by Jeff Mortimer
photos by Martin Vloet

Julie Kovach

The epiphany came for Julie Kovach, M.D., after 72 straight hours in the coronary care unit of her training program.

“I was still awake and having fun,” she says. “That’s when I knew I wanted to be a cardiologist.”

Now a clinical assistant professor of internal medicine-cardiology, Kovach is also one of the Medical School faculty who have agreed to be “shadowed” by students in the Health Sciences Scholars Program, the University of Michigan’s newest Learning Community. Open to first-year undergraduates who have demonstrated interest in a health-related career, one of its requirements is that each student spend time with a practitioner in his or her work environment. The stint is only for about four hours, not 72, but the aim is the same: to help students discover for themselves, through encounters with real-world experience, which health care profession, if any, is for them.

Just as important to the program is a series of oral autobiographies that faculty from health care-related schools present, in which they informally discuss “the trajectory of their career, what their interests were when they were young, what they currently are, and how they integrated those interests into their work,” says Wallace Genser, Ph.D., the Health Sciences Scholars Program manager.

Kovach, who has been shadowed at her work in a clinic for adults with congenital heart disease, has also presented one of those autobiographies. “I hope this program helps people to have a realistic idea of what they’re getting into,” she says. “It’s not all pretty. You’re going to be tired a lot. You’re going to have to make compromises in your life and family time. I remember students from my medical school class who didn’t sort it out until their third year that this was not what they wanted to do for the rest of their lives and had to change gears then. If students can figure it out early, it gives them more time to pursue what they really have a passion for. I try to get across to students that whatever it is you choose to do, the rewards are worth it if you have the passion, but the sacrifices are such that if you don’t … ”

Sixty students were accepted into the program for 2001-02, its first year, and 87 for 2002-03. The majority of them list medicine as their first career choice. As the program’s faculty director, Michelle O’Grady, points out, the majority of them also probably think medicine is synonymous with health care, when in fact the field also encompasses pharmacy, nursing, public health, dentistry, social work, kinesiology and, increasingly, biomedical engineering. Once exposed to these options, students often find their true passions lie elsewhere, even outside the mansion altogether. In O’Grady’s view, that’s just fine, both for the students and the professions.

“We can bring a lot of faculty and practitioners right into the residence hall, into the classroom — people that they would have to seek out otherwise,” she says. “They’re learning about fields they might not have heard of, much less known much about. Students who do feel some certainty about a field can explore it a little more deeply, and they may learn that they are in fact totally dedicated to that or they may learn that it’s not what they thought and something else fits the bill for them a little bit better. If we can help that happen earlier rather than later, we consider that a success.”

Michelle O’Grady and Wallace Genser

The schools benefit not only from a better-informed pool of applicants but also from a bigger blip on the radar screens of some top-notch undergraduates. “The schools have the chance to come into contact with students who are younger than those they might otherwise meet,” says O’Grady, a lecturer in the U-M School of Nursing, “and they can talk about their fields earlier in the students’ career planning process. I think it is to all the graduate schools’benefit to have a presence in the undergraduate community.”

According to Medical School faculty members who are involved with the program, it is certainly to their school’s benefit.

Vincent Cimmino

“Don’t forget, we take just under a third of our students from this undergraduate school,” says Vincent Cimmino, M.D., clinical associate professor of surgery, a member of the Medical School’s admissions committee and its liaison to the Health Sciences Scholars Program. “Therefore, we’re certainly interested in recruiting the best and the brightest. Any initiative we take toward showing the undergraduates what the quality of this medical school is will benefit us as much as the student.”

“These are clearly some of the brightest undergraduate students in the country,” says Kovach. “If they come here for undergraduate school, you certainly don’t want to lose them to another medical school.”

Andrea Asnes

“The more experiences they have, the better they’ll be able to choose whether medicine is right for them and come into medical school with clearer ideas of what they want to do,” says Andrea Asnes, M.D., former U-M lecturer in pediatrics, who has been shadowed by program students at the Wellness Center, a middle school clinic in Ypsilanti. “They’re learning why they might want to be doctors or other health professionals and they’re basing it on true-life experiences instead of the I-want-to-help-people mantra, which may or may not be based on a real understanding of what being a doctor is like.” Regardless of how their thinking evolves over the course of the year, students say they are well served by the greater clarity that results. And, as Genser says, “clarity is good.”

Nick Godwin

Nick Godwin of Macomb was one of the pioneering students of 2001-02 and served as a peer advisor in the program last year. He’s wanted to be a doctor since he was seven years old. The Health Sciences Scholars experience didn’t alter his goal one whit (in fact, he says, “It reaffirmed that this is where I want to be, this is what I want to do”), but it did enrich his approach to it. “Before, I think I was a little narrow-minded,” he says. “I thought the doctors did it all, and everybody else was in the band, the supporting cast. Now I see there isn’t really a lead role. If you take out one piece of the machinery, it’s not going to run. I think I’ve developed a special appreciation for other occupations. I never really understood what they did and what they went through.”

His approach to patients changed, too. “Learning how all the fields work together gave me a holistic view of the patient,” he says. “In your observation experience, you see how doctors work with nurses, with social workers, and how it all ties together, everyone working together to give the patient a complete treatment. You need to treat the patient as a whole. You can’t just treat the patient medically.”

Mary-Catherine Steer

Then there are those who changed their minds. Mary-Catherine Steer, of Novi, decided when she was five that she wanted to go to medical school and be a pediatrician. Then she shadowed a neonatologist. “While I was there, I started talking to some of the neonatal nurse practitioners about their jobs and what they were doing and how they got there and what they did,” she says. “And that’s what I want to do.”

In addition to shadowing health science professionals and attending autobiography presentations, all Health Sciences scholars take Perspectives on Health and Health Care, a two-semester core course taught by O’Grady, and spots are reserved for them in freshman seminars of particular relevance. Two tutors are available five nights a week at the residence hall where all program students live. This fall, the program will move to Alice Lloyd Hall, enabling all its students to be housed on co-ed floors again, as they were the first year, and to attend at least some of their classes without leaving the building.

As the program grows — it’s projected to reach 300 eventually, although that’s not written in stone — such considerations become even more important, given that easing the passage from high school to higher education by “making the university smaller” is one of the essential principles of a learning community.

“Most universities now recognize that this transition is a really big deal,” says O’Grady. “It’s a quantum leap both academically and socially. People are no longer the brightest star; other bright stars surround them. And, all of a sudden, you go from being a dependent child to a nearly independent adult, with all these decisions to be made. The University has a commitment, and the learning communities are part of the commitment, to support people as they make that transition.”

While the University may be “shrunk” for the students, their understanding of what comprises health care is expanded. “Health care is provided in a physical place by particular people with particular educations and funded by various sources,” O’Grady says. “Any kind of health professional at all, whether it’s someone sitting at NIH or in a lab here or a pediatrician in a community clinic, needs to understand that health has a context and health care has a context. You can’t really do the best possible job unless you understand that context.”

Julie Conley

Julie Conley can, and does, testify to that. “I never would have thought culture or race had anything to do with the health care anyone is getting or giving,” says Conley, of Grand Rapids, a student of the program’s first year who returned as a peer advisor. “That was eye-opening. Depending on their cultural background, the providers and the patients can conflict and clash. I never really thought about it, how that can play a role in how somebody is caring for another individual. We got into a lot of arguments last year in class. Some people were really opinionated but it was really good to hear, kind of on the opposite end of my perspective. It gave me another path to look down.”

Julie Kovach is candid with students about the extra-curricular aspects of the work. “They have a lot of incredibly good sharp questions, not just about the procedures but about how I came to do what I do, and what life is like as a cardiologist,” she says. “For many of the women, it’s ‘what is life and family like for a woman cardiologist?’ There was no one in my family that was medical at all, so when I was anticipating going to medical school I had this vision of what it would be, but I didn’t have a realistic knowledge of what I was getting into.”

James Carpenter

It was different for James Carpenter (M.D. 1984), another Medical School faculty member who’s opened his workplace to Health Sciences scholars. “My father was a physician, so it was a little easier to get an idea of what the job was,” he says. “I sympathize with people who don’t know. You get images of how things are from television or from what you read or hear about it.”

An associate professor of orthopedic surgery and director of surgical services for the U-M Athletic Department, Carpenter has been shadowed at MedSport Clinic, an orthopedic surgery outpatient center with a physical therapy rehabilitation area. He says he tries to give students a balanced picture.

“It’s sort of a good-feeling center,” he says. “We’ve got a group of people working here who are motivated and enthusiastic, and most people are happy about getting better. But if you think it’s always going to be like that, you’re a little mistaken. I try to point out the potentially unpleasant parts of the job. I hate to see people get too far and realize they really don’t like this or this is something they really don’t want to be involved in. We’ve had some surgeons who’ve gone through all their training and it’s their turn to be the person, the bottom-line surgeon, and they just don’t like it. They’ve had to change fields. It’s crazy to have that happen.”

Alphonse Burdi

But it’s more than merely logical to support the Medical School’s presence in the Health Sciences Scholars Program. “Unlike other fine medical schools that have the medical center in one city and the college some distance away, we’ve got the wonderful situation at Michigan where our outstanding medical school and health system are on the same geographic site as outstanding university undergraduate schools — and, in a sense, on the same philosophical site, too,” says Alphonse Burdi (Ph.D. 1963), a professor of cell and developmental biology who designed (with the students, he would have you know) and teaches a science, ethics and societal values course for the program that places special emphasis on learning and research skills. “I did a survey several years ago and found that the number of undergraduates flowing through the research laboratories of our Medical School faculty by far exceeded the number of medical students. The ‘take home’ message of that survey is that the medical campus is not perched in isolation up on the hill, but rather very much involved in nurturing the undergraduate experience of our students, many of whom will go on to successful careers in the health sciences.”

Her experience with seeing Health Sciences scholars at the school-based clinic where she worked has reinforced for Andrea Asnes the significance of another connection. “The more university students make forays out into the community, the better it is for both the community and the students themselves,” she says. “Those members of the Ypsilanti public school community and health community that I worked with really like it when interested and respectful students want to come and see what they’re doing. It shows the university has an interest in the community.”

The program inspires loyalty, that’s for sure. After deciding that she wanted to be a nurse practitioner instead of a physician, Mary-Catherine Steer decided to return to the Health Sciences Scholars Program — as a peer advisor, just as Godwin and Conley did.

“The program had given me so much,” she says. “I wanted to help somebody else who was on the border to make a decision and get on the road to doing what they wanted to do.”