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So you’ve decided to become a doctor

Yale Medicine Magazine, 2015 - Spring

Contents

Appendicitis landed Xiang (Aveline) Li in the emergency room during her junior year at Bowdoin College, where she was majoring in biochemistry. Her parents, both physicians, were living halfway around the world in China and she was frightened and unsure about what was happening. After the appendectomy, complications required a second surgery and two more weeks in the hospital. During her recovery Li gained firsthand insights into the needs of patients. Prior to her illness, she’d been exploring medicine to see whether she wanted to become a doctor. Becoming a patient helped confirm her decision.

While Li was recovering, Nidharshan Anandasivam, also a college junior, was studying biomedical engineering at MIT and exploring volunteer opportunities to see whether medicine was in his future. Having injured his ankle several times while playing basketball, Anandasivam wondered whether he would be able to integrate his passions for sports, health, and science into a career. His physician parents had encouraged him to pursue his interests in college and see where they led.

What influences a child of physicians to choose a career in medicine? For Li and Anandasivam, students in the Class of 2018, a future in medicine was not a foregone conclusion even though their parents are physicians.

Fascinated by high school biology and the human body, Li’s interest in medicine grew as she sought opportunities to engage patients and observe the physician’s role. During high school she volunteered at the Veterans Health Administration and worked with a physician on reducing patient waiting times. “That experience had a big impact,” she said. “Seeing how happy patients were to see their doctor and observing the mutual trust involved in the doctor-patient relationship was inspiring.” In college, she volunteered at a local hospital and the American Cancer Society. “Each new volunteer experience confirmed that I wanted to become a doctor,” Li explained.

Li’s maternal grandfather had been a doctor and her maternal grandmother had been a nurse. But her father, a neurologist, and her mother, a pediatrician, had no expectation that Li would go into medicine. In fact, because of the consuming nature of the profession, they initially tried to dissuade her. Li didn’t grow up seeing her parents working with patients, because they lived in Canada and the United States, where neither parent was licensed to practice. They instead did genetics research, and when Li started college they returned to China to practice medicine. During visits to China, Li observed the very limited time her parents could spend with their patients. She valued the patient-physician relationship and was determined to practice medicine in a different way. “China’s large population means my parents don’t have time to do what I’m learning at Yale—the patient-centered interview,” she explained.

Anandasivam’s family is from Sri Lanka, but he grew up in Rancho Viejo, Texas, where his father is a nephrologist and his mother is an internist. During high school, strong interests in math and physics pointed him toward engineering. But his college classes, research, and volunteer activities increasingly pulled him toward medicine. Anandasivam carefully chose volunteer opportunities that exposed him to different aspects of medicine, including working as an EMT Basic with MIT’s EMS service and participating in the MIT MedLinks program, a dorm-based peer-to-peer health advocacy group. He also worked with LIFT, a community service program, where he enjoyed helping people solve problems and find resources. “My experiences in college serving the community were the driving forces in my choice,” he explained.

Anandasivam said that his parents and especially his grandmothers, who lived with his family and helped raise him and his younger brother, modeled the importance of service. “They were ‘service first’ people and that had a big effect on me,” he said. As he experienced the service side of medicine in concert with the intellectual side, it became clear that medicine was a good fit.

The influences that led Li and Anandasivam to choose medicine were multifaceted. They enjoyed the intellectual challenges of medicine and valued serving others. For Li, meeting outstanding clinicians—including the surgeon who performed her second surgery—also confirmed her decision. His engaging bedside manner provided a role model for the type of doctor she wants to become. Anandasivam said his parents’ enthusiasm for their profession helped him see how rich a life in medicine could be. “I would’ve been less enthusiastic about it if my parents’ work compromised their ability to perform their other important responsibilities,” he added. “But they spent a lot of time with us and showed us that it’s possible to have an engaging career and fulfill your role as a parent and spouse.”