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Pre-med with a purpose

Being pre-med is hard. All of us pre-med students know that well. Sure, organic chemistry and physics suck, but actually applying to medical school means so much more than that. As a group, many of us feel a desire to go abroad and engage with communities that are pertinent to our medical interests. Plus, medical schools stress the importance being hands-on outside of the classroom. So, naturally, many of us seek out international programs that explore the world of medicine. Do we have good intentions? Yes. Are we eager to help? Of course. Are we actually helpful? Quite frankly, not always.

Despite our intentions, pre-med students often fail to be beneficial in the countries and programs they work for when abroad. As member of this pre-med community, I feel an urge to help people who are in need. Yet, what one might not realize that the work they do in other countries can actually negatively affect them and the people they “help.” How can this happen?

Centered around participation in procedures for which students are unqualified, detrimental volunteerism attracts large chunks of undergraduate students, especially pre-medical students. When students are presented with unique medical opportunities, such as delivering a baby or suturing a wound, they proceed with enthusiasm since they think both parties are benefiting. Such a mindset, however, is dangerous.

Detrimental volunteerism is harmful because it involves providing aid that cannot be sustained. Most of the communities in which students perform volunteer work are of lower socioeconomic status and lack proper infrastructure. These underlying issues are what prompt students and universities to help. Yet, especially in the field of medicine, providing aid for a short period of time only helps for that time period. Soon after, the clinics that students assisted fail to sustain the progress set into motion. These clinics experience a brief moment of efficiency to only decline back to their normal routines, damaging the community’s health care structure

In addition, detrimental volunteerism reflects negatively on the students. By going into a community unqualified and performing unrefined medical procedures, students violate the standards of bioethics. Anyone who is not properly trained and certified in a particular field should not be operating in that field because they run the risk of potentially hurting other people. Professionals have been in the career long enough to know how to properly apply their knowledge and skills to offer help safely. Amateurs, like undergraduate students, have not been in their career path long enough to have this knowledge and skill, and therefore run the risk of being more harmful than helpful.

The issue of detrimental volunteerism directly violates the Duke Community Standard that we, as a university, created. Pre-medical students working abroad may not be lying or cheating per say, but they sometimes fail to conduct themselves honorably in such endeavors. A direct violation of the Community Standard is something to be further examined. It is important to start asking ourselves: how do we conduct ourselves honorably when representing Duke in other communities?

The issue at hand is that undergraduate students have no business performing medical procedures without a medical degree. Students are fooled by the illusion that they are helping out and that they are taking advantage of unique opportunities. Such an illusion is easily explainable, and perhaps mildly understandable. Pre-medical students feel an enormous amount of pressure to excel in all aspects of their undergraduate career. In addition, these students want to stand out to medical schools by displaying unparalleled stories of active participation in the healing process. I know as a fellow pre-med student that I feel this exact same pressure. Not only do feel the need to actually get a decent grade in organic chemistry, but I also want to be active in the medical community outside Duke’s doors.

Although it is important to introspect and evaluate how exactly we, as students, can do better, it is equally important to examine how Duke may or may not be contributing to this issue. As this issue of what is ethical and would is not could burden a large range of undergraduate students, how does Duke specifically compare in terms of upholding the Community Standard? Duke offers a wide variety of international and domestic programs such Bass Connections and DukeEngage, which often offer medically orientated programs. How does Duke avoid this of detrimental volunteerism? The answer isn’t so simple.

“We have modules with case studies,” Meredith Casper, Assistant Director for Assessment and Development for DukeEngage said, “They help to inform students on how unethical scenarios arise and how these situations have the potential to not only harm others but themselves as well.” 

Clearly, DukeEngage is proactive in ensuring students are well equipped with the knowledge of what is ethical and what is not before going abroad. Students, prior to going abroad, should be well versed in what is deemed as acceptable and what is not. This is how Duke starts to play a role in their students’ actions around the world. Dr. Eric Mlyn, the Assistant Vice Provost for Civic Engagement, said that in terms of making ethical decisions, “our students will be different.”

It is reassuring to know that the Duke community plays an active role in developing its students’ ability to make ethical decisions. The DukeEngage program demonstrates that in order to be aware of the implications of your actions in a foreign country, you need to know what could deemed as an ethical violation. The culture demonstrated through DukeEngage reflects how Duke is active in their responsibility of student actions and cultivates a more ethically aware community. Duke seems to have a strong grasp on the ethical obligation of volunteers working in other communities and educate their students well. Precautions and actions taken by Duke to groom a better, more ethically aware student body sets us apart from other universities. 

But why is Duke different? How come we are more aware than the average student? I simply think it comes from Duke’s strong role in our outside lives. Duke inundates our daily lives and the community at this university cares deeply about the wellbeing of its students. In addition, places like the Chronicle open discussions like this one to make students think critically. In terms of discussing ethical issues, Dr. Mlyn says, “I don’t know how many universities are having these conversations with undergraduates.” The openness of the community to discuss key issues allows students to be generally more aware of their actions than before. Perhaps that really is the “Duke Difference.”

Most of the time, these students participate in unethical medical practices not solely because they are oblivious to the negative implications, but rather because they are encouraged to do so by people outside the program. Students typically work for hospitals and clinics internationally where medical help is limited or the regulations are not institutionalized. So, when students come eager to participate, and help is needed, the people working in these environments encourage student contributions. It is difficult to differentiate right from wrong when an authority figure explicitly states something is okay. “Students sometimes face a lot of pressure from the community they’re in” Dr. Mlyn said. “We need to teach students to withstand that pressure.”

Duke is an incredible place to chase your wildest dreams and indulge your intellectual passions, and it is also a very socially aware environment. The community, whether it be DukeEngage, professors, or fellow students, works to discuss issues that are not always talked about on other college campuses. It is important to note I’m not only trying to inform fellow pre-med students; such detrimental volunteerism can be applied to virtually any other field. “These issues aren’t just in health,” Casper said, “They’re anywhere within development work.” No matter if your dreams lie within education, service learning, health, law, or any other discipline, your actions can affect large communities in negative ways if you aren’t careful. Sometimes you need to step away from your graduate school application and say, “Am I really helping the people around me?” 

Cliff Haley is a Trinity first-year. His column runs once monthly.

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