Subscribe to Pittwire Today
Get the most interesting and important stories from the University of Pittsburgh.The relationship and trust established between a patient and physician is crucial for high-quality care. While empathy and clear communication strengthen this relationship and patient outcomes, research suggests many physicians and medical students don’t effectively communicate, resulting in decreased health literacy and patient adherence, among other challenges.
Through the School of Medicine's Community Alliance Program (CAP), Andy McCormick and Maya Ragavan are teaching Pitt med students to be exceptional communicators who consider patient perceptions and experiences as primary metrics for success.
“Our goal is to guide students as they transition into physicians, helping them shape a professional identity that strongly emphasizes community engagement,” explained McCormick, associate professor of pediatrics and co-director of CAP, which he initially launched with UPMC physician Betty Liu in 2023.
While conventional approaches to medical education often prioritize developing expertise within the silo of academia and the disease model, focusing on “fixing” someone, CAP prioritizes community engagement and input.
“This often resulted in physicians entering a community solely for diagnosis, and then leaving,” said McCormick. “We’re redefining the role of a servant-leader, so our students see themselves as members of the communities they serve.
During the first 15 months of medical school and before clinical work consumes schedules, CAP pairs students with “community classrooms,” local organizations like Casa San Jose, the Down Syndrome Association of Pittsburgh and the Neighborhood Resilience Project that support people with a range of needs, including those facing food insecurity, English as a second language speakers, immigrants, recovering addicts and those with mental illness. Each community organization receives $1,000 per student for their involvement.
“These community sites are just as important as Scaife Hall, where students are learning about biochemistry, anatomy and the different scientific medical aspects of becoming a physician, so we need to remunerate them for their work,” McCormick said.
The students first learn about their assigned organizations and then work to advance specific service-learning projects.
Student Karensa Tjoa, who plans to pursue pediatric oncology, partnered with Hugh Lane Wellness, an organization that aims to improve the health of LGBTQ+ community members and HIV-impacted Pennsylvanians. She chose to attend Pitt because of the Medical Scientist Training Program and the mentorship and collaboration opportunities available within Pitt Med. She said CAP embodies this and is the perfect way to escape the “medical school bubble.”
“It is a great way to connect with community members [beyond the institution] and remember why we wanted to become doctors in the first place,” said Tjoa. “It can be easy to lose sight of your larger purpose amid the continuous information overload and exams, but advocacy is an integral part of being a physician, and those skills are often best learned within the community versus a lecture hall.”
For Tjoa, this consisted primarily of working with LGBTQ+ youths in the organization’s after-school program. Learning to play Dungeons and Dragons and about TikTok trends in exchange for algebra assistance offered her insights into their daily lives and experiences. She also hopes early positive experiences with medical professionals might inspire some to consider the career path for themselves.
“Having dedicated time within the medical school curriculum to go and learn directly from people in the communities we hope to serve is an incredible opportunity,” she added.
Alongside community and cultural exposure, students gain access to a specialized in-classroom curriculum that spotlights key concepts like trustworthiness and the importance of embracing diverse perspectives and lived experiences.
“Time spent in these communities leads to a deeper understanding of different needs and the development of culturally sensitive care,” McCormick said.
As CAP’s assistant director, Tara McCoy, who McCormick described as “the glue” for the entire operation, manages existing and new community partnerships, reviews curriculum content and supports the program evaluation process.
Previously, she worked in service coordination for a local hospital, a role that allowed her to make strong connections with local organizations, many of which are now CAP partners.
Citing her firsthand knowledge of the distrust of doctors that has permeated the Black community, she praised the program for teaching students “how to interact in diverse communities, the importance of bedside manners and establishing trust from the very beginning.”
McCormick said that CAP’s broad impact is both individual and systemic.
For students like Tjoa, it offers a way to develop rewarding relationships outside of the hospital setting and acclimate to the city. For physicians broadly, he said, it can provide early experiences that steer them toward community-centered roles like primary care, which is facing a shortage of physicians.
“Many students have said they hadn’t before considered the concept of community-based participatory research at inception,” McCormick said. “CAP, with its purposeful curriculum, can train a future generation of physicians who alter what the practice of medicine looks like in Pittsburgh and eliminate that distrust we’ve created in our health care system that creates chasms with our communities.”
Photography courtesy of McCoy