VCU news

By Grace McOmber
School of Medicine

Just four blocks from their classrooms, preclinical medical students at Virginia Commonwealth University are getting a preview of their future careers caring for their community.

Once a month, members of the Student Family Medicine Association student interest group gather in the sun-bathed atrium of St. Paul’s Episcopal Church in downtown Richmond to provide cost-free, basic health screenings to anyone that wants it.

The health screenings are held during St. Paul’s Emmaus Lunch Ministry, a weekly event that attracts around 100 Richmond downtown community members. The program offers a free hot meal, social service referrals, financial assistance and donated items. Throughout the midday event, guests trickle into the atrium, where students offer to take their blood pressure, check their blood glucose levels and consult on their results and any other health concerns they may have. For students, it’s a chance to start putting what they’re learning into practice and connect with members of the community.

“As preclinical medical students, we spend a lot of time at our desks learning about medicine,” said student Samara Shabon, SFMA chair of community outreach. “Being in the free clinic serves as a reminder of why we’re studying for these long hours and taking these exams. Interacting with the community gives me energy and joy.”

Taking action

In 2021, Joseph Gallagher and Ashley Le-Pham, SMFA’s co-chairs of community outreach at the time, were on the hunt for ways to get involved. Community clinics and other opportunities in the Richmond area were gradually opening back up after being halted due to the COVID-19 pandemic, and they were eager to venture out beyond the MCV Campus.

They found that opportunity through the Practice of Clinical Medicine (PCM) course, an 18-month curriculum that covers a broad spectrum of basic clinical skills, where a session on chronic illnesses inspired Gallagher and Le-Pham to get involved.

A subsequent endocrinology session really “hammered in the intricacies of diabetes management,” Le-Pham said. As part of the session, students participate in a diabetes immersion — they measure their own blood sugar using glucometers, inject themselves with saline to emulate insulin shots and even have the option of wearing a continuous glucose monitor for 10 days. The goal of immersion is to put students in the shoes of someone living and managing diabetes.

Following the sessions, Gallagher reached out to Michelle Whitehurst-Cook, M.D., professor emeritus in the Department of Family Medicine and Population Health and former advisor to SFMA, who is deeply involved in community engagement and always happy to connect students with local programming.

“It was exactly what we were looking for — to get students connected with underserved populations in Richmond and get clinical experience,” Gallagher said. “It’s an opportunity for students to learn about how health care, the community and the city interact, which is something Ashley and I are very passionate about.”

Rosellen Roche, M.D., Ph.D., vice chair of medical education in the Department of Family Medicine and current advisor to SFMA, said engaging with the community is an essential part of family medicine. She noted that the specialty relies heavily on communication and trust between physician and patient, and she encourages aspiring family doctors to seek out opportunities to practice those skills.

“Being involved with the community is part and parcel of being a family medicine physician, so seeing patient and community-member needs is important,” Roche said. “Early opportunities like this contribute to understanding patients within the context of family and community.”

Students in the group use manual blood pressure cuffs and stethoscopes from the School of Medicine, and collect other medical equipment, like bandages, lancets and gloves, via donation drive or purchased with funds from a 2021 grant from the American Association of Family Physicians. The SIG sources its glucometers from the diabetes immersion session, an idea that came to Le-Pham when she realized the supplies would expire before the next class needed them.

“A big part of our mission was to make this a sustainable event,” Le-Pham said. “Those are otherwise perfectly usable glucometers that would’ve expired within the year. It’s a win-win situation, because we’re keeping those out of landfills and it’s one less thing we need to spend money on.”

Sustainability also meant ensuring the long-term success of the program by advising the next class of student leaders. Gallagher and Le-Pham have passed the baton to group members in lower classes, and said the commitment and leadership of first-year and second-year medical students this year has been a "really rewarding thing to see." Both Gallagher and Le-Pham matched into family medicine residency programs in March, and as fourth-year medical students they continued attending the events between rotations and interviews.

For Samara Shabon, a first-year student and SMFA’s current chair of community outreach, guidance from older students has been indispensable in building her confidence when interacting with patients and using the medical equipment. She said she now passes along what she has learned to other SFMA members and volunteers.

“I really appreciate learning from them, because they were in our shoes just three years ago,” Shabon said. “They know what’s coming up for us and it’s nice to have someone in your corner that truly understands what you’re going through.”

Serving the underserved

While open to anyone, the Emmaus Lunch Ministry predominantly serves guests who are unhoused or housing insecure, a community that often faces barriers in accessing basic preventative health care like regular physicals. Le-Pham noted that many patients she has met at the church clinic want to manage their chronic conditions, but financial barriers prevent them from accessing doctors and medical supplies.

“There are so many circumstances that can make things like monitoring blood pressure and glucose difficult,” Le-Pham said. “When your base needs — like shelter and food — aren’t able to be met, it becomes a really difficult thing to manage.”

Stigma around chronic diseases like diabetes can also discourage patients from visiting doctors, like a man Shabon met at the church clinic. She recalled his concern that seeing a doctor would, in his mind, mean he was sick. In an effort to connect with him, not as a health care provider but as a fellow patient, Shabon shared that she sees her primary care doctor at a regular cadence, even when she isn’t sick. She explained that routine check-ups can catch problems early and lead to better health outcomes.

“That conversation really gave me a new perspective on medicine and why someone might be hesitant to see a doctor, and it was a chance for me to speak up and provide my own perspective,” Shabon said. “I think I was able to get across to him that before doctors are physicians, they’re patients first.”

Shabon said interacting with the people of Richmond is mutually beneficial for the students and their patients, allowing both groups to receive the attention and interaction that they need. During the lunch event on a sunny day in April, community members were friendly and patient with the students, even reassuring them if they seemed nervous while conducting the screenings.

“You all are going to be great doctors,” one woman said warmly to the group after having her glucose and blood pressure checked. “You have a bright future. Thank you for everything.”

This story was originally published on the School of Medicine website.