February 24, 2021 by
Dana Allison, UVM Larner Med Clas of 2023 medical student
In the classroom, medical students learn about social determinants of health — “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” — and how they will inform care plans for future patients (US Department of Health & Human Services
). At the same time, many U.S. medical students are experiencing these challenges first-hand, often without easy access to or knowledge of school-based or local support networks and resources.
The consequences of these social determinants of health — food insecurity, unstable housing, financial instability — disproportionately effect non-traditional students and students who are underrepresented in medicine. Often far from home and personal support networks, the results are calamitous. Students can struggle to maintain their grades and balance curricular commitments, suffer mental health crises, and in some cases must put their medical education on pause or leave school entirely.
When she was in medical school, University of Vermont Larner College of Medicine alum Jasmine Robinson, M.D.’20, recalls having to decide between purchasing groceries or paying rent some months. “It definitely affected my ability to focus on medical school and focus on what we were doing in class every day,” Robinson says, “It was a constant struggle, and I know I’m not the only medical student who felt that way.” For students like her, Robinson says, the lack of financial support exacerbates the inequities and hurdles they already face.
In late 2019, as Robinson prepared to graduate, she was introduced to Dana Allison, a Class of 2023 Larner medical student, by Tiffany Delany, MA.Ed, the director of the Office of Diversity, Equity, & Inclusion. Delaney wanted to know if Robinson might be willing to serve as a mentor for Allison, who was seeking support as a first-year out-of-state medical student. Allison says the moment was a blessing.
“I was experiencing a lot of stress,” says Allison. “I’d come from South Florida and didn’t have a family or a community up here, in Vermont." During that challenging time, Allison relied on her faith. “I prayed one day, I said ‘I don’t know how I’m going to get through this period, but God, please help me’,” she says, “I met Jasmine just days after that prayer.”
Taking advice from Robinson, Allison says she gathered up the courage to ask for help. Robinson told her about University and College resources available to medical students and put her in contact with staff and faculty who could help. “When I able to get through that difficult period, I knew it was behind me because of the people and resources I had around me,” says Allison.
That experience, and those she heard about from classmates and colleagues, left her determined to ensure and maintain awareness about resources for medical students and to create new resources in areas where few or none existed. “I wanted to put a platform in place so that medical students could focus on being medical students rather than how to secure adequate shelter, food, financial aid, and clothing,” says Allison.
Allison’s idea quickly took flight. “Dana is the kind of person who, when she sees something that needs to be fixed, she says ‘let’s fix it,'” says Robinson.
In March 2020, as COVID-19 shut down in-person learning at medical schools around the country and shined an event brighter spotlight on issues of food, housing, and financial insecurity and disparities throughout the country, the Larner College of Medicine LHOMe Initiative was born. Its mission is to “establish internal avenues of support for [medical] students [including a] main resource hub to focus on their academics and professional responsibilities — to help medical students meet all academic and professional expectations; improve academic performance; contribute to ongoing class-wide student support; and limit medical student attrition.”
As a first crucial step, Allison created and disseminated a survey to all Larner medical students with the help of Robinson, Delaney, Class of 2023 medical student Vinh Le, the Larner Social Justice Coalition, the Office of Medical Alumni Relations, Director of Curricular Evaluation and Assessment and Assistant Professor of Psychiatry Leigh Ann Holterman, Ph.D., and Director of Student Well-being and Interim Associate Dean for Students Lee Rosen, Ph.D.
The survey’s objective — to gain a clear understanding of medical student needs, gauge awareness of how to get help in an emergent situation and identify gaps in available resources — was met. Within only twelve days, 300 of the 480 surveyed students replied, with many reporting that they were either unaware of available resources or were unsure about who to contact at the College to speak about personal resource insecurities.
In just a few short months, while balancing classwork and medical school stressors, Allison joined the UVM Food Insecurity Working Group
, connected with Medical Student Financial Services Coordinator Kari Brayden and reached out to Hunger Free Vermont and 3Squares VT to pull together an Emergency Relief Town Hall for Larner medical students. Medical students and members of the LHOMe leadership tip Le, Matt Tsai (Class of 2021), and Sarah Kendrick (Class of 2023) helped.
“She had a clear vision, and her approach was bold,” says Le. “She was very efficient in gathering resources and rallying the College’s administration. It was impressive. They were dealing with all of the challenges presented by the pandemic and they were still able to pull everything together so quickly.”
During the town hall, Brayden spoke to students about a wide range of medical student financial services including free meetings with a certified financial planner via WellConnect, the creation of a Medical Student Financial Services Student Advisory Council, new financial wellness initiatives (including a financial book club), and the restoration of the Coronavirus Aid, Relief, and Economic Security (CARES) Act and how to apply for emergency grants through it. Gail Shampnois, chair of the UVM Food Insecurity Working Group, presented data gathered by the group and shared information about UVM and Community resources such as the RallyCat’s Cupboard
and the City of Burlington’s Resource and Recovery Center
. Phil Morin and Ivy Enoch from Hunger Free Vermont
were final presenters at the event, providing information about community assistance through their organization and the 3SquaresVT
Since then, Allison has worked with Brayden to create an online compendium of all available resources
including a recording of the November 2020 town hall
The LHOMe Initiative team’s future plans include weekly reminders about resource availability and contacts via the Medical Student Wellness Committee’s Instagram account (@larnerwellness
) and the weekly medical student e-newsletter, The Weekly Wire; continued work to identify and address new or widening gaps in need and resources; and continued future expansion.
Rosen stresses the importance of the work Allison and the LHOMe team are doing saying, “Dana’s LHOME project has been absolutely crucial — filling an important gap in our understanding of medical students’ needs at a critical moment. Dana and her collaborators led the way to helping us develop a language and a dialogue about issues related to basic needs and equity. These issues can be hard to discuss, but they only worsen in silence."
Allison is excited and hopeful about the future of the Initiative and what it will mean for her classmates and future medical students. “Adverse situations nearly compromised my opportunity, but people who didn’t even know me took it upon themselves to support me,” says Allison. “Because of them, I got through it. LHOMe is me paying it forward."
The following administrators, faculty, staff, and students have made the creation and maintenance of the LHOMe Initiative possible: Dean Richard L. Page, Dr. Margaret Tandoh, Dr. Lee Rosen, Dr. Christa Zehle, Dr. Eileen Chicoskikelly, Dr. Prema Menon, Dr. Michael Upton, Dr. Katie Huggett, Dr. Leigh Ann Holterman, Tiffany Delaney, Dr. Jasmine Robinson, Kari Brayden, Vinh Le, Sarah Kendrick, Matt Tsai, Luke Hallgarth, Helen Gandler, Willie Dong, Alex Cohen, Elena Danskey, Richard Brach, and Luke Higgins.