This picture is from August 2009. It’s from a KSL TV story about one of my favorite clients — a brand new farmer’s market at the time on the diverse west-side of Salt Lake City. I’m the guy with the trumpet. The guy looking on became the chair of Salt Lake City Council. I’d been working for myself in public relations at that point for a year. It was glorious and challenging. Every day meant waking up and participating in the flow of life. It meant serving on city- and state-wide committees and advisory councils. It meant knowing your neighbors and their needs. Finding and fitting into niches. People would pay me (and my company) to do work for them! The clients I had – farmer’s markets, a coalition of mothers campaigning for clean air, a bird zoo, a statewide senate race, yoga studios, a chain of indie record stores, a professional cycling race, to name a few – represent a diverse coalition of interests that represent as well as anything else who I am and what I stand for. I was on TV, wrote editorials, was featured in a magazine spread and generally felt like I was making an impact in my community. With friends, we started a community radio station. It was a blast. The Community Foundation of Utah even gave me an award for it — one that I neither expected nor paid attention to. I wasn’t trying to get into medical school. It was just the life I happened to be living! I was fortunate enough to be in a position to work for the causes that I was attracted to — and were attracted to me. Ah, the entrepreneurial spirit.
I’d like to fast-forward 3 years. I’m sitting in the well-decorated waiting of an elite east-coast medical school on the first possible day of interview season at this particular school. The other applicants and I are nervously awaiting our judgments-er-interviews. In walks the admissions director, a stately and feisty woman who in summative assessment declares “you’re all the same to me. Every one of you. Elite grades, the highest MCAT scores, impeccable records, glowing letters of recommendations. But you’re the same as one another and every other applicant.” It’s a rough thing to hear. And immediately – as intended – cuts you down to size. What size? Whose size? For what purpose? So that we are malleable into physicians. Fine. But after leading a life – an actual life – and then going to two years of pre-med courses, waiting a year through the admissions process – and then embarking on medical school – it is difficult to hear “your past is nothing, your slate is clean, you are ready to be impressed upon.” Perhaps this is true to some extent – we are needing to be rewired to think like physicians. But, oh, what you may be missing out upon by wiping fresh medical students clean of their life’s experience.
And this, I believe, is an area in which Michigan is establishing itself to really excel in medical education.
Flashing forward again now to a month ago. I had the chance to watch a baseball game with the dean of medical student education at Michigan. It was a great experience. I’d like to relay a conversation we had about what it’s like to actually “delay life” to go to medical school. And we’re not just talking about my “special flower” of an experience. We’re talking about the fact that across the country some of the top test-takers and accolades-earners are sequestered into medical schools, essentially shuttered from society for 4, 8 (residency), 12 (fellowship) years in addition to their undergraduate coursework and experiences which in many ways are often geared toward getting into medical school in the first place. We spoke of the vast potential energy trapped in this national resource. Think about it – some of the biggest nerds with the biggest hearts memorizing the Krebs cycle. Again.
I don’t want to speak for the dean. I just wish to relay my point of view from our conversation; why I think that Michigan’s evolving curriculum contains the spirit of unleashing some of this pent-up potential. None of us coming into medical school are – or wish to be – tabula rasa. We come with our expressed and hidden desires. Our passions. The excitement we bring into the medical field. For many of us, we look upon the current state of healthcare and see massive inequality; disparity that ought to be fixed. Others see political opportunity; ways to use their skills within the legislative system to create change. Others are hardcore biomechanical engineers who want to create gadgets. We’ve got master-pipetters (God bless them) that just want to (bless their hearts) sequence DNA all day long and invent cures for obscure diseases. We’ve got folks that singlemindedly and not secretively whatsoever want, wish and need to become the highest powered surgeon on the planet. And society needs folks like that.
What I think we’re trying to do at Michigan is create a place – through trunks, branches and paths of excellence – where students can find, create and flourish within niches. Can carve their space. Can be entrepreneurial in their educational endeavors. And can make an impact on healthcare while they are in medical school. This is the spirit of our conversation, from my perspective. Right now the curriculum is an evolving structure. M2s are voluntarily demoing components of the curriculum that are being rolled out for M1s. It’s an exciting process. There are growing pains, and like any moment of change, great opportunity. Many of my classmates are actively involved in committees that are shaping the curriculum. A few friends and I are organizing co-curricular nutrition seminars. Another group of students is hosting weekly meditation groups. Students are running free health clinics, putting on lunch talks about any interest imaginable, inventing paths of excellence, creating peer-reviewed journals, and hosting Medical Student Grand Rounds. I could extend the list all night. The point is: you carve your niche. You grab a piece of the school and help grow it. In many ways, as a second year medical student, I feel like the intrepid guy in the photograph at the top of this blog – a guy with a passion on a mission, wielding a trumpet for who-knows-what-reason and raising a fuss about a cause I care about.
Why not have a better healthcare system? Why not make a medical education system that makes more sense? I think we’re taking a step forward – albeit one somewhat into the unknown – with the evolving curriculum at Michigan. Look, you still have to buckle down and muscle your way through OCHEM 1&2, PCHEM 1&2, BIOCHEM, CALC 1&2, PHYSICS 1&2, etc. You’ve still got to study sometimes when you could be dreaming, exploring, playing, and actively contributing. You’ve still got to take that financial, time and opportunity cost to get into and get through medical school. And your Physics MCAT score is still the best predictor of your future USMLE Step scores (good for me) and still has no correlation to how you’ll do as a physician (work on your skills). But “carving your niche at Michigan.” I just like the sound of it. It’s a step in the right direction.
Hah – it’s late and time to be pushing off. To the spirit of desire that fuels your mad quest to become an amazing physician – you eminently weird soul who is reading this. You could be making money, riding a bicycle and doing yoga. All day long. But you want to become a physician. We need folks like you.