NOV. 13, 2009

Stimulus funds foster medical diversity through new Stanford internship program

BY TRACIE WHITE

Medical student Cam Tu Nguyen touched her 74-year-old patient’s hand then spoke in her native tongue, Vietnamese, helping to soothe the elderly man’s worries. He had arrived at Stanford Hospital & Clinics a few days earlier, and became upset because he wasn’t sleeping well. He wanted to go home.

The patient, Hue Ngo, a Vietnamese immigrant, looked a little like her grandfather.

“This is my first patient that I’ve spoken Vietnamese with,” said Nguyen, 29, of Atlanta, during the second week of a monthlong internship at Stanford University Medical Center paid for with federal stimulus funds. “He’s got dysarthria and dysphagia, which means he can’t speak and has difficulty swallowing. We don’t have the definitive diagnosis yet. He’s lost 30 pounds.”

Nguyen is one of 14 fourth-year medical student interns from minority institutions whose travel and living expenses will be paid for out of a two-year grant of $400,000 awarded to Stanford from the National Institutes of Health allocated through the American Recovery and Reinvestment Act. The program, called the Stanford Clinical and Translational Research Scholars Program, brings these students to Stanford for four-week visiting rotations in the medical specialty of their choice. The proposal for the program was authored by Hannah Valantine, MD, senior associate dean for diversity and leadership, and selected through a highly competitive review process.

It’s designed to help bolster the careers of minority medical students and propel them into academic and medical research careers in greater numbers. Stanford also hopes to recruit some of these students into its own residency programs and build long-term relationships with the minority institutions where they’re attending medical school.

The first batch of interns who arrived on campus Oct. 26 are spending their time making rounds through the hospital wards, treating patients under the supervision of practicing physicians, and preparing for the next stage of their medical careers as residents by working directly with patients. They’re also learning what it’s like to work in an academic facility where physicians are both caregivers and researchers.

“The rounds are excellent: You watch the attending physician and the resident, and you see them putting the pieces together, reasoning it out — you get to be the detective,” said Nguyen, the daughter of Vietnamese refugees who settled in Atlanta after fleeing Saigon when she was 4 years old. She attends the Morehouse School of Medicine and has chosen internal medicine as her specialty. “As a student you learn from books. Here we’re translating that knowledge to real patients.”

While short, intensive internships at top-notch medical center are common for medical students around the country, this one is unique because it’s designed to help improve the medical careers of underprivileged, under-represented minority students, who might not otherwise have been able to afford to attend.

Currently Hispanics, African Americans and Native Americans together make up less than 8 percent of the faculty at the nation’s academic medical centers and even fewer are translational scientists, said Valantine. “Their poor representation in medicine, in particular academic medicine, is a national issue,” said Valantine, who is also a professor of cardiovascular medicine. “Addressing this imbalance is an important approach to alleviating health disparities that are over-represented in these groups.”

Research shows that when patients are treated by physicians of a similar ethnic background, the communication is superior and the quality of care is enhanced, Valantine said. Currently the ethnic makeup of the U.S. population is far more diverse than its physician workforce. For example, only 3 percent of the physician population is African American while the U.S. population as a whole is 13.5 percent African American. The program will also help stimulate the economy in the short term by creating new jobs for program coordinators and support staff.

Intern Enrique Rivera, 27, a fourth-year medical student at the University of Puerto Rico, who is specializing in ophthalmology, said doing an internship at a renowned hospital like Stanford will help his career in a variety of ways. He’s been busy observing multiple surgeries using equipment he’s never had the chance to use before.

“Actually having the opportunity to say that you were at Stanford and did a rotation helps you get into residencies,” said Rivera who is interested both in pursuing medical research and treating the underserved Puerto Rican population.

For Nguyen, the internship has given her the chance to become the “medical investigator” she’s always wanted to be, and to treat patients like the Vietnamese grandfather, Ngo, who had arrived at the hospital scared, confused and unable to speak English.

Nguyen figured out a way to listen. By speaking to the patient in his native Vietnamese, she discovered that he could write a little in English. She got him a clipboard, spoke to him in Vietnamese and he wrote back answers in English. During the two weeks that she treated him, Nguyen explained to him the tests he was taking. When the neurologist diagnosed Lou Gehrig’s disease, she told him what that meant. When he said he was cold, she made sure he got blankets. And she talked to his family about his condition in Vietnamese.

“Every morning I would come by and check to see how he was doing,” she said. “I was able to advocate for his needs since he couldn’t himself. It was very sad for me because I followed him closely. He died Wednesday at 12:59 p.m.”

Stanford University Medical Center integrates research, medical education and patient care at its three institutions - Stanford University School of Medicine, Stanford Hospital & Clinics and Lucile Packard Children's Hospital. For more information, please visit the Office of Communication & Public Affairs site at http://mednews.stanford.edu/.