Minutes of the Alcohol Medical Scholars Meeting
Present at the meeting were
First Year Scholars: Christina Delos Reyes, Karen Drexler, Katie McQueen, Gail Rose,
and Joe Thornton, Second Year Scholars: Evaristo Akerele, Margaret Rukstalis,
Woody Levy, and Steven Madonick; invited guests: Valger Dur (Iceland) and
Roberta Agabio (Italy). Hosted by Marc
A. Schuckit, M.D., with assistance by Susan Tapert, Ph.D., and Marianne
Guschwan, M.D., along with Marcy Gregg.
I. Wednesday, October 23rd (The Introductory
Session)
After arrival at the Montague hotel, our group convened at 6:45 p.m. Introductions were made all around, and we proceeded to a separate room in Vasco’s Restaurant for dinner and discussions. The agenda and goals for the following days were discussed, and Junior Scholars were reminded of their need to select a topic, outline potential activities at their university over the upcoming year, and to select a Senior Scholar as a mentor.
II. Thursday, October 24th
The
meeting began at 8:00 a.m. with a review of the final itinerary for that
day. The various topics were discussed
including the importance of using an outline form for lectures and the fact
that all participants had taken the opportunity to review the website.
The
first formal presentation was an extended discussion of the lecture: How to
Give a Lecture, by Marc Schuckit.
This involved great detail relating to literature reviews, taking notes,
sifting through information to that most relevant to the individual, and the
use of an outline form. This session
also gave the opportunity of demonstrating the production of slides, and more
formal aspects of the presentation itself.
These discussions occupied most of the morning.
A
working lunch was accompanied by a discussion of career development issues. These included topics on how to choose a
mentor, the steps usually required for promotion, and some of the assets and
liabilities of various grant applications such as K Awards.
The
final session of the day gave the opportunity for Woody Levy to demonstrate
his lecture. This was presented as
it would actually be given to medical students, and the full 45 minutes was
used. The presentation was then
discussed in the context of the morning’s first lecture on How to Give a
Lecture.
Thursday’s
work ended with a review of Friday’s schedule. All participants were on their own Thursday evening.
III. Friday, October 25th
The
morning began with a review of the outline developed by Margaret Rukstalis
regarding goals, methods, and details for the development of lectures.
Marc
Schuckit then demonstrated how a 40-minute lecture can be cut back to 20
minutes. Both the long and short
outline were handed out and discussed.
Continuing
with the discussion of lecture style and organization, Susan Tapert
demonstrated her lecture on The Effect of Alcohol Advertising among Youth.
Steven
Madonick, a Senior Scholar, next reviewed his accomplishments to date at Yale
as an AMSP scholar. These included: participation in the alcohol
and drug-related issues for the Yale grant on the Importance of Geriatric
Issues in the Medical School Curriculum; the incorporation of material related
to substance use disorders in existing lectures, including those on
schizophrenia; education of staff of the clozapine clinic regarding
substance-related topics; and enhanced visibility of alcohol and drug-related
education among his research and clinical groups at Yale. In the future, Steve hopes to incorporate
more lectures including the presentation on How to Give a Lecture, and enhance
the substance-related education in the residency.
Woody
Levy next presented his update of accomplishments
at the University of South Florida.
Woody began a year ago with very little in alcohol education at USF, but
has had excellent help from Dr. Odorica and Dr. Frances. His work these last 12 months has included:
active participation in the substance-related disorders fellowship; development
of a lecture series for that group; developing a substance-related inpatient
component of the fellowship which now runs for six weeks full time;
incorporation of substance-related material into the general psychiatry
residency; having all psychiatric residents rotate through the outpatient
substance use disorders treatment program; beginning a series of 12 two-hour
lectures for psychiatric residents; running of three two-hour workshops each
year for medical students on topics related to substance use disorders; and
working to develop a psychiatry substance use disorder rotation for medical
students. At the same time, Dr. Levy’s
prominence in his Department has markedly expanded as he functions as Chief of the
Inpatient Substance Use Disorders Unit, and Chief of the Emergency Psychiatric
Service. He was recently named
Assistant Chief of Psychiatry, is a member of the Medical School Education
Committee, and developed a relationship with the Residency Education
Committee. Woody also works with the
Dual Diagnosis Program, and this last year became Board Certified in Addiction
Psychiatry.
Steve
Madonick next presented a brief version of his geriatric substance use disorder
lecture developed for AMSP. He volunteered to demonstrate how a
30-minute version (originally developed from the full 45 minutes) could further
be cut down to ten minutes—and to present how he would arrange such slides as
the kick-off for the Saturday morning session.
Margaret
Rukstalis reviewed her accomplishments at the University of Pennsylvania, emphasizing that her relationship with AMSP has
helped give her visibility in a department where substance use disorders issues
were already relatively prominent.
Specifically, she has: added new alcohol and drug-related cases to the
first-year case discussion series; presented her lecture on Substance Use
Disorders in Women to first-year students; offered a lecture to a subgroup of
first-year students regarding how to give a lecture; worked with two separate
groups of between 10 and 20 minority medical students on a similar topic, as
well as teaching about her alcohol and nicotine lecture; and is now working on
the development of an elective for first-year students. For psychiatry residents, Margaret helps
coordinate the substance use disorder lecture series, has helped develop a
three-month block for third-year residents where substance use disorder
material is discussed, and she is involved with individual supervision of two
hours per week with a fourth year resident, with much of the material dealing
with substance-related issues. For
fellows, she serves on the Executive Committee, is a mentor for substance use
disorders fellows, and is a teacher in the program. Next year, Margaret hopes to expand this work, as well as
establishing a liaison with the treatment program at the VA Hospital as a
potential venue for teaching psychiatry residents and third-year medical
students.
The informal
lunch time discussion of career development issues focused on problems in
career development for women, steps that can be taken to balance personal life
and professional life, finding appropriate mentors, appropriate use of free
time, and ways of limiting activities by knowing how and when to say no.
In
the final session of the day, Evaristo Akerele gave a brief version of the
manner in which his lecture on Substance Use Disorders among Schizophrenics
might be presented. Plans were made
for him to actually present a subsection of this material directly the next
morning.
IV. Friday, October 25th evening get-together
The group reconvened in the lobby of the hotel and proceeded to Le Deuxieme restaurant for our discussion of issues and celebration of accomplishments. The Junior Scholars were reminded that the Saturday session would focus primarily on their announcements regarding their lecture topics, senior supervisor, and goals.
V. Saturday, October 26th.
We
began with a 15-minute section of Evaristo Akerele’s lecture on
Schizophrenia and Substance Use Disorders.
A number of issues related to slides and his excellent presentation
style were discussed.
Susan
Tapert then gave an update of accomplishments at UCSD. These
included her work with the DOC Program; the excellent manner in which the
medical student elective is progressing; both her work, as well as that of Marc
Schuckit with medical students individual study projects; Marc’s lecture about
How to Give a Lecture; the input that both Susan and Marc give to the
Psychology Training Program; consulting with the Child Psychiatry Fellowship on
integrating substance use disorder information into the curriculum; as well as
the development of a new substance use disorders psychology fellowship through
both UCSD and SDSU.
Susan
next reviewed the website. In the nine and a half months between
January 1, 2002 and approximately October 15th, the website had over
56,000 hits and about 17,000 visits. In
September this included 75 unique visits per day from approximately 2400
different sites. She reviewed the search
strings that were used, the referral source, and the specific components of the
site most often visited.
Marianne
Guschwan next gave her update from NYU. She has successfully implemented a club
(similar to an elective) on substance use disorders, developed a new rotation
for third-year medical students, and is reaching out to the internal medicine
residency regarding substance-related problems. Marianne continues to develop workshops on How to Give a Lecture,
where she prominently cites AMSP. She
is also teaching medical residents in the Physicians in Residence Program at
Hazelden New York, and developed a Lunch with the Experts on education in
addiction at the American Academy of Addiction Psychiatry. Marianne published a paper on AMSP for the
Association for Academic Psychiatry, and continues to work with medical
students as well as fellows.
Margaret
Rukstalis then presented her lecture on Nicotine and Alcohol. This was
done as a 30-minute version, and she was able to demonstrate how well a lecture
can work even when shortened.
Evaristo
Akerele then presented his accomplishments at Columbia. He has been
very active in teaching second-year residents about substance use disorders,
reaching out to PGY3 residents, teaching fellows, and working with other
prominent substance use disorder experts at his university. Evaristo is the Assistant Medical Director
for the program headed by Dr. Herb Kleber, and is working with his department
regarding the relevance of slides and lectures using a format somewhat similar
to AMSP. In the future, he hopes to
continue to teach at major meetings, and is part of a proposed workshop and
symposium at CPDD.
Our
two guests, Valger Dur (Iceland) and Roberta Agabio (Italy), next reviewed
their impressions of AMSP, what it is they gained from the meeting, and
suggestions regarding additional such participants in the future.
Susan
Tapert then presented her overview of
PowerPoint.
The
meeting then turned to the presentation by the new scholars regarding their topics
and goals.
Joe
Thornton selected the topic of “PTSD
and Substance Use Disorders” and will work with Woody Levy as the Senior
Scholar. His goals include documenting
what already exists regarding alcohol and drugs at the University of Texas
Health Science Center, working with the Chair of his Department regarding
expanding substance use disorder materials in the residency, and reaching out
to house staff regarding education on substance use problems. He is considering the possible development
of an elective based on the AMSP material developed by Susan Tapert, and of
beginning to work with a DOC program.
Katie
McQueen of Baylor College of
Medicine, will develop a lecture on “Alcohol and Cocaine,” working with
Evaristo Akerele as a Senior Scholar.
Her goals will include seeking to expand her work at the University
through a joint appointment with psychiatry, establishing collaborations on
substance use disorders education and research, potentially developing an
elective for first- and second-year medical students, possibly developing a
fourth-year clinical elective on substance use disorders for medical students,
working on developing a lecture on the genetics of alcoholism that might be
appropriate for the Department of Medicine, and participating in the
skills-based half-day sessions on screening and intervention—being sure that
substance use disorders are represented.
Gail
Rose from the University of Vermont
has selected as her topic the “Process of Mentoring,” and will work with
Margaret Rukstalis. Her goals at her
University include developing a lecture on How to Give a Lecture, work toward
an elective rotation through the research laboratory, and continuing to expand
her efforts in her medical school regarding a variety of medical school and
resident education projects. Since
being selected as an AMSP scholar this summer, Gail has already worked to
impact on psychiatric resident education in alcohol and drugs, and is working
toward getting on the Residency Training Committee. She is also working to develop up to six session to be
incorporated into the Journal Club relating to reading and understanding
papers, and is attempting to make substance use-related issues prominent. Gail now serves on a group looking at the
optimization of the medical school curriculum, and hopes to be able to
incorporate alcohol and drug-related issues into the first year series that
relates to medical skill development.
Furthermore, she is working on using alcohol and drug-related subjects
for the medical school course on interviewing skills. In the future she hopes to expand her work with a DOC-like
program while considering development of an elective course.
Karen
Drexler, from Emory University, will
work to develop an AMSP lecture on “Craving,” selecting Steve Madonick as her
Senior Scholar. The goals for her first
AMSP year take advantage of the fact that she already occupies a relatively
prominent role in her school.
Therefore, she hopes to: expand her work in training junior faculty to
help her teach in the addiction fellowship, implement some of the skills
learned from AMSP for use in her roles as Director of the Substance Use
Disorders Treatment Program at the VA Hospital, and Director of the General
Psychiatric Course on Addiction Psychiatry.
She also hopes to be able to lobby for incorporation of medical students
in a clinical rotation on the substance use disorder unit at the VA Hospital,
improve the five-week block in addiction psychiatry for second year medical
students, and she is planning to join the Impaired Physician Committee.
Chris
Delos Reyes from Case Western Reserve
University has chosen the topic of “Presenting Physicians with Evidence that
Treatment for Substance Use Disorders is Effective.” For this, Marianne Guschwan has agreed to serve as the immediate
supervisor. As Chris also occupies a
relatively prominent role in her medical school, she hopes to use the skills
gained from AMSP to help her with her 90-minute lecture on Impaired Physicians,
and her activities in teaching general psychiatry. She will also implement some of her skills for enhancing her
three hours of lecture on substance use disorders to the PGY1 residents, and
for an elective series for PGY3's.
Chris currently functions as the Addiction Psychiatry Fellowship Assistant
Director, and as a liaison to the Medical School Physician Wellness
Program. Her goals will also include
obtaining a position on the Medical School Education Committee, working with
fellows on how to give lectures, and optimizing the curriculum in the Addiction
Fellowship. On a longer-term basis,
Chris hopes to work to expand the clinical experience in substance use
disorders of PGY2 residents.
We
next turned to a discussion of the time and place for the spring, 2003 AMSP
meeting. The meeting is to take
place from 5:00 p.m. on Wednesday, March 26th through noon on
Saturday, March 29th. The specific
place and activities will depend upon the determination of costs for the
current London meeting as we try to stay within our yearly budget. We had considered San Francisco, but this is
not appropriate because the American Psychiatric Association will be there the
following month. It’s also possible
that we may choose to meet in San Diego, Laguna Beach near San Diego, and,
although not directly discussed at the meeting, we hope to consider a potential
meeting in New York sometime over the next year or so. If money permits, and considering the fact
that several of our scholars live in Texas, it might be cost effective to hold
the meeting someplace in Mexico, and Marc’s office will look into this.
The meeting
adjourned shortly after noon on Saturday, October 26th. All participants returned home with a full
agenda of tasks. We will next get
together on a conference call for one hour approximately three months from the
October meeting, tentatively scheduled for a noon time (San Diego time) in
mid-January. Marcy will work toward
potential dates by contacting everyone in December.
Marc
A. Schuckit, M.D.
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Potential Activities for Enhancing Education on Alcohol
and Drugs at Medical Schools
November 18, 2002
I. Actions relevant to medical
students:
A. Add new lectures and improve upon existing
lecture formats regarding substance use and disorders in courses offered to
year 1 and 2 students. These can
include lectures on liver disease, neurology, AIDS and other immunodeficiencies,
psychiatry, introductions to clinical medicine, and so on.
B. Offer an elective one session noontime
discussion for first and second year students dealing with the nature of
substance use disorders, how to identify them among patients/school mates,
relatives, and approaches for intervention.
C. Develop an elective for first or second year
students, including the ten-session, one hour each, patient
description-oriented elective listed on the AMSP website.
D. Join with an ongoing Doctors Ought To Care
(DOC) program, or help develop a new group if one does not exist. DOC offers medical students the opportunity
to visit local schools to discuss issues related to alcohol and drugs.
E. Develop independent study programs for
medical students where clinical or basic research issues focus on alcohol or
drug use disorders.
F. Carry out a survey of existing medical school
courses to document what is currently being offered on alcohol and drugs as a
starting point for what needs to be done.
G. Work with the faculty responsible for the
third or fourth year psychiatry clinical rotation to explore how lectures on
alcohol and drugs can be fit into the curriculum, and how a rotation to an
inpatient or outpatient substance use disorders treatment program might be
instituted.
H. Work to become a member of your department’s
Medical School Education Committee.
I. Meet with the Chair of your department
and/or the Director of clinical services to determine how alcohol and
drug-related education might be better incorporated. This will both provide information on AMSP, and enhance your
visibility in the program.
J. Offer a special presentation to medical
students on “How to Give a Lecture.”
K. Develop a film series (or one session) to
discuss alcohol and drug issues in the media.
L. Offer a program where students attend an AA
meeting, with a faculty led back-up discussion.
II. Efforts to consider in reaching out to residents
in psychiatry, internal medicine, family practice, etc., masters and Ph.D.
level psychology students, and other educational groups at your university:
A. Explore whether you can be appointed to the
Residency Education Committee, which will give you the opportunity of enhancing
alcohol and drug education.
B. See whether you can become part of the
Residency Selection Committee to enhance choosing individuals with an interest
in alcohol and drug-related problems.
C. Work to incorporate alcohol and drug education
into the lecture series on medical/psychiatric emergencies, and courses offered
to introduce residents to issues related to major psychiatric disorders.
D. Offer residents a lecture on “How to Give a
Lecture.”
E. Create an inventory of current alcohol and
drug education within the residency, as a basis for future expansion.
III. Educational efforts appropriate for fellows:
A. Develop and/or enhance a lecture series on
substance use disorders.
B. Explore whether any of the AMSP lectures can
and should be offered to the fellows.
C. Offer to supervise fellows to enhance their
education on substance use disorders.
D. Consider offering lectures to fellows,
borrowing from those already developed on the AMSP website.
E. Consider working with other faculty to start
up a fellowship in substance use disorders, clinical issues, or research, if
one does not exist.
IV. Other potential activities:
A. Look toward developing in-service lectures on
an alcohol or drug-related topic for nursing, social work, emergency room
personnel, and so on.
B. Explore the possibility of establishing a
liaison with a relevant teaching service to enhance education on alcohol and
drugs.
C. Determine whether any medical school
continuing medical education program would be open to incorporating lectures on
alcohol and drugs, or if a symposium on this topic can be developed.
D. Consider working with Medical Student
organizations like AMSA, AMWA to present a lecture, hold a forum and/or
organize activities for alcohol awareness week.
E. Before/after attending the next AMSP meeting
when you arrange for coverage and notify colleagues and staff that you will be
away, use the opportunity to describe AMSP and your role AND put in a plug for
them to use and view www.alcoholmedicalscholars.org.
F. Notify your university public relations that
you are an AMSP Scholar and give them the information that you would be happy
to serve as a contact person for any alcohol/drug media-related questions.
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