Minh Pham

Flashback from over the six-week internship with UCLA-Harbor with Summer Urban Health Fellowship!

It had been such a privilege to be selected to be one of the few undergraduate students from different schools and undergrad all over the nations to be a part of the Harbor UCLA Summer Urban Health Fellowship (SUHF). It was an honor of working on cutting edge, community based research within the Watts community with a group of like-minded, inspiring people consisting of Residents from Harbor-UCLA, Medical Students from UCI, UCLA and from other medical schools, fellow undergraduates from different colleges, and high school students. Thanks to SUHF’s Coordinator, Dr. Puvvula, Dr. Granados for this unique opportunity to follow my passion as the future healthcare providers for the community. Here are couple thoughts after the experience working at the internship this summer along with my past experiences.

Throughout the program I have learnt that all of these enrichment programs designed to strengthen the academic pipeline were initially started to address the underrepresentation of minority groups in health care professions and to provide an opportunity for diverse health care providers to practice in their own communities. Most enrichment programs were offered in the summer and provided additional academic preparation and support to underrepresented minority (URM) students in the sciences. They often addressed barriers to student achievement such as unevenness in academic preparation, less rigorous educational background, family influence on preparation aspiration and success, and unease in a new setting. Since these programs must address both the academic and social complexities of URM students including high school students, they often required a range of programs to meet the specific needs of various student groups.

Historically, the civil rights movement of the 1960s led universities and the federal government to examine and address the issue of equal access to careers in the health professions by removing cultural, educational, and other discriminatory barriers that historically discouraged URM students from pursuing health careers.The federal government was an early advocate for addressing the shortage and workforce diversity issues, having enacted the Health Professions Educational Assistance Act of 1963 (Public Law 88-129). This law was designed to increase the total number of health professionals through grants for expansion of existing schools, incentives for new schools, and student loan and scholarship programs which is one of the ways to resolve the issues of health disparities in the healthcare educational system. Nonetheless, the number of URM students remained extremely low. Frankly, back in the 80s, the academic enrichment programs typically come under scrutiny by the public and the courts. In terms of legal issues, there is always a huge gap in terms of accessing into the educational system between different underrepresented minority ethnic group. Their legality and fairness have always been an issue and continue to receive public attention. In Regents of the University of California v. Bakke (1978), the U.S. Supreme Court ruled that while colleges and universities can consider race as a “plus” factor in the admission process, they may not do so by imposing quotas. In Hopwood v. Texas (1996), the U.S. Court of Appeals for the Fifth Circuit ruled that any consideration of race in admissions is unconstitutional. When the U.S. Supreme Court declined to review the Hopwood decision, all affirmative action programs in public universities in Louisiana, Mississippi, and Texas were ended. That same year, California Proposition 209, a state ballot initiative (known as the California Civil Rights Initiative), was voted into law prohibiting preferences in public education on the basis of race and sex. In 1998, the Washington State Initiative 200, modeled on California’s Proposition 209, ordered public agencies in the state of Washington to stop giving preferential treatment on the basis of sex, color, ethnicity, or national origin.

Secondly, one of the important topics which this internship is trying to address is the underserved communities. As we might have known, the mission of the majority of our healthcare’s program and their goals is to be health equity, quality services, and improved health workplace; however, in an underserved community you can expect to see these qualities neglected. To be more specific, underserved communities are occupied with families earning incomes at the poverty level. Often times, patients in these vulnerable areas are victim to chronic illness or disabilities or limiting access to certain healthcare services. What we are finding in these areas is that the healthcare standards are often not up to par. Reasons vary for healthcare disparities but the highest factor is due to maldistribution of professionals. Specifically, these people were malnourished, underserved, and lacking the necessities of life. I just remembered how fortunate I am to have simple pleasures of a hot shower, dinner with my family, shelter, clean clothing, and the ability to visit my family physician. That is the moment when I knew working in an underserved community is my call. Conspicuously by their bravery to succeed and survive in this country, I sincerely wanted to help these people and provide them the best health services for them. From the little girls’ single touch and the old lady’s silently asking for help, and even more to the harsh reality that many people are starving and lacking health care, this moment alone along with my other experiences working with the underserved community in the past define my experience with the underserved communities.

Figure 1: Group Picture After Wilmington Health Fair With SUFH’s Fellows, Dr. Gilberto Granados, Dr. Jyoti Puvvula and Group of Family Medicine’s Residents from UCLA-Harbor Medical Center – Courtesy of Minh Pham

One of the other important components of this program is mentorship. During our lifetime, each of us always had some difficulties and obstacles during our academic and professional career. Therefore, it is easier for us to have someone who had experienced or previous knowledge in order to guide us into the right direction and right path where our passion allows us to do. For me, mentoring is like a professional activity, a trusted relationship and meaningful experience, commitment. Throughout the program, I have mentored and learnt a lot from other high school students who have been struggled with their academic and their college applications as well as have been mentored by other medical students and residents to become a much better person and the future physician for the community.

Figure 2 : Group of Young/Brilliant High School Students From Different High Schools Whom I mentored Throughout The Program- Courtesy of Evelyn Gomez

Lastly, another important component of this program is health advocacy training. As we might have known, there are many illnesses uniquely affecting the URM communities leading to preventable deaths and a lower quality of life. Additionally, there are large cultural barriers in providing treatment to these communities such as the lack of culturally competent care, access into the adequate health issues and social stigmas associated with the illness. Hence, health advocates play a crucial role in removing these barriers and making these issues widely known to make treatment more accessible and effective. Advocates work through a variety of means, such as raising awareness among policymakers, securing additional funds for addressing health disparities and working to end discrimination against certain conditions. On the broader scope, health advocacy can be seen as actively involving with different campaign and fight for the right reason and for the equality in our healthcare system. Two of the important health advocacy events this summer within the program include: The Rally at UCLA-Harbor Medical Center to stand up alongside U.S. Senator Kamala Harris to RESIST the current Senate Bill for the ACA Repeal with Dr Alex Nguyen and The Health Advocacy Training at David Geffen School of Medicine at UCLA with Dr. Puvvula. Throughout these advocacy trainings, I have learnt that Healthcare is a right, not a privilege and everyone should have access to it regardless of their background and their immigration status. From my own perspectives, as the future healthcare provider for the community, I want to be able to provide the care that I had limited access to growing up — and to change policy. According to Dr. Jay Lee, one of many people, a middle-aged financial services professional named Kenrick Bascom, lost his health insurance in 2007 and was unable to get reinsured until he became covered thanks to Medicaid expansion under the Affordable Care Act. For the record, 31 states, including California and Kentucky, plus the District of Columbia, have expanded Medicaid since 2014. Coverage came just in time for Kenrick. You see, he had been suffering from back and abdominal pain for years. Soon after he got his insurance card, he scheduled an appointment with one of Venice Family Clinic’s primary care specialists, and thanks to important tests he otherwise could not have afforded, Kenrick learned he had cancer in his left kidney. He was referred to a surgeon to have the cancer removed, and today, Kenrick is cancer-free—all because he was covered by Medicaid and able to access quality primary care when he needed it most.

Figure 3: The Rally at UCLA-Harbor Medical Center To Resist The Current Senate Bill for the ACA Repeal – Courtesy of Minh Pham

Figure 4 : The Advocacy Training’s Workshop (“Don’t Mourn, Organize”) With Dr. Jyoti Puvvula at David Geffen School of Medicine at UCLA- Courtesy of Minh Pham

As a future healthcare provider and a young, compassionate individual and culturally-competent individual, I will also have the sense of knowing the inner historical background and trauma of the family while guiding the patients and providing complete care under the instruction of current healthcare providers and training medical students. I believe that as a future healthcare provider, I will be able to have a lasting impact on a diverse patient population, much like my family physician has had on me. It is my desire to gain a deeper understanding and knowledge of how to implement health care to underprivileged populations. As an immigrant who settled in this country for over the past 7 years from my little hometowns in Viet Nam where the underserved communities are highly populated, I can personally relate to the challenges and struggles that face many underserved communities. In addition, I have had several volunteer experiences during time in high school in the States and my undergraduate studies at UCLA that have furthered my passion for helping those less privileged. It seemed so ironic to me that in this urban setting, there could be so many people hurting, so many people sick and not able to get the care they deserve, yet others had no problems getting the appropriate health care. Through community outreach and experiences working with other communities (Native American, Asian Pacific Islanders, Hispanic,…), I hope to make a difference in access to healthcare for many disadvantaged populations.

I will continue to actively pursue opportunities to work with the underserved because it is a part of my passion. I have a minimal knowledge of Spanish languages during my undergraduate studies, however, these knowledge already gave myself a broader foundation of language skills for helping the underserved and communicate effectively with a patient.

There are a lot of different organizations which targeted specifically to certain underserved communities or through different means to provide the competent care for the patient. One of them is Vietnamese Community Health at UCLA. From the Vietnamese Community Health websites, “In 2006, Vietnamese Community Health (VCH) was founded by five UCLA students with the words, Sức khỏe là vàng (Health is gold), in mind. Years later, VCH has exponentially grown to over 60 members. Like its founders, those who are a part of VCH aim to improve the health and overall well being of the underserved communities in Orange County (O.C.) and strive to solve the health disparities faced by these communities. Though Vietnamese immigration began decades ago, the Vietnamese people continue to struggle. Many lack health care access and insurance due to financial, language, and cultural barriers. Thus, it is essential that VCH alleviates some of these barriers and works hard to show that we empathize with and understand our patients and their needs.” (Coutesy from VCH-Vietnamese speaking’s population). The other organization which I was a part of during my time at UCLA which is Global Medical Training which is “an International Humanitarian Organization that provides free medical-dental services to medically deprived communities in Central American countries.” (Coutesy from GMT- spanish speaking’s population). One of the ways to promote culturally competent care which is through promoting health literacy which is exact the mission of MSO (Morning Sign Out) which is “ to turn science and medicine into something understandable for our readers, with enough critical information that leaves them more knowledgeable than before.” (Courtesy from MSO-Promoting Health through Health Literacy). Many more other amazing organizations which carried out the same missions to help the underserved.

Finally, I hope that I can contribute my mission to help the underserved because I have so much knowledge, and deep passion to offer to the lives of my patients. My deeply rooted passion goes far beyond my own material needs and into the needs of the individuals that I am fortunate enough to serve. By committing to work as a future healthcare providers in an underserved community, I can personally contribute to this important mission. Through my work as a premedical student, and the support of teamwork of professionals whom surround me, we can improve the health of the patients by providing quality care in order to build a healthy community, which can make an impact disadvantaged communities and provide complete, well rounded heath care.