By Amy Widner

COVID-19 really made Alexa Martin, M.D., a third-year resident in the Department of Family and Preventive Medicine, see the “big picture.”

Thankfully, the last six months have also made her feel like she can tackle it, because of leadership experiences and educational opportunities she couldn’t have imagined before.

“I think I was always interested in the big picture, but sometimes as a med student and resident you’re so focused on learning that you can get task-oriented – focusing on one skill at a time, one patient at a time,” Martin said. “The COVID-19 pandemic really reminded me of the big picture of what medicine is all about – improving human health.”

Martin received the highly competitive and prestigious travel award from the National Institutes of Health and the National Medical Association to attend the NMA’s 2020 annual Convention and Scientific Assembly, which was held virtually in August.

She was recommended for the award because of the leadership role she held with UAMS’ drive-thru COVID-19 screening and testing triage that sprang up quickly in the early days of the pandemic’s impact on Arkansas.

“When the triage was only a few days old, they started pulling some of the residents in to help,” Martin said. “I did my first shift, and I did a good job at it and didn’t complain too much while I was sweating under my PPE. When it was time to go, my replacement didn’t show up, so I stayed on, and they were like, ‘hey, you’re good at this, can you train the next shift?’ So I did, and that’s how it all started.”

Martin ended up as a physician lead, training others who volunteered or were assigned to help. She spent all her spare time reading up on the latest on the disease. She and a few other residents turned out to have a knack for understanding systems and workflow, so when it came time to identify gaps and make improvements, she gave valuable feedback.

She was one of the staff members who suggested that the Family Medicine Clinic create a special clinic dedicated to acute respiratory illnesses so that patients who didn’t need hospitalization could still get valuable care in a time when fears were high but hospital beds were scarce. She also participated in the first mobile triage unit to take the skills of UAMS across the state. Their first stop was Helena.

“It was really good experience to see how quickly we could make changes and come up with solutions,” Martin said. “More than once since then in the hospital I’ve run into professors who under any other circumstances would outrank me, and they’ll say, ‘hey, you were the one that trained me my first day at triage!’ It’s humbling, but also empowering to have an experience as a resident where you see that you can really step into a leadership role and make a difference.”

It was through the COVID-19 triage that Martin met Gloria Richard-Davis, M.D., executive director of the Division of Diversity, Equity and Inclusion at UAMS, who recommended she apply for the NIH travel award, which would have covered travel and expenses for the weeklong conference if it had been held in person.

Although the conference was held online, Martin said she still benefitted from learning about the opportunities the NIH offers for early-career physicians who are interested in research or academics. The award came with the title of 2020 academic medicine fellow, and Martin was featured in the conference program under that header and was able to do plenty of networking – even virtually – because of the prestigious distinction.

“I met so many people and learned so much,” Martin said. “I didn’t know there were so many avenues for research and funding to help with loan repayment. It was great to see all of these avenues that I didn’t know about.

“The COVID-19 pandemic had already made me start thinking about whether I should pursue a master’s in public health and go into issues dealing with community and population health, maybe getting involved with state or federal health offices or the Surgeon General’s office – places where you can practice medicine but also be involved in policymaking. This travel grant and fellowship helped me see what the next steps on that path might be.”

HRSA, the Health Resources and Services Administration agency in the US Department of Health and Human Services, has awarded a $4.66 million grant designed to increase the number of primary care physicians in underserved communities in Arkansas.

The director of the project is Christopher T. Westfall, M.D., FACS (UAMS Executive Vice Chancellor and Dean of the College of Medicine). Co-directors are Daniel A. Knight M.D., FAAFP (Chair, UAMS Department of Family and Preventive Medicine) and Marcia Byers, Ph.D., RN (Director of Clinical Innovation and Research for Regional Programs). The evaluator of the project is Diane Jarrett, Ed.D. (DFPM Director of Education and Communications).

Specific objectives of the grant project include enhancing recruitment and retention to increase the number of medical students from Arkansas’ rural and medically underserved communities; expanding medical student clinical opportunities throughout the state; and in general attracting more students to practice in rural and medically underserved communities.

Partners in the program include the UAMS College of Medicine, UAMS Department of Family and Preventive Medicine, UAMS Regional Programs, Community Health Centers of Arkansas, the Arkansas Rural Health Partnership – Critical Access Hospitals and Rural Health Clinics, the University of Arkansas at Pine Bluff, and Philander Smith College, among others.

Great things are happening in the UAMS College of Medicine’s Department of Family and Preventive Medicine, with a recent research poster day as just the latest sign of the department’s “good health.”

The poster session featured 35 posters, including 20 projects by residents. Topics included residency administration and education, ethics, case reports, improvements in patient care, and research on medical conditions like anemia, HIV, COPD and chlamydia.

Event organizers were Shashank Kraleti, M.D., residency program director, and Diane Jarrett, Ed.D., assistant residency director and director of education and communications for the department. They said the poster session gave residents a chance to highlight the department’s strong commitment to research and to practice their presentation skills in a laidback environment at their home campus before showcasing their work elsewhere.

“Family medicine isn’t a field that’s necessarily thought of as a huge research-producing specialty, when in fact, our department has a lot going on,” Jarrett said. “So events like these serve a dual purpose. They show our residents that the academic projects they participate in are important and that others are interested in their results, and it showcases to the wider campus all the great things that are going on in our department.”

Kraleti said he thinks the emphasis on research results in better physicians and patient care.

“I have always believed that when residents do research, they take an extensive look at a particular topic and gain knowledge that they can use in their practice,” Kraleti said. “Research also gets residents thinking creatively and proactively about how they can contribute to improving patient care in their clinic and beyond.”

For example, third-year residents Obioma Nwaiwu, M.D., Ph.D., and Brian Yuen, M.D., presented their poster on how to improve shared decision making between providers and patients for prostate cancer screening, especially given that new guidelines leave the decision on whether to screen up to the patients.

Nwaiwu and Yuen tried passive approaches like handing patients flyers in the waiting room. They also tried more direct approaches like calling the patient on the phone before their appointment and contacting providers to remind them of the new guidelines.

They found that the direct approaches significantly improved the shared decision-making process.

“What this tells us is that when you empower the patient, when you empower the provider and tell them about the changes in the guidelines and give them some of the statistics involved, then they can really talk about it and come up with the decision that is best for the patient,” Nwaiwu said.

These opportunities for resident research haven’t developed in a vacuum. The department’s Research and Evaluation Division (RED) started 10 years ago. The residency program has also developed a strong research and scholarly activity curriculum for the residents and the faculty. And across the department, Kraleti said the faculty do an amazing job on both their own work and investing time to collaborate with the residents.

“They are very strong and produce a lot of work, and the clinical side and research side are always looking for collaborations,” Kraleti said. “It’s paid off. We do posters and presentations nationally and internationally, and there are lots of publications. By the time we started thinking about a poster session on campus, it was well overdue.”

The first event was in the fall and featured 25 posters. Now in the spring, the event is intended as an annual tradition, and Kraleti said they may expand it to a research day with presentations in the future.

The Family Medicine program was also recognized at Dean’s Honor Day in the spring. Kraleti won the Residency Educator Award. Nicola Edge, Ph.D., won the Faculty Excellence in Research Award. Shalese “Fitz” Fitzgerald, M.S., won the Staff Excellence in Research Award.

“It was wonderful to see our research efforts in family medicine recognized,” Kraleti said. “Several of our faculty were promoted this year. We also have had a 100% board pass rate for our residency program for seven years, which puts us among the best in the country. We feel we have good synergy happening within the department, and we’re happy to feature it with events like this.”

For the sixth consecutive year, all of the graduating family medicine residents in the Department of Family and Preventive Medicine passed their American Board for Family Medicine exams in their first attempt. This 100% rate is unmatched in other Arkansas family medicine programs and is unsurpassed in the nation.

The residents took the exam in April, and preliminary results show that all seven have passed. Official scores won’t be available for another five weeks.

The third-year residents are Aleobe Eruemulor, M.D., David Wilkins, M.D., Deepa Jayakrishnan, M.D., Erica Stokes, M.D., John Allen Cockerell, M.D., Omololu Omowanile, M.D., and Zac Ottis, M.D.

“I am very pleased that all of our residents have passed boards,” said Dr. Cockerell, who plans to join his wife (a pediatrician) at the Sherwood Family Medical Center. “It is a testament to hard work by the residents and to the teaching we receive here in Little Rock. We routinely see high acuity patients and learn from some of the finest physicians around. Overall, dedication and education have again delivered a 100% pass rate.”

The ABFM Family Medicine Certification Examination is a day-long test that measures clinical decision-making ability and the required medical knowledge needed to make decisions in family medicine.