Training the doctors of tomorrow

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The patient, a 7-year-old girl, was visiting Michigan Medicine in response to foot pain. Her parents told Marcus Jarboe, M.D., that the child had stepped on something in their living room. Visual examination revealed nothing, but further testing revealed the culprit: a large sewing needle had punctured her sole and worked its way deep into the tissue. Jarboe told the family that surgery would be required.

The child, who recently had undergone an appendectomy at another hospital, did not welcome the idea of another operation. As the scene unfolded, aspiring surgeon Dariane Vesey watched silently from a corner of the exam room. She made a mental note to ask Jarboe, clinical assistant professor of surgery and radiology and the director of pediatric minimally invasive surgery at C.S. Mott Children’s Hospital, how he steeled himself against his young patients’ fears.

After the consultation, they spoke about how — even though children are sometimes anxious — the procedures that need to be done are for the good of his patients.

Vesey, just 14 years old, was on campus as part of a five-year-old U-M Medical School program called Doctors of Tomorrow. Her monthly visits to Ann Arbor, where she has shadowed physicians, listened to technical talks and tried out surgical tools in the simulation lab, have already provided her with a thorough preview of the exciting work — and tough questions — that she hopes await her a decade down the road.

“She’s so forward-thinking, while genuinely being bright-eyed and excited,” said Jourdin Batchelor, a first-year medical student who mentors Vesey through Doctors of Tomorrow. “When I first met her, she said, ‘I will go here.’”

Closing the gap

Vesey is admittedly more ambitious than the average 14-year-old, even among her classmates at Cass Tech High School, Detroit’s prestigious public magnet school. But statistics suggest students like her — working class, from an urban area and African-American — may face extra hurdles on the way to becoming physicians. Just 5 percent of practicing doctors are African-American, compared with 13 percent of the U.S. population.

The gap begins in the medical school applicant pool, where African-Americans, Latinos and Native Americans number about 18 percent, compared to about 32 percent of the U.S. population as a whole. Once these aspiring doctors of color arrive on campus, they often find few role models.

“Doctors of Tomorrow started with a recognition that there’s a real lack of diversity among medical students, nationally and at U-M,” said Jonathan F. Finks, M.D., associate professor of surgery and co-director of the Michigan Bariatric Surgery Collaborative. He founded the program in 2012 as a partnership with Cass Tech, which has a student body that is about 90 percent African-American. “Even though Detroit is just 35 miles away, we have very few students from the city.”

U-M and other medical schools value diversity, and they compete fiercely for highly-qualified applicants who are underrepresented minorities. “But if you’re waiting until then, you’ve already missed the boat,” Finks said, “because you’ve lost all of these kids who could have gotten there with the right support.”

‘You can be anything you want’

One morning each month, Cass Tech’s Doctors of Tomorrow — 36 ninth-graders — board a maize-and-blue bus for the 45-minute ride to Ann Arbor. Some burn with ambition like Vesey, while others are simply bright students, curious about what it’s really like to be a doctor. Some will be the first in their families to attend college; others are the children of nurses and teachers. Some are Detroit natives going back generations, while others are recent immigrants.

One of the latter is Rounaq Khan, who was born in Bangladesh and immigrated with his family to Hamtramck, Michigan when he was 3. His father, an auto plant worker, helps to support relatives back home, and Khan has long been aware that his family came to the U.S. in part to secure better opportunities for their only son. He has a personal motto: “Study as if there’s a test tomorrow.”

“When I was younger, my parents told me, ‘You can be anything you want,’” Khan said, though Khan had little exposure to medical careers prior to joining the program.

With Doctors of Tomorrow, Khan has observed the lives of first-year medical students through regular meetings and email exchanges with mentors. Watching them navigate medical school has made it seem more concrete, and the steps he will need to take to get there now feel more real — and achievable.

Beyond tomorrow

By halfway through the school year, the students had the opportunity to try on white coats. They listened to research talks and panels of doctors representing a host of specialties. In the Clinical Simulation Center, they practiced defibrillator resuscitation.

While Doctors of Tomorrow is made available to ninth graders, a follow-up program called Doctors of Tomorrow Rising will encourage them to continue their relationships with their mentors through the rest of high school, providing them with advisers and role models as they apply to college.

“We don’t want to just be there when they’re 14 and hope they have the ambition to make it,” said second-year medical student Andrea Matthew. “We’ve already seen the excitement of the first cohort going off to college — and every one of them did. There’s no better feeling than that.”

To read more about Doctors of Tomorrow, click here.