Nancy Hardt has a clear message to the graduating students of the Virginia Tech Carilion School of Medicine: Do something extraordinary. 

She doesn’t think that task should be particularly difficult after all they have been through during the past four years.

“These students have done amazing things to make it through their clinicals, their boards, their rotations, and everything else during this time of COVID-19,” said Hardt, who will speak at the private graduation ceremony on Saturday, May 7, in Roanoke. “They have learned one of the most important lessons for any doctor: to tolerate ambiguity. Not only have they done that, they have thrived.”

Hardt knows a thing or two about doing the extraordinary. A renowned public health activist and advocate, she is Professor Emerita of Pathology and Obstetrics and Gynecology at the University of Florida College of Medicine. She likes to say her areas of expertise are birth and death, and she focused on social determinants of health with the U.S. Congress as a Robert Wood Johnson Health Policy Fellow.

“My time in U.S. Congress gave me a unique perspective on population health and ways that physicians can improve systems by understanding the importance of policies,” she said. “We tend to think in terms of programs, but policy changes really make the sustainable gains.”

Hardt hasn’t just debated policy changes in Washington, D.C., though. She also has been the wheels on the ground. Seeing research that kids who experience poverty, abuse, neglect, or witness domestic violence are more likely to have negative health outcomes, she decided to do something about it. She created a mobile health clinic, in a converted Bluebird school bus, and organized a crew of volunteer doctors and medical students to regularly visit the most impoverished areas of Gainesville, Florida. Today, the clinic on wheels makes more than 5,000 patient visits per year and is positively impacting public health.

Image of a group of medical students and health professionals in front of a school bus that has been converted into a mobile health clinic.
To help address public health disparities in communities near the University of Florida, Nancy Hardt created a mobile health clinic, in a converted Bluebird school bus, and organized students and health professionals to staff it. The clinic on wheels makes more than 5,000 patient visits per year.

She said it’s extremely important for physicians to see the whole picture of their patients and their communities in order to serve them.

“The simplest message is that we cannot assure the health of a population without considering their housing, education [literacy], transportation needs, access to nutritious food, and personal safety,” Hardt said. “For example, we make assumptions that people can actually read or are willing to read the hospital discharge instructions we give them in written form. Even if they understand those instructions, they may encounter barriers trying to carry them out. If physicians are well-versed in the social determinants of health, they can avoid mistakes and they can have better outcomes.”

At the Virginia Tech Carilion School of Medicine (VTCSOM), students are not only encouraged to interact with the local communities, critical service learning is part of the curriculum through the VTCSOM Engage program. It helps students learn how to work successfully in larger systems and communities through effective teamwork and to engage in meaningful long-term projects. 

“At Virginia Tech Carilion School of Medicine, community service is a core part of our identity. Our vision of impact is anchored by the Virginia Tech motto of Ut Prosim (That I May Serve) and supported by Carilion Clinic’s mission to improve the health of the communities we serve,” said Lee Learman, dean of the Virginia Tech Carilion School of Medicine. “Our students become engaged in the Roanoke community soon after they matriculate, and their connections deepen as the curriculum unfolds culminating in memories that will guide their future careers.”

As members of the Class of 2022 prepare to move on to their residencies, whether locally or in new communities around the country, Hardt will remind them of the excitement and opportunities that lay ahead.

“Residencies are very different than medical school, in lots of good ways. It’s a great adventure, and there will be opportunities to make their residency (and later, their practice) even better than they found it,” Hardt said. “I hope they seize these opportunities, because their medical school has given them a strong start. We need their energy and creativity to solve lots of problems in our current health systems.”

We need them to do something extraordinary.


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