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Symbiosis

The Graduate Medical Education Consortium board met recently for a strategic retreat. Since we had new members, the dreaded icebreaker appeared, that activity collegial strangers detest in professional gatherings.

It was a simple icebreaker: answer the question HOW DID YOU GET HERE?  As the nine board members described their routes into medicine and academia, a pattern emerged: a spiral.

Not a one of these high flyers took a straight path to their destination. One read a book in sixth grade that made her decide—with no background in the family and limited opportunity in her secondary education—to become a doctor. Another left his job as a mail carrier after a chemistry professor told (perhaps even kindly bullied) him to take the MCAT. One drifted toward law school, only to be diverted by a family friend who said he would make a good surgeon because of his interest in working with his hands. Three or four of us were pushed into academic roles by people we had casual friendships with, who encouraged us to exert influence on policy as well as students.

The point being, the path to any career satisfaction is rarely a simple straight row, more like a big squiggly line that involves numerous fallbacks, moments of questioning, and without fail an advocate. Usually this voice guides and supports from within an existing relationship. And quite often, the job one winds up doing is not based on any prior knowledge of how to do it. (Uhm, that’s not true for the surgeons, btw.)

One board member described her learning curve going from the ministry into medical education as steep, fast, and friendly, because she was hand-picked by a colleague to take on a difficult role, based on his observations of her skills. She had not aspired to the leadership thrust upon her, but a decade later is adept at running the department, even though she described herself as “still feeling more lucky than skilled.”

Imposter syndrome abounds, but as the stories emerged, so did that spiral pattern, circling a core of relationships and networks. As one board member observed, “once you’re inside the field of medicine, you can go about anywhere. The opportunities are daunting, so many exist.” A fellow board member (provost of a regional college) added quickly, “Or Academic Administration” and the board members laughed and agreed.

It is as true in Southwest Virginia as it is in any part of the world: relationships build careers, and careers build relationships. That’s a good thing.

Wendy Welch, PhD
Editor
“Masks, Misinformation and Making Do: Appalachian Health-Care Workers and the COVID-19 Pandemic”

Head for the Hills 2022 – Registration & Details

November 4-5th, 2022
The Martha Washington Inn & Spa
Abingdon, VA

Topics will include:

– Breaking Down “Structural” and “Systemic” Racism
– How to talk so patients will listen, how to listen so patients will talk
– Overview of commonly used botanicals and supplements
– Doctoring in Small Town Appalachia
– Dentition and Diabetes
– Opioid Alternatives for Odontogenic Pain
– Opioids: The Good, The Bad, and the Latest in Best Practice

View Full Agenda

Why I Chose to be a Physician Assistant

From a young age, I always found science fascinating, and as I progressed through high school and college, I also found that I had a strong desire to help people in my rural community, so the decision to choose a career in healthcare seemed natural. When choosing what role I wanted to have in the healthcare team, I wanted a job that would allow me to truly practice medicine in terms of diagnosing, treating, and being directly responsible for the management of patients while also being able to enjoy a life outside of my career so I could give my best self to my patients. Becoming a physician assistant will meet these expectations.


As a PA, I will be able to enter the workforce and begin treating patients faster – the training for a PA is a master’s degree that takes about 24-28 months to complete. Furthermore, PA school follows the medical model. This approach to medicine will allow me to satisfy that desire instilled in me as a child to know the how and why of the science behind what I will be diagnosing and treating.


Another thing that drew me to the PA profession is after completing school and passing board exams, PAs can immediately apply for jobs without having to complete a residency that may last several years as physicians do. PAs not only can work in any specialty they choose, but they also have the ability to change specialties throughout their career. I love growing and learning new things, so I believe the lateral mobility will prevent me from becoming burnout in the profession as many healthcare workers are.


As I apply to programs this year, I look forward to entering a wonderful profession and a lifetime of serving and learning.

Sarah Dotson
Student
The University of Virginia’s College at Wise

Congress Needs YOU!

The National Rural Health Association hosts an Annual Policy Institute, in which people with a passion for improving health in rural communities visit Washington, DC to encourage Members of Congress to support that passion. While I have experienced this event sixteen times, I will never forget my very first Policy Institute. Unsure of myself, terrified that I would make a mistake, I was absolutely positive that the meetings I had scheduled with Congressional staff were pointless because none of them would care about what I had to say.

Because, too often Rural America is made to feel like we should have to beg for resources. We’re like a little kid at Thanksgiving Dinner and everyone keeps passing plates over our heads. We ask for more and are told that we’ve already had more than our share.

What they forget, what we forget, is that we shouldn’t have to beg, because those resources are ours. The food on that table? It came from Rural America. The wood that made the table? It came from Rural America. The electricity that powers the oven and the lights are from a coal plant or nuclear plant or hydro dam or wind farm or solar field in Rural America. The water that washes the dishes? It’s rural too.

The resources urban America uses comes from rural farms, rural mines, rural rivers, and rural forests. And those resources travel to suburbia on rural roads.

I don’t say this to drive a wedge between urban and rural, but to remind each other that there is value in more than the number of people per square mile. Rural and urban need each other to make this nation function, and if rural starts to fall, it will drag urban down with it.

We need to all work together to find solutions. Which is why, during that very first Policy Institute all those years ago, I was surprised to discover that Congressional staffers did want to talk to me. They were interested in what I had to say and asked questions to learn more about our rural hospitals and clinics and how federal policy plays out in our communities.

At the end of that long, confusing day, I trudged to my last appointment at the Office of Representative Virgil Goode to meet with his Legislative Aid. The receptionist asked if we would mind waiting a while, because Congressman Goode wanted to meet with us.

When Congressman Goode arrived, he didn’t just agree to support the policy proposals we brought to him, he requested our support for a bill of his own. A Member of Congress needed me.

And they need you. Please be a lifelong advocate for rural America, even if you never make a Hill visit of your own. We’re all in this together.

Beth O’Connor, M. Ed.
Executive Director
Virginia Rural Health Association
President
National Rural Health Association

Startup Appalachia Pitch Competition

*NOTE: applicants must be based in one of the 54 ARC-mandated counties in Eastern Kentucky*

Shaping Our Appalachian Region, Inc. (SOAR), in partnership with the Cabinet for Economic Development’s KY Innovation Office, is hosting the Startup Appalachia Pitch Competition, presented by Community Trust Bancorp., on June 24 in Hazard, KY.

Finalists will take the stage during the SOAR FOCUS Summit on Entrepreneurship and Innovation for a chance to win:

$10,000 | First place

$3,500 | Second Place

$1,500 | Third Place

By completing this application, you are already a winner. Following your submission, a member of our Business and Innovation team will connect with you to schedule a time to learn more about your idea.

Deadline to apply is May 13th! Click here for application and more details.

AHECs Provide Students Opportunities to Help the Underserved

Posted March 31, 2022 by Emil Chuck – The Student Doctor Network

For decades, rural and highly urban communities have had challenges accessing healthcare due to a lack of available providers.  Passion to work with underserved communities in rural or underserved urban settings often wanes once a student begins preclinical coursework.  

Area Health Education Centers, or AHECs, consist of around 300 locations that address primary care and family health needs in underserved communities. These sites provide pre-health and health professional students with opportunities to experience serving in healthcare shortage areas and working with health professional students from other disciplines.

Read the Full Article:
The Student Doctor Network – “AHECs Provide Students Opportunities to Help the Underserve”

Found out more about your local AHEC!
Southwestern Virginia Rural Area Health Education Center (AHEC)

Those “screw-ups” are now respected physicians

One of the best things about being part of the faculty at a small school is getting to know your students, and being in a position to intervene at critical points in their lives. 

We all see students who never put a foot wrong, who are organized and hard-working and smart, the students who earn most of the accolades and awards along the way.  I value and respect those students, who know their own minds and know how to set goals and stick to them.

But I also have a great deal of affection for another group of students, the ones who screwed up.  Sometimes students (particularly first generation college students) really don’t know how to navigate college. Some students just take a little longer to grow up and realize that they are moving in a bad direction; and unfortunately some students think football is going to be their life until they find themselves on an airplane into a war zone.

Being in a position to sit down with young people who have screwed up and have no idea how to turn their life around, helping them map out a way forward, writing their letters of recommendation and watching them go off to graduate or professional school is a  privilege like no other. 

And yes, some of those screw-ups are now respected physicians in this region, and their patients love them. So do I.

Margie Tucker, Ph.D.
Professor of Chemistry
Department of Natural Sciences
University of Virginia’s College at Wise

Institutional Funding Opportunities

Provider’s Clinical Support System Grant for Universities (SAMSHA)

Funding to support graduate-level education for students in medical, physician assistant, nurse practitioner, and other eligible advanced practice nursing programs with a focus on treating opioid use disorders and prescribing medications for opioid use disorder in office-based settings upon graduation.

Anticipated award amount up to $245,000 per year per award.

Application Deadline: May 27, 2022


Public Health Scholarship Program (HRSA)

Grants to strengthen the public health workforce by providing support to organizations to develop scholarship programs that incentivize individuals to pursue training and careers in public health. Projects should focus on workforce shortages, populations at highest risk for health disparities, low health literacy, social determinants of health, and infrastructure to provide necessary services in rural and underserved communities.

Estimated total award amount up to $1,500,000 per award (fully-funded at the outset for the use over the period of performance)

Application Deadline: June 1, 2022

The Warmth of Rural Residency

“The true beauty of Norton, and the larger area of Southwest Virginia, lies within the people who constitute it.”

You do not have to look far to appreciate the beauty of Norton, Virginia. At every turn, you are greeted by mesmerizing mountains that span as far as the horizon, rugged trails that are sure to be an adventure and breathtaking sunsets that could easily find themselves colorfully painted on canvas. However, these grand scenes are merely the tip of the iceberg of what makes the Appalachian Highlands so unique.

When I first interacted with leaders of the internal medicine residency program, I was impressed with their warm, courteous and genuine demeanor. This initial impression was further reinforced when I observed how closely the program administrators and residents interacted, a stark contrast from the interactions I have witnessed at other institutions. I also had the opportunity to experience this close interaction when I met my program director for the first time at a local supermarket. The humor of the situation was surpassed only by the speed at which news of this encounter spread to others. It truly made me appreciate the dynamics of a rural area.

The true beauty of Norton, and the larger area of Southwest Virginia, lies within the people who constitute it. The program administration and hospital staff are among the sincerest and most approachable groups of individuals I have come across in my medical career. These values reflect the culture and way of life in this area. Many of my friends marvel at how closely I work with program administration, attendings and hospital staff because I am treated as an individual and not as a statistic. The degree of personal attention we receive and give to the patients here is unparalleled. I feel truly blessed to be part of this community.

Dr. Rehan Alam, MD
Internal Medicine Resident
Norton Community Hospital