April 21, 2021
For Dennis Hopkinson, M.D., remote work took on a whole new meaning this past year.
The Virginia Commonwealth University doctor and instructor is working on research projects from more than 7,000 miles away, leading marathon Zoom meetings and fielding messages from across the time difference in Kigali, Rwanda. The remote work allows Hopkinson to finish investigations into topics like sepsis and heart attacks with fellow doctors and study collaborators in the Rwandan capital city.
The trans-Atlantic research is just one element of Hopkinson’s varied experience at VCU since coming for his medical residency in 2015. A fellowship as a Fulbright scholar, the VCU Rising Scholars program, a master’s degree — Hopkinson is taking it all with him to a fellowship at Duke University later this year. His time at VCU has shaped his clinical practice and research, bringing classwork to life through clinical trials and community-engaged research.
“What informs the work I do now is really listening to what people on the ground have to say and what is most important to them,” Hopkinson said. “I can come in with my ideas, but I really need to get strong local support and feedback. That's something that's important wherever I do health research or practice medicine.”
Residency at VCU led to love and fellowship
It all started with a trip in 2016 by the woman Hopkinson would eventually marry.
Karen McIntyre, Ph.D., a VCU associate professor of journalism, traveled to Rwanda to interview journalists about the role of media in their country after the 1994 genocide. She enjoyed the people and the country, and back at VCU, McIntyre looked for a way to return to the country to continue her research.
Meanwhile, she matched with Hopkinson on Tinder.
“She was looking into applying to Fulbrights, and I didn't even know that they had medical Fulbrights,” Hopkinson said.
They both received separate Fulbright awards to Kigali, McIntyre’s in journalism and Hopkinson’s in medicine.
Living in Rwanda wasn’t completely out of left field for Hopkinson — or simply a case of following his new partner. Hopkinson had engaged in research during medical school and his residency at VCU.
“It had been a long interest of mine to do work in a developing country in some sort of medical capacity, but nothing formalized until my wife and I applied for the Fulbrights in 2017,” he said.
The Fulbright allowed Hopkinson to split his time in Kigali between research and teaching. Hopkinson chose a more research-heavy split, working with local contacts to choose projects for which they saw a need.
“Working collaboratively is so important,” Hopkinson said. “I wanted to know, what are the real issues that people are experiencing here? To make a meaningful impact, you can't just be in your silo, thinking of great ideas.”
One of the physicians in Kigali interested Hopkinson in acute coronary syndrome, or heart attacks. Another contact interested him in sepsis, which occurs during an infection. The body mounts an overwhelming response, causing organ damage. And Hopkinson had long been interested in adherence, or understanding why people take their medications properly or not, and the barriers to taking medications.
Those ended up being his three major projects. Hopkinson established a research team of 25 faculty members, residents and medical students in Kigali to help him carry them out. Dennis Hopkinson and Karen McIntyre. [View Image] Dennis Hopkinson, a student in the M.S. in clinical and translational research program at the C. Kenneth and Dianne Wright Center for Clinical and Translational Research at VCU, and Karen McIntyre, a journalism professor at the Richard T. Robertson School of Media and Culture, in 2018. Hopkinson and McIntyre spent 10 months teaching and researching in Rwanda as part of their Fulbright scholarships. (University Relations file)
The challenges and rewards of global health research
To conduct health research abroad means meeting challenges and differences at every turn.
For the sepsis study, the team wanted to look at how people present with sepsis, how it’s managed in the major Rwandan hospitals and those patients’ outcomes. Hopkinson said the analog system of maintaining medical records made for a unique challenge, with medical charts handwritten in a mix of French and English and stacked haphazardly in a room. Getting approval for research can be much slower in Rwanda, too.
“There's just not the infrastructure that we have here for research,” Hopkinson said. “Here, you'll have your research coordinator, forms ready to go, etc. We had to build our own infrastructure in Kigali to some extent.”
But the rewards are great, too. Much of the data is untapped, Hopkinson said, and the findings are often unpublished and surprising.
“For example, sepsis mortality is very high in Rwanda,” he said. “And we learned that with some simple medical education and basic interventions, you could improve mortality quite a bit. So there are the challenges, but the rewards are very high for the patients.”
In many senses though, Hopkinson said, the lessons of health research abroad are just as applicable back home. Community partners are co-educators and co-researchers. And the same principles of community engagement, listening, adapting and persistence apply.
The needs for research, training and education exist everywhere, Hopkinson said. “Life expectancy in Rwanda is now higher than in certain neighborhoods of Richmond.”
Back to the classroom as a student and teacher
Back at VCU, Hopkinson wanted to build on the research experience in Kigali. The VCU Department of Internal Medicine’s Rising Scholar Program allowed him to dedicate 70% of his time to continuing that research. And as an instructor in the VCU Pulmonary Critical Care Global Health Program, he helps train future international health researchers.
“With global health research, you really have to have a passion for working in challenging environments,” Hopkinson said. “That’s something I try to impart on my students.”
As a Rising Scholar, Hopkinson also had the opportunity to get a Master’s in Clinical and Translational Science, which trains people in how to conduct the research that brings better health care to patients.
“In medical school, you get minimal training on research for those interested in a career in research, and the same is true for residency,” Hopkinson said. “Plenty of researchers have no additional research training and do great, but I found the additional training really helpful. And I've always valued formal education.”
Classes in team science and clinical trial design appealed to Hopkinson. He also found a new passion in biostatistics with Leroy Thacker, Ph.D., an associate professor in the VCU Department of Biostatistics.
“I really liked learning how to build predictive models,” Hopkinson said. “We got all this data from the sepsis study, and we needed to find what predicts a high mortality likelihood. Learning how to piece all the statistics together and build predictors — it's really powerful and can inform health care so well.”
Hopkinson completes the degree this spring.
“We’re so pleased and proud of all the great work that Dr. Hopkinson has accomplished since coming to VCU for his residency,” said Peter Buckley, M.D., dean of the VCU School of Medicine. “It’s a testament to his drive and his abilities, which were a great fit for the School of Medicine’s strong programs for early career researchers and those interested in careers in global health.”
Hopkinson is taking his medical and research experience to Duke this summer for a three-year fellowship in pulmonology and critical care. The first year and a half will focus on clinical care, and the second half of the fellowship will be research-centric. He’ll continue with his projects in Rwanda, collaborating with researchers in Kigali and at VCU.
“I've learned so much in the last few years between the residency, the Fulbright experience, the Rising Scholars Program, the master’s program and from my mentor, Dr. [Aamer] Syed,” Hopkinson said.
“They’ve made me a much better researcher. And I think that's part of what was strong about my application for the fellowship — just how much I've been able to get done in the last couple of years at VCU.”
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