With dense course material, licensing exams, rotations, applying to residency, and everything in between, medical students juggle myriad personal and professional challenges as they trek down the path to becoming a doctor.
Sometimes those challenges arise before they get to medical school.
Amira Collison, a student from Johns Hopkins University School of Medicine, recently matched at the UCLA Department of Psychiatry and Biobehavioral Sciences. Though she says she felt destined to become a doctor, her journey to UCLA had twists and turns in it that she never expected.
The youngest of four children, Collison says her interest in medicine stemmed from her early fascination with science and the human body. “I remember asking for one of those anatomy mannequins for Christmas, the one where you can see the organs,” she says.
Collison’s late father, Hector Collison, was a beloved interventional cardiologist in the Potomac, Md., area. The connections he made with patients were inspiring, she recalls.
“I remember so many of his patients saying how much of a wonderful doctor he was and they talked about how they truly felt that he cared about them and listened to them,” Collison says. “He wanted to give his patients as much time as they needed to feel heard, to figure out what was going on with them, and to truly help them. He even knew all of their kids’ names.”
Dr. Collison flew small planes as a hobby. In 2008, he and his 15-year-old son died in a plane crash in the Shenandoah Mountains during a storm.
At 12 years old, Collison lost her father, older brother and way of life as she knew it – “most of everything we had, including our home and our livelihood,” she says.
Unable to maintain the life Dr. Collison had built for their family, and shattered from the loss of her husband and son, Mrs. Collison became severely depressed and anxious. She sent Amira Collison away from their affluent Maryland community to live with her grandmother in South Side Chicago.
There, she would see and experience firsthand the disparities people of color and lower socioeconomic status face – namely in health care and education.
“Something that was very visible to me was that a lot of people were very sick,” she says. Those people included her grandmother, who had chronic kidney disease. She died while on dialysis in one of the neighborhood centers she had spent hours in each week.
The pain of losing her grandmother during her first year of medical school was twofold, “because not only was she my grandmother, but she became one of my primary caretakers when my mom couldn't take care of me,” Collison says.
Months later, a lecture would teach her the racial disparities that exist around kidney transplants.
Several studies have shown that while live donor kidney transplants among white and Asian patients have increased over the past 20 years, they have decreased among Black and Latino patients.
Live donor kidney transplantation is associated with improved clinical outcomes and quality of life compared with kidneys received from deceased donors, studies show. However, patients with conditions such as hypertension, diabetes and kidney disease are often ineligible to receive and donate organs for live donor kidney transplantation.
Such conditions are disproportionately present among Black and Latino populations.
“For me, it was just another example of how racism is still so ingrained in our health care system – who gets access to care, who gets quality care and who gets certain types of treatments and who doesn't,” Collison says.
Education was another area in which Collison witnessed and experienced both sides of privilege.
In Chicago, she attended two schools to get the level of education she was receiving in Maryland. “I would walk to a high school to take the classes I needed and then walk back to the middle school for my other classes,” she recalls of her eighth-grade year.
As she progressed in school, Collison’s mother realized that Amira wouldn’t be in the competitive position to attend college and medical school as she would have been in their former neighborhood in Maryland.
“Even though staying in Chicago would have been what was best for my mother because she had her family there to take care of her and it was what she needed at the time, she moved me back to Maryland and talked to the principal in Potomac,” Collison says.
Mrs. Collison shared with the principal that her family could no longer afford to live in that neighborhood, but that Amira was a good student, well-behaved and had aspirations to become a doctor some day. She asked the principal to give her daughter a chance.
The principal agreed and Amira Collison was enrolled at what would have been her district high school, Winston Churchill High School. Mrs. Collison would drive an hour and a half to get Amira to school each day.
“I remember on those drives, a lot of the days she would be crying, and we would have to pull over,” Collison recalls. “She was just going through so much, but even through that she always put me first and would say, ‘no matter what, Amira needs to be in a position where she can follow her dreams.’”
Collison attended college at the University of Maryland. While there, she and a classmate developed a tutoring program called the Foundation in Science and Health (FISH) program, to help low-income students get support to pursue higher education in science and health disciplines.
Through the program, Collison tutored many Spanish-speaking English as a Second Language (ESL) students, which inspired her to minor in Spanish Languages and Cultures.
After graduating magna cum laude with a degree in neurobiology and physiology, she was accepted to Johns Hopkins University School of Medicine. She also was accepted to the Fulbright Program, a cultural exchange program providing students opportunities to study or conduct research abroad.
Collison deferred medical school for a year to teach high school courses in Spain.
“When I was working with my English Second Language students in the tutoring program, it reaffirmed that working with Spanish speaking populations is something that I'm really passionate about and want to do in my career,” she says.
At Johns Hopkins, Collison focused on pursuing cardiology – like her father – until her third year. That would change upon starting a rotation in psychiatry, which “wowed her,” she says.
“Psychiatry is one of the few fields that allows you to spend an hour or more with the patient and listen to them tell their story,” she says. “You’re not just targeting questions around what brought them into the hospital today.
“You're learning about their childhood, their meaningful relationships and all the factors that molded them into the person that you're seeing before you.”
Though she didn’t realize it then, pursuing psychiatry would allow her to closely follow in her father’s footsteps – being able to listen to her patients, get to know them deeply, learn their children’s names, and most of all, help them heal.
During her psychiatry rotation, she began to see the similarities of what she experienced growing up with what people in the Baltimore community were experiencing.
“The Black and brown individuals who are disproportionately affected by things like trauma, adversity, racism and chronic stressors – these are all these things that we know lead to mental illness,” she says. “Unfortunately, we’re also the ones that don't have access to care, or experience stigma surrounding mental illness that bars us from seeking help.”
In Chicago, Collison recalls, she and her family belonged to a church which held weekly food pantries, Bible studies and educational classes for the community. She says the church served as a healing sanctuary and “safe space” for anyone involved.
There was no equivalent when it came to health care.
“What pains me now thinking back, is that I didn’t know things like counseling or therapy were options for the things that we were going through,” Collison says.
During a residency interview, she was asked if she had spoken to a therapist following her brother and father’s death and mother’s depression.
“That was the first time that I realized I had never even had that as an option. I never even knew that that was something that people were supposed to do,” she says.
Collison says it was very clear in that moment that this was exactly the patient population that she wanted to work with, in an environment where equity, diversity, inclusion and social justice were valued.
“I knew that in Los Angeles was the patient population that I would truly fall in love with,” she says.
She listed UCLA as her top training program based on intuition, population demographics and from conversations with current residents, held virtually due to the COVID-19 pandemic. Talking with UCLA Psychiatry resident Brittany Tarrant about the intersectionality of incarceration, homelessness and psychiatry would help cement her decision.
“It just seemed like the perfect program,” she says. “I knew it was my number one months before applications.”
As Collison embarks on yet another big journey – moving cross country after having never visited Los Angeles, finding a place to live and preparing for residency, she says she doesn’t want to lose sight of the path that brought her here.
“I was privileged to spend 12 years of my life with a father who was a cardiologist. So even though I had some road bumps in my journey, I knew that becoming a doctor was a goal that I could accomplish,” she says. “There's so many people that I come into contact with that have never seen doctors or lawyers, scientists or anyone that's graduated college, so they don't even know to aspire to those paths.”
She says she intends to help change that.
Learn more about the Road to Residency program at the David Geffen School of Medicine at UCLA.