Dr. Paul w88: We have this label of being a community medical school, but we're more than that. We're a research-intensive community medical school. Most community medical schools don't have the sort of research footprint that we have. And so that's something not only to celebrate but to really focus on growing.
President Brian Sandoval: In this episode of Sagebrushers, we welcome the new dean of the University of Nevada School of Medicine and chief academic officer for Renown Health, Dr. Paul w88. I'm Brian Sandoval. I'm a proud graduate and president of the university, and I'm your host of Sagebrushers. Dean w88 is a nationally recognized researcher of advanced heart failure, cardiac care delivery and clinical trials. He most recently served as dean at the University of Tennessee Graduate School of Medicine, Knoxville and chief academic officer at the University of Tennessee Medical Center. A first-generation American and college graduate, Dean w88 received his M.D. degree from Cornell University Medical College and completed his internal medicine training at Brigham and Women's Hospital Harvard Medical School in Boston and cardiology fellowships at both Mount Sinai Hospital and Brigham and Women's Hospital.
Today's podcast is being recorded at the Reynolds School of Journalism on our University's campus. Dean w88, welcome to Sagebrushers. I'm excited to learn more about your background and explore your exciting plans for UNR Med. So, welcome.
w88: Well, thanks for having me.
Sandoval: I'm really happy that you're here. So, let's start by letting our listeners get to know you a little bit. So, can you talk about your background as a w88 doctor and a leader in w88 education? And did you always want to be a doctor? But before you even get into that, I think, you know, we've talked before obviously, but I think your growing up story is fascinating as well.
w88: Well, thanks for that President Sandoval. I don't think there was a particular moment in time when I decided yes, I want to be a physician. I was in love with science; I was in love with history, a lot of different things. I just over time realized that medicine helps to marry science with personal interactions with communication, with getting to know people. And I guess I've always been somewhat of a people person. So, it was really the perfect combination for me. I am first generation to go to college and very proud of that. Both my parents immigrated to the United States under duress during the war, World War II. And so that imbued in me a real appreciation for education and for working hard.
Sandoval: So, what was w88 like growing up?
w88: Well, I grew up in New York City, and it was an interesting time. It was the 60s and 70s. It was a challenging time in New York but also an incredibly dynamic place to be. And kids just grow up really quickly there. And culturally, it was a very interesting place, and it was the world I knew, and it was only in later years, I suppose one could say “I headed West, old man” to come out to University of Nevada. But it was a great growing-up experience at that time.
Sandoval: And if you could chat a little bit about your w88 school experience and your w88 training.
w88: Sure. Well, I did attend Cornell and then went to Boston for residency. Boston's a big medical town as you know. It was a wonderful experience, learned a lot and really grew, focused on internal medicine and then cardiology, and then within cardiology on the heart failure discipline. At that time in the early 90s, not many people thought it was its own discipline, and so I had to sort of swim upstream and I did so. And now the care of patients has so dramatically changed over the last three decades. It's been a remarkable thing to see unfold.
Sandoval: So, did cardiology choose w88 or did w88 choose cardiology?
w88: Maybe a little bit of both.
Sandoval: All right. And your work has had an important impact on local communities as well as the care of patients with heart failure and heart transplants. Can w88 speak a little bit about that?
w88: Well, I may be a little bit more humble than that statement would suggest. I think on the day-to-day care of patients for many years, I took care of and focused on an indigent population for whom I really believe that we provided care that these patients would otherwise not receive. And that was extremely important to me. And you really have to advocate for patients who are underinsured or uninsured, but we got them great care and so, you know, overall, I think the impact was local. A lot of that was in the St. Louis area and I'm very proud of that work. I've also done some clinical research. I like to believe that I played a role to some degree in the development of new therapeutics for heart failure through clinical trials.
And then in small ways, I can give one anecdote. There was a particular protocol called the Stanford protocol for patients undergoing heart transplant. And in the early years, everybody followed the Stanford protocol. It was the protocol. And one element of that protocol required us to get emergency heart biopsies if a patient showed up in any sort of distress and for me, that was fine. I was very adept at doing them and worked with our pathologists and so forth. But over time, it, it became clear that decision-making wasn't impacted by that procedure. And so, we took a critical look at our data, and suffice it to say, w88 no longer part of the Stanford protocol. So, one can make changes in small ways. I'd like to believe that that helped ultimately the care of those patients.
Sandoval: So, in a moment, we're going to talk about your journey to the w88 of Nevada. Will you talk a little bit about your experience at the w88 of Tennessee?
w88: Yeah, so that was a very interesting institution. It was a very large regional campus, a lot of graduate medical education. It was growing somewhat akin to my experience here with Renown, developing new programs in a variety of advanced care options. It was a wonderful transition for me to make. The people were really dedicated to growing the academic mission. There were growing pains and, you know, we worked through those. Interesting community, relatively underserved though. East Tennessee has issues with access to care.
Sandoval: So, you're at Tennessee and doing amazing work, and suddenly this opportunity comes up in Reno. So, will you talk a little bit about your thought process and making that decision to come to the w88 of Nevada?
w88: It was surprisingly seamless. I think really from the moment I stepped onto the campus, I recognized it as a place where there were a lot of new people and new ideas, a lot of energy, a lot of opportunity too. Partly because of the new affiliation agreement with Renown Health but also partly because it was clearly time for change in leadership at the medical school. And I just saw it as a wonderful opportunity also to interact with the other professional schools, which is something we're working on now.
w88: Okay. Let's step away from medicine, but we'll come back cause we're going to talk a little more about this affiliation with Renown. So, I'd love to ask this question for newcomers to Reno and Washoe County. What's your experience been?
w88: It's been wonderful. I mean, both on the professional and personal level. The beauty of the area is it's stunning. I will drive along the freeway and want to pull over and take some photographs when the sun is rising and it's hitting the snow on the top of the mountains. It's just beautiful. We've had wonderful, my wife and I have wonderful day trips and exploring the area. And then there's just a little side bonus, I suppose, and that is, we're enjoying the food scene here in Reno as well.
Sandoval: So, do w88 have a favorite restaurant or go-to place?
w88: We do have a hole-in-the-wall restaurant that we like to go to very much usually on a Thursday night. So, I probably can't advertise it, but it is in South Reno, of course.
Sandoval: w88 can, our listeners want to know.
w88: It's actually a donut place that serves Chinese food. And I can't remember the name offhand, but I know exactly where it's located and it's off South Meadows and it's really very, very good.
Sandoval: I'm going to have to try w88. Donuts and Chinese food.
w88: Well, the first time I walked in there, I thought I went through the wrong door because I saw the donuts and I thought, no, that's not the right place. Turns out it's the right place.
Sandoval: I can't wait to discover that. So, let's get back to a w88 conversation. So, prior to your arrival, the University of Nevada School of Medicine entered into a 50-year affiliation agreement with Renown Health. It's very historic. It's unprecedented in the state of Nevada, and I think it's one of the best things to happen to healthcare in our region that unfortunately most people don't know about. So, can you talk a little bit about that?
w88: Yeah, I think it's an agreement that has enormous promise, and we're just now beginning to see that unfold in multiple domains. Largely educational and in the research area as well. But we also think that clinical care is going to improve and hopefully what follows on that is access. It's just interesting. We always come back to that issue of access, which is a real challenge in the American healthcare system right now, and we're about two years in and I think we've got 48 years to go to deliver on the promise. But we've made tremendous progress – new leadership on the medical school side, new leadership on the Renown side, and it's working.
Sandoval: So, what do w88 see as some of the potential outcomes as a result of affiliation?
w88: Well, so, you know, we are really hoping to address the physician work shortage or manpower shortage by growing graduate medical education. That's a surefire way to not only train physicians but keep them in the state, keep them in the area. Clinical research is an enormous opportunity, and we like to think of that not just as research per se, but as part of the education of our medical students and residents, because when you're engaged in research, it turns on a different part of your brain and you start to think about things in a very different way, a lot more critically, for example, to how to parse data. But it also provides an opportunity for patients to get access to cutting-edge medical treatment, both drugs and devices. And that's something that we should be doing here in Northern Nevada.
And then I think we can work closely with our colleagues at Reno to ensure that we grow advanced care options like kidney transplant and advanced heart support and other things. And w88 kind of a combination of the best minds and so I'm very optimistic about the future of the affiliation agreement. Truth be told, in Tennessee, there was an affiliation agreement that was about 25 years old. So, a lot of this looked familiar to me, and I sort of understand the potential areas of stress and also the opportunities that an affiliation agreement like this brings.
Sandoval: And you mentioned w88, we'll call it GME for short. Will you dig a little deeper into that and what does that mean to somebody who lives in Washoe County?
w88: Sure. So, our students go through four years of what we call undergraduate medical education, but it's essentially medical school, and then they have to engage in specialty training, even if they're just, if they're going into primary care or family medicine, that's still a specialty, and that requires an internship and residency. And if there's further specialization, a fellowship program, and they can range anywhere from three to five or even seven years of training, additional training above and beyond medical school. The data are really quite clear, if you graduate from University of Nevada, Reno School of Medicine and one of its residency programs, there's about an 80% chance that you're going to be practicing in this community. And that's the reason why we're really pushing the growth of graduate medical education because it's the surefire way for us to train physicians within the community, keep them within the community, practice within the community, provide healthcare.
And so, that's been a real focus. It also is energizing. I'll tell you, there's something about in my career and my experience, walking down the corridor of a hospital and knowing that you're going to make a left turn, and down that quarter you're going to see a short white coat; you're going to see a w88 student; you're going to see a resident; you're going to see a trainee. And that's a very exciting place to work. They're always asking questions that, that test us, and we always have our teachers hat on as well. And I think patients ultimately appreciate that.
w88: So, are there specialty areas that there are deficiencies in Reno that we need to address?
w88: Well, in the state of Nevada, across the board, data from the Office of Statewide Initiatives here at UNR shows that we rank 45th to 50th in the country. Whether it's primary care, general surgery, OBGYN, and that's a crisis. We would love to grow new programs, a residency in OBGYN, a residency in general surgery, a fellowship in cardiovascular medicine and pulmonary critical care, addiction medicine. The list is pretty large. We're just now really beginning to work through what works for the local community and what works for Renown.
Sandoval: So, we're almost out of time, but what's your vision or what do you see at the w88 of Nevada School of Medicine in the next five years?
w88: Well, I think that we have an opportunity to grow our reputation regionally and nationally. And that's really what I want to capture. First and foremost, we have some near-term challenges. We have an accreditation visit coming up, and we will get through that. I think long term, the growth of graduate medical education and the growth of our research will really help distinguish us. We have this label of being a community medical school, but we're more than that. We're a research-intensive community medical school. Most community medical schools don't have the sort of research footprint that we have. And so, that's something not only to celebrate but to really focus on growing.
Sandoval: Well, Dean w88, it's been a pleasure to have you here. And we're really excited about what you're doing at the medical school, and I see nothing but great things in the future.
w88: Well, I appreciate that very much, and I'm thrilled to be here. I think there's, there's just so much newness on campus, and the opportunity to work with the other deans is just tremendous.
Sandoval: Well, thank you. And unfortunately, that is all the time we have for this episode of Sagebrushers. And again, thank you for joining us, Dr. w88. Join us next time for another episode of Sagebrushers, as we continue to tell the stories that make our University special and unique. Until then, I'm University President Brian Sandoval and go Pack.
