Year 3. September 16. Investing in the Future of Medicine.
As a member of a major teaching institution, I am reminded often that our department plays an essential role in training and mentoring the next generation of clinicians and clinician-scientists. UCLA Department of Medicine (DoM) faculty, provide critical training and mentorship for undergraduates, medical students, residents and fellows. Moreover, our trainees are also themselves teachers, as evidenced by the awards that our residents obtain each year for their efforts and examples as teachers. This week, I will share stories that illustrate the many ways that our trainees and faculty form a seamless tapestry of training, mentorship and education.
DoM LEADERS Guide Medical Students on Road to Residency
On August 24th, I joined DoM LEADERS and the UCLA Office of Graduate Medical Education to deliver the keynote address to medical students from across the country at UCLA’s 6th Annual Road to Residency Event. This conference aims to support medical students from minoritized and non-traditional backgrounds with guidance on how to achieve their best residency match. As I looked at these young, eager faces, I saw the future of medicine. I framed my remarks around the concepts of storytelling despite uncertainty. I reminded these students that academically, they were already exceptional in many ways and had similar CVs. As such, they should not worry about whether they would match into a strong residency program. Instead, they should focus their narrative on what makes them unique. I reminded them that residency programs across the nation are actively seeking to diversify the physician/physician-scientist pipeline. As such, their applications will stand out, and they should frame their application strategy from a position of strength
I shared that they will shine bright by presenting their unique life stories and the journey that brought them to the point of being in a room with the future leaders of medicine. I encouraged them as they reflect on the challenges that they have overcome and the support system that helped them achieve their unique position, they should pay it forward. It is critical for our future that as they advance in their chosen specialties, they continue to extend a hand to those who are following in their footsteps.
I see this commitment to mentoring the next generation every day in the DoM and I saw it again at the Road to Residency event as several DoM LEADERS shared their pearls of wisdom throughout the day. They included:
- Mina W. Ma, MD and Gifty-Maria J. Ntim, MD, MPH who presented during the program director's panel and led a workshop on ERAS pearls.
- E. John Ly, MD who participated in the medical school gap year panel facilitated by resident physician Danielle Vazquez, MD.
- Simon Wu, MD who has provided mock interviews continuously for the last 6 years.
DoM residents Courtnie Brown, MD, Dr. Vazquez, and chief resident Sergio De La Torre, MD were instrumental as conference planning leads and participated in various panels hosted throughout the day.
Below is the complete list of faculty and residents who participated as volunteers for this year's conference. They are wonderful reflections of our department’s values and commitment to developing the future leaders in medicine and health sciences.
| Specialty | Name |
| Internal Medicine | Kelley Chuang, MD |
| Internal Medicine | Simon Wu, MD |
| Internal Medicine | Daniel Gonzalez, MD |
| Internal Medicine | Christopher Graber, MD |
| Internal Medicine | Mina Ma, MD |
| Internal Medicine | Keni Lasitani, MD |
| Internal Medicine | Alaní Estrella, MD |
| Internal Medicine | Max Jordan Nguemeni Tiako, MD |
| Internal Medicine | Sergio De La Torre, MD |
| Internal Medicine | Danielle Vazquez, MD |
| Internal Medicine | Courtnie Brown, MD |
| Medicine - Pediatrics | Lindsay Wells, MD |
| Medicine - Pediatrics | Gifty-Maria Ntim, MD |
| Medicine - Pediatrics | John Ly, MD |
| Medicine - Pediatrics | Lindsay Olson, MD |
| Medicine - Pediatrics | Daniel Hodson, MD |
Program Directors Seek Curiosity, Enthusiasm and Roads Well Traveled in Future Fellows
Fellow selection season is underway! Our fellowship program directors and faculty are in the process of sorting through hundreds of applications to recruit the leaders who will thrive in our programs and shape the future of medicine. Among their priorities for the next class are strong clinical backgrounds, intellectual curiosity and a demonstrated commitment to caring for patients.
“We’re looking for service-oriented fellows who, first and foremost, are interested in rigorous clinical training and in getting a really comprehensive clinical care experience — people who are willing to grab the bull by the horns,” Kathryn Melamed, MD, director of the UCLA Health pulmonary and critical care fellowship program, said.
For her wide-ranging program especially, “there’s not one specific type of person” who would be successful. Instead, “We’re seeking people who can fit our flexible, diverse mold in multiple different ways.”
Speaking of diversity, bringing together a class of highly qualified physicians with a wide range of racial, ethnic, socioeconomic and gender backgrounds, as well as a mix of interests, is also a top-level consideration for program directors. Our department’s commitment to a holistic review process for fellowship applicants is underscored by directors’ approach to considering applicants’ unique journeys— their “distance traveled,” as Infectious Diseases Fellowship Program Director Christopher Graber, MD put it.
“What kinds of obstacles have fellows overcome, for instance?” he explained.
For Stephanie Smooke Praw, MD, director of the endocrine fellowship program, how applicants spent their time is more important than where they spent it.
“It doesn’t matter necessarily where you went to college, but what does matter is whether or not you took advantage of the resources there, made connections with professors and started to get yourself some exposure to medicine. Then, when you got to medical school, wherever that happened to be, did you do the same thing?,” Dr. Praw said. “I think that’s what really tells us about somebody’s drive and desire to do the work and become the best physician they can.”
Pediatric Dermatology Fellowship Program Director Carol Cheng, MD, wants to see that candidates themselves are dedicated to diversity and equality — and to continuing to work in a field that needs more hands on deck.
“As there is a pediatric workforce shortage, we want to train fellows who will continue their career as a pediatric dermatologist,” Dr. Cheng said. “Additionally, we prioritize diversity and inclusion, seeking candidates who are committed to promoting diversity within the field and providing equitable care."
Each member of the department plays a critical role in recruiting trainees who will build on our successes in the years to come. For faculty who aren’t directly involved in interviewing fellows or reviewing applications, there are still ways to get involved. Jeannette Lin, MD, director of the adult congenital heart disease (ACHD) fellowship, encourages faculty to help connect residents with program directors and specialists in the resident’s field of interest, as does Dr. Graber.
“We have some fantastic residents in our program that I’m always trying to get to go into infectious diseases,” he said. “They’re all terrific. But if you think they’re particularly terrific, let me know.”
I will also add that the DoM committed to identifying those applicants with an interest in developing careers as a physician scientist. Our Specialty Training and Advanced Research (STAR) Program at the David Geffen School of Medicine at UCLA is a unique and nationally recognized program that provides rigorous training and mentorship for MDs or MD-PhDs who aspire to develop independent research careers. The DoM has asked fellowship program directors to proactively identify qualified candidates among prospective recruits to ensure that we can recruit fellows who will excel across all missions including research and clinical care.
Daniel Gonzalez, MD and Walter Solorzano, MD Join National Clinician Scholars Program
This summer the National Clinician Scholars Program (NCSP) at UCLA welcomed a new cohort of fellows that includes two scholars from the UCLA Department of Medicine: Daniel Gonzalez, MD and Walter Solorzano, MD, both of whom are first-generation physicians who completed residency in our internal medicine at UCLA last year. The NCSP is a post-doctoral program for physicians and doctoral nurses who are motivated to solve some of the health system’s biggest challenges by making high-quality care accessible to all.
“Our most recent cohort of scholars is an impressive group.,” Jennifer Serpas, administrative director of the NCSP at UCLA, said. “They are driven to improve healthcare and resolve health disparities for a variety of different populations. We're impressed by their dedication to learning new skills, engaging with Los Angeles community members, and working together interprofessionally.”
Over the next two years, Dr. Gonzalez and Dr. Solorzano will design and conduct research projects that investigate and improve upon the delivery of health services. They will also complete a curriculum tailored towards honing the research and leadership skills necessary for a career in health services research, graduating with master’s degrees in health policy and management through the UCLA Fielding School of Public Health. Many program alumni go on to lead healthcare systems and government agencies.
For Dr. Gonzalez, NCSP felt like a natural fit for his drive to make medicine more equitable by strengthening the public health safety net. He believes what he learns in the program will support his goal of treating patients in marginalized communities like those in which he grew up in while also working to bolster safety net infrastructure through leadership roles in health systems and in healthcare policy more broadly.
"I pursued the NCSP fellowship because it provides structured, dedicated time to further explore my research and policy interests to inform the direction of my career instead of having to decide right out of residency,” Dr. Gonzalez said. His experience as a trainee conducting research alongside NCSP fellows and faculty, which culminated in a publication about barriers to care for patients with California Medicaid, also shaped his decision to apply.
Dr. Solorzano’s research experience during residency also influenced his decision to enter the program. In his second year as a trainee, he and Estelle Everett, MD received a grant to conduct research on the obstacles to accessing continuous glucose monitors among vulnerable populations with diabetes. While that work is still ongoing, he believes what he has learned so far about community-based research will serve him well in NCSP.
“I think working with Dr. Everett showed me that there are different ways to approach health disparities, and research is a potentially powerful one,” he said. While the new cohort of participants are still deciding what projects to pursue, Dr. Solorzano anticipates that one of his will center on payment models, and value-based care in particular.
As for what comes after NCSP, Dr. Solorzano is open to many of the multiple paths that the program could take. One of its biggest benefits is access to so many different careers, from academic research to leading public health initiatives.
“I think the most important thing for me is to staying true to my values and focusing on the community, especially the community where I came from, and making sure that my work is at least moving the needle a little bit to improve the way that we deliver care for vulnerable populations,” Dr. Solorzano said. “I think NCSP has only gotten me even more excited about what route my career could take.”
DoM Residents and Fellows Honored for Excellence in Teaching
Now I would like to bring your attention to some special LEADERS in the UCLA Department of Medicine who were recently recognized for their exceptional abilities as educators. The David Geffen School of Medicine medical student body honored Hans Gao, MD; Nancy Miles, MD; Wilson Ricketts, MD; Jay Shah, MD and Christopher Soriano, MD with Excellence in Teaching with Humanism Awards for Residents and Fellows at the White Coat Ceremony on Sept. 6. DGSOM medical students nominate residents who mentor, empower and display a vested interest in the education of our future physicians. Let’s learn a little more about them!
Hans Gao, MD
Dr. Gao is a first-year fellow in the adult congenital heart disease (ACHD) fellowship. He sees medical training as a social contract, one in which trainees receive education in return for providing service. When every person at every level – from student to attending – gives their 100% and upholds their part of the contract, the system runs smoothly. He feels lucky that his fellowship values his education, such that his attendings take time to teach even when the day is busy.
“With that comes a responsibility for me to pay it forward,” he said. “The way that I make sure my learners know I don’t take their work for granted is by upholding my end of the contract as a fellow — to teach."
Dr. Gao uses a framework when teaching: interns should know the algorithms and guidelines; second-year residents should know the trials that led the development of those guidelines; third-year residents should transcend guidelines and think about competing risks. Beyond that technical knowledge, he also hopes to help prospective trainees and fellows navigate the application process, and especially encourages those who are interested in cardiology and internal medicine to contact him.
“I genuinely think ACHD is the most incredible sub-specialty in the world,” he said. “If you’re interested in cardiology, let’s chat!"
Nancy Miles, MD
Dr. Miles is a second-year resident in the internal medicine program. She sees teaching as one way to make sure our future doctors are good ones — after all, she jokes, “eventually I’m going to need them!” And also, she added:
“More truthfully and fundamentally, I think teaching is how we instill a sense of belonging within medicine. We need doctors who come from all sorts of backgrounds, and being a teacher means instilling a sense in somebody that they can learn something they don’t know how to do — that it’s not a gap in their ability, but rather a gap in their learning. And I think that distinction is something I find a lot of joy in.”
Dr. Miles hopes that she has helped cure learners of imposter syndrome, something she herself has experienced as the first woman in her family to pursue medicine.
“If you don’t feel like you belong in medicine, it’s hard to learn the coagulation cascade or the differential for an AST or ALT elevation,” she said. “If I can help someone know that they belong in medicine, that their patients are lucky to have them, there’s nothing better I can leave them with.”
Wilson Ricketts, MD
Dr. Ricketts is a palliative care fellow who completed residency in internal medicine-pediatrics at UCLA last year. He finds that teaching reminds him of the “tug” to help others that drew him into medicine in the first place. He also notes that a call to teach was included in the original Hippocratic Oath:
“The original version says that, basically, you treat those training you and those that you’re training like family, and you’re indebted to them. It recognized that medicine is a beautiful kind of social endeavor that will hopefully ramify into the future and help people be cared for in generations to come. It’s a neat thing to participate in that’s a lot bigger than yourself. Teaching is a very core way into that.”
Dr. Ricketts hopes that those who have learned from him have gained a generosity towards themselves and each other. He believes physicians are privileged to work with and serve other human beings, whether they’re patients or colleagues.
“I think generosity can be a great starting point to really help other people learn as adults — not just the way we learned in elementary school, but to become more actualized clinicians who can identify the things we want to move towards and grow in and actually see that change happen iteratively as we move through training,” he said. “I think that being able to give someone a sense of excitement over helping someone else move into becoming a full-fledged, independent practitioner is a really exciting thing. Hopefully we can all just pass that on to each other.”
Jay Shah, MD
Dr. Shah is a third-year resident in the internal medicine program. He views teaching future medical professionals as a way to “keep medicine moving forward”. His own journey into medicine — and to UCLA — was made possible by the teachers he met along the way, he added:
“I think the mentors and teachers I’ve had in my life have really gotten me to where I am today. Being a teacher now allows me to do the same for the people that are coming through the same process that I went through. That is something I’m really passionate about and I hope to continue working in academic centers to train the next generation of physicians.”
Dr. Shah hopes he has left a positive impact on all of the trainees he’s worked with, whether it’s in the form of learning something new or simply having a good time on his team.
“As an educator, I like to create an environment where people feel really comfortable existing as themselves, where they can engage in their own learning and, in the end, just feel like they are one step better than they were before they started with me.”
Chris Soriano, MD
Dr. Soriano graduated last year from the UCLA residency program in internal medicine and is now a first-year fellow in gastroenterology at the University of California Irvine. As someone who never saw himself as a teacher prior to residency, he feels honored to have been viewed and acknowledged as a teacher.
“Working with the medical students and resident colleagues is a wonderful environment that allows me to teach in my own way, which I think has allowed me to turn what used to be formal teaching into informal sessions that I think students highly valued,” he said.
Dr. Soriano hopes those who learned from him left with the impression that it's a fun, enlightening and empowering position to be able to care for those who need it the most. He also hopes he instilled in them the confidence that they too can make the transition from learner to teacher.
“Whatever stage of education they are in, there is always someone willing to learn,” he said. “We all have something to contribute and provide, whether it’s our own personal journey through medicine or motivating the next generation to reach their true potential.”
Medical Scientist Training Program to Expand with Renewed NIH Grant
The UCLA-Caltech Medical Scientist Training Program (MSTP) at the DGSOM attracts some of the brightest prospective physician-scientists in the world. I am excited to share that now, thanks to the hard work of co-directors Olujimi Ajijola, MD, PhD, David Dawson, MD, PhD and their team, the program has renewed this significant NIH grant and will expand the number of training positions from 26 to 30, the maximum number of slots provided by the NIH relative to program size.
“The new grant that we’ve received from the NIH really speaks to the quality of the proposal that we put together, but that proposal is only strong in the sense that we, the faculty at UCLA and Caltech, and the innovative training program we’ve designed is very strong,” Dr. Ajijola said.
MSTPs are highly competitive NIH-funded programs designed to train the next generation of leaders in medicine and scientific inquiry. Participants are accepted simultaneously into medical school and into a PhD program of their choosing in the third year, graduating an average of eight years later with both degrees. Alumni of the UCLA-Caltech MSTP are leaders in academia, industry, government, and business, with accomplishments that include paradigm-shifting discoveries that impact human health.
“By all metrics you could use, we truly have a program that stands out nationally,” Dr. Ajijola said.
The NIH in recent years has changed the application process for MSTP T32 grant funding, along with the metrics and outcomes used to measure the success of program graduates. As a result, all institutions with MSTPs had to rethink how they train their students in medicine and science. For the program at UCLA-Caltech, that involved taking all aspects of medical and scientific training “back to the workshop,” as Dr. Dawson put it, and re-emerging with something more cohesive: a pedagogy that trains students to practice medicine and science as one.
“We wanted our students to reflect an identity as a physician-scientist, which means that they are thinking and applying science when they see patients — but at the same time, during scientific investigation, they’re thinking about patients and applying tenets of patient care in their science as well,” he explained. “We think that by doing so, we’re going to create a new generation of trainees that live and breathe the physician-scientist mindset in all that they do.”
The NIH gave the proposal a high score and, with it, enough funding to add four new training positions to the program. The UCLA-Caltech MSTP is larger than MSTPs at most other institutions, suggesting that the NIH trusts the program to produce exceptional physician-scientists who drive discoveries and innovation in medicine, Dr. Ajijola noted. He hopes that the program’s emphasis on helping trainees develop identities as physician-scientists will keep them going down a long, challenging path.
“We think that by better harmonizing the two parts of the training, medical training and science training together, we’re likely to retain our students within the pipeline — not only within our program, but also beyond,” he said.
Congratulations to Dr. Ajijola, Dr. Dawson and the UCLA-Caltech MSTP on this wonderful news. We can’t wait to have more physician-scientist trainees join us in our mission to drive transformative advancements in medicine!
Dale
P.S.
Consistent with the spirit and theme of this week’s message, let me share a picture taken last week at the 21st annual meeting of the Society for Heart and Vascular Metabolism, where we had a mini-reunion with some of the Abel lab members spanning more than 20 years.
Back Row, L-R: Jijun Huang, PhD, UCLA, Yuan Zhang, PhD, UCLA, Renata Pereira, PhD, University of Iowa, Me, Vlad Zaha, MD, PhD, UT Southwestern, Quanjiang Zhang, PhD, UCLA, Warren Tai, MD, UCLA.
Front Row: Jaetaek Kim, MD, PhD, Chung-Ang University, Kensuke Tsushima, MD, PhD, UCLA and University of Tokyo, Adam Wende, PhD, UAB.
One Professor and Division Chief, 2 Associate Professors, 5 Assistant Professors and one STAR fellow. Beginning to feel like a grandfather.
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