Every PLME’s “mom on campus” talks about her 50 years at Brown, the evolution of medical education, and what the future holds.
In the faculty address to the MD Class of 2025 at their White Coat Ceremony in September, Julianne Ip ’75 MD’78 RES’81, P’18, confessed to the first-year students that she had never walked in through the Van Wickle Gates. That is, until September 2021, when she snuck in to process with them at Convocation.
During her own first year, Ip said, she was homesick and never left her room in the first few weeks of the semester except to go to class and meet a few people in her dorm.
Who could have imagined after that rocky start that she would stay at Brown for a half century? Ip retired December 31, 2021, as associate dean of medicine for the Program in Liberal Medical Education and International Medical Exchange Programs. While her years as an employee and faculty member may have come to a close, she’ll sustain her ties to the University as a professor of family medicine emeritus, an alum and Brown parent, and her lasting impact on two generations of physicians.
In her own words, she describes her life’s journey and what comes next.
When I first arrived at Brown 50 years ago, I was a pretty shy, introverted, well-protected Chinese-American girl who grew up in a town where there were only two Chinese families: Swarthmore, PA. It was a fairly non-diverse town. Coming to Brown was overwhelming. I really wanted to go to Princeton, and you know why? Because the campus looked like Swarthmore.
I came because my father’s friend’s daughter, Stephanie Spangler [’73 MD’76], was in the seven-year Program in Medicine and my dad thought this was an ideal program for me. I knew since I was 6 that I wanted to be a doctor. As usual, my dad was right.
When I got here I literally cried for the first two weeks because I was so homesick. So that’s who I was. But beyond family, education was our core value, so I hunkered down, met a small group of great people, and studied hard. I had a permanent seat on the ninth floor of the Sci Li as an undergrad.
We didn’t have a lot of choice back then in our concentrations if you were in the seven-year program, so I did an ScB in biology. It was a lot of biology courses, four chemistry courses. We were only allowed like one elective per year pretty much. My favorite course was in humanities: Modes of Thinking taught by Dr. Fred Barnes. It was sort of philosophy, humanitarian ethics, history, and literature all rolled into one. It was my favorite course ever because it gave some perspective to the patient care and narratives I hoped to share with my patients.
When I got to the medical school, I was one of only two Chinese women. It was me and Madeline Luke [MD’79, P’10]. But because most of us were in the combined degree program, I knew most of my classmates. I’m one of the weird people that loved med school more than undergrad. Maybe it was because, again, it was a small group of people and Brown was so big and so diverse and, for me, overwhelming. The med students—these were my people, and we were a very close class. It was a very fun time. We socialized, shared meals together, and were extremely collaborative students, helping each other all the time. I take handwritten notes, verbatim, to learn. Steve Upham [’75 MD’78] sat next to me (I was a righty and he a lefty) and between us, we had EVERY word that the professors said documented. We printed them up for anyone in the class that wanted them.
Our faculty were phenomenally holistic, phenomenally collaborative. Maybe because we were so small, and the low number of students, but we got such personal teaching and that was so Brown. I can still name my preceptors, Dr. Richard Mead and Dr. Harold Horowitz, from my doctoring rotations. They literally took care of us like their apprentices. We had the most amazing teachers … Drs. Nelson Fausto, James McIllwain, and then in the hospitals, Drs. Milton Hamolsky, Mary Arnold, Steve Zinner, Al Erickson, and for my research, an internationally known neonatologist, William Oh. I sought him out in part because he was Chinese but mostly because he had done so much to bring cutting-edge neonatal care to the world and I thought that would be amazing research to participate in. All of our professors taught us how to be empathic, compassionate, and lifelong learners. They were dedicated to teaching and mostly to the best care for the patients of Rhode Island.
As I came out of family medicine residency, I got a job right away at RIGHA, the Rhode Island Group Health Association. I pretty much immediately became the chief of the urgent care. As you might have figured out, I like organizing people, networking, and improving systems, as I was chief resident at Memorial Hospital during residency as well. I started teaching right away, having residents come work with me, and then-Associate Dean of Medicine Steve Smith started inviting me to faculty meetings so I could become more involved. It was at one of those meetings that Steve came up to me and said, [then-Dean of Medicine] “David Greer and I want to talk to you about a position that we want you to apply for.” They wanted to evolve the seven-year program into the Program in Liberal Medical Education. I was able to say, “This is exactly what I think we should have had in the program that I was part of.”
Steve had been in the six-year program at Boston University and both of us felt like we really wanted more time to become better educated to round out our science education with more liberal arts. I never got to take a Barrett Hazeltine course or an incredible political science, history, economics, or English course. I knew about the Open Curriculum because I read about it in a brochure, but we didn’t get to participate fully in this wonderful Brown opportunity as our program was so set.
Of course, there was pushback when we implemented the PLME. A competency-based curriculum was not the norm. Plus, Brown was a research institution and the MEP [the seven-year Medical Education Program]was intended to create physician-scientists. At the time, [liberal education]was not necessarily a good thing. However, Steve Smith and David Greer’s vision came to fruition despite that. Anytime we try to make changes to the competencies, people are all over us. I had to have data. … I had to show them, look, we have kids that placed out of physics because they’re brilliant, and they did fine in medical school. The PLME students proved to Brown and to residencies that this was a highly successful way to train physicians. Some are now deans, chairs of departments, professors, directors of clinics for socioeconomically disadvantaged, leaders in the care of homeless or indigents, visionaries in women’s health care and career development, developing big data or medical technology. You name it, a PLME is doing it.
Over the years, I do feel like the rest of medicine has kind of come around to embrace the social sciences and humanities. Pre-meds now are also not bound to be science concentrators. The PLME provides individualized advising, competency-based preparation for The Warren Alpert Medical School, and many special programs to encourage our PLMEs to reach their full potential and follow their passions. For applicants through the standard route, our director of medical school admissions, Joanne McEvoy, talks all the time about a holistic review of applicants, so my gut says, yes, people are really embracing the more humanistic approach to medicine.
Medicine swings back and forth. We were responding, in part, to needing physician-scientists during my era, as it was during the Cold War. It was about getting doctors who are scientists. Now things are swinging the other way with needing primary care and more humanistic physicians to really connect with people. I think it’ll keep doing that. The PLME and Brown provide the basis for our graduates to do what they feel their patients and the health care system need. A broad-based education allows for each of them to make that choice.
Brown has always, always emphasized the importance of diversity in the PLME classes. I was and am a member of that diverse group. I embrace that Brown wants physicians to go not necessarily back to their community, but for all of us to understand the communities they grew up in so that we can better care for them. That doesn’t mean we cut off all the legacy and majority race people, because we need them too, but we need the breadth. This year’s incoming freshman class was 40 percent first-generation or from backgrounds underrepresented in medicine. The diversity allows us to learn from each other and be culturally competent, truly empathetic, compassionate physicians. If we understand each other’s values, beliefs, and cultures, we can provide the best care based on what the individual patient wants.
When I transitioned to working more time at Brown, I was given responsibility for the international medical programs. At the time, we had two German programs, several in Japan, one in Stockholm, and maybe a few more, but they had evolved into one-way streets. We had international medical students coming to Brown, but there was no exchange—no Brown medical students or PLMEs going to medical exchange programs—so it was my job to make the programs into an exchange or we were not going to have them. It has been such a fun experience for me. The places I went and people I have met; I truly believe that they are friends more than just colleagues. The international cultural differences in approaching medicine and education have been eye opening and have allowed me, as well as the student participants, to bring ideas back to the US to improve health care, particularly access. We have expanded research collaborations and have not only student but also faculty and educational exchanges.
I don’t know yet what I’m going to do in retirement. I love dogs and I have a new dog. I thought for a long time about doing therapy with dogs, so that might be something to try. Collaborating with a dog may be easier than advising students (just kidding). I would love to be able to go into hospice or health care facilities. You see people just perk up when they are able to pet a dog or spend time with an animal. I know I will miss the people at Brown, particularly the students, tremendously. They have been inspirational and so much a part of my life. I am a “Mom on Campus” because I get to see these intelligent, altruistic, dedicated superstars grow even more over eight years into the physicians of the future. They are simply the best of the best.
When I think about what I want my legacy at Brown to be, I hope that Brown continues to be supportive of students. It’s about the long range, not just about wanting to graduate a class with X number of AOA students or whatever metrics. We have to remember what makes the PLME different and what makes Brown different.
People that keep in touch with me say that they’re grateful for the opportunities that Brown and the PLME in particular afforded them … to concentrate in something different or to delve deeply into academic pursuits; non-academic passions such as art, writing, sports, or community service; or research that they might not have had they been a traditional student. You can go out on a limb and be the leader for the Community Health Advocacy Program or get into art in a meaningful way. And when you are a physician, you can meld that into your practice as a physician or as a person.
As a person, I think they burn out less. They’re more willing to be flexible and creative about how they approach patient care and their practices. They had that opportunity as an undergrad, that they could craft this experience, and they learned how to do that, they come out, and they’re really happy. Content human beings practice in a humanistic way because they’re happy.
I thank my lucky stars to have had the opportunity to work with such incredible people. The one thing that I love about Brown is the collaboration. The collegiality in this university and certainly among other medical schools, it’s unparalleled. It is truly something that I cannot emphasize enough. For me to spend my career here, it’s been an honor. Education and family are my core values. … Brown, with its incredible faculty, staff, and students, has truly been my extended family. What a great journey.
