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School of Medicine discoveries

February 2017 Archives

09
2017

M4 Yeri Park presents on I2CRP success at national conference

The Class of 2017’s Yeri Park presents at the 2017 Society of Teachers of Family Medicine Conference on Medical Student Education.

The Class of 2017’s Yeri Park presents at the 2017 Society of Teachers of Family Medicine Conference on Medical Student Education, where she showed that I2CRP graduates are more likely to match to primary care specialties than their classmates.

By 2030, the U.S. could see a shortfall of as many as 43,100 primary care physicians, according to the latest research from the Association of American Medical Colleges. That’s not even taking into account the doctors who are already needed to treat patients in medically underserved areas. Meeting their needs would require additional doctors, bringing the shortfall closer to 100,000 physicians — with nearly three-quarters of those doctors needed in urban areas.

The VCU School of Medicine is doing its part to answer the call through the International/Inner City/Rural Preceptorship, 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.

New findings show I2CRP graduates are more likely to match to primary care specialties than their classmates — 79 percent compared to 44 percent. That’s according to research by the Class of 2017’s Yeri Park, who presented her findings at the 2017 Society of Teachers of Family Medicine Conference on Medical Student Education in Anaheim, California, in February. She was one of 20 students across the country chosen for a national scholarship award to attend the conference.

“From the time the program’s first participants graduated in 2000 to 2016, about 37 percent of I2CRP graduates entered family medicine compared to 10 percent for graduates across the medical school,” Park says. “In other primary care fields, 14 percent of I2CRP graduates went into pediatrics compared to 10 percent of all graduates and 4 percent compared to 2 percent for med/peds.”

The Class of 2017's Yeri Park, Nancy Pandhi, M’01, and Bethany Howlett, M’12

Park connects with I2CRP graduates Nancy Pandhi, M’01, and Bethany Howlett, M’12, at the STFM national conference.

For internal medicine, the program’s graduates are on par with the rest of the medical school with 18 percent of I2CRP graduates entering the field compared to 21 percent for graduates across the school.

The results pleased Mark Ryan, M’00, H’03, I2CRP medical director and assistant professor in the Department of Family Medicine and Population Health, who says the driving goal of the I2CRP program is to increase the number of students selecting primary care careers with a focus on underserved communities or underserved fields.

“We were really excited,” he says. “Yeri put in a great deal of resource-intensive work and to know that the program does seem to have a meaningful, valuable outcome is really rewarding.”

The research also showed that of the I2CRP graduates who have completed residency training, 30 percent are working in medically underserved areas and 23 percent are working in health professional shortage areas.

“That means one in four of our students who graduated in the program’s first 12 years is currently working in a medically underserved setting,” Ryan says. “We think that’s a robust number.”

Fighting the physician shortage

The dream of a career in medicine often comes with a heavy burden of debt that may influence future physicians who choose a specialty because of its earning potential and not because it’s a field they are passionate about.

Ryan says this is a defining factor for the shortage of primary care physicians. “Primary care doctors are paid 60 to 70 percent of an average specialist’s salary. Every year that salary separation grows, our family medicine matches slow; when it narrows, family medicine matches rise. It’s a near two-decade long trend.”

In the Class of 2016, only 47 students graduated debt-free. The rest carried an average debt of more than $180,000. Scholarships can help ease the burden for students such as Park, a recipient of multiple scholarships during her medical school career. Even so, the partial scholarships did not fully fund her tuition and fees.

“Financial hardship was always on my mind at the beginning of each school year,” Park says. “Knowing that I wanted to pursue primary care, this was a constant conversation between myself and my colleagues — whether I would still be happy with my choice still being in debt many years post-residency.”

The medical school launched the 1838 Campaign with the goal of providing meaningful scholarship support for students with financial need. The $25-million campaign will build the medical school’s scholarship endowment into a resource on par with peer schools.

Full and half-tuition scholarships are most urgently needed. They are one of the medical school’s best resources for recruiting and rewarding top students.

If medical schools nationwide put up similar numbers, he points out, a workforce shortage in underserved areas likely wouldn’t exist.

As I2CRP enters its 20th year, program director Mary Lee Magee says next steps include working to understand physicians’ long-term investment in primary care. “We know our graduates are out there carrying forward their vision to make a difference,” she says. “We’d like to know more about what makes it possible to sustain this important and challenging work for the long run.”

Park connected with two I2CRP graduates at the STFM national conference: Bethany Howlett, M’12, and Nancy Pandhi, M’01. “They reminisced about their time in the I2CRP program and how it was helpful for them to spend time with like-minded peers throughout the tough journey of medical school,” Park says.

Both alumni enjoy family medicine careers in Madison, Wisconsin. Howlett practices family medicine at UnityPoint Health – Meriter, while Pandhi works as a researcher and assistant professor at the University of Wisconsin’s Department of Family Medicine and Community Health. She researches ambulatory care redesign for vulnerable populations in addition to practicing at the William T. Evjue Clinic of Access Community Health Centers.

Park is eager to follow in their footsteps. Enrolled in fmSTAT, the medical school’s four-year program designed to nurture and sustain students committed to careers in family medicine, Park recently learned she will complete family medicine residency training at Greater Lawrence Family Health Center in Massachusetts.

An aspiring doctor since she was a young girl, Park says the conference motivated her to encourage the next generation of family medicine physicians. “As someone who has highly benefited from the support and guidance from my faculty mentors, I’m looking forward to sharing my love for family medicine with future students.”

By Polly Roberts
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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