by Edwin Quinabo
Deans at medical schools today must navigate their institutions through arguably the most dynamic times in medicine and public health. Traditional concerns like budgeting distribution of resources and preparing students to be the best doctors possible are still central priorities.
But there’s also rapid cutting-edge technologies to be integrated in instruction, the case for expanding scholarships in light of skyrocketing educational costs. They must examine: how can research and patient care meet demands of the post-COVID-19 era and deal with threats of potentially new viruses.
Specific to Hawaii, how can the University of Hawaiʻi at Mānoa John A. Burns School of Medicine (JABSOM) lead the state to tackle the shortage of physicians?
Medical schools are not just instructional institutions in their own bubble. For public universities in particular and in JABSOM’s case being the only medical school in the state, they are a part of the fabric of their local communities; while at the same time, must be national and global in hustling to access competitive federal grants and pursue groundbreaking research if they aim to be a top medical school.
There’s also new attention being placed on diversity at medical schools nationwide to reflect the changing demographics of the country, something that has been placed in the backburner or given zero consideration for decades.
In Hawaii, boosting minorities like Filipino and Native Hawaiian representation is a no-brainer to meet the needs of patients in Hawaii’s diverse communities. Cultural sensitivity makes for relatable, better, and effective doctors in Hawaii, some local doctors say.
Interim Dean at JABSOM
The point person to meet some of these traditional and new challenges is Dr. Lee Buenconsejo-Lum, the new interim dean of JABSOM as of this month, following the retirement of Dr. Jerris Hedges who served in that position for 15 years.
Buenconsejo-Lum will serve as interim dean until a permanent dean is named which is expected to be by the end of this year. The medical school will launch a national search for its new dean and Buenconsejo-Lum told the Hawaii Filipino Chronicle she will be applying for that position as well.
The dean is the medical school’s chief executive officer and chief academic officer. Dr. Buenconsejo-Lum said, “We have a strong team of associate deans, directors, and their teams who have helped strengthen JABSOM to where it is today in the mission areas of education, research and discovery, clinical healing, and community partnerships and engagement.”
Where is JABSOM today? Solid footing and among the best.
JABSOM is #23 in Best Medical Schools: Primary care and #74 in Best Medical Schools: Research, according to U.S. News & World Report’s 2023 ranking. JABSOM has been nationally ranked in the top 25 consistently, retired dean Hedges said. There are 154 medical schools in the U.S. offering an MD program.
Buenconsejo-Lum said “the dean is also part of the University of Hawai’i at Mānoa leadership team. The dean works with the provost and other deans and directors in health and health sciences to help ensure that UH Mānoa and UH can help improve the overall health of the people of our state.
“As Interim Dean, I have the privilege of leading this team, as everything that JABSOM does is for the benefit of the people of Hawai’i and the Asia-Pacific region,” she said. Her lifelong goal is to serve her community and rural areas through her leadership at JABSOM.
Last year Buenconsejo-Lum got a boost to help her be an effective leader in her new position by being selected to the Association of American Medical College’s Council of Deans (COD) Fellowship Program, colloquially known as “the dean of school.” She was one of six (out of 28 national applicants) selected.
“Dr. Buenconsejo-Lum is well versed with JABSOM’s operations, and I am confident that she will successfully guide JABSOM during this period of transition until a permanent dean can be hired,” said UH Mānoa Provost Michael Bruno.
When asked what her leadership style is, she said “as a servant leader who values inclusivity, collaboration, constant learning and improvement, and ensuring that all members of the JABSOM ‘ohana’ feel empowered to do their best.”
Over 25 years dedicated to JABSOM
If the criterion for selecting the interim dean is finding an insider knowledgeable in practically all aspects of JABSOM, Buenconsejo-Lum fits the bill.
For starters she is an alumni of JABSOM herself and completed her residency training with the University of University of Hawai’i Family Medicine Residency Program. She also received fellowship training with Faculty Development, at JABSOM.
She has a trifecta background at JABSOM as a teacher, researcher and administrator. Additionally, her experience goes beyond academia with a working background as a family physician in Hawaii. As a researcher, she’s well published and has been a principal investigator.
Prior to her new position as interim dean, she was JABSOM’s associate dean for academic affairs and director of graduate medical education.
For the last six years, she has been a member of the dean’s executive management team and was involved in all major strategic initiatives, with budget and policy issues, not only within the medical school and UH Mānoa, but also in partnership with the state’s health systems, and Veterans Affairs and Department of Defense partners.
Buenconsejo-Lum has also worked to ensure JABSOM’s medical educational programs remain accredited and has prepared medical student and residency/fellowship graduates for the rapidly changing healthcare environment, which she says includes approaching care delivery through a more holistic, system-wide and team-based approach.
For the three years she’s also been overseeing all of the educational programs.
Work during the COVID-19’S critical stages
This year Dr. Buenconsejo-Lum was awarded the UH Board of Regents Willard Wilson Distinguished Service Award, in part for her efforts leading the school and state through the COVID-19 pandemic.
Since the threat of COVID-19 in March 2020, Buenconsejo-Lum has taken on a vital role as a trusted advisor and leader working directly with executives in multiple areas within UH and the COVID-19 Health & Well-Being Working Group. She served as one of the primary university liaisons to the Hawaiʻi State Department of Health and the Hawaiʻi Emergency Management Agency. She has guided institutional leaders on decisions regarding post-pandemic planning, including school reopenings. To this day, Buenconsejo-Lum is one of the COVID-19 lead advisors for UH and JABSOM.
When asked what are some of the post-pandemic plans JABSOM is working on with the state and health community in dealing with COVID-19 and prevention response for possible future pandemics — she said, JABSOM scientists continue to discover why and how post-acute sequelae of COVID (or “long-COVID”) affect some individuals more than others, which will help identify possible treatments to prevent some of the worst side effects.
“Additionally, many who worked with Native Hawaiian, Pacific Islander, and Filipino communities during the pandemic continue this critical work to help ensure these communities have knowledge, tools, and resources to deal with future public health emergencies.”
Dealing with state physician shortage
Besides COVID-19, JABSOM is playing a leading role helping to address other public health concerns such as the state’s physician shortage.
Under Dean Hedges’ leadership, JABSOM has been working to increase the number of students at the school. Currently there are 77 medical students enrolled at JABSOM; and more than 225 participate in JABSOM’s Accreditation Council of Graduate Medical Education (ACGME)-accredited residency and fellowship programs.
Expanding Hawaii’s medical school and post-graduate residency programs are ideal solutions, but the impacts wouldn’t kick in for another seven to 10 years, experts say.
The long-term goal is to train 100 students and have medical school branches on all islands. The challenge is that these goals are expensive. More faculty would be needed to teach additional students.
There is data to support the idea that increasing student numbers at JABSOM would most likely lead to more physicians practicing in Hawaii.
Hedges said more than 80% of physicians who graduate from both JABSOM and its residency programs tend to stay in Hawaii to practice—that is one of the highest retention rates in the country.
Buenconsejo-Lum said JABSOM is involved in many efforts in synchrony with others across the state to help address this issue. “We partner with many high schools to provide exposure and, in some cases, help educate and mentor students interested in medicine or another health career. These are called pathway programs.
“Our `Imi Ho`ōla post-baccalaureate program celebrates its 50th anniversary this year. Many of the `Imi Ho`ōla completers have Filipino ancestry, as Filipinos are considered underrepresented in medicine. Over several years, we have also increased our class size to accept 77 medical students yearly. Eighty-five (85) percent of our students are Hawai’i residents, and 16% of the current second-year class identify as Filipino. Additionally, at least one-third of medical students spend some time training on neighbor islands,” Buenconsejo-Lum said.
She said Dean Hedges worked very hard to increase scholarships so that JABSOM students can graduate with less educational debt – this also helps to keep them in Hawai’i after their training is complete. Once someone completes medical school, they complete additional training in their chosen specialty area (also known as a residency program).
“We currently have 19 residency and fellowship specialty programs in Hawai’i and are working to increase portions of their training on neighbor islands, where the physician need is greatest. We also have a successful loan repayment program which, in exchange for working in an underserved area in the State for two years, pays off up to $50,000 of student loans.
“We also work closely with our health system partners and others to attract Hawai’i-born and raised physicians back to home by creating excellent learning and work environments that embrace teaching the next generation of health providers,” Buenconsejo-Lum said.
JABSOM’s top priorities
The interim dean said, “JABSOM, as part of the fabric of Hawai’i, has many strategic priorities to help achieve the vision of ALOHA or Attaining Lasting Optimal Health for All. Our top priority is to train excellent physicians, biomedical scientists, and allied health workers (in medical laboratory technology and speech-language pathology) to care for the peoples of Hawai’i and the Pacific.”
She said JABSOM was founded to provide an opportunity for medical education previously not available to residents of Hawai’i and other Pacific nations. JABSOM is one of the nation’s most culturally and ethnically diverse schools. “We strive to be a Native Hawaiian place of learning – meaning that we embrace and teach values core to the indigenous peoples of Hawai’i, work in partnerships with all facets of society, and have the responsibility and privilege to act with respect, fairness, and in harmony to achieve healthy communities and people.
Back to her roots
Buenconsejo-Lum grew up in Wahiawā and Mililani. Her parents, Gervacio “Harvey” Buenconsejo and Fay Molina, were both teachers at Leilehua High School. Her father’s parents, Lino and Leonarda Buenconsejo, arrived from Baler in Central Luzon in 1928 and worked as a barber and a seamstress, respectively.
Her maternal grandmother, Ellen Wee, was born in Kona to emigrants from what is now North Korea, raised in Wahiawā, and taught in Wailuku, Maui, where she met her husband, Manuel Molina.
Buenconsejo-Lum said her maternal grandfather and his family arrived from Casares, Malaga, Spain, in the early 1900s and worked for Maui Pineapple Company in Keahua, Maui.
Her great uncle Timothy Wee was a general practice physician in Wahiawā.
“My family instilled the work ethic and values that inspired me to pursue medicine. Growing up around my ‘uncle doctor’s’ office, I found it pretty special that he had formed bonds with and cared for many generations of families from Wahiawā and surrounding areas. I also shadowed or worked for other physicians in Wahiawā, who taught me always to keep the needs of patients and families at the core.”
She said her leadership journey started at Wahiawā Elementary School, in student council, and as a Junior Police Officer and has continued since then. Her favorite non-class was student council, followed in close second by band. “I was blessed to be given the opportunity to serve in the Central O’ahu district, Hawai’i State Student Councils, and other state committees.
“I had the chance to learn from government officials and work to address many issues facing public school students and families, including poverty, safety, and the need for better school-based health services, including STD and HIV prevention.”
Premed, Medical School
Buenconsejo said “I had to buckle down at Stanford University where I was a pre-med student with so many others who were smarter than I was.”
She recalls many nights not getting sleep. “[It was] a bad idea, now that I have learned better.”
She helped pay for her schooling by working as a manager of the school dorm’s student-run food service and worked at the medical school.
“I didn’t have time to do research or become very involved with other activities besides the Hawai’i Club. However, there were so many opportunities at Stanford to learn different subjects that helped shape my interests and make me more well-rounded.”
She said when she returned home to JABSOM in 1990, the problem-based learning curriculum fit her learning style – “so while the content was challenging, medical school didn’t feel like a struggle because of the tremendous support by the faculty and my fellow students. I was in the first recruited class of Family Medicine residents in 1994, with four of my classmates from JABSOM and two who have made Hawai`i their home.”
She recalls, “back then, there were no restrictions on duty hours, so I was pretty tired and grumpy. However, because Wahiawā General Hospital was our home-base hospital and the clinic was in Mililani, I was supported by family. I felt I had come full circle, as I was born at that hospital and grew up in the community.
“I joined the faculty of JABSOM in 1997 because I felt I could significantly impact the community’s health by training the next generation of physicians and family medicine physicians.”
When asked about being the first dean of JABSOM having Filipino ancestry, what does this trailblazing role mean to her? Dr. Buenconsejo-Lum said, “My family has always valued education, working hard, and improving situations for the next generation. That is why my paternal grandparents decided to come to the United States in 1928. I am so fortunate to have been encouraged and guided by family and many teachers and mentors, starting at Wahiawā Elementary, Wheeler Intermediate, and Leilehua High School.”
Advice to youth considering a career as a medical doctor
Buenconsejo-Lum said those with interest in science, teaching, and helping others, medicine is a great career to explore. Unfortunately, many students feel the cost of higher education and the time it takes to become a doctor is unaffordable.
“I would say that college and higher education are increasingly more affordable to those families with financial need. Many scholarships are available to those who work hard, have a passion for what they are doing, and are clear on why they want to pursue a career in medicine.”
She said you will need to do well in high school and college – especially in math, English, and science and ensure you develop great study habits and time management skills.
“It is also important to be well-rounded and participate in activities that make you a better human being and allow you to learn how to deal well with stress. We need intelligent and skilled physicians who live a life of compassion and service and advocate for optimal health as a human right so that everyone can achieve their dreams and maximum potential regardless of their life circumstances,” Buenconsejo-Lum said.
by Edwin Quinabo