VCU news

By Jackie Kruszewski
VCU School of Medicine

Never be afraid to ask a question: that’s one of the guiding principles of Greg Vanichkachorn, M.D., and a trait that’s opened many doors in his career – including NASA’s.

“I literally sent an email to NASA: ‘Hey, I'm interested in aerospace medicine. Can I come down and hang out?,’” he says.

“They said, ‘Sure! Why not!”

That was in 2008. This January, Vanichkachorn, an alum of the Virginia Commonwealth University School of Medicine, took and passed his aerospace medicine boards, joining a small group of doctors who take care of pilots and astronauts. And as the section chief for Transportation Medicine and medical director for Mayo Clinic’s long-haul COVID-19 program, Vanichkachorn also sees commercial drivers and long COVID patients in his clinical work.

It’s a unique cohort of patients, and no two days are the same.

“Many people, when they talk about their medical careers, it sounds all polished,” he says. “You go to medical school, straight to residency and then you're out practicing. But mine definitely wasn't like that.”

Finding a niche in occupational medicine

Vanichkachorn comes from a medical family. His father was an orthopaedic surgeon in South Hill, Virginia, and his older brother Jed Vanichkachorn, M.D., a VCU School of Medicine alum, stayed in the family specialty. The younger Vanichkachorn wasn’t interested in surgery.

“I was really attracted to being part of a community,” he says, “to getting to know my patients and having a long relationship with them.”

That led at first to VCU-affiliated training at St. Francis Medical Center in family medicine. Vanichkachorn also completed a novel rotation with the Chesterfield County Health Department.

“Again, I just sent an email to the district health director asking if I could come learn more about everything that goes into keeping a community healthy,” he says. “It wasn’t long before I found myself at the water treatment plant, inspecting a restaurant and laying out septic lines.”

Vanichkachorn’s background in athletics and orthopaedic-minded family meant that he became one of the go-to musculoskeletal physicians in his primary care group.

“That led me to being the low-back-pain guy, which led me to be the guy who helps people who have work-related issues,” he says.

Expertise in worker’s compensation and occupational medicine landed Vanichkachorn in Montana for eight years practicing occupational and preventive medicine – often remotely via telemedicine.

To better help his community and patients, he obtained a Master of Public Health from the University of Washington and completed a second residency in occupational medicine from the University of Pennsylvania. He also trained with the Federal Aviation Administration to examine pilots and has worked with pilots since 2014.

This diverse background made him the perfect candidate for a unique position that opened up at Mayo in 2019 for a leader in telemedicine, occupational medicine and aerospace medicine.

Improving pilot-doctor relationships and tackling long-COVID

At Mayo in Rochester, Minnesota, Vanichkachorn is working to improve any distrust between pilots and their doctors.

“It used to be, they didn't want to tell us anything,” Vanichkachorn says. “They just wanted to get out with their medical certificate. But by reaching out proactively to pilots, showing them that we're all on the same team, we can change the paradigm.”

He sees pilots with medical problems and guides them through the extensive FAA process to return to the cockpit.

“Perhaps a pilot had a stroke, or fell and lost consciousness,” he says. “Anytime something like that happens, they need brain imaging and cognitive evaluations regularly for a while.”

That includes pilots with alcohol use disorder or mental health conditions. “The FAA certification process, it’s very, very structured, and there's a whole lot of monitoring – a lot of provider-pilot interaction.”

Vanichkachorn has worked to proactively prevent pilots from reaching that point, through consulting work and engagement with the aviation community. He hosts a Mayo podcast called “Clear Approach” to reach and educate pilots.

“We hope that pilots can see physicians differently,” he says. “It’s down-to-earth – with a lot of humor in there.”

Vanichkachorn also has become an unexpected expert on long COVID, having identified it early on in the pandemic in his occupational medicine practice. Patients were struggling to return to work after a bout with the virus – with fatigue and trouble breathing.

“We formalized a long-COVID program in June 2020, one of the first clinical and research programs,” he says. “People from all over the world come to Mayo for it.”

Space medicine and space to grow

Aerospace medicine had always been in the back of Vanichkachorn’s mind. As a kid, he was interested in space. And the fortuitous email to NASA led to a stint in Texas with the agency and the University of Texas Medical Branch.

It’s a tiny niche: only two to four resident spots for aerospace medicine training open up annually and there are just a handful of fellowships. But after many years of working with pilots, Vanichkachorn was granted the opportunity to take the boards.

Now triple board certified, Vanichkachorn looks forward to meeting the challenges of a new era in aviation and space flight. Commercial air travel, for example, is constantly changing, he says, with new technologies and recurrent problems like pandemics.

“And astronauts used to be primarily with NASA or the European Space Agency,” he says. “Now, with commercial space flight, many more people are embarking on space flight, many with chronic medical conditions. Our specialty will work to protect these new astronauts – and the public – going forward.”

It all adds up to a unique amalgamation of clinical care that allows Vanichkachorn to form meaningful connections with his patients – just like he wanted when he left the MCV Campus.

“I joke to my kids that I'm still trying to figure out exactly what I want to do with my life, even at the age of 45,” he says.

“In this journey through medicine and serving others, there's also space in there for us to find ourselves. Don't be afraid to explore.”

This story was published in the spring 2023 issue of 12th & Marshall. You can find the current and past issues online.