Cesar Eber Montelongo Hernandez

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Cesar couldn't apply to medical school when he first graduated from college due to his undocumented status. Now he's in a MD-PhD program and hopes to practice in the Southwest where there's a high need for Spanish-speaking physicians.

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Undergraduate: New Mexico State University, 2011
Major: BS Biology, BS Microbiology, BA Spanish
Medical school: Loyola Stritch School of Medicine MD-PhD program, 2022

What makes your story unique?

I am an undocumented immigrant student in a MD-PhD program, perhaps a first in our nation. I feel like my story is a testament to what my community can offer, and I hope I can be an example to the next generation of students.

As an undocumented student, how did you overcome the limitations of your status and ultimately apply and gain acceptance to medical school?

It was not an easy path. By 2011, I’d graduated with three bachelors degrees and honors, yet spent my graduation day trying not to cry. I could not leave my local area because of immigration checkpoints, I could not be employed despite my degrees, and I could not apply to medical school. I spent the next year and a half helping my parents and working odd jobs (e.g., cleaning yards, selling items on eBay). In 2012, President Obama announced Deferred Action for Childhood Arrivals (DACA) which granted a temporary social security number and a work permit to young undocumented immigrants. It is important to note that DACA does not grant any lawful status, or access to any federal benefits. But with DACA, I was able to enroll in a biology master’s program and work as a teaching assistant. By 2014, various medical schools begun accepting DACA applicants. My master’s experience instilled in me a deep interest in scientific research, and I applied to MD-PhD programs that would consider DACA students. 

In all, the reasons that I am here are many. The pioneering activism of the immigrant community, the legislative action of our leaders, medical programs that saw me as person rather than a status, and simply not giving up even when reality said otherwise.

Did anyone encourage or discourage you from applying to medical school?

During my undergraduate career, I had very little encouragement due to my status. Even people who were sympathetic knew that being accepted into medical school was nearly impossible. But DACA changed the conversation in regards to what undocumented students could do, and gave hope to people like myself. I learned an important lesson that reality is not set in stone, and simply because something has always been the case it does not mean it will always be. I find this especially applicable in medicine, when thinking about the landscape of disease prevention and treatment.

Did you have any concerns about taking the MCAT® exam?

I took my first MCAT® exam in 2010, a year prior to finishing undergrad. My score was on par with students accepted into medical school, but I realized that by the time I would apply to medical school it would likely expire. It was frustrating to know this, and more so to take the MCAT a second time knowing that this second score could also expire. In the end I realized that all I could do was try my best.

As a child, what did you want to be when you grew up?

I wanted to keep people from getting sick. In Mexico, my family did not have regular access to care (outside of childbirth and vaccinations), and I did not have a solid grasp on what health care providers were. As such, the concept of a physician was foreign to me, but the idea of helping with illness was not.

What led to your interest in medicine?

Disease can be devastating to people’s quality of life, especially for the ones subsisting on a day-to-day basis. I wanted to find a way to help people from becoming sick in the first place, because I thought that life was hard enough as it is.

What experiences did you have that confirmed medicine was the right career for you?

When I was very young, my father became ill and then was bedridden for months. He was the primary breadwinner, and I saw him as our protector. Watching him immobilized and screaming in pain had a huge impact on my world view. Years later we would find out that my father had suffered from diabetic myopathy and neuropathy. Learning that both his illness and our family’s suffering could have been prevented by education and relatively inexpensive medication was heart-breaking. But at the same time, it made me realize the potential of medicine.

Did you have any fears going into medical school?

Growing up as an undocumented immigrant in a rural border area, I had almost no world experience to rely on. My flight to medical school interviews was my first flight, my suit for medical school interviews was my first suit. Deep down I feared that I would not fit it in. But eventually these fears were abated, in large part to how understanding and welcoming my classmates and my medicals school was.  

What made your medical school the right fit for you?

I personally see medicine as a component of social progress and justice.Loyola Stritch School of Medicine is immensely dedicated to social justice and involvement with marginalized and vulnerable populations; therefore, it was a great fit.  

Do you have assistance paying tuition and fees?

Students admitted into the MD-PhD program at my medical school are awarded a tuition waiver and a living stipend. I am very fortunate, since even with DACA status, DACA medical students cannot apply for federal loans or aid. Because securing funding for their medical school education is so difficult, this has become the limiting factor for DACA applicants even after being admitted to medical school.

Will your status impact your ability to practice or be licensed, and if so, in what ways and how are you planning for that?

DACA affords a social security number and work permit, but the decision on whether you can practice or be licensed depends on multiple factors, chief among them the laws of each state. That said, DACA medical student involvement has been a positive factor in further developing this conversation. We can only hope that conditions will become more favorable nationwide as DACA students become full-fledged physicians. I would personally like to return to the Southwest, which has a need for Spanish-speaking physicians. I hope to do my part in convincing our legislative leaders that undocumented physicians can be an important component of health care, especially with underserved minority and immigrant populations. 

Please describe your participation in extracurricular activities, volunteer work, research, or study abroad opportunities during medical school or residency.

I am currently involved in various projects that promote immigrant health access and undocumented student success in the medical education setting. These range from being an in-training medical Spanish interpreter, promoting medical residency access to DACA students, and taking part in media activities that bring attention to the issue of undocumented health care. 

The other side of my passion is scientific research.  Last summer I worked in Dr. Alan Wolfe’s lab at Loyola. His work has shown that the healthy bladder of women is not only colonized by bacteria, but the microbiome may be an important component for health and potentially diagnostic for urinary tract infection. Next year I will begin my PhD years and return to the lab. My interest is in using bioinformatic methods to predict infection profiles and treatment options for women suffering from urinary tract infections. I would like to use these years as a base for future work in predictive and personalized medicine.

What did you enjoy most about medical school?

There is so much to learn!   

If you had the opportunity to talk to a potential medical student, what would you tell them, off the top of your head?

Grades and application bullet points are not the measure of what a person is, but at the same time you do not want to let such things keep you from reaching your goal. Remind yourself that you are not just an applicant, and that these years of preparation are precious. Find purpose in what you are doing and spend time with your loved ones!

What advice would you give to someone interested in pursuing a career track similar to yours?

Whether something is a benefit or drawback can be a matter of perspective. One of the traits of an MD-PhD program is its length, which means that you are afforded more time to pursue your medical school goals and activities. The training path we take, whether it be 7 years or 15 years, will serve us for the rest of our lives.

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