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Med student Briggs joins surgical team on Dominican Republic mission

View of the ocean from the roof of Hospital el Buen Samaritano in La Ramona, Dominican Republic, where UMKC School of Medicine student Kayla Briggs is part of a surgical mission team. The smokestack in the distance is a sugar refinery.
Kayla Briggs

Kayla Briggs, a sixth-year student at UMKC School of Medicine, is part of a 11-person group that left Saturday for the Dominican Republic on an eight-day medical mission trip.

The team consists of physicians, nurses, paramedics, an interpreter and Briggs.

Visit the UMKC School of Medicine’s PRN news page regularly to read Kayla Briggs’ daily blog beginning March 18 as she takes part in an eight-day surgical mission trip to the Dominican Republic.

Working from the Good Samaritan Hospital in La Ramona, Dominican Republic, the group plans to spend the first two days in clinics meeting patients and assessing needs before spending the remainder of its time performing surgical procedures.

“We will have two operating rooms, one for general surgery and one for urology,” Briggs said.

The team will be performing elective procedures such as repairing hernias, removing gallbladders and excising masses all in hopes of preventing patients from encountering more serious complications in the future.

Briggs will serve as the first assistant in the operating room once the surgery procedures begin. She has already completed seven months of surgical rotations at UMKC. On March 17, which was Match Day, Briggs learned that she will begin a surgical residency at the University of California-Davis Medical Center in Sacramento, California, this summer.

“I’ve done medical mission trips before but never a surgery trip, so I’m really excited about this trip,” she said.

The mission is a collaborative effort with the Dominican Republic Medical Fellowship.

Other members of the mission team include:

  • Glenn Talboy, M.D., Chair and Program Director of the UMKC Department of Surgery
  • Edna Talboy, interpreter
  • Teisha Shiozaki, M.D., chief resident, UMKC general surgery
  • Patrick Murphy, M.D., section chief, Children’s Mercy Department of Urology
  • John Gatti, M.D., director of minimally invasive urology, Children’s Mercy Department of Urology
  • Louise Davis, CRNA and mission trip coordinator
  • Reidun Fuemmler, CRNA
  • Scott Davis, CRNA
  • Vahe Ender, paramedic
  • Matt Libby, paramedic

DAY ONE, SATURDAY, MARCH 18
Kayla Briggs

Today was quite the day – we had to be at the KCI airport at 4:30 am. After a relatively short layover in Chicago, we headed to Punta Cana, Dominican Republic.

The Dominican Republic is a hot tourist destination and the airport shows it. The terminals are modeled after tropical huts with straw roofs.

Our bunks, complete with Peanuts sheets.

Navigating customs was surprisingly easy. After picking up our five duffels and several rolling bags of surgical supplies, we headed to the exit where our bags were scanned once more. Our surgical instruments looked like weapons in the scanner and we were held for nearly 30 minutes trying to explain who we are and what we’re doing here. After lots of talking (shoutout to Edna Talboy for being an incredible translator), we were released.

We rented our cars (a van and sedan) and were on our way to La Romana – about a two hour drive. The highway system is what you see in the U.S. and was easy to navigate. Once in the city and at our mission, we unloaded our personal belongings.

The mission has separate bunks for women and men with a common room. All our sheets and linens are provided.

All meals are cooked by the ladies at the Mission. They take great care of us!

After a great dinner of roasted chicken, rice, and beans, we headed off to Jumbo. The only way I can describe it is a mix of Walmart, Target, H.E.B., and a department store … except much shinier. They have EVERYTHING – food, clothes, electronics, appliances, outdoor supplies, you name it. It was fun to browse the aisles and see what brands are similar and what’s different.

After picking up some snacks, we headed back to the mission to meet Matt and Vahe, the two paramedics joining our group from Boston. We then walked to the local restaurant and had ceviche, calamari, and bruschetta. Needless to say, we all slept like rocks after a long day of travel.

 


DAY TWO, SUNDAY, MARCH 19
Kayla Briggs
The Mission Team: (left to right) me (Kayla Briggs, MS6); Reidun Fuemmler, CRNA; Vahe Ender, paramedic; Edna Talboy, translator and surgeon wrangler; Dr. Glenn Talboy, general surgeon; Matt Libby, paramedic; Dr. Teisha Shiozaki, general surgery chief resident; Dr. Pat Murphy, pediatric urologist; Louise Davis, CRNA and mission trip coordinator; Scott Davis, CRNA; Dr. John Gatti, pediatric urologist.

Because it’s the weekend, we slept in a bit. Breakfast was served at 8 a.m. and was a hearty offering of pancakes, bacon, sausage, and fresh pineapple and papaya.

Hospital el Buen Samaritano

After breakfast, we headed off to Hospital el Buen Samaritano. It’s a private hospital that is funded by the Village Presbyterian Church. The operating rooms have the basics – anesthesia machines, overhead lights, and one even has a C-arm for taking X-rays during orthopedic cases.

We spent the morning organizing the plethora of supplies – laparoscopic equipment, suture, instruments, suction tubing, drapes, sterile water, sterile towels, liter boluses, etc. After dividing the two operating rooms (one for adults, one for children), we headed to Jumbo again to shop. Then it was time for lunch.

Unloading medical supplies.

After a busy morning, garlicky noodles with chili and a short siesta was just what we needed. Our afternoon was spent seeing all the patients that had been identified in the bateys (rural areas where the sugar workers live) by the promotoras (health promoter) as needing surgery.

On the adult side, 21 patients were scheduled for pre-operative evaluation. Patients were asked about their past medical history, any prior surgeries, and if they’d ever had trouble with anesthesia. Twelve were scheduled on the adult side with three more that will be coming tomorrow for evaluation (transportation can be an issue for some).

I was reminded time and time again just how rusty my Spanish is. Without Alex and Edna, our amazing translators, it would be impossible to provide safe and smooth patient care. After refueling with a dinner of roasted pork, potatoes, broccoli, and carrots, we indulged in coconut pie and passion fruit cheesecake from a local bakery. We then fell into our nightly routine: a walk to Jumbo followed by relaxation at the restaurant. Tomorrow, we start operating at 8 a.m.!


DAY THREE, MONDAY, MARCH 20
Kayla Briggs

Breakfast is served at 7 a.m. on the days we’re working. Oatmeal and fresh fruit energized us for the day ahead.

Dr. Shiozaki (right) and me operating. Reidun is behind us administering anesthesia.

We arrived at the hospital just after 7:30 and patients showed up shortly thereafter. On the agenda for the adult room was a laparoscopic cholecystectomy (removing the gallbladder), lipoma excision, and fibrous adenoma excision. The pediatric room performed three hernia repairs, one case involving the removal of a child’s extra digits (called polydactyly), and a ganglion cyst excision.

It felt great to be back in the OR! After the first two cases, we took a break outside in the courtyard to eat a lunch of ham and cheese sandwiches and rice. There’s nothing like enjoying a real sugar sweetened Fanta underneath the warm Dominican sun.

We finished operating at around 4 p.m. After monitoring our last patients for post-operative complications, we instructed them all to return to clinic on Friday for wound checks.

Flat Lyla amongst a bed full of gifts.

Lyla Graham, a 12-year old from back home, had family and friends donate gifts for the children in lieu of receiving birthday presents for herself. We toted around a drawing of Lyla that we lovingly named ‘Flat Lyla’ (in the tradition of Flat Stanley) and snapped a few photos of the children with their gifts. These were not only a great tool for distracting purposes, but were also the sweetest parting gift before sending the children home.

Muchas gracias, Lyla!

We experienced our first tropical rainstorm (what seemed like a torrential downpour) of the trip during our evening siesta time. Dinner was fantastic – roasted chicken, rice, beans with lentils, roasted carrots, and fresh cherry lime juice. Dessert was just as good – a massive chocolate layer cake filled with dulce de leche.

Tomorrow is our busy day. Can’t wait to update you all on how it goes!


DAY FOUR, TUESDAY, MARCH 21
Kayla Briggs
Dr. Talboy and me excising a lipoma.

WOW – what a day!

Teisha said something the other day that resonated with me. When she’s not busy, she has a tendency to be lazy. When she is busy, she is more energized. I found myself relating to that and I think most surgeons would agree – downtime or a lighter schedule is nice, but being busy makes you feel productive and useful.

Working on a massive lipoma that was hidden under a patient’s deltoid (shoulder) muscle. Couldn’t have done it without Dr. Talboy’s help!

Today was our busy (and productive) day.

The pediatric room performed three cases (all inguinal hernias). We did six cases on the adult general surgery side: one laparoscopic cholecystectomy, two lipoma excisions, two inguinal hernia repairs, and one add on hydrocele repair. We did our best to stay on a tight schedule. I got to help a lot with our first lipoma excision (on the back of the patient’s neck) and got to perform a significant portion of the lipoma excision on our next patient’s arm (with the expert assistance of Dr. Talboy, of course!).

The first case – the laparoscopic cholecystectomy – was not without a few hiccups. The power in the Dominican Republic is not as reliable as in the States. Just as we were achieving our critical view the power went off – taking away our “eyes” by cutting power to our camera and light cord. In the room next to us, an OB/GYN was performing a c-section. After three minutes of wondering when the backup generator was going to kick in, the lights flickered back on. We heard a newborn’s cries shortly thereafter, and finished the remaining cases without further incident.

Just one of our amazing meals!

Our meals were fantastic. Breakfast was scrambled eggs and fresh croissants. Lunch was empanadas and rice delivered to the hospital. Dinner was roasted chicken, pasta, potato salad, fried plantains, tres leches cake, and banana pineapple juice. I don’t think any of us will come back from this trip any slimmer.

Today, we broke from tradition and drove to Plaza Lama instead of walking to Jumbo. Different selection, similar massive super store idea.

Our schedule is all downhill from here! We have two lipoma excisions and one inguinal hernia repair tomorrow. I’m excited for the lipomas – they’re satisfying.

Kayla


DAY FIVE, WEDNESDAY, MARCH 22
Kayla Briggs
Teisha teaching a U. Mass nursing practitioner student how to suture.

Today was an eventful day. We started off with a breakfast of French toast and bacon before heading off to the hospital. Our first case went off without a hitch – an uncomplicated bilateral inguinal hernia repair. Our second case was a slightly more complicated. After a few tense moments, we successfully repaired a patient’s hydrocele and hernia. He was admitted to the hospital and we will check on him tomorrow morning.

We followed with a simple forehead lipoma excision. While in the recovery room, the patient and his mother took a look at our work in the mirror and returned to shake our hands numerous times. They were so thankful to have such a simple but visible problem resolved. It was a great reminder of why we do this.

During our cases, two c-sections were performed in the OR next to us. We had so much fun fawning over the babies; they were so cute.

¡La playa bonita! Beach Day!

After a quick lunch of braised chicken and rice, we finished up all the cases (including three inguinal hernia repairs on the pediatric side) by 1 p.m. We all looked at each other knowingly and said, “Beach day? Beach day.”

We returned to Casa Pastoral to grab our swimsuits and sunblock before heading to a public beach in Bayahibe, a 30-minute drive from La Romana. The scene was picturesque. A bright sunny day, sandy beach, beautiful water, happy voices of people from all over the world carrying in the wind, and plenty of Lay’s limón potato chips (our favorite!). The waves were so tranquil, perfect for jumping in without being too rough. I haven’t been on a beach since my fourth year in the program and I had forgotten how much I missed the ocean.

Dinner was (once again) delicious. Braised pork, rice and beans, and carrots with cabbage. Dessert was a super rich, super tasty carrot cake. After dinner, we walked to the central square in La Romana and went to Trigo de Oro, a French bakery and restaurant. At about 8:30 p.m., yawns were circling the table and we decided it was time for bed.

Tomorrow is a quick day – two lipoma excisions. Dinner will be at a pizza parlor on the river. Can’t believe tomorrow is our last day of operating!


DAY SIX, THURSDAY, MARCH 23
Kayla Briggs
Dr. Patrick Murphy, Dr. Glenn Talboy, Kayla Briggs, and Dr. John Gatti.

¡Hola mis amigos!

The name of the game is to front-load cases at the beginning of the week to make room for any add-ons. Today was a lighter day; we were scheduled for two cases in the adult room and three in the pediatric room.

First, we checked in on the patients we admitted to the hospital yesterday. They were doing well and were discharged later in the day. Our first case was a neck mass excision that we initially thought was a lipoma. After removal, we discovered that it was actually an infected cyst. The second was a foot mass that turned out to be a ganglion cyst.

Our pre-op and post-op room is the same three-bed space. Because the cases are elective procedures on healthy patients, once the patient is alert, can eat and drink, and is able to walk, he or she can go home. For cases like the foot mass, you want to ensure the patient isn’t in pain and won’t move during the case. Our awesome CRNAs came up with the idea to lightly sedate the patient and administer an ankle block in the hopes of numbing up their foot. Not only did this work like a charm (the patient snored as we were cutting out the large mass) but will also provide extended pain relief.

After both rooms had completed their first two cases, we hung around and ate empanadas with a side of rice and beans for lunch. The third child never arrived so we decided to pack up our equipment.

Group selfie.

Louise, our mission coordinator, has been on this trip 21 times. Dr. Murphy has been on it many times, too. They’re experts at identifying what leftover supplies can be donated, what we should save for next year, and what we’ll need when we come back. That’s one thing I’ve loved about this trip. It’s a sustainable effort and you don’t leave feeling that without your presence, the patients are abandoned.

After packing up our supplies in the hospital, we headed back to the mission to clean up. We ate at El Chiringuito, a local pizza shop. The food was incredible – chewy pizza crust, plenty of cheese, and lots of fresh ingredients. The company was excellent, too.

Tomorrow, we will see patients back in clinic for post-op wound checks. Our afternoon will be spent at the beach with plenty of sunblock and Lay’s limón chips. Hard to believe this trip is almost over.

Weidling chosen for public health scholars program

Robert Weidling

Robert Weidling, a fifth year medical student at the School of Medicine, has been selected to participate in a scholars program that prepares public health professionals to meet population health challenges at the community and national levels.

The Paul Ambrose Scholars Program helps students develop leadership and organizational skills in public heath education through activities outside the classroom.

As a member of the program, Weidling will participate in online public health assessments, the planning, implementation and evaluation of a local community health project, and a public health leadership symposium.

Scholars learn to define and recognize evidence-based public health programming, obtain resources and carry out public health intervention, use logic models for planning public health programs and serve as public health advocates.

More than 600 students from 207 academic institutions across the country have participated in the program since its inception in 2002.

The yearlong program is sponsored by the Association for Prevention Teaching Research and the Office of Disease Prevention and Health Promotion. The organization is a national association of medical and health professions institutions and faculty promoting prevention and population health education and research.

Students reach out to community with free health fairs

apamsa-slider_health-fair
Members of the School of Medicine’s Asian Pacific American Medical Student Association recently organized and conducted two free community health fairs.

UMKC School of Medicine members of the Asian Pacific American Medical Student Association reached out to underserved populations of the community with two free health fairs.

Students conducted glucose and blood pressure screenings, and cholesterol and lipid profiles at an Oct. 15 health fair for the local Vietnamese community at the KIPP Endeavor Academy Charter School. The second health fair was Oct. 29 for the Indian community at the Hindu Temple and Cultural Center.

Nearly 30 medical student volunteers as well as  UMKC pharmacy students and local physicians participated at each event, said APAMSA member Sarthak Garg.

“The majority of the people that show up are elderly and don’t go to the doctor as often,” Garg said. “This is, for a lot of people, the main time that they’re getting those screenings.”

Students and volunteers from the local Vietnamese and Indian communities also served as translators between the patients and those conducting the screenings.

The student volunteers were largely made up of first and second-year medical students. Second and third-year students are generally paired with a first-year student to act as a mentor during the screening sessions.

“This lets them see what’s going on and gives them some hands-on activity without them struggling,” Garg said. “They have someone to guide them.”

APAMSA is one of the largest student groups at the School of Medicine with more than 100 members. Three student coordinators work together as organizers for each event along with the organization’s 16-member board of directors.

The APAMSA health fairs have become annual events. Garg said the younger students participating get experience working with patients before they start their clinic and docent rotations.

“It’s not hard,” he said. “It’s something that gives them the understanding that everything is not just about school stuff, it’s also about getting out there in the community. And it starts building that confidence.”

 

Hasnie selected to AMA Med Student Section planning committee

usman-hasnie
Usman Hasnie

Usman Hasnie, a fourth-year medical student at the School of Medicine, was selected to a national leadership position with the American Medical Association. Hasnie was one of 15 medical students elected to a one-year term on the organization’s Committee on Long-Range Planning.

The committee focuses on issues surrounding the AMA’s Medical Student Section. These include issues such as structure, function and strategic planning as presented by the student section’s governing council.

Recently, Hasnie has been working with members of the planning committee to provide a report on the value of restructuring districts and the relationship to delegate voting among the medical student section of the AMA. The report will be presented at this month’s interim AMA meeting in Orlando, Florida.

Hasnie said the committee is also preparing a featured educational event for medical professionals and students on technology resources to help prevent physician burnout. That event will also be presented at the upcoming interim meeting.

UMKC ambulance adds new experience to EMS training

EMS Ambulance
The UMKC School of Medicine’s Emergency Medical Services program purchased an ambulance for simulation and training exercise earlier this summer.

A team of paramedics worked together to carefully load the accident victim into an ambulance. The emergency medical personnel continued to monitor the patient while maintaining the necessary life support techniques as the vehicle left the scene.

The scenario is actually a training exercise for Paramedic and Emergency Medical Technician students at the UMKC School of Medicine.

EMS Ambulance3The school’s EMS program purchased an ambulance in May from an emergency vehicle dealer in Toledo, Ohio, who also detailed it with UMKC’s blue and gold colors, the School of Medicine logo and program signage. The rear of the ambulance also displays the Freedom House Ambulance Service logo in honor of the first paramedics in the United States.

After getting the vehicle to Kansas City, EMS education program director Paul Ganss, MS, NRP, NCEE, CHSE, spent a few weeks having it equipped to look and perform like a real ambulance. The ambulance has also been modified to support the use of the school’s high-fidelity simulators, such as its SimMan 3G and SimMom manikins, in the field environment.

Ganss said the vehicle expands the program’s capability of creating a realistic experience and allows students in the School’s Paramedic and Emergency Medical Technician training programs to practice in a unique environment.

EMS Ambulance4“We can set up calls around the area, put simulated patients out there, and the students go out and take care of them,” Ganss said. “It gives them the experience of working in that environment. Working in a moving vehicle, that is challenging and this makes it more real for the students.”

The ambulance is not used to transport actual patients, but Ganss said it is stocked with equipment that mirrors an actual in-service vehicle. Earlier this summer, members of the EMS education program took the ambulance to Hutchinson, Kansas, to participate in a state-wide field day training exercise at the Kansas State Fairgrounds. EMT students participated in a field operations night in July by responding to mock calls around the Hospital Hill campus.

UMKC’s Emergency Medicine Residency Program has expanded its training as well and uses the vehicle to allow residents to experience what takes place in caring for patients as they are transported to a hospital emergency room.

“Some EMS programs have a mockup of an ambulance to train in,” Ganss said. “What’s unique about our setup is that we’re a medical school that has a training and simulation ambulance and that we have expanded it beyond the EMS students.”

Hassanzadeh receives AOA research fellowship award

Comron Hassanzadeh
Comron Hassanzadeh

Comron Hassanzadeh plans to pursue a career in radiation oncology. Next fall, he’ll start applying for a residency position that will propel him in that direction.

In the meantime, the fifth-year student is taking time away his UMKC classes to collaborate on a research study. Hassanzadeh is working full-time for five months on a project with two leading radiology researchers at Washington University School of Medicine in St. Louis.

With Perry Grigsby, M.D., an accomplished radiation oncologist, and Farrokh Dehdashti, M.D., a nationally renowned leader in nuclear medicine imaging, Hassanzadeh is exploring the use of pre-treatment PET/CT scans to predict clinical outcomes for cervical cancer patients. He recently received the 2016 Alpha Omega Alpha Carolyn L. Kuckein Student Research Fellowship, a $5,000 award to help with his research effort. John Foxworth, Pharm.D., professor of medicine, assistant dean for faculty development, and a mentor for student and resident research, assisted Hassanzadeh in receiving the award.

“I am currently conducting several studies, however, the PET/CT study was my first project and I was grateful to have received the award to support my research,” he said.

If the researchers can adequately demonstrate the PET/CT scans’ ability to measure cervical tumor heterogeneity, Hassanzadeh said it could provide physicians a new tool to guide future cervical cancer management and treatment.

“Upon completion of the study, I hope to submit the final results to a scientific journal for publication,” Hassanzadeh said. “All in all, I hope to use this experience as a stepping stone to a future in academic medicine.”

Robie receives 2016 Women’s Council award

Robie Loreley
Loreley Robie

Sixth-year medical student Loreley Robie was recently honored as one of the recipients of the 2016 UMKC Women’s Council Graduate Assistance Fund awards.

The awards are given to UMKC women students in post-baccalaureate approved programs. They are used to assist students in completing requirements for graduation and first professional degrees, facilitate studies beyond the classroom, and to enrich and encourage educational experiences.

Robie is using her award to help complete a research project at the School of Medicine, “The use of oral clarithromycin in the prevention and treatment of recurrent chalazia in children.” She was recommended for the award by Rebecca Pauly, M.D., docent and professor of medicine; and Steven Couch, M.D., ’06, a St. Louis ophthalmologist.

Recipients of this year’s awards were formally recognized during a reception by the Women’s Council.

Cunningham receives student scholarship in interventional radiology

4 sno up close

Fourth-year medical student Danielle Cunningham recently received a student travel scholarship to attend the next Society of Interventional Radiology Annual Scientific Meeting.

The award provides funding for selected medical students to take part in sessions of the organization’s upcoming meetings in April 2016 in Vancouver, British Columbia. Student training programs will focus on topics ranging from the history of interventional radiology to cutting-edge clinical approaches and procedures in vascular disease, pediatrics, liver disease and research.

“The Society of Interventional Radiology scholarship will help me learn about how to succeed in the residency match process, as well as the newest techniques in interventional radiology,” Cunningham said. “I’m especially excited for the classes about interventional oncology, which uses interventional radiology techniques to treat cancer.”

Students are selected to receive the scholarship based on applications that include their CV, short essays on interventional radiology questions and recommendations by mentors or instructors.