New First-Generation Low-Income Program Aims to Create Community at YSM

It certainly does not define her, but it is a part of who she is and a driving force to much of what she does. Yale Assistant Professor of Urology Jaime Cavallo, MD, MPHS, is quite open about self-identifying as a first-generation low-income [FGLI] student when she was in medical school. Now a reconstructive urologist, she wants to find out who at Yale School of Medicine [YSM] self-identifies the same way [an individual who is first in the family to attend higher education and/or was raised in a low-income environment].

“I promised myself that once I completed my training, I would work to provide the FGLI medical community with things I didn’t have: long-term mentorship from those with shared experiences, cultural capital, and a sense of community,” says Cavallo.

That resonates with Natasha Tillett, MD, who has just started her otolaryngology [ear, nose, and throat] residency. “I’m the first in my family to go into medicine. We don’t even have a nurse,” Tillett laughs. “I’m drawn to this group because I’ve already found it takes a similar background to understand what it’s like to navigate the system for the first time. Others just don’t get it,” says Tillett.

Over the past three years, Cavallo has volunteered countless hours for the FGLI medical community, founding and implementing YSM’s new First-Generation Low-Income Longitudinal Mentorship Program [FGLI LMP]. Her co-director is Daryn David, PhD, assistant professor in the Yale Child Study Center and associate director for leadership development in the Office of Academic & Professional Development [OAPD] and the Office of Diversity, Equity & Inclusion [ODEI].

“As a first generation American, I can also identify with entering spaces of higher education and professionalism and needing to learn the ‘rules,’” says David. "Supporting others as they navigate this type of growth informs so much of my work at the OAPD and ODEI. So, when [Cavallo] approached me for support with this program, my response was a resounding yes."

FGLI LMP is sponsored by ODEI; the Graduate Medical Education department; OAPD; and their leaders, including Deputy Dean, Chief Diversity Officer, and Associate Professor Darin Latimore, MD; Senior Associate Dean and Professor Stephen Huot, MD, PhD; and Associate/Deputy Dean and Professor Robert Rohrbaugh, MD—all of whom were early collaborators and designers of the program.

It is September and just weeks into a lot of newness. For many in the auditorium it is the first time in medical school; the first time on rounds; the first time in New England.

“It’s a lot of firsts at once,” shares Gabrielle [Gabi] Carmichael, MD, who just began her residency in pathology. “There are times I have very much felt alone in the academic arena.”

It is the kickoff event for the FGLI LMP, and Carmichael is at a numbered table with Tyler Harvey and Oscar Perales. Just as Cavallo and organizers had hoped, the three linger and laugh after the formal presentation. They likely would not have crossed paths otherwise. Now, they are sharing personal experiences and finishing each other’s sentences.

“I’m very excited about the potential of this program,” says Harvey, a first-year medical student at Yale. “Just getting this group in the same room … It’s powerful in and of itself,” chimes in Carmichael.

“I can Google what a cardiologist does, but you don’t often hear about their experiences,” says Perales, a third-year medical student. “That’s why I’m drawn to check it out.”

Mamadou Jallow is from Montreal. Aside from a quick trip to New York, he had never been to the United States until he came to Yale. “Just having someone to talk to and learn from the obstacles they faced… I have no generational knowledge about this. Also, I don’t know exactly what I want to do in medicine yet. It’s good to build a network where I can learn firsthand,” says Jallow.

Just across the table from him is Hector Acosta Rodriguez, a first-year medical student from Puerto Rico. “Having a person guide you who has already been through the steps, I think, is quite valuable,” says Rodriguez.

And these points, say Cavallo, are precisely why the FGLI longitudinal mentorship program was formed.

It aims to create community; to provide support, resources, mentorship, and networking opportunities; and to help overcome potential adversity and facilitate career progression.

“This is what the FGLI medical community has expressed that they need and are seeking,” Cavallo says.

A safe space is one must. “I think having mentors outside our own departments could facilitate a place to be more vulnerable for both mentors and mentees, without the traditional supervisor-supervisee power dynamic,” says pathology resident Carmichael. “Plus, a little separation from our ‘departmental bubbles’ exposes us to perspectives we probably wouldn't have encountered otherwise.”

Cavallo explains that all 138 who signed up to be a part of the longitudinal mentorship program have been divided into strategic “pods” of two to three faculty members, two to three residents/fellows, and two to three medical students from different disciplines.

“This gives people the opportunity to engage with others outside their field who do not directly impact their career progression,” says Cavallo.

The FGLI program will include a coaching curriculum focused on developing essential skills for growing leadership presence and potential. This will be led by Assistant Professor David who is a licensed clinical psychologist, educator, and leadership development coach. It will also consist of series and workshops on financial health literacy, as well as team-building, networking, and social events.

“It’s all about paying it forward,” says Magna Dias, MD, professor of pediatrics at YSM, regional medical director for pediatric inpatient services at Yale New Haven Hospital, and chair of pediatrics at Bridgeport Hospital. She also self-identifies as a first-generation individual and signed up to join the group along with 49 other faculty members, 46 residents/fellows, and 42 medical students.

“At so many points in my training, I misstepped or muddled through,” shares Dias. “Don’t get me wrong. I got to Yale. I’m successful, but many of my colleagues, for example, had a parent in medicine. They understood how to navigate the system. I didn’t.”

Dias emphasizes it is important to her to now be a pseudo-parent to someone else. “I can help them to not feel like an outsider as I did.”

It is a full circle that Cavallo and other FGLI organizers hope to repeat and refine.