All posts by Greg Hack

How to Conduct a Good Death

Dr. Gary Salzman delivered the 2018 William T. Sirridge, M.D., Medical Humanities Lecture.

Former UMKC School of Medicine docent and Humanities Department namesake William T. Sirridge, M.D., was a master at connecting with patients, including in their final days.

So it was fitting that this year’s medical humanities lecture endowed in Sirridge’s name was titled “How to Conduct a Good Death.” Gary Salzman, M.D., a 1980 graduate of the School of Medicine, delivered the lecture March 22.

“William Sirridge was my docent and mentor and taught me many things not published in books,” said Salzman, himself a faculty member, docent and Truman Medical Center physician since 1985.

Sharing a half dozen stories about patients at the end of their lives, Salzman told the lessons he had learned from Sirridge and how they had played out in his career. The most important lesson focused on how to connect with patients.

“As we bring more and more technology into medicine, we become less and less able to connect with patients,” said Salzman. “Connecting with patients is as important today as it was 40 years ago when I was in medical school.”

Salzman first told two stories of how, as a student, he had failed miserably in dealing with a patient’s death. In one case, he was ill prepared and “got it all wrong” telling a woman over the phone that her mother had just died at the hospital.

In the other case, he had prepared a case for presentation by examining a woman with a classic case of scleroderma, studying the medical literature on the woman’s dire condition and working up a detailed treatment plan. But he had left out the human element, and was unaware that Sirridge had already tried the recommended treatments – which all failed. Instead, Salzman learned Sirridge was helping the patient and her three daughters take the necessary steps for the woman to die peacefully at home.

“He looked over his glasses and said to me, ‘Salzman, do you know how to conduct a good death?’ ”

After those two instances, Salzman said, he dedicated himself to listening, watching and learning from Sirridge and other veteran physicians. He saw that Sirridge’s skill at connecting with patients had three parts:

  • Physical touch. A gentle hand on a patient’s arm could be “more powerful than morphine.”
  • Common interests. Finding and sharing commonalities with some humor mixed in.
  • Direct and honest conversation.

As Salzman practiced and applied those principals over the years with dying patients and their family members, he began to learn how to conduct a good death, and to pass his lessons on to colleagues, residents and students.

Salzman recounted his education and evolution through cases that took him from trying to do too much for dying patients, to pushing too hard for removing life support. He told of one patient who, after being taken off life support, woke up, looked at him and said, “I need a beer!”

He found equilibrium by listening deeply, respecting patient and family wishes, and then doing his best to find a balanced course of action.

In one case, a hospice patient who recently reunited with his estranged spouse desperately wanted to live and have more time. Salzman, though skeptical, went with the man’s wishes and got him out of hospice and back home with a portable breathing unit. “Eight years later, he still sings my praises as the man who saved his life,” Salzman said. “I just listened to his wishes.”

And for patients “who want you to do everything,” Salzman said, “I tell them, ‘Let’s do everything that will help you, and nothing that will hurt you.’ ” Through that lens, he said, appropriate individual plans can be worked out for each patient.

Salzman closed with a case in which a sixth-year student got to know a patient with severe pulmonary fibrosis and her daughter. They were having trouble letting go even though the patient’s essential life-support mask, not meant for long-term continuous use, was causing her more and more pain and skin deterioration. Eventually, the student was able to describe what would happen if life support was removed, and what medicines would be used so the woman could die comfortably. Eventually, they agreed to remove the mask, and the mother died in peace.

“The student told me she determined the best way to connect with this family was to sit quietly, to just be present while watching television. So she watched ‘Ellen’ with them, most afternoons for two weeks.” Salzman praised the student on her outstanding work

“I told the student that I had a story that I wanted to tell her. It is about a man she never met but influenced her education. It is a story of my docent, William T. Sirridge, and a question he asked me a long time ago: ‘Do you know how to conduct a good death?’”

The lessons Dr. Sirridge taught on connecting with patients and conducting a good death learned by Salzman are now being passed on to current students. And, according to Salzman, these students will carry on, teaching these skills to their students and continuing the legacy of Dr. Sirridge long after his death.

Michael Hinni takes wing

Michael Hinni, M.D., ’88, a pioneer in head and neck surgery, is the 2018 winner of the E. Grey Dimond, M.D., Take Wing Award.

Hinni is professor of otolaryngology and head and neck surgery at the Mayo Clinic School of Medicine and head of the Mayo Clinic’s Department of Otolaryngology at Mayo Scottsdale. He is known for being in the forefront of developing minimally invasive procedures for surgical removal of head and neck tumors.

Those efforts included designing instruments to accomplish better, safer surgery; contributing to the published medical literature on such topics as how much tissue needs to be removed to completely clear malignancy from the throat and surrounding areas; and presenting the evidence for this medical advances at local , national and international forums.

In letters nominating him for the award, his colleagues praised him for displaying substance, purpose, courage, care for and loyalty to followers, integrity and self sacrifice.

As Take Wing winner, Hinni is scheduled receive his award and deliver the annual Take Wing lecture on May 21 at the School of Medicine and to speak as part of the School of Medicine’s commencement ceremony later that afternoon.

Surgeon says interventions can help disrupt cycle of violence

Dr. Moncure.

Violence tears apart too many young lives in minority communities, but interventions at crucial times can help reduce such violence and its effects, Dr. Michael Moncure said at the 2018 Dr. Reaner & Henry Shannon Lecture, held Feb. 23.

In his presentation at the UMKC School of Medicine, “Factors Associated With Interpersonal Violence in Minority Communities,” Moncure recounted anti-violence efforts from his career as a trauma surgeon. And he praised and drew hope from such recent efforts as Kansas City’s AIM4PEACE, which de-fuses violence with effective actions backed by research.

The direct results of violence are devastating, Moncure said, citing Centers for Disease Control statistics for 2015: 44,000 suicides; 17,000 homicides; and $107 billion in lost wages. In Kansas City, Missouri, he noted, homicides spiked in 2016 and remained high in 2017. The toll on minority communities can be devastating, and particularly tragic when young lives are lost or disrupted.

Moncure, a professor in the Department of Surgery at the School of Medicine, said his first job was in Camden, New Jersey, at the time notorious for crime and poverty. Moncure got involved with a program much like the TV show “Scared Straight,” which showed young people in high-crime areas how bad life could be if they committed violent crimes and were imprisoned.

“Those programs had some splash, but they weren’t evidence-based,” Moncure said. The programs ultimately were ineffective. “We even got a little cocky, and shared some of our materials with adults” in the criminal justice system. It was a reality check, he said, when those adults were unimpressed and even incredulous that Moncure and his colleagues thought their efforts would have any effect.

Research on violence and trauma and their causes and effects has come a long way since then, Moncure said, and trauma has come to be seen much more broadly than shootings or other violent crimes. Many studies have associated both recurring violence and adult diseases such as cancer, diabetes, heart failure and hypertension with the number and severity of someone’s ACES — adverse childhood experiences. ACES include poverty, divorce, and incarcerated parent, violence in the home and sexual abuse.

But research also has shown that interventions to support trauma victims at the right times can reduce the effects of such trauma and often prevent more violence.

For example, Moncure said one shooting often leads to another in retaliation. But an intervention specialist quickly summoned to a hospital bedside can help the wounded person and calm friends and relatives who might think they know who fired the shots and are bent on revenge.

In Kansas City, Missouri, Moncure said, the AIM4PEACE program specializes in such interventions, builds healthy relationships and gets results. Those efforts also are part of a community-wide plan that includes social support, counseling, job training and other efforts to combat violence. Another benefit of having research behind these efforts is demonstrating that they are cost-effective. Moncure believes this has helped get support from the Kansas City business community.

Henry and Dr. Reaner Shannon sponsor the annual lecture, given Feb. 23 by Dr. Moncure.

Thankful to be part of the annual Dr. Reaner and Mr. Henry Shannon Lectureship in Minority Health, Moncure noted that the series, developed to create awareness about health disparities affecting underserved and minority communities, encouraged exploring solutions to society’s problems.

“There’s no better use of science,” he said.

 

Research indicates racism a factor in pre-term births, lecturer says

Dr. Collins presented at Children’s Mercy Hospital.

 

Research indicating that stress from racism contributes to low birth weights and premature births was presented Feb. 22 at Children’s Mercy Hospital by Dr. James W. Collins Jr.

Collins, medical director for the Neonatal Intensive Care Nursery at Ann and Robert H. Lurie Children’s Hospital of Chicago, said pre-term birth rates in the United States had changed little in the past seven decades. The rate for African American women also has seen little change, remaining about 50 percent higher than for white women.

Collins’ presentation, titled “The Social Determinants of the Racial Disparity in Adverse Birth Outcomes: ZIP Code Eclipses Genetic Code,” reviewed several studies looking at possible causes or explanations for the persistent racial gap in low birth weights.

Those factors include age, education, income, upward economic mobility and geographic mobility, and they often correlate with rates of pre-term birth in predictable ways. For example, women living in low-income neighborhoods have more pre-term births than women in middle- or upper-income neighborhoods. But African American mothers in every type of income-bracket neighborhood still have higher rates of pre-term births than their white counterparts.

The results are much the same across the studies. Whatever factor is isolated and adjusted for, African American mothers still have higher rates of pre-term births. That leaves researchers looking for other causes, including racism and stress.

“Racism is kind of the elephant in the room,” Collins said. He presented research indicating that African American women who experienced racism more frequently and consistently in their lives were more likely to give birth prematurely.

“We are made to deal with acute stress pretty well,” Collins said. But when stress is chronic, such as from persistent racism, “you respond to acute stressors but you don’t come back down. I suspect this predisposes African American men to hypertension and African American women to pre-term birth.”

Collins said the biological mechanism for these ill affects was still unknown, but could be something that suppresses the immune system or otherwise fosters infections. But the exact mechanism doesn’t need to be known, he said, to see the problem as social rather than strictly medical, and to “go big” and “ecologic” in confronting and combating racism.

Medically, Collins said the day-to-day challenge for pediatricians is to provide comprehensive care for African American girls from before birth and to see them as potential mothers-to-be. Raising those girls for resilience, he said, while also working to change society, is work that requires everyone “to start slow and be tenacious.”

Collins closed with President John F. Kennedy’s reminder and exhortation that good and difficult work “will not be finished in the first 100 days … nor perhaps in our lifetime on this planet. But let us begin.” He then recited lines from Langston Hughes’ “Let America Be America Again,” with a gender switch:

O, let America be America again —
The land that never has been yet —
And yet must be — the land where every woman is free.

Eight School of Medicine students get 2018 awards from Women’s Council Graduate Assistance Fund

Eight School of Medicine students, double the number from last year, will receive awards from the 2018 UMKC Women’s Council Graduate Assistance Fund.

Across UMKC, 67 women received support gifts totaling $78,212.

The School of Medicine winners, their field of study, and their projects:

— Kelly Anderson, anesthesiology, will attend the annual American Academy of Anesthesiologist Assistants conference in St. Petersburg, Florida, with help from the Charles W. Nielsen Award in honor of Georgia Pierson Nielsen.

— Priyesha Bijlani, medicine, will present at the American Society of Hematology Annual Meeting and Exposition, with help from the Presidents and Past Presidents General Assembly of Greater Kansas City Award II.

— Taylor Carter, medicine, received funding for her Step 2 Clinical Knowledge and Clinical Skills medical licensing exams through the Soroptimist International of Kansas City Award and the Clarence and Shirley Kelley Award.

— Frances Grimstad, bioinformatics, received support to compensate transgender patients participating in radiology imaging as a part of her master’s thesis project, through the Curtis J. Crespino Award and Dorothy A. Stubbs Charitable Trust Award.

— Anna Grodzinsky, cardiology, received support to attend the Cardiac Problems in Pregnancy Conference from the Mary Kay McPhee and Bill Pfeiffer Award.

— Jessica Kieu, obstetrics and gynecology, received support to present research at the 16th World Association for Infant Mental Health World Congress through the Women’s Council Annual Fund Donors Award and Planned Parenthood of Kansas City Award.

— Grace Rector, medicine, received support for an out-of-country elective to provide care to the African pediatric population, through the Zonta Club of Kansas City, Missouri, II Award and the Harriette Yeckel Friendship Across Borders Award.

— Nyaluma Wagala, medicine, received support for her Orthopedic Research and Abstract Presentation through the Marilyn McGuyre and Frances Nelson Office of Student Affairs Award.

Compassionate care will get an extra boost during Patient Solidarity Week

Really listening to patients and providing empathetic, compassionate care have always been a big part of the UMKC School of Medicine’s physician education. Next week those elements will get an extra boost from National Patient Solidarity Week.

The week, Feb. 12-16 this year, is sponsored by the Arnold P. Gold Foundation, a nonprofit organization that promotes patient-centered care. UMKC has had a chapter for 15 years and last month inducted more than three-dozen new members.

National Patient Solidarity Week activities are designed to strengthen the bond between patients and their physicians, nurses and other care givers. By increasing such engagement with patients, the program aims to enhance patient and staff satisfaction and improve health care outcomes.

For several years, members of the school’s Gold Humanism Honor Society chapter also have delivered roses and Valentines to Truman Medical Center patients on or near Valentine’s Day. And for the past three years, a “Tell Me More” activity during the week has emphasized medical students’ conversations that engage patients on important non-medical aspects of their lives.

Answers to some of the questions (such as “How would your friends describe you?”) are written on posters and hung at the head of each patient’s bed, so that everyone on the health care team has the opportunity to relate to patients in ways other than their clinical diagnoses. 

Members of the School of Medicine chapter of the Gold Humanism Honor Society and their faculty sponsor, Carol Stanford, M.D., delivered roses and Valentine's cards to patients at Truman Medical Center.
For several years, members of the School of Medicine chapter of the Gold Humanism Honor Society and their faculty sponsor, Carol Stanford, M.D., have delivered roses and Valentine’s cards to patients at Truman Medical Center.

 

 

 

Introducing UMKC’s new chancellor, C. Mauli Agrawal

UMKC chancellor designate C. Mauli Agrawal

University of Missouri System President Mun Choi announced that C. Mauli Agrawal, interim provost and vice president for academic affairs at the University of Texas at San Antonio, has been appointed chancellor of the University of Missouri-Kansas City, effective June 20.

“I’m thrilled that Dr. Agrawal has agreed to serve as the next chancellor of UMKC, and I’m confident that the university will reach new heights of success in research, education and outreach through his leadership,” Choi said. “UMKC has an outstanding team of administrators, faculty, staff and alumni supporters who will work closely with him to achieve our collective vision.”

David Steelman, chair of the University of Missouri Board of Curators, said, “We had a very strong finalist pool, but what made Dr. Agrawal stand out was his combination of strong academic credentials with proven entrepreneurial skills. He understands the mission of UMKC, but he also knows that mission can only be fulfilled through innovative approaches and risk; he is not a status quo leader.”

Choi will introduce Agrawal to the Kansas City campus at 10 a.m. Friday in Spencer Theatre in the Olson Performing Arts Center. The event will be streamed live at www.umsystem.edu.

“I’m very grateful for the work of the search committee members who spent countless hours reviewing and interviewing candidates,” Choi said. “I’m also extremely appreciative of Dr. Barbara Bichelmeyer, who has made important contributions as interim chancellor and provost at UMKC. Dr. Bichelmeyer will continue in her role as interim chancellor during the transition period and will return to her provost role when Dr. Agrawal arrives in June 2018.”

Bichelmeyer is leading a number of key initiatives that will continue to move forward at UMKC, including academic reorganization, academic portfolio review, strategic plan development and the budgeting process.  She has the full backing and support of Choi to implement changes to achieve UMKC’s goals of excellence in student success, research breakthroughs and effective engagement.

“I will work closely with Dr. Bichelmeyer to make the important and necessary changes during the transition period,” Choi said. “We are indebted to her for her work in continuing to move UMKC forward. She will be a great asset to Dr. Agrawal as he moves into this position.”

Bichelmeyer said she looks forward to working with the new chancellor.

“I’m excited to partner with Chancellor-designate Agrawal and look forward to his arrival in Kansas City,” she said. “His background and experiences complement the mission and vision of UMKC – and together, with all the great partners on this campus and in this metro area, we will keep the momentum going as we grow UMKC into the great university this region needs.”

Before his appointment at UTSA, Agrawal served as vice president for research and dean of the College of Engineering. He also has been a professor of orthopedics and bioengineering at the University of Texas Health Science Center in San Antonio, one of the largest medical schools in the United States. He obtained a doctorate from Duke University in 1989, a master’s degree from Clemson University in 1985 and a bachelor’s degree of technology from IIT-Kanpur, India.

“I’m very excited to be chosen to help lead this great university. The potential for the University of Missouri-Kansas City is immense and exciting,” Agrawal said. “UMKC has all the elements necessary to make a great university. With strengths in medicine, dentistry, pharmacy, business, engineering, arts and theater, the university is an exceptional anchor for economic development in the Kansas City region. I’m looking forward to working with UMKC’s faculty and staff as well as Kansas City’s civic leaders who are passionate about higher education and are constantly working to make Kansas City a great place to live, learn and work.”

During his tenure as dean, Agrawal led the UTSA College of Engineering to a 40 percent increase in student enrollment, a 50 percent increase in faculty, and a 400 percent increase in research funding. In 2010, he worked closely with the city of San Antonio and Mayor Julian Castro to establish the Texas Sustainable Energy Research Institute at UTSA, which received a $50 million pledge of support from CPS Energy, the city-owned utility operation.

“Mauli is a beloved member of the San Antonio community who has earned admiration and respect from the university community, the business community and civic leadership,” current San Antonio Mayor Ron Nirenberg said. “I certainly wish him the very best at UMKC. You have an absolute gem of a man to lead the university forward. He understands the important role that a university plays in the civic life of a city and has a unique skill set of translating that role into meeting the needs of the university. His skill set is one of a kind.”

Agrawal has served on the editorial boards of various scientific journals, including the Journal of Biomedical Materials Research, Tissue Engineering, the Journal of System of Systems, and the Journal of Tissue Engineering and Regenerative Medicine.

Agrawal’s research specializes in the area of orthopedic and cardiovascular biomaterials/implants, and he has written more than 300 scientific publications and holds 29 patents. He is a Fellow of Biomaterials Science and Engineering, the National Academy of Inventors, the American Association for the Advancement of Science, and the American Institute for Medical and Biological Engineering.  Additionally, he served as president of the Society for Biomaterials in 2006. His bioengineering research group has been responsible for starting three companies in San Antonio.

 

School of Medicine welcomes 2018 Gold Humanism Honor Society members

The 2018 Gold Humanism Society inductees.

The School of Medicine’s Gold Humanism Honor Society welcomed the 2018 class of inductees during its annual induction ceremony on Jan. 20 at Diastole.

It is the 15th consecutive year that the UMKC chapter has recognized students with induction into the national organization. More than three-dozen new members were chosen — 17 students and 20 who are residents, fellows or faculty members.

The students were selected from nominations made by colleagues and faculty based on their excellence in clinical care, leadership, compassion and dedication to service. Members are selected for their exemplary care of patients and their humanistic approach to clinical practice. Dr. R. Stephen Griffith, M.D., and Dr. Glenn E. Talboy Jr., M.D., were this year’s faculty inductees.

With funding support from the Gold Foundation, the School of Medicine established its chapter of the honor society in 2004. A Graduate Medical Education chapter was added in 2014 specifically for School of Medicine/Truman Medical Center residents.

Established in 2002 by the Arnold P. Gold Foundation, the Gold Humanism Honor Society today has 30,000 members nationally in training or practice. It recognizes 149 undergraduate medical education and 14 graduate medical education chapters at medical schools throughout the country.

Members are viewed by their peers as role models for humanistic care within their communities. The society also provides educational events, supports research, promotes professional growth and creates networking opportunities.

2018 Gold Humanism Honor Society

STUDENTS

Avosuashi Akande
Muhammed Alikhan
Saba Bajwa
Deven Bhatia
Matthew Decker
Ahmed Elbermawy
Luke He
Cindy Jiang
Christian Lamb
Raksha Madhavan
Dominic Nardi
Imran Nizamuddin
Uzoamaka Ofodu
Ajay Patel
Ami Purohit
Kale Turner
Vivek Vallurupalli

FACULTY

Dr. R. Stephen Griffith, M.D.
Dr. Glenn E. Talboy, Jr., M.D.

FELLOWS

Amine Bourbia
Stephen Eikerman
Mir Fahad Faisal
Charles McMahon

RESIDENTS

Hussein Asad
Laith Derbas
Jeremy Jennings
Jonathan Kendall
Olivia Kwan
Barbara Nguyen
Anas Noman
Thomas Odeny
Madhuri Ramakrishnan
Shubha Deep Roy
Anweshan Samanta
Justin Stowell
Merrill Thomas
Kaitlin Wittler

He Wrote the Book on That

Waldman’s wealth of textbooks fills needs in practice, education

“HE WROTE THE BOOK ON THAT” usually is a figure of speech. But when it comes to diagnosing, treating and managing pain, Steve Waldman, M.D. ’77, did write the book — dozens, in fact.

His “Interventional Pain Management,” published in 1996, was the first textbook on the new subspecialty of interventional pain management, said Waldman, the School of Medicine’s associate dean of international programs and chair of the Department of Medical Humanities & Bioethics. Other groundbreaking works followed.

Waldman coined the term interventional pain management, for treating pain as the primary focus instead of as a symptom, like fever.

“That was a big shift in pain management,” said Waldman, a clinical professor of anesthesiology at the School of Medicine since 1992. “There were great advances in medical knowledge in the field but the literature really lagged. There was a need and I wrote the book.”

Steven Waldman and book collection.

Steven Waldman, M.D. ’77, has published 29 medical textbooks, in addition to hundreds of peer-reviewed articles and book chapters.

For more than 20 years, Waldman has kept seeing such needs and writing books to meet them, on pain management and on his other area of expertise, diagnostic ultrasound. His published writings have grown to 29 leading medical textbooks, chapters in dozens of others, and more than 240 articles, reviews and other contributions to peer-reviewed journals.

Several of his books have gone into multiple editions, a sign that they are filling vital medical needs and that Waldman is committed to keeping them up to date. Besides topping medical-text sales charts, the books have won awards such as the 2016 British Medical Association Book Award for the third edition of “Physical Diagnosis of Pain: An Atlas of Signs and Symptoms.”

How does an author become so prolific, while also teaching and fulfilling two key administrative posts at the School of Medicine? His longtime editor at W.B. Saunders Co., Michael Houston, said Waldman combined practical knowledge with a keen focus on thoroughness and maximum efficiency.

“Dr. Waldman is one of our most productive and dependable authors,” Houston said. “He is very much aware of what the practicing pain management physician needs to know day to day.”

One physician who values Waldman’s deep knowledge and ability to explain and display medical concepts is Commander Ian M. Fowler, M.D., the head of pain medicine and anesthesiology for the U.S. Navy.

“The anatomic illustrations, radiographic and ultrasound images and detailed explanations in Dr. Waldman’s procedural and comprehensive pain management textbooks have improved my care of patients and improved the learning of my trainees,” Fowler said. “He has kept these informative textbooks up to date with frequent new editions and text on emerging technologies such as ultrasound guided procedures.”

On many of his books, Waldman’s productivity has been enhanced with the help of his three sons and daughter. They’ve done everything from acting as a sounding board for ideas and models for photo illustrations to co-writing, editing and proofreading.

Waldman’s efforts are far from finished. His latest project is a textbook on the use of technology in medical education, which he is writing with a professor at Trakya University in Turkey. Several faculty at UMKC also are contributing.

How much Waldman’s texts have helped medical education and practice is impossible to measure. But his books have been translated into a dozen languages, so their reach is global.

“When I was in China last year representing UMKC at the Edgar Snow Symposium, we toured the hospital at Peking University,” Waldman said. “It was gratifying to see a copy of one of my books, in Chinese, being used in a procedure there.”

Exchange program brings Peking University medical students to UMKC

Two medical students, a man and a woman, are asked why they wanted to study medicine.  

“Because doctors can save lives and help heal wounds,” he replies. For her, being a doctor “means I will be able to take care of my family, both financially and physically.” They add that social status and family pride will be nice side benefits, too.  

Zhang Qiming (back left) and Gao Yufei (right front) were met by student ambassadors from the UMKC School of Medicine in a welcoming reception at Diastole.

Their answers may be typical. But the students, Zhang Qiming and Gao Yufei, are not — at least not in the halls of the UMKC School of Medicine. They recently wrapped up a month-long exchange visit from the Peking University School of Medicine, seeing how one American school educates the next generation of U.S. physicians. 

Some differences between their school and UMKC are obvious. One is the Hospital Hill campus, “which is like a park,” Zhang said, with green space between the med school and the Health Sciences Building, in contrast with the walled area of their university and hospital. Another is UMKC students’ individual offices in their docent unit. Compare that to much tighter, shared study spaces at Peking University. 

And then there is UMKC students’ freedom — and much greater expense — to live and eat where they want to.  

“At our school, the majority of students live in the dormitories, all eight years,” Zhang said. 

“And we take all our meals in the canteen on weekdays,” Gao added. 

To do otherwise would simply cost too much, Zhang said, especially in Beijing, where already high rent and other living expenses have risen rapidly in the past 10 years.  

But there also are similarities between UMKC and Peking University, including how difficult it is to get into medical school.  

Zhang and Gao, both 23 years old, had to be top students to study medicine at Peking University, regarded as “the Harvard of China.” Zhang was in the top 50 of 200,000 high school seniors who took a university placement exam in his province of Fujian, on China’s southeast coast. Gao faced a similar challenge in her province of Yunnan, in southwest China. 

Peking University’s medical program is eight years, like most traditional U.S. medical schools that follow four years of undergraduate work to earn a bachelor’s degree. And like UMKC’s six-year B.A./M.D. program, their medical school takes students straight from high school. The last two years are known as a residency, and emphasize patient care. After graduation, Chinese medical students still must get further training, similar to U.S. residency programs. 

Zhang and Gao have completed their fifth year. “We have taken many classes to prepare us, including basic sciences and medical sciences,” said Gao. “We have not spent much time yet seeing patients, as students here have, but we will in our final three years.” 

In China, Gao and Zhang also have been exposed to various branches of medicine, and each has settled on a specialty — ophthalmology for Gao and urology for Zhang. During their UMKC visit, they have been able to see those specialties taught and practiced at the School of Medicine, Truman Medical Center-Hospital Hill and the Eye Foundation of Kansas City. 

“My first years at university were a bit overwhelming; there was so much information to learn,” Gao said. “But when I found ophthalmology, I knew what I wanted to do. I believe interest is the best teacher, and I am very interested in learning everything about how our eyes work. Because I have myopia and must wear glasses, I understand how terrible it is to have bad vision.” 

Zhang is similarly excited about his chosen area. 

“This is a very strong area at our medical school—urology and urological cancer,” he said. “I also want to be a surgeon, and some of the best cancer surgeons are in urology.” 

Zhang and Gao are the first students to visit UMKC under a new cooperation agreement between the School of Medicine and Peking University. The universities hope for further exchanges of students and faculty, along with research collaboration. UMKC’s leadership in bioinformatics and other research was one reason the Chinese school was interested in adding UMKC to its U.S. partners. 

The agreement came at the right time for Zhang and Gao, because after their fifth year, students in their program are eligible to do an international rotation. 

Their stay, which ran through Dec. 10, began with a welcoming reception at the Diastole Scholars’ Center and a meeting of the board of the Edgar Snow Foundation. The foundation carries on the legacy of Snow, an American journalist who was the first Westerner to report extensively on China under Mao Zedong. Snow and School of Medicine founder E. Grey Dimond were friends, and Gao said one highlight of the trip was seeing Snow’s papers, which are housed at UMKC’s Nichols Library. 

Zhang and Gao said they enjoyed meeting faculty and students, and were eager to share what they had learned about the docent system and other aspects of the UMKC School of Medicine.  

“I like how each third-year student has one-to-one help from a fifth-year student,” Gao said, “and they continue as fourth-year and sixth-year students. There is so much support.”