When I started medical school, I pledged to take care of anyone who would walk through the door. I pledged not to discriminate between my patients and to advocate for them both inside and outside the clinic. Like many first-year medical students, I entered medicine with a certain idealism. I believed medicine was fundamentally about serving those who needed care most, and I assumed everyone around me would agree with that.
The day I received my white coat, my medical school deans emphasized our school’s mission of advocacy, equity, and anti-racism. They encouraged us to speak up when we witnessed injustices in the hospital or in the world around us. They reminded us that our voices would soon carry weight. I remember sitting there full of hope and conviction, feeling grateful that I had finally entered a profession aligned with the values I had always hoped to uphold.
Four years later, I still believe in those values. What has changed is my understanding of how fragile they can be.
I loved every stage of medical school. Whether studying late into the night, speaking with patients, or scrubbing into surgeries, I felt a deep sense of purpose. I developed passions for patient education, women’s health, and advocacy. I was surrounded by brilliant, compassionate classmates who genuinely believed we could improve the systems around us. We felt invincible, ready to shape the future of medicine and confident in our ability to do so.
Now, as I graduate from medical school, I leave with invaluable clinical experience and a far clearer understanding of the realities of practicing medicine today. I have grown as a clinician, a scientist, and a person. Yet instead of feeling inspired and energized, I find myself deeply unsettled.
My medical education unfolded during a time when hospitals no longer felt like guaranteed safe havens for every patient and when scientific evidence itself increasingly became politicized and contested. I sat through trainings on how to respond if immigration officers interrupted clinical care. I listened to patients describe delaying care out of fear. I watched trusted public health information about contraception and sexually transmitted infections disappear from platforms I once relied on for patient education. I saw mentors face legal threats for providing evidence-based care, research projects lose funding, and scientific priorities shift in response to political pressure rather than patient need.
When access to health care becomes more limited, when misinformation spreads faster than evidence, and when physicians feel constrained in speaking openly, patients are the first to suffer. As I witnessed these consequences and the growing disillusionment among trainees, I could not ignore what these changes were doing to the future of medicine. Yet, I often sensed hesitation where I expected outrage and uncertainty where I hoped for guidance.
As I enter residency, I understand that being a physician carries responsibilities that extend beyond diagnosing disease and prescribing treatment. Our work does not end at the bedside or in the operating room. Beyond our training, our diagnoses, and our procedures, we are physicians in a system that depends on our willingness to advocate for evidence, for access to care, and for the patients we serve. On my first day of medical school, I was told that my voice mattered. Today, I intend to use it.
Agathe de Pins is a physician.
