Episode 10- MCW's Health Equity Scholars Program

Transcript

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Welcome to Pulse Check, Wisconsin. Good morning. Good evening. Good afternoon. Whatever it may be for you. This is Chris Ford again with Pulse Check Wisconsin. And I want to thank you guys for joining us yet again for another episode. Today we have. Another great episode for you. We're going to have some students on as well as One of the faculty leads., Dr. Michael Levis. Who is running the program, which is called the Health Equity Scholars Program that is working in the community of Milwaukee right now. In hopes to increase the amount of applicants and matriculants into medicine from the city of Milwaukee. The goal being to not only address the health and healthcare disparities that we see in the city of Milwaukee. But to also address the upcoming physician shortage and to improve the number. Of physicians from the community. So it's a great program. We are hoping to give it more. Advertisement hoping to increase the number of applicants to it, because it is going to have a direct effect in the community. And the community's health overall. I wanted to start off with a case today. That will underline and emphasize the importance of such a program. So with that being said, let's go ahead and start off with. Our case. patient is a 57 year old male who is presenting with complaints of sore throat and fever. The patient had been seen earlier. In the day. At another emergency department. And according to that note and to the patients. History. The patient is homeless. The patient is seen in the emergency department often. He frequents a lot of the emergency departments throughout the city. However, the complaints of fever and sore throat appear to be new. As compared to his visit at, uh, Nearby hospital a couple of days prior. When I went to see the patient, the patient has a temperature of a 100.4 degrees Fahrenheit. His vital signs are otherwise stable and within normal limits. It's the middle of the winter. So it's possible that this could be something like an upper respiratory infection. Of course we're in the middle of cold and flu season. COVID is a consideration as well. However, when I see the patient. Of whom I've seen before in the past, just in working with him in the emergency department. I noticed that he's got this new rash that appears to be new from the last time that I saw him. The patient has a rash on his hands. And he also tells me that he has a similar rash on his feet as well. So I take a look at the rash. And it looks rough. It looks reddish. And he informed me that he has noticed it over the last several days. It's not painful. It doesn't itch or anything of that nature. So I go back and I take a look at his most recent records. And going back a couple of weeks, it looks like he was hospitalized. A couple of weeks ago for complaints of chest pain. Somehow during that visit. They ended up running several tests on him at the time. The patient had blood tests that were performed. And in addition, he had testing for. The sexually transmitted infection. What came back positive during those tests were. Testing for syphilis, because of this, the. Doctors that saw him. Prescribed him penicillin That was to be given at an initial dose. And then prescribed them a 14 day course of doxycycline. Which is another medication. To treat. Syphilis. however it appears that. During his course. The patient ended up leaving the emergency department and. Not picking up his medications. I went back and asked the patient. If he had picked up his medications. Since that time of discharge from his most recent visit. And he informed me that he didn't have time. That he was confused as to what the medication was for. I sat the patient down and we talked a little bit about the course of syphilis and how it can affect you in the long-term. I also explained to the patient how this is a progressive disease. If it's not treated. And how it can proceed to. Have some central nervous system. Symptoms as well. The patient agrees. And he said that he would. Take the medication now. So I went back to the desk and I prescribed the patient an additional course at this time. And it also gave the patient information. Of how to follow up with his primary doctor. In the event additional treatment and additional referral to infectious disease was indicated at this time, as he was now demonstrating signs of secondary syphilis, which is a progressive form of syphilis. Unfortunately. When I went to go back to see the patient. The patient had left the emergency department. And eloped. I went up to the pharmacy. And I had the patient's prescription filled anyway. Again, the patient has been seen multiple times in the Emergency department. And so I suspected that he would come back at some point in time and we can give him his medication at that time. I explained the situation to the pharmacist and the pharmacist is very helpful. I worked out a plan with our social worker. Uh, in order to keep the patient's medication. In the social worker's office. So that when he would come back, we would be able to give him his medications. I worked the next week. And the patient. Presented again to the emergency department. At that time, I was able to give him his medications. And the patient was able to complete the course of the medications. Given the duration of treatment. So a couple of things in that case, first off. This patient is not unlike a lot of patients that we see. And the city of Milwaukee. Unfortunately. There are a lot of patients who, don't have access to care. There's a lot of different barriers that are in place, especially if you don't have access to transportation. If you were homeless, if you don't have the adequate funds in order to pay for medications. Or even get to the pharmacy. What we're seeing, especially in a lot of communities throughout the city. Is. They're increasing barriers to access to care. So not only access to clinics in the area. But also, there are a lot of pharmacies that are pulling out of the communities as well. So pharmacies that patients once went to are no longer there. And the closest nearby pharmacy. Is miles away in some cases. This patient in particular had additional barriers to garnering that medication. Given his lack of resources what the patient had in this case was again, syphilis. Syphilis is a sexually transmitted infection. That can start out as a primary infection. We usually will commonly see it as a painless sore. Uh, either on the genitals or. On the body. The dangerous thing about syphilis is that. It's a sexually transmitted infection that essentially has four stages. In the first two stages, they can be relatively mild. The symptoms that is. The first stage, latent syphilis, a patient may start out with the primary painless sore. And then after about three to six weeks, The wound heals on its own. So patients may think that it was something that came and went away. However, if you don't treat it. And if you don't cure it initially with penicillin, which is that primary medication that we give. It can progress to more dangerous phases. What the patient was manifesting here in our emergency department is a secondary. syphilis And the secondary course of syphilis, you usually will have things like sore throat. Fever, you can have some lymph nodes swelling. Headaches and just kind of feel general fatigue. The other thing that you'll see commonly are those reddish. Or brown. Rashes that will present on the palms of the hands and soles of the feet. Again, most like the. Primary syphilis the secondary syphilis rash may go away on its own. And again, that can be something that is very dangerous because after you've finished that period of time where you're not having any symptoms. The infection can go to the third stage, which is tertiary syphilis, which is a late stage. And this stage. You're no longer contagious, but the infection has started to affect your organs. The infection can also go to your central nervous system or to your brain and your spinal cord. And you'll have problems controlling your muscle movements. You have problems with walking or ambulating. You can even have vision problems. There can be numbness and there can be some complications associated with dementia. So I'll say that to say that it's very important to treat syphilis as soon as you. Have suspicion, or as soon as you test positive, And this patient's case. They're the perfect example of why doctors in the community are important. Because again, this patient had been to multiple emergency departments, had been to multiple hospitals. And this was something that slipped between the cracks. The patient had not had an opportunity to pick up his medication that didn't really have access to medications. And if we did not treat him. Then this is something that could have potentially been dangerous. I will say that this patient in particular. I've seen multiple times since. This presentation. And not only is he not demonstrating any more signs of secondary syphilis. He doesn't have any signs concerning for a tertiary syphilis. So I don't think that he's manifesting another latent phase. I think that fortunately, we were able to treat him in this timeframe. having doctors in the community. From the community. May help health outcomes in general. Doctors from the community often will. Take the next step and put themselves in the shoes of the patient that they have in front of them. Again, I knew this patient and seeing him before I knew. That, what I was seeing currently was off of his baseline. And I took the next step to go to the patient's pharmacy and pick up the patient's medication for him hand, walk it down and work out a plan with our social workers, because I knew the barriers that were in place for this patient. And I knew that that was the only opportunity that we would have to treat this patient before. His situation turned dire and became even worse. So with that being said, I want to segue into our interview. With our health equity scholars program. Which is a program that is going to be designed to improve. The amount of doctors from the community and improve the number of doctors within the community. To help address similar health disparities. And healthcare disparities throughout the city of Milwaukee. So would that be and said, let's go ahead and transition to our interview.

Mike: 13:06

So my name is Michael Leavis. I am a professor of pediatric emergency medicine. We're clinically mainly at the Children's Hospital in the emergency department, but I also work closely with a lot of the traditional pathway and pipeline programs that the medical college has. And I am serving as co director of the Health Equity Scholars Program, which we're going to be talking about today.

Chris: 13:34

Awesome. Amazing. Well needed in the community too. So I appreciate all that you're doing. Dr Levis is so and then with our soon to be student doctors, I guess we can go ahead and start with delicia. You want to go ahead and start? Just kind of what's your name and where are you from?

Delicia: 13:47

Yes. My name is delicia Simpson. I'm originally from Milwaukee, Wisconsin. And I'll be a first year medical student at MCW this fall.

Chris: 13:57

Awesome. Awesome. Welcome. Welcome to the club here. And Miracle, you want to go ahead and kick off too?

Miracle: 14:04

Absolutely. So my name is Miracle Powell. Me and Delisha come from similar backgrounds. Side note, we are best friends. Middle school. I am also from Milwaukee, Wisconsin, and I will also be starting as a medical student. And Test scholar in the next couple of weeks at the medical biology Wisconsin as well.

Chris: 14:29

Awesome guys. Awesome. Very excited. So I guess, you know, we can kind of start out just with some background. Mike, if you want to give us some background as to what the program is and kind of what inspired MCW to initiate a program like this specifically targeting you know, residents of Milwaukee.

Mike: 14:47

Yeah, so the, the Health Equity Scholars Program really started and was kind of the brainchild of a community leader assistant fire chief Josh Parrish who was talking to leaders here at the Medical College about what they did for their fire cadets and some of the novel ways that they recruited and really found the firefighters that the community wanted to be their firefighters. So some of the novel things they did was they had kind of co learning environments for the cadets where they offered, cohabitation and housing so that the cadets could train together and build up a sense of community. And then they also included community members on their boards that were selecting future cadets, basically kind of changing that paradigm. And instead of. Milwaukee fire saying, here's the cadets. We're going to have work for the community, asking the community, which cadets do they want to be their firefighters? So that's circulated around through leadership here at the medical college. And, you know, I've been involved, I am a graduate of the medical college of Wisconsin. I'm not going to tell you how long ago it was, but I was the president of the Latino medical student association. When I came back to work here, I was an aim mentor. You know, so 1 of the the pathway pipeline programs I've had. And involved with a lot of those programs. And I think the medical college has done a really good job of exposing youth from all over the state, including Milwaukee, to health care, to the potential jobs. One thing we have not had a good track record of is once we expose getting those, those youth to want to stay. And want to stay in Milwaukee, want to practice in Milwaukee. So we've had this Health Equity Scholars Program is really an idea that wanted to address that. Right? So what more can we do as an institution? How can we You know, break down certain barriers for individuals to stay in practice in Milwaukee or in underserved communities. And how can we really invest in those, you know, Potential students, those students that really are interested in health equity and interested in practicing locally and I'm sure we'll talk a little bit more about everything else, but really, really, I want to give a shout out to assistant chief Josh. She's just a brilliant mind and, you know, the whole idea of translating what's working in 1 industry to another is, I think, has been really fruitful.

Chris: 17:40

Yeah, and that's perfect. You know, the kind of that idea of that community retention, right? Like you see that and all can be on all progressive organizations now, especially at the state level to we're trying to retain, you know, trying to avoid that brain drain in the state of Wisconsin and more so in the city of Milwaukee. We had Dr Nimmer, who is with the Department of Pediatrics as well. She came on during our last episode. Thanks And she talked about, you know, how that health inequity can be remedied in some sense by having folks from the community, folks who look like their patients, folks who understand kind of that you know, that journey that patients will walk and how that translates into better patient outcomes, how that translates into that retention of your patient panel and, you know, visits and things like that. So, you know, I applaud, like you said, I applaud you guys for, for working in the community with community advocates, as well as retain, retaining folks from the community, pulling from the community as well. For Delisha and Miracle, you know Dr. Levis mentioned a couple of programs there that, you know, some folks from Milwaukee can get involved in kids that have ideas of going into medicine. Can you guys speak to, you know, any involvement that you guys have had and your journey into, getting to where you guys are right now being student doctors?

Miracle: 18:52

Absolutely. So, first and foremost, Dr, I did not know that you were an aim mentor that made me so happy because I also participated in aim. I participated in all 3 of the pipeline programs that are offered by office of student inclusion and diversity at M. C. W. So a mentorship and medicine. R. O. DSHRAP, which are short acronyms for very long program names those programs were literally the catalyst for why I decided to go into medicine. Those programs exposed me to things I feel like students don't Get to experience until college, sometimes medical school. For example, in the aim program, we got to go into the anatomy lab and see cadavers and learn about anatomy and physiology firsthand. And then in Rosen DSHREP being able to be inside of bench labs and being able to see science translate to the clinic space that early on was extremely instrumental in. This entire process, I would like to say I would not be a first year medical student here at M. C. W. without the exposure that I had in those programs. I am indebted to those programs. I will forever ever support those programs. They really meant a lot to me personally.

Delicia: 20:15

And for me, I did not participate in any of the pipeline programs. I did apply, but I also was involved in the upper bound math and science program at Marquette University for all 4 years of high school. And so that program taught me a lot about. Because it was focused on math and science, I of course got my science brain from there. I've always wanted to be a physician since middle school. And so I knew that I needed to focus on the sciences and the math math courses in order to be a strong competitor for medical school. But I also, because of Miracle Bean and Ames and Rose and D. Shrepp and a few of our other friends have been in there as well. I got to also learn from them as well. And I know that their journeys were so amazing with the program, and I know the program is super duper amazing. I wanted to go to. So it's really overall, the pipeline programs were really beneficial in helping just the youth get ready used to medical colleges in general, and just the field of medicine also.

Miracle: 21:20

And then I'd also like to add to with the pipeline programs at MCW not only do I feel like they provide that early STEM and healthcare exposure, but I feel like it is just a beautiful space for youth to be in when it comes to seeing other young people. Medical students, physicians, and just health care professionals who come from underrepresented backgrounds just because, you know, the schools that students attend outside of MCW, they don't have that type of representation. And so just being able to spend an entire summer. In filling your mind with, you know, science and also professional development is extremely instrumental to that early professional development in high school and then leading throughout college.

Chris: 22:09

Yeah. And thank you guys for touching on that too, because As we're hearing right now in the media, especially the local media, we're hearing a lot of things about MPS and you know how some folks that are going there, how it's hard for them to obtain secondary education and even professional education like, like medical school. Before we get into kind of the nuts and bolts of the program that you're in right now, can you guys walk us through a little bit of your own personal educational journeys? Did you guys go to school here in Milwaukee? Where'd you go for undergrad? Things of that nature. Sure. Just to give our listeners a little bit more background and just to hear it from, your own journey

Delicia: 22:43

yes. Thank you for asking that question. So again, I was raised here in Milwaukee, so I, I have attended NPS for my entire life, Milwaukee Public Schools. I started at Starm's Elementary then I went to Capital West Academy, which was more of a private school it's no longer here and then for middle school I went to Morris Marshall for the Gifted and Talented, and then, yes, we both did, and then for high school, we both went to Woofus King. For my undergrad, I completed my Developmental psychology degree at the University of Minnesota, Twin Cities. And then after that, I took some gap years. I completed a post bac program at Northwestern Health Sciences University in Minnesota. And then now I'm here back in Milwaukee for, to attend medical school. Welcome

Chris: 23:34

back. Welcome home. Yes.

Delicia: 23:37

Thank

Miracle: 23:37

you. And then as far as my educational path, my path was not. 100 percent linear. So I started out at Hampton Elementary, which was literally five minutes away from my childhood home. And I want to say that that is really where my spark for science started because I noticed a, what I now can put language to a disparity in our science education in fifth grade. So when I was in fifth grade, I can vividly remember we would only learn science One time out of the week for maybe 30 minutes a day at the end of the day. And I remember this so vividly because I remember how frustrated I would feel because science was innately my favorite subject and I wasn't getting that. And so that was one of the first you know, experiences that I had where I felt where I felt like even as a child that my education was. Lacking so I attended Hampton elementary from there. I went to Morris Marshall High School for middle school. They were combined. I did 1 year at Riverside High School graduated for Rufus King in 2017 with the Alicia. First year of college I did at UW Oshkosh and then I ended up transferring and completing my Bachelors of Science and Psych at the University of Houston. Beautiful experience I had there as well. Came back here to Milwaukee to do some gap years at UWM and now starting at the Medical College of Wisconsin. So, and I also did want to add another experience that I feel like that we should may be able to touch on as well. That mean experience in middle school. So, we would have metal detectors and weapon detectors. At our school early in the morning, couldn't even enter the building without the entire school going through this process of, of, you know, looking for weapons. And I feel like having that experience that early on in perspective, the environment that our early education, yes, was surrounded by and. I don't know. I, I just feel like it, it, it affected me and I don't know, at least you can take it from there, but it was just It was it was difficult having that experience that early on.

Delicia: 26:09

Yes. Yes. Yes, I'll definitely touch on that. I remember we didn't have those the metal detectors in those things until maybe like the 2nd month of 6th grade and it was such a jarring experience because Again, I had come from a private school too. So it was kind of like, I was like, wait, what's going on? What is this? And it like started your day off with the imminent sense of danger in a sense. And now that I look back on it and I've spoken to so many people in different States, especially in Minnesota, since that's where I completed my undergrad. And they had such different experiences. They never had metal detectors at their schools and their. The way that their education system was set up was completely different and until knowing that that was an anomaly. I didn't think about it deeper. But it was truly truly a jarring experience and I don't. And ever since sixth grade, we had always had metal detectors, even at our high school we would do random checks and things like that. And it was it's hard to put into words kind of the feeling that you have as a sixth grader where you're just coming into like a whole new world and you're automatically met with metal detectors and police at your school every single morning. And yeah, it's, it's, it's really, really hard. To be quite honest, yeah.

Chris: 27:30

And I think that's even more of a testimony to, like, the importance of programs like this, right? Yes. Especially, you know, if you're going into pediatrics, if you're in the emergency department, if you're having any interface with anyone who is an adolescent or anyone who could be experiencing that on a day to day basis, I actually had a similar experience with you all with the Chicago Public Schools, right? And so, like, we had the metal detectives, we had, you know, the police dogs do random searches on our lockers every now and then, right, and police in, police in the building. Yeah. And so, you know, without having that context, you know, and without having that idea of what things could be barriers in the way of someone's education outside of, as Miracle spoke to, you know, sometimes some educational deficit, just getting in the building is an experience, right? So, you know, there's very important. It's important to have that experience and also to have that experience in context of being a provider who is empathetic to that situation, who can understand, the direction that this, that, that your patients are walking in and can understand, you know, why they're late for an appointment, you know, do they have access to care? It seems like that. So thank you guys for sharing that. So Dr. Levis, in general, just kind of giving us the outline of the key objectives of this program, and by, you know, implementing pathways to have folks from the community come into the medical college and hopefully, you know, matriculate and retain them in the state of Wisconsin. Can you outline some of the objectives and how we will address these unique challenges experienced by. Some of our students,

Mike: 28:54

yeah, yeah, the so the program is called the health equity scholars program. And really the whole basis is the idea of, of training future physicians who wants to know what health equity is. So, to your point about understanding the different challenges that every individual has brings uniquely to their health care experience. We wanted students that really already had a lot of that worked in some of those areas, have had experiences, had deep connections to Milwaukee first, Wisconsin second, and, you know, then beyond that, had experience in underserved communities. So we have five health equity scholars you're meeting Delisha and Miracle right now we also have us. Sierra, Alex, and Ghani who will be starting as well. And really everyone who applied, we had over a hundred applications so first and foremost, everyone had to be accepted to our medical school first. We're not, we weren't part of the, the decision process in terms of, of Who got into the medical college of Wisconsin. We have a separate admissions process. So but this was an application. So, once students were accepted in the medical school, everyone was offered this program. And we had, again, over 100 applications, we had 4 months of interviews where we had current students on that panel, community leaders on that panel. And two professors on the panel and then we, we basically, the community decided that they wanted Delisha, Miracle, Gunny, Alex, and Sierra to be their doctors, right? This, that's the unique part of this. So the first thing we addressed is, is the community is saying, this is who, this is who I see. As being whatever, this is the medical student I want to see training and in clinic where I'm going, right, that the community is telling us that, right, that's the first thing that, you know, that this program acknowledges is that we haven't done that before. I don't know many programs that have done that before. When we talk to funders, like Robert Wood Johnson, the foundation. Well, the minute we told them that we had community leaders on the selection committee, they were like, whoa, they hadn't heard of that before. Right. And I think that's the first part of addressing health equity is, is changing that, that the shifting the way we think of medical school, instead of being a privilege is more being a duty to the patients. Right. You know, so knowing that, knowing what medical school is like across the country, medical school is hard Deletion Miracle, I don't think we've lied to you about that. It's not, it's not easy, right? It's hard, but then acknowledging that if it's our duty to train the future, to train the provider that can That is giving empathetic and knowledge based care, then we also have to make sure that they succeed. So in the, the curriculum, it's a mix of mentorship, a mix of exposure, and then a ton of support. And that's how we are. We have advertised the program. That's how we plan the program. Right away, we're going to start out with orientation. That's going to have some community leaders that come in and talk about their programs and opportunities and how they see physicians and providers in the health equity space. But then we're also going to have, some sessions that were really informed by current students. We, we did whole focus groups. We probably could publish on this. We did focus groups with current students and asked them, What's missing? What do you wish you had? What kind of, you know, what kind of training, what, what topics do you wish that the medical school would address? Why, You know, if you're matching somewhere else and go into another city after you train here, why? What's, what's the reason why? So we took all that information and we're, we're we've devised a curriculum that will expose our five health equity scholars to these resources. You know, financial, you know, financial planning resources you know living resource, housing resources self care resources. And then we're really embedding kind of the mentorship in with these experiences. The mentors are going to. Have the opportunity to share the experiences with the health equity scholars. When we have some mindfulness training, when we do yoga with a community, community based organization, the mentors are going to hang out with you too. It will probably bring our families. Right? It's going to be more of a community building, a family building, a different approach to, to, medical education. You know, I wanna, there's so many things I wanna, I wanna say'cause I think it's, it's really, you know, I'm super excited about it and, and the medical school is super excited about it. But I think, you know, the, the framework it is our first year. I think that one of the things that is really unique about the leadership team that we have is that we're pretty flexible. Both of the co directors were emergency medicine physicians. We can move, we can shift on the fly. Chris, you know, right. So we can shift on the fly. We have planned feedback sessions. We want deletion miracle to tell us what's working and what's not because next year we want to make it better. And next year, guess what? Deletion miracle. We're probably going to ask you to be on our interview, on our interview panel because we want to know who you think would be a good partner. Right? So, we plan on evolving this. We plan on, on really making it something where, you know, Talisha and Miracle, it would be hard for you to leave because you feel so tied in already. And even if you do leave, like if you go to Harvard, So residency cool go, but I want you to come back. Right? We want you to feel like this is your home and this is where where you want to practice. Yeah,

Chris: 35:43

you guys should probably publish this as you said before, because I don't know of any other program. I'm so proud that this program is, is coming out of my alma mater as well as at the Levi said too. But, you know, programs like this are invaluable. One of the things that I would say kind of coming from south side of Chicago was to, integrate into medical education. Now, you know, there's a huge cultural shock. There's a huge transition that you need to make and sort of having not only some faculty that are there to help you with that transition, but that 11 that you were saying there's going to be community leaders to that will be there to assist students.

Mike: 36:21

Yeah, absolutely. We have so we've been working close with Janine Edwards, who's a community leader. She's helping us to develop a lot of curriculum. She has tons of connections with businesses in the community. So, you know, when we talk about Dr. Cassie Ferguson, she's the other co director and her All of her research and all of her expertise is in wellness, belonging and medical health education. So, as she, as we develop some of this curriculum, she has expertise in what works and what Jenny Edwards is helping us with is connecting us with the people in the community that do that stuff so that we're tapping in. To the community, you know, we haven't talked about, you know, the tie on with the Thrive On initiative, which is which is on Martin Luther King Boulevard that's going to be the center of the program. We're going to be housed, right? And, you know, we have offices right there with all the other medical school offices that are going into Thrive On, along with the Greater Milwaukee Foundation, all kinds of other community partners. Hey, you know, geez, barbers right across the way we plan at partnering with, you know, cheese barbershop. We have the Howard fuller academy is right across. I could throw a stone and it's there. Right? We have all these connections and that's who, you know. The community is excited. They want, they, they want access to the, the five has scholars because they want to convince them when they, as they develop their medical school projects. Right. Do it here. We've got these resources. So, so we're, we're really trying to really integrate into the idea of being an anchor institution. We see that thrive on building as being kind of an. You know, can serve as an anchor in the community as kind of a hub where, you know, our scholars can. Really use that it's kind of like the neural center where, you know, all their connections are there. There's meeting space there. There's community spaces there. There's community based organizations there. There's residents living in there and then hopefully. You know, the, the. That a residential part of the building isn't done yet, but the idea is that these, there would be apartments that are available to the, to the health equity scholars so that they can also live with the community that they're serving. Right? And I think 1 of the most powerful. Things that Jackie heard Barbara was she's a board trustee member community pillar and she she was on our selection committee. And 1 of the things she said is I want the students at Howard fuller to look across the street and see. Someone in a white coat that looks like them. Policy. Policy that can talk to them. Mm-Hmm. yes. And know that that's, and, and wonder what's that white coat mean? And maybe have a conversation. Right. Mm-Hmm. And have, you know, so I, I think, I think being, you know, having the whole idea of like the, you know, what. What Josh Parrish brought about that living, that learning community, and then embedding it right in, right in that hub center, I think is a really another novel piece that

Chris: 39:47

hopefully will be fruitful. Absolutely. And for those unfamiliar Dr. Levis, can you tell us a little bit about ThriveOn just to kind of give our listeners a little bit more background for it. And then we'll kind of tie into it. Well, how it connects to the, to the program.

Mike: 40:01

Yeah, so ThriveOn initiative is an initiative with the Greater Milwaukee Foundation, partnering with the Medical College of Wisconsin. And really it's an, The Thrive On building, it was an old, I want to say gimbals. That I miracle I was talking to your dad, I can't remember shopping there, but it was an old gimbal. So it was an old really, it's an old. Department store that was purchased by this and this collaboration royal capital investments, you know, a whole bunch to name but basically, the idea was investing. Into the community and having space there where, you would have residential space, but you would also have business space and then also medical college community based programs there. So our HIV program is there for, and for life, which is our, which is freighters hospital based violence intervention program is there. The comprehensive injury center is going to be housed there. And I. I can't name all of them, but if you name a medical college community based program, it's probably going to be housed there now. It's more centralizing it, right? Kind of getting away from the ivory tower concept that we have out here in Wauwatosa. And then partnering with, you know, local businesses that, you know, the, there's going to be a catering company on the 1st floor and a restaurant that's, you know black gold, right? There's, there's a child development center. That's that's going to be on the 1st floor there. And then there's again, the residential part. It's in the building. There's going to be. Mixed income intergenerational, there's a community space that organizations across the city can can use. There's a team space on the 1st floor. And really, it's, it's kind of neat, because. They stayed I'm not an architect, but the architects are really like, they're kind of real excited about all of the old keeping, like, all of the old designs. So there's really, really neat architecture in there. It's I was just in the 1st floor space and it's really. It's really come along nicely. There's going to be, I think, a grand opening is planned for late summer, early fall, and they just had the ribbon cutting last week, but it's a huge investment. You know, the cities involved, you know, I think the mayor was at the ribbon cutting the there's there's some state funding going into it to governor give a shout out to the health equity scholars during his 2 minute speech at the ribbon cutting. So it is it is a big investment with. You know, a lot of ideas on collaboration and how do we really show the community that we want, you know, medical college wants to be an anchor institution. Medical college is going to put their money where their mouth is and, and really invest and then you know, we just had. A meeting yesterday, and we had someone who's works in the cancer center who does the community work and she is already planning, you know, learning sessions and community discussions and like learning circles really trying to address all of the. Disparities there are just in cancer alone, right? And, and then getting trust from the community and explaining in real words what the data means, right? And asking the community what they want to know about it and what, what, you know, where are they seeing the barriers? It's, it's going to be a very powerful space. We have, our offices are there we have two offices and then there's a lot of community community space where, you know, I think. That's where a lot of our orientation next week, deletion miracle is going to be. He will be in the space. I got him a badge already. We're good. Nice. Nice.

Chris: 44:10

And, you know, 1 of the things that comes up oftentimes when I'm doing lectures to pre meds, or if I'm mentoring them on the path of how to become, physicians. Are some of the financial barriers, which are real, right? Especially if you're coming from the inner city what programs or what measures are in place by this program to address sort of those financial barriers and to, you know, are there any. Coverage is for like tuition costs, living expenses. You made mention of potentially one day getting those apartment buildings, which is going to be a huge you know, avenue for a lot of folks who can't afford it themselves, or, you know, coming from a situation in the inner city, what programs are in place right now from this pathway?

Mike: 44:52

So thank you for that question. The so when we did those focus groups with the medical students 1 of the things we heard was that there's a huge financial barrier. Your average medical student coming out of training is going to be almost 300, 000 dollars in debt. That's across the country. I see you nodding your head, Chris. I just paid mine off. I'm 20 something years out and I just paid my student loans off last year. So finances are a big barrier and there's a lot of evidence in health equity work that money is a real barrier to, to how we choose our future positions, right? So it's a lot of evidence. Even there's some, some good evidence that shows that even the, the loan repayment programs that have kind of been the traditional staple, they're only temporary and and, you know, getting providers to stay. In the underserved communities, right? You know, working on on the, you know, at the reservations for the indigenous populations, working in urban or rural underserved communities, the loan repayment programs usually wants that. Period of of. Time paid back is done a lot of providers move on and a lot of that is because of, you know, recuperating financial delays, right? And and and and pay. So. We, when we were talking to one of the fire department one of the cool things about that living learning community for the cadets is it wasn't, you know, they didn't really have to, it was kind of like free housing, right? So we heard from our current students that like, oh, yeah, if you could pay for, for our apartments, our rent, that would be a definitely something that would, would Decrease that barrier to for our future decisions. So, when we initially designed the program we've we garnered you know, donations from from foundations on the idea that we would have living learning communities that were free to the students that that were, that enrolled in our program the Green Bay Packer Foundation among some other foundations thought it was a really good idea. They invested. And so we had that covered right away. When we proposed this idea to our Dean Dean Kirshner, he said, you know what? I like this program so much. I'll do you one better. I'll give them four years of tuition free. So right now, powerful, right? Yes. Huge investment. So right now and there are 3 other health equity scholars will go to the middle college of Wisconsin with full scholarships and with housing covered, which are, you know, right? I'm. I'm a data, I'm a scientist, right? I'm a researcher. I got research grants. So, like, my hypothesis, our hypothesis is that by trying to decrease that, that hurdle, that barrier and get rid of that right away, that we open up more options for them to decide to, you know, Really follow their passion, right? So they don't, so that's the, what reimbursement is for their services might weigh less on their decisions in the future. It's hard, right? It's really hard to go out and, you know, I don't know many people that, you know, Take a, you know, take a huge pay cut in any field. At some point, that pay cuts outweighs your passion and you have to provide for your family. You have loans to pay. So we're trying to get rid of that barrier. And Really, you know, allow the health equity scholars to not have that on their mind as they're really deciding what they're passionate about, where they want to work, who they want to work with, you know, because they won't have that debt. And you're seeing some, a lot of med schools across the country do similar things. And why you famously, I think their whole student body goes for free because if you look at at. Medical schools income, you know, across the country, tuition is just a really, really, really small portion of it. And in order to be competitive for, you know, top students there's a lot of, you know, Duke, I think we, we did a comparison and there's like 10 other schools that are doing similar type of scholarship based or, you know, fee waivers tuition waivers. Sorry. And I think that's, that's just a nod to the fact that like, if we want to have a, diversity of providers Mm-Hmm. from we can't just, we can't have finances be the barrier that we lose out. And so people just Mm-Hmm. it's not financially feasible. Right. Right. And or that$300,000 debt makes me decide that I, I don't know. I love adolescent medicine, but I don't know that. Take and provide for my family, right? I'm using adolescent medicine. I love adolescent medicine docs out there It is a calling and but you know, traditionally not reimbursed at the same rate as say a cardiothoracic surgeon And I think some of the reality of the shortages of providers that we're seeing or that they're predicting is that you know it's It's hard to choose pediatrics when you can go into adult medicine and make a, you know, a third more right? And then it's hard to choose medicine when you can go into surgery and make even more, right? And I think. you know, it's, it's not unique to, you know, Physicians, Physician Assistants, we're all human to There's a lot of altruism in what we do, but in the end the financial burdens drive a lot of decisions. Yeah, absolutely. I've had three kids, I'm sending one of them to college next year. You know, it's, it's. Everyone's got fees, right? Everyone has to feed my kids. I got, you know, it's, it's everyone has, has those tangible pressures and we just want to, we wanted to, to get rid of that pressure. And see what happens, right? You know, see what Alicia and Miracle and Alex and Sierra and Gadi decided to do. And then for next year, you know, we're going to have another 5, so we'll have we have the, the, the other exciting piece is. Through all this momentum we apply for HW Advancing Healthy Wisconsin grant and they agree, they just notified us that they approved Funding to have the next 3 to 5 years. So we know what's a pilot. We want to show return on investment. We want to show success. We want to show we want to be a model for the rest of the medical school. Right? Like, if. If we support medical students in a certain way, does it, does it, you know, can those be translated to the rest of the student population, some of these practices so that we can decrease, you know, burnout student burnout so that we can decrease Increased success in terms of, you know steps and boards and that sort of thing. So, so we're, it is a pilot program and we are very thankful. Delicia, Miracle, thank you for stepping into our pilot and helping us, but we see this as a partnership. I think a lot of the way in the future that the program goes and is going to be. Written by delicia and miracle and their colleagues, right? Their ideas what's working? What's not those are going to 100 percent be incorporated to the next. And then we have to ask about built in mentorship. What better mentor for next year's health equity scholars than this year's health equity scholars. Right? Especially. You know, if we can get, if a lot of them choose to live in the same building, right? Like, that's built in. I had to say,

Chris: 53:46

yeah,

Mike: 53:46

the support. I, I, when I went to medical school, again, I'm not going to tell you how long ago I think I studied with my dog. And, and then I wanted to like, remember that bookstore borders? Yep. Yep. I was there, right? Like I, like, it wasn't I had some people I studied with, but like, we'd have to like meet up. It would have been really nice to just go next door or to be like, Hey, I'm having trouble in this OB GYN rotation, but I know you did this. Let's have, you know, can we have dinner tonight? Like, like, cause we live right here. Absolutely. That's the vision for this. And, and we're, I know it's going to be successful. I think it's, it has been tried and I think it's probably the next model for successful programs.

Chris: 54:37

And to your point, you know, I, I won't get overly political. I won't wear that hat today, but what I will say is, you know, as we're seeing more and more attacks on like DNI initiative, diversity, equity, and inclusion initiatives, it's, it's, it's heartening to know you know, at the medical college and other private groups are, are. Putting, you know, their money where their mouth is and like really pushing forward to create these avenues to create these, you know, communities that are going to help improve, you know, that retention, improve those numbers of DNA candidates, because I mean, ultimately, even. Historically, with similar programs like you spoke to, Dr. Levis in place, we're still only sitting at about, you know, five or six percent in terms of African American physicians in the United States of America, you know Latino American four percent, you know, right? So we're, we're, we're, we're not anywhere close to where our populations are, especially in the city of Milwaukee when you have a majority minority, and I can tell you this personally, because I reviewed all the civic data and all this stuff. Census data. For the first time, I have a majority minority population here in the city of Milwaukee. It would behoove us to have these communities in place and to have these avenues these more so the safe spaces for not only the community to choose their positions, but also for those, you know, potential candidates to have a safe environment to learn and to make their experience the best that it could be in order to achieve at the highest levels. So one thing I'll say the best for last year. So what I want to ask Delicia and Miracle, and you guys can start either way you want, what, what are your own personal goals in medicine? And like, what are you hoping to do? You know, like, like Dr. Levis was saying, you guys have a huge responsibility, but I commend both of you for, for taking it on and kind of being those mentors for the next generations, even though you just started, right. But like, what, what are some of the things that you guys are hoping for both personally and professionally in medicine?

Delicia: 56:28

Yes. So first, I just want to say thank you to Dr. Levis, Dr. Ferguson. This program is truly like amazing. I can't, I'm so excited to be a part of the program just as much as you guys are excited for us to start. I'm excited to start for you guys as well. So I do, I am interested in child psychiatry, child and adolescent psychiatry and pediatrics as well. I do want to work with kids. I love working with kids. I think that because they are the future, it's a very important for us to attend to their mental health, their health in general, especially with the times that we're having now, especially with, you know, kids having to be home all the time with covid and like the transition out of that. I can see just. Being around people with kids and just social media, I can see that that's has taken a toll. And so that's the generation that I find is just, you know, needing the most help right now. So, professionally, I do intend to either be a child psychiatrist or pediatrician in hopes to come back to Milwaukee. If I end up leaving for residency, which we don't want necessarily. So I do plan to come back and also have my own practice where I will hopefully be able to have just a wellness center with women and children in general so that they feel in minorities in general, feel safe to come there. They feel safe talking to me, talking to the physicians that will be in the practice. And professionally, I do, I just really hope to be. a good doctor in general. I just want people to see me, see somebody that they can just trust, depend on because as we know, minorities don't have a good relationship with medicine in general. And I really do want to bridge that gap. I want people to be comfortable. I want people to feel safe. I want people to get all the health care that they need have access to the health care that they need. Quality health care is key. So, those

Mike: 58:35

are, those are my goals for the future. Awesome.

Miracle: 58:42

As far as for me, for my professional goals similar to Delisha, I want to be a good doctor. I think that that's the question that I'm looking forward to. I know as first year, everybody wants to ask what we want to go into. I have no idea. I have a lot of curiosities. I'm curious about maternal and women's health, but I'm also fascinated by the immune system as well. So, we're excited about that. See where this path takes me. But I will say just to go back to the thrive on complex and just the amazing narrative that Dr. Lewis just shared about this entire program. I know that as a medical student, and as a future physician, servant leadership is. On the forefront of my mind of how I want to implement my service and my practice to the community, and I think that the HEST program, the Thrive on Complex, you know, what better way to be fully integrated into the patient population that we're going to be seeing than to be living right in the heart of where, you know, our patients are coming from and being able to see, you know, The things that they deal with firsthand. And I know that me and Dulicia have grown up in these environments. So, you know, this is not necessarily new to us, but I think being able to live there as students, in addition to acquiring all this new medical knowledge is just going to amplify, you know, how we are, our mindsets and how we're going to be approaching treating our patients who come from these spaces. I, I want to be a good physician. I am ready to get my hands dirty. I'm ready to get my white coat dirty. Like, I, I am just ready to serve the community and, you know, bridge the gap in, in repair the broken trust that you know, patients who come from underrepresented groups may have when it comes to going to. Receive health care and I just I'm very much so looking forward to learning more about how to integrate health equity practices into decreasing disparities into my practice eventually as a physician. And I also think that this program is going to do a really good job of exposing us to community engagement, which I think is extremely important when it comes to building rapport and connections with patients in just the community as a whole. And I think that that really, really it's. It expands and it changes the mindset that the community will have when it comes to health care, and it just puts the Medical College of Wisconsin, the freighter system as a green flag in people's minds when they'll be able to see students and professionals from this space. Literally sitting and living in the community with them. So I'm very much so looking forward to that. I am also extremely. I mean, words can't even capture the amount of gratitude that I have with the intention that the heads program is putting into our will, our personal wellbeing, because I think that you know, as a society, we are becoming more conscious of the fact that we cannot pour from empty cups. And I think that. You know, physicians, I don't want to say medical students yet because I feel like we haven't earned this yet, but I know you guys don't

Chris: 1:02:03

worry about it. You got,

Miracle: 1:02:07

you know, positions can definitely say that. We put a lot into this entire process of getting to becoming doctors just to be able to give it all back and we know that that can't come from an empty cup. So I think that the HESS program is extremely intentional with.

Mike: 1:02:24

Yeah.

Miracle: 1:02:24

Feeling that cut back up for us and I can't even begin. I hope that just the work that we do will show the gratitude that we have for this. This is such a blessing. Yeah. It's such a honor and a privilege to be able to be a medical student for one, and then be able to be in this program to intentionally give back in the ways that we're being allowed to. Yeah. It's an honor and a privilege. And then as far, and I said that to say when it comes to the personal goals, I think that all of the wellbeing and mindfulness that has been integrated into the program is going to really, really allow us to learn how to balance. And I think that that in itself is just going to integrate into how we operate as students and as professionals. So I'm very much so looking forward to that.

Mike: 1:03:12

Yes.

Chris: 1:03:15

And, you know, for Dr. Levis, I'll kind of conclude with you just about how folks will can get in touch with you guys for this program if they have any interest. But before we do that for deletion miracle, is there anything, let's say, you know, kids that are walking similar pathways that you walk, is there any advice that you may have for them? You know, they're coming in the school every day, like you said, in the environments where they're not feeling like they're getting, you know, the, the utmost learning opportunity or having walking through, you know, different situations at home and going through metal detectors in the morning and things like that, that we talked about. Is there any pieces of advice, one thing you would tell them to get to the place that you guys are?

Delicia: 1:03:56

My one piece of advice that I. Love to give literally everyone is believe in yourself. If you have a vision for yourself, don't let anyone talk you out of it. Always follow and do what's best for you. Because at the end of the day, you really have you that's, that's really all you can count on is yourself. And so believing in yourself and truly don't let anyone tell you that your vision is too big or that no, they've never seen anyone like you do this. There's a first time for everything. And if you feel like you're supposed to be in a certain space, you are, you just keep working towards it. You, you got it. And just do not let anybody to tear you from your dreams, your aspirations, anything you want to do in life.

Miracle: 1:04:45

And then my piece of advice I have two pieces of advice. One would be you have to make sacrifices. There has to come, there has to come a time where you have to sit down, dedicate and focus. That is just a key pillar of wanting to get to a place of achievement. I can't say success because I think we, we achieve success on a daily basis, but there has to come a time where you are, you know, Dedicated to your focus. And then in addition to that, I would say being your most authentic self, similar to what the Alicia said My authenticity has gotten me farther than I feel like any degree I've earned in

Mike: 1:05:26

this

Miracle: 1:05:27

space and time has ever gotten me. You know, we, we both were accepted into this HES program. When I interviewed, was I nervous? Absolutely. And I actually, I remember getting off that interview. And when I learned that the Thrive On Complex was Next to Honey B Sage, which is one of my favorite tea shops. I almost screamed on the interview and I was like, Oh my God, I love you. When it was over, I was like, I should not have said that. I should not have said that. But that was just me being my authentic self. And I think that that was just reflected upon, you know. That I am from Milwaukee and that these are spaces that I care about, your authenticity is going to carry you far. It can be very intimidating coming into these spaces and, and, and again, as an underrepresented minority, not seeing a lot of people who look like you, but just being your most authentic self, being the real you is going to carry you very far and that will keep you focused. So, yes, authenticity is key.

Chris: 1:06:31

Man, so many pearls in there. Thank you guys so much. And Dr. Levis, for anyone who is interested in pursuing or applying for this program, where should they go? And again, I'll post anything to the website that you'll talk about here.

Mike: 1:06:46

Yeah, so the main contact is we have an email. It's healthequityscholars at mcw. edu and that will go to the leadership team. Any questions that any potential students have about the program, we have, we can share links with the website, the Medical College's homepage. There's a Health Equity Scholars page there that talks about and now now is featuring our first 5 scholars with little bios that, I think we messed up on 1 of them, but we're working on it.

Delicia: 1:07:26

It's fine. It's fine. It's updated. Yes.

Mike: 1:07:32

Little things we so the, the, but email us and that's not just for potential student applicants. That's also for local businesses. If you want to get involved if you have. A program where you think that you might want to integrate with some of the stuff that we're doing. Connect with us if you're a local leader, and you think that the health equity scholars could learn something about some of the efforts that you're doing. We, we absolutely want to have more connections. Because we know that we haven't exhausted every opportunity. There's so many assets in Milwaukee, Wisconsin, then it's impossible to know all of them. So please email us. We'll, we'll connect with you. We'll sit down. We'll talk about what your ideas are. We'll pitch some of it to our scholars, right? Like, they're, you are going to have to have projects, not specifically for us, but for medical school, but we want to make that those connections easier. We want to help you find the people that are already working in your passion spaces. So that you're not starting from scratch with, with your ideas and your projects. So, yeah, I think, I think anyone can email us at health equity scholars at ncw. edu and we'd be, we would welcome any input.

Chris: 1:08:52

Amazing. Well, thank you guys so much, Dr. Leavis. Officially student Dr. Simpson and student Dr. Powell. Welcome to the crew. Welcome to the team. Yeah, exactly. Applause. I'm so looking forward to everything that you guys are going to accomplish. Feel free to reach out to me if you need any have any questions or if you guys need anything in the process. And like I'm looking forward, you know, if you guys need anything from me I'm looking forward to help out in any way that I can.

Mike: 1:09:16

Well, I'm sure, I'm sure they're going to want to shadow a shift or two. Oh yeah, sure. They'll, yes.

Delicia: 1:09:27

Thank you for having us, Chris. Thank you. Thank you.

Chris: 1:09:30

Absolutely Gu. Alright guys, well you guys have a good, happy Juneteenth

Delicia: 1:09:34

Juneteenth. Thank you.

1:09:37

So I want to thank you for listening today. I want to thank Delicia and MIracle for coming out. Our two new student doctors who are going to be. Excellent physicians for the community and in the community. Hopefully we can continue to. Support them in their efforts and to retain them here in the city of Milwaukee, because we're going to need providers from the community. And provide us that want to work in the community to help improve community health in the long run. I want to thank Levis. For joining us today as well. Thank him for all of the amazing work that he is doing in order to help support this program. I want to thank Dr. Cassie Ferguson, who is also one of the leaders in this program and who reached out to the show in order to give it a platform and to help. Give you guys more information for the next classes who may have an interest in joining us. So thank you to Dr. Ferguson. I want to thank the medical college of Wisconsin for. Putting forth efforts like this in the community to continue to improve the community access to care in addition to helping to support folks within the community. To become the providers. That will make our public health better in the long run. So proud to be a medical college of Wisconsin graduate. And as I said, during the interview, Would love to help out in any way that I can in going forward. With that being said I hope you will join us for our next episode of post check Wisconsin. We are nearing the end of our first season that went quick. But looking forward to seeing you for our finale. We are going to have another very special guest on with us, and then we're going to continue to cover the health topics that affects you. And effect your health overall. So with that being said, Thank you for joining us again. As always. Take care of yourselves. Take care of each other. And if you need me. Come and see me.