Karen E Kim, M.D., M.S., Dean-Designate of Penn State College of Medicine

You are globally renowned for your accomplishments as a physician and a respected member of the medical community. What initially sparked your interest in pursuing a career as a physician, and how did you decide to specialize in your particular field of Gastroenterology?

Since the age of four, I decided that I wanted to be a doctor. I don’t come from a family of physicians and it was a particularly hard decision because I didn’t necessarily have a natural inclination towards being gifted in science. I was influenced by watching Marcus Welby, M.D. which aired in the 1970's and decided that I had to be a doctor with the mindset of saving the world.

It was an uphill battle to make it to where I am now but like I always tell young people, if you have a passion for it, go for it. Initially, there were people that questioned my decision but I knew in my heart that I could do it and I was going to believe in myself. If you think that you have a path for it, you have to believe in yourself and follow it.

Despite all my early challenges with my GPA and science curriculum, I found medical school to be extremely easy. I just took off from there and I graduated top of my class. I had so much fun with the people focused environment which was the main reason why I wanted to go into medical school, having the ability to connect with all different kinds of people in a diverse population.

Medical school is when I decided to become a surgeon but at that time, there were a lot of inequities in how men and women were treated in medicine. It was difficult for me to think about being both a surgeon and having a family, both of which are very important to me. Gastroenterology seemed like the right fit for me because the GI system stood out to me. I liked being in the abdomen and operating there. I enjoyed studying and doing luminal procedures, doing things with my hands, and just being able to solve a problem right then and there, so Gastroenterology became a natural pathway for me.

Even before going to medical school, I spent a lot of time doing basic science, bench research. During my residency, I never expected that I would work with patients.When I became a GI fellow, I was studying to become a gastroenterologist, doing epithelial transport, and understanding the pathogenesis of diarrhea in the GI system.

My mother was diagnosed with Hepatitis B related liver cancer and subsequently passed away from it. It was very shocking to me that I went through medical school, residency, and GI fellowship which treats Hep B and I was never told that 1 out of 10 people that have Hep B are Asian Americans, 50% Hep B burden in the U.S. are Asian Americans. I thought to myself, if I don't do something to help these communities while being Asian myself, who will do it?

From here, I did a 180 degree pivot and focused on Asian health even though I knew nothing about it. Growing up in a African-American neighborhood, I always thought about myself as a south side Chicago person. Having gone through their public schools and surrounded by African-American friends which I considered family, I never gave much thought about myself as an Asian person. So, my decision to focus on Asian health was a big rude awakening and I was angry.

What role do you see technology and innovation playing in the future of patient care in Gastroenterology?

I think there's a lot of exciting technology and innovations that will have a big impact in Gastrology.

One area is how we can better visualize because treating the GI system is a very visual process having to identify abnormalities in the lining of the mucosa. Current technologies are pretty good at this but there is still a 10-20% miss rate. Self-propelled endoscopies is an exciting new technology in which the device can navigate and steer itself within the body.

Another area is the utilization of AI and different types of magnification processes to determine what the problem is, what needs to come out, what is missing, how are we getting a 360 degree visualization, and how we could improve the accuracy of the procedure itself. Generative AI is taking off in so many areas and we have also to be a part of it in healthcare. We need to ask ourselves, can we do better in AI generative algorithms and predictive models to determine who is at risk and who is not at risk?

I think that's what we’re all grappling with now. How do we do the work that we do now, and can we do it in a more efficient way that will not only deliver a higher quality and timeliness of care, but also make it more cost effective.

Do you specifically see Asian Americans benefiting from the utilization of AI?

When I think about the application of AI, it is colorblind and algorithm based. They are only as good as the diversity in which these algorithms are created so we need to think about “fair” AI.

Asians are an extremely understudied population so most of these algorithms are created for the majority population and we can’t use data from Asia because we know that social determinants of health and local environment may play a role in how you express your genes.

So I think that use of technology for special populations should include racial ethnic minority populations and other underserved populations. We have to do better in making sure we create an inclusive framework so that these algorithms can actually generate data that are specific to populations that are often left out.

Here is an example: the American Diabetes Association a few years ago just determined that the BMI, body mass index, for Asians at risk for diabetes is significantly less than those of other Americans, almost to the tune of 15 pounds. We are called the “skinny fat” population because of all the skinny Asians with diabetes. You would never think that such a thin person would need testing for diabetes. There's something about fat metabolism in Asian Americans that makes us predetermined to have diabetes at a much lower BMI. A lot of central obesity is from the fat that collects around the abdomen which is the kind of fat that puts one at the highest risk of insulin resistance. Even though we knew this data 30 years ago, it was only several years ago that the American Diabetes Association announced they would begin screening Asians at a lower BMI threshold than other populations. These are the kinds of studies that need to be inputted into the AI algorithms so that we can benefit from the use of these new technologies.

You have long been interested in health equity and founded the Center for Asian Health Equity at the University of Chicago. Are there any particular healthcare disparities or challenges that you are particularly eager to address?

There's not a large Asian American population in Hershey, Pennsylvania, where I am going to work from this September, but I’m still very convinced that I can do this work on a regional and national platform.

One is inclusive research, how do we make sure that Asian Americans are disaggregated, meaning that Koreans are different from Chinese, Indians, and so on. Their ethnic populations have different health diseases and risks so how do we make sure that we promote a disaggregated approach for research data collection for Asian Americans. It's very important to me that we can create an inclusive recruitment and enrollment process for large clinical trials.

For instance, we have an All of Us Research Program. An amazing collective of a million people, an epidemiological cohort with greater than 50% of underrepresented populations in research which include Asian Americans. My team, through the Center for Asian Health Equity and our partner Asian Health Coalition, which is our non-profit arm, leads the national strategy in recruitment and enrollment for Asian American Native Hawaiian Pacific Islanders. We lead this program from the small non-profit arm in Chicago and we run this national program across the 50 states with dozens of community partners, hospitals, health systems. So, it is very important to me to make sure that we are at the table.

Hep B, without a doubt has the biggest health disparity compared to any other racial ethnic population. It's endemic in some parts of Asia and extremely common here in the United States. In a room full of 12 Asians in the United States, 1 will have Hep B without any knowledge of it, and a fourth of them will die from cancer.

Mental Health in Asian American is also very prevalent with highest suicides rates for those between ages 18-24 and 65-80. One of the problems is that there are very few bilingual, bicultural providers who can understand the cultural nuances of Asian Americans, which is crucial for effectively treating their mental health, a huge stigma problem.

Another thing that other people probably don't think about but I am very passionate about, is cancer. Asians are the only population to die of cancer as the number 1 cause of death. This has been the case since 1980 which most people don’t know about. I believe at this point, it should be more of a common knowledge and I keep thinking to myself, how many more Asian Americans have to die of preventable cancers before we realize that these populations need special studies and special outreach to make sure that they benefit from what should be normal healthcare.

These are some of the challenges that I wish to address and now there are increasing amounts of studies looking at how we can think about social determinants of health, dietary habits of these populations to decrease risks.

You have been appointed as the next dean of Penn State College of Medicine, effective September 2023. Could you share your thoughts and feelings about this new role and what it means to you?

It is unbelievably exciting and as you know, I do a lot of work on disparities. For me, I feel very proud to wear this position and I want to use this interview as an opportunity to promote Asians in Leadership.

One really glaring area of disparity that I would like to point out in the US, is that 1 out of 5 graduates of medical school are Asian Americans, about 20% of the physician workforce are Asian Americans, about 10% of our Chair of Medicine Roles are Asian Americans. Yet, if you look at how many deans there are out of the +150 medical schools, there’s less than a handful of Asian American Deans and I am the only East Asian Dean in the US. I hope I will not fall flat and will try my best to make sure that other Asians are pulled up into these leadership positions because we deserve it and we are capable of being really outstanding leaders.

Mainly, I would like to see greater impacts and be able to lead in terms of students, staff, faculty. I want to make sure that the work that we do will maximize our ability to deliver better patient care, build research in a significant way, make sure that the education we are providing for the next generation is top notch, and impart in these students a sense of social justice and health disparity.

As the new incoming dean, what are your goals for advancing medical education, research, and patient care within Penn State? Could you discuss any innovative research areas or programs that you would like to develop or expand upon?

I try to think about what makes Penn State unique and there's so many. We are a state school and one of the only academic medical school centers that is located within a rural area. We fit within a sort of T shaped rural area of PA and it’s a really underserved area.

I did a lot of research in Chicago, Illinois around colon cancer prevention and I ran our state run programs there. IL is 65% rural while PA is 75% rural, I did a lot of rural health work in IL, so bringing in that framework, it really seems to me an area of tremendous opportunity for Penn State College of Medicine to bring the rural pipeline — both in trainees who stay in PA to serve these underserved populations and in research on how we can better improve rural health.

How do we leverage the strength of the community health centers, federal qualified health centers, public health system, other commonwealth Penn State campuses, and nurses to deliver interdisciplinary health and improve the health of rural Pennsylvanians? That for me, is an area that I'm challenged by and feel excited about addressing.

The areas that are really strong in Penn State for college medicine is certainly pediatric oncology. We have a very big foot print in this area and an incredible philanthropic arm called Four Diamonds. It’s one of the largest student run philanthropic organizations that funds pediatric cancer, a huge opportunity in clinical research and education. Last year, one of their biggest events, an annual fundraiser, raised over 16 million dollars in less than 2 days. All of that goes into funding pediatric research, pediatric patients, clinical care, and out of pocket costs for anyone who needs it.

I also think we have a tremendous department in our basic science research as well, particularly how this basic science research interfaces with translational research. How do we take our bench research, to bedside, to innovation, then back to the bench and be able to leverage the patient population to better inform the science that is happening around our campus. In particular with the patient populations that we serve, I think we make a big mark on what that rural health will look like going forward.

In terms of students, my goal would be to continue to train the next generation of students that are interested in serving the area around Penn State, particular in the Hershey area. That's sort of my goal there, how can we approach our interdisciplinary health services and health science curriculum in this area, which we are really well known for.

As the founder and Board President of Asian Health Coalition, what are your primary responsibilities and duties? Could you provide an overview of AHC and its impact on the Asian community?

I am the Founder and Board President of AHC, Asian Health Coalition, which is a non profit organization that we founded in 1996. This was around the time my mother passed away from Hep B related liver cancer and I decided I had to do something. I knew nothing about being Asian and Asian health disparities so we formed this organization in order for us to become a passive building organization that works with direct serving Asian communities. We brought in millions of dollars in grants to be able to fund these organizations to do their work. It was a great model because these organizations are very ethnic specific and have community health workers so they can be on the ground. It is a sort of a public health model.

In 2014, it was clear that AHC was doing really well but in some ways we were competing against the organizations that we were trying to fund because we were applying for the same grants. So, we ended up affiliating with Chicago University to create the Center for Asian Health Equity, which is AHC + Chicago University. Here, we were really able to focus on research and training the next generation, do a lot of policy advocacy, and still provide funding for our organizations but more from federal grants.

We have been making huge impacts and started working with Blue Cross and Blue Shield. We created a disaggregated Asian Cohort, understanding the health needs of Asian populations. We give back to the community based organizations and we were able to raise a lot of funds to support these specific health needs.

Most recently, we received a large grant from NIH, National Institutes of Health. After aggregating with them for about 3 years, they will start the first epidemiologic Asian cohort which is launching now across the country. We are one of the original grants out of the many grantees.

In your opinion, what are the most significant health challenges faced by the Asian community in the U.S., and how does the Asian Health Coalition address these challenges?

I think being invisible is the biggest problem as well as an absence of knowledge in health problems. We need to get seated at the table and make sure we are included in important studies.

We’ve done that really well in AHC and we run the national strategy with a tremendous amount of funding for disaggregated data. We have a very diverse portfolio of funding and we share it with our community. Every time we receive money, we add more branches and grow into a bigger tree with a very robust network, and we will continue to do so even after I go to Penn State.

Is there any additional information, vision, or message you would like to share with our readers in your roles as a dean, physician, and healthcare leader?

My parting message is to follow your passion and your dreams. Find those people who keep the doors open for you. As the only Korean American Dean and East Asian Dean, I hope people will knock on my door because I’m going to reach out and pull people up. I hope to use this position not only to promote the health and wellness of PA but also to engage the broader Asian community in leadership and education training in a way that's very meaningful and impactful.

August 7, 2023

Karen E Kim, M.D., M.S.

• Dean-Designate of Penn State College of Medicine

• Vice Provost for Research at the University of Chicago

Dr. Karen Kim is a prominent figure in medicine and cancer research, serving as Professor

of Medicine and Dean for Faculty Affairs at the Division of Biological Sciences. As

Associate Director of the University of Chicago Comprehensive Cancer Center and Director

of the University of Chicago Medicine Comprehensive Cancer Center Office of Community

Engagement and Cancer Disparities, Dr. Kim’s dedication to addressing health disparities

is evident. She established and leads the University of Chicago Center for Asian Health

Equity, focusing on health disparities in Midwest Asian communities through community engaged health and policy strategies. Her research spanning 15 years aims to reduce

cancer health disparities among racial and ethnic minorities, particularly Asian American

communities, advancing health equity nationally.