Campbell’s charter class of medical students is already making an impact on their first round of rotations
ERICA BROTZMAN
12:12 PM Erica Brotzman hasn’t eaten in over five hours, and for a moment, it doesn’t look like lunch will be an option. Dr. Connie Mulroy offers part of her “lunch,” a small bag of peanut butter crackers.
The last two hours have offered more on-the-job experience for Brotzman than her whole first week on the night shift. It began with the call from the hospital, and at precisely 10:07 a.m., the two were leaving Mulroy’s clinic to rush back to the labor and delivery wing at SRMC.
At 10:15, Mulroy was assessing the situation — a woman in just the 29th week of her pregnancy was in labor — and three minutes later, Brotzman was scrubbing in outside of the operating room.
At 10:23, she walked into a room full of at least eight to 10 hospital personnel — doctors, nurses, anesthesiologists and others at the ready. At 10:27, a nurse walked out of the room declaring a 4-pound baby boy, premature but otherwise in good condition.
“It was nine minutes from the decision to go with a C-section,” Brotzman says. “It was all so fast … bang, bang, bang. Very exciting.”
In just a few days with Mulroy, she has experienced a valuable lesson from her preceptor — the patient comes first.
“She basically told the mother, ‘My name is Dr. Mulroy, and we’re taking you to the C-section room,’” she says. “Everything else was secondary. You skip meals, you get here in the middle of the night. You do what you have to do.”
Mulroy herself has benefited first-hand from quick thinking on the doctor’s part. One of her sons was a premature baby, born in the 26th week of her pregnancy. While the survival rate is high between the 27th and 30th week (about 95 percent), babies born that early face a higher risk of health problems down the line. Her son has no lingering effects of a premature birth, but she remembers her experience and her fear at the time.
At 10:39, the baby was wheeled out of the operating room, and with Brotzman at her side, Mulroy began sewing up the mother, who was still under anesthesia. Midway through the procedure, she handed the “needle and thread” to her student, offering another learn-on-the-job moment you can’t experience in the simulation labs back in Buies Creek.
It was the first time she has ever stitched up a live patient, and by 11:20, the room began to clear out. Mulroy walked next door to deliver good news to the young father, who clearly looked like he could use reassurance.
Back to now, Brotzman crosses paths with another third-year med student on her OB/GYN rotation, Jessica Herman, and the two begin sharing stories. Brotzman beams as she talks about the past two hours.
At the same time, Mulroy is filling up on peanut butter crackers and offers one to her student. Just as Brotzman is about to turn it down, the doctor looks around at the relative calm in the wing and changes her mind.
“Go ahead and go to lunch,” she tells her student. “Just have your phone nearby.”
TOM SOKER
12:18 PM When the students do get a break for lunch, they are well taken care of at SRMC. Daily “lunch and learn” discussions and presentations are held in the large classroom on the newly renovated fourth floor, home to the recently opened Medical Education Center.
Tom Soker is skipping the lesson, though, and hiding out in a smaller study room with two classmates, Michael Ouzts and Christina Samaan, to prepare for Friday’s lunch presentation — a Jeopardy! style quiz game to help their classmates study for upcoming exams. The trio is having fun with the categories: “You’re So Vein,” “Quit Playing Games With My Heart,” “I Like Big Hearts and I Cannot Lie” … and so on.
“They’ll love us and hate us,” says Samaan, an Orlando native. “The categories are funny, but the questions are hard.”
Soker (cardiology), Ouzts (pulmonology) and Samaan (infectious diseases) feel fortunate to be making Jeopardy! questions and not cramming for the end-of-the-month exams that await those taking one of the core rotations — which include internal medicine, emergency medicine, OB/GYN and others. These rotations will make up their third and fourth years of med school, but the education doesn’t end with graduation in 2017.
Osteopathic physicians often spend a year after graduation in an internship if they’re interested in further exploring various specialties. Then the residency programs typically last another three to seven years, offering specialized training to the newly minted doctors in particular areas of medicine. Another one to three years can be spent in a fellowship, a formal, full-time training program that focuses on a particular area within a specialty. A fellowship would be required for Soker if he sticks with a highly specialized field like cardiology.
With the next 10 years of their lives pretty much spoken for, it doesn’t leave for much of a social life, says Samaan.
“I spend my days in the wound clinic looking at foot ulcers, toes that need to be amputated, bones through skin and other infectious diseases all day,” she says. “When I get home, I just want to take a shower and study.”
She and Ouzts live in nearby Hope Mills, renting homes with roommates, while Soker lives with six other classmates just blocks from the hospital in another rented house. Soker says aside from work, the only things he’s done in his short time in Lumberton are go to the supermarket, Walmart and the gym.
“A group of us are going to CiCi’s Pizza this Friday,” he adds. “I’m sure it’ll be a big time.”
Samaan views the small town vibe as a positive for med school students. She describes coming to Buies Creek for her first two years as a “culture shock,” considering she grew up in the Theme Park Capital of the World. Working in Lumberton and living in Hope Mills isn’t much different.
“I feel like if you’re going to med school, go where there’s no distractions,” she says. “And definitely go where the people are nice to you.”
SADIA MOBEEN
1:15 PM Lunch is over, and Sadia Mobeen and the three classmates joining her on this month-long psychiatry rotation — Andrew Lee, Richard Baggaley and Jeffrey Sobecki — are in waiting mode, back in the locked office from this morning’s meeting and on stand-by until Dr. Sid Hosseini returns with a new set of rounds and other assignments.
The group teases each other about who’s Hosseini’s favorite and compliment the meatloaf and chicken served at the buffet line during lunch today. They throw guesses at what will be on the exam following their core rotation and reveal what rotation each will be taking in the second month.
Before long, the conversation turns to the social lives — or lack thereof — of the four third-years. The four lead different lives — Lee is married with two children ages 2 ½ and 10 months. Baggaley is newly married to a physician assistant student from Campbell whom he met at the ribbon-cutting ceremony for the med school building they now share. Neither Sobecki nor Mobeen are married; Mobeen even rolls her eyes at the suggestion there’s even time to go out and meet somebody during the all-consuming four years of med school.
“It’s hard to put the effort into building a relationship right now,” says Sobecki. “I mean, you might meet people you could be interested in outside of med school, but if they don’t understand the time commitment, you don’t really have a choice. That’s why there’s a fair amount of inter-dating for the students.”
The group starts counting off at least four or five relationships — current and past — within their class in the past two-plus years. Baggaley is almost included in that count, being married to a PA student. It’s easier to find someone who understands the amount of work it takes to get through med school, he says, and even easier when that person is going through the same type of struggle.
“We get home at the same time, study together, take a break together, maybe watch some TV, stop, then start studying again until it’s time to sleep,” says Baggaley, a Utah native who married Brittany on Dec. 20, 2014, a year and two months after that ribbon-cutting ceremony. “Our knowledge base is basically the same, and we’re always bouncing questions off each other. Her understanding of what I’m going through has definitely made it easier.”
Lee’s wife is not a medical student, nor does she work in the medical field. The couple had their first child, a daughter, two months before Lee’s first interview with Campbell during the application process. Their daughter was 9 months old when he began classes in August 2013. Their son was born in October 2014. They make life work by keeping an open line of communication, Lee says.
“It can be tough, don’t get me wrong. It’s a balancing act,” he says. “I’ll spend a few hours studying at the hospital because it’s so hard to concentrate at home, but then I’ll spend the new few hours at home with my family. It’s crazy now, but it will get better. I’m hoping to go into a family practice residency [after med school], and the hours are more regular. It would be nearly impossible for me to go into surgery or OB/GYN, because those hours are crazy and very unpredictable.”
Campbell resident Dr. Courtney Maiden has bad news for the group. This third year of med school — the same one that sucks up all of their time and social life — is the easy year.
“Enjoy it before it gets hectic,” the recent Pikeville (Ky.) College School of Osteopathic Medicine graduate says. “This is calm. In the fourth year, you start worrying about getting into a residency, and it’s far from enjoyable. It can be very competitive, depending on the field. Even the non-competitive specialties can be a challenge. So no … this isn’t hectic yet.”
RAJBIR SINGH
1:27 PM Rajbir Singh is preceptor-less on this day, but those who have stepped in to teach him are more than capable. None more so than Dr. Lina Vargas, a vascular surgeon who came to Lumberton in 2014 after nine years of residency training at The Cleveland Clinic Heart & Vascular Institute, the No. 1-ranked heart program in the United States.
Vargas has already achieved “rock star status” at SRMC, appearing in advertisements, YouTube videos and radio shows promoting the hospital. Her expertise — surgery for aortic, artery and venous diseases — is in high demand in a place like Robeson County, which ranks near the bottom nationally in smoking prevalence, obesity, physical activity and life expectancy.
Of the nation’s 3,143 counties, Robeson ranked 3,087th in “recommended physical activity” for men in 2011.
Vargas is leading Singh and the physician assistants on rounds and going over patient records after a lunch break, and in no time it becomes clear she’s in high demand. Vargas’ discussion with Simeone and Metzger are interrupted every other minute by her cell or office phone.
“She’s been in the operating room so much, my time with her has been limited,” Raj later says. “When I do get to sit down with her and talk or stand by her while she’s in surgery, she’s amazing. She’ll explain what she’s doing without my asking. She’ll tell me what structures she’s working on, what this procedure is and why she’s doing it. And she has no obligation to do it. She’s not my preceptor, but she’s taken me under her wing this week.”
Vargas’ importance to not only the hospital but now the community has inspired Singh in his short time in Lumberton. He entered med school with the idea that he would one day become a general surgeon, which he says fits the “primary care component” that Campbell encourages.
He now sees himself spending a few extra years as a resident and specializing in cardiothoracic surgery, which involves treating diseases mainly of the heart and lungs.
“I love cardiology and the heart, and this combines the two,” he explains. “More importantly, there’s only one cardiothoracic and cardiovascular surgeon [at SRMC]. You have a hospital like Duke where there are a whole mess of them, and Lumberton doesn’t have that luxury.”
“If I can practice a field of medicine I love and do it in a place where I’m needed, then that’s the best opportunity for me.”
Singh follows Simeone and Vargas into a patient’s room, and the doctor begins comforting the elderly woman as she unwraps her newly amputated leg to check the stapled-up wound.
“You’ve been through a lot,” she tells her as Singh leans in to look at the amputation performed above the knee. “So get some rest and make sure we stay on top of this wound.”
CHERIE DICKSON
1:32 PM Not long ago, Cherie Dickson wanted to be a politician. She could see herself as a senator or representative, and she marked political science as her major entering her freshman year of college.
Medicine, she says, was the farthest thing from her mind. In fact, the sight of blood made her queasy.
“I had to leave biology class when you just mentioned the word ‘blood,’” she recalls. “I started enjoying those classes later in high school, and I can’t tell you what happened. It was probably a God thing. I went from the kid who never wanted to be a doctor to one day telling my mom in the car that I was ready to change majors and go for it.”
That queasy teen could have never imagined that a decade later, she’d be spending the second part of her Wednesday med school rotation in a wound clinic — where blood, pus, sores, tendons, bones and all sorts of things found under the skin are on full display.
Every Wednesday, McLeod spends his afternoon at the Southeastern Wound Healing Center, located across the street from the hospital’s parking garage. Over the years, McLeod has seen every wound imaginable, he says.
The afternoon’s first patient is an easy start for Dickson — a man with large sores on his shin and ankle from years of wearing work boots. Patient 2 is having wounds looked at as a result of a botched breast enlargement surgery (the procedure was not performed at SRMC). It gets progressively worse.
Next is an 86-year-old woman who will need a below-the-knee amputation. One of her toes is so gangrenous, McLeod says, and will only get worse if left untreated.
A 65-year-old man’s ankle wounds reveal tendons in his leg. Patient 5 is unique in that her skin is ossifying around her wound. In simpler terms, the skin is as hard as bone.
Through each case, Dickson remains focused and doesn’t show any signs of uneasiness. The once-queasy med student is feeling more comfortable in her new setting, and curiosity kicks in with each new patient. She has seen worse prior to this. Prior to med school, she worked with a medical missionary group at a women and children’s hospital in Pakistan.
“I was elbow deep in people’s bodies on the first day,” she says. “And I loved it. I fell in love with the Middle East, loved doing procedures and loved seeing patients there.”
Cherie took post-baccalaureate courses in Tennessee before applying to Campbell’s new medical school. She says she fell in love with the school during her first visit and interview in Buies Creek. The people, atmosphere and new dean’s passion for missionary medicine shot Campbell to the top of her wish list.
“Campbell is truly about getting doctors out there to serve the underserved,” she says. “That’s also why I chose Lumberton for rotations. I wanted to be in a community with a large disparity of income and access to medical care.”
“I haven’t regretted a single decision.”