The son of a rural family physician, Adam Tate took a winding path to realize he may be destined for a similar calling.
The fourth-year student at the Virginia Tech Carilion School of Medicine grew up in Carroll County, Virginia, in the far southwest corner of the commonwealth near the border of North Carolina. He headed to the University of Virginia as a pre-med student, but a bit of “culture shock” redirected his academic pursuits.
“I always thought my life was ‘normal’ but I soon began to realize that my isolated rural upbringing was not the norm for most of my classmates,” Tate said. “I thought I needed to learn more about myself and my place in the world. I did my pre-med classes but majored in anthropology. It made sense to me since I grew up in a place, moved somewhere else, and realized my culture was not the only culture.”
After graduating in 2003, Tate pursued a variety of jobs, first in construction management for two years and then as a ski instructor in Oregon. A ski buddy who was applying to medical school recommended Tate read “Complications: A Surgeon’s Notes on an Imperfect Science.” The book, which examines what medical science does well and what it doesn’t, prompted Tate to reconsider a medically focused career.
He came back closer to home to work at the University of North Carolina Wilmington where he did safety programming and education, focused on providing sexual assault and domestic abuse education to college students. During his four years in the position, he applied to a few medical schools in North Carolina, but was not accepted.
“Around that time, I started closely following the policy debate around what would ultimately become the Affordable Care Act,” Tate said. “I got really invested in the details, so when I didn’t get into medical school, I decided that even if I eventually go to med school, I would want to get my master’s in public health.”
Tate entered the health policy master’s program at The Bloomberg School of Public Health at Johns Hopkins University in Baltimore. “I'm very interested in underserved populations. In Baltimore, there are huge health disparities in the population. It's impossible to set yourself apart from it. There are neighborhoods that are very affluent right next to neighborhoods that are not at all.”
After his M.P.H. degree, he worked in public health through youth alcohol prevention research at the University of Maryland. “My supervisor brought me into her office after about six months into the job and said, ‘I love what you are doing, but this is a temporary job for you. If you try to stay longer than a year or two, I'm going to push you into a Ph.D. program,’” Tate said.
Tate knew a doctoral program was not for him. “I got tired of sitting in meetings all day and missed the one-on-one health education and counseling aspect that I had with students at UNCW. I was thinking, I want to combine it all.”
Tate gave medical school another try. This time, he would accept admission to the Virginia Tech Carilion School of Medicine (VTCSOM).
“The small class size is fantastic and it’s a great community. I know all my classmates beyond just seeing them in class. Also, I feel like the faculty care, not that they don't elsewhere, but because of our size we get a ton of resident and attending attention here. They get to know us well,” Tate said.
Serving as his class president for three years, Tate has been able to advocate for issues that are important to his classmates and the school’s curriculum goals. He saw a need for additional rural medicine education to be integrated into the curriculum and has been working with faculty and the administration to make it happen.
“The Ninth Congressional District of Virginia, comprising the far southwest portion of the commonwealth, is very different than the rest of the state, particularly economically,” Tate said. “You realize how impoverished certain areas are here and how that can affect health in ways not readily recognized.” Patients from across Southwest Virginia often have to come to Roanoke for care that is not available in their own community; this lack of regional access to tertiary health care is one of many health disparities that can impact rural populations.
Tate thought it was important for fellow classmates to better understand the community they would be serving to dispel stigmas regarding rural populations and improve their care.
“You may get frustrated thinking a patient is not being compliant. You tell them to go home, get rest, and eat well, but they may not be able to afford food or can’t take time off to rest because they have to work to support their family,” Tate said.
Tate is one of two recipients this year of the Sam and Priscilla McCall VTC School of Medicine Scholarship. He also received the scholarship in 2015, making him the first student to receive the honor twice.
The late Sam McCall was raised in Richlands, Virginia, and studied for a year in business administration at Virginia Tech with the Class of 1958. He moved away from the area to Texas, but his family that remained in rural Southwest Virginia faced limited access to health care. Sam and his wife Priscilla, who now serves on the VTCSOM Dean’s Council on Advancement, created the scholarship with the hopes that some graduates would stay to practice in the area or other underserved communities.
Ultimately, Tate hopes to serve as a rural family medicine physician like his father, seeing longitudinal care as a way to overcome hurdles for a healthier life.
“I grew up with this experience that you know your patients, you will see them out places, and you are not a separate entity from them. Your lives are entwined with theirs because you are part of the same community,” Tate said. “Hopefully, over time, my patients and I will build trust and there will be certain things that we can do to improve their health that would have been difficult initially. That's the most fulfilling to me - the moments when I am talking to a patient and we have a break through that would not have otherwise have been possible without time spend building that relationship.”