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Medical Training in the Maelstrom

The Call to Physician Advocacy and Activism in Turbulent Times

Paul, Dereck W. Jr MS

doi: 10.1097/ACM.0000000000002765
Invited Commentary: PDF Only

In this Invited Commentary, the author probes current events overlapping with his early medical education for unwritten lessons. Today’s generation of trainees studies the careful application of science to suffering in the context of resurgent white supremacy, anti-immigrant hatred, climate disasters, contentious public health epidemics, and attacks on the structures undergirding access to health care for millions. The author reflects on the connections between sociopolitical events and his own experiences, as well as those of his classmates, friends, and family members. These experiences, he argues, have galvanized his and his fellow medical students’ commitment to decency, truth, diversity, and equity. He concludes that, in the current climate, the practice of healing is inextricably tied to the social and political context, such that advocacy and activism have become essential to a career in medicine.

D.W. Paul Jr is an MD candidate, Class of 2021, University of California, San Francisco School of Medicine, San Francisco, California; ORCID:

Acknowledgements: The author expresses deep gratitude to his classmates, Daniella Cordero, Matthew Ryan, Carmen Lee, Amy Ransohoff, Amer Alsoudi, and Shakkaura Kemet, for their inspiration and review of this manuscript, and to Dr. Louise Aronson and Dr. Dan Lowenstein for their wisdom, mentorship, and review of an early version of this manuscript.

Funding/Support: None reported.

Other disclosures: None reported.

Ethical approval: Reported as not applicable.

Previous presentations: A subset of these stories were shared as oral presentations at the Learn Serve Lead 2018: The Association of American Medical Colleges Annual Meeting, November 2018, Austin, TX, and at the University of Michigan’s Inaugural Diversity Conference, February 2019, Ann Arbor, MI.

Correspondence should be addressed to Dereck W. Paul Jr, University of California, San Francisco School of Medicine, 513 Parnassus Ave, Suite-245, San Francisco CA, 94131; telephone: 301-807-1176; e-mail:; Twitter: dereckwpaul.

© 2019 by the Association of American Medical Colleges