1. < Message from the Chair

This week we chose to focus on the accomplishments of many of our trainee LEADERS as we acknowledge their many contributions during this season of graduations. We also hear the voices of faculty and staff as they reflect on the meaning of the upcoming Juneteenth holiday. I hope that these stories will uplift you especially after a challenging few weeks for many in our community, including colleagues in the UCLA Department of Medicine (DoM), which I know has caused varying degrees of stress. The challenges that many of you are experiencing include ongoing delays in federal research funding, for which we have been issuing separate communications to impacted faculty and staff, personal impacts of current federal immigration enforcement policies, the media and national focus on Los Angeles protests, and the growing international geopolitical crises that could impact some of your loved ones. My mom actually called me earlier last week to check in on me, to see how I was doing. I reassured her that Los Angeles was not burning down and that I am privileged to lead some of the most resilient people that I know! Our department leadership is cognizant of the many challenges that you are facing, both personally and professionally and we will sustain an environment in which you are welcomed and encouraged to share those concerns, and for us in turn to work with you to provide support as needed. I am impressed by your commitment to sustaining excellence across all of our missions despite adversity and for the many ways that I have seen how you have supported your colleagues, while providing the best care for our patients and education for our trainees.

Farewell To Our Chief Residents 

A couple of weeks ago, we introduced you to the “Brady Bunch,” the chief residents who will lead our internal medicine residents in the coming year. The time has now come to bid farewell to our outgoing class of Chief Residents, the “X Factors.” They have strengthened the educational curriculum, supported innovations to increase exposure to subspecialties, increased opportunities for resident scholarship and built community while supporting our trainees through unique challenges great and small throughout the year. I could not be more grateful for their LEADERShip! Thus, I invited them to reflect on their experiences, and I encourage you to hear their voices below.

Thank you X Factor chiefs! It was my privilege to work closely with you this year and to watch you develop into outstanding LEADERS. Your boundless dedication to our patients and the education of our trainees is inspiring and humbling. Take what you learned into the next phase of your careers, to enrich lives of your new colleagues and collaborators.

IM Graduation Sends Residents Off to Shape Future of Health Care 

Our internal medicine residents graduated from their residency program on June 2. The day was dedicated to their tenacity and dedication to their chosen careers, and it was an honor to join them to celebrate the hard-earned accomplishments of this class of exceptionally talented physicians. See photos from this special day and the list of award-winners announced during the graduation ceremony, at this link.

Internal Medicine Residents Shine in Informaticist Program 

For those who work in the clinic, all roads ultimately intersects with the electronic health record (EHR) — the central repository for information pertaining to our patients’ well-being. When optimized, the EHR has the potential to dramatically advance our precision health and preventive medicine efforts by connecting the dots between lifestyle, symptoms and treatments. It is thus crucial to develop physicians who can serve as experts in information technology.

Enter the UCLA Health Resident Informaticist Program, a yearlong curriculum designed to deepen clinician trainees’ understanding of the EHR and other topics in health IT. Participants complete a practicum that involves a real-world research project that leverages the EHR to improve health outcomes. I am proud to share that two DoM trainees — pulmonary and critical care medicine fellow Siyuan Cao, MD and cardiology fellow Joseph Isaac S. Wong, MD — recently completed the informaticist program. They presented their projects on June 10 at a special virtual symposium.

Congratulations to Dr. Cao and Dr. Wong on your success in the informaticist program! Your work will go a long way toward advancing patient care.

STAR and STAR-PSTP Program Graduates Share Memories and Advice

The UCLA Specialty Training and Advanced Research (STAR) Program provides a world-class curriculum for physician-scientists who want a formal, dedicated research experience as they complete their residency or clinical fellowships and prepare for careers as physician-scientists. Graduates of this three-decades old program have become leaders in academic medicine. Some now lead health systems or have launched biotech companies, and the majority continue to conduct groundbreaking research.

On June 2, 14 scholars graduated from our STAR and STAR-Physician Scientist Training Program (PSTP). I am pleased that all of our STAR graduates will be remaining on the faculty of UCLA to build their academic careers, and all of our PSTP graduates will be entering prestigious fellowship programs — many of them right here at UCLA. We asked them to share reflections on their experiences and their future plans

STAR

STAR-PSTP

Other STAR graduates included Jane C. Fazio, MD, PhD; Michael Oh, MD, PhD; and Hugo Torres, MD, PhD, MPH. Other STAR-PSTP graduates included Lloyd Harvey, MD, PhD and Jiajia Zhang, M.Med, MB, MPH. Congratulations to all of you. I cannot wait to see you soar!

The National Clinician Scholars Program Creates Change-Makers In Medicine

Few programs are better suited to medicine practitioners who wish to create systemic change than the UCLA National Clinician Scholars Program (NCSP), a two-year fellowship that gives doctors and doctoral nurses the opportunity to develop the research and leadership skills necessary to address complex challenges in health care. In honor of the program’s upcoming deadline for summer applicants, July 25, this week’s newsletter highlights the experiences of an incoming scholar, a current scholar and an alumnus to demonstrate how participation in the NCSP supports the DoM’s mission to advance healthcare for all.

Dr. Stokes’s experience in Rio de Janeiro was one of many that inspired him to apply to the UCLA NCSP, which he will begin in July. The program’s emphasis on training scholars to be advocates and LEADERS in medicine aligns with his hope to find ways for healthcare to better meet the priorities of patients and their communities. 

“For me, it always has started with direct patient care, and I definitely see myself in my career going forward spending a lot of time doing clinic visits and home-based visits with older adults,” Dr. Stokes said. For him, however, working in a system where he cannot create change is “a recipe for burnout.”

“It's really important to develop the skills and knowledge to be able to be a change-maker in medicine,” he said.

As a geriatrics fellow, Dr. Stokes has been especially interested in how social connections and support impact older adults’ health and recovery.

“Within geriatrics, something that I find really hard is when older adults who don’t have social support come to the hospital, and they don’t have a family network to encourage them to get out of bed or to engage with physical therapy or occupational therapy during the hospitalization,” he said. “You worry about what recovery is going to look like when this person goes home.” 

One aspect of his research will involve trying to understand how social connections may impact older adults’ risk of hospitalization, risk of muscle loss during hospitalization, and chance of rebuilding muscle after leaving the hospital. He hypothesizes that those who have stronger social networks might be more likely to get out of bed earlier, exercise more frequently, and engage more in rehabilitation.

“The thought is that those who have more of a social support network will be more likely to have the kind of functional recovery that’s so important for people as they age compared with those who are more socially isolated and don’t have others cheering them on, either in the hospital or when they get home,” Dr. Stokes said.

By the time Dr. Stokes graduates from the NCSP, he will have spent six years at UCLA, including three as an internal medicine resident and one as a geriatrics fellow. What he loves most about being a DoM Bruin is his proximity to experts who are moving the field forward, even as a trainee.

“I’m thinking about people like Dr. Carol Mangione, Dr. Debra Saliba and Dr. Arleen Brown,” Dr. Stokes said. “These are people who are shaping the future of medicine, and to have them make a point to take time out of their days to mentor trainees like myself feels really special.”

“I was a chief resident in internal medicine before this program and really enjoyed being in a leadership role,” she added. “I also enjoyed educational scholarship, so I thought that this program would help me advance those skills, as well.”

Dr. Tsevat did not know she wanted to study ACEs, events that occur in childhood that are often preventable, potentially traumatic, and can have detrimental effects throughout people’s lives. She was led to her research through the UCLA-UCSF ACEs Aware Family Resilience Network (UCAAN), a first-of-its-kind program to promote early intervention against the impacts of ACEs and chronic stress that has generously funded her fellowship After connecting with UCAAN through the NCSP, she entrenched herself in understanding associations between adverse childhood experiences and absenteeism from school — an important problem that is connected with later challenges in adulthood. This work led her to LAUSD, which had been collecting ACEs screening data for over a year.

“I said to them, ‘Oh, have you analyzed that data?’ and they said, ‘No, but we’d love to.’ That’s how our partnership organically came about” Dr. Tsevat recalled. “The impact of ACEs had become an important question for them to be able to understand, and for me to think about how we can contribute to the literature and support youth who have experienced adversity.” 

Dr. Tsevat’s time in the NCSP has helped her to realize other projects that she is interested in pursuing. It has also made it clear to her that research should be part of her future career.

“One of the things that I hoped to get out of the program was a better understanding of the direction that I wanted to take in the future,” Dr. Tsevat said. “It’s cemented in me that I really do enjoy research and want to continue along this path.”

In addition to skills and the satisfaction of improving the lives of adolescents and young adults,” Dr. Tsevat has made many lasting connections.

“Lifelong friends, lifelong mentors, colleagues — all of that comes with the NCSP,” Dr. Tsevat said. “That’s something I’m really grateful for, as well."

"The priorities of those who are making decisions at a health system level and those who live in a community are naturally different,” she said. “The NCSP gave me tools to get to know them and work with them.”

For her NCSP research project, Dr. Takada demonstrated that social support and stigma complicate whether a patient will receive care or adhere to medications. This work has continued to progress and evolve since she completed the program and took on her present role as faculty in the UCLA Division of General Internal Medicine/Health Services Research (GIMHSR). For example, she currently works with the UCLA Homeless Healthcare Collaborative to figure out how to measure its success in improving patient outcomes; she has also collaborated with the LA County Department of Health Services to use medical records data to evaluate social care interventions for patients at risk of poor outcomes. 

“As a researcher, it's really exciting to be able to provide science and data for these very well-thought out, complex interventions so we can say, ‘It’s working,’” Dr. Takada said. “And I think all of this comes from my experience as a scholar in the NCSP, learning how to do partnered research.”

Skills were not the only thing Dr. Takada gained from her time in the NCSP. She also established a close network of fellow researchers who understand the challenges of being a clinician-scientist — and who share the program’s spirit of service, collaboration and drive to create meaningful change.“

It’s always nice to feel that there is a community of colleagues out there who share this similar vision, because research is a hard career every step of the way,” Dr. Takada said. “There’s definitely this special sort of culture working with community-based partners that runs through the program, and I think it’s really valuable to be able to carry that throughout your career.”

DoM Faculty and Staff Reflect on Juneteenth

This coming Thursday, June 19, marks 160 years since the first Juneteenth, a celebration of the day African American slaves in Texas became the first in the nation to learn that the Civil War had ended and they were free. It is a time to reflect on U.S. history — and its sustained impact on our communities — as well as the invaluable contributions Black and African American people have made to our country’s progress in every realm, including science and health care. To celebrate Juneteenth, I asked Black and African American faculty and staff to share their thoughts on what the holiday means to them. Here are their voices.

Our family was lucky and was not forced into sharecropping, a privilege for us I never forget. So, Juneteenth means the formal recognition of the start of the journey of my family and the broader African American community in America beyond enslavement.

I am moved by the words of my colleagues as they reflect on what Juneteenth means to them. I grew up in Jamaica, which also had a legacy of slavery, although my ancestors were emancipated much earlier in 1838, ending 150 years of slavery in the former British colony. Growing up in Jamaica, we openly acknowledged the past, studied the impact of slavery on the development of our unique culture and recognized how these experiences built resilience. Emancipation Day became a public holiday in Jamaica in 1893 and has been actively included in our Independence Day Celebrations since 1962. It became a distinct national holiday in 1997. Thus, for my entire life, actively embracing my heritage and remembering the sacrifices of our forefathers collectively made us stronger and deepened our commitment to respecting everyone’s dignity.

As we recognize Juneteenth this year, albeit a more recent innovation in the USA, let us use this time to learn from history and to harness these reflections to build a better future for all of us.

Dale

P.S.

Let me congratulate Mary-Rose Abraham, Senior Science Writer – UCLA Health Newsroom, for being the first person to guess that my 50^th state visited was North Dakota. As far as I am aware, the first member of the DoM to conclude that the state was North Dakota was Dr. Rachel Brook. I owe you both coffee!

I will miss the X-Factor Chiefs, not only for the reasons articulated above but for the yellow X photo shoot that preceded all of my Chair rounds this year.

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