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Behind the Scenes: Tracing the 5-year history of our Social Mission Committee

Posted by on Monday, August 3, 2020 in Culture, Student Activities .

Social Mission: Tracing the 5-year history

by Emma Mattson

As any medical student will tell you, medicine is about far more than memorizing anatomy diagrams and symptoms of disease. Being an excellent physician means attending to the holistic needs of your patients—including needs that arise from social factors.

As our social mission statement says, VUSM empowers all members of our medical community to work towards health equity, and med students themselves play a crucial role in this work.

The Social Mission Committee (SMC) stands alongside other pillar organizations in our community, like the Council of Class Officers, the Student Wellness Committee, and Careers in Medicine. Of these four organizations, the SMC is by far the youngest. In fact, it’s only been an official organization for one year. (Read more about the SMC’s inaugural year in a previous post.)

So how did the SMC, now such an essential body on campus, come into being?

We spoke with several medical student leaders to hear their stories about the challenges and achievements in SMC history.

Year 1: An Unexpected Beginning (2016-17)

Like many examples of social change, the vibrant student organization that we now know as the SMC began with a critique of the existing system.

In 2016, then-second-year med students Pierce Trumbo, Jillian Berkman, and Daniel Markwalter stumbled across a 2010 article from The Annals of Internal Medicine which assessed medical education across the country according to a factor it called “social mission.”

The article was just one element of a larger movement to pay greater attention to social mission in medical education, and that October, Berkman, Trumbo, and Markwalter organized a small group discussion with faculty, staff, and students from Vanderbilt and Meharry medical schools.

“We didn’t necessarily agree with all the metrics that were used in that paper,” Berkman said, “but we did agree that it was important that there were actual, dictated changes.”

After the meeting, the participants agreed to form a small group to write up a social mission statement, which would outline areas of focus and key performance indicators.

But, Markwalter reports, crafting a mission statement is more complicated than it sounds.

“It’s not just writing up a few words. We had lots of different voices and opinions involved on what the language should say,” Markwalter said. “We were trying to make it something more than just a couple sentences to look pretty on the website, but actually craft language that will direct the coming years.”

Finally, the committee settled on three main areas of focus: recruitment, mentoring, and curriculum. Most of all, they wanted the curriculum to pay more attention to issues in social mission.

Year 2: Visible Progress (2017-18)

The outcomes over the following year were even better than they could have hoped for.

Besides adding social mission elements to the existing curriculum, new social mission-oriented courses were added, and Dr. Consuelo Wilkins, the VUSM associate dean for Health Equity, began the process to establish a health equity certificate.

“It’s easy to feel that adding something new is going to disrupt things, create more work, or take away from other learning experiences,” Markwalter said. “But it turned out there were fairly easy ways to integrate learning objectives and social mission-oriented topics into the curriculum that were already there.”

Nearing the end of her medical school journey, Berkman presented the progress of the Social Mission Task Force at a Beyond Flexner Conference to an audience that included the authors of the original 2010 study. Berkman’s presentation won an award.

Now, Berkman, Trumbo, and Markwalter turned their attention to ensuring the survival of the task force in the future.

Enter rising fourth year Rohini Chakravarthy, who quickly set about looking for new leaders for the task force. Chakravarthy kept her eyes open for students who were already committed to social mission in their free time.

It didn’t take her long to find three such medical students: second year Will Furuyama and fourth years Katy Anthony and Kelly Scheuring.

“People who lived the social mission were people we were looking for, and I think that all three of them have done that fantastically well,” Chakravarthy said.

Year 3: Getting Organized (2018-19)

As the new Social Mission leaders, Furuyama, Anthony, and Scheuring dedicated their attention to securing recognition and funding for the organization.

“Pierce [Trumbo] and Jill [Berkman] had already garnered a lot of institutional support for this,” Anthony said, “and we had the privilege of starting to set up a structure with a lot of support already in place.”

The three co-leaders wrote a constitution and met with Deans Bonnie Miller and Amy Fleming to find possible funding sources. According to Scheuring, support from VUSM leadership was instrumental in securing funding for Social Mission.

“We never felt short on support,” Markwalter said. “They were extremely receptive to providing their input, letting us develop our plan, our language, our materials, taking it to them, and then integrating it in a way they felt would be appropriate for the medical center.”

By the end of the year, the Social Mission Task Force had transformed into the Social Mission Committee, with status as an official student organization and a team of fresh leaders ready to push forward.

Year 4: Social Mission in Action (2019-20)

Furuyama, who played a key role in the transition to official status as a student organization, served as co-president this past year, joined by fellow third-year Mollie Limb. The organization’s inaugural year was full of firsts.

“We had to answer every question,” Limb said. “How do we want to communicate with each other? Do we want to do it through emails or through texts? How often do we want to meet as a group? How often do we want to meet with our advisors?”

Even with this myriad of unprecedented decisions, Furuyama and Limb maintained the six original targets identified by the task force: research, service, mentorship, education, recruitment, and evaluation of SMC work. Their ten-person executive board worked on projects ranging from social mission research to a patient advocacy guide. You can read more about their amazing work this year in our post about the SMC’s first year.

Beyond the Committee

Projects and initiatives to support social mission form a crucial part of medical education, but social mission goes further than that. It raises questions about the fundamental purposes of medicine itself.

When people talk about social mission, for example, they often highlight the work of primary care providers, the first points of contact for patients entering the healthcare system.

Anthony, one of the three main ‘18-19 social mission leaders, chose to specialize in family medicine, and is now completing her residency at a community-based hospital in Lawrence, MA. Anthony reports she sometimes felt tension between a pull towards traditional understandings of social mission (which prioritize family medicine and primary care) and the expectations of people around her.

“There was, at times, a stigma when people thought I was not living up to Vanderbilt potential by choosing my career field,” Anthony said. “I hope that the Social Mission Committee is revealing to students that we need really bright, intelligent research-focused physicians in marginalized communities.”

In fact, Anthony says, under-resourced communities are where we most need stellar physicians, since serving these communities well requires innovation and creativity.

“What the social mission movement brought as I was leaving Vanderbilt, and what I hope it’s continuing to bring, was more opportunities for students to see that really intelligent engaged physicians can go into primary care, community care, and under-served care.”

On the other hand, Vanderbilt’s traditional emphasis on subspecialty and surgical care opens up unexplored pathways for contributing to social mission.

“We did feel to some degree that a lot of social mission-oriented work is done by boots on the ground primary care providers,” Markwalter said, “but certainly social mission can be lived out through research and even subspecialty care and surgical care, which is not captured by the original study.”

According to Markwalter, the original Social Mission Task Force had to realize that a single institution can’t fill every single definition of social mission. Vanderbilt’s commitment to social mission will reflect its individual strengths as an institution.

Year 5 and Beyond

It’s been ten years now since the milestone article on social mission in medical education was published, and almost four years since that first student-led social mission workshop.

Fall of 2020 marks the beginning of the fifth year for student-led social mission efforts at Vanderbilt, and rising third years Heidi Carpenter and Somto Ukwuani will assume the co-president roles, maintaining continuity with ongoing projects and bringing their own fresh ideas to the table.

All social mission work is, of course, an ongoing effort that continues outside the classrooms and clinics of med school, but the SMC bears witness to the power of student initiative and persistence.

“The lesson that I learned was that if you set your mind to something you can accomplish it,” Berkman said. “People were like, ‘No way this is going to happen,’ but we sent out emails and the important people showed up for that workshop. The two hours on that Monday really helped propel things forward, and the fact that it’s still going strong shows that there are people in the Vanderbilt community that think this is really important.”