March 10, 2017

Julia Stella: Preparing to serve

Adventurous learners find even more of what they are looking for in pilot courses

Julia (far right) at Galens Tag Days with fellow med students

The University of Michigan Medical School is in the middle of a curriculum transformation that was launched in 2013 when the AMA awarded our program a $1.1 million grant to change medical education. Since then, more than 250 members of our community have come together to better align our educational goals with the health care needs of society. Our med students are not only actively involved as partners on various curriculum committees, but also volunteer to participate in pilot courses and programs.

What have you enjoyed about the Patients and Populations Branch pilot so far?

Three aspects of this program that I have particularly liked are the ability to create my own clinical electives (for example, I completed two-week electives in Dermatology, Pediatric Infectious Disease, Adolescent Medicine and Ob/Gyn at Planned Parenthood); my weekly longitudinal clinic at the Corner Health Center; and our patient-based scientific inquiry (PBSI) projects, where we did in-depth research on a clinical question of our choosing based on a former patient, and then presented our findings to a group of peers. My favorite projects so far have been researching palliative care in young adults with terminal illnesses and the cost-effectiveness of long-acting contraceptives.

I was interested in participating in the pilot because I wanted to take advantage of the unique opportunities the pilot offered, specifically the longitudinal clinic (more below). I also wanted to learn more about medical student education and curricular reform and saw an opportunity to do this with the pilot program.

What have you found valuable in this experience?

The most valuable part of the experience so far has been my weekly longitudinal clinic at the Corner Health Center. As medical students, we are not often able to have continuity with patients, and building relationships with patients is one of the main reasons many of us decide to become physicians in the first place. Because of the Branch pilot, I was able to work at the Corner Health Center every Tuesday afternoon for the entire year. This gave me the opportunity to see patients on consecutive visits and begin to build relationships with them. For example, I had the privilege of seeing one patient for multiple prenatal visits, was present at the delivery of her son, and was able to care for her son at his newborn visit and subsequent well child visits. This experience reaffirmed my desire to go into Family Medicine and to work with underserved adolescents and women in the future.

The experience of participating in a pilot program also helped me learn how to critically evaluate different aspects of the Branch curriculum and give concrete feedback to the Branch leaders about what was working and what needed to be changed for the upcoming year.

Why do you think it is important to include students as part of the curriculum development process?

We have a ground-level perspective from actually participating in rotations or projects, and can give feedback about what works or what doesn't work in regard to changes that may have seemed well vetted from the administrative perspective. Because of this unique role, I think students are well positioned to be creative problem solvers or fierce advocates of positive aspects of the curriculum change.

What would you say future med students can look forward to most with the new curriculum?

I believe that future students have a lot to look forward to with the new curriculum. Not only will they be spending more of their medical school years in clinical rotations actually seeing patients, but they will also have opportunities to create their own clinical electives and longitudinal experiences so that they may further develop their clinical skills and determine what field of medicine best suits them. Furthermore, there will be many opportunities to get involved for those interested in curriculum development and medical student teaching.

You have been involved in so many activities in med school. How do you find time for it all?

I truly enjoy being involved in many extracurricular activities. I find that they are a wonderful way to destress and remember that there is a life outside of our medical school bubble. I also think that extracurriculars are a great way to connect with medical students from different classes. For example, I currently serve on the executive board for Galens Medical Society (UMMS' oldest student organization) and have met wonderful M1s-M3s that I may have not gotten to know otherwise.

I also think it is important to be involved in community service while in medical school, specifically in the preclinical years. During this time it is easy to get bogged down by lectures and studying and lose track of why we all wanted to become physicians in the first place: helping patients! I started volunteering at the Hope Clinic as a patient advocate in the summer between my M1 and M2 years so that I could connect with patients during these preclinical years and help them feel empowered in a complicated medical system.

I have been able to be involved in so many activities throughout medical school because of the flexible curriculum, newly-learned time management skills, and my amazing supportive classmates and friends who I can rely on. I also always remember to take time for myself to do activities that have nothing to do with medicine, like play volleyball every Tuesday night with my Rec and Ed team.

Why did you choose Family Medicine as your specialty?

I have been interested in inequalities in health care and working with underserved populations since my time as an undergrad here at U of M, however this desire grew in medical school while working at Hope Clinic and the Corner Health Center. I knew I wanted a career that combined my passion for health education, patient advocacy, preventative care, and social justice.

I fell in love with family medicine on my rotation M3 year and my feelings were reaffirmed through my experience on my family medicine sub-internship in the hospital and working with family medicine physicians at the Corner Health Center. The connections I was able to make with my patients during my longitudinal clinic were truly transformative and unlike any other experience I have had thus far in medical school. Furthermore, I enjoy the broad scope of family medicine and the ability to create long-lasting relationships and provide care for my patients and their families from infancy to old age.

What are you most looking forward to on your upcoming Ob/Gyn rotation in Addis Ababa, Ethiopia?

I am excited for the opportunity to learn about the similarities and differences in contraceptive, prenatal, and gynecologic care between the U.S. and Ethiopia. Furthermore, I am excited for the opportunity to continue to gain skills in prenatal care and deliveries before entering residency. I also hope to gain a better understanding of how to provide medical care in a low resource setting, as this is the area I ultimately want to work in as a physician in the U.S.

I believe that it is important for medical students to learn about systems of medical care outside of the U.S. in order to appreciate the immense resources that are available here, and to learn how we can make our health care system more efficient and functional by adopting practices from other countries. The best way to do this is by participating in a global health elective and working directly with patients, physicians and students from countries other than our own. It is important for medical students to learn about different cultures so that we may be more open-minded and understanding of our patients in the future.

What would you say to a prospective student who is considering the University of Michigan Medical School for their medical education?

The University of Michigan Medical School is a wonderful place to learn medicine and begin your career as a physician! I have been so grateful for the opportunities to participate in extracurricular activities and student organizations where I have learned invaluable time-management and leadership skills that I may have not learned solely through my clinical rotations.

I am also thankful for the opportunities to continue to pursue my passion for caring for underserved populations throughout medical school by volunteering at Hope Clinic and the Corner Health Center. The support and flexibility that UMMS provides have made this possible for me, and allowed me to create a unique fourth year schedule that has reaffirmed my career choice a million times over. The administration is extremely willing to work with you to help your career goals become a reality.