- Associated Press - Saturday, June 3, 2017

URBANA, Ill. (AP) - When a patient developed a complication following stomach surgery, Dr. Blair Rowitz thought of a novel way to repair it - but the right tool hadn’t been invented yet.

His patient, Arrow Ambulance paramedic David Burt, underwent gastric bypass surgery as part of a broader weight-loss plan. The procedure went fine, but later Burt developed a bowel obstruction related to a surgery years earlier.

Rowitz operated again to repair the obstruction, but that led to a perforated bowel. Rowitz sewed it up, but it leaked, leading to an infection and four more surgeries.

If he’d been able to use a “stent” made of a material that could be absorbed by the body, Rowitz could have placed that inside the bowel to prevent the leak and protect the repair. Stents, used to open clogged arteries or perforations in the colon and esophagus, are normally made of metal and silicone, he said.

So Rowitz teamed up with University of Illinois bioengineering professor Dipanjan Pan, who was already working on an absorbable stent for a different application. They got a seed grant from the new Carle Illinois College of Medicine and have developed a prototype to test in animals.

“Had I had this tool at the time of the gentleman’s initial problem, we very well could have saved a year and a half of hospitalizations, multiple surgeries and radiological procedures,” Rowitz said.

It’s a “perfect example,” he said, of the collaborations that can grow out of the new Carle Illinois College of Medicine, designed to bridge a gap between scientists and engineers who design new medical tools and the physicians, and future doctors, who will use them.

Rowitz is one of 104 faculty who’ve signed on to teach at the new engineering-based medical school, which is set to open in July 2018.

“As a physician, the opportunity to do things better for our patients and innovate and solve these problems, that’s really exciting,” Rowitz said.

The 100-faculty threshold is key, as it allows the college to create faculty committees and a shared governance system.

Most of the faculty are familiar faces, doctors already working at Carle (41) or professors at the UI’s Urbana campus (63) who will hold full or partial appointments at the medical school.

The majority of professors come from engineering or traditional basic science departments, such as physiology or microbiology. But they also span eight different colleges, from agriculture to social work. Dr. King Li, hired from Wake Forest to be the medical school’s new dean, said traditional medical schools typically hire full-time faculty so they’re limited to a smaller pool.

“What we’re trying to do is really leverage the diverse expertise throughout the campus, and also from the Carle system,” Li said.

Salaries for faculty with joint UI appointments will be shared by the medical school and the professors’ home departments, with most holding 25 percent appointments in the college of medicine, Li said. Some Carle physicians will have smaller appointments, and some leadership positions are full-time.

The medical school is also recruiting outside Champaign-Urbana for additional “physician-scientists” who will teach medical students and do research, Li said.

Li said deans and department heads across campus have been generous about giving their “star faculty” time to contribute to the new medical school, to help “build something unique.”

“This campuswide collaboration, I would say, is almost impossible to see in other campuses in this country. Most people want to hold on to their star faculty. They spend time and money recruiting these people to their college,” he said.

The academic diversity is important for pursuing interdisciplinary research and instruction in the medical school, he said.

Among the “stars” is chemistry Professor Martin Burke, who holds both a Ph.D. and an M.D. from Harvard. His research focuses on the synthesis of small molecules with protein-like functions, with the hope that they could be used to treat diseases caused by missing proteins, such as cystic fibrosis. Burke refers to it as “molecular prosthetics.”

Working with yeast, Burke and his team found that a small molecule known as amphotericin B - extracted from bacteria and used to treat fungal infections - could substitute for a missing protein and make the yeast grow, “like a prosthesis on a molecular scale.”

The team is now expanding on that research. Burke and other UI colleagues hope the new College of Medicine will make it easier to do patient trials someday.

“Many of us have been really hungry for direct connection to medical colleagues” who could ultimately help translate research to help patients, Burke said.

As interim associate dean of research, Burke said he will work with Li and medical school faculty to take advantage of the new partnership to empower cutting-edge research and use it to improve human health.

“The College of Medicine represents just such an extraordinary opportunity,” Burke said. “This is an incredibly powerful thing, to bridge fundamental science and engineering to transmit game-changing health research, in an environment with such a history of ground-breaking research and now a connection to the medical community. The sky is the limit.”

Burke and Rowitz believe the school will be able to attract “absolutely top-notch talent” and “national thought leaders” in medicine from around the world.

“There’s going to be one place in the world where this research can be done at the highest level, and it’s going to be here,” Burke said.

The list of new faculty also includes several of the dozen or so professors who now teach for the regional medical school in Urbana, run by the UI College of Medicine in Chicago. That program is being phased out. Other faculty there have decided to teach full-time in the College of Liberal Arts and Sciences.

Microbiology Professor James Slauch, who has taught at the regional medical school for 23 years, is now interim associate dean for academic affairs for the new Carle Illinois College of Medicine. He also runs the Medical Scholars Program at Urbana for students earning both an M.D. and a Ph.D. in another field. He will continue in that role until the last of the medical scholars students graduates in 2022.

He said the new college sent emails to every faculty member on campus and every physician at Carle, asking if they wanted to apply to be part of the new medical school.

“It’s a once-in-a-lifetime opportunity,” Slauch said. “There’s really a lot of excitement across campus, and at Carle.”

Slauch oversees the team developing the curriculum for the new medical school. The first year and a half is composed of a series of integrated courses, team-taught by a basic scientist, a practicing doctor and an engineer, centered on a different patient case study each week. Traditional medical schools involve two years of classroom-based instruction in basic sciences, followed by two years of clinical training working alongside physicians.

About 70 of the 100-plus faculty are directly involved in teaching those courses, Slauch said.

Others help with curriculum oversight and administration - including Department of Bioengineering head Rashid Bashir, who is the medical school’s interim vice dean, and biochemistry professor Susan Martinis, interim director of biomedical science and engineering.

Four “facilitators” are also being recruited to coordinate the courses and work closely with students; they could be doctors or education professors or other scholars. More will be hired as the initial class of 32 medical students ramps up to 64 over time.

Some UI humanities faculty had pressed administrators about other aspects of medical education at the engineering-based medical school, such as policy analysis and ethics.

Li said medical humanities will be “infused” into the curriculum from the start. He said he elevated medical humanities to be one of the college’s four “pillars” of medical education, along with engineering and the traditional basic sciences and clinical sciences.

“We are very focused on not losing sight of what’s most important in medicine: the care side,” he said.

“Medical education is not just about teaching the students to prescribe the right treatment or make the right diagnosis, but actually looking at the entire health system, a 360-degree view. So if a patient can’t afford a prescription, how can you help this person?” Li said.

“Medical humanities” will cover medical ethics, professionalism, the history of medicine, how to work as a team, medical finances, health policy, even engineering copyright, said Carle neurologist Dr. Robert Cranston, who is chairing the college’s subcommittee on ethics and professionalism.

Some of that will be taught in lectures, but it will also be part of the case studies that students will take on in every class from day one, Cranston said.

One hypothetical example: An oncologist, or cancer doctor, who isn’t sure if a patient with a brain tumor is still able to make decisions about his treatment. How should he balance the patient’s wishes with the person who has power of health-care attorney?

Cranston said the ethics training at some medical schools is too broad and doesn’t focus enough on an individual doctor’s behavior.

An early mentoring program will allow UI students to develop relationships with physicians throughout their four years of training, rather than spend a few days shadowing different doctors during their first year, Cranston said. That should give them more exposure to “what ethical behavior is,” he said.

Teamwork is another key. Most medical students are talented academically, know how to work on their own and test well, he said. Here, they have to learn not just about medicine but how to be a doctor.

“This is a completely different skill set,” he said. “One of the key things that we want to teach people right from the beginning is it’s not all about the doctors. It’s about the interactions with the team, and with the patient, and with the family and with the community.”

Rowitz said the school’s potential goes beyond technological advances to improving the way medical care is delivered or lowering health costs. The college also plans to work with community health agencies, to improve home-based care and address other patient needs, such as transportation, nutrition or affordable prescriptions, he said.

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Source: The (Champaign) News-Gazette, https://bit.ly/2pXFwe2

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Information from: The News-Gazette, https://www.news-gazette.com

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