Making the Rounds

MAKING THE ROUNDS SPRING 2022

KERN MEDICAL YEAR IN REVIEW: INFLECTION POINT

with time, no single individual was immune to the infection, often with disheartening and frightening consequences. This once-in-a lifetime event has dramatically changed the field of medicine and how we educate future generations of physicians to come. Imagine, how in just 9 months, our brilliant and diligent scientists were able to create and synthesize a vaccine for a virus not seen before, using mRNA technology once thought to be years in the future. Research and scholarly activity proliferated exponentially around the globe, as physicians and scientists, united in effort, collaborated on creating novel treatments for this deadly virus. Telemedicine, usually attributed to the lore of sci-fi movies, is now a key component of how we

T he history of humanity is ripe with inflection points, specific events in time that dramatically alter and change the trajectory of our culture, technology and society. The industrial revolution, the creation of the telegraph, the atomic bomb, the internet…all of these specific points in history have molded and shaped the world we currently live in. The COVID-19 pandemic is the most recent inflection point; not just in Amir Berjis, MD, MACM, FACS, FCCP Director of Medical Education

Prior to March 2020, healthcare workers were rarely exposed to healthy “normal” patients who suffered significant morbidity and mortality without a prior history of trauma or malignancy. Since March 2020, countless “normal” patients were infected with this new strain of the Coronavirus, entering and overwhelming our hospital emergency rooms and intensive care units. Despite the

THE SENSE OF UNITY &

most advanced and modern healthcare technologies and treatments in the world, these “normal patients”

FELLOWSHIP AMONG OUR TRAINEES ONLY GREW

human society, but in the field of medicine and medical education. Extraordinary,

succumbed to the effects of the virus within a few days or

weeks. 18-year-old teenagers, 25-year-old mothers, 37-year-old professionals, 58-year-old retirees, and 72-year-old grandparents. At first, the extraordinary pandemic affected the most vulnerable and medically underserved. However,

inequitable, disheartening, once in-a-lifetime. These are but a few adjectives that describe the last 2 years of our lives. Over 1 million Americans have now lost their lives to this pandemic, with many more infected and recovering.

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interact with our patients. In similar fashion, medical education has transitioned to a hybrid setting, with teleconferences and high fidelity simulations. Indeed, this inflection point in our history has changed our entire clinical learning environment. Kern Medical was not immune to these changes brought on by the pandemic. In the past 2 years, our faculty, fellows, residents, medical students, and nurses have endured one surge after another. Though each surge brought new challenges and hardships, our workforce was ready and capable to provide the life-saving critical care that these patients demanded. Yet, as the pandemic wore on, we identified mounting anxiety, fatigue, and burnout in our workforce. As physicians, we are taught to uphold the science and ethics of our profession at all times while considering the welfare of our patients first. Yet, the pandemic has created a new inflection point in our field; we must uphold the health and well-being of our caregivers as well. Leaders in our four residency programs and three

fellowships at Kern Medical were tasked to ensure the well-being of our faculty and learners. Specific programs and interventions were created to promote and ensure the mental and physical well being of our residents and fellows, not to mention our faculty as well. Throughout this ordeal, the sense of unity and fellowship among our trainees only grew as the pandemic wore on. I am proud to state that Kern Medical and our community is stronger today, unified in our purpose to serve the most underserved and vulnerable in our community. To fulfill our mission, Kern Medical again welcomed a new class of first-year residents into our sponsored programs in July of last year. At least a quarter of these residents were our former medical students, with several originating from the Central Valley. Throughout the academic year, we continued to recruit new physicians into our programs, serving as teaching faculty and providing subspecialized care and treatments previously not available in our community.

As the number of patients being seen in our clinics, evaluated in our emergency room, and admitted to our inpatient services have grown, so have the resident complements in our sponsored programs. This past year, we added an additional two residents into our Internal Medicine Residency Program and are on the verge of adding additional residents to our Psychiatry and Emergency Medicine programs, and additional fellows to our Child and Adolescent Fellowship. This upcoming year, we will begin the application process for our Surgery Residency Program with our newly named program director and alumnus, Dr. Amber Jones. As medical education continues to incorporate hybrid models of learning and teaching, our Simulation Center, under the directorship of Dr. Sage Wexner, continues to be a key pedagogical component. Each of our residencies now participate in simulation with specific curriculum designed to enhance the medical knowledge and procedural skills of our residents. We have also introduced simulation modules specifically designed for our medical student cohorts completing their clinical clerkships at Kern Medical. Indeed, we are proud to announce that we will Kern Medical faculty, residents and medical students in attendance at the AFMR Western Medical Research Conference.

“ We must uphold the health and well-being of our caregivers. ”

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be continuing our partnership with Ross University School of Medicine and the American University of the Caribbean while adding a new partner with Western University of Health Sciences. These medical students will join our growing cohort of students from the David Geffen School of Medicine at UCLA. Over this past year, we increased our collaboration with UCLA, hosting a Graduate Medical Education Summit and multiple hybrid and in-person faculty development sessions. Our faculty, who hold clinical appointments at DGSOM, remain committed to the rigorous academic standards set forth by UCLA. Scholarly activity has also

proliferated over the last year. Our Valley Fever Institute hosted the inaugural Cocci-Con in April, bringing together multiple notable physicians

in multiple research projects and NIH-funded grants. As we traverse this inflection point and prepare to

hopefully transition from a pandemic to an endemic state, Kern Medical is poised to meet the challenges of medical training for years to come. We are especially proud of our 31 graduating residents and fellows who will be G R A D U A T I N G R E S

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and scientists from the United States and around the world. In May, we hosted our 3rd Annual Southern San Joaquin Valley Research Forum, showcasing

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joining the hundreds of alumni who have trained at Kern Medical over the last 66 years. I urge you to join our Alumni Association and help us continue our vital mission.

presentations. Medical continues to serve as the premier academic and scholarly institution in our community, participating Kern

Did you know? (2021)

OUTPATIENT CLINIC VISITS 225,999

SURGERIES 5,733

INPATIENT ADMISSIONS 12,846

EMERGENCY ROOM VISITS 54,725 COVID VACCINATIONS 50,476

TRAUMA ACTIVATIONS 3,365 BIRTHS 2,321

COVID DRIVE THROUGH TESTS 27,935

WORKFORCE Employees, Contractors, Academics & Volunteers 2,500

COVID MOBILE EVENTS 249

SUPPORT OFFICES 5 TOTAL LOCATIONS 23 + + = ADDITIONAL LOCATIONS 6

CLINICAL LOCATIONS 12

OPHTHALMOLOGY

COLUMBUS CLINIC

PEDIATRICS

MEDI SPA

Refine by Kern Medical is in the heart of downtown Bakersfield and offers laser services, Botox, fillers, facials and full body

Kern Medical has an Eye Institute on F Street with a full time Ophthalmologist

Columbus Clinic houses the Valley Fever Institute, a fully functional Oncology Suite and 38 Infusion Bays, and is home to the Sickle Cell Center

Kern Medical has a Pediatric office on Truxtun Avenue with 3 dedicated Pediatricians

plastic surgery consultations

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GRADUATING CLASS OF 2022 RESIDENTS & FELLOWS

CLINICAL PHARMACY

CHILD & ADOLESCENT PSYCHIATRY FELLOWSHIP

Ammar Ahmad, MD

Yu-Hsi Hu, DO

Jaylen Mungcal, PharmD

Christina Downing, DO

Karen Pelham, PharmD

INTERNAL MEDICINE

EMERGENCY MEDICINE

Amar Shah, MD

Khalid Elharrif, MD

Ikechukwu Amobi, MD

Shelah Hayes, MD

Manrajan Gill, MD

Tejave Sharigan, MD

Sean Heavey, MD

Kulraj Grewal, MD

Michael Valdez, MD

Nanse Mendoza, MD

Tammy Issa, MD

Frederick Venter, MD

David Pouldar, MD

Roopam Jariwal, MD

OB/GYN

Alexandra Neiman, MD

Cuauhtlehuanitzin Rangel, MD

Natalie Karapetians, MD

Minerva Pineda, MD

Atish Vanmali, MD

Nadia Raza, MD

PSYCHIATRY

Minal Bhatia, MD

Matthew Louie, MD

Artur Saakyan, MD

Homero Camacho, MD

Sarah Pospos, MD

Chandan Samra, MD

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RESIDENT & FELLOW CHIEFS 2022-2023

Gurkaron Nijjar, MD Child & Adolescent Psychiatry Fellowship Academic Chief

Rama Yasaei, MD Child & Adolescent Psychiatry Fellowship Clinical Chief

Violet Yeager, DO Child & Adolescent Psychiatry Fellowship Research Chief

Brett Cowan, MD Emergency Medicine Residency Chief

Hobart Lai, DO Internal Medicine Residency Chief

Marah Sukkar, MD Internal Medicine Residency Chief

Jennifer Franks, MD Obstetrics & Gynecology Residency Chief

Taide Chavez-Sturman, MD Obstetrics & Gynecology Residency Chief

Angelina Prat, DO Obstetrics & Gynecology Residency Chief

Katie Van Cleave, DO Obstetrics & Gynecology Residency Chief

Goli Shenasan, MD Psychiatry Residency Academic Chief

Tyler Wheeler, MD Psychiatry Residency Administrative Chief

Itwinder Sivia, MD Psychiatry Residency Research/QI Chief

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INTERNAL MEDICINE

NEW RESIDENTS & FELLOWS 2022

Cesar Aranguri, MD

Nihad Al-Yousfi, MD

Rohini Bilagi, MD

CHILD & ADOLESCENT PSYCHIATRY

Edvard Davtyan, MD

Elias Inga Jaco, MD Melanie Khamlong, MD

Thomas Campi, MD

Zershana Khan, MD

Michael Ntim, MD

Colby Kulyn, MD

Lawrence Okumoto, MD

Michael Salzle, MD

EMERGENCY MEDICINE

Rupam Sharma, MD

Syed Saad Uddin, MD

Mahum Zahid, MD

Brittney Banfer, DO

Kiley Clark, MD

Ruben Geeraert, MD

OB/GYN

PHARMACY

Lawrence Liu, MD

Jordan Karroll, DO

Kenneth Lam, MD

INFECTIOUS DISEASE

Daniela Amodio Medina, MD

Alena Cave, MD

Tinh Duong, PharmD

Matthias Park, MD

Alma Guerrero Villareal, PharmD

Vikas Nookala, MD

Eneti Tagaloa, MD

Michael Valdez, MD

PSYCHIATRY

Amanpreet Gill, DO

Bhagat Cheema, MD Howard Cheung, MD

Benjamin Woodward, MD

Theodore Chun, MD

Chloe Telles, DO

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R E S I D E N C Y S P O T L I G H T EMERGENCY MEDICINE RESIDENCY PROGRAM

Dr. Manish Amin, Program Director

T his last academic year in the emergency department has been both challenging and gratifying. Challengingdue toCOVID. Gratifying also due to COVID. Our residents have shown great poise, empathy and compassion as they have been overwhelmedwith the volumeandacuity of patients due to this worldwide pandemic. Nevertheless, they have responded in a way that only makes our emergency department proud. Though they have had to deal with personal illnesses and family constraints they have risen above and beyond those circumstances and supplied excellent care to all in our community whether it be seeing patients in the emergency department, aiding in the Kern Medical vaccination clinics or covering extra shifts in the intensive care unit to help our internal medicine colleagues. All levels of trainees from intern to senior

residency have felt this great burden and met the challenge. We are very grateful to be part of this amazing team serving the county of Kern.

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COCCI-CON T he Valley Fever Institute at Kern Medical continues its mission to increase education and awareness of Valley Fever for the public, patients, and healthcare providers. The first ever multi-day valley fever conference coined “Cocci Con” provided an opportunity for researchers, physicians, legislators, and health partners to come together with a common purpose; to bring additional resources, identify funding needs, achieve consensus on Valley Fever research priorities, and strategize on the development of a Valley Fever vaccine. Cocci Con included a Valley Fever task force meeting, an educational symposium for primary care providers, a vaccine workshop, and culminated in the 66th annual Coccidioidomycosis Study Group meeting (CSG). This meeting brought together clinicians, scientists, government agencies, and politicians from all over to bring attention to and help address the threat of Valley Fever in our community.

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Valley Fever at Kern Medical Institute

THE INSTITUTE

MISSION

We remain focused on increasing education and awareness for the public, patients and health care providers; providing the best patient care available and performing research that includes epidemiology, clinical drug development, prevention, immunology, and immunizations.

For more than 7 decades, Kern Medical has cared for those suffering from Valley Fever. Our long history of Valley Fever care began in the 1950’s with Hans E. Einstein, MD, who led efforts that included treatment, research, education and awareness. In 2015, Kern Medical formalized Valley Fever efforts by institutionalizing the Valley Fever Institute. In the summer of 2020, the Valley Fever Institute opened its new state-of-the-art research and treatment facility. The Valley Fever Institute was designed as a patient-centered specialty care clinic that provides comprehensive services at a single location. Our efforts include:

INFECTIOUS DISEASE FELLOWSHIP

Established in 2021, Kern Medical’s Infectious Disease Fellowship grants current and future physicians the opportunity to train and treat patients fighting Valley Fever in a setting that has been designed specifically to treat manage the complicated and chronic effects of this disease.

• Public Education • Patient Education

• Professional Education • Patient Centered Care • Patient Centered Research

WWW.VALLEYFEVERINSTITUTE.COM

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Simulation Center

MASS CASUALTY INCIDENT O n October 1st, 2017, Las Vegas had one of the deadliest mass shooting

Dr. Sage Wexner Director of Medical Simulation

nurses, would be limited and the priority of holistic patient care would shift to triaged care; saving as many lives possible. Decision making in the most stressful of situations merits education, training, and practice, as it is a very different medicine than the one we deliver on any other day. The 2017 tragedy in Las Vegas, Nevada provided many lessons for emergency personnel. It highlighted key considerations and strategies that would help prepare us for future mass casualty incidents.

events in the history of the United States. Hundreds of wounded individuals were taken to local hospitals, including a Level 2 trauma center that handled nearly 200 trauma activations that arrived within 45 minutes from the time of the incident. A mass casualty incident, or MCI, is any disaster that overwhelms the resources of local hospitals in a short period of time. Incidents like these can take the form of fires,

floods, earthquakes, or a mass shooting. In situations like these, resources, including doctors and Simulation educators: Sage Wexner, MD, Priscilla Zamarron, RN, and Amber Jones, DO.

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crowded and filled with noise and chaos, overwhelming and challenging the medical staff to communicate effectively. At the 12-minute mark, participants were debriefed by a Trauma Nurse Educator, an Emergency Department Physician, and a Trauma Surgeon. The primary goal of this MCI was to simulate multiple high-volume, high acuity scenarios, and identify which resources, personnel, processes, and procedures would be

necessary during a mass shooting. After being debriefed, the scenario was repeated. Things went much smoother the second time; even to the untrained eye. There was less noise, less chaos, and patients were grouped according to severity, allowing concentration on those who required focused attention. Through the use of simulation, utilizing a combination of high fidelity plastic manikins and volunteers acting as standardized patients, Kern Medical teams improved and demonstrated

As the only level 2 trauma center as far north as Visalia and as far south as Los Angeles, Kern Medical would be the first local hospital in Kern County to receive wounded individuals following a mass casualty incident. To prepare for incidents like these, four teams of doctors and nurses recently came together in the Simulation Center to provide clinical staff with a simulated experience. On May 17th, Kern Medical staff were given a hypothetical mass shooting scenario, where one of the rooms was converted to a replica of a real trauma bay. As the learners oriented themselves to the role, location and situation, the screams began! Over 10 volunteers, all trained as standardized patients (actors pretending to have sustained injuries) began to enter the simulation. The first cases were relatively mild: a graze, or a fall with a hurt ankle. Then the simulated ambulances began to arrive, with medical students pretending to be overwhelmed paramedics, rushing to deliver their patient, only to leave and come back with another. The room quickly became

capability with the MCI. While we hope that a situation like this never happens in Kern County, simulations like these better prepare our staff by engaging them and providing them with training in a controlled environment, allowing us to improve our response plan.

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AFFILIATION WESTERN UNIVERSITY COMP

I n April, 2022, Kern Medical entered into an agreement with Western University Health Sciences, College of Osteopathic Medicine of the Pacific (Western COMP). Western COMP will be sending up to 32 Medical Students to us per year who are looking to experience Hospital and Ambulatory based care during their 3rd and 4th year clinical clerkship rotations. Each 3rd year rotation is 4 weeks in duration. Kern Medical will provide these rotations in several of our specialty offices as well as our Inpatient and Outpatient Primary Care venues. Rotations will cover: • Internal Medicine Outpatient & Inpatient • General Surgery • Pediatrics • OBGYN/Women’s Health • Psychiatry • Family Medicine • 3 Electives Western COMP will be our latest US Based Medical School affiliation since UCLA. Additional funding from Western COMP will support our SIMCenter, aClerkshipDirector, and a Clinical Coordinator.

Western COMP was established in 1977 and provides medical education to prospective doctors in the Pomona Valley and Rancho Cucamonga areas, Palm Desert, West Los Angeles, and Oregon. They havea reputation for excellent academics and a postgraduate residency placement track record of 98.8%. A Doctor of Osteopathic Medicine sees patients, prescribes medications, performs surgeries, and delivers babies just like Medical Doctors (MDs) across the US, but are distinct in their whole person approach they incorporate traditional allopathic care with Osteopathic Manipulative Medicine (OMM). OMMemphasizes the physical manipulation of the body’smuscle tissueandboneswith a focus on pain relief, conditioning, and wellness. Approximately 11% of all physicians in the US are now Doctors of Osteopathic Medicine (DO’s) and are considered equally under the Accreditation Council of Graduate Medical Education (ACGME). Kern County remains one of the most medically underserved areas in California while Kern Medical is

Glenn Goldis, MD, MMM CMO, Kern Medical

one of only 26 Safety Net Facilities in the state that are willing to care for anyone who needs medical intervention regardless of their ability to pay. To that end, we look forward to furthering our collaboration with Western COMP as we seek to establish “pipeline” programs that feed the service needs of our community and help lay out a pathway for those interested in a career in health care. We are excited to have Kern Medical share our physicians’ time and talents with the future medical professionals from Western COMP and look forward to our future collaboration.

“ Kern County remains one of the most medically underserved areas in California while Kern Medical is one of only 26 Safety Net Facilities in the state that are willing to care for anyone who needs medical intervention regardless of their ability to pay. ”

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JOINING FORCES FOR HEALTHCARE CHANGE K ern County’s healthcare is poised for generational leap as two leading healthcare

in Kern County, and bringing together their respective strengths to multiply the choices patients have for treatment and create across the county a sought-after, powerful network for patients and physicians. Leaders from each organization say that they see immediate avenues

to expand patient care, but even more, they share a vision to elevate healthcare in the region through what this partnership brings. The impact to Kern County residents will be positive – better care, improved access and the availability to more physicians, while keeping the ability to choose the physician and hospital they have always used. The partnership, giving each health system the ability to tap the resources of the other, will create the largest healthcare coalition in Kern County, with more than 30 locations, over 4,500 healthcare professionals, and more than a 1,000 physicians and physicians in-training.

providers have joined forced to recruit top talent, creating a “more healthy” region with better care, improved access and top specialists. Kern Medical and Adventist Health have

announced an unprecedented p a r t n e r s h i p , making them the focal point of healthcare e x p a n s i o n and surgical advancement

LEADERSHIP ANNOUNCEMENT I n late 2021, Kern Medical announced its new CEO, Scott Thygerson. Mr. Thygerson has served as the organization’s Chief Strategy Officer since 2013 and later became President of Hospital and Clinic Operations in November 2019. Thygerson earned a Master of Health Administration from Indiana University and a Bachelor of Arts degree from Brigham Young University and has more than 20 years of experience as an executive and consultant in health care strategic planning, operations, business development, and marketing. Under his leadership, Kern Medical will continue to fulfill its three-part mission as the area’s only teaching hospital, trauma and specialty center, and designated safety net hospital. Please join us in welcoming Scott into his new role! We look forward to having him continue the organizations legacy for a long time to come.

Scott Thygerson CEO, Kern Medical

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INTRODUCING KERN MEDICAL’S SURGERY PROGRAM DIRECTOR

On behalf of Dr. Berjis, Dr. Koh, and my colleagues in the Department of Surgery, I am pleased to announce the appointment of Dr. Amber Jones as Program Director, Department of Surgery at Kern Medical effective immediately. Dr. Jones has established herself as a well-respected, highly skilled Trauma Surgeon and an esteemed clinician-educator in the department. She will serve a vital role in the shaping of our future Surgical Residency Program. Jeffrey G. Nalesnik, MD Chair, Department of Surgery

Dr. Amber Jones SURGERY PROGRAM DIRECTOR

REFINING BEAUTY INSIDE AND OUT

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RELAY FOR LIFE 2022

This year, Kern Medical joined Relayers from all around the county to show support for our cancer patients, family, and friends. Our Team helped bring awareness by rallying together to raise money for cancer research and patient programs.

As a community, we came together and raised more than $323,573.73 to go to helping the American Cancer Society save lives.

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Welc e Kern Medical Alumni! Benefits of Membership

» » » » »

All funds raised will support Medical Student & Resident Education at Kern Medical Learning opportunities that include CME credit lectures & events Invitations to Alumni Society social events Stay up to date on Kern Medical news Membership fee is 100% tax deductible

All Graduating Residents & Fellows will receive the first year of membership FREE!

Yes! I want to join the Kern Medical Alumni Society.

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Questions – please contact Erica Easton at (661) 489-5253 or Erica.Easton@kernmedical.com

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