Is medical school just for rich kids?

Is medical school just for rich kids?

This letter was received and edited for clarity by Pamela Wible, MD.

Dear Dr. Wible,

This will be my last email to you because I am giving up on my dream of being a doctor.

I’ve contacted so many colleges and medical schools hoping to find one that would help me become a doctor for my tribe. Today, I finally got a response from the University of Pennsylvania! But when I opened the official email, all I saw was a pretty girl with beautiful eyes staring back at me. She introduced herself as Lily, a premed majoring in biology with a specialization in neuroscience. She is a sophomore just like me.

Is medical school just for rich kids?

Lily writes: “I am currently a research assistant in the neuroscience lab, where I am analyzing the neural circuits underlying the development of empathy in young children. Over the summer I volunteered at Children’s Hospital where I shadowed a pediatric neurosurgeon and attended my first brain surgery! This year I am president of student affairs so I’ll be organizing all the fun large-scale events on campus. Currently I am on the dance team and I love it! My biggest project right now is working with a mobile clinic in Peru. Being able to shadow local doctors, dentists, and gynecologists, build sanitary bathrooms, and educate the people on basic hygiene was a great experience for me …” She ends her marketing pitch by inviting future students to participate in her exciting activities.

Lily and I have similar dreams. The difference is that she is from Asia while I’m Native American. She will be a pediatrician while I want to be a family physician.

Is medical school just for rich kids?

Despite being accepted by an Ivy League college, I’m at a low-tier school near my reservation while Lily studies at a super-elite university. Lily is already attending brain surgeries, but our local doctors don’t allow Native Americans to shadow them. While I am struggling to find money to take premed biology this summer, Lily is a research assistant in a neuroscience lab. While I’m scratching my head trying to figure out how to come up with money to buy the biology textbook, she’s analyzing neural circuits underlying the development of empathy in children. By the time I get approval to take biology at the closest college where it’s offered, Lily will have coauthored at least one scientific article from her research. While I struggle to find money to travel to Mississippi and rent an apartment so I can take biology, Lily has already been to Peru where she shadowed local doctors, constructed sanitary bathrooms, and amply padded her resume for medical school.

Now I am a winner. I like to win. I absolutely hate to be in a situation where I could lose. The situation I am in is guaranteed to make me lose.

An African medical student just visited our tribe. His family has seven servants. Barely 23, he owns two planes. They’re small planes. One seats two people and the other seats four, I think. He’s the kind of person who gets into med school with affirmative action, not me.

Many whites are now legally Native Americans. Why? Oral history tells us mainly because their white ancestors were fraudulently enrolled by government agents to get Native American benefits and land. These whites have federally-recognized Native American status, so medical schools are fooled into thinking they are legitimate Native Americans. One federally-recognized tribe built a casino over their dead ancestors which no real Native Americans would do. Now many are millionaires. Once accepted into med school, these white Native Americans choose lucrative specialties, move to affluent suburbs, and serve white patients without helping Native Americans in any way. White Native Americans benefit from affirmative action, not me.

I have dark skin. I look Native American. Because I am Native American. But I am non-status Native American so I cannot legally claim a tribe or receive benefits. My grandparents belonged to different tribes, so no tribe accepts me, even the tribe whose reservation I live on where my grandfather was Chief and my grandmother was Medicine Woman.

Racism is real. My college professors think I’m stupid because of my skin color, my shabby clothes, my status as a single mom. They warn, “This class is hard. Be prepared to get a failing grade. I’d drop this class if I were you.” My doctor asks, “Have you been drinking again?” I tell him, “I’ve never touched alcohol in my life.” But he always asks me the same question.

Native Americans struggle with diabetes, alcoholism, drug abuse, suicides. Natives like me struggle to pay for our next meal. We carry water home because we have no running water. We have no bathrooms at home. We use outhouses or buckets. It may be thirty below, but there’s no heat at home. We had electricity shut off Friday because we couldn’t afford our bills.

I want to be a family doctor. I want to return to my reservation and heal my people. But primary care is no way to pay off a quarter-to-half-million debt I’d accumulate as a student.

My tribe is poor. They can’t pay tuition or give benefits. Even if I were a card-carrying member, the only benefit I’d get is funeral expenses which hardly helps me because I’d be dead then. Even with my near-perfect GPA, my local college won’t grant scholarships. How can I hope that a medical school will grant me a scholarship when they won’t send me a personal email?

I recognize a system that is designed to set me up to fail and I refuse to be part of that system. I’d rather spend my life on the rez as a teacher saving our dying languages. After all, I am one of four people who speak our language and probably the only one with a real shot of saving it.

I want to win, not be part of a system that frustrates me at every step. Medical school is not for me. The current system ensures that my dream of being a doctor is just for rich kids.

Love to you<3


Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your DoctorPhotos by Geve.

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  • ninguem

    Do the military and National Health Service Corps medical school programs no longer exist? A year of service for a year of support. The NHSC would put the docs in the tribal clinics, among other places,

    I mean…..maybe they don’t, it’s been a long time for me. That’s how about a third of my medical school class got through.

    • PamelaWibleMD

      They do exist. I think the issue here is the extreme poverty and disadvantages faced by poor Natives just getting their premed requirements.

      • ninguem

        No, I still don’t understand.

        “…..Despite being accepted by an Ivy League college, I’m at a low-tier school near my reservation…..”

        She got accepted Ivy, and didn’t go……why?

        Going back to the military and NHSC programs again, about a third of my class went one of those two routes.

  • PamelaWibleMD

    The author of this letter and many like her are scared to leave comments on KevinMD unless they are anonymous (Kevin does not publish anonymous comments I am told). Even physicians in abusive work environments have been scared to reveal their true identities for fear of loss of employment and other repercussions. I hope you all will visit my blog and read these anonymous comments (I publish all comments on my site except spam):

    • Suzi Q 38

      I use the name SuziQ 38, and I am fairly anonymous.
      This student could make up any name she wants.
      She could even choose a male name if she so desires.

    • kevinmd

      Anonymous or pseudo-anonymous comments are fine. But they must all pass moderation before showing up:


    • Patient Kit

      Dr Wible, I don’t understand what you mean when you say that Kevin doesn’t publish any anonymous comments. Huh? Aren’t Guest, myself (Patient Kit), guest, Dr Drake Ramoray, DoubtfulGuest, DeceasedMD and many other regular KMD commenters anonymous?

      • PamelaWibleMD

        My mistake. Your name can be anonymous, but you do need an e-mail that may be tracked back to you. I think some people are extremely nervous about sharing their identity or being found out in any way.

        • Patient Kit

          And I can certainly understand that fear. As a job hunting cancer patient, believe me, I paused before jumping in here and telling my personal story. But I thought the benefits outweighed the risks, so in I jumped.

          • PamelaWibleMD

            Thank you for your courage and speaking your truth. You are liberating others with the same fears.

          • Suzi Q 38

            Yes, no potential employer needs to know that you have had cancer.
            I never told my boss.
            I denied that I had cancer for even a minute.
            I lied through my teeth…why? My personal, medical problems were not his business.

            When he got nosy, i would just start talking about vaginal bleeding or something truly female and personal. He would get embarrassed, and then he knew not to ask me anymore.


        • ninguem

          And I’m nobody.

          • Suzi Q 38

            Yes, you are like the rest of us, too “chicken” to post our real names.

      • Suzi Q 38

        Don’t forget about me, Suzi Q.
        I am anonymous.

    • JR

      Make an anonymous email address on the fly.

  • Suzi Q 38

    Probably because she can not afford the room and board for a college that is farther away than her low-tier college near her reservation.
    I am surprised that she didn’t qualify for state tuition and federal tuition aid.

    • ninguem

      Maybe she’d get more aid if she said she was an illegal immigrant.

      • buzzkillerjsmith


  • Suzi Q 38

    “……I want to win, not be part of a system that frustrates me at every step. Medical school is not for me. The current system ensures that my dream of being a doctor is just for rich kids.”

    With this self-defeatist and negative attitude, she is going to get frustrated at every step. The last sentence sounds so negative about her own future and resentful of those with money. if this is her natural inclination, she will remain resentful for the rest of her life. What a way to live. I might not want her at my school, if I were the admissions coordinator.

    There are a lot of us who moved here from another country or state and had to be poor for a long while. I refused to think that my rich friends or other students had anything to do with me getting or not getting the education I wanted.

    If her parents make little money, and they do not own a home, she can apply of FASFA, which is federal aid.

    If she wants to get help with her loans, then get more realistic and positive. Decide if she has what it takes to “go for it” or not.

    I am sure there are thousands of young men and women who are in medical school who did not have much help from their families or community. It did not stop them from their life’s “calling” and they got through it because they believed in themselves and figured out a way.

  • Joanne Yankovich

    There are lots of resources out there just for you as a young Native woman who wishes to become a doctor. Below are the names of programs, and links.

    Center of American Indian and Minority Health at UMinn in Duluth, which graduates the second largest number of Native physicians in the country:

    Association of Native American Medical Students:

    Indians Into Medicine – University of North Dakota:

    Indians Into Medicine – University of Arizona

    My takoja at Pine Ridge will be attending an introductory session at Duluth soon called Native Americans Into Medicine. He comes from extremely difficult circumstances, is attending tribal college and is excited to learn what he can do.

    Good luck.

  • PamelaWibleMD

    Being a poor Native American is not equivalent to being a poor run-of-the-mill American. There are very unique struggles such as the SS# above that are additional barriers.

  • buzzkillerjsmith

    I’d rather light a candle than curse the darkness.

    So this woman wants to be a family doc and heal her people. Then why the heck doesn’t she become an NP or a PA? Less costly, get on the hamster wheel much sooner.

    As a proud family doc I say that my specialty is dying and perhaps should die. Most of it can be done by persons with 2 years of education after college instead of 7.

    Glad to be of help. Next case.

    • Suzi Q 38

      I don’t believe that she has to give up her entire dream of helping her people because the “path” is difficult.
      You are right. A PA or and NP would be better than giving up entirely to teach her tribe’s language.
      She can always work for awhile and then take the next step as Micaela did.

    • guest

      I hope she reads this blog and sees there are other options for her.

      However, even college seems to be a challenge for the poor and disenfranchised. They may be able to get their school paid for but they have no money for expenses and no support when things get rough (and we all know things get rough). Making it to grad school? The deck is really stacked against her unless she is a supremely motivated individual.

      Frankly, had I not had every advantage in my favor I would never have made it. I can’t imagine what it’s like for a student with social or financial issues.

    • PamelaWibleMD

      buzzkiller you are killing me. In my last post you were cursing the darkness rather than lighting a candle. :)

      • buzzkillerjsmith

        A foolish consistency is not my style.

  • buzzkillerjsmith

    The standard line from the Ivies is that no one who is accepted can’t go for financial reasons. They try to make sure of that. I am very skeptical of the claims of this person.

  • guest

    Without a doubt, yes. I went to a school that was considered “progressive” for minority students. Every student who was not from a reasonably affluent background dropped out or failed out. I see the same thing happening when that token student escapes the inner city and actually makes it to college. They are unprepared academically and have no financial or emotional support from back home. In fact, sometimes those back home often criticize the student for “forgetting their roots” or “leaving their people behind.”

    I don’t think this poor girl is being defeatist. I think she’s right on.

    • PamelaWibleMD

      Yep. I agree. Seems overwhelming the obstacles many face. No wonder we lack proper representation of minorities (especially natives) in the health professions.

    • Suzi Q 38

      Since you agree with her, do you think she should stay put at her reservation and give her idea up?

      • understandnatives

        Yes, I think she should give up her idea. Moving along this path will only cause failure and frustration.

        • Suzi Q 38

          So you don’t believe that she can become a doctor if she wants to?
          It is clearly her decision, not yours or mine.
          I hope that she tries to help her people with whatever health degree she can get.
          It isn’t all or nothing.
          Just because you go to PA school does not mean that you can’t become a doctor someday.
          Heck, I knew pharmaceutical reps who eventually became doctors.
          There is an anesthesiologist who writes on Kevin’s blog who was a former nurse.
          My sister’s surgeon started out with an art/history degree.
          If she decides to do plan 2 and become a language teacher for her tribe, so be it. That is a worthwhile endeavor, too.

          I don’t think that she should give up what she wants to do for a career in life, based on her and other’s ideation that “only rich kids become doctors.”

  • J Rizzo

    Read it and weep rich doctor peoples!

    It’s funny I’ve been thinking about this a lot lately. The class differences that are obvious between my physician colleagues and my NP self. Admittedly, I notice my own resentment at their life advantages, advantages they had from the get go and utterly don’t understand how they were even advantages. I am jealous of their confidence, their expectation that things should go their way because they always have. They clearly come from affluent somewhat intact families. I came from a single Mom who was into cocaine, pot, insanity, and welfare. Their families placed an emphasis on education, competition, and success. I learned to hustle for my needs be it through legit employment or otherwise.
    In my immediate area of practice (psychiatry) I work closely with 5 doctors. All of them come from very wealthy families. They do not talk like me, they do not dress like me in street clothes. They hold value on “the look good”, the firm professional demeanor. They feel their decisions are absolute and never discuss rationale, nor show any vein of fear about the finality of their decisions. They strike me as selfish and narcissistic. I suspect they see me as a wannabe second rate who thinks he knows a lot and over emotes. It’s as if they feel they are holders of a divine scepter called a MD degree. I call it being born entitled.
    I place value on being real, on being down to Earth, and perhaps even keeping myself down. But as important as providing culturally competent care is in our profession (I’m still not sure if Doc’s are as concerned about this as nurses) it completely baffles me how MD’s can be so clueless as to how utterly confining being poor is. God help you if you have ambition and are poor. It’s not like you have one hurdle to jump over but like hundreds of hurtles some small some massive. As a working class person you overcome these hurdles, on your own because you have to and that’s life. For working class people, being poor and moving ahead is a double edged sword. Imagine my dismay when aunts and uncles, friends actually resented me for the audacity to think that I could be more than a lowly male ICU nurse. (Which is not lowly it’s friggin’ awesome!)

    My point is this: In America, anyone can be successful if you are willing to sacrifice. But in America, poor people do not become doctors. It would be nice if more MD’s could understand this.

    • incomingmedstudent

      I come from poverty. The area that I called home for seventeen years of my life outside of my parent’s apartment in South LA this was riddled with easy access to drugs and the lure of gangs. Inside our home there were many years were my parents had to rely on Food Stamps to complete our meals. We never had a family physician because my father’s sewage machine operator job in the LA textile industry didn’t provide health insurance. Our health care was provided for by the local LA county clinics. My father was diagnosed with diabetes and we didn’t understand this. Over time my father failed to manage his diabetes. Witnessing this, I had dreams of becoming a physician, but I was always more pre-occupied with finding a job and securing a source of income after graduation. Thinking about how difficult and challenging it is to get into medical school, I pursued a financially safer route and studied engineering. This proved to be the most challenging course of study I could have picked given that I was severely behind everybody else in terms of knowledge that I was already supposed to possess (basic physics, chemistry, and mathematics). Often I felt dumb thinking I was not good enough to be in this classes and twice I considered dropping this major and once i thought about leaving school and finding a job. It took me five years to graduate, but I did thanks to the support of my family and on-campus advisers. Settling into an engineering job after college, my mind wandered on about my father and his access to care. I now lived in a whole different world. One were access to care is readily available with a 25 dollar co-pay and white laminated card that had my name and PPO number. I am now on the verge of starting medical school later this year, five years after I received my engineering degree. I am no longer a student that comes from immediate poverty but I know poverty because at the age of 27, I still have spent more years (17) in poverty than not.

      Simply said, J Rizzo I understand where you are coming from. I am not your typical medical student or future doctor. I am a kid that with a lot of hard work, support, and in the end sheer luck has made it to this point. One of very few in this country. When I filled out the medical school application (AAMC), it asked for my parents education level, I had to select other and write down second grade for my father and sixth grade for my mother.

      • J Rizzo

        Keep on! Keep on! Representing Long Beach here.

        • Suzi Q 38

          Long Beach, California?
          I lived there for awhile.
          On the “West Side.”

      • Micaela Wexler

        Way to go! I’m a physician who was a non-traditional med student, also. People like us bring a lot to the table. Remember that as you go through your journey. Congrats!

      • Suzi Q 38

        Keep working. You will attain it.
        27 is not old.

      • guest

        Awesome! Good for you and best of luck to you in your future.

      • PamelaWibleMD

        Wow. Let me know if I can help you along your journey in any way.

    • Suzi Q 38

      “…My point is this: In America, anyone can be successful if you are willing to sacrifice. But in America, poor people do not become doctors. It would be nice if more MD’s could understand this…”

      How can you say something so absolute as “…poor people do not become doctors?…”

      There are some poor people who have become doctors.

      Anecdotally, I have known a few.

      • guest

        I took it as it is very difficult and unusual for poor people to become doctors. I imagine poor kids don’t have many doctors as adult role models. So how could you imagine that you could be a doctor when most of the adults around you have blue collar jobs?

        I have also known a few poor people who became doctors. However, they were extremely exceptional people who had a lot of family support. I am certain a lot of poor people do not feel they can even complete college at a university much less become a doctor.

  • Patient Kit

    Oh, OK. I certainly get that. Since I log on, Dr Pho has enough info to trace my identity, if necessary. But we don’t have to use our full real names in order to post articles or comment here. So, to the other participants and to the public readership, we are relatively “anonymous”.

    The main reason that I’m not using my real name here is because I am a cancer patient who is job hunting and I don’t want potential employers to google me and find out that I have ovarian cancer. But I wanted to be able to tell my own true story here about my current odyssey through our healthcare system. You are right that we are never absolutely anonymous online since we are technically traceable. However, I think students like Sage would be relatively”safe” posting here.

    • PamelaWibleMD

      Sage has real concerns about losing housing and being ostracized by some in power within her tribe. I know Natives who have lost many family members to murder on the rez and they are just not willing to risk putting themselves or their kids in harms way.

      Do rich kids have to worry about this? No. They just have to get to their Kaplan class on time.

      • Suzi Q 38

        When I moved out of my parent’s home when I turned 18, I left with my clothes and that was it.
        I had a car and a car payment, and now I had to pay the rent, pay utilities, insurance, and buy food.
        I had to figure out how to work full-time and go to college part-time. Paying for tuition and books was also tough.

        Sometimes, life is not easy. It is a struggle.
        At times it can not be helped.

        I just realized when I decided to leave that toxic family situation, that I had to survive by saving myself. No one was going to save me.

        If she can not leave her reservation, she is giving in to her fears of a life without the reservation, even if it is only to get an education.

      • ninguem

        So…….you’re telling us it’s better to be rich than poor?

  • buzzkillerjsmith

    Blanket judgement? Hardly. There is one specific case here, the person that Dr. W. discusses.

    There are indeed constraints. I would submit, then, that this woman would be much much better off going to NP or PA school than going to med school. Med school represents a much greater time commitment and would make it almost impossible to take care of a sick child. Then there is the extra expense, which would make her more likely to sub-specialize and not go into primary care.

    Wasn’t primary care the whole point?

    I’m not sure where suicide rates enter in this particular discussion. Perhaps high suicide rates among physicians is yet another reason that she should avoid medicine.

    In any case, thanks for inadvertently advancing my argument.

  • understandnatives

    We have six college students on our reservation who are at a stage where they each have to make a decision like Sage. Of them one is mobile, relatively well off with a stable family, has non-alcoholic parents, and she is willing to pursue her dream anywhere. Philippines huh? Maybe I can tell her about medical colleges in the Philippines. What is the tuition like – is it affordable when you consider living expenses along with tuition? Do they need all the pre-med courses like the US schools? – because the only college that is accessible to our students does not offer all the required premed classes. Are medical schools in the Philippines also four year programs? Finally, will she match into residencies in the US after her MD/MBBS from the Philippines?

  • J Rizzo

    And that’s why I know you are really good at what you do.
    You are right, my post speaks in generalities. But I’m okay with that because it’s a relief to have a discussion about a topic that seems utterly taboo. Perhaps this subject is crucial, now more than ever, because income disparities are rising and the boundaries for middle class are evaporating.
    Your story is absolutely important.

  • ninguem

    Half Jewish, half Native American?

    Hosti gezen in dayne lebn?


    Loz im geyn!

  • SteveCaley

    I agree with Sage. I do not want her to leave the path. Sometimes one is called on to wage a lifelong struggle against what IS, in hopes for what CAN BE.

    There is great cruelty and discrimination on this path, and that is wrong and harmful to human beings. Perhaps individual attempts to change things will be meritorious; perhaps they will be futile. I do not know the future.

    When I think of Indians in America, I think of Elouise Cobell, a member of the Blackfoot Nation. She had no special advantage at all, she had no privilege or standing; and she took on the Federal Government, and she won. I do not admire her as a Blackfeet or an American Indian. I am proud to be an American person, like her. Yellow Bird Woman was an American woman – that’s all you need to say about her.

    It’s OK to suffer, but don’t give up now. Don’t give up just because the system’s not fair. Not many people can see that unfairness; Sage can. That is a special view that deserves to be brought to fruition. Mrs. Cobell saw it; and no descendent of Mountain Chief would willingly let the injustice continue one generation more. Read her story, and understand, please.

    • Suzi Q 38

      I agree that she should persevere, but shouldn’t give up because there are “rich kids” that have it easy. Why should she bemoan what the others were given, or what they have?
      She is better to serve herself by figuring out how she could attain her goal on her own terms, given what she has to work with.

      Talk about unfairness. Life, in general, is not fair.
      I don’t know one minority race who has had everything given to them. Also we can not forget the poor anglos in this country. I am not familiar with their life, but growing up in the Appalachian mountains and working in the coal mines aren’t exactly pleasant.

      I couldn’t get an educated job in the 70′s because people thought I was Chinese. My parent’s were alcoholics who made life miserable for all of us while I was growing up. I had to care for my FIL, who had had 3 major strokes for 12 years of my life….is any of that fair???

      I read Micaela Wexler’s post and have nothing but admiration for her. She had a dream to be a doctor, and figured it out.

      • Pat Brown

        “I don’t know one minority race who has had everything given to them”.
        Actually, “I don’t know one person of any gender or color or accident of birth who has had everything given to them!” *
        (…..*although many ARE endowed with huge head-starts, both financially, cognitively, and socially….if they do not continue with at least a modicum of effort, they can and WILL lose these gifts. It troubles me that anyone can still beleive that being white, or a white male, is an unbreachable shield against misfortune.)

        • JR

          I’ve never met anyone that believed being white or a white male as an unbreachable shield against misfortune…

          But I have met people who don’t know what “white privilege” is and get really upset at people discussing it, not understanding that it is something used to describe social groups and not individual circumstances.

  • Suzi Q 38

    I think you are reaching for excuses, when there are some opportunities for assistance.

    Are there school loans for being Native Americans, or not? I will admit, I truly do not know.
    I definitely will find out.
    As for the SSN….Can they get state or federal aid without a birth certificate or SSN number?

    You say “….Sometimes Indian students don’t have an SSN in which the basic financial aid application cannot be filled which automatically eliminates consideration for scholarships….”

    Interesting quote. Where do you get that information? “Sometimes” can be anything from about 30%-60%, which is ambiguous at best.

    The Indian woman in the story might have had her SSN. If so, there are more options.

    Is there any reason why a child born on an Indian reservation from the 1980′s and later would NOT have a birth certificate? Isn’t it the parent’s duty to request one on behalf of their native born baby?

  • ninguem

    What’s with the Native Americans not having Social Security Numbers?

    Accepting the premise, I have no idea one way or another. The story still puzzles me. A woman with the intelligence to get an Ivy acceptance, and all of a sudden the Social Security Number thing is a deal-breaker?

    Social Security Numbers were started almost 80 years ago. Educational loans, let’s say about the mid-1960′s, almost 50 years.

    So……she’s the first Native American in history to get accepted to college, that this glitch has never before been encountered?

    Sorry, there’s something in this story that just doesn’t add up.

    • Suzi Q 38

      I agree.
      At some point in time, the tribe leaders would say, “We must get birth certificates and Social Security numbers.”

      • ninguem

        The particular tribe that seems the obsession of someone posting here, the reservation land straddles the USA-Mexican border. Yes, I bet some of the tribal members have a hard time with Social Security numbers, as they may have difficulty proving that they were born on the USA side of the reservation.

        Does this problem extend to tribes that are 100% within the USA geographically.

        • Suzi Q 38

          Thanks for the information and clarification.
          Your findings are interesting, and may explain why there is no birth certificate.
          If they can not determine if the baby was born in the US or not, this is a problem.
          You can be sure though, if the baby was born in the U.S., the parents would demand a bona fide birth certificate.

          • ninguem

            Talked to a Native American well-versed in tribal affairs in my part of the Northwest, he had no idea what this person was talking about.

            This part of the country, the tribal members get Social Security numbers like everyone else.

          • Suzi Q 38

            I could not believe that a leader of a tribe could not get social security numbers for their children if they were legal.
            If they were legal and they did not have the SSN’s, She/he should be fired for not doing his/her job.

  • SteveCaley

    Michaela, find the Association of American Indian Premed Warriors (AAIPW), if you would please. For three hundred years, Indians have been tempted from the mountaintop – just renounce who you are, and you will have all the splendors of the world. The (now-closed) Indian School in my town taught Indian children to stop being themselves. That made them into nobody. Please show yourself to the students who need your words, and let them know that the only way to make it is to be who you are.

  • SteveCaley

    I believe that it is critical for people to look directly into the abyss of racism in America, especially in medical education.

    Abraham Flexner published his famous Report in 1910, and played a powerful hand in the reforming of the medical schools in America. In many ways, American Medical Education and the AMA are the brainchildren of Flexner. Flexner himself trained at Harvard and Hopkins, and became in the mind of many, an expert on medical education.

    In his words:
    “THE medical care of the Negro race will never be wholly left to Negro physicians. Nevertheless, if the Negro can be brought to feel a sharp responsibility for the physical integrity of his people, the outlook for their mental and moral improvement will be distinctly brightened. The practice of the Negro doctor will be limited to his own race, which in its turn will be cared for better by good Negro physicians than by poor White ones. But the physical wellbeing of the Negro is not only of moment to the Negro himself. Ten million of them live in close contact with sixty million Whites. Not only does the Negro himself suffer from
    hookworm and tuberculosis; he communicates them to his White neighbors…
    The Negro must be educated not only for his sake, but for ours. He is, as far as human eye can see, a permanent factor in the nation. He has his rights and due and value as an individual; but he has, besides, the tremendous importance that belongs to a potential source of infection and contagion.

    That was written and published to the best minds in America from New York City; this was how educated (White) men spoke, less than twenty years before Reverend Martin Luther King was born. It was seen as Liberal and tolerant to Black people at the time. How far have we really come from the abyss? And who has dragged us to safety?

    • ninguem

      I think the Flexner Report is sort of like a Rorschach test.

      The Report was either a noble effort to rid the country of the charlatans in medical education, or a racist and sexist plot to make medicine a white male bastion. Depends where you’re coming from in the first place, and surely there are elements of both.

      The paternalistic racism that often drips from the Flexner Report, was of a kind with similar ideas coming out of Planned Parenthood at the time.

      I bet Abraham Flexner and Margaret Sanger would have had a lot in common. I wonder if they knew each other?

      • PamelaWibleMD

        Exactly what I was thinking regarding Margaret Sanger.

        • SteveCaley

          Flexner on Women (1910): MEDICAL education is now, in the United States and Canada, open to women upon practically the same terms as men. If all institutions do not receive women, so many do, that no woman desiring an education in medicine is under any disability in find­ing a school to which she may gain admittance. Her choice is free and varied….
          Now that women are freely admitted to the medical profession, it is clear that they show a decreasing inclination to enter it.
          …(is there) any strong demand for women physicians, or any strong ungratified desire on the part of women to enter the profession..(?) One or the other of these conditions is lacking, ­perhaps both.

          I believe that the lid never gets left open by accident on the glass ceiling. If a profession is declining in status, it becomes a “pink collar” profession. Thanks, Mr. Flexner.

  • ninguem

    The Tohono O’odham

    Isn’t that the tribal land that was bisected with the Gadsen Purchase? Straddles the USA/Mexico border?

  • buzzkillerjsmith

    OK, maybe that’s what understandnatives is trying to say.

    But of course devastated and debilitated people should not go to med school or be doctors lest they become more devastated and debilitated. Medical training and doctoring can chew up and spit out even the most robust characters.

    Again, NP or PA is a much simpler and easier route for this person if she wants to help her people by practicing primary care.

    • Micaela Wexler

      I would never suggest a person attempt even nursing school while devastated and debilitated. That person needs nurturing, so she/he can heal. These are not permanent conditions. I work with many competent NPs and PAs, so I find it a bit demeaning that someone should be encouraged to do this simply because it is easier.

      • PamelaWibleMD

        Hard to practice caring for another when devastated and debilitated. Many med students feel they suffer from PTSD as a result of their training. Add that to the mix. This is not an easy road without some psychological support. Then there is the economics, financial, social class elements.

      • buzzkillerjsmith

        I always like to start with a compliment, so I should state for the record that I find psychiatrists mildly less irritating than I find docs in some other specialties. Some psychiatrists anyway. Well, maybe one or two. Maybe one that I once met but I’m not 100% sure of that.

        Nurturing, healing–on the reservation where, by hypothesis, she is trapped. And then, Deus ex machina, permanently cured, impervious to any and all stresses that might come her way in the practice of medicine in perhaps the difficult circumstances in the country.

        I guess psychiatry has advanced some since back in the day. Miracles upon miracles.

        Demeaning. I don’t think so. More realistic is more like it. But I guess you can dream….

      • RenegadeRN

        ” even nursing school”?? That’s a bit of an insult- from someone I am pretty sure never attended a nursing school.

        I agree med school is harder, but nursing school isn’t exactly high school.

        • buzzkillerjsmith


          • RenegadeRN

            Sorry buzz, it just hit me wrong… And I am not the ” looking to be offended” type at all.

      • Suzi Q 38

        I can see your point, Dr. Wexler,
        I would concur with Buzz only because Sage was talking about “serving her people.”
        If she decides not to be a doctor, and instead becomes a tribal school language teacher, is she “settling” for less? Maybe so, maybe not. That is in the “eyes of the beholder.” If she gives up her dream and stays at her reservation and becomes a language teacher, how is that serving the medical needs of her people?

        At this point she is annoyed that “only rich people can become doctors,” as if the only thing stopping her from doing so is the great society divide.

        You have proven that this is far from the truth.
        Against all odds, you and many other poor students became physicians with determination, hard work, and nice mentors.

  • Suzi Q 38

    Applying to FAFSA is not such a farfetched solution as far as assistance. If one generation has not figured it out, where are the others who have moved on coming back to assist?
    I don’t buy the notion that most of the people in that tribe have never had a social security number.

    If fully one third of the Native Americans from the Tohono tribe cannot get a SSN, there must be at least two thirds who can. The two thirds should be helping the one-third with this endeavor (making sure to have a social security number).

    Based on your findings, the majority of Native Americans from this tribe do have a social security number and are therefore eligible for benefits, including applying for FAFSA.

  • Suzi Q 38

    Thank you for your information.
    There are many ways to attain your goals.

    You site a very affordable alternative.
    I had a friend in high school who was very poor.
    At least though, her parents provided a modest apartment in the poor side of town. They were a supportive and loving family.
    She knew she wanted to be a doctor, yet had no money. In order to achieve her goals, she enlisted in the Air Force, who paid her way through undergrad and medical school. she had to pay them back with her time as a pediatrician after her graduation.
    She was fine with it, as it was a “means to an end.”
    I always admired her for what she did.

    A young man I dated for a short time was an ENT physician. His family was very poor. His dad was a factory worker, with a stay at home wife and 5 children to support. He said that his dad’s spending money consisted of $5.00 a week allowance that he used to buy cigarettes.

    The children knew from the start that there was no money for college. He said that he borrowed most of the money for undergrad and medical school and worked his way through, living very frugally.

    This is why I don’t believe that “only rich people become doctors.”

    • PamelaWibleMD

      Obviously many poor people do become doctors, but the numbers are small and the obstacles can appear nearly insurmountable from a Honey Bucket.

      • Suzi Q 38

        Of course.
        I am glad that you are honest about that realization.

        It appears that it is just more exciting to talk about the rich as if they had done something wrong, as if they weren’t deserving of their MD degree because they did not socially or financially suffer through medical school.

        We need to keep blaming other groups of people for our own failures or challenges.
        It is far better to use that energy to figure out how to get what you want in life.

  • PamelaWibleMD

    Aha! Trying to cover some the real issues here.

  • ninguem

    Still waiting for an explanation that makes sense, why someone able to get accepted to an Ivy college, walked away from that for some (author’s description) bottom-tier school.

    • Michelle

      Agreed. My spouse is currently in school for DPT. While he wished to become a doctor, our disabled child and the fact that we are doing this all on our own, made it impossible. So he’s pursuing his DPT with everything he has, and I am working full time to support us during this time. Oh, we also are part of a minority group. It did not hinder his path, if anything more schools accepted him because they found his story intriguing.
      The original post was negative and defeatist. Sometimes we have to realign our dreams to fit reality, but we may not blame the unfulfilled dreams on external factors, only on our lack of perseverance.

      • Suzi Q 38

        I agree.
        Resenting those with money is wasted time.

    • PamelaWibleMD


      1) She is a single parent

      2) Can’t afford to move across country

      3) Caretaker for her parents

      and more . . .

      • ninguem

        Finally, a reason that makes sense.

        So… did having a child out of wedlock or being a caretaker for elderly parents, become a uniquely American Indian problem?

        The story is presented as though Asians are immune to this problem…….let alone whites.

        Tokyo Rose ended up in Japan doing propaganda broadcasts because she was expected to defer her educational plans……..medical school you might remember…….to care for elderly relatives in the old country. She left America for Japan, the war broke out, you know the rest.

  • ninguem

    Rizzo, sorry to hear our mother was mentally ill, abusing hard drugs and unable to provide for her family.

    How does that translate unto some unfair advantage for someone from a family that managed to marry, maintain a stable marriage, work for a living, and avoid hard drugs?

    • rbthe4th2

      You dont have the financial and emotional support, the stability, to get ahead. You are more worried about your next meal, like we were, rather than trying to figure out chemistry and physics equations. Whether or not you are going to get beaten because you got in the middle of a physical fight between parents. Recovering from being beaten.

      • Suzi Q 38

        I agree that it is harder, but life is not fair.
        We all can’t have the perfect, doting, success driven parents. Oh, and I would have loved the type of parent who would have written out the check for the tuition, room, and board for college.
        I could go on and on.
        The fact is that as my Jewish pharmacists (clients) would tell me: “You are what you are.”
        In other words: Accept who you are, where you are from, and improve from there.

        I came from a family of 6 kids, from two parents who were college drop outs and also alcoholics.
        They were demanding money from US from the time we were 11 or 12.

        This doesn’t mean that we couldn’t succeed in life.


        • rbthe4th2

          No life isn’t fair but with that many obstacles in your way, with all the extracurriculars that parents with $$$ can buy cars and other things, poor kids can’t or have to be inside in case they get shot at or kidnapped or beaten or whatever, yes that makes a difference. One can say all they want but if you can’t get the prep school stuff, you can’t afford to go to a decent school, you end up as the caregiver for the other siblings because parents are working or drugged up, realistically it just doesn’t happen that your dreams will come true. Some of us didn’t leave our siblings. We helped out. So I guess it is all our fault for not dropping our family, saying :P~~~ because our dreams are not worth you?

          • Suzi Q 38

            Not really your fault.
            We all make our choices.
            It is our life.
            I had two older brothers, a younger one, and two younger sisters.
            One brother left first and he lived in his car for awhile. That both fascinated and scared me.
            To think that he was so brave to do that, really got me to thinking.
            I thought: “Is there a better life out there?”
            I didn’t have to think about it for long, because my parents started acting up again. I made my decision for myself.
            Of course, you are judging me for my decision, yet you have not lived my life.

            I will not and do not have to explain what it was like, as we are not in therapy.

            I don’t know what your dreams are, except that whatever they are, you can do it. If you decide that you can’t, then that is your decision.

            The student in the chair next to you with the famous last name and a large bank account has no bearing on whether or not you will succeed.

            I don’t get how you would resent the wealthy, but that is just me.

            Everyone is entitled to their own opinion.

            I left when I was 18. As far as helping out, I did about 12 years of it. Amidst a lot of chaos.

            I knew I wasn’t going to volunteer for another decade or two.

            I asked a sister to leave with me, and my parents begged her to stay.
            They knew my mind was made up.
            She left when she turned 20.

          • rbthe4th2

            Exactly my point. People are on here condemning the lady when she had obstacles that may or may not have been surmountable. As you said, “Of course, you are judging me for my decision, yet you have not lived my life.” and that’s what we’re doing about this lady.

            A lot of what you wrote is contrary to life in truth. People can’t always overcome the obstacles in their path and its not always the fault they can’t.

            We may or may not have made the same choices. However, what about seeing that another person isn’t getting their dreams jeopardized due to money when they’ve got a worthy goal?

            Aren’t you judging me for “resenting the wealthy” when I have yet to see evidence that’s true, and then questioning it later on? You don’t know me at all. We’re all entitled to our own opinions here as you said.

            The fact remains that even a biased media shows that the rich have the ability to use power stop people from actions that may help them and others. We’ve seen people use their power for less than the public or anothers’ good.

            The stats are there. With more MD’s marrying MD’s, generational wealth perpetuates. There is a big difference between someone who has to pay for 4 years of room and board and everything else at a college when someone who has a more affluent family does not. That person without money may have to take jobs that take time away from studying. Meaning lower grades. That’s the way things are.

          • Suzi Q 38

            I am not condemning this lady.
            I don’t agree with her ideation that she can’t be a doctor because only the rich become doctors.
            I got the idea at the time that she wanted to give up because only rich people became doctors.

            This is simply not true.
            I am judging her statement that only the rich become doctors, by saying that I DONOT agree.
            Am I aloud to say that?

            i guess not.

          • rbthe4th2

            See the below links. Pretty much most all agree that it is skewed to more affluent/rich people. If you have so many hits against you, the probabilities that it is going to happen are about nil. Realistically speaking. That’s all someone is trying to say. We don’t have enough data to say what went on in this ladies’ life. Seeing data and what people talk about, the extra $8-10K or more for interviews for residency, etc. and there is another blog I’ve seen data on also (but dont know if I can post since its another blog) make me feel that while I normally say people can do what they want, that is not always true in real life.

            Now hear this: George Washingon (GW) University openly admitted to placing poorer students on the waitlist instead of admitting them. This was reported in The Hatchet, an independent GW student publication. The report revealed that George Washington’s medical school takes into account an applicant’s ability to pay tuition when it comes time to admit or waitlist the student.


          • Suzi Q 38

            I like those links.
            As usual, you have done some “homework.”

            Interesting reading.

            It does not take any studies or articles to prove that money makes life and whatever you want to do a heck of a lot easier. We have known that for a long, long, time.

            My point is that you can still be poor and become a doctor. It isn’t just for “rich kids.”

            As far as what is happening at George Washington University, I will read about it.
            If they are placing poorer students on the waitlist, they should be “called out’ on it.

            Hopefully, not all universities follow this practice.

            For example, UC Berkeley had some scholarships to give out earmarked for very specific students. They were students from a certain school district who had parents who could not afford to send them to UC Berkeley on their own. Their benefactor was a deceased man (in the 1970′s) named Cecil Ditty who graduated from the local school district and attended UC Berkeley. He and his wife lived in Berkeley, had no heirs, so they came up with this idea for a scholarship before they died. They selected students who academically qualified, had financial need, and wanted to attend the school. First they had to qualify for the Pell Grant and the Cal Grant.
            Then came the FAFSA allowance. This scholarship literally paid the remainder, allowing
            many students to go to this school and graduate with no student loans whatsoever. They also paid for food, toiletries, books, and air fare to and from school for major holidays.

      • ninguem

        That’s a lousy situation I agree.

        An intact family with a mother and a father, and no drugs in the house, is 90% of the battle.

        The people who point out that obvious fact, usually get called racist.

        Daniel Patrick Moynahan, in 1964, a prime example.

        I don’t know how that makes medicine a club for rich kids, as implied in the title of this thread.

        • rbthe4th2

          If a kid has to look at going thru college and getting a job, they can do the local community college and then last 2 years at a local school without having to pay for room and board. Not that many will be able to study hard for the science courses needed, and if they have to work, then they can’t do a lot of extracurs that help you get to med school. A kid who does have rich parents can afford to not work, spend time studying, get in clubs and network, big difference. They can also afford to go to better schools with a better chance at med school.

      • Suzi Q 38

        …..Brings back memories.

        Respectfully, even though my life was similar, I still don’t resent the wealthy nor do I think being an MD is only for the rich.

    • Suzi Q 38


      Did you mean to send this post to Rizzo?

      • ninguem


        Oh yeah, I guess so, I clicked where I should have clacked.


  • Anne-Marie

    I’m dismayed that some of the commenters here feel the answer is for Sage to just dial down her ambitions and settle for less. And that you have overlooked the prejudice she describes, e.g. the assumption in the doctor’s office that if she’s Native American, she must have an alcohol problem, the assumption by her college professors that she’s going to fail or that the coursework will be too hard for her.

    The inequities are very real and they start early with income, geography, quality of the middle school and high school experience, level of family functioning, belonging to the “right” kinds of social and professional networks, etc. Check out some of the AAMC stats: The average student entering medical school comes from a household with a median family income of $100,000-plus; about 60 percent of med students come from the top economic quintile.

    I know for a fact there are many medical students and doctors who do not come from wealthy backgrounds. I’ve met them. But there is a very real privilege gap here that can’t be ignored. Given how expensive and how competitive it is to get into med school these days, I suspect the privilege gap is getting wider with every passing year. The burden lies with the system to reduce the inequities, not to tell bright, aspiring young people to give up their dreams.

    It sounds like what Sage needs is a mentor who can work one-on-one with her to remove some of the barriers and connect her with the right resources. I hope she finds that mentor.

    • Suzi Q 38

      I think she has already found a mentor in Dr. Wimble.

      • PamelaWibleMD

        Wible like Bible. :)

  • ninguem

    Portland Oregon police department.

    Officer with five years experience, $76,000. They pick up overtime to bring salary well above that. Various bonuses for educational level, foreign language proficiency.

    Schoolteacher, Multnomah County schools, fifty, sixty grand with experience. A two-schoolteacher household can make six figures.

    I’ve got two cousins in the fire department. They’re coming in at about 70-80 grand a year, salary is a public document.

    Brother-in-law is a power dispatcher (electric company), gets about $100K with overtime. He works a lot of hours, night and weekend call.

    They all earn their pay.

    I don’t think any of the police officers, firefighters, schoolteachers, power lineman and dispatchers will call themselves “rich”. I think they would call themselves middle class.

    Medicine is a field for the middle class, and for first, second-generation immigrants. The really rich, the multimillionaires, usually can find far easier ways to keep their income going.

    • PamelaWibleMD

      Yep. Agree.

  • ninguem

    So, they’re having trouble with Social Security numbers because they have to prove they are on the USA side of their reservation land. I can imagine they have problems with the numbers.

    As the USA tries to tighten border security, I can see how a reservation like this can be a huge headache.

    You say 33% can’t get SSN’s.

    That means that two-thirds…..67%……DO get SSN’s.

    Does this problem extend to tribes that are entirely within the borders of the United States?

    Do the Mohawks get the same problem across the Canadian border?

    These border-straddling reservations can be prime spots for smuggling.

    Sometimes cigarettes, like the Mohawks across the Canadian border.

    Sometimes the smuggling is people.

    • understandnatives

      > Does this problem extend to tribes
      > that are entirely within the borders
      > of the United States?

      Yes that happens too occasionally and the person lacks a social security number. Sometimes the person is born at home, sometimes the tribal admin hates the Indian family and gives their little kid a hard time with tribal membership, sometimes the family is already in the process of being disenrolled from the tribe, sometimes tribal documents are not accepted by city or county officials as adequate, sometimes parents are too much into alcohol and drugs to bother with getting their children SSNs, sometimes uneducated Indians try to get documents for their children only after they are 12 or 13 years old and have a difficult time proving anything, sometimes Indian definition of the family is not accepted by local officials, sometimes the family moves and has a hard time finding documents, etc. In some tribes, traditional individuals change their names each time a family member dies. So they may have a SSN under one name, a driver license under another name, a tribal id under a third name but they may be going by some fourth name (this is especially true for almost all Pitjantjajara Australian Aborigines who never seem to have any documents). The family then needs a lawyer to help them sort out these name issues but they may be too poor and uneducated to bother with that. There could be numerous other reasons. The problem is worse in the border states where full-blood Indians are sometimes deported because they are mistaken to be illegal Mexicans by the Border Patrol officials.

      • ninguem

        All I can say is, not in my area. I have yet to see tribal members who don’t have SSN’s. You bring up Australian tribes, not that I would have any idea how they do things Down Under.

        I did work in African projects, where we made sure clinical officers from all tribes were represented. It became apparent to me quickly, and the locals agreed, not all the tribes were the same.

        Some tribes, their clinical officers (sort of like a nurse of physician assistant), some tribes sent clinical officers as good as medical residents back home. Other tribes, they were complete dunces, and the best you could do was make sure they were not dangerous at best.

        I suppose USA native tribes, the same thing applies. All I can say is the few natives I know, they have not heard of any such thing in our area. They are sovereign nations, they organize their affairs as they see fit, some well, some not.

  • Suzi Q 38

    Where is your reservation located?
    I live in Southern California.

  • Eric W Thompson

    She touches on many issues. It is hard for a single parent of any race to get through a college degree, let alone med school. There are rich Native American tribes and poor. The rich seem to get more from the government. Seems that many can claim benefits with even a tiny percentage of blood relation to a tribe. If anyone is less than 50% Native American, or any minority, they are more of something else. There would be several ways to level the playing field, but I believe the rich Native American tribes would fight any changes.

    • querywoman

      When I worked in public welfare, I had a blonde woman from Alaska who was getting Native American money.

  • Karen Sibert MD

    Dear Sage,

    I am so sorry to hear your story, and hate to see you give up on your dream of becoming a family physician. What I am particularly struck by, though, is this: why are you in a “low-tier” college when you were accepted to an Ivy League school? This would have been the single biggest factor that would/could have helped you achieve your dream. Many of the Ivy League schools have a no-loan policy, which enables students to attend without taking out any loans at all, and thus graduating debt-free. The advisors could help you so much in the premed process. Is it too late for you to rethink that decision and contact the school that accepted you before?

    Best wishes,

    Karen Sibert MD

  • PamelaWibleMD

    Thank you for explaining some of these VERY UNIQUE circumstances that we have NO EARTHLY IDEA are going on. How would one know about this unless informed by a Native on the inside of the reservation? This is just not common knowledge for any non-Native. We all see the world through our own (sometimes rose-colored) lenses.

    When someone has a rags-to-riches story they somehow think anyone can replicate it. The CEO of Pepsico spoke at my brother’s college graduation with that common American message: “I did it so you can too.” Well, the FACT is there are so many unique obstacles for some people that there is just no way in the world we can make that assumption.

    How I wish we the CEO of Pepsico could sit on your Honey Bucket for a while and realize that life is not unicorns and rainbows for everyone (no matter how hard they try).

    A dose of compassion and empathy is needed here. And a burning passion to eradicate some of these core injustices would be helpful. These beautiful, beautiful Native people were here long before most of the rest of us. These people need to be honored and revered. They are our elders. America’s true forefathers and foremothers.

  • ninguem

    I have nothing to do with SuziQ, but if it makes you feel better, fine. Your name, on the other hand, shows up in Disqus in this thread only, and nowhere else.

    If there’s anyone with a suspect avatar it’s you.

    You come to exactly the wrong conclusion. One third of the tribe in question cannot get SSN’s. Two-thirds can. Simple arithmetic. That so many in the tribe do not have SSN’s says something about the TRIBE.

    Somehow you are able to just snap up admittances to top schools. You claim Michigan and Northwestern. and then you don’t do. In the presence of that, you try again next year and snap up Cornell, Duke, Dartmouth and Notre Dame. And then you don’t go again.

    The Social Security Number was not a problem in the whole application process, and all of a sudden it was a problem afterwards?

    Why don’t you try for the Sorbonne and Oxford next time? In fact, that will be perfect, they don’t know what a Social Security number is. I’m sure they will snap you up as quickly as the US Ivy colleges that you claim wanted you.

    Actually I have ceased to believe you at all.

  • rbthe4th2

    One thing not addressed here is that kids of medical families have more of an “in” than others. They can write in their statement letters my parents were doctors, here is what I learned, or get mommy’s medical school contacts to get them an “in” for where they want to go. They can ask daddy to talk to the medical school where he went and see if they have an opening. I’ve heard docs talk about it. That’s another “in” that the non medical families don’t have.

    • Suzi Q 38

      So true.
      This could also be said for prestigious law schools, business schools, and the like.
      Again, this practice is not fair, but life is not fair.

      I remember when both our children made it into one of the better public universities in the U.S…U.C. Berkeley.
      People thought there was some kind of “legacy” thing going on…. How could two siblings make it in within a year of admittance?
      Neither my husband or myself attended that university…nor had anyone else in our family, for that matter.
      My husband and I went to average state schools.

      My point is that while that practice still exists, I am not sure what can be done to change it. Believe me, I would love to change it so that the admissions were always equitable.
      With humans involved, stuff happens.

      Kind of like the job openings in Hawaii….The island is so small (Oahu and others) that when one family member retires at a good job with benefits, another family member takes h/her place.

      That isn’t fair either.

  • rbthe4th2

    One thing not addressed is that medical families have “ins” we regular people don’t. If you have a kid who wants to do medicine and they have a family member – parent, cousin, aunt/uncle, etc. – then they can pull strings and get noticed. I’ve seen it and heard it before: they’ll save a spot for a “legacy” and then everyone fights over the last position. It makes it that much harder for the regular kid to get in when choice spots are given to medical families’ kids and the like. If you are talking 30% of kids in medical school (the last figure I’ve seen) are from “medical families”, then 70% are from non medical. If you have kids from better schools, etc. with more curriculars, you’ll give them the chance for what is left over. There isn’t a lot of reason to give it to a 3.8 kid from Podunk U who wants to just help their people with FP. They’ll want to give it to a specialist – because academic medicine has a history of looking down on PCP type specialties to prefer specialists.

  • Suzi Q 38

    I like your viewpoint, but I didn’t say my story paralleled anyone’s.

    Life is full of choices.
    It is not impossible, but it is difficult to “have it all.”
    The author has to make her own choices based on what is best for her and her family.

    She didn’t have running water, our family did.

    My staying at home with crazy parents who drank booze and got violent with us was no “picnic.”

    If she wants to become a doctor, how do you propose she go to medical school while living on her reservation? She has to leave at some point in time, leave for a few years to do that and achieve her dream of being a doctor.

    i know doctors who graduated from “dare I say it”
    inexpensive state schools for their undergrad. These schools give FAFSA aid to those who are fairly poor. They don’t hand aid to those who are rich.
    Medical school was more expensive, but don’t they start getting some meager pay by then to help out?

    I see nothing wrong with her taking things “step by step, based on what she can provide for herself.

    If she has nothing, then get a mentor and figure it out. There are other poor medical students who have done so. She would not be the first, and she most certainly would not be the last.

  • Suzi Q 38

    Ninguem is not associated with me.
    What is a suspect Avatar?

  • incomingmedstudent

    Thank you for all the positive thoughts and support. I sincerely appreciate them. I will keep this mind on my journey.

  • Suzi Q 38

    Well said.
    Sad, but true.

    After my series of bad medical experiences in a “perfect storm” scenario, I unconsciously have done the same. I have tried to avoid doctors, as I now realize after hearing from them that many are resentful and their attitudes are not the best at this point in time.
    After reading your letter, I will be more deliberate with avoiding doctors who want to line their pockets with proceeds from my PPO insurance payments.

    Instead of using their calling and “art” to treat me, they have simply made matters worse, which is contrary to their Hippocratic Oath of “Do no harm.”

    Five years or so ago, I would have never thought that this kind of “trouble” and attitude pervasive with so many doctors was brewing under the “cloak” of compassionate medical care and human reason.

    After all, as you say, this is supposed to be “the best health care system in the world.” Also, I thought patients were revered by their doctors, and the feeling was mutual, as I am older and more trusting because of my dealings with doctors of decades past.

    I will try very hard not to be a customer.
    I have a feeling, though, that my family will not allow me to make that decision.

    • Nick Maneck

      Suzi Q 38, it is encouraging to hear from you. There are many more who have come to the realization you and I share. I am sorry your condition was made worse by the medical system.

      The last sentence of your post was very telling. “I will try very hard not to be a customer. I have a feeling, though, that my family will not allow me to make that decision.” Family members live in a belief system that says when you are in distress, you get relief by going to this magical place called the “health care system.” Their attitudes need to change as well. We are looking at a all around transformation.

  • Jeffrey

    There are many generalizations being echoed here. Kudos to
    post by “Alcomendras” recognizing the
    reality of life. There will always be someone smarter/prettier/richer than you. It doesn’t matter how others achieved their goals easy or hard. What
    matters are the choices you make for yourself. What I know for sure is that determination,
    perseverance and desire can overcome most obstacles. I was raised in a blue
    collar family of eight. We had a roof and food on the table but I knew from the
    outset that there would be no money for college and I wasn’t “smart enough” for
    a scholarship but I had decided that I wanted to be a doctor in ninth grade
    thanks to a high school science teacher’s encouragement. So I worked my way through public college. I
    had no professional mentor, no hospital experience, no doctor friends or
    relatives, no premed club or advisor. My
    grades were barely above average and I was rejected by medical school after
    medical school for seven years in a row. In the meantime, I became a medical technologist,
    then a research lab tech, then graduate school taking advanced science courses,
    then a physician’s assistant and with the contacts and experience from those endeavors,
    I finally got into a state medical school (no Ivy league here). What my parents
    did give me was the advice that “life is not fair” and that “you are never too
    old to become who or what you want to be”. I started medical school at age 31.
    Whenever I got to feeling how tough I had it, I would look to my left at my
    classmate who started med school at age 42. In my class of 120 there were at
    least 15- 20 students for whom med school was a second career. I don’t know how many were “rich” or from wealthy
    families but I did know several who had
    it harder than me and I could count on one hand the number that were known to
    be there to “become rich”. It was my 2nd
    year in residency when it hit me—anyone who would put themselves through this (ie. medical school and residency) for anything other than loving what they were
    doing was crazy. Everyone has a story and obstacles, some tougher than others
    but no one I know can buy their way through medical school and residency. Money
    may give you more opportunities or make the process easier/quicker but lack of
    it doesn’t mean you can’t succeed. It’s
    all about making choices that will put you in a position to succeed. Sometimes,
    its” baby steps” and persistence. I have
    since mentored two students into medical
    school and neither from families that made anywhere near 100K/yr. No doubt “the
    system” favors those with money but the way to change that is from inside by
    being your own success. I do know I am a
    better person/doctor for what I went through and I’d rather be that than rich
    any day.

  • querywoman

    My dermatologist is a training doctor. The last time I went in, he had a female general internal med resident with him. I was discussing some problems that I have had with women doctors in the past, especially gynecologists.
    He asked her, and her graduating class was 53% female.
    Over the years, as I look back, I have seen doctors in training from many nations with him, like India and other Asian nations.
    I don’t think I have ever seen a Hispanic or black resident with him.
    Systems always leave someone out.
    Switching back to myself, I’m blonde and Northern European. I’m from a blue collar family, and my family income shot up the year before I graduated high school. My parents had no savings and were over the limit for financial aid for my undergraduate degree in the mid-seventies.
    I’ve always been bitter about not getting any money to go to school. I wasn’t fit enough for the military and other options. And blondes aren’t politically sympathetic!
    When I worked cruddy jobs, I paid taxes to send other people to school free.
    I married a rotten man and moved away to West Texas for a while and saw Vietnamese refugees getting college aid.

    Now that I am older and on disability, I could clean up on student loan money if I wanted. I am not able to go to college full time.

  • understandnatives

    About a third of the nation’s 24,000 enrolled members BORN IN THE USA don’t have paperwork needed to prove citizenship. Without birth certificates, they cannot obtain SSNs. Source:

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