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Game Changer

By Dan Gordon

David GeffenThe David Geffen Medical Scholarships promises a debt-free education, drawing a special breed of students to UCLA to create a cadre of physicians with the vision and leadership to alter the future course of medicine.

William Sheppard, Jr. is a student at one of the world’s most-prestigious medical schools, but when he asks his own family members if he can check their blood pressure, they don’t want any part of it. “They don’t trust medicine at all,” says the first-year student in the David Geffen School of Medicine at UCLA. “Even if I were to find something, they wouldn’t go to the doctor; they’d rather not know.”

Sheppard grew up in an underserved African American community in South Los Angeles. For many of the members of his family, particularly the older males, distrust of medicine is a legacy that stems from years of racism and injustices such as the infamous Tuskegee study — in which impoverished rural African American men who thought they were receiving free healthcare from the federal government instead were being studied to examine the untreated progression of syphilis.

Beyond not seeking treatment for anything but the most-serious ailments, the distrust has contributed to a lack of awareness about chronic conditions such as diabetes or about the importance of preventive care. And it’s not just a problem within Sheppard’s family. “When I go to church, I see people who know they have diabetes but don’t really understand why that is,” he says. “They eat the food around them, which typically is fast food, and they don’t realize the importance of taking their medications. It becomes a downward spiral.”

The problem hit home for Sheppard when his uncle was diagnosed, after ignoring early symptoms, with late-stage kidney cancer. Troubled by his uncle’s potentially avoidable death, Sheppard, who was 15 at the time, began to contemplate a career in medicine. In the summer before his junior year at UC Davis, where he pursued research in organic chemistry and co-authored papers that were published in the prestigious journals Nature Chemistry and Journal of the American Chemical Association, he joined the student-run Imani Clinic, which serves a low-income African American area in Sacramento. There, he realized that there was nothing unique about his own family, or community. “Many of the patients displayed reticence while interacting with the volunteers and doctors,” Sheppard recalls. They would conceal medically important information or admit to not following prescribed treatments. Some hadn’t seen a physician in several years.”

Matiar Jafari, Caroline Gross and William Sheppard, Jr, the first David Geffen Medical Scholarships recipients.
Top: Matiar Jafari: “I can now join any lab without funding restrictions. What Mr. Geffen has done with this donation is just unbelievable.”

Middle: Caroline Gross: “As someone whose interests have always been more in primary care, I’ve been given a chance to follow my dreams.”

Bottom: William Sheppard, Jr.: “This scholarship ... provides me with the opportunity to connect with our school’s leaders and with leaders in the communities I plan to serve.”

Lack of trust and poor access are a deadly combination that Sheppard is determined to address. He has set lofty goals: In addition to practicing in an underserved community, he is committed to dedicating time to being an advocate, dismantling barriers to trust and educating the population about healthier lifestyles.

THANKS TO A HISTORIC GIFT by entertainment executive and philanthropist David Geffen, Sheppard and 14 other first-year medical students now are pursuing their grand ambitions unencumbered by the often-stifling reality of graduating with six-figure debt. The David Geffen Medical Scholarships provides full financial support to nearly 20 percent of students entering UCLA’s medical school each year. It is based entirely on merit — the students chosen demonstrate enormous intellectual achievement as well as accomplishments and leadership in more than one area — and the total cost of attending medical school, including tuition, room and board, books and supplies and other expenses, is covered by the $100-million scholarship fund.

“Mr. Geffen has once again made a transformative gift to medical education,” says A. Eugene Washington, MD, MSc, vice chancellor of UCLA Health Sciences and dean of the medical school that bears Geffen’s name following a previous $200-million gift to the school in 2002 — the largest gift to a medical school ever given up to that time. “This new fund is about more than just money. This gift is about helping students to pursue their dreams.”

“The cost of a world-class medical education should not deter our future innovators, doctors and scientists from the path they hope to pursue,” Geffen said when the scholarships were first announced. “We need the students at this world-class institution to be driven by determination and the desire to do their best work and not by the fear of crushing debt. I hope in doing this that others will be inspired to do the same.” In recognition of his advocacy and achievements, Geffen was awarded The UCLA Medal during May’s Hippocratic Oath ceremony for the 2014 medical-school graduates.

For graduates of medical school preparing to embark on their careers, the prospect of paying back loans taken out to cover the cost of their education is daunting. Nationally, 86 percent of new doctors finished school in 2012 with an average debt of $170,000. One-in-three graduates owes in excess of $200,000. At UCLA, the numbers are somewhat better, but with the tuition, fees and other expenses continuing to rise, the cost of a four-year medical education at UCLA is more than $300,000. Although most students are partially supported by scholarships, the average debt for a UCLA student upon graduation still is $130,000.

While it’s true that most practicing physicians will have sufficient means to pay off their debt, it inevitably affects decisions they make about what directions to pursue, says Clarence H. Braddock III, MD, MPH, vice dean for education. “During their training, students may forgo opportunities to delve into areas about which they are passionate — experiences that could change them in some fundamental way and create the kind of physician who might do some amazing things in the world,” Dr. Braddock says. For example, he notes, some students want to pursue a second degree in public health, public policy or business administration but are deterred by the specter of racking up additional debt.

For others, the need to pay off large sums of money is a factor to consider in deciding on a specialty. “Often, physicians end up choosing a path because they’re driven by the need to pay off enormous debt,” says Dr. Washington. Those who are passionate about going into primary care in an underserved community can easily find their enthusiasm dampened by the looming financial burden. “At this time of great societal need and unprecedented opportunity for improving health, it is critical that more medical students find relief from career-dictating debt,” Dr. Washington adds. “Freed to make career choices based on their passions, students are expected to pursue aspirations better aligned with the evolving healthcare needs of an ever-changing society.”

CAROLINE GROSS KNEW SHE WOULD BE A PHYSICIAN for as long as she can remember. Beginning when she was a little girl, Gross would accompany her father, a gastroenterologist, on his hospital rounds. From her spot at the nearest nurse’s station, she would watch her dad’s warm interactions with his patients. “I would draw pictures for the patents and pretend to fill out medical forms when I was first learning to read,” Gross recalls. “My father never pushed me into medicine, but I could see his passion and how proud he was to be a physician, and I saw myself doing the same thing.”

Growing up in Westwood, in the shadow of one of the world’s leading academic medical centers, Gross became involved with UCLA Health. In the summer before her junior year of high school, she jumped at the opportunity to observe the work of Theodore B. Moore, MD (RES ’92, FEL ’95), who is now chief of pediatric hematology/oncology at Mattel Children’s Hospital UCLA. In a clinic that smelled both of disinfectant and lollipops, Gross sat in on Dr. Moore’s patient checkups. After days of witnessing sobs from toddlers undergoing painful therapy and optimistic smiles from children who were far more ill than they knew, Gross would collapse in her bed and cry. But amid the sadness, she also saw miracles of survival, remission and hope. “I realized a physician’s greatest potential — the opportunity to directly change a life or at least ease a vulnerable individual’s pain,” she says. “Physicians offer an incomparable gift. I knew that this was a gift I wanted to help provide.”

As Gross went through school, she became fascinated with the science underpinning medicine, but it was always the humanistic element that held the greatest appeal. While an undergraduate at Cornell, in Ithaca, New York, she held the hand of an older woman, while the woman struggled through memory tests being conducted as part of a study by the university’s Memory, Aging and Cognitive Impairment Lab. Gross was moved by the aging veterans she worked with who were suffering from congestive heart failure and stroke and fighting to change deeply entrenched health behaviors. And she’ll never forget the young mother she met one summer while in Tanzania to educate villagers in the small town of Babati about HIV and AIDS; with no access to medical care, the HIV-positive infant girl the mother was holding was sure to be added to the nearly 100,000 AIDS-related deaths in that country. Each experience strengthened Gross’s resolve to pursue a career helping the sick and vulnerable as a physician.

The first class of David Geffen Medical Scholarships recipients.
The first class of David Geffen Medical Scholarships recipients. (From left) Front row: Catherine Beni, Mariel Bailey, Elyse Guran, Parinaz Abiri, Julia Arzeno. Middle row: Kevin Terashima, Caroline Gross, Mostafa Amer Al-Alusi, MacLean Sellars, David Weiss, Jessica Lucier. Back row: Andrew Fischer Lees, Matiar Jafari, William Sheppard, Jr., Natalie Villa.

She applied to 31 medical schools and was accepted to some of the nation’s best. As Gross pondered her options, UCLA was a clear front-runner. She loved the diversity of the patient populations she would be seeing in her rotations through the four UCLA-associated hospitals, the boundless research opportunities and the dedication of the faculty to the medical students. Then, two weeks before Gross had to make a final decision, she learned she had been chosen as part of the first class of David Geffen Medical Scholarships recipients. She was ecstatic. “I’ve never been financially focused, but the debts of going to medical school are so high that you have to think about it when choosing,” she says.

“We’re all so in awe of what David Geffen has done for us,” Gross adds. “A lot of our most-talented people are turning away from the medical profession because of the burden of debt that comes with medical school and the possibilities of lower compensation in the future. This program allows people to put aside these financial burdens and enter a field that really needs them. As someone whose interests have always been more in primary care, I have been given a chance to follow my dreams. I will be exposed to so many possibilities, with all options open.”

IT DIDN’T TAKE LONG FOR THE FIRST CLASS OF DAVID GEFFEN MEDICAL SCHOLARSHIPS recipients to confirm what had been assumed from the beginning, that the students chosen for the prestigious awards would be special. At an introductory luncheon, where the students could meet some of the faculty and provide feedback on the selection process to help further develop the program, “we asked the students if there was anything they wanted to discuss,” recounts Dr. Braddock. “And they said they had already been talking about launching an initiative as a group and had ideas they wanted to propose.”

One of the ideas was for the students to volunteer as decision-support coaches for patients entering the UCLA health system — talking through educational materials with newly diagnosed patients, helping them develop questions for their doctors and assisting them in making the best decisions about their treatments. “The first year of medical school is like jumping on a treadmill that’s already moving at six miles an hour,” says Dr. Braddock. “These were busy students, and yet there was something inside each of them that wanted to figure out how to make an authentic impact on patients. That was impressive to me, that they would coalesce around something like that without us asking them to do anything.”

The selection process for admission to the David Geffen School of Medicine at UCLA is already highly selective; each year, as many as 8,000 individuals apply for fewer than 200 spots. The task of choosing the recipients from the highly accomplished pool of accepted students falls to a diverse committee consisting of physicians and scientists across a broad spectrum of practice settings and research interests.

“There are no set criteria,” says Dr. Braddock.

“The goal is to find individuals who have something extra in their life narrative that predicts that they could make a huge impact — whether in research, policy advocacy, bringing new paradigms to clinical practice, or in some other way — if given the opportunity to discover and pursue their passions.”

MATIAR JAFARI BEGAN TO CONSIDER MEDICINE after his grandfather stopped recognizing him. “He was always a huge part of my life,” Jafari says. “Then he came back after two years of living in Iran, and he didn’t know who I was.” Sadly, Jafari’s grandmother would soon suffer the same fate as her spouse. Jafari, then in college, turned to research for answers.

“I wanted to learn about the scientific basis of these illnesses,” he says. While earning his degree in biology at UC Irvine, Jafari spent all four years of his undergraduate education working in a neuroscience-research lab, looking at how to enhance learning and memory in autism mouse models and ultimately getting the opportunity to present his group’s findings at national meetings.

His dreams of medical school, vague when he began college, started to solidify. At the urging of mentors, he began doing volunteer work to learn more about the medical field. At a local homeless clinic, he witnessed firsthand the needs of an underserved community. Traveling to Nicaragua with Global Medical Training, he helped to serve medically deprived communities in the region and came away inspired by the impact physicians had on these populations. Shadowing a group of surgeons, Jafari gained an appreciation for the application of basic-science knowledge to improve patient care. He started to see himself as a physician-scientist, helping to unravel the mysteries behind diseases such as the Alzheimer’s and dementia that had robbed his grandparents of their cognition and identity.

Then things became even more personal.

“The first year of medical school is like jumping on a treadmill that’s
“The first year of medical school is like jumping on a treadmill that’s
already moving at six miles an hour,” says Dr. Clarence H. Braddock III, vice dean for education. Photo: Paul Babin
In December 2011, as Jafari was finishing his last year as an undergraduate, his mother was diagnosed with breast cancer. “We have such a close relationship,” he says. “We share everything, help each other through difficult times.” This would be the most difficult of all. Even though it had been only a year since her last mammogram, Jafari’s mother was diagnosed with stage 3B cancer. She required a double mastectomy and removal of nearby lymph nodes where the cancer had spread. Jafari was there as his mother opened her eyes after the surgery. “Can I get you anything?” he asked. She looked back and whispered, “A hug.”

The next night, Jafari watched as his mother’s surgeon visited her bedside at 11 pm and sat with her for more than an hour. Jafari had hardly ever seen his mother cry, but now she was scared. The physician held her hand, caressed her head and talked to her in detail about the treatment plan.

“He made my mom feel comfortable — that there was someone looking out for her who would be there at a moment’s notice if she needed anything in this battle,” Jafari says. That was the night he decided he wanted to be a physician-scientist, caring for patients as well as conducting research to find better treatments for them. “In one of the darkest moments of my life, I was able to find something that was good,” Jafari says. “Pursuing my dream of being a physician-scientist, I could provide that compassionate care for patients on a daily basis, while making discoveries in the laboratory that can help future generations of patients.”

Jafari received acceptances from some of the nation’s top MD/PhD programs. His mother, who was by now undergoing chemotherapy treatments, insisted he not choose based on which was closest to home, but UCLA was already the leading candidate for other reasons. Jafari loved the breadth of research opportunities, the proximity of the labs to the hospital and the emphasis on translational research. Then he learned he had been chosen as a recipient of The David Geffen Medical Scholarships, and the decision became an easy one. “In most MD/PhD programs, only one of the four years it takes to get your PhD is covered; the other three have to be funded by your principal investigator,” Jafari explains. “With this scholarship, all of the training is covered, which makes me so much more appealing to PIs. I can now join any lab without funding restrictions. What Mr. Geffen has done with this donation is just unbelievable.”

TO BE SURE, THE DAVID GEFFEN MEDICAL SCHOLARSHIPS provides the medical school with an invaluable recruitment tool. But Dr. Braddock believes the potential impact of the program extends well beyond the benefits to UCLA.

“We are committing, with Mr. Geffen’s support, to a different approach to admitting and training future physician leaders,” he says. “We believe the legacy of these scholarships will be a cadre of physicians with the vision and leadership abilities to make an impact on the world in ways that haven’t been possible before.” It already appears that the impact of The David Geffen Medical Scholarships is extending beyond UCLA; the gift has been a catalyst for other schools to substantially boost their financial support to medical students.

Sheppard decided early on that he wanted to be among the new breed of doctors that Geffen’s gift will make possible. While providing free primary care to an adult population at the Imani Clinic in Sacramento as a UC Davis undergraduate, he concluded that the area’s youth could also be suffering from gang influence and the nutritional problems associated with underserved communities. So he started Hoops 4 Health, a basketball-based organization located next door to the clinic, to give the area’s youth an outlet to stay physically active and away from negative influences, while providing education about healthy lifestyles.

“Basketball kept me focused and out of trouble during a time when a lot of my peers would hang out with the wrong crowd,” Sheppard says. But under Sheppard’s leadership, Hoops 4 Health grew into something larger. The youth who attend are educated about diabetes, hypertension and obesity in the hope that they will bring their lessons home to their parents and spread them through the community. Parents are also invited to become involved in everything from blood pressure readings to taking home free healthy food bags. Hoops 4 Health continues to thrive under new leadership now that Sheppard is at UCLA.

When he was growing up, Sheppard had no mentors directing him onto the path of a college education and medical school. As a David Geffen Medical Scholarships recipient, he undertakes that role for others, returning to his home neighborhood most weekends, making sure to talk to the youth at his church and also taking a leadership role in his community — giving talks, being visible at neighborhood meetings, advocating for patients. And now he is much-better positioned to achieve his dream of being a truly engaged physician.

“This scholarship is about much more than just having the costs of my education paid for,” he says. “It allows me to pursue any field of medicine that sparks my interest. It provides me with the opportunity to connect with our school’s leaders and with leaders in the communities I plan to serve. It doesn’t get any better than that.”

Dan Gordon is a regular contributor to U Magazine.

For more information about The David Geffen Medical Scholarships and to watch a video, go to: geffenscholarship.medschool.ucla.edu

 





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