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ASPECTS Southern Illinois University School of Medicine | Winter 2019 | 42-3

50 Years of Learning and Leading

Education Innovations

In his book “Reinventing American Healthcare,” health policy analyst Ezekiel Emanuel states, “For the last 100 years, medical education has been largely unchanged... Medical education is probably the slowest-evolving institution in society. This will need to change.”

The 50-year evolution of Southern Illinois University School of Medicine defies expectations. Almost from the beginning, we distinguished ourselves with an innovative curriculum and ability to set medical education trends rather than follow them. We encourage continuous learning with innovative spaces and tech tools that lead the way in medical education. We are proud of the achievements that brought us here, but eager to push for progress that benefits the learner of the future.

This issue of Aspects inaugurates our 50-year anniversary as a medical school. Join us as we explore some of the creative ways SIU is using technology and innovation to prepare our students for medical care in the digital age.

IN THIS ISSUE

Campus News

AWIMS Honors Basnet

Aspects of a Learner | Matt Mannion

A Cut Above

Innovative Spaces

Alums@50

Alumni News

The Top 5

Class Notes and Alumni News

As we approach the 50th anniversary of the school and the 42nd anniversary of Aspects, we will find ourselves both nostalgic for the ways things have been and excited by innovations on the horizon at SIU School of Medicine. Through Aspects, we intend to celebrate both the old and the new.

Over the years, Aspects has been a showcase of our school’s educational programs, clinical activities, progressive research and our commitment to serve communities. We also publicize the achievements of faculty, the successes of our alumni and activities of our medical students. As we move forward in our 50th year as a school, we will continue to document our progress while reaching new generations of alumni and friends who read online and consume content digitally.

Beginning in spring 2020, Aspects will be featured primarily as a digital publication with print distribution only to alumni and friends who request a mailed copy. We know that some of you will always cherish the print version delivered to your homes. We also recognize that going digital offers new, cost-effective ways to tell stories about the news and innovations that happen at SIU School of Medicine every day.

Our approach to digitization is not designed to reduce content, impact or the quality of this publication. Instead our convenient, mobile-friendly format will continue to provide you with updates and features from SIU School of Medicine. You can expect the same quality content you have come to rely on while being introduced to new photo galleries, social content, videos and engaging interviews.

We have come a long way since the first issue of Aspects was distributed in the spring of 1977. Since then, each issue has been distributed free of charge to alumni, faculty and friends, bringing the news to more than 10,000 individuals across the country. We want to take some time to celebrate the success of this publication while embracing the changing digital landscape and trends in readership. Whether you choose to continue to receive a printed copy or you engage with us online, we hope that you will continue to move forward with Aspects.

Bohn Nielsen Lobby Brightens 801 Building

Dean Jerry Kruse and Drs. Kathryn Bohn, Thomas Nielsen and Beth Nielsen

SIU School of Medicine held an official dedication of the newly renovated space at 801 North Rutledge on Sept. 27. A gathering of faculty, colleagues and friends celebrated the completion of a 6-month construction project in the space commonly referred to as the Dean’s Lobby. Thanks to a generous contribution from guests of honor Drs. Kathryn Bohn and Thomas Nielsen, the new Bohn Nielsen Lobby now serves as an impressive entrance and gathering spot within the oldest building on our Springfield campus.

Drs. Bohn and Nielsen are proud SOM alumni — Classes of ’83 and ’81 respectively — and of its family medicine residency programs. They have a long history of commitment and giving to the school, with investments in the library, the Dean’s Initiative and a student scholarship fund to help future physicians from small towns in western or northern Illinois.

In addition to the new lobby, their legacy also includes a daughter, Dr. Beth Nielsen, who completed her internal medicine residency at SIU in 2019 and has started a pulmonary medicine critical care fellowship.

“We’re very proud of Beth and we’re grateful to SIU School of Medicine for the education that she is getting here, for the medical degrees that Tom and I received, and for helping us achieve the life that we have,” said Dr. Bohn. “We are very honored and pleased to give back to the institution that gave us so much.”

NEW YORK --> NEW BERLIN

Cancer survivors, local businesses advocate for breast reconstruction awareness in fashion show

SIU Medicine brought the New York City catwalk to the cornfields of New Berlin.

The Institute for Plastic Surgery at SIU Medicine teamed up with area businesses to educate women about their breast reconstruction options in a unique event. On Sept. 28, Danenberger Family Vineyards hosted “Angels Among Us,” a fashion show featuring local cancer survivors, with the help of AnaOno, an international intimates clothing line for women who have or are undergoing breast cancer treatment, and Eye Candy, a boutique, salon and spa located in Springfield.

The event was modeled after AnaOno designer Dana Donofree’s New York Fashion Week runway shows. Since 2017, Donofree’s shows have raised more than $250,000 for metastatic breast cancer research. In February 2019, Danenberger Family Vineyards winemaker Susan Danenberger was one of 24 models, all of whom are living with or in remission from stage IV, metastatic breast cancer, to walk the New York Fashion Show runway.

The fashion show is part of the Plastic Surgery Foundation’s seventh annual Breast Reconstruction Awareness (BRA) Day, which aims to raise awareness and educate women about their post-mastectomy breast cancer care options.

“BRA Day inspires women to know that life beyond breast cancer can be very fulfilling,” said Nicole Sommer, MD, a plastic surgeon at SIU Medicine who specializes in breast reconstruction. “Many women aren’t told and don’t know that breast reconstruction is an option, or that insurance must cover at least part of the cost.”

Breast reconstruction surgery after breast cancer is considered a reconstructive procedure and should be covered by health insurance, regardless of when a woman chooses to undergo reconstructive surgery.

“Together, we must spread the word to breast cancer patients about their breast reconstruction options,” said Danenberger, who underwent a double mastectomy after being diagnosed with metastatic breast cancer in 2016. “Informing women of their reconstruction options before or at the time of diagnosis is critically important to improving life after breast cancer.”

BRA Day is a collaboration between the American Society of Plastic Surgeons, the Plastic Surgery Foundation, breast centers, nurse navigators, corporate partners and breast cancer support groups.

WISH GRANTED

Springfield boy meets bone marrow donor from Germany

On Aug. 19, a young patient and his family met a bone marrow donor in the newly renovated Bohn Nielsen Lobby at SIU Medicine for a “good news” press event. The meeting between 7-yearold Gabriel Smith of Springfield and Dennis Gutt, a native of Kappeln, Germany, spotlighted the work of the Be The Match program, which encourages registration for bone marrow donations, and the Make-A-Wish Foundation, which brought the two together across the miles, granting Gabriel’s wish to meet the man who helped save his life.

Gabriel was born with aplastic anemia, a rare blood disease that kept his body from producing enough new blood cells. Dr. Gregory Brandt, chief of pediatric hematology/oncology at SIU Medicine, recommended a transfer to the Children’s Hospital in St. Louis to treat the illness. Gabriel was able to undergo a bone marrow transfusion when he matched with Dennis. The young boy is now healthy and leading a normal life in Springfield. Following the press event, the family led Dennis on a tour of central Illinois, St. Louis and Chicago as a way to thank him for his generosity.

LINCOLN SCHOLARS PROGRAM

Training the Next Generation of Rural Physicians

In 2018, the SIU School of Medicine, in collaboration with the SIU Paul Simon Public Policy Institute, the Illinois Department of Public Health, and others, issued a report, The State of Rural Health in Illinois: Great Challenges and a Path Forward. In it, the authors noted both the higher prevalence of illness in rural Illinois and the region’s lack of health care resources. Articles in publications like Academic Medicine, Medical Teacher, and the Bulletin of the World Health Organization have lamented health care challenges facing rural areas and have proposed solutions for improving rural health outcomes. In keeping with its mission, the SIU School of Medicine is attempting to counteract these disparities through new educational programming and outreach.

The SIU School of Medicine is launching the Lincoln Scholars Program (LSP), a new Doctor of Medicine track, in the summer of 2020. Its purpose is to train the next generation of generalist, rural physicians. Currently, medical students attend one year in Carbondale, and the rest of the curriculum takes place in Springfield. This program – based entirely in Carbondale, with clinical placements in neighboring rural communities – allows LSP students to learn alongside an interdisciplinary team of medical professionals.

The curriculum is innovative, accelerated and emphasizes continuous clinical experience beginning in the first few weeks of the first year. “The students learn to work on a medical team from day one,” said James Daniels, MD, Professor of Family and Community Medicine and one of the chief architects of the Lincoln Scholars Program. “The students also work with a rural physician throughout their entire training. This allows a longitudinal experience that is difficult to obtain in medicine today.”

The LSP’s collaborative and interdisciplinary approach to medical education is unlike anything SIU School of Medicine has ever attempted. Lincoln Scholars will spend their first year learning and training alongside physician assistant students in Carbondale’s new SIU Medicine building that opened in 2019. According to Dean and Provost Jerry Kruse, MD, “this is the biggest step we’ve taken in interprofessional education with our PA program.”

In addition, the LSP leadership team has conducted preliminary conversations about how to initiate future partnerships with students and programs across the SIU System, including social work, psychology, pharmacy and law.

Research has demonstrated a link between physicians’ connection to rural areas and their subsequent practice of rural medicine. For that reason, LSP students will be strategically chosen both for their academic potential and for their experience in, and dedication to, rural Illinois. “Not all LSP graduates will stay in the region, but data tells us a higher percentage of them will,” Kruse said. Connectedness to rural Illinois is central to the mission of the Lincoln Scholars Program. For Dr. Daniels, this benefits both patients and our physicians-in-training.

“Students will start to form, not only close bonds between themselves and their patients, but also with the communities where they work. This, in many people’s view, is the most rewarding part of practicing medicine.”

To equip students with the skills they need to become good members and leaders in rural communities, the Lincoln Scholars Program will sponsor retreats focusing on self-care, group dynamics and community involvement. “We want the program to produce quality physicians, yes, but also better people,” Daniels said.

Students in the inaugural class of the Lincoln Scholars Program will be selected in spring 2020.

LEARNING AND LEADING

A Message from the Dean

In 1968, the Illinois Board of Higher Education, noting the critical shortage of physicians in central and southern Illinois, called for the creation of a new medical school in that part of the state. By 1970, the SIU School of Medicine was a reality.

The first dean, Richard H. Moy, MD, dubbed the new school “The Springfield Experiment.” Dr. Moy’s vision for the school was evident. Innovative, nontraditional educational methods would be used to improve medical education. SIU laid twin foundations – one of social accountability for the medical needs of central and southern Illinois; and a second for educational excellence and curricular innovation.

Compared to traditional medical schools, SIU education placed greater emphasis on critical thinking and clinical problem solving than on memorization. SIU integrated basic and clinical sciences using a variety of hands-on learning methods, with a more rigorous process of assessment. SIU students spent far less time in lectures, and more time with physical models, earlier interactions with patients, and training designed to make students more empathetic, compassionate and humanistic physicians. Students learned to be true professionals.

In the early 1980s, Howard Barrows, MD, implemented the first complete problem-based learning curriculum in the U.S. at SIU School of Medicine. SIU became the first medical school to have a clinical competency examination with standardized patients as a graduation requirement. This exam became the model for a part of the current medical licensure examination (USMLE CS). The school’s early experiments in problem-based learning, surgical skills simulation and clinical competency examinations eventually became the standard for most U.S. medical schools.

Innovative curricula in vascular, plastic and general surgery quickly developed. A symbiotic relationship between the Departments of Medical Education and Surgery flourished, and gave the school international notoriety in surgical education.

The school focused on the particular need for more primary care physicians. The first department at the school, the Department of Family Practice, developed strong relationships with family physicians in the region. SIU students in the family medicine clerkship lived and breathed a real-life practice in a community setting for six weeks. This was the school’s “field of dreams” – “If you train them, they will stay.”

The school demonstrated a commitment to equity with the MEDPREP program, beginning in 1972. This two-year, post-baccalaureate program now has more than 1,400 graduates, many from underrepresented groups. The program has helped students become successful candidates for medical and dental school. MEDPREP and other SIU pipeline programs provide medical schools across the nation with a more diverse pool of highly-qualified applicants.

SIU’s Department of Medical Education, curriculum committee and Educational Policy Council, assure the school stays on the cutting edge of medical education. Their joint motto is, “If it ain’t broke, make it better.” The educational leaders focus on shedding outdated methods to have a sharper focus on effective, necessary innovations. In recent years, a new program in clinical decision-making (the Critical Clinical Competencies) and a Year 3 Clerkship model have received international attention. The school is on the leading edge of programmatic assessment, a philosophy that moves us from “assessment of learning” to “assessment for learning.”

Since 1975, nearly 6,000 physicians have completed medical school, residency training or fellowship training at SIU. These providers serve the region and the rest of the world, practicing in every medical specialty, and developing innovative programs that improve health, health care and health care education. One needs only to examine the list of distinguished alumni to appreciate the impact of SIU School of Medicine.

The word has spread. SIU is one of only two medical schools in the world to have received as many as five Aspire to Excellence Awards from the Association of Medical Education of Europe. These awards are for Student Assessment, Student Engagement in the Curriculum, Social Accountability, Medical Simulation and Curriculum Innovation and Excellence. Another indicator of excellence comes from the Liaison Committee on Medical Education, who gave SIU full accreditations in 2007 and 2015 with no citations. SIU is the only medical school to ever have received two consecutive full accreditations with no citations.

These things make us smile. We are proud of our graduates and our school. We are proud of our faculty, staff and learners. We will keep up the good work.

Jerry Kruse, MD, MSPH Dean and Provost, Southern Illinois University School of Medicine CEO, SIU Medicine

AWIMS HONORS BASNET

Mother, Mentor & Medical Leader

Sangita Basnet, MD, is a physician, a fighter, and a champion for those in need, both here and abroad. As professor and chief of pediatric critical care at SIU School of Medicine and medical director of the Pediatric Intensive Care Unit at St. John’s Children’s Hospital in Springfield, she was recently honored with the inaugural AWIMS Award for Outstanding Contributions to the Advancement of Women in Medicine and Science.

Dr. Basnet exemplifies the core tenets of the Alliance for Women in Medicine and Science: promoting positive change toward gender equity, encouraging professional development and career advancement for women, supporting efforts to improve work-life integration within the medical community and a commitment to community service.

Her nominators described her as a guiding light, always compassionate and kind, but willing to push others beyond a personal comfort zone while reiterating “the sky’s the limit for whatever you want to do.”

We wanted Dr. Basnet to answer some questions, and she graciously agreed.

AS A MOTHER OF TWO, WIFE, CRITICAL CARE PEDIATRICIAN, MENTOR AND INTERNATIONAL MEDICAL AND POLICY ADVOCATE, HOW DO YOU FIND BALANCE BETWEEN PERSONAL LIFE AND CAREER? WHAT ADVICE DO YOU HAVE FOR OTHER WOMEN?

My advice to women is strive to achieve what you think you will love doing for the rest of your life. It may mean a few initial years of hard work and difficulties. But those few years will pass. Develop a support system around you. If you are happy, then those you love will be happy. Be true to yourself and what you care for – be it work, children, hobbies, global health, volunteering, anything. You should not have to choose family over work, or vice versa.

Support from loved ones is always important. My husband supports me unconditionally in all my endeavors. My children have always loved what I have done, encourage me all the time, and are very proud of me.

I have never put my family and my children second. I always believed work can wait – family cannot.

As a division chief I expect the best performance from my division members, but there is a lot of flexibility where calls and service days are concerned. We help each other all the time. I do not want anyone, male or female, to miss, for example, a “parent’s day” in school or any other activity where their child needs them. Their families are very important.

“Teachers are lifetime learners.”

TELL ME ABOUT YOUR PATH TO BECOMING A CRITICAL CARE PEDIATRICIAN.

I always wanted to be a doctor. After med school in Nepal, I followed my husband, Janak Koirala, to the U.S. for better opportunities at training. I was offered a residency in anesthesiology in Chicago and was asked to sign the day I went for the interview. As an international graduate, with very limited choices, it was difficult to walk away. But it gave me the courage to go to Cook County Children’s Hospital in Chicago and ask the pediatric program director if he thought he could offer me a residency in pediatrics. He immediately offered me a residency position. In those days offering pre-match positions was acceptable.

Here is a lesson I teach my residents and my children: Do not be afraid to ask. What is the worst that can happen? That you will get a “no” for an answer? But you can also get a “yes.” You will not know unless you ask.

TELL ME ABOUT YOUR FAMILY.

Whatever I have achieved in life is due, in large part, to my father. I grew up in Nepal, which used to be an extremely male-dominated, patriarchal society (still is, but at a smaller scale). However, I actually never felt at a disadvantage. My father never differentiated between my brothers and me. I was pressured to do well in the most elite school for girls in Nepal. I rode bicycles and motorbikes, and even drove a tractor at our farm. I climbed trees and played marbles with my brothers. Many girls were told to work in the house, learn to cook, wash clothes and prepare to get married early in their lives. My time was spent on reading books and performing traditional dances at various venues. This was all because my father allowed it. My father never entertained the several suitors and proposals for marriage that match-makers brought to our house. He would proudly say to everyone “My daughter is going to be a doctor.”

My husband and I have two children. My son just completed his master’s in public health and started his own consultancy firm doing data analysis and impact evaluations, and also works in finance and trading. My daughter is a junior in college. She is an athlete and interested in pursuing medicine and global development.

All four of us visit my home country Nepal at least once a year. My children love my home country as much as we do. They have been exposed early in life to disparities in health, disease, living conditions, education and socioeconomic status.

Looking back, it was very difficult when we first came to the U.S., with a 2-yearold child, no support system and complete cultural shock. But my husband always had a positive attitude towards life, always optimistic.

YOU’VE ALREADY ACCOMPLISHED SO MUCH SINCE JOINING SIU MEDICINE IN 2006 – TWO-TIME RECIPIENT OF THE TEACHER OF THE YEAR AWARD IN THE DEPT. OF PEDIATRICS, DIRECTOR OF THE PEDIATRIC FUNDAMENTAL CRITICAL CARE SUPPORT COURSE, PAST PRESIDENT OF THE AMERICAN NEPAL MEDICAL FOUNDATION WHO ALSO DEVELOPED THE FIRST PEDIATRIC CRITICAL CARE UNIT IN NEPAL, AND SO MUCH MORE. WHAT’S NEXT ON YOUR BUCKET LIST?

I want to serve in my home country and be with my parents. Janak and I are returning to Nepal early next year to establish fellowship training programs in our respective subspecialties. I will return to the U.S. to work 16 weeks per year on a part-time basis. We have always dreamt of returning to Nepal to share what we learned here in the U.S. Our decision is a culmination of the 26 years of effort we put toward the preparation for our ultimate return.

We also want to be with my parents now. They are very advanced in age and need us. Our children are grown and no longer need us to the extent they did when growing up. First generation immigrants like us are, what I call “the sandwiched generation.” Our children are here and our work is here. But our parents and family are there. This is always a conflict that gnaws at us. Janak and I are fortunate that we can go back to Nepal whenever our parents need us.

YOUR NOMINATORS MENTIONED YOUR PASSION FOR DANCE. WHAT KIND OF DANCE IS YOUR FORTE, AND HOW DOES DANCE FIT INTO YOUR DAILY LIFE?

My forte is Nepali Folk and semi-classical Indian. I perform at various venues- variety shows, charity shows. I choreograph my dances myself. I practice in my basement for 30 minutes to an hour about 3 times a week, particularly around the time of performances.

WHAT LED YOU TO CHOOSE ACADEMIC MEDICINE?

Growing up, there were three paths I wanted to pursue - dance, teaching and medicine. I am very fortunate that I am able to do all three.

My love of teaching emerges from my desire to impart what I love to learners, and visualize the delight on their expressions when they understand basic concepts of a theory or disease process. It is a very rewarding feeling. And as we teach, we learn. Teachers are lifetime learners. Medicine is rapidly evolving. We get to refresh our knowledge when we are tasked with teaching.

ASPECTS OF A LEARNER

Matt Mannion

Preparing tomorrow’s physicians has been the central focus of SIU School of Medicine since its founding in 1970. Our progressive educational philosophy has helped to distinguish us from the other U.S. medical schools that also began in that era, and it is one of the features that continues to attract learners and academic leaders to the institution.

As SIU School of Medicine turns 50 in 2020, it is becoming more common to have second-generation students come through the system and train in some of the same spaces that their parent did. In this expanded ‘Aspects of a Learner’ profile, we spotlight a central Illinois family that has produced one teacher and three students following the family tradition of medicine.

Marion Panepinto, MD, was one of the school’s original cardiology instructors. His daughter, Julie, is a professor of pediatrics, hematology, and a clinician scientist from the Class of ’91. Second-year medical student Matt Mannion is Marion’s grandson, and Matt’s younger sister, Aileen, is now enrolled in SIU’s Physician Pipeline Preparatory Program for high school students, the same ‘P4 ’ that Matt attended in its inaugural year

On an overcast autumn afternoon, the group gathered at SIU to reflect on their overlapping histories.

FATHER MARION

“My father was a general practice physician,” said Dr. Marion Panepinto, a retired cardiologist. “I came to Springfield in 1970. I was the city’s third cardiologist. Cardiology wasn’t as developed as it is now, so we saw a lot of general medicine patients as well.”

“As the new medical school was getting established, there was no full-time faculty, so the administration relied on some of us physicians in the community to help educate the learners,” he said. The first students began training in classrooms, clinics and spaces around Springfield in 1972 with doctors who were interested in teaching.

Panepinto initially worked with residents, but later “clerked” third-year students who would spend a month rotating through his office and making hospital rounds as an internal medicine elective. (At the time, medical school could be completed in three years.) He would let them see patients, discuss diagnoses and accompany him to the cath lab—the exam room where diagnostic imaging equipment was used to visualize the physiology of the heart. He’d also let them do some of the easier procedures, often for the first time, under his supervision.

The community physicians received a modest stipend. After SIU had hired full-time faculty, the stipend ended. “So we worked as volunteers, because the money didn’t matter anyway,” said Panepinto. “That wasn’t why we were doing it.”

Panepinto found a considerable benefit to the time spent with students.

“I enjoyed it a great deal. It kept my mind sharp. I had to keep up with everything because the students were quite intelligent and they asked a lot of questions. And they were questions that you’d better know the answers to.”

DAUGHTER JULIE

Julie Panepinto, MD, MSPH, one of Marion’s four daughters, decided to follow in her father’s and grandfather’s footsteps and pursue medicine as a career. She began classes at SIU’s Carbondale campus in 1987. She is now a professor of pediatrics at the Medical College of Wisconsin/Children’s Wisconsin Milwaukee, where she spends a majority of her time in research, investigating therapies for sickle cell disease.

She has fond memories of her time in medical school, the people and curriculum that prepared her for the challenging and rewarding career ahead.

“There was such an early, strong exposure to clinical medicine and good diagnosticians… and the novel, innovative ways they’d work in simulations and interactions with patients,” she said. “Even to this day, I don’t think other medical schools are doing it as well as SIU did it for us way back in the ‘90s.”

Julie believes SIU’s small class size fosters friendships. “You got to know everyone. You were working hard but also enjoying time when we could get away from school. My parents had a boat and eventually a home on Lake Springfield, so we could get out and go skiing and boating and have fun.”

She considers three physicians to be among the most influential in her youth. “Dr. [J. Kevin] Dorsey, when he was still faculty down in Carbondale, really enjoyed teaching. He taught us so much about clinical medicine during our first year,” she said. “Dr. Randy Kienstra was the chair of the pediatrics department when I rotated through. Some of the class could be a little intimidated by him, including myself, but I thought it showed he had high expectations and really cared about the students. I learned a lot from him.”

“And of course, my father. I got to do an ambulatory care rotation with him in my fourth year.”

An interest in hematology/oncology in medical school set Julie on a course for relevant programs and training early in her residency. “I knew I wanted to be in a practice where I could take care of children throughout their lifespans, but focus on the chronic disease care, too. Kids are happy and resilient, even when dealing with chronic disorders. They still bring a fair amount of joy despite the hardships they face. I was drawn to that.”

Panepinto completed her pediatric residency in Madison, Wisconsin, and fellowship training in hematology/oncology/ bone marrow transplant in Denver at the Children’s Hospital of Colorado. She then worked for three years at Brown University/Hasboro Children’s Hospital in Rhode Island where her husband did his fellowship training before returning to Wisconsin and joining the faculty at the Medical College of Wisconsin.

“I always knew I wanted to see patients and practice clinically. I had no idea I was going to become a researcher, but it’s really become a primary part of my job,” says Panepinto. “You don’t see a lot of that in medical school or understand what it might involve for your career. I’ve been fortunate to be able to support my lab through new projects over the years.”

“Kids with sickle cell disease are diagnosed right after birth, so you’re following them until they become a young adult and graduate into adult medicine. Since it is a genetic disease, you are also taking care of siblings in the family. It’s a population that has typically not had the benefit of a lot of advanced medicine,” she said. “Being able to advocate for them has been one of the most fulfilling things of my life.”

Dr. Marion Panepinto, Dr. Julie Panepinto, Matt and Aileen Mannion

GRANDSON MATT

Matt Mannion has some clinical experience in common with his Aunt Julie. He worked in a biochemistry research lab at Ohio’s Miami University, with a professor who emphasized the work’s importance “from bench to bedside.” He followed his undergraduate education with a year as a clinical research coordinator at the University of Cincinnati Department of Emergency Medicine.

His work at UC required lots of collaboration that prepared him for medical school. “Whether it is residents, fellows, other medical students or the patients themselves, health care is a team effort and that’s something that SIU does well.”

Mannion also did some research for the SIU Department of Emergency Medicine in the summer of 2019 and got to present his findings at the Society of Academic Emergency Medicine regional meeting. “It has biased me toward emergency medicine, but I really don’t know what I want to do yet. I want to try to do my best through the rotations and enjoy each one.”

“SIU does a great job of providing those experiences— research, community engagement, strong clinical opportunities to learn outside the curriculum. A lot of the physician professors will let you shadow them and tell you the advantages and disadvantages of their specialties.”

It reminds Mannion of something he picked up in the Physician Pipeline Preparatory Program.

“[P4 Director] Dr. [Wesley] McNeese brought in physicians who didn’t just talk about their specialties, they talked about why they loved their specialties. They were very candid. That was almost more important to hear when you’re high school age.”

Matt found out about “this brand new program being offered to high school students” in the fall of his freshman year. He met with his guidance counselor, discussed it with his parents and put his application together. In retrospect, he said the interview was similar to applying to medical school, with some of the same questions.

P4 is now 10 years old, but to Matt “it was great right off the bat. It gave you a taste of what medical school was like. You’re interacting with students, talking to someone who’s not a doctor or a resident, and they’re closer to your own age. It gives you something to think about, to learn how they did it, what was their path from high school to medical school. That’s very valuable for kids.”

“I feel fortunate that I was here, in one of the few places in the country with a high school pipeline program, and that I got to go through it and matriculate into medical school,” said Matt. “I’m grateful to SIU for making it happen.”

GRANDDAUGHTER AILEEN

Aileen Mannion, a sophomore at Springfield High School, just completed the fall P4 module. She knew much of what to expect from talking to Matt, and so far the pipeline program is living up to its billing.

“I’m enjoying learning from the physicians and medical students just what it takes to become a doctor, the different perspectives in the medical field.” She said the hands-on activities, like the trauma simulation where she got to triage patients, are particularly potent

Growing up with a mother who is a social worker, and physicians and a medical student in her immediate family, Aileen does not lack for role models. This particular afternoon she smiled at her aunt who was visiting from Milwaukee. “Aunt Julie works very hard, and she’s really, really good at what she does. It’s inspirational to have a strong female doctor to look up to.”

GRANDPA KNOWS BEST

When asked what advice he would give his grandchildren, the retired cardiologist Dr. Marion Panepinto speaks from the heart. “There are many things I can tell them, but the most important one is how they relate to the patient,” he said. “Compassion is so important.”

“It’s something that you can’t teach. But you have to let them know what it means to be kind to patients who are suffering with their illness.”

Pipelines to a More Diverse Physician Workforce

Equity, diversity and inclusion are central strategies for the continuing success of SIU School of Medicine in meeting its mission and preparing the physician workforce for the future. It is committed to cultivating a diverse campus population and a spirit of inclusion, to foster a nurturing educational environment ideal for learners at all levels, as well as the school’s faculty and staff.

EQUITY SPOTLIGHT: The Physician Pipeline Preparatory Program

Wesley Robinson-McNeese, MD, director of diversity initiatives for the SIU System, helped to launch SIU’s Office of Diversity, Multicultural and Minority Affairs in 2001. It has evolved into the Office of Equity, Diversity and Inclusion, now led by Wendi Wills El-Amin, MD, associate dean for equity, diversity and inclusion.

One of the office’s most valuable creations is the Physician Pipeline Preparatory Program or ‘P4 .’ The P4 is a partnership among SIU School of Medicine, Springfield Public School District 186 and the Sangamon County Medical Society that enrolls Springfield-area high school students interested in potential careers as doctors. The after-school program provides mentors and exposure to the medical field. The 2019-20 program includes more than 70 area high school students, the largest enrollment in the program’s 10- year history.

Faculty and staff from both SPS and SIU developed the P4 curriculum. The components include participation in medical school-style curriculum; an introduction to problem-based learning; tours and shadowing; and interactions with SIU students and faculty.

“These are young people eager to learn about the life of medical students and how challenging and rewarding a physician’s career can be. They represent a bright future for health care in central and southern Illinois,” said Dr. McNeese, the P4 director. Both Dr. McNeese and Dr. ElAmin share a vision for expanding the program.

“We are encouraged by the success and growth of P4 and of all the ways the model is being replicated by others who seek to diversify the workforce,” said Dr. El-Amin. “Every student we attract intensifies the imperative that we create ecosystems of equity and nurturing educational environments for learners at all levels of medical education.”

AT A GLANCE

  • SIU SOM ranks in the 93rd percentile for AFRICAN-AMERICAN GRADUATES
  • SIU SOM ranks in the 88th percentile for FEMALE FACULTY
  • SIU SOM ranks in the 48th percentile for UNDERREPRESENTED GROUPS IN MEDICINE

A CUT ABOVE

Learning From the Best in Microsurgery

Imagine being a resident physician – doing your normal rounds in the emergency department – when you encounter a woman walking in with no pants and covered in blood. Maybe your first thought is that she has suffered some sort of trauma, until you learn that it’s her husband who suffered an accident. In the moment of crisis, she gave the only item of clothing she could, to make a tourniquet and try to prevent her husband’s loss of blood – her pants.

The only person who offered her a clean pair of pants, after she had spent several hours in two different hospitals, happened to be the surgeon who would save the use of her husband’s hand.

“It was like an old-time western movie,” said Jim Stephens, who was 38 at the time of the accident in 1997. “Michael Neumeister walked into the room and everyone snapped to attention.”

Stephens and his wife Shelly were building their first log home together, when he accidentally cut his left hand with the miter saw – leaving it attached by a small piece of skin. When they arrived in Springfield, Dr. Neumeister gave Stephens a choice: We can try to put the hand back on and see how it goes or we can simply cut it off.

“I told him, ‘Put it back on. What have I got to lose?’” Stephens said. “He asked me some other questions, and then he said as he was leaving the room for someone to please get my wife some pants and a clean shirt.”

ADVANCES IN MICROSURGERY

Microsurgery is a key component to the SIU School of Medicine plastic surgery residency program. It involves using a microscope to complete very detailed work. In the late 1990s when Stephens nearly amputated his hand, the SIU Medicine plastic surgery team was doing microsurgery, but the operations took much longer.

“Since then, technology has advanced through improved clarity and magnification on the microscopes, as well as some key tools have been developed to help us perform tiny sutures faster,” said Michael Neumeister, MD, now chair of the Department of Surgery at SIU Medicine. In 1997, Dr. Neumeister was a young surgeon, and had recently completed a fellowship at Harvard. Dr. Neumeister built his career specializing in putting limbs back together.

pecializing in putting limbs back together. “One of the reasons I wanted to work at SIU School of Medicine originally is because we did those types of surgeries,” he said. “Not all institutions were doing these, and some still do not, because it requires a certain level of expertise within a team setting, that is willing to do these long operations. They also frequently rearrange an entire day of scheduled surgeries if an emergent case presents in the ER.”

If you were a medical student in the operating room in 1997, you would see two surgeons looking in the microscope and know they are working on something, but no one else in the room would know where those surgeons were in the procedure. Now, we have large monitors so everyone in the room can see what you’re doing. That helps the general flow of the procedure, as our medical students and residents can visually be part of the entire surgery,” Dr. Neumeister said.

Medical students and residents perfect the skill of suturing, or anastomosis, in the microsurgery lab. The learners build their skills by sewing sutures on computerized veins and arteries that can track against national benchmarks; for example, if the suture is in the appropriate position, free of leaks after the repair, and if the surgeon’s hands tremored during the procedure.

“We really define the precision at which they are performing anastomosis, which builds confidence for when they are entering the operating room for the first time with a real patient,” said Dr. Neumeister.

MOVEMENT IMMEDIATELY AFTER SURGERY

Not only have surgical techniques improved over time, but post-surgical therapy has as well. SIU Medicine has an entire Hand Therapy Center dedicated to helping those with hand injuries recover through physical and occupational therapy treatments.

“We now know that early motion improves the outcomes of pretty much any surgery – with hand, shoulder, knees, hips – it strengthens tendons and bones if it’s done in a controlled environment,” said Dr. Neumeister. “We start early motion with all of our amputees these days. But in the ‘90s, that was not the case.”

When Stephens cut off his hand, the protocol was to remain still to allow the veins and arteries time to heal, for fear of tearing the tiny sutures holding them together. However, the day after his surgery, Jim was already trying to move his fingers.

“He was actually one of the patients that made us think, made us question our postsurgical therapy and showed us that we could try moving hands right away,” Dr. Neumeister said. “We thought it needed to be still and let it heal a bit first. But actually, he was doing the right thing, something we learned to be best practice a few years later.”

TECH TOOLS

3D imaging, brain tumor fluorescence added to patient care

Robots, 3D imagery and glowing tumors are changing the way neurosurgeons operate at SIU Medicine. The scientific advances are increasing the accuracy of a variety of surgeries, reducing the time a patient is under sedation and improving outcomes. Jeffrey Cozzens, MD, professor in the Department of Surgery and chief of the Division of Neurosurgery, discussed some of the newest tools being integrated into the OR.

3D IMAGERY

SIU School of Medicine obtained a new microscope with 3D capabilities to help surgeons improve surgical precision for patients needing spinal surgery or brain tumor removal.

With two cameras for each port, the Zeiss Kinevo Miscroscope broadcasts what the microscope sees in 3D so the team in the operating room can better see what is happening inside the patient.

“This microscope has multiple benefits,” said Jeffrey Cozzens, MD, professor in the Department of Surgery and chief of the Division of Neurosurgery. “The residents can learn by actively participating more because the attending can better see what exactly the residents are doing, and the med students can learn far more from a 3D image when following along on the screen.”

The new technology also allows for more minimally invasive surgery for patients.

“The 3D microscope can be used with neurosurgical navigation devices, and we can achieve an even higher level of accuracy when operating on the brain and spine,” said Dr. Cozzens.

A GLOWING REVIEW

Ten years ago, SIU Medicine patients with brain tumors participated in an SIU-initiated clinical trial of a drug that helps neurosurgeons pinpoint affected tissues when removing a brain tumor. The drug, called 5-Aminolevulinic Acid (5-ALA), has now received FDA approval and SIU Medicine patients are some of the first patients in the United States to use it.

The patient drinks the drug, and it metabolizes in the body in such a way that a malignant tumor “glows” when placed under a special microscope during surgery. This gives the surgeon greater certainty that the entire tumor has been removed.

ROBOT HELPS EPILEPSY PATIENTS

During a procedure called an SEEG, or stereo-electroencephalogram, neurosurgeons at SIU Medicine are using a new surgical robot to place electrodes in the brain to better study patients suffering from epilepsy

“Our goal in epilepsy surgery is to find the area of the brain that is causing seizures and does nothing else, then we know we can remove that area of the brain,” said Dr. Cozzens. “The trick is trying to find it. Because often we can’t see any abnormality on a scan, we use electrodes on the scalp and inside the brain to find that area.”

Cozzens said electrodes placed on the scalp usually find the general area, but the new technology offers much greater precision for monitoring.

“Without the robot, it takes eight hours for the surgery to be done by hand, with continually planning and evaluating where we’re going within the brain,” Dr. Cozzens said. “The robot allows us to do this same procedure in an hour, with the route already mapped.”

WATCH AND LEARN - In 1989, Dr. Richard Bass used an ENT examination as a teachable moment with third-year medical students. As technology has evolved, faculty have adjusted training methods, adding hardware and soft skills into the curricula to engage learners and improve patient outcomes

INNOVATIVE SPACES

SIU Medicine is welcoming patients, residents and students to a new state-of-the-art clinic and teaching facility at 300 W. Oak Street in Carbondale. The 40,000-square-foot space is the home to SIU Center for Family Medicine–Carbondale and SIU Medicine’s Physician Assistant Program.

Southern Illinois Healthcare (SIH) funded the new facility and is leasing the building to SIU Medicine. The construction plan was developed as SIU’s family medicine clinic began to outgrow its space in the professional office building connected to SIH Memorial Hospital of Carbondale.

SIU Medicine–Carbondale

New home, new technology for family medicine and PA training

In August 2019, SIU Medicine unveiled a new state-of-the-art clinic and teaching facility at 300 W. Oak Street in Carbondale, Illinois. The 40,000-square-foot space is now home to SIU Center for Family Medicine–Carbondale and SIU Medicine’s Physician Assistant Program.

The construction plan was developed as SIU’s family medicine clinic began to outgrow its space in the professional office building connected to SIH Memorial Hospital of Carbondale. The Physician Assistant Program was previously housed on the SIU Carbondale campus.

Since its opening in 1974, health care professionals at SIU Center for Family Medicine–Carbondale have provided care for the entire family, from newborns to seniors. The center is also home to an accredited family medicine residency program, which provides learners with comprehensive training in diverse medical fields, including pediatrics, behavioral health, surgery and geriatrics. The program also offers advanced training in sports medicine through its fellowship program.

“Developing this space gave us an incredible opportunity to plan for the future,” says Center Director Quincy Scott, DO. “We’ve created a beautiful new home for our health care providers, residents and students, with patient care that’s forward-focused and backed by the latest research and discoveries in medical education.”

SIU’s Physician Assistant Program occupies the second floor of the building. Like the medical school, the PA program uses problem-based learning, with a focus on small group discussions and simulated patient experiences. The program graduates 40 new physician assistants each year.

Physician Assistant Program Director Don Diemer considers the center’s teaching innovations and technology tools as a boon for better training and care.

“We are here to continually educate the next generation of providers and to elevate the entire field of primary care,” he said. “Offering this training in a new, high-tech learning space makes the program more attractive and it will anchor future providers to the region.”

SIU Family Medicine’s clinic occupies the ground level of the new building. On the second floor, the physician assistant space has a wealth of new resources to offer students who sign on for the 26-month program.

SynDavers and plastinated models will be used to teach anatomy to the PA students and Lincoln Scholars medical students. The SynDavers are synthetic cadavers that have all the major organs and musculature of a traditional cadaver, plus arteries, nerves, veins INNOVATIVE SPACES: SIU Medicine–Carbondale New home, new technology for family medicine and PA training 22 and bones. They require no chemicals, won’t decay or change appearance, and can be sent back to the company periodically to be refurbished.

The German company Von Hagens Plastination is providing the plastinated cadavers. (They are the same group that created the touring exhibition Body Worlds.) Plastination is a process where body fluids are drawn out of the tissues and replaced with a silicone-based polymer which, when dry, does not decompose.

The SynDavers cost $60,000 each and the plastinated cadavers $90,000 each. Because the new facility is also an outpatient clinic, the investment in the models allows for teaching anatomy and later, surgical techniques and dissection, without preservative requirements and the accompanying smells. The School of Medicine has been using plastinated partial models for years.

According to the companies who created the technologies, the SIU Physician Assistant Program is the first laboratory in the United States to have both types of instructional models in one lab.

OTHER HIGHLIGHTS OF THE SPACE INCLUDE:

  • Point of care ultrasound (POCUS) equipment, which allows clinicians to make a quick diagnosis in the office for many common problems without the need to first send a patient to radiology for an ultrasound and then wait for a formal report from the radiologist or another specialist. POCUS use is expanding to evaluate things like abdominal aortas, gallbladders, skin, eyes, musculoskeletal and OB-GYN disorders.
  • Increased digital instruction. The laboratory has a digital photo atlas for anatomy, and students use online resources almost exclusively.
  • 90-person seating capacity, with desks, computers and power outlets for the full roster of PA students, residents, PA and FM faculty to have classes together. There are chairs and power/ computer outlets for an additional 30 guests. Presentations can be viewed from every seat in the room.
  • Student amenities areas, one of the most popular upgrades. “In our previous building the students would spend their breaks standing in line for a microwave, the bathroom or waiting to make a copy. Now all the facilities easily accommodate them,” said Diemer.

The Imagineering Lab

In 2016, orthopedic surgery resident David Tapscott, MD, approached library instructor Karli White with an unusual request. He asked if the library’s 3D printer could adequately render a model of a child’s spinal column. The physician wanted to use it to help explain a potential surgical procedure to the child’s family.

Unfortunately, the library’s small 3D printer was a loaner and could not print the life-sized model. The pair looked elsewhere and were able to find an alternative printer at the Springfield Community Makerspace.

White discussed the request with Library Director Taran Ley, who decided to draft a grant proposal to acquire a 3D printer for the Medical Library. The National Library of Medicine grant was awarded in 2018, and the $6,500 Makerbot Z18 was soon installed in the library. The library began printing the 3D items free of charge, using various colors of PLA (polylactic acid) biodegradable filament.

The use of three-dimensional models in medicine has been growing rapidly. They can help students learn anatomy, increase patients’ and families’ understanding of their medical conditions, and help physicians plan and provide personalized patient care. Studying the models can reduce surgical risk, increase efficiency and improve the success rate of difficult operations.

The 3D printer has been utilized by physicians in surgery, cardiology and clinical radiology. SIU facial plastic and reconstructive surgeon Matt Johnson, MD, has become a fan. “Previously, in preparation for surgery, we would review imaging. This can be challenging and at times, abstract to visualize. With a 3D model we have direct assessment and appreciation of anatomy. We use virtual surgical planning to prepare plates, implants, location of osteotomies [procedures altering bones], and anticipate the steps of surgery,” Johnson said.

Otolaryngology–Head and Neck Surgery can pre-bend hardware specific to the patient for the best approach to the area of repair. During surgery, the model can provide a roadmap and aids in directing dissection, which benefits both surgeon and patient. “We’re doing all these things beforehand that save time in the OR and reduces the anesthetic duration,” he said.

The Medical Library created a new designated space — dubbed the Imagineering Lab — that is anchored by the 3D printer. Located behind the main reference desk, the iLab contains the Makerbot and its printing supplies, a pair of the school’s most advanced computers, and an assortment of anatomical models.

It also has a corner spot reserved for something more ambitious: the Stratasys J750. The next generation 3D printer, the Stratasys can produce models in flexible textures, recreating skin and muscle complete with veins, arteries and occasionally, tumors. It can print several objects simultaneously and in multiple colors. The size of a large copier, “it’s a game-changer,” Ley says.

When the second printer becomes a reality, Ley said students will be able to begin training on the Makerbot to learn the basics: how to use the software, feed the printing spools, and clean the equipment and models. As residents, they can apply what they’ve learned to the more expensive Stratasys model. The library has already purchased Materialise Mimics, new software with FDA clearance to create models from CT scans and print 3D patientspecific anatomical models that can be used for diagnostic purposes. “Our plan is to offer this software as a fourth-year elective,” she said.

The library is also preparing a proposal to acquire Augmented Reality (AR) for the iLab. AR is a technology that works on computer visionbased recognition algorithms to augment sound, video, graphics and other sensor-based inputs on real world objects, using the camera of a personal device. Think of Tony Stark’s workshop in ‘Iron Man,’ or the 2016 national craze that had people hunting for digital Pokémon characters using their smartphones. The visual field requires only a light pair of sunglasses.

Ley said they hope to get Microsoft’s Hololens 2 software for the iLab, once it receives FCC approval.

Physicians and learners in the very near future will have these new tools to explore and use in consultations with peers and patients. The day nears when they can prepare for surgery by holding a replica of the target tissue in their hands or maneuver it while it literally floats before their eyes.

Surgical Skills Center

The orthopedic surgery residents were crowded around tables of the J. Roland Folse, MD Surgical Skills Center on the fourth floor of the Memorial Center for Learning and Innovation. Surgical equipment hummed as the doctors drilled and sawed into assorted pieces of resin. The materials were crafted to create realistic resistance for the surgical residents as they practiced the procedures over and over, perforating and precisely removing sections from the blocks and cylinders.

And there was another thing removed from the surgical simulation: the heightened pressure a trainee would experience in an operating room. This lower-anxiety setting is why the surgical skills center has become one of SIU School of Medicine’s most popular training destinations.

It was championed by a forward-looking SIU surgeon who envisioned a versatile facility where surgeons could practice and proficiency would prevail.

BUILDING CONFIDENCE

Gary Dunnington, MD, former professor and chair of the SIU Department of Surgery and founding director of the SIU Surgical Skills Lab, led the efforts to open the Springfield-based Surgical Skills Lab in May 2000. At the time, it was one of the nation’s only laboratories designed specifically for training surgical residents.

Skills labs have since revolutionized surgical training. Using computer simulators and virtual reality technology, as well as specially designed procedure models, surgical residents learn a wide array of skills including instrument tying, one/two-handed knot tying, laparoscopic procedures, vascular anastomosis, chest tubes, central lines and splinting.

Dunnington and the surgical faculty and staff had helped create the national curriculum developed jointly by the American College of Surgeons and the Association of Program Directors in Surgery, comprised of three phases. Phase 1 and 2 includes modules that address basic surgical skills, designed with first- and second-year residents in mind.

Janet Ketchum has been the surgical skills director and skills coach in the Department of Surgery since the center opened in 2000. She was working in Memorial Medical Center’s operating room as a scrub nurse and preceptor for the new nurses when Dunnington recognized her aptitude as an educator.

With a $50,000 private grant and some generously donated space adjacent to Memorial’s OR, Dunnington asked Ketchum to join him in creating the Surgical Skills Center.

The center was established to address the increasing complexity of surgical techniques in a reduced-stress environment, free from patient safety concerns. Its simulationdriven skill labs were an immediate hit with general surgery residents, and sessions were soon expanded to include other specialties: urology, plastics and orthopedics. An open-door policy allowed learners to practice procedures in their spare time.

The confines were intimate and sometimes got crowded, Ketchum said, even after Memorial enlarged the space. Storage was always at a premium because specialized surgical instruments were needed as technologies evolved.

The medical school does not keep its successes secret. In its formative years, Dunnington and the staff organized and hosted annual two-day CME workshops on the basics of setting up these unique teaching spaces, to help dismantle hurdles before they appear.

In 2013, planning for the Memorial Center for Learning and Innovation was getting underway. The $40-million, four-story facility would be built on property adjacent to both Memorial Medical Center and SIU School of Medicine. The plans designated a spacious wing of the top floor for a new Surgical Skills Center.

The new J. Roland Folse, MD Surgical Skills Center was dedicated in August 2015, named in honor of SIU’s first chair of the Department of Surgery

SIU surgeons value the time spent in the state-of-the-art facility with their teams. Rebecka Lopez, MD, assistant professor in the Department of Emergency Medicine, said, “The skills center gives our residents some of the best opportunities to hone their skills with the safety net of simulated models and direct, hands24 WINTER 2019 | ASPECTS on instruction. They can experience some once-in-a-career procedures before ever having the life of an actual patient on the line – an encounter that can be truly life-saving in the future.”

“When I visit other centers, I often see skills labs that are ‘expensive closets’ in the sense that they have nice equipment, but are empty most of the time,” said Dr. John Mellinger, professor and chair of the Division of General Surgery. “Residents are encouraged to use them, but are on their own to do so, and rarely able to amidst other duties.”

“The beauty of our facility is not just the physical space, but the curricular, staffing and protected time for use strategies that make the lab hum with learner activity on a daily basis.”

MODEL MAKING

Senior skills specialist Jennifer Bartlett is the engineer responsible for creating many of the lab simulation models. There are realistic hands, fingers and toes cast in poured silicone from alginate molds and an impressive array of unique molds and models, many fashioned in MacGuyver-like simplicity. Models typically fit into two categories: things surgeons encounter all the time or “specialty items.” The latter are as important as the former, because no surgeon wants to be unfamiliar with something that a patient is experiencing.

Novelty pushes research forward, so when Bartlett creates a specialty item, she frequently designs ‘how-to’ documentation around it that the physician can integrate into a research article. The Surgical Skills team freely shares its construction processes with colleagues and other medical schools.

Bartlett and skills specialist Brian Hollinshead have attended classes to expand the center’s repertoire. After a recent workshop where they learned how to mold an entire head, an SIU plastic surgeon contacted them to do just that. The surgical team already had a template of the bony part of the subject’s face but wanted a cast of the soft tissues so they could prepare scenarios for the reconstruction process.

Because she’d never done a whole-head cast, especially one so crucial to a surgical team’s plan, Bartlett contacted the workshop hosts and explained the situation. “They were able to send a professional to Springfield who cast the patient’s head in the doctor’s office,” she said. The resulting mold was then used to try multiple approaches for the best possible surgical outcome.

The surgical skills team is eager to add a state-of-the-art 3D printer to their service line. Ketchum envisions using it for mass-production of the more sophisticated models that require different textures. It could also be engineered for one of the group’s newest assignments. Dr. Matt Johnson, assistant professor in the Department of Otolaryngology-ENT, has asked Bartlett to create a soft tissue face mold for cleft palate repair. The procedure is one of the most frequently performed surgeries on mission trips. The models could be sent overseas in advance for physician training and remain behind after the mission’s ends to help sustain the quality of the work.

With two decades of experience to draw upon, the Surgical Skills Center will continue to refine its technology and teamwork to meet the next anatomical challenge, to improve training opportunities and to enhance the abilities of SIU’s students, residents and surgeons.

In celebration of the School of Medicine’s 50th Anniversary, each issue of this year’s Aspects will feature a sampling of our physician graduates. Their careers, like so many of our alumni, represent SIU School of Medicine’s core values of education, patient care, research and community service.

Our graduates practice in a broad range of specialties, following diverse career paths after earning their medical degrees from SIU. They practice medicine in a variety of settings, from private practice offices and community clinics to sophisticated tertiary care centers.

Some have become university professors while others serve as volunteer faculty for health professions schools in their regions. Some have taken up careers in research while many others are applying clinical research findings to the everyday practice of medicine. Some serve their communities through military careers or government service. And many more serve their communities through mission work, volunteering and civic engagement.

SIU School of Medicine graduates have developed their talents in countless ways that enrich the lives of others at the local, national and international levels. We are proud of their service, their accomplishments and their commitment.

WILLIAM DIRKSEN, MD

  • Class of 1975 Pediatrician and Partner
  • Coastal Children’s Clinic
  • Corpus Christi, Texas

I did my undergraduate studies at the University of South Dakota, graduating in 1971. I completed my first two years of medical school at the same university, which at that time was a two-year school and students had to transfer for their last two years of clinical training. Deans [Richard] Moy and [Deane] Doolen came to South Dakota on a recruiting trip in an effort to establish a beginning thirdyear class for 1973. I was impressed by the innovation and faculty of SIU School of Medicine and knew this was where I belonged. Being from a small town, I also liked Springfield, with its big “small town” feel.

I was part of the Health Professions Scholarship Program committed to the USAF, so after graduation I moved to San Antonio, Texas, and began my pediatrics residency at Wilford Hall USAF Medical Center. Because of mentors at SIU like Drs. Garfunkel, Lascari and Silber, I was hooked on pediatrics. The summer before my junior year at SIU I also had an opportunity to work with Springfield pediatricians, and that was an amazing time of “learning in the trenches.”

After residency, I was assigned as the lone base pediatrician at F.E. Warren USAF Base in Cheyenne, WY, and I felt well-prepared from my medical school and residency training. In 1980, with my obligation to the Air Force repaid, I joined the Coastal Children’s Clinic in Corpus Christi, Texas, as the fourth member of the group. Since that time, we have expanded to four offices, 17 pediatricians and nine nurse practitioners. I have been on the active medical staff at the local Driscoll Children’s Hospital (DCH) since 1980 and have served as pediatrics chair and chief of staff on multiple occasions. For 12 years I was the pediatric residency program director at DCH, retiring from that position two years ago. In addition, I have had the honor of being elected president of the Texas Chapter of the American Academy of Pediatrics, The Texas Pediatric Society.

My passions outside medicine include furniture making and restorations, general construction and trim carpentry, antiquing and spending time with family and grandchildren. I also have had numerous opportunities to do medical mission work in remote villages in Ghana, West Africa, most recently in June of 2019. For the past two years, I work six months in Corpus Christi and take six months off to pursue my hobbies and spend time with grandchildren in northern Colorado, at my log home in the mountains at 7500 feet.

SAM GAINES, MD

  • Class of 1977
  • Emergency physician,
  • HSHS St. John’s Hospital, Springfield

I was born in Mississippi and moved to Peoria in 1968. I attended Manual High School, graduated in 1970. I did my undergraduate work at the University of Illinois Champaign-Urbana and received a bachelor of science. I had a chance to talk to Dean Doolen when he came to the University of Illinois recruiting for SIU medical school for about three years before the school started the first class. He convinced me I would like to go into family practice and serve the communities of Illinois.

I went to Carbondale in 1974 with a wife and two kids, so I was more challenged than the other single students. I loved medical school. It was quite an experience. That was back when school took three years and the only vacation you got was moving from Carbondale to Springfield between your first and second year.

I found that medicine was a very jealous mistress, and my wife and I divorced at the end of my first year residency. I did residency in internal medicine but shifted into emergency medicine after moonlighting for years and was able to grandfather into college at that time to take the exam. I practice emergency medicine and also became an officer in the Illinois Guard and worked my way up to the commander of the state health and dental clinic as a colonel. I retired from the Army just before Desert Storm.

I had an opportunity to open a free clinic on the east side of Springfield, and worked there for a few years. The clinic was able to use my office initially and then became federally funded. It is now the Central Counties Health Center. I’m still a board member and very passionate about it. We have been able to increase access to health care to the citizens of Springfield and multiple small communities around the area.

ROBIN DETERDING, MD

ROBIN DETERDING, MD

  • Class of 1986
  • Professor of Pediatrics;
  • Chief, Pediatric Pulmonary and Sleep Medicine;
  • Medical Director of both The Innovation Center and The Breathing Institute at Children’s Hospital Colorado;
  • Ed and Roxanne Fie Anderson Family Endowed Chair for Breathing

My parents were teachers in Granite City and valued learning. I was the first in my family to pursue a medical career and sought to combine elements of education with a love for sports in the pursuit of sports medicine at Southern Illinois University, which was known for excellence in medical education. Medical school and residency exposed trainees to innovative methods of learning, evaluation and patient-centered practice approaches. It was novel to have simulated patients and evaluations that included patient communication, as well as content and knowledge. My classmates and I were engaged in these new methods.

Sports medicine wasn’t my final calling, as I learned I was more drawn to complex medical issues and procedures, in caring for children and families. This took me to a fellowship in pediatric pulmonary medicine at the University of Colorado, and the Children’s Hospital of Colorado, where I have been since.

I have had the privilege to pursue a combination of clinical care, medical education, innovation and research at different phases of my career. Currently, I remain active in all phases of the academic mission, including academic leadership. I see a direct path from my formative training at SIU, to my love for innovation and learning, entrepreneurial spirit, leadership style and my guiding north star, focused on quality care for the patient.

As the principal investigator on an NIH R13 conference grant, I co-founded the multi-disciplinary Children’s Interstitial and Diffuse Lung Disease (chILD) Research Network and the chILD Family Foundation in 2004. chILD is an umbrella term for over 200 rare lung diseases. We have since defined new classification systems, published landmark care guidelines and disease discoveries, partnered with basic scientists to better understand disease mechanism and established family education and support to transform this field. Today, there are chILD Research Networks and chILD Foundations around the world, pluripotent stem cell banks, chILD grant opportunities, disease registries and the first prospective drug study in chILD lung fibrosis. As a leader in chILD, I am proud to have established a foundation from which others have built new discoveries, and a future of hope for children with these diseases.

Creating programs to inspire the next generation of leaders, embrace innovation and build change has also been my passion. I have had the opportunity, at different phases of my career, to lead the modernization of the medical school curriculum at the University of Colorado as the Associate Dean of Education, create the Breathing Institute at the Children’s Hospital Colorado to transform pediatric pulmonary care across the continuum, co-founded the Children’s Hospital Colorado Center for Innovation, and medical startups to bring novel care models to patients.

CYNTHIA THOMAS, MD

  • Class of 1991
  • Associate Professor of Family Medicine

I was born in Morehead, Mississippi, and raised in Chicago. I received my undergraduate degree from the University of Illinois at ChampaignUrbana in 1987 and my medical degree from SIU School of Medicine in 1991. I completed my residency in family medicine at SIU in 1994.

I’ve always had a desire to help the underserved. I received an Illinois Department of Public Health Scholarship and worked at the Decatur Community Health Improvement Center to fulfill its service obligation from 1994-97. I joined the faculty of the SIU Department of Family & Community Medicine right after that, and I have been seeing patients and teaching students and residents ever since. I am medical director of the Integrated Wellness Center, which facilitates the provision of primary care services onsite at a behavioral health facility.

My passion for community medicine inspired me to complete a faculty development fellowship in community medicine with an emphasis on meeting the health needs of the underserved. I was honored to receive the Edwin A. Lee Award for community service and the SIU SOM Humanism in Medicine award. I keep active in the Springfield community in various capacities, including ongoing involvement in my church. I am happily married to Darryl, and we are the parents of four wonderful children, Lauren, Christina, Gabrielle and Darryl Josiah.

WILLIAM GOSSMAN, MD

  • Class of 1992
  • Director of Emergency Medicine at Creighton University School of Medicine

There was only one medical school I wanted to attend and that was Southern Illinois University. They had a philosophy of not only training physicians to serve southern Illinois but also producing clinicians that would make a difference wherever they practiced. Upon graduating from residency in emergency medicine, I took this philosophy with me to Chicago where I felt called to work in an inner-city emergency department.

After working at Mt. Sinai in Chicago for eight years, I took an academic position at Creighton University Medical School and Medical Center in Nebraska. I chose that institution because their philosophy aligned with SIU’s. I am now the director of emergency medicine. I work in an exciting field and get to train the next generation of clinicians who will go out and change the world. Through all of this, I and my wife Sherry, have been married for more than 30 years and have raised two girls, Casey and Taylor.

Editor’s note: Bill was also instrumental in founding Boston Medical Publishing, eMedicine and StatPearls (which he donated to SIU SOM for use by the students, residents and faculty). He was inducted into the Gold Humanism Honor Society for medicine and is a 2015 inductee to the SIU chapter of AOA Medical Honor Society.

CLASS NOTES

First-year students Danielle Hawthorne, Danel Voorhees and Mary Dickerson visited with alum Dr. Arlene Miksanek at Walker’s Bluff in Carterville.

1970s

JOHN MAGDSICK, MD, ’75, is retiring after 41 years as a practicing anesthesiologist and hopes to see classmates at the next reunion.

BRUCE PETERSON, MD, ’75, retired in 2017 after 40 years of practicing pediatrics in Rockford.

LARRY NEWELL, MD, ’78, retired from private practice in Springfield and is now working in a free clinic in St. Louis for the homeless, indigent, uninsured and immigrants; “a win-win-win arrangement!”

FLOYD SALLEE, MD, ’78, is CMO of Ironshore Pharmaceuticals and Development, Inc., and had the privilege to participate in the development of Jornay PM, the first nighttime-dosed methylphenidate for the treatment of ADHD.

DIANA WIDICUS, MD, ’78, was named a finalist for Best Doctor in Springfield by The State Journal-Register

1980s

JEFFREY PARKS, MD, ’80, received the Physician of Excellence Award from the Illinois Rural Health Association in a ceremony at his office on Oct. 30.

ADOLFO NAPOLEZ, MD, ’81, returned from the 5-Continent Congress Conference in Barcelona, Spain, where he presented and was proud to represent SIU School of Medicine.

REGINA RABINOVICH, MD, ’82, is on the Board of Trustees at the Sabin Vaccine Institute, is a Scholar in Residence at Harvard School of Public Health, and is a member of the BOD-CMMB Catholic Medical Mission Board and the Board of Directors for Aeras TB Vaccines. Regina was previously director of IDD at the Bill & Melinda Gates Foundation in Seattle. markets.

KAREN BROQUET, MD, ’84, received the ACGME Parker J. Palmer ‘Courage to Lead’ Award in 2019.

TIM FENGLER, MD, ’85, is semi-retired, no call or weekends, and looking forward to the ‘84/’85 Reunion next spring.

Sharon Hull, MD, '87

SHARON HULL, MD, ’87, recently earned the designation of Professional Certified Coach from the International Coach Federation (ICF), the leading global organization for professional personal and business coaching.

BRIAN KING, MD, ’88, was honored In August 2019 as a Fellow of the American College of Radiology and was nominated to the ACR Board of Chancellors.

1990s

FRANK JAMES, MD, ’96, was honored to receive the designation of Distinguished Fellow of the American Society of Addiction Medicine.

MANISH KOHLI, MD, ‘97, produced a 4 x 4 Health Podcast in October on his work in international health and health IT, sponsored by Datica. Manish is SVP and CMIO of family medicine at Aurora Health Care in Milwaukee. He was the first physician to be recruited by Cleveland Clinic Abu Dhabi and was named to serve as chief of medical informatics.

A Class of ’02 mini-reunion: Drs. Stacy Sattovia, Tracy Mizeur, Jamie Wallman, Brooke Ballard and Andy Riffey

2000s

ALANNA BREE, MD, ’00, runs a successful nonprofit for children with dermatological disorders in Houston. One of her projects (“I was made a masterpiece”) was featured on CBS This Morning on October 11.

JENNIFER COOK, MD, ’00, was appointed global medical director of Itamar Medical, a company that develops, manufactures and markets devices for sleep apnea and uses a digital health care platform to facilitate the continuum of care for effective sleep apnea treatment with a focus on the cardiology market.

MATTHEW WINKLEMAN, MD, ’02, received the 2019 Distinguished Service Award from the Illinois Academy of Family Physicians for providing outstanding primary care to southern Illinois, and for his decades of service to the Harrisburg community and students of SIU School of Medicine.

STACY SATTOVIA, MD, JAMIE WALLMAN, MD, ANDY RIFFEY, MD, BROOKE BALLARD, MD, and TRACEY MIZEUR, MD, all ’02, had a mini-reunion while attending the Women’s Health Conference in Springfield in October.

BROOKE FRENCH, MD, ’04, started a new position as co-director of the Cleft Lip and Palate Program at Children’s Hospital Colorado. She is an associate professor of plastic surgery-craniofacial at the University of Colorado School of Medicine Children’s Hospital Colorado.

JASON GILLIHAN, MD, ’06, was appointed division chief of anesthesiology at Barnes-Jewish West County Hospital (BJWCH) Department of Anesthesiology, Washington University School of Medicine. He will oversee anesthesiology services at BJWCH, the Washington University Orthopedics Center in Chesterfield, and the Advanced Endoscopy Center.

STEPHEN GARRISON, MD, ’08, became chief of radiology at Citrus Memorial Hospital in Inverness, Florida, in summer 2019.

Dyana and Dr. Victor Stams

VICTOR STAMS, MD, ’08, finished his plastic surgery fellowship at UT San Antonio and has moved back to central Illinois, joining the Carle Clinic in Champaign-Urbana.

KATRINA PEDERSEN, MD, ’09, led the National Comprehensive Cancer Network guidelines subcommittee to create the first national guidelines for treating small bowel adenocarcinoma. The guidelines were published August 2019.

2010s

JUSTIN HINZMAN, MD, ’11, and his wife Laura welcomed their baby boy, Wirth Hinzman, in April 2019.

BRANDON HAMM, MD, ’13, is new consultation liaison psychiatry faculty at Northwestern Memorial Hospital.

THOMAS SELBY, MD, ’13, is practicing family medicine in Mt. Carmel. He matched into Wright State University’s dermatology program and will start in Dayton, Ohio, in July 2020.

RUSTIN MEISTER, MD, ’15, is a first-year fellow in the Pediatric Intensive Care Unit Program at Ann & Robert H. Lurie Children’s Hospital of Chicago.

MATTHEW KRESCA, MD, ’18, married Sondra Clarkson on October 18, 2019

Dr. Matthew Kresca and Sondra Clarkson

Helping Our Students To Succeed

Dr. Veling Tsai, ‘02, and Mason Tippy | Farris Abou-Hanna and Dr. Joe Lachica, ‘01

HOSTS (Helping Our Students To Succeed) season runs through January, and we extend our sincere thanks to all our alumni who have shown hospitality to the fourth-year students as they travel the country for residency interviews. By sharing their homes and experiences, alums save the students the cost of a hotel and also provide useful insights into the community. The Office of Alumni Affairs will contact alumni if a student has registered for a host in their area.

To learn more, visit siumed.edu/alumniaffairs/hosts-program.htm.

FIRST CLASS - Members of the first graduating class file into the rotunda of the Illinois State Capitol Building for their commencement ceremony in June 1975.

Here’s a look at the Top 5 education innovations that have put SIU at the forefront of medical education worldwide.

SIU School of Medicine has been innovative from day one, striving to find better ways to educate medical students.

In 1976, it was the first U.S. medical school to publish curricular objectives, the first time in the history of medical education that the entire curriculum was identified through learning objectives.

A few years later, problem-based learning (PBL) and standardized patients (SP) made SIU School of Medicine world-renowned. These two principles of medicine have been adopted by medical programs throughout the world. At least 90 percent of U.S. and Canadian medical schools use some form of PBL’s small group teaching, according to the Association for American Medical Colleges. All medical schools now use standardized patients and/or simulations for teaching and assessment.

SIU is viewed, and always has been, as a place that supports and fosters education and educational innovations. It is known for its trailblazing in clinical assessment, and encouraging a culture of creativity and continuous learning at every level -- from its students and physicians up to its deans and clinical department chairs.

Innovation has never stopped at SIU. Educators at SIU School of Medicine have built upon the sturdy foundation of its early successes to create new programs, teaching modules and methods of evaluation. As evidence, the Bohn Nielsen Lobby in the school’s main education building houses a collection of five Aspire Awards from the Association of Medical Education of Europe. Over the past six years SIU has been recognized in five different categories: for student assessment, student engagement in curriculum, social accountability, medical simulation and curriculum innovation and excellence. Clearly, we don’t rest on our laurels.

1. Department of Medical Humanities (1975)

SIU School of Medicine was one of the first medical schools in the nation to establish a Department of Medical Humanities. SIU was the fifth pilot project to bring humanities into the clinical experience, according to Glen Davidson, PhD, founding chairman of the department. “SIU was the first to bring humanism integrated directly into clinical education,” says Dr. Davidson. “While other schools offered courses in medical humanities, no other medical school so carefully integrated them in students’ clinical experiences.” Working with the curriculum model brought by Dax Taylor, former associate dean for academic affairs, “we didn’t think in terms of courses but themes broken into modules like the rest of the SIU curriculum,” Dr. Davidson says. “Somebody from the medical humanities team participated in every clerkship, teaching with one of the clinicians.” Disciplines covered in medical humanities include: ethics, health policy, medical history, medical jurisprudence, psychosocial care and religious studies. The department also is home for the MD/JD dual degree program, one of 19 U.S. medical schools offering this combined degree.

2. Senior Clinical Competency Exam (1986, 2004)

The Senior Clinical Competency Exam (SCCX), developed by Reed Williams, PhD, Howard Barrows, MD, and others, has been used at SIU School of Medicine for more than 30 years. The school was the first among U.S. medical schools to develop this comprehensive, direct measurement of students’ clinical skills using standardized patients. What’s unique about this 14-station exam is that questions are administered randomly from any discipline of medicine. “This replicates what the student would see in practice,” notes Debra Klamen, MD, MHPE, senior associate dean for education and curriculum as well as professor and chair of the Department of Medical Education. Today, more than 90 percent of schools have some kind of clinical competency exam. The Step 2 Clinical Skills exam, which all students in the nation have to pass, now uses standardized patients in the testing process.

But what about students who fail this exam? “Most schools send students to a single preceptor for a month who guides students,” Dr. Klamen explains. “We decided that probably wasn’t the best way to assure students were competent.” In 2004, SIU developed the Senior Clinical Competency Exam Remediation, a four-week course in which students are immersed full-time with clinical faculty to walk them through symptom presentations and differential diagnoses, giving students feedback all the way along.

3. Nurse Educators (2000)

“I think this is the most innovative technique since standardized patients,” notes Dr. Klamen. SIU is one of only two medical schools in the nation who use nurse educators so extensively in their curriculums. The idea is simple: Experienced master’s-degree-educated nurses devote their days to educating students and ensuring they develop good clinical skills. Ten nurse educators have become embedded in the culture of SIU School of Medicine, working with nearly every department to ensure students in groups or individually receive guidance. The Department of Surgery is the only surgical program in the U.S. with two nurse educators. With nurses guiding them throughout their medical education, students develop positive attitudes toward nurses that carry over into their careers. SIU SOM was lauded by the Liaison Committee for Medical Education for its success using nurse educators. The school’s first nurse educator, Norma Wylie, MSN, RN, was hired in 1978. She was the first nurse to become a full professor with tenure at a U.S. medical school.

4. Surgical Skills Lab (2000)

Gary Dunnington, MD, professor and chair of the Department of Surgery, led efforts and secured grant funding to establish the Surgical Skills Lab—one of the first in the nation. Skills labs have revolutionized surgical training. Using computer simulators and virtual reality technology, surgical residents learn basic skills like suturing and knot tying and more advanced laparoscopic techniques. Users also include primary care residents, faculty from emergency medicine, internal medicine, OB-GYN and third- and fourth-year students, said Skills Center Director Janet Ketchum. Surgical skills specialists Jennifer Bartlett and Brian Hollinshead and Office Support Assistant Heather Rogers also work in the accredited lab.

Dr. Dunnington and other SIU faculty were integral in the development of a national curriculum for skills labs. SIU’s lab is a model for similar labs around the world. For a number of years, SIU hosted Surgical Skills Lab Workshops to assist other medical schools in building or enhancing a skills lab.

For more information about the Surgical Skills Center, see the Innovative Spaces article in this issue.

5. Longitudinal Performance Assessment (2005)

This assessment tests students’ growth in clinical reasoning across their four years of medical school training. “Previously, there had not been one test that looks at the growth of skill throughout the four years,” Dr. Klamen says. Students start each year of medical school by taking the test. Current questions include the ability of students to recognize a pattern of illness and clinical data interpretation. “We map the results over time to measure students’ progress. Then we know where we need to intervene,” Dr. Klamen says. Updating the assessment, faculty are planning to use photographs and other media to test detection of physical findings. In a dynamic twist, SIU is comparing its results of the Longitudinal Performance Assessment with six other schools so all the medical students will know how they’re doing in relation to their peers. Dr. Klamen hopes other medical schools will join this assessment with their students.

Next generation scientific research showcased at

TECHNOLOGY & INNOVATION EXPO

Investors and researchers gathered at the Chicago Merchandise Mart Oct. 10 for a look at how SIU technologies are making an impact on worldwide health and wellness. Presentations at the 2019 SIU System Technology & Innovation Expo were wide-ranging but struck a common, transformative chord: If developed, the resulting therapies and products have the potential to improve the health of vast populations.

The cannabis panelists, left to right: Aldwin Anterola, PhD, and Dale Buck Hales, PhD, both with SIU-Carbondale; Mitch Meyers, Nature’s Care Company; and Dina Rollman, Green Thumb Industries

Among the many topics:

  • Boyd Goodson, PhD, chemistry professor and acting associate dean of the College of Science at SIU-Carbondale, has perfected a process called “hyperpolarization” that enhances the sensitivity of MRIs (magnetic resonance imaging). By bubbling a gas through a liquid, his team can increase the equipment’s speed and power 300,000- fold. It would make the procedure more efficient and easier on the patient.
  • Debashree Mukherjea, PhD, research assistant professor of surgery at SIU School of Medicine, has helped develop a new drug that provides hearing protection from cisplatin, a commonly prescribed cancer chemotherapy treatment that causes deafness. The therapeutic drug also has recovery properties for noise exposure, so it could also benefit military personnel and become an emergency room staple.
  • Jay De Long, director of the Research Interchange for Southern Illinois University and University of Missouri Systems, previewed the new research portal developed by the academic groups to direct assets to solve research challenges and meet the needs of industry partners.
  • A diverse panel of experts discussed how cannabis business opportunities may be leveraged as Illinois’ legal landscape changes.

Additionally, two of the day’s presentations are already generating buzz within the medical community.

Hales talks with Keith Gagnon, PhD, SIU School of Medicine

MACHINE LEARNING

Machine learning (ML) is a new programming paradigm that uses code capable of learning by examples rather than rules. When applied to medicine, it can look at large datasets and provide another layer of expertise for screenings and routine imaging diagnoses.

Sara Robinson, a developer advocate for Google, explained how ML applications are programmed to recognize edges or patterns of pixels and learn as they process the information. They then can generate predictions based on the data input. ML medical applications already in use include diabetic retinopathy diagnosis, cancer detection using chest x-rays, and transcribing hand-written physicians’ notes.

“In areas of the world where there may not be enough doctors to treat an increasing incidence of disease, machine learning can be incredibly useful,” Robinson says.

She encouraged the scientists and entrepreneurs to consider adding machine learning to their studies to improve efficiency and accuracy. Google’s AI division has developed software (e.g., TensorFlow, Cloud AutoML and Google Vision API) for research and medical use.

Debbie Mukherjea, PhD, SIU School of Medicine

CRISPR SAFEGUARDS

Keith Gagnon, PhD, is an assistant professor in the Department of Biochemistry and Molecular Biology at SIU School of Medicine. His lab’s work was spotlighted in a June issue of the New England Journal of Medicine, for advances in CRISPR gene editing.

Gene therapy has been around since the 1990s, but took a very promising step forward in 2014, with the breakthrough of CRISPR (clustered regularly interspaced short palindromic repeats). CRISPR is an enzyme that can prune DNA within a cell, somewhat like a pair of molecular scissors. The cell then tries to repair the damage by adding or removing sequences. Through this mechanism, scientists can chemically control the process.

“The gene editing tool’s magic is in the guide RNA, which can be programmed to go to any of the thousands of genes in a person’s body,” Gagnon said. “It turns gene therapy into precision medicine.”

With all the promise shown by CRISPR, there is also concern about its side effects. One cut in the wrong gene could potentially trigger a disease like cancer. Gagnon’s lab has characterized the myriad of chemistries involved and established rules for modifications to the guide RNA, offering better guardrails to control the activity and specificity of CRISPR.

The group has also created molecules to act as “kill switches,” inhibitors that satisfy safety mandates and address side effects for specific therapeutic CRISPR applications. These can be fast-tracked into clinics because the FDA has already approved similar therapies.

Gagnon has two patents filed in the U.S. and Canada for the chemically modified CRISPR guide RNAs.

THEN & NOW