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Table 3 Themes, subthemes, and participants related quotes

From: Underrepresented in medicine students’ perspectives on impactful medical education

1. GROUNDING LEARNING IN THE COMMUNITY

a. Community Engagement

  • “Our community is our family”

MS 2, Participant # 6

  • “As URM students …we desire, to do something in the community, to make a difference, to influence the… decision makers.”

MS 4, Participant # 1

  • “One thing that would be cool to see, that I’ve seen at orientations … is a community walk to nurture our sense of community and passion to serve, which also helps us with mapping out what resources are in the community.”

MS 3, Participant # 3

  • “Some sort of community engagement because I think what separates your average medical student is that constant reminder, desire, to do something in the community, to make a difference.”

MS 4, Participant # 2

b. Student-Run Clinic, Mobile Clinic, Homeless Clinic Rotations

  • “I like the idea of having a possible mobile clinic that is ours because it would really help integrate the community aspect into our curriculum”.

MS 3, Participant # 9

  • “Learning about different medical systems, I don’t know going to Cuba or something to learn about their medical system.”

MS 3, Participant # 5

  • “I think if we’re supposed to be working in teams with other health professionals, …what parts overlap, what can we expect of them in any situation? I think this can easily be done just getting us all together and having a giant overview of what we do”.

MS 3, Participant # 10

2. PROGRESSIVE SYSTEM-BASED PRACTICE COMPETENCY

a. Interprofessional Learning

  • “I think problem-based learning should be focused on team building with interdisciplinary learning, rather than finding the correct diagnosis of a case.”

MS 2, Participant # 6

  • “I think if we’re supposed to be working in teams with other health professionals, …what parts overlap, what can we expect of them in any situation? I think this can easily be done just getting us all together and having a giant overview of what we do.”

MS 3, Participant # 10

  • “Learning about different medical systems,… incorporating that into the curriculum where you could go to a different country, learn about healthcare and then bring positive things ... You know maybe use here especially in the community.”

MS 3, Participant # 7

  • “Learning about different medical systems, I don’t know going to Cuba or something to learn about their medical system.”

MS 3, Participant # 5

b. Multidisciplinary Medicine for Cultivating a Just Healthcare System

  • “…learning how a sociologist would look at our patient population, how a anthropologist, how a psychologist, how they would see this population and our interactions with them, and sort of expand on that wholistic mentality of medicine.”

MS4, Participant # 14

  • “Or bringing in faculty members, like public policy faculty members during the selective or during the doctoring sessions could be away to incorporate those components (i.e., social justice).”

MS 3, Participants # 9

  • “Just a fundamental understanding of how one’s experience directly contributes to their health, whether that be income status or insurance status or whatever the case may be.”

MS 3, Participant # 7

  • “We talk about black people are disproportionately this, or Latinos are disproportionately that, or Asians are disproportionately that. They never talk about what black people have gone through and what those communities of black people ... there’s just so much other things that are affecting these diseases, and we give so much weight and so much clout to the biology, but there’s so much research that’s coming out that’s showing that the social context affects the biology.”

MS 3, Participant 12

3. SOCIAL JUSTICE COMPETENCY

a. Longitudinal Social Justice Curriculum

 

  • “… the social justice health disparities curriculum within the 1st and 2nd year,..”

MS 2 Participants # 8

  • “As we talk about heart disease or as we talk about kidney function or whatever, talking about things like chronic stress and the research on chronic stress and how that’s related to health inequities. I think there’s so many opportunities across the curriculum to interweave these topics with what we’re learning.”

MS 4, Participant # 14

  • “Whatever can be done to make sure that the curricula on social justice and/or health disparities is required, okay, and I’m emphasizing required because I think it’s easy for people to opt out.”

MS 4, Participant # 11

  • “…actually integrate it into when people are discussing pathophysiology or the physiology of a certain system. I think it’d be a really unique aspect of a program.”

MS 2, Participants # 6

  • “… social justice minded project in the first years of medical school so that we can actually feel like we are contributing to the well-being of our surroundings sooner rather than later.”

MS 4 Participant # 4

b. Advocacy

  • “I would say just more practical advocacy experiences and opportunities.”

MS 3, Participant # 5

  • “I think having us as future physicians be involved with community-based efforts that are not just health access, but talking about the inequities that lead to health disparity. Economic inequities. Things like people being undocumented and what’s the experience like. Things like people being incarcerated. I think having us see ourselves as needing to be a part of that conversation and… not just …provide free blood pressure screenings, but we lend our voices to the concerns of the community.”

MS 2, Participants # 8

  • “I want to learn how to lobby. I want to learn what are the things that I can practically do in these communities from a law perspective, from a criminal justice perspective, or from a health.”

MS 3, Participant # 12

c. Health Disparity Research

  • “This (Senior thesis with health disparity thread) could potentially be the most important thing that you do in medical school.” “…have the opportunity to do some research that’s not just sort of lab-based…”

MS 4, Participants # 14

  • “One thing, I mean, from my perspective is having that ability to have research early on…all the different tools they needed to have to do independent research. And putting that in the beginning and really having a focus on that would really be a great transferable skill ... I think it would increase people’s confidence with doing research.”

MS 3, Participants # 7

4. TRAUMA-INFORMED MEDICAL EDUCATION DELIVERY

a. Early and Ongoing Mentoring

  • “…. I think that mentorship very early should be emphasized, ….

MS 4, Participant # 1

  • “Introduce mentorship during the 1st year orientation.”

MS 2 Participant # 6

  • “I feel like there’s no such thing as having too many mentors.”

MS 3, Participant # 3

b. Provision of Supportive Policies, Services and Practices to Maximize Learning and Mental Health

  • “I think being able to minimize stress as much as possible is important so I like the idea of pass/fail.”

MS 3, Participants # 13

  • “Moral support during the STEPS, and, preparation for shelf exams.”

MS 3 Participant # 12

  • “Having a financial person who would know aspects of finances that are going to be more prevalent to URM students. A lot of us do not come from a lot of money, who need help financially and need advising when we leave because we don’t necessarily have that wealth accumulated, and wealth knowledge at home.”

MS 4, Participants # 14

  • “…recognizing when students are struggling academically because they’re struggling academically or they’re struggling personally or they’re struggling with family problems, and understanding the difference.”

MS 2, Participant # 8

  • “Let’s not talk so much about the medicine and talk more about just learning. How does a person’s brain work?”

MS 3, Participant # 15

  • “…recognize and place importance on URM students’ mental, physical, spiritual, emotional health.”

MS 2, Participant # 6

  • “And then having mental health providers who look like our students, who understand the interaction between racism, sexism, oppression, and how that’s manifesting in our students’ lives.”

MS 3, Participant # 12