Issue 03 | 2018
Women in Medicine
PRACTICING WITH PASSION Swathi Krishna Annie Lecavalier Stephanie Vazquez Regina Krel OVERCOMING OBSTACLES Eronmwon Okoye Xian Li Kimberly Harden Gloria Hwang
LEADER WITH A
RAISING THE BAR Brintha Vasagar Jasmine Riviere-Marcelin Kalpana Gopalswamy Ashley Young
BRINTHA VASAGAR, MD, MPH Class of 2012
PRACTICING WITH PASSION
Table of Contents AUA Alumni | Issue 03
06 08 10
Both Sides of the Brain The skills Dr. Swathi Krishna developed as a businesswoman help her to innovate as a psychiatrist. Confidence Through ExperienceÂ How Dr. Annie Lecavalier found her path to Internal Medicine. Love of Miami, Love of Family How AUA's Florida International University collaboration allowed one med student to stay local. Migraines and Maternity Leave Dr. Regina Krel balances treating patients and being a new mom.
12 16 18 23
Change Your Strategy, Change Your Life Failure taught Dr. Eronmwon Okoye to study the science of The Match, and she came out on top. Going the Distance. Literally. Dr. Xian Li's travels first brought her to America then around the world. Bringing Treatment to Scale In unfamiliar surroundings, Dr. Kimberly Harden found herself. A Long Road to MD How one doctor started med school late in life and crossed the finished line.
RAISING THE BAR
24 26 30 34
Leader with a Vision Dr. Brintha Vasagar is giving residents the tools they need to put the focus on patients, manage healthcare teams, and serve their communities. From the Very Beginning Dr. Jasmine Riviere-Marcelin first studied infectious diseases in elementary school. More than Meets the Eye If there's a "Face of AUA," it belongs to Dr. Kalpana Gopalswamy, the Class of 2014's co-valedictorian. Positive Support, Perspective, and Perceptions Dr. Ashley Young proves that perseverance and dedication can beat the odds.
ALUMNI, Hello, and welcome to the Women in Medicine issue of the AUA Alumni Magazine! In January 1849, America’s first female doctor, Elizabeth Blackwell, graduated from medical school. Immediately, she was prevented by her male colleagues from practicing medicine in New York City, as well as in several countries in Europe. Nevertheless, she persisted. Dr. Blackwell rejected the naysayers and opened her own clinic in Jersey City, New Jersey in 1853 and began teaching classes on women’s health, paving the road for generations to come. While we still have plenty of barriers to knock down, the medical field has come a long way. For example, 34 percent of physicians in the United States, 45 percent of physicians in the United Kingdom, and 45 percent of physicians in the European Union are female. In 2014, 32 percent of all med school graduates were female. Last November, the Association of American Medical Colleges (AAMC) reported a 6.2 percent increase in the number of women who enrolled in medical school—a 10-year high! As a member of the AUA community, I am proud to say with great confidence that the institution I work for is committed to supporting these trends and has done an excellent job of it since we opened in 2004. In the past few years, 55 percent of students accepted to AUA were women. Forty percent of the AUA faculty are women, including several of our department chairs, and as of January 2018, three of the seven on-campus deans are women. Inside these pages are stories of some of the incredible women who have earned their MDs at AUA. We have chosen to highlight alumni who have pushed themselves to achieve their dreams even when the odds were stacked against them. These women have dedicated themselves to lives of service and excelled in their academic and professional careers, often at great personal sacrifice. They continue to amaze me. Kimberly Mallin, MD Director of Health Services, AUA Clinic
Both Sides of the
BRAIN The skills Dr. Swathi Krishna developed as a businesswoman help her to innovate as a psychiatrist.
DR. SWATHI KRISHNA Class of 2013
Fellow, Child and Adolescent Psychiatry Emory University School of Medicine, Atlanta, GA Founding Partner, Stanford Brainstorm Stanford Medicine, Palo Alto, CA Fellow, Substance Abuse and Mental Health Services Administration (SAMHSA) American Psychiatric Association Resident, General Psychiatry Morehouse School of Medicine, Atlanta, GA
PRACTICING WITH PASSION
reativity, business acumen, and medical expertise may be a rare combination, but you'll find it in Dr. Swathi Krishna, who's now entering her second year as a newly selected Chief in the Child and Adolescent Psychiatry fellowship at Emory University School of Medicine. She's been collaborating with a select team of young psychiatrists from all over the country to launch Brainstorm, Stanford University's new Laboratory for Behavioral Health Innovation and Entrepreneurship. She describes it as "an academic center to integrate education and collaboration amongst young entrepreneurs, industry leaders, and brain health experts." It's being introduced at a time when there's significant investor interest in healthcare but many do not know where to put their money, and the developers of healthcare technologies may not know how to get their innovations off the ground. Dr. Krishna, who was a marketing and communications officer at her father's IT firm before she studied medicine at AUA and was a finance major before switching to biology, says that for entrepreneurs and their backers, it's challenging to place a new product or service in a "true healthcare setting." For the latest app or device to be adopted by healthcare providers, it first has to pass through a tiered system of evidence-based testing. Inspired by the American Psychiatric Association's (APA) Psychiatry Innovation Lab, Brainstorm bridges all the parties involved. Having completed a two-year fellowship with the APA, Dr. Krishna continues to serve on the APA's Workgroup for Psychiatry Innovation. To streamline connecting parties within the brain health innovation business space, Brainstorm is developing stand-alone consulting services as an adjunct to Stanford's academic laboratory. With Dr. Krishna's background, it's evident her duties as a Founding Partner of Brainstorm would include finance, media relations, and business development. "Merging business and mental healthcare has always been a passion of mine. A lot of people have good ideas. They just don't know how to apply them." Brainstorm selected 10 companies to attend their launch event, where they demonstrated their behavioral healthcare products to an invite-only audience of clinicians, entrepreneurs, industry influencers, and student leaders from Stanford. The
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following day, Brainstorm hosted the first-ever Virtual Reality/ Augmented Reality Innovation Lab, where five finalists were picked to participate in a Shark Tank-style pitch contest. Given Dr. Krishna's passion for the study of human behavior, it's surprising to learn that she originally wanted to become a family medicine specialist, not a psychiatrist. "Psychiatry just happened to be my first rotation when I began Clinical Sciences at AUA, and that was a done deal for me. It was more about the whole story than about isolated concerns. You have to approach the same problem in different people from different angles. Psychiatric problems don't have one answer," she says. However, Dr. Krishna did always know that she wanted a community-based setting. The residency program at Morehouse was ideal, as the greatest needs for psychiatric services and mental health awareness are in community work, and the majority of psychiatry residencies are in academic centers that cater to the needs of mostly low-income patients. "What made Morehouse especially attractive was that it fit this profile, and since there were only four residents in the program, I could get to do so many different things." Dr. Krishna was also looking for an institution that really values diversity, and Morehouse, a historically black college, met this criterion. As a Morehouse resident, she was assigned to Grady Memorial Hospital, the Atlanta region's biggest Level I trauma center and the fifth-largest public hospital in the country. Many of the patients were uninsured or underinsured, all low-income, and some undocumented. She also worked with retired military servicemen and servicewomen at the Atlanta VA Medical Center. "Unfortunately, there are a lot of substance-abuse issues," Dr. Krishna says about the VA. "It's exceedingly trauma-focused and more about getting to the root of what's going on and finding the best method of treatment." Child and adolescent development is really what has fascinated her most from the beginning, "the idea that a child is born and you have all these expectations, and the child starts to exhibit an atypical developmental pattern. Why does that happen, and how can we help parents navigate those waters?"
My passion is working with children because they can't do certain things or understand why they feel a certain way.
Dr. Krishna may be in a better position to get the most out of her fellowship in Child and Adolescent Psychiatry at Emory than she might have been previously. Last summer, Dr. Krishna and her husband welcomed their second child, a girl named Zara. Their son, Dhilan, was born in the middle of Dr. Krishna's residency and is now three years old. "My passion is working with children because they can't do certain things or understand why they feel a certain way. A lot of times this creates frustration in the family environment," she says. "This fellowship is going to be a great opportunity to learn about treatments for autism and other developmental disorders. Emory is one of the Southeast's top research universities, especially in my area of psychiatry." While she's there, Dr. Krishna hopes to develop a video game-like therapeutic app that will integrate
Applied Behavioral Analysis (ABA), the evidence-based therapy used to treat autism. Currently in the proposal stage, she hopes to one day use Brainstorm to help her secure the funding, create the app, and get it to market. Dr. Krishna certainly takes on many projects, especially considering her original intention of becoming a clinician and seeking residencies that did not require demanding research. Through her APA fellowship, however, she was expected to attend many events with "lots of smart people in the same room, bouncing ideas off of one another and discussing how to make them a reality," she remembers. "In a sense, you could say that for a long time, I fell into a lot of the projects and activities, whereas now I know where I want to go and where I'm headed." â&#x2013;
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Confidence through Experience How Dr. Annie Lecavalier found her path to Internal Medicine.
aving grown up in a Canadian family full of accountants who were squeamish around blood, Dr. Annie Lecavalier would initially seem unlikely to choose a career in medicine. Always fascinated by the sciences, she became determined to work in the field after a high school biology course captured her interest. Although her family was extremely supportive of that career path, she was unsure of where exactly that path would take her. First earning her bachelor's in Biomedical Sciences, Dr. Lecavalier recalls, "It was not medicine per se, but I liked biological sciences, and that's where my interest grew over time. After completing my bachelor's, I thought, 'Okay, this was interesting but, not really what I wanted to do.' The prospects were more towards working in a pharmaceutical company or in a lab." Rather than occupying a removed, behind-the-scenes role, Dr. Lecavalier sought to interact with patients and directly evaluate the problems they were facing, even though she admits to not thinking of herself as a people person. It wasn't until her clinical rotations at AUA, where she first had significant patient contact, that she discovered the personable qualities she didn't know she had. At the same time, the specialty of Internal Medicine was not something she thought she was cut out for. During her residency, one of her supervising physicians convinced her otherwise, having observed her aptitude for working in the fast-paced environment of the ICU. "I thought I was way too nervous and unsure of myself, but he planted that seed. A few months later, I started to think he was right, and I had people telling me I had the potential. That was a turning point when I decided to apply for that specialty training," she says. Speaking from her experience as a female resident in the ICU, Dr. Lecavalier notes that her supervisors have been about 95% men, and the remnants of a "boys club" mentality may still exist with some of the older physicians. "I don't think it's a negative thing; it's just the way things
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were 20 or 30 years ago, and things are evolving," she says. There seems to be some progress, as Dr. Lecavalier notes significant steps toward gender balance in historically maledominated specialties and an overall improvement in the perception of women in medicine. At the time of this writing, Dr. Lecavalier is finishing up her General Internal Medicine fellowship at McGill University in Montreal and will almost immediately start work nearby as attending physician at Hôpital Cité-de-laSanté in Laval, Quebec. She explains that socialized healthcare in Canada makes for a very different setting than that of the United States, and there are a number of positions mandated by the government in every Canadian hospital and city. The availability of those positions is often contingent on timing, but Dr. Lecavalier credits making a name for herself, networking, and little bit of luck with landing her new role. It's an exciting opportunity, but Dr. Lecavalier recognizes the new challenges it presents, saying, "Residency is a very long and slow transition to independent practice, but having that supervision during residency is very comforting. So even though I've been doing this at some level for seven years, now as an independent physician everything is on my shoulders." As the patients she treats are often very sick or critically injured, she adds, "No matter how long we train, we see patients and conditions and pathologies that we haven't seen before. So the learning is constant, and every day is different." That passion to educate ties directly back to the impact of her experience at AUA. Dr. Lecavalier is actively involved in AUA's seminars and webinars, and in regards to teaching, she says, "The professors on the island remember me when I go back; they were amazing, and I recognize that the tremendous amount I learned was because of them. Looking back, it's a testament to AUA's faculty that I also want to teach as part of my career. ■
DR. ANNIE LECAVALIER Class of 2009
Attending Internist and Intensivist Hôpital Cité-de-la-Santé Laval, Quebec Fellow, General Internal Medicine McGill University Montreal, Quebec Fellow, Critical Care Medicine McGill University, Montreal, Quebec Resident, Internal Medicine Albany Medical Center, Albany, NY
Love of Miami, LOVE OF
How AUA's Florida International University collaboration allowed one med student to stay local.
peaking to us just days before AUA's 2018 commencement ceremony, new graduate Dr. Stephanie Vazquez beams, "AUA gave me so much. Right when I started, AUA launched a clinical program with FIU, and everything just seemed to work out perfectly. The way my teachers and attendings prepared us, they were there for us for one reason: to make us doctors." The landmark agreement she cites between AUA and Florida International University (FIU), the Graduate Core Clinical Clerkship Certificate program, enables students to finish their education at a US medical schoolâ&#x20AC;&#x201D;the only arrangement of its kind for Caribbean medical students. Having completed her final rotation in Critical Care at Westchester Hospital in her native Miami, Dr. Vazquez is now beginning her residency at Joe DiMaggio Children's Hospital in nearby Hollywood, Florida. When starting at AUA, Dr. Vazquez had planned to eventually return to Miami; however, she thought it would have been further down the road. "I'm very close with my family, and I knew I didn't want to be away for too long," she says. Dr. Vazquez comes from a family of Cuban immigrants who decided to settle in the "Magic City" in the 1960s. "My grandparents wanted to escape the Castro regime. They came to the United States ready to work hard and pursue the American dream. I get my drive and determination from them." After completing two years of Basic Science courses in Antigua, Dr. Vazquez felt lucky to return home to Miami so soon, having qualified to participate in AUA's program offered in collaboration with FIU. Students in the Core Clinical Clerkship Certificate program are able to complete all of their core rotations back to back at FIU-affiliated clinical sites in South Florida. Graduates of the programs
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receive a Certificate of Completion, an official transcript, and performance evaluations from FIU. These documents serve to enhance their residency applications. Dr. Vazquez says there were considerable perks that came with the program. "FIU gives you the schedule for the whole year, so I didn't have to go crazy trying to book my rotations." AUA students also receive an FIU ID, which allows access to the school's academic and recreational facilities. "In the beginning, I was worried that I would stand out as an international student," Dr. Vazquez admits. "But once you get in the hospital, everybody is the same. We all learned the same things. There are no labels." Dr. Vazquez's enrollment in med school was by no means immediately after graduating from university. After receiving her degree from the University of Florida in Human Nutritional Science, she worked for four years as a nutrition and lactation educator in the Florida Department of Health's Women, Infants, and Children (WIC) Program. Though she dreamt of becoming a doctor, she wasn't confident in her MCAT score, and she concedes her GPA "could have been better." Stifled by the thought of being rejected by multiple medical schools, she was encouraged by a close friend to apply to AUA, where she would be evaluated as a person, not a number. That progressive approach to admissions landed Dr. Vazquez in medical school. Dr. Vazquez had intended to pursue OB-GYN, having always been fascinated with the prenatal and obstetrics aspects. That plan ended up shifting toward Pediatrics. "As I got clinical experience, and comparing what an OBGYN really does to what a Pediatrician really does, I could make more of an impact as a Pediatrician because it's more primary care in the sense that there's more one-on-one time with the patient and with the parent," she says.
With her 2018 graduation, Dr. Vazquez became the first doctor in her family. The work ethic and perseverance in getting there was, of course, instilled by her parents. Discussing how she was raised with her two sisters, Dr. Vazquez has immense respect for her mother and father. "It has always been 'You have to work hard, no excuses, you just have to keep on going. As hard as things can be, there's always a door that's going to open. As long as you never give up, anything is possible.'" At AUA, Dr. Vazquez quickly developed a different form of respect, for other cultures and religions. Having grown up in a primarily Hispanic Catholic area, Dr. Vazquez is highly appreciative of AUA's international diversity, opening her eyes to the world, "Meeting the people that I met is going to make me a much better doctor and help me further understand the needs of my patients. The experience I got at AUA can't be learned from a book." Looking toward the future, Dr. Vazquez aspires to establish a clinic in a poor community, offering cohesive care all under one roof. That includes education in parenting, lactation, and nutrition. "When one specialist says one thing and another specialist says something different,
DR. STEPHANIE VAZQUEZ Class of 2018
Resident, Pediatrics Joe DiMaggio Children's Hospital, Hollywood, FL Nutrition and Lactation Educator Florida Health Department, Women, Infant, & Children (WIC) Program, Miami, FL
patients don't know whom to listen to," she's observed. Dr. Vazquez's strategic solution is one unified vision of an individual's healthcare: primary care physicians and other professionals would serve the patient as one team, simplifying the communication. Joining the two specialties of OB-GYN and Pediatrics would be her goal, to ensure that the best care and health foundation is provided from birth to adolescence. Where does Dr. Vazquez plan on locating her dream clinic? Miami, of course. "This is my community," she says. "This is my home." â&#x2013; PRACTICING WITH PASSION
MIGRAINES and MATERNITY LEAVE Dr. Regina Krel balances treating patients and being a new mom.
or 60 million people in the United States alone, life is one big headache. Often these frequent headache and migraine sufferers are not diagnosed properly; however, specialists like Dr. Regina Krel are equipped to treat these historically underserved patients. In August 2017, Dr. Krel joined the then-recently founded Neuroscience Institute at Hackensack University Medical Center. She works closely with a quickly expanding in-house interdisciplinary team to provide patients with the thorough assessment and care they require. "There's a lot of misconceptions of how to treat migraines, and what causes them. So the problem arises that you have to treat the patient as a whole; you can't just focus on, 'okay, they have a headache,'" she says. "You can't ignore the fact that the patient has a lot of stress going on in their life or they're not sleeping right or not eating a complete meal. All of these things will impact how they respond to headache treatments. A pill is not always the answer."
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Dr. Krel's fascination with headache medicine began during her Neurology residency training at Stony Brook Medicine, where her mentor was a headache specialist. Fortunately, Dr. Krel is not a frequent sufferer herself, but she does experience the occasional stifling headache, which helps her empathize with her patients who endure them regularly. After being born in Ukraine and moving to the United States when she was three years old, Dr. Krel and her entire family became involved in medicine in some capacity. From an early age, she developed a love of science, curiosity about how things work, and drive to help people. Another passion emerged in the form of competitive ballroom and Latin dancing, in which she was involved through college. Yes, if you're envisioning Dancing with the Stars, you've pretty much got it. Dr. Krel credits that phase of her life with mentally prepping her for a career in medicine. "Although obviously completely different than being a physician, the discipline for
the training was still there. In order to succeed you have to practice and get better; there are no shortcuts in life. If you want to be the best, you've got to train with them. You've just got to put the time in, and sometimes that requires sacrifices." That lesson of making sacrifices has carried over to navigating through work-life balance. Dr. Krel and her husbandâ&#x20AC;&#x201D;whom she met while they interned together at Richmond University Medical Center in Staten Islandâ&#x20AC;&#x201D;welcomed their first child in 2016. It is an understatement to say that being a new mom while attempting to provide seamless care to patients presents its challenges. Although Dr. Krel is pleased to say that she has seen much progress in equal pay for equal work and feels like she has always been treated fairly as a woman, there is much improvement needed in the age-old issue of maternity leave in medicine. While the states of New York and New Jersey have taken some encouraging steps, Dr. Krel speaks from a stance of experience and professional integrity,
There are no shortcuts in life. If you want to be the best, you've got to train with them. You've just got to put the time in, and sometimes that requires sacrifices.
DR. REGINA KREL Class of 2011
Board Certified Neurologist Hackensack University Medical Center Headache Center at the Neuroscience Institute, Hackensack, NJ Assistant Professor, Neurology Seton Hall-Hackensack Meridian School of Medicine, Hackensack, NJ Fellow, Headache Medicine Brigham and Women's Hospital/Harvard Medical School, Boston, MA Chief Resident, Neurology SUNY Stony Brook University Hospital and Medical Center, Stony Brook, NY
"It's hard. Female physicians feel that guilt because they're not practicing medicine while taking time off to spend with their child. Ultimately, I think we have to stop feeling guilty as a society. You have to raise your child." It is a challenge that has no easy answer. When Dr. Krel took her maternity leave, she worked for a private practice with multiple practitioners and several other physicians who could cover her patients. Prior to her delivery, Dr. Krel met with her follow-
up patients so they would not require another visit until after she was back from leave. In the end, she took only eight weeks off instead of the full 12. Dr. Krel says that she is fortunate to currently be at Hackensack, where her department and chairs are very understanding. They allow her the flexibility to get home at a reasonable time, enough to spend a few hours with her daughter, put her to bed each night, and have weekends together. Of course, there are still sleep deprivation
issues, but Dr. Krel says with a chuckle, "We make it work." The other important family in Dr. Krel's life is the one she made at AUA. She stays in touch with most of her class through social media, and when time allows, she meets up with local fellow alumni. "It was so nice to be in one of the earliest AUA classes; it being a new school certainly didn't stand in my way. AUA got me to where I am today." â&#x2013;
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STRATEGY CHANGE YOUR
LIFE Failure taught Dr. Eronmwon Okoye to study the science of The Match, and she came out on top.
he ability to rebound from setbacks and regroup by figuring out new ways to achieve her goals is one of Dr. Eronmwon Okoye's best qualities. She views every mistake as a learning opportunity, and although her story may be something of a cautionary tale for aspiring residents, it has a very happy ending. Originally from Nigeria, Dr. Okoye and her family moved to Pennsylvania when she was seven years old and later moved to New Jersey, which she's called home ever since. She was drawn to medical sciences at an early age and eventually decided to pursue a career in pharmacy. By the time Dr. Okoye graduated from Temple University with a bachelor's degree in chemistry, she realized that she wanted more direct contact with patients and a chance to help them on a more continual basis. Imagine discovering this after completing three pharmacy-related internships as an undergrad, including two at Johnson & Johnson. Dr. Okoye has a positive perspective on it, though.
DR. ERONMWON OKOYE Class of 2015
PGY2 Resident, Psychiatry Rutgers New Jersey Medical SchoolTrinitas Regional Medical Center, Elizabeth, NJ
"Sometimes you find the right path by taking a couple turns in a different direction. My pharmacy work really drove home that what I needed to do was become a physician," Dr. Okoye says. Dr. Okoye fell in love with psychiatry as a clinical student. "It had the most interesting patient population of all the specialties I was exposed to during Clinical Sciences. What makes it even more fascinating is how little we know about mental health compared to other areas of medicine and science." Dr. Okoye completed her core Psychiatry rotation at Richmond University Medical Center (RUMC) in Staten Island, New York. She also did electives in General Psychiatry and Child and Adolescent Psychiatry. When it was time to apply to residency programs, Dr. Okoye had no doubt she wanted to complete hers in psychiatry. Confident she'd have no problem matching because of her strong grades and test scores, Dr. Okoye applied to psychiatry residency programs only. Additionally, she targeted residencies only in New York, New Jersey, and Pennsylvania, to stay close to her husband, Steven, and her daughter, Maria. Unfortunately, Dr. Okoye was rejected by all of them. "I just couldn't understand why. I didn't know what I did wrong. I wondered if I should have taken the advice of AUA alumni who told me to apply for a backup specialty," Dr. Okoye remembers. After some reflection, she came to believe that she had hurt her chances by keeping her focus so narrow in both specialty and location. Not matching did allow her a year to make up for lost time with Maria, who was born in October 2014 when Dr. Okoye was completing her clinical rotations in New York and Steven had just started law school. After a short maternity leave, Dr. Okoye returned to her clinical sites
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in New York, where she lived during the week. On weekends, she traveled back to her family in New Jersey. It was a major sacrifice for all, but Dr. Okoye and her husband agreed that it was best for Maria's future. Dr. Okoye did remain engaged and active in the medical field during this period, completing a monthlong observership in the Psychiatry department of AtlantiCare Regional
Medical Center in New Jersey and participating in an ongoing study at RUMC that measures the daily calcium intake of outpatients to help prevent diseases like osteoporosis, kidney stones, obesity, and other conditions and ailments. Naturally, coming back as a stronger residency candidate was Dr. Okoye's top priority. Analyzing why she initially failed to match, she realized she had
Sometimes you find the right path by taking a couple turns in a different direction.
underestimated just how increasingly would all but guarantee her interviews. competitive psychiatry programs "As international medical graduates, we have become. "As a result, there were have to work harder during and after so many more applicants to psych med school in terms of obtaining residencies in New Jersey." The reality is residency positions. You have to market that with the increase in mental health yourself aggressively," she says. awareness nationwide, more graduates When it was time to reapply, Dr. of US medical schools are interested in Okoye had a new, simple yet effective psychiatry than ever before. strategy. "I was incredibly proactive," Dr. Okoye's other error was she says. "I applied to 100 programs assuming that her GPA and test scores and, rather than passively waiting for
responses, I called each director the day after submitting my application. I didn't demand interviews. I just introduced myself." She intentionally mentioned that she lived nearby and was very interested in their program. Directors often take this into consideration, as it cuts down on logistical considerations, and candidates that have roots in the community are often more prepared to connect with the local patient population. The new approach paid off. This time, Dr. Okoye landed 21 interviews and obtained her first-choice residency, a psychiatry program at what is now Rutgers New Jersey Medical School-Trinitas Regional Medical Center, one of the most complete behavioral health and psychiatry departments in the state. All age groups are treated there, and it has the only inpatient facility for dually diagnosed, mentally ill, and developmentally disabled patients. Dr. Okoye also liked that it was a multidisciplinary program in which residents complete rotations in psychiatry, neurology, and internal medicine. On top of all that, it had a 100 percent board certification rate. Dr. Okoye's road to residency has been long, but it proved to her that success as an applicant depends on strategy and persistenceâ&#x20AC;&#x201D;not on the program evaluating you or on the school attended. That said, she attributes to AUA her ability to persevere and shine as a candidate, and she enthusiastically shared her story here as an opportunity to give back. "AUA gave me a rigorous education. I couldn't have asked for a better foundation and will always be grateful for the experiences it provided me." â&#x2013; OVERCOMING OBSTACLES
Going the Distance.
LITERALLY. Dr. Xian Li's travels first brought her to America then around the world.
DR. XIAN LI
Co-Valedictorian, Class of 2015 Board Certified Physician, Family Medicine Northwell Health-GoHealth Urgent Care Glen Cove Hospital, Glen Cove, NY Huntington Hospital, Huntington, NY Faculty, Family Medicine Glen Cove Hospital, Glen Cove, NY
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Resident, Family Medicine Northwell Health Glen Cove Hospital, Long Island, NY
or some, language barriers are insurmountable. For others, culture shock can be paralyzing. For Dr. Xian Li, neither became a permanent obstacle, due to her determination and self-confidence, along with AUA giving her the chance she deserved. Dr. Li was raised in Beijing, China, by her father and grandparents, while her mother was in the United States working as a nurse and later as a Cardiac Cath Lab Nurse Practitioner. In 2003 at age 15, Dr. Li joined her mother and stepfather in Long Island, knowing little to no English. By nature, high school can be difficult for any teenager, but being from a foreign country and not having a command of the language made it understandably that much more so. Taking ESL throughout high school along with standard classes, Dr. Li went on to attend Stony Brook University, graduating with a Bachelor of Science in Nursing degree in 2010. With her sights set on becoming a doctor, she knew that although her English had markedly improved year by year, it was not yet at the level for her to perform well on the MCAT. What Dr. Li really needed was a medical school that thoughtfully evaluated the candidate as a whole without using an MCAT score as a primary condition for acceptance. That school, of course, was AUA. "That's why I really appreciated AUA. I really couldn't do well on the MCAT, because when I took it in college, my English wasn't strong enough. If just given the opportunity to attend med school, I knew I could do it. AUA gave me that opportunity," Dr. Li says with deep gratitude. It was at AUA where Dr. Li's love for travel was amplified. Agreeing that AUA is unrivaled in international diversity, she embraces the benefits of learning from other cultures, originating from her experience of moving from China to the United States. Among the other countries she's spent time in are Russia, Ukraine, Iceland, Germany, Austria, Hungary, Sweden, Norway, Hong Kong, Japan, India, Indonesia, Panama, Ecuador, Mexico, the Dominican Republic, and Saint Kitts and Nevis. One cultural stance Dr. Li has encountered in some countries—including her native China—is that women are not meant to achieve the same professional status as men. This is a point of view that Dr. Li refused to subscribe to from an early age, saying, "In China, it's all tradition. 'Men can do this, men can do that, but not women.' So, as a kid I always told myself, 'I am a woman, and I can do whatever I want to do, and I can do it better than men do.' That was always in the back of my head."
In China, it's all tradition. `Men can do this, men can do that, but not women.' So, as a kid I always told myself, `I am a woman, and I can do whatever I want to do, and I can do it better than men do.' That was always in the back of my head. Dr. Li graduated from AUA as co-valedictorian in 2014. Her extremely proud family supported her throughout the entire four-year process and continues to do so. As of this writing, Dr. Li is just a month away from finishing up her residency at Northwell Glen Cove Hospital on Long Island, graduating with both a Global Health Track and an Urgent Care Track. Specializing in Family Medicine, Dr. Li has lined up a full-time role at Northwell Health-GoHealth Urgent Care, as well as a working per diem at Glen Cove and Huntington Hospitals. Also exciting for Dr. Li is the additional role she'll be taking on as part of the faculty at Glen Cove. While at AUA, she worked as a TA in neurology, physiology, anatomy, pharmacology, and biochemistry. Dr. Li finds teaching and tutoring highly rewarding, especially when working with students who may be facing the same communication or cultural struggles she initially did. One objective she has is to give residents more decision-making latitude within reason. "I want to give a new resident more autonomy, because as a resident, you have attendings that sometimes just tell you what you need to do rather than listen to your plan," Dr. Li says. Despite her undoubtedly packed work schedule, is more travel in Dr. Li's future? For sure. She recently returned from Jamaica and aspires to volunteer in countries around the world. As she's already demonstrated, no barrier or border is a deterrent from growing as an individual and seeking to better the human condition. ■ OVERCOMING OBSTACLES
BRINGING T R E AT M E N T TO
SCALE In unfamiliar surroundings, Dr. Kimberly Harden found herself.
r. Kimberly Harden's certification by the American Board of Obesity Medicine was the latest chapter in a journey triggered by a reality check during her residency at LSU Bogalusa Medical Center (now Our Lady of the Angels Hospital), in Bogalusa, Louisiana. At the time, Bogalusa had a population of about 12,000, and the nearest Level I trauma center was 26 miles away. Her friends were surprised that she'd want to relocate to "the backcountry and live across the street from an empty field for three years" since they knew the Houston native appreciated big cities. During med school, she completed almost all of her rotations in the Chicago area and finished Clinical Sciences with an oncology clerkship in New Orleans at Tulane University School of Medicine.
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DR. KIMBERLY HARDEN
Class of 2009
Board Certified Physician, Family Medicine Physician Advisor Rush Oak Park Physician's Group, Rush Oak Park Hospital, Oak Park, IL Resident, Rural Family Medicine Louisiana State University School of Medicine, Bogalusa, LA
Dr. Harden made a deliberate choice to apply to the Louisiana State University (LSU) School of Medicine residency in Rural Family Medicine and beat out more than a thousand applicants to become one of only four residents at the entire hospital. "It reminded me of the doctors I watched on TV when I was a kid. They did everything. I wanted to do that," Dr. Harden says. She would not be disappointed. On her first day as a resident, she delivered two babies, rounded on an ICU patient who had been on a ventilator for about a month, and participated in a code, or a medical emergency designated by colors to indicate the degree of severity and urgency. "Between all of that, we had to admit patients and direct them to the right specialists and departments, too," she adds. Between 32 and 35 percent of adults in the state of Louisiana were considered obese during the three years Dr. Harden lived in Bogalusa. Today that number is slightly higher, and Louisiana is the fifth-heaviest state in the country. As she treated multiple patients who were overweight, Dr. Harden quickly began to realize that treating obesity involves more than weight loss. The accompanying comorbidities—diabetes, sleep apnea, and heart disease, to name a few—all require attention. Among this group, the patient that she remembers most was a man who weighed 747 pounds but had relatively few comorbidities and wanted to lose weight on his own instead of having surgery. Dr. Harden had no experience treating a patient with such a severe weight issue and was surprised to find that medications such as topiramate (Qsymia) are a reasonable and often-suggested treatment for weight loss. They are generally recommended by doctors to patients who have a body mass index (BMI) of 30 or higher, or who have a BMI of higher than 27 but also have comorbidities like high blood pressure, sleep apnea, or diabetes. Most of her attendings, however, were strongly against giving this patient medication and in favor of operating. One of the attendings was open to her idea, knowing if done correctly, it would be an acceptable method of treatment. At the time, Dr. Harden herself weighed about 200 pounds and had hypertension, as she found out when she suddenly had a nosebleed while admitting a patient in the ER. "This case really hit home and opened my eyes because it was such a deeply personal subject for me. I can count the members of my extended family who are not overweight on one hand," Dr. Harden says. "It's an issue that's near and dear to my heart." She attributed her own weight issues to lifestyle, not genetics, which she says are often incorrectly identified as the
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reason some struggle to lose weight more than others. Dr. Harden began making important changes in her habits after she saw how effective that was for so many of her patients. "I wanted to prove to myself that I could lose weight using the same strategies we were using to treat our patients," she explains. Through minor adjustments to her diet, lots of exercise, and medication, Dr. Harden took the weight off and was able to stop taking blood pressure drugs. She's felt great ever since. "I thought to myself, 'This is wonderful! I want to help other people do the same thing,'" she recalls. Ultimately, it motivated her to study for her certification from the American Board of Obesity Medicine. Although Dr. Harden was offered a job as an attending physician by LSU when she finished her residency, she missed the energy of Chicago and turned it down. "I love Chicago, and I'm so happy to be here again," she says. She is grateful to AUA for coordinating the vast majority of her clerkships there, and she returned in 2013 to treat patients as a family medicine specialist at a community clinic and for a telemedicine service. Today she practices at Rush Oak Park Physicians Group, a practice owned by Rush Oak Park Hospital. There, Dr. Harden sees patients of all ages in clinic and hospital discharges from all levels of care, in addition to ICU discharges. Getting her certification in Obesity Medicine was well-timed, as Rush Oak Park Hospital is opening a new weight-loss clinic, and Dr. Harden plans to be significantly involved. Speaking of how women are perceived in medicine, Dr. Harden has observed positive strides. But she does stress that "there are things that need to change in how people think about women in leadership positions. That is throughout medicine and our society in general. We haven't seen the pinnacle of success of what women can do yet." In addition to her duties as a physician, Dr. Harden serves as a board member and medical director of Character Camp, a Houston-area nonprofit charity for at-risk youth that her uncle founded 31 years ago. The group offers programs year-round, including mentorship and internship opportunities, retreats like the summer camp Dr. Harden participates in, and tutoring to elementary, middle, and high school kids. "I love it, and it's definitely an important resource for the community because it meets the emotional needs of local kids rather than just providing clothing, food, and other goods," she says. Growing up on the south side of Houston, Dr. Harden excelled as a student, playing piano and handbells, singing in the choir, and running track. She graduated from high school two years early and majored in biology
I T WA S R E A L L Y R E F R E S H I N G TO B E AROUND SO MANY PEOPLE WHOSE EXPERIENCES WERE DIFFERENT FROM MY O W N . T H AT WA S H O W I WA N T E D TO L I V E MY LIFE. at the historically black Prairie View A&M University in Texas. Although she wanted to become a doctor, she was intimidated by the MCAT and didn't sit for the exam. She worked in the corporate world for two years and finally got the courage to take the test, but she didn't do well and was wait-listed at the med schools she had applied to, all of them in Texas. Rather than waiting a year to reapply, Dr. Harden began looking into Caribbean medical schools. The thenrecently opened AUA was the most responsive, immediately impressing her. As an AUA student, she felt that her professors and the administration were constant sources of support. "They knew where we wanted to go in our careers and prepared us well so we could get there. It was also the
first time I had been so far away from home, so the decision to go seemed like a gamble at first, but it paid off in the end," she says. AUA's emphasis on diversity and the value it places on recruiting students from different cultures and locations meant a lot to Dr. Harden from the very beginning. "Going to AUA was the first time that I stepped outside the black community. I was raised in a black neighborhood, I attended predominantly African American schools, and after I graduated from college I moved to another predominantly African American area of Houston," Dr. Harden explains. "It was really refreshing to be around so many people whose experiences were different from my own. That was how I wanted to live my life." â&#x2013; OVERCOMING OBSTACLES
DR. GLORIA HWANG Class of 2014
Resident, Physical Medicine & Rehabilitation Montefiore Medical Center, Albert Einstein College of Medicine, The Bronx, NY
A LONG ROAD to MD How one doctor started med school late in life and crossed the finished line.
on't become a doctor. Marry a doctor!" was something Gloria Hwang was told when she announced she was going to medical school a number of years ago. Dr. Hwang says it had a lot to do with the time in her life when she decided to make the leap. "I don't tell people my age, but let's just say I entered med school a little later than most." In search of better opportunities for their children, Dr. Hwang's parents moved the family from South Korea, where she was born, to Chicago when she was five years old. Eventually they settled in Los Angeles, where her extended family had made a success of operating dry cleaning businesses in California. Fortunately, Dr. Hwang had a few family members in the medical field who could open her eyes to the possibility of one day becoming a doctor. "I'm thankful that my cousin and his wife are physicians. They have always been there for guidance through the whole process." After finishing undergrad at University of California San Diego, Dr. Hwang worked as a drug rep at Parke-Davis, which was acquired by Pfizer in 2000. "I learned a lot while I was a drug rep, but I could tell it wasn't going to be long term. I would meet with doctors to talk about the drugs I was selling, but in reality I wanted to be on the other side of the table. I just wanted to be able to help people, to provide them with care so they could get better." Dr. Hwang wanted to be strategic about getting into med school. She decided to pursue a Master of Public Administration at NYU as a way to get back into the rhythm of school. She then enrolled at AUA in 2008. "When you're studying so hard and working with others who are working just as hard, there is a sense of camaraderie. It's like a club, and we're all struggling through it together." Dr. Hwang was thankful she had spent the time getting her master's degree, but AUA still proved to be quite rigorous. "Med school is like drinking out of a fire
hydrant. There's almost a sense of panic because there's so much you need to learn and a sense of urgency to learn it all." Now with the white-coat ceremony behind her, Dr. Hwang is completing her second year of residency at Montefiore Medical Center in the Bronx, New York, which serves a mostly indigent population. "Our patients speak many different languages and have many cultural backgrounds. It's challenging at times. We treat people who would otherwise not receive healthcare because they don't have insurance. Sometimes I'm treating people with psychological or life problems, which makes it difficult to find the right course of action." Dr. Hwang's time at Montefiore consists mainly of talking with patients, administering pain medications, and coordinating follow-ups. "I wouldn't say that calling people for follow-ups is my favorite part of the job, but it's so important to keep people on a schedule to manage their pain." Dr. Hwang is thankful for AUA helping her find mentors in the field of Physical Medicine and Rehabilitation (PM&R). "Nothing has come easy to me. I wouldn't say I'm naturally brilliant, but I am a hard worker. I would not have been able to do this without the help of my mentors, Dr. Stitik and Dr. Foye. Their guidance and connections certainly contributed to obtaining this residency." PM&R was attractive to Dr. Hwang because of its goal of enhancing the quality of life for people with physical impairments or disabilities. "The physicians in the field are great to work with, usually easygoing, humble, and kind. It's very rewarding work because the patients are generally so grateful for the help we provide." Dr. Hwang has two more years of her residency, and she's excited for the next phase. "It's been a long road," she laughs. Dr. Hwang doesn't think she'll stick around New York. "I'm a suburb girl. I'm looking forward to some peace and quiet!" â&#x2013;
BRINTHA VASAGAR, MD, MPH Class of 2012
Founding Associate Program Director Director of Leadership and Advocacy Tidelands MUSC Family Medicine Residency Program, Murrells Inlet, SC Assistant Professor, Family Medicine Attending Physician, Family Medicine Medical University of South Carolina, Charleston, SC
LEADER WITH A
Dr. Brintha Vasagar is giving residents the tools they need to put the focus on patients, manage healthcare teams, and serve their communities.
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r. Brintha Vasagar's list of achievements is beyond impressive. In 2016, Dr. Vasagar joined the Medical University of South Carolina to become the founding Associate Program Director of a very unique training program for family medicine specialists at the Tidelands Health MUSC Family Medicine Residency Program located in Murrells Inlet, South Carolina. "In establishing a new residency program, we had a lot of freedom to create our dream program. We asked ourselves: what do we feel is missing from graduate medical education, and how can we meet those needs?" Dr. Vasagar said. One key theme was addressing the physician burnout epidemic. "We have one of the most comprehensive wellness programs in the country," Dr. Vasagar says. Once a week, the clinic where residents practice closes early so they can participate in wellness activities designed to combat physician burnout. Yoga on the beach and healthy cooking lessons are just some examples. As a researcher, Dr. Vasagar is tracking things like empathy and burnout to determine the success of the program. Dr. Vasagar is excited about the wellness component, but the part of the residency that really fuels her is its leadership program. There are other residencies that have a leadership component, but hers goes a step further. Residents dedicate one month per year and one hour per week to leadership training, during which they learn skills such as quality improvement, patient safety, healthcare policy, and how to manage a team. "Typically, you're not taught the skills required to advocate for your patients. That's what we're trying to do. It's a program designed to empower physicians to be leaders in their communities, no matter where they practice," Dr. Vasagar explains. Residents analyze what they value as an organization and as individuals, and how those elements intersect. They examine issues like trust and communication with the goal of providing team-based and patient-centered care. The residency is in its second recruitment year, and Dr. Vasagar says that many of the applicants make clear in their
personal statements that the focus on leadership is specifically why they want to get into the program. It's what sparked her own interest. "I had always been active in community initiatives, but the skills practiced in the leadership program are really the ones I wish I had been taught to help me help my patients to the best of my ability. They're the skills employers will be looking for in the coming years," she says. Dr. Vasagar refers to a fairly recent survey among employers who hire physicians that showed leadership as the skill most valued but missing from medical training. She suspects that this is one factor that has contributed to the strong response her program has garnered from applicants. Last year, Dr. Vasagar was one of only 60 individuals from across the United States to be selected for the Presidential Leadership Scholars national development program, coordinated by the Lyndon B. Johnson, George H.W. Bush, William J. Clinton, and George W. Bush presidential centers. Each class of Scholars represents a variety of industries and is taught by former presidents, key administration officials, respected presidential scholars, academicians, and one another. Sessions utilize compelling presidential and business case studies and are rooted in leadership research. "For me, the real success was learning from my classmates. They put us all in the same room with the idea that we could learn from each other, and we came up with new ideas around the common goal of making the world a better place." Dr. Vasagar has already brought back to her residency program concepts she learned about from other Scholars in aviation and other high-reliability industries where even one mistake is too many. "Even though they're in completely different fields, the ideas they share are transferable." In light of everything Dr. Vasagar is involved with, it seems fair to wonder whether she sees herself in politics eventually. "My ultimate goal is to become Surgeon General of the United States and address population health. It is so important to not just treat individuals but to also treat communities." â&#x2013;
RAISING THE BAR
ISSUE 03 â&#x20AC;¢ 2018
From the very
BEGINNING Dr. Jasmine Riviere-Marcelin first studied Infectious Diseases in elementary school.
DR. JASMINE RIVIEREMARCELIN Class of 2011
Associate Medical Director of Antimicrobial Stewardship, Associate Medical Director of Infection Control & Epidemiology, Assistant Professor of Medicine, Division of Infectious Diseases University of Nebraska Medical Center, Omaha, NE Fellow, Infectious Diseases Mayo Clinic, Rochester, MN Resident, Internal Medicine Mayo Clinic, Rochester, MN
t the University of Nebraska Medical Center (UNMC) in Omaha, the Antimicrobial Stewardship Program helps clinicians determine when antibiotics should be used, which ones to use, and how to administer them. The program's goals are also to treat and prevent infections and minimize adverse reactions and resistance to the antibiotics, all while staying cost effective. The Associate Medical Director of the program is Infectious Diseases Specialist and AUA graduate Dr. Jasmine Riviere Marcelin. When discussing infectious diseases and specifically antimicrobial stewardship, Dr. Marcelin makes her authority and passion for both subjects obvious. As Dr. Marcelin was speaking about her position, the topic shifted to antibiotic-resistant strains of bacteria, viruses, and fungi that have the ability to mutate and become immune to various antimicrobials. Compounding the problem is the fact that pharmaceutical companies are not manufacturing antibiotic drugs quickly enough, resulting in a limited supply. In this "post-antibiotic era," doctors end up having to treat simple bacterial infections with expensive, broadspectrum drugs. The issue is concentrated along the northeast coast of the United States, although it occurs nationwide. "Antimicrobial stewardship is about trying to understand why and how bacteria do this and to come up with a plan that will enable us to keep using antibiotics to treat patients who need them and avoid wasting our supply of the ones used to treat very serious infections," Dr. Marcelin says. RAISING THE BAR
It was almost as if I were destined to become an Infectious Disease Specialist even though I didn't know what that was yet.
As a child in Dominica, where she was born, then–Jasmine Riviere was already fascinated by the sciences and the mysteries they could unlock. While her classmates stuck to tried-andtrue science projects—vinegar and baking soda volcanoes, solar system models, invisible ink—Jasmine was studying mosquitoborne illnesses. She wanted to know what the diseases were, how to identify them, and how to eradicate the pests. "It was almost as if I were destined to become an Infectious Disease Specialist even though I didn't know what that was yet." A precocious child, she had "a heart-to-heart" with her pediatrician, Dr. Carissa F. Etienne, who happens to be the current Director of the Pan American Health Organization. "I was eight, and I told her that I loved kids and science. She told me I could become a science teacher or a pediatrician. I thought, 'I don't have the patience to be a teacher, so I'll be a pediatrician,'" laughs Dr. Marcelin, whose mother is a special education teacher. When Dr. Marcelin was 13, her family moved to Antigua, where she eventually studied at AUA on a full scholarship. Graduating as the class of 2011's valedictorian, she became the first physician in her immediate family. While attending AUA, Dr. Marcelin was compelled by microbiology, recalling the late Dr. Dipeolu's enthusiasm that brought the material to life. Despite significant time in AUA's microbiology lab, Dr. Marcelin didn't yet realize that Infectious Diseases was a specialty to pursue. During her Pediatrics rotation at Richmond University Medical Center (RUMC) in New York, she became convinced that pediatrics was no longer her path, and reflecting on her previous rotations, she realized Internal Medicine was her favorite and that she was most drawn to treating patients with infections. In 2010, she relocated to the Mayo Clinic in
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Rochester, Minnesota, for an elective clerkship in Infectious Diseases. She credits Dr. Peter Bell, AUA's Vice President for Global Medical Education and Executive Dean of Clinical Sciences, for encouraging her to take this clerkship and supporting her throughout. By the time Dr. Marcelin was finished, the Mayo Clinic's Internal Medicine residency program had become her first choice, and she secured a highly competitive position there after graduating from AUA. Toward the end of her residency, she was accepted into their fellowship program in Infectious Diseases. Dr. Marcelin attributes AUA with getting her where she is today. "It really was my second home. There was a big focus on self-directed learning. The professors had a great open-door policy, and it was very easy to get involved on campus as well." Dr. Marcelin added, "I felt fortunate to work with standardized patients because they presented a wide range of pathologies and seemed very eager for us to learn from them." Dr. Marcelin remembers that her AUA classmates seemed to have "a person," not necessarily a significant other but someone they could confide in and find mutual support with. "I don't think that's stressed enough. I see young physicians and medical students burning out because they don't have a support system," Dr. Marcelin says. Then she smiles. "Actually, the best part of my medical education was meeting my husband." She met Dr. Alberto Marcelin, Class of 2011, (pictured on the right) in anatomy class during their first semester of Basic Sciences. They became "inseparable," as she told Reader's Digest in a recent article about real-life love stories. The couple worked together at the Mayo Clinic and now both work at UNMC, where Alberto directs a clinic and teaches Family Medicine residents. They have two sons—Nathaniel, who is six, and Giovanni, who is almost two.
Dr. Alberto Marcelin (Class of 2011) was the Chair of Family Medicine at Mayo Clinic Health System in Austin, Minnesota. He was also an Assistant Professor of Family Medicine at Mayo Clinic College of Medicine and Science. Recently, he and his wife, Dr. Jasmine R. Marcelin moved to Omaha, Nebraska, where he directs a clinic connected to the University of Nebraska Medical Center and teaches Family Medicine residents.
Dr. Marcelin also teaches residents and fellows, and she consults with inpatients and outpatients. She's been working at UNMC's outpatient HIV clinic since her job began and finds it particularly rewarding to take a patient from diagnosis to treatment to an almost completely normal immune system. "The discussion then becomes less about HIV and more about the types of routine concerns people bring to their primary care doctors. You get to be their support system and help get them back to that level of wellness. It's a remarkable feeling."
Having always been interested in academic writing, Dr. Marcelin has published several papers in peer-reviewed journals. She was the founding editor of the monthly AUA student newsletter, Calypso News, and produced several posts on the AUA blog as a student. Currently, Dr. Marcelin blogs for the UNMC Infectious Diseases Division at blog.unmc.edu/ infectious-disease, moderates the UNMC ID division Twitter account @UNMC_ID, and of course tweets from her personal account, @DrJRMarcelin. â&#x2013; RAISING THE BAR
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MORE THAN meets
THE EYE If there's a "Face of AUA," it belongs to Dr. Kalpana Gopalswamy, the Class of 2014's co-valedictorian.
DR. KALPANA GOPALSWAMY Co-Valedictorian, Class of 2014 Hospitalist Sound Physicians, Shady Grove Medical Center Rockville, MD Resident, Internal Medicine UPMC Mercy Hospital Pittsburgh, PA RAISING THE BAR
hopeful, confident young doctor stands in her white coat. She gazes into the lens with her hands and stethoscope in her pockets. Her eyes and easygoing smile and her apparent comfort in front of the camera suggest that whoever is taking her picture is someone she knows well, a colleague perhaps. If there are iconic images of AUA, this is one of them. This picture of Dr. Kalpana Gopalswamy appears in all manner of AUA print and digital publications, as well as in our social media posts. It seems to say, "This is what your future could be" to prospective students. During her Internal Medicine residency, which she completed this year, Dr. Gopalswamy, co-Valedictorian of AUA's class of 2014, practiced at UPMC Mercy Hospital in Pittsburgh. It gave her valuable experience with a diverse range of pathologies because it's a tertiary facility. Tertiary facilities are large hospitals that cater to patients who are initially admitted to smaller facilities that are not equipped to treat them; in this case, hospitals in western Pennsylvania, Ohio, and West Virginia. As a resident, Dr. Gopalswamy provided a photo that had been requested for use in marketing materials to AUA's New York office. "I sent it in without a second thought. It was my pleasure to help promote the university," said Dr. Gopalswamy. "Without AUA I would not be the doctor I am today. They provided an environment where I could thrive, both in Antigua and at my clinical sites. I can connect just about everything I do in my work to the foundation in the Basic Sciences and the clinical skills that AUA enabled me to develop."
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As a group, AUA students and alumni are high achievers, culturally and ethnically diverse, incredibly motivated, and compassionate. Often, they are the first doctors in their families. They have a passion for medicine and the sciences and aspire to serve the communities in which they were raised. Dr. Gopalswamy is a perfect example of someone who embodies these characteristics and values. Dr. Gopalswamy was born in India and immigrated to the United States when she was a year and a half old. She grew up in North Potomac, Maryland. The devotion of her mother, Suseela, a computer programmer, and her father, Nat, an astrophysicist, to their children inspired her to work in the medical field one day. After graduating from the University of Maryland with a BS in Biology, she became a neuro-diagnostic technician, which enabled her to work alongside physicians as they diagnosed neurological conditions. Dr. Gopalswamy decided to apply to medical school after seeing firsthand how strong a bond these doctors were able to build with their patients. "Doctors may see 10 to 20 patients a day, but these connections make a huge difference to all of them," she said. Dr. Gopalswamy's first semester at AUA was exciting and challenging. She developed a time-management strategy that helped her review and master the formidable amount of material thrust at new med students. She formed relationships with the faculty, who helped her to succeed in her classes. "My professors were receptive to student feedback and always available to answer questions and provide guidance," said
Dr. Gopalswamy. As a Biochemistry Teaching Assistant, she had the chance to share her study techniques with her classmates and really absorb the material they were learning together. Clinical rotations were Dr. Gopalswamy's favorite part of med school. They provided her with opportunities to interact with real patients on a regular basis in a meaningful way. At one clinical site, many of the patients were Spanish speakers. Dr. Gopalswamy is fluent in the language and became a valuable resource for physicians, attendings, and residents, who had trouble communicating with these patients. "It was more than just translating," Dr. Gopalswamy remembers. "I made a connection with each patient and made them feel comfortable enough to speak candidly, because I was speaking to them in their native language." Dr. Gopalswamy completed orientation for her new job as a hospitalist at Shady Grove Hospital in Rockville, Maryland, in September. It's located about five and a half miles from her hometown. Her main responsibilities there include managing the care of general medicine patients admitted to the ER, as well as surgical patients during their stay at the hospital, and ensuring that they receive proper follow-up and treatment after they're discharged. Dr. Gopalswamy chose to pursue a residency in internal medicine because it gave her options. Doctors who complete internal medicine residencies can apply for fellowships in primary care, pediatrics, family medicine, and other specialties. They can also go into private practice as internists. She chose the hospitalist position because its schedule of seven days
I MADE A CONNECTION WITH EACH PATIENT AND MADE THEM FEEL COMFORTABLE ENOUGH TO SPEAK CANDIDLY, BECAUSE I WAS SPEAKING TO THEM IN THEIR NATIVE LANGUAGE.
on and seven days off meant she would have ample time for travel and fitness, both of which are passions of hers. Shady Grove Hospital's proximity to North Potomac would make it possible for her to spend plenty of time with family and friends as well. Shortly after she sent the nowfamous portrait of herself to AUA, Dr. Gopalswamy's friends began emailing her links or screenshots whenever it appeared on social media or in an ad.
She realized at this point that for many students considering Caribbean med schools, she had become their first impression of AUA. She says she felt, if only for a moment, like a minor celebrity. "The truth is that it's an honor to be one of the 'alumni faces' of AUA. I received the foundation and the clinical skills I needed to become the physician I always dreamed of being, at AUA. My professors and clinical mentors always went the extra mile in supporting me
and helping me to succeed, and I want students from around the world to have the same opportunity," Dr. Gopalswamy explained. It also prepared her for residency and her career afterwards. "Few things are as rewarding as alleviating a patient's suffering and knowing that the patient and his or her loved ones appreciate it. I get to experience that feeling all the time because of the journey I began when I first arrived at AUA." â&#x2013;
RAISING THE BAR
DR. ASHLEY YOUNG Class of 2017 Resident, Emergency Medicine Wyckoff Heights Medical Center, Brooklyn, NY
Positive Support, Perspective, &
PERCEPTIONS Dr. Ashley Young proves that perseverance and dedication can beat the odds.
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very day, I look down at my badge and see 'Emergency Medicine MD,' and I want to pinch myself," says 2017 AUA graduate Dr. Ashley Young. Raised in the Long Island, New York, hamlet of Ronkonkoma, Dr. Young started learning about medicine from as young as she can remember. The daughter of a nurse, Dr. Young fondly recalls her mother's love for her job and the impact she had on not only her patients' lives but those of their families. Dr. Young's admiration for the medical field was reinforced at age nine, when she was struck by viral meningitis and endured the traumatic experience of having lumbar punctures performed on her repeatedly. Through it all, she observed how kind the doctors were, inspiring her to empathize with her own future patients one day and treat them with the same respect she had received. It was in high school and college that she shadowed pediatric emergency medicine physician Dr. Nafis Khan, whom Dr. Young credits as a father figure and mentor who had total belief in her abilities. "During undergrad, I had a lot of people telling me I couldn't be a doctor, it's so competitive. My MCAT score wasn't great, and I was starting to think this dream would never become reality," she remembers. It was Dr. Khan who strongly encouraged her and drowned out the naysayers, telling Dr. Young she had way too much potential to not become a physician. In what now could be considered a twist of fate, the idea of attending AUA almost fell into Dr. Young's lap. During the time she was applying to medical schools, she had just purchased a car, and in one of the back seat pockets she found an AUA informational DVD. "I took that as a sign," she laughs. That sign did of course become reality. Dr. Young made lifelong friends at AUA, watched in amazement as their careers flourished, and now remotely mentors current students. There was, however, a major bump in the road during medical school: a serious case of kidney stones right before Step 1 necessitated surgery, leaving Dr. Young no choice but to pause her education to recover. While that postponement put her six months behind, all has gone exceptionally well since. Dr. Young is now a member of the tight-knit inaugural group of Emergency Medicine residents at Wyckoff Heights Medical Center in Brooklyn, New York. "I was fortunate to have rotated through Wyckoff as a medical student, so I was able to make connections here and meet the program director. At the time I was rotating, they didn't yet have a residency in Emergency Medicine," she says. Soon thereafter, the residency
program at Wyckoff was approved, and Dr. Young's application was accepted with open arms by the warm, family-like staff whom she bonded with during rotations. "I'm constantly smiling through all my shifts," she says. That positive team environment has been essential as Dr. Young takes on the challenges of an urban hospital's ER. Speaking of the perspective it has given her, she says, "When I shadowed in Ronkonkoma, I noticed the suburban population is financially able to seek medical care as needed and schedule follow-ups with their doctors. In Bushwick, I definitely see more diverse pathologies ranging from privileged patients who have private doctors to homeless patients with no medical care. We do see a lot of very sad things and rare pathologies that you wouldn't find in the suburbs where patients receive proper and preventative treatment." Comparing the overall medical care quality in the United States to that in Antigua, Dr. Young adds, "The island has limited resources, and it was very humbling to see how lucky we are to have what we do in the US." An antiquated perception of women in medicine is also something Dr. Young regularly encounters in the ER. "When I introduce myself to a patient, they always think I'm a nurse, and I have to correct them," she concedes. Currently only about 15% of emergency medicine physicians are female. However, Dr. Young does see a shift toward balance and cites the Association of American Medical Colleges' stat that in 2017, for the first time, the number of women enrolling in US medical schools has exceeded the number of men. According to a December 2017 press release published on aamc.org, females represented 50.7% of the 21,338 matriculants (new enrollees) in 2017. Since 2015, the number of female matriculants has grown by 9.6%, while the number of male matriculants has declined by 2.3%. Dr. Young's role model for being a strong independent woman has, of course, always been her mother. "She has been my rock throughout my career and my biggest advocate and cheerleader of my achieving my dreams. It has been really comforting to have someone to talk to that understands the medical terminology and a medical career, and I always turn to her for guidance. I'm the first doctor in my family; as such it has been an incredible honor and journey," she proudly says. If there's any piece of advice Dr. Young offers, it's that growth comes from pushing oneself. "Each stage of my life I've surprised myself with what I can handle. I think the more you challenge yourself, the more you learn about yourself. Unless you feel a little bit uncomfortable, you're not doing it right." â&#x2013; RAISING THE BAR
o imagine your future, it helps to look to those who have already reached the places you want to be. The women in this issue are determined to carve out a path that future generations can follow. Their academic and professional strides are an inspiring indication of what can be achieved with perseverence, dedication, and a commitment to improve the lives of others. Current and prospective AUA students can learn from these women 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. If you are an AUA graduate and would like to be included in a future issue, please visit: AUAalumni.org. We also invite you connect with us on LinkedIn: linkedin.com/school/american-university-of-antigua-inc./ By engaging with our content, you'll help us build a community on the site and create a valuable resource for all current, former, and future students. Congratulations to everyone featured in the magazine this year. You truly embody AUA’s mission and make us proud.■
ISSUE 03 • 2018
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