Take the plunge

Before medical students hit the books, they hit the streets of St. Louis, where their ideals meet face-to-face the realities of health care in America.

WUSM student volunteers teach nutrition at St. Louis’ Herbert Hoover Boys and Gi

WUSM student volunteers teach nutrition at St. Louis’ Herbert Hoover Boys and Girls Club.


Each year, first-year students are invited to St. Louis a week before Orientation to participate in WUMP, the Washington University Medical Plunge — five days of lectures, site visits and community service related to public health. In one short week, the people they meet, the problems they face, and the lessons they learn may focus the trajectories of their medical careers.

In 2009, 55 students — nearly half of the first-year class — attended WUMP to learn how they might have an impact on the city’s health problems.

According to Will Ross, MD, MPH, associate dean for diversity and the creator of and mentor for WUMP, the program began more than 10 years ago as an offshoot of the Saturday Neighborhood Health Center, a free, student-run health clinic located near the medical school. Ross recalls how the topic came up in a casual conversation with former medical student and Coro leadership fellow Edy Kim.

“The clinic was an excellent opportunity to get students involved in providing health care to a distressed neighborhood, but they wanted to know more about health care in St. Louis,” says Ross, who had several goals for WUMP at its inception. He wanted to make students aware of St. Louis’ unique public health challenges and to introduce them to the people and nonprofit organizations working to reduce disparities. He also hoped they would develop a long-term commitment to the city and create a variety of innovative and successful ventures. Ross says that over the years, his original goals have been exceeded.

Children and their families learn how to make healthy snacks as part of a WUSM student outreach program.

“I assumed a handful of students each year would have an interest in population-based health,” he says. “So, when almost half the class signed up in 2009, I was elated.”

Bradley A. Evanoff, MD, MPH, the Richard A. and Elizabeth Henby Sutter Professor of Occupational and Environmental Medicine, was an early supporter of the program.

“Many of our incoming medical students are interested in health disparities and in public health,” says Evanoff. “WUMP exposes them to diverse populations with a variety of health issues related to socioeconomic factors and helps them appreciate the complex determinants of health. And I hope that it inspires some to pursue careers that improve public health and reduce health disparities.”

WUMP’s schedule is dynamic, with speakers and subjects changing from year to year. One element that has become a standard, however, is a bus tour of St. Louis hosted by Bob Hansman, associate professor at the Washington University College of Architecture and the Graduate School of Architecture & Urban Design. An artist-in-residence at the School of Architecture, Hansman is nationally renowned for his work with underprivileged inner-city youth.

“In my own teaching, at Washington University and in the Clinton-Peabody Housing Projects, health is a recurrent theme,” says Hansman. “I often talk to my architecture students about health being the ultimate goal of design. In the projects, health — or the lack thereof — whether through issues of lifestyle, violence, nutrition or access to medical care, is a constant issue.”

Hansman says that the bus tour shows medical students the “real” St. Louis and allows him to bring up certain issues related to health in an urban setting, such as exposure to environmental toxins, lack of access to safe, open green spaces, and difficulty in finding adequate sources of nutritional food. “Confronting these questions and issues is why I look forward every year to being a part of the WU Medical Plunge — and why, even against daunting odds, it fills me with hope,” he says.

Second-year medical students Rashmi Agarwal and Elaine C. Khoong, president of the Class of 2013, are the student coordinators for this year’s WUMP. They have worked to further enhance the experience for participants.

Will Ross, MD, with student coordinators Elaine C. Khoong and Rashmi Agarwal

Agarwal believes that medical student interest in public health is representative of an overall rising interest in public health issues. To better accommodate student interests, Agarwal and Khoong have added more student speakers. For instance, on the day of the sexual health panel, students from the STATS (Students Teaching AIDS to Students) and SHARE (Sexual Health and Reproductive Education) spoke alongside medical professionals. They also included more panel discussions and built in more informal discussion time so that participants could synthesize the information they learned from each day’s activities.

After WUMP,first-year students who want a more formal exposure to public health can take Introduction to Public Health, a selective taught by Ross, which reviews the history, practices and administration of public health and epidemiology.

The course gives students the tools to translate what they observed and talked about in WUMP into action, channeling their enthusiasm into amplifying existing programs and implementing long-term, community-based programs.

According to Ross, many WUMP students go on to become active members of other student-led initiatives at the School of Medicine. One such program, the Public Health Interest Group, partners with people in the community to improve health by offering health screenings, nutritional outreach and public policy discussions.

“The projects have become very sustainable because of the large nucleus of interested students,” says Ross. “They really are institutionalizing public health in the medical school.”

Third-year student David Levine has been the leader of several successful community health efforts. In his first two years, Levine coordinated a series of student-run health screenings held at grocery stores in underserved areas and a nutrition program for children and parents at the local Boys & Girls Club. In the coming year, the nutrition program is expanding to add additional sites and, with a $2,000 grant Levine recently received, two Farmers’ Markets will be held in the city.

It’s not just School of Medicine students who benefit from involvement. Those living and working in the community appreciate their efforts.

“The WUMP students learn their new art of medicine with an eye for health care equity,” says Heidi B. Miller, MD, an internist primary care doctor at the Family Care Health Centers, a community health center in the City of St. Louis that serves the uninsured and underinsured.

“Regardless of what field these students ultimately select, they have an obligation to care for the underserved in some capacity,” says Miller, who also is a voluntary clinical faculty member of the School of Medicine. “WUMP enables them to act on this in an informed and committed way.”

Another longtime community liaison is Judy Bentley, founder and CEO of CHIPS Health and Wellness Center (Community Health-in-Partnership Services), a not-for-profit organization on the city’s North Side that provides health care and social services for the uninsured and underserved. Last fall School of Medicine students started a fund-raising program with CHIPS and helped to put on a gala honoring the group’s volunteers.

“There is a level of compassion and sensitivity of the broader world in these young people, which they are using to enrich not only their own lives but those of people in need,” says Bentley.

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