Alex Miner, a third-year student at the Virginia Tech Carilion School of Medicine, has spent the summer working under a prestigious Gold Student Summer Fellowship to follow her passions relating to neuroscience and international health. The grant is one of only 10 awarded nationally by the Gold Foundation to medical students to complete a research or service project related to community health.

“Psychiatric and neurological concerns are underreported, underaddressed, and more difficult to manage in populations such as refugees and immigrants who may be less comfortable discussing their health care needs within a predominantly English-functioning health care system,” Miner said. “This is due to factors such as language-based assessments, lack of access to care, inadequate translation services, and cultural stigma associated with seeking care.”

Miner’s project, under the mentorship of Cynthia Morrow, a physician, public health expert, and co-leader of the school’s Health Systems Sciences Domain, will shine light on specific patient, provider, and resource-based variables contributing to mental health inequities and develop interventions for patients with limited-English proficiency at the Bradley Free Clinic in Roanoke. The free clinic is open to low-income, uninsured, or underinsured residents who come seeking care for illnesses, minor injuries, and ongoing medical conditions and has recently been working to serve more Spanish-speaking patients.

Reliable access to care and timely follow-up have been shown to improve outcomes for uninsured and underserved patient populations, particularly for psychiatric and neurological conditions.

“It’s often difficult for people to talk about their neurological or psychiatric struggles,” Miner said. “And for patients who also have to navigate translation services in order to receive care, or are from communities that don’t traditionally consider these issues to be health care priorities, there is a whole additional set of barriers.”

Miner has been recruiting patients to participate throughout the summer and will be reporting her preliminary results next month with the hope of continuing outreach and volunteer efforts throughout the year.

Through collaboration with the psychiatry, neurology, and neurosurgery departments at Carilion Clinic, Miner conducted assessment interviews with patients who reported preferred languages other than English to hear about their health care journeys and unique experiences with psychiatric and neurological conditions. The project also involved working with the Bradley Free Clinic, the emergency department at Carilion Roanoke Memorial Hospital, and her fellow students who are members of the International Health Clinic to establish case management services for similar patients who don’t have a place to receive neuropsychiatric care.

Miner served last year as one of the leaders of the International Health Clinic, a student group dedicated to connecting international and/or underserved patient populations with health resources in the community. The group was involved with setting up a pipeline for Spanish-speaking patients between the emergency department and the clinic, ultimately leading to a designated evening each month for these patients. Noticing the frequency of psychiatric and neurological chief complaints and the added complexity of the care required for such patients was what prompted her to pursue the fellowship project.

“The long-term goal of this project is to create lasting change in the community through expansion of free clinic resources and development of meaningful education and service opportunities for students,” she said. “Ultimately, I hope we can develop an official psych-neuro branch of the clinic that can see a subset of patients on a regular basis to provide more specialized care.”

Miner is quick to acknowledge her fellow students who are involved in the International Health Clinic: Macy Marcucci, Madeline D’Aquila, Vemmy Metsutnan, Riya Patel, Ilona Jileaeva, Devra Asah, Abhishek Bhutada, and Martin Barylak.

“This project has the potential to give medical students a chance they might not otherwise have in their regular clinical curriculum to work with a more diverse patient population,” Miner said. “I’m excited to look more closely at how language, culture, and demographics influence psychiatric and neurological care, and I know this experience will help me better envision how I can integrate interdisciplinary community service into my future career and continue to become a more understanding and compassionate physician.”

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