2005 MSS Annual Meeting
June 16-18, 2005

Hilton Chicago
Chicago, IL

2005 Annual Meeting Highlights
The MSS held its 27th Annual Meeting on June 16–18 at the Hilton Chicago. Over 700 students attended the meeting, which offered two full days of educational programming on topics such as health care access, minority issues, student debt, global health, and much more. John P. Howe, III, MD, President and CEO, Project HOPE, presented the keynote address “Medical Diplomacy in 2005: Lessons learned from the USNS Mercy/HOPE Partnership – Banda Aceh and Nias Island, Indonesia” on Friday afternoon, June 17.

The AMA-MSS held our second Medical Specialty Showcase on Saturday, June 18, in conjunction with the MSS Annual Meeting. It was a resounding success with 40 specialties participating and hundreds of medical students in attendance. Our students felt that this event provided a unique experience to learn more about the various specialties in one location, as well as the opportunity to network with physicians and specialty staff. The specialties appreciated the chance to talk with students one-on-one about their distinct specialties, as well as discuss future career opportunities.

The MSS presented three awards during our Welcome Reception on Thursday evening. Baylor College of Medicine received the first MSS Chapter of the Year Award; Kansas City University of Medicine and Biosciences was the finalist. The MSS also presented our first Excellence in Community Service Award to University of Arkansas for Medical Sciences.

The MSS is pleased to welcome into its leadership ranks: Vice Chair, Stephen Sherick, University of Colorado School of Medicine; Delegate, Jana Montgomery, Boston University School of Medicine; Alternate Delegate, Kenan R. Omurtag, University of Missouri-Kansas City School of Medicine; At-Large Officer, Shubhada B. Hooli, University of Florida College of Medicine; Speaker, Krystal L. Tomei, University of Florida College of Medicine; and Vice Speaker, Adam Green, New York University School of Medicine.

June commenced the official start of Chair, Alik Widge, University of Pittsburgh School of Medicine, and Trustee, Joe T. McDonald, University of Kansas School of Medicine.

“Healthy Lifestyles to Reduce Obesity”
Energy levels were high on Friday, June 17 as 100 MSS members loaded on buses to the Museum of Science and Industry’s BodyWorlds exhibit, ready to promote our new National Service Project. Some students hosted a health fair for visitors at the museum while other students staffed the BodyWorlds information booth. The health fair consisted of exhibits focused on healthy lifestyle topics, such as nutrition, physical activity, smoking, sun protection, and living wills. In addition, the MSS Assembly collected $150 that will be used to build a playground at a local Chicago school for the final “Healthy Lifestyles” event at the 2006 Annual Meeting.

MSS Policy Highlights
At the 2005 Annual Meeting, the MSS Assembly considered 45 items of business, including 31 resolutions and 14 reports. The MSS focused on various issues including medical education, student debt, political action, public health, the obesity epidemic, and internal MSS issues.

Read the final actions from the meeting (PDF, 100KB).

Of the 25 MSS-authored resolutions brought forward to the AMA House of Delegates (including one immediate-forward and a number of state-authored student resolutions), many were adopted, a few were referred, and only two were not adopted/reaffirmed:

Resolution 304, Teaching and Evaluating Professionalism in Medical Schools, introduced by the Medical Student Section, asked our AMA to strongly urge the LCME to create and enforce uniform accreditation standards to evaluate professionalism; and to develop competencies and a mechanism for outcome assessment at least every four years. The resolution asks our AMA to recognize that professionalism is best evaluated by medical schools and should not be used for licensure of LCME graduates and also asks our AMA to actively oppose any attempt by the National Board of Medical Examiners and/or the Federation of State Medical Boards to add separate, fee-based examinations of professionalism to the U.S. Medical Licensing Examinations. With a few editorial amendments, Resolution 304 was adopted.

Resolution 303, Educating Medical Students About the Pharmaceutical Industry, introduced by the Medical Student Section, asked our AMA to strongly encourage medical schools to include unbiased curricula concerning marketing practices used by the pharmaceutical industry and additional information concerning the pharmaceutical industry. Testimony was overwhelming pro, and Resolution 303 was adopted.

Resolution 316, Eliminating Religious Discrimination from Residency Programs asked our AMA to encourage the ACGME and the AOA to require that all residency program become aware of and make an effort to ensure that residents be allowed to practice in a manner that does not interfere with their religious convictions, including observance of religious holidays and observances, assuming that patient care is not compromised. All testimony reaffirmed long-standing AMA policies against discrimination of all kinds, including religious discrimination. The testimony in opposition was specific and raised practical and ethical concerns. Pragmatic concerns included opposition to the ACGME placing more accreditation requirements on programs resulting in the need for additional documentation by program directors. Also, it would be more difficult for smaller programs to comply. However, the major reason for referral was the lack of clarity in both resolutions on how to resolve conflicts between resident physicians’ religious beliefs and their professional obligations to patients. Since these are fundamentally ethical issues, the Reference Committee recommended Resolution 316 (and it’s companion Resolution 308) were referred to the Board of Trustees to be considered by the Council on Ethical and Judicial Affairs.

Resolution 314, Improving Sexual History Curriculum in the Medical School, introduced by the New York Delegation (on behalf of the MSS), asked our AMA to encourage all medical schools to train medical students to be able to take a thorough and non-judgmental sexual history. The resolution also asks our AMA to support the creation of a public service announcement encouraging patients to discuss concerns related to sexual health with their physician and reinforces AMA’s commitment to helping patients maintain sexual health and well-being. Testimony was all pro, and Resolution 314 was adopted.
 
Resolution 401 asked that our American Medical Association amend Policy H-130.983 to read as follows: “The AMA supports publicizing the importance of teaching CPR, including the use of automated external defibrillation, and strongly recommends the incorporation of CPR classes as a voluntary part of secondary school programs.” Strong support for this resolution was voiced. Youth are an easily accessible population for this training if it is incorporated into school health education programs. In addition, the inclusion of CPR training as a part of a comprehensive public health education program was stressed and the Reference Committee has added a third resolve to address this issue.
 
Resolution 403 asks that our AMA work with the National Association of State Boards of Education, the Centers for Disease Control and Prevention, and other appropriate entities to encourage elementary schools to develop sun protection policies. Testimony was all pro, and this resolution was adopted.
 
Resolution 406 asked that our AMA encourage the Department of Education to ensure mentally and/or physically disabled youth receive more effective and comprehensive sexual education and that our AMA encourage the Department of Education to offer sexual education counseling targeted to mentally and/or physically disabled youth. Testimony was heard in overwhelming support of this resolution. Testimony was also heard indicating the need for all students to get appropriate sexual health education and that it not be misinterpreted that mentally and physically disabled youth need to be singled out for such action. With editorial amendments, Resolution 406 was adopted.
 
Resolution 413 asks that our AMA seek to promote the consumption and availability of low calorie, low sugar drinks as a healthy alternative in public schools instead of beverages such as carbonated sodas. Testimony was all pro and with editorial amendments Resolution 413 was adopted.

Resolution 422 asked that our AMA continue to recognize the need for possible adaptation of the US health care system to prospectively prevent the development of disease by ethically using genomics, proteomics, metabolomics, imaging and other advanced diagnostics, along with standardized informatics tools to develop individual risk assessments and personal health plans and that our AMA support studies aimed at determining the viability of prospective care models and measures that will assist in creating a stronger focus on prospective care in the US health care system. The resolution also asks that our AMA support research and discussion regarding the multidimensional ethical issues related to prospective care models, such as genetic testing. Limited but unanimous testimony on this resolution was heard in favor of referral to the Council on Scientific Affairs, and Resolution 422 was referred.

Resolution 424 asked that our AMA recognize teen and young-adult suicide as a serious health concern in the United States and that our AMA compile resources to reduce teen and young-adult suicide, including but not limited to continuing medical education classes, patient education programs and other appropriate educational and interventional programs for health care providers, and report back at the 2006 Annual Meeting. Testimony was all pro and with editorial amendments Resolution 413 was adopted.

Resolution 430 asked that our AMA encourage and support outreach efforts to provide vision screenings for school-age children prior to primary school enrollment, encourage the development of programs to improve school readiness by detecting undiagnosed vision problems and support periodic pediatric eye screenings with referral for comprehensive professional evaluation as appropriate. Testimony was all pro and with editorial amendments Resolution 413 was adopted.

Resolution 435 asked that our AMA advise that businesses that serve alcohol should offer incentives to patrons who elect to be designated drivers and that our AMA use its credible voice to encourage the hospitality industry to enact the above resolved clause. Testimony in reference committee reflected the complexity of this issue, and policy H-30.945 was reaffirmed.

Resolution 501 asks our American Medical Association to : (1) adopt the current Food and Drug Administration (FDA) policy on use of non-diagnostic fetal ultrasound, which views “keepsake” fetal videos as an unapproved use of a medical device, and (2) lobby the federal government to enforce the current FDA position, which views “keepsake” fetal videos as an unapproved use of a medical device, on non-medical use of ultrasonic fetal imaging. Testimony was all pro and the resolution was adopted.

Resolution 504 addressed the potential for consumers to confuse dietary supplements (that are marketed as herbal remedies) with over-the-counter (OTC) drugs. Testimony noted that the Federal Food, Drug, and Cosmetic Act requires that dietary supplements be labeled using the term “dietary supplement” or an appropriately descriptive alternative that reflects the ingredients (such as “herbal supplement’). With respect to the fifth resolve, the labels of all dietary supplements (including herbal remedies) are already currently required to bear an ingredient list and a “Supplement Facts” panel similar to the “Nutrition Facts” panel for conventional foods. The Council on Scientific Affairs offered a substitute resolution that condensed and simplified the first three resolves: RESOLVED, That the naming, packaging, and advertising of dietary supplement products be such that they cannot be confused with pharmaceutical products, and be it further RESOLVED, That Policy H─150.954 be reaffirmed.

Resolution 505 asked our AMA to study the feasibility of creating and implementing a national patient safety error reporting database incorporating existing policy guidelines. Reference Committee also heard much testimony on the potential pitfalls of initiating discussion on a national patient safety database as described in the resolution. While the sponsor was lauded for the intent of the resolution, it was noted that such a database could be abused especially if it were created with no safeguards for physician protection and no method to limit all peer review from legal scrutiny. Additionally, testimony also highlighted the National Quality Forum’s (NQF) current initiative on patient safety. The NQF has assembled a group of experts comprising many diverse stakeholders to put together a national standardized taxonomy on patient safety that would facilitate the management of patient safety data across reporting systems and should support patient safety data management innovation. Finally, it was pointed out that our AMA already has strong policy on patient safety, and Resolution 505 was not adopted

Resolution 506 asks the AMA amend existing Policy H-60.944 by addition as follows: Our AMA: (1) endorses efforts to train additional qualified clinical investigators in pediatrics, child psychiatry, and therapeutics to carry out studies related to the effects of psychotropic drugs in children, adolescents, and young adults; and (2) promotes efforts to educate physicians about the appropriate use of psychotropic medications in the treatment of children, adolescents, and young adults. Limited testimony from the sponsor and the American Academy of Pediatrics was totally in support of this resolution, and it was adopted.

Resolution 511 asks the AMA to: (1) work with any and all local and state medical societies, and other interested US and international organizations, to increase access to and utilization of Food and Drug Administration (FDA)-approved rapid HIV testing by personnel appropriately trained in test administration and results counseling; and (2) report back on its efforts to increase access to FDA-approved HIV rapid testing at the 2006 Interim Meeting. With editorial amendments, Resolution 511 was adopted.

Resolution 513 asked the AMA to: (1) support the development of a center or institute for pain research, similar to that described in the National Pain Care Act of 2003 (HR 1863), that would assist in the distribution of funding toward more clinical and basic science research regarding the treatment as well as the biology of pain; and (2) support efforts to create public awareness on responsible pain management, symptom management, and palliative care. Reference Committee recommended referral for decision based on information presented that the NIH is currently in the process of consolidating its Centers and Institutes. Thus, the timing of this resolution may be inopportune and adoption may result in our AMA being perceived as not being sensitive to the issues currently underway at the NIH. Accordingly, Resolution 513 was referred for decision so the BOT could take into account all factors pertaining to this important issue.

Resolution 515 asks the AMA to: (1) urge the Food and Drug Administration to recommend the folic acid fortification of all grains marketed for human consumption, including grains not carrying the “enriched” label; (2) write letters to domestic and international producers of corn grain products, including masa, nixtamal, maize, and pozole, to advocate for folic acid fortification of such products; and (3) amend existing Policy H-440.898 to add (7) encourage the FDA to recommend the folic acid fortification of all grains marketed for human consumption, including grains not carrying the “enriched” label. Reference Committee heard limited testimony in support of this resolution and thus was left with several questions regarding the ramifications of fortifying all grain products intended for human consumption. While there is evidence that fortification of grains has helped to reduce the incidence of NTDs in this country, Reference Committee felt referral would be the most appropriate matter for the CSPH to take up.

Resolution 530 asked that our American Medical Association: (1) support and recognize a need for uniform minimum newborn screening (NBS) recommendations: (2) encourage continued research on the benefits of NBS for certain diseases and the development of new NBS technology; and (3) recommend the adoption of a national minimum uniform screening panel for newborns by establishment of model state legislation and encouragement of legislation for adoption by Congress, pending completion and a review of the evaluation by the Advisory Committee on Heritable Disorders and Genetic Diseases in Newborns and Children. Reference Committee heard limited testimony on this resolution, and with its complexity recommended referral to the CSPH as they’re already in the process of preparing a report on this matter.

Resolution 603 asked our AMA to study establish lifetime email addresses as a benefit of membership – a partner resolution, 614, asked that lifetime email addressed be immediately implemented. Reference Committee heard considerable testimony in support of e-mail communication with physicians, and testimony seemed to favor a forwarding-type system. To ensure the most effective implementation Reference Committee recommended referral.

Resolution 606 urged that resolutions refer to both “MD and DO” unless clearly applicable to only one or the other and further, that reference committees amend the language of resolutions as necessary to specifically refer to MDs and DOs. Reference Committee heard minimal testimony, all of which was supportive and the resolution was adopted.

Resolution 607 asks our AMA to seek travel discounts for medical student members utilizing travel services. With mixed testimony both in reference committee and in the HOD, Resolution 607 was referred for decision.
 
Resolution 608 called on our AMA to establish an international health consortium of physicians, residents and medical students. After discussion with the Chair of the Board of Trustees, the MSS withdrew this resolution in order to approach increasing medical student interaction with AMA international activities on a Board-level.

Resolution 617 calls for our AMA to investigate the feasibility of developing and marketing a health insurance plan tailored for medical students. Testimony was uniformly favorable, and Resolution 617 was adopted.

There were also a few physician authored resolutions/reports the MSS spoke to that are of note here:

The House Compensation Committee Report recommended that the compensation for AMA officers and BOT members remain unchanged for 2004-2005, that honoraria and per diems for the student and resident BOT members be set at half the rate of other BOT members, and that the allowance for travel by the spouse of the president be increased to $6000 annually. With uniformly positive testimony, the HCC report was adopted.

Resolution 4 called for our American Medical Association to work with the AMA Medical Student Section to propose an amendment to the AMA Bylaws making US citizens and legal permanent residents attending medical schools abroad eligible for AMA membership, including non-voting membership in the AMA Medical Student Section. Testimony presenting this resolution indicated that it was intended to extend membership to students who attend accredited schools, but was opposed by both the Section on Medical Schools and the MSS. The Medical Student Section opposed this resolution predominantly because it had not first been presented to the MSS Assembly, and thus our Section’s opinion had not been heard prior to HOD action. The Reference Committee recommended that the resolution not be adopted, and it was not adopted.

Resolution 6 called for our American Medical Association to enter into discussions with appropriate organizations in order to protect a patient’s right to obtain legally prescribed, medically indicated therapy. It also directs the Association to work with state medical societies to support state laws that protect patients’ access to legally prescribed, medically indicated therapies. Resolution 8 directed our American Medical Association to reaffirm its policies supporting the principles of responsibility to the patient as paramount and access to medical care for all people; to oppose use of conscience clauses to obstruct and impede patient care; to work with state and federal legislatures to prevent and/or overturn laws providing protection for conscientious objectors; to encourage relevant pharmaceutical associations and other organizations dealing with patient care to advise, strengthen and enforce policies that assure that individual rights of conscience do not impede with access to legally prescribed care. And finally, resolution 9 directed the AMA to work with the American Pharmacists Association to ensure that pharmacies and pharmacists set up systems which guarantee patient access to legal pharmaceuticals without unnecessary delay or interference and that our AMA support corresponding legislation. Reference Committee heard these three resolutions in a group, and recommended the following substitute resolution (which was adopted with additional resolved noted by the HOD): RESOLVED, That our American Medical Association reaffirm our policies supporting responsibility to the patient as paramount in all situations and the principle of access to medical care for all people (Reaffirm HOD Policy); and be it further RESOLVED, That our AMA support legislation that requires individual pharmacists or pharmacy chains to fill legally valid prescriptions or to provide immediate referral to an appropriate alternative dispensing pharmacy without interference (New HOD Policy); and be it further RESOLVED, That our AMA work with state medical societies to support legislation to protect patients’ ability to have legally valid prescriptions filled (Directive to Take Action); and be it further RESOLVED, That our AMA enter into discussions with relevant associations (including but not limited to the American Hospital Association, American Pharmacists Association, American Society of Health System Pharmacists, National Association of Chain Drug Stores, and National Community Pharmacists Association) to guarantee that, if an individual pharmacist exercises a conscientious refusal to dispense a legal prescription, a patient’s right to obtain legal prescriptions will be protected by immediate referral to an appropriate dispensing pharmacy (Directive to Take Action). RESOLVED, That our AMA, in the absence of all other remedies, work with state medical societies to adopt state legislation that will allow physicians to dispense medication to their own patients when there is no pharmacist within a thirty mile radius who is able and willing to dispense that medication. (Directive to Take Action).

Resolution 307, Residents’ Salaries, introduced by the California Delegation, asked our AMA to support appropriate increases in resident salaries. Your Reference Committee heard substantial testimony in favor of adopting this resolution, and it was adopted.

Council on Medical Education Report 8, The Physician Workforce: Recommendations for Policy Implementation, responds to resolutions asking the AMA to develop and implement policy positions directed at increasing the number of physicians and reducing geographic maldistribution. The report proposes policies and strategies, including changes in the current funding mechanisms to increase enrollment in medical schools and residency programs. Testimony recognized the need for explicit AMA policy about existing and predicted shortages in at least some geographic regions and specialties. However, many who testified were not convinced that specific targets for expansion of enrollment in medical school and residency training positions were warranted at this time. There also were concerns that limited data had been obtained from state and medical specialty societies, and about specific subsets of the physician workforce, such as international medical graduates. Many who testified called for remedies to address existing geographic maldistribution. Amendments were made, including one eliminating the call for creating 15% more medical student positions (without addressing increasing debt-loads and increasing tuition) – this clause was stricken, and Report 8 was adopted with amendments.

Resolution 323, Eliminating Health Disparities – Promoting Awareness and Education of Lesbian, Gay, Bisexual, and Transgender (LGBT) Health Issues in Medical Education, introduced by the Resident and Fellow Section, asked our AMA to support the right of medical students and residents to form groups and meet on-site to further their medical education or enhance patient care without regard to their gender, sexual orientation, race, religion, disability, ethnic origin, national origin or age. It further asks our AMA to encourage the Liaison Committee on Medical Education and the Accreditation Council for Graduate Medical Education to include Lesbian, Gay, Bisexual, and Transgender health issues in the cultural competency curriculum for medical education. Reference Committee heard testimony strongly supporting the elimination of healthcare disparities, promoting cultural competence and educating medical students and resident physicians about Lesbian, Gay, Bisexual, and Transgender health issues through the adoption of this resolution. With editorial amendments, Resolution 323 was adopted.

Lastly, Board of Trustees Report 5 dealt with Pay-for-Performance guidelines. We’d refer you to the reference committee’s discussion, as adding it to this e-mail would make it another 15 pages longer. It is well worth the read though, as P4P is likely going to be at the forefront of discussion among organized medicine for quite some time.