pulse Volume 16 Number 1
Summer 2018
SPECIAL ISSUE
Better Medicine through
Diversity
message from the dean
M
pulse
y association with Rutgers New Jersey Medical School began 50 years ago when I enrolled in the institution as a first-year student. Back in those days, I was the only underrepresented minority student, not just in my class but in the entire school.
VOLUME 16 NUMBER 1 SUMMER 2018 RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY Dean
Robert L. Johnson, MD, FAAP’72 The Sharon and Joseph L. Muscarelle Endowed Dean Chief Operating Officer
Walter L. Douglas, Jr. Director of Marketing and Communications
Tiffany J. Cody Senior Editor, Pulse
Merry Sue Baum Contributing Writers
Ty Baldwin Genene W. Morris Design
Sherer Graphic Design Principal Photographer
Keith B. Bratcher, Jr. KEEP IN TOUCH
Pulse is published twice a year by Rutgers New Jersey Medical School. We welcome letters to the editor and suggestions for future articles. Send all correspondence to: LaCarla Donaldson Marketing and Communications Rutgers New Jersey Medical School ADMC Building 11, Suite 1110 30 Bergen Street Newark, NJ 07107 or via email to njmsmarketing@njms.rutgers.edu
ON THE COVER Vice Dean Maria Soto-Greene, MD, and Dean Robert L. Johnson, MD
Although New Jersey Medical School was still located in Jersey City at the time, we were preparing for the school’s big move to Newark’s Central Ward. What’s more, we were still reeling from the assassination of the Rev. Dr. Martin Luther King, Jr. And while we were four years out from the Civil Rights Act of 1964, racial tensions ran high. These are the events that helped to set the stage for our school’s long-standing commitment to diversity and inclusion in medical education. It is this commitment that not only makes our student body and faculty one of the most diverse in the nation, but one that makes us exceptional at serving diverse communities and caring for the underserved. This special issue of Pulse is devoted to shedding light on our diversity and inclusion initiatives. On the pages that follow, you can read stories about our efforts in this important area. One article documents the journey that Vice Dean Maria Soto-Greene, MD, and I made from medical students to administrators who work to promote diversity. It has been my honor and privilege to serve New Jersey Medical School for 50 years and counting. To have spent a portion of that time as dean fills me with enormous pride. When I reflect on my tenure here, some of the most satisfying moments have come while interacting with my patients. There’s no question that the stellar education I received here is what makes those moments possible. This is why I remain committed to ensuring that aspiring doctors, regardless of their backgrounds, are afforded the opportunity to study here, so they can also realize their dreams. In turn maybe they too will return to New Jersey Medical School to work and inspire future generations of doctors. In health,
C O V E R P H O T O B Y K E I T H B . B R AT C H E R , J R .
Robert L. Johnson, MD, FAAP’72 The Sharon and Joseph L. Muscarelle Endowed Dean Rutgers New Jersey Medical School
SPECIAL ISSUE • SUMMER 2018
pulse 3
Better Medicine through
Diversity 6
FE ATURES
10 From Medical Students to Highest-Ranking Administrators
7
Drs. Robert Johnson and Maria Soto-Greene discuss the changing face of NJMS.
12 NJMS Senior Leadership: Bastions of Diversity and Inclusion NJMS administrators are at the helm of one of the most diverse medical schools in the country.
12
D E PA RT M E N T S
2 FYI 4 A CLOSER LOOK
7 NJMS PEOPLE 1 6 ENDPAGE
Notable
FYI
others, formalized the Group for Women in
five minutes exchanging information about
Medicine and Science (GWIMS) four years
themselves and what they were looking for in a
ago. It is the local chapter of the Association of
mentor, then moved on. “There were about 70
American Medical Colleges’ GWIMS group. The
faculty there, and the response was very posi-
goal is to help women faculty thrive and support
tive,” Lamba says.
their advancement.
Many of those who attended asked for more
Lamba, NJMS’s
frequent mentoring opportunities, so Lamba and
representative to the
Soto-Greene are launching a program this fall,
national GWIMS,
known as AEM-Women, or Advancement through
explains that a number
Engagement and Mentoring. The first cohort will
of women faculty have
be comprised of about 20 underrepresented
been sponsored by
minority women faculty, who will participate in
NJMS for the Executive Leadership in Aca-
Lamba
monthly workshops related to building skills for career effectiveness and leadership.
Women Helping Women
demic Medicine (ELAM) Fellowship at Drexel University. Some of the “ELUMs,” as they call
but there’s still work to do,” says Mosenthal.
In 1847 when the all-male student body at
themselves, got together to plan the inaugural
“Through GWIMS we can contribute to moving
Geneva Medical College voted to admit Elizabeth
event for the new GWIMS. The result was a
women forward.”
Blackwell, they did it as a joke. She went on to
highly successful networking reception held in
become the first female physician; however, she
2015, with some 85 faculty—mostly female—at-
was never truly welcomed into the profession.
tending. Based on feedback, the group now has a presence on social media and peer mentoring
Things have come
and networking continue to increase.
a long way since then.
Last year Lamba developed a unique event
Today roughly one-third
“As female physicians we’ve come a long way,
NJMS Launches Maternal Health Day A patient we’ll call Maddie delivers a healthy
of all physicians are
that she called “speed mentoring.” Modeled
baby in the hospital, and both are fine. They go
women, and for the first
after speed dating, women faculty rotated among
home, and all is well until Maddie develops a
time this year 51 per-
tables that each had a theme, such as research,
severe headache. She takes an aspirin and tries
cent of entering medi-
education and work/life balance. Everyone spent
to ignore it. A few hours later, Maddie’s husband
cal school classes are female. (For the past 20
Mosenthal
years, the ratio held steady at 50:50.)
finds her dead. She’s had a fatal stroke. A phone call to her doctor may have saved her life. Scenarios like this play out across the country
There’s still a downside, however. “As
every day, particularly among African-
you go up in academic rank and
American and low-income women. To help
seniority, there are fewer and fewer women at each level,”
decrease maternal deaths, NJMS
says Anne Mosenthal, MD, the
held the first Maternal
Benjamin F. Rush, Jr. Endowed
Health Awareness Day
Chair, and professor of surgery.
earlier this year. New
“Only about 17 percent of
Jersey is the only state
women are department
in the country to
chairs or deans. Even in the
hold such an event.
female-dominated specialties,
“Maternal mortal-
like pediatrics and ob/gyn, the leadership is still mostly men.” To help end the discrepancy,
Apuzzio
ity can be caused by many things: eclampsia, blood clots and hemorrhages are just a few,” says Joseph Apuzzio, MD, professor and vice
Maria Soto-Greene MD, vice dean,
chair of ob/gyn and women’s health. “In many
and Sangeeta Lamba, MD,
cases we can prevent death, but patients need to
associate dean of education,
be aware. So do healthcare providers, legislators
along with Mosenthal and
and insurance company executives.”
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L E F T: N I C K R O M A N E N K O ; B O T T O M R I G H T: J O H N E M E R S O N
Jilyan Decker (left) and Matt Pulaski
Apuzzio, and a group of colleagues, have
ing speakers Tammy Murphy (wife of NJ Gover-
been working on creating a special awareness
nor Phil Murphy) and former model and health
day for two years. They garnered the support of
activist Christy Turlington. Drs. Apuzzio and Lisa
State Senator Joseph Vitale, and Maternal Health
Gittens-Williams also held an information session
Awareness Day in New Jersey was signed into
for pregnant patients in University Hospital’s ob/
law by Governor Christie in May 2017.
gyn outpatient clinic. “We’re doing all we can to
The day was marked across the state. On the
help keep every mother safe,” he says.
Newark campus there was a conference featur-
news
Compassionate Care Week
Every year the Gold Humanism Honor Society celebrates Compassionate Care Week, with a variety of events to reinforce awareness of how important benevolent care is to a patient’s recovery and to demonstrate that even the smallest gesture of kindness can make a person’s day. This year’s events included handing out baked goods to coworkers, putting handmade valentines on patients’ lunch trays and the following two events.
Paving the Way in LGBTQ Care When the Association of American Medical Colleges announced that physicians should learn to better serve their lesbian, gay, bisexual, transgender and queer (LGBTQ) patients, NJMS immediately took notice. An LGBTQ Clinical Taskforce was formed, and members integrated two days of curriculum content aimed at helping future physicians address the unique healthcare
Humanism Talks
needs of this minority population.
Should volunteerism exist? Can innovation and humanism coexist? These were just two of the
topics discussed at this year’s Humanism Talks, which are presented annually by the Healthcare
Foundation Center for Humanism and Medicine. The signature event, which is in its second year,
features short speeches by medical students and faculty that are modeled after TED talks. “These talks demonstrate the breadth of humanism and its relationship to all aspects of life and medi-
cine,” says Tanya Norment, program administrator of the Center. “The talks are always open to all RBHS schools, and we invited everyone to come including staff members.” This year for the first
time a medical resident gave a talk, along with one faculty member and five students. More than 100 people attended.
“We want NJMS to be a safe place for LGBTQ
patients, faculty and students,” says Matt Pulaski, Taskforce member and third-year student. “We want to confidently treat these patients and break down barriers that keep them from getting care.” The Taskforce developed the content that
is now part of the second-year genitourinary curriculum. Students hear lectures, participate in small group workshops that include videos, depicting culturally incompetent and competent
Reducing Stress with Four-Legged Friends
physicians interacting with LGBTQ patients. The video scripts were written by NJMS stu-
It’s a fact: petting a dog—even for a few minutes—can lower your blood pressure and heart rate,
dent/Taskforce member Jilyan Decker, who spent
relieve stress, improve your mood and simply make you feel better all over.
a year at the University of Minnesota studying
That was the case when some 75 students, faculty and staff members spent time with four
sexual health in transgenders. “This is a newly
therapy dogs and their owners from Creature Comforts, a New Jersey organization of volunteers
emerging area; it’s no longer taboo to talk about
and their therapy dogs. Fourth-year student and Gold Humanism Honor Society member Krystal Thumann headed up the two-hour event, which she says was designed to introduce students to the pet therapy program and to give ev-
these things,” she says. “It’s exciting to be part of that change, and I’m grateful to NJMS for giving me this opportunity.”
eryone on campus a chance to de-stress. It worked. “A lot of people came
The course is mandatory, and students are re-
to meet the dogs out of curiosity; they didn’t know anything about therapy
quired to fill out a survey on preparedness before
dogs,” says Thumann, “But later many of them told me they felt so much
and after taking the course. Pulaski says almost
calmer and happier after they spent time with their new furry friends.”
everyone writes that they feel more confident to treat LGBTQ patients thanks to the course.
RUTGERS NEW JERSEY MEDICAL SCHOOL
3
a closer look at diversity and inclusion
Enriching Our Campus and Community BY TY BALDWIN
In Education
A
strong commitment to diversity and inclusion is at the core of everything the Office of Education does. “Whether we are nurturing underrepresented youth in our pipeline programs, preparing medical students to serve in underrepresented communities or helping minority faculty members thrive, that is our focus,” says Sangeeta Lamba, MD, MS, HPEd, associate dean for education. And she should know. She oversaw a major curriculum renewal that was rolled out in 2015. The first class to participate in the new curriculum will graduate next year. “The major question for the curriculum committee was, how do we prepare our
students to recognize and address social injustice and health disparities among different communities?” she explains.” That led to the creation of a longitudinal course called Health Equity and Social Justice, which students take during their first two years. They participate in a host of activities, beginning with what’s called a Privilege Walk. The students stand shoulder to shoulder in a line, and each takes a step forward or backward after the facilitator asks a series of questions. For example, if one parent went to college, the student takes a step forward. If a parent did not grow up in the United States, the student takes a step backward. “The objective is for students to appreciate differences, understand social privilege and how it may affect patient/physician interactions,” Lamba
Sangeeta Lamba, MD
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says. Students participate in small group discussions covering topics such as unconscious bias, race in medicine and culture in death and dying, and there are panel discussions with faculty who are experts in the many dimensions of diversity and inclusion. The learning doesn’t end in the classroom, however. The future physicians are required to participate in Community Engagement Service Learning projects, putting in at least 80 hours of service to the community. One popular project is working with the Green Club that plants and maintains a Newark urban garden. The future physicians help grow vegetables that are free to the community, and they explain the benefits of healthful eating. Students who would rather work indoors often opt to volunteer in Newark schools, homeless shelters, student-run free family clinics or nursing homes. “I am continually amazed at all that our students do,” says Lamba. “They always go well above and beyond what’s expected. They are so passionate about service to our community.” There is very thoughtful mapping of health equity, diversity and inclusion content woven throughout each course and each clerkship rotation throughout the four years. For example, during their gastrointestinal rotation, students may learn about the social factors that may cause obesity; or while doing a surgical rotation, they may learn about surgical care for vulnerable populations, as well as issues related to violence and trauma. Lamba says that such immersion in issues of diversity and inclusion is an important aspect of preparing NJMS students as they embrace the larger Newark community and address its needs. “I’ve been a practicing physician in this community since 1989,” she says, “and I’m very passionate in my belief that our community is part of what makes us great. After all, it’s our patients who help teach our students to become physicians.”
Justin Sambol, MD
In Research
D
Among the Faculty
J
ustin Sambol, MD, believes having a diverse faculty and staff is very important to NJMS’s ability to care for a diverse patient population. “There’s been plenty of research that shows having a diverse physician group caring for a diverse community has a positive effect on treatment outcomes,” says the senior associate dean for clinical affairs. Of course, a physician doesn’t have to be African-American to take care of an AfricanAmerican patient, he adds, just as you don’t have to be Latino or Jewish or Catholic or Muslim to take care of those ethnic or religious groups. Still, there’s no denying that “working with a diverse group of physicians—and understanding the differences within people’s racial, ethnic, and religious backgrounds—helps you understand the perspective of your patients.” Sambol cites an example from his own
practice when he was doing a heart valve replacement on a patient who was Muslim. “I had planned to put in a mechanical valve, but for a variety of reasons I decided a biological valve would be better. But the biological valve is a pig valve. “I’m Jewish. I knew that in Judaism there’s no problem with putting a pig valve in a Jewish patient. But I wasn’t absolutely sure whether or not the same issue existed with Muslim patients. I consulted with a colleague who I knew to be Muslim, and I was able to get his thoughts and opinions on that.” Sambol emphasizes that the important thing to remember when taking care of patients is that in any group of people there are certain special needs. “Whether they’re minorities, majorities, underrepresented or not, every patient is unique. I think having such a diverse population of practitioners as we do at NJMS helps to remind us of that fact every day.”
iversity is critical to everything NJMS researchers do. “There are serious racial/ethnic disparities in some of the country’s most debilitating chronic health conditions, like hypertension, diabetes, asthma and cardiovascular disease,” says William Gause, PhD, senior associate dean, research. “We need to understand why that occurs, and we can’t do that without a diverse community of researchers.” He adds that minority physicians are more likely to conduct research in minority populations and are usually able to gain the trust of those communities more easily when recruiting. What many people don’t know, Gause points out, is that research results from one ethnic group may not be applicable to others. Some drugs, for example, are effective in one population but are ineffective or even harmful in another. One is the asthma drug albuterol, which has a lower response rate in African-Americans, and another is a blood thinner prescribed after angioplasty that is ineffective in 50 percent of Asians who lack the enzyme to activate it. Perhaps most importantly, however, is that a diverse faculty broadens the ability to recruit an underrepresented cohort of graduate students, post-doctorates and staff. “These scientists serve as role models,” Gause says. “Minority students can more easily identify with them and develop a rapport. There are many brilliant minority students out there, but they need mentors to move forward.” Amariliz Rivera-Medina, PhD, who earned her PhD at Rutgers Graduate School of Biomedical Sciences (GSBS), is an example. After completing undergraduate work in Puerto Rico, she did a post-doctorate at Memorial Sloan Kettering then returned to join the NJMS faculty. She later recruited Vanessa Espinosa, PhD, post-doctoral fellow, who received an NIH F31 pre-doctoral fellowship for underrepresented minorities. Espinosa completed her PhD at GSBS and is now working on a post-doctorate in RiveraContinued on page 6
RUTGERS NEW JERSEY MEDICAL SCHOOL
5
In the Community
“N
William Gause, PhD
Medina’s lab at the Center for Immunity and Inflammation. “That team has done tremendous research in the area of infectious and inflammatory diseases, particularly the immune response to fungal infections,” Gause says. This past year they published a paper in the journal Science Immunology, with Espinosa as the first author. The newest member of NJMS’s research team is Nataki Douglas, MD, PhD, associate professor and director of basic scientific research in the Department of Obstetrics/ Gynecology and Women’s Health. She is also a member of the Center for Immunity and Inflammation and the Institute for Infectious and Inflammatory Diseases. Douglas is a leader in understanding molecular mechanisms that underlie uterine vascular development in early pregnancy at the time of formation of the placenta. Her research is aimed at improving the diagnosis and treatment of infertility and common adverse pregnancy outcomes, including early miscarriages, intrauterine growth restriction, and pre-eclampsia. “We recruited Dr. Douglas from Columbia University Medical Center-New York Presbyterian Hospital,” Gause says. “She is one of the few AfricanAmerican ob/gyn physicians with active NIH funding. We are very fortunate to have her.”
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JMS has a rich history in diversifying the medical and academic medicine workforces,” says John Paul Sánchez, MD, who was named associate dean for diversity and inclusion earlier this year. “When you consider our community of assistant and associate deans, across the different medical school offices, there’s diversity by gender, race, ethnicity, sexual orientation and other dimensions. They bring unique perspectives and help facilitate dialogue among students, staff, and faculty. Additionally, we have several student organizations dedicated to the personal and professional development of diverse groups by ethnicity, race, gender, sexual orientation, faith, and others. All of these groups are very active on campus and in the local community.” Sánchez says that his new appointment will provide additional time and resources to focus on increasing engagement and leadership by diverse trainees and junior faculty, and to develop new curriculum for the diversity committee members to discuss with their departmental communities. He also wants to enhance the Pipeline and Pathways programs by improving communication with partners and potential applicants. “I’m hopeful that this will support increased diversity in our
John Paul Sánchez, MD
medical and academic workforces,” he says. Recently Sánchez worked with a diverse group of faculty and trainees from NJMS (and other institutions) to develop 10 interactive, multi-modal educational workshops to inspire diverse medical students, residents, and fellows to become future faculty. These workshops cover topics such as “transforming educational, research, and service work to scholarship,” “leadership development,” “effective mentee-mentor relationships,” and “finding an academic residency or position.” To date, the 10 modules have been implemented at 21 medical schools, and nine of the 10 have been published in the Association of American Medical Colleges (AAMC) MedEdPortal: The Journal of Teaching and Learning Resources (mededportal.org). Sánchez was also recently named the inaugural associate editor for diversity, inclusion, and health equity for AAMC MedEdPORTAL (mededportal.org/collection/diversity-inclusion-and-health-equitycollection/). “It’s a huge honor and opportunity to encourage and support more trainees and faculty across the country in completing educational scholarship related to diversity, inclusion and health equity.” These are topics on which Sánchez and NJMS can boast a broad base of knowledge and experience. ●
njms people…do you know?
SH O B HA SWAMI NATH A N
NJMS Takes the Lead in HIV Prevention BY MERRY SUE BAUM
H
IV, the virus that causes AIDS, is no longer grabbing headlines, but it is still as pervasive as ever, and minority populations are being hit the hardest. “New Jersey has a higher rate of women infected with HIV than many other states, and it disproportionately affects black men who have sex with men,” says Shobha Swaminathan, MD, associate professor of medicine at NJMS and director of HIV programs. “The transgender community in particular is one of the highest risk groups, with new cases diagnosed in that popula-
NJMS continues to be at the forefront in helping prevent HIV in the local community.
tion at more than three times the national average, according to the Centers for Disease Control and Prevention.” NJMS continues to be at the forefront in helping to prevent HIV in the local community. Physicians in the school’s clinics use what’s known as the HIV treatment cascade JOHN EMERSON
Shobha Swaminathan, MD
to evaluate outcomes. It includes testing, then linking positive individuals to care, retaining that care, prescribing medications and finally viral suppression. “Our goal is to attain 90 percent success at each of those five points over the next few years,” she says. “And our physicians offer risk-reduction tools for those who are HIV negative, including prescribing PrEP, or pre-exposure prophylaxis.” Besides helping to prevent HIV close to home, the school is participating in two international clinical trials, designed by the National Institutes of Health. The study known as Antibody Mediated Prevention (AMP) is looking at the role of the broadly neutralizing antibody known as (bnAb) VRC-0. It is given intravenously every eight
weeks, with the hope that it will reduce new HIV cases. The second trial, HPTN083, is comparing two medications: the pill currently approved to prevent HIV and a new integratase inhibitor, Cabotegravir, given as a long-acting injection. NJMS is the only site in the state participating in both. “The results of these trials will potentially give people different choices for preventing HIV,” says Swaminathan. She feels fortunate to be able to use this unique opportunity to make a difference in the lives of so many people. And she’s not about to stop anytime soon. “When you roll up your sleeves and get in there, you realize that the more you do, the more there is to be done,” she says. “That’s why I’ll never stop trying to prevent HIV.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL
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njms people…do you know? CH R ISTI N TRAB A
CHIPping Away at Healthcare Disparities BY MERRY SUE BAUM
T
he basic building blocks for keeping kids healthy are a well-rounded diet, plenty of exercise and a solid eight hours of sleep. But the key is access to regular medical care. Without annual checkups, immunizations and the ability to see a doctor when they’re sick, kids usually don’t thrive. In fact, sometimes they don’t even survive. It’s not surprising that the uninsured or underinsured generally are the ones who fall through the “healthcare cracks.” But the Children’s Health Insurance Program (CHIP) has helped change that. Signed into law in 1997, CHIP provides insurance for children whose families make too much
money to qualify for Medicaid but can’t afford to buy private insurance. “We have significant health disparities right in our own state,” says Christin Traba, MD, assistant professor of pediatrics. “Seventeen percent of kids in New Jersey are living at or below the federal poverty level, and in Newark alone it’s 44 percent. And, 50 percent of Newark residents are black or African-American and more than 33 percent are Hispanic.” Traba says the preventive care offered by NJMS’s clinics is helping to keep Newark kids healthy. Besides providing immunizations, doctors perform screenings for things like developmental delays and lead toxic-
ity, and they counsel families on things like nutrition, gun safety and injury prevention. Physicians also link families to the resources they may need, like pediatric specialists, legal experts and social workers. These visits are also when chronic illnesses, like diabetes and asthma, are managed. “There is a disproportionate rate of children with asthma in Newark, particularly
Preventive care offered by NJMS’s clinics is helping to keep Newark kids healthy, linking families to resources like pediatric specialists, legal experts and social workers.
Christin Traba, MD
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among Hispanic and non-Hispanic blacks,” she says. “With a solid action plan, we can better control a child’s asthma. And through CHIP, prescription inhalers are covered, which at several hundred dollars each would otherwise be prohibitively expensive.” The impact of CHIP goes beyond the patients, however. Students at NJMS see the most vulnerable patients and learn about disparities and the social determinants of health. They learn what questions to ask and get a deeper understanding of all the things that affect a patient’s health. “If a child comes from a home where there’s very little food, for example, or the parents can’t work because they have a special-needs child, that all has an impact. It prepares our students to provide the best care possible to every single patient.” ●
Mercedes Rivero, MS, with a student
M ER CEDES R I VERO
Taking a Unique Approach to Admissions BY MERRY SUE BAUM
T
here are hundreds of stories that Mercedes Rivero, MS, the assistant dean for admissions at Rutgers New Jersey Medical School (NJMS), can tell of students who succeeded against all odds. A particularly memorable one is that of a female Hispanic student, who we’ll call Ana (not her real name). Ana came from a hard-working family that struggled to survive. She grew up in a predominantly white neighborhood and often faced bullying and discrimination. As a member of an ethnic group that is often stigmatized with weaker academic performance, Ana worried about confirming that stereotype. Nevertheless, she was determined to fulfill her dream of becoming a doctor, and NJMS provided the perfect environment for her to do so. Ana is one of the many students who was evaluated holistically by the NJMS admissions committee. In addition to reviewing undergraduate GPA and MCAT scores, NJMS takes an expansive approach in considering the “whole” applicant. “Our applicants are multi-dimensional; the value
of their candidacy is assessed in the context of their experiences, personal qualities and academics,” explains Rivero. “We value resilience and one’s ability to identify and utilize the resources needed to succeed. None of those things can be measured by something as tangible as a test score.” Rivero has first-hand knowledge of the ongoing challenges students face in a complex society and understands the importance of providing access, support and opportunities to disadvantaged students who have shown potential for success. “I attended college as part of the Higher Education Opportunity Program, which was created to provide economically and educationally disadvantaged students the opportunity for success. Over the last 20 years, I have appreciated the opportunity to champion the persistence and success of many students coming from similar starting points in life.” According to Rivero, the intangibles are just as important as the tangibles. She adds, “We believe that success in medical school and beyond requires more than academic
ability; it requires good interpersonal and communication skills, self-awareness, maturity, integrity, persistence and a commitment to humanism in medicine.” Medical schools are increasingly taking this approach, thanks to an initiative by the Association of American Medical Colleges (AAMC) in 2009. Rivero was one of a dozen admissions professionals from across the country trained by the AAMC in facilitating Holistic Review in Admissions. “It quickly became apparent to me that NJMS was conducting holistic review in admissions long before the phrase was coined by AAMC,” says Rivero. “We’ve been implementing thoughtful admissions policies, processes, and practices that impact the educational continuum for over 25 years.” Along with taking a unique approach to admissions, NJMS offers a personal touch by offering consultations and meetings with pre-health advisors each year. Taking it a step further, the school encourages all students to learn from one another’s life experiences in order to be better prepared to serve an increasingly diverse patient population. “By the time our students graduate, they are not only confident and competent, they are compassionate healthcare providers.” Ana is a prime example of the efficacy of this approach. In her final year at NJMS, she matched into her first choice in an extremely competitive specialty. “From our first interaction with her, we knew that Ana would become a compassionate and brilliant physician,” Rivero recalls. “Despite the obstacles she faced, Ana was passionate and clear-eyed about reaching her goals. We had no doubt that she would succeed and were honored to have her as part of the NJMS family.” Today Ana is a successful physician who wrote in a recent note to Rivero: You helped give me perspective into understanding the societal factors that influence bias. Thank you for giving me a chance and always believing in me! I promise to be the humanistic physician to my patients that you saw in me all those years ago! ● RUTGERS NEW JERSEY MEDICAL SCHOOL
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Better Medicine through
Diversity
From Medical Students to Highest-Ranking Administrators NJMS Dean Robert L. Johnson, MD, and Vice Dean Maria Soto-Greene, MD, discuss the experiences that drive their commitment to diversity and inclusion. | By Genene W. Morris
E
very August, scores of first-year students spill out onto the plaza of Rutgers New Jersey Medical School to take part in the institution’s annual White Coat Ceremony, a rite of passage welcoming new medical students to the healthcare field. There, trainees from different walks of life —African Americans, Caucasians, Latinos, Asians, and the many other dimensions of diversity— gather, knitted together by their aspirations to become physicians. Surveying the panoply of smiling, multi-complexioned faces, New Jersey Medical School Dean Robert L. Johnson, MD,’72, and Vice Dean Maria Soto-Greene, MD,’80, smile back, reveling in the scene that decades ago would have looked very different. In some ways it is a scene that speaks to NJMS’s standing as a school at the forefront of diversity and inclusion in medical education. It also hints at the story of the pair’s own journey from medical students who learned to practice at NJMS to their ascension as the academy’s two highest-ranking administrators, the first underrepresented minorities in the institution’s history to hold these prestigious positions. With their combined 92 years of service at NJMS, Johnson and Soto-Greene can remember a time when such gatherings at the school would have been predominantly male with very few underrepresented minorities to speak of. In fact, Johnson spent much of his educational experiences throughout the 1960s as an “only.” He was the only African-American in most of his classes at White Plains High School, a detail noted during a recent ceremony where he was inducted into the school’s Hall of Fame. He was the only African-American in his undergraduate class at Alfred University. And, long before becoming the first AfricanAmerican dean at NJMS, he was the only African-American among his peers in the NJMS Class of 1972, and for a time, the only one in the entire school, Johnson adds. “When I first came here, I was the only minority in the school. I think the next year, the number of minority students doubled,” with the addition of one more underrepresented minority student, the professor of pediatrics and psychiatry says with a laugh. He points to 10
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his own graduation as an example of how far the school has come in terms of diversity and inclusion. “My wife, Maxine, talks about this. When she went to the graduation, she and I and my parents were the only black people in the whole place,” Johnson says.
Robert L. Johnson, MD
Maria Soto-Greene, MD, (standing), director of the Hispanic Center of Excellence (HCOE), with faculty member Raquel Olivo Villabrille, MD, (left) and former HCOE Summer Youth Scholars Program student Victoria Mosconi
Underrepresented minorities made up 23 percent of the medical school’s enrollment in the 2017– 2018 school year. What’s more, NJMS ranks in the 80th percentile for underrepresented minority graduates and 85th percentile for minority faculty, according to the 2014 Association of American Medical Colleges’ Missions Management Tool. “She is so amazed at how much has changed,” Johnson says of his wife. “And it really does make me feel gratified that this is something that I had some part in achieving.” Johnson and Soto-Greene assumed the roles of dean and vice dean, respectively, in 2005. Since then, they have worked tirelessly to not only ensure that each student receives a top-notch education, but to foster a nurturing environment where students, residents, and faculty— regardless of race, ethnicity, gender, or sexual orientation— can thrive. NJMS’s commitment to diversity and inclusion can be traced back some 50 years ago to 1968 with the signing of the Newark Agreements, a document created in response to a plan to relocate the school from Jersey City to Newark’s Central Ward. It provided for, among other things, public-sector healthcare services and employment opportunities for city residents and emphasized the recruitment of minority students. That same year Johnson, a first-year medical student at NJMS, joined other trainees to help establish a program that would do some good in the city of Newark. Their collective efforts resulted in the founding of the Student Family Health Care Center (SFHCC). “At the time, we knew we were going to Newark the next year and so we…opened the clinic in the basement of the old Newark City Hospital, which became Martland, and eventually University
Hospital,” Johnson says. Renowned as the oldest free student clinic in the nation offering medical care to the underserved, the SFHCC remains an enduring symbol of the school’s dedication to the residents of Newark and its commitment to fighting health disparities. This devotion to the community is attributable to the school’s very location, Johnson says. “We certainly could not be in the Central Ward of Newark and just ignore the importance of responding to the needs of underrepresented minorities.” Now medical schools throughout the nation are working hard to implement diversity and inclusion initiatives to respond to standards established by the Liaison Committee on Medical Education. But, Johnson states, this is an area where NJMS has an advantage. “We have so much depth already,” Johnson says of the school’s programs geared toward the recruitment, development, and retention of underrepresented minority students and faculty. From the school’s robust health equity and social justice curriculum to its efforts to promote cultural humility, NJMS is a place where students, residents, and faculty are given the tools to care for diverse communities of people. “I guess we’ve been doing it so long, and we find that it is so critical to the education of our students, that it’s like breathing.” After becoming interim dean of NJMS in 2005 (a role that became permanent in 2011), Johnson tapped SotoGreene as his vice dean. Not only was she someone who he knew well, Johnson says, “She was the best person for the job.”
“When I first came here, I was the only minority in the whole school. I think the next year the number of minority students doubled.” DEAN ROBERT JOHNSON, MD
A pipeline-to-medicine success story, the professor of medicine knows what it is like to be disadvantaged. The second person in her family to graduate from high school, Soto-Greene was the first to go to college and, ultimately, medical school. “Having been a product of teenage parents, being part of the uninsured, being part of the language minority, and being both part of the economically and educationally disadvantaged, shaped me tremendously,” she says. Continued on page 15
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NJMS SENI OR LEADERSHI P
Bastions of Diversity and Inclusion By Genene W. Morris
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ommanding a student body and faculty that are among the most diverse in the nation, Rutgers New Jersey Medical School (NJMS) has long pioneered diversity and inclusion in medical education. From its effective recruitment of qualified underrepresented minority students and faculty to its creation of consistently funded pipeline programs that are second to none, NJMS has shown that the cause of diversity and inclusion is not just an obligation to achieve accreditation. It is at the core of the school’s mission and values. Backing those efforts is NJMS’s senior leadership team. Bastions of this movement, the team comprises a mix of medical and administrative professionals who work to ensure that diversity, inclusion, and health equity permeate every aspect of the school. “New Jersey Medical School’s leadership doesn’t just talk about diversity and inclusion,” says NJMS Associate Dean for Education Sangeeta Lamba, MD. “They live it, they breathe it, and they truly value it.” She should know. A native of India and member of NJMS’s
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senior leadership, Lamba joined the school in 1990 as a resident in internal medicine. Since then, she has climbed the school’s leadership ranks. “I’m an example of the nurturing and inclusive environment at NJMS,” she says, adding, “I’ve grown in different leadership roles, built on abilities and strengths. The institution grows you. That is something that NJMS has given me.” Lamba, in turn, does her part to continue that level of nurturing and inclusivity at the school. As the person charged with heading medical education at the school, there is great emphasis, she says, on fostering “a very safe, collaborative, and inclusive learning environment. We very much like to incorporate diverse perspectives in our course content… and to teach our students a robust curriculum in appreciating cultural differences and cultural humility.” The significance of diversity and inclusion cannot be overstated as it enhances the training that students receive and health of the communities that they will serve as graduates, says NJMS Dean Robert L. Johnson, MD,’72. “If our students are in classes with
Better Medicine through
Diversity underrepresented minorities, the experiences they’ve had result in better vocally and proudly honor diversity.” The significance of doing so, he outcomes for them as well as for patients. If you have a class where all notes, boils down to something very basic: the respect of everyone’s dignity. “Healthcare workers need to understand the communities that people look alike, you’re not going to achieve that.” The culture of diversity and inclusiveness at the school is a highly they work with; they need to respect them; and patients need to see prized one, notes NJMS Vice Dean Maria Soto-Greene, MD,’80. “It’s themselves reflected in the professionals they seek out,” he says. For example, Petti says, “As an out gay man, I can tell you that it’s part of everything we do. This hallmark and major strength is both a driver of excellence and distinguishes NJMS from many medical really important to me that I find providers that have a stated interest in treating gay people. It was really important to me when I could find schools.” This abiding commitment to the equitable inclusion and a gay provider. And I know that I’m not unique in that.” Achieving that level of respect and understanding is the ultimate promotion of all is what inspired NJMS’s Associate Dean for Diversity and Inclusion John P. Sánchez, MD, MPH, to join the school’s faculty goal at the school, explains NJMS’s Senior Associate Dean for Clinical Affairs Justin Sambol, MD,’97. in 2014. “NJMS is one of the “The school and the leadership institutions that has had a track recognize the importance of record in recruiting, retaining, and making sure that we’re educating a having faculty succeed.” diverse group of students so when In his role, Sánchez, who we send them out in the world identifies as Puerto Rican and gay, to be physicians, they should oversees the Office for Diversity understand that different people and Community Engagement and have different needs and that has worked to further expand the they should be sensitive to those school’s diversity and inclusion needs.” efforts in several ways, including: Selecting a diverse pool of students Many incoming students • To enhance the school’s recognize that not only will they work to build a pipeline toward who fit well with NJMS’s family receive a high-quality education academic medicine careers by at NJMS, they will also have helping to create a new curriculum environment is essential to admissions. an opportunity to take part in that encourages diverse trainees a variety of community service and junior faculty to join and programs that provide handssucceed in academia. • To develop the school’s community engagement service learning on training in diverse and underserved communities, says NJMS’s elective, a longitudinal four-year mandatory elective which ensures that Associate Dean for Admissions George F. Heinrich, MD,’72. In fact, when researching the school, many prospective students ask about every graduating medical student completes 40 hours of direct service. • To integrate Lesbian Gay Bisexual Transgender and Queer activities like the Healthcare Foundation Center for Humanism and (LGBTQ) content into the curriculum; increase the school’s recruitment, Medicine — which promotes dignity and respect for all and the delivery retention, and promotion of faculty who identify as LGBTQ; and raise of care that is kind, just, and humble — as well as its Student Family Health Care Center— the country’s oldest student-run clinic, which a more positive climate and culture for the LGBTQ community. “Our integrating these issues into the full depth and breadth of our provides free medical services to the disenfranchised. Selecting a diverse pool of students who fit in well with NJMS’s institution shows that NJMS is an innovator, trailblazer, and is fearless in tackling the issues of diversity and inclusion,” says NJMS Chief family environment is essential to admissions, notes Heinrich. “We want to find the best students for New Jersey Medical School who Operating Officer Walter L. Douglas, Jr. As an African-American administrator, Douglas has engaged in will be reflective of our goals and objectives and commitment to our mentoring and coaching, and established at NJMS the Student Training community and to society. This comes naturally because of who we are Education Program (STEP), which brings on interns —from high school and what we do.” Aside from ensuring that different racial and ethnic backgrounds to postgraduate students —who have an interest in learning the business disciplines that support an academic medical center, such as marketing are represented at the school, the emphasis of diversity and inclusion and communications, information technology, facilities and project also invites a broad spectrum of views and beliefs, says Douglas. “Diversity is diversity of thought, diversity of specialties, diversity management. “Because we are in the city of Newark, this program has of religion and gender, diversity of origins,” he says, explaining, “In largely had minority and women students come through it.” Everything that NJMS has done in this area, adds Executive order to have a really healthy ecosystem, it takes all types of people, all Assistant to the Dean Michael Petti, also shows that at NJMS “we disciplines, all walks of life.” ● RUTGERS NEW JERSEY MEDICAL SCHOOL
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ALUMNI FOCUS AN A NATALE- PER EI RA
Why I Still Choose NJMS BY TY BALDWIN
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na Natale-Pereira, MD, MPH, describes the journey that led her to NJMS in one short sentence: “It was a very winding road.” The associate professor of medicine; division director, general internal medicine; and assistant dean for primary care and com-
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munity initiatives, says she wanted to be a doctor from the time she was 8 years old. “It was the only thing I ever wanted to do. My great aunt, who was a nurse back home in Uruguay, had a great deal of influence on my decision. She would take us to the hospital
for dental care, and we’d have to wait for what seemed like forever. While we were waiting, we would walk around to the wards and other parts of the hospital. It caught my imagination and my hopes.” Natale-Pereira was 13 when she and her family came to the US and settled in Orange, New Jersey. “All my mother really wanted was that we go to school,” she says. At that time Uruguay was in the grips of a right-wing dictatorship. For someone like Natale-Pereira, who had no family ties to anyone in medicine or the military, it was nearly impossible to go to medical school. “My mom knew I had no chance there. That’s one of the reasons we left,” she says. The first few years in her new country were difficult because of the language barrier. By the time she was a junior in high school, however, Natale-Pereira had “gotten the hang of it.” She became an honors student and was accepted at Montclair State University contingent upon successfully completing a summer program for minority students. As fate would have it, it was not to be. She became ill and was unable to finish the program. Montclair withdrew its acceptance. All was not lost, however. “I had a friend who was going to Fairleigh Dickinson University (FDU) for nursing, and she suggested I go there with her,” Natale-Pereira explains. She was accepted and earned a bachelor’s degree in biology and molecular technology. “I sometimes look back and laugh,” she says. “I had no clue that there was such a thing as a pre-med curriculum. I was just a regular student. I commuted, I went to class, and I worked. All I knew was that I had to go to school. That was my mom’s goal, that was my goal. And I was going to go to medical school. How I was going to get there, I had no idea.” After graduating from FDU in 1988, Natale-Pereira took a job at the University of Medicine and Dentistry of New Jersey in what was then known as the Center for Molecular Medicine and Immunology. She enrolled in a PhD program in biology. And she had a very strong ally, her high-school sweetheart who became her husband in
1989. “He knew I wanted to go to medical school, and he just kept encouraging me,” she says. “I let it go for about a year, and then I started getting in contact with people at NJMS.” She applied in 1991 but did not get accepted. The Hispanic Center of Excellence under the leadership of Maria Soto-Greene, MD, had just been established, with the goal of improving the health status of the Latino and other underserved populations by increasing the number of Latinos in the health professions, particularly in medicine “The assistant dean at that time, James Foster, MD, gave me a chance,” she says. “He explained that if I wanted to go to medical school, there were a number of things I’d have to do. He helped guide me through them.” She applied again the following year and was put on the waiting list. That summer Natale-Pereira was invited to take part in the Students for Medicine and Dentistry, a summer pipeline program. “The other students had already been accepted to medical school. I was the only one who hadn’t. They didn’t understand why I was working so hard all summer. I finally explained that I was still trying to get accepted. At the end of that summer, Dean Foster gave Natale-Pereira her letter of acceptance. She graduated from NJMS in 1996. When it came time to think about residencies, Natale-Pereira considered leaving NJMS. Like many new medical school graduates, she interviewed at a number of places, focusing on programs that had multiple hospital experiences and an academic environment. “At the end of the road, I realized that what I was looking for was right here,” she says. Natale-Pereira did her residency in medicine at NJMS from 1996-1999, became chief resident in 2000, and never looked back. “I’ve been blessed,” she says. “I grew up here and now I’m helping take care of my own community. Along the way I was mentored by incredible people and have had the pleasure of mentoring many as well. Being part of the diverse fabric of NJMS and learning from our patients and their experiences is a privilege. Staying at NJMS was the right decision for me.” ●
Administrators Continued from page 11
By the time she matriculated at NJMS in 1976, the number of minority students had grown at the institution and so did the number of underrepresented minority faculty members. “Once I got here, it was a no-brainer. You did see others like you,” Soto-Greene says, adding, “In our class there happened to be five Puerto Ricans and we formed a close bond.” Additionally, she says, “There was a cadre of minority role models who were in senior level positions who instilled a level of confidence that ‘I could do whatever I set out to do.’” Soto-Greene strives to do for the NJMS student body what those role models did for her and her classmates. “What they did was instilled in us a level of social responsibility,” not just to the surrounding community but to each other, she says. “Whether by serving as a notetaker or arranging peer tutorials, we were taught the importance of uplifting each other to ensure our combined success.” But even as the makeup of NJMS classes became more diverse with the increased enrollment of underrepresented minority students, attitudes about what your typical medical student looks like did not shift immediately. Recounting an incident at a conference that she attended with three others in Chicago during her senior year at NJMS, Soto-Greene says, “We were two women and two men. Of the four of us, two were minorities.” But when they registered, she and the other woman were sent to separate locations. “We quickly realized they were triaging us as spouses rather than as medical students.” This was just one of the many challenges Soto-Greene faced, both as a woman and as a minority. However, with the help of others, she felt well-equipped to overcome those challenges, she says. As a resident at NJMS, where she met her now-husband of 33 years, Bruce Greene, MD, she became the first Latina chief resident at University Hospital. It wasn’t a role she sought, she says. Nonetheless, it was a decision
that propelled her onto a leadership track that eventually led to her joining the NJMS faculty. “I didn’t plan to be a faculty member, but I was invited to the academy and since I was very comfortable here, it became natural to join.” A former associate dean for Special Programs at NJMS, the mother of three is a champion of health equity and social justice and has proven herself adept at building successful pipelines to medicine, dentistry,
“This is an institution that is committed to inclusion and, thus, having everyone reach their full potential.” VICE DEAN MARIA SOTO-GREENE, MD
and other health-related professions. She is the co-principal investigator of the Health Careers Opportunity Program, which implements pipeline education programs—from sixth grade on through to medical school—that are centered on increasing the number of minority and disadvantaged students entering health professions, including medicine. She is also the principal investigator of one of the nation’s longest-running Hispanic Centers of Excellence. Initially funded in 1991, the HCOE aims to increase the number of Latino physicians and faculty members at the local, regional, and national levels. “We work really hard at having diversity represented along every stage of the continuum,” Soto-Greene says, noting that if trainees see people who look like themselves at every aspirational level— including her and Johnson—perhaps they too can see themselves in those roles. “This is an institution that is committed to inclusion and, thus, having everyone reach their full potential. And so, having the two of us (in charge), I think, embodies that ‘if we can do it, why can’t others?’” ● RUTGERS NEW JERSEY MEDICAL SCHOOL
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Students Work to Promote
Understanding
Reem Alsalman (left) and Hael Abdulrazeq (front, fifth from left) with the Muslim Medical/Dental Association
BY MERRY SUE BAUM
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ringing people together and shattering stereotypes is what the Muslim Medical / Dental Association is all about. “With everything that’s going on in the world and all the anti-Muslim rhetoric in the media, it’s more important than ever for us to promote an understanding of our religion and culture,” says third-year Rutgers School of Dental Medicine student Reem Alsalman. Alsalman is co-president of the Association, along with Hael Abdulrazeq, a third-year student at NJMS. Each headed up his/her school’s Muslim organization, until they merged a few years ago. Today the group is 62-members strong and works together to get their message out. Each month they meet and discuss a variety of topics, including what it means to be a Muslim 16
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healthcare student. “People sometimes have misconceptions,” says Abdulrazeq. “I’ve had patients ask what country I’m from, and they want to learn more about my background. Answering questions like that is an opportunity for us to help them realize that we’re just like everyone else.” Peer support is only one aspect of their mission, however. Raising awareness and an appreciation of Muslim culture/religion across campus is another. Everyone is invited to a monthly get-together, known as a halaqas, to discuss a pre-selected topic. “It’s like an old-fashioned coffee klatch,” says Alsalman. “We recently talked about Noor Tagouri, a Muslim-American journalist who was on the cover of Playboy fully clothed and wearing a head scarf, or hijab. Some found
it offensive, others were supportive, but it sparked an exchange of ideas, which is what’s important.” At a cultural night on campus, the group hosted a table about Islam, where they had a Koran for people to peruse, hijabs for the female students to try on, and they offered dates, the first food Muslims eat when breaking a fast. During the month of Ramadan, the organization holds several events. Everyone on campus is invited to join in the tradition of fasting from sunrise to sunset, along with Muslims around the world. “Some of my friends found it very difficult,” says Alsalman. “The idea is that by the end of the month, you feel for the hungry and the poor. Those who have never done it gain a whole new perspective.” The group also holds an Iftar, the typical meal that is served each evening after fasting. This year some 120 people attended. “After that dinner, some of my friends told me they know more about Islam than their own religions,” says Alsalman. The organization also takes its message off campus, by hosting annual health fairs at Islamic centers in Newark, Clifton and Paterson. Non-Muslim students support the effort, which enables the public to get health information and have free blood pressure, diabetes and dental screenings. The two presidents say they believe what they’re doing is working. “We all went into medicine and dentistry to help others,” says Abdulrazeq. “By breaking down barriers, we’ll be able to provide the best possible care to all people, no matter what their religion or background.” ● T O P R I G H T C O U R T E S Y O F M U S L I M M E D I C A L / D E N TA L A S S O C I AT I O N
Match Day 2018 Match day — the day when soon-to-be doctors find out where they will complete their residencies — is arguably the most exciting day of medical school. Each spring at high noon students across the country simultaneously open envelopes that reveal which medical centers have chosen them. It’s a dramatic day, full of laughter, hugs and sometimes even a few tears. This year 98 percent of NJMS students matched to a specialty of their choice, beating the national average of 94 percent. You can see the number of students who were accepted into each specialty at: njms.rutgers.edu/MatchDay2018.
PHOTOS: KEITH B. BRATCHER, JR.
185 South Orange Avenue Newark, New Jersey 07103
njms.rutgers.edu
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Match Day 2018 Photo by Keith B. Bratcher, Jr.
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