First Smith Family Scholars look to turn generosity into service

When Jim ’74 and Augustine ’71 Smith made the largest scholarship gift in Virginia Tech history earlier this year, they envisioned an impact that would extend far beyond helping students pay for medical school.

Their $20 million gift established an endowed scholarship fund at the Virginia Tech Carilion School of Medicine to help talented Virginians overcome the financial barriers of becoming physicians and, in turn, strengthen the pipeline of doctors serving communities across the Commonwealth.

For the Roanoke natives and Virginia Tech alumni, the investment is personal. Augustine Smith attended Virginia Tech with the help of a scholarship, while Jim Smith served as the first chair of the medical school’s advisory board. The couple previously established the James R. Smith Family VTC School of Medicine Endowment and have supported the medical school since its early years.

Now, the first two students supported by the new endowment are beginning to put faces and stories to that vision. First-year medical students Noah Perrotte and William Hanger are both Virginians and Virginia Tech alumni. They bring experiences that have shaped a desire to practice medicine as a form of service.

And for both, the Smiths’ investment has changed what they believe will be possible along the way.

Noah Perrotte: Creating a ripple effect

Perrotte was on the phone with a friend when he opened the email telling him he had received the Smith Family Scholarship.

“I was just speechless,” Perrotte said.

He started running around the house. His mother cried. Perrotte even searched online to make sure the scholarship was real.

“I definitely will never forget that day,” he said. “It was life changing.”

For Perrotte, who grew up in Fredericksburg, the experience echoed an important lesson from his childhood: what can happen when someone is willing to invest in another person during a time of uncertainty.

After his parents separated, Perrotte, his mother, and his sister moved into his grandparents’ crowded home. His scholarship application describes a house where every room was occupied, and the living room sometimes served as his bedroom. But Perrotte’s memories are as much about what the experience gave him as what his family lacked.

“I feel like it was a great place to grow up because I got to know my grandparents very well,” he said.

Watching his grandparents stretch their resources to make room for his family taught Perrotte how transformative support can be: a lesson that helped draw him toward a career centered on serving others.

After high school, Perrotte attended Germanna Community College before transferring to Virginia Tech. He credits community college with helping him discover himself as a student.

Medicine, meanwhile, became part of his life through his work as a technician in hospital emergency departments before and after attending Virginia Tech.

“Working in the ED gives you a glimpse what people are going through in your community,” Perrotte said.

Those experiences introduced him to patients from all walks of life, including rural patients who delayed seeking care because of financial, transportation, and other barriers. With family roots in Appalachia, Perrotte hopes to work with rural communities and explore ways to make health care more accessible and preventive rather than waiting until patients reach an emergency department.

The Smith Family Scholarship gives him greater freedom to pursue those opportunities without the same financial pressure.

“I don’t think I could fully put into words how profound it is,” Perrotte said.

He hopes the impact will not end with him.

“The way I view the Smiths’ donation is that I want it to be a drop in a puddle that kind of ripples out,” Perrotte said. “I want to be able to magnify the gift that they’ve given to me onto other people.”

William Hanger: A path back home

Hanger jokes that he has never lived more than about 10 miles from Interstate 81.

He grew up near Staunton, attended Virginia Tech in Blacksburg, and now is a first-year student at Virginia Tech Carilion School of Medicine in Roanoke. And if things go according to plan, the interstate may eventually lead him back home.

“I’ve always wanted to be a doctor where I grew up,” Hanger said.

He saw physicians in Augusta County become more than health care providers. They were trusted members of their communities. The were people who cared for families over time and stepped in when their neighbors needed them.

Hanger remembers one local physician, H. Lynn Moore Jr. ’53, providing free sports physicals to students at his high school, making sure cost didn’t prevent them from participating in athletics.

That model of medicine stuck with him. Hanger is interested in a patient-focused specialty that would allow him to build relationships over time while also becoming a resource for the place that raised him.

“That’s what I want to do as a physician,” he said, “not necessarily be in the hospital, but be in the community.”

His interest in medicine, however, began from the other side of the doctor-patient relationship.

Born with a congenital heart defect and treated with a pacemaker, Hanger grew up regularly seeing pediatricians and cardiologists. He remembers physicians who explained his condition, welcomed his questions, and allowed him to feel involved in his own care.

“I’ve always wanted to give that back in a similar fashion to others,” Hanger said.

Working as a pharmacy technician at Walmart during college added another perspective. Hanger interacted with patients across age groups and socioeconomic backgrounds and saw what could happen after they left a doctor’s office with a prescription.

He encountered patients struggling with insurance and medication costs and helped search for coupons, communicate with physicians’ offices, and find other solutions. His experience taught him that caring for patients sometimes means helping them navigate a complicated health care system as well as treating their medical conditions.

“I’ve been able to see a lot about how insurance and cost barriers really impact patients,” Hanger said.

Those experiences reinforced his desire to return to Augusta County. In his scholarship application, Hanger wrote that he hopes to practice in Virginia and contribute to the long-term health and well-being of the community that shaped him.

The Smith Family Scholarship gives Hanger more freedom to pursue that goal without allowing the cost of medical school to dictate the kind of physician he becomes.

Before receiving the scholarship, the prospect of medical school debt was “a huge worry,” Hanger said, particularly if he chooses a career outside one of medicine’s highest-paying specialties.

Since receiving the scholarship, that concern has receded. 

“I’ve been able to focus more on school,” Hanger said. “I’ve been able to focus more on what medical school is supposed to be about — learning, getting involved in my community, and research. It’s just taken a huge weight off my shoulders.”

For Hanger, the scholarship also carries meaning beyond its financial value. Someone who didn’t know him personally was willing to invest in the physician he is working to become.

“Somebody believes that I’m doing it right,” Hanger said. “It means a lot.”