First-Year Medical Students Immerse Themselves in Community

The students made visits to a mosque, an East Side church and a Buddhist monastery; met with refugees; and attended lectures and discussions with community leaders about poverty and public health.

Students said they were seeking to gain a better understanding of the community in which they are learning about medicine by meeting its residents on their own terms and speaking to them in a context in which they felt comfortable.

“I think a physician is more than an individual that does the right thing at the right time when it comes to caring for patients,” says Tom Shi, a first-year student in the medical scientist training program and an organizer of the community immersion program.

“I think to truly care about individuals, we need to understand the social context of their health. When we start to learn about our community — not as people coming from the outside, but really placing ourselves in the community — we start to take on a more meaningful role.”

The community meetings provided students with real-world context to their studies, and Shi says he was focused on “having honest discussions with individuals about the obstacles they face day to day, their thoughts on solutions that have been proposed and their experiences with health care.”

Topics of discussion included how people in the community experience health care, what they think are impediments to health and wellness, what could make a difference to how comfortable they feel within the health care system and what changes would improve access for them.

Shi said students will be gleaning as much as possible from the meetings and then discussing with each other what they have learned and how their perspectives have changed.

Prior to beginning the community immersion, students took the Implicit Attitude Test (IAT) developed at Harvard University, which is designed to measure attitudes and beliefs, including prejudices, that people are unaware of or are unwilling to report. They will then take the same test again to see if their feelings and attitudes have changed.

“I look forward to sitting down with my fellow classmates and thinking about what our profession means to us and the different role that physicians can play in communities,” Shi says. “I look for these experiences to provide more meaning to my studies and to guide me in determining my role in medicine.”

Among the activities the medical students participated in during the program:

• an East Side tour with Sam Magavern, co-director, Partnership for the Public Good
• tour of Allentown, Richmond Avenue and Delaware Park with urban activist Mark Goldman
• meeting with Henry Louis Taylor Jr., PhD, professor of urban and regional planning, and director, Center for Urban Studies; and Pastor Kinzer Pointer, Greater Buffalo United Ministries; and Pastor Dennis Lee at Hopewell Baptist Church
• an introduction to the Yemeni community in Lackawanna with Gamileh Jamil, executive director, Access of WNY; a conversation with Yemeni women about their perception of providers; and a mosque visit
• meeting at Burmese Community Support Center with community leader Ba Zan Lin, visiting a Buddhist monastery and a discussion with former Myanmar political prisoners
• visits to the Child Advocacy Center and local agencies, including Buffalo Prenatal-Perinatal Network, Jericho Road Community Health Center and Matt Urban Hope Center; and a discussion program at United Way with Michael Weiner, president and CEO of the United Way of Buffalo & Erie County
• presentation and discussion about health disparities with Heather Orom, PhD, associate professor of community health and health behavior
• discussion with local physicians engaged with community: Kim Griswold, MD, MPH, associate professor of family medicine; and Kirk Scirto, MD, medical director, VIVE, Inc.
• a wrap-up dinner, which featured Gale Burstein, MD ’90, MPH, Erie County health commissioner, and clinical professor of pediatrics, as guest speaker 
  

The idea for the pilot program came from students involved with the Jacobs Center for Medical Humanities. Established in 2013, the center focuses on psychological, social, cultural and economic forces that influence the practice of medicine and the doctor-patient relationship.

Linda F. Pessar, MD, director of the UB Center for Medical Humanities and professor emerita of psychiatry, says students’ interest in becoming more attuned to the concerns of community members is in line with similar sentiments being expressed nationally, especially in academic medicine circles.

“Throughout medicine, there is increased interest in becoming more accessible to the average person and not putting up so many hierarchical obstacles, which are especially true for people living in poverty and from other cultures,” she says.

It’s part of an increasing trend Pessar has seen during the past few years at the medical school.

“There is a core of students here that is really interested in global health and wellness in the underserved, which is wonderful to see and which the medical school is nurturing,” she says.

In fact, with a new medical school building set to open downtown in 2017, outreach to the community will be more important than ever, Pessar says.

“Involvement of our school with the community is of enormous importance to the medical school as we move downtown,” she says. “We want very much to be good neighbors.”

Pessar said the response to the community inversion program from Buffalo’s community organizations was overwhelmingly positive, noting that “everyone was immediately on board.”

She added that strong support also came from medical school administrators, including Alan J. Lesse, MD, senior associate dean for medical curriculum and associate professor of medicine, and David A. Milling, MD, senior associate dean for student and academic affairs.