David Quackenbush (Host): Thank you for joining the Golden Voices podcast, the podcast of Golden Valley Health Centers. I'm the host, David Quackenbush, president and CEO of Golden Valley, and joining me today is Dr. Eduardo Villa Ramma, who is the Chief Medical Officer of Golden Valley. Dr. Vmu welcome. Thank you for joining us today.

Eduardo Villarama, MD: Thank you David, and thank you for having me.

David Quackenbush (Host): So we've talked, several times about how we kind of both ended up where we're at. You have a pretty unique journey. This podcast, we really try to highlight people's journeys. I've always been fascinated by. People's journeys primarily my journey has been somewhat simple in the same area of California, never really having lived many other places, but folks like you, which Golden Valley has hundreds of staff with very robust backgrounds and exciting stories, and they've lived in countries and their career has taken 'em many, many places.

with you being the chief Medical Officer, now, that's kind of where you are now, but you've had a lot of stops on the way and you, are a inter international medical graduate from the Philippines. which isn't necessarily common. in California having a, medical doctor from the Philippines, Philippines is well-known for in importing nurses into the United States.

but not so much. With medical doctors and your story is a very unique one. So, I mean, I have your bio here, but would love for you to kind of talk about your journey. So why don't we just start with, and I know you've told this story hundreds of times, but I'm gonna ask you to tell it one more time.

I, 'cause it's very unique. can you tell us a little bit about your childhood. A little bit about how you decided, or it was somewhat decided for you to become a medical doctor and, how you ended up being a doctor in the Philippines, prior to your career in the us.

Eduardo Villarama, MD: Yes, actually, I think my profession and my journey had been decided, since my early childhood. unfortunately, I, had a life-changing event early in my childhood. I lost my mom at the age of 14. I'm able to comfortably talk about it now, but it wasn't like this before. Thinking about it.

And I'm the oldest of five siblings so early. I must be a role model. I must be responsible and care for my younger siblings and my family very early in life. My mother is, from a big family. She's a fifth child of 12 siblings. She has a very kind heart and a natural entrepreneur.

she only went to fifth grade, but she was very smart. So in our community, You know, she saw the potential given that it's in an agricultural environment, that, folks are not thriving well in terms of, opportunities, for employment and opportunities to make a living. So she started this vegetable plantation in our community where she grew all types of crops and vegetables And then, sold them to the city market, for about retail and wholesale, and gradually grew that business employing almost all of the people in our small town that kind of inspired other's, kind of with the same resources to step up.

And that led to our town growing into a thriving community. Selling root crops and vegetables. So, that kind of background really shaped the person And the professional that I am right now. I carry on with me, you know, her legacy of integrity And the passion for helping other's and making a difference in their lives, especially of the underprivileged population.

she exemplified this together with my, parents and grandparents To answer your, question that I have shared many times, back in my childhood is a very interesting one. 'cause my grandma is one of the traditional healers in our small town. 'cause we didn't have easy access to healthcare. she was the midwife And the go-to person.

When someone is. So she's one of those, women that uses oil, three barks extracts or, and any sort of things that she can, to provide relief and care for those sick and delivering babies is very interesting 'cause it's a remote town, so we don't have those fancy tools or gadgets or equipment.

So she took me under her wing as her sidekick delivering babies. So as you can imagine at the age of 10, it was a very interesting, and at the same time a bit of a traumatic experience for me, but that kind of triggered something in me and got my interest, in kind of helping people that are sick and if we cannot heal them, at least provide comfort and tend to their needs.

That's how it was.

David Quackenbush (Host): So let me ask real quick, 'cause I'm just thinking about a a 10-year-old helping to deliver babies. Do you remember what was going through your mind at the time, like when you were there with your grandmother? Helping to deliver babies. what were you, do you remember what was going through your mind?

Eduardo Villarama, MD: I actually, yes, unfortunately, very vividly. And then I can still hear her voice, right. Just 'cause I'm proud to say that we are. A very matriarchal family. She's like the head of the household. My grandma is the head of the household. Right. I can hear her voice. So anything that she asks you or she wants you to do, you need to get it done right?

no. And she's very good though, in terms of giving instructions to people around her. So that you will not, make a mistake or, inadvertently, become unhelpful in that chaotic environment when someone's delivering a baby. Everyone is shouting, right? But she has this calming voice and calming presence. Like, don't worry about it.

I'm here. I got it. I got my grandson who's gonna help us out. He's gonna be taking care of the boiling water or the cloth and things like that. You'll be fine. just listen to me and, we'll get you through it. Yeah, I can. remember all those, but the first one was the most difficult.

But after third, fourth, and fifth deliveries, I was like, you know what? I'm having such a great time with my grandma. This is good. This is cool. Back then.

David Quackenbush (Host): That's fascinating. I can only imagine. my children are. 10-year-old American children going with their grandparents to deliver babies. so obviously that had a very direct impact. And then I wanna go back to your comment about your mother's big hearts. That's kind of, you've obviously inherited that because that's what you are known for.

people who know you and people and your patient's know that you kind of lead with your heart. So that's always been very. That's a big piece of, you And what we see at Golden Valley. So how does, your mother's heart, your grandmother's, helping deliver, assist your mother, grandmother in deliveries?

how does that evolve into a career in medicine when first a career in medicine in the Philippines? And then how did you end up in the United States?

Eduardo Villarama, MD: So I think I can start with, where I grew up, right? So it's a very, very small and remote town in the Philippines, And that we did not have the taste or luxury of electricity until 1995. Yes, I can remember I was graduating in high school when suddenly we have electricity.

So, so we now have the ability to prepare for it.

David Quackenbush (Host): The year you graduated high school was the first year you had electricity.

Eduardo Villarama, MD: Yes. So yes, we depend on the natural life. When the sun comes up And the sun goes down, that's where a lot of activities are happening. Right. And at night, the saying you burn the midnight oil. I was literally using oil lamp to study and make sure that I do well, right?

So, town is really, small, underprivileged. So town is naturally poor. opportunities for employment are very limited. Literacy is very low as well. Agricultural people work in the fields. Education is not a priority. And I think my mom is a trailblazer. Like she's one of 12, none of her siblings, by the way.

Oh, well, not three. I wanted to correct that. Only two of her siblings of 12 went to school, and she's not one of them, but she probably had sent seven or eight of them to school. Because she was the one that, had kind of really worked. She was considered the rebel in the family because she did not wanna go to the field.

She wanted to study and wanted to do better. we do not have access to healthcare back home. the clinic that, we go to for vaccinations. but we do vaccinations. That's one good thing. The clinic that we go to for vaccination is about two hours away, And the hospital is even further.

And transportation is a big challenge. If you do not own a vehicle, chances are you're gonna travel by foot or by one of those animal drawn buggies or wagons. That's how we, go the city, right? And, my mom always, when she had me, 'cause I'm the first born, I'm the oldest of five.

She'll always, kind of brag about, my first born. It is a man, it is a son, right? he will be the first doctor in town, so I don't know. But for her, maintaining health, keeping health and having access to healthcare is a priority, next to education. So she always wanted someone in the community, to be first in terms of providing that healthcare access.

Yeah, 10 years old, 11 years old. I remember this. My mom will kind of tell all her friends. My son will be a doctor one day. He will be a doctor. So yeah, she started that idea.

David Quackenbush (Host): That's a lot of pressure. Did you feel the pressure? Did you feel that pressure?

Eduardo Villarama, MD: I did not know any better. I was 10 years old. It's like, I love my mom. It's like, yes, mom, I will be a doctor. And then that's when, I started with my grandma taking me to this birth and attending to sick. So yeah, it was a well coordinated plot to get me to med school.

and I have no complaints. can't complain.

David Quackenbush (Host): So tell us about med school.

Eduardo Villarama, MD: So, med school, it was one of the universities in the Philippines called Part Eastern University, so it's in Manila. I live in a very remote town, so I have to move to the city, the bigger city of Manila to go to school. interestingly, I did not find med school to be difficult.

Now I'm bragging a little bit, I guess because of that motivation and experience in life, because life was hard, where I grew up and, we were able to, do things, within our means and with our resources and kind of enjoy what we can enjoy At that time, we didn't have anything to compare things with.

So we didn't know of any beautiful, new, shiny things and, all of those. So we were very satisfied with what we have. And really focus is around family and faith and, tradition. because people are, probably even have less resources than us. we pride ourselves with being able to share the resources that we have, for those folks that are lacking them.

Yeah, but the school is in Manila, so went to school And then had my, postgraduate internship in one of the government hospitals. government hospitals are usually a great training ground because they're very, very busy And we are always short of healthcare providers. So in my, intern years, so This is one-year prior to graduating med school.

I had my OB rotation and general surgery rotation back to back, because I am this guy who's always volunteering to do things. 'cause, I am a bit, bold and a bit unafraid in learning and, putting myself in a situation where I can be challenged and helpful. At the same time, I was doing cesarean sections.

I was doing appendectomies and I was doing all kinds of procedures that usually only a full pledged physician can do or will be able to do. But I had the confidence of, all the, physicians around me, to help me because I'm motivated, I'm driven. And again, that time I already lost my mom and I told you that I can never break that promise.

I will be a physician. So that has always been my driving.

David Quackenbush (Host): So you were really motivated at that

Eduardo Villarama, MD: Yes, I am I'm always driven. Yeah.

David Quackenbush (Host): I'm just curious from the, change, so growing up in a small agricultural town and how was the move to Manila, which is, that's one of the biggest cities in the Philippines at the time, it probably isn't, obviously wasn't as big as it is now, but how, And that must have been a bit of a culture shock itself, right?

Eduardo Villarama, MD: Yeah. Yeah. it is a culture shock. 'cause again, you know, first electricity and access to everything and other fancy stuff I'm not used to. And I am, I now have to live with one of my mom's, sisters because we didn't have, we didn't have, a property in the city in Manila.

I have to live with her and, kind of learn how to adjust. And even their family, you still have to adjust. There is that feeling of being uncomfortable at times. But again, I have to sort through it 'cause I know I have to do it. yeah. But that gave me an opportunity and an additional perspective in life.

Right. You know what, there's a big difference. Like I think This is another world compared to what I remember growing up. Yeah, that was challenging, but also, because I'm with family, it assured me that everything's gonna be okay.

David Quackenbush (Host): So you did your school and training in Manila, And then you practiced, you were a doctor in the Philippines for a while. where, did you do that and how was practicing in the Philippines?

Eduardo Villarama, MD: So soon after graduation, I think this wants, a bit too much information I will have to share. I got married after, graduation, but I got married. I had my baby and I started practice, in, in an order That is acceptable to our culture. But my grandma will joke about.

But you did that within a year, all of them. It's like, yes, I did. Yeah. So I got married and my wife is from a different town. So I'm from the north and my wife is from the south. We met in the middle. We met in Manila. 'cause Manila is in the middle.

Right. So soon after graduation, I'm married and I have, we had our first child, so I have to be responsible, more responsible. So I ended up practicing in another small town in the province of Alba B called, This is kind of like the, region number five of the Philippines, one of the poorest regions in the country, actually.

that's where I learned what we call it, medicine that serves cradle to the grave. So I see anything and everything, from, pregnancy to, caring for the elderly that are, very sick and about to past, right? And that, offered, me the opportunity of, trying to be better in everything that I will be faced or be attending to.

Be it just a simple consultation for cough, cold, be it, You know, suturing lacerations and taking care of someone with a wound or even doing, You know, some procedures like appendectomies and, other surgeries because I'm the only physician in that town that people have access to. The bigger hospital is again, about a couple of hours away.

So I do everything and anything for them. And I did that for four years. Then we had our second child there and my wife, she's the I, call her the architect of my life. an opportunity that, you know what, you're very hardworking. Kids are growing. I think I want a better environment for them.

So that's when, she researched about the international medical graduates opportunities for a residency training or a specialty training abroad. And that's how it started. So I was in practice for four years, but in my third year, I started applying, For, the residency program here in the us I took all the necessary examinations and fortunately I passed them and went on interviewing and, landed in one of the programs in Pennsylvania, Penn State University, Hershey Medical Center, in Lebanon, Pennsylvania, where I did my community and family medicine residency training for three years.

David Quackenbush (Host): So you were a doctor in the Philippines for four years, And so the. Requirements to come to the US is you have to take the, appropriate examinations, you have to pass the exams, And then you have to get placed in a residency program. And you did your residency program in Pennsylvania.

How long was that And what kind of, experience was that for you?

Eduardo Villarama, MD: So the residency program is three years. it was really fun for me 'cause it feels to me like I was just doing, my regular stuff or things that I've already been doing in my private practice back home. and of course, the addition of having access now to technology and other materials so I can stay up-to-date and be able to be more effective as a physician.

but honestly the most challenging for me is the English word, the vocabulary. 'cause all the Philippines, the teaching instructions are in English. We never speak English on a regular basis. We have our native tongue Tagalog, right? yeah, when I was, in my first year, what I do is I go to parks and libraries and talk to older folks so I can practice my English.

They're all very nice and accommodating. I can't remember this,

David Quackenbush (Host): Did they know why you were talking to them?

Eduardo Villarama, MD: Yes.

David Quackenbush (Host): So they knew you were trying to improve your English when you were

Eduardo Villarama, MD: Yes. I was very open about it.

David Quackenbush (Host): you would just go up to strangers and say, can I practice my English?

Eduardo Villarama, MD: Yes. That's like, hey, I'm new to town. Good morning. can I ask you a favor? Can I have a conversation with you? 'cause I'm practicing on my conversational English and they're all very accommodating. Yeah. I.

David Quackenbush (Host): that's really adventurous of you. And so you would just like, talk about news of the day or, just kind of general conversation with these strangers?

Eduardo Villarama, MD: Small talks. 'cause that's, I think, where I lack the most, I know formal English, right? But I don't know the, like, the norm, like how people talk in the community conversationally. So that, actually very helpful to me. I go up to the cashiers, I go to the librarians, to the security guards.

I talk to all people. So there are probably like, this guy is creepy, this guy, there must be something wrong with this guy. But I was nice enough to kind of really, make introductions and make them feel comfortable as I approached him.

David Quackenbush (Host): I'm just curious because, you're now the chief medical officer here and folks who are familiar with the healthcare system, especially health centers similar to ours that serve low income underserved communities. Workforce is so difficult and having enough clinicians is very, very difficult. as you know, 'cause you've been involved in hiring a lot of folks, golden Valley, we have 30 some odd international medical graduates on staff.

So you were already a doctor in the Philippines for four years doing family do, literally doing kind of the traditional family practice, as you said, cradle to grave. So everything in between. And then you came to the US and still had to do residency. what are your thoughts on, that system and kind of those barriers?

Also recognizing just how difficult it is to find clinicians to serve underserved areas.

Eduardo Villarama, MD: I probably will respond to that. David, kind of like. Two ways, right? One is, I think it has to do with how driven and motivated the individual is, how driven and motivated the providers are. And then secondly, has to do with their, skills and background and, in academics. For those folks that already had been doing the work prior to entering a residency program, it's probably not as challenging or not as difficult.

for those that are f fresh from graduation now going into the residency program, trying to kinda emerge yourself in a different culture, in a different way of practicing medicine. 'cause the western medicine is, really different from the third world of medicine where I came from. Right. so I felt like here we have the abundance of technology and resources to make things easier, safer, and more efficient.

Back home. You have to settle with what you have available, make it work, and with a clear understanding that, it might not be the best approach, but that's what we have and we'll make the most out of it. I have a soft spot for folks that are, coming from a different country and, trying to kind of better themselves and have an opportunity here.

'cause I know the drive is there. I'm pretty sure the drive And the motivation is always gonna be there. So hard work is something that you can never question, And the dedication to furthering and improving themselves, it is just now, comes to, the natural skills and talent into. Developing further into the better version of yourself as an individual and as a professional.

it can be a bit, redundant, I would say, going to the Residency program again when you're already in practice for so many years back, for so many years in back in your home country. But I would say, it is beneficial because really, as I have said, those skills. that you have And the resources that you have from where you're from, it is not the same as you have here.

You have to be comfortable in doing things the way people are expecting for you to do it over here. I think that's beneficial. again, it will be controversial in terms of how long the, do you have to subject yourself or get yourself in that training program to be as, competent as equally.

Skilled, compared to the local grads.

David Quackenbush (Host): Yeah, You know, a daily challenge for us and we're very creative in our recruitment and, the international medical graduates are a important piece of, our clinician, staff. So you did your residency in Pennsylvania And then you end up in Merced, California. can you tell us how that happened?

Eduardo Villarama, MD: Yes. Well, I, told you my wife is the architecture of my life, right? So. Pennsylvania, great. Very country laid back. Community, feels home. however, it's very cold. And, where we're at, we have snow, I would say seven to eight months out of a year. So, it can be a, a bit, tiring to be digging your car out of your driveway every morning just to go to work or go about your, regular events during the weekend.

And my wife missed the sun. it happened that one of my, brother-in-laws. Live in California, well hour, California. So my wife was saying, Hey, after dressing this program, would you wanna consider going into a bit of a sunny state where we don't have this much snow, but we can have access to snow?

'cause I know you enjoy it. I was like, yes. What are you thinking? I was like, California. Oh, okay. Sure. So I was in my second year, because I came here on a visa, right? So when I joined the residency program, I was on what, you called a J one visa.

So the J one visa is the visa That is, that makes you eligible to convert into an H one a working visa. So I was on a J one, so, I have to make sure that I would have secured a job or a position before I graduate from the program.

Otherwise, my requirement is to go back home And then, serve about a year or two And then be eligible again to come back to the US and apply for a job. Right? So I was fortunate, that I have secured, during my, early third year into the program, so I interviewed only California 'cause that's where my wife wanted to go, right.

So I interviewed south to north of California And then I ended up in the middle. 'cause Golden Valley is in the middle. It's in the middle of California. It's a very interesting experience 'cause it's like. California is so diverse and it's so huge, right. But I felt like, the diversity of the state makes it unique and makes it, for me, attractable, and conducive to where I wanted to grow, my family and my profession at the same time.

And out of all the interviews that I did, I felt. So much more comfortable and at home with Golden Valley Health Centers. 'cause everyone, when I walk into the building, everyone was greeting me with a smile. they're also warm. And, I can relate to the types of patient's that are being served, growing from an underserved community.

I've said earlier, I have a soft spot and dedication to the patient population. 'cause I know how struggles and difficulties are. And if I can make a difference in their lives, if I cannot make them feel better every single time at, least I can comfort them and make them smile.

So That is how I ended up in California. So soon after graduation, I moved to California and joined Golden Valley Health Centers. This has been my only employment since graduating from the residency program to date.

David Quackenbush (Host): I probably should ask this question, but it's kind of obvious. This is really just a continuation of your, life's work.

Eduardo Villarama, MD: Correct. Absolutely.

David Quackenbush (Host): Yeah. And very interesting how, your life has played out. my last question, so I'd like to ask about how your journey determines your, career and your personal passions and serving the uninsured, but as we've talked about, I mean, your life was pretty much preordained. By the strong women in your life.

I mean all really, all three of them, your mother, grandmother, and now wife, So, It was kind of built-in that you were gonna serve the community and, your big heart is always very evident. So the influence of them on your life and on your careers, very, very obvious. But I would ask, what advice would you give people to consider in their own journeys?

Eduardo Villarama, MD: I am, uh, pleased to be in a position to give advice, and especially for folks that are not my patient's. I'm very comfortable giving them to patient's. it's different when they're not patient's, right. I'm humbled by the opportunity.

David Quackenbush (Host): That is a very it. That's a, for a non-clinician, I completely understand. That point, but it's also kind of odd to say that, right? Because you literally give people, you really, you give people advice on a daily basis as

Eduardo Villarama, MD: on a regular basis. Yeah, but on that professional level. But, kidding aside, so first I would say, because we're in healthcare, right? I would say. I would encourage everyone to prioritize and invest in their personal health in a mind, body and spirit. 'cause if you are healthy, you are always better navigating your own life's journey, like anything in life, will be not as challenging or as difficult for you if you are healthy.

So that's first. And then secondly, I wanted to share my motto in life. I think this has been the guiding principle of my life, right? It is a Latin phrase that goes. Add Astra Perra to the stars through difficulties. 'cause in life, There are celebratory moments, there are successes and There are difficulties, and I embrace them both.

So my advice is to embrace both challenges and successes because in successes, you'll appreciate your efforts and it'll enhance your self belief And in difficulties. That's actually where you discover more about yourself. Your values, your strengths, your weaknesses, which are keys, to unlocking those untapped potentials so you can ensure, success in whatever you do.

as we know, greatness is achieved by overcoming difficulties and adversities. So keep moving forward at Astra per.

David Quackenbush (Host): That is a, great place to. And so, you know, I always enjoy our conversations, especially when I get you talking about your journey. 'cause it's very, very impressive and impactful. But I appreciate your time today and sharing with, the audience. So thank you for joining the Golden Voices podcast, Dr. And good luck to you and your continued journey.

Eduardo Villarama, MD: Thank you, David. It a pleasure. Sure. And, I'm humbled by the opportunity to share my life's journey. And if this can inspire folks, even better. So thank you so much. Appreciate it.