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Many Americans are reluctant to see their doctor. According to a recent survey commissioned by ZocDoc, a medical scheduling company found that 80% of Americans say they delay or avoid getting preventative care. Though there are a number of variables that keep us from seeing our doctors I imagine that the odds of avoiding a doctor visit might be even higher as an immigrant who is unfamiliar with the English language, much less the health care system. Certainly, the American population is in constant flux. New immigrants, including refugees, are changing our population. How we train our health care professionals is changing too.

The Global Health Fellows Program (GHFP) II serves the United States Agency for International Development (USAID) by developing the next generation of global health professionals starting at the high school level with FACES for the Future Coalition (FACES). The program was co- founded 15 years ago by Dr. Tomas Magaña who recognized the lack of diversity in the health professions and shortage of opportunity for youth seeking options to improve their lives. Recently, I had a chance to see their work first-hand during a visit to the FACES Summer Medical Academy (FSMA), located at Samuel Merritt University in Oakland, California.

Dr. Tomas Magaña reviews the typical medical school trajectory, two pre-clinical years followed by another two years of clinical training.

Angelina Gordon, GHFP II Director of Communications, Outreach, and Diversity, and I were greeted by Brooke Briggance, FACES Program Director, and a group of 30 young faces – all high school students from the Bay Area. Immediately following a brief introduction by Ms. Briggance, we transitioned into a morning lecture, led by Dr. Magaña. On the lesson plan for the day: Patient Centered Care (PCC). PCC is model that encourages patients to actively participate in decisions about their own care. This method is based on establishing trust and opening of the lines of communication. To introduce the concept students were asked to solve a puzzle using very limited information provided by Dr. Magaña who emphasized the importance of asking the questions, “What do we know? And what do we need to know?” This is all to say, when doctors interact with patients, they may have a chart, but not all the information they need to get to the root of medical concerns – a puzzle to solve in each exam room.

An FSMA student writes notes during the group activity on problem solving and patient centered care

As public health professionals know, a kaleidoscope of factors contributes to each person’s overall health and well-being. Some of those factors, the social determinants of health, are not so pretty. Poverty, political instability, and proximity to environmental hazards, such as landfills or factory farms, are all major influencers of health. Ms. Briggance and Dr. Magaña both reviewed the many ways that health is compromised in America and how groups of people, like African Americans and Latinos, are impacted more than others. When Dr. Magana asked the room full of high school students what they thought was the most important aspect of treating a patient, I immediately thought of genetics, however, the answer turned out to be a patient’s medical history.

Student’s act as doctors for a series of patient care simulations.

To practice collecting a patient’s medical history and the problem solving skills learned earlier that day the students broke up into groups to participate in round robin of patient care simulations. I acted as a newlywed immigrant from Mexico with consistent stomach pain and nausea. In my role, I played an anxious patient who was reluctant to share information with my team of young doctors. I realized that the patient experience can get very awkward, especially when a few of my student doctors posed biting questions, recommended confusing lab tests, or jumped to conclusions. At times, the student’s asked their questions without even taking the time to introduce them or check in to see how I felt or what I thought about their recommendations. However, I could tell that they were trying to get as much information as possible and before long they were finding better ways to ask questions by taking a more attentive and gentle approach.

Overall, it impressed me how driven and thoughtful the FMSA students were. In the two weeks of the FACES program, students were exposed to clinical skills trainings, anatomy and pathology workshops, and of course, culturally sensitive patient centered care. At the end of the day we were left with one more question: how do you become a better doctor? Everyone agreed that it starts by omitting your white coat and connecting as a human being. Perhaps in doing so, health professionals will be better equipped to care for our diverse patients and in turn we will all be a little less reluctant to see the doctor, regardless of our background.

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Maribel Sierra, Communications & Outreach Assistant for the Global Health Fellows Program II