S3E11: Shaping the Future - Conversations from AAMC 2019

Leen: But I don't have it right now. Okay.

Bushra: Okay, you guys. Let's do it.

Margaux: Okay, I'll start. Hey everyone. It's Bundle Of Hers in the house here at AAMC 2019 conference and we've been here for a couple of days.

Harjit: Whoop, whoop.

Margaux: And we just want to say, hey, come stop by booth #booth two . . . sorry.

Bushra: 629, girl.

Harjit: Why are you saying that?

Leen: It's okay, Bushra's got it.

Margaux: We are here at booth 1629?

Bushra: I got it.

Leen: 629?

Harjit: This is afterwards. Who cares what booth we are at. They're not going to be able to . . .

Leen: We were at booth 16 . . .

Bushra: 629. You all don't even know the booth and you're trying to shout it out.

Leen: Basically.

Bushra: Let me stop throwing shade for a minute.

Margaux: Getting shady in here.

Bushra: Hey you guys, this is Bushra from the Bundle of Hers and we have Leen, Margaux, Harjit. We're all representing BOH at AAMC 2019 annual meeting, and we have a pretty cool set up here, you guys. You all who think we're fancy AF, check out our Instagram for what I'm talking about.

Margaux: The nice couch that they gave us with the beautiful backdrop.

Bushra: We're like official.

Margaux: We're super official.

Harjit: Official, official.

Margaux: We've been having great conversations here with medical students as well as faculty and people who really care about diversity in medicine. And it's been great to branch out of Utah and talk to people who are interested in and invested in the same work that we are.

Harjit: Yes, for sure. And I think that like, it's really cool to see that we have these thoughts, you know, in our communities, but also seeing them translated into the bigger world. It's been so wonderful and so connecting to know that there's people that think like us, there's people that also give us new things to think about and also challenge the ways that we've been thinking about things.

Bushra: Do you have anything to say, Leen?

Leen: There's really good food here. Like you can constantly go back and forth. They had like a roast back there. I was quite amazed with that.

Bushra: We're in Phoenix, Arizona guys, and this is my first time in Phoenix.

Harjit: Mine too.

Bushra: I did not expect it to be so freaking awesome.

Harjit: It's so cute.

Bushra: No, yeah, I thought we were going to be, I mean it is a desert, but I thought we were all going to be like nothing around desert like . . .

Leen: Tumbleweed in the road.

Margaux: It's probably what people think about Utah too.

Bushra: To be fair, yeah. No, this place is really nice and we're ready to explore a little bit too.

Margaux: So we've had a great, like we just talked about great opportunities to talk with different people. So this episode will be clips from our various interview, so enjoy.

Margaux: Hey, so this is Margaux with the University of Utah Health here at the AAMC conference, 2019 in Phoenix. And we're at our beautiful booth for University of Utah Health called "Shaping The Future." And I'm here today, right now with Dr. Samuelson who is our current and Vice Dean for Medical Education.

Dr. Samuelson: Hello there.

Margaux: How are you doing?

Dr. Samuelson: Good. It's nice to be here.

Margaux: Yeah. What do you think about the AAMC in this conference and that we get to represent our university here?

Dr. Samuelson: Well, it's a great conference and it's a nice forum for us to talk about the good things that the university does and some of the things that we've initiated and some of our programs, gives us a chance to showcase that.

Margaux: Yeah, I think it's really cool that the whole university came out to represent ourselves. What do you think the U is doing to shape the future of medicine in Med Ed?

Dr. Samuelson: I think the best contribution we're making is people like you. We think that our students are the future. We feel like our students are the most capable and the best students around. And our goal is to make sure that when our students leave our medical school that they can go to any training program and any specialty in any kind of hospital or institution and be the best doctors there. That's our goal.

Margaux: Today we have a great pleasure of talking with Dr. Alicia Monroe, who is the senior vice president of academic and faculty affairs at the Baylor College of Medicine.

Harjit: So Dr. Monroe, we actually got to speak with you for about 15 or 20 minutes before we started this interview. We're really grateful that you wanted to come speak with us. We really connected with the work that you do with diversity and inclusion and you've been doing it, it seems like for many, many years. We very much talk about our stories and our identities and why we do the work that we do. What kind of really started you in this area?

Dr. Monroe: I need to go back to probably my middle school, high school years. And one of the things I observed is that there were a lot of relatively young people in my family. Many of my grandparents, I never had a chance to know because they passed away in their 40s and their 50s. A number of moms in my neighborhood who died of cardiovascular disease.

There were a number of moms who died of cancer and my mother had a very delayed diagnosis of her Hodgkin's lymphoma. She had stage four cancer at the time of her diagnosis. She had gone in to see physicians, specialists on more than one occasion and she was told it was in her head. And one of the things that I observed is that sadly, when their stories related to their interactions with physicians, they were often unpleasant interactions, demeaning interactions, and they were reluctant to go.

There was not as much conversation about cost as there was about the experience. Part of what my project as a medical student was to go door to door and do blood pressure screenings. I worked with a community agency and I realized the lack of understanding and awareness of many people who were either not just at risk but frankly had high blood pressure. Not only not understanding it, but having a reluctance to see a physician or take a pill for treatment. So there were significant gaps in patient education, significant gaps in the physician patient relationship. And that was clearly a motivating factor for me. So it opened my eyes to the need of the medically underserved from a variety of groups, particularly those who had experienced intergenerational abuse and trauma.

Margaux: And something that we were talking about just before we started recording was how do you, and I think Harjit, and I have noticed this too, in our infancy in starting psychiatry is the discrepancies in access to care. And then even beyond that, within our own school and in our own communities, the barriers to even access medical school and have people with a broad diverse background entering the medical field to help care for those patients. And something that you said before that really resonated with me is that we sometimes have to take away that personal feeling of offense in order to be able to activate. Could you speak a little bit to that?

Dr. Monroe: There is a bias in many communities of color about psychiatry and mental health. There are biases related to if I have faith, then I will be healed and I don't need that medical care or if you're saying I'm crazy, rather than I'm depressed and there's treatment for that. So there are sort of cultural beliefs and perspectives that physicians need to understand and embrace in order to create a trusting bond with their patients to remove some of those additional hidden barriers to care even when an individual is face to face with a compassionate, well-trained provider.

What are the additional barriers as it relates to establishing a trusting physician-patient relationship? The physicians having the skills to engage in shared decision making. And so, there are a lot of complexities but they're important for us to engage and to identify effective strategies to overcome.

Margaux: This is Margaux Miller with the university of Utah Health at the AAMC 2019 Learn Serve Lead conference here in Phoenix, Arizona. And we have Dr. Michael Good, who is the CEO and Dean of the medical school. And you have another title too, right?

Dr. Good: Senior Vice President for Health Sciences.

Margaux: Yes, thank you. And it's been really fun to be here. The University of Utah has hosted some medical students to come here and it's been a wonderful opportunity. And our booth here at the AAMC in 2019s theme is shaping the future of medicine. So I'd like to ask you, what do you think the U is doing to shape the future?

Dr. Good: Well, I think first and foremost, graduates of the university of Utah Medical School get into the top residency programs across the country and they go on to become great physicians. In fact, somewhere between two thirds and three quarters of the physicians in the state of Utah come from our medical school.

And so, first and foremost, we shape the future by making sure they are going to be great physicians to take care of the citizens of our state and of our nation. I'm also really impressed with some of the exciting research initiatives that are happening on campus. If you look at work that's being done in the broadly in the genetic space, whether it's using our genetic code to help better diagnose disease, to predict who may become susceptible to disease and even gene therapies where we alter genetic makeup in order to prevent or cure a disease.

It's very exciting times and in many ways that's an area where the University of Utah is leading the nation and shaping the future. Just innovative things in our education programs. For example, the center for medical innovation. I don't know if any of the listeners have participated in the bench to bedside program, but that's a real highlight of the year for me where we get to see the projects, student led, student generated, but tackling real life problems and challenges with some very innovative solutions. Again, I think that's an area where the University of Utah is really shaping the future.

Margaux: I agree. There's a lot of exciting things about being at the U, so that's great that we had the opportunity to be here and represent the AAMC conference.

Bushra: Hello guys, this is Bushra with a Bundle Of Hers. I'm here with Leen and we have a special guest, Dr. Ron Garcia, who is from Stanford University and does extensive diversity work there and we're super excited to have you here. So thank you for talking with us.

Dr. Garcia: Of course, of course. It's my pleasure and I love your venue. This is the place to be. People could see all the folks who are around here. Wow, cool.

Bushra: You know, podcasting is a audio medium, but if you guys could see the platform that we're sitting on right now, it's pretty legit you guys.

Dr. Garcia: That's great.

Bushra: So the reason why we wanted to talk to you is we feel like your values and the work that you've done for the past 40 years aligns with some of the things that we're passionate about. And that includes diversity and inclusion and equity as well. You've sustained a super long career. Forty years is like something almost unimaginable to me. How do you sustain something with longevity? And you've also developed a pipeline program for people underserved or disadvantaged populations to pursue higher education and particularly in medicine. How do you get to the point where you can sustain that longitudinal message of education?

Dr. Garcia: I just am fascinated by human interactions. I'm fascinated by the potential that people have. I've had so many life experiences in working with students who came to this country who could not speak a word of English, who went with their father in terms of gardening kinds of things. People who had Ds in chemistry, organic chemistry, they struggled. And you know what I call them today? Doctor.

And I think that's a real challenge that people aren't around folks who see that. They look at metrics. What's your GPA? Where does your family live? What school did you go? That is such baloney. That is sheer baloney. And I think that we are really facing a crisis in terms of our workforce issues. And you know, people talked about climate change, you know, global warming, tons of data about that. And we still see laws related to fossil fuel use. Let me tell you, my phrase and off that is the, we are going through a social climate change.

Bushra: Absolutely.

Dr. Garcia: The data is there. This is nothing new and how we're going respond to that I think depends on what we do now. I've worked with so many students who really want to go into medicine, but they battle with the isms of our society. The isms of our society I think probably about, I used to say 13 or 14, it's probably about eight or nine now where people start getting categorized and labelized. And the challenge to me is when that gets internalized in the student and they think that, well I can't do that and all those things.

Bushra: Something that we actually struggle with as first generation medical students. I'm a Somali refugee came in '93 or '96 as a three year old to a new environment and Leen is a Palestinian American who . . .

Dr. Garcia: My team here. I love it.

Bushra: And we struggled a lot with that during our first year. Our confidence was kind of directly correlated with this new environment of learning that we weren't ever exposed to because to be quite frank, we weren't expected to come this far. And so, a lot of the things that we needed is that kind of support in our development and also our professional development as well. And so we struggled but we struggled together.

Dr. Garcia: Well, that that is absolutely huge, because one of the thing that is so important I think is that, you know, for the person experiencing it, it's a challenge. And for many people they see you're not from this country. It may be seen as a negative. I don't see any of that as negative. I see what we need in our country are people who are culturally aware, people who bring in experiences from the world and we need them in medicine. That is a positive. You work with me, whoa, that is like so cool. You speak another language, fantastic. You know this culture, fantastic. You come from a religion and beliefs that are not here, fantastic. Because there's other people, we need people who know that, who don't study it, who have lived it.

And that's what I'm a real fan of the lived experience and people go out and do global stuff. But if you come from those communities, oh my God, what insight. That is so special and it should be valued. And I tried to work with students say let's turn that around. You are special. And you know, we need you in medicine because look at the things that are going on and health inequities, health disparities, health access, language, culture. It just goes right down the line, you know? And so, you, I think that has to be reframed into a strength and into a positive dynamic.

Leen: You know, try to grab those students who I feel like are kind of falling in the cracks of society because they don't see themselves in that position.

Dr. Garcia: That's right. It's the isms.

Leen: It's like why, you know, this person needs to be there. This person has a background that is not represented, that there's no platform for them, you know? So what you're saying is preaching to my soul and I love it so much.

Dr. Garcia: Well, there's a phrase I like to use that I don't know where I heard it. It goes like this, if I can't see it, I can't be it. And that's what I love about. And when I got the request to come here, that's exactly . . . I mean, I know it's on the radio, it's a podcast, but still, you know, you need to hear it. You need to see it, you need to see people. You can't just say, well, I'm going to be something. Well . . . what?

Leen: It's why we dream, right? It's like a definition of a dream. And that's what it is. You have to see it to believe it.

Dr. Garcia: And then there's families in our society that you look at who goes into first year medicine. Over almost 50% come from the upper quintile.

Bushra: That change within one family is actually very inspiring. That just one person has to get through that, break that glass ceiling so to speak.

Dr. Garcia: That is so important. And that's when I have worked with a lot of people who are going to be mentors. And I tell them, you know, you may be doing this for a quarter, but you have the opportunity to change a person's life. And if you change that person's life, you can change your trajectory within a family. And if you can change its trajectory in a family, you're impacting a generation. So do a good job.

Leen: I love it. So that's a wrap on our AAMC 2019 conference.

Bushra: Live with our fancy little studio and we will see you guys later or talk to you guys later.

Margaux: We hope that you enjoyed our conversations and continue to follow us on Bundle Of Hers at Instagram . . .

Leen: And Facebook and Twitter and my Snapchat, my personal account on.

Margaux: Okay. We hope you continue to follow us on Instagram at Bundle Of Hers.

Leen: Google my name please. Just kidding.

Margaux: Bye.

Leen: Adios.

Bushra: Until . . . no, I already did that bye bye part. So we'll see you all later. I guess.

Leen: Hasta la vista.

Harjit: Bye.