Surrounded by hospital beds draped in mosquito netting, Jenna Carlson was just where she wanted to be. The community hospital in Chiapas, Mexico was facing a new spike of dengue in the region this summer. With a high number of patients and only basic resources at hand, the student doctor of the College of Osteopathic Medicine helped abate the terrible abdominal pain, headaches, and muscle aches that come with dengue. Many of those worst affected were children.
“Parents were scared,” remembered Jenna, Class of 2020. “There was a lot of fear in the community because most knew someone who has had dengue. Patient education is key. Some didn’t know that mosquitos cause dengue or that death is rare if you stay hydrated and are hospitalized appropriately.”
A double major in Spanish during college, Jenna was glad for the opportunity to use Spanish in clinical settings. For four weeks, she also gained clinical experience in a well-equipped federal hospital and provided field work for the National Institute of Public Health.
The Global Health Program also enables field studies in public health. Matthew Musselman, Class of 2019, was able to support a unique research project at the rural towns surrounding Tapachula that hopes to reduce the impact of mosquito borne illnesses in the region by releasing sterile male mosquitos. Grown in the lab, these modified insects increase the competition for mates while not biting (since only female mosquitos bite), thereby controlling the mosquito population by first increasing it.
Matthew held meetings throughout the community to answer questions about the project and explain what can be done at home to reduce breeding grounds for mosquitos. Many came with specific concerns about dengue, uncertain about what actions to take and when to go to the hospital. Matthew prepared a simple and direct guide to answer exactly when a person who thinks he has dengue should seek medical care.
“This was a great learning opportunity,” stressed Matthew. “I got to work on a multidisciplinary team to help fight diseases like dengue fever, immerse myself in a different culture, and become closer to fluent in Spanish than I’ve ever been in my life.”
In its fourth year, the number of students embarking on global health rotations to Mexico City, Cuernavaca, and Tapachula has almost doubled in size.
“Students can work in very rural areas and see cases of malaria or malnutrition or they can enter the National Institute of Public Health’s headquarters and be part of a 300 person strong state-of-the-art laboratory that processes 10,000 specimens of human papillomavirus (HPV) a day,” explained Dr. H. Eduardo Velasco, Associate Dean for Preclinical Education and coordinator for the Mexico rotations. “The rotation exposes them to cultural, scientific, and medical learning experiences that they won’t find elsewhere.”
TUC’s oldest student organization, Spanish Club was founded by students from the second class of the College of Osteopathic Medicine when the college was still in San Francisco. Recognizing the need for practicing in the community, Spanish Club celebrates the richness of Hispanic culture while providing a place to speak and improve in Spanish.
The first opportunity that many club members have to engage the Spanish speaking community before going on rotation is to volunteer as translators at TUC’s Student-Run Free Clinic (SRFC).
For Michael Hagopian, club president, it was while translating at the SRFC that he was able to help a farmworker from Vallejo who had been living with chronic pain.
“He couldn’t remember how his wrist was injured,” said Mr. Hagopian, College of Osteopathic Medicine Class of 2021. “But when we started speaking in Spanish, it actually helped him remember that he had fallen in a specific way, which allowed us to better diagnose and treat him.”
It was to help students have experiences like this that Mr. Hagopian joined the Spanish Club.
“With patients, if you show them what you know and that you care to learn their language, immediately they want to tell you about their families or their culture,” he continued. “It’s like the barrier is broken down.”
The Spanish Club helps students realize their potential as Spanish speakers. For those looking to learn more, there is the Medical Spanish Elective taught by Dr. Teresita Menini, who helped start the club when the founding students first asked for help to improve their Spanish speaking skills.
“The students are aware of the large Spanish speaking population around the country and in particular in California,” said Dr. Menini. “They know that the quality of care declines when physicians cannot directly understand their patients and translators are poor substitutes to a direct conversation with a patient.”
The Spanish Club also brings students across all programs together in celebration of Hispanic culture. For Cinco de Mayo, students took dancing lessons from the Salsa Club in the courtyard. The date commemorates an unlikely victory of the Mexican army over the French Empire. This month, be on the lookout for the upcoming Día de los Muertos celebration. The campus community is welcomed to join and paint your own calaveras (skull) masks.
Last month, we printed our first edition of The Record, a paper version of the otherwise e-newsletter that is sent to your inboxes on a monthly basis.
We brought back this classic medium of communication amid the age of smart phones because paper has weight. It has substance. And it has meaning.
Although historians can date back to the earliest form of news media to 202 BC in China, it wasn’t until 1690 when the first true American newspaper was printed in Boston. A century later, freedom of the press was guaranteed in the U.S. by the First Amendment in the Bill of Rights (1791).
Newspaper reporters cover an array of subjects, many of which enlighten us to the outside world. They are on the frontline of creating content for stories that we could only imagine.
The 21st century saw a telling trend in newspapers: ad revenues and readership dropped significantly as digital online news peaked; a trend that continues to rise each year.
But print newspapers are important. They have the power to focus the reader. Unlike online news, where one can easily be distracted, a newspaper is tangible, has substance, and presents only useful information to the reader.
And that’s what this paper does – bring valuable campus information to our community. We invite you to sit back, read about your colleagues, and learn of the great things being done at Touro University California.
The month of October is a busy one for many of Touro’s student organizations. October is American Pharmacists Month as well as Hispanic Heritage Month and Filipino Heritage Month; and there will be events all month long revolving around these celebrations. Physician Assistant clubs will also be advocating for their profession during PA Week, October 6-12. With midterm elections coming up in November, Touro’s politically focused student organizations are planning events to inform our community about pressing issues as well as holding voter registration drives to get everyone actively involved in guiding the direction of our state and federal government. Keep an eye on the TUStudentLife. com webpage for more information about
The Inaugural Lamplighter Gala & Awards
This fall, Touro University California is proud to acknowledge five community lamplighters whose work in Solano County has started a spark to light the way forward for others. The Inaugural Lamplighter Gala and Awards will be held Thursday, November 15 in Farragut Inn. Proceeds will support TUC’s diversity student scholarships with the goal of further diversifying healthcare and educational professionals to better reflect the communities they serve.
THE 2018 LAMPLIGHTER AWARD RECIPIENTS
SOCIAL JUSTICE ADVOCACY
TOURO BULL AWARD
“In the Jewish tradition, lamplighters are pillars of the community,” stressed CEO and Senior Provost, Shelley Berkley. “We are excited to recognize the lamplighters who have been steadfast in showing the way for others.”
The Community Lamplighter Awards will be awarded in the areas of health, education, community mobilization, and social justice. A TUC alumnus will receive the Bernard Lander to Serve, to Lead, to Teach Alumni Award for making a positive difference in their community and field.
Provost and CAO Dr. Sarah Sweitzer expounded, “Lamplighters uphold and demonstrate the timeless values that define us as a community: respect for the inherent value and dignity of all individuals, intellectual inquiry and a passion for life-long learning, acceptance and appreciation of diversity, and compassionate service to society.”
Keynote speaker for the event, Xavier Becerra, California Attorney General and the first Latino to hold the office in the history of the state, will discuss the importance of diversity in healthcare and education as well as the issues addressing the employment sector in various fields, including healthcare.
Also being introduced at this year’s inaugural event is the Touro Bull Award, which honors those who show the noble, unbeatable spirit of the Touro Bull.
The Lamplighter will feature a live auction, cocktail reception, and full dinner with awards made possible by the generous support of the Lamplighter Sponsors. The event is $180 per person with registration requested by October 25, 2018. You may register online at: tu.edu/lamplighter2018 or call 707-638-5205. TUC Campus Community pricing available.
Two Years of the Digital Media Studio at TUC
Since opening in Lander Hall on October 2016, the experts of TUC have had a new, bright green home where their knowledge and spirit can take shape out of the classroom. The Digital Media Studio sees the production of roughly one video a week with lengths ranging from a few minutes to hour long lectures. Behind every hour of shoot time lies 15 hours of editing. That’s where Jeff Reedy, Educational Technical Support Technician and man behind the camera comes in.
“I try to execute it as a low stress thing and make it as much fun as possible,” said Mr. Reedy. “I work closely with the end client simply because I want to make sure that the product is the exact vision of what they had in mind.”
Through a combination of art and technology, Mr. Reedy pieces together videos like the OMT (Osteopathic Manipulative Treatment) Minutes.
Displaying how manipulative treatment can be applied to unique bodies, OMT Minutes make rare learning opportunities readily available for students and doctors to review. How to apply OMT to infants, patients with multiple sclerosis, or patients with concussions are just some of the recent topics that have been made available through the Journal of the American Osteopathic Association (JAOA) Youtube page.
“We were contacted by the JAOA about making different videos to show OMT techniques that are partnered with an article,” said Dr. Stacey Pierce-Talsma, Chair of Osteopathic Manipulative Medicine. “You can display an image of the anatomy while you’re demonstrating treatment to show exactly where the technique is performed at the skull or the rib cage. People often don’t realize that DOs can perform hands on treatment for many of these diseases.”
During Fall Orientation, new students were introduced to TUC’s library with a video of other students highlighting what library features they found useful during their first year.
“We thought it would be more interesting if it was other students sharing their experiences with the library instead of us just telling them what we think they should know,” said Amy Castro, Access Services & Instruction Librarian.
Students also recently took to the screen to demonstrate secure knot tying in Dr. Touraj Kormi’s suturing lab.
Looking forward this fall, be on the lookout for a new podcast from the College of Osteopathic Medicine as well as informational videos from both the College of Osteopathic Medicine and the College of Education and Health Sciences.
Jessica Poquiz, PharmD, COP Class of 2009
Born and raised in the Bay Area, Jessica Poquiz, PharmD, first fell in love with ambulatory while on rotation.
“You can really see the outcomes,” said Dr. Poquiz. “You’re with that patient through different time points, and you see their improvement. I’m glad that Touro allowed us to have two years of rotations to see all the possibilities of being a pharmacist. Beyond the counter, I was exposed to all aspects of pharmacist work. I definitely thank Touro for that.”
An ambulatory care clinical pharmacist and alumna of the first graduating class from the College of Pharmacy, Dr. Poquiz reviews the medical history and conditions of patients from throughout Northern California, beginning and monitoring the most efficacious, safe, and cost-effective psoriasis therapy for them.
Some patients have as much as 90% of their body covered by psoriasis or have debilitating psoriatic arthritis. Dr. Poquiz narrows in on to the right course of treatment by applying stepwise therapy. Starting with treatments like photo therapy before going to injectibles can be both cost-saving and avoid the burden of adverse side effects.
“We’ve seen a lot of our patients become clear or almost fully clear,” said Dr. Poquiz. “For many, psoriasis has severely affected their lives. They see their self-confidence and quality of life improve so they can go back to work.”
Her passion for care also inspired her to start her own business to help people with the most common skin care concerns, from acne to aging. Operating free from a storefront online, Dr. Poquiz is happy to see the business take off.
Puja Khana, PharmD, COP Class of 2009
Puja Khana, PharmD, wasn’t always set on becoming a pharmacist. In high school, she thought she wanted to be a physical therapist instead. But after volunteering in the field, something didn’t connect. Then tragedy struck her family with the sudden death of her sister in a car accident. Devastated, Dr. Khana put her career plans completely on hold.
“During that time, my uncle was a pharmacist at Rite Aid, and he invited me to work there as a clerk,” she explained. “I enjoyed it and became a pharmacy technician before finishing my remaining requirements to apply for pharmacy school.”
Today, Dr. Khana owns her own independent pharmacy in Roseville, Remedy RX Pharmacy and Compounding , which she opened in 2013.
“I’ve gotten to the point where I know a lot of the patients who walk in my door,” said Dr. Khana. “We talk about their recent vacations or their kids. It’s always so exciting to catch up with somebody whom I haven’t seen in a month.”
Patients can receive their prescriptions with their doses separated into daily amounts. Providing this extra step aims to keep patients at care homes or those with multiple medications out of the hospital when they lose or forget their medication.
Dr. Khana also specializes in nonsterile compounding, which includes the development of creams, ointments, gels, capsules, and troches. This level of care allows her to provide bioidentical hormone replacement therapy (BHRT) as well as many veterinary and dermatological treatments. She has also found that creams for pain relief have become more frequently prescribed in the wake of the recent opioid crisis.
“I really fell in love with the compounding sector,” said Dr. Khana. “I wanted to be able to make medications, and what we have isn’t readily available in the area. I wanted to be able to give that back to the community.”
Now almost a decade after graduating in TUC’s first class of pharmacy, Dr. Khana’s younger sister is applying to pharmacy programs too. Recently, they came back to visit the campus.
“It’s really grown a lot, like with the new library,” Dr. Khana reflected. “It’s amazing to see the improvements that Touro has made.”
Juliana Ma Crawford, Joint MSPAS/MPH Class of 2019
Rotations have been my favorite part of the Physician Assistant academic experience. They’re a chance for us to hone our clinical skills, flex our medical knowledge, and fall in love with whatever fields of medicine match our personalities. We are lucky that in our profession, we get to try out everything—from all areas of primary care, to surgery and emergency medicine, and many other specialties! It has been a delight to see my classmates and myself blossom in settings that have been a good fit.
Now that my peers and I are more than halfway through our clinicals, we are expected not only to take an excellent history from our patients and perform solid physical exams but master the identification of disease states and formulate a treatment plan that includes medication prescriptions and patient education. While it feels good to have a preceptor agree with you, those moments when you are challenged in less familiar territory have been the most memorable.
And even when you have settled into your routine, there are still situations where you cannot find your management plan in a textbook. A patient without insurance usually cannot afford to see a specialist or pay out of pocket for testing they need, and you have to develop a care plan that meets the patient halfway. Together with your preceptor, you have to be resourceful and seek out programs that help the patient achieve the best possible care. And from making that effort, you learn how to become a better and more caring provider for your patients.
Over the next 15 years, California will face a statewide shortage of primary care clinicians with a need for an additional 4,700 primary care providers. Here at Touro, we are poised to address this shortage with our focus on training primary care providers from multiple healthcare disciplines. Our emphasis on serving underserved populations leads to graduates who make a positive difference in our communities. Each new pharmacy graduate is considered a primary care provider, with nearly all graduates licensed in California and returning to local communities. Over half of our Physician Assistant graduates practice in primary care and serve in underserved areas. Recognizing that over 52% of Nurse Practitioners work in primary care, we launched our Family Nurse Practitioner Program this fall. We also graduated our first Doctors of Nursing Practice/Family Nurse Practitioners in May 2018. For the past three years, we have been #1 in the state for our DO graduates who place in primary care and serve in rural and underserved areas. We have been awarded the HERO Award from the California Primary Care Association for producing the most primary care clinicians in California. Optimization of primary care delivery over the next decade is going to be hinged on the interprofessional collaborative practice of DO/MD, PA, NP, and PharmD clinicians. Here at Touro we are training our students to become our future leaders of interprofessional primary care teams that deliver care to underserved populations.
Associate Professor of Osteopathic Manipulative Medicine (OMM), COM Class of 2008
Dr. Victor Nuño was a world traveler before hitting the age of ten. Born in Spain, he spent his early childhood in Idaho, Colorado, Panama, and Guadalajara, before settling in the Monterey Bay Area, following his father who was an air traffic controller for the US Air Force. A second-generation Mexican-American, Dr. Nuño has always looked up to his father who put himself through college after coming to the United States at 16.
A TUC alumnus of the College of Osteopathic Medicine (COM), Dr. Nuño’s approach to medicine is heavily influenced by Dr. Andrew Taylor Still’s adage, “To find health should be the object of the doctor, anyone can find disease.” In addition to teaching OMM at TUC, he is a physician and owner of Seek Optimal Health, P.C., which is an integrative and holistic medical practice serving the Vallejo community. He also plays in several adult hockey leagues at the Oakland Ice Center where he has still kept his teeth against those with much more experience.
How do you treat your patients?
I like to educate my patients, lay out all the options and make treatment decisions as a team. I understand that all treatment decisions have pros and cons, including financial, cultural, religious, and other connotations. Many times patients choose to treat empirically (without testing) due to financial concerns, or they just want to try to feel better quickly. I want to ensure that my patients make the right decision for them with the best possible information.
At Seek Optimal Health, we strive to find health. Finding health is a bit more complex than identifying and treating disease. In order to find health, we have to do thorough history and physical examination and perform cutting edge laboratory tests. When treating, we always try to work with the body, not against it. We give vitamins, minerals, herbs, and hormones that stimulate or complement natural physiologic processes. We utilize some drugs or other substances to minimize the toxic load on the body. And we treat everyone with osteopathic manipulative medicine. My osteopathic training allows me to critically evaluate all potential treatments and decide what is best for that individual patient by applying the osteopathic tenets.
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