Each year, soon-to-be graduating medical students count down to the third Friday in March, also known as “Match Day,” when they find out where they will continue their medical training. Pratyusha Yalamanchi, a fifth-year MD/MBA candidate in the Perelman School of Medicine at the University of Pennsylvania, shares how her experience working with community health workers has shaped her career in medicine.
As the first person in my immediate family to go into medicine, this system as proven difficult to explain to my parents – questions like “So what do you do if you match at multiple programs?” (Not a possibility thanks to the Match algorithm.) and “Wait - how do you know that you matched but not where?” (Matching status alone is revealed on March 12, days before the full news comes.), abound. Yet the process of reflecting on my choice of specialty, meeting and building friendships with future colleagues on the interview trail, and being star-struck during interviews with leaders in the field has proven memorable.
Now, with residency interviews behind me, program rank lists debated and certified, and Match Day approaching, I have had ample opportunity to reflect on my time in medical school. I chose a career in medicine for the opportunity to meld my two passions, service and science. While I was growing up, my father, a community development foundation manager in Flint, Michigan, frequently shared stories of families in need of low income housing. An intimate familiarity with my father’s public service inspired my own passion for leadership through service, which combined with my love for the sciences, translated into my desire to become a practicing clinician.
Clinical rotations heightened my awareness of socioeconomic barriers to care that are beyond the scope of the patient-physician interaction. As a medical student, I witnessed patients’ inability to access preventative care services due to cost and time constraints, which then led to avoidable sickness, hospital admissions, and jeopardized employment. During my first two years of medical school, I volunteered with the Penn Center for Community Health Workers (CHWs), which pairs low-income patients with CHWs to address care barriers such as transportation access and insurance coverage. As I began meeting patients in their homes as opposed to the clinic or hospital, I heard stories of individuals borrowing money at unforgiving rates to pay medical copays and bridge paychecks. These families then found themselves in a cycle of ever-increasing debt, collection agency harassment, and the inability to build sufficient credit – all of which affected their ability to actively manage their health.
My time in medical school made me realize that each day, seemingly small sums of money can keep people from moving forward in life. Medical expenses from copays to accumulating hospital bills preclude individuals from seeking the care they need. Modest fines and fees entrap people in court systems, making it difficult to hold a steady job and emerge from poverty. Technical school and college application fees as well as the cost of a commute to school or employment remain prohibitive for those seeking to better their lives.
As a combined degree student in Penn’s Wharton School of Business, I was able to use my business school training to establish the Shift Fund, a 501(c)(3) dedicated to small sum, high impact giving, specifically applying small sums to break down constraining barriers (court fines, medical bills, etc.) and generate high impact at an individual level. By applying small sums to break down constraining barriers, the Shift Fund seeks to connect individuals with needs left otherwise unaddressed with the means to make it happen. My co-founder and I built partnerships with community organizations such as Juvenile Law Center, YouthBuild, and Community Legal Services to identify and support individual cases. To date, we have raised more than $30,000 to support individual barriers.
But more important than what we’ve done to create the Shift Fund are the stories of the people who have been touched by its efforts. A beneficiary, whom I’ll call Z, was arrested at age 15 for armed robbery. He was not alleged to have touched a weapon or to have taken any items from anyone, but he was present during a robbery and was charged under conspiracy liability as an adult. He spent approximately six months in an adult jail pre-trial and then was sent to a juvenile placement for five months. Z lost one of the most formative years of his life behind bars – a year of high school when many young people, including myself a decade ago, were studying for the SAT, playing sports and musical instruments, and thinking of college.
Once Z was released, he had $60.50 of non-waivable court costs the he couldn’t afford to pay and therefore kept him on probation. The $60.50 prevented Z from attending class and basketball practice. $60.50 – the cost of my train ticket to a residency interview.
Through our community organization partners, Z was able to reach out to the Shift Fund for assistance to recieve the funds he needed to get off of probation and move on with his life as a scholar and athlete. Z is now 16 years old and back in the same high school in West Philadelphia where he was enrolled prior to his arrest. Z is a standout basketball player and now is actively involved in his community, working as a youth advocate to help other young people and he plans to work at a recreation center in Philadelphia this summer.
I am so proud of the work the Shift Fund has done to help Z and others like him. Ultimately, my time at Penn opened my eyes to opportunities to make an impact on an individual level, whether in the operating room, clinic, or at a systems level. I look forward to taking these lessons from my time here and bringing them with me as I continue my journey to becoming a practicing physician.
Learn about other shifted outcomes and help make more stories like Z’s a reality by joining us in shifting outcomes today at shiftfund.gives.
Follow Pratyusha and the rest of PSOM’s class of 2018 using #PSOMMatch to stay updated as Match Day approaches.