Centerville, Ohio-based Premier Health and Premier Orthopedics have launched an orthopedic externship program for minority and female high school students.
Premier Health is Southwest Ohio’s largest comprehensive health system. It is a network of hospitals, medical organizations, and physicians. Premier Orthopedics is an orthopedic and sports medicine group with approximately 30 doctors and more than 12 locations.
This is the first year that the health system has offered the weeklong externship program to Dayton Public Schools students. OTW spoke with Michael Herbenick, M.D., a board-certified and fellowship-trained orthopedic surgeon at Premier Orthopedics, about the program. OTW also received feedback from the program’s two student participants.
Bridging the Gap
Diversity is not something that is seen in orthopedics. Despite the efforts of many different groups and the growing diversity among medical students, orthopedics is lagging. Orthopedic surgery continues to be a specialty where minorities and women are underrepresented.
There are many steps that the orthopedic community can take to address this gap in representation. Exposing students at a young age to foster an interest in orthopedics is one such step. In the press release on the program, Dr. Herbenick explained, “Developing this program has been something I’ve always wanted to do. Patients want to be seen by someone who looks like them, talks like them, and acts like them. This program’s goal is to bridge that gap and introduce more minorities and females to medicine.”
During its first year, the program focused on reaching local students with an expressed interest in medicine. Dr. Herbenick explained that the program would not have been possible without the help of its faculty partner in the Dayton Public School system, Christina Harsch, Ph.D. Dr. Harsch helped with student selection as well as with coordinating transportation for the students.
Dr. Herbenick told OTW, “Our contact with Dayton Public Schools helped coordinate our inaugural class and select the students with us ahead of time. They are part of a science and health care interest group at their school that Dr. Harsch coordinates. We wanted to start small and make sure we were doing it right and meeting the needs of the students.”
A Learning Curve
It is easy for physicians to forget how intimidated most people are by the practice of medicine. Even for students with an expressed interest in science and health care, an immersive week with orthopedists can still be overwhelming.
During the initial launch of the externship, the team at Premier Health and Premier Orthopedics was reminded of how the practice of medicine can appear intimidating. Dr. Herbenick explained to OTW, “We initially had six kids from Dayton Public Schools signed up for the program, but only two completed the program. As we got closer to the time of the program several kids backed out and, from what we learned, they were very nervous about spending a week with us. I didn’t realize how intimidating the thought of the experience might be for a high school student.”
Looking forward, Dr. Herbenick hopes to learn from the program’s rough introduction. He told OTW, “It was our first year for the program and I think that we could have done a better job of reaching out to the students ahead of time with a demonstration of what to expect prior to the week with us. Meeting us ahead of time would have made them more comfortable and the feedback from our students after the program was invaluable. We will have an introductory experience before the next summer session and hopefully that will allow the students to feel more comfortable.”
The team also plans to utilize program veterans to combat some of the challenges it experienced during its initial launch. Dr. Herbenick informed OTW, “Our two students we had in the program committed to coming back and serving as student mentors in the future as well, which I think will help make incoming students more comfortable.”
The Immersive Experience
Externships are all about learning from doing. The weeklong externship at Miami Valley Hospital South provided the two student participants with an immersive orthopedic experience. The program simulated the experience of a medical student or resident surgeon while also taking into account the students’ age and education. Through the externship, students were exposed to every aspect of orthopedic surgical practice, from office visits to surgery.
Dr. Herbenick described to OTW how the students spent their week, stating “The students saw arthroscopic shoulder labral repairs, arthroscopic rotator cuff repairs, a distal biceps tendon repair, total knee and hip arthroplasty, spinal fusion, and some hand surgery procedures. We used our time in the mornings during the week to observe physician mentors seeing patients and surgical cases that were done at the surgery center.”
Dr. Herbenick continued, “To get them comfortable at the beginning of the week, we created a number of skills labs for them. We spent an entire Monday getting them oriented on how to scrub their hands, how to gown and glove for a surgical procedure, instruction on proper sterile technique, how to use some of the basic instruments we use, what we do to sterilize surgical instruments. We did a casting and splinting lab, a wound suturing lab, an ultrasound lab and injection introductory lab, discussed the history of orthopedics, introduced our physical therapy department to them and had them observe some of our physical therapists and sports acceleration program strength and conditioning providers.”
The students had full days. After their office observations in the morning, the students moved on to surgical simulation labs. Dr. Herbenick told OTW, “Each of our surgical simulation labs were in the afternoons. We performed an arthroscopic simulation lab, saw bones trauma lab, total hip arthroplasty and total shoulder arthroplasty labs. The students had their hands on all the instruments that we use during the actual procedures and were able to complete the procedures on saw bones models. We taught them as if they were our medical student or resident surgeon trainees.”
Student Focused
Dr. Herbenick emphasized during our discussion that the program was student focused. The goal is to create a program that meets the needs of the students, both now and in the future. Since the program is a first for the health system, feedback was incorporated into the experience.
Dr. Herbenick said to OTW, “Each afternoon we had a 15-minute debriefing session for them [the students] to find out what worked and what didn’t work for them during the education process. It was a truly immersive experience in the world of orthopedics, and they were fabulous students.”
Student Feedback
When their teachers ask how they spent their summer, only two Dayton Public School students will be able to boast of scrubbing, gowning, and gloving. Luckily, OTW didn’t have to wait for a back-to-school essay to find out what the students thought about the program.
The two student participants issued a joint statement to OTW, stating, “We are very grateful for the opportunity to explore the many different aspects of the orthopedic career field. Being allowed to shadow the professionals of Premier Orthopedics opened our eyes to a profession we had not been exposed to. This truly was a blessed opportunity opening our minds to consider a field that really helps people, but not many city kids are privy to. From learning how to suture, to practicing joint replacements and arthroscopy on various bone models, and even being inside the operating room to see everything we’ve learned be put into practice.”
The two students continued, “We also learned how patient visits were conducted as well and the necessary charisma and hospitality that comes with them. The doctors we shadowed, and the overall atmosphere of the hospital were very welcoming and encouraging. We appreciate the time and efforts expended by all involved that assisted in this experience and would highly recommend it to all those without prior medical knowledge or are even slightly curious.”
Looking Forward
In less than a year, Premier Health and Premier Orthopedics will offer its second orthopedic externship for high school students. Students are already counting down the days until the program begins. Dr. Herbenick commented to OTW, “We already have interest from 10 students for our program next year since the press release.”
Looking forward, the health system hopes to expand the reach of the program. Dr. Herbenick told OTW, “We plan on continuing to expand the program and impact as many students as we can. We have several other hospital sites in our system that would like to be involved, a dedicated group of faculty members, and eventually we look to expand the program. We know there is a large disparity of minorities and women in orthopedics, and we will continue to change that in our community and hopefully be a catalyst to change this throughout the country.”
If readers know of any high school students in the area who may be interested in the program, encourage them to apply. The selection process for next summer will be more interactive. Dr. Herbenick explained to OTW, “This year we will have a more formal application process that will start this spring. We have asked all interested students to send me an email and we will give them a sample itinerary of the program and keep in touch with those who expressed interest when the application process begins.” Interested students can reach Dr. Herbenick at maherbenick@premierhealth.com.
