Emma Lawrence’s two-year fellowship will combine a master’s program with extended in-country research in Ghana. Her history of extensive work in that country – beginning in undergraduate school and continuing throughout her medical training – made Lawrence a good candidate to pilot the new training program, said Professor of Obstetrics and Gynecology Timothy Johnson, who helped envision the new fellowship and will serve as the initial program director for it.
“Emma’s developed the personal relationships and the necessary understanding of the politics, geography, and systems in Ghana to be successful. She’s committed to the Michigan principle: get to know one country really well and build something sustainable,” said Johnson. “Emma is the poster child for those values and the perfect trainee to launch this new fellowship.”
Lawrence, who obtained her MD from UMMS in 2015, will spend the first year of the fellowship earning a master’s degree in health systems and research through the U-M Institute for Healthcare Policy and Innovation (IHPI). The second half of the program will be split between Michigan Medicine and Ghana, where she has already been involved in research on preeclampsia.
“This is such an awesome opportunity to combine my clinical and research interests and develop core research skills in the global setting,” Lawrence said. “I spent a lot of time with Doctor Johnson talking through and developing what this fellowship will look like. Being the first is a little intimidating, but mostly exciting.”
While not common, global health fellowships have been cropping up at institutions with a large international presence. Medical schools at the University of Washington, Harvard and Duke offer them. Lawrence’s program, nested in the Ob-Gyn Department, will be Michigan Medicine’s first.
“As an institution, and for us specifically as a department, our presence in global health has been a differentiator. It’s part of our brand and who we are,” Johnson said. “This fellowship adds another attractive dimension to that. The hope is that, if this is successful, we will select another fellow two years hence.”
Lawrence began working in Ghana long before medical school – or even before thinking about medicine as a career. Then as a senior-level undergraduate public policy student at the University of North Carolina, Chapel Hill, Lawrence led multiple groups of fellow students on short, service and cultural immersion trips to northern Ghana. The primary site for the work, which focused on education in areas like nutrition and first aid, was an orphanage, but students on the trips increasingly urged Lawrence to incorporate health centers into the experience.
“We always had pre-med students who wanted to observe in the hospitals, so I arranged site visits. I was not interested in medicine and was literally being dragged there by other people,” Lawrence said. “But after spending time in the hospitals, I realized I was attracted to medicine.”
Before long, Lawrence’s groups were routinely returning to the hospitals hauling extra luggage filled with donated medical supplies. That endeavor evolved into a non-governmental organization, MedPlus Connect, which coordinates large medical supply and equipment shipments from the US to Ghana. An effort that literally started in a suitcase has grown exponentially over the years; to date MedPlus Connect has facilitated the delivery of more than 20 full-size shipping containers – more than 300,000 pounds – of donated supplies and equipment. This includes 260 hospital and examination beds, 1.7 million gloves, and 250 pieces of medical equipment ranging from autoclaves to anesthesia machines. Lawrence helps run the organization, based in her native Cleveland, with two former undergraduate classmates (one is now a lawyer and the other is a healthcare economist).
Lawrence brought this ample global experience to her medical school application and admissions process. When she arrived for her admissions interview in 2011, undecided about where she wanted to attend medical school, she met Johnson, whose extensive work in global health – and in Ghana specifically – is well known.
“When I came to interview, they told me I had to meet Tim Johnson. I talked to him for like 10 minutes and knew I wanted to come to Michigan,” said Lawrence. “It was the global health work and the Ghana connection that brought me here. With Doctor Johnson and more broadly at UMMS, it’s been my experience that, if you’re passionate about something, people here will find a way to work with you in order to make it happen.”
Throughout her training, Lawrence has been able to develop and expand her relationships in Ghana. She traveled there three times as a medical student for clinical observation and to participate in faculty research. As a resident, she visited three more times for clinical work and to lead her own research studying preeclampsia, a disorder of high blood pressure in pregnancy that disproportionately effects women in the developing world. That work, which explores the clinical efficacy and pharmacokinetics of different durations of magnesium sulfate, commonly used to treat preeclampsia and eclampsia, will continue under Lawrence’s new global health fellowship.
“For me, as someone who’s been active in Ghana for so long, sustainability is such an important part of the work,” said Johnson. “That’s part of what makes fellowships like this critical, to make sure there are people we can hand this off to who, are able to carry it forward in their own way.”