Build Your Pre Med Resume
Consider Developing a Health Disparities Project
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Your Health Disparities Project:
Developing Your Pre Med Resume Through Service & Research
Jo Peterson, Ph.D.
Director, Minnesota’s Future Doctors
Thinking about becoming a doctor?
You’ll need to get into medical school first.
It’s true. Medical schools are looking for applicants who have high college grade point averages and excellent MCAT scores (scores from the Medical College Admissions Test).
It’s also true that the smartest students in college biology and chemistry classes aren’t always accepted into medical school.
What’s the disconnect?
What’s the key to becoming an excellent medical school applicant?
Well Rounded Medical School Applicants Have Unique Experineces in Medicine
The truth is, many medical school applicants haven’t taken the time to become well-rounded in medicine during their undergraduate college years. They haven’t volunteered within underserved communities who have limited access to healthcare, led projects related to health care, or set foot in a medical facility to see what doctors do on a day to day basis.
Why would a medical school admissions committee select an applicant who hasn’t been active in healthcare settings or demonstrated his or her interest in helping challenged communities become healthier? Wouldn’t a medical school admissions committee look for someone who has been in healthcare, volunteered in at risk communities, and developed leadership skills while serving in a healthcare environment?
Today’s medical schools are looking for young leaders with compassion. They’re also looking for future leaders who have demonstrated their commitment to do research, helped underserved communities become more healthy, and thought about what it means to have health concerns in a country that is known for world class medicine.
You can be a leader. You can demonstrate your commitment to serving others.
One way to demonstrate your leadership qualities, interest in research, and commitment to serving underserved communities is to create and implement a health disparities project.
Health Disparities that Impact You
Did you grow up on an American Indian reservation? Are your younger cousins heavier than you and your sister when you were at that age? What is occurring on your reservation that is causing kids to be heavier and unhealthy? What can you do about it? Did your grandmother die of heart disease? Did she have a shorter life because she couldn’t afford to take all of her heart medication every day? Does this inability to cover all medical needs happen to other African Americans in your neighborhood. Why? What can you do about it? Is your Hmong brother wary of doctors in St. Paul? Why didn’t he go to the doctor when his thumb broke last summer? Do others in your family and community have the same sense of indifference when they need to see medical professional? Why? What can you do about it? Is your dad, the wheat farmer, reluctant to have his “bum knee” looked at? He says he doesn’t have time to get to a orthopedic specialist, and drive all that way. Why doesn’t he go? Is it really about mileage? What can you do about it? These are health disparities. |
Health Disparities Defined
Health disparities refer to gaps in the quality of health and health care across racial, ethnic, and socioeconomic groups.
This information was found in:
U.S. Department of Health and Human Services (HHS), Healthy People 2010: National Health Promotion and Disease Prevention Objectives, conference ed. in two vols (Washington, D.C., January 2000).
In the United States, health disparities are well documented in minority populations such as African Americans, Native Americans, Asian Americans, and Latinos. When compared to whites, minority groups have higher incidence of chronic diseases, higher mortality, and poorer health outcomes. Among the disease-specific examples of racial and ethnic disparities in the United States is the cancer incidence rate among African Americans, which is 10% higher than among whites. In addition, adult African Americans and Latinos have approximately twice the risk as whites of developing diabetes. Minorities also have higher rates of cardiovascular disease, HIV/AIDS, and infant mortality than whites.
This information was found in:
Goldberg, J., Hayes, W., and Huntley, J. "Understanding Health Disparities." Health Policy Institute of Ohio (November 2004), pages 4-5.
American Public Health Association (APHA), Eliminating Health Disparities: Toolkit (2004).
Causes of Health Disparities
There is debate about what causes health disparities between ethnic and racial groups. However, many recognize that disparities can result from three main areas:
1. From the personal, socioeconomic, and environmental characteristics of different ethnic and racial groups.
2. From the barriers certain racial and ethnic groups encounter when trying to enter into the health care delivery system.
3. From the quality of health care different ethnic and racial groups receive.
Is Access to Healthcare the Cause of Most Disparities?
Each of these three dimensions have been suggested as possible causes for disparities between racial and ethnic groups. However, most attention on the issue has been given to the health outcomes that result from differences in access to medical care among groups, and the quality of care different groups receive.
Reasons for disparities in access to health care are many, but can include the following:
Lack of insurance coverage.
Without health insurance, patients are more likely to postpone medical care, more likely to go without needed medical care, and more likely to go without prescription medicines. Minority groups in the United States lack insurance coverage at higher rates than whites.
Lack of a regular source of care.
Without access to a regular source of care, patients have greater difficulty obtaining care, fewer doctor visits, and more difficulty obtaining prescription drugs. Compared to whites, minority groups in the United States are less likely to have a doctor they go to on a regular basis and are more likely to use emergency rooms and clinics as their regular source of care.
Lack of financial resources.
Although the lack of financial resources is a barrier to health care access for many Americans, the impact on access appears to be greater for minority populations.
Legal barriers.
Access to medical care by low-income immigrant minorities can be hindered by legal barriers to public insurance programs. For example, in the United States federal law bars states from providing Medicaid coverage to immigrants who have been in the country fewer than five years.
Structural barriers.
These barriers include poor transportation, an inability to schedule appointments quickly or during convenient hours, and excessive time spent in the waiting room, all of which affect a person's ability and willingness to obtain needed care.
The health care financing system.
The Institute of Medicine in the United States says fragmentation of the U.S. health care delivery and financing system is a barrier to accessing care. Racial and ethnic minorities are more likely to be enrolled in health insurance plans which place limits on covered services and offer a limited number of health care providers.
Scarcity of providers.
In inner cities, rural areas, and communities with high concentrations of minority populations, access to medical care can be limited due to the scarcity of primary care practitioners, specialists, and diagnostic facilities.
Language barriers.
Language differences restrict access to medical care for minorities in the United States who are not English-proficient.
Health literacy.
This is where patients have problems obtaining, processing, and understanding basic health information. For example, patients with a poor understanding of good health may not know when it is necessary to seek care for certain symptoms. While problems with health literacy are not limited to minority groups, the problem can be more pronounced in these groups than in whites due to socioeconomic and educational factors.
Lack of diversity in the health care workforce.
A major reason for disparities in access to care are the cultural differences between predominantly white health care providers and minority patients. Only 4% of physicians in the United States are African American, and Hispanics represent just 5%, even though these percentages are much less than their groups' proportion of the United States population.
Health Disparities: Your Paln
You’re going to follow some steps to create a small, yet effective health disparities project. You may wish to develop a project that works directly with individuals who need to change their lifestyles or research an issue and share their findings with healthcare leaders, doctors, and policy makers (ie: elected officials). Health Disparities projects must be meaningful to you.
Steps for creating your own health disparities project:
1. Identify
2. Research
3. Listen
4. Summarize
5. Plan
6. Implement
7. Evaluate
8. Share
9. Return
Step 1:
Identify a Health Disparities Issue that Concerns You
Figure out what you care about.
Ask yourself, “What’s happening to a group of people that I care about?”
What happened to a friend or family member that appears to be a concern among all people in my community?
How are the health concerns of people in my community changing? What is causing these changes?
Here are some health disparity concerns: There appears to be a growing number of obese American Indian children in my community. I am concerned that these kids will get diabetes. I am concerned about the number of Latino girls in my home town that are pregnant this year. Is there sufficient prenatal care that is culturally appropriate for them to access locally? My grandmother died of complications from heart disease. I believe her life might have been longer and better if she had had more money to pay for medication. Is this common among African American women in my area? I am concerned about the rate of physical violence perpetrated toward women in my community. Are there culturally appropriate sources of support? If so, how do women learn about these sources – specifically those who don’t speak English well. |
Step 2:
Research Your Health Disparities Concern
Look for five sources of printed information and five leaders in the local medical community that share your concerns.
What general research has been done on the topic outside of Minnesota?
What general research has been done by the University of Minnesota or the Mayo Clinic?
Research examples: You did a Google search and found that a project was done to research obese American Indian youth in 2002. The location is rural Oklahoma. If your researching rural American Indians in Minnesota, this information would have relevance. Would it have relevance if your interest is in urban American Indians? Yes, but you would have to keep digging. A study of African American men, with limited health insurance and prescription drug coverage, was done in 1994. Would this have relevance to your research? Perhaps. The research is dated, the project is on men – and your concern is women. However, the study is African Americans in the United States. Keep digging. |
Remember you can look at “popular” research that has been put into common magazines and online with Google. However, you must dig deeper into literature that is used by doctors and other health professionals to make decisions.
You may need some help from your campus biology faculty, your college librarian, or a medical professional to get access to medical journals, common databases, and specific information that the medical community has access to.
Step 3:
Listen to Others Discuss this Health Disparities Issue
Imagine youself as a physician in the year 2020. You’ve noticed that a specific group of people have a health disparities issue (list your concern here) in the community you serve.
As a physician, where would you start - in order to gain credibility and access to the community that you’ve identified? Ø Who would you talk to? Who leads this community? Ø What organizations is a vibrant part of the community? (Places of workshop, organizations that provide economic development, housing organizations, sources of recreation for children, shopping centers, coffee/tea houses). Ø Where does your target audience go for help with housing, transportation, education, or social justice issues? Ø Where does your target audience go for health care? |
Find five doctors, non profit leaders, community liaisons, or individuals who share your health disparities concerns or concerns about a specific community that you’ve identified. Those will be the people “in the trenches” who work with your targeted group every single day.
Often some of the best people that will help you find doctors or other health care providers, who work with specific health disparities issues are already working with a targeted community in a different way. These may be individuals who focus on public transportation, affordable housing, banking services, childcare, culturally-related communications professionals (radio, newspaper). Networks run deep.
To understand a local health disparity issue, it is important to learn more about the doctors, community leaders, and supporters who promote and support healthy behavior and provide quality health information. You’ll need to travel to and visit a few sites to learn what’s already going on. If you’re not interested in making those “house calls”, chances are – your health disparities project will lack vibrancy and won’t give you much insight into the community.
Does your target audience meet together? If so, where? Go there. Ask questions and listen, listen, listen.
Step 4:
Summarize Your Findings & Thoughts
After you’ve read common popular articles, sifted through medical research on your topic, and talked to community stakeholders, ask yourself… “What did I learn?”
Develop a response to at least ten of these questions: Ø What is the issue that I care about? Ø Who is impacted by the issue that concerns me? Ø Who are the 20 people that I could help in the year 2008, 2009 or 2010? Ø Why do I care? Ø Will I go into the community of need or will I be an observer who doesn’t want to get into the mix? Ø What causes this health disparities issue? Ø What research has been done about the issue? Ø What will happen to my group of 20 people if I don’t do anything about it? Ø Why would people want to talk to me about this issue? Ø What are the demographics of the 20 people that I care about most – who has this health disparities issue? Are they children, adults, men, women, persons of a specific minority, specific immigrants, from a certain neighborhood? Ø Who will help me with this research project? Ø How can I put four hours a week into this project over the next 18 months? Ø How can I take action, even as a student – and do something? What makes me more willing to serve than other pre med students who aren’t doing a project? Ø Is the issue that I care about common? Ø Is the issue that I care about regional, national, or global? Ø Who has done major research on this topic? What are the research findings? Ø Who is a leader in this type of research issue? Ø Who cares about this issue locally? How can I contact these people? Ø What have others done to work with individuals, families, and communities who have the issues that I care about? |
Step 5:
Plan Your Health Disparities Project
Actually doing something about a health disparities concern is what will separate you from all of the other medical school candidates. You can do a project or ignore the issue. The choice is yours.
Ø Leaders take action.
Ø Followers watch TV, surf the net, and find excuses.
Determine if you want to research the issue and add to the body of knowledge, influence change in a specific group, help provide access to better health care, raise money for a specific health concern, or simply learn more about the issue from a grass roots point of view.
What can a health disparities project do for a targeted community? Ø Create a culturally respectful document that gives guidance on a health concern. Ø Provide insight into an issue to help others understand why it happens. Ø Give insight to healthcare workers who are already serving in that community. They can try new approaches based on your findings. Ø Give insight to individuals, to help them make positive changes in their own lifestyles. Ø Shine light on the health disparities issue, so that policy makers (insurers, elected officials, community leaders) can make new decisions. Ø Help individuals get better access to care. |
My Health Disparities Project Idea: My goal is collaborate with La Clinica of St. Paul to develop an awareness campaign, targeted toward Latino teen boys, which details ways to reduce rates of unplanned pregnancy. My project will take 20 months to develop and implement. I intend to spend four hours per month on this project. I will return to discuss the project with stakeholders at La Clinica and within the Latino community in 21 months.
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Step 6
Implement Your Plan
Use an activity sheet, like the one below, to set small, monthly goals. Chart your progress each month.
Project Timeline
| Step
| Measurable Activity
|
October 2008 | Identify | Identify the issue that concerns you. Meet with others who are concerned about this issue or similar issues. |
November 2008 | Research | Research information that has been published online. You can simply access the web using common search engines. An example would be Google. |
December 2008 | Research | Research information that has been published in professional medical journals. You may need assistance from a campus or medically-trained librarian. |
January 2009 | Listen | Go and listen to the concerns of the community. Specifically those medical professionals who care about this concern. Ask them to explain why the health disparity occurs and what they do to serve families in need. |
February 2009 | Listen | Ask questions about health disparities to people who live with them everyday. Listen to those individuals and families who face the health disparity every day. Ask them to explain why the health disparity occurs, what medical professionals are doing about it, how they wish the situation were different, and what you can do to serve as an advocate or researcher. You will want to skip this step, because it is the most difficult to do. This is the critical step. If you do nothing else, meet with families and individuals.
|
March 2009 | Summarize | Summarize your findings briefly. What is my health disparity issue? What do others call this health disparity? Do they have a different name for it? Who does this health disparity influence? Who is working on this now? Who will help me? What are the findings of research? What are the findings about how to resolve the issue? What do people want me to do about this issue? What do I want to do about this issue? Where is the issue most common? Where am I targeting my project? Where should I go to study this project or help? When should I get moving on this project? When did this disparity start? Why do people care about this issue? Why should healthcare providers care about this issue?
|
April 2009 | Plan | Plan your project, setting your own goals. |
May 2009 | Plan | Ask five health care or college professionals what they think about your project. |
September 2009 | Plan | Revise your project based on the output of others. Be very clear about what your “end goal” is. What are you going to do EXACTLY? To whom, when, why, and how?
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October 2009 | Implement | Start your project. |
November 2009 | Implement | Continue with your project. |
December 20009 | Implement | Continue, and then finish with your project. |
January 2010 | Evaluate | Evaluate your success and areas of concern. Ask yourself, “Did I accomplish what I planned to do?” “Did I learn other things that I didn’t expect to learn?”
|
February 2010 | Share | Gather your thoughts on how you did the project and what the end result was. |
March 2010 | Share | Share this information with a trusted advisor and a trusted individual who serves within your community of need. |
April 2010 | Share | Share your information with a healthcare worker who could use your work to change the way they serve people in underserved communities. |
May 2010 | Return | Return to the organization where you did the research. Share your findings. Ask your target audience what they need help with next. |
Step 7
Evaluate Your Project
Ask yourself if your project made a difference? Asking this question is a form of evaluation.
When you’re finished with your health disparities project, it is important to ask yourself some or all of these questions.
Did I actually do the project? If yes, how did I do it?
Write down the steps.
Use this journal entry or blog to help you with your next project.
Did others see me do the project? If yes, how do they think I did?
Ask individuals who helped you with this project, give their impression of your work.
Ask these individuals to fill out a survey. Use a service such as www.surveymonkey.com to help you.
Did I make contact with the target audience? Did I identify their concern effectively? Did I make a difference?
Go back to those people that you served. Ask them what they thought of your project, your activities, or your services.
OR
Have a trusted friend ask the same individuals what they thought of you and your ideas.
Here are more questions to consider:
Ø Did I talk to the right people about my project?
Ø Did my confidence grow as a result of serving within this community?
Ø Am I more confident with the idea of serving in this community at some future date?
Ø Am I more confident with the idea of doing another health disparities project?
Ø Did I find this work meaningful?
Ø Do I have a network of professionals and others that I can talk to, when I decide to do future projects?
What is an evaluation plan? You’re familiar with the idea of being evaluated. You just might not realize it. Ø When someone asks your opinion of a class, through a questionnaire at the end of a semester, the instructor (or her/his boss) is evaluating the instructor and the class. Ø When you take a test or a quiz, the instructor is evaluating your performance as a student. Ø When you take an online survey, your ideas are being evaluated. Chances are, your feedback has influenced a new product. Ø When you evaluate yourself, you are essentially looking into a mirror and asking yourself, “Have I done my best? Did I try hard enough? Did others see me as a meaningful addition to their lives?” |
How would you know if you had done a good job or if others thought you were impressive?
Here are some simple ways to evaluate your project and your services:
Questionnaires
Pen and paper, given to a group www.surveymonkey.com – emailed to a group
Focus Groups
Ask a group of eight (or so) individuals what they thought of the project. You can ask the questions yourself or have a trusted friend do the asking. Take very specific notes.
Interviews
Ask individuals what they thought, using a script of interview questions. Interviews may be done in person or on the phone.
Personal, Reflective Essay
Write down what you thought in an essay. Reflect on your thoughts, ideas, and performance with the project, what you enjoyed about the project and what you didn’t like about the project.
What if my project is a complete failure? I am worried that I will put time into a project and it will be a complete failure. What if I don’t do anything amazing with my research and project? What if no one cares about what I find out? What if I look foolish being out in the community? Chances are the first time you rode your tricycle, you fell off. Was this trip amazing? No. Did anyone care that I fell off my trike? Yes, but only because they love you. Did I look foolish? No. Falling off your trike had meaning. It was the start of something special. You learned what didn’t work. And, you got back on the trike again. After a few small spills to the ground, you found success. And, that success with the tricycle allowed you to become confident in riding a bicycle with training wheels. Again, you found success. Now you can ride a bike with no training wheels. You probably do it well. What did it take to become successful? Practice, Trial and error. What if your first health disparities isn’t perfect? What are other measures of success? Did you meet a new network of caring doctors that will help you build your pre med resume for medical school? SUCCESS. Do you feel more connected to people who need you? Did you enjoy getting to know them? SUCCESS. Did you find a new restaurant, shop, or annual cultural event during your journey – that will become a part of your life? SUCCESS. Did you see yourself as a leader? Did others see you as a leader? SUCCESS. |
Step 8
Share Your Project
You’ve done a lot of work. Select three people, organizations, or publications to share your findings with.
Ideas on where you share your information:
Ø Physicians who care about the population you serve
Ø Community clinics and leaders at all levels within the clinic
Ø Local hospital community relations professionals
Ø Members of the community that you met with, particularly those who are concerned about the issue or impacted by the issue
Ø Policy makers/law makers
Ø Student run health care organizations
Ø Professors on your campus
Ø Health care providers
Ø Social workers and other workers who serve in the community
Ø Newspapers, locally, that would run a story about you, your project, and your findings
Ø Schools
Ø Colleges
Ø Community centers, their bulletins, e newsletters, and bulletin boards
Ø Churches, and church bulletins
Step 9
Return to the Community
Take time to thank those people who helped you with your research. Share your outcomes with them. Ask what you can do in the future to help.
You’re a leader now!
People are counting on you!
Build your Pre Med Resume.
Develop a Health Disparities Project...