Two UCF medical students were among only three doctors-in-training selected for a national fellowship program on how poverty and lack of access to healthcare impact patients suffering from substance abuse.
Matthew Abrams and Courtney Bell were selected for the inaugural Yale University Recognizing and Eliminating disparities in Addiction through Culturally-Informed Healthcare (REACH) fellowship program. Participants included residents and fellows studying addiction medicine and addiction psychiatry from across the United States.
Led by the American Academy of Addiction Psychiatry, the program’s goal is to increase the number of physicians who are trained to work with under-represented minority patients suffering from substance abuse and associated mental health disorders like depression and PTSD.
“One of the big takeaways for me was realizing how structural barriers sometimes create a framework for how people are treated,” said Bell, a third-year M.D. student. “For example, a millionaire with a cocaine addiction may be viewed or treated differently than a homeless person addicted to crack. So it really taught me to be mindful of how, as physicians, our social constructs and perceptions can exacerbate someone’s situation.”
Abrams said he plans to use the knowledge he received to break down the language, cultural, socioeconomic and structural barriers that LGBTQI+, racial minorities and immigrant patients face when accessing care.
“From learning more about stigmatizing language, culturally-informed harm-reduction interventions and barriers that racial minorities have to overcome, this program has prepared me to be a better clinician and deepened my interest in addiction psychiatry,” he said.
Abrams said addiction and mental health issues are conditions that hit close to home and motivated him to study medicine. “As a future psychiatrist, I hope to help prevent others from losing loved ones like I did,” he said.
Though the in-person training at Yale lasts a week, participants are year-long REACH scholars and are paired with mentors such as addiction medicine fellows who provide guidance on how to pursue careers in the specialty. They also have the opportunity to complete an optional research study on health disparities and substance abuse. Bell plans to study the impact of substance abuse on family members and its effects on relationships.
Bell called the Yale program “pivotal.”
“This program has definitely changed my approach to patient care, in general,” she said. “It has challenged me to dig deeper on a personal level to see what I could possibly be missing, what challenges the patient may have or what structural barriers I need to bear when in mind while determining how best to treat them.”
Bell says she has always had an interest in addiction medicine and wants to work with marginalized groups.
“When I first heard about the program, I thought it was a great way for me to not only merge those two interests but to gain a deeper understanding,” she said. “As a future physician, it is important to recognize how all of these things affect not only people’s quality of life but also their quality of care, so it was indeed an honor to have been selected and be able to participate.”
Dr. Saleh Rahman, interim assistant dean for diversity and inclusion at the College of Medicine, said programs like REACH provide future physicians with much-needed training in cultural humility and the social determinants of health.
“Cultural humility teaches a life-long commitment to learn each other’s culture and become competent in it,” Dr. Rahman said. “And social determinants of health make us understand how social justice is linked to human health and quality of life. So the importance of training future physicians in these key skills cannot be overemphasized.”
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