CROSSROADS

The Quest To Make Life Better For East Texans

BY ANDREW FAUGHT

ILLUSTRATIONS BY KEITH NEGLEY

MMonths before the UT Tyler School of Medicine welcomes its inaugural class, President Kirk Calhoun is to the point as he considers the university’s ambitious plans to help advance health and education in East Texas.¶ “We’re busy,” he says without a trace of understatement. “When you open up possibilities, m e perience is that good things fow from that. Certainly, the new medical school has been a game-changer for UT Tyler.” ¶ The School of Medicine — the 156th and one of the newest medical schools in the United States — isn’t the only big news to come out of UT Tyler. The university is undergoing its most significant transformation since being founded 51 ears ago as a regional institution for higher learning. ¶ Consider the rest of the story:

THERE ARE PLANS to boost enrollment by 50%; create deeper partnerships with community colleges to improve higher education access in rural counties; and, significantly, UT Tyler will use its prestigious new research designation to do work — medical and otherwise — that can benefit the world.

“We have a new five-year strategic plan that I believe is very forward thinking in what we want to accomplish,” says Calhoun, a driving force who prefers to spread the credit. “I’ve been able to go out and recruit and retain good talent around me.”

One of those hires is Dr. Brigham Willis, the founding dean at the School of Medicine. Willis is a longtime educator, scholar and leader in academic medicine, having received the award for top educator at the University of California, Riverside in 2020 and 2021.

He will help lead a school of medicine that became reality when, in the fall of 2019, the University of Texas System Board of Regents voted to merge UT Tyler and the UT Health Science Center at Tyler into a single educational, research and clinical delivery facility in a region where many more physicians will be needed, due to coming retirements. The development made the UT Tyler School of Medicine the seventh medical school in the UT System.

“The Board of Regents had the vision to enhance resources for East Texas by creating a fully integrated university that will more comprehensively serve the region with exceptional learning, teaching, research and patient care,” says Kevin Eltife, chairman of the UT System Board of Regents and a former mayor of Tyler.

“The unification of the two institu - tions also establishes a clear pathway from undergraduate education to graduate and professional programs, especially in the health sciences,” he adds.

Willis is well aware of the challenges at hand.

Parts of the 35-county East Texas region lack access to even a single provider. As the greater Tyler region ages, projections are that there will be a “sizable” shortage of physicians if there’s not a way to create a new doctor corps. The School of Medicine’s first class will include 40 students. Their selection will be deliberate and part of a calculated plan to meet the needs of rural and underserved areas.

“Our mission is to recruit students who were born and raised in East Texas, and train them to eventually become skilled physicians who will meet the rural health care needs here,” Willis says. “The University of Texas at Tyler School of Medicine aims to be part of that change.”

Even now, before the first cohort of medical students is able to don its white coats, the community is reaping benefits because of the presence of the medical school. The School of Medicine hosts a number of “lifestyle change programs” — from blood pressure management to Type 2 diabetes prevention, health challenges that are endemic to East Texas. Other outreach programs educate the community on a variety of health topics.

The School of Medicine is moving forward with a strong foundation: There are more than 16 residency and fellowship training programs embedded throughout the region, offering physicians training in such areas as internal and family medicine, psychiatry and surgery. The medical school, meanwhile, has brought speakers to campus from around the country to educate faculty about the latest innovations in medical technology.

Residents of East Texas will be the biggest beneficiaries.

“Community engagement is our top priority, and we will remain focused on our community in everything we do,” Willis says. “I’m excited to contribute to these efforts, and I know, without a doubt, that the impact of the School of Medicine on East Texas will continue to grow.”

Adds Dr. Julie Philley, executive vice president for health affairs and vice provost at UT Tyler: “We strive to partner and include the community in our efforts — especially with the advent of the School of Medicine — to improve health. Whether it be with local nonprofit organizations such as the East Texas Food Bank, St. Paul Children’s Services or other well-known institutions, we believe that working together is the only path forward.”

Clearly, the creation of the School of Medicine has raised UT Tyler’s profile in East Texas and nationally. The medical school is partnering with UT Health Houston, UT Rio Grande Valley, Rice University and the MD Anderson Cancer Center as part of the innovation-driven Clinical and Translational Science Awards Program. That effort seeks to efficiently turn research into ready-to-use interventions and treatments aimed at improving public health.

“Medical schools are big and exciting, and it brings a level of prestige to UT Tyler,” says Calhoun, who has led the newly consolidated UT Tyler since 2020 and was president of The University of Texas Health Science Center at Tyler from 2002–20. Calhoun is no stranger to medical pedagogy: He earned his medical degree from the University of Kansas, and he completed a fellowship in clinical nephrology, hypertension and metabolism at the University of Chicago.

Meanwhile, other forces are at play. Much of the university’s path forward centers on increasing enrollment from 10,000 to 15,000 students through improved retention strategies, expanded online program offerings and nurturing a better pipeline from community colleges. The move is driven by the idea that education is an engine for upward mobility and helps support industries throughout East Texas.

“Our guiding principle for growing our program portfolio is considering what occupations are needed in East Texas,” says Dr. Amir Mirmiran, executive vice president for academic affairs and provost at UT Tyler. “There are pretty much three areas: health - related, education and technology.”

While UT Tyler has always worked with community colleges to expose prospective students to opportunities on campus, the latest effort doubles down on outreach — and is a concrete response to current trends. Sixty percent of East Texas residents who enroll at a four-year university end up leaving the region to do so, Mirmiran says.

“We believe it is our responsibility to our region to provide services so that students don’t have to go somewhere else,” Mirmiran says. “We should be able to provide them with degree programs that they’re interested in and for which there is a need in our community.”

When members of the local community questioned why UT Tyler didn’t have a social work degree, the university developed an undergraduate degree. Efforts are now underway to add a master’s in social work. Similarly, UT Tyler is creat- ing a speech-language pathology degree.

“One of the advantages of the merger is that it allows us to expand our health care portfolio,” Mirmiran says. “So, for example, we currently have occupational therapy, and we hope to bring on board physical therapy, for which there’s so much demand in our region.

“Our community has a higher expectation of us now, and we have higher expectations of ourselves,” he adds. “While we have come a long way since UT Tyler was founded 50 years ago, there’s always more we can do. We’re empowered, and the community actually feels the same way.” colleges, the university has stepped up its outreach efforts exposing students to pathways that will outline plans for earning a bachelor’s degree or higher. Efforts are paying off. Freshman enrollment, for example, has increased in each of the last three years, Mirmiran says.

Raising awareness of offerings is now a heightened priority. UT Tyler academic counselors, as part of the College Readiness Program, go to high schools and community colleges to explain career “pathways” to would-be college students, while also helping them complete the Free Application for Federal Student Aid — or FAFSA — that could gain them funding toward a baccalaureate degree.

For some, there are formidable barriers toward seeking a higher education. Many can’t afford the cost, while for others, traveling great distances to Tyler is both time- and cost-prohibitive. That’s why the university continues to develop its off-campus instructional sites at the Houston Engineering Center, Longview University Center and the Palestine Campus, while enhancing the online program portfolio.

The merger has benefited UT Tyler in other ways. It helped the university gain coveted R2 status, a Carnegie Commission on Higher Education classification that denotes “high research activity.” Specifically, the classification signifies that a university has at least $5 million in research expenditures. UT Tyler far exceeds the threshold, with about $25 million in expenditures.

The distinction gives UT Tyler new standing in the research community, but more importantly it can help the university secure lucrative research funding from organizations such as the National Science Foundation. With an annual budget of $8.8 billion, NSF accounts for 27% of the total federal budget for basic research conducted at U.S. colleges and universities.

R2 is prompting the development of doctoral programs — such as one now being prepared for biomedical sciences, says Dr. Steven Idell, UT Tyler’s senior vice president for research. Before the merger, UT Health Science Center at Tyler did not award doctoral degrees.

“This is an exciting time with the medical school coming on board and programs expanding and realigning,” says Idell, who notes that when he arrived on campus 38 years ago, members of the university talked hopefully about a merger. Now that the day has arrived, look for even bigger things to come. UT Tyler could become an R1 institution — meaning “very high research activity” — within five years, Idell says.

Changes will necessitate the construction of new facilities — from the medical school itself, to expanded facilities for the School of Nursing. New and state-ofthe-art research labs also will be added to the campus landscape.

Watching it all enthusiastically is Scott Martinez, Tyler Economic Development Council president and CEO of the Tyler Area Chamber of Commerce. These are heady times in Tyler, and he likes what he sees.

Even before its first cohort of students, the medical school is helping improve lives through lifestyle change programs and other outreach initiatives.

In 2022, UT Tyler initiated the Patriot Promise Scholarship, which is funded by the UT System. The scholarship covers all tuition and mandatory fees for freshmen and transfer students who meet income requirements.

While there has always been a general linkage between UT Tyler and its partnering school districts and community

“If you want to build a great city, build a great university,” Martinez says. “The secret sauce to prosperous communities is higher education.”

Martinez is careful not to focus his excitement only on the medical school. “There’s a lot of depth in UT Tyler’s offerings, and there’s a lot taking place on that campus,” he says.

UT TYLER AND THE REGION TRANSFORMED WITH CREATION OF SCHOOL OF MEDICINE, AIMED TO BOOST THE HEALTH AND PROSPERITY OF EAST TEXAS. BY ANDREW FAUGHT

IN A REGION THAT BUILT ITS FORTUNES ON OIL AND GAS, UT Tyler is leading East Texas into a new and prosperous economic era for the 21st century.

That’s due in no small part to the creation of the university’s new School of Medicine, which operates alongside the UT Tyler Health Science Center and UT Health East Texas. The Association of American Medical Colleges calls medical schools and teaching hospitals “economic engines” that pump $728 billion, nearly 3.2% of the country’s total gross domestic product, into the national economy. They also support more than 7 million jobs.

In East Texas, the School of Medicine is ultimately expected to create in excess of $1 billion in annual economic activity in the region, according to analyst projections.

UT Tyler’s health care presence already was an economic force before the creation of the medical school: HSC and UTHET contribute 3,050 jobs and $278.3 million in annual gross product to the East Texas region, according to the Waco-based Perryman Group, which conducts economic analyses.

“Any time you place quality health care facilities in a region, you’re going to see a notable economic impact,” says Ray Perryman, the group’s president and CEO.

There’s a “multiplier effect” beyond the initial figures, Perryman notes. The economic benefits resulting from the first 10 classes of graduates — who are expected to remain in the area — could result in $760.4 million in annual gross product and 7,064 jobs in the Tyler region; the annual gross product balloons to $1.2 billion and nearly 11,000 jobs when considering the impact on East Texas at large.

Developments in Tyler and, in particular, some of the smaller nearby communities run counter to what’s seen in communities of a similar size elsewhere in the country.

“One of the most impressive things about the new medical school and UT Health East Texas is the quality of care and training provided across the region,” Perryman says. “At a time when many smaller population centers are struggling to maintain local access to health care, these facilities will help serve residents across East Texas.”

The region’s health care infrastructure, along with UT Tyler, “represent an economic force within the area,” Perryman writes in his executive summary.

The presence of a medical school will allow the region to better attract and retain doctors and other health care professionals, Perryman notes, and the combination of health care and educational resources could be a job -creation catalyst in the region’s developing bioscience sector. He adds that Tyler has exceeded expectations for a community of just over 100,000 residents.

“It is unusual for an area of this size to have a large health care system able to partner with a university system to bring all of these resources together,” he says.

Perryman published his findings in a 2020 report titled “The Economic and Fiscal Benefits of The University of Texas Health Science Center at Tyler and UT Health East Texas to the Local Area, Surrounding Region, and Texas.”

The medical school builds on Smith County’s relative economic strengths. In 2021, the Tyler region outpaced the United States and all other Texas metro areas in job growth, according to the Tyler Economic Development Council. The city also ranks sixth in the United States for the largest gains in employment by metropolitan area, the U.S. Bureau of Labor reports.

Much of Tyler’s stability was due to employees working in crucial and varied sectors that didn’t experience heavy job losses – such as education and health care/social assistance. The medical school will further diversify the regional economy. Perryman calls the medical school’s impact on Tyler and East Texas “large and impressive.”

Part of that economic impact will be the result of a healthier populace. Rural Americans are more likely to die prematurely from heart disease, cancer, lung disease and stroke, according to the National Institutes of Health. Poverty, unemployment, low education and inadequate transportation are contributing factors, NIH reports. Healthier populations require less sick days from work, resulting in less lost productivity.

As UT Tyler sets the economic and cultural tone for the region, the energy and enthusiasm are palpable along the downtown Tyler streetscape, says Mayor Don Warren.

“You’ll see college kids in the plaza eating their Andy’s custard and drinking coffee,” says Warren, noting that the city’s average age, according to the U.S. Census Bureau, has dropped to 34 years old in 2022, from 37 years old in 2010. “A lot of these young people are living downtown, and they’re creating bustle. People used to think of Tyler being a place to go and retire.”

By the Numbers

760.4

MILLION IN ANNUAL GROSS PRODUCT AND 7,064 JOBS ARE EXPECTED TO RESULT FROM THE SCHOOL OF MEDICINE'S FIRST 10 CLASSES OF GRADUATES

IT'S A

VITALITY THAT, COMBINED

WITH THE EVOLUTION of UT Tyler, is helping to fuel development in town. The Morrison Lofts, a 112-unit, high-end apartment complex that opened in the summer, is completely occupied. A half-dozen other developments are under consideration for downtown, according to Warren.

“The young people are driving the train, and the older people are on the train giving guidance,” he says. “The vibe is real, and I don’t see it stopping anytime soon.”

Economic benefits are expected to carry over into counties neighboring Smith County, according to Dr. Manuel Reyes, acting director and senior research analyst at UT Tyler’s Hibbs Institute for Business and Economic Research. Census Bureau data from 2019 show that more than 44% of people who work in Smith County commute to the Tyler area from homes in adjacent counties.

East Texas is home to 1.1 million people in 23 counties. Fourteen of those counties, including Smith, make up the bulk of the region’s gross domestic product — $36 billion in 2021. That accounted for a 9.9% increase from 2020, Reyes says. Of that total, health care and social assistance contributed the largest portion of the Tyler-area GDP, $3.48 billion, he adds. The health care sector forms the backbone of the East Texas economy, accounting for 15% of the workforce.

The increased health care presence in Tyler will position as a destination point, while improving the health and economies of residents beyond the city’s boundaries, Reyes says.

“I see people coming from everywhere to study something related to health care, or to receive medical attention,” he adds. “There’s a ripple effect. The development in Tyler is helping these rural counties catch up.”

Medical schools and teaching hospitals pump roughly $728 billion into the national economy. And in the East Texas region: 1

BILLION IN ANNUAL ECONOMIC ACTIVITY IS EXPECTED FROM THE UT TYLER SCHOOL OF MEDICINE

3,050

JOBS AND $278.3 MILLION IN ANNUAL GROSS PRODUCT CONTRIBUTED BY THE UT TYLER HEALTH SCIENCE CENTER AND UT HEALTH EAST TEXAS

JOSH AND HOLLY SMALLWOOD TURN THEIR DREAM INTO REALITY WITH 80 ACRE MARKET

by Emily Battle

MY DESTINATION ON AN EAST

Texas farm-to-market road, I turn onto a driveway lined with majestic pines and focus in on the view ahead — a stately mansion surrounded by scenic landscapes. As I draw closer, there is much more to see. Hundreds of visitors mingling on the grounds. Families and friends gathering for photos. Children running and playing. Vendor booths, food trucks and live entertainment.

This is 80 Acre Market, owned by UT Tyler alumni Josh and Holly Smallwood. Last year, they turned their former residence between Longview and Gilmer into a shopping and recreational venue for East Texas families to enjoy. But the venue, open every other weekend, also attracts visitors from other parts of Texas and several other states. Over 2,000 visitors make their way to the 80 acres each market weekend.

The market is only the latest venture for Josh Smallwood since graduating with honors from UT Tyler with his Bachelor of Business Administration in accounting in 2010 and Master of Business Administration in 2011.

He began building rustic picture frames in 2012 with one employee and has turned it into a $100 -million business that designs and manufactures home décor and textile products. Known as Smallwoods, the e - commerce -based company employs over 400 people locally and ships products to all 50 states and Canada from its Longview distribution center. Smallwood family enterprises also include SweetHoney, an online children’s clothing business with customers across the U.S. It was founded in 2012 by Holly Smallwood, a 2008 Bachelor of Science in Nursing graduate and 2015 Distinguished Alumni honoree. The company name was inspired by the nickname of one of the Smallwoods’ five children.

FAMILY & COMMUNITY

Talking with Josh Smallwood a few days prior to my visit to 80 Acre Market, I discover a common thread throughout his story — the importance of family and community.

During childhood, the East Texas native and his older brother went to live with their grandparents on their Kilgore farm due to family circumstances. Their grandparents were of limited financial means but provided stability for the brothers, who also received an outpouring of community support. Neighboring families helped with food and the boys’ transportation to extracurricular activities.

“Our parents were out of our lives early on, but we didn’t feel like we were missing out because our grandparents were very giving to us and we had so many people within our community who always included us,’’ Smallwood says. “We had this network of relationships with different families who were happy to help.’’ Smallwood has fond memories of life on the farm. There was always work to be done, but the 100 acres with its hay mead- ows and ponds was also a fun place to play and enjoy the outdoors. In fact, he was drawn to the land where 80 Acre Market now stands because it reminded him of those childhood experiences. He also learned the value of hard work from his grandfather, for whom Ronnie Brown Road in Kilgore is named. “My grandfather was kind of a jack-of-alltrades. He raised cattle, raised chickens, ran a butcher shop and he was a contractor laying waterlines for the city. It was thrilling to see how he had a variety of things that kept him motivated and interested,’’ he says.

Preparing For The Business World

Smallwood married after high school and began attending junior college, transferring to UT Tyler as a sophomore when the university offered him a scholarship. He recalls finding a supportive learning community in the Soules College of Business.

“I definitely received a top-level education coupled with great access to professors. Many of my instructors were working in their fields aside from teaching and brought an enormous amount of real-world experience to our classes,’’ he says. “They also knew me on a first-name basis and were available to help anytime I was challenged in my coursework. I’m sure I could call them today if I needed to know something in particular and they’d be more than willing to help.’’

Dr. Mary Fischer, UT Tyler professor of accounting, remembers Smallwood as an overachiever who took more than the minimum full-time course load and excelled in both undergraduate and graduate studies. “He was outstanding as an accounting major, performing very well in difficult courses; and he graduated magna cum laude, which is not easy to achieve,’’ she says.

Early on as an undergraduate, Smallwood was able to enhance his classroom learning through an internship with a Tyler accounting firm. The internship evolved into a full-time position that he held — along with a couple of part-time jobs — while continuing his undergraduate and graduate studies. After completing his MBA, Smallwood stayed with the accounting firm for about a year, until receiving a business opportunity that would alter the course of his life.

Venturing Out

As one of his jobs after graduation, Smallwood helped produce Western-style wall art, making rustic frames out of barnwood. Given the opportunity, he purchased the business in 2012 and worked diligently to make it his own. Using social media as a platform to reach mass markets, he began allowing customers to upload their own art and photos online for custom framing.

By 2015, Smallwoods had evolved from a two -man operation to 60 employees, spread out over several area facilities. That year, the company purchased and renovated a former grocery store in nearby Diana to serve as its headquarters.

At last, all of its operations were located under one roof — until September 2017, when the building was destroyed by an overnight fire. But Smallwoods quickly regained its momentum with the help of staffers, vendors and suppliers, and backup equipment the company had stored offsite. Within a week, operations were up and running again in various area locations.

“I remember looking around at the people involved in the effort and being so proud. It took a community rallying around us, both internally and externally, to rebuild in a short amount of time,’’ says Smallwood, who values a close-knit community within the company and refers to staff as work family.

Smallwoods grew from 60 to 200 staffers within a year after the fire and was making strides toward becoming the operation that it is today. The company is now constructing a 1-million-square-foot facility on land near 80 Acre Market to house its operations and allow for growth.

A Community Gathering Place

Seeing a need for more family- oriented venues, the Smallwoods established 80 Acre Market as a way to give back to local communities, providing families an opportunity to enjoy free space and time together.

The market is unique to East Texas, including locally-produced retail items as well as regional vendors, food trucks and live entertainment, and often serves as a launching pad for new businesses and performers.

On the day of my visit, I prepare to walk the short distance from the parking lot to the mansion, but a staffer pulls up in a golf cart and kindly offers me a ride. This is one of the many accommodations offered to those who visit. “We want to have that extra touch that people might not get elsewhere,’’ Ashley Nichols, chief of staff, explains. She says the goal is for visitors to enjoy the day stress-free.

Repurposed as a retail space, the house is filled with shoppers and stocked with a variety of wares, from home furnishings, apparel and gift items to pastries and chocolates. When the Smallwoods set out to create a community venue, Nichols says, “they began with the idea of a store and then expanded to the grounds to have a place for families to come and feel free to relax. If you want to shop in the store, great. If not, there are free activities outside for everyone.’’

Across the expansive grounds, I see activities in every direction. Guests are chatting in groups, visiting vendor booths, placing their orders at food trucks and dining at picnic tables. Others are relaxing in lawn chairs, listening to live music.

Children are doing what they enjoy as well, playing yard games built by ranch staff, getting their faces painted, being creative in the arts and crafts tent, and having fun in bounce houses. And for adults who prefer not to shop or participate in activities, there is a “man cave” tent with football games on big- screen TVs. Store offerings and outdoor events change every market weekend to provide a different experience each time, Nichols notes.

Visitors often give feedback, and the most typical comment is “ ‘This is what East Texas needed,’ ’’ Nichols says, adding that several on staff were visitors first. “They came and then wanted to join us — we consider that the greatest stamp of approval.’’

80 Acre Market is named for the original acreage where the Smallwoods built their home, but surrounding land has been purchased for future plans, which include walking trails, fishing ponds and a swimming facility the size of a football stadium. The property has expanded from 80 to 240 acres, so there’s plenty of room for growth.

FIVE QUESTIONS