Joseph El-Khoury, MD

Dr. Joseph El-Khoury, MD, MRCPsych, is an assistant professor of clinical psychiatry at the American University of Beirut (AUB). He began his medical studies at St. George’s University in 1998 and, after qualifying as a medical doctor in London in 2002, he trained at Oxford University and St. George’s, University of London, in the UK, obtaining Membership of the Royal College of Psychiatrists (MRCPsych) in 2006. He has held a Certificate of Completion of Training (CCT) in adult and substance misuse psychiatry since 2010. In that same year, he was appointed as a consultant psychiatrist in the UK National Health Service. In 2012 and after 14 years abroad, Dr. El-Khoury returned to Lebanon to continue his medical career.

Dr. El-Khoury directs the newly created Psychosis Recovery Outreach Program and is responsible for the residency training program at AUB. He also acts as the Global Mental Health Scholar for the Arab region for a joint program by Columbia University and the World Health Organization.

He is enrolled in the Master of Science in War and Psychiatry track at King’s College London with an emphasis on trauma and political psychology. His current research and academic interests include addiction, severe mental disorders, health services development, the socio-political interface of psychiatry, conflict medicine, and cross-cultural psychiatry.

You grew up in Lebanon, so what attracted you to medical studies at St. George’s University?

I wanted a different experience and I saw an advertisement for SGU in my local newspaper. I liked what it offered, and my family was very encouraging about me traveling as part of my education. SGU also very generously offered me a 50 percent scholarship so it was a terrific opportunity for me.

What made you want to follow a career in psychiatry?

I was always interested in medicine but I enjoyed humanities as well. The mind impacts everything we do and this inspired me to learn more about it. I knew I wanted to be a psychiatrist from the start of my medical studies and I’ve never regretted my choice of specialism.

What would you say to other students who are thinking of enrolling at a medical school in another country?

I’ve benefited from studying and working in a number of different countries. I began my pre-clinical studies in Grenada and St. Vincent and the Grenadines in the Caribbean as part of the SGU course. I then had the opportunity to take part in an exchange program with Guy’s Hospital in London and ended up achieving a double degree from SGU and the Society of Apothecaries in the UK. After qualifying as a medical doctor, I trained at Oxford University and St. George’s, University of London and ended up working as consultant psychiatrist in the NHS for two years. The experience of working and studying in other countries and health systems was invaluable. I would encourage any student to seek out diverse experiences as part of their education.

How would you describe your experiences at SGU?

SGU was an important and solid stepping stone for me. It was an incredible mix of a studious and serious academic environment alongside Caribbean sunsets, wonderful food, and beautiful scenery. I took great pleasure in learning from the SGU professors who had so much knowledge to share. It was a stimulating educational experience surrounded by peers who became lifelong friends and it’s great to see how successful they’ve all become. I have very fond memories of my time there.

What was it like to come back to Lebanon after 14 years abroad?

I came back to Lebanon in 2012 because the country was, and still is, in need of psychiatrists. I took up a position at the American University of Beirut where I direct the Psychosis Recovery Outreach Program and I’m responsible for the University’s residence training program which is the biggest of its kind in Lebanon. I have a combined clinical and academic role which means I run a daily clinic and take part in advocacy work as well as research.

The principles of psychiatry are the same wherever you practice. Once the cultural layer is removed, you see similarities in human experiences and that what we have in common is more than what separates us. If you’re well trained, then you’re ready for anything.

Much of your research has a focus on the Middle East. How do you hope psychiatric care will change in the region in the coming years?

I’m currently working towards a master’s degree in war and psychiatry at King’s College London with an emphasis on trauma and political psychology. I’m focusing my research on Lebanon, Syria, and Iraq because there hasn’t been a lot written about this in the Middle East. I was born during the civil war in Lebanon and I’ve also found that there isn’t a lot of data from this conflict, so I’m conducting a study to look into the mental health of people who lived and fought in it.

I’m also researching psychosis service development in this region alongside addiction and its impact on mental health.

I hope to see the standards of mental healthcare in Lebanon improve the level of wealthier countries. It’s going to take a lot of collective work and strong leadership. This is what I’ll aim for.

What has been your career highlight?

It has been hugely satisfying to travel the world and then return to my home country and teach at the university where I was previously a student.

Svjetlana Lozo, MD

Undergrad/Graduate: Bachelor of Science in Biology and Psychology, Drexel University; Master of Public Health, T.H. Chan School of Public Health, Harvard University

Residency: Obstetrics and Gynecology, Maimonides Medical Center

Fellowship: Global Health Leadership, Massachusetts General Hospital

Fellowship: Female Pelvic Medicine and Reconstructive Surgery, University of Chicago/North Shore University Health System

How did your upbringing shape your perspective in general and in terms of health care?

“Growing up in the war-torn Bosnia in early 1990s, I learned that death and suffering is a part of life. Twenty years later, working in the small village in western Kenya, I was faced again with the similar challenges that I grew up in.

As a 15-year-old, I received a scholarship to attend high school in Philadelphia and was fortunate to have had family and mentors that supported my dream of becoming a physician. During my high school years, I volunteered in homeless shelters and learned that discrepancies in healthcare are extremely pronounced in American society. My desire to pursue a career in medicine is led by my desire to decrease the healthcare gap around the world and provide the best possible care to patients no matter their background or zip code.”

After finishing your residency, you worked as a global health leadership fellow at Massachusetts General Hospital. How would you describe that experience?

“During my residency, I was fortunate to have great mentors and have had the ability to travel to Jamaica, Eritrea, Tanzania, and Haiti and see healthcare concerns faced by physicians and patients in these countries.

“My desire to pursue a global health fellowship stemmed from the understanding that in order to have a long-term impact on the health system, you need to be physically present for a certain amount of time. During my fellowship, I spent about a year and a half in Kenya at the same site, within the same hospital system. I lived and worked there for three to four months at a time, two times a year. The majority of my time was spent providing hands-on education to physicians, nurses, and medical assistants. We also started a family and emergency medicine residency program and spent a significant amount of time collaborating with the local university to develop programs that would provide adequate training to physicians who are remote from large medical centers.

“Giving someone gift of education and empowering them to take better care of their society is one of the most empowering gifts that one can give.”

How did your career come to focus on female pelvic medicine and reconstructive surgery?

“OB/GYN combines surgery and medicine, as well as my desire to do global health work. Urogynecology as one of the gynecological subspecialties that directly addresses patients’ quality of life and has a great need for further education internationally. Patients are often not comfortable with discussing their intimate problems such as urinary incontinence, fecal incontinence or uterine prolapses.”

In what ways is the St. George’s University experience unique?

“The St. George’s experience provided me with the family of extremely diverse, open-minded and highly driven physicians. Taking in account that most of us were away from our families, we have become each other’s family. Today, I am proud to say that my SGU family consists of amazing, well-trained physicians all around the US, and many of them having leading positions in major universities or healthcare organizations.

How did it prepare you for clinical training and beyond?

“Having an ability to do my third and fourth year of medical school in Brooklyn was instrumental. We as medical students were intimately involved in taking care of a large volume of sick patients, with wide variety of pathologies. I did all of my third-year rotations at Brooklyn Hospital, and most of my fourth year at Brooklyn Hospital and Maimonides Medical Center. Our rotations were done with students from US medical schools, and I felt we were equally well prepared. Because it was such an enriching experience, a significant percentage of us desired to do our residencies in New York City and were able to do so.”

Sara Shahram, MD

Undergrad: Integrated Sciences (Physiology/Evolutionary Ecology) and Arts (Religious Studies/Ancient Art and Architecture), University of British Columbia

Residency: Family Medicine, Dalhousie University

You grew up just a short drive from where you’re practicing. Was that the plan all along?

The goal the entire way through medical school was to come back to Canada. I knew it was going to be difficult, but whether it was finding rotations in Canada, doing research, or working on ways to improve my resume for when it came time to apply to match, I was so determined for it to happen.

I had gone on a number of interviews in the US, including at Ivy League schools, and also at schools in Ontario, Saskatchewan and throughout Canada. Thankfully I was accepted to do family medicine at Dalhousie University, which was my first-choice program here in Canada in part because they spoke French at that site.

It was an uphill battle for sure, and there were so many other obstacles in my life during school, including my dad passing away and some financial struggles, that I wasn’t sure if I could continue. But I was able to work through everything, and now I go to work every day and am so grateful.

How did St. George’s University come into view for you?

When I was applying to medical school, truthfully, I didn’t even know where Grenada was. I had seen a poster on the wall during my undergrad years at UBC. I had applied to schools here in Canada and also to SGU because I didn’t know what the future held. I hadn’t heard back from Canadian schools when I received a scholarship to join the January 2009 class at SGU, so I said yes. Then during my first term, I got called for an interview at UBC, and went back for it, so even if I had gotten accepted there, I really loved SGU by that time so I probably would have declined.

How well prepared did you feel for each hurdle along the path back to Canada?

If you’re determined and have the goal of becoming a physician, you will be able to reach it by going to St. George’s University. It has anything and everything you’d need to do it. At the same time, independently, you have to go and do it. At some places, you may be spoon-fed, and even if you aren’t determined you will probably still get through it. The SGU experience is not like that. I went to class, studied hard, did my rotations, and as a result, I was more than prepared for the USMLEs and for the MCCEE in Canada. In fact, I don’t think I even got one question wrong on the MCCEE. So I felt very prepared.

You also spent time in New York. How different was the experience there as a person from western Canada?

Living and working in New York is an experience like no other. When I was there, I actually thought that I should have grown up there. I really felt at home.

The diversity at SGU and during my rotations made me so much more well-rounded as a person, and that spilled over into my work as a physician. Having that perspective has allowed me to understand some of the situations that they’re going through and to make better decisions as their doctor.

What prompted you to include academic medicine among your focuses?

Currently I’m a clinical instructor with the faculty of medicine at UBC, and I’m hoping to create other affiliations that would allow for SGU students to come to my clinic.

That’s my passion: helping someone who was in the same position as I was and is seeking guidance on how to return to Canada. Even during my time in Grenada and when doing rotations in New York, I enjoyed teaching the other students as well as nursing students at the various hospitals. Even now, when I know that I have a medical student working with me, it motivates me because I remember being in their shoes and it is so rewarding to help them learn.

Abdulla Al-Khan, MD

Dr. Abdulla Al-Khan is the vice chair and division director of maternal-fetal medicine and surgery at Hackensack University Medical Center, which is part of the Meridian Healthcare System. He is also the director and founder of The Center for Abnormal Placentation at Hackensack University Medical Center in New Jersey.

As a double-board-certified physician, he holds academic titles as an assistant professor of obstetrics and gynecology at the University of Medicine and Dentistry of New Jersey, New Jersey Medical School, and Seton Hall University School of Graduate Medical Education. He is an associate professor at St. George’s University School of Medicine.

After completing medical school at St. George’s University, Dr Al-Khan took an internship at Mount Sinai School of Medicine in New York City and a residency in obstetrics and gynecology at Seton Hall University in New Jersey. He was in academic faculty practice for two years and then proceeded to a three-year fellowship in maternal fetal medicine at the University of Medicine and Dentistry at New Jersey Medical School.

Dr. Al-Khan is recognized as an expert in high-risk pregnancy, caring for patients with the most complex medical and surgical conditions. He was the first physician in the world to perform a robotic transabdominal cerclage on a pregnant patient.

In 2008, he established The Center for Abnormal Placentation at Hackensack University Medical Center, a multidisciplinary center that was the first in the world to coordinate the care of patients who present with placenta accreta, a major cause of obstetric hemorrhage and maternal mortality.

What initially drew you to a career in obstetrics and gynecology?

I enjoyed all aspects of my medical studies, but I chose obstetrics and gynecology because it offers a combination of a number of disciplines, including pediatrics, surgery, psychiatry, radiology, and urology. It’s extremely rewarding to help women who have difficult pregnancies to deliver a healthy baby. It allows you to make an impact on the person in your care, wider society, and generations to come.

In 2008, you established the world’s first Center for Abnormal Placentation at Hackensack University Medical Center. What motivated you to do this?

Placenta accreta is a serious pregnancy condition that occurs when the placenta grows too deeply into the uterine wall and other pelvic structures (primarily the bladder). It’s a major cause of obstetric hemorrhage and maternal mortality. Fifteen years ago, I witnessed a pregnant woman suffering from placenta accreta in her second pregnancy. She required emergency treatment, 12 hours of surgery, and three days of surgical ICU admission on a ventilator with an open abdomen, followed by numerous surgeries in order to save her life. I told myself that I never wanted another woman to experience this. I dedicated my time to finding effective diagnoses and treatments for this condition and now have models which are replicated in the world’s leading hospitals.

The center provides much-needed comprehensive services to women who currently have no other place to go for expert care. Our innovative program has been developed and designed to serve as a template for regional, national, and international institutions. It has led to the improvement of pre-delivery diagnosis and delivery complications have been significantly reduced.

We have operated on 250 pregnant women with placenta accreta and have had a 100 percent success rate. I now have four PhD researchers dedicated to developing further diagnosis techniques and treatments, and our methods are being practiced across the world. We also have two senior research scientists actively working on data collection and outcome analysis. I have helped set up our care for placenta accreta programs across Europe, the Middle East, Far East, and of course the United States.

What are your hopes for the future of maternal health care?

Over 500,000 women die worldwide each year from pregnancy-related conditions. That is unacceptable. It’s heartbreaking to visit developing countries and see the rates of avoidable maternal death. Wealthier countries can change this by donating medical equipment we no longer use and continuing to research and share our knowledge with practitioners across the globe, particularly those with limited resources.

In developed countries, we’re seeing a significant increase in births by cesarean section each year, which directly contribute to problems with placental formation in subsequent pregnancies. Because of this, the incidence of placenta accreta will continue to rise, as will mortality rates for pregnant women. This trend is set to continue so further research is crucial if we’re going to improve the health outcomes of pregnant women and their babies. My goal is to establish methods for diagnosing placenta accreta in pregnant women with 100% accuracy as early as possible so we can provide timely treatment and avoid maternal deaths.

How did your experiences at St George’s University shape your career?

My time at St. George’s was extremely beneficial. Living in the Caribbean for two years was very different to my childhood in Bahrain and teenage years in the United States. I was 21 when I started my studies there and it made me mature quickly and gave me a work ethic and drive to succeed. My class of medical students was relatively small so we became close and this created a great support system. All the St. George’s professors were outstanding, and they encouraged me to push myself and have belief in my abilities. I had a fabulous education, and my desire to learn and succeed is still with me today.

What advice would you give to medical students at the start of their careers?

I would say that, while nothing in life is easy, if you work hard and take opportunities as they appear, then there are no limits to what you can achieve. Throughout your career, if you have ideas, speak up and be persuasive. Think big and never settle for less.

Andrew Persits, MD

Undergrad: Chemistry and Psychology, Boston University

Residency: Internal Medicine, SUNY Downstate Medical Center

Chief Residency: Internal Medicine, SUNY Downstate Medical Center

Fellowship: Cardiology/Interventional Cardiology, North Shore University Hospital

 

Last summer, you completed your interventional cardiology fellowship at North Shore University Hospital and began at Peconic Bay as an attending. How do you look back on the journey?

“It’s a little surreal. Each step along the way, you’re so focused on the next step in the process—residency, chief residency, fellowship, getting a job, another step exam, another board exam. Now I look back, I am so thankful for where it’s taken me and for those who have helped along the way.

“It’s really my dream job. I see patients in the office three days a week, and then I do procedures like angiograms, catheterizations, stents, and valve replacements the other two days. Some days I’ll round at the hospitals, I’ll read EKGs, or go where I’m needed.”

PBMC opened its new cardiac cath lab in October 2017. How has that changed the landscape of medicine in the region?

“Before the cath lab opened, patients would have to be transferred from here or Southampton Hospital all the way to Stony Brook University Hospital, which is an hour away give or take. It was an underserved population as far as Long Island goes. The new facility has already made such a difference.

“Recently there was an elderly gentleman who lived on Shelter Island—about 30 minutes east of here and even farther away from Stony Brook. He was driving back from a holiday trip when he began to experience chest pains. He stopped in the parking lot of our hospital, he was helped in, and we had him on the table within a half hour to open up his artery. If he had waited or gone back home, there’s a chance he might not be with us right now. The community has been very grateful, and we’re grateful for the opportunity to help.”

What initially prompted you to pursue cardiology?

“It had been my dream to be a doctor since I was 2 or 3 years old. One of my best friends growing up had open heart surgery twice, and seeing him go through that, with several trips to the hospital at such a young age, it’s one of those things that drew me toward cardiology.

“As an undergrad, I did some research through the Pediatric Cardiomyopathy Registry, which tracks children who inherited conditions that led to heart failure. I worked under Dr. Daphne Hsu, who was with Columbia at the time and is at Montefiore Medical Center, sitting in on procedures and consulting with patients.

“Then at SGU, I spent all of my first clinical year at Maimonides Medical Center, which is where I was born. When I was there—in addition to meeting the doctor who delivered me—I saw just how much cardiology factored into just about everything that went on there. We saw a wide array of patients of different ages and ethnic backgrounds.

“I really enjoy it. To open someone’s artery, to put in a stent, and to see them get better and go on to live a long, healthy life afterward, it doesn’t get much better than that as a doctor.”

How would you describe your experience at St. George’s University?

“I got an absolutely awesome education from SGU. I went to Grenada and made some very close friends. We were all going through something that only we could understand. Our parents can’t. Our friends from home can’t. We all went to SGU with the same ultimate goal—to become a physician. We knew that we were in the trenches together to make that happen for everyone. We all worked hard and we made it happen.”

In what ways did SGU’s support services help you during your time as a student?

“I received tutoring in anatomy and histology, which I hadn’t done much of in undergrad. Medical school is completely different from anything you’ve done before just because of the sheer volume of material that there is. At first, you don’t even know where to begin. The support and tutoring at SGU really help you focus your attention and give you the confidence that you can get through it. I’m very grateful for the help.

“Of my circle of friends, we all ended up in the specialties that we wanted, whether it’s interventional radiology, emergency medicine, anesthesiology, hematology and oncology, trauma surgery, pediatric dermatology, or for me, interventional cardiology. We all felt very prepared for the step exams, we did our clinical rotations in some terrific hospitals, and we learned how to become physicians.”

Denzil Etienne, MD

Undergrad: St. George’s University
Residency: Internal Medicine, SUNY Upstate Medical University
Fellowship: Gastroenterology, The Brooklyn Hospital Center

You grew up in Brooklyn and did much of your medical training there as well, including most recently as a gastroenterology fellow at the Brooklyn Hospital Center. How much did that background play a role in your decision to stay on as an attending physician?

Brooklyn Hospital is a great place to work. There’s great diversity in New York City. The people are quite friendly and grounded, which is important when you’re spending long days here and it’s one of the main reasons I stayed. I also stayed to be in an academic position, figuring ‘what better place to practice than the place in which I was taught?’ We have a number of fellows on the floors and with us during procedures, so there’s quite a bit of teaching and mentoring that happens each day. That’s the nature of the position, and it is extremely rewarding each day.”

What has the transition from fellow to attending been like?

Whereas a fellow is usually concentrated on the nitty gritty of a clinical case, an attending is responsible for that in addition to various social, administrative, and financial factors surrounding it. I have found that once you understand the medical aspects, the rest falls into place. There was some trepidation to remain in a program where I did my fellowship, but the process has been quite a natural transition for me. As a mentor, it’s rewarding when you’re doing procedures with a fellow, and you see significant progression in skill level over the course of a few weeks or months.

How did your upbringing shape your future as a physician?

I was born in Venezuela, and spent my formative years both in Grenada and Brooklyn. Growing up in each place really grounded me. Health care in Grenada is quite different than the US. However, as is the case in many parts of the world, both places are have groups of people with less access to specialized medical services. That was one of the driving factors in my decision to become a doctor and later to become a gastroenterologist. It’s important to me, as a physician, to give back and serve people who would otherwise not have access to specialty medical care.

During my fellowship and now as an attending, I’ve focused a great deal on colon cancer screening and awareness. There really is a lack of it in many parts of the world. We need to remedy that because, while colon cancer can be a devastating disease if caught in its later stages, it is also quite preventable.

I have to thank one of my mentors, Dr. Marios Loukas, who helped form the research fellowship in Grenada. I was part of the first class there and that experience was very beneficial and a nice launching pad into residency and even further into fellowship.

Was becoming a gastroenterologist always the end goal for you?

Not at all. I grew up playing the saxophone and piano, so at one point I thought I was going to be a jazz musician. Eventually though, there was a stronger calling to humanitarianism which guided me to pursue medicine.

At the start of my residency I thought I wanted to become a primary care physician, working in the community. I gradually realized that what I enjoyed more was being an authority on one particular field of medicine, which in this case was gastroenterology. What’s great about gastroenterology is that it isn’t monotonous. For me, I sometimes do consulting rounds on the medical floors and see office patients in the morning and focus on procedures in the afternoon. There is never a dull moment.

What advice would you give to a student who is just beginning his or her studies at SGU?

I encourage them to keep an open mind about the academic and cultural experience that SGU affords. In addition to focusing on their studies, I would try to immerse myself in some of the different activities that are happening everyday on campus. It is also important to forge long-lasting mentoring relationships and friendships that help you grow as a person and eventually factor into you becoming a great physician.

Eric Vail, MD

Undergrad: Binghamton University

Residency/Chief Resident: Anatomic and Clinical Pathology, Westchester Medical Center

Fellowship: Molecular Genetic Pathology, Cedars-Sinai Medical Center

 

You grew up in New York. What prompted you to move out west?

Molecular pathology is a very small specialty, and it just so happened that the spots in New York were filled by the time I was applying. After that, I really wanted to live in Los Angeles over some of the other cities on the west coast, and I thought the training at Cedars-Sinai would be great not just in terms of academics but the practical, on-the-ground education that really propelled me into the position that I’m in now. By the end of fellowship, I was fully confident that I would be able to run a lab.

I met my wife, Selina Vail, during first term at SGU. She’s now a family medicine physician. We live two blocks away from the hospital, and she works at an urgent care center four blocks in the other direction, so it works out.

What type of personality does it take to be a pathologist?

Everyone says a pathologist has to be reserved and antisocial, but I think that’s a really poor way of looking at it. I’m the exact opposite. Even though I’m not dealing with patients, we’re dealing with the rest of the patient care team, whether they’re oncologists, radiologists, or other clinicians. Essentially, we help to formulate the basis for which patients get treated. Almost every patient in the hospital has labs, so the way I see it, we’re treating every single patient in the hospital even if we’re not directly seeing them.

In the lab, you mentioned that you have limited patient interaction. What are the pros and cons of that setup?

Pathologists are the doctors’ doctor. You’re the one that, in the end, everyone comes to, and it’s your job to say, “this is the diagnosis; this is the answer.” There’s a mystery there, a puzzle to be solved, and pathologists get to be the final arbiter on most diagnoses. It’s immensely rewarding. I definitely miss patient interaction, which is something that I enjoyed a lot during medical school, but it’s one of those things where you close one door and open another. I think the benefits of this specialty, in a professional and intellectual sense, far outweigh the negatives.

In addition to your work in the lab, you’ve been active in academia. What has drawn you to that role?

I’ve been an instructor for both small-group and large-group sessions since residency, and expect appointment as an assistant professor here shortly. My feeling is, what’s the use of having all of this information if you don’t pass it on to the next generation? It’s amazing to see when something just clicks with someone. You start talking about something and you can see the gears going, and then all of a sudden they just light up. It’s a great feeling.

How has the SGU experience prepared you to be a successful physician?

When you go down to the island, you’re faced with a situation that you’re not used to. You’re on your own, yet you make new friends and your success is based on your own skill and work ethic. You need to be able to perform and to do it in a way that is acceptable for everyone. The experience really sharpens your teeth and hones your drive.

But you can’t make a diamond without pressure. You need that sort of pressure to push forward. With all the pressure that comes with medical school—any medical school—there was ample opportunity to relieve stress if you could. I lived in Lance aux Epines and looked out at Prickly Bay. It was pretty ideal. That said, another great quality that that taught us was restraint, the ability to moderate both your work and your play. You can’t succeed by just working. You need to compartmentalize your life. Learning to do that makes you a better doctor and a better person.

My group of friends at SGU included some of the best, brightest, and hardest-working people who also knew how to relax when they weren’t under the gun. That sort of balance led every single one of them to be immensely successful. There’s nothing better than working hard all day, finishing up, and going on a sunset cruise. No American school can compete with that.

My experience at SGU was fantastic. I look back on the entire experience with nothing but tremendous fondness.

Roxana Mehran, MD

Undergrad: New York University
Residency/Chief Residency: Internal Medicine, University of Connecticut
Fellowship: Cardiovascular Disease, Icahn School of Medicine at Mount Sinai

In addition to being an interventional cardiologist, you have long been an advocate for women in medicine. What drives you to be a pioneer in that initiative?

I want to see that there is equality and fair representation of women and minorities, not only as patients in clinical trials but also across the field of medicine. The number of female cardiologists delivering health care to patients is tremendously low–just 20 percent. And for interventional cardiologists, it’s under 5 percent. Women also earn considerably less over the course of their careers than men. My mission is to make sure that women are well represented and well respected.

Have the numbers improved over the years?

Not as much as they should. If you look at the last 10 years, the percentage of interventional cardiologists in the US who are women has stayed between 4 and 8 percent. I recently wrote in JAMA Cardiology that I felt women had cracked the glass ceiling, but we really haven’t. We’ve made important strides, but there is still so far to go.

For your work, you were recently bestowed the Wenger Excellence in Medical Leadership Award by WomenHeart, as well as Bernadette Healy Leadership in Women’s Cardiovascular Disease Award from the American College of Cardiology. What was your reaction for earning such distinctions?

I’m very humbled. These awards fuel the fire in me to continue this work and reduce cardiovascular disease in women and minorities. In fact, improving the care of women with cardiovascular disease also ties closely with my work to improve representation of female cardiologists. There is strong evidence connecting female cardiologists to improved outcomes for female patients. It’s unconscionable to believe that, in 2018, there’s discrimination against women in medicine. We have to stop that. It’s an honor to receive awards, but it’s not about the recognition. It’s about having a platform to help my fellow women colleagues, as well as patients, who are underrepresented.

Going back to when you were first getting started. How did a career in cardiology come on to your radar screen?

I was part of one of the very early classes of SGU, and very determined to build a career in medicine. I didn’t want to go into cardiology immediately, but my exposure to cardiology, my love for cardiology came when I was a fourth-year student at Mount Sinai Hospital. I remember working in the critical care unit and loving every single minute of what I did. Once I got to the catheterization lab, I knew that that’s what I wanted to do, even if it meant working the crazy hours. Twenty-five years later, I can say very strongly that it was absolutely the right choice.

Can you elaborate further on the passion you have for this particular field?

Interventional cardiology is one of the most rewarding sub-specialties. We get to perform procedures involving cutting-edge science. I’m able to work on one of the biggest problems in the world—cardiovascular disease. We are literally saving lives every single day. To be in the driver’s seat for that, how much better could it be?

Paulina Buraczynski, MD

You were an environmental sciences major at Syracuse University. What prompted you to transition to a career in pediatrics?

“One summer, I started volunteering at a local children’s hospital. I saw how the nurses and doctors interacted with the children, and at times, I felt there was a minimal to no interaction at all with the actual patients but solely with the parents. I understand that children may be too young to fully understand what is happening and do not even have choice in the matter, but it doesn’t mean they should be left out of the loop. They are the ones that everything is happening to. It made a big difference once you explained in simple terms to the children what is happening and what will happen. I decided I wanted to change that mentality, that children should be part of the discussion.

“In pediatrics especially, it is incredibly rewarding to know that your hard work is going to change a person’s life, to see a child who’s knocking on death’s door recuperate and grow into a normal child that no one would even know the troubles they went through. I don’t know if there is a greater sense of personal satisfaction. The beauty of pediatrics is that you get to see your patient grow through life. You may have started to see them when they were just born and continue to see them until they are 18 or even over 21. You create a much stronger bond with the child and family.”

You became a mother recently. How did having a child of your own change your perspective?

“It has changed everything. It’s really been a total 180 for me. In the NICU, you know a woman has been preparing this child for 40 weeks, and if they end up in my unit we all know this wasn’t the way it was supposed to unfold. The version that has been building up for months is not in shambles. Fortunately for me, I never experienced what it was like for my daughter to be in the NICU, but I can only imagine how I would feel. The most joyous time in someone’s life becomes one of the worst. As a mother, it’s very difficult to be able to compare these women and what they are going through to yourself. You now can empathize with them, thinking of your little one in the position that theirs is in.

“It can be difficult to disengage at the end of the day, constantly thinking about the babies and parents. I feel a very deep connection now that I am a parent. It changes your perspective on the entire world, not just medicine.”

Can you elaborate further on the kind of relationships that you form with the families you see?

“Since I work in the NICU, you develop a very personal and deep connection with the families, and especially mothers. You are in the trenches with them, helping them through possibly the worst moments of their lives. Here in Hawaii the word ‘Ohana’ means family and togetherness, and ‘Aloha’ means love and unity, both words run very deep here. The Hawaiian culture is very family centered, which can make your job easier or more difficult. But once you have entered that sacred bond with the families, you become Ohana, a part of their family. I know this is very different when compared to other parts of the United States.

“Truthfully, everything you learn in medical school or during residency doesn’t adequately prepare you for the personal connection you need to make with families and patients. You learn how to read people very quickly and well, and that something that might work for one patient could be considered offensive to the next.

“My job is to help these babies come out of the NICU and live the most normal life they can, but also to give the family hope, patience, and love.”

Do you have a story from your time in the NICU that stands out in your mind?

“There was one scenario where we had a full-term baby who had hypoxic ischemic encelopathy (HIE). The directors of the NICU, PICU, and all of our specialists had thought it was a lost cause, that damage was too severe to continue on. After multiple discussions with the parents to withdraw care, they persisted to fight. Since Ohana and Aloha are big components of life here, this isn’t that uncommon. We all were convinced this was a lost cause and the child would never leave the hospital alive. That was a year and a half ago. After a few months of intense treatment, ECMO, dialysis, she was finally discharged at eight months. That same baby came back two months ago, and you would never have guessed the complications that she went through. There were delayed milestones and some other issues with vision, but otherwise as healthy as can be. You never would have guessed that this is the child that everyone almost gave up on. This situation showed us the true miracle of medicine and that we, even though we think we do, don’t know how the human body can respond. I see the miracle of modern medicine every day.”

Hawaii’s only your latest stop. You were born in Poland, and grew up in Canada and Syracuse, NY. How would you describe your experience as a student in Grenada?

“I loved it. I’m pretty adventurous and love to travel, so I had a great time exploring the island and the surrounding islands. Weekend getaways to different parts of the island were the norm, Fish Friday in Gouyave every other Friday, snorkeling, sailing, hiking, and the hashes. Grenada holds a very special place in my heart. I even met my husband there (Gautham Kanagaraj, MD SGU ’12), who recently finished up his cardiovascular disease fellowship at the University of Hawaii. I hope to take my daughter there one day and show her where it all began.”

Tanzid Shams, MD

Undergrad: Harvard University
Residency: Pediatrics, New York Medical College at Westchester Medical Center (2008-2010); Neurology, Columbia University Medical Center (2010-2013)
Fellowship: Clinical Neurophysiology, University of Texas Health Science Center

Why did you choose neurology for a career path?

“There are so many different things you can get into. For me, I was passionate about brain health and sports medicine, so concussion is the perfect overlap. I had done two years of pediatric training at Westchester Medical Center and three years of neurology at Columbia University Medical Center as part of a combined program, and that’s when some of the stories surrounding the NFL and how football players were demonstrating long-term psychological and neurological derangements.”

What have you done to expand health care coverage for the population in your region?

“When I joined three years ago, I was the only hospital-based neurologist for a 13-hospital network. We have since merged with another group, so we are now providing care for 29 counties in Tennessee, southern Virginia, and North Carolina.

“Over the course of the last three years, we have been able to transform our hospital from primary to comprehensive stroke center. Out of 5,000 or so hospitals in the United States, only 72 others have this designation. It’s very meaningful. The patients in Tennessee are so appreciative, and that really has a huge impact on your work-life balance. From the beginning, what I liked about this job is that it was an opportunity to build something from the ground up.”

How does rural health care differ from what you experienced growing up?

“I was raised in Bangladesh and went to high school in New Jersey. My time in the US has been in three big cities—New York, Boston, and San Francisco—so to work in Tennessee is eye-opening for me. Growing up in the northeast, I had no idea how underserved some parts of America are. If you’re in the northeast, you can choose from hundreds of neurologists. Here, it’s very meaningful to provide care to patients who don’t have a lot of access to medicine.”

You have said that you enjoying launching new projects. Can you describe some of your recent initiatives?

“I have been working on incubating several healthcare startups. The first one is called concussiontriagenetwork.com. The concept is that if a mom or dad is on the sidelines and their son or daughter takes a tough hit and looks groggy, they can use an app or iPad to dial up a neurologist and have a video assessment done within three to five minutes. Right now, it’s in a healthcare incubator and we have seed funding launch the company.

“My second startup is called Sentinel Healthcare, which is at a more advanced stage. Because it’s hard to predict who’s going to be sick, we built a health care platform that can take data from your blood pressure monitor at home, and we can monitor it remotely. We recently won the Seattle Angel Investor startup competition, beating out 64 other startups. We’ve been able to raise about $200,000 to this point and hope to build momentum toward Serie A financing.”

In what direction do you see digital health going in the future?

“Right now, I think it’s just the tip of the iceberg. One day I think that you’ll likely see health care data readily available to health care companies so that when people are at home and they’re hypertensive or suffering from sleep apnea or COPD, a system is set up so we don’t have to wait until people are sick. We’ll be able to see who’s getting sicker and give them the care they need immediately. It’s just a matter of how we can scale this process for 100 or 1,000 patients, how we can leverage technology, analyze the data, and make better health care decisions.”