Clinicians Ceremony 2016

Please welcome Associate Dean of Medical Education for the University of Nevada, Reno School of Medicine, Dr. Timothy Baker.

[applause] Baker: Please be seated.

Good evening everyone, I'm Timothy Baker; I'm Associate Dean for Medical Education.

Welcome to the Class of 2018's Clinician Ceremony.

This gathering signifies our student's success and transitioning from the Basic Science years into the Clinical years of their medical education.

We're pleased to support all of our students and we thank you all for being here to commemorate this event.

We're very happy to hold this event in Reno for the first time since 2011 and while we remain dedicated to the statewide mission of the School of Medicine; the relocation of the Clinician Ceremony to Reno signifies the commitment that the University of Nevada, Reno School of Medicine has to the Northern Nevada community.

2016 saw the development of new clerkships in surgery and Obstetrics and Gynecology here in Reno; and for the first time in more than two decades students have the opportunity to complete their full third-year here in Reno.

As we continue to develop our campus here in Reno, the number of students who complete this, their third-year, in Northern Nevada will grow substantially.

In fact, the class of 2018 about half of them will do their full third-year here in Reno; and we're very excited about that.

This ability to stay here in Reno gives students the opportunity to stay close to friends and family, if they wish to do so.

The friends and family that have been here with them for the last few years.

Through our ongoing partnership with the community, the University of Nevada, Reno School of Medicine will continue to grow and prosper here in Northern Nevada.

We have some distinguished guests that have joined us tonight and I want to take a moment to recognize them.

Chancellor emeritus of the Nevada System of Higher Education, Dan Klaich.

[applause] Chancellor Klaich's wife Denise, thank you.

[applause] Dean of the University of Nevada, Reno School of Medicine and Vice President of the Division of Health Sciences, Dr. Tom Schwenk.

[applause] And our guest speaker alumna from the class of 2008 School of Medicine, community faculty member and Chief Medical Officer of Northern Nevada HOPES, Dr. Reka Danko.

[applause] Thank you all for your continued support of the School of Medicine.

I'd now like to invite up Dr. Melissa Piasecki Executive Associate Dean of the University of Nevada, Reno School of Medicine and Senior Associate Dean of Academic Affairs.

[applause] Piasecki: Thank you Tim and thank you everyone for joining us this afternoon.

This is a special event for us, we are very proud of our students and as you can see they represent the excellence and they represent the bright future of medicine.

We're proud also of our alumni and you'll hear one of our distinguished alumna very soon.

Our alumni join our faculty in leadership of medicine, they are leaders of medicine in Nevada as well as nationally and internationally, but what I'd really like to highlight today is how proud and grateful we are for the community of our teachers.

Medical education takes a village of medical educators, the model for medical education is see one, do one, teach one.

This is a highly personalized and very hands-on approach for learning.

Teaching medical students to take care of people requires patience, wisdom and kindness; this in turn helps the students develop the confidence and the skills that they need to become independent practitioners in a few years.

Our partners and medical education are the individual physicians in our community often alumni who bring students into their patient practices.

Our partners are also our local and state medical societies and they are our community hospitals such as Renown Hospital that hosts our students as they learn the art and science of patient care.

We are truly fortunate to have such a strongly committed community of teachers who will support this wonderful class of students and guide them in the upcoming years as they develop into wonderful physicians.

Now to speak on behalf of the Class of 2018, I would like to invite president Sam Dugan to the stage.

[applause and cheering] Dugan: Welcome, faculty, friends, fellow students and honored guests.

Dr. Baker has explained a bit about why we are here tonight but I would like to tell you a little bit more about that.

Medicine is both extremely complex and so very simple.

We have spent the last two years studying most of the nights looking at a computer or a book and this speaks to the complexity of medicine as we learned the thousands of different things that occur at the body, simultaneously.

For the next two years we are going to learn a little bit more about the simplicity of medicine.

When the patient walks in and they can't breathe, maybe they're not walking anymore, but our job is to return breath to them.

When a patient has difficulty getting around their home or spending time with their loved ones, our job is to give that back to them as best we can.

The practice of medicine is both complex and simple.

The ideas are simple and the actions are often times much more complex than hopefully we let on when we're talking to patients.

It is often said, and I hope you will excuse my shameless cliché, that medicine is both a science and an art.

While we might currently describe the electronic medical record or the way a hospital works as more of a Picasso than a Monet; hopefully, in the next two years we will be able to take that Picasso and turn it into a Monet.

These next two years are about learning how to accomplish many aspects of medicine.

We must now not remember some obscure fact on a piece of paper but we must turn that fact into a question that a person can answer in the office, and then we have to take the answer they give us, we have to turn it into a test, an image, a set of lab values and then we have to take the result of those images and lab values and turn it into a plan we have to present that plan to a patient, who is an actual person, not just the computer this time.

and then we have to agree to enact that plan together with that person and this is something that we will learn in the next two years.

As one might imagine, there will be a few mistakes we make along the way what I want you to know and what I want my fellow students to know is that there is no finer group of students one could ask to be a part of.

Spending the last two years with my fellow students has been the most humbling experience of my life.

They are talented passionate, intelligent and kind.

They strive for excellence and they define it by their own high personal standards and it has been an absolute honor to learn from them and minus a few people that I truly love I would trust their care with anyone that walks in the door.

[laughter] They have impressed me with their endless effort and their ability to keep striving when anyone else would have given up long ago.

When one of us fails, we don't judge, we don't wonder how they couldn't, we offer help and support and we get back to work together.

That is what these next two years will be, this is a team game and we are the new team member bound to fail and struggle; but this is a group of people before you and they just keep struggling and eventually that patient will go home with the proper diagnosis I promise.

I know there are many family members, friends and partners here tonight and I would like to take this opportunity to thank you for all the support you have given my classmates these past two years.

I would also like to warn you, your support is going to have to continue.

[chuckling] Where it was once complaining about sitting for hours and not getting to stand up ever.

We will now complain about never getting to sit down; you're going to hear stories about long hours on the wards instead of long hours in front of the computers and I need you to keep supporting my classmates as you have done so far.

We would not be here, if it were not for you and you remind us why we have chosen this life of service.

Thank you all so much for your time, congratulations to my classmates on your accomplishments thus far I know there will be many more in front of you.

See you all on the floor.

[applause] Baker: Thank you Sam.

I'm really honored to introduce our next speaker, our guest speaker tonight.

I first met Dr. Danko about eight years ago when I was a new faculty member here and she was about three months into being able to call herself 'doctor' having just graduated from this medical school in 2008.

We were lucky enough to have her stay on with us in the Department of Internal Medicine to complete her Internal Medicine residency training.

She's really excelled since then, she's one of our outstanding community faculty members she's a member of the office for Community Faculty Advisory Board, she's a board member of the School of Medicine's Alumni Association and currently she's the Chief Medical Officer for Northern Nevada HOPES.

Please join me in welcoming Dr. Reka Danko.

[applause] Danko: Thank you Dr. Baker and thank you for the opportunity to be here today.

Hello Dean Schwenk, University of Nevada School of Medicine faculty and staff, friends, family members, fellow alumni and hello to you Class of 2018; congratulations to each of you on what you have accomplished so far and welcome to the next part of this journey.

What an exciting journey this will be, you will have opportunities that will challenge you make you stronger as a person, humble you, entertain you and each day you will build memories and experiences which will last you a lifetime.

I will never forget my first day as a third-year medical student, feels like yesterday, I moved to Las Vegas just a few days prior, of course with more boxes of textbooks then I had clothing.

The evening before my first day I was sure to make a test drive to make sure I could find the hospital in the hustle of Las Vegas traffic.

Little did I realize, that in the crisp morning hour of 3 a.

m.

when I was going to be getting up for that first day, there wasn't a whole lot of traffic.

[chuckling] In fact it was dark and the majority of the community was sleeping, but I was walking in ready to see my first patient.

Here we go.

I found his room and I walked in and woke him up It was at that point that we both realized, very quickly, that he knew more about what I was supposed to be doing in there, than I did.

So I asked him about his surgeries and how he was feeling.

I remember wishing that there was an instruction manual at the side of the bed with step-by-step instructions.

So I looked in his chart and I started reading; between the shorthand notes, the medical abbreviations and the fishbone labs I may as well have been trying to decode an Arabic script.

So I started flipping through the abundance of pocket books that were weighing down my white coat.

And I thought 'Where is that predictable, reliable, flow sheet that I am comfortable with in Biochemistry? where is the Krebs cycle around here?' BAM! That's when I realized, medicine is unpredictable and requires problem solving.

At that point, a kind nurse came to my rescue.

She helped me decode the clinical encounter, understand what happened to the patient and detail with me, his plan of care; most of all, she helped me realize that although I had spent the last two years soaking up valuable foundations of core knowledge I had a lot to learn, it was both overwhelming and encouraging.

I went back in an attempt to have another discussion with my first patient.

I remember everything resonating from Practice of Medicine lectures as I walked towards his room chief complaint, history of present illness, past medical history, social history, I got this! So I sat down and he began to tell me about his experience in the hospital he told me about the difficulties he has faced being on the ward for the past three weeks sharing a roommate situation seeing his family and friends for sporadic daytime visits and the pain and uphill recovery after his surgeries as well as the fear he had in facing additional skin grafting to help his burn wounds.

It was amazing, I was humbled.

I was humbled to be a person who was given so much private and heartfelt information so freely from another person.

I was humbled that although my morning felt overwhelming and challenging, it was nothing compared to the experience on his side of the bed.

I realized in that encounter and still continue to realize every day in practice that medicine is not just a skill set of gathering and obtaining the right pieces of information, putting together a differential diagnosis, interpreting results of exams and tests and utilizing foundations of science- and evidence-based practices to formulate treatment plans, medicine encompasses all of that, plus the unique privilege of caring for people, people who tell you things they don't tell other people, people who look up to you for guidance, help and hope people who rely on you and your team to combine complex science with empathy, compassion and understanding.

In these clinical years you will learn the value of teamwork from fellow students, residents, physician mentors, nurses, unit clerks, case managers, your friends and family, your patients and all members of your interdisciplinary teams.

You will learn about the levels of vulnerability and fear that happen on the other side of the bed; you will learn that patients will humble you every single day, you will learn that although patients don't come with a step-by-step manual; it is so amazing to be a part of a team helping another person.

You will also learn that sometimes patients will teach you, more than you will teach them, if you take the time to listen.

You will learn that you don't need to have all the answers or be the smartest person in the room, you will learn that a little bit of fear may come in moments of uncertainty, but those moments remind you that you care about the person you are treating and you will continue to build upon your strong foundations of knowledge and expertise.

You will learn that you are more capable than you ever gave yourself credit for so stay open and stay thankful.

Remember your oath to respect science and combine it with the art of warmth, sympathy and understanding and to share knowledge to those working towards health and to those working to deliver health care.

So my advice for the change that will come in the transition to the clinical years carry with you an attitude of gratitude for the opportunity and be thankful for the privilege of what we get to do for a living.

Even on the mornings when you are awake when no one else seems to be, when your feet are numb from wearing the wrong shoes to your first transplant surgery or the moment you realize that there is so much more to learn, be thankful for the unique privilege, soak up the opportunities to keep learning and embrace the opportunities to provide non-judgmental care to those who need it.

Congratulations to the Class of 2018 and welcome to the clinical years.

[applause] Baker: Thank you Dr. Danko, it's alumni like that and community faculty like that that makes our school such a great place to train.

At this point in the program we have some awards we'd like to acknowledge.

I'd like to ask Dr. Cherie Singer, our Associate Dean for Admissions and Student Affairs and Dr. Jennifer Hagen, our Associate Dean for Faculty Development to come up.

Singer: A lot shorter than Dr. Baker, practiced that.

So I'm honored tonight to announce the University of Nevada, Reno School of Medicine Professionalism in Medicine awards to the Class of 2018.

These awards are intended to highlight outstanding achievement in the areas of altruism, duty, humility, integrity and respect.

What makes them really special is that they're not in any way faculty-motivated; the students themselves actually nominated their classmates for these awards to recognize this evening.

Our tradition about these awardees being nominated by their classmates has actually been around since 2002.

So, we're really carrying on a great tradition here and up to this point, what's actually special is the students are not aware of who is winning the awards this evening, so it's a little bit of a surprise.

Also, we're very pleased to have the continuous, generous support of Jerry and Janet Zebrack as each of these awardees who received these professionalism awards will also receive the Jerry and Janet Zebrack Family Scholarship in Humanism.

Dr. Zebrack and his family have strong ties to the School of Medicine; Dr. Zebrack is a long time faculty member, who taught cardiac physiology and actually served as a clinical mentor for more than 200 students over the years, and two of Jerry and Janet sons are graduates of our school.

The Scholarship in Humanism recognizes the Zebrack family's strong commitment, not only to the care of patients, but to the teaching and nurturing of future generations of physicians.

And while they're not able to join us this evening, I'd like to recognize their support of the students and the School of Medicine.

[applause] Finally, each recipient of these awards will be inducted into the Gold Humanism Honor Society.

This society recognizes individuals for practicing patient-centered medical care by modeling the qualities of integrity, excellence, compassion, altruism, respect and empathy at various stages in their careers.

Each recipient will receive a membership pin and a certificate from the Gold Humanism Honor Society to commemorate the honor.

So, with all that explanation, let's get on to the awards which will be presented by Dr. Jennifer Hagen, who herself, is a member of the Gold Humanism Honor Society.

[applause] So, I tried to remember who is on each side, I might forget a little bit.

So, the University of Nevada, Reno School of Medicine Professionalism in Medicine award for altruism is given to the student who demonstrates unselfish concern for the welfare of others, often at the expense of their own needs this year's awardee is Yumi Esaki, Yumi.

[cheering and applause] So I'm going to embarrass each student a little bit by telling them what their classmates said about them.

The class of 2018 commented that Yumi deserves this award because she's a strong advocate for her patients that she sees at the SOC, tirelessly following up on their care, but she also puts the needs of others before her own by providing kind and thoughtful words to her classmates and listening intently to someone else's opinion often taking on extra work or consoling them when they're really down and most importantly, she does these things with humility and kindness.

[cheering and applause] [applause] So, the next award is the Professionalism in Medicine award for duty and this is given to the student who is identified as a reliable, capable, leader of their class with the strong sense of values to guide their efforts.

The awardee this year is Jeremiah Pavelka.

[cheering and applause] So, his classmates commented that Jeremiah deserves this award because his work and leadership as the Executive Director of our Student Outreach Clinic.

In that role he has managed his peers and in an, I quote, "a professional and distinguished manner" with grace and competence.

And also he conveys leadership, responsibility and strong values with every word and action.

[applause] Our next Professionalism in Medicine award is for humility and this is given to the student who demonstrates a gentle nature motivated by values, but who does not seek attention or acknowledgement from others when doing something remarkable and the awardee this year, is Robert Davis.

[cheering and applause] Robert, your classmates commented that you deserve this award because you are the kindest and most encouraging member of the class.

Always willing to boast those around you without ever promoting yourself.

[applause] Our next Professionalism in Medicine award is for integrity and this is given to the student who demonstrates strong personal ethics and steadfast adherence to a strict moral code.

someone who is always trustworthy and who has gained the trust of others.

And the award this year is Justin Baumgartner.

[cheering and applause] Justin's classmates commented that he adheres to his moral code and is willing to put his own interests aside in order to protect and stand up for the values of others and make sure that they are respected.

He also has the moral courage and tenacity to stand up for justice in all of its many forms.

[applause] So, our final Professionalism in Medicine award is given for respect [laughter] and this is for a student who is often sought out for their insight, knowledge and opinion; who abides by a do-onto-others philosophy and interactions with others and the awardee this year is Sally Higgins.

[applause] Sally's classmates commented that she deserves this award because many have sought her out for her insight and knowledge and that she shows genuine interest and is inclusive and kind in her interactions with others.

[applause] So, students behind me, congratulations on your Professionalism in Medicine awards and the Jerry and Janet Zebrack Family Scholarship for medicine.

Remain on the stage, so you can be inducted into the Gold Humanism Honor Society.

But before that, I would like to recognize our residents who also received the Arnold P.

Gold Foundations 2016 Humanism and Excellence in teaching awards.

These residents exhibited particularly strong teaching skills and are role models for compassionate relationship-centered care.

The residents are: Travis Walker from Family Medicine who's with us this evening.

[applause] Benjamin Hansen from Family Medicine, Lannah Lua from the Obstetrics and Gynecology Department.

Lucy Won from Surgery, Hasan Khashwji from Surgery, and Krystle Tuano from Surgery.

Travis is with us this evening, would you come up on stage.

[applause] So, now I'm going to turn over the podium to Dr. Hagen.

Oh wait, we have to take a picture first I should have done that, gotten comments from Travis.

So, we're going to take a group photo of everybody and then you can be inducted into the Gold Humanism Honor Society.

[silence] [continued silence] Hagen: Inductees and current members in attendance, please stand and join me in reciting the Gold Humanism Honor Society Oath which can be found on the back of your programs or certificate.

Ready? Okay.

Multiple voices: I pledge by all that I hold dear as a physician: I will care for my patients with compassion, respect, empathy, integrity and clinical excellence.

I will listen to my patients with my whole being.

I will advocate for each patient as a unique individual.

I will serve as a role model and mentor to promote humanism in healthcare.

I will remember always the healing power of acts of caring.

I will dedicate myself to joining with others to make healthcare optimal for all.

Okay, congratulations to all of our award recipients; we are so proud of your accomplishments.

[applause] And now, I would like to invite Dr. Thomas Schwenk to speak.

Dr. Schwenk has served as Dean of the University of Nevada, Reno School of Medicine and Vice President of the University of Nevada, Reno Division of Health Sciences since July 2011.

Schwenk: Dr. Hagan, thank you very much.

I want to begin by recognizing another distinguished guest who has joined us, came from another important University event.

And I do so with particular emphasis on the relationship of the school and as you know our new name with the University of Nevada, Reno.

I'd like to recognize our Executive Vice President and Provost Kevin Carman.

[applause] This day marks a transition for the Class of 2018 to the first of many intense years of clinical training that will lead to their full development as a physician.

These students first put on their white coats, when they started medical school two years ago.

At the time they learned about the symbolism of the white coat and they were introduced to the concept of what it means to cross that line into the world of the physician.

I noted at that time that the moment they cross that line, they could never fully cross back.

Now, after two years of early clinical exposure and skills training, diligent study, hard exams, they are about to put on new white coats and cross permanently into the world of the physician.

From this point on, they will learn more from patients then they will from books.

In the early 1900s, medical education consisted of a single year of lectures and reading.

The really top schools, offered a two year curriculum which consisted of the same year, twice.

So, it could be worse.

[laughter] Sir William Osler, the great physician and teacher, was one of the founders of Johns Hopkins Hospital, and is considered the father of modern medicine, and he was the first to emphasize the importance of a clinical context for all medical teaching and to bring medical students out of the lecture hall and into clinical training.

He was quoted as saying, "he who studies medicine without books sails an uncharted sea; he who studies medicine without patients does not go to sea at all.

" You are about to go to sea, with excellent guidance and charts as physicians in training you'll be faced with challenges and opportunities that all have to do with the patients for whom you are responsible and I emphasize they are your patients and you are indeed responsible.

You will care for these patients with guidance, with support, with excellent teaching and supervision, but you will call them your patients and for the rest of your professional life, you will always refer to them as your patients.

Now, before I ask you to stand and put on your coats, I have a bit of explanation.

You will note that these coats currently have only your name embroidered on them as you know, last week the Board of Regents endorsed a change in our name to the University of Nevada, Reno School of Medicine.

I am extremely proud and very excited about this change.

It reflects our academic home and the community from which we will draw our partnerships, draw our teaching and clinical resources.

We wanted you to have coats that had the true name and logo and we have yet to work on a possible change in the logo.

So, we're going to collect your coats at some point.

Rip them off your backs and have them embroidered following the ceremony and we'll return them to you once we finalize these changes.

So, I asked our students to stand and please don your new coats.

[silence] Please join me in congratulating them.

[cheering and applause] Please be seated.

A final comment as with the white coat ceremony two years ago; this ceremony and the donning of your coats signify the responsibilities that you have accepted as part of becoming a physician.

With this transformation you will face many challenges, one of which is the challenge as exemplified by the Gold Humanism awards this evening, challenge during the long days and nights of clinical duties to come that you will remain present, you'll remain human, humane and kind.

I know you will meet that challenge, I present you to the community of physicians, educators and mentors who will guide you to the next phase of your growth and development.

Congratulations.

[applause] Thank you all for coming, if you could all stand, the students will recess and will join you in the back for a reception.

Thank you all.