Program Formalizes Ad Hoc Advising of Students
By Gina Shaw

Photo credit: Robert Bean
Program Formalizes Ad Hoc Advising of Students
In addition to meeting with students, advisory deans meet twice a monthwith Peter Puchner, chairman of the advisory deans committee, and Lisa Mellman, dean for student affairs, to discuss common advising issues and concerns and to share new ideas and relevant information. After one April meeting, the deans joined several students they advise for a group photo.
Front row, from left: William Macaulay, Alessandra Pernis, Dr. Mellman, Joseph Haddad Jr.,and Dr. Puchner. Advisory deans not pictured: Saundra Curry and Donald Quest. Students,from left, are (second row from front) Cathy Shu, Hadi Halazun, Michael Fingerhood, and John Kaczmar ; (third row) Marie Roguski, Meaghan Wilson, Rongron Fan, Amy Cheng, and Cristina Carpio; (back row) Preeti Thyparampil, Chris Boyle, Jeanette Tse, and Marc Pimentel

For many years, Saundra Curry, clinical professor of anesthesiology, has advised P&S students on many of the tough decisions they face as future physicians. But until recently, the relationships were fairly informal. “I had students with whom I had close relationships for four years and others I never saw,” she says.
   That changed with the creation of the advisory deans program. Founded in 2003 by Linda Lewis, then senior associate dean for student affairs, and Peter Puchner’62, professor emeritus of clinical urology, the advisory dean program gives students the kind of individual mentoring that can get lost in a large, busy medical school. Five advisory deans make a commitment to spend 10 hours a week advising students. The class of 2007 is the first graduating class to have been guided by advisory deans throughout their entire medical school careers.
   “It has replaced the traditional ‘hit or miss’ system of medical student advising,” says Dr. Puchner, who directs the program. “Each student now has at least one faculty member who, from the beginning to the end of their student years at P&S, can be counted upon as an adviser, mentor, advocate, and guide. In just four years, the program has become integrated into the fabric of the school.”
   “It takes away some of the uncertainty and makes a very big place seem like a small, personal place,” says Joseph Haddad Jr., M.D., the Lawrence Savetsky Professor of Clinical Otolaryngology/Head and Neck Surgery. “We’re more like
“We’re more like a big brother or a big sister. We’re not here to grade or evaluate them. We’re just a neutral person that they can come to for advice, whether it’s about choosing a specialty, dealing with patients, or even personal issues that come up.”
a big brother or a big sister. We’re not here to grade or evaluate them. We’re just a neutral person that they can come to for advice, whether it’s about choosing a specialty, dealing with patients, or even personal issues that come up.”
   Some of the original advisory deans have given up their roles with the program, but other faculty, including leading clinicians and educators, have been eager to step into their shoes. Besides Dr. Curry and Dr. Haddad, current advisory deans are Donald O. Quest’70, the J. Lawrence Pool Professor of Clinical Neurological Surgery; William Macaulay’92, associate professor of clinical orthopedic surgery; and Alessandra Pernis’86, associate professor of medicine-molecular medicine.
   First-year students have lunch meetings weekly during their first month of medical school. From that point on, students
Saundra Cury
Saundra Curry
meet with their advisory deans every other week throughout the first and second years. A “semi-structured” curriculum that has evolved over the first few years of the program covers how to respond to concerns ranging from “I don’t fit in” and “How do I deal with mediocrity after being a valedictorian” to ethical dilemmas, making choices in medical specialties, time management, dealing with exams, and the realities of life as a physician.
   “We try to talk about topics that never seem to come up in their usual curriculum, things like what it’s like to have a community practice or an academic practice, how doctors pay their practice bills, how physicians relate to hospitals, things they otherwise wouldn’t even hear about,” says Dr. Macaulay, who also is director of the Center for Hip and Knee Replacement. “And then we bring in visitors who know more about these things than we do. Maybe one week I’ll bring in a friend of mine who’s a cardiologist in private practice, and she’ll talk about what it means to have two young kids, manage the household, and still practice as a physician full time.”
   During the third year of medical school, occasional evening meetings replace the biweekly lunch meetings. Since third- and fourth-year students have widely varying clinical responsibilities in multiple locations, the evening sessions are supplemented with individual meetings between advisory dean and student.

Photo credit: Peter Puchner, M.D.
Donald Quest with a few of the first-year students he advises,
Donald Quest with a few of the first-year students he advises,
From left: Vik Saxena, Alec Macaulay, and Rob Sorabella.

For Marc Manseau’08, the advisory dean program literally kept him from abandoning a medical career. As an undergraduate at Brown University, he had thrived in that school’s laissez-faire environment, but initially struggled with the rigid and hierarchical environment of medical school. Indeed, Mr. Manseau found his first year at P&S so challenging that he seriously considered dropping out. His bête noire: gross anatomy. “I hated that course with a fiery passion,” he confesses. “It got to the point where I didn’t like enough of the rest of med school to convince me that gross anatomy was worth it.”
   If he had entered P&S a few years earlier, Mr. Manseau might well have given up his medical dream. But his advisory dean during that first year helped Mr. Manseau realize that there was a place for him in medicine, and at P&S. “My advisory dean told me she hated gross anatomy too! Here was a faculty member, telling me that if I stuck it out, I’d be okay,” he says. “I ended up pulling through and have done really well academically since then, but it was nice to know that I had an advocate.”

The Hub of a Wheel
The advisory deans operate as the hub of a wheel, directing students to a wide variety of resources tailored to their interests and needs. “Without this kind of system, students are on their own, sifting through Web sites and handbooks for information to meet their needs,” says Lisa Mellman, M.D., clinical professor of psychiatry and one of the first advisory deans before succeeding Dr. Lewis as senior associate dean for student affairs. “A student interested in research, for example, may have difficulty identifying someone on the faculty in their area of interest. With the advent of this program, the advisory dean can help students make that kind of connection.”
   That’s just what Dr. Quest did for Darius Fewlass’09. “I sought him out for advice on what to do with the summer between my first and second year,” he says. “It’s ostensibly the last summer when you have a big chunk of time to do what you want to do. Not only did he put me in contact with people in the hospital I could reach out to, but he said summer opportunities would be a good topic to discuss with the whole group and had people come in to talk about different summer experiences.”
   Mr. Fewless ended up splitting his summer, spending half of it doing HIV public health research in the Dominican Republic through a program Dr. Quest knew about and the other half in New York as a counselor for high school students interested in a career in medicine.
   Having worked for two years in finance before pursuing medical school, Mr. Fewless appreciates the wide range of speakers Dr. Quest brings to talk with students. “He actually had the chief operating officer of the hospital talk about serving in that role and being an anesthesiologist at the same time. He also had his own contacts come in from hospitals in New Jersey to talk about malpractice insurance and how they transitioned from a career in medicine to lobbying and running a medical association,” he says. “My mindset is that I want to be a physician plus something else, so this has been very helpful as I figure out how to carve out what I want from medicine.”
   Matthew Doran’07, who will soon begin an anesthesiology residency program at Brigham and Women’s Hospital,
“P&S students are smart and capable and usually find their way to the appropriate career eventually, but the advisory dean system helps them not to have to work so hard in this endeavor and supports them along the way.”
witnessed the serendipitous power of the advisory dean program during his third year, when he e-mailed Dr. Quest for advice about selecting an elective on the West Coast. “Within the same day, he e-mailed me back contact information from a colleague of his in the neurosurgery department at the institution I was interested in, in Portland, Ore.,” he says. “It turned out that the school’s chair of anesthesia was in New York on business, so within one day of my e-mailing Dr. Quest I had an appointment to meet the chair downtown for a cup of coffee.”
   Mr. Manseau also has benefited from the relationship with Dr. Macaulay, the advisory dean who succeeded his first advisory dean. With his M.P.H. from Brown, he wants to pursue a career in public health psychiatry and research. Guided by advice he gleaned during a group session with Dr. Macaulay, he’s chosen to take a year off before his fourth year of medical school to do psychiatric epidemiology research at Columbia, studying how children’s mental health is affected when their mothers are incarcerated.
   “When I was worried that taking a year off would be disadvantageous and might not look good, he pointed out that not only does it look very good to do research, it actually can help you match in a good residency program. That’s something I didn’t realize,” Mr. Manseau says.
   First-year student Kelly Fahl found her advisory dean, Dr. Pernis (the newest advisory dean, who succeeded Gwen Nichols this year), particularly helpful after a hoped-for summer NIH research grant failed to materialize. “She walked me through other research opportunities and gave me a real insider’s perspective that you don’t get just from a printed list,” Ms. Fahl says. “She knows which people have good reputations as mentors and which projects would be a good fit for a first-year medical student. Since it can be difficult to find funding for research, she helped me figure out where to look for paid opportunities here at Columbia.”
   Dr. Curry notes that each P&S class has its own personality, needs, and goals. “One of the challenges to the deans is to be able to reassure each group that there is a place for them in medicine and to help them find it,” she says. “P&S students are smart and capable and usually find their way to the appropriate career eventually, but the advisory dean system helps them not to have to work so hard in this endeavor and supports them along the way.”

An Evolving Program
In just four years since its inception, the advisory dean program has evolved significantly, adopting a rigorous outcome evaluation program and refining its curricular calendar and meeting schedule to best meet student needs. In the most recent student survey, members of the Class of 2006, who had been involved in the program for three years, gave it a 96 percent approval rating.
   “We’ve also been able to further develop and understand the process of residency advising,” says Dr. Mellman. “The

Photo credit: Robert Bean
An Evolving Program
deans are each assigned a number of specialties to oversee, including the one that they’re in, but it’s become clearer that they are one step in a several-step process. When they’re advising a student in their own specialty, they can give very specific advice, but for other specialties, they are an excellent starting point. We’ve been able to understand further what the advisory deans can do well and where they can be facilitators, helping students to get to the next step.”
   The program has enabled P&S to be more responsive to student needs. “When we first began, there was always a problem with study space, and students were going all over the place to find a decent place to study,” says Dr. Puchner. “The program made that a primary issue and, working with the administration, we developed the idea of changing the whole first floor of the Hammer building, which houses the library. The first floor is now a wonderful open space with lots of study facilities, IT materials, and a snack bar.”
   The advisory dean program has even brought about curricular change. “During the first couple of years of the program, we consistently heard about problems in the first-year curriculum regarding access to teaching materials, inconsistency in the quality of lectures, and lectures overly focused on the presenter’s own research,” Dr. Mellman says. “We were able to pool those comments and bring a group of students and advisory deans to meet with associate dean of education Ron Drusin’66 to provide input to curricular affairs.”
   Changes to the course in question, Science Basic to the Practice of Medicine, were made rapidly. Not only did the complaints dissipate, but the course director, Marc Dickstein’87, associate professor of clinical anesthesiology, went on to be selected “Teacher of the Year” by the first-year class and received a Columbia University Presidential Award for Excellence in Teaching.
   Some students, inspired by the advisory dean program, have created a mentoring program of their own. The peer support network, part of the Center for Student Wellness, is a group of second-year students committed to advising first years on everything from loneliness to time management problems to eating healthy in Washington Heights. “We came up with the idea of the peer support as a level of support that was even more immediate, students helping other students,” says Holly Martin’08, one of the founders of the program. “When second-year students came to talk to us as first years through the advisory dean program, that was hugely helpful, so we wanted to create something that would build on that. And we’ve found that one of the best ways for the network to get to the first-year students is to go through the advisory dean program.”
   That initiative came as no surprise to Dr. Haddad. “The program is really growing. Upperclass advisees love to come in and help out the classes below them. They’re already starting to mentor, and that cycle is what medicine is all about. Hopefully, we will serve as good mentors for them, and they’ll mentor others down the line. We might be creating the next generation of advisory deans or at least faculty members who will understand how important it is to be there for their students.”