Writer-in-Training
The Geisel School of Medicine at Dartmouth
I am a first year medical student at Dartmouth and currently loving the rural New England lifestyle that I signed up for. I graduated from the College of William and Mary in 2013 where I majored in neuroscience and minored in philosophy. I also have a Masters in philosophy of medicine from King's College London. My interests include bioethics, end of life care, and neuroscience. When I am not hitting the books I can be found running, sailing, re-reading Harry Potter, singing to Taylor Swift, or snapping pictures.
Four years ago I was sitting in the living room of my basement apartment in Ann Arbor, Michigan watching the opening ceremonies of the Olympic Games. Now I am a week away from starting my second year of medical school, and the opening ceremonies for the 2016 Rio Olympics are upon us as well.
When I started medical school, I was most excited to start learning again. Having spent the last couple years as a teacher in a classroom, I sorely missed the experience of being the student. Reflecting on my college days, I missed the intellectual conversations generated in our seminars, hours poring over literature under dimly lit alcoves of Sanborn Library, even the far-too-frequent all-nighters spent hashing through complex biochemical pathways with my study group.
The epidemics of diabetes, cardiovascular disease, cancer and dementia roll through the US and across much of the world, eerily reminiscent to the sweeping cholera outbreaks of Snow’s era. Even in the majority of low- and middle-income countries, these chronic illnesses have already displaced infectious diseases to become the leading causes of death and disability. Yet, the majority of these are potentially preventable.
I walk down Summit Avenue in St. Paul, Minnesota this evening, and it is packed with people. People grieving, people chatting, people holding one another, people holding banners and people giving speeches. July 7, 2016: a black man named Philandro Castile had been killed barely twenty-four hours ago by a police officer.
During my first year of medical school, I had the privilege of speaking at several high schools and colleges. The purpose of these interactions was to shed light on what I did to matriculate into medical school, my experiences as a medical student, and to answer any questions. No matter where I went though, one question always followed: “What is the hardest part of medical school?”
As I write this article, 49 people have been confirmed dead after a mass shooting at a popular nightclub in Orlando, FL, with an additional 53 reported injured. In recent times, similar shootings have occurred with frightening regularity. In 2015 alone, we can recount San Bernadino, California; Colorado Springs, Colorado; Roseburg, Oregon; Chattanooga, Tennessee; and Charleston, North Carolina. People are being killed in unprecedented numbers, yet we have a poor understanding of the disease that is taking their lives. Gun violence is now a concerning public health issue and it begs the question: where are the patient advocates?
A little while ago I had the privilege of sitting around a table with several other physicians and researchers to discuss a potential collaboration involving my thesis project. About two hours into the meeting, I realized that I was the only person in this room without at least one doctoral degree. Yet these incredible scientists with decades of experience had been treating me — a second-year grad student — as an equal.
A ubiquitous hierarchy pervades all levels of medicine. Medical students are anchored firmly at the bottom of medicine’s social ladder, rendering them functionally powerless. Although students theoretically have a “voice”, their precarious position low down makes them apprehensive to use it. Students’ grades, evaluations and recommendations, etc.– which have real, tangible impacts, not only on students’ academics, but also their future careers and lives — are contingent on appeasing those higher up on the so-called social ladder.
Traditional “clerkships,” as they are known, are two-to-eight-week-long clinical experiences in each of the many medical specialties taken during the third and fourth years of medical school. During these programs, students see patients and learn directly from the doctors responsible for their care. It’s a combination of structured didactic learning, self-directed experience and day-to-day grunt work. After the month-plus spent in, for example, neurology, students get comfortable thinking about common problems people seeing neurologists might have and the options for dealing with those problems … and then they move on to the next clerkship.
Medical education has remained largely unchanged since 1889, when a young William Osler was recruited to be the chair of medicine at the newly formed Johns Hopkins Medical School in Baltimore. Borrowing principles he learned at universities in Europe, he established the Hopkins’ residency model, originally named because doctors-in-training lived in the hospitals where they apprenticed. He also recognized the importance of bringing students to the patient’s bedside during their early training, understanding that basic scientific principles are better retained when applied to real-world illness.
Last Sunday, Orlando was home to the most fatal mass shooting in American history. The gunman, Omar Mateen, opened fire early Sunday morning at Pulse nightclub, killing 49 people and wounding 53 more. This sickening tragedy marks the 133rd mass shooting in 2016 so far, meaning this year has born witness to nearly as many mass shootings as days. Health professional organizations have echoed the cries of our president, our media, and our citizens that we must do better — that we …
Among my professor’s stories from Lima, the chicken dinner story haunts me most. It features two students from his time as a middle school teacher in one of Lima’s most dangerous outskirt neighborhoods. A young teacher working at a Fe y Alegria school in North Lima, my professor, Kyle, had promised to take them anywhere they desired for dinner in exchange for exam success. The students requested chicken, standard Peruvian celebratory fare.
Contributing Writer
Creighton School of Medicine
Jocelyn is a fast-talking swing dancer from Tacoma, Washington. She appreciates short lines at the post-office and fine point pens. She is 26 years old and a third year medical student at Creighton School of Medicine in Omaha, Nebraska.
