University of British Columbia – Doctor of Medicine – 2020
Dear future self,
I hope you are doing well. I hope you find the time to read and to reflect on this letter.
I want you to ask yourself, what does health mean to you?
When you were 5, it meant picking broccoli over candy. It meant having ice cream once a week.
When you were 12, it meant not having to take any medicines.
When you were 16, it meant no smoking, drugs, or alcohol.
When you were 21, it meant realizing that your mental health is just as important as your physical health.
But what about today?
Currently, you are in your last months of medical school, and the future looks uncertain. In the next 4 months, you will apply for different post-graduate specialties. In the next 6 months, you will interview at various programs. In the next 8 months, you will find out which area you will practice in. In the face of this uncertainty, the purpose of this letter is to remind you of your core values: why you wanted to become a physician, and how you want to practice in the future.
When you started volunteering- with your peers, with community members, and with various organizations- you explored paths down mental health, quality improvement, and chronic pain. The common thread holding these experiences together was your interest in the power of forming connections: not only the transformative effects that it had on an individual, but the effects that it can have on a community.
This is what you admired about physicians: how they formed connections to empower others to make small triumphs, and even big triumphs, in their own lives. What bigger impact can you have than to help individuals lead the best lives that they can?
As you’ve gone through medical school, you’ve learnt that you now have the skills to do this. You’ve been a part of many first birthdays, helping to promote best practices in reproductive and child health. You’ve participated in rehabilitation, helping patients get back to living the lives they once were. You’ve been privileged enough to speak with those who put their vulnerabilities first, opening up conversations about mental health.
Yet you found that there were many days filled with grief, and many days with outcomes that seemed unpreventable. Although you have come to realize these situations are part of life, what has frustrated you the most throughout medical school is that healthcare is reactive, and not proactive. What if we could prevent the onset of chronic disease and injuries? What if we could provide equitable opportunities in communities?
This all comes back to the question I posed to you at the beginning of this letter.
At the age of 25, you’ve learnt that health is more than just healthcare and the absence of disease. Health is a state of well-being where individuals and communities live in a setting where they can thrive–physically, mentally, and socially. To truly provide a better life for others, health consists of policies and a society that values preventative care. But how can you practice this?
Well, medical school has taught you skills to help you enable others. At an individual level, you
can practice preventative medicine with your patients: advise them on the benefits of exercise and vaccinations. At a community level, advocate on behalf of others outside of the clinic, in areas of poverty reduction and affordable housing.
Keep in mind that you cannot do this alone, and that to successfully practice preventative care, you will need a team that operates at multiple levels. Members of your team must include frontline staff, like nurses, dieticians, and physiotherapists. It must also include those at the community level, like researchers and policymakers. Most of all, however, it should include your patients.
Today, your definition of health is prevention. Regardless of whichever field you practice in, I hope that you remember this is the type of clinician you want to be, and I hope that you are continually striving to achieve a society that sees and values prevention as part of health.