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A Piece of My Mind
August 28, 2018

Advice for a Student Starting Medical School

Author Affiliations
  • 1Department of Medicine, University of Chicago, Chicago, Illinois
JAMA. 2018;320(8):759-760. doi:10.1001/jama.2018.11225

I sat at my desk trying to write a letter to Madeline, the daughter of two close friends. I have known her since she was born and mentored her on the path to medical school acceptance. My intention was to write a letter to Madeline as she embarked on her medical training. I imagined coming up with something to inspire her. However, all I could think to write was some combination of the pithy statements that fill the addresses at white-coat ceremonies or the conclusions of personal statements.

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    3 Comments for this article
    Complexity of Human Life & Medical Training
    Muhammad Saeed, MBBS, DCPS-HPE; MPHSE | Shifa Tameer e Millat University, Shifa College of Medicine

    A heart-touching experience translated into concise advice for new medical school entrants. I fully endorse the author's tripartite lesson of patient autonomy, careful nuance of patient-doctor relationship, and usefulness of a  sunshine folder. As I am moving towards the end of the sixth decade of my professional life, I can rightly justify the usefulness of the article's advice for the next generation of medical trainees. My sunshine folder has always been the source of motivation & inspiration in moments of failures & frustrations.

    Advice for Students Starting Medical School or Contemplating Medicine
    Stephen Strum, MD, FACP | Private Practice
    Dr. Adam Cifu's article is one of the most sentient presentations I have heard in my lifetime. I will share this with other colleagues and patients with the likelihood that patients will be far more receptive. I have seen medicine devolve in my lifetime. Just two days ago on a support group forum called "SP (SmartPatients) Forum for Amyloidosis" (which I have just been diagnosed with) I shared with patients the "The C's" that make a fine physician: competent, caring, collaborative, conscientious, collegial, cost-effective, considerate, cooperative, concerned, compassionate, compulsive.

    I have talked to patients about their
    commitment to getting better but I can now add one more C to the "characteristics" that make a fine physician.

    Joe Biden in his "Moonshot for Cancer" focused on collaboration amongst physicians as the key ingredient in solving the riddle of cancer, yet I have not found that collaboration and collegiality to be common, not in the 70's as a post-doctoral fellow doing work on Hodgkin’s disease but definitely less so in our current times of "modern medicine".

    I ignored the advice of a senior medical oncologist who said "Steve, you must learn the art of dispassionate enthusiasm" i.e. don't get so close to your patients. And yet, and I am sure the author will concur, medicine is an art and science that affords the gift of immediate intimacy with a fellow human being at a time of crisis in their life. How can anyone entering medicine not realize the grace, the opportunity to "to know even one life has breathed easier because you have lived—this is to have succeeded"? (Bessie Stanley 1904)

    Sharing clinical experience
    Samy Azer, MD, PhD, MEd, MPH,FACG | King Said University, College of Medicine and King Khalid Hospital
    The article by Dr. Adam Cifu is a master piece of advice to students starting their medical program. The scenario and the three lessons evolving in the discussion are true lessons that reminded me of similar situations I faced during my career as a gastroenterologist, researcher, and medical educator over the last 40 years of my life. That said, I wonder, do young adults starting their medical school learn from such shared clinical experiences, or we usually learn through practice, interaction with patients, difficult and challenging situations and many times from our own failures? Maybe these lessons are of value or more meaningful to young doctors and medical graduates starting their medical career.