Looking forward – July 2016

David B. Hoyt

David B. Hoyt, MD, FACS

The surgical workforce in the U.S. is arguably more diverse than it was 20 years ago; however, we still have a long way to go before the percentage of women and minority surgeons is representative of the overall patient population. Furthermore, disparities in access and quality of care persist and must be addressed.

I recently had the privilege of serving as the Aubre de Lambert Maynard Guest Lecturer at Morehouse School of Medicine (MSM), Atlanta, GA, and of participating in the department of surgery’s grand rounds. I had always wanted to visit MSM to learn more about its highly acclaimed social agenda. What really struck me during the course of this experience was the commitment of the surgeon leaders to fulfilling this mission. Particularly impressive is a mentoring program for talented high school students who have an interest in pursuing a health care career.

Mentorship program

Founded in 1975 as the medical education program at Morehouse College and now an independently chartered institution, MSM seeks to accomplish the following goals: improve the health and well-being of individuals and communities; increase the diversity of the health care workforce; and address primary health care through programs in education, research, and service with emphasis on people of color and the underserved urban and rural populations in Georgia and throughout the U.S.

The youth mentoring and medical exposure initiative known as Reach One Each One (ROEO) was started by Omar K. Danner, MD, FACS, associate professor of surgery and chief of trauma, in an effort to help MSM achieve its mission. The program is a collaborative initiative between three Atlanta institutions—MSM, Emory University School of Medicine, and Grady Memorial Hospital—and is designed to meet the following objectives:

  • Encourage interaction between a multidisciplinary group of physicians, medical students, hospital faculty, and mentors during their normal workflow to stimulate the high school students’ interest in pursuing a career in medicine
  • Expose high school students to various medical specialties, medical technology, and trauma care with an emphasis on violence and injury prevention, safety, and future opportunities in health care
  • Educate participants on how to navigate undergraduate studies and medical school
  • Spark students’ interest in health care careers and stimulate their understanding of how they can ensure access to care for socioeconomically disadvantaged patients and Georgians
  • Help students determine whether they would like to pursue a career in medicine, surgery, or another health care profession

MSM and Emory faculty for the program represent a range of specialties, including general surgery, internal medicine, obstetrics and gynecology, emergency medicine, trauma surgery, thoracic surgery, neuroscience and neurosurgery, orthopaedics, and nursing. A total of 27 Atlanta public high school students participated in the 2014–2015 program: 15 seniors, 11 juniors, and one sophomore. Of note, among last year’s ROEO participants, two were Gates Millennium Scholarship Award recipients. The students completed a 10-week program consisting of a two-week orientation and medical clearance process; a six-rotation multidisciplinary rounding and clinical exposure experience, including a tour of MSM; a financial literacy seminar; and ultimately a graduation ceremony at which the students were given white coats.

The ROEO program also beta-tested a Summer Capstone Experience in 2015 with seven participants. This program featured a brief orientation and badge clearance followed by three weeks of clinical shadowing and multidisciplinary clinical rounding. The summer program was supported and supervised by the MSM departments of surgery, obstetrics and gynecology, and internal medicine.

Reports back from the student participants in both programs were uniformly positive. One student wrote that the ROEO program “exceeded my expectations by tenfold.” This young man said he viewed the program as “a chance of a lifetime,” noting that he was able to see cardiothoracic and hernia operations performed and to be introduced to surgery at the same time and in the same way as third-year medical students. Other students also expressed their enthusiasm, appreciation, and wonder for the work of surgeons and other health care professionals. They also remarked on the incredible pride they feel when wearing the white coats they received at graduation and the boundless appreciation they feel toward the faculty who mentored them through the program.

Other highlights

Another highlight of the lectureship was the welcoming remarks offered by Ed W. Childs, MD, FACS, professor of trauma and critical care and chair, department of surgery, who invited me to the event. I commend Dr. Childs for his outstanding vision and focus on diversity. Under his leadership, the department of surgery has begun implementing a strategic plan to fulfill the MSM mission, including the mentorship program.

After a case presentation by MSM’s two surgery department chief residents—Carl Lokko, MD, and Ruben Burbank, MD—Daniel E. Dawes, JD, MSM’s executive director of government affairs, president’s office, led a discussion on health policy and its effects on quality and equity. He specifically addressed the impact of the Affordable Care Act and the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act with respect to reducing disparities in care among vulnerable populations. He also addressed the challenges in implementing many of the provisions aimed at improving health care for underserved patients in Georgia.

Shaneeta Johnson, MD, FACS, associate professor of surgery, spoke on health care disparities and disease management, particularly treatment for morbid obesity among underserved populations. In addition, Jacquelyn Turner, MD, FACS, assistant professor of colon and rectal surgery, discussed undergraduate medical education and its effects on residency training.

A more equitable future

As many of you may know, Aubre de Lambert Maynard, MD, is the chief of surgery with whom John  Cordice, Jr., MD, FACS, and Emil Naclerio, MD, consulted when they operated on Martin Luther King, Jr., PhD, after the civil rights leader was stabbed by a mentally ill woman in 1958 in Harlem, New York, NY. It is only fitting that Morehouse should sponsor a lectureship in honor of the surgeon who saved the life of one the school’s most distinguished alumni. It further follows that this lectureship program focuses on the themes that Dr. King promoted: equality for people of all races, colors, and creeds, as well as access to health care services for people of all socioeconomic backgrounds.

Participation in the 27th Aubre de Lambert Maynard Lectureship was a humbling and moving experience. It is exciting to see the health care community in Atlanta pull together with surgeon leadership to actively try to overcome the challenges associated with improving diversity and eliminating disparities. I believe the ROEO program and the research and public policy work that is being carried out at MSM will have profound long-term effects on health care in Georgia, and I encourage surgeons who are interested in diversity and variations in care to further explore these efforts and to implement similar models in their communities.

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