It's Academic: February 2014


 Johnston Named Inaugural Dean of UT Austin Med School

The Dell Medical School at The University of Texas at Austin named S. Claiborne “Clay” Johnston, MD, its inaugural dean. He says he will lead the school in developing new approaches for teaching, patient care, and research that build on a vision to transform medical education and health care delivery.

Dr. Johnston is associate vice chancellor of research at the University of California, San Francisco (UCSF), and is a practicing neurologist specializing in prevention and treatment of stroke. He will begin March 1 at Dell Medical School, which plans to welcome its first class of students in fall 2016.

“There is no greater opportunity for improving health care than by building a medical school from the ground up at a top institution like UT and in an entrepreneurial city like Austin,” Dr. Johnston said. “With a deeply committed community, it’s remarkable Austin hasn’t had a medical school until now. The opening of Dell Medical School gives the city the chance to approach medical education differently and more effectively than ever before.”

In 2012, the UT System Board of Regents committed $25 million a year and an additional $5 million for the first eight years to establish and operate the medical school at UT Austin. The Seton Healthcare Family committed $295 million to build a teaching hospital that will partner with the school.

The Michael & Susan Dell Foundation pledged $50 million to establish the school. And it became a reality when Travis County voters decided in 2012 to increase the tax rate for Central Health, the countywide health care district, and commit $35 million each year to support the medical school.

Dr. Johnston earned a bachelor’s degree in physics at Amherst College and a medical degree from Harvard University. He earned a PhD in epidemiology at the University of California, Berkeley, and completed residency and fellowship training in neurology and stroke at UCSF.

In his 17 years on the UCSF faculty, he has served as director of stroke services and professor of neurology and epidemiology. He also directs UCSF’s Clinical and Translational Science Institute, where he has helped accelerate research to improve health care and has secured partnerships with biotech companies, foundations, and private funders. 

He founded the Center for Healthcare Value to create new models to support innovation in health care delivery and has launched several new educational programs. Dr. Johnston has published extensively on stroke prevention and treatment and has won multiple national honors for his work.

At UT Austin, he will become a professor of neurology and maintain an active clinical practice.   

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Should Texas Medical Licensing Laws Include Testing Limits?

Both the November and December issues of It’s Academic invited readers to take an informal poll on whether TMA should support limits on passage attempts for national tests such as the United States Medical Licensing Examination (USMLE). Texas law sets the limit at three attempts per test and at seven years for completion of the testing series, with some exceptions. 

Bills routinely surface each session to increase or even completely waive these limits to accommodate an individual physician’s testing record. TMA’s Council on Medical Education has been considering whether to draft new TMA policy on testing limits. About 1.3 percent of newsletter subscribers participated in the poll. 

Results From Informal Poll on Testing Limits, to Date (49 responses)

The overwhelming majority expressed support for limits: 

  • 69% favored limits on testing passage attempts. 
  • 47% supported a passage attempt limit of three per test.
  • 69% favored a time limit for completion of a testing series.
  • 47% supported a limit of seven years for completion of a full testing series (e.g., USMLE). 
  • 78% did not support lower testing requirements if a physician makes a commitment to practice in an underserved community.
  • 58% supported lower testing requirements if a physician has had an unrestricted license in another state and is in good standing for at least five years.  

The Council on Medical Education plans to submit a policy proposal to the TMA House of Delegates at TexMed in May. Watch for more in coming issues of It’s Academic

A related story, “Testing the Limits: TMA Evaluates New Policy on Medical Licensing Tests,” in the February 2014 issue of Texas Medicine, touches on various aspects of medical education and residency training in addition to state medical licensing laws. Texas medical schools and residency programs have specific testing requirements for their medical students, residency program candidates, and residents. 

Most Texas medical schools won’t promote students from the second to third year of medical school if they have not passed Step 1 of the USMLE, and won’t graduate them until they pass Step 2, Christian T. Cable, MD, explains in the story. And, most graduate medical education programs won’t advance residents to a higher level of residency needed for board certification until they pass Step 3. 

Dr. Cable is a member of TMA's Council on Medical Education and director of the hematology/oncology fellowship at Baylor Scott & White Health. 

The story notes that changing medical license testing limits without taking into consideration the medical school graduate’s potential ability to enter residency training could create a gap between state rules and medical school policies. Such a gap could harm a candidate’s potential for being admitted into a residency program. 

The story includes the perspective of a San Antonio physician who graduated from a medical school outside the United States. The physician drew attention to the possibility that international medical graduates may have more difficulty in gaining admission to a residency program. Those who are delayed a year or more in entering residency training could reasonably be expected to have greater difficulty in completing a full testing series within a seven-year limit, the story states.  

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Know a Resident Physician With Big Loans? Federal Loan Repayment Is Available

The National Health Service Corps (NHSC) is accepting applications from primary care physicians through March 20 for loan repayment awards for 2014. Tax-free loan repayment awards are available for licensed primary care physicians (family medicine, general internal medicine, general pediatrics, general psychiatry, obstetrics-gynecology, and geriatrics) in exchange for two years of service in a health professional shortage area (HPSA). 

Loans of up to $50,000 are available for two-year, full-time commitments and up to $25,000 is available for two-year, part-time commitments. Repayment amounts vary and correlate to the HPSA score for the service location. 

Last year, NHSC gave 4,505 awards, totaling $169.7 million for all eligible practitioners, including physicians. Encourage residents with high levels of debt to visit the NHSC Loan Repayment Program website to learn more about the program, determine eligibility, and download an application.

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Survey Says Residents Concerned About Time With Patients

Residents worry about reduced “face-time” with patients, according to The American Resident Survey by The American Resident Project. More than 80 percent say care coordination will help them better manage chronic diseases by allowing more time with patients. 

About the same percentage of residents who work in team-based care settings say medical school prepared them well for working in this environment. A majority report their ability to engage patients in their own care is more challenging than they anticipated. 

The survey asked residents from across the country about issues ranging from public policy to patient engagement and included questions on the most pressing concerns and important trends they face as they begin a career in medicine. 

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New Debt Management Help for Medical Students and Residents

The Association of American Medical Colleges (AAMC) published a new guide on managing medical education-related debt titled Education Debt Manager for Graduating Medical School Students. The guide is offered as part of the Financial Information, Resources, Services, and Tools (FIRST) program to help students and residents navigate the complexities of financial aid, student debt, and money management.

According to the AAMC, 85 percent of the 2013 graduating class of U.S. medical students reported they were leaving medical school with student loan debt, with an average debt load of $172,000. 

FIRST’s guide provides step-by-step, easy-to-understand strategies for managing student loan debt and repayment. The resource features detailed information on types of loans, how and when to pay them off, tax credits for loans, financial literacy, budgeting, and credit scores. Spread the word about this new resource with your medical students and residents. 

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Cigarroa to Step Down as UT System Chancellor

The University of Texas (UT) System Chancellor Francisco Cigarroa, MD, a member of a great South Texas physician family, will resign his post to return to the clinical practice of medicine.The Texas Tribune says Dr. Cigarroa will become head of pediatric transplant surgery at The UT Health Science Center at San Antonio once his successor is named.

Dr. Cigarroa is a longtime TMA member. “My father continues to practice medicine daily at age 89, and three of my brothers are physicians,” the Tribune quoted him as saying in an email to UT administrators. “It is time to honor what my parents did for me by returning to my father’s and my first love, the practice of medicine.”

Gov. Rick Perry released the following statement on Chancellor Cigarroa’s stepping down: "Francisco Cigarroa has been a strong proponent for the university system throughout his tenure, and his efforts will pay dividends for our state for many years to come. It says a lot about him that his departure is tied to his love of his important work saving lives as a pediatric transplant surgeon. I thank him for his service to the people of Texas and wish him well in the future."

UT officials say they expect it will take them up to six months to hire a new chancellor.

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Foster Medical School Names Representative to TMA Academic Subcommittee

Kathryn V. Horn, MD, joined the TMA Subcommittee for Academic Physicians in January as the representative from the Foster Medical School at Texas Tech University Health Sciences Center in El Paso. Dr. Horn, a family physician, serves as associate dean for student affairs at Foster. 

She received her medical degree from Baylor College of Medicine in Houston and completed her family medicine residency training at the Texas Tech regional academic health center in El Paso. 

The subcommittee includes representatives from each of the state’s 11 health-related institutions. This group focuses on:   

  • Representing the unique concerns and interests of academic physicians; 
  • Informing the Council on Medical Education, TMA members, and policymakers on policy issues of importance to physicians in academic medicine; and 
  • Exploring and implementing activities, programs, and services to allow TMA to better serve the needs and interests of academic physicians.   

In addition to Dr. Horn, the members of the Subcommittee for Academic Physicians include:

Lisa R. Nash, DO, Chair
University of North Texas Health Science Center, Fort Worth

Syed S. Azhar, MD
The University of Texas Medical Branch, Galveston 

Carlos Hamilton Jr., MD
The University of Texas Health Science Center at Houston

William J. Krippner Jr., MD
The University of Texas Southwestern Medical Center, Dallas

Jeffrey L. Levin, MD
The University of Texas Health Science Center at Tyler

Kaparaboyna Ashok Kumar, MD
The University of Texas Health Science Center at San Antonio

Curtis R. Mirkes, DO
Texas A&M Health Science Center/Scott & White Healthcare, Temple

Carlos Vallbona, MD
Baylor College of Medicine, Houston

Surendra Varma, MD
Texas Tech University Health Sciences Center, Lubbock

Ronald S. Walters, MD
The University of Texas MD Anderson Cancer Center, Houston

Visit the Subcommittee for Academic Physicians page on the TMA website to learn more about the group's activities, to access reference materials, and to find contact information for subcommittee members. 

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TexMed 2014 Registration Open

Register today for TMA's free annual conference, and join thousands of fellow Texas physicians, as TexMed 2014 descends on Fort Worth May 2-3 for a weekend of continuing medical education (CME) events, networking, policymaking, and all-around fun. 

TexMed is TMA's largest event of the year, offering more than 80 hours of available CME, an extensive gathering of exhibitors to help with every aspect of your practice, and, of course, this year's keynote speaker, Zubin Damania, MD ― perhaps better known for his alter ego and street persona, ZDogg, MD.

Practicing medicine today involves a dizzying array of regulations, standards, electronic health records, and payment plans that interfere with physicians' ability to develop a positive, productive medical culture. In his TexMed General Session presentation, Redefining the Culture of Medicine, Dr. Damania will delve into the ethical challenges of delivering excellent care in our dysfunctional health care system and will propose ways to revitalize it. 

In his new clinic, Dr. Damania seeks to break down the barriers, bringing together physicians and frontline health care professionals to mend the system and put autonomy back into health care.

Be sure to connect with Dr. Damania before attending TexMed 2014. And check out ZDogg's personal invitation for you to go to Fort Worth.

For a full schedule of events, CME, exhibitors, lodging information, and fun things to do in and around Fort Worth, visit the TexMed 2014 webpage, and be sure to register today to reserve your spot so that you can enjoy this free benefit of your TMA membership. 

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 Join or Renew TMA Today: We Could Use Your Help!

TMA has been a longtime advocate for academic faculty and medical schools — monitoring legislation, determining the potential impact on patients, and lobbying for your interests.

The results of the last legislative session were outstanding for academic medicine. Our efforts in the session, including public testimony provided by TMA leaders at every applicable legislative committee hearing and personal visits with legislative members and staff, paid off. For example, lawmakers restored graduate medical education formula funding, which took a 31-percent hit in 2011, with a 15-percent ($8.8 million) increase this budget cycle. 

Lawmakers also restored the Family Medicine Residency and State Physician Loan Repayment programs, which faced elimination in the past budget. Undergraduate medical education also received a 7-percent boost in per-student funding. TMA helped stop off-shore medical schools from buying up clerkship spots in Texas hospitals and repealed a 2011 law that forced international medical graduates to spend three years working in only medically underserved areas.  

TMA is extremely successful in Texas for one reason only. TMA speaks with one strong, firm, and consistent voice, the voice of its members. Only with grassroots support — only with your support — can we continue to be successful. 

Join or renew today and see what a difference TMA membership can make. Within your department and/or academic institution, funds may be available to cover the cost of your membership. Please check with your department administrator or chair. 

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New-to-Texas Physicians Can Start Here

Are you a new Texas physician? Have you recruited a physician for your school, your practice, or your community from out of state?

TMA’s Welcome To Texas webpage can help new or returning Texans get their practices up and running. The page provides links that doctors need to obtain a Texas license; contact information for relevant state and federal agencies; and links to resources such as practice consulting for setups, health insurance plan contacts, and employee salary data.

TMA members can email the TMA Knowledge Center or call (800) 880-7955 for fast answers to questions about membership, TMA member benefits and services, practice management or legal information, and more.

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This Month in Texas Medicine

The February issue of Texas Medicine explains how physician practices are staying financially viable, why the TMA Council on Education is considering new policy on medical licensing exams, how legislators responded to the 2013 Texas Health Perception Survey, and the progress being made by health information exchanges in the state. By reading an article on meaningful use and quality improvement and then completing a post-test and evaluation, you may earn continuing medical education credit. Check out our digital edition.

Also, you can subscribe to RSS feeds for TMA Practice E-Tips, TMA news releases, Blogged Arteries, and Texas MedicineMore

It's Academic is for physicians in academic settings. For more information about TMA’s efforts on behalf of medical education and academic physicians, visit the TMA Council on Medical Education’s Subcommittee for Academic Physicians page on the TMA website.

Please share with your colleagues who are not TMA members and ask them to join.

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