aua alumni Issue 02 _ 2017
hope RESTORING
Dr. Jason Pryor treats the youngest and most vulnerable patients
ON THE LINE Srikant Sivaraman Alexander Austin Gurleen Sidhu Anil George
TO HEAL A NATION Elizabeth Bulat Renée Peterkin-McCalman Ashley Bernotas Jason Pryor
ROOTS, LEGACY, PROMISE Michelle Ramsay Nickul Shah Whitney Boling Vincent Gallo
A FINE BALANCE Bindiya Gandhi Kunal Sood Adrian Wyllie Jasmine Sawhne
2017
01 02 06
AUA Alumni
The Heart of AUA After 13 years of dedicated service, beloved mentor and head of Alumni Relations, Bob Gelles retires. AUA's Newest Alumni The 2017 Commencement is yet another example of how far AUA has come.
09 12
Living the Dream Dr. Srikant Sivaraman didn't plan on becoming a surgeon. Today there's nothing else he'd rather be.
16 20
Going Under Dr. Gurleen Sidhu considers the high-pressure/ high-reward specialty that is cardiothoracic anesthesiology.
ROOTS, LEGACY, PROMISE: For These Graduates, Medicine is a Family Affair
Serving His Country Major Alexander Austin is the most recent member of his family to serve in the US Air Force and the first to become a doctor.
Examining the Bigger Picture Dr. Anil George’s research may change the way childhood cancers are treated.
38 42 45 48
TO HEAL A NATION: These Physicians are Tackling Some of Public Health’s Biggest Issues
34
Issue 02.
Letter to Alumni From Joanna Serra
ON THE LINE: These MDs Spring to Action When the Stakes Are Highest
24 28 31
A Nation in Crisis by Dr. Elizabeth Bulat Q&A Dr. Renée Peterkin-McCalman shares the experiences that led her to focus on public health. Making a Big Impact in a Small Community Dr. Ashley Bernotas is one of four residents in a new program designed to address upstate New York’s primary care shortage. Restoring Hope Dr. Jason Pryor treats the youngest and most vulnerable patients.
A Worthy Sacrifice Dr. Michelle Ramsay entered med school as a 30-year-old single mother. Today she's a family medicine specialist. The Art of Detection: My Journey to Pathology by Dr. Nickul Shah Keep Your Goals in Focus With a competitor’s mindset, Dr. Whitney Boling continues her family’s legacy. Advocate for Your Specialty Dr. Vincent Gallo wants every medical student to know there’s more to radiology than interpreting images. A FINE BALANCE: When Research, Community, and Practice Converge, Patients Are Better for It
52 55 58 61
Striking a Balance by Dr. Bindiya Gandhi Beyond the Lab Dr. Kunal Sood loves doing research, but his true passion is working with patients. Q&A Dr. Adrian Wyllie talks about leadership and research. A Grassroots Approach to Mental Health As a public psychiatry fellow, Dr. Jasmine Sawhne has a chance to improve treatment for those who need it most.
dear
ALUMNI, Welcome! In this issue, we have chosen to highlight some of the many graduates who continue to embody AUA’s mission by giving back to their communities. Our alumni are primary care specialists in underserved communities, fundraisers for humanitarian causes, and volunteers on medical relief missions around the world. You already know that becoming a physician is an intense academic undertaking and the bonds created in the process can last a lifetime. We envision a robust network of former classmates who nurture these relationships long after they’ve graduated and in doing so, allow the University to expand its presence and continue to flourish in the medical community. The great news is that this is already happening, and we welcome you to be a part of it! Creating a profile on our website AUAalumni.org will help your former classmates stay up to date on the latest happenings in your life and career. You’ll learn about alumni events as soon as they’re announced, the latest campus news, volunteer opportunities, and fellow alumni who are making headlines. We can’t wait to see you at the next alumni gathering and hear your ideas about our future as an association. Joanna Serra Alumni Relations Office
LETTER TO ALUMNI
| 1
the
HEART OF AUA After 13 years, beloved mentor and head of Alumni Relations, Bob Gelles, retires.
B
efore our first students arrived in 2004, Bob Gelles was working tirelessly to help AUA President and cofounder Neal Simon make his vision of a newer, better kind of medical school a reality. In February, Bob formally announced his retirement after 13 years of service, and we will miss him dearly. By recruiting the University’s inaugural class along with many others, Bob helped build the Admissions Department from the ground up. Along the way, he amassed an unrivaled amount of institutional knowledge that he continued to draw upon in his work in Admissions and later as Alumni Relations Coordinator. The interviews he conducted produced meticulously detailed applicant reports that AUA’s Admissions Committee would count on over the years. When he took over Alumni Relations, it was as if the role had been waiting for him all along. He has since become an almost paternal figure to a loyal following of students and alumni, most of whom he recruited while still in Admissions. One the earliest AUA graduates, Dr. Adam Isacoff (Class of 2008), now a pediatrician in Florida, says that Bob was one of the first people he met at AUA and has fond memories of him. “Throughout my years in medical school and beyond, Bob has been an ardent supporter of the school and all who attend. He is truly invested in the success of the students and deserves nothing but the best in his retirement.”
2|
ISSUE 02 • 2017
Mamta Purbey, Executive Director of Enrollment Management, worked closely with Bob and underscores the formative role he had as Admissions Director. “Bob helped establish the rubric by which we screen applicants. He leaves a legacy of hard work, wisdom, and impeccable customer service. Most of all, his charismatic nature has imprinted indelible memories that we will cherish. On a personal note, I'll really miss the delicious, homemade salmon latkes he often shared with us," she says with a laugh. Vice President for Enrollment Management and Clinical Sciences, and Chief Marketing Officer Corey Greenberg recognizes the lasting impact that Bob has had on so many AUA alumni as well as his colleagues. “Bob’s success can be measured by the relationships he built and by the credibility he brought to an unknown entity that is now considered a top medical school. He has made many dreams come true for those aspiring to become doctors.” Mr. Simon feels a debt of gratitude to Bob for his instrumental role in growing the AUA community into the diverse group of inspired medical students that it is today and has always been impressed by the connections Bob created and maintained with prospective, current, and former students. “To ‘his’ students, Bob has always been something of a sage. They know that his enthusiasm about their potential is genuine. He has been truly invested in this university and the success and happiness of its students.”
LETTER TO ALUMNI
| 3
4|
ISSUE 02 • 2017
Bob was one of the most available, informative people at AUA and had the best sense of humor of anyone I met there. He was always there to offer guidance. Dr. Radha Rani Padhy Class of 2013 Bob was there from day one of my journey to medical school, up to the day I graduated and became an attending. He was always very supportive and encouraging. I wish him nothing but happiness in this new phase of his life. Dr. Bindiya Gandhi Class of 2010 Whether you were an alumni or a student, if you needed help with anything you could always contact Bob and it got done. Bob always felt more like a family friend than someone who worked at my medical school. I was a pharmacist before I went to AUA. To Bob, I was always his ‘pharmacist from Wisconsin’ because I did my phone interview with him. He was always a ray of sunshine. Dr. Angela Echeverria Class of 2010
“
Bob Gelles is the first person I met from AUA when I applied. He knew my story could not be told based on grades and a personal statement alone and said he would do his best to represent me at the Admissions Committee meeting. Not only did he keep his word but he also remained by my side long after I graduated. Bob ‘put me on the map’ by placing me in positions where he knew I would have a voice. I also have to credit him for giving me the benefit of the doubt during my interview. My personal statement, in which I referred to myself as ‘a renaissance man,’ wasn’t exactly a humble piece of writing. Bob told me he scheduled an interview because he wanted to see if I was actually that arrogant or truly believed in myself that much. After I convinced him of the latter, he became a true ally and still is. We will always share a very close bond and I am reminded of Bob annually, given that the day I officially graduated from AUA is also his birthday. Dr. Bilal Khan Class of 2011
"
It was a true pleasure working with Bob. He was a pillar of support and a source of encouragement for all AUA students. By connecting alumni, building relationships among students, or providing guidance, Bob was always ready and willing to give a helping hand. Our relationship persevered beyond my graduation from medical school, into residency, and even fellowship. Dr. Jay Umarvadia Class of 2012 I worked with Bob Gelles for over 10 years. The commitment and dedication that Bob had to ‘his’ students from the time of application, to acceptance, to graduation was unsurpassed. Bob was often the first point of contact for prospective students. His advocacy on their behalf was his most important contribution. Bob touched the lives of hundreds of people who are physicians today. We will be forever grateful to him for his experience, dedication, and profound love of AUA and its mission. Dick Woodward Former AUA Senior Vice President and Chief Operating Officer
THE HEART OF AUA
| 5
AUA'S NEWEST ALUMNI The 2017 Commencement is yet another example of how far AUA has come.
O
n June 2nd, AUA's Class of 2017 roamed the grounds of the New Jersey Performing Arts Center, stopping every now and then to pose for photos; the excitement in the air was palpable.
a doctor has exceeded his expectations, and how well AUA prepared him for the intensity of his job as an internal medicine resident at Lenox Hill Hospital in Manhattan.
In his opening remarks, AUA President and cofounder Neal Simon presented Antigua and Barbuda’s prime minister, the Honorable Gaston Alphonso Browne, with an Honorary Doctor of Medical Science degree. This conferral was in recognition of the prime minister’s humanitarian work, leadership, and steadfast support of the University.
The AUA administration and faculty are extremely proud of the Class of 2017. As they prepare themselves for their residencies, we look forward to welcoming them into the AUA alumni community. Anesthesiology, diagnostic radiology, pathology, physical medicine & rehabilitation, surgery, and of course primary care—these are just some of the specialties to which this year’s AUA graduates will be applying what they’ve learned over the past four years. From New York to Florida, to California, to Ontario, they will represent all that AUA stands for as providers of the highest quality of care to their patients.
Dr. Unni Karunakara, former director of the Campaign for Access to Essential Medicines for Médecins Sans Frontières/Doctors Without Borders gave the keynote address. Dr. Karunakara is a Senior Fellow at Yale University’s Jackson Institute of Global Affairs and a visiting professor at Manipal University. Dr. Dinithi Ketagoda, this year’s valedictorian, addressed the Class of 2017 as well. During her time at AUA, she achieved a near-perfect overall GPA and had outstanding USMLE Step scores on both Step 1 and Step 2 Clinical Knowledge. She matched into an internal medicine residency at UCSF Fresno, which she started in June. In his alumni address, Dr. Peter Sayegh (Class of 2016) spoke about how much being
6|
ISSUE 02 • 2017
As they put on their white coats for pictures before they entered the auditorium, and after AUA Provost Dr. Seymour Schwartz ended the ceremony by reciting the Hippocratic Oath with them, it was obvious that the Class of 2017 and their families were experiencing one of the happiest days of their lives. Soon they would begin residencies in teaching hospitals all over the country. The medical careers they had always dreamed of were about to begin, careers that would be marked by their own milestones. ■
LETTER TO ALUMNI
| 7
8|
ISSUE 02 • 2017
“
I would like to be at an academic institution because teaching is also a passion of mine, and it would allow me to continue operating. That’d be the best of both worlds, but providing quality patient care is always the goal.
"
LIVING THE
DREAM Dr. Srikant Sivaraman didn't plan on becoming a surgeon. Today there's nothing else he'd rather be.
S R I K A N T S I VA R A M A N , M D Class of 2012 Fellow, Vascular Surgery Wayne State University/Detroit Medical Center Detroit, MI Resident, General Surgery University of Maryland Medical Center Baltimore, MD
ON THE LINE
| 9
I
n 2010, Dr. Srikant Sivaraman was a third-year AUA student rotating at Medstar Harbor Hospital in Baltimore, Maryland. Often, he would drive by the University of Maryland Medical Center’s Shock Trauma Center, wondering what it was like inside and imagining how rewarding it would be to do his residency there. Today, he works in that very building and is completing his final year as a general surgery resident. In July, he’ll begin a fellowship in vascular surgery at Detroit Medical Center. Originally from Canada, Dr. Sivaraman is the first member of his family to become a physician. He started his undergraduate education as a media and business major but later realized he was “a science kid” at heart and ended up graduating from the University of Western Ontario with bachelor’s degrees in Psychology and Medical Science. Medical school seemed to be the natural next step, but he didn’t get into any of the schools he applied to and knew that instead of waiting another year to try again, he could apply to Caribbean schools right away. AUA’s emphasis on integrating clinical concepts during Basic Sciences made it his first choice. As passionate as he is today, specializing in surgery did not occur to Dr. Sivaraman until he was almost finished with medical school. As he gained more clinical experience, the specialties he considered evolved with each rotation. During an OB/GYN rotation, he first discovered how much he loved the operating room. After a rigorous 12 weeks of general surgery at Richmond University Medical Center in New York and a sub-internship in gynecological oncology, Dr. Sivaraman knew without a doubt what path he would follow. When he reached the end of his general surgery internship at Robert Packer Hospital in Sayre, Pennsylvania, he found out he landed a residency at the University of Maryland Medical Center and could hardly believe his good fortune. “I was so excited to be a part of an institution at the forefront of research and surgery,” he remembers. As a general surgeon there, he’s had many first experiences, like letting a patient know he successfully removed a tumor and informing another that the only option was amputation. He also restored circulation to a patient’s leg by performing bypass surgery for the first time.
10 |
ISSUE 02 • 2017
During an OB/GYN rotation, Dr. Sivaraman first discovered how much he loved the operating room.
Dr. Sivaraman finds his work extremely rewarding and admits that he can be a bit sentimental. After removing the dead gut of a six-year-old, the child drew him a picture of a Teenage Mutant Ninja Turtle, which Dr. Sivaraman says he’ll keep with him wherever his career takes him. He also remembers offering the best comfort he could to the parents of a gunshot wound victim by assuring them no amount of trauma surgery could have saved their son. At the same time, Dr. Sivaraman recalls the expression on another patient’s face as he thanked him for saving his life after being shot seven times. “I was able to do all these things because I was at this amazing place, this incredible center that helps so many different people from all kinds of backgrounds,” he says. The complexity, the cases, and the patient population are what drew Dr. Sivaraman to vascular surgery, which he was introduced to while working with various faculty and attending physicians at six hospitals during his residency. This led him to seek out fellowships that would offer a similar blend of autonomy and instruction from experienced surgeons. He found his match at Wayne State University and is preparing to move to Detroit for a two-year fellowship. Dr. Sivaraman is considering returning to Canada once his fellowship ends. “Ideally, I would like to be at an academic institution because teaching is also a passion of mine, and it would allow me to continue operating. That’d be the best of both worlds, but providing quality patient care is always the goal.” ■
ON THE LINE
| 11
SERVING HIS
COUNTRY Major Alexander Austin is the most recent member of his family to serve in the US Air Force and the first to become a doctor.
D
el Rio, Texas is roughly two and a half hours west of San Antonio. It’s a rural community of about 36,000 people near the US-Mexico border. There you’ll find Laughlin, the Air Force’s largest pilottraining military base, home to 2,000 people and 600 families, and the area’s largest employer.
A member of the Air Force’s 47th Medical Operations Squadron, Major Alexander Austin, MD, practices at Laughlin’s Family Health Clinic or “FHC.” The FHC is responsible for the care of 900 people and sees an average of 18-20 patients a day, including many retired military personnel living in the area. Most medical specialists are located in San Antonio, so Major Austin often finds himself taking on a broader role than the average primary care physician might. “You have to shoulder a lot more responsibility and really know your way around the body, so you’re not just referring people without a good reason,” he says.
12 |
ISSUE 02 • 2017
Members of the 47th Force Support Squadron carry the POW/MIA flag through the early hours of the morning on Laughlin Air Force Base, Sept. 16, 2016.
Major Austin mostly sees adults, some of whom are elderly patients. Although there’s a pediatrician on staff, occasionally he and his team of one nurse and two technicians will work with young patients if needed. Major Austin is not the first member of his family to join the Air Force either. Shortly after he was born in Brooklyn, New York, his father Clairmont enlisted and moved the family to Nebraska for the first of what he estimates were 10 or 11 moves around the country. After 20 years serving with the armed forces, Clairmont retired as a Coast Guard officer. At the age of 40, Major Austin’s mother Roxanne joined the Air Force as a nurse and served four years at Andrews Air Force Base in Maryland, its national headquarters. Their careers, and early exposure to his mother’s medical books, made life as a military physician especially appealing. “These things opened my eyes to how fully I could serve,” he says.
In high school, Major Austin participated in a program at Stony Brook University Hospital in New York that involved shadowing doctors. This experience reinforced his decision to study medicine. He went on to attend the University of Massachusetts at Amherst, graduating with a degree in biology in just three years, and then chose AUA, where he specialized in primary care. “I wanted something with that full scope, that full knowledge, where I’m doing everything or at least have exposure to everything.” At AUA, Major Austin had the opportunity to study with a dynamic group of students and professors from around the world, but what made his experience there most significant was meeting his wife Onica, who was working on campus at the time. She is currently earning her degree in healthcare management, and together, they have three kids.
ON THE LINE
| 13
M A J O R A L E X A N D E R AU S T I N , M D
Class of 2011
“
Helping out those in need, who also wear the uniform, is one of biggest commitments and sacrifices you can make.
14 |
ISSUE 02 • 2017
Primary Care Physician Family Health Clinic Laughlin Air Force Base Del Rio, TX
After graduating from AUA, Major Austin felt ready to serve his country and signed up for active duty in the Air Force. In civilian settings, family medicine is normally characterized by stability, with physicians treating the same patients over the course of their entire lives. On a military base, however, the population is mostly on the move, traveling around the country and the world on assignment. These patients are “PCS-ing,” which is a term used by the military to refer to those with a Permanent Change of Station. To stay informed about this constantly transient group of patients, Major Austin and his team conduct frequent population health assessments, the results of which are used to track diabetes and hypertension. When patients return from overseas deployments, they present a unique challenge. “You have to be knowledgeable about the diseases prevalent in the countries where they were stationed. You need to know what symptoms to look for,” Major Austin says. While Ebola might not be an immediate concern in rural Texas, the staff at Laughlin must be able to recognize it in patients who have recently returned from assignments in West Africa.
The six-week program takes place in Montgomery, Alabama where new recruits learn the customs and courtesies of the Air Force including how to march and salute, how to wear a uniform, and how to interact with different people of varying ranks. Major Austin also completed squadron officer school, a fiveweek program that focuses on leadership skills and managing large groups of people when resources are limited. Currently, he’s preparing to become a flight surgeon and taking a course in aerospace medicine, which involves flying lessons and studying how a pilot’s body is uniquely affected by flight. Down the road, Major Austin hopes to relocate to Guyana, where his parents and wife are originally from, and open a healthcare facility there. The path he has taken in his education and career has paved the way for him to realize this dream, but for now he’s very happy to live the military life and serve his country as a physician. “Helping out those in need, who also wear the uniform, is one of biggest commitments and sacrifices you can make.” ■
According to Major Austin, serving as a doctor in the military has a lot of perks. He enjoys how the clinics are mostly free of the wrangling that goes on between physicians and insurers in the private sector. He also has the opportunity to transfer to different domestic and international locations every few years and participate in humanitarian aid missions. There is one perk, however, that comes with a little extra work—as a uniformed member of the military, he must exercise regularly with his squadron and meet physical training requirements that are tested yearly. “If I didn’t have that, I’d probably be fifty pounds heavier!” Medical specialists in the Air Force are also required to complete Commissioned Officer Training (COT), which he describes as “almost a modified boot camp.” Major Austin's wife Onica and children Ava, Angelo, and Antonio outside of Laughlin's Family Health Clinic. LETTER TO ALUMNI
| 15
GOING UNDER As she prepares to start a new job in California, Dr. Gurleen Sidhu considers .. the high-pressure high-reward specialty . that is cardiothoracic anesthesiology. .
16 |
ISSUE 02 • 2017
LETTER TO ALUMNI
| 17
Dr.
Gurleen Sidhu is the first to admit she's intimidated by her job every single day. She means this in the most positive sense of the word. “The day you aren’t intimidated by your job as an anesthesiologist is the day you put your patient’s life at risk.” Any medical scenario requiring anesthesia is by its nature, a matter of life and death. She acknowledges that for this reason, anesthesiology is not for everyone, but it was precisely this urgency and level of responsibility that compelled her to pursue the field in the first place. As Dr. Sidhu nears the end of a one-year fellowship in cardiothoracic anesthesiology at Montefiore Medical Center in New York, she considers the essential qualities of a highly skilled anesthesiologist. “You have to be ready for anything at all times. You’re always expecting the worst to happen. You’re always looking at the monitors. You have to thrive on stress and perform best under pressure, but also stay calm and collected.” Every time Dr. Sidhu sets foot into an operating room, she takes control of a patient’s hemodynamics (blood pressure and heart rate) to keep them alive and supported during surgery. Dr. Sidhu has a roughly ten-minute interaction with patients before she puts them to sleep in the presence of the doctors who will be operating. The amount of physiological and pharmacological knowledge she is required to draw upon is vast, and it is only within this brief window that she has the opportunity to capture the patient’s medical information. Hers is usually the last voice a patient hears and the last face a patient sees before ‘going under,’ so it’s also important that she’s reassuring and collects this information without exciting the patient. It’s rare for patients to remember their anesthesiologist after waking up, especially since they tend to be on several painkillers during the recovery process. An older man once assured Dr. Sidhu that her smile would get him through his surgery. It was a complicated case; he was having a left ventricular assist device implanted, a component of an artificial heart.
18 |
ISSUE 02 • 2017
When the assist was implanted into the left ventricle, the right side of his heart went into failure. The team had to put him on two extra support devices and intubate him. A few months later, Dr. Sidhu ran into the patient during an ICU rotation, and as promised, he remembered her by her smile. She admits the recollection was highly unusual, but cherishes it as an extremely rewarding moment. As a clinical student, Dr. Sidhu was excited to learn that AUA had been recognized by the Medical Board of California, which would allow her to practice in her home state. Once her fellowship ends, she will join Sutter Medical Center, a private practice in Sacramento. It’s about a 40-minute drive from Vacaville, her hometown. Dr. Sidhu's husband, Khaled, a family medicine specialist she met at AUA and with whom she did the couples match at Louisiana State University Health Sciences Center, has found work in the area as well. Dr. Sidhu estimates that about 80 percent of her cases at Sutter will involve cardiothoracic procedures, such as coronary bypass grafting surgeries, heart valve operations, or lung surgeries. Video-assisted thoracic surgery is commonly performed at Sutter as well. She will also be anesthetizing patients who are undergoing heart transplants and receiving left and right ventricular assist devices. Dr. Sidhu considers herself fortunate to have obtained a position so closely related to her subspecialty because she knows the more specific your training, the harder it is to find an exact match when job hunting. One of the things Dr. Sidhu really enjoyed about her fellowship was teaching. She is looking forward to entering the private sector, but at some point she’d like to return to academia, an interest she credits to the inspiring teachers she’s had throughout her education, including those at AUA. “When I was a clinical student I used to tell people that our Basic Sciences teachers were so knowledgeable that you’d feel comfortable having them operate on you. Their thought processes were so sharp you could just tell what excellent clinicians they were.” ■
GURLEEN SIDHU, MD
Class of 2012
Fellow, Cardiothoracic Anesthesiology Montefiore Medical Center, Albert Einstein College of Medicine Bronx, NY Resident, Anesthesiology LSU Health Sciences Center Shreveport, LA
“
The day you aren’t intimidated by your job as an anesthesiologist is the day you put your patient’s life at risk.
LETTER TO ALUMNI
| 19
EXAMINING THE BIGGER
PICTURE Dr. Anil George’s research may change the way childhood cancers are treated.
W
hen he entered the University of California at Davis (UC Davis), Bay Area native Dr. Anil George was an Asian American Studies major seriously considering law school. That all changed during the spring semester of his junior year when he interned at UC Davis’s pediatric subspecialty clinic to fulfill some volunteering requirements. It proved to be a transformative experience. The clinic’s patients were at-risk children considered to be “medically fragile.” Children who are medically fragile have one or more debilitating, often chronic, conditions. Witnessing the joy that these kids and their parents experienced while working with him and his fellow volunteers was something of a revelation.
20 |
ISSUE 02 • 2017
LETTER TO ALUMNI
| 21
“They had been dealt such a bad hand from the very beginning, but they were so happy and positive, so full of life,” he says. “Their parents were incredibly optimistic and their energy was infectious.” This led to a major shift in Dr. George’s academic focus. He spent the next year scrambling to complete prerequisite courses for med school, working in labs, and studying for exams in the library. It was a huge undertaking but proved to be worth the effort. As a nontraditional applicant, Dr. George found a home at AUA and half-jokingly refers to it as his “study abroad experience.” An active participant in campus leadership, he served as secretary of his Med 3 class, then president of his Med 4 class. “I couldn’t have asked for a better group of teachers,” he says, rattling off a list of Basic Sciences professors. “The foundation for everything I learned as a doctor was built in Antigua and during my rotations.” In addition to working with patients as a resident at the University of Kentucky, Dr. George was involved with community outreach and public advocacy. He recognized that nationwide, vaccination compliance rates were low and saw the potential for technology to raise awareness on a local level. Using a version developed at Columbia University as a model, he and a colleague created a mobile app to notify parents throughout the Lexington area via text message when it was time to take their children to a pediatrician for vaccinations. Dr. George also got involved with an organization called AdvoCats. As members of AdvoCats, medical residents at the University of Kentucky lead public health initiatives on behalf of children. During his residency, the group supported and argued for a smoking ban in public places where kids might be present and sought to establish penalties for teendating violence. They also educated parents about the dangers of tanning beds because at the time, teenagers were allowed to independently visit these salons. Last year, Dr. George began a three-year fellowship in pediatric hematology and oncology at the University
22 |
ISSUE 02 • 2017
of Illinois (UIC) College of Medicine in Chicago. In that time he has learned an enormous amount and successfully made the transition from resident to fellow. He says that as a fellow there is a greater emphasis on autonomy in medical decision-making and continuity of care. His fellowship is a unique program in that it is shared by three Chicago institutions: UIC, Rush University Medical Center, and John H. Stroger, Jr. Hospital. The structure of the program consists of a year of hospital-based inpatient/outpatient work followed by two years of research, which includes lab work and clinical applications simultaneously. Dr. George hopes to start using bioinformatics software to comb publicly available databases so he can identify genes that are implicated in pediatric brain cancer. This is especially important work because unlike childhood leukemia, the survival rates for childhood brain cancers are extremely low. The five-to-ten-year goal for the project is to help develop reliable gene therapies for the disease based on his findings. With its emphasis on research, this fellowship is a great opportunity for Dr. George and his colleagues to achieve breakthroughs. “That’s the way things are shifting. It’s about seeing what you can contribute to the ongoing effort, whether you’re spending time doing clinical research or you’re going to a lab and trying to work on potential therapies,” he says. Working in pediatric oncology can take an emotional toll—Dr. George is faced with the reality that despite his best efforts, some children will not survive. However, he keeps his focus on the big picture by staying positive and reminding himself daily that he’s not just treating ‘patients.’ “You’re treating someone’s son, or daughter, or brother, or sister, or friend. You’re treating a member of a much larger community.” Some might look at his field and conclude that it’s ‘not for the faint of heart,’ yet Dr. George’s career and his outlook suggest that it’s actually for the bighearted. ■
A N I L P. G E O R G E , M D
Class of 2013
Fellow, Pediatric Hematology/Oncology University of Illinois College of Medicine Chicago, IL Resident, Pediatrics University of Kentucky Lexington, KY
“
You’re treating someone’s son, or daughter, or brother, or sister, or friend. You’re treating a member of a much larger community. LETTER TO ALUMNI
| 23
A NATION IN CRISIS As America confronts the opioid epidemic, a hometown approach is vital. by: Dr. Elizabeth Bulat
24 |
ISSUE 02 • 2017
The daughter of Polish immigrants and a Detroit native, Dr. Elizabeth Bulat always envisioned herself returning home to practice medicine. As its economy declined, she realized that by the time she graduated from AUA, Detroit’s need for highly skilled, caring, primary care physicians would be greater than ever. Immigrants would continue to be among the many without adequate health care. St. Mary Mercy Hospital, where she was a resident, had its own Chemical Dependency Unit, and there she watched attending physicians detox patients. It was her first time closely observing patients dealing with substance use disorders or addiction, and it opened her eyes to the way these health problems are addressed. “They were constantly being treated for chronic illnesses like liver disease but not for the addictive behaviors that caused those conditions,” Dr. Bulat remembers. Recognizing this shaped the evolution of her career. Today, she directs the Henry Ford Maplegrove Center, a 62-bed, voluntary, residential treatment center in Detroit.
T
hose who suffer from addiction or substance use disorders are in a tragically unique position. They have a chronic brain disease that society continuously misdiagnoses as a character flaw or a moral failing. It is a misinterpretation that permeates our healthcare system and affects how we treat their symptoms. This tone deaf response always struck me and is one of the primary reasons I decided to specialize in addiction medicine. While the picture may be bleak in many ways, physicians are increasingly taking approaches that define addiction as the long-term, relapse-prone illness it is. These doctors are aware that more people recover than the general public realizes, that helpful medications exist to prevent relapse and are being developed, and that with the right aftercare program, success is achievable.
TO HEAL A NATION
| 25
I work with all types of chemically dependent patients, but as a Midwesterner, I am particularly concerned about opiate addiction. Carfentanil, an opioid 100 times more powerful than Fentanyl and sold on the street, created such a profound increase in overdoses that in September 2016, the State of Ohio declared a public health emergency. Opiates, drugs derived from opium, and opioids, the term commonly used to describe synthetic drugs that mimic the effects of opiates, have devastated families all over the country. In a longitudinal study, (Increases in Drug and Opioid-Involved Deaths – United States 2010-2015) the Centers for Disease Control reported that “drug overdose deaths nearly tripled during 1999–2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 61% involved an opioid.” In addition to my duties at the Maplegrove Center, I am part of the Henry Ford Opiate Task Force. We are a select group of doctors who specialize in areas like pain medicine and rehabilitation, and anesthesiology. All of us treat patients suffering from opiate addiction and are pooling our resources to come up with the best ways to respond to the epidemic. Our biggest goal is to establish appropriate prescribing practices. Treating chronic pain doesn’t always require medication. Another important goal is to help doctors identify opiate addiction earlier. Other healthcare institutions are launching similar initiatives. Government agencies are taking action and extensive media coverage is continuing to increase awareness about the crisis. While more than 1,000 people are treated daily in emergency rooms nationwide for misusing opioids, the net effect of this movement is positive and gives me encouragement. For example, in 2015, then-US Secretary of Health and Human Services (HHS) Sylvia M. Burwell publicly identified three priority areas for combating the opiate epidemic: examining opioid prescribing practices to reduce the use and misuse of these drugs; increasing the use of Naloxone, which can save the life of someone who has overdosed; and providing wider access to medication-assisted treatment for addicts.
26 |
ISSUE 02 • 2017
In March of this year, the governor of my home state, Rick Snyder, explained that the number of prescriptions written for opioids in Michigan the previous year had ballooned to 690 million. It’s staggering when you consider that in 2007, 180 million such prescriptions were written. Yet just last month the state introduced a new automated system that will make it much easier for doctors to access a real-time history of a patient’s prescriptions and whether Schedule II-V drugs are among them. Opiates and opioids are included in these classifications. Legislators on both sides of the aisle have introduced bills that address the issue as well. One bill, if signed into law, would create penalties for failing to enter prescriptions into the database and another would offer treatment options through Medicaid for those addicted to opioids. Earlier this year, the State of Michigan was notified that it will be receiving about $16.5 million from HHS to combat the opioid epidemic. One of the priorities that HHS has added is “supporting cutting-edge research” in this area. If you were to meet the patients at the Maplegrove Center, you would realize that the opioid epidemic and addiction in general do not discriminate. Patients of all socioeconomic backgrounds check themselves into our facility. They range in age from 18 onwards. Obviously, there are many challenges to improving this kind of care on the national level. However, my first concern will always be my patients, the people of my city, Detroit. Few things are as satisfying as meeting patients in recovery and having them thank you for helping them through the toughest moments of their lives. It makes every frustration worth the effort. ■
“
Few things are as satisfying as meeting patients in recovery and having them thank you for helping them through the toughest moments of their lives.
"
E L I Z A B E T H B U L AT , M D , FA S A M
Class of 2010
Medical Director, Henry Ford Maplegrove Center Henry Ford Health System Detroit, MI Clinical Associate Professor Wayne State University/Detroit Medical Center Detroit, MI Fellow, Addiction Medicine St. Joseph Mercy Hospital Ann Arbor, MI Resident, Internal Medicine St. Mary Mercy Hospital Livonia, MI
TO HEAL A NATION
| 27
R E N É E P E T E R K I N - M CC A L M A N , M D , M P H
Class of 2015
Resident, Internal Medicine Augusta University Medical Center Medical College of Georgia Augusta, GA
“
I was able to identify a life-threatening problem and get through to the patient about the gravity of the situation, which saved her.
28 |
ISSUE 02 • 2017
Q& A Dr. Renée Peterkin-McCalman shares the experiences that led her to focus on public health.
Dr.
Renée Peterkin-McCalman remembers her graduate work in public health as “a pleasant detour” on the way to medical school. Though she always intended to become a physician, she had an early focus on the social determinants of health and how healthcare is provided in underserved communities. Dr. Peterkin-McCalman and her family moved to the United States from Jamaica when she was in elementary school. Her childhood there formed the basis of her interest in global medicine and inspired her to work in community outreach and research. She graduated from historically black, Lincoln University with a degree in biology, and then became a research assistant at Georgia State University while earning her Master’s in Public Health there. Dr. Peterkin-McCalman volunteered with the DeKalb County Board of Health: Refugee Health Program during this time as well. She loves being an internal medicine resident but misses the emphasis on public healthcare issues. “When I say ‘public health,’ I’m referring to underserved and impoverished populations first and foremost. While I plan to serve those communities within the United States, the Caribbean and Jamaica will, of course, always have a very special place in my heart,” Dr. Peterkin-McCalman says.
When you were still in Jamaica, did you have any experiences with the healthcare system that made improving public health so important to you? Growing up, my mother was hospitalized there and I remember how dreadful the conditions were. The hospital didn’t have air conditioning and we’d just open the windows and hope for a cool breeze. Comparing that experience to what you find within the American system has motivated me to explore different ways to initiate outreach efforts back home. I’ve been talking with the people here at Augusta about doing global health mission work in Jamaica in the near future.
Who are your patients at Augusta University Medical Center? We’re a public hospital with a mostly indigent population. We see multiple comorbidities and a lot of Medicaid recipients. These are people who can’t always afford medications and the best care. As a second-year resident how have your responsibilities changed? As a first-year, it was definitely an adjustment. Initially, I had confidence issues because I was one of only two international medical graduates in a class of 19. Now I feel more assertive and capable in teaching the interns
TO HEAL A NATION
| 29
and taking on all the additional responsibilities that second-year residents have. I remember going to my program director my first year and telling her that I felt overwhelmed. She told me to stop doubting myself and that I was on the same level as everyone else. When I thought about it again, it made perfect sense. I knew I was on an equal footing with my colleagues. After all, the training I received at AUA, on campus and as a clinical student, was modeled on US medical programs. Was medical school a major transition? I went to AUA when it was still on a trimester system, where you only get a week off between terms. I remember having difficulty in my physiology class so I went to the Education Enhancement Department (EED) and it was incredible. That same semester all my grades turned around. I had a better understanding of the material and even became a tutor afterwards. How did EED help you to improve your performance on exams? The first was organization, the second was time management. Forcing me to map out my day with a study plan and goals for the week instead of just jumping into it blindly was an immense help. It made a real difference in my preparation and ultimately, my exam scores improved. I use those lessons in my work today. What has been the most rewarding experience you’ve had as a resident so far? As an intern, you inherit the patients of the residents who came before you. A woman kept coming in and complaining of chest pain that was written off as heartburn, but I knew she was hypertensive, diabetic, a smoker, and that she had never had a full cardiac workup. At AUA, you learn a lot about patient interaction and bedside manner before your rotations even begin, so I knew I could convince her to see a cardiologist. The next week she ended up having bypass surgery. She had complete occlusion. It still sits with me, and to this day, she thanks me. I was able to identify a life-threatening problem and get through to the patient about the gravity of the situation, which saved her. There’s no way to describe that feeling. ■
30 |
ISSUE 02 • 2017
MAKING A
BIG IMPACT IN A SMALL COMMUNITY
Dr. Ashley Bernotas is one of four residents in a new program designed to address upstate New York’s primary care shortage.
T
here are only 17 medical schools in Canada, which makes getting into one that much more challenging. When Dr. Ashley Bernotas applied to McMaster University’s School of Medicine in Hamilton, Ontario, she was one of almost 5,000 qualified applicants. Only 194 were accepted. After learning that she had not been accepted to McMaster, Dr. Bernotas considered Caribbean medical schools and chose AUA because of its “reputation, the strength of its MD program, and the convenience and safety of Antigua.”
TO HEAL A NATION
| 31
“
I felt very privileged to have opportunities that were diverse not only in location and socioeconomic demographics, but also in healthcare accessibility and patient population.
During Clinical Sciences, Dr. Bernotas actively selected rotations in various locations knowing each one would offer a distinct experience in serving different communities. “I felt very privileged to have opportunities that were diverse not only in location and socioeconomic demographics, but also in healthcare accessibility and patient population,” she says. “I got to see different parts of the country from a unique perspective.” Ultimately, she chose family medicine as her specialty because of the range of patients she would be able to treat. Last year, Dr. Bernotas became one of four residents in a new residency program at the 300-bed Champlain Valley Physicians Hospital (CVPH). It’s located about 25 minutes south of the Canadian
32 |
ISSUE 02 • 2017
"
border in Plattsburgh, New York, in the Champlain Valley, which includes parts of Upstate New York, Vermont, and Quebec. During the interview process, CVPH administrators made it clear to Dr. Bernotas that the program had never existed before and that a lack of primary care physicians in the region was its driving force. This shortage is due to an aging population and the pending retirement of physicians. It is estimated an additional 100 primary care providers will be needed by 2018. With 20,000 residents, Plattsburgh is the largest municipality in the Champlain Valley, while the rural surrounding areas have 140,000 residents combined. Primary care is in especially short supply in these towns.
A S H L E Y B E R N O TA S , M D
Class of 2015
Resident, Family Medicine University of Vermont Healthcare Network Champlain Valley Physicians Hospital Plattsburgh, NY
Dr. Bernotas was intrigued. As a natural leader and problem-solver, she had often thought about directing a residency program herself someday. This was a ground-floor opportunity and a chance to learn a great deal. “When you’re in a program’s first class you get to learn a lot about what works and what doesn’t, what the pitfalls and the benefits are,” she says. Despite working 12-hour shifts and having little free time, Dr. Bernotas has always been able to make herself at home wherever she is. “I’m the kind of person who can have a conversation with anybody and make friends easily,” she says. Plattsburgh’s size makes this particularly easy and the town seems to agree with her. She’s able to get to know her patients really well because the community is so close-knit.
“You don’t get continuity of care to this degree at a lot of other places. Doctors at CVPH deliver babies and end up caring for them through childhood, adolescence, and adulthood.” After residency, she plans to go into private practice but wants to maintain her relationship with CVPH, ideally, as faculty. The bonds she’s formed with her patients, colleagues, and mentors and the clinical experience she’s gained there have made her feel like a full-fledged member of the hospital and the Plattsburgh community. “Practicing medicine was always my dream but actually being able do it at this level has far exceeded my expectations.” ■
TO HEAL A NATION
| 33
34 |
ISSUE 02 • 2017
“
Treating children and helping families in their time of need is what gets me out of bed every morning. It’s why I’m a doctor.
"
RESTORING
HOPE Dr. Jason Pryor treats the youngest and most vulnerable patients.
JA S O N P R YO R , M D , M P H
Class of 2011
Attending Neonatologist, Neonatal Intensive Care Unit Carilion Roanoke Memorial Hospital Roanoke, VA Fellow, Neonatology-Perinatology Vanderbilt University School of Medicine Nashville, TN Chief Resident, Pediatrics ETSU Quillen College of Medicine Johnson City, TN TO HEAL A NATION
| 35
L
ong before he became the first MD in his family, before he was a pediatrician or a neonatologist, before he had any idea where his career path would lead, Dr. Jason Pryor knew without a doubt that he would advocate for children and his community in some way. He grew up in Seymour, Tennessee, a small town near Knoxville, and spent much of his teenage years volunteering with kids in his community. He counts his volunteer work with the Knoxville Special Olympics among his most rewarding experiences. Still unsure of ‘what he wanted to be when he grew up,’ Dr. Pryor went to Union College in Kentucky for his freshman through junior years and played on the school’s baseball and football teams, the Bulldogs. It was during this time Dr. Pryor realized that becoming a pediatrician would allow him to make the greatest impact on the lives of children and their families. He decided to focus solely on medicine and for his senior year, transferred to East Tennessee State University (ETSU) in Johnson City as a biology major. Because ETSU quickly became a second home to Dr. Pryor, he ranked its medical school as his first choice, but unfortunately, was not accepted. On top of that, US med schools require students to wait a full year before they can reapply. Restless and eager to begin his medical education right away, he began looking at Caribbean schools that admit students on a rolling basis. This would give him the opportunity to start working towards his MD immediately after college. His research and the discussions he had with AUA administrators, especially Bob Gelles, who Dr. Pryor mentions by name, left no doubt in his mind that AUA was the right school for him. “Of all the Caribbean schools I evaluated, AUA was the one that impressed me most. I found that same personalized approach that made ETSU feel like my home away from home. The accessibility of professors, the genuine interest that the administrators and faculty take in you as a person—it was just so welcoming,” Dr. Pryor recalls.
36 |
ISSUE 02 • 2017
Today, Dr. Pryor is a fellow in neonatology-perinatology at Vanderbilt University in Nashville, where he treats premature babies and infants with special surgical needs.
Although he was disappointed to leave Johnson City, Dr. Pryor soon immersed himself in the AUA community. He focused on his studies, developed strong relationships with his professors, and learned about other cultures by being part of an incredibly diverse student body. During his clerkships, he took every opportunity to broaden his clinical experiences and in doing so, pursued emerging interests as elective rotations. “I worked extremely hard at AUA and took advantage of all the resources available to me,” Dr. Pryor says. When he started applying for residency, of course his thoughts returned to ETSU and the hope to complete some component of his medical training at his “home away from home.” Five years had passed since he first applied to ETSU’s Quillen College of Medicine when Dr. Pryor received a letter from the Pediatrics department, offering him a position in their residency program. Everything seemed to come full circle when he returned to ETSU as a pediatrics resident and eventually became chief resident. Today, Dr. Pryor is a fellow in neonatologyperinatology at Vanderbilt University in Nashville, where he treats premature babies and infants with special surgical needs. “What I love about neonatology is that it’s the ideal combination of intensive care and pediatrics. It forces me to think on my feet, in the sense that every patient outcome is critically important. Every case is urgent.” Neonatology also allows for a longer continuity of care than many other specialties.
For one month each year, Dr. Pryor and his colleagues provide neurodevelopmental follow-up. During this process, recent patients return to the hospital for a series of tests that measure cognitive and motor skills. “It’s incredibly rewarding to measure their improvement and witness how resilient these babies are as they grow healthier. Parents that were worried when we last met are now filled with joy and relief. You can’t help but share in that.” The focus of Dr. Pryor’s ambition was always twofold—help children and improve his community. As a neonatologist, he certainly achieved the former, but felt there was more he could contribute to the latter. He recently completed a Master’s in Public Health (MPH) at Vanderbilt. By evaluating health programs, utilizing qualitative data analysis, and studying the social determinants of health and epidemiology, Dr. Pryor’s master’s work taught him to see “the bigger picture” when considering issues like perinatal substance abuse. The opioid epidemic was of particular interest to him because of its prevalence in the southeast region of the country. Earlier this year, The Chattanoogan, a daily
news website based in Tennessee, reported that an “estimated 69,100 [people in the state] are addicted to prescription opioids and require treatment for prescription opioid abuse.” While earning his MPH, Dr. Pryor conducted research on this crisis and its relationship to neonatal abstinence syndrome in the United States. The resulting article will appear in an upcoming issue of Archives of Disease in Childhood, Fetal and Neonatal. His research on maternal alcohol consumption during pregnancy also appeared recently in Obstetrics and Gynecology. Now, Dr. Pryor is about to start a new phase of his life and career. Newly married, he recently accepted a position in Roanoke, Virginia and will be working as a neonatologist at the same hospital where his wife Meghan, a Doctor of Pharmacy, is based. “I’m really looking forward to this next chapter,” Dr. Pryor says. “I love what I do. Treating children and helping families in their time of need is what gets me out of bed every morning. It’s why I’m a doctor.” ■
TO HEAL A NATION
| 37
M I C H E L L E R A M S AY , M D , M B A Class of 2014 Resident, Family Medicine Henry Ford Hospital, Detroit, MI
“
My mom reminded me that becoming a doctor wasn’t just for me. It was for my daughter too and would lead us to a better future.
38 |
ISSUE 02 • 2017
A WORTHY SACRIFICE Dr. Michelle Ramsay entered medical school as a 30-year-old single mother. Today she is a family medicine specialist.
ROOTS, LEGACY, PROMISE
| 39
I
n 2009, Dr. Michelle Ramsay faced the biggest decision of her life. She had applied to AUA almost on a whim, but once she was accepted, the stakes instantly rose. Dr. Ramsay was finally given the opportunity fulfill her dream to go to medical school and earn her MD. Now presented with that chance, she felt uneasy. “You get the news you’ve always wanted to hear, but never thought you’d hear, and it scares you,” she explains. Dr. Ramsay, who left Barbados with her family when she was 12 and grew up in Bowie, Maryland, is the first college graduate in her family. She attended Bowie State University because it was an historically black university and kept her close to family. Medical school was always her intended destination, but marriage, motherhood, and divorce intervened. Deciding whether or not to attend AUA kept her up at night, while weighing the pros and cons occupied her mind by day. For the past six years, she had worked as a lab technician at Good Samaritan Hospital in Washington, DC. As she read and reread her acceptance letter, she wondered if she could meet the demands of med school. At the age of 30? She hadn’t been a student in eight years! None of that really mattered when it came to her biggest priority— her little girl, Desiree Duncan. As a single mother, Dr. Ramsay was raising a sevenyear-old alone and they were inseparable. She also didn’t want to uproot her child by taking her out of school, away from her friends, and moving to another country. With that in mind, her only option would be to leave Desiree with her parents in Bowie while she studied in Antigua for two years. What effect would that have on a small child? How often would they be able to visit each other? Dr. Ramsay remembers the encouraging words from her own mother that helped her not only commit to a decision, but also feel confident she made the right decision. “I’ll never forget sitting in my parents’ backyard going over it again and again with my mother, agonizing over it, really. I knew with 100 percent certainty Desi would be well cared for by her grandparents and feel at home with them. But how would I feel? Then my mom reminded me that becoming a doctor wasn’t just for me. It was for my daughter too and would lead us to a better future.”
40 |
ISSUE 02 • 2017
Henry Ford Hospital is also known for heart, liver, and pulmonary care, and a majority of the patients on Dr. Ramsay’s floor have been told that nothing can be done to improve their condition.
With that, she put her house up for rent, Desiree moved in with her grandparents, and Dr. Ramsay began her first semester of Basic Sciences at AUA. Being a student again after such a long time was a major adjustment. “AUA’s MD program is very intense. It’s extremely hands-on and you have to dive in from day one,” she says. Her first anatomy exam literally reduced her to tears. With the help of resources like AUA’s Educational Enhancement Department, she was able to strengthen study habits that had atrophied. She ended up doing well in her anatomy class and gained the confidence needed to excel throughout her medical education. “Once you learn new ways to approach learning and organize your thoughts and study skills around them, a whole new world opens up to you,” Dr. Ramsay says. By the time Clinical Sciences began, Dr. Ramsay was leaning towards internal medicine as her specialty, but her rotation in family medicine was such a great experience that she reconsidered. The wide range of patients she saw—children and adults, some OB/ GYN and elderly patients—appealed to her most. Through it all, from her time on campus to her rotations at clinical sites, Dr. Ramsay remained
present in her daughter's life by maintaining a nurturing relationship and keeping in close contact with her and her parents. With Skype, regular phone calls, and as many visits as time and money allowed, they remained best friends. Still, it wasn’t easy. “I really missed Desi and even though I was completely consumed by my studies and a demanding rotation schedule, there were definitely moments when I had to stop and remind myself why I chose this path,” Dr. Ramsay admits. This reminder and Dr. Ramsay’s persistence kept her focused through it all and ultimately, enabled her to obtain a competitive residency. Although the majority of her interviews were for internal medicine programs, she was so impressed by the family medicine specialists and resources at Henry Ford Hospital, that it quickly became her first choice. It aligned perfectly with how Dr. Ramsay saw herself—a primary care physician working with underserved populations. Henry Ford Hospital is also known for heart, liver, and pulmonary care, and a majority of the patients on Dr. Ramsay’s floor have been told that nothing can be done to improve their condition. They go there to get a second opinion. She likes the challenge of taking cases considered ‘closed’ by other physicians, especially because it forces her to improve her
consultative skills on a continual basis. Many of Dr. Ramsay’s patients lack awareness about their health, so she addresses this by emphasizing prevention and explaining why specific medications have been prescribed in an effort to encourage compliance with their treatment. Now remarried, Dr. Ramsay has welcomed a son, Chauncy Jr., who is nearly two-years-old. Her husband Chauncy Eakins is a pain management and rehabilitation specialist from Ohio, where the family will soon relocate. Desiree, practically grown up, is 17 now and about to begin college at Howard University, where she will be studying on a scholarship. She hopes to become a doctor as well and is interested in anesthesiology, the specialty that Dr. Ramsay once said she would have pursued had she entered medical school at a younger age. “I’m incredibly proud of Desi but I’m also extremely grateful that she was so understanding and supportive as I followed this dream,” Dr. Ramsay says with affection. “I couldn’t have asked for more.” ■
ROOTS, LEGACY, PROMISE
| 41
“
The closer I got to applying for residencies, the clearer it became that I did indeed want to become a pathologist like my grandfather.
42 |
ISSUE 02 • 2017
THE ART OF DETECTION My Journey to Pathology by Dr. Nickul Shah
NICKUL SHAH, MD Class of 2017 Resident, Pathology University of Massachusetts Baystate Medical Center Springfield, MA
The authors of most published medical research are already well-established MDs. Dr. Nickul Shah published his first book, Hepatitis C Infection and Adverse Hepatic Complications to Anesthesia (Scholars’ Press), shortly after he graduated from medical school. The book focuses on a case he observed during a surgical rotation he completed as an AUA student. In it, Dr. Shah details how he and an anesthesiologist tried to determine whether a drug used during a routine hernia surgery caused or contributed to the death of a cirrhotic patient. Of the eight journal articles he has published so far, two appeared in print before he graduated.
ROOTS, LEGACY, PROMISE
| 43
A
common thread among all medical specialties is the need to look for correlative factors and trace the symptoms of an illness to their source. This is the essence of pathology. I always knew I wanted to be a doctor, but for a long time, I didn’t know what area of medicine I wanted to pursue. My grandfather, who inspired me to serve my community more than anyone, was a pathologist in India, so I was aware of the field at a young age. I grew up hearing his stories about the puzzling cases he was presented with and how he was able, most of the time, to solve them. Hints about the specific path my medical career might take were present by the time I began studying at the University of Massachusetts Amherst, but the future was wide open as far as I was concerned. I first gained clinical laboratory experience as an assistant in the same hospital I’d one day return to as a resident. During my six-year employment with Baystate Medical Center’s Department of Transfusion Medical Services, I got hands-on exposure to various conditions. ABO incompatibility, transfusionrelated-lung-injury (TRALI), neonatal jaundice, and disseminated intravascular coagulation (DIC) were just a few. As a microbiology major, I was able to study fatty acid compositions using elemental analyzers to assess geological climate change. I was also able to study parasitology in a declining bee population using the immunodetection method called “polymerase chain reaction-enzyme linked immunosorbent assay (PCRELISA),” as well as Western Blotting technologies. I felt fortunate to be studying at a place where it was possible to learn how to utilize these techniques. When I finally entered medical school, I had more than an inkling that I wanted to specialize in pathology. What I knew without question was that my career and even my education had to put me in front of the rarest diseases and conditions. My fascination with the unknown and the power of science to unmask it drove me. The potential for that knowledge to help people and save lives propelled me. Between classes and studying for exams in Antigua, I had little time to spare but found myself scouring medical journals for articles about medical anomalies. My rotations were really the first chance I had to work with unusual cases. I made an effort to learn not just
44 |
ISSUE 02 • 2017
about individual patients and their chief complaints, but also about the pathophysiology of their ailments. I took every opportunity to follow up with pathologists at these sites so I could learn more about patients and their cases, especially after a resection, biopsy, or culture. I was relieved to find that these pathologists were willing and often eager to help me discover that something extra about a given patient’s history and condition. As I worked hard to complete all of my rotations, I constantly reminded myself to stay alert and recognize any unusual cases in need of closer attention. The more I did this, the more I realized that many of these cases deserved to be explored by others. Apart from the sciences, I had always enjoyed writing in high school and college. It later occurred to me that publishing articles about the rare medical conditions I was observing would be an ideal way to raise awareness and maybe even improve treatment. My work began to appear in journals. One was about a young woman with colorectal carcinoma. Another was about a man with squamous cell carcinoma, and another, about a patient with neuropathy in the ulnar artery. I co-authored an article on a Central Nervous System infection that was found in a patient who had a compromised immune system. Before long, I was approached to expand an article of mine into a book, something I had never anticipated. The closer I got to applying for residencies, the clearer it became that I did indeed want to become a pathologist like my grandfather. My interest deepened as I completed rotations in a variety of specialties, even ones that might have seemed unrelated at first. When I started writing about the cases I examined, that interest became a passion. I would recommend that any clinical student think beyond the immediate scope of the cases they are presented with during their clerkships. They should take full advantage of the wealth of knowledge possessed by supervising doctors and physicians in other departments at their clinical sites. Taking that extra bit of initiative will help them get closer to finding out where their place within medicine is, just as it did in my case. ■
KEEP YOUR
GOALS IN
FOCUS With a competitor’s mindset, Dr. Whitney Boling continues her family’s legacy.
ROOTS, LEGACY, PROMISE
| 45
WHITNEY BOLING, MD
Valedictorian, Class of 2011 Resident, Ophthalmology Indiana University Health Indianapolis, IN Transitional Year Wayne State University Detroit Medical Center Detroit, MI
“
‘I quit’ is not in my vocabulary and that often led me to work past the point of exhaustion if it got me closer to my goal.
46 |
ISSUE 02 • 2017
Dr.
Whitney Boling distinctly remembers the thrill and intensity of competition. The gymnasium lights unsympathetically glaring down on the volleyball court at the University of Indianapolis or that of a rival school. The hum of the crowd filling the background with cheers and gasps that rose during the most critical seconds of play. None of it mattered. Nothing could crack the invisible barrier Dr. Boling built to ensure her focus was uninterrupted and every last reserve of energy and concentration was put into the game. As a lifelong athlete and a member of The Greyhounds, a Division II women’s team, Dr. Boling knew that defeat was as much a part of competition as victory, and that in a way, the two defined each other. Those were perhaps the two principles that most prepared Dr. Boling for her medical education and career—shut out all distractions while pursuing a goal and walk beyond a loss towards the next win. Today, Dr. Boling is nearly finished with her residency in the highly competitive field of ophthalmology. As she looks back on the ten-year journey of her medical education, she sees parallels between sports and academics. She was valedictorian of her graduating class at AUA and says that the discipline she developed as an athlete helped get her through the toughest moments of medical school. “I’m a naturally competitive person, and in med school, that gave me the laser focus I needed to be successful. ‘I quit’ is not in my vocabulary and that often led me to work past the point of exhaustion if it got me closer to my goal.” At the same time, when Dr. Boling learned she hadn’t matched to her dream ophthalmology residency on her first attempt, she was devastated. She wanted to follow in the footsteps of her father and grandfather, both ophthalmologists who completed their residencies at Indiana University Health. Dr. Boling’s father now runs the family practice opened
originally by her late grandfather in Elkhart, Indiana, about three hours north of Indianapolis. Naturally, she envisioned a rewarding career working there as a third-generation ophthalmologist. “It was like that dream was snatched away in a second leaving me in the fetal position for a week,” Dr. Boling half-jokes as she recalls how it felt when failing to match. After taking a moment to regroup and reassess, she picked herself up, true to form, and prepared to defy the odds. While many of those close to Dr. Boling encouraged her to apply to residencies in less competitive specialties, she harnessed the determination she developed as an athlete and reapplied to ophthalmology programs. The following year, Dr. Boling matched into a transitional program at Wayne State/Detroit Medical Center. Then she got her big win. Like her father and grandfather before her, she was offered a residency position in ophthalmology at Indiana University Health. Although her transitional year took her out of her home state, she had an incredible learning experience at Detroit Medical Center, where she also met her husband, a hospitalist. Soon, Dr. Boling will finish her residency and work alongside her father. She will perform laser procedures, cataract surgery, and intravitreal injections, as well as LASIK and other types of refractive procedures. She’s looking forward to having more rewarding experiences with her patients. “You wouldn’t expect it, but I’ve had patients hug me after an intravitreal injection,” Dr. Boling says about a procedure that involves sticking needles into the eyes. The same is true of her cataract patients. “They go from not being able to see their own hands in front of their faces to being able to read with almost 20/20 vision immediately after the operation. We are truly in the business of restoring sight.” ■
ROOTS, LEGACY, PROMISE
| 47
ADVOCATE FOR YOUR SPECIALTY Dr. Vincent Gallo wants every medical student to know there’s more to radiology than interpreting images.
W
hen he talks about the circuitous route he took to get into his field, Dr. Vincent Gallo almost sounds like an ambassador for interventional radiology. “If I can get one medical student interested in interventional radiology, somebody I could mentor or just talk to about it, I’d be extremely happy,” he says. Dr. Gallo calls interventional radiology “the future of medicine” and is eager to raise awareness about it because many medical students miss out on pursuing this specialty. The majority of radiologists read and interpret diagnostic images. Interventional radiologists, on the other hand, use diagnostic images like fluoroscopy, ultrasound, CT, or MRI to assist in performing minimally invasive surgery. This, plus plenty of patient consultation, describes about 90 percent of Dr. Gallo’s day-to-day work. Most of these procedures are done by using small needles to insert even smaller catheters into blood vessels, often through veins or arteries in the hip or wrist. The catheters are then streamed into various areas affected by a given disease. Even chemotherapy or radiation treatment can be applied using this method. When treating peripheral arterial disease, interventional radiologists can use catheters to put stents in place or to inflate balloons.
48 |
ISSUE 02 • 2017
VINCENT GALLO, MD
Class of 2009
Interventional Radiologist Advanced Interventional Radiology Services, LLP Holy Name Medical Center, Teaneck, NJ Saint Mary’s General Hospital, Passaic, NJ
“
If I can get one medical student interested in interventional radiology, somebody I could mentor or just talk to about it, I’d be extremely happy. LETTER TO ALUMNI
| 49
They can perform uterine fibroid embolization, a treatment in which sand-sized pellets are injected into the uterus to make growths or fibroids shrink. This type of treatment makes it possible for women with large uterine fibroids to avoid open hysterectomies. “When we’re done, we pull the catheter out and the patient is left with a small, pin-sized hole that we just cover with a Band-Aid,” he explains. Dr. Gallo, who grew up in New Jersey and studied health sciences and minored in biology at Quinnipiac University in Connecticut, is the first college graduate in his immediate family. This is something he acknowledges but downplays. Instead, he stresses the long line of hard workers he comes from and talks about his father’s landscaping business. “He used to make me work with him when I was kid. I quickly realized I wasn’t interested in the family business, but at the same time, it taught me how to work hard, treat your clients well, provide for your family, and run a business. I take that with me to this day.” Dr. Gallo enjoyed his clerkship in diagnostic radiology but it seemed to lack one of the biggest draws that attracted him to medicine in the first place—patient interaction. He didn’t like the idea of sitting in front of a screen in a dark room all day, not knowing what was going on in other parts of the hospital. Since he still knew nothing about interventional radiology, he prepared himself for a career in primary care. It was during his internal medicine residency at the State University of New York (SUNY) Downstate in Brooklyn, that he learned about interventional radiology. With its combination of patient interaction, diagnostic image interpretation, and surgery, it seemed like the perfect fit. After completing his residency, he stayed at SUNY Downstate and entered a Diagnostic and Interventional Radiology Enhanced Clinical Training (DIRECT) Pathway fellowship. The DIRECT Pathway allows fellows to count two years of their clinical training towards a certificate in Diagnostic Radiology and a subspecialty certificate in Vascular and Interventional Radiology (VIR).
50 |
ISSUE 02 • 2017
While completing the DIRECT Pathway, he also created the Interventional Radiology Interest Group for Medical Students to expose future physicians to the concepts that he and his colleagues were working with and the procedures they were performing. Soon the DIRECT Pathway will no longer exist, but in the near future, students will be able to complete residencies in interventional radiology straight out of medical school. Dr. Gallo is particularly eager to publicize this. On top of consulting with patients and performing surgery, he and his wife, Kerry, are raising two young children. Dr. Gallo is eternally grateful for the support and guidance Kerry has provided for him throughout his medical education and career. “She has played a crucial role in everything I’ve managed to achieve. Without her I wouldn’t be where I am today,” Dr. Gallo says. He is also co-authoring a book chapter with Dr. John Rundback, his director at Holy Name Medical Center. The subject addresses how to treat acute and chronic mesenteric ischemia, a gastrointestinal disorder, from an interventional radiologist’s perspective. AUA continues to hold a special place in Dr. Gallo’s heart. He is grateful to his professors, who he says were instrumental in preparing him to pass the USMLE Step 1 on his first attempt. Long after graduating, he still carries the same sense of camaraderie and support he found within the AUA community by regularly getting together with friends he made on campus and by reaching out to current and prospective students. Dr. Gallo shares an anecdote to illustrate his affection. While an internal medicine resident at SUNY Downstate, he recalls meeting an AUA graduate there who was doing a residency in orthopedics, one of medicine’s most competitive specialties. Dr. Gallo says, “In that moment, I just felt so proud, like his accomplishment was ours.” ■
ROOTS, LEGACY, PROMISE
| 51
B I N D I YA G A N D H I , M D
Class of 2010
Family Medicine Specialist Revive Atlanta MD Atlanta, GA
“
As doctors, we need to place a greater emphasis on patient education, stress reduction, and prevention.
52 |
ISSUE 02 • 2017
STRIKING
A
BALANCE Integrative and Functional Medicine Are Compatible with Traditional Approaches and Will Improve the Lives of Patients. by: Dr. Bindiya Gandhi
A
ccording to the Centers for Medicare and Medicaid Services (CMS), between 2014 and 2015, Americans spent $3.2 trillion on healthcare for chronic conditions or almost $10,000 per person. Between 2016 and 2025, the CMS expects National Health Expenditures to increase by a yearly average of 5.8 percent. The American healthcare system and Western medicine in general have a wealth of talent, financial resources, and technology that make them the envy of the world. However, this data illustrates that we need to adjust our focus.
The greatest strength of Western medicine is acute care. It is excellent in addressing medical emergencies to save lives. However, I believe Western medicine must pay more attention to preventive care than it currently does. I once viewed concepts like meditation, movement, Traditional Chinese Medicine, Ayurveda, herbal medicine, mind-body therapies, and even self-care with a great deal of skepticism. Yet the more experience I gained as a practicing physician, the more I began to see the need to view symptoms holistically and come up with an appropriate course of treatment.
A FINE BALANCE
| 53
In my practice, I have found that the emerging areas of integrative and functional medicine provide an excellent complement to the benefits of Western medicine by focusing on prevention, wellness, and chronic care. It is also important to mention that both are evidence-based fields. Rather than waiting for patients to get sick, then treating isolated symptoms, doctors who operate from this perspective get to root causes by spending a longer period of time with patients than they would using a traditional approach. They take detailed histories of each patient, which makes highly individualized treatment more possible.
These are newer fields, so it’s understandable that much of the wider medical community does not recognize them yet or that they aren't part of medical school curriculum. I received my own training in these areas post-residency and am encouraged when I hear of new programs similar to the fellowship I completed in Integrative Medicine at the University of Arizona. The fact is, this type of care is in demand. I constantly meet new patients who want to focus on improving their entire lifestyle. The general public is also more aware of the need for prevention, for healthy habits, and the role genetics plays in illness and chronic conditions.
Integrative medicine is about giving patients tools they can draw upon to really take charge of their lives. In this way, the physician plays the role of educator. Integrative medicine specialists also coordinate with other healthcare providers like chiropractors, physical therapists, and nutritionists. It is an expanded, specialized approach designed to help patients get better and stay well. As integrative medicine specialists, we emphasize stress reduction and a lifestyle that is healthier overall.
The French government already incorporates functional and integrative medicine into its healthcare system. Homeopathy is taught in medical schools in many European countries and doctors in the Cuban healthcare system use it as well. Ayurveda has been a staple of Indian medicine for decades and Traditional Chinese Medicine has been practiced for centuries in East Asia.
Assessing, preventing, and treating chronic diseases are central to the practice of functional medicine. These physicians get to the heart of a problem with a variety of tests that determine nutrition, genetics, toxicity, hormone levels, as well as the health of each patient’s immune system and metabolism. Supplements and other integrative resources are used to help symptoms improve.
54 |
ISSUE 02 • 2017
As doctors, we need to place a greater emphasis on patient education, stress reduction, and prevention. Integrative and functional medicine complement the many gifts of traditional Western medicine and their application should be viewed as a way to enhance the quality of patient care and reduce healthcare costs. Younger generations must be included in this movement. After all, they are the ones who will be able to build on these approaches to lifestyle and medicine and teach them to their colleagues and patients. ■
THE LAB Dr. Kunal Sood loves doing research, but his true passion is working with patients.
I
n April, Dr. Kunal Sood received great news from the International Anesthesia Research Society (IARS). Findings from a retrospective study he designed and conducted with his colleagues at Detroit Medical Center had been selected for presentation at the IARS Annual Meeting and International Science Symposium to be held in Washington, DC. Dr. Sood had already presented this research last fall at the American Society of Anesthesiologists annual meeting in Chicago and the American Society of Regional Anesthesia and Pain Medicine in San Diego.
The study looked at how participants responded to different types of anesthesia used during joint surgeries like hip and knee replacements. Specifically, it sought to determine how various drugs affected the rate of joint infection at surgical sites. The results indicated that this rate was lower for patients who received regional anesthesia as opposed to general anesthesia. Dr. Sood and his colleagues also considered risk factors for surgical site joint infection, like smoking, diabetes, obesity, and peripheral vascular disease.
A FINE BALANCE
| 55
K U N A L S OO D , M D Class of 2013 Fellow, Interventional Pain Medicine Wayne State University Detroit Medical Center Detroit, MI Resident, Anesthesiology Wayne State University Detroit Medical Center Detroit, MI
56 |
ISSUE 02 • 2017
“
Cancer patients have a tough battle to fight, and I believe that helping them is my calling.
"
Earlier this year, a case study on post-surgical vision loss that Dr. Sood co-authored appeared in Anesthesia & Analgesia as well. He and his team concluded that when patients present with postoperative blindness and the cause is uncertain, they should always be given an electroencephalogram (EEG) to determine whether they have had an occipital seizure. Despite how much he enjoys research, Dr. Sood’s true passion is working with patients. While he was a college student at the University of Maryland, College Park, Dr. Sood volunteered at local hospitals, including the oncology ward, which left him with a deep sense of compassion for cancer patients and a desire to help them. He completed his first two years of medical school at Manipal University and his fifth semester at the AUA campus in Antigua. The majority of his rotations were done in Brooklyn at Wyckoff Heights Medical Center. Throughout his medical education, Dr. Sood excelled at pharmacology and physiology, both of which are integral to anesthesiology. This led him to pursue it as his specialty. In 2013, he graduated magna cum laude from AUA and began his residency in anesthesiology at Detroit Medical Center. It was a seamless transition made possible by AUA’s Clinical Sciences department. Because back-to-back rotations were scheduled for him, he was able to match before he graduated.
“They really went the extra mile for me. A lot of other schools don’t do that. Students often have to contend with big gaps in between clerkships. I was able to finish on time and match the same year. I really appreciated that,” he says. Dr. Sood chose to do his residency in Detroit because he knew the city’s need for quality healthcare was significant and would present him with great challenges as a clinician. The vast majority of his patients are obese and have multiple comorbidities. Most are on more than one prescription medication and some are substance abusers. “For anesthesiologists, these are the hardest to put under for surgery,” says Dr. Sood. In his view, practicing in Detroit was the perfect way to make a difference while sharpening his skills as a physician. One of the highlights of Dr. Sood’s medical career came shortly after he sat for his first board exam in the summer of 2015. He left feeling confident but didn’t anticipate what was to come. Six months later, the American Board of Anesthesiology wrote to congratulate him. Dr. Sood had scored in the top tenth percentile of test-takers. “That’s one of the achievements I’m most proud of and it can be traced back to AUA, where I built a strong foundation in the sciences that continues to influence the way I learn and apply knowledge,” he says. Dr. Sood’s residency ended in June, so he is preparing for his next move—a one-year fellowship in interventional pain medicine, also at Detroit Medical Center. Afterwards, he envisions himself practicing in his home state of Maryland, where ideally, he will obtain a position in interventional pain medicine or one that is half anesthesiology, half interventional pain medicine. In the meantime, he is looking forward to a change of pace. While his residency was primarily OR-centric, the fellowship will involve more patient interaction and a broader range of conditions. Dr. Sood will also spend part of his time at the Karmonas Cancer Institute, located on the Detroit Medical Center campus. He is particularly excited because he will get to spend much more time with oncology patients than he was able to in the past. “Cancer patients have a tough battle to fight, and I believe that helping them is my calling,” he says. ■
A FINE BALANCE
| 57
ADRIAN WYLLIE, MD, MBA
Class of 2014
Resident, General Surgery Yale University School of Medicine Yale-New Haven Hospital New Haven, CT
“
It’s important that we get a seat at the table because on the floors and in the clinics, we see the impact that policy changes are having on our patients.
58 |
ISSUE 02 • 2017
Q& A Dr. Adrian Wyllie talks about leadership and research.
Dr.
Adrian Wyllie grew up in St. Vincent and the Grenadines, where he says parents are known to push their kids towards careers in law or medicine. “In college, I took refuge in biology. I was fascinated by the human body and the way it responds to ailments and treatments, so I wanted to learn more,” he explains. After studying biology on a tennis scholarship at the historically black University of the District of Columbia, Dr. Wyllie graduated cum laude. In a roundabout way, he learned of AUA’s medical program on the Yale campus. His then girlfriend, now wife, was a Yale student and came across a flyer advertising AUA and its scholarship opportunities. Shortly thereafter, Dr. Wyllie applied and began his medical education as a recipient of AUA’s Physician Diversification Initiative Grant. As a second-year resident in a preliminary general surgery program, he’s the one at Yale now. Dr. Wyllie rotates through various surgical departments including Thoracic, Endocrine, and Colorectal Surgery, among other areas of the Yale-New Haven Hospital for about a month at a time. Soon, he’ll be doing research in vascular surgery, which he plans to specialize in after finishing his residency.
Was going to medical school in Antigua much of a transition for you? I had a wonderful experience at AUA. I’m originally from St. Vincent so I was already acclimated to the weather, culture, and food. It wasn't a big change for me, especially since Antigua is one of the more modern islands in the Caribbean. When it comes to AUA itself, I think the Teaching Assistant (TA) program is one of the true gems of the school. I was an Anatomy TA and prosector, and occasionally led small groups in biochemistry. These experiences helped me become a stronger leader and made studying much easier.
As a general surgery resident, what is your day-today like? I may be assigned to trauma surgery where I am evaluating patients with gunshot wounds, liver lacerations, or splenic rupture from motor vehicle collisions. Then I may rotate on surgical oncology where I’m managing patients with pancreatic or breast cancers. It is challenging in the sense that you are on a new team every month with different attendings. Each attending surgeon has a different approach to patient care, so it’s important to ask a lot of questions and be adaptable. In addition to this, I see consults in the Department of Emergency Medicine.
A FINE BALANCE
| 59
What’s interesting about vascular surgery research? Vascular surgery is so versatile. Vascular surgeons perform a broad range of endovascular and open procedures. From endovenous laser therapy on venous ulcers, to open repair of abdominal aortic aneurysms, to carotid artery stenting, its complexity and potential are vast. Endovascular procedures are less invasive than open surgery and spare the patient a long recovery. Grafts, for example, provide necessary treatments to patients who may be at greater risk for complications during surgery. You completed your MBA through the partnership AUA has with Plymouth State University. Has this affected your thinking about the US healthcare system and how to improve it? I see myself becoming a chief or the chairman of a department at some point in my career, so having an MBA in healthcare administration will definitely help me become an effective leader. We need more physicians to play an integral role in hospital administration and even on Capitol Hill. It’s important that we get a seat at the table because on the floors and in the clinics, we see the impact that policy changes are having on our patients. What separates good doctors from great ones? You need to spend time with patients. Residents are so busy and patient lists are never truncated, so it is challenging to find enough hours in the day. I like to visit them in the afternoon or just before I head home and ask how their day was or if their pain has improved. This makes the job much more enjoyable, and I’m sure the patients appreciate it as well. ■
60 |
ISSUE 02 • 2017
A
GRASSROOTS
APPROACH TO
MENTAL HEALTH As a public psychiatry fellow, Dr. Jasmine Sawhne will have a chance to improve treatment for those who need it most.
T
he Tuesday afternoon Dr. Jasmine Sawhne spoke to AUA Alumni marked the beginning of her elective in Assertive Community Therapy (ACT) in Staten Island, New York. ACT is an integrated, evidence-based practice that utilizes the services of nurses, social workers, psychiatrists, and other mental health professionals to treat the severely mentally ill in their homes when traditional, hospital-based approaches have failed them. Dr. Sawhne, who is originally from Staten Island, has taken the majority of her electives in community-based psychiatry to prepare for a fellowship at the University of Pennsylvania’s Center for Mental Health Policy and Services Research in Philadelphia.
A FINE BALANCE
| 61
JA S M I N E S AW H N E , M D , M B A
Class of 2013
Fellow, Community Services Psychiatry Center for Mental Health Policy & Services Research University of Pennsylvania Philadelphia, PA Resident, Psychiatry Creedmoor Psychiatric Center Queens Village, NY New York-Presbyterian Medical Center Columbia University Manhattan, NY
“
I truly want to make advancements in this field as part of the next generation of leaders in public psychiatry.
62 |
ISSUE 02 • 2017
Dr. Sawhne spends roughly half her time at Columbia The University of Pennsylvania fellowship has a strong University’s New York-Presbyterian Medical Center, administrative component, so she’ll benefit from her where she treats a combination of inpatients and MBA experience, which prepared her to have skilled outpatients for mood disorders. They are usually conversations about budgeting and related issues with high-functioning individuals suffering from major healthcare administrators. depression, bipolar disorder, and anxiety issues. The other half of her working hours are spent at Dr. Sawhne also believes that extracurricular work Creedmoor, a large state hospital where she works helped her obtain the fellowship. As a resident, she with the chronically mentally ill. Creedmoor’s patients created a quality improvement program for managing are highly resistant to treatment and tend to have the care of diabetic patients, gave presentations on extensive histories of involvement with the criminal “hot topics” like K2, a synthetic cannabinoid, and justice system. volunteered at local Hindu temples to improve mental health awareness. The Creedmoor residency also allows all participants to work as Chief Resident for three months, which Additionally, Dr. Sawhne is part of the American Dr. Sawhne did last summer. As Chief Resident, Psychiatric Association, the Queens County she gained experience interacting with hospital Psychiatric Society, and the American Association committees and other parts of the hospital of Community Psychiatrists. She’s certain that infrastructure. Currently, Dr. Sawhne is completing community outreach like this, as well as being an an elective in administrative psychiatry. active member of the American Medical Student Association, writing on global health topics When she began researching fellowships, Dr. Sawhne for Examiner.com, and volunteering with local looked for programs with the prestige and resources organizations while she was an AUA student made a of an Ivy League institution but within a familial big difference. environment similar to what she enjoyed during her residency. After much consideration, she chose the A significant part of the work psychiatrists have to University of Pennsylvania over an offer from Yale do from a public health perspective is to remove the University. stigma from mental health issues and provide counter narratives to those often presented by traditional Although she was impressed by both programs, it was and social media. For example, Dr. Sawhne wants fellowship director Dr. Travis Hadley’s unconventional psychiatrists to help correct the notion that the approach to the interview process that influenced her majority of mentally ill people are aggressive and decision. Rather than conducting a series of standard prone to committing more acts of violence. According on-campus question and answer sessions, Dr. Hadley to the US Department of Health and Human Services took her on a tour of Philadelphia’s mostly poor, “most people with mental illness are not violent and urban, and suburban neighborhoods to introduce only 3-5 percent of violent acts can be attributed to Dr. Sawhne to the populations she would treat. These individuals living with a serious mental illness.” patients are often homeless, living with HIV, or have substance abuse issues. With only herself, another When she finishes her fellowship, Dr. Sawhne sees fellow, and Dr. Hadley participating in the program, herself taking on a field placement that will combine she could count on the didactics being highly clinical work with leadership, administration, and personalized. management. Whether it’s in a hospital or a smaller setting is not that important. "I truly want to Dr. Sawhne got her MBA through the AUA– make advancements in this field as part of the next Plymouth State partnership and credits it among other generation of leaders in public psychiatry.” ■ things for making her such a competitive applicant.
A FINE BALANCE
| 63
IN CLOSING T
o imagine your future, it helps to look to those who have already reached the places you want to be. Current and prospective AUA students can learn from the alumni whose stories appear in this issue and gain insight into what it’s like to be a doctor in various settings, the challenges they may face in getting there, and the rewards that await them once they arrive.
AUA graduates can learn about the amazing things their fellow alumni are achieving and how far they’ve come. Congratulations to everyone featured in the magazine this year. You truly embody AUA’s mission and make us proud. If you are an AUA graduate and would like to be included in a future issue please visit AUAalumni.org ■
64 |
ISSUE 02 • 2017
auamed.org
Manipal Education Americas, LLC, Representative for: American University of Antigua College of Medicine 40 Wall Street, 10th Floor, New York, NY 10005