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► Above, UVM Larner College of Medicine students took a trip to Chruch Street to see the brightly lit holiday tree.

Getting a First-Hand Perspective on Life with Disabilities

On November 15, members of the Class of 2021 participated in Disability Awareness Day, a day-long series of educational activities developed by UVM Professor Emeritus of Pediatrics Stephen Contompasis, M.D. The event has been part of the Human Development and Reproductive Health course curriculum for more than 15 years and is required for all second-year medical students.  

Through a series of disability simulations and panel discussions, the students "gain a greater awareness of the health issues faced by people with disabilities and learn of some ways in which they can improve their practice in the future," said Contompasis.

Students took part in disability simulations – including mobility/paraplegia and visual disability – throughout the day and were led by clinical volunteers from a variety of disciplines at UVM, the UVM Medical Center, the Vermont Association for the Blind and Visually Impaired, the Nine East Network, and other community agencies. 

Sharon Wille-Padnos, a vision rehabilitation therapist with the Vermont Association for the Blind and Visually Impaired, led students through a series of visual impairment simulations and exposed them to tools sometimes used by people who are blind or visually impaired. Raghav Goyal ’21 said he "appreciated the little things she shared with us: how to offer someone who is blind your arm to help them get somewhere (instead of pushing or pulling them)...[or] that words like 'see' and 'look' are [as much a part] of the blind community's vocabulary as they are [a part] of the sighted community's, and using them is not off limits." 

For a mobility impairment simulation, students were asked to navigate the College and complete a variety of tasks while in a wheelchair. Tasks included going to the Dana Medical Library, finding a journal and simulating making a copy of it; navigating to the bathroom and transferring from the chair to the toilet; and going to the Student Lounge and simulating making a pot of coffee in the kitchen. Pamela Cummings, a physical therapy consultant on the Vermont I-Team and the I-Team Early Intervention Project through UVM’s Center on Disability and Community Inclusion, led the exercise.

In addition to participating in simulations, students also attended panel presentations by community members who are living with disabilities. One panelist, Vermont Assistant Attorney General Ben Chater, has cerebral palsy and uses a motorized wheelchair and other tools and technologies to complete daily tasks both at work and at home. For student Alex Miller '21, listening to Chater's story was inspiring. "My biggest take-away was [that] a disability does not define someone," Miller said. 

Goyal feels the day is an important part of the students' medical education. "I think experiences like today are what medical school is all about," he said. "Talking about complicated issues that require reflecting on my own place in things...There is no end to how much time we can spend learning to love and empathize."

► Class of 2021 - Save the Date for your Foundations Awards Celebration on Thursday, January 24, 2019!

Tsai Researches Opioid Misuse Risk

Last spring, as the mirage of a few medical school-free weeks danced on the horizon, Matt Tsai '21 began to consider his summer vacation options. "Aside from sun tanning and grilling burgers, I wanted to spend my summer developing some skills in medical research and data analysis in order to prepare myself for the upcoming years of training centered on evidence-based medicine," he said. Much like one plans for a camping trip or beach vacation, Tsai started making lists. But, instead of flip flops and sunglasses, his lists contained research topics that interest him, including opioid addiction and pain management.  

Next, Tsai reached out to Associate Professor of Medicine and Director of Medical Student Research Renee Stapleton, M.D., Ph.D. She connected him with Professor of Medicine Charles MacLean, M.D., and, as Tsai says, "The rest is history."

Throughout the summer and into the fall, Tsai and MacLean analyzed electronic health record data from University of Vermont Medical Center (UVMMC) patients, paying particular attention to the Current Opioid Misuse Measure (COMM). The COMM is an annual brief self-report survey that is administered by UVMMC primary care sites to assess a patient's risk for developing opioid misuse. Although UVMMC recently standardized the survey for all of its patients on chronic pain therapy, the collected data was still largely unexplored. 

Given the glut of data and the lack of its analysis, MacLean and Tsai set out to "characterize the use of the COMM and distribution of COMM responses in the primary care population, identify clinical or sociodemographic factors that might predict a positive COMM score (at least a 9 on a scale of 0 to 68), and to assess whether patients with positive scores are more likely to experience increased opioid surveillance.

Tsai and MacLean found the results compelling and cause for further research. "For one, our data suggests patients taking benzodiazepines (or a similar GABA agonist) concurrently with a prescription opioid and patients with severe mental illnesses are more likely to have a positive COMM score," Tsai said. "Furthermore, both of these traits are fairly prevalent in our population."

Tsai and MacLean are planning on submitting their research findings to a national research conference and hope to present their study to researchers there in early May. In preparation, Tsai presented their initial findings to a group of UVM researchers in early October and received positive feedback.  

While the two prepare to submit their research, Tsai says that although he plans to pursue future projects with MacLean, "my ambition may have to wait until I am further along this busy season of boards preparation and third-year clinical rotations." Stay tuned for further updates on MacLean and Tsai's research at http://med.uvm.edu and in future editions of this Larner College of Medicine Student Newsletter.

Ethical Dilemmas in Global Health: Cases That Challenge Ethical Beliefs 

Sahand Arfaie, M.D., critical care specialist and co-director of the Critical Care Unit at Essential Health - Fargo in North Dakota discusses "Cases that Challenge Ethical Beliefs" in the most recent post in the Ethical Dilemmas series on the Global Health Diaries blog. Scroll through other ethical dilemmas that have been presented and discussed.

► Important! Student Ambassadors needed for Community Rounds on Thursday, December 6.

SIG Highlight: Wellness Committee Welcomes Class of 2022 Reps

This week, the Wellness Committee announced their newly appointed representatives from the Class of 2022: Isi Beach, Tierra Lynch, Colby McGinn and Emerson Wheeler. These students will serve as the liaisons for issues that pertain to the mental and physical health of their fellow UVM medical students. McGinn is excited about his new role on the Committee and said, “I feel connected to my peers, communicate honestly and enthusiastically, and am confident in my ability to provide support and encourage my classmates as they pursue their own mental, emotional and physical well-being.” Wheeler added, “I was interested in joining the Wellness Committee because I have always prioritized wellness in my own life, and I know how crucial coping skills, resiliency, and overall mental health are to a person's well-being. I'm a strong believer in the fact that establishing good habits for our wellness while we’re still in medical school is one of the most important things we can do for our success in the future.”   To learn more about the Wellness Committee, click here.

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