With the goal of one day becoming a physician, Kiana Heredia started her undergraduate degree at Mount Holyoke College as a pre-medical student. Faced with a course load of classes such as organic chemistry, inorganic chemistry, and physics, Heredia says she began to second-guess the gut feeling that she belonged in the medical field.

"An Intro to Physics course was my first taste of what it meant to be a pre-med student and as a newly minted first-year undergraduate college student, it was nothing like I expected,” wrote Heredia in a March 2022 post for the UVM Larner Med Blog. “I remember thinking to myself, ‘This can’t be something I want to do for the rest of my life — kinetic energy? magnetic fields? What am I doing here?’” she recalled. In addition, she said, “This Intro to Physics course shaped my first academic relationship to medicine and with no family members or friends in the healthcare field, I was convinced that these pre-med requirements and medicine were synonymous, in meaning and experience, without any room for expansion.”

Heredia graduated with a degree in psychology, but it wasn’t until a few years later, after volunteering at a geriatric facility and fertility clinic in Spain, that she rediscovered her love of medicine and began her path back to a career as a physician.

Now Heredia is a medical student in the University of Vermont’s Larner College of Medicine Class of 2024 and recently helped Larner Assistant Professor of Pediatrics L.E. Faricy, M.D., create the URiM Pathway to Pediatrics (UPP) program to assist others who may encounter the doubts she experienced during her undergraduate years. The UPP program originated from a grant proposal Faricy and Heredia developed with help from Nicole Obongo ’24, Annaliese Lapides ‘24 and Mialovena Exume ’24, for American Academy of Pediatrics funding to support events aimed at increasing workforce diversity and supporting students historically underrepresented in medicine (URiM). It was Heredia’s idea to target pre-medical students in the first years of their undergraduate experience based on the disillusionment she felt at that stage of her education.

When the grant proposal was not accepted, Faricy approached her chair, Lewis First, M.D., to see if the Department of Pediatrics would be interested in funding the program. Not only did First agree to funding the program, he also became an integral part of the event.

The Inaugural Cohort of the UPP Program

On April 30, 2022, the inaugural cohort of 14 participants including undergraduate pre-med college students from UVM, State University of New York (SUNY)-Plattsburgh, Community College of Vermont, Saint Michael’s College, Middlebury College, and Castleton University, along with two students from Burlington High School, began the day with a greeting from Faricy and Senior Associate Dean for Medical Education Christa Zehle, M.D.

The daylong event included hands-on group skills sessions, including a "Clinical Mystery Case” session led by First and interactive simulation stations to practice colonoscopy and laparoscopic skills, care for a newborn just after delivery, learn point-of-care ultrasound techniques, treat a child in respiratory distress, understand vital signs, and  perform lumbar punctures led by current Larner faculty members. Teachers at the event included Assistant Professors of Pediatrics Nina Gluchowski, M.D., Scarlett Johnson, M.D., Hillary Anderson, M.D., and Faricy, Associate Professor of Pediatrics Paul Rosenau, M.D., M.Sc., Professor of Pediatrics Molly Rideout, M.D., and Assistant Professor of Surgery Christian Pulcini, M.D., M.Ed., M.P.H.

First’s session was one of the most highly rated events of the day.

“My favorite activity – the one that really centered on why I want to be a physician was the diagnosis workshop with Dr. First,” said Kelechi “KC” Onuoha, a biology and philosophy double major and rising senior at Saint Michael’s College. “The way he interacted with us made me feel like I was already in medical school. I thought doctors had to be a certain way, that I would have to be ‘corporate professional,’ not be too much, tone down my personality. But seeing Dr. First with his amazing personality made me realize that I can be myself – embrace my personality – and be an incredible physician.”

Ahmed Alrai, a UVM rising senior and business administration major, also enjoyed the hands-on simulation stations. “This event was the first time I was able to get a valuable hands-on experience of what being a physician is like,” said Alrai. “During the ultrasound station, one organ we were able to view in real-time was the heart...I could have stared at that screen for hours,” he said, adding, “I also loved the birthing station [where] I was able to learn and practice difference scenarios involving a newborn. In those moments, I envisioned myself as a real physician.”

Medical Student Mentors

While planning the event, Heredia recognized the importance of having current medical students, including students like her who may have struggled during their pre-medical years or who are underrepresented in medicine, available to interact with participants throughout the day. She approached leaders of the Larner chapters of the Latino Medical Student Association and the Student National Medical Association and other peers for help, recruiting 11 colleagues to act as “mentors” for UPP attendees. Class of 2025 medical students Sofia Toro Alvarez, Louis Briones, Olivia Darko, Isabel Martinez Daniel, Tom Notcovich, Elizabeth O’Neill, Virginia Ramirez, and Paige Song, and Class of 2024’s Exume, Lapides, and Obongo served as mentors for the event.

In addition to helping guide participants through the mystery case and simulation sessions, mentors also dined with them at a lunch and attended an end-of-day mixer during which participants could ask them more about their journeys into medicine, the process of applying to medical school, and advice for staying motivated during pre-med coursework.

Obongo said that being a part of the project was a no-brainer. “I am a strong supporter of programs and initiatives that inspire those particularly from underrepresented communities to consider entering the medical field,” she said, adding, “I also recall some reports I have come across predicting doctor shortages in primary care. The UPP program just made perfect sense to me.”

Darko felt similarly and, like Heredia, was familiar with how difficult it is for medical student hopefuls to navigate the exhausting and, often, overwhelming journey to medical school, especially when close friends, family, and mentors are unable to guide them. “I really didn't have a lot of guidance when trying to pursue a career in medicine – I very much felt like I was alone,” she said. "It’s so important to me to offer advice and support to folks who want to pursue medicine – I love any chance that I can get!” Darko added.

Alrai said that the support and interactions with the current medical students was an integral part of the program’s success in his mind. “Having them involved made it much easier for me to ask questions and learn about their personal journeys,” he admitted.

From Onuoha’s perspective, she said that the impact of representation cannot be overstated. “Seeing all these Black women who are intelligent, educated, and successful medical students meant so much to me,” she said. “Sometimes when you only know one person, it can seem like luck. But when you see more people that look like you in the field, it makes you feel more confident about yourself. Now I know I have more role models to look up to,” Onuoha said, adding that after the program she told her mother, “Mom, these are my role models. I want to be like them.”

Physician Advocates

The health advocacy panel was one of the most important parts of the program. “Physicians are natural health advocates,” said Faricy. “There are a lot of preconceptions about the types of people who become pediatricians – preconceptions that really do not fit very well with the active search for justice that a lot of folks have in this upcoming generation of physicians. People want to make systemic changes and that starts in infancy and even before birth – this is a lot of what our health advocacy panel spoke about: how to affect social and systemic policies to give children a strong start in life."

Among the panelists were Professor of Pediatrics and former Vermont Commissioner of Health Wendy Davis, M.D., Clinical Assistant Professor of Pediatrics Leah Costello, M.D., Assistant Professor of Pediatrics Anisha Rimal, M.D., and Pulcini.

The panelists spoke about the successes and challenges they had experienced as they worked on advocacy at the community, school, state, federal, and legislative levels around issues such as housing justice, universal school meals, and firearm safety.

UPP program participant Martha Harrold, a rising senior molecular biology and biomedicine major at Castleton University, said the panel discussion helped clarify for her one of the many ways physicians deal with burnout. “Dr. Pulcini’s answer stood out to me when he spoke about his research on gun violence and reducing emergency department visits for children with medical complexities,” she said. “He told us that finding something that is important to you can become the antidote to your burnout – that you find the things you want to fight for and that you're passionate about,” she added.

Larner medical students acting as program mentors also found the panel helpful. “As a current student, the health advocacy panel meant the most to me,” said Heredia. “It was eye-opening to learn that, even before you have the title of an M.D., you can voice your concerns and have an impact on your community. It was one of the most powerful points of the day,” she added.

Following the panel, participants, mentors, and panelists split into groups to work on a thought exercise focused on discussing current health advocacy topics such as COVID and school, housing as a human right, universal school meals, and the Youth Mental Health and Suicide Prevention Act. The small groups considered questions, such as “Who is already doing this type of work in the community,” “Which voices should be highlighted and/or included,” and “What opposition to this issue could be expected and for what reasons?”

A Resounding Success

Pre- and post-program surveys provided evidence supporting the value of the UPP Program. While only 43 percent of respondents stated they had a “good understanding of possible careers in medicine” prior to participating, that measure changed to 100 percent after attendance. Additionally, after the event 93 percent reported they were likely to engage in health advocacy work, 93 percent of respondents reported that they were more interested in the field of pediatrics, and 100 percent agreed that they have gained clinical skills, insight into medical procedures, and health advocacy skills and knowledge, following the event.

Even more encouraging than the statistics was the feedback from mentors and participants alike.

“Being a part of UPP as a mentor was ... a great reminder as to why I, myself, was drawn to medicine,” commented Obongo.

Darko agreed that participating in the program as a mentor helped her become reinvigorated in her own journey. “When you are in medical school, you get a little bit jaded. The work and the monotony become taxing, so having students so excited to meet me, even when I am still on my own journey of trying to become a doctor was a reminder of one of the reasons I am doing this,” she said.

UVM undergrad Alrai said, “For as long as I can remember, I have wanted to be a physician and the UPP program just gave me more motivation to fulfill my dreams. I called my parents before I even sat in my car and told them ‘I will do whatever it takes to become a physician!’”

“You talk about destiny and how things are supposed to be … I’m not going to lie – if I hadn’t done this program, I was going to let these pre-med classes stop me.” Onuoha said. “She [Heredia] just saved me years of being lost and fearful of what I was going to do with my life because she went through it herself … because of this of this program she planned, I’m back on track.”

Read Kiana Heredia’s blog post, “Pre-Med Science Classes Pushed Me Away from Being a Doctor; the Art and Humanism of Medicine Brought Me Back.”