“I 100% want to be a doctor. I have always wanted to be a doctor.”
From an early age, Jasmin Hernandez-Alamillo had her sights set on a medical degree. The first in her family to graduate high school, much less think of college, Hernandez-Alamillo got her start before the first grade.
“My grandma from Mexico, actually, she came and visited when I was five, but she was diagnosed with breast cancer and so she got super sick when she was here,” Hernandez-Alamillo explained. “I wanted to translate, and so I was translating the little things that I could. [It was] not the actual diagnosis itself, but whatever small thing I knew how to say in Spanish.”
What many may consider a traumatic experience became Hernandez-Alamillo’s impetus.
“I think that really pushed me to want to become a doctor because my… grandparents had gone through lots of health issues. And the Mexican health care system isn't necessarily the best,” said Hernandez-Alamillo. “And so I would write in my diary, ‘oh, I want to grow up and be a doctor so I can go to Mexico and cure all my family and make everyone okay.’”
A current UAB junior, Hernandez-Alamillo still has a desire to help those without access to quality healthcare. She now believes she can make a difference far closer to home.
“Being Hispanic and growing up in that base, I was able to see a lot of discrimination that people in my community face so, I really want to give back and work in those spaces,” Hernandez-Alamillo explained. “I speak Spanish, which I think is a very, very necessary part of medicine, since our Spanish population in the United States is growing.”
Hernandez-Alamillo has always loved pediatrics and, until recently, all of her experiences were leading her towards a career in caring for kids. However, her experiences in the Comprehensive Urban Underserved and Rural Experience (CU2RE) Longitudinal Primary Care Pipeline Program in the UAB Department of Family and Community Medicine have opened her eyes to new opportunities in primary care, including obstetrics and gynecology.
“I never honestly knew a lot about OBGYN’s and then we started to learn about all these subspecialties within primary care and OBGYN’s get to do surgery, as well,” said Hernandez-Alamillo. “By joining the pipeline program, I've also just enjoyed primary care and getting to learn a little bit more about what that entails.”
Hernandez-Alamillo is part of the program’s first cohort of students. Pipeline, like the CU2RE program for medical students, is designed to recruit, train and retain the next generation of primary care physicians in Alabama.
The program, launched in spring 2022, is open to sophomores and juniors enrolled in a four-year degree program and who are interested in applying for medical school. A chief requirement for admission is a passion to confront primary care needs of the community and a desire to practice primary care in one’s community or an underserved area in the region.
“Pipeline is [meant] to bridge the gap between their interests and how they tie into family medicine and primary care,” explained Pipeline Education Coordinator and CU2RE Program Coordinator Carmella Goree.
Valuable Early Experience for the Medical School Application Process
Along with 11 other undergraduates from five, different Alabama college campuses, Hernandez-Alamillo is learning more about the value of primary care and the role primary care physicians play in the community, especially in rural or underserved, urban areas. What’s more, in several years when these students graduate, the CU2RE Longitudinal Primary Care Pipeline Program promises to steer and financially assist them through the medical school application process.
It aims to “guide these aspiring-pre-med undergraduates through the medical school application process and beyond,” said Program Director and Assistant Professor in the Department of Family and Community Medicine Sameera Davuluri, M.D. “The quality of information we’re sharing is incomparable.”
Davuluri believes primary care providers are the backbone of health care. A part of UAB’s Family and Community Medicine Department since 2013, she joined CU2RE in 2022, expanding on existing ideas to create the pipeline program. Davuluri says faculty and staff designed unique educational materials specially tailored for undergraduates’ level of learning.
“I have a great opportunity in my role to help create an impact highlighting the importance of primary care physicians and to guide future generations to pursue their dreams of going to medical school,” said Davuluri. “All these elements we are providing helps them transform individually, as a person; just helping them prepare for any profession,” Davuluri said.
In addition to preparing students for medical school, the program affords them unique opportunities and a better understanding of concepts, such as leadership and cultural competency, earlier in their careers. This way, they are able to weave it into their own medical practice. The pipeline program also serves to foster interest in primary care; and it details the role a primary care provider plays in the community. Organizers say that knowledge will prove valuable regardless of what specialty a student chooses.
“Let’s say this particular student changes his mind and goes into public health. With the recent public health emergency we had with COVID, having knowledge of the importance of primary care, what they have learned through our program, and infusing that cultural competency and leadership skills … can be extremely useful for these students in public health. [It’s the] same thing if they decide to go into a specialty field, like neurology or cardiology,” Davuluri explained. “They still understand the value a primary care doctor plays in the community, and that really helps to build bridges between primary care doctors and [specialists] in the future.”
Addressing Health Care Gaps in Alabama
Established with a $7 million HRSA grant in 2020, the larger purpose of the CU2RE and pipeline programs are to increase the number of primary care providers in Alabama. CU2RE’s medical student program provides support, clinical experience, mentoring and research opportunities for UAB Heersink School of Medicine students interested in primary care in underserved areas.
“We got to read this book called Medical Apartheid (Harriet A. Washington) basically highlighting a lot of the racism involved in medicine,” said Hernandez-Alamillo.
Hernandez-Alamillo calls the small, virtual, group conversation about Washington’s book chronicling the “Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present” one of the highlights of the program, so far.
“I think discrimination runs rampant through all of American society, especially health care, and I think when you're in such a vulnerable state like that, wanting to ask someone to help you, it's very damaging psychologically to not receive that sort of, I don't know, just empathy, really,” Hernandez-Alamillo explained. “There's a lack of empathy in health care and having that sort of conversation really…made me feel a little bit better knowing that the people involved in the program also understood how important that is and that we all need to aspire to be more understanding people, especially in health care.”
She says getting into medical school can be daunting for anyone, much less someone with limited resources, like those affected by “socioeconomic factors, [long] distance, lack of guidance [or] role models,” explained Davuluri. The pipeline program aims to level the playing field and streamline the process with mentorship, training and resources for the application process, especially for those coming from a rural or underserved urban area.
Students in the CU2RE medical program are paired with pipeline program students to provide such mentorship and advice. Students in both programs also learn about and discuss similar topics, many focused on six core elements of the CU2RE program: interprofessional education, behavioral health, social determinants of health, cultural and linguistic competency, practice transformation and telehealth.
“We got to talk with some medical students,” Hernandez-Alamillo recalled. “They were very transparent and they obviously said [the application process is] a hard process, but… it allowed me to see like a different side of what the process looks like and it doesn't seem as intimidating as I once thought it was in my head.”
Hernandez-Alamillo says these sorts of interactions have been some of the most impactful. They bolstered her excitement for medicine and reaffirmed her desire to pursue a career in healthcare.
“It made me feel a lot more connected to the possibility of that being me in the future,” said Hernandez-Alamillo. “It made me almost, I don't know, this could sound corny, but it really made me feel like that could be me and I could be sitting in their shoes and I could be having the same exact conversation with another student who's also in the same boat as me.”
While mentoring-- in a group or one on one with Davuluri—is an integral part of CU2RE Pipeline, so are the virtual, two-hour discussions and workshops. In this small community of students and faculty, participants are able to discuss sensitive topics, like race and discrimination, review materials, as well as to share thoughts with professionals and learn collaboratively with like-minded individuals.
“I do feel like I can be vulnerable and talk about very serious issues like that and not feel judged at all,” Hernandez-Alamillo attested.
Though some programming is in-person, especially over the summer, many conversations and learning modules take place virtually as students are spread out across the state, including UAB, Oakwood University, Alabama A&M University, Huntingdon College and Samford University.
“We’re trying to build our virtual culture as much as possible,” said Davuluri.
Early Clinical Experiences
One element, however, makes a bigger impact in person: UAB’s simulation lab.
“It looks like a clinic office, like you're in a hospital. There's a patient in the bed in a full nightgown,” said Hernandez-Alamillo. “You come in and you introduce yourself and they give you all these different symptoms …And you have to get their history, you have to ask if they're taking any medications, anything like that. That was a super cool process… it was crazy realistic.”
Over the summer, in all, Hernandez-Alamillo and her peers completed virtual and in-person educational activities; they visited a primary care clinic, practiced interviewing patients and conducted physical exams.
Thanks to what they learned working with the first group of students, pipeline coordinators are now making modifications and improvements to the program. Moving forward, Davuluri plans to make changes in the way they accept students into the program. She also wants to attract more applicants by beginning the recruitment process earlier. Right now, Goree is gearing up to visit two, local community colleges for CU2RE Pipeline presentations in an effort to garner interest.
Meanwhile, Hernandez-Alamillo and other pipeline program students have been shadowing a primary care physician since October—doctors from UAB Highlands, Cahaba Medical Care, Christ Health and UAB Hoover. This is in addition to students’ continued participation in virtual workshops and learning experiences pertaining to primary care, leadership, cultural awareness and more.
To most effectively pair students and physicians, Goree says she spent time getting to know each participant. It worked for Hernandez-Alamillo. She says the physician she is shadowing-- assistant professor Jill Marsh, M.D., and the UAB Highlands Family and Community Medicine clinic -- is an excellent fit.
“She is very conscious of different things-- like discrimination-- that go on in medicine, which I think is very, very good to see,” said Hernandez-Alamillo. “That someone good like that is in health care.”
Hernandez-Alamillo has come a long way from her first virtual workshop as a pipeline participant and applauds the program for seeking to provide more physicians in underserved areas; she is more determined than ever to serve her community.
“I'm 100% on that. I don't care where I am,” started Hernandez-Alamillo. “Give back to them and also serve as a role model for other little Latina girls who never thought that they could achieve those sorts of dreams-- gives them a little glimpse of hope that they can do it.”
As Hernandez-Alamillo continues to foster her love for medicine, Davuluri and Goree are recruiting more students like her for their next cohort. The pair is now accepting applications for CU2RE Pipeline’s 2023 program.