TRIUMPH Brings Medicine and Public Health to the Inner City
Brian Hilgeman, who recently completed his third year at the University of Wisconsin School of Medicine and Public Health (SMPH), was raised in Brookfield, Wisconsin, an affluent suburb of Milwaukee. The town boasts superior schools, safe neighborhoods and a booming commercial center.
Yet, when Hilgeman graduates from medical school next year, he hopes to use his training in a setting that's far different from his comfortable hometown.
Hilgeman and other third-year School of Medicine and Public Health students recently completed a five-month pilot program called Training in Urban Medicine and Public Health, or TRIUMPH.
"TRIUMPH prepares physicians for urban health careers in medically underserved areas like central Milwaukee," says faculty director Cynthia Haq, MD, professor of family medicine and population health sciences at the School of Medicine and Public Health. "On a national level, we desperately need more physicians working in inner cities. Some students love urban environments and are drawn to work with disadvantaged urban populations."
|Medical student Theresa Umhoefer (center) admires potato plants cultivated by (from left) Gabriella Newson, Cameron Bond and Tasha Gamble. The teens worked at Walnut Way, one of several Milwaukee organizations involved in the Training in Urban Medicine and Public Health (TRIUMPH) program.|
Training in Urban Medicine and Public Health supplements clinical experiences in Aurora Health Care sites by adding community and public health projects to a combined third- and fourth-year curriculum. A second-year summer TRIUMPH internship is in the pilot stage.
"Students learn about the history, cultural traditions and conditions of specific neighborhoods," Haq says. "They meet with community leaders and visit families to learn of their strengths and challenges."
Each student is matched with a local organization and its staff to focus on a major health issue impacting the community. Students work closely with leaders to address the issue of concern and promote better health.
Working in and around downtown Milwaukee a half-day per week, Hilgeman and his fellow students visited cultural sites and engaged in projects with a variety of health agencies and community organizations.
Learning About Patients as People
Patients in these neighbor-hoods usually are more ethnically diverse and much more likely to be uninsured or on Medicaid than the patients the medical students typically serve in Madison or other training sites. Here, students can learn about the sociologically complex situations patients deal with on a daily basis.
The learning experiences can be eye-opening.
"Three of these students grew up in the Milwaukee area, yet they had little knowledge of 99 percent of what we saw and did," says Haq. "Together, we attended clinics for the homeless and uninsured and confronted the challenges of urban poverty and lack of access to health care. We also met many wonderful people who are leading programs to address these problems."
Hilgeman was responsible for helping tobacco users stop smoking at the 16th Street Community Health Center, where generally one third of the clients have no health insurance and over 60 percent live below the federal poverty level.
"Before I started medical school, I worked at the 16th Street Community Health Center for a year as an AmeriCorps member," Hilgeman says. "From that experience, I became very interested in working with urban populations and people of different ethnic backgrounds. I thought TRIUMPH would give me a good idea of what it was like to practice medicine in the inner city and help me clarify my future goals of working with inner-city residents."
Hilgeman says Training in Urban Medicine and Public Health was rewarding and clearly will benefit his future medical practice.
"By exploring the economic challenges inner-city residents face and also experiencing the unique and diverse cultures found in the inner city, I became more familiar with my patients as people, not just diseases," Hilgeman says.
Michelle Buelow, also from Brookfield, addressed teen pregnancy prevention with girls and young women between the ages of 11 and 21 at the 16th Street health center.
Emily Fish of Reedsburg offered guidance to Hispanic seniors over age 60 at the United Community Center, concentrating on how to understand, prevent and manage diabetes.
Milwaukee native Erin Marra spent her time at the United Community Center with substance abusers in recovery. She initiated discussions on sexually transmitted diseases, mental illness and the effects of drugs on the body, aiming to help clients lead healthier lives.
Working at a Milwaukee high school, Hannah Gaedtke, who comes from rural Tomahawk, Wisconsin, organized talks on reproductive health in an effort to reduce soaring student pregnancy rates and help the youngsters understand how having a child can impact their lives.
"Medical school focuses a lot of attention on providing us with the knowledge we need to treat patients," Gaedkte says. "But it doesn't take long to realize that in order to truly help patients find health, you need to spend time learning about their culture and lifestyle as well. This is more difficult and not something that can be found in a textbook."
Meanwhile, Liliana Kanu of Atlanta, who worked through the Bread of Healing Clinic, investigated nutrition and food purchasing habits of African Americans. Her goal was to understand barriers that keep people from accessing healthy foods that could reduce their risk of serious medical conditions.
Kanu's investigations led the students to Will Allen, who is promoting urban gardening through an organization aptly named Growing Power.
Summer TRIUMPH Internship an "Unforgettable Experience"
The summer TRIUMPH internship consisted of seven School of Medicine and Public Health students, all from Wisconsin. They included Mark Kaeppler of Richfield, Ebba Hjerstedt of Shorewood, Caitlin Wallach of Mequon, Theresa Umhoefer of Franklin, Diana Dovorany of Racine, Matthew Augustine of Muskego and Steve Kidd of Whitewater.
Umhoefer and Augustine immersed themselves in the Walnut Way Conservation Corp, a community revital-ization project that has transformed a "disinvested" area northwest of downtown into a vibrant community of rehabilitated housing, inviting parks and bountiful gardens, thanks in large part to the vision of Sharon and Larry Adams. The ultimate goal, they say, is to provide residents access to quality education, health care, technical assistance and investment support.
The medical students learned about Walnut Way's Gardens to Market program, which introduces local teens to horticultural knowlege and skills and teaches them about nutritious dietary choices and growing their own food.
Umhoefer and Augustine presented talks on healthy eating and the dangers of heat. It was an unforgettable experience, says Umhoefer, and the lessons she learned were important.
"The only way to really get to know about a culture or community is through interaction," she says. "It all starts with a conversation."
Now a TRIUMPH champion, Umhoefer is helping spread the word. Eight School of Medicine and Public Health students have already signed up to begin Training in Urban Medicine and Public Health in their third year.
The Training in Urban Medicine and Public Health program complements the medical school's Wisconsin Academy for Rural Medicine (WARM), created three years ago to train future doctors for careers in underserved rural areas. Together, the two programs contribute in important ways to addressing serious physician shortages in all areas of the Badger State.
By Mike Klawitter
This article appears in the summer 2009 issue of Quarterly.
Date Published: 09/28/2009