north dakota medicine

Spring 2012VOLUME 37, NUMBER 1

www.ndmedicine.org

The Doctor-CEO is In

Opening Day for UND Med Students

State Stroke Program

North Dakota Youth Experience Their Future in Health Care

2 NORTH DAKOTA MEDICINE Spring 2012

NORTH DAKOTA MEDICINE Spring 2012 3

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POSTMASTER: Send address corrections to:ND Medicine Address Correction UND School of Medicine and Health SciencesOffice of Alumni and Community Relations, Attn: Kristen Peterson501 North Columbia Rd. Stop 9037, Grand Forks, ND 58202-9037 e-mail: [email protected]: 701-777-4305

NORTH DAKOTA MEDICINE is available online at www.ndmedicine.org

UNIVERSITY OF NORTH DAKOTA SCHOOL OF MEDICINE AND HEALTH SCIENCES

ROBERT O. KELLEY, President, University of North Dakota

JOSHUA WYNNE, Vice President for Health Affairs and Dean, School of Medicine and Health Sciences

EDITOR Denis MacLeodWRITERS Christen Furlong, Kristine Henke,

Barbara Knight, Denis MacLeod, Dave Miedema, Aaron Ortiz, Lila Pedersen, Juan Pedraza, Jessica Sobolik

CONTRIBUTORS Kristen PetersonGRAPHIC DESIGN Laura Cory, John Lee, Victoria Swift PHOTOGRAPHY Lonna Augustadt, Laura Cory,

Ann Flower, Eric Hylden, Dan Koeck, Kylie Nissen, Aaron Ortiz, Farrah Spivey, Katie Thompson, Wanda Weber

COVER ART Wanda Weber

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WEBMASTER Eric Walter

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FEATURESThe Doctor-CEO Is In 10

MDs with MBAs lead the School of Medicine and Health Sciences.

Opening Day for UND Med Students 14The North Dakota Department of Health seeks to improve strokepatients’ care and outcomes.

State Stroke Program 18The North Dakota Department of Health seeks to improve stroke patients’ care and outcomes.

North Dakota Youth Experience Their Future in Health Care 30High school students attend the first Career Academy

DEPARTMENTSDean’s Letter 4News Briefs 6Guest Author - Lila Pederson and Barbara Knight 20Student Profile - Chris and Stacy Irmen 22Campus Spotlight: Fargo 24Alumni Notes 27Alumni Profile - David Monson 28Workforce 32In Memoriam 34Gift Planning 36Philanthropy 37Spotlight: Anatomy and Cell Biology 38Parting Shots 39

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In a recent report I prepared for UNDPresident Robert Kelley about thestrategic direction of the School ofMedicine and Health Sciences, I notedthat the School has been and isundergoing fundamental change in theway we approach each of our coremissions—education, scholarship andresearch, and service. In each of theseareas, our approach is changing from anemphasis on individuals to an emphasison a team, group, or population. Thechange in focus truly is from “me” to“we.” This metamorphosis is most fully

developed in our educational programs,where the SMHS has long been aleader in promoting the benefits ofsmall group patient-centered learning(PCL). Following a major strategicreanalysis of our medical studentcurriculum two years ago, we are nowevolving our PCL approach into a team-based and interdisciplinary approach,where the medical students arechallenged to solve patient issues bypartnering with other medical andhealth sciences students. This is, afterall, the way we practice medicine inthe real world—a team of providersworking together to achieve the bestpossible patient outcomes. But workingtogether effectively in a team doesn’tnecessarily just happen—it takespreparation and practice. And that’sprecisely what we’re trying to do in oursmall group and simulation sessions—emulating what our students willencounter after graduation. The modelof the physician as the autocraticcaptain of the ship is outmoded, andwe are now training our students for thepresent and future, not the past.

Similarly, we are transforming howwe undertake scholarship and discovery.For some time now, it has been apparentthat science is a team effort, requiringthe skills and insights of a spectrum ofinvestigators from disparate disciplinesand backgrounds. Thus, the imperativeto reorganize our basic sciencedepartments into a single department ofbasic sciences, and to restructure ourresearch efforts around six or soresearch clusters that all share twofundamental characteristics—the focuson a disease or problem rather than a

DEAN’S LETTER

The Evolving Approachto Our Core Missions

discipline (such as neurodegenerativediseases rather than anatomy orbiochemistry), and the imperative thatthe research cluster have a clinicalcomponent so discoveries in thelaboratory can be applied at thepatient’s bedside. The formation ofresearch clusters allows interestedscientists from different disciplines andbackgrounds to come together to attacka common problemand research interest.As with oureducational efforts,our research efforts areshifting from theindividual to the team.This shift is nowheremore evident than inthe nomenclature usedwhen submitting grantapplications. For mostof my professional life,the indication of majorachievement as aninvestigator was to bethe principalinvestigator (called the PI) on a majorgrant. No more—grants now typicallyhave multiple co-PIs, and that is widelyviewed as a good thing!

Lastly, the School is evolving itsservice function. Heretofore, the SMHSlargely fulfilled its service function tothe community by providing a cadre ofhighly qualified and dedicated healthpractitioners. And certainly thatcommitment has not changed over theyears—and will not in the future. Butthe School understands that it has alarger responsibility to the people ofNorth Dakota than “simply” producinggreat practitioners. It also has aresponsibility to advocate for goodhealth and optimal health care policies.Thus, the School partnered with NorthDakota State University to develop agraduate program in public health to

train health providers, administrators,and others in population-basedstrategies to improve health and healthoutcomes. So while training a doctor,for example, can help improve thehealth of that doctor’s individualpatients, training a public health workercan help improve the health of anentire community. As in education andresearch, the School is enlarging its

focus from theindividual healthprovider and theindividual patient topopulations andcommunities.

This maturing ofour focus anddirection is essentialto our goal ofoptimizing the healthof North Dakotansand the health caredelivery system in thestate. As the babyboomers age anddevelop more chronic

diseases, our health care system isgoing to be stressed—and it is alreadynot as efficient, equitable, available, oraffordable as it needs to be. The changesthat are underway at the School shouldhelp us prepare for the future, and enableus to handle the challenges ahead. I’mexcited about our maturation as aSchool, and thank all of you for helpingto guide the way on our journey.

Joshua Wynne, MD, MBA, MPHUND Vice President for Health Affairs and Dean


”

“

...the School has been and is undergoing

fundamental changein the way we approach each

of our core missions—education, scholarship and

research, and service


NEWS BRIEFS

A total of $356,505 in scholarships was awarded to 129medical students at the University of North Dakota Schoolof Medicine and Health Sciences for the 2011–2012academic year. Funds for the scholarships are given fromvarious private sources, endowments, and scholarshipfunds. For the complete list, visit http://bit.ly/vGaBe6.

The University of North Dakota School of Medicine andHealth Sciences is a proud participant in the WhiteHouse’s Joining Forces initiative to serve veterans and theirfamilies. The UND SMHS has joined other members of theAssociation of American Medical Colleges (AAMC) in theAAMC’s effort to implement the Joining Forces initiativenationwide in medical schools. This effort is designed toachieve two basic goals: (1) greater understanding by ourstudents of the unique clinical challenges of caring formilitary service members, veterans, and their families; and(2) enhanced health care and community-support forpatients and families dealing with combat-relatedconditions like traumatic brain injury and post-traumaticstress disorder. Further details regarding the Joining Forcesinitiative can be found in the association’s news release:http://bit.ly/zVyyyD.

Through its long-standing affiliation with the VeteransAffairs Medical Center in Fargo, the UND School ofMedicine and Health Sciences provides post-MD medicaleducation and patient care, where resident physicians learnquality management of chronic long-term illnesses andabout problems unique to veterans.

For nearly five years, the School’s Center for Rural Healthhas worked to help veterans and their families through itsTraumatic Brain Injury Program, participating on the Inter-Service Family Assistance Committee, and research oninfectious diseases in returning veterans and on reducinghospital readmissions through follow-up care for veterans.

The School’s broad-reaching program will be cross-disciplinary, and will involve both the medical and healthsciences faculty. Leading the Joining Forces effort at theSchool of Medicine and Health Sciences will be EricMurphy, PhD, associate professor in the Department ofPharmacology, Physiology and Therapeutics.

UND School of Medicine and HealthSciences enlists in Joining Forces initiative

UND medical students receive scholarshipsfor 2011–2012

The Center for Rural Health (CRH) at the University of NorthDakota School of Medicine and Health Sciences has received$1,117,968 in grant funds for the North Dakota MedicareRural Hospital Flexibility Program (Flex), the Small RuralHospital Improvement Program (SHIP), and the North DakotaFrontier Community Health Integration Project (FCHIP).

The Flex program helps sustain rural health careinfrastructure by strengthening critical access hospitals andemergency medical services, which helps maintain accessto care for rural residents. The Flex program fosters thegrowth and sustainment of rural collaborative health caresystems across the continuum of care. Now in its thirteenthyear of funding, Flex received $708,968 in North Dakota.The SHIP program received $324,000 to provide supportfor small rural hospitals to help implement changes in howthe hospital delivers care. These funds will benefit ruralhospitals and help ensure they have a strong foundation toprovide health care to their community. SHIP is in itseleventh year of funding for North Dakota.

FCHIP was awarded $85,000 in its first year of funding.These dollars will be used to help hospitals explore ways toincrease access to and improve the adequacy of paymentsfor acute care and other essential health care servicesprovided under the Medicare and Medicaid programs. Inaddition to this, FCHIP funds will be used to evaluateregulatory challenges facing providers located in frontierareas of North Dakota and the communities they serve.

The Center for Rural Health participates in thesecompetitive federal grant programs to bring in much-needed dollars to support rural health care delivery. Asignificant amount of these funds will go directly to ruralcommunities to implement local solutions related to qualityof care, financial viability, and future access issues relatedto health care. This year, about $600,000 will bedistributed to critical access hospitals in North Dakota. Theremaining funds are used to support staff time and travel towork directly with rural health care entities and theirpartners to provide technical assistance such as strategicplanning, community health needs assessments, policyimplications, and education with these grant dollars. TheFlex, SHIP, and FCHIP programs are directed by MarleneMiller, program director at the Center for Rural Health.

Center for Rural Health receives $1.1 million in grants

Thomas Mohr, PT, PhD, professor and chair, and ReneeMabey, PT, PhD, professor, from the SMHS Department ofPhysical Therapy, along with Debbie Ingram, PT, EdD, andNancy Fell, PT, PhD, from the University of Tennessee atChattanooga, earned the Stanford Award for 2011 at theAmerican Physical Therapy Association’s CombinedSections Meeting in Chicago. The Stanford Award wasgiven to the authors of the article containing the mostinfluential ideas for physical therapy education publishedthat year in the Journal of Physical Therapy Education (vol.25, no. 2, spring 2011). The editorial staff of the journalselects the award winners. The title of the article was “TheCase for Academic Integrity in Physical TherapyEducation.” Mohr was the lead author.

Mohr and Mabey earn Stanford Award fromthe Journal of Physical Therapy Education


The dedication and efforts of faculty, staff and students inthe Department of Occupational Therapy at the Universityof North Dakota School of Medicine and Health Scienceswere instrumental in achieving a 10-year reaccreditation forthe department, which has a program in Grand Forks and asatellite program in Casper, Wyo.

“Very pleased,” said Janet Jedlicka, chair and associateprofessor for the Department of Occupational Therapy, inreaction to the report from the Accreditation Council forOccupational Therapy Education, which is the accreditingagency for the American Occupational TherapyAssociation. “We work hard to integrate the two programsand meet the standards. Our focus is on quality ofteaching, and in many cases, we exceed the requirementsfor an accredited program.”

Joshua Wynne, UND vice president for Health Affairsand dean of the UND School of Medicine and HealthSciences, lauded Jedlicka and her department for the“marvelously positive report and truly outstandingaccreditation evaluation, which is a direct result of thework of you and your colleagues in educating excellentoccupational therapists.”

In their assessment of the department, the council’sreport was noteworthy in that they cited no areas ofnoncompliance and eight areas of strength:

● Administrators’ “knowledge and valuing ofoccupational therapy in recognizing the importance ofimproving interdisciplinary collaboration, and insupport of delivery of the program at multiple sites.”

● Program chair’s “leadership in facilitating thedevelopment of an innovative curriculum design thatoptimally guides course design and sequencing,resulting in students who express a confidentknowledge of the curricular threads.”

● “Academic fieldwork coordinator is applauded for hercreativity and innovation in designing educationalmaterials for fieldwork educators.”

● Faculty’s “consistent andextraordinary dedication infostering the development ofexcellent occupational therapiststhrough creative course design,course delivery, and studentadvisement practices.”

● Support staff’s “organization andmanagement on behalf of theoccupational therapy programand students.”

● Fieldwork educators’ and employers’ “investment andstrong commitment to the program.”

● “Students are positive representatives of the university,the program and the profession. They were noted fortheir initiative for independent learning,professionalism, and enthusiasm for occupation-basedpractice by the fieldwork educators and employers.”

● “The program is commended for being a leader withinthe University of North Dakota by delivering excellentprogram content at the Grand Forks location and thesatellite location in Casper, Wyoming. Specifically,faculty dedication, coordination, and vigilance ensurethat all students are exceptionally prepared for entry-level practice by working diligently to deliver oneuniform curriculum to two separate locations.”

The accreditation council’s only suggestion to enhancethe occupational therapy program was for the university toreevaluate faculty workloads “based on the high teachingloads and the unique needs of an off-site program and theuniversity’s expectations for research and service.”

“The program receives excellent support from thefieldwork supervisors and graduates,” Jedlicka said. “Weare fortunate to have wonderful students, faculty, staff andadministration at the School of Medicine and Health Sciences.”

NEWS BRIEFS

Faculty, staff, and students achieve 10-year reaccreditation for UND occupational therapy program

Dr. Janet Jedlicka

Randy Szlabick, MD, was appointed as North Dakota’s firstState Emergency Medical Services and Trauma medicaldirector by the North Dakota Department of Health. He isassociate program director of the University of NorthDakota School of Medicine and Health Sciences GeneralSurgery Residency Program, assistant professor of surgery,and a general surgeon at Altru Health System. As medicaldirector, Szlabick will provide medical oversight andconsultation in planning, evaluation, and education for thestate trauma system.

Szlabick is a graduate of Wayne State School ofMedicine in Detroit, Michigan. He completed his residency

in general surgery at WilliamBeaumont Hospital in Royal Oak,Michigan He currently serves as amember of the North Dakota StateTrauma Committee and as the chairfor the North Dakota Chapter of theAmerican College of SurgeonsCommittee on Trauma.

Randy Szlabick named North Dakota’s first State EMS and Trauma medical director


NEWS BRIEFS

The University of North Dakota and Neomatrix, LLCannounced on January 9 that they signed an exclusiveagreement to develop technology for the early detection ofbreast cancer using the company’s HALO® Breast Pap Test device.

The HALO® breast test is for physicians and is designedto help screen and assess breast cancer risk in womenusing techniques from cell biology. The UND technology,used with the HALO® device, is based on the detection ofcancer indicators in breast nipple aspirate fluid (NAF).

Early detection of breast cancer is widely recognized asthe most effective strategy for successfully treating thedisease. Health outcomes are greatly improved when breastcancer is discovered in the early stages of development.

“Dr. Edward Sauter, professor in the department ofsurgery at the UND School of Medicine and Health Sciences,renowned for his research on NAF constituents and theirrole in breast cancer prediction, and his team find itrewarding to begin collaborations with our partnerNeomatrix and its scientists to help develop our technology,”said Michael Moore, UND associate vice president forintellectual property commercialization & economicdevelopment. “I want to recognize Dr. Kumi Combs in mygroup for her work in putting this agreement and

relationship together. This optionagreement sets the stage for furtherdevelopment of the technology. Welook forward to working withNeomatrix and sincerely hope wecan be part of an importantdiagnostic technology and assay forthe early detection of breast cancer.”

“We identified a promisingbreast cancer predictive markerpanel through funding from theNational Institutes of Health,” Sauter said. “We needed apartner to take the next step toward practical application indevelopment of an assay. It is exciting to partner withNeomatrix to validate our panel, in the hopes of gainingFood and Drug Administration (FDA) approval andbringing it to clinical use.”

“We are thrilled to be participating in this importantcollaborative program with the world-class personnel andfacilities at the University of North Dakota School ofMedicine and Health Sciences,” said France Dixon Helfer,president and CEO of Neomatrix, LLC. “We concur withthe University that this biomarker research will open newdoors in the early detection of breast cancer in women.”

UND signs license to develop breakthrough breast cancer detection technology

Dr. Edward Sauter

Dorscher new Associate Dean of Student Affairs and Admissions at UND School of Medicine and Health Sciences

Joycelyn Ann Dorscher, M.D., hasbeen named associate dean ofStudent Affairs and Admissions at theUniversity of North Dakota (UND)School of Medicine and HealthSciences. Dorscher comes from theUniversity of Minnesota MedicalSchool, Duluth, where she wasdirector of the Center of AmericanIndian and Minority Health, and anassistant professor in the Department

of Family Medicine and Community Health. “Dr. Dorscher combines a passion for student

education with a quest for excellence that will resonatewith our students” said Joshua Wynne, M.D., M.B.A.,M.P.H., UND vice president for health affairs and dean ofthe UND School of Medicine and Health Sciences. “She isan eloquent and seasoned clinician-educator. We aredelighted that we were able to recruit her to the School.”

Dorscher earned her Doctor of Medicine from theUniversity of Minnesota School of Medicine. She is aboard-certified family practice doctor who also holds aBachelor of Arts degree in medical technology from theCollege of St. Scholastica in Duluth. Dorscher notablymaintains an active clinical practice to keep her close to

patient care, most recently with the Mille Lacs Band ofObjiwe Outpatient Clinic in East Lake, Minn.

“The UND School of Medicine and Health Sciences hassuch a strong reputation,” Dorscher said. “I am honored to bea member of the administrative team, where core interests arethe success of students and the needs of communities.”

As a leader in a broad array of public health organizationsand foundations in the Duluth area, Dorscher has providedher medical expertise to help prevent cancer, heart disease,and tobacco abuse, as well as to improve child care andAmerican Indian health. She is active in medical research,with a focus on American Indian communities.

In 2011, Dorscher won the YWCA Women ofDistinction Award. The award recognizes women whoembody the mission of eliminating racism, empoweringwomen, and promoting peace, justice, freedom, anddignity for all. The University of Minnesota honored her in2007 with the President’s Outstanding Service Award forher local, state and national efforts to promote diversity inmedical education.

Dorscher spent her early years in North Dakota becauseboth of her parents Conrad and Lucille (Belgarde) Dorschergrew up in the state, and she still has many familymembers throughout North Dakota. She is an enrolledmember of the Turtle Mountain Band of Chippewa Indians.

Dr. Joycelyn Dorscher

Goldsteen Named Founding Director of UND MPH Program


NEWS BRIEFS

GRAND FORKS, N.D.–Raymond L.Goldsteen, DPH, has been named thefounding director of the University ofNorth Dakota’s Master of PublicHealth (MPH) Program, a jointendeavor of North Dakota StateUniversity’s (NDSU) College ofPharmacy, Nursing, and AlliedSciences and the University of NorthDakota (UND) School of Medicineand Health Sciences. The appointmentof Dr. Goldsteen mirrors the recent

arrival of Dr. Donald Warne to direct the NDSU program.Goldsteen comes to UND from the State University of

New York at Stony Brook Medical Center, where he wasthe founding director of the Graduate Program in PublicHealth, head of the New York City-Long Island-Lower Tri-County Public Health Training Center at Stony Brook,director of the Center for Health Services and OutcomesResearch, and a tenured professor of preventive medicine.

“Dr. Goldsteen brings enormous experience in publichealth education” said Joshua Wynne, M.D., M.B.A.,M.P.H., UND vice president for health affairs and dean ofthe UND School of Medicine and Health Sciences. “Heoversaw the development of the MPH program at StonyBrook, and we look forward to his experienced hand inguiding the growth of our fledgling program here in NorthDakota. We are delighted that he’ll be joining theUniversity of North Dakota. I know that our colleagues atNDSU share our excitement at his recruitment.”

Goldsteen earned his Doctor of Public Health insociomedical sciences from Columbia University. Hisdissertation was a public health case study of the most seriouscommercial nuclear power plant accident in U.S. historythat occurred at Three Mile Island near Middletown, Pa., in1979. He also earned a Master of Arts in sociology fromBrown University and a Bachelor of Arts in history andurban studies from Columbia University. Goldsteen is aFellow of the New York Academy of Medicine.

“I am honored to have been chosen as the foundingdirector of the University of North Dakota MPH Program,”Goldsteen said. “UND has demonstrated a commitment todeveloping an excellent MPH program that will serve thepeople of North Dakota. I can’t wait to get started andcontribute to bringing this promise to reality.”

Goldsteen has extensive experience in public health atthe federal level. He served on the U.S. Department ofHealth and Human Services’ committee on Drug UsageTerminology, and he has served as a reviewer for theCenters for Disease Control’s Special Emphasis Panel forObesity and Nutrition. In addition, Goldsteen was anofficer in the U.S. Public Health Service CommissionedCorps, where he served as a social science research

scientist working on Medicare issues.His research expertise is in health policy, particularly

fairness and effectiveness of health care resourceallocation, and public support for fair and effectiveallocation of health resources. Goldsteen’s workconsistently attracts grant funding from federal agenciesand private foundations. He is currently conductingresearch on the availability of medical residency trainingprograms in the United States and its implications forexpanding medical schools and the number of physicians.He also is exploring how the guidelines established by theGlobal Initiative for Chronic Obstructive Lung Diseaseaffect the outcomes for patients in Veterans Affairs hospitalswho have chronic obstructive pulmonary disease. He is thefirst author of “Introduction to Public Health,” published bySpringer Publishing, which has been well-received. He hasassumed the first authorship of “Jonas’ Introduction to theU.S. Health Care System,” 7th edition, a widely usedtextbook in the field.

Goldsteen is married to Karen Goldsteen, M.P.H.,Ph.D., a health outcomes researcher in her own right, aswell as his frequent collaborator. They have threechildren—Jonathan, Benjamin, and Sune—who live inBrooklyn and California.

The North Dakota Master of Public Health (MPH)program offers two tracks:

• NDSU offers specialization tracks in Health Promotion,Pharmacy in Public Health, Infectious DiseaseManagement, and Emergency Management. Thosewishing to pursue one of these tracks will apply toNorth Dakota State University. Learn more aboutNDSU’s specializations at http://www.ndsu.edu/gradschool/programs/public_health/public_health/.

• UND offers specialization tracks in Rural HealthManagement and Policy, Rural Health and HealthCare, and A Healthy Society. Those interested inpursuing one of these tracks will apply to theUniversity of North Dakota. Learn more about UND’sspecializations at http://www.med.und.edu/degrees/graduate-programs/public-health/.

The first students in the program begin classes thisfall, and the application deadline is April 1.

Dr. Raymond Goldsteen


The Doctor-CEO Is InBy Juan Pedraza

MDs with MBAs lead the School of Medicine and Health Sciences.


oshua Wynne, MD, MBA, MPH,scrolls through lots ofspreadsheets—a lot more thanmost of us and more than mostother physicians. As University of North Dakota vice

president for health affairs, dean of theSchool of Medicine and HealthSciences, and a practicing cardiologist,he’s basically managing a big business.That’s why Wynne considers having amaster’s in business administration(MBA) a major asset. He’s one of only11 med school deans, of the 137accredited U.S. medical schools, whohold MBA degrees in addition to theMD (and other degrees).

Like the CEO of any bigenterprise—the School’s budget isroughly $80 million annually from allsources, including research grants andcontracts—Wynne deals every day withthe big picture of the School’s financesplus a lot of other items such asscholarships and endowments.

In other words, Wynne and hismanagement team—including hisdeputy, Senior Associate Dean GwenHalaas, a physician who also holds anMBA—keep a close watch on theSchool’s bottom line.

“When I was chief of cardiology atWayne State University, I combinedteaching, patient care, andadministration with running thedivision, which had 25 facultymembers. Two things prompted me toget an MBA,” said Wynne, who tookover as SMHS dean in 2010. “One wasI felt the need for supplementing myon-the-job training as an administrator;the second was that I liked theadministration side of medicine and feltthat I wanted more rigorous businesstraining to tackle the challenges ofsenior administrative positions.”

The course he chose required someserious planning and time management;he kept his day job while completingthe University of Chicago’s executiveMBA program.

“It was the most challengingexperience I have had since I was anintern,” Wynne said. “But I learnedhow other industries ran and produced

J

”

“

... I learned how otherindustries ran

and produced value...

Gwen Halaas and Joshua Wynne


value, though I still wanted to knowmore about health-related managementpolicy. So after a year’s hiatus, I got amaster’s of public health (MPH) degreeat the University of Michigan.”

So what’s the bottom-line reasonfor tackling an MBA once a person hassurvived the long rigors of medicalschool and internships?

“As a physician, you’re dealingwith individuals, with health care at thepersonal level,” Wynne said. “But theMBA broadens that perspective toanalyzing not justindividuals butcommunities. Thecombination of amedical degree, anMBA, and an MPHgave me theperspective and toolsthat I now use everyday as dean.”

For example,Wynne said, theMBA degree helpshim analyzeworkforce issues asthey apply in NorthDakota, especiallythe looming healthcare worker shortage,including physiciansand nurses.

“It helps meunderstand how to deploy resourceseffectively and deal with health careaffordability issues,” Wynne said. “Thisis all about a lot more than anindividual. What we’re concernedabout is delivering the best and mostcost effective health care we can affordto everyone in the state.”

Wynne, who visits with studentsinformally and also delivers lectures,said he often talks about how to applybusiness practices and principles in medicine.

“What I don’t talk about is billing,salaries, and other day-to-day financialmatters,” Wynne said. “What I do talkabout with students is how doctors andother health care professionals can be apositive force in helping to optimizeour health care delivery system.”

Wynne sees a trend in medicalschool curricula across the country toincorporate more business education.But he also notes that the MBA is notfor everybody.

“It’s a great complement to the MDdegree if you’re interested in healthcare management, where you’redealing with broader policy issues,”said Wynne.

Today, an increasing number ofU.S. medical schools offer so-calleddual-track business degree programs,

where a graduate getsboth an MD degree andan MBA; schools ofosteopathy are likewisefollowing suit.

“We certainly believethat all medical studentswould be more effective ifthey had business training,”said Maria Chandler, MD,MBA, director of theMD/MBA program andassociate clinical professorof pediatrics at theUniversity of California,Irvine. She launched the school’s dual-trackMD/MBA program.

“Medical schools arenow graduating hundredsof MD/MBAs per year, sohopefully, they will make

their way to the top in the industry,including academics,” said Chandlerwho also is founder and president ofthe Association of MD/MBA Programs.She agreed with Dean Wynne regardingher purpose in adding MBA to her MDdegree: it was all about boosting heradministrative skills.

The Association of AmericanMedical Colleges stated more than a decade ago that future physiciansmust acquire leadership skills, be able to analyze financial data, and negotiate contracts.

Though still relatively new, theMD/MBA phenomenon is growing.

For example, the UND School ofMedicine and Health Sciences’ top twoexecutives both hold MBA degrees.

“It wasn’t at all a thought in my

”

“The physician/MBA

knows that the practice of

medicine requires tools that include

business leadershipand management; it’s a larger scope

of practice.


mind right after I got out of Harvard,”said Halaas, a Concordia College alumwho started a family practice clinic witha colleague right after she completedher residency program.

“But at about the time I decided toget my MBA, there was a growing needin health care for physicians withbusiness leadership experience,” Halaassaid. “The pendulum has swung fromthe physician-owned and physician-ledpractice to more physician-executivesin team-based settings such as hospitals,other health carefacilities, and healthinsurance companies.”

Halaas, a familypractice physician, hasheld several executivepositions in both theprivate health caresector and in education.

“I took a 13-weekmini-MBA certificateprogram for health careprofessionals at theUniversity of St. Thomasand really enjoyed it,”said Halaas. “Thenext year there was abrand new MBAprogram in medicalgroup management atUST, and I was in thefirst cohort; I loved it,even though I continued to work fulltime and had children at home.”

Halaas agrees with Wynne andChandler that a business degree adds adifferent dimension to medicine.

“The main difference is that withan MD you’re focused on the patientor, at most, with the patient’s family,”Halaas said. “In fact, physicianshistorically have separated themselvesfrom the financial aspects of health carein order to do the best for their patientswithout being mindful of cost,” Halaassaid. “Certainly, it can be a virtue topractice that way; I’d call it an idealizedpractice. But the physician-MBA knowsthat the practice of medicine requirestools that include business leadershipand management; it’s a larger scope of practice.”

“For example, when I was anassociate medical director atHealthPartners, as a family physicianoverseeing the care of 700,000 peopleit was overwhelming,” Halaas said. “Itwas my job to see that they got the bestcare possible that the system could afford.I needed to be knowledgeable aboutthe latest medical science, and I had tounderstand the costs. Somehow I had toassure patient access to preventivehealth care while balancing the need forexpensive or cutting edge therapies.”

Halaas argues, like Wynne and others,that not every studentneeds or would wantan MBA degree.

“But if you aspireto be a leader and takeon important roles inmanaging health care,at some point in yourcareer you shouldconsider an MBA,”Halaas said.

”

“if you aspireto be a leaderand take on

important roles inmanaging health care,

at some point in your career

you should consider an MBA


Opening envelopes that held the secrets towhere they will spend the next few yearsof their lives, 58 senior medical students,members of the Doctor of Medicine(M.D.) Class of 2012 at the University ofNorth Dakota (UND) School of Medicineand Health Sciences, learned where inthe United States they will hone theirskills as resident physicians. On MatchDay, March 16, medical school seniorsacross the country found out wherethey will complete their residencies, aperiod of advanced intensive training intheir chosen medical specialty beforeindependent practice as a physician.Depending on the medical specialty,medical school graduates completeanywhere from three to seven years of

residency training after medical school. Match Day is the culmination of the

National Resident Matching Program(NRMP), a private, not-for-profitcorporation established in 1952 to providea uniform date of appointment to positionsof graduate medical education orresidency in the United States. Each yearapproximately 16,000 U.S. medicalschool seniors participate in the residencymatch. Students as well as residencyprogram directors register their preferencesfor each other with the NRMP. The NRMPthen feeds the rank-ordered choices of thestudents and directors into a computer,which provides an impartial matchbetween the two groups. In the thirdweek of March, at the same time across

Aaron Audet Family MedicineProvidence Sacred Heart Medical CenterUniversity of Washington School of Medicine ProgramSpokane, Washington

Melissa Austreim Family MedicineSiouxland Medical Education Foundation ProgramSioux City, Iowa

Jess Belling PediatricsTripler Army Medical CenterHonolulu, Hawaii

Elizabeth Blixt TransitionalUniversity of North Dakota School of Medicine and Health SciencesFargo, North Dakota

Mayo School of Graduate Medical Education DermatologyRochester, Minnesota

Patrick Britton PsychiatryMedical College of Wisconsin Affiliated Hospitals ProgramMilwaukee, Wisconsin

Brottlund, Jennifer Family MedicineSt. Joseph’s Regional Medical Center South Bend ProgramMishawaka, Indiana

Match Day Residency Sites

Opening Day for


the country, students open envelopes tofind the results of the match.

“The match is all about what ourstudents will do after they graduate. It isthe culmination of a lot of hard workand dedication to become professionals,”said Robert Beattie, M.D., chair of theDepartment of Family and CommunityMedicine and interim associate dean ofStudent Affairs and Admissions for theUND School of Medicine and HealthSciences. “Once again our studentshave done an exceptional job ofpreparing themselves to be successful.”

UND medical students successfullymatched in the traditional primary carespecialties of family medicine (14),internal medicine (7), and pediatrics

(5)—for a total of 26 or 44.8 percent ofthe class. Other specialties chosen bythis year’s class include anesthesiology,child neurology, dermatology,emergency medicine, general surgery,obstetrics/gynecology, orthopaedicsurgery, pathology, plastic surgery,psychiatry, and radiology.

“Students from the UND School ofMedicine and Health Sciences are well-regarded throughout the nation becauseof their broad-based educationalfoundation and work ethic,” Beattie said.“We also know that many of our studentswho choose a training site outside of ourstate return after residency to providecare for the citizens of North Dakota.”

By Denis MacLeod

UND Med Students

Lindsay Carlile Obstetrics/GynecologyLoyola University Medical CenterMaywood, Illinois

Katie Carlson Internal MedicineUniversity of Pittsburgh Medical CenterMedical Education ProgramPittsburgh, Pennsylvania

Christine Carlson Rahn Family MedicineClarkson Regional Health Services ProgramOmaha, Nebraska

Adam Cole Medicine – PreliminaryCreighton University School of MedicineOmaha, Nebraska

University of Nebraska Radiology – DiagnosticMedical CenterCollege of Medicine ProgramOmaha, Nebraska

Sarah Cole PediatricsUniversity of South Dakota ProgramSioux Falls, South Dakota

Jenna Cusic Plastic SurgeryMedical College of Wisconsin Affiliated Hospitals ProgramMilwaukee, Wisconsin


Susan Derry Emergency MedicineCarilion ClinicVirginia Tech Carilion School of MedicineRoanoke, Virginia

Mark Detwiller Emergency MedicineGrand Rapids Medical Education PartnersMichigan State University ProgramGrand Rapids, Michigan

Amanda Dhuyvetter Obstetrics/GynecologyRush University Medical Center ProgramChicago, Illinois

Lance Doeden TransitionalUniversity of North Dakota School of Medicine and Health SciencesFargo, North Dakota

University of Nebraska Medical Center AnesthesiologyCollege of Medicine ProgramOmaha, Nebraska

Tiffany Doyle PsychiatryUniversity of North Dakota School of Medicine and Health SciencesFargo, North Dakota

Angela Eakin Family MedicineValley Medical Center ProgramRenton, Washington

Justin Ferragut Radiology – DiagnosticUniversity of Illinois College of Medicine at Peoria ProgramSt. Francis Medical CenterPeoria, Illinois

Colin Fitterer Internal MedicineMayo School of Graduate Medical Education Arizona ProgramScottsdale, Arizona

Foughty, Stephanie Family MedicineAltru Health SystemGrand Forks, North Dakota

Kristen Fried Obstetrics/GynecologyUniversity of Missouri at Kansas City ProgramKansas City, Missouri

Morgan Grundstad PediatricsUniversity of Iowa Hospitals and Clinics ProgramIowa City, Iowa

Elizabeth Hagen Surgery – GeneralHennepin County Medical Center ProgramMinneapolis, Minnesota

Nathan Harris Orthopaedic SurgeryUniversity of Missouri at Kansas City ProgramKansas City, Missouri

Christopher Irmen Family MedicineAltru Health SystemGrand Forks, North Dakota

Derrick Kuntz Family MedicineRapid City Regional Hospital ProgramRapid City, South Dakota

Charles Lenz Internal MedicineMayo School of Graduate Medical EducationRochester, Minnesota

Brianna MacQueen PediatricsMayo School of Graduate Medical EducationRochester, Minnesota

Seth Maliske Internal MedicineUniversity of Iowa Hospitals and Clinics ProgramIowa City, Iowa

Robert Marshall PediatricsUniversity of Nebraska Medical CenterCollege of Medicine/Creighton University ProgramOmaha, Nebraska

Laura Matzke Bitterman TransitionalUniversity of North DakotaSchool of Medicine and Health SciencesFargo, North Dakota

Mayo School of Graduate AnesthesiologyMedical EducationRochester, Minnesota

Justin Mauch TransitionalUniversity of North Dakota School of Medicine and Health SciencesFargo, North Dakota

Mayo School of Graduate Radiology – DiagnosticMedical EducationRochester, Minnesota

Melanie McCarroll Emergency MedicineNew York Methodist Hospital ProgramBrooklyn, New York

Kathryn McEvoy Obstetrics/GynecologyUniversity of Missouri at Kansas City ProgramKansas City, Missouri

Adam McGauvran Surgery – PreliminaryUniversity of North DakotaSchool of Medicine and Health SciencesGrand Forks, North Dakota

Mayo School of Graduate Radiology – DiagnosticMedical EducationRochester, Minnesota

Match Day Residency Sites


James Miles Child NeurologyMayo School of Graduate Medical EducationRochester, Minnesota

Thomas Miskavige Internal MedicineAbbot-Northwestern Hospital ProgramMinneapolis, Minnesota

Katherine Neubauer Family MedicineSt. Joseph’s Regional Medical Center South Bend ProgramMishawaka, Indiana

Brett Oestreich Internal MedicineUniversity of Colorado Denver ProgramAurora, Colorado

Rochelle Palmiscno Family MedicineNorth Colorado Medical Center ProgramGreeley, Colorado

Eric Ragland Surgery – PreliminaryUniversity of Colorado Denver ProgramAurora, Colorado

Michelle Reinholdt Obstetrics/GynecologyMayo School of Graduate Medical EducationRochester, Minnesota

Meredith Reisenauer DermatologyMayo School of Graduate Medical EducationRochester, Minnesota

Jennifer Risan AnesthesiologyUniversity of New Mexico ProgramAlbuquerque, New Mexico

Ray Rivas Surgery – GeneralTexas A&M – Scott and White ProgramTemple, Texas

Luke Roller Radiology – DiagnosticUniversity of Minnesota ProgramMinneapolis, Minnesota

Erica Sauer PediatricsUniversity of Missouri at Kansas CityChildren’s Mercy HospitalKansas City, Missouri

Amy Stokka Emergency MedicineUniversity of Missouri at Kansas City ProgramKansas City, Missouri

Andrew Swenson Emergency MedicineGrand Rapids Medical Education PartnersMichigan State University ProgramGrand Rapids, Michigan

Sarah Tillman Obstetrics/GynecologyMedical University of South Carolina ProgramCharleston, South Carolina

Amber Tincher Family MedicineUniversity of North Dakota School of Medicine and Health SciencesBismarck, North Dakota

Archana Varma Family MedicineUniversity of Minnesota Mankato ProgramMankato, Minnesota

Diane Voeller Family MedicineAltru Health SystemGrand Forks, North Dakota

John Wagener Internal MedicineDuke University Hospital ProgramDurham, North Carolina

Katie Wetsch Surgery – GeneralNaval Medical CenterSan Diego, California

Kailey Witt Family MedicineSioux Falls Family Medicine ProgramSioux Falls, South Dakota

Jennifer Wolf Obstetrics/GynecologyUniversity of Missouri – Columbia Program University Hospitals and ClinicsColumbia, Missouri

Ryan Clauson (2008) Family MedicineUniversity of North Dakota School of Medicine and Health SciencesBismarck, North Dakota

Justin Gross (2010) TransitionalUniversity of North Dakota School of Medicine and Health SciencesFargo, North Dakota

University of Nebraska Radiology – DiagnosticMedical CenterCollege of Medicine ProgramOmaha, Nebraska

Emily Welle (2011) PsychiatryUniversity of North Dakota School of Medicine and Health SciencesFargo, North Dakota

Graduates

“

”

Hospitals that participatehave learned about

the quality of care they aregiving to stroke patientsand are using what they

have learned to focus on care improvement.


From Hettinger to Hillsboro, Tioga toTurtle Lake, North Dakotans deserve thehighest quality of care wherever they are.With a highly rural and older population,it is imperative that health care providerswork together like a well-oiled machine.This is especially true when time is afactor, such as when someone isexperiencing symptoms of a stroke.According to the National Institutes ofHealth, when a stroke occurs, most ofthe time patients must reach a hospitalwithin three hours after symptoms beginin order to maximize the availabletreatment interventions. In rural NorthDakota, an emergency room within acritical access hospital may likely bewhere patients will first seek care ifthey experience symptoms of a stroke.

With the realization of the need tomaintain or improve the care strokevictims in North Dakota receive, theState Stroke Program was createdthrough the 2009 Legislature when theNorth Dakota Department of Healthreceived appropriated funds to begin a

state stroke program. Susan Mormann,strategy specialist for the Heart Diseaseand Stroke Prevention Program at theDepartment of Health said, “The mainpurpose of the program is to improvethe level of care to enhance patientoutcomes and save lives.” The goal ofthe State Stroke Program is to reducestroke morbidity and mortality causedby stroke through implementing theAmerican Heart Association’s “Get withthe Guidelines—Stroke” program inevery hospital in the state. Get with theGuidelines—Stroke is designed toimprove or maintain how health carefacilities adhere to evidence-based careof patients hospitalized because of astroke. According to a fact sheet fromthe American Heart Association, theprogram provides hospitals with a Web-based Patient Management Tool thatprovides decision support, a robustregistry, real-time benchmarkingcapabilities, and other performance-improvement methods to enhancepatient outcomes and save lives.

State Stroke ProgramThe North Dakota Department of Health seeks to improve stroke patients’ care and outcomes. By Kristine Henke

Once the Department of Healthreceived funding for the State StrokeProgram, they approached the CriticalAccess Hospital (CAH) Quality Network,a program of the UND Center for RuralHealth, and requested a partnership thatwould use the CAH Quality Network’sexpertise to raise awareness and helpgain participation in the program. TheCenter hired Nikki Massmann as a StateStroke Program coordinator to helphospitals “on-board,” or become familiarwith the online stroke registry, providepractical assistance to the hospitals asneeded, and find good sources ofeducation and information. The CAHQuality Network was already workingwith the small rural hospitals of the stateon other quality improvement initiatives,so adding this program was a good fitfor both entities. Since Massmannbegan working with the State StrokeProgram in 2010, 28 of the 36 criticalaccess hospitals and all of the larger,tertiary hospitals in North Dakota havebeen on-boarded and are participating.

Massmann said, “The program ismore than chart entry into abenchmarking tool. Hospitals thatparticipate have learned about the qualityof care they are giving to stroke patientsand are using what they have learned tofocus on care improvement. The mostimpressive part is how the urban andrural hospitals are working together toimplement quality improvement andguide each other through the process ofchange. They have all been so willingto share knowledge and successes onstroke care improvements, whichbenefits the ultimate focus of theprogram, the patient.”

Hospitals participating in the programreceive a grant to purchase the Web-basedPatient Management Tool, into whichthey enter nonidentifiable stroke caseinformation. For large facilities in thestate, such as Altru or Medcenter One,30 consecutive cases are entered as aninitial entry to establish a baseline;critical access hospitals enter one year’sworth of cases for their initial entry. Allhospitals will continue to annuallyenter data to help measure against thebaseline; these respective numbers are

what the hospitals are asked to record.From the data entered, a benchmark, orline of quality, is created for measuressuch as the percentage of patients witha history of smoking who are, or whosecaregivers are, given smoking-cessationadvice or counseling during theirhospital stay; the percentage of patientswho are treated within 60 minutes oftheir emergency department arrival; andhow patients arrived at the hospital.

Ultimately, the program’s goal isfor all hospitals, physicians, emergencymedical services, and communities tospeak the same language. The topic ofstroke care has been brought to theforefront, and North Dakota hospitals largeand small will continue to implementthe State Stroke Program, sharing bestpractices with one another to providethe best care possible to every strokepatient. With this dedicated work andcollaboration, when the unfortunateincident of a stroke occurs, patients inNorth Dakota can expect the bestquality of care wherever they are.

Nicole Massman


F —Facial WeaknessA—Arm and Leg WeaknessS —Speech ProblemsT —is for Time.

Call 911 right away.

Know the symptoms of a stroke


Library outreach to the fire department?emergency responders? EMTs? Youmight find these to be strangeaudiences for library outreach.

The Harley E. French Library has along history of outreach services to thestate, and even beyond. Our outreachefforts were able to grow as theNational Library of Medicine (NLM)began promoting outreach by awardingfunds to medical libraries. In 1992 wereceived a grant from the NLM to travelto Indian reservations in North Dakota,South Dakota and Nebraska—theAberdeen Region of the Indian HealthService (IHS). Lorraine Ettl (the library’shead of public services, now retired)traveled thousands of miles to 25 IHSfacilities, where she trained 350 healthcare workers to search the medicalliterature database, Medline.

Since then, the library has takenadvantage of many opportunities tocontinue outreach to many groups—health care professionals, AmericanIndians, public health workers, socialservice agencies, the public as healthcare consumers, and most recentlyemergency responders.

From 2002 to 2007, Judy Rieke,then the library’s assistant director andnow retired, rejuvenated outreach toAmerican Indian communities throughseveral projects funded by the NLM.She forged partnerships with North

Dakota’s five tribal colleges by providingtheir libraries with computers and accessto databases, and teaching the librarianshow to mine Pubmed and other NLMdatabases. Rieke formed a cohort ofAmerican Indians recruited from theNorth Dakota reservations to assist theNLM to develop its American IndianHealth website. And she trained manyhealth professionals at the IHS sites inthe state to make expert use of Pubmedand related NLM and NIH databases.

In 2006, the Harley E. FrenchLibrary was designated an OutreachLibrary by the Greater Midwest Regionof the National Network of Libraries ofMedicine. As an Outreach Library, wehave received funds every year sincethen to support outreach services. Ourlibrarians have traveled throughout thestate to small communities such asVelva, Williston, Grafton, Rolla,Bottineau, Rugby, Stanley, Oakes, andCarrington to acquaint health careproviders with information services andto train them in effective use of themedical literature. We have offeredclasses in public libraries to thelibrarians and the public alike inMandan, Minot, Bismarck, Harvey,Bowman, and Fargo. Our staff haveeven been guest lecturers in classes atNorth Dakota State University andMinot State University.

Sandi Bates, head of reference and

GUEST AUTHOR

Outreach Services by the Harley E. French Library of the Health Sciences

By Lila Pedersen, director of libraries, and Barbara Knight, assistant director,

Harley E. French Library of the Health Sciences


user education, has just identified a newgroup to reach—emergency responders.This spring she will begin teachingWISER: NLM’s Wireless InformationSystem for Emergency Responders,which assists first responders inhazardous material incidents.

Our four clinical campus librariansare dedicated to promoting libraryservices and helping people get themost out of the medical literature andinformation resources. If you or acolleague would like to discuss thepossibility of a visit from a librarian,please contact the one serving yourarea of the state.

Karen Anderson (Northwest)[email protected]

Sandi Bates (Northeast and Southwest)[email protected]

Mary Markland (Southeast)[email protected]

Lila Pederson and Barbara Knight


Ice hockey is a game better known forfueling heated fights than kindling theflame of romance between its players.Every week at the School of Medicineand Health Sciences, a group ofgraduate and medical students, faculty,and friends take to the ice for a “mildly”competitive game. Chris and StacyIrmen met while playing in a game.“She’s pretty good; she’s quite a bitbetter than I am,” Chris said. Stacyplayed college hockey for the Collegeof St. Benedict Blazers in Saint Joseph,Minn. That on ice encounter also led toChris’s decision to enter medicine.

When Stacy, MD ’08, and Chris, PhD’08, started dating, she was in medicalschool and he was a graduate studentstudying anatomy in the PhD track.“She would talk about her stories at theend of the day,” Chris said. “I wouldget pretty interested and ask a lot ofquestions. Diagnostic puzzles and beingcontinually challenged by a wide varietyof patients seemed very appealing tome. It dawned on me that this issomething I am very much interested inand should pursue while I was stillsomewhat young. So I decided to applyto medical school while I was nearingthe end of my graduate program.”

“I always loved the sciences in highschool, particularly anatomy,” said Chris,a native of Bismarck, where he earnedhis undergraduate degree in biology fromthe University of Mary in 2003. “I likedrelating function to structure of the body.I had thoughts about medicine as anundergrad, but I shied away from it afterI worked as a certified nursing assistantfor a year from 2002 to 2003,” a job inretrospect he acknowledges was a goodexperience in his preparing to go intomedicine. “I liked everything medically

related to the job, but some of thebureaucratic components were not veryappealing. At the time, I didn’t feel likemedicine was the right choice, but I stillloved the science behind it all—especiallyanatomy and physiology. So I decidedto continue my love of sciences in alaboratory setting, specifically anatomy.Anatomy always clicked with me, andit offered the opportunity to study oneof my interests: pain.”

Chris obtained his PhD in thesummer of 2008, the week beforestarting medical school. Dr. PatrickCarr was his faculty mentor. The title ofChris’s dissertation was “The Role ofSRC Suppressed C-Kinase Substrate(SSeCKS) in Primary Sensory Neurons.”Chris researched the protein SSeCKS(pronounced “essex”). It was a study ofthe novel protein’s role in the central andperipheral nervous system, particularlyits relationship to pain. “The researchwas exciting in that not many peoplewere studying SSeCKS in the nervoussystem,” Chris said. “But on the otherhand, it was difficult because you hadno one else’s research to fall back on.”

With PhD in hand and his MDforthcoming this spring, you wouldexpect Chris to be pursuing hisresidency at a large urban medicalcenter that offers post-graduatephysician training and researchopportunities. Instead, Chris chosefamily medicine. “It has the mostvariety. It gives you a lot of freedom todo as much and learn as much as youfeel comfortable with in many areas,”Chris said. He had been leaningtoward family medicine when heentered medical school. “Practicing in arural town was appealing to me. Familymedicine doctors get to do things in a

STUDENT PROFILE

Check MatesThe endgame for this couple is to practice family medicine in rural North Dakota.

“Family medicine doctors

get to do things in a smaller town that you don’t

otherwise get to do.

”

By Denis MacLeod


smaller town that you don’t otherwiseget to do. You can work in emergencymedicine, sports medicine, obstetrics,and do plenty of procedures.”

Chris and Stacy’s daughter Elena wasborn on January 12, 2012. Chris is seekinga residency that would be close to homeand family, and with hours that coincideclosely with Stacy’s. Stacy has completedher three-year family medicineresidency with Altru Health System inGrand Forks, where she is currentlycompleting a fellowship in obstetrics.For this year’s residency match, Chrisapplied to programs in Bismarck, GrandForks, and Rapid City, S.Dak.

After his residency, Chris wouldlike to complete a one-year fellowshipin sports medicine, and then practice ina rural setting in North Dakota. “Stacycould practice OB, and I could practicea lot of the medicine I prefer in asmaller community as well, acommunity, for example, the size ofDevils Lake or Dickinson.”

Chris had played baseball in highschool, and got cut from the team hisfirst year in college. He picked upplaying hockey while in graduateschool. “Sports medicine has a lot ofthe ingredients I love about medicine:musculoskeletal anatomy, neurology,radiology, and procedures.”

Like Chris, Stacy’s interest inmedicine began with her high schoolanatomy and physiology classes inWest Fargo. “Medicine always piquedmy interest. I knew going into collegethat I wanted to go into medicine,” saidStacy, who grew up in Horace, N. Dak.,and earned her undergraduate degree inbiology from the College of St. Benedict.

“I always liked obstetrics andwomen’s and children’s health,” shesaid. “It’s nice to be able to take care ofthe whole family as opposed to takingcare of mom during pregnancy anddelivering the baby and never seeingthe baby again. Being able to stay inNorth Dakota for my residency wasreally important. I enjoy therelationships that family doctors havewith their patients, and I wanted to beable to continue that.”

What has it been like for Chris tobe married to a doctor and also be amedical student? “Everybody told us itwould be very challenging, and havingthat in mind—not expecting the journeyto be easy—has really helped us,” Chrissaid. “We have handled it well. Itactually has been more beneficial forme. Stacy knows what I am goingthrough. She doesn’t get angry when Icome home late. If I am dead tired thenext day, she understands why. It hasworked out pretty well for us.”

As Chris prepares to join the rankswith his professional colleague Dr. StacyIrmen, what do they remember the mostabout the School? “The amount of supportwe get at the School is amazing,” Stacysaid. “The relationships you developwith faculty; the teachers and professorsare unique. We get one-on-one attentionsometimes that allows you to developrelationships with people such as Dr.Patrick Carr, who has become a goodfamily friend of ours, as was the casewith Judy DeMers. Because we are asmall school, the amount of individualattention and support we get is probablynot seen at most other medical schools.”

“The biggest thing is the faculty,”Chris said. “The volunteer faculty don’tget anything extra to teach us. Wemight even slow them down; yet, theycontinually make sacrifices on ourbehalf to ensure that we becomewell-prepared physicians.”

I enjoy the relationshipsthat family doctors have withtheir patients, and I wantedto be able to continue that.

”

Elena, Chris, and Stacy Irmen. Photo courtesy of Farrah Spivey Photography.

“


The bricks and mortar tell only a small part of the story of theUniversity of North Dakota’s Southeast Campus, adjacentto the Veterans Affairs (VA) Medical Center in north Fargo.

The associate dean, or campus dean, is Julie Blehm,MD, FACP, appointed to the position in 2007.

She is a 1981 alum of the UND School of Medicineand Health Sciences who practices geriatric and internalmedicine. Blehm also is clinical director of the internalmedicine residency outpatient clinic and as of last year, thenew governor of the North Dakota Chapter of theAmerican College of Physicians.

The Southeast Campus is a vital part of UND’sstatewide program of medical education, administeredthrough four regional campuses, represented by quadrants(Southwest, Northwest, Northeast, and Southeast), based inBismarck, Minot, Grand Forks, and Fargo.

The Southeast Campus is home to 30 to 33 third-yearand 15 fourth-year medical students, as well as about 60

residents specializing in internal medicine, psychiatry,surgery, or in a preparatory transitional year. The campusalso regularly hosts visiting students from other institutionsabout once a month.

Most of the Southeast Campus offices are located inthe Medical Education Center on the VA Medical Center’sgrounds. The campus consists of the following departmentsand divisions: Clinical Neuroscience, Internal Medicine,Pediatrics, Obstetrics and Gynecology, Surgery, RuralHealth, Library Services, Campus Deanship, and theGraduate Medical Education office.

Additionally, the Southeast Campus includes the UND-affiliated Neuropsychiatric Research Institute, a private, not-for-profit, endowed research institute that includes both basicand clinical research components. James Mitchell, ChesterFritz Distinguished Professor of Neuroscience, chairs UND’sDepartment of Clinical Neuroscience. Mitchell also servesas the president and scientific director of the institute.

CAMPUS SPOTLIGHTFARGO

Julie Blehm By Juan Pedraza


“We’re at the forefront of educating future physicians,”said Blehm, who works part-time for UND while holdingdown an appointment as a practicing physician andadministrator with Sanford Health.

“When students come to us, they’ve already completedtwo years of medical school, but they don’t have their MDdegrees yet,” Blehm said. “They have been involved withpatients—and there’s a lot more patient involvement in thefirst two years than when I went through the UND Schoolof Medicine and Health Sciences—but basically the thirdand fourth years are mostly all patient involvement. We tryto teach students here a lot aboutcommunication and relating to patients.We also stress that patient care improveswhen nurses, physicians, advanced-practice providers, and others on the teamtreat one another with respect. With ateam-based approach, it’s much morelikely that patients will get good care.”

At its core, the focus of the third- andfourth-year portion of a student’s medicaleducation is clinical.

“There certainly are lectures,” Blehmsaid. “Our clerkship directors and otherfaculty members do lectures so that thestudents get the knowledge they need; butthe most important part of their educationis rotations they do with doctors in thearea, for example, internal medicine inhospital service. Thus they see how theresidents and attending physicians interactwith patients and manage their cases.They practice taking histories and doingphysicals, and they practice theirdiagnostic and assessment skills.”

First and second years: fill your headwith knowledge. Third and fourth years:experience medicine and practice clinical skills.

“Campuses such as ours are at the focal point of goingfrom medical student to becoming a practicing physician,”Blehm said.

The Southeast Campus (Fargo) has the largestconcentration of physicians, including the 50 percent thatare UND alums, and the largest concentration of healthcare facilities in the state.

“We have great tools for managing this part of astudent’s medical education,” Blehm said.

Though the core rotations—family medicine, internalmedicine, surgery, psychiatry, obstetrics/gynecology—arethe same for every campus, the scale of operations is not.

“We have 30 to 33 third-year students and 15 fourth-year students, the most of any campus, which makes sensebecause we have by far the highest concentration of

physicians in North Dakota,” Blehm said. According to theNorth Dakota State Board of Medical Examiners, roughly30 percent of the 1,670 licensed physicians in NorthDakota practice in Fargo (that percentage does not includephysicians who practice in Moorhead and vicinity).

Almost all of the physicians who engage with studentsat the Southeast campus are part-time.

“Part of my time is contracted to UND, but I alsopractice medicine at Sanford,” said Blehm. “That’s uniqueto UND’s medical school—the vast majority of us acrossthe state who are associated with UND are doing our

clinical time working for a big system, a hospital, or otherhealth care provider.”

“Here and across the state, most of our faculty are so-called community teachers—full-time practicing physicianswho donate their teaching time,” Blehm said. “We havededicated faculty people who take our students on rotationfor no compensation. Some—but by no means all—hospitals or health care systems give those physicians‘protected’ time to teach.”

“This is not just a building but a complex piece of medicaleducation,” Blehm said of the Southeast campus facility.“Part of the challenge of leadership is to sustain and encourageour physicians’ energy for teaching. We want to keepour students and our community faculty engaged.”


Julie Blehm, MD, FACP


Dr. James Mitchell, a psychiatrist, chairs the University ofNorth Dakota Department of Clinical Neuroscience, amultidisciplinary department, which includes psychiatry-behavioral science, neurology, neurosurgery,neuropharmacology, and neuroradiology.

Mitchell also is president and scientific director of theUND-affiliated Neuropsychiatric Research Institute inFargo, which is part of the School of Medicine and HealthSciences’ Southeast Campus.

NRI scientists study the brain’s functions as they relateto some of the problems families fear most and of specialconcern among young people: eating disorders andobesity. Major areas of research include obesity, eatingdisorders, and bariatric surgery. This program includeshuman research, centered at the Eating Disorders Institute,an entity jointly sponsored by the UND School ofMedicine and Health Sciences Department of ClinicalNeuroscience, the Neuropsychiatric Research Institute, andSanford Health.

“We are involved heavily in UND’s psychiatryresidency program,” said Mitchell, Chester FritzDistinguished Professor of Neuroscience. “We have someof the faculty members who interact with residencystudents who rotate through here in their third and fourthyear of medical school. We give lectures to the medicalstudents when they rotate through.”

“We’re also in regular contact with colleagues such asJonathan Geiger [Chester Fritz Distinguished Professor andchair, Department of Pharmacology, Physiology, andTherapeutics] in terms of ongoing research projects,” saidMitchell, who has an office in the Southeast Campus buildingas well as his office at NRI. And we’re in frequent contactwith Dean Joshua Wynne about what’s going on.”

“A lot of the psychiatrists in this area have come out ofour program,” Mitchell said. “People tend to stay wherethey train in terms of residencies.”

A major role played by medical professionals such asMitchell in the education process is mentoring.

“We can really help students make important careerand life decisions,” said Mitchell. “A lot of what we do is mentoring.”

Jim Mitchell


By Juan Pedraza


ALUMNI NOTES

Mark Klabo, PA ’08, has joined thefamily medicine department atEssentia Health Clinic in Valley City.He will also continue to work in theMercy Hospital Emergency Room inValley City.

Chad Pedersen, MD ’08, recentlyjoined the medical staff at WinonaHealth, Winona, Minn., as ahospitalist.

Fauzia Shuja, IM Res ’07, has joined the hospitalist team atEssential Health’s 32nd Ave. campus in Fargo. She waspreviously employed at the Family Healthcare Center inFargo as an assistant clinical professor.

Anne Riddle, MD ’01, has joined theteam of physicians at MarinerMedical Clinic in Superior, Wisc.

Brian Riddle, MD ’00, has joinedMariner Medical Clinic in Superior, Wisc.

Richard Martin, MD ’84, has beennamed medical director of theemergency department at St. Mary’sHospital in Detroit Lakes, Minn. Hehas been at St. Mary’s since 2005.

David Skurdal, MD ’76, was named2011 Physician of the Year at MercyMedical Center in Williston.

Jon Tingelstad, BS Med ’58, has been appointed to theUniversity Health Systems Beaufort Hospital Directors’Council in Beaufort, N.C. He served on the faculty at theBrody School of Medicine at East Carolina University for24 years. He was professor and chair of the Department ofPediatrics for 22 years. He currently serves on theChocowinity Emergency Medical Services Board.

Got news?We want to hear it!Please send your news items for the next issue of North Dakota Medicineto Kristen Peterson:[email protected] or call 701.777.4305.

’80s’00s

’70s

’50s


Some new faces will be makingappearances at the University of NorthDakota School of Medicine and HealthSciences in the coming months andyears, thanks to a $1 million gift fromDr. David, ’61, and Lola RognlieMonson, ’60.

First, it'll be one or more guestspeakers on an annual basis. Down theroad, a scholar-in-residence will spenda week or two at the School. This willdevelop into a full-time, on-siteprofessorship. And in a few years, theposition may evolve into a Chair ofMedical Education, for which someone outside of the universitywould be recruited.

Dean Joshua Wynne intends forthis person to weave the basic, clinical,and educational pedagogy into asynergistic competency that wouldbuild a strong educational foundationfor medical students. When theMonsons personally visited with Wynneand UND Foundation DevelopmentDirector Dave Miedema about thisopportunity earlier this year, they likedthe fact that the professorship wouldbenefit more than one medical studentfor more than one year.

“Our hope was that the studentsreceive the best education possible, notin surgery or cardiac surgery orendocrinology, but in medicine and

ALUMNI PROFILE

Committed to Medical Education

A generous gift by Dr. David and Lola Rognlie Monson will help tie the School’s basic and clinical sciences together in a way that will benefit medical students for years to come.

Degrees: BSMed, UND, 1961; MD, University of Minnesota, 1963

Internship and residency: General surgery, Cook County Hospital, ChicagoFellowship: Surgery, Lahey Clinic, Boston

Service: U.S. Army Medical Corps (two years)Residency: Cardiothoracic surgery,

Rush University Medical Center, Chicago

RésuméDr. David Monson, ’61


that they get it in such a way that theyare forever grateful to the university,”said Dr. Monson, who lives with Lolain the Chicago area.

Wynne and the Monsons envision aprofessor who understands Midwesternvalues, such as hard work, commitmentto community, and self-reliance. Thosevalues, shared by students, would beincorporated into the pedagogy.

“Never has the need been greaterfor physicians who are lifelong learnersand able to evaluate, integrate, andapply new evidence-based approachesinto their clinical practices,” Wynnesaid. “We need an individual whounderstands and promotes the criticalintersection between the discovery ofnew knowledge, the clinical practice ofmedicine, and service to our patients.”

While UND’s basic and clinicalscience departments operate separately,the Monsons were impressed with howthe School's first- and second-yearmedical students are offered clinicalexperience earlier than in the dayswhen David earned his BSMed and MDdegrees. After his two years at UND’smedical school, which was primarilyclassroom education with a shortclerkship, the Climax, Minn., native firstgained his clinical experience whileearning his medical degree at theUniversity of Minnesota in 1963.

The professorship would also bringinnovative and integrative approaches topreclinical and clinical education ofmedical students, along with improvedways of bringing continuing medicaleducation to the practicing medical

community. Since UND relies on itsclinical faculty throughout the state toteach its students, the professorship wouldalso lead efforts to assist those communityvoluntary faculty members to optimizetheir teaching methods and techniques.

Dr. Monson is familiar with theacademic side of medicine. “At thetime I was actively practicing at RushUniversity Medical Center, I also hadacademic appointments and teachingresponsibilities,” he said. “Medicaleducation was understood to be aphysician’s responsibility to studentsand resident physicians, and was a partof our practice. At that time, there werevery few full-time educators, but that'schanging with the times.”

Now retired for 10 years, Davidspends his free time with Lola and theirtwo daughters, one of whom is aphysician and the other a nurse and actor,soon to be married. David says of Lola,whom he met in first grade, “We havebeen so fortunate to have practicedmedicine, with the help of UND, withfine colleagues, and in great institutions.We have had a fine time.”

“Because we left the area, ourrelationship with UND was at a relativelymodest level,” David acknowledged.“But now we have an opportunity, andthere is a need for giving back. That’simportant. So it was quite easy toexplore the possibilities with Dr. Wynneand, with his advice and insight,choose this direction for our gift. Wehope it leads to continued excellencein education at the University.”

”“

... now we have an opportunity, and there is a need for giving back.

We hope it leads to continued excellencein education at the university.

”“


It’s 8 a.m. on the last Friday ofChristmas break—the day that meansone more weekend for high schoolstudents before they are back to gettingup while it’s still dark outside, goingout in the cold, and after sharing witheach other about presents received, nomore excitement until prom,graduation, or summer break.

Niney-eight students are sitting in alecture hall in the University of NorthDakota School of Medicine and HealthSciences (UND SMHS), possibly thinkingthose very thoughts as they wait tobegin a day that will, maybe, break upthe routine they are bound to go backto. This day may help them answerone of life’s biggest questions: what doI want to be when I grow up? Such aserious question is quite a leap fromChristmas break, which means thesejuniors and seniors must get down to

business and learn more about thedifferent careers available in medicine.

The event they are attending, thefirst-ever Career Academy, involvedstudents from central North Dakota whoare in the Missouri River Area Careerand Technology Center’s medicalcareers class. Students from Ashley,Bismarck, Grant County, Halliday,Mercer, New Salem, Strasburg, TurtleLake, Underwood, Wishek, andsurrounding areas were involved in thisinaugural event hosted by the EasternArea Health Education Center (AHEC),the UND Center for Rural Health(CRH), and the UND School ofMedicine and Health Sciences.

Katie Thompson, educationcoordinator for the Eastern AHEC,worked countless hours with teachers—who also sacrificed a precious day ofChristmas break—and staff and facultyfrom the CRH and the UND SMHS tomake this day happen without a hitch.

At the Career Academy, students hadthe opportunity to learn about brainresearch, medical laboratory science,physical therapy, occupational therapy,sports medicine, and they alsoparticipated in clinical scenarios withhuman simulators at the SMHSsimulation lab. In addition to learningabout the personal experiences of thehealth professionals they interacted with,in each of the sessions the students wereable to participate in hands-on activities.For example, during the brain researchsession, students learned from graduatestudents about the various components ofthe brain and what function each areacontrols. They also were able to seeactual brains with medical abnormalitiessuch as tumors. Instructors from themedical laboratory science department

North Dakota Youth ExperienceTheir Future in Health Care

By Kristine HenkeHigh school students attend the first Career Academy

Steve Westereng, MS, ATC, CSCS,assistant professor and director ofSports Medicine (center), helpsstudents practice taping an ankle.


provided students with informationabout the high demand for medicallaboratory scientists, and students createdslides showing types of bacteria and thenexamined them under a microscope.Learning how to use crutches,wheelchairs, and walkers, and how toeffectively use these aids with patientstook place during the physical therapysession. In addition, students learnedabout the field of occupational therapy(OT), where they heard about otherassistive devices and learned howoccupational therapists use shavingcream and a mirror to demonstrate onetype of communication aid they use withsome of their clients. During the sportsmedicine session, students were allowedto tape a sprained ankle, a commoninjury athletic trainers work to prevent.In the simulation lab, students learned thedifferent responsibilities of physicians,nurses, and other health careprofessionals during simulated child birth.

Lynette Dickson, associate directorat the Center for Rural Health andprogram director for the North DakotaAHEC program office, said, “Thiscollaborative effort was well worth itand demonstrates the important roleeach partner—School of Medicine andHealth Sciences faculty and staff, theEastern AHEC, the Center for RuralHealth, and high school teachers—playsto inform, engage, and inspire ourNorth Dakota youth to consider acareer in health care.”

Gwen Halaas, MD, MBA, seniorassociate dean for academic and facultyaffairs, encouraged departments withinthe School of Medicine and HealthSciences to participate in this event,which is one of many initiatives theCenter for Rural Health, the EasternArea Health Education Center, and theUniversity of North Dakota School ofMedicine and Health Sciences hasunderway to “grow our own” byexposing students to the breadth ofcareer opportunities in health care. Thegoal of this type of programming is toincrease the interest and ultimately thenumber of students who pursue acareer in health care.

Katie Thompson said, “The 2012

Career Academy was a tremendoussuccess. The faculty who participatedwere strong advocates for theirdepartments and shared importantinformation with the students. This wasan exciting event to show studentsopportunities here at home in NorthDakota. We hope to extend thisopportunity to other schools in thefuture—stay tuned!”

At the end of the day, the studentspacked up and loaded into their twocharter buses to travel halfway acrossthe state. On the four-hour journeyhome, they may have been thinking ofthe new things they had to share withfriends back at school on Mondaymorning: the new gadgets they receivedas gifts, and the new careers in healthcare they are considering pursuingduring the next chapter of their lives—that is, the chapter after prom,graduation, or summer break.


“Come on, one more. Nice work!” Thebench-press bar lands on the stand with athundering crash, and two students begina conversation I can’t help but overhear.

“Those last ones were tough,” onestudent remarked as he grabbed weightsfrom the rack. “So, I hear you’re movingout of Grand Forks next year. Howdoes all that work with medical school?”

“Well in the third year of medschool, I start doing more rotations,basically shadowing physicians atdifferent hospitals. I have family in Minotand Fargo, so those are my top choices.”

“So you just follow around a physician?”

“Well, we actually do a coupledifferent rotations that expose us todifferent specialties like internalmedicine, cardiology, or psychiatry.Honestly, I’m not really excited for myfamily medicine rotation. Familymedicine docs have to be on call allthe time, are limited in what they cando, and the pay is terrible.”

“That sounds pretty awful,” theother student said.

While listening to this conversation,the rural physician recruiter in me resiststhe urge to walk over and explain thatfacilities in rural North Dakota aredeveloping innovative solutions to solvethese challenges. Anyone involved infamily medicine physician recruitmentknows there is a growing segment ofmedical students who hold some of thesebeliefs about choosing a career in familymedicine. With these types of biasesout there, the national primary care

shortage continues to become a largerissue, particularly in rural communities,where a wide array of challenges existin recruiting hospital staff.

To better understand this issue, it’simportant to consider the percentage offirst-year medical students who areconsidering careers in family medicine.This perspective is gathered by theAssociation of American MedicalColleges’ annual survey called theMatriculating Student Questionnaire(MSQ).© The MSQ is distributed to allfirst-year medical students in the UnitedStates before their studies begin.Information reported on the MSQ hasbeen found to be a significant predictorof practice type and location. Accordingto findings on the 2011 MSQ, only 8percent of responding students wereplanning to select careers in familymedicine. With the number of medicalstudents choosing careers in varyingspecialties, it’s imperative thatcommunities keep their opportunitiesattractive to the small pool ofphysicians who have selected to go intoprimary care and will eventually besearching for jobs.

North Dakota is one of six statesimplementing the Community ApgarProgram (CAP) to assist facilities inrecruiting family medicine physicians.The CAP uses the Community ApgarQuestionnaire (CAQ) to assess theadvantages and challenges of a practiceopportunity when recruiting and is basedon five classes: geography, scope ofpractice, medical support, economic,

North Dakota Community

Apgar ProgramAn innovative program is being used to assist facilities in recruiting and retaining family medicine physicians. By Aaron Ortiz

WORKFORCE

Edward Baker, PhD

David Schmitz, MD


and hospital and community support.Bundled in these five classes are 10factors, for a total of 50 factors orquestions representing specific elementsrelated to recruitment and retention ofphysicians. The developers of the CAP,Edward Baker, PhD, director of theCenter for Health Policy at Boise StateUniversity, and David Schmitz, MD,the associate director of Family Medicineat the Idaho Family Medicine ResidencyProgram, worked with rural hospitaladministrators and physicians, andreviewed literature to develop the factors.

In 2011, the UND Center for RuralHealth brought the CAP to North Dakotasupported by a combination of stateand federal funding from U.S. HealthResources and Services Administration,State Office of Rural Health, andMedicare Rural Hospital Flexibilitygrant programs. Sixteen of the 36critical access hospitals (CAHs) in NorthDakota participated in the project.Each hospital was visited twice: first, togain administrator and physician inputon the 50 factors and again, to presentthe results to board members,administration, and physician staff. Theinformation gathered is sent to Bakerand Schmitz for analysis. Each of thefactors is scored to determine whetherit can be classified as an advantage or achallenge to that community’s efforts inrecruiting a family medicine physician.

Each hospital receives a detailedprofile on what their individual strengthsor advantages are for recruiting familymedicine physicians and where

opportunities toimprove may exist. In addition, theyare able to see how they compare tothe statewide trends. The informationhas also been used to offer an outsideperspective on what a particularcommunity and job opportunity maylook like to an interviewing physician.

“The Community Apgar Program isintended to get at the heart of whatcauses a physician to choose acommunity and a practice, and what acommunity can do to recruit the type ofphysician that is going to work out andstay long term” said Schmitz.

Similar to the medical student at thebeginning of this article, each medicalresident is influenced by factors thataffect what specialty they will choose.New residents and practicing familymedicine physicians will have varyingmotivations and triggers that influencethem to select certain opportunities.The CAP is one method North Dakota’srural hospitals can use to put theiropportunity under a microscope, makeadjustments where needed, narrow theirsearch for candidates, and improvetheir overall recruitment and retentionefforts for family medicine physicians.

An in-depth session on the NorthDakota Community Apgar Program willbe held on May 30, 2012, at theDakota Conference on Rural and PublicHealth. For additional information onthe program, contact Aaron Ortiz at theCenter for Rural Health,[email protected].

WORKFORCE

©2012 Association of AmericanMedical Colleges. All rights reserved.

Reproduced with permission.

“

”

The Community Apgar program is intended

to get at the heart of... what a community can do to recruit

the type of physicianthat is going to work out

and stay long term.


IN MEMORIAM

Janice “Jan” (Brentrup) Byrd, BS MT ’71, 63, Madison, S.Dak.,formerly of New England, N. Dak., died Wednesday, February8, at her home in Madison. Janice was born February 15,1948, the daughter of Hubert and Millie (Narum) Brentrup,New England. Janice graduated from St. Mary’s High School inNew England in 1966 and went to Presentation College inAberdeen, S. Dak., for the first two years of her education. Shefinished her degree in medical technology at the University ofNorth Dakota in 1971. She started her career in Kenosha,Wisc., working in the hospital from 1971 to 1980. She movedto Sheridan, Wyo., in 1980, where she met and married, RickByrd in Rapid City, S.Dak. In 1986, they were transferredto Chandler, Ariz., and lived there until 1998. In 1998,they were transferred to Madison. Janice has one son Brian,born February 16, 1987, who resides in Hartford, S.Dak.Janice was nationally registered as a medical technologist withthe American Society of Clinical Pathology. She loved skiing(snow and water), swimming, most sports, music, crafts, cardplaying, and reading. Her loving heart and ever-ready sense ofhumor and wit made her a special friend to all who knew her.

John James Gust, Jr., BS PT ’72, of Slidell, La., died onSaturday, February 4, at the age of 62. He was the belovedhusband of Lisa Brown Gust and the devoted father to Jenniferand Brian Gust and stepfather to Lauren Lipscomb. He wasthe son of John James Gust, Sr. and the late Norma Gust andthe brother of Robert Gust, Tom Gust and Dan Gust. A nativeof St. Thomas, N.Dak., and a longtime resident of Slidell,La., he graduated with a Bachelor of Science in PhysicalTherapy from the University of North Dakota in 1972.John’s passion in life was his career in physical therapy,and he was currently at Ochsner North Shore. He lovedliving in the South and was an avid New Orleans Saintsfan. Whether he was singing, whistling, or trying to snap apicture of you, John was an absolute joy to be around, andhis smile was contagious. He will be dearly missed by all.

Richard K. Helm, BS Med ’55, passed away on TuesdayJanuary 31, in Yuma, Ariz., as a result of complicationsfrom cancer. He was born to Erna and Michael G. HelmJuly 15, 1932, in Jamestown, N.Dak. The family moved toGrand Forks when he was six. He graduated from Grand ForksCentral High School in 1951. He attended the University ofNorth Dakota, receiving a Bachelor of Science in Medicinein 1955 and graduated from the University of Kansas MedicalSchool in 1957. At UND, he was a member of the Beta ThetaPi fraternity. He served in the North Dakota National Guardand the U.S. Army Reserves. He was a family physician for12 years. In 1970 he entered a residency program in radiologyat Emanuel Hospital in Portland, Ore. Following his residency,he was on the staff at Emanuel Hospital and then moved toPolson, Mont., in 1975. He practiced medicine in Montanauntil his retirement in 1996. He was an Eagle Scout and anactive member of the Lutheran Church. He loved the outdoors:backpacking, water and snow skiing, fishing, and hunting.

Gregory Iverson, BS Med ’73, died from multiple myelomaon December 23, 2011. He had fought this cancer for 6½years. Gregory Iverson, or Iver, as he’s been known for overhalf of his life, was born August 4, 1949, in Binford, N.Dak.,to Norris and Virginia Iverson. This farm family, bynecessity and intent, instilled a strong work ethic in himand his two brothers. He was expected to excel in schooland other extracurricular activities, including chorus, band,and drama. He went on to graduate summa cum laude fromConcordia College, and then received a BS in Medicinefrom the University of North Dakota in 1973, and an MDfrom the University of Minnesota, followed by completing aresidency in family medicine in Duluth, Minn., in 1978. OnDecember 28, 1974, he married the love of his life and soulmate Dianne Porter, and they raised two beautiful, talented,and intelligent daughters, Megan and Kirsten. They have beena very close and happy family, which has now expanded toinclude Drew and Aaron, and most recently a beautifulgranddaughter, Dregan, who has been one of the highlights ofhis life these last few months. In 1979, he began a long careerin emergency medicine in Rapid City, S.Dak. He was thefirst board-certified emergency physician in South Dakota,back during the infancy of emergency medicine as a specialty.He was instrumental in the development of advanced cardiaclife support in South Dakota, and was the director of the ACLSProgram at Rapid City Regional Hospital for many years.Additionally, he served on the ACLS Board of the DakotaAffiliate of the American Heart Association for several years.In addition to his professional life, he was always interestedin many hobbies and pursued them with intensity. Over theyears he developed a great fondness for computers. Music wasalways important to him, and he sang with the DakotaChoral Union and the Shrine of Democracy BarbershopChorus for years. He also served on the board, as treasurer, ofthe Black Hills Symphony Orchestra. His garden was oneof the driving forces in his life for over the last 30 years.

John Carroll Lund, BS Med ’64, 71 of Silver City, N.Mex.,passed away peacefully Monday, November 7, 2011. Hewas born in Sidney, Mont., on March 3, 1940, and wasraised in Williston, N.Dak., where he also graduated fromhigh school. He attended Concordia College in Moorhead,Minn., and graduated with a degree in science. John startedhis medical career at the University of North DakotaMedical School and received a Bachelor of Science inMedicine in 1964. He received his medical degree fromthe University of Omaha, Nebraska. He served as a doctorin the United States Air Force for two years and thencompleted his residency in surgery at Tucson MedicalCenter in Tucson, Ariz. He practiced in Alamogordo,N.Mex., for seven years and moved to Silver City, N.Mex.,where he practiced surgery, sports, and family medicine for28 years. He retired two years ago. As a pastime, John wasa professional magician, performing for PTA fundraisers,parties, and for clubs in the area.


Judith Mitchell, BS MT ’55, 75, Jamestown, N.Dak., diedMonday, December 26, 2011, at Medcenter One in Bismarck,N.Dak. Judith Moore was born January 14, 1936, at Forbes,N.Dak., the daughter of V. C. and Ellen (Burke) Moore. Shegraduated from Courtenay, N.Dak., High School in 1954and from the University of North Dakota in 1959 as amedical technician. After college she worked at the clinicin Ellendale, N.Dak. On January 27, 1960, Judith marriedAbner Mitchell in Aberdeen, S.Dak. They moved toCourtenay, where they farmed, ranched, and raised Suffolksheep and Angus cattle until her passing. Judith enjoyedgardening, knitting, crocheting, cooking, and loved herpets. She was a member of Corrine Homemakers, theschool board, and was a 4-H leader for many years.

Louis Arthur Noltimier, BS Med ’57, a nationally prominentpsychiatrist, passed away August 31, 2011, at the age of 83.Originally from Churchs Ferry, N.Dak., he was a graduateof Hamline University, Minneapolis, Minn., and graduatedwith a Bachelor of Science in Medicine from the Universityof North Dakota in 1957. He completed medical school atCreighton University in Omaha, Neb. He then set up a privatepsychiatric practice in San Francisco, which he operated for20 years. While practicing in San Francisco, he was a memberof the Physicians for Good Government and a significant forcein both the San Francisco Medical Society and CaliforniaMedical Association. Additionally, while in San Francisco, heserved in the U.S. Army Reserve as a mobilization augmenteeto the 6th Army stationed at the Presidio of San Francisco.After 10 years, he transferred into the Retired Reserve. Herelocated to Atlanta in 1979. He served as the medicaldirector for Cobb and Douglas County Public Mental Healthfor 10 years. Concurrently, he served in the Air Force Reserveat Dobbins Air Force Base in Marietta and Robins Air ForceBase in Macon. He obtained the rank of full colonel in the AirForce Reserve and was awarded Outstanding Flight Surgeonof the Year of the Air Force Reserve. During OperationDesert Storm, he was activated to active status in the U.S.Air Force and became the commander of the Charleston AirForce Base Clinic, which was an important logistical basefor wounded warriors from the conflict in the Middle East.Upon his retirement from the U.S. Air Force in 1991, he wasawarded the Legion of Merit—the highest non-combat awardgiven. Holding medical licenses in multiple states, he servedas a locum tenens throughout the country. Most recently, hepracticed psychiatry in Hiram, Ga., with Family InterventionSpecialists until his health declined in the spring of 2011.When asked by friends when he planned to fully retire, hewould reply, “When I find something I enjoy as much aspsychiatry.” A devout Catholic, he was a member of theSacred Heart choir at the Basilica of the Sacred Heart of Jesusin Atlanta. In recent years, he and his partner enjoyed buildingtheir Rockmart farm into a rural utopia, where he indulgedin his passion for gourmet cooking and entertaining, raisingdogs and horses, gardening, and reading.

Jennifer Kay (Stites) Roberts, MS PT ’95, was born on July29, 1971, in Valley City, N.Dak., to Sharon (Hardy) andRandy Stites. She graduated from Valley City High Schoolin 1990. Jennifer graduated from the University of NorthDakota with a Master of Science in Physical Therapy in1995 and was enrolled in the ROTC program. It was therethat she met her husband Joseph Roberts of InternationalFalls, Minn. They were married on Oct. 22, 1984, in ValleyCity. Joe and Jen’s life in the military led them to live inmany places, including Oklahoma; Fairbanks, Alaska;Grafenwoehr, Germany; Garmisch, Germany; Indiana;Washington, D.C.; and eventually the country of Tajikistan,where Joe was the defense attaché for the U.S. Army.Jennifer died on November 30, 2011, in Dushanbe, Tajikistan.

Thomas Levin Sussex, BS Med ’57, age 78, of Bloomington(Roseville), Minn., passed away January 23. Aftergraduating from high school in his hometown of Hope,N.Dak., he earned his Bachelor in Science in Medicine in1957 from the University of North Dakota, then a medicaldegree from the University of Illinois, Chicago in 1960. Hepursued further medical training through a fellowship atYale University in 1963–1964 in his field of obstetrics andgynecology, followed by a practice at the Fargo Clinic. In1972, a car accident and subsequent stroke resulted in hisearly retirement from medicine. As a member of the NorthSuburban Kiwanis and St. Anthony Park United MethodistChurch, he was involved in a multitude of volunteerinitiatives. He was a lifelong learner and relished a goodstory or a joke. He was a role model for his ability to livelife to its fullest, no matter what the circumstances, andhis example will inspire us all.

IN MEMORIAM

For additional information on how to best structure yourbequest or gift to benefit the School of Medicine andHealth Sciences, please contact:

Dave Miedema, Director of DevelopmentSchool of Medicine and HealthSciencesUND [email protected](701) 777-4933(800) 543-8764


Real estate may be an ideal asset for you to consider usingas your investment in medical and health sciences education,research, and service at the School of Medicine and HealthSciences. The University of North Dakota Foundation hasreceived many gifts of real property over the years,including farmland, residential, and commercial property.The Foundation has extensive experience recommendingthe most tax-wise and appropriate gift methods for donorsand their counsel to consider. Particularly in NorthDakota, where farmland prices are soaring and mineralrights are highly sought, now may be an ideal time for youto consider a gift of such appreciated assets.

The most common method of contributing real propertyis an outright gift. Donors receive a charitable deductionequal to the property’s appraised fair market value, andmost often, the Foundation immediately liquidates the giftand invests the proceeds, generally into an endowmentnamed for the donor. Before acceptance, the Foundationwill conduct its due diligence, needing to be confident ofthe property’s marketability and environmental cleanliness.

Other options exist where real estate may becontributed to fund an income arrangement, such as acharitable trust. In this case, a donor transfers real propertyinto the trust, receives some income tax deduction benefit,and generally receives income back for life. Uponmaturity, the balance of the trust becomes a gift benefitingthe School of Medicine and Health Sciences.

Additional options for making gifts of real estate areavailable, and depending on your situation, we willrecommend techniques that best fit your charitable andfinancial goals. We will help you address questions such as,“How do I make a gift of real property? May I contributemy house and still live in it? Should I sell first, and thengive the proceeds? How may I direct my gift to be used forthe benefit of the School of Medicine and HealthSciences?” These questions and others can be answered byme or other UND Foundation gift planners. Pleasecontact me today, and let’s begin the conversation.

Real Estate & Mineral Rights

By Dave Miedema

GIFT PLANNING


PHILANTHROPY

Dr. Bill, ’90, and Sandy Altringer ofMandan, N.Dak., continue to growthe Altringer Family MedicalScholarship Endowment, whichsupports medical students. Dr.Altringer, originally from Dickinson,N.Dak., is a general surgeon at MidDakota Clinic in Bismarck. He is alsoassociate director of the UND Schoolof Medicine and Health Sciences(SMHS) Surgery Residency Program.

In memory of her husband, Dr. JulieBlehm, ’81, of Fargo, N.Dak., hascreated the Dr. David M. BlehmMemorial Endowment, which willsupport medical students, preferablythose interested in practicing primarycare in North Dakota. David, ’81,passed away Nov. 7, 2011. Julie,originally from Hatton, N.Dak., worksat Sanford Health in Fargo and is alsoassociate dean of the UND SMHSsoutheast (Fargo) campus. Shecompleted her internal medicineresidency at Iowa Methodist MedicalCenter in 1984.

Jodi, ’84, ‘93, and Scott Boettner ofGrand Forks, N.Dak., have pledged tocreate the Jodi and Scott BoettnerPhysical Therapy ScholarshipEndowment, which will supportphysical therapy students. Jodi, whogrew up in Grand Forks, works atAltru Health System.

Drs. Sarah McCullough, ’98, and TomMagill, ’90, of Bismarck, N.Dak., havecreated the Drs. Sarah McCulloughand Thomas Magill Endowment,which will support fourth-yearmedical students with an interest inemergency medicine. Both work at St.Alexius Medical Center in Bismarck.Sarah, who grew up in Oakes,N.Dak., completed transitional andemergency medicine residencies atthe University of California, SanFrancisco. Tom is originally fromPleasant Grove, Calif.

Dr. David, ’61, and Lola Monson ofRiver Forest, Ill., have created the Dr.David and Lola Rognlie MonsonEndowed Professorship in MedicalEducation (for more information, readthe Alumni Profile on page 28).

who recently gave gifts or made pledges.

Dr. Cecil, ’63, and Penny Chally of St. Paul, Minn., have established the Dr.Cecil and Penny Chally Medical Scholarship Endowment, which supportsmedical students, preferably those from Walsh County, N.Dak. Cecil, who grewup in Fairdale, N.Dak., works at the Plymouth Endoscopy Center and Clinic inPlymouth, Minn. After earning his BS Med degree from UND, he earned hismedical doctor degree from Harvard Medical School in 1965. He returned toMinnesota for his internship and residency in internal medicine at the Universityof Minnesota Hospitals in Minneapolis. He began his fellowship ingastroenterology at the university in 1970. He served as chief resident of theInternal Medicine Department in 1971 and finished his gastroenterologyfellowship at the Veteran’s Administration Hospital in 1972. He was appointedassistant clinical professor of medicine in 1973 and became an associate clinicalprofessor of medicine in 1983.

Dr. Robert and Charlene Kyleof Rochester, Minn., continue tosupport the Dr. Robert A. andCharlene M. Kyle Med SchoolEndowment, which supportsmedical students. Bob, who grewup in Bottineau, N.Dak., worksat Mayo Clinic. He earned hismedical doctor degree fromNorthwestern University MedicalSchool. He completed aninternal medicine residency atMayo Clinic, a residency at theNational Cancer Institute inBethesda, Md., and a hematologyresidency at Tufts University inBoston. He completed a surgicalpathology fellowship at theUniversity of Iowa Hospitals andClinics in Iowa City. He is alsopast chair of the EasternCooperative Oncology Group,and director and member of theScientific Advisory Board of theInternational Myeloma Foundation.

Thank you to our thoughtful donors


The Department of Anatomy and Cell Biology is currentlybudding with new faculty, research, and equipment thisspring to help educate UND students and make advancesin medical knowledge and technology.

Recently, the Edward C. Carlson Imaging and ImageAnalysis Core Facility in the Anatomy and Cell BiologyDepartment has become the new home of an OlympusFV1000 multiphoton microscope. The microscope uses adistinct tunable, pulsed infrared laser to visualize cellularevents deep within fixed and living animal tissues such asthe brain and nervous system. The Olympus microscopewas purchased using funds from a Centers of BiomedicalResearch Excellence grant, the Office of the Vice Presidentfor Research and Economic Development, variousdepartments throughout the School of Medicine and HealthSciences, as well as funds from the School itself. It isimportant to note that this new instrument is part of alarger imaging center within the School that serves bothUND and the surrounding research community.

One of the faculty members within the Department ofAnatomy and Cell Biology is Jane Dunlevy, PhD, thedirector of Graduate Education, who received her PhDfrom the University of Alabama Birmingham. Besidesserving as an associate professor within the department forgraduate and medical students, it is her responsibility toadvise graduate students from the time they submit theirapplication to graduation day. Dunlevy takes great pride inher graduate students; they teach over 500 undergrads ayear in the human cadaver laboratory, oversee all aspectsof the anatomy lab, and supervise undergraduate teachingassistants while continually grading all exams and assistingstudents with academic issues and concerns. Outside ofher director position, Dunlevy also manages a basicscience laboratory, where she performs experiments todetermine what types of cell biology changes occur whennormal cells become cancerous after being exposed toheavy metals within the environment.

The department is currently collaborating with theDepartment of Microbiology and Immunology as John Watt,PhD, and Catherine Brissette, PhD, research what mechanismsthe vector-borne pathogen Borrelia burgdorferi uses topenetrate through the human blood brain barrier and theblood–cerebrospinal fluid barrier to cause various neurologicaldisorders jointly called neuroborreliosis. Neuroborreliosis iscommonly linked to Lyme disease but is reasonablyunexplored in the role of adaptive immune response. Wattreceived his PhD in Neurobiology from Montana StateUniversity, and Brissette received her PhD in Pathobiologyfrom the University of Washington. Through their

collaborative research, they will use three cell types pre-activated with the pathogen to determine the contribution ofeach component of the immune system to neuroborreliosis.

One of the newest additions to the Department ofAnatomy and Cell Biology is Sergei Nechaev, PhD.Originally from Russia, Nechaev obtained a PhD from theInstitute of Genetics and Selection of IndustrialMicroorganisms in Moscow. Nechaev will be conductingexperiments using mouse stem cells to study a processcalled transcription. During this process, the enzyme RNApolymerase creates an RNA copy of a gene. He explainsthat the pause of the RNA, which occurs duringtranscription, is crucial for the regulation of gene activity,and he hopes to define how RNA-polymerase pausingrelates to the establishment of gene programs and thedetermination of cell identity.

The Department of Anatomy and Cell Biology not onlyworks within its own field but also collaborates with manydepartments in order to make advances in medicaltechnology and increase its knowledge of cell developmentprocesses. This collaborative spirit is behind the transitionthat will take place over the next few months as the threeother basic science departments are merged with theDepartment of Anatomy and Cell Biology into a singleintegrated Department of Basic Sciences. It is the dedicationof the faculty and students that helps contribute to theachievements of the department as well as to the overallsuccess of the School of Medicine and Health Sciences.

By Christen Furlong

SPOTLIGHTANATOMY AND CELL BIOLOGY


PARTING SHOTS

Attending the Medical School Winter Formal were (left to right)Brennan Hack, Tara Mertz-Hack, Erin Beachey, Joel Beachey,Elizabeth Hoff, and Jered Ewing.

Physical Therapy students Theresa Cowles (left)and Rachel Bloms practice their pediatric skillswith Jocelyn Dawes (center).

Med School talent show.Top: Eric Johnson andMandie BakerLeft: Dr. Thomas Hilland Scott Erpelding

The Department of Biochemistry and MolecularBiology poses with the Fellows of the University

Award for Departmental Excellence in Research. Back Row: Paul LeBel, Katherine Sukalski,

Min Wu, Brij Singh, John Shabb, Jamie Foster, Dean Joshua Wynne

Front Row: Archana Dhasarathy, Linglin Xie, Roxanne Vaughan

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