When Katerina Roma, DO, who recently completed her internal medicine residency through the Kirk Kerkorian School of Medicine at UNLV, says it is not the cards we are dealt that control our lives, but how we choose to play them, she is living proof that the metaphor holds as we work to move forward – what you do with the cards, how you react to negative life events, makes all the difference in the world.

“I entered foster care at the age of 12 and found myself crying in despair at the state of my life,” she says. “I realized I needed to take control. I was not blessed with a supportive background, but I was blessed with an unrelenting spirit, and ever since that day, I have worked tirelessly to achieve my goals.”

During this Women In Medicine Month – each September the American Medical Association’s celebratory creation rolls around to recognize the growing number of female physicians – how Dr. Roma rose from abject poverty and foster care to enter one of the world’s most noble professions is both instructive and inspirational.

Now a MountainView Hospital chief resident who is pursuing a gastroenterology fellowship, Roma was born in Seoul, South Korea, living with her parents and younger sister in the basement of an apartment complex for low-income families. An outhouse served as the bathroom. Although her father worked as a barber, dumpster diving was still necessary by his oldest daughter to feed the family. Roma says her mother, a homemaker who grew up homeless after the Korean War, often spoke about stealing rice from street vendors to survive.

Even though Roma’s family was able to immigrate to the U.S. when she was seven – an aunt who had married an American helped bring the family to the states – life did not become appreciably better. “We continued to live in poverty,” Roma says. “My parents cannot speak English and still cannot, making it difficult for them to find a job that pays living wages. We went dumpster diving for food and furniture and used food stamps to make ends meet.”

Her family’s chaotic life drew the attention of teachers and subsequently children’s protective services in Oregon. In 2001, the 12-year-old girl who would become a physician found herself in a foster care girls’ home. “It is in the best interest and for the welfare of the child that the child be removed from the home,” a circuit court judge ruled.

Foster care – Roma’s 7-year-old sister also became a ward of the state – wasn’t easy.

“We were living in a group home with five other girls. They were troubled, and I was beaten up and bullied often … I was being bullied in my foster home as a weird Korean girl with an accent … I remember sitting on the floor of my bedroom crying after being beaten … I was crying, feeling alone and hopeless. I didn’t know who I was going to be since I had no role models. I had no one who looked after me. And I realized a few things: If I am at rock bottom, it could not get any worse … I was around so much hate, pain, and sadness, I wanted the opposite for me and my sister. I wanted to make a positive difference in the world … I wanted to be a good role model for my sister, and I believe I have been. She is now completing a residency in radiology at Stanford.”

Roma became an honor student in high school, gravitating toward math and science. She took up dance and won hip-hop competitions. Her paintings, an emotional outlet, became so accomplished that after she was accepted at the University of Oregon for undergraduate studies, her work was featured in local art galleries.

To help pay her way through college, where she majored in physics and math – scholarships didn’t cover food and rent – she worked full-time in adult foster homes, helping cook, bathe, and take care of adults who could not take care of themselves. “I remember one man who I cared for … He was autistic and blind. When I tried to bathe him, he was scared to take off his clothes. I then realized that there must have been prior abuse. This interaction moved me so much that I wanted to care for others and help them when they are most vulnerable.”

While Roma went on to earn bachelor's degrees in both physics and math – she initially planned to become a physicist like her husband – her experience in adult foster homes served as a catalyst for her interest in a medical career. She earned a master’s degree in medical sciences from Heritage University in Washington state to prepare for medical school. And then she was accepted at Pacific Northwest University of Health Sciences College of Osteopathic Medicine in Yakima, Washington. Financing school with loans, she graduated in the upper third of her medical school class, which helped her earn a residency spot at the Kirk Kerkorian School of Medicine.

Her desire to pursue a fellowship in gastroenterology was fueled, in part, by her father’s battle with stomach cancer, patients she worked with at University Medical Center, and her love for working with her hands.

“As a resident working mainly at University Medical Center, I found myself looking forward to both reading about gastroenterologic diseases we encountered on the wards and teaching this new information to the medical students in the morning … These patients were often of low socioeconomic status with many comorbidities, likely exacerbated by a lack of health care access and community resources. Their adversities resonated with me. These adults were struggling to meet basic medical needs, which I understood, having witnessed similar experiences in my own family … My residency training also helped me discover a love for procedures in gastroenterology … Growing up, I was accustomed to fixing up old furniture, bicycles or televisions found in dumpsters, as well as sewing old clothes to transform them into something new. I love working with my hands. Gastroenterology will not only allow me to do procedures, but will also challenge me with interesting pathology and cases.”

Her ever-growing interest in gastroenterology while a resident at the medical school spurred her to establish a gastroenterology research group for the residency program, creating an environment of comradery and a platform for residents, fellows, and attending physicians to come together. Not having done enough research, Roma says, played a role in her unsuccessful 2022 application for a fellowship in gastroenterology, according to some representatives of fellowship programs.

Kate Martin, MD, MPH, MBA, associate dean for graduate medical education at the Kirk Kerkorian School of Medicine, says it is not uncommon for strong applicants to fellowship programs to make subsequent applications. The competition for fellowship slots in gastroenterology is particularly keen, with only about 60 percent of applicants accepted into programs, despite the fact that analysts say that there will be a shortage nationwide of more than 1600 gastroenterologists by 2025. According to Dr. Martin, there is a critical need for more residency and fellowship slots nationwide if physician shortages are to be addressed.

No one can accuse Roma, who has also begun a gastroenterology research group at MountainView Hospital for residents, of not strengthening her research efforts this year. Her peer-reviewed publications alone have jumped from two to eight, with one of them being a book chapter. She has also completed three non peer-reviewed publications, four abstract publications plus four other abstracts that will be published in November-December. Her research poster presentations have increased 10 fold over last year.

“During my interviews with fellowship programs this year, interviewers have remarked that I certainly have been busy,” she says. “So I’m optimistic.”

Roma has no intention of ever giving up on a career in medicine.

“Life can be difficult. Sometimes it may even feel impossible. Throughout countless moments of despair, I knew I was not the only one. Growing up, I watched people around me suffer and become the product of their circumstances. This instilled in me a desire to become a positive influence in the world. Medicine has been my avenue to reach those in need and help change their lives for the better. I will continue to fight for equality in medicine while mentoring young women and advocating for underrepresented populations.”