Student Uses Challenges as Motivation for Success
ONCE HOMELESS, UNIVERSITY OF KENTUCKY MEDICAL SCHOOL STUDENT HOPES TO HELP THOSE IN NEED
ROOTS IN RURAL KENTUCKY FUEL MEDICAL STUDENT’S DESIRE TO RESPOND TO EMERGENCIES RPLP+ News
14 Student Awards
CONTENT On the cover: Rural Physician Leadership Program class of 2015
New names and New Faces
Meet the University of Kentucky Rural Physician Leadership Program class of 2017
Discover the future plans of the Rural Physician Leadership Program class of 2014
6 Student Uses Challenges as Motivation for Success
Once homeless, University of Kentucky medical school student hopes to help those in need
5 10 Rural Roots Roots in rural Kentucky fuel medical studentâ€™s desire to respond to emergencies
4 From the Assistant Dean Dr. Weaver reflects on the past while looking to the future
HISTORY The University of Kentucky and St. Claire Regional Medical Center have been partners in educating future health care providers for 50 years. This collaboration has given a brief glimpse at rural practice and rural life to hundreds of students. However with the current primary care physician ratio of 1,232:1a, this brief glimpse was not providing as many additional practitioners to rural Kentucky as needed. The first attempt at changing this experience began in 2004 with grant funding to pilot a rural training track in Morehead and Hazard. This experience was four months during students’ third year of medical school. It was also a voluntary experience that included clinical rotations in Family Medicine, Pediatrics, and Internal Medicine.
Nate Hudson, MD RPLP Class of 2013 Favorite Patient Story
At the end of the pilot in 2007, representatives from the University of Kentucky College of Medicine and St. Claire Regional Medical Center began discussions aimed at establishing a new clinical site and curriculum at a regional site in Northeast Kentucky. These discussions led to the development of the UK College of Medicine Rural Physician Leadership Program (RPLP). The RPLP is a four-year program within the University of Kentucky College of Medicine. Students complete their first two years of medical school in Lexington, following the curriculum required for all MD program students. During the third and fourth years of medical school, RPLP students complete the majority of their clinical experiences with St. Claire Regional Medical Center and
other health care providers in Northeastern Kentucky. In addition to this collaboration, the University of Kentucky has an agreement with Morehead State University to provide additional business training to RPLP students. These courses focus on health systems, business practices, and health policy and lead to a Certificate in Health Systems Leadership from Morehead State University. a
Reference: Current Health Profession Statistics for the Region: The current Primary Care Physician Ratio is 1,232:1 in Kentucky. The National Benchmark is 631:1. http://www.countyhealthrankings. org/?sid=8510#app/kentucky/2012/comparecounties/063+043+205+175+127
“There was one guy in the ICU and his wife was really a character – I really liked her. It was one of my first weeks on Internal Medicine, and I was listening to his chest – I had not really learned my breath sounds yet – and it was clearly just rhonchi. Later it was determined it was because of the mucus in the throat that needed cleared. I had heard of the crackles of heart failure though – so I go and get the doctor. His wife had been telling me that she thought he had pneumonia because she put her ear up to his chest and could hear a whistle. I could also hear sounds in his chest and told her I was going to go find the doctor. When the doctor came to listen, the secretions were clear and the sounds were gone. Later that day when the patient had a chest x-ray, it turned out he had pneumonia. Since then, the patients’ wife thought that I was the only one that could hear pneumonia. I saw her several months later and she said “You and I are the only ones that could hear that pneumonia my husband has.” To which I replied, “Yep, that was me.” He was in the hospital for three weeks, and I followed him even through other rotations. I went mostly for his wife. I ran into them during Ortho. He was seeing a doctor for a heart follow-up. The way the man treated me made me feel honored and humbled – to know that you can kind of have an impact was very encouraging.”
FROM THE ASSISTANT DEAN The RPLP is developing a strong reputation for excellence within the University
Dr. Weaver shares a laugh with Amreen Farooqui during the class of 2017 White Coat Ceremony Dear friends and colleagues, First, I want to thank all those students, teachers, and supporters who have enabled the Rural Physician Leadership Program to transition from paper to reality. Your hard work has enabled this program to spring into existence, and also has produced a more general change in the approach to training rural physicians at the University of Kentucky. Thanks to you, the RPLP is developing a strong reputation for excellence within the University, and we are getting more applicant referrals from UK faculty and administration. This year, for the first time, we are supplying 4
candidates for the Lexington campus from our surplus. Additionally, our MCAT scores and GPAs are inching closer to those of the Lexington campus students. We are reforming and refining our curriculum, and the MSU Business and Leadership curriculum has been completely revamped in response to student suggestions. We have developed an M2 elective in rural health, which is at capacity. This spring, we conducted our first “Admissions Boot Camp”, an intensive experience for selected students
from regional colleges and universities in rural Eastern Kentucky, funded by the Dean’s office, and we collaborated with the Northeast AHEC to develop a longer program, piloted for Morehead State University premeds. Despite our collective success thus far, we are still anxiously waiting to see whether the program, and its graduates, will have a real and measurable impact on healthcare in rural Kentucky. We are pleased with our progress thus far, but there is still much to do.
Writer of the story Kristi Lopez, Kody Kiser, Amy Jones-Timoney
RPLP Student Uses Challenges as Motivation for Success Once homeless, University of Kentucky medical school student hopes to help those in need During the University of Kentucky College of Medicine’s recent White Coat ceremony, 136 future physicians from across the Commonwealth as well as from 16 states and 21 countries walked one by one across the stage at the UK Singletary Center for the Arts. The students put on their new white coats symbolizing their first steps toward becoming a medical professional. And although each student has had a different journey to reach that stage, few if any have had more challenges and obstacles to overcome than Kayla Kinker of Covington, Ky. “It was my dream to come to school here but I never thought it was possible,” Kinker said. The summer before her senior year in high school is when Kayla had to make some tough decisions that would set the course for her future. “Life was pretty rough,” she said. “The apartments we were living in weren’t stable and we would go without basic utilities.” At times not knowing where or when she would get her next meal, she said it was during this difficult time that she made an important decision. “I had to decide if I was going to withdraw from school to work full time to help my family or find a way to keep
going and pursue my education,” she said. In the end she knew she could do more for her family and her community by staying in school and trying to get to college. She also found a more stable environment when she moved to the Welcome House, a homeless shelter for women and children in Northern Kentucky, where she lived while completing her senior year in high school. After graduating from high school with honors and going on to finish her degree at Berea College, Kinker is now ready to embark on her next goal: to become a physician and help others who find themselves in situations not unlike her own. “I’ve always felt like a lot of people had to work very hard to get me here, so now that I have this (white) coat I feel like I’m really on my way to paying that back and I’ll finally be in a position where I can help others.” Kinker’s goal is to eventually open a community health center to help others. RPLP+ News
NEW NAMES & NEW FACES University of Kentucky Rural Physician Leadership Class of 2017
KHERCIE SMITH GOOSE ROCK, KY
ETHAN RITTER BUTLER, KY
I was raised in Goose Rock, a small rural area six miles southeast of Manchester in Clay County, Kentucky. I have a passion for these hills and the people who call them home. I chose the Rural Physician Leadership Program because I feel it will provide me with training catered to best serving my rural hometown. I was raised in Goose Rock with one older sister who is currently practicing law there. In May, I graduated from the University of Kentucky with a degree in Biology. While attending the university I worked part time as a certified pharmacy technician at Kentucky Clinic Pharmacy. I enjoyed volunteering with many great organizations around Lexington including Scott County Humane Society and the Amachi mentoring program. In my free time I really love to go camping with my family and tend my garden. Currently, I spend my rare study breaks making jewelry and rock climbing.
I grew up in Butler, Kentucky, a small town in the northern part of the state. While attending University of Kentucky, I decided to pursue a degree in Animal Sciences. The experience of caring for a small herd of cattle on my grandparents’ farm left me with great interest in the scientific aspect of animal agriculture. At UK, I was involved in several campus organizations. The one that became dearest to my heart was DanceBlue, a dance marathon that raises funds for the Pediatric Hematology/Oncology clinic at Kentucky Children’s hospital. As my involvement with this organization increased I began to wonder: how could I possible unite my love with the life sciences with my love for people. After wrestling with myself about it for a while the answer became clear: Medicine. RPLP seemed to be the perfect fit. We’ll be equipped to be the movers and the shakers, the boisterous characters at town hall meetings regarding the issues facing our children and their friends, we’ll fight alongside our patients to ensure a better tomorrow.
COLTON JAYNE SALYERSVILLE, KY
KAYLA KINKER PORTSMOUTH, OH
PARKER BACH ROUSSEAU, KY
I am from a small town in eastern Kentucky called Salyersville. I completed by Bachelor of Science degree in Geology in 2007, and worked as a Geologist until August 2011. At that point, I decided to come back to school and pursue my true passion of becoming a physician. I had multiple reasons for choosing the Rural Physician Leadership Program. First, I felt like it would better fit my personality. Second was for my educational benefit. I know that as an RPLP student, I will be spending the most part of my third and fourth year one on one with a very capable doctor in Morehead, Kentucky. And lastly, I plan on living in a rural place as a physician, so why not get my education in a rural setting. Plus, I used to live in Morehead, and I honestly can’t wait to move there for my third and fourth year.
I was born and raised to a loving but destitute family in a small town called Portsmouth along the Ohio River. We struggled through many difficulties but my parents always made a point to tell me that I could do anything I wanted with my life if I worked hard enough and stayed out of trouble. After graduating from Holmes High School, I attended Berea College, where I met the love of my life…my husband. After Berea, I spent several years working at Cincinnati Children’s Hospital in asthma research and volunteering with my husband at the shelter I once lived in. Having never given up on my dream of going to medical school, I applied and was accepted to several schools. There was no doubt in my mind that I wanted to come to the University of Kentucky. Once accepted, my husband and I became aware of what a wonderful opportunity the Rural Physician’s Leadership Program provides for students to become trained in caring for the needs of patients in underserved regions of our state. Our shared passion for medicine and service has provided us with the privilege of participating in this program, and we are eagerly looking forward to a lifetime providing for the health needs of our communities.
My name is Parker Bach, and I am from Rousseau, a small community in Breathitt County. There were several factors which inspired me to pursue medicine, but the most powerful motivator was definitely my grandfather. At a young age I watched cancer take hold and eat away at the loving, jovial man that my family so often talks about, turning him into a withered shell of his former self. I don’t remember much from this time, but the two things I do remember are pain and helplessness; The pain of losing someone I loved so dearly, and the overwhelming feeling of helplessness in knowing that I couldn’t do a thing to stop it. As for why I chose the RPLP program, that basically boils down to growing up in Eastern Kentucky. So for as long as I can remember I’ve known I wanted to do rural medicine, to go back to eastern Kentucky to serve my community, I just didn’t know how I would do it. Then I learned about the RPLP program, and I realized I wasn’t alone. There were others out there that felt the same conviction that I felt, and instantly I knew where I was supposed to be. RPLP+ News
AMREEN FAROOQUI TOLEDO, OH
PIPER VONSEDERHOLM SAN DIEGO, CA
DOMINIC SUMA CLEVELAND, OH
I was born in Toledo, Ohio but at a very young age moved to Somerset, Kentucky. I did my undergraduate at Emory university in Atlanta which was my first experience living in a big city. Making the transition from my small town to a large city was tough at first, but I learned many lessons over my four years there. Big cities are important for personal growth, life experiences, exposure to different cultures, etc. However, I was also able to clearly see the discrepancy between medical practices in a small town versus a big city. I knew that I wanted to practice in a place where doctors were most needed—underserved areas. I knew I wanted to practice medicine in a small town as my dad has for over 20 years. Apart from the need for doctors in underserviced areas, I am drawn to the charm of small town medicine. The patient is more than a problem that needs solving or just a set of symptoms. The doctor is able to build a relationship with his or her patients while still remaining professional. I am so happy and privileged to be a part of the RPLP program. It is a good group of bright individuals who I know will make a huge impact wherever they practice!
I’m a bit of a non-traditional medical student. I took a round-about route to medical school, testing out other careers before finding something that I could see myself happily practicing for a lifetime: medicine. However, it wasn’t until I moved from San Diego to southeastern Kentucky that I really considered becoming a doctor. In truth, it was the stark contrast my new rural home provided that first inspired my interest. Being part of a close-knit community like the four-mile-wide town I grew up in is one of the biggest appeals of rural medicine. When we went to a store, we discovered the sales clerk was one of my classmates and my mother worked with her aunt. We saw my professors at the movie theater and our doctor grocery shopping. Our lives became interconnected so that we know each other as customers, patients, students, and most importantly as neighbors. This is why I chose UK’s Rural Physician Leadership Program: to learn how to be a rural doctor, to treat rural patients with problems unique to rural Kentucky, and to be an integrated part of my own community.
Although I grew up in the heart of Cleveland Ohio, I have developed a strong connection to and appreciation for rural Kentucky. Growing up in a devout catholic family with eleven siblings, I was aware early that I had to work hard for the things I wanted, including the means to fund my higher education. I was fortunate to discover Berea College. I had the opportunity to see farms in Frankfort and the mountains in the eastern regions. At Berea I became aware of the joys of living simply and acquired a fondness for the small towns and the hidden treasures within them. While visiting these regions, I was also made aware of how medically underserved the communities are. I want to provide for those without access to care and without the means to pay for it. The Rural Physician’s Leadership Program will allow me to fulfill my goal to help the less fortunate by facilitating the development of skills required to serve rural populations. Along with my wife Kayla, I plan to practice medicine in a community based health center. We have had the privilege to experience and overcome hardship which we hope to help others achieve as well.
LAURA DEWALT EASTON, PA
DANIEL HUDSON SOUTH SHORE, KY
PAUL PRYOR HARLAN, KY
I am from Easton, Pennsylvania, which is north of Philadelphia along the Pennsylvania/ New Jersey border. Through my involvement with 4-H, my younger brother and I both raised pigs and sheep as 4-H projects on my family’s small farm. It was through raising my livestock animals that I first became interested in medicine. Many aspects of caring for animals fascinated me; however, the patients are unable to speak. The challenge of convincing people to make healthy changes in their lives is what draws me to human medicine. I attended Penn State University majoring in Biobehavioral Health. When searching for medical schools, I was determined to find a program that has a focus, or at the very least an appreciation, for rural primary care medicine. After reading about RPLP, the University of Kentucky jumped to the top of my list, and after visiting for my interview, I loved it even more. The people are so nice and the program is very comprehensive. I was very impressed that it even included some business instruction. Now that I’m in medical school and living in a new state, I am definitely not regretting my decision to come to medical school here.
“Greater love has no one than this, that one lay down his life for his friends.” As human beings, this statement sums up the highest calling we have on our lives. Throughout my life, I have been surrounded by people who have exemplified this self-sacrificing love, people who have constantly laid their lives aside and made my well-being their priority. From my parents, Greg and Jan to my wife, Chelsie, I consider myself most blessed to have been shown such love. Growing up in South Shore, Kentucky, I thought everyone was cared for the way I was. However, as I have grown and seen more of this world, it has become clear to me that this is not the case. I have seen and personally experienced the benefits that come along with having people love you. If I can show to others even a fraction of the goodness that has been shown to me, I believe it will make a difference. I think becoming a doctor will provide an unequaled platform to make that difference, and that is why I have chosen to enter this profession. On top of this passion, I have a strong desire to return home and give back to the community that has given so much to me.
My name is Paul Pryor and I’m a first year medical student. I am from Harlan, Kentucky, which is located in the southeast corner of the state. I graduated from the University of the Cumberlands with a BS in chemistry and biology. I am very excited to be here at UK, and to have the opportunity to study to become a physician. I am from one of the more rural parts of the state, and I’m aware of many of the healthcare needs facing these regions. I am in the Rural Physician Leadership Program because I hope to be able to help meet the healthcare needs of these regions of the state. I don’t yet know what specialty I would like to pursue, but I’m anxious to explore different fields this year and beyond. Thank you so much for your contribution to my education.
Roots in Rural Kentucky Fuel Medical Student’s Desire to Respond to Emergencies Writer of the story Elizabeth Adams University of Kentucky medical student Ashley Loan eagerly anticipates the day she handles the chaos of the emergency room with a controlled calm. “I can’t wait for the day I develop that calm,” Loan said. “It’s an eerie thing when you see a physician gain control of the room.” Loan recognized the importance of a calm emergency response at a young age when her mother Elizabeth Loan performed CPR on a farmer in the fields of Greenup County. The farmer was pinned from the waist down under a turned-over tractor. Elizabeth Loan administered CPR to keep him alive until emergency responders from the nearest hospital arrived. Loan graduated along with the other 115 members of the UK College of Medicine Class of 2014 on Saturday, May 17, at in the Concert Hall of the UK Singletary Center for the Arts. She also is one of 11 students that participated in UK’s Rural Physician Leadership Program, where she believes her roots in Greenup County prepared her for a future responding to medical emergencies in rural Kentucky. Loan was raised on a tobacco farm, following behind her father’s setter when she was just 8 years old and selling produce at the family’s roadside farm stand during the summers. She showed lambs raised on the farm at county fairs and through the 4-H program. She understands cultural 10
characteristics that influence health in rural populations, like the patient’s attitude of self-reliance that results in attempts to self-medicate or postpone a doctor’s visits. It’s often difficult for doctors from urban environments to appreciate those cultural
that are common in many rural communities. Loan’s father, a lifelong tobacco user, suffers from COPD. Understanding that tobacco farming was once a way of life for many farmers, Loan thinks it’s important that doctors aren’t judgmental when working
I feel an obligation to come back and serve the people who have really believed in me for so long. --Ashley Loan variances. “I get why people don’t go to the doctor - rural people are raised to take care of themselves,” Loan said. “Before they come to the doctor, they’ve tried a few things.” Loan’s earliest experiences in emergency medicine were watching her mother respond to accidents in the farming community. Elizabeth Loan commuted to the nearest community college to obtain an associate’s degree in nursing, which qualified her as the most educated health care provider within a 10-mile radius of the Loan farm. When the neighbor’s son went into a diabetic coma, Loan remembers her mother rushing to their house to administer sugar water. “There have been a lot of instances when my mom was the sole health care provider,” Loan said. Loan has personal ties to health challenges
with rural patients. She has also learned the importance of thorough questioning when asking about a patient’s health condition. Loan said growing up in a rural area isolated
from hospitals fueled her desire to deliver more efficient emergency medical care to rural communities. She enjoys the challenge of being the first doctor on the trauma scene and “Macgyver-ing” her way through emergencies with limited resources. She said it’s especially rewarding see relief in the patient with a few steps and in a short period of time. “I love the fact that patients who come to the emergency department are the sickest patients you are going to see,” Loan said. “You lay your eyes on them, you have no previous notes - you are the person who has an hour before the patient crashes to figure out what’s going on.”
entire situation calmly and come up with a plan to take care of the patient.” As the assistant dean for the Rural Physician Leadership Program, Dr. Anthony Weaver recruited Loan to the program four years ago. When evaluating students for the program, Weaver considers the student’s mindfulness of family and sense of responsibility to the community where they practice. Weaver said rural practices and hospitals need physicians who are
Along with the other students part of UK’s Rural Physician Bottom Left: Ashley (front row, far left) pictured with fellow Alpha Omega Alpha Honor Society inductees. Top Right: Dr. Leadership Program, Ravisankar and Ashley at the Class of 2014 Senior Awards Brunch where she presented him the Community Preceptor Award. Loan participated in Bottom Right : Ashley is pictured with a lamb on her Greenup County farm. clerkship rotations and lectures at St. Claire Regional Medical committed to living and working in small emergency department one day. Center. She said the hospital’s smaller towns. Loan’s closeness to her family and As a high school student, Loan wanted to medical staff and fewer residents opened ability to “have conversations with anyone escape rural Kentucky, but she now finds up more opportunities for medical students about just about anything” made her an herself drawn back to the farming life. Loan and her fiancé Ryan Brown, who she met to gain hands-on experience with patients. ideal candidate for the program. at a county fair during high school, recently Loan has delivered more than 10 babies, assisted attending physicians with bowel “Ashley Loan has the intelligence and purchased an 87-acre farm in Greenup surgery and helped stabilize a coding drive to succeed as a physician, but more County. They built a small house on the patient in the emergency department. She’s importantly, she cares about her family and farm, which will serve as their weekend her neighbors,” Weaver said. “Improvements home while Loan completes her residency also visited rural hospitals in West Virginia. in the health of rural Kentucky will come program in Lexington. Dr. Phillip Overall, a UK College of Medicine from people like Ashley.” After residency, Loan plans to practice graduate and the emergency clerkship director at St. Claire Regional Medical Center, With her commitment to practicing medicine emergency medicine at a nearby hospital. believes Loan has already demonstrated in Greenup County, Loan was awarded the She will raise beef cattle when she’s not the calm and decisive qualities needed in an $20,000 Vernon Smith Scholarship for responding to emergencies. emergency room doctor. Overall said Loan students who graduated from Greenup has shown both compassion and leadership County High School. Along with a doctorate “I’m definitely a small-town person,” Loan in medicine, she also received a certificate in said. “I feel an obligation to come back and in the midst of an emergency. health systems leadership from Morehead serve the people who have really believed “She is able to think very quickly on her State University. During her medical in me for so long. It makes my day when feet and subsequently provide excellent residency, also being completed at UK, she someone says, ‘You are coming back here?’ patient care,” Overall said. “We take care of will take one class a semester to obtain a I’m Ashley - I’m the girl who sold corn with critical patients on a daily basis and she is master’s in business administration, with her dad on the side of the road - they trust absolutely able to step back and assess the aspirations to serve as the director of a rural me, and I like that.” RPLP+ News
THE GRADUATING CLASS OF 2014
Hometown: Cynthiana, KY Residency: Internal Medicine Louisiana State University Health Sciences Center Shreveport, LA
Hometown: Morehead, KY
Hometown: Munfordville, KY
Hometown: Oxford, OH
Residency: Internal Medicine
Residency: Family Medicine/
University of Kentucky
Residency: Psychiatry - Triple
University of Kentucky
University of Kentucky
University of Kentucky
Hometown: Cynthiana, KY
Hometown: Lexington, KY
Hometown: Cave City, KY
Hometown: South Shore, KY
Residency: Transitional Year
Residency: Family Medicine
Residency: Internal Medicine
Self Regional Healthcare
UVM / Fletcher Allen
University of Kentucky
Fort Gordon, GA
Medical Center Lexington, KY
Hometown: Pikeville, KY
Hometown: Manchester, KY
Hometown: Berea, KY
Mayo School of Graduate
University of Kentucky
University of Kentucky
University of Louisville
STUDENT AWARDS Recognition of Student Anatomy Mentor Program Ashtin Nix
Graduating with High Distinction & Alpha Omega Alpha Honor Society Inductee Ashley Loan
Pharmacology Student Achievement Award Shanna Deerfield Sharber
Leonard Tow Humanism in Medicine Award, Community Service Award, & Graduating with High Distinction Leslie Aslam
Introduction to Clinical Medicine I Portfolio Award Randi Barnett 14
Morehead State University Certificate in Health System Leadership Katie Smallwood, Tess Smallwood, Matt Sexton, Ashley Loan, & Brittney Dudley
Pratt Memorial Scholarship Award Lesley Jackson
Graduating with High Distinction Tess Smallwood
Githens Award for Excellence in Pediatrics & Graduating with Distinction Katie Smallwood Graduating with High Distinction Matt Sexton
MISSION: To increase the number of physicians who are trained to provide high-quality health care and leadership, who are knowledgeable about community health, and who will address the acute shortage of physicians in the rural areas of the Commonwealth.
CURRICULUM: • Year 1 and Year 2, including the basic science education, are completed
mainly at regional sites in the Morehead area.
at the University of Kentucky campus in Lexington. The initial two years of
~ Clinical rotations are similar to UK–block rotations
the RPLP curriculum are taken with students enrolled in UK’s regular M.D.
~ The Family Medicine Rotation in the RPLP involves attending one clinic
once weekly for the entire year.
• Year 3 is the beginning of the clinical experiences and occur
~ The curriculum also includes one month of community medicine, in which students begin formulating a community project. • Year 4 consists of acting internships and electives. These can be completed in Morehead or the northeast region, in Lexington, or other sites in Kentucky, or other states.
316 West Second Street, Morehead, Kentucky 606.783.8991 rplp.uky.edu