by Mustapha Jaber | Aug 17, 2023
Following my first year at the University of Michigan Medical School, I had the absolute privilege of being one of the four Health Equity Interns in the American Academy of Family Physicians (AAFP) Underrepresented in Medicine Health Equity Internship Program.
Presenting my work on the Social Determinants of Health Screening Action Guide at the AAFP National Conference in Kansas City, MO.
Throughout the summer, I engaged in learning about policy and commission making in healthcare. From the start, I had the honor of attending the Commission on Diversity, Equity, and Inclusiveness in Family Medicine, providing me an early vantage point to delve into health policy and witness the decision-making process shaping our healthcare landscape. Meeting leaders from around the nation and engaging with their expertise and perspectives on crucial issues left me enlightened.
One of the hallmarks of the internship program was the “Mentorship Mondays,” which afforded us the opportunity to meet and learn from Family Physicians from all around the country. It was amazing to meet inspirational physicians doing such diverse and impactful work. I left each meeting feeling empowered and inspired.
Additionally, to supplement our learning during the program, we were given a book called “The Political Determinants of Health” written by Daniel E. Dawes. This book was very insightful, providing an intricate dive into the forces and systems that have resulted in the disparities in health we see throughout history that are ever much present today. One of the major lessons I learned from reading this book, as well as our discussions with physicians, was the multitude of levels in which health disparities exist and conversely can be addressed. Starting from the individual patient encounter all the way to political structures, in order to properly address the health inequities we see today, we must have a comprehensive approach at all levels.
The core of the internship centered around developing action guides to improve the foundation of patient care and address social factors beyond the walls of the clinic. My role involved developing a guide to assist family physicians in identifying and addressing patients’ social needs. At first, I could not believe I would be working on such an important and impactful guide that would be used by family physicians across the entire country! I was equally excited and nervous to play such a pivotal role.
After a deep dive into the existing literature, it became apparent to me just how critical this guide will be. Did you know that clinical care is estimated to account for about 20% of health outcomes, whereas social determinants of health affect up to 50% of health outcomes (Hood CM)? The more I learned, the more I developed the guide by tailoring information to what seems to be most important for patients whose needs are not being met. Through introspection, I gained invaluable insights into my role as a future physician and what patient-centered care truly means.
Embarking on this uncharted process was inherently difficult, but I had the utmost privilege of being mentored by Dr. Margot Savoy. Our discussions and her unwavering support empowered me to visualize what I wanted the guide to be and the lasting impact I wanted to make. Her guidance encouraged us to take the lead and express our thoughts freely. This allowed me to write about my personal perspective on what is truly important to me and to the communities I deeply care about.
Photo Credit: American Academy of Family Physicians Instagram: (the_aafp)
In the midst of the program, I had the opportunity to travel to Kansas City, Missouri, and present an overview of the Social Determinants of Health Screening action guide at the AAFP National Conference! The conference was a transformative experience that opened my eyes to the critical work passionate individuals are doing across the world. I was able to attend discussions, listen to congressional reforms and network with peers from around the world. I could not help but feel a profound sense of purpose and commitment to my role in driving healthcare reform.
I am proud and honored to be a part of such an incredible and transformative program. I hope to take all the skills and knowledge I have gained thus far and use them throughout my career and to continue to be an agent of change.
References: Hood CM, Gennuso KP, Swain GR, Catlin BB. County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. Am J Prev Med. 2016 Feb;50(2):129-35. doi: 10.1016/j.amepre.2015.08.024. Epub 2015 Oct 31. PMID: 26526164.
Mustapha Jaber is a rising second year Medical Student at the University of Michigan Medical School. He is the Co-founder of the Disabilities, Research, Education, Advocacy, Movement (DREAM), and is passionate about Health Equity. He enjoys all kinds of physical pursuits and is currently preparing for his first marathon!
by Emmanuel (Manny) Quaye | Aug 19, 2021
My research interests have evolved over the years. As an undergraduate at Michigan, I spent three months in Hangzhou, China studying iron deficiency and its effects on cognition in 9-and-18-month-old infants. Although I spent most of the summer coding videos and entering data, I learned much more about the process of conducting research, which involved lots of reading, asking questions, maintaining a healthy amount of skepticism, and most importantly, embracing the unknown.
Daniel Moura (on my right) and the entire research team alongside myself at the Zhejiang School of Medicine in Hangzhou, China.
After graduation, I spent one year working as an AmeriCorps Vista member, where I helped facilitate college access workshops for 9th graders and their families. As a Vista, I also had to live at the poverty level for Washtenaw County (the county Ann Arbor is located in), which was $13,000 at the time. Not only did I have to apply for food stamps and learn how to budget, among other life skills, but I also began to understand the financial hardship that many families in our country face on a day-to-day basis. Not knowing if you can afford rent, healthy food, or health insurance is something that many of us in medicine, including myself, don’t have to think about and often take for granted. This experience sparked my interest in health disparities research and led me to Johns Hopkins, where I earned a master’s degree in epidemiology.
As a graduate student, my research focused on the relationship between the social determinants of health (e.g., education level) and obesity using data from a community study called ARIC (Atherosclerosis Risk in Communities). During my time in graduate school, my mentor Dr. Josef Coresh encouraged me to apply for a Diversity Supplement, a grant awarded to minority students to increase diversity in the research workforce. I learned in graduate school about the importance of choosing the right research mentor—someone who invests in your academic success and personal well-being, and connects you to others if there is a need they can’t meet. Typically, the process of finding the right mentor is often trial and error. I still remember the days when Dr. Coresh and I would go to spin class or eat dinner at Fells Point in Baltimore.
My mentor Dr. Josef Coresh (left), and I at the Johns Hopkins Bloomberg School of Public Health graduation ceremony.
When deciding on where to attend medical school, I wanted to be at a place with excellent clinical training, ample opportunities for research, and a vibrant, diverse, and supportive community. Michigan fit all three criteria. I also knew that I wanted to get involved in research in medical school, but I was unsure about what kind of doctor I wanted to be and how to get involved. I reached out to an upperclassman I knew who had taken a year away from medical school to participate in the National Institutes of Health (NIH) Medical Research Scholars Program. He loved his experience, and he and other mentors at Michigan encouraged me to apply.
The NIH Medical Research Scholars Program is a year-long, paid, mentored research fellowship on the NIH campus in Bethesda, Maryland. I chose to apply because the NIH is at the forefront of medical research. They have the world’s leading experts in every field of medicine, and all patients who receive care at the NIH Clinical Center (the nation’s largest research hospital) are on a research protocol. During the COVID-19 pandemic, being surrounded by the experts leading the charge to develop a safe and effective vaccine and other medical devices and therapies to combat the virus was truly a privilege.
My roommates and I enjoying some good food at our ugly sweater party.
At the NIH, I wanted to try something new and gain additional skills to complement my public health background. I also felt that to understand health disparities better, I needed to have a solid understanding of the biological determinants of health. At the NIH, I worked with Dr. Rebecca Brown, a fantastic mentor and world expert in lipodystrophy, studying the mechanisms of action of leptin therapy and associated changes in energy expenditure in patients with partial and generalized forms of lipodystrophy. The analyses I conducted led to new questions and hypotheses that turned into new projects.
Celebrating the groom Tochukwu Ndukwe (right), who is now a PGY-1 in Ophthalmology at the Illinois Eye and Ear Infirmary.
At the NIH, there were opportunities to take classes, attend national (virtual) meetings, listen to lectures by medical experts, and explore some of the great restaurants in D.C. My experience at the NIH was nothing short of transformative. I worked on exciting projects, formed new friendships with my co-scholars, learned from the brightest minds, and even had time to make it to my classmate’s wedding.
My journey in medicine has been filled with twists and turns, but each unique experience has helped shape me into the kind of physician I aspire to be. It’s okay to delve into new experiences even if it’s uncomfortable. Learning what you like and don’t like is critical early in your career, and having supportive mentors who have your best interest at heart can be life-changing.
Emmanuel (Manny) Quaye is a fourth-year medical student at the University of Michigan Medical School. He’s interested in pursuing a career in internal medicine and enjoys weightlifting and listening to Afrobeats.
by Natalie Guzman | Dec 3, 2020
Before I even started high school, I knew I wanted to become a physician. However, after my freshman year of college, I questioned whether I would make that dream come true. I was struggling to maintain my STEM GPA, and I believed I just was not cut out for medicine. I was ready to give up, but then I participated in the Biomedical Research Internship for Minority Students (BRIMS) at Cincinnati Children’s Hospital. This program gave me the courage and confidence to continue pursuing medicine. I was able to network with highly successful minority physicians, learn new study techniques, and most importantly, I gained a new outlook.
During the BRIMS program, I discussed the struggles I faced with science courses my freshman year. Through workshops with my colleagues and mentors, I realized that my public-school College Preparatory Chemistry course during 10th grade might have left me with less of a foundation than some of my classmates. This by no means meant I was not as intelligent or qualified, but it did mean that I needed to take the extra time to strengthen my foundation moving forward. Going into my sophomore year of college, I no longer saw my knowledge gaps as incompetence, but something I could work through by going to office hours and seeking out additional resources like Khan Academy videos. Unfortunately, many students are not able to participate in programs like BRIMS and in their case, they may decide to give up on medicine just as I would have if I did not participate in the BRIMS program.
My UM SMART poster presentation.
Many students who are from populations that are underrepresented in medicine (URiM) face significant barriers to becoming a physician. Whether that be a lack of foundational knowledge as in my case, low standardized test scores, lack of representative mentorship, financial barriers, imposter syndrome, and so much more. For many URiM students these challenges become prohibitive to applying to medical school, leading to a lack of diversity in the field. During my junior year of college, I decided to not only apply to medical school but also pursue a PhD because of my strong research interest.
The lack of diversity was amplified amongst the physician-scientist field. MD/PhD programs are notoriously selective and competitive. The years of research experience needed, high median MCAT, and lack of representative physician-scientist mentors with a culmination of other factors have resulted in a field that lacks diversity. In 2019, out of 579 MD/PhD graduates, 5.35% were Black, 5.17% were Hispanic, and 0 were Native Hawaiian or Other Pacific Islander (https://www.aamc.org/media/8231/download).
With such a low number of URiM students in the MD/PhD field, it is clear change needs to be made in order to strengthen the pipeline for aspiring URiM physician-scientists. This summer, I collaborated with URiM MD/PhD students at Emory, Stanford, and the University of Pennsylvania to address this very problem. We wrote a paper that discusses the challenges URiM applicants may face in the MD/PhD process and advice for overcoming these challenges. We also highlighted next steps for institutions to improve URiM recruitment, such as creating URiM-specific MD/PhD programs, implementing implicit bias trainings, and improving on the holistic review process. It was an amazing experience to unite with other URiM MD/PhD students across the country. During our Zoom meetings, we not only brainstormed ideas for effecting change, but we were also able to connect on unique challenges that arose during the application and interview process.
While there is still a lot of work to be done, I feel a sense of pride that the University of Michigan is doing such a great job in regards to improving the MD/PhD pipeline. We have a program called the UM-SMART program that is specifically for underrepresented students who are exploring the possibility of a career as a physician-scientist. After graduation, 78% of the past participants have entered MD/PhD, PhD, or MD programs. The UM-SMART program was the reason I decided to pursue an MD/PhD. It will be a long and difficult road to increase representation within the physician-scientist workforce, but I feel assured by the passion for change amongst my peers, faculty, and collaborators at other institutions.
Natalie Guzman is a first-year medical student pursuing her MD/PhD. She has gotten involved with Doctors of Tomorrow and the University of Michigan Asylum Collaborative. In her free time, she enjoys going to the Arb.
