Friday, October 25, 2013

For Graduate Practicum, George Washington University Earns an F

Recently, news came out that Mark Geier, the man who tried to treat autistic children's autism by using a powerful drug that suppresses testosterone (essentially chemically castrating these children), the man who lost every one of his twelve state medical licenses and had a 13th denied due to his medical misconduct (to put it lightly), served as a site preceptor for a graduate student at George Washington University. Autism News Beat rightly criticized the university. That Geier was able to serve as a preceptor for a student is pretty damning, since it means that GWU did not do its due diligence to ensure that individuals who apply to be a preceptor meet certain minimum standards. Either that, or someone at GWU was actively promoting Geier's nonsense.

The problem is that a site preceptor has a number of responsibilities, according to the GW SHHS Practicum Site Preceptor Guide:
  1. Visit the Practicum Website http://www.gwumc.edu/sphhs/studentres/practicum/index.cfm and Register. (See Register: for instructions)
  2. Review and approve the Student’s Practicum Plan
  3. Negotiate payment/stipend with Student, if applicable
  4. Engage student in work and provide constructive feedback and guidance to the student
  5. Provide guidance for professional conduct
  6. Complete the following on the Practicum Website:
    a. Midpoint evaluation form in conjunction with the student
    b. Final site preceptor evaluation of student and practicum
  7. Address student’s reports of problems, including site safety issues and/or harassment
Take note of numbers 2, 4, 5 and 6. Mark Geier is not fit to fill those responsibilities, having been stripped of his medical licenses and being found by several Special Masters of the vaccine court to lack expertise in many different areas relevant to epidemiology, biostatistics and immunology. Coupled with his lack of medical ethics, it is grossly irresponsible to allow him to serve as a site preceptor for any student. Orac and Reuben Gaines have both chimed in, as well, castigating George Washington University for allowing this to happen.

And now it looks like GWU has taken notice.

Someone from the communications office left the following comment at Autism News Beat, Respectful Insolence and The Poxes Blog:
The George Washington University School of Public Health and Health Services is still investigating the claims in this article. However, the article gives the impression that Mark Geier was teaching or advising a GW student who was doing a practicum at SPHHS. In fact, Mark Geier was facilitating the use of a non-GW database the student used while doing his/her research, which was not part of a practicum. The student in question was being supervised by a faculty member at the university and the student’s contact with Mark Geier was limited mainly to accessing the information in this database.

GW School of Public Health
Office of Communications
Clearly the three posts ruffled some feathers. However, this attempt at PR damage control doesn't really help the university. Whoever wrote that is trying to imply that Geier did not serve in any teaching, advising or supervisory role. This is at odds, however, with the role of a site preceptor, who is charged with reviewing and approving the student's practicum plan, engaging the student in work and providing constructive feedback and guidance, providing professional guidance to the student, and evaluating the student and the practicum. Those all certainly seem like "teaching" and "advising".

But what is this about Mark Geier facilitating access to a database outside of George Washington University? If his past problems with confidentiality when it comes to patient databases is any indication, one wonders what "facilitation" Geier provided. What information did he make available?

Then there's the mention of the student being supervised by a faculty member. I wonder if the faculty member supervising him was Heather Young, who collaborated with Mark and David Geier on two studies looking at thimerosal (one in 2008 and one in 2010) and whose 2008 paper with the Geiers was submitted as expert evidence joined Geier as an expert witness in the Geiers' attempt at being expert witnesses in the Omnibus Autism Proceedings. This is purely speculation, though, so perhaps Dr. Young is not involved in this debacle.

In the end, the comment from the GWU spokesperson notwithstanding, Mark Geier, as a site preceptor, was in a position to "teach" and "advise" a graduate student, even if he was not employed by the university; many preceptors have no affiliation with the university. That the university allowed this to happen and did not properly vet his qualifications, or lack thereof, let alone take into account the disciplinary actions being taken against him in numerous states at the time the student was doing their practicum, is unconscionable. Their abject failure in this instance calls into question the overall quality of their practicum program. Have they allowed anyone else to be a site preceptor who was not only not qualified, but antithetical to the promotion of public health?

3 comments:

  1. I've been trying to figure out if there is a vetting process for site preceptors and not been having much luck. Here is the registration form: https://sphhs.gwu.edu/practicum/practicumApp/applicationPre.cfm And the guidebook above talks about sponsoring organizations, but I haven't found any clear description of who and how supervises who can be a site preceptor.

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  2. "who joined Geier as an expert witness in the Autism Omnibus Proceedings."

    To be clear--While their paper was submitted as evidence, and that paper was commissioned by the PSC, the Geiers did not serve directly as expert witnesses. I don't recall about Young. The Geiers did not prepare expert reports and did not testify. Mark Geier was paid as a consultant, a step below expert.

    My own speculation would be that the Geiers and Prof. Young are probably not working together with this student or on other projects. Prof. Young was compensated by the Court for the work involved in the paper. The Geiers were not (and sued the PSC about that).

    The Special Master wrote something which is on-point for the expertise of the Geiers in the field they were working with the student:

    "Thus, Dr. Geier does not appear to have had any formal academic training or degrees or medical faculty experience in epidemiology, and his medical experience has been chiefly in genetics rather than epidemiology."

    I wouldn't be too hard on GWU. GWU was tricked. A lot of smart people were tricked by the Geiers. It's a question of whether they continue. somehow I suspect there are very few public health students who would request or accept the Geiers as preceptors.

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  3. @leftbrainrightbrain

    Thank you for the clarification on Young's role in the OAP. I've updated the text accordingly.

    I suspect that she probably is not working with them at this point, but I also do not think it beyond the realm of possibility.

    As for GWU, my whole point is that they really dropped the ball. A very simple and brief search for information on Geier would have turned up plenty of reason to think twice about letting him be a preceptor. That's my main criticism, and I don't think I'm being too harsh on them. What would be worse is if they actually knew that Geier was bad and still let him take on that role. At any rate, the important thing now is that the university take a serious look at how they handle preceptor applications.

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