Mytien Nguyen, a third-year student at the Yale School of Medicine, often hears narratives about medical students that run contrary to her personal history. The assumption, Nguyen says, is that she and her classmates are wealthy and their parents are highly educated. But as a first-generation, low-income student who immigrated to the United States from Vietnam, her story looks different.
“The most subtle but striking situation to me is when we have a patient come share their stories with us, and I would see myself or one of my family members or childhood friends reflected [in] that patient,” she says.
Nguyen’s background undoubtedly has helped her become a more empathetic, culturally competent provider. But her success — and the success of first-generation medical students like her — comes with its own share of challenges, from navigating the complex world of financial aid to learning proper etiquette at professional meetings and dinners.
“A lot of what I hear over and over from students is that you don't know what you don't know,” says Mijiza Maláne Sanchez, MPA, EdD, associate dean for the Office of Medical Student Affairs at Stanford School of Medicine.
First-generation students “are in many ways a minority within medical school,” says Geoffrey Young, PhD, AAMC senior director of student affairs and programs. But despite their small numbers, first-generation medical students are increasingly visible as medical schools become more attuned to underrepresented student populations. And medical schools are doing their part, offering mentoring programs and offices dedicated to helping these first-generation students succeed. The AMCAS® program now includes the First Generation College Student Indicator to identify students early on and help them navigate the transition to medical school.
With all that they have accomplished, first-generation students are a positive contribution to academic medicine, and their achievements are to be celebrated, says Young. “It’s not a deficit,” he says. “It’s definitely a strength.”
Not long ago, Rose Marcellon, now a third-year student at Albany Medical College, learned the meaning of academic medicine at a conference hosted by Building the Next Generation of Academic Physicians (BNGAP).
“Often, if you don't know what questions to ask, you'll never come across some information,” she says. “Being in medicine and not being aware of academic medicine as a field is an example of that.”
It’s the kind of knowledge that gets passed down to continuing-generation students, particularly those whose parents are in medicine, says Marcellon, who is a member of Albany’s 1GMD, or first-generation student group.
Fortunately, Marcellon isn’t alone at her institution. Albany boasts a sizeable first-generation student population who are embraced by faculty and staff. When she needs help, Marcellon has turned to people like Hyacinth R. C. Mason, PhD, MPH, CHES, assistant dean of student support and inclusion, for practical and social support at the medical school.
Mason has worked with students from the Albany chapters of BNGAP, the Latino Medical Students Association, and the Student National Medical Association as well as Albany’s 1GMD club to talk about what they wish they’d known their first year.
“Being a first-gen student myself, I know firsthand how challenging it is in higher education, particularly in graduate studies, how hard it is to navigate institutions that weren’t really built or set up for folks like us.”
Mijiza Maláne Sanchez, MPA, EdD
“We're not trying to fix people and make people become like us,” says Mason. “We are trying to do what’s necessary for all students to thrive and succeed.”
That mindset is also being put into practice at the Office of Rural Initiatives at the University of North Carolina at Chapel Hill School of Medicine. In partnership with the Office of Special Programs, the Office of Rural Initiatives has begun asking students to self-identify as first-generation and work alongside staff to create relevant resources and programming.
Staff have brought in speakers, including a loan officer from a local credit union to help students understand their loan options, as well as first-generation faculty and staff who can discuss their own career trajectories, says Meredith Bazemore, MPA, program director for the Office of Rural Initiatives.
These get-togethers serve another purpose: They allow students to connect with each other and celebrate the qualities, like persistence and resilience, that helped them get into medical school. “Those are important pieces that need to be talked about, and one way to talk about that is to give them a space to really own that and recognize the value in that,” Bazemore says.
Mentoring — and being mentored
For students who are finding their own way in medical education, mentors who themselves are first-generation provide guidance and the assurance that they belong in medicine.
Stanford University School of Medicine’s First Generation Mentorship Program was developed with a personal and altruistic mission by Sanchez.
“Being a first-gen student myself, I know firsthand how challenging it is in higher education, particularly in graduate studies, how hard it is to navigate institutions that weren’t really built or set up for folks like us,” she says.
Through the program, Sanchez wants to build a community of first-generation mentors and students where they feel comfortable asking questions. And hopefully, those who have received mentoring will one day return the favor.
“You're always going to need mentorship, and you're also going to have to continue to mentor,” she says. “I think it's our duty to continue to reach down, to lift as we climb.”
No more hiding
First-generation students and their advocates also want to change the narrative of their status, from one of deprivation to one of empowerment, by acknowledging all that they contribute to the medical field.
“The more sunshine we can provide faculty and staff regarding the experiences of people with this life experience, celebrate it and accentuate the positive attributes of grit, determination, ingenuity, stick-to-itiveness inherent in it, I think we can turn around people's vision of what might be possible,” says Mason.
Hailey Roumimper is one of those trying to change the narrative. Though she didn’t often advertise her first-generation status in college, she now is a founding member of Georgetown University School of Medicine Generation I, which pairs first-generation physician and faculty mentors with student mentees. At group dinners, students discuss topics like financial literacy. And during a pinning ceremony for fourth-year students, they affix markers of their first-generation status to their white coats as a symbol of honor.
“One of the biggest things to advocate and communicate is that being a first-gen is not a disadvantaged status. Being a first-gen in medicine brings a lot of experiences that enhance the medical profession.”
Yale School of Medicine
Now Roumimper and her colleagues at U.S. medical schools are elevating their advocacy by creating a network and organizing a national symposium for first-generation and low-income students.
Nguyen is one of the organizers of the event as well, which is focused on the themes of empowerment, community, and advocacy. She’s also the co-founder and co-president of the Yale First Generation/Low Income affinity group.
“One of the biggest things to advocate and communicate is that being a first-gen is not a disadvantaged status,” says Nguyen. “Being a first-gen in medicine brings a lot of experiences that enhance the medical profession.”