Curbing Maternal Mortality

U-M delegation witnesses impact of health mission in Ghana

When a colleague was unable to attend a Continuing Medical Education session in Ghana in 1986, Timothy R.B. Johnson, M.D. (Residency 1979), now chair of obstetrics and gynecology, took his place, making his first trip to Africa. That simple, serendipitous event sparked more than two decades of partnerships between Ghana and the University of Michigan, starting with a residency program in ob/gyn funded by the Carnegie Corporation — which continues with Ghanaian government support today.

In May, a nine-member U-M delegation, which included members of the Board of Regents, faculty, alumni and friends, visited Ghana to witness firsthand the breadth and depth of the U-M’s work there, and to explore new partnership opportunities. Led by Joseph C. Kolars, M.D. (Fellowship 1989), professor of internal medicine and senior associate dean for education and global initiatives, the delegation visited Ghanaian teaching hospitals and government agencies and met with students, residents, postgraduates and faculty.

Carnegie’s goal in funding the U-M and other programs in Ghana in the 1980s was to build international medical capacity and improve maternal medicine. Key to that effort is raising Ghanaian educational standards and implementing an improved system of teaching.

“Medicine in Ghana, even though it’s very different, is still good medicine,” says Johnson, the Bates Professor of the Diseases of Women and Children and a member of the visiting delegation. “However, their education system needs to catch up to ours.”

Johnson would know: Since that first trip, he’s visited Ghana more than 30 times, spearheading a physician education effort that now includes specialty training at the University of Ghana Medical School and the Kwame Nkrumah University of Science and Technology, both of which the delegation visited. More than 60 Ghanaian students have been trained in Ghana, with nearly all of them opting to remain in the country after completing their residencies.

High maternal mortality rates are the reason the U-M Health System became engaged in a health initiative in Ghana. According to UNICEF, the annual maternal mortality ratio in Ghana in 2008 was 450 deaths per 100,000 live births, compared to eight in the U.S. Rates are declining but remain unacceptably high. While the Health System’s involvement is growing in many other disciplines — emergency and family medicine, oncology, physical medicine and rehabilitation — its main goal still lies squarely in reducing maternal deaths, according to Johnson.

Members of the group stressed Michigan’s strong relations with its funding and donor communities, which have reduced the U-M’s reliance on state funding. They hope that more members of the Board of Regents, faculty and friends of the University will visit Ghana in the future. University of Ghana Vice Chancellor, C.N.B. Tagoe, noted that U-G’s relationship with the U-M is one of the most significant with a foreign university in the field of health sciences.

Says Tim Johnson, “The lesson for me was: Never hesitate to pick up the phone to see if someone might be interested in supporting some wild idea.” — MARGARITA BAUZA AND RICK KRUPINSKI

Photos from the U-M Delegation’s trip to Ghana

Depression Increases During Internship

A study conducted by Assistant Professor of Psychiatry Srijan Sen (M.D. and Ph.D. 2005) and published in the June issue of Archives of General Psychiatry, indicates that depression among clinicians increases markedly during the period of medical internship. While studies have shown that rates of depression are higher among medical interns than the general population, few have looked at specific factors responsible. Sen and colleagues found that increased work hours, medical errors, genetic predisposition and receiving a medical education in the U.S appear to be associated with depressive symptoms. The study involved 740 interns who began residencies in 13 U.S. hospitals in 2007 or 2008. — RK

An expanded version of the story

Student’s Leadership Honored

Third-year medical student Brandon M. Wojcik was one of only 20 students nationwide to receive the 2010 Leadership Award from the American Medical Association Foundation. Wojcik, from Saranac, Michigan, was honored for outstanding non-clinical leadership skills in advocacy, community service and education. The award was presented, in association with Pfizer, Inc., at the AMA National Advocacy Conference, which provides training to students, residents, fellows and early-career physicians to prepare future leaders in medicine and community affairs. — RK

New Leadership for Psychiatry

The Department of Psychiatry has a new chair with the appointment of Gregory Dalack, M.D., who has been serving as interim chair since John Greden, M.D., stepped down from the role in 2007 after 22 years to direct the U-M Depression Center. Dalack, an associate professor of psychiatry, leads a department comprised of 182 faculty members, 54 residents and fellows, and 364 administrative, research, nursing and clinical support staff.

Dalack earned his M.D. at Columbia University and completed his residency and a clinical research fellowship at the New York State Psychiatric Institute. Upon joining the Medical School in 1992, he headed the Mental Health Clinic at the VA Ann Arbor Healthcare System until 1999. From 2006 until his appointment as interim chair, Dalack also served as vice chair of the department. — RK

Former Dean Dies at 79

Former U-M Medical School Dean Joseph Eggleston Johnson III, M.D., died April 19, 2010, in Jacksonville, Florida, at the age of 79.

Johnson served as dean of the U-M Medical School from 1985-90. During his tenure as dean, the Medical School curriculum was revised to emphasize preventive care, critical thought and independent learning. He oversaw the opening of the new University Hospital, the A. Alfred Taubman Health Care Center, and the Medical Science Research Building I — all in 1986 — as well as MSRB II in 1989. Johnson recruited eight new department chairs, and research funding from external sources more than doubled during his deanship. After completing his service as dean, he remained on the faculty as a professor of internal medicine until he retired in 2003.

Johnson received his bachelor’s and medical degrees from Vanderbilt University and completed a residency at the Johns Hopkins Hospital. He served in the U.S. Navy as a medical officer aboard a nuclear submarine for two years, then returned to Hopkins to complete a fellowship in infectious diseases and immunology. Before coming to the U-M, Johnson held faculty and administrative positions at Hopkins, the University of Florida and Wake Forest University. — MF