Rural Health Spotlight: Kauaʻi Medical Training Track

It was a year ago when the John A. Burns School of Medicine (JABSOM) leaders got the word that the Chan Zuckerberg Initiative (CZI) would help launch a new training track for medical students on Kauaʻi. The grant would allow JABSOM to expand education and health care to some of the most remote parts of Hawaiʻi.

The Kauaʻi Medical Training Track will allow JABSOM to have a more prolonged and impactful presence on the Garden Isle.

There are two halves of a medical student’s journey. The first two years are devoted to classroom learning, while on-location clinical training makes up the second half.

Prior to the Kauaʻi Medical Training Track, students would learn for the first two years in JABSOM classrooms on Oʻahu. The opportunity for a student to go to Kauaʻi would be reserved exclusively for clinical learners and, even then, would only be extended to a select few.

“Historically, JABSOM has always had students centered in Oʻahu, and they do almost all their training here. There are some opportunities in the first year to go to Hawaiʻi Island, Kauaʻi or Lānaʻi” said Dr. Travis Hong, the director of Rural Training at JABSOM. “In their 3rd or 4th year, students can go to Kauaʻi, Maui, or Hawaiʻi Island. That’s been the extent of student experiences on the neighbor islands.”

Thanks to the CZI grant, JABSOM is now planting roots on the Garden Isle. Each year, six students will learn and reside on Kauaʻi for the next five years. Dr. Hong says the first cohort of learners, Jaime Emoto, Erin Evangelista, Dylan Lawton, Kirra Borrello, Ivana Yoon, and Brent Fujimoto, will begin their studies in March.

“They will be on Kauaʻi for three months, living together in a house. The Oʻahu curriculum in the medical school will be translated over to Kauaʻi. Lectures will be conducted virtually, but we’ll have an onsite physician doing the same Problem Based Learning tutorials and curricular activities with the students, so it’s really the same experience on Oʻahu,” he said.

When students enter their clinical years, they will treat patients on Kauaʻi.

“Students in their third year will spend at least six months on Kauaʻi, rotating through primary care, which includes pediatrics, internal medicine, family medicine, OBGYN, surgery, and psychiatry,” Hong says. “This is what every JABSOM student does. This group will just do it on Kauaʻi.”

Electives and different specialties are reserved for medical students’ fourth year. JABSOM’s Kauaʻi Medical Training Track students will do two elective months, and two required months in emergency medicine and geriatrics on Kauaʻi.

The CZI grant provides the Medical Training Track students with a full, four-year scholarship to JABSOM, but it comes with a promise that ensures Kauaʻi residents will also reap the benefits of the grant. “Work commitment,” Hong says. “Once they finish residency training, they must return to Kauaʻi for at least four years to practice as independent physicians. There’s no mandatory specialty they have to go into. We encourage primary care because that’s the greatest need for underserved areas.”

While primary care physicians are needed statewide, students will feel free to take a different route. Neighbor islands have a shortage of specialized doctors, and it’s common to have doctors on Oʻahu take monthly trips to neighbor islands to treat patients.
Hong, who was born and raised on Kauaʻi explains the problem there is reflective of many neighbor islands.

“Kauaʻi has 12 specialty needs, and Hawaiʻi Island has the same. Maui needs 10,” Hong says. “It’s the downside to being an island state. You can’t jump in a car and drive two hours to your nearest academic health center.”

That curse is a blessing for medical students because the vast need on the neighbor islands gives students a myriad of options to explore as they decide which medical route they’d like to practice.

“If you look at it in broad strokes, every island is dealing with the same issues, but this program allows us to get students into the hospitals and clinics to see patients and shadow physicians early on,” Hong said.

“If you have a connection to Kauaʻi like if you were born there or have family there, we feel you’ll be more comfortable serving the population,” Hong said. “When that four-year commitment is complete, the hope is that you’ll stay. Ultimately our goal is to have these students return to Kauaʻi and practice and start to do a small part in managing the physician shortage on the island.”