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Discovering the Intersection of Social Justice and HIV Holistic Healthcare

In the spring of 2014, I applied for the Shepherd Higher Education Consortium on Poverty Internship Program, not knowing how valuable it would become for my education and career development. I was in my junior year at John Carroll University in Cleveland studying biology and public health with plans to apply for medical school during the coming summer. During my time at John Carroll, the passion for community service I had as a high school student matured into a desire to work towards social justice. Several of my courses in public health and biology featured ethics and poverty studies, leading me to find my passion for HIV medicine, especially in the context of social justice and the socioeconomic status of those affected by the disease. I saw the Shepherd Internship experience as an opportunity to consider how my knowledge and passion could be put into practice in the healthcare field.

Megan Boyk, 2014 SHECP intern at the Cone Clinic in Greensboro and a 2015 graduate of John Carroll University.

Megan Boyk, 2014 SHECP intern at the Cone Clinic in Greensboro and a 2015 graduate of John Carroll University.

For my summer internship, I was placed in Greensboro, North Carolina at the Cone Health Regional Center for Infectious Disease (RCID). The medical staff at the RCID includes five infectious disease physicians as well as several nurses and medical assistants. The majority of the patients there are HIV positive. Many of the HIV patients also faced additional challenges in their daily lives, whether they were racial minorities, living in poverty, sexual or gender minorities, or experiencing addiction or other mental illnesses. To address the unique needs of these populations, the clinic also offers in-house services and counseling for financial aid, housing and food insecurity, substance abuse, mental illness, case management, and navigation of government and charity resources. I spent most of each day shadowing the physicians in the practice and helping the staff with day-to-day office tasks. I also spent a few hours a week at a local HIV resource center, Triad Health Project, where I assisted with free walk-in STD testing. Over the course of these two months, this internship contributed significantly to my education and career.

In regards to my education, my internship helped me see how HIV, poverty, and healthcare interacted in the real world for real people. Seeing theories and statistics play out in patients’ lives was quite different from learning about them in a classroom. Hearing the stories of the patients I met – transgender women, refugees, undocumented immigrants, people recently released from prison, and gay men who were diagnosed near the beginning of the epidemic and survived against all odds – brought the intersection of social justice and HIV medicine into sharp focus, bringing what I learned in the classroom into the real world. I also learned the importance of holistic care for patients in poverty. I learned more about issues RCID patients faced every day by talking with my three roommates, who had Shepherd internships in an urban gardening initiative, a housing coalition to help people in unsafe living conditions negotiate better housing, and a legal aid organization that assisted inmates in the county jail. At the closing conference at the end of the summer, I also had the opportunity to attend panel presentations by other interns who worked in healthcare and various other fields. Hearing the experiences of my fellow interns gave me a multidisciplinary perspective on how poverty affects people’s lives and broadened my education on various social justice issues.

My internship was also vital for my career development. In the fall of 2015, I will begin my first year at Oakland University William Beaumont School of Medicine in Rochester, Michigan. I have long desired to be a physician who works with underserved populations, and more recently developed an interest in HIV medicine. Through my internship, I had the opportunity to be mentored by physicians and other healthcare and public health professionals who are doing exactly what I want to do in my career. My primary supervisor, Dr. Jeffrey Hatcher, was an outstanding mentor. Throughout my internship, he provided me with opportunities for independent study related to cases we saw in the clinic and was more than willing to answer any questions I had, and we are still in touch today. Additionally, the clinic staff set an incredible example of how a passion for social justice might intersect with a career in medicine. Providing care for someone in poverty often means much more than simply assessing signs and symptoms, ordering tests, and prescribing medications. It means identifying root causes of conditions, acknowledging barriers to adequate care, and providing resources to address external challenges and determinants of health. All of the staff members I worked with had unique ways of integrating compassionate and personalized care for each of their patients, and watching them taught me a lot about what it means to be a good physician. For example, one week, the medical staff collected and donated baby clothes, furniture, and other supplies for an HIV positive refugee woman who was pregnant with her first child, abandoned by the baby’s father, and separated from her friends and family in Africa. Another time, the staff pooled their money to purchase custom shoes for a patient with extraordinarily large feet who wore shoes that were a few sizes too small and held together by duct tape. Many of the staff were also politically active in advocating for improved access to healthcare for underserved populations. Although these actions may not have been directly related to the patients’ health, they were an important part of caring for the patient rather than simply managing their diseases.

Overall, the Shepherd Internship was an extremely valuable experience for the development of my education and career. It was an outstanding opportunity for me to gain experience in service to others through healthcare and to network with other students, mentors, and future colleagues who are passionate about social justice. Following the internship, my experience gave me a new perspective on my remaining public health coursework and helped me qualify for a second internship in which I worked in HIV case management and outreach at a community health center in Cleveland. Both my public health coursework and my hands-on experience have been vital in my understanding of care for patients with HIV. I saw how HIV can be closely related to various socioeconomic and psychological issues in patients’ lives, and saw the importance of holistic care that addresses the social determinants of health as well as the disease itself. As I begin medical school, I will continue to seek out opportunities to lead and serve in the medical field and explore the relationship between poverty, social justice, and disease. My Shepherd Internship was a foundational experience in my pursuit of a career as a physician serving and advocating for those in greatest need of care.


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