The song from the Broadway musical Hamilton, “(Yorktown) The World Turned Upside Down,” is stuck in my head. Indeed, these are no ordinary times. We have a measles outbreak in the U.S. that has resulted in numerous hospitalizations and now deaths. With censorship at the CDC, disruption of vaccine-related meetings, cancellation of active research grants, health impacts due to global aid interruptions, universities freezing hiring and graduate student admissions, and more, we are witnessing attempts to dismantle the crown jewels of the U.S. (and the world’s) biomedical research and public health infrastructure, the likes of which we have not seen before.
All of this raises many questions, of course. My thoughts turn to our graduating medical students and Match Day, this year scheduled for March 21, 2025. This is a day filled with anticipation and excitement, and emotions range from disappointment to over-the-top joy. What is our responsibility as physicians to these graduating students? Indeed, what is our responsibility to ensure that these students’ contributions to advancing medicine and providing the best possible care for patients will be encouraged, supported, and embraced?
The answer is that we all have a responsibility. This means that in addition to caring about our younger colleagues’ futures, we also care about their north star—their future patients. We took this pledge when we took our oath upon graduating from medical school. We are compassionate, empathetic physicians who do our best for patients.
So, what is being done to protect our students’ future, our profession, patients, and the advancement of science? Here are three examples of actions taken by medical journal editors, professional societies, and colleagues.
Medical journal editors have sounded the alarm. The editorial team of Annals of Internal Medicine published “Damage Control in the Wake of Political Action Which Threatens the Integrity of Medical Research.” They state, “The integrity of U.S. government-funded medical research, perhaps its very existence, is uncertain in the wake of a torrent of executive orders that have flowed from the White House since Inauguration Day 2025.” They go on to describe the onslaught of daily issues the editorial team faces, from government employees requesting that their names be removed as authors on papers to email communications with authors being returned as undeliverable. I urge you to read this article.
What are professional societies doing in this milieu? Many have been criticized for a lack of action, not enough action, or not the right kind of action. Here is the ACP’s site, which shares recent advocacy efforts undertaken to address concerns. This recent Ideas and Opinion piece in Annals of Internal Medicine, “International Medical Graduates Are Integral to the Delivery of Patient Care in the United States,” describes the critical role international medical graduates play in the U.S. health care system. Any looming travel restrictions or deportation threats must not impact this vital group that comprises our physician workforce.
And what about our many colleagues? What actions are they taking? Colleagues at the American Association of Medical Colleges successfully obtained a temporary restraining order to block the proposed cuts at the National Institutes of Health. Some colleagues are writing informative pieces or letters to the editor, others are doing podcasts and attending pro-science rallies. Social media is abuzz with concerns. Many colleagues are regularly calling their congressional representatives. Others are learning about how to discuss health issues more effectively with our patients and the public, and some are serving as allies to biomedical researchers, who have been hit hard by the instability and threats of lost funding. Many are doing these things while tending to the tasks at hand, which include, first and foremost, taking care of patients.
This Match Day 2025, we will celebrate with our students, as we usually do. What the future holds for them, of course, no one knows. The current environment continues to change rapidly. Just like Alexander Hamilton, though, we possess the power of the pen, and we have a voice. It is our responsibility to use them.
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.
The American College of Physicians is the largest medical specialty organization in the United States, boasting members in over 145 countries worldwide. ACP’s membership encompasses 161,000 internal medicine physicians, related subspecialists, and medical students. Internal medicine physicians are specialists who utilize scientific knowledge and clinical expertise for diagnosing, treating, and providing compassionate care to adults, spanning from those in good health to individuals with complex illnesses. Stay connected with ACP on X @ACPIMPhysicians, Facebook, LinkedIn, and Instagram @acpimphysicians.
