Essay 1) If you are not a full-time student during this application cycle, in particular at any time between August 2023 and July 2024, please detail your current and planned activities below. (500 words max)

Essay 2) The medical profession is frequently described as being both a science and an art. One could summarize this by saying that patients must “be well cared for” (science) but they must also “feel well cared for” (art). We work to teach our students not only the scientific principles of medicine, but also the core values of medicine, often called “professionalism”. Toward this end we keep patients at the center of our education and often reflect on their stories with our students.The exciting advances in our understanding of the biological basis for disease have led to the emergence of a host of targeted therapies and amazing technologies improving the duration and quality of our patients’ lives. The better a physician knows his/her patient, the better decisions they will make together as they approach important healthcare related questions. This so-called shared decision-making model is one key feature of patient centered care. Practicing the art of medicine in this way yields a physician patient relationship (PPR) that is both therapeutic and mutually enriching. However, many of these same technologies have the unintended consequence of separating us from our patients, both literally and figuratively. In addition, the industrialization of medicine and use of electronic health records have led to a decrease in the time physicians spend with their patients further eroding the strength of the PPR.

At the UFCOM, we have many strategies to equip our students to preserve their own humanity and that of their patients. One of the most important is the ability to make connections with and get to know their patients. Frequently such connections become the student’s first taste of the joy of medical practice. In fact, the UFCOM version of the Hippocratic Oath includes the following affirmation. “I will remember with gratitude and humility those whose illness or injury provided examples from which I learned, and, in their honor, I will continue the pursuit of knowledge.”

In our polarized society, the importance of such virtues as humility and gratitude have perhaps never been greater. Over the last two decades, the Greater Good Science Center at the University of California Berkeley has offered strong scientific support for the importance of such virtues as gratitude and humility in human well-being. But it should also be remembered that philosophers and theologians have cherished these virtues for centuries. For example, when mounting a legal defense for a friend, Cicero observed, “while I wish to be adorned with every virtue, yet there is nothing which I can esteem more highly than the being and appearing grateful. For this one virtue is not only the greatest, but is also the parent of all the other virtues.” Offering a similar endorsement for the virtue of humility, Augustine of Hippo observed, “Humility is the foundation of all the other virtues hence, in the soul in which this virtue does not exist there cannot be any other virtue except in mere appearance.”

Students at UFCOM regularly write about and discuss encounters with patients that shape their professional identity in important ways. In so doing, we all learn to become better physicians and human beings.
Here are two such reflections, by our students, one a poem and the other an essay. Read and reflect on both and then choose one and describe how the writer grew from the experience. Consider the affirmation from the Hippocratic Oath in your response. (500 words max)

Reflections – from the University of Florida College of Medicine:

Reflection #1

Again, Next Saturday A pit of nerves in my stomach before we met. A frigid Friday in Florida; the sun’s yellow warmth shone on me. Orange polo and khakis, pacing to my red car, driving to the ALF where you and your wife lived. I got lost, mispronounced your surname at security, and wondered what else I would botch.

My year before medical school, I began to volunteer with hospice as an aspiring oncologist. I wished to comfort those in the most uncomfortable setting – green, naive, eager. Prior to meeting you, for five months, I spent Friday mornings at the bedside of patients actively dying. Gravely white, cold walls surrounded each patient as they mustered final, fleeting breaths. I felt helpless, tried making a difference, holding pale hands in final moments when a family could not. Blue, rudderless, useless – each shift I left wondering if I helped. I heard about home visits: volunteers were assigned a patient and would meet them weekly. A soft, sweet voice answered my call – I spoke with your wife and overheard you ask who was calling. Next Saturday, we would meet.

I knocked on your front door – “come in!” The weather channel on, brown blinds cracked, dusted black and white family portraits. You sat: tall, frail, sunken in a recliner, yet full of life with a grand smile. You wanted to go for a walk outside – this would become our routine. Your wife showed me how to help you from your chair to your walker – “nose over toes.” Slowly, out of breath, leaning on your walker, shaking arms with purple patches – “take your time.” To the toilet, then to your walking clothes, and finally to assemble your Swiss-army walker: Tissue box, snacks, extra sunscreen, a grabber-reacher – you triple-checked that we had it all. “Let’s boogie!”

We began our first walk – 10 steps in, we turned around – we forgot your sweater. Embarking again, we slowly shuffled by the navy pond to the gazebo. We chatted in the shade about your life as an engineer, how you met your wife, your six daughters. My face hurt from smiling as you lured in a family of ducks with wheat bread. Once 2 o’clock hit, it was time to boogie for your late snack – “nose over toes.” You had a shortcut back you were excited to show me. Back to your living room, exhausted, but still sporting a smile – “again, next Saturday.”

This was our routine each Saturday for two months, until one day, it was not. Your wife called on a Thursday morning – you had fallen, EMS had to help you up. You were being kept at the hospice center for respite care. I worriedly rushed over but was relieved to find you smiling, tired, with no major injuries. We sat and talked like old times – you were excited to return home for us to walk again. I saw you again Friday morning – you seemed more exhausted with only a weak smile – “I’m A-okay.” Friday night, something didn’t sit right – I drove back to see you and found you tired, but comfortable. We chatted until you fell asleep – I said goodbye, uneasy, though unsure why.

The next morning, Saturday, I walked to your room – your wife and six daughters solemnly greeted me. “He just passed.” Knees buckle, clear tears puddle on the floor, I try to hold it in – beige tree moss sway by the window. Motionless, peaceful – encased by the warmth of family and loved ones – blocking the bleak white walls. I hugged your family – “we never saw him as happy as he was the last two months.”

We all embraced again – I offered my condolences, went home thinking that was the end of our chapter.

A few weeks went by – I received an email from your wife about your funeral. I felt uncomfortable – not family, only present for two months of your 89 years. Another cool Florida morning – I drove to the cemetery, a winding gray gravel path, forgetting my blazer. Deep in the forest green – walking to your grave, sun rays seeping through, your warmth shining on me. During your eulogy, your wife thanked me for being the son you never had. I only visited, walked, talked – I never thought things so simple could make such a difference. I thanked you for your lessons, and I vowed to come back to visit – again, next Saturday

Reflection #2

It was the last day of my surgery rotation, and the last day on the Trauma service. I was feeling quite tired that day and nervous about my oral exam scheduled at 3pm, and I remember thinking, “I just need to survive today.” Then right around 12pm, the pager went off. It was a Level 1 Trauma Alert. The message read: 25yr M motorcycle crash, unresponsive, CPR on scene. At the trauma bay, the senior resident briefly walked me through the Trauma Algorithm, explaining how it was unlikely the patient would recover after CPR >10mins in the setting of blunt torso trauma. Things happened so fast. The patient arrived, cardiac activity was observed and it was all hands-on deck trying to save his life. I jumped in cutting away his jacket, jeans, and gloves, discovering injury after injury, scrapes, and broken bones. I saw the trauma attending intensely focused trying to place a femoral line. I saw the trauma residents quickly placing chest tubes. I saw nurse after nurse performing CPR. And suddenly, everyone stopped. The resident called the time of death and asked us to hold a minute of silence. I stood there, and I felt heavy. I tried to put a name to the emotions I saw across the room, and I realized I could not name my own. This was the first patient I witnessed die, and I just felt heavy. It wasn’t until I made it back to the call room that the tears finally kicked in.

This experience affected me as I think it affects all medical students. That was the first time a patient had died in front of me, and even though I was technically part of the team trying to save his life, I felt useless. I remembered how much I hated that feeling. One of the reasons I decided to apply to medical school was to avoid feeling useless again…like I did when I was little, when my sister died of a ruptured cerebral aneurysm. Then I felt guilty. Guilty for thinking that finishing my surgery rotation was equivalent to fighting for survival. Guilty for thinking only of how I was feeling in that moment. He was someone’s son, maybe someone’s brother, and he had died at 25 years old all alone. I began to imagine what his family would feel when they got that phone call, and my heart sank. I am grateful to have had a supportive classmate find me in the call room. He allowed me to cry it out, to sit with all those feelings, and to find a way to move forward to face my other responsibilities.

I was no longer worried about the oral exam. It felt so trivial now; however, it made me consider another hardship of this profession. We are expected to bounce back so quickly. To process all those feelings in an efficient way so that we can step into the next patient’s room and give it our 100%, all over again. Sitting here today, I have my doubts if I will one day be able to “efficiently” process the loss of a patient. I hope I continue to remember that heavy feeling. I believe it will keep me motivated to learn as much as I can throughout my career, to make sure I give each of my patients the absolute best care possible. This reflection exercise made me realize that I must also continue to hold space for myself and for my colleagues. It is okay to feel all those emotions. Taking the time to reflect on those moments will help us remember what is important to us as future physicians.

Essay 3) The profession of medicine has always had an explicit contract with society about our expertise and competence but it also includes an important affirmation. Namely, that we will subordinate self-interest to patient interest when the needs of our patients require us to do so. This does not mean we do not take care of ourselves and one another, but it does mean we willingly take on risks to ourselves that many others would not. The COVID-19 pandemic has brought this commitment to light as many medical professionals labored on the front lines caring for the sick despite the potential dangers.

When we consider medical practice and hence, medical education, one could ask what sorts of virtues or character traits equip young medical professionals for such a noble calling. Many come to mind including courage, compassion, intellectual honesty and integrity. But recently attention has been given to the ability to stay with a task or course even when one is tired, discouraged and the work is daunting and laborious. Terms such as “resilience”, “endurance”, “perseverance”, “determination” or “grit” describe this character trait. Dr. Angela Duckworth has explored this in detail in her book “Grit: The Power of Passion and Perseverance” (Angela Duckworth). Cultivating this virtue, in ourselves and one another, offers a tangible means to lean against the depersonalizing and emotionally exhausting forces at work in healthcare.

As physicians, we have the privilege of caring for people who are in the most difficult places of their lives. Being present during these times can be both a source of joy as we help our patients, but can also challenge our own emotional health and resilience. Struggling to make sense of suffering induced by disease, social forces and human agency has brought an occasion for growth among many of us who work in healthcare.

As you grow into your new identity as a physician, you will come face to face with the suffering of other human beings. In fact, we will all have to face our own losses as we go through medical training and practice. Put simply, none of us is exempt from suffering. As the Nigerian novelist Chinua Achebe (1930-2013) once observed, “When suffering knocks at your door and you say there is no seat for him, he tells you not to worry because he has brought his own stool.”

Holocaust survivor and renowned psychiatrist Viktor Frankl, (1905-1997) wrote an account of his time in the concentration camp called, “Man’s Search for Meaning”. It has sold more than 10 million copies in 24 languages and offers profound insights into how finding meaning in suffering sustains us during our darkest times.

Below are several quotes from Dr. Frankl that deal with finding purpose and meaning in suffering.After reading and thinking about his insights, chose one or two and tell us about experiences where you have seen these principles at work either in your own life, or in the lives of others. (500 words max)

“Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.”

“If there is a meaning in life at all, then there must be a meaning in suffering. Suffering is an ineradicable part of life, even as fate and death. Without suffering and death, human life cannot be complete.”

“A man who becomes conscious of the responsibility he bears toward a human being who affectionately waits for him, or to an unfinished work, will never be able to throw away his life. He knows the ‘why’ for his existence, and will be able to bear almost any ‘how.’”

“Being human always points, and is directed, to something or someone, other than oneself – be it a meaning to fulfill or another human being to encounter. “

Essay 4) (Optional) If you think there is any additional information that would help the admissions committee in its review of your application, including any disruptions in your academic/volunteer/work/personal life related to COVID-19, please use the space below. (4,000 characters max)

Essay 5) (If applicable) If you are not a legal resident of Florida according to your AMCAS application, write a statement describing your association with the State of Florida below. This statement is required even if you have no ties to the State of Florida. (no word limit)

Essay 6) (If applicable) Reflect upon your life experiences, values and/or personal background. Do any or all of these help frame how you envision your future contributions to the health and wellbeing of others as a physician and if so, how?  (500 words max)

Essay 7) 

Read the following description of introversion and extraversion from the Myers-Briggs foundation website. Most people, while seeing themselves to one degree or another in each description, are inclined towards either being introverted or extroverted. Both groups make wonderful physicians, but each personality type has some inherent strengths and weaknesses which need to be appreciated as individuals develop into practicing physicians. Indicate using the checklists below to what extent you see yourself as more of an extravert or an introvert.

Extraversion (E)

I like getting my energy from active involvement in events and having a lot of different activities. I’m excited when I’m around people and I like to energize other people. I like moving into action and making things happen. I generally feel at home in the world. I often understand a problem better when I can talk out loud about it and hear what others have to say.

The following statements generally apply to me:

• I am seen as “outgoing” or as a “people person.”
• I feel comfortable in groups and like working in them.
• I have a wide range of friends and know lots of people.
• I sometimes jump too quickly into an activity and don’t allow enough time to think it over.
• Before I start a project, I sometimes forget to stop and get clear on what I want to do and why.

Introversion (I)

I like getting my energy from dealing with the ideas, pictures, memories, and reactions that are inside my head, in my inner world. I often prefer doing things alone or with one or two people I feel comfortable with. I take time to reflect so that I have a clear idea of what I’ll be doing when I decide to act. Ideas are almost solid things for me. Sometimes I like the idea of something better than the real thing.

The following statements generally apply to me:

• • I am seen as “reflective” or “reserved.”
  • I feel comfortable being alone and like things I can do on my own.
  • I prefer to know just a few people well.
  • I sometimes spend too much time reflecting and don’t move into action quickly enough.
  • I sometimes forget to check with the outside world to see if my ideas really fit the experience.