The Virginia Tech Carilion School of Medicine has received the largest scholarship endowment in its history: a $20 million gift from Virginia Tech alumni Jim and Augustine Smith.
The endowment will provide $100,000 for scholarships in its first year, supporting tuition for one or two students starting in the next academic year. School leaders say the gift will help reduce medical school debt and strengthen the pipeline of physicians who choose to practice in rural Virginia.
Priority is given to students from Virginia who need financial support.
Medical school students routinely graduate with hundreds of thousands of dollars in loans, said Jim Smith, a financial burden that often steers new doctors away from rural communities and specialties with lower salaries.
“If we can reduce that debt load and take more in-state students, we’re able to get more doctors to actually stay in Roanoke. They finish school, they like Roanoke, they like Southwestern Virginia, so they stay,” he said. “I think that’s a good way to enhance medical coverage.”
A longstanding commitment to the medical school
The Smiths, who now live in South Carolina, have supported the Roanoke-based medical school since the early 2000s, when it existed only as a concept. When the school opened, the couple donated a $1 million endowment to help meet its most pressing needs.
Until now, that gift had been the largest in the school’s history, said Dr. Lee Learman, the dean of the medical school.
This new endowment will allow the school to recruit more Virginians with less debt when they finish their training.
The Virginia Tech Carilion School of Medicine is one of the smallest medical schools in the country, with an enrollment of just under 200. It welcomed its inaugural class in 2010. In 2024, school leadership announced plans to expand both the campus and enrollment.
The medical school has worked with local partners for years to cultivate interest in health care careers, reaching students as early as elementary school. But Learman said many prospective medical students already carry undergraduate debt by the time they apply. Adding the cost of medical school on top of that may not be feasible.
By focusing on students from Virginia, Learman said the Smiths’ gift will help solidify the school’s mission and help accelerate its growth.
“It will allow us to more rapidly achieve the goals that we need to achieve as a young medical school in order to make sure we are being competitive in the marketplace of attracting the best and brightest students from Virginia,” Learman said.
Scholarships free students to focus on learning
For Maedot Haymete, a rising fourth-year medical student, the impact of scholarship support has been transformative.
Born and raised in Ethiopia, Haymete became interested in medicine after watching a documentary in high school about Dr. Catherine Hamlin, an Australian OB-GYN who moved to Ethiopia to train midwives and ended up working to address widespread obstetric fistulas. The film solidified Haymete’s desire to become a physician.
She finished high school in South Africa and moved to the United States, enrolling at Amherst College in Massachusetts on a pre-med track.
The Association of American Medical Colleges offers a financial assistance program to help medical students pay for fees for entrance exams and application fees. But when Haymete finished her undergraduate degree, she did not initially qualify for assistance due to her non-permanent resident status.
For four years, Haymete worked at a pharmaceutical company and as a medical scribe in Northern Virginia, saving money while waiting to obtain her green card.
“There were a whole bunch of challenges with me leaving Ethiopia and coming to the U.S. but I always knew one day I would be applying to med school,” Haymete said. “I never gave up.”
After gaining permanent residency, Haymete paid for the medical school entrance exams and applied. Though she was accepted to an Ivy League school, she chose the Virginia Tech Carilion School of Medicine because it was in-state and she liked the small class sizes.
She expected to work part-time throughout medical school. But then she learned she had been selected for the James R. Smith Family Charitable Foundation Scholarship, which came from the Smiths’ original $1 million gift to the school.
Instead of juggling work and classes, Haymete immersed herself fully in her education and volunteer work.
“I’m grateful for the opportunity to be a very focused student. I didn’t have to worry about anything else on a day to day basis. I was able to explore all the specialties I wanted. I didn’t feel like I had to go into a speciality that pays well just to pay off my loans,” Haymete said.
Haymete plans to specialize in diagnostic radiology. While her residency may take her elsewhere, she hopes to return to Virginia or the Washington, D.C., metro area after completing her training.
That outcome is exactly what the Smiths envision for future scholarship recipients.
Who are Jim and Augustine Smith?
Augustine Smith remembers a very different era of higher education. As a Virginia Tech student, she received a four-year scholarship from the Women’s Alumni Association. In the 1960s, she said more government support and financial assistance made college much more affordable.
“I know how important it is for people that do have goals and they want to accomplish great things. And we felt the medical school with the leadership that they have would be a good place to put those resources,” she said.
She earned a bachelor’s degree in accounting in 1971 and worked for the Niles and Niles accounting firm, then at Peat Marwick Mitchell & Co., a predecessor company to KPMG, where she was promoted to the management team.
She eventually founded a CPA firm in Rocky Mount, and she extended her work to teach at Ferrum College. At the same time, she served in the region’s chamber of commerce and Business Women’s Association.
She sold her share of the accounting firm to her partners and worked alongside her husband to help build his business.
Jim Smith’s connection to health care began in high school, when he joined the National Guard and trained as a medic. He later earned an associate degree in business administration from Virginia Western Community College before completing a bachelor’s in sociology at Virginia Tech in 1974.
He went on to work in behavioral health at the Southwest Virginia Training Center in Hillsville and later served as business manager for the Department of Mental Health and Retardation at Catawba Hospital. His career also included roles at Blue Cross Blue Shield and the Department of Defense, before he founded his own business developing nursing homes and senior housing facilities.
Jim Smith has helped develop more than 200 senior living facilities. He also founded a private equity company focused on senior housing and commercial real estate, where he continues to serve as president and CEO.
Together, the Smiths say they hope their gift will ease financial barriers for future physicians — and help ensure that Virginia communities have access to the care they need.