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.
Josh Goyert and Hana Murphy are on the leadership team for Doctors of Tomorrow, a partnership between Cass Technical High School and the University of Michigan Medical School focused on exposing underrepresented minority students in Detroit to careers in medicine and providing mentorship to help them pursue this path.
When applying to medical school in the summer of 2019, we didn’t really know what to expect from our M1 year, but we certainly did not anticipate what this past year has held. The COVID-19 pandemic has drastically altered nearly every facet of our daily lives. The traditions of how we work, learn, and live have all been upended by this virus. Yet, while COVID-19 has been challenging for all of us, it has certainly not been equally difficult for each of us. This virus has disproportionately impacted minority populations, with Black and Hispanic communities being drastically overrepresented in both hospitalizations and deaths. COVID-19 has compounded America’s existing health disparities and serves as another powerful reminder of how much more work there is to be done in addressing them.
Prior to medical school, we both really enjoyed our work in youth mentorship and wanted to stay involved through programs that advanced equal opportunity in medicine. We know we wouldn’t be at UMMS without the caring and selfless mentors in our lives and hoped to find a way to pay it forward and support a more diverse generation of physicians. Our shared passion for mentorship and our goal to help patch medicine’s leaky pipeline led us to Doctors of Tomorrow (DoT).
DoT is a partnership between Cass Technical High School and the University of Michigan Medical School designed to increase representation in medicine by providing students from underrepresented communities mentorship and exposure to the field. DoT is split into three main cohorts: DoT Foundations (9th & 10th grade), DoT Rising (11th & 12th grade), and DoT Succeed (program alumni who matriculate at the University of Michigan for undergrad). Each cohort meets virtually twice a month where they might learn from a cardiologist teaching about heart disease, a surgeon hosting an interactive suture session, or medical students demystifying the path to medical school. Students also meet regularly with their medical student mentors and work in groups on longitudinal capstone projects to solve community health issues. The goal of these sessions is to expose students to different fields in medicine so that they can better visualize a career in health care.
Hana:As Director of DoT Rising, I organize educational sessions with Michigan Medicine physicians, create programming to outline career paths in health care, and provide guidance and facilitate essay support throughout the college application process. Our most recent session, “Diversity in Medicine: Representation Matters” included physicians Dr. Donnele Daley and Dr. Randy Vince, who shared with DoT students their career paths, life obstacles, and experiences as a BIPOC individual in the medical field. Their guidance and genuine life perspective I could tell struck a chord with students, helping them to see what the road to medicine might look like. Dr. Vince’s powerful reminder that “it’s extremely hard to become what you can never see,” serves as a testament to the importance of programs like Doctors of Tomorrow. How can we hope to diversify, and thus improve, health care if the talent we need most is never exposed?
DoT Rising Diversity in Medicine Panel, January 2021
Josh: Alongside Hana, I work as the Director of Capstone. Each month, we meet to work on students’ community health projects and continue to build on their public speaking and research abilities. Despite hours of “Zoom school,” DoT students show up eager and driven to complete capstone projects that address issues important to them. Our initial brainstorming sessions evolved into student-led discussions that spanned racial disparities in preterm labor to environmental racism and its impact on health outcomes. Their conversations were impassioned and persuasive. It was clear that their research projects had the potential to result in real change. To support their efforts, we sought out individuals well-positioned to help implement their ideas. With the help of Wayne County Commissioner Joseph Palamara, we were introduced to Michigan State Representative Clemente who has agreed to review and respond to DoT student proposals. Providing channels for civic engagement and community service supports DoT’s mission to prepare students to become future leaders in health care.
Dr. Finks demonstrating surgical techniques in the UMMS Clinical Simulation Center, December 2019
Josh & Hana: The failure of our health care system to produce physicians that represent their patients is not simply a moral failure, but it propagates the very disparities it seeks to address. While only 14% of the population, Black Americans have accounted for up to 48% of COVID-related deaths in Michigan. Although the health care industry is not solely responsible for this discrepancy, the tragic death of Dr. Susan Moore, a UMMS alumnus, demonstrates acutely how the medical field continues to fail Black patients. Doctors of Tomorrow aims to increase diversity by promoting educational opportunities in communities that have traditionally been excluded from medicine. A more diverse medical workforce will ensure that patients are able to see providers who more thoroughly understand their perspectives, which can result in increased patient satisfaction and more positive health outcomes. While increasing representation in medicine is necessary, it will not be sufficient to eradicate the health disparities that have long plagued the United States. Significant institutional change is required to effectively eliminate the health disparities that exist today.
Medical students leading interactive physiology lessons on Clinical Skills Day, February 2020
The incorporation of anti-racism components into medical school curriculums is a start to addressing these disparities, but this education without action leads to little progress. Advocacy is not a sideline sport, and all of us have a role to play. Medical students in particular are in a unique position to advocate for a more equitable future. For us, Doctors of Tomorrow was a means to translate words into action. We encourage current and future medical students to find meaningful opportunities that allow them to contribute to a more equitable future in medicine.
Joshua Goyert is a first-year medical student at the University of Michigan Medical School. His interests include mentorship and research. Outside of studying, he enjoys spending time outdoors exploring parks throughout Michigan.
Hana Murphy is also a first-year medical student at University of Michigan Medical School. Her interests include women’s health, youth mentorship, and urban health equity. She loves being outside and on a sunny day you can find her running Argo Park, doing outdoor yoga, or hiking with friends.