Graduate students tackle healthcare policy reform during new fellowship at Johns Hopkins

Three students from Liberty University’s Master of Public Health (MPH) program have spent nearly a year in an exciting new fellowship thanks to a partnership between the School of Health Sciences (SHS) and Johns Hopkins University School of Medicine.

The research fellowship at Hopkins, a collaboration between Dr. Heidi DiFrancesca, dean of Liberty’s School of Health Sciences, and Dr. Marty Makary, Professor of Surgery at Johns Hopkins, is designed for MPH students to conduct research on healthcare policy at the JHU School of Medicine and attend related events. The fellowship is one year long, beginning each August, and is under the direction of Makary and his research team, which includes Christi Walsh, M.S.N.-C.R.N.P., director of the Healthcare Graduate Research Program at Johns Hopkins. Makary, a pancreatic surgeon, is an outspoken proponent for healthcare reform and has given multiple Grand Rounds lectures on the topic at Liberty.

One of three students selected to particiate in the competitive fellowship, Andrea Mackenzie, saw the fellowship as a chance to fulfill her dreams of impacting the modern healthcare system in America.

“This couldn’t have been a more perfect opportunity,” said Mackenzie, who has been accepted to start her Ph.D. in Public Policy at Liberty. “It was through my (MPH) studies that I realized that one of the greatest effects we could have on the health of the nation would be in education and primary prevention, which seeks to avoids problems in the first place before they happen. It became clear to me that the policies, programs, and choices of our culture have a direct impact on health outcomes, and following a problem upstream to the source often leads to public policy opportunities.”

She joined fellow MPH students Faith Magwenzi and Asonganyi Aminkeng in the fellowship, working mainly in a remote setting, in addition to meeting together one or two times per month virtually and once a month in Washington, D.C.

“After hearing about the fellowship, I was immediately drawn to it due to the valuable skill sets that fellows would gain upon completion,” Aminkeng said. “I wanted to apply because I saw this as an excellent opportunity to enhance my knowledge and skills in public health, and it aligned perfectly with my career goals.

A core phase of the fellowship for each student was coming up with three scientific ideas presumed to be true, looking into the history of these “facts,” and determining their validity based on the researched evidence. The purpose of the exercise was to show how the practices and standards of medicine change over time, sometimes far later than they ought to, and that healthcare can and should make changes as new findings are discovered.

“We were challenged to think and question everything and research and really ask, ‘What do we know and what do we not know? What do we think we know that we get wrong?’” Mackenzie explained. “We looked back historically to see how these beliefs or conclusions came to be. We got to do a different type of research where it wasn’t just gathering publications from recent years; we were going back decades and, in some cases, centuries.”

One example that Mackenzie looked into was the history of ovarian cancer treatments that have existed since the 18th century. She read through old journals and accounts of surgeries that talked about how ovarian cancer was believed to originate in the ovaries, leading doctors to perform surgeries that remove ovaries, when recent findings point to fallopian tubes as the place where the cancer starts.

Magwenzi said this survey of scientific findings and beliefs over the centuries was a highlight for her as well.

“I have enjoyed the internship, particularly diving into literature and learning new things,” she said. “The fact that the internship challenged deeply held assumptions about health was eye-opening.”

Additionally, the students participated in three research projects, working collaboratively as each student took the lead on one of the projects. Aminkeng oversaw research on the prescribing of antibiotics in telemedicine and instances of improper dosage. Magwenzi led a project on the association between prescription rates and costs of weight-loss medications and obesity trends among Medicaid users in the United States. Mackenzie led a study on national physician cesarean section rates in low-risk deliveries.

All three projects were presented at Liberty’s annual Research Week in April. Mackenzie’s C-section research won first place in the Graduate Applied Research Poster Presentation category. Her presentation was also selected by the National Delta Omega Public Health Honor Society to be presented at the American Public Health Association (APHA) national conference in October.

During the fellowship, the students traveled to conferences where they met with professionals who are impacting healthcare policy from different angles. On Capitol Hill, the students attended a conference hosted by the Paragon Health Institute, which provides healthcare research as well as market-based policy proposals for improved outcomes in the public and private sectors. They also met with members of Congress, including Kentucky Sen. Rand Paul, and sat in on hearings regarding healthcare reform. In Oklahoma City, the group attended the Free Market Medical Association’s 10th annual conference, where they met innovators who are finding alternative and efficient routes to provide patient care.

The fellowship also included lessons in searching for and writing grants, and students were able to shadow Makary in the operating room at Johns Hopkins Hospital.

“I have particularly enjoyed learning about grant writing, which is an essential skill for an aspiring public health expert like me,” Aminkeng said. “Additionally, I have developed a deeper understanding of health policy issues and health insurance challenges in the U.S. Understanding the intricate relationship between public health and the health systems in America has reinforced my commitment to making meaningful contributions to improve health outcomes both nationally and globally.”

Mackenzie said the experience of the fellowship was a “springboard” for her career: “This experience brought theory and hypothetical learning into practical reality. We met and made professional connections that are invaluable to my breadth of understanding and a future vision of hope for our healthcare system.”

“The internship awarded me a network of talented individuals and groups that I would otherwise not have access to who can be potential employers and partners in the future,” Magwenzi added. “I gained tons of research experience and as someone who wants to focus on research, the experience has been invaluable.”

DiFrancesca is excited for all the ways the students have benefitted from the experience and how they can now share it with their classmates and the department.

“Through this research fellowship collaboration, we are making an investment in the next generation of public health leaders, underscoring the (School of Health Sciences’) commitment to ensuring our students are well-prepared to tackle the multifacteted challenges of the public health landscape. This enriching experience fosters students growth as burgeoning public health professionals and researchers, equipping them with the necessary skills, knowledge, and exposure to thrive as public health professionals capable of addressing complex health issues and contributing to evidence-based solutions.”

She also spoke about the benefits that this program brings with respect to both their academic journey and on their career trajectory.

“The comprehensive and immersive research fellowship provides a holistic learning experience through a combination of hands-on research, exposure to real-world policy and practice, interdisciplinary learning, and personal and professional development opportunities. This positions them well for successful careers in the dynamic field of public health.”

The first year of the original three-year partnership agreement is about to conclude — an agreement that includes a rigorous, competitive application process that begins with the department chair and other faculty identifying potential candidates and ends with candidates interviewing with Johns Hopkins staff.

“I am delighted to see the profoundly positive and dynamic outcome of our first year and look forward to more students having the opportunity to participate in this collaborative research fellowship in upcoming years.” DiFrancesca said.