Under the Microscope
Students and graduates prepare to address Valley health care needs
By Eddie Hughes | Photos by Cary Edmondson
The more we grow, the shorter we become.
This is not a riddle. It’s the very real challenge California’s Central Valley faces in regard to a continuously growing population and an increasing shortage in health care providers. When it comes to doctors, nurses and other health care professionals, the Central Valley comes up short. Shorter than anywhere else in California.
This problem has existed for decades throughout the state, but particularly in the Valley. And it’s a problem that has been catapulted to the forefront in recent months as the world’s attention has shifted to the coronavirus, COVID-19.
California must deal with a projected shortage of 4,100 primary care physicians in the next decade, according to a study by the California Future Health Workforce Commission. By 2030, the population age 65 and older in California is expected to double while more than one-third of doctors are age 55 and older and nearing retirement themselves, according to an editorial in The Sacramento Bee.
In the San Joaquin Valley, there are 39 primary care providers for every 100,000 residents, compared to 64 per 100,000 residents in the Bay Area.
While there isn’t a medical school at Fresno State, make no mistake the University is serving as the springboard for a number of future doctors and researchers who have gained an intimate understanding of the challenges unique to this Valley and its patient population.
Micah Olivas, Alyssa Rivera and Jennifer Phan are just three of the Fresno State students aiming to make a difference. Their research focuses on cancer, an unforgiving disease that continues to impact millions of lives amid an unrelated pandemic.
These are the types of standout students capable of doing the kind of work that has the potential to increase the value of all of our Fresno State degrees. They’ve won international recognition, been recruited by top-notch graduate programs and positioned themselves for three different careers related to health care, all with one thing in common — making a difference in the Valley, the state and beyond.
These are their stories.
THE EMERGENCY PROVIDER
Alyssa Rivera’s family moved to Ohio from the Philippines when she was 5 years old. For a while, her mother, Veronica, was the only one working. America needed nurses and her mother answered the call. But soon, she was forced to answer to something else —a leukemia diagnosis.
It was a challenging time for the Rivera family. A scary time for Alyssa Rivera.
“I spent a lot of my childhood in hospitals,” Rivera says. “I knew what diabetes was, what cancer was and the medicine my mom had to take before I could even do long division.”
Thankfully, Veronica got the care she needed, fought that blood cancer diagnosis and won. She’s been cancer-free for more than a decade and is now working as a registered nurse at Saint Agnes Medical Center in Fresno.
The Rivera family relocated to Fresno in 2008 when Alyssa Rivera was in fourth grade. But it wasn’t until her time at Clovis West High School that she began gravitating toward science. During her senior year, her AP biology teacher, Wayne Garabedian, recognized her passion and encouraged her to pursue it. “Medicine is your passion, you’ll be great at it,” she remembers him saying.
Rivera’s mother thought so, too, encouraging her daughter to follow in her footsteps and become a nurse. “Nursing gave her security in America as an immigrant,” Rivera says.
But that was around the time Rivera started to shape her own path and follow the inspiration within her.
Rivera met Dr. Qiao-Hong Chen, a Fresno State chemistry professor, as a curious high school student who wanted to learn something new. She started working in Chen’s lab and helped her investigate quercetin, a flavonoid found in vegetables and fruits, and its potential as a treatment for prostate cancer.
Living just a 10-minute car ride from the Fresno State campus during high school, Rivera always considered attending the University in her “backyard.” She remembers visiting for math competitions while at Clovis West.
She applied to the Smittcamp Family Honors College, a unique Fresno State program that attracts 50 of the highest performing high school students in California and beyond each year. “When I got accepted, it was obvious this was the best choice financially for where I should go,” Rivera says of the program that provides a full, four-year scholarship.
Once she arrived on campus full time, Rivera continued on a similar research project in Chen’s lab, studying how natural products can serve as potential anti-cancer treatments.
Her work helped her become one of 496 students nationwide to earn the 2019 Goldwater Scholarship for showing exceptional promise of becoming the next generation of natural sciences, mathematics and engineering research leaders. The award comes with up to $7,500 in additional scholarship support.
Rivera, a junior, now has a career path in mind. She wants to be a doctor, and is leaning toward emergency medicine.
“You don’t know what’s going to come in. Are we going to get chest pains today or something more serious like a trauma patient?” says Rivera, who currently works as a scribe at Community Regional Medical Center in downtown Fresno, the only Level 1 trauma center between Los Angeles and Sacramento. “You just don’t know, and I like that aspect of it. You get a little bit of everything from adult medicine to neuro to pediatrics.”
Feeling at Home
She won’t be the first in her family to go to medical school. Rivera’s brother, Lemuel, graduated from Fresno State and is now attending the University of California, San Francisco School of Medicine. He, too, was involved in undergraduate research and participated in the Health Careers Opportunity Program.
The program supports students who aspire to give back to their communities as doctors, dentists, pharmacists and other health care professionals. Rivera is also part of the Louis Stokes Alliance for Minority Participation (LSAMP) program to increase the quality and quantity of students completing science, technology, engineering and math (STEM) programs.
“It gave me a group of students that had similar backgrounds as I,” Rivera says. “Without that program, I would have had a different experience in college.”
Rivera is also involved in a mentorship project with UCSF Fresno to build health equities in impoverished communities. She hopes to return to UCSF Fresno for her medical residency to serve “where they started to cultivate my passion.”
The Central Valley has long been known to have an acute shortage of primary care and specialist physicians — a problem Rivera plans to personally address.
That passion, she realizes now, has been within her all the way back to her childhood days in Ohio when her mother was beating cancer. “Medicine found me before I found it,” Rivera says.
“Looking back, I realize my mom got the very best care she could have gotten at that time, and I know that’s not how it always is depending on socioeconomic status.”
A PASSION FOR PEDIATRICS
Jennifer Phan got accepted by every University of California campus she applied to about five years ago. She also got accepted to Fresno State. She says she had honestly never heard of Fresno at the time. So when it came time for her to decide on a college, she might have surprised a few people.
“I’m so happy, I’ve met so many great people,” Phan says. “It’s so easy to build a connection with professors here at Fresno State. It’s so hard to do elsewhere because of how big the classes are.”
Phan grew up on Edwards Air Force Base, about 22 miles northeast of Lancaster. Her parents had immigrated from Vietnam and her father had a civilian job on the base. When she was young, her family spoke mainly Vietnamese at home. Learning English as a second language, she sometimes didn’t fully understand what was being taught. But she was determined and loved learning.
One of her teachers at Desert Junior Senior High School, Debbie Lewis, saw something special in her and told her she should apply for the Smittcamp Family Honors College at Fresno State. “She knew about the hardships my family had with money,” Phan says.
Lewis also knew about the honors college. Her daughter, Lindsay Lewis, graduated from the program four years ago and was named a dean’s medalist. Turns out, Lewis has an eye for talent.
Paying it Forward
Phan, who graduated with a degree in biochemistry in May, was one of 23 students chosen by the California State University (one from each campus) to receive the 2019 CSU Trustees’ Award for Outstanding Achievement. The award provides donor-funded scholarships to students who demonstrate superior academic accomplishments, community service and financial need.
“I was very surprised, and I’m so grateful because now I don’t have to worry about the cost of applying for medical school and the travel expenses to get to interviews,” says Phan, who was a scholar in service through the Jan and Bud Richter Center for Community Engagement and Service-Learning. “I can focus on my education instead of the financial burden that comes with it.”
If it’s not clear yet, Phan plans to become a doctor — a pediatric oncologist. As an undergrad, she worked as a medical assistant at Cardiovascular Consultant Health Center, and she volunteered at Valley Children’s Healthcare and for the Tzu Chi Medical Foundation mobile clinic serving the Valley.
“I want to practice in underserved areas like the Central Valley,” Phan says. “There are a lot of people who don’t have access to health care or who can’t afford it, and I want to make it accessible for everyone.”
A Natural Curiosity
Even when she was little, Phan had questions about science. “Every time I was sick, my parents would tell me to take herbal remedies like ginseng,” she says. “I always wondered why that was the case and that’s why I majored in biochemistry. I wanted to understand prescriptions we were taking to make us feel better.”
She worked with Dr. Jason Bush, a Fresno State biology professor, to characterize a new class of modular immunotherapy for a type of breast cancer. She also received funding to conduct research on natural medicinal projects to fight cancer.
Five years ago, Phan didn’t know where Fresno was, let alone that it is the fifth-largest city in California with more than 530,000 people.
“There are a lot of people who come to college and don’t find their place. The Smittcamp Family Honors College helped me find my place from the first day, before I even started,” Phan says.
“I feel like the Central Valley, Fresno State and the Smittcamp Family Honors College have given me so much, and I just want to give back to the community.”
THE LIFELONG RESEARCHER
It was a rather routine day at Hanford High School for Micah Olivas. He attended classes all day before water polo practice in the afternoon. But on this particular day, when he jumped in the swimming pool, he glanced up and made a seemingly small observation that stuck with him for years.
Olivas looked up at the polluted sky on a particularly bad air day, and thought to himself, “How is this affecting my health? What is this doing to my lungs and cardiovascular system?”
It’s not a typical thing for a high school student to think or say — but Olivas is far from a typical student.
While that smog-filled air disrupted the clarity of the sky, it helped make his academic and career goals clearer than ever.
Just over four years after asking himself that question about the effects of the polluted air, Olivas graduated from Fresno State in May with a bachelor’s degree in biochemistry. He became one of the most accomplished students on the Fresno State campus, and, after being wooed by the who’s who of graduate schools, Olivas chose to attend Stanford University to pursue his Ph.D. in genetics with hopes of one day starting his own lab.
He is infatuated with studying cell biology and exploring how gene-editing technologies — he equates them to molecular scissors — can identify the genetic kinks that cause disease. “How can we create tools to observe this disease and see how it works?” Olivas says. “And through this, can we find drugs to combat cancers and other diseases more effectively?”
Choosing to be a ’Dog
Olivas’ familiarity with Fresno State from a young age solidified it as one of his top college choices. Growing up about 30 miles from campus, he says his first exposure to the University was through athletics. From the time Olivas was a child, his family drove to Fresno for Bulldogs football games on fall Saturdays.
His mother, Tonya Mendonca, was a record-breaking high jumper on the track and field team who earned an art degree in 1988. His father, John Olivas, earned a degree in agricultural sciences the same year.
“He got an ag scholarship, she got an athletic scholarship and I got a Smittcamp scholarship,” Micah Olivas says.
He’s referring to the Smittcamp Family Honors College, a competitive program that attracts 50 of the highest performing high school students in California and beyond each year and provides a four-year scholarship for those who maintain the high GPA requirements.
During his orientation for the honors program his senior year at Hanford High, Olivas was hooked on Fresno State once he was introduced to Dr. Laurent Dejean’s project on the biochemistry of air pollution. Dejean simulated a respiratory system in his lab and showed what happened when it was exposed to air pollutants.
A Love for Research
As a Fresno State student, Olivas worked with Dejean to research how small particulate matter in Valley air causes cell stress in the lungs. He was drawn to the research climate at Fresno State and the emphasis on addressing challenges unique to the community.
“We don’t have the biggest budget,” Olivas says, “but we have these convictions, and we are very aware of how this affects the Valley.”
Olivas took that experience into a summer fellowship at Duke University two years ago when he developed genetic editing tools for use in the study of cancer dormancy. He continued similar work as an Amgen Scholar at Stanford University this past summer and has worked remotely on the project since returning to Fresno State for his final semester as an undergrad.
He spent the fall 2019 semester studying stem cell biology and physical chemistry at the University of Oxford in England.
Olivas was also one of 496 students nationwide (from a pool of more than 5,000) awarded the 2019 Goldwater Scholarship for showing exceptional promise of becoming the next generation of natural sciences, mathematics and engineering research leaders.
He served as the only student volunteer on a South Fresno steering committee for Assembly Bill 617, to reduce exposure to air pollution and preserve public health. The committee worked with community members to develop a district-wide Community Emission Reduction Program and air pollution monitoring strategies.
“These are really local problems that nobody else is asking about,” Olivas says.
“It comes from having experienced some of these problems. A lot of the most prolific universities that research these problems don’t live in these conditions.”
— Eddie Hughes is senior editor for Fresno State Magazine.