Early Successes: Global Medicine Update from Mozambique

Since it began last summer, the Global Medicine Program at UC San Diego has sent 11 internal medicine residents to Mozambique, sparked several new research projects, and stimulated learning on both sides of this unique international partnership.

The Republic of Mozambique. Map from CIA: The World Factbook.

The Republic of Mozambique.
Map from CIA: The World Factbook.

The Global Medicine Program is a two-way exchange of faculty and residents between UCSD and the Universidade Eduardo Mondlane in Maputo, Mozambique. It is part of the Department of Medicine’s efforts to expand its involvement in global health.

“I think the program has made absolutely incredible progress,” said Dr. Constance Benson, Professor of Medicine and Director of UCSD’s Fellowship Training Program in Infectious Diseases.

Dr. Benson is a faculty director of the program.

During their 3-week stay, the UCSD internal medicine residents rotate through four different wards at Maputo General Hospital. Dr. Michael Preziosi, Clinical Director of the program, serves as faculty attending physician on site in Maputo.

Mozambican internal medicine residents

Mozambican internal medicine residents (left to right) Drs. Clotilde Tilwene, Neusa Jessen, Marilia Vida. Photo by Mike Preziosi, MD

Working together with the Mozambican doctors, the UCSD residents are encountering diseases they have never seen before and far more advanced stages of diseases frequently seen in San Diego; schistosomiasis, for example, and full-blown tuberculosis.

In one 24-hour period, Dr. Preziosi said, his patients included one who had tetanus with lockjaw, one with a liver cancer caused by a fungus that grows on peanuts, and one who had an advanced case of pellagra.

Broadening UCSD’s Internal Medicine Residency Training Program is one of the goals of the Global Medicine Program. Promoting collaborative global health research is another.

Mozambican residents at a presentation

U.S. and Mozambican residents at a presentation. Photo by Mike Preziosi, MD.

In the past six months, UCSD residents, fellows, and faculty members have begun to partner with Maputo researchers in new studies of tuberculosis and other endemic diseases.

UCSD is also introducing tools and practices that will strengthen the medical education program at Universidade Eduardo Mondlane.

A weekly journal club, instituted by UCSD residents, has been very well received.

“On the wards with the Mozambican residents, what’s going on has been really inspiring,” said Dr. Preziosi. “We’re seeing them get excited about medicine again.”This, in turn, refreshes the American residents, he said.

“I think they are getting a renewed sense of the purpose and value of the educational activities they are helping to introduce,” Dr. Preziosi said, “and are participating in them with renewed energy.”

Mozambican and American residents

Mozambican resident Marilia Vida (left) with Dr. Sarah Fox, second-year UCSD resident. Photo by Mike Preziosi, MD.

Mozambican residents will begin rotations at UCSD later this year.

“What makes our program unique,” said Dr. Robert “Chip” Schooley, “is that the transfer of capacity is being done in a peer-to-peer fashion by people who are transferring knowledge about jobs they do all the time.“The Mozambican residents see our residents as counterparts who are sharing their own experiences.”

Dr. Schooley, a Faculty Director of the program, is Professor of Medicine and Chief of the Division of Infectious Diseases. “I think this program will break a lot of ground,” he said.

UCSD faculty appointments have been granted to Drs. Emilia Noormahomed and Sam Patel, the faculty leaders on the Universidade Eduardo Mondlane side of the Global Medicine Program.

UCSD is assisting with material needs in Maputo as well.

Last summer, a UCSD team brought a supply of modern tuberculosis protective masks for the Mozambican residents’ workroom at the hospital. There is a great shortage of other basic clinical supplies.

To help meet such needs and to sustain the Global Medicine Program, Dr. Schooley and colleagues are stepping up their fundraising efforts.

“We can make a real impact on the health of this country with a very modest investment,” said Dr. Kenneth Kaushansky. Dr. Kaushansky, Helen M. Ranney Distinguished Professor and Chair of the Department of Medicine, is Director of the Global Medicine Program.

As the U.S. and Mozambican residents care for patients and pursue their studies together, they lay groundwork for stronger healthcare systems in both nations. In the face of overwhelming need in Maputo, they press forward with the resources available.

Drs. Benson and Schooley are veterans of many successful efforts to improve healthcare delivery in Africa.

“You overcome,” said Dr. Benson. “One day at a time, one patient at a time.”

* * *

The Global Medicine elective rotation is open to second- and third-year residents and to Department of Medicine faculty members from all specialties.

For more information on the Global Medicine Program,
visit http://imresidency.ucsd.edu/GlobalMed.shtml.

Read our news story about the launch of the Global Medicine Program here.

Give to our Global Medicine Program.

Internal Medicine Residents’ Research Highlighted in Symposiums

On topics ranging from the genetics of cardiac conduction to the delivery of healthcare for Iraqi refugees, UC San Diego internal medicine residents are presenting their research in two symposiums on campus this month.

The Medical Resident Research Symposiums are an annual event that highlights the residents’ work for their fellow trainees, the faculty, and the general academic community.This year, 16 residents are presenting.Residents develop and conduct their research under the guidance of faculty mentors.

The work takes place during a two-month research rotation, an elective offered in the second and third years of the UC San Diego Internal Medicine Residency Program.

Dr. Kenneth Kaushansky initiated the annual symposiums when he came to UC San Diego to head the Department of Medicine in 2002.

Kenneth Kaushansky, MD, MACP, Helen M. Ranney Distinguished Professor and Chair of the department, is a physician-scientist.

The first of this year’s two research symposiums convened on May 20.

The second will be offered on Thursday, May 28, at 6:00 pm in the Leichtag Biomedical Research Building, Room 107, on the UC San Diego main campus.

For reservations, which are required, please contact Allison Reinhardt.

Symposium flyers (PDF):

More Information:

Stepping Down in ’08: Dr. Robert B. “Brownie” Schoene, Internal Medicine Residency Program Director

After four years as Director of the UCSD Internal Medicine Residency Program, Dr. Robert B. “Brownie” Schoene will step down from his position in June, 2008.

“We support Brownie in his decision, but we are extremely sad to see him go,” said Dr. Ken Kaushansky, Helen M. Ranney Professor and Chair of the Department of Medicine.

“Brownie’s warmth, intelligence, and passion for internal medicine in all its guises, have been a huge plus for the UC San Diego Department of Medicine.”

Dr. Kaushansky made the announcement to department faculty and residents last week. He said Dr. Schoene made the decision for family reasons.

“Brownie’s devotion to our program will continue in full stride through his departure at the end of the academic year,” Dr. Kaushansky said.

The program’s new director will be Dr. Elaine Muchmore, UCSD Professor of Clinical Medicine and Director of the Hematology/Oncology Fellowship Training Program.

“We are extremely fortunate to look ahead to a smooth transition in the residency program,” Dr. Kaushansky said.

Successes in the UCSD Internal Medicine Residency Program

Dr. Schoene has guided the Internal Medicine Residency Program successfully through a period of exceptional growth and change.

He and his associate program directors have expanded the program while successfully negotiating the complexities of the new ACGME and RRC requirements.

The program now graduates approximately 30 outstanding internists every year who establish outpatient practices, work as hospitalists, receive further training as subspecialty fellows and join the ranks of academic medicine physicians.

Dr. Schoene a High-Altitude Physiology Researcher, ICU Physician, Medical Educator

Dr. Schoene came to UC San Diego from the University of Washington in Seattle, where he started as an internal medicine resident and rose through the ranks to become Professor of Medicine in the Division of Pulmonary and Critical Care Medicine.

In Seattle, Dr. Schoene established his career as a high-altitude physiology researcher, intensive care unit physician and medical educator. He was Associate Program Director of the Internal Medicine Residency at the University of Washington when he was recruited to UCSD.

A mountain climber, Dr. Schoene was a member of the 1981 American Medical Research Expedition to Mt. Everest. He was President of the Wilderness Medical Society from 2001-2004.

Dr. Schoene and his wife Kim are both specialists in pulmonary and critical care medicine. In July 2008, they will move to Bozeman, Montana, to expand the pulmonary medicine presence in eastern Montana.

There, Dr. Schoene will also head an offsite medical student and residency rotation for the University of Washington, one of several “WWAMI” sites. He will continue his clinical investigations of exercise physiology.

Dr. Elaine Muchmore an Experienced Medical Education Administrator

Dr. Kaushansky said he is extremely pleased that Dr. Elaine Muchmore will step in as Director of the Internal Medicine Residency Program.

“Elaine has a passion for medical education, and has been intimately connected to the Internal Medicine training program virtually since her arrival here,” he said.

Dr. Muchmore has served as Vice Chair for Educational Affairs of the Department since 1999. She has been Associate Chief of Staff for Education at the San Diego Veterans Affairs Medical Center for 12 years.

She received her training in internal medicine at Virginia Mason in Seattle, and her training in Hematology and Oncology here at UCSD.

“Elaine consistently wins graduating housestaff and chief medical resident teaching awards,” Dr. Kaushansky said.

“She garners high praise from students, residents and fellows for her constant willingness to go the extra mile to make an important teaching point.”

Dr. Muchmore is an experienced administrator in post-graduate medical training. She is Hematology/Oncology Fellowship director, and served previously as Interim Dean for Graduate Medical Education of the School of Medicine.

For several years, Dr. Muchmore has co-directed the American Society of Hematology (ASH) annual Training Program Director Symposium. She represents the ASH on the council of the Association of Specialty Professors as well as the AAMC Council of Academic Specialties. She is the VA’s representative on the AAMC Group on Resident Affairs board.

“Obviously, with Elaine as our new Residency Director we will accomplish as smooth a leadership transition as possible,” Dr. Kaushansky said.

“Nevertheless, we still have room to make an outstanding residency program superlative.”