What does it mean to become a physician?
This was the question that was at the front of our minds as we began to design the Becoming a Doctor course for the University of Minnesota Medical School in 2017. Led by Dr. Anne Pereira, Assistant Dean for Curriculum, major changes in the structure of the medical school’s clinical curriculum had recently been made that created four weeks of “intersession” during students’ third and fourth year of medical school. These weeks were meant to complement students’ experiences in the clinical environment, helping to ensure they were equipped for success as residents and practicing clinicians.
As we began to design this course, however, we discovered that answering this question was challenging and complex. What did our students need? How do the answers to these questions change and evolve over time?
After many discussions with faculty, students, and medical school leaders, the answer began to come into focus. Our students didn’t need more content about basic or clinical science – there is already more of those things in the curriculum than can be effectively learned or retained. Instead, our students needed time to come together and make sense of the experiences they were having during their journey to becoming a physician. They needed to ask questions of themselves and one another, seeking answers while also realizing that often, there are no answers.
They needed time and space to reflect on questions such as:
“What does it mean for me to become a physician?”
“How can I use my voice as a physician to advocate for change?”
“What do I do when my patients die?”
We realized the most important gift we could give our students was an experience that held space to ask and try to answer these questions, while also intentionally building community. While we initially focused on the content that could be delivered during these weeks, we quickly pivoted to considering how we could hold space for making meaning. Holding space for this important work, however, meant ensuring that students were encouraged, equipped, and empowered to engage in reflection about who they are, who they are becoming, and how they can be the healers, teachers, researchers, and advocates that the world so desperately needs. This also meant focusing on being and staying whole and well in the chaos of modern medicine.
Once this mission became clear, we recognized that the only meaningful way to assess our new course – focused on professional identity formation, reflective practice, and community building – was through reflection. Thus, students are asked after each week of our course to compose a written reflection about their journey toward becoming a physician. These reflections, some of which are contained in this anthology, represent our student’s journeys toward becoming physicians at the University of Minnesota Medical School. With our gratitude for the efforts of the authors, the student editorial board capably led by our editor in chief Lizzy Kim, and advisory support from faculty and trainees, including through the Center for the Art of Medicine, we are honored to share these voices and stories in the anthology.
They are honest, optimistic, realistic, woeful, wondering, believing, doubting, persevering, joyful, and grieving. Said simply, they are real.
They are complex and beautiful – and deeply important. Just like the practice of medicine.
We are deeply grateful and humbled to walk this journey with you, our students, and we welcome you to the practice of medicine. This is a broken, hurting world; yet, you will make a very real difference in it.
Andrew P.J. Olson, MD
Founding Director, Becoming a Doctor Course
Johannah M. Scheurer, MD
Founding Assistant Director, Becoming a Doctor Course