Campbell’s charter class of medical students is already making an impact on their first round of rotations
TOM SOKER
1:35 PM If watching a TEE procedure up close was cool, standing in the surgery control room while a heart stent surgery is being performed on one side and a peripheral artery surgery on the other takes “cool” to the next level.
And that’s before the physician for the latter procedure enters the room, fully scrubbed and carrying an iPhone that has Nirvana’s “Smells Like Teen Spirit” going full blast.
Tom Soker and Dr. Danielle Eagan are spending a little downtime from Dr. Sydney Short to observe the two surgeries not only through the windows, but also on the several computer monitors in the control room. Much of their time today has been spent at patients’ bedsides, but also standing around their own computers and patient folders discussing illnesses and treatments and learning to fill out the proper forms.
Eagan is in her first year as a resident, but her experience in rotations at VCOM have her light years ahead of Soker. Her field is internal medicine, and her residency will last at least another three years. She has empathy for Soker, and hopes his experience is nothing like hers.
“I once had a preceptor who treated me like I’d already been there for four years, and expected way too much out of his students,” she says. “He’d spend three to four hours a day quizzing me and expecting me to know complex procedures.”
Even though she’s only been in Lumberton three months, she enjoys the energy Campbell’s medical students have brought to the hospital.
“It’s great to put more smart minds together,” she says. “I’m still learning, too, and I’m still getting asked questions. Sometimes Tom will get a question that I secretly don’t know, so I’m learning something there, too. It’s good for all of us.”
She tells her new friend that the flood of information over the next few years will seem a bit overwhelming, but one day, it will all just click. Soker thinks his strengths coming in are his ability to bond with a patient and come off as trusting, but his weakness is his confidence. He’s not a “see it once and do it” kind of learner. He prefers lots of practice, he says, and he needs to get comfortable in not being perfect every time.
“There’s so much about medicine I don’t know, but I understand it all comes with experience. I recognize that,” he says. “But just seeing where I’m at today, my progression of knowledge and ability to recognize things compared to where I was three years ago is just incredible. It’s a testament to the great teaching at Campbell. Without a doubt.”
With the surgeries and Nirvana behind them, Soker and Eagan connect again with Short, who’s on his way to check with a patient who’s had six heart stents in the past 25 years and another who’s in need of another bypass surgery.
The man’s wife sees Soker and tells him he looks like he should be in high school. Soker answers with an embarrassed smile and thanks her for the compliment.
As they leave the room, the wife has one last thing to tell the doctor.
“You take care of these children.”
RAJBIR SINGH
2:45 PM Rajbir Singh has already seen a lot in his few days as a third-year medical student at Southeastern Regional Medical Center, and one story will probably be brought up in lunch-time conversations with other doctors or chats with future students and residents for years.
Two days prior, a man in his 50s came in because of sudden difficulty breathing. A scan of his chest revealed a pleural effusion — fluid building around his lungs — and doctors ordered a VATS (video-assisted thoracoscopic surgery), which requires a few small incisions in the chest and includes a small camera to assist the surgeon.
Singh was allowed to observe the routine bedside procedure and assisted by holding some of the equipment. Minutes into the surgery, the story took a turn.
“They went in thinking it was fluid, but the build-up was like a liquified pus. A bacterial infection … maybe pneumonia,” Singh recalls, adding that a strong and unpleasant smell “took over the room” at once.
The procedure continued, and as doctors suctioned out the build-up and blood, Singh held his ground. The smell, he says, was enough to alter one’s concentration, but the doctors and assistants remained focused and professional.
“I held it in,” he says. “I didn’t want to look like a student in front of everyone.”
When the pus was removed, doctors peeled a “rind” off the lung’s outer wall, and when all was said and done, Singh was rewarded by being allowed to stitch the patient up.
Nearly nine hours into his day, Singh and Campbell resident Meredith Beeler are back in that patient’s room for a PICC (peripherally inserted central catheter) procedure, which allows the doctor to insert a long-term antibiotic into a deeper, stronger vein. The patient is in good spirits as he and Beeler put on radiation vests, which are required for anyone in the room, even those merely observing.
His experience makes for a good story — he told it to a fellow third-year during lunch on this day — but it’s also cause for reflection for Singh.
“A lot of people in this community don’t go to the doctor right away,” he says. “Whether it’s because they can’t pay for it or they think they’re better off leaving it alone … many wait so long that minor problems turn into life-threatening conditions.”
“For us, we’ll never see some of the problems we’re seeing here if we move on to larger cities. You see how dire the situation is here and how important it is to have more doctors who want to work here.”
Singh’s own father was that way, he says, up until very recently. At his white coat ceremony during his first year as a med student, Singh learned his father had lost 15 pounds and was coughing up small amounts of blood. He ordered his father — a diabetic — to see a doctor. That doctor told his father he was about a week away from going into a diabetic coma.
“I didn’t know a whole lot then, but I knew something was wrong,” he says, “and by stepping in, I saved my family from a lot of heartache.”
When med school stresses him out or when he’s up late at night cramming for a particularly hard test, Singh thinks of his family.
“That’s why I’m here,” he says. “Being here and seeing what we do for other families reminds me of that.”
THE HOSPITALS
Third- and fourth-year medical students at Campbell are being trained on a rotational basis at eight hospitals throughout North Carolina. By fall of 2016, more than 320 Campbell University medical students will be working their rotations split up among these hospitals:
• Southeastern Regional Medical Center, Lumberton
• Cape Fear Valley Medical Center, Fayetteville
• Wake Med, Raleigh
• Wake Med, Cary
• Harnett Health, Lillington
• Betsy Johnson Hospital, Dunn
• Novant Health Rowan Medical Center, Salisbury
• Wayne Memorial Hospital, Goldsboro
• Sampson Regional Medical Center, Clinton
ERICA ROTZMAN
3:00 PM Yes, the loafers were a bad idea.
Erica Brotzman declares her feet are killing her after eight hours, three deliveries, countless check-ups with new and soon-to-be new mothers, that shortened trip to the clinic and just trying to keep up with Dr. Mulroy. The day has been a physical challenge, but it doesn’t compare to the mental challenge that Campbell’s med school has presented to Brotzman and her 159 classmates during their first two years.
“You can have 50 people sit and tell you, ‘Oh yeah, med school is going to be tough. I hope you’re ready.’ But you really don’t understand what they mean until you go through it yourself,” she says. “It’s emotionally challenging having to put your life on hold to go to class and study constantly. It’s physically challenging, too. I remember we’d have to treat each other in the OMM labs because our backs were hurting from sitting in the same position to study for hours and hours.”
“It’s a challenge in every sense of the word,” she adds. “But it’s worth it. It’s worth it. All that we’re going to be doing to help people; it’s worth it.”
Brotzman was fortunate to have time for lunch today, but it was cut a few minutes short after a text from Mulroy called her back to the third floor at 1:20 p.m. She and classmate Jessica Herman followed Mulroy and a few other nurses into delivery room, drew the curtains and offered support in the form of a few “There you go!” and “That’s it! Push!” chants for the next 30 minutes. As she did in the operating room, Mulroy allowed her student another “first” during this more traditional delivery — Brotzman got to deliver the baby, suction the nostrils and throat, clamp the cord, clean the newborn and finally deliver the placenta.
“It was surprisingly similar [to the simulation robots at med school], except a real baby’s a lot warmer. A lot messier,” Brotzman beams afterward. “I’d never done that before, though. It was really, really cool.”
“You did good,” Mulroy says, smiling.
Brotzman’s four-week rotation will end with an exam, just months after her class’ COMLEX USA Level 1 exam they took over the summer. That Level 1 test “was probably the hardest one we’ll ever take,” she declares, adding that she took both the MD and DO exams and did pretty well on both. Her next rotation in Lumberton will be in pediatrics, the field she wants to practice in.
Wherever the coming year takes her, it will be difficult to top the roller coaster day she experienced today.
“It’s been a crazy day,” she says to her preceptor, tired and excited at once. “Yeah, it’s been a day,” Mulroy answers. “Welcome to OB.”
SADIA MOBEEN
3:30 PM Her handwriting much too clean for a doctor, Sadia Mobeen writes her first patient admission order — with help from her preceptor, Dr. Sid Hosseini — for a man who overdosed while on a Greyhound bus traveling on Interstate 95.
The two are on the second-most heavily monitored portion of the hospital, the sixth floor patient wing. The rooms and nurse station look just like the other wings of the hospital, but here all rooms are equipped with video cameras, and all patients are monitored in a nearby control room by a staffer sitting in front of about nine black-and-white screens.
Hosseini recalls some of his most bizarre cases to his student. Odd cases are actually a major reason Mobeen chose Lumberton for her rotations. She knew coming to SRMC would introduce her to some “great pathology,” she says, and a few short days in the psychiatry rotation, she’s proven correct.
“In poorer communities, patients tend to wait longer to see a doctor when they’re sick,” she says. “And that makes things worse. Here, we’re seeing a lot of things we learned in our first two years … cases we might not have seen in other places.”
Mobeen often talks about life as a third-year with her younger sister, Sidra, also a third-year medical student entering her rotations with the Lake Erie College of Osteopathic Medicine in Pennsylvania. The two come from a family of nine children, five of them either doctors or studying to be doctors. Seeing that Mobeen and her classmates don’t have upperclassmen to learn from at Campbell (being charter class members), she benefits from having siblings to bounce ideas and questions off of and to share experiences.
And four of those five who are in medicine have chosen the osteopathic route, she says.
“We like the philosophy better,” she says. “Believing in the whole-person approach and focusing on the person, rather than just the medical issue at hand.”
Mobeen, like many in her class, had never heard of Campbell until it came up during her application process. She was drawn to the school because of the weather mostly, but also because she liked reading about its big expectations. Meeting the staff and faculty during her interview sealed her decision.
“Everyone was so nice, and just the culture down here is so different,” she says. “I’m not used to having a 15-minute conversation with the clerk at a grocery store. I’m not used to people holding a door for you or when you signal to change a lane, they actually let you in.”
The Brooklynite who talks at a breakneck speed also likes the slower pace of life, which surprises her somewhat.
“It’s hard to get used to at first,” she says. “But you do. The only thing I really miss is 24-hour grocery stores. Back home you can go down to the corner and get what you want any time of day.”
Speaking of slower pace, today has officially been labeled a “calm one” by Hosseini. He tells Mobeen these admission orders will one day become second nature for her, and at the end of her third day in the psych ward, she seems less on edge and more comfortable in her role.
“Are you learning?” Hosseini asks her with a smile. “You’re paying too much to not get a good education here.”
“Oh, I’m learning a lot,” Mobeen replies. “Definitely.”
CHERIE DICKSON
3:45 PM The final stretch of Cherie Dickson’s day begins with a morbidly obese man who’s at the wound clinic to have several sores on his body looked at. The 34-year-old man’s mother does most of the talking for him, but despite the potentially embarrassing predicament of having to strip down in front of three nurses, a doctor and a student, he has a sense of humor about him.
“Make sure you get my good side,” he says, noticing a camera in the room.
Two rooms over, a man paralyzed from the waist down is having sores examined. McLeod explains the patient fell down after eating breakfast one morning a few years back and hasn’t walked since. The paralysis is a result of a neurological disorder called transverse myelitis, and the wounds that have developed as a result of inactivity and muscular atrophy are “huge.”
“The pain is excrutiating, all day and all night,” the patient says. “But I’m a warrior.”
Both men have seen Dr. McLeod several times before this, and both are comfortable sharing very personal information in front of both him and his student. That trust is the result of McLeod’s personality and his roots, Dickson says.
“He was a banker for 20 years, but said God was calling him to med school when he turned 40,” she says. “He went to Wake Forest, got his degree and ended up back in his hometown to practice at a clinic in an area of town that isn’t always the safest place to be.”
“Today, we saw the richest and poorest people in Robeson County sitting side by side in our clinic,” McLeod adds. “That’s one of the things that drove me to medicine — hoping we can do something like that. I’m very pleased with the clinic we have and with what we’ve been able to do.”
McLeod says he’s thrilled to see Campbell students in Lumberton, and a big reason is that he feels it makes him a better doctor.
“When you know some smart person who’s reading, studying and learning with the latest and greatest stuff is looking over your shoulder while you practice medicine, you tend to not take the shortcuts you might otherwise take,” he says. He asks Dickson how many medical terms they’ve had to look up in her few days in the clinic. The answer is “too many to count.”
“It forces you to be as good a doctor as you can be,” he says. “These third-year students on their first rotations have no experience, no expectations. It’s now that they’re taking all the facts they learned in their first two years and learning what to do with them. It’s a big responsibility on our part to help them along.”
And the students in Lumberton, he says, are encountering diseases and conditions they’ll rarely see in other places. Today, Dickson has seen everything from Ehler Danlos syndrome (an inherited disorder that affects connective tissues) to transverse myelitis.
“This is a good rotation for you,” McLeod tells her at their desks. “You’re seeing things they probably never mentioned in medical school; things you may never see again.”
Throughout the day, McLeod has been asking his student several questions about this disease or that diagnosis or prescription. “It’s OK if you don’t know the answers,” he tells her.
“Good,” Dickson smiles. “I haven’t known any of them.”
“You’re a good seven or eight years away from knowing everything,” he tells her.
It all comes with experience.
IMPORTANT TO LUMBERTON
Major construction and renovation projects at Campbell in last decade:
Since the inception of the North Carolina County Health Rankings in 2010, Robeson County — home to the city of Lumberton and Southeastern Regional Medical Center — has consistently ranked last or near the very bottom. Despite this, Robeson has seen slightly improved health outcomes in several categories year over year.
It’s the type of county Campbell had in mind when it launched North Carolina’s first new medical school in over 35 years in 2013 — a school that would graduate doctors who would go on to practice in underserved regions of North Carolina, the U.S. and the world. Currently, 40 of the 160-member charter class of the Jerry M. Wallace School of Osteopathic Medicine are doing their rotations at SRMC.
“Places like Robeson County really are central to our mission statement, and I know that training physicians there will make a big impact in improving access to patients and enhancing quality in the long run,” says Dr. Robert Hasty.
The data is clear, adds Hasty, that being in a teaching hospital decreases costs, decreases hospital stays and improves patient satisfaction. President and CEO of SeHealth Joann Anderson had these results in mind when she fought to add Campbell’s new med school as a teaching partner for her hospital. SeHealth cut the ribbon on a new Medical Education Center in July, and a few months in, she’s already certain she made the right call.
“It’s not just the better health care, it’s also the perception in our community that this organization is doing something great,” she says. “Hopefully, many of these students and these residents will choose to continue their practice in Lumberton. It’s an exciting time for us. It’s an exciting time for this community.”
(Out of 100 N.C. Counties)
• Health outcomes: 97
• Health factors: 100
• Diabetes: 100
• Premature mortality: 96
• Food insecurity: 91
• Uninsured adults: 100
• Uninsured children: 85]