IU School of Medicine-South Bend: Developing justice-minded physician leaders
Laura Gates Mar 30, 2022
He ended up with his third choice—and is now grateful. At IU School of Medicine-South Bend, Harding discovered so much more than a storied Division 1 football team at the partner institution.
“Knowing what I know now, the South Bend campus would’ve been my first choice,” he said.
It turns out, Harding was a perfect fit for this regional campus with a bent toward community health and social justice. He was a non-traditional student who had done work in health equity prior to medical school. It was an easy decision to be among the first cohort of students to join South Bend’s new Scholarly Concentration in Ethics, Equity and Justice.
“Those are the things I’m really passionate about,” Harding said. “As I got to know the faculty, I could see their clinical and research interests aligned with mine.”
Per capita, the South Bend campus has more faculty with expertise in ethics than any other IU School of Medicine campus, including Indianapolis, said Mark Fox, MD, PhD, MPH, associate dean and director of IU School of Medicine-South Bend since 2015.
Fox holds a PhD in religion, ethics and society and has more than 20 years of experience as an ethics consultant and ethics committee member. He co-directs the Scholarly Concentration program with Joseph Kotva, PhD, a former pastor who has served as a clinical ethics consultant and has been teaching medical ethics for more than 25 years.
“We talk a lot about moral formation, narratives, social determinants of health, conceptions of justice, climate health—framing ethical dilemmas within those larger circles of moral concern,” Kotva said of the Scholarly Concentration seminars. “Medical ethics have typically been about quandaries. Our students are asking bigger questions about the social context of health care.”
Engaging in experiential learning
Along with leading the South Bend campus, Fox serves as deputy health officer for the St. Joseph County Department of Health. When the COVID-19 pandemic emerged in early 2020, Fox became the county’s de facto COVID czar.
“Instead of taking care of individual patients, I take care of 270,000 patients,” said Fox, who is an internal medicine physician, pediatrician and preventive cardiologist.
His role in public health has led to opportunities for experiential student learning. Although students were not permitted to directly interact with COVID patients, many volunteered to help monitor symptom progressions via phone and online systems. One student helped St. Joseph County set up a data system for COVID tracing, and another student fabricated masks from recycled surgical gowns when they were initially in short supply, Fox said. Later in the pandemic’s progression, several students volunteered to help administer vaccinations.
South Bend medical students are particularly service-minded. In 2014, South Bend was the first regional campus to open a student-run community outreach clinic on Saturdays. The vision was to provide completely free services in a low-income area where people frequently went to the emergency room for non-emergency reasons, said Stacey Patrick, MS, director of regional medical education.
The collaborative effort came together through help from local health systems, generous donations from community supporters and the enthusiasm of physicians, pharmacists and interpreters who volunteer their time. A local pathology facility offered to make lab work free to the clinic’s patients, and the South Bend Student Outreach Clinic was the first in the state to get an electronic medical records system, donated by the same company servicing local health networks.
“It’s a collaboration with community partners—no one is paid,” Patrick said. “We have an incredible donor base that allows us to keep our clinic going over the years.”
Discovering passions through mentorship
In early 2020—right before the pandemic shut down travel—Patrick organized the South Bend campus’ first international service learning opportunity. Stefani Vande Lune, JD, MD, and one other student piloted the program, joining South Bend family physician Cameron Gongwer, MD, on a medical mission trip to the Ankaase Methodist Hospital, which he helped develop in Ghana.
Vande Lune–now a resident in emergency medicine at the Naval Medical Center in Portsmouth, Virginia–remembers being shocked that the Ghanaian hospital did not have electrocardiogram (EKG) equipment.
“I order an EKG on three-fourths of my patients in America,” she said. “In Ghana, they are limited on resources but can still practice good medicine. You develop better physical exam skills and treat based on your best clinical suspicion.”
Vande Lune is grateful for the experience in global medicine. She also credits Patrick with enabling her exploration of emergency medicine. Rather than going to Indianapolis for that elective, she asked Patrick to help her get an emergency medicine elective approved in South Bend. The result was a one-on-one experience with Keith Sherry, MD, who was directing several EMS providers in St. Joseph County as part of a cooperative consortium.
“There is nothing like having a whole month where you have access to an EMS director who directs MedFlight and three EMS provider systems,” said Vande Lune, who also credits emergency medicine physician Mark Walsh, MD, with helping inspire her passion for that field.
Vande Lune chose to stay in South Bend for all four years of her medical education, valuing the close community on the regional campus.
“The South Bend administration was very supportive,” she said. “The dean and all of our professors were right there wandering around the halls. They would show up to student events, and we tailgated at Notre Dame football games with faculty and their families.”
Rachel Macias, MD, a 2015 IU School of Medicine-South Bend graduate, feels the same. She always thought she would become a pediatrician, but her South Bend mentors helped her discover she enjoys surgery, particularly more intricate procedures.
After doing an elective rotation in plastic surgery with Ronald Downs, MD, FACS, and Patrick Viscardi, MD, she knew she had found her passion. She now works alongside her former preceptors at The Centre P.C. in South Bend, joining the practice in September 2021 following her residency in Grand Rapids, Michigan.
“It was in the back of my mind as a dream to come back here,” said Macias. “I don’t think I would have become a plastic surgeon had I not been at the South Bend regional campus. Now I’m the only female plastic surgeon in the area.”
Developing world-changing physicians
Second-year medical students Maggie Holohan and Megan Eigsti have also discovered their passions through their experiences on the South Bend campus. As part of the Scholarly Concentration program, they are delving into research and making connections aimed at educating the medical community on its role in climate change.
“Dr. Kotva has connected us with top people in climate health education across the country, including physicians from Atlanta and New England,” Holohan said.
She became interested in social justice as an undergrad at Notre Dame and spent two years teaching at an underserved school in rural Louisiana before returning to South Bend for medical school. Eigsti had also been involved in political activism before starting medical school and applied directly to the South Bend campus because of its Scholarly Concentration in Ethics, Equity and Justice. Now the pair has teamed up to create a new Climate Health elective for fourth-year medical students that will be available throughout the state. Kotva will serve as faculty advisor.
Holohan and Eigsti are representative of the next-generation physicians IU School of Medicine-South Bend is developing, said Kotva.
“Our students are going to be the people who are creative enough to shape medicine in different directions,” he said. “They’re going to be the ones who won’t just say, ‘This is the way medicine is and we have to work within these constraints.’ They’re going to be the people looking for health care that is more environmentally friendly and more just.”
About this series
Indiana University School of Medicine is commemorating the 50th anniversary of its statewide system for medical education, established by the Indiana State Legislature in 1971. This series highlights the unique history of each regional campus and celebrates its distinctive learning environment and special programs.
Read more about the history of IU School of Medicine-South Bend and its leaders’ vision for this innovation-minded campus.
Spirit of Medicine
IU School of Medicine-South Bend boasts history of innovation in medical education
Laura Gates | Mar 29, 2022