During their first two years of study, students at the University of Pittsburgh School of Medicine are required to engage in three, monthlong, clinical experiences.
One experience focuses on primary care, one on specialized medicine and one on community service. It’s the last one that forms the basis for this story.
Joel Wolf and Tory Steen entered medical school at the same time. The two Jewish students met during the opening week of class. As the semester went on, they shared a Shabbat dinner and quickly became friends. Wolf and Steen undertook their curricular requirements and witnessed an array of medical opportunities. Both developed a penchant for dermatology.
As the years passed, despite his exposure to other specialties, Wolf kept thinking about dermatology. He researched the subject and conversed with those in the field. At every curricular juncture, Wolf searched for dermatological opportunities. Finally, he made a discovery.
For his third clinical experience, Wolf worked at the Birmingham Free Clinic, a center self-described as serving “uninsured and other medically vulnerable groups by utilizing an exclusively volunteer group of health care providers.” Wolf shadowed a group of ophthalmologists.
As he observed the equipment and objects, he had a revelation: Dermatologists, unlike other specialists, don’t require many materials. “We mostly use our eyes,” he said. Apart from acquiring the few requisite instruments, Wolf wondered what it would take to create a free dermatology clinic for Pittsburgh’s underserved patients.
He brought his idea back to Steen, who developed a plan. The two would need materials, residents, attending physicians — Wolf and Steen call them “attendings” — funding and a building. Afterward, they would need to find patients.
“We went through a lot of obstacles to get this going,” said Steen.
They reached out to residents and attendings at the University of Pittsburgh about volunteering time and services. Next, Wolf and Steen worked with the medical school and insurance companies to ensure complete compliance.
The final step, finding a home for the clinic, proved to be the most challenging. Wolf insisted that the clinic be student run, with their work confirmed by attendings. In his mind, this pedagogical model would yield an optimal educational environment.
Fortuitously, during this time, Dr. Andrea Fox, chief medical officer at the Squirrel Hill Health Center, delivered a lecture at the medical school. Within her talk, she explained the mission and work of the SHHC. As soon as Fox finished her presentation, Wolf approached her with his plan.
“The SHHC was exactly what we were looking for,” said Wolf. With its underserved patient population and willingness to embrace a student-led clinic, a partnership soon developed.
Over the course of several months, the free dermatology clinic, now named Student Dermatology for the Underserved, has welcomed nearly 50 patients, most of whom are non-English speakers. Cases of lupus, melanoma, chronic urticaria, epidermal inclusion cysts and other disorders have all been addressed. Per Wolf’s model, students run the clinic, with residents and attendings supervising and assisting patient care.
To date, biopsies have been taken, diagnoses have been made and medicine has been prescribed.
The results are remarkable.
“For most of these patients, this is their only access to health care,” said Steen. “These people are immigrants and don’t speak the language. They’re afraid and can’t express their pain; you have to bring it to their level and reassure them about things,” added Wolf.
Volunteers at the clinic strive to preserve the patients’ dignity. And of the nearly 50 beneficiaries of Student Dermatology for the Underserved, all remain nameless, except for two: Joel Wolf and Tory Steen, the two aspiring dermatologists, who used their eyes to diagnose a blemish in Pittsburgh patient care.
(Adam Reinherz, who writes about life in Jewish Pittsburgh, can be reached at firstname.lastname@example.org.)