PHILADELPHIA — In the highly competitive process of finding students with the best potential to become doctors, Temple University has turned to a previously untapped resource: members of its North Philadelphia community, who know better than anyone whom they would like to see treating them and their family members.
For the first time, five people who live and/or work in the community surrounding the campus and its hospital helped interview hundreds of candidates for the Lewis Katz School of Medicine class that will enter in fall 2022. And one of those members had a seat on the 25-member admissions decision committee, largely made up of medical school faculty and physicians.
The idea came from members of Temple medical school's Student Diversity Council, who worked alongside medical school leaders to hammer out details, including a decision to pay community members for their time to prove the value of their input. The goal was to make sure prospective students understood Temple's values and had the capacity and empathy to appreciate and respect their future patients.
"We think it was just high time to make sure that our largest stakeholders, the community, our patients, had a say in who was selected for the medical school class and who ultimately would be in the hospital taking care of them," said Randolph B. Lyde, 32, a Philadelphia native and 2022 Temple medical school graduate who founded and chaired the diversity council.
Among the community members selected to serve was Naida Elena Montes, 33, a youth mentor at the Norris Square Community Alliance who also is a Temple doctoral candidate and research assistant and adjunct instructor at another college. She has lived in the area most of her life and currently is about a 10-minute walk from campus. Her parents have been to Temple University Hospital. A close family friend who was like a sister died there.
The main goal, Montes said, was for community members to assess whether they would be comfortable having that student treat their community members.
She told students: "For you, it's a career. For me, it's life or death."
Amy Goldberg, a longtime trauma surgeon and interim dean of Temple's medical school, was immediately on board with the idea.
"It's such a tremendous message to our community: We want to know what you think," said Goldberg, who replaced John Daly after his sudden death in March 2021. "We appreciate you ... and know that many of you are patients within our hospital and assist us in education all the time."
Temple officials, including Jacob Ufberg, the medical school's associate dean of admissions, said they weren't aware of other medical schools that incorporated "true, on-the-ground" community members the way they have. Some others have used a retired physician in the community or a medical school graduate or employee or ex-employee, Ufberg said.
The Association of American Medical Colleges didn't have immediate information on other schools employing community members. No other colleges in the Philadelphia region that responded to a query said they currently incorporated them, or did so in the same way as Temple.
"The idea is on our radar for future consideration," said Drexel University spokesperson Niki Gianakaris.
Pennsylvania State University's College of Medicine said it began including community members from the Hershey area several years ago: A cancer survivor and someone who previously acted as a patient for medical student practice currently serve.
Temple has one of the most diverse medical student bodies in the country — U.S. News & World Report ranked it tied for No. 6 this year. Nearly 10,400 students applied to the medical school last year, with 467 accepted to fill about 220 spots. Of those who enrolled, 66 were from underrepresented groups.
The students end up learning inside Temple's hospital, which serves many patients of color and low-income families. In 2022, 86% of Temple Hospital patients had government health insurance, either Medicare or Medicaid, according to a hospital report. Two-thirds of those who live in the hospital's service area are Black and Hispanic, and the median household income is $35,405.
Gail Loney, a block captain in the 2200 block of North Lambert Street and a longtime North Philadelphia resident, said she likes that Temple sought to involve the local community in medical school admissions, but said Temple should have reached out in a broader way through fliers and social media to announce the approach and seek volunteers. She said she knew nothing about it.
"They always talk about engaging the community, but there is a large portion of the community that never knows anything about what they are engaging the community in," said Loney, 61.
As for Temple Hospital, she said she would never go there again after the way she was treated during a late-night trip to the ER. She was discharged within hours, she said, and had to go to Thomas Jefferson University Hospital, where she was admitted and kept for a week to be treated for pneumonia.
Goldberg and Ufberg said they haven't observed problems with the way their medical students treat patients, but acknowledged that community members have preferences.
"They definitely feel differences between providers, and their comfort levels are different based on the way they are interacted with," said Ufberg, whose specialty is emergency medicine.
Lyde, a graduate of Masterman, a prestigious Philadelphia magnet, also got his bachelor's from Temple in cellular molecular neuroscience, then went to the University of Pennsylvania for a doctorate in biomedical pharmacology. He then returned to Temple for medical school because of its deep community ties.
But as good as Temple was, he said, he thought it could get better. About three years ago, he and another student started having lunch with deans to talk about areas for improvement. While the school was receptive, students saw a better chance of their ideas being implemented if they formed a group that would continue after some of them graduated, said Lyde, who just entered his residency at the University of Pittsburgh Medical Center.
The diversity council, including about 60 students from underrepresented groups and their allies, was formed. The council sought more scholarship funds for underrepresented students, money for community service projects, and curriculum changes to omit bias, he said. Students, who are getting paid for their work, have been going through the curriculum and recommending changes.
"They may have said this disease is more prevalent in this group of people but never talked about economic factors or food deserts," explained Sidnei Newman, 28, a third-year medical student from Wilmington and new council chair. "We wanted to give more context.
"The worst thing we could do is send students across the street believing all Black people have diabetes without understanding there are other factors that go into that statistic."
The council also issued the recommendation about community members. It tapped Temple's Center for Urban Bioethics, which already had long-standing relationships with community nonprofits, to find potential members.
Montes and other community members received interview training, and for about seven months participated in virtual interviews with candidates that took about four hours a week. Montes asked prospective students why they chose Temple, what community means to them, and what they would say to her or a family member about to die soon.
She said she found the vast majority acceptable and about 10% to 15% exceptionally good.
"There were a very few times that I was like, 'Absolutely not,'" she said. Arrogance especially turned her off. One fellow interviewer was particularly upset after a candidate exhibited extreme bias, she said.
But she also found it refreshing when some candidates acknowledged they had been called out for biases and welcomed it. She particularly liked a candidate in the military who had a strong sense of service, but found another candidate's answers too "perfect," almost rehearsed.
"Practicing medicine is a matter of being an expert but also having some of the emotional intelligence that is necessary for working with people," she said. "You can give someone a medication, but if you treat them like crap, the medicine may take the pain, but the damage that you done did in their brain, how do you get over that?"
Ufberg, who is a nonvoting committee member, said when community members strongly objected to candidates, they were not accepted.
In surveys, community members, admission committee participants, and medical school candidates were overwhelmingly positive about the experience, Temple said. About 90% of candidates who completed a survey said the community interviewer added value to their experience and helped them better understand the school.
"Hopefully, it helped the right students choose us as much as it helped us choose the right students," Ufberg said.
Newman, the new council president, said she's ready to continue the work.
"I feel like Temple is setting a trend," she said, "and setting a standard that if we are going to be in these communities, we have to value them and respect them."
