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Vital Signs

Students learn to lobby between classes

By Jennifer Durgin

The furthest most busy young doctors or doctors-to-be get in advocating for public health policy is the voting booth. But the members of a DMS student group have gotten to the state capitals of Vermont and New Hampshire and even to Washington, D.C.

Chaired by second-year M.D. student Robert Lampman, a once-dormant committee of the student government has become one of its most active. Known as the Public Health Policy Advocacy Committee (PHPAC, pronounced "P-H- pack"), the organization has two goals, says Lampman. "The point of the organization is not just to try to get medical students to be active right now, but to try to get people interested and comfortable to be active later on, wherever they go," he says.

In the past year and a half, through PHPAC, DMS students have traveled to Washington, D.C., to lobby for increasing the National Cancer Institute's budget; met with local representatives to learn about the legislative process; spoken to New Hampshire legislators about raising the tax on cigarettes; attended health-care policy forums in Burlington and Barre, Vt.; and participated in advocacy training workshops. PHPAC has also hosted a series of lunchtime talks with faculty from DMS's Center for the Evaluative Clinical Sciences, which studies health policy questions.

Teaching medical students how to advocate for better health policy "hasn't been a big agenda in medical schools," says Dr. Joseph O'Donnell, senior

Joe O'Donnell, left, looks to get medical students like Rob Lampman, right, engaged in advocating for health policy.

advising dean at DMS. "Most of the time at medical schools," adds O'Donnell, who recruited Lampman to chair PHPAC, "you educate not at the policy level but at the one-on-one patient level."

Activism: While nearly all DMS students are involved in some form of community service, few, until PHPAC's revival, were involved in health policy advocacy. Perhaps that's because "it's a different kind of activism," says Lampman of getting involved in the political process. Now, however, PHPAC has an e-mail list of 50 students and its events are well attended. For example, about 30 students

came to a PHPAC-sponsored talk by a representative of the Children's Alliance of New Hampshire. Lampman says he is drawn to public policy for the same reason that he is drawn to medicine. "You just want to help people," he explains. "You want to make other people's lives better." He and fellow PHPAC members have also been inspired to act by the health-care inequalities they have witnessed both during their clinical rotations and in their personal lives.

Wonder: "Coming into medical school," says Salma Dabiri, a fourth-year medical student and a PHPAC member, "I always thought there were never enough resources." But as her training has progressed, "you start to wonder," she says. "Is it that those resources are there and they're just not appropriately distributed? That's a different question entirely. It's difficult to ask all these questions when you're so fully involved in your day and you're taking care of your patients."

Rob Lampman, who starts his clinical rotations this fall, worries that he, too, will feel the time constraints of the clinical setting and will not be able to play as active a role in PHPAC. "We are looking for another student to pick up leadership of this organization," he says.

The U.S. health-care system is full of gaps, points out O'Donnell, so "the Robs of the world are trying to make a system without gaps." And O'Donnell is staying on the lookout for more "Robs" to make PHPAC an ongoing force at DMS.

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