals,and it's a joy for us to be part of that.

With the summer months approaching,we hope your travels will bring you toGrand Forks, and that you'll schedule timeto return to your school. We'd be happy tohost a visit and to show you 100 years ofgrowth and accomplishment!

H. David Wilson, M.D. Vice President for Health Affairs and Dean

Welcome to our newlook! It is my pleasure tointroduce the new designof our publication, formerly THE REVIEW.We are committed to giving you an inside viewof all the terrific thingshappening at theUniversity of NorthDakota School ofMedicine and HealthSciences. Enjoy!

Our mission is to educate and prepare North Dakota residents as physicians, medicalscientists and other health professionals for service to the people of North Dakotaand the nation, and to advance medical and biomedical knowledge through research.

DEAN’S LETTER

NORTH DAKOTA MEDICINE Spring 2006 3

Change of address? Please send address changes to:Kitty Monley, Office of Administration and Finance, School of Medicine &Health Sciences Room 1000, 501 North Columbia Rd. Stop 9037,GrandForks, ND 58202-9037 e-mail: [email protected] phone: 701-777-2431

NORTH DAKOTA MEDICINE and past issues of THE REVIEW are available at www.ndmedicine.org

Cover Photo by Chuck Kimmerle:Nine-year old Connor Moore, Mayville, ND, poses as one of �Tomorrow�s Doctors�

FEATURESTraining Tomorrow�s Doctors 5

Medical Students are taught via patient-centered learning, a nationally respected curriculum that focuses on patients.

TeamWork 10A new interprofessional Health Care Couse ensures future health care and human services professionals work as a team.

Professionalism: The Responsibilities of the White Coat 12Students learn about professionalism through the Strategies for Teaching and Evaluating Professionalism (STEP) project.

Prescription: Poetry 16Medicine through the eyes of a poet

Crossing Borders Online 18A new website created at UND’s Rural Assistance Center provides health and service information to citizens at the borders of the United States.

Superwoman 20This student juggles being a wife, mother and outstanding medical student

DEPARTMENTSStudent Profile 20Alumni Notes 25News Briefs 22Opportunities 28In Memoriam 30Planning Ahead 31Calendar Back Cover

NORTH DAKOTA MEDICINE

UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES

CHARLES E. KUPCHELLA, President,University of North Dakota

H. DAVID WILSON, Vice President for Health Affairs Dean, School of Medicine and Health Sciences

WRITERSPamela Knudson, Amanda Scurry

CONTRIBUTORSBlanche Abdallah, Wendy Opsahl

GRAPHIC DESIGNJohn Lee, Victoria Swift

PHOTOGRAPHYChuck Kimmerle, Wanda Weber

NORTH DAKOTA MEDICINE (ISSN 0888-1456; USPS077-680) is published five times a year by the Universityof North Dakota School of Medicine and Health Sciences,Room 1000, 501 N. Columbia Road Stop 9037, GrandForks, ND 58202-9037. Periodical postage paid at Grand Forks ND.

POSTMASTER:Send address changes to ND MEDICINE, Office of PublicAffairs, UND School of Medicine and Health Sciences,P.O. Box 9037, Grand Forks, ND 58202-9037.Printed at Fine Print Inc., Grand Forks, ND.

All articles published in NORTH DAKOTA MEDICINE, excluding photographs and copy concerningpatients, can be reproduced without prior permission fromthe editor.

Want more NORTH DAKOTA MEDICINE?Check out our WEB EXCLUSIVES site:www.ndmedicine.org

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on Allen, M.D. �84, associate professor of internalmedicine, recalls the days when a medical studentwould enter a patient's room and fumble through anawkward exchange, not exactly sure what to say ordo.�You could just tell they were insecure. It was very

easy to tell they were third-year medical students," he said.�And the patient would say, encouragingly, 'You'll be agood doctor someday.'"

Today, with the UND medical school's curriculumfocused on patient-centered learning (PCL), students aremuch more adept, comfortable and "ready to roll" whenthey get on the wards, says Allen, who played a major rolein developing the clinical teaching components of PCL.�Now you�d have a hard time telling if they're a resident ora student. Their skills are so advanced and they know howto interact with patients.�

Not too surprising. By the time they complete theirfirst two years at UND in Grand Forks, they have dealtwith 64 patients, on paper, one each week. Including thepatients they have "seen and examined" as part of clinicalskills testing and those they process during exam week atthe end of each block, that number jumps to well over100.

What's different?Since 1998, the UND School of Medicine and

Health Sciences has offered a medical curriculum thatplaces the patient at the center of learning. This patient-centered learning approach was launched only after severalyears of work and study by the faculty and consultationwith other schools that had initiated this method or a version of it.

"We've integrated clinical medicine basically fromday one," Allen said. "Students have exposure to patientsand clinical medicine early on, so it makes the transition tothe clinical (third and fourth) years easier... It's not asscary for students to begin interacting with patients as itwas under the former, more traditional curriculum."

In the past, first- and second-year students typicallyhad little or no contact with patients. In a curriculumheavy with lectures, they were busy memorizing volumesof basic science information usually for the sake of exams,without a clear understanding of how this informationwould be used or how to apply it to a patient case.

"We weren't allowed to touch a patient until thethird year of medical school,� Dean H. David Wilson,M.D., recalls.

Now, with two years of studying patients under theirbelts, third-year med students "are far more advanced" thanthey were in the past, Allen said. "They are more comfort-able with doctor-patient interactions and further ahead inclinical skills, interviewing and clinical examinationbecause they've had so much practice already.

"They are more advanced in clinical-reasoningskills," he says. "They're taking medical knowledge andapplying it to the clinical setting much more effectivelythan in the older curriculum."

Why change?What are the reasons for changing the curriculum

offered in medical school? Why did medical school lead-ers feel so strongly a need for curricular reform?

Richard Vari, Ph.D., associate dean for medical education and an early leader in the reform process atUND, says the faculty saw burnout in the faces of studentsand wanted to do something to change it.

Explaining the flaws in the traditional model of medical education, he says, "We took the finest youngpeople, right out of college, full of altruism and enthusiasm, and we essentially beat them down. In twoyears, we made them hate the basic sciences, because allthey did was regurgitate it. We never asked them to learnthe basic sciences in context. They sat in lectures and labsfor eight hours every day. It was like boot camp.Typically,by January of the first year, they were burned out.�

Training Tomorrow’s Doctorswith Patient-Centered Learning

J

Clockwise from upper left, second-year medical students Jerry Eckardt, Cody,WY;April Batcheller, West Fargo; Eric Fenstad, Fargo; and Lindsay Magura, Fargo


From the first day of medical school, students are introduced to patients, in �paper cases,� and learn the basic sciences necessary to arrive at the correct diagnosis for thecondition presented. They meet three times weekly insmall groups of seven or eight. Every Monday morning,they receive their �paper patient,� study the signs and symptoms, determine the basic science learning issues andmake assignments to members to find information at thelibrary and computer. They do have lectures and labs, butthose have been streamlined and greatly reduced, by 50 to60 percent, Vari says.

On Wednesday, they present each other with the information they�ve found and further define learning issuesfor the case. Then they are given the faculty-derived

learning objectives for the case, making the group focuseven harder on the crucial basic and clinical sciences con-cepts. They progress in much the same way the practicingphysician does (history, physical exam, laboratory testresults, etc.).

On Friday, the entire class meets the patient they havebeen studying all week. The physician-faculty member presents the case and his/her line of thinking for the bestdiagnosis and treatment plan.

Students ask the patient and teacher questions about allfactors that have come into play: health and quality of care,patient emotional reactions, familial concerns, financialproblems, health care team assistance, how might thingshave gone differently and what improvements could bemade in the health system.

Patient-Centered Learning: How It Works

Jon Allen, M.D., (left), associate professor of internal medicine, Grand Forks, shows second-year medical students Kyle Barker, St. Thomas, and April Batcheller,West Fargo, how to check the carotid pulse of volunteerpatient Cathy Martsolf.


NOW "WE GIVE THEM A FRESHpatient every week," Vari says, "Theyare learning basic science in the context they'll use it every day.Students are engaged in their learning,and they value it more. They learn tothink from the very beginning."

�We've integrated all the basicsciences (in the patient cases), andthey process that information withevery case," he says. Students don'tjust remember basic science informa-tion for tests, but learn how it appliesto patients even from the very beginning.

They also learn where to findinformation, he adds. "They becomemore vested in life-long learning," acritically important trait in any healthcare provider.

After eight years in use, how hasthe PCL curriculum held up?

"The major concept, the structureand design, has remained intact," Varisays. "We've changed some of ourassessments (and) improved . . . clinical skills teaching in interviewingand psychological aspects . . . We'reholding to our standards.�

Evidence of excellenceWhat confirms that this curricu-

lum is preparing students well for acareer in medicine?

Medical schools nationwide arerecognizing the importance of patient-centered learning, yet just a few,including the UND medical school,are supporting a fully integrated PCL

“We give them a fresh patientevery week...they are learningbasic science in the contextthey’ll use it every day. Studentsare engaged in their learning...”

Rick Vari, Ph.D.

Jon Allen, M.D. (left), associate professor of internal medicine, and Richard Vari, Ph.D., associate dean for medical education, areinstrumental in the development and implementation of UND's curriculum, focused on patient-centered learning.

“We were one of a handful ofschools to go with PCL. Nowother programs are looking at us.It’s nice to be the leaders.”

Jon Allen, M.D.


...SAYS THE DEAN OF THE MAYOSchool of Medicine as he steps out ofa PCL (patient-centered learning)room where six UND medical stu-dents are presenting information toeach other on the case they are study-ing this week, a patient with a gas-trointestinal disorder.

Dean Keith Lindor, M.D., isspending the day in January at theUND medical school at the invitationof Dean H. David Wilson, M.D.,who spearheaded the curricularreform soon after arriving at UND in1995.

�There�s been a real concern inmedical education that we�re � vanquishing virtue,�� Lindor says,referring to the traditional methods ofmedical education so intense theyseem to suffocate the very humanqualities so necessary in physicians.

�Students come in with idealistic values and altruism and, oftentimes,leave medical school more callousand cynical than they have to.

�Your dedicated faculty and staffreally seem to be doing more to helpthat problem than most schools,� he

concludes after witnessing the process of patient-centered learningfirsthand. �Patients are � or shouldbe � at the center of attention. Whynot have that start right at the begin-ning of medical school?�

�I�m impressed by the amount ofpersonal time the faculty commits toproviding quality medical education,he comments. �They know thenames of the students,� which is sel-dom the case in larger medicalschools.

He also cites the advantages ofPCL in promoting professionalism, anarea for which UND is gaining national status.

Lindor, a hepatologist, has servedas dean of Mayo�s medical school forthe past year � �a very short, or verylong, year,� he quips.

Before becoming dean, he served

as division chair of gastrointestinal medicine, a post that has been assumed by UND grad, Greg Gores, M.D. � 80. Many UND medical gradshave gone on for residency training atMayo and/or are members of its staff.

As his visit to UND ends, Lindorsays, �It�s always nice to have a successful example, a starting point.At UND, the medical school and cur-riculum, everything is so focused onstudents and their education.

�There�s a dynamic that�s beencreated here between the basic sci-ences and clinical sciences� support-ed by having medical education spe-cialists facilitating the whole process.

�The process developed at UNDto facilitate the interaction betweenbasic and clinical scientists reallyseems to work,� he says, �and looksto be paying big dividends.�

Keith Lindor, M.D., left,with Dean H. DavidWilson, M.D., spent a dayat the UND School ofMedicine and HealthSciences to get a close-upand personal look at ourpatient-centered curriculum. Dean Lindorgives good grades to our faculty for preparing competent, skilled and compassionate physicians.

“I can’t believe these are first-year students...,”

“I believe professionalism is more easily modeled thantaught. Your curriculum offers that opportunity to model it.”

Keith Lindor, M.D., dean of the Mayo Medical School

ASSESSING QUALITY


program. While larger schools strugglewith budgetary and staffing needs, the sizeof the UND school has worked to itsadvantage and the school has thusbecome a national role model for patient-centered learning and medical educationin the 21st century.

Board scores for USMLE Steps I andII are as good or better than in the past,Vari says. When students take shelfexams in various disciplines, during clerk-ships in surgery, pediatrics and internalmedicine, for example, their scores arehigher than the national average.

Vari points to the school's selection asone of eight medical schools (and the onlycommunity-based school) to be studied forthe Carnegie Foundation's report on thestatus of and promising practices in medical education in the United States -

a rare honor shared with schools such asHarvard, the University of California-SanFrancisco and the University ofPennsylvania.

It is clear from the data the Office ofMedical Education (OME) collects that"students perceive themselves as moreconfident in their abilities and more competent"... so "student satisfaction isvery high," he says, noting that OME seeksstudent feedback regularly.

"We know that most students cometo this school because of the curriculum,�he says. "This is their first choice.�

Want to read what faculty and students sayabout patient-centered learning? Check out our WEB EXCLUSIVEat www.ndmedicine.org

“Students seem muchmore comfortable obtaining H/P (historyand physicals) frompatients... they are betterdata gatherers whichmakes it easier to focuson differential diagnosis,assessment and plan.”

Joan Connell, M.D., clinical associate profes-

sor of pediatrics,Bismarck

Jon Allen, M.D. (left), associate professor of internalmedicine, teaches EricFenstad, Fargo, and MichelleMcCann, Grand Forks, second-year medical students,how to palpate the spleen.

TEAM


The new Interprofessional Health CareCourse at UND will ensure that futurehealth care and human service profes-sionals can better work as a team to provide high quality and consistant careto patients. The new course involves students from the full spectrum of healthcare: medicine, nursing, physical therapy,social work, communication sciences anddisorders, dietetics, occupational therapy,clinical lab science and the physicianassistant program.

In response to a national movement,UND began development of a interpro-fessional course two years ago. The firstgroup of just over 80 students to enroll inthe new course met for the first timeJanuary 10.

"This course shows UND's commit-ment to producing quality graduates forour workforce," said UND PresidentCharles Kupchella. "The people whoworked together as a team to develop thiscourse across departmental boundarieshave shown their commitment to a uni-fied goal to enhance the professionalskills of future health care and humanservice professionals."

Leading a national movementIn 2001, the national Institute of

Medicine (IOM) issued a report whichargued that to improve the quality ofmedical care provided in this country,doctors and other health care profes-sionals need to be taught to work ininterdisciplinary teams. According tothe IOM, members of the health careteam must learn approaches to deliverthe best possible care to patientsthrough collaborative work, ensure thattimely information reaches those whoneed it, and manage patient transitionsacross settings and over time, evenwhen team members are in differentlocations.

In response to the IOM report, Dean H. David Wilson, M.D., conveneda task force, comprised of deans, departmental chairs, and directors ofseveral health and human service-related education programs on campus.

�Generally speaking, the complexityof 21st century medicine works in favorof the patient,� said Mary Wakefield,Ph.D., associate dean for rural health,who chaired the task force. �But whenhealth care providers don't communicateand are unaware of the others� scope ofpractice, this complexity can hurtpatients.�

TEAMWork

New InterprofessionalHealth Care Courseensures future healthcare and human service professionalswork as a team

UND's new Interprofessional Health Care Course began with a kickoff gathering January 10, 2006.

Mary Jo Schill, clinical assistant professor,communication sciences and disorders

Rick Vari, Ph.D., and second-year medstudent Joshua Knudson, Bismarck

Janet Jedlicka, Ph.D., chair,Occupational Therapy


�It was once, but isn't any more,enough to train health care profession-als in silos and expect that the day theygraduate they will, by osmosis, be ableto work in complex environments withpeople whose education and focuscomplements but is very different fromtheir own,� said Wakefield.

Understanding the roles of otherhealth professionals

For this course, students are separated into groups of about seven,representing a variety of health andhuman service education programs atUND. Faculty members in each of thedisciplines also serve as facilitators foreach group.

The students will meet in theirgroups once a week for six weeks towork on patient case studies. There areno textbooks for the class. The caseunfolds as the team works together toapply knowledge and perspectives ofeach health profession, apply groupskills in case management approachesand demonstrate a patient/client-centered approach in decision-makingas an interdisciplinary team.

Rick Vari, Ph.D., associate dean formedical education, who led the teamthat developed the course, is pleasedwith the progress that's been made.

�All the faculty facilitators are reallyexcited about what they see in theirgroups," he said. "Everyone has beenvery respectful of each others' profes-sions, but one thing that has already

come out is that we really don't knowwhat other professions bring to thetable.�

"With all the various professionsthat are caring for a single person, it isnice to know what each one is doing,�agreed Emily Hansen, a physical therapy student. "Knowing what every-one is doing will help to provide themost optimal care for the patient."

�Discussing these issues in an interdisciplinary group is so much better than giving lectures on each profession,� Vari continued. �The goalis being achieved. Students will gain areally good appreciation of each profession.�

Involving more students onlineThe school plans to develop the

course into an online format for the fall2006 semester. The online version ofthe course will be used in programs thatdo much of their teaching through dis-tance education. The physician assis-tant, clinical lab science, dietetics andoccupational therapy programs willhave students participating through theonline course in the future.

�While many other academic set-tings are still thinking about it," saidWakefield, "UND is doing it. And Iwill wager that the patient care, provid-ed by the next generation of clinicianswho are in this room today, will befar better for it.�

“While many other academic settings are stillthinking about it, UND isdoing it. And I will wagerthat the patient care, provided by the next generation of clinicianswho are in this roomtoday, will be far better for it.”

Mary Wakefield, Ph.D., Associate Dean

for Rural Health

Tracey Evanson, assistant professor,Nursing

Second-year med student John Cawley,Inkster, and senior nursing studentSarah Graves, Minot

Patti Vari, Ph.D., clinical associate professor, Nursing


Professionalism:

Charles Christianson, M.D.,associate professor of family medicineand head of the Strategies for Teach-ing and Evaluating Professionalism(STEP) project at the UND medicalschool, came to North Dakota in 2002after 25 years in the Washington, D.C.,area.

In D.C., he was in private practicefor 10 years and taught at GeorgetownUniversity School of Medicine, finish-ing his service there as vice chair foracademic affairs in the family medicinedepartment. He trained in medicineand health services research at JohnsHopkins University and was a residentand chief resident in family medicineat the University of California-SanFrancisco.


The Responsibility of the White Coat"You can pass all your exams with flyingcolors, but if you do not act in a respect-ful and professional manner, I am goingto kick you out of here," says Dean H.David Wilson, M.D., in his annual speechto new medical students who arrive eachAugust at the University of North Dakota(UND).

At the UND School of Medicine andHealth Sciences, professionalism is at thecore of the curriculum that educatestomorrow's doctors.

"Doctors in the 21st century face newchallenges," said Charles Christianson,M.D., associate professor of family medicine and head of the Strategies forTeaching and Evaluating Professionalism(STEP) project at the UND medical school.

"They are no longer the unquestioned,all-knowing physician. Patients researchtheir problems on the Internet and expecttheir doctor to educate and communicatewith them; society expects more accounta-bility, and insurance companies exertmore financial pressure. There are troubling issues of the proper relationshipof physicians to the drug industry. Ourstudents need to leave medical schoolknowing how to deal with those pressuresappropriately."

A recent University of Californiastudy, which looked at medical schoolrecords of doctors who had been disciplined by their licensing boards,reveals that even in medical school thosedoctors showed unprofessional behaviorssuch as failing to carry out their responsi-bilities, only doing enough to get by, nottaking feedback well and developing badrelationships with fellow students and co-workers.

In 2003, UND was selected as one often medical schools to receive fundingfrom the American Medical Association(AMA) to develop its STEP project, to lookat how professionalism can best be taughtin medical school and beyond.

"With the STEP project we strength-ened our professionalism teaching in the

preclinical years," said Christianson, whocame to UND after 25 years in theWashington, D.C., area, where he was inprivate practice for 10 years and taught atGeorgetown University School ofMedicine, finishing his service there asvice chair for academic affairs in the family medicine department. "Thepatient-centered learning curriculum herelends itself to professionalism development early in medical school."

Through the unique, patient-centeredlearning curriculum at the UND medicalschool, students have contact withpatients starting the very first week ofclasses. Three afternoons each week aredevoted to the clinical sciences, includingthe patient-physician relationship, ethics,behavioral and professional issues andother issues that arise from the case of theweek.

"In the first two years our contact withstandardized patients taught us how toapproach and examine real patients withrespect and sensitivity," said Andy Bakke,a fourth-year medical student.

"Case-based learning offers the oppor-tunity to present professionalism, ethicaland behavioral sciences issues in the largercontext of patient care," said Christianson."For example, one case deals with breastcancer. Although the students learn thepathology of cancer, they also examinethe elements of informed consent andhow the process should be carried out."

The 'Hidden Curriculum'Incorporating and emphasizing

professionalism into the formal curriculumensures that students are exposed to theseimportant issues from a very early stage oftheir education. However, students learnmore than what the curriculum offers during their medical school education andit is this implicit learning or "hidden curriculum" that Christianson and his teamhave also been studying.

At each entrance of themedical school at UNDthere is posted this quote:

"A profession is composed of a body ofknowledge, a substantialportion of which isderived from experience.

“A profession is responsible for advancingthat knowledge and transmitting it to the nextgeneration.

“A profession sets its ownstandards… and cherishesperformance above personal rewards.

“A profession is directedby a code of ethics whichincludes the moral imperative to serve others."

U.S. Supreme CourtJustice Louis Brandeis


THIS PAST SUMMER, THE UNDSchool of Medicine and Health Scienceswas one of only eight medical schools inthe country to be invited to attend a spe-cial conference aimed at examining howthe culture of a medical school shapesmedical students' values, attitudes andbehaviors.

Through a competitive process, thefollowing medical schools were selectedto send representatives to theRelationship-Centered Care InitiativeImmersion Conference, hosted byIndiana University School of Medicine atIndianapolis: Baylor College of Medicine,Dartmouth Medical School, DrexelUniversity, McMaster University,Southern Illinois University, theUniversity of Missouri-Columbia, UNDand the University of Washington.

"Those of us in medical educationspend a lot of time planning the facts,clinical skills and principles of medicine

that we teach to our students," saidChristianson. "But one of the most impor-tant and lasting aspects of the students' experience is the informal education,sometimes called the 'hidden curriculum,' that occurs as students areexposed for the first time to the culture ofthe clinic and the hospital ward."

Rosanne McBride, Ph.D., a psychol-ogist and assistant professor of familymedicine, has extensive experienceteaching behavioral issues to physiciansand says the key to really dealing withthe "hidden curriculum" of a medicalschool is a process of self-reflection, asindividual students and faculty and as aninstitution.

UND's unique patient-centered, case-based curriculum in the first two years ofmedical school helps to develop the practice of reflection. At the end of eachweek, each learning group reviews itsperformance during that week and draws

Professionalism: The Responsibility of the White Coat

Occupational TherapyIn their first semester, occupational therapy students take a personal and professional development course which provides the foundation for self-awareness, communication techniques and other skills. Later classes build on this, in terms of therapeutic use of self, managing groups, providing effective intervention, etc. Also, throughout the curriculum students complete a reflective self-evaluation each semester they are on campus. They then meet with a faculty member to review their reflective piece and get feedback on their growth and development.

Physical Therapy Physical therapy students are introduced to the American Physical Therapy Association's Code for Professional Conduct in their first semester during a professional communication and behavior course.Just prior to their first clinical rotations, physical therapy students participate in a Professional Recognition Ceremony, and hear a physical therapist talk about professionalism.

Physician AssistantsIn the Physician Assistant Program, professionalism is interwoven throughout the program. In the first week of the first course, they are introduced to the concept. The Physician Assistant Policy Manual, distributed to each student, identifies not only academic standards but also the professionalstandards to which each student is held accountable.At the end of the first week on campus, a White Coat Ceremony is held. At that time the students are presented with the white coat they will wear whenever they have patient contact. The entire theme of the ceremony is a concrete reminder of the profession they are entering and the professionalism required in this role. Various aspects of professionalism are interwoven into many of the case studies throughout the succeeding months and in all the clinical courses. At the end of the course of study, during the last two weeks before graduation, concentration is again on the professional standards expected of each of them as they enter into the role of a primary care practitioner.

Not Just DocsSeveral allied health education programs in the UND School of Medicine and HealthSciences also place a strong emphasis on professionalism in their curriculums.


lessons for the future. On a regular basiseach student performs an individual self-assessment including his or her strengthsand plans for improvement, then meetswith the facilitator, who has performedthe same assessment on the student. Thetwo discuss and reach a common under-standing of the student�s strengths andplans for improvement.

�This begins a process of life-longself-evaluation and active learning," saidMcBride who recently received a BushTeaching Scholars Fellowship to look further into this issue. "This process inthe first two years of medical school initiates models and reinforces the importance of a life-long process of reflec-tion and self-assessment leading to profes-sional development.�

As a way to encourage reflection inthe third year of medical school, which isthe first year of clerkships, Christiansonoriginated a pilot professional develop-ment group for students on the GrandForks campus.

Those six students meet monthly witha faculty facilitator to discuss ethics andprofessionalism issues. The studentsrotate responsibility for choosing a topicand leading the discussion on topics suchas end-of-life and code status issues, howto respond when an attending makes aninsensitive remark and the relationship ofstudents to drug company representatives.

�The group gave me a great opportunityto reflect on my own professionalism,�said Nicole Veitenheimer, fourth-yearmedical student, who participated in thepilot professional development group. �Itgave me a chance to hear about mypeers' experiences in their clerkships andto think about what I would do if I was inthe same situation.�

�The third-year focus group broughtto light many issues we as studentsencountered on the wards and allowed usa venue to exchange our thoughts andfeelings about them," agreed Bakke, whowas also in the group. "We could thenconsider how we would handle these situations before actually experiencingthem.�

Is it making a difference?Christianson and his colleagues

recently received another grant from theAMA to examine if the work being doneto instill professionalism in medical students is truly working. The team plansto look at the range of medical practicefrom medical school through residencytraining and especially at the challengesfaced by practicing physicians.

To do this, they have developed aunique collaboration with the NorthDakota Medical Association (NDMA) tohelp support professionalism amongphysicians in the state and to involvethem in teaching professionalism to students and residents.

Robert Beattie, M.D., the new chairof family medicine, helped to develop theproject. Recently completing two termsas president of NDMA, he focused onprofessionalism as a major theme of hispresidency.

Christianson, Beattie and McBrideattended a national meeting in Februarywith the 16 grantee-organizations tobrainstorm approaches to enhancing professionalism across the spectrum ofmedical practice.

Professionalism: The Responsibility of the White Coat

“The . . . group broughtto light many issues we as students encountered on thewards and allowed us avenue to exchange ourthoughts and feelings aboutthem . . . We could then consider how we would handle these situationsbefore actually experiencingthem.”

Andy Bakke,M.D. Class of 2006

Dean Wilson congratulates Andy Bakke, Grand Forks, now a fourth-year medical student, during the White Coat Ceremony in 2002.


�I�ve been writing poetry for as long as Ican remember,� says Barbara Swenson,fourth-year medical student. �Writing forme has been a pastime of relaxation andenjoyment.�

Readers of The Legible Script*, a liter-ary journal published by the students of theUniversity of South Florida College ofMedicine, will be able to enjoy two piecesof her writing in the most recent issue.

Her poems, Three Pound Miracle andThe Procedure, were selected for inclusionin the publication.

�More of my writing is short storiesand a few novels,� she says. AssociateDean for Student Affairs Judy DeMers says,�I think she�s someone who�s been veryartistic throughout most of her life,� notingher accomplishments in music, classicalballet, ice-skating and other pursuits.

As an ice-skater, one of her manyawards was being named NationalSynchronized Figure Skating Champion in1998 and then placing third in the interna-tional competition in Milan, Italy.

She has also shown an interest inresearch: during her final college summer,she was a research intern in a biochemistrylab at Arizona State University where sheworked with mutated bacterial genes andused laser spectroscopy in a study examin-ing electron transport.

A very active memberof the M.D. Class of 2006,she belongs to theAmerican Medical StudentAssociation, DOC (DoctorsOught to Care) andPhysicians for HumanRights.

Swenson plans to pursue residency trainingin neurology beginning inJuly at the University ofMinnesota. The daughterof Jan and Bruce Swenson,M.D., (B.S. Med. � 72) ofMinot earned a bachelor ofarts degree, majoring inbiochemistry, fromColorado College.

For senior medical studentBarbara Swenson, writing

poetry is one of many meansshe uses to express her

artistic nature. Here she caresfor a tiny patient in the

Neonatal Intensive Care Unitat Trinity Health in Minot.

Medicine through the eyes of a poet

* Note: The Legible Script is supported through the Dean�s Academic Fund from the University of South Florida and by individual contributions.For more information, go to: http://www.hsc.usf.edu/medstud/thelegiblescript/

Prescription: Poetry

The Procedure, another poem by Barb Swenson, is availableon our WEB EXCLUSIVES site: www.ndmedicine.org


So ended the newborn lecture. The attending physician Moves us students aside, The brand new motherTaking our place at the incubator.

Her hands clasped to her chest Suppressing impulse to touch The three pound miracle Inside the glass case.

“Chance of survival?” says The physician, for his Students’ ears only. “Ten percent, at the most.”

Eyes of the mother Hold tight to her child. A whole ten percent Chance for life.

“As you may notice, Tape covers its eyes Which are still fused Into one. Quite like a Cyclops.”

Mother’s lips soften Drawing into a smile. Why the tape?Must be to protect his eyes From those bright glaring lights.

“With lungs like that, So underdeveloped, Three days Is the most it’ll survive.”

Her hand caressing the glass, The mother sighs. With her tiny, Tiny beloved, She has this moment,

And the next, and The next.

Three Pound Miracle


The U.S.-Mexico Border Health Website (http://borderhealth.raconline.org)created by the Rural Assistance Center(RAC) at the UND medical school�s Centerfor Rural Health, serves as a virtual libraryof information pertaining to the uniquehealth and human services issues facingcommunities in Texas, Arizona, NewMexico and California. The site includesfunding opportunities, grant-writing information, pages on each border state,topic pages, federal activities and a searchable resource database.

Topic pages focus �on issues of mostconcern to people in the border region,�said Kristine Sande, project manager,Grand Forks, such as diabetes, tuberculo-sis, environmental health and women�shealth, including prenatal care.

Visitors to the Web site also may usethe full range of services provided by RACinformation specialists who provide customized assistance through phone or e-mail.

Crossing Borders OnlineThe U.S.-MexicoBorder Health Website is part of a $3.78million project whichcontinues over thenext five years

Topic pages focus “on issues of most concern to people in the border region,” such as diabetes, tuberculosis, environmental health and women’s health, including prenatal care.

Kristine Sande, project manager, Grand Forks


�THE RURAL ASSISTANCE CENTER provides a terrific platform on which tobuild the new U.S.-Mexico Border HealthWeb site,� said Mary Wakefield, Ph.D.,director of UND�s Center for Rural Healthwhich houses RAC. �The new Web siteand its end-users will be able to takeadvantage of a team of content expertsand web developers who have a nationalreputation for excellence in quality ofinformation and timely responsiveness.�

The site �is yet another lane of theinformation highway that extends from theUniversity of North Dakota to the rest ofthe nation,� Wakefield said. �It shows thattime and distance no longer matter. Theonline service is available to anyone 24hours a day and is constantly updatedwith the most recent information.�

RAC and its online resourcewww.raconline.org were developed in2002 at the Center for Rural Health inpartnership with the Rural Policy ResearchInstitute through a grant from the U.S.Department of Health and HumanServices� (DHHS) Health Resources andServices Administration.

RAC is a national resource whichserves as a single point of entry for ruralresidents and others seeking informationon health and human services for ruralcommunities. Its personnel help ruralcommunities and other rural stakeholdersaccess programs, funding and researchthat can enable them to provide qualityhealth and human services to rural residents.

Since it was established three yearsago, nearly a half-million visits have beenmade to the RAC Web site by peoplethroughout the U.S. and several foreigncountries.

“This new Web site isyet another lane in theinformation highwaythat extends fromUND to the rest of the nation.”

Mary Wakefield, Ph.D.,director,

Center for Rural Health

http://borderhealth.raconline.org


he wakes up at 6 a.m. and gets ready for her

day. She grabs a quick breakfast and takes a

shower. She peeks in on her sleeping children,three-year old Elyse and 6-month-old Aiden;kisses her husband, Garret, goodbye, and leavesfor school.

School, for fourth-year medical student Kara

Johnson is a clerkship at MeritCare Hospital inFargo.

She arrives at the hospital about 7 a.m. andspends her day learning the art and science ofmedicine. At 5 p.m. she picks up her kids fromdaycare, where Garret left them before going tohis job as a pharmacist, brings them home andstarts dinner. When Garret arrives home, thefamily enjoys dinner and some quality time.

SUPERWOMANMed student, wife & mother

KARA JOHNSONM.D. CLASS OF 2006HOMETOWN: FARGOCAREER GOAL: She plans togo into internal medicineand hopes it will lead herback to North Dakota topractice.

STUDENT PROFILE

KARA JOHNSONM.D. CLASS OF 2006HOMETOWN: FARGOCAREER GOAL: She plans togo into internal medicineand hopes it will lead herback to North Dakota topractice.


oon it is 8:30 p.m. andtime to put the kids tobed. Kara spends the restof the evening studyingand goes to bed herself

around midnight.It seems her life is pretty normal, but

this remarkable woman has given birth toboth of her children while attending medical school and will graduate in Mayat the very top of her class.

She took the long road to medicalschool. Kara met Garret when they wereboth in pharmacy school at North DakotaState University in Fargo. After complet-ing her doctorate in pharmacy in 1998and working as a clinical pharmacist for afew years, she realized she was muchmore interested in what the doctors weredoing.

"I found myself wondering,what does that X-ray mean?What makes that person sick?And then I knew I had to followmy dream and apply to medicalschool," she said. "My husband hasalways been very supportive, and I havenever regretted my decision."

Still, her pharmacy education is notgoing to waste. Pharmacology is onetopic she already understands and the culture of the hospital wasn't a surprise toher.

"It's nice," she said, "because I alreadyknow the workings of the medical team:what to do, whom to ask, what not toask."

At the UND School of Medicine andHealth Sciences, medical students aregraded against themselves, not againsteach other and they rarely know theirrank in their class. Some scholarships,however, are given to the top-ranking student in the class. Last summer, Karawas informed that she was the top-rankingstudent of the UND Doctor of MedicineClass of 2006 and was awarded the mostprestigious scholarship available to medical students: the Gustav Golseth,M.D., and Wesley Morrish MedicalSchool Scholarship, worth $12,000.

Kara said she was shocked. "I didn'teven know where I was in the class whenI found out."

So, how does she do it? Consistency,flexibility and dedication.

"I started studying from the beginning,"she explains. "I was pregnant when Istarted medical school and I knew theonly way I would be able to get throughwas to study consistently, not just rightbefore exams."

The family has plans and back-upplans to make sure the children are welllooked-after. "My husband has been wonderful," she said. "We have to remainflexible and he goes with the flow."

Medical school requires a high levelof dedication from all students, but Kara'ssituation is extraordinary. After deliveringElyse by c-section in the middle of her firstyear of medical school, she returned toschool just two weeks later.

�I was quite a sight, waddling aroundthis place, running home for feedings,�she remembers. �But I had to get back assoon as possible. I didn't want to missanything!�

�Sometimes I feel guilty,� admits Karawho realizes she took on a lot all at once."But I think that I will be a better motherbecause I am a career woman."

She is, no doubt, a strong role modelfor mothers and career women alike.

"I always wanted to go into healthcare," she said. "I couldn't be happy if Iwasn't doing this."

Kara, who is originally from Fargo,N.D., is the daughter of Ronald Brakke ofGrace City, N.D. and the late Jean Brakke.She plans to go into internal medicine andhopes it will lead her back to NorthDakota to practice.

Two weeks after delivering Elyse by c-section in the middle ofher first year of medicalschool, Kara returned toclass.

“I was quite a sight,waddling around thisplace, running home forfeedings... but I had to getback as soon as possible.I didn’t want to miss anything!”

Kara Johnsonfourth-year medical student


NEWS BRIEFS

Richard Larson, M.D. (B.S. Med. � 82), clinical assistant professor of family medicine, Belcourt, ND, has been selected as the 2006 Physician of the Year by the IndianHealth Service (IHS), National Council of Clinical Directors.He accepted the award at the IHS annual meeting of theNational Combined Councils Jan. 30 in Phoenix.

He was nominated for the award by LaVerne Parker, chiefexecutive officer of the Quentin Burdick Memorial HealthcareFacility, Belcourt, where Larson is a staff

physician. The award has been presented annually since1979 by the National Council of Clinical Directors.Parker nominated him for the award because, she said, �heembodies the very highest qualities of the skilled physician inmultiple areas of direct patient care over an extended periodof time and for his commitment to the care of the patient pop-ulation he serves.�

Larson, a member of the Turtle Mountain ChippewaTribe, earned the Bachelor of Science in Medicine degree atUND in 1982, and then went on to Michigan State UniversityCollege of Human Medicine in Flint, MI, where he earned theM.D. degree in 1984.

�After completing family medicine residency training at the UND Center for Family Medicine in Minot in 1987, hejoined the medical staff at the Burdick Healthcare Facility andcontinues to practice on his home reservation,� Parker said.

An active member of the UND medical school faculty, hereceived the Dean�s Outstanding Volunteer Faculty SpecialAward during commencement ceremonies for the M.D. Classof 2005.

�He has shown a deep commitment to his practice andpatients through his work as a family practicephysician and director of the emergencyroom,� Parker said. Under his leadership asmedical director, �the emergency room hasbeen certified as a Level IV ER. The ER hasbeen certified since 1998 and continues tomeet the certification requirements today.�

�The ER has been certified as a Level IVTrauma Center, the first in the Aberdeen areaof the IHS,� she said. The BurdickHealthcare Facility also had the largest num-ber of outpatient visits in fiscal year 2005 incomparison to other facilities of the same sizewithin the area.

�Dr. Larson is well-recognized in the� hospital community� and local communityfor his dedication to care of the patientsunder his service. (He) is often seen at thehospital before his tour and long after his tourto complete charting and see inpatients.�

Larson has served as chief executive offi-cer during an interim period at the BurdickHealthcare Facility and as clinical director fora time when the facility was in transition andunder a great deal of stress due to insufficientnumbers of primary care providers, Parkersaid. He has been able to accomplish somuch because of �his great commitment tothe people and the community,� she said.�He is willing to work weekends to provideeducation to the EMTs (emergency medical

technicians) and to act as a mentor and recruiter for potentialphysicians and employees. He frequently goes above andbeyond to accomplish the mission of the (IHS)...

�The Quentin Burdick Memorial Healthcare Facility isvery fortunate to have a physician with the commitment andcaliber of Dr. Richard Larson.�

Richard Larson, M.D. (B.S. Med. '82), clinical assistant professor of family medicine,Belcourt, ND, receives the 2006 Physician of the Year by the Indian Health Service(IHS). At the awards ceremony, Larson (center) is pictured with LaVerne Parker(left), chief executive officer of the Quentin Burdick Memorial Healthcare Facility,Belcourt, and Charles Grim, D.D.S., director of the IHS, a division of the U.S.Department of Health and Human Services. Providers from 144 sites throughout thenation were eligible to be considered for this award.

Larson Named IHS Physician of the Year


Jedlicka Named OT ChairJanet Jedlicka, Ph.D., has beenappointed chair of the Departmentof Occupational Therapy (OT) at theUniversity of North Dakota Schoolof Medicine and Health Sciences.

Jedlicka, who has been servingas interim chair since last July,replaces Sue McIntyre, who retiredJune 30 after a distinguished careerat UND of 38 years, serving asdepartment chair since 1981.

"Janet Jedlicka is a provenleader," Dean H. David Wilson,M.D., said, "and has significantadministrative experience, including previously chairing anoccupational therapy department. I'm confident the depart-ment will benefit from her leadership and we are very pleasedto have her as the department chair."

Jedlicka joined the OT faculty at UND medical school asan associate professor in January 2003, with extensive admin-istrative, clinical and consultative experience. She came toUND from the Medical College of Georgia, Columbus, GA,where she was coordinator of the OT satellite program. Priorto that she was on the faculties at the University of Alabamaat Birmingham and Kirksville College of OsteopathicMedicine (now known as Arizona School of Health Sciences),where she developed their program in Occupational Therapy. Jedlicka also served on theprofessional staff at the University of Mississippi MedicalCenter. Her professional area of interest is developing teaching strategies.

Jedlicka grew up in Bismarck and earned a Bachelor ofScience degree in occupational therapy and a Bachelor of Artsdegree in Spanish from UND in 1982. She holds a Master ofArts degree in occupational therapy from New YorkUniversity, specializing in mental health. Shecompleted the doctoral (Ph.D.) degree inhigher education and leadership in 1995 atthe University of Mississippi.

UND's OT program provides educationleading to a Master of Occupational Therapy(MOT) degree. Its faculty also offer a satellitedegree program, developed and launched in1992, in cooperation with Casper (WY) Collegeand an online masters degree for the practicingtherapist.

Brosseau Elected ACP Governor-elect James Brosseau, M.D. (B.S. Med.� 68), associate professor and chairof community medicine, GrandForks, has been elected governor-elect of the American College ofPhysicians (ACP). His term as gov-ernor-elect began April 6, 2006; hisfour-year term as governor willbegin in April 2007.

The ACP Board of Governorsconsists of 79 individuals who rep-resent ACP members in variouschapters and regions of the UnitedStates, regions in Canada, several Latin American countries and Japan. The governors provide a critical link between members, headquarters and the Board of Regents, and are responsiblefor coordinating local ACP activities.

Nationally, the Board of Governors serves in an advisory capacity to the Board of Regents, the policy-making body of the College.

Reading, Writing and Living History

Professor Emeritus John Vennes, Ph.D. (center), co-author of the book, “North Dakota, Heal Thyself,”the 100-year history of the medical school, signedbooks last fall in Bismarck. Here, he greets Georgeand Diane Saiki of Bismarck; George is the son ofArthur Saiki, M.D., who taught pathology for manyyears at the UND medical school. George is aretired counselor who worked 30-plus years for thevocational rehabilitation division of state govern-ment. To purchase your copy of the book “NorthDakota, Heal Thyself,” call Monica at (701) 777-2002 or email [email protected] The book

price is $48.04 (including tax). For $6.00, you can also purchasea DVD with interviews that Vennes made with alumni and friendsof the medical school; hear it all in their own words! To order, con-tact Monica at information above.

NEWS BRIEFS

James Brosseau, M.D.Janet Jedlicka, Ph.D.


Delegation Announces Nearly $500,000For UND Health Research

Senators Kent Conradand Byron Dorgan andCongressman EarlPomeroy announced thatthe University of NorthDakota's Center for RuralHealth has been awardeda federal grant totalingnearly $500,000 to support a new projectthat seeks to improve the

quality of health care in rural communities. The funding, which is part of the Building Research

Infrastructure Capacity program, will help bring together theCenter for Rural Health with renowned rural healthresearchers from across the U.S. over the next two years.The goal of this project is to help rural health providersidentify new ways to improve patient safety and to achievebetter health care service. Of 43 nationwide applicants forthis competitive grant, UND was one of four recipients.

North Dakota Public Radio examines"Health At What Cost?"A radio documentary titled "Health At What Cost?"explores, through many voices, how North Dakotans arebeing financially impacted by the rising cost of health careand health insurance. It also focuses on ideas for makingthe cost of health insurance and health care in NorthDakota more affordable. The show will feature UNDCenter for Rural Health research on the characteristics ofthe uninsured in North Dakota. Visithttp://www.med.und.nodak.edu/publicaffairs/NDPRHearitNow.html to listen.

Dakota Conference Announces EmergingHealth IssuesThe theme of the 21st annual Dakota Conference on Ruraland Public Health, an interdisciplinary forum for sharingstrategies for building and sustaining healthy rural communities, was "Emerging Health Issues: Preparing forTomorrow."

This year's keynote speakers included Dr. Patricia Mail,president of the American Public Health Association; AlanMorgan, president of the National Rural Health Association,Capt. B. Kevin Molloy of the U.S. Public Health Service;and Dr. Sarah Patrick, director of the Center of Excellencein Women's Health Demonstration Project for Region VIII,University of South Dakota School of Medicine and HealthSciences.

American Indian Research Forum HeldApril 6 AT UNDThe Center for Rural Health sponsored the American IndianResearch Forum on April 6.The event featured nationally known speakers in the area ofAmerican Indian health research, oral and poster presenta-tions featuring American Indian populations by students andresearchers and discussions of new ways to developAmerican Indian research opportunities.

"The forum provides a venue to sharecurrent research activities concerning health risks and healthpromotion among NativeAmerican communities," said Dr.Jacque Gray, assistant professor at the Center for RuralHealth and chair of the planningcommittee. "This also gave us anexcellent opportunity to develop possible research collaborations forfuture projects."

Annual 'Science Day' Engrosses StudentsFifth- and sixth-grade students attended the annual ScienceDay on Saturday, March 25 at the University of NorthDakota (UND) School of Medicine and Health Sciences inGrand Forks.

Offered at no charge and hosted by the UND chapter ofthe American Medical Student Association (AMSA), theevent featured a hands-on approach to learning.Medical student supervised activities designed to stimulatechildren's interest in science, focused on human health andanatomy, heart and the importance of exercise, awarenessof the dangers of tobacco use, "grossology" and variousprojects that demonstrate scientific principles.

NEWS BRIEFS

Senator Kent Conrad visited UNDin March 2006.

Fifth- and sixth-grade students express dubious excitementwhile second-year medical student Dustin Hawley explains thewonders of the intestines during the “grossology” section ofScience Day.

NORTH DAKOTA MEDICINE MARCH 2006 25

ALUMNI NOTES

Laura Mastel, B.S.C.L.S. � 05, Grand Forks, earned the highest score on the American Society for ClinicalPathology (ASCP) Board of Registry Exam for MedicalTechnologists for the 2005 second quarter reporting period,when most students take the exam. She was among 468people who took the exam.

The ASCP Board of Registry exam is a national certify-ing exam that clinical laboratory science (CLS) students takeafter completing the bachelor of science degree in CLS atthe UND School of Medicine and Health Sciences.

�She was one of our best students,� recalls MaryColeman, assistant professor in the CLS program, GrandForks. �This is the first time, I can remember, that one ofour students has attained the top score (on this exam).Some of our students have been in the top two percent, andthe program average is in the top 10 percent.�

Mastel was inspired by television�s popular � CSI� showto pursue a career in clinical laboratory science, she says. �I really wanted to be part of a lab and to do lab work. Myadvisor suggested taking a CLS course and I really liked it.�She knew then that becoming a lab scientist was what shewanted to do.

Mastel, joined Northwood (ND) Deaconess HealthCenter last May, just two days after graduation from UND.

�They have a nice small hospital and clinic here, andthey are a very close bunch. They interact with the doc-tors,�she said. �Because it�s a smaller facility, I�m getting alot of management-based experience.�

In the lab team of five, she is the only one who holds afour-year degree, she says, so her colleagues �can come tome with questions.�

CLS Grad Earns Top Score in National Certifying Exam

Laura (Voller) Mastel, B.S.C.L.S. '05, attributes her stellar per-formance on the national certification exam to the excellent edu-cation she received at UND, which "is noted as one of the best inthe nation in clinical lab science," she says. Originally fromHazelton, ND, she is pictured here at work in the Northwood(ND) Deaconess Health Center.

Members of the classes of ‘77 and ‘79 enjoyedrenewing acquaintances and the opportunity tocatch up with classmates during a reunion dinner as part of the medical school’s centennial celebration during Homecoming last fall.Pictured (from left) are: Kenneth Keller, M.D.‘79, Prescott, AZ; Barbara Assel, M.D. (B.S.Med. ‘77), Eagan, MN; Randy Idler, M.D.(B.S. Med. ‘77), Reno, NV; Judith Kaur, M.D.(B.S. Med. ‘77), Rochester, MN; DavidBrusven, M.D. (B.S. Med. ‘77), Ramsey, MN;Robert Rust, M.D. ‘79, Granger, IN, andThomas Hanson, M.D. (B.S. Med. ‘77),Fargo, ND. Along with the photo, Idler sentgreetings to the school, “Thank you so much forall your efforts in making our med schoolreunion so enjoyable.”

Reconnecting at Centennial GatheringReconnecting at Centennial Gathering


‘99 PA Grad Named Montana’sPhysician Assistant of the YearPenny Denning, PA � 99, Glendive, MT, was named the2005 Physician Assistant of the Year by the MontanaAcademy of Physician Assistants (MAPA). For MAPA, sheserves as chair of the scholarship committee and as aregional board member.

Denning is a board-certified physician assistant at theGlendive Medical Center, where she has a �very busy fami-ly practice� and provides �outreach women�s health inMalta, MT (240 miles away), and family planning clinic twoafternoons a month.� She also covers the emergency roomin Glendive, Circle and Malta occasionally.

She has served as a school board trustee since 1999and on the Glendive Swim Team Board since 1990.

Jensen Receives NDMA Community and Professional Services AwardClayton Jensen, M.D. (B.S. Med. � 56), professor emeritus offamily medicine, Detroit Lakes, MN, received the NorthDakota Medical Association (NDMA) 2005 PhysicianCommunity and Professional Services Award.

The award, presentedannually since 1977, recog-nizes outstanding members ofthe NDMA who serve as rolemodels, active in both theirprofession and in their commu-nity.

He practiced for 25 yearsin Valley City, ND, prior tojoining the UND School ofMedicine, where he served aschair of family medicine and,later, as associate dean for clinical affairs and interim deanof the school. After leaving active practice in 1996, hebegan a vigorous retirement serving from 1998 to 2003 aslead investigator in the Matters of Life and Death project toimprove end-of-life care in North Dakota.

He served as a delegate to the White HouseConference on Aging, which convened in December atWashington, D.C.

ALUMNI NOTES

Do you have a news note you�d like to see included inan upcoming issue of NORTH DAKOTA MEDICINE?Please drop us a line at: UND School of Medicine andHealth Sciences, Office of Public Affairs Room 1916,501 North Columbia Road Stop 9037, Grand Forks,ND 58202-9037.Or e-mail: [email protected] Please include your daytime phone number.

Each year the classes celebrating their 65th, 60th, 55th,50th, and 45th reunions are featured.

The 2006 Alumni Days (May 24-26) is unique inthat we will be honoring former President TomClifford and his wife Gayle. Join us for tours, dining,dancing and more!

Featured events include :High Tea at the North Dakota Museum of Art! Welcome Home Dinner - A Toast to Tom and Gayle at �Touch of Magic� in East Grand Forks! Luncheon at the medical school hosted by Dean H.David Wilson, M.D.Reception at the medical school honoring Sioux Award recipient Don McIntyre, M.D. (B.S. Med. � 57) of Rugby, North DakotaThe Sioux Award Banquet honoring Peter Simonson, Lyle Kasprick, Darald Rath, Dr. Don McIntyre and Diane Langemo! The President's Brunch hosted by UND President and Adele Kupchella, in their beautiful home! This year, we're proud to host the classes of 1966, 1961, 1956, 1951, and 1946 and prior.

To register, visit www.undalumni.org or call (800) 543-8764.

Class of 1946: Recognize any of these faces?(front row left) Dean Harley E. French, L. Mero, T. Myers,Roger P. Mattson (back row left) Robert P. Crabill, Harry Shamhart, and Keith McCormick.

Alumni Days is athree-day celebration on

the UND campus,a wonderful opportunity

to rekindle friendships, relive campus daysand enjoy North

Dakota hospitality.

Clayton Jensen, M.D.


Note: The last issue of THE REVIEW (December � 05)included a picture of Clayton Klakeg, M.D. (B.S. Med.� 43), Goleta, CA, and Don Yamaguchi, M.D. (B.S. Med.� 55), Rolling Hills, CA, on a page with obituaries. Weapologize and assure our readers that neither of thesealums are deceased.

Don McIntyre, M.D., to Receive SiouxAwardThe University of North DakotaAlumni Association will honor distinguished alumnus DonMcIntyre, (B.S. Med. � 57), with its highest honor, The Sioux Award, at 5:30 p.m., Thursday, May 25, inthe Alerus Center Ballroom inGrand Forks.

Dr. McIntyre, originally fromrural Leeds, N.D., received his B.S.Med. degree and M.S. degree inphysiology and pharmacologyfrom the UND School of Medicineand Health Sciences in 1957. He went on to complete his medical degree at the University of Pennsylvania in 1959.After 32 years of practicing rural health, he retired from hisposition as an internal medicine specialist with the JohnsonClinic in Rugby, N.D. He continues to practice as a locum-tenens physician occasionally in North Dakota.

Dr. McIntyre was a board member of the UND AlumniAssociation and UND Foundation from 1982-1991, andpresident of the UND Alumni Association during the 1989-

1990 term. He currentlyserves on the UNDAlumni Association andUND Foundation boardemeritus.

He was founder of Life, Inc., a charitable organization andthe Heart of America HMO, the only surviving health maintenance organization in North Dakota.

Dr. McIntyre received the Greater North DakotaAssociation Leadership Award and has been honored byUND for work with the physician assistant program. He hasalso received several American Medical AssociationRecognition Awards. Don is a member of several organiza-tions including the American Academy of Family Practiceand is a fellow of the American College of Physicians. Heand his wife, Joann, reside in Rugby. They have four children.

� 59Dennis Wolf, M.D. (B.S. Med. � 59), clinical assistant profes-sor of family medicine, Dickinson, has been elected as vicechairman of the State Health Council, which governs theNorth Dakota Department of Health policy. He is theNorth Dakota Medical Association�s representative on theState Health Council.

� 74Subhas Chakrabarty, Ph.D. (M.S. in Microbiology � 74), isassociate director for basic science for the SIU CancerInstitute at Southern Illinois University School of Medicine.Last year, he joined the SIU faculty as a professor of medical microbiology, immunology and cell biology.

Chakrabarty�s primary responsibility is the developmentof a complete cancer research team. He brought a five-yeargrant, to study colon cancer, from the National Institutes ofHealth, as well as a new five-year $1.9 million grant studying colon cancer from the National Cancer Institute.His previous grants total $4.4 million.

Most recently, he was an associate professor of molecu-lar pathology and of molecular and cellular oncology at theUniversity of Texas (UT) M.D. Anderson Cancer Center. Healso was a member of the graduate school of biomedicalsciences at UT.

� 90Larry Leadbetter, M.D. � 90, Park Rapids, MN, has beenelected to fellowship in the American College of Physicians(ACP). He is an internist with Dakota Clinic in Park Rapids.

The fellowship is an honorary designation given to doc-tors by the ACP to recognize ongoing individual service andcontributions to the practice of medicine.

�01Colleen Patton (Physician Assistant Program � 01), has begunteaching in the Physician Assistant Program at SouthUniversity in Savannah, GA. Her husband is in the Army,active duty, and stationed at Hunter Army Airfield inSavannah.

� 02Dana Monet Fitzgerald, M.D. � 02, completed pediatricstraining at Rush University Medical Center in Chicago, andis now doing a Primary Care Sports Medicine Fellowshipthrough Baylor College of Medicine at the Texas Children�sHospital in Houston.

ALUMNI NOTES

Don McIntyre, M.D.


ABERDEEN AREA INDIANHEALTH SERVICEVina Bohling, [email protected] Totten - Family medicineFort Berthold - Family medicine

BELCOURTQuentin Burdick MemorialHealthcare FacilityLaverne Parker, [email protected] Practice, nurse practi-tioner, physician assistant

BISMARCKSt. Alexius Medical CenterMark Sheldon, [email protected], hospitalist, infec-tious disease, anesthesiology,neurology, physical medicineand rehabilitation, psychiatry

BOTTINEAUSt. Andrew's Health CenterJodi Atkinson, [email protected] medicine

BOWMANSouthwest Healthcare ServicesJocelyn Gruebele, [email protected] nurse

CANDOTowner County MedicalCenterBob Spencer, [email protected] medicine

CARRINGTONCommunity Health CenterMary Ellen Frey, Interim CEO701-652-3141Nurse practitioner, physicianassistant

CAVALIERAltru Clinic/CavalierJean Keller, Physician [email protected] medicine

COOPERSTOWNCooperstown Medical CenterGreg Stomp, [email protected] nurse, licensed prac-tical nurse, clinical laboratoryscience

CROSBYCrosby ClinicKeith Baker, [email protected] medicine

DEVILS LAKEAltru Clinic/Devils LakeJean Keller, Physician [email protected] medicine, internal medicine

Lake Region Human ServiceCenterLynn Nelson, Division [email protected]

Mercy Hospital of Devils LakeMarlene Krein, President/CEO701-662-2131Registered nurse, clinical labo-ratory science, physical therapy

DICKINSONSt. Joseph's HospitalAllan Sonduck, Administrator701-456-4271Nurse practitioner, physicianassistant, registered nurse,licensed practical nurse, clinical laboratory science,physical therapy

Dickinson ClinicRod Mitzel, [email protected] medicine, internal

medicine, general surgery,licensed practical nurse

Great Plains ClinicMark Grove, [email protected] medicine, internal medicine, general surgery

ELGINJacobson Memorial HospitalCare CenterBruce Bowersox, Interim [email protected] medicine, nurse practitioner, physician assistant

FARGODakota Clinic, Ltd.Dick Reis, PhysicianRecruitment [email protected] and interventional, orthopedics, ENT, neurosurgery, obstetrics-gynecology, internal medicine,

FARGO - continuedendocrinology, dermatology,anesthesiology, ICU/PUL

MeritCare Health SystemJill Gilleshammer, PhysicianRecruiter701-280-4851jillgilleshammer@meritcare.comAllergy/pulmonology, anesthe-siology, cardiology, criticalcare, dermatology, ENT, familymedicine, gastroenterology,infectious disease, internalmedicine, medical oncology,obstetrics-gynecology, generalsurgery-trauma, neonatal/pediatrics, neurology, neuro-surgery, orthopedic surgery,pediatrics, pediatric oncology,psychology-EDI, radiology,rheumatology

VA Medical CenterHuman Resources701-239-3700, ext. [email protected], primary care (Fargoand Bismarck), dentist, gas-troenterology, radiology,nephrology, neurology,rheumatology, urology, anes-thesiology, research, registerednurse, licensed practical nurse

GRAND FORKSAltru Health SystemJean Keller, Physician [email protected] medicine, internal med-icine, obstetrics, cardiology,critical care, dermatology, ENT,gastroenterology, interventionalradiology, neurology, orthope-dic hand surgery, orthopedicsurgery, psychiatry, plastic sur-gery, psychiatry, radiationoncology, rheumatology, urology, diagnostic radiology

HAZENSakakawea Medical CenterKurt Waldbillig, [email protected] practitioner, physicianassistant

ND OPPORTUNITIES

This feature offers information for physicians and other health care professionals

interested in practice opportunities in North Dakota.For more information about these

listings or loan repayment programs, pleasecontact Mary Amundson, M.A., at 701-777-4018

or [email protected] is a partial list; for the complete list, go to:

http://medicine.nodak.edu/crh/rhw/recruit/opportunities.html

NORTH DAKOTA MEDICINE MARCH 2006 29

HEBRONHebron Community ClinicKim Zink, [email protected] practitioner, physicianassistant

JAMESTOWNDakota Clinic/JamestownDick Reis, Recruiting [email protected] medicine, licensedpractical nurse

MeritCare Jamestown ClinicJill Gilleshammer, PhysicianRecruiter701-280-4851jillgilleshammer@meritcare.comFamily medicine, orthopedicsurgery

KENMAREKenmare Community HospitalShawn Smothers, [email protected] medicine, nurse practi-tioner, registered nurse,licensed practical nurse

LINTONLinton Medical CenterDiansyia Volk, Clinic [email protected] surgery, registerednurse, licensed practical nurse,physical therapy

MINOTDepartment of Human ServicesMarilyn Rudolph, [email protected]

Trinity HealthShar Grigsby, [email protected], emergency medicine,endocrinology, family medicine,gastroenterology, hematology/oncology, internal medicine,neonatology, neurology, orthope-dic surgery, pediatrics, radiology

OAKESSoutheast Medical CenterTerri Kelly, [email protected] medicine

ROLLARolla Clinic PCJune Banse, [email protected] medicine

Presentation Medical CenterKimber Wralstad, [email protected] medicine, registerednurse, licensed practical nurse,clinical laboratory science

RUGBYHeart of America MedicalCenterJerry Jurena, CEO701-776-5261General surgery

Johnson Clinic PCBonnie Mattern, [email protected] medicine

STANLEYMountrail County MedicalCenter ClinicMitch Leupp, [email protected] nurse practitioner, registered nurse

TIOGATioga Medical Center ClinicRandall Pederson, CHFPPresident/[email protected] medicine or internalmedicine, registered nurse orlicensed practical nurse

VALLEY CITYMeritCare Valley City ClinicJill Gilleshammer, PhysicianRecruiter701-280-4851jillgilleshammer@meritcare.comFamily medicine or internalmedicine

Dakota Clinic/Valley CityDick Reis, PhysicianRecruitment [email protected] medicine with obstetrics

WAHPETONDakota Clinic WahpetonDick Reis, PhysicianRecruitment [email protected] practice with or withoutobstetrics

MeritCare Wahpeton ClinicJill Gilleshammer, PhysicianRecruiter701-280-4851jillgilleshammer@meritcare.comFamily practice, general surgery

WEST FARGOMeritCare/West FargoJill Gilleshammer, PhysicianRecruiter701-280-4851jillgilleshammer@meritcare.comFamily medicine

WILLISTONMercy Medical CenterJanice Arnson, VP SupportServices/Physician [email protected] surgery, orthopedicsurgery, internal medicine,medical oncology, psychiatry,pediatrics, urology, registerednurses, registered dietitian

Fishing at sunset on Lake Metigoshe, near

Bottineau, North Dakota


IN MEMORIAM

Mary Ann Keller-WakefieldMary Ann Keller-Wakefield,widow of Reed Keller, M.D.(B.S. Med. � 61), died Jan. 31,2006, at her home in GrandForks.

The Keller family hasplayed a significant role in thegrowth and development ofthe UND School of Medicineand Health Sciences. Dr.Keller, who died in 1991,served as the first chairman ofinternal medicine. Theschool�s 285-seat auditoriumwas dedicated in his honor in 1994.

�We are truly saddened by the death of Mary AnnKeller-Wakefield,� said Dean H. David Wilson, M.D.�She has long been admired and respected as a vibrantand very active advocate for education and research,especially on behalf of people with diabetes.�

Dr. Keller served as the first chairman of theDepartment of Internal Medicine when the schoolexpanded from a two-year school to a complete, four-year, doctor of medicine (M.D.) degree-granting institu-tion in the early 1970s. At the time, at age 29, he wasthe youngest person to serve as chair of a medicalschool�s internal medicine department in the country.He also was an alumnus of the school, having earned theBachelor of Science in Medicine degree in 1961.

�Through lives dedicated to medical education,research and health care,� Wilson said, �the Kellers leavea remarkable legacy which has had an enormous impactand continues to enhance the quality of life for peoplethroughout this state and region.�

Originally from Bismarck, Mary Ann (Larsen) Keller-Wakefield earned a bachelor of science degree in nursingin 1961 and a master of science degree in counseling andguidance in 1977, both from UND. In 1992, shereceived the Sioux Award, the highest honor bestowed bythe UND Alumni Association.

She dedicated many years to the advancement of diabetes education and research in her role as executivedirector of the North Dakota chapter of the AmericanDiabetes Association (ND-ADA). She built the state chap-ter into what many colleagues considered to be one ofthe most successful in the nation. Her work with ND-ADA included supervision of a summer camp for childrenwith diabetes, Camp Sioux, near Turtle River State Park,west of Grand Forks.

She is survived by her husband, Scott Wakefield;daughters, Kristen (Ray) Rohde, Fargo; Laura Keller, SiouxFalls, SD, and Julie (Dan) Keller-Cowan, Sacramento, CA,and three grandchildren.

John Bacon, M.D. (B.S. Med. '40)Santa Rosa, CA, died Jan. 12, 2006. He was 91.He earned a Bachelor of Arts degree in natural sciencefrom UND in 1935.

After earning the Bachelor of Science in Medicinedegree at the UND medical school in 1940, he went onto complete the Doctor of Medicine degree at theUniversity of Pennsylvania School of Medicine. He tookfellowship training in radiology at the Mayo Clinic inRochester, MN, and became board-certified in radiology.

He practiced in Ames, Iowa, from 1949 until hisretirement in 1979. He took a sabbatical at MassachusettsGeneral Hospital and Harvard Medical School in 1962-63. He was active in local and national medical societies,serving as president of the Rocky Mountain RadiologicalSociety and on the board of chancellors of the AmericanCollege of Radiology, serving as vice president in 1979.

Dr. Bacon is survived by his wife, Jane; three daugh-ters and two sons and their spouses; eight grandchildren,and two granddaughters.

Walter Hinz, M.D. (B.S. Med. '40)Great Falls, MT, died Jan. 11, 2006. He was 89.Originally from Lidgerwood, ND, he earned the Bachelorof Science in Medicine degree at the UND medicalschool in 1940, and went on to complete the Doctor ofMedicine degree at Northwestern University School ofMedicine.

He practiced general and obstetric medicine in BirdIsland and Willmar, MN, before retiring in 1981. He wasproud to have delivered more than 4,000 babies duringthe course of his medical practice.

He is survived by sons, Jeff (Sandy) Hinz of GreatFalls and Tom (Candy) Hinz of Bozeman, MT; a daughter,Barbara (Jim) Quale of Littleton, CO; eight grandchildren,and nine great-grandchildren.

Gary (Garold) Paul, M.D. (B.S. Med. ‘69)Colorado Springs, CO, died Nov. 27, 2005, from injurieshe suffered in a car accident in Gillette, WY, while traveling home from Bismarck.

After completing the B.S. Med. degree at the UNDmedical school in 1969, he went on to earn the doctor ofmedicine (M.D.) degree at the University of NebraskaCollege of Medicine. He was board-certified in internalmedicine.

After retiring as a colonel in the U.S. Army in 1993,he continued to serve at Evans Army Community Hospitalfor another 12 years.

He is survived by his wife, Sherrie, and daughters,Wendy Tavenner and Vicky Watt; parents, George andEunice Paul; sister, Connie Quinn, and brothers, Bill andKip Paul.

Mary Ann Keller-Wakefield


Alumni and friends can support theUniversity of North Dakota School ofMedicine and Health Sciencesthrough many programs. The endowment program highlights asolution to reducing the burden ofstudent debt while leaving a legacy atthe University in your name.

Consider this: over ninety-fivepercent of the medical school's classof 2006 qualified (and received)financial aid. Without scholarshipsupport, their average debt at graduation is projected at more than $120,000.

The generosity of one alumnus can make a difference.Meet Kara Johnson! Kara is a fourth-year medical

student who balances her life with school and family. Notonly is she at the top of her class academically, she alsohas given birth to two children since beginning medicalschool. A major reason it is working is because Kara wasnamed the recipient of the prestigious Gustave Golseth,M.D., and Wesley Morrish Medical School Scholarship,providing her full medical school tuition.

The late Dr. James G. Golseth established the endowment in memory and honor of his father, Dr.Gustave Golseth, and father-in-law, Wesley Morrish.James completed his B.S. Med. degree from UND in 1939

and became a medical pioneer in thefields of electromyography and electrodiagnosis. Dr. Golseth was gratefulfor his education, and believedstrongly in reaching back to assistthose who would follow. Because ofhis efforts Kara will carry forward thehonored tradition of excellence in thefield of medicine.

"It's such an honor to be therecipient. Interview season is expensive; the last year of school isexpensive with tests, traveling, and, inour case, daycare is more than $1000per month! It's wonderful that I canboth have a family and go to medicalschool. The scholarship has helpedout tremendously," said Kara.

For more information aboutestablishing a named endowment atthe UND School of Medicine andHealth Sciences, please contact :

Blanche E. AbdallahDirector of Development (701) 777-2004 or [email protected]

The Power of OnePLANNING AHEAD

❑ YES, Please send me more information about establishing named endowments.

UND Foundation ● 3100 University Avenue Stop 8157 ● Grand Forks, ND 58202 (701) 777-2611 or (800) 543-8764 ● www.undgift.org

Name: ____________________________________________________________________________________________

Address: __________________________________________________________________________________________

City: _________________________________________ State: __________ Zip: _______________________________

I would like you to call me at this number: ______________________________________________

at this time: _____________________________________.

I would like you to contact me by e-mail: ______________________________________________________________

Blanche Abdallah talks with Kara Johnson. Seealso Kara’s Student Profile story on page twenty.

James G. Golseth, M.D.

May 6M.D. Class of 2006 CommencementCommencement Awards Brunch, 10 a.m., UND MemorialUnion; Commencement Ceremony, 1:30 p.m., ChesterFritz Auditorium; keynote speaker: Jon Allen, M.D. � 84,assistant dean, Northeast Campus, and associate professorof internal medicine, Grand Forks; for more information,contact the Office of the Dean, 701-777-3021 or [email protected]

May 13 General CommencementUND�s spring commencement, 1:30 p.m., Alerus Center,Grand Forks; for more information, contact the Office ofStudent and Outreach Services at UND, 701-777-2724 orgo to http://commencement.und.edu

May 24-26 Alumni Days All alumni are cordially invited to return to UND for thisfun-filled annual event; honored classes are 1946, 1951,1956, 1961 and 1966; for more information or to register,please contact the UND Alumni Association at 1-800-543-8764 or visit www.undalumni.org (click on �tours andevents�); see page 26 for a partial listing of Alumni Daysevents.

University of North Dakota School of Medicine and Health SciencesThe Nation�s Leader in Rural Health Serving North Dakota Since 1905501 North Columbia Road Stop 9037 Grand Forks ND 58202-9037701-777-2516 www.med.und.nodak.edu

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What is a Profession?WHAT IS A PROFESSION?A Profession is composed of a body of knowledge, a substantial portion of which is derived from experience.

A Profession is responsible for advancing that knowledge and transmitting it to the next generation.A Profession sets its own standards... and cherishes performance above personal rewards.

A Profession is dictated by a code of ethics which includes the moral imperative to serve others.Supreme Court Justice Louis Brandeis

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