Addressing the ‘Pipeline Problem’ in Infectious Diseases: Program Creates Pathways for Students Underrepresented in Medicine

Members of this year’s BRIDGE Summer Fellowship cohort celebrate their completion of the program. From left: Déjà Clement, Jeriel Garcia, Anadela Navarrete Gomez, Emily Afriyie, Mariana Bouchan, Nicholas Malone, Lauren Elvrum, Javier Huerta, Karina Garcia and Whitney Camille Ford
Tufts University chemistry student Emily Afriyie was curious about a career in infectious diseases, but she found it difficult to imagine how she might enter the field. That all changed when she was accepted into the Brigham Research in Infectious Disease and Global Engagement (BRIDGE) Summer Fellowship Program.
Now in its second year, the program provides a mentored research internship in the Division of Infectious Diseases to college students and recent graduates who are from racial or ethnic groups underrepresented in medicine and other health professions. Over seven weeks, students work closely with Brigham researchers and gain hands-on experience in basic science, clinical or translational research in infectious diseases and global health.
“I’ve always had an interest in infectious disease, but I didn’t know about the different pathways in research and clinical care as an infectious disease doctor,” Afriyie said. “This was a new door opened for me. It’s nice to know that there are people who can help you and who are rooting for you, especially when there are not many others who look like you in the room.”
This gap is exactly what the program seeks to address, explained infectious diseases specialist Sophia Koo, MD, a co-founder and co-director of BRIDGE.
“We have a pipeline problem in infectious disease where physicians and health care providers do not really reflect the demographics of the patients we serve,” Koo said. “Clinical outcomes and trust are improved when there is race and ethnicity concordant care. We want to improve diversity by creating this program to mentor students from underrepresented racial and ethnic backgrounds, many of whom are the first in their family to think about going to college or medical school.”
This year’s cohort comprised students who identify as Black, Latine, Native American and Mesoamerican. Koo hopes the nascent program, which hosted 12 interns this summer, can continue to grow and reach more students who may lack structured opportunities to pursue research.
“Disparities in pursuing health care careers are perpetuated when you don’t have exposure to a field, mentors who can write recommendation letters or connections with people who can support you to reach the next step,” Koo said.
Intriguing Research
Also among this year’s cohort was aspiring physician-scientist Javier Huerta, who is pursuing a master’s in public health at Oregon Health and Science University. His interest in medicine began when he was a pediatric surgery patient, and his mother had to navigate the complexities of the health care system as a single parent. Over time, his interest solidified as he conducted pediatric outcomes research and served as an HIV counselor.
“Being an HIV counselor really opened my eyes to how stigma can limit access to care in particular communities and motivated me to understand infectious disease and global health, which I had only studied through classes,” he said.
During his BRIDGE fellowship, Huerta worked with mentors Jennifer Manne-Goehler, MD, ScD, to study patient outcomes for Chagas, a tropical disease primarily affecting impoverished communities in Latin America, and MGH infectious diseases researcher Andrea Ciaranello, MD, MPH, on HIV outcomes.
“Chagas is a neglected tropical disease amongst neglected individuals who might not seek care because of fear, lack of insurance, stigma, language and literacy challenges,” Huerta said. “There’s so much room for improvement in health care system in the United States for these communities.”
Huerta enjoyed the program’s immersive experience, which enabled him to attend weekly lab meetings, work with other research assistants and receive quick feedback on his ideas.
“It was nice to directly apply the epidemiology skills I am learning through the MPH,” he said. “I was given the autonomy to come up with new research questions using the datasets we have. My mentors were very receptive.”
Intangible Benefits: Sustained Mentorship and Self-Advocacy
When selecting fellows from over 250 applications, the program’s leadership applied an equity lens to the process, understanding that applicants may have experienced barriers to conventional markers of success, Koo said.
“We try not to filter applicants based on grades or prior experience like many other programs,” she explained. “We look at interest in infectious disease. I would say the personal statement is the most important part.”
The program adapted its structure in other ways to be more inclusive. In response to feedback from students last year that the cost of living was difficult to manage, this year the BRIDGE program arranged for most of the students (apart from Boston locals) to be housed in dorms at the Massachusetts College of Art and Design. The setup also allowed students to bond outside of the program.
Huerta explains that the program’s leadership go above and beyond for the students, even sending regular check-in text messages. His research mentors also provided him with opportunities to publish his research and continue working remotely after the summer ends.
Likewise, for another participant, Anadela Navarrete Gomez, a recent University of California at Los Angeles graduate who studied biology and Chicanx studies, her BRIDGE mentors will serve as an important resource to guide her medical school applications.
“I applied to BRIDGE because I wanted to connect with physician mentors,” Gomez said. “The people I met really inspired me to keep pursuing medicine, and I hope to stay in touch with them as I approach the medical school application process.”
Often, the mentorship extends beyond professional support.
“I think a good mentor connects with the mentee in more ways than just professionally and really gets to know their needs so they can address their needs,” Huerta explained. “Mentees, especially when they are from underrepresented backgrounds, need mentors who are present. They host frequent check-in meetings, welcome questions and create a deeper connection with students.”
For Afriyie this looked like seeking out opportunities to shadow others in the lab and see patients with her mentor, Ann Woolley, MD, MPH, to build relationships beyond her research project.
“Being able to ask for the things you want to get out of a program is important,” Afriyie said. “Learning how to advocate for myself has made me stronger person.”
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