2011-2012 Update #4

The Structuralist
As we began the new year, the Structure course continued its roll out, with our students exploring the normal, abnormal, and interventional aspects of structure related to metabolism and digestion. The end of 2011 marked the completion of the portion of Structure residing within The Biologic Imperative (BI) and also marked the first time our students completed a Problem Based Structure project. Problem Based Structure is a unique aspect of the course that gives students the opportunity to perform focused dissections as part of a small group. These dissections are framed in the context of a clinical case scenario, and the student group has the ability to produce a creative dissection that reflects the case vignette. The project is spread over 12 weeks, culminating in a Presentation Day, where each student has the opportunity to present their case and dissection to their colleagues and faculty members. The presentations focus not only on the anatomical principles of the case, but also must bring in other Structural aspects of the course including pathology, embryology and medical imaging. The results of this first run through the project were quite impressive. Students performed extremely creative prosections and presentations were professional, informative and entertaining.

Schedule of Structure Labs: February 14 - Upper GI: Function, Dysfunction, Intervention February 22 - Normal Liver and Neoplasia February 28 - Acute & Chronic Liver Disease March 6 - Small & Large Bowel: Function, Dysfunction, Intervention March 13 - Problem Based Structure Presentations March 20 - Structure: Fueling the Body Laboratory Examination
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December-January 2011-2012
anatomy, pathology, embryology and medical imaging of the gastrointestinal system. The first three weeks presented an overview of the GI system three ways. First, using a traditional open field anatomical approach, second, looking at the gut from the inside-out and examining GI histology and endoscopic imaging, and finally from the outside-in, utilizing a surgical (including laparoscopic) perspective. Following these labs, we have started to focus more closely on specific regions and structures of the GI tract.

Starting in January, we moved on to the portion of the Structure course within the Fueling the Body course. In terms of content, Fueling the Body focuses on topics in biochemistry and metabolism in the context of normal and abnormal nutritional and gastrointestinal function. Structure during Fueling the Body has largely focused on the

HOMEOSTASIS COURSE BEGINS March 27 Reintroduction to Cardiopulmonary Structure April 3 - Normal and Abnormal Vascular Structure April 17 - Heart I: Conduction, Myocardium, Pericardium April 24 - Heart II: Valves and Circulation May 1 - Heart III: Cardiac Pathology May 8 - Problem- Based Structure
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Presentation of a Problem Based Structure Project to colleagues and faculty members.

You might notice that we have changed the name of this update to The Structuralist. This title represents how we view our faculty members as content experts who bring together various basic and clinical science disciplines in order to illustrate to our students the integral role of understanding structure for patient care.

Why The Structuralist?

Outside of the Structure course, students have been participating in a number of activities and courses that have been a part of the integrated School of Medicine Curriculum. An excellent example of this is the Patient, Physician and Society (PPS) course. A major component of this course, the longitudinal Initial Clinical Experience (ICE), occurs in in selected community outpatient and inpatient facilities of the Health System. This experience affords students direct, meaningful patient responsibilities while learning to apply scientific, social, and behavioral patient care principles as they progressively build clinical skills. In ICE, students develop longitudinal relationships with preceptors and selected patients. The preceptors represent the five core disciplines: general medicine (internist or family physician), surgery, pediatrics, obstetrics and gynecology, and psychiatry. Site Directors select patients who allow students to experience clinical conditions that evolve over the First 100 Weeks. These include, for example, a pregnant woman; a newborn; a pediatric patient; an elder patient with common chronic conditions; a patient requiring surgery for a new diagnosis of cancer; an individual referred for an emotional or behavioral problem; patients with chronic problems including vascular, functional and metabolic disorders, and neurologic conditions; and patients requiring nursing home or other extended care and rehabilitation. We hear from our students on a regular basis how they have been able to integrate what they are experiencing in the Structure lab and the classroom into the Initial Clinical Experience. These reports vary widely in their content, but include active participation in surgical procedures, use of ultrasound in the clinical setting, interpretation of pathology reports.

Featured Clinical Faculty Member: Alex Williamson, MD- Pathology and Laboratory Medicine
Alex Williamson is a boardcertified pathologist who specializes in pediatric, perinatal, and forensic pathology. He earned his A.B. in chemistry from Harvard and his M.D. from Georgetown, and he completed a pathology residency at Cedars-Sinai Medical Center in Los Angeles, a pediatric pathology fellowship at Childrens Hospital Boston, and a forensic pathology fellowship at the New York City Office of Chief Medical Examiner. Alex joined the North Shore-LIJ Health System and faculty of Hofstra North Shore-LIJ School of Medicine in July 2011. Outside the realm of pediatric and forensic pathology, Alex researches and has published and lectured on the health risks and consequences of modern slavery, the development and implementation of an integrated forensic response for victims of trafficking and slavery, and the history of medicine, pathology, and surgery during the American Civil War.

COMING SOON. . . .
Within the next month, we will be sending out requests for participation in Structure sessions for the upcoming academic year. As the course will be running for two classes simultaneously, we will run labs on both Tuesday (M2s) and Thursdays (M1s). Lab time next year will expand from 8am-1pm to allow more time for faculty breaks and student transitions.
The Structure of Diabetes- Students assess distal pulse points as part of a peripheral vasculature station before moving on to examination of cadaveric specimens and angiograms.

If you have questions or suggestions about the Structure course, please contact Keith Metzger (Keith.Metzger@hofstra.edu) or Gina Kirschenheiter (Gina.Kirschenheiter@hofstra.edu)

Questions? Suggestions?