Abhinav Mishra, a former high school teacher now entering his fourth and final year at the Foster School of Medicine, was one of five medical students nationwide to be selected this spring for the American Psychiatric Association Foundation’s Medical Student Externship in Addiction Psychiatry.
The fellowship program included a cash stipend to support Mishra for a month this summer while he shadowed a Texas Tech Physicians of El Paso psychiatrist and studied substance abuse, an issue that plagued his former high school students.
The program supports racial/ethnic minority medical students interested in studying psychiatric care for substance use disorders, including strategies for prevention and early intervention. The fellowship allowed Mishra to shadow a mentor, Fabrizzio Delgado, M.D., an assistant professor of psychiatry at Texas Tech University Health Sciences Center El Paso, throughout July. Dr. Delgado is associate program director for the combined internal medicine-psychiatry residency program at TTUHSC El Paso.
Mishra is interested in substance abuse, especially among teenagers and adolescents. Substance abuse is a major problem in the country, and he saw the impact it has on teenagers while teaching in McAllen, Texas.
“I had a lot of students who were addicted to substances, whether it was alcohol, marijuana or stronger drugs. For me, it was personal, and that’s why I applied for the fellowship,” Mishra said. “Students would talk to me – as young as 13 and 14 years old – and they would tell me about the drinking they did over the weekend. Seeing that left an impact on me and made me realize there’s a serious problem.”
It was alarming to hear what students were doing over the weekend, but even worse when Mishra realized they were addicted. He noticed they looked physically ill when they didn’t drink alcohol over the weekend.
“These kids have been exposed to drugs and alcohol at a young age, and they no longer feel good with just alcohol or marijuana, so they use harder drugs just to feel normal. It’s no longer about feeling good, it’s about feeling normal,” Mishra said. “I would see students come in on a Monday, and I could tell they didn’t use because they looked terrible. It hurt me personally because I wish there was more that we could’ve done. Now that I’m in medical school, I realize there is something I can do.”
About 10% to 15% of the general population has a substance abuse disorder, which many experts consider to be a disease of pediatric onset, Dr. Delgado said. This makes Mishra’s work of great interest to the medical community.
“Fortunately, the Southwest hasn’t been hit by the opioid epidemic as hard as the Northeast and Midwest, but we’ve seen a very high number of patients with stimulant, alcohol and benzodiazepine use disorders,” Dr. Delgado said. “The fact that we’re in a border town and have the privilege of a diverse population makes El Paso a great place to learn about human behavior. Our department of psychiatry, our established child and adolescent psychiatry fellowship, and our growing division of addiction psychiatry makes TTUHSC El Paso a great place to learn for students like Abhinav.”
Mishra hopes to become a child and adolescent addiction psychiatrist after graduating from the Foster School of Medicine. He wants to treat teenagers affected by substance abuse in communities where medical access is scarce.
“I want to be part of a movement to bring this to the front lines. Addiction is a medical problem. It isn’t different than diabetes or hypertension. We have to remove the stigma and treat the people who are addicted,” Mishra said.
Mishra said he gained a great deal of knowledge from the externship experience, and being selected for the program serves as an endorsement of the work and talent at TTUHSC El Paso.
“It’s been a huge blessing to get recognition from the American Psychiatric Association,” Mishra said. “Little by little, it seems my career is headed in the right direction. The experience is something I can use to help others in the future.”
Dr. Delgado is a member of Texas Tech Physicians of El Paso, the region’s largest multispecialty medical group practice, with over 250 specialists and subspecialists providing care for the entire family at several locations across El Paso. As the medical practice of the Foster School of Medicine, the physicians who comprise Texas Tech Physicians of El Paso each hold faculty appointments at the Foster School of Medicine, where they teach the next generation of doctors.