Match Day is an important day in the life of graduating medical students—it’s when they discover where they will be spending their residency. This story (parts 1 and 2) features seven students on the cusp of their professional careers.
Before starting medical school, Simrun Bal ’19, already had a background in family health and primary care—she spent a year volunteering in a rural California health center where she counseled, educated, and coached patients on how to manage their diabetes. She also worked on a project designed to promote empathy and foster a person-centered approach to healthcare among the clinic’s providers.
These experiences solidified Bal’s desire to become an internal medicine-primary care physician and by the time she started medical school, she knew it was the right choice. For her, the field embodies humanism in medicine—seeing other dimensions of a patient’s life, beyond symptoms, to understand who they are.
But as sure as she was about her decision to go to medical school, Bal was worried about how the experience might change her.
“I was concerned that I’d lose what initially drew me to medicine, which was the idea of serving people with compassion and through science,” she says. “I was worried about that because of the rigors of medical training—then I realized there has always been a focus on humanism at Geisel, which is evident throughout the curriculum. My understanding of who I am was strengthened and kept me true to my mission,” Bal says. “The curriculum is challenging. We were always learning new material and new ways of learning new material, but throughout it all the capacity to care is something that’s emphasized—empathy is the way doctors serve. I think that is a good testament to the medical education Geisel provides.”
During her third- and fourth-years, Geisel’s geographically wide-ranging rotations gave Bal a valuable overview of how medicine is practiced in clinics and hospital settings in both rural communities and urban centers. “Family medicine in Belfast, ME, where I stayed with my preceptor’s grandmother; internal medicine at California Pacific Medical Center in San Francisco; and a rotation in rural New Mexico with the Indian Health Services was an amazing experience,” she says.
Though focused on internal medicine, Bal’s experiences led to an interest in psychiatry, which presented a conflict—a choice between internal medicine or psychiatry. She turned to her mentors for advice. “I reached out to my two On Doctoring professors, Dr. Manish Mishra and Dr. Steve Schwartz—both took time out of their busy schedules to advise and guide me through a difficult decision. The close relationship we had developed earlier through the two-year On Doctoring curriculum was helpful because they understood me and my motivations within medicine.”
Bal chose internal medicine and is entering Dartmouth-Hitchcock’s primary care-internal medicine residency program—it was her first choice. “I really like the rural Upper Valley community and I’m really excited about my residency,” she enthusiastically says. “Internal medicine integrates my fascination with clinical problem-solving with a passion for understanding each patient’s unique story, and the clinical reasoning and the diagnostic process in terms of both inpatient acuity as well as outpatient chronic disease management. Internal medicine also involves an element of teaching the patient, family, and other members of the medical team getting to a point of clarity—I really enjoy that process.”
The opportunity to continue living and working in the Upper Valley allows Bal to pursue her interest in rural healthcare while remaining an active member of the community—in her view, a key component of healthcare. “I’ve seen how my mentor and preceptor Dr. Ken Borie, a physician in rural Randolph, VT, is an integral part of that community and how the trusting relationships he’s built there affect his practice,” she says. “I’m looking forward to getting to know my patients in the same way.”
When Aaron Briggs ’19 (D ’15), arrived at Dartmouth College he was sure of two things—the role mentors and philanthropists play in our lives and a desire to become a physician. Both seed his belief in the responsibility of the fortunate to help those who are less so.
Once in medical school, that ethos defined how he plans to practice medicine. He quickly became interested in disparities in health and began educating himself in the hope that he might be able to help mitigate them as a physician.
“The United States leads the developed world in health disparity and social inequality—the two of which are inextricably linked. America’s disparities in health are striking not only in their magnitude—but also in the degree to which they have persisted over time, with some disparities actually having worsened,” he says. “This is an unacceptable situation demanding the utmost attention of the medical community.”
Motivated by what he learned, Briggs and three fellow Geisel students founded Beyond the Books to help equip students with the understanding and compassion necessary to effectively intervene on behalf of underserved communities as physicians. Now in its fourth year, he says the program is thriving, “I’m happy to see that it was sustainable. Health disparity is a serious issue in this country and I’m glad Geisel has an established program that is dedicated to helping better prepare students to address it.”
Wanting to resolve health disparities in under-resourced communities fueled his dedication to community service, mentorship, and philanthropy throughout medical school as well as his choice of pediatrics, which, he admits, was a bit of a surprise. “I’ve always loved working with kids but for some reason never stepped back and saw myself as a ‘kid person.’ After my third-year pediatric clerkship, it became clear to me that I’d found what I wanted to do. The pediatric community also tends to be more socially conscious and is focused on reducing disparities in health, so it was a good fit.”
Briggs is spending the next three years at the Children’s Hospital of Philadelphia (CHOP), even though the hospital lacks a formal program for residents interested in advocacy, he sees potential. “The hospital has an encouraging track record of supporting resident initiatives to serve underserved populations in the city. Although CHOP may not have formal urban health or advocacy programs the hospital has a lot of resources and is surrounded by communities with significant need.”
Briggs’ path to CHOP, however, was not direct.
“CHOP wasn’t initially a strong consideration for me—mostly because it doesn’t have as much of a social justice focus as some other residency programs. When I took more time to think about it, heading to Philly seemed like the right choice. Half of my family lives in underserved communities in the city,” Briggs says. “My decision to preference CHOP really boiled down to my desire to get to know my family better and just wanting to help. CHOP has resources and invests in its residents—it's possible I could help direct some resources to communities that need them.”
Briggs’ family shares his philanthropic ideals—frequently reaching out to help neighbors in need. “I am amazed by this,” he says. “I’ve seen my family step out into dangerous situations, putting themselves in harm’s way to help others. The communities where my family lives aren’t safe. In some areas, no matter how much medical knowledge or good intentions you have, unless you’re familiar with the environment you can’t really operate safely. Many of the communities in Philly are foreign to me—I grew up in San Diego suburbs and spent the last eight years in Hanover. So, it’s a blessing to have family there who understand the need, know how to help, and who can educate me in this way.”
Briggs knows he will need mentors to help guide his next steps toward becoming deeply invested in the community. “I’ll certainly require mentorship to help me determine how I might support underserved communities in Philly in a meaningful way. Some of this will no doubt come from faculty—but a lot of this mentorship will come through my family who have graciously been teaching me over the years.
“I’d be lying to you if I said I wasn’t afraid. It’s daunting to try to make a difference in a community I don’t fully understand. I also recognize that in many respects I’m not the best person to do this because not only am I not from the area, but I’m representative of a medical system that has a track record of injury and indifference toward African-Americans,” Briggs says.
“There are too many people in this world who suffer and perish from preventable causes of morbidity and mortality. Millions of children in the richest country on Earth experience hunger each year for literally no reason other than that we allow it. These are victims of apathy. I want to use my life and career to reduce as much of this preventable suffering as I can—both domestically and internationally if possible. I understand that my goals are ambitious—but I have to try.”
Emily Dollar ’19 (D’14), didn’t think twice about her desire to become a family physician.
As a Dartmouth undergraduate she was student director of the Tucker Foundation for Service, Spirituality, and Social Justice, where she worked with local community service organizations and oversaw a variety of social justice initiatives at the college. It was there that Dollar began working with young women at the Ledyard Charter School in Lebanon, NH, where more than half of the students’ families live at or below the poverty level. She says while working with this group of girls that included two young mothers, food and nutrition was a frequently discussed topic.
During her first year at Geisel, Dollar was among eight student finalists pitching proposals designed to address serious issues affecting healthcare or population health during the Make a Difference (MaD) Project and Symposium, the culmination of a first-year course—Patients and Populations: Improving Health and Health Care—that launched the medical school’s healthcare delivery science curriculum.
At that time, research suggested clinicians were uncomfortable raising the topic of obesity with adolescent patients during wellness visits, but when they did, many sent subtle and shaming messages. Because counseling was often ineffective and perhaps harmful, the messages had the power to damage self-esteem. Dollar wanted to change this dynamic, so she created an assessment of obesity counseling for adolescent patients.
Back at the Ledyard School, faculty and school leadership began a project focused on creating partnerships with Upper Valley community organizations to address adolescent students’ nutritional needs. The project involved students preparing food for each other, then integrating what they learned about nutrition into the curriculum—baking is chemistry and math.
As part of the Rural Health Scholar’s program, which provides care to underserved patient populations, Dollar and fellow student Emily Georges ’19, volunteered for the project—they created a curriculum providing students with case studies on a variety of health and nutrition issues and also taught the students about food safety and how to prevent contamination.
The project reflects a growing trend of including nutrition in the learning process—and fits with Dollar’s interest in primary care.
“I believe longitudinal relationships between patients and providers are at the crux of keeping people well, promoting healthy behaviors, and helping people make informed medical decisions that reflect their values and preferences,” Dollar says. “I find joy and fulfillment in getting to know patients over a long period of time and am excited to be able to care for the whole person (and sometimes whole family!) as a family medicine doctor.”
Next month, Dollar begins a family medicine residency at Oregon Health Sciences University in Portland. “Oregon is similar to Dartmouth with all of their incredible research opportunities,” she says. “And their culture is reflective of Geisel’s.”