David Buck, M.D.
In January, American Medical News, the magazine of the American Medical Association, reported that “85 percent of primary care physicians … say their patients have health concerns caused by unmet social needs” – but only 20 percent of physicians feel equipped to address those needs.
That’s where The Albert Schweitzer Fellowship – a unique, service-learning and professional development program that enhances traditional health- professional training – comes in.
Named in honor of medical humanitarian Dr. Albert Schweitzer, the fellowship program takes a two-pronged approach that includes both a mentored, 200-hour service project and a multidisciplinary, reflective leadership development program. Offered in large urban cities throughout the country, including the Houston-Galveston area, the program develops professionals who enter the workforce with the skills and confidence to address not only clinical health issues, but also the social determinants of health, like poverty, the environment and education.
Participating in the fellowship has been a transformative experience for medical and graduate students like David Darrow, a University of Texas Medical Branch at Galveston student who helped run St. Vincent’s Student Clinic in Galveston but felt powerless to address the underlying social factors impacting his patients’ health.
“Since Hurricane Ike in 2008, we’ve seen see an exorbitant number of diabetic patients,” the Schweitzer Fellow says. “I found myself growing increasingly frustrated as I watched my patients suffer enormously – we’d struggle for months to normalize blood sugar, but most of the time the root of the issue remained hidden behind layers of social barriers.”
So Darrow took action to break down those social barriers, through community gardening. With the support of the Houston-Galveston Schweitzer Fellows Program and other friends and allies in the Galveston community, Darrow has established two gardens in Galveston’s low-income neighborhoods that will serve as the lynchpin of an interactive, culturally competent curriculum and training program on nutrition and health behaviors – and that will, he hopes, ultimately reverberate back to the examination rooms at St. Vincent’s Clinic.
“I had to apply to the fellowship twice to be accepted, and I was and am incredibly happy to have the privilege to participate while I’m still in medical school,” Darrow says. “Simply preparing my application took me down a rewarding path of meeting people who have become an essential part of my life. I have learned so much since I began that process, and I look forward to the day when I can serve as that crucial link for another ambitious student looking to change the world.”
Launched in 2008 by Healthcare for the Homeless-Houston, the Houston-Galveston Schweitzer Fellows Program is hosted at Baylor College of Medicine and is one of thirteen Schweitzer program sites across the U.S. Competitively selected from a variety of graduate schools and disciplines each year, Schweitzer Fellows undertake the fellowship on top of their regular academic responsibilities.
“Instead of simply volunteering to fill a pre-set role, each fellow must partner with a community-based organization to identify an unmet health need, design a sustainable service project with an enduring impact, and bring the project from idea to implementation,” says David Buck, M.D., founder and president of Health Care for the Homeless-Houston.
“By doing so over the course of a year and on top of their regular academic responsibilities, Schweitzer Fellows learn to integrate service to vulnerable people into their everyday lives,” said Buck, who also holds a master’s degree in public health and is a professor of family and community medicine at Baylor College of Medicine, and Houston-Galveston Schweitzer Fellows program chair.
In addition to carrying out their service projects under the guidance of academic and site mentors, each interdisciplinary class of Schweitzer Fellows meets monthly for trainings on issues such as cultural competency and effective advocacy.
“By learning to work respectfully and collaboratively with peers in other fields of study,” Buck says, “fellows broaden their understanding of the many social factors that impact health, and adjust their perspective and actions as future professionals accordingly.”
Upon successfully completing their fellowship year, Houston-Galveston Schweitzer Fellows will become members of the Fellows for Life alumni network – a pipeline of emerging professionals with the capacity to effect change that will reduce and ultimately eliminate disparities impacting vulnerable people’s health and lives.
Joshua Liao is one of those alumni. As Baylor College of Medicine students, he and Revathi Jyothindran implemented a Schweitzer project at Ben Taub Hospital’s Emergency Center that doubled the rate of follow-up care for newly diagnosed HIV patients. In a recent issue of IMPact, the medical student newsletter of the American College of Physicians, Liao reflected on the ways in which medical education can and should focus on community service in order to cultivate more empathetic, selfless health care providers.
“Having just completed my fellowship year addressing HIV linkage and follow-up care, I feel that the Schweitzer Fellowship provided a particularly powerful structure for cultivating service,” Liao wrote. “First, it required that the students themselves identify unmet needs and craft project proposals, ensuring that we identified issues we personally encountered and then thought critically about how to address them.”
“Secondly, the work was done over twelve months concurrently with our academic and clinical responsibilities, allowing us to experience the time, energy, and resources required to serve our communities both as service workers and health care professionals,” he wrote.
“Thirdly, the multidisciplinary, multi-institutional nature of the program allowed for a unique blend of encouragement, brainstorming, and growth. As a candidate for the M.D. degree, I brought certain clinical, patient-care perspectives that helped inform others’ work, but I also learned a great deal about myself and my project from the other fellows who were studying public health and social work,” Liao wrote.
“Fourthly,” he wrote, “the fellowship emphasized regular feedback, introspection, and planning – aspects that I found particularly helpful when I had to re-assess the direction of my project or face setbacks.”
“All in all,” Liao wrote, “the Schweitzer Fellowship was as complete a service opportunity as I’ve ever experienced in medical school because it allowed me take ownership of my work while having access to ready support, persevere through tough periods while brainstorming creative alternatives with others, and realize that lifetimes of service begin with a few initial steps, ones I don’t have to – and perhaps shouldn’t – take alone.”
The Houston-Galveston Schweitzer Fellows Program is actively seeking partners and sponsors. To discuss sponsorship opportunities, contact Program Director Tiffany Harris at firstname.lastname@example.org.
To learn more about the Houston-Galveston Schweitzer Fellows Program, visit www.schweitzerfellowship.org/houston.