Journal for Minority Medical Students Career Issue 2010
A quarterly magazine to assist and aspire underrepresented minorities—African American, Latino, and Native Americans—in medical school and residency. This issue focuses on primary care.
� F O R M I N O R I T Y M E D I C A L S T U D E N T S Charter Members 2010 American Academy of Family Physicians American Academy of Orthopaedic Surgeons American Academy of Pediatrics Department of Veterans Affairs (VA) Harvard Medical School Minority Faculty Development Program Summa Health System U.S. Army Jefferson Medical College U.S. Commissioned Corps Association of American Medical Colleges Kaiser Permanente California U.S. Navy Aurora Health Care Long Island Jewish Medical Center Medical College of Wisconsin UAB School of Medicine University of Michigan Medical Center Boston Medical Center Cedars-Sinai Medical Genetics Institute Cincinnati Children's Hospital Medical Center David Geffen School of Medicine at UCLA MSU / Kalamazoo Center for Medical Studies Mount Sinai School of Medicine/ Elmhurst Hospital Center Office of Minority Health U.S. Department of Health and Human Services UPMC Mercy Vanderbilt School of Medicine Office of Diversity Wake Forest University School of Medicine These special friends of the Journal for Minority Medical Students have demonstrated their commitment to reach out to minority medical students by placing their recruitment messages in each quarterly issue. We salute them and encourage our readers to consider these programs as they continue their medical education. North Shore Long Island Jewish Health System A Major Academic Health System Dedicated to Patient Care, Teaching and Research Allergy & Immunology Colon & Rectal Surgery Diagnostic Radiology Emergency Medicine Family Practice General Practice Dentistry General Surgery Internal Medicine Neurology Nuclear Medicine Obstetrics & Gynecology Ophthalmology Oral & Maxillofacial Pathology Oral & Maxillofacial Surgery Orthopaedic Surgery Osteopathic Family Practice Osteopathic Neurological Surgery Neuromusculoskeletal Pathology Pediatric Dental Medicine Pediatrics Physical Medicine & Rehabilitation Podiatric Medicine Psychiatry Thoracic Surgery Urology Vascular Surgery The nation's third largest, non-profit, secular healthcare system, the North Shore-Long Island Jewish Health System provides care for people at all stages of illness throughout Long Island, Queens and Staten Island � a service area encompassing more than five million people. The health system includes 15 hospitals, four long-term care facilities, a medical research institute, three trauma centers, five home health agencies and dozens of out-patient centers. North Shore-LIJ facilities house more than 5,576 beds, and are staffed by over 7,000 physicians, 7,000 nurses and a total workforce of more than 35,000 � the largest employer on Long Island and the ninth largest in New York City. For further information: Office of Academic Affairs Telephone: 516-465-3192 Fax: 516-465-3190 www.northshorelij.com 9773-11-05 47 Journal for Minority Medical Students the MAtch issue vol. 22, no. 3 Features 35 The Careers issue intro 38 Doctor Rules: six important Things to Know about Your Future Medical Practice by Rob Lamberts, MD38 Match 2010 Profile: Michelle L. Aguillar, university of Arizona on the cover "Yellow Hat" by Laurie Cooper Philadelphia artist Laurie Cooper is known for her striking images of Face Realities. Cooper went to the University of Arts for her bachelors and received her master's degree in Fine Arts from the University of Pennsylvania. After that, she has been publishing prints with Collectible Art and Frames, a publisher and distributor of popular African American art located in Center City, Philadelphia. 37 Primcare Care: A Day in the Life 38 Primary Care by the Numbers 40 What Does the New DHHs Primary Care Funding Cover? 42 How Do Community Health Centers Fit into the New Health Care Law? 45 Primary Care Profiles: Jessica A. Wilson, MD 48 Primary Care Profiles: uyi Osaseri, MD 49 Primary Care Profiles: Mark Beaumont, MD Perspectives 6 9 Publisher's Page AAMC Perspective by Laura Castillo-Page , PhD and sarah schoolcraft 13 AMA Perspective 21 sNMA Perspective 23 AMsA Perspective by Drew Lee 27 The surgeon General's Report by Regina M. Benjamin, MD, MBA 31 Health Disparities Report Special report National Heart, Lung, and Blood institute PASSION: global health MY CALLING: MY family medicin e My family medicine training gave me the skills I need to create sustainable solutions where they are needed most. BE THE DOCTOR you always wanted to be. fmignet.aafp.org JoUrnAl For MInorItY MeDIcAl StUDentS PUBLISHER Bill Bowers EDITOR-In-cHIEf Laura L. Scholes email@example.com cOnTRIBUTIng WRITER John Dunn, MD SEnIOR AccOUnT EXEcUTIVES Amy c. Harrison , Anna Xiong cAMPUS REP LIAISOn Leea Royal ART DIREcTOR Kate Hunt cOPy EDITOR Robert Blue MARKETIng DIREcTOR Erica Perkins PUBLISHER'S ADVISOR Michelle Perkins, MD EXEcUTIVE ASSISTAnT to the PUBLISHER Leea Royal SPectrUM heAlthcAre DIverSItY & InForMAtIcS PRIncIPAL InVESTIgATOR Bill Bowers VIcE PRESIDEnT Of OPERATIOnS Tamika goins SEnIOR DEVELOPER/DBA Robin Shriver TEcHnIcAL ADVISOR naresh Kumar cOnTRAcT MAnAgER Lorry Rome PROJEcT cOORDInATOR Amita gavalas MYTH: You can forget about raising a family when you pursue a career in orthopaedics. FACT: With care and attention, you can be a great parent and a great surgeon. The truth is, being an orthopaedic surgeon is hard work. So is being a parent. But there's no reason you can't manage both with careful attention to organization and time management. So, if you're driven to help restore patients to a higher quality of life, you have the beginning of what it takes to succeed. Our unique mentoring programs connect you with experienced orthopaedic surgeons who can personally guide you forward. We invite you to go online for all the information and resources to get started. You'll discover it's easier than you realized. Choose a career in Orthopaedics-- our special mentoring programs offer personalized guidance and support to help you realize your dreams. For more information, visit aaos.org/diversity or email firstname.lastname@example.org J. Robert Gladden Orthopaedic Society A MultiCultural Organization The AAOS extends sincere appreciation to Zimmer for its charitable contribution. PUBLISHER'S PAgE Working Together to End Disparities By Bill Bowers, Publisher, Journal for Minority Medical Students his issue of the Journal is always a celebration of people just like you who decided to follow their dreams. Along our 20-year journey, Spectrum Publishers has helped to guide minority medical students toward successful medical career paths and has become a leader in healthcare informatics disseminating health disparity information. The National Institute on Minority Health and Health Disparities (NIMHD) recognized our strength in this area by awarding Spectrum a grant to develop the National Health Disparities Research Coordinating Center (NHDRCC). Why informatics? And what does informatics have to do with health care? As a resource used to optimize, store, and retrieve pertinent data on health and biomedicine, informatics is key to addressing health disparities. Health disparities are an epidemic among minorities, affecting communities and healthcare providers, including you! Have you ever asked yourself why so many minorities are stricken with obesity, diabetes, hypertension, HIV, and cancer? What are the forces that drive health disparities among minorities? Who is addressing the issues amongst the communities? With the goal of eliminating health disparities, NIMHD was established by the Minority Health and Health Disparities Research and Education Act to spectrum joins forces with NiMHD to launch informatics center T Bill Bowers address health disparities and research the causes. NIMHD is responsible by law to coordinate research and activities based on the NIH strategic plan. Under this strategic plan, Spectrum has been awarded funding for the creation of the NHDRCC. The goal of NHDRCC is to provide a complex relational database containing records of research and other related work in the area of health disparities. At the core of this goal is the compilation of a com- pendium of all the minority health research data. Spectrum has designed and begun implementing the database to achieve this goal, as well as disseminate pertinent information to various stakeholders throughout the United States. The future dissemination plan of the National Health Disparities Research Coordinating Center (NHDRCC) will continue to expand the database with ongoing data collection functionality, increasing research results, and providing a browse facility. Once the NHDRCC has reached the goals of the strategic plan objective to enhance information dissemination activities on health disparities research, it will be transferred to the NIMHD for further development. The informatics team at Spectrum has worked extremely hard and diligently on the development of the NHDRCC. We celebrate our contribution to minority health disparities research, and express gratitude to the healthcare providers, community, policy makers, and scientists who are determined to help fix what is broken in health care for minority communities. Along with the National Health Disparities Research Coordinating Center (NHDRCC), let's build on what works! 6 Journal for Minority Medical Students Spectrum Joins the Fight to End Health Disparities Spectrum Healthcare Diversity & Informatics, publisher of The Young Scientist, was recently awarded a contract through the National Institutes of Health (NIH) under the American Recovery and Reinvestment Act to develop a centralized computer database. This database will enhance our efforts to encourage students to enter and serve in the challenging fields of science, bioscience, and other research areas that allow them to fight and eliminate health disparities. We encourage all those involved in research through NIH to share their experiences with us. For more information, please visit www.spectrumunlimited.com. Medical Students: A Career In Pediatrics Can Open Up New Doors The American Academy of Pediatrics (AAP) has a membership opportunity for medical students. The AAP offers many benefits, both general and specific to medical students, including: Affiliate membership in the Resident Section Free admission to the AAP National Conference & Exhibition (NCE) Discounts on all AAP products and services Pediatrics 101--a resource guide from the AAP Online Resources - An e-newsletter for medical students, - Medical Student Listserv�, - Access to the YoungPeds Network And much, much more! For information please contact us at: email@example.com or call Julie Raymond at (800) 433-9016 ext. 7137 or visit www.aap.org/ypn michigan state university kalamazoo center for medical studies At MSU/KCMS, we realize that being an exceptional physician means having a balance between the personal and professional areas of your life. Our mission is to help you achieve your clinical and academic goals in a truly supportive environment. More than 180 residents take part in our residency programs and have exposure to the broadest range of health care. Our partnership with awardwinning Level One Trauma Centers means that from newborns to the elderly, you will have patient diversity that will allow for you to develop your skills to their fullest. At MSU/KCMS, you will have opportunities to participate in a variety of research projects. We are proud of our numerous awards and grants and our faculty that understands the correlation between great research and great patient care. At MSU/KCMS, with quality of education comes quality of life. Almost half our residents own their own homes in a region that has been ranked as one of the best places in America to live. The "Kalamazoo Promise"--which provides free college tuition for students completing K�12 in the Kalamazoo Public Schools--low cost of living, clean air and an abundance of recreation means your hours outside of MSU/KCMS will be as fulfilling as those inside. Our MissiOn Michigan State University Kalamazoo Center for Medical Studies is a university and community partnership driven by a team of dedicated professionals committed to provide excellence in graduate, undergraduate and continuing medical education, knowledgeable and caring service, and research. Our VisiOn Michigan State University Kalamazoo Center for Medical Studies will excel in providing quality medical education. We will deliver expert, responsive patient care and pursue innovative research. www.kcms.msu.edu � (800) ASK-KCMS Our Values MSU/KCMS offers fully accredited programs in Internal Medicine, Pediatrics, General Surgery, Family Medicine, Psychiatry, Orthopaedic Surgery, Medicine-Pediatrics, Emergency Medicine, Primary Care Sports Medicine Fellowship, and Transitional Year. MSU/KCMS also offers an Osteopathic Traditional Internship and dually accredited AOA/ACGME Family Medicine and Internal Medicine residencies. Compassionate Service Leadership Lifelong Learning Teamwork Commitment to Excellence AAMC perspective The Next Generation of Academic Physicians By Laura Castillo-Page, PhD, and Sarah Schoolcraft any of you may have dreamed of becoming doctors in grade school, while the realization of the possibility came much later for others. You may have been inspired to pursue medicine after being cared for by a compassionate doctor or from witnessing health disparities in your community. Regardless, we're delighted you're interested in the medical profession! Research has consistently shown that diversity enhances medical education, and employing a diverse physician workforce is a useful strategy in achieving healthcare equity. There is still a need for a larger physician workforce, and shortages in some specialties and geographic areas are especially pronounced. However, there are other careers in medicine essential to building a competent physician workforce that are often overlooked. For instance, there is growing recognition to develop a culturally competent and sensitive academic medicine workforce to train the next generation of physicians to address the diverse healthcare needs of our national and global patient population. The Association of American Medical Colleges (AAMC) and the Hispanic Center of Excellence at M Laura Castillo-Page, PhD the Albert Einstein College of Medicine (Einstein-HCOE) have jointly launched an initiative to better prepare students to enter this academic medicine workforce. Their study, "Building the Next Generation of Academic Physicians," is currently in the process of data collection. The researchers have been surveying and interviewing medical students, residents, and faculty Sarah Schoolcraft to investigate personal and professional experiences that have influenced their interest or disinterest in an academic medicine career. In addition, the researchers hope to identify ways in which to enhance professional development training and opportunities for marginalized medical students and residents interested in academic medicine careers. Journal for Minority Medical Students 9 David Geffen School of Medicine at UCLA �� Ranked among the top ten U.S. medical schools*. Ranked among the top ten U.S. medical schools*. �� UCLA Medical Center, judged "Best in the West" and UCLA Medical Center, judged "Best in the West" and in the top five nationally* in the top five nationally* �� More students at UCLA honored with the prestigious More students at UCLA honored with the prestigious McLean and Cadbury Awards than at any other McLean and Cadbury Awards than at any other medical school (Awarded annually by National medical school (Awarded annually by National Medical Fellowships, Inc. to the number one and the Medical Fellowships, Inc. to the number one and the number two graduating minority student in the nation) number two graduating minority student in the nation) � Instruction and mentoring by distinguished, award� Instruction and mentoring by distinguished, awardwinning faculty winning faculty � Research fellowships and training programs � Research fellowships and training programs � Small group sessions, guided by faculty, demonstrate � Small group sessions, guided by faculty, demonstrate the relationship between course material and clinical the relationship between course material and clinical application application � Combined degree programs with other UCLA � Combined degree programs with other UCLA professional schools (Law, Management, Public Health professional schools (Law, Management, Public Health and Public Policy) and Public Policy) � Superior recruitment, retention and graduation record � 2005 Entering Class: 12% African American; 15% Latino and 1% Native American � Strong alumni and mentor network � Affiliated hospitals and clinics providing one of the most broad and diverse medical training programs available � Celebrations of diversity including exhibits, distinguished guest lectures, multi-media and theatrical events, traditional food shares and film festivals � Comprehensive premedical outreach and academic programs � Outreach to designated health manpower shortage areas and communities Excellence Committed to: Diversity *U.S. News and World Report *U.S. News and World Report The Office of Academic Enrichment and Outreach, David Geffen School of Medicine at UCLA, PO Box 956990, Los Angeles CA 90095 (310) 825-3575 www.medstudent.ucla.edu/prospective For additional information contact The best medical education is personal....................come home to UCLA! AAMC perspective Research has indicated that diversity among physician scientists helps broaden the research agenda to focus on diseases disproportionately impacting typically underserved populations. This initiative has received support from organizations such as the Student National Medical Association (SNMA), the National Hispanic Medical Association (NHMA), the Latino Medical Student Association (LMSA), the American Medical Association (AMA) the National Medical Association (NMA), and the Josiah Macy Jr. Foundation. These organizations serve essential roles as platforms to bring students from all backgrounds together to network, obtain information, and provide mutual support. The support of these organizations illustrates the widespread commitment to promote, build, and strengthen the academic medicine workforce, and to ensure health equity for all. As with any career, there are factors that might make academic medicine challenging. Pressure to perform multiple duties (research, teaching, serving on committees, serving as mentors, etc.), might make it difficult to secure grant funding and publish articles. This, in turn, might complicate or prolong the tenure process. Additionally, pressure to pay off student loans makes careers in academia less appealing. However, there are multiple benefits to choosing a career in academic medicine. Participants in the pilot focus group indicated a desire to counteract the persistent paucity of minorities in academic medicine, and increase diversity among all levels of academia. Furthermore, research has indicated that diversity among physician scientists helps broaden the research agenda to focus on diseases disproportionately impacting typically underserved populations.1,2 Members of the pilot focus group indicated that this opportunity was a benefit of a career in academia. Additionally, participants mentioned the importance of having faculty from racial and ethnic minority backgrounds to serve as mentors and role models for aspiring physicians and physician scientists, and expressed pride in seeing a diverse medical school faculty. It is never too late to consider a career in academic medicine! The contributions made to the training of the future generation of physicians, are significant and worthwhile. It is the hope of the AAMC and Einstein-HCOE that institutions will change or create policies to foster diversity among all ranks of academia, that faculty from racial and ethnic minority backgrounds will have a supportive peer group, as well as access to role models and mentors, and that students will be exposed to the benefits of a career in academic medicine. NOTES 1. NIEHS News. Making More Minority Scientists. Environmental Health Perspectives. 1997;105(2). (http://www.ehponline.org/docs/1997/105-2/ niehsnews.html) Accessed April 28, 2010. 2. Powell K. Beyond the glass ceiling. Nature; 448:29-100. Journal for Minority Medical Students 11 A physiatrist is a doctor who treats medical conditions that can cause pain or limit function. Also called physical medicine and rehabilitation (PM&R) physicians, physiatrists provide a full spectrum of care from diagnosis to treatment and rehabilitation to restore maximum health and quality of life. This multidisciplinary specialty approach allows us to treat a wide range of patients from children to adults in an inpatient and/or outpatient setting. The physiatrist diagnoses and treats congenital anomalies, amputations, cerebral palsy, back and neck pain, spinal cord injury and other function limiting conditions. Physiatrists perform electromyography/nerve conduction studies, write prescriptions for physical/occupational therapy, wheelchairs, braces and prostheses; and various types of spine injections. Physiatrists treat conditions of the bones, muscles, joints, brain and nervous system, which can affect other systems of the body and limit a person's ability to function. Example: A 56-year-old man has a stroke, leaving him temporarily unable to work and depressed. His physiatrist designs a comprehensive rehabilitation program, working with a neurologist to evaluate the brain's adjustment to stroke, an occupational therapist to work on regaining motor skills, and a psychologist to help the man cope with his depression. Physiatrists treat people, not just symptoms. By evaluating the impact of a condition on the whole person � medically, socially, emotionally and vocationally, the physiatrist help their patients understand and take control of their health. world CHANGE you let the Bolivia � Ecuador � India � Mexico � South Africa "Sure I got credit for my time in India and the clinical work might help me get into medical school. However, the mentality I have developed, my heightened perception of others, an appreciation of diversity and a newfound patience with life are the most important things I will take away from this experience." Nicole Tierney, Infectious Diseases in Mumbai, India Socially Responsible and Financially Just Global Health Education Programs since1992 Child Family Health International Open to Students of the Health Sciences � � � Clinical Exposure Cultural Immersion Language Training Component in Latin America Service-Learning Opportunities Quality online resources Home stays Expert on-site partners Dedicated staff support � � � � � Apply Online Today www.cfhi.org AMA perspective I did it�you can too! By Dionne Hart, MD, Governing Council, Minority Affairs Consortium I t can be very therapeutic to step back from the busy daily routine of life and take stock of where you've been, where you are, and where you want to go. As I reflect back on my own personal challenges, my accomplishments, and my failures in life, I would hope that my "self-therapy" can also serve as an inspiration to others. At almost age 40, I know about half of what I knew at age 18. At 18, I knew for certain that a) I'd found the man of my dreams, b) I wanted to begin a family, and c) my father had absolutely no clue about anything. I eloped during my first year in college. Three years later, with three babies on one side and my pride on the other, I returned home. My father assisted me as I began to build a life as a single parent and struggling college student. A year after returning home, I graduated with a bachelor's degree in psychology and eventually accepted a position as a mental health worker on a psychiatric unit. I found myself fascinated by the patients and personally fulfilled by providing care to a disenfranchised group. I would try to discuss my observations with the treating psychiatrist, but he'd regularly Dionne Hart, MD dismiss me. I'd watch as patients stood single file in the unit's hallway for their meeting with the psychiatrist as he read a list of possible side effects and completed a checklist. There was no eye contact, no attempt to discover more about the patient's struggle, and absolutely no privacy. I vividly remember one day, I stood in line beside a patient who was struggling in his repeated attempts to start a dialogue with the psychiatrist, who made no effort to listen. When I tried to help the patient communicate his needs, the psychiatrist looked me straight in the eye and said, "If you think you can do it better, then go to medical school." He stood and walked away. I never saw him again, but every day I thank him. He inspired me to stop standing on the sideline and go to the forefront. My father, to my surprise, wasn't that excited about my decision to apply for medical school, since the chances of being accepted and graduating -- with three young children--were marginal at best. But I was determined. I completed the pre-med requisites at night school. After entering medical school with so much idealism I soon was squashed by the demands of rigorous courses and limited time. Luckily, I found daycare on campus so I could attend classes, but finding time to study at night was difficult. When my father realized I was determined to succeed, however, he began to offer daycare assistance while I studied. He was unable to assist financially so I ac- Journal for Minority Medical Students 13 AMA perspective I have dedicated my life to assisting the mentally ill as their advocate, confidante, and medical provider. cepted a service-related scholarship from the National Health Service Corps. My dream was slowly becoming a reality when my father was diagnosed with multiple myeloma. I immediately made an effort to assist in his care while continuing school but later became his full-time caregiver. After his death, I didn't believe I had the strength or support to finish, but to my surprise, many offered to help, and some (like that psychiatrist who told me to go to medical school if I could do better) provided inadvertent motivation through their efforts to dissuade me. With the assistance of so many people, I graduated from medical school and completed a psychiatry residency program at Mayo Clinic. Today, for the first time in my adult life, I live alone as my children pursue their own educational goals. To honor those who showed me compassion and support, I have dedicated my life to assisting the mentally ill as their advocate, confidante, and medical provider. I overcame many challenges to become a psychiatrist, and I believe anyone who wants to follow in my footsteps can do so as well. Remember, be determined, but not hardened; stay strong, but rely on friends and family to help you; and learn the science of medicine, but master the art of patient communication--the true center of doctoring. Dr. Hart is a psychiatrist in practice in Rochester, Minnesota. She is an active member of the American Medical Association and sits on the Governing Council, Minority Affairs Consortium. In August 2010, she will complete her service obligation to the National Health Service Corps. Her children are pursuing careers in healthcare, social work, and criminal justice. AMA Foundation promotes diversity and alleviates debt The American Medical Association (AMA) Foundation is currently accepting nominations for the 2010 Minority Scholars Award. This program is presented in association with the AMA Minority Affairs Consortium, with support from Pfizer Inc. Scholarships in the amount of $10,000 are granted to first or second year medical students from historically underrepresented groups in the medical profession and recognize scholastic achievement, financial need, community involvement and personal commitment to improving minority health. Started in 2004, the program has provided over $600,000 in scholarships to individuals who are dedicated to the elimination of healthcare disparities. How to apply: Applications are available in February, 2011; deadline for submissions is April 15, 2011. Accredited medical schools in the United States can submit up to two nominations per institution. 14 Journal for Minority Medical Students OFFICE OF STUDENT AFFAIRS/DIVERSITY The Medical College of Wisconsin (MCW) recognizes the importance of allowing its medical students the opportunity to exchange ideas with others who have talents, backgrounds, viewpoints, experiences and interests different from their own. To this end, the Medical College is committed to the recruitment, admission and graduation of talented students from diverse backgrounds. SUMMER ENRICHMENT PROGRAMS Academic programs are offered to local high school, resident and nonresident college level students through a series of educational pipeline programs. The Diversity Summer Healthrelated Research Education Program (DSHREP) allows undergraduate, graduate and medical students from diverse backgrounds, the opportunity to engage in a tenweek summer fellowship for students interested in the areas of cardiovascular, pulmonary and hematological research. The program is sponsored by the National Institutes of Health, Lung and Blood Division and offers a monthly stipend to participants. ACADEMIC SUPPORT The Office of Student Affairs/Diversity has implemented several new initiatives to support your successful study here at MCW and to provide enrichment experiences. We have a student counselor who is available to you whenever you need academic, personal or other counseling. We also have our Academic and Career Development Specialist, who provides tutoring in areas such as study skills, testtaking strategies and helps develop a board preparation course, ensuring students' ability to master the basic and clinical sciences. STUDENT SUPPORT GROUPS AND COMMUNITY OUTREACH PROGRAMS Student National Medical Association (SNMA) La Raza Medical Association (LaRaMA) American Medical Student Association (AMSA) Physicians for Social Responsibility (PSR) Applicant Host Program (AHP) MEDICAL COLLEGE OF WISCONSIN AFFILIATED HOSPITALS, INC (MCWAH) The Medical College of Wisconsin Affiliated Hospitals (MCWAH) is a consortium that was established in 1980 to facilitate the administration of Graduate Medical Education (GME) programs conducted jointly by the Medical College of Wisconsin in conjunction with 10 health care institutions in the greater Milwaukee area; specifically Froedtert Memorial Lutheran Hospital and Children's Hospital of Wisconsin are directly located on the campus grounds. In addition, MCWAH ensures the accreditation of its training programs by the Accreditation Council of Graduate Medical Education (ACGME). Currently, MCWAH employs 800 housestaff in 75 accredited residency and fellowship programs. For more information contact Dawn St. A. Bragg, PhD Assistant Dean Student Affairs/Diversity (414) 456-8734 Trenace L. Cole Recruiter/Student Counselor Student Affairs/Diversity (414) 456-8735 email: firstname.lastname@example.org Karen Shanahan, M.S. Ed. Academic & Career Development Specialist Student Affairs/Diversity (414) 456-8583 email@example.com LMSA perspective Educational Debt How it affects the medical workforce diversity and underserved communities By Alvaro E. Galvis T raditionally, many of the health professions student associations have focused on diversifying the healthcare workforce by promoting mentorship and pipeline programs. The basis is to promote one-on-one attention that will lead to the success of students from diverse backgrounds. The ultimate goal is that by diversifying the healthcare workforce, the medical needs of underserved communities will be better addressed. Yet in these efforts many of us have overlooked the impact of finances on meeting this ultimate goal. A 2008 AAMC study on parental income1 of US medical students reported the beginning of an undesirable trend in which the number of matriculates from the top quintile of parental income increased from 50.8% in 2000 to 55.2% in 2005 (Fig.1). Note that this study is based solely on those matriculates reporting their parental income for financial aid purposes. Therefore, those who did not need financial aid presumably come from families that can afford to pay their entire medical education and thus are at a higher bracket of income than the average top quintile on this graph. This skew could potentially create a state in which the medical profession sion will be greatly affected. Another 2008 study by the AAMC2 reported that underrepresented minorities (URM) begin with a disadvantage of increased debt prior to entering medical school. In 2007, 44% of African Americans and 39.2% of Hispanics owed $25,000 or more in premedical school debt. Whites and Asians reported the lowest percentages of overall premedical schools debt, presumably because of the availability of their financial resources from their families. This will greatly impact underserved communities, in that both African-Americans and Hispanics tend to favor at greater rates practicing in an underserved communities in contrast to both whites and Asians. If we look at the educational debt from medical school, the picture gets worse. The cost of medical education in the United States has dramatically increased over the last 30 years, by approximately Alvaro E Galvis 400% at private schools and 250% at becomes elitist and medical graduates will public institutions. The AAMC reported opt out of serving in underserved areas or in 2007, that graduating medical student choosing a primary care specialty. Further- debt was increasing at an annual rate of more, by having medical students coming 6.9% and 5.9% in public and private from the top quintiles of society, the racial schools, respectively3. In contrast, physiand socioeconomic diversity of the profes- cian compensation has modestly increased Journal for Minority Medical Students 17 Major strength lies in the quality of our faculty, residents and students OffIcE fOR DIVERSITy HOUSE STAff AnD fAcULTy AffAIRS Vanderbilt School of Medicine is seeking to bring the best residents, fellows and faculty from all ethnic, racial and gender groups into this great Medical center. As we broaden our reach, you will enrich our environment and make Vanderbilt a leader in promoting people of diverse backgrounds. We invite you to visit Vanderbilt and learn more regarding our training programs or visit our website at www.mc.vanderbilt.edu/gmediversity. U.S. News & World Report listed Vanderbilt Medical center 16th on its 2009 "Honor Roll" of hospitals, a tribute reserved for a select group of institutions labeled the "best of the best." Vanderbilt is the third fastest growing health sciences center in the country in research funding. The Monroe carell Jr. children's Hospital at Vanderbilt has been ranked no. 15 on a listing of best children's hospitals in the U.S. by Parents magazine, the third national accolade earned by the hospital this year. Our office supports the Minority House Staff for Academic and Medical Advancement (MHAMA), an organization of Vanderbilt house staff and advi sors. See website: www.mc.vanderbilt.edu/mhama. contact us by e-mail at firstname.lastname@example.org or call 615-343-7958 Andr� L. Churchwell, MD Associate Professor of Medicine (cardiology) Associate Dean for Diversity in graduate Medical Education and faculty Affairs Vanderbilt University School of Medicine www.mc.vanderbilt.edu/gmediversity LMSA perspective by 2.6% from 2001-2006. This currently means that based on the average physician salary of $216,000 (before taxes), monthly loan payments can represent anywhere from 8.8% (in MEDLOANS) to 14% (Federal Loans) of their income. However, this average physician salary is significantly higher than most primary care physicians earn, which can be 30% less, and significantly lower than most specialties (an average of 16% more). The 2025 projection of overall shortage of 124,000 physicians will not affect medical disciplines equally and it is expected that 37% of the shortage will be in primary care (PC)4, presumably because educational debt is the driving force behind graduating medical students choosing the higher paying specialties. Furthermore, not all communities will be affected equally. Rural and urban underserved communities will be much more greatly impacted than their affluent counterparts, again because of the financial compensation We must begin to promote the idea that education, diversity, and health care cannot be separate issues. 100% 80% Highest quintile Fourth quintile Third quintile Second quintile Lowest quintile 60% 40% What are we to do? 20% 0% A new commitment to advocacy needs to be established by the various health profession associations and its allies (e.g., LMSA, SNMA, AMSA, PAMSA) to oppose any further increase in tuition fees at all levels of post-secondary education, from community colleges all the way to medical school. We must begin to promote the idea that education, diversity, and healthcare cannot be separate issues. Further changes to the recently passed healthcare reform must include increased financial aid via scholarships and grants for students that belong to the lower quintile of income, and increased funding to financial incentive programs in medical education (such as long repayment programs or service-requiring scholarships). Figure 1: Parental Income of Entering Medical Students in U.S. Medical Schools by Quintiles of U.S. Household Income, 1987-2005 REFERENCES 1. Jolly P. Diversity of U.S. Medical Students by Parental Income. Analysis in Brief. Washington, DC: AAMC. 2008 Jan;8(1). 2. Castillo-Page L. Diversity in Medical Education Facts and Figures 2008. Washington, DC: AAMC Diversity Policy and Programs. 2008. 3. Jolly, P. Medical School Tuition and Young Physician Indebtedness. An update of the 2004 Report. Washington, DC: AAMC. 2007 Oct. 4. Dill M, Salsbert E. The Complexities of Physician Supply and Demand: Projections through 2025. Washington, DC: AAMC. 2008 Nov. 1987 1989 1991 1993 1995 1997 1999 Journal for Minority Medical Students 19 2001 2003 2005 Medical Student Programs at Harvard Medical School Boston, Massachusetts VISITING RESEARCH INTERNSHIP PROGRAM (VRIP) Sponsored by the Harvard Catalyst Program for Faculty Development and Diversity, VRIP is an 8-week mentored summer research program open to 1st and 2nd year U.S. medical students, particularly underrepresented minority and/or disadvantaged individuals from accredited U.S. medical schools. VRIP is designed to enrich medical students' interest in research and health-related careers, particularly clinical/translational research careers. VRIP offers students housing as well as a stipend and transportation reimbursement for travel to and from Boston. Applicants must be U.S. Citizens or U.S. Noncitizen Nationals or Permanent Residents of U.S. For more information on Harvard Catalyst programs please contact: Vera Yanovsky, Program Coordinator Phone: 617-432-1892 E-mail: email@example.com Web Site: www.mfdp.med.harvard.edu/catalyst VISITING CLERKSHIP PROGRAM (VCP) Sponsored by the Harvard Medical School Minority Faculty Development Program, VCP is open to 4th-year and last quarter 3rd-year minority medical students in good standing at U.S. accredited medical schools who wish to participate in a clerkship in any discipline at Harvard Medical School (HMS) affiliated hospitals. Housing and financial assistance towards transportation expenses to and from Boston are available. Students are assigned a faculty advisor, provided the potential to network with HMS residency training programs and have access to the medical school library, seminars and workshops. Clerkships are offered year-round. Applications must be submitted 3-6 months in advance of the desired rotation. For more information please contact: Jo Cole, Program Coordinator Phone: 617-432-4422 E-mail: firstname.lastname@example.org Web Site: www.mfdp.med.harvard.edu Program Director: Joan Y. Reede, MD, MPH, MBA Dean for Diversity and Community Partnership Associate Professor of Medicine Harvard Medical School SnMA perspective UAB SNMA Members Mix Haircuts with Healthcare Barbershops provide a relaxed atmosphere for health screenings. Assistant Dean Anjanetta Foster (middle) and medical student Whitney McNeil (right) attend to a patient in downtown Birmingham. D uring her second week as a UAB medical student, Whitney McNeil was performing a blood-sugar check when she got a shock. Instead of providing a numeric value, the glucose meter simply read "high." She alerted her supervisor, who told the patient to go straight to the emergency room. "I was worried that he might not make it," McNeil says. Barbershops provide a relaxed atmosphere for health screenings. Assistant Dean Anjanetta Foster (middle) and medi- cal student Whitney McNeil (right) attend to a patient in downtown Birmingham. The procedure was unusual for another reason- it didn't take place in a medical facility. McNeil's patient was in a Birmingham barbershop. Journal for Minority Medical Students 21 SnMA perspective We found people who hadn't been to a doctor in 30 years. It's not that they don't want to go; there's just no access. This past year, the group conducted screenThis screening and others like it are ings for the Labor Day weekend March for part of a volunteer effort organized by Health Equity in Selma and Montgomery. UAB School of Medicine chapter of the "We found people who hadn't been to a Student National Medical Association (SNMA). The chapter conducts communi- doctor in 30 years. It's not that they ty-based health screenings for hypertension don't want to go; there's just no access," McNeil says. and diabetes, and its members counsel the At the barbershop screenings, most public about preventing and treating these common, sometimes avoidable conditions. people have health insurance, "but they SNMA members often seek locations often have health concerns they just don't like barbershops and beauty salons--places want to think about," McNeil says. "We help open their eyes and make them realize where people "just relax and hang out," says McNeil, the SNMA chapter president. they need to see a doctor." The students point out opportuniThere the doctors-in-training also find a ties for free and low-cost health care, such ready audience of mainly African-Amerias the M-Power Clinic, which involves can patrons, owners and employees. And it provides a less intimidating ex- volunteers from the SOM's Equal Access Birmingham group. They also steer highperience for patients, who often feel more risk patients to the emergency room, as at ease with a doctor of their own race, Foster did at a recent screening where two says Anjanetta Foster, MD, assistant dean women were found to have near strokefor diversity and multicultural affairs, who level blood pressure. also volunteers. "Blacks are disproportionately affected by the consequences of high blood presEncouraging diversity sure," says Foster. "We often see a lack of The SNMA also organizes the annual understanding about how to treat it or why Teen Summit for more than 100 Birmingit should be treated." ham-area high-school students. The oneThe student outreach brings care to day event includes preparation assistance individuals who rarely, if ever, receive it. for the ACT college entrance exam, meetings with college representatives, and a forum with doctors, lawyers and other professionals. The summit's broad goal is to prepare teens for college, but it also helps dispel any doubts about pursuing a healthcare career. "We've had teens say, `I was told by a counselor that I should become an engineer, but I've always wanted to be a doctor,' " says Foster, who works to identify, recruit, and retain minority medical students. Without this experience, a potential physician could have been lost, she says. McNeil, who grew up in Birmingham, says these activities "changed how I think about medicine." She feels that the group is making a definite difference in the city. "We're the ones who need to make people aware of what's going on in these communities," she says. "If we don't do it, who will?" Foster agrees: "If the students go out and affect one person's life, they can say, `I've accomplished something today.'" 22 Journal for Minority Medical Students AMSA perspective Health Equity Leadership Institute 2010: Preparing Future Physicians to become Future Leaders By Drew Lee, AMSA Race, Ethnicity, and Culture in Health (REACH) Education Coordinator i n the midst of our busy schedules and academic lives, 21 medical and premedical students gathered in Washington DC to explore topics in health equity at this year's Health Equity Leadership Institute (HELI). I was fortunate to be one of the few individuals selected to participate in this three-day crash course on medical advocacy, in which I learned various advocacy skills and formed lasting friendships with others who share a similar passion for health equity as I do. Like many of my peers, I entered medical school in order to become an advocate for my patients. I began my first day of medical school excited to explore topics in health equity and social justice, only to quickly find out that the topics I wished to cover and the skills I wished to develop were often beyond the scope of the medical curriculum. As a result, I began reading up on the literature, attending various talks, and getting involved wherever I could. I felt it was important patients in the future. However, without any specific direction, I found myself overwhelmed by the amount of issues that needed to be addressed, and I wanted to know what else I could do to become a better, more efficient advocate. This is when I came across the HELI application. For those who may be in a similar situation as I was, I would like to share a glimpse of what I learned during this oneof-a kind experience. Advocacy Requires a Little Courage Drew Lee to develop the necessary knowledge and skills now, in order to become the best physician-advocate I can be for my Even before arriving in Washington, DC, I could tell I was going to learn a lot at HELI by the amount and content of the homework we received in preparation for the institute. We were assigned to read several articles, watch PBS's Unnatural Causes, approach our deans to obtain funding to attend HELI, as well as participate in a webinar to learn about H.R. 3090: Health Equity and Accountability Journal for Minority Medical Students 23 AMSA perspective Act. Though these assignments were not incredibly difficult, we would soon find out that we would be lobbying for H.R. 3090 on Capitol Hill as the first activity of HELI! Although this was my second time lobbying, I could not help feeling a little anxious as we prepared our short spiel on why we need to increase funds for health equity. However, once we arrived on Capitol Hill and began talking with the staffers, the tentativeness quickly disappeared as it became apparent how much the staffers valued our perspective. Naturally, we began recalling different incidents of health inequities that we have personally experienced and have seen in the lives of our patients. As different members of our team told their stories, I could sense how much they also cared about health equity, and Lobby Day reminded me once again of the importance of the dialogue between medical professionals and policymakers in affecting change that will have a real world impact. While most people would agree that health inequity in our medical system is not a good thing, without a general knowledge of cultural competency and general principles such as health disparity vs. inequity, it is often difficult to recognize and eliminate these inequities in the clinical setting. Although it is impossible to become an expert on every single different ethnic and cultural group in the world, one of the key concepts in cultural competency that I gained through HELI was to avoid what novelist Chimamanda Adichie referred to as the "single story" (TEDBlog: http://blog.ted.com/2009/10/ the_danger_of_a.php). According to Adichie, the "single story" is dangerous as it does not take other viewpoints into consideration; but rather, interprets everything through a single lens, creating the risk for misunderstanding and in the clinical setting, the risk for negative health outcomes. Moreover, without the proper knowledge and research, even our best intentions can have negative effects. Without understanding the strengths and needs of the communities we work in, we can often create more problems for the community through our efforts. As a result, we learned about Community Asset Mapping and Participatory Models in order to engage communities, and work together for change. Advocacy Requires Knowledge AMSA perspective Advocacy Requires networking Needless to say, I think passion was a common characteristic among all the HELI participants. While some of us were passionate about ethnic inequities in health, others were fervent about topics in socioeconomic status, sexual orientation, immigration, and linguistic barriers. I was fascinated by all the different projects everyone was involved in, and it really reassured me that, even through the rigors of medical school, I can find the time to be a patient advocate. However, it is important to realize that passion without direction can lead to burnout with very little to show for one's efforts. One way to avoid this is to network with other people who share a similar interest for health equity, rather than approaching these complex issues on your own. At HELI, we learned many wonderful ways to network, and I realized that networking is an essential component to efficiently solving issues in health inequities. Without networking, health inequities are often too complex and multifaceted for any one individual to solve. But through collaboration, we can move several steps closer to making the world a better and more equitable place to live. In the end, HELI ended up being what I needed to develop the necessary skills to become a better advocate. I am extremely thankful to all the supportive deans and professors at Loyola University Chicago Stritch SOM and the Department of Preventive Medicine and Epidemiology who provided a significant portion of the funding for me to attend HELI. For those who may be passionate about health equity and want to take the next step to becoming a better advocate, I highly recommend taking advantage of this wonderful opportunity before the end of your medical education. Drew Lee is a MSIII at Loyola University Chicago Stritch School of Medicine where he is pursuing a dual MD/MA degree in Medicine and Bioethics and Health Policy. He is currently involved with several projects in health equity, global health and preventive medicine. In 2010-2011, Drew will be serving as AMSA's Medical Education Coordinator for the Race, Ethnicity, & Culture in Health (REACH) Action Committee. Cincinnati Children's Hospital Medical Center A National Leader in Pediatrics The Cincinnati Children's Pediatric Residency program is dedicated to quality education; outstanding patient care; innovative discovery through clinical, laboratory, and outcomes research; and advocacy for their patients and families. You'll have the opportunity to work sideby-side with excellent residents and faculty from all over the world, and with a variety of patients from all different ethnic and socioeconomic backgrounds. The large number of subspecialty programs at Cincinnati Children's allows the medical center to attract a wide variety of patients, and their patient volume ensures that your experience as a resident is comprehensive. In fact, almost every aspect of a residency at Cincinnati Children's can be tailored to meet an individual's needs. Each year they train approximately 175 residents in a variety of programs: �Categorical Pediatrics Pediatric Primary Care Track Pediatric Research Track Global Health Track �Internal Medicine / Pediatrics �Physical Medicine and Rehabilitation / Pediatrics �Psychiatry / Child Psychiatry / Pediatrics (Triple Board) �Human Genetics / Pediatrics �Neurology / Pediatrics For more information: www.cincinnatichildrens.org "The Cincinnati Children's Pediatric Residency Program provides you with the opportunity to work side-by-side with excellent residents from all over the world. You will work within all areas � from primary to quaternary care � with a variety of patients from different ethnic and socioeconomic backgrounds. We are unique in our individualized attention to each one of our resident's needs and our dedication to family-centered care in our daily work. Upon graduation our trainees enter outstanding fellowships and primary care positions throughout the country. We look forward to answering any of your questions and making this the best experience in your professional career." Javier A. Gonzalez del Rey, MD, M.Ed. Director, Pediatric Residency Training Programs T HE M OUNT S INAI S CHOOL OF M EDICINE ' S C ENTER FOR M ULTICULTURAL & C OMMUNITY A FFAIRS AND THE G RADUATE M EDICAL E DUCATION C ONSORTIUM VISITING ELECTIVES PROGRAM FOR STUDENTS UNDERREPRESENTED IN MEDICINE (VEPSUM) VEPSUM offers four-week electives at Mount Sinai School of Medicine (MSSM) and its affiliates in the Graduate Medical Education Consortium to qualified 3rd-year and 4th-year medical students who are from groups underrepresented in medicine1 and who attend U.S. accredited medical schools. In collaboration with the MSSM Center for Multicultural and Community Affairs, VEPSUM is designed to increase diversity in the house staff and subsequently the faculty of the Mount Sinai School of Medicine and its affiliated institutions. Electives are available between July and February. Students must have completed their required core clerkships before starting the program. Tuition is not charged. Housing and travel expenses are subsidized for one month. Students are provided the potential to network with residency program directors, residents, minority faculty, and students, and have access to the Office of Graduate Medical Education, Center for Multicultural and Community Affairs, medical school library, seminars, and workshops. To learn more about VEPSUM and the application process, please visit: http://www.mssm.edu/about-us/diversity/initiatives/visiting-electives-program We look forward to receiving your application and to having you visit with us! For more information please contact: Adam Aponte, MD, MS at email@example.com Monique Sylvester, MA at firstname.lastname@example.org 1 The Association of American Medical Colleges (AAMC) defines groups underrepresented in medicine "those racial and ethnic populations that are underrepresented in the medical profession relative to their numbers in the general population." THe suRGeON GeNeRAL's rePort Finding My Way to electronic Health Records By Regina M. Benjamin, MD, MBA VADM, USPHS T he recent oil spill off the Gulf Coast may prove to be one of the great environmental challenges of our lifetime. It is yet another devastating blow to the Gulf region, a place I call home. My heart goes out to the people there who are concerned about how this latest disaster will affect their livelihood and their health. Though the full effects of the spill remain to be seen, already the health needs of Gulf Coast inhabitants are increasing during this time of crisis. Physicians in the area will need to adapt and find innovative ways to efficiently deliver health care for an already underserved population. I recall my experiences as a physician during the crises of Hurricanes Georges and Katrina and try to remember how I adapted. The day after Katrina hit, I drove through Bayou La Batre, a small fishing village on the Gulf Coast where I practiced medicine for 23 years. The damage didn't look so bad when I pulled up to my clinic. However, when I opened the door, I nearly fell sick from the smell of dead fish and crabs. Furniture had been tossed around the office every which way. All the patient information--all the paper records--were ruined. I remember thinking that I had tried to prepare for this kind of crisis and recalled that I had strongly considered moving to electronic health records (EHRs). But money was tight, as it was for many small practices throughout the country, and it eventually came down to a choice: I could either install an EHR system or pay the electricity bill. Searching for a source of courage, I recalled the reasons I had chosen to become a family physician. Like many physicians just out of school, I believed strongly in primary care--my mother, father, and brother had all died of preventable diseases. As a National Health Service Corps scholar, I now had the privilege of making a difference in a small community. Bayou La Batre was my assignment. I was familiar with the town, since I had grown up in nearby Daphne, where my family has been since the early 1800s-- the Seafood Capital of Alabama, a shrimping town, where people made their living on the water. But the seafood industry had been hurting, which meant that there was little money for health insurance or out-of-pocket copayments, and more important, that there weren't enough primary care physicians. Many of my patients spent most of their time on the boats, going out for two months at a time. Skipping from coast to coast was part of their job. I remember one patient who had been out for nearly three weeks and had used superglue to treat a gash on his hand. My patients had Surgeon General Regina Benjamin to improvise, and they had few medical options for managing their illnesses, whether acute or chronic. I felt I had arrived in the right place at the right time. Well, perhaps it wasn't exactly the right time. In 1998, Hurricane Georges made landfall in the Gulf Coast, causing over $100 million in damage to Alabama alone. My clinic was destroyed. Without a building in which to treat patients, my nurse Nell Bosarge and I spent the next two years driving my pickup truck to their homes. Eventually, I mustered the resources to rebuild the Bayou La Batre Rural Health Clinic-- on higher ground this time, and on four-foot stilts. Meanwhile, we managed to save the drenched paper records of our patients by carefully drying them in the hot Alabama sun. In 2005, Hurricane Katrina came, again threatening to destroy the Bayou La Batre Rural Health Clinic. We had 48 hours to evacuate the area and, given Journal for Minority Medical Students 27 the new secure location of the building, saw no reason to pack away all the paper medical records. When I returned to the Bayou, the building had been destroyed by the water. Nell and I knew we had to get everything out of there, or else it would mildew. We spent just as much time clearing out the medical records--again placing them in the sun in 90-degree weather to dry them, carefully turning them over--as we did trying to salvage the structure of the place. This time, I could not make house calls to my patients' homes, because the vast majority of their homes had been destroyed, too. Our staff set up a makeshift clinic in the auditorium of the local shelter, while volunteers and donations helped us prepare for a January 2 reopening. Tragedy befell the Bayou Clinic once again, when, in the early morning hours of New Year's Day, just before our clinic was to reopen, a fire broke out and the clinic burned to the ground. This time, the precious records, the ones that Nell, the staff, and I had spent hours drying and recovering on two separate occasions, were completely destroyed. We were forced to rely on memory and intuition in treating our patients. Any information on allergies, coexisting conditions, and specific family history was now left to recollection. Having lost the Bayou Clinic three times, I knew we had to have a better way of practicing. I needed to find a way to deliver high-quality health care to people who didn't have a lot of money. From the experiences with the hurricanes and the fire, I knew we had to be able to evacuate the clinic quickly, while still safeguarding the vital patient information. Whereas I had previously decided against installing an EHR system because I couldn't afford one, I now realized I couldn't afford not to have one. Our trials did not go unnoticed. Wonderful people from all over volunteered their time and money to help us rebuild. A generous donation from a private foundation supported our efforts through the Katrina Phoenix program, helping us rebuild our clinic with computer hardware, in coordination with a generous EHR vendor and with the help of good-hearted student volunteers from Bentley College in Waltham, Massachusetts. They also provided us with support, teaching us how to use the system and helping to implement it in our practice. Needless to say, Nell and I were relieved when we turned on the switch and became a paperless office. Though it is challenging to persuade some doctors and nurses to convert from paper records, "buy-in" was not an issue at the Bayou Clinic, since Nell and the rest of the staff were adamant about never having to "bake charts in the sun" again. The new system we implemented allowed us to easily track and document our patients' histories; with a click of a button, we could send a prescription or remind patients of upcoming mammograms, thus improving the quality of care. Practicing medicine became easier for the clinicians and better for the patients. With the availability of new incentive payments made possible by the Health Information Technology for Economic and Clinical Health Act (HITECH), and assistance for the transition to electronic health records available from regional extension centers, small practices like mine now have the kind of support that I had -- and fewer reasons to delay a decision that should have been obvious long ago. Until the day we turned on our EHR system, I was still using pens with waterproof ink. It is a very good thing for both me and our patients that my fellow physicians and I don't need to use those pens anymore. This article was originally published on July 13, 2010, at NEJM.org. 28 Journal for Minority Medical Students The School of Medicine at the University of Alabama at Birmingham offers you more than a world-renowned medical curriculum. We also provide you with opportunities to succeed. Our Office of Minority Enhancement was created specifically to help students like you to make the most of your education and enjoy all of the advantages of medical school. Call us, and find out more about: our special programs, including combined M.D./Ph.D. and M.D./M.P.H. degrees, the Early Decision Plan, and the Summer Health Enrichment Program (UAB-SHEP), which prepare you to enter medical school. financial assistance, assistance in securing research and clinical opportunities, counseling and support for academic and personal concerns, tutorial programs, and liaison activities among the School of Medicine, minority students, and medical organizations. For more information about our minority programs, please call 1-800-707-3579, ext. 6 today. Or write: Office of Diversity and Multicultural Affairs The University of Alabama School of Medicine 1530 3rd Avenue South, VH 102K Birmingham, AL 35294-0019 Visit our web site: http://medicine.uab.edu Standing, from left: Sandrine Niyongere, MSII, Ezinne Okwandu, MSII, Alexis Mason, MSII, Whitney McNeil, MSII. Seated, Justin Jackson, MSII. Make The Commitment To Medical School, And We'll Make The Commitment To You. UAB is an equal education opportunity institution. 49 Journal for Minority Medical Students Journal for Minority Medical Students 29 Excellence. Persistence. Success. The Class of 2010 W ake Forest University School of Medicine and North Carolina Baptist Hospital comprise one of the major academic medical centers in the United States. We extend congratulations and our best wishes for continued success to the Class of 2010. Elfriede A. Aygemang Internal Medicine Mayo School of Graduate Medical Education Rochester, MN Diandra N. Ayala Medicine - Preliminary and Radiation Oncology Wake Forest Baptist Medical Center Winston-Salem, NC Jewell P. Carr Family Medicine Carolinas Med Center Charlotte, NC Demaura K. Hawkins Family Medicine CMC--Northeast Medical Center/Cabarrus Concord, NC Mikhail C. S. S. Higgins Transitional St. Joseph Hospital Chicago, IL and Radiology-Diagnostical/Clinical-4yr Hospital of the University of Pennsylvania Philadelphia, PA Nichole L. Johnson Family Medicine/Urban Carolinas Med Center Charlotte, NC Seon B. Kum Anesthesiology Wake Forest Baptist Medical Center Winston-Salem, NC Steven J. Newton Family Medicine Moses H. Cone Memorial Hospital Greensboro, NC Ugonna T. A. Nwankwo Medicine - Pediatrics University of Pennsylvania Medical Center Pittsburgh, PA Bamidele A. Olatunbosun Surgery - Preliminary University of California San Francisco - East Bay Oakland, CA Cheryl N. Onwuchuruba Obstetrics-Gynecology University of Tennessee Graduate School of Medicine Knoxville, TN David M. Seif Anesthesiology Wake Forest Baptist Medical Center Winston-Salem, NC Nanna H. Sulai Internal Medicine Mayo School of Graduate Medical Education Rochester, MN Cortney C. Wilson Pediatrics NCC Bethesda Bethesda, MD HEALTH DISPARITIES NiH seeks to Break New Ground in reducing health Disparities The National Institutes of Health (NIH) recently launched a multidisciplinary network of experts who will explore new approaches to understanding the origins of health disparities, or differences in the burden of disease among population groups. Using state-of-the-science conceptual and computational models, the network's goal is to identify important areas where interventions or policy changes could have the greatest impact in eliminating health disparities. The Office of Behavioral and Social Sciences Research (OBSSR), part of NIH, is contracting with the University of Michigan's School of Public Health, Ann Arbor, to establish the Network on Inequality, Complexity, and Health (NICH) Comprised of scientists with expertise across disciplines, including economics, biology, ecology, computer science, education, sociology, mathematics and epidemiology, NICH will be the first network to apply systems science approaches to the study of health inequities. Systems science methods enable investigators to examine the dynamic interrelationships of variables at multiple levels of analysis (e.g., from cells to society) simultaneously. They also study the impact on the behavior of the system as a whole over time. For example, factors such as access to health care, neighborhood environment, educational opportunities, physiology, and genetics all may interact over the course of a person's life to influence risk for diseases such as diabetes and cardiovascular disease. rePort Access to health care, neighborhood environment, educational opportunities, physiology and genetics all may interact over the course of a person's life to influence risk for diseases such as diabetes and cardiovascular disease. Besides exploring hypothesized causes of health inequalities, these simulations may reveal unexpected causes, and help researchers predict better which interventions have the most potential for reducing or eliminating health disparities. The computational models function as computer-simulated laboratories in which to probe the causes of health disparities, as well as their solutions. "NICH brings together scientists from many different disciplines to create a new conceptual approach for examining the behavioral, social, and biological factors which interact to cause inequalities in health," said Deborah H. Olster, PhD acting director of OBSSR. Led by chair and principal investigator George A. Kaplan, PhD at the University of Michigan School of Public Health, NICH's primary goal is to catalyze groundbreaking research on health disparities and population health using systems science methods. NICH will foster areas of health disparities research that are receptive to using a systems science approach. "Much of the health disparities research conducted to date took place within single disciplines, and therefore could not comprehensively approach the multitude of factors that are involved. NICH will fundamentally change this approach by embracing perspectives from the biological to the societal, while employing cutting-edge simulation methods from computer science," Kaplan said. The network will foster collaborative research, which builds bridges between disciplines interested in health disparities and complex systems research. NICH will produce reports and publications, including possible books or special journal issues, on the collaborative work of network members and other experts. Publications will focus on breaking new ground by illustrating, explaining, promoting and translating the application of complex systems approaches to critical health disparities areas that require transdisciplinary development. To learn more about how I got 100% tuition coverage, a sign-on bonus of $20,000, and $1,907 a month with the Navy Health Professions Scholarship Program (HPSP) while going to medical school, visit navyhealthcare.com The Navy landed me here. � 2008. Paid for by the U.S. Navy. All rights reserved. HEALTH DISPARITIES | rePort Morehouse school of Medicine ranks #1 in Newly Released study on social Missions The study, funded with a grant from Morehouse School of Medicine ranks number one in the country in the first-ever the Josiah Macy, Jr., the first to score all U.S. medical schools on their abilstudy of all U.S. medical schools in the area of social mission. The ranking comes ity to meet a social mission, shows wide variations among institutions in their as a result of the emphasis MSM places production of physicians who practice on primary care and serving underserved communities--a role the study emphasizes primary care, work in underserved areas, and increase diversity in the medical field. as critical to improving overall health care "Where doctors choose to work, and what in the US. specialty they select, are heavily influ"This ranking is an acknowledgeenced by medical school," said lead author ment of the hard work and dedication of Fitzhugh Mullan, MD, a GWU professor our faculty, staff, and students and goes of health policy. "By recruiting minority to the very core of what MSM has stood students and prioritizing the training of for from the very beginning: building a primary care physicians and promoting healthier America by focusing on those practice in underserved areas, medical communities with the biggest health schools will help deliver the health care challenges," said MSM President John E. that Americans desperately need." Maupin, Jr. , DDS. "Morehouse School of Medicine was established to recruit and train minority and other individuals from disadvantaged backgrounds, as physicians committed to the primary health care needs of the undeserved in Georgia and the nation," said Sandra Harris-Hooker, interim dean and senior vice president for Academic Affairs, vice president and senior associate dean for research. "This study emphasizes the importance of what we do every day at MSM to meet the health care needs of those most vulnerable." The researchers examined data from medical school graduates from 1999 to 2001 and developed a metric called the social mission score to evaluate medical school output. The measurements used were the percentage of graduates who practice primary care, work in health professional shortage areas, and are underrepresented minorities, then combined into a composite social mission score. Key findings from the study of 141 medical schools include: �public and community-based medical schools graduated higher proportions of primary care physicians than did private and noncommunity-based schools; �schools in progressively smaller cities produced more primary care physicians and physicians who practiced in underserved communities, but they graduated fewer minorities; �osteopathic schools produced more primary care physicians than did allopathic schools, but also trained fewer minorities; �for the most part, schools with substantial NIH research funding produced fewer primary care physicians and physicians who went on to practice in underserved areas and had lower overall social mission scores; & Erica Shantha, a second-year medical student at Morehouse School of Medicine, takes a patient's blood pressure at the triage unit at the mobile clinic during a trip to Haiti with Project Medishare. Photo by Jennifer Browning. 34 36 Journal for Minority Medical Students Journal for Minority Medical Students �schools in the Northeast performed poorly on all three goals and had the lowest social mission scores of any region in the country. The Careers Issue If you've wanted to be a doctor since you were a kid, you likely pictured yourself working in your community, doing everything from setting a broken arm to managing a challenging case of diabetes or CVD. now that you're in medical school, things might have changed. Every time you sign a piece of paper that says you owe a huge chunk of future earnings to a bank you've never heard of--$100,000, $250,000, $400,000?--it means you've got to think seriously about how you're going to pay that money back, and that often means specializing. But the need for primary care physicians is growing, just like med school debt levels. What's the answer? It's complicated, as you well know. Read on to find out more about your options and how people just like you are navigating the waters of change. We know you'll find a way to have the career you've always dreamed of. Doctor RULES: Six important things to know about your future medical practice By Rob Lamberts, MD They don't want to be at your office Rule 1: It may seem odd to patients, but most doctors forget that going to the doctor is generally unnerving. We work there, and being in a doctor's office is normal to us. Not so with most patients. The spotlight is on them and their health. They stand on the scale, undress, tell intimate things about their lives, confess errors, are poked, prodded, shot with needles, lectured at, and then billed for the whole thing. Yes, it seems that some patients are happy to be there--and I do my best to make my patients feel comfortable, but there is always an underlying fear and self-consciousness that present when a person is sitting on the exam table. The best thing to do in response is to show compassion. If you feel awkward, scared, or self-conscious, the thing you most want is for someone else to understand how you feel. Patients are much more likely to follow a doctor's advice when they feel the doctor understands. Identifying the fear and relating to it are the first steps at building trust. They have a reason to be at your office It took me being in my own practice (and trying to keep my business going) to realize that there was (almost) always an underlying reason for a patient to come People don't like to waste time and in. Sometimes that reason is simple: they money. They don't come to the office to need an excuse from work, or they have waste the doctor's time. Yet early in my terrible pain that needs to be treated. Othtraining I was incredulous at the reasons er times, however, the reason is more some of my patients were coming to see subtle. When a person comes to my office the doctor. Why come in for a headache? Why come in for a cold? Doesn't the with enlarged lymph nodes, for example, person realize that a stomach bug won't get the real reason they are coming in is that they are afraid it is cancer. When patients any better by coming to the doctor? Rule 2: 36 Journal for Minority Medical Students have chest pain, they are afraid it is their heart. On every visit I try to identify the real reason (or the real fear) that brings them to see me. I don't end the visit until I have addressed that reason. If they have an enlarged lymph node, I make sure to say, "I don't think this is cancer because...." If they come in with chest pain, I say "This doesn't sound like a heart attack because....." If I fail to do so, then they leave the office with the fear and feel ignored. Rule 3: They feel what they feel of fear that you won't hear them for lesser symptoms, but then your job is to uncover the anxiety, not ignore the complaint. I have heard from many patients that their doctor "did not believe" their complaints because they did not make sense. If you don't trust them, why should they trust you? If symptoms seem to contradict what I know to be possible, I often openly tell them that this seems to contradict. But I make sure I don't imply that they might not be telling the truth. A puzzle is a puzzle. It is my job to undo a seeming contradiction. I may not ever be able to do so, but at least I don't make them feel bad for feeling what they feel. weeks. Here I was, a few months out and couldn't even lie down in bed. I felt like a wimp. Was this other guy just tougher than me? My orthopedist made me feel much better when he explained that my colleague had a mid-shaft fracture, while mine was right in the shoulder joint--a much slower place to heal. Patients will often tell me their symptoms in a very apologetic tone. They seem to think that they have to come to me with the "right" set of symptoms, and not having those symptoms is their fault. Sometimes those symptoms make no sense to me at all and I am tempted to dismiss or ignore them. But as a physician, you have to trust your patient. Only the really crazy patients make up symptoms. Yes, some may exaggerate what they feel out of anxiety or out Rule 4: They don't want to look stupid I remember when I broke my shoulder--a compression fracture of the neck of the humerus bone--and went to the orthopedist office. I always felt self-conscious about how much pain I was reporting. A colleague had fractured his humerus the year before and had reported he was back to doing surgery within a few Journal for Minority Medical Students 37 I try and give a plan, either verbal or written, to each patient that walks out of the exam room. They pay for a plan This event made me realize how many they have an ear infection the plan is to use Rule 6: patients felt when they came into my office. an antibiotic (maybe) and treat the pain. If they have abdominal pain, the plan may be People are often worried that they are With all of the stresses in a doctor's much more complex. They want to know over-reacting. They wonder what I must office, I get tempted to complain about what is going to be done, and that it is think for a person to come to the office things. Who better to complain to than going to help. with that symptom. This is especially true someone who feels much the same way? I try to give a plan, either verbal or of parents bringing their children in. NoBut patients are paying for you to take written, to each patient that walks out of body wants to be "that mother that overcare of their problems, not the reverse. I the exam room. What medications are reacts to everything." In response to this, I keep my personal gripes or frustrations to given and why? What medications are to try to say specifically, "I am glad you came myself as much as possible. be stopped? What tests are ordered and to the office for this because..." or "Yeah, what will the results mean? When is the I can see how that worried you because it next appointment? What should they call could be...." for if they have problems? The better I can Dr. Rob Lamberts is a primary care practitioner Rule 5: with a practice in Georgia. He is board certified answer these questions, the more confidently the patient will walk out of the exam in Internal Medicine and Pediatrics. You can follow his blog, Musings of a Distractible Mind, room. The days of paternalistic medicine What do people pay for when they at http://distractible.org. are over--no handing a prescription and come to the medical office? They pay for just saying "take it." Patients should know opinion, yes. They pay for knowledge as why they are putting things in their body. well. But what they really pay for is a plan of action based on their circumstances. If The visit is about them 38 Journal for Minority Medical Students PrIMArY cAre: A day in the life recent issue of the New England Journal of Medicine chronicled the day-in, day-out work of an internist Dr. Rich Baron and his five-person Philadelphia practice. Here's the breakdown to give you an idea of a typical "day in the life." A On top of these daily visits, each physician also: � Made 24 telephone calls � refilled 12 prescriptions (an underestimate, since the number doesn't count refills done during an office visit and because the refilling 10 meds for a single patient counted as one refill) � Wrote 17 e-mails to patients � looked at 11 imaging reports � reviewed 14 consultation reports. each of the physicians in his practice conducted 18 patient visits per day (a total of 16,640 visits over the year for the practice) After Baron's practice analyzed the data, they decided to redefine a "full-time physician" as one with 24 scheduled visit-hours per week, embedded in a 50-hour workweek. Put another way, doctors in Baron's practice can expect to spend half their time on office visits with patients, and the remaining half on non-visit administrative (paper/computer/telephone) work. Median compensation for Selected Specialties Family Practice (without oB) Internal Medicine * Pediatric/Adolescent Medicine* 2009 $183,999 $197,080 $191,401 Inflation Adjusted change 2008-09 2005-09 2.77% 4.21% 3.44% 1.86% 2.92% 4.22% Data from Physician Compensation and Production Survey: 2010 Report Based on 2009 Data Source: Medical Group Management Association Journal for Minority Medical Students 39 Primary Care Primary care physicians earn the lowest salary of all physicians, according to the medical search and consulting firm Merritt Hawkins & Associates' 2010 Review of Physician Recruiting Incentives. Why do primary care docs make less than specialists? It all comes down to simple economics: less money in, less money out. 1 2 3 4 5 A Merritt Hawkins survey ing: With nearly 30 perof hospital revenues showed cent of California's phythat of the 114 hospitals sicians more than 60 surveyed, primary care physi- years old, more doctors are cians brought in an average nearing retirement here than of $225,383 less per in any other state. year than specialists. � � Massachusetts has the Family practitioners highest ratio of doctors per earned $16,000 less in population in the country, 2009 than certified regisbut the state's health care tered nurse anesthetists. law (that mandates near� universal coverage) makes it The American Medihard for residents to find a cal Association predicts a primary care physician who shortage of 35,000 to is accepting new patients. 40,000 primary care physi- Last year 60 percent of cians by 2025. family medicine doctors' � offices were acceptSix out of nine regions in ing new patients, down California have a shortage of from 70 percent in 2007. primary care physicians, and Last year only 44 percent of the problem may be worsen- internal medicine practices Compare | $180,000. . . . . . . . . . . . . pediatricians $175,000. . . . . . . . family practitioners To | $519,000. . . . . . .orthopedic surgeons $400,000. . . . . . . . . . . . . . . . . urologists 40 Journal for Minority Medical Students By the numbers were accepting new patients, down from 66% in 2005. � Department of Health and Human Services Secretary Kathleen Sebelius announced $250 million schools were considering a career in adult primary care. � Among the seven nations studied in a recent Commonwealth Fund reportreport (Australia, Canada, Germany, the netherlands, new Zealand, the United Kingdom, and the United States) the worth of new investments designed to support the training and development of more than 16,000 new primary care providers over the next five years. The investments were mandated by the Affordable Care Act, that controversial health care bill signed into law by President Obama in March. � A 2007 survey showed that only 7% of fourth-year students at 11 U.S. medical U.S. ranks last overall and fails to achieve better health outcomes than the other countries on dimensions of access, patient safety, coordination, efficiency, and equity. It all comes down to simple economics. Journal for Minority Medical Students 41 What does the new DhhS primary care funding cover? secretary Kathleen sebelius announced $250 million worth of new investments designed to support the training and development of more than 16,000 new primary care providers over the next five years. The investments were mandated by the Affordable Care Act, the health care bill signed into law by President Obama in March. "These new investments will strengthen our primary care workforce to ensure that more Americans can get the quality care they need to stay healthy," sebelius said. "Primary care providers are on the front line in helping Americans stay healthy by preventing disease, treating illness, and helping to manage chronic conditions. These investments build on the According to HHs, the investments will be used as follows: �creating additional primary care residency slots: $168 million to train 500 new primary care physicians by 2015 �Supporting physician assistant training in primary care: $32 million to train 600 new physician assistants, who practice medicine under the supervision of a physician, and can be trained more quickly than a physician �encouraging students to pursue full-time nursing careers: $30 million to encourage 600 nursing students to attend school full-time which will increase the likelihood they complete their education �establishing new nurse practitioner-led clinics: $15 million to cover operating expenses for 10 health clinics that help train nurse practitioners. The clinics will be located in medically underserved communities. �encouraging states to plan for and address health professional workforce needs: $5 million to fund state programs designed to expand their primary care workforce by 10-25% over the next 10 years. Recently, Department of Health and Human services Administration's strong commitment to training the primary care doctors and nurses of tomorrow and improving both health care quality and access for Americans throughout the country." in addition, the Health Resources and services Administration will direct some federal dollars towards repayment of the loans held by medical school graduates who choose to practice primary care in medically underserved communities. Grants will also be given to community colleges, Hispanic-serving institutions and historically black universities, which were recently ranked as the top producers of primary care doctors. students will be able to tap new financial aid, and health professionals working in underserved areas will get expanded tax benefits. 42 Journal for Minority Medical Students Why is this med student smiling? Photo courtesy of Vanderbilt University SOM Because she just found out she can contribute to the Journal. So can you--find out how! email@example.com How do community health centers fit into the new health care law? The first Community Health Centers (CHCs) billion to expand to serve nearly 20 million new were launched in 1965 as patients while adding an estimated 15,000 provida component of President ers to their staffs by 2015. Lyndon Johnson's War on Poverty and were designed Commensurate support to act as a national public ($300 million) has been extended to the National safety net and reduce or eliminate health disparities Health services Corps that affected racial and (NHsC), a close CHC partethnic minority groups, the ner that recruits and places poor, and the uninsured. health care professionals Now operating at in health professional shortmore than 8000 urban age areas (HPsAs). Finally, and rural sites around the the health care reform law country, federally funded, established a new Title non-profit CHCs serve 20 iii grant program ($230 million Americans, or 5% million over 5 years) for of the current u.s. populacommunity-based teaching tion. seven of 10 CHC programs and authorized patients live in poverty; a new Title Vii grant prowell over half are members gram for the development of minority groups. of primary care residency The recently passed Pa- training programs in CHCs. tient Protection and Affordable Care Act underwrites Source: New England CHCs, giving them $12.5 Journal of Medicine 44 Journal for Minority Medical Students disadvantaged backgrounds who have historically been underrepresented in medicine. This program is sponsored by the School of Medicine Office of Diversity and Internal Medicine Department. The program is designed to: � Expose students to both the clinical education and community service opportunities offered though the UCD Internal Medicine Department. � Allow students to care for an ethnically diverse patient population from rural and urban communities. � Encourage students from diverse backgrounds to apply to the Internal Medicine Residency Program. Eligibility: Eligible participants are: full-time, fourth-year medical students in good standing at accredited US medical school. Students remain registered at their own school while participating in the externship at UCD, but must complete a UCD visiting student application form. VSAS http://www.aamc.org/programs/vsas/start.htm Length: A.I. rotations are four weeks in duration and are subject to space availability. Mentoring and Networking opportunities: The students will meet Dr. Darin Latimore, Director of Medical Student Diversity, with the Office of Diversity and will be introduced to the Latino Medical Student Association and Student National Medical Association members. Courses offered: AI in Ward medicine, MICU, CC and nine subspecialty rotations. Please see website http://www.ucdmc.ucdavis.edu/mdprogram/registrar/visiting.html Financial Assistance: Reimburse up to $500 toward travel cost. Provide a $500 food allowance Waive the application processing fee ($150) Housing: The Visiting Clerkship Program provides housing for participating students at the Courtyard Marriot, located directly across from the hospital. Applications are available at http://www.ucdmc.ucdavis.edu/mdprogram/registrar/visiting.html For information about the Visiting Clerkship Program please contact, firstname.lastname@example.org. UC Davis School of Medicine Office of Diversity Presents The Visiting Clerkship Program provides support for fourth-year students from socially and economically UC Davis School of Presents Office of Diversity Office of Diversity Medicine Education Building, 4610 X Street Sacramento, CA 95817 STATEN ISLAND UNIVERSITY HOSPITAL North Shore-Long Island Jewish Health System Internal Medicine Residency S taten Island University Hospital offers an Internal Medicine Residency Training Program in modern and well equipped medical facilities with a diverse patient population and high quality teaching staff. University Hospital is a 716 bed voluntary non-profit acute care hospital which has earned its place among the leading health care facilities in the northeast. The hospital is a major affiliate of the State University of New York Downstate College of Medicine. Each year over 100 medical students are assigned to University Hospital, where they rotate through the various clinical divisions of the Department of Medicine. The program includes established comprehensive primary care curricula including innovative programs in Managed Care, Women's Health and Doctor Patient Communication. Our traditional Internal Medicine Program has a history of producing high quality, board certified general internists and medical specialists. Some highlights include: � An expanded ambulatory experience, including multiple specialties � Specialized curricula not emphasized in other programs including evidence-based medicine; biostatistics and epidemiology; preventive medicine and public health; surgical subspecialties (ENT, orthopedics, breast clinic, etc.); adolescent medicine; geriatrics; women's health; dermatology; palliative medicine; pain management; hospitalist medicine; perioperative medicine; etc. � An ABIM board certification examination passing rate of 97% for our categorical, IM residents (over the past 5 years) � Our hospital was awarded a "Best Practices" commendation by the ACGME for our work in competency care of Systems-Based Practice � Exposure to state-of-the-art medical care including: bone marrow transplantation; sleep medicine; all forms of dialysis; open-heart surgery; advanced critical care; stroke unit; epilepsy unit � Full-time (24/7), on-site supervision by board certified hospitalists and intensivists � Residents serve as mentors to high school students in a minority medicine pipeline program via a New York state grant Luane Rabito Shaleesh Medical Residency Coordinator Staten Island University Hospital Department of Medicine 475 Seaview Avenue Staten Island, NY 10305 718/226-6205 � 718/226-8695 (fax) Robert V. Wetz, M.D., F.A.C.P. Program Director, Internal Medicine Staten Island University Hospital Department of Medicine 475 Seaview Avenue Staten Island, NY 10305 718/226-6527 � 718/226-9271 (fax) IMResidencyPD@siuh.edu PrIMArY cAre ProFIleS Jessica A. Wilson, M.D. Medical School: Medical College of Wisconsin residency: Med-Peds, Medical College of Wisconsin new Job: staff Physician at Healthcare for the Homeless, Milwaukee, Wi Did you know you wanted to go into primary care when you started med school? Dr. Wilson: I thought so, but I wasn't sure; I thought I might also be interested in surgery. But when I did my thirdyear rotations, I really felt like primary care was the biggest need was in my community. I like talking to patients and doing health education, so primary care is what I chose. Also, I believe there's starting to be a greater respect for primary care. Especially if you do primarcy care in an underserved area, it gives you credentials and "bragging rights" because it is so tough. It lets people know you can handle yourself and you're dedicated to the craft of medicine. Finally, primary care really lets you help do the groundbreaking work in global health. People go abroad and surgical subspecialties are needed for short-term trips, but if you're really interested in doing long-term global health work or going in after a disaster is over, primary care is the way to go. Were you at all concerned about money? Dr. Wilson: Money is definitely a big issue; I went to a private medical school, so I owe over $250,000. Primary care is Dr. Jennifer Wilson (standing, far right) with other medical workers on a mission to Nicaragua. not the way to go if you have interest in making a ton of money. But for me, it was more important to be happy. Are you participating in any loan repayment programs? Dr. Wilson: Not yet. I didn't want to be backed into a corner in case I decided I loved GI or another subspecialty; the repayment penalties are pretty steep. Also, I knew you could go backwards and do a loan repayment program once you finished if you chose to go into primary care. I have a mentor who was the clinic attending physician. He did the primary care loan and did his residency in MedPeds. He served his three years and has gotten his loans paid back. This year he's going back for a fellowship because he decided he wanted to specialize. once you made the decision to go into primary care, did Journal for Minority Medical Students 47 Look for places that are more interested in health care than in the bottom dollar. Dr. Wilson (seated) discusses patient care on a mission trip to Nicaragua. you ever have second thoughts about the much-publicized pitfalls: money (again), burnout, lack of prestige? Dr. Wilson: You have to be a strongminded person. If you know that primary care is going to make you happy, then you have to figure out a way to not burn out. For example, when I was looking for jobs, I told my potential employers, `It's non-negotiable: I'm not going to see 40 patients in a day.' So you have to look for places that are more interested in health care than in the bottom dollar. They're hard to find, but I did it. Because my new clinic is an FHQC (Federally Qualified Health Center), they get federal funds so they don't have to push numbers like more traditional practices. I wouldn't feel right if I were working in a setting where I had 10 minutes to see a patient who had five medical conditions. I think that's the biggest reason primary care docs have burnout: they have to see so many people. If you see 40 patients per day, that's 200 patients a week, and even if only 50% of those people get labs, then you're having to look at 100 labs and call 100 people back or write 100 letters and on top of that. What else was "nonnegotiable" for your contract? Dr. Wilson: I also have an interest in global health, I made sure I would be able to have time off to do medical mission trips. I went to Honduras this year, Nicaragua last year, Haiti this year. As long as you know what you want and need ahead of time, there's such a paucity of primary care doctors that you can negotiate what you want to keep you sane. Where do you see yourself in 10 years? Dr. Wilson: As the health care system improves, I think the reimbursement system will improve as well and more academic institutions will start focusing on care for the underserved, which is where my heart is. I used to be a teacher before I went to med school, so an academic position where I could do clinical work as well as teach med students and residents would be ideal for me. What other tips do you have for med students as they start to consider their futures? Dr. Wilson: Definitely learn a language! An additional language is a great bonus if you're trying to get into a quality residency and a bargaining chip with potential employers. 48 Journal for Minority Medical Students Student Research Opportunity The Societies welcome applications from all qualified candidates and encourage women and underrepresented minorities to apply. Consider a career in research related to pediatrics by participating in a Summer Student Research Program available from the American Pediatric Society and the Society for Pediatric Research. The summer research program provides interested medical school students with the following: � Research experience at an institution other than your own medical school � Two to three months (40-hour weeks) in a research environment � A stipend of $58.83 per day or a maximum of $5,295 Since 1991, more than 836 students have attained valuable experience in pediatric labs across the U.S. and Canada. Currently more than 200 laboratories participate, allowing students to select a research project and lab in their own area of interest. U.S. and Canadian medical students seeking a research opportunity in pediatrics are encouraged to apply. Completed applications must be received no later than January, 21, 2011 to be eligible for evaluation for the 2011 Summer Student Research Program. Application packets and the Directory of Laboratory Opportunities are available on our website at www.aps-spr.org. American Pediatric Society/Society for Pediatric Research, Student Research Program 3400 Research Forest Dr. Ste. B7 The Woodlands, TX 77381 Phone: 281.419.0052 � Fax: 281.419.0082 www.aps-spr.org � email@example.com Minority Student Opportunities in United States Medical Schools (2009) The information in this book is supplied by individual medical schools in response to a questionnaire from the AAMC's Division of Diversity Policy and Programs about minority student opportunities. For most school entries, the narrative descriptions cover seven topics: � recruitment � admissions � academic support programs � enrichment programs � student financial assistance � educational partnerships � other pertinent information This current data includes the number of applicants, first-time applicants, and matriculants, for each school by gender and race/ethnicity (source: AAMC Data Warehouse). The publication also contains two appendices: a chart identifying enrichment and other programs related to individual medical schools and tables supplying selected AAMC data of interest. Cost: $15 To order please visit www.aamc.org/publications or call (202) 828-0416. Association of American Medical Colleges PrIMArY cAre ProFIleS Uyi osaseri, MD Medical School: uCLA residency: Family Medicine, uCLA Were you worried about any of the financial repercussions or other things about choosing family medicine? Dr. osaseri: I had some raised eyebrows from my peers and other physicians in my family. It's kind of a joke with some truth in it: "You're not going to make money." But it never bothered me. I know that I have lots of options with family medicine. I can go into teaching or specialize a bit-- sports medicine, boutique medicine. I can do international medicine or research. The sky's the limit. tell us about your residency experience. Dr. osaseri: Nothing in life prepares one for intern year, except maybe childbirth. [laughs] I knew it be a hard year. You leave being the exalted fourth-year medical student and you're back down on the bottom of the ladder again. But the physical demand that's required of you was a real eye opener. It takes a lot of stamina. You're "on" while you're learning and the days just blend together. By second year, I had my bearings. The hours were still grueling, but in a different way. Afterwork I wasn't completely drained as I had been in first year; I was able to go out or go exercise. The best thing, though was that in second year, I found myself wanting to know more. I was always picking up an article, wanting to learn more to be better. I really felt my drive kick in in second year. I'm going into third year now, which will definitely have less call (thank goodness). I'll teach and train the interns and have elective time to go out in the community and work more with specialists to get a better sense of what's out there. I love being at the Santa Monica UCLA Hospital. It's an amazing place for all kinds of diversity: ethnic, age, disease states. And overall, I still enjoy what I do. No matter how tired I am, I can still see the joy in it. What does your ideal career look like? Dr. osaseri: I appreciate research and its role in medicine, so at some point I'd like to come back into the academic setting to practice and teach. But first, I want to get out there and work in the community. What advice do you have for med students considering their own careers in medicine? Dr. osaseri: I tell students now to take your time, be honest with yourself, and be honest with your personality. I was very narrow-minded, but I was finally able to relax and take a look at all the other amazing options out there. It can go the other way, too. For example, I have a close buddy who was always gung ho on primary care, but he had a surgical epiphany. He stopped and looked at what his quality of life was and he wasn't happy. He made the switch. I also have another friend who was in pediatrics, but found herself always drawn to issues of the skin she was seeing in her patients. She loves the skin; she gets excited about it. So she went to see the mentor she'd had since undergrad--a pediatrician--to talk about dermatology. And even her mentor said, "As long as your happy, you're still serving your community as a specialist." Plus, we need minority leaders in all fields so I can refer to them! Did you know going into med school you wanted to be a primary care doc? Dr. osaseri: I'd wanted to be a doctor since third grade and I did a school project on the stages of pregnancy, but going into med school, family medicine was the furthest thing from my mind. After doing all of my rotations with some great mentors, it was clear what I wanted to do: family medicine. I enjoyed being with the broad spectrum of patients and I have a good bedside manner. It was kind of scary because I didn't think I would pick it. It actually picked me, and once I was objective about it, it made sense and I had a great sense of piece about it. What about it felt right? Dr. osaseri: I like the idea that I'll be a gatekeeper to people's total health; I'm not just going to focus on one piece of the body. 50 Journal for Minority Medical Students PrIMArY cAre ProFIleS Mark Beaumont, MD Med School: Boston university school of Medicine residency: Family Medicine, Boston Medical Center currently: Family Medicine doc, Codman square Health Center, Dorchester Center, MA Did you know going into med school you wanted to be a primary care doc? Dr. Beaumont: No, I thought I wanted to be a cardiothoracic surgeon. That mainly was because I had done some research with a cardiothoracic surgeon when I was in high school, along with the fact that my grandfather had a really big heart attack. But when I did my surgery rotation during third year, I did well, but I didn't love it, and I just couldn't see myself doing that for rest of my life. I don't mean to stereotype, but to me, it felt very impersonal; they don't take time to sit down and talk to a patient. I longed for a deeper way to practice medicine and make a difference with the patients I had. Primary care gets a bad rap compared to other specialties that are a lot more trendy and technological. Some fields have a reputation for being less stressful--punch in and punch out and you're done. But it just felt right to me. Why did you choose to go into family medicine? Dr. Beaumont: When I did my family medicine rotation, I just loved it and I did well. By the end of my fourth year, I had narrowed it down to either family medicine or pediatrics. I chose family medicine because I wanted to be able to have continuity of care over generations. Did you ever have doubts or second thoughts? Dr. Beaumont: No, once I knew what I loved, then I figured everything else would fall into place as it should. I promised myself a long time ago I wouldn't choose a particular specialty based on income. I wanted to pick a specialty where I would love what I do every single day. Family medicine was the best choice for me. What was your residency like? Dr. Beaumont: Where to go was the most difficult decision. I applied heavily in the northeast area and I looked at a lot of programs in the New York area where I grew up, but I felt like BMC had the best program for me. delivery. I start seeing patients at 9am and stop at 5pm; I'm scheduled to see a patient every 15 minutes. Wow...every 15 minutes? Dr. Beaumont: The 15-minute visit can be constraining, and sometimes I have to bring a patient back in order to continue to address whatever's going on. For example, I saw someone recently who had lost his job and had been looking for a job for quite some time. When he came to see me, he was suicidal. I had to take the time to get the necessary services for him because I felt uncomfortable letting him What's a typical week like for you? Dr. Beaumont: I'm an attending in the Department of Family Medicine at Boston Medical Center, so I round on the internal medicine/family medicine team. I'm an attending in labor and delivery; I can participate in C-sections (though I can't do them myself). I also work at Codman Square Health Center, a local community health center in a very urban and underserved area with a high minority population with a lot of chronic medical illnesses, like diabetes. I'm there every day unless I get called to the hospital for a Journal for Minority Medical Students 51 When i graduated, i was about $210,000 in debt. i applied for the National Health service Corps, and i've been in that program for three years. leave the clinic. I definitely felt he was a danger to himself, so I had to coordinate care with our behavioral health person. What do you like most about your job? Dr. Beaumont: I like the flexibility. Family medicine docs are trained to do a little bit of everything. What I heard when I was looking for a position was that, because of where they end up practicing, most family medicine docs end up doing just peds or just adult medicine. I didn't want to do that; I wanted to practice full scope of comprehensive family medicine to the best of my abilities. In my job, I can do that. I do obstetrical care, pediatric care, and adult medicine. I round at the hospital. I teach residents and medical students. Do you like the teaching aspect of your work? Dr. Beaumont: I love the academic environment, and I think it's really important to stay up-to-date with current research. Is your schedule manageable? Dr. Beaumont: It is now. I used to be gone 12 to 14 hours a day, but as an attending, my quality of life is awesome and I can tailor my schedule to work a little more or a little less. I'm able to take my daughter to school in the morning and I'm able to pick her up some days. I'm definitely home in the evening when my kids are home from school. Also, all of my charts are electronic, so I can do charting from home. I don't have to stay at the clinic to do charting after I'm done seeing patients. A lot of docs don't have this luxury, so I feel very fortunate. how are you dealing with your debt? Dr. Beaumont: When I graduated, I was about $210,000 in debt. I applied for the National Health Service Corps, and I've been in that program for three years. It's been an awesome opportunity and I plan to stay with the program as long as I can. What are the requirements for the nhSc? Dr. Beaumont: You have to work full time (40 hours/week) and serve in a priority health professional shortage area. What would you like to be doing 10 years from now? Dr. Beaumont: I definitely plan on continuing to do outpatient work seeing different generations of patients, and doing obstetrical care. Though I probably would want to do less clinical time and spend more time teaching residents and medical students. I'm also developing a passion to work with adolescent men. I find that particularly in the area where I work, they don't have the skills they need when they graduate high school or when they drop out. They don't get a GED, they don't have a particular trade, and then they don't work, so it creates this cycle of absentee fathers. I'd like to develop a young man's clinic or something where I can reach out to the young men in our community to provide services to them beyond medical. What one piece of advice do you have for med students considering their careers in medicine? Dr. Beaumont: I would say explore all options and keep an open mind. Once you find the specialty you could see yourself doing for the rest of your life, go for it. 52 Journal for Minority Medical Students ERAS Network pediatriCs pEdiATRicS RESidENcy TRAiNiNg ANd OppORTuNiTiES CinCinnati Children's ciNciNNATi childREN'S PEDIATRIcS hospital cHILDREn'S HOSPITAL hOSpiTAl MEdicAl cENTER cIncInnATI MediCal Center Cincinnati, OH Oh cincinnati, MEDIcAL cEnTER cincinnati, OH Cincinnati Children's is a national leader in pediatrics. As a major academic Cincinnati Children's is a national leader in pediatrics. As a major academic pediatric medical center, we attract patients from from all the world, conduct pediatric medical center, we attract patients all over over the world, conduct pioneering medical research and offer outstanding teaching programs. We We pioneering medical research and offer outstanding teaching programs. work work closely community basedbased caregivers. vision is to be to be the closely with with community caregivers. Our Our vision is the Cincinnati Children's is health and in preparing tomorrow's pediatricians. leader in improving child child a and in preparing tomorrow's pediatricians. leader in improving health national leader in pediatrics. As Weaare proud to be to be ranked third in National Institutes of Health funding to We are proud ranked third in National Institutes attract funding to major academic pediatric medical center, weof Healthpachildren's hospitals and pediatric departments nationwide. In addition, US US children's hospitals the world, departments nationwide. In addition, tients from all overand pediatric conduct pioneering medical NewsNewsWorld Report consistently ranksranks Cincinnati Children's Departand and World Report consistently Cincinnati Children's Departresearch and offer outstanding teaching programs. We work mentment of Pediatrics asof theof the top three departments in the country. of Pediatrics as one one top three departments in the country. PHySIcAL MEDIcInE AnD REHABILITATIOn REHABILITATIOn InSTITUTE Of cHIcAgO/nORTHWESTERn UnIVERSITy MEDIcAL ScHOOL chicago, IL Providing medical care to this nation's estimated 40 million physically disabled citizens is a responsibility that often falls to the physiatrist--the physician specializing in the field of physical medicine and rehabilitation. Patients commonly seen by physiatrists include children and adults who have closely with community based caregivers. Our vision is to disabilities such as hemiplegia; paraplegia; quadriplegia; be the leader in improving child health and in preparing Running the Numbers Running the Numbers amputations; arthritis; fractures; pulmonary, vascular or Number of Beds:pediatricians. We are proud to be ranked third tomorrow's 475 neuromuscular diseases; and other less disabling conditions. Annual admissions, including short stays: 27,392 to children's hosNumber of Institutes of Health funding Beds 475 in National Radiologic procedures: 150,000 + short stays 27,392 Annual admissions, including The Department of Physical Medicine and Rehabilitation at pitals and pediatric departments nationwide. In addition, Outpatient visitsproceduressatellites): + Radiologic (includes 150,000 790,949 Northwestern University Medical School offers a program US News and World Report consistently ranks Cincinnati Emergency department visits: 93,456 Outpatient visits (includes satellites) 790,949 of interdisciplinary studies centered at the Rehabilitation Children's Department of Pediatrics as one of Surgical procedures (inpatientvisits outpatient): 29,168 the top three Emergency department and 93,456 Institute of Chicago (RIC), with associations at Veterans Critical care admissions (cardiac, ICU, NICU): 3,287 Surgical procedures country. departments in the (inpatient and outpatient) 29,168 Administration Westside Medical Center, Northwestern Critical care admissions (cardiac, ICU, NICU) 3,287 Interactive Team CareCare Interactive Team Memorial, Children's Memorial, Evanston Hospital, Illinois Running the made up of four four PL-1's, with primary responsibility Numbers Each Each ward team is made up of PL-1's, with primary responsibility for for Masonic Medical Center and Alexian Brothers Hospitals. ward team is Number of ward and and two or PL-3 patients on their Beds:wardtwo PL-2 PL-2 or supervisors. Each team also patients on their 475 With more than three decades of experience in the field, Annual admissions, who makes rounds and plays member who includes a faculty memberincluding short stays:facultyan integral rolemakes PL-3 supervisors. Each team also includes a 27,392 in teaching. These teams cover wards that admit primary pediatric and rounds and plays an integral role in teaching. These teams cover wards that RIC is dedicated to excellence in research, education and Radiologic procedures: 150,000 + providing comprehensive care programs to the physically subspecialtyprimary pediatric and satellites): 790,949of all ages. admit patients of all ages. Outpatient visits (includes subspecialty patients disabled. A 176-bed private, nonprofit freestanding facility, Emergency department our website: visits: 93,456 Please contact us or us orour website: Please contact visit visit RIC was named top rehabilitation hospital in the country Surgical proceduresTraining Program Pediatric Residency Training Program and outpatient): 29,168 Pediatric Residency (inpatient by US News & World Report for fourteen years in a row. Critical careChildren's Hospital Medical Center Cincinnati Children's Hospital (cardiac,Center NICU): 3,287 Cincinnati admissions Medical ICU, 3333 3333 Burnet Avenue,5018 5018 Burnet Avenue, ML ML Cincinnati, OhioOhio Care Cincinnati, 45229 Interactive Team 45229 513-636-4315 513-636-4315 www.cincinnatichildrens.org Each ward team is made up of four PL-1's, with primary www.cincinnatichildrens.org responsibility for patients on their ward and two PL-2 or PL-3 supervisors. Each team also includes a faculty member who makes rounds and plays an integral role in teaching. These teams cover wards that admit primary pediatric and subspecialty patients of all ages. Please contact us or visit our website: Pediatric Residency Training Program Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, ML 5018 Cincinnati, Ohio 45229513-636-4315 www.cincinnatichildrens.org Information: Office of GME Northwestern University Medical School 645 N. Michigan Avenue Suite 1058-A Chicago, IL 60611 312-503-7975 firstname.lastname@example.org Contact: James Sliwa, DO Residency Program Director Rehabilitation Institute of Chicago 345 E. Superior St. Chicago, IL 60611 www.northwestern.edu/pmr email@example.com Applications: Electronic Residency Application System (ERAS) firstname.lastname@example.org www.aamc.org/eras 202-828-0413 202-828-1125 Journal for Minority Medical Students 53 fAMILy MEDIcInE PSycHIATRy SPARTAnBURg REgIOnAL HEALTH cARE SySTEM Spartanburg, Sc InDIAnA UnIVERSITy ScHOOL Of MEDIcInE Indianapolis, In Spartanburg Family Medicine Residency Program is situated in the foothills of upstate South Carolina, near lakes and mountains, and 3-1/2 hours from the ocean. Spartanburg is a college town with a diverse industry, a four-season climate, and new modern facilities. We have core experiences in IM, Peds, OB, Surgery and multiple others that rival any in the country. Advance OB, endoscopy and other procedural training is strong. An OB fellowship and rural site is available. Our dynamic Family Medicine Residency Program is looking for graduating students to join our "family" in June 2010. If you are looking for a community-based program with university strengths, where the educational opportunities are matched by a quality and beautiful place to live, then Spartanburg may be the place for you. Contact: Otis L. Baughman, III, MD Professor of Family Medicine Director, Spartanburg Family Medicine Residency Program 853 N. Church Street, Suite 510 Spartanburg, South Carolina 29303 (864) 560-1558 Fax: (864) 560-1510 E-mail: email@example.com www.spartfam.org The psychiatric residency program at Indiana university School of Medicine has a national reputation for excellence in clinical training. As a major academic medical center, we are leaders in psychiatric research into disorders affecting children, adolescents, adults, and older adults. Being the second largest medical school in the country, we have multiple opportunities for teaching and research interactions with medical and health sciences graduate students, and as the only medical school in Indiana, we draw patients from the entire state, as well as the wider mid-western region and beyond. The Department is actively involved in cutting-edge psychiatric services within six diverse healthcare systems, providing exposure to every type of psychiatric practice. We also provide a number of accredited psychiatric fellowships, including addiction, child and adolescent, and geriatric psychiatry, as well as non-accredited fellowships in research and in autism and related disorders. We will be accepting applications for 2011 within our clinical and academic training tracks (applicants need not specify in advance) through ERAS� and NRMP�. Key Information: Six hospitals--private, county general/CMHC, children's, university, VA, and a state-run, intermediate-stay teaching and research hospital. Busiest emergency departments in Indiana, with over 275,000 annual visits. Contact: Joanna E. Chambers, M.D. Director of Psychiatric Residency Education firstname.lastname@example.org 317/274-7423 http://psychiatry.medicine.iu.edu/ The goals that YOU have are OUR goals for you Our major strength lies in the quality of our faculty and students Vanderbilt School of Medicine is actively committed to attracting and maintaining a diversified body of graduate and professional students, residents and faculty in an environment dedicated to excellence. Vanderbilt School of Medicine's major strength lies in the quality of our students and faculty. We provide a supportive, positive environment in which students are treated individually in their pursuit of excellence. Our students have one of the highest satisfaction rates in the country. 3 Vanderbilt is one of the top medical schools in the country and is located in the hospitable city of Nashville 3 Vanderbilt is the third fastest growing health sciences center in the country in research funding 3 Vanderbilt Medical Center has been named one of the top 17 and its Children's Hospital ranks eighth in the country 3 We offer numerous activities, such as SNMA, Meharry-Vanderbilt Student Association, NNLAMS and APAMSA, all which enhance diversity at our institution We welcome your inquiries and look forward to hearing from you. For more information please call 1-615-322-7498 George C. Hill, Ph.D. Levi Watkins, Jr. Professor and Associate Dean for Diversity in Medical Education Professor, Department of Microbiology and Immunology Vanderbilt University School of Medicine Nashville, TN 37232 www.mc.vanderbilt.edu/medschool/diversity/odme.php YOU alwaYs wanted [ a career in healthcare. ] TOGETHER, WE'LL BUILD YOUR FUTURE. CHICAGO COLLEGE OF OSTEOPATHIC MEDICINE ARIZONA COLLEGE OF OSTEOPATHIC MEDICINE CHICAGO COLLEGE OF PHARMACY COLLEGE OF PHARMACY�GLENDALE COLLEGE OF HEALTH SCIENCES Physician Assistant Studies Physical Therapy Occupational Therapy Biomedical Sciences Bioethics Health Professions Education Cardiovascular Science/ Perfusion Podiatric Medicine Nurse Anesthesia Clinical Psychology Health Science COLLEGE OF DENTAL MEDICINE-ARIZONA ARIZONA COLLEGE OF OPTOMETRY LEARN MORE AbOuT OuR PROFESSIONAL DEGREE PROGraMS IN HEALTH CARE, AT www.MIDwESTERN.EDu. DOwNERS GROvE CAMPuS 555 31ST STREET | DOwNERS GROvE, ILLINOIS 60515 800.458.6253 | ADMISSIL@MIDwESTERN.EDu Educating Tomorrow's Healthcare Team www.midwestern.edu GLENDALE CAMPuS 19555 N. 59TH AvENuE | GLENDALE, AZ 85308 888.247.9277 | ADMISSAZ@MIDwESTERN.EDu Journal for Minority Medical Students 55 ADVeRTiseR's iNDex AAfP* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4 AAMc* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49, cV3 American Academy of Orthopaedic Surgeons . . . . . . . . . . . . . . . . . . .5 American Academy of Pediatrics* . . . . . . . . . . . . . . . . . . . . . . . . . . .8 APS-SPR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 Aurora Health care* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . cV4 Boston Medical center* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 cedars Sinai Medical genetics Institute . . . . . . . . . . . . . . . . . . . . . .56 child family Health International . . . . . . . . . . . . . . . . . . . . . . . . . . .12 cincinnati children's Hospital Medical center* . . . . . . . . . . . . . . . . .24 David geffen School of Medicine at UcLA*. . . . . . . . . . . . . . . . . . . .10 Harvard Medical School Visiting clerkship Program* . . . . . . . . . . . . .20 Kaiser Permanente* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . cV2 Medical college of Wisconsin* . . . . . . . . . . . . . . . . . . . . . . . . . . . .16 Mercy Health System* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Michigan State University Kalamazoo* . . . . . . . . . . . . . . . . . . . . . . . .8 Midwestern University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .55 Mount Sinai School of Medicine* . . . . . . . . . . . . . . . . . . . . . . . . . . .26 national Science foundation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49 north Shore Long Island Jewish Health System* . . . . . . . . . . . . . . . . . .2 Staten Island University Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . .46 U.S. navy* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32-33 UAB School of Medicine* . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29 Uc Davis School of Medicine . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45 University of Michigan Dept. of Physical Medicine and Rehabilitation* .12 Vanderbilt University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18, 54 Wake forest University School of Medicine . . . . . . . . . . . . . . . . . . . .30 he UCLA Intercampus postdoctoral research and clinical training programs in Medical Genetics utilize the resources of its affiliated campuses and teaching hospitals to train academically oriented applicants with M. D., Ph.D., D.D.S. or equivalent degrees in a wide variety of clinical and/ or research opportunities in molecular, biochemical, immuno-, cancer, cyto-, somatic cell, and population genetics. Five-year combined Pediatric/ Medical Genetics residencies are also available at each of the affiliated hospitals and applications are accepted through ERAS. These programs meet all the requirements of the American Board of Medical Genetics and Accreditation Council for Graduate Medical Education (RRC). T *charter Advertisers Application forms are available from: Patricia Kearney Coord. Academic Affairs Medical Genetics Institute Cedars-Sinai Med Ctr 8700 Beverly Blvd West Tower 665 Los Angeles, CA 90048 www.uclamedgeneticspostdoc.org R esi D e N CY i N D ex PeDiATRiCs cincinnati children's . . . . . . . . . . . . . . . . PHYsiCAL MeDiCiNe & ReHABiLiTATiON Rehabilitation Institute of chicago . . . . . . . FAMiLY MeDiCiNe Spartanburg Regional Health care System . PsYCHiATRY Indiana University . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53 . . . . . . . . . . . . . . . . . . . . . . . 53 . . . . . . . . . . . . . . . . . . . . . . . 54 . . . . . . . . . . . . . . . . . . . . . . . 54 The Journal for Minority Medical Students is published quarterly by Spectrum Unlimited. Subscription rates: $20 per year. Back issues: $5. copyright 2010 Spectrum Unlimited. no part of this publication may be reproduced without the consent of the publisher. The opinions expressed in this publication are those of the authors and do not necessarily reflect the view of the magazine managers or owners. The appearance of advertisements in the publication does not constitute endorsement of the product or company. SPEcTRUM UnLIMITED � 1194-A Buckhead crossing � Woodstock, gA 30189 � (770) 852-2671 � fax: (770) 924-4327 � JMMSmag@aol.com � www.minoritymedicalstudents.com