Dan Hodson | Global Health Program

Daniel Z. Hodson, MD is a graduate of the UCLA Internal Medicine - Pediatrics residency program. Prior to medical school, he served in the Peace Corps for more than four years, briefly in Niger and mostly in southern Senegal, where he was involved in a broad range of malaria control activities. During medical school, he conducted research on the epidemiology of malaria in Douala, Cameroon. During residency, Dr. Hodson rotated with UCLA partner sites Partners in Hope and Lighthouse Clinic in Lilongwe, Malawi. He is now working as a Medicine and Pediatrics provider with the Indian Health Service (IHS) at the Gallup Indian Medical Center in Gallup, New Mexico and applying to fellowship programs in adult cardiology.

GHP was excited to learn more about Dr. Hodson, who recently completed his residency program at UCLA.

GHP: What inspired your dedication to improving global health equity?

Dr. Hodson: I believe one of the main tenants of medicine is service to patients and populations. When you attempt to meet patients where they are, whether this be a quaternary referral hospital in a major city in southern California or in their home in a small village in southern Senegal, you quickly realize that there are innumerable barriers to delivering care and that many systems are designed (intentionally or not) to deliver inequitable care and obtain inequitable outcomes. This is unacceptable. Rather than abandon clinical care or public health entirely, I think we are obligated to work within these existing, albeit imperfect, health systems to improve health care delivery and patient outcomes.

In addition, there are also inequities in medical education and scholarship that make it difficult for trainees from certain backgrounds and/or places to manifest their talents. For example, we could not find funding for a colleague at the Senegalese National Malaria Control Program to attend a summer program in the U.S., and she ended up funding this expensive training herself. For my medical student research, I applied for multiple minimally competitive or non-competitive grants, while the same opportunities were not available to my counterpart from Douala, Cameroon. My colleague in Cameroon also did not have access to scholarly journals (i.e. PubMed articles) or statistical software.

I fundamentally believe that a diversity of experience/exposure is a core tenant of any education, especially in medicine. Medicine in both global and local, so we have much to learn from colleagues practicing at different hospitals, in different systems, in different countries Yet, when we try to learn from others, we realize some voices are systematically being silenced.

GHP: We couldn’t agree more! During residency at UCLA, how did you continue to engage in global health equity work while balancing the clinical demands of training?

Dr. Hodson: I am so grateful to have had the opportunity to be a part of the Internal Medicine Residency Global Health Pathway and to rotate three times through our partner sites in Lilongwe, Malawi. The UCLA Department of Medicine has built strong relationships over many years, and I was fortunate to take part in the strong collaboration with partner sites in Lilongwe. Most importantly, several UCLA faculty members, including Dr. Risa Hoffman, Dr. Faysal Saab, and Dr. Chris Tymchuk, have been working for years to advance equity in these relationships by bringing colleagues and trainees from around the world to UCLA.

GHP: How did you decide which opportunities to pursue? Did your focus shift or change as you moved further along in your medical training?

Dr. Hodson: Most people who will read this interview are very aware that inequities in access to care and health outcomes are pervasive both in the U.S. and abroad. As I gained more experience in academic scholarship and through shared experience with collaborators, I learned more about inequities in scholarship and educational opportunities. As a resident, it can feel daunting to try to change an entire health system, so I attempted small, concerted efforts to open doors for colleagues from abroad in the domains of training and scholarship. For example, one of my mentors from my thesis research, Professor Yap Boum, has published on inequities in coveted first-author and last-author positions on manuscripts, so I tried to involve colleagues from our partner site in Lilongwe to take part in our presentations at UCLA and encouraged colleagues to be first authors on manuscripts.

GHP: We love how intentional you have been about access to opportunities for collaborators. Looking back, what are you most proud of in your journey so far? And what continues to drive your work forward?

Dr. Hodson: Amidst many failures along the way, some highlights include helping eliminate widespread stockouts of first line malaria rapid diagnostic tests and medications leading to tens of thousands more patients treated at the community level across a rural health district in southern Senegal; encouraging a physician from the Senegalese National Malaria Control Program to attend a summer program at the Harvard School of Public Health; co-authoring a manuscript on health equity in global health scholarship with colleagues from Cameroon; coaching my collaborator from Cameroon to present at multiple international conferences in the United States; supporting the efforts to bring two colleagues from Lilongwe to UCLA for training; and guiding a colleague from Lilongwe to her first lead-author manuscript that won a research award from UNC-Project Malawi.

GHP: How rewarding! You’ve also just begun a new role working with the Indian Health Service (IHS) in New Mexico. What motivated this decision?

Dr. Hodson: I’m so grateful and excited to be able to be a provider within IHS, and particularly within the wonderful community of intensely brilliant and passionate, yet also humble and genuine, health care professionals at Gallup Indian Medical Center (GIMC). First, I wanted to gain experience as a full Attending in community medicine in the United States away from quaternary academic centers, and IHS is one of the few systems where Med Peds practitioners can practice the full breath of both Internal Medicine and Pediatrics. Second, while residency is often about surviving inpatient and clinic workflows, I wanted to return to the core value of service and lend my skills as a physician where clinicians are most needed. My new colleagues at GIMC will push and support me to be a better provider.

GHP: What advice would you give to medical trainees who want to pursue a similar educational and career path in health equity, especially when faced with institutional or systemic barriers?

Dr. Hodson: First, I would advocate to remain working with patients and community members within imperfect systems. One can work directly with people in many different roles, such as clinicians, public health nurses, or community health workers. Too often, brilliant providers get burnt out and end up retreating from patient-facing roles, but I believe we need to be directly engaged with patients and communities to understand the issues being faced. Next, be creative in how you approach your career. It is possible that no one will be able to offer you exactly the job or path you want; you might have to create it, but this is possible, and you don’t necessarily need to sacrifice your family’s wellbeing or your personal sanity to engage in the work you want to do. Third, always question the status quo; if you are told something is “not possible”, consider if it would be “possible” if the patient were from another socioeconomic group, another geographic area, another racial or ethnic group, another insurance provider, another health system, etc. Often “possible” simply means “typical” for particular people in a particular system at a particular point in time working under particular assumptions. Finally, open doors for others; only through diverse and often unexpected collaborations can we begin to address all the varied and diverse challenges in health care delivery across our communities and the world.