Physician career change guide

NAME: JOSHUA CONNOR, M.D., MPH (correctional medicine physician during medical school)

EDUCATION

UNDERGRADUATE: LANEY COLLEGE, OAKLAND, CALIFORNIA; NEW COLLEGE OF CALIFORNIA, SAN FRANCISCO

POSTGRADUATE: MASTER OF PUBLIC HEALTH (MPH), UNIVERSITY OF CALIFORNIA BERKELEY MED SCHOOL: UNIVERSITY OF CALIFORNIA SAN FRANCISCO SCHOOL (UCSF) OF MEDICINE

RESIDENCY: UCSF/SAN FRANCISCO GENERAL HOSPITAL

EMPLOYER: CALIFORNIA MEDICAL FACILITY, VACAVILLE

Joshua Connor, M.D., MPH, participated in the Program in Medical Education for the Urban Underserved (PRIME-US) while in medical school. He earned an MPH in maternal and child health. His capstone research explored access to healthcare for women in prison.

What do you like about working in the correctional system? 

There are a lot of rewards in working with this patient population of incarcerated and historically very underserved patients. There are many patients who have had past traumatic experiences and mental illness. There’s a huge intersection of those issues with medical services and health care. I find it very rewarding to serve that population. There are also complex ethical issues that arise in this field. I really enjoy witnessing the transformation of some individuals who have caused serious harm in the past and are really working to make their lives better and to make amends. For example, we have a pastoral care services program where incarcerated workers are trained to work in the health care setting. Often, they are people who have caused serious harm in the past and now are trying to give back by trying to provide services to their own peers. I really enjoy witnessing those programs.

What’s the most challenging part? 

It can be a very challenging environment to work in. There are all of the typical challenges of working in health care. Then, on top of that, working inside the carceral setting. There are patients who have had adverse childhood events, traumatic experiences, behavioral issues and often poor coping strategies. Some of that can lead to difficult interactions, and there’s navigating the prison system while also trying to advocate for your patient.

Anything about this role that surprised you? 

Covid-19 surprised everyone in health care. Even as it started, I didn’t know that I was basically going to be at Ground Zero of a pandemic. If you look nationwide at the biggest outbreaks, at least half of them were in prisons and jails. We were really on the front line. We witnessed huge outbreaks and really poor outcomes for some of our patients.

At the same time, we also witnessed the staff who stepped up and provided care during that time even though we were worried about our own families and exposing ourselves and getting vaccines out there.

Another surprise when I came here was the sophistication of our tracking and our health care outcomes. It’s really a huge help in our patient care, so I was pleasantly surprised how sophisticated the public health tracking and registries are for our health care outcomes.

What’s your advice to physicians considering correctional medicine? 

For primary care, we hire family medicine or internal medicine board certified physicians. We also have a whole separate section for psychiatry. We have residents and medical students who come throughout the year to California Medical Facility and other institutions. So, for those who are in training, please come and rotate with us. For any physician currently practicing, there are ways to sign up to shadow us or to talk with one of our physicians to see if this is something that might fit. We really enjoy the educational programs and love the trainees. It’s a good idea to see this in person; television shows and movies don’t always paint an accurate picture. Other than that, we perform everyday primary care to medical care for patients with moderate to severe mental illness. We have a very broad practice.

Anything else to add? 

Most of the patients are one day going to return to their communities. If we can work on improving their health care here, they can also bring that back with them. •