Photo caption: “He makes it a priority to never let his life become his diagnosis,” Viktoria Voragen (left) says of Geo Coulston (center), her patient partner in the Longitudinal Alliance Program. She and fellow medical student Taylor Duffy (right) have had the chance to get to know Coulston thanks to the program. 

Kate McKay returned to the University of Pittsburgh for medical school in 2025, feeling reinvigorated from two gap years in the mountains of Montana. She had been looking for some fresh air after four years at Pitt, where she’d earned a bachelor’s degree in biological sciences as a transfer student, received All-ACC honors as a defender on the soccer team, and then completed the Biomedical Master’s Program. 

All the while, she wasn’t certain whether med school was the right path for her. Throughout a childhood and adolescence spent in British Columbia, Idaho and Arizona, she had grown up around health care: Her father is a doctor, as was her grandfather. But some uncomfortable experiences with doctors as a patient herself loomed in her mind.  

“If done the wrong way, it can be very disempowering, and it can be very harmful, and that’s how I felt as a patient,” she says. 

In Montana, working both in a cardiac rehabilitation clinic and as a Pilates instructor, she saw something different. The general practitioners she worked with in the rural community developed deep, personal relationships with their patients, whom they spoke to with humility and listened to with full attention. 

Meanwhile, many of the women attending McKay’s Pilates classes shared the orthopaedic issues they dealt with. Some of their experiences as patients reflected her own. When McKay mentioned she was considering med school, they encouraged her: “You can advocate for us.” It was a push she needed. 

McKay didn’t want to lose that feeling when she stepped back on campus. She knew, though, that the rigors of med school could make it easy to forget why she’d finally resolved to be there.

She soon found a constant reminder.

Through Pitt’s Longitudinal Alliance Program (LAP), McKay met Sara, a bubbly 2-year-old girl with a congenital bone condition. (Sara’s name has been changed for privacy.) The program connects every medical student, for the entirety of their med school experience, with a “patient partner” who has a chronic condition. Initially a voluntary program for med students, LAP became required with the launch of the School of Medicine’s new Three Rivers Curriculum in 2023. 

McKay, accompanied by another student who also matched with Sara, meets regularly with the toddler and her mother, learning about their lives and witnessing their medical journey. Because McKay is not yet a physician, she is free from some of the pressures of deciding on the girl’s treatment plan—and from having to move on to the next patient. 

Students are expected to take time to get to know their patient partners beyond their diagnosis. Yet McKay also gets to see Sara’s care up close in a way few others do.  

“She had surgery, and I got to see her for the consult. I got to see her for the pre-op. I got to see her in anesthesia. I got to see the whole surgery. I got to be there in the [postanesthesia care unit] with her,” McKay says. “Not a lot of doctors get to see every single stage of that. Even her mom didn’t get to see her in the OR.”

After the procedure, McKay recalls, “I was able to tell her mom, ‘She did great,’ with no vested interest other than caring about her.” 

The relationship, it turns out, is not only to the students’ benefit. Sara’s mother told McKay and her classmate that she thought of them like “angels watching over [Sara] in the surgery.”

“When she said that, I was like, ‘OK, whoa. This is bigger than just a program,’” McKay says. “If I’m ever like, ‘I don’t know why I’m here. I don’t know why I’m doing this,’ I think about them.” 

***

The average hospital stay for a patient in the United States is 4.5 to 5.5 days. That means most doctors see only a tiny sliver of what a patient goes through, says Lisa Podgurski, LAP’s director and an assistant professor of medicine. 

Podgurski became a palliative care physician in part so she could form long-term relationships with patients. When LAP began to take shape, she jumped at the chance to help more students have those relationships, too. 

The program launched in 2013 as a pilot, developed by inaugural director Robin Maier, associate professor of family medicine. It was conceived as a counterpart to the Longitudinal Research Project, at the time the only other project medical students consistently took part in throughout their four years. 

That first year, 20 students volunteered, and LAP accepted half of them. That soon ballooned to about 60 students in the program per year, typically more than a third of each incoming class. 

Students who volunteered for LAP often shared that it was among their most rewarding experiences in med school. One UPMC residency applicant wrote their personal statement about how meaningful LAP had been. Unbeknownst to the student, it was reviewed by Podgurski.

But there was still room to grow. Expanding the program to the whole student body arose out of both challenges and opportunities. Because LAP was optional, it sometimes became difficult for students to prioritize their connection with their patient partners in their third and fourth years, as they moved on to the very clear-cut demands of clinical rotations.

“I’ve always been a believer that third and fourth years are part of what makes our program unique and special, even though it is logistically challenging,” Podgurski says. 

By then, the students are beginning to apply what they’ve learned through courses and clerkships to their patient relationship, says Beth Oczypok, a general internist, assistant professor of medicine and assistant director of LAP. “And they’re also meeting patients clinically on the wards, using what they’ve learned in LAP to see the person behind the patient.” 

Anna Vogel, who was part of the last LAP class before it became required, saw her own self-assurance grow. Her first year or so with her patient partner, Claudia Lee, who needed an organ transplant, saw dramatic highs and lows. Multiple times, donor organs became available, then suddenly they weren’t. It was jarring for Vogel, who was largely listening, learning and taking it all in. 

Her cheery, chatty patient partner, meanwhile, was eager to include her in appointments and hospitalizations for the transplant procedure and post-op. Early on, Lee (whose name has been changed for this article) would introduce Vogel to her physicians as “my medical student.” Vogel would jump in to say that she was not guiding treatment for Lee. 

“I felt like I had to clarify,” she notes. 

By her third year, though, Vogel began to feel more confident in both their relationship and her grasp of Lee’s conditions. Before one appointment, Lee told Vogel about some increased pain she had been feeling. 

“And then we’re in the [exam] room, and she says to the physician, ‘Nope, all good. Nothing to do here.’ And I was like, ‘Wait, that’s not right. Didn’t you want to talk about this?’” The physician was happy to adjust Lee’s pain management in response. 

At that moment, Vogel saw how she’d grown from an observer to a patient advocate. (In the spring, Vogel matched ob/gyn at Corewell Health Beaumont University Hospital in Michigan.)

Making LAP required, the program’s leaders thought, would help all students undergo the same evolution.

In the early 2020s, the School of Medicine was developing a new med school curriculum that prioritized patient voices and patient-centered care. It would also be structured around longitudinal education and case-based learning. What better way for med students to see all of this in action than to follow a real person dealing with a chronic condition throughout years of their care?

Anantha Shekhar, senior vice chancellor for the health sciences at Pitt and John and Gertrude Petersen Dean of the School of Medicine, agreed. In 2023, LAP became a formal, pass/fail course in the curriculum. 

The students meet with their patient partners and also gather in small student groups led by faculty facilitators. There, they share and reflect on the blossoming relationships, the challenges their patient partners face, the joys in positive outcomes—and what it all means for their futures as physicians. 

***

Geo Coulston worked as a trauma technician in a hospital early in his career. He even thought about going to medical school to become a surgeon, but he soon found himself on another path. He earned a PhD in engineering and applied physics and went on to management and executive positions at several companies. Now retired, he was most recently a technology licensing manager in Pitt’s Office of Innovation and Entrepreneurship. 

But his time at the trauma center stuck with him. “I’ve always been interested in supporting medical schools and developing their physicians,” he says. “I’ve been hospitalized several times, and I’ve always gone to teaching hospitals. It’s just something I feel is important.”

In 2016, Coulston was diagnosed with Parkinson’s disease after having symptoms for two years. When he learned about LAP, it seemed like a new way to help medical students mature as future doctors. He could see the value in letting students get to know a patient beyond their clinical rotations. 

After an introductory Zoom call with his student partners, Coulston and his wife, Donna, invited them over to deep-fry a turkey, which neither student had ever done before. On another visit, Coulston says, “I got them to get their hands dirty making ravioli dough. 

“I wanted them to see my home life—nothing in particular, but just to give them an opportunity to be immersed in my world,” Coulston says. 

His student partners, Viktoria Voragen and Taylor Duffy, have been interested to learn how he’s navigated his condition—and much more than that.  

“He didn’t shy away from discussing the challenges he had faced, but he also talked about the lessons he had taken from those experiences,” Duffy says. “What stood out most was that he was just as interested in getting to know us as we were in getting to know him.”

In May, caring for stroke patients on a neurology rotation, Duffy says, “I found myself wondering what hobbies those patients enjoyed, what roles they played in their families, and what parts of their daily lives they were most worried about losing. LAP helped me appreciate that those questions are often just as important as the medical ones.”

Coulston’s openness made it easy for his student partners to see the person behind the diagnosis. For some patient partners—whether because they work inflexible jobs, live in far-off locations or have other family obligations—offering that degree of access can be more challenging. 

As LAP has expanded, a major undertaking for its organizers has been recruiting enough patient partners who can commit to what the program asks of them.

When the commitments grow too steep for a patient, that itself can be a learning experience for students. Third-year student Gabi Desjardins’ first patient partner withdrew from the program after scheduling and transportation difficulties kept them from meeting. 

“It helped me see some of the barriers that people face [in getting care],” Desjardins says. “I know that health care is more necessary than voluntary participation in this program, but the takeaway was very pertinent.”

Some students, too, take more naturally to LAP than others. Podgurski’s team knew that—it was, in part, why they wanted to expand the program.  

“Students who volunteered for this program when it was optional are folks who might have found ways to learn those lessons on their own if the program hadn’t existed,” says Podgurski. “We wanted to include people who weren’t necessarily stepping forward and volunteering to do this particular type of extra work.”

Debbie Whitfield, another patient partner, suspects some of her own physicians were once that kind of medical student. And in nearly three decades working in Pitt’s School of Dental Medicine, she has seen firsthand that many students going into health care need some practice talking to patients.

“I always tell my husband, ‘There are two kinds of people in this world.’ There are the people that get on the bus, sit down and talk to the person next to them. That’s me. Then there’s the people that sit on the bus and look out the window. That’s him,” she says. 

“If you’re not that person where talking to strangers comes second nature, you have to develop that. You can get to the point where it’s comfortable.” The chance to help future doctors learn those skills in a casual, relaxed setting inspired her to sign up for the program. 

Her first two student partners didn’t need much help getting comfortable with her. (“They’re going to be excellent doctors,” Whitfield says.) She’s excited to take on new student partners after they graduate—perhaps she’ll end up with a tougher nut to crack.

“Some people become so book smart that they don’t have the time or the energy to develop social skills,” she says. 

“I don’t care if you’re going to be a pediatrician, a surgeon or even an anesthesiologist—you’re going to have to talk to that patient before you put them under.”

***

When Elise Barberis was studying biochemistry and biophysics as an undergraduate, she auditioned for a play on a whim with few expectations. She landed a role—and ended up graduating with a BFA in acting. 

Barberis spent six years as an actor while living in Atlanta and saw the value of immersing herself in different perspectives. “I’ve played characters who have . . . made choices that horrify me as a person,” she says. “But when I stepped into that character, it was really important that I understood their motivations.” 

She also started picking up jobs role-playing for health care companies’ employee trainings and as a “standardized patient,” helping medical students learn how to handle difficult patient interactions. It helped bring back an early interest in going to medical school. 

“I got really excited about the idea of developing some individual impact,” Barberis says. “And, if I did my job right, changing the course of patients’ experiences.” 

She arrived at Pitt for med school as part of the first class required to take part in LAP and matched with a preteen with a developmental disability. They first met at a coffee shop, and her patient partner wasted no time in showing Barberis her world. 

“She was very adamant, after we finished our drinks, that she show us around her neighborhood,” Barberis says. “She showed us her favorite stores and favorite restaurants. And she was hoping that we would go home with her to meet her dog and see her room.”

The relationship has only grown from there—especially when the girl, now a teenager, got Barberis’ cellphone number.  (Part of LAP is teaching students how to navigate complex professional boundaries in a supported setting.)

At the end of the four years of LAP, every student will complete a capstone project: It could be a patient narrative, a photo book or some other reflection. The idea excites Barberis. 

“I got into medicine because I cared about stories. And in my mind, LAP is all about learning one patient’s story,” she says. “There’s no way that an experience like this doesn’t help in some small way to make us better doctors.” 

If you or someone you know would like to join the Longitudinal Alliance Program as a patient partner, call Michelle Wargo at +1-412-383-2457 or email Lap@pitt.edu. 

Read more from the Summer 2026 issue.