After completing her bachelor’s degree in Tennessee and medical school in India, Abraham arrived in Louisville seven years ago. She was shadowing doctors and getting ready for a medical residency when she became intrigued by the idea of helping not just individuals but populations.

“I am a numbers person so I was comparing clinical versus population health data and seeing how research could impact a lot more people,” Abraham said.

Once she decided to embark on her master’s degree in public health at the University of Louisville School of Public Health and Information Sciences (SPHIS), Abraham met Stephanie Boone, a two-time UofL alumna (MPH ’08, PhD ’13) and associate professor in the Department of Epidemiology and Population Health and faculty member at the Brown Cancer Center, Boone encouraged her to apply for the PhD program and got her involved in epidemiological research.

Now a graduate of SPHIS, Abraham has been working as the coordinator of the Kentucky Core (Boone, PI) of the RURAL (Risk Underlying Rural Areas Longitudinal) Study. This is a large National Institutes of Health-funded study to conduct community engagement and evaluate heart and lung diseases among rural populations in four states: Kentucky, Alabama, Mississippi and Louisiana.

Abraham has connected with local communities in Perry, Breathitt, Boyle and Garrard counties in Kentucky, to help recruit more than 1,000 residents and provide education and resources for unmet needs for hundreds at community meetings and events.

Since 2021, Abraham has been building a network, spreading the message and promoting the study, becoming a constant presence and trusted local contact in these counties. A mobile exam unit is traveling county by county and offering free health screenings to participants to determine lung, heart and overall wellness indicators.

Abraham, Boone and epidemiology graduate assistant Scotland Stewart, along with Community Advisory Boards established from each of the counties, meet with residents virtually or in person at city councils, church events, health fairs and festivals.

“You don’t want them to think you’re just there to use them for their data and leave,” Abraham said. “We want to share the results with the community and help them find funding or grants and design programs for what the data shows is lacking in their community.”

Establishing the participant cohort for the study has been a game changer for each community’s health now and in the future. “The CT scan on the mobile unit can measure Coronary Artery Calcium, which could show an individual if they are at risk for future heart disease, but also the scans have found incidental findings in the lung or other health concerns that people did not know existed, which is life-changing,” Abraham said. “It’s gratifying to know that your work does mean something and it is actually making a difference.”

Abraham plans to continue in her role until study participant recruitment is completed in Kentucky. After that, Abraham said she hopes to seek post-doc opportunities to take her population level research one step further into dissemination and implementation.

“Research shouldn’t just be about publishing papers, it should be about translating your findings to make a positive impact in people’s lives – that’s where my heart is.”

Two UofL College of Arts & Sciences winter graduates are looking to their hometowns for guidance in their professions and hope to serve the people who shaped them. Chloe Hale and Emmy Walters, studying anthropology and biology respectively, plan to continue their education in graduate school with the goal of utilizing their advanced degrees to support communities like those in which they grew up.

Documenting home

Moving to a city from a rural county can be a culture shock. Coming from Martin County, Hale quickly realized she had a different experience growing up in Kentucky than many of her classmates. Hale’s quiet anxiety around drinking tap water is something few could understand.

“It makes me sad to see on the internet when a place in my home county doesn’t have water and it’s not gonna be back on for two weeks or something like that,” Hale said. “Just the fact that I can drink the water here in Louisville from the tap makes me feel guilty, in a way, because my family members are there, and they can’t drink the water.”

Hale grew up in an Appalachian community where clean drinking water was not a guarantee or to be taken for granted. Martin County lost its regular access to safe water due to infrastructure, resource access, mining contamination and environmental destruction.

“I think when you can’t drink the water there’s this little piece of trauma in the back of your mind every time you drink from the tap,” Hale said. “It’s like, ‘Is it clean? Can I? Is this drinkable?’”

For an independent study, Hale chose to document how hairstylists back home struggled to work without guaranteed access to clean water. She asked her sister and fellow hairstylists to take pictures throughout their workday anytime they encountered the need to use water.

“I decided that it would be a good idea to examine water access through a group of women that rely on water for an income,” Hale explained. “Hairstylists need water for absolutely everything: to clean, to wash hair, to rinse hair, to make different cleaning solutions.”

The project used these pictures as a “photo voice” to document and display the obstacles the Martin County hairstylists encounter every day due to the lack of access to consistently safe tap water.

While returning home is a complicated option with the ongoing water crisis, Hale hopes to continue her education in Appalachian studies at UofL with her sights set on a future PhD to continue to document and uplift her hometown and other communities.

“I definitely love my hometown, but think I’ve been able to curate what it means to be Appalachian a little bit more just because it is its own culture and it is an identity I’m proud of,” Hale said.

A better vision for Kentucky’s future

Emmy Walters’ first connection to optometry was through her love of reading and an early vision assessment at school. She was one of the only members in her family to need glasses and this sparked a curiosity about the relationship between her vision and the biological mechanisms that supported her eyesight and her favorite hobby. As she aged, her curiosity for vision only grew as she understood the obstacles to both eye assessments and literacy in her community.

“Growing up, our access to eye care was sufficient, but then you get in surrounding counties where there won’t be an optometrist for 45 minutes,” Walters said.

Walters early childhood love for reading was protected by her access to an optometrist, and an early assessment allowed her natural curiosity toward books to go uninterrupted. Walters still reads regularly and will attend optometry school next year. After shadowing an optometrist in Campbellsville Kentucky, her hometown, she hopes to practice in a similar rural area.

“I felt like I was home, like I was talking to my own family members; the way that they approached me and talked about things is something I’m used to, and it was comforting,” Walters said.

While shadowing in the practice, Walters began to see the personal impact she could have as an optometrist practicing outside of a major city.

“At least a third of the people that came in had never been to an eye doctor or hadn’t been in a very long time, and most of the time those were people from surrounding areas,” Walters said.

Walters hopes to one day combine her interest in optometry with her love for reading by supporting literacy through eye exams and philanthropy.

Interested in pursuing a degree or certificate program with UofL? Check out the  to find a program.

Such a schism became evident to Metro Councilman Brandon Coan, who said, “I’m Louisville person, I’m not a Kentucky person.”

However, following Coan’s experience with the Rural-Urban Exchange, also known as RUX, his eyes were opened to the symbiotic relationship between the two.

, which was co-founded by alumna Savannah Barrett ’08.

The program involves connecting businessmen, artists and other Kentuckians to how the “other half” operates. It includes three intensive meetings where community members come together to exchange ideas and cultures.

Barrett noted that during the first session, participants came face-to-face with the indigenous people who still reside in areas of Kentucky that are well off the beaten path. It was an important discussion on how harmful it was to refuse to acknowledge the differences between groups.

Barrett along with Josh May, the former communications director of Appalshop, conceived the idea for RUX in 2014. They were motivated by the common misconceptions about the state of Kentucky and the lack of knowledge about the cultural nuances of the state. Together, they combined the efforts of Appalshop and Art of the Rural to form RUX, which is funded primarily through donations and grants.

Barrett, who earned a degree in humanities, is in works to expand education on the program outside of the state.

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“I remember her explaining what a one-of-a-kind program GEMS was, how those selected had unique opportunities in undergrad that others would not have until much later in their medical careers and how the GEMS were a close-knit group seen around campus together,” Smoot said. “Overhearing that one conversation affected my whole life.”

For 30 years, GEMS has provided mentoring and support for nearly 300 academically-talented youth from across Kentucky interested in becoming physicians by providing a clear path to complete college and enter medical school. Each academic year, about 10 students are admitted to the program as freshmen entering UofL.

Established in 1988, GEMS paves the way for the students selected for the program as they enter UofL as undergraduates knowing they will have automatic admission to the UofL School of Medicine as long as they maintain certain academic standards. In addition, GEMS students have the opportunity to shadow practicing physicians and faculty, participate in seminars, serve the Louisville community and build relationships with other students who have the goal of becoming a physician.

The students retain their automatic admission to the UofL School of Medicine as long as they have maintained a 3.4 cumulative and science grade point average in undergraduate work, scored at or above the national mean on each section of the Medical College Admissions Test (MCAT), and participated fully in program activities.

Kevin Trice, MD, MBA, now a director of sleep medicine at Baptist Hospital in Madisonville, said GEMS gave him the confidence and freedom to pursue medicine.

“It completely changed my trajectory. I was interested in medicine, but planned to pursue engineering since it was easier and I had a better chance,” Trice said. “Once I was accepted, it relieved me of the anxiety and stress common in undergraduate pre-med students.”

James Frazier, MD, was a member of the 1990 GEMS class and graduated from the UofL School of Medicine in 1998. Now the vice president of medical affairs at Norton Healthcare, Frazier said the GEMS program was life changing.

“I owe everything to GEMS. They took a chance on me right out of high school. It took a lot of pressure off that I saw my future classmates going through,” Frazier said. “You would see those who were trying to get in, how stressed they were about MCAT and maintaining their GPA. It definitely gave me an advantage not having to worry about maintaining perfect grades.”

Frazier said the freedom from stress allowed him to broaden his undergraduate education.

“Because of that reduced stress, I got to take more well-rounded classes – history, economics, finance – than if I had to maintain a 4.0 GPA. It helped me when I started private practice to have a little knowledge about the business world and how to run practice,” Frazier said.

Scott Sullivan, MD, a member of the 1989 GEMS class and 1996 alumnus of the UofL School of Medicine, credits the program with providing resources he needed to enter medicine.

“I doubt I would be in medicine without the program.��Living in a rural area and never having much exposure to medicine, I lacked mentors and direction.��The program provided both, which proved to be invaluable,” said Sullivan, who is from Ballardsville.

Now an ob/gyn and specialist in maternal-fetal medicine, Sullivan is a professor at Medical University of South Carolina in Charleston, South Carolina.��

“Having access to dedicated and experienced mentors at the age of 18 was incredibly helpful,” Sullivan said. “They got me on the right track very quickly. They gave mentorship not only about how to become a physician, but how to be interested in public health, education and community involvement.”

Another advantage for students who have participated in the program is the relationships they built with colleagues and mentors that enrich their college and medical school experience, including physicians, researchers and faculty in the School of Medicine.

“The most valuable part is the people you meet and you are with for four years in undergrad and medical school. For those eight years you are extremely tight. I am still in close contact with all the people in GEMS with fair regularity,” Frazier said. “We have a 20^th reunion coming up and I am looking forward to seeing them. Having that network of people here in town is invaluable.”

“The program was very forward thinking at the time as a way to keep Kentucky physicians in the state, and I believe they have done a pretty good job,” Frazier said. “It was a very progressive thing for UofL to have done 30 years ago, and I’m happy the school has supported it for so long.”

Smoot was admitted to the GEMS program in 1997 and graduated from UofL School of Medicine in 2006. She now is a pediatrician at Juniper Health in Campton, Kentucky.

“I often wonder if I had not happened to overhear a chance conversation, being from Eastern Kentucky, would I have gone to UofL for my undergraduate years, and then on to UofL medical school?” Smoot said. “Looking back now, I can’t imagine a different past, and I certainly would regret missing out on the friendships I made at UofL 20 years ago that still mean the world to me.”

GEMS by the numbers 

• Number of students participating in GEMS 1988-2018: 290
• Number of GEMS students who have graduated from UofL School of Medicine: 148
• Number of GEMS students currently enrolled in UofL School of Medicine: 27
• Number of GEMS students enrolled or graduated from another school of medicine:19
• Number of GEMS students currently enrolled in UofL as undergraduates: 39
• Number of GEMS students who were Kentucky Derby Festival princesses: 5 (1 Queen)
• Number of Kentucky counties represented by GEMS students: 49
• Number of GEMS students who have completed or are enrolled in MD/PhD programs: 6