Select Page

One Semester in Detroit: The Henry Ford Health System Clinical Rotations

Hi, I’m Ione and I’m writing today about the six-month Henry Ford Health System (HFHS) rotation block!

I initially decided to participate in the Henry Ford Health System rotation block because I had come to medical school knowing that I wanted to engage deeply with health disparities, and I wanted to make health disparities a focus of my M3 Branches curriculum. Although I’ve loved my rotations at UofM, I knew I would learn some different lessons about health disparities by rotating at HFHS, and especially at the HFHS main hospital, which is a safety net hospital serving the Detroit area. I applied to participate over the summer of my M2 year, and started my first rotation in January of my M3 year.

Exploring Eastern Market in Detroit! On Saturdays, Eastern Market hosts an enormous farmers’ market. One Sunday every May, Eastern Market hosts “Flower Day,” which is a huge farmers’ market all for flowers.

For my six months at HFHS, I moved to Detroit and lived on campus at Henry Ford Hospital in an apartment building especially for students and residents. I had six, one-month rotation blocks: one month each of Ambulatory Care, Labor and Delivery, Trauma Surgery, and the Medical ICU, and two research blocks.

My rotations at HFHS spanned a broad spectrum of clinical care contexts. I found that on each of the services at HFHS, I learned something different about how clinicians are working to meet the health needs of the city of Detroit.  For example, on my Ambulatory Care rotation, I spent time at four different Federally Qualified Health Centers around the city of Detroit. On this rotation, I learned a lot about just how diverse FQHCs can be with huge variation in organizational structures, challenges at each clinic, funding streams, and patient populations. (I also met many inspiring clinicians passionate about delivering great primary care during this rotation!)

My Labor and Delivery rotation taught me a lot about the migration patterns that are bringing young people and families to Detroit right now: I routinely met patients from Mexico and Latin America, as well as Yemen, Lebanon, Syria, and Bangladesh, and I gained a better appreciation of the specific needs of immigrant patients. Each of these rotations taught me something different about health disparities, and efforts to address and reduce health disparities, in the context of Detroit.

Trying out Detroit Style Pizza!

Living in Detroit was itself another amazing part of the HFHS rotation block! Students who had completed this rotation before me gave me a list of great things to do to explore Detroit. While I was there, I added my own favorite places to the list. For anyone wanting to learn more about Detroit, here’s a list of recommendations:

Food:

Taqueria el Rey

Mi Pueblo

Detroit Vegan Soul

Cedarland (Dearborn)

Ima 

Pie Sci

Eater Detroit (great food blog about the restaurant scene in Detroit)

Golden Curry at Ima! So so tasty. I also very much recommend the ramen!

Drinks:

Flowers of Vietnam

Chartreuse

Culture:

DIA

Detroit Historical Society

Heidelberg Project

Motown Museum

Detroiters Speak lecture series

Eastern Market

Dequindre Cut Parkway

Still on my list of places to visit/try:

Rose’s Fine Foods

Sweet Potato Sensations

Bonoful Sweets & Cafe

Dabls MBAD African Bead Museum

Detroit Soup (Microgranting Dinner)

Baker’s Keyboard Lounge (Jazz Lounge)

Got other great recommendations of things to do in Detroit?? I’d love to hear them! Email me at ilocher@umich.edu

Starting Medical School with a Partner: What We’ve Learned So Far

Hi there, we are Matt and Patty. We’ve been together for 4.5 years after meeting in college, and moved from Boston to Ann Arbor in July for Matt to begin medical school. Having been in Ann Arbor for under a year, we are still discovering new things about our new home and each other. Here are a few things that have been the most important lessons for us so far.

 

Go Blue!

From the student, Matt:
Now that we’ve been here for a few months, I can look back on the choices that have made the biggest impact so far. One that has been especially helpful is my flexible quiz schedule. At Michigan, we take a quiz every two weeks that covers the previous two weeks’ material. The quiz helps us solidify our understanding of the material in a lower-stakes environment. Students can take the quiz from Friday night through midnight on Sunday at their convenience. This flexibility is nice, but without proper planning your weekends can become filled with studying instead of taking a much-needed break and spending time with your partner. At the outset, I decided that I would always take the quizzes on Friday night. This has allowed us to spend the weekends together (with a bit of light studying mixed in). It’s been so freeing to not have a quiz hanging over my head on the weekend. Being a self-enforced rule, there are times mid-week where I don’t feel fully prepared for a Friday quiz, but I’ve somehow managed to keep to my Friday rule. Michigan does allow a re-take of a different version of the quiz on Monday called remediation quizzing, which replaces your other quiz grade if you score better. Having the option to re-take the quiz on Monday lowers the pressure of the first quiz and has allowed me to learn from my mistakes on Friday’s quiz.

Another important aspect of our curriculum is the ability to stream lectures. This has allowed me to spend more time studying from our home, which works well since Patty works remotely. As for the content, streaming offers the ability to pause and re-watch components of the lecture and take notes at a pace that is appropriate for me. Studying from home lets us have breakfast and/or lunch together on days when I don’t have required events on campus. This lets us see each other more during the week. Even if your partner doesn’t work from home, it’s thoughtful to prioritize being home for at least one meal of the day to share with each other. The gradual accumulation of dedicated meals each day or week, regardless of how spectacular (or not) each one may feel, leads to greater feeling of closeness, especially when studying can feel all-consuming.

In terms of friends, we’ve both tried to establish independent lives and social circles. Patty has encouraged me to attend medical school social events without her, even if that means not being home some evenings. The students in your medical school class will be the people that you study and work with for the next four years. They make you feel less alone during the grueling periods of study. Both partners need to be OK with building up your networks separately from one another. In addition, your partner should try to develop their own network of friends because your medical school friends are likely just as busy as you, and that only escalates during the clinical years. Luckily, Patty has found a community with her water polo team. I encouraged her to seek out a community based on her interests, so that when she shows up, there are already built-in commonalities and shared experiences.

From the partner, Patty:
Supporting a partner in medical school requires patience and understanding that school is the number one priority. This acknowledgement is easier to stomach knowing that medical school lasts four to five years, while your relationship together is lifelong (I hope!). Being willing to support your partner through this time period is essential. In many ways, we’ve felt the schoolwork taking over our relationship in the past year. Meals, social events, and working out needs to be planned around it. Because of this, it can feel like you are always short of time with each other. We’ve tried our best to push away this feeling, as it gets in the way of being able to spend time pursuing independent aspirations. The happiest times of our life together (so far) have been moments when all the chips have fallen into place — when we’ve had a network of good friends, well developed hobbies, athletic outlets, and each other. Moving to Ann Arbor, we had each other as a guarantee, but that was about it. We both needed to find new friends, find ways to pursue our hobbies, and discover new fitness routines. Michigan Medical school offers all of these things for a student, but what about a partner who is along for the ride?

Early on, we acknowledged that this was something that could make or break our happiness. While Matt joined in on the activities laid out for him in school, I threw myself into anything I could find – saying “yes” to as many things I could. Pushing away the awkwardness and discomfort is challenging, but I felt that at 26, if I couldn’t move to a new city and make a life for myself, then I never would be able to. To my surprise, the “yes” strategy started working. I joined the Ann Arbor Master’s Water Polo team, which I was elated to find (it’s incredible that Ann Arbor has its own team!) and said “yes” to the tournaments in Toronto, Chicago, and Seattle. I downloaded Bumble BFF and found so many other women in similar situations to me. The friend dates that I went on were a lot of fun. I joined a networking group for women in tech roles, and after dragging myself to the first meeting, I made an amazing new friend! Setting yourself up for success needs to come along with the dedication to your partner.

Things to do together:
As folks who have jumped around the East Coast and New England for our whole lives, we were initially hesitant about Ann Arbor. Neither of us had ever been to the state of Michigan before. It was helpful for us to admit our privileged past openly — Ann Arbor is not the same as New York or Boston. Once we acknowledged that, we were opened up to see all the incredible things that this place has to offer. In many ways, we’ve been able to do more of the things we love in Ann Arbor than we did in Boston. Patty’s water polo team and watercolor painting classes didn’t exist in Boston (at least not affordably). We live around the corner from the Kerrytown Farmers Market, which is something we’ve never had access to in a big city. We are able to drive around without traffic — an understated benefit. In the summer, we visited local farms for sunflowers, pumpkins and hay rides. In the winter, we’ve attended basketball games and visited museums on and off campus. In any season, downtown Ann Arbor offers more restaurants than your wallet will allow.

Since we try to spend one full day on the weekend together, we are always looking for the next new place to explore. We’ve loved exploring Detroit and taking photos of the beautiful architecture. Detroit is filled to the brim with interesting restaurants, history, museums, and shops that showcase passion and flair of the Motor city. On our way in or out of Detroit, we’ve made pit stops in Dearborn for Middle Eastern food or at the Henry Ford Museum, which boasts a spectacular display of planes, trains and automobiles.

The one thing you should take away from reading this is to discuss priorities and set expectations. Despite feeling like you both are on the same page, there is a good chance that you and your partner have different expectations of what medical school will require, what your lives will look like, and what will be expected of each of you to help the partnership work. Discussing your thoughts, feelings, and hopes in this regard is absolutely essential and should be talked about as openly as possible, as vulnerable as it may feel. Disappointment and hardship often come from a mismatch between expectation and reality, so calibrating those expectations can lead to a much happier and fulfilled life for you and your partner. We both wish you all the best here at Michigan and we know you’ll love Ann Arbor as much as we do!

Maintaining your sense of community

Changing the face of medicine at LMSA

A few weeks ago, I was grateful to attend the Latino Medical Student Association (LMSA) National/Midwest Regional Conference at Washington University School of Medicine in St. Louis, Missouri. This conference came at a perfect time in the middle of my third year as a medical student at the University of Michigan (UM), and has been one of many events during medical school that have strengthened my sense of community, recharged and inspired me, and reminded me of why I came to medical school.

I have always been told college is where I belong, yet through my experiences I have been struck by how important it is to find mentors and community that can provide support for the journeys that lie ahead. I am the granddaughter of Mexican immigrants. My mother walked across her high school graduation stage four months pregnant with me. My father served in the Navy and I lived in nine different houses before I graduated high school. I am the first in my family to attend college. Like many first-generation college students, once I achieved the dream of college, I was left with the question of “where do I go from here?” I realized no one had ever asked me what I wanted to be when I grew up and I had no insight into navigating higher education. Looking back, I realize I missed many opportunities. Thankfully, I followed each of my passions as I encountered them, discovering a love of anatomy as a senior in undergrad that led to a Master’s in Anatomy. My first research experiences in my master’s program drove me to a PhD in Integrative Physiology, and my desire to help patients led me to medical school. Even with all of the lessons I learned through my previous education, medical school has still felt daunting and at times I’ve felt lost on how to navigate all of these novel experiences.

However, I’ve found that having a sense of community has truly helped ground and revitalize me. Throughout my time in medical school, I have loved game and movie nights with the Latin American Native American Medical Association (LANAMA), going to conferences with passionate people, including LMSA or surgical conferences, mentoring first generation and women medical students and undergraduates, serving as co-director of the UM Student-Run Free Clinic, coaching track and field for first-sixth graders in Ypsilanti, and co-founding the Leadership Exposure for the Advancement of Gender and Underrepresented Minority Equity in Surgery (LEAGUES) Fellowship: an initiative to provide early surgical experiences for underrepresented minority medical students. Spending time with my community, whether in a social environment or working together to bring forth change, re-centers me on why I came to medical school – to be a leader and advocate for others and my patients.

Friends poolside at the Academic Surgical Congress

The third year of medical school is an exciting and liberating time – you’ve taken Step 1 and have the freedom to personalize your schedule – explore rotations you’re interested in, perform research you’re passionate about, and pursue any opportunities you can think of. It’s also a time when your peers are scattered across different rotations and sometimes you can feel disconnected from your classmates. But many opportunities throughout the year do bring you together. So far I’ve been able to attend multiple conferences: Society of Thoracic Surgeons, where I was paired with inspiring women Cardiothoracic resident and surgeon mentors; Academic Surgical Congress where I presented my research, and heard passionate and inspiring talks about improving the future of surgery for patients and medical professionals; and the Moses Gunn Research Conference hosted by our Department of Surgery, where I presented my research and felt motivated by our surgical department to change the world through research.

The LMSA National/Midwest Regional Conference in particular was a beautiful conference that lasted three days where I was able to catch up with my peers and hear about everything in their lives, from the amazing things they are doing, to their rotations, exciting research, or submitting their match rank list! The days were filled with talks and presentations by the AAMC President, faculty, residents, and our peers that ignited conversations on advocating for ourselves and patients to change medicine and provide not only access to care but quality care for all. My fellow UM third year medical students, Gracia Vargas and Maria Santos, poured their hearts and souls into organizing the conference and their passion was evident!

Grateful for my husband and I to be side by side on this journey

One thing I value about Michigan is the amount of support they provide their students. There was great UM representation at our exhibitor booth: medical students tabling for our medical school Admissions office, the UM Office for Health Equity & Inclusion sharing the opportunities at UM for students passionate about diversity and health equity care, and the Surgery Department, representing strong with our attending surgeon Dr. Filip Bednar and inspiring residents Valeria Valbuena and Shukri Dualeh sharing about the surgery department and great initiatives for underrepresented minority medical students, including LEAGUES and an away sub-Internship. These amazing surgeons spent one-on-one time teaching surgical skills, like knot tying, suturing, and laparoscopic skills to conference attendees.

The last night of the conference fittingly ended dancing into the night to Latin music with my husband and our friends. The conference strengthened that we are changing the face of medicine and that is something I am grateful to do with amazing fellow medical students, residents, and faculty at Michigan. I am most thankful to experience everything medical school (and life) has to offer, including the LMSA conference, with my husband, who is also a third-year medical student and has been my best friend and constant support. ❤️

¡Si Se Puede!

Finding Your Voice: The 2020 APAMSA Region V Conference

This past weekend, four of my M1 classmates and I had the wonderful opportunity to attend the 2020 APAMSA Region V Conference – Finding Your Voice hosted by the APAMSA chapter at the Ohio State University College of Medicine! The Asian Pacific American Medical Students Association (APAMSA) is a national organization that brings together medical and pre-medical students across the U.S. through local, regional, and national events. The organization’s mission is to promote the health of the Asian and Pacific Islander American (APIA) community and to address issues that disproportionately affect APIA individuals while serving these populations in a culturally sensitive manner.

Shannon Jiang, Curtis Kuo, Daniel Yang, Angela Yim, and I represented the UMMS chapter of APAMSA, also known as the United Asian American Medical Students Association (UAAMSA) here on campus. We made the three-hour drive to Columbus, Ohio last Friday afternoon, and had the chance to get to know each other even better than we already had through some fun conversations on the car ride and throughout the weekend. When Saturday morning came around, we headed off to the incredibly beautiful Ross Heart Hospital for the conference, and met several medical and pre-medical students from all across the Midwest region. First, we heard from State Senator Tina Maharath, the first Asian-American woman ever to be elected to the Ohio Senate. She overcame great adversity as the daughter of Laotian refugees, and she is now tremendously involved in her community and advocates for diverse representation in politics. I was then mesmerized by Dr. Peter Lee, a practicing cardiothoracic surgeon who impressively merged his various passions including Tae Kwon Do and space into his career path in medicine and research. He pursued degrees at various institutions including the International Space University, and he has flown several microgravity and spaceflight projects with support from the NIH and NASA (so cool!).

Afterwards we had several breakout sessions including a resident panel, a leadership workshop, and a discussion on breaking the APIA mental health stigma. One of the panelists that spoke to us is currently a general surgery resident who graduated from the University of Michigan Medical School and actually started the Medicine in Mandarin course that over a dozen of my classmates participated in this year! Another session featured Dr. Ron Jacob, a former Be The Match Executive Director, who addressed the inequality of available life-saving blood, stem cell, and marrow donors for ethnically diverse patients. And the last breakout session featured a dermatologist and a facial plastic surgeon who shared their personal stories and achievements (lots of words of wisdom). Finally, to end the conference, we heard from two women who have dedicated much of their lives to building strong communities through leadership in community-based Asian organizations that strive to address health concerns within the Asian population in Ohio through free clinics and local screenings.

I was thoroughly fascinated by each of the speakers and all the stories that they shared! The marvelous thing about conferences (for me, at least) is their power to inspire and reinvigorate my passion for medicine. I love having the chance to get out of the library and Ann Arbor for a weekend so I can meet and make connections with medical students at other institutions while learning about their experiences, be reminded of the importance of giving back to the community particularly in the context of health care, and hear about the roller coaster of a journey that successful practicing physicians have lived through.

 

What is Social Medicine? An experiential course in Africa inspires and motivates two future physicians

Hi! We are Anita and Ione, and we’re writing today in the wake of our return from a four-week trip to Uganda and Rwanda where we participated in an experiential course about Social Medicine.

We first heard about this course nearly two years ago through the Global Health & Disparities Pathway of Excellence, of which we are both a part. At the time, we were in the midst of our core clerkship rotations, deep in the weeds learning about the presentations of various clinical pathologies and the process of disease diagnosis and management. The title of SocMed’s course, “Beyond the Biologic Basis of Disease: The Social and Economic Causation of Illness,” stood out as a chance to revisit and go deeper into the structural framework that shapes health outcomes. We both kept the course on our radar as we moved through the Branches phase of the medical school curriculum, and the stars aligned for both of us to enroll in the January 2020 course in Uganda and Rwanda, with the generous support of Global REACH.

On a village visit in Northern Uganda to learn about culture as it relates to health

Arriving in Uganda at the start of the course, we joined a diverse cohort of learners from a spectrum of nationalities, ethnicities, professions, and personal experiences for a truly global educational immersion. Approximately half of the course students were from African countries, and the other half were from Western countries. The structure of the lesson plans offered ample opportunities to share and learn about the similarities and differences of our different contexts. Thus, as students we were also each others’ teachers, and through this approach we learned from our fellow classmates in ways that would have been impossible to organize into any kind of syllabus.

The curriculum of the course ensured that we spent our days exploring the structural causes of disease and the response of health systems to these structural causes, not only through conventional techniques like classroom-based lecture, discussion, and group projects, but also through reflective writing, dramatic expression, and place-based site visits. These layered exercises in critical thinking and action (termed praxis) encouraged us to interrogate how and why health systems are structured, and the considerations that must be given to demand, resource availability, and resource distribution. Moreover, the course structure left space to discern the values that define these health systems, and what implications that has for health equity.

Anita and Ione at the peak of Mount Kalongo!

However, we didn’t stop at the level of health systems: we also investigated the role of social movements in addressing structural causes of disease, and implementing the principles of advocacy for change. We practiced engaging with these practices in an intrinsically personal way: by drawing upon our personal histories and situating those within the work we do, we can approach action, agency, and change from a place of authenticity and security. Moreover, we can give ourselves the space to reflect on how we, too, are a part of the structures we choose to critique, and how power dynamics and systems of oppression that we might learn about in an abstract sense unfold on deeply personal levels. After completion of this course, we both feel inspired and motivated to use our voices as future physicians to engage with our communities at a grassroots level, and organize to effect change at a structural level!

Winter is Warm Somewhere…Rotating Abroad in Med School

Each year, the Universidade de São Paulo Medical School in São Paulo, Brazil hosts Winter School. It is a program that brings together medical students from all over the world to further develop and explore their interests in various medical specialties such as psychiatry, neurology, tropical medicine, surgery, cardiology, OB-GYN, and dermatology, just to name a few. Didactics and hands-on clinical experience take place at the Hospital das Clínicas medical complex, which is the largest hospital system in Latin America. While participating in the program, students are integrated into medical teams according to the specialty of their choice and take part in clinical care alongside residents, medical students, and attendings just as they would at their home institutions. University of Michigan Global REACH offers travel grants to medical students who participate in Winter School.

My classmates. 24 countries…60 new friends!

What really set the tone for the entire experience was the official welcome on orientation day. There was genuine excitement among the members of the University that we were joining their school, even if for a short time. As they introduced the history of the school and the mission statement for Winter School programming, the term “academic internationalization” stuck out to me. It was the term they used to communicate their belief that their medical students were better able to provide care to their patients when they invited other cultures and ideas into their sphere of practice. This openness laid a foundation of respect, curiosity, humility, and cooperation so that as we set off onto our respective rotations, we did so excited to learn about one another and this new health system we were so privileged to join.

During my rotation in Trauma Surgery, we completed a mixture of didactics, ultrasound/surgical skills labs, OR observation, and rounding with patients on the ED, ICU, and general wards. These experiences typically sparked in-depth case discussions as we followed our patients throughout the course of their treatment and explored the nuances of care within our international team. What was awesome about the clinical experience was that our reception on the wards as Winter School students was just as welcoming as it had been on orientation day. Everyone was excited to chat with us, to teach, and to give their time to make this experience a superb learning opportunity.

I still remember some of the “cool” cases we saw, but more than anything what I remember is how the attendings and residents went above and beyond to make sure we felt valued as clinical colleagues and as guests in their country. For the duration of Winter School, the attending physicians and residents halted all of their normal clinical activities and dedicated all of their energy to teaching Winter School students. That was no small feat for such a high-volume medical center. The dedication of so many resources to our learning and growth is something for which I will always have tremendous gratitude. At the conclusion of this time, I was truly saddened to leave the new friends I had made from around the world and this beautiful city. This was truly one of the greatest experiences I have ever had during medical school, and I think there is no substitute for what we can learn when we pair an open invitation with an open mind.