Concentration Directors

Esther Entin, MD
Clinical Associate Professor of Family Medicine
Email: ejentin@aol.com

Liz Tobin Tyler, Esq.
Director of Public Service and Community Partnerships
Lecturer in Public Interest Law
Feinstein Institute for Legal Service
Roger Williams University School of Law
10 Metacom Avenue
Bristol, RI 02809
Ph: (401)254-4634
Email: ltyler@rwu.edu

Alpert Medical School has a longstanding commitment to community involvement and patient advocacy as essential elements in medical education. The mission of Brown Medical School lists two major goals for its graduates: “that they be broadly and liberally educated men and women, and that they view medicine as a socially responsible human service profession.” Brown Med graduates are known to be scientifically informed, scholastically excellent physicians and devoted patient advocates, who are committed to public service. Building on this student profile, a faculty commitment to advocacy, and a diverse training environment, Brown is well positioned to integrate activism and advocacy as a central part of its new medical training program.

The Scholarly Track in Advocacy/Activism will promote new scholarship that addresses a range of timely issues including:

• The societal and economic consequences of disparities in the provision of medical care
• Collaborative (cross-disciplinary) approaches to advocating for the underserved (to be carried out with our colleagues at Roger Williams University Law School and other concentrations with similar goals such as Caring for Underserved Communities, Health Policy, and Women's Reproductive Health)
• Shaping public policy
• Advocacy across borders – implications for global health

We intend to take full advantage of the broader Brown community of teachers and researchers, including public policy experts from the Taubman Center, The Center for Study of Urban Education Policy, scholars from the Watson Institute for International Studies, faculty within the Program in Public Health and the International Health Institute.

CURRICULUM

Learning Objectives

• Concentrators will gain an understanding of advocacy and activism on behalf of patients and their communities as an essential part of professionalism.
• Concentrators will understand the role of structural violence and societal injustice in creating health disparities.
• Concentrators will gain skills and experience in identifying issues, analyzing issues and policy, organizing advocacy strategies, and advocating for patients and communities with policy makers, stakeholders, with the media, and legislatively.
• Concentrators will be able to analyze and influence health and social policy to the benefit of patients and their communities.

Concentrators will design and carry out a summer research project between years I and II.  It is hoped that they will continue their advocacy and activism pursuits throughout the remainder of their medical school education, particularly during the second year.  It is expected that concentrators (from MD 2016 on)  will  produce a scholarly product such as a published paper in a peer-reviewed journal, or a presentation at a national meeting  or a policy paper with a targeted distribution to key area decision-makers that would be of a  quality that it would be suitable for broader distribution. This  product should be created with the guidance and feedback of their project mentor.  It may be based on the summer research project or may be an outgrowth of interests developed as a result of the Poverty, Health and Law course.  The student will be expected to communicate regularly with the concentration director about the direction and status of their scholarly work.  

Timeline of Activities

Year I: All students will receive experiential opportunities and didactic sessions on a wide range of issues of social justice and health care. This will be done as part of the Doctoring course.
Students interested in pursuing deeper study of advocacy and activism will identify a mentor and propose a project for summer following Year I. The mentor will continue working with the students through completion of the capstone project.

Summer between Years I & II: Experiential Learning/ in-depth study. Opportunities may include working with legislators, at the Department of Health, at community based organizations, policy and advocacy organizations, or studying the history of an issue or topic. In addition, summer immersion experiences should include service learning work with vulnerable populations and their communities.

The rationale for this is that (1) it puts the advocacy into context and is made relevant to the people most affected by it; and (2) it practices an approach that discourages students from being interlopers into a community of need who may take on an issue but with little connection to the cause, process, or outcome.  The summer cultural immersion model, particularly for international studies programs, is used commonly in undergraduate education as a means of informing cultural competency and might be an interesting process driving advocacy competency.

Year II: Students will be encouraged to pursue coursework in electives such as public policy, community health, or other areas related to their issues of interest. In addition, Poverty, Health and Law is a six-session evening seminar offered each fall and is held jointly with Roger Williams University Law students. Concentrators are required to attend.

Year III:  Throughout their third year core clerkships, advocacy concentrators will be encouraged to keep a case-series related to their chosen issue. They will keep a reflective journal as they complete various clerkships, documenting ways in which the issue they are studying affects different population as they encounter the health care system. 

Year IV: Advocacy Concentrators will be encouraged to take electives related to their areas of interest, both clinical electives, study electives, coursework.

Year IV: Advocacy Concentrators will share their scholarly project with classmates.  The capstone project will be (1) something that could be presented at a regional or national meeting; or (2) a policy paper with a targeted distribution to key area decision-makers that would be of a mentored-quality that it would be suitable for broader distribution. 

Concentration Related Electives

Pre-clinical:
BIOL 3710 C: Poverty, Health, and Law
BIOL 3710 L: Health Care in America

Clinical:
Child Maltreatment
Controversies in the Health Care Policy
HIV/AIDS
Occupational and Environmental Medicolegal Medicine

Project Examples

1. A study of Access to Health Care of Undocumented Children in Rhode Island.
   1. An in-depth analysis of the issue and its demographics in RI
   2. An understanding of policies and regulatory issues that help or hinder access
   3. Identifying and meeting with people in RI including families, community activists, legislators, policy makers and other stakeholders in RI
   4. A study of model programs across the US
   5. A proposal, plan and implementation strategy to improve access
2. Nutrition and Exercise for Rhode Island Teens
   1. An in-depth analysis of the issue and its demographics in RI
   2. An understanding of laws, policies, and regulations that impact the issue
   3. Identifying groups and initiatives addressing the issue, including teens
   4. Study model programs from around the US
   5. Develop a proposal, plan, and implementation strategy to improve nutrition and exercise among teens in RI
3. Improving Recreational Opportunities for Special Needs Youth in South Providence
   1. An in-depth analysis of the issue and its demographics. (follow families and kids, map playgrounds, analyze for access and safety)
   2. An understanding of policies, laws, and regulations that impact the issue. Explore planning/zoning processes. Perhaps do “Child heath Impact” study on proposed building or roads projects
   3. Identify groups and initiatives already involved, key stakeholders, policy makers, and neighborhood organizations
   4. Develop a proposal, plan, and implementation strategy to improve opportunities for recreation for Special Needs children in South Providence
4. For more examples of potential projects, please visit the Patient Advocacy Coordinating Council's list of "orphaned" projects

2011 and 2012 Accepted Students and Scholarly Concentration Projects

Maximum Number of Students

Four students per year

Faculty Mentors

The concentration directors and staff will help you identify appropriate mentors for projects.

Funding Opportunities (alternatives to Summer Assistantships)

At the present time there are no resources other than the generally available Summer Assistantships (SA’s) that can be used by students in an Advocacy & Activism Concentration.

Concentration Director

Selim Suner, MD, MS
Associate Professor
Email: SSuner@lifespan.org
Phone: 401-639-3483
CORO Suite 106
One Hoppin Street Providence RI 02903

Concentration Co-Director

Gregory Jay, MD, PhD
Professor of Emergency Medicine
Email:  GJay@lifespan.org
Phone: (401) 444-6656
CORO Suite 106
One Hoppin Street Providence RI 02903

Overview

Innovation in science and engineering has been the dominant source of productivity gains and new enterprises in the United States economy over the last 50 years, accounting for as much as 50% of U.S. economic growth.  In our increasingly complex, technologically oriented economy, technology and science savvy professionals with the expertise to manage human and financial, in addition to technological, resources are in great demand.  No one person has all of the solutions in situations where the state of the art is a moving target, change is relentless, technology is pervasive, and global competition is fierce.

Whether it is in the fields of biotechnology, neuroscience, microelectronics, information technology, or others, it is widely agreed that science, engineering, and medical education must undergo significant changes in order to properly train students. Many science, engineering, and medical school graduates will find themselves in job environments demanding additional skills beyond those offered by traditional programs.  With aspirations of wanting to chair or lead a department within a hospital setting, medical school students need to be trained in a new way.  With many hospitals having not-for-profit models for each individual department, entrepreneurial skills are of the utmost importance.  In addition, high technology infrastructure and equipment will need to be procured and the hospital will have to make a business case for the investment.  In addition, some physicians will recognize a need for a new technology and will ultimately want to create a business out of it so others can benefit. 

We must therefore educate medical students to meet the challenges they will face in the future where innovation, technology management and entrepreneurship will play a key role.  Innovation has generated astonishing, tangible benefits to society, including improved healthcare. Today’s challenges center on managing innovation in a rapidly changing global economy and high technology health care setting.

This scholarly concentration is an educational solution designed to address the many issues a medical professional will encounter.  By committing to this scholarly concentration during their medical studies, students will receive a set of unique core competencies to lead them in the high technology, innovation, and entrepreneurship workplace. The proposed program has many educational objectives:

• To train medical students who understand both the technical and business aspects of technology as well as the intimate and intricate interrelationship between the two;
• To combine the study of the development of embryonic idea generation and emerging technologies (fuzzy front end) with contemporary principles of innovation and management to bring medical students to the forefront of high technology leadership and entrepreneurship;
• To develop an innovative learning environment where students discover the value of cutting across disciplinary boundaries to solve complex problems in the medical environment;
• To prepare medical students to lead within and across interdisciplinary organizations, such as hospitals;
• To train medical students to be actively engaged in organizations where understanding and exploiting rapidly changing technology is a key to success;
• To converge the core expertise of enthusiastic engineering faculty with the experience of other professionals, serving as adjunct faculty, who will bring to students strategic innovation and technology management perspectives with regard to the challenge of emerging technology;
• To leverage Brown University’s research infrastructure to seed student project ideas and satisfy their innovation and entrepreneurship experience;
• To develop medical leaders who will be successful in a world of accelerating technology change.

Curriculum

Year I

In collaboration with concentration area Directors, students will identify a project mentor and outline a proposal for their concentration area work. 

Summer between Years I & II

Students will undertake a concentration-related summer project of 8-10 weeks duration. 

Year II

In addition to continuing with their scholarly project work, students will participate in the “Topics in Translational Research and Technologies” seminar.  The seminar generally takes place weekly January through April on Friday afternoons for ~2 hours.  The seminar deals with such topics as “New Modalities in the Triage of Acute Medical Emergencies”, “Development of the LRS Thermosuit: A Device for rapid Whole Body Cooling”, “Novel Medical Devices as Therapeutic Toys”, “Marketing Medical Devices- Who Needs It?”, “Institutional Review Boards and Human Subjects Protection”, and “Nanotechnology for Regenerative Medicine”.

Students will also participate in regular meetings with faculty and peers.

Years III & IV

Students will continue to work on their concentration project, culminating in a final scholarly product to be submitted to concentration area faculty for review in Year IV.

Concentration Related Electives

Biotechnology

Project Examples

These are examples of medical related projects in the past – of course, students are not limited to such projects, they only serve as examples:

• Electronic medical records;
• Novel device to facilitate oxygen delivery for COPD patients;
• Novel vest to monitor post-cardiac patients during rehabilitative exercise;
• Devices for Neuro-implants;
• Devices for non-invasive medical diagnostics;
• Nanoscience in drug delivery and toxicity.
• Biomedical Optics and Photonics;
• Biomedical Imaging;
• Bedside Diagnostic Devices;
• Microfluidics for infectious disease;
• Mechanics of Lubricin;

2010 Accepted Students & Scholarly Concentration Projects:

Maximum Number of Students

The concentration will accept up to 5 students per year.

Faculty Mentors

There are a number of faculty members who are able to provide mentorship in this area.

Funding Opportunities

(alternatives to Summer Assistantships)

Faculty members may be able to write summer internships into their grants. 

Concentration Directors

Harold D. Roth, PhD
Professor of Religious Studies and East Asian Studies
Director, Contemplative Studies Initiative
Box 1927
Brown University
Providence, RI 02912
(o) 401-863-3104
(f)  401-863-3109
Harold_Roth@Brown.edu
Contemplative Studies Initiative

Ellen Flynn, MD
Clinical Assistant Professor
Psychiatry and Human Behavior
eflynn@lifespan.org
Tel: (401) 453-7955

Overview

The Scholarly Concentration in Contemplative Studies is a branch of the Brown University Contemplative Studies Initiative.  The Contemplative Studies Initiative is a group of Brown faculty with diverse academic specializations who are united around a common interest in the study of a particular range of beneficial mental states (deemed “contemplative”) that exhibit characteristics that include focused attention, deep concentration, and complete absorption in activity. We are involved in studying the nature of these states from a variety of perspectives that include their underlying philosophy, psychology, physiology and their links with human creativity.

Contemplative Studies in Medicine

In 2004, The World Health Organization defined health as a “complete state,” consisting of the presence of positive states of wellbeing as well as the absence of disease or infirmity.

Contemplative Studies is a cutting edge interdisciplinary and multicultural field that focuses on the possible uses of contemplative states and mental training practices to promote such “Complete Health.”   The use of contemplative practices, such as mindfulness, has been integrated into psychiatry and is now considered part of a “Third Wave” of psychological treatments and a standard practice in behavioral medicine. However, comprehensive training in contemplative methods, history, and theory within clinical contexts is not widely available and is typically cursory. In addition, contemplative methods in clinical contexts tend to be abbreviated and decontextualized from the traditions that created them. The Brown Contemplative Studies Initiative aims to study contemplative practice and states within their original contexts, as well as within the newer applications in science and medicine, in order to identify the most beneficial elements for health and wellbeing.

We approach this study through three large disciplinary areas: Science (the study of human consciousness and mental and emotional development within the context of neuroscience, cognitive science, and psychology; the study of the mind and culture; applications of contemplative practices within clinical science and basic and behavioral medicine, focusing on how these practices contribute to improved mental and physical health); Humanities (the study of the nature of contemplative experiences in philosophy, the major religious traditions of the world, in world literature, in the classical texts of antiquity and in a variety of other related disciplines); Creative Arts (the study of the contemplative experiences in the visual and fine arts, creative writing, and in the various performing arts of dance, drama, and music). We study contemplation through traditional third-person approaches and innovative “critical first-person approaches.” The latter involve direct experience with the various arts and methods of contemplation.

Curriculum

Medical students choosing Contemplative Studies as their scholarly concentration will take the foundational course, UC 54 “An Introduction to Contemplative Studies” (offered on Wednesday afternoon, 3-5:20 in 2008 and all subsequent years) or its equivalent through a Summer Study Project, and at least two other courses that will be offered on Wednesdays during the student’s second year that include critical first-person approaches. These are the core courses of the Contemplative Studies Initiative. Please see our website for a list of the core course offerings for any given academic year.

Students would be required to include one or more Contemplative Retreats of their own choosing in the program. There are a wide range of possible contemplative retreat programs in the Massachusetts-Rhode Island area. These include the Kripalu Yoga Center in Lennox MA, The Insight Meditation Society in Barre MA, The Cambridge Insight Meditation Center in Cambridge, MA and The Providence Zen Center in Cumberland RI. As a complement or an alternative to a tradition-based retreat program, students are encouraged to consider receiving training in Mindfulness-Based Stress Reduction, a widely used clinical program developed by Jon Kabat-Zinn at the Center for Mindfulness (MBSR), University of Massachusetts Medical School in Worcester. Students may participate in an MBSR course that is open to the general public, or a highly motivated student could participate in the Center for Mindfulness’ Oasis Program, a training for instructors that consists of a seven-day summer program followed by a flexible series of practicum opportunities that could be integrated into the student’s program.

Learning Objectives

1. Developing an understanding of the newly developing field of contemplative studies: how is it defined? What are its major works? What are the ways in which it is relevant to clinical practice? How might a clinician answer patient questions regarding meditation or other “stress reduction” treatments?
2. Establishing a comprehensive and empirically-grounded knowledge base of the scientific research literature on the effects of contemplative practices. Research has typically been divided into three main categories: Cognitive Neuroscience (effect of contemplative practices on basic cognitive functions such as attention, memory and synaptic plasticity); Affective Neuroscience or Psychiatry (the effects of contemplative practices on emotional regulation, emotional/behavioral disturbances and psychiatric disorders); General Medical Applications (the effects of contemplative practices on physiological systems, including neuroendocrine, cardiovascular and immune functioning).
3. Understanding the types of contemplative practices currently under scientific scrutiny and having a firm grounding in the contemplative traditions from which they are derived.
4. Understanding how to apply contemplative practice in a clinical medical context. This would be developed by student’s working as interns in a “Clinical Contemplative Program” with mentors from the larger Brown medical community who are using contemplative practices in their clinical work.
5. Contemplative self-development: having the opportunity to engage in one’s own contemplative practice. This is an essential part of the concentration and recent research has shown very positive clinical outcomes showing reduced stress in medical students.

Timeline

By the middle of Year I: the student will meet with the Director and possible Advisory Committee members to begin planning a program.

Summer after Year I: Student chooses one of two possible tracks:
Track A: Summer Study Project (8-10 weeks) in which the student takes a course (either an independent reading course or one in the Brown Summer school that could be developed) that covers the same ground as the UC 54 course, “Intro To Contemplative Studies.” The student would also attend the Mind and Life Summer Research Institute, a week long program that presents cutting edge research on the science of meditation. The student would also complete a contemplative retreat of 2-7 days at one of the area’s tradition-based Contemplative Retreat Centers.

Track B: Summer Study Project (8-10 weeks) in which the student takes a course (either an independent reading course or one in the Brown Summer School that could be developed) that covers the same ground as the UC 54 course, “Intro to Contemplative Studies.” The student would also attend the Mindfulness Based Stress Reduction course in the community or one of the instructor training opportunities through the Oasis Program for Clinicians at the Center for Mindfulness.

Written reports will be expected for either Summer Study Project.

By the end of the Summer of Year I, students will form an Advisory Committee consisting of the Concentration Director and at least one other member of the Contemplative Studies Scholarly Concentration faculty (see list below).

Year II: Student uses Wednesday elective time taking relevant Contemplative Studies Initiative courses:: The specific choice of courses will depend on which Track is chosen in Year I and will be made in consultation with Advisory Committee.  The Contemplative Studies Initiative will endeavor to have a range of possible courses taught on Wednesday afternoons to assist medical students. The following courses will definitely be offered on Wednesday afternoon in the 2007-08 academic year: RS 0500: “The Theory and Practice of Buddhist Meditation;” UC 54: “Introduction to Contemplative Studies.” In addition, a new course, “The Contemplative Life: Meditation in Psychology and the Creative Arts” (UC 55) is currently being developed. The student will also be encouraged to continue his/her own contemplative practice by participating in Wednesday CSI course “Meditation Labs,” occasional CSI Contemplative Retreats, and relevant Tradition-Based Contemplative Retreats. No later than the middle of Year II the student will meet with his/her Advisory Committee to decide upon the student’s Contemplative Studies Capstone Project, which will be interwoven into the student’s program during the next two years. Two basic categories of Capstone will be available: Scholarly Research and Clinical Contemplative Practice.

Years III and IV: Contemplative Studies Capstone Projects will be individually tailored by the student and his/her advisory committee based on student interest and scheduling constraints. Scholarly Research Capstones will result in summary statements of research in a given field. These will be fundamentally oriented to reading and writing about relevant literature and will not involve specific clinical research or practice. Students who choose the Clinical Contemplative Practice Capstones will choose a member of the Brown Medical Community who uses contemplative practices in his/her clinical work and decide upon an appropriate form of internship with that person. This “Clinical Contemplative Mentor” will oversee the student’s apprenticeship and will help the student chose a suitable Capstone Project, in consultation with the Advisory Committee. With both categories of Capstone Project, the student will be expected to write a summary of the work he or she accomplished during the past two years. This is not intended to be a “Thesis” level original research project but rather more of a report on the work accomplished.  However, should a student wish to do an original research project, the program will be pleased to support and accept it. Throughout these two years the student would be encouraged to continue his/her own contemplative development whenever possible.

Throughout the four-year program, the Contemplative Studies Initiative will hold events in which students in the Scholarly Concentration can share their expertise and experience with one another and the interested Contemplative Studies faculty.

Concentration Related Electives

Pre-clinical:
BIOL 3710 N: Mindfulness in Clinical Practice: A Primer for Medical Students
BIOL 3710 N: Seminar in Mindfulness and Healthy Living

Project Examples

Students will design a Contemplative Studies Capstone Project in which they bring their interests in doing a scholarly concentration in Contemplative Studies to bear on a particular problem or set of problems.  These projects fall into two basic categories : Scholarly Research Projects and  Clinical Contemplative Practice Projects. Examples of each category are as follows:

Scholarly Research Projects
“The Essential Neuroscience of Contemplative Experience;”
“The History of Mindfulness Based Stress Reduction and its South Asian Buddhist Origins;”
“Applying Contemplative Techniques to the Treatment of Eating Disorders.” 

Clinical Contemplative Practice Projects
“The Philosophy and Clinical Applications of Indian Yoga Techniques;” 
“The Clinical Application of Mindfulness Based Stress Reduction to the Treatment of Depression;”
“Mindfulness Meditation in the Treatment of Attention Deficit Disorder.” 

Capstone Projects will be evaluated by the student’s Advisory Committee in conjunction with the Clinical Contemplative Mentor where relevant.

2010 Accepted Students & Scholarly Concentration Projects:

Maximum Number of Students

We can train up to five students per year.

Faculty Mentors

The following CONTEMPLATIVE STUDIES INITIATIVE CORE FACULTY would be able to advise students in their concentration:
Michelle Bach-Coulibaly , Theatre Arts, who works with contemplative states induced through African dance and drumming;

Susan Bernstein , Comparative Literature, who works on contemplative aspects of post-modernist thought and literature;

Ruth Colwill , Psychology, who works on consciousness in animals;

Albert Dahlberg, Molecular Biology, Cell Biology, & Biochemistry, who is interested in complementary and alternative medicine, consciousness and creativity;

John Emigh , Theatre Arts, who often works with contemplative materials in his explorations of the various performing artistic traditions of the world;

Thalia Field, English and Creative Writing: a poet and performance artist whose works are grounded in the study of consciousness;

Forrest Gander, English and Creative Writing: a poet and essayist whose interests include the interplay of subjective and objective elements in the act of creation;

Paget Henry , Sociology and Africana Studies, who has studied, among other things, the contemplative practices of African and Afro-Caribbean religion;

Dore Levy , Comparative Literature, who studies contemplative aspects of Chinese literature;

Hal Roth , Religious Studies, who works on the early Chinese mystical tradition of Taoism;

Peter Scharf , Classics, who does research in Indian linguistics and philosophy;

Donna Wulff , Religious Studies, who works with contemplative practices associated with South Asian religious drama.

Furthermore, CLINICAL CONTEMPLATIVE MENTORS may be chosen from the following list:
Bruce Becker, MD, MPH; Associate Professor of Community Health; Attending Physician, Rhode Island Hospital and Hasbro Children’s Hospital Department of Emergency Medicine.  Dr. Becker has completed research on yoga as an adjunctive intervention for behavioral change and is currently working on an NIH funded initiative using yoga as an adjunct for smoking cessation in women.

Willoughby Britton, PhD; Psychology Intern in Behavioral Medicine.  Dr. Britton’s research has focused on neuroscience correlates of varied states of consciousness and the effects of mindfulness based cognitive therapy on sleep and depression.  Dr. Britton is an instructor of mindfulness based stress reduction.

Michael Fiori, MD; Clinical Assistant Professor of Psychiatry; Director of the Alcohol and Drug Inpatient Unit, Butler Hospital.  Dr. Fiori is interested in objective measurement and neuroscience correlates of contemplative states.

Ellen Flynn, MD; Attending Psychiatrist, Women and Infants’ Hospital.  Dr. Flynn is assisting with the provision of a research project investigating mindfulness based stress reduction (MBSR) as a treatment for pelvic pain.  Dr. Flynn is an instructor of MBSR.

Brandon Gaudiano, PhD; Assistant Professor of Psychiatry (Research).  Dr. Gaudiano has expertise in Acceptance and Commitment Therapy (ACT).  His current NIMH-supported research is to develop an adjunctive behavioral treatment for psychotic depression.

Neeta Jain, MD; Clinical Assistant Professor of Psychiatry; Attending Psychiatrist, Women and Infants’ Hospital.  Dr. Jain recently served as the medical director of the Mind-Body Program at Bellevue Hospital in New York.

Mitchell M. Levy, MD; Professor of Medicine; Director of Critical Care Services, Rhode Island Hospital.  Dr. Levy’s research includes the development of interventions regarding ICU care at the end of life.

Gary Epstein-Lubow, MD; Assistant Professor of Psychiatry; Assistant Unit Chief of Geriatrics, Butler Hospital.  Dr. Lubow’s research has included pilot studies of mindfulness based stress reduction for distressed family caregivers.  Dr. Lubow assisted as Co-Director of the Scholarly Concentration in Contemplative Studies from 2007 – 2010.

Maria McKay, RN, MA. CIC, Manager Infection Control and Employee Health; Butler Hospital.  Holistic Counseling and Consulting, Private Practice. Ms. McKay completed her holistic counseling masters degree at Salve Regina University and is currently completing the requirements for a CAGS in Mental Health Counseling.  Her interests are in helping people process grief using mindfulness and the body.

Barbara Ostrove, OTR/L; Director of Occupational Therapy, Butler Hospital.  Ms. Ostrove has initiated a Holistic Work Group with the initial goal of implementing and investigating a “Sensory De-escalation Milieu Project” designed to reduce the use of seclusion and restraint.

Keith W.L. Rafal, MD, MPH; Clinical Assistant Professor in the Department of Family Medicine; Director of Healing Choices an integrative medical practice specializing in the management of Fibromyalgia, Chronic Pain and the rehabilitation and treatment of other chronic medical conditions.  Dr. Rafal is Medical Director of the Rehabilitation Hospital of Rhode Island.  He is currently developing a new approach that incorporates the power of Belief and Intuition as the centerpiece of care.

Karen Ryder, M.A.; Ms. Ryder is a psychotherapist in private practice who is a former associate of Jon-Kabat-Zinn at the Center for Mindfulness and a trained instructor of Mindfulness Based Stress Reduction. She teaches courses in MBSR for the Division of Behavioral Medicine at the Miriam Hospital.

Ronald Thebarge, PhD, MA; Clinical Assistant Professor of Psychiatry; Psychologist, Division of Behavioral Medicine, The Miriam Hospital.  Dr. Thebarge organizes the department’s Spirituality and Religion interest group.  He is a board member of The Center for Mindful Eating.  Prior research includes use of MBSR with breast cancer survivors.

Geoffrey Tremont, PhD; Assistant Professor of Psychiatry; Director of Neuropsychology, Rhode Island Hospital.  Dr. Tremont’s research includes family interventions for distressed dementia caregivers.  Dr. Tremont is a Vinyasa yoga instructor.

Funding Opportunities (alternatives to Summer Research Assistantships)

At present there are no funds for summer projects other than the SRA’s.

Selected Bibliography

BOOKS

1. Austin, James. Zen and the Brain. Cambridge: MIT Press, 1998.
2.  -------. Zen-Brain Reflections. Cambridge: MIT Press, 2006
3. Barnard, G. William, and Jeffrey J. Kripal, Crossing Boundaries: Essays on the Ethical Status of Mysticism. Seven Bridges, 2002.
4. Conze, Edward (trans.).Buddhist Wisdom : The Diamond Sutra and The Heart Sutra. Reprint, Vintage, 2001.
5. Csikszentmihalyi, Mihalyi. Flow: The Psychology of Optimal Experience. NY Harper, 1990.
6. Davidson, Richard and Anne Harrington eds., Visions of Compassion . Oxford and New York, Oxford U Press, 2002. (selections)
7. DeWit,  Han F. Contemplative Psychology. Marie Louise Baird (trans.) Pittsburgh: Duquesne UP, 1991.
8. Goleman, Daniel. The Meditative Mind. Putnam, 1988.
9. James, William. The Varieties of Religious Experience. Reprint, Touchstone, 1997.
10. Kabat-Zinn, Jon. Full Catastrophe Living. Delacorte Press, 1990.
11. ------------------.Wherever You Go You Are There. Hyperion, 1995.
12. Mair, Victor. Lao Tzu: Tao Te Ching. Reissue edition. Bantam, 1990.
13. Rosenberg, Larry, Breath by Breath: The Liberating Practice of Insight Meditation. Shambala, 1999.
14. Roth, Harold D. Original Tao: Inward Training and the Foundations of Taoist Mysticism. Columbia, 1999.
15. Segal, Z. V., Williams, J. M., & Teasdale, J. D. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. London: Guilford, 2002.
16. Sekida, Katsuki, Two Zen Classics. Weatherhill, 1977.
17. Thompson, Evan (ed.), Between Ourselves: Second-Person Issues in the Study of Consciousness. Imprint, 2001. (selections)
18. Varela, Francisco, Evan Thompson, and Eleanor Rosch. The Embodied Mind: Cognitive Science and Human Experience. Cambridge: MIT Press, 1991.
19. Wallace, B. Allan. The Taboo of Subjectivity: Towards a New Science of Consciousness. Oxford UPress, 2000.

ARTICLES

1. Astin, J. A. (2004). Mind-body therapies for the management of pain. Clin J Pain, 20(1), 27-32.
2. Baer, Ruth A. “Mindfulness Training as a Clinical Intervention: A Conceptual Review.” Clinical Psychology: Science and Practice, 10#2 (Summer 2003): 125-43.
3. Barnard, G. William. “Debating the Mystical as the Ethical: A Response.” In Barnard and Kripal, Crossing Boundaries: Essays on the Ethical Status of Mysticism, 0-99
4. Barnes, V. A., Davis, H. C., Murzynowski, J. B., & Treiber, F. A. (2004). Impact of meditation on resting and ambulatory blood pressure and heart rate in youth. Psychosomatic Medicine, 66(6), 909-914.
5. Bishop, Scott, Mark Lau, Shauna Shapiro, Linda Carlson, Nicole Anderson, James Carmody, Zindel Segal, Susan Abbey, Michael Speca, Drew Velting, and Gerald Devins. “Mindfulness: A Proposed Operational Definition.”  In Clinical Psychology: Science and Practice, 11#3 (Fall 2004): 230-41.
6. Brown, Kirk Warren, and Richard M. Ryan. “The Benefits of Being Present: Mindfulness and Its Role in Psychological Well-Being.” Journal of Personality and Social Psychology, 84#4 (2003): 822-48.
7. Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65(4), 571-581.
8. Davidson, Richard. “Towards a  Biology of Positive Affect and Compassion.” In Visions of Compassion, 107-30.
9. Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkrantz, M., Muller, D., Santorelli, S. F., et al. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65, 564-570.
10. Nancy Eisenberg. “Empathy-Related Emotional Responses, Altruism, and Their Socialization.” In Visions of Compassion, 131-64.
11. Epstein, R. M. (1999). Mindful Practice. Journal of the American Medical Association, 282 (9): 833-839.
12. Grossman, Paul (2004). MBSR and health benefits: a meta-analysis. Journal of Psychosomatic Medicine , 57, 35-43.
13. Kabat-Zinn, Jon. “Mindfulness-Based Interventions in Context: Past, Present, and Future. Clinical Psychology: Science and Practice, 10#2 (Summer 2003): 144-56.
14. Kohn, Livia. “The Sage in the World: Mysticism and Moral Responsibility in Chinese Religions.” In Barnard and Kripal, Crossing Boundaries: Essays on the Ethical Status of Mysticism, 288-308.
15. Kripal, Jeffrey. “Debating the Mystical as Ethical: An Indological Map.” In Barnard and Kripal, Crossing Boundaries: Essays on the Ethical Status of Mysticism, 15-69.
16. Lazar, Sarah, Herbert Benson, et. al. ”Meditation Experience is Associated with Increased Cortical Thickness.” NeuroReport
17. Loy, David. “The Lack of Ethics and the Ethics of Lack in Buddhism.” In Barnard and Kripal, Crossing Boundaries: Essays on the Ethical Status of Mysticism, 265-87.
18. Lutz, Antoine, and Evan Thompson. “Neurophenomenology: Integrating Subjective Experience and Brain Dynamics in the Neuroscience of Consciousness.” Journal of Consciousness Studies (JCS), 10(2003): 21-52.
19. Lutz, Antoine, Laurence Greischar, Nancy Rawlings, Mattieu Riccard, and Richard Davidson, “Long-term Meditators self-induce high amplitude gamma synchrony during mental practice.” Publications of the National Academy of Sciences vol. 101 #46 (November 2004): 16360-16373.
20. Ott, MJ, Norris, R., and Bauer-Wu, S (2006): Mindfulness Meditation for Oncology Patients: A Discussion and Critical Review. Integrative Cancer Therapies, 5, 98-108.
21. Preston, Stephanie, and Frans deWaal. “Empathy: Its Ultimate and Proximate Bases.” Behavioural and Brain Sciences. 25 #1 (2002): 1-20.
22. Shapiro, Shauna, Gary Schwartz, and Ginny Bonner.” Effects of Mindfulness-Based Stress Reduction on Medical and Premedical Students.” In Journal of Behavioral Medicine, 21#6 (1998): 581-99.
23. Thompson, Evan, “Empathy and Human Experience.” In James D. Proctor (ed.), Science, Religion, and Human Experience. Oxford, 2005.
24. Thompson, Evan, “Empathy and Consciousness.” In Between Ourselves, 1-32.
25. Wallace, B. Allan. “Intersubjectivity in Indo-Tibetan Buddhism.” In Between Ourselves, 209-30.
26. Zahavi, Dan. “Beyond Empathy: Phenomenological Approaches to Intersubjectivity.” In Between Ourselves, 151-68.
27. Young, Shinzen, “How Meditation Works.” Shinzen.org

Concentration Directors

Timothy Empkie, MD, MPH
Email: Timothy_Empkie@brown.edu
Phone: (401) 863-2019
Box G-B222, Brown University

Jennifer Friedman, MD, MPH, PhD
Associate Professor of Pediatrics
Email: Jennifer_Friedman@brown.edu
Phone: (401) 444-7449
Center for International Health Research

55 Claverick Street

Delma-Jean Watts, MD
Clinical Instructor, Dept of Pediatrics
Email: Delma-Jean_Watts@brown.edu
Phone: (401) 444-8531
Potter Suite 200, Rhode Island Hospital

Global Health Advisory Board

Susan Cu-Uvin, MD
Professor of Obstetrics and Gynecology
Email: SCu-Uvin@lifespan.org
Phone: 401-793-4775
Box G-MH, Brown University

Stephen McGarvey, PhD, MPH
Professor of Community Health
Email: Stephen_McGarvey@brown.edu
Phone: (401) 863-1354
Box G0S121-2

Timothy P. Flanigan, MD
Email: Timothy_Flanigan@lifespan.org
Phone: 401-793-7152
Box G-MH, Brown University

Overview

There are two purposes of the Global Health Scholarly Concentration. First, to educate medical students about the breadth and depth of global health, with an emphasis on populations in lesser developed countries characterized as resource-poor communities who are medically underserved. These communities will have low levels of population health measured by general measures of mortality and morbidity and by specific measures of disease and risk factor prevalence and incidence.  Second, to provide and support a close mentoring relationship between medical students and both Brown University and hospital-based faculty. Students will conduct a scholarly activity in global health under the direction of a faculty member.
The final result of this mentored relationship and the three and one-half years of learning is a scholarly product in global health. This product may take the form of a scholarly abstract, manuscript, technical report, or another output defined by the student and faculty mentor(s), and approved by the leaders of the global health scholarly concentration. 

Curriculum

The timeline of the Scholarly Concentration in Global Health is as follows: 1) Recruitment, applications and admission in Year I; 2) Preparation for, and implementation of, summer experience between Years I and II; 3) Year II Global Health Seminars; 4) Year IV Scholarly Product

Recruitment, applications and admission

The first component pertains to annual selection of students for the Global Health Scholarly Concentration.  Early in Year I and well prior to the February application date, interested students will meet with concentration leaders to identify an area of interest and a specific faculty mentor. Together, they will develop a summer experience, investigate summer funding opportunities, and outline a plan to complete the concentration requirements in the next years.  The completed applications for entrance into the Global Health Scholarly Concentration will be due to the Scholarly Concentrations Office in February.  The faculty leaders of the Global Health Scholarly Concentration will review applications for project merit and determine program acceptance. A list of faculty and their international interests can be found HERE.

Summer experience between Years I and II

 A global health summer experience must be preceded by adequate preparation and close mentoring by faculty. Ideally, the summer experience would occur after intensive training in interdisciplinary aspects of global health perspectives and methods, but the realities of the regular medical school curriculum prevent that. Though clinical electives are highly valuable and inspire many students, these alone rarely meet requirements of the concentration. Further, at this juncture in medical student training, many students are not sufficiently prepared to make significant contributions to direct patient care. Thus, students should articulate in a GH concentration application not only what they will do during first summer, but how that will evolve, how it can continue over the ensuing 3 years, how it impacts human health beyond what they might have done clinically, and a plan for what the scholarly product will be.

The period of March to June will be a very busy and critical time for Year I students in the global health concentration. In Spring semester of Year I, after entry into the global health concentration and proceeding the summer, Year I students will be required to work closely with their faculty mentor to prepare. March through early May, Year I students and faculty mentors should meet every 2 weeks. The faculty leaders of the concentration will meet with students 3-4 times from acceptance in the concentration and summer departure to review progress and share with other students their plans. These meetings will emphasize general aspects of a foreign experience and specific items related to conduct of a research or clinical project.  Using the basic plan provided by the student in the SC Program Application form as a starting point, students and faculty will more fully outline plans for the summer experience.  Students and faculty may also use this time to apply for additional funding of the summer experience if necessary.

During this planning period, possible discussion topics with concentration leaders and mentors include:
A. Clinical Science and Practice
1. Clinical Care challenges in LDCs
2. Ethical dilemmas in delivery of clinical care in LDCs for US medical students & faculty
3. Understanding cultural barriers to adherence
4. Clinical translational and implementation issues in communities
B. Research Concepts, Methods and Conduct:
1. Demonstrate understanding of fundamental epidemiological and clinical research concepts and methods: study designs, rates and proportions, definition of populations and sampling, bias, and confounding.    
2. Demonstrate understanding of screening and surveillance concepts and methods.
3. Understand purpose, design & conduct of experimental trials at community & individual levels.
4. Understand qualitative methods and utility in global health research.
5. Identify a medical or public health problem with a defined population deserving of further study.
6. For a specific health problem, contrast generalizability and limitations of data from different sources.
7. Discuss ethical issues related to human research participants.
8. Discuss ethical issues related to the conduct of global health research.
9. Read and critique medical and public health research literature.
10. State a global health research problem in terms of a research hypothesis.
11. Develop research methods for study of a particular public health problem.
During the summer months between Years I and II, students will engage in in-depth summer experiences (~8-10 weeks). 
Although summer experiences at foreign sites will be encouraged, experiences at domestic sites with underserved and resource poor communities are entirely suitable as well. Ideally this summer work will provide the basic direction and topical interest for the four-year concentration and the final scholarly product, but since global health research and clinical opportunities can change quickly, there will be a lot of flexibility.
Upon return to Brown in the fall, Global Health concentrators will be expected to give public presentations on their summer projects.
For tips on requirements and preparation for foreign travel, please review the Foreign Travel Guide

Year II Global Health Seminars

Substantial time has been scheduled for students in Year II to work on their mentored projects that they conducted in the preceding summer. They should be meeting also regularly with their faculty mentors to make progress on their projects and plan for the scholarly product. During Year II, the Global Health Scholarly Concentration will meet regularly as a group with faculty leaders every 2-3 weeks at lunch time from September to March.  Students will be required to attend at least 75-80% of these meetings. The structure and format of the meetings will be a combination of small group discussions and presentations, faculty panels on global health careers, and seminars on selected global health topics.  The guest lecture series will focus on Brown or invited faculty working in global health in the area of service, public health, clinical research or education.  The format will be a 30-45 minute talk followed by 30 minutes of active discussion. These meetings will stop in March due to the 2nd years students need to prepare for the USMLE Step 1 exam.  

In addition, Brown University Framework in global health sponsors approximately 4-5 evening lectures, generally on the Brown campus. These lectures are often given by guest speakers from around the country. Concentrators are strongly encouraged to attend these evening lectures during their entire tenure as concentrators in global health at Brown.

Students in Year II will be expected to submit an abstract and present a poster at the Brown Global Health Poster Session in the Fall.

Additionally, the current Tropical Medicine elective course for medical students will be strongly suggested as a vital part of the scholarly concentration.

A list of Global Health activities at Brown can be found on the IHI lecture page.

Year III Activities

Although Year III will be very busy with clinical training rotations, it is essential that students maintain contact with their faculty mentors and discuss the progress on their scholarly product. Year III students will submit two brief cases/reflections from their clinical experiences that have global health relevance.   These may include cases of less common infectious diseases, experiences with refugee or immigrant patients, cultural or interpretation challenges, or reflections on specific differences seen in health care utilization here and in previous global health experiences. In addition, most students have more optional time in Year IV, so it is wise to plan far ahead for global health activities in the last year.

There is a funding opportunity for students via International Clinical Research Scholars Program which offers overseas fellowships in Global Health and Clinical Research. This program is administered through Vanderbilt University.  Several Brown medical students have taken advantage of this program. Dr Flanigan and Kenneth Mayer can tell you about the students who have done this.

Year IV Scholarly Products

The final component of the Scholarly Concentration consists of a fourth year elective and the submission of a scholarly product. It is envisioned that well over half of the students that participate in this Scholarly Concentration will go overseas in their 4th year and participate in an international elective in a resource poor setting, although international travel is not required.  Students will also have the ability to pursue an in-depth elective on health issues in the United States that are pertinent to global health. These might include evaluation of health problems in the Dominican or Haitian communities in New England, refugee clinic, or an in-depth study on vaccine or medication availability or the benefits and weaknesses of non-governmental organization programs providing health care overseas.  The fourth year elective must include a clinical component requiring students to interact in a meaningful fashion utilizing their clinical skills. 
Students will be required to submit a scholarly product for review by their faculty mentor and the concentration leadership by April of their fourth year. Approval of this product will indicate successful completion of the global health scholarly concentration.

Concentration Related Electives

Pre-clinical:
BIOL 3710: An Introduction to Tropical Medicine

Clinical:
Crossing Borders
Elective in Guatemala
HIV/AIDS
Internal Medicine in the Dominican Republic
Pediatrics in a Developing Country
Public Health and Primary Care in Rural Honduras
Tropical Medicine in East Africa

Project Examples

Scholarly products may take the form of a manuscript conforming to peer review standards, a curriculum contribution or a policy paper relevant to global health. Presentation at a regional or national conference will also be encouraged.

2010 Accepted Students and Scholarly Concentration Projects

Maximum Number of Students

We anticipate that the concentration will be able to provide adequate guidance and mentorship to 7-8 scholars per year.

Faculty Mentors and Advisors

A critical goal of the scholarly concentration will be to match students with faculty mentors in the 1st year of medical school. The application for joining the concentration which is due in February of Year I requires a mentor at that time. We recognize that students’ interests change, faculty resources change and other factors will influence students to seek out new mentors as they progress through the concentration. It is crucial that faculty mentors understand the need to provide ongoing mentorship beyond the first summer experience. This includes assurance of safety and adequate supervision at the field site as well as continued mentorship in creation of the scholarly product. The faculty mentor is primarily responsible for overseeing the work related to the scholarly concentration product. The concentration directors will work hard to provide guidance and counseling throughout all four years and assess the quality of the student and mentor fit.  The global health scholarly concentration will also attend and oversee didactic and other educational opportunities in the concentration. In addition, each student will be assigned a faculty advisor, whose role is to review progress reports and suggest changes over years 2-4 if a student is at risk for not completing concentration goals.   Often the advisor will be a concentration director or co-director, but not always.
There is a large number of faculty who have declared their interest and others who are potentially interested. We anticipate having no problems finding good matches, as the opportunity for long-term mentoring and collaboration is very attractive to faculty.

Funding Opportunities
(alternatives to Summer Assistantships)

There are several internal sources of funds that could provide financial support for proposed foreign global health experiences. The International Health Institute also provides useful information on its web site about outside funding sources.

We also believe that the training and mentoring offered by the Global Health Scholarly Concentration will prepare students to compete successfully for external funds for their proposed experiences.

In the Fall of 2008 Brown University received an education grant titled “Framework in Global Health at Brown University”, from the NIH Fogarty International Center. Dr Susan Cu-Uvin is the PI and Prof. Stephen T. McGarvey is the Co-PI.  The goal of the Framework program is to provide an academic structure and initial resources for faculty collaborations on curricular developments and mentoring of students in practical global health experiences. The Framework will take advantage of Brown’s flexible boundaries to help form new global health research collaborations, thus furthering incentives for faculty participation and opportunities for practical experiences for students and clinical trainees.  In addition to promoting the coordination of global health activities at Brown, this grant also funds the Framework Global Health Scholarship program. Please visit the Framework in Global Health page for more information and an application.

Visit AMS Global Health Initiative for further information about research, training and funding opportunities as well as global health events at Brown.

Concentration Director:

Robert Heffron, MD 
Clinical Asst Professor in Family Medicine 
Email: Robert_Heffron@brown.edu 
Phone: 401-578-6345  
Memorial Hospital of RI
111 Brewster Street
Pawtucket, RI  02860

Concentration Co-Directors:

Catherine Kerr, PhD 
Principle Investigator at the Neuroscience of Meditation, Health and the Sense of Touch 
Email: Catherine_Kerr@Brown.edu 
Phone: 617-384-8583

John McGonigle, MD 
Clinical Instructor in Family Medicine 
Email: John_McGonigle@brown.edu 
Phone: 401-688-2782  
182 Gano Street 
Providence, RI 02906

Julian D. Ginsberg-Peltz, MD 
Clinical Asst Professor in Family Medicine 
Email: drjulesorama@gmail.com 
Phone: 401-688-2782  
182 Gano Street 
Providence, RI 02906

Donna Parker, ScD 
Asst Professor in Family Medicine (Research) 
Email: Donna_Parker@brown.edu 
Phone: 401-729-2531  
111 Brewster Street 
Pawtucket, RI 02860

Overview

In the past few decades, the public’s use of complementary and alternative medicine (CAM) has steadily increased. A National Health Interview Survey in 2002 revealed that 62% of U.S. adults had used CAM within the 12 months prior to being interviewed, while 54.9% believed that the combination of CAM and conventional medical care would provide added benefit. Despite the major advances of biomedical science during the 20th century, doctors have become increasingly burdened by the difficulties and challenges of treating chronic illnesses, and patients have grown wary of medicine’s over-reliance on technology and the harmful side effects of pharmaceuticals and invasive procedures. These factors, among others, have contributed to the public’s seeking of alternative forms of healing.

In the wake of these recent developments in CAM, integrative medicine has emerged as a promising field that draws from the best of the world’s healing modalities to provide safe, individualized care to patients. Integrative medicine acknowledges the role of mind, body, spirit and community as vital to the healing process and seeks to foster a healing partnership between doctors and patients. While it recognizes the power of conventional biomedicine, integrative medicine also recognizes and attempts to facilitate the body’s own healing response; it promotes the use of less invasive methods where safe and when possible; and it seeks to integrate CAM with conventional therapies in the pursuit of disease prevention, wellness, and the treatment of illness. Integrative medicine rejects the notion of an “alternative” medicine by proposing that all safe and efficacious healing modalities have a place in our medical paradigm. It seeks to broaden a doctor’s options so that he or she is able to apply the most appropriate treatment to a particular patient’s ailments. If there is a healing modality that is safer and more effective than conventional methods, then it should be included in the doctor’s toolkit.

Learning Objectives

The goal of the program is to deepen and broaden students’ conceptual and clinical understanding of CAM, and to incorporate this knowledge into the framework of integrative medicine. 

Students who complete this concentration shall be able to demonstrate the following:

1. Discuss the core concepts of the integrative medicine model
2. Identify the strengths and limitations of conventional biomedicine and the various healing
3. modalities of CAM
4. Apply an interdisciplinary approach to clinical thinking that incorporates a broad range of
5. medical worldviews
6. Consider the role of the mind, body, spirit, and community in illness, health, and healing
7. Discuss issues and methods of research concerning CAM
8. Analyze the scientific literature and evidence on CAM
9. Participate in experiential learning that develops skills in several areas of CAM,
10. including acupuncture, bodywork techniques, nutritional guidance, and others
11. Establish a healing relationship with patients
12. Advise patients in their use of CAM and conventional treatment methods
13. Understand the importance of physicians and patient self-care in the promotion of health
14. and treatment of illness

Timeline of Activities

Year I

Those who elect to pursue a Scholarly Concentration in Integrative Medicine will begin to develop a curriculum and plan for an intensive project to complete during the Summer of Year I. Under the supervision of their mentors, students will design an intensive 8-10 week summer project, which may be clinically-oriented, research-focused, or both. 

Summer of Year I

Brown has partnerships with an extensive network of other schools and clinics that feature

programs in integrative medicine.

Year II

After the Summer of Year I, the Director and students’ mentors will evaluate students’ posters at the Summer Showcase. Students will be encouraged to organize workshop events that promote awareness of integrative medicine and spark dialogue within the Brown community. This will mostly be done in conjunction with the student-run Brown Integrative Medicine Initiative (BIMI). Students will also be encouraged to attend the monthly integrative medicine “grand rounds” that take place at the Memorial Hospital at 6:30 pm on the first Thursday of every month during the academic year.

In the fall semester, students will be required to take BIOL3710-J: “Integrative Medicine: From

Alternative to Mainstream,” a preclinical elective. In this course, students will have the opportunity to experience CAM therapies, learn from clinicians who practice CAM, and discuss the scientific literature and research in this emerging field.  Learning in the course is both didactic and experiential.

Mentors will be available throughout the year for monthly meetings to advise students and to

receive updates on student progress. During these meetings, students will be working with

mentors to craft a long-term project that will be completed in the next two years. 

Years III & IV

During this time, students will have opportunities to complete clinical rotations in certain healing modalities at several of Brown’s partner schools and clinics. Depending on the students’ interests, projects may take various forms. Students pursuing research-focused projects may choose to present their work in the form of a paper, poster, and/or a conference presentation, whereas students with clinically-oriented projects may choose a format that enables them to practice and develop their clinical skills.

 Mentors will be available throughout the year to advise students. They will also continue to hold monthly meetings with students to receive an update on their projects.

In early April of Year IV, the Director and the students’ mentors will evaluate students’ presentation of their final projects. Because the format of these projects will vary, each mentor will decide on an appropriate method of evaluation. For projects that are research-focused, mentors may choose to evaluate students’ work in the form of a paper, poster, or conference presentation. For projects that are more clinically-oriented, mentors may choose to evaluate the students’  skills and performance in a clinical setting. Regardless of the format, project evaluations should enable students to demonstrate competency in each of the areas outlined in the Overview section. 

Project Examples

1. The Acupuncture Clinic at Memorial Hospital, is a potential site for a student project. Students may design a clinically-oriented project, in which they explore how acupuncture is used in a clinical setting while learning the appropriate acupuncture points and needling techniques. Or students may choose a research-focused project, in which they use outcome studies to examine the efficacy of acupuncture for certain medical conditions, such as chronic back pain
2. Clinical experience in the Ocean State Holistic Medical Collaborative in Providence. At this site students will have the opportunity to work with physicians practicing family medicine, pediatrics and psychiatry, complemented by homeopathy, acupuncture, functional medicine, and bodywork.

Potential Sites

Below is a list of potential sites where students can complete a summer project; students are not required to choose from this list.

Students who choose these sites will have the option of joining an existing project or creating their own.

• Acupuncture Clinic, Memorial Hospital, Department of Family Medicine, Alpert Medical School (Chinese medicine)
• Integrative Care Program in Women’s Oncology, Women and Infants Hospital (acupuncture, Reiki, bodywork, hypnotherapy, art/music therapy)
• Hasbro Children’s Hospital and Bradley Hospital (art/music therapy)
• Ocean State Holistic Medical Collaborative, 182 Gano Street, Providence, RI (homeopathy, Chinese medicine, mind-body medicine)
• Way of the Dragon School, Providence, RI (Qi Gong, Tai Chi, mind-body medicine)
• Pathways to Wellness, Boston, MA (Chinese medicine, bodywork)
• College of Naturopathic Medicine, Univ. of Bridgeport, Bridgeport, CT (naturopathy)
• Center for Mind-Body Medicine, Georgetown University (mind-body medicine)
• School of Classical Chinese Medicine, National College of Naturopathic Medicine, Portland, OR (Chinese Medicine, naturopathy)
• National Cheng Kung University, Taiwan (Chinese medicine)
• Zhejiang University, School of Medicine, China (Chinese medicine)

Maximum Number of Students

This concentration can currently accommodate a total of 2-4 students per year. However, if there

is significant interest, additional faculty members can be recruited to serve as mentors.

Funding Opportunities  
(alternatives to Summer Assistantships)

1. Students who participate in the five-day training session offered by AMSA’s Leadership and

Education Program for Students in Integrative Medicine (LEAPS into IM) will be eligible to apply for small project grants of $300.

2. Students with interests in art/music therapy may apply for the Student Scholarship ($1000) or various research grants offered by the Society for the Arts in Healthcare.

3. Students who are committed to research in the field of naturopathy may be eligible to apply for funding provided by the Institute for Natural Medicine (INM).

4. The National Center for Complementary Alternative Medicine (NCCAM) may provide research supplements to students who are committed to health-related research.

Concentration Director

Richard Dollase, EdD, Director, Office of Medical Education 
Email Address: Richard_Dollase@brown.edu
Phone:  401 863-3198
Mailing Address:  Box G-B 215, Providence, RI  02912

Other participating faculty:
Luba Dumenco, MD, Department of Pathology and Office of Medical Education
Paul George, MD, Department of Family Medicine and the Office of Medical Education
Thais Mather, PhD, Office of Medical Education
Dale Ritter, PHD, Department of Ecology and Evolutionary Biology

Overview

Students participating in the Scholarly Concentration in Medical Education develop an interdisciplinary perspective on the teaching and learning processes related to patient-centered health care. Specifically, the concentration program integrates the study of education, philosophy, and psychology to enable students to gain a holistic view of medical education in the context of academic medicine and clinical care. The seminars and workshops focus on active teaching-learning processes including current assessment strategies in the field of psychometrics.  Concentrators gain competence in lecturing, leading small groups, tutoring, motivating and counseling students, and assessing individual student progress and a student’s small-group and class performance.

Moreover, in developing an educational philosophy that is based on moral and ethical standards related to clinical practice, students draw upon the literature in the field of philosophy and clinical ethics.  Students also gain perspective on the underlying principles related to information technology and its impact on teaching and learning in the classroom and in medical practice. 

Curriculum

Timeline of Activities

Summer after Year I: Students are involved in curriculum-development activities related to developing or revising first- or second-year preclinical courses. Students may also be engaged in developing preclinical electives or constructing self-learning modules related to the first-year or second-year curriculum.

Year II:  Students participate in teaching and learning seminars on Wednesdays that address such topics as students’ various learning styles; how to lead a small group or how to effectively use technology in teaching and in patient care. In the second-year, students are expected to assume a leadership role in teaching and mentoring other preclinical students. They often serve as coordinators and tutors  in  the Doctoring Teaching Academy, the Content Tutoring Program or a preclinical elective they have created. Medical Education Concentrators may also give workshops related to such topics as health disparities or aged-based stereotyping or serving as small-group leaders, participate in undergraduate basic science courses that are offered on Wednesday mornings or afternoons.

Years III & IV: After completing a core clerkship, medical education concentrators are asked to serve as Teacher Assistants in the third-year Clinical Skills Clerkship, the transition course preparing third-year students for the clinical experience. As a Teaching Assistant, the medical education concentrator leads daily seminar sessions that further develop third-year students’ clinical skills and working knowledge about how to “survive” and succeed in the core clerkships. The Teaching Assistants also evaluate third-year students’ clinical performance and their professionalism by administering and grading an end-of-the course OSCE.

 Students may also undertake an independent study at the end of the third year or during the fourth year to prepare a final project. Medical Education Concentrators who are interested in teaching in the preclinical classes may also be able to work in a basic science course or the Doctoring course during the fall or spring semester.

 Learning Objectives

The medical education concentrators 1) develop an interdisciplinary perspective on the teaching and learning processes related to patient-centered health care; 2) employ active-learning strategies that enable them to become highly effective teachers and mentors; 3) self-reflect and effectively self-evaluate their effectiveness as tutors, teachers, and mentors.

Specifically, the medical education concentrators will demonstrate competence in

• Lecturing and preparing effective PowerPoint Presentations
• Leading a small-group discussion
• Tutoring and counseling other students
• Applying the latest educational technology to improve instruction
• Developing curriculum
• Creating  written examinations and  OSCE cases
• Evaluating the clinical performance of other students
• Utilizing self-evaluation strategies to assess their teaching effectiveness

Evaluation

Teaching:  During their teaching and tutoring, students will be observed and evaluated by faculty who are members of the Medical Education Concentration faculty and by other faculty members who may supervise students as tutors and/or teacher assistants in preclinical and clinical courses.  There will also be peer observations and evaluations by other medical students who may be concentrators or in the Teaching Academy.
Curriculum Development:  In planning, developing and implementing new curriculum modules, students will be assigned faculty mentors who will review and critique their curriculum at each stage of  development; and then the faculty mentors will observe the students teaching some of the teaching material. The faculty will also review the evaluation of the materials by students who participated in the curriculum project. A final report will be developed by the Medical Education Concentrator that will be reviewed by the faculty mentor and then student will make an oral presentation to the Medical Education Concentration faculty.
Research:  Under the supervision of a faculty mentor, the student will develop and implement a research design to evaluate the effectiveness of a component of our interdisciplinary preclinical curriculum. The research will be critiqued by the faculty member and two other members of a review team. The student will then make an oral presentation to the Medical Education Concentration faculty and to other students in the concentration. 

Resources

Participating students will work closely with Medical Education Concentration faculty, composed of excellent teachers and mentors, and the core clerkship directors in family medicine, medicine and pediatrics, who are also very effective teachers and mentors. Standardized patients will also be used to help develop and refine the Medical Education Concentrators’ clinical teaching skills. The University libraries have a substantive collection of books and articles on education. The Concentration will also utilize the resources of the Harriett Sheridan Center for Teaching and Learning. 

Concentration Related Electives

Clinical:
Teaching Medical Interviewing

Project Examples

1) Develop a curriculum module in a core clerkship or in a preclinical course that will involve creating an interdisciplinary curriculum unit, teaching the material, and evaluating the curriculum innovation. Once the curriculum module has been completed, the student will present the written document for review and then make an oral presentation to the Medical Education Concentration faculty and other students in the concentration on its educational goals, pedagogy and overall effectiveness. 
2) Undertake an evaluation project related to the effectiveness of an interdisciplinary component of a preclinical course or clinical course, or conduct a study of the effectiveness of one or more elements of the new integrated preclinical curriculum. The written report will be reviewed by a faculty mentor and the student will make an oral presentation to the Medical Education Concentration faculty and other students in the concentration.
3) Create and design an interdisciplinary preclinical or clinical elective that focuses on a topic of interest and that employs active-learning strategies and valid assessment protocols. The student will offer the elective to 5 or more students. The student will develop the curriculum, teach a substantive part of the material, and receive feedback on its effectiveness from students who take the elective and from a faculty mentor who has reviewed the material and observed a number of the classes. The student then will write a final report and make an oral presentation to the Medical Education Concentration faculty and other students in the concentration.
4) Teach for a semester or half-a-semester in first- and second-year basic science courses and/or the two-year Doctoring course. Collaborating with course faculty, the student will develop and implement lesson plans in lecturing or helping lead small-groups; also assess or critique the academic and/or clinical performance of students; and work effectively as a team member with senior faculty in the course. The student will be systematically observed by faculty and will also be evaluated by students in the course. The Medical Education Concentrator will keep a journal of reflections on the teaching experience and develop a substantive reflective essay related to the individual’s strengths and weaknesses as a teacher and mentor; what important “lesson” the student has learned during the teaching rotation; and recommendations for improving the teaching component of the concentration.

2010 Accepted Students and Scholarly Concentration Projects

Maximum Number of Students

We can generally accommodate 3-5 students. 

Faculty Mentors

Presently there are four faculty members who will mentor students.

Funding Opportunities
(alternatives to Summer Assistantships)

Curriculum-development funds from the Dean of Medical Education are available to two to three Medical Education Concentrators interested in developing or revising the preclinical curriculum.