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03
2017

Alumni star M’99 Eduardo Rodriguez inspires the next generation

It was front-page news out of NYU Langone Health in August 2015. In a 26-hour operation, the face of a 26-year-old bike mechanic who was declared brain-dead after a cycling crash was transplanted onto a 41-year-old former firefighter who was severely burned in the line of duty.

Eduardo D. Rodriguez, M'99 (center) with the Class of 2019's Diana Otoya and the Class of 2020's Frank Soto at the 2017 Alumni Stars Ceremony.

Eduardo D. Rodriguez, M’99 (center) with the Class of 2019’s Diana Otoya and the Class of 2020’s Frank Soto at the 2017 Alumni Stars Ceremony. Photo credit: Jay Paul.

Leading the team that performed the most extensive facial transplant ever was M’99 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. The painstakingly delicate surgery was a resounding success.

Becoming a leader in facial transplantation, Rodriguez says, wasn’t an anticipated career goal.

“However, I’ve always had an interest in finding solutions to difficult problems, and this pursuit has led me to the position in which I currently reside,” he says.

Rodriguez recently returned to Richmond to be honored at the 2017 Alumni Stars ceremony, a biennial event that celebrates alumni from across the university’s academic units for their extraordinary personal and professional achievements. During the event, Rodriguez met the Class of 2019’s Diana Otoya, who says she was encouraged by Rodriguez’s non-traditional path to medical school.

“I confessed to him I didn’t really know what I wanted to do yet,” Otoya says. “He made me feel comforted by his own story about starting in dentistry before even thinking about medical school. He gave me reassurance that there is no path that is set in stone and that our careers are fluid.”

Rodriguez and his team at NYU Langone are planning for future reconstructive procedures while expanding the face transplant program’s clinical, research and education/training efforts.

“Clinical efforts will focus on patient selection and achieving the most optimal aesthetic and functional results,” he says. “Research efforts are focused on improving immune surveillance and designing patient-specific targeted immune therapies to lessen drug toxicity without increasing risk of transplant rejection.”

Peter F. Buckley, M.D., dean of the VCU School of Medicine, praised Rodriguez’s work. “He brings hope to patients in the most difficult of circumstances and I have no doubt he will continue to transform countless lives,” Buckley says. “I’m proud to see him receive this alumni honor and grateful we can call him one of our own.”

Rodriguez, the son of Cuban immigrants, was born and raised in Miami. His road to VCU began with undergraduate education at the University of Florida followed by a dental degree from NYU College of Dentistry. He completed a residency in oral and maxillofacial surgery at Montefiore Medical Center/Albert Einstein College of Medicine before enrolling at VCU, where he earned his medical degree in 1999.

“I was fortunate to have been part of a newly designed education curriculum there and certainly received the best medical education at VCU,” he says.

In addition to pioneering clinical achievements, Rodriguez has written more than 130 articles and 21 book chapters. He is a member of numerous national and international professional societies, and he was the Dawson Theogaraj visiting professor in plastic surgery on VCU’s MCV Campus in 2016.

Rodriguez is quick to share credit for his accomplishments and accolades.

“I am lucky to have been mentored by remarkable individuals, and along the way, I have worked hard but have enjoyed every moment,” he says. “I have learned from the most challenging moments, and that is why one must always look forward and never give up.”

By Polly Roberts

16
2017

Answering the call of the underserved

Could scholarships and targeted preceptorships address the physician shortage?

“Go where the need is.”

This story first appeared in the fall 2017 issue of the medical school’s alumni magazine, 12th & Marshall. You can flip through the whole issue online.

Katherine Mullins, M’07 (right), with one of her students in Memphis, Tennessee, where Mullins provides care to inner-city underserved patients.

That’s the motto of Katherine Mullins, M’07, and what led her to Memphis, Tennessee, a city where she says, “the need is all around me.” Mullins arrived in Memphis post-residency to provide primary care to inner-city, underserved patients who otherwise wouldn’t have access to medical services. Patients like “Mama Amina,” a Somalian refugee whose first time in an American doctor’s office was at the clinic where Mullins worked. Over the next six months, Mullins diagnosed her with a foot deformity, thyroid cancer and heart failure.

It’s the kind of work that Mullins, a self-described “relationship-driven” physician, feels called to do. And thanks to the full-tuition scholarship she received while in medical school, she can make caring for Memphis’ neediest patients her top priority without worrying about repaying student debt.

“It has been an incredible factor in my life,” says Mullins, who held the Harry and Harriet Grandis Scholarship for four years.

Privately endowed and housed at the MCV Foundation, the Grandis Scholarship Fund was the medical school’s first full-tuition scholarship. Mullins says the scholarship allowed her to take a position that paid “significantly less” than other career paths.

“Many of my colleagues have had to make decisions based on salary,” Mullins says. “I was free to make choices based on what was the right decision for myself to follow a path to serve others who are in need of compassionate medical care.”

Katherine Mullins, M’07, works in a clinic offering free prenatal care. “These were women who would simply show up at the hospital and deliver.”

She points out that many of her classmates still carry as much as $100,000 of debt — even a decade after graduation. In the Class of 2017, only 39 students graduated debt-free. The rest carried an average debt of more than $190,000.

This is troubling news to Mark Ryan, M’00, H’03, associate professor, VCU Department of Family Medicine and Population Health. He’s noted that the burden of medical school debt plays a defining role in the number of medical students who choose a primary care specialty.

“Primary care doctors are paid 60 to 70 percent of an average specialist’s salary,” he explains. “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.” 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 even more doctors, bringing the shortfall closer to 100,000 physicians — with nearly three-quarters of those doctors needed in urban areas.

The medical school 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. Ryan serves as the I2CRP’s medical director and says the program’s goal is to increase the number of students selecting primary care careers with a focus on underserved communities.

A recent study reveals the program has done just that. Yeri Park, M’17, conducted research showing I2CRP graduates are more likely to match to primary care specialties than their classmates — 79 percent compared to 44 percent. She presented her  findings at the 2017 Society of Teachers of Family Medicine Conference on Medical Student Education in Anaheim, California. 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,” says Park, now in family medicine residency training at Greater Lawrence Family Health Center in Massachusetts. “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 research also showed that of the I2CRP graduates who have completed residency training, 36 percent are working in medically underserved areas and/or health professional shortage areas.

“We think that’s a robust number,” Ryan says. If medical schools nationwide put up similar numbers, he adds, 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.”

Yet a program like I2CRP can’t completely solve the looming physician shortage. While Park had dreamed of pursuing family medicine since she was a young girl, at times she worried about the financial implications of her career path. Even as a recipient of multiple scholarships during her medical school career, 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.”

Of course, graduates who choose primary care are not the only ones who face a heavy burden of debt. And so, to help recruit and reward deserving students, the medical school launched the 1838 Campaign with the goal of providing meaningful scholarship support for students, regardless of what specialty they pursue.

The $25 million campaign will build the medical school’s scholarship endowment into a resource on par with peer schools.

Already since the 1838 Campaign’s launch, donors have made gifts creating or expanding more than 50 scholarships. In accord with the donors’ wishes, those scholarships carry a variety of award criteria such as supporting students with financial need, students who have experienced adversity or students who are headed into primary care or another field.

“If medical students are making decisions about the future based on debt, they are not going to choose primary care,” Mullins says. “Having scholarships available for people interested in primary care gives them that option — that freedom to choose otherwise.”
The gift of a scholarship not only benefits students and future physicians. It could be the difference in the lives of future patients as well.

Earlier this year in Memphis, Mullins began working in a clinic offering free prenatal care to women who previously had little or no access to medical care. “These were women who would simply show up at the hospital and deliver,” she says.

Now Mullins provides concentrated care over nine months, building relationships with women who face additional challenges such as domestic violence and other situations that may have gone unnoticed during a brief hospital stay.

“We get a chance to really see what they need and find resources for them,” Mullins says. “Getting to know them, what they’re going through, the things that they have on their mind — that’s my favorite thing about family medicine. Those longstanding relationships. Patients open up their lives.”

A scholarship made it possible for Mullins to go where the need is and, she says, “I’m exactly where I’m supposed to be.”

By Polly Roberts

WANT TO HAVE AN IMPACT?1 – Recruit top students.
2 – Reward student excellence.
3 – Reduce the burden of debt.

Those are the goals of the $25 million 1838 Campaign to build the medical school’s scholarship endowment into a resource on par with our peers.

For the campaign’s inaugural 1838 Fund scholar, it means even more. “It allows me to continue to follow my dream,” says the Class of 2019’s Jessica Mace.

ONE SCHOLARSHIP, A LIFE CHANGED

The 1838 Fund is an endowed scholarship established from the pooled resources of the
medical school’s alumni and friends. This and other endowed scholarships exist in perpetuity and provide annual tuition support for deserving students. The school encourages gifts of $25,000 and up to the endowment.

Named endowments are established with gifts of $50,000 or more and housed at the MCV Foundation. An endowed scholarship carries the name of its creator or the name of an honoree the donor chooses. Full- and half-tuition scholarships are most urgently needed and are created with a commitment of $750,000 or $375,000.

Learn more at go.vcu.edu/1838campaign.

16
2017

Smart and Nice

New Interview Process Produces the Class of 2021

Any patient will tell you: the best physicians aren’t just knowledgeable. They’re caring. Excellent communicators. Nice.

This story first appeared in the fall 2017 issue of the medical school’s alumni magazine, 12th & Marshall. You can flip through the whole issue online.

Wait for the bell: A series of interviews is designed to identify core competencies and personality. A bell prompts students when it’s time to uncover and read the question they’ll be asked. They get two minutes to ponder the answer, then enter a private room and spend the next seven minutes with the interviewer.

Each year, finding and nurturing that kind of physician-to-be is an imperative for VCU’s School of Medicine. Applicants may look good on paper, but winnowing the field to
find those who are smart, empathetic and good at expressing themselves takes special skill. That’s why the School of Medicine now screens students using the new Multiple Mini-Interview (MMI) system.

Michelle Y. Whitehurst-Cook, M’79, H’82, senior associate dean for admissions, explains that the MMI gives students a chance to show off skills that aren’t on their written application. And do it for a variety of stakeholders — faculty, administrators, fourth-year students and select community members.

In the past, a prospective student typically talked with one interviewer, which, she notes, doesn’t tell a complete story.

“Previously, you had one interviewer to tell it all to the committee. Some interviewers loved — or hated — everybody.” Now, she says, “the committee gets to see comments from all the interviewers, with an aggregate score.

“We have been very diligent about putting together an objective system for reviewing those files and I think if we get that right, then we’re interviewing people who are smart and nice. We know they’re smart; we use the interviews to see how nice they are and observe their passion for medicine.”

If you’re interested in working with the medical school’s admissions office to identify the most promising applicants, please contact senior associate dean for admissions, Michelle Whitehurst-Cook, M’79, at mwcook@vcu.edu

Keith Baker, Ph.D., is the assistant dean for admissions and an assistant professor of biochemistry and molecular biology. He helped develop the MMI program. “We’re trying to eliminate a subjective approach and see if the person we’ve invited to interview is the same person as they are on paper.”

HOW THE MMI PROCESS WORKS
The fundamental process of gaining admission to the School of Medicine hasn’t changed. Each year, about 9,000 prospective students apply, and about two-thirds are typically weeded out early on because their grades and/or MCATs aren’t competitive enough or they lack relevant clinical or community service experience. The remaining applications — 2,700 last year — were file reviewed starting in July and assigned points for various components. At the end of that process, the highest scorers were invited for an interview. To fill the Class of 2021’s 216 students, interviewers talked to more than 600 candidates.

The interviews were scheduled several days a week August through March. Each candidate rotated through a series of seven stations, each interviewer asking a different question designed to uncover core competencies and personality.

During the process, held in the McGlothlin Medical Education Center, a bell prompts students when it’s time to uncover and read the question they’ll be asked. They get two minutes to ponder the answer, then enter a private room and spend the next seven minutes with the interviewer. Then it’s out and on to the next one.

For students, it gives them a chance to present themselves beyond the essay. “You have several chances to make a good first impression and you don’t run the risk of not having a great personality match or having an interviewer who’s distracted by other things,” says Kiera Sibbald, an M1 who began studies in August as part of the Class of 2021 — the first to go through the MMI process. “And so you’re able to show different
aspects of your experiences and address some things that might be unique about you as an applicant.”

Students are scored on a 1 to 5 scale. Whitehurst-Cook noted that during the school’s inaugural year of MMIs, various interviewers’ ratings tended to correlate and reflect the same impressions of individual candidates. Occasional scores deemed as outliers — if perhaps, a student totally botched an answer — are removed when the committee begins choosing the class. With rolling admissions, the committee takes another look at the applications in conjunction with the interview scores, and offers admission to selected students beginning in October.

Though students don’t know the questions ahead of time, they’re not going in cold.

We’re trying to eliminate a subjective approach and see if the person we’ve invited to interview is the same person as they are on paper.

“To prepare, I used some online question banks, read a couple books and talked to friends who had been through an MMI process somewhere else,” says Sibbald, who completed VCU’s Premedical Graduate Certificate Program last year.

“One of the challenges is knowing what five minutes sounds like when you’re talking, and practicing at home to figure out how to frame an interview in a way that has a good introduction, body and conclusion, and tells a story in a succinct way — and then leaves some room for follow-up questions. I think that’s something the students can practice and can work to their advantage.”

A VARIETY OF BACKGROUNDS
Interviewers are drawn from a variety of sources, Whitehurst-Cook says, including School of Medicine faculty, alumni and students, other medical professionals, and people with backgrounds in teaching, administration or human resources. Though most have a connection to the university, “we use a fair number of community people. These are people who know what they’re looking for in a doctor. We typically find them through word-of-mouth. And while I don’t have a list of criteria, it’s mostly people who’ve been around young people before. “I tell the applicants, ‘these are people who are going to be working with you: your professors, your peers and your patients.’”

Another bonus of the MMI process is its flexibility, Baker says. “We’re doing this for general admissions, but also the guaranteed admissions program (which admits students out of high school) and the preferred applicants (for VCU honors students after their sophomore year). I like that it’s pliable.”

For Sibbald, the process was a great way to meet a variety of people from the School of Medicine. “It offered us an opportunity to get different perspectives on the school. If you finished the question early, you had the opportunity to talk about their favorite part of VCU, why they chose to come here and so on. For me, it was really encouraging to see how many fourth-year medical students chose to be involved in this process.

They didn’t have to give up their Saturday, but it was important to them to give back to the school.”

TRANSITIONING TO THE MMI
Currently, about 30 of the 147 accredited medical schools in the U.S. are using some variation of the MMI process, Whitehurst-Cook says, which was pioneered at Canada’s McMaster University two decades ago.

Admissions administrators spoke to peers at McMaster and each of the medical schools currently using MMIs. “They all said they would not go back to the traditional way of interviewing,” Whitehurst-Cook recalls, though each school cautioned that getting enough interviewers can be a challenge.

Once VCU decided to adopt the MMI system, administrators began crafting questions to identify the best students to make up future classes. “We use behavioral questions and scenarios,” she says. “None are really medical-based. We’re looking for their passion for medicine, motivation, how well they work together, mistakes they’ve made and lessons learned.”

HOW TO BUILD A CLASS

You have to show you care. I don’t think that in this kind of interview process you can fake it.

What’s the most desirable trait in a candidate? “A holistic approach to medicine,” Whitehurst-Cook says. “They’re very respectful — to the attending, to the nurses, to their peers, to the janitor — and most of all, to their patients. We don’t want them to treat a college professor any differently than they’d treat a homeless person, because they really do have the same needs.”

“While all medical schools are looking for the same basic types of students — smart and nice — what sets VCU apart is the desire to attract students who will thrive working with a very diverse patient population,” says Assistant Dean for Admissions DONNA JACKSON, M.ED., ED.D. “I think that’s a draw for prospective students who have true service at their core. There is more to being a doctor than just treating the people who can afford your services. This is a good place where you can get the gamut of those who can and those who can’t, and be able to learn in an environment where you provide the same quality of care regardless of who is in front of you. We teach that well and we model that well.”

While the questions are designed to identify students with dedication and history of community service, also important is finding students who are effective communicators. “There’s an art to medicine,” Whitehurst-Cook says. “We want to be sure they have the communications skills necessary to be good physicians.”

If a physician is sued, oftentimes it’s not because of a lack of medical skills; rather, they lack the aptitude to talk to patients and families, she noted.

“You have to show you care. I don’t think that in this kind of interview process that you can fake it. We’re seeing how well they listen to the questions that are asked.”

MEASURING SUCCESS
The first class selected via MMIs is already hard at work. Admissions committee members are eager to see how they’ll do. “All indications seem to point toward better accuracy in identifying the qualities and traits of the candidates we’re looking for,” Baker says.

“I think you’ll see more and more institutions adopt this,” he adds. “We’re on the cutting edge, and I believe this is a better way of identifying future physicians.

“We’re confident that the people we identify through this process are exactly who we’re looking for.”

By Lisa Crutchfield

22
2017

Opioids: an American health crisis

Overdose deaths in the U.S. involving prescription opioids have quadrupled since 1999, according to the Centers for Disease Control and Prevention. Ninety-one Americans die daily from an opioid overdose and more than 1,000 are treated daily in emergency departments for not using prescription opioids as directed.

In 2016, Gov. Terry McAuliffe and Virginia Health Commissioner Marissa Levine declared the opioid addiction crisis a public health emergency in Virginia.

At VCU and VCU Health, efforts are underway to combat this public health crisis — through addiction treatment, pain management, health care policy, education and research. The below news articles, videos and continuing education opportunities provide a snapshot of those efforts.

VCU News opioid series

VCU Health Facebook Live opioid series

Continuing medical education

VCU News opioid series

To end the opioid epidemic, VCU health sciences faculty are changing the way pain management is taught
In the School of Medicine, changes mean explaining new CDC guidelines, discussing opioid alternatives and guiding students on how to adjust patient expectations. Students also go through a simulation exercise where they must revive a patient who has overdosed on opioids. “We want students to leave with the idea that chronic pain should be managed primarily with non-opioid medications, which has not been the way of thinking in recent history.”

VCU researchers combat opiate addiction
Researchers are fighting the opioid epidemic by brainstorming more effective clinical approaches, elucidating the biological mechanisms of addiction and developing safer alternatives for pain relief.

VCU Health outpatient clinic treats addiction with compassion and medication
Cathy Wilson greets the diverse group of patients she sees every week with the same line: “If it were easy, I’d tell you to go home and stop using. But it’s not that easy and that’s why we’re here to help you.”

VCU Health Pain Resource Nurse Program adopts ‘never just opioids’ approach for treatment
At VCU Health, nurses are studying alternative pain methods, and being taught how to address varied pain levels, responsibly. In 2013, VCU Health began its Pain Resource Nurse Program, an effort to improve care for those with pain and teach multi-modal treatment of acute/chronic cancer and non-cancer pain and addiction.

VCU to lead evaluation of new state-sponsored substance abuse treatment program
The Virginia Department of Medical Assistance Services has selected VCU to lead a five-year evaluation of the state’s new Addiction Recovery Treatment Services program. A major statewide initiative that started in April, the ARTS program is intended to address the rise of opioid-related deaths in Virginia by enhancing Medicaid-sponsored substance use disorder treatment services.

Study: Women who fixate on chronic pain more likely to be prescribed opioids
Female chronic pain sufferers who negatively fixate on their symptoms report greater pain intensity and are more likely to have an opioid prescription than men with the same condition, according to a study conducted by researchers at the Stanford University School of Medicine and led by current VCU medical student Yasamin Sharifzadeh.

‘Dreamland’ author Sam Quinones: Opioid epidemic is ‘a nightmare for American families’
Sam Quinones describes speaking dates to talk about his book “Dreamland: The True Tale of America’s Opiate Epidemic,” as a sad map reflecting the breadth of territory where the opioid crisis has made its mark.

New free community series brings VCU experts to Regency Square
An interactive presentation on Wednesday, Sept. 20, will provide an overview of the opiate epidemic in Virginia. Experts will talk about current Virginia statistics and what is happening in local communities. They will also review some of the changes happening to address the opioid epidemic, including increasing continuing education for a variety of providers, community resources and training, and treatment resources.

Heroin and prescription painkiller overdoses kill at least two Virginians every day, VCU reports
Nearly 80 percent of the almost 1,000 fatal drug overdoses in Virginia in 2014 involved prescription painkillers or heroin, known as opioids, according to a new policy brief by researchers at VCU School of Medicine.

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VCU Health Facebook Live opioid series

VCU Health hosted Facebook Live interviews with institutional experts to highlight efforts underway at the health system and VCU aimed at combating the opioid epidemic. Viewers were invited to participate by submitting questions and comments during the interviews. Interviews broadcasted live at facebook.com/vcuhealth.

• VCU School of Medicine professor F. Gerard Moeller, M.D., discusses medical school curriculum changes related to opioid prescribing practices.

• VCU School of Dentistry professor Omar Abubaker, D.M.D., Ph.D., discusses his commitment to learning about the disease that took his son’s life and the educational initiatives at the dentistry and nursing schools that are related to opioid prescribing practices and addiction treatment.

• VCU School of Medicine assistant clinical professor Jenny Fox, M.D., discusses efforts to combat and treat neonatal abstinence syndrome at the Children’s Hospital of Richmond at VCU.

• VCU professor of medicine and health administration Alan Dow, M.D., discusses continuing medical education initiatives hosted at VCU that are aimed at aligning opioid prescription practices throughout the commonwealth with new state and national guidelines.

• VCU School of Medicine professor Mishka Terplan, M.D., discusses the addiction recovery services offered at VCU Health and the newly opened VCU Health Motivate Clinic.

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Continuing medical education

Best Practices in Pain Management – Primary Care and Specialty Collaboration
Sept. 16-17, 2017
Williamsburg, Virginia
cme.vcuhealth.org

Stepping Stones to Excellence in Wound Care
Sept. 28-29, 2017
Richmond, Virginia
cme.vcuhealth.org

Safe Opiate Prescribing
Online Course
safeopiateprescribing.org

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13
2017

Reflections on Pinares as HOMBRE team heads back to Honduras

Medical students travel to Honduras, as part of HOMBRE.

Medical students travel to Pinares, Honduras, as part of the Honduras Outreach Medical Brigagda Relief Effort.

This June a team of more than a dozen health sciences students head to Pinares, Honduras, as part of the Honduras Outreach Medical Brigada Relief Effort, where alongside faculty they will provide medical services and health care education to the country’s underserved and rural populations.

Nine medical students will travel with this year’s team, led by faculty members Michael Filak, M.D., and Sandra Tandeciarz, M.D., who have a combined decade of HOMBRE experience between them.

“We are ever grateful to our School of Medicine faculty for their volunteerism, as well as mentorship, as exemplified here in this global outreach with our dedicated medical students,” says Peter F. Buckley, M.D., Dean of Medicine.

Team members also include Kate DiPasquale Seelig, M’12, an HOMBRE alumna now returning for the second time as faculty. As a student, Seelig received an Aesculapian Scholarship, made possible through the medical school’s Annual Fund. Even a partial scholarship relieves the burden of debt today’s medical students face and can make it easier for recipients to choose to travel and gain global health experience.

In Honduras, team members will work in health care clinics or on public health projects geared toward improving villagers’ quality of life. On the trip, held June 13-24, medical students gain interdisciplinary experience working alongside nursing, pharmacy and physical therapy students.

After HOMBRE’s summer 2016 trip to Honduras, nonprofit partner Shoulder to Shoulder provided a glimpse into the landscape and people of Honduras, as well as the work of the HOMBRE team. Read on for highlights from the Shoulder to Shoulder blog as this year’s team embarks on a new journey.

As the crow flies

HOMBRE team members provide medical services and education.

HOMBRE team members provide medical services and education to Honduras’ underserved and rural populations.

“As the crow flies …” is a great expression, probably a little bit overused in the U.S. We don’t hear the expression here in Honduras very much. Primarily, I guess, because we don’t have too many crows. We do have vultures, “zopilotes” we call them, and they fly across the mountains with great ease. Perhaps that’s more the reason why the expression doesn’t get used that often here. It is just a little too depressing to think on how quickly a zopilote crosses from one mountain peak to the other, a matter of a minute or two, and then to think that the same trip takes up to an hour or two in a four-wheel drive pickup. It’s just a little bit too humbling to think that nature is that far ahead of human ingenuity. Here, the terrain and the elements of the natural world continue to present tremendous challenges to human dominance. Perhaps not so much in the U.S. Here, we prefer to not remind ourselves how much easier it is to be a crow or a zopilote.

The Frontera is a really small place, less than 700 square kilometers, smaller than El Paso, Texas. But, there are no straight lines and nothing is ever level. One goes north to arrive at a destination to the south, or up in order to go down. This counterintuitive travel is yet worsened by roads that would not merit the designation of a road in the U.S. Steep volcanic mountains are breathtakingly beautiful, but living within them is hardly practical.

San Marcos de La Sierra is the first municipality that one encounters in the Frontera, driving south from La Esperanza. The road here is still at a high elevation and one doesn’t really see any evidence that people live here. Virginia Commonwealth University and Fairfax Family Practices have been coming to this area three times a year for many years. They were just here once again. We dropped them off at the school and clinic in Pinares and we came back about a week or so later to pick them up. If we didn’t know what they do while they are there, we might assume they just hang out and admire the tremendous vistas they are privileged to view. But we do know better.

During HOMBRE, medical students gain interdisciplinary experience.

During HOMBRE, medical students gain interdisciplinary experience working alongside nursing, pharmacy and physical therapy students.

Hiding behind those mountains, across ravines and beyond the treacherous slopes, are about 9,000 residents. Few of them make their way to the health clinic. This is not surprising. They are poor, simple people. They have all they can do to maintain a small home and, if they are fortunate, a small plot of land on which to farm. They travel to a river for water. They collect wood for a fire to cook humble meals. They battle daily with a harsh, unforgiving environment so that they can stay ahead of a mortality curve. They remain unseen, forgotten, abandoned, invisible if you will, except for the zopilote vultures that circle their heads. If anyone is going to know these people, if anyone is going to care for them, treat their illnesses, recognize their dignity, then it demands going to them. They can’t come to us.

We sometimes look naively upon a just response to inequity and poverty. It would be easy to sit outside the school at Pinares where VCU/Fairfax houses their service team and admire the beauty of majestic mountains. It takes insight, compassion and even sacrifice to gain the view of a zopilote that flies beyond the mountains with ease. For the doctors, students, translators and volunteers, they brave the rough terrain to make their way to unseen, ignored people who live in poverty. They climb into the beds of pickup trucks, squished in among the bins of medical supplies, and bump along to destinations where most anyone would not dare to go. They stare down the cliffs as they go. They stop when they can go no further with a car because the road has fallen down the mountain. They sling their supplies over their shoulders and into backpacks. Then they walk. Perhaps even as they trek along, they wonder about this odd journey: going south to arrive to the north, and up in order to get down. Then they finally arrive in a little village, a place mostly unknown. Maybe they look up and see a zopilote circling their heads. Perhaps they indulge themselves with a knowing smile.

This is how we discover people. We make our way along treacherous journeys. Once again, VCU/Fairfax has made their journey to reach a poor, forgotten, invisible people. The people they have met are happy and grateful for the encounter. For this journey, to have arrived to where the crow flies, everyone has been enriched.

13
2017

For the Class of 2020’s Jay Pham, persistence and resilience earn a second chance

The pride overflows from the Class of 2020’s Jay Pham as he talks about life on the MCV Campus as a first-year medical student.

“It’s been blissful to finally be here,” says Pham, his smile growing wider. “Pure happiness. I’m happier now than I’ve ever been.”

At 34, he says he’s finally where he’s supposed to be.

The Class of 2020’s Jay Pham and family

The Class of 2020’s Jay Pham and his wife with four of their five children, ages 5, 10, 11 and 14. Not pictured: their newest addition, a 1-year-old boy.

Five years ago, Pham found himself in a much different spot. He was running his family’s business in Seattle, Washington, having dropped out of college years earlier when he became a young father. He was making ends meet for his family but longed for a sense of fulfillment.

“I saw my children, who were so young and just beginning their lives, as a biological miracle,” Pham says. “The process of life is fascinating. They came out pretty perfectly yet so many things could have gone wrong. I wanted to understand this amazingness.”

So in 2012 the then-father of three went back to the University of Washington, where he had been one political science class shy of graduating, to finish his bachelor’s degree and earn his prerequisites. “This time I knew I had it in me. It was four hours round trip to school. I studied on the bus. I studied while brushing my teeth. It’s amazing what time you can find,” he laughs.

Jay Pham (right) and his father in 2012 before Pham started his post-baccalaureate studies at VCU.

Jay Pham (right) and his father in 2012 before Pham started his post-baccalaureate studies at VCU. “He is truly the one man who understands me completely. Perhaps also my greatest supporter.”

A Vietnamese immigrant who moved to the U.S with his parents and three siblings at age 10, Pham’s parents had always dreamed of him becoming a doctor. “Most immigrant families feel the need to be successful. You have to finish school. Be somebody.”

For much of his life, Pham followed this track. A bright high school student, he took community college classes his junior and senior years, earning his associate’s degree at the same time he graduated from high school. But he resisted his parents’ push toward medical school and ultimately abandoned his undergraduate studies. Eventually he found himself far from the life he’d envisioned.

It wasn’t until someone told him, “You made a mistake, but I believe you can recover from it,” that Pham began to reflect on what he could give back to society. “When you don’t have anything, you appreciate your body and your health. In Vietnam, it was how you could get work in the fields. My family was poor — we were on welfare when we came to the United States — but we had our health.

“I want to be the ‘keeper of health’ for the underserved and the poor,” Pham says. “That’s what I was. Now I want to pay it forward to the next generation.”

But while his career path was now clear to Pham, he had more work to do before being accepted into medical school. On the advice of senior associate dean of admissions Michelle Whitehurst-Cook, M’79, he completed VCU’s post-baccalaureate graduate certificate program.

“When I was emailing medical schools, Dr. Whitehurst-Cook was the only one who emailed me back personally and said ‘here are some of the things you could do,’” Pham says. “Other schools sent an auto response but this school, this person, found time to respond. It’s like the kind of doctor I want to be. VCU felt like the right school.”

The Class of 58’s James Darden (left) mentors Jay Pham at CrossOver Clinic

The Class of 58’s James Darden (left) mentors Jay Pham at CrossOver Clinic, Virginia’s largest free clinic where Pham volunteered prior to medical school and continues to give his time.

After earning his certificate and a 4.0 GPA, Pham spent 2016 volunteering at CrossOver Ministry in Richmond under the mentorship of James Darden, M’58. Seeing the patients at CrossOver, Virginia’s largest free clinic serving more than 6,000 individuals, reinforced his desire to become a doctor and work with the underserved.

Whitehurst-Cook says Pham’s persistence and hard work showed he would be successful at VCU and as a physician.

“We saw a real passion in Jay for helping others,” she says. “He is a great role model. He’s learned a lot from his life’s journey and can share it with other students and help others develop cultural sensitivity, not just to his heritage, but to his path to medical school. Resilience is so important.”

Since arriving on campus, Pham’s path has been made a little easier as a recipient of the Lillian H. and Steward R. Moore Scholarship, which partially funds his tuition. “I’m very proud to be worthy of a scholarship and appreciate any amount that I don’t have to borrow. It’s tremendous.”

Providing meaningful scholarship support for students with financial need is the goal of the medical school’s 1838 Campaign. Full and half-tuition scholarships are most urgently needed. They are one of the medical school’s best resources for recruiting and rewarding deserving students like Pham.

The now married father of five is a leader in his class — other students affectionately call him “Pappy”— and in his family, where he and his children often study side-by-side. “It’s easy to tell them to study when they’re always seeing me study,” he laughs. “We are students together.”

It’s not the path to medical school Pham may have chosen, but he’s shared the ups and downs of his journey with his children, ages 1 to 14. He tells them while it’s OK to make mistakes, sometimes there is a better way.

“Do things right the first time,” he says. “Fixing it is hard.”

But as Pham eyes his second of year of medical school, he knows better than most that it’s possible.

By Polly Roberts

Virginia Commonwealth University
VCU Medical Center
School of Medicine
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Updated: 04/29/2016