January 16, 2026

Dear Eva,

I’m pleased to share this annual update on the Mark Herzog Memorial Fund in Rural Health Equity. Support from the Herzog Fund enabled four Harvard Medical School students in 2024 and another four in 2025 to travel to Indian Health Service clinics in rural New Mexico and South Dakota, where they carried out clinical rotations. In the report that follows, those eight students describe their experiences in their own words.

Your commitment to HMS in Mark’s memory is inspiring, and I am grateful for your support, which empowers service-oriented students like these to pursue clinical opportunities in fields that meant a great deal to Mark.

Sincerely,

George Q. Daley, MD, PhD

George Q Daley, MD, PhD | Dean of the Faculty of Medicine | Caroline Shields Walker Professor of Medicine 25 Shattuck Street, Boston, MA 02115 | t: (617) 432-1501 | e: George_Daley@hms.harvard.edu

The Mark Herzog Memorial Fund in Rural Health Equity supports MD students who pursue research in health equity. HMS gives preference to students who engage in clinical training and research in rural areas. The Herzog Fund supports a range of activities, including research, travel costs, and scholarly projects in rural health equity, both domestically and internationally.

Since 2010, the Mass General Brigham Outreach Program with Native American Communities has partnered with the Navajo Nation to provide care in Shiprock, New Mexico, and since 2016, the Massachusetts General Hospital Rural Medicine Program has worked with the Rosebud Sioux Tribe to provide clinical services in Rosebud, South Dakota. Through these programs, and with financial support from the Herzog Fund, eight HMS students participated in rural clinical medicine rotations in 2024 and 2025. 

Rachel Wittenberg, Class of 2024

Mentors: Matthew Tobey, MD, Massachusetts General Hospital, and Michael Sundberg, MD, MPH, University of Minnesota

Clinical Rotation: February 24–March 22, 2024

Indian Health Service Elective in Rosebud, South Dakota

While in Rosebud, I primarily worked with the clinical teams in the inpatient internal medicine service and the outpatient primary care clinic. I also spent a day in the emergency department and several days exploring other clinical opportunities, including the jail telehealth clinic, the detoxification center, and the physical therapy clinic.

I also had the opportunity to join and learn from several community health events, including two local town halls with a local public health educator who was providing community education on hepatitis C diagnosis, testing, and treatment (an important public health issue in Rosebud). I was primarily in a learning role and gained a much deeper knowledge and appreciation of health issues, sociodemographic disparities, cultural nuances, and historical injustices. However, I also tried, to the best of my ability, to contribute in clinical settings. This included acting in a sub-internship role in both inpatient and outpatient settings, where I saw patients independently, presented to the attending physician, and completed the visit together. This experience furthered my interest in rural health care, the Indian Health Service (IHS), and reducing health care disparities nationally and around the world. I hope that Rosebud and other underserved patient populations will benefit from my personal and professional growth and my integration of these interests into my future career.

During the remote portion at the end of my elective, I completed several modules and engaged in self-directed learning on issues related to health care in the IHS and the Rosebud community, specifically. This included reading scholarly articles and watching videos that the Boston-based Rosebud team collated and provided, including a very helpful video that a local leader recorded on health care issues affecting Rosebud. I also contributed to the development of a community health survey for the Rosebud community in a new, more interactive electronic format (Qualtrics) in conjunction with the clerkship director, Dr. Matthew Tobey. I hope that the dissemination of this survey and the thoughtful analysis of the information and perspectives provided by Rosebud community members will inform future health interventions and contribute to advocacy for devoting much-needed resources to the IHS and the Rosebud community.

Selena Gonzalez, Class of 2025

Mentors: Kathe Miller, MD, Cambridge Health Alliance, and Eleanor Emery, MD, Cambridge Health Alliance

Clinical Rotation: May 27–June 22, 2024

Indian Health Service Elective in Shiprock, New Mexico

I had the unique opportunity to work with the IHS at the Northern Navajo Medical Center (NNMC) in Shiprock, New Mexico, for four weeks last summer. My schedule consisted primarily of outpatient primary care clinics, neurology and infectious disease clinical work, and street medicine. During outpatient clinic days, each morning and afternoon consisted of a different clinic run by a different preceptor. During these clinics, I met with patients and collaborated with my preceptor on the visit, assessment, and plan. During my time in the neurology clinic, I met a patient who had neuromyelitis optica spectrum disorder and learned more about its treatment. My infectious disease work focused on developing a clinical summary of a patient with mucormycosis and gathering information about her treatments and surgical interventions to date. I also spent time updating the syphilis patient tracker in order to keep an updated record for diagnosis and treatment in the community.

During street medicine practice, I spoke with and treated individuals experiencing homelessness in various communities, including Shiprock itself, Farmington, New Mexico, and Cortez, Colorado. During outreach, we talked to these individuals, addressed any medical needs they had (e.g., providing acetaminophen, ibuprofen, antibiotics, and medication-assisted therapies for substance use disorder; bandaging wounds; providing food and water; excising cysts; conducting point-of-care ultrasounds, etc.), and referred patients to providers or the emergency department as needed. My goal was to alleviate the burden of work on my preceptors and the team members with whom I worked, which I believe I effectively did. When appropriate, I shared my knowledge on certain topics. For example, I contributed to a palliative care project by developing materials for Navajo families to help them better understand palliative care and how it could serve their family members, as well as a resource sheet for patients to have in case they need to contact a particular person, like their palliative care team, EMS, the police, or the hospital.

I was able to learn a lot about the customs and values of the Navajo community through my interactions with patients and my interactions with medical staff who are culturally affiliated with the Navajo community. I used this knowledge to further develop my cultural competence when working with these patients, both in the clinic and in the street. I developed a sense of independence while working on street medicine, to the point where I could successfully manage some individuals’ low-acuity medical needs directly without requiring much supervision. The medical team at NNMC also responded well to my palliative care materials, which appear to have benefited the team.

Leena Ambady, Class of 2025

Mentors: Kathe Miller, MD, Cambridge Health Alliance, and Heather Kovich, MD, Indian Health Service

Clinical Rotation: August 2–September 1, 2024

Indian Health Service Elective in Shiprock, New Mexico

I completed a month-long rotation in family medicine at NNMC in Shiprock, New Mexico. I spent my mornings and afternoons in the family medicine clinic working with an attending physician. I also spent four days with the street medicine team, seeing unhoused patients in Shiprock, Farmington, and Cortez.

This elective taught me so much about Indigenous health, Navajo culture, and what it means to practice broad‐spectrum primary care in a rural setting. This experience strengthened my outpatient skills, and now I feel comfortable seeing three or four patients in a half-day of clinic work independently. In turn, I hope that I contributed enthusiasm for the learning and a different perspective from a more urban clinical setting. I did not give a case report or presentation during this elective.

Taylor Weckstein, Class of 2025

Mentors: Kathe Miller, MD, Cambridge Health Alliance, and Eleanor Emery, MD, Cambridge Health Alliance

Clinical Rotation: August 4–27, 2024

Indian Health Service Elective in Shiprock, New Mexico

My time rotating with the IHS in Shiprock was incredibly valuable. I learned so much from the patients and practitioners I worked with during my time there. The physicians truly practice full-spectrum general medicine, with a very broad scope of care necessitated by limited resources. Despite the constraints, many brilliant and compassionate doctors deliver extremely high-quality patient‐centered care. Seeing this scope of practice firsthand inspired me as an aspiring primary care physician. During my time, I rotated in the outpatient internal medicine clinic, usually seeing three patients in each half-day session. I also had the opportunity to work in special clinics, including a session that screened and treated diseases from occupational exposure among uranium miners. I also did home visits with a palliative care nurse and worked with the fantastic street medicine team.

During my time at Shiprock, I gave a short presentation on trauma‐informed care and harm reduction for IHS patients experiencing homelessness. I worked closely with the street medicine team, particularly with Navajo practitioners who provided me with valuable cultural context and suggestions. I worked with street medicine for five days (morning and afternoon sessions)—I requested an extra day because I found the work so engaging and meaningful. I only did one day of palliative-care home visits. On that day, we saw two patients. We delivered medications, performed symptom evaluation and management (i.e., assessing pain, nausea, etc.), and took one patient having a pain crisis to the hospital, where we provided a warm handoff. 

Samhita Kadiyala, Class of 2027

Mentors: Kathe Miller, MD, Cambridge Health Alliance, and Heather Kovich, MD, Indian Health Service

Clinical Rotation: May 5–30, 2025

Indian Health Service Elective in Shiprock, New Mexico

I thoroughly enjoyed my time at NNMC and would highly recommend it to all HMS students with an interest in public health. I rotated with the family medicine department and had an amazing experience with the patients and providers there. It was my first real experience with rural medicine in the United States and my first experience with the IHS, which is a fascinating institution. My days consisted of time in the family medicine clinic (including the metabolic clinic and high-risk pregnancy clinic), home visits with the palliative care nursing team, and off-site clinics at the Sanostee Field Clinic, a much smaller facility located in a remote area south of Shiprock. I also spent time with the outpatient neurologist and shadowed osteopathic manipulation therapy practitioners. During my visits, I saw patients independently before presenting to my preceptors; I wrote notes for all the patients I saw. 

Over the course of the month, I learned much about Indigenous history and the sociopolitical factors that have resulted in the vast health care disparities that exist for these populations in the United States. I found the home visits to be one of the most memorable experiences of the month—it was a really special experience to visit patients in their own homes. It was truly eye-opening for me to see that such large areas of the Navajo Nation lack electricity, running water, and basic utilities, and that there is only one grocery store within a 45-minute driving distance. It really enabled me to better contextualize many of the chronic conditions I saw frequently in the clinic.

I loved the culture of rural family medicine—it felt truly familial and community-minded, with less formality than large academic institutions, yet equally competent and thoughtful physicians and health care providers. It was incredible to see how well the physicians knew their patients and their families, and it was clear that all the physicians present felt drawn to the mission of the IHS. I felt valued as a member of the health care team and contributed what I have learned so far during my training, particularly with regard to musculoskeletal health, as I am interested in orthopaedic surgery. In fact, one of my key takeaways from my month was that I would like to return to the IHS as an orthopaedic surgeon in some capacity (locum, volunteer, part-time, etc.) in my future career. This was not something I had given much thought to prior to my elective, largely because I did not realize it was a possibility for my career. The most frequent concerns that patients reported (after chronic cardiovascular conditions and diabetes) were musculoskeletal in nature, yet I saw that access to an orthopaedic surgeon was unreliable because none worked for the IHS. The referral process to outside facilities was extremely cumbersome (and many facilities had a history of treating Navajo patients poorly).

I lived in the Navajo Nation and made every effort to see and do as much as I reasonably could within the Four Corners area. I spent time outdoors at Canyonlands National Park, Mesa Verde National Park, and Antelope Canyon. I also spent a weekend in Albuquerque and Santa Fe (where I happened to get engaged!). I went to pickleball games on Tuesday nights with the family medicine department, participated in Just Move It walkathons hosted by NNMC in the community, and attended Mesa Night and Rez Cafes (open forums at chapter houses in the area where community members could share their experiences and suggestions regarding their health care). All of these experiences added tremendously to my time in Shiprock and made the month a very memorable and fulfilling experience.

Jacob Meyerson, Class of 2026

Mentors: Kathe Miller, MD, Cambridge Health Alliance, and Heather Kovich, MD, Indian Health Service

Clinical Rotation: May 31–June 28, 2025

Indian Health Service Elective in Shiprock, New Mexico

I did a month-long family medicine clinical elective at NNMC. I spent most of my time at the hospital-based outpatient family medicine clinic. A typical day consisted of a morning and afternoon clinic session with a supervising family medicine doctor. I would see patients on my own, generate a treatment plan, present it to the attending physician, and then return to the patient with the attending physician to discuss the next steps. I wrote notes for all my patient encounters. I saw six to eight patients over the course of each full day. I contributed to patient care by building therapeutic relationships with the patients and by contributing to the optimization of their medical treatment.

I also spent some time at alternative sites. I spent two days at the hospital’s mental health unit, where I worked with an attending psychiatrist and saw patients who presented for mental health concerns. I spent a day shadowing a palliative care nurse on rural home visits. I spent two days at rural clinics, where my work was similar to that of the hospital-based clinic, albeit with fewer resources and a more rural patient population.

I presented on a case of suspected MALT lymphoma in an elderly woman. The patient presented to clinic a couple of days after discharge from a hospitalization for hypovolemic hyponatremia; an abdominal CT scan showed duodenal thickening. At our visit, our questions elicited a year-long history of fatigue, diarrhea, and night sweats. We suspected MALT lymphoma, and I presented on its diagnostic steps, pre-treatment evaluation, histopathology, and risk factors, including any current medications.

Overall, the rotation was an absolutely fantastic experience that I highly recommend to any interested students. The family medicine department has a strong academic culture and is invested in teaching. Each attending I worked with was kind, welcoming, and enjoyable to work with. Working in a more rural primary care setting is very different from Boston primary care, which I felt was a valuable experience. Since there was minimal specialty care to refer out, we were responsible for a much larger portion of patients’ care than I experienced during home rotations, which lent itself to a different perspective on the breadth of primary care and provided fantastic learning opportunities.

Emma Seevak, Class of 2027

Mentors: Matthew Tobey, MD, Massachusetts General Hospital, and Stephanie Sun, MD, MPH, MSc, Massachusetts General Hospital

Clinical Rotation: June 30–July 25, 2025

Indian Health Service Elective in Rosebud, South Dakota 

I participated in the four-week Advanced Clinical Elective through HMS. The rotation is a mix of inpatient and outpatient time (roughly 50/50), along with scheduled public health community clinics and flexible time for elective pursuits. During this period, I spent time in the emergency department, on outreach with IHS public health nurses, and riding along with ambulances. I also attended community events, such as a powwow and two Sun Dances, to which tribal members extended an invitation. There was also a Tribal Health Summit during my time there.

At the request of the Rosebud Sioux Tribe Child Care Program, another trainee and I gave a presentation about adverse childhood experiences and protective childhood experiences. The presentation provided me with a great opportunity to get to know community leaders and learn about important initiatives.

Emily Yang, Class of 2026

Mentors: Matthew Tobey, MD, Massachusetts General Hospital, and Stephanie Sun, MD, MPH, MSc, Massachusetts General Hospital

Clinical Rotation: July 28–August 22, 2025

Indian Health Service Elective in Rosebud, South Dakota 

As part of the American Indian Health elective, I rotated at the Rosebud Service Unit, an IHS hospital on the Rosebud Indian Reservation. There, I worked in the emergency room, outpatient primary care clinic, and inpatient medicine service. I also volunteered with the reservation’s community clinic, the Rosebud Sioux Tribe Health Administration, to provide free STI testing to community members. The Lakota people have faced numerous and repeated injustices that presently manifest in unmanaged chronic health problems, STIs, significant child and maternal morbidity, and overall poor health. I learned a lot from the rotation, and in return, I provided my clinical services at the community clinics and at the hospital.