Student Article – Tarrant County Physician Online

Student Article: Continuing the Passion for Science in Medicine

This article was originally published in the January/February 2023 issue of the Tarrant County Physician.

by Homero Coss, OMS-II

OFTEN ONE OF THE FIRST QUESTIONS I AM ASKED WHEN I mention that I am in medical school is, “How did you know you wanted to become a doctor?” Sometimes I scramble to find the most inspirational and motivating answer, as there were many reasons why I chose the career path that I did, However, at the core of every underlying reason was first, my love for science, and second, the desire to put that love into good use. Throughout my undergraduate years, I made sure to put scientific research at the forefront of my priorities. I took additional classes to help develop my skills as a researcher and participated in local symposiums whenever I could. Going into medical school, I kept research and the scientific process in mind as I learned about each body system. Given my medical education, I could delve further into the pathologies and the application of their respective treatments, and, if there were any developing treatments, I could keep an open mind about them and seek an opportunity to participate in the field research (if my busy school schedule let me). Thankfully, this past summer, my school presented the perfect chance to participate in the Pediatric Research Program (PRP) with Cook Children’s Hospital.

The PRP selects a group of second year medical students to take part in research “that aligns with their specialty interest.” There are also additional benefits such as being provided a mentor who guides you along the way and opportunities to present work at local/regional/national conferences. I chose neurology as y number one field of interest, so I was assigned a case study with a pediatric neurologist as my research mentor. I was excited and eager at the prospect of beginning work, especially since I had been assigned to Cook Children’s. The idea of being in an environment that was dedicated to helping children with challenging diseases brought a sense of fulfillment to my foundational goal of helping people heal.

Writing a case study was a novel experience, but I was fortunate to have a dedicated mentor who aided me through the process and helped me understand clinical information that my then year-one-medical-student mind could not comprehend. My mentor further allowed me to shadow her periodically throughout the summer, which was a nourishing experience to my medical education. I was able to interact with many pediatric patients who were affected by a variety of neurological disorders, especially congenital ones. This provided me with an appreciation for specialist physicians since they offer a great sense of hope and security to their patients- something I had associated more with primary care. What was even more admirable was my own mentor pursuing her research and developing case studies to help spread awareness of the pathologies that affect her patients.

Regarding my own project, I was able to learn more about the neurovascular complications of Marfan syndrome and the importance of considering it as a possible cause of stroke. I thoroughly enjoyed the process of gathering information and researching literature since it showed me how physicians from different parts of the country can come together and use their scientific nature to bring light to issues and possibly come to solutions. I look forward to working on more case studies and research projects as a medical student because it reaffirms my belief in using scientific methods and research to better the lives of patients and reach new heights in treatments.

Medical Student Syndrome

By Sujata Ojha, MS – III

This article was originally published in the July/August 2022 issue of the Tarrant County Physician.

As medical students, we have an incredible opportunity to discover a vast amount of medical knowledge, learn about the normal and the pathological, and to immerse ourselves in clinical settings where we witness the complexity of diseases. In the process of learning about life-threatening diseases, the risk of nosophobia, or illness anxiety disorder, can develop. More commonly termed “Medical Student Syndrome,” it is a concept that medical trainees are well acquainted with.

What is Medical Student Syndrome? It is the phenomenon that causes fear of contracting or experiencing symptoms of the disease that the students are studying or are exposed to.

Medical students learn the pathophysiology, the diagnosis, the treatment, the prognosis, the best-case scenario, and the worst-case scenario of diseases. We learn about teenagers diagnosed with melanoma and hear stories about patients in their early 20s diagnosed with breast or cervical cancer. The worst-case scenario tends to grab our attention. This reinforces us to not ignore a patient or symptom that doesn’t follow the general pattern of the disease, allowing us to widen our baseline scope of clinical suspicion when it comes to debilitating pathologies. The constant medical stimulation and limited clinical experience earlier on in our education can cause students to become preoccupied with symptoms and construct connections between what we are experiencing with the worse-case scenarios we learn about.

“I booked an appointment with the dermatologist because I thought I had a melanoma,” said one classmate after we shortly finished our dermatology unit. After undergoing a biopsy, the classmate discovered that the melanoma in question was a benign nevus. During the cardiopulmonary block, another medical student said he went to the ER after experiencing mild epigastric pain and tachycardia, thinking he was experiencing symptoms of atypical myocardial infarction. He had recently encountered a patient in his late 30s with a history of MI who presented with similar symptoms, further reinforcing the “worst-case scenario” in this trainee’s mind. After hours spent in the ER, he was diagnosed with gastritis and sent home with a prescription for a proton-pump inhibitor.

Throughout my medical training, I have heard countless stories resembling these. This is not an uncommon phenomenon that trainees experience. It is a topic that everyone in medicine is familiar with, whether through personal anecdotes or through stories discussed with classmates, mentors, and acquaintances. Understanding the complexity of medicine takes more than four years of medical school. Medicine is a field that requires life-long learning and an internal motivation to be updated with evidence-based practice. Expertise comes with clinical experience and after encountering numerous successes and failures. I believe that these experiences can help future physicians connect with their patients more effectively. If we as medical trainees can fall victim to an overwhelming fear of vague symptoms, how can we expect our patients with limited medical knowledge to be immune to this? With Dr. Google, a benign tension headache can be escalated to look like brain cancer. Understanding these fears and reflecting on the days when we experienced these uncertainties can bridge the gap in patient-physician encounters. It allows us to effectively address the patient’s fears without judgement, urging us to educate our patients about their symptoms instead of dismissing or minimizing them.

Medicine on the Road

by Sebastian Meza, OMS-I

This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

Texas is suffering a healthcare crisis from a lack of practicing physicians. This fact is even graver in rural communities, where the nearest hospital might be a couple of hours away. It is time that we take medical care closer to these vulnerable patients, and that is where mobile healthcare clinics can offer an efficient solution.

As a first-year medical student at the Texas College of Osteopathic medicine, I was fortunate enough to serve with the Pediatric Mobile Clinic at the Health Science Center. To picture this mobile clinic, you must imagine a bus or RV that has been transformed into a fully functional pediatric clinic. It might seem like there would not be much space in the mobile unit, but it is fully equipped to perform many medical services. The unit carries out vaccination drives, full screen wellness check-ups, sports physicals, and much more. It is a small glimpse into the future of medicine.

Looking back at my very first day serving as a student doctor, I did not know the extent of what the pediatric mobile clinic could do. My first patient came in and presented with learning difficulties, café au lait spots, and some vision problems. It was an enormous surprise to find myself examining a possible case of neurofibromatosis, a rare disease that we had covered just a few days prior. I left that day thinking about how this child would not have been able to receive care or be referred to a specialist if the Pediatric Mobile Clinic had not shown up at his school. I felt grateful and fortunate to have been there to serve the children of our Fort Worth community.

It was not until I had a chance to serve in this mobile unit that I realized that this concept was a great solution for Texas’ rural communities. Mobile clinics bring medical services to areas that are hours away from major cities with large medical centers. These clinics are easily adaptable and can be transformed to house many different kinds of practices. They operate much like a regular clinic; patients can look up when the mobile clinic will be near them and then schedule appointments online. Primary care practices can take full advantage of transforming and adapting the mobile units to serve a specific patient population.

For example, mobile clinics can directly help many underserved communities by being closer to patients, which saves time and transportation costs that can often be barriers to seeking treatment. Mobile health clinics do require an initial capital expense for institutions and hospitals. However, they bring in enough revenue to cover their own costs, they draw patients into the sphere of the base clinic or the hospital, and they help keep our community healthier.

I did not expect to feel so strongly about the concept of mobile healthcare clinics when I first set foot onto that crowded bus, but it is impossible not to recognize how efficient it is to have mobile clinics at our major schools and hospital institutions, as well as in rural communities. These mobile clinics should be part of our vision for the future of healthcare. It is time to advocate for more mobile clinics on our Fort Worth roads!

Behavioral Health to Combat Physician Burnout

By Sofia Olsson, MS-I, and Anand Singh, MS-I

This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

Burnout is not a new term for physicians. In fact, prior to the pandemic, an online survey conducted by the American Medical Association in January 2020 found that there was an overall physician burnout rate of 46 percent.¹ Unfortunately, the pandemic has exacerbated burnout for physicians due to a multitude of unprecedented factors. Burnout can be defined by three main symptoms: exhaustion, depersonalization, and lack of efficacy.² Physicians may exhibit harmful behaviors as coping methods in response to burnout, so it is important to acknowledge behavioral health as it addresses how individuals’ daily habits and actions impact their mental and physical health. As two medical students, we founded Behaviors Supporting Mental Health (BSMH) to raise awareness surrounding behavioral health for all individuals. For our current campaign, we are focusing on physicians’ response to burnout. Through BSMH, we hope to provide resources for physicians to address their behavioral health and reduce or prevent burnout.

Continuous refinement of our daily habits, actions, and behaviors leads to better
mental and physical health.

First, though, we want to acknowledge the prevalence of burnout and what factors are contributing to this phenomenon. According to research conducted by the Agency for Healthcare Research and Quality, the cause of physician burnout is multifactorial.³ The study found that some of the main causes of physician burnout are tied to physicians having to balance family responsibilities, work under time pressure, deal with a chaotic work environment, have a low control of pace, and implement electronic health records.³ Unfortunately, physician burnout has been linked to consequences such as lower quality of patient satisfaction and care, physician alcohol and drug abuse, and even physician suicide.² Therefore, addressing physician burnout and combatting unhealthy behaviors are critical for physicians themselves as well as for the patients they serve.

The activities physicians partake in can impact their risk for burnout, so assessment of one’s behavioral health is important regardless of current mental health. Several coping strategies, such as making an action plan, taking a time out, or having discussions with colleagues, have been correlated with a lower frequency of emotional exhaustion in physicians.⁴ On the other hand, keeping stress to oneself has been associated with a greater frequency of emotional exhaustion.⁴ After making note of behaviors and identifying their purpose, one can decide whether these actions should be eliminated, continued, or supplemented.⁵ Changing behaviors, however, is easier said than done. Since useful coping skills are not “one size fits all,” BSMH aims to provide resources that help physicians build a toolkit of ways to improve their behavioral health. For example, the app Provider Resilience, designed by the Defense Health Agency, functions as a method to keep physicians motivated and hold them accountable in their behavioral health.⁶ The QR code shown is a link to the BSMH website (https://tinyurl.com/bsmhproject), which includes further resources tailored to prevent or relieve burnout in physicians. Our contact information can also be found here for anyone with questions or a desire to collaborate.

Continuous refinement of our daily habits, actions, and behaviors leads to better mental and physical health. Regardless of the extent of a physician’s burnout, addressing behavioral health is always a necessity. Intentional actions impact one’s identity as a physician and any other role they have outside the clinic. Transitioning one’s behavioral health from passive to intentional can improve one’s ability to balance familial responsibilities, work under pressure, and deal with a chaotic work environment.² This puts physicians in control of their behaviors and decreases their risk for substance abuse and suicide while improving the quality of patient care.^7,8 Meaningful reflection and continuous behavioral health improvement creates a healthier mindset that allows physicians to better care for their patients and themselves.

References

1. Berg S. Physician burnout: Which medical specialties feel the most stress. American Medical Association. https://www.ama-assn.org/practice-management/physician-health/physician-burnout-which-medical-specialties-feel-most-stress. Published January 21, 2020. Accessed May 18, 2022.

2. Drummond D. Physician Burnout: Its Origin, Symptoms, and Five Main Causes. Fam Pract Manag. 2015;22(5):42-47.

3. Physician Burnout. Content last reviewed July 2017. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/prevention/clinician/ahrq-works/burnout/index.html

4. Lemaire JB, Wallace JE. Not all coping strategies are created equal: a mixed methods study exploring physicians’ self reported coping strategies. BMC Health Serv Res. 2010;10:208. Published 2010 Jul 14. doi:10.1186/1472-6963-10-208

5. Hem, Marit Helene, et al. “The Significance of Ethics Reflection Groups in Mental Health Care: A FOCUS Group Study among Health Care Professionals.” BMC Medical Ethics, vol. 19, no. 1, 2018, https://doi.org/10.1186/s12910-018-0297-y. 

6. Provider Resilience. Version 2.0.1. National Center for Telehealth & Technology. 2021.

7. Harvey, Samuel B, et al. “Mental Illness and Suicide among Physicians.” The Lancet, vol. 398, no. 10303, 2021, pp. 920–930., https://doi.org/10.1016/s0140-6736(21)01596-8. 

8. Panagioti M, Geraghty K, Johnson J, et al. Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Intern Med. 2018;178(10):1317–1331. doi:10.1001/jamainternmed.2018.3713

Medicine Has No Borders

by Aiyana Ponce, OMS-I

This article was originally published in the May/June 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

As a high schooler attending a medical magnet school, my first patient interaction came early, but the lesson I learned that day has influenced the type of physician I hope to become. Nervously, I greeted my first patient, Laura, and informed her that I would be assisting the nurse that day. I helped with her bath and brushed her hair with care, just as I brushed my own mother’s hair when she was hospitalized. Laura was blind and her tracheostomy tube prevented her from speaking, but despite that initial disconnected feeling, I was told, “The goal should be to take care of the patient as if she were your own family member.” That goal was to serve with compassion and empathy. These words have remained with me each time I have interacted with a patient. I took lessons such as this one with me after graduating and made it my mission to maximize my impact on others while serving my community.

Over spring break this year, I participated in a medical mission trip to Guatemala with 35 of my peers. Over the course of five days, we traveled by air, sea, and land to visit Santa Maria de Jesus, Magdalena Milpas Atlas, Monterrico, and San Juan, where we saw over 600 patients. Upon arrival at the pop-up clinic locations that were normally schools or church community rooms, there was often an impressively long line that formed before doors opened. Patients waited hours to be seen each day, and that was a humbling sight.

As a first-generation American raised in the U.S.-Mexico border region and a native Spanish speaker, I served as a link between patients, physicians, and medical students. My responsibilities were to initially take patient’s vital signs and blood glucose readings and then discuss their medical history and chief complaints so I could give the information to the attending physicians volunteering with us. Other days, I had the opportunity to work with a student partner and conduct full patient interviews. We would present our differential diagnoses to one of the attending physicians and work alongside the patient to create the best plan of care. On one of these days, I noticed that a patient came in particular distress. Upon my initial analysis, I noticed that he had what I call “working hands.” Large, dry, and calloused, they resembled the hands of my construction laborer father. As soon as I introduced myself by saying, “Buenos días, mi nombre es Aiyana,” his demeanor changed entirely. One moment he was shyly nodding and following the motions, and the next he looked up, seemingly comforted by familiar words. He, like many others, opened up and provided critical information necessary for his recovery. This change in demeanor occurred patient after patient, and I began realizing how incredible it was to contribute to the enhancement of patient care that would otherwise be limited by communication barriers. I am proud of my work as a translator, but I learned that there is far more that goes into quality of care than a shared language. Though some physicians and students were limited by language, I witnessed spectacular uses of eye contact, hand motions, diagrams, and body language – all of which portrayed a genuine desire to connect with and educate patients. Everyone seemed to have an impeccable awareness of their patients’ needs and feelings, despite their differences.

As soon as I introduced myself by saying, “Buenos días, mi nombre es Aiyana,” his demeanor changed entirely. One moment he was shyly nodding and following the motions, and the next he looked up, seemingly comforted by familiar words.

It is a privilege to be entrusted to care for the life of another human being and I do not plan on taking such a responsibility lightly. It is important to acknowledge that one does not need to travel to faraway lands to serve those in need, as many underserved individuals are likely residing minutes away from us right now. In the future, I will continue to participate in mission trips abroad in addition to serving the local community, wherever I go!

The Delicate Dance of Disseminating Information

By Siri Tummala, MS-II

This article was originally published in the May/June 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

“Cranial nerves two through twelve intact. Sensation is absent to light touch in right C5 and C6. Strength five out of five in bilateral upper and lower extremities. Bilateral hyperreflexia noted in patellar reflexes. No gait abnormalities,” I recite to my neurology preceptor. I quickly tap my right foot in nervous anticipation of disseminating the physical examination findings and their implications to the patient.

Context is everything. One year ago, abnormal neurological findings on an Objective Structured Clinical Examination (OSCE) would excite me. It was a free space to explore various pathologies in depth without fear of harming the patient. But this is not an OSCE. Gone are the days when hired actors pretended to be patients with medical cases. This is the real world with patients experiencing debilitating symptoms presenting to clinics. Now, abnormalities are not just an opportunity to see topics I learned in class or in a textbook last year come to life. Rather, abnormal physical exam findings in the real world can have devastating effects on individuals’ lives and on their overall wellbeing.

Informing patients about abnormal findings that warrant further imaging is not an easy task. I take a deep breath and knock on the door. I calmly deliver the news that his neck pain, hyperreflexia, as well as his numbness and pain in the middle and pinky fingers necessitates an MRI of the cervical spine for evaluation of possible cervical degenerative disc disease.

“So, I won’t know if I have that disease until I get the MRI?” asks the patient.

“Yes, that’s correct. Imaging is a tool we can use to confirm our clinical findings,” I reply.

The patient’s body starts to reflect the stress he feels from this information. Sweat beads form on his forehead. His brows furrow. His lips quiver.

“But it won’t be until a couple of weeks that I can get the MRI and have the results back,” he worriedly says.

I sense his uncertainty, and I spend twenty extra minutes with him. I calmly explain that it is normal to feel anxious about the unknown. I further explain that imaging is a helpful tool we can use to confirm our clinical findings. I reassure him that physical exam findings and imaging results together will allow us to formulate an efficacious treatment plan to fulfill his goal of improving his symptoms.

Our job as healthcare professionals transcends purely applying medical knowledge to real-life settings. The quality of the medical information we give patients is valuable only if it is delivered in an understandable manner that takes into consideration how that information affects their daily lives. If the pathology is prioritized over the patient, medical care will not suffer, but the patient will. Given that our primary duty is to ensure the wellbeing of patients, patient encounters are more fruitful when extra time is spent explaining the importance and relevance of the information. It takes years to fully master medical topics for medical students who spend all day studying and are constantly immersed in the material. It is not a fair expectation to assume that patients will recognize the significance of and be able to apply health recommendations without a clear and thorough explanation by the caregiver. Patients are real people, and this recent encounter reminded me that entering medical settings is a vulnerable situation that requires physicians to acknowledge their experiences with care and compassion.

TCU Medical Student Publishes Two Children’s Books

By Prescotte Stokes III

You can find the original article here.

During a short break from medical school during Summer 2021, Sereena Jivraj, a second-year medical student at the TCU School of Medicine, had a burning desire to create something.

She combined her love for science, medicine and children for something special. She made the most of her time by writing two children’s books entitled, “Connor and His Composting Adventures” and “Ella and Her Vaccine Soldiers.”

“I’ve had these ideas in the back of my mind for some time,” Jivraj said. “I’ve spent so much time around children whether that was tutoring or babysitting and I’ve always been reading children’s books for years and it just felt like I’ve been so involved with kids in the past that it would be cool to keep it going in the future.”

Sereena Jivraj, a second-year medical student at the TCU School of Medicine, holds her newly published children’s books entitled “Connor and His Composting Adventures” and “Ella and Her Vaccine Soldiers.”

In “Connor and His Composting Adventures,” Connor learns what the difference is between compost and regular trash. Throughout the course of the story Connor learns what everyday items can be composted and how to prevent trash from ending up in a landfill.

“The point is just to educate kids and even parents on what composting is,” Jivraj said. “A lot of people when you speak to them about it they’ve never heard of it. What I really wanted to do is be able to instill that knowledge from a young age. Hopefully that will make it easier to make changes in our society one day in the future.”

Her second children’s book called “Ella and Her Vaccine Soldiers” is about young Ella’s visit to her doctor. Ella learns how important vaccines are and how they can turn into “mini soldiers” to help her body fight viruses and diseases.

“With COVID-19 around last few years and previously with flu shots, I can remember everyone being afraid to go to the doctor just because they knew a shot was coming,” Jivraj said. “I want kids’ fears to be diminished so they can have a healthy relationship with their doctors and not fear them because you’re really brave when you get these vaccinations. I don’t want this fear of vaccines to prevent you getting the help that you need.”

Writing the books was a process that helped Jivraj tackle some of her own issues with long form writing. She reached out to the medical school’s Compassionate Practice® team after she did some volunteer work gathering donations for homeless individuals in Fort Worth and felt compelled to pen a poem about her experience.

“I used it as a way to get out my emotions and help me decompress,” Jivraj said. “I went to the Compassionate Practice® team and that kind of gave me the confidence to do this because I always felt like writing was my weakness.”

She also talked to Samir Nangia, M.D., a Physician Development Coach at the medical school, about the idea of penning the children’s books. During their chats, Dr. Naniga said that her urged Jivraj not to put her ideas off and take some time during her break to pursue them.

“In some instances, through coaching we can help students become more efficient with their time management and help them discover what resources they need to make their dreams a reality,” Dr. Nangia said. “However, in some instances all it takes is that motivation and emotional support. Both of which were true in Sereena’s case.”

In addition to embracing her creativity, Jivraj said that she chose to author children’s books so the information would be easy to understand and accessible to all people.

“This is a book that you can read to your child in your belly or read to your newborn,” Jivraj said. “Because just exposing them to the vocabulary and to the words it helps create those processes in their brains so when they are exposed to it later on, they are not completely confused about it.”

Both books “Connor and His Composting Adventures” and “Ella and Her Vaccine Soldiers” are available in the Amazon Store as a download or paperback version. They are also available to download on Kindle.

Booked Up Together

A Tarrant County Physician Student Article

by Brittany Shah, OMS-II

This piece was originally published in the January/February 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

Deciding to become a doctor meant comparing myself to numbers my whole academic career. In high school, I put my self-worth in my class rank and SAT score. In college, my sense of self relied heavily on my GPA, MCAT score, and volunteer hours. Getting anything less than an A (which happened more often than I would like to admit) sent me into a spiral of anxiety. I found myself scouring through online forums such as Reddit and Student Doctor Network to see where I stacked up to my peers. I would compare my GPA and MCAT score to the acceptance data provided by schools to determine if I was truly worthy of applying to that school. The uncertainty and stress of being a pre-medical student caused me to value numbers over relationships, but I told myself that one day, it would be worth it.

The sad reality was that in an effort to succeed, I had isolated myself emotionally and physically. These numbers I was chasing had come at a cost – I had become so single-minded that I had conditioned myself to study alone. I found class, study groups, and review sessions pointless because, in my mind, I was counting the hours down to when I could be alone at my desk, studying how I thought was best.

I started medical school in 2020 during the height of the pandemic. I had a positive mindset going in, but the first semester was one of the hardest times of my medical career. The forced social isolation stripped me of any sense of drive. I started missing class, my mental health declined, and my grades reflected my inner turmoil. The propensity for self-imposed seclusion that I had developed came back with a vengeance and worsened my cycle of apathy and misery. I struggled silently.

Things did not get much better during my second semester, so when I saw a classmate post about forming a study group called “Booked Up Together” over Zoom, I figured it was at least worth trying. As dramatic as this sounds, there was a little voice in my head telling me that I needed to admit that my way was not working, and I had to try something different. Let me tell you – I am so glad that I listened to that side of myself. Time that would have normally been spent alone in my room was now filled with friends quizzing each other and breaking down lecture material in a way that was easier to understand. Joining Booked Up Together was hands-down the best decision I have made since starting medical school. I started going to class, my mental health improved, and my grades got better. I became friends with warm and genuine people who helped me see the importance of not going through school alone. Study group became a safe space – I knew even on my bad days, there were people who understood and related to the pressure and stress.

Healthcare is multifaceted. As physicians, we will work together with different specialties and healthcare workers to ensure our patients receive the best care possible. While we are told that medicine is collaborative, the journey through medicine often feels solitary. I suppose it seems obvious now, but it is vital to protect our humanity while going through medical education not only for ourselves but for our future patients. For me, studying with my classmates reminded me that medicine at its root is a collective field, and while it is easy to get swayed by numbers and resume building, it is also important to remember why we decided to become physicians in the first place. What worked for me might not necessarily work for someone else, but I believe finding an avenue to collaborate is a beneficial way to stay connected with that part of yourself. Medical school is hard but going about it alone is even harder.

Navigating Blindly

Kristian Falcon, OMS-III

This article was originally published in the November/December issue of the Tarrant County Physician. You can read find the full magazine here.

“Si se puede!” (Yes, you can). . .

. . . is what I have been told throughout my life by my parents and by my entire familia. Being the first ever in my family to go into the medical field is a commonality that many Hispanic students share. My father emigrated from Mexico at the age of 18 and had to delay attending university to first learn English. My mother immigrated here at the age of 26, after already holding a teaching license and an equivalent master’s degree in Mexico. She had to redo her education after first learning English to regain her teaching license in the U.S.

Learning English at the same time as my mother was no easy feat. She taught me my vowels and how to read while we taught her proper syntax and English grammar. When it came time to apply to college, how was I supposed to ask my parents to revise my application essays since when growing up, I was the one who edited and revised their emails and text messages?

When I began college, my father asked me, “What are you going to do with a degree in biology?” to which I responded, “Be a scientist.” He wasn’t asking because he didn’t believe in me; he was asking because he truly didn’t know what I could do with such a degree, and to be 100 percent honest, I didn’t either. Becoming a doctor was not a thought I had before; I fell into this path through getting involved with my passion to serve others and my interest in science. Once I realized that I pictured my future self as being a physician, my family grew concerned about the difficult path I would face. They suggested alternative careers, knowing that no one from our family had ever gone down this path before and that many who try, fail.

Maybe I was naïve and didn’t do the proper research on what a career as a physician entailed, but without any guidance, I faced only my short-term goals, one at a time. What I didn’t realize was that becoming a doctor involved much more than just meeting specific checkboxes. It required immense dedication, time, and sacrifice.

At times, I questioned if I even belonged in medical school. During my application process I was told, “You only interviewed there because you’re Hispanic and speak Spanish,” or “You’re lucky you’re underrepresented in medicine; you’ll get accepted anywhere.” I was continually discredited of my merits and accomplishments because of my ethnicity, even though I had years of volunteering, research, and experiences in the medical field as an EMT, and had not only a bachelor’s but also a master’s degree. Upon entering medical school there were less than 20 Hispanic medical students in my class of 220. Hispanic students make up only 15 percent of the student population of all the health professional colleges combined in the health science center I attend, while in Texas, the Hispanic population comprises roughly 40 percent of the state’s population.

Lacking representation and not having mentors who had faced similar paths, I struggled to fit in and find my place. While many of my colleagues had family and friends that were doctors, I grew up not knowing a single person in this field besides my own doctor. I faced obstacles because I had to find resources on my own to help me accomplish my goals. Every medical experience, preceptorship, or shadowing opportunity was one I went out and found on my own; I didn’t have the luxury of growing up with those opportunities around me. I carved my own path.

Within the first month of my third year, I was reminded of the importance of having Hispanic representation in the medical field. I attended to many patients who were Hispanic and spoke only Spanish. While medical translators are vital and do an amazing job of communicating adequately with a patient when there is a language barrier, being able to communicate directly and relate to a patient forms a bond unlike another. Conversations with a translator can sometimes be procedural and very formal; being able to communicate freely in one’s own language allows for a more human interaction and a better understanding between a provider and a patient.

It is the moment when I see a patient become more animated and more comfortable that I remember why I chose this career and that I bring more representation to this field. I remember why I chose to be the first in my family to carve this path, and why I choose to be involved in leadership and advocacy so that many others like me can take this path a little less blindly. While I still have over a year left until I graduate and become a physician, my message to those who seek this path is, “Si se puede!”

A Love Letter to the Community

by Rachel Marie G. Felix, OMS-II

This article was originally published in the September/October issue of the Tarrant County Physician. You can read find the full magazine here.

by Rachel Marie G. Felix, OMS-II

If everything I’ve learned in medical school thus far, my favorite realization has been that I love people. Given the fact that we live in a society rooted in individualism, becoming aware of this fundamental truth of mine was not as straightforward as it sounds. Especially when being part of the medical field, where there is constant pressure to compete, accomplish extremely taxing feats, and be the best all-around people we can possibly be at all times. From a young age, those who pursue medicine are conditioned to hyper focus on their individual accomplishments. However, through guidance from my extraordinary mom, support from my childhood loved ones, and interactions with my incredible classmates, I’ve come to truly understand my “why,” and it’s all for the community.

With a jam-packed schedule and overflowing course material, during the first few weeks of medical school I knew I had to take time to contemplate who I was and what I wanted from life, or else I would risk losing myself to the grind. And from deep reflection and unlearning during the Black Lives Matter movement, I realized that I thrive when I am able to contribute to the joy and wellbeing of those around me.

What came from living daily in this truth was life altering. I found myself soaking in every conversation shared with my mom and truly learning the depth of her selflessness. I challenged myself to go on a medical mission trip to help those with limited access to healthcare and was overwhelmed by both the support from my family and friends and the gratitude from those we were able to serve. I would even go to campus completely open to meeting new people and end up having such enjoyable conversations. This would lead to sessions of vulnerability and genuine connection, leaving me feeling enriched by the opportunity to appreciate the different sides of each classmate-turned-friend.

As I made a point to cherish each interpersonal opportunity, I realized just how fulfilling every day can be when we immerse ourselves in community. Yes, we can say we show appreciation for our communities through volunteering or even through our careers, but intentionally showing how much we care for one another as a regular practice is a lifestyle that I highly recommend. While there are many outside influences that can cause us to get caught up in our own worlds and participate in a zero-sum game, the truth is, there is abundance in the shared human experience. We are each beautifully complex and different beings with something unique to contribute to one another. So when one of us wins, we all win.

Conversely, we all hurt when one of us hurts. As made obvious by the pandemic, a flourishing community depends on the health of its people. So dear reader, I hope you are able to appreciate the unparalleled opportunity we have to positively impact those around us as healthcare professionals. Moreover, I hope you see how valuable both you and your patients are in creating a thriving community and allow every interaction—inside and outside of the clinic—to reflect that.