Comilla Sasson, MD, MS, FACEP is an attending physician at the University of Colorado Hospital and Assistant Professor in the Department of Emergency Medicine at the University of Colorado.  Sasson was a Robert Wood Johnson Foundation (RWJF) Clinical Scholar at the University of Michigan from 2007 to 2010. Her latest study is published in the October 25th, 2012 issue of the New England Journal of Medicine.

Dead. How do you make someone “undead?” How, with just your two hands, can you prolong the time that paramedics have to restart a person’s heart? How can a normal, ordinary person make a difference and literally save a life?

We know that a person’s chances of surviving an out-of-hospital sudden heart arrest decreases by 10 percent for every one minute he/she does not get CPR (cardiopulmonary resuscitation).  I had learned about hands-only CPR in my medical training.  Hands-only CPR is where all you have to do is push hard and fast (to the tune of “Staying Alive”) at a 100 times a minute until helps arrives.

But time and time again, I cared for African-American patients in Atlanta who had laid in their families’ homes for critical minutes as their brains slowly died from a lack of blood supply from the heart.  Their hearts had stopped and no one called 911. No one placed their hands on the chest and started doing hands-only CPR.

Maybe this is just Atlanta? Is it the color of a person’s skin or is the place where he or she collapses that makes the difference?

In my Robert Wood Johnson Foundation Clinical Scholars Program (RWJCSP) at the University of Michigan (2007-2010), I learned about the importance of neighborhoods in determining a person’s health.  After wading through the literature, my a priori hypothesis was that having someone stop to provide CPR is completely dependent upon others; therefore, the neighborhood plays a large role in whether or not someone does CPR.

After consulting with my two RWJCSP alumni mentors, David Magid, MD, MPH, and Arthur Kellermann, MD, MPH, FACEP, the question became clear: What role does the racial and socioeconomic composition of a neighborhood have on an individual’s likelihood of receiving life-saving bystander CPR?

Large population centers like Las Vegas and Detroit are feeling the effects of the nation’s physician shortage, Bloomberg News reports, which is no longer limited to rural areas. Patients in populous urban areas are waiting weeks—or even months—or traveling to find the care they need.

Many factors are contributing to the shortage, including an aging physician workforce that is reaching retirement, and not enough new doctors in the pipeline to replace them and care for an influx of patients with increasingly complex health care needs.

Doctors also tend to stay near where they train, the story reports, creating poor distribution in states like Nevada that don’t have large medical schools or training hospitals. Census Bureau data shows that Nevada has the fifth-lowest ratio of doctors to patients in the country, behind Wyoming, Mississippi, Oklahoma and Idaho.

One possible solution: other health care professionals. “In a bid to address the shortage, the medical community has embraced the greater use of nurse practitioners and physician assistants, who can prescribe medicines and diagnose and treat many illnesses,” the story reports.

What do you think? What steps will convince physicians to practice in underserved areas? Register below to leave a comment.

Read the Bloomberg News story.

This is part of a series introducing programs in the Robert Wood Johnson Foundation (RWJF) Human Capital Portfolio. The RWJF Center for Health Policy at the University of New Mexico is working to increase the diversity of those with formal training in the fields of economics, political science and sociology who engage in health services and health policy research, and to become a nationally recognized locus for health policy research that will support work to inform health policy debates at multiple levels.

The Robert Wood Johnson Foundation Center for Health Policy at the University of New Mexico is poised to have a far-reaching impact on the nation. The Center is the only institution dedicated to increasing the number of leaders from Latino and American Indian communities who will help shape the future of our nation’s health and health care.

At the heart of this work is the academic and professional development of its doctoral and post-doctoral fellows, a diverse group who are on their way to careers in health policy, academia, philanthropy, and health care financing and delivery systems. 

The Center is dedicated to preparing these future leaders through on-the-job research, policy analysis training, leadership development, and community capacity building. Through interdisciplinary research with health care professionals, and by partnering with other researchers and professional organizations, fellows pursue resolutions for complex policy issues affecting our nation’s health, especially in Latino and American Indian communities.

Alden M. Landry, MD, MPH and Kameron Leigh Matthews, MD, JD are  co-directors of Tour for Diversity in Medicine, a grassroots effort to educate, inspire, and cultivate future minority physicians. Landry, 31, is an emergency medicine physician at Beth Israel Deaconess Medical Center in Boston, and Matthews, 33, and is the medical director for a Chicago-based family health clinic. Landry is an alumnus of the Robert Wood Johnson Foundation Summer Medical and Dental Education Program (SMDEP), formerly the Minority Medical Education Program.

Alden Landry reflects on the second Tour for Diversity which ended last week:

Dr Matthews and I created the Tour for Diversity in Medicine (T4D) to reach out to students in their comfort zones and show them that they could be successful and become health care providers. We enlisted the help of our friends and colleagues to come along with us on the tour as Mentors, to lead lectures, workshops and interactive sessions and motivate the next generation of minority physicians. The Mentors range from pre-health advisors to medical and dental students as well as physicians and dentists in practice. More importantly, they share their personal stories with students. We’ve found this to be one of the most valuable parts of the tour—giving a human face to what can sometimes seem like an unattainable profession.

The tour was different than our earlier, February tour because we had a broader mix of host institutions. Host institutions ranged from small historically black colleges and universities (HBCUs) to larger institutions. We visited schools in rural settings as well as large cities. Each institution was as unique as were the students who attended and the stories we heard.

There wasn't just one stop that was memorable. All of the stops were filled with amazing groups of students hungry for more knowledge about careers in medicine and dentistry.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Alison Hernandez
Hometown: North Bergen, NJ
Rising senior at Rutgers University
Major: Pharmacy
Internship Research Project: The Influence of Patient Health Perceptions on Engagement in End-of-Life Discussions

Human Capital Blog: How does your Project L/EARN experience relate to or support your educational and professional goals?

Alison Hernandez: Before Project L/EARN I did not have appreciation for research the way I do today. As a prospective clinician, I think it’s important that clinicians know about research and improving health outcomes through programs and initiatives. And if clinicians don’t know about this research that’s going on, nothing’s going to change. So it’s important that I take these lessons I’ve learned at Project L/Earn and bring it to my fellow classmates.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Stephanie Jimenez
Hometown: Jersey City, NJ
Rising junior at Rutgers University
Major: Sociology
Internship Research Project: Breast Cancer Survivors’ Perceptions of Quality Cancer-Related Care from Primary Care Providers

Human Capital Blog: What aspect of the Project L/EARN internship has been most helpful and why?

Stephanie Jimenez: The most helpful part of my Project L/EARN experience this summer was the guidance that I received from my mentor as well as the things I learned from my instructional staff. The feedback I gained from my presentation helped me gain perspective.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Brandon McDonald
Hometown: Rochester, NY
Rising Senior at the University of Rochester
Major: Public Health
Internship Research Project: Marital Status as a Predictor of Dental Health Service Utilization

Human Capital Blog: What did you expect before you arrived? How different is the reality?

Brandon McDonald: When I first arrived at Project L/EARN, I expected there’d be a sense of difficulty as well as more independent-based projects. In actuality, I realized that there’s a broader sense of structure and a bigger support system than I would have ever expected. There are different segments when the papers are due so you have [more] connections with your mentor than what I would have thought as well.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University. This is part of a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Thomasina Anane
Hometown: Silver Spring, MD
Rising junior at Johns Hopkins University
Major: Public Health / Sociology
Internship Research Project: Goal-Striving Stress & Mental Health: Race and SES Variations

Human Capital Blog: Are there any insights about your Project L/EARN experience you’d like to share?

Thomasina Anane: Project L/EARN taught me two things. One: stop procrastinating and learn better time management skills and two: Project L/EARN is a lot like a 9 to 5. You can equate it to a work day. Having to wake up on time every day to be here has taught me the importance of how you present yourself as a professional who’s confident in what she’s doing. Just knowing what you’re doing and how people perceive you and your work. It’s added a sense of rigor to what I do. I’m definitely taking what I’m doing seriously. Project L/EARN has taught me the importance of what all this education means. In the future, being able to use what we learned and be confident and becoming the career person you want to be now. And I appreciate Project L/EARN for that.

By Brent MacWilliams, PhD, ANP, Assistant Professor, University of Wisconsin-Oshkosh, Member of the Board of Directors, American Assembly for Men in Nursing

The Robert Wood Johnson Foundation (RWJF) values diversity and inclusion, which includes historically underrepresented populations like men. The population of the United States is becoming more diverse, and the best way to increase cultural competence in the health care system is to increase the diversity of health care providers.

Medicine, pharmacy and other allied professions have increased gender diversity to near equitable levels. Nearly half—or 48 percent—of 2010 medical school graduates were women, according to the Association of American Medical Colleges. Yet men account for less than 10 percent of the nursing profession. 

It is time for nursing to recalibrate to meet the needs of a 21st century health care workforce through sustainable metrics. RWJF and the American Assembly for Men in Nursing (AAMN) share a vision for measurable change to take place in the nursing workforce through cultural change, greater diversity in health care leadership and evidence-based change.

Project L/EARN is an intensive, 10-week summer internship for undergraduate college students who are from socioeconomic, ethnic, and cultural groups that have been traditionally underrepresented in graduate education. The program, funded in part by the Robert Wood Johnson Foundation, provides students with training, experience and mentoring to make them stronger candidates for admission to graduate programs. Interns attend lecture sessions, complete Graduate Record Examinations (GRE) preparation, and work with mentors to write a research paper, which they present as a poster. This year’s program was held at the Institute for Health, Health Care Policy and Aging Research at Rutgers University.This is the first in a series of posts where scholars who completed the program discuss the experience. Learn more about Project L/EARN.

Symonne Kennedy
Hometown: Teaneck, NJ
Rising senior at Rutgers University
Major: Psychology
Internship Research Project: The Association between Prenatal Substance Exposure and Adolescent Emotional Competence

Human Capital Blog: What’s the most surprising thing you learned during internship?

Symonne Kennedy: The most surprising thing I’ve learned in Project L/EARN is the sheer extent of the amount of work that goes into a research project and the amount of statistics it takes to do it. I’ve taken advanced research statistics, so I thought I was “big man on campus.” But no, there’s so much more to learn, and I haven’t even touched the tip of the iceberg.

HCB: Are there any insights about your Project L/EARN experience you’d like to share?

Kennedy: The program is really tough, it is a grueling program. They said that beforehand – it’s going to be difficult, it’s an intensive 10-week research program, and that’s exactly what it is. They said you’re not going to believe us, but when you start going through you start to feel it. For future Project L/EARN students it’s important to know that it is a lot of work but it’s very doable. The program is good preparation for what grad school’s really going to be like. It’s tough but you just have to put your mind to it. It’s very accessible, you can do it.