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In with the Old, In with the New: Building Community and Continuity in Medical School

A couple of weeks before the start of my M1 year at the University of Michigan Medical School (UMMS), I remember feeling a huge range of emotions. Of course, I was ecstatic to be coming to such an amazing “powerhouse” of an institution to finally start my medical education after three gap years. At the same time, I was anxious about leaving the city where I had built a community of mentors, role models and friends over seven years. I had also gotten used to having time to pursue my hobbies other than studying – what if I didn’t have time to bake or sing anymore in medical school?!

Once I arrived and got started, I quickly saw that although beginning a new chapter in life inevitably comes with some initial discomfort, UMMS is the perfect place for me to learn lessons from new people and experiences, build new relationships and continue to grow.

As far as finding mentors and role models is concerned, there is no lack of incredible physicians here who want to uplift medical students. As our first unit of the year got underway, I started reaching out to those in different fields of interest to explore all that’s out there (I’ve since learned that there is much more than I even knew existed!). I remember logging into a Zoom call in late September. Sitting in the virtual waiting room, I was nervous: What if the attending physician on the other side of the screen thought I was wasting her time? What if she thought my questions could have been answered with a Google search? However, she introduced herself and then immediately, cheerfully asked, “How can I help?” We spent the rest of the call discussing my interests, what life as a neonatologist looks like for her, opportunities to get involved in research and scheduling a time for me to come shadow in the NICU (neonatal intensive care unit) a few weeks later. After hanging up, I was both excited and overwhelmed by how many doors are open for medical students at UMMS. I was equally grateful that someone doing such important things and navigating such a busy schedule would take time out of her day just to “chat” with a first-year medical student who is trying to take full advantage of the next four years.

Two women standing side by side next to a picture of babies

Had a great time learning more about Maternal-Fetal Medicine and shadowing Dr. Berman

While I was struck by this physician’s attitude and willingness to help, since that call, I’ve come to see that these conversations are not the exception but rather the norm at UMMS. I’ve had similar experiences with senior medical students and other attendings who have all been more than willing to help point me in the right direction. Since shadowing in the NICU, I also observed on the high-risk obstetrics floor of the hospital, in a fetal echocardiogram clinic, in the PICU (pediatric intensive care unit) and on a geriatrics consultation team.

During a conversation more recently, I was struck by the words of another physician, at the forefront of qualitative research in her field. She too was so willing to provide opportunities so that medical students can get involved in ways that are not only meaningful and personalized to their interests but will also help build them up for the future. When I expressed some insecurity because I don’t have much experience writing research papers intended for publication, she reassured me that with her and the team I would have the tools and learn the skills. I know she would have said the same thing to any student. I imagine she didn’t think there was anything unusual about the conversation, but it made me think even more about the community I’ve joined and the emphasis placed on opening doors for those coming up in their training.

The caliber of clinical role models and educators across the board is another reason I’m grateful for the opportunity to learn and grow here; I know that I will be a physician who thinks about all aspects of my patients’ lives and takes joy in getting to know them because I’ve had (and will continue to have!) examples who do the same. I’ve seen doctors make a conscious effort to empower their patients, diffuse tensions during difficult discussions and acknowledge when mental health needs must be met before delving into conversations about healthy habits and chronic disease risk.

Large group of medical students smiling at camera in conference room

Making holiday cookies with a fabulous group of American Medical Women’s Association mentors and mentees

I’m already becoming inspired by them and previous role models to help those who are currently applying to medical school and completing the pre-medical curriculum. Luckily for me, there are so many opportunities to begin practicing to be the type of mentor I want to be one day. As the undergraduate mentorship coordinator of our American Medical Women’s Association chapter, I periodically meet with my own mentees and plan events that provide some guidance for the pre-medical years and help foster connections between undergraduates and their M1 mentors. I’ve also loved speaking with students at my undergraduate institution who are interested in applying to UMMS.

As for the hobbies I worried I wouldn’t have time for, I’m happy to report that I’ve been able to continue them as a medical student and even picked up one more! To scratch my singing itch, I participate in a medical student a capella group, the Auscultations, and though I don’t act or dance, I’ve had many opportunities to watch my classmates perform in shows like The Smoker and Biorhythms. I’ve been able to keep baking, especially because of M-Home’s Flour Hour programming. And, at the encouragement of some friends in my class, I’ve taken up running and training for a half marathon (something I NEVER thought I would say about myself!). Because of the flexibility of our curriculum during the first year, I’ve had time to do these things while also staying in touch with friends and family in other states.

A small group of medical students standing in a kitchen surrounded by baking supplies

Baking muffins for our classmates at Flour Hour!

So, while I was initially apprehensive about leaving the comfort of a city I had grown to love, I now see that instead of leaving everything about it behind, I’m melding that stage of my life with my current experiences. I’m able to maintain those relationships and keep working with mentors from my gap years, even getting an academic paper published! At the same time, I’m making new connections and learning from incredible role models and classmates at UMMS. I know that these four years will foster personal and professional growth, and I can’t wait to see what kind of physician I become.

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.

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.