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Finding Your Voice in Medical School

One of the biggest challenges medical students face is finding their voice: with their medical team, with the hospital staff, with patients, and with their chosen specialty.

As a medical student, you want to be proactive, to advocate for the patient, and to learn the best management techniques. But ‘proactive’ for one physician can easily be ‘annoying’ for another physician. Likewise, what can be viewed as ‘lack of initiative’ by one physician is ‘eager to learn’ by another.

During my third-year rotations, I became hyper-aware of my body language, tone, level of voice, where I am expected to sit in the conference room, what computers I can touch to write a note on, and so forth. The social construct of the hospital is exhausting for medical students, especially when we feel so low on the totem pole. I know my personality didn’t change on a day-to-day basis, but how it was interpreted and critiqued by my professors did. It almost made medicine and treatment the easy part.

Beyond the medical team, students struggle to find the right voice for each patient. Voicing a concern to one patient can be misinterpreted as being judgmental to another; enthusiasm can be viewed as naivety.

Some patients distrust students the moment we enter the room in our short white coats and student-colored scrubs, as if to warn the patient with a giant siren blaring, “student approaching!” I once had a patient tell me to leave the room faster than I could hold out my hand to introduce myself. Other patients love the extra set of hands to help, a voice to advocate for them, and ears to listen and make sure nothing is missed.

On my obstetrics rotation, one patient told me she hoped her future baby was a girl so she could name her after me. It was on this rotation that I truly felt I found my voice.

So, on this journey through medical school, how did I learn to normalize myself so all patients trusted that I am here for them? How did I find my voice that is true to myself, to my patients and to my supervisors? Most importantly, how did I learn to hang up my judgments when I put on my white coat every morning?

There is no right answer to these questions. For me, I found that the only way to find my voice is by knowing my patients. And the best way to know my patients is to approach them without judgment, and to not be afraid to ask them anything. Patients can sense when you’re uncomfortable asking a question, and they’ll only reflect your body language, which will lead you to a dead-end.

But hanging up my emotions, my reactions and my beliefs as soon as I put on my white coat in the morning is easier said than done. I’ve been blessed to see some doctors place their emotions and opinions to the side beautifully, and other physicians fail miserably.

One clinic that I worked at during my obstetrics rotation had a far higher rate of teenage pregnancies. Understanding my opinions about teenage pregnancy but not wanting my body language or questions to reflect judgment, I asked my attending how he is able to phrase specific social questions like ‘marital status’ or ‘do you do drugs’ in a nonjudgmental way to his patients.

His response was: “Elizabeth, there is no such thing as a nonjudgmental question. You are a white, blonde female. You cannot change your demographics just like you cannot change that you will be judged. It’s inevitable. These patients can go to any doctor they’d like in Northeast Washington, D.C. But instead they choose to get on trains, buses, or foot to come to me in Northwest Washington, D.C. And for that I am overwhelmingly honored. It doesn’t matter how late they come to the appointments, I always see them.”

And honestly, this is the truest and most humbling advice I have been given. I think these patients travel long distances for this doctor because they know he is an excellent physician who will not judge them and, ergo, provides excellent care. Sure he has his own judgments, but there is a difference between personal opinion and medical opinion. In order to believe in patient-centered medical care, personal views must be left at the door when you put on your white coat. Someone will always be pre-judgmental of my personality. But I think as long as I continue to be appreciative of my patients’ time, respectful of their goals, and patient along the journey, everything else will fall into place.