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Dr. Fenske featured in Tampa Bay Medical News (Physician Spotlight)

PHYSICIAN SPOTLIGHT: Neil A. Fenske, MD Chairman, Department of Dermatology & Cutaneous Surgery, USFCOM, Tampa
Some might think that growing up “dirt poor” on a farm in Blue Earth, Minn. would be a liability. But Neil Fenske treasures it as a character-building experience that allows him to appreciate how far he has come in life.

“I’m a guy who came up the hard way,” said Fenske, chairman of the Department of Dermatology & Cutaneous Surgery at the University of South Florida College of Medicine in Tampa. “I had to carve, scratch, dig and cajole. That’s not a complaint. It has made me stronger, Fenske said.

How poor was his family? Fenske, the eldest of five children, wore only used clothes and one winter his only jacket was a girl’s. “I had to wear it to school because that was all (his parents) could afford for $1.50,” he remembered.

Fenske was driving a tractor and plowing fields at 10 years of age. His parents eventually purchased a small grocery store in nearby Winnebago, where he and his siblings worked at night and weekends. Fenske credits the long hours and hard work to forging his work ethic. “It was working behind the cash register where I learned to interact and communicate will people of all ages and personalities, which has served me well as a physician,” he said.

The family’s diet was low-budget and high-cholesterol. “SPAM® was a staple … and hot dogs and hamburgers were served on thin white bread because buns were ‘too expensive,’” he said, adding that an experience with a hamburger at age 12 was a turning point in his young life. “A friend’s mom took him and me for my first restaurant experience – a hamburger on a bun, French fries and a Coke. What a treat! It was at that point that I decided I was not going to be poor when I grew up. I committed myself to academic and athletic excellence throughout my high school years,” Fenske recalled.

He earned a basketball scholarship to Gustavus Adolphus College, becoming the first Fenske to attend college. He already knew he wanted to study medicine because of his teenage admiration for two family physicians. After college he enrolled in medical school at St. Louis University, where he took an elective course in dermatology and “fell in love with it,” Fenske said. He completed his internship at St. Mary’s Hospital in Duluth, and residency at the University of Wisconsin, where he met and married his wife Robyn, and soon realized “an academic career was my calling,” he said. Fenske was recruited to USF to start a residency training program in dermatology and he has been there since 1977.

But in many ways that is just the beginning of a career in which he has influenced the lives of countless patients, students and the institution he has served for 34 years. Along the way Fenske has left his mark in many ways, including being president of seven dermatologic organizations and being named the 1999 practitioner of the year by the Florida Society of Dermatology. In addition, he was chosen by his peers in the Castle Connolly Medical Ltd., directory as one of America’s top cancer doctors for five of the past seven years.

But the professional accomplishments that Fenske treasures most are his relationships with students and patients.

“I have had the privilege to educate and mentor many bright young men and women, many of whom practice in the greater Tampa Bay area,” he said. “All our grads are reputable and very highly sought-after. (Tampa-area) docs scoop up my residents all the time. I’m proud of all of them.”

Fenske said he still spends about 50 to 60 percent of his time seeing patients, which is unusual for a department chair, and that he still thrives on that interaction. “I have not lost my zeal,” he said. “I have as much enthusiasm today as when I started here 35 years ago. … I’m very motivated and high-energy.”

Others confirm Fenske’s self-evaluation. Stephen Klasko, MD, MBA, is senior vice president of USF Health and dean of the College of Medicine. “He is very well thought of by me and others,” Klasko said, pointing out his work with Fenske to transform the Dermatology Division into a full-fledged department. Klasko also noted that Fenske was instrumental in securing the endowment of the Dermatology Department Chair. It was Fenske’s relationship with a patient that made it possible.

Tampa resident Chris Sullivan is co-founder and CEO of Outback Steakhouse, and a patient of Fenske’s for about 15 years. “I’ve dealt with a lot of skin cancer issues personally and in my family. Over time I observed how he was teaching young doctors and how innovative he was in his practice and teaching,” said Sullivan. “They did not have a dermatology chair at USF and I knew he had done a fantastic job of building that department. The idea of endowing that chair became available to me and I thought it was the right thing to do because Neil had earned that opportunity. Personally, he has impacted me very positively and I like the way he goes about his business. He’s an outstanding educator and an outstanding doctor,” Sullivan said.

Fenske said that when he and Klasko met with Sullivan to discuss a fundraising effort, Sullivan volunteered not only to endow the chair for $2 million, but he insisted on putting it in Fenske’s name. “I was caught off guard” by Sullivan’s generosity,” Fenske said. “I literally had tears welling in my eyes. Most people (who make a donation of that size) would want their name on the chair.”

But Sullivan saw it differently. “Neil’s the one who did all the work. It should be named after him,” he said.

And, Fenske said, his work is nowhere near done. Several area dermatologists and philanthropists have contributed, and one of his goals before retirement is to endow the entire Dermatology Department, which will require raising several million dollars. “It would be a great legacy for this great university,” he said.

But that doesn’t mean Fenske is eyeing retirement. “I still love going to work on Monday mornings. … Other than my grandkids and my immediate family, my work is my life and it’s a labor of love. God willing, and my health holds up, I’m here several more years,” he said.

Fenske has three children and four grandchildren and he savors the time he and Robyn spend together with them, especially during autumn at “our mountain house in the Smokies,” he said.

Reflecting on his humble beginnings, Fenske takes heart in the fact that “in America, you can still overcome it. … You’ll have to work harder than the average bear,” he said, but adhering to a simple set of principles has served him well: “Always work hard, do your best, and always do what’s right.”

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Seeking their perfect match

Three dreams.

One day.

Three USF students envision different careers in medicine – all highly competitive, all different paths.

They all have special talents outside of doctoring: One is an artist. One, a politican. Another, a visionary. In their different ways, all are leaders.

Their talents and their dreams are different. But they – and more than than 100 other members of the USF College of Medicine class of 2010 – would all find out within the space of an hour whether those dreams would be fulfilled.

On March 18, 2010. Match Day.

On the same day, all across the country, medical students would find out where they will spend the next few years of their lives, doing graduate training in the specialties they hope to pursue.

The ritual is foreign to those outside of medicine. Medical students apply to the programs they seek, and rank them in order. Programs list which students they want. A computer matches them all. On Match Day, students find out where – and whether – they have matched.

Some would be jubilant. Some, crushed.

And until it’s over, all would be nervous. Medical students know that matching is getting harder. Certain specialties, such as dermatology and orthopaedics, have become so popular that only top students can win a coveted slot. And finding a match is becoming more difficult for all students, as the number of medical students is growing faster than the number of residents, or students doing graduate training.

Which is why these three students – Navid Eghbalieh, Nishit Patel, and Lindsay Rumberger – were anxious as they awaited their fate.

NAVID  EGHBALIEH

Eghbalieh, 28, has always seen the world as an artist. He sees the world in lines and colors, light and shadow. He meets people and imagines what they would be like to paint. Sometimes he would rather paint than sleep.

So maybe it’s not surprising that Eghbalieh’s painting brought him to medicine – and has helped him choose the specialty he hopes to pursue.

As a teenager in Los Angeles, Eghbalieh would go out and sketch people. He would hang each picture on his bedroom wall for a while as he thought about what he learned from doing that picture. What did it tell him about his subjects’ experience? He’d think about it, mull it over, and then the picture would make way for a new one.

It was a good way to make sense of a world that hasn’t always been easy for Eghbalieh and his family. Of Greek-Persian descent, Eghbalieh was born in Iran, the youngest of three brothers. When he was 6, his family fled the country abruptly, in fear that his oldest brother was about to be conscripted.

They started all over again in Los Angeles, where at first, his parents worked multiple jobs and the three brothers shared a bedroom. Gradually, things became easier. He is grateful.

“I was very lucky,” he said.

Yet Eghbalieh has always been drawn to documenting the problems of the less fortunate. The rotating art gallery in his room ended the day Eghbalieh came across a free clinic for homeless people at the Santa Monica pier. He sketched a doctor helping a mother with three children. He came home and put the picture on his wall.

And then he couldn’t take it down.

Eghbalieh began volunteering as a patient escort and asking to shadow doctors. As a college student at UCLA, he became an EMT. Then he went on to medical school.

At USF, he first thought he would become a surgeon. But then he discovered radiology. It spoke to his artistic sense.

“With radiology, it was a visual approach to a diagnostic puzzle,” he said.

His interest in radiology deepened as some of his family members faced medical challenges, and he saw the importance of imaging firsthand.

Along the way, Eghbalieh has kept up his interest in helping homeless people. He will graduate from USF with a scholarly concentration in health disparities. He volunteers with homeless shelters in Tampa Bay, giving talks on preventive medicine. He’s working now on a series of paintings of homeless children, which he hopes to exhibit to raise awareness about the challenges they face.

Eghbalieh knows radiology is a competitive specialty. He tried not to worry about whether he will match.

Or where.

“Whatever’s meant to be will be,” he said.

Nor does he worry about whether he’ll be able to juggle medicine and art.

“No matter how busy I am or will be some day,” he said, “I will always find time for art.”

NISHIT PATEL

Nishit Patel was born in India, but his earliest memories are in South Florida. His family moved there when he was a toddler. His parents got the jobs they could find, working in a grocery store, because they wanted better lives for Patel and his older sister.

“It was the constant message,” he said. “Everybody is dying to be here and you got this opportunity.”

It’s easy to take American opportunities for granted, said Patel, 24. He had to remind himself, growing up, to stop and think about how different it could have been.

“Even the fact that you can get a free education and have it be a good one is really radical,” he pointed out.

Patel’s parents pushed another message as well: the importance of service and selflessness.

“If you’re not doing anything for your community, it doesn’t matter how successful you are,” Patel was told.

Those messages may have primed Patel, “the dork in the high school math club,” to consider medicine. But it was an experience in college, shadowing a hospitalist, that convinced him. Patel was deeply impressed by the doctor’s dedication.

“There are really very few people who love their job,” Patel said. “That made me realize that this is what I want.”

Those same values have pushed Patel to be a leader. He served as class co-president each of his first three years in medical school and this year is the student council president. Among the most meaningful experiences has been his work to have his class adopt a middle school.

The class learned the school had never had a school dance, so they hosted one for them. They also did a mini med-school day for the students. The most satisfying thing for Patel was hearing students say, “I want to be a doctor.”

Patel decided on dermatology after another shadowing experience. He shadowed Dr. Mary Lien, assistant professor and director of medical student education for USF dermatology. Patel was struck by Dr. Lien’s excitement and passion for her work.  Then Dr. Basil Cherpelis, assistant professor and USF’s chief of dermatologic surgery, became a mentor to Patel.

As Patel spent more time in dermatology, he saw more doctors who loved their jobs – as well as many who shared his beliefs about community involvement. He was hooked.

Patel worried about how hard it would be to find a dermatology residency.

But he decided to try anyway.

“I don’t know if I can pull it off,” he said. “The one thing I learned is if you want something badly enough, you may not get it the first time….but eventually, you do.”

So Patel applied only to dermatology residencies, with no back-up plan. His top choice: staying here, at USF.

“The whole time, USF has felt like home,” he said. “I never got that feeling anywhere else.”

LINDSAY RUMBERGER

Like children everywhere, Lindsay Rumberger loved to sculpt objects out of Play-Doh.

Her favorite Play-Doh activity: making a pancreas.

As one of six children growing up in Vero Beach, Rumberger learned a lot about the pancreas. She and three of her siblings share the same rare condition, hereditary pancreatitis.

It’s a disease marked by nausea, vomiting, and abdominal pain. But Rumberger used her experience to look forward – toward a career in medicine.

“We had a lot of exposure to the medical field,” said Rumberger, 26.

All through med school, Rumberger has carried her childhood fascination with her. She hopes to be a surgeon and specialize in oncologic or other surgeries of the pancreas.

From the beginning, Rumberger has heard a constant refrain: “The lifestyle is hard,” people would say. It’s a tough choice for a woman.

Rumberger decided not to listen.

Instead, she found a role model in Dr. Sharona Ross, assistant professor of surgery and director of surgical endoscopy at USF Health. Last fall, Dr. Ross launched the USF Women in Surgery initiative.  Rumberger pointed out that not only is Dr. Ross recognized for her innovative surgical techniques, but balances her career with raising four children.

“Seeing that a woman really can do it was really inspiring,” Rumberger said.

Rumberger pointed out that surgery is rapidly becoming less of a male field. Although only six women have chaired academic surgery programs in the U.S., these days thirty to fifty percent of applicants to surgical residencies are women.

At Dr. Ross’ request, Rumberger helped organize a Women in Surgery symposium in February that brought in experts from across the nation. Rumberger hopes the group can give women considering surgery as a career the support they need to choose that path.

“You really realize that a lot of women get discouraged along the career path,” she said.

Instead, she hopes the group can highlight the positives.

“The definite pro side is that it’s a job you’ll love,” Rumberger said. “It will always be different and fun and exciting, every day.”

But Rumberger has found the anticipation of Match Day to be more excitement than she needs.

“It’s nerve racking,” she confessed. “I definitely haven’t slept well.”

Then there’s the oddity of interviews around the country, leading up to the match.

“It’s like dating a bunch of different people at the same time,” Rumberger joked. “You like them, do they like you? You’re not sure…There’s nothing like it in any other profession.”

MATCH DAY

By Florida standards, it was chilly at Skipper’s for Match Day, but the students didn’t seem to mind. They gathered with classmates, parents and children, waiting for their names to be called.

For the first time, USF Health produced live streaming video to Facebook, allowing students to greet family members watching elsewhere – from as far away as India and Dubai. More than 1,000 people watched from their computers.

They saw as students screamed and laughed and cried and jumped up and down. Some students brought their children up to the stage to open envelopes, and one little boy read his mother’s letter.

They learned that many in the class would scatter, traveling as far as Utah and Arizona, Indiana and Ohio. Another large group will stay at home, here at USF or nearby in Orlando. Programs that USF students matched into this year include Massachusetts General Hospital, Emory University School of Medicine, Duke University Medical Center, and Childrens Hospital Boston.

When Dr. Steven Specter, associate dean of student affairs, called out Rumberger’s name, she hurried to the stage.

“I’m nervous,” she told Specter.

And then she waved her paper in the air.

“University of Tennessee KNOXVILLE!” she yelled.

It’s good news for Rumberger: one of her top choices. Her mother is originally from the Knoxville area, and Rumberger thought the program seemed like a good fit for her.

Then it was Eghbalieh’s turn.

“My heart is beating really fast,” he announced.

“WOOOOOOO!!!” he yelled. “All right!”

Eghbalieh will head to the University of California at San Francisco for his first year and then on to Tulane University School of Medicine for his diagnostic radiology residency.

Eghbalieh’s oldest brother is a UCSF surgeon, and he’ll get to spend a year closer to his parents. He’s thrilled.

Another handful of students, and it was Patel’s turn.

“Go Nish!” students yelled as Patel went up to read the news. He opened the envelope and smiled.

“You’re stuck with me another four years!” he cried. “USF dermatology!”

He hugged Dr. Specter, then Dr. Stephen Klasko, dean of the College of Medicine.

Once it was all over, he still couldn’t quite believe it.

“There were so many good people applying,” Patel said. “To be able to get my first choice is exhilarating.”

– Story by Lisa Greene, photos by Eric Younghans, USF Health Communications

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