College of Medicine

I was very pleased to see how many people participated in the recent visit of Linda Pololi here as she came to provide us summary feedback on the “C-Change Survey” that we distributed last Fall. Dr. Pololi had meetings with staff, students, the Council on Diversity and Inclusion, college leadership, and she capped it off with a Grand Rounds for students, staff and faculty on Thursday, 16 November. I met with her several times and we discussed her visit and some potential next steps.

Dr. Pololi was quite happy with the response rate in each of the categories solicited, including faculty, staff, and students. Central campus faculty had a response rate of 84%, campus faculty were 36% with 281 responses received. Staff had 187 members complete the survey with an 82% response rate and students had response rates from 71-83% among the classes. This tremendous response allowed for a rich pool of data and certainly made conclusions much more reliable. I appreciate everyone who participated and took this look at our culture very seriously.

I believe that Linda was very impressed with the overall culture of our medical school and our openness to take a hard look at all of our factors here. We have much to be proud of here and to build upon as the College of Medicine scored well above our peer institutions in the dimensions of “vitality”, “institutional support”, “values alignment”, “ethical / moral distress”, and “respect”. Each of these domains had several questions addressing these areas and our responses were well above her US national mean in previous studies. At the same time we have some work to do in the areas of mentoring (particularly for females), gender equity, and underrepresented minority equity. This led to great discussions at each of Linda's sessions and there were many positive recommendations in the index cards turned in at the end of Grand Rounds.

I realize that many of our present students and staff did not participate in this survey since it was administered over a year ago, but I hope everyone got a chance to see how this “snapshot in time” can help define future initiatives. I look forward to the Council on Diversity and Inclusion and the new Wellness Committee taking the lead on next steps in building on these results to make recommendations for changes ahead. I’ve heard that the staff have already created a working group to look at improvements for their area. I welcome this early active initiative.

Thank you again for your participation and interest in our climate and culture. I will be reporting on a regular basis over the next few months on our progress, an update on the efforts of the Wellness Committee to add in positive ways to our community, and on our preparation for the LCME Self Study and site visit for 2019.

Happy Thanksgiving to all.

J. Fogarty, Dean

Though it’s the usual busy summer here at the College of Medicine, with the Class of 2021 hard at work in the anatomy lab and the Clinical Learning Center, there also are many new initiatives making headlines.

We’re busy preparing for the first class of 40 PA students who will arrive here Aug. 22 and start classes Aug. 28. Jim Zedaker and his team are working hard to begin a new tradition at FSU. The students will spend their first 15-month phase here at the main campus and then report to the regional campuses for a 12-month clinical phase in pursuit of a Master of Science in Physician Assistant Practice.

Our Interdisciplinary Medical Sciences program is a joint collaboration with six other FSU colleges and provides a new major for undergraduate students potentially interested in health careers. They will receive guidance and support as they attend seminars, complete their requirements and consider what track to pursue later on: Community Patient Care; Health Management, Policy & Information; or Pre-Health Professions. This highly popular major already has more students signing up for it than were projected for the first five years.

We continue to expand our graduate medical education offerings to provide more places for our alumni to match without having to leave Florida. Recently we helped recruit a program director for Sarasota Memorial Hospital to begin an emergency medicine residency program, alongside our recently established internal medicine program there. Next month we’ll announce a partnership with Winter Haven Hospital to sponsor a family medicine program there, and we’re planning a psychiatry residency with Tallahassee Memorial in the near future.

More impressive news: Our total research funding has accelerated to $64 million, compared with $46 million last year and just $9 million back in 2005. Many of our investigators were rewarded this year with new or renewal R01 grants from the National Institutes of Health, and we’re reaping the benefits of superb recruiting over the past 10 years. We are clearly making a major impact on total grants at FSU, and we trust that our newest faculty members to join us this summer will continue this record of success.

Meanwhile, our first-year medical students are about to take their final block exams and then receive their White Coats on Aug. 11. I greatly enjoy this annual rite of passage as they take the Student Oath and promise to uphold the values of the profession. On that same evening, we also will induct 13 fourth-year students into the Chapman Chapter of the Gold Humanism Honor Society. By doing so, we’ll remind our first-year students of the ideals they should aspire to in patient-centered and compassionate care.

Many thanks to all who participate in our teaching programs at the central campus and regional campuses. Here’s to a productive fall semester.

Sincerely,

J. Fogarty, M.D., Dean

As the first subtle hint of cooler weather arrives, I wanted to take this opportunity to share several College of Medicine updates.

1.  The Physician Assistant program is progressing well. We have hired our initial faculty members and look forward to a mock site visit  later this month and the ARC-PA accreditation site visit Dec. 5-6. The full application for accreditation was submitted in early September and is a very complete and excellent set of documents. Our founding director, Jim Zedaker, has spent innumerable hours both meeting with faculty to ensure we had the resources and support for the program, and writing the document to reflect our unique model.

We received more than 800 applications for a program that is planned to start in August 2017 with a first class of 40 students, pending favorable action by the ARC-PA in March 2017. We are planning on naming the program as the School for Physician Assistant Practice under the College of Medicine. The request for that name change has been approved by the FSU Provost’s Deans Advisory Council and by the FSU Faculty Senate. The proposal will go to the FSU Board of Trustees at the end of this month.

2. The Interdisciplinary Medical Science (IMS) program launched this semester with more than 100 students signing up for this new FSU undergraduate major. We have received great support from FSU Provost Sally McRorie to develop this program, and have created a new Senior Associate Dean for Interdisciplinary Medical Science within the College of Medicine that will oversee all of the undergraduate teaching and advising programs for this and the college’s programs. Drs. Myra Hurt and Helen Livingston and their team have done incredible work over a very short period to get this innovative and collaborative program up and running.

We had a very successful IMS “kickoff:" celebration Oct. 14 and the excitement on display for this program was contagious.

3. I recently named Dr. Dan Van Durme, Chair of Family Medicine and Rural Health, as my new Associate Dean for Clinical and Community Affairs. He is actively working on developing plans for a new FSU Primary Health practice in the local area to both provide primary care and meet our mission. He will also work with regional campuses on coordinating their local community engagements.

We are working on a new organizational chart to reflect all of these changes, and it will be out next month.

John P. Fogarty, M.D.

Dean
Florida State University College of Medicine

As spring approaches, I want to fill you in on progress we’re making in two critical areas. One is Graduate Medical Education. The other is our new Physician Assistant Program.

In GME, we’re developing more programs around Florida to both contribute to the physician workforce and provide opportunities for our graduates to train here in Florida. Let’s review them one at a time:

1. Internal medicine — At Tallahassee Memorial Hospital, our program is doing well and recently underwent its site visit for full accreditation. We’ve now graduated two classes, and the program is matching well. At Sarasota Memorial Hospital, we recruited a wonderful director for the program, which already had a very successful site visit last month. We await the accreditation decision from the Accreditation Council for Graduate Medical Education’s Internal Medicine Review Committee, with a goal of recruiting 13 residents to start training in July 2017.
2. General surgery — Our program at TMH received its initial accreditation last June and has had a very successful interview season with lots of interest. It has recruited two second-year transfer residents and plans to match four first-year residents (two categorical and two preliminary) to begin training in July. We are in discussions to help sponsor another program in the next year and recognize general surgery as a critically short specialty.
3. Family medicine — Our program at Lee Memorial in Fort Myers is at its full complement and will graduate its second cohort this summer. We are in conversations with other hospitals across the state that are interested in developing new College of Medicine-sponsored programs.
4. Dermatology — We entered into a collaborative partnership with Dermatology Associates of Tallahassee to sponsor both the Micrographic Surgery and Dermatologic Oncology Fellowship (formerly MOHs Fellowship) and a new dermatology residency program. The fellowship was accredited effective 2013, and we have graduated two fellows since assuming sponsorship. We were notified last month that the residency received accreditation, with no citations, by the ACGME, so we are recruiting two residents to start training this July.
5. Other — After nearly 10 years of sponsoring the Obstetrics and Gynecology and Pediatric Residency Programs at Sacred Heart Health System in Pensacola, we recently transferred sponsorship of both residencies to the University of Florida effective Jan. 1, 2016, at Sacred Heart’s request. These primary-care residencies have a long history in Pensacola, having initially been established by the medical community and then transferred to Sacred Heart Hospital decades ago. In time, they become academically affiliated residencies under the sponsorship of UF. In 2006, after the FSU College of Medicine was established, UF requested that FSU become the programs’ institutional sponsor, given its closer geographic proximity to Pensacola and the presence of an FSU College of Medicine regional campus there. Over the course of FSU’s oversight, both residency programs regularly received ongoing accreditation from the ACGME, resolved all previous citations and achieved continuously improved outcomes in both the quality of resident education and the quality of patient care. Recently, Sacred Heart announced a strategy to form a clinical alliance with UF Health for specialty service lines. In an effort to align residency education with these clinical goals, the hospital’s administration chose to place its primary-care residencies under the same UF umbrella. Since graduate medical education programs within the FSU College of Medicine model are funded entirely by the hospital partner, a decision to transfer residency sponsorship is generally the decision of the hospital, not the College of Medicine as institutional sponsor.

We are pursuing a Physician Assistant Program for the FSU College of Medicine because the primary-care shortages are not likely to be resolved by medical school graduates alone. FSU’s model of distributed regional campuses, which train future physicians in office settings that provide patient-centered care, is an ideal environment for this program. Learning to work in the same settings as our medical students will provide early experience in team-based care, a critical model to address Florida’s primary-care shortages. PA students at Florida State will spend 15 months at the main campus in Tallahassee and one year at one of the medical school’s regional campuses. Here are PA progress updates:

1. We’ve had a great team working on the documents to approve the master’s program here at FSU over the past 18 months, and the Board of Trustees approved the proposal at its June meeting.
2. We recently hired Jim Zedaker as our founding program director, and he’s hard at work developing the initial application for accreditation to the Accreditation Review Commission on Education for the Physician Assistant, the accrediting body for PA programs.
3. We have a site visit scheduled in December 2016, and the program will be reviewed at the March 2017 meeting of the ARC-PA. Assuming that we receive our initial accreditation, we anticipate matriculating students in fall 2017.
4. We are busy with the website and information materials for this program and anticipate a great deal of interest and applications in the future.

I hope these updates give you a clearer picture of what’s going on. These are exciting times at the College of Medicine.

John P. Fogarty, M.D.
Dean

Unfortunately, I open the Dean’s Message again this month with sad news. With former state Sen. Durell Peaden’s passing last month, the College of Medicine has lost another good friend and supporter. Several of us attended his service at the United Methodist Church in Crestview, and it was packed with friends and relatives remembering a man who never forgot where he came from and always tried to help others. A large delegation from the Florida Legislature was there to honor him also, reflecting their admiration for “Doc” Peaden and all that he accomplished with them. I was proud to recognize him at our graduation in May and saw him again at a research event at Sacred Heart in Pensacola in June, and he was so proud of the College of Medicine that he had helped to create. I always enjoyed seeing him and his wife, Nancy. I regularly thanked him for bringing me here as dean, since he was part of the Dean’s Search Committee in 2008, and he always asked how he could help us next. We are planning a larger event here at the College of Medicine to remember Durell in the fall and look forward to celebrating his life and accomplishments.

I’m pleased to share good news about graduate medical education. Last month we celebrated the graduation of our first class from the Family Medicine Residency Program at Fort Myers and the second graduation at our Internal Medicine Residency Program at TMH here in Tallahassee. Both programs are moving to full strength and doing the great work of producing the physicians we need for Florida. We also received the good news that our surgery program at TMH has received its initial accreditation, so it will be able to enter the match for residents to start there in 2016.

We continue to experience transitions among our faculty — especially this summer among our clerkship directors, after many years of impressive retention and stability. Also I’m pleased to welcome Dr. Juliette Lomax-Homier, in Fort Pierce, as our newest regional campus dean. Having served as a campus clerkship director and OB-GYN education director, Juliette is an experienced leader and educator and is an excellent addition to our team.

Our Class of 2019 is on board and has already survived the first block exams. For this class, we received the most applications in our history (over 6,200) and had to make the fewest offers (around 150). Clearly applicants have heard our story, like what they hear and want to come here. I thank the admissions office — and all the faculty who participate in interviews and admissions — who do such a great job of telling that story.

Summer is going fast. White Coat is just around the corner, along with welcoming the second-year students back. Enjoy the mid-summer edition of EMR!

John P. Fogarty, M.D.
Dean

This message unfortunately starts with sad news. We have lost a dear and devoted friend in Charlotte Maguire after a short illness. Dr. Maguire was determined to the very end to be in control and died peacefully in her home this month with friends and family nearby. While she insisted that we not “make a fuss” about her after her passing, we think she wouldn’t mind an informal ice cream social, to be held in late January, as a celebration of her life and contributions. More details to follow as the event draws nearer. I hope you’ll find time to read the story of her amazing life in this edition of our e-newsletter.

Meantime, things continue to be busy here at the College of Medicine:

1. We’re applying to Florida State University to create an M.S. in Physician Assistant Studies program, with an expected start date of summer 2017. It is in line with our mission and consistent with our desire to expand access to primary care for Floridians.
2. We’re working with the University of Florida to submit a renewal application next month for a collaborative Clinical Translational Science Award (CTSA), with the FSU College of Medicine providing the community-practice-based arm for the program.
3. We’re forming a Strategic Planning Working Group among the chairs and executive leadership to prioritize the multiple activities and set the College of Medicine’s direction for the future.
4. We’re continuing to work on the curriculum redesign in preparation for the arrival of the Class of 2019 in May. This involves multiple committees and tremendous work by faculty, staff and students to create a competency-based, patient-focused and fully integrated curriculum to prepare our students for the 21st century.
5. Over the past three months, we have interviewed multiple candidates for the chair of our Department of Geriatrics. Ken Brummel-Smith is stepping down from that role, but not leaving the college. We’re also interviewing candidates for senior associate dean for research, where Myra Hurt is also stepping down to complete her book about the creation of the FSU College of Medicine. We hope to announce the conclusions soon. Renata McCann has done amazing work scheduling and facilitating visits across the university while coordinating with a national search firm, and we could not complete these two important hires without her.
6. First-year students are in exam week, second-year students are taking finals next week, third-years are in their required community medicine rotation and fourth-years are in the midst of interviews and residency applications, so the student cycle continues unabated.
7. We continue to work with community partners across the state to develop and expand graduate medical education programs and provide more options for our students to train in Florida.

Enjoy the stories of our amazing faculty and students. Our highly professional public affairs and communications staff is kept busy with the myriad of events, publications and awards of our College of Medicine every week, and I am very proud of all of them.

John P. Fogarty, M.D.
Dean

     It’s that time of year when I “make rounds” to each of our regional campuses for their all-faculty meetings and thank them for the incredible work they do to make our apprenticeship model work so well. I get a chance to update the faculty on what’s going on at the main campus and share the success stories of our clinical students. Here are some of the highlights of my comments to them:

• Curriculum redesign: We’re working hard to move toward a competency-based, patient-focused and fully integrated program. This started right after the LCME visit in 2011, and we rolled out the first component, Medicine 1, this summer for the Class of 2018. It combined anatomy, doctoring and a new “vision and values” component. Multiple teams are working on developing the systems-based components to come online in 2015. It’s expected that the medical students’ third year – the clerkship year – will remain structured as it is now. The plan is to also create opportunities for electives during the third year, to integrate the doctoring component and to rework the chronic-care-continuity component.
   
• The Class of 2018: Our 14th class arrived in late May and completed its first semester with the White Coat Ceremony on Aug. 22. We’re very pleased with our newest students and the energy they bring to the College of Medicine.
   
• How our students are doing in their clinical years: The Class of 2015 has done very well with USMLE Step 2 Clinical Knowledge. As of mid-August, 102 scores had been reported. Ninety-nine percent of those were passing marks, and 60 percent of them were above last year’s average (238). We continue to be impressed with how well our students do on Step 2, scoring well above the national average. It’s a direct reflection on the type of educational experiences they have with their clinical preceptors. For the Class of 2016, with 117 scores reported, we have a 96-percent pass rate and strong performances by our students. Given what’s at stake for students taking USMLE Step 1, we’re confident that we’re providing the support they need to be successful. The scores we’ve seen from our students are especially impressive in light of the changes made in the USMLE to raise the exam’s passing score.
   
• New clerkship evaluation system: Our Office of Medical Education has developed a refined competency-based assessment of students’ clinical performance. We ask preceptors to report how our students are meeting each of the expected competency milestones, and to determine at what level those students are performing based on the following scale: less than that of a typical third-year medical student, or on level with a new third-year, a progressing third-year, fourth-year or resident. We have found very strong correlations between preceptor evaluations and student success. Our regional campus deans and clerkship directors are using this information to provide feedback to students who are doing well and to those who may need to work on specific areas.
   
• Comments from program directors: Each year we survey residency program directors to see how our graduates are performing compared with other residents in those programs. We’re seeing impressive results. In many of the areas we stress, including professional behavior, interpersonal skills, medical knowledge and patient care, 90-99 percent rate superior to or comparable to their peers. Eighty-seven percent are rated in the top half of their class (a very fun statistic to share since I tell all of our students that only 50 percent can be in the top half here).
   
• Development and philanthropy: This has been a good year for the College of Medicine and our development team, with more than $4.3 million raised. That includes more than $2.9 million in planned gifts, more than $900,000 in cash, and pledges of more than $550,000. We appreciate our many friends who have supported us financially by contributing to student scholarships. Many faculty members have joined the President’s Club ($10,000 minimum contribution) through pledges, including many of our preceptors who donate their stipends to support our programs. This year we began a Primary Care Scholarship program, which seeks to provide $20,000 a year to 10 students in exchange for a commitment to return to Florida to do primary care in the future. In order to maintain the level of scholarship support, we obviously need to fund these new programs. Response from the students so far has been incredibly positive.

     Our second-year students returned to campus last week and the undergrads are back, so the joy of driving on Tallahassee streets with little or no traffic has obviously faded. The tradeoff is that football season is here. Go Noles – and thanks again for your support.

John P. Fogarty, M.D.
Dean, Florida State University College of Medicine

     I’m writing this during our 2014 “gap week” – that brief period between the May 17 graduation of our fourth-year students and the May 27 arrival of our first-year students. We’re always amused at this time of year when people across the university say things like, “Isn’t it great to finally be able to take a break without students?” We’re hard pressed to determine exactly when that is! The College of Medicine is always in operation.

     Speaking of graduation, I hope you were able to attend our Gold Humanism Honor Society, Awards or Graduation ceremonies May 16 and 17. They highlighted the incredible accomplishments of the students who are living our mission and the great places they’re going. There were some very proud parents here who thanked us for what we’ve done to help shape and mold their sons and daughters. It was another opportunity to show off our students and our innovative model of medical education.

     At graduation we added a military oath ceremony, and the audience loved it when 10 students came out in uniform to take the oath as new military medical corps officers in the Army, Navy and Air Force. We gave a “shoutout” to veteran Navy pilot Jimmy Westbrook, who missed graduation to keep his family safe at Camp Pendleton, protecting them from wildfires. (Please read his amazing story[pdf] pre-graduation on our website.) We also surprised Charlie Ouimet as the first Emeritus Professor in Biomedical Sciences, and it was clear that Charlie’s love for the students was mutual.

     Our story continues to impress, as we had more than 5,200 applications this year. I wish to thank our incredible admissions team, who work incredibly hard to find amazing students for us. 

Enjoy the summer!

John P. Fogarty, M.D.
Dean

Read more about the Class of 2014 Commencement.

     It’s springtime here in Tallahassee, time for March Madness and Match Day. We had a wonderful Match Day celebration in Ruby Diamond Concert Hall on March 21 and were pleased with the results for our 115 graduating seniors. This is our 10th graduating class, and we’re graduating our first three Honors Medical Scholars, who came through our undergraduate FSU Honors program. We had a slightly higher percentage of students stay here in Florida for their matches this year (39 percent), hopefully reflecting the work we’ve done in building new GME programs in Florida. We had nine residents match to our programs in Pensacola, Tallahassee and Fort Myers. We continue to do better than the rest of the country (52 percent vs. 42 percent) in primary care (internal medicine, family medicine, pediatrics and OB-GYN) and are pleased with the numbers who matched in general surgery, emergency medicine and psychiatry.

     We also held our annual Clerkship Directors Meeting in conjunction with Match Day. I was pleased to interact with so many of our faculty from the campuses who really make our model work on a daily basis. They met as specialty groups on Thursday, and on Friday they had a joint meeting where Nancy Hayes provided a thorough update on our progress with curriculum redesign. We’re ready to launch the first integrated summer course this year for the Class of 2018, and we’re hard at work developing the next courses to fully implement this patient-focused, competency-based and fully integrated curriculum over the next two to three years. Multiple small working groups are engaged in this exciting process. Lynn Romrell then reported on a survey of program directors who have received our students as residents. It’s gratifying to see how well our students are perceived by their programs. Amazingly, the program directors rated 83 percent of our students in the top half of their respective resident classes. I guess we truly have created the Lake Wobegon School of Medicine, where all of our students are well above average! Romrell also presented a graduate survey that describes in great detail how much our students value their education and how well-prepared they feel for residency.

     Thanks to our faculty and staff for making this medical school such a good place to learn, where our graduates are highly sought for their quality, skills and incredible talents.

Best wishes,

J.

John P. Fogarty, M.D.
Dean

Florida State University is now the home of the most advanced DNA sequencer in the state of Florida, allowing FSU researchers access to genome sequencing at a scale and cost never before available.
Located in the College of Medicine’s Translational Science Laboratory, the Illumina NovaSeq 6000 is the platform expected to enable the sequencing of a human genome for one hundred dollars, while producing the sequences of forty-eight human genomes in each forty hour run. To put that in perspective, COM’s previous DNA sequencer, which was state-of-the art when it was purchased five years ago, required four days to produce a human genome at a cost of approximately $3500, while the sequencing of the first human genome in the late 1990s by the publicly-funded Human Genome Project took almost fifteen years and cost nearly three billion dollars.
The decrease in cost and increase in speed for DNA sequencing is a result of massively parallel operations in modern sequencers. The devices used in the Human Genome Project could sequence approximately one hundred DNA fragments simultaneously. In contrast, the NovaSeq 6000 is capable of sequencing up to twenty billion DNA fragments at the same time.
In addition to enabling rapid and inexpensive sequencing of human genomes, the NovaSeq also allows FSU researchers to perform de novo sequencing of organisms whose genomes are unknown, to determine the extent to which each of an organism’s genes are turned on, to measure how closely related different organisms are, and to precisely determine the three dimensional structure of an organism’s chromosomes, along with many other applications.
The purchase and operation of the NovaSeq is a collaboration between many groups on campus. Funding was provided by Professor of Biology Peter Fraser, the College of Arts and Sciences, and the FSU Office of Research, in addition to the College of Medicine. The Translational Science Laboratory will operate the sequencer and will pay for its maintenance and repair.