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School of Medicine discoveries

09
2017

M4 John Weeks returns to Eastern Shore to treat underserved population

For the Class of 2017’s John Weeks, practicing medicine means more than providing care to patients in an exam room. It’s a commitment to caring for an entire community and the challenges it may face.

That’s why after earning his undergraduate degree from the College of William & Mary and spending three years as an outreach worker on Virginia’s Eastern Shore, he enrolled in the VCU School of Medicine where he also was accepted into the International/Inner City/Rural Preceptorship program on the MCV Campus. I2CRP is a four-year program for students who declare an interest in and commitment to working with medically underserved populations in urban, rural or international settings.

“The I2CRP program is one of the big things that drew me to VCU,” says Weeks. “There’s an overall sense that you can really make an impact — improving people’s lives and improving the community they live in. It’s not just serving one patient, treating them, and moving on to the next, but going beyond and helping a whole community.”

International/Inner City/Rural Preceptorship program ‘Open your eyes and look around you’
In addition to working for the Eastern Shore Rural Health System prior to medical school, he returned during his third-year family medicine clerkship and fourth-year community immersion elective. There Weeks experienced firsthand the challenges of providing effective medical care to an underserved population that included the indigent, elderly and Spanish-speaking migrant farm workers.

For starters, some of the biggest hurdles he saw had very little to do with the medical issues that originally brought patients to the clinic. High blood pressure, diabetes and work-related injuries are further complicated by high levels of poverty, housing and food insecurity, lack of transportation, exposure to pesticides and chemicals, legal problems with immigration status or navigating Medicare.

“People think that to truly find the underserved, you have to go international,” Weeks said. “But that’s just not the case. All you have to do is open your eyes and look around you. The biggest similarity of all underserved populations, regardless of location, is access.”

Serving the Eastern Shore population has particular meaning for Weeks, who grew up in Northern Virginia and appreciated the small, intimate community he met on the shore.

“It was constantly amazing to me how much the people knew each other,” he says. “The outreach worker I partnered with knew not only everyone’s family ties, but where they lived, what they needed and, most importantly, what resources they might be willing to accept to help them through difficult times.”

Weeks received the medical school’s Scott Scholarship, awarded by the Marguerite L. Hopkins Trust and James Perkins Memorial Trust to a deserving medical student from Virginia with preference given to a student with ties to the Eastern Shore.

Marguerite Hopkins grew up on the Eastern Shore and stipulated that some of the funds in her trust should be used to create an annual scholarship named for her cousin, Ralph M. Scott, M’50. Scholarships continue to be a high-priority need for the medical school and donors may outline criteria to select student recipients, including supporting students from a particular geographic region.

‘I want to go someplace and make people healthier’
Approximately 24 students are admitted to I2CRP from each medical school class, said Mark Ryan, M’00, H’03, I2CRP medical director and assistant professor in the Department of Family Medicine and Population Health. “Our students are amazing. They have diverse experiences and diverse backgrounds but a similar sense of ‘I want to go someplace and make people healthier where otherwise they would have struggled.’”

Since its first graduating class in 2000, 37 percent of I2CRP graduates have gone on to practice in family medicine with nearly a third of those practicing in rural areas. All told, 85 percent of graduates enter careers in the National Health Service Corps priority fields of family medicine, internal medicine, pediatrics, combined internal medicine-pediatrics, OB-GYN, psychiatry and general surgery.

I2CRP director Mary Lee Magee attributes much of the program’s success to its curriculum that spans all four years of medical school, starting with electives in the spring semester of M1 and ending with a month-long community immersion during M4. Along the way, students share their experiences with their peers and faculty members.

“Our retention rate is very strong,” she says. “The program offers meaningful opportunities for critical thinking, reflection, mentorship and community building that are essential to support careers in underserved communities.”

That support is designed to go beyond graduation, Ryan says, when the challenges of caring for the underserved can become trying.

“Patients can’t fill prescriptions, can’t get to appointments, don’t have the same language as their physicians,” he says. “There will be times when it feels very hard to sustain and it’s important to have a support system to lean on. Hopefully through I2CRP, John and others will develop a network of peers, physicians and faculty who they can ask for advice and connect with when that time comes.”

It’s advice Weeks takes to heart as he applies for a family medicine residency with the ultimate goal of working “where people need me.”

“Find the little victories,” he says. “Some patients have a million obstacles lying in their path but if you can remove one or some of those obstacles, it’s huge. Every piece of the puzzle matters and once you start putting it together and help people get healthy, you realize everything you do, no matter how big or small, can be really rewarding.”

By Polly Roberts

30
2017

MD-PhD students spotlighted in Internal Medicine’s research newsletter

A pair of M.D.-Ph.D. students have been featured in the winter 2017 issue of the Department of Internal Medicine’s research newsletter. The Class of 2017’s Bridget Quinn and Tim Kegelman are both preparing to graduate this spring and hoping for a residency match in radiation oncology.

M.D.-Ph.D. student Bridget Quinn

M.D.-Ph.D. student Bridget Quinn is preparing to graduate from the program this spring and hoping for a residency match in radiation oncology.

Originally from central New Jersey, Bridget Quinn earned her bachelor’s degree from Loyola University in Maryland and then she spent two years doing ovarian cancer research at Fox Chase Cancer Center in Philadelphia before entering medical school. Quinn had been drawn to a career in clinical medicine since she was young, but it was the two years she spent in the lab after college that pushed her to pursue a dual degree.

The M.D.-Ph.D. dual degree program is designed to provide students the knowledge to ask pertinent and meaningful clinical questions that may ultimately lead to novel discovery in the medical field. The degree gives graduates the preparation to stay involved in research and work on the translational border between science and medicine.

Quinn completed her Ph.D. work in the lab of Department Chair Paul B. Fisher, M.Ph., Ph.D., in the Department of Human and Molecular Genetics where she focused on novel therapeutics for pancreatic cancer.

After completing the graduate phase of her MD-PhD program in late 2014, Quinn has been working on clinical research projects with the Department of Radiation Oncology’s Emma C. Fields while completing the program’s medicine phase. In addition to providing clinical mentorship, Fields has also spent time with Quinn discussing various aspects of career planning and the process of applying to residency programs. Quinn is currently applying to residency in the field of radiation oncology and plans to do an internal medicine intern year. You can read more about her background and research on page 5 in the Department of Internal Medicine’s research newsletter.

Finding a career that balances discoveries with patients

In Tim Kegelman’s final year of the MD-PhD program, he’s pursued an elective with the Center for Human-Animal Interaction. Now he’s certified his Siberian Husky, Lola, to be a Therapy Dog and part of VCU’s Dogs on Call program.

Tim Kegelman grew up in Yorktown, Virginia, where his mom, a nurse practitioner, and his dad, a NASA scientist, influenced his interest in becoming a physician-scientist. The path he took led to the University of Notre Dame where he pursued a chemical engineering degree.

Drawn by the potential of making discoveries in medical sciences while also having significant and direct patient interactions, Kegelman enrolled in the M.D.-Ph.D. program. Like Quinn, he performed his dissertation research with Department Chair Paul Fisher, M.Ph., Ph.D., where he could explore his interest in cancer molecular biology and genetics.

He’s known he wanted to work in oncology research since he enrolled in the M.D.-Ph.D. program, and more recently he’s begun collaborating with the Department of Radiation Oncology on projects combining a small molecule inhibitor in combination with radiation in glioblastoma.

While at Notre Dame, Kegelman worked as an undergraduate research assistant in the chemical engineering department. He also was captain of the men’s swim team and competed at the NCAA championships. He has applied a student-athlete’s work ethic to various aspects of M.D.-Ph.D. training and credits his time as a collegiate swimmer with helping him integrate well into new teams – which is something he does regularly during his clinical training.

Away from campus, both Quinn and Kegelman have young children as well as a love for dogs. Kegelman, in fact, recently certified his Siberian Husky to be a therapy dog as part of VCU’s Dogs on Call program.

You can read more about Kegelman on page 7 of the Department of Internal Medicine’s research newsletter.

10
2017

Social and behavioral health PhD alumna Lindsey Saul: “This is what I was meant to do”

PhD alumna Lindsey Saul

“Data is a means to provide action for change, such as providing more services to the military,” says Lindsey Saul, PhD’13 (SBHD). “This is what I was meant to do. It fits my personality to be that connector and get information and results where they need to be.”

Since graduating from VCU with a Ph.D. in social and behavioral health, Lindsey Saul, PhD’13, has taken a career path straight to the Pentagon.

In July 2016, she completed a two-year appointment to the Presidential Management Fellow program, assigned to the Department of Defense’s Defense Health Agency. At that point last summer, Saul converted to a permanent position as branch chief of the data and analysis team for the Non-Medical Counseling Program Office, where she analyzes data from the Military and Family Life Counseling program. The MFLC program was established after 9/11 as a short-term, confidential program to provide U.S. service members and their families with emotional, social, financial and marital support that falls outside of medical attention.

“Our job is to keep our force ready,” she says of her office, where she oversees a team of three. “Part of that is making sure we care for service members, their families and their well-being.”

When service members contact an MFLC counselor for assistance — for anything ranging from grief and loss to mitigating problems in school — Saul’s team receives the who, why and where of the requests and translates the data into plain English to aid senior leadership in their decision-making. Saul is responsible for improving the program’s data collection, analysis and reporting processes as well as providing the team and leadership with program trend analyses. She also oversees developing and implementing a new business operations support system that integrates masses of data across multiple sources in order to capture and convey meaningful metrics.

“Data,” Saul says, “is a means to provide action for change, such as providing more services to the military. It also guides decisions to benefit or impact service members and their families.”

Her job comes with an inherent obstacle. “I work with teams of civil servants and the military who are accustomed to doing business a certain way. I need buy-in when bringing a new and innovative approach,” Saul says. “It’s a challenge.”

But it’s a challenge she has long been prepared for.

With an interdisciplinary educational and work background that includes public health, psychology, forensic science, social work and project management, Saul has a unique ability to translate research findings into succinct, compelling and persuasive information for various audiences.

“I’ve worked at ground level as a social worker in the field, and I’ve worked at operational level,” says Saul. “When I became a civil servant, it was a huge milestone. This is what I was meant to do. It fits my personality to be that connector and get information and results where they need to be.”

Growing up, Saul envisioned herself in a hands-on profession — as a doctor, for example — but pursued experiences and interests that would one day enable her to inform policy and thereby help groups of people, rather than individuals. Yet she didn’t see herself as a researcher. “I resisted certain aspects of the job because of the initial time spent away from direct interaction with the community, as well as the pace at which tangible change is achieved,” she says. “I wanted to be the voice of the people, but it can take years before your work affects the community you’re researching.”

She pursued her doctorate at VCU after earning a bachelor’s in psychology from Duke University and a master’s in forensic studies with a behavior analysis concentration from Florida Gulf Coast University. Studying under the Ph.D. program’s founder, Laura Siminoff, Ph.D., Saul was a motivated, focused student who wrote her dissertation in a speedy six months.

Saul is driven to help the greatest number of people possible, and, to that end, is prepared for a high-level leadership role in the government. She sees her current job as a place to stimulate important discussions and drive decisions that are evidence-based. “The more people I can impact,” she says,” the more meaningful my work would be. That’s my ultimate goal.”

This story by Carla Davis first appeared on the Department of Health Behavior and Policy’s website.

14
2016

The Class of 72’s David Lorber: Just say ‘yes’ – to a nontraditional career path

David Lorber, M’72

“Most physicians practice medicine,” says David Lorber, M’72. “But it doesn’t mean you can’t do other things.”

David Lorber, M’72, rarely says no – it’s a trait that has worked out well for him. It’s led him into a career he never planned, but one which has been extremely rewarding, he says.

Lorber visited the MCV Campus this month to share stories with medical students about his nontraditional career that jumped from academia to a busy practice to industry … and almost to the South Pole. “Most physicians practice medicine,” he notes, “but it doesn’t mean you can’t do other things.”

After completing a fellowship at the University of Arizona, he first assumed he’d have a future in academia. But that wasn’t as fulfilling as he hoped, so he ended up in Albuquerque, New Mexico, becoming the state’s fourth pulmonary critical care physician. Despite a grueling schedule, Lorber kept doing more. “I volunteered for everything I could,” he recalls. “Whatever we needed, I always raised my hand.

“My objective was to learn everything I could about the business of health care and to be able to provide value.”

On the side, he started a consulting firm, worked in an emergency and urgent care department and began exploring options for a post-clinical career. Though medicine was rewarding, he says, after two decades, he was burned out on 100-hour work weeks and started looking for something else.

He didn’t have to look long, as all the extra knowledge he’d gleaned paid off in an understanding of all facets of the health care industry.

David Lorber, M’72

Lorber returned to the MCV Campus in November to talk with students about alternative careers in medicine.

A friend at Blue Cross/Blue Shield pointed him towards a job there; he ended up as medical director of Blue Cross Blue Shield of New Mexico, working in utilization management, disease management, provider relations, oversight of pharmacy and credentialing. He also served as medical director for the Indian Health Service Contract Health Services, managed by BCBS. After that, he joined the small company, PCS Health Systems, which eventually transformed into CVS Caremark, where Lorber became a vice president. When he left that job, he was snapped up by Walgreens. “I felt like you can impact the way health care is delivered in the U.S. more in industry than from the clinical side.”

Lorber is rarely content with just one job, and though he calls himself retired, he still works as consultant, entrepreneur, marketer and clinician. One of his side jobs he still loves is working as a consulting physician for National Geographic’s Lindblad Expeditions adventure cruise line.

As the company has grown, he’s become, in effect, the company’s chief medical officer, overseeing about 50 physicians who travel on Lindblad’s ships to remote corners of the earth.

“It can be gut-wrenching when you have something that in an emergency department would be a no-brainer and easy to do, but can become a catastrophe because of where you are,” he says. On a cruise to Antarctica, he once had to treat a patient with a bowel obstruction when the nearest hospital was days away. In Norway, he jumped in to treat a woman with an undiagnosed ectopic pregnancy; the nearest airstrip was on a small island 10 hours away. The patient survived, was treated on the mainland and returned to the ship several days later.

With Lindblad, Lorber has traveled to about 40 countries on all seven continents, allowing him to indulge his passion for photography (check out some of his travel photos below that appeared in the latest issue of the school’s 12th & Marshall magazine).

Lorber continues his routine of learning new skills and keeping an eye out for his next adventure. “You can’t have a five-year plan,” he muses. “You’ve got to be open to new things.”

Still, he says, his career hasn’t been totally random. It’s been about being prepared to be in the right place at the right time. “I really do believe you make your own luck.”

His advice for medical students?

“It’s about relationship building. While you’re in practice, get on committees, get involved politically and get involved any way you can. You’ve got to develop people skills, public speaking skills and the ability to negotiate.

“And learn everything you can. You never know when it’ll come in handy or may spark your interest.”

Always open to opportunities, David Lorber, M’72, said ‘yes’ to National Geographic’s Lindblad Expeditions adventure cruise line. As a result, he’s traveled to about 40 countries on all seven continents. It’s allowed him to indulge his passion for photography, like this shot that was taken in Montenegro. Click the images below for expanded views.

By Lisa Crutchfield

12
2016

M4 Andrew Percy honored with scholarship carrying name of surgeon Jim Brooks

The Class of 2017's Andrew Percy (left) met Stephen Yang, M'84, H'94

The Class of 2017’s Andrew Percy (left) met Stephen Yang, M’84, H’94, at the Southern Thoracic Surgical Association annual meeting in November. Yang helped establish the James W. Brooks Medical Student Scholarship in memory of his mentor, and Percy is the latest recipient.

Ask Andrew Percy, M’17, the key to a successful future and he will sum it up in one word.

Mentorship.

“No matter what field you go into, it helps to have someone guiding you,” he said. “Mentors have always been a special part of my life.”

That bond continues today. Percy was one of two students in the country to receive the James W. Brooks Medical Student Scholarship, which enabled him to attend the Southern Thoracic Surgical Association (STSA) annual meeting in Naples, Florida, Nov. 9-12.

“I was very humbled to be associated with an award in Dr. Brooks’ memory,” Percy said. “He was an important mentor to a lot of people. That’s the spirit of this scholarship. It inspires me to become a better clinician, researcher and person.”

Jim Brooks, M’46, H’55, joined the MCV Campus in 1957 as a thoracic and vascular surgeon and trained hundreds of residents and students. Even after retiring from the operating room, he continued to go into work each day to teach and serve on the admissions committee, communicating his love for the school to all the applicants he met. Appointed emeritus professor of surgery in 2000, he was active on campus until his death in 2008. He was the 23rd president of the STSA.

Jim Brooks, M'46, H'55

Longtime faculty member Jim Brooks, M’46, H’55. Courtesy of Tompkins-McCaw Library’s Special Collections and Archives

“Dr. Brooks had this aura about him,” said Stephen Yang, M’84, H’94, who trained under Brooks and now holds the Arthur B. and Patricia B. Modell Endowed Chair of Thoracic Surgery at Johns Hopkins. “You just loved the man. One of the things that impressed me the most was how much time he spent with his patients. He touched so many lives.”

To honor his memory, Yang helped establish the STSA fund in 2010 that supports the Brooks Scholarship.

“How do you repay the past?” Yang asked. “You want to honor those who trained you, who mentored you.”

Even though Percy never met Brooks, stories about the surgeon still abound on the MCV Campus. Percy has heard enough of them to know he would have loved him, too.

“It sounds like he was a remarkable individual,” Percy said. “He had a great sense of humor.”

Brooks is warmly remembered for not only his compassion, but his quirks. He wore his scrub pants backwards; his glasses hung near the end of his nose; a white towel was draped around his neck; and a bar of Dove soap was always at the scrub sink.

The stories also emphasize how Brooks valued mentorship.
“That’s so important,” Percy said. “I know I wouldn’t be where I am today without mentors.”

Percy’s parents and later his high school cross country coach provided guidance early on. While studying biology and philosophy at Bates College in Maine, Percy spent his summers doing research for the chief of cardiothoracic surgery at Yale. The two have published several papers together since then, and they are currently working on a research project focused on redefining the size cutoff in which surgery is warranted for aortic aneurysms. Percy is also writing a book chapter on the medical management of aortic aneurysms.

After graduating in 2008, Percy worked in research for four years at Beth Israel Deaconess Medical Center at Harvard Medical School and earned a master’s in medical sciences from Boston University. He has also conducted research in oncology and urology.

“I’ve been fortunate to have been involved in very interesting research projects across different disciplines because of mentors I had who gave me generous opportunities that they were under no obligation to give,” Percy said.

He found that same spirit at the STSA meeting, where he got to know some of the country’s leading cardiac surgeons, including Joseph Coselli, M.D., chief of adult cardiac surgery at the Texas Heart Institute, and Andrea J. Carpenter, M.D., Ph.D., president of the STSA and director of cardiac surgery at the UT School of Medicine in San Antonio.

“They were all so generous with their time,” Percy said. “I want to emulate that and become a mentor to others. I want to make a positive impact. One way to do that is by reflecting on all the help that you received along the way and then paying it forward throughout your career. ”

Do you want to help pay it forward? Learn more about our 1838 Scholarship Campaign aimed at increasing the number and size of available scholarships for the School of Medicine.

By Janet Showalter

11
2016

Face time: The Class of 99’s Eduardo Rodriguez returns to campus to discuss his pioneering transplant surgery

In 2005, surgeons in France completed the world’s first partial face transplant on a woman who lost her lips, cheeks, chin and most of her nose after she was mauled by her dog.

Class of 99’s Eduardo D. Rodriguez, MD, DDS

In August 2015, the Class of 99’s Eduardo D. Rodriguez, M.D., D.D.S., the Helen L. Kimmel Professor of Reconstructive Plastic Surgery and chair of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone, led a team of more than 100 physicians, nurses, technical and support staff to complete the most extensive face transplant to date, and the first in New York State. PHOTO CREDIT: NYU Langone

Eleven years and many lessons later, face transplantation has moved from possibility to reality, with surgeons refining techniques and transforming the lives of patients once considered beyond hope.

Leading the way is Eduardo D. Rodriguez, M’99, considered one of the world’s leading surgeons in the field.

He returned to VCU’s MCV Campus this summer as the speaker of the annual S. Dawson Theogaraj Lecture. Rodriguez is the Helen L. Kimmel Professor of Reconstructive Plastic Surgery and chair of the Hansjörg Wyss Department of Plastic Surgery at New York University’s School of Medicine.

In August 2015, Rodriguez led a team at the NYU Langone Medical Center that completed the most extensive face transplant ever.

Patrick Hardison, a 41-year old fireman from Mississippi who had received horrific facial injuries received the face of cyclist David Rodebaugh. The operation received extensive media coverage and cemented Rodriguez’s reputation as a pioneer in the field.

He credits his time in VCU’s School of Medicine for a solid foundation in medicine. Rodriguez earned a D.D.S. degree from New York University in 1992, then completed his residency in oral and maxillofacial surgery at Montefiore Medical Center/Albert Einstein College of Medicine.

“There are oral surgery programs that have affiliations with a medical degree, and I had colleagues who recommended that this was something I should do. I applied to all the medical schools in the country that had a relationship with an oral surgery program.” He ended up at VCU, condensing his medical degree into two years. After that, he trained in the plastic surgery program at Johns Hopkins Hospital/University of Maryland Medical Center and completed a fellowship in Taiwan.

“I thought VCU was the best education I ever received,” he said in a telephone interview from New York. “Those were the most enriching educational years of my life. I became a very good student. Living in Richmond, a smaller town, allowed me to focus on education and gave me a very strong foundation to be successful.”

Class of 99’s Eduardo D. Rodriguez, MD, DDS

Eduardo D. Rodriguez, pictured with his face transplant patient Patrick Hardison at NYU Langone on Nov. 12, 2015. PHOTO CREDIT: NYU Langone

Rodriguez first became interested in the possibility of face transplants after hearing a lecture at Johns Hopkins about face transplants in rats. “My mentor at Johns Hopkins, the chief of plastic surgery, told me this is what I should be doing. I had no idea what that really meant, but I was fascinated by it.”

In March, 2012, Rodriguez led a team in what was one of the most extensive facial transplants ever, from hairline to the neck of a Virginia man who had suffered a gunshot wound. The 36-hour operation involved more than 100 health care providers along with meticulous planning and execution.

Rodriguez notes that such transplants include health and mental risks that must be weighed against the benefits. Recipients deal with the psychological battles of living with someone else’s face, as well as life-long reliance and side-effects of immunosuppressant medicines. As with other transplants, the body can reject a new face.

In such a developing field, he notes, there’s not yet a blueprint for success.

“Physicians and patients are on this journey together,” he says. “Once you’re successful and you see the patient doing well and you reflect on what we’ve achieved, and reflect on change in this individual’s life, you can’t help but be amazed by the complexity of the process.”

The Department of Defense and several research institutions, including NYU, have dedicated funding and resources to refining the procedure.

Rodriguez knows that the next decade will include improvements in transplantation and perhaps even some breakthroughs that seemed unimaginable in recent years.

“First, we have to keep working on trying to reduce the toxic effects of the [anti-rejection] medicines,” he says. He believes biomedical engineers will one day be able to create tissues specifically for patients needing transplants.

“It’s not just how many more transplants I can do, it’s how can we continue to improve the quality of face reconstruction and bring in different elements of science to provide these types of procedures safely, as well as improving the quality of these patients’ lives and shape a better future for these individuals.”

By Lisa Crutchfield