Published January 20, 2017
The goal is to expose students to the social and cultural issues they will encounter with patients throughout Western New York when they start clinical rotations in their third year.
“In order to forge a trusting relationship with patients, students need to have some understanding of the social, economic, psychological and cultural issues that shape them,” says Linda F. Pessar, MD, director of the Jacobs Center for Medical Humanities and professor emerita of psychiatry.
“Getting our first-year students off campus and into the city so that they are exposed to some of the challenges our patients face allows us to introduce them early in their professional development to the important goal of better understanding how our patients live,” she explains.
“This is a new opportunity, in addition to the others we provide, for our students to actively engage with the city.”
Pastor Kinzer Pointer of the Promiseland Missionary Baptist Church at the corner of Mulberry and High streets welcomed the opportunity to give students a tour of the neighborhood.
“What we want from you is to become excellent medical doctors,” Pointer says. “Consider this an invitation: I invite you to stay with us and grow with us, right here in this neighborhood. There is an absolute necessity for you to do that because in this neighborhood you see people suffering from the social determinants of health in ways that other people don’t.”
The conversation with Pointer was just one of more than a dozen sessions held throughout the city as students began the day by taking part in programs presented by agencies that provide services throughout Buffalo, including:
As students who met with Pastor Pointer learned, the needs of community members are great.
Students attending a Buffalo Public Schools’ English as a second language program at the Immigration and Refugee Assistance Program Education Center spoke with refugees about their experiences with health care in their home countries and in the U.S.
Others who toured the neighborhood near Martin Luther King Jr. Park on Buffalo’s East Side with Henry Louis Taylor, PhD, UB professor of urban and regional planning, and Pastor Dennis Lee of Hopewell Baptist Church experienced firsthand what it’s like to shop in a food desert, an urban area where access to nutritional food is very limited. Their market: a neighborhood convenience store.
Students later reconvened at the medical school for afternoon sessions, during which they talked about their experiences from the morning sessions with UB faculty members and community leaders.
During one session, refugee leaders discussed folk beliefs from their cultures, factors that sometimes conflict with American medical practice. Other sessions focused on social factors that impact health care and health disparities as well as a discussion of implicit bias, during which works of art were used to challenge inherent assumptions and stereotypes.
“We hope that better understanding of cultural assumptions will aid our ability to form empathic relationships,” Pessar says.
The program, which is mandatory for all first-year medical students, stems from last year’s pilot program, during which 11 first-year students took part in community immersion activities.
“That experience was so beneficial and profound for students,” Pessar recalls. “They felt it really changed their understanding of medical practice and even, in some cases, made them rethink career plans about which specialties of medicine to pursue.”
She notes the experience led students to realize that some of what they had been taught might not be applicable to certain patients. For example, students are generally taught that if an obese patient visits a primary care physician, the main issue to discuss is a treatment plan for obesity.
“But the students learned that if the patient is a single mother, and she is working two jobs and has two small children, and the nearest supermarket is two bus rides away, then to start telling her about the risks of obesity and why she should eat better is unempathic and shaming,” Pessar says. “Somehow, there has to be a different kind of engagement.”