Tuesday, June 30, 2015
Two students in Virginia Commonwealth University’s School of Medicine are interning this summer in Geneva at the World Health Organization to work on projects that seek to improve the cost-effectiveness of medical treatments and to stamp out the diseases of poverty.
Rachel Shin, who received a dual degree in Spanish and biology from VCU in 2014 and is entering her second year of medical school, is interning with WHO’s TDR Department, or the Special Programme for Research and Training in Tropical Diseases, which seeks to facilitate, support and influence efforts to combat diseases of poverty.
“Since I specifically want to serve disadvantaged populations within the U.S. and internationally as a physician, TDR’s mission to equip low- and middle-income countries with the capacity to fight its own infectious diseases of poverty and empower communities to nurse themselves to full health is fully in line with the kind of impact I hope to involve myself with,” Shin said.
Michelle Baer, also a second-year medical student at VCU, is working with WHO’s Costs, Effectiveness, Expenditure & Priority Setting team, which works with policymakers at the country level on strategic planning. The department, she said, provides information on cost-effectiveness and ensures that the money spent on health is intelligently invested to produce the best possible health outcomes.
“I am helping with their work on the economic benefit and return on investment for the treatment of noncommunicable diseases, specifically with regard to treatment of cardiovascular disease and reducing maternal mortality,” Baer said. “I am also working with the team to revise the methodology utilized in their cost structure and modeling of the cost burden of disease.”
Both Shin and Baer are taking part in the Global Health Fellows Program through Duke University, which aims to provide a unique opportunity to learn firsthand how global health policy is formulated and implemented and is designed to equip students to join in the fight against HIV and AIDS, tuberculosis, malaria and other pressing health challenges. Both students received $2,500 from VCU's Global Education Office in the form of Global Health Funds to support their internships.
TDR, Shin said, is a relatively small department, but it is engaged in multiple projects that are playing an important role in global health.
“I have spoken at length with scientists at the department who are involved in almost every aspect of research from eliminating Chagas and Dengue in Latin America to looking at population health vulnerability to vector-borne disease in the context of environmental and social change,” she said. “I am truly excited to be here, and for the opportunity to see how these projects unfold from the public health point of view.”
As part of her internship, Shin is investigating TDR’s current and past grant review process with a goal of making sure it is as effective and efficient as possible.
“TDR receives hundreds of grants for proposals that range from building research capacity to investigating residual malaria transmission,[so] it’s essential that the most promising grants are the ones that receive funding,” she said.
Shin said her goal for the summer is to gain a better understanding of how WHO operates behind the scenes, how it manages projects that impact global health, and how those projects can be turned into policy.
“From an overall perspective, I want to learn where global health is making gains, where more needs to be done, and how I, in whatever way I might fit in, can contribute,” she said.
At VCU, Shin is enrolled in an honors program in the School of Medicine called the International/Inner City/Rural Preceptorship, or I2CRP, that aims to increase the number of primary care physicians practicing in rural, urban and international underserved communities.
Shin has not yet committed to a specific track of medicine, but she says she has a strong interest in pursuing a career in global health.
As an undergrad at VCU, Shin had several experiences that helped hone her interest in global and public health.
I want to learn where global health is making gains, where more needs to be done, and how I, in whatever way I might fit in, can contribute.
“My sophomore year, I traveled to rural villages throughout Tena, Ecuador, for a short week on a mission trip, during which I was exposed to — and shocked by — the lack of resources and access to basic health care,” she said. “I had just begun to internalize how deeply poverty affected health care, so I then committed to a Spanish major and spent a semester abroad in Costa Rica to widen my cultural perspective.”
Shin became increasingly interested in how rudimentary delivery systems fought epidemic disease, and began to volunteer in Richmond at the Fan Free Clinic and the Richmond Center for High Blood Pressure.
“I learned the U.S. was not immune to the shortage of physicians fighting disparity, and I became acutely aware of the extent to which health care inequity saturated home grounds than I ever dared imagine,” she said. “As I entered medical school therefore at [the School of Medicine], I knew I wanted to be involved with I2CRP, so that I could better understand how I could help treat this population from a medical perspective.”
Maria Lourdes De Panbehchi, a Spanish instructor in the School of World Studies in the College of Humanities and Sciences, said Shin was one of the best students she has taught in the past five years.
“Rachel is not afraid to learn from others and to learn with others. She is a very likable person and it is always a pleasure to talk to her. She is trilingual — or multilingual, if you prefer — and that gives her three different cultural points of view,” she said. “This is the type of student that I always remember.”
De Panbehchi added that Shin has very high goals for herself, and that she has no doubt that Shin will achieve them.
“She wants to become a medical doctor and, believe me, if I ever need to see her as her patient I will have no doubt that she will be the best doctor,” De Panbehchi said.
For Baer, her internship provides an opportunity to learn firsthand about global health and the barriers faced in achieving health equity around the world.
“In my short time here, I already feel inspired by the people around me, both those with years of experiences and the interns alike,” she said. “With the incredibly diverse background of experience, culture and personality comes fresh ideas and passion for change, but also contention and barriers to action. All of this has opened my eyes to the great work that is being done all over the world, as well as the need for continued research and collaboration.”
Baer said her work this summer on cost effectiveness and strategic planning has proven particularly interesting and relevant in light of the challenges facing affordable and accessible health care in the United States.
All of this has opened my eyes to the great work that is being done all over the world, as well as the need for continued research and collaboration.
“While this is by no means limited to the United States, the need for cost-effective health care has become more and more apparent to me as I progress through my medical education,” she said. “Noncommunicable diseases, especially cardiovascular disease, pose a growing health burden and they will continue to be a major challenge for our generation.”
Baer, who graduated from Cornell University, spent time volunteering in Ghana, Nicaragua, the South Bronx and rural upstate New York.
“After witnessing the stark poverty and the inefficiencies and shortcomings of health care systems both internationally and in America, I became driven to advocate for health equity,” Baer said. “As the world becomes more globalized, local and global problems become one and the same — the Ebola crisis is a perfect example of this.”
Baer added that she plans to become a primary care physician in the United States, but she envisions her career as one that encompasses clinical treatment, community involvement and domestic and public health policy work.
“I chose medicine because I want to heal, treat and improve health, but to make real changes as physicians we must also recognize our privilege and power to be champions for our patients in public health and public policy,” she said.
Featured image up top : Rachel Shin, at left, and Michelle Baer, at right.
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