"Who let you into this country?" Medical Students write about Racism, Mistrust During Training

The attack on medical expertise and the racism that was in full view during the pandemic is reflected in a collection of essays penned by the nation's future doctors.

Today, the American Medical Student Association (AMSA) the ABIM Foundation announced the winners of the inaugural Building Trust Essay Contest. Medical students from 18 schools across the country submitted essays about how they built, lost, or restored trust in a health care setting. Submissions were evaluated by an esteemed panel of judges.

The four winners – along with brief excerpts from their essays – are as follows:

Teva Brender, Oregon Health & Sciences University

I had been on my sub-internship two months before when Mr. Marshall was first admitted, hypoxemic, gasping for air. I had listened as my attending spoke to his son over the phone to get consent to intubate. I had seen his heart rate rise, his blood pressure fall, and our team order one, two, three vasopressors. Now, on an infectious disease elective I was back in the medical ICU, Mr. Marshall was dying, and Mrs. Marshall still did not want a COVID-19 vaccine.

Howard Chang, Johns Hopkins School of Medicine

After reading nearly a thousand comments from patients with chronic pain, I appreciated anew how truly delicate it is for patients to entrust their lives to people they barely knew. I also gleaned that when delivered without the patient's utmost wellbeing in mind, physician self-disclosure can deteriorate trust.

Sunil Joshi, Oregon Health & Sciences University

It was my first day on the internal medicine rotation. A 77-year-old male, Mr. Marrow, had been admitted overnight for disseminated MSSA bacteremia. I went to his room and introduced myself. "Good morning Mr. Marrow, my name is Sunil and I am the medical student on the medicine team that will be taking care of you." Before I could ask any questions, he looked up with his blue eyes, stared at me for a good ten seconds, and in a sharp tone said, "Who let you into this country?"

Meher Kalkat, Johns Hopkins School of Medicine

It took three Tuesdays for me to learn that fostering trust is a broken and messy process, oftentimes taking one step forward and three steps back. It is no easy feat for someone in their most vulnerable moments to invite you into the complicated prism of their lives.

AMSA and the ABIM Foundation received essay submissions that ranged from personal stories of leadership and mentorship, to health equity, and faculty relationships.

"In an era when medical expertise is under attack and where trust in science is being questioned, we all need to pay rapt attention to our next generation of doctors," said Richard J. Baron, MD, President and CEO of the American Board of Internal Medicine and the ABIM Foundation. "It's important to give medical students a forum to express themselves, and we received personal stories about racism, miscommunication, caregiving, and compassion. We look forward to a second contest next year."

"Medical student voices are as important as they have always been, but especially when it comes to fighting misinformation and building trust with our patients and communities," said Michael Walls, DO, MPH, AMSA National President. "This contest really highlighted how medical students can individually build that connection and impact patient lives for the better."

Winning essays have been published in the September/October edition of AMSA's The New Physician magazine.

Honorable mentions were awarded to six medical students:

Clarice Douille, Creighton University School of Medicine

Veenadhari Kollipara, Pennsylvania State University College of Medicine

Paul Lewis, Columbia University Vagelos College of Physicians and Surgeons

Armaan Ahmen Rowther, PhD, Johns Hopkins University School of Medicine

Suman Vadlamani, UT Southwestern Medical School

Nicholas Wilson, Morehouse School of Medicine

Essays were reviewed and scored on the (1) connection to the topic of trust, (2) quality of writing, (3) novelty of the message, and (4) opportunity for others to learn by a panel of judges:

Andres Diaz, Editor of AMSA's The New Physician, MD/PhD student at the University of Arizona College of Medicine, Tucson

Marianne M. Green, MD, FACP, Vice Dean for Education, Raymond H. Curry MD Professor of Medical Education, and Professor of Medicine at Northwestern University, Feinberg School of Medicine

Shan Jin, AMSA Academy Chair, a third-year medical student at the NYIT College Of Osteopathic Medicine

Furman S. McDonald, MD, MPH, Senior Vice President for Academic and Medical Affairs at the American Board of Internal Medicine

David Reuben, MD, Director, Multicampus Program in Geriatrics Medicine and Gerontology and Chief, Division of Geriatrics at UCL

Michael Walls, DO, MPH, AMSA National President, graduate of Touro University California

Full essays can be read here.

Details about the second annual Building Trust Essay Contest will be released in early 2023.

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About the ABIM Foundation
The ABIM Foundation's mission is to advance medical professionalism to improve the health care system by collaborating with physicians and physician leaders, medical trainees, health care delivery systems, payers, policymakers, consumer organizations and patients to foster a shared understanding of professionalism and how they can adopt the tenets of professionalism in practice. To learn more about the ABIM Foundation, visit www.abimfoundation.org, connect on LinkedIn or follow on Twitter.

About the American Medical Student Association
AMSA is the oldest and largest independent association of physicians-in-training in the United States. Founded in 1950, AMSA is a student-governed, non-profit organization committed to representing physicians-in-training, advocating for quality and affordable health care for all, and building the next generation of physician leaders. To join our community, visit amsa.org.