Anitha Menon: Addressing inequities

I studied biomedical engineering in college and although I loved using systems-level thinking to solve complex problems I realized that I find most fulfillment through working directly with people to improve outcomes in a community or population. Also, various experiences — including growing up in a predominantly white, conservative town and several international experiences — opened my eyes to the relationship between inequity in society and health. I realized that a career in medicine would give me the opportunity to work in that space, both as a clinician and researcher.

I think that what distinguishes Michigan from many other medical schools in the country is its supportive environment, fostered by brilliant, yet caring faculty and residents. I love the Doctoring program here that immediately connects you to two faculty members who follow you throughout all four years of medical school. My doctoring faculty have been excellent mentors to me, especially in periods of transition (such as from the pre-clinical to the clinical years).

The class counselors have also been one of the most amazing resources I have had access to as a medical student here. Whenever I have any type of personal conflict, emergency, or question that comes up that is impairing my ability to participate fully in school, my counselor (Eric!) is always quick to swoop in and offer support. This support has made several challenging times in medical school far less stressful for me.

Finally, my excellent classmates are my greatest resource. I belong to a professional society, Phi Rho Sigma, where I immediately made close friends who I could lean on in medical school (and will continue to lean on for the rest of my life!).

In medical school I was involved with research looking at the national and state-level impacts of the Medicaid Expansion. My most recent project is looking at its impact on HIV testing rates in different racial/ethnic and sex groups. I am interested in social epidemiology and learned a variety of research skills (including statistical coding) through my Master of Public Health capstone project involving C. difficile testing methods. In addition to being passionate about health equity, I am also passionate about gender equity in medical training. Unfortunately, sexual harassment is pervasive in medical training. In order to become involved in solutions for this enormous issue, a group of my classmates and I developed an evidence-based bystander intervention training (using both qualitative and quantitative methods!) to help medical students learn skills to prevent and address witnessed sexual harassment in the clerkships. As you can see, I am very interested in diverse types of research and have had ample opportunity to explore these interests during medical school.

“Wellness” is a buzzword in medical training these days, and for good reason: it is deeply important to be well in order to care well for others. In my opinion, if you are not well, it is difficult to feel passion for your job. There are so many competing priorities in medical school, but I knew that I wanted to place my personal happiness and wellness at the very top of my list of priorities. To support this goal, I made an effort to develop a strong social network here and continue to fully live my 20s — I go to concerts in Detroit, travel to see my friends and family across the country, and hike, camp and rock climb with my partner, Joe, as often as I can. Of course, finding balance is a skill that we all will continue to hone throughout our careers. The reality is that medical training is a difficult and long road that is, at times, overwhelming; this is why it is so important to know what makes you feel well outside of medicine and to prioritize these things. For me, these things are my relationships and spending time in the outdoors.

I really fit in with the residents and attendings on my internal medicine (IM) rotation. I am the kind of person who loves to think about medical problems carefully and systematically, and IM offered me the time and space to do this. I loved being a generalist, with no medical or social needs off limits. I also really enjoyed the face-to-face time I get with patients; it is rewarding to build relationships with patients and their families throughout an inpatient stay or longitudinally in clinic.

I also found that a career in IM went hand-in-hand with work on health inequalities. In most settings, it is impossible to be a generalist without paying attention to the structural determinants of health. Last year, I went to the Society for General Internal Medicine conference in D.C. and found the topics that the conference covered — including the impact of racism on health outcomes and how institutions can partner with community organizations to conduct research ethically — fascinating!

Some of the best advice I have gotten for choosing a specialty is to think about what kind of literature you enjoy reading (because we will spend the rest of our careers learning). For me, that was policy, sociology and social inequalities and how they relate to health. In internal medicine, I found a strong community of clinicians and researchers who also share these passions.

I envision a career that involves either hospital medicine or primary care and research. In fact, I got my MPH in epidemiology to begin learning the methodology to someday conduct my own policy analyses. I am passionate about using quantitative and qualitative methods to conduct community-driven research to interrogate and hopefully re-build the structures that enable inequalities to persist. In addition, I was exhausted after my clinical year and Step 1; I felt unprepared to make big decisions about my future specialty and career directions. So my MPH gave me the opportunity to really reflect on what I wanted my career to look like five to 10 years in the future and take some really interesting policy and epidemiology classes, too!

Do it! Taking a year away from medical school to get my MPH was one of the best decisions I have ever made. If you are considering a dual degree, don’t feel as though your only choices are an MPH or MSCR. I would encourage you to look into master’s degrees in public policy, education etc. In my opinion, a dual degree is a golden opportunity to learn things that you are passionate about and might not learn elsewhere in medical training, be it nutrition, history, social policy, the environment or something else! If you are interested in teaching, I highly recommend being a graduate student instructor during your year off. I had the opportunity to facilitate a women’s studies course analyzing reproductive health using a feminist lens; this was one of the most rewarding experiences I’ve had during medical school.

I wish I had known how common it is to take time off between college and medical school. Some of my friends have had entire careers prior to medical school, and I sometimes wish I’d had such experiences. The vast majority of people I knew who took time off either worked in a research lab or became scribes. I wish I had known that there were other interesting jobs I could have gotten, for instance in health departments, healthcare consulting or socially-conscious organizations unrelated to health! I am lucky to have had the opportunity to have taken a year off to get my MPH, but (with some exceptions), medical training — from medical school to residency to potentially fellowship — is a long ride with few stops. I wish I had taken a bit of time away from school after college to broaden my worldview.

The culture at Michigan is simply phenomenal. I interviewed at a different medical school where one student described his experience as being "in the middle of a dark sea without oars." My experience at Michigan has been the polar opposite of this. I’ve had such great colleagues, residents and attendings that I rarely feel alone in this process.

I thrive in environments where I have autonomy, can make some mistakes, but am protected from making enormous mistakes that may jeopardize my mental health, patient care, ethics etc. Michigan is the epitome of this kind of environment, be it in the pre-clinical, clinical or research settings. At the risk of sounding cliche, I’ve learned a lot about medicine and about myself here! In addition, both my family and my partner’s family live nearby, which is a huge plus!

I applaud you for taking this important step in your career! This is one of the most interesting, challenging and privileged professions one can pursue, and not many people have this opportunity. I think that, in a nutshell, if you want rigorous medical training in a supportive environment, Michigan is the place for you.

Medical school will be a uniformly challenging experience wherever you go. So try to choose a place where you feel like you fit in with the people. On my interview trail, I thought Michigan medical students seemed genuinely happy with rich social lives and diverse interests. And I wasn’t wrong: I met the most outstanding mentors, my best friends and my partner here. Going to the University of Michigan Medical School has been one of the best decisions of my life!