minority medical mentoring programsys.mahec.net/media/brochures/2016-17 mmmp...

Minority Medical Mentoring Program

November 2, 2015

Dear Counselors and Educators:

The Minority Medical Mentoring Program (MMMP) will be awarding internships

for the 2016-17 academic school year to 4-6 minority high school seniors that are

enrolled in a high school located in Buncombe County. The program is designed for

students who are participating in a school-sanctioned internship program. The

Minority Medical Mentoring Program (MMMP) began in the fall of 2005 as an

internship for under-represented minority students who had an interest in practicing

medicine. Today, the program pairs minority high school students with physicians,

pharmacists, dentists, physical therapists, physician assistants and other health care

providers practicing in Buncombe County.

To be eligible for this internship, students must have a minimum weighted grade point

average of 3.0, qualify as an underrepresented minority, and have a strong desire to

pursue a career as a dentist, pharmacist, physician, physician assistant or physical

therapist, have an active record of work and/or community service and access to

reliable transportation.

If you have students who are interested in pursuing one of the above-mentioned

careers and may be interested in this program, please share the enclosed information.

We are looking for students who are excited about a career in health care, are mature,

responsible and focused, need minimal supervision, must be dependable, practice good

oral and written communication skills, and have an excellent attitude and personality.

This program is a collaborative effort of the Asheville-Buncombe Institute of Parity

Achievement (ABIPA), the Mountain Area Health Education Center (MAHEC),

Mission Health and the Western Carolina Medical Society (WCMS). Thanks to the

tremendous efforts of our program preceptors and mentors, we have forty-four (44)

program completers since the program began in 2005. We have 2 students enrolled in

PH.D programs at Chapel Hill & Emory, 2 students in medical school; Harvard and

UNC Chapel Hill, 1 graduate with a Master’s degree, 3 students enrolled in Masters

level programs, 1 graduate from West Point that is now a Tank Commander, 16

college graduates with 13 still on the health career track and 31 enrolled in 4 year

college programs. We hope that by giving students this unique experience, they will

eventually come back to practice in WNC. At present, we have seven (7) outstanding

interns enrolled for the 2015-16 academic school year. The MMMP brochure is

enclosed for additional information. Applications may be downloaded from the

MAHEC website: www.mahec.net.

The deadline for submission of this application is Friday, December 11, 2015. If you

have any additional questions, please contact: Jacquelyn Hallum, Program Director at

[email protected] or 828-257-4479.

Thank you,

Jacquelyn Hallum, MBA, MHA

Director, Health Careers and Diversity Education

MMMP

Steering Committee

Bill Mance

Calvin Gardner

Erika Germer

Francisco Castelblanco

Je'wana Grier-McEachin

Keynon Lake

Laura Misner

Leslie Council

Miriam Schwarz

Rebecca Bernstein, MD

Staff

Jacquelyn Hallum

Kirstie Thompson

Collaborating Agencies:

http://www.mahec.net/

mailto:[email protected]

Revised: 2015-10-28 2


A Collaboration of:

Asheville-Buncombe Institute of Parity Achievement (ABIPA)

Mission Health

Mountain Area Health Education Center (MAHEC)

Western Carolina Medical Society (WCMS)

Application Deadline (application must be received by):

Friday, December 11, 2015

Mail or deliver completed application packet to:

MAHEC


Health Careers and Diversity Education

121 Hendersonville Road

Asheville, NC 28803

Revised: 2015-10-28 3

History and Overview

The Minority Medical Mentoring Program (MMMP) began in the fall of 2005 as an internship

for under-represented minority high school students who had an interest in practicing medicine.

This program was replicated from a similar program in Florida for African-American students.

The Asheville program targeted African-American students the first few years and then was

expanded to Hispanic/Latino students in 2009 and is now an inclusive program for all

underrepresented minorities. The program started as collaboration with the late Dr. John P. Holt,

Dr. Albert Anderson, MAHEC (Jacquelyn Hallum), Mission Hospital (Bill Mance & Sharon

K.West), and the Western Carolina Medical Society (then Buncombe County Medical Society)

Alan McKenzie.

Today, the program pairs minority high school students with a diversity of health professionals

in Buncombe County. This program is designed for high school seniors who have a serious

interest in becoming a dentist, pharmacist, physician, physician assistant or physical therapist.

MMMP is open to students who are participating in a school-sanctioned internship for course

credit through Asheville City or Buncombe County Schools. The program provides a minimum

of 135 intern hours for one semester. Out of the 974 physicians actively practicing medicine in

Buncombe County; only two percent (2%) are underrepresented minorities “self-reporting” The

latest numbers are seven African Americans (0.72%), eight Indian (.82%), two Vietnamese

(0.21%), one Latino (0.10%), one Korean (0.10%) and one Asian/Pacific Islander (10%). -

Western Carolina Medical Society physician database, May 29, 2013

Student interns are exposed to a variety of healthcare fields such as cardiology, dentistry

dermatology, emergency medicine, family medicine, geriatrics, internal medicine, ob/gyn,

optometry, palliative care, pharmacy, physical therapy, and public health, to name a few. The

rotations will take place in clinics, hospitals, private practices, education centers, resident

didactics, Grand Rounds and MAHEC’s Library and Knowledge Services. In addition to

scheduled rotations, students may use internship hours to participate on ABIPA Action Teams,

MAHEC health career programs for academic enrichment, college planning, and conferences

and service learning opportunities. Each student is also assigned a leadership mentor who

provides guidance and coaching during the internship.

The program begins with a week-long orientation with topics addressing:

Confidentiality

Diversity

Health Information Portability and Accountability Act (HIPAA)

MAHEC Library and Knowledge Services

Mission Health and MAHEC facilities tour

Occupational Safety and Health Administration (OSHA)

Personal attitude and presentation

Professional Etiquette

Workplace etiquette and practices

Folic Acid Training

MMMP INTERNSHIP

Mountain Area Health

Education Center

Revised: 2015-10-28 4

Goals

Students will have an impact on health disparities in Western North Carolina.

Increase the numbers of underrepresented minorities training and practicing in WNC.

Enhanced the quality of care as a result of increased workforce diversity.

Increased levels of health parity for people of color in WNC.

Outcomes:

As of June 2015:

MMMP will have 51 program completers.

o 2 students enrolled in PH.D programs at Chapel Hill and Emory

o 2 in medical school at Harvard and UNC Chapel Hill

o 3 graduates with Masters level degree

o 3 students enrolled in Masters level programs

o 1 graduate from West Point and is now a Tank Commander

o 16 college undergraduates

o 31 enrolled in 4 year college programs

o 1 students enrolled in community college

o 6 community college graduates

o 2 students dropped out of undergrad and future plans unknown

o 43 students in health-related curriculums and/or work-related fields

We hope that by giving students this unique experience, they will eventually come back to

practice in WNC. At present, we have seven (7) outstanding interns enrolled for the 2015-16

academic school year. The MMMP brochure is enclosed for additional information.

According to the Executive Summary of the 2004 release of the Sullivan Report, there is a dire

need to increase minority representation in healthcare. Diversity in healthcare is imperative

because “the cultural challenges posed by a shifting patient demographic can best be addressed

by health professionals educated and trained in a culturally dynamic environment.”

(http://www.jointcenter.org/healthpolicy/docs/SullivanExecutiveSummary.pdf). We hope that by

giving students this unique experience, they will eventually come back to practice in Western

North Carolina and that we as a community are taking positive steps toward achieving health

parity in Buncombe County.

THE EXPERIENCE: Student interns are scheduled weekly rotations with participating physicians, pharmacists, dentists,

physical therapists, physician assistants and other health care practitioners in Buncombe County. Student

are exposed to a variety of health related disciplines such as, Anesthesiology, Cardiology, Chinese

Medical Arts, Dentistry, Dermatology, Diabetes Management, Ear, Head, Nose & Throat, Emergency

Medicine, Family Medicine, Genetics, Geriatrics, Integrative Medicine, Internal Medicine, Memory Care,

Obstetrics and Gynecology, Oncology, Ophthalmology, Optometry, Palliative Care, Pediatrics,

Pharmacotherapy, Physical Medicine, Public Health, Radiology, Sleep Lab, Social Work, Sports

Medicine, Traumatic Surgery, and more.. The rotations will take place in clinics, hospitals, private

practices, education centers, resident didactics, Grand Rounds and MAHEC’s Library and Knowledge

Services. In addition to scheduled rotations, students may use internship hours to participate on ABIPA

Action Teams, MAHEC’s health career programs that include academic enrichment, college preparation,

conferences, service learning opportunities, public speaking, leadership and presentation skills. Each

student is also assigned a leadership mentor who provides guidance and coaching during the internship.

MMMP INTERNSHIP

http://www.jointcenter.org/healthpolicy/docs/SullivanExecutiveSummary.pdf

Revised: 2015-10-28 5

An 18-hour student orientation includes program overview and expectations, training on the Health

Information Portability and Accountability Act (HIPAA), Occupational Safety and Health Administration

(OSHA), diversity and workplace etiquette, group project requirements, internship grading rubric, folic

acid training, building tours & orientation to MAHEC Library and Knowledge Services and facility tours.

INTERNSHIP SCHEDULE: Students wishing to participate in MMMP should enroll in their

school’s internship program for the last period of the day and the last available lunch. This will enable the

student to have a rotation schedule from 2:30–4:30 pm.

LIABILITY INSURANCE: Students enrolled in the internship program are covered under their

school’s liability coverage. Verification of the school’s liability coverage must be provided to MAHEC

prior to the start of the program.

Eligibility Requirements

Underrepresented Minority

o American Indian or Alaskan Native

o Asian Underrepresented (Bangladeshi, Cambodian, Hmong, Indonesian, Laotian,

Malaysian, Nepalese, Pakistani, Sri Lankan and Vietnamese)

o Black or African American

o Hispanic or Latino

o Native Hawaiian or Other Pacific Islander

Rising high school senior enrolled in a high school located in Buncombe County

Strong desire to pursue a career as a physician, pharmacist, physical therapist, physician

assistant or dentist

Minimum weighted grade point average of 3.0

Excellent references, based on teacher recommendation

Active record of work and/or community service

Access to reliable transportation

Completion of all health requirements

MMMP INTERNSHIP

Revised: 2015-10-28 6

Must have access to reliable transportation

All information will be held in strictest confidentiality.

Please type or print your responses attaching additional pages as necessary.

Student Application Form

Student Name: ________________________________________________________________

For internal use only

Date received: __________________________________

Please select the semester in which you would like to participate in the internship program:

Fall 2016 Spring 2017

Student Information:

________________________________ _________________________ _______________ ________________

Last name First name Middle name Nickname

_________________________________ _______________ ____________ ___________ __________________

Street address/P. O. Box City State Zip code County

Race: Black or African American More Than One Race American Indian or Alaskan Native

Native Hawaiian or Other Pacific Islander Asian Underrepresented (Bangladeshi, Cambodian, Hmong, Indonesian,

Laotian, Malaysian, Nepalese, Pakistani, Sri Lankan and Vietnamese): please specify: _____________________________________

Ethnicity: Hispanic Non-Hispanic

Gender: ____________ Date of Birth: _______________ Last 4 digits of SSN: _______________

Graduation year: ________ Home telephone number: (____) _____-______Cell: (____) _____-________

Email address: _______________________________________________________________________

________________________________ _____________________ (______)________-________

Name of school City School Telephone number

_____________________________ _____________________________ (______)________-________

Parent/Guardian name Place of work Work Telephone number

_____________________________ _____________________________ (______)________-________

Parent/Guardian name Place of work Work telephone number

Parent/Guardian Email: ____________________________ Evening/cell phone: _________________

___________________ (______) _______-__________

Name of school official who recommended you (Please print) Telephone number

SIGNATURES:

I am in full support of _______________________________ participating in the MMMP Internship.

(Name of student)

Student Signature ______________________________________________ Date _____________

Parent Signature ________________________________________________ Date ______________

Parent Signature _______________________________________________ Date ______________

MMMP INTERNSHIP

Revised: 2015-10-28 7

Student Application Form: Page 2

Please type or print your responses attaching additional pages as necessary.

Student name: _______________________________________

PERSONAL STATEMENT OF CAREER GOALS (250 words or less): Describe in detail

your interest in the Minority Medical Mentoring Program. Include your educational and career goals.

Leadership Roles, Community Service, Employment, Extracurricular

Activities, Awards/Honors List all awards, honors, community and school activities in which you have participated including beginning

and end dates and number of hours of participation. Attach an additional sheet if necessary. Include sports,

student government, volunteer projects, paid employment, and other activities you believe helped you to grow

and contribute during your time as a high school student. Please note those activities that you are currently

involved in.

LEADERSHIP

Do you have any Leadership roles to list? Yes: _____ No: _____, If no, please explain why

Leadership Information (most recent):

Begin Date: _________ End Date: _________ Organization: _______________________

Occupation or Title: ____________________ Description of Activities: _______________________

Leadership Information:



Leadership Information:



Please list others on a separate sheet of paper

MMMP INTERNSHIP

Revised: 2015-10-28 8

COMMUNITY SERVICE

Do you have any unpaid volunteer work or community activities to list?

Yes: _____ No: _____, If no, please explain why

Community Service Detail Information (most recent):

Dates: _______________________________________________________________________________

Name of Organization: ___________________________________________________________________

Total Number of Hours: ___________________ Description of Activities: _________________________


Dates: _______________________________________________________________________________




Dates: _______________________________________________________________________________




EMPLOYMENT

Do you have any paid employment to list? Yes _____ No _____

Employment Information

Dates: ____________________________________________

Employer: ___________________________________________________________________________

Number of hours: __________________________________ Weekly: _____ Monthly: _____

Description of duties: _____________________________________________________________________


Dates: ____________________________________________

Employer: ___________________________________________________________________________


Description of duties: _____________________________________________________________________

Revised: 2015-10-28 9


Dates: ____________________________________________

Employer: ___________________________________________________________________________


Description of duties: ______________________________________________________________________


List of Extracurricular Activities:

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

Lists of Awards/Honors:

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________

______________________________________________________ Date: _______________________


Self Assessment Please complete the below assessment evaluating yourself on the following traits.

Excellent: 5 Good: 4 Average: 3 Fair: 2 Poor: 1

Communication Skills

Leadership Ability

Attendance / Punctuality

Quality of Work

Time Management

Organizational Skills

Writing Skills

Initiative

Professional Conduct

Self-Confidence

Maturity / Judgement

Creativity

Revised: 2015-10-28 10

Student Recommendation Form

Student name: _______________________________________________________________

1. I have known the applicant for a period of _____________________ in the following capacity:

2. Student Grade Point Average: _________

3. Please evaluate the applicant on the following traits:

No

Basis

Excellent

5

Good

4

Average

3

Fair

2

Poor

1 Comments


Leadership Ability


Quality of Work

Time Management


Writing Skills

Initiative


Self-Confidence


Creativity

Additional characteristics and considerations: (Please use other side if needed)

I recommend this student: with reservation fairly strongly strongly enthusiastically

Name of recommender: ________________________________________________________________________ (Please print)

Title: _________________________________________________ Phone: _______________________________

School: _____________________________________________________________________________________

Email: ______________________________________________________ Date: ___________________________

Signature, verifying GPA and above information: __________________________________________________

MMMP INTERNSHIP

Revised: 2015-10-28 11

Student Recommendation Form

Student name: _______________________________________________________________

4. I have known the applicant for a period of _____________________ in the following capacity:

5. Student Grade Point Average: _________

6. Please evaluate the applicant on the following traits:

No

Basis

Excellent

5

Good

4

Average

3

Fair

2

Poor

1 Comments


Leadership Ability


Quality of Work

Time Management


Writing Skills

Initiative


Self-Confidence


Creativity

Additional characteristics and considerations: (Please use other side if needed)

I recommend this student: with reservation fairly strongly strongly enthusiastically

Name of recommender: ________________________________________________________________________ (Please print)

Title: _________________________________________________ Phone: _______________________________

School: _____________________________________________________________________________________

Email: ______________________________________________________ Date: ___________________________

Signature, verifying GPA and above information: __________________________________________________

MMMP INTERNSHIP

Revised: 2015-10-28 12

THIS PAGE IS FOR YOUR REFERENCE ONLY – DO NOT SUBMIT

Please verify that you have enclosed all the items listed below. Incomplete applications will

not be considered.

Minimum weighted grade point average of 3.0

Submit original application packet and three copies

Official high school transcript that includes weighted GPA/class rank

Two Student Recommendation Forms (sealed) enclosed with

completed application packet

Please provide a recent wallet size photo

Resume listing your work and/or community service activities

NOTE: As a condition of participation, Students are required to have the following

immunizations and tests:

a tetanus booster within the past ten (10) years;

a measles vaccination (if Participant was born after 1957);

a rubella immunization (unless Participant provides serologic confirmation

of immunity);

a mumps immunization (unless Participant provides serologic

confirmation of immunity);

an intradermal, protein-derivative-type tuberculin skin test within the past

twelve (12) months (unless Participant is known to have an allergic or

positive reaction to same, in which case a chest X-ray is required);

a Hepatitis B vaccination series (unless Participant signs an appropriate

declination form);

a varicella immunization (unless Participant provides serologic

confirmation of immunity); and

influenza vaccination(s).

Prior to commencing the MMMP clinical experience, students must complete and submit

a urine drug screen (minimum drug screening requirements include testing completed at a

CAP or SAMSHA certified lab using a nine (9) panel test including marijuana, cocaine,

methamphetamines, benzodiazepines, PCPphencyclidine, opiates, methadone, arbiturates,

and propoxyphene.)

Requirements Checklist

MMMP INTERNSHIP

Revised: 2015-10-28 13

Questions? Contact Jacquelyn Hallum, Program Director

828 257-4479 or email: [email protected] or Kirstie Conner, Program

Specialist at (828) 257-4461 or [email protected]

Mail or deliver completed application packet and three

additional copies to:


MAHEC Health Careers and Diversity Education

121 Hendersonville Road

Asheville, NC 28803

The application packet and recommendations must be

received on or before December 11, 2015 by 5:00pm



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