Dr. David Gozal, Dean, Joan C. Edwards School of Medicine

Please tell us your name, position and the name of the institution you represent.

My name is David Gozal. I am at the Joan C. Edwards School of Medicine at Marshall University in Huntington, West Virginia, where I serve as the dean of the School of Medicine and vice president for health affairs for the university.

Please give us an introduction to the Joan C. Edwards School of Medicine.

The School of Medicine was established in 1977. So, we’re reaching our 50-year anniversary in 2027. It opened after several attempts, as state universities require the approval of the state legislature and the community. Initially, there was some hesitation, as the state government and community were concerned about whether this would be a successful initiative, even though there was a substantial need for physicians in West Virginia.

The school began in trailers, which was a testament to the will and effort of the community. We started with a very small class—an embryonic beginning—but quickly began producing outstanding physicians. Within a few years, the school started expanding its class sizes and eventually reached the stage we’re at today.

Our mission has remained the same since the beginning: to train physicians who will contribute to the health care workforce of West Virginia and the surrounding states, but primarily West Virginia. The goal has been to serve this very rural state in both primary care and in specialties and subspecialties, providing a more comprehensive coverage of all health professions.

Over time, things have evolved. From trailers, we’ve moved into better facilities, and we hope that in the next three to five years, we’ll finally create what I like to call “the temple,”castle” or “palace.” That building will be a hub for medical education and community health. It will serve as the entry point for medical students, exposing them to primary clinical care while also hosting all student activities, scholarship efforts, innovation, research, service to the community and everything else that is needed to provide the optimal education for our students. That’s the vision we’re working toward.

I joined Marshall University and the School of Medicine a little over a year ago. The president of the university, Brad Smith, gave us a mandate to focus on health care initiatives and entrepreneurship in four major areas, or pillars, which we’re pursuing ambitiously.

The first is rural health care and primary care. We aim to tailor a precision medicine-oriented center of excellence that delivers outstanding care to rural and community settings, covering both primary and specialty care. This is an area in which we will be investing a lot of effort to go all the way. This is true to all the pillars or to all the centers of excellence all the way from anything that applies to translational science to implementation, from science through epidemiology, so really the whole continuum of care and innovation.

The second pillar is one that is of tremendous importance to all of us as nobody wants to age. The issues of gerontology and geriatrics are obviously of great importance to our community, as we have an aging population. What can we do to improve wellness in the community? What can we do to prevent accelerated aging, which is part and parcel of many of the chronic diseases that afflict modern society?

We see a reduction in fertility rates and the number of babies being born, and at the same time, people are living longer, but that doesn’t mean they live healthily. One of the important questions is: How do we keep an aging community well, productive and living a satisfactory life both during their work years, potentially delaying retirement, and after retirement, continuing to live without illness?

As you may know, one of the most costly elements of health care is the last year of life, which accounts for more than 20 percent of all costs throughout a lifetime. Anything we can do to reduce the burden of disease in those final years is going to be very important, both for community wellness and welfare, but also as a way to innovate and transmit those innovations to the rest of the world.

The third area of interest, one that particularly afflicts West Virginia, is obesity. We started a very ambitious set of goals to study obesity comprehensively, from genes and gene regulation to implementation science at the population level. Rural communities are especially affected by obesity, and you can see where the cross-pollination and cross-fertilization across these areas come into play. These are not isolated towers or topics; they are interconnected and relate to each other.

If you are obese, you are more likely to age faster and develop chronic diseases like cardiovascular disease, cancer, diabetes and others. This can lead to very accelerated aging and a poor quality of life as you manage and survive through these chronic conditions.

The fourth area of focus is substance use disorder or addiction sciences. Huntington, in 2017, was the subject of a Netflix documentary called Heroin(e). It’s a remarkable documentary created because Huntington, a small town of 50,000 people and home to our university, had gained the unfortunate reputation of being the overdose capital of the world. The opioid epidemic, which has affected the United States and particularly the Midwest, placed us at the epicenter.

In response, a group of physicians, health care providers, psychologists, community advocates, firefighters, police officers, the mayor and other city officials came together to launch what we now call the “City of Solutions.” Rather than succumb to pessimism, we united to combat the crisis head-on. It’s no surprise, then, that one of our key priorities is addiction sciences.

While we’ve made progress in curbing some of the problems associated with drug addiction, there’s still much work to do. We’re focused on developing systems that not only lead to better outcomes in our region but can also be replicated elsewhere to facilitate best practices. Along the way, we’ve accumulated quite a few success stories.

Parallel to these efforts, our priority remains to train medical students from West Virginia, although we’ve noticed that our geographic region acts as a magnet for students within 100 to 200 miles. These students are attracted to our medical school because it’s close to their families and offers excellent training in a solid university that focuses on the pillars I’ve mentioned.

Our medical school has grown steadily and now accepts about 90 students each year from 2,700 applicants—a very selective process. We prioritize those who align with our mission to serve the state’s health care needs. We’re accountable to the university’s Board of Governors and the state legislature, and the support we receive is tied to fulfilling our mission.

We look for students with an internal drive and a will to serve, both as health care providers and as examples to their communities during their four years of training. They need to be excellent students and outstanding individuals, with a deep understanding that medicine is a lifelong learning process. In medicine, you don’t learn everything in four years—you barely learn what to learn, what you need to know.

To prepare students for modern health care, we heavily invest in simulation-based training, bringing together multidisciplinary teams of physicians, nurses, psychologists, respiratory therapists, pharmacists and others. Medicine today is multidisciplinary and patient-centered. Decisions require input from the entire health care team, so we create opportunities for students to engage in this approach from day one.

In parallel with all this, we invest in clinical care and partner with the Marshall Health network, a large academic health center that serves as our base. This partnership is mutually beneficial: we provide health care to the community through our physicians and faculty, while the health care system offers locations and opportunities for our trainees—both medical students and those completing their specialties—to engage in a complex, hybrid health care system. This system encompasses rural, urban, semi-urban, primary, secondary, tertiary and quaternary care, enabling students and trainees to experience all facets of medicine before pursuing their professional careers.

Through this partnership, we also develop research initiatives, collaborating with the rest of the university and investing heavily in areas like basic research, genomic research and laboratory bench-based studies. These efforts extend to clinical trials, population science and other innovative projects, providing opportunities for students and trainees to engage in research and innovation. Good ideas often come from diverse directions, and fostering a sense of scholarship and academia is essential for our students’ success and for our physicians to gain recognition for their contributions to science.

To summarize, the integration of the university and its colleges plays a critical role in our operations. We are part of the Marshall Health network, and metaphorically, the School of Medicine is like a child carried by two parents: one being the Academic Health Center and the other the university. Together, they support the school, while the community and state serve as the playground for our activities. This collaboration creates a dynamic environment that ensures the successful training of individuals who will make us proud throughout their careers.

What would be your message to the community and potential donors or partners who want to support you?

The message I would convey is one of modesty and ambition. Modesty because we do not aim to compete with the world’s largest medical schools; that is not our goal. Instead, we focus on training the next generation of hardworking, dedicated and outstanding physicians. These individuals will serve their patients and communities with passion, integrity and the best knowledge and training we can provide.

If, in that process, some of our students contribute to the expansion of knowledge through their skills, innovation and creativity, we would be absolutely delighted. We strive to equip them with the tools they need as early as possible. For instance, we offer MD/PhD programs for students pursuing both medicine and doctoral degrees in the sciences, as well as MD/Master’s programs in translational or clinical sciences, health informatics, cybersecurity and even social media journalism. These initiatives allow students to communicate effectively, share their stories and become influencers who educate the public about what it means to be a medical professional.

In the past, we often relied on jargon and technical language, but we now emphasize training physicians to communicate clearly about disease, its management and how health care professionals serve their communities. This fosters a patient-centered approach, empowering informed patients and ensuring they feel supported throughout their health care journey. An essential part of our mission is to communicate knowledge and facilitate an informed patient. An informed patient, combined with a patient-centered approach, is the best way to ensure everyone feels they are achieving what they seek and deserve.

The study of medicine is a very expensive endeavor. Like many other students in the United States, our students graduate with a large debt, averaging about $250,000 and now approaching $300,000. Through fundraising, community donations and various initiatives, we provide scholarships to reduce this burden. This enables students to make real decisions—not just pursuing remunerative specialties but following what is truly in their hearts to serve the community and be the best physicians they can be.

We have two dreams. First, to build a structure that will house the services through which we aim to give back to the community through the training of our medical students, particularly in the four areas of excellence. This would prepare them to be the best in the world at these tasks. Second, to contribute to scholarships, especially for those who cannot afford the cost of education, to reduce their financial burden.

Almost 60 percent of students coming to Marshall University are first-generation college students. They have no family members who have attended college. We aim to bring these individuals with social determinants of health and economic success into an environment where we foster their development and make the most of their unique skills. These students are no less than others, but their environment has been so challenging that even dreaming of attending medical school feels impossible.

As a first-generation college graduate myself, I understand. My grandparents worked in coal mines, enduring 18-hour days, low wages and challenging living conditions. Families like mine often struggled to survive. How do we get out of this? Do we dare to dream enough to go all the way and be the best we can be?

That is the message we instill early through pipeline programs that start in high school and continue through college. These programs introduce students to health care and health care professions, conveying a message of hope—hope through work, education and effort, a real hope for the future.

Any support that helps reduce the fear of being unable to afford education is invaluable. We do everything we can, but there’s always room for more. This is an area where donors and supporters can make a meaningful difference.

Is there anything I haven’t asked you about that you’d like to mention?

I think what we need to put into context is that the School of Medicine is not evolving in an isolated glass tube. We’re not isolated from the rest. We live and breathe the community. Our students volunteer for a variety of community-related activities, which is always amazing and emotional to witness. For example, when we renewed our voluntary clinic for the homeless and those with limited access to health care after the summer, 60 students spent their weekends delivering free health care as a dedicated service to the community.

This is just one of many initiatives. They raise funds for cancer research and children, help poor families, support pregnant women battling drug addiction and more. They organize events like fashion shows and charity runs, all while managing their rigorous studies.

Marshall School of Medicine, the Joan C. Edwards School of Medicine and the university as a whole form a true partnership with the community. Everyone cares for each other, which creates an environment that is very appealing to students and families seeking to join a compassionate, service-oriented community.