Working in underserved communities “resonates with the soul”

Jeremiah Madedor, MD ’20

From up close, and from a young age, Jeremiah Madedor, MD ’20, has gained intimate knowledge of the disadvantages that stem from a lack of healthcare access. His mother, who immigrated to the United States from Nigeria, pushed him to volunteer at the local veterans affairs hospital and homeless shelter, and he also went on mission trips with the family’s church. Then as a medical student at St. George’s University, he got hands-on experience working with the homeless population in New York City, as well as those who struggled to make ends meet.

“Those things really resonate with the soul and need to be addressed,” said Dr. Madedor. “I feel that, as a physician, I can do that.”

Now a first-year internal medicine resident at Spectrum Health in Grand Rapids, MI, Dr. Madedor sat down with SGU News to discuss ongoing healthcare issues in underserved communities, as well as his experience entering medicine in an especially challenging time.

St. George’s University: What are the most significant problems facing healthcare in underserved communities?

Dr. Jeremiah Madedor: Means and access. Patients usually fall into those two categories. In terms of means, we’re talking about money, resources, insurance, and connections to get to a primary care provider or the medical help you need. For financial reasons, a lot of patients don’t see physicians. An emergency department visit can cost thousands of dollars even without surgery, and with surgery, you can be looking six or seven figures for the cost.

Access is just as bad as means, because people may have the money or insurance, but if they don’t have the time to go for care, then nothing will be done. Several patients I see in the clinic skip appointments because they don’t have a babysitter or they work long workdays, and the list could go on.

SGU: What was it like entering medicine in the thick of a coronavirus pandemic? How would you describe the hospital and the community in Grand Rapids?

Dr. Madedor: My hospital has been preparing for COVID spikes since March, and has handled it as well as you can. Residents are educated on cases with didactics, and MICU/pulmonary attendings have been instrumental in learning managements of COVID. During my clinic, I have been tasked with seeing COVID patients with virtual visits, and while on the intensive care unit I have been seeing patients firsthand and managing them with the guidance of pulmonary attendings. It’s definitely been a life-changing experience seeing the complications firsthand of this new disease.

SGU: How has the recent social justice movement energized or changed you personally and/or professionally?

Dr. Madedor: I don’t believe it has energized or changed me personally because I have always fought for those disenfranchised or less fortunate. As an African American, I live this fight every day, so with my patients, I can empathize with them. I relate to them on a personal and ethnic level. A lot of people say ‘hi’ to me on the hospital floors or in the clinic and are happy to have their skin color represented by the physician they see.

“SGU took a student who was a potential diamond in the mine and refined him.”

 

SGU: Is there a case or experience that you can point to that brought your career path into focus?

Dr. Madedor: When I worked at Brooklyn Hospital as a medical student, there are incidents I can always lean on that fueled my fire. Working with Dr. Mansur and Dr. Bakshi is something I will always cherish. They taught me not see a patient as a pit stop but, as a physician, you become their conduit who will guide them to their next destination. So with that in mind, I did my best to learn their cases better and do thorough chart reviews so I could prevent potential oversights. Then in the rooms, I treated them like human beings, because patients are more than stats, and sometimes we forget that with a busy schedule.

SGU: How would you describe your experience at SGU, and how has it prepared you for your career?

Dr. Madedor: SGU was one of the most challenging and exhausting journeys of my life. I wouldn’t change that for the world because it prepared for me the roadblocks ahead. Now, as I sit here in the ICU, we had two patients code, two admissions, and I had to follow up on multiple patients throughout the night. Without the tools and guidance I received at SGU, I don’t think I would be capable of this feat. SGU took a student who was a potential diamond in the mine and refined him. Now he is a resident living out his dreams amongst the elite in his craft. From the days of eight- to 10-hour study dates, student support sessions, and rounding as a medical student, SGU provided the necessary environment for me to grow. With great resources, teaching, and great hospitals to rotate at, my experience couldn’t have been any better.

– Brett Mauser

On Match Day 2020, Dr. Madedor shared the news that he was headed to Grand Rapids, MI, for an internal medicine residency with Spectrum Health.

The Surprising Impact of COVID on Small Animal Veterinarians

Dr. Heather Douglas, DVM ’06

It’s not just human healthcare that has been dramatically impacted as a result of the COVID pandemic—animal medicine had its own challenges and some surprising opportunities for small animal veterinarians.

Dr. Heather Douglas, DVM ’06, owns and operates Douglas Animal Hospital in Osseo, MN. Douglas Animal Hospital treats a wide variety of animals from cats and dogs to geckos, snakes, potbellied pigs, and hamsters. She is also heavily involved in community services—both in the states as well as Grenada. Dr. Douglas founded the non-profit veterinary service, GrenVet, which provides free care to animals in Grenada.

Last month, Dr. Douglas presented a continuing education webinar to SVM alumni titled, “The Surprising Impact of the Pandemic on Veterinary Care.” She recently spoke with SGU News to explain how COVID is changing the way that veterinarians treat patients and interact with pet owners.

St. George’s University: What are the top concerns of pet owners about their pets in this environment?

Dr. Douglas: There has been an increase in cases of pets with behavioral changes which is most likely a result of the increased amount of time the owner is spending at home. This can escalate when owners return to work and patients have decreased contact time with them.

SGU: How have you had to adapt your clinical skills during the pandemic to care for your patients?

Dr. Douglas: I’ve had to become more efficient and spend more time communicating with owners. With new owners, it is harder to establish trust, so we gained their trust during what were essentially “curbside services,” by talking to clients on the phone when they can physically see you or performing physical exams in exam rooms with windows so clients can observe and support their pet.

SGU: Has the pandemic presented opportunity to small animal veterinarians? In what way?

Dr. Douglas: Yes, in the most surprising way. Initially, businesses like my own were slow when lockdowns were in place. We, along with other veterinary practices across the US affected by the downturn, received funding via the Paycheck Protection Program (PPP) and Economic Injury Disaster Loans (EIDL) to help keep us going. Then in mid- to late-April the floodgates opened. Some veterinary practices became so busy they were put in a tough position of choosing not to accept new clients or referrals. This influx was due to clients waiting to bring their pets in during lockdown, clients paying more attention to their pets while at home for extended periods so that illnesses were being detected much sooner, and people adopting new pets to decrease loneliness and feelings of isolation at home.

“I’ve had to become more efficient and spend more time communicating with owners.”

 

SGU: What are some additional ways the pandemic has affected veterinarians?

Dr. Douglas: Veterinarians are working longer hours to be there for our patients. But we’ve learned to value our emotional well-being and spend more time caring for our mental and physical health. Many veterinarians are hiring more staff to handle the increased number of patients, which is an unusual response considering the national unemployment rate.

SGU: How have technology and mobile care played an increased role in vet care, especially as a result of the pandemic?

Dr. Douglas: Telemedicine has been a valuable piece of technology to allow us to see our patients without a physical point of contact. This is especially important for those clients who are at higher risk of COVID-19 and complications.

SGU: What lessons can vet students take away from the global epidemic and how it affects them as future veterinarians?

Dr. Douglas: Vet students should learn to be adaptable. Going forward, there will be more opportunities in the veterinary field with increased hiring rates as well as opportunities in public health. Students will also have the upper hand compared to older veterinarians when it comes to technology and innovation.

– Laurie Chartorynsky

SGU grad takes to skies to save lives in Florida

It was the fall of 2012 when Larissa Dudley, MD ’13, then an SGU medical student on an emergency medicine/EMS clinical rotation at Newark Beth Israel Medical Center, accompanied helicopter crew on an airlift. It not only left an impression; it changed the course of her life.

“I happened to fly very shortly after Hurricane Sandy, and I was amazed by not only the view but by the amazing responsibility that these flight nurses and medics had,” she said. “Those in the aircraft risk their health and wellbeing to be available 24/7 to triage, stabilize, and safely deliver the most critical patients to their destinations, whether it be an emergency department, trauma center, or to the catheterization lab or operating room for definitive care.”

Dr. Dudley, now an emergency medicine physician in Florida, also serves as the assistant medical director of Health First’s First Flight, a helicopter program that makes approximately 700 flights per year covering the state’s Space Coast. First Flight is called for pre-hospital transports, often for severely injured trauma patients where the crew performs life-saving procedures and stabilization, as well as inter-facility transports. Dr. Dudley’s leadership role means that she is teaching and reviewing cases and best practices, updating and adjusting protocols, and maintaining relationships with local cities and towns to help coordinate seamless care.

“My heart is in EMS—all facets of EMS,” Dr. Dudley said. “As a physician, the oversight is nothing short of imperative, and the responsibility to maintain the crew’s education, clinical competencies, and best practices is humbling.”

– Brett Mauser

Simulation labs critical to emergency room efficiency

Traci Thoureen, MD ’98, in the Duke University Hospital Emergency Department. Photos courtesy Shawn Rocco/Duke Health

Before emergency medicine physicians face the myriad of cases that may come through the door on any given day, they will have practiced—over and over—the techniques and procedures needed to provide quality care with great efficiency. Some of the training occurs in a simulation lab, where practice can save critical minutes and even seconds when they’re needed most.

SGU News caught up with Traci Thoureen, MD ’98, the director of simulation and associate professor in the Division of Emergency Medicine at Duke University Medical Center in North Carolina, to learn more about the role that simulation plays at Duke, and how it was especially important at the onset of the COVID-19 pandemic.

St. George’s University: What is simulation and how important has it become in the training of emergency medicine residents?

Dr. Traci Thoureen: Simulation is one technique that we use in educating our medical school students and residents, as well as to provide context for attending physicians. It’s become paramount to add this live training to our department—such as procedural training, seeing rare cases, and also for team training and leadership. The sim lab allows us to have a safe learning environment that is incredible for practice and evaluation.

SGU: In addition to practical training, what intangible skills can be taught in the simulation lab?

Dr. Thoureen: In the emergency department, most of our day is spent working as a team—with nursing, techs, consultant residents, and/or attendings. We work in teams certainly for our trauma activations, as well as our sick medical patients and resuscitations. This is a skill starting from the first year that our residents are learning, and simulation allows them to practice their roles and the techniques that work well in those roles. Communication is a skill that we don’t often get to take a look at and with simulated scenarios, we really slice and dice it out to improve it.

“Simulation is one of the few ways that we can teach in a safe way yet get a visceral reaction.”

 

SGU: How and why did simulation become your career path, and what do you enjoy most about it?

Dr. Thoureen: I’ve been doing academic emergency medicine since I finished residency, and I’ve been lucky enough to have great mentors. I was able to learn from some of the best in simulation at Harvard’s Center for Medical Simulation in 2004 and that started my interest and passion for it. I really enjoy being creative in developing new cases and thinking about all the ways to make it more real. Simulation is one of the few ways that we can teach in a safe way yet get a visceral reaction. Also, I really enjoy trying out other educational technologies and seeing how they could fit into curriculum.

SGU: In what ways did simulation scenarios assist with addressing the COVID-19 pandemic?

Dr. Thoureen: We were able to set up a simulated airway area within our emergency department. We first got the attending staff onboarded with the equipment that we were going to be using for addressing intubations with COVID patients. Because of the success and safety we had with that, we extended that to our second- and third-year residents. We were able to see the ins and outs of the equipment on a manikin before having to use it on an actual patient.

SGU: How did the department adjust for online education in the early stages of the pandemic?

Dr. Thoureen: I teach a course to our first-year medical students, “Body and Disease.” It covers pathophysiology, immunology, and pharmacology, and we do four cases over three months. With COVID, I had to rethink and rework how to do simulation patient activity without a simulator. It was an abrupt change, but we were able to creatively mirror the experience virtually. Through Laerdal, one of the main manufacturers of human patient high-fidelity simulators, we could pipe in software and display a patient monitor that could show the effect of vital sign changes, and incorporate other aspects of the case with other instructors who would represent the patient, a nurse, or a family member. In our residency, we transitioned to Zoom conference. It became a wonderful way to incorporate national speakers and alumni to our education, as well as to do creative activities like using Zoom breakout rooms for gamification activities.

SGU: You co-authored the book Emergency Medicine Simulation Workbook: A Tool for Bringing the Curriculum to Life. The second edition comes out next year. What can readers expect to see in the book?

Dr. Thoureen: One of the frustrations that people have with new technology is that they feel like they don’t even know where to start. This is meant to be a catch-all book for novices and seasoned educators alike when it comes to simulation, specifically EM simulation. It can appeal to not only physician groups but nursing groups, RTs, and EMS. It’s broken down from nuts and bolts, to educational objectives, to all the things that you need to run a case. There’s also an online component, with images and labs for each case so that you have everything you need to run a case or a whole EM simulation curriculum.

SGU: How would you describe your St. George’s University experience?

Dr. Thoureen: I have really fond memories of my time at St. George’s. I made great friendships and bonds, and I felt like it was the time where I got to really try my best and move everything forward in my career. Medical school was a period where there were a lot of transitions, but they have served me well in my residency training and going forth in my now 18 years in practice in academic medicine. It’s been really fun for me to read about the expansion of education at SGU and to see SGU residents along the way join academic medicine and emergency medicine.

– Brett Mauser

SGU President: “Everyone Should Get a Flu Shot”

With flu season further threatening an already challenging year due to the global COVID-19 pandemic, the Centers for Disease Control is recommending that everyone ages six months and up receive a flu vaccine.

“While it’s not possible to say with certainty what will happen in the fall and winter, CDC believes it’s likely that flu viruses and the virus that causes COVID-19 will both be spreading. In this context, getting a flu vaccine will be more important than ever,” according to the CDC’s website.

 

To understand the science behind flu vaccines and how it helps minimize infections, SGU News spoke with St. George’s University President Dr. G. Richard Olds, an expert in infectious diseases.

St. George’s University: What are the benefits of getting a flu vaccine?

Dr. Olds: Most of the time the flu vaccine prevents you from getting the flu, and even if it doesn’t, it makes your flu illness less severe and shorter in duration.

SGU: Who should get a flu shot?

Dr. Olds: Everyone should get a flu shot every year. There is almost no downside to getting one, and it clearly helps lessen the severity of the flu. In addition, it keeps us from transmitting flu to vulnerable older adults who are at higher risk from the flu. Thus, the vaccine protects you as well as society.

Importantly, all healthcare professionals are required to get it, so they don’t bring the flu to elderly patients and those with altered immune systems.

SGU: Why is getting a flu shot even more important this year, given the global pandemic?

Dr. Olds: Since COVID-19 symptoms are very similar to flu symptoms—at least in the beginning—getting a flu shot is helpful in avoiding confusion if you develop respiratory symptoms or a fever. It’s important to note that a person can be infected with both flu and COVID at the same time, and it is likely that this double infection will be far worse that either alone.

SGU: How does the vaccine work? Why do some people get “sick” after getting the vaccine?

Dr. Olds: Flu vaccines come in several types. There is a live weakened viral vaccine used primarily for children; there is the killed vaccine, used for many years, primarily for young adults through age 65; and a new high potency vaccine designed for those over 65.

Contrary to popular belief, adults and seniors can’t get the flu from the flu shot given to them. Because we give the flu shot during the fall/winter when many respiratory viruses are around, people often get infected with a non-flu virus around the time they get the flu shot and blame the vaccine for their illness.

That said, children are given a live weakened vaccine that sometimes causes a very mild flu illness. When the child recovers their immune system is ready to fight off the real flu.

SGU: How effective is the flu vaccine?

Dr. Olds: Unlike tetanus shorts or Measles vaccines, the flu virus vaccine must change slightly from year to year in order to work. That’s because the target—the flu virus—mutates rapidly. As a result, the vaccine has to be reformulated every year to match the specific flu virus we expect each flu season. Most years we do a good job of “guessing” what exact flu viruses we will face each fall, but some years the virus mutates in an unpredictable way and the vaccine is not as effective. Even with a mismatch, the vaccine reduces the severity of the illness. Fortunately, we also have antivirals like Tamiflu that we can use to fight flu if a vaccinated person gets infected.

The real problem is that too few people get the vaccine, so the virus circulates effectively and eventually finds the vulnerable members of our society. Very few people would die of flu each year if everyone got a flu shot.

SGU: Can you speak to the speed at which a flu vaccine is created?

Dr. Olds: The entire process takes about four months. Scientists decide what strains they think will circulate in the fall around March and April of each year. Flu shots are usually a combination of three or four specific flu virus strains. Then they have to grow each strain in eggs, harvest the virus, and then formulate the year’s new vaccine. Flu shots first appear in the market in late August or early September.

Since the vaccine is only good for one year (because the virus changes each year), manufacturers try to produce about the same amount of vaccine used the previous year. As a result, if demand going way up, such as this year, we could run out of vaccines before the flu season is over.

 

—Laurie Chartorynsky

SGU and Grenada: A Strong Partnership to Address the COVID-19 Pandemic

For more than 40 years, St. George’s University in collaboration with the Government of Grenada have worked hand in hand to confront challenges both big and small. Their partnership may have never been more stalwart, their mission more resolute, than in 2020, when the country and the world have grappled, and continue to grapple with, the ramifications of a widespread and persistent coronavirus pandemic due to SARS-CoV-2. 

Close collaboration on the development of lifesaving testing capabilities and the donation of critical medical equipment has been a crucial outcome of the partnership between SGU and Government of Grenada. The University and the Grenadian government have upheld their commitment to the nation—to ensure that its residents remain, above all else, safe and healthy. 

“We applaud and thank those with the Government of Grenada for their vision, diligence, and resolve in these unprecedented times in healthcare,” said Dr. Charles Modica, Chancellor of St. George’s University. “When faced with the myriad of challenges that the COVID-19 pandemic presented, we worked collaboratively and in the best interest of the entire Grenadian community, including the alumni, faculty, and staff at St. George’s University.”  

This public private partnership is an exemplar of cooperation,” said the Hon. Nickolas Steele, Grenada’s Minister of Health and Social Security, and member of the Executive Council of the World Health Organization. “Remarkable results have been achieved through this partnership, and we will continue to work together in this fight. 

St. George’s University was the national testing site for Grenada during the spring, testing Grenadian citizens as well as University faculty, staff, and students.

Partnership Aces the Test 

This spring, COVID-19 outbreaks around the world forced government and university officials to act decisively. The Government of Grenada, the Caribbean Public Health Agency (CARPHA), the Pan American Health Organization (PAHO), and the Windward Islands Research and Education Foundation (WINDREF), a research and education foundation based at SGU, worked to establish one of the first diagnostic testing facilities in the Caribbean and was established on the lower campus. 

Under the leadership of Dr. Calum Macpherson, Dean of the School of Graduate Studies and SGU’s Director of Research, qPCR testing operations at St. George’s University have so far resulted in more than 3,000 individuals (with and without symptoms) receiving safe and prompt COVID-19 diagnostic tests, with results received within eight hours.  

Crucial to its success was the Minister of Health’s procurement of the necessary primers, probes, and reagents through PAHO, as well as an ample supply of personal protective equipment (PPE) from the onset of testing. Results were shared each night by Dr. Trevor Noel, SGU’s Director of Field Research, with the Ministry of Health, as well as PAHO and University officials. These outcomes helped guide government COVID-19 policies, including at airports and ports of entry, during the peak weeks and months of the pandemic. 

“Because there was a global shortage of reagents, we couldn’t have had the testing capacity if not for the extraordinary efforts of the Minister of Health,” said Dr. Macpherson. “We have one home—Grenada—and our common agenda was to diagnose the virus, implement a test, trace, and isolate policy from early on in the epidemic, which has served us well.”  

This testing was administered by the University’s School of Veterinary Medicine, which had the necessary equipment in place due to its ongoing influenza research efforts, as well as qualified personnel to administer the tests. The campus-based site served as the national testing service into the summer months, and still operates as one of approximately 250 quality control labs around the world overseen by the WHO. Results from SGU’s lab have been in 100 percent concordance with the expected test results from WHO. 

“SGU was one of the first vet schools to do COVID-19 testing. In April, we began testing the community in Grenada and helped the Government of Grenada test repatriating Grenadians who returned home by ship and by air,” said Dr. Neil Olson, dean of SGU’s School of Veterinary Medicine. “We were so happy to have had the equipment and the expertise—including lab and technician expertise—to take this on.” 

According to the WHO, Grenada has reported 27 COVID-19 cases and zero COVID-19 related deaths to date. SGU’s testing site has since been a beacon of excellence for the entire region. SGU’s diagnostic team helped design and set up the Ministry of Health’s testing site at Grenada General Hospital, including training of lab staff and troubleshooting with initial qPCR lab testing. 

 

Since breaking ground more than 40 years ago, all the way to present day, we truly believe that we couldn’t have chosen a better partner for this university.”

 

Equipped for the Challenge 

Grenada General Hospital is responsible for the great majority of emergency healthcare services throughout the islandUpon the arrival of COVID-19 in the global conversation, it braced for a surge of patients like other facilities around the world. 

Its primary need: ventilators. The hospital had just two ventilators, designed to mechanically assist patients with breathing, for the entire population of more than 100,000 people. Responding to that need, St. George’s University tapped into its international consortium of resources to facilitate the acquisition and delivery of 18 additional ventilators.  

“The substantial support from SGU served to bolster our efforts to tackle COVID-19,” said Dr. Carol McIntosh, Director of Hospital Services. “Their acquisition and donation of critical medical resources such as ventilators and PPE for health workers helped to ensure that we were better prepared to deal with any potential outbreak of the disease here in Grenada.”  

SGU also secured tens of thousands of pieces of personal protection equipment, ranging from gloves and gowns to goggles and facemasks, for medical personnel as well as members of the community. In addition, SGU was able to bring in 18 combination defibrillator monitors, two handheld ultrasound machines, two portable X-ray machines, as well as blood gas analyzers and supplies.  

The equipment has been crucial to providing critical care to patients throughout the pandemic. The fight with COVID-19 is still ongoing, both in Grenada and around the world, and St. George’s University and the Government of Grenada are committed to continuing to collaborate and innovate, with the health and safety of its citizens in mind. 

“Since breaking ground more than 40 years ago, all the way to present day, we truly believe that we couldn’t have chosen a better partner for this university,” said Dr. Modica. “Our mission has always been to improve healthcare on a national, regional, and global levels, and we are thrilled to have had the support of the government—and the people—of Grenada throughout this journey.” 

– Brett Mauser

The Laboratory Personnel Behind SGU’s COVID Testing Site

Even before the coronavirus disease (COVID-19) reached the shores of Grenada, St. George’s University’s School of Veterinary Medicine, together with the Government of Grenada and the Pan American Health Organization (PAHO), were prepared for it. With the proper equipment and a team led by two staff members—both SGU graduates—in the SVM’s molecular virology lab, the virus has had minimal impact on the island, with just 27 cases and zero deaths reported.

“We are grateful for all the individuals, volunteers, and organizations whose commitment to a common cause has helped minimize the effects of the virus in Grenada,” said Dr. Calum Macpherson, dean of the School Graduate Studies and SGU’s director of research. “It has been a complex operation, from the team of nurses and physicians that completed the nasopharyngeal swabs led by Dr. Kathy Yearwood, director of the University Health Services, to the School of Veterinary Medicine team led by Dean Neil Olson. They have done a tremendous job, navigating the university and the country through a very difficult time with a testing operation that was accessible, accurate, and efficient.”

SGU’s lab served as Grenada’s national testing site at the onset of the pandemic. The effort has been facilitated by a number of staff members. In particular, SGU graduates Trevor Noel, MPH ’03, PhD ’17, Bhumika Sharma, PhD ’20, Vanessa Matthew-Belmar, MSc ’16, have tested more than 2,000 St. George’s University students, faculty, and staff, over 1,200 members of the Grenadian community, as well as individuals arriving in Grenada via plane or cruise ship.

“In the beginning, we knew we had an equipped laboratory and the personnel with specific molecular biology training who could step in during this emergency to take on COVID testing,” said Dr. Melinda Wilkerson, chair of pathobiology in the SVM.

In addition to Dr. Sharma and Ms. Matthew, Dr. Wilkerson praised the efforts of Associate Dean of Research Dr. Sonia Cheetham-Brow, molecular virologist Dr. Mercedes Abeya, and faculty members Dr. Andy Alhassan and Mr. Dan Fitzpatrick, as well as the leadership provided by Drs. Macpherson, Olson, and Noel, the field research director for SGU and deputy director of the campus-based Windward Islands Research and Education Foundation (WINDREF) who was instrumental in coordinating with the Ministry of Health, Government Cabinet Ministers and the SGU testing team regarding sample collection, on-time delivery of samples to the lab, and the reporting of results and discussion with the Ministry of Health, Grenada Government Cabinet of Ministers and PAHO.

“We couldn’t be prouder of the professional work that our entire team has done in the face of a daunting challenge,” Dr. Olson said. “There has been plenty of uncertainty around the coronavirus, and the thorough diagnostic testing has provided not only answers but peace of mind for so many people in Grenada.”

In the early stages of the pandemic, Dr. Sharma and Ms. Matthew-Belmar extracted and processed 30-70 samples each day working up to eight hours, seven days a week, for three months. COVID testing required the use of similar techniques and materials, such as primers and probes, used for RNA extraction in a standard PCR test. Results were received within eight hours.

“To find out if COVID is present, we would exponentially amplify, using PCR, any virus gene sequences in the sample,” said Dr. Sharma, an instructor in the SVM’s Department of Pathobiology. “If the virus is there, the primers and probes would adhere to it and produce multiple copies of the RNA.”

Their work continued into the summer months and now into the fall, not only as an on-campus but in helping the Grenada Ministry of Health develop its own testing facility, training the new facility’s lab staff and troubleshooting initial qPCR testing. The campus-based site still operates as one of approximately 250 quality control labs around the world overseen by the World Health Organization (WHO). Results from SGU’s lab have been in 100 percent concordance with the expected test results from WHO.

“It gives me a sense of pride to give back to the country what I have learned,” said Ms. Matthew-Belmar, the head laboratory technician in the SVM. “I’m grateful for SGU, where I have learned many different testing techniques.”

“When there’s a pandemic, everyone has to come together, regardless of whether you’re working under medicine or are in the veterinary field,” Dr. Sharma added. “I feel so proud to be able to do something helpful for this community. It has been a great experience.”

– Brett Mauser

School of Veterinary Medicine Spotlight: A Look Inside the Large Animal Resource Facility

St. George’s University’s Large Animal Resource Facility (LARF) is a one-acre farm located just outside of its True Blue campus in Grenada. The facility is home to the equine and bovine teaching herds that students of the School of Veterinary Medicine use to gain crucial large animal clinical skills prior to their fourth year.

Dr. Inga Karasek, director of the Large Animal Resource Facility and an assistant professor in the School of Veterinary Medicine, is one of a dozen SGU faculty and staff members, including technicians, clerks, and veterinarians, who care for the animals living on the LARF. She was also one of a handful of SGU staff who remained on the island to care for the animals during the early days of the global pandemic. Dr. Karasek shared why the farm’s ecosystem—even while students are learning remotely—is important to studying veterinary medicine at SGU.

St. George’s University: Why is the facility important for students who are learning veterinary medicine?

Inga Karasek: The majority of today’s students come from cities or heavily populated areas. Gone are the days where most veterinary students came from rural counties. This means that the average veterinary student has had no or minimal exposure to large animals. Veterinary students are expected to become proficient in dealing with all species by the time they are finished with their curriculum. It is important for them to acquire the skills and the confidence of handling large animals prior to their clinical year.

SGU: What type of hands-on experience do students receive through the LARF?

IK: Students learn to complete physical examinations on the cows, horses, and donkeys with more specialized examinations in upper terms, e.g. lameness examinations and neurologic examinations in horses. In their last year, they are also able to perform reproductive examinations on the bovine herd.

SGU: How has the LARF incorporated distance learning while students are away from campus?

IK: We recently did a live zoom session for SGU’s large animal society where we looked at a couple of lame horses on the yard. Our large animal professors are also incorporating live physical examination sessions for their courses as well. In addition, there are a handful of term 6 students on island and they came to the LARF to cover their clinical skills externship requirements for the term. We also allow a small number of students to come and help at the weekends if they so wish. All, of course, following COVID protocols.

SGU: How do you protect the animals?

IK: Animals are vaccinated against endemic diseases and have 24/7 veterinary care. Every time an animal is used in a lab with students, it is noted in their “Animal Use” files to ensure that animals are not being overused. This is also a mandate of the Institutional Animal Care and Use Committee (IACUC), which every institution that uses live animals for teaching or research purposes must have in place. (The IACUC reviews the practices on the LARF and other areas at SGU where live animals are to ensure that animals are always treated fairly.)

SGU: During the height of the COVID pandemic, who took care of the animals? What precautions were put in place and continue to be practiced for safe veterinary care?

IK: The farm staff, myself, and Drs. Janicke and Nigito took care of the animals. During the early days of the pandemic, we implemented an initiative where only two staff members and one veterinarian were allowed to be on the farm at a time. This allowed us to practice social distancing, even if it did make some jobs more challenging accomplish. Today, masks must be worn if persons are working in close proximity with each other, while handwashing/sanitizing is to be done prior to entering the LARF and on leaving. There is a boot wash to walk through on entering and leaving. As mandated by SGU, all staff and faculty are PCR tested as well.

SGU: What is one thing you would like the SGU community to know about the LARF?

IK: Students really enjoy spending time on the LARF, and many have made the point that they were surprised by how much they enjoyed working with the horses and cows. These experiences really open their eyes to the possibility of working in mixed animal or large animal practices upon graduation. This is a great thing—as North America is lacking large animal veterinarians, especially in very rural areas, and this will affect the care of the production of animals in those regions (cattle, pigs, chickens, etc.).

The veterinarians that work here are also those involved in the One Health, One Medicine clinics and go out to local farms with students to take care of the community’s large animals.

SGU: Anything else about the SGU community should know about the LARF?

IK: I believe one of the strengths of the program at SGU is that because of the relatively basic setup of our facility, students get multiple opportunities to practice real-life general practitioner’s difficulties that need creative solutions. This makes our students (and faculty) become more flexible and resourceful people, and able to find solutions with minimal resources.

We are proud of the work that the LARF does and its contributions to making SGU students’ excellent veterinarians.

 

— Laurie Chartorynsky

School of Veterinary Medicine Hosts Virtual Wellness Event for Students

More than 50 veterinary students attended a virtual wellness event on Saturday, October 17, hosted by St. George’s University’s School of Veterinary Medicine and the SVM Affairs group.

The Zoom presentation featured Dr. Melanie Goble, vice president and a founding board member of Not One More Vet, a nonprofit organization dedicated to helping veterinarians in need of mental health support. Dr. Goble’s presentation was titled “Finding Motivation, Setting Boundaries, and Life During COVID.”

Following Dr. Goble’s speech, there was a question-and-answer panel consisting of Dr. Goble; Dr. Barbara Landon, director of SGU’s Psychological Services Center; Dr. Adria Rodriguez, SVM’s wellbeing, diversity, and inclusion officer and the faculty advisor the SVM Wellness Committee; as well as Drs. India Paharsingh, Arend Werners, and Anne Marie Corrigan. The Q&A consisted of questions submitted by the students of the SVM community.

“We are thrilled with the turnout for our virtual mental health event,” said Jennifer Kirk, DVM ’22 (expected), SGA’s president of SVM Affairs. “Mental health is a very serious issue in the field of veterinary medicine, particularly during this unprecedented time due to the COVID-19 pandemic. Our goal was to provide students with resources and an opportunity to ask questions and provide a sense of community and support that we are all in this together.”

Dr. Corrigan, SVM’s associate dean of academic programs and professor of small animal medicine and Surgery, echoed Ms. Kirk’s sentiment: “Dr. Goble provided a very engaging discussion about the necessity of self-care. We plan to host more of these events for our students.”

Emotional and Psychological Support  

To acknowledge World Mental Health Day, SGU reminded students of the free mental health support resources provided by the school.

If you or one of your colleagues needs help, there are several options:

  • Email PSCscheduling@sgu.edu to set up an appointment with a psychologist. Crisis appointments are available 24/7 by phoning the Psychological Services Center at (473) 439-2277 during business hours, or after 5pm and on weekends through the University Health Clinic at (473) 444-4671.
  • To receive 24/7 counseling services, register with Brooklyn Counseling Service at SGU-BCS Counseling or call (877) 328-0993.
  • Visit our self-help resources page or our Instagram page for tips about managing stress and isolation related to COVID-19.
  • Visit the Well on the SGU portal for a collection of health and wellness activities and resources from SGU designed to help your mind, body, and soul.
  • Use the self-help therapy app WellTrack for self-help. WellTrack will track your mood, and contains quick recorded lessons for managing depression, anxiety, and stress.

Additional Mental Health Resources

Dr. Landon hosts a weekly Mindfulness Workshop on Thursdays at 12pm AST. All are invited to join (https://sgu.zoom.us/j/97007160217; Meeting ID: 970 0716 0217).

Students are encouraged to take advantage of these services and to review the resources available from the Psychological Services Center.

 

— Laurie Chartorynsky

SVM Research Findings: First-Year Clinical Exposure Benefits Students

 

Four St. George’s University School of Veterinary Medicine graduates, two current students, and SVM Professor Dr. Anne Marie Corrigan were among the 10 authors of a paper recently published in the Journal of Veterinary Medical Education.

The research paper, “Introducing Clinical Behavior Medicine to Veterinary Students with Real Clients and Pets: A Required Class Activity and an Optional Workshop,” focuses on how behavior problems in clinical practice requires diagnostic expertise as well as excellent client skills in communication, gained by experience. The research addressed the issue by introducing small animal clinical behavior to first-year veterinary students at St. George’s University.