January 30, 2017 - The Record
Dr. Atif Saleem, COM '16, spent last year at the Shirati District Hospital in Tanzania as part of his rotation in the Touro University California College of Osteopathic Medicine's Global Health program. Now in the pathology residency program at Stanford University Medical Center, Dr. Saleem is focused on anatomic and clinical pathology. And his experience in Tanzania still sticks with him to this day.
What was your clinical focus in Tanzania?
After the Cardiovascular-Respiratory-Renal unit at TUC, I developed an interest in pathology and wanted to see if that manifested in the hospital setting. I spent countless hours in the laboratory at the Shirati KMT Hospital, whether it was determining someone's blood type or interpreting a lymph node biopsy. One day the Shirati nursing students surrounded me at the microscope and asked me to teach them the different parasitic forms, which I was no expert in. But we all spent an hour learning them together, and that ended up being very enlightening. I bring up that anecdote because there were less than 20 pathologists in the entire country of Tanzania at the time (whose population is approximately 50 million people), and the need for teaching is essential.
What was the most impactful patient experience that you had there?
It was close to midnight one night when me and my classmates, Harjyot and Eric, were at the hospital, and a mother in the pediatric ward frantically waved her arms at us. We ran to find that her infant had experienced a seizure and then became comatose. We each performed CPR on the infant until the night attending requested we stop. It was clear that the infant had passed away. We all felt despondent and had difficulty sleeping that night since this was our first patient death. Our TUC attending Dr. Nibbe spent the entirety of the next day with us and helped us grieve and cope with what happened the night before. We discussed the likely causes of death, including Reye's syndrome, since a local healer had given the infant a white liquid which may have contained aspirin. We also discussed how to deal with patient death. Our sympathetic debriefing helped us gain closure to become not only better physicians but better humans.
What changed about the way that you approach a patient after your rotation in Tanzania? What lessons are you applying from your time there?
After my rotation in Tanzania, I approach each patient with a broader, differential, and more humane attitude. I have learnt that the "zebras" in medicine should always be considered in one's differential since they do exist and can sometimes be treated easily, for example Schistosomiasis. Lessons I am applying from my time there include being cognizant of health inequities and never considering a skill to be too basic. We take laboratory tests for granted in the United States; in Shirati, I was forced to perform blood typing by hand or learn new physical exam techniques that would give me additional, vital information since automated machines were not available.
Why did you choose the Global Health Program at TUC? What about its program in Tanzania called you to pick up your life and go there?
I chose the global health program at TUC because it provided a superlative experience in tropical diseases, which was of interest to me. I also chose the program since it incorporated clinical experience and research into one summer which I thought was efficient and effective. Plus who wouldn't want to go to Tanzania??
What's next for you?
Most pathology residents do a 1-2 year fellowship, and I am considering cytopathology since it is intriguing and has global health relevance. My ultimate plans are to teach and practice pathology on the global scale and maybe one day be a part of the World Health Organization (WHO) Assembly.
For more information on TUC's Tanzania rotation, go to: http://com.tu.edu/globalhealth/tanzania.html
20/20 Series - Stronger Together: TUC's Spouses in Teaching and Research, Dr. Alejandro Gugliucci and Dr. Teresita Menini
For nearly 20 years at TUC, married couple Dr. Alejandro Gugliucci and Dr. Teresita Menini have published a wealth of papers, studies, and textbook chapters together. Throughout their careers, they supported each other's work, which ranges from diabetes and atherosclerosis to how yerba mate lowers cholesterol. It was in the school of medi cine at the University of Montevideo, Uruguay that they first met as students, then colleagues at the Department of Clinical Pathology and today they remain each other's best (and even bluntest) critics.
"There was a time when I didn't have any help, and the only help that I had was my wife," tells Dr. Gugliucci. "If I had too many classes at the time, she would go down and do my experiments, and vice versa."
Dr. Menini adds, "Sometimes he presents to me a new idea, and I just go for the weak points. He is the creative one. But I am very critical."
"Hypercritical," jokes Dr. Gugliucci, and the two laugh together.
"It happened today. Those are my rambling ideas for a grant." Dr. Gugliucci mentions, pointing to the white board. "I presented it to her, and she came up with all the missing parts. 'What are you going to do if this doesn't work? What is the future of this? Where are you going?' But when I gave her all my answers, she said okay, that's good."
Life has taken Drs. Gugliucci and Menini all over the world, but for 20 years they have called TUC their home. They first left Uruguay to pursue further education in France. Then they brought their children to Montreal where Dr. Gugliucci served as a professor. But after four years, they took the opportunity to help start a new Osteopathic Medical School at TUC. Dr. Gugliucci is one of TUC's first four founding faculty members. And Dr. Menini volunteered in the labs and founded the Medical Spanish Club before becoming a professor in 1999 with the move to Mare Island.
Dr. Gugliucci received TUC's first grant for $50,000. He became Research Director in 2004, and has seen the grants at TUC increase to several million dollars as Associate Dean for Research. Dr. Gugliucci left the Basic Science department in 2009 to start the Department of Research with the support of Dr. Michael Clearfield, Dean of the College of Osteopathic Medicine.
And it was Dr. Menini who performed TUC's first study involving students along with Dr. James Binkerd, who was teaching osteopathic manipulative treatment at the time and is now Associate Dean of Student Affairs. Together, they set out to find how a certain kind of osteopathic manipulation could help reduce stress for students. Today as Assistant Dean of the Clinical Faculty Department, Dr. Menini provides development for TUC's clinical faculty.
Drs. Gugliucci and Menini's first priority has always been teaching. And in TUC, they found a student-focused medical school where they can engage students individually.
"What I like are my labs," says Dr. Menini. "Because it's in the lab that I can have this one-to-one relationship with the students and I can see them work and think, which is the most important part in this."
And Dr. Gugliucci agrees, "It's about having an interaction with an intelligent person who's not simply waiting for you to give them the answers to the test. As a doctor, you always look for your legacy, and you're looking at the patient who comes after the doctor, that's your responsibility."
Follow the rest of the 20/20 Anniversary Series at tu.edu/2020
Dr. Keith Yoshizuka, Chair of Social Behavioral and Administrative Sciences, and Dr. Eric Ip, Chair of Clinical Sciences from the College of Pharmacy, spearheaded the approval of an Advanced Pharmacy Practice certificate program in collaboration with the California Society of Health-System Pharmacists (CSHP). This innovative program will consist of over 30 hours of training and prepare pharmacists who wish to pursue the newly issued Advanced Pharmacy Practice licensure.
The program will be delivered by Touro University California College of Pharmacy faculty (Drs. Emily Chan, Shadi Doroudgar, Eric Ip, Melissa Kirkpatrick, Keith Yoshizuka). It will train pharmacists to perform patient assessments, order and interpret drug therapy-related tests, participate in evaluating and managing diseases with other health care providers, and optimize medication therapy via initiation/adjustment/discontinuation.
This advancement is yet another example of the College of Pharmacy's contribution to the profession's commitment to lifelong learning. The Advanced Pharmacy Practice (APP) license allows the pharmacist to take the type of collaborative practice that has up to now been restricted to a hospital or clinic environment, and allows this increased access to care in any venue.
Find out more at cop.tu.edu/programs_degrees/APPcertificate.html
Sometimes the best way to see yourself is to turn to your neighbor.
New Associate Professor of the Graduate School of Education, Dr. Michael K. Barbour, has recently released his ninth annual "State of the Nation: K-12 E-Learning in Canada ". He explains that not only is the study a unique tool for Canadian policy makers, but that the US can also learn more about e-learning by looking at different approaches.
"In contrast to the US where the idea is that we need to be proliferating this wave of the future in online learning," explains Dr. Barbour, "Canada's biggest question comes down to 'Is this the best way for a child to learn at this time?'"
Both the US and Canada have seen similar levels of growth in the number students engaged in distance learning. But Canada primarily uses e-learning as a supplement to the classroom, while there is a much higher proportion of full-time e-learning in the US.
"This is important because in the United States the growth has largely been advocated for by for-profit corporations," says Dr. Barbour , "whereas in Canada that growth has been largely due to the necessity to provide equitable access to education and/or due to conscious decisions by practitioners about the appropriateness of its use for their students."
Dr. Barbour continues, "In Canada, K-12 online and blended learning began as a way to serve students that didn't have access to certain aspects of the mandated curriculum, but it has evolved into an option that teachers have to better serve their students as another arrow in their pedagogical quiver. There are still some elements of this in the United States, but it tends to be dwarfed by free market principles."
Dr. Barbour's project is the most complete study of its kind in Canada and demonstrates that enrollment in blended and online learning courses continues to increase. The report collects data for Canadian education policy makers that would otherwise fall through the cracks.
"There is no national department of education in Canada. Often one province doesn't really know what the others are doing," explains Dr. Barbour. "Ontario and Atlantic Canada are highly centralized, while most of the West of Canada goes largely unregulated. But all parts of the country are finding similar results in growth."
For a complete look at the study, please go to: http://k12sotn.ca/
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What is a way that your family has shaped who you are?
[Andrea Garcia] My mom instilled the value of determination and hope; to never give up on my dreams and to believe in myself wholeheartedly. And I'm fortunate that my husband supports the realization of these dreams.
[Diyosa Carter] I'm an only child but come from a big extended family. My mom is one of ten, and I've lost count of the number of cousins I have. After my dad passed away, I was raised mostly by my mom, grandmother... and 5 of her sisters. They taught me how to be both strong and soft, something I'm working on passing on to my own 3 daughters.
[Guy Remo-Aguigui] My family has been very influential in shaping who I am today as a person by providing me with a strong background of our Filipino culture, including learning how to read, write, and speak Tagalog fluently, while learning English and American history. They were all about meshing together the Filipino and American way of life, and they taught me that family and faith are the most important things that I could always count on for support to help me deal with everyday life.
[Alan Berquist] I come from a long line of strong women educators and my great-grandfather was an ER surgeon. From a young age, respect for teaching and culture lead to embracing efficient and creative solutions.
[Nicholas Crawford] Put simply, my brother is my counterpoint, my parents are my emotional grounding, and my wife is my life.
What luxury item would you bring with you to a desert island?
[Andrea Garcia] Can I call my husband a luxury item?!
[Diyosa Carter] I'm fairly used to roughing it from camping and backpacking trips, so I would bring writing/drawing supplies. Lots of notebooks and pens so I can write out my thoughts, draw, make paper airplanes and later use the paper to help with fires.
[Guy Remo-Aguigui] It may not seem luxurious but I would bring a lighter with me, since I know I'd have a very difficult time trying to start a fire on my own. Fire would provide me with heat to keep me safe and warm at night, along with providing flames so I could cook food and boil water.
[Alan Berquist] A blender for making all those coconut drinks? Or perhaps an iPod full of music.
[Nicholas Crawford] If I can't have working internet, I'm going to go there with blank journals and pens. That way, I can make my own. Or at least I'll have the obligation to be making something when I'm off embracing nature and living primally.
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