Beyond Gross Anatomy
Mass Medical Society honors two BU profs for advancing medical education
During her years of training as a medical student and as a young doctor in the late 1970s, Elaine Alpert, a School of Public Health associate professor, never heard the words “domestic violence” or “sexual abuse” in the context of patient care. It was, she says, “a black hole in medical education.”
But, over the last two decades, Alpert has worked to bring these issues into the light, writing curricula to train medical professionals in recognizing and asking about family violence, giving talks on the topic, and serving on numerous committees, such as the American Medical Association’s National Advisory Council on Violence and Abuse and the Massachusetts Governor’s Commission on Sexual and Domestic Violence.
This year, the Massachusetts Medical Society recognized Alpert’s leadership by awarding her its Henry Ingersoll Bowditch Award for Excellence in Public Health. The medical society also honored Steven Borkan, a School of Medicine associate professor of nephrology, giving him the Grant V. Rodkey Award for “outstanding contributions to medical education.” The award recognizes Borkan’s volunteer mentoring in a pilot program to help M.D.-Ph.D. students transition from lab work to clinical training.
Alpert, who teaches graduate courses in family violence and sexual violence prevention, says her rise to expert status on these issues was both rapid and unexpected. In 1987, as a new MED assistant dean for student affairs, a post she held until 2003, a medical student suggested a discussion group around the topic for female students. Alpert expected 12 to 15 students to attend, but 180 showed up.
“I very quickly became recognized as the medical leader in this field, even though I did not feel very expert,” says Alpert, who learned by consulting abuse survivors, advocates, other health-care providers, attorneys, and police. “But because the field was so new and the need was so great, I was very quickly asked to write chapters, give talks, and serve on committees.”
According to Alpert, one in four women and one in seven men will be affected by family violence or sexual assault at some point in their lives, and the health consequences of being abused or witnessing such abuse “are far-ranging and affect both physical and psychological health over the lifespan.” A late 1990s study commissioned by the Centers for Disease Control, for example, found that children who suffered from “adverse childhood experiences,” including sexual abuse or witnessing domestic violence, had increased risk for problems from substance abuse and suicide attempts to heart and lung disease.
In 1992, Alpert helped found the Massachusetts Medical Society’s Committee on Domestic Violence, initiating the first statewide campaign against domestic violence and coining the acronym RADAR — remember to ask, ask directly, document findings, assess for danger, review options, and refer as appropriate — to establish assessment guidelines for health-care professionals. Alpert is also the lead author of the training manual Partner Violence: How to Recognize and Treat Victims of Abuse, currently in its fourth edition.
Like Alpert, Borkan has also been working to fill a gap in the education of medical professionals. Borkan teaches medical students the basic science of kidney failure on the cellular level. He also teaches patient care to young doctors in the medical wards of Boston Medical Center. In the spring of 2006, he volunteered to mentor an M.D.-Ph.D. student who was about to return to clinical training after several years of lab work.
“For all those years they’re in the lab, these students have little contact with patients or clinical medicine,” explains Borkan. “When they’re suddenly asked to go back to patient care, they experience enormous anxiety.”
Borkan spent 40 half-day sessions with one such student, Daniel Roberts (MED’08), who was then completing his time in the lab. Roberts accompanied Borkan on clinical visits to Boston Medical Center’s general medical wards and dialysis clinic. Borkan also directed Roberts to selected readings in the medical literature and brought him to meetings of the hospital’s renal consult team and to weekly clinical teaching conferences.
“Dr. Borkan exemplifies what it means to be a student-friendly faculty member,” Roberts wrote in a letter recommending his mentor for the Rodkey Award. “He is genuinely interested in the student’s perspective and values all members of his team.”
For his part, Borkan encourages other faculty to volunteer as mentors. “There are plenty of teachers on the Medical Campus who do both clinical and basic research, which would be a perfect match for these students” says Borkan. “The ultimate goal is to show them that it is possible to integrate clinical medicine with basic research.”
Chris Berdik can be reached at cberdik@bu.edu.