ENG - To The Diversified Medical Succession (2020) by IFMSA-Québec

TO THE DIVERSIFIED MEDICAL SUCCESSION COLLECTION OF WELCOME LETTERS TO THE DIVERSE FUTURE MEDICAL STUDENTS OF QUEBEC

TABLE OF CONTENTS

INTRODUCTION

PREAMBLE

DEAR FUTURE BIPOC STUDENTS

DEAR FUTURE LGBTQ2+ STUDENTS

DEAR FUTURE STUDENTS WITH CHILDREN

DEAR FUTURE STUDENTS WITH A MEDICAL CONDITION

RELEVANT ORGANIZATIONS AND RESOURCES

CONCLUSION

INTRODUCTION

Entering medical school can be stressful given all the adaptations that need to be made. It is not always easy, especially when you have a feeling of not belonging. This feeling can be further amplified if you do not see yourself in your peers. Therefore, the goal of this project is to offer new medical students from underrepresented communities welcome letters that are tailored to their community. As these letters come from medical students to new medical students, we wish for you to see yourself in one of these people and to connect with their story. Within these letters, you will find their personal story, encouragements and advices that can help you with your own journey. We want you to know that you are not alone and many others have gone through a similar path. This is the first edition of the project and we have tried our best to get as many diverse letters as possible in order to increase representation. However, this has not been an achievable goal in all respects. As such, this is a project that will be improved throughout the years and will hopefully have an increasing trend of inclusion in the next editions ! With warm regards, The organizing committee

Nissrine Ammari

Vice-president of external affairs

Adam Benabdesselam

National Coordinator of the Human Rights and Peace committee (NORP)

Jimmy Chau

National Coordinator of the Sexual and Reproductive Health and Rights committee including HIV and AIDS (NORA)

IFMSA-QUÉBEC

IFMSA-Quebec represents all Quebec medical students since 2002. The organization works on the social, cultural and global aspects of health, on the national and international scenes. IFMSA-Quebec is the International Affairs Division of the Quebec Federation of Medical Students (FMEQ). As such, it gathers all medical students in Quebec and its mission is to raise awareness and mobilize them around social, cultural and global health issues. Through its outreach projects, its international exchange programs and its policy statements, IFMSA-Québec is dedicated to improving health here and abroad. To do this, the organization is actively involved on the local and national scenes on the four medical school campuses in Quebec, as well as within the International Federation of Medical Students’ Associations (IFMSA) internationally.

PREAMBLE

Dear student, Congratulations on all the efforts you put throughout your journey! I hope you celebrated your admission into medical school, because you deserve it. On behalf of IFMSA-Quebec, I wish you a warm welcome in medicine! The medical field has gained an amazing person who will be an asset to the medical field. We are super excited to have you here. Welcome to our family! Medicine: a profession where you will read a lot of books (the Netter will become your best friend in anatomy) but above all it is an area that is full of extra-curricular opportunities for all tastes. Whether sexual health and reproductive rights or public health intrigues you, you may find a committee that you can get involved with. And above all, don't hesitate to get involved! In medicine, while the whole educational aspect is important, you need to take the time to breathe and keep up with your hobbits. It's easy to get lost in your books, but you should never give up what you love. Our mental health is crucial, and we must not forget to take care of it. There will be some more difficult times. The medical field is not a straight and fast line like a sprint, but rather a marathon for which we must prepare and work hard on an educational and personal level. Also, you shouldn't feel like you're alone. There is nothing wrong with seeking help for your education or your mental health. There are plenty of resources on all campuses to support you. In short, in these moments, remember one thing: you entered medicine because you have the necessary skills to become an excellent healthcare professional. I am confident that you will excel in your studies and in your personal projects. Finally, we are all unique and we must be proud of what we bring to the table. Thanks to our cultural, gender and racial differences, together we can bring diversity and a new way of approaching health. You must be inclusive in medicine; have a team spirit and you must be open-minded. Without this, we will not be able to help the population, which is extremely diverse. So, don't be afraid to use your voice for the well-being of everyone, because you are the next generation of medical professionals! Hope to see you soon at one of our events, Maria Alexandra Rosca IFMSA-Quebec’s President presidence@ifmsa.qc.ca

Greetings everyone, To all newly admitted students , welcome to medicine! Medical studies are fraught with challenges, often different for everyone. I believe that well-being starts with admitting to yourself that sometimes it's too much and it doesn't work anymore ... being at the end of the line and saying it out loud. Someone very wise once said that in order to heal well you must also learn to heal yourself. Do not wait to do it; do not wait until the end of your studies or the end of an exam, listen to each other and take care of each other when we feel the need. When all is well, let's deflate our ego and be present and listen to the difficulties of our colleagues. Let's talk about our mistakes, our weaknesses, our hard times and how we came back up. This year, I therefore wish us to put words on our states, to accept our limits, to defend them, to judge these limits less and those of others and to find solutions that are in line with our values. In doing so, we can only make ourselves better caregivers! You are starting an extraordinary journey that will lead you to new horizons! Medicine is one of the best disciplines to study. I wish you to fall in love with the study of medicine and its many facets. Medicine is also a steppingstone for calling loud and clear for permanent changes in our society, and that starts with you! I encourage you to get involved and stand up for what is important to you. Finally, be proud of who you are and who you are going to become, do not be afraid of your beliefs and ideas, and do not doubt your place here. The beauty of medicine lies in the diversity of its members, and never forget it! Be gentle with yourself and your colleagues, nurture the relationships you care about, and cultivate the interests that make you the human you are before you became a medical student. Catherine Lajoie President of Fédération médicale étudiante du Québec

Dear future doctor, First of all, congratulations on your admission to medicine! Getting to this stage is a huge accomplishment, and it deserves to be highlighted. To get there, it certainly took a lot of work, motivation and sacrifice on your part. It will be important throughout your journey to think about what motivated you to pursue a career in medicine, and to keep that same passion within you. As you begin this new chapter in your life, I want you to remember one thing: You belong here. Yes you, black medical student, one of the few in your class. There may be professors who are more interested in your home country than your career ambitions, but know that you belong in medicine. In the middle of the internship, you may get confused with the nursing staff or even the maintenance staff, but always know that you have your place in medicine. There will be times when you witness derogatory comments about black patients, and there will be times when you will be called upon to speak on behalf of the entire community. All of this will force you to come to grips with the fact that, as a black medical student, you are different from most of your colleagues. Maybe you expected it, or maybe like me, you come on this adventure with the admirable naivety of believing that the medical world is free from ignorance and discrimination. However, rest assured, I don't have all bad news for you. The situations mentioned above, while hurtful and demoralizing, remain a minority among the multitude of interactions you will have as a future doctor. It is important to recognize them so that changes can take place, but you should not let them define your experience. The various faculties of medicine in Quebec have made commitments to promote equity, diversity and inclusion in their programs. In addition, students across the country are increasingly aware of micro-aggressions, unconscious bias and structural racism that affects the health field. Through the Youth Initiative of the Quebec Black Medical Association (QBMA), you will find a small community of students who share a similar background to you and who seek to promote the representation of black people in the medical field. You will also have the opportunity, through the Canadian Association of Black Students in Medicine, to network with students and doctors across the country, to get involved in volunteer projects and even to work on research projects if that interests you.

All in all, it is a huge privilege to be introduced to the world of medicine. Even as a learner, you will have the opportunity to participate in care and interact with people in their most vulnerable times. As a visible minority, you will have a special connection with patients who feel they can relate to you. These are very rewarding times that are to be cherished and not taken for granted. I therefore invite you to make the most of every moment. Keep going as you already do and take time each week to rest, refocus, do something that makes you happy, and spend time with your loved ones. Above all, don't hesitate to contact the QBMA Youth Initiative for anything. We can't wait to meet you and welcome you to the family. See you soon! Truly, Samantha Bizimungu President, Youth Initiative - Quebec Black Medical Association jeunesseqbma@gmail.com

DEAR FUTURE BIPOC STUDENTS

I WOULD HAVE LIKED SOMEONE TO TELL ME

Hello to you, dear future colleague. I would like to start by saying CONGRATULATIONS, from the bottom of my heart! It is no small feat to get into medicine, while operating within a system that is not built for our success and that puts obstacles in our way. Now that I am in third year, there are a few things I wish someone had told me three years ago. I wish someone had told me I did not have to dilute my personality for the comfort of people. I wish someone had told me I did not have to make myself miserable to endure micro-aggressions on microaggressions. I wish someone had told me I did not have to give myself anxiety trying to get away from stereotypes. I wish someone had told me I did not need to change my appearance by looking "less black" to fit in better. I wish someone had told me I wouldn’t always feel like I belong. I wish someone had told me I will often be the only black person in the room. I wish someone had told me I would face many ignorant and hurtful comments and actions. I wish someone had told me that for many of my comrades, I would be one of the few, if not the only, black person they know. I wish someone had told me I would be underestimated on a daily basis. I wish someone had told me I did not have to prove myself to anyone. I wish someone had told me I deserve my place in the program as much as anyone else. I admit that with what I'm writing, one might wonder if it’s really worth it to study medicine when black... But on the contrary, there is nothing more incredible than to pursue medical studies. I wish someone had told me that when I entered medicine, I would learn more than I thought humanly possible. I wish someone had told me that there is nothing more rewarding than working in the health field. I wish someone had told me that despite everything, I would find these few people, these rare pearls, this handful of amazing friends that I would carry deep in my heart. I wish someone had told me that despite everything, I am realizing the dream of many. I wish someone had told me that our community desperately needs competent black doctors. Our community needs you, believes in you, prays for you, fights for you. That’s what I wish someone had told me, but I’m telling you now. I can’t wait for you to realize and reach your full potential. Be patient with yourself. Evolve, improve, but never forget who you are and where you come from. "Since you're going to stand out anyways, then you might as well be outstanding" -Dre Onye Nnorom. Looking forward to meeting you in the corridors of hospitals, JAMILAH LAVAL UNIVERSITY | JAMILAHTEMFACK@GMAIL.COM

GREETINGS

this text will probably not be the most beautiful or the most inspiring. It's just part of my story. It might be a bit long, but I hope it will bring you something. Last year, I realized a big dream: to be accepted in medicine! It was surely one of the things I most hoped to achieve in my life, even if I was just half admitting it to myself. Firstly, I was already a healthcare professional in the labor market. I was a little frustrated with the lack of leadership within my profession. I wanted more: to be at the heart of decision-making and the care of my patients. Secondly, medicine opens doors to many opportunities for me. Thirdly, medicine was my childhood dream. I was a little girl who changed elementary schools 5 times and high school 3 times, who was bullied, who didn't know who she really was for a long time, who sometimes failed… She finally realized her dream. This decision was accompanied by many sacrifices when I was already an adult. I had to leave behind an incredible job, colleagues that I loved, move to a new city, live in a residence and on top of that, learn to be around people about 10 years younger than me. As I wrote this letter, I wondered what other obstacles I had to overcome as a woman of color… After 1 year at Laval University in medicine, I did not experience clear and direct racism from other students. But, as systemic racism is a continuum, I have noticed it through the lack of attention that we sometimes pay to issues of diversity and cultural dimension in my clinical and ethics courses, to my teachers who did not know how to answer my questions about their immigrant patients ... It was nott hurtful like a racist comment, but unsurprisingly, it disappointed me. Then, there are some comments. The racism that we experience is not only comments like "Go back to your country", "Here we speak French" or "I am not racist but ...". It is often much more subtle than that, as you know. It is often passive-aggressive. Very often it is even only passive. There have been so many times when I have been able to rely on my journey to face situations that I experienced in my first year in medicine. It's going to take a lot of determination and motivation to get through these studies, but you already have everything to get there. Now, might as well, put all the chances on your side to do it while being fulfilled and happy. That's why you applied in the first place, right? Fortunately, studying medicine at ULaval has no shortage of opportunities to meet amazing students and grow! I have no doubt for a second that you will find your group. Personally, I will be available to go for coffee, study or just chat if you feel the need. I promise you can write to me any of the 365 days of the year and you will have a listening ear. We do not know each other, but you have my word. Some of my interests are reading, tennis, food, travel, DIY and social involvement (at the university, I'm in the SPOT-UL committee). Have a great journey! See you! ANONYMOUS LAVAL UNIVERSITY

LETTER TO MYSELF

If I had the chance to go back in time and talk to myself during my first year of medical school at Laval University, I would tell myself that I have to enjoy life now, because 2020 will not be a promising year. To put you in context, I was a student from Montreal, fresh out of CEGEP, who had just moved to a city where I knew absolutely no one. Growing up in Montreal, I was used to cultural diversity and easily blended into the ethnic mosaic. However, when I arrived in Quebec, I quickly realized that my Asian features often attracted curious glances. I spoke differently, I had a different cultural background and my physical appearance was different. For these reasons, I was afraid that I would not be able to integrate into university and that I would not feel like I belonged there. I cannot deny the fact that it was natural for me to become friends with people from Montreal. However, when I was not paying attention to my anxiety, I had no problem socializing with my other classmates. When the school year officially began, I was determined to prioritize my education over my mental health and my social life. I was afraid of failing, since I had worked very hard to get to where I was. So, I put a lot of pressure on myself. My first session in medical school was similar to a trip in hell. In retrospect, there are several things I would have done differently. I would have agreed to leave my laptop for a few hours to go out with my friends when they invited me. I would have gone to the school parties and I would have been to the gym enough times to justify my membership card’s price. Of course, I also have accomplishments that deserve recognition. I would have congratulated myself on joining the Medgames dance team, socializing with my classmates despite my introverted nature, and surviving my first year in medicine. The lesson I take from this is that it is important to prioritize your studies, but never at the expense of your health. One day, I will be a doctor and I will not let my doctor title solely define my identity, because when I take off my white coat at the end of the day, I will just be an Asian with an interest in fashion, who loves to dance, sing, and eat Korean cuisine. In short, my message is to keep a balanced lifestyle and stay consistent with your commitments. Finally, a quote that I like is: "You are not required to set yourself on fire to keep others warm." Good luck on your journey! Bonne chance et bonne aventure! MY-CHI NGUYEN LAVAL UNIVERSITY | MY-CHI.NGUYEN.1@ULAVAL.CA

WHAT I WOULD HAVE LIKED TO KNOW WHEN I STARTED MEDICINE

Hi, dear new Med Student! I’m a Second year medical student at UdeM. I remember my first day of university in Autumn 2018: the stress caused by the ideas of meeting new people (there were not many students admitted from my Cegep) and of having to join an already close group of friends. I also remember the shock after realizing things were not the way I was expecting them to be. I was expecting to be less stressed out by school since the days of having to perform and get good grades to get into medical school were over. I was expecting to meet people like me, who shared my interests and passions outside of medicine. Coming from a predominantly white high school, I hadn’t realized the need I had to be with other minorities. My parents made financial sacrifices in order to allow me to study in a private school, thinking I would necessarily get a better education. My white friends were nice and ‘’open-minded’’ (fun fact: they’re the one who gave me the confidence to wear my natural hair and be proud of it, despite the comments I would sometimes hear such as : ‘’it looks like ramen noodles!’’) It’s when I started Cegep that I realized I needed to meet young people from minorities. I made new friends, closer friends than I ever had. Studying in a multicultural school and having a more diverse group of friends, both culturally and socioeconomically speaking, allowed me to discover myself and understand who I was for the first time. As I mentioned previously, things were not like what I expected when I got into university: there were so many things to learn! I wasn’t good at school anymore. I wasn’t even average! I also felt like mostly white students participated in some activities while students from minorities participated in others. For example, the student council and the after school 5@7 were for white students (it was the way things were perceived and students were openly saying it). I got involved in the committees and social activities I liked and ignored these tendencies, although being aware of them bothered me. Eventually, the desire I had to get involved as much as I was in Cegep slowly drowned in the ocean of students always eager to do more: involved in this and that committee, academic representative… Who was I, me, to represent any of these excellent students in anything? Also, I was drowning in the countless hours of studying required and the feeling of being mediocre if I didn’t do more, to the point where I didn’t want to study anymore: my ambition was suffocating. Maybe you don’t feel that way at all, maybe you’re handling your new schedule well. But, if it’s not the case, don’t be mistaken: not everyone gets involved in the program’s activities and committees and few people really understand medicine classes when they first hear of a subject. But we still all have our place.

Here’s some advice: If you don’t want to be involved in other things than your studies, don’t. If you want to get involved, don't let Impostor Syndrome stop you. It's okay to feel that a task seems bigger than you ("chair" of this and "responsible" for that). It's normal to think that you are not up to the task: it just means that you take it seriously, you will be excellent! f you want to do so, do it for yourself and choose activities that you like (not what others are expecting you to do). You’ll be better at it and it will prevent you from a burn out. Don’t blame yourself. If you watch your favourite TV show instead of studying, if you sleep more than you had planned, or if you get behind in the online classes you have to watch: take a deep breath and go at your own pace. Remember to congratulate yourself sometimes (or often). Let yourself doubt: it’s okay to question your own choices. Take a moment to remember why you decided to get in medicine in the first place. When you feel confident, write yourself a letter for the moments you won’t. Surround yourself with friends and family: I know you’re starting university during a pandemic and social encounters (especially meeting new friends) can be tricky. Make sure you don’t isolate yourself: take the lead and invite people for study sessions (together physically or via Zoom), keep contact with your old friends and organize activities. I hope the advice helps. Have a good year! ISABELLE GRAVEL UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | ISABELLE.GRAVEL@UMONTREAL.CA

CELEBRATE OUR DIFFERENCES

Welcome to the big family of medicine! First of all, congratulations on entering medical school! This is a big accomplishment that you should be extremely proud of! Whether you’re a new Med-P or a first year medical student, this new beginning can be very stressful and challenging. Not only does one have to get used to the exceptional pace of studying required as a medical student, but also sacrifice time and social activities in order to succeed. As an individual belonging to an ethnic minority or a marginalized group, medical school can bring an extra load of stress. As one of the only South Asian Muslim women in my cohort, I felt out of place when I started medical school. The lack of representation as well as the fact that I was visibly different from the majority of the cohort made me uncomfortable at first. However, I quickly realized that my culture, language, values, beliefs and experiences were not things that I should hide in order to fit in, but express in order to offer a different perspective and correct misconceptions. I took it upon myself to voice my opinion more often and participate in different activities that promote diversity and inclusion. I also got involved in different committees and groups which led me to meet amazingly diverse individuals! Throughout my first year in medical school, the biggest lesson I learned is to not be concerned about my differences but to celebrate them. All in all, not seeing or meeting people from your community or background within your program as well as having different values and opinions from the majority can make you feel isolated and shy. However, the next four or five years of medical school are your opportunity to feed the conversation, talk about health related issues that touch your community and bring your perspective to the table. Racial biases, stereotypes and prejudice about minority groups still exist in healthcare and it is people like you that are needed to make a change. Become the role model that you would have wanted to have as you entered medical school and inspire students like you to pursue a career in the healthcare field. Wishing you the best of luck for the years to come! ZUHA SHABBIR UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | SHABBIRZUHA@GMAIL.COM

FINDING A SECOND FAMILY IN MEDICINE

Congratulations on your admission! As a foreign student, it is all the more important to congratulate yourself on your efforts during the difficult journey you have overcome. Whether you are accompanied by your family or you’re alone in Canada, this remains a big change in your life and it most likely has caused you to be apprehensive. Do not panic, I've also been there! It's only been 2 years since I moved to Canada and was separated by a whole ocean from my family. It scared me at first. I wondered how I was going to do it on my own, if I was going to be homesick or if I was going to be able to endure long studies on my own. What I didn't know at the time was that I was going to meet my second family in medical school: people who have different and exciting backgrounds, generous people who encourage me to adopt a healthy lifestyle! Friends with whom I can go out to play sports, study in a cafe, or walk in a park to fill up on vitamin D. These people, there are hundreds of them in your cohort! Just jump in and start the conversation. I'm sure you'll find friends who share common interests with you. Studying in Quebec makes the experience all the more rewarding. Multiple interest groups exist and activities are constantly planned to make your university experience as rich and enjoyable as possible. These events (per zoom or inperson) are a great way to meet new people, get out of your comfort zone and get out of the study bubble, in which it is easy to get isolated. Medical studies should not consist of staying home, locked in your room, studying from 6 a.m. to midnight. It is important to find a balance in life, to allocate time to sport, to indulge in your hobby and to socialize with other people (PS: you can also make friends in other programs than medicine!). This is also the time to develop your transversal skills such as teamwork or leadership, while getting involved in a project that interests you among the many that you will see unfold throughout the year! I hope you enjoyed the first few days and that the next few will please you all the more. MERYEM ZELLAG UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | MERYEM.ZELLAG@UMONTREAL.CA

STARTER PACK FOR MY FUTURE NORTH AFRICAN COLLEAGUES

Dear new medical student, Dear member of the Muslim community, Dear member of the beautiful North African community, Welcome to the big family of future healthcare professionals (we are lucky to have you !!). First of all, congratulations on being here: we hear it often, it's a privilege to be able to study medicine, but the journey leading up to your admission should be recognized and celebrated. You are embarking on a transformative, demanding, exciting and rewarding stage of your professional career. For many of us, the college years represent a process that frames our professional and personal development. You quickly discover that it's not just about books and the hospital, but that there is a wealth of opportunities that allow students to learn skills outside of the classroom and thrive. For many of us, it is also during these years that we discover our vocation. Vocation here not only refers to your future specialty, but also to how you want to contribute to the health of the population. It can also be called a goal, a vision. For some it is research, for others it is politics, community involvement or global health ... the possibilities are endless! Extracurricular opportunities even allow you to discover a passion and have a more global vision of what you can accomplish as future doctors. They also allow us to breathe, to express ourselves, to discover ourselves, to connect with individuals with similar aspirations and ideals and to have a balanced life, while training us to become better future doctors. All of these opportunities go through student groups, associations, the faculty, etc. They are for everyone, by everyone. We are not going to lie to each other, certain unconscious biases and the effects of “networking” mean that some people seem to have privileged access. Many efforts are currently being made to democratize access to opportunities and make it equitable. However, if you ever feel that you are being treated unfairly, don't hesitate to talk about it - people are there to listen and support you. Sometimes all of us have impostor syndrome, don't feel quite included in certain activities, or feel overwhelmed - don't worry! We have to be honest with ourselves, recognize our limits while valuing our successes and accomplishments. Being a medical student is a success in itself and represents proof of resilience and determination. Do not hesitate to seek help : there are plenty of people with similar backgrounds and / or similar backgrounds who will be able to advise and support you.

To conclude, you are contributing to the beautiful diversity of the medical student body, a diversity that must be celebrated. There is a diversity of origins, sexual diversity, many religions that coexist and different ideals; this is something that we should be proud of and that should be reflected in our activities. Do not hesitate to innovate and offer inclusive activities that reflect this diversity of ideas and individuals. And above all, never hesitate to seek help or raise situations that can threaten the development and well-being of students from certain groups, both in the curriculum and in the context of teaching and extracurriculars. We are a big family in which each and everyone should be able to flourish; you have the right to a socio-academic boost. We must all work together for more inclusive and healthy medical studies for all. If you ever want help with anything or just having a chat, please don't hesitate to contact me! Have a good entry in medical school ! :) IMANE BENASKEUR UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | YOUSRA.IMANE@GMAIL.COM

DEAR MUSLIM SISTER,

Congratulations, you have won the golden ticket. Welcome to the chocolate factory! In the upcoming years, you'll live some of your most stressful moments, push limits you didn't think you could push further and dig so deep within yourself for strength and motivation that you'll discover things about you that you never knew: what is important to you, what keeps you alive, what makes you love, what makes you shine, what you want to fight for and the strength to keep fighting for what you believe in. But you'll also live your most perfect moments, your most heartfelt hugs, your most crazy nights studying or partying with friends, your loudest waves of laughter that roots so deep within yourself that your abs hurt for days and your most "I can't believe I get to do/live that" moments. I want to tell you so many things, but most things in life can't be said, only experienced. And I hope you get to experience it all. When I started this letter, I kept asking myself, "what would I want to tell myself three years ago?" which lead me to this list of rules I can offer you. RULES FOR THE BEST MEDSCHOOL EXPERIENCE EVER Rule #1: Don't be scared to go out of your comfort One of my first fears when anticipating medical school was social activities. Being muslim, I don't drink. And from previous experiences, I know how much alcohol is predominant in social contexts. I was apprehending a lot being asked why I didn't drink or even feeling marginalized because of that. If it weren't for some friends, I probably would have missed many parties wondering why to bother going if I would end up sober surrounded by drunk people. Honestly, go to parties. You won't regret it. Or maybe 1 or 2, but most of the time you'll be happy you went. Besides alcohol, I also had some anxieties about applying on several opportunities like class president or an IFMSA delegation. I think women, particularly women of color, tend to have a very strong imposter syndrome. We always feel like we're either too much #socialanxiety or not enough #perfomanceanxiety. You are exactly who you need to be. Your experiences, insight, and quirks bring diversity to an organization and help it avoid overlooking things they could improve or do differently. Therefore, don't sell yourself short to anyone, including you.

Rule #2: Talk to that person you think is weird or obnoxious One weird thing with med school is half of the people in med school think the other half is not in med school for the right reasons and vice versa. There are a few exceptions of people that don't care, but overall we all have an idea of what a "good medical student" is, and we tend to be judgemental to people that do not fit our vision of what it is. Trust me when I say that there are as many ways of becoming a good doctor than medical students. Some students are more focused on theory and knowledge; others are more focused on community involvement. Just because someone spends their time studying doesn't mean they have no emotional intelligence. Someone who cares less about their grades to focus more on student engagement isn't going to be less competent. And that guy you only see at parties is maybe just trying to control his performance anxiety by having a good time with friends. Nothing is certain, except for the fact you're going to miss out on a lot of amazing people if you never take a leap of faith and talk with them. Don't think someone dislikes you or has nothing in common with you until you give it a shot. As a Muslim woman, I am sometimes apprehensive, wondering if that person will hate me because of my faith or not; honestly, people are way more open-minded than we give them credits for. Med school is not a comment section below an article of Journal de Montréal. Trust that people will be more agreeable than you thought. Rule #3 : Do other things than medical school things If you don't know what brings value to your own life, you won't understand what life means to your patients. Your family, friends, hobbies, spirituality and dreams give you an understanding of what life means and what it means for your patient. Being balanced will make you a better doctor, but most importantly it will keep you healthier. Not everything is about medicine. Go dance, go get involved, go travel, go meet people outside of medicine. Go be alive. Rule #4: Failing is normal Please take my word for it. We need to normalize failures; they are opportunities and ladders, not the end of the world. Some students just slide through med school like a hot knife through soft butter. Everything seems to fall perfectly in their brain like the most successfully well organized Tetris game. But for a lot of us, med school is one crazy roller coaster: it's a lot of fun, but damn the ups and downs are there. It is hard to understand the bigger picture in life, and we usually realize it years later. Being Muslim, my parents would often say "it's mektoub" (translation : "it's written," meaning that it's fate), and I've also learned to accept that some things are out of my control. The best thing you can buy for yourself in med school are not books, but a very sharp knife to cut yourself some slack. You may fail an exam or a class, you'll receive inadequate evaluations, and you know what? You'll still be a fantastic doctor. The best doctors are resilient and focused on continuous improvement of their skills and knowledge. They are flexible with others and themselves and everything else that no one else can control. The best doctors get it wrong too, but they have learned to spring back quickly, be transparent about it, and not let it impede them from learning and becoming better at what they do: they have learned to be excellent at failing. So be a failure; be excellent at it.

Rule #5: It's ok not to be ok Cutting yourself some slack also means you should understand the level of stress and pressure we are under, and this goes for so many other programs, not just medicine. Not only is the pressure increasing in the academic world, but the world itself is becoming crazier. You're also going through your things: break-ups, griefs, getting married, raising kids, just handling the year 2020. It's ok to give yourself a break even though you’re “late” in your studies, and just lay in your bed with ice cream, rewatching Friends or The Office. Rule #6: You'll have it harder, embrace it I wanted to say something else, but as a muslim woman, you'll have it harder. I am already exceeding my word limit, so I cannot go at length on all the ways systemic discrimination makes it more difficult for BIPOC women to thrive in med school. Please remember this won't impede you from thriving, but you'll have to work harder. During my med school, it was something difficult to digest until I met Dr. Gigi Osler #aqueen, who was the president of the Canadian Medical Association. And she said in an interview done by FMEQ, "I knew I had to work twice harder, but I didn't care, I loved my specialty, and I loved the operating room." And honestly, this is the best example of resilience I can think of. It will always be unfair how much stigma and added challenges BIPOC women have to face, mostly when talking about high decisional positions in medicine. Still, the only way forward except fighting it is embracing that journey and not letting it get to us. So now I think, "I'll have to work twice harder to get where I need to be, but that's alright; I love medicine, I’ll just love medicine twice harder and that special connection to my passion will be a privilege in itself." Through all of the hardships remember that a community of women is there to support you and help you rise from the height of their own experiences so you can go further. Now you’re part of this community and one day it will be your turn to be a mentor to new sisters. Rule #7: Keep your finances organized Honestly, just do. Limit your expenses to important ones, but allow yourself expenses to lift your spirit when you need to #gotravel. Treat yourself responsibly, indulge without overdoing it. Contact your financial counsellor, establish a budget, and if you have financial anxiety, I suggest looking into affirmations for financial freedom. Rule #8: Make yourself a priority A real priority, make your health as necessary as your cote R. You have to realize that abnegating on essential needs like sleeping less or eating lower quality foods to pursue an unsustainable study pace is not acceptable for yourself. I have a really hard time on this one, but we need to normalize being less successful in work/school to have more balanced lives. I will repeat it, cut yourself some slack. If you feel like eating poutine every day during your last week of finals because it keeps you going and it's comforting: do it. We all have our strategies to get better. Some are good on longitudinal perspective (physical activity, praying, meditating, writing, talking with friends), and some are good from time to time (comfort food, binge-watching Netflix).

Rule #9: Your loved ones are more important than grades I think nothing saved me more than my family and friends. Being able to talk to them daily was my lifeline. They help you relativize some of your issues, take the mind of your work and remind you of your worth when things get hard. Also, don't forget about the community. During the most challenging parts of my journey, nothing brought me more peace than Taraweeh during Ramadan. I struggled with grief, a failed class, anxiety, and feelings of inadequacy, but the moment my feet stepped on the masjid mat, my heart felt a thousand times lighter. Feeling connected to my community to synchronous prayers made me feel like things would be ok, that there were things greater than me, than my problems and that in the overall big picture of things: everything was going to be good. That brought so much serenity through trouble times. I wish you the same. I hope that whenever things get hard, you have this little place on earth that makes the most overwhelming challenges a little bit more bearable. Rule #9: Ramadan at your pace As much as spirituality has always been something I leaned on when things got tough, studying full time or doing your clerkship while fasting can be challenging. And even though it is a controversial topic, do what feels right for you, physically, emotionally and spiritually. I know I stopped fasting in my first year because it was just too hard with my summer session's fast pace. If you also decide to do it, please remember that it doesn't make you less of a good Muslim. Faith goes deeper than just fasting, even though it is a pillar of it, being kind to your peers, coworkers, and patients is also a way to celebrate your faith during Ramadan. Being charitable, patient, doing supplementary prayers after work or between your studies are also other ways to expand your spirituality. Rule #10: Scratch those rules and make your own I know how cheesy this sounds, trust me. But honestly, you will have your own experience through your med school. All I can say is I have no doubt you'll love it. It is better than you imagine it and less stressful than what you fear it will be. Lastly, I want you to know that in my heart, there is no doubt that you have all it takes to succeed, so there shouldn't be any fear in yours either. All my love, Your sister HANÈNE MANKOUR LAVAL UNIVERSITY | MANKOUR.H@GMAIL.COM

DEAR FUTURE LGBTQ2+ STUDENTS

3 SMALL TIPS

Hello !!! First, a BIG congratulations on your admission to medicine. The field in which you will study now is simply WONDERFUL and I hope from the bottom of my heart that you will flourish throughout your studies. Thus, I allow myself to give you 3 little tips that, in my opinion, will make your medicine experience one of the most rewarding ones: 1. Be yourself. It may sound "cheesy", but it is 100% true. When I started my medicine, I was afraid: afraid of rejection, afraid of judgment and afraid of dissatisfying. I'm a guy, and I love guys. It's 2020, so it's really well accepted. However, it was the first time that I had been going to play hockey again since I first “came out” a few years ago. I feared the "boys" would be uncomfortable around me, especially in the hockey room. Yet from day one, the guys welcomed me and made me feel like one of theirs. I had never felt judgment from them. They became my friends and accepted every little part of me. I love them for it. You too will meet good and beautiful people like the ones I have met, do not worry. Be yourself and people will love you because you are amazing. 2. Don't limit yourself. No, your gender or sexual orientation does not define you. You do not have to meet any social norm. Whether you are a woman, a man, a non-binary person, or you don't know it, and no matter what your sexual orientation is, you are not a label. You are a whole person, unique, beautiful and special. Believe in yourself and go for it. Don't be afraid to make yourself heard or create waves in your path, because it is you who will change the world. Speak loudly and aim high, since you set your own limits; up to you to surpass them. 3. Accept to make mistakes, because you will. I will not lie to you: medicine is difficult. If you are where you are today, it is because you've worked hard. Yet the next few years will be filled with difficulties, big and small. When you stumble, remember the reasons you started it all. It is nice to be wrong sometimes, it contributes to growth. University is about self-discovery and becoming the best version of oneself. Give yourself the gift of letting yourself evolve. In short, whether you know yourself perfectly or are still defining yourself, keep an open mind and be honest to who you are. People will love you just for that. ANONYMOUS SHERBROOKE UNIVERSITY - SHERBROOKE CAMPUS

OUT OF THE CLOSET, BUT ON PROBATION?

Dear new medical students, To start off, I wish you welcome to a new chapter of your life! You have worked hard to come where you are today and even if we haven’t met, I couldn't be any prouder of you <3. My experience is a mixture of being a second generation asian immigrant, an openly gay man, and having trouble adapting to school. Not everyone can relate to my story, but if it can help at least one person, it will have done its job. Before coming to medical school, I had a lot of apprehensions. Ever since highschool, I was out of the closet and was pretty open about my sexuality. However, when I moved to Quebec city, I was out of my comfort zone and was scared of my new peers’ reaction. I didn’t necessarily know how to act. I was asking myself if I would have to conform to society’s definition of a heterosexual man around other people. During my first semester, I slowly got used to my new environment. Some people had doubts about my sexual orientation and would openly ask me if I were gay. I was honest with them and told them the truth. Gradually, more and more people knew about it. As for the other people around me, I didn’t have a lot of problems in the past three years. I found a new support system and I felt comfortable around my friends. Looking back, I didn’t really change how I acted or talked. I just continued to be myself and wouldn’t have changed anything. However, what was hard for me was to adapt during my first semester. I had a hard time adapting to my new environment. I was in a new city, I was living alone for the first time, and I wasn’t used to life as a university student. I failed a few exams, a class, and ultimately was on probation. As the second semester started, I was highly stressed and was afraid of getting kicked out of the program. However, I was lucky enough to know someone a year older than me who was exactly in the same situation as me when he was in his first semester. He calmed me down and explained to me that the faculty would not kick me out suddenly and I will get out of probation easily in the next semester. And he was right. I got out of probation the next semester and my grades rapidly rose. I currently have a GPA that is around my peers and I haven’t had any problems ever since. What I am trying to say is that it is normal to have difficulties in your first year. It might not always seem evident with the high averages in medicine, but I guarantee you that there are students that also have some difficulties at the beginning. In medicine, there’s this stigma surrounding failure and a lot of people are afraid to talk about it. I just want to tell you that it is normal to struggle. Being a medical student is just like being a student in any other program. You are here to learn and it is ok to not be perfect. You’ve got over 6 years of studying to do, it is definitely not your first year of medical school that will define if you will be a good doctor or not. Do not let a few setbacks define you.

My tip for you all would simply be to try not to put too much pressure on yourself. I know that it is hard, but once you learn to give yourself a break, it will make your journey far better. You will experience so many new things, meet new people, go on adventures, and thrive. Believe in yourself, because I believe in you. If you ever have any questions, feel free to reach out. When I was doubting myself, someone was there to support me and answer my worries. It would therefore be my pleasure to give back to the next person. With much love, JIMMY CHAU LAVAL UNIVERSITY | JIMMEYCHAU@GMAIL.COM

DEAR FUTURE STUDENTS WITH CHILDREN

DISCOVERING YOUR PATH AFTER 30 YEARS

I welcome you to the great family of medicine. My name is David and I am a medical student at the University of Montreal. I first started my professional career as a mechanical engineer for nearly ten years. During this time, I was fortunate enough to become a father to two wonderful children, who are now 4 and 7 years old. Then, at the age of 33, I decided to continue my professional life in medicine. Throughout the following text, I’ll take the liberty of providing you with some advice drawn from my own personal experience and the wisdom of the people I met during my first year of study. If, like me and several other students, you have decided to reorient your career to medicine, I sincerely want to tip my hat off to you for the courage you have shown. Know first and foremost that you are not the only one in this situation and that you will be working with several students with similar backgrounds to yours. I invite you to take this opportunity and be open to meet these students, but also others with different profiles from yours. Certainly, the current pandemic complicates traditional interpersonal interactions, so be creative and avoid isolation. The links you’ll forge will be of great support to you in demystifying classes, sharing study techniques, discussing with people who share your reality and of course making your experience pleasant. Leaving a familiar, comfortable and stable universe is not easy. It shows your ability to adapt. This skill will be a key component of your medical career. Make no mistake, your life will be turned upside down and won't be the way it was before you started medical school. In my opinion, we must first and foremost accept this new reality as it is and define the personal priorities that are most important to us (the must!) In order to incorporate them into our daily lives. You will surely feel some butterflies in your stomach at the sight of your first exams. You will find (or you already found...) that the pace of medicine is different from what you have experienced in the past. You will feel like you are facing a titanic body of knowledge. You might even doubt yourself at times. Don't worry, memorizing everything down to the smallest detail the first time is impossible. Long-term retention will come through multiple re-exposures in subsequent classes. Be patient, indulgent with yourself, and open to trying new study skills. Slowly, but surely, you will find your working methods and you will adapt to the pace and amount of work. Never forget the personal convictions that led you to reorient your career and choose medicine. In difficult times (yes there will be some!), having a global vision of your project will allow you to see beyond the doubts and difficulties that you will experience in the immediate future. Although your previous professional career is not necessarily closely related to medicine, you should not underestimate the impact that it will have on your studies. What you have acquired during these years will in part forge your identity as a future health worker. So, be proud of the road traveled. I wish you the best!

DAVID HOULE UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | DAVID.HOULE.3@UMONTREAL.CA

PARENTHOOD AND STUDIES IN MEDICINE

First of all, I welcome you to the big family of medicine and to the bigger family of healthcare professionals. It is certainly not an easy, relaxing and routine-prone area, but I believe that no health professional chooses this area for these reasons! I started my medical studies in September 2019, by integrating the brand new premed at the University of Montreal. I was precedently a nurse and I am the mother of three children aged 11, 10 and 7. This testimony represents my very personal life as a medical student, a unique drop in a sea of different experiences. Although my experience is unique, know that even if it is small and sometimes discreet, a tightly woven community of parent-medical students exists to support you on this new adventure. In my opinion, four elements are essential in order to have healthy study years. First, accept that your life will no longer be the same. While we always want to spare our children from the repercussions of our personal choices, studying medicine full time will have a definite impact on the whole family unit. Denial will, in my opinion, bring a lot of stress and a very heavy burden, as keeping everything the way it was before will be difficult. Acceptance will allow you to prioritize what is untouchable and determine what can be changed considering the circumstances. Second, surround yourself with people you trust and who can support you when you need them to. Don't be afraid to accept the help that is offered to you. In no case will this make you a bad parent! Whether it is to prepare meals in advance, to babysit during a study sprint or a little nap, to help you with the oldest's homework or to accompany the youngest to his appointment at the dentist, having an available and supportive entourage will facilitate your passage into medical school. Third, I recommend that you find other students in your cohort with whom you have affinities. Not only will this make your experience much more pleasant, it will allow you to have a group with which you’ll be able to share your questions, your misunderstandings, discuss course elements, share study documents, separate the revision ... In short, it is essential support for studies. Fourth, I don't think I will teach you anything new by telling you that organization is key! To juggle your studies, household chores, family time and all the other responsibilities you may have, a well-structured schedule that leaves room for the unexpected and moments of spontaneity is essential. Procrastination is to be avoided! Be aware that initially you will likely take more time to study and revise the material until, through trial and error, you find THE study method that is right for you. You may reorganize your schedule several times but I assure you that you will arrive at an arrangement that will suit your particular situation. And if it is rather difficult, all the parent-medical students will be there to support and help you! PATRICE JEANNOTTE UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | PATRICE.JEANNOTTE-DUMAS@UMONTREAL.CA

FAMILY, CAREER CHANGE AND MEDICAL STUDIES, A GREAT CHALLENGE!

Congratulations! You have now taken a great step in your path towards your future (and perhaps new) career : your admission to medical school! Evidently, this stage is exciting, but perhaps also strongly destabilizing. This is normal and you are probably not the only one feeling like this... My name is Jean-Philippe and I have been a medical student at the University of Montreal for a year. I am the father of 3 wonderful children, aged 10, 8 and 6. I started my professional career in environmental engineering, worked there for several years and still work part-time. The plan to study medicine was in the back of my mind for several years now. Finally, I decided to really get started in 2019. At first, I admit that it was very confusing ... as if I had jumped in free fall from a vertiginous height! Before embarking on this great project, yes, I reflected a lot, to weigh the pros and cons and assess the impact of this decision on my family and on my entourage. Yes, I also had a lot of deep questioning during the first few months of medical school. Most likely you will have some too! This is normal : choosing a career is not an easy decision and changing career after many years is not either. There are many reasons that prompted me to embark on this new project, but one of them triumphs over the others: to understand the marvelous complexity of humans and to be able to commit to improving the health of individuals and populations. That is the meaning, the direction that I have decided to give to my life adventure! So, I feel privileged and lucky to have been admitted and to be here right now on this quest. You will probably wonder if it is possible to maintain a "certain" balance between studies, family, love life, work and yourself (please do not forget to take some time for yourself) ... Yes, conciliation is possible! It's a big challenge but you will successfully face it, just like me. Of course, you have to put a lot of energy into it, but it's worth the effort! Tips? You will probably try several methods along the way and you will definitely find the ones that are best suited to you. For my part, I would suggest that you first have some flexibility ... not only financial flexibility, to take away this potentially worrying aspect, and flexibility regarding your part-time work schedule, but also flexibility when it comes to family time! You will need help on this adventure, so be well surrounded and recognize that you cannot be a superhero. Your family, friends, loved ones and your new and younger study compatriots (you'll see, no matter the age difference, they're all great and exceptional!) will definitely be there to help and motivate you, to make you even stronger and more determined!

There is no doubt that you will have to develop your capacities of adaptation and acceptance! This will most likely be very useful for your future career as well. Accept that you will not perform the same way you did before academically. Accept that you may not be able to attend all your children's sport games or dance competitions. Accept that you cannot manage everything the same way you did just before that vertiginous leap ... Accept that your "performance" as a special student cannot be reduced to a simple academic grade, but is rather defined by a "certain" maintenance of the balance between all the spheres of your life (balance, by the way, which will be in constant evolution and adaptation!). And above all, whenever you question yourself during your studies, remember the reason that prompted you to take that free fall jump and embark on this splendid adventure! Finally, enjoy every moment of this new adventure and find pleasure even in the most difficult moments! You will undoubtedly come out of this life adventure grown and transformed! JEAN-PHILIPPE BOUDREAULT UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS | JEAN-PHILIPPE.BOUDREAULT@UMONTREAL.CA

DEAR FUTURE STUDENTS WITH A MEDICAL CONDITION

FOR NEW STUDENTS WITH A HANDICAP (ADHD)

Dear new student, I am about to start my first year of med school. As I just completed a bachelor in a field related to health sciences, I do not have to do my premed. I also happen to have ADHD, which can bring its fair share of problems if unmanaged. Let me tell you a few tips that I learned along the way and that made my life so much easier. 1. Routine is everything. I prefer to have my time planned in advance, otherwise, it brings me a lot of unwanted stress. I like to print out a weekly calendar and do a resume of all assignments/exams for every class. That way, I can plan in advance what I’ll have to do every week. Make sure to leave a bit of wiggle room given that some unplanned stuff will probably come up. 2. Down time is as important as study time. I personally need quite a bit of down time to keep up with my studies. I like to keep at least 2h every night to myself and some break time during my studies. Do not feel bad for taking a break, overworking yourself will not bring anything good. In your routine, make sure to plan some time to relax. 3. Figure out an efficient way to study. I personally cannot study for long periods of time, I prefer 2-3h per weekday and maybe 5h max on the weekend. In order to make the most of this time, I need to be efficient in my studies. Always try to find a way to synthesize what’s to learn, this’ll condense and shorten your study time. I prefer quality over quantity. Find a way to condense the material to learn, in a way that fits your style. Resumes are great, but not for everyone, maybe some tutoring or online videos, whichever fits you best.

4. Figure out what you like and participate in activities related to your field of interest. At the end of med school, when the time comes to apply for residency, everybody is going to have an MD. Everybody will be on the same page, however, what’s going to allow you to do what you want is your extracurricular activities. Go out there and figure out what you like, there’s nothing like real life experience, apply to internships, observation days, etc. Putting yourself out there will allow you to learn more about yourself and interests. This’ll eventually allow you to figure out what field of medicine suits you best. Once you figure that out, try to involve yourself in that field. Doing so will, firstly, make you a better doctor and, secondly, make you a prime candidate for residency in that field. Having prior experience is a great way to showcase your skills and interest while implicating yourself, whether it be by having academic experience (e.g. publication), or practical experience (e.g. observation). These will be amazing assets to your future professional and personal life. This is it guys, these are the top 4 tips that have helped me through my studies as a student with ADHD. I certainly hope it can help you too. I wish you all a great career and to be the better version of yourself! ANONYMOUS UNIVERSITY OF MONTRÉAL - MONTRÉAL CAMPUS

HARD WORK PAYS OFF

My name is Hind Ziady, I have been suffering from panuveitis, which is an inflammation of the eyes, since the fall of 2011 - when I was only 12 years old - and I have decided not to give in to my illness and to persevere to achieve my academic, professional and social goals. The causes of my disease’s onset are as yet unknown. At the time, my ophthalmologists at Sainte-Justine hospital and Maisonneuve-Rosemont hospital prescribed several tests, including a magnetic resonance examination of my brain, an xray of my lungs as well as various blood tests to try to link a cause to my illness, in vain. Therefore, ophthalmologists had no choice but to treat the symptoms of my disease with anti-inflammatory drops, in this case ophthalmic corticosteroids, but it was not enough. Little by little, the inflammation became resistant to the local treatment. It was therefore necessary to add a systemic treatment, that is to say oral corticosteroid tablets, to try to control my inflammation. The problem is that these tablets had more harmful effects (e.g. weight gain, hair growth, recurrence, etc.) than benefits, which is why my ophthalmologist at Maisonneuve-Rosemont hospital decided to introduce , with the help of a rheumatologist, methotrexate by injection under the skin, which is an immunosuppressive drug also used in chemotherapy, to try to withdraw the corticosteroid tablets. However, these injections made me nauseous. Then, my ophthalmologist and my rheumatologist introduced another drug, this time more expensive, named Remicade, by intravenous infusion. Combined with methotrexate and my drops, Remicade was able to better control my inflammation and safely withdraw oral corticosteroids gradually. The long-term use of ophthalmic corticosteroids (my drops) has led to other eye pathologies, namely glaucoma and cataracts in both eyes. Regarding my cataracts, I had a lot of trouble accepting that my vision was deteriorating over the weeks without me being able to do anything to stop it, but I worked really hard to minimize the consequences of it on my academic career. I spoke to the assistant principal of my high school about it. I was entitled to accommodation measures and I learned to go at my own pace and that sometimes you had to give time to time for it to do its work. Fortunately, my ophthalmologists, in this case the specialist in uveitis and the specialist in glaucoma, succeeded in replacing my two opacified crystalline lenses with artificial intraocular lenses in 2014 and I was able to regain a good part of my vision, apart from my near-sighted vision - knowing that an artificial lens cannot bulge like a crystalline lens. Glaucoma is a serious eye disease in which the increased pressure in my eyes caused permanent - and significant - damage to my optic nerves. As a result, I had surgery for my left eye in 2014 and three more for my right eye in 2014, 2015 and 2018, in addition to various injections and other local and systemic treatments (plus many absences from school). In fact, my first procedure, a trabeculectomy, in the right eye had failed because the opening in question had closed. My ophthalmologist specializing in glaucoma therefore opted for a Baerveldt implant, a drainage tube, which had worked well for about two years before my iris began to lock up in this implant, leading to several acute and unpredictable glaucoma attacks that required several trips to the emergency room very late at night and which had significant effects on the condition of my optic nerve in my right eye.

One of my seizures took place the day before my medical interviews in Quebec and it went like this: on April 27, 2018, around 9 p.m., as I was rereading my notes and preparing for my interview the next day at Laval University at 7:45 am, I felt pain in my eyes which increased over time and which signaled to me that my iris had become imprisoned in my drainage tube. It was the first time that my mother and I visited Quebec and we knew no ophthalmic emergency, but luckily it was not the first time that my iris was imprisoned in my tube: I therefore knew how to react quickly and, above all, calmly in this kind of situation. We contacted a taxi who took us to the CHUL and Center Mère-Enfant Soleil. I met the emergency physician and explained my health situation to her, and she contacted the ophthalmology resident who was on call that night and who was waiting for me at Saint-Sacrement Hospital. Considering the complexity of the situation of my eye, he contacted his supervisor. Together, they succeeded in reducing the pressure in my eye, while also freeing my iris from my implant and I was able to return around 1 a.m. . Five hours later, I woke up with my red inflamed eye and got ready for my interviews. I told myself that day that I was there to do my best and that "whatever happens, happens" for the rest. Even if I had not been accepted in medicine, I still had a fairly satisfactory score and I was very close from entering Laval University’s program before it closed its waiting list. Faced with my two offers of admission in dentistry at the University of Montreal and in pharmacy at Laval University, I chose to do pharmacy, which implied separating myself from my family, my friends and my city while waiting for the next date round of application in medicine. Two weeks before I returned to university, my ophthalmologist had replaced my implant to prevent the onset of other glaucoma attacks. The following year, I reapplied in medicine, I passed my interviews and I received, to my great joy, an offer of admission in medicine at the University of Sherbrooke’s Saguenay campus. In short, all there is to say is that hard work pays off and we can do it :)! The important thing is to arm yourself with a good support system and go at it at your own pace. HIND ZIADY UNIVERSITÉY OF SHERBROOKE - SAGUENAY CAMPUS | HIND.ZIADY@OUTLOOK.COM

YES, MEDICAL STUDENTS CAN BE PATIENTS!

Welcome, dear medical student! Congratulations on entering this wonderful program! You may already be familiar with the medical world considering the health-related challenges you faced. Finally, you can play a role other than that of the patient. We need people like you, with your rich background, to humanize the care and services offered to patients. Unfortunately, our population is under-represented in health education programs. It is up to all of us to make a difference in the next generation of physicians and healthcare professionals. Getting admitted to medicine is hard. With a disability, it is even harder. You have all the credit. I tip my hat to you! Maybe people (unfortunately ignorant) have told you that you cannot be a doctor because of your disease or disorder. That you are too sick to care for others. That only people who don't have any health problems can become doctors. That you won't last long during your studies. These comments are hurtful, but you are resilient. You have listened to your heart, your mind, your dreams, your goals and your ambitions, and not the unfounded opinion of others. Maybe medical school will be more difficult for you than for students with no health problems. You may need to take fewer classes or take some off sessions from time to time. This is okay. You are entitled to it. You will not be penalized. I felt bad about having a particular path, about differing from others and from the "norm". But, the medical curriculum is more flexible than you think. I think it's worth taking a longer road to graduate. Just because our journey is different doesn't mean that we’ll be worse doctors. Academic accommodations exist precisely to allow students to reach their full potential and complete their studies. Don't give up. Don't quit the program because you think you're not good enough. You deserve to accomplish your goals. The difference, the handicap or the difficulties can be overwhelming at times when they make you vulnerable. You can feel lonely. Suffering is not a condemnation. It’s an indicator that you need help. You can consult the resources that I recommend to you if you do not feel well. Asking for help is a sign of self-respect, not a sign of weakness. I shared with a teacher the challenges of my chronic illnesses. He told me that it is the University's duty to diversify the pool of students and do everything to ensure their success. It is in the interest of the University to provide support to students experiencing difficulties, as it improves the University's success statistics.

Don't be ashamed of your story. It can inspire a lot of people. I share some tips with you: Follow inspiring Instagram accounts : @claudiaimartinez : Claudia is a physiatry resident in Texas living with a brain malformation. @theseatednurse : Andrea is a nurse from New York with transverse myelitis. @internistatipo1 : María is an internist with type 1 diabetes. @dr.mely : Mélanie is a medical student who suffered from a burnout. @chronicloveclub : A community for people living with chronic illness. Create / write a notebook with inspirational quotes. Make time for yourself, for hobbies, to see friends and family Participate in support groups (in the "resources" section) Surround yourself with people who make you feel good and get away from those who devalue you In times of difficulty or doubt, never forget why you chose to become a doctor. Good luck and never underestimate your potential! ANONYMOUS LAVAL UNIVERSITY

IN MY EYES - FROM A VISUALLY IMPAIRED STUDENT

Dear new med student, Congratulations, you made it! You have undoubtedly worked countless hours, put in many sleepless nights, gave blood, sweat, and tears and anxiously waited for your letter of admission. The hardest part is over and your next great adventure is about to begin. If you are reading this, it might be because, like me, you are starting this next phase of your life with a physical disability. You may have gone through your education process so far requiring special adaptations, like I did, and finding your own arsenal of useful tricks along the way. You may have had to fight much harder to be where you are today. Four years ago, I was in your shoes. Now, I am about to become a visually impaired doctor. My journey through medicine was full of peaks and valleys. I experienced great empathy and support, as well as subtle and open discrimination. I faced challenges I could not have foreseen, found allies in unexpected places, and, in IFMSA, I discovered a new home, a network of like-minded people from all over the world with their minds open wide and a thirst for change and acceptance. The best advice I can give you, baby med student, is to trust yourself. If you love medicine, care about your patients, and strive to be the best version of yourself, you will become an incredible doctor. Whatever obstacles you face can become your strengths if you let them. They can make you a more empathetic and human doctor, with a unique insight on what life can be like for patients who share a similar reality. Trust others, too. Reach out if you need to and don’t be afraid to speak up. Ask for advice and support. Try to find others who share your experience. People with disabilities in medicine are few and far between, but we are here, and we can be loud! For years, many of us have been sharing our experiences and dedicating our time to making sure the medical field is more prepared for your arrival. You are never alone. Above all, remember to enjoy every second of your experience. Use your time to grow as much as you can. Never stop doing the things you love, even when the workload seems overwhelming. Never forget how happy you were on the day you received your acceptance letter and realized your dream was finally coming true. From the bottom of my heart, I wish you the absolute best in the years to come. Future colleague, I can’t wait to meet you. ANONYMOUS

RELEVANT ORGANIZATIONS AND RESOURCES

UNIVERSITY OF MONTRÉAL MONTRÉAL CAMPUS

Réseau d'entraide étudiant en médecine (REEM) Bureau d’aide aux étudiants et aux résidents (BAER) Orientation, emploi et soutien à l’apprentissage (CÉSAR) Centre de santé et consultation psychologique de l’Université de Montréal (CSCP) Bureau de soutien aux étudiants en situation de handicap (BSESH) Bureau d’intervention en matière de harcèlement (BIMH) MAURICIE CAMPUS

Réseau d'entraide étudiant en médecine (REEM) Bureau d’aide aux étudiants et aux résidents (BAER) Clinique universitaire de services psychologiques de l’Université du Québec à Trois-Rivières (CUSP) Bureau d’intervention en matière de harcèlement (BIMH) Services aux étudiants de l’Université du Québec à Trois-Rivières

MCGILL UNIVERSITY MONTRÉAL CAMPUS

Undergraduate Medical Education (UGME) The Well office of the Faculty of Medicine (Wellness Enhanced Lifelong Learning Office) Health queer professionals (MSS student club) Queer McGill (SSMU student club) Office of the dean of students McGill counselling and mental health services McGill students services Peer support center Indigenous health professions program First Peoples’ house OUTAOUAIS CAMPUS

Service de santé de l'Université du Québec en Outaouais Keep.meSAFE The Well office of the Faculty of Medicine (Wellness Enhanced Lifelong Learning Office)

LAVAL UNIVERSITY Réseau d’aides des étudiants en médecine (RAÉM) Direction des affaires étudiantes (DAE) Centre d’intervention en matière de harcèlement (CPIMH) Centre d’aide aux étudiants Service de consultation de l’École de psychologie

UNIVERSITY OF SHERBROOKE SHERBROOKE CAMPUS

Service de psychologie et d’orientation de l’Université de Sherbrooke Centre d’intervention psychologique de l’Université de Sherbrooke (CIPUS) Programme de soutien pédagogique de la faculté de médecine de l’Université Sherbrooke Programme de soutien personnel de la faculté de médecine de l’Université Sherbrooke Services de soutien personnel et professionnel des Services à la vie étudiante l’Université de Sherbrooke Bureau du respect des personnes de l’Université de Sherbrooke Programme d’intégration des étudiantes et étudiants en situation de handicap ou trouble d'apprentissage de l’Université de Sherbrooke

de de de

SAGUENAY CAMPUS

Service de consultation psychosociale Clinique universitaire de psychologie de l’Université du Québec à Chicoutimi MONCTON CAMPUS

Service de santé et de psychologie psychologie de l’Université de Moncton Service d’appui à la réussite et de soutien à l’apprentissage de l’Université de Moncton Programme REBONDIR Service aux étudiantes et étudiants internationaux de l’Université de Moncton

OTHER RESOURCES Forum jeunesse Afro-Québécois (FJAQ) Association médicale des personnes de race noire du Québec (AMPRNQ/QBMA) Groupe Facebook ''Professionnels de la santé BIPOC du Québec'' GRIS-Montréal (Groupe de Recherche et d'Intervention Sociale) Association québécoise de la douleur chronique (AQDC) Programme d’aide aux médecins du Québec (PAMQ) Commission des droits de la personne et des droits de la jeunesse (CDPDJ)

CONCLUSION

We wish to thank the writers from the bottom of our hearts. They took time to reflect on and share their journey, in order to facilitate the medical school journey of new generations of students. We wish that these letters will help you start university with less apprehension. We hope they will be a source of inspiration and support through difficult times you’ll face. Throughout your studies, don't hesitate to raise your voice. There is always room to improve the program and we need you in order to achieve this. This will help build a diverse program that reflects our society. Also, several resources are at your disposal. Don't hesitate to ask for help if you need it. Plus, we're sure you'll meet great people who will be there to support you and help you become the best version of yourself. Know that you have an ally in IFMSA-Quebec, who will listen to you and defend you at all costs, because you deserve to feel like you belong here like any other student. Remember that our society, so diverse, needs doctors from all walks of life. Welcome to medical school! The organizing committee

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