February 2026 – Tarrant County Physician Online

A DO Dilemma

TCOM Student Article

By Jared Sloan, OMS-II

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

January to February can be a tough time for many people: The air is cold, holiday street lights are taken down, New Year’s resolutions are abandoned, and osteopathic medical students are deciding whether they want to take double the amount of national licensing exams. While taking the USMLE (United States Medical Licensing Examination) Steps 1 and 2 is not a new expectation of osteopathic students, recent changes, including the formation of a single accreditation system, which fully merged the previously separate osteopathic and allopathic residency accreditation pathways in 2020, as well as the transition of STEP 1 to pass/fail scoring, have left many students scratching their heads and biting their nails at the thought of even more high-stakes exams. Early in their education, students are forced to make a career-defining choice: Should I take both the DO and MD licensure exams if it improves my residency outlook?

Since 1995, osteopathic students have taken the Comprehensive Osteopathic Medical Licensing Examination (COMLEX) as their primary means of gaining licensure. With the large overlap in content between COMLEX and the USMLE (the main difference being the inclusion of osteopathic-specific content), many professional medical societies have stated that the COMLEX is a perfectly acceptable alternative to the USMLE. However, this decision truly lies with individual residencies. Typically, osteopathic students who take STEP do so because it is required for the residencies they are interested in. But for the many year-two students who have not decided on a specific specialty, myself included, this decision is far from simple. Although many of my classmates and I are drawn to specialties that are historically “DO-friendly,” we are also aware that there is still much of medicine we have yet to experience. Many students don’t discover the field of medicine they are passionate about until their clinical rotations, but we must decide to take STEP 1 before we ever step into those roles. Students feel that by choosing not to take STEP they are closing doors to future programs before they even know about them. Many feel it is wiser to “play it safe” by taking the extra licensing exam. At the heart of this dilemma is the tension between what is technically sufficient for licensure and what is perceived as necessary to remain competitive across an increasingly uncertain residency landscape.

Unfortunately, students seeking mentor guidance on this matter often hear conflicting opinions from faculty and experienced osteopathic physicians. With the advancement of the osteopathic profession, many mentors insist that students should not feel pressured to take unnecessary exams. Others concede that, while COMLEX is becoming more accepted, there remains a very real preference for the STEP exams. Students are left with ambiguous answers and are told what they already know, namely, that choosing to take the extra exam depends on what specialty they are interested in.

How does the new pass/fail status of STEP 1 impact this predicament? Now that allopathic schools emphasize STEP 2, should second-year students feel free to skip the stress of STEP 1 and take STEP 2 only if they feel it is necessary? Yes, and some do exactly that. Many, however, are terrified by the idea of taking what feels like the most important test of our lives without taking its predecessor. While the core competencies of COMLEX and USMLE are similar in many ways, it is well known that there are differences in the style of writing and focus areas between the exams. With so much riding on STEP 2, students continue to feel pressured to prepare as best they can, which includes taking STEP 1.

Regardless of which licensure a medical student takes, almost all students would agree that these exams are hard. Fatigue, stress, and financial cost all increase when students choose to take more national boards. I know that I, and many students, worry how this increased burden will impact our performance. Taking an extra exam means risking failure on our core licensing exam or risking failure on an exam that was never necessary in the first place. Ultimately, we as medical students are high achievers, and many of us are willing to put in this extra work if it means more opportunities in the future.

Despite numerous residencies stating that they will review a COMLEX Level 2 score under the single accreditation system, students remain keenly suspicious that STEP 2 functions as a silent requirement. DO students are left wishing that our standard licensing exams were fairly considered but realize there is no way to enforce a fair consideration of COMLEX. Looking ahead, many osteopathic students are hopeful for one of two future outcomes. The first possibility is that the National Board of Osteopathic Medical Examiners (NBOME) could move toward standardization with the USMLE (potentially by accepting a unified licensing exam supplemented by osteopathic-specific assessments). However, given the NBOME’s longstanding commitment to a distinct osteopathic licensure pathway, this outcome appears unlikely. What feels like the more plausible future is that COMLEX scores will become more routinely considered by residency programs as familiarity increases. While this shift may already be underway, it will take time to fully materialize. As a result, although future osteopathic students may ultimately face fewer barriers, for the foreseeable future, many cohorts will continue to navigate a residency application in which the expectation of STEP remains firmly in place. As I look toward my future, I see a wide range of possibilities, possibilities that may quietly close if I choose to ignore this silent requirement.

2026 Tarrant County Medical Society President Cheryl L. Hurd, MD

Feature Article

By Allison Howard Hunter

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

Dr. Cheryl Hurd, a psychiatrist committed to both clinical care and medical education, believes that organized medicine is the foundation that supports every other part of medical practice. But she’ll be the first to admit that she didn’t realize its importance early on.

“I was a student member of TMA, but I never did anything,” she says. The same was true during her residency in Arizona. But after years of participation, Dr. Hurd’s advice for medical students and residents is simple: Don’t just join—get involved.

When she returned to Texas and entered private practice, it was as the only psychiatrist in her medical group. Feeling alone, she rejoined TMA and immediately found connection in colleagues, committees, and a whole psychiatry track of support she didn’t know she was missing. “The camaraderie was huge,” she says. “I finally didn’t feel like the only one.”

Dr. Hurd’s involvement in organized medicine also offered practical benefits: TMLT insurance, CME funding, and—most importantly—the chance to advocate. Advocacy, she says, is what allows physicians to push back against excessive regulation, protect physician-led teams, and fight for the future of the profession.

She’s candid about the challenges physicians face. “Healthcare is regulated more than almost any other industry,” she says. Yet advocacy has delivered real wins: tort reform, increased medical education funding, and—critically for her field—expanded mental health funding in Texas even during budget-cut years.
“That’s why advocacy matters,” she says. “It protects us, it protects our patients, and it keeps our profession alive.”

And, as she found, those who advocate for you also have your back at the toughest of times, sometimes in ways that are less obvious than legislative wins. In 2020, when physicians were on the front lines of the COVID-19 pandemic and PPE was scarce, putting healthcare professionals at greater risk, Dr. Hurd was surprised to receive a box from TCMS.

“I opened it up and it was five hundred N-95 masks,” she says. “Just this whole box of N-95s. And then there was an email. It was from TCMS, saying, ‘Hey, we’re trying to help you.’ And they sent it to every single member; they sent every member a box because they wanted to protect us.”

Dr. Hurd credits that support as the reason she got even more involved, leading to her serving as our 2026 TCMS president. She saw in TCMS a reflection of her own ideals—a mission to care for patients, physicians, and the physician-patient relationship.

But it is the physicians like Dr. Hurd who give our medical society its heart, inform its values, and guide its vision.

“Dr. Hurd is the intelligent and compassionate doctor that you would wish to take care of your dearest loved ones,” says Helene Alphonso, DO, a friend and mentee of Dr. Hurd. “As a mentor, she nurtures lifelong learning at every level of medical education. She advocates for her patients and fellow physicians with countless hours and innovative solutions. . . . We can’t wait to see how her leadership in the Tarrant County Medical Society will shape the future.”

Though Dr. Hurd is now passionate about all things medicine, growing up, she did not want to be a doctor—or a teacher or a dancer or even a veterinarian (though she does have a major love for animals). No—at six years old, Dr. Hurd was determined that she was going to be a lawyer. She held on to this dream all the way through college, where she earned both a bachelor’s and a master’s degree in English from SMU, still convinced that law school was her next step.

It was during those years of study that Dr. Hurd met her husband, Howard. They had a good plan: he would go to medical school, and she would go to law school. Still, she decided to defer for a year because his education was taking him to Houston, while Dr. Hurd’s was taking her to Austin. As newlyweds, this separation was hardly appealing, and with law school only taking three years against medical school’s four, the choice was easy for her to make.

Dr. Hurd had planned to work in editing or proofreading for the year, but with a competitive job market and no connections in a new city, she had a frustrating lack of success. One day, she asked her husband if she could join him for his classes to give her something to focus on aside from the unfriendly job market, so he brought her along. She was immediately enthralled.

“A couple of weeks into his school, and I’m sitting there in the classroom taking more notes than he is,” Dr. Hurd says, laughing. “And I just thought, ‘Wow—this is fascinating. Why did I never study this?’”

Quickly, her decision was made—medicine was her future. In a short time, a passion grew into something she knew would sustain her in the years ahead.
Dr. Hurd and her husband were both accepted to Texas Tech’s School of Medicine, so they made the move to Lubbock. A couple of years later, Howard matched to a general surgery residency in Temple, Texas, so she transferred to A&M College of Medicine to complete her clinical rotations. When she graduated in 1998, she began her psychiatry internship at Good Samaritan Regional Medical Center in Phoenix, Arizona. Her training was unique—a joint internal medicine and psychiatry program that allowed her to combine the specialties that most interested her.

After her internship and four years of residency, Dr. Hurd was more than ready to begin practicing as a fully qualified psychiatrist. She and her husband knew they wanted to come back to Texas—the question was simply where they would land. Having their friends and family here was a huge draw for the young couple, but they were also motivated by positive legislation for medicine.

“With tort reform in 2003—that’s when I graduated residency—I was thinking it would really be nice to not have escalating malpractice costs,” Dr. Hurd says. “They’d still get money if I actually did something wrong, but the goal was that all the frivolous lawsuits would go away. And by and large, they have.”

They settled in Brownwood, Texas, where Dr. Hurd set up a psychiatry solo-practice collaborating with a larger organization of specialists. She was the only psychiatrist in the area, and she also consulted at the county hospital. At first this kept Dr. Hurd quite busy, but her practice slowed down after the financial crash of 2008. Soon she moved to Fort Worth, where she joined UNT Health Science Center and UNT Health, although her clinical assignment was at JPS. She later transitioned to Acclaim Physician Group when it was formed, and she stayed there until 2022. Throughout that time, her role grew from serving as the consult medical director to being the psychiatry program director and vice chair of education.

Though she was involved in education through TCOM and JPS, she maintained an active full-time practice. However, when she began serving as TCU Burnett School of Medicine’s psychiatry clerkship director, she stepped back from her role at JPS and joined Connections Wellness in a part-time role.

“At Connections Wellness, I still have a clinical job where I see patients and precept students,” says Dr. Hurd. “And then I had my role as psychiatry clerkship director. I do the behavioral health year-one lectures, clinical skills, and things like that. So, I’m all things psychiatry at the School of Medicine.”

Though Dr. Hurd treasures her role within medical education, she did not seek it in the early days of her career. When opportunities first arose in education, she turned them down in favor of focusing on her clinical practice.

“I thought, ‘No, I’m just going to go out and save the world one patient at a time,’” she remembers. “‘I’ll do clinic and just be a doctor, be a practicing physician. That’s what I was trained for.’ When I started at JPS, I just thought I’d be a psych consultant like I was at the county hospital down in Brownwood. So, I show up, do my orientation, and they’re like, ‘Here’s your team.’

“I went, ‘Team? What team?’ I had a resident, I had an intern, I had students. I just tried to base my precepting on some of the best preceptors I’ve had in my training. So that’s how I got involved and learned that I really loved it.”

Much like her discovery of medicine, Dr. Hurd considers this unexpected assignment another act of serendipity—one that was to her benefit, as it was (and is) for the many residents and medical students who have been under her tutelage.

Her colleague, Debra Atkisson, MD, has seen Dr. Hurd make a big impact both in education and practice throughout her career.

“I have known her for more than fifteen years and have observed her dedication to her patients and the medical students and residents she has taught,” says Dr. Atkisson. “She has provided our community and the state of Texas with outstanding education about psychiatry. . . . We are very fortunate to have Dr. Hurd serve as our president for Tarrant County Medical Society.”

Dr. Hurd has had variety in the roles she has held throughout her career, but they have all hinged on one overarching goal: supporting mental health for physicians and patients alike. This has involved making petitions both to TMA and the Texas Medical Board, being involved in mental health legislation through First Tuesdays, and serving on councils and boards supporting mental health—including TMA’s Physician Health and Wellness Committee, where Dr. Hurd served for the maximum nine-year term, including two years as vice chair and two years as chair.

Though progress has been made in mental health support and treatment, she sees that much more lies ahead.

“I want to continue to work on reducing the stigma and also try and get more involvement in the community itself to support and encourage and grow mental health access.”

But the problem goes beyond the average patients—physicians struggle greatly when it comes to accessing mental health.

“We’re the last ones to go seek help,” she says. “There used to be punishment for physicians with their licensure when they were under treatment. So, they didn’t seek treatment, or they felt like they couldn’t be honest about treatment. And there’s been a huge effort to flip that narrative and get physicians to understand it’s actually okay to get treatment, and this is thanks to both the TMA and the Texas Society of Psychiatric Physicians, after much work and many, many years.”

As she begins her term as TCMS president, Dr. Hurd does so with the goal of continuing this mission.

“One of my goals is to get the community more informed of opportunities for mental health support,” she says. “We are also trying to work on increasing access and bringing more behavioral health and mental health programs to the area.”

Those who know her believe Dr. Hurd will thrive in this role and ably utilize the opportunities it provides.

“I knew of her leadership at the Texas Medical Association, where she served on the Physician Health and Wellness Committee,” says Angela Self, MD, who has been friends with Dr. Hurd for many years. “She works tirelessly for her patients and for the practice of medicine. . . . She sacrifices many hours volunteering, advocating for the improvement of healthcare for physicians and patients across the country.”

As Dr. Hurd looks toward the future, she does so remembering the many physicians who have impacted her career. Carol Nati, MD, was a great mentor for Dr. Hurd, especially during her time at JPS. Dr. Atkisson encouraged her to get involved with TCU’s School of Medicine and Connections Wellness, and Greg Phillips, MD, helped give Dr. Hurd the drive she needed to get more involved with TCMS. Dr. Hurd credits these physicians—alongside many others, and her ever-supportive family— for helping her become the doctor she is today.

Though medicine always keeps her busy, Dr. Hurd loves spending time with her husband; their two children, Dawna and Perry; and their dogs (they always have several, and there is usually a rescue in the mix). If she has a spare moment, you’ll probably find her reading a book—all genres are welcome!—or joining in a multiplayer computer game that her husband got her involved in years ago. She’s now the only one in her family that plays, but through it, she has developed a network of friends spanning the globe.

“It’s kind of fun to have long-term friendships that are not based on just your circle,” says Dr. Hurd. “It gets us out of our comfort zones in those boxes we live in, where we only do things with people who are pretty much like us.”
Dr. Hurd is eager to widen her scope of friends and colleagues even further in the year ahead as she partners with physicians and other change-makers to make a difference for medicine in Tarrant County and beyond.

“I’m excited to see what we accomplish for medicine in 2026,” she says. “There’s a lot of work to be done!”

Project Access Tarrant County: 2025 in Review and Building Toward 2026

Project Access Tarrant County Update

By Kathryn Keaton

This article was originally published in the January/February 2026 issue of Tarrant County Physician.

Another year has come and gone at Project Access Tarrant County (PATC), and as we close out 2025, we reflect on a year marked by both meaningful growth and strengthened community collaboration. Through the efforts of our volunteer physicians, hospital partners, and community collaborators, PATC continued its mission of bridging gaps in specialty and surgical access for uninsured residents of Tarrant County.

Patients Served and Clinical Impact
In 2025, PATC supported 243 patients through specialty and surgical care that would otherwise have been treated through emergency departments or would have gone untreated. These services included surgical care in general surgery, gynecology, colorectal surgery, urology, orthopedic surgery, cardiology, gastroenterology, ENT, and ophthalmology, as well as other non-surgical specialties. Despite continued high demand, we eliminated our gynecology waiting list, leaving only general surgery with a significant waiting period.

“I never thought this type of help existed for people in my condition. Even though I work, I don’t have health insurance and cannot afford medical care. I do all kinds of jobs; I don’t look for handouts. I am beyond thankful.” – Joe, 74, prostatectomy

Provider Engagement & Volunteer Leadership
None of PATC’s impact is possible without our network of volunteers. In 2025, over 60 physicians donated their expertise as well as ten hospitals and surgery centers. Our ancillary partners are vital as well, providing required imaging, anesthesia, pathology/labs, physical therapy, and other services. Volunteers see patients in their own offices and choose the maximum number of patients they see annually.

“Volunteering for Project Access is easy. PATC sends physicians the workup needed for patients vetted for our specialty. We just show up and treat the patient!” – Omar Selod, DO; Physical Medical and Rehabilitation and Project Access Tarrant County volunteer

Program Innovation & Process Improvements
In 2025, PATC expanded our technological capabilities. We broadened our patient communication tools to reduce no-shows and improve follow-up adherence and continued integration of CareMessage for appointment reminders, health and disease education, and multi-lingual patient support. In addition, we introduced Salud en Tus Manos (Health in Your Hands), in-person classes that address a variety of social drivers of health issues that our patients face. Thirty-one patients attended four classes held over 2025, and more curriculum is being added for 2026.

“Because of this class, I feel more confident in asking my doctor questions so I can better understand my diabetes care.” – Yolanda, Salud en Tus Manos “How to Communicate with Your Doctor” attendee

Community Value & Financial Stewardship
The collective value of donated care in 2025 is estimated at $1.5 million, reflecting both the generosity of our volunteers and the community’s investment in equitable access. Despite these high service levels, operational efficiency has kept PATC’s cost per surgical procedure coordination at approximately $1,500.

By facilitating specialty care, PATC reduces unnecessary emergency department utilization, prevents costly complications, and supports patient well-being beyond the clinical encounter, underscoring the value of collaboration and reflecting strong stewardship of both financial and human resources.

“The emergency department is the least efficient and most expensive way to deliver gynecologic care. Hemorrhaging women are transfused and sent home, only to return the next month when their menses return. Project Access identifies these suffering women and connects them with the definitive care—usually hysterectomy—they need. My role as the volunteer surgeon is made incredibly easy. Project Access coordinates the facilities, supplies, OR staff, and nursing—all I have to do is operate.” – Michelle Arevalo, MD; Obstetrics and Gynecology and Project Access physician volunteer

Challenges and Lessons Learned
While 2025 brought significant milestones, we also encountered challenges—including our wait list in general surgery, variable engagement across certain ZIP codes, and continued navigation barriers tied to social determinants of health. We are using these insights to expand patient education efforts and approach partnerships from a data-informed angle.

2026 Goals & Momentum
As we enter 2026, PATC is focused on expanding our capacity to meet growing needs. Our priorities include recruiting new physician volunteers—especially general surgeons—as well as expanding patient education related to social drivers of health.

With continued support from physicians and partners across the county, we anticipate a year of elevated impact and strengthened patient outcomes. We thank our physician community for their commitment and look forward to what we can achieve together in 2026.

“This experience changed my mentality—that there are people that may not know someone but still care about them. Sometimes people aren’t willing to donate five minutes of their time, so the doctors giving their services and time is incredible.” – Marisa, 48, hysterectomy

What We Carry: Reflections of Tomorrow’s Physicians

TCOM Student Article

By Jean Nie, OMS-II

This article was originally published in the September/October 2025 issue of Tarrant County Physician.

While weaving through the Oculus in New York City, I found myself drawn to a small storefront with walls covered in handwritten notes. The space, The Strangers Project, invited passersby to pause and read the anonymous stories of others—fragments of lives laid bare in ink. I wandered slowly, absorbing confessions of heartbreak, illness, hope, loss, and quiet resilience. As I read, I was reminded that every person is carrying something—often invisible, often unspoken—and how unjust it is to reduce a person to a single narrative, a surface impression, when human beings are anything but simple. Despite the many ways we might differ, I felt a deep familiarity with their words. Suddenly, in a city that often feels vast and indifferent, the room felt like a heartbeat—small, warm, and profoundly human.

Fast forward to my first year of medical school. That experience stuck with me, and I found myself trying to recreate a version of that space—this time in the halls of my own school. I organized a “reflection wall” for SOMA, a student-led advocacy organization, not knowing how it would be received. Nevertheless, I wanted this reflection wall to serve as a space for medical students to share their feelings and thoughts in the midst of a seemingly never-ending study session. Over the course of the day, I watched as students came in, some in waves, some peeping their heads in out of curiosity. Some students I knew, others I had only smiled at in passing. But gradually, the wall became filled with notes. Some were long, taking up the entire allotted half page, while others left short yet equally impactful single liners. The vision for this wall was to provide a space for students to pause in the middle of the relentless pace, to process what we often suppress, and to speak without needing a response—only to be heard.

There were papers written with bubbly letters that matched bubbly attitudes. Several students wrote about the moment they knew they wanted to enter medicine: a family member that was saved, a compassionate healthcare worker who made an exception to hospital policy so a patient could say goodbye to a loved one, and personal anecdotes of healthcare saving the writer. These stories echoed familiar themes of wanting to make a difference, to help people feel seen, to be a source of hope during dreary times. Many mentioned that despite the difficult journey, they are reminded of the privilege it is to be in this position, and by expressing gratitude, they are able to see the light at the end of the tunnel, even during the late nights.

But alongside the gratitude, the wall became a fuller picture. Many of the students were tired—beyond tired. Not just from studying, but from what feels like a constant negotiation between who they are and who this profession demands them to be. There were reflections that whispered of burnout and others that screamed of it. There were fears that ran deeper than fatigue—fears that this profession might not deliver on its promise of fulfillment and that a patient’s care would be determined by billing codes and insurance coverage rather than sound clinical judgment. Some reflections expressed fear of the future as well as scars from the past, especially moments where the healthcare system abandoned them or a family member physically or fiscally.

But the pain extended beyond the personal. Threaded through many reflections was a sense of despair about the system itself. Students wrote about the deep inequities they had witnessed: how wealth shapes not only who becomes a doctor but who gets to see one. How poverty, often the root of illness, remains beyond the reach of prescriptions. How medicine tends to treat symptoms while the structural causes—housing, food insecurity, systemic injustice—go untouched. One note captured a particularly painful irony: that even physicians, trained to heal others, often struggle to care for themselves.
I stood in front of the wall in silence, letting each emotion resonate with a part of me that’s felt it before. Like those notes in the Oculus storefront, the ones we wrote were acts of vulnerability—honest, unfiltered moments that revealed the beating heart beneath the white coat. That tension between inspiration and injury felt like the core of the wall. I realized that in creating this space for my classmates, I found myself reconnecting with the essence of why I chose medicine: to confront, to share, and to bear witness to the human experience alongside others. Because at its core, medicine is not just a discipline of diagnoses and treatments—it is a deeply human endeavor. It asks us not only to learn but to listen. Not only to act but to bear witness. Science may guide our hands, but it is our humanity that allows us to truly heal.

The fears expressed by my peers are real, and some will undoubtedly come to pass, if they haven’t already. But within the fatigue and frustration, I felt a reprieve. It’s in these moments of reflection, both quiet and collective, that I find the thread connecting all of us—not just as students or future physicians but as human beings. If we can protect that thread and create space for our own humanity as fiercely as we do for our patients’, then perhaps we won’t merely endure this profession; we’ll have a hand in reshaping it.