Grades Anatomy

“Why am I doing this?”

I can hear my two suitemates in the adjacent room, debating whether or not they should quit the pre-medical (pre-med) track at Tufts. Their intense back and forth does not hinge on their ambition to become doctors, but rather on the pre-med classes’ rigor and workload. This semester, it’s chemistry. All the while, I am hunkered over my laptop, typing up my chemistry lab due the next day. My eyes are strained from staring at the bright screen for too long, and an overwhelming fatigue is beckoning me to sleep. This is a common scene in my suite, and in my experience as a pre-med student at Tufts—feeling overworked, exhausted, and deflated. This feeling stems from the heavy emphasis placed on GPA in the pre-med track, as well as the amount of “weed out” classes it requires. Even more troubling is the competitive and perfectionist environment it creates, which actively works against fostering care or compassion––two characteristics essential to being a good physician.

Preparing for medical school at Tufts requires various core courses: Biology 13, Biology 14, Chemistry 1 and 2, Physics 1 and 2, Organic Chemistry, and Biochemistry. These core science classes must be completed by the end of junior year in order for a student to take the MCAT, apply to medical school during their senior year, and then immediately begin medical school.

Many of these required classes are intended to “weed out” the pool of pre-med students. These classes create a high-pressure environment in which low grades, high levels of stress, and feelings of inferiority become the norm. One bad test grade in a pre-med class is often the deciding factor for students who drop the track. It is not enough to survive in these classes—students must also strive for perfection, given the  selectivity of medical schools. For Boston University, which ranked the 30th best medical school in the country, the average undergraduate GPA was 3.72 and the average MCAT score was 516, which is in the 94th percentile, for the Class of 2018. According to Princeton Review, the school’s average acceptance rate is 4%.

I have not felt smart once while being a pre-med student. This feeling is exacerbated by the looks I receive from my peers when I don’t grasp a concept. It resurfaces when I constantly feel behind in whatever we are learning. Most of all, I feel it when after all the time and work I invest into studying for an exam, all I receive is one cold number. Yes, being a doctor requires a certain intellectual capacity and rigor, but these quantitative qualities are tested to an unnecessary extreme in a college environment.

Reducing students to a single number sets them up for an overwhelming feeling of disposability. Instead of a culture of support and enrichment, pre-med culture is one of coldness and competition, where self-preservation trumps all else. If I dropped out of pre-med, a track I have put so much care and labor into, no one would blink an eye.

This cutthroat culture continues into medical school. In pursuit of the the highest-achieving undergraduates, medical schools lose sight of the importance of patient care. In a “common courtesy” study conducted by the Johns Hopkins University School of Medicine, residency interns were found to be lacking in doctor-patient communications, only using the skills necessary for properly interacting with patients 4% of the time.

In addition, the extent to which students are discouraged from the pre-med track may be detrimental to the healthcare industry. The Association of American Medical Colleagues (AAMC) predicts a doctor shortage of 120,000 by 2030 as older doctors retire, particularly for marginalized populations such as the elderly, people who live in rural areas, and communities of color. I imagine my suitemates would be great doctors, but due to the pressures of pre-med culture, they may not actually end up pursuing this career. These two individuals are empathetic people who possess the interpersonal traits that are lacking in the healthcare industry, but pre-med culture only measures their value based on academic performance.

There are resources in place at Tufts that are intended to alleviate the stress of pre-med. Both the Academic Resources Center and two administrative pre-medical advisors offer tutoring and advising sessions. However, the problems of pre-med culture reach far beyond what one tutoring or advising session can fix. When I meet with a pre-med advisor, I get the validation that I am on the right track and my insecurities are allayed. While these advising and tutor sessions provide a source of validation and comfort, these insecurities immediately resurface when I enter my Chemistry lecture the next day.

Outside of the pre-medical track, I am involved in the Tufts Observer and Tisch Scholars, two activities that I care about deeply. However, since they are not related to my studies, the culture of pre-med makes me feel that they are not worth my time and have no bearing on my future. To prove to myself I am more than just a number, and to even engage in self-care, are antithetical to being pre-med. It seems impossible to have the best of both worlds, and this makes me debate what I have to sacrifice to follow a career I would love.

So why do I continue? It is because I want to be a doctor, specifically an OB-GYN. I want to be in science because my mother, an engineer, showed me what it means to be a strong woman in STEM. I want to help people in an impactful way. However, there is a disconnect between the career of a doctor, especially the interpersonal aspect, and the track of pre-med.

Other higher education institutions have gotten a start in the right direction to correct this disconnect. Harvard University provides Life Sciences foundation classes for students from schools with a weak STEM background to better prepare them for science classes, including pre-medical courses.  In medical schools, they have integrated “Empathetics Training” in a variety of ways, such as offering online courses on how to display empathy while interacting with patients or virtual reality simulations that allow students to experience the world from a patient’s perspective. Tufts also conducts some programming, such as sending out a pre-health newsletter to inform students of events and resources, or hosting panels with past alumni. However, Tufts should still follow in the footsteps of other institutions to help further combat the toxic environment of the pre-med track.

Tufts could require pre-med students to take community health classes that center marginalized communities as well as create courses teaching patient empathy. This would better contextualize purpose of being a doctor. Even if these changes are implemented, it is hard to say if these steps will truly eliminate the pressures and stresses of being pre-med. All I know is that something has to change in order to prevent Tufts and other schools from pushing out their best and brightest.  For me personally, the desire to drop pre-med lingers constantly in the back of my mind; it is only the promise of what comes after—being an OB-GYN—that keeps me going.

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