Guest Opinion | The Doctor Is In: Medical trainees view medicine as activism. Do programs?

How a social justice movement and a pandemic are changing the way applicants choose medical schools and residency programs.

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In the wake of the murders of George Floyd, Ahmaud Arbery, Breonna Taylor, and countless others, this generation of future physicians is waking up and paying attention to the systems that promote racial inequality, including healthcare. In the middle of a pandemic that is disproportionately affecting Black, Brown, and low-income communities, health disparities have become so glaringly obvious, we can no longer ignore our contributions to that inequity. Current physicians-in-training see that medicine cannot be separated from social, cultural, and economic factors, and we are choosing to engage with communities working for equality. We volunteer as medics for BLM protests. We bring voter registration to Emergency Departments. We look beyond the clinical diagnoses and treatments inside the walls of our hospitals.

While social justice movements continue, medical students and medical student hopefuls enter application and interview season. Because of in-person limitations, residency programs and medical schools are relying on social media for recruitment efforts. Programs are hosting sessions over Zoom – casual hangouts with residents, Q&A sessions with program directors, focused panels on diversity and inclusion and more. They are using Instagram and Twitter to advertise these events and to highlight the unique aspects of their programs. Across platforms, one topic has come up again and again from programs and applicants alike – social medicine. As I attend these events and follow social media posts, I am paying close attention to which programs have spoken out about diversity, racial injustice, and social and structural determinants of health and which have shown support for their residents who are trying to actively fight against these injustices. I am also taking note of the programs that have nothing to say on these matters, as well as those that have actively worked to suppress the voices of their trainees. I am not the only one paying attention; in public forums and in private conversations, my colleagues across the country are asking these same questions. In the same way social media has changed interactions between programs and applicants, it has also facilitated exchange between applicants from all over the country that may not have otherwise taken place.

What I have to say is this: Any accredited program and medical school can train a clinically competent physician. But I want to become more than just clinically competent; I want to learn about the ways I can best advocate for the health of my patients and community. It is clear which programs have long prioritized social medicine and which programs are unprepared to address these difficult questions. Programs and schools that want to attract passionate candidates who will work to make the world of medicine more equitable are going to have to step up and show that they are listening and responding to our concerns. They must show that they will support their trainees both in their development as physicians and as people in both their formal and informal curriculums. Applicants are paying attention to the intersection between medicine and society. Programs need to be paying attention, too.

—Destinee Gwee, MS4, UI Carver College of Medicine