Starting my training as an MD/PhD student at Yale, I expected long nights of memorizing biochemical pathways and drug mechanisms. I predicted challenging times learning how to care for patients in tough situations. But what I didn’t expect was just how difficult the current federal landscape would make this journey.
I felt this directly in early 2025. I came to Yale to study the health of LGBTQ+ populations. But when my PhD advisor was defunded by this administration’s initial attempt to cut funding for LGBTQ+ health research, I had to pivot. My previous advisor could no longer support me as a trainee. At the same time, a diversity supplement grant application I submitted to the NIH has been all but been forgotten by the funding agency. Access to funds for attending conferences, collecting and analyzing data, professional development opportunities (all gone).
But I have learned something potentially even more important than the research skills I would have gained: that advocacy is not only required if we want to truly help our patients but also required to keep our profession alive and well. Yet, advocacy training within medical school curricula is often treated as extracurricular endeavors or volunteer experiences.
The urgency of training physicians in advocacy couldn’t be greater. Donald Trump’s return to the White House has marked the greatest threat to not only the foundations of our health systems that serve patients but also the ability of the scientific community to generate evidence-based clinical practices. Only nine months into Trump’s second term, federal health research funding has become destabilized. According to one database, Grant Watch, 5,462 grants in total have been impacted in 2025 and over $2 billion in grant funds have been lost. As a result, the pipeline for trainees to become early-career physician-scientists, like myself, who rely on these training and development grants for resources and support has been greatly diminished.
If medical schools want to prepare trainees for the future we are walking into, they cannot remain neutral. Training future physicians to navigate (and challenge) the political landscape dictating health is not partisan; it’s pragmatic. Our advocacy is useless if we don’t have the skills to win support for evidence-based, equity-focused policies and practices. Right now, we are losing, and embracing advocacy as both a clinical competency and a vital lifeline for our profession and our patients is the path forward.
Medical education has taken some steps to evolve. The LCME, the body that accredits medical schools in the U.S., has taken a step in the right direction in requiring curricula addressing health disparities and equity. At Yale, where I’m part of the Health Equity Thread for our school’s curriculum, a new clinical elective focused squarely on health advocacy was recently approved for students to learn how legislative processes shape conditions that produce illness (and to participate in them). The American Medical Association’s Medical Justice in Advocacy Fellowship is another example of redefining what it means to practice medicine. Unfortunately, these are all exceptions, not norms.
Training institutions must do more. First, competency in health advocacy must be incorporated into medical education training, and accreditation entities (like the LCME) have a role in holding institutions to this standard. This could include simulated advocacy activities, such as writing policy briefs and engaging with legislative bodies. Related, creating pathways or certificates rooted in advocacy could also allow students with a particular interest to have more dedicated time and that can appear on their record and be valuable for post-graduation plans. Third, medical schools must provide protected time and resources for students, including but not limited to mentorship programs with physicians already doing this work, connections to local community organizations or larger organizations such as Physicians for Human Rights, and potential changes in curriculum that allow for trainees to engage in this work fully (not on the weekends or late-nights following other educational obligations).
As attacks on scientific integrity and health equity grow, medical education systems face a choice: either allow trainees to be passive technicians in a politicized system or equip them to be credible advocates for science and justice. Physicians and trainees must realize that any amount of trust they have earned means very little if they are silent on politics that harm our patients and undermine the profession. It’s time for medical schools to recognize advocacy as a core clinical skill (neither a hobby nor a volunteer extracurricular but an obligation). The health of our democracy, of patients, and our profession depends on it.
Tyler D. Harvey is a medical student.
