UMass FMCH Tuesday Talk - June 13, 2023/EDUCATION

Welcome to the FMCH Tuesday Talk. Please continue to send us your announcements, celebrations, and accomplishments to [email protected]

Table of Contents

Upcoming Events

Focus of the Week – Education


Frankly Speaking Podcast

Clinical Services Spotlight

Upcoming Events

FMCH Grand Rounds

Tuesday, June 13th, 12:00 - 1:00pm"Supporting Diverse Learning Styles: Addressing Bias in Feedback", presented by Melissa Gleckel, MD and Elizabeth Dykhouse, PhD.

Virtual Only via Zoom.

Meeting ID: 191 986 273 Passcode: FMCH

FMCH Grand Rounds

Tuesday, June 20th, 12:00 - 1:00pm, "Thomas Zand Lectureship in Refugee Health: Advancing Health Equity in Refugee Communities" - In Person, Memorial Amphitheater and Virtual via Zoompresented by Christa Johnson-Agbakwu, MD.

Meeting ID: 191 986 273 Passcode: FMCH

FMCH Grand Rounds

Tuesday, June 27th, 12:00 - 1:00pm"Provider Wellness Post-pandemic", presented by Steven Bird, MD, FACEP, FACMT.

Virtual Only via Zoom.

Meeting ID: 191 986 273 Passcode: FMCH

Focus of the Week - Education


Congratulations to our UMass Chan Graduates! On June 4th, UMass Chan Medical School celebrated its 50th Commencement.

Family Medicine Education Consortium Student Scholarships now available. Scholarships cover housing and registration as well as conference meals. Encourage students you work with to experience this incredible, high energy, family medicine inspiring event.  October 13-15 / Rhode Island Convention Center. Visit for more details.



Big celebrations coming up. Congratulations all!  

  • Worcester Family Medicine Residency Awards Ceremony 

Tuesday, June 13th at 6-8pm by zoom. Please attend and celebrate the outstanding successes of our residents and faculty awardees. Password: 56789

  • Hospice and Palliative Medicine Fellowship Graduation Celebration

Wednesday, June 14th 

  • Preventive Medicine Fellowship Graduation Celebration

Wednesday, June 14th - Dean Park

  • Worcester Family Medicine Residency and Fellowships Graduation 

Friday, June 16th, 6-9pm

Cyprian Keyes Event to celebrate WFMR and Fellowship Graduates. .

  • Fitchburg Family Medicine Residency Graduation 

Friday, June 23rd, 2-5pm 


Faculty Development

Mentorship Circle Groups 

Thank you for all of you who completed the Mentorship Circle survey. More information will be coming soon for a Fall launch of the mentorship circles.  

Ethics Corner with Philip Day, PhD.

Topic: Informed Refusal of Care

Question 1: What is “informed refusal?”

Response 1: Informed refusal (or refusal of care) is when a patient exercises their right to autonomy and refuses a recommended intervention. Informed refusal applies the same ethical concepts as informed consent and is thereby also a product of the informed consent process.

2015;131(1):105-108. doi:10.1016/j.ijgo.2015.07.001.

Question 2: How does it relate to capacity?

Response 2: While informed refusal is a legitimate exercise of patient autonomy, in certain circumstances patient refusal of care needs to be coupled with a formal assessment of decision-making capacity. I have covered informal and formal capacity assessments at more length in Ethics Corner 2.

Question 3: What should I do if a patient refuses care/treatment?

Response 3: If a patient refuses care with assessed and established capacity, then document their refusal. In all cases, high and low risk, normal and outstanding circumstances, engage with patients in shared decision-making and guarantee that, regardless of their choice, they are informed well enough to make one. The documentation should describe the intervention offered; identify the reasons the intervention was offered; identify the potential benefits and risks of the intervention; note that the patient has been told of the risks in not accepting the intervention; identify why the patient refused.

Summary: Patient values, preferences, and their own assessment of risk/benefit all play a role in consenting or refusing care. Just as with informed consent, informed refusal should be a process and patients should be able to weigh information for themselves, change their minds, and exercise their autonomy. I will cover vaccine hesitancy and refusal in a separate Ethics Corner.

Further Reading: Ridley DT. Informed consent, informed refusal, informed choice--what is it that makes a patient's medical treatment decisions informed?. Med Law. 2001;20(2):205-214; Dickens BM, Cook RJ. Patients' refusal of recommended treatment. Int J Gynaecol Obstet.


Past editions of the Tuesday Talk Newsletter are available

at under Resources.

We are pleased to announce the launch of the Thomas Zand Refugee Health Initiative (see flyer for additional information) made possible by the funding from the Estate of the late Dr. Thomas Zand – local pediatrician, advocate of children, refugees, and education, which includes:

  1. Thomas Zand Lectureship on Refugee Health, to engage and recognize national leaders in this field. Lectureship recipients will deliver an annual talk on refugee health to the UMass community and engage with local refugee-serving community organizations.
  2. Thomas Zand Refugee Health Community Award, given annually to recognize the work done by Worcester community organizations working with newly arriving refugees and immigrants. (To nominate an organization for the Thomas Zand Community Organization award, please fill out this form:
  3. Thomas Zand Refugee Health Scholarship, provided to UMass Chan learners to support their attendance to the North American Refugee Health Conference.

Our inaugural events will occur on June 20th, 2023 - World Refugee Day:

  1. 12:00 pm Grand Rounds by the inaugural speaker Dr. Crista Johnson-Agbakwu, MD (Memorial Amphitheater and Zoom)
  2. 1:00 pm Discussion with Worcester and Fitchburg residents (Knowles Hall)
  3. 3:00 pm Community Panel Discussion and Award Presentation (Albert Sherman Cube) - To RSVP:

Funding Opportunity: The Blue Cross Shields of MA Foundation Special Initiatives grant program provides organizations with a one-time grant of up to $50,000 to pilot or launch a new project over a one-year period which empowers communities to advance health equity. Visit their website for more details:

Applications are due September 11th, 2023.

The Department of Psychiatry is enrolling participants with Treatment-Resistant Depression (TRD) in a clinical research study to look at the effectiveness, safety, and usefulness of an investigational nasal spray medication when it is used alone to improve depressive symptoms. Participants must: be 18 years of age or older, have been diagnosed with treatment-resistant depression, have not adequately responded to at least 2 different antidepressant treatments, must be comfortable with using a nasal spray and not be pregnant or have plans to become pregnant. Contact Chelsea Kosma @ 508-856-5312.

Frankly Speaking Podcast

A weekly Podcast series covering newsworthy topics in primary care medicine.

Listen on Apple Podcasts:

Please join us for an overview: In this episode, we take a look at the dynamic landscape of hyperlipidemia management, discussing current guidelines for hyperlipidemia treatment and the interplay between evidence-based recommendations and expert opinions. Tune in to gain a broader understanding of hyperlipidemia management and unlock fresh perspectives to enhance patient care. Guest: Robert A. Baldor, MD, FAAFP, presents: "Decoding Hyperlipidemia Management: What Does the Evidence Say?" - Frankly Speaking Ep 332.

Clinical Services Spotlight:

Maternal and Child Health Updates

The Pregnant Workers Fairness Act (PWFA) HR 1065 (Effective June 27, 2023)

  • Initiated by Representative Nadler Jerroid of NY, the bill has passed the House and Senate.
  • This bill prohibits employment practices that discriminate against making reasonable accommodations for qualified employees affected by pregnancy, childbirth, or related medical conditions.
  • A qualified employee is an employee or applicant who, with or without reasonable accommodation, can perform the essential functions of the position, with specified exceptions.


Upcoming ALSO Instructor and Provider Courses

  • The ALSO Instructor course will take place on June 20th at 333 South Street in Shrewsbury from 8:30-11:45 am.
  • Contact Kristina Gracey if your Instructor Status has expired and you want to take the course.
  • Watch email and this newsletter for additional updates.


Ethno-Health - Sickle Cell Anemia and Hemoglobinopathies

  • More common in certain ethnic groups, including people of African descent, including African Americans (among whom 1 in 12 carries a sickle cell gene), Hispanic Americans from Central and South America, and people of Middle Eastern, Asian, Indian, and Mediterranean descent.
  • Hemoglobin electrophoresis is routine testing in prenatal care in populations that meet the criteria above. 
  • Sickle cell trait can also affect Hispanics, South Asians, Caucasians from Southern Europe.
  • There is an increased number of Hb SE disease resulting from multiethnic partnerships. 
  • Beta-thalassemia (beta-thal) is present in 59% and 75% of patients with abnormal hemoglobin disorders in northwestern and central Mexico, respectively.

Ref: Perea FJ, Magaña MT, Cobián JG, Sánchez-López JY, Chávez ML, Zamudio G, Esparza MA, López-Guido B, Ibarra B. Molecular spectrum of beta-thalassemia in the Mexican population. Blood Cells Mol Dis. 2004 Sep-Oct;33(2):150-2. doi: 10.1016/j.bcmd.2004.06.001. PMID: 15315794.


COVID-19 Updates

  • COVID-19 vaccination is no longer a mandatory requirement for transplant candidacy at UMMMC. Vaccination is no longer a requirement for waitlist determination. 



  • As of June 7th, there were 787 new confirmed cases in MA in the last 7 days. 
  • The 7-day average percent positivity is 4.15%.
  • As of June 6th, there were 54 patients primarily hospitalized with Covid-19.
  • There have been 22,465 deaths since the beginning of COVID.

Wellness Resources

The Caring for the Caregiver Program provides resources such as the Caregiver Support Line (508-334-HELP) and The Employee Assistance Program (EAP) which offers a variety of services and supports (including virtual peer support and wellness tips. EAP can be accessed at 866-263-3525, or, [company code: UmassMemorial]. 

More information is available on the Caring for the Caregiver page.

Yoga Classes with Dr. Liz Erban

New members always welcome. 

Please join for early morning gentle yoga, Wednesday mornings 6:30am via Zoom.

Much appreciation to Dr. Liz Erban for hosting these outstanding classes. 

Join Zoom Meeting ID: 923 9393 3653 Passcode: 764113