After Kjersti Knox graduated from Earlham College with a degree in biochemistry, she was awarded a Fulbright Fellowship to study health care policy in Sweden. There, she learned about that country’s universal health care system and how Sweden integrates alternative medicine into the system. That experience piqued her interest in studying medicine.
Similarly, Knox’s experience as one of the first eight graduates to complete the University of Wisconsin School of Medicine and Public Health’s new Training in Urban Medicine and Public Health (TRIUMPH) program inspired her to stay in Milwaukee’s central city for her 3-year post-graduate family medicine residency.
“I learned about the TRIUMPH program after I arrived at UW. It seemed like the perfect match for me and my interests, because I came to medicine with a social justice focus and was very interested in the integration of public health and medicine,” Knox said.
Knox’s TRIUMPH classmate Anne Getzin also came to medical school with a social justice focus. Both credit their family upbringing, education and pre-med school experiences for their interest in working in underserved communities.
During her last year and a half of medical school, Knox worked in Lindsay Heights at the Bread of Healing clinic, 1821 N. 16th St. Getzin was assigned to work in Clarke Square at the Sixteenth Street Community Health Center, 1032 S. Cesar E. Chavez Dr.
Dr. Cindy Haq, director of TRIUMPH, understands the power of the program to change lives. “I’ve found that if I can get the students really excited and show them that they can make a difference, and introduce them to really wonderful people like [Walnut Way co-founder] Sharon Adams and [Lindsay Heights community health leader] Dr. Tom Jackson, they kind of fall in love with the place.” That makes it rewarding for them and then they want to stay, Haq said.
Haq, a UW professor who has designed and led programs in Uganda, Pakistan, Brazil and Afghanistan, practiced family medicine in a small rural Wisconsin community, and now practices family medicine in a Milwaukee urban health care center, said she is “having the time of [her] life with these students … who have a very deep commitment to working with urban underserved populations.”
She explained that the TRIUMPH students moved to Milwaukee after their first two and a half years in Madison to have an immersion experience working with diverse populations. Each of them devoted much of their time to a community/public health project.
Haq noted that the program’s core curriculum also includes Milwaukee history and “a lot of what we call the social determinants of health.” What she is trying to teach these students, she said, is that health is not just about medical care. It’s about the way people live – their housing, jobs, food and social connections. She believes that doctors who really understand this will not just treat people when they’re sick, but rather will promote health in the community and “work to strengthen the many assets that we already know are present in Milwaukee,” Haq said.
She credited TRIUMPH’s community partners with being great hosts and mentors for the students and crucial in familiarizing them with Milwaukee’s neighborhoods.The advantages must flow in both directions, Haq added. “I’ve said from the beginning, [TRIUMPH] has to be good for the community.”
In addition to a six-week clinical rotation seeing patients, the TRIUMPH students participated in regular group meetings, which were vital in creating a supportive community for them, according to Getzin. The discussions covered a wide spectrum of topics, but always addressed how students could be community advocates and incorporate community and public health into their practices. Having those conversations frequently reinforced their clinical training in community medicine and public health, Getzin said. “It absolutely affected our viewpoints over those two years.”
As for their community projects, Getzin explained, organizations in the community proposed project ideas. Then, together with clinic personnel, the TRIUMPH students developed the projects and defined their roles.
“The first step was to get to know the people at our community sites and collaborate with them and then perform a community needs assessment,” Getzin said.
Knox saw patients at the Bread of Healing Clinic, under Jackson’s supervision. She also worked with him and the Lindsay Heights Neighborhood Health Alliance on her TRIUMPH project.
Knox’s major project was to support the health alliance’s Access to Care work group, chaired by Jackson. The group’s goal is to gather data that gives an accurate picture of the health status of Lindsay Heights residents and their access to medical, mental health and dental services, as well as healthy food and exercise facilities, Jackson said.
For example, Knox found that for the last few years, the largest number of emergency room patients with dental problems came from the Lindsay Heights zip codes, 53205 and 53206. This reflects the severe shortage of dental services in the neighborhood. Knox continues to work on the project as a resident, Jackson added.
Jackson is excited that Knox came to Milwaukee for her residency and wants to stay in the community. “She’s exactly the kind of person we need to recruit, because she has both the passion for taking care of the patients and the ability and interest to deal more broadly with their health problems,” he said.
At the Sixteenth Street clinic in Clarke Square, Getzin and her colleagues identified the need for a health clinic dedicated to providing confidential care to adolescents. The Tuesday evening clinic, which offers STD testing and treatment, pregnancy testing and care (but not abortions), contraception, acne treatment and counseling referrals among other services, opened in June at the center’s Cesar E. Chavez Drive site.
Dr. Steven Murphy, one of Getzin’s supervising physicians, said that TRIUMPH’s public health training gave her a strong vision of the teen clinic as a collaborative effort. Instead of the traditional one-patient-treated-by-one-doctor model, the teen clinic has medical doctors treating teenagers alongside social workers, mental health professionals and a team that does HIV and STD testing and risk reduction, Murphy said.
UW’s medical students are clamoring to get in to the TRIUMPH program, according to Haq. A recent survey of the current second-year class showed that 45 of the 150 students plan to apply for the program next year. There are 24 third- and fourth-year students participating this year.
Knox and Getzin began their residencies at St. Luke’s Family Medicine Residency Program in July. After completing their residencies, they both plan to continue working with urban underserved populations as family medicine physicians, they said.
Knox said that TRIUMPH showed her the importance of teaching and learning in underserved areas early in a doctor’s career, and “how possible it is, and what great people are doing that work right now.”
Getzin said the program taught her practical, pragmatic tools for working in public health and community medicine. “We also did a lot of important support work with each other in developing tools to avoid burn-out. I can’t say enough good things about the [TRIUMPH] program. It was pretty amazing.”
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