From Yale to healthcare leader: Dr Shika Pappoe’s impact on kidney care

In the ever-evolving field of STEM, individuals are continually shaping their careers through both innovation and perseverance. Dr Shika Pappoe, an advisor at Carna Health, is a leader in healthcare transformation, focused on improving kidney care, addressing systemic healthcare challenges and developing new models for chronic kidney disease (CKD). With an academic foundation from Yale and Harvard, combined with key leadership roles across healthcare organisations, Pappoe’s journey highlights the impact of blending clinical expertise with a commitment to public health. In this interview, she shares her insights on overcoming challenges, advancing patient care and driving future innovations in healthcare and STEM.

Please tell us about your journey in the field of STEM and the challenges you encountered along the way

My STEM journey began with my undergraduate and medical degrees from Yale, followed by an internal medicine residency and nephrology fellowship at Brigham and Women’s Hospital. During my fellowship, I earned an MPH from Harvard. Afterwards, I began my career in private practice in Southern California and later joined the nephrology division at USC, working at LA County Hospital, one of the largest safety-net hospitals in the US.

Throughout my career, I’ve faced challenges navigating complex healthcare systems and witnessing the gaps in patient care. These challenges fuelled my desire to drive change, leading me to pursue an MBA from Wharton to enhance my leadership capabilities.

With expertise in kidney care, public health and business management, I joined CareMore as regional medical officer and director of the renal programme. Later, as CMO at Strive Health, I designed and implemented a value-based care model for kidney patients across the US. I later served as CMO at Hill Physicians and PriMed, Northern California’s largest independent physician association. In addition to these roles, I joined Carna Health as CMO, and now advisor, where I helped further shape the company’s mission to improve kidney care. Currently, I am the co- founder and CEO of MitoKhon Advisors, a social impact design and innovation firm.

My career has been shaped by a commitment to improve patient care and address systemic healthcare challenges.

Could you share an example of a specific project or research that you have worked on that has impacted your field?

One of the significant gaps I’ve observed in healthcare is the delayed detection and management of chronic kidney disease (CKD), particularly in high-risk populations like those with diabetes and hypertension. At Carna Health, I had the opportunity to work on a project specifically aimed at addressing this gap. Our team has built a digital platform that supports point-of-care testing for kidney biomarkers. One of the key challenges in managing CKD is integrating early detection into the workflows of primary care providers, who already juggle numerous responsibilities. What sets Carna Health apart is our model, which brings testing to the point of care. By detecting kidney issues before they progress, clinicians can intervene earlier leading to improved patient outcomes and reduced long-term healthcare costs.

Another project that stands out is my work with Strive Health where I developed a value-based care model for kidney health. This body of work involved evolving the traditional fee-for-service approach to a value-based care model, where the focus shifted to improving patient outcomes, optimising population health, reducing disparities, enhancing the patient-provider experience and reducing healthcare costs. I had the opportunity to design a patient-centred model that reframes how kidney care is delivered by incorporating interdisciplinary teams, high-touch clinical workflows for care teams, and a customised digital health platform with advanced data science models.

What potential future applications or implications do you foresee based on your work?

Looking ahead, I see several; particularly in the context of CKD. While we’ve made incredible scientific advances, such as the transplantation of genetically edited pig kidneys, these solutions are expensive and accessible to only a small number of people. It is now crucial to empower patients with the necessary information and tools to take charge of their own health before they reach the point of serious illness.

The potential for preventative healthcare in CKD is enormous, offering benefits for quality of life, public health, improved healthcare economics and reduced strain on the environment. However, achieving this requires overcoming challenges such as global disparities in access to treatment. I am particularly focused on solutions that are not just innovative but also accessible to a broad range of people.

In the future, I believe the key to combatting the global burden of CKD lies in cost-effective, accessible screening and early interventions that can be implemented within existing healthcare infrastructures worldwide. This approach has the potential to shift the course of CKD treatment and significantly improve outcomes, all while making care more equitable and sustainable.

As a woman in STEM, what unique perspectives or strengths do you believe you bring to your work?

As a woman, member of the BIPOC community and a child of immigrants, I bring a unique set of perspectives to my work that have been shaped by my life experiences. Growing up with these identities has given me a different lens through which I view, receive and deliver care. I’ve learned to approach challenges from a place of empathy and understanding, knowing that every individual’s background and experience influences their healthcare needs and decisions. This has been especially important in the field of nephrology, where understanding diverse patient populations and being sensitive to their unique circumstances can significantly impact outcomes of care.

One of my key strengths is a different approach to critical thinking. I often find myself asking questions that others may not consider, challenging existing assumptions and envisioning next steps that take account of the broader social and cultural contexts. This allows me to think outside the box and approach problems from angles that might be overlooked by those with a traditional lens.

I also believe that science thrives on and advances through diversity – not only in the sense of ethnic or gender diversity, but in diversity of thought, experience and perspective. The traditional narrative in many fields has often been dominated by a single point of view, but bringing more voices to the table allows us to be more expansive in our creativity and evolve in ways we might not have otherwise. The more perspectives we incorporate into scientific inquiry, the more robust and innovative our solutions can be.

Women in STEM bring essential diversity of thought, driving innovation and more inclusive scientific advancements. Increasing their representation is crucial to breaking barriers, fostering equity, and ensuring a broader impact across industries.

What advice would you give to young women who are considering a career in STEM but may be hesitant due to societal stereotypes or perceived challenges?

My first piece of advice is to always follow your gut and your passion. There may be those who doubt you or say you will fail, but if you’re passionate about something, it will fuel you to keep going. Trust that passion – it’s a powerful compass that can guide you through the inevitable challenges.

It’s also important to remember that when you’re doing something new or innovative, there will always be pushbacks. People are often resistant to change, especially when it comes from someone who doesn’t fit the traditional mould. But if you’re truly committed to your goal, you’ll be able to navigate that negativity and keep pushing forward. Resilience is key, and the more you stay true to your path and your authenticity, the more you will prove that it’s possible.

Change only happens when individuals are willing to hold firm to their beliefs and challenge the status quo. Surround yourself with a community that supports you – people who make you feel safe, seen, heard and valued. Having that network is crucial because it will help you stay grounded and remind you of why you’re doing what you’re doing. It will help you stay true to your values, even when things get tough.

And always remember that by forging your own path, you’re also setting the stage for others to follow. You are paving the way for the next generation of women who will look up to you, inspired by your courage and determination. So, even when it feels challenging, know that you’re not just doing this for yourself; you’re also doing it for those who will come after you.

Finally, embrace your uniqueness – it’s your superpower. The qualities that make you different are what will allow you to approach problems in fresh, innovative ways. Don’t try to fit into someone else’s mould. Instead, celebrate what sets you apart. The world needs your unique perspective now more than ever.

How do you see the representation of women in STEM changing over the years, and what further progress do you believe is needed?

When I first entered the field, I was fortunate to be part of a community of women who were already paving the way. While there’s been significant progress and we are seeing an increase in the numbers of women in many spaces, we still have a long way to go. As more women join traditionally male-dominated fields, some pushback is inevitable, especially from those who feel threatened by the change. This discomfort is part of progress, but it also highlights the need for more work, particularly in getting women into senior leadership roles.

Many women still face a ‘glass ceiling’ where their growth is limited. To break through this barrier, we need more discussions about creating clear pathways to leadership positions and supporting women’s career advancement. Mentorship is essential here – having experienced mentors who can offer guidance and advice is crucial for helping women navigate the challenges of climbing the corporate ladder.

Additionally, external factors like family building, health concerns and caregiving responsibilities create barriers to career advancement that are often overlooked by traditional corporate structures. Women should not be penalised for taking time off for these reasons; in fact, the skills they gain – such as multitasking, problem-solving and resilience – are valuable and transferable to the workplace. We need to recognise and embrace these experiences as an important part of women’s career growth.

In your opinion, what can organisations and institutions do to create a more inclusive and supportive environment for women pursuing STEM careers?

To truly support women in STEM, recruiting women is just the first step; there must also be clear, sustainable paths for success, with equal access to advancement opportunities and resources for growth. Creating a culture of inclusion is key – diversity should be prioritised at all levels, not only by HR or designated equity leaders. Every employee, from entry-level to executive, needs to actively contribute to building an inclusive environment where inclusion is ingrained in everyday practices.

A McKinsey & Company study highlights a key issue: many men consider themselves allies to women in the workplace, but fewer actually take actionable steps to support them. Allyship needs to move beyond a label to become a concrete commitment, through mentorship, sponsorship and advocating for equal opportunities.

To achieve success it is also critical that organisations align resources and financial investments with their commitments.

Finally, diversity and inclusion should be viewed as both a moral imperative and a strategic business decision. Studies have shown that diverse teams lead to better innovation, higher financial returns and improved decision-making. Investing in inclusive environments for women in STEM isn’t just the right thing to do – it’s also smart business.

Looking ahead, what exciting developments or advancements do you foresee in your field of STEM, and how do you envision your own research contributing to those future innovations?

Looking ahead, I’m excited about the possibility of eradicating the need for dialysis. The key is to identify patients with CKD as early as possible, allowing us to intervene before the disease progresses to end-stage renal failure. Early detection can drastically improve clinical outcomes, quality of life, and reduce the economic and environmental burden of CKD.

My work is focused on the intersection of social impact and health. I believe that healthcare can help individuals create accessible, equitable and cost-effective solutions for early identification and management of CKD. I envision a future where these innovations are globally available, improving health outcomes and making kidney care more efficient and equitable. By advancing screening, treatment and patient engagement, I believe we can change the trajectory of CKD worldwide, ultimately reducing the need for dialysis and transforming patient care.