Dr. Joanna Cole – a key player in helping to improve Internal Medicine

Aug 21, 2016 News

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By Sharmain Grainger
There are some people who are driven by the mere passion to see positive changes occur.

Many hope that they will be able to benefit from this change themselves. But there are those who simply help to pave the way for the needful change then move on.
The latter notion could perhaps adequately describe Dr. Joanna Cole. But then again she could easily be referred to as a one-woman army whose vision is trained on making major a difference in the delivery of health care.
Dr. Cole is an American doctor with a passion to see positive changes in the health sector. But she hasn’t only been focused on the health sector in her homeland, she has, since 2013, diverted her focus here at a time when it was needed the most.
She has essentially helped to make an immense different at the country’s premier health institution, the Georgetown Public Hospital Corporation (GPHC).
In January 2013, the GPHC introduced its Internal Medicine Residency programme. This saw a number of young doctors being selected for specialist training in Internal Medicine through an Infectious Diseases Masters Programme. The programme was initiated with sponsorship and support from a Faculty at Maryland University in the United States.
By August 2013, Dr. Cole was involved in the initiative and was in fact asked to take up residency here to spearhead the venture as Programme Director.
Accompanied by her husband, she jumped at the opportunity and has never regretted that decision. This was despite the fact that a few months after relocating to Guyana, sponsorship for the programme came to an abrupt end.
She simply couldn’t see herself leaving with the funds as there was a glaring need for her expertise at the GPHC. As such, even without funds, Dr Cole decided that she was going to help make a difference.

It wasn’t a hard decision for her to make, as according to her, she went into the field of Medicine with the primary motive of doing global health. This move was linked to the fact that she had long recognised that there existed inequality when it came to the delivery of health care and she wanted to make a difference in this regard. She also wanted to delve into the field of giving health care to persons with HIV and AIDS, and thus went into the area of Infectious Disease.
And since training in the United States meant indulging in some medical teaching as well, it felt only natural for her to become involved in medical education in a developing country when the need presented itself.
But relocating to Guyana was not the easiest thing to do as, according to Dr Cole, “the culture is very different here and that took a lot of adapting to. You don’t see it right away because there is a lot of western influence, but when you start working and living here then you notice those subtle culture differences that play a big part.”
Of course an even greater challenge was the withdrawal of funding and other support for the programme by the institution that hired her in the first place.
It certainly wasn’t a bad decision to stay on as, according to Dr Cole, “just seeing how much the young doctors have learned and watching them grow, it was so encouraging…it is such a big difference than just taking care of patients. Changing the way doctors behave with patients, changing the way they think about diseases, changing the way they approach the treatment of patients was really the best part,” recounted Dr. Cole.
She recalled three years ago it was just herself and one other consultant managing the Department of Medicine, which caters to 500-odd patients per month. At the time there were seven residents enrolled and four other General Medical Officers who were assigned to the Department.
“I basically saw patients from morning till night and it was just keeping up with the most urgent things. I would then go home from work, probably around 6 pm or so, but would still work until 11 or 12 at nights on preparing whatever teaching was needed to be prepared for that week’s teaching session.”
But according to Dr. Cole, today her job is completely different.
“We have teams that are headed by registrars and they are managing the patients…that don’t require a whole lot of input from me, so when I go on rounds it is more of a teaching occasion,” Dr. Cole asserted.
The doctors she has taught over the past few years are now capable to do exactly what she did when she first came. She now gets to focus on the bigger things such as the overall programme direction and vision of the programme. And she is happy to take her leave, knowing that her mission has been accomplished.
“The decision was always to stay temporarily. I always saw myself as a bridge for this programme to something that is more sustainable than what it was when I came in,” Dr. Cole noted, as she disclosed that “we now have partnership with the University of Calgary, we have partnerships with the University of Pittsburgh, partnership with McMaster and health volunteers overseas that are doing different roles in supporting the programme.”
She, however, noted that she is never satisfied and certainly does not expect those she has helped trained to be satisfied.
“There is always more to be done…there is lots of room for improvement; with the residency there is still room to grow…there is room for sub-specialisation among the graduates and we even have potential for someone to train specifically for kidney disease to help support the kidney transplant programme,” related Dr Cole.
In fact she has plans to eventually establish a global health fellowship that will allow graduates from the United States to visit Guyana to do their fellowship since, according to her, “it is such a rich experience and I think that the exchange will be really good too.”
Dr. Cole has guided to expertise in Internal Medicine at least three batches of doctors, whom she is confident can handle a much improved Internal Medicine Programme at the GPHC. She is therefore preparing to bring the curtains down on her stay here in Guyana and take her expertise to another place where it is needed.
The first batch is currently awaiting graduation when the University of Guyana conducts its convocation ceremony later this year. Among them are: doctors Terrence Haynes, Grace Waldron-White, Ramdeo Jainarine, Kamela Benaul-Sukhu, Hamichand Barran and Kishore Ramdass, all of whom are acting Registrars until graduation when they will be confirmed.
Graduation for a batch of 10 others, with Dr. Melissa McDonald as the Chief Resident, is expected to eventually follow.
Feeling privileged to have been a part of the Internal Medicine programme, Dr. Waldron-White said that from the inception she was amazed by the energy level exuded by Dr. Cole.
“She has this ability to keep going despite the fact that she had great responsibilities coming here and taking over the programme…she had so many responsibilities because at the time there wasn’t as much staff as there is now. She basically had to spread herself across the wards in addition to dealing with our didactics and all the other things involved in facilitating this residency programme,” related Dr. Waldron-White.
But her efforts didn’t merely stop at offering instruction as, according to Dr. Waldron-White, Dr. Cole possesses an unusual ability to bring out the best in anyone.
“There were times you fell short, there were mistakes made, but she always led you to believe that you can do better and she encouraged you to do better. We found her to be very patient, very understanding, but yet able to maintain a high standard,” Dr. Waldron-White asserted.
Dr. Cole will leave these shores in September but filling the gap, according to Dr. Waldron-White, will be a tall task for anyone person. Moreover, a number of persons will have to be strategically placed to ensure that all aspects of Dr. Cole’s work are catered to.
“Clinically she has taken us a long way from the point that we started…so in terms of being clinicians she has contributed to us being prepared,” said a confident Dr. Waldron-White.
Dr. Ramdass, like Dr Waldron-White, had nothing but praise for the knowledge he was able to gain from Dr. Cole. In fact he questioned whether the programme would have been a success without the priceless support that was offered by the “selfless” Dr. Cole.
“I don’t know if it would have still been going or even if it would have been like this,” said Dr. Ramdass as he added “it was a big plus for us to have her here to shoulder this programme.”
According to Dr. Ramdass, seeing the dedication and professionalism of Dr. Cole, has given him the drive to be a better doctor. He too couldn’t help commenting on the almost unnatural energy level Dr. Cole has.
“She is very organised and she gets things done…I’ve rarely seen her get angry or frustrated even if you did something wrong; I hope to emulate her professionalism,” he added.
But Dr. Haynes is mostly impressed by the fact that Dr. Cole was willing to put her personal, evolving career on hold in a developed country to lend support to a country that is now striving to become developed.
“What she chose to do for us is nothing compared to what she could have gained had she stayed in her own country. She has done something for us that many people wouldn’t…she is the only one that has really kept this programme going,” Dr. Haynes considered.
According to him, seeing Dr. Cole operate despite her immense expertise has taught him humility. But he claimed to be the most humbled by the fact that she easily adapted to a system that wasn’t on par with what she was accustomed to and wasn’t daunted by the many hurdles and stumbling blocks she was faced with.
“She helped change the structure of the Internal Medicine department…and we have seen the fruits of it, and she had also helped with the Medical School, which has lost its accreditation. She is one of the key players in terms of getting things where they should be so we can regain accreditation,” Dr. Haynes added.
Dr. McDonald on the other hand was eager to share that among the great deal of things she has learnt from Dr. Cole is the fact that not everyone is perfect, and therefore it is important to look at their positive sides since there are some things about people’s personalities you just can’t change.
“She is very inspiring and very compassionate,” said Lisa Marie Merai of Dr. Cole. Merai has worked as Programme Administrative Assistant to Dr. Cole since the inception of the programme.
“I will be really, really be sad when she leaves; I can’t imagine working with anybody better than her,” she reflected.

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