Dean's Newsletter

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Alpha Omega Alpha, Part 1: History and AΩA Lecture

February 16, 2007

Each year, among a group of 100 outstanding medical students at SMD, we are asked to pick 15 students for induction to Alpha Omega Alpha (AΩA), the national medical honor society.  We are asked to choose students who not only are at the top of the class in academic record, but excel in leadership, community service and scholarship.  In addition, we name an alumni inductee as well as resident and faculty inductees. 

This is a two-part newsletter on AΩA.  In this first part, I will provide some history on AΩA, and a summary of this year's AA lecture, which was given by Arthur Moss, M.D., Professor of Medicine (Cardiology) and Director of the Heart Research Follow-up Program.   

Arthur Moss, M.D., Professor of Medicine (Cardiology) and Director of the Heart Research Follow-up Program

AΩA was founded by a group of medical students at the University of Illinois College of Medicine in 1902.  To understand its founding and the remarkable early history of AΩA, it is helpful to place this in the context of medical practice and medical education in the United States at the turn of the century.  In the late 1800s, most students entered medicine with only a high school education or less.  With time, a subset of schools began to require some college education, or even a college degree.  The medical school curriculum was typically 2-3 years; the University of Pennsylvania, was the first to require four years of medical school.

The turn of the 20th century was also the era in which the practice and safety of surgery advanced considerably, with the general availability of anesthesia and improved aseptic techniques.  Advances in the biological sciences—bacteriology, physiology, and pathology—also led to a more scientific basis for the practice of medicine.

Paralleling these changes, there was a dramatic increase in the number of medical schools and medical students.  In 1880, there were 100 U.S. medical schools with 12,000 students.  In his 1880 report on medical education, the President of Harvard University, Charles Elliott, wrote, "In this University, the medical students are noticeably inferior in bearing, manners and discipline to students in other departments."  The lack of discipline and manners did not hurt demand for enrollment in medical schools--over the next 20 years, there was a 60% increase in the number of schools, from 100 to 160, and more than a doubling of the number of medical students, with an increase to an estimated 25,000 medical students in U.S. schools in 1900.

Enter William W. Root, a native of Niagra Falls, NY, who began medical school at the University of Illinois in 1901.  Root was a graduate of Cornell, and had taught chemistry, physics, and biology to pay his way to medical school.  He was 36 years old and a serious student.  Root stated that he found at medical school an environment of "rowdyism, boorishness, immorality, and low educational ideas."  To do what they could to "raise the level of student conduct and scholarly attainment," Root and eight of his classmates met first on August 25, 1902, and then recruited a larger group—28 medical students--who gathered at the Bismarck Hotel in October 1902 to ratify a proposed constitution written by Root.  The original name of this organization, Alpha Omega Alpha, its motto: "Worthy to serve the suffering," and its goals of emphasizing scholarship and appropriate professional demeanor, have not changed from its founding.  It is also remarkable that the founders clearly stated their intentions that "race, color, creed, sex and social standing should never be barriers to membership."

Today, medical schools across the U.S. have AΩA chapters in which they induct those students who not only show excellence in their academic work, but in their leadership, community service, and scholarship.  This year's group of AΩA inductees at the University of Rochester are listed at the end of this newsletter; they will be highlighted in next week's newsletter.

One of the first tasks of the new student inductees is to choose the AΩA keynote speaker.  They can choose someone from our medical school, or someone from the outside.  This year, they handed me a list of potential speakers, at the top of which was our own Dr. Arthur Moss.  When I called Art to ask whether he'd be willing and available to do the lecture, he said: "Absolutely.  I'm honored, and whatever is on my calendar I will clear out to make room."

Dr. Moss received his undergraduate degree from Yale University and his M.D. from Harvard Medical School.   He completed his residency in Medicine and a fellowship in Cardiology here at URSMD.  Dr. Moss is internationally recognized for his many contributions that have increased our understanding and improved the treatment of cardiac arrhythmias, coronary heart disease, heart failure, and long QT Syndrome. 

Here is Dr. Moss's summary of the superb AΩA lecture that he gave on February 7, 2007, entitled "Four Faces of Medicine:."

The AΩA Honor Medical Society was formed in 1902 by a group of 6 medical students at the College of Physicians and Surgeons in Chicago. The 3 letters, Alpha Omega Alpha, are the initials for the Greek motto, "worthy to serve the suffering." To put the formation of AΩA in a chronological perspective, the Flexner Report was published 8 years later in 1910, construction of the URSM&D began in 1923, and the first medical school class entered in 1926 and was graduated in 1930. The current 15 medical students elected into AΩA are members of the 78th graduating class of the URSM&D. When these students were applying to medical school, they were asked "why do you want to become a doctor." Today, as these outstanding medical students approach graduation, they are asking themselves what kind of doctor they want to become – and this is what my talk today is about. The Four Faces of Medicine highlight four important responsibilities doctors assume when they receive their medical degree.

The First Face of Medicine relates to clinical patient care. When caring for patients, doctors have a special calling to solve each patient's medical problem and render optimal medical treatment. In some patients, diagnosis and therapy may be exceedingly challenging, and the total experience involved in caring for individual patients can meaningfully impact ones career. It should be remembered that medicine is learned by caring for the patient at the side of the bed, and not simply talking about the patient at the foot of the bed. Solving a patient's problem can also serve as the stimulus for creative research ideas.

The Second Face of Medicine relates to clinical research. Physicians have a responsibility to advance the science of clinical medicine. This can be done at many different levels along a spectrum from basic research, to clinical research, to clinical case reports. Many in the graduating class have had a meaningful research experience during medical school, often with the development of a special mentor-mentee ‘partnership'. While deductive reasoning is at the core of patient care, inductive reasoning is at the foundation of clinical research. Involvement in clinical research makes a doctor a better physician, for the complimentary aspect of medical care and clinical research is a two-way street. Many of the rewards involved in combined clinical practice and research are the priceless intangible values that underlie our profession.

The Third Face of Medicine relates to marriage and the family. Medicine is a demanding profession, and family structure requires thought and planning if one is going to make optimal use of ones time. Early on, my wife and I appreciated the importance of the family dinner with our children where all members could share their experiences. Such day-to-day communicative interactions are essential for transmitting values, an essential responsibility of a parent. From my perspective, the medical profession provides the optimal background for transmitting values, for such values are at the heart of the practice of medicine.

The Fourth Face of Medicine relates to community involvement. As physicians, we are also teachers, and our responsibilities extend beyond the borders of the hospital and the clinical office; we each have a commitment to the community in which we live. We have a responsibility to educate members of our society about medical issues in which we have expertise. As examples, such activities can involve lay programs in cardiac resuscitation, educational talks on relevant medical topics to various social groups, and participation in outreach programs to citizens who are anxious to learn about preventative medicine.

Over the years in which I have been involved in both patient care and clinical research, I have developed a "Top 10 List" for physicians:

#10: We are all on the bell-shaped quality of medical practice curve, and each physician should aim to be in the top 1% of the curve – being average is not good enough.
#9: We have a responsibility to achieve the best possible result in every patient, with full realization that some patients' problems are more difficult to diagnose and treat than others.
#8: Internalize medical professionalism, for we are members of a special service profession. It is important to remember the dignity and seriousness of purpose in patient care. Long hours are part of the job.
#7: Commit oneself to long-term learning, caring, and excellence.
#6: Avoid arrogance, greed, and intellectual laziness.
#5: Learn how to confront uncertainty, ambiguity, and complications in medical practice. The response to these medical challenges builds character.
#4: Continued medical growth is essential and requires not only long-term commitment, but also, ongoing personal reflection. Such reflection helps one adapt to changes that are part of medical progress.
#3: Recognize and appreciate the importance of the clinical paradox. Inquiry into the cause of the paradox can be remarkably rewarding for the patient and for ones professional career.
#2: Think outside the box using curiosity, vision, and inventiveness. "Evidence-based practice" is the current buzzword, but it a record of the past and should have an expiration date.
#1: As physicians, we have a responsibility to save lives, stamp out disease, and relieve pain and suffering.

In the same year that the AΩA Honor Medical Society was formed, Sir William Osler gave a talk to the Canadian Medical Association on September 17, 1902 entitled Chauvinism in Medicine. A few sentences in that address highlight our goals as we practice our profession: "To wrest from nature the secrets which have perplexed philosophers in all ages, to track to their sources the causes of disease, to correlate the vast stores of knowledge that may be quickly available for the prevention and cure of disease – these are our ambitions" (This address appears as a chapter in the book, Aquanimatas, With Other Addresses to Medical Students, Nurses and Practitioners of Medicine, 3rd ed. Philadelphia: P Blakston; 1932).

Thank you, Dr. Moss.  These are important ideas indeed, and powerfully conveyed, even in abstract form.  Next week, we will focus on our inductees, listed below:

Students

Katherine Blumoff	Kim Corbin	Jessica Felt
Waseem Knan	Joy Knopf	Benjamin McClintic
Catherine Moore	Alexis Mottl	Sarah Peterson
Anthony Petraglia	Gretchen Rickards	Andrew Sauer
John Scherer	Karolina Zareba	Alicia Zysman Cromwell

 

Alumnus

James D. Cox, M.D. ‘65, Hubert L. And Olive Stringer Distinguished Chair in Oncology, M.D. Anderson Cancer Center

Residents and Faculty

Chris Burke, M.D. PGY3 Resident in Neurology
Tran La, M.D., Chief Resident in Medicine
Ryan Nelson, M.D., PGY2 Resident in Medicine
John Bisognano, M.D., Associate Professor of Medicine
Garrett Riggs, M.D., Assistant Professor of Neurology
Jules Zysman, M.D., Clinical Associate Professor of Family Medicine

Meliora,

David S. Guzick, MD, PhD
Dean, School of Medicine and Dentistry