For Carmen Roessler, MD ’14, there is great joy in the company she keeps. The native South African splits time between three sites within England’s National Health Service, including a rehabilitation unit for predominantly older patients who require physical and occupational therapy. It’s her job to develop their functionality and, ideally, their independence.

Along the way, she appreciates getting to hear about the path they took in life, and applying their healthcare goals to the treatment plan she gives them.

“They often have different insights and some amazing stories,” she said.

Dr. Roessler recently shared her story, one that began on a sugar cane farm outside of Durban and has taken her around the world.

What do you enjoy most about working with an older population?

I enjoy interacting with people who have had a lot more time in this world than I have. And along with that, people in this part of their lives can be quite lonely and frustrated. I’m glad to get a feel for who they really are and what’s important to them. There are nuances to caring for them as their priorities may be different than someone who is middle-aged.

What is one challenge facing physicians in this field?

One challenge is that there’s not a lot of evidence out there that’s based on putting older people in studies. If you think about most of the medicines that we take, they’re based on younger people having been in the clinical trials. I think there are limited insights into how medications are processed by older people. People at different stages of their life are going to respond to medications differently. This is an area of medicine where there needs to be more research, and we also need more people to be trained to work in this sphere of medicine.

You completed your GP training in the heart of the COVID-19 pandemic. How do you believe it’s changed medicine?

COVID is still a major concern. It’s an ongoing threat to human life and human quality of life. One thing it has done is accelerate some of the technological advances that were probably already coming our way. There are benefits, but seeing someone in person can sometimes give you clues that you aren’t privy to if you’re having a telephone consultation. I think primary care is trying to balance and negotiate that very carefully.

When did pursuing an MD come on your radar?

I grew up on a sugar cane farm in South Africa. We had a bit of timber and cattle as well. I think the earliest roots of my interest in medicine were in nature or biology, and was probably inspired by growing up with a lot of contact with the outdoors. And then later on, I had a great aunt who was ill with cancer, and I found it rewarding to be able to offer her emotional support.

You spent your first year in the SGU/NU program in the UK. What was that like?

My experience in the Global Scholars program in the UK was brilliant. We had a smaller class size and we were a really tightly knit group. We built this sort of mini community that studied together and, when exams were over, we’d celebrate together. It was a fantastic bond. Together it was a time of growth and learning across multiple spheres.

In what ways did attending SGU help shape you as a physician?

Going to SGU exposed me to different cultures, different ways of thinking, and different ways of communicating. I think that it made me richer on a personal level; not only that but it has also made me a better communicator and hopefully, therefore, a more understanding doctor.

– Brett Mauser

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As an infectious disease fellow at Louis Stokes Cleveland VA Medical Center, Lewis Musoke, MD ’16, is combating two pandemics at once—COVID-19, which the world has grappled with for nearly two years, and the still prevalent human immunodeficiency virus, better known as HIV.

Growing up in Kenya, Dr. Musoke was all too familiar with HIV. It was not only in the community but in his household and his circle of friends. That’s why he has committed his career to not only caring for patients afflicted with such diseases but making sure that his community is equipped with the information and resources they need to prevent it.

The St. George’s University graduate shared what he sees as similarities between the two pandemics, and the role he thinks the greater community can play to assist in the fight.

SGU: What do you think is the biggest issue in the HIV community?

Dr. Musoke: There’s a lot of stigma when it comes to HIV, and while we’ve come up with good medications to treat and suppress the virus, we still haven’t gotten to the point where we can sit down and talk about it the way we talk about diabetes or high blood pressure without feeling ashamed. And if you’re not talking about it, then in all likelihood you’re not thinking about it.

This percolates even to the physician level where people are not even testing for it as frequently as they should. We’ve become good in screening for things like colon cancer and breast cancer, but we’re still falling way short of the mark for screening for HIV, and it shows in high prevalent areas where we’re still having a lot of new infections.

SGU: What parallels do you see between the HIV/AIDS crisis and the ongoing COVID pandemic?

Dr. Musoke: The viruses are different but the principles are the same. One of the things that we can learn from HIV is the importance of getting the community engaged and educated. I think a problem that we have in this country and in the world is there’s a lot of misinformation, even at the provider level. It’s affecting our ability to be able to respond.

Back in the 1980s, the lack of education and desire to talk about HIV was what inhibited the progress of treating HIV. But the government shifted and now basically any HIV positive patient in the country, whether or not they have a job or access to healthcare, has pretty much subsidized healthcare through federal funding. My hope is that—as providers, physicians, patients, and the community—everybody understands the seriousness of these pandemics, and that we’re better equipped to tackle it as a whole. You can’t really isolate them to one part of the country. Everyone has to get involved, from all age groups or from all walks of life.

 

SGU: What drew you to specializing in infectious disease?

Dr. Musoke: Growing up in East Africa, you’re exposed to HIV from a very young age. HIV was—and still is—a prevalent issue not just in the community but within your household and circle of friends. What was inspiring to me was how, as drug development and treatment options improved, I started to appreciate the role that community outreach played. Some of the clinical trial data and outreach strategies that were implemented in East Africa ended up being used in the United States and around the world.

What solidified this career path for me was a public health field practicum through Boston University that turned out to be in Kenya. It was in a beautiful area right at the base of Mount Kilimanjaro. I had never lived there, but I had probably driven past it as a child. The purview of the project was to evaluate public health interventions that had been placed in regard to improving access to water. Doing that made me realize the importance of public health, and also that a lot of those health issues were infectious disease related

SGU: How well did you fit in at SGU?

Dr. Musoke: It was clear very early on that SGU was the perfect fit. I went there and knew six or seven people from Kenya, but then you got to meet people from different parts of the world. It was beautiful to learn about their experiences and the different paths they were on. It was a strange sense of almost feeling like I was home.

I made a lot of close friends, and I even met my wife (Chandula Seneviratne, MD ’16). For those reasons and more, SGU has a special place in my heart. I wouldn’t have done anything differently.

SGU: As an international student, did you have the support you needed?

Dr. Musoke: The basic sciences training was rigorous, but you have a lot of support from the Department of Educational Services. If you’re struggling with something, you have a good support system to help you get back on track. And SGU doesn’t create this illusion that it’s going to be easy. They make you work for it, and I think that’s key. In my clinical rotations, a lot of the physicians were very impressed with how hard-working and diligent we all were, and I think that came from training at SGU. I think that if you put the work in and network, you’re going to make it far, if not further than any US school graduate.

– Brett Mauser

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What does it take to be a urology resident?

“You must be extremely hard working and empathetic at the same time,” said Devon Thomas, MD ’20, a second-year resident at The University of Florida College of Medicine—Jacksonville in the Department of Urology. “We are often taking care of patients in their most vulnerable state, which requires a lot of compassion and maturity.”

In urology, one of most competitive medical fields to get into, Dr. Thomas said her training varies day-to-day. “It includes both inpatient and outpatient responsibilities with the majority of my training focusing on surgical skills and surgical training for the genitourinary system,” she said.

Dr. Thomas shared what’s most exciting about the specialty for her, her plans post-residency, and the essential advice she has for aspiring physicians.

St. George’s University: Why did you choose this career path/specialty? Did you always want to become a doctor?

Dr. Thomas: I always wanted to become a doctor. I truly can’t remember a time I didn’t want to be a doctor and I grew up telling people I was going to be a surgeon. I had some medical conditions as a child, so I actually became very familiar with hospitals and being around doctors, and I was always intrigued by the medical field. I also really like working with my hands and helping people, so I felt surgery was my true calling.

SGU: What excites you most about the work that you do? 

Dr. Thomas: The most exciting part of my job is definitely the surgical aspect. I love getting new cases and trying to analyze the best avenues for treatment and patient care. Each patient is different and requires a slightly different surgical approach, which requires using some creativity when devising a surgery plan.

SGU: What was your reaction when you found out where you were headed for residency?

Dr. Thomas: I was ecstatic when I got my residency match. Urology is one of the most competitive specialties in medicine so I was very anxious that I wouldn’t match into it. When I got the email that I not only matched into the specialty of my dreams but also was getting to go back to my home state, I truly could not have been happier.

SGU: How well do you feel that SGU prepared you for this next step in your journey?

Dr. Thomas: I think SGU prepared me extremely well for residency. SGU gave me the foundation to be an excellent basic sciences student, which helped me excel on the USMLE exams. In my clinical rotations, I was constantly pushed to be the best clinical student I could be, which in turn made me a hard-working resident. I wouldn’t be where I am today without SGU.

SGU: You were recently named “Intern of the Year” by the hospital where you work. Describe how that made you feel.

Dr. Thomas: It was great to see that all of my hard work throughout the year was recognized by my mentors and made me want to continue to strive for even more excellence.

SGU: What insights would you share to future PGY-1 residents about what residency is like?

Dr. Thomas: Future PGY-1s should know that residency is unlike anything they’ve ever done before. They will have more responsibility than they ever have. At first, it can feel very overwhelming, but in the end it is worth it. In addition, you will always have people to learn from and support you, which makes things easier.

SGU: What advice would you give to someone on a similar journey to becoming a physician?

Dr. Thomas: My advice for future physicians is—don’t give up and don’t take no for an answer. There were multiple times along my journey that I heard “you won’t match into urology,” but I refused to believe that and worked even harder when someone doubted me.

SGU: What’s next after residency?  

Dr. Thomas: I’m looking at fellowships for when I finish residency. I am interested in becoming a reconstructive urologist and am trying to begin preparing my applications for that.

 

 

– Ray-Donna Peters and Laurie Chartorynsky

 

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