UMB Staff
As a 16-year-old from Guam, Austin Kim watched his grandmother fight for her life in an intensive care unit after she suffered a severe heart attack and found his family caught in a devastating reality of island health care.
Doctors presented an impossible choice: keep her on Guam with limited care options or risk transferring her to the Philippines for surgery she might not survive the journey to receive.
“I realized there were probably many people on Guam facing similar situations,” Kim says. “It’s unfortunate that people have to make life-or-death decisions based solely on where they live.”
Ultimately, Kim’s grandmother remained on Guam and recovered. Now a third-year medical student at the University of Maryland School of Medicine (UMSOM), Kim, 25, carries that moment with him as he pursues a path that will eventually lead him back to his island home.
Kim has become involved with Chålan (CHUH-lan) Åmte (UHM-ti), an organization whose name translates to “road to healing” in Chamorro, the language of the Indigenous people of Guam. The group comprises about 50 members, mostly medical students from the U.S. territory who understand the island’s health care struggles.
“Our main focus is improving the health care workforce and advocating for patients on Guam and throughout the Pacific Islands,” he says.
With just two civilian hospitals plus Naval Hospital Guam for military personnel, Guam’s health care infrastructure struggles to meet the needs of its 170,000 residents. The island has slightly over 1 physician per 1,000 people, well below the U.S. average of 3, leaving specialists particularly scarce. For many islanders like Kim’s grandmother, this shortage presents difficult choices between limited local care or risky medical evacuation to the Philippines or Hawaii.
“Austin represents a big part of our health care solution — islanders who understand our unique challenges, gain specialized training at the best medical schools, and return home with those skills,” says Vincent T. Akimoto, MD, Chålan Åmte advisor and family medical physician on Guam.
Kim helped develop Chålan Åmte’s website and high school initiative to inspire young people to pursue health care careers. The group also partners with the Area Health Education Center (AHEC), a U.S. program to improve the quality of health care in underserved areas, to facilitate clinical rotations on Guam for medical students and serves as interim pre-med advisors for University of Guam students.
“Without a dedicated pre-med advisor on island, students struggle with knowing which classes to take, how to prepare for the MCAT, or navigate the application process,” Kim says. “We’re able to provide guidance since many of us went through the process recently.”
Interest in Clinical Care
Kim’s connection to Guam began with his grandparents, Korean refugees who arrived on the West Pacific island after working as ancillary staff for the United States during the Vietnam War. Born and raised on Guam, Kim graduated from high school in 2018 before heading to Pacific Union College in California’s Napa Valley.
During a gap year before medical school, Kim worked as a telemedicine technician at Guam Memorial Hospital, serving as the crucial link between off-island specialists and local health care providers. This experience, combined with the inspiration he drew from pulmonologist Joleen Aguon, MD, during his grandmother’s ICU stay, cemented his interest in critical care. Critical care physicians treat the most severely ill patients, often managing multiple failing organ systems and life-threatening conditions.
“Guam has only a few critical care doctors,” Kim says. “While telemedicine helps, it has limitations — especially during typhoons when internet connectivity becomes unreliable.”
This led him to apply to UMSOM, home to the renowned R Adams Cowley Shock Trauma Center. “Shock Trauma is like a tower full of ICUs, which is crazy to me,” he says. “I thought it would be fascinating to see all the complex cases come in.”
At UMSOM, Kim has completed rotations in emergency medicine, family medicine, psychiatry, and neurology. He’s been struck by the similarities between patient populations in Baltimore and on Guam.
“I’ve seen very similar comorbidities — diabetes, high blood pressure, chronic kidney disease. I didn’t expect the two patient populations to be so similar,” he says.
Kim values the supportive environment at UMSOM. “Everyone from attendings to junior residents has been kind and willing to teach,” he says. “My psychiatry attending told me, ‘Don’t be afraid to be stupid,’ which really resonated with me. They want to see that you try.”
Optimistic About the Future
Looking ahead, Kim plans to specialize in critical care through the internal medicine and pulmonology route. In 10 years, he sees himself on Guam.
“I’ll be an attending by then, and hopefully someone on Guam will give me a job in the ICU,” he says. Despite funding and resource challenges facing the island’s health care system, he remains optimistic about making a difference.
“I’m very hopeful for the next 10 years,” Kim says. “We’ll have a new set of doctors coming back to bolster the health care workforce. That’s what keeps me going.”
