I recently sat down with Megha Patel, a fourth-year medical student at Central Michigan University College of Medicine (CMED), who is currently interviewing for residency in obstetrics and gynecology.
Tell me about your cultural identity growing up.
Megha Patel: I was born in the Metro Detroit area where I received all my schooling. I grew up in a diverse area with a big Indian community, which had the best of both Indian and American cultures. I went to Michigan State for undergrad where I engaged aspects of both my Indian and American identities through my involvement with the Michigan State Raas team and in general campus life. After graduating, I took a year off to stay at home and save money, scribe and travel. Afterward, I finally came to medical school.
What were your expectations regarding your cultural identity and its expression in medical school?
MP: When I was younger and in high school, I would participate in activities like the Indian American Student Association and its cultural shows. I grew up doing Bharatanatyam, an Indian classical dance form. When you are a part of the Indian dance community, you tend to gravitate towards colleges that have Indian dance teams. When I went to Michigan State, I knew that joining a dance group was an option — something that would connect me to my cultural roots while being a student at a large university. Coming to Central Michigan, I knew that I wouldn’t be able to do the things that I used to do because of the demands that med school would place on my time.
What were some of the challenges you experienced in acclimating to the diversity or lack thereof at CMED?
MP: The oddest thing to me was being the only Patel in my class. That has never happened to me before. I went to school in Plymouth-Canton where there is an entire page in the yearbook index just for Patels. We had a big Indian community at Michigan State as well. Coming to Central Michigan and being the only Patel in my class was very surprising for me, and I didn’t expect that when I came in.
I did know when coming here that there would be a culture shock. I had an Indian friend who went here and warned me that it would be different. I didn’t think it would phase me as much because I imagined I would always be busy studying. I also knew that during third and fourth year I would move to one of the clinical campuses that had more diversity.
Archana Bharadwaj: You knew that you just had to survive the pre-clinical years.
MP: That’s kind of what I told myself, to tell you the truth.
Actually, when I first moved here, there was an Indian restaurant. My experience did not match my expectations. For one, they didn’t have any Indian staff. The biggest disconnect was that the Gulab jamun (an Indian milk sweet), clearly came from the freezer. My new friends told me not to worry, it would be different in my clinical year location. It’s not like I would die without Indian food.
AB: It’s more the comfort of knowing these things exist.
MP: Yeah, even in East Lansing, I felt secure knowing that there was an Indian restaurant and Indian store within driving distance because it meant that there was a decent-sized Indian community. I liked having that comfort, and I didn’t find that here.
What forced you to start coping with the lack of diversity in our pre-clinical site here at Mount Pleasant?
MP: During my first few weeks on campus, I went to Walmart to buy things for my new apartment. There was a guy that followed me around the store telling me to go back to my country and asking me to leave. There were specific moments where I turned around and said that I was born and raised in the States.
It got to the point that I left the store. It was very odd; something this aggressive had never happened to me in Detroit or Lansing. People have certainly said dumb things, but nothing so overt. I would call it harassment.
I only went back once and went with a white male.
AB: So that he could validate you being there.
MP: Yeah and he shouldn’t have to. I shouldn’t have to go somewhere with someone of a different skin color just to feel comfortable. When I told my Caucasian friends about the incident, they were very surprised that it happened — but they also were like ‘did that really happen?’
AB: There wasn’t that intrinsic understanding.
MP: Yeah, it was hard.
How did you cope with what happened to you?
MP: I went to Charmica Abinojar, the Executive Director of Student Affairs, to learn more about diversity at CMED. She told me that they were going to establish a multicultural coordinator position as part of the medical student council. It was a completely new position which would open during my first year. She said that it would be helpful to have a voice among the students and liaison between the students, faculty and staff to create a safe space for diversity within the school.
I applied for the position and was voted in by my classmates. Every year we have elections and I have been running unopposed after the first year. Promoting diversity on campus is how I coped with what happened to me. Meeting with Charmica once a month and talking to her about diversity initiatives was a safe space for me. She would tell me about diversity events around campus and simply knowing that those events existed also helped.
As a part of the diversity committees, the student representatives voiced our needs and concerns for more diversity in future classes. You can see the difference from our involvement; the class after us had even more diversity with even more students of color than ours. I also got involved with C.A.R.E.S. (Continuous Improvement/Curriculum, Assessment, Reinforcement/Remediation, and Evaluation and Skills) week, which is an opportunity for students to evaluate their course experiences, reinforce content knowledge and skills and plan diversity-related programming. In other words, I attempted to bring multicultural awareness to students. As a future physician, you need to be culturally competent to bring everyone’s perspective to light.
What were some of the challenges of creating culture change in your role as Multicultural Coordinator?
MP: For the Diversity Health Spotlight Symposium, I didn’t have too many challenges. The school was very supportive and provided as much as they could. Faculty and staff were very willing to help when they could.
Participation was the biggest problem. M1s got involved, but it was much harder to engage M2s because they were studying for Step 1. Also, students received a certificate and pin if they attended all the programming for the symposium. I think it was the combination of these short-term and long-term incentives, which included food provided at the event and a certificate upon attendance at four of five events, that got people involved. I wish we could have this at every event, but at the same time, I wish that we wouldn’t need such an incentive to get people to show up.
As you geared up for the transitions to clinical years, what were your expectations?
MP: I always knew that I wanted to go to Saginaw for rotations, and I wanted to be on a campus with my friends. I had family friends in the area, so I knew there was an Indian population out there. I wouldn’t say my expectations for diversity were high, but I knew that there was going to be more diversity than in Mount Pleasant. Sure enough, there was a large range of diversity among the attendings and residents. I looked up the demographics in the city of Saginaw, and, compared to Mount Pleasant, there was a significant improvement in diversity.
My expectations were met knowing that I would have more of a comfort zone especially with places like Indian restaurants and stores.
What was the reality of living in Saginaw?
MP: I thought it was better. I walked into the Walmart, and nothing happened to me there.
AB: It’s kind of crazy that your ability to safely walk through Walmart had to be your test of diversity.
MP: It sucks that was my way of knowing I could feel comfortable in Saginaw, but it is what it is. The apartment complex I lived in had a lot of diversity, so the reality was a lot better than what it was in Mount Pleasant. The other thing is that in Mount Pleasant, where we do pre-clinical years, we aren’t in a hospital, so we may not really experience the local population’s diversity. When someone is sick, they go to a hospital, so you see all forms of diversity there. You experience a city’s diversity in a large health system like the Saginaw ER.
How did your Comprehensive Community Clerkship (CCC) 6-month family medicine rotation experience compare to your core rotations?
MP: I was in Owosso, and almost every patient of mine was Caucasian. It was very rare to see diversity, so when I did see a patient of a minority demographic, I got very excited. I never had a Walmart moment, but if I walked into the room or a coffee shop or something, I was probably the only colored person in the room. It’s a small town, so it’s understandable. It was the ideal location for CCC in that I was able to be immersed in the community. I never was offended by anyone for being a woman of color, but I knew that I stuck out like a sore thumb sometimes.
AB: You were aware of yourself, but you didn’t feel unsafe being yourself either.
MP: Yeah, the only reason that I didn’t feel unsafe there was because I was there for six months as part of the medical community. As a result, I was paired with the surgeons and preceptors. My preceptors were Syrian and, with them, I found allies and comfort. I knew that if the patients were prepared to see physicians different than themselves, then they wouldn’t be offended by a med student of differing background either.
AB: Your preceptors set that tone for you.
MP: Yeah, I felt that comfort. I became so involved in the community that people knew me, so it never felt dangerous or uncomfortable.
AP: As you’ve gone through each year of medical school, you have been able to find that community in different ways.
MP: I think that’s what this process taught me. I am very big about community, but, in the past, it was always given to me. I had to make that community here and my work on the diversity committee has been a part of that.
As part of creating that community, I’ve also made some great friendships during medical school, and we’ve all learned a lot from each other. Some of these friends were very open about not growing up with much diversity around them, but they wanted to learn. They recognized their limitations and grew into the well-rounded support system I needed. They’ve developed into allies that would better be able to handle something like the Walmart incident if it happened now.
AB: Thanks for sharing your experiences with me today.
MP: Thank you for having me!
After our conversation, I’ve been thinking a lot about creating community. As students of color, especially in areas with low diversity, we create our communities of allies with other students of color or students who are open-minded and willing to learn. For students who come from places with established diversity, the transition to creating communities of their own can be a challenge. Committees and organizations focusing on diversity can be a starting point for building these communities. If you are interested in joining a national organization that promotes the needs of underrepresented students and communities, the Student National Medical Association (SNMA) is a good starting point. Thank you to Charmica Abinojar, Executive Director of Student Affairs at CMED, for this recommendation.
Featured image provided by Archana Bharadwaj.
In this column, I will explore the unique challenges of training as a provider of color and offer solutions for improving diversity and inclusion in medicine. Through conversations with colleagues of color, including premedical students, medical students in training, and residents, I hope to create a community where we can learn from one another, cultivate allyhood, and find support in our professional journeys.