PERSPECTIVES IN MEDICINE
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Feeling different

I’ve always dreamed about making it to medical school, for countless reasons that aren’t relevant to this story. But I didn’t anticipate that, after getting in, I would experience a near constant struggle to feel like I belong amongst my peers.

I love my classmates, and most of my preceptors and teachers - all genuinely wonderful people. However, I simply feel down to my core different from other medical students, in a way I don’t think a lot of my friends could understand. For the first time in my life, I’ve been surrounded by people of affluence and privilege. People whose parents are physicians. If not physicians, then managers, business owners, lawyers, or any other profession that confers upper middle class status. For so many of my friends, their first job in their entire lives will be “surgeon” or “ophthalmologist”. They’ve never known financial stresses, and have spent their entire lives up until their acceptance cultivating a perfect medical school application. Everything from their MCAT prep courses to spending summers volunteering in the lab rather than working for money gave my friends a boost that I did not have. They had parents who supported their journey every step of the way.

I feel imposter syndrome every day, and it’s not because I feel I lack intelligence or work ethic. It’s because I don’t feel I came from the same place most medical students do. It’s an outcome of the system – us lower SES folks just don’t have the resources, time, support, or social capital to navigate the competitive world of medical school applications.

However, it’s not just a matter of getting into medical school. Once in, their advantage is still apparent. My peers who come from duo doctor parents are comfortable and confident with their preceptors in clerkship, whilst I feel shy and inferior. Some classmates are able to get shadowing or research with a connection through a family connection. I always feel steps behind. Several of my preceptors in clerkship thus far have asked me what my parents do for a living and I always feel awkward to admit to them the reality. What if I said doctor? Would they teach me better…?

The moment that took the greatest toll on my self-esteem and mental health was a case-based small group where we were to apply the adverse childhood experience (ACE) checklist to an imaginary patient. This patient scored three, and there were sympathetic noises from the group and comments attributing their different childhood to their poor health currently. I had gone through the checklist the night before when preparing for the small group. I scored 9 out of 10. It was distressing to feel like an anomaly. Like someone who shouldn’t have been able to get into medical school. Perhaps, to an extent, like someone who shouldn’t be well or whole enough to be a physician.

I know that everyone has had hardships and no one’s journeys are smooth sailing. But when nobody shares their hardships, it’s easy to feel alone and that everyone else is thriving. It’s hard not to feel like most of the class came from money and perfectly functioning nuclear families.

It takes effort but I have to remember what the end goal is and why I wanted to pursue medicine in the first place. I recognize that in the future, my children (should they pursue medicine) will be the classmates that I currently harbour a mildly simmering jealously towards.

​We’re all in this to come out as great physicians and provide excellent care. The outcome is the same, regardless of the exact path. I continue to work on these feelings, recognizing that upon entering the medical profession, I’ll be launched into a different stratosphere from which I grew up in terms of money, connection, and privilege. My biggest hope is I never lose sight of what it took to get there.

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