Introduction

From Gail Morrison, M’71, FEL’76: 

Welcome to new Pulse readers, including parents of current students! This issue offers a glimpse of the far-ranging interests and travels of Perelman School of Medicine students: a dose of their international experiences, and a sense of the ways that you can get involved in nurturing our students along their paths toward careers in medicine.

As I mentioned in last month’s issue, the Alumni Development and Alumni Relations Office is launching a new annual giving campaign, You Are Here, to show how, with your support and encouragement, Perelman students are able to make remarkable accomplishments. Please look for more information about the You Are Here campaign in upcoming emails.

Our Q&A this month features a member of the Medical Alumni Advisory Council: Rona Woldenberg, M’87, is a successful radiologist, leader in her field, and now an Associate Dean of Admissions at the Hofstra North Shore-LIJ School of Medicine. Dr. Woldenberg covers a lot of fascinating ground in this interview; I was particularly interested in hearing how her Penn experience has informed her role in medical school administration.

Current student Vasiliki (Vicki) Triantafillou, M’18, a member of the John Morgan virtual house, has written an enlightening piece about her summer experience in three children’s hospitals in Athens, Greece following her first year in medical school. I can’t speak highly enough of the opportunity for our students to broaden their medical education through international medical experiences—and Vicki seems to have benefited considerably and I expect her patients will, too.

Fellow student Robert Bonacci, M’16, a member of the Helen O. Dickens virtual house, also spent time overseas in South Africa before completing his inpatient medical elective in Botswana. Like Vicki, Robert gained a deep appreciation for the natural beauty of a foreign environment in addition to the effects of limited resources on patients and practitioners. I think you’ll enjoy reading about the story behind his Perelman School award-winning photo.

The travel theme continues in this issue, as Robert and his fellow classmates will clock some more time “on the road” in the next few months. It’s the season for fourth-year students to pursue residency interviews around the country, culminating in the exuberance of Match Day: when they learn where they will be spending the next few years of their lives. We explain it all in our article on the HOST Program (Host Our Students as they Travel), which I hope you will register for if you have not already.

Please visit our events calendar for Penn Medicine gatherings in Philadelphia and elsewhere that you may want to attend. Upcoming events include the Penn Medicine Alumni Reception in Baltimore at the annual meeting of the Association of American Medical Colleges (AAMC) on November 7, and the Elizabeth Kirk Rose, M’26, Women in Medicine Luncheon honoring Marie A. Savard, HUP’70, NU’72, M’76, INT’79, on December 8.

A new regular feature in Pulse is a brief review of just some of the notable recent results from Penn Medicine researchers. Please go here to subscribe to Penn Medicine in the News to receive a daily email about research findings, our faculty in the news, and the latest pertaining to our hospitals or the medical system in general.

A great way to keep up with Penn Medicine events, stay connected to alumni, and to volunteer for the School or University is to enroll in QuakerNet. If you don’t already have a PennKey, please sign up and then start searching through QuakerNet to get a directory or just see what is on the upcoming events calendar throughout the Perelman School and University.

In health system news, Penn Medicine and Virtua have partnered in a strategic alliance that will offer new options for cancer and neurosciences patients in south New Jersey. Go here for the Penn Medicine news release or here for coverage in the Philadelphia Inquirer.

In faculty news, it is a great pleasure to announce that Frances Jensen, MD, FACP, and Sean Hennessy, PharmD, PhD, have been elected to the National Academy of Medicine (NAM), formerly the Institute of Medicine, which is one of the highest honors in medicine and recognizes individuals for outstanding professional achievement and commitment to service. We now have 66 total current and emeritus members of the Penn Medicine community who belong to the NAM, and serve as inspiring role models to our students.

Enjoy this issue of Pulse! As always, please write to let us know what you would most like to see covered in your alumni online newsletter, to update us on your current or upcoming publications—which we would be happy to highlight and link to here—or to convey any news that you would like to share with your alumni community (gailm71@exchange.upenn.edu).

P.S. If you haven’t yet purchased a copy of To Spread the Light of Knowledge, a limited-edition book filled with nearly 200 pages of history celebrating the 250th birthday of the nation’s first medical school, I recommend taking a look. This wonderful book, which includes photos dating back to the founding of the School, really elicits a deep pride and appreciation for the pioneering role our School has played in American medicine. To order a copy, click here and make your selection.

Images of Change:
A Q&A with Radiologist and MAAC Member Rona Woldenberg, M’87 

Pulse recently spoke with Rona Woldenberg, M’87, about the crucial role of lifelong learning and mentorship in medical practice—from the changes in the field of radiology to her unique perspective in shaping one of the nation’s youngest medical schools.

Dr. Woldenberg—a member of our Medical Alumni Advisory Council—is Associate Dean of Admissions  and Associate Professor of Radiology at the Hofstra North Shore-LIJ School of Medicine. She is the immediate past president of the Eastern Neuroradiological Society and a member of its executive committee. Her interest in education has ranged from her service as Founding Editor and Editor-in-Chief of Case in Point—an online daily case presentation sponsored by the American College of Radiology (ACR) —and heading the neuroradiology section of the radiology in-training examination sponsored by the ACR. She was inducted as a Fellow of the American College of Radiology in 2007.

Q: It’s a special opportunity to speak with someone who studied at the nation’s oldest school of medicine and now has a hand in “building” a new one. With that view in mind, what changes in the School stand out, compared to your days as a student?

A: Penn has always been ahead of the curve in its approach to medical education. The School acted on the understanding of the real value of patient-centered learning. Doctors remember patients, not the finer points of the Krebs cycle.

And reflecting an insightful view of what it takes to prepare doctors to humanistically practice medicine, the Perelman School has even innovated in terms of not requiring science backgrounds for students. The School provides a list of recommended prerequisite courses. It is a much more integrative approach than the decades-old model that prevailed after the Flexner Report.

Also, Penn is offering such a wide range of opportunities, leading the way in advocating and granting dual degrees, embedding research in the curriculum, supporting physician-scientists, and personalizing education and career paths. The skills a neurosurgeon requires differ from that of a palliative care practitioner, for instance, and Penn does a wonderful job of preparing students for their individual specialties, while giving them the tools to deal with the potential twists and turns inherent in a career, particularly in the quickly-evolving practice of medicine.

Q: On a similar note, in the years since you graduated, what have you seen as some of the major hurdles to modern medical practice?

A: While the industry as a whole has focused resources on increasing diversity and facilitating pipeline programs—efforts largely directed to increase engagement of disadvantaged youth in the health care professions—I think we’re neglecting another group: physicians in the later years of their careers.

Take a moment to consider: We talk about the evolving nature of medicine quite a bit when the issue is preparing the next generation of physicians. But that change is affecting all of us, every physician. I think we can make more of a concerted effort to help physicians keep pace with the changes in the profession—so they can continue to make meaningful contributions to health care. And this is particularly crucial in this era of looming physician shortages in multiple regions in the country.

Q: It sounds like life-long learning and engagement is very important to you. How has your Penn experience informed your current administrative role at Hofstra?

A: I graduated from the oldest medical school in the country and yet I work for one of the newest. My Penn experience directly impacts the way I go about my administrative role in trying to shape our “Doctors of Tomorrow.” Penn was and remains focused on the learner, as opposed to the teacher, and instills the value of lifelong learning in medicine.

This interest in the student is pervasive at Penn, as reflected in the rigorous but humane education that it offers, which is apparent from the minute a prospective student walks in the door. This is remarkable, particularly given the university’s elite status. I credit the administration of the School for creating such a warm and nurturing environment despite its size and reputation.

At Hofstra, I try to emulate what was inspired at Penn. It is a problem/case-based curriculum, without many formal lectures; the grading scale is pass/fail. It is a collaborative, interdependent educational experience that is all about team learning and building with the intention of creating lifelong learners.

While some of the business of medicine can be draining, and physician burnout remains an important concern, seeing the quality of applicants to medical school gives me real hope for the future.

There is tremendous energy in medical education, particularly at the Perelman School, and any way in which alumni—particularly those late-career physicians—can connect with that can help preserve their passion in their daily practice of medicine. Engagement with your medical alma mater is my prescription.

Q: How would you encourage fellow alumni to become more engaged with the School?

A: I think the Alumni Development and Alumni Relations department has done a fantastic job in increasing alumni engagement. And based on what I’m hearing, it sounds like the new virtual house program is a bold way to spur interest. That is, alumni could more readily become involved in the School, beyond reunions and regional events, through affiliations to the virtual houses.

Not only would this increase interaction with students, but it would also foster mentorship and Penn Medicine relationships—just as the wonderful HOST program has. (Ed. Note: You can learn more about becoming involved with the HOST program in this issue of Pulse.)

Q: Obviously, the only constant in medicine is change, and you have wonderful ideas on how alumni engagement can help new and seasoned physicians alike flow with that change. So looking at your specialty, how has the practice of radiology and the image of radiologists changed since you started your career, and what future changes would you like to see?

A: My own career has changed dramatically based on the constant introduction of innovative technology. Unbelievable advances in imaging have led to greater changes in patient care.

When I first started in practice, it was not uncommon for me to be called into the hospital in the middle of the night to perform catheter angiography to diagnose a ruptured aneurysm or a carotid dissection. Now this is done within minutes of the diagnostic CT (computed tomography) scan using noninvasive techniques such as CT angiography and MR (magnetic resonance) angiography. And the use of catheters has shifted from the diagnostic to the therapeutic realm, with endovascular management of ruptured aneurysms and arteriovenous malformations augmenting and replacing open craniotomies—a definite benefit to the patient.

Magnetic resonance imaging (MRI) as a diagnostic tool was in its earliest stages of development when I started my career. Now, functional MRI (fMRI), MR spectroscopy, and diffusion weighted and diffusion tensor imaging are all part of everyday practice in brain imaging.

Likewise, the role of the radiologist is evolving in significant ways. In the older model, the perception of the radiologist was that of a diagnostician, locked away in a dark room, on the edges of the patient care team. The ACR has promoted an expanded role for the radiologist: one that is much more involved in directing hospital policy, primary patient care, and patient case management.

Exciting future trends are directed toward “radiogenomics,” where imaging biomarkers can identify the genomics of a disease, especially cancer, without the use of a biopsy. Consider that it has been nearly 30 years since my medical education “ended”: Now, we are witnessing yet another technology in its infancy, and only beginning to understand the future impact it will have in the practice of medicine. The importance of life-long learning is clear to me—even in my own career.

It's All Greece to Me:
A Personal Perspective on Health Care in the Hellenic Republic

By Vicki Triantafillous, M'18

Growing up in a Greek family meant that twice a week after school, I attended Greek school to formally learn how to read, write, and speak Greek, with a sprinkle of history and traditional Greek dance lessons. This was non-negotiable, and no amount of feigning being sick was enough to get me out of going. Despite the half-hour struggle on the car ride there—during which I tried to convince my mother that I really was sick—I do fondly remember learning about ancient Greece’s contributions to science and medicine and about Hippocrates, born on the Greek island of Kos around 460 BCE and widely regarded as the “Father of Medicine.”

This summer, after my first year of medical school, I found myself walking up to a gray stone, yellow balcony-lined building in the middle of Athens, thankful for my ability to speak and read Greek and yet second-guessing that I had properly read the sign “ΝΟΣΚΟΜΕΙΟ ΠΑΙΔΩΝ Η ΑΓΙΑ ΣΟΦΙΑ” (Aghia Sophia Children’s Hospital) because this was unlike any hospital I had ever seen.

I went to Greece to work on a research project born here in Philadelphia under the mentorship of Julia Szymczak, PhD, a medical sociologist and postdoctoral fellow in the Division of Infectious Diseases at The Children’s Hospital of Philadelphia (CHOP), and Theoklis Zaoutis, MD, MSCE, Chief of the Division of Infectious Diseases at CHOP. With funding from Penn’s Center for Global Health, I spent six weeks at the Collaborative Center for Clinical Epidemiology and Outcomes (CLEO) Research in Athens, visiting the neonatal intensive care units (NICU) of three of Athens children’s hospitals and interviewing their doctors and nurses about health care-associated infections (HAIs) and antimicrobial resistance as a first step in understanding barriers to improving infection control practices and promoting the judicious use of antibiotics. Established in 2011 by Dr. Zaoutis, CLEO specifically addresses HAIs and the growing threat of antimicrobial resistance: two major problems in Greece.

While HAIs and antimicrobial resistance are a growing global problem, Greece in particular stands out with one of the highest rates of antimicrobial use—and resistance—of all European countries. It is hoped that identifying health care worker attitudes and beliefs around these topics may allow us to design and implement interventions that will be more effective and more likely to be adopted because they fit within the culture of medicine as it is practiced in Greece. In addition to improving patient outcomes, reducing the financial burden associated with HAIs is particularly significant for a country whose hospitals are already struggling to provide basic services.

Since 2008, health care spending in Greece has been cut by 25% according to the Organization for Economic Co-operation and Development, and Greek hospitals have faced shortages of personnel, medications, and even the most basic supplies, such as gloves and paper towels, as the country’s health care system teeters on the brink of collapse. Hospitals and clinics have closed; 30,000 health workers have been laid off; and many young, talented doctors have left the country. At the same time, Greece has seen more refugees from the worst global conflict zones than any other country in Europe, which, coupled with imposed austerity measures has left Greece struggling to cope with multiple national crises.

Living and working in Athens this summer, I was able to understand for the first time the heavy cloud of uncertainty and worry that shrouds the country. From my conversations with hospital staff, it is clear to me that the only reason the hospitals in Greece continue to function is the tenacity and integrity of the people I had the opportunity to interview: doctors and nurses that are tired, but truly love what they do, and work each day with every ounce of their being. Their response to the crisis can be summarized by a Greek word the meaning of which encompasses the values that form the very foundation of Greek culture and identity, a word that cannot be adequately captured by any translation: Φιλότιμο (philotimo). Roughly, it is a way of life rooted in dignity, respect, compassion, and gratitude; it is an overwhelming, intrinsic sense of duty and social responsibility to one’s self, one’s country, and one’s fellow human beings.

As I reflect on my experience in Greece working with CLEO, I feel lucky to have had the incredible opportunity to witness medicine as it is practiced in another country, an experience through which I learned more about the practice of medicine itself—a couple of humbling lessons that have a permanent place in my white coat pocket. I have returned to Philadelphia with humility in the face of what health care practitioners are facing in Greece, and a newfound gratitude for all that I take for granted as I grow into a doctor in the era of medicine as it is practiced in the US today.

Despite the apparent differences at first glance—yellow balconies and open windows, “Thank you for not smoking” signs posted not around the hospital grounds but in the hospitals themselves, and handwritten lab results—I have seen that medicine at its core, the commitment to healing, is the same.

"Hope Amongst the Seas":
Photo Contest Winner Rober Bonacci, M'16, Captures the Meeting of Two Oceans Before Meeting the Health Care System in Botswana

Before beginning his inpatient medicine elective in Botswana, fourth-year student Robert Bonacci visited Cape Town, South Africa for four days, and found himself captivated by the beauty of the Atlantic and Indian Oceans.

Bonacci felt fortunate to have such an uplifting experience before subsequently witnessing the “profound medical and public health consequences of the HIV and tuberculosis co-epidemics that so heavily burden Botswana and neighboring countries.” The Akron, OH native spent seven weeks working in the inpatient general medicine wards at the Princess Marina Hospital, the country’s primary academic medical center, as well as the district-level Bamalete Lutheran Hospital.

Despite encountering so many young people suffering or dying of treatable conditions, Bonacci left Botswana filled with a sense of optimism from the experience of working alongside “tireless, resilient creative, and thoughtful physicians who are providing excellent medical care despite limited resources—and whose government committed early on to providing all citizens with HIV treatment and addressing the epidemic.”

Working in another country on public health was a logical extension of the path that Bonacci has set for himself. He earned a BS in microbiology and BA in Spanish at Ohio State, then completed a year-long Fulbright Fellowship in 2011 studying tuberculosis and tobacco epidemiology in Mexico at the National Institute of Public Health of Mexico (INSP). Between his third and fourth years at the Perelman School, he took a year out to complete a master’s in public health in epidemiology at Johns Hopkins.

Back at the Perelman School for his fourth year, he is currently applying to internal medicine residency programs. Bonacci is interested in the global control of HIV and tuberculosis, and caring for Latino immigrants and other vulnerable populations.

During his South African trip, Robert positioned himself at the base of Cape Point lighthouse in South Africa’s Table Mountain National Park, and took a panoramic photo deemed the best of all student offerings in the 2nd annual Student Summer Photo.

“Depending on the water currents,” he noted, “this is where the Atlantic and Indian Oceans meet.” He added, “Encountering such natural beauty, I was left with a sense of awe and possibility, reminding me of how large the world is, how little we actually understand about it, and how much more there is to learn and explore.” 

Please go to the Perelman School of Medicine Facebook page to see a gallery of all of the outstanding entries in addition to Robert’s contest-winning picture appearing above.

The Science of Art:

The Work of a Penn Medicine PhD Adorns the Walls at Biomedical Graduate Studies Anniversary

After completing his PhD in neuroscience, Greg Dunn, GR’11, dove headlong into the art world. His creative work doesn’t eschew his Penn training; in fact, with his colleague Brian Edwards, GR’09, he co-invented a technique of manipulating light on a microscopic scale to alter reflectivity and a viewer’s experience of a painting. His work, which delves into the nexus of art and science through designs in gold leaf, was prominently displayed at the Biomedical Graduate Studies (BGS) 30th Anniversary Event, October 8 to 10. An exhibition of Dr. Dunn’s is running at the Mutter Museum through January 2016.

Please click here to read about his artistic vision and see some of his work.

Host a Perelman Student!

Host a Perelman student or two to help them on their way toward a jubilant March Match Day.

Managed by the Office of Alumni Development and Alumni Relations, HOST (Host Our Students as they Travel) matches fourth-year medical students traveling for residency interviews with participating alumni and now parent volunteers—enthusiastic supporters who offer lodging, meals, and information about residency programs and nearby medical centers. The program typically runs from October through January.

At last count, 197 HOST volunteers had registered to participate in this year’s program—and 69 of those are new alumni volunteers, with 35 parent volunteers. Compared to last year, the program boasts 82 more volunteers overall.

Help our fourth-year medical students cut down on the cost of travel and get the chance to re-engage with the School. Alumni Development and Alumni Relations particularly hopes to register more volunteers who live in or near Ann Arbor, Chicago, Los Angeles, San Francisco, and Seattle.

To volunteer, please register here. While all who volunteer to be hosts may not be matched with a student, know that every effort will be made if there is anyone visiting your city. If you have any questions about the HOST program, please feel free to send an email to pmhost@exchange.upenn.edu or call Nicole McGarry at 215-898-8302.

Penn Medicine Research in the News
A Brief Survey of Notable Findings by Faculty

Penn Medicine faculty direct some of the most groundbreaking research conducted around the world. This new feature highlights just a few attention-getting results reported in the last six weeks.

New Method to Identify Epileptic Lesions

Lead author Kathryn Davis, MD, MSTR, Assistant Professor of Neurology, and senior author Ravinder Reddy, PhD, Professor of Radiology and Director of Penn’s Center for Magnetic Resonance and Optical Imaging, along with several additional Penn authors, reported in Science Translational Medicine that they had developed a new method using advanced noninvasive neuroimaging to recognize the neurotransmitter glutamate, which is believed to account for the most common form of medication-resistant epilepsy. Click here to read the full news release.

Potential Treatment for a Serious Clotting Condition

A study led by Mark Greene, MD, PhD, the John W. Eckman Professor of Medical Science, and Douglas Cines, MD, Professor of Pathology and Laboratory Medicine, Professor of Medicine, and Director of the Coagulation Laboratory, found that a better understanding of the protein complex at the root of a serious clotting condition that can affect patients receiving heparin to treat or prevent blood clots may lead to a new treatment. The findings, published in Nature Communications, suggest new diagnostics that the authors think may lead to an approach to halting the disorder in its early stages.

Significant Gap in Cancer Research Filled

An international team of researchers led by Lin Zhang, MD, the Harry Fields Associate Professor of Obstetrics and Gynecology, and Chi V. Dang, MD, PhD, Director of the Abramson Cancer Center and John H. Glick, MD Abramson Cancer Center Director’s Professor, has identified non-protein-coding segments of the human genome whose expression is associated with 13 distinct types of cancer. The authors believe that their study of long non-coding RNA sequences, published in Cancer Cell, has set the stage for the development of novel tools to diagnose and treat cancer. Click here to read the full news release.

Events Calendar 

This fall and winter feature several noteworthy events for alumni and students. Please join us!

November 7               Association of American Medical Colleges (AAMC) Alumni Reception
                                    6:00 PM – 8:00 PM, Hilton Hotel – Baltimore

November 9              The Institute for Diabetes, Obesity and Metabolism (IDOM)
                                   10th Anniversary Celebration
                                   5:30 PM – 7:00 PM, Smilow Center for Translational Research – Commons

November 14             Scheie Eye Institute Alumni Reception – American Academy of Ophthalmology Annual Meeting
                                   7:30 PM – 10:30 PM, The Wynn - Las Vegas

December 1               RSNA Reception
                                   University Club - Chicago

December 8              Elizabeth Kirk Rose, M’26, Women in Medicine Luncheon
                                   Honoring Marie A. Savard, HUP’70, NU’72, M’76, INT’79
                                   12:00 Noon – 1:30 PM, Law Family Pavilion

December 10             Student Study Break/Holiday Party
                                   4:30 PM – 6:00 PM, Atrium JMEC

February 21                Penn Medicine Alumni Dinner
                                    Palm Beach

February 22               Palm Beach Sessions: Living Better 2016
                                    2:00 PM – 5:00 PM, Norton Museum, Palm Beach

February 22               Palm Beach Dean’s Dinner
                                    6:30 PM, The Breakers, Palm Beach