Highland Hospital, Oakland, CA

The clinical research portion of my job took the largest share of my time while I was working as a research assistant at Highland Hospital. The attending physicians who work in the emergency department (ED) at Highland serve as principal investigators for the research projects carried out by the research office, and those who work in the office itself are tasked with gathering the relevant data for ongoing studies. There were two main studies I worked on this summer. The first is focused on ED use by patients with housing troubles. The purpose of the study is to determine the proportion of patients coming into the ED that are homeless, marginally housed, or insecurely housed. The study is also looking to determine at what times these homeless and marginally housed patients are seeking care within the ED. Furthermore, the Highland ED is looking to hire a housing linkage coordinator to connect those with housing needs to supportive housing. It is of great importance to gage the need for this service, as well as determine times of day when the presence of a housing linkage coordinator would be most effective to be able to reach the largest population of patients with housing needs. The way we collected data was through administering surveys measuring social needs to each patient that came through the doors of the ED. With respect to my involvement in this study, I spent time within the ED administering surveys to patients, interacting one-on-one with patients, and explaining the purpose of the study. The patient interaction experience I gained was unparalleled. In addition, I also spent much of my time reviewing patient charts—extracting pertinent information and entering that information into a database for future data analysis.

The second study I worked on was concerned with measuring the connection between the current political climate and the fears and misconceptions of the undocumented Latinx community with respect to accessing healthcare. The hypothesis for the study was that the anti-immigrant rhetoric coming from the current administration had made undocumented immigrants less willing to access healthcare for fear of being discovered as undocumented. Even though clinicians are barred from sharing this information with immigrant authorities under doctor-patient confidentiality, the expectation was that knowledge of this would be relatively low. For this study, I spent a lot of time on the floor of the ED surveying patients and trying to record their thoughts on the matter. It was very interesting to engage with such a large and diverse patient population about such a current and complex topic. Furthermore, I also spent time entering the relevant data I collected into a research database for analysis once the data collection portion of the study is concluded.
Another aspect of this job that was noteworthy was my exposure to clinicians practicing medicine. During my time at Highland, I shadowed multiple healthcare professionals—attending physicians, medical residents, nurses, and physician assistants—all of which gave me a unique perspective into the interworking of an emergency department and also provided me a new appreciation for the ED and the team based approach to medicine. I was able to observe multiple procedures within the emergency department such as ultrasounds and wound care to name a few. One of my favorite parts of the shadowing component was my ability to observe the traumas coming into the ED. As Highland Hospital is the designated Level 1 Trauma Center for Alameda County, the most serious and life-threatening trauma cases are all siphoned to Highland. While observing these traumas I was struck by how calm, efficient, and effective all of the clinicians were in such high-pressure situations. The high volume of traumas that came through the emergency department allowed me to see countless different cases, and to become very familiarized with the trauma protocol and the sequence of events that occur in a trauma case, which was super interesting.
Lastly, I also spent a large amount of time editing and revising a manuscript for an attending medical physician working in the ED. This physician spearheaded the creation of a new subspecialty in emergency medicine called Social Emergency Medicine (SEM), which incorporates the role of social needs as main contributors to disease. As emergency departments have become the safety-net for society’s most at risk populations, SEM works to lower the incidence of disease in high risk populations through meeting both their medical and social needs, as the two are greatly intertwined. This manuscript was made up of articles written by SEM physicians and also included commentaries and reflections on these articles, which were discussed at a conference for SEM physicians. The articles included in the manuscript looked at many complex issues plaguing EDs across the country such as the issue of chronic homelessness, high ED utilization, the lack of trauma informed care in the ED, and emergency physician burnout. It was very informative to be able to learn more about the complexities of these programs, and the possible solutions that are being brought forward by some of the country’s foremost emergency physicians.

Highland Hospital, and more specifically the ED Research Office, is an amazing place to work and I really enjoyed my time there this summer. The work done at Highland is interesting and groundbreaking, and I am so glad that I was given the opportunity to contribute to such important research work. The academic advice and professional career insight I received from my research supervisors, attendings, and medical residents were an invaluable aspect of the job. Each employee I came into contact with was extremely welcoming and always willing to help me or talk about their experiences. Everyone seemed to genuinely love the work they were doing, which was incredibly motivating for me to be a part of such a driven working community. In addition, my supervisor was very attentive in making me feel at home within the research office, and she was also very helpful in arranging multiple opportunities for me to shadow multiple clinicians in the department, which was a highlight of my experience at Highland.
While I only have one year left at Williams, and I was pretty set on pursuing a career in medicine, this internship has further confirmed my future in medicine. This internship opportunity has also been clarifying in terms of what specialty I might want to pursue as a future healthcare professional. I loved working in an emergency department, and definitely think I would like to pursue working in emergency medicine—the fast-paced nature of the work, the excitement, and the exposure to so many different diseases are all incredibly appealing. Furthermore, I definitely would look to incorporate clinical research into my career. I find it very appealing that as a doctor in a research institution, one can effectively practice medicine, while also carrying out groundbreaking research projects asking research questions that are of personal interest.
Lastly, I want to thank the Class of 1974 for their generosity in sponsoring the grant given to me through the Williams College ’68 Center for Career Exploration. I am so grateful for this opportunity—for the people I met and the things I have learned. This job gave me unparalleled insight into what it is like to work in an emergency department and how research is conducted within hospitals, specifically emergency rooms. This experience was truly invaluable.