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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 she’s a treasurer of the American College of Physicians. Today’s KevinMD article is “How one medical student’s life-changing conversation reshaped her career.” Janet, welcome back to the show.
Janet A. 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 who didn’t get a chance to read it.
Janet A. Jokela: Sure, sure, my pleasure. This was a situation that occurred a few years ago now, but a student appeared in my office, you know, desperately and eagerly wanting to speak with me. They seemed kind of distracted, and even, 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.
At any rate, the student’s job was to meet with these patients, talk with them, and all of that. This one patient asked Megan, and it’s Megan, you know, “Megan, can I be honest with you?” Of course, she said, “Sure.” The patient said, “Megan, you’re not a pathologist.” 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 she was taking it to heart, and she was really struggling with, “Well, now what do I do?” So that was the impetus for that.
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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 A. Jokela: Yeah, so we had a really interesting conversation. She was a strong, talented student, and she really could have gone any direction that she wanted to. But clearly I could tell that, again, her boat was rocked, and what the patient said to her really had had a profound impact on her. So we talked about that, and we talked about how the patient had the courage and the willingness and the honesty to be kind and compassionate with her.
I think on some level she knew that the patient was right. She and I had talked many times before about what direction to go and everything else, and she liked what she perceived to be the certainty of pathology. It was perhaps, for lack of a better word, less messy in some ways, and she wouldn’t have to, you know, work so hard with patients and all the gray in medicine. It’s not black and white; there’s a lot of gray, all the uncertainties and things with patients. But at the same time, she also knew on some level that she loved that. The patient identified that, and in some ways the patient exposed that to her, and she knew on some level the patient was right. So we talked through that, 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, of course, 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 often change as they go through different rotations? Like, how malleable is their career path?
Janet A. Jokela: That’s an important question, and it varies. I think for most students, as they go along in medical school, their ideas may become more solidified as they get into their third-year clerkships especially, and their clinical rotations. So there are certainly some students who have an idea before they start of what they want to do, and they stay on that path, and they’re there, and that’s what they do.
I think, on the other hand, there are a number of students who are really open-minded about what they want to do, and they explore it during their clerkships and then solidify on a path forward at that time. There are students I know of who, similar to Megan, changed their mind abruptly, perhaps during their clinical rotations, their clinical clerkships. Some I know did change their mind after they matched into residency, so a year or two down the road after that. And some, as we all know, would change their mind after they’re done with residency. So it varies. I think the majority of students kind of stay on a straightforward path, but there are some who change, and that’s a good thing. That’s a good thing.
Kevin Pho: And can I ask you what career path this medical student eventually chose?
Janet A. Jokela: Yeah, they ended up going into dermatology. Yeah, they would have made a wonderful internal medicine physician, you know, and they know that. They ended up choosing dermatology, and they had done some research in derm, and it all kind of fit together and made sense. And yeah, Megan has done incredibly well, incredibly well, in that field.
Kevin Pho: So how do you advise medical students to regularly assess whether their career alignment matches their personal skills, values, and long-term goals? Is there a set way? Do they have, like, check-ins with mentors like yourself to see whether they’re on the right path or not?
Janet A. Jokela: Yeah, a lot of it’s so personal in terms of what their aspirations are and what they value and, you know, where they see themselves going. One thing that I’d like to advise students on is, as they’re going through their clinical rotations, just how does it feel? With the residents that you’re working with and the attendings that you’re working with, the question is, do you want what they have? And do you want to become the kind of physician that you see these residents and the attendings, you know, the type of physicians that they are? Do you want that? Is that what you aspire to for yourself? That’s often, I think, a good measure of where a student may end up and what they may like and what they, you know, are gravitating toward.
If there’s a student who, by the time, say, they’re approaching their fourth year, really doesn’t know, and they’re stuck between, you know, one specialty and another, one piece of advice that we’ve shared with them is to try writing a personal statement. Write a personal statement for specialty X, and then write a second personal statement for specialty Y. Then which one flowed easier? Which one was easier to write, and which one feels like a better fit for you? Sometimes that is kind of eye-opening as well.
Kevin Pho: Sometimes these medical students have to make career decisions without really knowing what it’s like to be in a particular specialty, right? So, you know, you get, like, whatever, a four-week rotation in dermatology, but does that really give you the taste of what it’s like to be a dermatologist? So does that happen a lot when you teach the medical students, that they’re really making these life-defining choices based on a limited set of data?
Janet A. Jokela: Absolutely, absolutely. One thing I like to encourage students to do, regardless of whatever specialty they’re leaning toward, assuming their circumstances permit, their schedules, finances, all of that, is to do an away rotation somewhere else, somewhere where you think you may want to do residency, and just experience it somewhere else, and you can see what it’s like. Just because a student has experienced a certain clinical rotation and clinical experience in the setting where they are doesn’t mean that it’s fixed that way in every single clinical setting elsewhere.
So I think by doing an away rotation somewhere else, it gives students the inside knowledge and the understanding that things may be different in other places. I think it provides a more informative opinion and understanding of what’s out there and what’s awaiting them.
Kevin Pho: So in this story that you told, it was actually a patient that gave her that light bulb moment, that she should maybe put her interpersonal skills to a field other than pathology. She must have had a little bit of doubt before going in, or did that patient solely convince her?
Janet A. Jokela: Well, I think, in many ways, there are a number of us who chatted with Megan along her path and emphasized to her that she had an incredible number of talents and skills that would contribute to her being a wonderful asset to a number of different specialties. So she had heard this before, but I think for her to hear it from this well-educated, very savvy patient, it was suddenly like, “Oh my goodness, what am I doing?” The patient’s words had a certain gravitas to her, which, again, I think speaks to her character and who she was. You know, she was willing to be open-minded and listen to that patient, and thank goodness the patient had the courage and the willingness and the honesty to speak with her about this.
Kevin Pho: One of the adjectives I used earlier was “messy,” and I think that’s something that I want to explore, because, as we both know, medicine can be messy. It’s often not the straightforward path that pre-med students and medical students go through to get into medical school. So talk about some of the things that you’ve seen, the stories that you’ve seen, where perhaps an intern may have changed their career course and may have reconsidered what they were going to initially do. Talk about some stories where it’s OK to change your mind and still be successful with a career in medicine.
Janet A. Jokela: Oh, absolutely, it’s so important. I think it’s critical that any of us, whether we’re medical students or somewhere else, you know, along our career path, remember that we always have options and we can always change our mind. Just because we settle on a certain specialty or a certain place of employment or whatever it may be, it doesn’t mean that we have to stick with that indefinitely. We can always change our mind.
I don’t know about you, Kevin, but for me, starting medical school, it was really interesting. I expected in some ways that things would be very black and white or clear-cut in terms of how to handle certain circumstances. But as we all know, that’s not necessarily the case. You know, patients may not be ready for a certain therapy or medication, or there may be insurance-related issues that would prevent us from prescribing a certain medication or treatment, or whatever it might be. And so there are a lot of soft edges around these things that we have to decide and do for patients; it’s not necessarily clear-cut. That can be hard, I think, especially for students early on, to see and to struggle with, that there may not be a clear-cut answer, a clear-cut way forward. And so however we can support patients through that process, I think, is really important.
Kevin Pho: Now, another question to follow up on the messiness of medicine. As you know, there are a lot of factors outside of clinical medicine that influence the profession. It could be reimbursement; it could be a takeover by business interests like private equity. Are you seeing medical students consider some of these nonclinical aspects influencing their choice of career path going forward?
Janet A. Jokela: Oh, absolutely, absolutely. In many ways, it saddens me, especially as far as primary care is concerned, because I think that primary care physicians especially are burdened by so many of these outside forces, and students see that. You know, our students are bright, they’re savvy, they can see; they see what’s going on. I think, for a number of those reasons, that may be in part why students are drawn to some of the other specialties, where some of those things are not as burdensome as they are in primary care. So that said, for students who are really committed to primary care despite knowing that all this other stuff is going on, it warms my heart. It absolutely affects students’ choices; I’m convinced of that.
Kevin Pho: And as a mentor, how do you talk to these students about some of the realities of practicing medicine that they may not be aware of?
Janet A. Jokela: Yeah, I think that’s where, for instance, the American College of Physicians can come in handy and play a really important role for students in their decision-making, and, you know, what we do. I’m sure that’s true of, you know, all of our specialty societies in that way. I think the specialty societies in particular can really help support students’ decision-making and exploration of these different fields as students try to make decisions about, you know, “Do we turn right? Do we turn left? Or, you know, what do we do?” The specialty societies have a tremendous amount of resources and insights that I think can be quite informative for students as they’re trying to make these important decisions.
Kevin Pho: We’re talking to Janet Jokela. She’s an infectious disease physician, and she’s 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, as always, we’ll end with some take-home messages for the KevinMD audience.
Janet A. Jokela: Sure, thank you, Kevin. I think the biggest take-home message is we can always change our mind. We always have options. We don’t have to stay in a position or a field that doesn’t feel right to us, or that isn’t fulfilling in the way that we had hoped or expected. So I think that’s critical.
In addition, for students, when students go out on their interviews to interview for residencies, I just want the students to remember that you are interviewing them as well. It’s not just a one-way street, and that’s critically important.
Kevin Pho: Janet, as always, thank you so much for sharing your story, time, and perspective, and thanks again for coming back on the show.
Janet A. Jokela: Thank you, Kevin. So appreciate it.
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