Med student has her finger on pulse of community, culture

Future physician Maria Garcia-Jimenez was planning a nutrition class for at-risk Latina teens when it became clear, in discussions with her community partner, that the girls had other, equally pressing needs. Which is how García, 23 at the time, found herself designing an eight-week sex-education workshop.

Maria Garcia-Jimenez

Maria Garcia-Jimenez (Cathy Cockrell/NewsCenter photo)

Health was Garcia’s area of expertise — she’s a medical and masters-degree student, after all, in the UC Berkeley-UC San Francisco Joint Medical Program (JMP). Yet it felt like a tall order — earning the girls’ trust, keeping them engaged, being “science-y and factual” on delicate topics like contraception and sexually transmitted infections, all without imposing her own moral values.

“I was pretty anxious,” Garcia says of her mindset as she overhauled her plans.

On a hunch, she decided to rely largely on peer teaching. In one workshop, for instance, the girls worked in groups to identify pros and cons of different contraceptive options, then presented their findings to one another — a great way, it turned out, “to address their true interests and questions, and have more material actually stick.”

Case-based med ed

For Garcia, that’s a good formula for learning medicine as well. The JMP, where she just finished her second year, allows UCSF medical students to earn a master’s of science degree at UC Berkeley’s School of Public Health, where they explore health-related issues through a humanities, social-science and social-justice lens. Meanwhile, JMP faculty offer a problem-based basic-medicine curriculum: Instead of memorizing heaps of information on a single organ system at a time, students work in teams to study hypothetical cases, some quite complex, then present on biomedical topics related to the case.

“There’s a lot of back and forth as we progress — filling tubs of knowledge [incrementally] until they’re completely full,” she says. “Studies have shown that the best way to learn dense information is to revisit it several times.

“We learn a lot of physiology, biochemistry, pharmacology,” Garcia adds. “But at the same time we learn how to be problem solvers” — to ask the patient the right questions and “think critically about lab results.”

Granted, being asked to figure out so much for yourself can get old. “I sometimes really wish for a lecture,” says Garcia. “‘Please, just tell me what I need to know!'”

Cultural competence

Garcia, now 24, is the youngest student of 16 in her JMP class of 2013; she was also selected for the pipeline Program in Medical Education for the Urban Underserved (PRIME-US). Being part of both programs represents, for Garcia, “an amazing opportunity” and “more good fortune,” as she puts it.

Born in Guadalajara, she moved to Woodland, Calif. when she was 6, as her college-educated parents, underemployed in Mexico, sought better opportunities for themselves and their two children. Family resources were “scant,” but her parents were “super instrumental” in seeing their children flourish. Eventually, aided by a full scholarship from the Buck Foundation, Garcia landed at Brown University, in Providence, R.I.

There, several experiences led her to “reframe” how she wanted to be a doctor. From anthropology coursework she learned the importance of appreciating a patient’s background, while a job as a hospital medical interpreter brought home cultural variations among native Spanish speakers.

“Being California-centric, you think everyone who speaks Spanish is Mexican,” Garcia notes. Yet she found herself interpreting for Dominicans, Cubans, Puerto Ricans and other Latinos, using Spanish words “I’d never heard or that had completely different meanings.”

Community doctoring

Garcia plans to do analysis this summer for a UCSF study on Latinas with breast cancer, their levels of acculturation and how confident they feel about managing their disease.

Support groups, for example, have been shown to decrease anxiety and depression for white breast-cancer survivors. Are such interventions being accessed to the same degree by U.S. Latinas, particularly poor Latinas with limited English skills? If not, why, and what interventions would serve them best?

She expects to keep asking questions about the social and cultural aspects of illness and healing — as a community doctor and “a resource for community organizations” — far into the future.

“I’m young. I’m very young,” Garcia says, with many important decisions ahead — including whether or not to go into a medical specialty.

Gynecology is a field she’s considering, oncology another. As a cancer specialist she’d strive to deliver culturally sensitive patient care and to contribute to the field, by shining a light on disparities in cancer rates and in how survivors cope.

Seeing “how different races and ethnicities deal with cancer,” she predicts, “would help me be more culturally humble.”