Gezzer Ortega, MD, an instructor in surgery at Brigham and Women’s Hospital (BWH), knows what it’s like to work your way into an academic research career against all odds.
As the eldest of Dominican immigrants who didn’t speak English and the first to go to college, no one provided a road map. He figured out mostly for himself how to get into and navigate college, then medical school, then graduate school to obtain his MPH. He did it without the resources that 80% of his classmates had. Cultural expectations were different too.
When Ortega sees young scientists who come from circumstances like his, he gets it. That’s why he wanted to be a mentor for the Visiting Research Internship Program (VRIP). Offered by our Diversity Inclusion program, VRIP pairs researchers like Ortega with first- and second-year medical students from groups historically under-represented in medical research for a summer intensive. Students spend two months at Harvard Medical School (this year, in person) investigating a specific research question. Gezzer, a health services researcher who is focused on finding solutions to surgical inequities, mentored Bryan Torres, a medical student at Tulane University.
We caught up with Ortega in San Francisco, where he was taking an NIH-funded course on how to implement evidence-based interventions in real-world settings while ensuring equity and inclusion.
You are a first-year mentor for the VRIP program as well as other programs within and outside of BWH. Is the value of mentorship different for under-represented groups?
I think it is different for under-represented groups in medicine. With Latino students specifically, one of the challenges is that there’s not a lot of diversity within the faculty, so you have a limited number of individuals through which you can see yourself achieving these goals. I think part of it is having an opportunity to see someone who looks like you who has accomplished or at least walked that journey. It’s inspiring and motivating to know that there are others who have done this, so that I know I can do it as well. Certain challenges come up along the journey that make it easier or not easier sometimes, and it’s nice to have someone who can understand those challenges because they have a similar background.
As a medical student and as an undergraduate student, I participated in summer research programs and summer enrichment programs focused on exposure to academic medicine or medicine in general, and this is a great opportunity for me to pay it forward.
How has your own experience as a Latino in medical research training influenced your mentorship of young scientists like your VRIP mentee Bryan Torres?
“We all provide unique perspectives, which I think is why diversity is crucial in medicine.”
I was the first in my family to go to college, and then graduate school and medical school. Not having people that I knew early on who had done it made the whole process of even getting into those higher educational levels that much more challenging. I had a lot of bumps, hurdles, and failures along the way that I had to overcome in order to figure out what I needed to be successful. A few key individuals–mentors and coaches–nudged me in the right directions and supported me, even though they didn’t understand how to navigate a career as a physician, so mentorship was key in that pathway.
I think it’s also difficult coming from a low-income background like I did, where we didn’t have unlimited resources. That created another sense of just having to hustle and try to figure out what opportunities I could take advantage of to continue to advance in my career.
And then there are cultural nuances that I noticed along the journey, for example, in supporting my family. As the eldest of my family, I was expected to work throughout my education and take care of my siblings and support them. Those things made it a little more challenging, but also more rewarding, because I feel that I provide a different perspective than some of my colleagues. We all provide unique perspectives, which I think is why diversity is crucial in medicine.
How does the VRIP research project you’re mentoring reach back to that cultural upbringing?
I had this experience growing up where I often served as an interpreter for my parents, in educational settings and especially in the healthcare setting. My parents immigrated to this country a year before I was born and learned English alongside me. In our provider’s office, they would have a confused look and ask me to translate what the doctor was saying.
We’ve come a long way in that translation services have become more accessible, but there’s still a great unmet need among non-English-speaking patients. A significant portion of my research focuses on improving language access and concordance for surgical patients. In doing so, one of the questions that we are interested in asking is whether patient outcomes vary according to a hospital’s level of resources for interpretive services. Bryan’s research project is helping to answer that question.
This research raises the issue of language as a potentially important driver of healthcare inequities among non-English-speaking people. Can you unpack that?
“My research focuses on improving language access and concordance for surgical patients. One of the questions that we are interested in asking is whether patient outcomes vary according to a hospital’s level of resources for interpretive services.”
Part of providing high-quality patient care is really understanding your patient and their needs and their goals. Having a language barrier makes that much harder. I think that in most cases English-speaking individuals are able to communicate all of their care needs in the same language as their providers. The challenge for non-English-speaking patients is that, even when interpreters are available, they are typically used only at the most critical moments. The conversation tends to become transactional; depth and detail can be lost.
Take a scenario in which a patient comes in who speaks a language that you, as the doctor, have no familiarity with. You’re trying to do your best to communicate with them. If you have a resource like an interpreter, great – if it allows you to have a conversation with that patient. But depending on the acuity of the setting, it could be very transactional. There’s a natural inclination to just get it done and not really dig a little bit deeper.
But when you have an opportunity to communicate with someone in the same language, you’re more likely to ask questions such as “What is your home situation? Do you live alone? Do you have support? Can we discuss your discharge options and plan?” And that makes a difference because then you can provide an appropriate discharge for this patient knowing what level of support they have.
What do you do for fun outside of science?
I love to travel and learn new things. I am a huge sports fan. I follow football. I’m a New York Yankees fan in Boston, as well as the New York Giants fan. I can’t tell anyone because I want people to like me (laughing). It’s tough. I might be in trouble for saying so when this article comes out, but it’s true, I am a New York fan. I also enjoy New England because I love to hike in the summers on various trails around Mt. Washington in New Hampshire and other areas, and I love to ski in the winter.