Emergency Medicine News Providing Exceptional and Compassionate Patient Care

Contents

Division Director 1

Residency 2

Ultrasound 3

Prehospital Medicine 4

Local & Global Outreach 5

Wellness: EMPPowered 6

News/Kudos 7-9

Summer Issue 2016

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Edward C. Jauch, MD MS Division of Emergency Medicine Director

Summer is now in full swing and we are beginning a new and exciting academic year. Please join me in welcoming our new Intern Class into the MUSC Emergency Medicine family; I am sure Mel has them off to a great start! Speaking of family, please take time this summer to spend quality time with your loved ones before the hectic pace of the new school year kicks in and be safe. As always, thank you for making Emergency Medicine at MUSC the best in the region. Ed

Residency Program News

Exciting News & Updates

Huge shout out to Dr. Christina Bourne – she has been a wonderful Program Director and has been instrumental in the program’s success! She is now Associate Dean for Student Career Planning and Advising, in the College of Medicine. Luckily, we’ll still get to work closely together and she’ll be our Emergency Medicine advocate. This will be vital as our Residency Program grows, and especially beneficial to our very own MUSC Medical Students interested in Emergency Medicine! THANK YOU, for all you’ve done – your hard work and dedication to the EM Residency is appreciated and has paved a path which will flourish with success!

Dr. Will Long (class of 2013) married Amanda Melton. Congrats!

Congratulations to Dr. Clayton Hofstra & Sara Bakhtiarnejad on their engagement! Dr. Joe Mahoney (class of 2010) joined staff at GHS in Greenville, SC. GHS has been approved for an EM Residency. Dr. Scott Witt (class of 2012) and Dr. Page Bridges (class of 2015) both have titles within the residency leadership team!

Thank you all for your continued support to the EM Residency!

Please help us in welcoming our 2016 Interns:

Hesham Abukhdeir, MD, MPH

Danika Brodak, MD, MPH

Tyler Clare, MD

Kyle Embertson, MD

Iman Tamimi, MD

Julia West, MD We are confident they will exceed expectations!

Congrats to our new PGY2s and PGY3s, who’ve moved forward to the next level! You

guys rock. Reminder: Drs. Caleb King & Leanne Radecki are our 2016-2017 Chief

Residents – they will excel! Dr. Connors will continue to be our Curriculum/Didactic Czar

– if you’d like to give a lecture, please contact him and Mel. The EM Resident Didactic

Presentations outline was reviewed during June’s Faculty Meeting. 3rd years with an

interest for an EKG elective, please contact Dr. Matuskowitz or Mel.

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Need to Know….

Page Bridges, MD – one of our

fabulous Alumni will be presenting a

Grand Rounds lecture on August 4,

2016. Please be sure to join us! Page

has accomplished a ton since

graduating – including joining the

SCCEP Board and taking on a

leadership role in the new GHS

Residency Program. Congrats to her!!

EM Clerkship News….

This year we had a record number of

VSAS (Visiting Student Application

Service) applicants to our EMED 852

Externship!

201 candidates submitted their

application; of those we chose 21

students to rotate with us during

Blocks 1-4 of the 2016-2017 Academic

Year. While they are here we will

conduct formal residency interviews,

as in the past.

Emergency Medicine had more

applicants than all other MUSC

programs!!

Simon Watson, MD & Lindsey

Jennings, MD spent a great deal of

time reviewing applications and

selecting some great candidates to

join us this Summer & Fall!!

Jeffrey Bush, MD Program Director, Emergency

Medicine Residency

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Ultrasound Geoffrey Hayden, MD, FACEP, FAAEM, RDMS Emergency Ultrasound Director

The Section of Emergency Ultrasound is proud to announce our 2015-2016 Golden Lube Award recipient, Dr. Brant Domangue. Dr. Domangue has demonstrated an uncanny dedication (borderline obsession) with regards to ultrasound that absolutely exemplifies this ignominious award. Congratulations, Brant, and keep up the scanning! The Section is also proud to announce the successful completion of the Emergency Ultrasound Fellowship by Dr. Jon Jennings. Dr. Jennings has managed to prove his doubters (of which, there are many) wrong in what has been an outstanding year of bedside teaching and the development of a real expertise in point-of-care sonography. Moreover, he’ll be joining us as faculty in July. We are lucky to have you, Dr. Jennings!

Dr. Blake Willis will be wrapping up his joint Global Health and Emergency Ultrasound Fellowship this winter, and we’re thrilled to have him around for another 6 months. Between saving the world from tropical diseases and providing outstanding care to his MUSC ED patients, Dr. Willis continues to excel in teaching and scanning. He will continue to be a core member of the teaching faculty in ultrasound.

On a sad note, Dr. Dan Park, an ultrasound faculty member representing Pediatric Emergency Medicine, will be departing for UNC in July. Huge loss for PEM ultrasound education and an even bigger personal loss of a great friend. Good luck, Dr. Park! As a reminder, Mel will be sending out monthly reminders about our Emergency Ultrasound Meet-Ups. Sign up for some one-on-one instruction, learn some advanced modalities or re-visit some lost skills.

Section of Emergency Ultrasound www.emergencyultrasoundteaching.com

Ultrasound Monthly

Meet-ups:

There will not be a meeting in

July 2016; more info forthcoming.

News Flash….

As of July 2016, Dr. Ryan Barnes will be taking on the role of Emergency Ultrasound Fellowship Director, and will be aggressively recruiting our next fellow for 2017-2018. Way to go, Dr. Barnes!

Prehospital Medicine Dave French, MD, FACEP, FAAEM Director of Prehospital Medicine

Lots of good things happening in our section! We are continuing forward progress on many fronts and hope that you reap the benefits. EMS The EMS to Epic computer interface is up and running. We have had a few glitches, but they are being worked out. When the main local EMS agencies finish their charts, it should be automatically uploaded into Epic. In turn, EMS will get automatic feedback on the patients that they bring. Let us know how it is working. EMS relations work continues. We are hoping to put in an EMS breakroom and continue to encourage nurses to ride-along and residents to take advantage of some of the many opportunities available to them. I am hearing a lot of positive feedback from EMS crews – some of them even want to buy our shirts! Please keep it up! Stefani Michael and Robin Dawson are continuing to help move some of these initiatives forward. As usual, our outreach CPR training at Wando went well. We are still planning to expand our program, especially given recent SC legislation that will require CPR training for high school students. We are also looking at other opportunities for CPR training, and I will try to send out dates when I have them. We have some ongoing learning opportunities, including our monthly lecture series on the first Wednesday of each month at noon in the ART conference room. Last month, our own Dan Fisher presented a great overview of OB emergencies, and we continue to have experts from different departments rotating through. We are also hosting a DHEC “Medical Control” Workshop on July 27th at the Haborview Office Tower (HOT). It is an all-day event and is a required course for any physician wanting to be an EMS Medical Director. If any providers, specifically Residents, Attendings, or Nurse Practitioners, want to attend, let me know or sign up at: Registration Form

Disaster The disaster plans, carts and manuals are essentially completed, and it is time to start training! Hooray! Thanks to Kathy Lehman-Huskamp, Robin Dawson and many of our outstanding staff for their hard work in getting this done. We had our first tabletop with the residents a few weeks ago and initial feedback has been good. Let us know if you would like to undergo similar training for your group. As always, thank you for your support, and let us know what else we can be doing for you!

Need to Know….

CPR Training at Wando High School Future training sessions will be announced soon. If you’re interested in helping down the line, please contact Dr. French!

Autism Support Materials: Room D44 is a quiet room,

with TV/DVD, and dimmable lights. There is also an Autism Support cart which has DVDs, books, games, sensory items,

card and coloring books.

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Local and Global Outreach Blake Willis, MD Global Health/EUS Fellow

Earlier this year I received my Diploma of Tropical Disease and Hygiene from the Gorgas Course in Lima, Peru. The Gorgas Course is an intense, 9 week course that consists of lectures, rounds on patients, small group discussion, and microscopy. I also completed the Advanced Medical Leadership Training course in El Salvador in May. The course is designed to equip medical care providers with the knowledge and resources to lead short-term medical trips to remote areas in the developing world.

Local and Global Outreach

Edward O’Bryan III, MD Global Health Director Please visit: SC Prison Telemedicine Program to Save Taxpayers Money Newsroom: Telemedicine July 12, 2016 Dr. O’Bryan, is part of this pilot program – a collaboration between the prison system and the Medical University of South Carolina. Reminder: In local service opportunities, a clinical service opportunity in Mt. Pleasant has arisen within the MUSC Community. The St. Andrews Free Clinic meets every Tuesday in the Old Village under St. Andrews Church and sees patients without insurance with the assistance of the MUSC PA and NP Programs. Faculty MDs, PAs, and NPs are needed to supervise students as they serve. The clinic provides full JUA Malpractice coverage. Contact the Executive Coordinator of the clinic, Hope Caldwell, for more information (hopecaldwell@comcast.net or 843-297-9424).

Travel

Interested in getting involved?

Check out:

http://palmettomedical.org/

Tropical Medicine &

Hygiene

Blake Willis, MD (below, left) – will be with us, to complete his EUS and Global Health Fellowships, until December 2016.

Glad he’s going to be with us for a bit longer!!

Also pictured, our very own Jon Jennings, MD

Global Emergency

Medicine Fellow 2016-2017

Lacey MenkinSmith, MD

Dr. MenkinSmith will begin her

time abroad this August in Haiti.

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Wellness Committee Diann Krywko, MD, FACEP This edition of the EM Newsletter marks the official beginning of EMPPOWERED, a newly developing program with the goal of making our EM family healthier, happier, stronger and more confident in our lives, both personally and professionally. Current happenings:

Resident Wellness Committee – Drs. Diann Krywko and Lindsey Jennings, Dr. Libby Barton (PGY3), Dr. Owen Stell (PGY2), and

PGY1. This committee is currently directing energy towards a new innovative BigSib Program to pair incoming interns with PGYIII as mentors, intern welcome, and social events. As funding becomes available, the Wellness Committee is planning to expand.

Anyone interested is welcome to join in and/or send ideas to the committee.

1. 2. EMPPOWERED Lecture Series: Beginning in July. 3. Have a thought, quote, or excerpt that is meaningful? Please send to me to share with the

group in the “Search for Wellness- Quote/Thought of the Week”. Topic of the Month: Burnout and Depression Whether you’re a seasoned faculty veteran or just entering residency, summer time tends to bring on fun, sun, and smiles. However, that may not be true for everyone. Face it, we have a very stressful job no matter the time of year. 52% (50% male/58% female) of EM physicians feel burnout [Source: Medscape 2015 Physician Lifestyle Report], 15–30% of medical students and residents screen positive for depression and 400 physicians die from suicide each year. Let’s keep each other at the top of the list when it comes to taking care of people. Ask, support, help. There are many programs at MUSC to help if the need arises. CAPS (Counseling and Psychological Services) How Physicians, Health Care Workers Can Handle Depression, Burnout, and Suicidal Thoughts

By Jay A. Kaplan, MD, FACEP | on January 15, 2016 When I was an intern in 1976, I invited a good friend over for dinner. She had been having some trouble with her boyfriend, and I was hoping to cheer her up. I cooked dinner, and we talked. The evening was a connected one, and at its end, I offered her a plant cutting, which I had made for her. This was my way of saying I care. She declined my gift. The next day, I was told that she had committed suicide the morning following our evening of friendship. I felt so guilty. I almost quit my internship that week. Here Is What I Wish I Knew Depression is insidious. It sneaks up and can take you down in an instant. We as physicians, and other health care professionals, are not good at recognizing burnout and depression in ourselves. We are perfectionists and expect ourselves to be experts from day one, which is unrealistic. The most difficult task, and the most important when you believe a friend or colleague is depressed, is to reach out and offer your help. If your assistance is refused, share your concern with another friend and ask again. The most difficult task, and the most important when you are having difficulty, is to reach out and ask for help. Admitting your own struggle and powerlessness is a big first step in helping yourself. It takes courageous humility. Seeking to establish a relationship and talk with a therapist is not something to be ashamed of. It should be something to be proud of. We all have our strengths, things we are good at, and we all have our opportunities, areas where we are weak. We need to seek out those who appreciate our strengths and assist us to get better in those areas where we fall short. Time passes very quickly. There is always more work. There is not always more time. We need to treasure our families and our friends. We will never regret bringing more love to who we are and what we do.

2016

Emergency Residency Graduation

News & Kudos!

Christina Bourne, MD: Has accepted a position to become a charter member of the LEAD Executive Board. She was selected for her unique talents and capabilities – providing input into curricula, recruitment, assessment of programs and the development of graduates.

Christina Bourne, MD: National AAMC GSA-CiM-OSR Conference in St. Louis, MO (June 2016) Poster Presentation: "Optimizing the learning environment: A strategy to foster student wellbeing and success" Conference Presentation: "Career Advising for Millennials on a Shoestring Budget"

Edward Jauch, MD, MS: Accepted invitation to become Chairman of the Stroke System of Care Advisory Council (April 2016), for a 3-year term. The Stroke Advisory Council is responsible for advising the Department of Health and Environmental Control (DHEC) on the development and implementation of a statewide system of stroke care.

Christine Carr, MD: Dr. Carr has been appointed as an Associate Professor in the School of Public Health Sciences and is working on several funded projects with the BMIC (BioMedical Informatics Center). She is working with the BMIC and Health Sciences South Carolina HSSC to expand Health Information Exchange (HIE) in the state to improve the health of all South Carolinians.

Diann Krywko, MD: American College of Physicians (ACEP) – fellow status achieved! Her status becomes effective this October and she may begin using the FACEP designation. She will officially be inducted during the ACEP 2016 Scientific Assembly.

Diann Krywko, MD: Dr. Krywko was accepted into the LEAD (Leadership in Academic Medicine): Transformations Program, which begins this September.

Jon Jennings, MD and Drew Johnson, MD: Both were mentioned in a letter to Dr. Jauch for their professionalism, compassionate handling and exceptional care provided during a patient’s stay in the ED. Superb physicians! (March 2016)

Keith Borg, MD, PhD: Became President Elect, Board of Director – South Carolina College of Emergency Physicians.

Daniel Barr: Accepted a position with our IT group, as an Information Resource Consultant. He, along with Matt McCoy and Erika Murphy, are here to assist with our IT needs. Please email medhelp@musc.edu for any questions or concerns relating to IT. This is a group email and one of the members will respond to ensure everything is handled in a timely manner. They are all wonderful to work with.

Press Ganey Employee Engagement Survey Results: Tier 1 rating for our unit (EM) – meaning we are engaged and well-prepared to move forward; this is a result of hard work and commitment of leaders who strive to make their units high-functioning and aligned with the institution’s goals. Recognition by Dr. Raymond DuBois.

James Tolley, MD: Honorary Resident in Emergency Medicine - Cleveland Clinic Akron General, Emergency Medicine Residency, Akron Ohio. Daughter: Jessica Tolley-McLendon, MD and Granddaughter: Miss Ella McLendon

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Updates from Dr. Matuskowitz New ECG Workflow - On July 25th, we will be piloting a new ECG workflow. Please attend Dr. Matuskowitz’s 10am lecture at conference this week for further clarification. He will also email instructions for the new workflow. Please be sure to read carefully and ask him if you have any questions. Chest Pain Center Monthly Meetings - We will be starting Chest Pain Center monthly meetings in order to identify pathways to improve patient care at the CPC. This will be an excellent opportunity for residents who are interested in future administrative roles as well as cardiovascular research opportunities. Please email Dr. Matuskowitz if interested in hearing more. Observation Unit – Due to psychiatry boarding issues, the observation unit pilot is currently on hold. Once we have the infrastructure in place, we plan to utilize the E-pod for psych boarding to offload the B side, and then we hope to use a portion of the B-pod for Observation Patients. As the psych boarder issues improve, we will update you further about the observation unit.

Presentations/Posters: King J, Hayden G, Connors N. “Polyneuropathy from Acute on Chronic Inhalation of Nitrous Oxide.” Poster presentation, 2016 Annual Scientific Meeting of the American College of Medical Toxicology, Huntington Beach, CA. March 2016.

Nina Asbury, MD - Made a case presentation for the American College of Medical Toxicology. She was unable to attend, but Dr. Connors presented on her behalf.

Susan Wilcox, MD - “Mechanical Ventilation in Critical Care Transport” Invited Lecture, Critical Care Transport Medicine Conference, Charlotte, NC, April 2016.

Susan Wilcox, MD - “Pulse Pressure Variation” Invited Lecture, Society for Academic Emergency Medicine, New Orleans, LA, May 2016.

Keith Borg, MD, PhD - Orthopedic Emergencies. (Co-presented) Family Medicine Update 2016. Kiawah Island, SC. June 16, 2016.

Keith Borg, MD, PhD - AWS Advance Life Support Biking and Skiing. EMED 843: Wilderness Medicine. Medical Students (4Y). Medical University of South Carolina. April 6, 2016.

Keith Borg, MD, PhD - VP Shuts. Pediatric Resident Noon Conference. Medical University of South Carolina. Charleston, SC. March 17, 2016.

Angotti LB, Wilcox SR, Richards JB. “Duration Of Mechanical Ventilation In The ED: Impact On Length Of Mechanical Ventilation, Hospital Length Of Stay And In-Hospital Mortality” Presented at the American Thoracic Society conference, May 2016.

Nick Connors, MD - New York-Presbyterian Emergency Medicine Residency Grand Rounds: Cardiotoxins. May 4, 2016. Nick Connors, MD - NYC Poison Control Center Intensive Toxicology Review Course. Clinico-Pathological Correlation. March 11, 2016.

Dan Fisher, MD – “Prehospital Management of Obstetric Emergencies" to Charleston County EMS on June 1, 2016.

Jauch, MD - “Stroke Systems of Care and the Role of Neuroradiology”. American Society of Neuroradiology Annual meeting, Washington DC, May 22, 2016.

Jauch, MD - “Disaster Preparedness for the Radiologist”. American Society of Neuroradiology Annual meeting, Washington DC, May 21, 2016.

Jauch, MD - “Stroke Management in 2016”. Visiting Professor, Department of Emergency Medicine, University of Cincinnati, April 13, 2016

Jauch, MD - “The Role of Emergency Medicine in the Future of Telehealth”. Visiting Professor, Department of Emergency Medicine, University of Cincinnati, April 13, 2016 Publications: Park D, Borg KT, Russell WS. Imaging in Pediatric Abdominal Pain. Critical Decisions in Emergency Medicine. 2015 29(8):2-8.

Nicholas K1, Yeatts SD, Zhao W, Ciolino J, Borg KT, Durkalski V. The impact of covariate adjustment at randomization and analysis for binary outcomes: understanding differences between superiority and noninferiority trials. Stat Med. 2015. 34(11):1834-40.

Saef SH, Carr CM, Bush JS, Bartman MT, Sendor AB*, Zhao W, Su Z; Zhang J, Arnaud C, Marsden J, Melvin CL, Lenert L, Moran W, Mauldin P, PhD; Obeid J. A comprehensive view of frequent Emergency Department users based on data from a regional HIE. South Med J. 2016 Jul;109(7):434-9. doi: 10.14423/SMJ.0000000000000488. PMID: 27364030 Melvin, CL, Saef, SH, Pierce, HO, Obeid, JS, Carr, CM. Health Information Exchange in the Emergency Department: What Do Emergency Department Clinicians Think? South Med J. 2016 Jul;109(7):419-26. doi: 10.14423/SMJ.0000000000000466. PMID: 27364028

Carr CM, Saef SH, Zhang J, Su Z, Melvin C, Obeid JS, Zhao W, Arnaud CL, Marsden J, Sendor AB*, Lenert L, Moran WP, Mauldin PD. When should ED Physicians use an HIE? Predicting presence of patient data in a HIE. South Med J. 2016 Jul;109(7):427-33. doi: 10.14423/SMJ.0000000000000490. PMID: 27364029 Takx RA, Vliegenthart R, Schoepf UJ, Abro JA, Nance JW, Ebersberger U, Bamberg, F, Carr, CM, Apfaltrer P. Computed Tomography-derived Parameters of Myocardial Morphology and Function in Black and White Patients with Acute Chest Pain. Am J Cardiol. 2015 Nov 18. pii: S0002-9149(15)02232-8. doi: 10.1016/j.amjcard.2015.11.006. [Epub ahead of print] PMID: 26739395

Elle’s 5th Grade Graduation Amy Robison’s daughter & Family

Tradd-Michael’s High School Graduation Amy Robison’s son & Family

He will be attending the College of Charleston

Please join us in welcoming Lilian Mona Fisher, born June 28th – 6lb 1 oz and 19.5

inches. Congrats on your bundle of joy!

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Publications:

Connors NJ, Nelson LS2. The Evolution of Recommended Naloxone Dosing for Opioid Overdose by Medical Specialty. J Med Toxicol. 2016 Jun 7. [Epub ahead of print]. Connors NJ, Nelson LS. The Devil is in the details, but the details are not in NHAMCS. J Med Toxicol. J Med Toxicol. 2016 Jun;12(2)145-7. PMID: 27083902. Connors NJ and Jauch EC. Suspected Intoxication and Overdose. Principles and Practice of Hospital Medicine, 2nd edition. Cenveo Publisher Services, 2016. Thurman JR, Jauch EC, De Leacy R, Mocco J, Oxley TJ, Kellner CP, Panagos PD. Evolving strategies in the emergent treatment of acute ischemic stroke. In: Jagoda A, ed. Emergency Stroke Care: Advances and Controversies, Volume I. EB Medicine, LLC; 2016:39-74. Jauch EC, Sean P. Barbabella, Frank Fernandez. ENT Conditions, Photographic Atlas of Emergency Medicine. Knoop, Stack, and Storrow, Editors. Fourth edition, McGraw-Hill Publishers, 2016. Jauch EC, Howell J, Gottesman B. Mouth Conditions, Photographic Atlas of Emergency Medicine. Knoop, Stack, and Storrow, Editors. Fourth edition, McGraw-Hill Publishers, 2016. Jauch EC and Holmstedt C. Intravenous Thrombolytic Therapy for Acute Ischemic Stroke: Results of Large, Randomized Clinical Trials, Thrombolytic Therapy for Acute Stroke. Lyden P. Springer, 2015.

Evan M. Pucillo, PT, DPT, Matthew B. Huish, PT, MBA, Quinn Tate, MS, Edward C. O’Bryan, MD, Ty T. Dickerson, MD, MPH. Global Health and Disability: A Review and Call to Action for All Rehabilitation Professions. Journal of Global Health Leadership, V1, Q4, 2016.

Wilcox SR, Strout TD, Schneider JI, Mitchell PM, Smith J, Lutfy-Clayton L, Marcolini EG, Aydin A, Seigel TA, Richards JB. Academic Emergency Medicine Physicians' Knowledge of Mechanical Ventilation. West J Emerg Med. 2016 May;17(3):271-9.

Wilcox SR, Saia MS, Waden H, Frakes M, Wedel SK, Richards JB. Mechanical Ventilation in Critical Care Transport. Air Med J. 2016 May-Jun;35(3):161-5. Meisner JA, Wilcox SR, Richards JB. Ibogaine-associated cardiac arrest and death: case report and review of the literature. Ther Adv Psychopharmacol. 2016 Apr;6(2):95-8.

Wilcox SR, Richards JB, Fisher DF, Sankoff J, Seigel TA. Initial mechanical ventilator settings and lung protective ventilation in the ED. Am J Emerg Med. 2016 Apr 23. pii: S0735-6757(16)30051-1.

Wilcox SR, Saia MS, Waden H, McGahn SJ, Frakes M, Wedel SK, Richards JB. On-scene Times for Inter-Facility Transport of Patients with Hypoxemic Respiratory Failure. Prehosp Disaster Med. 2016 Jun;31(3):267-71. Research: Our NIH SC-CoAST grant have been renewed for a 4th year! It is the longest running NIH grant in the Division’s history. Keep your fingers crossed. Emergency Medicine led the multidisciplinary submission involving Cardiology, Critical Care, Trauma, Neurosurgery, and Pediatrics from MUSC on a multicenter submission to the NIH for the new Emergency Care SIREN network. Our submission, SE-SIREN, is a collaborative with Vanderbilt University, University of Alabama Birmingham, University of Mississippi, University of Florida, and Augusta University. This new network is replacing the former NHLBI Resuscitation Outcomes Consortium and the NINDS Neurological Emergencies Treatment Trials (NETT) Network. If funded, we will see multiple new clinical trials coming to the ED on a broad spectrum of emergency care over the next 5 years and perhaps more.

Congrats to our 2015-2016 Interns/Residents for successfully completing the Resident Incentive Program!

Special Thank You to all of our Faculty Members who have given lectures for our EM Resident

Didactics during the 2015-2016 Academic Year! We greatly appreciate your time!

Mission Trip

In June Dr. Jauch enjoyed his 6th medical trip to Trujillo Honduras serving as a physician in a collaborative rural village clinic in Guadeloupe Carney with the Honduran health ministry. This was a record-breaking year with 104 people staffing in partnership with local physicians and nurses the hospital in Trujillo, a dental clinic, an eye clinic and 3 rural villages. Most of the physicians and nurses are affiliated with the University of Arkansas Medical Center, including his sister who is the jefa of his clinic.

Medical University of South Carolina 843-876-8023

Melanie Pigott Residency & Clerkship Coordinator EUS Fellowship Coordinator EM Grand Rounds Coordinator pigott@musc.edu