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<p>Founded by medical students, the MedServe program allows recent college graduates to work in clinics for underserved North Carolina communities.

By Minali Nigam

Before being accepted into UNC Chapel Hill’s School of Medicine and working toward a dual degree in medicine and business, Patrick O’Shea worked with Teach for America where he spent two years teaching science to eighth grade students in the Vance County city of Henderson.

“You gain insights from education that you simply didn’t have, and you couldn’t have without being on the ground,” said O’Shea, who’s now a fourth year medical student.

That experience served as a catalyst for O’Shea, who helped found MedServe, a two-year program designed to give recent college graduates a Teach for America-like opportunity to gain clinical experience in underserved North Carolina communities.

MedServe Fellows not in order: Adele Clifford (Wellesley College), Adelina Cato (Wake Forest University), Allison Draper (Duke University), Andrew Marburg (Yale University), Anna Ressel (Brown University), Jiyun Chang (Harvard University), Kyle Kufert (UNC Chapel Hill), Laura Bird (UNC Pembroke), Misty Cox (UNC Chapel Hill), Natalie Malpass (East Carolina University), Rashieda Pugh (Brandeis University), Spencer Bell (NC State), Tyler Moore (UNC Pembroke). Photo courtesy MedServe

“We provide kind of [a] boots-on-the-ground insight to what it means to deliver high quality primary care,” he said.

Anne Steptoe, another dual MD/MBA student, first pitched the idea to O’Shea last fall. Since then, with support from government and philanthropic funding, Steptoe and O’Shea worked with faculty members and clinics to start MedServe. They held their first two-week training session in June and placed participants in their clinical sites on July 5.

Thirteen MedServe Fellows, selected from a pool of about 80 applicants nationwide, are now working in clinics from Williamston to Hayesville. The fellows are also in underserved areas in Asheville, Durham, Apex and Raleigh.

“I’m a very extroverted person,” said Kyle Kufert, a UNC graduate and MedServe Fellow.

“My passion is for people and I want to be on the frontline, learning about primary care,” he said. Kufert now works in O’Shea’s old home of Henderson.

Transformational experience

”Growing up, I never had a primary care doctor,” said Rashieda Pugh, from Brooklyn, N.Y., who graduated from Brandeis University in May.

“I wish I had somebody saying, ‘Oh, this is what’s happening to your body. And you’re going to have to start getting your period,’ things like that,” she said. “If I can do that for my community that’s what I want to do, especially for young girls.”

Pugh works at the Lincoln Community Health Center in Durham as a medical scribe, recording everything that happens during a doctor’s visit into an electronic medical record.

“This is the first time that Lincoln has had a medical scribe,” she said. “So we’re trying to work out the kinks.”

Rashieda Pugh works as a medical scribe at Lincoln Community Health Center. Photo credit: Minali Nigam

Pugh is one of three medical scribes in the program. The others, including Kufert, work as medical assistants, which O’Shea describes as “the jack of all trades.” Medical assistants show patients to their rooms, take basic histories, call insurance companies for approval to prescribe more specialized medications, and organize a patient’s medication list, among other jobs.

MedServe Fellows also do community outreach, O’Shea said. Fellows can be a behavioral health coach, a community health worker, or an analyst looking at population health data.

Kufert will be a behavioral health coach, using interviewing techniques and medical knowledge to advise people.

“You’re trying to see where they are, not just say ‘You need to quit [smoking],’ but how much they want to quit and what steps they want to take and start from there,” he said.

O’Shea said he hopes that these clinical and community experiences encourage fellows to pursue a career in primary care.

“We want to be on [the] front end to provide this transformational experience and understanding of what great primary care looks like,” he said.

Training institute

All thirteen fellows learned basic clinical skills in a two-week training institute at UNC School of Medicine in June. Faculty members and student volunteers ran the sessions where fellows took histories, measured pulses and blood pressures, and performed physical exams.

“We acted as patient cases for the students,” said second-year UNC medical student, Ashley Cairns, who volunteered at the training institute.

“There were 13 MedServe Fellows who rotated around our room in tight intervals. We had a couple of minutes after each rotation to discuss what they did well and provide recommendations or tips.”

Pugh said patient interviews were initially “nerve-racking,” but it got easier.

“I didn’t realize how natural getting a patient’s history and chief complaint could be,” she said. “Eventually you get comfortable where you get to everything in a conversation form.”

The fellows gained more than just clinical skills in the comprehensive training, said Kufert.

“We got a break down of what primary care is, as well as what a Federally Qualified Health Center is, how to be an empathetic caregiver for patients, being mindful to avoid burnout,” he said.

Cairns said she was impressed with how “eloquent, compassionate, thorough, and efficient” the fellows were during the training.

“Other medical students were saying that it took us quite some time to have that level of confidence and efficiency,” she said.

“It was really incredible how much they accomplished in two weeks.”

In the clinic

At Lincoln Community Health Center, Pugh sees around 10 to 15 patients each day.

During her first week, she learned to use the clinic’s electronic medical record. Now, she’s working directly with patients.

MedServe Clinic Locations, courtesy of MedServe.

“I’ve been going in by myself. I take the chief complaint, social history, family history, things that the patient can just talk about.”

Once a week, Pugh works as a medical scribe at an HIV clinic. She is still figuring out what to do for her community role. Initially, she wanted to do Zumba and cooking classes.

“In my head when I first came, I was like, ‘Oh, okay I gotta do an outreach part. I’m a-do Zumba classes and cooking classes,’ but the reality is do we have the funding? Where’s the space?” she said. “Those are just starting to hit me now.”

Pugh enjoys seeing interactions between doctors, nurses, social workers, pharmacists and community workers, all in one place.

“Working here at Lincoln really gave me that opportunity to see that holistic approach,” Pugh said.

Kufert also spent his first week at the Rural Health Group in Henderson learning to use a “complicated electronic medical system” and shadowing other medical assistants. In his third week, he began taking patient’s vital signs and asking about medications.

“It’s definitely interesting to go from training where everything is perfect, you have unlimited amount of time, you get constant feedback, to being in the clinic,” he said.

“This is real life. These are real people. And that means that there are hiccups.”

MedServe was the right fit for several reasons, Kufert said, but his main priority was learning about primary care in an underserved community.

“I had this epiphany last year … ‘What is the meaning of my life?’” he said. “I asked myself that question and I decided, I want to make the biggest positive impact that I can in this world.”

“I want to do that by becoming a doctor and working with people who don’t have access to care.”

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