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Join us in this episode as we explore the story of a medical student who redefined her career path after a pivotal moment of self-discovery and patient insight. Our guest, Janet A. Jokela, an infectious disease physician, delves into the lessons learned about career alignment, mentorship, and the vital role of compassion in medicine. Together, we discuss the power of patient interactions, the courage to pivot, and the importance of finding one’s true calling in a demanding field.
Janet A. Jokela, MD, MPH, ACP’s Treasurer 2022-2025, served as the Regional Dean of the University of Illinois College of Medicine-Urbana, and currently serves as Professor and Senior Associate Dean of Engagement at the Carle Illinois College of Medicine, Urbana, IL.
She discusses the KevinMD article, “How one medical student’s life-changing conversation reshaped her career.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Janet Jokela. She’s an infectious disease physician and the treasurer of the American College of Physicians. Today’s KevinMD article is “How one medical student’s life-changing conversation reshaped her career.”
Janet Jokela: Thank you so much, Kevin.
Kevin Pho: So, let’s start by jumping right into this recent article. Tell us what it’s about for those that didn’t get a chance to read it.
Janet Jokela: Sure, sure. Now, my pleasure. This was a situation that occurred a few years ago, but a student appeared in my office, you know, desperately and eagerly wanting to speak with me. They seemed kind of distracted and almost, in retrospect, like the blood had drained out of their face. So, they urgently wanted to meet with me. They had just returned from an away rotation where they did a pathology rotation. They were a fourth-year student, and it was a great rotation. They really enjoyed it. One of their responsibilities was to meet with patients who were participating in a longitudinal study where they had to give blood samples periodically.
So, at any rate, the student’s job was to meet with these patients, talk with them, and all of that. And this one patient asked Megan, and it’s Megan, you know, “Megan, can I be honest with you?” And of course, she said, “Sure.” And the patient said, “Megan, you’re not a pathologist.” And she was so taken aback. But he said, “Look, you know, you have wonderful interpersonal skills. You’re so good at what you do, and you really need to put those to good use in a field that offers more opportunities for interpersonal interactions than what pathology does.” So, that was the situation. Her pathology application was all ready to go and all of this, but she felt like her boat had been rocked.
Clearly, she listened to her patient and was taking it to heart, and she was really struggling with, “Well, now what do I do?” So that was the impetus for that.
Kevin Pho: So, when she came to you telling you about the story, how did you react and what did you say to her?
Janet Jokela: Yeah, yeah, yeah. So, we had a really interesting conversation, and she was a strong, talented student who could have gone in any direction she wanted to. But clearly, I could tell that her boat was rocked, and what the patient said to her had a profound impact. We talked about how the patient had the courage, the willingness, and the honesty to be kind and compassionate with her. On some level, she knew the patient was right. She and I had talked many times before about her career direction, and she liked what she perceived as the certainty of pathology. It was perhaps less messy—meaning she wouldn’t have to work so hard with patients and navigate all the gray areas of medicine, which isn’t black and white.
But at the same time, she knew she loved the patient interactions that the patient had identified and accepted that insight. So, we talked through it, and she realized she had to make a change. And she did, and the rest is history.
Kevin Pho: Now, you work with medical students all the time. How often do they change their career plans? Do you find that a lot of them come into medical school with a set path, and if so, do you see that path change as they go through different rotations? How malleable is their career path?
Janet Jokela: That’s an important question, and it varies. I think for most students, their ideas become more solidified as they get into their third-year clerkships, especially during clinical rotations. Some students come in knowing what they want and stay on that path, but others are open-minded and explore during their clerkships, solidifying a path at that time. Some, like Megan, change their mind abruptly during clinical rotations. Others change after they match into residency, sometimes a year or two into it. And some change even after completing residency.
The majority of students stay on a straightforward path, but there are those who change, and that’s a good thing.
Kevin Pho: Can I ask what career path this medical student eventually chose?
Janet Jokela: Yeah, she ended up going into dermatology. She would have made a wonderful internal medicine physician, and she knows that. But she chose dermatology, where she had done some research, and it all fit together and made sense. Megan has done incredibly well in that field.
Kevin Pho: How do you advise medical students to regularly assess whether their career alignment matches their skills, values, and long-term goals? Do they have check-ins with mentors like you to see if they’re on the right path?
Janet Jokela: A lot of it is personal regarding what they aspire to and value, and where they see themselves. I advise students to consider how they feel during clinical rotations. When working with residents and attendings, I ask them to think: “Do you want what they have? Do you want to be the kind of physician they are?” That reflection can help guide them.
For students stuck between specialties, I recommend writing a personal statement for each option. Which one flows easier? Which one feels like a better fit? That can be eye-opening.
Kevin Pho: Sometimes, medical students have to make career decisions without fully knowing what a specialty is like, right? Does that happen often when you teach them, where they’re making significant choices based on limited data?
Janet Jokela: Absolutely. I encourage students, if their circumstances allow, to do an away rotation at a place where they may want to do residency. It provides insight and a different perspective. Just because a student had a certain experience in one setting doesn’t mean it’s the same everywhere. Away rotations can inform students and help them understand what’s out there.
Kevin Pho: In the story, a patient gave Megan that light bulb moment. Did she have doubts before, or did the patient solely convince her?
Janet Jokela: She had heard from others, including me, that she had many talents that would be an asset to different specialties. But hearing it from a well-educated, savvy patient made her realize, “Oh my goodness, what am I doing?” The patient’s words carried weight and gravitas. Megan was willing to listen and consider the patient’s input, which speaks to her character. I’m grateful the patient had the courage to speak up.
Kevin Pho: You mentioned earlier that medicine can be messy. Talk about the times when interns or residents changed their career path and found success in a different area.
Janet Jokela: It’s so important to remember that we always have options. We don’t have to stick with something that isn’t fulfilling. Starting medical school, I thought some things would be straightforward, but they weren’t. Patients may not be ready for certain treatments, or insurance issues may limit options. There’s a lot of ambiguity and soft edges in medicine, and that can be challenging for students. Supporting patients through those challenges is essential.
Kevin Pho: There are factors outside clinical medicine, like reimbursement and private equity. Are medical students considering these when choosing their career path?
Janet Jokela: Absolutely, and it saddens me, especially for primary care. Primary care physicians bear many burdens. Students see this; they’re bright and aware of these issues. That’s why some students are drawn to specialties where these burdens aren’t as significant. For students who remain committed to primary care despite these challenges, it warms my heart.
Kevin Pho: As a mentor, how do you discuss these realities with students?
Janet Jokela: That’s where specialty societies like the American College of Physicians can help. They support students’ decision-making and exploration. Specialty societies offer valuable resources and insights that can guide students as they decide on their path.
Kevin Pho: We’re talking to Janet Jokela, an infectious disease physician and treasurer of the American College of Physicians. Today’s KevinMD article is “How one medical student’s life-changing conversation reshaped her career.”
Janet Jokela: Thank you, Kevin. The biggest takeaway is that we can change our mind and have options. We don’t have to stay in a position or field that isn’t fulfilling. It’s also essential for students to remember, during residency interviews, that they are interviewing the program too. It’s a two-way street.
Kevin Pho: Janet, thank you for sharing your story and perspective. Thanks again for coming back on the show.
Janet Jokela: Thank you, Kevin. So appreciated.
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