Stanford Medicine Unplugged (formerly SMS Unplugged) is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the Stanford Medicine Unplugged category.
Any Stanford student knows all too well that the immense campus, with its seemingly eternal sunshine and endless rows of palm trees, can make it difficult to want to get outside and experience the real world. When it comes to medical education, this creates a very real concern: Is it possible to experience the full diversity of our health-care system when you are living in the so-called “Stanford bubble” – an idyllic college campus in one of the wealthiest counties in the United States?
I’ve certainly felt the effects of the Stanford bubble, but interestingly, working with a diverse population of patients has not been my primary challenge. Stanford has a wide net of connections with the Peninsula region and larger Bay Area – from clinics serving the urban underserved in East Palo Alto to flu vaccination programs reaching a rural population in the Central Valley farmlands. Those experiences are widely accessible to anybody who seeks them out.
No, my problem with the Stanford bubble is not about the patients – but rather the doctors. Doctors are known for being overworked and stressed, right? It certainly doesn’t seem that way in our bubble, where speaking with our outstanding pre-clinical faculty about their careers brings inspiring stories of cutting-edge research achievements, clinics filled with fulfilling cases and grateful patients and many years of training bright up-and-coming doctors. On the contrary, my faculty mentors speak highly of the balance they’ve found in their professional lives – clinic one day, research the next and teaching in between.
But is this really representative of the real world? When you step outside the realm of “academic medicine,” the picture seems to change considerably. It’s not a secret that, among physicians nationwide, burnout is widespread and pervasive – afflicting 46 percent of doctors in a recent study. Burnout was defined as “emotional exhaustion, depersonalization and low personal accomplishment.” To be honest, I can’t say that I’ve ever observed anything like that in my pre-clinical years, let alone in 46 percent of our faculty. As pre-clinical medical students, burnout is something that we hear about constantly, but witness never, allowing us to convince ourselves that it’s just some abstract idea that doesn’t apply to us.
I’m constantly inspired by my teachers and mentors here at Stanford. I will consider myself incredibly fortunate if I manage to step into their shoes at some point in my career. But part of me that wonders if we’re really seeing the full picture as pre-clinical students. We’re being shielded from the “front lines” – the thousands and thousands of primary care doctors who work tirelessly under the strains that our health-care system imposes on private practice physicians. Are we being set up for an unpleasant surprise later on? How can we possibly avoid being part of the 46 percent if we don’t have a good awareness that it exists? Perhaps it’s time to start bringing these questions into the medical school bubble.
Nathaniel Fleming is a second-year medical student and a native Oregonian. His interests include health policy and clinical research.
Photo by Norbert von der Groeben