When Michael Perez thinks about his interview for medical school at the University of Pennsylvania, the conversations with faculty aren’t the only ones that stand out. He recalls eating breakfast with fellow interviewees and learning that one of them was the son of an ambassador. “All I could think about was how my dad sells tires and my mom was a secretary,” he said. “I don’t know how to compare our experiences.”

Michaela Hitchner, a medical student at Penn, laughed when she heard this. “I feel like that was my entire undergrad experience,” she said.

Perez, now a medical resident at Penn, shared this story with the co-hosts of “Med Legs,” a podcast launched in June 2020 by Hitchner and two fellow students to highlight the experience of first-generation or low-income (FGLI) medical students. Their eight episodes — covering topics ranging from medical school interviews to side jobs — have accumulated more than 700 streams. Episodes feature FGLI guests, including recent alums such as Perez and physicians from across the country.

“It really is a steep learning curve in terms of how medicine itself works, how to build yourself professionally, and how to set yourself up for success going into some competitive residencies,” Perez said.

The series aims to make the FGLI medical community visible and accessible to more people.

As a first-generation college student from a rural high school in Cumberland County, South Jersey who dreamed of being a doctor, Hitchner didn’t have a clear map of how to get there. She wanted to create a platform for FGLI students who had navigated medical school to share the resources that were useful to them with incoming students. “Then they don’t feel as lost when they’re going through it,” she said.

Lifting each other up

Like many recent creative endeavors, the podcast was born out of pandemic-driven necessity.

Hitchner and fellow student Cecilia Zhou had just started their first year at Penn in fall 2019 and quickly stepped up to lead an FGLI student group called Lift Us Up.

Perez had founded the group a year earlier when he noticed differences between the experiences of FGLI medical students and their peers. For example, the resources required to study for major exams cost hundreds of dollars. According to the American Association of Medical Colleges, only 5% of medical students come from the bottom 20% of U.S. families by income.

In addition to group dinners and hangouts, members of the group shared study resources and suggestions of funding sources or faculty mentors who were particularly supportive of FGLI students.

Neha Vapiwala, professor and vice chair of education in radiation oncology and associate dean of admissions at the medical school, is the group’s faculty advisor and has provided help to publish a peer-reviewed commentary about FGLI disparities in medical school applications and a guide to med school admissions for FGLI students.

Increasing visibility and awareness of FGLI students is important, said Vapiwala, who was a first-generation student at Penn. She thought the group would have been helpful when she was going through medical school.

“Institutional knowledge is not necessarily available to us, given our background, but does become available as we connect and learn from each other,” Perez said.

Taking the first steps

Just a few months into Hitchner and Zhou’s first year of medical school, the campus entered a COVID-19 lockdown, pausing group meetings including Lift Us Up. Hitchner thought that a podcast could continue support for the FGLI community.

She even had a name in mind: Med Legs. “It’s supposed to be like finding your footing, almost like your sea legs,” she said. “When you’re unsteady, then you find your sea legs and you’re good.”

Vapiwala was enthusiastic about the idea. “I appreciate the reach and the informal sort of view into other people’s world that you can only really get in that format,” she said.

Along with Anitra Persaud, their third co-host and a former leader of the FGLI group, they started talking to other podcasters on campus to pick up tips on editing and distributing the podcast. The first few episodes were cranked out through extensive trial and error. In a fortunate coincidence, one of Zhou’s college professors connected them to Jon Pfeffer, an experienced editor who also knew how to engage an audience.

Some episodes took almost a month to create. The hosts would record roughly an hour of content for Pfeffer to edit into a 30-minute episode. Interviews sometimes needed to be re-taped or cut.

This painstaking process was added on top of other academic commitments, but working on the podcast made Hitchner realize the importance of having a passion project.

“Medicine does not have to be your whole life,” she said. “I think that you should do more than that, personally, because that’s what keeps you human.”

‘A unique addition to medicine’

The episodes cover a range of topics, including medical school admissions, interviews, and social dynamics and how an FGLI background can shape these experiences. For example, the burden of having to explain your first-generation status to surprised classmates, or how to prepare for interviews as a student who lacks personal connections to elite institutions or the medical profession.

Perez was happy to be interviewed. “The podcast is really an honest look into some of our experiences applying to medical school and being in medical school,” he said. “It’s just a wealth of information that wasn’t there when I was applying to medical school.”

For Zhou, who didn’t always embrace her FGLI experience publicly before medical school, working on the podcast was also a way of pushing herself out of her comfort zone. “I wanted to show other people, as well as myself, that my background and my identity as FGLI is a strength and not a burden,” she said. “In fact, our experiences can be a unique addition to medicine.”

Hitchner, who is currently doing clinical rotations, said her FGLI background helps her relate more closely to some patients than other medical staff can. “Sometimes, when we’re talking to patients in a room, I can imagine where [my dad] would get lost in the explanation,” Hitchner said. “I always feel very compelled to sit down a little bit longer with them and make sure they understand.”

Zhou said FGLI physicians “level the playing field for FGLI patients.”

As the three co-hosts have gotten busier in clinic, Hitchner hopes to build out the podcast’s staff and find more continuous funding to make the project sustainable. But it has been challenging to convince people that the podcast is worth expanding. “They kind of see it as funding a student project,” Hitchner said. “But we envisioned this as more. … This could be a way to build community on a nationwide level with different students in different schools.”

In future episodes, Hitchner wants to talk more about the importance of being confident and jumping in to participate in rotations and talk to professors in classes. Zhou wants to make an episode about exams and the stigma around failing.

Working on the podcast has had unexpected benefits for the hosts. Hitchner has appreciated the chance to learn more about her co-hosts’ journeys, especially from Persaud, who is a year ahead of her. She also thinks it has helped her articulate her own experience and her values, which will be important when she interviews for residencies.

“I have a very strong understanding of myself and the person that I want to be,” Hitchner said, recognizing “how my experience is similar but different to others and how that will then impact the kind of doctor I’m going to be.”

Aparna Nathan is getting her doctorate at Harvard University and recently completed an AAAS internship at The Inquirer.

The Future of Work is produced with support from the William Penn Foundation and the Lenfest Institute for Journalism. Editorial content is created independently of the project’s donors.