At the University of Michigan Medical School, third- and fourth-year students have flexibility to schedule a variety of clinical and non-clinical electives for both in-person and online formats. This unique curricular framework, better known as "the branches," is designed around lifelong learning.

"During this portion of their educational training, we aspire to provide our students with the skills to become leaders in the health of society and have a broad impact on our world," said Michael Englesbe, M.D., who previously served as the branch director at U-M Medical School. "We teach our aspiring physicians how to understand and apply science, as well as how to educate, innovate, be a leader, communicate, ask questions, and inspire patients, as well as other people."

The branches consist of three distinct phases, which are referred to as discovery, focus and finishing.

In the discovery phase, students have access to over 150 exploratory electives designed around defining their career pathways. These two- to four-week blocks can be clinical, non-clinical or research-related. Students can also individually arrange electives to match their specific interests within this phase or later, as they continue in the branches.

The U-M Medical School defines the focus phase of their students' education as an intense clinical time where most of their core clinical course requirements are met. And the finishing phase is a time for students to continue taking electives, while interviewing for residency programs, refining their skills as future doctors and completing their Capstone for Impact projects.

But when it comes to medical education, what kind of electives does the U-M Medical School offer and are they unique? Here, three former and current medical students offer a snapshot of the electives they created themselves.

Pride in practice: enhancing LGBTQIA+ health education

According to fourth-year medical students Anuj Patel and Hannah Glick, LGBTQIA+ people face several challenges in everyday life, including many health disparities.

"On average, LGBTQIA+ people have higher rates of chronic diseases, as well as poor physical and mental health when compared to cisgender and/or straight people," said Patel. "In addition, micro and macro aggressions when seeing a doctor are all too common for individuals within this community, whether it be in the form of non-inclusive intake forms, insensitive history-taking or physical exams given by physicians."

Both Patel and Glick are members of the LGBTQIA+ community and became acutely aware of these health disparities when they began medical school.

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"We became resolved to learn more about these inequities from our patients and our curriculum and wanted to both seek and create methods to combat them," said Glick. "In our first year of medical school, both of us were immensely grateful to have had the opportunity to serve on the leadership team for OutMD, U-M's LGBTQIA+ medical student group. Throughout our gatherings and monthly lunch talks, OutMD helped us learn about a number of topics within LGBTQIA+ health, including transgender hormonal care, health policy and primary care."

As a part of a collaboration with the Indiana University School of Medicine and OutCare Health, Patel and Glick conducted a research project on LGTQIA+ health medical education. They found that medical students need as many as 35 hours of curricular education in order to ensure high levels of LGBTQIA+ cultural humility in patient care. However, students at U-M Medical School were receiving fewer hours than this benchmark at the time.

"While completing the branches, we set a goal to create a new two-week, fully online introduction to LGBTQIA+ health elective for students to participate in during their third and fourth years of medical education," said Patel. "We are lucky to be surrounded by talented and supportive faculty like Julie Blaszczak, M.D., who is an expert in LGBTQIA+ health. She really has been instrumental in us getting this project off the ground."

Glick said that they hope this new course will conveniently offer their peers a "broad, comprehensive introduction to LGBTQIA+ health care." 

"The idea is to educate others through a number of modules that cover important things like basic background, language, health disparities, clinical skills and specialty topics in the care of LGBTQIA+ patients," she said. "And we are incredibly excited and grateful to have had the time and the support to incorporate our passion for LGBTQIA+ health into the curriculum at U-M Medical School. This elective will leave an important and lasting impact on our school and is a critical step in creating a new generation of physicians."

A new frontier: space medicine

Recent U-M Medical School graduate, Taania Girgla, always dreamed about contributing to the advancement of the space frontier as a child.

"I naively believed that I had to pursue a career in engineering to make this dream a reality," said Girgla. "But when I was accepted to the U-M Medical School in 2017, I became committed to making a career for myself in space medicine. It was also important to me to bring it to my school and my peers."

Girgla immersed herself in the field and attended the Red Risk School webinar series as a first-year medical student, which was how she learned about the Aerospace Medicine Association's meeting the following month.

"After that, I slowly but surely began to reach out to faculty who could mentor me in this area of interest," she said. "It took me a while to collate a list of names, as this is quite a niche field, but everyone I spoke to was immensely supportive of my interest and also, with helping me further develop it."

Eventually, Girgla led the development of a two-week online and self-paced introduction to space medicine elective for medical students completing the branches. The course launched in January of 2021.

"The aim of this course is to create an online curriculum that informs students about the field and principles of space medicine," she said. "The goal is to inspire students to engage with and contribute to the ongoing efforts within the field of space medicine, while exploring the possibilities of building a niche in this area for future careers. Ultimately, this will help create the next generation of leaders in space medicine."

Girgla notes that she developed this course with the help of a six-student team (across three different medical schools), as well as James Bagian, M.D., who is a former NASA astronaut and current research professor at the U-M Medical School.

"I owe a lot to my team for helping make my vision a reality," she said. "My partner in crime and peer, Riley Ferguson, also arranged for this course to launch at her medical school, the University of Cincinnati College of Medicine, and that's really rewarding to see."

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