Dr. Jerris Hedges recently announced he plans to step down in March 2023 as dean of the University of Hawaiʻi John A. Burns School of Medicine after 15 years at the helm. Dr. Lee Buenconsejo-Lum will be the interim dean.
The Conversation invited him to reflect on how far Hawaiʻiʻs only medical school has come over the years. He also shared the latest on a $22.5 million National Institutes of Health research grant, the challenges of a physician shortage, student tuition, and more.
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On helping the medical school gain recognition over the last 15 years
DR. JERRIS HEDGES: I'm very pleased and obviously it takes a village. I can't take full credit for this. But I do want to point out a couple of milestones. When I came, our school was approximately ranked 102 out of 110 medical schools at that time. Now there's over 180 medical schools, and we're in the top quartile, the top 25. We've been there three out of the last five years. We're recognized nationally and we've always had wonderful students trained here in Hawaiʻi. But because we're in the Pacific, there's not as much media coverage, we just don't get the same national recognition. But by doing more in the research sphere — and so these projects like I mentioned, Ola Hawaiʻi that's been sponsored by the National Institutes of Health through its National Institute of Minority Health and Health Disparities branch — we've been able to bring the level of awareness of what we're doing in terms of science, and also the quality of our trainees. And so we've also been strengthening the network of our graduates not only here in Hawaiʻi, but also on the continent. We think that that helps because we know that we don't have as many training programs as we need here in Hawaiʻi, so many of our learners have to go to the continent to complete their training so they can be licensed, and then come back to Hawaiʻi. So we're working very hard to make sure that we have opportunities for them to return and practice here in Hawaiʻi.
On the rising cost of tuition and the physician shortage
HEDGES: We're doing two things. One, I mentioned the scholarship program with the service payback. But the other is we've been doing a loan repayment program. And so Dr. Kelley Withy who heads up our Area Health Education Center has also applied for support from our federal government. And we're working with our Legislature to use state monies and obtain a federal one-to-one match. So we are now paying off educational debt not only for physicians, but also for nursing students and nurse practitioners who are working in some of the most difficult-to-recruit areas in Hawaiʻi. So it's an important program. And I'm just really pleased, first of all, with the ʻohana that we developed at the school, it's a very supportive community. We have such strong ties and commitments to the community beyond the university that, you know, that is very heartwarming, it's very gratifying.
As we look at trying to address the physician shortage, we know that we're not going to be able to train physicians such that all of one's care can be guided by a physician directly, but rather, we'll have to have teams and we'll have to train a whole cadre of health care providers as part of that team. The health systems are beginning to move in that direction. So Kaiser, Queen's Health System, Hawaiʻi Pacific Health, Adventist Castle, they're already making adjustments in that manner. But we need to look at how we can help that evolve in some of our other community settings.
I've been working with my colleagues in nursing, social work, pharmacy and trying to build programs that will allow us to bridge the health sciences and work together more effectively. And seeing those bridges and what we've been able to produce, we have a Hawaiʻi Interprofessional Education, or HIPE program, that is really focused around geriatric education and it brings folks together to work through scenarios as a team. So our nursing students, nurse practice students, medical residents and medical students, along with pharmacists and social workers get together and they solve problems together just like it was a real-world case using a simulation environment. Very innovative — gotten federal dollars as well as the Robert Wood Johnson Foundation to support it. But what it's done is just dramatically changed how we work together as health professionals in the educational sphere, in the research sphere. And now we're seeing it in the clinical practice setting. Just a quick anecdote, when we did our very first class with the School of Nursing, where we brought nursing students and medical students together, I literally had faculty from the School of Nursing crying. They said, "We've waited 20 years to see the medical school reach out." Now, our students are learning together. You think that's a no-brainer, right?
On the $22.5 million grant to study health disparities among Native Hawaiians and Pacific Islanders
HEDGES: The medical school has served as the home base for this project. But it's really a collective project of all the health science units at UH Mānoa and also working with UH Hilo's College of Pharmacy. It has two components. One is to do some very key research projects that look at areas of what we call health disparities where some members of our community have shorter lifespans or heavy disease burden. And we look for how we can extend lifespan and provide better equity in health outcomes. We have specific projects we work on and we also have support to provide resources for young investigators to come together as multidisciplinary teams to work to solve problems. So for this particular project, which will be about $22.5 million over five years coming into Hawaiʻi, the co-lead with me is Noreen Mokuau, the former dean of the Thompson School of Social Work and Public Health. She and I have worked with a team of leaders in our respective units to identify three projects.
One will be a community-based project looking at the health benefits of home aquaponics. And we'll be focusing on how we can bring this mechanism of raising one's own food in the home to some of our Native Hawaiian communities, many of whom live in areas that are food deserts, whether it's very hard to get fresh food to their homes. So this engages the family, in fact, it engages the whole community because in each community we put several of these aquaponic units, and then we will look at the impact on their life activities, exercise, nutrition, and so forth to see what impact this has had.
The other project, which is very topical, is one that's looking at the long-term effects of COVID in particular on pulmonary function because we know a number of individuals who've suffered from COVID end up with chronic fatigue, difficulty breathing, and are really struggling to get by. And we don't know how long these effects will last. In some cases, they've had them for more than two years if they acquired the disease early in the pandemic. So we're looking at some of the underlying inflammation that goes along with this. And looking at what other factors in one's life may have contributed to a less desirable outcome, and then trying to see how we can change our approach to treating COVID to help individuals better.
The third project is actually looking at a really novel finding that we've discovered here in Hawaiʻi that relates to little packets of proteins that our muscles release during exercise. And we know that some people benefit in terms of weight maintenance, and weight loss through exercise better than others. And we suspect that the way these protein packets are formed and released, and the impact that they have on the body during and after exercise probably plays a role into why certain individuals benefit more from exercise versus others. And maybe we can change the nature of how we form those packets, and really get the benefit of exercise to everyone in general. So that's a more basic science project looking at the fundamental mechanisms whereby our physiology contributes to our health.
On what he'll do after stepping down as dean
HEDGES: I've got a number of things that I would like to do. The usual, sort of, kind of spend some time learning about some things that I had to put on the side, and a little bit of travel. But the other important thing is this Ola Hawaiʻi grant, I'll continue to be engaged with that. I will continue to do some mentoring with some of the faculty at the medical school that have sought me out. So I'll keep engaged, I love Hawaiʻi, it's the place I want to be. And the university gives you so many opportunities to give to the community. So I expect to continue doing that.
This interview aired on The Conversation on Oct. 3, 2022. The Conversation airs weekdays at 11 a.m. on HPR-1. This interview was adapted for the web by Sophia McCullough.
