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The Message America's Future Doctors Need to Hear

The University of Michigan medical students who walked out of their white coat ceremony missed a transcendent lecture about staying human in an age of machines.

Dr. Kristin Collier is an assistant professor of internal medicine at the University of Michigan, where she has served on faculty for 17 years. She also is the director of the medical school’s Program on Health, Spirituality and Religion and has been published in publications including the Journal of the American Medical Association and the Annals of Internal Medicine.

Many describe her as a consummate physician and superb teacher—deeply liked and respected by her peers. That’s why, out of some 3,000 faculty at Michigan, Dr. Collier was chosen by students and her peers to be this year’s White Coat Ceremony speaker. The White Coat ceremony is one bookend of medical school (graduation is the other), where students put on their white coats for the first time, take a modified Hippocratic oath and begin the long path to becoming a doctor. 

The trouble is that Professor Collier has views on abortion that are out of step with many Michigan medical students—likely the majority of them. She has stated that she defines herself as pro-life, though she does not state the extent of her position (i.e. whether she allows exemptions for rape or incest). In that same interview, in which she talks about her personal transformation from a pro-choice atheist to a Christian, she laments the intolerance for religious people among medical colleagues. “When we consider diversity in the medical profession, religious diversity is not—should not—be exempt from this goal.”

After Michigan announced her speech, the university made it clear that Dr. Collier would not be addressing abortion in her talk. “The White Coat Ceremony is not a platform for discussion of controversial issues, and Dr. Collier never planned to address a divisive topic as part of her remarks,” the dean of the medical school, Marshall Runge, wrote to students and staff earlier this month.

That didn’t stop hundreds of students and staff from signing a petition demanding Dr. Collier be replaced with another speaker. “While we support the rights of freedom of speech and religion, an anti-choice speaker as a representative of the University of Michigan undermines the University’s position on abortion and supports the non-universal, theology-rooted platform to restrict abortion access, an essential part of medical care,” they wrote. “We demand that UM stands in solidarity with us and selects a speaker whose values align with institutional policies, students, and the broader medical community.”

The school stood firm. But on Sunday, just as Dr. Collier rose to give her remarks, dozens of students and family members began walking out of their white coat ceremony.

By now we are all accustomed to such displays from American students. The particular shame here is that those who walked out missed a transcendent lecture about the meaning of practicing medicine in a culture that increasingly treats human beings like machines.

“The risk of this education and the one that I fell into is that you can come out of medical school with a bio-reductionist, mechanistic view of people and ultimately of yourself. You can easily end up seeing your patients as just a bag of blood and bones or human life as just molecules in motion,” Dr. Collier said.

“You are not technicians taking care of complex machines, but human beings taking care of other human beings,” she said. “Medicine is not merely a technical endeavor but above all a human one.”

I urge you to watch the whole thing here, beginning at 1:45:50:

Dr. Collier has handled the whole thing with grace. She tweeted yesterday: “I’ve heard that some of the students who walked out have been harassed and targeted—please stop. Everyone has a right to stand up for what they believe in.” 

I do not share Dr. Collier’s faith or her views on abortion. But ultimately, the decision of students to walk out of the lecture because they disagree with the speaker on another topic has no limit. 

In medicine, abortion is an important life or death issue. So too is universal health care, immigration and school closure. All these topics have the highest stakes. And all are controversial. If students walk out on speakers discussing unrelated issues, where does it end?  Would they learn about the nephron from a nephrologist who favors strict immigration limits? Could they learn how to perform CPR from an instructor who lobbied to keep schools open during Covid-19? 

Most concerning, what does it mean for American patients, if their future doctors cannot sit through a speech by a beloved professor who has a different view on abortion? Could you trust a physician knowing that they may judge you for holding views that they deem beyond the pale?

As a professor at UCSF medical school, I worry deeply that we are not preparing our future doctors for practicing medicine on real people in the real world. Medicine has to meet patients where they are; often that means caring for people and working with people with whom we disagree. We can’t walk out on that.

The state of American medicine is a subject of profound importance to all of us.

If you missed Katie Herzog’s excellent reporting on the topic, we highly recommend:

What Happens When Doctors Can’t Tell the Truth?

Med Schools Are Now Denying Biological Sex

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