For M4 Joy Justice, academics has always been a family affair. Raised in a tight-knit community in rural West Virginia, Justice’s support system has quite literally followed her every step of the way; from her grandparents moving to Charlottesville to support her while she pursued her undergraduate degree as a Jefferson Scholar at the University of Virginia, to Nashville, where they once again relocated to be part of her medical school experience. Those close family ties not only grounded her, but also helped shape her path toward medicine, as experiences within her own family sparked a deeper appreciation for patient care and the people who support it. That same network will soon make the move again as she begins a combined internal medicine-dermatology residency at the University of Pennsylvania, with her with her family by her side. Grounded in that unwavering support, Justice has charted a path that blends her passions for patient care, education, and complex disease and will guide her in the next chapter of her training.
Tell me a little bit about your background and where you’re from.
I’m from a pretty small town in West Virginia called Poca. It’s about 900 people, so very tiny compared to Nashville. My specific corner of the world was called Lee Acres, and back in the 70s, my great grandparents bought 50 acres of cornfield and built their house on it. My whole family followed suit; my grandparents built their house there, my mom, my cousins, my entire family all pretty much live in that one specific community.
I wasn’t home schooled, but I always tell people that if you saw my home, you wouldn’t have been able to tell the difference. My part of West Virginia had a teacher shortage when I was a kid, especially in math and science, so my mom and my grandparents would buy all the textbooks they could find to help me study and learn at home.
My mom taught me math and science and my grandma was a Spanish teacher, so she would cover languages and English. My granddad had also been a history teacher, so he would teach history. And then my great grandma would make me sit on the porch and read all of my books out loud so that I could learn how to put language together.
What inspired you to pursue medicine?
During my second year of college, on my 20th birthday, I found out that my mom had been diagnosed with stage four lymphoma, which has a pretty bad prognosis. If you can believe it, one week before that, I had signed up to volunteer to explore medicine at the University of Virginia Medical Center’s leukemia and lymphoma inpatient oncology ward. Over the next couple of months, my mom had a bone marrow biopsy and a tonsillectomy, and they were talking about chemotherapy. At the same time, I was in an inpatient oncology ward with some of the sickest cancer patients in Virginia. I was scared that that would turn me away from medicine, but if anything, I actually think that was what solidified medicine for me.
As a kid you see medicine as fixing people, but through that experience, I saw that you can’t necessarily fix everything. I couldn’t fix my mom, but I could help facilitate the journey of patients as they navigated the medical system and their diagnosis, even if I couldn’t cure them. So I think that it changed my perspective on medicine a lot. In the end, my mother ended up being correctly diagnosed with cutaneous lymphoma, which has a much better prognosis!
What made you decide to attend VUSM?
Geography and the flexibility of second through fourth years were really important to me. I knew I might be interested in dermatology and maybe internal medicine, but I also liked kids, and surgery seemed fun. I wanted to have that breadth and depth of exposure so that I could confidently enter my career, whatever that was going to be. Also, I like to tell people that if you can’t get somebody off the phone, it’s a green flag, and that’s what I felt like when I asked people about Vanderbilt.I’d call to talk for 10 minutes, and they’d be on the phone with me for an hour telling me how great the attendings were in the clinical environment. There’s really just such a strong emphasis on creating a positive educational environment; if you’re interested in something, somebody will make it happen for you.
What was it like transitioning to Vanderbilt?
The most difficult part of medical school was when I started. Orientation was so much fun, but we went on a hiking experience at the end of orientation and I broke both bones in my ankle. It was a really difficult transition on top of learning how to use the flash card platforms and how to study.
What made things easier was my grandparents. They would come over every Sunday and I would teach them what we learned. My granddad bought, like, an Osmosis subscription, which is one of the video platforms you can use to study as a first year med student. I would assign him topics and he would listen to them so by Sunday he’d be ready to go through them with me. I had whiteboards up all over my apartment, and I would draw out what we learned, whether it was the spine or the differential of diastolic heart failure. I’d get to, like, ask him what he thought the answer was, and then teach him about it; you don’t know if you’ve learned something until you can teach it.
What has been the most impactful part of your medical school experience?
My favorite part of medical school is probably being a part of Shade Tree Clinic. I always tell prospective students that Shade Tree is the biggest asset of Vanderbilt University School of Medicine. Students really get the chance to develop themselves as clinicians, but also as advocates for patients. During my third year, I directed the Dermatology Clinic, which was such a special experience. I think it’s where I solidified that dermatology was the path for me, and then also where I got a glimpse of what community health looks like in dermatology. It’s an amazing learning experience for somebody who’s about to enter residency and hopefully continue to advocate for patients who have barriers to accessing necessary medications.
What sparked your interest in dermatology and eventually med-derm?
My time in Shade Tree is what solidified that dermatology needed to be part of my life. To be able to look at somebody’s skin and know what’s happening inside their body is the magic of dermatology. You also get to help with visible impacts on somebody’s quality of life. Skin conditions can really dramatically change somebody’s day-to-day experience, and I think the free clinic lets me actually see that versus just hear it from people who have pursued derm.
I didn’t know that med-derm existed until my third year, when I met people who did combined residencies at the American Academy of Dermatology annual meeting. I immediately called Dean Fleming and said I really wanted to do my derm and medicine acting internship back-to-back to see if I could envision a life where I could train in both specialties. Within a couple of days, I had the medicine sub-internshipscheduled, and I went straight from inpatient derm to four weeks of inpatient medicine. At the end, I just felt really happy, fulfilled, and content. I could see how medicine helps you understand the skin better, and vice versa.
What’s it been like having such significant family support as you’ve navigated medical school?
I don’t think there’s anything like it. Having family support, especially with my family being so tied to the education system, is so important. They emphasized that if you have the opportunity to learn more than you thought you could, you need to take it. It’s inspiring to see such a large group of people believe in me. I picked a pretty unique path for residency, and when I told them I might be interested, they were like, “Go for it!” And it’s more than just the people that came to Nashville with me for match day. My other grandparents are still in Poca, and they send me a card every month. My aunt sends me motivational GIFs on my phone. I have a large community that started with my great grandma and expanded so much. I could have any dream of what I wanted to do, and I know that they would help me get there.
Have there been any mentors who have impacted your journey?
The [dermatology] department as a whole has supported me just spectacularly. Dr. John Zic is wonderful. He’s the director of the clinical dermatology rotation. He was the first person I asked to meet with when I thought about pursuing dermatology, and he’s been a great cheerleader for me. Dr. Dustin Taylor was one of my other main mentors. We talked through what life and my career could look like in dermatology. I called him during interview season when I was nervous, and he reminded me that I could do this.
On the medicine side, I worked with Dr. Rohini Chakravarthy and Dr. Babatunde Carew at Shade Tree, and they really helped me build a sense of autonomy. Sometimes in medicine, you feel nervous to make a plan or to do a procedure, and they are spectacular at helping students feel empowered to try.
How does it feel to be starting your next chapter and what do you hope the future looks like?
It feels crazy. If you’d asked my seventeen-year-old self what I’d be doing at this age, she would have no idea what opportunities existed. It’s a very surreal, out of body experience. Even watching videos of me talking on match day feels like I’m watching it happen to somebody else. It’s amazing seeing your life come together.
Thinking about my future in med-derm, I see myself staying in an academic setting. Icurrently see myself landing in autoimmune dermatology, working with patients who have lupus or sarcoidosis . That and infectious dermatology, treating patients with HIV or other immunocompromised populations. Having an internal medicine background may helpaddressing more challenging, full-system infections.
What advice would you give to incoming medical students?
Take every opportunity awarded to you. I think that when you’re a medical student trying to balance clinical work and research and studying, it can be hard, and you may find yourself having to change your priorities. But if you get a chance to learn a new procedure, to see a new patient, or to go to a cool conference, say yes because this is your only chance to do it. It’s your only chance to see every specialty of medicine before you have to pick what you’re going to do for the rest of your life.