How a Great Idea and a STFM Fellowship Empowered Underserved Children to Pursue Health Care Careers

Renee Crichlow, MD,

Renee Crichlow, MD,

“What do you want to be when you grow up?”

My parents always asked me this. I learned later that this was about creating a vision and expectation of the future.

Now I am Dr Renee Crichlow, a family physician working and teaching family medicine in underserved North Minneapolis, and I ask every child I see, “what do you want to be when you grow up?”

Many answer doctor or nurse and yet in the medical school and the residency applications I rarely saw any kids from the neighborhood. My co-worker Shailey Prasad, MD, MPH, and I knew this was a complex problem not to be solved overnight.

We decided with the support of our department chair, Mac Baird, MD, MS, to build The Ladder, a structured health care pipeline mentorship program that incorporates hands-on science fun with values and character development designed to facilitate the development of lifelong learners and leaders interested in health care careers.

CrichlowR, The Ladder

The Ladder began in September 2012. Our motto is “Lift as you climb, build as you grow.”

The Ladder starts early, 4th grade and up, to create a community of scholars who help each other get to the next level. The high school students mentor middle school students, college students mentor high schoolers, medical and dental students mentor college students, and residents, practicing physicians, and other health professionals mentor everyone and each other.


Who knew a 7th grader could recognize an AC separation on an x-ray or that 10th graders know how to run an AED or use an otoscope? More than you realize if you are talking about members of The Ladder.

The Ladder:

  • Sets a routine up for kids that connects them to their peers as well as adults in health care careers
  • Builds leadership from within, teaching kids to mentor and model the positive behavior of their mentors
  • Provides concrete and useful skills like CPR, taking blood pressure, or filling out a college application
  • Sets kids up to be guardians of the community’s health by giving them health and wellness knowledge and leadership skills
  • Empowers them to affect change in their lives and the lives of others through the service learning components to make a positive difference in their communities,
  • Creates and sustains strong bonds, renews bridges, and establishes connections


STFM has been an integral part of the development and growth of The Ladder, which was the product of my fellowship project during the 2012-2013 Emerging Leaders Fellowship. The fellowship developed the skills I needed to get the group started and the understanding to help The Ladder grow. The biggest lesson I learned was leaders build leaders, and that is what The Ladder is about at every level.

The University of Minnesota Department of Family and Community Medicine has invested in The Ladder as a focus of both mission and mentorship. The Ladder is an attractor of diverse and underserved students and faculty. Members report that working with The Ladder is an opportunity to serve a community in need and find personal support for their individual growth, two very important factors in attracting and retaining both diverse and socially conscious students, residents, and faculty.

I am currently submitting a joint STFM Foundation Group Project Fund grant application called “Pipeline is Policy, with the Group On Health Policy and Access, the Group on Minority and Multicultural Health, and the Group On Latino Faculty to develop a web-based toolkit. The toolkit will provide a structured approach to developing and growing additional chapters of The Ladder through other interested departments in other neighborhoods and communities.

Will there be one near you, and will you be mentor in The Ladder? I hope so! In the meanwhile, keep up with us and ask me questions on Facebook at, follow us on Twitter @TheLadderMN, or read our blog at

Too Much of Anything Is Bad: Advising Students on the Number of Programs to Apply to

By David Anthony, MD, MSc, Alec Chessman, MD, Kristina Duarte, MD, ScM, Katie Margo, MD, of Medicine Jacob Prunuske, MD, MSPH, and Martha Seagrave, PA-C.

This is in response to a previous blog post, How Faculty Can Prepare Students for the Match.

In an effort to address the increasing challenge of assisting students in obtaining family medicine positions in the Match, Michelfelder et al recently published a set of recommendations derived from discussions at sessions presented at the Society of Teachers of Family Medicine (STFM) Conference on Medical Student Education (MSE) and the Association of Departments of Family Medicine Conference. We commend the authors on their important work, and we support many of their recommendations, including:

  • Encouraging increased communication between medical school advisors and program directors
  • Discouraging students who do not “see themselves as thriving as family physicians” from applying to family medicine programs

However, we take issue with one of their recommendations, and pose an alternate viewpoint.

The authors state that “Most clerkship directors recommend students apply to 20–40 programs to increase interview offers.” While this statement may represent the prevailing voiced opinion during the lecture discussion at MSE, we take issue with the claim that most clerkship directors recommend students apply to 20–40 programs, and we vigorously disagree with the recommendation. Broadly encouraging students to apply to such a large number of programs will worsen the challenges of students in obtaining interviews and residency positions.

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