Addressing challenges of diversity and inclusion within medical schools and the larger physician workforce should begin with a conversation about the intrinsic barriers to higher education. In an economic analysis report of medical school matriculants published by the AAMC, it was found that nearly 75% of each medical school class from 2007–2018 came from the top two quintiles of family income (Youngclaus & Roskovensky, 2018). In fact, only 5% of students in medical school come from the lowest quintile of familial income.
Had someone told me that I only had a 5% chance of getting into medical school, I may have chosen a different career path. Getting a four-year undergraduate degree, study materials for the MCAT, applying to dozens of schools, and possible gap years to strengthen your application only to tackle four more years of tuition is a colossal commitment to make—exponentially more-so for children of lower working-class families.
In addition, students from lower socioeconomic status families may also struggle to adapt to the steep learning curve of the hidden curriculum, which requires one to understand the social norms and practices associated with becoming a more competitive applicant (Giroux & Penna, 1979). What these students are looking for is not a golden ticket that grants free admission into medical school—what they are really searching for is guidance on how to navigate the systems necessary to succeed.
Growing up, my mother always told me to get a proper education so that I would never be forced to work as gruelingly as she does. Guidance was hard to come by when your parents don’t know the language, culture, or systems of the country you live in. Back in 2013 as a junior in high school, my life was forever changed when I attended a 10-week medicine immersion program for under-represented and disadvantaged youths at Mount Sinai Icahn School of Medicine. It was this experience that connected me with my mentor, Dr. Vicki Teodorescu (AKA Dr. Teo), who inspired me to embrace the challenge of becoming the first in my family to attend college.
It’s never too early or too late to become a mentor
Never underestimate the impact you can have on a potential mentee. From a fresh intern to someone bordering on retirement, there is knowledge to be imparted that can enrich a student’s personal and academic journey. Throughout my time shadowing Dr. Teo, I learned about the importance of developing meaningful relationships with people to achieve a common goal, the impact of fluid teamwork in overcoming challenging tasks and the value of being inquisitive. Mentorship is more than just helping improve clinical decision-making or operative skillset, it can help mentees develop self-efficacy towards achieving their goals. Even simple gestures like giving positive affirmation and motivation can be significant to mentees.
We should view mentorship as an investment in the life of another. Finding meaningful extracurricular activities to strengthen college applications can be a struggle for many students from working-class families. Experiences with a physician mentor can act as a stepping-stone for many students of disadvantaged backgrounds to be considered for other competitive programs, which may help spark a passion for a field of medicine they never considered before.
It was during the clinic visits with Dr. Teo that I first learned about the concept of social determinants to health. Although I did not understand the concept at the time, I began noticing certain trends and patterns in the patients that we saw, and I could not help but ask questions. Why there were so many patients who were homeless requiring dialysis access? Why were visits with non-native English speakers longer than usual? Why did patients on Medicaid seem to have longer patient charts than patients with private insurance? This curiosity in the social determinants behind vascular surgery then led to my decision to major in the social sciences in college, conduct research on the interaction of education and health, become an AmeriCorps English teacher, and pursue a graduate degree in public health, and become a medical student. Mentorship helped expose me to a world that I had never known about before, which planted the seed for my educational journey.
Mentees must be proactive: It’s a two-way street
There are several qualities that make a great mentee. Becoming one requires a dedication to learning and an unrelenting desire for continuous self-improvement. It is not enough for mentors to provide the opportunity – mentees must also be proactive.
However, tackling new challenges can often be intimidating, since there is a risk of failure. Failure can become crippling to new learners but mentees that clearly communicate their needs and demonstrate a commitment to problem-solving, soon learn to embrace their failures and learn from them. In fact, failure is often a necessary ingredient in the recipe for success in any venture.
Maximizing the impact of mentorship
There are several different styles of mentorship. Mentorship can be an evolving process, one that requires trying different approaches and seeing what works and what doesn’t. Systems of constructive feedback are crucial.
Mentorship is such a valuable tool at the disposal of physicians. It has the capacity to not only change the lives of students, but to shape what the future of medicine can look like. As I reflect on the impact of mentors in my life, I’m inspired to want to become a future mentor myself—particularly to students who come from lower working-class families that face challenges of social inequity and barriers of access to higher education. Dr. Teo’s mentorship catalyzed my academic journey into medicine. For most of my upbringing the idea of college felt unobtainable and unaffordable to an inner-city public-school kid like myself. Had it not been for this experience, I would not be here today—just like Dr. Teo.
It is my hope that more vascular surgeons consider the possibility of mentoring students of working-class backgrounds as they can bring such unique diversity in life experience to the profession of medicine. Tackling the challenge of representation is an extraordinary task but creating more opportunities for mentorship can be the first step in investing towards the future of vascular surgery.
Sheng Dong, MPH, is a medical student at George Washington University School of Medicine and Health Sciences in Washington, D.C.