Today we have part two of a three part interview with Jordan Hoese, MD, MPH, a recently graduated fourth year medical student. She Matched into Family Medicine and let us ask her a barrage of questions about specialty conflict, hidden curriculum, Choosing Family Medicine and more.

Getting students to see what Family Medicine actually is and can be… is the most powerful tool we have.

If you’re just now joining us please read part one here.

You’ve tweeted in the past about the “hidden curriculum” – what do you think we can do to combat this as fourth year medical students, interns and residents?

I think it’s really hard, especially at medical schools like mine: a research-focused, tertiary referral center that is more focused on churning out a seventh Nobel prize winner than primary care docs (and literally ousted FM off premises to dedicate their clinic space to OB instead). These kind of institutional cultures and barriers are difficult to overcome. My dean literally told us to rank residency programs based on “the most prestigious program that you could also be happy at”. But to choose family medicine, I feel like you have to be comfortable renouncing the hierarchy and value system of traditional academic medicine. Because it’s really hard to overcome that kind of messaging and feel good about it, especially when it’s coming from your med school deans and being perpetuated by your classmates.

That said, as someone who once bought into the values and traditions of such places, I think the same things that worked for me will work for other students. Which is EXPOSURE, EXPOSURE, EXPOSURE. As with everything, we fear what we aren’t familiar with and don’t understand. To a lot of medical students, family medicine is an abstract concept that exists outside of the ivory tower of academia, where overworked and underpaid doctors wipe runny noses and do paperwork all day.

Getting students to see what Family Medicine actually is and can be, rather than what they are told about it by sub-specialists, is the most powerful tool we have; and it goes hand in hand with mentorship. If someone can find a Family Medicine physician whose life and career are what they imagine for their future, it’s easy to convince that person to follow in that doctor’s footsteps. And there is such a diversity of family docs out there, like those guys practicing pediatric pulm, there’s a mentor for everyone!

FMIG was an organization on life support on our campus until my team took over leadership last year. Most of our initiatives centered on two key things: exposure and mentorship. Those changes, coupled with new leadership and improvements in the Family Medicine department, led to our class setting a record for number of people matching into FM at my institution this year (11%).

Tell us more about being the FMIG Chapter President.

Honestly the only thing I’m going to miss about medical school itself is all of the work we have done with FMIG over the last year. I’m sad I won’t be able to see it through! I was elected President at the end of my third year. Until I saw the leadership application show up in my inbox, I didn’t even know we had an FMIG. But after undergoing my own journey to Family Medicine and feeling like I had no institutional support (all of my mentors and experiences have been off campus with community docs, or docs associated with a neighboring DO school), I was super passionate about getting other students exposed to the same stuff I had, and had SO MANY ideas about how to do it.

One of these ideas included creating and streamlining our social media presence. I have a modest personal Instagram following, and I ended up creating and personally running our @utswfmig instagram account. Actually, I am currently searching for next year’s leadership and I even went so far as to create a “social media manager” leadership position for an underclassman medical student. Maybe next we will get a UTSW FMIG Twitter!

I am lucky that the rest of the elected leadership team had passion and great ideas to bring to the table as well. We started a pre-clinical procedure elective and a shadowing program, and held communication workshops, ultrasound workshops, and monthly lunch lectures. Last semester we started a mentorship program where students can find a Family Medicine doc who shares their clinical interests, and form a relationship with them longitudinally! We also got really involved with our local chapter of the Texas Academy of Family Physicians, and advertised their events, Family Med Grand Rounds and AAFP events as well.

I’m most proud of an event we did a couple weeks before this interview. As a first year, I remembered going to an IM recruiting event at our faculty club, with fancy dinner and fancy doctors that made me consider IM. So this year, I invited TAFP community docs, recently matched MS4s, and underclassmen medical students to a fancy Post-Match dinner event where we had a presentation, a panel, structured networking activities, and more, all to expose students to Family Medicine, and provide them with opportunties in mentorship. I am super proud of how this event went, grateful to the team that helped me put it together, and hopeful that it’s just the first event in a long series of Family Med recruiting events! I need to write a leadership manual for next year’s leaders so we can keep up this momentum! 🙂

Finally, we applied for “Most Improved FMIG” at the AAFPNC this year!

What are some advantages in being an FM doing full spectrum, versus other primary care, you’ve noticed as a student?

I have Type 1 Diabetes and other health conditions… in my experiences as a patient it’s pretty easy to realize how unsustainable having a different specialist for every body part is. I was lucky my endocrinologist used to be a PCP (who did a lot of women’s health before he did endocrinology fellowship) so I was able to utilize him as a PCP throughout medical school. When I rotated through various specialties as a medical student, I definitely brought this perspective with me, and was shocked to realize that nobody else (students, faculty, etc.) in academic medicine seemed to share my perspective.

It’s pretty easy to realize how unsustainable having a different specialist for every body part is.

But as I learned more about family medicine and public health, I realized that it is so much better for patient outcomes, patient experiences, and our healthcare system in general when one doctor who they know and trust can take care of the vast majority of healthcare issues.

A lot of people I’m graduating with have it in their minds that fields like IM or peds are broad, but I actually think they’re pretty narrow. I feel really strongly that it’s a doctor’s responsibility to still care for their patient when a normal life event like pregnancy or your 18th birthday happen, or when your patient gets a disease in an organ system that isn’t your favorite to deal with. So what? They’re still your patient and it’s better for everyone if you do your best to help them by managing as much as you can before referring them out (if at all).

I love family medicine because it’s the only specialty that changes its scope to fit the needs of its patient population, rather than the other way around.

This feels like the only way I can practice medicine while doing it for the good of other people, rather than for myself.

That’s it for this week…

More to come next week, when we wrap up our interview with Jordan by asking what advice she has for medical students considering Family Medicine, and how she selected her perfect residency program.

Have a great weekend, listen to some new music and enjoy the day. Or night.

By Pixie