Ethics in Action

The Center for Medical Humanities & Ethics promotes empathy, compassion, and the doctor-patient relationship through experiential learning opportunities.

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By Sheila Hotchkin
Assistant Director for Administration
Center for Medical Humanities & Ethics
UT Health San Antonio

 
 

Growing up in Rio Grande City, Dr. Monica Ruiz often spent her afternoons at a family medicine clinic owned by her best friend’s father. As she grew older, she worked as a Spanish-language interpreter assisting medical and physician assistant students during their rotations.

The bond between the physician and his patients made a deep impression on Ruiz, inspiring her to pursue a career in medicine.   

“I remember thinking, ‘Everyone is just so nice to each other,’” said Ruiz, who graduated from the UT Health San Antonio Long School of Medicine and is now concluding a pediatrics residency there. “People just came and trusted that the doctor would do the right thing for their parents and grandparents.”

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Soon after arriving at the Long School of Medicine, Ruiz found a home in the Center for Medical Humanities & Ethics, which promotes empathy, compassion, and the doctor-patient relationship through experiential learning opportunities. She was especially drawn to the Center’s community service learning and global health programs, which the Center describes as “ethics in action. 

“These experiences are creating future generations of professional humanitarians, advocates, legislators, researchers, educators, global health leaders, and so on,” said Ruiz. “Most notably, these experiences help us to remain passionate about the reasons we went into medicine.”

Established a decade ago, the Center’s community service learning (CSL) program boasts impressive numbers for university-wide community engagement. In an average year, more than 1,600 students spend 23,000 hours working with over 50 community-based organizations to serve some 12,000 beneficiaries in San Antonio and South Texas.

CSL is much more than just volunteerism. It’s a structured learning experience where students provide meaningful service to the community while benefiting themselves from mentored preparation and reflection.

This commitment to service has earned UT Health San Antonio a place on the U.S. President’s Higher Education Community Service Honor Roll since 2009. More recently, the Long School of Medicine was named a 2018 finalist for the Association of American Medical College’s prestigious Spencer Foreman Award for Outstanding Community Service, in part due to its expansive community service learning program.

CSL projects range from increasing the health literacy of elementary students in an underserved rural community to diabetes screenings for residents of colonias (border communities lacking basic infrastructure) throughout the Rio Grande Valley to providing primary care for refugees resettled in San Antonio. Increasingly, these projects are interprofessional, giving UT Health San Antonio students opportunities to collaborate on real-world projects across health professions, learning what each has to offer.

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“Unlike traditional classrooms and simulations, CSL is immersive, experiential, and grounded in meeting the needs of real-world communities,” said Ruth Berggren, MD, director of the Center for Medical Humanities & Ethics.  “During this critical period of professional identity formation, CSL goes beyond the transfer of knowledge and skills to recruit the heart. We are preparing the healers of tomorrow to act with informed compassion, and reality-based approaches to health equity.” 

The Center provides mentorship for several expansive, ongoing CSL activities at UT Health San Antonio. These include a network of six Student-Faculty Collaborative Practice Clinics that provide free primary health services to underserved populations; the Frontera de Salud student group, which organizes health fairs in San Antonio and along the U.S.-Mexico border; and the ACT (Access Care Texas) student group, which educates Texans on health insurance literacy through a smartphone application. Students can also initiate their own, mentored CSL projects in response to community-identified needs.

Any of these projects is eligible for a faculty-mentored CSL Grant, an innovation developed by the Center to encourage and give structure to CSL projects. Every fall and spring, any UT Health San Antonio student can apply for a grant ranging from $500 to $4,000 to help cover the costs of service-learning projects, such as supplies, printing, or mileage reimbursements.

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 Melanie Stone, MPH, MEd, has directed the CSL program since its inception in 2008.  She explains that by applying for a CSL Grant, students not only stand to gain funding, but they also learn how to write a competitive grant application, set measurable objectives and develop a budget. Each application must identify a faculty mentor and community partner, and it must include a detailed statement of needs expressed by the community. All awardees agree to report their results back to their community partners and the Center.  

 “It turns out that our CSL grant structure is unique in medical education as an innovative way to teach engaged scholarship to our students,” Stone said.  “It encourages scholarly community-based work, much of which is worthy of national conference presentations and even peer-reviewed publication.”

All grant recipients are invited to share best practices and outcomes for their service-learning projects by presenting a poster at the Annual Community Service Learning Conference, organized by the Center since 2008. The conference attracts up to 400 students, faculty, staff, community partners and affiliates of other University of Texas System campuses. 

The 12th Annual CSL Conference is set for Feb. 2, 2019. Organized around the theme “Diving Deep into Community,” the conference will feature keynote speaker Loretta Sweet Jemmott, PhD, RN, FAAN, vice president of Health and Health Equity at Drexel University. The conference is free and open to all, and students from all UT System campuses are encouraged to submit abstracts. To learn more or register, visit www.texashumanities.org/cslconference.

Students who are interested in taking on CSL projects can prepare themselves through three elective courses as well as the “Build Your CSL Toolkit” training series offered by the Center. Medical students who distinguish themselves through their CSL activities may graduate with Distinction in Medical Humanities on their diploma. 

During medical school, Ruiz participated in the Student-Faculty Collaborative Practice Clinics, Frontera de Salud, and global health immersive experiences in Guatemala, and she took the “Humanism in Medicine” elective. As a resident, Ruiz received an award to conduct a Zika virus education and prevention program in the Rio Grande Valley through the Kleberg Scholars Program, which is administered by the Center and follows a service-learning model.

Ruiz recently interviewed at a number of top fellowship programs, and she said most were very interested in hearing about these experiences. 

“For me, I think it made me much more well-rounded. I find a lot of happiness in doing this kind of work,” said Ruiz, who will go on to a pediatric critical care residency at Stanford University. “Medicine is difficult, and it can be very stressful. The Center for Medical Humanities & Ethics is giving us reasons to stay in medicine but also to be true to why we came into medicine.”