Sunday, March 26, 2023

Disaffected osteopathic medical student

I have been carrying a weight on my shoulders for a while now, and while I am busy studying for exams, I need to unburden myself. I recently failed two out of three exams in my previous unit and had to face the Student Performance Committee (SPC). When summoned before the committee, students receive a terse email with the date, time, and location of the meeting. We are instructed to dress in business casual attire and wear our white coats. It's a well-known fact among the students that the sight of groups of students in white coats walking across campus on a Wednesday means that they are headed to an SPC meeting.

I am frustrated with the way these meetings are conducted, and I don't understand why the school doesn't take steps to protect the privacy and mental health of students during such a challenging time. It seems that all DO programs handle SPC meetings in the same way, which is disappointing. On the day of the meeting, I walked into the SPC office, and I was met with a long table with 8-12 faculty members sitting around it. There was a large monitor at the head of the table displaying my grades, and I was bombarded with questions such as "What happened?" "Why do you want to be a doctor?" and "Are you sure that you can handle this?"

Despite feeling angry and distressed inside, I had to keep a smile on my face and take full responsibility for my failure, even though it was not entirely my fault. I was stricken with COVID in Unit 2 and again in Unit 3, which caused me to miss two full weeks of classes in Unit 3. My school does not give us access to lecture recordings until after we prove that we are ill. Unfortunately, by the time I received access to the recorded lectures I had missed, it was too late for me to view them before the final exam period. The entire SPC process felt degrading to me, and I would have preferred to go through an Article 15 hearing instead.

The reason I am sharing all of this is that being an osteopathic medical student has not been what I had hoped for. I first learned about osteopathic medicine in my senior year of high school back in 1989. I was impressed by the ideas of holistic, nurturing, and different approaches to medicine, which I had read about in a catalogue from UNTHSC-Texas College of Osteopathic Medicine. Later in 2007, when A.T. Still University School of Osteopathic Medicine, Arizona opened, I became enamored and almost star-struck with the ideas espoused by osteopathic medicine.

After many struggles, I finally earned a seat at UIW School of Osteopathic Medicine in San Antonio, TX, and I was excited to start living my dream. However, I soon realized that there was nothing different between a DO school and an MD school, and the ideas espoused by osteopathic proponents did not measure up to the actions taken in the schools or at higher levels of leadership.

For example, osteopathic medicine has the Four Tenants of Osteopathic Medicine, which are closely related to the Social Determinants of Health (SDOH). However, very little of our education focuses on these tenants or SDOH. I recently submitted an idea for an article to The DO, the journal of the profession, and was told to focus on HIV prevention. The underlying subtext was to stay away from political and policy advocacy that might make the AOA look bad.

When it comes to the educational curriculum, there is an underlying patriarchal and controlling atmosphere that is prevalent in many schools. Despite being labeled as adult learners, students often feel like they are not given the autonomy and respect that comes with that label. Instead, there is a one-size-fits-all approach to learning that does not consider individual learning styles and preferences. We have mandatory attendance; most students work on Anki or study and the faculty get angry, but again, we all learn in different ways. Mandatory attendance does not make for better educational outcomes. The hesitance to change within osteopathic medicine is truly frustrating.

While some schools are better than others, there is still a long way to go in terms of providing a truly equitable and empowering education. As a student, it can be frustrating to feel like you are being educated in a broken system, only to be sent out to work in a similarly broken healthcare system. It raises the question of what the point of all this effort and time is.

As I reflect on my journey towards earning my DO and pursuing medicine, I find myself praying fervently to God for guidance. I question whether this is truly the path that He wants me to take. The arduous process of education and training in the current system can make it feel like the effort is not worth it.

Despite these doubts, I am committed to giving my all to the upcoming Unit 4 exam. If I pass, I will move on to Unit 5 and prepare for my exam retakes from the unit I failed. Assuming that I am successful, I will move into my OMS-2 year in late July.

As I move forward, I plan to spend time this summer in deep reflection and communication with God to determine if pursuing medicine is truly the path I should be on. I know that His guidance and wisdom will lead me to the right decision.

"Unmasking Structural Racism in U.S." by Daryl O. Traylor et al.

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