July 31, 2015

The countdown is on! We are now only about 11 weeks from the return visit by the Liaison Committee on Medical Education (LCME) to review the steps we’ve taken to address the citations emanating from the LCME’s initial visit here in 2015. As you may recall, we were found to be out of compliance with 10 of the 131 standards that medical schools must comply with for accreditation by the LCME. Under the guidance of Senior Associate Dean Gwen W. Halaas and Associate Dean Ken Ruit, the faculty, staff, and medical students have worked hard to resolve the citations and ensure full compliance with all of the cited standards. In reviewing their work, I believe that the LCME will be satisfied with the steps that we’ve taken.

But an important part of our preparation is to ensure that all in the UND SMHS family understand the areas where we were found to be deficient, and, most important of all, understand the corrective actions we’ve taken. To help with that informational and educational process, I plan to briefly review the steps the School has taken in response to each citation in my weekly E-News column. The first discussion will take place here next week, and that way I’ll discuss each of the 10 items by the time of the visit from October 18 to 21. We are putting the finishing touches on a Briefing Book that will be submitted to the LCME roughly six weeks before their visit; we are aiming for September 4 for submission of the final document. Once the finalized document is submitted, I’ll post it on our home page and invite you to review it as may be appropriate. The document is several dozen pages long without the appendixes, so it isn’t exactly light reading! Nevertheless, I’m sure that you will find that the portions of the document relevant to your role at the SMHS will help you prepare for the visit in October.

In addition to the LCME visit, two other countdowns are underway. In two weeks, Dr. Marc Basson will assume his duties as the School’s associate dean for medicine and tenured professor of surgery. Marc comes to us from Michigan State University, and he will be responsible for the School’s clinical enterprise related to medicine. The complementary dean who has been in place for about a year is Dr. Tom Mohr, who is associate dean for health sciences. All four campus deans and all the medical clinical department chairs will report to Marc, just as all the health sciences chairs report to Tom. We are counting the days until Marc arrives, and his oversight of all the medical students’ clinical and post-MD residents’ experiences will, among other things, reassure the LCME that the School has effective and efficient central oversight of the clinical curriculum as it relates to medical student and post-MD education. That concern—the lack of adequate central oversight of the curriculum—was a central theme in the LCME’s critique of our educational operation. So a hearty Welcome Aboard to Dr. Basson!

And the last countdown is this Monday, when we will welcome the 79 bright men and women who constitute the UND SMHS medical school Class of 2019. My wife Dr. Susan Farkas and I will get to visit with the students during a reception we host for them next Tuesday evening. Following that, I will oversee their first case wrap-up on Friday, during which time the students and I discuss the patient they have been studying all week as part of the patient-centered learning (PCL) small group experience. Since I’ve been doing this same case wrap-up each year at this time for the past five years, I’ve watched Ben, the actual patient in the case study, grow and mature from a boy into a high school student. And later on Friday, I’ll help introduce the students’ families to the SMHS by presenting an overview of the School, with a brief summary of our educational, scholarly and research, and service activities and accomplishments.

The highlight of the week, though, occurs late Friday afternoon. This is when we hold the White Coat Ceremony, where each student is inducted into the medical profession and presented with a white coat that symbolizes the special, unique, and sacred social contract that physicians and other healthcare providers have with patients. We have a special treat this year—our speaker at the ceremony will be Dr. Heidi Bittner, a family medicine physician from Devils Lake who has taught our medical students for decades. But more than just teach, she has welcomed them into her community, and helped make them feel at home. She is emblematic of the many dedicated physicians and healthcare providers in the state who give so generously of their time and wisdom to educate our students. I can’t say it frequently enough—thank you, thank you, thank you!

Joshua Wynne, MD, MBA, MPH
UND Vice President for Health Affairs
Dean UND School of Medicine and Health Sciences


Recent Educational Policies to Review

Conflict of Interest for Assessment.

Conflict of Interest for Standing Committees.

View all of the School's Policies and Procedures.

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UND summer undergraduate students present research on August 6

The 2015 Summer Undergraduate Biology Research poster session will be held from 9 a.m. to noon on Thursday, August 6, in the Vennes Atrium at the SMHS in Grand Forks. For the past 10 weeks, students from UND, as well as from rural and tribal colleges in Minnesota, North Dakota, and across the nation have conducted research and participated in a number of related educational opportunities.

Students participated, shoulder-to-shoulder, with their mentor scientists from the UND Department of Biology, the UND SMHS Departments of Pathology and Basic Sciences, Cankdeska Cikana Community College, Turtle Mountain Community College, and the UND SMHS Center for Rural Health.

Students receive specific laboratory training. In weekly professional development sessions, the undergraduates learn about responsible conduct of research, what is required in graduate and medical school application processes, and scientific writing, as well as learn about a variety of research areas.  At the end of the summer, the students present their work in a research poster session.
Funding for the students came from a variety of organizations, including the National Institutes of Health, National Science Foundation, U.S. Department of Health and Human Services, and the Office of the Dean at the UND School of Medicine and Health Sciences.

For more information and a list of the students and their hometowns, please read more.

Students C.U.R.E. Black Tie Gala is August 22

You are cordially invited to the Students C.U.R.E. (Caring for Underserved Regions Everywhere) Black Tie Gala on Saturday, August 22, from 6 p.m. to 11 p.m. at the Alerus Center, Ballroom 5, 1200 42nd Street South in Grand Forks. Tickets are $60, and the evening includes a social hour, dinner, silent auction, a speaker who has served with Doctors Without Borders, and a dance.

The C.U.R.E Gala will be an event for anyone to show his or her support for global and local health. Our goals are to raise over $30,000 for organizations that help in underserved regions both here and globally and to raise awareness for local and global health needs while championing interprofessional relationships and altruism among healthcare professionals. Your attendance will foster efforts to meet health needs everywhere.

Our group is made up of healthcare students and professionals who want to make a difference in people's lives not only here in North Dakota but also globally. Students C.U.R.E. is a state and federally registered 501(c)(3) nonprofit dedicated to the promotion of health and wellness and the enrichment of interprofessional medical education.

All proceeds from the evening go to Doctors Without Borders and Valley Community Health Center in Grand Forks. 

For more information, to register for the event, or to make a donation, please read more.

Thank you for your support.

Whitney Bettenhausen 
Second-Year Medical Student

Save the Date! American Indian Health Research Conference is October 23

Save the date for the 13th Annual American Indian Health Research Conference, to be held from 8:30 a.m. to 4 p.m. on October 23, 2015, at the Alerus Center in Grand Forks. The event is sponsored by North Dakota INBRE, Center for Rural Health, Seven Generations Center of Excellence in Native Behavioral Health, and the UND Chapter of the Society of Indian Psychologists.

Registration information coming soon!

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Doctor of Medicine Class of 2019 begins studies at the SMHS

The White Coat Ceremony for the MD Class of 2019 will be held on Friday, August 7, at 5:00 p.m. in the Memorial Union Ballroom on the UND Campus. An indoor picnic will take place immediately following the ceremony in the ballroom.

Heidi Marxen Bittner, MD, will deliver the keynote address for the ceremony titled "White Coat? I thought you said white GOAT!" Bittner practices as a family physician at Altru Clinic Lake Region and at Mercy Hospital in Devils Lake, N.Dak. She earned her Bachelor of Science in Natural Sciences and Honors from UND, and earned her Doctorate of Medicine from the UND School of Medicine and Health Sciences, where she is a clinical assistant professor in the Department of Family and Community Medicine. Bittner also serves as medical director and ultrasonographer for First Choice Clinic in Devils Lake and practices at the Obstetrics Outreach Clinic in Langdon, N.Dak. 

For more information and a list of students, please read more.

Host a Scrubs Camp in Your Community

The Rural Collaborative Opportunities for Occupational Learning in Health (R-COOL-Health) Scrubs Camp program is an opportunity for students in Grades 5–12 to learn about healthcare professions in fun, interactive ways. The Center for Rural Health and the North Dakota Area Health Education Center provide funding and support to communities to host a local Scrubs Camp. Grant proposals for the 2015–2016 Scrubs Camps are now being accepted.

An informational technical assistance call is taking place on Thursday, September 10, 2015, from 3:15 to 4:00 p.m. CDT. Call in number is 1-866-809-4014, Passcode 7773294. Proposals must be received by e-mail (not postmarked) by 4:00 p.m. CDT October 1, 2015.

The full guidance for submitting your proposal can be found on the Scrubs Camp project webpage. For more information or to submit your proposal, contact Kylie Nissen at the Center for Rural Health at 701-777-5380 or kylie.nissen@med.und.edu.

"Climate Change and Health—From Science to Practice"—CDC Grand Rounds

The Centers for Disease Control and Prevention's (CDC) Public Health Grand Rounds is a monthly webcast created to foster discussion on major public health issues. Each session focuses on key challenges related to a specific health topic, and explores the latest scientific evidence and the potential effect of different interventions. The Grand Rounds sessions also highlight how the CDC and its partners are already addressing these challenges and discuss the recommendations for future research and practice. July's presentation was "Climate Change and Health—From Science to Practice." All of the webcasts are archived for later viewing.

Social Media: Health Matters

On our Facebook page, Dean Wynne discusses the differences between a heart attack and sudden cardiac death in his latest Health Matters column, which can be found in the Grand Forks Herald every other Monday. Please submit any general health-related questions to healthmatters@med.und.edu.

You can also get the latest SMHS news by following the School on Twitter

University Letter: Tami Carmichael and Ryan Zerr to lead national pedagogic initiative

The Association of American Colleges and Universities (AAC&U) has chosen two University of North Dakota professors and the UND College of Arts and Sciences to develop and pilot an innovative curriculum program.

The project is the second phase of the AAC&U’s Scientific Thinking and Integrative Reasoning Skills (STIRS) initiative. The first phase involved creating case studies for a single course; the second phase will scale up to a thematic, four-year curriculum. Students completing the program will be expected to complete a long-term project, referred to as a “signature work,” that will take at least a semester to complete.

More information about this and other UND news can be found in the University Letter. Published on Tuesdays, it is distributed electronically to the University community and is always available online. For more information, contact editor Jan Orvik at (701) 777-3621.

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Singh receives over $1.7 million for oral health research

The National Institutes of Health has granted over $1.7 million to biomedical scientist Dr. Brij Singh (pictured) at the University of North Dakota School of Medicine and Health Sciences to fund his research in improving oral health.

Almost 9 million Americans suffer from the common problem of dry mouth or xerostomia, a result of decreased saliva flow from underfunctioning salivary glands. Patients with dry mouth suffer symptoms of varying severity, ranging from being an annoyance to a major detriment to general health. Chronic dry mouth significantly increases the risk of developing dental caries as well as other oral diseases.

For over 15 years, the NIH has funded the work of Professor Singh, PhD, whose research focuses on how a specific gene, TRPC1, regulates calcium levels in cells that control the secretion of saliva. The NIH recently awarded Singh over $1.7 million to continue his research on the function TRPC1 plays in saliva secretion in normal and disease conditions such as Sjögren’s syndrome, which is an autoimmune disorder—where the immune system attacks the body’s own cells and tissues. In Sjögren’s syndrome, the immune system attacks the moisture-secreting glands of the eyes and mouth. It can also affect joints, the thyroid gland, kidneys, liver, lungs, skin, and nerves.

“There is a critical need to characterize TRPC1 function and to define the molecular pathways involved in regulating saliva secretion in normal and disease conditions,” Singh said. “We have the required tools to successfully complete this project. This information will be critical to explore potential therapeutic interventions and strategies to treat salivary gland hypofunctions.”

Funding for Singh’s work is supported by a five-year R01 grant from the National Institute of Dental and Craniofacial Research, an institute of the National Institutes of Health. The Research Project Grant (R01) is the original and historically oldest grant mechanism used by the NIH. An R01 grant provides support for health-related research and development based on the mission of the NIH, which is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.

A part of the U.S. Department of Health and Human Services, the NIH is the nation's medical research agency. The NIH is the largest source of funding for medical research in the world.

Mishra and Singh receive $381,500 for oral health research

The National Institutes of Health has awarded a $381,500 two-year grant to biomedical scientists Assistant Professor Bibhuti Mishra, PhD, (pictured) and Professor Brij Singh, PhD, at the University of North Dakota School of Medicine and Health Sciences to fund their research on the role played by proteins called “galectins” in salivary gland inflammation.

Mishra’s recent studies suggest that galectins, specifically galectin-3 and galectin-9, act as novel alarmins, which are essentially self-molecules, bits of cells that present no harm to the body as long as they are safely clothed within the membranes of cells. However, during an infection or injury, these cells burst open and release self-molecules or alarmins into the medium outside of cells where they are not supposed to be. The body’s immune system sees the release of these self-molecules as a danger; the self-molecules or alarmins sound the alarm to mobilize the immune system to attack the cells and tissue where the alarmins are present—an autoimmune response—leading to inflammation that causes fever, swelling, and mouth or facial pain.
Sjögren’s syndrome is an autoimmune disease of the oral system that leads to salivary gland destruction. Almost 3 percent of the U.S. population is affected by salivary gland hypofunction, a complex disorder resulting from diseases as well as being a common side effect of drug therapy. However, the etiology as to why salivary glands are destroyed in diseases such as Sjögren’s syndrome is still not known. Recent findings have provided strong evidence that, like many inflammatory disorders, Sjögren’s syndrome has its origin in an overactive immune response against salivary tissue, thus causing glandular destruction. However, the mechanisms underlying infiltration of immune cells and development of an inflammatory response in salivary glands remain ill-understood.
In the current grant, Mishra and Singh propose that both galectin-3 and galectin-9 function as alarmins in and contribute to the pathophysiology of autoimmune or inflammatory disorders like Sjögren’s syndrome. The role of alarmins during salivary gland inflammation, injury or disease has never been studied. These are highly interdisciplinary studies because of the unique collaboration between Mishra and Singh.

“The overall impact of these studies is that it will identify novel alarmins contributing to exacerbation of salivary gland inflammation and destruction,” Mishra said. “These alarmins may be targeted for treatment of Sjögren’s syndrome and possibly other inflammatory conditions.” 

Pant and Olson coauthor International Journal of Medical Education article

Devendra Pant, MD, PhD, and Linda Olson, EdD, are coauthors of an International Journal of Medical Education article titled “Medical students’ preferences for problem-based learning in relation to culture and personality: a multicultural study.” The full article is available online

The aim of the study was to explore positive and negative preferences toward problem-based learning in relation to personality traits and sociocultural context. The study was an anonymous and voluntary cross-sectional survey of medical students in hybrid problem-based curricula in Nepal, Norway, and North Dakota. Data was collected on gender, age, year of study, cohabitation, and medical school. The PBL Preference Inventory identified students’ positive and negative preferences in relation to problem-based learning; the personality traits were detected by the NEO Five-Factor Inventory. The determinants of the two kinds of preferences were analyzed by hierarchical multiple linear regressions.

Positive preferences were mostly determined by personality; associations were found with the traits Extraversion, Openness to experience, Conscientiousness and Neuroticism; the first three are related to sociability, curiosity, and orderliness, the last, to mental health. The learning environments of such curricula may be supportive for some and unnerving for others who score high on Neuroticism. Negative preferences were rather determined by culture, but also, they correlated with Neuroticism and Conscientiousness. Negative preferences were lower among females and students living in symmetrical relationships. Some high on Conscientiousness disliked group work, and the negative correlation with Agreeableness indicated that less sociable students were not predisposed to this kind of learning activity.

Conclusions were that preferences related to problem-based learning were significantly and independently determined both by personality traits and culture. More insights into the nature of students’ preferences may guide aspects of curriculum modifications and the daily facilitation of groups.

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