“I want to help people” is a common response on a medical school application, but sometimes we experience trepidation when working within a new environment or group—especially when we lack understanding of these groups. Read about how one medical student ventured outside of her comfort zone and overcame her biases to provide her community with better care.
Moving from my parent’s suburban home to the city of Baltimore was a big adjustment. In my suburban bubble, homelessness, substance use disorders, crime, and mental illness seemed like far-off problems; when I moved to Baltimore, I began to see them every day. I was immediately forced to confront my personal biases, and it wasn’t easy.
My previously held-biases
Growing up I’d been raised with certain preconceptions which I know were problematic. Living in the suburbs, I never felt comfortable giving my neighborhood panhandler loose change; I was told that “these people” are lazy and giving them money would simply fuel their addictions. Growing up with this idea, I formed the bias that exposed populations—people without homes—could not be trusted.
When I first moved to Baltimore, I often opted to take the long way home from the library so I could avoid the homeless woman with her dog begging for money. I clutched my pepper spray tightly in my pocket as I passed the disheveled man talking to himself. I remember feeling extremely uneasy when I was assigned to interview a man, who was homeless, during one of my clinical experiences. I questioned whether he would be a reliable historian. When he told me that his pain was “an 11 out of 10,” I caught myself wondering if he just wanted narcotics. I even doubted his compliance with his current medication list.
As a small white woman, I even felt threatened by the diverse population of Baltimore that I had claimed to be so excited to work with in my medical school application. What would they think of me? Who was I to go in and tell them how to live their lives?
Making a PACT to do better
This attitude could not continue—I knew I had to do better. Fortunately, my school curriculum came with some service learning requirements, which presented an opportunity to confront my discomfort and the biases stemming from it head-on. I signed up for volunteer activities, hoping they would help me become more empathetic to the situations of different demographics while making their lives a little easier.
I chose to work with the Program of Assertive Community Treatment (PACT), a branch of Baltimore Mental Health Services. PACT serves adults with psychiatric conditions who are unable to use traditional outpatient services due to the seriousness of their diagnosis, or other socioeconomic factors. Because the work took place in different neighborhoods in Baltimore that I would never ordinarily go to, I was pushing myself out of my comfort zone.
It was the right choice. Each new clinical experience and interaction with the people using this program helped me chip away at previously-held stereotypes. I asked myself a lot of difficult questions and learned a lot from the people I worked with.
Through my interactions with people benefiting from the program, and discussions with my PACT mentor, I now recognize that many hard-working, educated, and talented people are on the verge of being evicted or live on the streets already. Some lost their homes while chasing their dreams; some chose to buy baby formula instead of paying rent; others simply preferred to spend their time outside.
Working with PACT was a tremendous growing experience, and extremely humbling. I came to realize how important it is for clinicians—and people in general!—to understand the unique story that every person has to tell. This realization helped me separate my biases from the people in front of me so I could provide better care.
Conversations with my mentor
While driving from one patient to the next, I had many conversations with the health professional who was mentoring me. Looking back, I realize how obvious my biases must have been. I once asked, “Why can’t these people come into the office? Why must we go to them?” This statement reveals that, consciously or not, I may have been attributing laziness or non-compliance to these outpatients.
The reality is that, sometimes, people simply don’t have the resources or the support to take care of themselves. A person’s brain chemistry can prevent them from staying organized and compliant on their own. This is not laziness—sometimes, people need a little more assistance to stay on track, which is where organizations like PACT come in.
As a future doctor, it is important for me to recognize the limitations of everyone in my care, and tailor my treatment methods to meet their needs. Every person is different, and some individuals may need much more support than others.
My takeaways from volunteering
My experience working with marginalized communities through PACT revealed so many of my personal misconceptions and biases. I am honestly not sure if I would have had the courage to pursue this experience if my school did not require service-learning. As a student, I already have so much on my plate—from classwork to family requirements, outside jobs, and then maintaining my own mental health—so it was hard to imagine adding another responsibility. However, it was such an invaluable experience, and it helped me grow into a better health professional, and into a better person, too.
I encourage every student in the medical field to go out into their community to get to know the people they plan to serve. You may find the experience challenging at first, but I am sure that this will make you more comfortable when serving your community in the future.
About Carly
Carly is a rising third year medical student at the University of Maryland School of Medicine in Baltimore. She is most interested in Dermatology and Plastic Surgery but who knows what specialty she will choose after her clinical years! In her spare time, Carly loves to exercise at the gym and play with the dogs at the local animal shelter.
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