USC medical students shape policy tackling tough global health challenges in D.C. summer program

At the Keck School of Medicine of USC, physicians-to-be get chances early in their training to have real-world impact on the community around them, both through clinical work and research. Now, USC’s Capital Campus in Washington, D.C., is giving them a shot at influencing global health policy. 

Following their first year in medical school, two students became USC’s inaugural summer global health policy scholars, taking part in a six-week program in the nation’s capital, jointly presented by the USC Institute on Inequalities in Global Health (IIGH) and the Keck School of Medicine. The summer scholarship program is designed to offer students a new way to fulfill their research requirement for their degrees by contributing to ongoing projects that inform policy. 

Partnering respectively with a U.S. State Department agency and a nonprofit, HelpAge USA, scholars Noah Green and Jonah Phipps gained experience that may well shape their careers, while at the same time moving forward efforts in two key IIGH priority areas: population aging and global health, and international sexual and reproductive health and rights.

“Both of our scholars are incredibly bright and engaged human beings who were passionate about addressing injustices even before medical school,” said Taylor Burkholder, MD, an assistant professor of clinical emergency medicine at the Keck School of Medicine and the IIGH’s director of academic programs. “Their work gave them a clearer sense of how they can have influence on a larger scale. They saw how to balance people’s stories with the data-driven focus needed to direct good policy.”

“Both of our scholars are incredibly bright and engaged human beings who were passionate about addressing injustices even before medical school.”
– Taylor Burkholder, MD

The program was developed and is currently managed by Burkholder and Jonathan Cohen, JD, a USC professor of clinical population and public health sciences and director of policy engagement at the IIGH. With support from the dean’s office at the Keck School of Medicine and Jeffrey Riddell, MD, assistant dean for medical student research, they are channeling the advantage of USC’s presence in Washington, D.C., to expand possibilities for medical education.

“The USC Capital Campus opens up a wealth of opportunities to medical school faculty, staff and students, connecting them to national and international decision-making affecting the health sciences,” Cohen said. “The range of partnerships is practically limitless, and this program is just the tip of the iceberg of what is possible now that IIGH and the Keck School of Medicine have a physical presence in the nation’s capital.”

“The USC Capital Campus opens up a wealth of opportunities to medical school faculty, staff and students, connecting them to national and international decision-making affecting the health sciences.”
– Jonathan Cohen, JD

Championing human rights in the face of a degrading practice

Green’s scholarly focus arose from his commitment to improving the health and well-being of LGBTQIA+ individuals. Among a longer list of causes he’s volunteered to promote, he has assisted with gender-affirming and reproductive health services for that population and counseled LGBTQIA+ youth in crisis. He envisions his future as a physician involving gender-affirming care.

“My identities as a Black male and a gay male really shape the care that I want to give in the future,” Green said. “I feel more fulfilled working with communities that I also identify with, because I understand them on a deeper level.”

At the Capital Campus, he took on a harrowing practice, often cloaked in shadows, used in some nations where homosexuality is outlawed or proscribed socially.

Green teamed up with the office of the U.S. Special Envoy to Advance the Human Rights of LGBTQI+ Persons to gather insight and recommendations on the use of forced anal “examinations.” Performed by medical providers under orders from authorities, the so-called exam is purported — falsely — to show evidence of homosexual activity, but really amounts to an act of punishment and intimate assault. 

“My identities as a Black male and a gay male really shape the care that I want to give in the future.”
– Noah Green

“It was a tough topic, because there’s not a lot of research about it,” Green said. “No one doing forced anal examinations wants to actively put that information out there.”

Overcoming substantial challenges, he created a policy memo to the Special Envoy summarizing evidence of the inhumane procedure’s usage in 19 nations, detailing where the practice has been newly documented, is ongoing, or on the wane.  Green also produced recommendations for reducing forced examinations by holding perpetrators accountable, boosting surveillance and updating terminology to reflect the cruelty of the practice.

“Knowing that people are not able to truly be who they are pushed me to put 100% effort into the memo,” he said. “I feel honored and thankful to make a difference in the world, empowering the voices of people affected by that torturous practice. Hopefully I’m able to help them.”

He credits Cohen and Burkholder with providing crucial guidance for his first foray into public policy research.

“It was a steep learning curve, but they taught me the skills I needed, as well as how to leverage other people’s expertise,” Green said. “I don’t think I would have the networking skills, the research skills or even the confidence to write a paper like this without their mentorship.”

In Burkholder’s estimation, his project was a success.

“Noah’s work is really important for understanding where the U.S. government might impose sanctions or other policies that would limit the practice of forced examinations,” he said. “He did a wonderful job identifying a bunch of different places where it happens, including some that were not previously reported.”

The quest to level up a population left behind in efforts against HIV

Phipps’ enduring interest in combating infectious diseases led him to dedicate his summer policy project to HIV prevention for older women in sub-Saharan Africa. He partnered with the nonprofit HelpAge USA, part of a global network of nongovernmental organizations defending the rights of older people, especially in areas with the least resources.

“Infectious diseases largely hit people who are forgotten by society,” Phipps said. “Health justice is naturally a part of that focus.”

Although there is plentiful research into HIV/AIDS, women over 50 years old in the most heavily HIV-affected countries of sub-Saharan Africa are seldom studied. The evidence that does exist indicates that they face unique barriers to diagnosis, treatment and suppression of the virus.

The summer project culminated in a policy memo elucidating the barriers affecting older women in sub-Saharan Africa and setting forth strategies for closing the gap. Phipps called for a renewed focus on the population — more HIV/AIDS research with them at the center or with their data separated out for analysis, more funding for prevention, and a greater advocacy and policy concentration. 

He emphasizes that accurate information upending stigmas will be key.

“We think of HIV as something largely affecting younger adults,” he said. “But, number one, as people age and survive HIV, they get into that older age bracket. Number two, quite simply, older adults are sexually active. That’s a fact, and we need to acknowledge our own bias in thinking that’s not occurring. When we make treatment and policy decisions based on that stigma, it’s to the detriment of these populations.”

Burkholder believes that Phipps’ project will yield real-world impact.

“Physicians have a responsibility beyond just caring for patients on an individual level. We have a responsibility to be leaders in the community — to keep informed on policy and to really be beacons for our society. The summer scholar experience makes me feel like I have more of a capacity to do that.”
– Jonah Phipps

“Jonah really highlighted a bunch of the inequities that must be tackled to improve prevention, diagnosis and treatment for older women living in Southern Africa,” he said. “We were proud of him for it, and HelpAge USA was incredibly grateful for his work.”

Phipps’ exposure to global health policy both prepares him for that path and reinforces his approach to the medical field.

“Physicians have a responsibility beyond just caring for patients on an individual level,” he said. “We have a responsibility to be leaders in the community —to keep informed on policy and to really be beacons for our society. The summer scholar experience makes me feel like I have more of a capacity to do that.”

Learn more about medical education at USC and the activities of the USC Institute on Inequalities in Global Health.