“FGLI students already have all the qualities necessary to be amazing doctors. We’ve overcome challenges, created the most from opportunities presented to us, and most importantly, we have the life experiences that allows us to connect with our diverse patient population.”
This is the message that Mytien Nguyen, an MD/PhD student, shared with new students at YSM’s first-ever First-Generation Low-Income [FGLI] Orientation on August 10, 2024.
The idea for an FGLI Orientation sprang from conversations between Professor of Pediatrics Marietta Vázquez, MD, and Javier Sánchez, a second-year medical student, about students’ experiences with getting acclimated to medical school and learning about its more intangible elements.
As YSM Associate Dean for Medical Student Diversity, Dr. Vázquez supports students from a variety of backgrounds and recognizes that “succeeding, is much more than just getting accepted into medical school.”
She wanted to create an event that served as “a kick-off, a beginning, to a sense of belonging. Acknowledging the many potential barriers to student success, while focusing on their special abilities.”
Jaime Cavallo, MD, MPHS, said the event welcomed students with, “open doors, open ears, and open arms.”
Resources for the Resourceful
In addition to collaborating with Dr. Vázquez to envision and create this inaugural event, Sánchez moderated a panel of FGLI faculty and fellow students. Panelists had a frank discussion about the tools, resources, and approaches have helped them achieve.
Nguyen advised, “To successfully navigate the hidden curriculum of medical school, FGLI students should utilize all the tools we already have in our repertoire, built from years of already navigating an education system that was not meant for us.”
Sánchez said that as a first-gen student, he does not adhere to the “rigidity of the inherent hierarchy” of medicine, and instead is “able to approach the faculty and administrators as people who happen to be excellent medical professionals. He says that “professors want to help,” but it’s imperative that first-year students reach out to their instructors.
Sánchez added that it’s a “tremendous privilege that medical students have in having access to a medical education.” He recommends taking advantage of the many avenues for help in achieving academic goals, plus Yale’s many free seminars and lectures to extend learning beyond the scope of the traditional MD curriculum.
Nguyen added, “Medical education is complex and challenging, so don’t hesitate to reach out for help -- and at times, demand resources that are essential for your education.”
Dr. Cavallo, YSM Assistant Professor of Urology, said that panelists spoke to “lived experiences that we all share, in addition to our own unique stories. A newcomer might think they’re alone in their experiences, when it’s actually a common phenomenon. By recognizing this, we can work together to overcome adversity, and grow to become our best selves.”
Dr. Cavallo is the faculty advisor for medical students, residents, and fellows who self-identify as FGLI. She says they share “self-initiation, perseverance, and drive toward toward a mission inspired by personal experience. It’s that passion that helps them through the journey, and that grit that pushes them through the finish line.”
The Gift of Lived Experience
Dr. Vázquez was a first-gen student herself, and in retrospect she values this identity. For her students, Vázquez wants their FGLI identities to be prized from the start: “You’ve faced adversity, you will be able to connect with patients in ways that are very powerful and effective.”
Third-year student Bassel Shanab shared, “FGLI identity has many strengths in the clinical setting, either in direct patient care or in the various processes that surround it. Often a time, trainees are reminded to place themselves in the shoes of a patient who is marginalized, underserved, or facing lived experiences different from that of their own.”
For FGLI students, that identity is a “set of hiking shoes that you get to share with patients,” allowing trainees to “traverse the onerous mountain with them, advocating for their care and better care systems.”
Shanab said empathy can help these future doctors develop stronger physician-patient relationships; connect to services related to social determinants of health, such as secure housing or food; or share a “no-shame-here explanation” of prescription manufacturer coupons or discounted care programs.
FGLI healthcare professionals “have experience with bridging the gap between their academic world, and an under-resourced community, to communicate information effectively,” Dr. Cavallo explained. They are able “to understand the limitations to accessing, navigating, and undergoing medical care, and to meet the patient where they are.”
Sánchez pointed out, “Our current full-time role is to learn how to be compassionate and competent health providers for people of all walks of life.”
Building Connections
In addition to shared strengths, Dr. Cavallo has identified some common obstacles for FGLI individuals, and says YSM is creating resources to address those in a targeted way. Current efforts include building connections with others within YSM, across Yale’s other graduate and professional schools, and to other campuses nation-wide. In fact, YSM students created a national organization for FGLI students and organized its first conference.
Over her five years at YSM, Dr. Cavallo has collaborated with the school’s leadership to build a longitudinal mentorship program providing resources at every stage of career progression, including a career coaching program developed by Daryn H. David, PhD, Assistant Professor at the Child Study Center, for faculty.
The First of Many
YSM’s first-ever FGLI Orientation was attended by dozens of incoming and returning medical students, faculty, residents, and fellows. Following the panel, attendees broke into smaller groups for deeper discussions of community, readings, and reflective writing. Sánchez remarked that, through conversations about challenging topics, he observed smiles and positive exchanges.
First-year students started getting to know each other and returning students, to show “that there is a community that welcomes them,” said Vázquez.
“Although this is YSM’s first-ever FGLI Orientation, it is a demonstration of YSM’s longstanding support for the FGLI community,” Mytien Nguyen reflected. “I strongly believe that [these] initiatives will enable FGLI students to foster a sense of community and belonging early in their medical training.”
“To me it was just a joy,” Vázquez remarked. “I’m already thinking about how to transform this event for next year.”
Panelists
Javier Sánchez – MD student, panel moderator
Morgan Brinker – MD student
Gabrielle Carmichael, MD – YNHH resident
Jaime Cavallo, MD – YSM faculty, Advisor for Yale FGLI
Magna Dias, MD – YSM faculty
Mursai Gardezi – YNHH resident
Mytien Nguyen – MD/PHD student, Founder of Yale FGLI
Olamide Olawoyin, MD – YNHH resident
Bassel Shanab – MD student