Four Lessons on the Journey Ahead for the Medical School Graduates of 2024
Graduates, I want to start by acknowledging that for you, medical school has been anything but typical. As the first “COVID class,” you navigated unprecedented challenges and began your journey during the thick of the pandemic. You were the first class to adapt to virtual learning, and you may have felt isolated and overwhelmed trying to adjust to this situation.
I am sure you also worried about your health and the well-being of your loved ones. Some of you were even grieving lost friends and family members.
During your clinical training, you no doubt cared for patients with COVID. You placed yourselves at personal risk. You had to make tough decisions when the hospital was full and resources were limited, leading to a moral distress that was new and unsettling.
And, of course, 2020 brought more upheaval than COVID-19, including polarization, misinformation, and mistrust. The murder of George Floyd marked the beginning of a new era in social justice, and many of you entered school amidst the protests that ensued. I know that for this incredibly diverse class of graduates, these incidents must have really hit hard. As an Asian American, the acts of prejudice and violence against the Asian American and Pacific Islander community that simultaneously unfolded hit very close to home for me, too.
And now, many of us are deeply disturbed by ongoing global conflicts, including Russia’s invasion of Ukraine and the war between Israel and Gaza. I know these conflicts have been very troubling for all of us. More recently, we have seen the related protests play out on campuses all over the US, including your own. They are truly painful to witness. Let’s all hope for a peaceful resolution soon.
From COVID to Black Lives Matter, to wars and protests, these happenings have undoubtedly affected your journey and your personal development over the past four years. Everything you experienced and are experiencing—from the pandemic to other distressing crises both near and far— are shaping who you are.
You are leaving campus as a different person than you were when you first came here. You have grown, matured, learned, and achieved so much, and you can take real pride in knowing the first part of the journey is complete.
As you embark on your careers, you will carry your unique perspective with you. Your hard-won life experience has prepared you in ways that academic training alone rarely can. You have begun to understand that although you will encounter inevitable setbacks and failures throughout your career, it’s how you respond to them that really matters.
I know this has been true for me. Indeed, over the course of my career, each of my successes has sprouted from the seeds of adversity.
Before I was a researcher searching for answers in the lab, I was a refugee searching for a home away from crisis. Before I was the head of a large healthcare system, I was a trainee struggling with burnout.
So, in helping to prepare you for the journey ahead, I’d like to share four lessons I have learned over the course of my career, which have helped me carve a path to where I am today.
First: Adversity Can Help Us Grow—If We Can Learn to Embrace It and Listen to What It Teaches Us
As the “COVID class,” you’ve already begun to build this capacity. You found a way to adapt to difficult circumstances and to keep going. Otherwise, you wouldn’t be graduating today. In my life, I’ve had to overcome adversity repeatedly and find a way through—even when it felt impossible.
One of my earliest memories is when I was five years old, and my family had to flee Shanghai after the civil war in China. We left in the dead of night, abandoning our familiar life. We didn’t even get to say goodbye to our loved ones.
We crossed the border at night to Hong Kong in search of safety. We brought few belongings with us, and our new home was nothing more than a single room, without a toilet or kitchen. Life for our neighbors was marked by suffering, with scarce access to clean water, prevalent illnesses like tuberculosis, and widespread poverty.
Those times were tough, but they deeply influenced my perspective on the world and inspired me to become a physician.
I imagine many of you have had similar revelations during the pandemic. Seeing the devastating effects of COVID-19 on patients—not just physically, but emotionally, financially, and mentally—likely ignited a calling within you to alleviate such suffering wherever possible.
This is what propelled me on my career path. I made the decision to leave behind everything I knew at age 18 to go to Canada alone in hopes of eventually gaining acceptance into medical school.
Eventually, I completed a rigorous medical program in the U.S., despite the challenges of studying in a language that was still somewhat foreign to me and navigating a culture that I sometimes found difficult to understand.
Those early days of medical training were hard. I felt inadequate, insecure, and isolated. And I experienced burnout.
Maybe you can relate to my experience. Burnout is common across the health field—this was true before the pandemic and has only become worse in the past few years.
During my residency, I also faced immense pressure, which was compounded by my wife being very ill. Despite her hospitalization, just floors above where I trained, I struggled to find time to visit her. And I felt guilty.
In a moment of distress, I made a hasty decision to quit my program, which I regretted immediately. When I attempted to return, I was informed that there was no longer a place for me.
Feeling like I had made a grave error, I was determined to fix it. I persevered eventually, finding another training program that accepted me.
Like me, you will also inevitably make mistakes and encounter uncertainties in both your professional and personal life. It’s part of being human. But what really matters is how you respond to these challenges.
It took effort, but I found my way back to medicine. In fact, the experience of almost losing my work made me realize how much I valued it. While that time in my life was difficult, it taught me that I could overcome obstacles in pursuit of the career I knew I really wanted.
But I didn’t do this alone. Which brings me to a second important lesson.
Second: To deal with the obstacles you face, you must build a strong support network.
I am sure you felt alone at some point during your medical school journey. I know I did at times, too. Vivek Murthy, our Surgeon General, has labeled loneliness as an “epidemic,” underscoring its profound impact on mental and physical well-being.
It is often only by creating a network of strong support that we can overcome the challenges we face. Indeed, nearly every successful individual will attest to the crucial role of a supportive community in their achievements.
It’s hard to overestimate just how important this was in my own life. I was fortunate to find needed support in tough times—from my loving wife, my family, good friends, and fellow residents.
Importantly, I also found mentors who believed in me. During my residency, I lacked self-confidence. I grappled with finding my way in a tough work environment. I needed support and advice.
I was fortunate to cross paths with Dr. Eugene Braunwald, the esteemed chair of medicine at Brigham and Women’s Hospital. Dr. Braunwald took a chance on me, even though I had yet to prove myself.
The lessons he taught me—not only in medicine, but in life—were invaluable. It was his guidance that helped me to navigate personal and professional setbacks while I was a resident.
So, I urge you to seek out individuals who will stand by you through the highs and lows of your journey. Whether they’re mentors, like Dr. Braunwald, friends, family, loved ones, fellow residents, or mental health professionals, building a strong support network is essential.
And when you are in a place where you can stand on your own, make sure to pay it forward by being a reliable source of support for others.
Now, with the right support and hard work, you should be ready for a successful career as a physician.
And this brings me to a third lesson I learned along the way:
Success is not defined by how lucrative your practice is or how many papers you publish. It is about finding meaning in what you do.
What drove you to enter the medical profession? For many of you, it may be the desire to help others and relieve suffering. You may be driven by a sense of social justice, or by conducting research to improve the lives of those in need. You may dream about shaping the future of our field by seeking leadership roles, contributing to policy decisions, or mentoring the next generation.
Regardless of your path, if you hang onto this sense of purpose, it will fuel your resilience in difficult times.
I have always been motivated by a profound commitment to service. I aimed to research and find cures for heart disease, improve population health, eliminate disparities, and engage in global health initiatives to extend the benefits of science and medicine to underserved populations worldwide.
These whys have served as guiding lights during the most challenging moments in my life. Ultimately, one’s career is not just about personal achievement, but about making a meaningful difference for others.
This brings me to my final message to you: Never forget what is at the heart of what we do.
Society grants practitioners trust and respect, but this is predicated on the understanding that we draw upon our expertise to address the needs of our patients and our communities.
This is the social contract that medicine is built on.
As practitioners, if we forget that people and communities are at the heart of our work, we will not be doing our jobs.
As medical students, you know how the pandemic disproportionately impacted communities of color, frontline workers, and those facing barriers to accessing quality healthcare. It laid bare and exacerbated existing injustices, emphasizing the critical need to address the social and economic factors that influence patient health.
And even before the pandemic, staggering health disparities were well-documented. For example, in Atlanta, there is a dramatic 25-year difference in life expectancy between residents of the affluent Buckhead Paces neighborhood compared to their neighbors in the lower-income Mechanicsville area.
Therefore, we must not only treat illnesses but address the social determinants that fuel the major health disparities facing our country today. There can be no health equity without social equity. To deliver the best care, we need to find ways to improve our communities and support policies that help our patients achieve their best health.
You all know that science and medicine are being politicized in ways we have never seen before. In Texas, court cases are challenging government-mandated coverage of low-cost preventative care. Other states have passed legislation limiting access to abortion care and gender-affirming treatment. Even basic public health measures—like school vaccine mandates—face opposition in some areas.
As leader of the National Academy of Medicine, a nonpolitical and independent organization, we provide trusted and objective advice to the nation, regardless of who is in political power.
However, I believe we have a responsibility to speak up when political interventions or regulations, which are not grounded in scientific evidence, threaten our ability to provide the best possible care to our patients. Furthermore, I ask you, as trusted professionals, to stand up and speak out when you see injustice and disparities, and to support what is best for your communities and the world around you.
Graduates, as you can see, we really need your help.
As you enter your chosen fields, remember that, as physicians, you have the power to effect meaningful transformations. With your dedication, support system, and unwavering purpose, I have no doubt that each of you can become the leaders that we need. You have the potential to make major contributions to our healthcare system and to society. I am really looking forward to seeing what you can accomplish!
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Share this! Dr. Victor Dzau, President of the NAM, provided a keynote address at the 2024 Emory Medical School Commencement Ceremony in early May. His speech is featured as a commentary in #NAMPerspectives. Read more: https://doi.org/10.31478/202407a
Share this! “Never forget what is at the heart of what we do,” said Dr. Victor Dzau to graduates at Emory’s 2024 M.D. Diploma Ceremony. Read more in a new #NAMPerspectives commentary: https://doi.org/10.31478/202407a
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