For many resident physicians, the grueling schedule of clinical training leaves little room for outside commitments. But for Whitney Sambhariya, MD, PhD, an ophthalmology resident, growing as an advocate is an essential part of her career—not an extracurricular activity.
Dr. Sambhariya is part of the third cohort of physicians to take part in the Medical Justice in Advocacy Fellowship. Run by the AMA and the Satcher Health Leadership Institute at Morehouse School of Medicine, the fellowship is a collaborative educational initiative to empower physician-led advocacy that advances equity and removes barriers to optimal health for marginalized people and communities.
Dr. Sambhariya, an AMA member, took time during the AMA National Advocacy Conference last month to offer valuable insight into how she manages the demands of residency and her advocacy work as well as how she has grown as an advocate from her experience.
Turn to the AMA Thriving in Residency series for timely guidance on making the most of your residency training. Get resources and tips about navigating the fast-paced demands of training, getting scientific research published, maintaining health and well-being, and handling medical student-loan debt.
Finding the time
Training in any residency program is going to eat up considerable bandwidth. For Dr. Sambhariya, her days as second-year ophthalmology resident often involve long hours in the clinic or the operating room (OR).
“I have a lot of residents and fellows come to me asking me how I'm able to do the work that I do during residency,” said Dr. Sambhariya, who serves as an alternate delegate for the Maryland State Medical Society in the AMA House of Delegates. “There are boundaries. You can do so much during residency, but you also have to stay focused.”
The key has been strategic communication and effective prioritization—both with her program and within her own schedule. For medical students and residents who are interested in advocacy, Dr. Sambhariya recommends strategically approaching the topic during residency interviews or in conversations with your program leadership early on in your transition to residency.
“It's important to be honest during your residency interviews about what is important to you,” she said. “I think always making sure you preface it similarly like I did—you’re a physician first, and that’s why you’re here. But in your free time, which you do have some during residency and fellowship, I want to utilize that time to be able to do these different advocacy initiatives and I really do want to stay involved.”
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Applying lessons from clinic
Dr. Sambhariya’s advocacy is tied to what she encounters in her clinical work. She has seen firsthand how patients with low vision—that is, with visual impairments that can sometimes be addressed with medical interventions—can struggle in many facets of their lives.
“Low vision doesn’t just affect our patients when they’re in the ophthalmology clinic,” she said. “It affects them when they're in anyone's office, when they're in the grocery store—every part of their life.”
Among the issues is that patients with visual impairments face added challenges in taking their medications as directed. She offered insulin for diabetic patients as an example of the problem.
“It can be very dangerous if you're using an insulin pen and you click it wrong because you can't see the numbers or you're not able to read the labels on your medications,” she said.
To rectify the dangers, Dr. Sambhariya has begun working with technologies that allow patients to have their prescriptions read aloud to them.
Dr. Sambhariya is of the belief that stories based on her patients’ lived experience are essential to fostering real change beyond the exam room or hospital corridors. Physicians are uniquely positioned to tell those stories.
“We need physicians to be there to tell the stories of their patients, to tell what they're going through at a more microscopic level,” she said. She called for greater use of “universal design” principles so that medications and other health care items are accessible at varying levels of ability.
“Blanket policies are not something that works,” she said. “Universal design recognizes that all changes must focus on acknowledging the diverse needs.”
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Honing advocacy skills
Dr. Sambhariya was active in advocacy work as a medical student through the AMA.
“I love clinic, and I love the OR, but there were also barriers to providing the health care and the opportunities I wanted for my patients,” she said. “And the AMA gives me the chance to say: You know what? I feel like I can make a difference in those barriers that before I thought I was much too small to ever have that voice.”
Her participation in the Medical Justice in Advocacy Fellowship has allowed her to broaden her perspective and sharpen her skill set. Through exposure to a variety of speakers from both physician and nonphysician backgrounds, the fellowship has offered lessons on editorial writing and how to communicate with policymakers.
“As a medical student, I learned about policy advocacy, and all the things we do through the AMA, but there’s still a world outside of there,” Dr. Sambhariya said. “We have to work with companies, we have to work with other stakeholders, we have to work with communities. And those interactions take different communication skills.”
In seeing what’s possible through her work in the fellowship, Dr. Sambhariya hopes that more residents and physicians will see advocacy as a natural extension of work in medicine.
Her advice to fellow trainees? Find what you’re passionate about and don’t be afraid to use your voice.
“We can't all reinvent the wheel every time,” she said. “But if we work together, we can make a real difference.”
Learn about the AMA’s 2024–2025 strategic plan to advance health equity.
