By Amy Widner

What does it mean to wear the physician’s white coat?

Reassurance. Competence. Professionalism. Cleanliness. Responsibility. Trust.

For patients, yes, but what about for the College of Medicine Class of 2023? Its 174 members donned their white coats for the first time during the White Coat Ceremony, held at Robinson Auditorium before a crowd of family, friends and faculty.

For the medical students, the white coat ceremony marks a transition to a new journey, said Neil Masangkay, M.D., assistant professor of neurology and director of the neurology medical clerkship.

“The journey that you are embarking on is a difficult one,” Masangkay said. “Your days will vacillate between moments of terror, sorrow and joy. How do you survive those highs and those lows? I think the most important principle is the simplest: Caring.”

Masangkay told the freshmen to be prepared to make sacrifices as physicians. Missed events, a lack of sleep, and disappointing friends and family with cancellations — it all comes with the job.

“You will get thanked for your work, but often in unexpected ways,” Masangkay said. “I know many physicians who receive food and thank you cards. The most recent gift I received from a patient was a box of Marvel super hero Band-Aids.”

Masangkay told the students to “grow your passion” rather than to simply follow it. To do this, he said, students must adopt a craftsman mindset to their work and dedicate themselves to the effort needed to master the art of medicine.

“To achieve mastery, you will have to learn to toil through long hours when you don’t want to review anatomy anymore, when you don’t want to practice that physical examination or surgical technique, when you would rather sit down and catch up on Netflix,” Masangkay said. “The ability to constantly push yourself to improve is perhaps the most important part of becoming a satisfied and passionate physician.”

Lastly, Masangkay urged the students to not lose sight of themselves during their journey to becoming physicians. Make sure to care for yourself, he said.

“Care for your family, care for yourself,” Masangkay said. “Although we serve an important calling in our professional lives, there is no calling more important than the one that we serve for our friends, our family and ourselves.”

When it came time for the students to put on their coats, they first recited the medical student oath together, pledging to conduct themselves with integrity, compassion, collaboration and a commitment to medicine. They then crossed the stage one at a time. Each student was allowed to select special people to help them put on their white coats, or they were aided by representatives of their respective “houses” — smaller groups the students stay in throughout medical school for peer support and faculty guidance.

The students also heard from UAMS Chancellor Cam Patterson, M.D., MBA; College of Medicine Dean Christopher T. Westfall, M.D.; and Dennis Yelvington, M.D., president of the Arkansas Medical Society.

Patterson urged them to care for each other during their medical school journey and to act like team players during their four years as part of the wider UAMS community.

“This white coat will be a link that connects you to everyone in your class,” Patterson said. “You don’t understand it now, but you will create a bond together among some of the strongest of your lifetime.”

Patterson encouraged the students to think about Edith Irby Jones, M.D., who in 1948 became the first African American to enroll in an all-white medical school in the South when she began her education at UAMS. She graduated from UAMS four years later and went on to have a distinguished career. Patterson asked the students to consider her bravery, but also how her classmates ideally would have treated her.

“Think about that level of respect, appreciation and encouragement that you hoped they gave Edith Irby Jones, and I want you to share that same level of respect, appreciation and encouragement with the people you will be working alongside at UAMS, 10,000-plus strong, over the next four years,” Patterson said.

Westfall told the students about his recent experience during the birth of his first grandchild.

“As you put on your white coat for the first time, and each time from now on, please remember what it stands for from the perspective of your patients and their families,” he said.

“Because of those things symbolized by the resident’s white coat — knowledge, trust and care — I relaxed,” he said. “I relaxed as a dad, a soon-to-be grandpa, and a very nervous incognito doctor and dean of the College of Medicine.”

By Amy Widner

Researcher Robert Eoff, Ph.D., has received a $1.2 million grant from the National Science Foundation to continue his work at the University of Arkansas for Medical Sciences (UAMS) on DNA damage, cell replication and its implications for diseases like dementia, ALS and cancer.

Eoff is an associate professor in the Department of Biochemistry and Molecular Biology in the UAMS College of Medicine and a member of UAMS’ Winthrop P. Rockefeller Cancer Institute. Julie Gunderson, Ph.D., assistant professor of physics at Hendrix College in Conway, is collaborating with Eoff on the project. The four-year grant will also support graduate student training at UAMS and undergraduate trainees at Hendrix.

Eoff’s research team studies what happens when DNA damage is not repaired in a timely manner and ends up blocking the mechanics behind how copies of new cells are made. Specifically, he studies the effect of large amounts of guanine in DNA sequences, which can form unusual structures called G-quadruplexes (G4).

“Imagine trying to copy a document containing over six billion letters in the span of a few hours,” Eoff said. “Now imagine finding that the text contains many words like ‘Mississippi,’ ‘Czechoslovakia,’ ‘Oberschleissheim’ and ‘Solgohachia.’ Even though you’re on a tight schedule, you might have to slow down a bit when you come to those tricky words.

“As it turns out, this is probably a good analogy for what happens when enzymes involved in DNA replication encounter certain sequences that contain an abundance of guanine bases,” Eoff said.

Errors in these G4 sequences can lead to changes in the genome that are associated with human disease. For example, neurological diseases such as frontotemporal dementia, amyotrophic lateral sclerosis (ALS), and the intellectual disability fragile X syndrome have all been linked to dysfunctional G4 maintenance.

There is also a substantive and growing body of literature linking G4 to the biology of cancer and cancer therapies. Many cancer-related genes are controlled by G4 motifs, and chromosomes in tumor specimens tend to be broken more frequently near G4 sites than other DNA sequences.

However, scientists do not fully understand how these errors occur.

For this specific grant, Eoff will study the role of a special enzyme called Rev1 in copying G4 sequences. Rev1 is a DNA polymerase — an enzyme that catalyzes synthesis of new strands of DNA.

“Successful completion of this research will give us a better understanding of how G4 replication errors occur and how they might have come about in the first place,” Eoff said. “Hopefully, this will give us new insight into replication barriers, which cause a wide range of issues in humans and other species, as a first step toward putting this greater understanding to use in the form of new treatments and therapies.”

By Amy Widner

Five UAMS medical students spent a week of their summer helping 13 high school students learn about brain science and STEM careers at CampNeuro.

This is the fourth year that UAMS has hosted CampNeuro, which is administered by a national organization but planned, organized and taught by students and faculty at the host sites. The student organizers are headed into their second year in the College of Medicine in the fall.

Student Board of Directors Chair Morgan Sweere said running the camp was a good way to reinforce what the students had learned during their first year of medical school. Working alongside their professors, she said they observed how to teach medical concepts in a way that younger students could understand — a useful skill for any future physician, whether they intend to go into academic medicine or simply want to communicate effectively with patients.

That said, Sweere said the students were an enthusiastic group who not only grasped the concepts but stayed engaged and asked great questions. Most of the students were from central Arkansas, although one participant was from out of state. Some wanted to become doctors, but most were interested in clinical psychology or researching drug abuse. The program is designed for students with any STEM (science, technology, engineering and math) interest, not just future doctors.

“Encouraging people to go into STEM fields is important, whether it be a graduate program or medicine or another health care field,” Sweere said. “For students their age, I think it’s really important to show them where they can go with that kind of training. It can go in a lot of different directions, so we tried to expose them to a variety of career paths, and most of the people they interacted with also told them what training it took to get to their position.”

Sweere said the students tried to use the many resources available at UAMS, not only to keep things engaging for the students, but to make them more aware of everything the institution has to offer.

For example, the students performed a sheep brain dissection and suturing lesson in the anatomy lab. They used the UAMS Simulation Center to learn about stroke, lumbar punctures and intubation. They also used the Center for Clinical Skills to take a patient history, perform a physical and do a detailed neurological exam. They played games and did a mock team-based learning event. They used the anatomy lab’s Sectra virtual dissection device, which is a touchscreen technology the size of a table through which students can explore anatomy in 3D.

There were also lectures on everything from traumatic brain injury to psychiatric disorders, drug abuse and neuroimaging. The speakers included:

• Rudy L. Van Hemert Jr., M.D., neuroradiology
• Charles Matthew Quick, M.D., pathology
• Aliza Brown, Ph.D., radiology
• Kevin Phelan, Ph.D., neurobiology and developmental sciences/li>
• Lauren Russel, Ph.D., candidate
• Rani Lindberg, M.D., physical medicine and rehabilitation
• Purushottam Thapa, M.D., psychiatry
• John Spollen, M.D., psychiatry
• Wendy Ward, Ph.D., clinical psychology
• Jerrilyn Jones, M.D., emergency medicine

The other student co-directors were Hayden Scott, Kristina Kennedy, Ushna Ilyas and William McEver. Additional students from their class helped on an as-needed basis.

“All of the faculty at UAMS were super willing to help, and we were grateful for that,” Sweere said.
Sweere said they were able to work closely with the high school students, getting to know them and giving them advice on their next steps for education after high school. Scott agreed.

“All of the kids who participated in the program were super excited,” Scott said. “You could tell they were very knowledgeable. Being so young, it was kind of inspiring. It was pretty cool to see the level these students were at academically. The opportunities available for young students interested in STEM are truly amazing, and having the chance to help lead a program like this was an awesome experience.”

By Spencer Watson

The Head Start/Early Head Start Program in Pulaski County, which has been administered by the University of Arkansas for Medical Sciences (UAMS) Department of Pediatrics since 1998, has received a grant of $41 million from U.S. Department of Health and Human Services.

The grant will be used to operate the program and is structured to provide $8.2 million a year for five years. Head Start/Early Head Start is a federally funded program designed to increase school readiness of low-income children.

The Pulaski County Head Start/Early Head Start Program serves more than 700 students age 6 weeks to 5 years and their families through both center-based and home-based programs across the county.

“Being chosen for this grant award in an open competition is very gratifying and proof of the good work this program has been doing for 20 years,” said Eduardo Ochoa, M.D., section chief of community pediatrics and an associate professor of pediatrics in the UAMS College of Medicine.

Ochoa said he was particularly pleased to have a variety of agencies partnered with the program submit support for the UAMS Head Start grant application.

“It just shows the value of the partnerships we’ve made all over the county and how important it is to serve the families we do,” he said.

The grant will allow some changes to the program’s design and management including:

• Increasing both the number of children served in Early Head Start and in home-based services, with an emphasis on serving pregnant women and a particular focus on teen moms and a growing Latino community;
• Centralization of services and consolidation of centers from 12 facilities to 9; collaborating with University of Arkansas – Pulaski Technical College both as a hub location, serving up to 249 children and housing the program’s administrative office, and using the college’s resources and staff in addition to those of UAMS;
• Strengthening teacher performance by using the Shine Early Learning Teacher Success Rubric as part of the program’s coaching and professional development plan; and
• Hiring two deputy directors to focus on providing quality services, full enrollment and program management.

“We are so grateful UAMS can continue serving the community with this comprehensive program, which is so needed,” said Tyra Larkin, director of the UAMS Head Start program. “We want to be the best program we can by focusing on closing the achievement gap for at-risk children and delivering high-quality services to families.”

Under the administration of the Department of Pediatrics in the UAMS College of Medicine, the program in Pulaski County offers more than traditional Head Start programs. Children and their parents also have access to health, nutrition, dental, disabilities, oral health and mental health services from UAMS and other providers. The program also provides service learning opportunities for students in the UAMS colleges of Medicine, Nursing, Health Professions and Public Health.

By Benjamin Waldrum

The University of Arkansas for Medical Sciences (UAMS) has received a $100,000 gift from the estate of Ambrose T. Walker Jr., M.D. to enhance the A.T. and Gladys Walker Memorial Scholarship in the UAMS College of Medicine.

“We are profoundly grateful for the enduring generosity of the late Dr. Walker and his family,” said Christopher T. Westfall, M.D., FACS, executive vice chancellor of UAMS and dean of the college. “Scholarships make all the difference in easing the burden of medical school debt while helping us recruit the very best students. Many outstanding physicians have benefited from the A.T. and Gladys Walker Memorial Scholarship over the past 25 years, and this new gift will help make medical school possible for countless more.”

The scholarship, awarded to a medical student with financial need and moral character, was established in 1994 in memory of Walker’s parents, with an initial gift of $30,000.

Walker was a 1946 College of Medicine graduate. He was a family practitioner in Thayer, Missouri before retiring to Springfield, Missouri. He passed away in 2018.

His mother, Gladys McKamie, taught school in a small rural community near the Red River in Texarkana. A.T. Walker was a salesman and worked for a family-owned wholesale grocery company in Stamps, Arkansas. “My parents were very supportive of me,” Walker said when the initial gift was established. “They helped me financially the best they could and encouraged me in every way. One of the happiest moments was when I received my M.D. degree. They were proud of me and I am proud of them.”

Walker was the eldest of three sons. As a child, he witnessed his brother, Jimmy, die of meningitis within a 24-hour period, and soon after, his youngest brother, Billy, became gravely ill. Although the family traveled to Shreveport, Louisiana to get Billy the best available medical treatment, he died of leukemia. These deaths affected Walker greatly.

Although Walker attended college on a musical scholarship, he switched his studies to pre-med and completed his medical degree in three years. After interning at Lutheran Hospital in Cleveland, he was assigned to the National Naval Medical Center at Bethesda, Maryland, for six months. Thereafter his postwar duties took him to the Caroline Islands in the western Pacific Ocean, where he served for two years.

Upon his honorable discharge from the Navy, Walker served an obstetrics/gynecology residency at St. Vincent Infirmary in Little Rock before beginning his general practice in Mammoth Springs, Arkansas, and then in Thayer, where he practiced for 40 years.

“There was no one like him – he was so caring about his patients,” said his wife, Carol. “What Ambrose wanted to do was serve people who needed medical attention, who may or may not have been able to afford it. He accepted people for who they were and valued them, and they knew it. I hope this scholarship can help students to focus less on making money in their careers and more on really caring about people.”

The College of Medicine has educated and trained more than 10,000 physicians since 1879, and has an annual enrollment of nearly 700 students. It is regularly listed in the top 10 nationwide for the percentage of its graduating class that pursue a career in family medicine. More than half of the practicing physicians in Arkansas are UAMS graduates.

More than two-thirds of Arkansas’ 75 counties include federally designated Primary Care Health Professional Shortage Areas. Primary care physician shortages are projected to increase substantially as the state’s population continues to age and require more medical care, and as more Arkansans seek primary care services.

The high cost of medical school and the burden of educational debt that most medical students face when entering their postgraduate residency training can be a factor in choosing higher-paying specialties instead of primary care and practicing in rural areas. The average medical school debt of recent UAMS graduates who have educational debt is about $190,000.

Tourist attractions are the usual highlights on a bus tour, but Becca Perin, M.D., had different sights on the itinerary for more than two dozen new UAMS pediatric interns this summer. Each stop was planned to help them provide the best possible care for some of Arkansas’ most vulnerable children.

“The bus tour was a way to show our brand new interns, who are just beginning their training to become pediatricians, some of the many things that impact a child’s health,” said Perin, an assistant professor in the General Pediatrics Section of the Department of Pediatrics who serves as an associate director of the Pediatrics Residency Program.

“The medical care we provide in clinic at Arkansas Children’s Hospital is just one small element of taking care of a child,” she said. “Social determinants of health are extremely important, and we wanted to show our interns what it means, for example, to have food insecurity and live in a food desert with limited access to nutritious, affordable food, and what it is like to have housing insecurity.”

The June 20 tour introduced the interns to many community organizations that serve low-income families and children with special needs, such as the Immerse Center, which supports children aging out of foster care and other youths in crisis.

“For many families in need, their child’s pediatrician may be their only access point for learning about community resources, and they look to their pediatrician for help in navigating those resources,” said Perin, who modeled the bus tour partly on an innovative program at Children’s National Medical Center in Washington, D.C.

The interns also learned about the role of Central High School in the integration of public schools and the Civil Rights Movement, and explored African American history and culture at the Mosaic Templars Cultural Center.

An internship is the first year of residency training for medical school graduates. A pediatrics residency is three years, and many graduates continue their training with a fellowship in a subspecialty such as pediatric cardiology, neonatology or critical care medicine for one or more additional years. This year’s 26 pediatric interns came to UAMS and Arkansas Children’s from 16 states and two other countries. Five interns training in medicine-pediatrics, a four-year program, also participated in the bus tour.

Sydney Middleton, M.D., a pediatric intern who graduated from the University of Alabama School of Medicine in Birmingham, was eager to learn about factors impacting the lives of the children and families she will be caring for during her residency. She had been active in the student-run free clinic in Birmingham, serving as the organization’s outreach executive officer during her second year.

“So much of patient care involves social elements that are not taught in textbooks in medical school, so getting out in the community and learning about those we care for was an invaluable experience,” Middleton said.

“The tour was incredibly well done, and it helped me start to recognize some of the disparities, resource needs and locations of our families within this community,” she said. “It also provided me with options for how we can address some of these needs. I am so grateful to Dr. Perin for putting this together because now I have a better, clearer perspective from which to care for my patients while here in Little Rock.”

James Graham, M.D., a longtime educational leader in the UAMS College of Medicine, has been named the college’s next executive associate dean for academic affairs. He will begin serving in his new role following the retirement of Richard P. Wheeler, M.D., on January 31, 2020.

“Those who have worked with Dr. Graham in his current post as associate dean for undergraduate medical education know that he brings great enthusiasm, collegiality and dedication to our educational mission, as well as extensive experience in medical education and strong institutional knowledge,” said Christopher T. Westfall, M.D., FACS, executive vice chancellor of UAMS and dean of the college. “These strengths will serve Dr. Graham very well as he leads our academic mission in collaboration with our outstanding leaders in undergraduate medical education and student affairs.”

Graham graduated from the College of Medicine in 1985 and remained at UAMS for his general pediatrics residency. He completed the University of Oklahoma-based National Center on Child Abuse and Neglect’s Interdisciplinary Training Program and continued his training in the Pediatric Emergency Medicine Fellowship at UAMS before joining the faculty as an assistant professor in 1991. He became an associate professor in 1996 and was promoted to professor in 2005.

Graham directed the Pediatric Emergency Medicine Fellowship in 1992-1997 and again in 2005-2010. He directed the Pediatrics Junior Clerkship in 2004-2009. He served as associate medical director of the Pediatric Emergency Department at Arkansas Children’s Hospital in 1992-2004 and as chief of Pediatric Emergency Medicine in 2005-2010.

Graham has held central educational roles in the college for the past two decades. He directed the Introduction to Clinical Medicine I course (now Practice of Medicine I) from 1999 to 2017. He has been active in numerous education-focused committees at UAMS and ACH, including the COM Curriculum Committee and the Undergraduate Medical Education Competencies Committee. Graham was appointed to his current post as associate dean for undergraduate medical education in 2010.

He has received many awards for teaching including the college’s student-selected Gold Sash and Red Sash awards, and he was three-time winner of the Educator of the Year award in the Department of Pediatrics. In addition to his work at UAMS, Graham served as chair of the Governor’s Trauma Advisory Council in 2008-2014, during development of Arkansas’ statewide trauma system.

“A strong mark of Dr. Graham’s leadership in our educational programs was the great success of our most recent Liaison Committee on Medical Education site visit and accreditation process in 2014-2015,” Westfall said.

With Graham as the primary leader of the comprehensive effort, UAMS received the maximum eight-year re-accreditation and exceptionally positive comments from the organization. Sponsored by the Association of American Medical Colleges and the American Medical Association, the Liaison Committee on Medical Education accredits medical schools in the United States and Canada.