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Many nights after she finished treating patients at UAB’s Hoover Family Medicine clinic this spring, Sumayah Abed, M.D., assistant professor and family physician, sat down with a stack of documents and painstakingly translated them into Arabic, often emailing her father in Iraq to double-check her work. 

Language barriers create issues at all levels of health care for both patients and providers. Miscommunication is common and important health markers can be missed when a patient and their care team cannot communicate properly. Abed, M.D. set out to improve the way that Arabic-speaking patients receive care at UAB clinics and hospitals.

Abed is originally from Iraq and attended medical school in Mosul. Her first language is Arabic but she learned English at school and began using it regularly while working in Qatar as a women’s health physician in 2006. When she moved to the United States to complete her residency in Birmingham, she began noticing a gap in communication between Arabic-speaking populations and their health care teams.

Beginning in early 2021, Abed began a project to address these communication gaps. For more than three months Abed has used her time off to translate common patient-facing documents into Arabic. Abed worked closely with her father, Khalid, who still lives in Iraq to ensure the documents included correct grammar and sentence structure. He is an Arabic literature teacher for high school students.

So far, Abed has translated more than 10 educational documents commonly given to patients with illnesses like hypertension, diabetes, respiratory diseases, and many others. Abed’s translated documents are available to any UAB physician or care provider in the electronic medical record (EMR) system supported by UAB.

“The idea came to me because of the increasing number of Arabic-speaking patients in our clinics,” said Abed. “I wanted to create these Arabic educational materials to help our patients better understand their medical conditions.”

The greater Birmingham area is home to many Arab immigrants and Abed sees several each week in her clinic. For physicians treating these populations, many of whom speak Arabic as their first or only language, the language barrier can create issues in providing quality and comprehensive care in the clinic. Abed’s translated documents will ensure future interactions with physicians will be more accessible for Arabic-speaking patients.

The Department of Family and Community Medicine strives to build bridges to underserved populations through access to medical care and improving resources.

The Department of Family and Community Medicine works to educate students and faculty on the importance of elevating diverse voices and addressing health disparities, social determinants of health, racism, and access to care issues within the primary care space. As part of the School of Medicine’s Unified in Pride series, Brandi Shah, M.D., MPH, and Program Manager Shyla K Fields spoke with Jess Jernigan, web content coordinator for the department, to discuss her experiences related to identity, access to healthcare, and more.

Shyla: Please tell us who you are, your profession, your age if you'd like, and how you identify in the LGBTQ+ community.

Jess: I'm Jessica Jernigan. I'm 24, a web content coordinator for UAB, and I identify as bisexual.

Shyla: How open are you about your sexual identity or gender identity at work, at school, at home, or with new acquaintances?

Jess: In a professional setting, it doesn't come up in a natural conversation, but with my friends and family, they all know. When I meet new people, it's not something I just go up and tell them. I've worked with a lot of bisexual women. It just determines not necessarily a romantic relationship. But say I was in a relationship with a man, it's not something that I would outright disclose, but I'm pretty ‘out,' and my bosses know just because of personal conversations you have with your coworkers. But yeah, I would say I'm as out as can be.

Shyla: That's excellent. What does bisexuality mean to you?

Jess: Many people I've come across and even discovering my own identity, it's not even so much your romantic preference. It's so much of who you are embedded in your personality and your character. It's how you see the world, and you treat other people. So even if I didn't have a relationship with a woman or a man. It would still be so much of my identity. It's kind of ingrained in my character if that makes sense.

Shyla: Yeah. What identity do you prefer to be addressed as in your professional and personal community?

Jess: I’m bisexual. I’m part of the LGBTQ+ community, and a lot of times, people just assume I'm straight, but I'll correct them if I need to.

Brandi: How do you do that? Jess, can you give an example of how you correct people?

Jess: If I'm out with new people or friends and they say something like, when was the last time you went on a date with a guy. I'll say, actually I don't just go out with men, I also go out with women, or I'll try not to put emphasis, so they don't feel embarrassed for assuming. Or I'll slip in; you know, I went out with a woman, or I was interested in her too just, so they're aware, and it doesn't draw too much attention to it because I don't want them to feel they've messed up. I keep it casual, and if they have more questions, obviously, I'll answer.

Brandi: How do people usually respond to that?

Jess: Usually, the times it's happened they'll respond, ‘I didn't know,’ or they just get past the conversation really fast. And I don't think it's because they are, against it or anything. It's just their own personal feeling, like, I didn't mean to slip up or feel dumb for assuming.

Brandi: And have you always been this comfortable talking about your sexuality, or can you recall a change, a moment or threshold when you were just like, this is just how I'm going to talk about it, and the people are going to come along.

Jess: I knew I was bisexual when I was really young. Obviously, I didn't know the term because I was probably 10 or 11, but I really felt comfortable when I got to college. I was surrounding myself with people who I just never really knew before. I remember specifically working for a magazine in college. My boss identified a lesbian woman and talked to me about her experience. It wasn't something that I necessarily talked with my friends about. We would just say it in passing, but I never really looked at it as something that I would label myself as, and I think I felt really comfortable with her (my boss). I would ask my boss questions about it because we were researching LGBTQ members and sororities. It's something that wasn't talked about. She told me about her experience, and it just made me reflect on how I present myself and how I actually wanted to be seen by the world, and how I want to see myself. And then I slowly started to come out to people in my life. I told my family 1st, then my friends. The more people I told, the more comfortable I would say it with myself. I feel like I kind of spoke it (identity) into existence, something that I always felt for myself, but it was more personal. The more I talked about it, the more accepting I felt of myself and accepted by other people. Yeah, it was my boss that helped me the most.

Brandi: Now that was that was beautiful. That really is. I think that's very important to say here.

Jess: And it was because it was in a professional environment too. In my experience at other jobs, they don't necessarily treat me differently, but they can make small comments, not necessarily support. It's more of an interest. Because we live in the South, and you don't see bisexual people a lot, at least in my experience.

Shyla: Do you feel the comments are microaggressions?

Jess: Well, I think bisexual women are hyper-sexualized in a lot of situations. That is a huge part of why I don't share my identity until I feel comfortable. There's a really big stigma around that, and I want to control how people view me. It's not that I'm not proud. I just think there is a lot of power in controlling your narrative and who you want to share information with. I think about this all the time. Letting people know that you're very intentional with the information you share. It's not that I'm disrespecting my community. It's how I want to operate in my professional world and my personal relationships.

Shyla: Yeah, that’s totally understandable. What I hear is, it's a form of protecting yourself professionally and personally.

Jess: Yes, exactly.

Shyla: Yeah, and a form of advocating for yourself.

Jess: And I would never hide or anything. I also don't think there is any shame in hiding, and any opportunity I have to correct someone or educate them a little more, I'm happy to do that.

Brandi: Have you had an experience you can compare where one was a more affirming and appropriate encounter medically and then compare it to one where it wasn't?

Jess: Well, I've never had a bad experience in a clinical setting because, as a bisexual woman, we have that straight passing ability. Everything that I would be checked for would be the same, there is no crossover. In a medical setting, I've never really had to disclose my sexual identity for my health. It's never been a conversation that's been brought up because I am a woman. But I know it's different for, non-binary or bisexual men.

Brandi: Well, from my experience working with young people, for adolescents and young adults, some of the evidence that we always try to stay on top of is understanding the spectrum of sexuality and gender identity, particularly for bisexual-identifying people. Sometimes I think what you just described can be more invisible in terms of their health care needs, and often what we see at the population level is higher unintended pregnancy rates and higher STI rates. When you look at the population level at the individual level. One of our challenges is, what are we not doing right to make them more visible? Make them still more comfortable talking about their sexual identity and the sexual behaviors that we can help. To help reduce risk or and offer them all of the services that they should have access to. So do you have any sort of thoughts on that?

Jess:  Being very selective with your language and, of course, never implying their sexuality. If I'm with my doctor and they asked me if I'm sexually active. Half the time, a lot of women will say this too; They'll say they are not sexually active because they think they can't get STIs if they are sexually active with a woman. I think physicians should share that you can contract STI’s without having penetrative sex or have open conversations about it. Half the time, people wouldn't disclose anything like that because maybe they weren’t necessarily in a relationship with a man, they think that that doesn't correlate if you're with a woman.

Brandi: Ok. I'll tell you what I do with my patients, and you can tell me that's if it's ok, or not ok, alright? This is what's recommended through CDC guidelines and all sorts of policy statements about how we should be engaging with people around, taking sexual history, especially with young people. I ask, have you ever been sexually active, or are you having sex currently? I also ask, are you at risk for anything right now that we should talk about? Then I'll say, are your partners male, female, or non-binary? If I know something else about the patient where I know it's not just on the binary. I say that quickly, and it opens the conversation up for them to say, well, most of my partners are male, but I've had some female partners in the past. And then I'll ask, what is sex for you? Is sex, Penis in the vagina? Is sex penis in mouth? Is it mouth on some other body part? Something in the anus? I've learned to use anatomical language because it's the anatomy that I need to be screening. So if all of those sites are involved in sex, I want to offer you screening for all of those sites in the case. And like bisexual women or women who identify as lesbian, some other things come up. There's certainly a risk of throat infections, but also we see higher rates of BV. There are moments where we could be doing individualized counseling about particular sexual health. Based on this sexual behavior, and I know that that doesn't happen with everybody. That's what I do because I know that how someone actually identifies is not the same as what kind of sex they're having and what I can provide as a clinician.

Jess: No, that's perfect, I wish more doctors would do that. When speaking with my physician, going over the standard list of questions (are you sexually active? chance of pregnancy?) and saying no, the questions stop there. Too often, conversations carry out with no space to convey that someone may be bisexual or have partners of the same sex. It is important for the patient to disclose their sexual history for their doctor to perform an accurate clinical assessment for health needs. And part of doing that is leaving space for that conversation between the lulls in the questions. As someone who identifies as bisexual, that means that my medical assessment could change, and having my physician know that is critical. A way for both the patient to feel comfortable and for the doctor to receive a clear understanding of the patient’s needs would be to have an open and comfortable conversation to ask questions that don’t necessarily assume one’s sexual orientation based on the gender of current partners.

Shyla: Yeah, so it's more of the general questions that speak to the anatomy that Brandi spoke of and the education on different sexual practices.

Jess: Exactly. Show the person how to properly protect themselves even when they’re not sexually active with another person's body.

Shyla: When we talk about being within the community, people know that you're Jess, your sexual identity. Are you also an advocate? What title do you hold?

Jess: It's so much ingrained in me. It's just something that I carry around with me. Part of being an ally is, yes, it's educating others. But it's also checking yourself, and because often, we'll all have some internalized negative thoughts about ourselves. I'll have to keep in check with my own mindset as well as with other people.

Jess: It's just so much of who I am. I don't know how to explain it. It's just supporting people when they need support and lending a hand before they even ask.

Shyla: If this was your Ted talk, speaking to health care providers, what would be the one-liner of what affirming care looked like for the LGBTQ+ community?

Jess: Being more intentional with how they bring up the conversation about it (sexual identity). I would feel more comfortable if, say, I was in a clinic setting or in the waiting room and see a sign to let me know they are inclusive. Even if it was just an LGBTQ pride flag or the bisexual symbol, I would immediately feel comfortable with them. It's also being unbiased as possible, like how Brandi talked about it. You're looking at the person's anatomy. You're not looking at their interior life. You're looking at how you can help them. It's who they are as a person. You're there to help them health-wise. I would feel more comfortable if my doctor was less involved in my interior life and more involved in how I view myself as a patient, better my health, and not look at my identity or my identifier.

Shyla: That's a perfect one-liner, "looking at me as far as how you can best serve my body versus how I identify or my identifier." How have you found, formed, and kept your community or communities together?

Jess: I don't know, this out of pocket to say, but I gravitate toward people who, you can just tell when someone is a gentle and open-minded person. I feel like because you know my identity and how I identify sexually, even though I think bisexuality and any sexual identity, again, has nothing to do with sex. It's so much of who you are as a person. I feel like it's very easy to gravitate to other people like that. So, even with my friends and my family, who are also part of the community somehow, we just check in with each other and see how the other person is constantly doing. If my friend says someone made an offhand comment to me at work today, they made a gay joke. We'll talk about it, and we'll think of how you can approach it the next time a comment was made. Just constantly checking in, and that sounds obvious, but so many times because there is no conversation, people just assume that something is being done when it's not. Even if it's something small, keep the conversation going. I've read and have seen much backlash about corporations "putting on" for Pride Month and its performative allyship. Still, even if it's performative, even if it's a capitalist gain, I would have loved to see that when I was a child. I would have loved to have gone into Target and see a rainbow flag! Is it disingenuous? Maybe, but does it make me feel comfortable? Yes! I would have loved to have seen that. It makes a huge difference. Even if it is performative, it's something.

Shyla: Yeah, representation matters.

Shyla: Brandi, do you have any more questions?

Brandi: I don't think so, but I feel like I could talk to you like all day, Jess, because representation does matter and visibility matters, and I really appreciate you. We talk about seeing others, and there's action and intention in that. But it also takes what you were describing earlier. It is a form of self-advocacy to decide if and when you're going to disclose something and how you want to be seen by the rest of the world. There's empowerment in that. And the openness and thoughtfulness that you clearly have with just this one part of your identity and how it interacts with all the other parts that we haven't even been able to talk about. It's critical for people and clinicians to hear that to know and understand how to check bias and check stigma that we intentionally or unintentionally bring into the exam room.

Shyla: What else should we know about you? How do you feel about Pride Month, healthcare, your profession, and how that intertwine?

Jess: These identifiers, they're just facets of a larger person. I can say my name is Jess, I'm bisexual, and I'm a communications coordinator. But if more people would look at people as a whole person and not just corners of their being, acceptance would come a lot easier. I think pride month is about supporting others, fighting for what's right in your own way. But it's also taking stock of your own mental health and taking stock of how comfortable you feel when you go to bed at night and how you think about yourself. It's such a personal thing, and if you feel comfortable sharing with other people, that's your right. There's a lot of power in knowing these things about yourself. You don't necessarily have to shout it to the world. It looks different for everyone, and people need to understand that. It would have helped me as a child and even going into a young adult. If I had known that. I would have been a lot easier on myself because there's just a lot of pressure. To speak up, but speaking up looks different for a lot of people. 

Shyla: That is a beautiful way to end the interview. Thank you so much.

As the summer heats up, it's time to welcome our new sports and exercise medicine fellows and say goodbye to our graduating trainees as they move forward in their careers. In partnership with Cahaba Medical Care, the Department of Family and Community Medicine's Sports and Exercise Medicine Fellowship program is a unique two-year fellowship that offers individuals an opportunity to gain hands-on, comprehensive sports and exercise medicine experience while also obtaining a master's degree in exercise and nutrition. Each fellow plays an essential role in caring for athletes of all ages, including organized sports at the professional, collegiate, and high school levels.

Learn more about the new class and graduating fellows below. 

Hello:

On July 1, the program will welcome two new fellows, Matthew Miesch, M.D., and Christian Muller, D.O., to the team.

"I'm excited to have such a great pair of fellows coming in to help us take this fellowship to the next level," said Ian McKeag, M.D., sports and exercise medicine fellowship director. "They both come from great programs and have fantastic attitudes. It's going to take some hard work and grit, but I believe these two can help us get there."

Matthew Miesch, M.D.

Hometown: Mount Pleasant, Michigan 

Medical School: Ross University School of Medicine

Residency: Family Medicine, University of Connecticut, Hartford, CT

Why I chose UAB: You cannot beat training in the southeast for football sideline coverage! The Division 1 athletic coverage was a huge draw for me. I also love how the program emphasizes research as a key part of the fellowship training. 

Looking ahead: I'm most looking forward to honing and sharpening my ultrasound skills (injections, diagnostic, etc.). I am also very much excited to begin working with Dr. McKeag! 

Christian Muller, D.O.

Hometown: Pine Bush, New York 

Medical School: Touro College of Osteopathic Medicine, Middletown, New York

Residency: Family Medicine, Rowan School of Medicine, Stratford, New Jersey

Why I chose UAB: I find the sports and exercise medicine program to have incredible leadership, ample opportunities to help me grow as a doctor, and all I need to reach my goal of being a sports medicine physician. 

Looking ahead: I'm most looking forward to the sideline coverage that is in my near future — high school, club, college, and professional. UAB has a great mix of it all, including the 2022 World Games! 

Goodbye:

Pictured left to right: Mallory Lewis, D.O., Ian McKeag, M.D., Patrick Ouzts, M.D.Congratulations to graduating fellows Mallory Lewis, D.O., and Patrick Ouzts, M.D., as they enter the next chapter in their professions. As fellows during the COVID-19 pandemic, Lewis and Ouzts were able to adapt and provide continuous quality care to their patients despite the selective pressure.

"I have loved having the opportunity to expose [Lewis and Ouzts] to the various experiences we have here at UAB," said McKeag. "My favorite of these were the initial Birmingham Legion FC games when they had just begun fellowship, and the coverage at the Birmingham Bulls hockey games, which was a unique atmosphere compared to the rest of the coverage we provide."

Both Lewis and Ouzts have accepted positions across the country, practicing a mix of sports and family medicine care.

"Mallory and Patrick hold the potential to make a huge impact in their respective communities as their careers grow," said McKeag. "They both have their own style, gifts, and swagger."

Mallory Lewis, D.O.

Hometown: Fort Worth, Texas

Residency: Family Medicine, University of Oklahoma 

Favorite fellowship memory: The opportunity to work with Division 1 athletes 

Favorite sport to cover: Football and soccer

Next steps: Ascension Sacred Heart in Pensacola, Florida. I will be in a private practice clinic doing a combination of family medicine and sports medicine.

Patrick Ouzts, M.D.

Hometown: Cleveland, Ohio

Residency: Family Medicine, Rutgers University, New Jersey

Favorite sport to cover: I love all sports, but especially covering soccer and football.

Next steps: I will be relocating to Tucson, Arizona to work for Northwest Medical in an outpatient practice doing both sports and family medicine.

The Department of Family and Community Medicine, in partnership with the UAB Center for Teaching and Learning and the Center for Clinical and Translational Science, began offering a 10-month primary care faculty development fellowship in 2019. Since then, 17 fellows have completed the program and 16 more are set to graduate on June 11, 2021.

The fellowship invests in senior residents and junior faculty who are interested in academic medicine and educating medical students. Focus areas include teaching, scholarship, leadership, and practice transformation. Michael Wiederman, Ph.D., director of the Office of Leadership and Professional Development, and Irfan Asif, M.D., department chair and associate dean for rural health and primary care, co-direct the fellowship alongside Becky Reamey, Ph.D., program director for the Center for Clinical and Translational Skills Training Academy, and Scott Phillips, Ph.D., director of the Center for Teaching and Learning.

“When I first came to UAB, many faculty members on campus and at our regional campuses wanted more training and professional development,” said Asif. “This fellowship offers participants the chance to grow in a rigorous and collaborative program.”

Fellows attend monthly training sessions on Fridays each month, conduct a group study project, develop a teaching philosophy and leadership statement, and learn from primary care and professional development experts throughout the fellowship.

“The fellowship enriched my professional skills, my teaching techniques, and uplifted my capacity in research writing,” said Sumayah Abed, M.D., assistant professor in the Department of Family and Community Medicine and 2021 graduate of the fellowship. “Most importantly, it expanded my professional network through the monthly opportunities to meet with leaders in my field, mentors, faculty members, and others who widened my scope of vision as a faculty member.”

The fellowship is open to family medicine and primary care senior residents, junior faculty, and faculty members. The 2021-2022 fellowship application is now open.

Learn more about the Faculty Development Fellowship here or by contacting Michael Wiederman, Ph.D.

Each year, the Department of Family and Community Medicine presents the G. Gayle Stephens, M.D. Award to a graduating medical student pursuing family medicine. Recipients are selected based on demonstrated leadership, professionalism, academic performance, and interpersonal skills. Brandon Honeywell, M.D., was presented with the award during a virtual ceremony on May 20, 2021.

This award honors G. Gayle Stephens, M.D. and his contributions to family medicine throughout his career. Stephens served as the first dean of the School of Primary Medical Care in Huntsville, Alabama, and was a chair of the Department of Family and Community Medicine at UAB. Beyond his clinical achievements, Stephens also founded one of the first family medicine residencies in Wichita, Kansas in 1969. After his retirement, Stephens was named a professor emeritus of family and community medicine at UAB in 1988.

While a medical student, Honeywell served as a co-head coordinator for the Internal Medicine Interest Group, was a member of the Argus Society, and volunteered at the COVID-19 Contact and Recovery Tracing site at UAB Hospital. Honeywell also worked as a peer mentor for medical students, a clinical skills teaching associate, and completed several scholarly research projects with UAB School of Medicine faculty. He is a member of the American Academy of Family Physicians, American Medical Association, and the American College of Physicians.

“Brandon built great rapport with patients and staff, and showed excellent medical knowledge and skill during his time in medical school,” said B. Earl Salser, M.D., director of medical student education and associate professor for the department. “He will make an outstanding future family physician.”

When asked about his future as a family medicine physician, Honeywell remarked on the impact the specialty has had on his life.

“Family medicine has been a part of my life since as early as I can remember as my father is a family physician,” said Honeywell. “I chose to pursue family for two reasons: the long-term patient relationships and the broad scope of practice available to practitioners. This is a very rewarding field.”

Honeywell will complete a family medicine residency at Wake Forest Baptist Medical Center beginning this year. The department would like to congratulate Honeywell on this achievemen

May is both National Physical Fitness and Sports Month and Mental Health Awareness Month, but did you know that these two topics share some of the same best practices?

With so much information available on how to keep healthy and fit, it can be overwhelming to focus on the best way to take care of yourself. Faculty members from the Department of Family and Community Medicine worked together to share four tips for maintaining a healthy mind and body.

Tip One: Get up and out, every day

Ian McKeag, M.D., is the program director for the UAB-Cahaba Sports Medicine Fellowship and an assistant professor in the department. He tells his patients to set a goal and to move their bodies for a set amount of time each day.

“Not everyone has the ability or the finances to join a gym, but nearly everyone can walk,” said McKeag. “Tell yourself that you are going to be out of the house or active for a least 30-60 minutes per day and stick to that goal.”

McKeag noted that setting a time-based goal helps his patients improve mobility over time and encourages physical activity in an accessible way.

Tip Two: Being active counts

“Remember that being ‘active’ counts as exercise,” noted Kim Fagan, M.D., associate professor and chief of the department’s sports medicine division. “Work in the garden, take the stairs at work, do squats while you talk on the phone, or complete a simple arm workout while watching the news.”

Fagan encourages her patients to have an active mindset and reminds them that small activities throughout the day add up to increase physical strength and health.

Tip Three: Build habits to support mental health

According to Kaylee Crockett, Ph.D., assistant professor and clinical psychologist, many people have gotten more creative about their physical activity routine during the pandemic.

“Studies have shown that individuals of all ages who maintained or increased their physical activity during the pandemic reported less anxiety and depressive symptoms, and a greater sense of well-being,” said Crockett.

By prioritizing physical activity and exercise, Crockett says that people can improve their mental health and general outlook.

“Now is a good time to reflect on what works well in terms of physical activity, especially as we transition back to ‘normal’ in the coming months,” she said. “Routines like the make-shift home gym, lunch hour walks or activity breaks, and increased outdoor time are worth keeping as ways to improve and maintain mental health.”

Tip Four: Find something you enjoy (and hydrate!)

Irfan Asif, M.D., chair for the department, asks his patients what they enjoy when encouraging increased physical activity.

“Don’t let yourself get discouraged if you don’t like a certain type of exercise,” said Asif. “The most important part of physical activity and exercise is staying active doing things you enjoy and trying new things to keep yourself motivated.”

Asif also reminds his patients and others to stay hydrated while completing workouts or outdoor activities. He recommends drinking water every 15 minutes during an hour of exercise and drinking a beverage with electrolytes if the activity exceeds an hour, especially during the summer.

Physical activity and exercise play a vital role in overall health and wellness, including mental health. As summer approaches, explore new ways to stay healthy with these physical activity and wellness tips from the Department of Family and Community Medicine.

The American Medical Society of Sports Medicine (AMSSM) is an organization dedicated to supporting growth in the sports medicine field. AMSSM offers educational resources, research opportunities, and collaboration among sports medicine physicians around the world. Irfan Asif, M.D., chair of the Department of Family and Community Medicine, has been involved with AMSSM since medical school.

As part of the School of Medicine’s spring 2021 curriculum offerings, faculty in the Department of Family and Community Medicine led three elective courses related to research, inclusion, and leadership. Each course allowed students to learn more about their interests and space to explore new ideas related to their future careers in medicine.

Holding Space: Power of Storytelling in Medicine

Brandi Shah, M.D., MPH, is the director of the department’s Office of Identity, Inclusion and Collective Conscience. Shah practices at the Student Health Clinic on campus and is an active community advocate for equity in healthcare. Shah led an elective course intended to help students understand the importance of storytelling and relationship-building with patients as they continue their medical training.

Shah met with four students—two MS2s and two MS3s—weekly to collaborate with them and their community storytellers. The first few classes introduced students to community engagement and story work. After these discussions, four class sessions were devoted to rapport-building with the group and activities aimed at helping the students engage with stories in an empathetic and creative way. The last five weeks of the course gave students time to complete the storytellers’ digital stories for an exhibit at Vinegar Contemporary, a local arts nonprofit.

The community storytellers shared their experiences with the students and collaborated on a digital presentation of some of their medical experiences as members of the LGBTQIA+ community.

“I offered this course because I believe that stories and storytelling/sharing are at the core of medical practice and relationship building with patients,” said Shah. “The most rewarding part of the course was witnessing the personal and group transformations that occurred between and because of the medical student and community storyteller interactions.”

Jasper Kennedy was one of the students in Shah’s class this spring. Kennedy remarked on the impact the class had on their education and future career.

“Being part of the course helped me practice one of the most valuable skills a physician can have—how to bear witness to another person’s struggles,” said Kennedy. “It was so impactful to collaborate with members of our community who are often silenced and to get their stories out into the world. I’m grateful for the vulnerability that our storytellers showed in sharing about their lives and specifically their interactions with the healthcare system. I will be taking the listening, support, and advocacy skills I gained in the process into my future interactions with patients.”

The students’ and community storytellers’ digital stories exhibition, “Holding Space: One Entity Embracing All,” is available for screenings on Saturdays from 10 a.m. until 2 p.m. or by appointment at Vinegar through May 15.

Shah plans to offer the course again in spring 2022. Interested students may reach out to her or to the Office of Identity, Inclusion, and Collective Conscience to learn more.

Health Psychology and Wellness in Primary Care

Michael Wiederman, Ph.D., director of the department’s Office of Leadership and Professional Development, held his second elective course this spring after a successful course on leadership in fall 2020. Wiederman explored the importance of psychology in primary care with his class, which was made up of 11 students in their second and third years of medical school.

“I was really impressed with the attitude of these students,” said Wiederman. “They invested in this course and took a collaborative approach to their learning and development.”

The course included pre-work reading and recorded lectures to study before virtual meetings, where Wiederman led discussions and active application exercises based on the material. Wiederman decided to offer the course to give medical students the chance to deepen their understanding of the scope of primary care and the application of psychology practices, such as motivational interviewing and intentional referring, in treating patients with mental health concerns.

Even if students do not continue into a psychology specialty, this course helped them become better physicians by exposing them to potential mental health hurdles that future patients may face, noted Wiederman. 

“The course was an invaluable class during my second year,” said Paris Long, a second-year medical student in the course. “It gave me the ability to practice my motivational interviewing skills in an environment that was both comfortable and conducive to learning.”

Wiederman plans to offer a similar course in 2022. Interested students can contact him for more information.

Clinical Research Experience: COVID Pandemic

Kimberly Smith, Ph.D., director of the Alabama Practice-Based Research Network offered a course on clinical research that explored topics related to completing a clinical research project while in medical school. Fourteen medical students, representing all years of medical school, participated in the course.

Each virtual session included didactic training and time for breakout group discussion and application of the research skill discussed that week. Smith covered how to set up a research question, create a survey, analyze data sets and more. All medical students are required to complete scholarly activity before graduating, and this course offered a look at how to approach future research activities.

“It was great to feel like I was empowering the students to research topics that they were passionate about this semester,” said Smith. “Research can be perceived as boring, but we were able to get these students excited about it because they chose topics that were important to them and encouraged them to explore their interests.”

As the course title suggests, students were asked to pick topics related to the COVID-19 pandemic and worked with Smith to study topics ranging from comorbidities to related conditions and the lasting impact of the illness.

James Crenshaw, a first-year medical student in the School of Medicine, completed the course and a research project on the impact of obesity on COVID-19 symptom severity.

“The COVID-19 Clinical Research course taught by Dr. Smith provided a valuable learning experience in clinical data analytics, employing the scientific method, and writing manuscripts,” said Crenshaw. “I learned to generate impactful research questions, develop an effective REDCap questionnaire, translate and analyze survey data, and produce a poster presentation yielding my findings. The process of gathering insights on COVID-19 symptom manifestation in obese populations was a rewarding project to work on during the pandemic, bolstering my understanding of the occult mechanisms of coronavirus and enhancing clinical research skills that I will utilize throughout my medical school career."

Smith plans to offer a similar course next year and encourages students to reach out to her for ways to get involved in research within the Department of Family and Community Medicine or through the Alabama Practice-Based Research Network online.

For more information about how the Department of Family and Community Medicine is working to educate the next generation of medical leaders, visit our website.

The Family Medicine Interest Group (FMIG) is a student-led organization that empowers medical students on campus to learn more about the family medicine specialty. There are similar interest groups on campus for other specialties that offer a place for medical students to ask questions, plug into professional organizations and learn more about the departments that represent these specialties on campus.

The Department of Family and Community Medicine’s FMIG recently completed selections for its 2021-2022 executive leadership team. The team includes four medical students, all in their first year, who will collaborate to plan events and work with their departmental advisor, Ksenia Blinnikova, M.D., to increase interest in family medicine among their peers. Fallon Lalor, Dalton Frederick, Claire Wilson, and Hope Cain will serve the organization this year. Each student has a different perspective on family medicine and looks forward to a successful year in FMIG.

For Women's History Month, we are spotlighting a few of the amazing women in the Department of Family and Community Medicine in collaboration with the UAB School of Medicine's "Women Making History" series. Read below about how they are making history in the mission areas of teaching, outreach, diversity, and clinical areas.

We are grateful for all of our female leaders and those who contribute to the important work done in our department each day. 

Celebrate National Nutrition Month with the Department of Family and Community Medicine by trying these healthy and delicious meal ideas from faculty members.

Caroline Cohen, Ph.D., R.D., a registered dietician and assistant professor in the department, regularly counsels patients on healthy eating and how to incorporate positive habits into daily life.

“Developing healthy eating habits looks a little different for everyone,” said Cohen. “As a way to celebrate National Nutrition Month, we wanted to show how providers in the department incorporate healthy eating into daily life.

Breakfast

Caroline Sullivan, DNP, RN, FNP-C, is a nurse practitioner at the UAB Highlands Family and Community Medicine clinic. For Sullivan, breakfast often includes whole grains and low-fat protein.

“My typical weekend breakfast is a healthier spin on a classic breakfast plate,” said Sullivan. “I scramble two eggs with a pinch of cheese and “Everything but the Bagel” seasoning. I toast a piece of Ezekiel Bread, which is a flourless whole-grain bread packed with sprouted grains and zinc, fiber and iron. I’ll finish with a few pieces of turkey bacon, which has 35% less fat and calories than pork bacon.”

Sullivan also enjoys baking healthy and kid-friendly muffins for an easy, on-the-go breakfast. They include applesauce, whole wheat flour, flaxseed, almond milk, eggs and shredded fruits and veggies for added vitamins.

Lunch

Sumayah Abed, M.D., assistant professor, provides details about nutrient-rich lunches that she and her family eat.

“Our typical lunch consists of a main dish and two side dishes, usually salad and rice,” said Abed.

She noted that while the recipes can include chicken or red meat, she often substitutes those with nutrient-dense proteins like shrimp or fish that have less saturated fat. Abed also prepares a tomato and okra soup to mix with the rice for a fruit and vegetable add-on.

Abed’s family enjoys sweets after each meal, but she says that does not mean that they have to eat a lot of sugar. She prepares sweet rolls with pistachio and coconut to provide a healthier dessert option.

Dinner

“Generally, my guiding nutrition philosophy is a high-fiber and low-sugar diet,” said Cohen. “By emphasizing high fiber foods, like vegetables, fruits and whole grains, and avoiding added sugar, patients may reap a variety of benefits including stabilizing blood sugar, lowering cholesterol, decreasing inflammation and improving gut health, all of which may prevent disease.”

For dinner, Cohen prepares nutritious meals like Mediterranean turkey burgers with a salad and roasted sweet potatoes.

“I made these burgers by combining lean ground turkey, chopped sun-dried tomatoes and fresh basil,” said Cohen. “I served mine on top of a salad with a red wine vinaigrette and feta cheese. On the side, I roasted some purple sweet potatoes. I chose the purple color and cut with a crinkle cutter to encourage my two kiddos to eat them like French fries.”

Snacks

Cohen also suggested some easy snack options with added health benefits like crunchy broad beans or popcorn. Both these snacks are high in fiber and come in plenty of flavors. Broad beans also contain high levels of folate, said Cohen, which is important for women who are interested in having children.

As each meal shows, healthy eating does not mean boring eating. These plates contain color, flavor and fresh ingredients that offer the eater health benefits and tasty meal ideas. 

Ian McKeag, M.D., M.S., assistant professor of family and community medicine and director of the Family and Community Medicine Sports and Exercise Medicine Fellowship, has been selected as one of the recipients of the inaugural President’s Award for Excellence in Shared Values. The award honors Blazers who demonstrated one or more of UAB’s shared values in the course of their work during the extraordinary times presented by the COVID-19 pandemic. The 20 members of the inaugural class of 2021 represents five schools and six institutional units across UAB.

The heart is on many people’s minds this time of year. Apps and online articles offer advice on how to find love and give the heart what it wants. Faculty members from UAB’s Department of Family and Community Medicine have gathered tips about cardiovascular health that will ensure the heart is ready for anything that this year may bring.

Check in with loved ones to keep your stress levels low.

Relationships play a major role in heart health by helping to regulate stress, according to Kaylee Crockett, Ph.D., assistant professor and clinical health psychologist for the department.

“Next time you’re feeling stressed take a minute to close your eyes and picture a loved one in your mind - be that your significant other, a family member or friend, or a beloved pet - and notice how your body and state of mind change,” said Crockett. “Of course, if that person or pet is nearby you can ask them for a hug or to hold your hand and talk things through with them.”

Prioritize healthy eating habits to protect the heart.

According to Caroline Cohen, Ph.D., R.D., assistant professor and clinical dietitian for the department, diet can impact heart health. Cohen recommends eating omega-3-fatty acids that reduce the risk of cardiovascular disease and decrease inflammation. Fish, especially mackerel, salmon, and tuna, are high in omega-3-fatty acids and are a great source of protein.

It is also important to incorporate plenty of fiber into a heart-healthy diet, said Cohen. Fruits, vegetables, and whole grains contain fiber that can reduce cholesterol and inflammation in the body. By prioritizing foods that include these and other necessary nutrients, a balanced diet can lead to a stronger, healthier heart.

Exercise regularly to strengthen the cardiovascular system.

Irfan Asif, M.D., chair of the Department of Family and Community Medicine and certified family and sports medicine physician, recommends regular exercise to boost cardiovascular health. According to the World Health Organization (WHO), failing to exercise can increase the risk for diabetes, obesity, heart attacks, and other diseases. The U.S. Department of Health and Human Services provides guidelines for physical activity for every age group on their website.

“Regular exercise is one of the most important things people can do to improve their health,” said Asif. “Even during the COVID-19 pandemic, I encourage my patients to go outside and exercise. Exercise is the best medicine for your health and heart.”

By taking steps to keep the heart healthy, the entire body benefits. Learn more about cardiovascular health and preventive measures by talking with a family medicine or primary care provider.

Happy Valentine’s from the Department of Family and Community Medicine.

The UAB Department of Family and Community Medicine is partnering with the Department of Psychiatry and the Depression and Suicide Prevention Center to bring the Project ECHO Model to family medicine and primary care practitioners across the state. Project ECHO Depression will connect Alabama providers with a team of experts at UAB to help them better care for patients suffering from depression.

Project ECHO uses a hub-and-spoke model to “move knowledge instead of people” in pursuit of better patient care. The model utilizes virtual tools to connect physicians with experts in other areas to encourage innovation and allows for open discussion about difficult cases to assist physicians in providing even better care.  It began in New Mexico and has quickly become a national standard for empowering regional clinicians through monthly e-learning clinics. By leaning on virtual tools, Project ECHO Depression can reach more practitioners and assist them with the diagnosis and treatment of depression in their practices.

Participating physicians will receive access to monthly clinics, staffed by UAB psychiatrists, a family medicine physician, psychologists, and patient advocates. These clinics will be held virtually and offer Alabama clinicians the chance to gain didactic instruction and undergo live, de-identified and HIPAA-compliant mental illness case discussion on a monthly basis.

“We are excited to bring this model to our department and to practitioners across the state,” said Kimberly Smith, Ph.D., director of the Alabama Practice-Based Research Network (APBRN) and assistant professor for the department. “Through monthly ECHO sessions, we aim to make a difference in the lives of these practitioners, by helping them gain knowledge and assurance in prescribing a variety of treatment plans to better take care of their patients who are struggling with mental illness.”

The project is currently seeking family and primary care physicians to participate in the study. To participate, please fill out the interest form.

To learn more about Project ECHO Depression or to donate to this project, click here.

UAB Medicine has begun administering COVID-19 vaccinations based on the Alabama Department of Public Health’s phased plan. But the Centers for Disease Control also recommends that patients stay current with other yearly immunizations.

Yearly immunizations are considered preventive, and family medicine physicians at the UAB Highlands and Hoover clinics are helping patients schedule appropriate immunizations while keeping their personal health history in mind.

“In addition to the COVID-19 vaccine, there are many vaccines that can help prevent illness and keep patients healthy,” said Erin DeLaney, M.D., assistant professor and vice chair for clinical care and quality in the Department of Family and Community Medicine. “These may include, but are not limited to, vaccines for the flu, pneumonia, shingles, tetanus, and meningitis. If patients have questions about these immunizations, they should discuss them with their primary care physician.  Any of these vaccines can be safely given at least 14 days before or after the COVID-19 vaccines.”

Sameera Davuluri, M.D., assistant professor in the Department of Family and Community Medicine, notes the importance of consulting medical professionals when considering yearly immunizations.

“Patients should check in with their primary care doctor who knows their health history,” said Davuluri. “The medical community recommends that nearly everyone take the COVID-19 vaccine as it becomes available to them. The CDC has created a guide for those who have questions about whether or not they should take the vaccine.”

DeLaney and Davuluri outlined several recommendations pertaining to the COVID-19 vaccine and their responses to common questions asked by patients:

• The current available COVID-19 vaccines are safe for most people who are at least 16 years of age. 
• Those who should not get a COVID-19 vaccine include anyone who has had a severe allergic reaction to a previous dose or component of either mRNA COVID-19 vaccine, an immediate allergic reaction of any severity to a previous dose or component of an mRNA COVID-19 vaccine (including polyethylene glycol), or an immediate allergic reaction of any severity to polysorbate.  
• Precautions should be taken by those who have a history of immediate allergic reaction to any other vaccine or injectable therapy and those with moderate to severe acute illness. 
• Patients who have had the COVID-19 illness, and those who have received the monoclonal antibodies or convalescent plasma treatment for the illness, need to wait 90 days before receiving the vaccine.  
• Patients with chronic conditions can receive the vaccine. 
• Patients who have immunocompromised conditions due to medications or illness may also receive the vaccine. These patients must be aware that there is currently an unknown safety profile or effectiveness of the vaccine in immunocompromised populations; there is potential for a reduced immune response; and there is still a need to continue to follow all current guidance to protect themselves against COVID-19. 

A full list of immunization recommendations and guidelines is available on the CDC’s website.

To schedule an appointment with a UAB family medicine physician, visit uabmedicine.org or call 800-UAB-8816.

For more information about vaccination and COVID-19, visit UAB United or consult the following UAB resources:

Why it is Safe and Important to get the COVID-19 Vaccine

Debunking the Myths about the COVID-19 Vaccine

One of the populations that Alabama AHEC’s testing initiative served is local to Birmingham and gave access to testing to one of the city’s most underserved populations: individuals struggling with homelessness.

Firehouse Ministries is working against the effects of homelessness in Birmingham. The Firehouse Shelter, located on 2nd Avenue North on the west side of Birmingham, serves city’s chronically-homeless male population with the ultimate goal of getting them into permanent, supportive housing. Firehouse offers emergency services that include a soup kitchen open to everyone—now held outside, for the safety of the staff and residents—a clothing closet, case management, and emergency shelter.

Like many of its counterparts across the country, Firehouse is currently in a holding pattern until CARES Act funds are distributed from both Jefferson County and the City of Birmingham. The Alabama AHEC Network was made aware of the challenges that Firehouse was facing through James “Rick” Kilgore, M.D., who serves in a leadership capacity within the Alabama Statewide AHEC Program and as an active force in its COVID-19 testing initiative.

“No one should be denied basic healthcare in this country and in the face of a pandemic that is affecting the lives of the wealthy and not so wealthy, equally. It is important that those less fortunate, who have limited access to health care, should not be forgotten” says Kilgore. “We have to make sure testing is available to the homeless population if we are going to truly stem the tide of the pandemic in our communities.”

As a member of the Firehouse Mission’s Board of Directors, Kilgore has been influential in acquiring what medical equipment and residential protections the shelter ​has in place. Prior to the emergence of COVID-19, Kilgore worked with the homeless and the Firehouse Shelter to establish a medical screening and education clinic, and knows the obstacles many of the residents face in getting basic and advanced medical care. It is through his efforts that the network was able to offer this vital, closed, and secure testing site for the Firehouse residents on December 10, 2020.

Demand was high—70 test kits were initially prepared, though UAB provided extra kits for the site. At least 70 tests were administered before 9:30 a.m., and 86 tests were administered in total before testing closed. Firehouse had been lucky—with limited resources and great effort, they had yet to experience positive COVID-19 cases within their resident population. Fortunately, the tests administered by the Alabama AHEC Network all came back negative for COVID-19.

Click here to learn more about the Firehouse Shelter.

Click here to learn more about the Alabama AHEC Network’s testing initiative, future testing dates, volunteer opportunities, or to donate PPE.

The Alabama AHEC program is committed to expanding the health care workforce of Alabama by maximizing diversity and facilitating distribution of resources, particularly in underserved communities. Its goals are to influence the training of health profession students and residents toward primary care; to provide continuing education and support for targeted health providers; and to implement programs, services, and activities that target underrepresented minorities, rural and otherwise disadvantaged Alabamians for careers in the health professions.

The Alabama Statewide Area Health Education Centers (AHEC) Program has planned and executed a COVID-19 testing strategy to serve Alabamians in rural and underserved areas during the pandemic. Alabama AHEC has focused on underserved populations with a higher incidence of COVID-19-related illnesses, particularly those in Hispanic and Black populations where access to care is limited. Their intent to bring specialized attention to areas that need it most has helped address the impact of COVID-19 on these communities.

Working with partners such as the Alabama Department of Public Health (ADPH), the University of Alabama at Birmingham, Alabama Civil Air Patrol, and other local leadership and community organizations, Alabama AHEC’s testing initiative has completed more than 3,500 COVID-19 tests in 24 counties at 61 community testing sites across the state.

Using its five regional centers as a basis for outreach, Alabama AHEC developed local coalitions with community leaders and health professionals to assist in providing a cohesive testing process. Because of their work, thousands of Alabamians have been empowered to make informed decisions about their health throughout this pandemic.

"We have learned a great deal about the problems we are facing in these communities through our conversations with our partners, as relates to accessibility and trust,” said Michael B. Faircloth, M.D., director of the Alabama AHEC, medical and lab director for UAB Student Health, and associate professor for the Department of Family and Community Medicine. “There remains a lot of work to be done, particularly as we move into Alabama's imminent vaccination phase. It is our goal to take these lessons to heart, and to move forward with purpose as we continue to fight this deadly disease."

The testing centers have helped to slow the spread of COVID-19, but many underserved communities continue to have higher infection numbers compared to national standards.

"Our greatest trouble, so far, has been overcoming mask and testing fatigue in these communities,” said Joe Crozier, executive director for the North Alabama AHEC and coordinator for the COVID-19 Testing Initiative. “Even with the ongoing statewide mandates, numbers continue to increase in our rural populations. We hope to help educate these community members while conducting our testing efforts—it may be our best chance of combatting the misinformation that has stymied such efforts across the country."

Alabama AHEC’s collaborative testing sites will continue into 2021 to provide this service to even more communities across the state.

The Department of Family and Community Medicine is pleased to announce that Erin DeLaney, M.D., has been tapped to become its first vice chair for clinical affairs and quality. In her new role, DeLaney will provide oversight for the clinical enterprise and ensure quality measures are in place for provider performance, patient care, and outcomes.

DeLaney received her medical training at the University of South Alabama and completed her residency at Maine Medical Center. She began her medical practice in Maine and returned to Alabama in 2013 to begin working for the department. She has served as the medical director and medical quality officer for UAB Family and Community Medicine–Highlands.

“Erin DeLaney is a thoughtful leader,” said Chair Irfan Asif, M.D. “Her interpersonal communication and ability to listen to others make her someone that others want to follow. She uses her skills and personal strengths to improve the lives of those she works for and the patients she serves. It is a pleasure to work with her, and I am excited for her to serve the department in this new role.”

DeLaney’s dedication to her patients and to maintaining excellent professional standards have earned her several awards throughout the years, including UAB Medicine’s awards for top communicators in 2019 and 2020 and a patient experience excellence award in 2018.

“I am honored and excited to be given the opportunity to serve our department and, ultimately, our patients in this new capacity,” said DeLaney. “I look forward to our continued growth as a department as we aim to improve the health of our community through education, research, and high-quality patient care.”

The UAB Medicine Office of Patient Experience and Engagement (OPXE) recognized eight providers from the Department of Family and Community Medicine in its 2020 list of "Top-Performing" providers.

According to the article on uabmedicine.org, “This year has been full of surprises, to say the least. With such massive disruptions across UAB Medicine, we expected to see a decline in our patient experience scores. However, throughout the COVID-19 pandemic, these measures have been rising. This is a testament to our providers’ commitment to the well-being and safety of patients.”

Faculty recognized from the Department of Family and Community Medicine:

Ksenia Blinnikova, M.D. 

Sameera Davuluri, M.D.

Erin W. Delaney, M.D. 

Raymond B. Hunt, M.D. 

Jill Marsh, M.D. 

Ian D. McKeag, M.D.

Billy Earl Salser Jr, M.D. 

Caroline F. Sullivan, CRNP

Drs. Delaney and Salser have made the list for the third year in a row. This is also Dr. Davuluri's second time featured.

Congratulations to all of our outstanding providers!