Conference Call #6

June 20, 2005

The conference call began at 11:45 noon (San Diego time). Present on the line were Drs. Schuckit, Guschwan, Tapert, Book, Sakai, DiMartini, Fireman, Brown, Hernandez-Avila (and by e-mail before the meeting—as with a new baby, she was unable to attend), Alisa Busch, along with Marcy Gregg.

The meeting began with a brief review of the fact that we have only one hour to cover a fairly large amount of things, so we would focus only on the most salient issues.

The first item on the agenda was for the Senior Scholars to review their accomplishments and the programs instituted at their medical schools after they leave AMSP.

Sarah Book has been busy since our meeting in New York. She recently received her Masters of Science in Clinical Research and is in the process of preparing an R21-type federal grant on the treatment of alcoholism with co-occurring social anxiety disorder. She will be submitting this to the National Institute of Alcohol Abuse and Alcoholism. She is also presenting a poster at the Research Society on Alcoholism (RSA) on alcohol expectancies in medical students, and a symposium on an economic model of alcoholism with and without co-occurring anxiety disorders.

As a direct result of her involvement in AMSP, Dr. Book is co-investigator on the educational component of a P60-type Alcohol Research Center grant. If this submission is funded, she will be the primary educator of medical students and residents on alcoholism.

Joseph Sakai is working with the new Residency Training Director at Colorado and continuing to emphasize the need for expanded information on substance use disorders. He is also hoping that the medical school curriculum changes in substance use disorders he proposed last year will now be developed into a Web-based program for medical students which will, hopefully, be part of the ongoing curriculum.

Andrea DiMartini told us that since the March meeting in New York she has arranged and given a half-day drug and alcohol teaching session to the first-year medical students (120 students attended); gave her "Clinical Assessment of Alcohol Use" lecture and Alisa Busch’s” Dependence as a Chronic Medical Illness." A video showing a substance-impaired patient being interviewed was used as an interactive tool, stopping it periodically and asking the students to identify symptoms, diagnostic criteria, or to comment on interviewing techniques.

She will be meeting with the new Director of Psychiatry Training for medical students to coordinate the lectures through the four years to make sure all substance-related topics are covered and that topics area relevant to their level of training. In July she will start a professional development series for psychiatry residents. Over the past two years she has been giving the "How to Give a Lecture," “How to Outline" and "How to Use PowerPoint” lectures. This year, in addition, she will add Karen Drexler’s "Managing References" and Gail Rose's "Mentoring" lectures.

Andrea has been assigned a psychiatry resident to mentor and they are working on a paper on quality of life in patients transplanted for alcoholic liver disease. She has a poster at RSA in July on alcohol use outcomes following liver transplantation for alcoholic liver disease.

Her article on smoking in alcoholic liver disease transplant patients was published and has received media attention. She has also been invited to give surgical Grand Rounds at Cleveland Clinic on alcohol use following liver transplantation.

Marian Fireman continues her work lecturing on hepatitis C and liver transplantation. She was responsible for delivering a major lecture at a national VA Conference; is working on the core curriculum for new psychiatric residents; was officially named Director of a seminar given to second and third-year residents; and is working on optimizing substance use disorders lectures in the core curriculum. Marian is part of the Dean’s Office efforts to obtain a Social and Behavioral Science educational grant for the medical school. She is also working with Andrea DiMartini presenting information at the Academy of Psychosomatic Medicine, and has been invited to give Grand Rounds at the Mayo Clinic.

The first-year scholars also reported their progress.

Carlos Hernandez-Avila recently published a prominent paper on genetic markers for the response to alcohol as a risk factor for alcoholism. He is working to expand electives on substance use disorders, with the major emphasis on a four-week rotation on his dual diagnosis unit for third and fourth-year medical students. He continues to enhance the number of hours of substance use disorders-related teaching at Connecticut, is now a member of the committee evaluating substance use disorder-related problems in medical students (proactively reaching out to the students themselves), and is serving as an ongoing consultant to the National University of Mexico for a project reaching out to 200,000 students, outlining the rate of substance-related problems among students at national universities in Mexico.

Randy Brown is actively working toward his Ph.D. (in addition to his M.D.), and will be presenting ideas to his doctoral committee this fall. He is enhancing his outreach to first, second, and third-year medical students, including rotations through his clinic, teaching more regarding buprenorphine, and the creation of electives. Randy is considering taking on the role of Medical Director for a needle exchange/naloxone program to decrease the rate of lethal overdoses among opioid-dependent individuals. In addition, Randy participates in a panel developing guidelines for the appropriate treatment of chronic pain and avoiding the development of abuse or dependence among such patients. This will be a University of Wisconsin-wide effort. Finally, Randy is active in an undergraduate course in sociology regarding drug use and the criminal justice system.

Alisa Busch continues to explore opportunities to educate students at Harvard Medical School regarding substance use disorders, including additions to the curriculum and meeting with student groups who have expressed an interest in psychiatry or primary care. She is also exploring ways she can teach medical students about addiction during their psychiatry rotation on the addiction service at McLean Hospital. Additionally, this fall, she will participate in a new program for the PGY-3 psychiatry residents in the Psychiatry Residency Program. In this program, she will meet four times through the year with a group of PGY-3 residents who will observe her interviewing a patient from the detoxification unit. A general discussion will follow the interview.

In the remaining time, our group discussed our get-together at the Research Society on Alcoholism meeting on June 24, 2005; the guidelines for recruitment for new scholars for 2006; and plans for the new 2005 scholars, and for the meeting in Hawaii in September. Marianne Guschwan had several excellent candidates from universities not yet represented, and she was encouraged to ask them to follow through with a letter and copy of their CV to Marc.

The meeting adjourned after one hour with warm wishes for the Senior Scholars rotating off AMSP. “Y’all come back and see us!”

Marc A. Schuckit, M.D.

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