Spring 2011 - School of Medicine
Transcription
Spring 2011 - School of Medicine
WELLNESSCHRONICLE Vol XIV No. 3 Spring 2011 Creighton Medical Humanities: A Look at Mind, Body, and Spirit Thomas Hansen, M.D. Associate Dean for Medical Education The Office of Medical Education is piloting a Creighton Medical Humanities program! The purpose of the Humanities Program is to focus on the Ignatian Values that are part of our Jesuit tradition as they apply to medicine. This will be a four-year, longitudinal course. Each year will focus on a different Ignatian value. The teaching methods will include speakers, online reflection and online small group activities and will utilize various forms of media. In this first year of the pilot, 25 M1 students are focusing on the Jesuit theme “Contemplatives in Action.” The word “Contemplative” generally refers to a monk or a nun in the Catholic tradition who spends his or her days focusing on reflection, scholarship, work and prayer. This seems to apply to firstyear medical students who spend most of their days in the lecture halls, labs or library focusing on learning, studying and reflecting on their new profession. Speakers from the Jesuit Community as well as a Sister of Mercy will present the Jesuit tradition and the Sisters of Mercy Spirituality to provide a context for understanding the mission statements for Creighton University, the School of Medicine and our two hospitals. Students will be asked to write their own mission statement and present it via PhotoStory. There will also be a session focusing on the Jesuit form of prayer using the senses as a method for continuing to develop empathy in patient care. Students will be asked to write a brief reflection of this based upon a patient in a television show or movie. Students will also write a reflection paper following the Memorial Service for their Anatomical Donors in April. The second year of the pilot will focus on the theme Cura Personalis, or Care for the Entire Individual. We will focus on the development of Mind, Body, and Spirit of both ourselves as well as of our patients. The third year will focus on the Magis (the Latin word for “more”), and the fourth year will focus on “Men and Women for Others.” Each year will first be piloted with volunteer students from the Class of 2014. As a group we will modify the course so that it is ready to be initiated into the curriculum the following year. We hope to have the first year of the Creighton Medical Humanities Program ready for the M1 year by August of this year. In This Issue Creighton Medical Humanities Taking a Spiritual Patient History Shrink Rap A Personal Approach to Stress Talent Show Time Management or Life Management 1 2 3 4 4 5 Transcending Omaha’s Artists The Grey Area Reflection as a First-Year Medical Student Importance of a Good Night’s Sleep Our Journey to Change Lives and Inspire Hope The Battle of the Boards 5 6 7 7 8 8 9 Blue-Jaywalking CURA 2011 Health Disparities Today: A Look at Diabetes in the Native American Apple and Ginger Turkey Burgers Kate’s Cookbook Big News Match 2011 9 10 12 12 13 14 15 “A rock pile ceases to be a WELLNESS CHRONICLE rock pile the FACULTY ADVISOR Dr. Michael Kavan, Ph.D. moment a EDITORS IN CHIEF Catherine Weaver Angela Chon single man contemplates it, CONTRIBUTORS Liz Ferguson Thomas Hansen Michael Kavan Michele Millard Linda Pappas Marcia Shadle-Cusic Maryal Concepcion Courtney Foote Patty Terp Sean Creeden Adam Pendleton Amanda Jo Ross Kate Tepper Naomi Whittaker Laura August-Schmidt Kay Bruemmer Christina Caruso Heather Dalton Kylie Dixson Megan Hamre John Hollowed Mike Mandrell Stephanie Ng Drew Keyser Amith Reddy Hannatu Tunga-Lergo bearing within him the image of a cathedral.” ~Antoine de Saint-Exupery Photo by Heather Dalton, M1 Taking a Spiritual Patient History Marcia Shadle-Cusic Chaplain As medical students you have an opportunity to learn the art of taking patient medical histories. Have you ever wondered about the value of taking a look at your patient’s spiritual history? The National Institutes of Health and Human Services, the Centers for Disease Control and Prevention and the National Center for Health Statistics has reported that more than 50% of all Americans use mind/body approaches for better health. The most commonly used intervention is praying for oneself. According to Dr. Herbert Benson from Harvard Medical School, the studies have also shown that unless asked, most patients do not communicate the use of these approaches to their healthcare providers. Knowing that your patients may look to their spirituality for coping, enduring, or healing you may want to ask them about their spirituality to fully understand your patients and how best to care for them. Dr Christine Puchalski from George Washington Hospital, has developed the FICA spiritual assessment with suggested questions to ask: F Faith Belief, meaning, “Do you have spiritual beliefs that help you cope?,” “What gives your life meaning?” I Importance and Influence, “Do you have specific beliefs that might influence your healthcare decisions?” C Community, “Is there a group of people you really love or who are important to you?” A Address/Action in Care, “How should the healthcare provider address these issues in your healthcare?” Spirituality is how we ”make sense” out of life. By simply exploring the belief system with a patient, you may find resources that would be valuable and enhance how they will cope and their overall compliance in taking care of their health in partnership with you, their physician. Shrink Rap: Tips for Coping with Anger and Helping to Prevent Violence Michael G. Kavan, Ph.D. Associate Dean for Student Affairs anger is bad, and you have to control it before it has untoward health consequences. Okay, you’re standing in Walmart on a Saturday night…I won’t comment on the fact that you are in a Walmart on a Saturday night…and you are standing behind a woman with three unruly kids, and she has 15 items in the 10-item or less checkout line. At first, you feel frustrated, but you try to distract yourself with the latest People magazine cover or better yet the National Enquirer!did Angelina Jolie really deliver two alien babies this past year??? However, as time progresses your anger begins to peak as you can’t believe that it is taking so long to buy a tube of toothpaste. Does this imbecile really not know how to count, and why is she keeping me from getting out of this hellhole!!! Closer to home!you are a medical student, and you see the forecast for a beautiful Friday!in January…in Nebraska nonetheless!and you have another mandatory event scheduled by the School of Medicine for that same day. It’s on alcohol abuse, and you think that rather than attending you could be out having a beer on one of the few nice days in this dreary winter. You steam… you’re angry. Either of these sound familiar? To be honest, getting angry is natural. However, staying angry is not and can have adverse health consequences. Anger Management So if you feel angry, what can you do about it? Here are my tips: • Take a deep breath!this allows you to take a time out and slow down the sympathetic nervous system response. Counting to ten really does work! • Get some space from the person you are angry with!research on marital arguments demonstrates that when couples get angry, they have a diffuse physiologic response that disables their ability to process information rationally, and they need 20 minutes to calm down before they should continue any discussion. • Reason with yourself!Is this really important enough to get angry about? Am I justified in getting angry? Will getting angry make a difference? • Focus on solutions versus what made you mad. • Use “I” statements versus “you made me…” or “you did…” • Practice empathy. Remember the woman in Walmart!put yourself into her shoes. Maybe she is a single parent struggling to make ends meet… okay, I can wait. •Finally, remember you get angry by accident, and you stay angry on purpose. Oh, the feeling of letting it go! Effects of Anger When you get angry, your body has a sympathetic nervous system reaction that triggers the release of catecholamines (epinephrine and norepinephrine), resulting in an increased heart rate and force of contraction, increased respiration, and other physical changes. Continued anger results in the release of cortisol and other nasty stress hormones that can certainly affect your body in a negative way. In fact, one study found that people most prone to anger are three times more likely to suffer from a heart attack than those persons with low anger. Another study found that medical students who became angry quickly when under stress were three times more likely to develop premature heart disease and five times more likely to have an early heart attack than their calmer colleagues. A study I conducted with colleagues and published in the Journal of Psychosomatic Research found that over-controlled hostility predicted onset and stage of presentation in colon cancer. So, Final Thoughts There is no better time to get control over your anger than now. Practice the above steps while dealing with classmates, driving to/from school, or shopping at Walmart. Learn to laugh at yourself and move on. Also, be aware of problematic anger in others. If you see classmates with anger issues, and you begin to see warning signs of violence, including them losing their temper, engaging in more risky behaviors (e.g. increased drinking/drug use), with-drawing from friends/ classmates, talking about getting back at someone, and so forth, then don’t hesitate to approach them about the issue. Also, keep in mind that faculty or administration may be able to offer assistance and referral for these issues as well. Again, be aware and take action within yourself and with others. image courtesy of brcurtis.net A Personal Approach to Stress Linda Pappas Academic Success Consultant It is spring time at CUSOM, and that means warmer days, flowers blooming, birds singing and students possibly stressing. M1s are concerned about Neuroscience; M2s are thinking about Step 1; M3s are starting to think about choosing a specialty. M4s are the only students who have relaxed since Match Day is behind them! Experiencing the pressure to do well is normal; it is how we choose to react to that pressure that makes the difference. The Myers-Briggs Type Indicator helps me to understand how people, including myself, experience that pressure. The MBTI measures self-reported life preferences. When we are unable to use our preferences because of our current circumstances, we may react in certain ways that reflect our personality type. The first set of preferences is where we get our energy: Extraversion is gathering our energy from other people and things, while Introversion is gathering our energy from internal thoughts and processes. Under stressful conditions E’s may become very “talky,” and I’s may withdraw more and more. The second set of preferences is how we take in information: Sensing is initially focusing on the details, while Intuitive is first focusing on the overall idea or concept. Under stressful conditions S’s may become overwhelmed by all the details, and N’s may get caught up in all the possibilities and become overwhelmed. The third set of preferences is how we make decisions: Thinking is taking the task-oriented route of decision-making, while Feeling is deciding by focusing on relationships with self and others. Under stressful conditions T’s may become negative or critical of self and others, and F’s may become emotional about disappointing self and others. The fourth and final preference set is how we like to manage our lives: Judging is preferring an organized, planned way of living, while Perceiving is preferring more spontaneity and a “go with the flow” way of living. Under stressful conditions J’s may become rigid, and P’s may become chaotic. When these individual four preferences combine into each of the sixteen types, then certain behaviors may become more apparent. The following is a chart of possible behaviors of the stressed out Introversion preference types: T N LE W O SH TA ISTJ ISFJ INFJ INTJ ISTP ISFP Become stubborn and irritable Become panicky and attempt to organize everything Become quiet and may start over-personalizing Become impatient and outwardly appear unfeeling Become irritated and forget to show appreciation Become avoidant of stressful situations and undervalue themselves INFP Become anticipatory of all negative possibilities and feel inadequate INTP Become reticent and don’t pay attention to detail and follow through Here is a chart of possible behaviors of the stressed out Extroversion preference types: ESTP ESFP Become antsy and begin to talk rapidly or too bluntly Become compulsive or scattered and experience difficulty with memory ENFP Become forgetful, sarcastic and disorganized or compulsive ENTP Become frustrated, mouthy and irritated with others’ incompetence ESTJ Become critical, negative, somber or quiet ESFJ Become negative, lose self-esteem or experience physical stress symptoms ENFJ Become cranky, self-critical, remote or short-tempered ENTJ Become anxious, insensitive, lose control or have tunnel vision When under stressful conditions, if a person is aware of tendencies toward these behaviors, he/she can watch for them or listen when others point them out. It is wise to explain to those close to us how our behaviors may have nothing to do with them; it is our preferences acting out, and we are attempting to monitor and minimize those behaviors. If we see them occurring, it is time to remember our stress reduction strategies and take time to use those (playing sports, going for a run, doing yoga, listening to music, talking to a good friend, etc.) Also don’t forget that first line of defense against stress: practicing good sleep habits, exercising and eating healthy. Take care! Your Creighton medical classmates would like to cordially invite You!!!......yes you, to attend the annual Med School Talent Show to be held the evening of Wednesday, April 20th. A happy hour with food and drink at Billy Blues Alumni Grill in the Harper Center will be open from 4:00-6:00 p.m. prior to show, with the show starting promptly at 6:00 p.m. across the hallway in the Harper Center Auditorium. Witness the broad ranging talents that our med school student body has to offer, and if you are lucky enough you may even have the opportunity to win some great prizes throughout the show. Please come out for an evening full of laughs and fun. Thanks, hope to see you all there! Sincerely, image courtesy of arborstation.dce.schoolinsites.com Med School Talent Show Planning Committee Time Management or Life Management? Michele Millard Academic Success Consultant Any guess at what the most used word in the English language is? It’s “time,” usually in the context of something that we don’t have enough of. . .” I would venture to say that the word is used exponentially more often by medical students as it seems that there is never enough time for what you are supposed to know or do. You might hear the word used amongst med students in different ways: M4s: Our time here is over. . .next year, I’ll have no time for a life at all. M3s: I have to find time to do residency applications. M2s: There is not enough time to study all this stuff for the boards. M1s: Neuro is sucking up all of our time. . . William Penn wrote, “Time is what we want most, but what, alas, we use worst.” We all have the same amount of time in a day!about 86,000 seconds (the same as Curie, Pasteur, Michelangelo, da Vinci, Mother Teresa, just to make us all feel guilty!). But we all live in a state of “time poverty” where we have too much to do and too little time for ourselves. We end up being reactive or responsive to time crunches rather than being proactive about time management, and time manages us rather than us managing time. We become addicted to complaining about how busy we are and how little time we have as if it’s a badge of honor or a game where “I win because I have less time than you do.”It’s a resource that is perishable, irreplaceable and can only be reallocated from activities of lower value to activities of higher value. Our approach to time should be to not try to cram more into every available minute of the day but to make decisions how to use time more effectively and productively. Some people might avoid time management, fearing that it would make life way to structured and stifled. To the contrary, the wise use of time leads to more freedom because it allows you peace of mind in fulfilling responsibilities at the same time as achieving some kind of balance between tasks and personal needs and between immediate needs and future goals. Time management forces us to ask some important questions like “Am I achieving the things I want to accomplish?,” “Am I getting what I want out of life?,” “Am I meeting my commitments?” and “Am I spending time doing the things that matter most?” We all have lots of time wasters in our lives such as indecision, interruptions, procrastination, unrealistic time estimates, poor planning, micromanagement, multitasking and ultimately, focusing on the urgent but unimportant things. You can develop a matrix of where you spend your time in life that might look like this: Not Urgent A Not Important Important C Transcen!ng Hannatu Tunga-Lergo M1 Shedding the old garment, Wearing my new vestment. Transcending. Urgent Releasing the cloak of darkness, B Draping myself with light. D Transcending. So. . . what quadrant do you spend most of your time? Typically, it’s in A or B where we spend time and energy on things that are not important. The urgent is screaming at us, and the not urgent is just tempting us with distraction. Where we really need to balance our time and energy is in C and D or things that are important, both urgent and nonurgent. Stephen Covey would call that moving from time management to life management. Some ideas about how to approach time: 1. Examine your perspective on time. Is it something to be overpowered, or is it a gift to be used wisely? 2. Know what’s important to you. If you have defined your values, you will know best how to focus your time. 3. Determine your priorities. Part of this approach is not only deciding what to do (do more of and do it sooner), but what not to do (do less of and do it later). 4. Strive for balance. You want to be successful in medical school, pass the boards and get good residencies, and you also want to have good relationships and take care of yourself. Those goals will guide your behavior. 5. Examine your time expenditures. What you do with your time reveals a lot about your goals, your values and your priorities. If inner and outer worlds are out of alignment, dissonance and disharmony is the result; if they align, then life is more harmonic and congruent!things just work better. Feeling my soul, Knowing my Love. Transcending. Sojourning towards Truth, Kneeling for the Word. Transcending. Wisdom becoming my friend, Love my companion. Transcending. Climbing towards infinity, Kissing forever. Transcending. Omaha’s Artists: Lost Treasures Resurfaced Amanda Jo Ross M2 Throughout my five and a half years of living in this wonderful city, I have discovered that Omaha has a wealth of artistic talent that is yet undiscovered by most of its student population. Unfortunately, as busy medical students, we usually only have time to appreciate Netter drawings and the myriad of photographs placed around the small group rooms and the computer lab. Perhaps after getting the lowdown on a couple of my favorite Omaha art institutions, you will be able to venture out and discover some masterpieces for yourself. The Joslyn Art Museum (www.joslyn.org) complex of artistic genius that houses an artists’ co-op of pure creativity. The building features over 80 studio artists and provides workshop space for Bruning Sculpture and Crystal Forge. The gamut of artistic endeavors can be found within The Hot Shops, and I would advise anyone interested in art to attend their spring open house on April 30th and May 1st. The open house is a time to tour the facility and to observe the artists at work as well as to purchase pieces of finished work. The pricing varies from artist to artist, but some pieces are very reasonably priced and make very unique gifts. Did I mention they also have another open house around Christmas? Wink-wink. Perhaps one of the more interesting exhibits is the glass blowing done at Crystal Forge. Glass work is an extremely labor intense process, not to mention blazingly hot and dangerous. But it is interesting to watch if you have never seen it done before. After you have toured the complex, sit down and watch an old craft come back to life. It will give you a new appreciation for that glass paperweight sitting on your desk. And if by the off chance you enjoy the show so much that you want to jump in and do it yourself, you can always sign up to take weekend glass blowing classes. How cool! I mean HOT!!! Tip: They take requests. If you like a certain glass mug, lamp shade or vase, they can make it in any color you like. Go ahead and get your Dad’s favorite sports team colors. He’ll probably think it’s the most awesome thing on the planet. Have you ever wondered what’s inside the salmon colored museum on 24th and Dodge Street? Well, the Joslyn boasts a healthy art collection that rivals any reputable museum around the nation, and it has been doing so since 1931. The museum is most known for its beautiful collection of “American West” watercolors by Karl Bodmer. The series chronicles his journey through the Missouri River frontier from 1832-1834. The Joslyn also features works from antiquity to present d a y. I t s p e r m a n e n t collection includes works Jun Kaneko (www.thekaneko.org) from Degas, Monet, Pollock and Segal, just to Have you ever been towed from the seemingly name a few. innocuous building across from Urban Wine While the world famous Company? Ok, I may have. I was mad as heck, artists and the entrancing but that incident gave me my first introduction to watercolors are some of Attic Black-Figure Ovoid Neck-Amphora at the Joslyn Art Jun Kaneko’s headquarters at 1111 Jones Street. t h e b e t t e r k n o w n Museum. I’ll admit it was not the greatest first impression, highlights of the museum, but I quickly learned that the property belonged to my personal love in the institution resides within an unassuming the world famous Japanese ceramic artist who made his home right corridor that is passed up by most visitors. The collection of here in Omaha. His works, ranging from drawing to bronzes, have Grecian amphora pottery attributed to the “Omaha Painter” and been featured in more than 40 museum collections. Neat-o! others from antiquity is a sight to see. In Archaic Greece (600-480 He is most known for his “Dango” collection of massive ceramic BC), the amphora pottery shape was a favorite among Attic blackforms. Translated from Japanese, Dango means “rounded form,” figure painters. The name amphora means “carried on both sides,” and Kaneko uses this three-dimensional canvas as his own way to as manifested in the handles. Amphorae were used in a wide express a visual language. If you went to Golden Apple last year, variety of ways, but most commonly they contained liquids. Try to you have seen his work. (Bet you didn’t know you were that find the “Attic Black-Figure Ovoid Neck-Amphora” on display. cultured). Some of the Dangos were purchased by the Hilton This piece represents a class of Tyrrhenian (derived from downtown and reside in the center of the circular drive way. In “Tyrrhenoi,” the name used by Athenians in reference to the strictly Nebraskan vernacular, they can be likened to giant egg Etruscans) amphorae offset by the detail painted on the neck of looking things that are either striped, polka-dotted or both. the vase that became characteristic of amphorae exported to the Stop by his studio in the Old Market and check out his new 2011 Etruscans from Attica. This amphora makes use of the common collection entitled “Metamorphosis.” He will have on display his Corinthian animal friezes and floral decorations in the upper and costume collection for Madame Butterfly as well as information lower registers, along with a unique combination of a about his collaboration with the Lauritizen Gardens on an outdoor mythological and genre scenes. exhibit running from late April until mid September. Tip: Take your significant other to the Joslyn and spout off what Tip: Don’t try to buy a Dango. While they are very pretty, they are you just learned about the amphora. You’ll look very suave and also very expensive. Or at least wait until you’ve paid off those sophisticated. Trust me. student loans. Then it’s all Louis Vuitton purses and huge ceramic eggs for the rest of your career. The Hot Shops (www.hotshopsartcenter.com) Located at 1301 Nicholas Street, The Hot Shops is a massive The Grey Area: Secret Keepers Laura August-Schmidt M1 And this, a dedication: To all the secret keepers, slowly preyed upon by silence. I hear you in the quiet. For an excessively talkative extrovert, I’ve got my tongue in a bit of a tangle. There’s a rather large cat holding my wriggling words, and I want very much to just let my insides burst out my eye balls and finger tips and finally release the crushing gravity of this pressure. The bliss and bitters of medical school are quite equipped at hunting down our every weakness, magnifying them tenfold, then drowning us in surging fire hydrants of medical knowledge. We signed up for this, it is true. And truth be told I love every minute of it. Sleep deprivation is no new challenge to an insomniac, but there are many more blunders of which I can only dream to tell you in this mad mad world we share. To catch my breath, I know what plagues you. And it terrifies me to think of you huddled in that silence. If I know one thing too intimately, it is that sickening silence, and suffice it to say, it is a killer, that one. Over the course of my twenty-five years, my neurons have run a bit amuck, and life, as it loves to do, waits for no man. With due time I developed a cluster of varying internal dragons whom I battle on a daily basis. They so choose, on their twisted own, to peek their taunting eyes out and take little jabs at me in the most inconvenient of times. One such time was during the dizzying days of my sandlot pre-teens. Who knows what my angsty deal was then, but I was in a ball of frustration on the floor one afternoon when I felt the gentle touch of a sticky, markered hand on my shoulder. I turned my puffy, dripping eyes to see my baby brother, not more than 3 or 4, shaggy blonde mullet in tow. He said to me through peanut butter breath, “D.W.A.I.” “D. W. What?” I asked, pausing in frustration for momentary confusion, to which he replied with remarkable wisdom, “Don’t worry about it.” He had no idea what was troubling me but regardless, his answer would have been the same. So I say to you, with heavy experience in too many things for me to tell you here: D.W.A.I. There’s always tomorrow and all that good stuff, they say. And it’s true, I’ve found out. Apparently there’s no end or disaster unless we make one ourselves. Who knew?? We’re in this together right? I mean, that’s what makes us Creighton. We are a family. And we are human. School is a monster, and life is even more blind than justice. There’s nothing fair or unfair about it. It is what it is; it gives and takes mercilessly. All we can do really is just take what we get and do the best we can…as a family. And like any family there’s that obnoxious uncle, prissy sister, arrogant stepbrother, suspiciously quiet second cousin once removed, and they make it annoyingly difficult to love…but love them we must. Should the worst find us in the worst way, they’ll catch us in our inevitable fall. Now, if you’ll trust me, I’ll get on my soap box.The next time you make that casual comment about all those things you know in the deepest part of your heart will alienate any one of us, even if meant in jest, think about that secret clawing at your throat in the dark of the night. Wouldn’t it be nice to have a friend to tell, get that darn cat out of that tormented bag? Well who will be there to listen when ignorance, fear, and, the worst of them, indifference, have stomped out any hope for a conversation? We all have a secret to tell. I’m listening, are you? Should any of you be interested, I and several of your classmates would like to begin a monthly (or so) frank open forum about what med school is doing to our psyche, our sex life, our marriages, our singledom, our health, our religion, our politics, our sanity, what have you, please email me at [email protected]. Also please let me know if you’d prefer our meetings to be confidential. I will gladly make arrangements for that. Reflection as a First-Year Medical Student Hannatu Tunga-Lergo M1 It is with an elated heart that I thank God for the blessing He has bestowed by giving me the opportunity to become a Doctor. Something uttered as a Child is becoming a reality, and at times this life seems surreal. I have encountered and undergone many battles that not even my closest friends would understand, and yet, I can stand shoulders pressed back, chest pushed up, back erect and feet planted firmly as I finish my first year as a neophyte of medicine. I’ve stressed, gotten angry and cried, yet the happiness and delight that is reverberating through my body, through my soul comes from God. I am joyful because I see and feel the growth into a Physician that seemed impossible at the commencement. In this journey I look to my right, and I see you. I look to my left, and I see them. I look forward, and I see us. Us, Doctors filled with Ignatian Spirit led by the teachings of Christ to serve our brothers and sisters, determined to use the gifts and talents He has granted us in order to reveal to the world a human’s capacity to love. That’s what we do. As Doctors we show Love. We may not be perfect; our philosophies may not be quite right; we may become cynical, sad, frustrated at times, but we will continue to treat. Is that not Love? Sacrificial Lovers: that is what we will become. That is what I look forward to becoming. That is what makes me joyful. Laughing, I remember when I would sit to study shaking my head wondering who was the guy that had the audacity to think I would learn all this, within a week, and pass my exam. And yet, time and time again I did. And yet, I sit here remembering and applying what I learned. Who would have thought that the audaciousness to believe in one’s greatness is integral to our learning processes? Who would have thought? All the reasons, the people, the purposes, the chances that brought us to Creighton I believe were orchestrated by God. For to bring together the people I now call my friends, my companions, my colleagues has the delicate and fine script that is the handwriting of God. It was like yesterday when I started to read the story of Class of 2014, and it will be like today when I read the chapters of our magnificent transformation. This year was truly a treasure that at times I wonder what I did to deserve. As I traverse this world of medicine, I shall look to my right, to my left and forward. Simply smile and say “Thank you God, I promise to be an audacious Sacrificial Lover just the way You intended.” Importance of a Good Night’s Sleep Liz Ferguson Events Coordinator, Office of Student Affairs Did you know that not getting enough sleep can affect your body mass index; increase your risk of diabetes, heart problems, depression and substance abuse; and increase risk of motor vehicle accidents? Lack of sleep can affect every aspect of our lives. So how much sleep is enough? Every person’s sleep requirements are different, and in fact our sleep needs change as we age. As a general rule you should be getting 7-9 hours of sleep each night. If you are struggling with getting enough sleep, experts recommend keeping a sleep journal for two weeks to determine what barriers may be preventing you from getting a good nights sleep. Here is a very simple sleep journal provided by webmd.com: http://img.webmd.com/dtmcms/live/ webmd/consumer_assets/site_images/ media/pdf/hw/form_tm4434.pdf According to the National Sleep Foundation, there are some basic steps to follow when trying to establish better sleep habits: 1. Establish consistent sleep and wake schedules, even on weekends. 2. Create a regular, relaxing bedtime routine that begins an hour or more before the time you expect to fall asleep. 3. Create a sleep-conducive environment that is dark, comfortable and cool. 4. Sleep on a comfortable mattress and pillows. 5. Use your bedroom only for sleep (keep “sleep stealers” out of the bedroom—avoid watching TV, using a computer or reading in bed). 6. Finish eating at least 2-3 hours before your regular bedtime. 7. Exercise regularly during the day or at least a few hours before bedtime. 8. Avoid caffeine and alcohol products close to bedtime, and give up smoking. For more information on sleep and strategies to improve sleep, visit: www.sleepfoundation.org Our Journey to Change Lives and Inspire Hope Naomi Whittaker M2 As the kick-off year for Partners Against Cancer comes to an end, we have matched over 40 students with patients and have heard compelling stories of students being by their patients’ sides at the hardest part of their lives. It is heart-breaking but inspirational to hear that a student was a patient’s sole companion as the patient reached the end of life. Every student has had a very unique experience in the program, so our officers are planning a retreat dinner for students to share their stories. The dinner will consist of a speaker to spark dialogue among students at their tables. We hope this will serve as a reminder of why we came into medicine and as an opportunity to share how students were able to handle difficult and very personal situations. We never could have imagined we would have such an incredible first year! Though we had some challenges along the way, we were able to learn from them in order to make the PAC experience rewarding and enjoyable for students, while engaging patients who would benefit most from the program. The best example happened when we redesigned our match process. Instead of shadowing to match with a patient, the oncologists at CUMC identify patients in need of a medical student partner. When Dr. Silberstein identifies a patient in need, he tells them, “If you choose to participate in PAC, you get your very own medical student. They are completely yours.” Oftentimes, patients are comforted to get such specialized attention from someone in the medical profession. For many patients, this marks the beginning of a difficult journey that is eased by having a partner by his or her side. A Special Thanks to… Partners Against Cancer’s volunteers, officers, oncologists, and clinic staff. Without you, the program could not exist. We want to take a moment to thank the PAC volunteers for being patient with us and giving us honest feedback. We could not have improved the program for next year without your feedback and support. Dr. Silberstein and his staff (especially Kathy Hebenstreit R.N. and Fellisha Miller) have taken it upon themselves to work extra hard with PAC to go above and beyond for patient care. In addition, we have had wonderful officers who have been flexible as the program was developing (especially Sara Birdsong, Evan Kirschner, and Joanna Gould). It is a credit to these amazing people that many cancer patients’ lives have been profoundly changed. Photo by Heather Dalton, M1 The Battle of the Boards Adam Pendleton M2 Over the past two years, the Board Monster (yes, this was actually a rejected Lady Gaga song) has been silently creeping up behind us. As M1s, “boards” was a word haphazardly thrown out by professors in an attempt to get our attention back after we’d been distracted by the “shiny things” of classroom life: who had fallen asleep in class for the third time this week, who was on Facebook, what type of blood Charlie Sheen had drank for breakfast, etc. It worked…sometimes. It was easy to say, “Boards? Those are so far away!” And with that phrase muttered out into the universe, unbeknownst to us, The Monster took one step closer. Then came the beginning of second year. Rejuvenated from our summer break, we were poised to attack: we sneezed our way through ID, bled through heme/onc, hallucinated through bmed, lub-dubbed through cardio, gasped through pulm, got pissed at renal, hor-moaned through endo and broke out during MSI. With every course, It took one more ghoulish step. No longer did the word “boards” incite apathy. When spoken now, “boards” creates a flurry of feverish note-taking, the occasional involuntary facial spasm and the ever-inconvenient bladder voiding. Every moment that passes, The Monster grows ever more fierce. As we begin to study, we can feel Its presence, like someone watching from the shadows…waiting. We can smell the stench of Its breath, rotten from devouring the dreams and free time of med students everywhere. At times, hopelessness sinks in. But, alas, all is not lost. Suddenly, from the foggy distance, you hear it: boom, boom, boom. Battle drums. The slow and steady beat grows louder as you peer over the horizon to see the cavalry, ready to join the fight: Linda Pappas, wielding the Crossbow of Courage; Michele Millard with her Nunchuks of Knowledge; Kavan slicing the air with his Blade of Balance (why he’s wearing tight leather shorts, I’m not sure, and it’s disturbing!don’t look directly at him). Following them is the rest of the Creighton Crusade ready to help us take on the beast. We all know the battle plan: stick together; support each other; ask for help. The Monster has stepped out of the darkness. We are ready to face It. If you get tired, Marcia is manning the coffee station. Need some heavy artillery? Call Dr. Hunter. He literally uses his first edition Robbins as a weapon. The battle will be exhausting, but we will make it through together!we always have. I have faith that when the dust settles, the Monster will lay slain on the battlefield, and we, though bloodstained, will be victorious. The reward will be great: personal accomplishment (…and Kavan promised to put a hot tub and a wet bar in the lounge). To my fellow M2s, have no fear!our army is strong and prepared. So, put your heads down and your weapons up… and let the battle begin. BlueJaywalking What are your plans for the summer? “To move. I’m going to Indiana. Indianapolis is the Paris of the Midwest.” -Jordan Whitson (M4) “I’m going to Chile for 3 weeks because all my family is there. I’m thinking about maybe going to the Andes Mountains and climbing. Maybe buying an alpaca sweater.” -Kevin Gysling (M2) “I’m going to Peru on Cura and then babysitting in Omaha after that.” -Mimi Longo (M1) “I’m going to hang out in Omaha and celebrate boards being done with everyone here then go to San Diego and hang out with my parents and go to the beach.” -Jaya Maewal (M2) “I’ll be in Minneapolis doing anesthesia research.” ~Mike Potter (M1) “Haven’t decided yet. Still looking for options. If anyone has anything, let me know!” -Dusty Sitzmann (M2) “I am going on a Mediterranean cruise with my family.” -Elena Strunk (M2) Pine Ridge: Eight M1s continued the Creighton tradition of spending Spring Break at the Pine Ridge Indian Reservation. Pine Ridge, South Dakota is in one of the poorest counties in the US. The Lakota Sioux, who live on the reservation, suffer from 80%-85% unemployment with 50% of the population living below the poverty line. They also suffer from the shortest life expectancies in the Western Hemisphere (about 50 years-old). We volunteered for three days in the Red Cloud Native American School teaching the basics of health and wellness with a focus on diabetes and heart disease prevention. The 3 schools in the Jesuit-affiliated Red Cloud School system have about 600 students ranging from K-12th grade. While our teaching abilities may have been underdeveloped, the kids responded with enthusiasm. At the conclusion of the week, we were invited to participate in a traditional Lakota sweat lodge ceremony. The sweat lodge consists of about 15 people sitting in a circle under a 3-ft. tall dome covered in blankets, tarps and skins. Red-hot stones are brought in and placed in the middle. The ceremony begins with Native American songs while water is poured over the hot rocks. The steam and heat are intense. It was an interesting and memorable experience for everyone. Team Members: Mike Mandrell (leader), Jordan Crow, John Franco, Steve Marcoux, Mario Mitkov, Eric Olge, Justin Otis, Sam Pearson, Sarah Takimoto Nicaragua: CURA Our group will be working with ATRAVES, a non-profit organization that is just finishing up a clinic we will use. We will be serving the neighborhoods ("barrios") Anexo Camilo Ortega and William Galeano on the southwest outskirts of Managua. We will be staying the entire 3 weeks with Nicaraguan families and are all looking forward to the homestays as one of the best parts of the trip! Nicaragua is the second poorest country in the Western hemisphere. About 80% of the population lives on less than $2 a day, and of that percentage, 45% lives on less than $1 a day. For these individuals, the nearest healthcare center is currently 2.5 miles away and not completely free. There are many health problems stemming from the poverty, including almost 30% of school-age children suffering from malnutrition. In the past, ATRAVES has ran half-day clinics out of the school and served over 1000 people in a month. We expect to see at least this many patients, as our services will be full day and from a new facility. As you can see, we have a lot of service to provide to this community! We will be working with Nicaraguan physicians but will be doing the majority of vitals, interviews, and physical exams we feel comfortable doing. On the weekends we will be doing a bit of sight-seeing and are very excited for all the beauty the country has to offer! Team Members: Kylie Dixson (leader), Carrie Cusack, Katie Cusack, Aimee Hintz, Nick Ingraham, Steve Marcoux, Rob McMillan, Daniel Mistrot, Peter Nguyen, Vy Nguyen, Briana Scott, Kayla Wiesner Peru I: Our group will be spending about 5 weeks in Peru this summer, 3 of which will be spent doing medical service in Cusco and Urubamba. For the duration of the trip, we will be working with Maximo Nivel, a volunteer service organization that allows international medical students to work within the government-run healthcare system in Peru. We are excited to have the opportunity to live with a host family, practice our Spanish during the trip, and volunteer in both urban and rural settings and in an orphanage and elder home. Dr. Walter Longo, a hematologist/oncologist at the University of Wisconsin-Madison (and Mimi's dad), will join us for the week we spend in the rural village of Urubamba. After volunteering for 3 weeks, we plan to embark on the Salkantay Trail to Machu Picchu and spend time traveling in southern and central Peru. Follow our experiences and reflections during and after our trip at http://projectcuraperu1.blogspot.com. Team Members: Megan Hamre (leader), Mimi Longo, Sarah DeWitt, Erik Egeland, Erik Frandsen, Matin Ebneshahrashoob, Jessica Veatch, Cameron Ghaffary, Kristina Khazeni Peru 2: Our group will be flying into Lima before taking a long bus ride through the Andes to Huancayo where we will be volunteering with CarismaPeru (www.carismaperu.org). While in Huancayo we will spend 3 weeks volunteering in local medical centers, helping at orphanages and schools, and taking Spanish lessons. After our time in Huancayo, we plan on traveling to Cusco before going on the Salcantay Trek, an alternative to the Classic Incan Trail, to Machu Picchu. We plan on bringing children’s clothes, dental supplies, and old laptops with us to Peru to aid CarismaPeru’s New Development Program, which aims at broadening the opportunities available to the children of Huancayo. Team Members: Christina Caruso (leader), Austin Andersen, Scott Bruschwein, Daniel Hosker, Ashley Husebye, Cody King, Corinne Lieu, Rachel Petersen 2011 Romania: We will be traveling to five cities within Romania where we will be providing basic medical services and free medicine. The cities include: Arad, Buteni, Sighisoara, Botosani, and Bucharesti. Through our efforts, we hope to gain valuable clinical and cultural experience that will help us become better physicians, and more importantly, better human beings. Team Members: Amith Reddy (leader), Heather Berigan, Gregory Dodaro, Matthew Dorweiler, Hasnain Hasham, Nicholas Mancuso, Shelby Takeshita. Ghana I: Our team will spend the first portion of the trip working with Dr. Young, who is currently the director of the Saboba Medical Centre in northern Ghana near the Togo border. Currently, Dr. Young is the only doctor servicing an area with a population of over 120,000. Students will work in the hospital with locally trained medical assistants in the areas of surgery, obstetrics, pediatrics, and medicine. Students will also travel around local villages to make much-needed house calls and assist in public health education within the community. The second portion of the trip will take place in the more urban setting of Kumasi, the former capital of the Ashanti kingdom, where students will participate in outreach work involving tutoring and education at the Mother Theresa Orphanage. Students will also have time to enjoy Ghana’s rich cultural and ecological diversity by visits to Mole National Park and the Cape Coast Castle and by participating in the local festivals and traditions in Kumasi and Saboba. Follow our blog: http://projectcuraghana1.blogspot.com/. Team Members: Kay Bruemmer (leader), Sarah Bly, Brittany Boswell, Lauren Brin, Tyson Hickle, Timothy McCarthy, Ian Steele, Mary Warlaumont Ghana II: As Ghana Team II, we will spend the first part of our service trip working with Rev. Goodwin Ahlijah, Dr. Lenusia Ahlijah and the Meaningful Life International (MLI) team in the city of Tema. While working with MLI, we will support mobile medical units that provide rural communities with free health care and will also provide fresh water wells to areas where there is no clean drinking water. Following a week with MLI, our team will travel to Saboba, near the Togo border. In Saboba, we will live on-site and work for two weeks with Dr. Jean Young, the director of the Saboba Medical Centre. This rural clinic services a population of over 120,000 people in the Northeastern part of the country. At the clinic we will have the opportunity to work with trained medical providers in areas of acute care, obstetrics/gynecology, surgery and pediatrics. In addition, Team Ghana will also have the opportunity experience the cultural highlights of Ghana. Among the many sights to be seen are: Mole National Park, Axim Beach, and the Cape Coast Castles. Team Members: John Hollowed (leader), Tom Knowles, Eddie Krajicek, David Skoglund, Jen Rosin, Jen Cabral, Laura August-Schmidt, Ariel Postone India: Our group plans to visit Calcutta, Delhi, Agra, Mumbai and Goa. We will work with the Mother Theresa house in Calcutta and hopefully in Delhi as well. At the Mother Theresa House, we will care for patients afflicted with tuberculosis, leprosy and various mental health disorders, and provide care and comfort to the terminally ill. In Delhi and Mumbai, we hope to tour state-of-the-art hospitals, and we will team up with local doctors to organize health clinics in rural areas. We are very excited to learn about the practice of medicine in India and to experience the wonderful Indian culture by serving the local communities! Team Members: Drew Keyser (leader), Susan Behnawa, Laura Brannen, Angela Chon, Alexander Cranwell, Salima Hasham, Jiten Patel, Nargis Sadat SE Asia: Our group will be traveling to the Philippines, Indonesia, and Cambodia. We will spend about a week in each country volunteering with different organizations. In the Philippines and Indonesia, we will be collaborating with HOPE Worldwide to bring medical care to the underserved populations around Manila and Jakarta, respectively. In Indonesia, we will also be working in HOPE's tuberculosis clinics. In Cambodia, we will be volunteering with Solaid International doing community health assessments, teaching English to Khmer students, and assisting Solaid with other projects. We are very excited to serve the communities of SE Asia and look forward to learning about the healthcare practices and cultures of the places we visit! Team Members: Stephanie Ng (leader), Lindsay Emerick, Natalie Erbs, Lindsay Ferguson, Drew Moss, Staci Shepard, Liz Wooster Health Disparities Today: A Look at Diabetes in the Native American Population According to a recent CDC report, “diabetes continues to affect American Indians/Alaskan Natives disproportionately and is becoming more common among younger populations.” As of 2007, there are 3.3 million American Indians and Alaska Natives in the United States who are members of 561 tribes. 16.3% of Native Americans have already been diagnosed with diabetes. That is over 500,000 individuals or roughly the entire population of Omaha, Nebraska. In 2004, 1,758 Indian youth had been diagnosed with diabetes. This is up 68% from 1994. 20-29 year old Indian and Alaskan Natives have seen a 58% increase in diabetes prevalence compared with a 9.1% increase in the general population. Complications include major comorbidities such as kidney failure, extremity amputation, cardiovascular diseases, blindness, and premature mortality. On average, receiving a diagnosis of diabetes means one’s lifespan is shortened by 15 years. In 2004, it was the fourth leading cause of death for Native Americans. The cause of the great disparity in diabetes prevalence between tribes and the general U.S. population is multifocal. Besides diminished physical activity and increased fat and calorie consumption leading to general obesity, genetics plays an important role. Numerous theories have been proposed including the Thrifty Gene Theory, which addresses the feast versus famine adaptation element, and a theory regarding a dual impairment in the processing of alcohol and sugars. These factors are compounded by a limited access to health care secondary to rural locations and a lack of funding for health programs. “People don’t think about the unique situations that occur in a rural setting like a reservation,” said Kelly Beam, nurse practitioner in charge of the Carl T. Curtis health clinic on the Omaha reservation. “For example, we lose water at least twice a week, and the biggest accomplishment of the community last year was killing over 300 wild dogs.” While that seemed a bit shocking to me, she explained that wild dogs are a major reason many on the reservation do not exercise. “It’s not just the obstacles to exercise either,” she continued. “Eating healthy is near impossible.” I discovered that most residents of the reservation do not have a car, and the nearest major grocery store is thirty miles away in Sioux City. There is a local grocery store on the reservation, but Kelly told me the pickings are sparse. “Pop is cheaper than milk, and milk spoils,” she said. “When the water’s off and your child is thirsty, you give him pop. That’s just the way it is here.” Even when the water was on, she explained, there have been so many incidences of tainted water that everyone tends to avoid drinking it. Funding is also a major obstacle in the fight against diabetes. According to the U.S. Department of Health and Human Services, the per capita spending for health in 2003 was $5,065. The government spent about $3,803 on average for health per federal prisoner. And for Native Americans, who are guaranteed healthcare through federal treaties, the federal allotment was only $1,914. That is less than half of what the average American spends on health care per year. Adds Debra Parker, former Diabetes Coordinator for the Omaha tribe, “The IHS will never fund 100% of our need. If you get only 65% of what you need, what do you pick to do?” Unfortunately, addressing this question may prove just as difficult as addressing the disparity in general. References available on demand: [email protected] Megan Hamre’s (M1) Apple & Ginger Turkey Burgers 1½ lbs ground turkey ¼ c. liquid egg substitute or 1 egg white 1 medium apple ¼ medium onion ¼ c. breadcrumbs 1½ tbsp grated ginger root Salt and pepper to taste ¼ c. ketchup (optional) *Make this recipe gluten-free by substituting gluten free breadcrumbs (ex: brown rice or tapioca bread) Place the ground turkey in a large bowl. Add the egg substitute. Peel and core the apple and cut into chunks. Place it in a food processor or blender with the onion and bread crumbs. Chop all ingredients fine. Add to the meat along with the ginger root. Salt and pepper to taste. I recommend adding ketchup for more flavorful burgers. Mix thoroughly and shape into 4” patties. Grill for about 15 to 20 minutes. You can also broil in the oven with meat approx. 7 inches from the heat. 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Enjo Big News cake topper image courtesy of www.tableandhome.com MATCH 2011 To the Fabulous Class of 2011! It's official!we've all matched, and nothing can stop us now! Match Day was such a fun day, and I could not be happier for any of you! Countless years of busting our a--es finally paid off, and in just a few weeks we will be "Doctors!" Now we can get excited for the festivities during graduation week, when we can fully celebrate our achievements all together before moving day. I feel fortunate to have known all of you, and I wish you all the best as you continue to be rockstars in residency! 2011 Love Forever! Patty Terp (M4) ANESTHESIOLOGY Aldrich, !Christopher Oregon !Health !& !Science !Univ, Portland, !OR Boyle, !Molly Mayo !School !of !Grad !Med !Edu, Rochester, !MN ! ! Medicine!Preliminary: !St !Josephs !Hospital, !Phoenix, !AZ Carney, !Seri U !Wisconsin !Hospital !and !Clinics,! Madison, !WI ! ! Medicine!Preliminary: !U !South !Dakota !SOM, !Sioux !Falls, !SD Farber, !Daniel U !Wisconsin !Hospital !and !Clinics,! Madison, !WI Guenzer, !Joseph Univ !of !Chicago !Med !Ctr,! Chicago, !IL Healy, !Elizabeth Univ !of !Chicago !Med !Ctr,! Chicago, !IL House, !Rebecca Virginia !Mason !Med !Ctr ! Seattle, !WA ! ! Preliminary !Surgery: !Creighton !Univ !Affil !Hosps, Omaha, !NE Otuwa, !Nnamdi Med !Coll !Wisconsin !Affil !Hosps,! Milwaukee, !WI ! ! Preliminary !Surgery: !Loyola !Univ. !Med !Center, !Chicago, !IL Rayl, !Thomas U !Minnesota !Med !School,! Minneapolis, !MN ! ! Medicine!Preliminary: !Creighton !Univ !Affil !Hosps, !Omaha, !NE Thelen, !Brendan U !Nebraska !Medical !Center,! Omaha, !NE ! ! Preliminary !Surgery: !UC !Davis !Med !Ctr, !Sacramento, !CA DERMATOLOGY Junck, !Marianne Med !Coll !Wisconsin !Affil !Hosps,! Milwaukee, !WI ! ! Transitional !Year: !St !Lukes !Med !Ctr, !Milwaukee, !WI EMERGENCY Ali, !Anah Barnes!Jewish !Hosp,! St. !Louis, !MO Benson, !Ryan Oregon !Health !& !Science !Univ,! Portland, !OR Ellingson, !Marc Regions !Hosp/HealthPartners,! St. !Paul, !MN Gross, !Maureen Barnes!Jewish !Hosp ! St. !Louis, !MO Rau, !Matthew Hennepin !Co !Med !Ctr,! Minneapolis, !MN Rogers, !Kirsten U !New !Mexico !SOM,! Albuquerque, !NM Wang, !Heeyoung U !Nebraska !Affil !Hosps,! Omaha, !NE FAMILY MEDICINE Azar, !Baubak Research !Medical !Center,! Kansas !City, !MO Bui, !Loan White !Mem !Med !Ctr,! Los !Angeles, !CA Dentlinger, !Renee Research !Medical !Center, Kansas !City, !MO Esteba !(Colina), !April Central !WA !Family !Med, !Yakima, !WA Ramig, !James Clarkson !Regional !Health !Services,! Omaha, !NE Wang, !Danielle U !Minnesota !Med !School,! Minneapolis, !MN GENERAL SURGERY Osmolak, !Angela Creighton !Univ !Affil !Hosps,! Omaha, !NE Hwang !(Macatangay),! Aileen Swedish !Medical !Center, Seattle, !WA Svetanoff, !Wendy !Jo Creighton !Univ !Affil !Hosps,! Omaha, !NE Tieva, !Erwin Tripler !Army !Medical !Center,! Tripler !AMC, !HI Torgersen, !Zachary Creighton !Univ !Affil !Hosps,! Omaha, !NE INTERNAL MEDICINE Anazia, !Gregg LSU !SOM!New !Orleans,! New !Orleans, !LA Barbee, !Stephen U !Utah !Affil !Hospitals,! Salt !Lake !City, !UT Batzlaff, !Cassandra Mayo !School !of !Grad !Med !Educ,! Rochester, !MN Beckman, !Jennifer U !Utah !Affil !Hospitals,! Salt !Lake !City, !UT Bracken, !Susanna Summa !Health/NEOUCOM,! Akron, !OH ! Daniel, !Kimberly U !Wisconsin !Hospital !and !Clinics,! Madison, !WI Fulton, !James Creighton !Univ !Affil !Hosps,! Omaha, !NE Gogia, !Namrita UC !Irvine !Med !Ctr,! Orange, !CA Gupta !(Sinha), !Jaya Creighton !Univ !Affil !Hosps,! Omaha, !NE Hurley, !Peter U !Minnesota !Med !School,! Minneapolis, !MN Koll, !Thuy Creighton !Univ !Affil !Hosps,! Omaha, !NE Lane, !Ashley Duke !Univ !Med !Ctr,! Durham, !NC Mackenzie, !Kara Vanderbilt !Univ !Med !Ctr,! Nashville, !TN Mathias, !Jonathan Cleveland !Clinic !Fdn,! Cleveland, !OH Mitchell, !Adam U !Minnesota !Med !School,! Minneapolis, !MN Oberle, !Amber Indiana !Univ !SOM,! Indianapolis, !IN Olson, !David Creighton !Univ !Affil !Hosps,! Omaha, !NE Pease, !Daniel Hennepin !Co !Med !Ctr,! Minneapolis, !MN Pedersen, !William U !Utah !Affil !Hospitals,! Salt !Lake !City, !UT Scheibe, !Meghan CA !Pacific !Med !Center,! San !Francisco, !CA Tran, !Phu UPMC !McKeesport,! McKeesport, !PA Walter, !James Thomas !Jefferson !Univ,! Philadelphia, !PA Werth, !Amy Creighton !Univ !Affil !Hosps,! Omaha, !NE Whitson, !Jordan Indiana !Univ !Sch !Of !Med, Indianapolis, !IN MEDICINE/EMERGENCY MEDICINE Dang, !Tam Christiana !Care,! Wilmington, !DE INTERNAL MEDICINE/PEDIATRICS Kaminski, !Amy St !Louis !Univ !SOM,! St. !Louis, !MO OBSTETRICS/GYNECOLOGY Arms, !Richard Creighton !Univ !Affil !Hosps,! Omaha, !NE Foote, !Courtney U !Texas !Med !Branch!Galveston,! Galveston, !TX Davis, !Andrew St !Johns !Mercy !Med !Ctr,! St. !Louis, !MO Donahue, !Meghan Maricopa !Med !Ctr,! Phoenix, !AZ ! Hammers, !Amy U !Florida !COM!Jacksonville,! Jacksonville, !FL Roediger, !Laurian U !Kentucky !Med !Ctr,! Lexington, !KY Viamonte, !Louis Maricopa !Med !Ctr,! Phoenix, !AZ Wood, !Amber Barnes!Jewish !Hosp,! St. !Louis, !MO OPHTHALMOLOGY Dworak, !Douglas Stroger/Cook !County,! Chicago, !IL ! ! Medicine!Preliminary: !U !Illinois !COM, !Chicago, !IL Joos, !Zachary U !Utah,! Salt !Lake !City, !UT ! ! Medicine!Preliminary: !U !Utah !Affil !Hospitals,! Salt !Lake !City, !UT Nash, !David Eastern !Virginia !MS,! Norfolk, !VA ! ! Medicine!Preliminary: !Eastern !VA !Med !School, !Norfolk, !VA Terp !(Schwartz), ! Patricia U !Nebraska !Medical !Center,! Omaha, !NE ! ! Medicine!Preliminary: !U !Nebraska !Affil !Hosps, !Omaha, !NE ORTHOPAEDIC SURGERY Busse, !Eric William !Beaumont !Hosp,! Royal !Oak, !MI Dinh, !Nam U !Kansas !SOM!Wichita,! Kansas !City, !MO Horrigan, !Patrick U !Minnesota !Med !School,! Minneapolis, !MN Hsiao, !Mark William !Beaumont !Army !Medical !Center,! El !Paso, !TX McCarthy, !Meagan UC !San !Diego !Med !Ctr,! San !Diego, !CA Neary, !Kaitlin Creighton!Nebraska !Hlth !Fnd,! Omaha, !NE ! Orsini, !David Summa !Health/NEOUCOM,! Akron, !OH Steiner, !Murphy SUNY !Upstate !Med !University,! Albany, !NY Van !Demark, !Robert Mayo !School !of !Grad !Med !Educ,! Rochester, !MN OTOLARYNGOLOGY Rasband-Lindquist, ! Allison U !Kansas !SOM!Kansas !City,! Kansas !City, !MO Wood, !Joshua U !Tennessee !COM!Memphis,! Memphis, !TN PATHOLOGY Lynch, !David San !Antonio !Military !Medical !Center,! Lackland !AFB, !TX Reinig, !Erica Oregon !Health !& !Science !Univ,! Portland, !OR Rusin, !Spencer U !North !Carolina !Hospitals,! Chapel !Hill, !NC Van !Gemert, !Lisa U !Wisconsin !Hospital !and !Clinics,! Madison, !WI PEDIATRICS Clark, !Kylie Childrens !Mercy !Hosp,! Kansas !City, !MO Kouri, !Anne Indiana !Univ !Sch !Of !Med,! Indianapolis, !IN Langerman, !Eric U !Arizona !Affil !Hospitals, Phoenix, !AZ Larsen, !Chari U !Utah !Affil !Hospitals,! Salt !Lake !City, !UT Long, !Michael Childrens !Hospital!Oakland,! Oakland, !CA McDermott !(Miller), ! Laura UC !Davis !Med !Ctr,! Sacramento, !CA Renn, !Caitlin Creighton!Nebraska !Hlth !Fnd,! Omaha, !NE Roenfeld, !Michelle Childrens !Mercy !Hosp,! Kansas !City, !MO Romans, !Ryan Childrens !Hospital!Boston,! Boston, !MA Senozan, !Erin Walter !Reed !Army !Medical !Center,! Washington, !DC Straley, !Matthew U !Minnesota !Med !School,! Minneapolis, !MN Venglarcik, !Carey Kaiser !Permanente!Oakland,! Oakland, !CA PSYCHIATRY Anazia !(Butler), TaSheitha LSU !SOM!New !Orleans,! New !Orleans, !LA Carlson !Jr., !Richard Vanderbilt !Univ !Med !Ctr,! Nashville, !TN Forystek, !Amanda U !Iowa !Hosps !and !Clinics,! Iowa !City, !IA Johnson, !Amber U !Iowa !Hosps !and !Clinics,! Iowa !City, !IA Miiller, !Jason U !Michigan !Hosps!Ann !Arbor,! Ann !Arbor, !MI ! Nguyen, !My !Phon Univ !of !Illinois !at !Chicago,! Chicago, !IL Schumacher, !Joseph U !Colorado !SOM!Denver,! Denver, !CO Turner, !Andrew Tripler !Army !Medical !Center,! Tippler !AMC, !HI Yang, !Bryan Harbor!UCLA !Med !Ctr,! Torrance, !CA RADIATION ONCOLOGY Nolan, !Nicole U !Kansas !SOM,! Kansas !City, !MO ! ! Medicine!Preliminary: !Creighton !Univ !Affil !Hosps, !Omaha, !NE RADIOLOGY-DIAGNOSTIC Bravo !(Cockson), !Erin U !Wisconsin !Hospital !and !Clinics,! Madison, !WI ! ! Medicine!Preliminary: !Creighton !Univ !Affil !Hosps, !Omaha, !NE Burke, !Richard Loyola !Univ !Med !Ctr,! Chicago, !IL ! ! Medicine!Preliminary: !Creighton !Univ !Affil !Hosps, !Omaha, !NE Haverkamp, !Benjamin Univ !of !MO!KC !Programs,! Kansas !City, !MO Hurd, !Elizabeth U !Nebraska !Affil !Hosps,! Omaha, !NE ! ! Medicine!Preliminary: !Creighton !Univ !Affil !Hosps, !Omaha, !NE Kehler, !Daniel Med !Coll !Wisconsin !Affil !Hosps,! Milwaukee, !WI ! ! Transitional !Year: !Gunderson !Lutheran !Med !Fdn, !La !Crosse, !WI Lindquist, !Jonathan U !Kansas !SOM!Kansas !City,! Kansas !City, !MO ! ! Medicine!Prelim/Radiology: !U !Kansas !SOM, !Kansas !City, !MO Packard, !Ann Mayo !School !of !Grad !Med !Educ,! Rochester, !MN ! ! Medicine!Preliminary: !Creighton !Univ !Affil !Hosps, !Omaha, !NE ! Sana, !SaidMunib Maine !Medical !Center,! Portland, !ME Simpson, !Dustin San !Antonio !Military !Medical !Center,! Ft. !Sam !Houston, !TX Snodgrass, !Douglas Madigan !Army !Medical !Center,! Tacoma, !WA Schemmel, !Andrew U !Wisconsin !Hospital !and !Clinics,! Madison, !WI Stetz, !Michael Med !Coll !Wisconsin !Affil !Hosps,! Milwaukee, !WI ! ! Transitional !Year: !Marshfield/St !Josephs, !Marshfield, !WI Stibbe, !Adam Creighton !Univ !Affil !Hosps,! Omaha, !NE ! ! Preliminary Surgery: Creighton !Univ !Affil !Hosps, !Omaha, !NE Welsh, !Brandon U !Kansas !SOM!Kansas !City,! Kansas !City, !MO ! ! Transitional !Year: !U !North !Dakota !SOM,! Grand !Forks, !ND UROLOGY Reznicek, !Daniel U !Maryland !Hospital,! Baltimore, !MD March 17, 2011 Maryal Concepcion M4