Editor’s note: This column is adapted from The Class of 1958 Commemorative Lecture that Dr. Ehrenfeld delivered to Harvard Medical School’s graduating MD class on this morning of Match Day.
Match Day is a special time of celebration as we reflect on the past—all of the hard work that has brought you to this moment—and look to a future that is complex, uncertain, yet filled with unlimited opportunities.
This is your day, and your moment. And no matter what happens from here, I assure you it’s a day you will never forget. Twenty years ago, I made the exact same transition you are making from medical school to residency—excited and quietly terrified for what would happen next. Had I made a huge mistake? Was I about to be rejected by my top choices? What if I don’t match at all?
But I had worked too hard and spent far too much on tuition to turn back. I had no choice but to rip open that envelope and see what life had in store for me. So, let me be the first to tell you: You’re going to be fine. No matter where your journey takes you from this moment forward, it’s going to be OK. You’re going to end up—like I did—exactly where you were always meant to be.
This isn’t the end of your journey, it’s just the next step. And trust me, there are a lot of steps ahead of you. And so, my message to all of you is a simple one: Thank you. Thank you for choosing medicine. Thank you for choosing science. Thank you for choosing to spread compassion and empathy in a world increasingly divided by anger and mistrust.
Thank you for recognizing the incredible public health challenges we face and saying to yourself, “I’ve got this.” Thank you for not only hoping for a better world, but for digging in, rolling up your sleeves, and promising to give everything you’ve got to make it a better world.
Hard moment for medicine
The truth is being a physician today is not easy. It’s very difficult work—even when everything goes right. And the health care environment you’ll soon be entering is already quite different than when I began my professional career. Twenty years may not be a lot of time in many professions, but it is a lifetime in medicine. The technology is different. The demands on your time are different. The hoops you must jump through to provide compassionate care to your patients are different.
And this moment is particularly challenging, with global health crises mounting, with political acrimony sowing distrust in medicine and scientific institutions. Society itself feels fragile and unprotected in ways that are unfamiliar to us. There is a weight to our chosen profession that will feel unbearable at times. This is true for all noble pursuits.
A doctor ages in dog years. But when it’s your turn, I know that each and every one of you will be ready. You will lean on your training. You will lean on your experiences in medical school. And you will lean on one another, your friends and classmates, who will show the same battle scars as you.
I am not one who thinks people are born to be doctors. Some people think that way, but I never have. I believe doctors are made by long nights and even longer days. Doctors are made by intense study and a bottomless curiosity. Why did it happen that way? What’s causing that? Why is this different than before?
Although we are problem-solvers by nature, being a good doctor isn’t about having all the answers. Science and medicine are constantly evolving as we learn more, do more, and understand more. A good doctor listens. She asks questions with an open mind. He counsels patients about all of their health options—and through honest and open dialogue, empowers them to make decisions about their health that are right for them. This sounds easy when you say it out loud, but it is incredibly challenging and complex.
And every so often, something dramatic happens—like, I don’t know, the U.S. Supreme Court overturns 50 years of settled law and makes it possible for politicians to insert themselves between a patient and physician about the reproductive care they receive. A ruling that stripped rights from patients—removes the most intimate decisions about their health and family planning from them—and, almost overnight, criminalizes the care you provide.
And if it makes you angry when politicians or bureaucrats interfere with medical decisions that belong with patients and their physicians, you are not alone. There is an entire community of doctors across this country speaking out on issues such as these, and elevating the concerns of their patients to decision-makers in their state and the nation’s capital.
Make no mistake: A doctor’s voice is a powerful voice. So use it.
No one way to lead
What I’ve come to realize in more than two decades in medicine is that everyone who pursues medicine is an advocate in his or her own way. We might not always recognize it, but we are. That is because each of us has a commitment to a set of beliefs in this world that we care deeply about.
What do you care about? Whose cause will you fight for? Discovering those answers is among the most important things you will ever do in medicine—and in life.
Most people I know who become physicians do so because they want to help people. They are driven to provide compassionate care that makes a real difference in the lives of others, and find that doing so is tremendously rewarding and personally fulfilling.
They help people in small ways—like when a teenager comes out to their family and the parents need guidance and support, or a mother is diagnosed with a rare condition, but in time for a full course of treatment and full recovery.
And they help people in big ways, by being leaders in organized medicine who are fighting to eliminate the tremendous burdens that physicians today face, to address health inequities, or offer guidance—and raise some concerns—about the emerging world of AI in health care.
Speak up—in the right way
These are enormous challenges that take more than leadership—they take a sincere belief in your own voice. In your ability to make a difference. As you embark on your residencies, remember that you are now in a place of privilege, and positioned to use your voices for your patients, your communities and your colleagues. How will you use the power of your physician voice?
Will you use it in a manner that is respectful of others? Will you conduct yourself with honesty, civility and the stature of your profession? Honesty. Civility. Integrity. Respect. Words that are thrown around a lot these days without many pausing to consider the meaning behind them.
As our world becomes more contested, more hyper partisan—fueled by mistrust and anger—the weight of these words take on increasing importance. How you use your voice is as crucial as what you say. I promise that whatever issues matter to you also matter to a lot of your colleagues. And that when you’re ready, you will find an ally in your corner to help you speak up for your patients and your profession.
It may be a friend. A confidant. A faculty member. It may be your county or state medical association.
It may even be the AMA. Being president of this 176-year-old institution has been the most rewarding and humbling opportunity of my professional life. It has strengthened my resolve to use my voice—and encourage others to do the same.
Entering the profession
Organized medicine—at the local, state or national level—reflects the issues that most matter to physicians at any moment in time. The AMA has led national health campaigns to reduce public smoking, champion childhood vaccinations, and helped make seat belts standard in all American automobiles.
These days we’re fighting misinformation in the public sphere around medical science and vaccines, working to remove barriers to care, improve medical training and education, reverse the rise in chronic disease and improve physician well-being on a broad scale.
And twice a year, doctors from every specialty and every corner of the country—including medical students and residents—gather in the AMA House of Delegates to tell us what to pursue next and which challenges to take on as we work tirelessly to promote the art and science of medicine and the betterment of public health.
It may seem silly, but I still remember holding the application to join the AMA as a first-year medical student. It was September 2000, and I recall walking to drop that paper application into the mail. It felt meaningful, pivotal.
“This is how I enter the profession,” I thought. This was the moment when the wider world of medicine opened for me. But that is my journey in medicine—that is my story. Each of you has the opportunity to write your own story in medicine.
Welcome to the next step in your journey. Now let’s get to work.
