Jump to content
Placeholder image for header
School of Medicine discoveries

May 2015 Archives

29
2015

Dozen with ties to medical school played roles at ACP’s Internal Medicine 2015 meeting

The American College of Physicians is the second-largest physician group in the United States. Its annual meeting, also its centennial celebration, was held April 30 – May 2, 2015, in Boston, Mass. From behind the scenes to center stage, a dozen with ties to the medical school played roles at the meeting.

Fisher,John-M69

John F. Fisher, M’69, H’77

John F. Fisher, M’69, H’77, received the Jane F. Desforges Distinguished Teacher Award at the American College of Physicians’ national meeting in Boston, Mass., on April 30, 2015.

A professor emeritus of Georgia Regents University, Fisher’s academic career spans 38 years. The ACP honor is that latest of nearly five dozen teaching awards, including the Clinical Teacher Award from the Infectious Diseases Society of America, the ACP Georgia Chapter’s J. Willis Hurst Teaching Award and two dozen Educator of the Year awards from Georgia Regents University.

During residency training at VCU, he was given the William Harrison Higgins Award. As an infectious disease fellow, he received the Best Fellow Award two years in succession. Following his training, Fisher joined the faculty of the Medical College of Georgia (now Georgia Regents University), where he was professor of medicine and program director for the Infectious Disease Fellowship. He also served as chief of the Division of Infectious Diseases at the VA Medical Center in Augusta, Ga.

Fisher has served on the education committees for both the IDSA and the National Foundation for Infectious Diseases. He has 101 publications including 57 articles in refereed journals and 44 book chapters. At the ACP annual meeting, he was advanced from Fellow of the American College of Physicians to Master of the American College of Physicians.

Wenzel_Richard

Richard “Dick” P. Wenzel, M.D.

Richard “Dick” P. Wenzel, M.D., was the Massachusetts Chapter Lecturer at the ACP meeting. An emeritus professor and former chairman of the Department of Internal Medicine, Wenzel has been long been involved with the ACP and has frequently presented at the annual meeting, keeping physicians up to date with the latest information on topics in internal medicine and infectious disease. His topic at Internal Medicine 2015 was evidence-based physical diagnosis.

In 1988, the Massachusetts Chapter Award Lectureship was established to honor a distinguished Massachusetts internist and to honor an outstanding member of the annual meeting faculty. Today, the recipient of the award is selected by the chair of the Internal Medicine Scientific Program Planning Committee.

Robert Centor

Robert M. Centor, M’75

Robert M. Centor, M’75, concluded his one-year term as chair of the ACP Board of Regents at the annual meeting. The Board of Regents is the main policy-making body of the College.

A member of ACP since 1978, Centor was named a Fellow of ACP in 1985 and became a Master of ACP on October 1, 2014. He has served on the Board of Regents since 2008 and also on many of ACP’s committees, including the Membership Committee, Finance Committee, Strategic Planning Committee and the Health and Public Policy Committee, which he chaired from 2009-2011. Centor was awarded the Laureate Award for outstanding service to medicine and ACP from the Alabama Chapter of ACP in 2009.

He is currently professor of medicine and regional dean of the University of Alabama at Birmingham, Huntsville Regional Medical Campus. He was on the internal medicine faculty on VCU’s Medical College of Virginia Campus until 1993.

Ellis,Lisa-M01-H04

Lisa L. Ellis, M’01, H’04

Lisa L. Ellis, M’01, H’04, chaired the Scientific Program Committee that created a mix of small group sessions, classic lectures and hands-on activities for the annual meeting. Faculty presented new findings in internal medicine and its subspecialties, presented new approaches in practice management and discussed issues related to health care policy as well as lead sessions to hone leadership and teaching skills.

“When I attend each year, I bring back new ideas for managing patients as well as techniques for enhancing my own leadership style,” says Ellis who as the ACP Governor for Virginia represents the state on the ACP’s national Board of Governors. In that role, she helps implement national projects and initiatives at the chapter level and represents member concerns at the national level. Ellis also is on the Board of Governors’ executive committee, which advises the Board of Regents.

Ellis currently is the chief medical officer for the Medical College of Virginia Physicians at VCU and has an appointment as an associate professor in internal medicine and OB-GYN.

A student and young alumnus have taken leadership roles in the organization:

Khan,Ali-M09-Headshot-IAS-1

Ali M. Khan, M’09

Ali M. Khan, M’09, is chair of the ACP’s National Council of Resident/Fellow Members that represents the interests of over 22,000 residents and fellows-in-training. He’s been on the 11-member council since his intern year at Yale and has helped lead ACP’s High Value Care initiative that educates and engages physicians as well as resident and fellow members in how to practice in a value-sensitive, thoughtful manner for resource stewardship and patient engagement.

At the ACP’s annual meeting, he co-hosted the council’s marquee event, a TED talk-style national forum for promising innovations and bright ideas for teaching high-value care. Moderated by author Sandeep Jauhar, M.D., and the New York Times’ Lisa Sanders, M.D., the event showcased winners from the second annual Teaching Value and Choosing Wisely Challenge sponsored by the ABIM Foundation and the national non-profit Costs of Care.

“We’ve read articles, attended lectures and held forums making the case for value-based care delivery,” Khan says. “Now, however, those words are being bolstered by action – on the ground, at institutions all across the country, led by talented health professionals with the creativity and drive to effect the collective change we seek. Award Winning Innovations isn’t about making the theoretical case for value – it’s about sharing the best work being done nationally to make that case a reality.”

Cockburn,Chelsea-MD-PhD-student

MD-PhD student Chelsea Cockburn

MD-PhD student Chelsea Cockburn began her four-year term as a representative on the National Council of Student Members in April 2015. Council members organize programming for medical students at the national ACP conference every year, and Cockburn attended the annual meeting in Boston where she was looking forward to meeting the rest of the council members as well as internal medicine physicians.

As a member of the student council, Cockburn is assigned a region of medical schools in the U.S. and will help advise the internal medicine interest groups at those schools to strengthen activities at the chapter level. She’s also been selected to represent the council on the ACP Education and Publication Committee that provides scientific and professional information to physicians, trainees and patients.

ACP-meeting

ACP attendees with ties to the medical school reunited during the Internal Medicine 2015 meeting. Each year, the Department of Internal Medicine hosts a reception. This year it was held at Boston’s Atlantic Beer Garden overlooking the harbor.

A number of faculty from the Department of Internal Medicine presented at Internal Medicine 2015:

  • Stephanie A. Call, M.D., MSPH, professor in the Division of General Medicine and Primary Care.
  • Alan W. Dow III, M.D., associate professor in the Division of General Medicine and Primary Care.
  • Mary H. Hackney, M.D., associate professor in the Division of Hematology/Oncology.
  • Puneet Puri, M.D., assistant professor in the Division of Gastroenterology.
  • George W. Vetrovec, M.D., professor in the Division of Cardiology.

Others were honored at the meeting:

  • Wendy Klein, M.D., associate professor emerita, was awarded the designation of ACP master and was recognized as the Virginia ACP chapter’s 2015 Laureate winner. Klein was co-founder of the VCU Institute for Women’s Health and was the department’s first program director for an innovative residency in Women’s Health.
  • Curtis N. Sessler M.D., the Orhan Muren Distinguished Professor of Medicine, and professor in the Division of Pulmonary Disease, was named an ACP fellow.
  • John R. Strunk, M.D., assistant professor in the Division of General Medicine, was named an ACP fellow.
  • Darren Witte, M.D., in General Medicine and Pediatrics, was named an ACP fellow.
20
2015

Internal Medicine’s Cultural Competency Program: “Bring Back the Humanism”

Krista Edelman

Krista Edelman, M’11

A patient doesn’t fill his prescriptions. Another doesn’t exercise, worsening chronic conditions. Still another is always late to appointments.

It’s frustrating for physicians, and easy to assume these patients just don’t care. But there are other sides to these stories, and an innovative program is helping interns find them.

“When there’s a disconnect between providers and patients, we sometimes don’t realize the issues that are affecting patients so they cannot adhere to a treatment plan,” said Bennett Lee, M’94, ambulatory clerkship director and associate professor in the Department of Internal Medicine. “We were thinking about how to really engage the interns with their patients and make sure they understand what a privilege it is to take care of them.”

Chief Resident Krista Edelman, M’11, along with Lee and Stephanie Call, M.D., M.S.P.H., associate chair for education in the Department of Internal Medicine, developed a cultural competency program, a four-week rotation designed to help the department’s interns:

  • Discover social and physical environments affecting health.
  • Reflect on how a better understanding of health is affected by the conditions in which patients are born, live, work and age.
  • Communicate and share these experiences.
Residents must learn sensitivity and responsiveness to a diverse patient population, including but not limited to diversity in gender, age, culture, race, religion, disabilities, and sexual orientation.
– ACGME


The program began in 2014, and about 30 interns have completed it so far. “The experience has been eye-opening,” said Edelman.

The interns are encouraged to go beyond standard medical examination questions to try to understand patients’ lives. They ask about family dynamics, income and whether or not they have convenient ways to obtain healthy food and necessary medicines.

They then go out into the community, sometimes using public transportation, and explore the neighborhoods where their patients live. Edelman prompts them to look around and see:

  • Are there signs of disrepair (broken windows, graffiti, overgrown grass)?
  • Are there parks or recreational areas in the neighborhood?
  • What supermarkets are available and do they carry affordable fresh produce, meat and other healthy food?
  • Are there functioning street lights or a sidewalk?
  • Where is the closest bus stop?

What they’re finding is changing the way they practice medicine and view patients, said Edelman. “They’ve taken photos of the food available, which might be something like a packet of bologna and potato chips, maybe an onion. It’s a revelation for these physicians, who wonder why patients aren’t eating more fruits and vegetables.

“Seeing the neighborhoods where the patients live, they come back and say, ‘I don’t think I would feel comfortable walking there alone either, let alone a 60-year old female patient.”

Interns might discover that a patient has to travel several miles in a wheelchair to get a prescription filled, or is too frightened to go out or maybe has to depend on three city buses to get to a physician’s appointment.

“In medical school, people are so keyed in to the science of how to take care of folks that sometimes they lose track of the idea that this is a person,” said Lee. “You need to ask, ‘how do I communicate with them? How do I understand?’”

Watch a digital story

Mrs. Hope
by Christina “Nina” Vitto, M.D., resident in the Emergency Medicine-Internal Medicine combined residency program

The culmination of the cultural competency program is creating a reflection piece on the experience, usually a digital video on a subject or patient who affected interns deeply.

Edelman believes this reflection will make them better, more compassionate physicians.  She’s also heartened by recent updates to the MCAT exam that tests prospective medical students.  In 2015, the exam was expanded to include a section on behavioral and socio-cultural factors.

“My parents are social workers, and I’ve always had a passion for the service in medicine,” she said. “It’s easy to get so jaded when you’re working long hours and patients come in who are obviously neglecting their health.

“But that’s not acceptable for physicians. I want to bring back the humanism.”

By Lisa Crutchfield

19
2015

Two GI fellows victorious in debate at national conference

Pritesh Mutha

Gastroenterology fellow Pritesh Mutha

The competition went down to the wire, with both the VCU team and the Johns Hopkins team relying on their preparation to perform under pressure. In the end, VCU came out with a decisive win on a national stage. No, this wasn’t a basketball game — it was a debate at the Digestive Disease Week conference between gastroenterology fellows from the two schools.

The School of Medicine was represented by senior GI fellows Vaishali Patel, M.D., and Pritesh Mutha, M.D. They were coached by their mentor, Puneet Puri, M.D., who is an assistant professor in the Division of Gastroenterology, Hepatology and Nutrition. They faced off against a duo from Johns Hopkins to debate whether patients with acute alcoholic hepatitis should be denied liver transplantation outright. The two teams sparred through three rounds of competition, with Patel and Mutha eventually convincing the judges of the wisdom of their position: that transplantations in such circumstances should not be denied.

More than 14,500 researchers, physicians and academics assembled for the Digestive Disease Week conference in Washington, D.C., this May. It’s the largest gathering of professionals in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery, and there’s no shortage of reasons to attend. “The conference is a tremendous platform to learn about the newest research, see cutting edge technology and network with leaders in the field,” said Mutha.

Vaishali Patel

Gastroenterology fellow Vaishali Patel

The size of the conference, and the qualifications of its attendees, made their debate win all the sweeter.

“Being able to participate, perform and win on a big, international stage was a huge boost of confidence,” Mutha explained, “but we also learned about critically analyzing research papers and about the difficult process of making decisions and arguments on sensitive topics.”

The debate hinged on Mutha and Patel’s ability to synthesize information from a large body of work and use that knowledge to respond to challenges and questions from the other team on the fly – all while on stage in front of colleagues, friends and leaders in the field.

The debate was organized by the American Association for the Study of Liver Disease as a pilot program designed to test the skills of GI fellows at top medical schools. The group hoped that the debate would propel fellows to further their research on a relevant topic while honing communication skills in pressure situations. The competition also featured a debate between fellows from the University of Virginia and the University of Maryland.

By Jack Carmichael

16
2015

The Art of Reconstruction

Taking advantage of today’s emphasis on active learning, Jennifer Rhodes, M.D, director of VCU’s Center for Craniofacial Care, partnered with a local sculptor, creating a pilot program of art workshops to enhance the plastic surgery residents’ experience.

“We are trying to foster the residents’ imagination, to encourage creativity,” said Rhodes. “Learning about aesthetics of the human body through sculpture is ideal for plastic surgery residents. In sculpting, we can talk about the things we used to talk about in lecture: proportions in face, different features in face, concept of lighting and how it changes your perception of proportion…all things they must understand when they are doing a surgical procedure that affects the aesthetics of the face.

“I think it clicks much better in the residents’ minds when they learn these concepts during a hands-on approach in the artist’s studio rather than on the black board. I have never had the same kind of enthusiasm from them for a lecture.”

“Oh, we do enjoy a good lecture,” said Collier Pace, M’11, a fourth year plastic surgery resident. “But especially for us as surgical types, the hands-on stuff is what we remember and get excited about. Most of us are tactile learners.”

To reach those tactile learners, Rhodes works with VCU sculpture department alumna Morgan Yacoe to design programs that allow residents to learn sculptural techniques and see how they relate to surgery – allowing them to test out aspects of their skill set before they apply them in the operating room.

For example, Yacoe developed a workshop for residents to practice flap design, for which she created replicas of a face with silicone skin and underlying foam.

“They could practice local tissue rearrangement and then suturing to learn about how best to reconstruct different types of skin cancer defects,” said Yacoe. “I tested different silicones to get the elasticity right. They got to practice tool handling, cutting, suturing, rotating the skin and other aspects of flap design and execution before they cut a real patient.”

The lesson was invaluable. “The next time I do this flap, I will have vision in my mind of how I want it,” said Pace. “These are helpful, subtle points that are hard to learn outside the operating room.”

Other workshops have included sculpting clay busts and anatomical drawing. The skills they learn teach residents that healing the body is art as well as science.

“Historically, plastic surgeons had set numbers for things – this is normal range for how thick lips should be or how much eyelid you should see or how far apart the eyes should be,” said Rhodes. “Now, our sensibilities are evolving and in resident education, we stress getting away from the numbers and into developing residents’ own ways of looking at the face, understanding balance and harmony, and understanding what features would be appropriate for a particular individual.”

Mixing up the learning environment by going outside the hospital has another benefit. “Residents can get burned out,” Rhodes said, “and that affects not only their ability to learn, but their empathy towards patients, their outlook on life, their health and their perception of their career path and what they want to do.

“I think transforming a lesson into an experience that they might not have sought on their own and outside their comfort zone is a way to help not only learning but to keep them inspired, foster creative thinking, and enhance their connection to their chosen field.”

By Lisa Crutchfield

16
2015

Acting Up

Physicians Learn New Skills in the Theater

Catherine Grossman, M.D., H’06, doesn’t expect any of the residents she supervises to ever pursue a career on stage, as entertaining as they may be. But she does see the value in learning theatrical improvisation skills. This year she incorporated an improv workshop into residency training.

Medicine, like theater, she believes, is an art as well as a skill, and improvisation enables residents to use different parts of the brain and approach ideas through a new lens.

“The millennial learner needs to be actively engaged and this is one way we engage them,” she said.

Grossman, associate professor of internal medicine, is not the first to see the parallel between art and science. Medical improv is an emerging field designed to improve cognition, communication and teamwork in medical settings. Actor Alan Alda was recently honored by Stony Brook University for helping to establish a center using improvisation techniques to aid in communicating scientific information.

Tips from a Pro

To get the most from improv, performer and teacher Townsend Hart says you should:

  • Leave your ego at the door.
  • Be open to feedback.
  • Ask for help.

Grossman was introduced to improvisation during a medical simulation course at Harvard and recognized its value as a teaching tool. After an introductory class, she signed up for more.

“It was really neat looking at how the skills transferred back and forth. It made me think about how I teach, how I am at adapting rapidly, being in the moment and responding.”

When she returned to Richmond, Grossman contacted the Richmond Comedy Coalition.

“Improv can be very funny, but it’s more than making jokes on stage,” said Matt Newman, the Coalition’s managing director.  “You really need to listen and respond to your scene partner with openness, honesty and empathy. It helps you become a more thoughtful and responsive communicator.”

Grant Farr, D.O., a chief resident in internal medicine who participated in the workshop, agreed. “Improv can help you express yourself so people will listen,” he said. Besides being fun, he added, it also helped loosen up the Type A personalities in his class.

Grossman, who was honored last fall for her innovative approach to education with the medical school’s Irby-James Award for Excellence in Clinical Teaching, notes that improv also is used in the school’s simulation center, where actors portray patients and physicians-in-training are required to react quickly.

Grossman has found her improv skills handy in many areas. “In improv, like real life, you have no idea how someone is going to respond.

“We’re always looking for ways to apply techniques from other fields into the way we teach. It’s interesting for me to work through different problems with different approaches. We’re walking down different pathways to be better at what we do.”

 By Lisa Crutchfield

16
2015

“They are here because they have heart”

Capstone projects open doors to helping the medically underserved

Jeremy Powers, M’14, was driven by one thing and one thing only when he entered medical school in 2010. Like many of his classmates, his main mission in life was, and continues to be, helping people.

Especially the underserved.

“I feel drawn to helping those people from an underserved area,” he said.
So when he began considering his options for medical school, he immediately was drawn to the MCV Campus, in large part because of the school’s International/Inner City/Rural Preceptorship (I2CRP) Program.

All medical students can apply to the four-year program. It fosters the knowledge, skills and values needed by doctors to provide quality and compassionate care to the less fortunate.

A major focus of the program comes during the final year, when students complete a community-based capstone project. Each project has the potential to help communities – local, elsewhere in the U.S. or overseas – by addressing critical medical needs. It gives students the opportunity to serve patients before they even graduate from medical school.
“I feel very proud to have been part of this,” said Powers, who traveled to Cameroon to complete his capstone project. “It provided me with a way to focus on the things that drew me to medicine in the first place.”

Other schools across the country have programs similar to I2CRP, but VCU’s offering is unique in that it runs for four years, allowing classmates to remain together as they share life-changing experiences.

“The nature of the training is invaluable,” said Mark Ryan, M’00, H’03, medical director of I2CRP.

Ryan was one of just two students to be part of I2CRP’s first graduating class in 2000. At that time, the program focused on inner-city and rural communities. The international element was added in 2007.

“It started small as a test program,” said Ryan, assistant professor for the Department of Family Medicine and Population Health. “Now, it is getting increasingly competitive. The quality of students who are not accepted is remarkable. It’s really hard to make that final cut.”

This year, 69 students applied for 24 spots.

“There is more and more interest each year,” said Ryan, who leads the program alongside assistant professor Mary Lee Magee, M.S., who serves as I2CRP’s educational director. “My sense is there is a generational component to it,” Ryan said. “There is a generational movement to serving others.”

I2CRP students participate in community volunteer activities, monthly journal club meetings and annual elective courses designed to foster a deeper understanding of underserved populations. Students also complete semester-long rotations in underserved settings during their first- and second-years.

By their third year, students spend a total of 10 weeks in underserved communities during rotations in family medicine, general internal medicine, pediatrics and general surgery.
“These students are not just in the program because they have great credentials,” Ryan said. “They are here because they have heart.”

Ryan himself was attracted to the idea of helping the underserved after spending a weekend on the Eastern Shore during his undergraduate studies at William & Mary.

“Driving around rural Virginia, I began recognizing the barriers people there had to accessing health care,” he said. “There was a level of need that was compelling to me.”
Most I2CRP students come into the program with a long list of volunteer hours already logged. Many have completed mission trips overseas, spent weekends in this country at rural clinics or traveled with church members during summer vacation to provide health care to the poor and homeless.

“There’s a different level of visibility today on the part of students in terms of the roles they can play,” Ryan said. “There is so much more awareness. They know they can do meaningful things. They want to step in and do their part.”

Take a look at four recent capstone projects that are bringing change to underserved communities locally and around the world.

Capstone project shapes life’s direction – Jeremy Powers, M’14

Interpreting what’s best for patients – Scott Toney, M’15

Alerting Latinos and other minorities to skin cancer risk – Ashley McWilliams, M’15

Breaking down the barriers to good health – The Class of 2015’s Gordon Pace, Heather Root and Lauren Clifford

Capstone project shapes life’s direction

Jeremy Powers, M’14

Jeremy Powers, M’14, traveled to Cameroon last year to find out if general surgery residents there could provide better care to patients if they had training in plastic surgery. The answer? A resounding yes.

“What walks through the door there is what they have to deal with, whether they have the training or not,” Powers said. “They see a lot, and a lot goes untreated because the expertise is not there.”

Patients may present with burns, soft tissue cancer, facial deformities, open wounds or other injuries that could benefit from plastic surgery but don’t, because the few surgeons who do practice in Cameroon don’t have the needed training.

“There are huge social and self-esteem issues associated with these types of cases,” Powers said. “Plastic surgery can often restore form and function, providing patients with a better quality of life.”

Medical care is hard to come by in Cameroon, where the doctor-to-patient ratio is about 1 to 15,000. Plastic surgeons are even more scarce.

That’s why Powers developed a survey and met with eight general surgery residents as part of his project. Because of the types of injuries these surgeons see and because specialists in plastic surgery are rarely available, all agreed more training would benefit patients.

“They want as much training as they can get, not just in plastic surgery, but in other areas as well, from experts in the field,” Powers said. “Medical aid is no longer simply about providing services to the underserved. In fact, if we just did that we may be doing a disservice to these communities, perpetuating a sense of dependency. We now have the opportunity to equip and train the brilliant and talented people who are already there with a heart to serve their own people.”

Powers graduated from William & Mary in 2009 and taught high school calculus, European history, physics and trigonometry before entering medical school to “make a positive difference in the world.” He remains at VCU as a resident in plastic and reconstructive surgery, and plans to one day practice and teach in underserved communities.
“My motivation comes from my faith, as Jesus teaches us to serve the poor,” Powers said. “I2CRP has taught me so much. I know that what I’ve learned will continue to serve my patients throughout my entire career.”

Interpreting what’s best for patients

Scott Toney, M’15

Scott Toney, M’15, will never forget the frightened teenager who had been rushed into the emergency room. Doctors tried to explain the injuries he had suffered when he fell off the roof, but they weren’t sure he understood the fact that surgery would be necessary to stop the internal bleeding.

“He did not speak English,” said Toney, who was on surgical rotation that day during his third year of medical school. “It became apparent that he did not fully understand the gravity of his injuries.”

With the memory of that experience still vividly in place, Toney examined interpretation services in the inpatient setting as part of his capstone project. He wanted to know if the type of interpretation method affects patient and provider satisfaction and if certain interpretation methods are more appropriate in certain clinical scenarios.

“I want the patients at VCU who are not English speaking to receive the best possible care,” he said. “We have interpretation services available, and by law we must provide them. But which method is best?”

The VCU Medical Center averages five to 20 Spanish-speaking patients on any given day. Health care providers can call on live interpreters to visit patients and translate for them or use technology assisted interpretation that are phone or web based.

“With the live interpreters, patients build a trust,” said Toney, who is headed to the Naval hospital in San Diego to begin his residency in pediatrics. “But as society becomes more tech savvy, patients are growing more comfortable with that as well.”

Toney, who grew up in Atlanta, has an undergraduate degree in health science from James Madison University. He is no stranger to visiting the underserved, having taken 10 mission trips to such places as Mexico, Peru, Ecuador, El Salvador and the Dominican Republic.

“To see other places in the world that don’t have the freedoms and the resources we have here is incredibly humbling,” he said. “It has motivated me to treat everyone with the utmost respect. I’ve come to realize that everyone has the same wants and desires. Everyone wants to be healthy.”

Alerting Latinos and other minorities to skin cancer risk

Ashley McWilliams, M’15

“There are misconceptions out there that people with darker skin won’t get skin cancer,” said Ashley McWilliams, M’15. “That simply is not true.”

As part of her capstone project, McWilliams made it her mission to raise awareness.
“As the population of Latinos continues to increase, we need to target that population or there will be an increase in skin cancer cases,” she said. “We must get in front of the problem.”

According to the Skin Cancer Foundation, skin cancer rates among Hispanics rose by almost 20 percent in the United States in the last two decades. And since Hispanics are the fastest-growing population in the U.S., McWilliams cautions, the number diagnosed will only continue to rise.

To increase awareness, McWilliams surveyed minority patients at a local clinic to assess their knowledge and perceptions of melanoma, including risk factors associated with this form of cancer, their ability to recognize the early stages of melanoma and their willingness to have a suspicious spot examined by a physician.

“When melanoma presents in minorities, it presents differently,” McWilliams said. “For Caucasians, it presents on the face, neck and chest. For persons of color, it usually presents on the palms and soles of the feet as well as underneath fingernails or toenails. And the outcome is not as good in these groups compared to Caucasians.”

Her project not only helped educate minorities about skin cancer, but it also gave physicians a better understanding of their patients’ points of view. Because some patients feel they are not at risk, for example, they don’t think it is necessary to talk with doctors about a change in their skin’s appearance, chalking it up instead to aging or some other factor. Physicians, therefore, should discuss the risks and the warning signs.

“It was really a quality improvement study,” said McWilliams, who is headed into her surgery intern year at the VCU Medical Center. “The more knowledge patients and providers have, the better our quality of care.”

McWilliams, who grew up in Pensacola, Fla., received her undergraduate degree in biology from Howard University in 2008. She worked in research and health policy for a few years before entering medical school.

“I wanted to interact more with patients and help educate them in the healthiest ways to live their lives,” she said.

Her interest in dermatology dates to her middle school days.

“My science fair project examined which brand of sunscreen or tanning oil provided the best protection from the sun,” she said. “Of course we all know now that tanning oil doesn’t provide any protection at all, but the project demonstrated to me how the lack of proper protection from UV rays can cause lots of damage to your skin and over time can increase your chances of developing skin cancer.”

It also opened her eyes to the importance of skin cancer prevention. “The odds might not be as high that a person of color will get skin cancer,” she said. “But if we can educate and in the process save one life, that’s the most important thing.”

Breaking down the barriers to good health

I2CRP students with family medicine residents at the health center in lIma

The challenges of caring for the underserved are many. Communication. Transportation. Trust. Physicians can’t always get a clear picture of what’s going on in the lives of their patients.

To help sharpen the view in one underserved area, the Class of 2015’s Heather Root, Lauren Clifford and Gordon Pace traveled to Lima, Peru for 10 days to uncover the roadblocks many face to achieving good health.

“When physicians get to know the whole patient, they can provide a higher quality of care,” said Root, who’ll begin her internal medicine residency at Emory this summer. “I welcome that challenge.”

The group teamed with the family medicine residents on site to survey local neighborhoods. They went door to door, asking family members about their backgrounds, daily diets, lifestyles, family medical histories, neighborhood crime and more.

“What was nice was how closely we got to work with the medical residents,” Pace said. “They welcomed us right in.”

The group visited more than 100 homes during their stay. They plan to analyze the information they gathered to see if correlations can be made between a person’s home life and their health care.

“We’ll look at those who have been vaccinated, for example, and those who haven’t and cross-reference that with those who have insurance and those who don’t,” Clifford said.
They will share their findings with the medical staff they worked with. They hope this study will be the first of many.

“What excites me is the idea of a cross-cultural partnership,” Pace said. “This was such an exceptional experience, I would love to see it continue.”

Traveling out of the country is nothing new for Pace, Clifford and Root. All three had experience working in Central America as part of the I2CRP and HOMBRE (Honduras Outreach Medical Brigada Relief Effort) programs. They also have done mission work on their own.

“While volunteering in rural clinics, I’ve seen the sickest of the sick and the poorest of the poor,” said Clifford, who has an undergraduate degree in art history from William & Mary. “I’m always shocked by how the people most in need are the ones who aren’t getting it. That has spurred me to do what I can to serve.”

Clifford, who is set to begin her pediatrics residency at the Medical University of South Carolina, is following in her father’s footsteps by becoming a doctor. She counts her experience with the I2CRP program as one of the most important of her life.

“I feel like this is something every single physician should be exposed to,” she said. “It has been a true privilege.”

Pace, who earned his undergraduate degree in history from Mississippi State University in 2003, took a few years off after school to volunteer in Belfast, Northern Ireland, where he worked with inner city youth. He also spent time in Arizona working with immigrants. He is headed to Yale New Haven Hospital for a residency in internal medicine.

“It’s interesting to go to different metropolitan areas around the world and compare nutrition and other cultural elements,” he said. “When we were in Peru, one minute we were surveying the poorest residents, and then within walking distance we saw upscale homes.”

No matter the location, people want the same thing – good health.

“The challenge is giving them a clear path to achieving it,” said Root, who has a math degree from Emory University. “When we understand the whole patient and the challenges they face at home, good health care can become more attainable.”
Her trip to Peru reaffirmed that belief.

“Some people may shy away from helping the underserved,” she said. “It can sometimes be complex and frustrating. But I believe that it doesn’t get any better than giving help to those who need it most.”

By Janet Showalter