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Now What for Future Physicians?

By PL JETER

At a recent policy forum on campus, students at the University of Central Florida College of Medicine (UCF-COM) peppered former American Medical Association (AMA) president Cecil B. Wilson, MD, with questions about the nation's healthcare policy and proposed changes expected under Republican President-elect Donald J. Trump.

"Several students expressed some fear of the unknown ... about what they're getting into as physicians," said Jessica Walsh O'Sullivan, a second-year medical student and AMA delegate for the UCF AMA chapter. "They want to know what's to come with healthcare delivery changes in general, and proposed adjustments to Obamacare."

Wilson, an internist in Winter Park, presided over the AMA when Congress passed the highly controversial, AMA-supported Affordable Care Act (ACA) in 2010 that he called "the most significant legislation since the Medicare Act in the 1960s."

"When I talk to medical students, the first question I'm usually asked is whether I would go into medicine again. And of course, the answer is yes," he said. "The second question typically is: how are we going to reorganize ourselves as a country to provide adequate medical care for everyone? Obviously at this point, it's an iffy question. That said, I'm not pessimistic at all."

Aaron Pollock, recipient of the prestigious UCF Order of Pegasus 2015 who anticipates graduating from medical school in 2020, admitted his primary concern post-graduation is dealing with "being overwhelmed."

"I was attracted to medicine through a sense of moral obligation to help those struggling with their health and wellness," he explained. "With the current physician/patient ratio, I predict I'll be seeing more patients than I'll have time to provide quality patient care."

Wilson, also a UCF-COM instructor, emphasized the national push for proportionate pay for primary care physicians, and fielded questions about "perhaps too much specialization."

"Do you think we'll still have job security if we pursue a specialty and several fellowships and find ourselves in a small niche?" asked one student. "If you're good at your job and choose a small subspecialty, you'll still have work," Wilson assured him.

Jacob Henderson, a first-year medical student, who plans to pursue a career in pediatric cardiology, said he's concerned about being able to make a difference in preventive patient care in an environment shrouded by heavy regulation, voluminous documentation, and other time-consuming technicalities.

"The plague of cardiovascular disease is largely self-imposed," he said, adding that, as a result, "we must become excellent educators to help our patients make the best decisions for their health. But will there be adequate time for that?"

Henderson is also concerned about the health of emerging patient populations, such as the LGBTQ community.

"These problems are far too big to be solved in isolation," he observed. "I hope my generation of physicians breaks free from the medical profession's history of lackluster political engagement."

Born in Ireland and raised in North Carolina, O'Sullivan, who is considering emergency medicine as a specialty, was keenly interested in Wilson's assessment of healthcare policy in various countries, particularly his anecdote about touring Nepal as president of the World Medical Association before the April 25, 2015 earthquake that killed 9,000 citizens and injured nearly 22,000. "No country has a perfect system, but there's a lot to learn about different ways countries take care of their people," she said.

By the end of the policy forum, O'Sullivan said she could sense a cloud of concern had lifted from the students. "Dr. Wilson was very encouraging to students," she said. "He was really humble, very positive and politically neutral. When asked how they could make a difference, whether through advocacy or patient care, it was really cool for them to hear him say that sometimes, 'the number one thing you can do is show up.'"



 
 
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