By Kelli Jarrell
Ms. Jarrell is completing her fourth and final year at Vanderbilt University School of Medicine in Nashville, TN. She plans to specialize in emergency medicine and is eagerly (but anxiously) awaiting Match Day in March 2016 when she will learn where she will spend the next few years for residency. She graduated from Washington and Lee in 2012 with a Bachelors of Science in Biochemistry and a minor in Poverty and Human Capabilities Studies.
It was not love at first sight for the Shepherd Program and myself. I ended up in Poverty 101 at the recommendation of my advisor; I was skeptical but needed to fulfill a requirement to graduate. After a semester of trying to understand Amartya Sen and what the heck “capabilities” really are, poverty studies and I parted ways for a time. I was going to focus on my pre-med science classes so I could learn to do something that would actually help people.
“It’s not what we do or how we do it that matters in the end, but how it affects those we’re trying to help. This is reinforced every day in the evidence-driven world of clinical medicine,” writes Jarrell (W&L 2012).
Flash forward eight years. As I’m writing this, I’ve just concluded the infamous fourth-year medical student event known as “The Residency Interview Trail”. For the past three months, I’ve been traveling around America, accruing Southwest points and hoping to convince various emergency medicine residency directors to train me at their program. At every single interview (eighteen total), I talked about the Shepherd Poverty program and how it impacted my undergraduate education, how I’ve used it in my medical education, and how its lessons will impact my future practice as an emergency medicine physician. I talk about the multidisciplinary nature of the program and how it prepared me to view medicine as a healthcare delivery system and patients in the context of their socioeconomic background and surroundings. About how it augmented the science I was learning by introducing me to the more nuanced, human side of a career in medicine. My personal statement and I tell of how my summer at So Others Might Eat in Washington, DC, my first true clinical experience, laid the groundwork for my choice to go into emergency medicine by introducing me to patients in medical and psychosocial crisis. When asked about what questions in medicine interest me, I discuss my community-based research project. I recount how I participated in a community health needs assessment with the Rockbridge Area Free Clinic and how my findings and recommendations were included in the final report from the assessment. I talk about the women I met at the local health department and how far they were driving to access prenatal care. These interviewers typically confirm how useful the Shepherd Poverty program can be to a career; they usually comment on the value of these experiences and the uniqueness of such a minor.
When I entered the Shepherd program, I thought I knew about poverty. Growing up in rural Appalachia, I saw the effects of the dying coalfields on my family, friends, and neighbors. But the Poverty Studies program taught me something more important than what poverty looks like, because that changes, or how to end poverty, because nobody agrees about that anyway. The program taught me that charity and service are not enough. It’s not what we do or how we do it that matters in the end, but how it affects those we’re trying to help. This is reinforced every day in the evidence-driven world of clinical medicine. It’s not enough to want to help your patients or think something might work to treat them. It’s a physician’s responsibility, to the best of her ability, to know that what she is doing is appropriate and helpful. And helping those in need is no different. One of the reasons I chose emergency medicine is that emergency physicians have the unique opportunity to serve as a medical safety net. Emergencies do not discriminate based on net worth and neither do emergency physicians. Yet neither are they need-blind; after appropriate treatment is rendered, a patient’s background and resources become huge factors in determining where he can go when he leaves the hospital and how he can follow-up after he leaves.
The science that I learned as a biochemistry major at W&L prepared me to be a medical student. Even now, I’ve forgotten the citric acid cycle and I’m not sure I’ve ever used that knowledge to the benefit of a patient. The Shepherd program, however, taught me what type of physician I want to be – one that treats people rather than disease processes – and prepared me to do so.