Students from Albert Einstein College of Medicine’s chapter of the Latino Medical Student Association (LMSA) connected with peers during a virtual fiesta, heard inspiring messages from Latinx physicians who came before them, and engaged in advocacy activities during Hispanic Heritage Month.
From September 15 to October 15, Einstein students joined medical schools and institutions across the country to celebrate the histories, cultures, and contributions of Americans with ancestors from Spain, Mexico, the Caribbean, and Central and South America. Einstein’s festivities, sponsored by the LMSA, emphasized activities to help students thrive in their medical careers while highlighting opportunities to build a community.
“Under any circumstances, medical school can get isolating,” said Cristian Escalera, a second-year student at Einstein, an LMSA board member, and Hispanic Heritage Month organizer. “But it has been especially true during the pandemic,” which also highlighted enduring systemic racism and health disparities in New York and around the country.
A Pathway to Medicine
Carlos Rodriguez, M.D., M.P.H., kicked off the month with a talk about his personal and professional journey, from his early years in the Dominican Republic to his current role as professor of medicine and of epidemiology & population health, director of clinical cardiology research and of cardiovascular epidemiology at Einstein and Montefiore. He described his often-challenging upbringing in the Washington Heights neighborhood of Manhattan. His childhood there included regular visits to the doctor for his heart murmur, which piqued his interest in medicine.
The first in his family to enter college, he struggled initially. “It ended horribly—I flunked out,” he said. But after two years of construction work and loading trucks, he enrolled in a community college to become a lab technician while working full time. “I was surprised at my success,” he said. An encouraging professor suggested he apply to the pre-med summer program at the University of Massachusetts Amherst, which set him on his career path.
He completed his bachelor of science degree at UMass and then entered Columbia University College of Physicians & Surgeons after a stint in the U.S. Army. Dr. Rodriguez became the institution’s first resident from Washington Heights—the neighborhood where Columbia University Medical Center is located—and first Dominican American to be hired as a full-time faculty member. Now at Einstein, his focus is on cardiovascular minority health, specifically in Hispanics, and hypertensive heart disease, work he feels he was born to do.
He encouraged students not to set their sights too low and to not shy away from the competitive world of academic medicine. “We need more Latinos in academia as well as in medicine,” he said. Dr. Rodriguez advised students to look toward the future and make a 5- to 10-year plan. “Start thinking about what the steps are to achieve that plan,” he said. “Don’t sit back and wait for it to come to you…it won’t.”
One of the goals of Einstein’s LMSA is to build a supportive community for its members. On campus, that means networking and socializing—including the annual Hispanic Heritage Month Fiesta. But this year, the pandemic forced adjustments to the celebration.
“I had my doubts about experiencing a ‘fiesta’ through Zoom, but it ended up being a great time,” said first-year student Michelle Nuñez-Garcia. Before it began, masked students ducked into Riklis Auditorium to say a quick hello and pick up an individual dinner ordered from a nearby Colombian restaurant. Once the partygoers returned to their apartments, they logged on and introduced themselves.
“We had a whole mix—Dominicans, Cubans, Mexicans, Colombians,” Mr. Escalera said. LMSA board member and student moderator Abel Infante adapted Zoom meeting polls into funny questionnaires. “There was good Latin music playing, and everyone was laughing and cracking jokes,” Ms. Nunez-Garcia added. “It felt almost normal.” The fiesta also allowed the students to let down their guard and discuss more serious matters, such as their worries about starting medical school at Einstein.
“Our goal was to get the first-years to know each other,” Mr. Escalera said. It worked: A group of students picked up their meals and went back to a location that offered social distancing and a television they could use to log on and view the party. “They made it an in-person event for themselves,” he added. “I hope it ignited friendships.”
LMSA, like many Einstein student groups, prioritizes advocacy—for patients and community members. This year, organizers arranged a virtual screening of “Immigration Nation,” the heart-rending Netflix series about U.S. immigration. The screening was followed by a question-and-answer session with Justin Kopa, M.D., assistant professor of medicine at Einstein and assistant medical director of Montefiore’s Bronx Health Collective, which includes the Terra Firma medical-legal partnership for unaccompanied immigrant children and families with children seeking asylum in the United States. LMSA board members and second-year students José Fernandez and Lesly Sanchez moderated the session.
“Everybody has a story that started long before the exam room,” said Dr. Kopa, who shared the journeys of some of his young patients in the Bronx and their families, from their country of origin—most often Guatemala, Honduras, or El Salvador—through migration and apprehension about their lives in the Bronx community.
“We see kids who have endured serious injuries from beatings or murder attempts and much of our work is cataloguing their scars,” said Dr. Kopa. There are higher rates of infectious diseases, untreated congenital diseases, under-immunization, and injuries from sports or roughhousing. But most prominently, a lot of kids suffer from post-traumatic stress disorder,” he said. Poverty, social exclusion, violence, labor, or sex trafficking, a terrifying river crossing, being caught, separation from parents or siblings, and a stay in a detention center inevitably leave their mark. Even when reunited with family, children often experience food insecurity, school problems, depression, anxiety, or conflicts with authority figures.
“If we're doing our job in primary care well, all of us are doing mental health most of the time,” said Dr. Kopa. “I’m so grateful to be a doctor and to have the opportunity to care for people, especially when it means that I can help to shoulder their burden, even if only for a bit.” But, he noted, it is exhausting, endless work. He stressed that students learn to understand their own needs for self-care—and to not be afraid to advocate for them.
Imposter Syndrome and Well-Being
People of color, women, and those from disadvantaged backgrounds can be particularly burdened by feelings of inadequacy despite their own proven success—such as getting into medical school or becoming a physician. Those struggling with “imposter syndrome” can suffer from chronic self-doubt, undermining their goals and ability to advocate for themselves.
LMSA addressed the issue head-on by closing Hispanic Heritage Month with a talk by Anna Maria Nápoles, Ph.D., M.P.H., the scientific director of the division of intramural research at the National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health (NIH). She spoke to Einstein students at Mr. Escalera’s invitation: “I worked with Dr. Nápoles when I was a post-baccalaureate intramural research training fellow in her lab in 2018 and 2019,” he said.
On the surface, Dr. Nápoles’ career path looks like a natural, steady ascent: from accumulating the necessary degrees to working her way up through faculty promotions and eventually landing at the NIH. Less apparent are the obstacles she encountered, including micro-aggressions, working full time while in school, divorce, financial stress, sabotage, racism, and imposter syndrome. “I always felt like I didn’t belong,” she said. However, she added, “These setbacks motivated me.”
Dr. Nápoles shared several dozen strategies for success with students: “Get mentors early, and get good ones—people who are supportive, understand your perspectives, and are willing to tell you the hard realities,” she said. She recommended changing thoughts from self-defeating to self-promoting; celebrating accomplishments; and not letting others undermine you. Build core skills, she advised, in research methods, epidemiology, statistics, data analysis, presentation, and writing. Grow your interpersonal skills—self-confidence, communication, negotiation, knowing your limitations, networking, and team building.
Most important, develop a personal narrative—who you are, where you’re going, and why you’re unique. “It’s critical to your health and well-being,” she said.
Einstein in the Community
“Our students are truly amazing,” said Irene Blanco, M.D. ’04, M.S., associate dean of diversity enhancement and professor of medicine at Einstein and a rheumatologist at Montefiore. “They are really focused on building and sustaining an environment at Einstein where everyone is valued and has what they need to succeed. The events and speakers our LMSA group lined up for the month really reflects their expectations for themselves and their dedication to their community.”
Einstein and Montefiore’s emphasis on social justice is one that resonates with students. “They are drawn to Einstein not only because of the patient population they see at Montefiore, but also the volunteer efforts they can participate in,” said Nilda I. Soto, M.S., Ed., assistant dean of diversity enhancement and director of the Einstein enrichment and diversity student summer research opportunity programs.
The majority of students are active volunteers, including at the ECHO (Einstein Community Health Outreach) Clinic, one of the first student-run free clinics in the nation, and for “pipeline” programs, such as the Einstein Enrichment Program, which aims to increase diversity in healthcare. Students also act as mentors to those from groups historically underrepresented in medicine, including the Bronx Community Health Leaders (BxCHL). They also participate in, with the support of Dr. Blanco’s office, dozens of service-oriented activities, including those that engage with homeless men and women, offer STEM education to students in public schools near campus, and advocacy groups like WhiteCoats4BlackLives.
As Dr. Nápoles said during her talk, “I believe we are in this world to help the voiceless and disenfranchised.”
Posted on: Tuesday, November 24, 2020