On Expanding My Medical Education

Editors’ Note: This afternoon, May 28, 2015, Albert Einstein College of Medicine will hold its 57th commencement at 3 p.m. at Lincoln Center’s Avery Fisher Hall. This is the second of two posts profiling students who’ve taken unique paths to Einstein and found great opportunity once here. Congrats to all graduates!”

Every morning, after I listened to his raspy, infected lungs, Mr. T and I would walk over to the window, looking out onto the street he knew all too well. He always surprised me with his trust and honesty, sharing details about years of sleeping in hospital lobbies, struggling with depression and substance use, and being locked in prison away from his family. He had gotten used to being stigmatized for his high methadone dose, “noncompliance” with medications, and difficult housing situation. The healthcare system had recreated instead of mitigating the difficulties he faced in the rest of his life, and did not do justice to the resilience that showed in his mischievous smile. There had to be more I could do to address the systems working against him.

Embarking on a career in medicine

Beyond the Hospital
Patients such as Mr. T led me to question my role in medicine, and by the middle of my third year, I knew I wanted to go beyond clinical work and try to change the way healthcare is delivered. However, I lacked the experience and skills to effect change using the language of evidence and practice that the medical system understands. When I expressed my concerns to Dr. Ellie Schoenbaum, she encouraged me to pursue the Clinical Research Training Program (CRTP), a two-year master’s degree program at Albert Einstein College of Medicine that trains clinicians in the basics of research design and analysis and requires trainees to submit original research projects. I sought out Dr. Aaron Fox, who first inspired me to use research as a tool for advocacy in the Health Disparities elective I took in my first year, and luckily learned that he was willing to mentor me in the CRTP.

Joining a Research Training Program to Effect Change
Consequently, I delayed my fourth year of medical school to join a handful of scholars—young attending physicians, fellows, and two of my medical school classmates—in the CRTP. We spent part of the first year in the classroom, learning about research principles, methods, and ethics. I began working on a research project exploring health outcomes at the Bronx Transitions Clinic, where people could go to receive care and support after being released from prison.

Research and clinical care cannot operate in isolation from the communities they seek to benefit. During the first year of the CRTP, I found myself with the rare luxury of a flexible schedule to do noncurricular work. As a way to expand the limited treatment options for people battling heroin addiction, I spent much of my time helping create and facilitate a group visit program for patients getting buprenorphine substitution therapy. In addition, thinking critically about the lack of community input in my own medical education and prior volunteer projects, I worked with a team of fellow students to organize a community-student advisory board for service learning at Einstein. In response to a request by a local prison for health education, I also had the opportunity to work with students and social medicine residents to form the group SPHERE (Space in Prison for Health Education and Re-Entry).

Next Steps
I began my fifth and last year at Einstein feeling incredibly lucky to have had the experiences that the CRTP allowed: I was using skills the program gave me to do two research projects, handing over several service groups to amazing new student leaders, and saying good-bye to the patients and providers I had gotten to know in the buprenorphine group. My research mentor, CRTP faculty and scholars, collaborators and patients at the clinic, and community work partners have helped me formulate my roles as a clinician, researcher, and advocate. I look forward to seeing our projects flourish and using our research to advance policy. But just as the antibiotics we gave Mr. T did not adequately address the scope of his needs, I question whether the language of science and medicine will be enough to confront the historic racism that underlies the illnesses we treat.

As I graduate from Einstein and grow into my new role as a resident in Montefiore’s family and social medicine program, I will seek new ways to use my work to promote true justice and healing.