FUTURE PHYSICIAN LEADERS

By Christopher Johns, MS3

A Student’s Ask for the Medical Profession

I distinctly remember an early summer day in downtown Minneapolis two weeks after the murder of George Floyd. I sat on my porch, thankful for the nice weather that granted me reprieve from my dark basement office. The pixelated faces of my peers lit up the screen as we began our virtual lab on bleeding disorders. When broken into small groups, I felt a light tremor and heard the growing hum of engines round the corner of my street. A group of national defense soldiers in armored vehicles interrupted the otherwise quiet road. They passed in a seizure of clanks and groans. One soldier about my age waved at me—like a neighbor in passing while perched atop the assault vehicle. These soldiers would continue to round every 15 minutes. Eventually I logged off the group, my mind too preoccupied to focus on clotting factors. It’s difficult to reflect on the precipitating events of this past year and a half when their fallout still resonates into how we, as students, learn. For those of us familiar with pre-pandemic medical education, the transition to online learning was acute. One day we were engaged in a physical and social space designed for growth, the next moment we were resource deprived. All the while hoping desperately that our Wi-Fi was strong enough, and our preceptors savvy enough, to feign the environment we lost. Yet, these tumultuous times have provided a novel lens with which to critique our medical education. As I sat on my porch chair, the roar of engines pulling me from the classroom, I couldn’t help but question the status quo. In a time when our social and political movements tie directly to the health outcomes of our community—the community we are in turn aiding as health professionals—why are we pulling students from these critical moments for lectures and small groups? The answer boils down to a 110-year-old academic paper that remains the foundation of American medical education: the Flexner Report. This critique of medical training would establish the current standards of academic medicine with the pursuit of scientific discovery and academic prowess as its central ethos.1 Our medical system today; schooling structure, research, rankings, and student selection criteria connect back to these values. While this paper, and the proceeding reconstruction of medicine, have undoubtedly led to outstanding discoveries within the past century, its hyper-rational model has neglected to elevate those who excel in clinical care, community engagement, and human compassion. This has a direct impact on students and how we navigate medicine. Selective specialties that require intense academic pursuit pull students away from the communities we serve to prioritize scholarly endeavors. This is impossible for many individuals, especially those whose health and lives are directly impacted by the social and political changes taking place outside our doors. Academic and scientific prowess is a luxury. A luxury that has become increasingly scarce for marginalized students over the past year and a half. No greater time has this been outwardly visible than this past year and a half. Our colleagues are fighting a war on health disparity, one against Black and brown bodies, essential workers, and vulnerable populations. Protests have been orchestrated, relief efforts coordinated, and policies enacted thanks to students, all the while compromising their academic “success.” These students have profoundly impacted the health of our local communities and yet will never be appropriately credited within academic medicine. Policies to remove rank and implement pass-fail grading are institutional band-aids on a nationally ingrained preference for hyper-analytical values. Meaningful change toward compassion-centered priorities in medicine merits meaningful reflection on how we as healers evaluate one another. Change requires us to reprioritize medicine: to relook at the standards set those hundred years ago, and to embrace the human condition when we care for our patients.

Acknowledgements to Chris Seaver, M3, for his contributions to the article.

Reference 1. Flexner A. Medical Education in the United States and Canada. Washington, DC: Science and Health Publications, Inc.; 1910. [Google Scholar]