Medicine From a Different Perspective

Cultural Competency> Grades

Cultural competence is one of my favorite terms. The ability to interact effectively with people of all cultures through the understanding of cultural differences and a patient’s  cultural perspective is a characteristic that defines a physicians ability to connect with a patient. Unfortunately, many of us overlook this. We spend our days buried in our textbooks worrying too much about the next exam and the letters on our transcripts that follow. I admire many of my friends that can spend countless hours in the library trying to master the nitty-gritty of science. Little do they realize the most successful physicians/researchers are the ones that can relate and interact with patients the best, not the ones that can recall physics formulas or orgo mechanisms off the top of their heads. Sure, grades are a deciding factor when the admission committee reviews your application-but they don’t define who you become once you get in. 

As the medical field continues to diversify, so do our patients. Patients of all backgrounds, cultures, and socio-economic status seek our help in hopes to develop one thing…a connection. Medical schools are beginning to see this. Yesterday, we had a panel discussion with the directors of Harvard Medical School’s MD/PhD admission committee. They mentioned they were extremely proud of accepting a student that had a 2.9 GPA out of college because he went on to become one of the most successful graduates of their program. Yes, Harvard Medical School. Yes, 2.9 GPA. You read it right. 

Many medical schools are beginning to integrate cultural classes into their curriculum. This is a great step in developing a well-rounded physician. It’s even great to see many medical schools beginning to implement a pass/fail system. Why? It eliminates competition among classmates. We shouldn’t be focusing on who gets the best grade. If you get into medical school, chances are you’re already smart. It’s about working with the group of diverse students in your class to better the lives of others.

During my time at NCDHR, we held an annual role-playing experience called Deaf Strong Hospital for first year medical students at University of Rochester School of Medicine. Members of the deaf community become “doctors” and the medical students become the “patients”. The “doctors” use ASL to communicate with the students and refrain from any verbal communication. Our goal is to provide them with a ‘cultural shock’  so students can recognize the communication difficulties the Deaf community often is faced when visiting their hearing physicians. It’s such an eye-opening experience for the medical students because we put them in our shoes. What they learn through this experience prepares them for the moment a deaf patient enters their care. 

I’m not writing this to demotivate you from studying. Grades ARE important. Study hard, but don’t limit your interaction with others for a letter that ends up on your transcript. Our cultural competence comes from practicing the art of communicating with people that are different than yourself. Take yourself out of your safe bubble; learn about a different community and their values so you can see the world from their perspective. Whether you realize it or not, you’re already training yourself to become a great physician. Take what you learn- the ability to understand the lives of people of all backgrounds, the barriers they’re faced with daily, and use it to eliminate the barriers they face in the health care system. Patients won’t remember you because of grades you got years ago, they’ll remember you from the bond you formed with them.

To learn more about Deaf Strong Hospital, visit: http://www.urmc.rochester.edu/ncdhr/training/hospital.cfm

Guest Speaker, MD/MPH

Early last week, students in my summer research program had a lecture with a physician who has his MD/MPH. Of all guest speakers, I was looking forward to meeting with him the most simply because this is the career path I’m interested in. I was captivated by every question he asked because I felt like I could write an essay on each one. After discussing factors that lead to health disparities, he asked us “Which patients experience obstacles when they visit their physicians?” I can’t emphasize how hard it was to refrain from shouting out my answer. He began asking us one-by- one for our opinions, and began listing each of our answers on the whiteboard. (Note: I have to sit at the end of the table so I have a view of everyone’s face to lipread.)  Just my luck, because he started on the opposite side of the table. One student before me answered “Linguistic minorities.” Damn, read my mind. So when it came my turn I wanted to be more specific, I answered “The Deaf community.”

Instead of listing the Deaf community under “Linguistic minorities”, our guest speaker goes up to the white board and adds another bullet to the list…”Physically/Mentally disabled.” Did that just happen? 

American ”Disability” Act?

I often wonder why society views the Deaf as handicapped or disabled. Many physicians/researchers spend their entire lives trying to find a cure for deafness rather than embrace it. Instead of taking  advantage of diversifying the medical field with deaf physicians that have a sense of “cultural competence”, they examine us with an  ”How can I fix their condition?” attitude. Physicians want to prevent, and cure our “disease”, rather than use us to help break down barriers in the health care system. Just another one of our many barriers, no big deal.  

But I’m not one to blame them. The very law that protects the rights of the deaf, the American Disability Act, labels us as disabled in its own title. So how could you blame society for their view of us? 

Unfortunately, many physicians that lack cultural competence are unaware that our community is considered a minority. ASL and the Deaf community is recognized by the National Institute of Health as a linguistic minority. We learn something new every day, don’t we? 

As much as I love the American Disability Act for the doors it has opened for us, it should be called American Minority Act. We stand ground and fight to be our own unique community, but in a sense the ADA puts us in a constant tug-of-war with how people perceive us. 

To learn more, visit: http://www.nidcd.nih.gov/health/hearing/pages/asl.aspx