I sat in my pink childhood bed, my name still written in cursive above it from when I redesigned the room at seven years old, staring at the letter that shattered my dream. I had been dismissed from medical school for “professionalism” concerns. I didn’t know what came next. No roadmap. No support. Just the crushing reality that everything I had worked for was suddenly gone.

Medical education demands resilience and ethical conduct, yet professionalism standards remain vague and inconsistently applied, disproportionately affecting learners from marginalized and disabled backgrounds. Assessments lack standardization and often privilege conformity over competence. When I was dismissed from a U.S. medical school, I experienced profound emotional distress, financial hardship, and isolation—challenges many dismissed students endure.

Confronting the reality of dismissal

My childhood room, once filled with dreams and now a symbol of anxiety, greeted me as I walked through the door. Above my bed, my name was elegantly scrawled, a remnant of my seven-year-old self, dreaming of becoming a doctor—an aspiration that was beyond reach at that point in time.

Many people distanced themselves from me as I reached out for support, but a few private advocates were willing to go against the norm, which allowed me to challenge them and fight for change.

The power imbalance in medical institutions

Institutions work toward self-preservation at all costs, a lesson I learned the hard way. To remain in school, I had to offer written apologies or sit in meetings where I was interrogated and forced to admit guilt—while the entire session was recorded. These tactics protect institutions from taking responsibility.

Important choices were frequently made behind closed doors via unrecorded telephonic conversations that could have offered supporting material for my case. This was an eye-opening experience, and one of the important conclusions I reached is that, just as doctors waste their time and money protecting their patients with charts, students need to pay attention to every detail of their academic career-altering conversations, policies, or decisions using their own documentation.

Systemic barriers for marginalized & disabled medical trainees

Accommodating disabled medical students is a challenging task for many institutions, which often choose to ignore these students instead of providing meaningful support. Disclosure of disabilities can lead to penalties, and disabled medical students face severe structural obstacles when it comes to obtaining accommodations.

Vulnerable students face disproportional impact stemming from bias and exclusionary dismissals as some institutions overlook the success metrics they employ while considering their students who might be overcoming medical or personal challenges.

Such diverse, resilient physicians must be included in the medical field, as patients usually need care and understanding. These are the people who have faced difficulties and who can provide empathy towards their patients.

From rock bottom to resilience

At my lowest, I hadn’t eaten for days, weighed 40 pounds less, sent over 300 applications, and landed a single interview. I was beyond desperate.

The bleakest of situations can often lead to a light in the distance, and this was the case with my rock bottom. I was firm in my resolve: One administrative choice wouldn’t govern the rest of my life.

Rebuilding and advocating for change

To potentially match into a residency, I must own my past while demonstrating resilience. Medicine must reevaluate the concept of professionalism and provide clear, standardized review criteria that do not compromise due process.

Students should not have to contest mediation, mentorship, or even second chances. The system should provide these automatically.

Such fundamental practices can be changed in medicine by policies that enable constructive criticism and honest engagement.

A final call to action

To all medical students, residents, and physicians: document everything. From meetings and decisions to disciplinary actions, ensure there is a paper trail. Institutions always serve their own interests first, and you, too, must start thinking this way.

For those suffering in silence: This is not the final chapter of your story. You possess the ability to transform it.

Hannah Wulk transformed adversity into advocacy, turning a life-changing motor vehicle accident and a professional setback into a mission to reform medical training. A UCLA psychobiology graduate who conducted exposure therapy research in the Craske Lab under Dr. Imbriano, she completed two and a half years of honors psychiatry clerkships in a U.S. MD program—chairing the Student Advocacy Network for Disability Inclusion, Wellness and Resiliency, MD+ Partnerships, and the Psychiatry Interest Group—and is now finishing her MD at the American University of Anguilla while pursuing an MBA in health administration at Florida Atlantic University. She is the founder of TheSubtext.Studio (@hannahwulk · @thesubtext.studio) to promote peer support and resilience. She writes about trauma-informed care, clinician wellness, and equity, and is preparing for the psychiatry residency match to drive compassionate, system-level reform.