University of Vermont

College of Medicine

Vermont Medicine Magazine

Student Interest Group Helps Orient New Refugees to U.S. Healthcare System

Student Teaching Flossing Techniques

It’s a Monday evening at the Community Health Center of Burlington (CHCB), and University of Vermont Class of 2016 medical student Ben Earle stands up in the middle of a circle of about 12 people seated in the lobby – all recently-arrived refugees from Bhutan. He wraps dental floss around each index finger and holds up his hands.

You want it to be perpendicular – that’s better,” he says. “And you want to do every tooth.”

ith each member of the group gripping his or her own piece of floss, they try out the movements as Earle demonstrates. He gives approving nods and some one-on-one help before he moves on to the next exercise in the evening’s lesson on dental health with his co-instructor, fellow medical student Emily Xue.

Every week, a group of first- and second-year medical students in the Refugee Healthcare Orientation Student Interest Group (SIG) make the trek to the health center on Riverside Avenue to help acquaint newly-arrived refugees to the American health care system. The sessions run for eight weeks at a time, and classes cover everything from navigating insurance options and understanding the scope of health care available in the U.S. to sexual health and preventing STDs. Typically, students conduct three sessions over the course of one year. Last year, 120 people participated, which amounts to about 75 percent of adult refugees who had arrived in Burlington, says Jon Bourgo, outreach program coordinator for CHCB.

“We’re covering a significant portion of newly-arrived refugees,” Bourgo says. “We aim for attendance by one adult in each family.”

The refugee healthcare orientation sessions are supported by a federal grant shared between the state of Vermont, CHCB, and several other agencies, and for the most part, the money pays to hire interpreters. In recent years, the refugees have hailed largely from Bhutan, a country that borders India and China, lying east of Nepal. Nepalese migrants in the south of the country have experienced systemic discrimination for decades as the result of a government policy known as “One Nation One People,” according to information from the Vermont Bhutanese Association. Although refugee orientation programs exist in other cities, Bourgo says it is “unique for a community health center to partner with a medical school.”

Both medical students and refugees benefit from the program. Bourgo says he’s seen how appreciative refugees are that “American medical students take the time to help” their transition to this country. And for med students, “It can be inspiring to meet someone who has faced a lot of challenges but is still upbeat and positive,” Bourgo says. Gains have also been made in the quality of health care participants receive.

"Providers are seeing patients who are willing to have a dialogue,” Bourgo says. “They’re also generally better prepared for a medical appointment.”

Grant Goodrich, a second-year medical student and co-organizer of the SIG with Earle and Xue, says the program has evolved from its early days as a Schweitzer Fellows project, and every year students continue to fine tune the curriculum.

“It started out teaching more about the science of health,” he says, adding that one of the most popular lessons now is on household health, which includes how to check for lead paint and winterize windows.

Earle says he’s thinking about working abroad as a physician, and is interested in how health care is accessed and used by different population groups. Xue, who is also considering a career related to global health, says she seizes every opportunity she can to work with refugee populations like the ones who attend the orientation sessions.

“Some of the lessons wind up being conversations,” she says, adding that despite the language barrier – and the very important role interpreters play in the sessions – students still manage to forge a connection with the groups.

The program has become a model for others, Bourgo says, with public health and medical students from Dartmouth Geisel School of Medicine now visiting the center as a step towards starting a program of their own. The United Way recognized the CHCB’s work by featuring co-organizer Xue in a video shown at the organization’s Building Blocks Award ceremony, and Bourgo received a leadership award from the Albert Schweitzer Fellowship Program in 2012.

“It’s nice for UVM to lead the way,” says Bourgo.