The Residency Update    
          E-Newsletter of the
UMass Fitchburg Family Medicine Residency    


Winter  2013
Inside This Edition
Our Newest Faculty Members
News Around the Residency
A Conversation with Professor Michele Pugnaire, MD
Community Health Projects
Patient Care Update
      Our Newest Faculty Members

While they have been on board for a few months now, here is a bit more information about our newest faculty members!

Margarita Castro-Zarraga, MD joined our team last summer after completing her residency at the Brooklyn Hospital Center. A graduate of the College of Medicine, University of the Phillipines Manila, Margarita's areas of interest include adult congenital heart disease, female sexual dysfunction, herbal medicine, meditation, raw food vitamins, and student education in family medicine.

Kristen Kavulich McCarthy, DO
came on board soon after her June 2012 graduation from our UMass Fitchburg residency, where she served last year as Chief Resident. Kristen is a 2009 graduate of Lake Erie College of Osteopathic Medicine (LECOM) and was raised in Wappingers Falls, NY. Her areas of interest include OMM/OMT, nutrition and healthy living, integrative medicine, acupuncture, resident and student education, continuity of care in family medicine and caring for the whole family.

News Around the Residency

Resident Update

Tim Lowney, PGY-3, was selected as one of seven finalists for the "Information Technology in Medicine Award" of the Massachusetts Medical Society.  Tim presented his project, the GIVE Outcomes software package, to the Committee on Information Technology on December 12.
Eighteen months in development, it is designed as an add-on to an existing EMR. Its utility is in tracking a patients clinical progress in real time using a simple 0-4 scoring system and assessing risk for re-hospitalizations, predicting outcomes based on primary diagnosis and co-morbidities.

CHC News

Dr. Nick Apostoleris and the CHC leadership have kept our residency up to date on new quality initiatives at the health center. We eagerly await news any day on the final push to complete the new building and a realistic move-in date this summer!

A former chief resident, Karla Christo, taught us to praise each other in a cross cultural manner.  Your program director salutes the residents and faculty who have pitched in to fill holes in our staffing due to my wife's illness, and for our colleagues confronting family emergencies and the current flu vaccine. I am proud of how this group works as a team. We are family!

Welcoming New Faculty for Summer 2013

We are also pleased to announce that two new faculty will be added to the residency practice team next summer: 


Rocio Nordfeldt, MD, current PGY-3, will join the faculty practice at the Leominster CHC site. She will be a regular contributor to our inpatient services and our educational program.


Abhijeet (Abhi) Patil, currently a fellow in geriatrics at UMass, will work primarily in Fitchburg while building upon our current geriatrics curriculum. In addition to office practice in Fitchburg and inpatient care, he will continue our long term care rounds program at the Highlands. 

Save the Date!  
Upcoming meetings of interest to faculty and residents:

     Department Faculty Retreat  March 8-9  (Shrewsbury)

     MassAFP Spring Refresher  April 12-13 (Leominster)   
     Optional elective for residents attending both dates

     BU Immersion on Addictions  May 1-4  (Hyannis)   
     Subject to application process going on now

     STFM Spring Conference    May 2-5  (Baltimore, MD)
     Opportunity for poster presentations

     UMMS CRIT Geriatrics       May 17-19  (Ogunquit, ME)
     Our Chief Resident (with possible second) will attend with faculty

 A Conversation with.....
Professor Michele Pugnaire, MD
Associate Dean for Educational Affairs


"I was supposed to be a radiology resident," recalls Professor Michele Pugnaire, MD on a recent afternoon at Community Health Connections. Dr. Pugnaire, currently Senior Associate Dean for Educational Affairs and Director of the UMMS Simulation Center, smiles frequently as she reminisces about her years as a medical student at McGill in Montreal. "Family medicine was not really promoted as a specialty back then," she points out. "I was pursuing radiology ...but, I was also aware that there was something missing."

The career trajectory that has led to a distinguished thirty-year career at UMass Medical School begins in Arlington, MA where Dr. Pugnaire was raised. Upon her 1980 graduation from McGill University Medical School, she completed a rotating internship at St. Paul's Hospital in Vancouver. It was while working in private practice at Fort St. John General Hospital in British Columbia that the Massachusetts native made a fateful phone call.

"It was the first time I encountered family medicine in practice," she says, and, with the realization that she might have indeed found what had been missing, Dr. Pugnaire placed a call to the UMass Worcester Family Practice Residency Program. "Dr. (Daniel) Lasser, who was then the Residency Director, picked up the phone and was very receptive," she laughs, a conversation that led to her matching in 1982 at what was then named the Barre Regional Family Health Center. She stayed on as an attending in Barre until 1987 and then worked for the next ten years at Gardner Family Practice. In 1997, Dr. Pugnaire joined Fitchburg Family Practice and Obstetrics before arriving at Community Health Connections in 2001.

Of the many leadership positions she has held at UMMS mentoring medical students (including Clerkship Director, Vice Dean for Undergraduate Medical Education and Associate Dean of Admissions) Dr. Pugnaire's first educational role was as the founding director of UMass' longitudinal preceptor program. Responding to a need which existed for ambulatory care experience for medical students, she became the program's first director and one of its first preceptors. "There were only ten to twenty students at the beginning. Now it is one of the medical school's marquee programs," she says with pride. Dr. Pugnaire has maintained her commitment to medical education, traveling each winter to the Dominican Republic on a mission trip with faculty colleagues and UMass students.

Dr. Pugnaire still treats patients she first cared for when she worked in Barre in the 1980s and Gardner in the 1990s. Now residing in the town of Harvard, MA, her next move is likely to be no further than the brand-new health center building that is approaching completion mere yards away from where she sees patients every Tuesday.

UMass has a strong commitment to education and a track record of excellence in primary care," Dr. Pugnaire emphasizes. Looking back once more to her days as a student doctor at McGill, she
adds, "Working at a federally qualified health center in Massachusetts is the closest I can get to the universal coverage of the Canadian medical system."  

Michael Smith, MS, Associate Director of Admissions, would like to thank Dr. Pugnaire for taking the time to speak with him for this profile.

Community Health Projects


Our new curriculum in community health includes resident projects in conjunction with local community Departments of Public Health.  


Listed below are project title, city name and names of the residents:   


"Reduction of Smoking in Pregnancy"  (City of Gardner)
Residents: Amanda Iantosca, Jennifer Lin, Crystal Benjamin

"Hoarding" (City of Leominster)
Residents:  Stephanie Muriglan, Ryan Montoya, Jennifer Smith

"Outreach Services at Ginny's" (City of Leominster)
Residents: Matt Plosker, Nicholas Hernandez, Kavita Deshpande

"Encouraging Breastfeeding in Teen Moms" (City of Leominster)
Resident: Samantha Richards

"Teen Pregnancy Prevention" (City of Fitchburg)
Residents: Tim Lowney, Elliot Schaeffer, Christine Ashour

"Elementary School Health Education" (Town of Princeton)
Residents:  Rocio Nordfeldt, Luisa Hiendlmayr, Jeffrey Wang

"Addressing Childhood Obesity" (City of Gardner)
Resident: Ed Jackman
Patient Care Update

This year new patient care approaches have been implemented in our residency practice.

Here is a quick summary of several highlights.

Healthy Weight Clinic: Child obesity is confronted with a weekly session led by Dr. Kristen McCarthy with diet and physical activity coaching from a multidisciplinary team. Our work in conjunction with another health center in New Bedford will be a model for similar project implementation statewide.

Maternity Clinic: Dr. Cheryl Divito mentors rotating residents in prenatal care visits every week, providing concentrated training and open access for initial prenatal visits, urgent exams, and for coverage of primary provider absences.
Post-Hospital Home Visits:  Always a part of our services, an aggressive QI project led by the Green and Yellow clinic teams aimed at reduction of re-hospitalization of patients with CHF and other high risk conditions includes a home visit to review medications and stability of the condition. We are eager to see if this approach has an impact in keeping our patients out of the hospital.

Post-Hospital Follow-up Clinic: Our Chief Resident, Matt Plosker, PGY-3, has piloted a weekly senior resident clinic to provide access to follow up in the office for patients recently admitted to the hospital. This member of the inpatient team will provide a bridge between the hospital team and the primary care provider. 

Spirometry: New spirometry and EKG instruments have been acquired through our HRSA Training Grant. These new instruments will interface directly with the EMR, improving documentation and tracking of the procedures.

Got news for our next newsletter?  

Contact Dr. Ledwith at 
or Michael Smith, MS, Associate Director of Admissions, at