North Dakota Medicine Holiday 2009

Practice Makes PerfectPractice with New Patient Simulators Teaches

Young Physicians Perfect Fundamentals

Call Him “Doctor Doctor”

Unique Teaching Assistants

Significant Impact

Holiday 2009 VOLUME 34, NUMBER 5 www.ndmedicine.org

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2 NOrtH DAKOtA MeDICINe Holiday 2009

As we near the end of the year andapproach the second decade of thetwenty-first century, I reflect on the yearpast and envision what is to come for theSchool of Medicine and Health Sciences.excellence is the common thread woveninto the past, present, and future of theSchool. the School demands a standard ofno less than excellent from its students,faculty, and staff. Aristotle’s reminder tous at the School is that excellence is notonly something to attain but also whatwe constantly seek. We cannot rest onour laurels; the race for excellence isnever over. the School’s pursuit ofexcellence comprises education,service, and scholarship and research inour mission to enhance the quality oflife for North Dakotans.

In 2009, the University of NorthDakota School of Medicine and HealthSciences is the top medical school inthe country for the percentage ofstudents who select family medicine forresidency, according to rankingsreleased by the American Academy ofFamily Physicians (AAFP).

the University of North DakotaSchool of Medicine and Health Sciencesis one of the best in the nation for itscommitment to rural medicine basedon the rankings released in the 2010edition of America’s Best GraduateSchools by U.S. News & World Report.

eight senior medical students fromthe University of North Dakota Schoolof Medicine and Health Sciences werethe first members inducted into a newchapter of the Gold Humanism HonorSociety, which recognizes senior medicalstudents who demonstrate exemplaryhumanism and professionalismthroughout their medical education.

the Physician Assistant program metevery established standard for function,structure, and performance needed to

be accredited for the next seven years,according to the Accreditation reviewCommission on education for thePhysician Assistant. the PA programhas had continuous accreditation sinceits inception in 1970 at the UNDSchool of Medicine and Health Sciences.

the School received the largestgrant in its history, $15.9 million, forthe North Dakota IDeA Networks forBiomedical research excellence (INBre).Half of the budget will support researchprojects at predominantly undergraduateinstitutions in the state. the Universityof North Dakota School of Medicineand Health Sciences in collaborationwith North Dakota State University willadminister the statewide network.Major projects will be led by researchersat Cankdeska Cikana CommunityCollege, Dickinson State University,Mayville State University, Minot StateUniversity, turtle Mountain CommunityCollege, and Valley City State University.

the examples I have used highlightthe interdependence of the two coremissions of the School: the education ofmedical and allied health care studentswho will serve the citizens of NorthDakota and the region, and the creation ofnew knowledge (research) and scholarship.Indeed, those three ingredients—education, service, and scholarship andresearch—form the core missions of all

medical and allied health schools, andare ingrained in our mission as definedby the North Dakota Legislature.

None of us at the School achievesexcellence on our own. Securing thequality of our students, faculty, and staffare the citizens of North Dakota andour generous benefactors who haverecognized the School’s merit with theirunceasing and generous assistance. theSchool’s mission is to enhance the qualityof life for all North Dakotans; achievingour mission ultimately rests on thebacking from North Dakotans and ourbenefactors. thank you for your support.

Joshua Wynne, MD, MBA, MPHInterim Vice President for Health Affairsand Interim Dean

DEaN’S Letter

“The primary purpose of the University of North Dakota School of Medicine and

Health Sciences is to educate physicians and other health professionals and to enhance

the quality of life in North Dakota. Other purposes include the discovery of knowledge

that benefits the people of this state and enhances the quality of their lives.”

—North Dakota Legislature

“We are what we repeatedly do. Excellence, then, is not an act but a habit.”

—Aristotle

NOrtH DAKOtA MeDICINe Holiday 2009 3

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pOstmaster: send address corrections to:nD medicine address Correction UnD school of medicine and Health sciencesOffice of Public Affairs, Attn: Shelley Pohlman501 North Columbia rd. Stop 9037, Grand Forks, ND 58202-9037 e-mail: [email protected] phone: 701-777-4305

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UNIVerSItY OF NOrtH DAKOtA SCHOOL OF MeDICINe AND HeALtH SCIeNCeS

rOBert O. KeLLeY, President, University of North Dakota

JOSHUA WYNNe, Interim Vice President for Health Affairs

and Interim Dean, School of Medicine and

Health Sciences

eDItOr Denis MacLeod

WrIters Brenda Haugen, Denis MacLeod,

tara Mertz, Gary Niemeier,

Juan Pedraza, Laura Scholz,

Amanda Scurry

COntrIBUtOrs Alexander Cavanaugh, Shelley Pohlman

GrapHIC DesIGn Laura Cory, John Lee, Victoria Swift

pHOtOGrapHY Chuck Kimmerle, Patrick Miller,

Wanda Weber

www.ndmedicine.org

DesIGn eric Walter

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Features

Practice Makes Perfect 4Clinical Education and Simulation Center

will provide far-reaching benefits

Call Him “Doctor Doctor” 8Physician-scientist works to translate research into treatment

Unique teaching Assistants 12DPT students get real-life experience through labs with local residents

Significant Impact 14New Center for Rural Health service provides hospitals with proof of

the economic impact they have on their communities.

Departments

Guest Columnist - David Bradley, PhD 16News Briefs 17Alumni Profile - edward Fogarty, MD 22Student Profile - Jenna Akkanen 24Alumni Notes 26In Memoriam 28Planning Ahead 30Parting Shots 31

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Clinical education and simulation Center will provide far-reaching benefits

”

He NeWeSt ADDItION tO tHe SCHOOLof Medicine and Health Sciences will not only keep the University of North Dakota in the forefront of medical education but also serve as a valuable resource for the entire region.

the Clinical education and Simulation Center, locatedon the west side of the Clinical education Center, isalready complete. By spring, the simulators will be inplace, and the facility will be fully functional by fall 2010,said the center’s director, Jon allen, mD ’84.

the building’s main floor includes about 5,200 squarefeet. A 1,900-square-foot basement will provide storage forequipment, oxygen, medical air, and other items requiredby the center.

the main floor houses four simulator rooms that willbe so realistic, students will feel as if they’re walking intoan emergency room, intensive care room, or a regularhospital room, depending on the scenario for which theroom is set up.

“everything is as it would be in the hospital,” Allen said. And the realism doesn’t end there. the rooms will be

equipped with human simulators that are so remarkablylifelike they can talk, cry, breathe, and bleed. running on acomputer system, the human simulators can mimic hundredsof human medical conditions, ranging from heart attacksand seizures to allergic reactions and drug overdoses.

Human simulators can cost anywhere from $30,000 toover $500,000. According to Allen, the ones ordered forthe sim center average in the $55,000 range and willinclude at least four adult human patient simulators, a babysimulator, a mother and baby birthing simulator, and fourcardiac patient simulators. Some also will be portable,meaning they can be used in an ambulance.

“We can reproduce almost any medical situation,”Allen said.

Instructors can watch their students working in the simrooms through one-way glass, and audio equipment willallow them to communicate as necessary. In addition,video cameras will digitally record what happens in thesim rooms.

“We review the scenario on video and talk about whatwent right and what went wrong and how to improve indebriefing sessions that follow,” Allen said.

partners with a passion for patient CareAccording to Allen, about four years ago, the former

medical school dean, H. David Wilson, mD, and others inthe program began dreaming of this project.

“We knew we had to get into simulation sometime,”Allen said. the day is likely coming, he explained, whensim centers will be required in order for medical schools toreceive accreditation.

they decided to approach Blue Cross Blue Shield ofNorth Dakota (BCBSND) for help in making the dream areality. BCBSND recognized the ultimate benefits the simcenter will bring to patient care and agreed to supply up to$4.25 million toward the project.

“the bottom line is patient safety. that’s why we’redoing this,” said Allen. “Blue Cross Blue Shield had thisgreat vision. We couldn’t do it without them.”

According to Denise Kolpack, vice president forcommunications at BCBSND, the insurer agreed to help getthe project going with grants of $1.5 million for constructionand about $2 million to purchase simulators. BCBSND alsois kicking in $150,000 annually for up to five years if thesim center is widely marketed to the entire North Dakotahealth-care community, which is part of the plan. UND’ssim center will not only be incorporated into the curriculumfor medical students but also available for conferences andtraining sessions for practicing doctors who want tosharpen their skills or learn new procedures. In addition,the center will be available to train nursing students,resident physicians, physician assistant students andpractitioners, physical therapists, public health workers, fireand rescue teams, military health personnel, paramedics,alumni, and other interested health care providers.

“After two years of discussions, the BCBSND board ofdirectors made the decision to support this project basedon the BCBSND mission to help provide quality access toall North Dakotans, and this project was a specific, tangible

way to support that mission,”Kolpack said. “the simulationlab will strengthen health-caredelivery to all corners of thestate. the program will offercritical hands-on training andpractice to medical andnursing students, practicingclinicians, and volunteeremergency responders who areespecially critical in deliveringcare in rural North Dakota.”

t

We can reproduce almost any medical situation.



“UND’s sim center is not the

only place in the area that willhave human simulators. In fact, it’snot the only place on campus thatcan say that. the simulation centerat UND’s College of Nursing recentlycelebrated its one-year anniversary.Stephanie Christian, chair of theDepartment of Practice and roleDevelopment and a clinicalassociate professor in the College ofNursing, also is serving on the Schoolof Medicine and Health Science’ssim center advisory committee. Shesaid the adult, pediatric, and toddlerhuman simulators located in theLearning resource and SimulationCenter on the first floor of theCollege of Nursing are meeting thecurrent simulation needs of UNDnursing students. As simulation

continues to be integrated into thenursing curriculum, the School ofMedicine and Health Science’sSimulation Center will enhance thismission. A larger simulation centersuch as the School of Medicine andHealth Science’s Simulation Centerwill allow the University’s studentsin health-care disciplines toparticipate in interdisciplinarysimulation, much like theinterdisciplinary approach used inall health-care settings.

Allen said he welcomes theopportunity to work with other simcenters in the area.

“We want to be a regionalparticipant,” he said. “We want towork together with other simcenters to provide training forbetter patient care.”

Working together

The simulation lab will strengthen health-care delivery

to all corners of the state.

Doing It rightIn an effort to make sure UND’s

sim center is the best it can be, Allentalked with officials at a number of simcenters across the United States andvisited several others, including theMayo Clinic in rochester, Minn., theUniversity of Kentucky in Lexington,Harvard University in Boston, and theUniversity of Miami. He also took acourse at Mayo on how to write thecurriculum and build the sim center.

Part of that effort has beeninvolving as many stakeholders aspossible. An advisory committee thathas helped with the project includes

people who will also be using thefacility—representatives from UND’sNursing, Aerospace, and technologydepartments and the hospitalcommander at the Grand Forks AirForce Base.

randal severson, the emergencyMedical Services coordinator at AltruHealth System in Grand Forks, is alsoamong those serving on the advisorycommittee. Severson said the simcenter will be a valuable resource for

the new critical care paramedicprogram he started at Altru, as well asfor training paramedics in moreinvasive procedures.


Allen agrees. He rememberslearning such procedures on realpatients in real situations.

“that’s all we had available to usfor years,” he said.

When Allen was learning to insert acatheter, for instance, he first watchedan experienced doctor perform theprocedure. the second time, a doctorguided Allen’s hand as he tried theprocedure himself. the third time,Allen performed the procedure as theexperienced doctor watched. And allthis was done on real patients. Now, withsimulators, students can practice anyprocedure 20 or 30 times on their own,until they’re comfortable and “theyhave the procedure down,” Allen said.

Severson said the sim center alsowill provide his staff with the valuableopportunity to practice teamwork and stay

sharp on skills they don’t use very often.“there’s no pretending anymore,”

Severson said of the sims’ reactions.“You can kill them.”

Because students treat thesimulators as they would real patients,and because the simulators themselvesreact in such a real way, students alsoget to work out some potential anxietyissues. If students have alreadypracticed an emergency with asimulator, they are less likely to be asanxious when a similar scenario playsout in the real world because they havealready been through it, Allen said. thiscan help cut down on potential medicalmistakes and increase efficiency, thuspotentially slowing the rising cost ofhealth care.

- Brenda Haugen

Jon allen, MD ’84, researched several

simulator options in preparation for

the med school’s sim lab.


“Doctor Doctor.”Call Him


SAOBO LeI IS BOtH A PHYSICIANand a PhD neuroscientist with a lifelongdrive to learn the intricate details abouthow the brain works—and what can gowrong and why. that quest now hashim here at the University of NorthDakota School of Medicine and HealthSciences as assistant professor in theDepartment of Pharmacology,

Physiology and therapeutics, probingthe intimate details of how individualneurons—the brain’s basic buildingblocks—behave at the cellular level.

“We’re very interested indiscovering what exactly neurons do interms of learning and memory,” saidLei, who got his MD degree at Sun Yat-sen University and his PhD at theUniversity of Alberta. And thoseconnections will lead to a more intimateand accurate understanding of brainproblems, such as memory loss, learningdisabilities, anxiety, and a host of diseasessuch as Alzheimer’s and epilepsy.

In scientific parlance, Lei said, “Weuse a variety of techniques includingelectrophysiology, immunocytochemisty,imaging, tissue culture, molecular biology,and in vivo physiology and animal modelsto study the functional changes of thecentral nervous system in physiologicaland pathological conditions.”

What that all boils down to isfiguring out what happens betweenneurons involved in memory andlearning and other brain functions.

“We want to know how they dowhat they do, how and why thosefunctions change and cause problems,and what chemicals can be used tohelp those neurons do what they’resupposed to do,” Lei said. this voyageof discovery starts with microscopicallythin slices of brain tissue that Lei and hisresearch team put into little test chambers.

“then we inject the sample withvarious chemicals such asneurotransmitters—substances that helpneurons communicate with eachother—and neuropeptides,” he said.these peptides are protein-likemolecules that also are used by neuronsto communicate with each other andare related to a number of brainfunctions, from eating behavior tolearning and memory.

Lei and his team are particularlyinterested in two areas of the brain that

”We use a variety of techniques

to study

the functional changes

of the central nervous system

in physiological and

pathological conditions.

“ ”


are critical to learning and memory: the hippocampus and the entorhinalcortex (eC).

the hippocampus is a relativelysmall—but vitally important—regioninside the middle of the brain. Ifsomething goes wrong in that area, lotsof bad things can result, includingamnesia and the loss of ability to formor retain new memories. It’s one of thefirst and most critically affected areas inpeople with Alzheimer’s. Othersymptoms of hippocampus dysfunctioninclude spatial disorientation.

the entorhinal cortext is a complexmultifunctional area toward the rear ofthe brain. Scientists like Lei are stilltrying to figure out more precisely what it does and what goes wrongwhen it malfunctions.

“It’s a very important memory center,and it is the main supplier of inputs intothe hippocampus,” Lei said. “It processesour external sensory inputs before sendingthat information to the hippocampus.

Basically, the entorhinalcortex–hippocampus system plays a keyrole in memory and learning. P roblemsin the eC will often lead to symptomssuch as a loss of your sense of direction.”

Lei and his team members use avariety of techniques and tools to probethe one-on-one actions among neuronsin these two important brain regions.

“Using infrared video microscopyand patch-clamp recording techniques,we record the electrical currents thatflow from the sending neuron acrossthe synapse to the receiving neuron,”Lei said. the synapse is a microscopicgap between the ends of axons, ornerve fibers, across which electricalsignals jump from one neuron toanother; at the synapse, these electricalpulses cause the release of a chemicalknown as a neurotransmitter. this

chemical, in turn, causes the receivingneuron to create its own electricalimpulse, Lei said. that’s the basicmessaging system within the brain—andthat’s how everything works and isregulated, from the heartbeat that keepsus alive to the millions of messages persecond required for us to drive a car.

“these synaptic activities and ion channel functions are modulated by numerous modulators, includingneurotransmitters and neuropeptides,”Lei said. “We are exploring theunderlying cellular and molecularmechanisms using molecular biology,pharmacology, and transgenic animal models.”

the functional changes of neuronsinduced by the neur otransmitters andneuromodulators are likely responsible

for many physiological functions suchas learning and memory; if they don’twork right, they’re also responsible fordisorders such as epilepsy and anxiety,and neurodegenerative diseasesincluding Alzheimer’s and parkinsonism.

“We also use in vivo diseasemodels—specially bred rats and mice—to study the roles of the neuromodulatorsin these clinical disorders,” Lei said.the discoveries that Lei, his team, andother researchers in the area arepursuing will help chemists formulatenew highly targeted drugs to treatdiseases and dysfunctions such asAlzheimer’s, epilepsy, and amnesia.

Lei recently had his paper “GABABreceptor Activation Inhibits Neuronalexcitability and Spatial Learning in theentorhinal Cortex by Activating treK-2K+ Channels” accepted for publicationby one of the top internationalacademic neuroscience journals,Neuron. the research it describesrepresents another step along the roadto effective treatment of these diseases.

The health of North Dakotans, and people everywhere,

will be better as a result

of the kinds of research that we are doing here.


It’s research that’s caught nationalattention.

Lei recently was awarded aprestigious and highly competitive r01five-year grant totaling $1.52 million bythe National Institutes of Health (NIH)to study the cell-level mechanism thattriggers anxiety; work that’s closelyrelated to his research into the electricalbehavior of neurons.

“Anxiety is among the mostcommon psychiatric disorders andaffects about 20 million people in thiscountry,” said Lei. Anxiety is treatablewith drugs, but only with moderatesuccess because scientists still do nothave a complete picture of the brainmechanisms that produce it. Moreover,most available anti-anxiety medicationshave side effects—sometimes veryserious—or they create problems withtolerance or dependence, Lei said.Solving this issue demands a muchmore accurate picture of what’s goingon at the level of individual neuronsand their interactions with otherneurons.

Jonathan Geiger, phD ’82, chair ofLei’s department and himself a well-established neuroscientist, recruited Leifrom NIH because of Lei’s widelyrecognized work in the field. Geiger’saim: build a world-class neuroscienceresearch center at UND.

“the research enterprise here is ona very steep incline,” Geiger said.“Ultimately, it’s about being a key partof the medical school’s plans to build acritical mass of like-mindedneuroscientists, so the success will beself-perpetuating. the health of NorthDakotans, and people everywhere, willbe better as a result of the kinds ofresearch that we are doing here.”

“We know so much more about thebrain than we did years ago,” Geigersaid. “It’s an interesting andcomplicated organ.” But also one of themost feared, Geiger said, “because ifsomething goes wrong in the brain—whether it’s seizures, effects of druguse, dysfunction—people can beisolated, ostracized, stigmatized.”

“So it’s really important to try tofigure out how the brain works, what cango wrong, and how to fix the problemsso that we can help people living withand suffering from various conditions,”Geiger said. “And that’s what researchsuch as Dr. Lei’s is all about.”

- Juan Miguel Pedraza

Jonathan Geiger, PhD


DPT students get real-life experience through labs with local residents

YOU WALK INtO tHe rOOM tOtreat a person who has had a stroke, butyou have never met a person with abrain injury. You are trying to explain adiagnosis to the parents of an infant,but you have never even held a baby.

the Department of Physicaltherapy at the UND School ofMedicine and Health Sciences ishelping students overcome this initialnervousness of dealing with realpatients by offering labs and clinics aspart of their class work that lets thempractice on the real thing.

each fall third-year doctor ofphysical therapy (DPt) studentsconduct two pro bono physical therapyclinics for area residents.

“this group of students will goback out in the clinic next spring andone of their clinical experiences will beeither with adults or with pediatrics thathave neurological types of conditions,”said Cindy Flom-meland, phD ’04,mpt ’93, assistant professor in thedepartment and organizer of the clinic.“this gives them an opportunity to seethat people are people.”

Brandy Johnson learns valuable

pediatrics skills with Joy and

Melissa Brown.


the 12 to 15 clinic patients eachsemester are previous patients of Ptfaculty members or referrals fromclinics in town. All the clients haveexperienced some sort of neurologicalepisode, such as a stroke, multiplesclerosis, spinal cord injury, or braintumor surgeries. these clients no longerqualify for benefited Pt services or maynot have insurance, so the department’sclinic fills that need.

“Our goal is to provide a service tothe community and to these clients, andalso a learning opportunity to ourstudents,” said Flom-Meland.

team approachthe students work in groups of two tothree per client with a faculty advisor andsee the patient once a week for six weeksduring the semester. they evaluate andtalk to the patients about mutual goals forthe therapy and work with them at thedepartment, at their homes or workplaces,and even at their health clubs.

“We work in diverse environmentsto help it be more real for the studentsand also for the clients themselves to helpthem get back to what they like to do intheir everyday lives,” said Flom-Meland.

richard roberts, a technologysupport specialist with UND’sInformation technology Systems andServices, has been attending the clinicfor four years since having brain surgeryto remove a tumor.

“I’ve had the actual injury, so I givethem the opportunity to practice on thereal thing,” explained roberts. “Goingto the clinic there and working with thestudents there has helped me get someof the movement and some of thefunction back.”

“It was really nice to be able to seepeople with actual pathologies instead ofjust reading about them or doing tests andpretending to treat healthy classmates,”said matthew Huber, Dpt ’09. “Notonly do you know how to treat apatient, but also explain the treatmentto them. that is one of the hardestparts, being able to explain what isgoing on and what you are going to doin language that someone not in themedical field is going to understand.”

Youngest assistantsA much younger set of teachingassistants are enlisted in two pediatricclasses within the DPt program. In asecond-year required course and athird-year elective course, students havethe opportunity to become familiar withworking with the youngest patients andtheir parents.

“Many students find pediatrics anintimidating part of our field becausethey have had little experience withchildren and dealing with children’sparents,” said peggy mohr, phD ’93,associate professor in the department.“the families really do reinforce ourcontent without even really knowingwhat our content is.”

these assistants range in age from afew days to ten years. During infantdevelopment labs, students observechildren from birth to 18 months andinterview family members to learn aboutnormal childhood motor and socialdevelopment. each child goes homewith a “teaching assistant” certificate.

In the third-year class, students alsowork with elementary-aged kids tocheck bone alignment, range of motion,and gross motor skills.

“It’s really good practice for thestudents to keep the child motivated, tokeep them on task, and to learn how tointeract with them,” said Mohr.

“Having children come in who areunfamiliar with our tests andterminology challenges us to use layterms and explain our procedures,” saidGreg paintner, Bspt ’08, a third yearDPt student who participated in thelabs as both a student and as a parent.“Having them there got me even moreexcited to get into the clinic andbegin a career working with kids.”

-Amanda Scurry


Significant IMPACTNew Center for Rural Health service provides hospitals with

proof of the economic impact they have on their communities.

Watford City, on the western border of North Dakota, has a healthy local economy

thanks in part to the significant impact of the area’s hospital, McKenzie County Health System.

SUre. THEY KNOW HOW IMPOrtANt tHeY Are,but how do they prove that to everyone else?

the North Dakota Medicare rural Flexibility (Flex)Program at the UND medical school’s Center for ruralHealth will take the next two years to determine theeconomic impact each rural hospital has on its community.through this new project, staff at the Center for ruralHealth will produce individualized reports for each of the36 critical access hospitals in the state.

“the main goal of the Flex Program is to support smallrural hospitals and one way to do that is to increase theirvisibility and contribution to their local economies, as wellas the state,” said marlene miller, msW, Flex Programdirector and interim co-director at the Center for rural Health.

General, state-level data have been available, but nothingthis specific for each hospital service area. Until now, mosthospitals have estimated their impact, being financiallyunable to independently hire a consultant to back it up.

providing proofthe hospitals already know they are major players in theirregions’ economies, and through this new service, theCenter for rural Health will serve as a neutral researchentity to validate this impact.

“Unlike most other states, in North Dakota the hospitalreally is probably the largest employer, and it is my impressionthat we have not done a good job, as health care personnel,of getting that message out,” said Dan Kelly, CeO of McKenzieCounty Health System in Watford City, N. Dak. “While we arehere to take care of the health care needs of the communities thatwe serve, the other real factor is that we are a major economicadvantage to the county and surrounding communities.”

“A lot of people don’t pay attention to health care untilthey need it,” said Miller, “and to that point, they don’t reallyhave a good understanding of how health care impacts theirlocal community.”

“With all the general clamor about health care todayand the reform that we are going through, I think that we

Significant IMPACT


have to be more proactive about tellingour story,” said Kelly, whose hospitalacted as a test case for the project. “Ifhospitals don’t survive, there is going tobe a major void that is going to occur.Not only would we be without healthservices, but hundreds and hundreds ofpeople would be without employment.”

the multiplier effectCenter for rural Health staff willcombine information provided by thehospitals, such as payroll, number ofemployees and service area, withpurchased IMPLAN data from theMinnesota Implan Group Inc. the dataare updated every two years andprovide county-level information on therelationship between the hospital and

hundreds of sectors of the localeconomy. the result is what is called amultiplier effect; a representation ofhow each dollar the hospital spendsmultiplies in the community.

“that salary dollar spent in thecommunity multiplies,” Kelly explains.“I pay an employee, then that employeegoes to the grocery store, that grocerpays money to the printer, and on andon and on.”

According to the first report doneon McKenzie County Health System inWatford City, the 125 jobs that thehospital directly provides, creates another39 jobs elsewhere in the county.Likewise, the hospital’s $5,071,074 insalaries generates another $940,552 ofincome in the county.

each hospital will not only beprovided with the complete report butalso with tools on how to use it to theiradvantage. they will receive talking pointsand even a PowerPoint slide presentationto help make their case with legislators,local economic developmentcorporations, new recruits to the hospital,or to the community as a whole.

the entire process will be redoneevery two years for each hospital usingupdated data as a regular Flex Programservice to the hospitals.

economic partnershipsthe Center for rural Health is workingwith the North Dakota HospitalAssociation, the North DakotaDepartment of Health, and the NorthDakota Health Care review, Inc. topromote the new service.

While they are collecting the data,they also hope to collect ideas on howhospitals and communities can worktogether on economic development.

“there are some terrific examples inNorth Dakota where small hospitals workin partnership with their local economicdevelopment corporations to meet theneeds of their communities,” said Miller.

By collecting case studies of howother communities have done it, Millerhopes more communities learn fromthem and do it too.

-Amanda Scurry

”If hospitals don’t survive…

hundreds and hundreds

of people would be

without employment.

Photo courtesy of Neal Shipman,

the McKenzie County Farmer, Watford City, ND


At tHe NAtIONAL LeVeL tHere HASbeen a significant increase in infectiousdisease research. National Institutes ofHealth’s (NIH) National Institute ofAllergy and Infectious Diseases ten-yearbudget reflects the increased focus oninfectious diseases (a 237.9% increasein funding compared to a 115.4%increase in the total NIH budget for thissame period). the upper red riverValley is also experiencing its ownboom in infectious disease research.Several events have led to the increasein both the number of researchers andin research funding in the infectiousdiseases sector:

� the efforts of U.S. Senator ByronDorgan to acquire funds directed atexpanding infectious diseaseresearch in the red river ValleyCorridor and funding through theCenters of excellence program bythe state of North Dakota.

� the collaborative relationshipbetween the School of Medicineand Health Sciences (SMHS), UNDresearch Foundation (UNDrF), andSchlitz Foods Inc. in investigatingtherapeutics and vaccines foremerging viral infections, utilizinggoose antibodies and eggs. thiswork has resulted in the formationof two new North Dakota-basedbiotechnology companies andattracted significant federal andstate funding that has led to theaddition of six new researchers,created openings for six more, andemployed 25 new support personnel.this project has also providedfunding at the SMHS for threegraduate students and a technician.

� the understanding of the need forbiosafety levels 2 and 3 (BSL-2/3)

laboratories both for university andfor commercial partners, and thenthe will and determination to buildthese by UNDrF. this is beingrealized in the research enterpriseand Commercialization-1 (reAC-1) building.

� NovaDigm therapeutics, Inc.transitioned their vaccinedevelopment efforts from LosAngeles to their new corporatelaboratory based in the reAC-1building. their priority program isa vaccine for methicillin-resistantStaphylococcus aureus andCandida. NovaDigm currentlyemploys five staff in Grand Forksand is expecting to add more soon.

As the newly appointed chair of theSMHS’s Department of Microbiologyand Immunology, I have both theprivilege and responsibility of leadingthe department as it grows to be anintegral player in this infectious diseaseresearch. In the very near future, thedepartment will be hiring fouradditional faculty whose researchexpertise will be in either host(immunology) or pathogen (viral orbacterial) interactions. together withthe three research laboratories currentlyin the department, the Department ofMicrobiology and Immunology will bepositioned to grow the researchrelationships with corporate partners inthe upper red river Valley, gain thenecessary mass to be competitive forvarious group and multidisciplinaryfunding opportunities in infectiousdisease, and prepare medical, graduate,and undergraduate students with anexcellent educational and researchfoundation in infectious disease forthe future of North Dakota and us all.

a Bright Future for

Infectious Disease researchin the upper red river Valley

GUEST AUtHOr

David Bradley, PhDAssociate Professor and Chair,Department of Microbiology

and Immunology,the University of North Dakota School of Medicine

and Health Sciences


Gwen Wagstrom Halaas, mD,mBa, a family physician andassociate professor of familymedicine and communityhealth at the University ofMinnesota, has been namedassociate dean for academicand faculty affairs at theUniversity of North Dakota(UND) School of Medicineand Health Sciences.

Dr. Halaas is a graduate ofConcordia College, Moorhead,and Harvard Medical School.

She completed her family medicine residency with theUniversity of Minnesota Medical School at BethesdaHospital in St. Paul. Halaas also earned a Master of BusinessAdministration in medical group management from theUniversity of St. thomas.

Halaas has practiced family medicine and worked inmedical education in Minnesota as assistant director anddirector of two family medicine residency programs, directorof the rural Physician Associate Program and foundingdirector of the Center for Interprofessional education. theMinnesota Academy of Family Physicians honored her as“2008 teacher of the Year.” Halaas has extensive

administrative experience in health care organizations. Shewas medical director for U Care at the University ofMinnesota, and she served as associate medical director ofHealthPartners, a health care system in Minnesota.

“I am very pleased that Dr. Halaas will be joining theSchool’s senior management team,” said Joshua Wynne,mD, mBa, mpH, interim vice president for health affairsand interim dean of the UND medical school. “She brings awealth of experience and is highly regarded by her colleaguesat the University of Minnesota. We are delighted that wewere able to recruit her to the University of North Dakota.”

Halaas has lectured nationally and internationally onrural health education and interprofessional education. Sheis nationally known for her work in ministerial health andwellness and has written two books—“Clergy, retirementand Wholeness” and “the right road: Life Choices for Clergy.”

She is profiled in Dr. Fitzhugh Mullan’s book, “BigDoctoring in America: Profiles in Primary Care,” whichprofiles 15 dedicated health care providers whom Mullandescribes as humanist, comprehensive, efficient andflexible; doctors who build on the rich legacy of the pastand the rich tradition of care in medicine and nursing.

Halaas and her husband rev. Mark Halaas, a pastor forthe evangelical Lutheran Church in America, have threeadult children: Per, Liv and erik.

NEWS BrIeFS

the University of North Dakota (UND) Physician Assistantprogram meets every established standard for function,structure and performance that are needed to be accreditedfor the next seven years, according to the Accreditationreview Commission on education for the PhysicianAssistant (ArC-PA). the PA program has had continuousaccreditation since its inception in 1970 at the UND Schoolof Medicine and Health Sciences.

“Accreditation wouldn’t have been possible without thededication and the quality of the faculty and staff supportingthe PA program,” said mary ann Laxen, maB, pa-C, associateprofessor of family medicine and director of the program.

Physician assistants work collegially with and under thesupervision of physicians, especially in primary care in ruralareas of North Dakota and other rural and underserved areaswithin the United States. the University of North DakotaPhysician Assistant Program is one of 140 PA programs inthe United States and is the only PA program in North Dakota.

the program admits health professionals who haveyears of experience working as nurses, clinical laboratoryscientists, paramedics, respiratory therapists, dietitians,military health care providers and related professions.Seventy students are accepted into the program every twoyears. the next class begins in May 2010.

“Mary Ann, the faculty and all the staff of the PhysicianAssistant Program have done an excellent job trainingindividuals to become PAs. It is appropriate the ArC-PArecognize their accomplishments and the quality ofeducation delivered with the longest accreditationavailable,” said robert Beattie, mD ’89, chair of theDepartment of Family Medicine.

Graduates of the Physician Assistant Program must passthe national certification exam before beginning practice.the first-time pass rate for UND graduates in 2008 surpassedthe national pass rate. With the present class, the PAprogram admitted its most diverse class ever, according toLaxen. Students originally came from Nigeria, Brazil, BritishGuyana, Vietnam, Laos and the Middle east. Various ethnicgroups, such as American Indian, are also represented.

the UND PA program has over 1,500 graduates whoare employed throughout the United States, Canada andoverseas. Over 65 percent of the graduates are employed inprimary care practices.

In a letter to UND President robert Kelley, ArC-PAexecutive Director John McCarty said, “the ArC-PAappreciates the commitment and dedication to quality PAeducation as demonstrated by your participation in theaccreditation process.”

UND Physician Assistant Program Earns Continued National Accreditation

Halaas Named associate Dean at uND Medical school


NEWS BrIeFS

For the 11th consecutive year, the Center for rural Health(CrH) at the University of North Dakota (UND) School ofMedicine and Health Sciences has received funding tosupport rural hospitals through the North Dakota ruralHospital Flexibility (Flex) Program.

the CrH has received a grant in excess of $636,000,which is an increase of approximately three percent fromthe previous year. Funds from the federal Office of ruralHealth Policy are used by the CrH to administer the NorthDakota Flex program, a state-based partnership that workswith and assists rural hospitals to stabilize and sustain theirlocal health care infrastructure.

“In North Dakota, we use partnerships between thefederal government, the state, and rural hospitals tostrengthen and improve the rural health care infrastructure,”said marlene miller, msW, CrH Flex program director.“Specifically, we combine grant dollars and communitydevelopment techniques to help critical access hospitalsaddress local and area needs.”

Since it began in 1998, the North Dakota Flex programhas provided nearly $4 million directly to rural hospitals,which has benefited about 120 rural communities. Inaddition to grants, the Center for rural Health uses Flexfunds to provide technical assistance to rural providers forperformance improvement planning, staff surveys, andleadership development. these services help facilities lookat their communities’ needs and assist them with theirplanning activities.

“Funds have been used in very meaningful ways,” saidMiller. “In North Dakota, funds have been used in the areasof health information technology, quality improvement,strategic planning, hospital finance, leadershipdevelopment, board training, trauma system support, andemergency medical services.”

the Flex Program relies on each of the state’s hospitalsto ensure its success. “Working collaboratively is at theheart of the Flex Program, and North Dakotans are knownfor working well together, sharing scarce resources, andproviding quality care to our rural citizens,” said Miller.eight rural hospital administrators from across the state formthe Flex Program Advisory Committee, and they provideadvice on the program’s goals and activities.

the Center for rural Health’s Flex program operates inpartnership with the North Dakota Health Care review,Inc., the North Dakota Healthcare Association and theNorth Dakota Department of Health.

uND Center for rural Health receives

Funding to support rural Hospitals

Sixty-six first-year medical students, members of the Doctorof Medicine (MD) Class of 2013, started their journey thisfall to become physicians at the University of North Dakota(UND) School of Medicine and Health Sciences.

the students, 24 men and 42 women, range in agefrom 21 to 38 years, with the average age of 24. they cometo medical school with work experience in an array of fieldsand academic degrees in biochemistry, biology, chemistry,zoology, psychology, and exercise science. One studentholds a PhD degree, one has earned a law degree, andsome hold various master’s degrees. Seventy-six percent ofthe students are from North Dakota.

“the Class of 2013 is a group of exceptional students,reflecting the high academic standards of the UND Schoolof Medicine and Health Sciences. they also enter medicalschool with a variety of impressive health care andhumanistic activities to their credit,” says Judy Demers, med,associate dean for student affairs and admissions.

Medical students’ first week is dedicated to orientation,including introduction to the four-year, patient-centeredcurriculum. Special emphasis is placed on the students’ newroles and expectations of them as health care professionals.

Orientation concluded with the White Coat Ceremonyon August 7 at the Alerus Center, when students receivedtheir first white coats, the physician’s traditional garment,which were donated by the North Dakota MedicalAssociation. they recited the Oath of Hippocrates, anancient vow to uphold basic professional principles.

Keynote speaker for the ceremony was Jon tingelstad,mD, chair of UND School of Medicine and HealthSciences’ National Advisory Council. He addressed “Wordsthat Begin with the Letter ‘P.’”

each student received a lapel pin engraved with“Humanism in Medicine”donated by the Arnold P. GoldFoundation. After the ceremony, the school hosts a picnicfor students, family, and friends.

“recognizing the importance of providing humanisticmedical care and establishing this as a goal is a trulysatisfying way to end the first week of medical school forour new students. the ability to share the White CoatCeremony with family and friends makes it even moremeaningful,” says DeMers.

Doctor of Medicine Class of 2013 Begins studies at

the uND school of Medicine and Health sciences

NEWS BrIeFS


North Dakota will receive $15.9million over five years for a NationalInstitutes of Health (NIH) programaimed at increasing researchopportunities, investigators, andresources in biomedical research.

Health and the environment arethe focuses of research conductedunder the North Dakota IDeANetworks for Biomedical researchexcellence (INBre) program. Half ofthe budget will be used to support

research projects at predominantly undergraduateinstitutions in the state.

the statewide network will be administered by theUniversity of North Dakota (UND) School of Medicine andHealth Sciences in collaboration with North Dakota StateUniversity. Major projects will be led by researchers atCankdeska Cikana Community College, Dickinson StateUniversity, Mayville State University, Minot StateUniversity, turtle Mountain Community College, and ValleyCity State University.

“this marks a major accomplishment for North Dakota,”said interim vice president for health affairs and interim deanJoshua Wynne, mD, mBa, mpH, of the UND medical school.“It will advance the level of scientific inquiry throughout thestate and encourage students to pursue meaningful andproductive careers in the biomedical sciences.”

Don sens, phD, INBre principal investigator and aprofessor in the Department of Pathology at the UNDmedical school, said the program provides a broad range of

benefits in biomedical research and science educationencompassing research universities, baccalaureateinstitutions and tribal colleges across North Dakota.

“North Dakota INBre’s goals complement SenatorByron Dorgan’s red river Valley research Corridor initiative,”he said. “It improves the collaborative research environmentbetween UND and NDSU and extends this network toinclude other colleges and universities across the state. Italso complements workforce training in the biosciences.”

the Institutional Development Awards (IDeA) programunder the NIH National Center for research resources(NCrr) assists states such as North Dakota that havehistorically received relatively little research funding fromthe NIH. the objective is to develop an infrastructure thatsupports biomedical research, creates opportunities forstudents to pursue careers in biomedical research, and assistsresearchers in becoming more competitive for NIH funding.

North Dakota’s INBre emphasizes capacity building atundergraduate institutions within the state. the goal is toimprove North Dakota’s research competitiveness byincreasing the number of students who continue theireducation at a research university—such as UND or NDSU—where they can receive advanced training in biomedicalresearch fields. to do this, INBre funds research projects atthe four-year schoolsand supports theirfaculty throughmentors and facilitiesat UND and NDSU.

uND Med school receives Largest Grant In Its History: $15.9 Million for INBre research Program

Don Sens, PhD

David Bradley, phD, has beennamed chair of the Department ofMicrobiology and Immunology at theUniversity of North Dakota (UND)School of Medicine and HealthSciences. An associate professor ofmicrobiology and immunology,Bradley joined the UND medicalschool in 1998. He completed hisdoctoral degree at the University ofSouth Dakota School of Medicineand took postdoctoral training at the

University of North Carolina, Chapel Hill, and the MayoClinic College of Medicine. Within the Department ofMicrobiology and Immunology, he served as director ofGraduate education from 2004 to 2008 and as interim chairfrom January to June of 2009.

Bradley and his laboratory team investigate immuneresponses in both autoimmune and infectious diseases. Aprimary focus is research aimed at creating avian diagnosticand therapeutic antibodies to emerging viral pathogens. Hisresearch has been funded by a number of sources,including the U.S. Department of energy, National Institutesof Health, National Science Foundation, the state of NorthDakota, and the Arthritis Foundation.

He has written numerous articles for research journalsand book chapters, is a peer reviewer for several scientificjournals, and serves on both the National Institutes ofHealth and Department of Defense study sections.

“this is an exciting time of growth for the Departmentof Microbiology and Immunology,” said Bradley. “It’s achance to build on our expertise in infectious disease andrecruit excellent new talent to UND.”

Bradley Named Chair of Microbiology and Immunology at uND Medical school

David Bradley, PhD

NEWS BrIeFS


the Department of Family and Community Medicine at theUniversity of North Dakota (UND) School of Medicine andHealth Sciences will receive $445,000 over three yearsfrom the U.S. Department of Health and Human Services,Health resources and Services Administration, Bureau ofHealth Professions, Division of Primary Care to strengthenthe communication skills of medical students. rosannemcBride, phD, a clinical psychologist in the departmentand co-director of Clinical Sciences education for the first-year curriculum, is the principal investigator of this project.this grant will help students understand the behavioral,emotional, and social factors that affect health as well ashow to manage these factors by strengthening students’ability to communicate effectively with their patients.

“this training fits well with the direction of nationalhealth care reform,” said McBride. “to a great extent, ourhealth care system has been problem-focused—addressinghealth issues only after they have become problematic.Growing trends for the future are placing a greater emphasison preventing disease and promoting wellness and thethings people can do to stay healthy.”

Medical advances now allow people with serious illnesseslike heart disease and cancer to live longer, so physiciansalso need to be better trained to help patients adoptlifestyles that result in better disease management, improvedquality of life, and decreased mortality. this can range fromhelping patients decrease tobacco use to identifying andtreating depression, a factor that can often interfere withmaintaining a healthy lifestyle. “to be effective in theseactivities, doctors need to improve their face-to-facecommunication with patients, so doctor and patient canwork as partners to manage each patient’s unique healthconcerns and ways of staying healthy,” said McBride.

the grant will extend and strengthen the School’sexisting communication skills training program. “Learning tocommunicate effectively with patients is a skill—much likedriving a car,” said McBride. “You can’t learn it from justhearing a lecture or reading a book—you actually have topractice the skill to become good at it.” For communicationskills, this means being able to practice interacting withpatients—actual “hands-on” practice.

Students in training frequently practice using“standardized patients” or actors trained to behave aspatients with specific health concerns such as diabetes ordepression. this state-of-the-art communication skillstraining requires considerable investment of resources upfront to recruit, train, and compensate standardized patientsand expand faculty supervision of student experiences. thisup-front investment is well worth it because it can significantlylower health care costs down the road. Namely, betterdoctor–patient communication plays a large role in

improving health outcomes and chronic disease management,improving patient satisfaction and quality of life, maintainingwellness and preventing health problems, decreasingmedical errors, and decreasing malpractice liability.

the UND medical school is consistently among the topmedical schools in the country for producing family practicephysicians, according to rankings released by the AmericanAcademy of Family Physicians, and 40 percent to 45percent of our graduates enter primary care specialties.Good communication is important for doctors in primarycare specialties like family medicine, general internalmedicine, and pediatrics because they manage a broadrange of patient concerns over time, including mentalhealth concerns like depression or anxiety as well asprevention and management of chronic disease.

In North Dakota, 81 percent of the state is designatedby the federal government as a primary care healthprofessions shortage area, and 90 percent of the state isdesignated as a mental health professions shortage area. theUND medical school places a high degree of importance onpreparing students for entry into primary care to encouragefuture practice in North Dakota’s health care shortage areas.As the focus of health care changes, arming students withgood communication skills is a crucial aspect of preparationfor both primary care and all medical specialties.

Grant to uND school of Medicine and Health sciences

Will expand training in Doctor–Patient Communication skills

Rosanne McBride, PhD, consults with student Michael Greenwood.

NEWS BrIeFS


the Center for rural Health at the University of NorthDakota School of Medicine and Health Sciences distributedover $267,000 from the Small Hospital ImprovementProgram (SHIP) to 35 small rural hospitals in North Dakota.

“For the 8th consecutive year North Dakota’s eligiblesmall rural hospitals have received an average of $8,000 eachyear,” said marlene miller, msW, program director at theCenter for rural Health. “to date, the program has broughtwell over $2 million to North Dakota’s small rural facilities.”

Administered by the Center for rural Health, SHIP isfunded through a grant from the federal Office of ruralHealth Policy. the purpose of the program is threefold: (1)to support small rural hospitals in providing quality care torural residents; (2) to ensure privacy of patient information;and (3) to fund financial studies designed to help withcomplex health care billing, coding, and reimbursementprocesses. Funds have been used to upgrade equipment forfinancial operations and information technology, and forstaff training, consultation, and educational materials.

small Hospitals receive Funds through uND Center for rural Health

Joshua Wynne, mD, mBa, mpH,interim vice president for health affairsand interim dean of the University ofNorth Dakota School of Medicineand Health Sciences has appointed asearch committee to help select thenext director of the Center for ruralHealth (CrH) at the medical school.Wynne chose rob Beattie, mD ’89,to chair and to guide the searchcommittee. the new director willassume the position formerly held bymary Wakefield, phD, who was appointed in February byPresident Obama to serve as administrator of the Healthresources and Services Administration.

“the Center for rural Health has been under the ableleadership of Interim Directors Brad Gibbens, mpa, andmarlene miller, msW. We now need to find a permanentdirector to lead the group, and I have appointed a searchcommittee to recommend a short list of candidates for theCrH directorship,” said Wynne.

the search committee has broad representation and iscomposed of the following individuals:

� rob Beattie, MD, chair, clinical professor and chair, Department of Family and Community Medicine

� Judy DeMers, Med, associate dean, Student Affairs and Admissions

� Lynette Dickson, MS, program director, Center for rural Health

� Louise Dryburgh, CeO, FirstCare Health Center � Dennis elbert, PhD, dean,

UND College of Business and Public Administration � Senator robert S. erbele, North Dakota Legislature � tracy evanson, PhD, associate professor,

Family and Community Nursing � Jacque Gray, PhD, assistant professor,

Center for rural Health � Kimberly Krohn, MD, program director, Center for

Family Medicine–Minot and associate professor,Department of Family and Community Medicine

� Karen Larson, deputy director, Community Healthcare Association of the Dakotas

� David Molmen, MPH, CeO, Altru Health Systems

Housed at the School of Medicine and Health Sciences,the Center for rural Health is designated as a Center ofexcellence in research, scholarship and creative activity bythe University of North Dakota. the center’s mission is toconnect resources and knowledge to strengthen the healthof people in rural communities. the CrH serves the peopleof the state, region and nation. As a resource, CrH staffmembers identify and research rural health issues, analyzehealth policy, strengthen local capabilities, developcommunity-based alternatives, and advocate for rural concerns.

search Begins for New Director at Center for rural Health

Rob Beattie, MD

Wishek Community Hospital and Clinics, Wishek, ND


JUSt LIKe tHe WINDSUrFING FOrwhich he is known, the mind of edwardFogarty, mD, skates freely over thechanging terrain of medical technology,seeking to shine a light on its benefits.Fogarty is chair of the Department ofradiology, UND School of Medicineand Health Sciences, and a radiologistin private practice at MedCenter One,Bismarck. Voluble and articulate, he is aself-confessed tech geek with a passionfor giving back. His career is one definedby relentless advances in technology—something he clearly finds exhilarating.

there is a certain measure of pre-ordainment to Fogarty’s life. He grewup in the smallest U.S. city with twomedical schools, ten blocks betweenCreighton University and the Universityof Nebraska, both destined to play largeroles in his life. At the age of 14, hesaw his brother injured in an AtVaccident, and the crisis got him thinkingabout medicine as a career.

Still, as the oldest son of an attorneyfather and an artist mother, he had somedifficulty in narrowing his choices.Initially drawn to physics as an undergrad,he shifted to biology, with a desire todo research. He had an inkling aboutworking in clinical medicine, but ittook a stint in radiology in his fourthyear of medical school to make thelightbulb glow brightly. “It just hit mein the midst of this rotation... I’d spentmy life surrounded by complex imageson the walls of our home with thoughtprovoking philosophical discussionsfloated across the floor in between.”Fogarty realized that radiology, whichcombines physics and biology presentedvisually, also requires someone withverbal fluency. the speciality perfectlymanifested his heritage, skills, andinterests. He still needed encouragement:he credits radiologist Jean saigh, mD,at the University of Nebraska for herrole as mentor.

After graduating with a degree inbiology (with honors) from theUniversity of Chicago in 1993, Fogartyearned his MD from the University ofNebraska College of Medicine in 1998.the following year, his first exposure toUND came through its “transitionalyear” internship program at MeritCareHospital in Fargo. He then returned toOmaha, where he completed a four-year radiology residency program atCreighton University Medical Center.During that time, he was recognized asChief resident. In 2003, he joinedMedCenter One as a staff radiologist.

aLUMNI PrOFILe

surfing theState of the Artist: A Career in Medical Imagery


”The ability to have CT data

in all of three minutes...

enables the neurologist or ER doc

to say with confidence,

‘this person is having a stroke

right now.’

a technophile’s Dream Jobeven as he mentions kite sailing as

a way of integrating physics into anextreme sport, he never strays far fromhis view of radiology as the ultimateplayground for a tech-obsessed doctor.Without question, he says, thecomputer has been the biggest agent ofchange. It has allowed for Ct(computed tomography) scanners thatcan image the entire heart, taking arapid series of photographic “slices” injust one beat. (He proudly notes thatMedCenter One has the only 320-slicescanner in North Dakota.)

But mention that most vital of organs,the brain, and Fogarty really gets excited.Stroke victims, for instance, have alwaysbeen vulnerable to the time delaystypical with MrI (magnetic resonanceimaging) scans, which take up to 45minutes. “the ability to have Ct data,”he says, “in all of three minutes,tracking the blood flow through thebrain—this enables the neurologist orer doc to say with confidence, ‘thisperson is having a stroke right now,’and they administer a powerful, yetrisky drug that can eliminate theblockage in the affected cerebral artery.It’s pretty amazing to see that!”

Fogarty also points to an importantshift in radiology from its traditionalrole of “defining structure to findpathology,” to an evolving new frontierwhere function itself is being revealed.Breast specific gamma imaging and Pet(positron emission tomography) imagingprovide a functional roadmap whereactive cancer cells are targeted(labeled). these functional tests makecancers easier to diagnose and allowthe care team to track responses totherapy with greater precision. Fogartystates the obvious benefit: “Cancerdrugs are not a walk in the park. thisinformation means we don’t have toovertreat patients.”

From “the Bends” to Brain HealingFogarty’s open-mindedness has led

to an out-of-the-box opportunity indefining how hyperbaric oxygentherapy (HBOt) is helping brain-injuredpatients. He’s teamed with Dr. PaulHarch of Louisiana State University, anunsung hero of medicine, using HBOtto improve the neurological function ofmany brain-damaged patients. Dr.Harch’s understanding evolved out ofthe treatment of brain-injured divers.

With the ongoing warfare in Iraq andAfghanistan, blast injury to the brainhas become an epidemic, and Fogartyis clearly passionate about extendingthe benefits of HBOt to these “silentinjuries,” often suffered by soldiers fromroadside bombs. He notes, “thepatriotism and graciousness in NorthDakota is such that we have a greaterpercentage of our citizens at risk. Weare not doing enough to define, byimaging, the real pathology. It’s how I’dlike to give back to the community.”

Fogarty and Harch have publisheda case report on the method of healingthe brain by HBOt and tracking thiswith functional neuroimaging. Hecredits two North Dakota natives, Stevereimers and Linda Butts, forintroducing him to Harch. “He’s a realpioneer, and I just happened to be alucky guy, the squirrel that came acrossthis cache of medical chestnuts.”

As if he weren’t busy enough,Fogarty is also working with Jon allen,mD ’84, the director of UND’s Clinicaleducation and Simulation Center, tomake classic radiology cases availableto students by computer.

What drives this windsurfing doctorto achieve so much? “It’s a calling. I’min the right place at the right time, andevery day there’s something new.I’ve never had a boring day.”

- Gary Niemeier

Winds of Change


WHILe MANY StUDeNtS SPeNDtheir summers in the surf and sun,UND student Jenna akkanen had avery different summer “vacation.”Akkanen, who’s finishing her master’sdegree in occupational therapy, spenther summer doing fieldwork in NewYork City at Barrier Free Living, thecountry’s only domestic violenceshelter specializing in services forindividuals with disabilities. While onsite in Harlem, Akkanen worked withstaff to develop extensive treatmentplans for residents and their children—with memories and valuable workexperience that last far longer than asummer tan.

this Minnesota native has long had apassion for caring for others. While still ateenager, she received her CNA (certifiednursing assistant) license and worked inskilled nursing and assisted living facilitiesthroughout high school and college.

“I have loved health and medicinesince I was old enough to appreciateit,” said Akkanen. “I knew very early onthat I wanted to have a career in ahealth field. I love helping people; it’s avery rewarding feeling.”

Her interest in occupationaltherapy began during her first year atUND. While working as a CNA in anursing home, the then pre-med studentbegan speaking with an occupationaltherapist (Ot) in a resident’s room.Akkanen asked the Ot about her work.

“When she described it to me, Ibecame very interested in occupationaltherapy, did some research, and observedher working with some residents. Idecided that I really liked the work, thatit was well suited to my strengths, anddecided to pursue a career in Ot.”

Already an undergraduate at UND,the choice of UND for graduate school

was easy, given the school’s greatreputation and medical program.

“I wanted to stay at UND if at allpossible,” said Akkanen.

She applied and was accepted intothe master’s Ot program, which placesgreat emphasis on real-world internships.

But how did this Midwesternwoman end up all the way across thecountry in the Big Apple?

Internships are an importantcomponent of UND’s Ot program.each student is required to completefive one-week internships and two 12-week internships.

Akkanen said her “passion forpeople” and her desire to experience“different cultures and places” madeher immediately interested in workingin New York City.

While UND didn’t have any directconnections with facilities in New York,Akkanen called some hospitals in the city

and was referred to Barrier Free Living.She contacted the facility’s Ot supervisor,flew out for an interview, and landedher dream summer internship atFreedom House, Barrier Free Living’semergency shelter for domesticviolence survivors and their children.

Akkanen was drawn to FreedomHouse not only because it is the onlydomestic violence shelter in the countrythat specializes in individuals withdisabilities but also because it is a verynontraditional setting for Ots. While onsite, Akkanen worked directly withresidents and their children on specifictarget issues, such as money and timemanagement, coping and parentingskills, and education and vocationaldevelopment. While attending andfacilitating classes for residents such ascooking, yoga, parenting and computerskills, Akkanen also helped the housing

STUDENT PrOFILe

Making the Most of my

“OTs are very much needed...

because we can have such

a positive impact

on survivors’ lives.


and entitlements department withdepartmental organization, createdbanners and flyers for facility events, anddeveloped a work-skills program to helpresidents build their resumes and becomemore marketable to future employers.

While the work could beemotionally draining, Akkanen found itimmensely fulfilling.

“Ots are very much needed insettings such as domestic violence shelters,because we can have such a positiveimpact on survivors’ lives,” she said.

the most rewarding aspect of her experience?

“Definitely working with residentsand watching them progress intoindependent and stronger individuals,”said Akkanen. “Whether it wasadvocating for themselves, getting theirGeD, or improving their parenting skillsto stop the violence, it was anincredibly rewarding experience.”

And it didn’t stop there. Akkanen isnow doing a physical disabilitiesrotation at a rehabilitation hospital nearLas Vegas and hopes to work withindividuals with spinal cord injuries,traumatic brain injuries, and strokes.

“I really could not have chosen amore perfect career for myself,” shesaid. “Because there are a variety ofsettings and populations I can workwith, there will always be somethingnew to experience and learn. I can beas creative as my imagination will letme, and I get the opportunity to helpindividuals help themselves be asindependent as possible. At the end ofthe day, I will go home feeling proud ofwhat I’ve done and, hopefully, havemade a difference in someone’s life.”

Who else can say that abouttheir summer vacation?

- Laura Scholz

Jenna Akkanen at Freedom House.


aLUMNI NOteS

sarah Dahl, Dpt ’09, has joinedAltru’s Outreach therapydepartment. Dahl provides servicesat Altru’s outreach site in Mayville.

megan schill, msOt ’09, has joinedAltru’s Outreach therapy department.Schill provides services in Langdon.

michael Brousseau, Bspt ’07, aphysical therapist, recently joinedthe Medcenter One OccupationalHealth Clinic in Bismarck.

Brousseau evaluates and treatswork-related injuries and overseespatient rehabilitation. He alsoperforms pre-placement testing, pre-injury screening, functional capacityassessments, work-conditioning

programs, jobsite analysis, and ergonomic assessments.

Joshua Deere, mD ’06, has joinedAltru Family Medicine Center uponcompletion of his residency at Altru’sFamily Medicine Center in GrandForks. Originally from ruralnorthwestern Minnesota, Dr. Deereacted as resident representative forGrand Forks Family Medicineresidency to the American Academyof Family Physicians of North Dakota.

Lisa Jamsa, mD ’06, joined the FamilyMedicine Department at Innovis Healthof Wahpeton. Dr. Jamsa is a memberof the American Medical Association,American Academy of FamilyPractitioners,andNorth Dakota Academyof Family Physicians. As a familymedicine physician, Dr. Jamsa specializesin pediatrics, obstetrics/gynecology,geriatrics, and sports medicine.

Bonnie Kvistad, mD ’06, joined the Pediatrics Departmentat the Southwest Children’s Clinic in Fargo. Dr. Kvistadmonitors the development of infants, children, and adolescentsto assess their needs and to diagnose and treat diseases.

Jeff andersen, mD ’05, has recentlyjoined MeritCare in Mayville. Beforejoining MeritCare, Dr. Andersenpracticed across North Dakota,working as a locum tenens physicianas well as spending time working inNew Zealand. Dr. Andersen isboard-certified in family medicine.

Jordan Coauette, mD ’05, hasjoined MeritCare’s obstetrics andgynecology department at theSouthpointe Clinic in Fargo.

alyssa Hoverson, mD ’05, recentlyjoined truyu Aesthetic Center inGrand Forks. After completing hermedical degree with the UNDSchool of Medicine and HealthSciences, she did a medicalinternship with MeritCare Hospital ofFargo. Hoverson then joined MayoSchool of Graduate Medicaleducation, where she completed herdermatology residency. She is a member of the AmericanSociety for Dermatologic Surgery, the American Academyof Dermatology, and the Women’s Dermatologic Society.

rhonda schafer-mcLean, mD ’05,phD, recently joined the obstetricsand gynecology department at theMid Dakota Clinic Center forWomen Prime Care in Bismarck inlate July. She completed an obstetricsand gynecology residency at theUniversity of Colorado in Denver,where she received the OB/GYNteaching Award.

alex thompson, Dpt ’05, CsCs, recently completed boardcertification in strength and conditioning through theNational Strength and Conditioning Association. He iscurrently training area athletes and is available forconsultation regarding conditioning programs forindividuals of all ages. Dr. thompson is the manager ofWest river Physical therapy Department.

’00s ’00s


aLUMNI NOteS

marissa Wisdom, mD ’05, has joinedthe Obstetrics and Gynecologydepartment at the Mid Dakota Clinicfor Women in Bismarck. Dr.Wisdom has completed a four-yearobstetrics and gynecology residencyat the University of Iowa Hospitalsand Clinics. Dr. Wisdom is a juniorFellow in the American College ofObstetricians and Gynecologists.

Duncan ackerman, mD ’03, has joined the Bone and JointCenter in Minot. After his medical training, Dr. Ackermanreceived an additional five years of training with the MayoClinic in the Orthopedic Surgery residency Program. Hesubsequently completed a one-year fellowship in Hand andMicrovascular Surgery at the Mayo Clinic in rochester, Minn.

tanya skager, mD ’01, has begun her duties as a full-timephysician at the richardton Medical Clinic. Before joiningthe clinic, Skager practiced medicine in South Dakota.

edward Fogarty, mD (transitionalresidency ’99), a board-certifiedradiologist at Medcenter One, co-wrote a case study that was recentlypublished in the medical publicationCases Journal. the case study istitled “Low pressure hyperbaricoxygen therapy and single-photonemission computed tomographybrain imaging in the treatment of

blast-induced chronic traumatic brain injury/post-concussionsyndrome and post traumatic stress disorder.”

Jeffrey tiongson, mD ’95, has joined the emergency medicinedepartment at MeritCare downtown hospital in Fargo.tiongson previously worked at Union Hospital in elkton, Md.

Kim Konzak-Jones, mD ’92, ofGrand Forks was re-elected vicepresident of the North DakotaAcademy of Family PhysiciansFoundation. Dr. Konzak-Jones iscurrently practicing with Altru inGrand Forks.

David strand, mD ’89, general,bariatric, breast, and thoracic surgeonwith the Surgical Institute of SouthDakota in Sioux Falls, has beenappointed chief of the medical staffat Avera McKennan Hospital andUniversity Health Center. At AveraMcKennan, he has served as chair ofthe pharmacy and therapeuticscommittee and as the chief of surgery.

He currently is chair of the South Dakota Committee ontrauma. He is certified by the American Board of Surgeryand has advanced training in laparoscopic bariatric surgery.

richard Vetter, mD ’88 (Family practice residency ’91),was chosen as North Dakota’s top family physician. theaward is presented to a physician who displays pride inpracticing family medicine. His name will be submitted tothe American Academy of Family Physicians forconsideration at the national level. Dr. Vetter is currentlypracticing at Innovis Health in West Fargo.

Greg Greek, mD ’85 (Family practiceresidency ’88), was re-elected assecretary/treasurer of the NorthDakota Academy of Family PhysiciansFoundation. Dr. Greek is currentlypracticing at Altru in Grand Forks.

tom Cariveau, Bs med. ’81, received the Friend of FamilyMedicine award during the North Dakota Academy ofFamily Physicians annual meeting in Fargo.

pierre a. rioux, mD ’81, DFapa,coauthored a new study,“Multifaceted Inpatient PsychiatryApproach to reducing readmissions:A Pilot Study,” which was publishedin the September 2009 issue of The

Journal of Rural Health. rioux is medical director of Austin

(Minn.) Medical Center’s psychiatricinpatient unit—a part of Mayo Health

System—and an instructor in psychiatry at Mayo Clinic.Access to psychiatric services in rural areas, particularly

inpatient psychiatric care, is limited and care may not be ascomprehensive as in metropolitan areas. the purpose of thestudy was to evaluate the effect of the MIPA approach topsychiatric inpatient care on readmission rates in a ruralhospital setting.

’90s

’00s ’80s


IN MeMOrIAM

major General Larry smith, Bs med.’36, died June 18, 2009 at the age of95. He was the son of Doctor JosephSmith and Lora Aird, a schoolteacher.He entered military school in 1927,ran the school newspaper after a yearin military school, earned ascholarship at Pittsburg MilitaryAcademy at Owatonna, Minnesota,and attended medical school and pre-

law school. He received a bachelor of science degree atthe University of North Dakota in 1936 and attendedNorthwestern University Medical School in 1937 and 1938.He was licensed to practice medicine and surgery in thestates of North Dakota and Minnesota in 1939. He joinedthe U.S. Army at the start of WW II; he was transferred tothe U.S. Air Force in 1947. He attended the AviationMedicine Navy School at Bethesda, Maryland, in 1955, andhe was certified by the American Board in PreventiveMedicine and Aviation Medicine in 1956. He served asCommand Surgeon at Hickman Air Force Base in Hawaii.During WWII, he participated in overseas duty in Icelandand the China-Burma-India theater. He served as DeputySurgeon of Strategic Air Command at Andrews Field andMedical Group Commander at Keesler, Mississippi. He wasalso a pilot until 1967 and served as flight surgeon, surgeongeneral, and command surgeon. His distinguished militaryservice spanned nearly 34 years. He was preceded in deathby his father, Joseph Smith, mother, Lora Aird; brother, AirdSmith; and sister, Miriam Avakian. Survivors include hiswife, Claudine Smith; daughter, Laurel Smith;stepdaughters, Dominique Wallace and Anna Hoey.

sidney O. Hughes, Bs med. ’44, 86, died peacefully in theearly hours of Saturday, February 21, 2009, at WinonaCommunity Memorial Hospital, the hospital where he caredtirelessly for others as a physician for over 40 years.

Sidney was born June 19, 1922, in Mandan, NorthDakota, to Charles Hughes and Flora Kollitz. He graduatedfrom Mandan High School in 1940, attended JamestownCollege from 1940 to 1944, then attended the University ofPennsylvania at Philadelphia for Medical School from 1946 to 1950, completing his internship at PresbyterianHospital from 1947 to 1948 and serving as AssistantInstructor of Medicine at the University of Pennsylvaniafrom 1948 to 1950.

He served stateside as a private first class in the Army from1943 to 1946 during WWII. He was called to active dutyDecember of 1950, serving in the Army stationed at PercyJones General Hospital for 11 months. In January 1952, he wasstationed in Korea at the 121st evacuation Hospital, wherehe served as Captain in a MASH unit. He also volunteeredas a physician at a local orphanage while in Korea.

He married Colleen J. Lindsay on June 15, 1947, inMandan. they moved to Winona in 1953 when he took aposition as a doctor at the Winona Clinic with an internalmedicine specialty, certified by the American Board ofInternal Medicine. He served on the Winona Clinic Boardfrom 1974 to 1991. His professional affiliations includedthe American College of Physicians, Minnesota StateMedical Association, and Winona County MedicalAssociation. He retired from full-time practice in 1999, butcontinued to practice part time at the Winona StateUniversity Health Care Center for several years.

He served as the primary caregiver for Colleen after shewas diagnosed with Alzheimer’s disease until her death in2001. Upon his retirement, he continued his life-longservice to the community by volunteering with Meals onWheels, providing respite care for other caregivers throughthe elders Network program, and reading to second-gradersat Washington-Kosciusko elementary School.

With Colleen, he enjoyed traveling to europe andhiking, fishing, sailing and camping with his four daughters.More recently, with his partner theda Hester, he enjoyedspending time on Sanibel Island in Florida in the winter,and visiting his daughters and their partners.

He is survived by his four daughters (and their partners):Honore Hughes (and Julie Gram) of St Louis, Mo.; MelissaHughes (and rob Harrison) of Conner, Mont.; HollyHughes (and John Pierce) of Indianola, Wash.; and StacyHughes Anderson (and Neal Hughes Anderson) of Winona,Minn.; his sister Dorothy Pederson of Bloomington, Minn.,and his colleague and partner of recent years, theda Hester.


Clarence “Bud” W. Jordahl, Bs med. ’52, 80, of Milwaukee,Wis., died Saturday, June 20, 2009. Bud’s family receivedfriends on Saturday, June 27 at Fox Point Lutheran Church.

Bud was born in Minot, North Dakota. He graduatedfrom the University of North Dakota, graduated fromAlbany Medical College, and interned at Upstate MedicalCenter in Syracuse, N.Y. He served in the Public HealthService on the Navajo Indian reservation. He did his internalmedicine residency at the New York Hospital-CornellMedical School, where he was chief resident. He completedfurther studies in pulmonary medicine at the University ofPennsylvania. Bud came to Milwaukee in 1962 toMarquette Medical College. He later had a consultingpractice in pulmonology, was medical director at NorthviewHome in Waukesha and ran the tuberculosis ControlCenter for the City of Milwaukee. Bud will be rememberedfor his strong spirit and wonderful sense of humor. Hisfamily greatly appreciates the prayers, love, and concerns oftheir many friends. they especially appreciate the medicalcare of his doctors and the staff at Columbia Hospital.

Bud was the beloved husband of Donna (née Boschee),the dear father of Ann (Stephen Sennott) Jordahl, William(Deb) Jordahl, and eric (Laura) Jordahl. He was the brotherof Marjorie Jordahl, Betty (Martin) Osmundson, and the lateGene W. Jordahl. He was also the grandfather of Briannaand Hille Sennott; and Adam, Anna, Haley, Lily, and CalebJordahl. Bud is further survived by nieces, nephews, andmany other relatives and friends.

alan Bloom, mD (Family practice residency program ’89),died thursday, June 11, 2009, at Sanford Hospital inWebster, S. Dak. His funeral was on June 16 at St. John’sLutheran Church in Webster. He was buried at the WebsterCemetery with military rites.

Alan ray Bloom was born thursday, April 6, 1950, toFred “Pete” and Geraldine (Pies) Bloom in Webster. He wasbaptized and confirmed at American Lutheran Church inWebster. the family lived on a farm south of Webster inWheatland township, Day County, where he attendedcountry school through the fifth grade and then transferredinto Webster, where he graduated from high school in 1968.He attended South Dakota State University in Brookingsfrom 1968 to 1972, where he was involved with rOtC andgraduated with a Bachelor of Science in Chemistry. OnSeptember 11, 1971, he married Sylvia Knapp in Waubay.From 1973 to 1978, he served active duty as a pilot with theU.S. Air Force as a Commissioned Officer. He received hispilot training in Big Spring, texas, and in 1974, he receivedhis B-52 training at Merced Air Force Base in California. In1977, he attended Squadron Officer School in Montgomery,Ala. He was stationed at Wurtsmith Air Force Base in Michiganfrom 1974 to 1978. While in Michigan, he received hisMaster of Arts in Public Administration in 1976. the couple

moved to Vermillion, S. Dak., where he received a Masterof Science in Biology in 1980, and he graduated from theUniversity of South Dakota Medical School in 1985.

He was an aircraft maintenance officer and squadroncommander with the Iowa Air National Guard in Sioux Cityfrom 1980 to 1988. He completed his Family Practiceresidency in 1988 through the University of North Dakota.the family then moved to his native Webster, S. Dak.,where he began his medical practice at the Day CountyMedical Center, which continued until the present. Hereceived a fellowship with the American Academy ofFamily Physicians in 1991. He served with the S. Dak. AirNational Guard in Sioux Falls from 1988 until 1994 asclinic commander and state air surgeon. On June 13, 1992,he was united in marriage to rita (Nielsen) Grupe at St.John’s Lutheran Church in Webster. the couple resided inWebster. He retired in 1994 as a lieutenant colonel withmore than 20 years of military service.

Dr. Bloom was a member of St. John’s Lutheran Churchin Webster. He also was an avid hunter and a member ofmany wildlife organizations, including the Isaak WaltonLeague. As a young man, he was active in 4-H, anaccomplished pianist, and church organist for the AmericanLutheran Church. He was a life member of HerbertMcKennett Post 40 American Legion.

Survivors include his wife, rita, of Webster; one son,Alan Grayson (Michelle) Bloom of Laurel, Md.; twodaughters: Alla (David) Bartell of Fargo, N. Dak., andAllegra (Clint) Duerre of Bristol, S. Dak.; two stepsons: rossGrupe of Webster, S. Dak., and Ben (Natasha) Grupe ofrapid City, S. Dak.; one stepdaughter, elizabeth (Dan)Basye of Watertown, S. Dak.; four grandchildren: Soren andClaire Bartell and Georgia and Max Duerre; and fivestepgrandchildren: Abbie and Kiera Grupe and tyler,rianne and Dane Basye. He was preceded in death by hisparents and a sister, Gaye.

IN MeMOrIAM


PLaNNING AHeAD


PaRTING SHOtS

Sudarshan Kadirvelu, MD, and Nikhil Batra, MD, second-year

family and community medicine residents; and Suman Regmi, MD,

a third-year family and community medicine resident, represented the

UND School of Medicine and Health Sciences at the 2009 American

Academy of Family Physicians Annual Conference of Residents and

Students July 30 - August 1 in Kansas City, Mo. Dr. Regmi and his

wife, Suima Aryal, MD (Family and Community Medicine

Residency ’09), will practice medicine in Wahpeton, N. Dak.,

when he completes his residency.

Jon Tingelstad, MD, BS Med. ’58, chair of the UND

School of Medicine and Health Sciences’ National

Advisory Council, delivers his keynote address,

“Words that Begin with the Letter ‘P,’” to the Class

of 2013 at the White Coat ceremony on August 7.

The Department of Family & Community Medicine’s National Centerof Excellence in Women’s Health hosted their annual Women’s HealthConnection on Saturday, September 19, at the UND Memorial Union.Patty Purpur, a Grand Forks native and a nationally recognized healthand fitness expert, is shown delivering the keynote address.

In October, over 100 students and faculty attended the 2009 North

Dakota INBRE Annual Symposium for Undergraduate Research.

INBRE (IDeA Network of Biomedical Research Excellence)

builds biomedical research capacity by serving research universities,

baccalaureate institutions, and tribal colleges within the state.

Dr. Mikhail Bobylev (front) and his research group from

Minot State University presented research focused on the

discovery and development of novel formamide anti-fungal

agents. Behind Dr. Bobylev (L to R) are undergraduate

students Jaklyn Sansaver, Braden Buckhard, Steven Lewis,

Tanner Scofield,and Jantze Hedges.

“North Dakota Medicine Goes Green”to subscribe to the electronic issue of North Dakota Medicine go to http://www.ndmedicine.org/

University of north Dakota school of medicine and Health sciencesA National Leader in rural Health - Serving North Dakota since 1905501 North Columbia road Stop 9037 � Grand Forks ND � 58202-9037 701-777-4305 www.med.und.edu

ADDreSS SerVICe reQUeSteD

Periodical POStAGe PAID

Dave Miedema, director of development and planned giving for the medical school, Jan Granum, MS ’67, and

John Vennes, PhD, MS ’52, celebrate Dr. Vennes’s birthday on August 28. Jan Granum was a former lab assistant for Dr. Vennes.

North Dakota Medicine Holiday 2009

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