Keywords

On the Brink of a National Union

In order to set the stage for the creation of a national Latino medical student association, political advocacy and advancement for Latinos in the United States had to occur. The GI Bill, the 1958 National Defense Education Act (NDEA), and the 1964 Higher Education Act (Civil Rights Act) opened new opportunities for low income and minority students to attain higher education, especially Chicanos [1]. The “blowouts” and “walkouts” led by high school students of East Los Angeles during March 1968 helped spark the rise of the Chicano Rights Movement [2]. Student-led organizations flourished, with examples including La Raza Unida; Organization of Latin American Students; the Hijas de Cuauhtémoc; the Mexican American Youth Organization; and the United Mexican American Students (UMAS), which later became El Movimiento Estudiantil Chicano de Aztlán (MEChA) [2,3,4].

By the late 1960s, there were Latino students in medical schools across the U.S. who saw a need to organize, support each other, and mentor premedical students aspiring to pursue medicine. In 1972, Jaime Rivera, MD, and Emilio Carillo, MD—then Harvard medical students and members of the political and social action organization known as the Young Lords [5]—founded the Boricua Health Organization (BHO). BHO went on to form a network of student chapters at other medical schools in the Northeast, eventually becoming the National Boricua Latino Health Organization (NBLHO) and then the Latino Medical Student Association (LMSA) Northeast. Around the same time, a group of medical and dental students from California, Arizona, Texas, Colorado, and New Mexico met at the University of California, San Francisco (UCSF); these pre-health, medical and dental school Chicano students came together to form the National Chicano Health Organization (NCHO) [6,7,8]. A similar organization called La Raza Medical Association (abbreviated La RaMA) emerged at a Fresno meeting of medical students from many California medical schools on December 18, 1976 [9]. In 1983, NHCO and La RaMA merged to create the Chicano/Latino Medical Student Association (CMSA), now known as LMSA West. While these organizations looked to other established national medical student organizations for inspiration, their beginnings differed greatly.

Early Steps Leading to the National Network of Latin American Medical Students

While LMSA had its beginnings from student efforts at individual medical schools, other national medical student organizations were offshoots from larger parent organizations. For example, the American Medical Association (AMA) formed the Student American Medical Association, the precursor to today’s American Medical Student Association (AMSA) in the 1950s as a way to get students involved in organized medicine [10]. The National Medical Association (NMA) was formed in 1895 as the major professional organization for African American doctors and health professionals who were excluded from white organizations like the AMA. The NMA played an important role in the passage of the Civil Rights Act of 1964 and the president of this organization helped establish the Student National Medical Association (SNMA) as a means of supporting students and encouraging them to pursue a career in medicine [11, 12].

AMSA and SNMA, though distinct, shared a parallel history, where the student sections “broke off” from the parent organization for various reasons; these included a mix of differences in political ideology, desire for programmatic autonomy, administrative demands and funding. Today, both organizations are thriving, well-established, independent non-profit organizations with large student members in medical school chapters across the country. The two organizations also have numerous staff, property including stocks, and gross receipts of over $1 million (SNMA) and $3 million (AMSA) according to recent 2018 IRS tax records [13, 14].

Latino medical student groups had a different developmental experience. As outlined in other chapters of this book, Latino medical students formed their local and then regional organizations in response to personal and community needs using grassroots approaches. These organizations were rooted primarily in ethnic enclaves with strong cultural identities: Puerto Ricans in the Northeast, Cubans in the Southeast, Chicanos in the West, Mexican Americans in the Southwest, and Puerto Rican and Chicanos in the Midwest. Later waves of immigration would eventually introduce other Latino groups into the medical student pool. These regional Latino medical student groups each had their own rich history, had differing extents of reach and popularity within their respective geographical areas, and had variable financial stability. Some were plagued by the usual issues that student groups face (e.g. diminished student interest and lack of institutional support). They struggled with yearly turnover of leaders on the chapter, regional and national levels. Another challenge was the lack of infrastructure, such as permanent staff or offices. Moreover, there was also limited advising and mentorship on how to grow an organization due to lack of connection to a ‘parent’ organization.

In 1994, the National Hispanic Medical Association (NHMA) was founded to unify physician leaders around the country to address Hispanic health [15]. Co-founder, Elena Rios, MD, MSPH, had been instrumental in the founding of the West regional medical organization as a medical student in 1982. Dr. Rios also organized regional student leaders to form a national network of Latino medical students in 1987. This network, however, never took hold nationally among medical students, as reported by alumni from the mid-1990s—to the point that NBLHO and CMSA leadership in 1998 had no awareness of it. Years later, with the formation of NHMA, there was increased enthusiasm in revisiting the idea of a national organization for Latino medical students.

By the late 1990s, NHMA had reached out and encouraged student leaders from the various regional groups to attend the first NHMA conference held in Washington, DC in 1997. Due to rumors among the student leaders that NHMA was considering starting their own medical student group, the existing regional medical student organizations (e.g., CMSA, NBLHO, etc.) wanted to preserve the integrity of their regions. The conference created a natural opportunity for the student leaders from the various organizations to come together to discuss their regional organizations, successes and opportunities, and learn more about the NHMA. While there are no known records from those gatherings, meeting notes in an email to an NBLHO member indicated that, by 1998, the regional organizations agreed towards working together as a consortium with the aspiration to form a national organization (E. Figueroa, personal communication, 2020). The two largest groups, the CMSA, representing the West coast, and NBLHO, representing the Northeast, would participate under the conditions that neither organization would give up their history and autonomy and that there would not be a new organization dictating how their regions must operate. The other three regions agreed.

Rise of the National Network of Latin American Medical Students (NNLAMS)

We cannot seek achievement for ourselves and forget about progress and prosperity for our community…Our ambitions must be broad enough to include the aspirations and needs of others, for their sakes and for our own.

—César Chávez

In March of 1998, the leaders of the five regional groups agreed to form the National Network of Latin American Medical Students (NNLAMS). The leaders of the following five regional organizations would serve as the ruling body of the organization called the NNLAMS Board of Directors: Latino Midwest Medical Student Association (LMMSA; Midwest), National Boricua Latino Health Organization (NBLHO; Northeast), Hispanic American Medical Student Association (HAMSA; Southeast), Texas Association of Latino American Medical Students (TALAMS; Southwest), and Chicano/Latino Medical Student Association (CMSA; West). As the inaugural National Coordinator, the board selected Fausto Meza, MD (Table 7.1), from the University of Texas Medical Branch at Galveston. Though there was agreement to align, the discussion was heated and lengthy to find a consensus on the national name. Fidencio Saldaña, MD, served as Fundraising Chair for NNLAMS from 1999 to 2001. As an attendee of NNLAMS’s first Garcia Leadership & Advocacy Seminar (GLAS) in Galveston, TX (Table 7.2), Dr. Saldaña recalls the debate surrounding which organizational name to use:

In our sense, it was the first time recognizing the importance of national connections and blending a Latino diaspora across the United States. It was a recognition of the importance of coming together, how big our Latino community was, and that GLAS was recognizing how to foster these leaders, the first steps.

However, there was deep concern about loss of regional autonomy, finances, history and identity in the movement to unify nationally.

The politics of identity is a particularly repetitive theme when organizing Latinos/Hispanics, as linguistic, socioeconomic, and numerous other differences exist within this single demographic. Although many Latino students are Spanish speaking, not all are; even within the Spanish language, different accents, phrases, and word definitions are used depending on country of origin. In terms of immigration status, some students were born in the United States to families who have resided for generations on land that formerly existed under Mexican or Spanish rule. Other students whose families more recently immigrated from Cuba, Mexico, Venezuela, El Salvador, or other Latin American countries have had vastly different lived experiences, especially with the U.S. immigration system. Some students have had one parent who identifies as Latino and another parent who has not, representing broad diversity in cultures and ethnicities. Some of the students were the first in their family to attend college, while others came from generations of physicians. It is with this background of differences that the members came to the table to negotiate an organizational name. The words in the name NNLAMS were carefully considered, as each conveyed identity and/or hierarchy; both of these needed to be balanced. Thus, it was agreed that the national structure would be a “network” and that the national leader would be a “coordinator”—not a president. In addition, the identity term chosen was not Hispanic, Chicano, Boricua, or Latino, but rather Latin American.

The 1999–2000 academic year saw significant progress towards building a unified, national Latino medical student organization. During this time, there was ongoing two-way communication between NNLAMS and the regional organizations, consisting of regular conference calls and emails. For the first time, all regions were coordinating small scale projects to deploy simultaneously, such as student surveys, bone marrow donor registration drives, and leadership development conferences. One of the NNLAMS national officer positions was the American Medical Association/Council of Medical Student Organizations Liaison (AMA/CMSO). From its inception in 1999, NNLAMS had a vote in the AMA Medical Student Section. In February 2000, NNLAMS leaders were invited to attend the 4th annual NHMA conference in Washington, DC, and were provided conference space and a time for meeting to discuss organizational matters and network. Over 150 pre-medical and medical students were registered to participate in NNLAMS at the NHMA conference. By March 2000, the NNLAMS board had drafted their own constitution, and regional organizations began the process to update their own organizational documents to reflect their membership in the consortium. Importantly, NNLAMS clarified that they were not, nor never had been, the official student arm of the NHMA.

Per its constitution’s mission statement, NNLAMS was “founded to represent, support, educate, and unify U.S. Latino/a medical students.” The organization’s objectives were as follows:

  • “To unify the body of Latino medical students in the U.S.;

  • To actively promote recruitment and retention programs at all levels for Latinos;

  • To educate Latino medical students on health issues; to protect and advocate for the rights and interests of Latinos in health care, both as providers and consumers;

  • To promote leadership opportunities for Latinos in medicine; and

  • To promote volunteerism in the Latino community.” (See Fig. 7.1.)

The NNLAMS constitution also established roles for its national officers and enabled its national board members—that is, the leaders of the five regional organizations—to make organizational decisions. This allowed regions to set the vision of NNLAMS and direct unified efforts among Latino medical students nationwide.

Fig. 7.1
The cover page of the first N N L A M S newsletter. It has the details of the N N L A M S formation and its 6 objectives. It has a photo of sixth annual G L A S.

Cover Page of First NNLAMS Newsletter, 2005 (©LMSA)

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Moreover, in 2000, NNLAMS leaders created an additional forum to meet, the Garcia Leadership and Advocacy Seminar (GLAS), which continued annually until 2015. The creation of GLAS was led by Fausto Meza, MD, with the aim to train regional student leaders and national student officers in effective leadership and advocacy skills. He noted “these students were leaders, and would go on to be leaders as physicians,” and so he wished to help better arm them for that role. He also had the goal in mind of bringing student leaders together in person to build bonds and trust, in order to foster national collaboration. From 2000 to 2003, NNLAMS leaders convened in person annually at GLAS and at NHMA’s annual meeting. While the regional organizations continued to focus on activities within their respective regional territories, NNLAMS began to function as an umbrella under which regions could more closely network. Moreover, as the annual turnover of leaders often jeopardized the survival of a national union, each meeting also served to reemphasize reasons to unify nationally and build trust between regions. NNLAMS leadership during these years kept the organization in existence, and created the opportunity for leadership and advocacy training at the GLAS conferences.

In 2003, these efforts culminated in the formal incorporation of NNLAMS as a consortium of five regional organizations under one national name. At that time, NBLHO and CMSA kept their regional names, while the other regions changed to NNLAMS Midwest, NNLAMS Southeast, and NNLAMS Southwest. Philip DeChávez, MD, MPH, then a 2003–2004 Morgan Commonwealth Fund Fellow in Minority Health Policy at Harvard University, led the efforts to acquire non-profit status, with advice from Dr. Rios of NHMA. While in medical school, Dr. DeChávez was a national leader of Latino medical students, serving as NBLHO President from 1998 to 1999. Dr. DeChávez was ultimately appointed by NNLAMS student leaders as the organization’s National Executive Director, though he had been serving as a physician advisor for several years. NNLAMS obtained federal recognition as a 501(c)(3) nonprofit organization in 2004, which facilitated more concerted fundraising and unification efforts.

NNLAMS held its first national conference in 2006, in conjunction with the NHMA annual meeting that year (Table 7.3). Thanks to the efforts and support of multiple individuals, including National Coordinator Anthony Oliva, MD, PhD, and Dr. Rios of NHMA, NNLAMS developed a 2-day conference attracting over 200 medical and health professional students from all over the country. The conference provided an opportunity for NNLAMS student leaders to reflect upon the previous year’s work, network with other students and health professionals, and organize the organization’s operations, vision, and strategic plan. NNLAMS was also able to fundraise $1000 from that first conference, facilitating the enactment of future programming. Moreover, the first conference furthered the organization’s goal of inspiring the next generation of Latino physicians. Lorena Del Pilar Bonilla, MD, 2005–2006 NNLAMS Secretary, recalls “being so impressed with the keynote speaker, Joxel García, MD, Deputy Director of Pan-American Health Organization (PAHO).” She remembers 14 years later how his words inspired her to “be a physician that can be a catalyst for positive change and go above and beyond to address Latino health disparities even as a medical student.” NNLAMS continued to receive physical space for its programming at the NHMA National Conference through 2009. Each year, conference attendees increased in number, and NNLAMS was growing in strength, participation, and aspirations.

Alongside its growing events, NNLAMS added a slew of other national initiatives from 2006 to 2009. These initiatives included a national community service day, titled NNLAMS César Chávez National Latino Health Day, and several publications geared at growing organizational funds and providing additional resources to medical students across the country. Daniel Turner Lloveras, MD, then a medical student at the University of Chicago, championed the idea of a service day alongside César Chávez’s niece and NNLAMS member Christina Chávez, MD; both proposed the initiative at the 2007 NNLAMS conference and the event was launched that year. One day a year, all NNLAMS chapters across the U.S. would volunteer, work towards, and advocate for the improved health of Latino communities. Then a medical student at the University of Illinois at Chicago (UIC), Elizabeth Homan Sandoval, MD, MPH created the NNLAMS Residency Guide as a mechanism to raise funds for the organization. Launched with the help of then-students Anika Backster, MD; Michael López, MD, PhD; and Gerardo Solorio, MD; the annual guide garnered sponsorships from medical schools wanting to advertise to Latino medical students. This generated a major source of revenue for NNLAMS until 2010. Additional publications included the NNLAMS National Newsletter started in 2005 by then-UIC student Vanessa Villacorta, MD (Fig. 7.1). Lastly, with the help of Dr. DeChávez, NNLAMS sought out grants and increased fundraising efforts to maintain its operations in the absence of national dues or regional contributions. While dues would later be instituted as the organization continued to grow, this rising NNLAMS—led primarily by students, for students—sowed the seeds for programs that would last for decades.

Unification: The Struggle and Compromise for a Shared National Identity

NNLAMS represented the first steps toward creating a national identity for Latino medical students. It had achieved this goal by setting the foundation of a national board and a means to communicate among the various regions. However, a major limitation was that the organization served merely as a “network” among various regional organizations, leaving NNLAMS with limited potential to grow. The identity and loyalty of most individual members rested firmly with their respective regional organizations, not with NNLAMS. Throughout the early 2000s, the engagement of various regions with NNLAMS waxed and waned depending on the priorities of the individual regions. For example, CMSA in the West was undergoing major internal restructuring from 2003 to 2007 that led to the name change into LMSA Inc.; its leadership had minimal to no desire of participating in the further development of NNLAMS. The West region created the junior executive position of NNLAMS Representative to attend national events and vote on behalf of the West rather than have their CEOs directly involved. Moreover, there was difficulty in recruiting members from all the regions to be part of the national leadership board, as medical student leaders felt that their time was best spent working to develop their regional organization. An exception to this was the NNLAMS Midwest region, which had student leadership involved in growth of both the Midwest and the national entity. A pivotal moment in greater unification occurred with the development of the first NNLAMS national conference, occurring in conjunction with NHMA in 2006 (Table 7.3). Many NNLAMS leaders saw the conference as a unique opportunity to develop its own workshops, programming materials and fundraising avenues independent of regional support. Moreover, Latino medical student leaders had a new avenue to come together in a setting outside their regional events where they could get excited about a national identity. With each new NNLAMS national conference, the number of participants increased, to the point where, eventually, an independent conference was needed.

Moreover, around the mid-2000s, conflicts began to emerge between NHMA and NNLAMS. First, while NNLAMS faced reduced room rental and food expenses by sharing a venue with NHMA for the organizations’ annual meetings, profit sharing was minimal. The joint event arrangement left NNLAMS with no revenue from conference attendee or exhibitor registration and only funds raised through advertising in the Residency Guide. This threatened long-term organizational growth. Secondly, NNLAMS faced competition from NHMA in the quest to represent Latino medical students nationwide. At the time, NHMA was working to form its own national medical student arm, in order to represent Hispanic physicians at every level of training—from premedical students to retired physicians. To achieve this goal, NHMA launched its own local medical student organization in the Washington, DC, metropolitan area. This organization primarily worked on mentorship for premedical students, helping to create the premedical student exhibitor fair and medical student panel held as part of the NHMA conference. The students involved with NHMA’s medical student section were invited to be part of the NNLAMS national conference in 2007. That year, NHMA medical student section representatives communicated that the eventual goal for NHMA was to have NNLAMS merge with the medical student section of NHMA, with NHMA maintaining control of the student section’s finances and leadership structure. For several reasons, many NNLAMS leaders worried such an arrangement would lead to a loss of historical identity, autonomy, flexibility, and ability to effectively serve students. Third, as the NNLAMS conference expanded, there was an increased need for larger rooms, additional time slots for educational and leadership sessions, and better coordination of conference planning than had been afforded by NHMA leadership. In interviews, several former NNLAMS leaders remarked that unnecessary logistical difficulties arose due to hosting the annual conference jointly with NHMA, kickstarting conversations regarding a standalone NNLAMS event.

A critical turning point between NHMA and NNLAMS took place at the 2008 national conference. Students complained that the NNLAMS workshops at the conference were overcrowded and hot, jeopardizing involvement in future events. Moreover, students involved with NHMA’s local medical student arm were introduced at the NHMA conference gala as national medical student leaders, with concomitant disregard of NNLAMS and NNLAMS’ established, autonomous leadership. Despite these two organizations existing separately from one another, leaders involved with the NHMA medical student section attempted to take part in the closed-door meeting of the NNLAMS board; this move was largely perceived by NNLAMS as encroachment. Based on the previously existing agreement between NNLAMS and NHMA, the final joint conference was set to take place in 2009. As NNLAMS Executive Director, National Coordinator, National Coordinator-Elect, and LMSA-NNLAMS Liaison, respectively, Dr. DeChavez, Ruben Font, MD, Julia Bregand-White, MD, and Mario Teran, MD, proposed the launch of a fully independent NNLAMS national conference in 2010. The proposal rapidly garnered broad approval.

Soon thereafter, the NNLAMS Board held further discussions about pursuing unification rather than remaining a network of regional organizations. Talks resumed at the LMSA Inc. conference in the West, hosted by the University of California, Davis. Mario Teran, MD, and Alvaro Galvis, MD, PhD, had just been elected as northern and southern CEOs for LMSA Inc. in the West. Working with Dr. DeChávez and student doctor Font, they devised a strategy to launch final unification of all the regions under the LMSA name. Several NNLAMS leaders felt the organization could no longer remain static, given the climate in which the organization found itself: one of rapid growth necessitating a robust long-term strategy and being recognized as an independent 501(c)(3) organization representing the national voice of thousands of Latino medical students. Regarding the name to use for the national organization, significant debate emerged regarding the differences between the terms “Hispanic” and “Latino.” The former was considered an English-language term that generally referred to the way that Latin Americans are united through their connection to Spain and their links to Spanish culture and tradition [16]. While Spaniards would be included under this term, Brazilians would not. The term had been used politically by White House administrations to distinguish Hispanics as a different type of “white” from Anglo descent, and was preferred by most Baby Boomers and older Generation X members. On the other hand, the term Latino was viewed as a Spanish-derived word that referred to the way that Latin Americans are connected to one another via their common history of colonization. Spaniards, then, would not be part of this formulation, while Brazilians would be. This term had been popularized in the late 1900s and early 2000s, appealing to younger members of Generation X and early Millennials. While these terms are often perceived as interchangeable in broader society, many students preferred using Latino based on their association with the common history of colonization rather than with a European power. Moreover, Latino as a Spanish/Latin word created an additional distinction from NHMA. Throughout the entire history of organizing by Latino medical students, all of the formal student groups that emerged at the regional and national levels chose words other than Hispanic in their titles (e.g., NBLHO, CMSA, La Raza Medical Student Association, LMMSA, LMSA). Thus, it came with little surprise that LMSA emerged as the name behind which all regions could rally.

The process by which unification would occur was developed by the “unification team,” consisting of student doctors Galvis, Teran, Font and Bregand-White, alongside Executive Director Dr. DeChávez. These individuals created a full presentation delineating the model for unification, which would serve as part of the strategic planning for the organization for the following year. The model was first presented at the combined NNLAMS GLAS & LMSA Inc. Leadership Conference, held in the summer of 2008 at University of California, San Diego. The model divided unification into four phases: acceptance, name change, integration, and completion. Phase 1—acceptance—had already been fulfilled, with the promotion of a national identity, the increased collaboration between regional organizations, the creation of NNLAMS, and the accomplishments of this national entity. Phase 2, scheduled to be finished in 2010, involved the adoption of the LMSA name by all regions, with the West region transitioning its name fromLMSA Inc. to LMSA West. Phase 3—integration—was originally presented to take place between 2011 and 2013, and entailed pursuing several opportunities for greater interconnectedness between LMSA National and its regions. Internally, this phase would involve the creation of a constitution and bylaws document for the new LMSA National, allowing the organization to define and synchronize the roles of its executive officers and governing Board of Directors. Externally, all regional websites would show a unified front by becoming subdomains of lmsa.net, using the same template and design, and hosting all content on a national server. Finally, national profits and fundraising would become more centralized, with some distribution of funds going to the regions. To be completed after 2013, Phase 4 was pitched as the culmination of unification efforts, with LMSA National in a position to seek funding to have permanent paid staff, seek other avenues of political involvement as a nonprofit with 501(c)(4) or 501(c)(6) status, and be on par with peer organizations such as SNMA and AMSA.

The process of the name change transition from start to finish took almost 2 years (2008–2010). From Fall 2008 to Spring 2009, the unification team traveled to all regional board meetings, presented the unification model, and addressed questions and concerns from regional leadership. Intense debate took place at the regional levels, particularly in the Northeast and West, as student leaders discussed concerns about loss of local and regional identity and history. As National Coordinator in 2009, Julia Bregand-White, MD, released a letter titled “State of the Network’‘ along with a video address; in both, she grounded the evolution of NNLAMS to LMSA in the need to further unite those dedicated to changing the “Face of Medicine and the way health care is delivered in our country.” According to Dr. Bregand-White, the transition from NNLAMS to LMSA was rooted in the desire to give Latino medical students a national presence, voice, power, and recognition. To do so, NNLAMS needed to trade siloed regional efforts to one national identity. Framing the transition in this light helped convert staunch opponents of the change into some of the transition’s most favorable proponents. Ultimately, the greater gain of a unified identity for a stronger national voice superseded the apprehensions that were passionately considered and debated. Over the 2009–2010 academic year, each region formally approved the name change to LMSA and executed said change in its legal and financial documents. The spring of 2010 marked two key milestones: the launch of the first independent national conference in Chicago, IL; and the rebranding of all regions to LMSA Midwest, LMSA Northeast, LMSA Southeast, LMSA Southwest, and LMSA West.

However, the work was not yet over. National student leaders at the time of the NNLAMS-LMSA transition focused heavily on further unifying regions and generating greater visibility for the organization on a national stage. At GLAS 2010, led by National Coordinator Galvis, the LMSA National leadership team moved to create new initiatives focused on a renaissance of the organization’s brand and reach. In line with the previously defined Phase 3 component of the unification plan, the organization pursued four major undertakings: (1) clarifying and redefining its relationship with NHMA; (2) fundraising as a unified entity; (3) restructuring national leadership and programming; and (4) rebranding the new LMSA National organization.

Upon completion of its name change, the new LMSA became the premier organization for Latino medical students. To mitigate ensuing tension with NHMA, National Coordinator Galvis and Dr. DeChávez traveled to Washington, DC, after GLAS to meet with Dr. Rios. In that meeting, NHMA agreed to halt its own independent medical student organization and LMSA agreed not to pursue its own physician organization. A new Memorandum of Understanding was created in which the National Coordinator of LMSA became an ex officio member of the NHMA Board. NHMA would recruit graduating medical students to become members of their organization through the NHMA Council of Residents (COR) and the latter entity’s involvement in LMSA meetings. LMSA agreed to send its National Board and National Coordinator to participate in the NHMA annual meeting with travel support by NHMA. LMSA and NHMA also agreed to coordinate so that their conferences and major events did not overlap, and to promote each other’s activities to their respective members.

In order to fundraise for the rebranded organization, LMSA National created a dedicated fundraising committee in 2010. This committee transformed the existing LMSA newsletter to the more formal Journal of the LMSA (JLMSA), with Orlando Sola MD, MPH, as editor. With its first edition launched at the 2011 LMSA National Conference at the University of California, Irvine (UCI), the JLMSA provided additional opportunities for fundraising, through advertisements from medical schools and residency programs, and for showcasing LMSA members’ scholarly work. The fundraising committee also created the first LMSA National prospectus and began fundraising efforts for both the National Conference and the organization as a whole. Notable new sponsors during this period included the California Endowment and the Doctors Hospital at Renaissance (DHR), which subsequently became the major sponsor for both GLAS and National Conference from 2011 to 2015.

Furthermore, the LMSA National leadership structure underwent its first major restructuring during this period. This included the formation of a new LMSA National Policy Chair and Committee. Led by student doctor Sola and then-LMSA West Southern CEO Tatianne Velo, MD, the Policy Committee sought to create policy stances for the organization, explore new avenues of activism for LMSA, and file for designation as a U.S. 501(c)(4) or 501(c)(6) nonprofit organization. With this updated designation, LMSA could engage in lobbying and political activities to champion important causes for medical trainees. Keeping this in mind, LMSA was invited to join the National Association of Hispanic Healthcare Executives (AHHE) by their president and founder, George Zeppenfeldt, MD. National Coordinator Galvis spoke at the AHHE National Legislative Summit in New York and the AHHE/Hispanic Congressional Causes Healthcare Summit about Hispanic health care disparities and the lack of support for Latinos to enter medical schools.

For rebranding, LMSA created a Branding Committee in 2010. Led by Victor Cueto, MD, MS, then a medical student at Drexel University College of Medicine, this working group spearheaded a number of new initiatives based on perspectives from all the regions. The committee invited each region to provide representatives, independent of the national leadership, and tasked committee members to help take stock of their region’s viewpoints. The most lasting and impactful work of the committee was the design and adoption of a new logo, which LMSA has continued to use through 2022 (Fig. 7.2). The decision to adopt a new logo was a practical, yet extremely symbolic and momentous change. At the time, the logo used at the national level was the original logo used by LMSA Inc. in the West. However, the digitized original work of this logo had been lost over time; hence, there was no available high-resolution copy that could be utilized for merchandising and printing purposes. In crafting the new logo, the branding committee and national leadership aimed to not break with tradition, but rather build on its strong foundation. After 1 year of discussion and debate at the local, regional and national levels, the executive board voted on a new logo with updated features that represented all regions, while honoring the tradition of the former logo, such as the UFW águila (eagle) and its important place in the cultural roots of the West region. The new logo had a familiar circular shape and blue color, yet the caduceus at its center was replaced by the rod of Asclepius, a more appropriate symbol of medicine. The rod of Asclepius was flanked by eagle’s wings on a background of a rising sun, and newly crowned with five stars representing the new unified organization of five sister regions. The logo was approved at the 2011 LMSA National Conference held at UCI, the largest LMSA conference to date with over 1000 attendees. By the fall of 2011, a year after the effort began, the new symbol of a unified LMSA began to be widely used in official publications. In the spring of 2012, it was officially introduced to members in the form of a commemorative pin. After a long and arduous transition process to assume a common name, website, logo, and identity, LMSA headed into a new decade with five regions and thousands of members – stronger and more united than ever before (Fig. 7.3).

Fig. 7.2
3 logos. a. L M S A National Logo, Caduceus flanked by eagle's wings on a shield, with a background of a sun. b. Caduceus is flanked by an eagle’s wings in a circle, surrounded by the text Latino Medical Student Association. c. The rod of Asclepius is flanked by an eagle’s wings in a circle, surrounded by the text Latino Medical Student Association.

NNLAMS & LMSA National Logos (©LMSA). (a) NNLAMS Logo prior to national unification and renaming in 2010. (b) Logo used by LMSA National between 2010 and 2011. (c) Updated LMSA logo, approved in 2011 and in use through 2022

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Fig. 7.3
A map of U S A. It highlights the L M S A national regions of the Midwest, Northeast, Southeast, Southwest, and West.

LMSA National Regions (©LMSA)

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Over a Decade of Evolution: LMSA National, 2009–2022

The following section will discuss the development and growth of the national organization’s identity specifically as LMSA. It should be noted that LMSA’s development process has, by no means, remained static since the organization’s renaming in 2009–2010. As alluded to above, LMSA continues to evolve each year with changing leaders and members, and its flexibility and dynamism imbue the organization with unique strengths, as well as distinct challenges.

Julia Bregand-White, MD, and subsequent National Coordinators/Presidents continued to prioritize unity over the years that followed, through deliberate attempts to have the national organization deliver clear benefits to LMSA members and regions. Such benefits included the creation of infrastructure and documentation so that students at individual medical schools could start their own chapters, thereby growing the LMSA network. Moreover, LMSA National sought to collaborate with AMSA, SNMA, and other peer organizations to establish joint programming that members of all organizations could attend. NHMA was tapped in order to create a list of physicians willing to advise LMSA students, regardless of geographical distance. LMSA continued to utilize its vote and voice at the AMA MSS; notably, through the efforts of AMA and LMSA leaders such as Dr. Homan Sandoval, voting participation of all Underrepresented Minority National Medical Student Organizations was codified by the AMA House of Delegates in 2008. National leaders over the years have sought to leverage these and other partnerships and collaborations to provide members and regions with the resources needed to thrive.

Simultaneously, LMSA began crafting new national priorities, in addition to those set in place by NNLAMS predecessors. Among the first of these was medical Spanish. In 2011, Ray Morales, MD, PhD, became National Coordinator after serving as NNLAMS Midwest Co-Director, and was elected on a platform of bringing medical Spanish curricula to the forefront of undergraduate medical education. From there, a national medical Spanish committee quickly came to be, and was led by student doctor Morales and Lauren N. Rodríguez, MD, with mentorship from longtime LMSA advisor Monica Vela, MD. Not only did LMSA develop and disseminate a medical Spanish curriculum that its chapters could implement, but the organization also conducted a national survey on the “state of medical Spanish curricula at U.S. medical schools,” obtaining responses from 83% of U.S. medical schools [17]. Though 66% of schools had some form of medical Spanish instruction incorporated into their curricula, very few of them had validated instruments to measure proficiency after course completion. This study was the first to discuss the expanding medical Spanish curricula in the U.S. and is thus cited repeatedly as a landmark article on the topic.

As another national priority, LMSA aimed to make the organization—and medical school in general—more accessible to students. At the 2012 LMSA National conference at Harvard, then-VP of Scholarship Jimena B. Alvarez, MD, presented the first LMSA National Scholarship, after fundraising for it and organizing for a year. This was also the first LMSA conference that had its own commercial, which was filmed and streamed thanks to National Coordinator Morales. That same year, the LMSA Regional Development Committee—led by then-Yale School of Medicine student Amanda Hernández, MD, PhD—sought to develop a structure for the formation of premedical student chapters. Through the proposed Pre-Medical Association of Latino Students (PALS), LMSA sought to develop pre-medical student groups that would branch off of LMSA medical school chapters, enabling the strengthening of relationships to pre-medical students for the provision of support, mentorship, and opportunities for involvement in LMSA events. The LMSA Regional Development Committee envisioned implementing PALS through a series of phases. Phase 1 was to gather information on existing Latino pre-medical programs and how LMSA could be supportive, creating momentum for the project. Phase 2 was to centralize and strengthen already existent premedical organizations and their relationships with medical students. Then a student at the University of Miami, Daniella Delgado, MD, did much in the role of Pre-Med Liaison to advance the initiative from the undergraduate side. Dr. Delgado shared, “Throughout my undergraduate years, LMSA involvement was one of my most formative experiences and helped me develop many of the skills I needed as a physician. For these reasons I love LMSA!” By 2012, with Emma Olivera, MD, as National Coordinator and Miguel Gosalbez, MD, as Membership Co-Chair, the pre-medical chapter program was launched as the LMSA Premedical Latino Undergraduate Society (LMSA PLUS).

Collaborations were continually emphasized during this period. In 2012, multiple memoranda of understanding (MOUs) were signed, updating and establishing relationships with partners such as the National Hispanic Medical Association, National Hispanic Serving Health Professions Schools (HSHPS), Student National Medical Association (SNMA), and Dr. First. SNMA invited National Coordinator Olivera to speak at their 2012 national Annual Medical Education Conference on the topic of Eliminating Health Disparities: Partnerships with a Purpose. Likewise, then-SNMA President Michael Knight, MD, MSHP, was invited to the LMSA National Conference that year. A much needed database software program was developed through collaboration with UIC to better track LMSA members and alumni. In 2012, Doctors Hospital at Renaissance (DHR) commenced their generous support of GLAS events for 4 years. Notably, this relationship with DHR was critical for the advancement of LMSA National. During GLAS, the mission and vision of LMSA were repeatedly reviewed, debated, and updated, as the leadership felt it was necessary to continue to clarify and agree on the future path of LMSA and its five regions. This discussion continued for another few years, culminating in significant updates to the constitution and officer positions.

When student doctor Galvis returned for a second term as National President in 2013, the task of evolving infrastructure to meet organizational demands was of the utmost priority. At that time, the Southeast and Southwest regions were having difficulties with recruitment and fundraising. To support them, a new profit sharing proposal was created that would not only give every region a certain portion of funds from National Conference profits but would also dedicate additional funds for regions that needed further development. Moreover, as NHMA had started to develop regional infrastructure modeled on LMSA’s regions, LMSA asked NHMA regional liaisons from the latter’s COR, Council of Young Physicians (CYP), and senior physicians to serve as advisors to LMSA regional leaders. To bolster scholarship fundraising efforts and amounts, a guaranteed portion of conference profits was set aside to fund scholarship recipients. Lastly, LMSA National expanded both its Policy Committee and its relationship with NHMA to facilitate the launch of the LMSA Policy Summit. Set to take place during the NHMA National Conference, the LMSA Policy Summit attracted students who would participate in the advocacy training sessions offered by the summit, as well as legislative visits with their respective elected representatives on Capitol Hill. NHMA facilitated the scheduling of these Hill visits, filling a key operational need at that time.

Enacting Structural Changes to Set a New Path Forward

The process of unifying regions into one national entity and identifying a new path forward for the organization highlighted the need for significant structural changes to leadership positions at both the regional and national level. In seeking to establish a more unified national organization, leaders after 2011 needed to develop an initial mission, vision, and structure of LMSA National, such that the organization’s core components embodied the shared goals and values of its diverse membership. Under the leadership of the National Coordinator Olivera and National Coordinator-Elect Galvis, LMSA voted at GLAS 2012 to simplify the mission statement, turn most of the NNLAMS old mission statement into objectives, and establish a vision of the organization. The approved proposal read as follows:

The Latino Medical Student Association unites and empowers medical students through service, mentorship and education to advocate for the health of the Latino community.

Our vision is: Unifying Medical Students to promote Latino health.

Part of our objectives include:

  • To unify all Latino medical students into one organization;

  • To provide a voice for underrepresented medical students;

  • To actively promote recruitment and retention of Latino students at all levels;

  • To educate medical students on Latino health issues;

  • To advocate for the rights of Latinos in health care;

  • To provide leadership opportunities for Latinos; [and]

  • To promote volunteerism in the Latino community [18].

Leadership positions at the national level reflected the aforementioned priorities: of 15 officers in 2011–2014, 3 focused on membership and regional development; 2 on health policy, one of which served as LMSA representative to the American Medical Association Medical Student Section (AMA MSS); 2 on publications, the positions of which oversaw the creation and maintenance of the Journal of the Latino Medical Student Association; and 1 on coordinating a nationwide community service day, termed Latino Health Day and timed to coincide with César Chávez Day.

As LMSA National’s programming, fundraising, and outreach expanded, so did the responsibilities of the National Coordinator. This, combined with growing trust between the regions and the national organization, led to the renaming of the top leadership position to National President for the 2013–2014 term and beyond. The increased frequency of in-person national meetings, between GLAS, leadership retreat, and a national conference assisted in the upswing of trust. In reflecting on the differences between his two terms at the helm of LMSA National, Dr. Galvis states:

My first term [as Coordinator] was about creating the new normal LMSA National with our motto of ‘strength in numbers.’ In my second term, [as President,] it became about infrastructure building: how to make an organizational impact for the next ten years. The energies between the groups were completely different. But that is the beauty of a constantly evolving organization.

The National President title more appropriately reflected the significant responsibilities of the position on the student’s curriculum vitae and residency applications. There was also a contraction of elected national officer positions to simplify elections at the LMSA National Conference. Many positions were shifted to appointed positions to save time for other business at the meetings. The National Coordinator-elect position was eliminated and the Vice President position was split into two: Internal Affairs and External Affairs.

Ultimately, LMSA sought to create a new organizational model and constitution which would better align regional leadership positions and improve efficiencies across the organization. This effort also aimed to harmonize regional and national leadership structures, as well as enhance collaboration between these bodies. In 2015, under the leadership of National President Amanda Lynn Hernández, MD, PhD, LMSA unveiled an updated constitution that ushered in a number of key changes. Notably, the updates formalized the LMSA National Executive Committee, creating a structure for the group of officers tasked with overseeing the national organization’s operations and programming. The Executive Committee was distinct from LMSA National’s Board of Directors (BOD), which consisted of two directors from each of the five regions. As was the case in NNLAMS, the BOD represents LMSA National’s voting body, such that initiatives LMSA seeks to implement at the national level must obtain approval by regional directors. This two-tiered governance structure has existed through 2022.

Within the Executive Committee, new positions were created to reflect both the growing ventures at the national level and the successful models at the regional level. Some of these positions fell under the newly formed External Affairs branch, which focused on outward-facing aspects of LMSA, such as public relations, digital media, and partnerships with other organizations. Other positions were added to the Internal Affairs branch, charged with managing all membership matters and business operations, such as finances and record-keeping. This expanded structure of the LMSA National Executive Committee remained as described in place until 2022, when it was further elaborated into Operations, Programming, and Communications branches (Fig. 7.4). Moreover, since 2015, regional leadership structures have also changed in order to mirror positions at the national level and promote collaborations between national and regional organizations. National committees have aligned with regional positions to ensure that all regional officers for a given position would sit on the corresponding national committee, mentor and be mentored by their peers and counterparts, and synergize national and regional efforts. Such changes, while seemingly minimal, have had significant implications for organizational unity and for increasing leadership opportunities for trainees from underrepresented backgrounds in medicine.

Fig. 7.4
A hierarchy chart of L M S A national leadership team. Level 1. Executive Director. National President. Regional Co-Directors. Level 2. Deputy E Ds. I P P. Regional officers. Level 3. National, regional, and chapter advisors under Deputy E Ds. V P operations, programming, and communications under I P P.

LMSA National Leadership Structure as of December 2022 (©LMSA)

Full size image

Expanding Advisory Support: The Role of Professional Advisors & Faculty

Historically, although each chapter had to have at least one faculty advisor, LMSA and its national precursors operated with few official faculty or physician advisors. In the decades since the formation of NNLAMS, the roles and structures of advisors have been revised multiple times. When Dr. DeChávez led the initiative to establish NNLAMS as a 501(c)(3) organization, he became the organization’s first National Executive Director (ED) in 2003. That position has remained the main advisory role to the organization even through 2023, and has always been filled by a volunteer physician. In 2004, NNLAMS established an Alumni Board of Trustees composed of physician alumni who had been involved with the organization for over 10 years. The objective of this alumni board was to ensure the stability, continuity, permanence and long-term vision of the organization. As listed in the NNLAMS 2007 and 2008 National Conference programs, advisors included Fausto Meza, MD, Phillip DeChávez, MD, MPH, and Louis DiBernardo, MD. Unfortunately, the Alumni Board of Trustees petered out over time.

Thus, in 2010–2011, National Coordinator Galvis created an Advisory Council which included Dr. DeChavez as National ED; Monica Vela, MD, as Physician Advisor; Richard Zapanta, MD, as NHMA Advisor; Ruben Font, MD, as Alumni Advisor; and Julia Bregard-White, MD, as Alumni Advisor. However, this council experienced frequent turnover and dissolved. Following the passing of Dr. DeChavez, Dr. Font was selected to serve as National ED in 2013. Following Dr. Font’s departure from the role, Elizabeth Homan Sandoval, MD, MPH, was selected by the LMSA National Board in 2015 to become the third LMSA National ED. As former LMSA Midwest Co-President, National leader, and Southeast Advisor during residency, Dr. Homan Sandoval had been highly involved with the organization for almost a decade. In 2017, John Paul Sánchez, MD, MPH, was selected as National Co-ED. While the plan at the time was for the position to become a two-person role, Dr. Homan Sandoval stepped down in Spring 2018.

Chosen for his instrumental role in the creation of NHMA COR and CYP, along with his extensive national and regional involvement in LMSA as NMHA COR Chair, Dr. Sánchez as National ED set out to develop a strong national advisor reservoir for LMSA leadership. During the LMSA National Conference at Hofstra in the spring of 2017, he created the first LMSA Advisor Orientation and Training programming to entice more chapter advisors to attend. In November 2017, alongside then-LMSA National President Eric Molina, Dr. Sánchez successfully established a formal LMSA Faculty/Physician Advisory Council (FPAC), with clearly defined and documented structure and objectives. Overseen by the National ED, LMSA FPAC was formed with physician and faculty advisors from each of the five regions. National advisors bear considerable knowledge and expertise in LMSA structure and history, and serve as content experts for varying responsibilities of the organization and topics of particular importance to the LHS+ medical student community.

LMSA National Faculty/Physician Advisory Council (LMSA FPAC)

As of this chapter’s development in 2022, FPAC consists of nine distinguished academicians, possessing dean, chancellor, and/or full professor with tenure designations, from across the country. Led by the LMSA National Executive Director, FPAC works to:

  • Support and refine the strategic plan of LMSA National each year;

  • Increase discussion of ongoing and emerging Hispanic-related health issues;

  • Promote more engagement by LMSA local medical school chapters in regional and national programming;

  • Empower local chapters and their advisors to develop the personal and professional interests of LMSA members and cultivate the next generation of Latino leaders; and

  • Identify strategies to bolster the promotion and tenure efforts of LMSA chapter advisors.

While NNLAMS and LMSA student leaders routinely consulted physicians and professionals for advice on various organizational matters, many of these same leaders emphasized the central role for students in dictating the organization’s direction. LMSA ultimately arose as a product of arduous grassroots organizing by medical students, fighting for collective recognition at the level of medical schools, states, and regions prior to national unification. As such, inherent in LMSA is an acute awareness of the balance between student leadership and advisor oversight. Moreover, student leaders have frequently debated the roles and responsibility of LMSA advisors, creating carefully crafted language and parameters for delineating the scope of advisor oversight and privileges.

However, LMSA’s growth, combined with the inevitable turnover of student leaders, necessitates the long-term involvement of physician and faculty advisors, the majority of which are LMSA alumni. Advisors provide institutional memory that extends beyond the 4 years of typical medical school training and are able to develop expertise around national organization professional responsibilities in order to mentor and foster successive generations of student leaders. Ultimately, the long-term involvement of physician, faculty, and alumni advisors in LMSA National has helped student leaders, across the years, maintain their focus and alignment on LMSA’s core values: unity, service, mentorship, education, and advocacy for patients and communities in need.

Embracing Allies

In recognizing the contributions of numerous student and faculty leaders, each with differing backgrounds and perspectives, it is important to acknowledge that LMSA would not be where it is today without the help of allies and allyship. In this section, allies will be defined as people who do not belong to a marginalized group but recognize the struggle of the marginalized group and are willing to:

…stand up and take on the problems borne of oppression as their own, without remove or distance…even if allies cannot fully understand what it’s like to be oppressed for their race or ethnicity, gender, sexuality, ability, class, religion, or other marker of identity.

—Roxane Gay, On Making Black Lives Matter [19]

Allyship is “a lifelong process of building relationship based on trust, consistency, and accountability with marginalized individuals and/or groups of people.” [20]

The growth of LMSA has benefited from mentors, members, and student leaders who do not identify as Latino. In 2019–2020, for the first time in the organization’s history, the LMSA National President position was filled by a self-identified ally: Julia Su, then an MD/PhD candidate at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. During her term, National President Su expanded the organization’s dialogue around allyship, and promoted similar discussions at other national organizations. Such discourse emphasized the importance of collaboration across racial, ethnic, and other identities in promoting the development of a diverse physician workforce and the improved health of all medically underserved communities.

Every year, many LMSA chapter leaders struggle with a common issue: they may be one of a few Latinos in their medical school and feel they do not have enough members to plan all the events they want while maintaining academic success. In working to plan initiatives ranging from Medical Spanish events to health fairs for immigrant communities, LMSA leaders may occasionally feel disempowered by the thought that their few numbers preclude them from accomplishing all the initiatives they set out to do. In such instances, allies and allyship have greatly benefitted LMSA. LMSA chapters often collaborate with their local SNMA counterparts to host events and programs that help reduce overall administrative burden. At some institutions, LMSA and SNMA chapters exist as combined entities. Additionally, allies join to learn about the health care disparities affecting Latinos and the ways they can better serve this population; sessions on cultural humility and Medical Spanish represent just a few examples of workshops that should extend beyond the walls of LMSA. Involving allies in such conversations is critical because, as future physicians, we all must learn to take care of patients from many diverse backgrounds.

LMSA activities play a critical role in developing this symbiotic relationship. With the help of allies, including, but not limited to, the SNMA, Asian Pacific American Medical Student Association (APAMSA), the Association of Native American Medical Students (ANAMS), and the AMA Medical Student Section, LMSA can better carry out its mission and goals to create a more diverse physician workforce that includes Latino individuals and allies and that—as a whole—better serves the Latino population. LMSA faces a serious task in 2023 and beyond of creating a clearer vision for its role in the world, particularly as the LHS+ (Latina/o/x/e, Hispanic, or of Spanish Origin+) community confronts exacerbated disparities in healthcare, immigration, education, and finances in the post-COVID-19 era. Allies will continue to be vital partners in LMSA’s fight to eliminate injustice.

National Initiatives & Programming for LHS+ Medical Students: Past, Present and Future

Since its inception as NNLAMS, LMSA National and its medical student leaders have sought to bolster the success of LHS+ individuals in medicine through the development and implementation of specific initiatives and programs, described further in this section.

Promoting Professional and Leadership Development of LHS+ Medical Students: The Garcia Leadership & Advocacy Seminar (GLAS)

In 2000, the Garcia Leadership and Advocacy Seminar (GLAS) was designed to cultivate and develop the leadership, organizational, and advocacy skills of recognized LHS+ medical student leaders from across the United States. As the architect of GLAS, NNLAMS National Coordinator Meza named the program in honor of Hector Pérez García, MD. Dr. García was a Presidential Medal of Freedom awardee in 1984, the first Mexican-American recipient of said award, and the subject of the Public Television documentary titled “Justice for My People: The Dr. Hector P. Garcia Story.” An important underlying objective of the conference was to formally develop national leaders and help unify leaders from across the U.S. in their work to build a national organization.

GLAS was hosted by the University of Texas at Galveston, Duke University in Raleigh, NC, and by Doctors Hospital at Renaissance (DHR) in Edinburg, Texas. In 2010–2011, Alvaro Galvis, MD, PhD, Ray Morales, MD, PhD, and Dr. DeChávez collaborated with Dr. Meza, who had gone on to become Chief Medical Officer at DHR. From 2012 to 2015, DHR was a generous supporter of LMSA National, hosting dozens of students for a 3-day conference each year and sourcing hotel rooms, conference space, support staff, and outstanding speakers. Speakers over the years that GLAS was held at DHR included former NASA astronaut Jose Moreno Hernández; Congressman José Ruiz, MD; Texas State Representative Veronica González; and several DHR hospital administrators, such as Carlos Cardenas, MD.

Annual National LMSA Conference

Over the years, there have been many outstanding accomplishments produced by dedicated medical student members volunteering their time to create a National Conference. The first great feat was in 2006 with the inaugural conference. In 2010, the next giant leap occurred with an independent conference. A year later, the largest National Conference in the organization’s history thus far took place at UCI. In 2014, the first round of 5 regions hosting the event was completed. By 2022, National Conferences have been held in each region twice, at allopathic and osteopathic medical schools, with average attendance of 200–500 medical and premedical students (Table 7.3).

Consistently, National Conferences have been packed with programming to build attendees’ knowledge base for advocacy and leadership, as well as clinical skills. The scientific poster sessions at every National Conference have provided a place for LMSA students to showcase their work and receive professional feedback on their posters and presentations. Awards presented at each poster session have helped students build their Curriculum Vitaes and their self-confidence. In 2018, a TED Talk-like session was started called “8 for 8” to highlight incredible scholarly works and service endeavors of LMSA members. One of the topics covered in the 2018 LMSA National Conference—hosted in conjunction with LMSA Southeast—was the Puerto Rico Task Force, which provided grants, textbooks, and other support to medical students in Puerto Rico severely impacted by Hurricane Maria. The 8 for 8 session was a chance for students to share the details of their extraordinary work, be recognized for their efforts, and inspire others.

Fostering Growth of Physician-Advocates: LMSA Policy Summit

Young people have a duty to defend their country with weapons of knowledge

—Pedro Albizu Campos

Since its inception in 2014 (Table 7.2), the LMSA National Health Policy Summit brought together LMSA members from around the country. Attendees have learned about timely health policy issues facing U.S. LHS+ communities, have gained exposure to leadership development strategies and opportunities, and have evaluated organizational resolutions and stances for LMSA National to adopt. The Summit was originally held in conjunction with NHMA’s annual meetings in 2014 and 2015. In 2016, the Summit became a stand-alone LMSA event and was held in-person at Association of American Medical Colleges (AAMC, Washington D.C. As the Summit grew, the event incorporated funding and objectives from GLAS, with the latter’s phasing out in 2016. The Summit has occurred in partnership with AAMC through 2022.

In its most recent format, the Summit takes place over 3 days, which include legislative visits with Democratic and Republican congressional offices; plenary sessions and workshops focusing on advocacy, leadership, and health policy; and review of potential LMSA resolutions. This review occurs during a formal business meeting in which LMSA leadership uses parliamentary procedure to vote on resolutions covering a wide range of health policy-related matters submitted by LMSA members across the country. This exercise provides member-originated feedback on LMSA National priorities and familiarizes members with meeting structures commonly used in other outlets of organized medicine, such as the AMA. Once passed, resolutions are often published in peer-reviewed medical and medical education journals recognized by the U.S. National Library of Medicine. The first resolution to be published in a medical education journal focused on a joint decision by LMSA, NHMA, and HSHPS to acknowledge the unique health issues and disparities of Latinos who identify as a part of the LGBT+ community [21]. Subsequent resolutions have encouraged even greater emphasis on supporting and mentoring subgroups within the Latino community, such as undocumented immigrant students and those from low-income or first-generation backgrounds.

Efforts to Strengthening the Pipeline of Underrepresented Racial and Ethnic Minoritized Trainees

LMSA members share a passion for ensuring that LHS+ patients and their families receive culturally and linguistically concordant and humble care by healthcare providers. To bring this vision forward and deliver the best care to an increasingly diverse patient population, the medical profession must invest in trainees from diverse backgrounds. Organizations like LMSA exist to support those who embrace the challenge of reducing health disparities across multiple medical specialties. In this vein, LMSA has continued to encourage its members to identify mentors for themselves, while serving as mentors for others; to seize opportunities for presenting, publishing, and disseminating original work; and to partner with allies in the pursuit of health equity.

Mentorship has been a core pillar of what LMSA does and why it exists. There are two parts to mentorship in LMSA: (1) LMSA members serving as mentors to premedical students (via LMSA PLUS or through partner organizations) and (2) LMSA members receive mentorship through mentors who guide them on their journey to residency and beyond. As mentorship is a critical part in what LMSA does, the National leadership team has often had two Mentorship Co-Chairs. These officers collaborate with their regional counterparts to provide programming for premedical and medical students at the chapter, regional and national levels. Moreover, all LMSA National Conferences have a premedical school track, which often include mock interviews, medical student panels, and personal statement workshops. Lastly, LMSA works closely with NHMA, HSHPS, and physician organizations centered around medical specialties (e.g. AAFP, AAOS, APA) to create additional opportunities for LMSA members to meet potential mentors.

One of the great success stories of LMSA in mentoring a student through the pipeline involves Emma Olivera, MD, who started as a premedical student attending a NNLAMS Midwest regional conference. Dr. Olivera went on to matriculate to UICOM at Rockford, and held many positions on the national level, including LMSA Midwest Co-President, LMSA National Coordinator, and NHMA COR Chair. She now serves a primarily Latino patient population in the Chicagoland area, and is a mentor to medical students. In addition to Dr. Olivera, many former LMSA leaders and award recipients go on to “pay it forward,” providing mentorship to trainees across the continuum of medical education and supporting the next generation of diverse U.S. physicians.

Recognizing the Exceptional: LMSA National Awards

As of 2022, LMSA bestows at least three National Awards upon outstanding individuals who have made great strides in supporting the mission and objectives of LMSA.

The first of these is the Phil DeChávez LMSA National Mentor of the Year Award. In the summer of 2012, the LMSA National Board and Officers were devastated to learn that National ED Dr. DeChávez had died unexpectedly. Dr. DeChávez was a devoted mentor to student leaders. He uplifted their spirits when doubt crept in, and when failures and setbacks occurred. He was a constant kind soul that had deep belief in the students and their ideas. His humble upbringing on the West side of San Antonio influenced him to always support those that had the world against them, and to speak for the voiceless until he had helped them find their voice. He is deeply missed by all who were mentored by him, and his mission and memory live on in the spirit of mentorship in LMSA. In recognition of his steadfast service and myriad accomplishments on behalf of Latino students, LMSA grants the Phil DeChávez LMSA National Mentor of the Year award annually to the organization’s most highly regarded mentor. Award recipients since 2013 are as follows:

Year

Recipient

2013

Philip DeChavez, MD, MPH

2014

Ruben Font Jr., MD

2015

Fernando Mendoza, MD, MPH

2016

(no award information available)

2017

Rebeccah R. Rodriguez Regner, D.O.

2018

Maria L. Soto-Greene, MD, MS-HPEd, FACP

2019

Monica B. Vela, MD

2020

Sunny Nakae, PhD, MSW

2021

Juan Robles, MD

2022

Denise A. Martinez, MD

At the 2014 LMSA National Policy Summit, the LMSA J.P. Sánchez LGBTQ Award was announced in honor of another beloved and outstanding mentor and advisor. The students honored National ED Dr. Sánchez’s LGBTQ educational, research, clinical, and service advocacy work by naming the scholarship after him. This award is presented annually for outstanding work in the field of LGBTQ Health serving Latino LGBTQ communities in the United States. Recipients have included David Alejandro Sanchez (2017), Alec Gibson (2018), Aileen Portugal (2019), Antonio Flores (2020), Mauricio Franco Jr. (2021), Joshua Soler (2022), and Delia Sosa (2023 SALUD Summit).

The LMSA National Scholarship was created by Jimena Alvarez, MD, after several years of fundraising and hard work. Financial prizes are given to outstanding LMSA students annually at the National Conference to help offset recipients’ costs of medical education. As of December 2022, over 50 students have received this award.

In March 2022, at the 50th Anniversary of LMSA’s first chapter, LMSA honored distinguished LHS+ leaders who have made considerable contributions for the LHS+ community during each decade between 1970 and 2019. Recipients of the LHS+ Leader of the Decade Award included David Hayes-Bautista, PhD (1970–1979 Award); Helen Rodriguez-Trias, MD, MPH (1980–1989 Award); Elena Rios MD, MSPH (1990–1999 Award); Jose Manuel de la Rosa, MD (2000–2009 Award), and J.P. Sánchez, MD, MPH (2010–2019 Award).

Conclusion: The Spark Became a Flame of Hope to Carry into the Next Decade

The scope of LMSA’s accomplishments and evolution is best understood through the challenges LMSA has faced over its lifespan. As noted throughout this chapter, the lack of full-time staff, coupled with the turnover of student leaders and advisors, has increased the difficulty of maintaining long-term initiatives and documenting impact. In the absence of financial support from U.S. government agencies or parent organizations, funding has varied significantly based on the national organization’s success in recruiting sponsors and exhibitors to LMSA events. Moreover, addressing the tug-of-war between regional and national identities remains a unique task for LMSA in comparison to its peer organizations and partners.

Yet, in spite of these hurdles, LMSA continues to provide conferences, webinars, publications, scholarships, mentorship, leadership opportunities, and other programming to empower the next generation of diverse physicians in the U.S. LMSA possesses immense untapped potential, waiting to be realized through the support of partner organizations that fund, collaborate, and enhance the visibility of LMSA; medical schools and faculty that invest in LMSA to the same extent as other medical student organizations; and students dedicated to growing a strong and more unified organization and maintaining institutional memory.

Over decades, LHS+ medical students have been able to bridge vast differences in geographic location, country of origin and heritage, socioeconomic status, immigration status, and even language, keeping their eye on the bigger picture of what they have in common, and the values they hold in union. The many years of empowering and inspiring conference themes demonstrate that shared hope and motivation. Examples include: “Todos Tenemos Valor: Building Solidarity through Health Care;” “Unidos por Medicina y Más;” “Tomando Acción: Ensuring Health Equity for All;” and “Nuestro Futuro en Nuestras Manos.” The power to overcome all obstacles has always emerged from the shared vision of medical student leaders, joining together to decrease health disparities, increase representation of Latinos in medicine, support each other through the rigor of medical training, and form even stronger future leaders. Their hope will be a flame to carry into the next decade as la lucha continúa.

Personal Narratives:

Gerardo Solorio, MD

National Coordinator (NC) 2006–2007, NC Elect 2005–2006

The NNLAMS National Coordinator of 2006–2007, Gerardo Solorio, MD, shared that he became involved in NNLAMS because he had been part of LMSA at UCLA as a premedical student. Yet, when he left California for Washington, DC, to attend George Washington University (GWU), he had no family or friends in the area. He was craving support and connection to a community. He attended the NBLHO conference at Temple University in Philadelphia, PA, in 2003; there, he met NNLAMS National Coordinator Eddie Machado, MD, who then became a mentor to him. “Now when I deal with issues and how to solve them, I have my leadership skills to fall back on from NNLAMS.” He notes he owes his leadership development to his experiences with GLAS and NNLAMS conferences and to the mentoring he received, including advice from Philip DeChávez, MD, MPH. Dr. Solorio helped build the NBLHO and NNLAMS chapter at GWU, went on to become NNLAMS National Coordinator-Elect, and then served as National Coordinator. He stated that, at the time, “NNLAMS was in state of infancy.” As leaders of NNLAMS, “we wanted to do these things for our people, our members, our community.” The biggest accomplishments during his years of involvement were:

Organizing for the first NNLAMS conferences, the launch of the Residency Guide… [the] approval of initiation of César Chávez National Latino Health Day, [the] start of the NNLAMS newsletter, the rebuilding of the Southeast region, and the Name Change Committee to attempt to unify regions under one name.

On the topic of campaigning for a single name across regions, he states:

[NNLAMS] is a complex organization, there are different views, different regional cultures and issues, there was a lot of passion behind the past names from historical standpoint and what they wanted to identify with. There were different names and each [region] wanted to identify to their names, but some of us understood that, in order for us to become mature and known as an organization, we probably needed to have a unifying name, unifying logo and websites. In the past each region had a different name, a different logo, a different website look; that did not work well when speaking with sponsors. There was a lot of blood, sweat and tears during these discussions. We had to go through that, we all had to go through that, it was part of the organic process of becoming a mature strong organization.

He adds:

What makes me proud when I go to the website is seeing that LMSA has not only continued what we built but it has expanded—it has exploded! It’s good to see new medical schools involved, new residency program sponsors, and new projects. Who would have thought we would have a stand alone national conference, we would have a unified name? Now 20 years later, we are leaders; we are the ones speaking up for our patients and our communities.

Dr. Solorio ends with stating he is proud to say LMSA leaders have remained steadfast to that ideal.

Julia Bregand-White, MD

National Coordinator (NC) 2009–2010, NC Elect 2008–2009

Early in my life I saw the struggles of a family living without higher education or advanced training. The financial struggles and barriers to change grew as my parents had more children at such a young age. Early on I knew that I wanted something different for my own life. I wanted to make a meaningful impact on people’s lives in a career that had personal and financial rewards. My parents hadn’t gone to college and I often felt isolated as a student without a clear path. With the constant love and encouragement from my family I paved my own way. I had a natural tendency towards science and found medicine fascinating. We didn’t know how to navigate the typical road to medicine so I started at a junior college and tried to use every opportunity I could, throwing on the track team while working full time hours and volunteering to build my CV. When I was accepted into medical school, I knew my hard work had only just begun but that, if I was able to keep up my momentum, I would be able to fulfill my dream of becoming a physician.

Many people are surprised that I am Latina when they meet me, and I often found myself explaining how or why I considered myself as such. I am of mixed heritage with a Puerto Rican paternal grandfather and otherwise European grandparents. My Stepmother is Puerto Rican and Stepfather is Ecuadorian so I have a diverse family in many ways. I know the community I was raised in, the struggles we faced, and the shared goal of making our lives better in each generation. I find great satisfaction in caring for the Latino community, the peace they feel when their doctor can speak to them in their own language, and the efforts I make to relate to their circumstances and create options for their care.

My time in LMSA allowed me to investigate my own ethnicity and culture. We had so many deep conversations about how race and ethnicity impacts medical care and outcomes and how we can work together to improve the health of the Latino community. We also had colorful conversations about the name of the organization. During my year as National Coordinator, I led a national movement to organize and unify all our regions under one name to optimize the impact we could make at local, regional and national levels. We had to take into consideration the history of the organizations before that time, [along with] the meaning of the words Latino, Hispanic, Latin American, and Boricua. During my role as National Coordinator, I learned even more about the passion our members had for their identity and—while we were hoping to work together as a unified organization—we could not and should not discount the diversity of the community we represented.

Table 7.1 History of NNLAMS and LMSA National Coordinators & Presidents
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Table 7.2 History of NNLAMS/LMSA National GLAS and LMSA Policy Summit Conferences
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Table 7.3 Themes and Locations for LMSA National Conferences, 2006–2022
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