The Life Bus Project: How two MCW Medical Students engaged in Social Innovation

From the 9/18/2020 newsletter

Student Perspective

The Life Bus Project: How two MCW Medical Students engaged in Social Innovation

Medical Students Kelli Cole & Gopika SenthilKumar describe how they partnered and utilized their passion, ingenuity, entrepreneurial mindsets, and community support to design a real-world public health solution which gave them a transformative learning experience.

We remember March 2020 clearly. The two of us, were looking forward to getting started on our Kern Institute TI2 project and finalizing our summer lab rotations. Suddenly, there were constant news updates about rising death tolls around the world and an incoming sense of doom as the pandemic spread to the US. As we watched the initial responses, we could not help but notice all the ways that our healthcare systems were not prepared - personal protective equipment (PPE) shortages, disproportionate impact on vulnerable and low-income communities, intensifying health disparities, fear amongst frontline healthcare workers. In an effort to help, we put together a grassroots team of students, physicians, scientists, and engineers for the Johns Hopkins COVID19 Design Challenge held in early April. Life Bus, the solution that sprouted from the competition and evolved since, has not only allowed us to persist towards improving healthcare delivery and access starting in our own MKE community, but has also been an incredible opportunity for growth and reflection.

In this article, we hope to share our story and reflect on our key takeaways/learnings thus far.

During the competition, our team (click our link here) conducted a rapid needs assessment and identified three key needs:

1. Protecting frontline healthcare providers 
2. Reaching vulnerable populations
3. Conserving PPE

Our solution was designed to meet all three of those needs by temporarily repurposing city buses into mobile COVID19 testing and triage centers. Life Bus incorporated key design solutions (physical barriers with gloves to overcome PPE shortage, indoor/outdoor models, creative vital sign collection, existing infrastructure/routes of city buses) that were truly made possible because of the multidisciplinary nature of our team and mentors. The 5-day challenge opened our eyes to the impact of the pandemic on various aspects of our society and uncovered avenues for improvement/change.

The Kern Institute provided invaluable support and local connections to further the project.

After the competition, we showed our idea to front-line providers, healthcare administration, and the Kern Institute. Given the overwhelmingly positive response and incredible support from the Kern Institute, our team decided to continue working on Life Bus. For the rest of the spring semester, we improved our design, added valuable team members, and identified other key stakeholders who could help refine and implement Life Bus. Balancing our roles as early-career professionals in this project while also juggling medical school courses challenged us to improve practice in these areas that we may not have otherwise gotten this early in our medical education.

Over the summer and at the beginning of our second year of medical school, the two of us participated in the National Science Foundation I-Corps program to develop a sustainable business model for Life Bus. We conducted 50 interviews with community partners, Wisconsin’s COVID19 testing committee, students, physicians, transit companies, outreach organizations, manufacturers, and private and public health systems. We are beyond grateful for the time and advice from everyone we interviewed and are honored that many of them are still involved and supportive of our initiative. Our conversations helped confirm the need for sustainable (i.e. not depleting PPE or straining our healthcare workforce) mobile healthcare and highlighted the feasibility of our project. Through this process, we developed entrepreneurial skills such as hypothesis-driven interviewing, synthesizing subjective feedback into tangible ideas, and asking for buy-in from higher-level executives. This opportunity taught us how to vet an idea based on customer discovery and pivot based on the information learned to create a refined solution. Moreover, we were mentored by inspiring local entrepreneurs who continue to provide us with constructive feedback and guidance as we move forward.

Life Bus is addressing ‘real-time’ issues from the pandemic in Milwaukee

All through this project, a common theme that kept arising was how ‘healthcare access has been a long-standing challenge in the Milwaukee community, and the pandemic merely intensified the problem.’ It became clear to us that Life Bus needed to not only provide COVID19 testing and triage but also focus on addressing basic health needs, building sustainable mobile care, and establishing a model for long-term continuity of care. This way, Life Bus is not just a “band-aid” for the time being, but rather a solution to the underlying etiology. We now envision our work as a necessary extension of our current healthcare delivery model, and we view it as a sustainable method for bringing care to the patients rather than relying on their ability to come to us.

There is still a lot of work to be done before Life Bus becomes a reality in MKE and beyond, but we are excited to see what the future holds. Our work has further exposed us to the innovation, engineering, public health, and business sides of medicine. It has allowed us to integrate our individual backgrounds (in basic science and education for Kelli, and in engineering and design thinking for Gopika) as well as our passion for medicine and public health, into a cohesive initiative that has the potential to tackle some of the challenges in healthcare delivery that have been exacerbated by the COVID19 pandemic. Someday, we hope contributing to real-world challenges becomes a part of our medical education. Not only does it expand our understanding of the numerous aspects of healthcare and its impact on our patients, but it also allows us to hang on to a sense of meaning and purpose even when feeling overwhelmed with coursework.

These few months have opened our eyes to the extent of health disparities and access deserts plaguing the Milwaukee community. As we move forward in our medical education, we plan to do our part in helping increase sustainable healthcare access in our community - through Life Bus and beyond. We would like to thank everyone who has contributed to our work thus far; it truly takes a village! This project would not be possible without all of your hard work, support, and mentorship! Please visit our website for more information on the project and team: https://covidlifebus.wixsite.com/website.

Kelli Cole & Gopika SenthilKumar are both M2 students in MCW’s MD/PhD Program.

"Questions from Milwaukee” Q & A with Reed Colling, MCW-Green Bay M4

 From the 9/18/2020 newsletter

Student Perspective

Life as an MCW Regional Campus Student

"Questions from Milwaukee” Q & A with Reed Colling, MCW-Green Bay M4

Associate Editor Olivia Davies (MCW-MKE M4) asks Reed Colling (MCW-GB M4) questions about what it’s like to be a student at one of MCW’s regional campuses.

Olivia: “Regional campus students have a different curriculum than MKE students. Refresh me on how that works, and what do you like better about it?”

Reed: “The curriculum during the M1 and M2 year are actually identical. The main difference is earlier clinical exposure and less time for electives. On the Green Bay campus, we start our core clerkships during the summer after M1 year. While it is challenging to start clinic before learning all the pathophysiology presented in the M2 year, starting to develop our clinical skills early on is super helpful as we progress through our education. One downside is there are only six weeks available for electives. By graduation, the difference between the main campus and the regional campuses is actually only twenty weeks of instruction.”

Olivia: “I know you’re applying Emergency Medicine (EM) this year and decided to do a fourth year, what does that process look like at a regional campus? How is your fourth year different than an M4 student on the MKE campus?”

Reed: “While the goal of the regional campus is to graduate as many students in three years as possible, the administration is very supportive of students pursuing whatever specialty fits them best! After you take USMLE Step 1, you submit an application requesting a fourth year outlining why it is necessary for your career path. In EM, you typically need to complete two EM rotations at a program with a residency which would not be possible during the accelerated curriculum. The application is then reviewed by both the MKE and regional campus. After a fourth year is approved, there is very little difference between an M4 student on the MKE campus and the regional campuses! We complete a mixture of rotations in MKE, on the regional campus, and away rotations.”

Olivia: “What’s one thing you wish Milwaukee students knew about being a student at a regional campus?”

Reed: “I think there can be a misconception that because the training does not take place in an academic center that it is less rigorous. Having done rotations at both campuses, neither is more or less intense, just different!”

Olivia: “What’s it like to be a part of a LARGE class (>200) but have a cohort of ~30 students you know really well? What benefits have you experienced as a part of a smaller regional cohort?”

Reed: “The smaller class size is one of my favorite things about being a student on the regional campus! The comradery that developed was really special and it wasn’t long until we were more like family than classmates. With a smaller group, it is easy to learn each other’s strengths and weaknesses so that we can all come together to succeed as a class.”

Olivia: “What challenges have you faced as a regional campus student?”

Reed: “The biggest challenge being a student on the regional campus is time management. Because of the truncated timeline and accelerated curriculum, it is easy to get overwhelmed. For example, within an approximately six-month time frame we take USMLE Step 1, complete core clinical rotations, fill out and submit ERAS, enter interview season, and take USMLE Step 2 CS and CK. I’m tired just typing it!”

Olivia: “What’s your favorite thing about being in Green Bay?”
Reed: “The people. Everyone really goes above and beyond to make us feel welcome and like

we are an integral part of the community. The occasional free Packers ticket doesn’t hurt either!”

Reed Colling is a fourth year medical student at MCW-Green Bay applying to residency in emergency medicine. He is passionate about public health advocacy and improving diversity and inclusion in medicine.

May I Drink Coffee?

 Student Perspective 

Interviewing in the COVID-19 Era

May I Drink Coffee?

Olivia Davies – MCW-Milwaukee medical student Class of 2021

I’ve tried three different zoom set ups, four if you count the one from my couch that I joke about. One of my friends has a bouquet of flowers set stage left on her screen, just in sight. I play with the tilt of my monitor to see if I can show the top leaves of my split leaf philodendron which sits on the floor next to me. Staring at the white wall behind me through the screen monitor I catch a glisten – is that grease? I turn around to examine it in real time, yup, grease. How did that even get there? To be fair, I am sitting next to the wall where our dinner table was just a mere two days ago before I declared it my new interview spot.

“Do you have the Milk Street Cookbook?” my fiancé calls from the other room. I sigh, removing it from the stack underneath my laptop. I know I should be grateful he’s making the grocery list this week (like he does almost every week), but doesn’t he understand we only have so many laptop-sized books in this apartment to elevate the built-in camera? I realize using Milk Street as my laptop prop probably won’t be sustainable.

One of my friends asked if I was planning to wear heels ... I guess I hadn’t thought of that. She smiles matter-of-factly and says, “I am, they make me feel put together, even if no one will see them.” She has a point, I think. I stand up shimmying out of the screen to go look for my suit jacket. Finally unearthing it from my closet I gasp at how dated it looks, were flashy gold buttons “in” five years ago? This won’t play well on camera. I sit back down and start to look for a simple suit jacket online.

Reaching for my phone to text my friend back, I glimpse my half hunched over frame in the monitor. “I think I’ll wear heels, too,” I say, un-pretzel-ing my feet from beneath me and placing them firmly on the ground. Before setting down my phone, I fire off one more text, “Do you think it’s OK to drink coffee?”

Olivia Davies is a fourth-year medical student at MCW-Milwaukee who is in the midst of applying for her dermatology residency. She is an associate editor of the Transformational Times. Follow her at @oliviamtdavies.

Front Line Adjacent: A Reflection on being Removed from Clinical Rotations

 

From the 9/18/2020 newsletter

Student perspective

Front Line Adjacent: A Reflection on being Removed from Clinical Rotations

David Lambert - M.D. Candidate, Class of 2021

I was just over two weeks into my internal medicine clerkship when I first heard the news that medical students would be removed from rotations due to COVID-19. I was filled with a flood of emotions. I was sure by then that I wanted to go into internal medicine, so of course I was disappointed I would not be able to finish our rotation. But I was mostly sad to say goodbye to the team. In just two weeks, we had already experienced late nights, challenging call shifts and difficult cases. We had experienced a range of emotions together and formed a deep sense of trust that made them feel like more than just coworkers. These are the very elements that are important for providing quality care. These elements also made it very hard for me to say goodbye. I realized that a team that I had come to genuinely care about would be facing a global pandemic that we still knew very little about.

As our rotations moved online, my days were filled with uncertainty. Each day, we would receive updates from the school and hospitals. Everyone was trying to react, to do the right thing, and to ease our anxiety. Third-year medical students are used to adapting to changing environments-we are never in the same rotation for more than four weeks. However, moving online felt profoundly different. In some ways, I felt like an imposter-not knowing when we would see another patient made me feel like I was just pretending to be a medical student. I had become accustomed to finding ways to be helpful in my rotations and seeking every possible opportunity to learn how to be a good physician. However, now as I sat at home with my laptop in front of me watching the coronavirus numbers rise, I felt helpless. I was fearful for the world, our nation, and my colleagues in the hospitals.

As our country went on lockdown, I watched as COVID-19 cases and deaths rose. I also watched as personal protective equipment became scarce, as unemployment rates rose, and as people began to fear losing their homes or becoming evicted. In some ways, I was fortunate as a medical student. Although my education looked different, I did not need to worry about feeding a family or finding a new job. A break in my education meant my anxieties centered around whether I’d be prepared for residency, whether I was falling behind my peers, or whether I would graduate on time. However, this felt selfish compared to the experiences others in our country were facing. When we commit to medical school, we commit to the very principles that guide physicians to do right by their patients and their profession. I felt a deep sense of guilt in not being able to do anything meaningful to help my team or fight the pandemic.

After nearly three months of not seeing a real patient, I was so excited to round on my first day back. It has been incredibly special to be able to continue to see patients and be a part of the teams that lift each other up again. I feel lucky to be going into the field of medicine and this pandemic has made me prouder than ever to be working alongside the dedicated and passionate people that continue to care for patients. I am also grateful to the dedicated staff at the Medical College of Wisconsin who worked incredibly hard to help us rapidly shift our rotations and courses completely online, all while working from home and managing their own personal and family challenges. Faculty made me feel like my education was a priority, even when this was not easy to achieve. I am proud to be part of the MCW community.