Print Email

Frontliners: Social Justice

SGIM is honoring our members at the front lines of Social Justice with our member highlight series, "Frontliners: Social Justice". Are you or anyone you know at the front lines of Social Justice? Contact us with the subject “Frontliners: Social Justice” to have your story told.

Rebecca Gold, MD, MAS, 3rd-Year Resident at the University of Washington's Internal Medicine Residency Training Program

Q: Why did you choose to present your research at SGIM23, and how was the experience?
A: I am a member of UW’s Internal Medicine Primary Care Track and Women’s Health Pathway. I am planning a career in academic primary care and I was excited to share my research with the General Internal Medicine community at SGIM. I was encouraged to submit my research to the 2023 SGIM National meeting by my research mentor. It was an incredible experience to meet other like-minded physicians and to talk about my project. The meeting itself was a really wonderful opportunity to learn from other GIM clinicians with diverse interests and career paths, and all with the shared identity and passion for caring for the entire person.

Q: Please give a brief overview of your research.
A:My research was completed in collaboration with the University of Washington’s Breast Health Equity group, which aims to address the notable inequities between white and Black women across the breast cancer care continuum. Decreased mammography utilization significantly contributes to breast cancer disparities. Black women are diagnosed with breast cancer at more advanced stages and have higher mortality rates. In Seattle, there is a growing population of Black immigrant women, namely from the East African countries of Somalia and Ethiopia. It is hypothesized that immigrant Black women face complex and intersecting barriers that compound these inequities, as national mammography rates are among the lowest for recent immigrants. I led focus groups and performed qualitative analysis to help better understand experiences, beliefs, and barriers encountered by Somali and Ethiopian women regarding breast cancer screening and to facilitate a community-centered process for intervention design.

Q: What were some of the biggest challenges in conducting this study?
The biggest challenge was that I and most of our research team are not members of the Somali or Ethiopian communities. This study required a trusting relationship between our team and the Somali and Ethiopian community members who participated. We could not have completed (or even started) this project without the partnership of our two cultural mediators and interpreters from Harborview Medical Center. As members of the Somali and Ethiopian communities, respectively, the cultural mediators were locally trusted partners and led the processes of both recruitment and language interpretation during focus groups – two notable challenges for a study of this kind that focused on very personal or private experiences. We worked with our cultural navigators to ensure the interview guides were clear and culturally appropriate, and we checked in with them during data analysis and synthesis to ensure our conclusions resonated with their observations from the groups and their own interactions with community members.

Q: What do you hope will come from this study regarding adjustments to immigrant medical care in Seattle or follow-up research?

A: Ultimately, my hope is that our findings can inform tailored, culturally relevant and community-centered interventions to increase access to mammography for East African communities in our region, as well as improve partnerships and engagement with the diverse communities served by our academic medical center to promote patient advocacy and health equity.

Q: How has working with a small population of immigrant women impacted the way you care for patients?

A: In one of our final focus groups, we asked, “what do you wish your doctor knew about your culture or your community?” A participant responded, “I want them to know about the whole person… like how do these people live?” She went on to share the amount of stress people in her community live with, particularly those who have recently arrived in the United States and do not know where to find information or resources: some are single parents, working multiple jobs and struggling without additional child care; many worry about expenses and food insecurity; some are experiencing homelessness. It was a heavy and important reminder that there is so much more to a person than what we see within the four walls of the clinic. To really have an impact on a patient’s health and well-being, we as clinicians must advocate and work to redesign our healthcare system to meet patients where they are and actually work for and with patients.

Emily Min, M.D. UMass/NEAETC/FHCW Community-Based HIV and Viral Hepatitis Fellow, Grace Noel, B.S. Third-year Medical Student at University of Pittsburgh School of Medicine

Brooke Hartenstein, M.S. Fourth Year Medical Student at Florida State University College of Medicine

Uttara Gadde MD, PGY-3 Internal Medicine at the University of Pennsylvania

Anna Thorndike, third-year medical student at the University of Chicago Pritzker School of Medicine

Alex Cardy, DO: PGY3 Internal Medicine Resident at Allegheny General Hospital, Internal Medicine Chief Resident 2023-2024

Shana Zucker, MD, MPH, MS; PGY-2 Internal Medicine Resident at the University of Miami/Jackson Memorial Hospital

Nicole E. McAmis, MD, Emergency Medicine Resident at Stanford Health Care

Areeba Kara MD, MS, Associate Professor of Clinical Medicine, IUSM, Associate Division Chief Division of General Internal Medicine and Geriatrics and Curtis Wright MD, MBA, Assistant Professor of Clinical Medicine, IUSM, Associate Program Director, IM Residency Program

Rahul Vanjani, MD, Assistant Professor of Medicine at Brown University

Michele Heisler, MD, MPH, Professor of Internal Medicine and Public Health at the University of Michigan and Medical Director of Physicians for Human Rights (PHR)

Avik Chatterjee, MD, MPH, Assistant Professor, Boston Medical Center/Boston University School of Medicine