Chad Brands, M.D., and Raquel Hernandez, M.D., the new director and associate director for medical education at All Children's Hospital, are designing a new residency program that will provide a new paradigm for training future pediatricians. After working with a consortium of Johns Hopkins University School of Medicine faculty members to shape priorities for the new program, Dr. Brands and Dr. Hernandez are now working with physician leaders at ACH to prepare for a site visit by the ACGME.

The pediatric residency program will incorporate standard components of residency training such as progressive responsibility and exposure to multiple pediatric subspecialties. Innovative elements of the curriculum will include a second year focused on outpatient experiences, an ACGME competency-based curriculum, and novel opportunities for career development woven into the residency program.

In addition, residents will create individualized learning plans that will form the basis for their rotation schedules and promote each resident's distinct career goals. The program will emphasize career development through frequent faculty exposure and guidance. The program's goal is to recruit the highest caliber of students, who will be trained as excellent clinicians and as outstanding future innovators and leaders in the field of pediatrics. The first class of trainees is expected to enter the program in July 2014.

"We are excited about the multifaceted opportunities in medical education at All Children's and look forward to working collaboratively with interdisciplinary colleagues to develop programs in the pursuit of excellence across the entire spectrum of medical education—from the premedical years to the emeritus years," says Dr. Brands.

The Office of Medical Education at All Children's Hospital Johns Hopkins Medicine also plans to offer one- to four-week leadership intersessions beginning in 2012 that will give medical students a taste of the diverse academic and research opportunities available.

Chad K. Brands, M.D.
Director for Medical Education

Dr. Brands earned his medical degree from Baylor College of Medicine in Houston and then completed a combined internal medicine-pediatrics residency at University of Cincinnati and the Children's Hospital Medical Center in Cincinnati. His early career efforts focused on medical education, hospitalism and transitional medicine, including young adult care. He joined the Mayo Clinic in Rochester, Minnesota in 2000 where he served as a charter member of the Diagnostic Clinic and the Pediatric Hospitalist Service and then a charter member of the Division of General Pediatric and Adolescent Medicine. He served as Chair of that division from 2008 to 2011. The division evaluated patients from around the world and developed internationally recognized clinical expertise in orthostatic intolerance syndromes and autonomic dysfunction, recently publishing the first set of criteria for the diagnosis of postural orthostatic tachycardia syndrome in children and adolescents.

At Mayo Clinic he held multiple leadership positions across the continuum of medical education, including serving as Mayo Medical School's Pediatric Clerkship Director. Dr. Brands chaired the Mayo Clerkship Directors' Committee, leading efforts across years three and four for the medical school's LCME reaccreditation site visit in 2011. He served as Recruitment Chair for the Pediatric Residency Program. As an associate program director over the last five years, he helped position the residency as an outcomes-driven program. Dr. Brands also directed the national CME course Pediatric Days.

In recognition of his contributions as a hospitalist to patient care, medical education and leadership, the Society of Hospital Medicine inducted Dr. Brands into its Inaugural Class of Fellows in Hospital Medicine in 2009 and its Inaugural Class of Senior Fellows in 2010. He recently served as a member of the task force reviewing potential pathways to subspecialty certification for pediatric hospitalists through the American Board of Pediatrics.

Raquel Hernandez, M.D., M.P.H., FAAP
Associate Director for Medical Education

Dr. Hernandez is a graduate of the Johns Hopkins University School of Medicine, where she also completed her residency in pediatrics and a general academic pediatrics fellowship. As a continuity clinic preceptor at the Harriet Lane Clinic, Johns Hopkins Children's Center, she provided ongoing guidance for pediatric residents and led weekly didactic sessions. Dr. Hernandez also was an attending faculty and preceptor for urgent and acute care, teaching medical students, interns and senior residents while providing urgent patient care and precepting on primary pediatric care issues. As a clinician educator, Dr. Hernandez is an ongoing contributor to the Harriet Lane Clinic resident learning curriculum and has been involved in resident education throughout her training.

With funding from the National Institutes of Health Scholars in Patient-Oriented Research program, Dr. Hernandez focused her research efforts on the prevention and management of early childhood obesity. Her additional research activities included evaluating resident perspectives and needs related to caring for patients and families with limited English proficiency. Dr. Hernandez also completed her Master's in Public Health degree with a focus on public health nutrition while at Johns Hopkins.

As Dr. Hernandez embarks on her course at All Children's, one of her key goals will be to enhance the ambulatory care experience for students across the learning spectrum. Along with the Office of Medical Education, Dr. Hernandez will be involved in the development and ongoing assessment of the pediatric residency program.

Messina AF, Namtu K, Guild M, Dumois JA, Berman DM: Trimethoprim-sulfamethoxazole Therapy for Children with Acute Osteomyelitis. Pediatr Infect Dis J 2011; 30: 1019-1021.

ACH pediatric infectious disease specialist Allison Messina, M.D. and ACH pharmacist Katie Namtu are the lead authors of this research paper published in the December 2011 issue of the Pediatric Infectious Disease Journal. Working with colleagues in pediatric infectious disease and pharmacy, they describe the use of orally administered trimethoprim-sulfamethoxazole for children with acute osteomyelitis.

Conventional management of acute osteomyelitis has been complicated by the emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Of particular note is the emergence of inducible clindamycin resistance among CA-MRSA isolates. At All Children's Hospital, inducible clindamycin resistance in methicillin-susceptible S. aureus infection and CA-MRSA isolates is 17% and 44% percent, respectively. Oral trimethoprim-sulfamethoxazole (TMP-SMX), with its excellent susceptibility profile, bioavailability, palatability and low cost, presented an attractive therapeutic option, but treatment of acute osteomyelitis with TMP-SMX has not been reported. This paper describes successful treatment of 20 patients with acute osteomyelitis using TMP-SMX.

Cox CM, Goodin K, Fisher E, Gray M et al: Prevalence of 2009 Pandemic Influenza A (H1N1) Virus Antibodies, Tampa Bay Florida-November-December 2009. PloS One6(12): e29301.
Epub 2011, Dec 20

Monica Gray, Immunology Manager in the ACH Clinical Laboratory, is a coauthor of this report documenting prevalence of antibodies to pandemic Influenza A (pH1N1) virus among adults and children in the Tampa Bay region in November-December 2009. The highest cumulative incidence of pH1N1 seropositivity was among school-aged children (age 5-17) and young adults (age 18-24), with respective rates of 53% and 47% in these age groups after adjusting for vaccine-induced seropositivity. The lowest cumulative incidence of seropositivity (11-13%) was found among adults 50 and older. These findings were consistent with clinical reports during the pandemic that prevalence was highest among children and young adults.