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Spotlight on Student Advocacy

How doctors of tomorrow are stepping up to shape medicine’s future today
By Anna Zelivianskaia

There was the “golden age” of the 1920s, the “swinging sixties,” and the “’me’ decade” of the 1970s. Now, will the early 21st century be remembered as the era of political disillusionment? Voting participation among young people has declined since the 1960s. Even motivated medical students are accused by older physicians of not being politically active. Given the persistent health inequities, insurance discrimination, and health care reform controversy, why aren’t medical students viewed as passionate advocates? While not every older physician has this view, the belief persists. In part, it becomes a self-fulfilling prophecy because one is more likely to cherry pick evidence in support of one’s beliefs. However, we must admit that there is some truth in that view, and all of us should be concerned; medicine is political and always will be. Fortunately, some students are stepping up to advocate and partner with other generations.

New Forms of Expression

Student political activism has many faces. For students who want to influence medical policy, writing and submitting resolutions through the Chicago Medical Society (CMS) to the appropriate bodies is a particularly important advocacy tool. We have the example of student Cindy Gregory, who authored a resolution on stethoscope disinfection practices. Her resolution was adopted by the Illinois State Medical Society (ISMS) in April. Cindy is a proud alternate AMA delegate from Illinois and a medical student at Southern Illinois University. She is joined by Eric Brandt, MD, a CMS member and delegate from the ISMS Resident and Fellow Section. His resolution, passed by the AMA House of Delegates in June, bans the use of artificial trans fats in all food products. These simple measures influence health professionals and members of the public. Resolutions also push relevant issues front and center for the next wave of physicians.

Another young activist, Christiana Shoushtari, provides a healthy dose of inspiration. A third-year medical student at the University of Illinois-Chicago, she partnered with CMS in personal discussions with U.S. Rep. Danny Davis to highlight the shortage of GME positions. She has advocated with both CMS and AMA on Capitol Hill in recent years, fighting for GME reform and medical student debt reduction. Here, Christiana shares her thoughts on these experiences.

AZ: What motivated you to reach out to the legislature?

CS: As a non-traditional medical student, I had decided to leave my federal employee position at HHS and pursue a career where I could help vulnerable and disenfranchised populations. But reality then hit: the limit on GME training positions and the $300,000 in loans now have me rethinking my career path. It seems that many medical students are either skeptical or just don’t understand how the political system works. If we could incorporate policy and government advocacy education within our training, more students would realize the opportunities and potential for long-lasting, powerful change within our communities. As the saying goes, “If you’re not seated at the table, you’re on the menu.”

AZ: Many students feel that the time commitment is not worth the small impact of student advocacy. What is your response?

CS: I think that argument comes from fear of the unknown and frustration. I urge those individuals to not get discouraged. Every little thing really does make an impact. Change is incremental and it happens when individuals consistently come together for a cause. Advocacy is not limited to organizing protests. Advocacy can be under the radar: it is letters, phone calls, emails; having conversations with your colleagues; attending public meetings, providing testimony, writing op-eds in your local paper. We have countless ways to get involved.

AZ: What tips do you have for students who want to advocate effectively?

CS: Be passionate. Find the issues that you care about the most and let your passion drive your work. You will need this passion to get through moments of frustration. Know your issue inside and out, including what your opponents are saying, and respect everyone, even those who oppose your views.

Compromise is not defeat; it is the starting point on a path toward achieving your goals. We need to see the bigger long-term picture. It took Congress over 10 years to finally repeal the SGR.

The branding of “advocacy” by older generations limits its scope. Advocacy today looks different than it used to, with new forms of expression. Just as political issues change, so do our advocacy methods. We students must realize that all medicine is political. While there is an activation energy for effective advocacy, we have many ways to climb that hill. Organizations like CMS and AMA are there to help us engage in the political process.

Acknowledgement: A special thank you to Rahul Bhansali, an ISMS delegate and University of Illinois at Chicago medical student.

Anna Zelivianskaia is fourth-year medical student at the University of Illinois at Chicago. She can be reached at azeliv2@uic.edu.

 

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