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Starting Medical School in the Woods: How Creating Adventurous and Mindful Physicians (CAMP) Fosters Student Community at Michigan

Having always dreamt of going to medical school, I long imagined what my first days would look like: meeting my classmates in lecture, exploring the anatomy lab, and receiving my white coat. I never expected to start school in a tent in the woods, carrying my food and clothes on my back. However, through Creating Adventurous and Mindful Physicians (CAMP), I was able to spend my first few days of this new chapter surrounded by nature, bonding with my classmates, and feeling empowered and strong as I stepped out to fulfill my dream of becoming a physician.

Hailing from different colleges, states and past lived experiences, myself and ten other students met at an Ann Arbor park and were shuttled north to begin our adventure. Despite coming in as strangers, we quickly bonded as we divided up gear to carry in our backpacks and took turns reading the map to navigate as we hiked. Some of us were experienced backpackers, and others had never camped before, but regardless of background, we all shared the feeling of being in a new place with new people, excited and nervous to take on the next four years.

Being heavily involved in Outdoor Education in undergrad, I recognize the special place that nature can be in bringing diverse groups of people together. There are few experiences that mimic the genuine joy of jumping into a lake at sunset, or gathering around a campfire to make s’mores. Nature creates an authentic space where you can show up as you are, offering opportunities that are both fun and challenging, but ultimately allowing for team-building, self reflection, and growth in a way that you can only find when you “unplug” from life outside of the woods.

Choosing to start medical school “unplugged” from life back in Ann Arbor offered a chance to jump fully into this new chapter. One of the most meaningful moments on this trip for me was one night after we had finished hiking, sitting around the fire with my new friends. Our M2 and M4 leaders had passed out paper for each of us to write three of our biggest fears about starting medical school and a bowl to place the papers in when we were done. We all sat in silence for a bit as we reflected about what to write, and shyly placed each of our fears into the bowl. Then, our leaders began to anonymously read out each fear we’d written down. I remember being shocked that so many of the things I was nervous about were read four or five times, meaning other people had the same fears. “Everyone will be smarter than me” or “I won’t fit in” suddenly felt a lot less scary when I realized that I was not the only one who felt that way. Sitting under the starry sky in the Michigan wilderness, medical school suddenly felt a lot less intimidating, and I felt a lot less alone going into it.

Starting medical school with CAMP empowered me to feel at home at the University of Michigan Medical School, feel capable and confident in myself as I took this next step, and equipped me with new friendships that still build me up today. As I begin to wrap up my M1 year at Michigan, I now serve as the President of CAMP and am working with my incredible CAMP team to plan the next round of trips for our next class of students. As was my experience with CAMP, our goal is to create a safe environment for students to build confidence, make friends and feel at home at Michigan.

Starting medical school is daunting, but starting medical school with new friends, new memories and a renewed confidence in yourself and your abilities can make the transition as seamless as possible. I am so grateful for the ways CAMP has made me feel welcome at Michigan Med and so excited to help create the same experiences for students who come after me!

Students from my CAMP group celebrating at our White Coat Ceremony!

Growing as a LEADer: From Non-Profit Management to Medical School

Before coming to the University of Michigan Medical School, I spent three years building the nonprofit organization, Lunar Doula Collective (LDC). After noting the lack of reproductive grief care at multiple health care systems, I helped build the first and only pregnancy loss doula program in Michigan. Not only did this experience inspire my motivation to pursue medicine, but it gave me a community that shared my passion for social justice and health equity.

2023 LEAD Cohort at Adventure Leadership in the summer

As I prepared to transition into medical school, I remember feeling anxious about leaving LDC behind. This next chapter of my life would come with a lot of challenges: making new friends, figuring out work-life balance and adjusting to a different environment. While I felt excited and grateful to begin my journey, I was equally as nervous to navigate this process as a first-generation medical student. 

When I heard about the LEAD (Leadership and Enrichment for Academic Diversity) Pre-Matriculation Program, I knew right away that I wanted to apply. This two-week leadership course is thoughtfully designed to prepare and help transition incoming medical students. Through early exposure to resources and mentorship, LEAD students are empowered to cultivate change in the community and seek professional growth. 

All smiles at our White Coat Ceremony – July 23, 2023

During my time in LEAD, I heard from faculty and current students about their experiences at UMMS as they shared advice on how to navigate medical school. From learning effective study strategies to identifying research opportunities, I began growing more confident as the first day of class approached. LEAD programming also included team bonding activities, health equity lessons and stress management strategies. As part of the LEAD cohort, I truly felt like I had the resources, attributes and support system to succeed.

Another thing I appreciate about LEAD is the longitudinal educational enrichment. Our cohort continues to meet throughout the year to hear from various guest speakers and engage in professional development opportunities. Whether it’s a financial literacy seminar or a CV-building workshop, we get to collectively decide what events and topics would interest and benefit us the most. At the end of LEAD, I got paired with a senior medical student as part of a peer-mentoring program. Having someone to lean on and seek guidance from was so immensely helpful when I began medical school. 

Checking out the Big House Stadium with some LEAD friends!

What surprised me the most about LEAD was its unique culture of collaboration and connectedness. I found a safe space to talk about failures, learn from my peers, and explore diverse perspectives. This close-knit community has been my source of encouragement and inspiration throughout my M1 year. I’ve seen my LEAD peers represent our class on the Student Council, encourage community building through M-Home, and facilitate resource and knowledge-sharing. Taking what I learned from LEAD, I was personally inspired to start two new organizations for medical students at UMMS this year: The Ruth Jackson Orthopaedic Society Chapter and Medicine in Motion

LEAD Besties: Krupa Patel (left) and Jennifer Lee (right)

The LEAD Program was the perfect start to my medical school journey. It allowed me to strengthen my leadership and professionalism skills, value the diversity and experiences of my peers, and turn my doubts and fears into self-confidence. These are lessons I will carry with me throughout and beyond the next four years.​ I am grateful to the Office of Admissions, the Office for Health Equity and Inclusion (OHEI), and the Office of Medical Student Education (OMSE) for planning and hosting such an impactful experience. To my 2023 LEAD cohort: thank you for our little community that cheers each other on, dreams big, and makes UMMS feel like home. 

Exploring My Interests in Medical School: From Transplant Surgery Research to Ceramics Classes

Our first week of medical school at the University of Michigan this past summer, I sat in South Lecture Hall with 163 of my new classmates listening to incredible physicians share their philosophies on the practice of medicine. These lectures were inspiring, ranging from how to make the most out of your medical education to how to make the most out of not just your medical career, but your life. One lecture in particular struck me: Chris Sonnenday, MD, a transplant surgeon, talking to us about the small acts of care that make the biggest difference to patients.

I entered medical school recovering from a distal radial ulnar joint injury— not an ideal way to start, but UMMS worked with me to make accommodations and my counselor even helped me find an appointment with a hand surgeon in Ann Arbor!

Dr. Sonnenday is the Surgical Director of Liver Transplantation for Michigan Medicine, and he performs complex hepatobiliary, oncologic and liver transplantation surgery, while also leading numerous research studies. For someone with such intense responsibilities, he is remarkably down to earth. He coaches his kid’s soccer team and runs marathons in his free time. When he started talking about patient care, he emphasized that he just tries to give his patients the honesty and humanity that he would want from his doctor. He described how before each of the surgeries he does, he has made it a practice to hold the hand of his patient while they fall asleep under anesthesia. Oftentimes this is the only thing patients remember when they awake from surgery — that they weren’t alone.

I sat in the lecture hall moved practically to tears and tried to write down takeaways from the lecture I had just heard. This proved difficult, as I was still recovering from donning a cast all summer after dislocating my wrist, and so these notes were even more illegible than my usual bad handwriting. Luckily, I was able to clearly write down Dr. Sonnenday’s email, and I decided to reach out to him that day to let him know how impactful his talk had been to me. To my surprise he responded right away and offered to meet with me to talk about my interests.

Pursuing Professional Interests: AI, Transplant Research and Inspiring Role Models
When we met on Zoom, I shared that I was interested in artificial intelligence for medical use cases — the research I pursued before medical school — and he immediately connected me to the Transplant Research, Education, and Engagement (TREE) team, where I’ve since started on a research project using computational tools to help optimize organ donor-recipient matching. The TREE team is a multidisciplinary group of data scientists, researchers and surgeons who collaborate on research projects in smaller groups and share their learnings with one another and the scientific community through manuscript publishing. TREE meets weekly to go through project updates from the broader transplant group at Michigan Medicine, and my smaller research group working on the donor-matching algorithm meets biweekly.

In addition to research opportunities, faculty like Dr. Sonnenday are very willing to allow students to shadow them and learn from their clinical practice. I was lucky to get to spend a day shadowing Dr. Sonnenday in his Liver Tumor Clinic. I accompanied him to see his clinic patients, all of whom he had formed longitudinal relationships with and spent the full appointment time (and sometimes more) ensuring that he answered all their questions. After each patient visit, he took further time to thoroughly explain the disease etiologies and relevant lab findings to me in detail.

I learned a lot that day, not just about cancer pathology and anatomy, but about what it really looks like to be a good doctor: someone who is unhurried and generous with their time, always making sure to thoroughly teach patients about their conditions, as well as teach trainees about how to care for these patients. Seeing his kindness, honesty and genuine care for each of his patients — whether they were the first patient of the day or the last one at the end of a long day of clinic — was so inspiring and modeled the type of physician I want to be one day. Many of my friends in medical school have had similarly impactful shadowing experiences with Michigan physicians who love teaching med students, starting as early as M1 year.

Introduction to Interprofessional Collaborative Skills: Shadowing a Sex Therapist
Doctors aren’t the only professionals we learn from and shadow as students. An integral part of our first-year curriculum includes the interprofessional collaborative skills introduction (ICS-I), which includes shadowing various health professionals such as nurse practitioners, physical therapists, social workers, doulas, music therapists, dietitians, pharmacists and pathologists. My ICS-I assignments proved to be equally valuable learning experiences as my day shadowing at the Liver Cancer Clinic. I was assigned to shadow a music/pet therapist, a child audiologist and a sex therapist, a social worker who specializes in sexual health counseling.

My first day of shadowing was with Amy Raad, LMSW, CST, a sex therapist at the Center for Vulvar Diseases, and I had no idea what to expect. Little did I know this would turn out to be one of the most interesting days of medical school so far. Amy is an expert in sexual health, women’s health, intimate relationship distress and trauma recovery. She works with patients to help overcome any concerns about sexual health or function after major changes like those brought about through radiation treatment for cancer. She sees an array of patients with varying conditions, from diverse backgrounds and age groups.

Amy made such a big impact on her patients with her openness, depth of knowledge and empathy. She was able to help patients feel comfortable talking about sexual health and function with seeming ease (although I’m sure that’s harder than she made it look!), and it was really inspiring to see her meet patients where they are and create a space where they felt safe to share difficulties rendered by their diagnoses. She was also just insanely cool. Before shadowing in the clinic, I didn’t know anything about this field, but after spending my day with Amy I was so thrilled to be part of a hospital system that offers these resources to patients. I left the clinic that day feeling assured that I had made the right choice in deciding to study medicine at Michigan.

Enjoying a sunset over Lake Michigan during a weekend trip to Grand Haven.

Life Outside Medical School: Ann Arbor, Student Orgs and Quiz-Free Weekends!
When I first began medical school, I was nervous about not being able to keep up with my life outside of school. As a nontraditional student, things like spending time with my family and friends, cultivating artistic outlets and pursuing research had grown paramount to my wellbeing in the years since I’ve graduated college, and I’ve gotten so used to having ample time for them. I was worried that M1 year wouldn’t allow me time for these diverse interests. Luckily, that worry was pretty unfounded — if anything, I feel encouraged to pursue these interests by everyone from the faculty and health professionals I shadow who share the important non-medicine-specific interests in their lives, to my doctoring coach who checks in on my self-care goals first thing every time we meet.

Taking a ceramics class at Ann Arbor Art Center!

Ann Arbor also provides ample opportunity to explore new interests. On a whim I applied for a financial
scholarship to take a ceramics class at the Ann Arbor Art Center, and now I’ve spent one night every week learning how to throw on the wheel and am working on a set of funky (read: lopsided) mugs as Christmas gifts for my roommates. Ceramics classes have been a really fun way to make friends outside of medical school, and they’re just one example of the myriad activities Ann Arbor has to offer for students.

While there’s basically a student group at Michigan Med for just about anything you might be interested in, if you don’t happen to find exactly the group you want, it’s really easy to create your own student group. In fact, this year, three friends and I started the AI in Medicine club to gather students interested in learning about AI developments in the medical field, host talks from faculty working in this field, connect students with research opportunities, and discuss ethical challenges of incorporating ever-advancing AI technology into our healthcare system.

Some med school friends during a camping trip to Sleeping Bear Dunes this fall (feat. Christopher the best dog ever).

Aside from these more organized activities, it’s been really fun just getting to know my amazing classmates. Since we have a non-quiz weekend approximately every two weekends, we take advantage of the free time to do things like go camping at Sleeping Bear Dunes, visit Lake Michigan, and host dinner parties. With all the rich opportunities for personal and professional growth afforded by Michigan Medicine, I’ve had an M1 year that has so far exceeded any and all expectations I had coming in. I can’t wait for what’s to come in my clinical year.

Improving Diversity and Representation in Our Medical School Curriculum

Coming into medical school, we knew we wanted to make an impact in the University of Michigan Medical School (UMMS) community by following our passion for improving equity, representation and inclusion. One student group that particularly caught our attention was the Student Diversity Council (SDC), which works to ensure the medical school community promotes diversity, equity, inclusion, accessibility and justice (DEIAJ). SDC also works closely with the administrators to amplify student voices in various medical school decisions.

Following a small group discussion in the medical student lounge (also known as the Slounge), we discovered our mutual interest in diversity promotion. We reached out to the leadership team of SDC hoping to find a way to make an impact, specifically how we might be able to help improve our M1 curriculum. We were shocked and thrilled by how receptive SDC was to our ideas and passion for improving DEIAJ in the curriculum and how they welcomed us with open arms. Every member of SDC comes to the group with their own personal motivations and ideas for initiatives, so we felt we had a lot of support and resources to help us enact our own project!

Our first project centered around patient presentations in the Scientific Trunk, the first year of pre-clinical studies at UMMS. Patient presentations are sessions where real patients tell their story and answer questions directly from students. While patient presentations during the Scientific Trunk served as opportunities to learn about the pathophysiology of disease, we found that students wanted to hear more about the impact of socioeconomic status, race and ethnicity on the patients’ health and journey through the health care system.

We worked alongside Hana Murphy, a fourth-year medical student, to conduct a survey to assess students’ thoughts about diversity in patient presentations. The overwhelming opinion from students was that they wanted to hear more from patients of diverse backgrounds, including representation of different race, ethnicity, gender, socioeconomic status, sexuality, educational status and ages. We brought the results of the survey and ideas for strategies to improve patient presentations to the Scientific Trunk faculty. We discovered the Office of Patient Experience, a department within Michigan Medicine that integrates patient perspectives by sharing their stories with the goal of maintaining and strengthening a patient-centered culture of care.

Our idea was to incorporate videos of patient stories from the Office of Patient Experience website into the Scientific Trunk. As a team, we went through each video and designated which part of the curriculum each story would best supplement. This helped contextualize the pathophysiology of specific disease processes with real-life patient experiences with more varied backgrounds. With the help of Scientific Trunk faculty, we were able to begin to more officially integrate these resources into the M1 curriculum.

As we progressed through our M1 year and the M2 clinical year rapidly approached, we began to think about how we could continue to incorporate values of DEIAJ into our education. Hana shared an experience she had prior to her emergency medicine clerkship where Dr. Marcia Perry, Assistant Professor and Associate Chair for Diversity, Equity and Inclusion in the Department of Emergency Medicine, and Dr. Samantha Chao, PGY-4 in Emergency Medicine, discussed strategies to minimize bias in clinical notation. She thought that the messages from their talk could be incredibly valuable to students before they entered the clinical setting, and we agreed.

Dr. Chao presenting at the lunch event.

SDC hosted “The Power of Language in Clinical Documentation,” a lunch event to incoming M2s led by Drs. Perry and Chao. They led an interactive discussion about their experiences in the Emergency Department and their process of writing and presenting patient information while minimizing bias in their care teams. We looked at examples of notes with biased language and how it might influence providers’ perceptions of patients. They provided us with strategies to advocate for patients as medical students, acknowledging that we are in a position where we might not always feel empowered to correct a resident or attending. These strategies included changing progress notes to remove stigmatizing language and add person-centered phrasing. Other strategies included using the correct language during presentations on rounds, even when other providers might be using biased language.

In just two months of being clinical students, we are already able to put what we learned into practice. After inheriting a patient who had been through many medical services, his “one-liner,” the very first sentence anyone reads about them when looking through his medical chart, described the patient as a “drug abuser.” Changing the one-liner from “drug abuser” to “patient with a substance use disorder” was a small but tangible action toward reducing bias in the clinical space.

While clerkships take a lot of our time, our projects are still ongoing. As we traverse the clinical space, we are mindful of our current experiences and how they will inspire us to take action in the future. If you are reading this and are similarly passionate about DEIAJ work and want to have an impact, please consider working with or supporting the efforts of SDC!

The Bus Will Take You Far: Getting Involved with Community Health Efforts in Washtenaw County

After attending Second Look at Michigan (SL@M), it was clear that the University of Michigan Medical School was the place for me to pursue my medical education. However, the beginning of my medical school journey was bittersweet.

As it is for many matriculants, I had spent most of my life working towards becoming a physician, but I found myself not wanting to leave the life I had built for myself in DC. I was passionate about my work at the DC Primary Care Association (DCPCA) and had fallen in love with DC’s culture and pace of life. Collaborating with DC’s Federally Qualified Health Centers was immensely fulfilling, and I was sad to leave my projects, especially the initiatives that aimed to improve the holistic wellbeing of DC’s underserved patients.

Moreover, I had never lived in Michigan before, and I wasn’t sure where to start when it came to learning about the health infrastructure of my new community. I was intimidated by the prospect of starting over, both personally and professionally, in a new place. Crazily enough, it was a chance bus ride to West Ann Arbor that put my worries to rest and helped me get involved with the community health work that I hoped to continue upon moving to Michigan.

On June 16th, my best friend and I drove a U-Haul stuffed to the brim with everything I own from DC to Michigan. I moved here a couple months before starting school because I knew that I would need time to settle into my new life. For me, a huge part of feeling at home in a new place is exploring my community, so I made it a point to take public transit and visit different community gathering spaces around town. Some early-July day, while taking the bus to one of Ann Arbor’s district libraries, I happened to sit directly across from an advertisement for the Corner Health Clinic. It was a vibrant flier, with lots of playful icons and smiling faces. It stated that the clinic was a community health center that provided primary care to young folks in the Ypsilanti community. The flier also listed the clinic’s services, and two caught my attention: the community pantry and gender-affirming care.

A commemorative selfie to celebrate my first shadowing experience as a medical student.

Fortuitously, the clinic manifested in my life again a few weeks later, when Dr. Emad Abou-Arab, who happens to work at Corner Health Clinic one day a week, came to speak with the LEAD cohort about practicing medicine after the pandemic. During his talk, he spoke about his passion for community health. He described how difficult it is for physicians to operate within the strict, arbitrary confines that insurance imposes on the provision of health care. He shared with us some of the strategies he uses to work around these issues and improve his patients’ ability to access care. Dr. Abou-Arab exemplifies the kind of physician and advocate I hope to become, so I reached out to him and asked if I could shadow him at Corner Health. He agreed and said he was excited to have me join him in the clinic. I took the bus over to Ypsilanti and we spent the morning seeing patients.

Genevieve Mulligan, a fourth-year medical student applying into family medicine, was also at the clinic that day as part of her clinical rotations. At the beginning of the day, Dr. Abou-Arab invited Genevieve to “run the show.” I accompanied Genevieve to the patient room and observed her perform the interview. It was inspiring to see Genevieve ask insightful questions and invite the patients to speak on all aspects of their health. Genevieve has an incredible passion for family medicine and is a generous peer mentor and teacher, who fervently shared her knowledge with me. After concluding the patient interview, we then returned to the office, reported our findings to Dr. Abou-Arab, and developed a preliminary course of action, making sure to consider the patient’s unique circumstances. All three of us then entered the patient room to collaborate with them to finalize the treatment plan.

Though I have been interested in gender-affirming care for many years, this was my first real clinical experience with this branch of medicine. It was rewarding to see how relieved and excited the patients were to be receiving hormone replacement therapies. It was amazing to see that Ypsilanti community members could not only get their primary care needs addressed at the clinic, but also receive life-saving treatments that have historically been withheld (and, in some states, continue to be) from patients. It was also meaningful to think about the impact that receiving these treatments would make on the patients’ emotional wellbeing on a daily basis. Unfortunately, identities are frequently forced upon us. Holding identities that aren’t readily apparent to others can be painful because society places us in boxes that don’t always match the ones that we would choose for ourselves. For this reason, there is indescribable power in reclaiming one’s ability to define their own selves and impact how they are perceived by those around them. I am glad that places like the Corner Health Clinic exist because every time that a patient who is transitioning takes a dose of their medication, they are moving forward in their journey to embodying the person who they know themselves to be.

Volunteering at the Packard Health Fair, another community health opportunity I’ve gotten the chance to be a part of since becoming a medical student at UMMS.

After we finished seeing patients, Genevieve and I went to the bottom floor of the clinic, where the community pantry is housed. It offers healthy foods, baby clothes, toiletries, and basic household necessities for free to Ypsilanti’s youth. While working at DCPCA, I learned that medical care alone does not make a significant impact on a patient’s health if their basic needs, like housing, food, and safety, are not being met. Therefore, health care providers must consider these external determinants of health and provide wraparound care and integrated resources that work beyond patients’ medical needs to ensure their physical and emotional wellbeing. In-house services like the clinic’s community pantry help do exactly that.

The ad that I saw for the first time in July and again on my way home from shadowing Dr. Abou-Arab at the Corner Health Clinic.

At the end of the morning, I thanked Dr. Abou-Arab and Genevieve for their time and enthusiasm for helping me learn. I got on the bus back to Ann Arbor and upon taking my seat, I saw something colorful out of the corner of my eye. You wouldn’t believe me if I told you that I found myself sitting across from the very Corner Health Clinic flier that I had seen on my bus ride to the library in July.

The word that best encapsulates my time so far at UMMS is serendipity. Though it was hard to leave DC, a series of chance interactions have catapulted me into incredible opportunities that make me feel as though I am exactly where I am supposed to be, and I am grateful for that.

 

Empowering Medical Students Through Process Art

MedART is a longitudinal art therapy class for medical students at the University of Michigan that creates a space for discussion and creative expression. The program was founded in March 2022 by a group of friends looking to meaningfully reflect upon and convey their experiences in medical school. This is a course created by medical students for medical students. We found a need to provide a long-term creative outlet for processing the unique experiences that medical students encounter, and the novel emotions that our peers face with limited time and resources to share and understand them.

The course started off with the idea of making art more accessible to medical students as a means to relieve stress and promote well-being. The University of Michigan Medical School has several amazing events and workshops dedicated to promoting well-being through the arts. However, we felt there was a gap between having a space where students interested in the arts could really delve into it regularly, and providing an environment where they can feel safe to be vulnerable and have access to the creative medium. We decided to bridge this gap by introducing our peers to art therapy.

The MedART Therapy course comprises eight sessions, led by our amazing art therapist, Dr. Katherine Munter, whose passion and dedication has been invaluable. The course focuses on topics such as grappling with perfectionism, body image, imposter syndrome, processing trauma, and reclaiming one’s identity as an individual through color theory, surrealism, tactile art, resourceful art, “anabolic” and “catabolic” art, and cultivating art from nature. Different from other art-based wellness programs that emphasize the visualization of art, MedART Therapy approaches healing and rejuvenation through the creation of art.

This notion of “process art” is core to our mission of empowering students, through art, to reframe personal struggles as opportunities for exploration, discovery and reflection. Students have found this course to provide an opportunity “to not be perfect, to be silly, to make friends, and to be mindful of what is going on around [them]”, and “learn to be more introspective… [using] different mediums to explore emotions and thought.”

Due to the success of the course last year, we have brought it back this fall and hope to establish it as a permanent elective available to medical students in the future. Today, MedART is a supportive community of learners spanning different cohort years, backgrounds, and interests who are all on this very outlandish journey we call medical school.

Special thanks to Dr. Joel Howell, Dr. Thomas Sisson, the Department of Internal Medicine, the Learner’s Wellbeing Office, and everyone involved in creating and establishing this course.