Meeting #10

San Diego, California

March 31 - April 3, 2004

Present at the meeting were Drs. Marc Schuckit, Christina Delos Reyes, Karen Drexler, Katie McQueen, Gail Rose (all second year scholars), and Drs. Joseph Sakai, Sarah Book, Andrea DiMartini, and Marianne Fireman (all first year scholars). The meeting was chaired by Dr. Marc Schuckit with the help of Drs. Marianne Guschwan and Susan Tapert, along with the AMSP Administrator, Marcy Gregg. Two guests from UCSD attended, including Bonnie Nagel, Ph.D. and Carmen Pulido.

I. Wednesday, March 31st.

The meeting began as participants met in the lobby of the hotel at 6:45 p.m. Introductions were made for guests and attending spouses, and the group proceeded to Sbicca Restaurant for the evening=s dinner meeting. At that time the tentative schedule and order of events for the next three days was discussed. Scholars were reminded of their need to present their lectures, and introduced to the room in which the meeting was occurring.

II. Thursday, April 1st.

We began at 8:00 a.m. over breakfast by discussing the agenda. The specific times of presentations, and (for second year scholars) the abbreviated format or changes in potential audience was presented.

Marc Schuckit then gave a demonstration of the lecture on How To Give a Lecture. The goal here was not so much to demonstrate the lecture itself (as this had already been done at the prior meeting), but to ask both junior and senior scholars how the material might be modified to help better prepare the new scholars when they arrive in October 2004. Among the suggestions were the need to emphasize more about when data are appropriate to use and when not; discuss how the lecture can be expanded into a data-oriented lecture if needed; spend a bit more time covering the philosophic underpinnings of the lecture approach; remind the first-year scholars that they are developing an outline that can be used by other people (e.g., imaging that a resident or additional faculty member has to give one of your own lectures at a time when you are unexpectedly called out of town); expanding information on the use of a bibliographic system such as Endnotes; the importance of seeing the four main points as if they were Alearning objectives@; asking first-year scholars to select one or more tentative topics in the several weeks prior to the meeting; etc.

The discussion broadened into a review of additional approaches that might help orient first-year scholars. Suggestions included advising scholars that if they are going to take a vacation it is best done before the meeting, not after. This will increase the probability that they will be able to use the energy generated at the meeting to go home and begin implementing the changes to curricula and working on their lectures. Additional suggestions were to remind first-year scholars that the time frame for deadlines goes very quickly; advise senior scholars to be very proactive in helping the junior scholars (which resulted in a suggestion that one of our scholars develop a written guideline to help senior scholars know what to do); advise junior scholars to get a rough outline of their topic to Marc before the fall meeting ends; being certain that the junior scholars know what the deadlines will be even before they attend their first meeting; encouraging junior scholars to discuss potential topics with Marc before the meeting begins; and so on.

Sarah Book then presented her lecture on the comorbidity between substance use disorders and anxiety conditions. As was true of all of the lectures at this meeting, this was an excellent presentation that was quite effective. A number of suggestions were made by the audience to make this even stronger (with notes taken by the relevant senior scholar), and Sarah (as well as all other first-year scholars) was asked to have a finalized copy of her presentation to Marc to be loaded on the website within six weeks of the meeting.

The next item on the agenda was Gail Rose=s (a senior scholar) report regarding her accomplishments at the University of Vermont, as well as her future plans. Gail hopes to remain active in AMSP through continuing development of several papers based on her lecture, helping to facilitate an alumni group, and, perhaps, through hosting an AMSP meeting in Vermont, perhaps in September of 2005. Gail then presented her accomplishments over the last six months. These have included a noontime lecture on Motivational Interviewing to about 30 second-year students that was organized by the Psychiatry Interest Group; an OSCE (objective structured clinical encounter) workshop at the Vermont Physicians Conference on Addiction Medicine on office-based Brief Intervention, featuring a case of a heavy drinker presenting to his primary care physician=s office complaining of gastric pain and sleep disturbance, that was attended by community-based and academically-affiliated practitioners and medical students from Vermont and New Hampshire; and serving as an instructor for the first-year medical interviewing course for which she advised the director on curriculum material for alcohol use disorders and motivational interviewing, which constituted 40% of the course content. Gail is collaborating with Marc Schuckit and alumnae scholar Margaret Rukstalis on two papers: (1) How to be a mentor; and (2) Teaching Teachers: The Alcohol Medical Scholars Program. She is mentoring 8 first-year students in the Medical Student Leadership Group (meet weekly for full academic year = 19 sessions), one of whom has applied to the Betty Ford Summer Institute for Medical Students. She has been working with a resident and a medical student to develop a screening site at one of the university=s family practice clinics for National Alcohol Screening Day. In the future, she plans to discuss with the psychiatry residency director her interest in offering a workshop on lecturing and the use of PowerPoint.

Joseph Sakai of the University of Colorado presented his accomplishments over the prior six months, along with the areas in which he hopes to focus in the next six months. Since October, Joe has attempted to increase educational activities regarding substance use disorders within 1) the CU psychiatric residency, 2) the department=s substance use disorder treatment programs, and 3) CU medical school.

Psychiatric residency: Dr. Sakai met with the CU residency training director (Robert House, M.D.) and reviewed copies of all course syllabi offered throughout the residency. He noted that most lectures on substance use disorders (SUD) were given in the PG III year and that no formal lectures on SUD were given to the intern class in the current curriculum. Joe offered to develop a series of lectures (a Aprimer@ course) on SUD for the current intern class. Five topic areas were approved by Bob House (1. assessment, 2. pharmacotherapy and SUD, 3. psychosocial treatments, 4. opioid agonist treatment, and 5. treatment of withdrawal) and Joe delivered these lectures for the first time 1/04-2/04. Reviews were positive and Dr. Sakai was offered the opportunity to continue giving this lecture series annually to each incoming intern class. Because of his involvement with AMSP, Joe was also approached by Tom Crowley, M.D. to become a lecturer in the main PG III lecture series on SUD. He lectured for the first time in this course in 3/04.

Department=s substance use disorder treatment programs: Within the division of substance dependence in the CU department of Psychiatry, ARTS (Addiction Research and Treatment Services) has a wide range of treatment programs including: male and female therapeutic communities, methadone, intensive outpatient, and adolescent outpatient, day treatment and residential services. Many clinicians are less familiar with comorbid psychiatric disorders and the use of medications. Joe has therefore instituted a series of in-service lectures for these clinicians.

Medical School: Joe met with the vice-chair of education (Mike Weissberg, M.D.) within the department of psychiatry. Under the vice chair=s direction he: 1) joined the threads working group (and proposed including substance use disorders as a thread within the curriculum, 2) drafted a curriculum on treatment of SUD for medical students, 3) developed a plan to evaluate knowledge/skills regarding substance use disorders among the medical students, and 4) developed a standardized patient (SP) testing assessment of an alcohol dependent patient (recently accepted by the clinical skills working group; this SP will be piloted this spring and will be included in the third-year medical student clinical skills exam this summer). Unfortunately the proposed thread on substance use disorders was not accepted but Mike Weissberg has continued his support for including a curriculum on substance use disorders within the second-year human behavior course and the third-year psychiatry clerkship.

In the next six months Dr. Sakai will: 1) continue the intern Amini@ course on substance use disorders, 2) continue to lecture in Tom Crowley=s PGIII substance use disorders course, 3) pilot and revise the standardized patient case for inclusion in the third-year clinical skills examination this summer, 4) develop a written exam for third-year medical students testing knowledge of substance use disorders, and 5) work to develop a handbook and case-driven lecture series for medical students on substance use disorders.

Finally, Joe concluded by discussing his K08 revised application (submitted 10/03). Because in the Apink sheets@ for the first submission one reviewer commented on the need to outline a plan for development as an educator, he included a new section in the revised application, outlining activities with AMSP. Dr. Sakai recently received a priority score of 140 for this revised application.

The next order of business was Susan Tapert=s lecture on PowerPoint. Susan emphasized how to best handle texts, graphics, and footers, as well as the need to stick to 32-point font if possible. She prefers Arial fonts, as Serifs can be distracting. The major emphasis of the talk after this brief introduction was to show ways around some stumbling blocks in PowerPoint. This generated lively discussion with many additional suggestions from the scholars themselves.

As is our tradition, a working lunch was used to review issues in career development. Topics included understanding more about steps needed for promotion; the meaning of tenure; aspects of writing data-oriented papers; the importance of selecting committees on which to work; time management; how to say Ano@ when requested to do something that isn=t in your best interest; assets and liabilities of switching one=s own career focus; how to take some educational materials and turn them into scholarly papers that can give credit for promotion; and a networking-like discussion regarding ways of generating additional monies for research in education.

The last official function on Thursday was Andrea DiMartini=s presentation of her lecture on assessing alcohol use problems. This was an excellent and comprehensive lecture that was extremely well received. A number of suggestions were made for clarification of a few of the major points, and additional comments focused on how to make an excellent delivery style even more effective.

The meeting adjourned at 2:30 p.m. after a brief discussion of the agenda for the next day.

III. Friday, April 2nd.

Our group reconvened at 8:00 a.m. The first item on our agenda was the presentation by Dr. Joseph Sakai of his lecture on opioid substitution therapies (e.g., methadone maintenance). This was a clear, well delivered, and effective lecture. The material raised a number of questions from the audience (primarily reflecting how interesting the lecture itself was), along with some suggestions for reaching an even higher level of effectiveness.

Chris Delos Reyes, a senior scholar, next presented her accomplishments at Case Western Reserve Medical School.

Despite a two-month maternity leave, she has impressive accomplishments. In the last six months she gave two lectures to the second-year medical students regarding Substance Use Disorders during the psychiatry didactic series, one of which was her own AMSP lecture, and the other one was on screening and assessment. She also gave an elective lecture on Physician Impairment and Recovery during the lunch hour, using an adaptation of the AMSP lecture on this topic. Chris is working to get this into the regular curriculum, as was suggested by a student.

She continues to direct didactics on substance use disorders to the PGY-1 psychiatry residents (4 lectures) and the PGY-3 psychiatry residents (8 lectures). For the first time, she was also asked to direct didactics for PGY-4 psychiatry residents regarding treatment of patients with dual diagnosis (3 lectures). As the director of the addiction psychiatry fellowship, she has assisted in recruiting four fellows for the next academic year with whom she meets on a weekly basis. Four fellows is a huge number!

She participated as a lecturer in a two-day training for primary care physicians on buprenorphine in December 2003, and gave three lectures: one on screening for substance use disorders, one on assessment of substance use disorders, and one on co-morbid psychiatric disorders in opiate-dependent persons. This is one of the few such programs to use this forum to teach about substance use disorders.

Short-term projects include mentoring a PGY-4 resident who is presenting grand rounds on physician impairment, presenting a talk on psychopharmacology in dual diagnosis at a statewide physician=s conference, and developing a day-long addiction psychiatry seminar at a statewide dual diagnosis conference. In terms of long-term goals, Chris hopes to establish a month-long addiction rotation for all psychiatric residents, to collaborate with faculty members on a buprenorphine clinic, to continue to refine the didactics courses on substance use disorders, and to develop a comprehensive system for identifying and treating medical students with alcohol and drug use disorders.

At this point, Gail Rose, a senior scholar, was asked to modify her original 45-minute lecture into a 30-minute presentation, but this time aimed at new faculty (the topic of the lecture was How to be An Effective Mentor). Her presentation was structured to demonstrate to the first-year scholars that a lecture developed in one time frame for a specific audience can fairly easily be modified to another time frame and another audience. Gail did so well, that after the first ten minutes she was asked to assume that their had been an emergency; ten minutes had been cut from her lecture; and she would need to proceed with a 20-minute lecture to the same audience. Gail demonstrated how this can be done if the written outline is effective (so she could briefly skim to find out what to skip over and what to emphasize), and if she could keep her three or four major points in mind. She did a wonderful job, and was able to show everyone at the meeting how these types of crises that can easily develop during a class or lecture can be handled and survived.

Katie McQueen of Baylor College of Medicine then presented her report of accomplishments as a senior scholar. She remains on the Internal Medicine (IM) Core Curriculum Committee and the Resident Ambulatory Curriculum Committee. As creator of the exam for students in Internal Medicine, there is always SUD content. She teaches all IM students for one hour on Screening and Brief Intervention and one hour on Intoxication and Withdrawal. She also teaches in the residency program. Katie is working with the Addiction Scholars Program at Baylor College of Medicine (which was in part patterned after AMSP) to create a longitudinal curriculum for medical students. She was a consultant and is now Medical Director for the Harris County Hospital District Screening, Brief Intervention, Referral, and Treatment Program. This program involves training physicians and nurses in screening for alcohol and drug problems and providing prevention and intervention services for patients at the large county hospital, four community clinics, and three school based clinics. She also does several CME lectures on a local, regional, and two national related to SUDs. Her Mentored Clinical Investigator Award is continuing, and she will revise and resubmit her K23 application that was not funded. AMSP has been very important in educational and service delivery, development and delivery.

Karen Drexler, the senior scholar from Emory University, then presented a variation of her lecture on the Neuroimaging of Craving. Her goal was to modify an already effective lecture that might be optimally appropriate for research graduate students, to make it a bit easier for a medical student audience to follow. This is a very challenging task, and Karen encouraged the group to interrupt her with suggestions, especially as they might recognize the types of problems they would face with their own data or research areas. This was a very useful exercise with many suggestions that resulted in further modification of this fine presentation. The revised lecture is to be incorporated on the website.

Sarah Book, from the Medical University of South Carolina, next presented her accomplishments and future plans. As a direct result of her involvement in AMSP, she has become a medical student lecturer on AThe Diagnosis and Treatment of Alcoholism@. Also, as a result of her participation in AMSP, Sarah is incorporating her interest in alcoholism education into several of her other roles at MUSC. For example, she has used her position on the Medical Student Selection Committee to discuss the importance of addiction related issues to interviewing medical students. She has taken on a similar role on the Psychiatry Resident Selection Committee when she meets with residency applicants. In this way, Dr. Book is actively recruiting students and residents with an interest in addiction-related issues. Also, Sarah is using her position on the Medical Student Education Committee to insure that addiction-related topics are an important priority when educating medical students in her department.

With AMSP, she has been developing a lecture on the comorbidity of Social Anxiety and Alcohol Use and she recently delivered the lecture to a group of community clinicians, at her university=s ADay of Discovery.@ This was a great opportunity to expose the public to issues related to alcohol use disorders. In addition, during her introduction, her division director, Dr. Raymond Anton, mentioned the importance of AMSP and of how valuable it is for both Dr. Book and the department, and the University as a whole to have a connection to AMSP under the guidance of Dr. Schuckit. This was indeed great exposure for AMSP.

Dr. Book is also a mentor each year to a third year medical student with an interest in pursuing a career in psychiatry. Through her involvement in AMSP, Dr Book is exposing her mentee to the importance of addiction psychiatry. In addition, Sarah has learned invaluable tools from AMSP on the topic of mentoring that will make her a more effective and successful mentor.

Finally, Dr. Book has developed a poster presentation about AMSP that she will be presenting at the Annual Meeting of the Research Society on Alcoholism in June 2004 in Vancouver, BC. There she and other scholars will provide information about AMSP to highlight its usefulness and increase its exposure in the scientific community, as well as to recruit potential new scholars.

In the next six months, Dr. Book will be working on developing a medical student elective on addictions. She plans on using Dr. Tapert=s curriculum posted on the AMSP website. Also, by networking with Dr. Delos Reyes at the AMSP meeting in Del Mar, Sarah learned about a CME program for primary care physicians on addiction to incorporate into buprenorphine training. She will look into the possibility of putting on one of these sessions.

The last presentation of the morning was Andrea DiMartini=s demonstration of how to insert video in PowerPoint. This is a challenging process (which she has mastered well), and Andrea was able to give many useful points to the scholars.

The working lunch focused on additional issues important to thriving in an academic medical school environment. These included more details regarding writing papers (when to, when not to, and how), as well as an extended discussion of time management. The group also touched on how to identify specific requests by other faculty members that should be honored, and those where one can respectfully bow out.

Following lunch, Sarah Book reviewed some of the activities going on at the Research Society on Alcoholism meeting in Vancouver, British Columbia in June. Sarah took on the task of creating a poster for the RSA meeting, and this was accepted by the Research Society and scheduled for a presentation on the Wednesday of the meeting at 1:00 p.m. Sarah will (with Marcy=s help) ask graduate scholars if they will be willing to help Aperson - or man@ the booth. We discussed the importance of having computers available to demonstrate the website, as well as handouts. This also raised the issue of a breakfast at RSA on Wednesday where scholars can get together and discuss how the meeting is going for them. This will include all graduate scholars, and Marcy will send a note to all graduates, as well as current scholars, reminding any of them attending the meeting about when (7:30 a.m. in all likelihood) and where (the luncheon room food line) to meet.

Marianne Fireman of the University of Oregon next presented her lecture on alcoholism and hepatitis C. This was also well organized, had very effective slides, and had a unique benefit of teaching the members of AMSP about a topic on which they are not yet expert. A number of suggestions were made regarding ways of building in some rest periods; altering a few slides; cutting back on the number of slides used; and so on. Everyone agreed that this was a well-organized and highly effective lecture.

The group adjourned at 2:30 p.m. on Friday, after reviewing plans for a working dinner that evening, as well as the agenda for Saturday morning.

IV. A working dinner was held at a local restaurant (Il Fornio) on the evening of Friday, April 2nd. The group met in the lobby at 7:15 to walk to the restaurant, and a most enjoyable (and productive) evening was experienced by all. We were especially fortunate that Gregory McQueen was available to help us settle down with some remarkable fiddle music. Gregory was appointed as an adjunct scholar for all of the efforts he has made on our behalf over the prior two years.

V. Saturday, April 3rd.

We began with a demonstration by a senior scholar, Chris Delos Reyes of a 20-minute paired down version of her lecture on substance use disorders; does it work? She limited herself to approximately five slides with three or four major points. Once again, this is a challenging task, performed very well by Chris. A number of suggestions were made regarding creation of some new slides (rather than using slides already developed for the longer presentation, as had been initially assigned), and Chris immediately reworked her slides to demonstrate how effective the alterations were likely to be.

The meeting continued with a 30-minute new lecture by, senior scholar, Dr. Katie McQueen who demonstrated material that she has developed regarding prescription drug misuse as it might be delivered to resident physicians. As is true of everything Katie has developed for AMSP, this was focused, extremely well organized, highly effective, with excellent slides. There were a few suggestions about areas that might be clarified a bit, but we all encouraged Dr. McQueen to take this excellent lecture and make it available on the AMSP website if at all possible.

Karen Drexler, a senior scholar, then presented a wonderfully creative and very effective lecture on the use of Endnotes. Many practical suggestions were made, and Karen had some interesting and effective ways of simulating attachment to a website. The group asked Karen to consider developing a form of this lecture on Endnotes to be incorporated in the educational approaches subsection of the AMSP website.

Marc then led a discussion on AMSP recruitment and evaluation. He reminded the group of the importance of selecting individuals who are relatively early in their careers but who are likely to stay in a medical school setting for many years to come. Several candidates for next year were discussed, and Marc will close recruitment within approximately the next week.

The group then turned to a discussion of the next meeting dates and site. After a series of possibilities were discussed, the group agreed that we will reconvene on Wednesday, October 20th. The meeting site will probably be in California (perhaps Laguna Beach or San Francisco). Depending upon the strength of the dollar (all meetings must be kept within a similar range of costs no matter where they are held), we will also look into the possibility of a meeting at an easy to get to site in Mexico; a possible meeting in New York; and the possibility of returning to Hawaii.

A related topic was the timing for the next conference call. The date selected was Wednesday, July 7th at noon San Diego time (3:00 p.m. East Coast time). Marcy will work with a new group to organize the conference call.

Marcy and Susan then led a discussion of the Web site. Briefly, there were approximately 14,000 hits per month, with as many as 6000 individual visits per month. In a 30-day period, approximately 4500 individuals downloaded material from our website, with interest appearing to be widespread across our lectures, including about 10% who requested the athletics lecture; 8% the lecture on personality; and 5% medical consequences. Our visitors came from six continents including approximately 10% from Europe and 6% from Asia. About 40% of the visitors reached the AMSP website through Google, and 10% through Yahoo, indicating that they were seeking out our website because of some personal or professional problem. Other sources include 5% who directly sought out our website, and 4% who found us through Operation Cork.

Karen Drexler, a senior scholar, then presented her accomplishments and future goals at Emory University in Atlanta, Georgia. Since the last meeting, Dr. Drexler has served as Chair for a Lunch and Learn panel discussion for second-year medical students entitled ALegalization of Marijuana: Legitimate Medical Treatment or Just Blowing Smoke?@ Karen was appointed Co-Chair of the PGY-5 committee of the American Academy of Addiction Psychiatry. She has been appointed as a member of the Physician Impairment Subcommittee of the Emory University Faculty and Staff Assistance Program Advisory Board. She lectured to Atlanta VA primary care providers (Emory Internal Medicine Faculty and VA Staff members) on Evidence-Based Treatment of Substance Use Disorders in Primary Care. She submitted a proposal for a VA Clinical Merit Review research project examining topiramate for treatment of nicotine craving.

Dr. Drexler continues ongoing teaching activities, which include directing one five-week block of the Human Behavior Course for second-year medical students on Substance Use Disorders. She continues as Director of Addiction Psychiatry Residency Training at Emory, continues to direct 12 hours of didactics on Substance Use Disorders for Emory general psychiatry residents, and provides another three hours of lectures on the comorbidity between substance use disorders and anxiety and mood disorders. Karen remains the Director of Substance Abuse Treatment Programs at the Atlanta VAMC. She is in the 4th year of her Career Development Award on neuroimaging of emotion regulation in cocaine dependence, and collaborates on several experiments in neuroimaging and addiction. She is a member of the Board of Directors for Metro Atlanta Recovery Residences, a non-profit substance use disorder treatment program, and also serves as a member of the Addiction Psychiatry Certification Examination Committee of the American Board of Psychiatry and Neurology.

Next, Marianne Fireman from the University of Oregon reviewed her accomplishments and future plans. Marian Fireman of Oregon Health and Science University (OHSU) reviewed her accomplishments over the last six months and her plans for the next six months. The LCME recently completed a site visit at OHSU and as Clerkship Director for Psychiatry, Marian submitted material for the self-study process and met with several of the site visitors. The site visit went well and a positive report is anticipated. In addition, the psychiatry clerkship is currently undergoing review (a process that occurs every three years) and she will meet with the Curriculum Committee regarding the clerkship next month. She has met with two of the assistant Deans for medical student education and will have the opportunity to review the content of curricula for the first- and second-year courses with regard to teaching of substance use disorders in the near future.

She will be reviewing, revamping and adding several lectures on addiction psychiatry to the 3rd year clerkship, and Marian hopes to collaborate with several other faculty on a half-day course on addictions also taught during the 3rd year of medical school B this course will be in March or May 2005. Because of changes in the structure of the 3rd and 4th year curricula, an opportunity may exist to add a required rotation in substance use disorders to the 4th year B this change will not occur until July 2005, but planning will occur during the next year. Marian currently meets with two to three 3rd-year medical students approximately twice per month on an informal basis for discussion of patient interviewing, diagnosis, pharmacology and management. She continues to be a member of the Clinical Services Subcommittee of the School of Medicine Curriculum Committee.

With regard to resident teaching, Marian is currently Director of the PGY-2 and 3 course in addiction psychiatry; she has requested that this course be expanded to six months (instead of three months) B it is taught every other year. In addition, she has met with the Director of Residency Training. It has been recommended to the Department Chair that she be appointed to the Residency Training Committee and to a subcommittee that will consider changes to the residency curriculum B including additional time for didactics in addiction psychiatry and restructuring of the 3rd-year clinical rotation in addiction psychiatry. Dr. Fireman continues to lecture to incoming residents on intoxication and withdrawal syndromes, on various subjects in the addiction psychiatry curriculum and on neurobiology of withdrawal syndromes in the neuroscience curriculum. She currently supervises a 2nd-year resident in the outpatient clinic, a 3rd-year resident in the Hepatitis C Clinic, spends one morning per week with the consultation-liaison resident in the Liver Transplant Clinic, and had the opportunity to interview 10-15 residency applicants this year.

With regard to fellowship training, Marian will likely be appointed Associate Director of the Addiction Psychiatry Fellowship within the next few months, which will give her an expanded teaching and administrative role. Also, starting in July 2004 she will be supervising geriatric psychiatry fellows in the Geriatric Substance Use Disorders Clinic. She plans to continue to meet with the Director of Residency Training, the Department Chair, the Deans for Undergraduate Medical Education and the Dean for Graduate Medical Education, as necessary, accomplish the above activities, and identify areas in need of improvement with regard to teaching of substance use disorders.

Marian has also been appointed to be one of two representatives of the Oregon Psychiatric Association who meet quarterly with the Director and Medical Director of the Oregon Board of Medical Examiners to discuss issues of Physician Wellness.

Andrea DiMartini of the University of Pittsburgh next reviewed her accomplishments and future goals. Over the last six months, Dr. DiMartini has instituted a AHow to Give a Lecture@ series for the fourth-year psychiatry residents and fellows. The first two weeks of the seminar she gave Marc Schuckit=s PowerPoint lecture on AHow To Give A Lecture@ and Susan Tapert=s lecture on APowerPoint@. With that foundation she is meeting with the residents weekly and the group is working on developing their outlines and PowerPoint slides for their upcoming Grand Rounds presentations. She is also doing practice sessions with residents so they can rehearse their presentations in the auditorium prior to their actual presentations. Dr. DiMartini has been asked to make this a regular part of the residency training didactics.

Andrea developed and presented a two-hour seminar to the Psychiatric Epidemiology graduate students on the epidemiology and diagnoses of substance use disorders. The second part of her talk dealt with methodological aspects of substance use disorders research.

She mentored a medical student who participated on her research project. This student met with her several times a week to discuss diagnostic, recruitment/retention, data collection, and data analysis issues. The student assisted in the collection and analysis of research data. Andrea helped the student to design a poster presentation on the data and attended the poster session with the student. They plan to write a paper on this project.

During the fall semester Andrea was the preceptor for a Masters graduate student=s research practicum. This student was interested in addiction research and participated in all aspects of research supervised by Dr. DiMartini from recruiting participants, to collecting and entering data, to assisting with the analysis of the data. Andrea also gave the student a tutorial on how to give a lecture and how to make a PowerPoint presentation, and assisted the student in designing and rehearsing her presentation.

Dr. DiMartini has offered and is now giving as a standard lecture to the consultation-liaison psychiatry residents a lecture on the assessment of organ transplant patients. This lecture includes a significant component of substance use/abuse assessment and treatment referral. This will become a standard lecture to the residents.

She attended the Medical School Curriculum Committee meeting and is joining one of the Medical School Curriculum committees to develop further integration of alcohol and substance use disorders education into the first-year medical student curriculum.

For the next six months Andrea plans to survey the full Medical School curriculum to see which areas could be improved with respect to substance use disorders teaching. She will also explore options for increasing substance use disorder education into the clinical rotations. She is also considering hosting an Alcohol Screening day to provide medical students an opportunity to be educated on and practice screening for alcohol use problems. This activity would combine nicely with her presentation on screening for alcohol use and alcohol problems.

The assistant AMSP Director, Marianne Guschwan, next presented some of her observations and accomplishments at New York University. Marianne reviewed some of the activities at New York University that she started during her tenure as an AMSP scholar, including starting a rotation for medical students on the detoxification unit and a club for medical students based on interest in substance use disorders. Marianne continues to supervise a third-year psychiatry resident and an addiction fellow. She teaches a four-session course on how to prepare and give a lecture to addiction fellows who teach the medical students, as well as to give two lectures yearly to neurology residents on substance use disorders.

Marianne has become more active within the Department of Psychiatry Residency Training Program serving as a member of the Psychiatry Residency Selection Committee and the Third and Fourth Year Committee. She recently was selected to work within the Residency Training Office to provide mentorship and guidance to residents interested in research. She is supervising a resident who will be shadowing her work as the study physician on medication trials targeted toward substance use disorders as well as attention deficit disorder in adults.

Outside of NYU, Marianne was able to utilize the lecture on spirituality and 12-step groups developed for AMSP at an educational program organized by Hazelden-New York, a rehabilitation program. The lecture was given to PGY2 internal medicine residents from Columbia University who were attending a one-day seminar on alcoholism. In addition, she continues to recruit for AMSP through her activities with the American Psychiatric Association. During the past year, she was asked to serve on the board of a rehabilitation program based on the therapeutic community model, Odyssey House, located in New York. Skills gained from AMSP have helped her in presenting data to non-physician members of the board.

Next, the second Assistant Director, Susan Tapert, reviewed some of the ongoing activities at UCSD.

Susan Tapert described the ongoing and recent activities at UCSD that have been initiated or made possible due to her affiliation with AMSP. She continues with Marc Schuckit to teach an elective course to medical students on AClinical Aspects of Alcohol and Drug Use Disorders.@ Nine students are enrolled. She continues to serve as consultant to the Doctors Ought to Care (DOC) Alcohol program in the UCSD Medical School. Susan also mentors 1-2 medical students each summer on alcohol-related research projects. At the residency level of training, Susan supervises a PGY III student on relapse prevention and cognitive behavior therapy. At the fellow level, she provides an annual in-service

to the PGY II and child psychiatry fellows rotating on the UCSD Child and Adolescent Psychiatry Service on assessing alcohol and drug problems in youth and on how to prepare and deliver lectures.

Dr. Tapert is also involved with imparting clinically relevant alcohol and drug material to psychology trainees. She mentors 5-6 psychology undergraduate students each quarter, and lectures in psychology and cognitive science courses on fetal alcohol syndrome, injection drug use, and the neurocognitive effects of alcohol and drug use on adolescents. Her two graduate students and postdoctoral research fellow have been trained to deliver these lectures. Dr. Tapert continues to annually deliver a lecture on the psychiatric and neuropsychological sequelae of alcohol and drugs to clinical psychology interns. In addition, Dr. Tapert highlighted that her AMSP participation has improved her lecturing abilities, which has served to broader her speaking opportunities and thus advance her career as a research psychologist.

The meeting ended with a brief review of additional housekeeping topics, as well as announcements. We officially adjourned at noon, with good wishes to everyone for a safe and swift trip home. All scholars (junior and senior) were reminded of the July 7th conference call, and the junior scholars were reminded that our next face-to-face get-together will begin at 5:00 p.m. on October 20th.

Marc A. Schuckit, M.D.

Layout and design by Brian Klima