International Family Medicine Fellowship

Slide 1: International Family Medicine Fellowship

Slide 2: THE NEED Women’s Health  OB/GYN  Perinatal Care  Surgery/Ortho  Wound/Burn Care  Infectious Disease  Prevention  Management  Ophthalmologic Care 

Slide 3: Women’s Health Estimated 529,000 women  died in 2000 from pregnancy and childbirth, 99% was in developing countries Top 5 causes of maternal  mortality: Illegal abortion  HTN disease  Obstructed labor  Hemorrhage  Sepsis 

Slide 4: Perinatal Morbidity/Mortality 4 million babies die each  year in the first 4 weeks of life, 99% in developing countries 4 major causes of death  Low birth weight  Prematurity  Tetanus  Infection (HIV) 

Slide 5: Trauma/Burns 45% of third world  morbidity and mortality under the age of 20 are secondary to trauma or burns 60% of the burns in third  world nations affect children under 5 years of age

Slide 6: Blindness 52 million people in this  world are blind or severely visually impaired. 90% of these people live  in developing countries. 20 million people around  the world are blind from cataracts and corneal disease

Slide 7: What is the IFMF? A fourth year of training, directed toward  international medicine skills, after completing a family medicine residency  Provide additional surgical, diagnostic, tropical medicine, and community health training needed in developing nations  First fellowship for Family Medicine in International Medicine!

Slide 8: Why are we creating the IFMF? Our residency draws medical graduates from many different geographic  locations who desire a “full scope” of Family Medicine and are passionate about doing so in an underserved, international setting. Medical students and residents from all over the country have expressed an  interest for this type of training. Physicians currently have few means by which to develop a comfort level in  treating the medical and surgical conditions specific to a third-world setting. High demand/need for physicians willing to do part time or full time  international mission. Those who chose to do so often find international medicine overwhelming due to lack of training.

Slide 9: What are our long term goals? Provide physicians with appropriate skill sets for  practicing and teaching in the developing world. Networking of like minded people across the  world. Help establish a team approach, as a practice  model for short term missions with a stateside practice.

Slide 10: Why Via Christi? Fulfillment of Via Christi Mission statement  “Community, Competence, Service, Human Dignity, Vision” Supportive, Dynamic environment with a large  population of internationally-minded physicians A completely unique primary care fellowship 

Slide 12: Curriculum 2 Months of Rural Health  4 Months at International Core Hospital  6 Months in Wichita  Core curriculum  Electives 

Slide 13: Core Curriculum In Wichita One month rotations  Trauma   Tropical Medicine/ID  Wound care and burn medicine Two week rotations  Dental   Anesthesia

Slide 14: Trauma Objectives  ATLS  Primary and secondary  survey management Stabilization: A,B,C’s  Procedures: Intubations,  FAST exam, Chest tubes, Line placement Contacts  Via Christi Trauma Team Wesley Trauma

Slide 15: Tropical Medicine Objectives: Focus on the diagnosis, treatment,  and prevention of diseases specific to tropical areas Topics include:  Intestinal/blood protazoa, nematodes, cestodes,  trematodes, tropical viruses/bacteria/fungi, nutritional disorders, environmental stress, epidemiology, travel health, and laboratory diagnosis.

Slide 16: Tropical Medicine Several Short Diploma Courses:  Gorgas Peru 9 weeks January 28 - March 28  West Virgina 8 weeks June 13 - August 4  Jon Hopkins 8 weeks June 26 - August 18  These diploma courses are approved by the American Society of Tropical Medicine and Hygiene. After completing one of these courses you can be approved to sit for the ASTM&H examination.

Slide 17: Wound and Burn Care Objectives:  Wound/burn management  Surgical debridement  Skin Grafts  Contacts:  Dr. Bingaman- general  surgeon with experience in burns Dr. McDonald- wound care at  St. Joseph Taking burn call along with  general surgery residents

Slide 18: Dental Objectives:  Dental Blocks  Tooth Extraction  Management of dental  infections Public Health Issues  Contacts:  Grace Med has two dentist,  they’ve agreed to teach 2-4 week course

Slide 19: Anesthesia Objectives  Epidural and spinal  blocks Intubation  Lines  Sedation Medication  Contacts: Via Christi 

Slide 20: Electives Ophthalmology  Radiology  Infectious Disease  OB/GYN  OMM and musculoskeletal pain management  Plastic Surgery 

Slide 21: Ophthalmology Objectives:  Infectious disease  Foreign body removal  Cataract surgery  Management of  emergencies

Slide 22: Radiology/Ultrasound Objectives:  Includes instruction in ultrasound technique as well as interpretation  Renal, liver, cardiac, and other organ evaluation  FAST exam  Contacts Dr. Kadison and Dr. Short (to teach interpretation)  Radiology tech (to teach technique), Cathy with Newman University  Echo (cardiologist to teach interpretation)  Echo tech: Mike with Kansas Cardiac Clinic (to teach technique) 

Slide 23: Infectious Disease Objectives:  Develop sound principles of diagnosis and  management of infectious disease  Hone the selection and usage of appropriate therapeutic agents  Recognize and treat opportunistic infections in immunocompromised patients  Develop strategies to prevent the further transmission of disease

Slide 24: OB/GYN Surgery Objectives:  TAH/BSO  Obstetric Experience  Cesarean Section  D&C  Other GYN related surgeries applicable to the mission field Contacts: Dr. Brown,

Slide 25: Plastic Surgery Rotation Objectives:  Wound management  Trauma management  Skin flaps  Skin grafts  Contacts:  Dr. Wheeler, Dr.  Peterson Via Christi/Wesley-  Plastic Surgery Call

Slide 26: OMM Objectives 

Slide 27: Longitudinal Learning Travel Clinic  Perspectives in Missions  Plastic Surgery  Tropical Medicine  Public Health Certificate Course  Junior Faculty Teaching Position 

Slide 28: Junior Faculty Each Fellow would share a junior faculty  positions at Via Christi Appropriate salary for the position  Would take call in place of existing faculty  Increases teaching ability for the fellows as well  as increased learning for existing residents

Slide 29: Travel Medicine Consultation provided to US citizens that will be  traveling internationally Pre Travel Risk Assessment  Available and appropriate vaccines/prophylaxis  In-Travel Prevention  Medical Care abroad  Special Needs travelers  Post Travel Management of disease  Our fellows will staff a clinic once or twice a month  longitudinally

Slide 31: Budget considerations (6 fellows) Director: $180,000 for director.  Dr. Todd Stephens approved for this position by Via Christi  Fellows: $60,000 X 6  Travel: $5,000 X 6  Malpractice approx. 15,000 X 6  Tail Coverage Insurance- ?  Total: $480,000 annually (not including director salary) 

Slide 32: Sustainability By staffing a hospital in rural Kansas, we will  defray costs by the equivalent of 1 physician salary annually Potential for moonlighting within Via Christi in  the proposed evening clinic. A goal of an endowment fund to sustain such  this endeavor.

Slide 33: Development-Where are we now? Curricular development  Contacting specific potential educators. (i.e. form letter  approach) Funding strategies  Raising awareness of the program among students,  residents, and faculty on the national level. Striving for excellent curricular quality, infrastructure,  educational framework, quality metrics, and incorporation of research.

Slide 34: Involved Residents Jared Cardwell M.D.  Paul McQuillen D.O.  Shea Epperly M.D.  Jack Kline M.D.  April McQuillen D.O.  Rick Moberly M.D.  John Epperly M.D.  Kevin Raymer M.D. 

Slide 35: How can you be involved? Please offer any guidance or advice that you  may have. Do you or other physicians you know want to  teach medical skills? Help to fund this exciting endeavor. 

Slide 36: Thank-you for being part of the first international family medicine fellowship! Any questions?