Fighting the Good Fight

Dr. Thomas Samuel “Sam” Shomaker is proof that not all heroes wear capes. Sometimes they show up in a sterile white coat. And other times, they don a white gi with not one black belt, but three.

“I am into a number of different martial arts. I still train several times a week,” says Shomaker, who sports black belts in Brazilian jiu-jitsu, judo and karate.

The dean of University of Hawaiʻi’s John A. Burns School of Medicine is primarily focusing on Brazilian ji- jitsu as of late. He says that while it helps clear the mind, it is also a challenge as it’s one of the hardest black belts to attain.

“The human body can move in many different ways and you’re allowed to do almost any technique in Brazilian jiu-jitsu, unlike judo, which is much more limited,” says Shomaker, noting that it took him a decade to achieve his black belt.

A clear mind and persistence are crucial for Shomaker as the dean of one of the most culturally and ethnically diverse medical universities in the nation. In charge of serving a vibrant population with ever-changing health needs, the JABSOM dean needs to be grounded yet flexible, ready for whatever life throws at him.

“Every day is a new adventure,” Shomaker laughs. “You have to adapt to whatever situations you’re called upon to deal with.”

The school celebrates its 60th anniversary with the annual gala on Oct. 11 at The Royal Hawaiian, a Luxury Collection Resort, Waikīkī. JABSOM graduates, including Shomaker (1986), will gather to celebrate with its inaugural alumni award ceremony.

This year also marks the need for a new five-year strategic plan. Although it’s still early in these conversations, Shomaker deeply prioritizes beefing up physician support on the neighbor islands.

Statewide, there is a shortage of nearly 800 full-time health care positions, according to a 2024 JABSOM study. The heaviest burden of this deficit falls on the neighbor islands. Having practiced medicine on the Big Island himself, Shomaker is personally acquainted with this sobering reality and its consequences.

In Shomaker’s mind, it’s the early 1990s again. He is working as the only anesthetist for the entire Kona area.

“I was on call 24 hours a day, seven days a week,” he recalls.

Treating patients day in and day out was Shomaker’s norm. Tourists and locals alike relied on his expertise.

It was a routine day for Shomaker when he got an urgent call. A tourist on the moped had fallen and hit his head on the pavement. The tourist’s brain had started to swell rapidly. Shomaker was tasked with inserting a breathing tube down into the man’s lungs. Struggling with the man’s erratic breathing and racing against the clock, Shomaker was successful as the breathing tube reached its destination. Tragically, it was not enough. The man later succumbed to his injuries.

“His injuries were just so massive, (it) was impossible to save him,” remembers Shomaker, his voice somber as he speaks. “Those kinds of situations happen on the neighbor islands, because there’s just not that much support available to the physicians that are practicing in those communities.”

Calling the encounter an “indelible memory,” Shomaker hasn’t forgotten the tourist — even though it’s more than 30 years later. Despite the immense skill and dedication of the state’s health care workers, these harrowing incidents are daily occurances. Shomaker saw firsthand how greater support is desperately needed, and that fuels his drive to bolster medical programs.

Excluding Niʻihau and Kahoʻolawe, JABSOM students are practicing medicine on all Hawaiian Islands. Kauaʻi, in particular, is home to a powerhouse medical training track funded by the Chan Zuckerberg Initiative. The Kauaʻi Medical Training Track hosts six students per year with their tuition fully paid for. In return, participants make a commitment to serve up to 15 months of their training on Kauaʻi and then at least four years post-training.

“That program is now in its fifth year, so the first cohort of students who started in the program is going to be graduating in May,” Shomaker says.

Other programs in the works include a family medicine program on Kauaʻi and the north side of Big Island. On Maui, a four-bedroom house was blessed earlier this year, allowing students without family there to practice on an island that had previously been inaccessible to them. As JABSOM director of communications Matthew Campbell puts it, “Now, anyone who wants to get a taste of Maui, we have the house (for them).”

The newly created Mohala Liko Lehua Program is another step forward for island mental health care. Launched in September in collaboration with nonprofit Hawai‘i Land Trust, the fellowship program will host post-Doctor of Psychology and post-Master of Social Work fellows to deliver culturally informed behavioral health services to O‘ahu, Maui, Kaua‘i and Hawai‘i island. The program is slated to reach at least 3,500 youth statewide per year.

While programming on the neighbor islands is increasing, Shomaker says ensuring there are enough training resources (location, funding, etc.) is a limiting factor.

“The other thing that is of critical importance is having an adequate number of trained faculty physicians that are available to supervise the trainees, because we want to put the students into excellent learning environments. It takes some time to get physicians trained to become effective faculty members,” he says.

While simultaneously building support on the neighbor islands, Shomaker is also focusing on well-established strongholds, namely the school’s problem-based learning and community-based curriculum. 

Employing problem-based learning is a point of pride for the school since it was one of the first to incorporate the curriculum in 1989. Twice a week, students divide up into groups of six, meet with a faculty facilitator and discuss a clinical case. If the students solve the case, they continue to the next one. If they’re stumped, the case becomes their research topic to investigate. They then present their findings to their classmates.

“It’s very clinically oriented,” Shomaker says. “The students love it, and they’re really into it.”

JABSOM is also uniquely a community-based medical school. Students go outside four-walled rooms and use the local community as their classroom. Whereas in traditional medical school settings, students sometimes wait until their third year to work in the  community, JABSOM students jump right in as early as their first day.

Programs like the Houseless Outreach and Medical Education Project allow students to offer medical treatment, such as wound care, checkups, connections to social support and psychiatry, in a dynamic setting to hundreds of people yearly. Deploying a fleet of mobile clinics and a brick-and-mortar clinic in Iwilei, the work students do through the H.O.M.E. project effectively decreases the amount of emergency department visits and emergency calls in the local area.   

A triple threat in martial arts, Shomaker also wields three degrees: a law degree from Georgetown University School of Law, a master’s degree in management from Stanford University Graduate School of Business and a medical degree from JABSOM. As a 1986 graduate of the school, Shomaker is the first-ever alumnus dean in the school’s history.

“It’s a great honor for me to have been selected for this position, especially as the first alumnus to serve as the dean,” Shomaker says. “I have a great team of people to work with, and we’re going to try to push the envelope and get the medical school to that next level of accomplishment.”

Although he officially started his position last July, Shomaker is no newcomer. He previously served as vice dean from 2000 to 2005 under the late Edwin Cadman and then interim dean from 2005 to 2006.

When Jerris Hedges was chosen to be the next official dean, Shomaker spent some time away from Hawai‘i. He became dean of the University of Texas Medical Branch in Austin, and dean and vice president of Texas A&M Health Science Center.

“I always wanted to come back,” he says. “When the dean position became available, I decided to throw my hat in the ring.”

Shomaker isn’t alone in wanting to serve in Hawaiʻi. The Association of American Medical Colleges ranks JABSOM No. 1 nationally in retention of combined doctor of medicine and resident alumni practicing in-state.

Despite the rich diversity of JABSOM students, there lies a common denominator among them: a love for and dedication to Hawaiʻi and the communities here. About half of all practicing physicians in Hawaiʻi are graduates of the JABSOM MD program, with nearly 90% being kamaʻāina born in Hawaiʻi.

“It’s a good return on the state’s investment,” Shomaker quips.

With 60 years of solid work laid out, Shomaker and the rest of the JABSOM faculty forge forward as there’s still much to be done. To be part of the next 60 years, the public is invited to donate at give.uhfoundation.org/campaigns/67662/donations.

Notwithstanding the uncertainty the future evidently brings, Shomaker isn’t too worried about the odds.

“Our school has stood the test of time; we’re 60 years strong,” he concludes. “Really, I’d put our students up against any students at any other medical school in the world.”