Dear future medical students:
You applied to medical school in record numbers this year. Whatever your reasons, we (three graduating medical students) applaud you. You come to medicine at an exciting time: a time of both celebration and moral reckoning. The rapid development of the COVID-19 vaccine has wowed the scientific community. However, COVID-19 has also highlighted the hidden pandemics of structural racism, inequitable access to care, skewed reimbursement schemes, and so many others. The three of us do not have all the answers to these challenges. Indeed, we have often felt inadequate in our response to them. We offer, instead, the lessons we have learned about how to be good doctors because change starts with a recognition of our own humanity and the humanity of those we serve.
Illness does not define the patient
When you decide to pursue medicine, you’ll be asked why. A lot. My (Catherine’s) why is simple: There is nothing more gratifying than helping patients achieve the lives they want. Carefully shaving my patient’s curly, black hair in preparation for surgery, I wondered why he — whose chief complaint was intractable hiccups — would risk a non-curative operation to remove a brain tumor. The hiccups were exhausting and disruptive, he replied, and he had a grandchild’s graduation to attend. Though we spend much of medical school learning to reduce our patients’ colorful lives into jargon, true clinical excellence comes from learning the whys of our patients. We must shed the anonymity of masks and medical parlance by remembering to treat our patients first and their diseases second.
Embrace the uncomfortable
I (Jay) remember pulling down the white plastic drape. I had never seen a cadaver before. Discomfort waxed and waned throughout the semester. One day, my group learned our cadaver’s name, occupation, and cause of death. Thinking about Meredith’s (name changed) life and her decision to donate her body to future doctors like me, I gave myself permission to replace uncertainty and guilt with gratitude and dedication during the dissections. I shared my feelings with my lab partners, and we worked together to understand the anatomy and humanity of the experience. Throughout medical school, there have been innumerable other uncomfortable “firsts.” I know now that I can manage discomfort with reflection and that these moments are rich opportunities for personal growth.
Be a whole human
If you’ve made it to medical school, you are most likely well-versed in the art of delayed gratification. When you get here, it is easy to feel guilty if you aren’t studying. There is an overwhelming quantity of information to learn, and time not studying can feel like time not becoming a good doctor. But we are not just students. Over the past four years, I (Kate) reckoned with the end of a long-term partnership, celebrated new friendships, wrote poetry, voted, taught middle school science lessons, overwatered succulents, and went to therapy. Through all of this, I also realized my resilience both inside and outside the hospital. I encourage you to hold close to all of the important parts of yourself, not just your identity as a student because this will keep you whole.
Let feelings in
I learned how to publicly grieve the day I (Catherine) saw a beautiful, otherwise healthy toddler die from the flu. Afterward, my supervising doctor invited us to join her for a cry and glass of water in the breakroom. This was the permission that I needed to release the feelings I was already struggling to choke back. Though I know I won’t always have the luxury of an immediate cry (sick patients often come in sets), I’ve learned to make time for grief, awe, and joy on a daily basis. This way, I can be the best version of myself for the next time I set foot in a patient’s room.
You are valuable
It can feel uncomfortable for medical students to question authority because we are positioned on the bottom rung of an often rigid medical hierarchy. I (Kate) challenge you to do it anyway. When a situation doesn’t feel right to you, explore that. I felt a gnawing disquiet as I watched a patient talk to her physician about the anesthesia plan for a cesarean section. I noticed that the patient seemed confused but also deferential. I alerted her doctor to this, and consequently, the discussion for informed consent was continued. I wish that I could tell you that I spoke up in every situation like this, but I didn’t. Some of my classmates were braver. What we share as newcomers to the medical system is the opportunity to notice and question with a fresh perspective. We can suggest a diagnosis that the team may have overlooked, offer a solution that we learned from a different specialty, or even point out an inequitable practice.
We need you to join the ranks of this time-honored profession with new eyes and determined minds and eyes that see medicine’s problematic foundations and minds that are willing to act on it. Because it is you, future medical students, who will soon take up the mantle of pushing medicine to change — as medical students have done for generations. We look forward to working alongside you. Welcome to medicine.
Kathryn Crofton, Jay Hwang, and Catherine Jay are medical students.
Image credit: Shutterstock.com