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Defining my own academic and community medicine

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

Gallegos sketchWhen I picture my future career, I see myself more as a community physician with a foot in academia than as an academic physician with a habit of finding himself in the community. Working in a county hospital and being involved in community-health programs have always been desired and natural end goals for me.

In college, while fellow pre-meds sought out laboratory research and publication opportunities, I was most content teaching health-education workshops in public high schools. In medical school, while others worked in clinical science labs, I chose to work as a health navigator in a clinic. I value the concept of biomedical research and its contribution to medicine as we understand it, but I feel more at home in community outreach than I do in lab research.

Academic medicine has traditionally been centered on advancing clinical and physical sciences, and knowing this wasn’t an interest of mine, I began to see it as something  perhaps I shouldn’t be a part of. I worried that academic medicine might draw me away from community involvement and, worse yet, I met professionals who felt I should focus on academic medicine or community medicine, unconvinced that I can do both.

But yet, I also enjoyed the innovation, the cutting-edge practices, and the game-changing discoveries that come from academic medical centers. And I came to realize that academic and community medicine actually aren’t mutually exclusive – it’s just that the traditional definitions I have of them imply they are. Unfortunately these were the definitions I brought with me into medicine, a consequence of the misrepresentations that exist at the pre-med level.

It was the advisors, professors, and students who make up the Community Health scholarly concentration at Stanford, through their approach to medicine, that showed me a redefined possibility for academia in community health. Currently, as I work on my Masters of Public Health I'm also looking to redefine the potential roles I can take as a physician. And as medicine and public health continue to embrace a synergistic approach to caring for people, I've tried to adapt my view of what being an academic physician can mean. While I may not be meant for research dealing with pathogenesis of disease, biophysical properties of medications, or stem cell innovation, I envision my role in understanding and developing the practical delivery of medicine, studying health-care use patterns, impact of health education, and health-needs assessments on a community level.

Lloyd Minor, MD, recently wrote in his “Letter from the Dean” that, “On an institutional level, we are striving toward excellence in patient care by building a network of care that gets our specialists out into the community and brings high quality physicians from the community into Stanford Medicine.”

Validating my career goals, Dean Minor recognizes that community experience is as essential to complete health-care delivery as academic experience, and that we need to strive to create an exchange of skills and service between the two. Academic inquiry in the community setting is necessary to inform best practices and better serve the target population of health interventions. In turn, community experience is important in the academic setting to better inform policy and directionality of health-care changes to ensure the most vulnerable populations are not forgotten.

I don’t see myself in the traditional academic role, marked by research, publications, and tenure tracks, but more as a physician learning skills in the academic setting to use more directly in the community, serving groups that might otherwise not be exposed to health professionals with such training.

Moises Gallegos is a medical student in between his third and fourth year. He’ll be going into emergency medicine, and he’s interested in public-health topics such as health education, health promotion and global health.

Sketch by Moises Gallegos

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