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High School Fellows Program Gives Students a Chance to STEP into Careers in Medicine and Science

August 15, 2013 @ NYU Langone Medical Center (NYULMC)

The 2013 class of High School Fellows on a visit to the Neuroscience Institute.

On the morning of Monday July 29, the “Red Team” was huddled around a small conference table at Tisch 17 East, hashing out a complex case. A 56-year-old woman with a history of endometriosis and several abdominal surgeries was experiencing acute pain. Was it being caused by an infection from a prior surgery, a new obstruction, or was the source neurological? Little by little, the team worked to tease apart the web of factors that could be contributing, and drill down to the most likely source of her current complaint. “Let’s try to put the pieces together, and build a history in terms of what might have happened to her,” said Fritz Francois, MD, Tisch Hospital chief of medicine, who had joined attending physician Benjamin Wertheimer, MD, a hospitalist and medical director of 17 East, on rounds that day.

The team itself was led by a resident, and also included interns and a medical student. But that Monday, there were two additional members, complete with white coats, following along and even occasionally joining in the discussion, for instance, when Dr. Francois asked the group to explain what a fistula is. (It’s a connective tissue that develops between two organs or tissues that are normally not attached.)

The two students joining the Red Team that morning weren’t medical trainees—not yet, anyway. They were incoming high school seniors Kenneth Rodriquez and Salvador Lopez, part of the STEP High School Fellows Program. STEP stands for Science and Technology Entry Program, an initiative sponsored by the New York State Department of Education to give under-represented students early exposure to science and medical careers. The Medical Center has been participating in the program, as part of a consortium with the Associated Medical Schools of New York (AMSNY), in various incarnations since 1987.

“The STEP High School Fellows Program is really a landmark in encouraging young people from diverse socioeconomic and ethnic backgrounds to pursue careers in the medical professions, whether it’s becoming a doctor, nurse, physical therapist, technician, even optometry and dentistry,” says Carlos Restrepo, who has served as director of the STEP-HSFP program for 11 years, most recently under the direction of Mariano Rey, MD, assistant professor and senior associate dean for community health affairs, part of the Department of Population Health, and Arnold Stern, MD, PhD, professor of pharmacology and assistant dean for extramural educational programs. Restrepo continued, “By giving kids first-hand exposure into these professions—actually going into the hospital, the clinic, the lab—they become viable career aspirations, whereas otherwise they might feel out of reach for some of these students.”

The 'Red Team' during rounds at Tisch 17 East, from left: Trainees Louisa Hong, MD; Iula
Guiroiu, MD; Alison Young, MD; and medical student Leah Traube; Tisch Hospital chief of
medicine Fritz Francois, MD; High School Fellows Kenneth Rodriguez and Salvador Lopez;
and Benjamin Wertheimer, MD, medical director of 17 East.

His sentiments were echoed by Kenneth, based on his experiences this summer. When asked what surprised him most, he responded, “How actually in touch you are with the patients. You’re by their bedside, you’re with the doctors. It does give you a sense that this is a realistic goal.”

The 'Red Team' during rounds at Tisch 17 East, from left: Trainees Louisa Hong, MD; Iula
Guiroiu, MD; Alison Young, MD; and medical student Leah Traube; Tisch Hospital chief of
medicine Fritz Francois, MD; High School Fellows Kenneth Rodriguez and Salvador Lopez;
and Benjamin Wertheimer, MD, medical director of 17 East.

Kenneth, who is 16, will be a senior at Brooklyn Tech in the fall. He was encouraged to apply to NYULMC’s program by his older sister, who had been a fellow three years ago and had an altogether different experience from his. “At first she wanted to go into medicine,” Kenneth said, “and she did this program, and she realized that it was not for her. She couldn’t even stand the sight of blood! I told her I was thinking about medicine, and she said ‘You have to do this program, just to make sure you really are interested.’” His answer, after five weeks? “Yes, definitely!”

That excitement is common among the High School Fellows. Dr. Wertheimer said, “When I told Kenneth and Salvador that I would arrange for them to observe a patient undergo a cardiac catheterization, they literally high-fived each other out of excitement. It is exactly that type of enthusiasm I hope that they take from this experience. I hope that they realize that their passion to become a doctor is real and that they should be more excited than ever about the opportunities ahead.”

STEP is actually a year-long program that begins in the spring of students’ junior years, with preparation for the college application process that includes SAT prep as well as beginning to look at schools. The six-week summer portion includes preceptorships, in which the students generally spend two mornings a week for four weeks “shadowing” various professionals around the Medical Center. Kenneth spent time with an orthopaedic surgeon, a neurologist who specializes in multiple sclerosis, and an oncologist, while Salvador visited a lab studying cholesterol at Bellevue and a radiologist.

High School Fellows Alexa Aarons (left) and Tiffany Gonzalez with their final project poster.

“I think it is hugely important to listen to young peoples' interests and to cultivate them; to hear the things that they are excited and passionate about and then to provide them opportunities to explore, develop and grow these interests,” said Dr. Wertheimer of his choice to participate in the program. “It was a great pleasure to show students the area of medicine I practice—to take them to the bedside to meet patients, to discuss the complexities of medical issues and decisions, to let them come on rounds to feel what it is like to be part of the medical team and to allow them to ask questions about what they saw and what it means to do medical work.”

High School Fellows Alexa Aarons (left) and Tiffany Gonzalez with their final project poster.

In addition to the preceptorships, the summer session also includes final projects that focus on public health, culminating in a poster presentation session held this year on August 8. Students go into the field in their communities to gauge public perceptions and awareness on a variety of health issues. In Kenneth and Salvador’s case, their four-member group focused on body image and how it may be influenced by socio-economic status and ethnicity. Other groups concentrated on substance abuse, teen pregnancy, diabetes, and bullying, to name a few examples.

When they are not shadowing doctors or working on their projects, the fellows also attend college fairs and visit related institutions, including the Washington Square campus, the schools of nursing and dentistry, and the SIM Center. It’s all part of giving students a leg up in choosing what path to pursue. In the fall, they will be paired with medical students who will provide support and mentorship in the college application process as well as giving insight into their chosen field.

While inevitably some STEP alums take up other pursuits—Restrepo mentions two who are currently in Teach for America—others go on to careers in healthcare. One former fellow is about to start NYU’s accelerated nursing program this fall, after already having earned her MPH. Another is in medical school at Temple University in Philadelphia, after doing research at Mount Sinai.

Whatever they chose to do, the High School Fellows program gives students a view of the medical profession they would likely never have through any other avenue at their age. After the Red Team had spent about half an hour retracing their patient’s case, they headed to the bedside, observing as Dr. Francois obtained a detailed medical history from her and examined what emerged as the most likely source of her pain—an ostomy in her abdomen.

Afterwards, Dr. Wertheimer shared a well-articulated and invaluable lesson about the practice of medicine. “I would just advocate in general that everything we do in medicine carries with it a risk of side-effects and complications,” he told the team. “Everything that has happened to her recently, has been a side effect or complication of medical treatment . . . . Being a great doctor doesn’t just mean doing more. It means knowing when to step back and show restraint and give things time to settle.”

When asked what about his experience has solidified his interest in becoming a doctor, Kenneth said, “Seeing the humility of the doctors with patient care, interacting one-on-one and understanding the patients, and trying to actually treat them. It’s a puzzle, really. You’re trying to solve it to help the patient.”

Source: New York University School of Medicine: Life at NYULMC


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